Why You Think It Is Important to Study Counseling

In our everyday life we hear about these issues all the time. Remaining value-neutral about abortion, suicide, adultery, drug use, domestic violence, and child abuse, will not be very easy because we all have our different opinion on such issues. Some of these issue my friends and I discuss everyday and we give our value opinion on these issues which is a little rough. If I would take my personal value along with my friend’s personal value and bring it into my therapy session, it would become overkill. Whether or not I agree with the issues that I am presented with and may not agree with the values of clients, I must respect the rights of my clients to hold ethical issues. Abortion will be a value clash to a lot of counselor, because of their own personal ethics and value. Abortion is a big issue even with Politics no one has or knows the right thing to say, and if you say something wrong trust me you will be crucified in public or a court room. Personal Values Counselors are aware of their own values, attitudes, beliefs, and behaviors and avoid imposing values that are inconsistent with counseling goals. Counselors respect the diversity of clients, trainees, and research participants (A. 4. b)† Remaining value-neutral to suicide will be very hard, especially for me until I evaluate whether a person’s suicide or hastened death is rational. Also, I need to confront my own fear about death and dying. I know one day we all have to go, but it is hard to know someone you love or care about is going to die or is suffering and want to end their lives. I feel if a client comes in for therapy to discuss suicide I would listen and find out if the client decision is a rational suicide. I do not think anyone should suffer before they die, if the client has a terminal illness and she tired of the constant suffering and want to end her life, I would counsel the client and help her with her decision. Counselors have their own personal values about sexual practices, so when a client comes to me as a therapist that is knowingly committed adultery or in domestic violence relationship I become judgmental. I feel I cannot remain value neutral about these issues. Two men in my life committed adultery which I have children with, I cannot forgive them, my home got destroy because of their adultery not only did I suffer but so did my children. I cannot be bias with a client who comes to me with those issues. I would make it clear to the client that it is my problem not theirs when I refer them to someone else. My good friend was in a domestic violence marriage and I watch her suffer. I try to talk with her concerning her health, I told her that man can kill her one day; nothing I could have said could make my friend leave her husband. When she had her daughter, the beaten continue until I threaten to call ACS on her and take her daughter out of that environment, I let her know I am the God mother of her daughter and I will not stand by and watch my God daughter grow up in that environment. This almost took our friendship, what was she thinking? I think this is a good as time as any to refer the client with these issues to someone else because my values and those of the client clash to such extent that I do question my ability to be helpful. â€Å" Yarhouse and VanOrman (1999) assert that value conflicts between clients and therapists are inevitable. The challenge for therapists is to recognize when their values clash with a client’s values to the extent that they are not able to function effectively. I feel these two issues might lead me to consider referring the client to another counselor, and if referring them was not an option I would read my ACA codes and keep referring to my supervisor or peers to help me with the clients Some counselors can remain value-neutral on drug use because most counselors that are drug counselors were once drug abuser themselves. The counselors can empathize with their feelings and the struggle that the clients are going to face, because they have shared experiences and value. I had a lot of friends that turned to drugs, and now they are drug free, working, got housing, and got their children back. There are a lot of options for drug abuser like rehab centers, detoxification clinic, methadone programs, and outpatient clinic. Issues such as child abuse are hard to remain value-neutral especially when you have children of your own. The ethic code will have to be use a lot so you can counsel the client with the same respect you will give anyone else. I would also look into other programs such as parenting, and group meeting so the clients can attend additionally.

Potential Hazards to Health, Safety and Security Essay

Make sure that I am aware of, and follow, my settings health, safety and security procedures before I start work. Ensure that before I begin any work activities I check and use any risk assessments examine the areas in which I work and any equipment I have to use to ensure that they are safe, hazard free and conform to legal and the settings requirements for health and safety, remove, where possible, hazards that might pose a health and safety risk to myself and others. Take account of individuals’ needs, wishes, preferences and choices, while ensuring my own and the safety of individuals, key people and others when carrying out my work activities. Operate within the limits of my own roles and responsibilities in relation to health and safety. Seek additional support to resolve health and safety problems where necessary. Report health and safety issues to the appropriate people and complete health, safety and security records according to legal and organisational requirements. Minimise risk. Identify and work with others to minimise potential risks in the place where I am working. Ensure that my own health and hygiene does not pose a threat to others. Ensure that the appropriate people know where I am at all times. Check for hazards and health, safety and security risks while I am working, taking appropriate action if there is the likelihood of an accident, injury or harm. Check that people who are present have a right to be there. Use approved methods and procedures when undertaking potentially hazardous work activities, including using correct moving and handling techniques wearing correct personal protective clothing appropriate to the situation, environment and activities using and storing equipment and materials dealing with spillages and disposal of waste. Take appropriate and immediate action to deal with health and environmental emergencies, including fire, security, serious and minor accidents and first aid. Record and report on incidents and emergencies accurately, completely, within confidentiality agreements, and according to the settings policies and legal requirements.

Battle of the Somme and Source

How far does Source 3 challenge the impression given in Sources 1 and 2 that the Battle of the Somme had achieved worthwhile objectives? Having analysed all 3 sources, it can be said that source 3 significantly challenges sources 1 and 2 giving an entirely different perspective on the battle of the Somme. Source 1 is an extract from Sir Douglas Haig’s final dispatch, published in March 1919. This source begins to describe the Battle of the Somme as a tremendous victory.Haig claims that â€Å"The three main objectives†¦ had been achieved. † Haig also then begins to describe the three objectives, â€Å"Verdun had been relieved†¦Ã¢â‚¬ , â€Å"German forces had been held down†¦Ã¢â‚¬  and â€Å"the enemy’s strength had been considerably worn down†. Haig also claims that as the objectives had been â€Å"achieved† this was enough to â€Å"†¦justify the Somme Battle. † This source was published shortly after the war in 1919, b ut was a few years after the Battle of the Somme allowing some time for the truth about the events of the battle to emerge.The source has some limitations as it was an extract from Haig’s own writing, who was Commander-in-Chief of the British Forces therefore the source may be bias towards Britain and their success in the battle. The purpose of the source was to inform people of Haig’s perception of the battle and due to this being one person’s view, the accuracy of the source cannot be verified. Source 2 is extract from a book published in 1929 by Charles Carrington who was a Junior Officer during the time of the Battle.Similar to source 1, this source was written by someone who had authority in the armed forces, and describes the Battle of the Somme as another â€Å"moral† booster for the British Army. The author of the source states there was a â€Å"definite and growing sense of superiority over the enemy† and by the use of the word â€Å"defi nite† the use of facts is now apparent. In contrast, later on in the source Carrington states â€Å"we were quite sure at the time that we had got the Germans beaten†¦Ã¢â‚¬  and by using the phrase â€Å"quite sure† it is now apparent that facts are no longer the basis of this source.Unlike source 1 where Haig describes the Somme Battle as a complete victory, Carrington quickly states that â€Å"we did not win a decisive victory† but is quick to reverse this by stating â€Å"†¦next spring we would deliver the knock-out blow† showing that he feels the end of the war is near. This source was published many years after the war, but it was published by someone who was there, similar to source 1.Also similar to source 1, this source is the view of someone with authority and someone with a high ranking position within the armed forces therefore their opinion may be bias towards the Somme and the British Army. Source 3 is part of an interview with Cor poral W. H. Shaw in the 1960s where Shaw is recalling the first day of the Battle. Already this source differs to sources 1 and 2 as it is no longer an extract but part of an interview. Shaw starts of the source with â€Å"we did not get anywhere, we never moved from the line, hardly†.This is different to source 1 where Haig claims â€Å"Verdun had been relieved†. Shaw states that â€Å"our men were just falling back into our trenches† which significantly differs to Carrington’s statement that â€Å"we had got the Germans beaten†. Shaw claims that the events of the some were â€Å"sheer bloody murder† and that â€Å"whatever was gained it wasn’t worth the price the men had to pay† which is in contrast with source 1 where Haig claims that the results of the Somme where â€Å"sufficient to justify† the battle.This purpose of this source is to spread light on the Somme battle and release the truth about the event. Because t his source was by a member of the British Forces and who of which is supplying eyewitness accounts of the events at the front line, this source can be classes as highly reliable. Due to the date of the source, it can be argued that Shaw’s memory may be slightly skewed but due to the lack of censorship at this time compared to during the time of the war, Shaw can now freely speak about the events of the Somme.Throughout all 3 sources it is noticeable that soldiers and officers of a higher rank are more likely to support the Battle of the Somme and argue that it achieved its objectives. Throughout sources 1 and 2, Officer Carrington and General Haig are extremely supportive of the Somme battle. This is demonstrated by Haig’s claims of â€Å"the three main objectives†¦ had been achieved† and Carrington’s view that â€Å"we had got the Germans beaten†.However, neither of these men were likely to have engaged in any front line combat within the tre nches during the Battle of the Somme. This is why source 3 proves very useful as an account of the first day at the Somme. Shaw describes the battle as â€Å"sheer bloody murder† and crushes Carrington’s claims of â€Å"superiority† with accounts such as â€Å"men were just falling back into the trench†. Therefore it can be argued that Source 3 significantly challenges the view given in sources 1 and 2 that the Battle of the Somme achieved its worthwhile objectives.

How far a company in the UK faces barriers to new product innovation Essay

How far a company in the UK faces barriers to new product innovation - Essay Example enterprises were surveyed , mostly across the manufacturing and services sectors and predominantly those firms which had more than 10 employees, and focused primarily on the development of new products. The innovativeness of films in the 2005 survey was categorized into three distinct sub classes, i.e., (a) novel innovators, who introduced at least one new product in the market (b) imitating innovators who have not introduced at least one new product and (c) incomplete innovators, who had engaged in innovation activities but had not introduced any new product or process during the period. When all the participant firms were assessed on the basis of novel innovators, it may be noted that only 16% from all the various sectors were found to belong in this first category, as depicted in the graph below: As clearly evident from the graph above, manufacturing firms appear to have been the largest innovators, followed closely by financial and business services, and these sectors have also been the most profitable sectors. As compared to this, the approximate percentage of firms engaging in continuing new innovation activity in the same sectors in 2007 is provided in the table and graph below: It is significant to note that construction is the sector that shows the highest percentage of new innovation activity, while similar activities in the manufacturing sector appear to have declined (See Figute 3.1 in 2007 survey). However, when this is compared to the extent of continuing innovation activity, the graphical representation changes as follows: This reveals that innovation activity has been continuing in the manufacturing sector, while the extent of continuing innovation is low in the construction sector. This appears to suggest that the patterns of innovative activity have changed; the drive to develop new products was greater in the manufacturing sector in 2005 which has been continued, while the manufacturing sector may be experiencing a similar drive towards

Business Decision Analysis Project Essay Example | Topics and Well Written Essays - 1250 words - 1

Business Decision Analysis Project - Essay Example This analysis report will help decide whether James starting a new business will generate enough income to cater for the income that James will forgo so as to run the new business. Also, the report will give him sound financial advice for his decision-making process. We shall also use US Code 1031- tax free exchange in the report. The rule states that a company can defer capital gain taxes if he sells property to reinvest in another one. Mr James Wiesman faces the major challenge of deciding whether or not he should buy/lease the equipment needed to manufacture the products or buy them from another company. Currently, Mr James owns a construction patent of a process that reduces the cost of production tremendously. The patent is highly lucrative, which has led to Mr James to sign contracts with the U.S. government to supply the products to the navy and army for Barrack constructions. The facts of this problem are that the cost of producing the products himself will attribute for 60% of his total costs (Glen& Howard, 91). In addition, the cost of production of the materials will be a third of buying it from another company. It is evident that the cost of buying the product from another company will be much higher than the former. Based on the mentioned facts, it is advisable that Mr James Wiesman buys/leases the equipment needed for production. Buying or leasing equipment will require Mr James to open his own firm. The initial costs of production include the purchase of land, building costs and the working capital that sum up to over2,120,000 $. Mr James has to decide the sources for his financing to make this decision. He has two options to choose. Firstly, Mr John Money Bag is willing to give him 2,000,000$ for controlling interest of the company as well as semi-active management participation. Secondly, Mr James can sell off some of his assets to raise the funds necessary for production. Mr James is

Sensory analysis Essay Example | Topics and Well Written Essays - 1000 words

Sensory analysis - Essay Example Sensory Analysis involves gathering information from the consumers about the objective facts, preferences, and the perceptions regarding a product. Large firms have traditionally had the advantage of employing a larger amount of money and manpower to implement costly, wide reaching advertising campaigns and experimenting with new product, which may be withdrawn, if not successful. The formulation and marketing of new products is a complex process and there can be many influencing factors such as consumer preferences, the target consumer’s perception of the product and the purchase behavior of the consumers. It is important for firms to have complete knowledge of the market segments that they are targeting their products at. The knowledge of these facts can come from marketing analysis and Sensory analysis. Sensory Analysis is conducted to get information about consumer’s acceptance of a product and in what way the product appeals to his/her senses (asiamarketresearch.com) For conducting sensory analysis, usually third party firms are engaged, a set of ‘naive’ people are requested to test the product. The analysis of their experience is done by collating the results of homogenous groups. These groups represent different socio-economic categories. It is therefore possible to gauge the responses of the groups and determine the product that would most appeal to a particular socio-economic stratum. Sensory Analysis can actually help businesses to come up with different flavors of a particular product by using the collected information. This can be a cost-effective way of pitching the same product to different sets of consumers. Sensory Analysis plays a very prominent role in quality control. Quality has always been described as fit-for-purpose and that which satisfies the requirements. Knowing what the consumer preferences are can be great help in determining the quality

Business intelligence Essay Example | Topics and Well Written Essays - 250 words - 1

Business intelligence - Essay Example lped shape firms business strategy as cross-functional and global processes that help business activities to be conducted across boundaries of time, distance, and function (El Sawy et al, 2013). The authors argue that digital technologies cannot be separated from businesses because it helps firms operate in distinct forms of dynamic capabilities relevant for difficult environments. In addition, digital technologies are reshaping the structure of social interaction in both the enterprise and consumer space with social sites and social media easing the means of interaction. The author wants to make it clear that digital technologies have introduced new trends in business strategy (El Sawy et al, 2013). They include emergence of huge information, pervasive connection between businesses and customers, enhanced price, growth of cloud computing and international supply chains. The author observes that digital business strategy has led to emergence of new organization shifts such as trans-functional role for information technology, increased knowledge with information technology and limitation of old business models. Furthermore, the emergence of digital business strategy has resulted in digitization of services and products and data or information around them (El Sawy et al, 2013). This incorporates the design of services and products with other related platforms using digital resources. The increase in speed of digital business strategy makes firms to reason about time and distance in significant

United States Uniform Personnel Identification System Thesis

United States Uniform Personnel Identification System - Thesis Example the world – the United States of America, with her idealism of liberty and equality inviting all, has to strengthen the security systems deemed to be the best and path-breaking by pioneering the use of exclusive Identity Cards, Biometrics and Microchip Implants for all her citizens – thus upholding the urgent mission of Homeland Security â€Å"to lead the unified national effort to secure the country and preserve our freedoms†. The advancement of technology and multi-faceted information system, as has ushered in a hi-tech futuristic era in the history of the Human race, it has also indulged in cryptic criminological affairs. This has necessitated a supremely secured, safe and sophisticated identification and access control methodologies thus strengthening screening specifications to protect sensitive information with a vision to shield the Nation against any covert intervention and activity. Thus in the foreseeable future United States of America can plan to build up a more protected networked society by the introduction of revolutionary human identity recognition systems. This unique personnel identification model can be based on broadly three factors, namely, introduction of single ID Card, implementation of biometric distinguisher and microchip implant identifier for each and every US citizen. This thesis proposes to strategize and explore on the broad spectrum of implementing this classified recognition system for American Citizens – its implications, the advantages, hindrances, legal aspects, process and period of introducing this system and long term prospects. This study will also formulate the development of a dedicated, stand-alone department within the US Department of Homeland Security to execute and monitor the above-mentioned security setup. United States of America, the pinnacle of power and prosperity supplemented by ideal illustration of liberty, equality and fraternity, has been the target of worst terrorist attacks in the history of

Marketing Case Research Paper Example | Topics and Well Written Essays - 2250 words

Marketing Case - Research Paper Example Primary aim of marketing is to understand, attract, communicate, and to maintain relationship with the target audience and hence, marketing is useful for the task where target consumers are important. This paper will attempt to frame a set of plausible marketing strategy for Canadian Museum for Human Rights (CMHR) for attracting large of visitors including domestic and foreigners. This is the national museum of Canada to be established by the Canadian Government. Currently, this museum is under construction, and the task for establishment was started from August 10, 2008 after the Parliamentary amendments of Museum Act on March 13, 2008. It is supposed to open from 2012 and will aim to offer the world a platform for engaging in discussions about serious issues like hate, oppression and suppression (Canadian Museum for Human Rights-a, 2010). The marketing activity for CMHR is communicating with the target audience for promoting its value and for understanding of human rights. This wil l help it to meet the commitments of Canadian Government to support â€Å"democracy, freedom, human rights, and the rule of law† (Canadian Museum for Human Rights-b, 2010). SWOT Analysis Strengths The biggest strength of the museum lies in its location based advantages. Canada being one of the developed nations, adds to the popularity of the museum. It also helps in garnering funds as the government has provided full support for the museum. Another major strength of the organization is the unique concept by which the museum has been conceptualized. The noble and unique nature of the museum helps in increasing the awareness of the individual’s on the aspect of human rights (Canadian Museum for Human Rights-a, 2010). The uniqueness of the museum also lies in its innovative, interactive and high technology environment that would enable interactions such as debates with regard to human rights. Any person can submit his/her story about human rights violations and the museum would provide a platform for sharing it across the globe (Krell, 2009, p.50). Weakness Lack of awareness about the concept of the museum amongst the target audience seems to be the most formidable weakness of the museum. This lack of awareness leads to generation of considerable weakness as people may not be aware of the museum. This would hamper the very basic intention of setting up the museum. Opportunities Being located in a developed nation and set up with a noble and unique concept generates large scale opportunity for the museum to draw visitors. The museum also provides opportunity for individuals to highlight their stories about human rights violations to showcase their problems on a global platform. Human rights violations form one of the most burning issues and there have been numerous issues of human rights violations which remain unreported due to lack of a proper platform. The museum with its unique concept would help in generating large scale opportunities that would help in drawing large crowds and make it a success story. Threats There have been certain controversies regarding the site of the project as many claim it as a land that has historical significance and building a structure over it

Branding Essay Example | Topics and Well Written Essays - 3000 words - 2

Branding - Essay Example jectives to help and innovate and expanded its product lines, which greatly helped the company to expand overseas as people everywhere had the same needs and wants. Presently, Colgate is listed as one of the best-selling brands and operates in over 200 countries with an annual turnover in excess of $9 billion (Kantar, 2014). Colgate’s success shows how important it is for global enterprises to support their values, for example; Colgate’s global values are: caring, continuous improvement, and global teamwork, which enable the company to improve and adapt to the changing customer needs, as well as, global market challenges (Colgate, 2013). The company’s stable global growth also is because of the company’s ability to focus on its four strategic initiatives, such as: engaging to build the brand, innovate for business growth, effectiveness and efficiency, and leading to win (Colgate, 2013). Colgate always carries out environmental scanning that helps the company to identify the external factors that will influence organisational performance (Wood, 2010). Factors that are political, legal or technological may pose different threats to Colgate’s business when entering a new country, or even, when the company has already successfully established its operations. Therefore, the external audits carried out are always considered to be a major focus for any organisation that wants prosperity (Baines, 2011). Furthermore, Colgate-Palmolive concentrates on creating personal care products in areas where the competition in this sector is relatively high. This means that; Colgate has to monitor the situation around its business in order to take the lead among its rivals (Schultz et al., 2006). The first and most important external audit that Colgate needs to constantly monitor is the governmental regulations. This is especially as Colgate is a multinational corporation each political atmosphere in every country that Colgate-Palmolive operates has the same value and

PEST Analysis of Starbuck in China Coursework Example | Topics and Well Written Essays - 1750 words

PEST Analysis of Starbuck in China - Coursework Example The object of analysis for the purpose of this assignment is Starbucks, an American coffee company which is operating in many countries worldwide. It has the title of being the largest coffeehouse company with around 25,000 stores. It is renowned for providing hot as well as cold beverages, pastries as well as snacks. It was founded in the year 1971 and has since then, opened up stores in around 62 stores. It was opened by three students who were inclined to sell high quality coffee beans as well as coffee equipment. In 1996, Starbucks opened its first location outside North America in Tokyo, Japan. People`s republic of China is the most populous country of the world and is located in the East Asian region. With around 1.35 billion people in the country, China is now being considered as the fastest growing economy of the world. It has become the second largest economy in terms of nominal GDP and purchasing power parity, after the United States of America. The first Starbucks in china opened in Taiwan in March 1998. The increase in consumer interests and appreciation of coffee resulted in the opening up of new stores in Beijing, Hong Kong as well as Macau. In all, Starbucks has around 1000 stores in China. PEST analysis includes political, economic, social as well as technological factors which have a direct impact on the operations of a firm. Political factors involve the intervention of the government in the economy in terms of tax policies, policies of export as well as other environmental and legal laws. Overall, it also includes other influences which the government can have on an organization`s operations. With regards to the political factors in Hongkong, it has been under the rule of mainland China but it has been allowed to implement its own business laws in the economy. This has made it easier for Starbucks to operate in China. However, Starbucks is required to comply with all the laws and regulations of the country. The Chinese government has introduc ed positive policies to encourage FDI by protecting the interests as well as the legal rights of foreign companies. China also has a consistent political environment as well as lower labor costs which attract foreign companies to start operations in the country. The local government policies including free trade zones and loans have encouraged Starbucks and other multinational to start operations as well as expand its business in China (Business Environment In China: Economic, Political, And Cultural Factors 2013). Another important factor is that these favorable governmental polices do not change with changes in the governments. This makes it easier for the foreign companies to operate. However, it has been observed that these policies and laws are not implemented in the country which affects the sustainability of Chinese economy. Furthermore, the company has lower and inefficient transportation, communication as well as energy resources. The city of Hong Kong, for example, is know n as the most tax-friendly economies of the world because of its low tax system as well as direct taxes only on profits, salaries and properties. The tax rates have remained constant showing the political stability in China, especially in Hong Kong (Starbucks in China, 2013; China Business News-Starbucks soars in China 2013). Economic factors: Economic factors include the inflation rate, interest rates, economic growth and exchange rates which have an impact on business operations. The factor of exchange rates, for example, has an impact on the costs and prices of exports and imports. Interest rates affect the cost of capital of firms which is further related to the growth and expansion of companies. Economic factors i

Quantum Software Case Study Essay Example for Free

Quantum Software Case Study Essay Quantum Software is a fairly new organization â€Å"No ties, no suits coats, first name only† that was founded by Stan Albright and Erin Barber. The company develops computer software specifically oriented to the needs of independent oil businesses. They’ve had a lot of success over the past 3years and are growing fairly fast. Quantum has gained over 200 employees and has made about 95 million dollars in sales. Currently, Employees at Quantum Software work 16 hour days 6 days a week. In order to keep the morel and sprit up, Quantum recognizes that their employees have been working extra hard and they want to compensate them by having a weekly â€Å"Beer Bust† party. Bill Carter, the corporate attorney, doesn’t agree with the â€Å"beer bust† idea. Instead he believes that serving alcohol at a company’s sponsor party can be a big liability to Quantum. A â€Å"beer bust† sounds fun and relaxing. However Bill Carter makes a good point, serving alcohol at a company’s sponsor party can be a huge liability on the company’s future. Recently an employee by the name of John Hooker lost his balance and fell on the snack table during one of the â€Å"beer bust† events. Luckily John didn’t get hurt. When having these types of events the company cannot guarantee that a person like John will not over drink and possibly drive home drunk and cause a serious accident. These are all things that Quantum needs to take into consideration. Accidents happen all the time and Quantum needs be aware that these â€Å"beer bust† can be a great liability to the company. I can understand that Quantum wants to reward their employees for their hard work. Working long days 6 days a week can get over whelming. What Quantum needs to do is analyze the situation. The company is growing really fast and they need more people. Hiring more programmers can help balance their work load making 8 hour days 5 days a week possible. I don’t think that having a weekly â€Å"beer bust† is a permanent solution. It is obvious that employees at Quantum like to be recognized for their accomplishments and hard work however in the beginning of the case study is it mention the most of the employees drop in to â€Å"unwind† to these â€Å" beer bust† events. Most, meaning that not everyone who works at Quantum shows up or participates in these† beer bust† parties. What I would recommend quantum to do at this point is to pass out an employee surveys and ask their employees what they want or prefer. Some employees might not like the type of environment and rather spend their free time doing something else. Others might like the idea of working fewer hours and having weekends off as a reward. An employee survey can actually help the company out by providing feedback and letting the company know what they like and dislike. The â€Å"beer bust† events have been going on for a while and have become a sort of a company’s tradition. I’m not saying to eliminate the whole â€Å"beer bust† events. The â€Å"beer bust† parties can be a great way to socialize, relax and unwind. Having social events like these can help co workers become closer and share ideas and knowledge which can be beneficial to the company. If Quantum decides to continued the â€Å"beer bust â€Å"parties, what needs to be done is that they need to need to get with Bill carter, the corporate attorney and come up ways to handle a situation if it occurs. Limiting the number of beers a person can have at each event can help by not over drinking or by providing some sort of transportation such as bus or taxi to take employees back home after a â€Å"beer bust† event. These are rules that can be implemented by the company in order to not only save Quantum from a future law suit but also to save a life. The fact that both Eric and Stan are not really listening to Bill’s concerns can and will affect the company’s future. Bill is the corporate attorney and he knows the law. I would recommend bill to talk to both Eric and Stan another day. Eric and Stan are in a relax mode at this point probably had a few drinks or two and might not think that what Bill has to say is quite as important as it really is. Scheduling a meeting with both Eric and Stan and going over what can happen if they don’t start implanting rules.

Hy-fy Hitch- Zygomatico-hyoid Suspension for Dysphagia

Hy-fy Hitch- Zygomatico-hyoid Suspension for Dysphagia Hy-fy Hitch- Zygomatico-hyoid Suspension for the Managment of Post Surgical Dysphagia abstract: Dysphagia is not only a main symptom of the head and neck cancer but also the dangerous complication of the various surgical and other treatment modalities for the same. Though various studies have been done to diagnose this condition but very little is done towards the surgical management of this life threatening condition. through this article the new surgical technique of managing oroesophgeal dysphagia by hyoid suspension. Our technique zygomatico-hyoid suspension is simple and logically effective way of managing dysphagia secondary to the surgical resection of lesion in the patient with head and neck cancer. Though this technique is not tried in large number of patients hence the long term benefits and overall improvement in patients quality of life is yet to be ascertained but still it can be a new direction in the surgical mangament of dysphagia. Introduction Dysphagia is a term derived from the Greek words dys (difficulty) and phagein (to eat)1. It is a symptom that expresses a disorder in the transport of food and endogenous secretions (saliva) through the upper digestive tract. Oropharyngeal dysphagia (OD) is a more anatomically restricted term referred to alterations in the transfer of the bolus from the mouth to the esophagus (that means, in bolus propelling from the mouth to the pharynx, in the pharyngeal reconfiguration during the swallow, or in the opening of the upper esophageal sphincter.2 OD is an inescapable concern in the management of patients with oral cancer. Being as a symptom at presentation, as an adverse effect during whatever the treatment, or as sequelae compromising the quality of life of the patients, swallowing disorders have to be adequately anticipated and dealt with. For an outcome to be considered functional, the patient has to be able to swallow in an effective and safe manner. Actually, preserving a functional deglutition is usually the most important goal of the different function-preserving surgical techniques in head and neck cancer surgery. Normal oropharyngeal swallowing: swallowing is mainly divided into three phases: 1) preparatory oral phase ,2) oral phase and the last 3) pharyngeal and oesophageal phase. mechanically ,several closely coordinated actions are involved:(1) elevation and retraction of the soft palate with closure of oropharynx,(2) UES opening, (3) laryngeal closure at the level of the laryngeal vestibule,(4) tongue loading (ramping), (5) tongue pulsion ,and (6) pharyngeal clearance. a fundamental aspect of deglutitive pharyngeal reconfiguration is in transforming the oropharynx from a respiratory to a swallowing pathway by opening the inlet to the esophagus and sealing the inlet to the larynx. Laryngeal vestibule closure and hence airway protection during swallowing is achieved by laryngeal elevation and anterior tilting of the arytenoid cartilages against the base of the epiglottis. UES opening results from anterior traction caused by contraction of the suprahyoid and infrahyoid musculature evident fluoroscopically by anterior hyoid movement. Pathophysiology of dysphagia: Can be divided into two categories: 1) directly due to the resection of the tissues involved in the swallowing i.e.tongue . 2) due to the damage caused by the radiation therapy by following ways: a: decreased pharyngeal peristalsis. b: decresed or defective posterior inversion of the base of the tongue towards the posterior pharyngeal wall. c: decreased elevation of hyoid bone and larynx and decreased inversion of epiglottis. The use of laryngeal suspension as a technique to improve function following surgcial resection of the anterior floor of the mouth was 1st decribed by edgerton and duncan and DesPrez and Kiehn.3,4 later Jabaley and Hoopes simplified the concept of laryngeal suspension after partial or complete resection of hyomandibular complex by means of a heavy chromic catgut suture between the thyroid cartilage and mandibular symphysis on the premise that the main vector of force required to support the larynx is anterior and superior in the midline.5 Goode R.L. also described the similar technique of laryngeal suspension after total laryngectomy by thyroid mandibular suspension and he found that swallowing function was improved significantly with his method of laryngeal suspension.6 Hillel A.D. and Goode R.L. gave lateral laryngeal suspension technique in which the throid cartlage was suspended to the condyle of resected mandible a modification of Goode R.L`s original technique, the advantage of this technique is it causes superior as well as lateral movement movement of larynx which widens the opening of opposite hypopharynx.7 al these techniques have proven that the hyoid suspension does improve swallowing function to some extent but all these techniques are hyomandibular suspension and our techniques is the only technique in which we have used zygomatic bone a support bone through which hyoid is suspended and in our view this technique provieds the most stable and most effective way of displacing hyoid anterio-superiorly resulting in the better swallowing control.in this article we describe our method of hyoid-zygomtic suspension. Material and methods: We perform zygomatico-hyoid suspension in all the patients undergoing total or partial glossectomy with or without mandible resection .the procedure was performed at the mahatma gandhi cnacer institute miraj . Notes on Hyoid-zygomatic Suspension Technique The hyoid suspension in which 24 gauge stainless steel wire was prestreched and using a awl 26cm in length a circumzygomatic to the hyoid bone suspension was carried out by the Key steps were the following. the procedure was performed under genearal anesthesia while doing primary resection of the tumor .patient was placd in anti-trendelenburg position with neck hyperextension. Incision was given in natural skin crease between the hyoid inferior body and the thyroid notch. Median strap muscle dissection between two imaginary parasagittal planes crossing the lesser cornu of the hyoid bone was carried out. Hyoid bone mobilizing test in anterosuperior direction carried out permanent hyoid fixation after having tested the correct position of the thyroid cartilage below the hyoid bone, following fixed steps which are as follows:The zygomatic arch is palpated and puncture wound is performed at the origin of the temporal process of the zygomatic bone.Two pre-streched 24 gauge wires are passe d circumferentially around the hyoid bone in the region where the insertion of the fibrous loop for the intermediate diagastric tendon is present.Later awl is inserted from the arch puncture wound and passed anterior to the masseteric muscle and brought to the hyoid bone body region where the already wire loops are present.The wire is fed into the eye of the awl and later pulled out.This wire is removed from the awls eye and stablised.The awl now is reinserted superficial to the arch brought out from the previous anterior massetric site to the hyoid bone, the other end of wire is fed in the eye and the wire along with the awl is brought out.Traction is given bilaterally and the mobility of the hyoid along with its infrahyoid component is examined.Mandibular movements have to be checked before the wires are twisted and stabilised.Untoward traction is to be avoided in order to avoid hyoid bone fractures.Incision lines are closed in layers. Postoperative Followup Postoperatively all patients tolerated the procedure well, with no intra- or postoperative complications. patients .all patients were kept on nasogatric tube ( NGT ) feeding for minimum 3 weeks postoperative period after which the decision to remove the tube and oral feeding was taken on the basis of patient to patient ability to swallow . No special or additional post-operative care or assessment is required . Discussion The hyoid is a u-shaped bone located in the anterior neck midline, at the centre of three force vectors directed, respectively, towards the mandible, sternum, and mastoid process. It gives insertion to the middle constrictor muscles, which form the lateral wall of the hypopharynx. The suspension of this bone to the Zygomatic bone restores the inferior collapse of the reconstructed floor and lateral mandibular region and improve the tone of the middle constrictor muscles. this technique unlike all the previous technique doesnt take support of the mandible at all hence in cases where in mandible resection is performed along with the tongue or the larynx this technique is probably the only option available to the surgeon to suspend the hyoid bone. Without resuspension, it is speculated that resection of submental lateral mandibular region may lead to inferior and posterior displacement of the hyoid bone. A posterior displacementof the hyoid bone may be implicated in obstruction of the p haryngeal airway which in turn may lead to Dysphagia, or swallowing impairment . The postsurgical alteration in size and position of the hard and soft tissues surrounding the pharyngeal space is also responsible for the airway obstruction. CONCLUSION: Cicumzygomatic hyoid suspension technique is a innovative technique and it is the only technique of hyoid suspension in which instead of mandible the support is taken from zygomatic bone . as in this technique the vector is in same direction but its supporting bone absolutely nonmobile there by giving greater elevation and stable anterior displacement in comparison to the other tehcniques of hyoid suspension. we found that swallowing and infra hyoid functions improvedin our patient thereby QOL improved. This Hyoid suspension technique is effective when short-term results are considered. The necessity of a more valuable anatomic-based diagnostic approach is crucial to guide the patient selection. Long-term follow-ups and randomized prospective trials with case-control series are needed to increase the level of evidence of this surgery.

Sony Company Analysis: SWOT, PEST, 5 Forces and SGA

Sony Company Analysis: SWOT, PEST, 5 Forces and SGA Sony SWOT Analysis | Five Forces Analysis of Sony | PEST Analysis of Sony | Strategic Group Analysis of Sony Executive Summary The purpose of this paper is to analyse Sonys strategy and assess various tools which give the greatest insight into that strategy. The assessment of the company is based on four tools, mainly: SWOT, PEST, Porters Five Forces and Strategic Group Analysis (SGA). Those tools are believed to critically evaluate Sonys tactics with regards to its competition, external and internal environment. Furthermore, the tools critically assess Sonys gaps in its strategy. Introduction Sony Corporation has been very successful over several decades and has used its innovation to create a multibillion and multinational electronic empire. With products such as: transistor radio, the Trinitron, the VTR and many more the company has changed our everyday lives. Nowadays, Japanese companies such as Sony can set a good example for other international companies to benchmark the way they implement their business strategy. However, the current slowdown of global economy, the appreciation of yen and the decline of Japanese stock market had forced Sony to re-examine its current business approach (Sony, 2009). Hence, this paper critically evaluates Sonys business strategy. The assessment of the company is based on four tools that give the greatest insight into Sonys strategy, mainly: SWOT, PEST, Porters Five Forces and Strategic Group Analysis (SGA). Sony Company: A brief introduction Sony is an international corporation with major businesses in electronics, movies, video games, and finance. The Japan-based company is one of the worlds largest media conglomerates with revenue of $89.6 billion in its fiscal 2008 (Sony, 2009). Sony is a well-recognized brand name of consumer electronics and its key products are CyberShot digital cameras, Bravia LCD TVs and VAIO computers. Those products constitute 65.1% of sales and operating revenue. The three biggest markets for SONY are Europe with 25.7 % of operating revenue followed by Japan with 24.2 % and USA with 23.6%. Innovation leader Sony is an innovation leader. In fact, Sony is still among the top 10 most innovative companies in the world, according to Leberecht (2008). What is more, Sony has led the market in terms of innovative technologies and high quality items. Throughout its history, Sony has proved that the company can capture the imagination and improve peoples lives by using cutting edge technologies. Sonys Business Strategy Sonys Business Strategy is to be the leading global provider of networked consumer electronics and entertainment in the world (Sony 2008). In order to do that Sony will try to retain market shares in developed markets by introducing innovative technologies and enter new products to emerging markets to achieve higher sales growth and eventually bigger market share. As can be seen above new user groups with great response to adoption of electronics have emerged. Those groups have been called BRIC (for Brazil, Russia, India and China). They are the worlds fastest growing economies, contributing to a great deal of the worlds explosive growth of trade. By 2020, the four biggest emerging markets share of world output will double to 16.1 % from 7.8% in 1992 (IDC, 2006). Consequently, Sony will aim to grab some of it. SWOT Analysis Why does a SWOT give the greatest insight into Sonys strategy? Organizations such as Sony do not exist in a vacuum but rather exist and compete and cooperate in an interrelated environment characterized by complexity. Understanding this environment is fundamental for Sony to become a leader and gain bigger market share. Therefore, SWOT analysis is a useful aid to do that. The analysis is used at the beginning of strategic decision-making where it provides the basic framework (Hamel Prahalad 1994). SWOT creates lists of strengths, weaknesses, opportunities and threats where an organizations use these to generate strategies that fit their particular projected situation, objectives and their capabilities (Bourgeois 1996; Pearce and Robinson 2003; Thompson and Strickland 1998).Consequently, buy conducting SWOT analysis on SONY it will be visible if the companys strategy fits projected situation. Furthermore, Valentin (2001) said that the SWOT analysis gives the greatest insights into companys strategy as it shows the companys conventional approach of realizing the desired alignment. As a result SWOT analysis is a valuable tool in the field of business strategy and gives the greatest insight into Sonys strategy because it illustrates important aspects of organisations environment and decisions made by the management. Sonys SWOT Strengths Ability to produce innovative, quality products Sonys innovations have become part of the mainstream culture. Starting with the first magnetic tape and tape recorder in 1950, then the transistor radio in 1995 and the worlds first all-transistor TV set in 1960 and many more as shown below. Ability to be successful in several different markets Sony is successful in several different markets. The company has made an impact in the PC market, video game market and especially the television market. Fast growing company Sony ranks among ZDNet Asias Top 10 fastest-growing companies for 2008/2009 (ZDNet Asia 2009). M2M monitoring technology Sony has M2M Machine-to-Machine (M2M) remote monitoring technology-based service solutions. The service solution allows cost-effectively and continually monitor and manage the various components of production (Sony, 2006). Weaknesses Products are expensive Sonys products are 20 to 30 percent higher than comparable goods (Cook, 2003). For that reason, for example, people in developing countries with minimum wage cannot afford to purchase them. Inefficient supply chain Sony is trying to close the gap with technologies companies such as Apple or Amazon which use Internet services to improve their electronics such as digital-music players. However, because of its business overload of heavy operating costs leading to inefficient supply chain Sony is missing that market gap. Opportunities Complementary products and services Sony has opportunity to sell complementary products and Internet services in saturated markets (Japan, USA) and standard products in emerging markets (China, India, Latin America). Innovative design Sony can use user- friendly applications, innovative materials and attractive visual appearance to differentiate products. New technologies 3D TV technologies that use a single image which is split by mirrors and not as in majority of 3D set ups that use two camera systems (BBC, 2009). Threats New entrants New companies can enter the market since the shift from analog to digital technology made it easier. This is because complicated functionality has become concentrated in semiconductors and easier to manufacture. Emerging markets Economic uncertainty and political instability in markets such as China, India, Russia is more violated than this of United States and Western Europe. Porters Five Forces Why Porters Five Forces would give the greatest insight into Sonys strategy Sony has to analyse and understand the industry context for developed markets in order to sustain its strategy which is to be an innovation leader and the worlds leading consumer brand. The model of the Five Competitive Forces developed by Porter can facilitate. Porter (1980) identified five competitive forces that shape every industry and every market. These forces determine the competition and show the attractiveness of an industry and its potential. Furthermore, Porters model is based on the approach that a corporate strategy should meet the opportunities and threats in the organizations external environment. Particularly, competitive strategy should focus on understanding industry structures and the way they change. Consequently, it is one of the most effective tools to give insight into Sonys strategy. Porters Five Forces Analysis The following model illustrates Porters Five Forces Analysis: Threat of New Entrants Low Any beginner will need economies of scale to be successful in this market. A small player will require strong relations with suppliers and efficient manufacturing processes otherwise it will not be achievable for him to produce at a low cost. This may result in incurring losses and failing to gain bigger market share. Furthermore, every company that wants to compete in this market will require sophisticated technology and well developed RD unit. Bargaining Power of Suppliers- Low Due to the fact that there are so many suppliers bargaining power of them is low. Companies in the electronics industry are looking for cheaper imports from countries such as Taiwan or China (Armstrong Kotler 2008). Many are relocating manufacturing facilities to these countries, as price competition is on the rise. Suppliers are forced to cut their prices or go bankrupt due to the price war as their customers can go to other suppliers who are offering lower price. What is more, manufacturing has shifted from brand owners to mass logistics manufacturers in order to cut the costs associated with the production (Sony, 2009). Large companies from similar industries can now enter this market and that is why bargaining power of suppliers is low. Bargaining Power of Buyers- High First group- buyers, who purchase from retailers: (Curry, Argos) that have long term relationships with global brands such as Sony, Canon, Kodak, Nikon, Olympus. Curry or Argos has high buying power since it offers customers great value by checking competitors prices and securing exclusive deals from key manufactures, and making a decision which product to choose. Second group- individual customers even though they have limited buying power and they do not have much impact on the company directly, they are the one who buy products from Curry or Argos and they influence those retailers over which product they will choose in future. Threat of Substitutes- High The threat of substitutes is very high example digital cameras. Camera phones are ideal substitute for all digital cameras. According to Lyras research, a digital imaging research firm, mobile phones are selling faster than digital cameras. Lyras (2006) estimated that the camera phones reached 850 million units in 2006, and this number is expected to grow to more than 1.5 billion units in 2010. Competitive Rivalry between Existing Players- High There are numerous and rather equally balanced firms competing in this market with Sony the biggest ones are Panasonic, Phillips. The competition is fierce; there is a short product life cycle, high cost associated with RD that gives low profit margins and finally high exit barriers. It is noticeable that over the years, the nature of the business has forced manufacturers such as Sony to offer innovations with enhanced models (Johnson et al 2008). Moreover, brand name is no longer as important as it used to be (Anderson, 2008). Consumers are now looking for electronic goods that offer their most wanted features at the lowest price, regardless of brand. PEST Analysis Why PEST analysis would give the greatest insight into Sonys strategy Another strategic tool that can help to evaluate Sonys strategy is PEST analysis. It is a valuable tool for understanding the big picture of the environment in which an organisation is operating (Bowman Faulkner, 1996). PEST analysis is a framework that categorises environmental influences as political, economic, social and technological forces (Jones Hill 1992). In view of the fact it is important to identify those factors as they might have affect on Sonys supply and demand levels and its costs especially in emerging markets. Furthermore, PEST gives the greatest insight into Sonys strategy since it will show the market growth (emerging markets) and decline (developed markets), potential and direction for Sonys operations. What is more, PEST analysis will show whether it was worth to enter Sonys business operations into new markets and new countries. Consequently, PEST analysis with SWOT and Porters Five Forces model will help to review Sonys strategic direction. Political Tariff reduction in EU Tariff reduction in EU countries will affect directly import and export procedures in Sony corporation, as the price will be modified due to this policy. Emerging markets Unfavourable political factor including unforeseen legal or regulatory changes such as foreign exchange, import and export controls, political instability and potential conflicts among developing nations. Economic Products Sonys products are rather expensive and people in developing countries with minimum wage cannot afford to purchase them. Uncertainty The economic situation in developing markets can get worse, which could result in future effects on earnings (Jeanet Hennessey 2004). Foreign exchange Foreign exchange rate fluctuations can have an effect on financial results since large portion of Sonys sales and assets are denominated in currencies other than the yen. Social Customer preferences In some markets, customer needs and preferences are becoming more similar (Johnson et al., 2008 p. 69). Electronics goods are standardised products therefore culture no longer has a big impact. In fact, the more standardized product, the better chances to sell it worldwide. According to Slack, et al. (2007) this helps organization to have transference of marketing across countries. Technological Advanced technology Advanced technology to be more competitive in the market is a key issue (Armstrong Kotler, 2008). Sony knows that to manufacture very innovative products that will be hard to copy and help to lead in the market the company needs to invest and constantly improve its RD department. Strategic Group Analysis Why Strategic Group Analysis gives the greatest insight Strategic Group Analysis is useful for every company as it can be performed in a short period of time. This tool would give insight into determining different competitive positions of companies in the industry (Mintzberg et al 2003). The analysis can illustrate intensity of rivalry within and between groups and implications of competitive position (Bourgeos, 1996). This is because Strategic Group Analysis is a collect of companies in an industry. Furthermore, groups of companies are clustered around a similar competitive approach or strategic position. Finally, the companies in a group are similar to each other but different from companies in other groups. Consequently, this tool is useful in assessing Sonys position among its rivals and provides insight into its strategy. The diagram above shows strategic groups that are in competition with each other. These are analysed according to price and customer perceived value (branding). Strategic spaces are opportunities for companies. For example in order to fulfil those spaces Sony could lower its prices and LG could change the perception of the brand to the higher value. However, this opportunity might be a threat as Sony could lose profits and customers by lowering prices and its perceived value. In LG case, the company would have to spend a lot of money on the marketing campaign to change the perception of the products and invest in RD to actually change the product to a higher standard. What is more, the company would have to charge more for its products and therefore it might lose customers. Mobility barriers The mobility barriers restrict enterprises in electronics industry to go from one strategic group to another. If Sony moved from one group to another, it could incur higher costs or threat of lowering perceived value. However, with more flexible manufacturing and fast development of new technologies in the future the barriers to mobility may be lowered and it might be easier for Sony to go from one strategic group to another. Conclusion Sonys strategy has been analysed using SWOT analysis, Porters competitive forces model, PEST analysis and Strategic Group Analysis. Those tools gave the greatest insight into the companys strategy. This is because they analysed the companys competition, its competitive advantage, internal and external environment. By understanding those, the company can retain market shares in developed markets and enter new products to emerging markets to achieve higher sales growth and eventually bigger market share. Consequently, those tools are vital for assessing the companys strategy as they take into consideration existing factors but also forecast change for the future. This way Sony can adjust its strategy to the environment in which it operates. Furthermore, appreciate its investment into RD by assessing its clients needs. This further leads to Sonys competitive gain. References: Anderson, C. (2008) Future of the Business available from [accessed 21 November] Armstrong, G. and Kotler, P. (2008) Principles of marketing 13th ed., New Jersey, Pearson Prentice Hall. BBC (2009) Sony shows off 3D TV technology available from http://news.bbc.co.uk/1/hi/technology/8285187.stm [Accessed 20 November] Bowman, C. and Faulkner, D (1996) The Essence of Competitive Strategy Prentice Hall. pp.25-19 Bourgeois, J.L. (1996), Strategic Management from Concept to Implementation, The Dryden Press, Florida pp. 34-40 Celik A. (2008) Emerging Markets available from http://celikalper.wordpress.com/2008/11/18/emerging-markets/ [Accessed on 22 November] Cook B. (2003) Sony Powered Brand Channel available form http://www.brandchannel.com/features_profile.asp?pr_id=128 [Accessed on 21 November] Grant, R.M. (2005) Contemporary strategic analysis. London: Blackwell pp. 56-62 Hamel, G. and Prahalad, H.K. (1994) Competing for the Future, Boston, Harvard Business School Press pp. 36-39 Jeanet, J.P., Hennessey, H.D. (2004) Global marketing strategies 6th ed., Boston, Houghton Mifflin pp. 41-45 Jones, G.R., Hill, C.W. (1992), Strategic Management: An Integrated Approach, Houghton Mifflin Company, Boston pp. 28-33 Johnson, G., Scholes, K. and Whittington, R. (2008) Exploring Corporate Strategy (8th Edition) Text and Cases, Prentice Hall, Harlow pp. 28-43 Leberecht T (2008) The worlds 50 most innovative companies available from http://news.cnet.com/8301-13641_3-9926227-44.html [Accessed 20 November] Lyra Research Corporation (2006) Mobile phones available from: [Accessed 23 November] Mintzberg, H., Lampel, J., Quinn, J., Ghoshal, S. (2003), The Strategy Process: Concepts, Contexts and Cases, 4th end., Prentice-Hall, Upper Saddle River, New Jersey. pp. 45-49 Pearce, J.A. and Robinson, R.B (2003) Strategic Management: Formulation, Implementation and Control (8th Edition), McGraw-Hill, New York, NY pp. 56-62 Porter M.E. (1980) Competitive Strategy Free Press, New York pp. 27-45 Slack N., Chambers S. and Johnston R. (2007) Operations Management, Fifth Edition, Harlow, Prentice Hall. pp 35-37 Sony (2006) Sony Annual Report 2006. Available from: http://www.sony.net/SonyInfo/IR/financial/ar/2006/index.html > [Accessed 15 November 2006] Sony (2008) Sony Group Corporate Strategy Update FY2008 FY2010. Available from: http://www.sony.net/SonyInfo/News/Press/200806/08-080E/ [Accessed 22 November] Sony (2009) Sony Annual Report 2009. Available from: http://www.sony.net/SonyInfo/IR/financial/ar/8ido180000023g2o-att/SonyAR09-E.pdf [Accessed 22 November] Thompson, Arthur A., Jr., and Strickland, A. J. (1998). Strategic Management, 10th ed. Boston: Irwin/McGraw-Hill. pp. 12-24 ZDNet Asia (2009) Sony is a leading consumer electronics and entertainment company globally Top Tech Index 2008/2009 available from http://www.zdnetasia.com/toptech/2008/0,3800017271,62048727,00.htm [Accessed 19 November] Sony aims to continue being one of the worlds leading consumer brands in the 21st century, providing customers with a wide range of attractive products, content and services (Sony 2009 p 3). Sony will aim to achieve higher sales growth through gaining bigger market share. PEST analysis can help to understand risks associated with the market growth or decline, and the position, potential and direction for an individual businesses or organizations (Grant, 2005). PEST analysis is frequently used as a generic orientation tool, that can help to find out where a company or a product is in the context of what is happening externally (Jones Hill 1992). The four elements shape a structure for reviewing a situation and strategy or position. PEST analysis needs to be carried out on a regular basis to be effective. Companies can gain competitive advantage when they do analyses regularly and systematically as they can spot trends before others and exploit them fully. Thus, PEST is a tool that would give the greatest insight into Sonys strategy. Effect of Yoga on Bed Wetting in Children | Study Effect of Yoga on Bed Wetting in Children | Study EFFECT OF YOGA ON BED WETTING FREQUENCY IN CHILDREN A Pilot study ABSTRACT Bed wetting or Nocturnal enuresis is a common problem in children. It refers to the unintentional passage of urine during sleep. Bed wetting is normal till the age of 5yrs, if continues over the age is due to physical as well as psychological connection. 15% of populations have this problem globally. Yoga is a traditional Indian medicine which was now used up for many clinical conditions. The aim of this study is to find out the effect of yoga on reduction of bed wetting frequency in children. 10 children with complains of nocturnal enuresis were selected by purposive sampling method. Structured yoga programme was given to the children. The yoga programme was conducted alternate days for 4 weeks. Voiding dairy was used to evaluate the improvement on bed wetting frequency. Following the 4 weeks of programme the collected data’s were analyzed using the descriptive statistical method. This study finds that yoga is useful method in reduction of bed wetting frequency. Thus the stud y concludes that yoga play a major role in reduction of bed wetting in children and it also promotes psychological and moral boost to the children. Key words: Yoga, Bed wetting, Voiding diary. Nocturnal enuresis. INTRODUCTION Bedwetting is also called as nocturnal enuresis, it is the involuntary discharge of urine in children during night or during sleep1. When the child tends to voids involuntarily for at least three times a week after 5 years without any congenital defects is termed as nocturnal enuresis.2 In India about 15 million children were having bed wetting problem. It is one of the commonest problems in young children. Usually it is found more common in boys3. 1.6% to 15% of children wet their bed during night, it is found that 10% to 15% of five-year-old children and 6% to 8% of eight-year-old children, and it declines to 1% to 2% by 15 years of age4. Nocturnal enuresis is one of the common urological problem. Actual cause of the bed wetting is unknown. It was considered to be one of the most disabling problems during child physical as well as psychological development. Though it looks a simple problem there may be various other conditions underlying like, neuromotor problems, attention difficulties, learning disabilities, and the possibility of being the cause of psychological status. 5,6,7 Bed wetting without day time symptoms are termed as mono-symptomatic nocturnal enuresis whereas bed wetting occurs both day and night are termed it as Non-monosymptomatic 9. Delvin conducted a population survey on 1800 Irish children with the age of 4—14 years and he found that 33% of children void less than once a week, 11% voids once a week and 25% voids two to four times per month10. Bed wetting will cause enormous emotional impact in child as well as their parents. Children with enuresis are commonly punished and are at the risk of emotional and physical abuse11. Parents should understand that bed wetting is never done on purpose or not done as laziness 8. Many studies have identified the impact of bed wetting may cause anxiety, embarrassment, loss of self-esteem, concentration difficulty, learning difficulty and may impact the psychological status of the children12. Bedwetting tend to run in families. Many children who wet the bed have a parent who did, too. Most of these children stop bedwetting on their own at about the same age the parent did.13 Most children outgrow bed-wetting without treatment4. However, some child may need some additional assistance from physician. Bedwetting is typically seen more as a social disturbance than a medical disease because it creates embarrassment and anxiety in the child and conflicts with parents. The single most important thing parents should do is to be supportive and reassuring rather than blaming and punishing. The many treatment options range from home remedies to drugs, even surgery for children with anatomical problems14. Primary management of bed wetting is behavioral modification and positive reinforcement15. Yoga isan ancient tradition that has been westernized and often practiced for its proposed health benefits. Yoga therapy was described by Indian authors 2500 years ago, but it still plays an important role in everyone’s life16. It often translates union of the mind, body and spirit17. Yoga is considered as a mind and body exercises, it helps to unite the body and mind; it brings the physiological state of the body and shape emotions, thoughts and attitudes18. Yoga becomes a promising therapy for the children. It plays an important role in development of several aspects of cognition and executive functions19. Certain yoga postures or asanas have proved to help the child to overcome the bed wetting. Though there were extensive articles on benefits of yoga in bed wetting, still there is no study to prove its efficacy. There is no head to head comparison of the yoga on its role on nocturnal enuresis. This pilot study tries to identify the effectiveness of yoga in the nocturnal enuresis. The study hypothesized that there will be no significant difference in reduction of Bed wetting frequency following yoga therapy. METHODOLOGY Subjects were selected through purposive sampling method with descriptive study design. 10 children complains of bed wetting were included in the study. Prior to the selection of the children for the study, a clear analysis was done by urologist and an approval from pediatrician who states that there was no other medical reason for the nocturnal enuresis. A clear examination was done by the senior physiotherapist to rule out any bony deformities (Structural). Clear instruction to the children and the mother about the benefits of yoga and its physiological role on urinary system was clearly explained. Informed consent was obtained from the mother. Upon obtaining the concern 10 male children were included with the age group of 6—10 years, having normal life style, complains of nocturnal enuresis at least 3 times in a week, well-nourished children, school going children and those who are willing to do yoga, and those who wish to continue yoga regularly. The study excludes mental retarded children, children with urinary infections, mal nourished, underweight and any other structural deformity. A detailed session on yoga and its benefits was given to all children and the mother / guardian. Queries and Questions raised by the parents were addressed, and advised all parents to bring the children compulsory. The yoga programme was conducted for 4 weeks of duration, and a session of the program was conducted alternate days, each sessions consist of 30—45 minutes of duration. All subjects were taught yoga postures (i.e asanas). Six asanas were chosen for this study, the asanas were chosen as per discussion with the stalwarts in yoga and yoga guru. Asanas were trained to the children by the researchers, all the postures / asanas have to sustain for ten to fifteen counts. For the first three sessions the children were taught to do asanas and difficult postures were assisted by the researcher, later, once they mastered the technique, they are all practiced to do these postures without support. List of asanas trained to the children are Konasana, Sakrasana (Standing), Yoga mudra, Sarvangasana, Savasana ,Nisbandabhava. Before commencement of the study a warm up programme was given with Suryanamaskar for 10 mins. Once they completed then the children were initiated the asanas. At the end of the program savasana was given to relax the muscles. The programme was conducted initially in groups, all the queries were cleared on every session. This study was accepted by the Institutional ethical committee. There was no harm involving the participants in this study. There was no drop out in this study. Voiding dairy given to the mother and asked them to fill up when their children does bed wetting. The data were collected in likert scale (i.e 0—5 scale), and the data are used for the analysis and it was tabulated in percentage. RESULT AND DISCUSSION The data was analyzed by using SPSS statistical package, 19.1. The table I shows the general information about the children. All children included in the study are males. There are various studies suggest that male children are mostly involved in nocturnal enuresis. Voiding history noted in these children is only during sleep and at the night time only. 80% Parents of the children has the family history of nocturnal enuresis. We also gathered that 85 % of parents scold or punish their children for the bed wetting. Table II shows the voiding history of the participants which was shown in percentage. It shows that 57 % of participants are with the age group of 6, 8 years. 4 times in a week is the maximum voiding frequency by the children. Two children has the history of voiding 2 times in a week, others are having the frequency of more than 3 times per week. Table III shows the voiding history before the yoga programme and after the yoga programme. The table value shows that there was a significant difference existed between the groups. There was a marked difference between the pre and post test values. The result of the study revealed that the yoga programme has showed a marked reduction on bed wetting frequency in children. Yoga helps to promote retention control, regular practicing helps to postpone urination by few seconds to few minutes. Bed wetting is a shameful situation for children as well as parents, but it is not a serious problem, and it is common in boys20. Yoga play a major role in control of bed wetting, the retention exercises should be increased gradually without putting pressure on the children, and the exercises would help to increase the control in bladder muscles and also increases bladder capacity20. Yoga helps to strengthen muscles which control urination. It also helps in increasing bladder capacity. Regular practicing yoga will stimulate the nervous system, and thereby influence the micturition system in the spinal cord lead to better control and coordination of the process21. Yoga also helps in reduction and prevention of the psychosomatic stress disorders 22. Studies found that yoga help in improving the bladder control in patients with urinary incontinence. Few researches conducted for women who show that yoga improves pelvic health and helps in gaining control over the urine leakage. Yoga programme directs the mind awareness and increases relaxation and relieves anxiety and stress23. The study confirms that the yoga programme will improve the bladder control in children and it was a beneficial one for the treatment of bed wetting. Regular practicing of yoga provides additional benefits like improvement of flexibility and also help to improve the concentration, memory and reduction in stress level. However, the study was done in a small group, the results can’t be generalized, and there was an elaborate and large group of participants needed. The other factors like psychological or pharmacological factors were not considered in this study, future study need a holistic approach in the management. REFERENCES: Dalton R. Enuresis. In: Behrman R, Kliegman R, Arvin A, Nelson W, editors.Nelson Textbook of Pediatrics.15th edn . Philadelphia: WB Saunders; 1996. pp. 79–80. Forsythe, W. I., Butler, R. J.: Fifty years enureticalarms.Archives of Disease in Childhood, 64: 879, 1989 Caldwell PH, Edgar D, Hodson E, Craig JC. Bedwetting and toileting problems in children.Med J Aust.2005;182(4):190–195 Mark Feldman et al., Management of primary nocturnal enuresis, Paediatr Child Health Vol 10 10(10): 611–614..December 2005. von Gontard A, Freitag CM, Seifen S, Pukrop R, RÃ ¶hling D. Neuromotor development in nocturnal enuresis.Dev Med Child Neurol.2006;48(9):744–750. Okur M, Ruzgar H, Erbey F, Kaya A. The evaluation of children with mono symptomatic nocturnal enuresis for attention deficit and hyperactivity disorder.Int J Psychiatry ClinPract.2012;16(3):229–232. Coppola G, Costantini A, Gaita M, Saraulli D. Psychological correlates of enuresis: a case-control study on an Italian sample.PediatrNephrol.2011;26(10):1829–1836 American Psychological Association.Diagnosis and Statistical Manual of Mental Disorders.4th ed. Washington, DC: American Psychological Association; 2000. pp. 108–110. vanGool, J. D., Nieuwenhuis, E., ten Doeschate, I. O. et al.: Subtypes in monosymptomatic nocturnal enuresis. II. Scandinavian Journal of Urology Nephrology Supplementum, 202: 8, 1999 Devlin, J. B.: Prevalence and risk factors for childhood nocturnal enuresis. Irish Medical Journal, 84: 118, 1991 Kaplan, Harold, I and Sadock, M.D, Synopsis of Psychiatry, eight edition, 1998, Baltimore: Williams and Wilkins. Moffatt ME. Nocturnal enuresis: psychologic implications of treatment and non-treatment.J Pediatr. Apr 1989;114(4 Pt 2):697-704. Katz ER, DeMaso DR. Enuresis (bed-wetting). In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds.Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 21.3. Ramakrishnan, K, Evaluation and treatment of enuresis, American family physician 2008, vol 78, 4, 489-496. Glazener CM, Evans JH. Simple behavioural and physical interventions for nocturnal enuresis in children.Cochrane Database Syst Rev.2004. Garfinkel M, Schumacher H. Yoga Effects.Rheum Dis Clin North Am.2000;26:125–32. Satchidananda S.The Yoga Sutras of Patanjali.Yogaville, VA: Integral Yoga Publications; 2005. Cowen VS, Adams T. Physical and perceptual benefits of yoga asana practice.J BodyMovTher.2005;9:211–9. Chen TL, Mao HC, Lai CH, Li CY, Kuo CH:The effect of yoga exercise intervention on health related physical fitness in school-age asthmatic children.Hu Li ZaZhi2009,56:42-52. Nadeem Naqvi, 2011, Bed wetting problem: How to deal with bed wetting, http://www.studyvillage.com/resources/2899-Bedwetting-problem-How-deal-with-bed-wetting.aspx. Udupa, K. N, 2000, Stress and its management by yoga. New delhi, MotilalBanarisdass. Huang, Alison J.; Jenny, Hillary E.; Chesney, Margaret A.; Schembri, Michael; Subak, Leslee L.A Group-Based Yoga Therapy Intervention for Urinary Incontinence in Women: A Pilot Randomized Trial Female pelvic medicine Reconstructive surgery May/June 2014-Volume 20-Issue 3 pp:123-184 Huang, Alison J.; Jenny, Hillary E.; Chesney, Margaret A.; Schembri, Michael; Subak, Leslee L.A Group-Based Yoga Therapy Intervention for Urinary Incontinence in Women: A Pilot Randomized Trial Female pelvic medicine Reconstructive surgery May/June 2014-Volume 20-Issue 3 pp:123-184. TABLE I General Information’s Table II VOIDING HISTORY Table III VOIDING HISTORY 1

Prostitution and Functionalism Essay -- Functionalist Theory Prostitut

Prostitution and Functionalism Works Cited Not Included Throughout America and the entire world, prostitution flourishes. Prostitution is another never ending war like abortion, which society feels is immoral. This immorality leads functionalists, who apply functionalism to this social problem, on a chase to figure out why prostitution is what it is today. Functionalism is the best theory for looking at prostitution. It allows us to see how prostitution changes along with other aspects of society.   Ã‚  Ã‚  Ã‚  Ã‚  Some ask why prostitution spreads like a wildfire through our cities and streets. This is an easy question for functionalists, prostitution flourishes because it satisfies sexual needs that are not able to be met elsewhere(Henslin 51). Prostitutes almost seem to serve as an outlet for sexually frustrated men. When a man is unable to find a partner he always holds the option of paying for sexual pleasure. A functionalist, Kingsley Davis, concluded that prostitutes provide a sexual outlet for men who: have difficulty in establishing sexual relationships, cannot find long-term partners, have a broken relationship, want sexual gratification that is defined as immoral, desire quick sexual gratification without attachment, are curious, and are sexually dissatisfied in marriage. From this it is shown that by meeting such needs prostitution functions as a form of social control over sexual behavior. This is beneficial because it brings men with sexual desires away from un wi...

Hesters Letter :: essays papers

Hester's Letter There are numerous characters in The Scarlet Letter, by Nathaniel Hawthorne, that play noteworthy roles. The character that stands out the most is Hester Prynne. Hester changes significantly during the course of the novel. In the beginning of the novel she is conceived as an extreme sinner through the eyes of the Puritans; she has gone against Puritan ways, committing adultery (Chuck). For this irrevocably harsh sin, she must wear a symbol of shame for the rest of her life. However, the Romantic philosophies of Hawthorne put down the Puritanical beliefs (Chuck). She is a beautiful, young woman who has sinned, but is forgiven. Hawthorne portrays Hester as a "divine maternity" and she can do no wrong. Not only Hester, but also the physical scarlet letter, a Puritanical sign of disownment, is shown through the author's style and rhetoric as a beautiful, gold and colorful piece (Chuck). Hawthorne uses Hester Prynne in the novel to convey many different meanings. Hawthorne is more inter ested in uncovering the flaws of puritan society and the hypocrisy of their reactions to Hester’s sin, than to analyze adultery. Hawthorne uses Hester to scrutinize the Puritan way indirectly, and show the role women should play in society. The Puritan culture is one that recognizes Protestantism, a sect of Christianity. Though a staple of Christianity is forgiveness for one’s sins, this has long been forgotten amongst the women of Boston: â€Å"Morally, as well as materially, there was a coarser fiber in those wives and maidens of old English birth and breeding, than in their fair descendants† (Marcus). When Hester is first brought out of her prison cell, it is the gossiping goodwives who keep recommending much harsher punishments, from a brand on her forehead to death. Hester, who had done nothing wrong prior to this sin of adultery, is no longer seen as a human being, but merely as a symbol of evil and shame upon the town. Hester is forced to stand on the scaffold with everyone in town ridiculing her until she confesses who her partner was in the sin, but instead she stands there for three hours, when she was allowed to come down. Her subjection for the Puritan onlookers was excoriating to bear , and Hester holds the child to her heart, a symbolic comparison between the child and the scarlet letter, implying that they are truly both intertwined (Chuck).

Swot of Ibm 2009

IBM – SWOT Analysis Strengths Since IBM was founded in 1896, it has gone through a very long experience in the technological industry with a very strong brand name. The company has a wide range of products to appeal and attract different customer needs and to maintain its competitive position. IBM in 2009 was considered as one of the largest and most profitable computer services company in the world with a market capital of about $119 billion and 319,000 employees speeded in 150 countries around the world. The company in 2009 has made a good cut of the cost structure while at the same time the company was achieving a good increase in the revenues. The company invested in the IT by outsourcing it completely to India just to compete more effectively in the IT services and to rebuild its competitive advantage. The company was concentrating a lot in the high value added business. Weaknesses In 2009 IBM announced 5,000 job cuts in the United States which was accounted for around 4% of the workforce in United Sates . This move could probably hurt the company’s external image. Also could be one of the company’s weaknesses is that, the company was facing very high operating costs. The company also is not investing a lot in the low end products. Opportunities The company needs to maintain its position in the market and to attract more customers. Also IBM has the opportunity to lead the market in many segments by investing more in the R&D and to generate innovative ideas. Many customers perceive IBM as an old brand in which they have the opportunity to rebuild its brand image to appeal to the younger generation, could by investing in the electronic games or the mobile phones. The company has a good opportunity to start design green products strategy that protects the environment and cut good percentage of the costs. IBM can develop a customized hardware & software for the key customers. Threats Probably one of the main threats that IBM is facing today, is the growing competitors that make a real threat for the company and those competitors who are able to create cheaper products and make more a considerable profit. The technological products are changing quickly and make the life cycle of these products much shorter. Also the economical fluctuations impose a real threat on the company of losing profits.

The Importance of Work in Society

In order to maintain structure within society there are many intuitions that employed to achieve this goal. Work is an example of responsibly, discipline, and cultural awareness, qualities you will need for your future work life. First, how working teaches you responsibility, while working you have a set schedule that you have to maintain in order to be paid, so missing work means you have a lower paycheck and young teenagers love money and don’t want to miss any paychecks. You are in charge of making all customers leave satisfied with a smile, if you don’t make that happen the company can have bad reviews, which can cause you to be fired. The more you the work the more you will have. Working also teaches you how to value things you have. The reason for this is that you work for the things you have saying you’re not going to work for something and let it go to waste or throw it away. Employers instruct their workers how to respect all costumers and how consumers are the reason, they are in business today, so tasks done to costumer’s satisfaction, with that being said employers drill into your head how to treat other people and how to run a successful business and that with hard work anything is possible. When you first but something with your own money you care about what, and how your money is being spent, also trains you that if what you’re is not of something of value than you really don’t need to have it. We as a community needs to teach our younger children the value of responsibility and discipline which is qualities that you need to have in your everyday life. Schools are biased on teaching you what they want you to know and not what you feel about it. So do not be ignorant to what the schools edify about values of life, learn it own your own.

Kants Ethics vs Utilitarianism Essay

The two ‘core’ ethical theories covered in class that I started to assess are the categorical imperative and utilitarianism, both of which offer an approach to decision making in the context of social and interpersonal relationships. In this with in depth understanding of both that Kantian ethics is much easily appreciated than the ethics of utilitarianism as Kantian ethics apply to everyone yet both ethical approaches lead to faults. Utilitarianism is the moral theory that brings upon the greatest happiness. This theory illustrates that right actions as said to be right as they endorse happiness to someone or a group of people whereas wrong as they uphold unhappiness. Kantian ethics on the other hand puts a persons benefit before the greater good, that is people never should be used as means only but means to an end. Both Kant’s ethics and Utilitarianism greatly analogize between each other as Kant is deontological which means that someone ought to do things because they are right, as it is duty and that in itself makes it right. On the other hand Utilitarianism is based on consequence as someone should act to bring the greatest good to the greatest number of people. Utilitarianism does not care if the greatest good/benefit is brought with someone’s manipulation, lies or coercion. Kant’s ethical would disagree with this completely as If someone lies then it becomes universal law that everyone would have the right to do the same thing. Ethical implication arise from Kant’s ethics even if this in my opinion is a more logical means that a person should consider in ethical decision making. Suppose for example you would lose your friends for telling the truth in a given situation, Kant’s ethics says you shouldn’t lie what so ever because it is you duty not to do so would bring unhappiness and here utilitarianism would differ completely. Another situation where Kant’s ethics would coincide with itself is for example if a woman was trying to hide from a guy that was trying to kill her and you decided to help that woman by letting her stay in your house, few hours later the guy trying to kill that woman come knocking on your door asking about her whereabouts. Here with Kant’s ethics you can’t lie as it is your duty not to and it is also your duty to protect that woman you made a promise to earlier, in this situation one action must be chosen and this shows a major fault in Kant’s ethics. Utilitarianism has its benefits but requires much more effort to do than Kant’s ethics. There are two classical types of utilitarianism, which are act and rule utilitarianism. Act utilitarianism is right only if the result of good is just as much or more than any other available substitute. Rule utilitarianism states that an act is right if the rule itself acceptance would lead to a greater utility for society that any other substitute then that act is right. The strength of utilitarianism comes in the fact of it offering a system that is absolute, giving us a potential solution to every situation faced. The second strength is that is seems to grasp the sense of morality even though the actions are come with deceitful like lying means it is for the greater good, uplifting the suffering in this world. Utilitarianism has its objections and can be problematic as different people have different thought on what happiness is and what pleasure is. One of the problems that arise from Utilitarianism is the no rest objection, for example if I wanted to sleep or go to the movies at those moments I could be trying to help poor people or saving the environment to promote more utility. Having my salary should mostly go into helping others as this brings upon the greatest good but as you see this theory does not make sense to why I shouldn’t make myself happy. Trying to help all the time with no rest becomes too demanding and this theory fails understand different obligations making utilitarianism a false doctrine to many.

Caring of Parents

Caring for Elderly Parents How to care for elderly parents is a major concern of many Foreign Service families. Our concerns mirror those of other American families, but how to ensure good health care, find the right living situation, and handle legal questions is often complicated for Foreign Service families by being posted abroad. The distance involved makes it harder to get information and help so contingency planning is essential. Often Foreign Service families only have short visits during R & R or on home leave and hate to spend the precious time with their parents talking about serious business or unpleasant possibilities. Or we may be caught up in hectic preparations for an overseas assignment and not want to take the time to do contingency planning with parents. While it is difficult to discuss the issues of aging, the family who has discussed the options and agreed on plans will be better able to handle whatever happens. It will be worth the time taken, if there is an emergency. The ideal situation is when the parents take control of their own situations and make decisions in advance of an emergency. They should investigate the types of retirement options and decide which is most appropriate, make informed decisions about life-sustaining medical care, and make sure that documents, instructions, and powers of attorney are available to those who must take responsibility in an emergency. The American Association of Retired Persons recommends that elderly people use a document locator list (scroll to bottom of this page) to make sure their papers are in order. This list can then be given to the person(s) who will be responsible for them should an emergency arise. Going through the list with your parents should ensure that their wishes are understood. Communicating with Elderly Parents Talking with our elderly parents about their living situations and the possible need for change is not always easy. A successful conversation depends to an extent upon the relationship we have with the parent, as well, of course, as on the parent's mental, emotional and physical condition. While many people put off serious conversations to avoid conflict or awkwardness, both parent and adult child may lose an opportunity for closeness, understanding, access to information that may affect the decision, and optimum peace of mind. To the extent possible, talk with your elderly parents gently and honestly about their wishes, their abilities and their options. Far more often than not, these conversations are helpful and put the adult child in a better position to make decisions later when the parent may not be able to do so. The following are suggestions for conversations with your elderly parent: * Share your own feelings, and reassure the parent that you will support them and can be depended upon to help them solve their problems. * Help the parent to retain whatever control is possible  in making his or her own decisions. Respect and try to honor their wishes wherever feasible. * Encourage the smallest change possible  at each step, so that the parent is more able to adjust to the change. Educate yourself on legal, financial and medical matters  that pertain to your parent as background for your conversations, including current knowledge on the aging process. * Respect your own needs  Ã¢â‚¬â€œ be honest with your parents about your time and energy limits. If this kind of conversation seems impossible or the situation and relationship with the elderly parent become overwhelming, professional counseling may be very helpful. You may also consider using the Department of State's resources to appro ach this delicate issue somewhat indirectly. Filling out FIVE WISHES for yourself and sharing your decisions with your parents may encourage them to open up on the subject. You may also wish to raise the subject of long-term care insurance as a practical matter. (For more information about FIVE WISHES and Long-Term Care Insurance, see below). When a Lifestyle Change May Be Necessary Physicians and geriatric social workers warn that there are a number of danger signs that indicate an elderly person needs extra help or a change in living arrangement. Any marked change in personality or behavior should be heeded. However, no change in lifestyle should be made without discussions with the elderly person, other family members, and doctors or other health professionals. Danger Signals * Sudden weight loss  could be an indication that the elderly person is simply not eating or not preparing foods. * Failure to take medication or over-dosing  may indicate confusion, forgetfulness, or a misunderstanding of the doctor's instructions. * Burns or injury marks  may indicate physical problems involving general weakness, forgetfulness, or a possible misuse of alcohol. Deterioration of personal habits  such as infrequent bathing and shampooing, not shaving, or not wearing dentures could be the result of either mental or physical problems. * Increased car accidents  can indicate slowed reflexes, poor vision, physical weakness, or general inability to handle a vehicle. * General forgetfulness  such as not paying bills, missing appointments, or consistently forgetting name, address, phone number, and meal times could be a signal. * Extreme suspiciousness  could indicate some thought disorder. Your parents thinking that their neighbors, friends, family, doctor, and lawyer are all conspiring against them would be an example. Intense ungrounded fears about dire consequences may be a danger signal. * A series of small fires  could be caused by dozing off, forgetting to turn off the stove or appliances, or carelessness with matches. They may indicate blackouts or dizzy spells. * Bizarre behavior of any kind  could be a warning sign. This behavior could be dressing in heavy gloves and overcoat in 90 degree weather or going outside without shoes when it's snowing. Watch for uncharacteristic actions or speech. Disorientation of a consistent nature  may indicate a need for help. Examples include not knowing who one is, where one is, who the family is, or talking to people who are not there. Elder Care Options If you see danger signals in your parent's behavior, it is important to discuss the changes and do some research. (See IQ: Information Quest below for information about the Department of State's free resource referral service. ) There are many housing options available to the elderly. Choosing the best one will depend on the elderly person's preference, age, health, and financial condition. Aging in Place Under this option, the elderly person continues to live in his/her own apartment. Many elderly people live in Naturally Occurring Retirement Communities (NORCs), apartment buildings, condominiums, or cooperatives not designed as retirement communities but where at least 50 percent of the residents are 62 years old or older. These buildings often have amenities such as grocery stores, pharmacies, limousine service, or shopping services. Recent technological advances often make aging in place easier: Velcro asteners, lightweight wheelchairs, devices to control appliances and dial telephone numbers. There is even a â€Å"walk-in bathtub† for people who have difficulty climbing into an ordinary bathtub. Many services are available to help the elderly person stay in his/her home. Information about them can be obtained from contacting IQ: Information Quest (see below) or  your local Area Agency on Aging. * Home care services  are available in many communities, pro viding appropriate, supervised personnel to help older persons with either health care (giving medications, changing dressings, catheter care, etc. or personal care (bathing, dressing, and grooming). * Meals and transportation  are available to older people to help them retain some independence. Group or home-delivered meal programs help ensure an adequate diet. Meals-On-Wheels programs are available in most parts of the United States. A number of communities offer door-to-door transportation services to help older people get to and from medical facilities, community facilities, and other services. * Adult day care  is similar to child day care. The elderly person goes to a community facility daily or 2 or 3 days per week. Activities include exercise programs, singing, guest lectures, and current events discussions. Cost varies and there are often long waiting lists at such centers. * Respite care  brings a trained person into the home to give the full-time caregiver time off to get a haircut, visit the dentist, or take a vacation. Service is generally offered through area Departments of Social Services and is based on a sliding fee scale. Other Housing Options There are several types of retirement communities that provide living arrangements and services to meet the needs of both independent seniors and those who need assistance. Large hotel corporations are in this field and other facilities are set up for members of a certain organization (retired military, Elks, etc. ). It is important when investigating these housing options to understand completely the services provided and the cost. * Adult congregate communities  are designed for the fully able-bodied, 55 and older. Residents buy co-ops or condominiums and pay a monthly fee for grass mowing, leaf raking, and snow shoveling. A pay-as-you-go medical center is on site and a nurse is on duty 24 hours a day to make home visits in emergencies. Leisure World is the most famous example of an adult congregate ommunity. * Assisted living communities  are rental retirement communities for independent seniors who need some assistance. A homelike atmosphere, three meals a day, maid, linen, and laundry service, availability of a registered nurse, and many personal care services are provided in the all-inclusive rent. * Rental retirement communities  with fee-f or-service nursing units charge residents an entrance fee plus a substantial monthly rent. When the need for nursing care arises, residents pay an extra daily fee and stay in a nursing unit, usually located on site or nearby. Life care or continuing care communities  provide a continuum of care from independent living to nursing home care on the premises. The individual must be independent when s/he enters the community. These communities require a substantial entrance fee and monthly service fee. Residents get one meal a day in a dining room, maid service, linen service, maintenance, transportation to shopping and cultural events, travel planning, and a pull cord to an emergency nurse. If nursing care is needed, it is provided at no extra cost. Personal care homes (board and care)  are licensed in many communities to provide shelter, supervision, meals, and personal care to a small number of residents. * Subsidized housing for the elderly  is an option for the elderly poor in reasonably good health. Subsidized by Department of Housing and Urban Development, income limits apply. No round-the-clock care is provided but nurses come in to check blood pressure and assess a resident's functioning. Residents take meals in a dining room and may have use of a library, recreation area, or beauty shop. Nursing Facilities If the elderly person is not capable of independent living, a nursing home may be the appropriate option. Nursing homes offer two levels of care – skilled nursing and intermediate care – depending on the patient's needs. Most nursing homes offer both levels of care on a single site. * Skilled nursing facilities  provide 24-hour nursing services for people who have serious health care needs but do not require the intense level of care provided in a hospital. Rehabilitation services may also be provided. * Intermediate care facilities  provide less extensive health care than skilled nursing facilities. Nursing and rehabilitation services are provided but not on a 24-hour basis. These facilities are for people who cannot live alone but need a minimum of medical assistance and help with personal and/or social care. Paying for Long-Term Care It is important to understand the different types of insurance that are available to older people. Many people believe that Medicare will cover long-term care needs. It will not. Medicare Medicare is a Federal health insurance program which helps defray many of the medical expenses of most Americans over the age of 65. Medicare has two parts: (Part A) Hospital Insurance  helps pay the cost of inpatient hospital care. The number of days in the hospital paid for by Medicare is governed by a system based upon patient diagnosis and medical necessity for hospital care. Once it is no longer medically necessary for the person to remain in the hospital, the physician will begin the discharge process. If the person or the family disagrees with this decision, they may appeal to the state's Peer Review Organization. Medicare  does not  pay for custodial care or nursing home care. It will, however, cover up to 60 days in a nursing home as part of convalescence after hospitalization. (Part B) Medical Insurance  pays for many medically necessary doctors' services, outpatient services, and some other medical services. Enrollees pay a monthly premium. Medicaid Medicaid is a joint federal-state health care program for people with a low income. The program is administered by each state and the type of services covered differs. There are strict income requirements so it is necessary for the person to â€Å"spend down† all income and assets to poverty levels before becoming eligible. Medicaid is the major payer of nursing home care. The Medicaid requirement to â€Å"spend down† all income and assets created a great hardship for the spouse of a person needing nursing home care. Changes in the Medicaid rules now allow the spouse to keep a monthly income and some assets, including the primary residence. The amounts allowed change, so you must check for current levels. Other Insurance Why buy other insurance? The purchase of additional insurance gives the policy holder access to a greater choice of facilities without dipping into additional financial resources. Medigap  is the name given to rivately-purchased supplemental health insurance. It is designed to help cover some of the gaps in Medicare coverage but does not cover long-term care. Study Medigap policies carefully to be sure they provide the protection needed and do not duplicate other health insurance. Long-Term Care Insurance  is a private insurance that is usually either an indemnity policy or p art of an individual life insurance policy. An indemnity policy pays a set amount per day for nursing home or home health care. Under the life insurance policy, a certain percentage of the death benefit is paid for each month the policyholder requires long-term care. Policies are priced differently depending on the age of the policyholder, the deductible periods chosen, and indemnity value or duration of benefits. Information about other long-term insurance policies are available from: The American Foreign Service Association (AFSA) Retiree Liaison 2101 E Street, NW Washington, DC 20037 Tel:  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  202-338-4045  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  , ext. 528 Fax: 202-338-6820 E-mail:  [email  protected] org http://www. afsa. org American Foreign Service Protective Association (AFSPA) 1716 N Street, NW Washington, DC 20036 Tel:  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  202-833-4910 Fax: 202-883-4918 ttp://www. afspa. org As with Medigap health insurance, it is important to read the policy carefully and understand its restrictions before purchasing. Who Can Help? IQ: Information Quest (formerly LifeCare? ) IQ: Information Quest is a free 24-hour/ 7 days per week counseling, education and referral service t hat can help Department of State employees find the programs, providers, information, and resources they need to manage personal and professional responsibilities. IQ: Information Quest makes referrals, not recommendations. IQ: Information Quest counselors will help etermine what services are needed and available in any U. S. locality and refer to appropriate providers. In addition to other services, they provide referrals in the area of adult care services (anywhere in the U. S. ), including case management, emergency and respite care, home health care, long-distance care giving and legal and financial issues. Their web site features information on caring for an aging loved one, discussing caregiving options with your loved one, adult care information worksheet, caregivers of older adults, managing work while caring for your loved one, and geriatric care management services. IQ: Information Quest will also provide an â€Å"Eldercare Kit† upon request which features caregiving guidance, checklists, and resources information, as well as a few useful practical items such as a pill sorter, night light and jar opener. Permanent employees of the Department of State, The U. S. Agency for International Development, the Department of Justice, the Department of Labor, and FMAs overseas are eligible to use IQ: Information Quest. For the Department of State, this includes both Civil Service and Foreign Service employees serving at any Department assignment location nationwide and worldwide. Other employees working for the Department are not covered at this time (contractors, Foreign Service Nationals, PITs, PSCs). Spouses, children or others who are members of the employee's immediate household may use IQ: Information Quest. They verify eligibility by providing the name and date of birth (month and day) of the eligible employee. Employees of agencies other than the Department of State should check with their headquarters for guidance in how to contact and use IQ: Information Quest services. IQ: Information Quest Tel:  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  1-800-222-0364  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  or  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  1-888-222-0364  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  for the hearing impaired http://www. worklife4you. com For access to the passworded area of the site, contact your agency's HR Bureau. The Employee Consultation Service (ECS) The Employee Consultation Service (ECS) at the Department of State should be the first stop for Foreign Service members with eldercare concerns. The clinical social workers offer brief counseling and help in coordinating an evaluation and assessment anywhere in the United States. ECS social workers act as a liaison in providing appropriate and necessary services for the elderly. All services are free and confidential. In Washington, make an appointment for a personal consultation; from overseas write or cable for advice. ECS also conducts support groups for employees and their families who are responsible for an aging relative. The groups meet at the State Department to share issues, resources, and approaches to the problems that arise as an elderly person declines, including the issue of emotional stress that occurs for family members watching such decline. Employee Consultation Service (M/MED/ECS) Columbia Plaza, Room H246 Washington, DC 20520 Tel:  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  202-663-1815 FAX: 202-663-1456 Email:  [email  protected] gov The Administration on Aging (AoA) The Administration on Aging (AoA) is part of the U. S. Department of Health and Human Services. It was set up to â€Å"remove barriers to the economic and personal independence of older persons and to assure the availability of a range of appropriate community and family based services for older persons in social or economic need. AoA supports a network of the state and  Area Agencies on Aging  that reinforce and supplement the daily support that the elderly receive from family, friends, and neighbors. Administration on Aging Department of Health and Human Services 330 Independence Avenue, SW Washington, DC 20201 Tel:  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  202-619-0724 http://www. aoa. gov To get information on eldercare servi ces in a particular community, contact the Area Agency on Aging. One can locate a specific state agency on aging through the Eldercare Locator Service via telephone (  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  1-800-677-1116  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  ) or the website at  http://www. ldercare. gov. The  Eldercare Locator Service  is sponsored by the AoA and operated by the National Association of Area Agencies on Aging. National Association of Area Agencies on Aging 927 15th Street, NW Washington, DC 20005 Tele:  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  202-296-8130 http://www. n4a. org Services provided by Area Agencies on Aging include information and referral, homemaker/home health aides, transportation, congregate and home delivered meals, chore and other supportive services. Types of services available vary in each community based upon needs and resources. Private Geriatric Care Managers Private geriatric care managers are professional social workers and nurses who assist the elderly and their families by assessing need, coordinating services, and monitoring care for a fee. They are particularly helpful when long-distance care giving is necessary. Fees vary and are sometimes covered by Medicare or private insurance. The Department of State's Employee Consultation Service or IQ: Information Quest, the local Area Agency on Aging, and community agencies can provide referrals nationwide. If the older person has been hospitalized, hospital discharge planners can also provide information and referrals for after-care. Services Offered by the Private Sector Some private companies have set up programs to help their employees with eldercare. Foreign Service spouses who work in the private sector should investigate any eldercare options offered by their employers. These programs can include seed money for eldercare services, flexible work schedules for caregivers, subsidies for eldercare expenses, unpaid leave for up to a year, referral services, inter-generational day care centers (for both the elderly and children), geriatric assessment and case management, and group rates for long-term care insurance. Unfortunately, many of the services provided by companies require that the elderly person meet the tax-law definition of a dependent. This increases the burden for families whose elderly relatives are not financially dependent or who are not living with the employee. Eldercare in the Foreign Service Putting Parents on Your Orders Foreign Service employees may request that their elderly relative(s) (including step parents and legally adopted parents) be approved as an eligible family member and added to their Post Assignment Travel Orders for an overseas assignment. The employee must complete an OF-126 Foreign Service Residence and Dependency Report. This form can be found on the Department of State Infoforms with instructions on completion. Each new OF-126 replaces the old OF-126, therefore all blocks must be filled out each time a new OF-126 is done. The new OF-126 must be forwarded to the employee's personnel technician in HR/CDA/ASD, Room 2419, Truman Building (Main State). Travel orders can not be authorized for newly-acquired eligible family members until the personnel technician receives the OF-126 form. Along with a completed OF-126 form, the officer must prove that the relative is at least 51 percent dependent for support (subject to review and approval per 6 FAM 117; USAID employees should also see Supplement 1B to HB 32, Chapter 1). The officer must quantify that he/she has provided more than 51% of support by submitting an affidavit or notarized statement testifying to that fact. This is termed passing the â€Å"financial support test. † An explanation regarding the parent's residency is also required, with an explanation as to why the application is being made to add the parent to the travel orders. Other documentary evidence may be required by the employee's agency. These documents are attached to the completed OF-126 form and sent to the officer's agency as specified on the forms. Requests are reviewed for approval by a Personnel OF-126 Committee. Employees of the Department of State can obtain advice on how to put your parents on your orders through the Career Development and Assignments (CDA) division of the Bureau of Human Resources. Ask for an Assignments Support (CDA/AS) officer. Employees of other agencies should contact their HR representative. See section below, Taking an Elderly Relative to Post, for details regarding official government support. Bringing Parents to Post Who Are Not on Your Orders If your relatives are not financially dependent on you, they may come to post as members of the employee's household, but will receive no official support from the U. S. Government. No official support translates into no access to the U. S. embassy health unit, no airfare or allowance payments in the case of evacuation from post, and no diplomatic status with the host country. Parents who come to live overseas for an extended period of time should consider having additional medical insurance (Medicare does not cover costs related to care overseas). In addition, parents should also maintain Air Medical Evacuation Insurance. A list of companies that provide this insurance can be found on theDepartment of State Consular Affairs  web site. Family Medical Leave Act and Family-Friendly Leave If you think you may need to care for an elderly relative, be sure to check the provisions of the 1993 Family Leave Act on taking leave for this purpose and contact the a leave specialist in your agency. Department of State employees can contact a Department leave specialist in the Office of Employee Relations (HR/ER/WLP) about paid and unpaid leave at  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  202-261-8180  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  . Eldercare Emergency Visitation Travel (Eldercare EVT) In January 2001, the Eldercare Emergency Visitation Travel (Eldercare EVT) provision was implemented, permitting travel at government expense for employees and eligible spouses serving at an overseas post who need to assist parents in declining health. Eldercare EVT allows an employee two trips over a career to visit his or her parents. It is meant to support one mother and one father of the employee and of the eligible spouse. It does not mean a couple may pool their four eldercare visits to assist the parent(s) of only one member of the married couple. For more information, email the Family Liaison Office ([email  protected] gov) for a copy of â€Å"Questions and Answers on Eldercare Emergency Visitation Travel. † Taking an Elderly Relative to Post If elderly relatives are classified as eligible family members, they travel on diplomatic passports and have the same diplomatic immunity as a spouse or child. If not classified as such, elderly parents use tourist passports and do not have diplomatic status. Housing assignments are based on the number of official eligible family members the employee brings to post. Travel to and from post (with the exception of medical travel) is also available to all elderly parents designated as eligible family members. Elderly parents, regardless of their status, are  not covered  by the Foreign Service medical insurance program. While the use of post's health facilities is not promised as a benefit, these limited facilities are sometimes available depending on the location and an authorization by the Ambassador. The medical officer has the authority to refuse to provide services should a patient have a complicated problem that the physician is unable to treat. Employees may, however, ask the Health Unit for names of local physicians who can provide medical services for their elderly parent. This kind of assistance from the Health Unit may also be requested during the bidding process, to determine if a post has adequate local heath care providers to meet the medical needs of a parent. The Department of State Office of Medical Services has a brochure entitled  Medical Questions and Answers about Taking Your Parent Overseas. The brochure addresses the questions of obtaining prescription medicines overseas, high altitude climates and the elderly, health unit access, hospitalization overseas, and more. For a copy of the brochure or more information about medical questions related to taking your parent overseas, contact the Office of Medical Services, Foreign Programs (MED/FP). Because elderly parents are not covered under the Foreign Service medical insurance program, they also do not have access to embassy medical evacuation (medevac) services. Therefore, all parents coming to post for either a short or an extended period of time should purchase (and maintain) Air Medical Evacuation Insurance. A list of companies that provide this insurance can be found on the  Department of State Consular Affairs website. Medical Insurance It is essential that a parent going overseas, either officially or unofficially, have adequate medical insurance. Medicare only pays medical expenses in the United States, and in Canada and Mexico under certain very limited circumstances. The insurance companies listed below provide a variety of coverage and can be contacted for more information. Pay special attention to â€Å"age limit† noted in the policy. Clements and Company Under its GlobalCare Plus program, Clements and Company provides overseas major medical insurance, including full world-wide evacuation services. Coverage is offered for individuals as well as families. Substantial coverage is available at a reasonable cost. GlobalCare Plus is for policies lasting 6 months to one year. Clements also write policies for shorter-term travel (15 days to 4 months) through Patriot Travel Medical Insurance.