Monday, May 25, 2020
Table of Contents 1. Introduction 1 1.2 Corporate Background 1 a. Industry 2 b. Products 2 c. Target market 3 d. Competitive environment 3 2. Income Statement Measures and Discussion 5 a. Exxon Mobil Income Statement 5 b. Net Cash Flow 6 c. Net Operating Profit after Tax (NOPAT) 6 d. Operating Cash Flow (OCF) 7 2.1 Balance Sheet Measures and Discussion 8 a. Exxon Mobil Balance Sheet 8 b. Net Operating Working Capital (NOWC) 8 c. Total Operating Capital 10 d. Net Investment in OPC and Gross Investment in OPC 10 2.2 Free Cash Flow (FCF) 11 3. Financial Ratios 12 a. Quick ratio 12 b. Debt to total asset ratio 13 c. TIE ratio 13 d. P/E ratio 14 e. Market/Book Ratio 14 4.Ã¢â¬ ¦show more contentÃ¢â¬ ¦Exxon, Esso, and Mobil are three of Exxon MobilÃ¢â¬â¢s brands that provide fuels, services and lubricants to fulfill personal and business needs. Their products drive modern transportation, power cities, lubricate industry and provide petrochemical building blocks that lead to thousan ds of consumer goods. c. Target market Exxon Mobil being the worldÃ¢â¬â¢s largest publicly traded international oil and gas company has a very large target market because they supply a high percentage of the people who use energy on a daily bases. Exxon MobilÃ¢â¬â¢s customer mission statement is Ã¢â¬Å"Success depends on our ability to consistently satisfy ever-changing customer preferences. We commit to be innovative and responsive, while offering high quality products and services at competitive prices.Ã¢â¬ d. Competitive environment The Major Integrated Oil and Gas industry is a very competitive environment. There is no room for relaxation, for a company to be at the top, they must always have to strive to make their product or product better. Below is a list of the top ten competitors of Exxon Mobil. As you can see from the chart below, Exxon Mobil is the leader in this industry and is the largest publicly traded international oil and Gas Company. Exxon MobilÃ¢â¬â¢s Net income compared to its number of employeeÃ¢â¬â¢s is where one can see how much better
Thursday, May 14, 2020
Research Methods in Health and Social Care Throughout research in Health and social care settings, there are many implications with the research, which takes place. Many research methods include ethical issues which have to be considered when conducting research. Ethical issues need to be considered when research is being conducted, in all methods of conducting the research information. One method of research is using interviews. For example, when using interviews in a care home, when conducting research, many ethical issues can be raised. Interviews not only take place face-to-face, but also can happen on the phone, online, through text messaging, using a video messenger and though social media. Interviews are a very useful way of collecting information because a wide range of detailed information can be collected at a large quantity. There are two types of interviews: structured or unstructured. Structured interviews are where the interviewer has already pre-planned the questions that they will use in the interview. This is useful because the interview can be repeated, as the questions are standardised. Unstructured interviews are not made up of prepared questions. The interviewer will ask more open questions about board topics and then use follow-up questions to gain more answers in further detail. This method of interview is time-consuming however it enables the interviewee to answer questions in more detail and depth. It is possible that audio-recordings can beShow MoreRelatedResearch Methods in Health and Social Care2462 Words Ã |Ã 10 PagesResearch Methods in Health and Social Care Critical review of quantitative research Majid,S.Foo,S.Luyt,B.Ahang,X.Theng,YL.Chang,YK.Mokhtar,IA.(2011) Adopting and evidence-based practice in clinical decision making: nursesÃ¢â¬â¢ perceptions, knowledge , and barriers. Journal of the Medical Library Association 99(3) PP229-236. This essay will be a critical review on the study conducted by Majid et al (2011). The article which is titled Ã¢â¬ËAdopting evidence-based practice in clinical decision making: NursesÃ¢â¬â¢Read MoreTraditional Conceptions Of Service Planning And Management1217 Words Ã |Ã 5 Pages Wherton et al support the notion that if Ã¢â¬Ëcare closer to homeÃ¢â¬â¢ is to be realised, then industry, health and social care providers must evolve ways to work with older people to co-produce useful and useable solutions. Ã¢â¬Å"Design Participation,Ã¢â¬ as the event was entitled, was the first international con- ference of the Design Research Society in 1966 (Cross). In the decade preceding the conference, design participation had become a matter of mounting social and political concern with growing impact onRead MoreFactors That Affect The Validity Of Research1280 Words Ã |Ã 6 Pagesis based on the specific claims that are made on a research and how reliable the claims are supported by the evidence given from the research. There are various factors that affect the validity of research and these factors are: ensuring that the methods used is appropriate for the purpose of the research. The methods can include using the right equipment and knowing the accuracy of it when itÃ¢â¬â¢s used to make measurements, observing how the research was carried out, the way the results were analysedRead MoreHealth and social care1434 Words Ã |Ã 6 PagesIn Health and Social Care Student Name Unit 16: Understanding Specific Needs in Health and Social Care Student No. Assessor name: Christine Pratt Date of Issue Completion date 30/05/2014 11/07/2014 Submitted on Assignment title LO2 Task No. Assess how perceptions of specific needs have changed over time. 1 1.3 LO1 In this assessment you will have the opportunity to present evidence that shows you are able to Analyse concepts of health, disabilityRead Morecare guid Essay1590 Words Ã |Ã 7 Pagesin health and social care Unit number: 24 Level: 5 Credit value: 15 Guided learning hours: 60 Unit reference number: A/601/1639 UNIT AIM AND PURPOSE This unit will provide learners with an understanding of methods used to bring information about contemporary health and social care issues to the public, progressing to examining how these methods can influence public opinion. Learners will also have the opportunity to explore a contemporary health and social careRead MoreHealth and Social Care Level 3 Unit 1 P11376 Words Ã |Ã 6 PagesÃ¯ » ¿Effective Communications in Health and Social Care Within this essay, the role of effective communication and interpersonal interaction in a health and social care context will be explained. It will also be linked to experiences in work placements for example, may be at a care home for adults with learning disabilities, and physical disabilities. The five contexts which will be researched are; one to one communication, group communication, multi agency working, multi professional working also communicationRead MoreHealth And Social Care Research1505 Words Ã |Ã 7 PagesIn health and social care research tends to accept the methods of social science research because the projects often involve investigating peopleÃ¢â¬â¢s feelings, observations and attitudes, which do not lend themselves to investigation by scientific methodology. Quantitative research Scientific method involves quantitative information. For example measuring changes in the body and analysing blood or urine samples. Body mass index is used to measure height and weight to distinguish whether an individualRead MoreUnder IndiaÃ¢â¬â¢S New National Health Policy, 2015, The Government1621 Words Ã |Ã 7 PagesNational Health Policy, 2015, the government aims to shape the current and future healthcare system improving upon the last policy, written in 2002. The National Health Policy, 2015, emphasized potentially effective strategies to combat widespread issues by reducing the need for additional physicians amongst the already strained human resources in healthcare, addressing the need for assessment of social determinants, and incorporating the variations in culture in future outreach and care practicesRead MoreHealth Geography Is A Branch Of Social Science1073 Words Ã |Ã 5 Pages*Health geography approaches. Health geography is a branch of social science which investigates the interaction between people and the environment. Health geography views health from an all-inclusive perspective combining society and space, and it intellectualises the role of place, location, and geography within the realm of health, wellbeing, and disease. To put it simply, health geography examines why space and place are central for health variation in the population. As a result, approachesRead MoreRelationship Between Health Care And Justice950 Words Ã |Ã 4 PagesPerhaps it was my parentsÃ¢â¬â¢ socialist upbringing in Yugoslavia or my motherÃ¢â¬â¢s struggles with her autoimmune disorders that helped foster my interest in health inequities. Although I now find the relationship between health care and justice fascinating, my initial academic encounters with health care were not anchored in sociological, political, or legal frameworks. Drawn to human physiology and anatomy, I excelled in the biological sciences throughout secondary school. I enrolled in university intent
Wednesday, May 6, 2020
Explore the Presentation and Role of Religion in Chronicle of a Death Foretold Chronicle of a Death Foretold is set in Columbia, where the extreme theocentricity means every characterÃ¢â¬â¢s actions are intrinsically affected by religion. Whilst Marquez also explores much deeper religious issues, the action of the novel centres on the God-fearing townspeople allowing the murder of Santiago Nasar, which clearly contradicts the Christian commandment Ã¢â¬ËThou shalt not killÃ¢â¬â¢1 Since female virginity is so venerated in the Catholic faith, when Santiago is accused of taking Angela VicarioÃ¢â¬â¢s virginity, her life would be worthless without it, and AngelaÃ¢â¬â¢s brothers are charged with redeeming her honour. The novel can boil down to the assertion that aÃ¢â¬ ¦show more contentÃ¢â¬ ¦The reader will also discern the scores of parallels able to be drawn between Santiago and Jesus Christ, making Santiago a literary Ã¢â¬ËChrist-figureÃ¢â¬â¢. Both were somewhat outcast, in SantiagoÃ¢â¬â¢s case because he was not a native Columbian. This makes it easier for the town to allow SantiagoÃ¢â¬â¢s death, and make him the scapegoat. The townÃ¢â¬â¢s unwillingness to save Santiago is similar to the Jews choosing to have Jesus killed rather than a murderer. In both cases, those who had the chance to save the innocent man felt terrible afterwards. Jesus had foretold his own death, and although Santiago was blissfully unaware of his demise until it befell him, the narrator states Ã¢â¬Ënever was there a death more foretold.Ã¢â¬â¢ In dying for the sake of Angela VicarioÃ¢â¬â¢s honour, Santiago is sacrificed for the sins of others, which was also JesusÃ¢â¬â¢ purpose in dying. In addition, the seven fatal wounds Santiago suffers probably represent the Seven Deadly sins. Even the way in which Santiago was murdered is akin to the RomansÃ¢â¬â¢ killing of Jesus. Ã¢â¬Å"The knife went through the palm of his right hand and then sank into his side up to the hilt.Ã¢â¬ 8 The Romans ensured their victims were dead by stabbing them in the side, their hands having been pierced by being nailed to the crucifix. Incidentally, the VicariosÃ¢â¬â¢ knives Ã¢â¬Å"kept coming out cleanÃ¢â¬ 9, which denotes SantiagoÃ¢â¬â¢s innocence. This is amplified by his Christ-like appearance that day, dressed in white. Finally, since Santiago eventually dies in theShow MoreRelatedChronicle Of A Death Foretold1866 Words Ã |Ã 8 PagesReflective statement: Chronicle of a Death Foretold The expectations of society and status quo are an important influence in Chronicle of a Death Foretold. The various interactive oral presentations that my classmates presented discussed an array of topics which included roles of women and machismo, specifically how women were forced to accept the unfair social expectations placed on them and how men were expected to exemplify macho behavior. My classmatesÃ¢â¬â¢ presentations also helped me to gain
Tuesday, May 5, 2020
While Nora uses general descriptors indicating a lack of definite knowledge Torvald delivers commands in a belittling way, a constant affirmation to his wife (and himself) that he is the man of the house, and therefore, he believes, entitled to control. Ibsen further demonstrates this through NoraÃ¢â¬â¢s desire to have some pennies, some financial power of her own. It is made clear in this conversation that Torvald has power over the household assets and through his reluctance to ive Nora any money of her own and his disparaging explanation as to why, Ibsen further sets up the imbalance in power. However not all of the opening act focuses on NoraÃ¢â¬â¢s subservience, for example, the device of the macaroons is used to foreshadow the final climax of the play. The forbidden macaroons, that Nora furtively dines upon behind the disapproving TorvaldÃ¢â¬â¢s back, is a demonstration that Nora is not completely in acceptance of her lack of power. The confectionery is the immediate manifestation of her desire for some form of power and control. The audienceÃ¢â¬â¢s perception of Nora as a submissive child-like figure, established by her relationship with her husband, is quickly destroyed by the arrival of Mrs. Linde. The initial balance of power lies with Kristine in this alternate relationship, as Nora appears envious of her individuality and freedom in having no commitments to a family. Yet, when Kristine declares Ã¢â¬Å"YouÃ¢â¬â¢re a child, NoraÃ¢â¬ (1565), this catalyses the first revelation of NoraÃ¢â¬â¢s actual power to the audience. Ibsen reveals that despite her interactions with her husband, Helmer is well indebted to the actions of his wife, who unbeknown to him, are responsible for saving his life. Nora is ecstatic at the fact that she is able to finally disclose her secret to someone; she then proceeds to declare that she has no need to reveal this to her husband as Torvald is already so devoted and so smitten by her current beauty. It is NoraÃ¢â¬â¢s false belief in the power she has over her husband, that when it is shown to be misplaced, she reaches the extreme of deciding to leave for ever. The theme of power and control in the text is not merely demonstrated by one character over another, but also by society over the actions of Krogstad and Torvald in particular. Krogstad simply desires a position at the bank because Ã¢â¬Å"my sons are growing up. For their sakes I have to try to win back as much respect as I can in this town. Ã¢â¬ (1574) He wants to have power in a society, where someone who has committed forgery and is well known for lying has none. This is further demonstrated by the quotation Ã¢â¬Å"What those spiteful men wrote about him in the paper, lies and slander. HeÃ¢â¬â¢d have lost his job if you hadnÃ¢â¬â¢t been sent to enquire,Ã¢â¬â¢ as said by Nora as she warns Helmer of the consequences of firing Krogstad. This implies that public opinion also has a form of control in determining what the characters created by Ibsen can and canÃ¢â¬â¢t do. Similarly Ã¢â¬Å"if it comes out that the new manager changes his mind when his wife demands it,Ã¢â¬ as is said by Torvald, shows that society believes that giving into the desires of a wife is a sign of weakness, a sign of a distinct lack of power placed in the influence of a female party. The best demonstration, however, of societyÃ¢â¬â¢s power over the characters is witnessed in the climax of the play. When Torvald is trying to justify his out-burst at Nora he declares Ã¢â¬Ëno man sacrifices his honor for the one he loves. Ã¢â¬â¢ Of course, what Helmer means is that he didnÃ¢â¬â¢t want to become stripped of all power and respect in society the same fate that Krogstad had suffered. Helmer was not willing to give up this power and respect that his post as bank manager entailed and, bound by this, he was unwilling to perform the miracle Nora had so desired. Other then the power of society over characters Ibsen also introduces the power of law and necessity as minor themes in the play. Mrs. Linde makes no denial of the fact that she married not out of love, but out of necessity to provide for her dying mother. By telling Nora of how little emotional commitment she had to her husband this shows Nora that, when the miracle doesnÃ¢â¬â¢t occur, she has no reason at all to stay with Torvald. KrogstadÃ¢â¬â¢s use of the power of the law to threaten Nora is also a commentary of Ibsen on society at the time. NoraÃ¢â¬â¢s belief that the reasons for which she forged the contract would be enough to save her from punishment (Ã¢â¬Ësurely there must be laws about that,Ã¢â¬â¢) is possibly IbsenÃ¢â¬â¢s way of speaking out against the lack of compassion the law shows for those in desperate need, or even against the fact that the power of law is seemingly far greater than the power of love between members of a family. The final element, which is concerned with the issue of power, is its transition between characters throughout the play. Initially Nora believes she has power over her husband in two forms. One is his desire for her as, in her own description, she is Ã¢â¬Ësuch a pretty little thing,Ã¢â¬â¢ and two, is the debt of gratitude he owes her for saving his life. By the conclusion of act three, it is clear that Nora has gained the power of independence, but the other two are no longer existent thanks to HelmerÃ¢â¬â¢s outburst and KrogstadÃ¢â¬â¢s letter. After shedding her fancy dress and re appearing Nora states Ã¢â¬ËIÃ¢â¬â¢ve changed,Ã¢â¬â¢ and from this moment on the infantilism she formerly showed and her inflated self-opinion leaves, and is replaced by a resolute decision and a lucid acceptance of her responsibility. This is almost a complete contrast to the power shift experienced by Torvald. Initially he views his wife as a mere possession, a toy doll which he is able to show off at parties to the admiration of fellow members of powerful society, Ã¢â¬Ëcurtsy here curtsy there Ã¢â¬â and the vision of loveliness was gone as they say in fairy tales. However when this Ã¢â¬ËpossessionÃ¢â¬â¢ of his shows any sign of independence and when he realizes the consequences of her leaving, he is forced to make a series of desperate appeals to NoraÃ¢â¬â¢s religion, morals and marital duty in order to attempt to persuade her to stay. The theme of power is a central issue in IbsenÃ¢â¬â¢s Ã¢â¬ËA DollÃ¢â¬â¢s House. Ã¢â¬â ¢ Through the presentation of power in the home, the power of society and the transition of control between characters, Ibsen is able to create a commentary on the rights and values of a society devoid of many gender equalities that are present today. The change in Nora, from being under the power of Krogstad and Helmer to eventually leaving the house and the children was a ground breaking power shift to portray in the social setting of late 1880Ã¢â¬â¢s and it is due to this radical shake up in the communityÃ¢â¬â¢s view on the power of independence that Ã¢â¬Å"A DollÃ¢â¬â¢s HouseÃ¢â¬ became the most significant piece of Scandinavian theatre of all time.
Wednesday, April 8, 2020
AssaelÃ¢â¬â¢s Matrix Essays AssaelÃ¢â¬â¢s Matrix Paper AssaelÃ¢â¬â¢s Matrix Paper AssaelÃ¢â¬â¢s Matrix Assael distinguished four types of consumer buying behaviour based on the degree of buyer involvement and the degree of differences among brands. The four types are named in the following table and described in the following paragraphs. TABLE 20: Four types of buying behaviour: Level of Significances Between |High Involvement |Low Involvement | |Brands | | | |Significant |Complex Buying Behaviour |Variety-seeking Buying Behaviour | |Few |Dissonance-reducing Buying Behaviour |Habitual Buying Behaviour | 1. Complex Buying Behaviour: Consumers go through complex buying behaviour when they are highly involved in a purchase and aware of significant differences among brands. Consumers are highly involved when the product is expensive, bought infrequently, risky and highly self-expressive. Typically the consumer does not know much about the product category and has much to learn. For example, a person buying a personal computer may not know what attribute to look for. Many of the product features like 16K memory disc storage, screen resolution carry no meaning to him or her. This buyer will pass through a learning process characterized by first developing beliefs about the product, then attitudes, and then making a thoughtful purchase choice. The marketer of a high-involvement product must understand the information-gathering and evaluation behaviour of high-involvement consumers. The marketer needs to develop strategies that assist the buyer in learning about the attributes of the product class, their relative importance, and the high standing of the companys brand on the more important attributes. The marketer needs to differentiate the brands features, use mainly print media and long copy to describe the brands benefits, and motivate store sales personnel and the buyers acquaintances to influence the final brand choice. 2. Dissonance-Reducing Buying Behaviour: Sometimes the consumer is highly, involved in a purchase but sees little difference in the brands. The high involvement is again based on the fact that the purchase is expensive, infrequent, and risky. In this case, the buyer will shop around to learn what is, available but will buy fairly quickly because brand differences are not pronounced. The buyer may respond primarily to a good price or to purchase convenience. After the purchase, the consumer might experience dissonance that stems from noticing certain disquieting features of the product or hearing favourable things about other brands. The consumer will be alert to information that might justify his or her decision. The consumer will first act, then acquire new beliefs and end up with a set of attitudes. Here marketing communications should aim to supply beliefs and evaluations that help the consumer feel good about his or her brand choice. 3. Habitual Buying Behaviour: Many products are bought under conditions of low consumer involvement and the absence of significant brand differences. Consider the purchase of salt. Consumers have little involvement in this product category. They go to the store and reach for the brand. If they keep reaching for the same brand, it is out of habit, not strong brand loyalty. There is good evidence that consumers have low involvement with most low-cost, frequently purchased products. Consumer behaviour in these cases does not pass through the normal belief/attitude/behaviour sequence. Consumers do not search extensively for information about the brands, evaluate their characteristics, and make a weighty decision on which brand to buy. Instead, they are passive recipients of information as they watch television or see print ads. Ad repetition creates brand familiarity rather than brand conviction. Consumers do not form a strong attitude towards a brand but select it because it is familiar. After purchase, they may not even evaluate the choice because they are not highly involved with the product. So the buying process is brand beliefs formed by passive learning, followed by purchase behaviour, which may be followed by evaluation. Marketers of low-involvement products with few brand differences find it effective to use price and sales promotions to stimulate product trial, since buyers are not highly committed to any brand. In advertising a low-involvement product, a number of things should be observed. The ad copy should stress only a few key points Visual symbols and Imagery are important because they can easily be remembered and associated with the brand. The ad campaigns should go for high repetition with short-duration messages. Television is more effective than print media because it is a low-involvement medium that is suitable for passive learning. Advertising planning should be based on classical conditioning theory where the buyer learns to identify a certain product by a symbol that is repeatedly attached to it. Marketers can try to convert the low-involvement product into one of higher involvement. The ways are: ? This can be accomplished by linking the product to some involving issue, as when Crest toothpaste is linked to avoiding cavities. The product can be linked to some involving personal situation, for instance, by advertising a coffee brand early in the morning when the consumer wants to shake oft sleepiness. ? The advertising might seek to trigger strong emotions related to personal values or ego defense. ? An important product feature might be added to a low-involvement product, such as by fortifying a plain drink wit h vitamins, These strategies at best raise consumer involvement from a low to a moderate level; they do not propel the consumer into highly involved buying behaviour. . Variety-Seeking Buying Behaviour: Some buying situations are characterised by low consumer involvement but significant brand differences. Here consumers are often observed to do a lot of brand switching. An example occurs in purchasing cookies. The consumer has some beliefs, chooses a brand of cookies without much evaluation, and evaluates it during consumption. But next time, the consumer may reach for another brand out of boredom or a wish for a different taste. Brand switching occurs for the sake of variety rather than dissatisfaction. The marketing strategy is different for the market leader and the minor brands in this product category. The market leader will try to encourage habitual buying behavior by dominating the shelf space, avoiding out-of-stock conditions, and sponsoring frequent reminder advertising. Challenger firms will encourage variety seeking by offering lower prices, deals, coupons, free samples and advertising that presents reasons for trying something new.
Monday, March 9, 2020
The Eclectic And Reflective Nature Social Work Essay Essays The Eclectic And Reflective Nature Social Work Essay Essay The Eclectic And Reflective Nature Social Work Essay Essay the typically low degree of wage for people in this class and inflexible nature of traveling from benefit claimant through into employment as restricting factors in increasing the life opportunities of kids and immature people in this sort of state of affairs. To back up this claim the more general findings of Tunnard ( 2004 ) are highlighted which link parental sick wellness jobs and household poorness and indicate that 50 % of handicapped people have incomes below half the national norm, this rises to 60 % for handicapped grownups with kids ( Gould 2006 ) . Guess in this study suggests that the figures would be worse in households where one or more parents experience important and digesting mental jobs. Therefore it is sensible to assume in the instance of Ruth and Megan that their degree of income is and will stay at a low degree without some important lifestyle alterations. Specific links between fiscal adversity and mental wellness are taken from an unpublished paper by Social Exclusion Unit in 2004 detailing the impact of poorness on mental ailment wellness, the trouble people experience had in accessing fiscal advice /services, disproportional dependance on province benefits, fluctuating incomes determined by wellness position and the challenge of procuring the right degree if benefit/personal finance. General findings about the impact on household poorness are besides relevant in the instance of Ruth and Megan and it is a factor that is really likely to add to the symptomology common to people diagnosed with marginal personality upset. Furthermore, as benefits and societal attention resources are constrained against a background of cardinal authorities s thrust to set people back into work, Spencer and Baldwin ( 2007 ) argue that many parents in the UK are expected to convey up their households in the context of unreasonably scarce resources . Therefore, practicians need to take into history Ruth and Megan s societal and economic factors when measuring their single demands, hazard and in finding a curative tract for this household. As might be expected, given these negative fiscal, wellness and well-being determiners societal exclusion is a likely to be a factor that needs to be overcome if an holistic, person-centred attack is to be adopted in back uping this household. Developing schemes to get the better of the destructive behavior that Ruth has developed as her personal header from mechanisms is a cardinal factor in turn toing the wider concern of her and Megan s societal exclusion and isolation. Megan s current state of affairs, which is one of compromised chance, a limited societal life, onerous duties, isolation, scarce personal resources and a deficiency of attending to her ain demands, represents the state of affairs of many carers in the UK, particularly so those who have or have had duties as a immature carer. . Research by Aldridge and Becker, ( 1999, p.306 ) suggests that kids who provide caring support to parents with mental unwellness will be more susceptible to increased degrees of anxiousness, depression, fright, alteration in behavioral and societal forms every bit good as being more at hazard of transmittal of the peculiar parental status . As caring moves through into maturity the hereafter tends to stay black and research from the Health and Social Care Information Centre ( 2010 ) studies increased grounds of hapless wellness, low income and a general sense of hopelessness for carers in the visible radiation of ongoing cuts to societal attention budgets. The chance for any important betterment is every bit cheerless. In sing the inside informations of this instance the eclectic and brooding nature of societal work is an attack that seems suited for the complexnesss back uping people with mental ailment wellness, peculiarly the of all time altering presentations of people who have a diagnosing of marginal personality upset. Payne ( 2009, p.100 ) describes the utility of these attacks in instance work foregrounding how practicians can follow and utilize theories together, possibly all at one time or possibly in turn or utilize different theories in different instances . Because this method requires important accomplishment and understanding Payne cites Epstein ( 1992 ) who suggests that flexible squad attacks to contemplation, argument and application offer a utile manner frontward to the bringing of flexible moment to minute pattern in response to complex instances. Payne ( 2009 ) identifies systems theory as being an of import facet of eclectic method. Pincus and Minahan ( 1973 ) applied the a ttack to societal work pattern and depict three types of system these being informal or natural ( friends/family ) , formal ( community groups, etc. ) and social systems ( hospital/schools, etc. ) . Peoples with mental wellness jobs are likely to hold some trouble in utilizing assisting systems to better their wellness, life experiences and general wellbeing. Using systems theory involves placing the point, and jobs persons experience in the interactions with their environment. The stages of this include measuring ; making/negotiating contracts ; forming/coordinating actions ; re-forming and influencing action systems ; ending alteration attempts. Payne ( 2005 ) extends the application of this attack and makes clear links to ecological systems theory, crisis theory/models and undertaking centred working. The application of these, peculiarly crisis intercession, could work in connexion with Ruth s current troubles and potentially offers short term span toward longer term curative wo rk. However in following this attack it is deserving sing the cautiousness raised by Doel ( 2009 ) and he notes that if done ill than crisis/task centred work can go inflexible, everyday and possibility lead to some degree of societal control. Doel suggests utilizing these methods should be accompanied by developing that considers factors such as values, attitudes and their application in pattern. Sherry ( 2007 ) identifies the increasing consideration and application of fond regard theory ( Bowlby 1973 ) in the causing of marginal personality upset and cites legion influences as menaces to attachment in childhood. Hazard factors in this respect include sexual injury ( Laporte A ; Guttman, 1996 ) , parental disregard ( Paris, 1997, 1998 ) , household instability and emotional disregard all of which are considered to lend to the development of personality manners in big life. For practicians, the logical thinking of Ivey 1989 who suggested utmost behavior by clients could be linked to their development history and the manner they respond and bring intending to their experiences in ulterior life. Therefore hapless parenting experienced by Ruth could hold been instrumental portion in the development of behaviors that for her now carry the label of marginal personality upset ( West A ; Sheldon-Keller ( 1994 ) . Therefore the assemblage of information in appraisal procedures can be a important factor in working out the manner and content of societal work intercession. In sing the tracts of person who experiences important mental wellness issues it is clear that from many positions that society perceptual experiences, life chances and thereby single wellbeing are compromised in many countries of life. The battle for a more balanced and supportive attack to mental wellness has been carried by the service user/survivor motion for many old ages and the demand for reform has led to many runs. It is easy to understand the demand secure better intervention and push through system reforms given subjugation, rejection and widespread ignorance that characterises the history of mental wellness in the UK. Ferguson ( 2008 ) foreground how the now recognized place of the subsister motions forcing for greater acknowledgment of the predicament of people with mental wellness issues came from the digesting effects of stigma, impotence, inequality and segregation which have been utilised to force governmental thought and maintain mental wellness, wellbeing and socie tal attention as political issues. The battle for improved rights and chance among the subsister motion merely truly collected gait in the 1970s ( Campbell 1996 ) ( Beresford, 1997 ) and in the early phases tended to concentrate on little scale self-help and common support enterprises. More late there has been greater, towards collective national runs refering intervention, reacting the alterations of the mental wellness statute law and broader battles to alter attitudes and apprehensions of lunacy and hurt. This has been cardinal to switching the stigma of mental wellness and clearly it is something that needs to go on. General concerns expressed by Campbell ( 2005 ) link good to Ruth s state of affairs and the urgent structural concerns that tend to convey of poorness, deficiency of chance, isolation, ennui, hopelessness and therefore a go oning committedness to province imposed legal and medical limitations are clearly relevant to the instance survey. Evidence of the negative impact of mental sick wellness can be found in the wellness inequalities highlighted in research carried out for the Disability Rights Commission in 2006 which showed that people with terrible mental unwellness are at higher hazard of sick wellness across a figure of conditions. Their study Equal Treatment: Closing the Gap highlighted increased incidence of clinical fleshiness, coronary bosom disease, diabetes, high blood force per unit area among people with terrible mental wellness issues. It besides noted higher hazards in connexion with people developing high blood force per unit area, shot, respiratory jobs and intestin e and chest malignant neoplastic disease. They are besides more likely to smoke. Although the grounds for this inequality are complex and have far making deductions for public wellness policy shapers, the effect remains that people who experience long-run mental ailment wellness dice on mean 5 to 10 old ages younger than other people, frequently from preventable unwellnesss. The response to this research and the continued focal point on issues of inequality, unfairness and stigma by administrations such as Rethink Mental Illness is yielded some important consequences with increased focal point on physical wellness being pursued within community mental wellness squads, increased focal point on speaking therapies and Mental Health ( Discrimination ) Bill traveling through to the House of Lords for farther argument. ( Rethink, 2012 ) However it is progressively evident that people with a diagnosing of marginal personality upset are capable to a specific type of stigma and favoritism that impacts on the relationships that are cardinal to accomplishing to accomplishing some degree of stableness in their lives, these being the therapeutic links with practicians within community mental wellness services. Ruth s status unluckily fits in with the perceptual experience held amongst professionals that it is about or wholly untreatable. Personality disordered patients are frequently described as the patient physiatrists disfavor and are frequently viewed as clip cachexia, hard, attending seeking, and manipulative bed blockers. ( Hadden A ; Haigh, 2002 ) . Having antecedently highlighted the significance of person-centred theory and attacks in developing curative confederations, it is supremely that favoritism within assisting professions can be raised so easy as cardinal restricting factor. Markham ( 2003 ) high spots multiple differences in the reactions of professional staff towards people who have a diagnosing of BPD. The suggestion is that the label leads to increased societal rejection, deceased optimism and acceptance of two-channel typical attitudes by staff hence making hazard of less favorable and thereby effectual intervention every bit compared to other groups of people with terrible and digesting mental wellness issues. As might be expected, the research draws to a great extent on labelling theory: The negative service user experience detailed by Wright A ; Jones ( 2012 ) in typifies Ruth s historical curative tract and include direct quotation marks that are clearly relevant: Rightly or wrongly, I interpreted the label as a mark that I was basically flawed, that the bad parts of me far outweighed any good properties that might besides be portion of my personality aÃâ Ã ¦and being told that I had a personality upset and that there was no remedy or intervention. The illation was that I was merely made this manner and that was the terminal of it. The article besides highlights the findings of Pilgrim ( 2001 ) who suggest that hapless responses to personality upset occur because causes are non known and that intervention results are frequently unpredictable and undependable. In sing this sort of grounds, it is easy to understand Ruth s surrender following another A A ; E admittance which in her head will convey approximately yet another dissatisfying rhythm curative hopelessness with small opportunity of any success. ( should this paragraph be justified or left centred? ) The state of affairs raised in the instance survey typifies many of the negative issues associated with the support that people with a diagnosing of marginal personality upset receive: dismissive attitudes, inconsistent attacks and autocratic attacks seem to be consistent subjects and are evidently non altering the nature and results of curative intercessions. While it might be hard at this phase, it seems of import for Ruth to take some duty perchance self-managing some grade of the presenting hazard which is consistent with the counsel provided by Wright and Jones ( 2012 ) and is besides in line with best pattern as detailed in the NICE counsel ( 2009 ) . This should be clearly stated within the attention program. Mead and Copland ( 2000 ) suggest that people are able to turn through positive hazards taking and that authorization through individual centred support can reframe typical service user response to hard, crisis state of affairss. Practically this can be supported through clear and effectual attention planning and this should be built into an person s intervention and crisis program. Ruth, along with her attention coordinator, should carefully see schemes to pull off ague and chronic hazards developing and integrating these in the attention program as appropriate. This will guarantee consistence when the attention coordinator is absent, guaranting that Ruth s attention and support follows boundaries and consistence agreed with her and thereby guaranting she is treated with self-respect, regard and compassion. Although hazard to self which Sherry ( 2007 ) clearly links to the diagnosing of marginal personality upset must be responded to in the context of community mental wellness services, admittance to psychiatric inpatient unit should merely take topographic point as a last resort and the least restrictive options should be pursued. The stepped attention theoretical account offers a utile statutory response and if hazards remain elevated so Ruth should be considered foremost for the high strength squad so a referral crisis declaration and place intervention squad, notwithstanding any negativeness that may environ her historical presentations. If possible excess support from attention coordinator would be the ideal solution, as this would use the curative relationship in topographic point to back up and steer Ruth through her crisis. In systematically disputing state of affairss Ruth s attention coordinator could besides research with Ruth and Megan a autonomous support ( SDS ) bundle. Th is bundle could back up with activities of her pick and it is possible for this to be used for Ruth to research and entree some community resources hence constructing societal webs for Ruth and alleviating Megan of some of the force per unit area of her carer s function. Hatton and Waters ( 2011 ) place the comparative success of SDS/personalisation in connexion with people sing mental wellness issues and this is at its most good when persons pursue direct payments and unafraid support on their ain footings. Whichever option in footings of ongoing support is chosen so it seems that there is demand for a more collaborative, shared attack both in connexion with hazard and besides around longer-term support schemes. The work and theories of Rogers ( 1956, 1957 ) specify the nucleus conditions of reding including unconditioned positive respect ( UPR ) , empathy and congruity for curative relationships to win peculiarly so in the context of personality alteration. It is of import to observe that this is a value based attack and religion that the individual can determine their ain positive hereafter if the status highlighted above can be provided. It is non a set of tools and techniques that can be turned on and off to accommodate practician demands at a given clip or chance. It links good to considerations around motivational attacks and Ruth s and Megan s desire to travel on is a good index in this respect. Basically, by following humanistic attacks, the purpose is to develop a form of inter action and support which keeps Ruth centrally involved in the nature and form of the curative relationship which will of course affect cardinal determinations about, hazard, intervention options, attention planning and end planning. Clearly this type of interaction is hard to sketch to all involved professionals but careful entries and appraisal within electronic records can assist significantly in modifying the responses all statutory workers who may meet Ruth in the professional work. If this person-centred attack is adopted so it will stand for a important displacement in the attention and support Ruth has received in her short psychiatric calling .
Friday, February 21, 2020
Vomiting Reflex - Essay Example This means that it can receive direct emetogenic stimulation from the cerebrospinal fluid and blood. The CTZ sends impulses to the vomiting impulses to the vomiting centre. The process of vomiting includes the retching and the expulsive phase. In the retching phase, the vomiting centre transmits motor efferent impulses to the abdominal muscles and the diaphragm resulting in increased intra-abdominal pressure. It also results in anti-peristalsis forces that can go all the way to the duodenum and ileum. Gastric content accumulates in the stomach resulting in relaxation of the lower esophageal sphincter (John, 2010). This is accompanied by hypersalivation, increased heart rate and sweating through the parasympathetic outflow. The hyoid bone and the larynx are elevated so as to open the upper esophageal sphincter. This is followed by the closure of the glottis. The increased intra-abdominal pressure and anti-peristalsis forces results in the expulsion of the abdominal contents. The following is a flow chart demonstrating the vomiting reflex. The contents and color of the vomitus may be used to diagnosis the cause of vomiting. Bleeding from the esophagus is showed by the presence of fresh blood in the vomitus. When the blood originates from the stomach, for example, perforated peptic ulcer, the vomitus has coffee ground appearance. This is because the acid found in the stomach reacts with the iron found in hemoglobin. Presence of bile in the vomitus indicates that the pyloric valve is open. This means that there is massive contraction of the duodenum leading to expulsion of bile (John, 2010). Fecal content in the vomitus indicates a gastrocolic fistula or intestinal obstruction. In case of intestinal obstruction, the vomiting relieves the associated abdominal pain and distension. These features are used to determine the origin of pathology in the gastrointestinal