Islam gave preference to men over women Research Paper

Islam gave preference to men over women - Research Paper Example In that case a burqa is a pagan invention, the pre-Islamic, preserved in some Muslim countries due to practical needs: protecting from the desert wind, carrying sand, protecting from the looks of men-strangers. By the way, the Arabs adhere increasingly the fourth verses of the Koran, which says to be married only on one woman, if the man has no possibility to satisfy her needs. Here we are talking about equality in property. In marriage, woman has the right to choose her husband. She can require the signing of a pre-nuptial agreement with her husband-to-be (Bakhtiar Web). The possibility of polygamy is provided in exceptional cases. For example, if a woman can`t have children, if there is a psychological or sexual incompatibility with her husband. The man is allowed to continue living with the first family and marries a second time. However the percentage of such marriages is extremely low in the Muslim countries, and on those territories, where women are more emancipated, like Syria, Jordan, Iraq, polygamy is practically absent, with rare exceptions. If we talk about the different rooms during praying in the mosques, it is arranged for the purpose that man must not see her in the position of committing Sujud (prostration during prayer). By the way, in many mosques women`s half of territory is carpeted or has heated floors. We have also another interesting fact. When a woman from a Muslim family goes to work, then all her salary arrives into her pocket, bypassing the so-called â€Å"family† budget. This point shows us that a Muslim woman can have even more rights in some cases than Christian one (â€Å"Women Laws† 40). Religion of Islam claims that a woman - as well as man - has a will, freedom of action and spirituality, and it considers her ability to achieve true perfection and happiness. Quran puts woman on a par with a man and refers to both at the same level (Roald 213). With this statement Islam destroys the ideology of the allegations

Mara Guevarra Personal Statement Example | Topics and Well Written Essays - 2000 words

Mara Guevarra - Personal Statement Example I never heard her judge anybody nor heard her complain about any problem. I never saw her cry. I guess that was her strength- the ability to hide her feelings. After two years, Mara got to be separated from her friends. She had to transfer to another school because of financial problems. All the times that we were together, she was not mentioning any problem. I could see in her eyes the sadness, but still, no tears dropped from her eyes and instead she said, "I will miss you guys, I will surely miss my pets." Still cracking joke despite of loneliness and still, trying to cover her emotion. The communication with her friends was constant but it was not like before wherein, she could saw them regularly and talk to them physically anytime she wanted to. She gained new friends on her new school but her friendship to her old friends remained the same. She chose to celebrate with us, her old friends, right after the graduation ceremony. I told her that I was so proud of her. I was not expecting her reply: "No problem can hinder me from achieving my goals. I need to fight and survive because in the end, I know I will always win. "That is such an optimistic and strong remark coming from a person that I once perceived as happy-go-lucky. Mara attended a party where he met Robert. He got Mara's cellular phone number from her friend and he started courting her. At first, Mara did not like him because he is under-graduate. But because of Robert perseverance and everyday sending of flowers, she fell in love with him and decided to accept the love that Robert was offering her. The relationship, at first, was fine. They are getting along and having fun just by doing simple things like watching movies together and spending time talking "anything under the sun." After three months, she discovered Robert's weakness. He loves hanging out with friends just to drink alcohol. Such weakness of him became their problem. They fought every now and then. One night, they had a big fight .She got out of control and she slapped him on his face. Robert being drunk and so angry hit her on her stomach. That was when she finally decided to break up with him. The first round of their story lasted for four years. HER DARKEST MOMENT Mara was so depressed with what happened to their relationship. She tried to forget Robert by having relationship with different guys. Robert on the other hand, was doing his best to win Mara back. Mara resigned from her work and in her new company, she met James. They had a relationship but he was not serious with herand she knew that. They were having premarital sex and unfortunately, Mara got pregnant. James denied being the father of her baby. She was terminated due to immoral act. She did not know where to get money for her needs. Robert was still there waiting for Mara's acceptance. When he found out her condition, he asked Mara to marry him and he will shoulder all the responsibility as his husband and as a father to her

Clinical Risk Management Health And Social Care Essay

Clinical Risk Management Health And Social Care Essay The aim of this essay to provide the reader with insight to the term clinical risk management and how this is implemented within NHS trusts focusing particularly on the role of Pharmacists in doing this. Objectives: Defining clinical risk management and discussing its importance Discussing ways in which trusts implement clinical risk management Defining what is a medication error and identifying the role of the pharmacist to reduce these Discussing systems or processes in place in my base hospital to reduce medication errors 1.0 Importance of clinical risk management Clinical governance was first mentioned in British Health policy in 1997 as a term used to describe the accountability processes for clinical quality of care. It evolved as a system to address and respond to a series of high profile media cases highlighting poor quality patient care as revealed in the Nottingham IT vincristine disaster, Bristol Heart surgery, Shimpan and Alder Hey organ retention. During I997 in England, the Department of Health published the white paper the New NHS; modern, dependable which introduced Clinical governance as a method of accounting for clinical quality in health care but really came to prominence in 1998 when Scally and Donaldson appraised Clinical governance and the drive for quality improvement in the NHS   in the British Medical Journal. The paper highlighted four components of quality as initially identified by the World Health Organisation: Professional performance (technical quality) Resource use (efficiency) Risk management (risk of injury or illness associated with the service provided) Patient satisfaction with the service provided. Majority of NHS care is of a very high standard and in comparison to the high volume of care provided on a daily basis in hospital and community, incidence of serious failures are uncommon.1 However when they do occur, they have devastating consequences for individual patients and families.1 Greater patient expectations, knowledge and media exposure of high profile cases have resulted in the NHS being scrutinized focusing on its policies of operation, facilities and operating culture. It is estimated that an average of 850,000 adverse events may occur in the NHS hospital sector each year resulting in a  £2billion direct cost in additional hospital days alone.1 Poor clinical performance results in patient harm and loss of patients confidence in the NHS services as well as an increase in litigation costs.4 In 2009/10, 6,652 claims of clinical negligence and 4,074 claims of non-clinical negligence against NHS bodies were received by the NHS Litigation Authority, up from 6,088 claims of clinical negligence and 3,743 claims of non-clinical negligence in 2008/09.4  £787 million was paid in connection with clinical negligence claims during 2009/10, up from  £769 million in 2008/09.4 Errors are discussed as either human or systematic in the Department of Health document An organisation with a memory. As an NHS organisation the focus is systematic, a more holistic approach when dealing with errors. This approach recognises the importance of resilience within organisations and that errors result as a number of interacting factors and failures within the system.1 NHS Quality Improvement Scotland (NHS QIS) clinical governance and risk management standards define risk management as the: Systematic identification and treatment of risk Continuous process of reducing risk to organisations and individuals alike Culture, processes and structures that are directed towards realising potential opportunities whilst managing adverse events In the past, clinical risk management was poorly managed in the NHS. There were no individuals designated to manage risk management, incident reporting in primary care was largely ignored, there was no standard approach to incident investigation, and existing systems did not facilitate learning across the NHS.1 In the 1990s there was a concerted drive to develop risk management and risk management within NHS organisations.1 Following on from this there has been an increased awareness of the cause of medication errors in NHS trusts and how these can be prevented.1 In 2000, the government made a commitment to reduce the rate of serious errors by 40%. The advances in technology and knowledge in recent decades has resulted in a more complex healthcare system.2 This complexity carries risks and evidence indicates that things do and will go wrong in the NHS sometimes resulting in patient harm.2 The NHS quality improvement strategy1 encompasses; Clear national quality standards; NICE, NSF Dependable local delivery; systems of clinical governance in NHS organisations Strong monitoring mechanisms; a new statutory commission for health improvement, an NHS performance assessment framework, and a national survey of NHS patient and user experience. It is hoped adaptation of these approaches in individual NHS organisations should have a positive impact on the development to detect, prevent and learn from system failures at a local level.1 The introduction of clinical governance provides NHS organisations with a powerful imperative to focus on tackling adverse health care events1. The time is right for a fundamental re-thinking of the way that the NHS approaches the challenges of learning from an adverse health care event.1 2.0 Implementing Risk Management within NHS trusts The Department of Health publication An organisation with a memory facilitated the patient safety movement in the NHS.2 It proposed solutions to risk management incidences through a culture of openness, reporting and safety consciousness within NHS organisations.2 Four Key areas highlighted from this report were:2 Unified mechanisms for reporting and analysis when things go wrong; A more open culture in which incidents or service failures can be reported and discussed; Systems and monitoring processes to ensure that where lessons are identified the necessary changes are put into practice; A much wider appreciation of the value of the systems approach in preventing, analyzing and learning from patient safety incidents. In response to an organisation with a memory, the Government report Building a safer NHS for patients focuses on how to implement these recommendations2. It outlined a blueprint for a national Incident reporting system and discussed the role of the National Patient Safety Agency (NPSA).2 The NPSA was set up by the Department of Health in 2001 with the aim of preventing harm from high risk medicines. The NPSA produced the National Incident reporting and Learning system (NRLS) to set priorities, develop and disseminate actionable learning following reports of patient safety incidents. Following this guidance all NHS trusts should have a risk management strategy in place. This includes systems for the identification of all risks which may compromise delivery of patient care. To aid with this trusts are obliged to deliver patient services in compliance with statutory regulations according to national and local requirements highlighting the level and quality of services required. The implementation of risk management policies within NHS trusts will be overseen by Clinical Governance managers and Risk managers4. Trust Risk management strategies will need to be regularly reviewed and audited; individual trusts will have Risk Managers within each department to oversee this4. The Trust Board will ensure that risk management, quality and safety receive priority and the necessary resources within budgets. Pharmacy departments will have a medicines management team comprising of a risk management pharmacist to implement risk management at a local level. The Risk management pharmacist will ensure staff are aware of risk management issues both locally and nationally and will update staff on actions to be taken to minimise risk thereby promoting compliance with external risk management standards. The risk management pharmacist will also need to ensure local risk management policies are kept up to date. In order to deliver the risk management agenda, individual trusts must meet the requirements of the NHS Litigation Authority Risk Management standards and the Care Quality Commission standards (CQC) from the Health and Social Act 2008. From April 2010, NHS providers will need to register with the CQC and provide proof of adherence to standards set by the CQC5. 2.1 National Patient safety agency and National Reporting Learning System In 2001, following the publication of the Department of Health document and Organisation with a Memory1 the National Patient safety agency (NPSA) was set up. The introduction of the NPSA has for the first time provided a systematic focus on medication safety6. The aim of the NPSA is to lead and contribute to improved, safe patient care by informing, supporting and influencing organisations and people working in the health sector with one core purpose to improve patient safety by reducing the risk of harm through error7. The NPSAs initiative was to identify patterns and trends in avoidable adverse events so that the NHS could implement changes to prevent these incidents from reoccurring. The NPSA will 2, 8: Collect and analyze information an adverse events in the NHS Assimilate other safety-related information from a variety of existing reporting systems Learn lessons and ensure that they are fed back into practice Where risks are identified, produce solutions to prevent harm, specify national goal and establish mechanisms to track progress The NPSA then went onto produce the National Incident Reporting and Learning system (NRLS) which aims to identify and reduce the risks to patients receiving NHS care and leads on national initiatives to improve patient safety. There are NHSLA risk management standards for each type of NHS health care organisation. The standards will address clinical and non-clinical health and safety risks.4 Individual trusts will be examined regularly and measured against standards to ensure a risk management strategy has been devised, it is in place throughout the trust, it is workable.4 This will minimise litigation costs resulting in more funds available to trusts to improve patient care; providing an incentive for better clinical and non-clinical risk management. The NRLS collects confidential data on medication errors from all NHS trusts in England and Wales and improves patient safety by enabling the NHS to learn from patient safety incidents8. This builds on incident reporting systems that were previously used on an adhoc basis in individual trusts. The NRLS reporting system has been designed to be compatible with local risk management systems that are used in majority of NHS organisations.2 NRLS reports are analyzed by clinicians and safety experts8 and key themes and trends contributing to patient safety incidents are identified.2 Steps are then taken to minimize these risks through the development and prioritisation of national solutions. Trusts reporting incidents regularly suggest a stronger organisational culture of safety.8 Encouraging staff to report clinical incidents affecting patient safety can help implement risk management strategies within NHS trusts. The more incident reports submitted the more data available to rapidly identify and act upon patient safety incidents. The NRLS suggests trusts should be submitting incident reports monthly.8 In pharmacy these will mostly involve incidents relating to medication errors. The development and promotion of the NHS fair blame culture encouraged error reporting reassuring staff the root causes of errors will be looked into. However, lack of awareness and fear of disciplinary action remain as some of the main barriers to incident reporting.8 To overcome this staff need to be adequately trained on when and how to report clinical incidents. At my base hospital, incident-reporting training is included in the trust induction and at a local pharmacy level as an in-house induction. Each trust incident is graded in accordance to standardised NPSA scoring systems; 1 being minor with no harm to patient ranging to catastrophic level 5 i.e. patient death. Following the completion of an online incident form, the risk lead for that particular area will receive a copy of the report. These reports will be analysed and appropriately graded and any serious incidents will then be reported to the Trust Board via the risk management committee. A report by the NPSA stated the most commonly reported medicine related incidents to be:8 Wrong dose, strength and frequency of medicines Wrong medicine Delayed and omitted doses Medicine related incidents will be reported to the Risk Management pharmacist who will provide feedback to the pharmacy team. All category 4 and 5 incidents have a full root-cause analysis performed and are submitted to the NRLS. These reports are then analysed by the NPSA, and if necessary rapid response alerts are produced.1, 8 Rapid response alerts act as a crucial means to focus the efforts of trust clinical risk managers into proven high risk areas.8 Delayed and omitted doses of medication led to the production of a recent rapid response alert. This alert was delivered to trusts by the NPSA via the NHSs Central Alerting system.8 On receipt of this alert, trusts were expected to respond and act upon requests contained within it within the specified deadline provided. Each alert contains instructions for regular audits in order to review the action taken. 3.0 Medication Errors Most medication are not without adverse effects and most side effects and adverse events are predictable, thus exposure to these adverse events can be minimised or avoided through careful prescribing and usage. Nevertheless some adverse effects are unpredictable and therefore unavoidable.6 However medication errors occurring as a result of mistakes or lapses when medications are prescribed dispensed or used are avoidable. These can be related to practice, procedures, products or systems. 6 Medication errors as defined by the NPSA are any preventable event(s) that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient or consumer. Such events may be related to professional practice, health care products, procedures and systems, including prescribing; order communication; product labeling, packaging and nomenclature; compounding; dispensing; distribution; administration; education; monitoring; and use. 10 Numerous studies have been conducted to investigate the incidence and outcomes of medication-related harm. A 2008 study conducted in an emergency department in Scotland found 2.7% of admissions were related to adverse drug reactions. 11 In 56.7% of cases the adverse drug reaction was the documented reason for admission but only 13.3% were considered to be unavoidable.11 Another study carried out by Charles Vincent reviewed more than 1000 records and found that 10.8% of patients experienced an adverse event and that half of these were preventable.12 It was found that a third of these adverse events led to either serious consequences or death.12 Medication errors also occur in other health care systems, and is estimated harmful errors occur in 1.8% of hospital admissions in the United States, leading to about 7,000 deaths each year.6 Similarly, an Australian study showed that 0.8% of inpatients suffered a harmful medication error.6 3.1 Why do medication errors occur? To be able to reduce the risk of medication errors, the cause of medication errors need to be understood.6 Previously medication errors were thought to be the sole responsibility of the individuals considered to be the cause of the error. However, now a more holistic approach is taken and it is acknowledged errors occur when both human and system factors interact in a chain of events often complex- resulting in an undesirable outcome.6 Not only the individual at fault but latent conditions within an organisation and triggering factors in clinical practice should also be considered as important causes of error as well.6 As Lucian Leape, the Physician and Professor at Harvan school of Public Health said: Human beings make mistakes because the systems, tasks and processes they work in are poorly designed. 6 Human factors result from the individual and may occur due to lack of training and education and lapses in concentration. System errors result from the running of the organisation and the lack of policies and procedures in place to reduce clinical risk. Recent experience shows in certain situations those safeguards have not been adequate and have failed to prevent serious error and harm to the patient.6 Active failures and latent conditions cause holes in the defence system to open up.6 The active failures occur as a result of unsafe practices of the people working with a system, examples include the prescriber failing to double check a prescription, or the pharmacist failing to identify an incorrect dose on a prescription.6 Latent conditions occur due to the structure of the organisation and its resources, management and processes in place.6 These either alone or in combination with an active failure, can lead to error. Examples include the lack of a computerised prescribing system with inbuilt systems to highlight an erroneous prescription or the lack of an effective communication system between primary and secondary care.6 3.2 The role of the pharmacist in managing medication errors Pharmacists as experts in medicines have an invaluable role in reducing medication errors. As a profession and specialists in the careful use of medicines we are best placed to minimise the risks associated with medication usage.12 The government safety of doses report recommended seven action points to improve medication safety. These are:13 Increase reporting and learning from medication incident. Implementation and audit of NPSA medication alerts guidance. Improve staff training and competence. Minimising dose errors. Ensure medicines not omitted. Ensure correct medicine correctly labeled gets to the patient. Document patient allergy status. The three areas of focus in medication error reduction for Pharmacists to detect and prevent are:12 Risk in the medicine itself. Risk in the manufacture, storage, and distribution of medicines. Risk in use of medicines. Pharmacy departments as a whole are similar to high quality manufacturing units and test each stage in the production, storage and distribution of medicines.12 Pharmacists are involved in almost all stages of the medication cycle from clinically checking of the prescription to the accuracy checking and final release of the medication dispensed. Within the pharmacy culture there is the expectation for errors to occur and consequently systems have been developed and put in place to minimise these.12 Examples of pharmacy services to reduce medication related errors in hospitals are:12 Checking of prescriptions and supplying of drugs. Ward drug charts. Use of our knowledge and pharmacokinetics to assess toxic and sub-therapeutic doses. Quality control and assurance measures. 3.2.1 Ward based Pharmacy services Pharmacy services at ward level were first proposed as a health policy in 1970 and have proven to detect and prevent prescribing errors.12 The role of the pharmacist is ever evolving and pharmacists are becoming recognised as an integral part of the multi-disciplinary team. The pharmacists role has moved on from the traditional supply role to a more clinical role allowing pharmacists to use their specialist knowledge surrounding medication use to reduce medication errors at ward level. Pharmacists are a lot more active at ward level and as such are now the first port of call for advice on medication by patients and other health care professionals. The pharmacists role also extends to medicines management and formulary development, medicines information and involvement in various dispensing stages. Throughout these different roles the pharmacists remain active in promoting safer practice and reduction of medication errors. 3.2.2 Medicines Reconciliation Medicines reconciliation is a process designed to ensure that all medication a patient is currently taking is correctly documented on admission and at each transfer of care. It encompasses: Collection Checking Communicating The National Institute for Health and Clinical Excellence (NICE) in collaboration with the NPSA issued guidance to ensure appropriate processes are in place to assure any medication patients are taking prior to admission is properly documented on admission to hospital.8 The NPSA reported the number of incidents of medication errors involving admission and discharge as 7070 with 2 fatalities and 30 that caused severe harm (figures from November 2003 and March 2007).8 An accurate medication history is necessary to aid safe prescribing. To improve medicines reconciliation at hospital admission NICE/NPSA has recommended that:8 pharmacists are involved in medicines reconciliation as soon as possible after admission the responsibilities of pharmacists and other staff in the medicines reconciliation process are clearly defined; these responsibilities may differ between clinical areas strategies are incorporated to obtain information about medications for people with communication difficulties. At my base hospital, medicines reconciliation involves doctors, nurses, pharmacists and pharmacy technicians. Systems and policies are in place to deliver medicines reconciliation in different areas of care and to ensure all staff involved in the medicines reconciliation process are accredited and adequately trained. 3.2.3 Education and Training At my base hospital information regarding clinical risk management is widely accessible to all staff through a variety of sources; alongside co-operate clinical mandatory training sessions and in-house local training sessions, a wide variety of information is available on the local trust intranet. These include a governance newsletter entitled Lessons Learned detailing adverse events which have occurred and steps taken to prevent reoccurrence of such events, risk management manuals available on-line and the NPSA patient safety literature. At a local pharmacy level, the monthly medicines management bulletin includes medication safety updates and is distributed to all pharmacy staff. As well as these measures education and training to other health care professionals and patients on medication is paramount. Pharmacists are the professionals best placed to do this. The Central Manchester Foundation Trust took part in a prescribing error audit known as the EQUIP study. This showed pharmacists as experts in medicines held invaluable knowledge and through organised education programmes can help reduce medication errors.14 The main cause of prescribing errors amongst newly qualified medical staff was simply due to lack of knowledge regarding medicines.14 Results demonstrated the need for pharmacists at ward based level and the prevention of potentially serious medication errors through their presence on the ward.14 Pharmacists on wards gave medical staff immediate access to advice regarding dosing, interactions and therapeutic monitoring of drugs.14 Pharmacists are also more likely to complete incident reports involving medicines and should encourage other staff to do the same. Ensuring staff are aware the only way to improve the systems in place is to learn what we are doing wrong. Pharmacists are also involved in developing and delivering teaching sessions for various groups of staff. Examples included at my base hospital are VTE prophylaxis, IV drug calculations and monitoring for unfractionated heparin. All Pharmacists are encouraged to deliver and attend teaching sessions early on in their career. As well as educating medical staff, pharmacists counselling of patients in outpatients and at discharge will also aid reduction in medication errors. As well as delivering information and teaching packages, pharmacists need to ensure information provided is sufficient, easily accessible and up to date. Medicine information pharmacists will review how best to provide information for safe prescribing and drug administration.6 The formulation and dissemination of medicine policies and clinical guidelines by pharmacists contributes to risk management. Pharmacists also advice clinicians on risk issues arising from quality assurance reports e.g. NPSA, national and local clinical audit.4 3.3 Reduction in medication errors Medication errors occur due to a number of failures. Pharmacists clinically reviewing a prescription can detect and prevent prescribing errors, but prescribing is only one aspect of the medication cycle.7 Failures in the processes of reviewing, dispensing, administering and monitoring of medicines also occur.7 To overcome these adequate systems and checks to prevent medication errors need to be in place. Examples of such systems include:13 Effective communication Education of all health care professionals Integrated electronic care records Systems and policies in place for ordering, dispensing, administering and transporting in medicines Providing 24 hours medicines information services and support to medical staff Increase specialists staff, more training for junior staff from an undergraduate level and improved discharge procedures Development of information technology services and standardised electronic incident reporting systems 3.3.1 Information Technology The developments of technological systems have helped in the running of medicine based services and include automated dispensing systems and electronic prescribing. Similar packagings of medications by the same manufacture lead to frequent dispensing errors. The implementation of an automated dispensing robot in my trust has significantly reduced error rates through the incorrect selection of medication. It also minimises administration errors through the production of standard warning labels such as Methotrexate weekly dosing warnings, and reminders to attach penicillin containing stickers to relevant antibiotics. However, the system is not fool proof and as such errors still occur mainly due to over reliance causing staff to become deskilled. Near miss audits to identify potential errors are conducted regularly within my trust to highlight areas of concern and systems put in place to prevent these errors reoccurring. Implementation of electronic prescribing systems (medisec) for discharge and electronic dose calculator on our neonatal unit has also proven to reduce medication errors. Medication errors due to illegible handwriting no longer occur minimising risk of dispensing errors. The availability of drug name, dose, formulation and dosing schedule have also reduced the risk of medication errors.7 3.3.2 Medication safety at discharge Poor communication between different health care professionals can lead to medication errors at discharge. Medicines reconciliation on admission has proven to be useful in linking patients care at primary care and secondary care. However, more focus needs to be placed on ensuring community pharmacists and GPs are aware of changes to medication at the point of discharge. Improved communication will prevent GPs from prescribing drugs that are no longer indicated, contra-indicated or even duplicate drugs.7 The implementation of the electronic discharge system medisec and the automated electronic copy of the discharge summary detailing information regarding medication changes has proven to be a useful tool in improving communication to GPs, and maintaining the link between primary care and secondary care. In addition to this, patients receiving a copy of their discharge summary and being counseled on their medication at the point of discharge will contribute to reducing medication errors . 4.0 Conclusion The need to manage risks is particularly important in the NHS because of: Finite resource the NHS has a limited amount of money and staff to provide a service Complexity the service we provide is extremely complex because of both the size and nature of the task Expectation we strive to meet the expectations of an increasingly aware public Clinical Risk Management is an integral part of clinical governance and thus everyones business. Managers in all areas are responsible for ensuring that risks in the area are identified, monitored and controlled in line with the Trusts Risk Management Strategy. This will contribute to improved delivery of services by providing a structured approach to decision-making. . All staff working in the NHS have a responsibility to be aware of and implement risk management within their individual job roles. The development of technology, systems and processes and education of all staff will be the key to implement clinical risk management at local and national levels in individual trusts. Word count: 4,338

Natural Born Killers :: essays papers

Natural Born Killers Violence is a constant on our screens whether it be an anvil falling on a cartoon character, a war zone on the news, a fight in an action movie or a pub brawl in a soap opera. But does this screen violence produce behavioural effects in the viewers? This is one of the most frequent and heatedly debated arguments in mass media. Is it the case that audiences are effected by what they see and that the producers of media texts are instigating or increasing violent behaviour, or do audiences have the ability to understand what they have seen without being overly influenced? It has to be ascertained as to whether audiences are passive or active. This subject has caused controversy within several of different schools of thought and ideologies over the years. They have either wide or only slight variations of opinion so it is difficult to come to one definite conclusion as each one also has valid and understandable explanations. It is difficult to deny that 'the whole point of communicating is to influence one another by conveying information' (Vine, 1997), but to what extent does this influence take control? To investigate this matter and come to a conclusion as to whether or not screen violence does instigate violent behaviour in the reader, we will be critically looking at two of the major ideological models as well as using some specific media texts to validate and/or criticise these theories. First there is the Hypodermic Needle or Hypodermic Syringe effect. This theory has it's root in 1950's America when dominant businesses and the then government wanted to discover how far the public were influenced by what they saw on television. The Hypodermic Theory came from this Media Effects model, which had a heavy emphasis in psychology. Businesses and the government alike wanted to know how much 'media is supposedly 'injected' into the consciousness of an audience' via television (Price, 1993). They wanted to know if through this relatively new medium the public could be persuaded unquestioningly to, for example, vote for a certain political party or buy a specific brand of washing powder. The Hypodermic model proposes that the media has a very direct and extremely immediate effect on the general public, who accept the injected message without question due to their passiveness. It is the idea that producers of media texts can persuade us to do what ever they want and we will unquestionably comply. When we bring the subject of violence into this field, a follower of this ideology would say that the violent behaviour witnessed on screen would be influentially accepted by the audience without question.

Communication Worksheet Essay

In your own words, please answer the following questions. Each response should be written as an academic paragraph of at least 150 words. Be clear and concise, and be sure to explain your answers. If you cite any sources, use APA format. Paragraph QUESTIONS 1. WHAT IS THE TEXTBOOK DEFINITION OF COMMUNICATION? WHAT DOES COMMUNICATION MEAN TO YOU PERSONALLY? GIVE AN EXAMPLE. (150 WORDS) Answers will vary. †¢ The textbook definition of communication is a social process in which individuals employ symbols to establish and interpret meaning in their environment (â€Å"West-Turner: Introducing Communication Theory,† 2004). With that being stated, communication is more than just speaking, typing, or texting and even signing. Real communication involves listening and paying attention to what the other person or group of people are expressing. Real communication is about response, give and take. In any real conversation we are all both teachers and learners. Real communication entails being open and honest. It shows the other person something about â€Å"who I am† on the inside. But if I really want the other person to pay attention and understand my message, I need to speak peacefully and quietly and directly. No one can really hear and understand anything when people are angry and shouting and looking all over the place. 1. Describe the differences between linear, interactional, and transactional. (150 words) Answers will vary. †¢ When it comes to communication, the differences between linear, interactional, and transactional communication are very different but are  also required for one another to work properly. Linear communication is a one-way street used for communication. It consists of the sender encoding a message and channeling it to the receiver in the presence of noise. There is an assumption that there is a clear beginning and end to this type of communication with no feedback from the receiver (â€Å"West-Turner: Introducing Communication Theory,† 2004). For example sending an email, text message, or giving a lecture. Interactional communication builds upon the linear communication model. It is a two-way street in which the sender channels a message to the receiver and the receiver becomes the sender and channels a message back to the original receiver(â€Å"West-Turner: Introducing Communication Theory,† 2004). This model has added feedback and field experience. Cultural b ackgrounds, ethnicity, location, and personal experiences play a major role in interactional communication. For example sending a text message to a receiver and the original sender having to wait for a text message back. Finally, transactional communication notices that each and every one of us is a sender and a receiver combined. It also notices that all parties involved in the communication are affected in some shape or form. The transactional communication method shows that communication is fluid and simultaneous (â€Å"West-Turner: Introducing Communication Theory,† 2004) and that most conversations are alike. It takes into consideration how each and every one of us interprets the data from the conversations, thus both parties being able to share the same meaning. For example friends talking and listening. While one friend is talking the others are constantly giving feedback on what they think or feel through facial expression or verbal feedback without stopping the original friend from talking.

Retail Sector in Uk

THE UK RETAIL SECTOR Retailing is one of the major economic sectors of United Kingdom, with retail sales of ? 221 billion, employing around 3 million people and operating over 300,000 shops. Within the sector there is a scale polarisation at both the business and the store level. The leading retailers are huge, multinational businesses which dominate the sector. They operate a range of stores from major hypermarkets and supercentres through to small convenience stores. Retailing is also significant it its social dimension as well.Whilst economically retailing bridges production and consumption, in social terms it effects most of the population every day. It is the rare person who does not go shopping, or indeed has not worked in retailing or been involved in it in some way. For some, retailers offer their major social intercourse of the day or week and act as a social network, setting or centre. The quality of UK retailing and its locations thus has both an economic and a social bear ing on the perceptions of the country.COMPETITIVE ANALYSIS 1. 1 Political Structure and Trends The activities of retailers and thus shoppers are affected by the political structure and trends in a number of ways. It would be wrong, however, to see this as a direct relationship derived through a body of legislation specifically targeted at retailing or shopping. Instead, trends in retailing and shopping are more dependent on a number of national debates and initiatives that have been developed recently by various levels in the political process.The main direct effect that politicians have on retailing and shopping is through their exercise of power over location through the levers of the land-use planning system. Whilst land-use planning is a local authority activity, national government can intervene to provide directions and guidance on the assessment of development opportunities and proposals. Whilst land-use planning towards retailing in the 1980s allowed decentralised activity, since the early 1990s there has been a growing consensus on the tightening of restrictions on off-centre and green field evelopment. Thus it has become much harder to obtain planning permission for developments away from existing town centres and newer forms of retailing such as factory outlet centres and regional shopping centres have become harder to accommodate. This consensus has emerged through a general concern with the health of town centres and a desire to see town centres as vital and viable parts of the urban structure, fulfilling traditional nodal activities, including providing a focus for shopping.Whilst land-use planning affects the location of retailing, other instruments of government can affect the operations of the business, although as we note there is no overall retail trading legislation. Instead, shoppers are affected by a battery of public policy which attempts variously to regulate competition, safeguard consumer interests and to regulate trading conditions. Recent changes in this arena have seen an easing of restrictions on trading hours for example but a strengthening of powers over retail selling and employment practices. Concerns over public health have led to tighter regulation on food stores.In essence the approach could be summed up as ensuring that retailers do their jobs properly and that there is as much a level playing field as possible. Again there is no reason to suspect that this will change, though the scale of the legislation will change as globalisation continues in this market. Big retailers will be created on a pan-European level and will be subjected to standard operating conditions across for example Europe, which safeguard consumer interests. The European dimension obviously has another political aspect as well, most notably in terms of the Euro.Whilst decisions about the Euro are beyond this report, retailers as a key service sector, will have to deal with its introduction (or not). For some this is already antici pated through their acceptance of Euros in the UK, their Irish and continental European experiences and in their forward planning of technological (eg POS) investment. Smaller retailers in particular however may be less prepared for any positive decision. Overall there will be costs in implementation, as well as potential trading disruption depending on timing of introduction. 1. 2 Economic Structures and TrendsTo a considerable extent, the economic structures and trends driver for change operates at such a macro-level of the economy that it is very hard to consider it in any detail. The general economic position of the country will condition to a great extent the outcomes retailers experience from the shopping activity. Thus the volume and value of retail sales is of importance in this arena, but it is hard to be certain of magnitudes looking forward. Political policy can have an impact by its promotion of certain sectors and locations in the economy, in pursuit for example of grea ter social inclusion and a fairer distribution of wealth.However alternative policies could equally be considered. The economic structure also has an affect on the retail landscape through the encouragement or otherwise of the construction of landscapes for consumption. Businesses have to be willing to invest in the built environment and to feel comfortable that such investments will make a return. Probably the only safe assumption to be made is that the broad economic structures will remain in place and that in the future Britain will be economically approximately ranked similarly to where it is now in the world.Taking this assumption, then it would seem that we can expect many of the trends we have seen in recent years to continue. Thus, there would seem to be scope for further growth in retail sales, if we take a broad definition of retailing. There will be developers wishing to invest in the UK in commercial property, but much of this development may take the form of redevelopme nt or enhancement of existing locations. The exceptions to this might be purpose built new facilities in areas of identified deprivation, though the exact form of these facilities will be open to question.The economic structure has an impact on retailers and retail structure. British retailing is dominated by large corporate chains, many of which are head-quartered outside the country. Whilst there is in a sense a requirement to improve local knowledge to meet consumer needs, large retailers have demonstrated that computing power can be used to understand markets. Knowledge management becomes a key element in the future economy. There does not seem therefore to be any particular reason why current trends towards bigger and foreign retailers (eg.Wal-Mart) dominating more of the market should not continue, although they will probably structure some of their activities on a national (ie. local) basis. There will be opportunities for local and new retailers, but overall the market struc ture is likely to remain dominated by such big and increasingly global players. The interaction of the political will and the economic situation of the country and locations and individuals within the country will be important in determining the affluence of otherwise of the population, and thus the attractiveness of sites for retailers.This personal disposable income is critical to the future of locations, though it is tempered by the aspirations and lifestyle choices, and the costs of these eg. monthly rental of satellite television reduces out-of-home shopping. Most recently there has been announced major investment in the country’s infrastructure, funded in part by increased tax and NI revenues. This could affect perceptions of affluence and personal disposable income for years to come. More worryingly perhaps is the possible pensions timebomb which is currently being exposed through the switch out of final-salary schemes.Continuing concerns over mortgage payments based u pon endowment policies and the high level of credit in the economy reinforce these worries. Socio-Cultural and Lifestyle Aspirations Changing socio-cultural and lifestyle considerations have fuelled much of the change in shopping and retailing in recent years. Attitudes and beliefs as well as wants and needs have been transformed. They continue to develop and further change can be expected. In particular, attitudes to work and leisure are worth identifying separately as they are potentially so important.Modern consumers are a mass of contradictions, many of which are inexplicable on any rational basis. Some travel miles by car, damaging the environment, to refill a plastic bottle which costs virtually nothing, or to place bottles in a bottlebank located on a superstore car park. Branded products with a conspicuous logo are purchased in preference to identical generic products selling at a vastly reduced price. People pay 50% more for a 30% smaller microwaveable pot of baked beans ra ther than have to open a tin and heat the product ‘normally’.Ready-washed salads or chopped vegetables in their millions are purchased to ‘save time’ or to cover up for lost culinary ‘skills’. Understanding and predicting change in this arena is therefore a little difficult. What can be said is that there is a tension in this aspect of shopping. On the one hand consumers have ever broader experiences and expectations that have been increased by their exposure to new events, horizons, ways of doing things etc. So holiday experiences are brought back and combined with UK products and behaviours. Things that are seen in TV programmes become available in local stores.On the other hand, the very nature of the global experience, particularly through leisure products such as TV and cinema, tends to reduce things to the lowest common denominator – Pringles, Coke, Gap, Nike – and it is no coincidence that the majority of exemplars are Amer ican. This differentiation/similarity paradox will also emerge in other ways, and in particular in terms of the attitudes and belief statements of individuals and the way they translate these into shopping actions. Single-issue causes are fundamentally important now and look set to remain a force.Attitudes to corporate or government activities may lead to both small-scale individual behaviour changes but possibly to more aggregate corporate behaviour changing movements. The ‘battle’ over GM foods and the rapid development of organic food sales are examples of the start of this rather than the end. Consumers and businesses will spend a lot of time in the future working out their positions on issues and changing behaviours appropriately. However, the number of individual positions by their very nature will outnumber choices available.This points to a continuing fragmentation of much of consumer demand, but overlain by certain common themes. For retailers, identifying thes e themes early will be critically important and reacting quickly will be vital. The issue of mobility is complicated. It is clear that people’s understanding of mobility has been transformed in a number of directions. The overall perception of mobility has extended significantly. This extension is both in terms of the mental view of locations and travel and a dramatic extension of what may be possible and also a willingness and ability to actually travel.The location of holidays and the influence this has on price perception and product purchase is one example of this. The willingness to travel longer distances to shop on a regular or an irregular (shopping centres) basis is another. It is also the case that as we are spending more time ‘on the move’, our needs in consumption terms have changed. We need to be able to consume as we go (food, music, information etc) and retailers have changed locations, products and shop formats to adjust to this. 1. 4 Demographic Structures and TrendsShopping and retailing are obviously heavily dependent on people, both as an industry, but also as the basic consuming unit. Changes in the population structure and the location of this population, as well as the make-up of the households in which people live, are fundamentally important to retailers and to understanding the shopping future. For example, population growth in specific locations or of age-groups of people encourage or discourage retailers to construct the retail environment differently.The ‘baby-boomers’ or ‘Generation X’ concepts have their reality in the shopping behaviour each group carries out and the demand for experiences and products they exhibit. Similarly, the growth of children as consumers and acknowledgement of the spending power of the â€Å"tweenies† represent new foci for retailers and service providers. Similarly, the breakdown of the nuclear family and the rise of single person households changed t he consumption landscape, both in non-food because of the absolute number of households, but also in food due to pack size issues and so on.More but smaller households will have an effect on the type of products and services purchased and the shopping trips undertaken. In short, understanding likely future demographic structures and trends provides a good base from which to examine future shopping, and because of the nature of population dynamics provides us with a solid foundation of understanding. New births notwithstanding, we have good estimates of population demography for the next twenty years.Population estimates for the UK suggest that there will be in the next twenty years an extra 4 million people in the country on the current base of 58 million. It is forecast that current trends will continue leading to a substantially older composition of the population than at present. There will be significant growth in the 45+ age groups, many of whom will be young in body and mind a nd will be able to finance their consumption (a group of time rich/cash rich). There is within this also an increase in the 75+ age group which will present significant issues for the delivery of shopping opportunities.The ageing of the population will present an opportunity to target older consumers, but it would seem to be likely that the differences within this group will be as great as differences between the 45+ age group and other groups. The ageing of the population has another dimension of interest to retailing. Retailing is a traditional user of young people and the workforce in retailing has been seen as being more youthful and transient than many other sectors. With a decline in the youth cohort and a large increase in older consumers, retailers are going to have to question their hiring policies.Some retailers have been aware of this for some time, but it is going to become a wider phenomenon. Older consumers are going to want to be served by older well-informed staff an d retailers are going to have to draw on this older workforce in order to keep their stores staffed in the first place. Willingness to work and the expectations of work for these groups may be much changed in the future. 1. 5 Product and Process Innovation Of all the drivers of change, the one that is most obviously in the news with respect to shopping and retailing is that of product, or more particularly, process innovation.The rapid development of the digital revolution, linked on occasions to the development of electronic commerce has caught the imagination of many, but perhaps blinded them to some of the pitfalls. Despite the fall from grace of the B2C Internet, most large retailers have a web site and are seriously exploring the opportunities or dangers of this new channel. The implications of this wave of experimentation for home delivery and for the very nature of retail organisations needs to be considered.In short, is the Internet the new way of shopping and retailing, whi ch will eventually conquer all, or is it a small additional channel of limited impact? Whilst it is crucial to consider the possible implication in this area, it is important to emphasise (unlike perhaps the UK Foresight process) that retail futures are not all technologically based or driven. Product innovation is almost impossible to predict due to the rapid development and innovation of technology and other components. There are some possible ‘straws in the wind’ associated with developments in miniaturisation, communications and digitisation.Books, videos, films and music may all be transformed by product changes associated with new mechanisms for making, storing and communicating such material. Beyond that however it is almost impossible to predict what new products will be around and futile to attempt to predict in any detail what we will be buying. Process innovation is however another matter. The process of shopping has for well over a century been composed of m ultiple channels, but process innovation in the form of e-retailing is challenging the balance amongst these channels, chiefly because the nature of the medium has changed.In addition, the current implementation of e-retailing has the scope to change the nature and cost structures of retail activities. The â€Å"traditional† model – in which the customer via self service undertakes most of the shopping tasks (and bears the costs) -changes with many tasks and the associated costs transferred to the retailer. The retail business economics of e-retailing differ from those of store based retailing. Predicting the extent of Internet or e-retailing take-off is foolhardy given the breadth of experimentation and the pace of change. It is however worth reflecting on the use to which the new format is being put.It would appear that e-retailing is being used in three different ways at least for shopping. First, there are sites and opportunities that are essentially price driven. The focus is on getting the cheapest price for the product. Secondly however some sites are being used to provide a form of service delivery. In this case, products are sought because they are special, unique, different or distinctive or because they are hard to find and thus a broad data source is needed. In short, the Internet can allow the breadth of retailing to be consulted more quickly than might otherwise be the case.It is possible to identify a third type of use, namely the time-saver, when basic components of shopping (provisioning? ) are routinised into some form of home delivery service. These three illustrations are themselves further (and this time ‘virtual’) examples of the categorisation of shopping behaviour outlined earlier. With the exception of downloadable digitised products such as video and music, most products purchased remotely will require some form of home delivery system. Shopping in the real world, with the exception of mail order places the onus for this aspect primarily on the consumer.However, Internet retailing separates these activities and thus reinforces the distinction between purchasing and obtaining. In order to obtain virtual purchased goods, home delivery points will probably be needed and solutions will need to be found to the problems of delivery timings, people absent deliveries and the like (though other solutions are possible focusing on local stores/distribution points). It is also the case that one of the conventionally perceived benefits of Internet retailing, namely the removal of many car journeys, might be obviated by the expansion of local home (or workplace) delivery services.In terms of process, the emergence of the Internet has also had effects ‘behind the scenes’. 1. 6 Environmental Changes and Trends The UK is a congested set of islands, although this can be overstated by those living in the South East of England. As such the environmental aspects of shopping and retailing are p articularly important given that the sector is a large user of land and the consumers are travellers to and from locations. Retailing of course is not only about consumers moving products, as shops are the commercial end of an entire supply chain.The way in which land is used for retailing and the retail supply chain have not remained static and there is good reason to presume that this will continue. Similarly the design and architecture of retail locations is not static and plays a considerable role in both the construction of the ‘feel’ of the retail location and experience and also, in environmental terms, its efficiency and effectiveness. Retailing uses land and locations for its physical activities. Consumers tend to travel to the store or shop components of this system.Space use by retailers has changed dramatically with broad trends towards the polarisation of shop size. In the main this has not led to any particular problems over space although many retailers h ave sought the prime locations. However some problems have been felt in secondary locations as concentration and competition effects have washed through the system. All the pressures being identified thus far suggest that there is not going to be a dramatic increase in space needs but rather that it is the quality of the space that will be most important. Current estimates of retail space, from CB Hillier Parker, suggests a stock of over 1. billion square feet of gross shop floorspace, which translates into 524 million square feet of net floorspace. Of the total gross floorspace 17. 7% is in â€Å"managed† retail environments (town and out-of-town shopping centres and retail warehouses), compared to 13. 5% in 1990 and 8% in 1980. Longer term however, it might be that existing space may be more problematical leading to either wholesale transformation or re-use as something else. Retail Sector Structure Size and Scope of Retail Sectors As has already been indicated, the definit ion of retailing has become more problematic.The horizontal and vertical blurring of activities and boundaries means that putting precise dimensions on the sector as a whole, and any component sub-sectors, is more difficult than before. Many examples of the issues abound, but we could for example contrast the coffee shop in the local Tesco, to the purchase of take-away sandwiches at Pret-a-Manager and the purchase of sushi for lunch at Sainsbury. Are they all retailing? Similarly Tesco sell pre-packaged insurance at the store but the same ‘product’ is available via the telephone and from banks and brokers. Where do we draw the line for retail sales?Even Delia Smith’s cookery programmes on the BBC could conceivably be seen as a retail activity, given the direct correlation between transmission and product purchase. The boundaries of retailing are highly blurred and volatile and government conceptualisations and statistics focused on product are not necessarily the most appropriate or helpful. There has been growth in product purchase, though of course in most cases the products themselves have not been static. New products have been introduced and dramatically changed categories, as computers replace typewriters and sunglasses, watches and fashion jewellery are sold by clothing chains.In non-food we can point to new products such as CDs and mobile phones, and in food ready meals would be a simple example. Furthermore in most product categories the range and choice available has expanded Organisational Structure and Competition As major retailers have grown in scale, so they have expanded their activities into new domains. With emerging scale has come a greater degree of knowledge and power in the channel. The pace of growth of retailers has been greater than for many manufacturers. Allied to operational changes such as the development of retailer brands and the better knowledge of consumer atterns and trends, retailers have reconstructed the traditional supply chain. In essence a dominant retail organisational type has emerged, characterised by strong vertical power which has been used to control, administer and command supply chains. Major retailers have also been involved in the use of horizontal power through their construction and reconstruction of the retail landscape. Where retailing locates and the form it takes has been transformed by the activities of major retailers and developers. Decentralisation is a key theme in this, and ‘waves’ of off-centre or out-of-town development have been identified.In most cases, these developments represent retail formats (eg. the food superstore and non-food retail warehouse) that can not readily be accommodated in existing centres. Such new locations tap into consumer needs, but have an impact on existing retailers and customers not able to travel to them. Moreover, they are in virtually all cases operated by major retailers and thus reinforce the competitive imba lance amongst organisational types. International Opportunities and Threats British retailers have had a chequered history in terms of international operations.At the same time, Britain is an open market and retailers who wish to enter the market can in most cases do exactly as they wish. The exceptions to this are those formats eg. Supercentres, which are constrained by land-use planning on the grounds of space use and various dimensions of impact. Essentially though the UK is a retail supermarket with the best bits of many retailing cultures. This open market is illustrated by the growing presence of many non-indigenous retailers in British retailing. This presence has been generated both by organic growth and by takeover.It encompasses most, if not all, retail sectors and formats. An increasing proportion of UK retail sales is therefore being captured by non-UK businesses operating here. This inward investment is a threat to the main ‘British’ retailers in competitiv e terms. Whilst international activity is risky, the retailers coming here are entering in many places a cosmopolitan market and one used to purchasing non-local products or travelling abroad. As such it seems not to matter to consumers where a retailer is from or who owns whom. If however competitive action combined with technological change eans that more imports are then generated and managerial head office positions, including research and development, are located outside the country, then these should be issues of concern for the country. For retailers entering this market, they have to adapt to a different (generally higher) cost structure and this can create difficulties for their positioning and performance. It is not likely that the pressure from overseas retailers will subside. Britain is a large market with a relatively small number of major cities and centres.For retailers looking for organic growth and being town or shopping centre-located, entry is relatively easy. Mor e problematic is the entry for free-standing or off-centre stores, where sites may not be as available. More likely however is entry via take-over. Given most major UK retailers are publicly quoted, such an entry is available at any time at the ‘right’ price. Whilst it is true to note that British retailers have not been overwhelmingly successful when they have internationalised, there is emerging evidence that some leading UK retailers are now seeing success.In a number of sectors, leading retailers have expanded across the globe, but particularly into Europe and Asia. Some of this expansion is due to opportunities to buy companies at reduced prices, and some is due to knowledge gained as international sourcing has expanded. Retailers such as Kingfisher, Tesco, and WH Smith are well known international retailers and have imported some of their experiences abroad back into their UK formats. Other smaller chains have also internationalised capitalising on niche strengths (eg Signet, Courts, Body Shop, Lush, Carphone Warehouse, Game, Thomas Pink).