Condom Availability in High Schools Essay

In 1991 the New York City Board of Education created a program to make condoms accessible to all high school students upon request. The program caused parental disagreement and the school board was taken to court. Parents claimed that making condoms available to students was a health service and could not be provided to students. The board argued that the condom plan was not a medical service. They explained it was one part of a comprehensive educational program that did not require direct parental consent. The school board lost the case. The program may have survived had the case been heard by the New York State Supreme Court â€Å"Massachusetts is the most significant, it is the highest court to address the issue, and it rejects,†¦Ã¢â‚¬ ¦ the claim that condom availability interferes with parental liberties† (Karen Mahler). In 1977 the United States denied a New York State Law prohibiting the distribution or sale of non-prescription contraceptives to teens under the age of 16. The United States Supreme Court seems to have support for the condom availability program. With teen pregnancy rates and the number of STD’s reported in teens on the rise, schools are beginning to realize that the parents are not doing their job when it comes to sexual education. The school system already has classes on sexual education; these classes are based mainly on human anatomy. Most schools do not teach their students about relationships, morals, respect, self-discipline, self-respect, and most importantly contraceptives. Everyday students engage in sexual activity, many of them without condoms. This simple act jeopardizes these students’ futures and possibly their lives. An increasing amount of school systems are starting to combine messages involving abstinence from sexual activity, and expanding availability of contraceptives, especially condoms. Schools are now stepping in to further equip their students for life. The distribution of condoms in public high schools will lower the rate of pregnancies and sexually transmitted diseases among teenagers. Eighty percent of teen mothers end up in poverty for long periods of time due to the fact that they never finished high school. They become financially dependent on programs such as Welfare and WIC (Women, Infants, and Children). Welfare provides money and food stamps for low-income families. WIC provides milk, cheese, eggs, cereals, fruit juices, dried beans or peas, peanut butter and infant formula for all participants. WIC also provides nutritional education and health care referrals at no cost. Programs such as these help millions of families every year. Considering the fact that the majority of teens will participate in sexual activity, Sex Ed should focus more on methods of contraception and less on abstinence. Giving adolescents more information about sex and making condoms more available are ways to cut the risk of pregnancy and sexually transmitted diseases. The condom is the only type of birth control that protects against the transmission of STD’s when properly used. Experts say the lack of knowledge on how to use a condom correctly and the lack of motivation to use a condom every time means that condoms fail more often. This could result in pregnancy or the contraction of STD’s. Teenagers reuse condoms or they use it with a petroleum-based lubricant which can dissolve the condom’s latex. Birth control products are only effective if used properly. Rates of failure for condoms are between 2 percent and 14 percent. Inexperienced users make up a larger percentage of failure rates because of improper use. This failure rate is also due to inconsistent use among teenagers. With the proper knowledge and training students can effectively use a condom to protect themselves. Health Resource Centers, or HRC’s are centers located in middle and high schools promoting safe sex. HRC’s provide reproductive health inf ormation, condoms, and general health referrals to students. All students in the participating schools are taught about the importance of abstinence, but they are provided with condoms if they choose to be sexually active. Trained staff members and volunteers, including health professionals, educators, nurses, psychologists and graduate interns provide counseling for students upon request. Students attending the junior high school also have access to condoms; however; counseling is mandatory for these students before they can receive condoms. Informational brochures can be obtained in the nurses’ office. Students are also able purchase condoms from vending machines located in remote places throughout the school. The HRC’s have large levels of administrative and staff support for its objectives. Students who used the program generally viewed the services they received favorably. Expanded condom availability, when accompanied with the proper education and information about safer sex, will decrease the amount of unprotected sexual encounters and the spread of sexually transmitted disease. Making love is not something to play around with. When people decide to do it, they make a life and deat h decision. If they contract an STD they risk their life for death. And if a woman gets pregnant, the woman is not guaranteed to live through it (although chances are that she will), and the child is not guaranteed to live for many reasons including abortion. Shouldn’t steps be taken to educate teenagers about what they are getting into before schools start handing out condoms? This would be a better way to prevent the spread of pregnancies and of STD’s and H.I.V. If teenagers do not have sex to begin with the risk of infection goes down because, condoms are not 100% effective. However, it is known that regardless of the consequences or risks, teens will partake in sexual inter course, it is the teacher’s job to help educate how to have safer sex. If the students know more about the risks, then they can make an educated decision about sex, and then it will be very likely that they will use a condom if they do decide to have sex. Rather than having one year of Sex Ed in High School like the majority of schools do across the nation, students should have Sex Ed classes starting in junior high school. They should learn about pregnancy, sexually transmitted diseases, and H.I.V. There would be a course or a section of a course dedicated to health where students learn about these subjects. Then in high school, students should do a more in-depth study of the consequences of pregnancy and sexually transmitted diseases. This could be done as a part of a biology course or as a research project in an English class. Finally, students should learn about H.I.V. and AIDS, how it affects the lives of those who have it, and what can be done about it. Again, this could be a separate course that is required or a part of another required course. Then, pamphlets about all these things should be made available at the health (or nurse’s) office and suggested for the students to read before they receive condoms. If this is done, then teenage sex should become much less of a problem than it is now. Abstract Over the past twenty years, the number of teen, unplanned pregnancies has nearly doubles in size. This is a problem to all people that it affects because it hurts people financially, not to mention all of the unexpected stress that comes along with being pregnant. Making condoms available in High Schools would surely decrease this number to what it once was and hopefully drastically decrease the number of orphans and teen parents in debt that we have in this country. References Furstenburg, Frank , Mariarz, Geitz , Teitler, Julien , Weiss, Christopher â€Å"Does Condom Availability Make a Difference? An Evaluation of Philadelphia’s Health Resource Centers† Family Planning Perspective Volume 29, Issue 3 (May-Jun.,1997), 123-127. Kreiner, Anna Learning to Say No to Sexual Pressure New York: The Rosen Publishing Group Mahler, Karen â€Å"Condom Availability in the Schools: Lessons from the Courtroom† Sexuality Volume 4, Article 63 1993-1996 Natale, Jo Anna â€Å"The Hot New Word is Sex Ed† School Volume 5 Article 30, 1994-1996 â€Å"Sex education: Anything goes.† Washington Times 1 Nov. 2000 Stewart, Gail B. Teen Parenting. San Diego: Lucent Books 2000 â€Å"Teens Regret Having Sex.† Maryland Abstinence Education and Coordination Program. Summer 2000

Patient Advocacy Analysis Essay

Introduction A patient advocate may be present for healthcare appointments and alert the healthcare provider about patient compliance issues. He or she may separately assist the healthcare provider and support staff with potential issues and communication challenges. The patient advocate is also responsible for maintaining communication with the patient and healthcare provider to ensure that patients understand the procedures. By reducing fear and increasing patient compliance, this can result in higher successful treatments. Generally, a patient advocacy contract that includes a release of medical information must be placed with each healthcare facility (Ad Hoc Committee on Advocacy, 1969). Some institutions may require a power of attorney for healthcare for a patient advocate to exchange confidential information. The patient advocate may provide medical literature and research services to the patient, family, or healthcare provider. The patient advocate may also assist with family communication on issues arising from illnesses and injuries . This may include further referral for care and support for both patients and families. The patient advocate has a responsibility for awareness of compliance, appropriateness, and coordination of care for the patient, such as oversight for potentially conflicting treatment modalities and medications. The patient advocate can ensure that questions about the appropriateness of treatment are promptly discussed with the patient’s care provider, and that all treatments and concerns are promptly entered into the patient’s healthcare record. The patient advocate is also responsible for reviewing the patient’s healthcare record for correctness and for explaining it to the patient. Another responsibility of the patient advocate is to create and maintain an electronic log for the patient that is available on disk to healthcare providers i This log may be of great benefit in subsequent urgent situations. The patient advocate can also assist in resolving disputes between patients and their healthcare provider, as well as engaging in communications on behalf of the patient in case of employment issues by approaching the employer to achieve a mutually beneficial solution for the employer and the individual employee. Where applicable compliance standards are not met, the patient advocate may conduct liaison with corporate oversight, government agencies, or legal professionals to further negotiate such issues on behalf of the patient and family. It is the duty of a patient advocate to maintain patient privacy according to local and national laws, treating all patient and family information as privileged and protected. This includes ensuring that healthcare providers’ communications are treated as highly confidential and privileged, whether or not those communications are specific to the patient, and that permissions to disclose information are negotiated carefully. It is also the duty of the patient advocate to follow any referrals for medical, financial, legal, administrative or other personnel to assure that the patient is always kept safe and well informed, never abandoned or misled during the process (Carlton, 1984) SWOT Analysis When developing a SWOT analysis for the Patient Advocate Organization, three primary purposes emerged: 1. Inspire continued trust and confidence in the nursing profession among patients, their families, and the American people; 2. Leverage nurses, the single largest health care workforce, together with patients, partners in their care, in accelerating performance improvement; and 3. Stimulate reform through shared perspectives, knowledge, and values among nurses and patients, their families, and consumer stakeholders. A SWOT analysis focuses on internal strengths and weaknesses and external opportunities and threats. In this instance, these concepts have been applied to a proposed alliance that serves these three proposed purposes. Typically, SWOT analyses are presented in tabular formats and entries are listed in one of four quadrants in the table (i.e., strengths, weaknesses, opportunities, threats). The SWOT analysis is presented in Table 1. Strengths Purpose 1. Inspire continued trust and confidence. a. Existing nurse workforce is the largest segment of the healthcare workforce b. Living up to nursing’s promise to represent the patient voice c. Expanding consumer recognized success (e.g., number of hospitals, evidence-based link to quality/safety). d. Expanding and maturing evidence-based that establishes nursing-quality-value linkages. e. Operating consumer advocacy groups is a well-known skill for several of the major groups with which we could partner f. Convener organizations have a proven track record in working together (e.g., areas of education, competency development, leadership) Purpose 2. Accelerate performance improvement a. Expanding and maturing evidence-based that establishes nursing-quality-value linkages b. Partnering to expand and accelerate current and future measurement sets (examples follow): b.1. Experience with, and advancement of, measure development and data collection (i.e. NDNQI, AWHONN EDGETM Database, etc) b. 2. Existing national, regional, and state nursing performance measures databases (e.g., NDNQI, CalNOC, Maine and Massachusetts) b.3 Existing national quality measurement and reporting infrastructure (e.g., Compare websites) Purpose 3. Stimulate reform a. Existing nurse leaders with strong organizational skills and credible backgrounds b. Threats by existing nursing and nurse faculty shortages are widely recognized by policy makers and health care stakeholders. c. Patients and nurses, each individually,†¨make strong advocates; together, their combined effectiveness will likely be transformative d. Reviewing the evidence suggests that nurses make effective policy advocates Weaknesses Purpose 1. Inspire continued trust and confidence. a. Existing, numerous professional nursing organizations and specialty groups result in fragmentation and diffusion of the expertise and resources among nursing as a whole. May be confusing/distracting to consumer groups who join an alliance b. Creating a new â€Å"fancy† alliance may not change nursing’s image from that of a profession that â€Å"takes orders.† We may remain unable to gain access to high levels of policy making and policy makers c. Funding source for sustained support is unknown d. Participation would be voluntary (e.g., What incentive†¨would organizations have to provide technical time and support for NPQA?) Purpose 2. Accelerate performance improvement a. Representation of VANOD, CalNOC, MilNOD is lacking in the convener group gathering under the planning grant b. Lacking sufficient nursing-sensitive outcome measures and resulting data to address all patients in all settings across an episode of care limits how comprehensively nursing care quality can be portrayed and might limit partnerships with certain consumer groups c. Developing standard language may be necessary prior to creating additional standard measures (e.g., birth date or date of birth) d. Adding/changing billing codes (e.g., G-codes, E-codes) to document nursing care is not in the realm of influence for nurses or consumers but together we may have more success. Purpose 3. Stimulate reform a. Nursing is not typically a ‘target’ of federal policies because of employee-employer relationship (rather than direct contractors with payers for services) b. Existing consumer and nursing organizations approach policy makers with multiple requests: lack of unity c. Nursing inclusion within existing alliances may be viewed as duplicative Opportunities Purpose 1. Inspire continued trust and confidence a. Build upon nursing social capital with consumers as the most trusted among health care professions b. Identify (empirically, anecdotally) and enhance the value-added of nursing with consumer participation and support c. Improve consumer understanding about the quality of nursing care d. Improve nursing’s knowledge of consumers’ experience of professional nursing Purpose 2. Accelerate performance improvement a. Continue quid pro quo to various alliances (i.e. HQA, KCA, QASC) providing entry into these policy discussions b. Dedicates significant, shared resources to improving quality, safety and value c. NPQA could serve as a neutral reporting entity to achieve economies of scale and scope by moving performance measurement reporting from various nursing organizations to a central source. d. NPQA sets agenda for measure adoption and collection Purpose 3. Stimulate reform a. Disseminate practice-based questions/issues to policy makers and thought leaders to guide funding of research or studies b. Recognize evidence that suggests that nurses, APRNs and consumer groups have opportunities to strengthen their policy voice c. Vision for proactive, toward thinking policy agenda that can push (e.g. What so we want decision makers know about nursing performance?), pull(e.g. What do decision makers already know about nursing performance ?) and/or Partner (e.g. What do decision makers want/need to know about nursing performance ?) Threats Purpose 1. Inspire continued trust and confidence a. Consumer partners may overwhelm nursing. Nursing may be subordinate to consumer leadership. b. Potential to be barraged or criticized by special†¨patient advocacy groups and specialty nursing groups who are not included in membership c. Partnership adds complexity to operational aspects of an alliance such as leadership, governance, membership dues, etc Purpose 2. Accelerate performance improvement a. Current national practice specialty organizations (AORN, AANA, ONS, AWOHNN, AACN, ACNM) have limited resources and will have to decide where to invest (e.g., choices will need to be made that could result in weakening NPQA) b. Data may portray low quality nursing performance with subsequent unintended consequences for nursing c. Established boards of both large nursing organizations and consumer organizations may refuse to support or may change support as leadership and resources fluctuate d. Alliances with whom nursing has a quid pro quo relationships have not universally welcomed nursing participation and have rationed our involvement (e.g., don’t recognize different nursing groups) e. Consumer group(s) may not recognize a need to measure nurse performance in the same manner in which nurses do. Conflict may result (e.g. consumers may think, â€Å"Did the nurse carry out the order?†) Purpose 3. Stimulate reform a. Absence and inattention to nursing issues/strengths in health care reform proposals b. Presence of a strong medical lobby and physician advocacy groups linked with consumers c. Established alliance landscape and inconsistent/ ‘unwelcoming’ nature among existing alliances to nursing d. Lack of awareness by policymakers of the necessity to engage nursing to realize dramatic and sustainable improvements in quality and safety Customer analysis Before implementing this process in South Florida, it is necessary to conduct the market research to check whether this process has market relevance to this area. In other words, it is important to find out whether customers want to use patient advocacy and then analyze if it is available for implementing it in this area via the drives of value. Basically, there are three interdependent drivers of value, including population health, patient experience and total cost per capital, to promote the development of patient advocacy. The data published by U.S. census government shows that the population in Florida is experiencing a huge change during recently year, no matter the change is characteristic by age or race. First, as illustrated in Figure 2, we can see that from 1960 to 2040, the actual and projected census population will rapidly grow from around 50,000 to over 25,000,000 in Florida. There are two main factors causing this phenomenon. On the one hand, there are the baby boomers. This accounts for the natural population increase. While births exceeded deaths during each of the two decades, less than half a million persons were added to Florida’s population each decade due to the natural increase. On average, 118 more Floridians were born than died each day during the decade of the nineties (Census Report, 2000). On the other hand, individuals’ life expectancy is rapidly extended. As populations of modern societies have begun to age, the older age cohorts have become disproportionately represented. Figure 3 show that the age group over 65 and up holds the largest percentage during 2010 to 2030. For example, in the area of Southeast Florida, its population of 6.2 million, is larger than 34 of the 50 states in 2008. About one in every three (31.2%) South Florida resident was born in the state of Florida. Meantime, in South Florida, the elderly are projected to reach almost one million (20.7% of the total) in 2030, up from 14.4% in 2010 (Ogburn, 2010). Compared to the Treasure Coast, the change is becoming more obviously as it is shown in Figure 4. The data described above figures out that even though the population growth slowed down in recent days, South Florida continue s to grow at a speed that is faster than the nation as a whole, with higher rates in the northern region. Apparently, the change population characteristic provides a huge market for the patient advocacy. A demographic trend often overlooked in discussions of healthcare is the changing structure of American families and households. There has been a decline in the proportion of the population that is married and a proportionate increase in the size of the single, divorced, and widowed population. The average household size has declined, and there has been a large increase in the proportion of the population that lives alone. Therefore, more and more households are involved in the health industry to some extent. This means that Floridians’ expectations for acquiring healthcare knowledge and learning about diseases is increasing. This will help them know how to make decisions when they face the healthcare problem and know whether the plan recommended by physicians and nurses are available to them. Secondly, as illustrated in Figure 5, it can be shown that the race/ethnic composition o f Southeast Florida was made up of 37% Hispanic or Latino. In 2000, the non-Hispanic White population represented 47% of the regional total, down from 57% in 1990. In other words, the non-Hispanic White population of Southeast Florida ceased to be the majority sometime in the 1990s, due mostly to the growth of the Hispanic population in Miami-Dade Country (Ogburn, 2010). Hence, it is very important to take the Spanish language into account when patient advocacy is established. Thirty-three percent of the South Florida population is over age 65, so for those elderly who do not know how to speak English, patient advocacy could help them understand what the medical staff tell them about their diseases or how to take those pills. It also helps to reduce the potential abuse error when patient advocacy staffs teach those patients via their own language. Thirdly, as acute illness has declined as the pervasive type of disorder, chronic conditions have emerged as the dominant type of health problem in developed countries. Chronic conditions generally do not contribute directly to mortality, but are often cited as underlying causes of death. They are more likely to interfere with the quality of life, since they often result in some form of disability. Chronic diseases always result in more cost and more time for recovery. Some maybe even cannot be treated. Thus, patients find themselves confused about the advantages and disadvantages of the treatment. Patient advocacy members listen to confused patients and help them collaborate with physicians and insurance companies. Patient advocacy will offer medical assistance, insurance assistance, home health assistance, elder and geriatric assistance and legal assistance. Those types of assistance will help patients with chronic illnesses to understand their healthcare conditions in detail. The Four Ps The four marketing Ps (product, price, place and promotion) are important in developing the entire marketing process for every company or organization. In other words, the heart of a marketing strategy is the development of a response to the marketplace. For every business, all they need to do first is to identify the customers’ needs, and then determine the price customers are willing to pay. Then, they need to identify what place is most convenient for customers to purchase the product or access the service and, finally, they need to promote the product to customers to let them know it is available (Berkowitz, 2011). Hence, when conducting the Four Ps analysis, there are some questions we need to figure out. Those questions are shown on Figure 6.1 (â€Å"4Ps Marketing,† n.d.): Product The important thing to remember when offering the service of patient advocacy to customers is that they have a choice. For example, for health care providers, they can rely on the customer service center in their own organization to deal with patients’ complains; for patients, they might turn to their doctors or friends who have those treatment experience for help when they need. Therefore, patient advocacy organizations should considerable emphasis on developing a list of help service which customers really want. For example, in South Florida, as we also mentioned earlier in this paper, a large proportion of people speak Spanish as their first language, so Spanish speaking can become a selling point and add into the service list in this area; especially in a situation of establishing commutation between a Hispanic or Latino patient and an English-speaking physician. What is more, for those existing services, the organization should also pay attention to the product life cycle as well. For example, with the implementation of Obama Care, the American healthcare system has become a complex system, and it has become increasingly difficult for patients to understand and adapt, so patients’ fears and frustrations have continued to grow since they may get confused by the new policies and become worried about how to get their reimbursements after the treatment. In other words, customers’ requirements change over time. What is important and useful today may be discarded tomorrow. Therefore, marketing should continuously monitor the external environment and other factors to modify the services in order to meet the customer’s need. Price Price focuses on what customers are willing to pay for a service (Berkowitz, 2011). And the customer’s perception of value is an important determinant of the price charged. Customers draw their own mental picture of what a service is worth. So the pricing decision is a major aspect of marketing strategy. In the healthcare industry, the issue of price is less likely to be a concern since pricing was based on predetermined reimbursement formulas. However, in order to sustain and develop and organization, whether public, non-profit organization, private, or for-profit, patient advocacy organizations still need to pay attention on how they establish the price. 1. The Types of Services and Complexity of Service. As customers’ needs are varied, there are perhaps dozens of services health advocates can provide, ranging from explaining treatment options to reviewing hospital bills, from uncovering clinical trials appropriate to customer’s need, to getting their insurance company to pay a claim they think should be covered. Each service should cost differently according to the time it takes to accomplish it. 2. The Background and Expertise of the Employee Just as would be true in any service business, the more credentials an advocate has achieved, the more it will cost. Further, some advocates have developed specific niches to their work that becomes a benefit to customers, who may be worth a higher salary. So obviously, a higher price should be made for these employees in order to sustain the organization. 3. Geographic Location. Just as there are variations in cost for almost anything we buy based on where we live, the same is true for health advocacy services. As shown in Figure A7 (â€Å"Miami Household,† 2011), in Florida, take Miami as an example, households with income under 15,000 reached 25% in 2010, which was twice as many household of the entire United States. Considering the low-income rate in this area, the price should not be too high when providing services. However, the danger of using low price as a marketing tool is that the customer may feel that quality is being compromised. It is important when deciding on price to be fully aware of the brand and its integrity. A further consequence of price reduction is that competitors match prices resulting in no extra demand. This means the profit margin has been reduced without increasing sales. Place All businesses must decide how many other organizations are needed to distribute their product or service, so does the patient advocacy organization (Berkowitz, 2011). In fact, the purpose of getting any intermediary organizations involved is to provide service to customers in a more accessible way. Therefore, not only big general hospital, but also small primary care clinic should be considered when providing services. Besides, â€Å"place’ in the marketing mix, is not just about the physical location or distribution points for services. Especially in the healthcare industry, it encompasses the management of a range of processes involved in bringing patient advocacy to the end consumer. Promotions Promotion is more than just advertising (O’Malley, 2001). The promotions aspect of the marketing mix covers all types of marketing communications such as advertising, personal selling, publicity, and sales promotion. However, advertising is an important part of promotion. Generally, advertising is conducted on TV, radio, cinema, online, poster sites and via the printed press (e.g., newspapers, magazines). Different advertising channels can be used to maximize the effectiveness of advertising. For example, TV advertising makes people aware of a help service and press advertising provides more detail. This may be supported by in clinic or hospital recommendation to get people to try the service. It is imperative that the messages communicated support each other and do not confuse customers. A thorough understanding of what the brand represents is the key to a consistent message. The purpose of most marketing communications is to move the target audience to some type of action. This may include purchasing the service, visiting or calling the organization, and recommending the choice to a friend or purchasing another service that he or she may also need. The key objectives of advertising are to make people aware of the service offered by the organization, which they cannot get from anywhere else, and to feel positive about it and remember it. Therefore, when promoting, messages should gain the customers’ attention and keep their interest. The next stage is to get them to want what is offered. Showing the benefits that they will obtain by taking action is usually sufficient. The right messages must be targeted at the right audience, using the right media. Take South Florida as an example, 33% of the population in this area is over age 65, so it is important to find an advertising channel to reaches this group of people. In this case, Internet advertising may not be such a good idea while newspaper and television may bring more customers to the organiza tion instead. Conclusion After analyzing the market in South Florida, we can easily reach the conclusion that there are great needs to have patient advocacy in South Florida. In fact, patient advocacy is an emerging practice, and it deserves more recognition when developing healthcare business. Whether you are in private practice, serve as a hospital patient advocate or are developing an advocacy program in a managed care company, having a clear marketing plan of patient advocacy in your business region is a key factor to successfully grow your practice in the future. References Agency for Healthcare Research and Quality. Healthcare costs and financing. Research Activities. 2011. Accessed at heep://www.ahrq.gov/research/jun11/0611RA11.htm. Ad Hoc Committee on Advocacy. (1969). The social worker as advocate: Champion of social victims. Social Work, April, 16–20. Berkowitz, E. N. (2011). Essentials of Health Care Marketing. 3rd Edition. Jones & Bartlett Learning, LLC. Carlton, T. O. (1984). Clinical social work in health settings. New York: Springer Publishing Company. Florida Population: Census Summary 1990 and 2000. Make a difference as a patient advocate. Retrieved from: http://allhealthcare.monster.com/benefits/articles/3210-make-a-difference-as-a-patient-advocate?page=2 Miami Household Income Statistics (2011). CLR Search.Retrieved from: http://www.clrsearch.com/Miami-Demographics/FL/Household-Income Ogburn R. F., 2010. Demographics and population growth in southeast Florida. South Florida Regional Planning Council. Retrieved from http://www.sfrpc.com/region/demographics.htm O’Malley, J. F. (2001). Healthcare marketing, sales, and service: An executive companion. Chicago: Health Administration Press, p. 101 4Ps Marketing Mix Example (n.d.). SmartDraw. Retrieved from http://www.smartdraw.com/examples/view/4ps+marketing+mix/

Carol Ann Duffys Mean Time

Carol Ann Duffy's Average Time Carol Ann Duffy's poetry Average Time is another way to lose love, change time and lose life itself. This poem is very personal and autobiographical for Duffy's life. It is almost the same as her poetry. Average time is based on mourning your lost love and when you awake one day you realize that it's not just time passed, regret seems meaningless but time also I steal my life It is your mourning regret. This contemporary Victorian poetry can also be compared with the Shakespearean sonnet and another contemporary Carroll Andhafi poem. Ann Hathaway plays a loving wife and an adventurous woman at Anne Hathaway's poet Anne Hathaway. Duffy 's way of demonstrating this is by her choosing the type of structure used in that poem. She became a rhyming crowd that could be thought of as resembling Shakespeare's Sonnet style, using a modified sonnet. After all, this couple almost imitates the style used in Shakespeare's sonnet. Because they always use rhyming coupl ets and end up with dramatic rhyming tuplets. Anne Hathaway was a wife of Shakespeare, so this sonnet style was being considered in her poem. Finally, using this rhyming phrase highlights the focus of her and his beloved poetry. Compare Carol Ann Duffy 's Valentine' s Day and Andrew Marvell with this mission 's niece and compare Carol Ann Duffy' s Lovers with Andrew Marvell 's To Coy Mistress. Valentine's Day written in this poem is the 20th century and speakers use onion as a metaphor for expressing her love. The poetry of giving his niece in the 17th century tells the poet that he is trying to persuade his lover to sleep with him. - The poetry of Andrew Marvel and John Donne is the era of beautiful poetry. In particular, the two poets, Andrew Marvell and John Donne, wrote a poem by Carpediem full of vivid images and metaphysical meditation. Everyone tells the message live for the present. This information can be clearly seen in Marvell and Donne's flea poem To the coy Mistress. Th rough clever metaphor and tools these poems are not only symbolic but also have physical features.

Does Affordable Housing on Exception Sites impact on making rural Essay

Does Affordable Housing on Exception Sites impact on making rural villages sustainable or unsustainable - Essay Example Simply an approximate ten percent of the homes within rural segments are communal housing for rent, in contrast to the twenty percent within urban communities (odpm.com) The various Housing Corporations and partnerships, like the Chichester District, and the CDC in West Sussex aims to make certain that all and sundry have an occasion of a respectable home which they can manage to pay for, as well as to guarantee a sustainable local society within the several villages inside the principally agricultural district, by way of a high percentage of aged population is dedicated to helping deal with the housing requirement within rural regions moreover this help invigorated the rural strategy which is premeditated to notify as well as support this vocation. The one and only resolution specific strategy, was majorly inaugurated within the year 2001 and ever since then has been accountable for a spotlight on rural requirements as well as a intensification within our rural housing programme, which has more than amplified ever since the strategy was primarily pioneered. Throughout the National Affordable Housing Programme for the year 2004 till 2008, all the housing associations are offering supplementary new 5,500 fresh homes for the rent as well as low cost home possession within rural regions. The additional Regiona... At the grassland roots, associations have counterfeit the joint ventures with rural community councils, land holders as well as local communities to recognize the regional requirements as well as to mark the assets to convene with them (odpm.com). The outgrowth of these corporations are innovative housing association schemes within a lot of England's marketplace towns, villages as well as hamlets including minor proposals that make it potential, for instance, for the sons as well as the daughters of the rural communities to donate to their vivacity as well as their sustainability. This approach is premeditated to carry on as well as perk up their workings inside the rural regions moreover concentrates on: - forming as well as supporting the joint ventures to distribute a lot more reasonably priced housing for rent out as well as reasonably priced residence ownership in rural areas; sustaining and making the best use of the existing affordable housing in rural areas; - forming sustainable rural societies, skirmishing social prohibiting, as well as dealing with discrete shortcoming within rural regions; - looking for ground-breaking ways of escalating the supply of terra firma for rural housing at the same time as shielding the veracity of the landscape; - sustaining as well as encouraging stumpy cost home rights inside rural regions with suitable defense to make certain a supply of reasonably priced housing within the near future; - also, endorsing and encouraging a good quality design in addition to the utilization of locally resourced materials within housing association systems; and - making sure that all the homes are constructed within

Arsenic in Groundwater in Eastern New England Research Proposal

Arsenic in Groundwater in Eastern New England - Research Proposal Example In eastern New England, the high concentrations of Arsenic occur in groundwater. Several researches have established that underground water contains arsenic due to bedrock geology (Environmental Science and Technology, 2006). A sample of 790 groundwater test samples from bedrocks within Maine and Augusta revealed that 31 of the samples contain arsenic greater than 10 milligrams per litre. High amount of geogenic arsenic within subsurface water in eastern New England has generated a lot of public health concern within US and the entire world. With a population of approximately 103, 000 majority of the inhabitant have private wells that supply drinking water. A large proportion of these wells have not complied with the requirement of Maximum Containment Level (MCL), which is 10 ÃŽ ¼g/L worldwide (De, Belkin & Lima, 2008). This situation increases exposure of the people using water from these wells to arsenic element. In this scenario, anthropogenic activities such as lumbering, use of pesticides and manufacturing contribute immensely to high levels of the element in groundwater (Henke, 2009). The private well owners by not complying with the MCL recommendations contribute to high increase in arsenic in drinking water drawn from the wells. However, drinking water drawn from unconsolidated aquifers contains less concentration of arsenic. Naturally, unconsolidated sedimentary rocks as well as bedrock aquifers contain arsenic. High concentrations of the chemicals are in glacial, alluvial, and volcanic basins occupied by sedimentary aquifers. In most instances, high concentrations of arsenic in groundwater occur due to geologic units in earth. These include Eliot formation, Berwick Formation, Rangeley Formation, and Ayer granodiorite (De, Belkin & Lima, 2008). Consequently, wells lying on metasedimentary bedrocks in New Hampshire and Maine produce water with the highest

Human Rescource Planning Essay Example | Topics and Well Written Essays - 1500 words

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What Is Human Reproductive Cloning Essay Example | Topics and Well Written Essays - 2000 words

What Is Human Reproductive Cloning - Essay Example As the report declares the most prominent theoretical source of objections in the ‘deontological’ school of thought is the moral philosophy of Immanuel Kant, the German eighteenth-century thinker who stressed the ideas of ‘transcendental’ freedom and autonomy. To define his idea of the transcendental autonomy of human reason, Kant presented several formulations of what he called the ‘categorical imperative.’ This is the moral law that he thought people should obey without exceptions. The general idea and two specific formulations of this overarching rule, and see how they can (or cannot) be employed in objections to human reproductive cloning. This paper discusses that Kant’s first formulation, which is of more use, was â€Å"Act only according to that maxim whereby you can at the same time will that it should become a universal law†. The definition of the goodness of genetic diversity does make some sense, but it does not support the Kantian objection to cloning. We can permit cloning in cases where people cannot have children by any other means without allowing it to become the only way of making babies – and without disturbing the human gene pool in any way. Besides, it could be argued that whatever accidental advantages the variety of genetic constitutions has had in the past could in the future be secured by considered genetic enhancements. The more Kantian way to proceed is to say that genetic diversity is good, because it is natural, or intrinsically linked with human reproduction.

Finance SLP5 Essay Example | Topics and Well Written Essays - 500 words

Finance SLP5 - Essay Example The average Japanese stock pays less than one percent in annual dividends per year (Norris, 1995). In Japan the overall sad state of the economy has gotten better during 2008. The country had endured a 15 year span of basically no economic growth and was stuck in a climate that felt like a constant recession. The stock market completely bottom out, but finally there is light at the end of the tunnel. The fourth quarter numbers for 2007 demonstrate an economy on the rise, if the benchmark of GDP was annualized it reflects a Japanese annual economic growth of 3.7% (Hutchinson, 2008). The economy is one of the most influential factors in the behavior of a country’s stock market behavior. Despite that fact last year was another bad year for Japanese stocks. The SPDR Russell / Nomura index which reflects the value of smaller companies dropped 30% altogether last year (Hutchinson, 2008). The stock market in Japan is extremely risky. If an econometric statistical analyst was perform I’m sure the Beta coefficient for the marketplace is extremely high. There is still lots of uncertaintly over the long term performance of the Japanese stock market. The yen during the last year has not done well and has lost purchasing power against the dollar which is bad sign for Japanese stocks. Investing in a marketplace with high level of risk has its advantages for sophisticated and smart investor that can find hidden gems within all the chaos. It is basic economic that with high risk come high rewards which means that in stock market such the Japanese stock market there are great short gains to be made in many stocks in the marketplace. I would personally invest in the Japanese stock market place. As stated earlier there are opportunities to find high yield stocks in such a market. The smart move is to diversify and include a portfolio of blue chip U.S. stocks when attempting to make money in high risk

Birth to death Essay Example | Topics and Well Written Essays - 250 words - 3

Birth to death - Essay Example This notion might result to drying of wells, reduction of stream water, deterioration of the quality of water in Tucson as well as land subsidence. The water table in Tucson has drastically lowered over the past 70years (City of Tucson, 2014). This is as a result of an increase in population over the years which have lead to excessive pumping of underground water. This is portrayed by the decline in the amount of water yield by most of the well in southern Tucson region (City of Tucson, 2014). The Central Arizona Project is a water supply and treatment project owned by the United States Bureau of Reclamation. It comprises of 336 miles length system of tunnels, aqueducts, pipelines and pumping ducts. The system is designed to carry water across the state of Arizona. Apart from drinking and agriculture, water from the CAP is used for outdoor recreation, wildlife conservation and fishing. Wildlife conservation practices and fishing are essential in the economy of

Communication system Essay Example for Free

Communication system Essay Use and develop systems that promote communication 1. Be able to address the range of communication requirement in own role 1. 1 Review the range of groups and individuals whose communication needs must be addressed in own job role. Working within Surestart I work with many groups and individuals whose communication needs must be addressed which include 16 staff members, services users to date we have 1700 families registered with Surestart. We would have a lot of communication with Health visitors regarding referrals that they have sent in and also follow up telephone calls if there is any concerns with the family. I would also have contact with social services and be asked to attend case review meetings. I would also be expected to communicate with other agencies to refer our service users on the appropriate agencies for example other children centres, counsellors, women’s Aid and Hidden Harm Social worker, 1. 2 Explain how to support effective communication within own job role Effective communication and interaction play a very important role in the work of everybody that works within Surestart. I feel that how I support effective communication is by setting a good example to staff. With communication been so important for the day to day running of the centre, each staff member would be asked to write in the diary in the main office so people can know where they are (this is for the save guarding of staff if they are out of the office, lone worker policy) There is also a white board in the main office so when staff are in programmes other staff are aware of this and that the parents/baby room are booked. I would also support communication by attending staff meeting ever second week and staff are told that they must attend once a month. There is also an open door policy as sometimes there is information that staff do not want to share in a team meeting as there maybe difficulties within the team and they would like to share information on a one to one basic. 1. 3 Analyse the barriers and challenges to communication within own job role The barriers and challenges that I would face is staff working part time, staff out doing programme and also may be difficult feeling between staff members. The other barriers and challenges that I would face is staff do not take on board what you are saying to them as they feel they are right so they do not even listen to what you are trying to explain. Some people may pick you up wrong on the information you are trying to get across. 1. 4 Implement a strategy to overcome communication barriers Make sure I speak very clear, focus on what information I would like them to take on board. Supervision on a monthly basis, open door policy if anyone has a problem they can talk about it. Staff can ring and send emails at any time. The childcare supervisor meets with the childcare team every morning to make sure that all creches have enough staff and if they have any concerns regarding the children. There is also a referral meeting once a week where we discuss the referral that health visitor/social workers have send in and also to discuss and concerns we would have regarding the parents. I also send rely slips to social worker / health visitor to let them know if a home visit has been completed or if we have been unable to contact the family. Use different means of communication to meet different needs I am aware that each staff member has different learning styles, some staff like sharing information in a group and other staff like to share information in a one to one. It is also very important for me to take this on board as I do not want any member of the team feeling frustrated and ineffective. I want staff to be able to trust me and let them see that I value the work that they do. The different means of communication I use to meet different needs are. Emails are a very effective means of communication as each staff members gets the information at the same time and not second hand. Emails can be sent at any time and also printed out to file or record information that has been sent or received. Team meeting again are a very good as all staff are getting the same information and this is a nice way for other staff to meet and let everyone else know how things are going and if anyone is finding a family or child difficult then there is the support of the whole team for ideas of how to handle a situation. If anyone cannot make it then the team minutes are there to read. Telephone if I am not in the office I can still be reached on my mobile if anyone needs anything. Health visitor/Social worker would also contact me by telephone if they needed an update on a family. Staff diary in the main office this lets staff members know who is in which room and if anyone is on leave or sick or if someone has an appointment. Sign in and out sheet beside the exit door this is for safety reasons as if there was a fire in the building then I would know who is in and out Reply slips are back to the health visitors/social worker as an update for the referral they have send in. Letters to parents this is to invite them along to programmes/events. Thought-out the year I would facilitate information mornings for breastfeeding support, weaning work shop and feeding for under 5’s this would be to share information to welcome new service users to the Surestart. Face to face, my office is open to all staff at any time if they need to talk about anything. CU2941 Use and develop systems that promote communication 2. Be able to improve communication systems and practise support positive outcomes for individuals 2. Monitor the effectiveness of communication systems and practices. The diary in the front office if very effective for staff on home visit as we know where there are for their safety (lone worker policy). white board in the main office is very effective as this is where all staff write down their programmes so if there is any phone calls for staff the secretary knows if they are in the office or in programmes. Emails can be sent at any time and it means that the same information is been told to the staff at the same time and it is also the staffs responsible to pick up their emails. The childcare supervisor meets with the childcare staff each morning I feel that this is very effective as this is in place to make sure that all rooms are covered with their ratio, and most importantly that the needs of the children are met and if there is any problem in any of the setting it can be addressed as needed and that staff do not have to wait 2 weeks for a team meeting to discuss. One to one communication i. e. Supervision and APR, I feel that this is very important within a setting. N-Drive this is where documents can be saved and all staff can access it. In our office we have a policy of hot desking so documents can accessed at any computer. This is also for Surestart forms and newsletters so all staff can print them out as needed. Reply slips to health visitors/social worker/other agencies this is where I reply to any referral letter that the project receives, I would reply to the other agencies if this family had received a home visit and services offered, if I was unable to contact the family for different reasons or if the family did not want to avail of Surestart services. Phone if I cannot be reached at any time then a message can be left for me to return there call. 2. 2 Evaluate the effectiveness of existing communication systems and practice Evaluating the effectiveness of existing communication systems and practice I am going to start with the ones I feels are the most effective. One to One Communication I feel that this works very well within a team as some staff members do not like to speak in front of other and feel that their ideas might not be good enough. I also feel that face to face communication is very effective as some people can pick up a message wrong and take the wrong tone with an email. Supervision this is there for staff to talk confidently with their manger I feel that this is very effective means of communication for the manger to tell how well things are going for that member of staff and for the staff member to say how they really feel about how things are going. ( I also feel that you have to have a good relationship with your staff for this to work, you have to be relaxed and friendly and staff members also have to trust you). Supervision is also very effective as this give staff clear boundaries of what is expected of them for the month a head and also make sure they are on target to achieve the targets in their APR. Team meetings I also think this is effective as this can let everybody know how programmes are going if there is any follows to do with families in any of the programmes. If anyone is having any difficulties if any of the programmes is nice to get other ideas how to deal with it. It is also there for sharing information for the Surestart board and action for children. To let staff know what training is coming up. ARP- I have been working in a Surestart setting for the last 11 years, I feel that this is the first year I have felt that an APR has been effective like the rest of communication systems if it is not done right then it will not be effective. APR is there to set goal and targets for the year ahead, I feel this is very important for staff as they know what is expected of them for the year ahead and then this is monitored at each supervision to make sure that staff in on track with their targets. Childcare meeting every morning I feel that this is very effective as each member of the childcare team no where they are each day and who is covering in each setting and also if any member of the childcare team is concerned about a child this is discussed each morning. Emails- I feel has pro and con. It is very effective in a way that emails can be sent at any time and is very good for all staff to receive the information at the same time. I also feels that staff can pick the tone of emails up wrong and some information is best said face to face. Reply letter to health visitors/social workers/other agencies I feel that this is a very effective The diary in the front office This is effective if everyone plays there part in filling it in. If someone is on training or off on A/L and forgets to fill it in then it is very hard for other staff to know where they are. N-Drive This is effective as all the Surestart form and standard letters are on it as well as newsletters. It is also that as this is used while hot desking it means that the documents that are placed on this drive can be accessed by the whole team so if I was saving any confidential information I would also password protect it. Phone I do feel that this is effective as if I am not available by phone or mobile then a message can also be left. 2. 3 Propose improvements to communication systems and practices to address any short comings I feel that communication can always be improved as we are only human and staff do forget to pass on messages, response to emails, and even fill in the diary in the main office. I have proposed that each desk has message pad so that all messages have to written down. I have proposed that the main diary is to be brought to the team meeting so that if anyone has any leave booked, any visits arranged or training then this can go into the diary. I would also remind everybody at team meeting about remembering to fill in the diary I have also propose that the reply slips to the health visitors/social workers be changed as I feel it could be improved. 2. 4 Lead the implementation of revised communication system and practices CU 2941 Use and develop systems that promote communication 3. Be able to improve communication systems to promote partnership working 3. 1 Use communication systems to promote partnership working The systems that we use to promote partnership working is: One to one communications I meet with the health visitor for breastfeeding once a week. Also any of the health visitors are welcome to call in at any time. Some health visitors like to bring parents that are hard to engage into the centre to meet me to show them around the building and meet the staff. I would also have contact face to face with our families on a daily basis through programmes and also registrations. Phone call health visitors/social services and other agencies would phone for update and regarding case review meetings. Families would also phone on a daily basis if they needed help with anything or information. Post we post letters to the agencies if we are unable to reach the families or if they no longer wish to be involved with the service. I would also post letters and newsletter to families. Emails some agencies like to send email as it is a faster way for them and this is ok with me as long as it is recorded. Referral reply this is a letter drawing and signed by Surestart parents that we have permission to send it back to the health visitors to say we have been in contact and the Surestart services have been offered. Information events this is different events for Surestart to promote their services 3. 2 Compare the effectiveness of different communications systems for partnership working I feel within waterside Surestart the systems we use are very effective. One to one communication I feel is very effective as this can reassure service users and colleagues and also outside agencies, you can focus on the goal. I can be supportive and positive to all that need it. I can also assess the services users’ needs and provide them with the support needed and I also feel that this builds trust and relationships. Phone call I feel that this is a very effective way of communicating as some health visitor/social worker/other agencies need an update ASAP as they may be on their way to a review meeting. All if a member of staff is not on the office this is a good way of communicating. As my role as family support worker I be in contact with families every day on the phone, may it be they have a question or I am inviting the families to programmes or arranging home visits. Emails This is a very effective way that I communicate in Surestart, supervision notes to be sent 3 says before supervision, team meeting are to be sent and read before the meeting. Agencies are able to send emails / newsletters Referral Response I feel that this is a very effective way that Surestart communicate. This is send to health visitors/social workers who send in a referral this is to show the agencies that we have made contact with that family or that we have tried to contact the family and after 4 weeks we are unable to reach them. Information events I feel that this is not really effective as we work on catchment areas and this is very hard to have an event in a general area, it has to be within the area, as we do not like to turn people away that may be interested in the service, as when agencies send in referrals they have a list of streets that is inside the catchment area and only if there is a need then they can be outside the area. Propose to improvements to communications systems for partnership working I do believe that communication within waterside Surestart has got a lot better in the last year, I feel that this has a great deal to do with our new manager, she has gained the trust and respect of the staff and in return it is a pleasure to work with. I feel that I have a great leader to follow and learn a great deal from. The only improvement that could be made is that a leaflet could be drawn up for families that are outside the catchment area so that they leave with something rather than going away with no information (this is in the process on being done). I am also assisting the upgrade of the referral response form so that families sign this form so that we have permission to hold their information and that we are allow to send the form back to the referrer. CU2941 Use and develop systems that promote communications 4. Be able to use systems for effective information management 4. 1 Explain legal and ethical tensions between maintaining confidentiality and sharing information Working with in a Surestart setting for the last 11 years, I know that confidentiality is very important. It’s important for agencies and services users to build a trusting relationship with me. I am very honest with the people I work with, when I am completing a registration form with parents I do tell them that their details will stay in a locked filing cabinet for 7 years, that there information is stored on a database password protected until there child/ren turn 4. I also let the parents know that under the data protection act they are able to see their file at any time. Parents also sign a form that we are able to share information with the health visitor and other agencies involved if we have any concerns regarding the child or parents. When I have taking programmes with parents I also start with group rules. Confidentiality always comes up, I always tell parents that whatever is discussed at the group I do not take it outside of the group, I can only speak for myself but that I would hope that everyone would stand by this too. I also always make it very clear to parents that if anything is discussed or disclosed any information regarding harm or danger or abuse to a child/ren then I will past this information on to my manger and the appropriate authorises. I feel that if I am honest with all the people that I work with then I do believe that you build up a trust and that by law I have to report and record all that is disclosed to me, although I did have a parent in the past that did not understand this, they felt that I was just reporting them to social services and she believed that social services where there to take her child away. This lady did not return to Surestart as what she disclosed I had to discuss with my manger. Analyse the essential features of information sharing agreements within and between organisations Under the data protection act 1998, the purpose of the act is to protect the rights and privacy of individuals and to ensure that data about them are not processed without their knowledge and are processed with their consent whenever possible, this act covers personal data held in electronic formats, manual data and relevant filing systems. Surestart has devised a form that has recently been updated by my colleagues and myself, this form is where we get service users to sign that they agree Surestart is able to keep their details in a secure place for up to seven years, and that if we had any concerns regarding the child that we would contact the appropriate service also that if there is a social worker involved that we are able to update them on any programmes they attend for case review meetings. Health visitors would send in referral form with parent’s consent, what happens is we then phone that family and do a home visit and in that visit we fill out the Surestart forms with the families details on it, the consent for is then signed and sent back to the health visitor to say we have completed a visit this is what programmes they would like to attend, I would also send back a form to the heath visitor if that family did not wish to avail of Surestart services or that I could not reach them. These forms are kept with the registration and filed in a locked cabinet. When I am facilitating a programme within Surestart I always do group rules, parents can put what they like on it, confidentially always comes up, I just remind parents that what happens in the group will stay in the group with me, but I can only speak for myself and not the rest of the group and I do tell them that It would not be nice to hear anyone talking bad about another parent. I do inform the parents that if there anything disclosed within the group that has caused abuse of harm to a child them I am bound by action for children policies and procedures and under the children order act 1995 to past this information on to my manger and the appropriate services, I do tell the parents that I would discuss this with them before I reported what I have heard. Demonstrate use of information management systems that meet legal and ethical requirement Under the data protection act 1998 Surestart need permission to hold data on the families that I work with, how this is done  is that all parents have to sign the registration form and also the consent for their details to be stored according to action for children policies and procedures, which is that their details are stored for up to seven years, in a locked filing cabinet and up to four years on the Surestart database. Under the children’s order 1995 I am bound to report anything that I have heard or seen that my or has caused harm to a child. This would also be discussed with the parent/s what information I would be passing on to my manger. This also gives the parent an opportunity to explain. The information my lead to a referral been made to social services.

Procter Gambles Innovation And Information Technology Practices Marketing Essay

Procter Gambles Innovation And Information Technology Practices Marketing Essay The PESTEL analysis found out that government taxes/ corporate tax and global economic downturn become the issues of the PG changes its business to merging market. And the SWOT analysis evaluate that PG have the strong financial position and strong branding makes it success in this new markets trend. The efficiency and effective of supply chain also is the strong point for PG innovation. The report also evaluates and concludes  that would be an ideal to meet the challenge which presented by the market and could satisfy the consumer demand since it uses open innovation- Connect and Develop program outsourcing the raw- materials and technologies and through acquisition of domestic and foreign competitors. But it also has the barriers on this program and acquisition. Since carriage out the Obamas foreign tax proposals, foreign rivals pay less in taxes in their home countries, foreign-based competitors would be able to reinvest more, expand faster and sell their products at lower prices than U.S. companies and this affect PG. The tax changes put PG at a cost disadvantage, PG gain a 15% to 20% cost disadvantage compared with other rivals. This will make PG unable to effectively compete against foreign corporations in the future (www.msnbc.msn.com). The heavily of IRS (Internal Revenue Service) fees is a burden of PG. This will reduce the profit of PG. For the example, PG valued artwork donated Cincinnati Art Museum in 2003 at $8.5 million but the IRS allowed PG subtract $6.4 million of the income taxes because the company states that in the lawsuit that PG is uses third-party appraisers to value its donations, so the company not allow PG subtract the full amount of the donation. And, PG had paid more than $6 billion of federal income taxes over the six years that were audited (www.usatoday.com). The national income and GDP growing will increase buying power. It will course PG raised its consumers especially in developing markets such as China and India. According to the report, GDP growing helps the Procter Gamble gain the premarket; it was gained from 2.2 percent to $58.51 after it reported results (www.reuters.com). Today, according to The New York Times (2009) reported that the sales from developing countries are doubling every four years. The sales from developing markets represent 32 percent of P Gs $78 billion in annual revenue, up from 23 percent four years ago. Global economic downturn- merging markets In the worlds four most populous nations, three are state in emerging markets; there are China, India and Indonesia. According to the Capital Groups estimation, it found that 70% of the worlds economic growth under the next 10 years will move towards from emerging market countries (Delfeld Carl T, 2009). Delfeld Carl T (2009) defines that Emerging markets now account for half of global economic growth, 33% of world GDP, and nearly 20% of world stock market value. After global economic downturn, PG trend to focus its growth strategy on emerging markets, it has opening about 20 new manufacturing facilities outside its established markets (www.wikinvest.com). It makes PG raising its capita sales in India and China more than 1 billion residents each and added $40 billion a year in Mexico (social.forecastfocus.com). And Delfeld Carl T (2009) also defines that PG now gains 32% of total sales from these merging markets and this is doubling every four years. PG have a large scale of operations and strong financial position in the domestic and foreign markets. PG serve 4 billion customers around the world and it has operations in over 80 countries (Procter Gamble, 2010). In the year 2008, PG was the 8th largest corporation in the world by market capitalisation and 14th largest US Company by profit. Now, it is 6th in Worlds Most Admired Companies in year 2009 (Americas Most Admired Companies 2009). In the Fortune 500, the company was the 20th in annual ranking of Americas largest corporations in the year of 2009 (CNN Fortune ranking). This strength helps PG gain opportunities in merging markets with the successful result. PG brings many new innovations to the market around the world. This is one of the strengths that PG success its business in the world. PG products innovation are very popular around the world, it gain a lot of awards, example, SymphonyIRI Group recognizes PG in its annual Pacesetters list and with the Outstanding Achievement in Innovation award (Procter Gamble, 2010). According to Business week, it reported PG is ranked 12 among the Worlds Most Innovative Companies (Procter Gamble, 2010). This is the marketing strategic that PG used to present around the world. PG provides well- known, trusted brands touch the lives of consumers in over 180 countries allows PG to efficiently and effectively to serve more consumers at more price points and gain the switch off markets advantages, for example Tide is the clear leader in the U.S. laundry detergent market with approximately 38% value share. Ariel is the leading detergent in Western Europe with about 16% value shares (2009 Annual Report). According to the IRI New Product Pacesetter Report, it ranks that PG products are the best-selling new products in the U.S. every year. Over the past 14 years, PG has had 114 top 25 Pacesetters. In the last year alone, PG had five of the top 10 new product launches in the U.S. and 10 of the top 25. (www.marketingweek.co.uk) Gillette acquisition, Ambi Pur acquisition After Gillette acquisition, PG believe that will create a group with annual sales of GBP 32bn, pushing its rival Unilever turn into second position in the UK toiletries market (Business Services Industry 05, 2010 CBS Interactive Inc). The PGs Gilette brand expend its market enters a new era in male personal care. That is a great opportunities to PG to expend it markets to male markets and gain more market share. There have many advantages to PG acquire Ambi Pur. Ambi Pur brand was rich history in innovation, if PG acquire with Ambi Pur success, it can enjoy millions of consumers which come from air care market. Beside that, Ambi Pur brings new technologies and high-performance products to PG current Air Care portfolio (Procter Gamble, 2010). This will increase the markets share of PG and brings PG go future. 2. Innovation and IT means to PG Innovation and IT become most and most importance in markets to every company. According to the Bob McDonalds speech which presented at the Innovation Institutes of India Global Conference (2008, p.4), claim that the innovation means at PG is the conversion of a new idea into consumer delight and, ultimately, into revenues and profits. In PG, the innovation very roughly, they innovate at every point of brands and innovate in every part of business. Its cover in terms of product or packaging innovation, and to innovate include design, media, communications, business models, cost structures and organizational structures (Bob McDonald, 2008). Open Innovation has significantly increased PGs innovation speed. Bob McDonald define that open innovation not as a form of out-sourcing but, rather, as a way to in source the creativity of the world. Nowadays, over half of the ideas and technologies innovations that PG bring to market are come from foreign countries (CASE III-5 by DeHayes, 2009). For examples, PGs Swiffer brand works together with Unicharm, Royal/Dirt Devil, and IDEO for the innovation of product, commercial and design. PGs Febreze partnerships with KJK, Givaudan, and GK Design for the package design, technology and perfume development. A Pringles potato chip is a successful example of the PGs open innovation effort (www.business-strategy-innovation.com). In this case, PG taking the innovation in, at the same time its also taking innovation out, for example: PG licensing PGs food technologies and packaging capabilities to ConAgra Foods (www.pg.com), in order to gain the licensing fee (CASE I-4 by Lyn Denend and Burg elman). Procter Gamble try to maintain its competitive advantages by focusing on product innovation, its always look for innovation ideas by its total portfolio of businesses and technologies. Its use its internal capability with an external network of innovation partners through Connect and Develop program. Theres a global network provide potential innovation partners for PG with about researchers, scientists and entrepreneurs doing work in areas relevant to PG businesses (www.pg.com). Through its Connect + Develop initiative, PG bring in new product ideas from outside, allows others developers to obtain their concepts and designs into PGs product pipeline. For example, they helped PG launch Olay Regenerist Eye Derma-Pods, and become its top-selling skin-care item in the year 2008 (www.fastcompany.com, 2008). According to the wiki analysis, it found that PG will launch a flurry of new products globally, using innovation to boost sales in fiscal 2010 coming out of the global recession (www. wikinvest.com, 2010). Acquisition of domestic and foreign competitors PG management had adopted another innovative play-to-win strategy by acquisition of domestic and foreign competitors. PG acquired other companies that helped in innovation its products, diversified its product line and increased its profits (knol.google.com knol.google.com). For example, the cases of Gillette acquisition, and Ambi Pur acquisition. After Gillette acquisition, PG gain the innovation in male personal care products, for example the Gillette Fusion ProGlideà ¢Ã¢â‚¬Å¾Ã‚ ¢ razors and ProSeriesà ¢Ã¢â‚¬Å¾Ã‚ ¢ male skin care products, there are innovation products which combine Gillette technologies (Procter Gamble, 2010). After acquisition of Gillette, PG increase its position in faster growing, higher margin, and more asset efficient businesses. The PG gain 22 brands with sales of $1 billion or more and 14 brands with sales between $500 million or $1 billion (Rick Ciccone, 2006). Besides, Ambi Pur brings new technologies and high-performance products to PG current Air Car e portfolio, (Procter Gamble, 2010). This will increase the product innovation, expands PGs market and gain more market share. (CASE II-17 by Burgelman and Meza). JIT inventory control Just-in-Time inventory control, can save costs, save time, reduce waste and move products and services to customers on time. In this case, PG is using this method and partnership with Wal- Mart. Wal-Mart linked with PGs inventory management system, provides information sharing and opened its consumer information to PG. After received the sales data directly from the checkout of Wal- Mart, PG used JIT inventory control on time deliveries to Wal-Mart and deliver the stock to the stores to meet the contracted customer service level. The just-in-time process works well for Wal-Mart and helps PG reduce the waste and more efficiency; PGs sales have increased significantly to Wal-Mart and directly to the consumer (Handfield and Nichols, 1999; Simchi-Levi, et al, 2000). TQM the process Total Quality Management (TQM)s principle provides many guidelines for PG to support its management approaches. Each principle will create their procedure to help PG in continually improving with training, practice and education (hubpages.com). The Five components of PGs TQM programs that primary to the improvements are: 1) Plant and division waste assessments to track discharges by site and set goals for improvement 2) Process assessments 3) Lifecycle assessments 4) Research on product impacts 5) Benchmarking. For example, the case at the Lima Ohio facility had success reduced 77% of air, water, and solid energy over four years using the TQM method. The other success example that is paper plant in Mehoopany, PG has created an innovation reduced 75% of the solid waste going to the landfill (www.future500.org). 3. The ways to improve and change The several ways that innovation and IT aspects of the organization/ supply chain of PG might be improved; there are supply chain reinventions, eStore website, products innovation and logistics. 3.1 Setting Up the Web Store Early in this year, PG ran e- commerce in USA, e Store provide a wide range of potential consumer to PG. EStore allow PG to monitor sales volume. World Wide Web allows PG to sell products directly to the consumer and it also allows PG get the relationships with customer. PG can get the comment and suggestion or advices directly to the consumer and take the action to change and improve faster. In addition, PG can overcome geographic barriers to reach a global markets and customer- base. In this case, PG can continue use e- commerce to expand its Web Store to another country, such as Western Europe, Asian countries, because online shopping is not new news to the world, people can accept this marketing method. The PG also can set up its eStore in the lower cost places or overseas, for overseas PG can set up the web store office at merging market such as India or Taiwan because, India is IT developed country can provide good IT with low prices. And in Taiwan, the online shopping market is mature and popular, there have a mature market to PG expands its market to South Asian and China. Beside that, consumer on the Internet do not care where are the web store built. If PG built in the low- cost places, it can gain more profit and reduce the cost. This method that have used by CASE II-4 by DeHayes (2009), they move their offices from high- cost New Jersey to lower- cost Indiana. Supply chain reinvention- supply network In the PGs existing supply chains, it was limit its ability to reduce material use in PGs packages. The existing supply chain in PG is: Supplier manufacturer retailer consumers. After reinventing to the supply networks the PGs supply chain method will be change to Supplier manufacturer consumers. The supply chain has shorter the journal and also giving many benefits. The supply network is more focus on external market and consumer, using supply chain will help PG in expand its market to merging markets. So using the supply networks, PG can more focus on the consumer- driven especially external consumer, it also help PG run its business more fast and flexible. The table 3.1 below has shown that the effective when PG after using the supply networks in PG (Rick Ciccone, 2006). From To Chain Network Long and slow Fast and flexible Forecast-based Demand-based Manufacturer-driven Consumer-driven Internal focus External focus Designed from product forward Designed from shelf back Cost-reduction Value and growth creation Table 3.1, source by : Ciccone, R. (2006) AMR Supply Chain Conference, Reinventing the Supply Chain and Manufacturings Role Improve product innovation- health medicines combine with Chinese herbal According to the research of University of Maryland Medical Center (UMMC), (2009) reported that Recently, the World Health Organization estimated that 80% of people worldwide rely on herbal medicines for some part of their primary health care. In Germany, about 600 700 plant-based medicines are available and are prescribed by some 70% of German physicians. In the last 20 years in the United States, public dissatisfaction with the cost of prescription medications, combined with an interest in returning to natural or organic remedies, has led to an increase in herbal medicine use. Nowadays, Traditional Chinese Herbal Medicines (TCHMs) have been modified into solutions, soluble granules and tablets by extracting the plants natural ingredients. Due to the fact that TCHMs are natural and with very little side effects, its usage has been increasing significantly throughout the world. Research has shown that, similar medicinal plants are being used for the same purposes around the world (Chen, 2009). In this case, PG can change the health- care products ingredients to Traditional Chinese Herbal such as facial products, shampoo products. This is a good idea for the products innovation that can bring PG into another business level and markets. 3.3 Partnership with foreign countries company Today, the merging markets are developing so fast, many businesses tries to invest in this market to gain the competitive advantages. In order to survival in the market, PG can choose partnership entry mode to entry foreign countries to avoid distribution system and high cost of inputs problems. This can help PG invest to overseas save more cost, share risk with others and easy to entry the market. Partnership Company will provide the supply chain information to PG, help PG run the business smoothly. For example, PG partnership with Darlie which is a toothpaste brand of the Taiwan of Hawley Hazel company. This product is very popular in Asian countries, including Malaysia, Thailand, Singapore and the China (www.darlie.com). If PG partnership with this company, it will increase the market share significant. At the same time, PG also can gain the innovation and IT technology. But the Hawley Hazel company may less international business experience. This makes collaboration has a littl e difficult to manage because of their inexperience in the global business arena (CASE III-3, Christensen and Anthony). 4. Overcome the barriers It might be very difficult to overcome the barrier indicated above, unless the organization appropriate financial resources and human resources in: Building global network in different language Although the online marketing has given PG a lot of advantages but the cost and logistics of delivering goods to consumers have been the biggest barriers to PG, this barrier is around this supply chain and cost-effective thing. The cost of logistics and packaging fees are costly, it will affect the profit of PG. Another problem is the delivery problem; some of the rural places there have no convenient transportation for transport. So PG have to create the solutions to reduce the cost of packaging fees and logistics fees. The language and cultural differences also are the barriers of supply network in PG. PG want to expand its business in the merging markets, its has to change the its website page language to multi- languages specially Chinese language because Chinese language popular in Asian including China, Singapore, Taiwan and Malaysia. Those are big developing markets to PG, PG have to improve this services in order to gain the competitive advantages (CASE III-8 by DeHayes, 2009) The program for building a global network of professionals requires a lot of time and resources. PG had taken many years to identify and build its network of technology entrepreneurs, suppliers and scientists (www.business-strategy-innovation.com). Another barrier in building global network that may face is online advertising. Using search engine advertising also is a costly media innovation, because the GoTo search engine charge for the list position. In order to solve these problems, there have two ways that let PG Web store may appear on search engine results, which are sponsored links and relevancy ranked listings (CASEII- 4 by DeHayes, 2009, p 329). Beside that, in order to remove the barriers in Chinese markets, PG has to spend the money and human resources to create a Chinese language website or software (CASE III- 8 by DeHayes, 2009). Using 3PL to remove logistics barriers For the case which improve product innovation to low- income market, normally the facility such as transportation in low- income countries not that develop and convenient especially in the rural places. The problem of delivery to the rural places problem might be very difficult to overcome, besides the organization appropriate financial resources to solve the problems, the another way is using 3PL to remove the logistics barriers, because 3PL helps company to save costs, reduce waste, reduce financial risks. Relationships with Asian retailer In Europe, PG partnerships with Wal- Mart retailer to serve the consumer needs and market. The PG also can use the same method to entry Asian market, it can relationship with Watson, Tesco, The Store, Guardian, Giant etc. Those are famous retailer in South Asian, partnership with them PG can gain more competitive advantages and market share. It also help PG invest to Asian easier. The Asian retailer can give the feedback from the Asian consumer comment and suggestion; this will help PG to improve and benchmark with others company and continue improve itself, same with CASE III-3 by Christen and Anthony (2009) relationship with outside, take the knowledge from others. Stay focused on its customers need, Kanban continue improvement strategy In order to overcome the barriers from competitor, PG should stay focused on its customers needs, continue improve in technologies and also product, using the Kanban continue improvement strategy to maintain its business strategy and competitive advantages. At the same have to benchmark itself and competitor. Benchmarking helps PG opens organizations to new methods, gives ideas and tools to improve their effectiveness. PF can get more innovation from this management method, and this management has been used by many companies, such as Toyota, Nissan etc. Continue the Open innovation activities Innovation is PG business strategy, it cannot survival without innovation, PG come out many ideas to remove the barrier. And the open innovation is the way that PG use to remove the lack of innovation period in its business and this activities run (CASE III-3 by Christensen and Anthony, 2009). The open innovation activities need a lot of money and human resources such as scientist, chemistry, engineering, materials science, biological sciences, designer to develop the technology or innovation products and also packaging design. To overcome the barrier indicated above, PG has appropriate financial resources in place and the appropriate human resources to operate the equipment. For example, the Summer Camp program, that is a way to search for the best or brightest innovation group (Procter and Gamble, 2010). Company has to appropriate financial resources to organize this program to keep the open innovation run. That is hard to find a talented and creative scientist, chemistry and engin eering, and also costly to hire (CASE IV- 2 by Matthew C. Verlinden). Mass advertise According to the research of University of Maryland Medical Center (2009) there are still some Europe countries which do not widely accept the usage of Chinese Herbs medicines, they classified the Chinese Herbs as drug that are not fully regulated. In order to overcome the problem, the company should mass advertise Chinese Herbal products to the public, by introducing its health benefits and the little side effect it has on people. To do that a company has to invest a large sum of money in promoting and advertising these products to gain consumers trust which then leads to an increase in its market share. Training system Human resource is one of the main resources that need most. Training system uses to provide company human resources such as expert skills and knowledge. PG training system provide a set of session to train all its leadership team and subject matter experts including cultural, language, and religious differences with the organization. People can use the knowledge which they learn in the training system to manage the implementation of innovation and change (www.business-strategy-innovation.com). In order to run this system successful, the financial resources have been providing by PG (CASE II- 1 by DeHayes, 2009). 5. Conclusions The findings indicate that PG is now looking for more innovation and IT that can move the supply chain more efficient and effectiveness. Recently PG has used the outsourcing method, there is open innovation and through the acquisitions other company to increase the innovation and IT. JIT and TQM to confirm the supply chain run smoothly, and meet the consumer demands on time. Open online web store helps PG expand its business without geography barriers, increase its market share. Change to supply network is to reinventing its Supply Chain and Manufacturings Role. However, there have a lot of barriers, such as lack of innovation problems, Websites language problems, logistics problem and the quality control barriers of the innovation and IT in the supply chain become the burden of PG to improve and reduce its benefit. In order to overcome the barriers, it can be concluded that the organization must appropriate financial resources and human resources in open innovation program, training system to overcome the lack of innovation barriers. Focus on merging market to gain the competitive advantages and overcome the competition barriers and using the 3PL to remove logistics barriers in low- income market.

There are No Children Here: Life in the Projects :: There are No Children Here Essays

Life in the Projects Exposed in There are No Children Here The book There are No Children Here by Alex Kotlowitz is a very tough yet emotional book. This book is important to me because it really made me see how fortunate I am to be living in a good and safe environment. In this powerful and moving book, reporter Alex Kotlowitz traces two years in the lives of ten-year-old Lafeyette and seven-year-old Pharoah Rivers as they struggle to beat the odds and grow up in one of Chicago's worst housing projects called Henry Horner. Lafeyette and Pharoah live with their mother LaJoe. LaJoe also had three older children, LaShawn at the age of twenty five was the oldest. She worked as a prostitute from time to time to support her drug habit. The next oldest, nineteen-year-old Paul, had served time in Indiana prison for burglary. Terence, now seventeen, had began selling drugs at the age of eleven and had been in and out of jail. LaJoes youngest kids were a set of four-year-old triplets, Timothy, Tiffany, and Tammie. All eight children had the same father, Paul, to whom LaJoe had been married to for seventeen years. The two had long ago fallen out of love. He lived at the home occasionally The families living conditions were horrible. They lived in a very small apartment which at times had more than ten people living in it. Since LaJoe was a very friendly and considerate person, she brought many kids and adults "under her wing" and took care of them when in need. Some kids in the neighborhood even called her "mom." LaJoe did not have the heart to turn her back on anyone that appeared at her door. All the apartments in Henry Horner were falling apart, many of which were vacant. During the spring of 1989 inspections were taking place in the basements of Henry Horner projects by the Manager, Assistant Manager, and maintenance Superintendant. The reported conditions of the basements shocked me. An estimated two thousand appliances, refrigerators, kitchen cabinets, doors, burners, grates, etc. were standing in pools of water rusting away. The basement was heavily infedsted with roaches and flees. Dead rodents were lying in storage areas. The stench and odor was unbearable. After much fighting LaJoe finally got the Chicago Housing Authority employees to clean the basement.

Internet Taxation :: Government Political Essays

Internet Taxation â€Å"Should We Tax the Internet?† was written in response to the recent findings of the Advisory Commission on Electronic Commerce in the May 2000 issue of The American Spectator. The argument is between the liberals and conservatives on the issue of whether or not to tax Internet purchases. The liberals believe that Internet purchases should be taxed so that state and local tax bases are not eroded because of increasing Internet purchases. On the other end the conservatives believe that Internet purchases should be kept tax-free, since tracking sales are completed and several states are involved with each purchase. George Gilder the author of â€Å"Should We Tax the Internet?† is extremely conservative in his views and is against all taxes. The article aims to convince its readers that Internet taxation is unlawful and should not implemented because of past tax increases results. To make Gilder’s arguments he uses logos arguments based on facts and reasons. Gilder implements his arguments into his article by relating the arguments to different peoples views and things. Gilder’s main argument is that â€Å"lower tax rates generate more revenue than higher ones† (Gilder 3). Through Gilder’s use of logos arguments, ethos arguments, and unique perspectives he makes an effective argument in favor of not implementing Internet taxes. Gilder starts off by attacking Republicans, which are traditional conservative, by saying that they suffer from the â€Å"tax-raising itch† (Gilder 1). He then moves on to say that two billionaires that he recently talked to are more afraid of a â€Å"reckless tax cut† than war or terrorism. Gilder is starting his argument off by using ethos argument by giving perspectives from high profile Silicon Valley cent millionaires. Gilder then goes onto to explain to his audience how taxes above a certain percent do not collect revenue. He does this by saying â€Å"that there has only been one advance since John Marshall opined that the power to tax is the power to destroy† (Gilder 3). John Marshall made this advance by showing that lower tax rates generate more revenues than higher ones. This is a logos argument, but is a fallacy because higher taxes would lead to higher revenues rather than lower taxes. Gilder then tries to make the argument that no tax rate above 20 percent collects revenue.

No Utopia Found in Wendell Berry’s What Are People For? :: What Are People For

No Utopia Found in Wendell Berry’s What Are People For? The preface to Wendell Berry’s What Are People For? is in the form of a two-part poem, titled â€Å"Damage† and â€Å"Healing.† By carefully digging through its cryptic obscurities (â€Å"It is despair that sees the work failing in one’s own failure†), we find the main message: The more diminutive, local, and settled a culture, the healthier it is and the less â€Å"damage† it inflicts upon its people and the land. Berry can be called a utopian but not in the traditional sense. He pines not for the future but for the past. Basing his lifestyle upon his boyhood memories of fifty years ago as well as America’s pioneer days, Berry is confident he has found the answer to the perfect existence. In this case, book and individual are difficult to separate. What Are People For? is Wendell Berry, so to criticize one is to criticize the other. His book is a compilation of contemplative essays on subjects ranging from literature to technology from the perspective of a Kentucky farmer. Having been in the same profession and location most of his young life, Berry in 1958 (at age twenty-four) accepted a Stanford University Stegner Fellowship. Intrigued, he decided to read Stegner’s books and take this professor’s writing seminar. Berry is reverent and testifies that Stegner filled the Jones Room of the Stanford Library with an aura of literary authority. It is here that Berry learns â€Å"responsible writing.† This is writing that contains the values one has â€Å"proven† by living exclusively in one country place and by perfecting one’s knowledge of the place so as to bring sustainable benefit to it. Responsible writing actively promotes â€Å"good agriculture and forestry† unlike writing â€Å"by self-styled smart people in the offices and laboratories of a centralized economy and then sold at the highest possible profit to the supposedly dumb country people.† What Berry says about his seminar experience is that it started him on his development toward working at home, and away from his assumption â€Å"that I was going to follow a literary career that would lead me far from [Henry County] to teach at a university in a large city.† In important ways Berry has some very good ideas. Concerned that radio and television have done too much to homogenize society, he uses â€Å"Nate Shaw† (a pseudonym) to provide an illustration of a man who lived without euphemistic clichà ©s.