The Issue Of Gender Inequality - 1415 Words

The issue of gender inequality is an issue that cuts across all demographics in all regions of the world. Gender inequality is one of the most recognizable limitations to female prosperity. Male dominance coincides with gender inequality to create a lack of female prosperity and a gender gap, and this is a prevalent issue for all women who seek employment within any organization. Gender inequality is a complex social and organizational issue that demands comprehensive evaluation, especially if it is to be challenged with a new approach. The ability to overcome challenges that are excusive to women in the workplace requires that women are respected, rewarded, and recognized. Likewise, anticipating problems to a new approach is a proper way to overcome such challenges. The most important step to overcoming gender inequality lies in the ability to not only recognize underlying factors that contribute to this issue, but to also implement new strategies designed to provide women with an a venue to prosperity. Lean In: Women, Work, and the Will to Lead by Sheryl Sandberg is a comprehensive book that provides extensive research on gender differences within organization, and feasible options for women to bridge the gender gap. Companies can overcome gender inequality by creating programs that facilitate female careers and personal balance for females, and it is this opportunity that [our company] seeks to provide to women so that there is an increased chance that they can have itShow MoreRelatedThe Issue Of Gender Inequality904 Words   |  4 PagesThe issue of gender inequality towards women in male-dominated fields still occurs today despite an equality law implanted over 50 years ago. The purpose of this collected research is to address the issues of sex-discrimination in traditional male careers such as segregated stereotypes, unfair career advancements and the gender based wage gap. Throughout the research process, discoveries revealed that women are viewed by ma les as incapable of completing work in male-based fields such as constructionRead MoreThe Issue Of Gender Inequality947 Words   |  4 Pagesto be on the horizon. Now, in the 21st century, the issue of gender inequality is still being discussed. Feminism is a growing trend among the new generation of Americans, but an aspect that is continually overlooked is the workplace. In the workplace, females are not treated the same as their male counterparts. They receive lesser pay, and because of discrimination, fewer employment opportunities are offered. The wage gap has been an ongoing issue. 50 years ago, women earned 59 cents to every dollarRead MoreThe Issue Of Gender Income Inequality1060 Words   |  5 Pagesthe issue of gender income inequality in terms of age. Gender income inequality can be described as the unequal treatment between men and women in terms of revenue, and has been an issue for women for a long period of time. According to Workplace Gender Equality Agency, the average gender pay gap between full-time men and women increases in accordance to age, when the gap begins to narrow due to reduced income in retirement. This report will explain the main issue of gender income inequality in termsRead MoreGender Inequality : A Global Issue756 Words   |  4 Pages Keisha Theodore 12/05/16 Gender inequality: Economics Gender inequality is a global issue as no country has achieved gender parity. I chose this topic because I am a female and will soon be entering the work force and this information pertains to not only me, but to other females who are unaware. I think it is important that we stay informed, so that we can work together to solve this issue. I think gender inequality is an issue that should be addressed for the reason that it goes againstRead MoreThe Social Issue Of Gender Inequality1939 Words   |  8 PagesThe Social Issue of Gender Inequality between Men and Women Nakia Bell University of South Alabama Abstract In this paper, I will be discussing the social issue of gender inequality between men and women. Gender inequality is a problem that is widely recognized and affects men and women alike. Gender inequality affects employment, earnings, how individuals are viewed, etc. This issue is one that needs to be resolved so women, and men, can make progress toward a gender-neutral societyRead MoreGender Inequality Is A Prominent Issue Globally1864 Words   |  8 Pages311 Gender inequality is a prominent issue globally. Gender inequality is defined as unequal treatment or perceptions of individuals based on their gender. Around the world, women are not treated as equally as men. In 2015, only 50% of the world’s working-age women were in the labor force, compared to 77% of working-age men. In this essay, I will be focusing on gender inequality in China and Japan and the causes and effects of gender inequality in both countries, as well as whether gender inequalityRead MoreThere Are Many Issues Regarding Gender Inequality In The1812 Words   |  8 PagesThere are many issues regarding gender inequality in the U.S. One of the many examples is gender inequality in the workforce. Women are unequally treated in the workforce due sex segregation. One of the main issues in the workforce is hiring discrimination. Hiring discrimination in the U.S. is illegal under the Civil Rights Act that was passed in 1964 (Pg. 275 Sociology project 2.0), but the law has not totally ended discrimination. Many businesses have biased leaders. Women are more likely to getRead MoreGender Inequality : An Ongoing Issue That Occurs Everywhere1420 Words   |  6 Pages Gender inequality is an ongoing issue that occurs everywhere. The Oxford Dictionary of Sports Science Medicine defines gender inequality as â€Å"Social process by which people are treated differently and disadvantageously, under similar circumstances, on the basis of gender† (Kent). This inequality is deeply related to the social view of the gender and inherent biological factors. According to Jay Mcsherry in his paper The Gender Divide, he claims that gender inequality can be seen from differencesRead MoreA Brief Note On Global Gender Inequality Issues1334 Words   |  6 Pages Global Gender Inequality Issues Continuing Problem Gains and Progress More than 110 million children in the world are not in school. Among them two third of it accounts for girls. Some of the developing countries including Jamaica, Philippines and South Africa has worked on gender inequalities and made such policies that women literacy rate has gone higher. Women represents an average of less than 10% in the parliaments of various countries around the world. In 2005 Iraqi government decided thatRead MoreGender Inequality Is A Grave Issue Throughout The History Of Time972 Words   |  4 PagesGender inequality is a grave issue throughout the history of time. However, black women have gotten the shorter end of the stick, and Marita Bonner addresses this issue in her essay, â€Å"On Being Young – a Woman – and Colored.† Bonner believes that time will heal the disjunction between men and women, and more specifically the ignorance of black women’s presence in society. This essay proves that Bonner’s solution – allow time to heal – is pragmatic and history proves that it worked. Women in the

Why Harry Truman Dropped the Bomb on Hiroshima, and the...

On August 6th 1945, the United States, led by Harry Truman, decided to drop the atomic bomb on Hiroshima, Japan, forever changing warfare. This paper will be dedicated to why Harry Truman decided to use the atomic bomb on Japan and the effects that this decision had on humanity afterward. The creation of the atomic bomb, and subsequently the Manhattan Project, was created in response to the belief that the German Government was in the process of creating atomic weapons. This belief was expressed to President Roosevelt in a letter written to him by Albert Einstein, who introduce Roosevelt to the ability of atomic weapons and shared with him that the German Government had stop selling the crucial ingredient of uranium from their recently†¦show more content†¦This attitude was only compounded when United States Government were informed of the treatment of American prisoners of war after the Battle of Bataan in the Philippines, which resulted in the Bataan Death March in April 1 942. The Bataan Death March was a 65-mile march in which American and Filipino prisoners of war were gathered into groups of 100 and forced to march North towards Camp O’Donnell. The prisoners were given little food or water during the march, which led to starvation and extreme fatigue for many of the soldiers. On occasion, soldiers would break formation to try and drink stagnant water of the sides of the road, after having their canteens emptied by the Japanese. These actions resulted in being bayoneted or shot. Other actions by the Japanese were dragging prisoners behind trucks, making the prisoners sit in the sun for hours without shade, and random executions . This brutal treatment of these prisoners resulted in over 5,000 deaths and has been labeled as one of the worst atrocities in modern wartime history. These events led the United States to have an attitude of revenge for the rest of the war, which played a factor in the decision to use the atomic bomb on Japan, whic h Truman made evident by stating, â€Å"The Japanese began the war from the air at Pearl Harbor. They have been repaid many fold.† Revenge was only part of the equation for the decision to use atomic weapons inShow MoreRelatedThe Atomic Bomb Of Hiroshima1701 Words   |  7 Pages‘The Atomic Bomb; a bomb which derives its destructive power from the rapid release of nuclear energy by fission of heavy atomic nuclei, causing damage through heat, blast, and radioactivity’. On August 6 1945, at 8:15 am local time, the city of Hiroshima in Japan, home to 350 000 people, became the first victim of the destructive war weapon. As of this vicious and devastating day, world history was changed forever. The long and short-term significance of this event shaped the way in which peopleRead MoreThe Power Of God : A Push Of A Button1639 Words   |  7 PagesThese weapons are unlike any other for they are unique in their tenacious, dispersing, genetically damaging radioactive af ter effects. They are so powerful that even the use of tens or hundreds of nuclear bombs would disrupt the global climate, causing widespread famine. The use of atomic bombs began in the times of World War II, the fight between the Axis powers and the Allies. In the Axis powers the three main countries were Germany, Italy, and Japan. In the Allied powers the main countriesRead MoreThe Atomic Bomb On Japan1625 Words   |  7 PagesIn 1945, a decision was made that would change the world. President Harry S. Truman gave the order for the United States to drop atomic bombs on the Japanese Empire. Now, almost seven decades later, that decision is still the topic of much debate. Why did Truman decide to use a weapon so destructive that it could kill hundreds of thousands of people at one time? Was the decision he made the right one? It is important to examine the factors that went into this difficult decision before taking sidesRead MoreThe Nineteen Hundred Years2196 Words   |  9 Pageschanged dramatically. This is often attributed to many social, political, and technological advancements in the world. These changes would ca use the eventual â€Å"Limiting† of war, a tactic never before seen and in fact never before needed, a direct consequence of war. During this term we’ve looked at many wars, beginning with the Italian conflicts of 1494, and progressing all the way to the current day war in Syria and Iraq, and the one thing that has changed and shifted the most in these five hundredRead MoreAnalysis Of The Movie An Anti Hero 2303 Words   |  10 PagesWhy is it that there are multiple new movies and books being created with antiheroes as the leading or main characters? The reason they want antiheroes instead of heroes is because antiheroes are a lot more relatable because they are flawed like every day people are. As Judy Lee Dunn says, â€Å"while ‘too good’ can make for an unbelievable story character, still I need someone who I want to succeed―against all odds† (Dunn). They tend to make several mistakes, the same way most people do, before findingRead Mor eOne Significant Change That Has Occurred in the World Between 1900 and 2005. Explain the Impact This Change Has Made on Our Lives and Why It Is an Important Change.163893 Words   |  656 Pagesdecades of agrarian and industrial depression from the late 1860s to the 1890s, as well as the social tensions and political rivalries that generated and were in turn fed by imperialist expansionism, one cannot begin to comprehend the causes and consequences of the Great War that began in 1914. That conflict determined the contours of the twentieth century in myriad ways. On the one hand, the war set in motion transformative processes that were clearly major departures from those that defined the

Harriet Jacobs Free Essays

â€Å"The educated differ from the uneducated as much as the living from the dead† (Power 1), Aristotle knew the importance of education; especially literacy. Literacy is what stood between the slaves and the slaves owners. However, some of the enslaved were fortunate enough to possess more intelligence than their owners knew. We will write a custom essay sample on Harriet Jacobs or any similar topic only for you Order Now Harriet Jacobs is one of the few that shared the knowledge of literacy and she knew the power that this held. She used this as her driving force to push through all of the hardships a slave had to endure on a daily basis. Jacobs account in Incidents in the Life of a Slave Girl truly depict the power of literacy. As a young girl Jacobs learns of her fate to come. â€Å"When I was six years old, my mother died; and then, for the first time, I learned, by the talk around me, that I was a slave† (Jacobs 10). Jacobs blesses her first mistress, Margaret Horniblow, for teaching her to read and spell. From this early age Jacobs begins to see that language and reality are intertwined. Through this interconnected thinking Jacobs discovers how to decode both the word and the world. This causes bitterness towards her mistress Margaret, when she teaches her the bible. â€Å"My mistress had taught me the percepts of God’s word: ‘Thou shalt love thy neighbor as thyself. ‘Whatsoever ye would that men should do unto you, do ye even so unto them. ’ But I was her slave, and I suppose she did not recognize me as her neighbor† (Jacobs). Jacobs realizes that her mistress does not view her as her neighbor and in turn doesn’t view her as a human being. The hypocrisy sh own to her through the bible infuriates Jacobs. This leads Jacobs to question literacy as a possible pathway to freedom, however, Jacobs ability to read and write never sets her free. â€Å"Education makes people easy to lead, but difficult to drive; easy to govern, but impossible to enslave† (Power 1). Henry Peter, Lord Brougham explain this in â€Å"The Present State of the Law†; this statement holds true to the way slave owners held their power over the Slaves. Unlike the biblical reading Jacobs reads with her mistress, the slave owners would warp Christ’s word to make slaves believe that their enslavement was warranted by God. These twisted passages would be read orally by the slave owners. Jacob’s now notices how language can be abused and used against her fellow slaves. As a testament to Jacobs eye opening experiences, Harryette Mullen uncovers the oral abuse slaves endured. This was necessary through the slave owners eyes because they were afraid of rioting and runaway slaves. There plantations depended on the slaves labour, so they needed to make it very clear tot their slaves that whites were of a higher society. â€Å"If institutionalized illiteracy was intended to exempt African Americans from access to or participation in the discursive formations of bourgeois society, then to the extent that it succeed, it also left them outside conventional ideological constructions that played a part in determining white identities† (Mullen 256) Along with these biblical reading slave owners also payed special attention to their women slaves. Most of the time female slaves were sexual harassed and raped. Jacobs was a victim of harassment when she lived in Dr. Flint’s household. â€Å"Illiterate slave women operated within a tradition of resistant orality, or verbal self defense, which included speech acts variously labeled sassy or saucy, impudent, impertinent, or insulant: the speech of slaves who refused to know their place, who contested their assigned social and legal inferiority as slaved and as black women† (Mullen 255). Jacobs was put into dozens of inappropriate situations and these became worse when Dr. Flint discovered Jacobs literacy. Dr. Flint send her sexual letters which Jacobs tells him that she cannot read. â€Å"While Harriet Jacob’s literacy was a tremendous source of empowerment, it also exposed her to an even more concentrated dose of the ideology of domesticity than the training she received while living and working in the homes of white women and observing their behavior† (Mullen 260) Quotes I want to use but I’m not sure how. —- Their texts, by focusing on a continuum of resistance to oppression available to the illiterate as well as the literate, tend to stress orality as a presence over illiteracy as an absence† (Mullen 255). â€Å"Harriet Jacob’s narrative, which may be seen as ascribing gender to the generic (male) narrative genre, demonstrates that it is possible to appropriate bourgeois ideology to affirm the humanity of slaves and illi terates-without Douglass’s rhetorical conflation of literacy, freedom, and manhood, which reinforces rather than challenges the symbolic emasculation of the male slave and the silencing of the female slave. Because she associates the slave’s humanity with defiant or subversive speech, resistant behavior, and the ethics of reciprocal relationships, as well as with writing and individual autonomy, Jacobs affirms the humanity of the collectivity of slaves as well as the successful fugitive and literate narrator† (Mullen 261) â€Å"For Jacobs, literacy serves to record for a reading audience a continuity of experience already constructed and preserved within her family through oral accounts† (Mullen 261). â€Å"Only the educated are free† Epictetus (Power 1) â€Å"Education is a better safeguard of liberty than a standing army† Edward Everett (Power 1) How to cite Harriet Jacobs, Papers

Strategic Marketing Problems Study Guide free essay sample

Midterm Exam Study Guide, Spring, 2014 Chapter 1: Foundations of Strategic Marketing Management Role of marketing in the strategic planning function Primary purpose of marketing is to create long-term mutually beneficial exchange relationships between an entity and the publics with which it interacts Product-Market Strategy Selection A recurrent issue in strategic marketing management is determining the consistency of product-markets strategies with the organization’s definition, mission and capabilities, market capacity and behavior, environmental forces, and competitive activities Strategic marketing process steps: Business, mission, goals a. What kind of business are we in? b. Compliments the definition. Written statement hat underscored ths scope of an org’s operations in its definition and reflects managements vision of what the org seeks to do i. Crystallizes managements vision of the org’s long term direction and character ii. Provides guidance in identifying, purusing, and evaluationg market and prduct opps iii. Inspire and challenge employees to do things that are valued by the org c. We will write a custom essay sample on Strategic Marketing Problems: Study Guide or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Goals convert the orgs mission into tangible actions and results to be achieved within a certain time frame 2. Organizational growth opportunities a. What might we do- environment opp. Unmet or changing consumer needs, unsatisfied buyer groups, and new means of tech for delivering value to prospective buyers b. What we do best- org capability and competency. Distinctive competency is what they UNIQUELY do best c. What must we do- success requirements in certain industries to be able to even slightly compete 3. Product-market strategies, including both growth strategies and marketing tactics Budgets a. Formal statement of plan in financial terms i. Operating- pro forma income statement because it is made up of futurerevenues and expenses ii. Financial- how to operating income statement will affect thte company’s cash position 5. Reformulation/recovery strategies a. Marketing audit- examination of company’s marketing environ, objectives, and strats to determine problem areas and opps and recommend a plan of action to improve the company’s marketing performance b. Are we doi ng things right, are we doing the right things? And the what ifs SWOT analysis formal framework for identifying and framing organizational growth opportunities S = strength W = weakness O = opportunity T = threat What strengths are distinctive competencies? What weaknesses disqualify the org from pursuing certain opps? Product-market grid and strategies (market penetration, market development, product development, diversification) product-market strategies consist of plans for matching an org existing or potential offerings with the needs of mkts, informing mkts that offerings exist, having offerings available at the right time and place to facilitate exchange, and assigning prices to offerings product market grid Market-Penetration. Strategydictates that an org seeks to gain greater dominance in a mkt in which it already has an offering involves attempts to increase present buyers’ usage or consumption rates of the offering, to attract buyers of competiting offeringss, or to stimulate product trial among potential customers marketing managers should consider a number of factors before adopting a penetration strategy: must examine market growth must consider competitive reaction must consider the capacity of the market to increase usage or consumption rates and the availabilty of new buyers Marketing Development Strategydictates that an org introduces its existing offerings to markets other than those it is currently serving examples include introducing existing products to different geographical areas or different buying publics mix of mkt activities used must often be varied to reach different markets with differing buying patterns and requirements marketing development involves a careful consideration o f competitor strengths and weaknesses and competitive retaliation potential mkt development in the international arena has grown in importance and usually takes 1/4 forms: exporting licensing joint venture direct investment Product-Development Strategy dictates that the org creates new offerings for existing markets approach taken may be to develop totally new offerings to enhance the value to customers of existing offerings or to broaden the existing line of fferings by adding different sizes, forms, flavors, and so forth (product extension) companies successful at developing and commercializing new offerings lead their industries in sales growth and profitability companies liklihood of success is increased if its product-development effort results in offerings that satisfy a clearly understood buyer need toy industry qualities:lasting play value ability to be shared with other children ability to stimulate a child’s imagination successful commercialization occurs when the offering can be communicated and delivered to a well-defined buyer group at a price it is willing and able to pay cannibalism occurs when sales of a new product or service come at the expense of sales of existing products or s ervices already marketed by the firm. Diversificationinvolves the development or acquisition of offerings new to the organization and the introduction of those offerings to publics not previously served by the organization diversification is often a high-risk strategy because both the offerings and the public or market served are new to the org Ethics and social responsibility should permeate every aspect stated above must do the right thing even if it may end up hurting your position in the org failure to recognize issues and to take action is the least ethical thing you can do—don’t ignore Anheeuser-Bush- Drink responsibly

QUALITIES OF SUCCESSFUL MARRIAGES

Communication Good communication is important in any marriage in order for it to succeed. Good communication helps to avoid all forms of disrespect between the parties. Such forms of disrespect have been referred to as disrespectful judgments.Advertising We will write a custom essay sample on Qualities of successful marriages specifically for you for only $16.05 $11/page Learn More They include ridiculing, sarcasm, making statements in a judgmental way or making false accusations. In other words, proper communication is qualitative (Hampson, Prince, Beavers, 2007). Good communication may also be quantitative in that, having meaningful conversations with your couple several times in a day or week means that the marriage would be more successful than those not having enough dialogue as couples. Good dialogue may also occur as couples engage in other activities. For example, couples may engage in meaningful dialogue while they help each other in doing the house chores, while taking a stroll or driving around. I have personally watched how my parents maintain conversations almost everywhere they are. This has improved their relationship and has positively influenced me too. I plan to emulate them and make communication a vital tool in my relationships. Empathy and sensitivity For couples to have successful marriages, they need to be able to identify with the thoughts and feelings or even the attitudes of their partner. This would mean that they would have affective sensitivity towards each other. When one empathizes with the other, one would be able to put him or herself in another’s shoes and subsequently be in a position to willingly respond to the partner’s needs. Sensitivity is also a great virtue in marriage since it helps a person understand the needs of the partner.Advertising Looking for essay on social sciences? Let's see if we can help you! Get your first paper with 15% OFF Learn More I have learn t a lot about sensitivity and empathy in marriage from the many visits I have made to my aunt and friend’s place. The way the couples understand each other’s issues and help themselves out has made me learn a lot and want to change some of my previous views and perceptions. Spirituality and values Spirituality and values are essential for any marriage if it is to succeed. Marriages built on firm spiritual values grow exponentially and the couples experience lasting happiness. Faith makes great differences in marriage and this is why it is very important to share your individual beliefs and values with the partner prior to marriage in order to understand each other and plan how the two of you will live with them. When partners in marriage have different spiritual values, it is almost certain that at some point in marriage, they will have trouble coping with each other. It is important for couples to share the same faith and have the same values. I recently learnt that a Christian friend of mine married an Indian woman. It has just been a few months now and they are filing for a divorce. This was mainly because of their differences when it came to values and spirituality. This has encouraged me to consider spirituality and values of the other partner before I can decide to settle. Commitment Commitment is usually a high priority in marriages and especially in the Christian society. Many couples have the misconception that marriage vows lead automatically to a happy marriage and a perfect union of intimacy.Advertising We will write a custom essay sample on Qualities of successful marriages specifically for you for only $16.05 $11/page Learn More What they fail to understand is that after marriage, many challenges come and it is not always rosy. This calls for the need for commitment. Violating the marriage vows usually lead to consequences. In most cases, when one partner violates that commitment in marriage, it is cons idered as unforgivable. This is because vows are involved in marriage as opposed to relationships where such activities that violate commitment may be forgiven. I have always appreciated the amount of commitment shown by my parents and this is evident in their many years of marriage. Therefore, I intend to make commitment a priority in marriage since this is what couples are intended to do after making vows. Companionship Companionship is vital in any marriage that seeks to make it a success. It involves the partners sharing their lives together on a day-to-day basis. Couples need to share their dreams and at the same time walk along each other to realize those dreams. As companions, couples need to work towards common goals. They should therefore share similar interests and in the event that their objectives are achieved, they should share the joy of victory. However, the grief of failure should also be shared and the couples should see themselves through the difficult moments. Som etimes in the life of couples, changes occur and due to unavoidable circumstances, they are forced to engage in different activities that have different timings.Advertising Looking for essay on social sciences? Let's see if we can help you! Get your first paper with 15% OFF Learn More This makes them lose track of each other’s activities and with time, may realize that they have nothing or little in common. The best way to combat this is by maintaining the love relationship on a day-to-day basis. This is possible through the maintenance of communication. If face-to-face communication is difficult to maintain, then making phone calls may do. I have learnt a lot in the way my parents have managed to maintain their love relationship even when they are far from each other and I definitely intend to emulate this. Adaptability and flexibility Adaptability and flexibility is another aspect that is important in marriage. Couples need to think about each other and not only worry about oneself. These qualities enable a partner in the relationship to change some of the activities that one intended to do in order to put the considerations of the other in mind. This would call for the partner to look for alternatives but still focus on achieving the same set goals. I h ave seen my father forgo some of his activities in order to cater for my mother’s needs first then get back to what he was doing. This way, I have learnt that in a relationship, a partner should not consider his own priorities first but also think about those of the other partner. I intend to make important considerations about my partner’s ideas when making decisions in the future. Honesty, trust and fidelity Honesty and fidelity must be observed in relationships in order for the marriage to be successful. When honesty and fidelity is observed, this leads to trust. In marriage, just like in any other relationship, trust is earned (Stinnett, Carter, Montgomery, 1972). Marriage partners should be faithful to each other since they swore to do so. My parents are my role models since they have built their marriage on trust and honesty. It is through trust that they have been able to maintain their love relationship over the years. I intend to maintain fidelity and remain honest to my partner in marriage. Responsibility One big issue in marriage life is the issue of responsibility. This governs the day-to-day life of the couple. Each partner has specific responsibilities to attend to outside the household but those within the household are usually delegated. Sometimes it is done equally but in most occasions, one partner usually takes a greater role. Delegation of responsibilities should be done in a fair manner in order not to overburden one partner. At home, I think my mother does most of the household activities. I understand that my father is usually busy with the office work but I think it would be fair if they shared some of the household responsibilities. I intend to change this in the future by helping out in most of the work in the house. Unselfishness Couples should avoid selfishness in marriage. This calls for each partner to forget self and direct all the life of the couple for the good of the whole family. Selfishness yields to the denia l of the other partner’s rights in the marriage and in most cases leads to unhealthy marriages or even divorce. My parents are good examples of couples who are not selfish. Both my parents usually share a lot and do not do things that favor one partner over the other. I intend to take from them on this issue. Admiration and respect Good marriages are fueled by great chemistry. This calls for mutual admiration and respect. The value that one places on the partner’s special abilities makes the partner feel appreciated and loved. Without this, one would not have confidence upon the opinions they bring forward. When one partner respects the other’s opinion, then communication will be developed (Murstein Beck, 1972). Showing admiration for your spouse is important to boost their self-esteem and make them feel appreciated. I admire my parent’s for the way they show admiration for each other and respect each other. I would like to develop such a relationship in the future. References Hampson, R., Prince, C., Beavers, R. (2007). Marital therapy: Qualities of couples who fare better or worse in treatment. Psychotherapy Counseling, 25(4), 141-190. Murstein, B. Beck, G. (1972). Person perception, marriage adjustment, and social desirability. Journal of Consulting and Clinical Psychology, 39(3), 396-403. Stinnett, N., Carter, M., Montgomery, J. (1972). Older Persons’ perceptions of their marriage. Journal of Marriage and Family, 34(4), 665-670. This essay on Qualities of successful marriages was written and submitted by user Aiyana Hurst to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.

Literature Review on Breast Reconstructive Surgery The WritePass Journal

Literature Review on Breast Reconstructive Surgery Literature Review on Breast Reconstructive Surgery IntroductionLiterature reviewQuantitative studiesQualitative studiesStudy DesignMethods and MethodologySampleAccessEthics approvalToolsRigorPilot StudyData collection analysisLimitationsTimetableBudgetConclusionReferencesRelated Introduction Research is from the French word â€Å"research† which literally means to investigate thoroughly. It is a process of systematic enquiry into a particular subject (phenomenon) which intends to create new knowledge and is governed by scientific principles (Cormack 1996). The department of health (DOH) defines research as: â€Å"the attempt to derive generalised new knowledge by addressing clearly defined questions with systematic and rigorous methods† (DOH 2005). The Nursing and Midwifery Council (NMC 2008) clearly states that nurses must deliver care based on the best available evidence or best practice. That any advice they give is evidence based if they suggest healthcare products or services and they must have the knowledge and skills for safe and effective practice. Nurses are expected to practice within an evidence based practice framework by utilising current, reliable and valid research (Smith Donze 2010). To achieve this, nurses should be familiar with the research process and how to incorporate findings into practice. Nurses who practice evidence based are fulfilling their responsibility to patients and their professional regulatory body. Nursing research can provide a hugely exciting and challenging facet to the concept that is nursing. Being the largest workforce within the National Health Service (NHS), they are the professionals with the most direct contact with patients it stands to reason that this workforce should have robust evidence to support their practice interventions (Parahoo2006). Patients can be asked to make decisions when they are emotionally fragile and thrust into an often unfamiliar world of doctors, nurses, hospital environments where the language used can seem unfamiliar. Working in the field of breast cancer can provide many opportunities to explore the experiences of women as they strive to make decisions about their physical and psychosocial wellbeing. Making a decision to undergo a breast reconstruction following mastectomy due to breast cancer can be harrowing and efforts must be made to ensure healthcare providers afford the best opportunities that enable women understand this process. A literature search using databases Medline, [emailprotected], British Nursing Index, Embase, CINAHL and PsycINFO was conducted to review previous research undertaken to determine influencing factors on decision making. The terms breast cancer, breast reconstruction, decision making, patient satisfaction and quality of life, Breast Care Nurse and Breast Clinical, Nurse Specialist were used. Results were limited to the English language, relevant to humans. Literature review A literature review should provide a rationale for the study, show why the study is required and how it will add to the body of knowledge already known about the phenomenon. (Parahoo 2006, Cormack1996). Adjusting to a diagnosis and the treatment options of breast cancer is a complex process (Brennan 2001). The process is influenced by numerous factors (Wenzel, Fairclough, Brady, Cella, Garret, Klushman 1999) and altered body image is one of the most significant (DeFrank, Mehta, Stein, Baker 2007). In the last few years there has been increasing attention paid to the role, perceived body image plays in   patient’s, diagnosed with breast cancer has on this adjustment. Pikler and Winterowed (2003) prove that patients who essentially felt good about their body were more firm in their belief in their ability to cope with the disease and the subsequent treatments. Women’s emotional and psychosocial functioning may be significantly affected when Coping with a diagnosis of breast cancer, which may impair their decision making ability. Reaby (1999) supports this view suggesting â€Å"their ability to make an informed decision about breast restoration is greatly reduced because of the emotional and physiological conditions created by their health crisis†. Literature supports the process of breast reconstruction following mastectomy as increasing long term health and wellbeing (Streu, Chung Alderman 2009). This assumption is refuted by Harcourt Rumsey (2001) who suggest this belief is not supported by evidence and further inquiry is required. However whilst there is much literature available highlighting the effects of timing of breast reconstruction, type of reconstruction (autologous or implant) and of the impact other treatment modalities may have on a technical success there is little robust evidence to support one method in favour of another in terms of quality of life or body image (Potter Winters 2008) . Guidelines have been produced by The Association of Breast Surgery, The British Association of Plastic, reconstructive and Anaesthetic Surgeons and the Training Interface Group which recognised that it is difficult to conduct controlled trials in this cohort and hopes the guidance will provide standards for safe breast reconstruction following mastectomy for breast cancer (Lee Bishop 2009). There remains a lack of consensus on when to perform the procedure, what procedure should be performed and which patients are/are not suitable to undergo the procedure.   Without consensus guidance from professionals cannot be anything other than subjective and ultimately can lead to decisions which are not fully informed (Lee, Dominik, Levin, Barry,Cosenza, O’Connor, Mulley Sepucha 2010). The authors of this study report on the necessity of tools to assess the quality of the patient’s decision making which will reflect shared decision making. Quantitative studies The reviewed literature highlights various findings on the decisions women make regarding breast reconstruction. Chevray (2008) suggests that women are not adequately informed about the availability of this option.   Older age and the less educated are less likely to opt for breast reconstruction according to (Greenberg, Schneider, Ko, Lipitz, Mallin, Epstein, Weeks Kahn 2007). Theses particular studies are American where the healthcare system is different from that in theUnited Kingdom. They were quantitative, retrospectively analysed from existing databases and neither study reflected the women’s personal experiences of the process they found themselves having to make decisions within. Limitations to the study such as women’s access to specialist centres for breast reconstruction and financial cost, if not adequately covered by insurance, which may have precluded them from breast reconstruction are not addressed in the findings. Falbijork, Karlsson, Salander, Rasussen (2010) concluded similar results with regard to age but did not take into consideration the meaning of mastectomy or body image to   women although recognise these variables should be considered. They conclude that age is of paramount importance for further studies to enable understanding women’s choices. Stacey, Spring, Breslin, Rao Gutowski (2008) reinforced the multifactorial nature of decision making regarding breast reconstruction following mastectomy for breast cancer. They evaluated the attitudes of circa 100 general surgeons to breast reconstruction; 40% did not refer all patients for breast reconstruction citing reasons which included refusal by patient, need for radiation treatment, may delay adjuvant oncological treatment, patient issues or the lack of available plastic surgeons.   One of the conclusions they reached highlighted the need for education of the referring surgeon and patient about options and indications for reconstructive surgery. A related study by Reefy, Patani, Burgoyne Osman Mokbel (2010) reviewed 127 patients who underwent immediate breast reconstruction following skin sparing mastectomy for early breast cancer. The patients were followed up for 36 months the procedure was associated with low morbidity and deemed oncologically safe for T, T1 T2 tumours without extensive skin involvement. It stated that 85% of patients who required either prior or post mastectomy radiation treatment underwent capsulotomy for significant capsule formation. In keeping with Stacey et al (2008) focus should be on the education of surgeons and patients on the effective, safest management of breast reconstruction to guide informed decision making. Lee, Belkora, Chang, Moy Patridge Sepucha (2011) evaluated patient decision making about breast reconstruction (BR) and patient involvement in the process and concluded that patients were not well informed about BR and as such would benefit from interventions which supported their decision making. Winters, Benson Pusic (2010) systematically reviewed 1012 abstracts of which 34 papers included Health Related Quality of Life (HRQoL) outcomes in breast reconstruction. Their findings showed that robust scientific data is sparse in methodology on HRQoL studies and increasingly patients and healthcare providers seek meaningful information to guide decision making. They concur with Lee Bishop (2009) that randomised clinical trials are required to establish guidelines to inform decision making. Another study carried out by Jeevan, Cromwell, Brown Traveller Pereira, Caddy, Sheppard Van Der Mullen (2010) identified that of 44, 837 women who underwent mastectomy for breast cancer, 7375 underwent immediate reconstruction. (IR) They showed that the uptake rate for IR was highest in the younger age group (50 years of age) and lowest in those over 70 years, a finding which concurs with Greenberg et al (2007) Falbijork et al (2010). Jeevan et al focused on the regional variations of IR uptake and showed that women from more deprived areas were less likely to undergo IR as were non white women. This is direct contrast to Osborn, Hodin, Drew, Fielder, Vaughn-Williams Sweetland (2005) who found no association between deprivation and ethnicity and treatment choice but did find older age as an indicator of being less likely to undergo breast reconstruction. Qualitative studies Qualitative studies have attempted to establish patterns in women decision making when considering surgical options. Reaby (1998) developed a decision making model hope to enhance decision making capability of the women. It seems to be designed to essentially slow down the women’s decision making to allow time for her to explore her understanding of the options that should have been presented to her, to alert that there may be options available and to explore the impact such decision making may be having on her and her family. The study Reaby conducted suggested that the specialist nurse was in a valuable position to undertake the role of providing physiological and psychological support, acting as their advocate thus enhancing the decision making process. Harcourt Rumsey (2001) conducted a literature review identified the need for further research into the experiences of women deciding for or against reconstruction and the process by which they decide. They highlight that studies in their review did not take cognisance of the nurse specialist. They identified the drawback of randomised controlled trials citing them as inappropriate in this area, and suggest that research in this area should be prospective and from the time of diagnosis. This is an identified gap this study seeks to address. Three years later Harcourt Rumsey (2004) followed up their previous research showing that individually, women need appropriate information, time to make decisions and ongoing emotional support. Limitations to the study were that interviews were conducted post decision which left the gathered information subject to recall and there were unidentified difficulties with the study being prospective. Lally (2009) study involving 18 women newly diagnosed with breast cancer who were to make decisions regarding surgical options, showed that women felt supported by specialist nurses and the surgeon in their decision making. This has implications for clinical practice providing evidence of the importance of the availability of these healthcare professionals to this patient cohort. Wolf (2004ab) identified the importance of the role of the breast clinical nurse specialist in facilitating the process of how patients receive information. Information giving has been associated with increased autonomy, moving away from a paternalistic approach and considered to help patients cope with cancer. Study Design Qualitative research seeks to lend understanding of how people think individually and as part of a group. The approach is one that is interactive, holistic and inductive, data collection is flexible and reflexive (Parahoo 2006). This results in data collection and analysis that has evolved as the researcher gains insight and new questions emerge throughout the process (Pollit Beck 2004). The following study design describes the approach to enquiry, the methods and methodology to be used to collect data, when, where and from whom the data will be collected and how the data will be analysed. Methods and Methodology In quantitative research comes from a philosophical paradigm which suggests  Ã‚   that human phenomena can be subject to objective study (Parhaoo 2006). Historically quantitative researchers believed that human behaviour could be predicted, a belief based on the positivist approach to natural science that the world works according to fixed laws of cause and effect or causality by testing hypothesis and theories (Muijs 2011). This approach strives for objectivity and to avoid bias advocates distance between researcher and subject (Holloway Wheeler 2002). Quantitative research has been used by nurses dating back to the Crimean war (1853-1856) and can produce robust scientific data which is essential for evidence based practice (Parahoo 2006). However it has been criticised for being narrow and inflexible, of focussing on a small part of the human experience where nursing concerns itself with a holistic approach (Pollit Beck2004). In comparison qualitative research is flexible and the relationship between researcher and participant less formal. Phenomenology, grounded theory and ethnography are the main research traditions which underpin the philosophical approach to qualitative research (Polit Hungler 1997). Such research traditions explore the subjective nature of the human experience (Magilvy2003) and aim to collect data in naturalistic environments ensuring a holistic approach to data gathering which requires the researcher to be intensely involved in the fieldwork   as â€Å"a full co-participant†(Polit Beck 2008). Each of the disciplines focuses on the experience of human beings and their interpretation of the experience (Holloway Wheeler 2002). The approaches demand careful collection and analysis of rich in-depth data to provide a comprehensive understanding of peoples thinking and behaviour which can improve efficiency and predict outcomes in the healthcare setting (Parahoo 2006). Qualitative research has been criticised as anecdotal, for producing findings that are neither scientific nor generalisable and, due to the intense involvement of the researcher, objectivity is lost (Parahoo2006). To reduce researcher bias or maintain objectivity in data collection a process known as bracketing may be used which enables the setting aside any personal beliefs, prior knowledge or expectations the researcher has regarding the study. Qualitative and quantitative research methods are appropriate for nursing research and both create or increase knowledge that may explain or describe the phenomenon being studied (Harper Hartman1997). The intent of this study is to explore and lend understanding about how women decide to uptake breast reconstruction or not following mastectomy for breast cancer therefore a qualitative approach will fit as it seeks to explore the experiences of decision making. Sample Sampling is the process of selecting a portion of the population from the total population of the subject of the enquiry; a sample is a subset of that population (Pollit Beck 2004). Sampling allows cost effective research as resources such as time and funds are likely to be limited and can provide robust information. There are two basic types of sample; probability and non-probability. A probability sample is randomly selected in contrast a non-probability sample is chosen to provide the sought data (Parahoo 2006). The selection of the sample should be robust enough to identify and use the participants who can supply the information to inform the study (Polit Hungler 1997).Qualitative researchers aim to gather data which is rich and in-depth; this is the underlying principle which guides the sampling technique. For the purpose of this study the researcher intends to recruit 8-10 participants using purposeful sampling technique. Polit and Beck (2008) describe this as using the researcher’s knowledge about the sample population to â€Å"hand pick† potential participants who will most benefit the study.   These individuals will be sampled as those most likely to be able to provide information on decision to undergo reconstruction following mastectomy or not. Sample size does not determine importance of the study or the quality of the data, in qualitative research too large a sample size risks loss of depth and meaning and may reduce the richness of the data (Holloway Wheeler 2002).Some texts recommend between six and eight participants (Holloway Wheeler 2002) others suggest size should be based on informational needs (Polit Beck 2004). If saturation occurs before this number is achieved then recruitment will be limited to the saturation point. Saturation refers to the point when no further meaningful data is obtained and as such the number of participants can be led by the fullness of the data collected (Wood Ross-Kerr 2006). Access To address the research question, the researcher initially considered recruiting female patients requiring mastectomy to the study at the time of diagnosis when discussion regarding breast reconstruction cancer would occur. However, following discussion with the course leader and a period of reflection, it was decided that this was a vulnerable cohort and it would not be ethical to approach them at a time when they were trying to process information regarding a cancer diagnosis and subsequent treatments. A decision was taken to approach the women 3-6 months post diagnosis when their rationale for their decision was still clear to them and breast cancer support mechanisms were in place. The intention is to approach the consultants who are responsible for breast cancer patients in a specific regional area for permission to recruit the patients. Being part of the multidisciplinary team, as a breast clinical nurse specialist, involved in managing the care of these women, the researcher is known to the consultants and does not anticipate any objection to this. Individual participants will be approached by the researcher and given verbal and written information about the study, a suitable length of time to decide to take part or not will be agreed. The individual will be reassured that their decision will be respected and, regardless of outcome, they will continue to receive care without bias. The researcher may be the healthcare professional designated to fulfil a particular aspect of care of some of the sample group. It is anticipated that this would not bias any data collection as the same level of professional intervention is given to all patients undertaking this decision making process. Goodman Moule (2009) highlight the responsibility of the nurse researcher to inform the participant that they are acting as a researcher. Bracketing can be utilised to suspend any researcher beliefs or preconceptions. This theory will be tested in the pilot study and should any bias be revealed then the researcher will ensure the standard care of the study cohort is supplied by an independent practioner. Potential participants will be recruited at a planned follow up appointment where patients attend for review of their treatment. This negates the requirement of an extra appointment for participants. Ethics approval Research supports the development of nursing knowledge and as individuals and professionals nurses undertaking research must consider the ethical issues that can arise (Smith Hunt 1997). When participants in research are vulnerable, as in the health care system, their rights must be protected (Wood Ross-Kerr 2006). The Royal College of Nursing Research Society Ethics Guidance Group (2009) highlight that nurses can have a variety of roles in research including carrying out their own projects, that it is important the nurse understands the important issues in research practice and it is their role to protect the participant and their rights. Beauchamp Childress (1983) illustrate the concept of biomedical standards as four principles; respect for Autonomy, Beneficence, Nonmaleficence and Justice which underpin healthcare ethics. Without understandable information an individual is not able to make an autonomous decision to participate in research or not; they are therefore unable to give informed consent. Berendt, Golz, Bertz Wunsch (2011) conducted a qualitative study asking what patients understood about trial participation, specifically assessing their understanding of informed consent and discovered that patients’ understanding was less than anticipated and the patients’ identified needs including â€Å" clear informed consent consultations†. The notion of informed consent encompasses; the right to be informed, consent to be given voluntarily and competence of the participant (Tschudin 2003). The participants anonymity and confidentiality must be protected therefore any information provided by interviewees will not identify them nor will it be accessible to others. For the purpose of the study suitable storage for data pertaining to the research will be sought. Prior to seeking approval for the study from the local National Health Service (NHS) research ethics committee and the local research and development department, the researcher will seek guidance from the appointed academic supervisor. To ensure informed consent participant information sheets about the study purpose which will include any benefits and risks, dissemination of results, assurance of participant anonymity and consent forms will be provided. Participants will be advised they are free to withdraw from the study at ant time without penalty and asked to sign a consent form a copy of which will be given to the participant and one retained by the researcher. Consent forms and information sheets will be utilised using guidance from the National Research Ethics Service website www.nres.npsa.nhs.uk/. Participants may recall experiences that cause emotional distress and as their needs are greater than those of the study the process would be suspended or discontinued ( Thompson, Melia Boyd 2000). Tools The intention is to generate data using in-depth unstructured interviews which enable the informant unlimited opportunity to convey their perception of events. This is an intentional approach to discovering the participants lived experience of the phenomenon and the interviewers’ ability to listen and convey respect and importance of the experience is crucial (Oman, Krugman Fink 2003). Unstructured interviews are purposeful conversations which enable rich but often unquantifiable information about the phenomenon (Smith Hunt 1997) the conversations are interactive and usually begin with general questions to enable truly unstructured interview, for example â€Å"What happened when you first learned you would need to undergo mastectomy?† (Polit Beck 2004).   Interviews can last from thirty minutes to two hours and interviewer/interviewee interaction may vary therefore in qualitative interviews flexibility of the researcher is key to obtaining useful data (Parahoo 2006). Structuring data generated from unstructured interviews is known as content analysis and themes will be looked for in the data and divided into categories. The categories that will be developed are dependent on the researcher and can be further categorised into frequency tables to indicate the frequency of the response (Wood Ross-Kerr 2006). The qualitative interviewer is the tool of data collection as it will be she who analysis data in her mind during interviews thereafter transcribing and presenting the data in a way that can be easily understood (Parahoo 2006). Rigor Qualitative researchers recognise the subjective nature of the interview process and seek to ensure rigor by incorporating reflexivity and validation of data by the interviewee, reflexivity enables the respondent to report on the accurateness of the transcribed interview and can provide opportunity for clarification (Parahoo 2006). Others utilise four criteria to establish trustworthiness; credibility, dependability, confirmability and transferability (Polit Hungler 1997). Credibility refers to trust in the data enhanced by giving sufficient time to gather data to give in-depth understanding of the study cohort. Member checking is regarded as an important technique for establishing the credibility of qualitative data and involves feedback of the data and researchers findings and recording the respondent’s reactions.   Peer debriefing relates to the exposure of the researcher to others who are experienced in either qualitative inquiry or the studied subject who can review as pects of the inquiry. Dependability refers to the ability of the data to stand the test of time regardless of the conditions and is liked to confirmability. Confirmability is a measure of the objectivity of the data and as such the researcher should present an audit trail of the data, methods and decisions to an external auditor to check trustworthiness. This strategy may offer some protection to support trustworthiness but caution should be used; the unique nature of inquiry may not lend themselves well to different interpretations of data. Transferability requires the researcher to demonstrate the extent their findings can be applied to other contexts (Goodman Moule 2009). Pilot Study A pilot study is a trial of the research method on a small scale the purpose of which is to ensure the study design is feasible (Presly 1996, Polit Beck2004). A pilot study will be conducted using an unstructured interview as planned for the main study. This will enable a trial of the interview process, gauge length of time interviews may take and allow the researcher to familiarise herself with technical equipment (Lacey 2006). Data collection analysis Data collection refers to the way information is collected, recorded and presented to address a research inquiry (Clamp, Gough Land 2004).High quality data increases the value of the research and the aim of the qualitative data analysis in this study is to structure the data into meaningful units using thematic analysis. This stepwise approach begins with the researcher identifying themes in the data, thereafter categorising the themes; this may be a natural occurrence or the researcher must decide the category. The final step is to structure the data and this can be achieved by developing a frequency table which serves to identify the frequency of every category, the response rate and number of participants who gave the same response (Brink Wood 2001). The researcher intends to audio tape participants during unstructured interviews, using field notes to complement data collection. Field notes can facilitate deeper understanding of the data as it enables conveyance intangible elements such as body language and feelings. They are also useful in the event of failure of audio equipment. Limitations Surgery for breast cancer is an emotional experience and mastectomy can be particularly harrowing as women face disfiguring surgery and a potentially life threatening disease. Making decisions at a difficult time may render potential study participants emotionally unavailable which may impact on recruitment to the study and delay the planned recruitment period. Should this situation evolve the intended cohort will be extended to include those women who underwent mastectomy more than six months previously but no longer that eight months to capture the freshness of their experience. The study forms part of a Masters programme which allows circa ten months for the completion of the study therefore any delay in the timeline could be crucial. As such ethical approval will be sought early to facilitate a prompt beginning to data collection. Timetable Details of the plan of work and timescales show the expected duration of each stage of the study and endeavour to show the feasibility of the study (Cormack1996). A Timetable for the proposed study has been prepared (appendix 2) and will be adhered to. It demonstrates the beginning and expected conclusion of the study activities and shows where they run simultaneously. Budget The budget estimation for this enquiry is as follows: Researcher time  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Agreed by local management / colleagues Transcribers’ time (agreed)                  Ã‚ £ 40.00 Paper                                                                                 Ã‚ £ Ink                                                                                       Ã‚ £ Transport costs                                                  £ Postal costs  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚    £ Conclusion The reviewed literature reveals a variety of reasons why breast reconstructive surgery is undertaken by some women following mastectomy for breast cancer. These include age, socio economic status, ethnicity, availability of surgeon, potential effects of radiotherapy id required amongst others. It has been highlighted that decision making ability may be impaired due to emotional conditions caused by a health crisis. All of the research identified the need for further research. There was very limited inquiry into how the women made their choices and none of it captured the women’s experiences of making the decision. This study provides an opportunity to discover how women feel about making decisions. It is anticipated such a study could enhance how healthcare providers attend to the needs of women who must make a decision to undergo breast reconstruction following mastectomy due to breast cancer. References Beauchamp TL, Childress JF (1983) Principles of Biomedical Ethics 4th Ed Oxford University Press.Oxford. Behrendt C, Golz T, Roesler C, Bertz H Wunsch A (2011) What do our patients understand about their trial participation? Assessing patients’ understanding of their informed consent consultation about randomised clinical trials. Journal of Medical Ethics 37: 2: 74- 80 Brennan J, (2001). Adjustment to cancer-coping or personal transition? Psycho-oncolgy 10 1-8. Brink JP, Wood MJ (2001) Basic Steps in Planning Nursing Research: From Question to proposal 5th Ed Jones and Bartlett Publishers.London. Chevray P, 2008. Timing of Breast Reconstruction: Immediate Versus Delayed. The Cancer Journal 14 (4), July/August, pp 223-229. Clamp CGL, Gough S, Land L (2004) Resources for Nursing Research: An  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Annotated Bibliography. 4th Ed Sage Publications.London Cormack   DFS. (Ed) Research process in nursing 3rd ed. get updated version DeFrank J, Mehta C, Stein K, Baker F. (2007) Body image dissatisfaction in cancer survivors. Oncology Nursing Forum 34 (3), pp623-631 Department of Health (2005) Research Governance Framework for Health and Social Care, second edition pg 3.London. Department of Health. Fallbjork U, Karlsson S, Salander P, Birgit H, Rasmussen H, (2010) Differences between women who have and have not undergone breast reconstruction after mastectomy due to breast cancer.   49, no 2. pp 174-179. downloaded 28/12/2010. http://informahealthcare.com.doi/full/10.3109/02841960903490069. Greenberg CC, Schneider EC, Ko CY, Lipsitz SR, Malin JL, Epstein AM, Weeks JC, Kahn KL (2007). The influence of socioeconomics on post-mastectomy reconstruction: A study of the national initiative on cancer care quality. Journal of Surgical Research 137, (2), pp 217-218. Goodman M, Moule P (2009) Nursing Research: An Introduction. SageLondon. Harcourt D, Rumsey N (2001) Psychological aspects of breast reconstruction: a review of the literature Journal of Advanced Nursing 35: 4: 477-487 Harcourt D, Rumsey N (2004) Mastectomy patients’ decision making for or against immediate   breast reconstruction Psycho-oncology 13: 106-115 Harper M, Hartman N (1997) Research Paradigms in Research mindnedness for Practice An Interactive Approach for Nursing and Healthcare Eds Smith P, Hunt JM Churchill LivingstoneNew York p19 Holloway I, Wheeler S (2002) Qualitative Research in Nursing. 2nd Ed Blackwell Science LtdOxford Jeevan R, Cromwell DA, Brown JP, Trivella M, Pereira J, Caddy CM, Sheppard C van der Meulan JH (2010) Regional variation in the use of immediate breast reconstruction after mastectomy for breas cancer in England. European Journal of Surgical Oncology 36:8: 750-755 Lacey A (2006) The Research Process. In The Research Process in Nursing Eds Gerrish K Lacey A. Blackwell Publishing Limited.Oxford. Lee C, Belkora J, Yuchiao c, May B Patridge A Sepucha K (2011) Are Patients Making High Quality Decisions about Breast Reconstruction after Mastectomy. Plastic and Reconstructive Surgery 127:1: 18-26 Lee CN, Dominik R, Levin CA, Barry MJ, Cosenza C, O’Connor AM, Mulley AG Sepucha KR (2020) Development of instruments to measure the quality of breast cancer treatment decisions. Health Expectations 13:258-272 Muijs D (2011) Doing Quantitative Research in Education with SPSS. Sage Publications Ltd.London Macilvy JK (2003) Qualitative Designs in Nursing Research Secrets Eds Oman KS, Krugman ME Fink RM Henry Belvis Inc Philidelphia. Nursing and Midwifery Council (2008) The Code Standards of conduct, performance and ethics for nurses and midwives. pp7. Osborn GD, Hodin M, Drew PJ, Fielder Vaughn-Williams Sweetland (2005) Patient demographics and treatment for early breast cancer: An observational study. The Breast 15: 377-381 Parahoo, K (2006). Nursing Research Principles, Process and Issues. 2ng Ed pp 11. Palgrave Macmillan. Hampshire.New York Polit DF, Beck CT(2004) Nursing Research Principles and Methods. 7th Ed. Lippincott Williams Wilkins Philidelphia. Polit DF, Beck CT(2008) Nursing Research Generating and Assessing Evidence for Nursing Practice 8th Ed Lippincott Williams Wilkins Philidelphia. Polit DF, Hungler BP (1997) Essentials of Nursing Research: Methods, Appraisal and Utilisation 4th Ed Lippincott –Raven Philidelphia Presly AS (1996) Common Terms and Concepts in Nursing Research in The research Process in Nursing. Ed Cormack DFS Blackwell Science.Oxford. Reaby LL (1998) Breast restoration decision making: Enhancing the process Cancer Nursing 21:3: 196-204 Reaby LL (1999) Breast restoration decision making. Plastic Surgical Nursing 19:1: 22-29 Reefy S, Patani N, Burgoyne G, Osman H Mokbel K (2010) Oncological outcomes and patient satisfaction with skin-sparing mastectomy and immediate reconstruction: a prospective observational study. BMC Cancer 10: 171 Smith RS, Donze A (2010) Assessing Environmental Readiness. First Steps in Developing an Evidence – Based Practiced Implementation Culture. J Perinat Neonat Nurse. 24, (1) pp 61-71. Smith P Hunt MJ (1997) Research Mindedness for Practice: An Interactive Approach for Nursing and Health Care. Churchill LivingstoneNew York Stacey DH, Spring MA, Breslin TM, Rao VK Gutowski KA (2008) Exploring the effect of the referring general surgeon’s attitudes on breast reconstruction utilization. WMJ 106: 6: 292-297 Steu R, Chung KC, AldermanAK(2009) Understanding the importance of reconstructive surgery on quality of life. Progress in Palliative Care 17, (5) 245-249. The RoyalCollegeof Nursing Research   Society Ethics Guidance Group (2009) Research Ethics: RCN Guidance for Nurses. Royal College of Nursing. London    Thompson IE, Melia KM, Boyd KM (2000) Nursing Ethics Churchill  Ã‚  Ã‚   Livingstone.Edinburgh. Tschudin V (2003) Ethics in Nursing: The Caring Relationship Butterworth Heineman.London Wenzel L, Fairclough D, Brady M, Cella D, Garret K, Kluhsman B, et al (1999). Age related differences in the quality of life of breast carcinoma patients after treatment.   Cancer 86, 1768-1774. Winters Z, Benson JR Pusic AL (2010) A Systematic Review of the Clinical Evidence to Guide Treatment Recommendations Based on Patient- Reported Outcome Measures and Health- Related Quality of Life. Annals of Surgery 256:6: 929-942 Wolf L (a) (2004) The information needs of women who have undergone breast reconstruction. Part 1: decision making and sources of information European Journal of Oncology Nursing 8: 211-223 Wolf (b) (2004) The information needs of women who have undergone breast reconstruction. Part 11: Information giving and content of information 8: 315-324 Wood JM Ross-Kerr JC (2006) Basic Steps in Planning Nursing Research: From Question to Proposal 6th Ed Jones and Bartlet Publishers. London

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Persuasive - Essay Example Statistics also reveal that 34% of women become pregnant at least once before the age of 20 (Teen pregnancy statistics, n.d; Facts on American, 2010; Tanne, 2005). Such unprotected or unwanted sex increases the risk of both unwanted teenage pregnancies and sexually transmitted infections (Facts on American, 2010). Additionally teenage pregnancy also affects the studies and career of the teenager and also the children born from such pregnancies suffer from problems such as low-birth weight and tend to perform less well in school compared to children born to adult mothers (Teen pregnancy statistics, n.d). While abstinence from sex is widely recommended for teenagers, many pediatricians and health counselors have also recommended that they also have access to birth control and emergency contraceptive options (Teen pregnancy statistics, n.d). Denial of access to information pertaining to sexual activity or contraceptive measures has not reduced the occurrence of unwanted pregnancies or s exually transmitted diseases according to studies (Wind, 2005). The need to educate teenagers about birth control and emergency contraception measures has been reinforced by pediatricians as they believe that preaching sexual abstinence alone will not help to reduce unwanted or unintended pregnancies. The pediatricians have suggested these updates as part of the teen pregnancy policy of the American Academy of Pediatrics. Teaching mere abstinence from sex will only drive the teenagers to engage in sexual acts and a lack of knowledge about safe sexual practices will only compound the issue (Tanner, 2005). Hence many pediatricians have recommended that in addition to counseling teenagers to postpone sexual activity it is also impertinent that they be educated about birth control measures and also ensure proper access to emergency contraception which would be vital in cases such as unintended or forces sexual

The Ethical Treatment of Animals Assignment Example | Topics and Well Written Essays - 750 words

The Ethical Treatment of Animals - Assignment Example arian to protect the rights of the animals while maintain maximum satisfaction of the interested parties, the guiding ethical principles should be universalistic, welfarelist, and aggregative. Being Universalist means that utilitarian ethics should protect the rights of all the animals regardless of whether they are domesticated or not. Utilitarian ethics should express welfare of the animals by looking at what is good for them. Lastly, being aggregative means the decisions made on how animals should be treated should add up to the weight, intensity and the number of interest of the animals affected by the possible actions of people. Rights-based ethics on the other hand, can refer to the basic rights of animals that should not be violated. As much as humans do harm to the animals, right-based ethics are there to ensure that they also benefit as well. I think right-based ethics put limits to the extent animals can be harmed, for example, in experiments, animals is morally wrong to su bject the subject under unnecessary pain jus t because the researcher is interested with some desired resulted that must be understood after the animals has endured pain. Basing on right-based ethics, rules apply differently according to the purpose of keeping the animals. For example, animals kept as pets have more protective ethical rights compared to the animals kept for experimentations. There have been major conflicts between utilitarian and right-based ethics. Arnold Schwarchezenegger who was the governor of California signed an ethic right document to stop ducks from being fed on foei grass. The grass enlarged their livers; causing them to have pain on their necks for the purpose of gourmet human delicacy (Cohen and Regan 380). As a result, controversies have emerged over utilitarian and right-based ethics of animals. The controversies have been based on three issues: Whether animals have direct moral standings and if so, what should be morally right for animals that are kept

Analysis of the World Anti Doping Agency (WADA) Success

Analysis of the World Anti Doping Agency (WADA) Success Sports, Leisure and Coaching Law Examine the success or otherwise of the WADA Code with regard to the regulation of the use of drugs and doping in sport It is submitted that the World Anti-doping Agency (WADA) has achieved a reasonable measure of success in the pursuit of its mandate to establish a drug free sports world. WADA, both in its structure and in its execution of its policies, is not presented as a perfect mechanism in this respect. There are also well articulated contrary philosophical positions concerning whether sport, particularly at a professional level, ought to be regulated for substance use at all. That question is beyond the scope of this paper. In the present review, WADA is presumed to be acting at all times as a legitimate agency to advance the broad public interest in safe and drug free sport. A brief definition and over view of WADA’s structure shall assist in the appreciation of the points made in support of the opening statement above. WADA was founded in 1999 at the instigation of the International Olympic Committee (IOC) and its member bodies in the wake of a number of well publicised doping scandals (Canadian sprinter Ben Johnson’s positive steroid test in the 1988 Olympics; the Festiva cycling team arrest at the 1998 Tour de France are two examples), WADA is the supreme authority with respect to both the establishment of proper test procedures and the determination of what substances will be the subject of athletic sanction when detected (Lerner, 2006; WADA, 2007). The WADA Code outlines the broad goals of the agency. The Code is the primary regulatory instrument employed to forge an international consensus concerning anti-doping practices in sport. The Code is the structure that binds sports governing bodies, national Olympic committees, and independent sports leagues to the enforcement of the WADA rules concerning doping tests procedures, both in-competition and out of competition, in conformity with the annual WADA Prohibited List of restricted substances and those subject to therapeutic exemption (WADA Code, 2) This background information is emphasised because it confirms one important yardstick by which to measure WADA success the critical mass that WADA has achieved since 1999 in assembling a broad membership of the world sports community that supports the anti-doping mandate, and the corresponding elevation of various doping issues and the inherent dangers of substance abuse in the public consciousness. This success, while somewhat intangible, is arguably as important as any specific drug testing programme or the successful pursuit of sanctions for doping violations. On a related basis, breaches of the WADA Code by athletes are now generally publicly perceived as more than mere transgressions – drug cheating and its ‘win at all costs’ mentality tend to create a negative image of the offender in the eyes of the fan. One example is drawn from the otherwise staid confines of international cricket; Australian star Shane Warne’s use of a banned diuretic was widely described as ‘†¦ the single biggest disappointment’ in the 2003 World Cup. (Mangan, p. 228) The WADA Code has been held to be in conformity with the generally accepted principles of international law in most respects (WADA Code, 2007, 2). The WADA Code provides for a strict liability regime concerning the presence of a prohibited substance in an athlete, the automatic disqualification of the offender from the subject event, and the imposition of a suspension; all such measures have been deemed to accord with fundamental international law principles, primarily due to the various provisions that permit an aggrieved athlete to apply for a hearing to seek an appropriate remedy by way of arbitration. (Kaufmann-Koehler, 2003, 3) The legal issues generated by the prevalence of doping in sport must be understood from several distinct perspectives. The first is the subsisting importance of the national or state criminal law regarding the possession, use or distribution of illegal substances. The fact that a stimulant such as cocaine is used by an athlete to enhance performance does not exclude the possible intervention of the state criminal law authorities upon its detection in the athlete’s system.(see Ulrich, below) In practice, the apparent acceptance of WADA styled enforcement in sports as excluding the intervention of the state is an interesting phenomenon. The effectiveness of WADA has created the undeniable impression that ‘sport crime’, in the sense of prohibited substances and a violation of the WADA ‘play clean’ mandate is an administrative sanction issue for the particular sport league or governing body, not a matter for the criminal law. A state criminal investigation may create an opportunity for WADA to intervene, or alternatively, to seek the production of search and seizure results from the state authority; the German police investigation into Tour de France cyclist Jan Ulrich and the 2007 Spanish criminal inquiry regarding doping products and public safety are examples (WADA Code, 3). Once in receipt of such evidence, WADA have successfully instituted proceedings pursuant to the Code against athletes targeted by state authorities; challenges to prohibit this approach by way of injunction have failed (Balco, 2006, 1). Distinct legal issues are engaged at three different points on the continuum mandated by WADA anti-doping procedures the testing, the analysis of the test results, and the appropriate sanction to be imposed. This continuum has created a definable body of administrative law that has mirrored the emergence of a global administrative law trend wherever private international bodies such as WADA possess authority. (Kingsbury, 2005, 16) Notwithstanding the attacks that have commonly been advanced against the process, a further indicator of over all WADA success is the perception of transparency concerning its practices and the corresponding heightening of confidence that WADA and its constituent organisations adhere to their own Code. Prior to the institution of the WADA Code, a common tactic for an athlete who was subject to sanction as a result of a positive doping test was to seek a civil injunction. In an era of less than standardised practices, such injunctions were routinely granted, as courts often stated that they would not see an athlete deprived of their ability to earn income on the basis of flawed testing or administrative procedures. (See Reynoldsv. IAAF, 1994) The Court for Arbitration in Sport (CAS) is now the primary vehicle for the determination of all international WADA related proceedings; most national and affiliated sports organisations have established similar arbitration mechanisms. (Pound, 2006, 113) A recent example of the reluctance of national (or supranational) courts to interfere in WADA-based proceedings is revealed in the Meca-Medina decision. Meca-Medina was an European Court application seeking to declare the IOC rules governing doping control (as propounded in the WADA Code) to be incompatible with European Community rules (EC Articles 82, 83) that regulate competition and freedom to provide services. (Meca-Medina, 2006, para 1, 4) The appellants were long distance elite level swimmers who had tested positive for a prohibited substance, (nandrolone) in post-event testing and each was subsequently suspended from competition for 4 years. The appellants had appealed the suspension to the CAS and each was unsuccessful before the arbitrator regarding the merits; the suspensions were reduced to 2 years. The European Court held that the economic interests of the appellants were secondary to the legitimacy of the anti-doping initiatives and the absence of any procedural irregularity on the part of the sport organisations involved. (Meca-Medina, para 58, 60) The CAS was founded in 1984 as an arm of the IOC. It is an unquestioned high level repository of sports administrative law expertise (over 200 cases per year with arbitrators drawn from over 80 countries; alleged WADA Code violations are a significant percentage of the case load). As with civil law arbitrations, the CAS acquires its jurisdiction by the mutual consent of the involved parties, where all decisions are final and binding (subject to extremely limited rights of review). (Lerner, 81) It is submitted that the definable body of sports law generated in CAS anti-doping proceedings is a further hallmark of WADA’s continued legitimacy and success. The primary focus of WADA’s anti-doping efforts is directed towards individual athletes; the Code extends to all persons involved in athlete support – coaches, trainers and medical personnel. The long and intricate machinations of the United States criminal investigation into the Bay Area Laboratory Co-operative is an example where support persons were implicated in the supply of steroids to Olympic champion sprinter Tim Montgomery and American baseball record holder Barry Bonds. (Balco, 2006, 1) The range of cases heard by the CAS reflects the breadth of the sporting world itself. The CAS has been called upon to consider reduced competition bans where extenuating circumstances are urged by the athlete (Lukin, 2007, 3); a request for relief from the Prohibited Substance list on the basis that the particular substance will aid in the health of the athlete (Brockman, (2004), 1); where an alleged tampering with a out of competition urine sample test procedure was challenged (Boyer, 2004, 1). A recent decision of the CAS that highlights the CAS interpretation of the strict liability rules of the WADA Code is that of Zach Lund, the American skeleton racer disqualified from participation in the 2006 Winter Olympics due to a positive test for a prohibited masking agent, finasteride. (Lund, 2006, 1,2) The uncontested evidence before the CAS was that Lund had finasteride in his system due to his long term use of a hair restorative product. The CAS held that Lund was â€Å"open and honest† in his description of his failure to take all appropriate measures to educate himself as to the risks.(Lund, p.8) It is submitted that in a traditional civil injunction proceeding, the absence of intent to gain a competitive advantage might be determinative of the issue, given that a berth in an Olympic Games was at stake. However, consistent with the ‘new age’ of anti-doping attitudes, the CAS held that ‘†¦the burden on the athlete to establish no fault or negligence is extremely high†¦Ã¢â‚¬â„¢ (Lund, p.9) The arbitrator ruled that Lund was banned from Olympic competition in 2006. In a 2006 arbitration conducted by the international basketball body, FIBA, a similar imposition of the WADA Code mandated and exacting strict liability standard was imposed for the inadvertent use of a hair restorative (Kurtoglu, 2006, 1), where FIBA upheld a two year competition ban. Other fact situations that highlight the primacy of the WADA Code in modern sport are contained in the newspaper articles excerpted below.( e.g. Gatlin; Ferdinand; Chambers) In its eight years of existence, WADA has successfully impressed its anti-doping will upon the international sport community. The rules developed and disseminated by WADA have created cohesion and significant consistency in the manner that doping cases are conducted world-wide. As noted in the opening paragraph above, the intangibles associated with WADA’s heightened promotion of the ethical, health and competition issues inextricably linked to performance enhancing substances are WADA’s greatest achievement. Bibliography American Arbitration Association (2006) â€Å"Sports Arbitration including Olympic Athlete Disputes† http://www.adr.org/About (Accessed March 21, 2007) Athletics: Prize-Money Row Bars Chambers from NIA Grand Prix.(2006) Birmingham Post (England) 17 Feb. 2006: 36 â€Å"Balco case trial date pushed back† (March 17, 2006) BBC News http://news.bbc.co.uk/sport1/hi/athletics/4357145.stm (Accessed March 21, 2007) Gatlin Faces Threat of a Life Ban from Athletics(2006) South Wales Echo (Cardiff) 31 July 2006: 10 Haley, James (2003) At Issue: Performance Enhancing Drugs (San Diego: Greenhaven Press) Kingsbury, Benedict, Nico Krisch and Richard B. Stewart (2005) The Emergence of Global Administrative Law Law and Contemporary Problems 68.3-4: 15 Lerner, K. Lee (ed.) (2006) World of Sports Science (New York: Thomson Gale) Manjumdar, Boria, and J. A. Mangan, eds. (2004) Cricketing Cultures in Conflict: World Cup 2003. New York: Routledge, Mottram, David R., ed. (2003) Drugs in Sport New York: Routledge Pound, Richard W. (2006) Inside Dope (Toronto: Wiley) Rio Deserved a Longer Ban (2004) The Evening Standard (London, England): 104 Kaufmann-Koehler, Gabrielle â€Å"Summary Opinion re: Conformity of the WADA Code† (2003) http://www.wada-ama.org/rtecontent/document/prof_kaufmann_kohler.pdf (Accessed March 21, 2007) World Anti-doping Agency, 2007 (WADA) http://www.wada-ama.org/en (Accessed March 21, 2007) World Anti-doping Agency Code http://www.wada-ama.org/en/dynamic.ch2?pageCategory.id=267 (Accessed March 21, 2007) World Anti-doping Agency Prohibited List http://www.wada-ama.org/en/prohibitedlist.ch2 (Accessed March 21, 2007) Table of Cases Bouyer v. UCI WADA CAS 2004/A/769, Canadian Centre for Ethics in Sport v Lukin; WADA third party (January 31, 2007) SDRCC DT-06-0050 IPC v. WADA Brockman CAS 2004/A/717, Meca-Medina and Majcen v Commission (Case C-519/04 P) (see also T-313/02 Re: initial opinions) Reynoldsv. IAAF, 23F.3d1110, (6thCir. 1994), (cert. denied 63USLW 3348). WADA v. USADA, USBSF Lund CAS OG 06/001, WADA v. FIBA Kurtoglu FIBA AC 2005-6 (Note: all WADA related case law may be accessed through the portals at the main WADA website)

County cork :: essays research papers

Philipps-Università ¤t Marburg  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Fachbereich 10: Fremdsprachliche Philologien Institut fà ¼r Anglistik und Amerikanistik PS: The Landscape of Ireland Leitung: Madeleine Kinsella Hausarbeit von Mathias Weber County Cork County Cork The aim of this term paper is to give an overview of the county Cork, beginning with its geographical location then present some historical events that are relevant to the history of Cork and finally show the places of interest, both of the county Cork and of the city itself. The population amounts to 400,000 inhabitants according to the CSO and the principal city, Cork city, covers an area of 378 hectares with about 120,000 inhabitants. County Cork also includes 640 km of coastline with many beaches, steep cliffs, making the importance of the sea play an even greater importance since Cork has one the principal harbor of Ireland. It connects Ireland to France (Roscoff, Le Havre) and the United Kingdom (Swansea). Until the sixties it used to be the starting point of many steamers for America and also the departure point of three million Irishmen who emigrated to the “new world'; in the 19th. This port has in fact contributed a lot to the economic and commercial development of Cork and the whole of Ireland. The climate is also largely influenced by the ocean: soft, wet and windy thus allowing a great variety in flora and fauna. Cork derives from the Irish ‘Corcah Mor Mumham’ and means the ‘great Marsh of Munster’ and refers to the fact that the center of Cork city is built on islands, surrounded by the River Lee, which were marshy and prone to episodes of flooding. Some of the waterways between the islands were built over to form some of the main streets of present day Cork. The oblong shape of the city center island, bounded by the north and south channel of the Lee give Cork much of its physical charm. Spencer even immortalized the unusual topography of the city when he wrote:   Ã‚  Ã‚  Ã‚  Ã‚  “The spreading Lee that like an island fayre   Ã‚  Ã‚  Ã‚  Ã‚   encloseth Cork with his divided flood'; Even tough a few prehistoric artifacts have been found, the monastery of Cork represents one of the earliest evidence of human settlement in this region. As said earlier the sea played an important role in the history of Cork as the first foreign known settlers came using maritime means: the Vikings frequently raided isolated monasteries. An attack by the Vikings is reported to have taken place around Cork in 802; they raided the abbey and the settlement nearby.