Group Proposal: develop a proposal for a group Essay

When the friction heats up in marriages, more people (10-20%) than ever before are considering getting professional help. That is very wise. We may be making progress. I am still disturbed that most do not seek help. What is wrong with the other 80%? Getting therapy seems so reasonable to me; it seems that every friend, every parent, every child, every relative, and every professional person in contact with the unhappy couple should recommend counseling. Why don’t they? Divorce is such an emotionally laden decision (perhaps more so than who to marry), we need help seeing the situation realistically, trying to resolve the problems, deciding what other alternatives exist, considering the consequences to others, making reasonable plans for our future, etc. Anyone going though marital hell or a divorce needs a friend to talk to and vent with, no doubt, but he/she needs much more than that–a wise, experienced, unemotional but empathic and caring counselor and a group of peop le who can relate. We are freer than we have been for centuries to dissolve an unhappy marriage. There are other factors associated with the increasing divorce rate. Many of these social-economic factors would be considered good, e.g. more equal education and job opportunities for women, higher incomes, fewer children, fewer religious restrictions, and general social acceptance of divorce and of women living alone. Yet, as we will see, there are terrible consequences frequently associated with divorce (and with continuing a bad marriage). Over 75% of Americans accept divorce as a solution when a couple can’t get along, even if they have children. There is concern by some that divorce may have become too easy (few people who have personally gone through a divorce consider it easy). But, what about those who are happily married and newly weds? Why not help a relationship strengthen before it gets to that point of divorce or feeling helpless? I would like to start a Support Group for newly married couples. These couples are not troubled couples but rather couples who want to enrichen their marriage and have the support of other newly married couples. Our society is built so much on how marriages fail but forget so easily those who work hard daily to keep their marriage healthy. Newly married couples need to know there are other couples out there who are making and succeeding  in this hard world. They need to know, yes, marriage is hard, but this is what we are doing to make it work. Therefore, I would like to propose a Support group called â€Å"Spousal Support†. Spousal Support would include all newly married couples who do not have serious marital issues. Those who are just married to ten years of marriage. Couples who are looking for support of other couples, building friendships, and other marriage enrichment resources. Couples who will be accepted into the group are those who feel they are alone in being happily married, or put down for saying they are happily married. The percent of married people who say they are â€Å"very happy† has gone down during the last 20 years, especially among women. â€Å"Happily married couples have rosy illusions about their marriage and they idealize their spouse. The more illusions, the happier the couple† (Azar, 1995). This Ideal stated here is the reason why more and more being a happy couple is in the minority and a support group is needed. A support group that believes being happily married is something you have to work on but is possible. Ursula K. LeGuin once said; â€Å"Love doesn’t just sit there, like a stone, it has to be made, like bread; re-made all the time, made new. Screening and selection of couples will be done through an interview. The interview will consist of questions about their relationship and what they want to get out of Spousal Support. Those who are not experiencing major marital issues and want support in their marriage will be accepted. Couples who are considering divorce, infidelity or other major marital issues will not be accepted into this group. Any couple who has been married ten years or less, and considers themselves happily married. Couples who have been married for less than ten years are many times considered either still in the â€Å"honey moon† stage or are considering Divorce. Regardless the first ten years can be hard, not just because you are working out your marriage but because of society pressures. This group will consist of five couples, meeting once a week on Sunday at 4 p.m. for 16 weeks. There will be a break of a month and new members will be  able to join at that time. The group will determine a convenient private meeting place and occasionally take outings to local venues. Group members will be briefed during the initial interview as to what will take place and what is expected in the group. Also discussed will be goals that each couple would like to make. Ground rules for the group will be open for discussion during the first meeting: Couples must always be as a couple never alone Please be timely Please be respectful and caring of other couples and relationships Confidentiality is very important Topics explored will consist of any marriage enrichment discussions, exercises, resources and free for all night once a month. Discussions would include any issues that may come about in day-to-day lives like finding intimate time together, free time, working on careers, building a family, and any outside pressures. Exercises would include questionnaires, inventories, role-playing, communication exercises, and games. Resources are very valuable to have, like a good self-help book, or videos, even ideas to help the couple be there for one another. A free for all night will be given for any topics that couples may want to talk about or focus an entire meeting on in the future. This will allow them to throw out ideas in a less structured tone. Couple will be given time to bond more freely with each other and plan any outings the group will take. The specific outcomes I would like the group members to attain is knowing that a marriage can succeed and not every issue has to be hard. I would like them to realize that there are other couples out there who work hard at making the marriage work. My last outcome I would like the group members to have is resources and ways for them to work through their problems and strengthen their marriage in a healthy way.

Memorandum: Net Present Value and Apex Investment Partners

MEMORANDUM To Apex Investment Partners: According to my analysis of the Accessline’s proposed term sheet, I do not believe that Apex would serve its own interests, or those of its investing partners, by investing in Accessline according to the terms proposed. By investing at the proposed valuation, according to the proposed control and incentive structure, Apex would be shouldering a disproportionate share of the risk should Accessline fail to meet its performance targets, or require fresh inflows of capital from future investment rounds.Nor can Accessline take the sort of steps necessary to protect its investment in the case of management failure. Should Apex make a counter-offer, I would suggest the following terms: Valuation: Accessline’s projected revenues in 1999 are $208m. Using the average price/revenue ratio of 3com and Boston Technologies, it seems reasonable to expect an IPO valuation at 3. 67 times revenues, producing gross proceeds of $764m with a present va lue of $116m (using our 60% discount rate).Assuming that Accessline meets this revenue target, and that no future funding is required, Apex will take a slight loss on its required rate of return, barring the voluntary distribution of the dividend from the board of directors, on which we are not offered a seat. The present price per share at such an exit would be approximately $7. 84. However, given Accessline’s historical burn rate, it seems unreasonable to expect the $16m investment produced in Series B to last Accessline until 1999.Assuming Accessline will need another $32m to reach its revenue targets by 1999, Apex takes a much more severe loss relative to its required rate of return. The present price per share at such an exit, assuming the new shares are also offered at $8 per share, would be $6. 18 per share. I therefore suggest using $6 per share as a point for a new valuation of the company, assuming the inclusion/revision of terms as described below. Rights and Prefe rences Apart from the valuation, other elements of the term sheet must be adjusted to allow Accessline to protect its interests and motivate or replace management in the case of performance failure.First and foremost, Apex must insist on the right to elect one director to the board. Series A investors already have one seat, and the current voting clauses allow Series A to effectively retain control of decision making by requiring 2/3rds majority for many key decisions. Should future funding rounds be required, those investors may insist on seats on the board. Apex must remove antidilution protection from employee shares, as this removes a significant incentive for employees and management to reduce Accessline’s burn rate.However, as Series A investors retain a veto over the deal, their shares must be allowed to retain anti-dilution protection. Additionally, we may propose a point at which additional investment rounds (above and beyond $32m of fresh capital) would cause diluti on of ESOP shares at an accelerated rate. Dividends should be made cumulative and issuable upon a liquidation event or an IPO. Such dividends may be converted, if the holder desires, to common shares. This will encourage management to seek a quicker exit. Liquidation preference must be strengthened in other ways.In my opinion, the current arrangement allows management and employees to receive unjustified returns in the case of a liquidation. I suggest a ratio of 1. 5 times the Series B purchase price, applicable to Series A shares, with the remainder to be distributed among Series A, Series B, and common shareholders/ESOP on an as-if-converted basis. In an IPO, Series B shares should auto-convert at a ratio of one-to-one at a target price of $12 until June 30th and $15 after June 30th 1996. After that, the targets must continue to ratchet upwards.The written consent of 3/4ths of Preferred shareholders could override this requirement while preserving Apex’s ability to veto aut o-conversion. This voting ratio should also be employed in the voting clause, since without it Apex lacks any ability to control future funding rounds. Series B must be allowed to redeem all of their shares upon the failure of Accessline to come within 5% of its revenue and income projections for 2 consecutive years. Alternatively, Apex could require that unvested management/ESOP shares be returned to Series A and Series B on a pari passu basis in the case of performance failure.Alternatively, Accessline could insist on a right to replace management in the case of this eventuality. Given the large number of competitors already present in the market, it is likely that if Accessline’s business fails, it will do so quickly and drastically. Negotiation considerations It is important to note that a counterproposal from Accessline that strengthens or enhances any of these provisions in Apex’ favor in exchange for a higher issue price of the Series B shares should be consider ed.However, there are limits to the premium we should pay for enhanced control, and firm limits for how far such control can be reduced. A board member and the voting rules are non-negotiable. The dividend and the autoconversion terms, however, are places in which we can demonstrate flexibility. At this price, with these changes to the term sheet, we are still exposed. Significant competitive, regulatory, or technological changes in the marketplace could quickly destroy Accessline’s profitability.This is, as it stands, a strong counterproposal that is bound to meet resistance from management and employees, but provided we preserve Series A’s valuation, I believe Series A investors will be inclined to allow us more control and latitude provided the performance requirements for management are strengthened. Since I believe our competitors will also propose lower valuations based on a view of these same numbers, we must act tactfully. Perhaps some sort of parachute can be arranged for senior management in the event of a takeover.

Tata Motors Assignment Example | Topics and Well Written Essays - 1000 words

Tata Motors - Assignment Example To respond to the market needs, automotive manufacturers have expanded their range of products through extensive research and development (Ireland, Hokisson & Hitt, 2011). According to the law of demand, when all factors are held constant a good that is highly priced will attract less demand. As such, sales are fewer when the products are highly priced. The automotive market has exploited this law of demand to its advantage (Harrison, 1993). The industry has in the recent past increased capacity to develop and produce affordable cars. Brands such as Tata Motors have invested in research and development to identify ways of cutting costs. Reduction in costs leads to the production of affordable cars and as such creating demand. A, B and C denote points on the demand curve. The points reflect the correlation between the quantities (Q) required and the particular price (P) associated with the  demand. From this it clear that highly priced automotive products have over the years experienced lesser demand. The law of supply demonstrates what quantities of automotive items are to be sold at individual prices. According to this law, a higher price leads to higher supply of automotive products. Tata Motors, like other players in the auto industry, responded to this law by producing more units when the prices are higher so as to increase revenues. Unlike to demand relationship, relationship of supply has a component of time. As such, many players of the automotive have reviewed how their ordering processes are done. Many industry players are allowing for invoicing twice a month as compared to initial practices of invoicing once a month. The follow graph is an illustration of this law: In the automotive industry, equilibrium of demand and supply has been in existence in the recent years. Growth of industry is attributable to the fact that the provision of the automotive matches with the

The Drug Diazepam in Pharmacology Essay Example | Topics and Well Written Essays - 4250 words

The Drug Diazepam in Pharmacology - Essay Example Only paramedics are allowed to use in the management of â€Å"psychostimulant-induced behavioral disturbances† in times of emergency (National Drug Strategy). a. A list of conventional over-the-counter (OTC) medicines, complementary alternative medicines (CAMs) and prescription medicines that are known or suspected to undergo clinically relevant interactions with your profile drug in humans. b. List the source(s) of information you have used and indicate the strength of the evidence (e.g. anecdotal report, clinical case, clinical trial, etc) for each of the interactions that you have identified. Fluconazole is an antifungal that belongs to a group of drugs known as azoles that increases the effects of Diazepam by increasing the levels of Diazepam available in the plasma at any given time. A study conducted by Saari established that Fluconazole increased the level of Diazepam two and a half times thereby increasing the sedative effects of Diazepam. However, the peak plasma concentrations and the pharmacodynamics of Diazepam were not affected (941-999). Voriconazole may inhibit Diazepams metabolism, increasing the risk of adverse effects. In essence, Voriconazole acts the same way as Fluconazole by increasing the levels of Diazepam that are available in the plasma at any given time (Saari 941-999). Therefore, a Diazepam dose should be decreased. Diazepam may possibly increase or decrease phenytoin concentration. The phenytoin concentration should be monitored in case of toxicity and the phenytoin dose should be adjusted as necessary (Australian Medicine Handbook 2011). Enhanced sedation or respiratory and cardiovascular depression may occur if diazepam or other benzodiazepines are combined with drugs that have CNS-depressant properties such as alcohol, antidepressants, sedative antihistamines, antipsychotics, general anesthetics, other hypnotics or sedatives and opioid analgesics.  

Statement of Purpose Personal Example | Topics and Well Written Essays - 750 words

Of Purpose - Personal Statement Example I have recently completed my graduation in field of business finance from Edmonds community college. My basic aim is to get admission in the master degree program in order to gain an in-depth understanding of all issues and concepts related to businessI think this is a right time for me to pursue a master level degree in business as I have not only completed my graduation but also it will help me get a good job upon completion. My good grades in the business related subjects, such as, economic, finance, accounting, and math, which I studied at the bachelor level, also show my extreme interest in studying business. The University of Washington Bothell is known for its well-experienced faculty not only in the field of business management but also in all other subjects that are being offered by the university. It is due to the highly qualified faculty of this university, that today I feel satisfied while thinking of getting admission in this prestigious university. I want to complete my masters under the guidance of well-experienced faculty of the University of Washington Bothell, as it will help me become a highly qualified business expert with excellent command over economics and finance. I have a desire to make educational and professional progress in the field of business management because of my huge interest in this field. I also want to take part in the industrial development and economic progress of my country. I want to be able to analyze the development of debenture certificates, GDP, and other matters related to economics. I have a belief that a country can progress in every field of life only if its citizens get high quality education from the most prestigious universities of the world. I have collected information from various sources about the universities that offer master degree program in business. Through the research, I have come to know that the University of Washington Bothell is the most suitable university, which can help me fulfill my aim t o get a masters degree in the field of business. I am seeking a career in some field related to business management, and that can only be possible if I get an opportunity to study under the supervision of highly qualified faculty of this university. In graduation, my main courses were economics, accounting, math, and English, whereas, some of the minors included psychology, health, and physics. I got good grades in all of these courses, which is a strong proof of my academic skills. I believe that my relevant educational background and interest in business management make me a suitable candidate for getting admission in the University of Washington Bothell. Another thing, which I would like to mention here, is that I had always been one of the position holders at my school and college. I have the ability to contribute to the educational experience of other students studying at the University of Washington Bothell. I can help my class fellows understand complex issues related to econ omics, accounting, and other business related subjects. Some of my core strengths and abilities include: Excellent interpersonal communication skills Excellent critical thinking skills due to excessive reading Ability to mix up with the people belonging to different backgrounds and cultures, as I have been a foreign student in the United States since 2008 Good understanding of different issues related to business management, and Knowledge of two key languages, which include, English and Chinese I also possess the ability to contribute to the recreational experience of other students studying at the university. I can teach them music as well as some key techniques related to soccer. I was the captain of my club and college soccer teams in China. As a captain, I won many titles for my teams at

The septuagint as a result of the diaspora of Jews in Egypt Research Paper

The septuagint as a result of the diaspora of Jews in Egypt - Research Paper Example locations.1 Under the reign of several foreign kings, most of the members of the Jewish faith were removed out of Judea. These people had to adapt to the languages of the ruling empires to continue trade and commerce, aside from being under the rule of another empire. Under Persian rule, apart from Hebrew as the language of Jews, Aramaic also became the lingua franca, and eventually was accepted as an official language. So profound was the effect of the Persians that prayer books of Jews during that time were written in Aramaic.2 During the reign of Alexander the Great, there was a wide spread of the Hellenistic culture, and as a result aside from being able to speak Aramaic and Hebrew, most Jews were able to speak fluent Greek as well. The flexibility of Jews in adapting to the reigning empire’s generic laws such as the choice of languages enabled them not only to translate some of their scriptures into Aramaic, but to Greek as well. The Septuagint, also known as LXX, is a co llection of Jewish scriptures that were translated into Greek, and was believed to have been written sometime during the Ptolemaic rule in Egypt, under Ptolemy II Philadelphus’ reign (282-246 BC).3 The original title of the Septuagint is interpretation septuaginta vivorum, or â€Å"the translation of seventy men† in English, and according to some legends these 70 or 72 men were composed of six scholars from each tribe of Judea. The collection of writings was considered to be the gift of Jews to the Greek-speaking world, as described by the Jewish author Philo of Alexandria in Egypt.4 For some scholars, the prototypes or the earliest forms of the translated scriptures were called Old Greek, abbreviated as OG, and the succeeding materials were collectively known as Septuagint.5 The texts were originally composed of the translations of the Pentateuch, but other scriptures were added to the collection.6 It can be deduced that the monotheistic nature of the Jews persisted d uring several periods under different rulers, which they considered to be polytheistic or Gentile. The resilience as well as the continuous faith of the Jews in their God has been proven by a number of works that have survived numerous centuries under the reign of several empires. Thus, the Septuagint, though being described by most Hebrew scholars during its time as a controversial document due to some deviations from the original Hebrew texts, is considered a testament of the Jews staying monotheistic regardless of where they are or who the reigning emperor is. THE DIASPORA OF JEWS The idea of leaving the homeland has been a recurring theme in the history of Jews, since the time of Abraham, and being exiled is the punishment of God that is to be accepted.7 Thus most of the stories in the Pentateuch were about the exile of Jews in search of the one true God. While the numerous travels and the long durations of being away from the homeland proved to be both harsh and not, for most J ews this also served as a blessing to them, especially with regard to the continuation of the Judean

The Future of Facebook Research Paper Example | Topics and Well Written Essays - 2000 words

The Future of Facebook - Research Paper Example The future of Facebook ultimately relies on what has happened in the past, and what is happening now. That is why, here, it will be examined: what has been the track record or history of Facebook; what the current state of Facebook is; and finally, perhaps most importantly to everyone, what is the future of Facebook. According to Carson (2010), Facebook was started in 2004 by Mark Zuckerberg, who was a student at Harvard (pgh. 1). He first made the social networking site as a sort of on-campus, online student look-book in which some of the students in Harvard’s student body were analyzed. Basically, the site was a success. With some of his associates, Zuckerberg dropped out of Harvard to develop his site. There was some internal haggling over who had developed what. Initially, some lawsuits were filed on behalf of other Harvard students who claimed that basically the idea for Facebook was theirs. However, such lawsuits were thrown out of court or dismissed.... One of the largest problems with Facebook is that it does not have Admins (or administration) who are the regulators of the site. For example, there should be at least one Admin for every 100 people. This way, any behavior that would be considered in poor taste or offensive would be regulated by the Administration, who would approve of posts. This might be considered a Communist tactic, but in reality it would solve a lot of problems of pictures and comments being posted that were inappropriate or unbecoming. This would then put 8 million people to work. They could work online from home, as long as they underwent many of the usual requirements required of job seekers—for example, submitting a resume. Anyone with an Internet connection could be employed. These are merely ideas, but they could fuel a nation struggling from unemployment beyond belief. According to national statistics, 14 million people in the United States are unemployed right now. Creating Admins for Facebook is a genius idea because it would allow people to: a) work from home; and b) transition seamlessly into the work force. Part of looking ahead to the future means looking at the past. Facebook has a long history and is almost going to be going on its eighth birthday in February of 2012. So, it makes much sense that Facebook be seen as a major employer in the United States. The cream of the crop—only the best workers—should be hired for these new jobs. Of course, this has the added danger of making a digital divide between the haves and the have-nots. Much of social networking has reached great heights, but Facebook has been at the helm of the majority of that success. Facebook is going to be a great force to be reckoned with in the future, but

HR services Essay Example | Topics and Well Written Essays - 1000 words

HR services - Essay Example While there are a great variety of users of human resource services (HR services) within an organization, this essay will identify three key users, identify two key needs for each user, and explain how they can be prioritized One use of the human resource department is through the hiring and firing of employees. In these regards, all aspects of the organization rely on the human resource department to ensure that employees are screened properly and when there are significant disciplinary problems that they be released. In some regards, the human resource department can confronted with conflicting needs in this category; in these regards, it’s necessary for the department to attend to an urgent need, but in most instances handle these issues in the order they occurred. Another user of human resources is upper level management, through employee record keeping; within this service the primary needs are for the use of employee records, while keeping the records confidential from m embers of the organization that are not privy to them. In these regards, it’s necessary for HR services to keep stringent record keeping, but also to remain highly cognizant of which organizational members are privy to the specific recorded content. Other users of HR services within an organization are entry-level employees. These employees use HR services for both training programs and compensation and benefit management. In some regards, there may be a conflict of interest here, as the same individuals responsible for training the department are responsible for determining compensation bonuses. In these regards, it’s necessary to have an outside department, generally management, conduct reports that will factor into employee progress reports and ultimately bonuses. 2. Identify at least 3 methods of communication appropriate to employees at different levels ? Among the different methods of communication appropriate for employees at different levels, this essay will co nsider three main types (‘Workplace Communication’). The first type of communication is verbal communication. Verbal communication represents the most direct and perhaps effective form of communication. The drawback of verbal communication is that it does not leave a record of the conversation that took place, nor is it always possible for upper level management to verbally address all the concerns of entry level, or low-level employees. In these regards, another level of communication that is effective is written communication. Written communication functions to produce a clear and understandable message in a context that allows for the individuals implementing this communication process to ensure there is a record of their communication. In these regards, written communication is important in matters wherein the individual receiving the message is of high importance. It’s also effective when the message is complex and it would be useful to be able to review the message. The final type of communication that is considered is visual communication. Generally visually communication is implemented through presentations from upper level to lower level employees, but it can also be implemented in presentations that speak to upper level organizational members, as a means of informing them of status updates, or proposing potential changes. Ultimately, visual communication is most effective for speaking to larger audiences, or in terms of explicating difficult to comprehend material through chart forms; finally it can demonstrate business prototypes or models highly effectively that couldn’t otherwise be articulated through verbal or written communication methods. 3. Describes the key components of effective service delivery including: ? Service delivery has taken on a variety of contextual meanings, making clear and precise definition of the various aspects of the

EDU 330 Special Education Foundations and Framework Benchmark Assessment Essay Example for Free

EDU 330 Special Education Foundations and Framework Benchmark Assessment Essay The Individuals with Disabilities Education Act (IDEA) has granted that placement options be available to better meet the needs of students. (Classroom Leadership, 2001) To better meet these requirements, educators have strived to make every effort to place students with and without disabilities in environments where they can learn, grow, and be successful. Each student is placed according to their individual needs, abilities, qualities, and level of services needed. Placing students in their correct environment is essential for obtaining a quality education. Today, there are many resourceful classrooms that are aimed at the specific abilities and disabilities of students. In these types of classrooms, students are better equipped to get the help they need. There are also related services within the school and the community that are aimed at offering support to families with disabilities. When students are placed in the correct environments, teachers can strategically help connect students and their families to these resources, and also integrate assistive technologies into the curriculum to support student learning abilities. When it comes to effectively placing student’s collaboration is key to assessing the type of environment that is presumed to be best for students. Educational environments affect teaching and learning, therefore the classroom environment must be designed to support the individual needs of students. A few types of classroom environments used in K-12 education include inclusion, self-contained, and resource rooms. The inclusion model allows students to participate in regular educational settings, and receive supported help by the inclusion teacher therein. The inclusion model is essential for increasing social  networking skills, developing behavior and academic skills through peer role-modeling, improving student achievement of IEP goals, and helping students acquire skills with the general education curriculum. The inclusion model is great for students who have mild learning disabilities, and those who are progressing consistently to a degree, where little or no help is needed. Based off of the student’s unique needs, the inclusion model is a great teaching environment, along with the self-contained education environment. In the self-contained classroom environment, students with disabilities are granted the  ability to receive much more one-on-one help given their unique disabilities. In this type of setting, educators receive additional specialized training to be able to aid students in making learning a success for students with disabilities, who are not able to participate in regular educational classroom settings. Students who learn at a slower pace, as a result of a learning disability, or uses modifications to lessons to acquire learning, a self-contained classroom may be beneficial. Nonetheless, resource educational environments may aide this same situation. In many cases, If a student is not mobile (using a wheelchair), have  severe disabilities like severe cerebral palsy, it may be beneficial to the student to participate in a resource classroom environment. Resource classroom environments focus on the student’s direct disability based on their IEP. They are potentially designed to be smaller for students to be able to get the one-on-one help they need yet still experience the social interaction with peers. Given the types of educational settings that were previously discussed, in the case of Gabriel, a kindergartener who battles cerebral palsy and has limited mobility it is necessary to place Gabriel in a resource room, to receive exceptional academic  training. Because, Gabriel is tub fed and has to use a diaper it is easier for instructors of a resource room to provide him his necessary needs, as they focus directly on the direct disability of students. Furthermore, it is concluded that Gabriel may not succeed in a regular educational setting, or a self-contained classroom setting because of his verbal inability. Although, he is able to communicate through a few eye movements, it is not enough to gain the benefits of a self-contained classroom, a regular education classroom, even though inclusion models. It is the  opinion of the author that Gabriel will better succeed in a resource room, where he will receive additional resources as physical therapy, to help him gain muscle strength to grasp things and even a speech therapist to help him gain control over his vocals. When it comes to exceptional education, there are many different related resources for students inside, and out of the school system. As for Gabriel, cerebral palsy or CP can mean life-long treatment. Generally, CP patients require 24-hour care. Therefore, in Gabriel’s case, eating, breathing, and moving freely can be a  challenge especially when trying to live independently, or study independently in an inclusion classroom, or self-contained environment. For this reason, educators may want to consider other related services, or services to assist their students with severe disabilities. Although, student have disabilities educators are still required to utilize these related services in order to provide those students with the best education possible. Most services are available to children in the public school system. While others can be accessed in the local community. However, there are related services abroad for students in public,  private, early education and head start school systems. Related services, in the terms of the educational setting of choice, calls for the special education classroom to utilize resources as assistive technology devices like wheelchairs, much physical therapy, and speech and language pathology services. Individuals who work to develop speech abilities in students who have communication impairments can effectively provide treatment to students like Gabriel, by showing them how to communicate with others. Furthermore, it is also beneficial to provide students like Gabriel with a physical therapist, who can work  through movement to help gain muscle control and movement. Nonetheless, teachers strive to develop independency in students of this type of educational setting, by providing assistive technology to encourage independent learning. Assistive technology for advancing communication with nonverbal students is made possible through devices, such as the DynaVox. This device can also be used to assess students like Gabriel to ensure they are understanding simple communication skills. Given the student’s abilities, it is necessary for educators to plan lessons and activities using a student’s IEP goals as guidelines. Then, during instruction time use many visuals and demonstrations, and even prompt the students for feedback. Moreover, in situations like Gabriel’s it is essential to students to use the co-teaching model To conclude, each type of educational setting discussed have significant roles in providing exceptional educational outcomes for students with disabilities. Whether a student is receiving training through inclusive model learning, self-contained strategies, or resource models of learning students are capable of receiving exceptional learning abilities and skills to build off of. It is a given, that all  types of educational settings has its pros and cons. However, it is believed that each type of environment has is benefits to support students in individual development. References Classroom Leadership (2001) Resource vs. Inclusion Classrooms; which is best for Students? Retrieved 8/17/14 from http://www. examiner. com/article/resource-vs-inclusion-classrooms-which-is-be st-for-students Council for Exceptional Children, (2014). Special Education Professional Ethical Principles and Practice Standards. Retrieved from http://www. cec. sped. org/Standards/Ethical-Principles-and-Practice-Standards.

Implementing A Nursing Dementia Care Bundle Tool Nursing Essay

Implementing A Nursing Dementia Care Bundle Tool Nursing Essay The purpose of this paper is to complete a diagnostic assessment and analysis to determine organisational readiness for an evidence-based service change linked to an action plan within Outer North East London Community Services (ONEL CS) Inpatient Unit within the London Borough of Havering. This paper will discuss how change can be achieved through completion of a diagnostic analysis. The evidence based change to be implemented and discussed in the paper, is the introduction of a Dementia Care bundle to improve dementia nursing care on the inpatient wards within Havering ONELCS. Through the use of a service improvement audit conducted within the Inpatient Unit; this paper will reflect upon the application of research methodologies that can support the diagnostic analysis; and the development and implementation of the action plan developed to achieve service innovation. The paper begins by giving the background information on the area of health care selected for review and service innovation. This will include the rationale for choosing this area, it importance and the explanation and definition of the key terms that will be used throughout the paper. The process by which the literature review was conducted will be detailed so that it could be replicated by the reader where necessary. Following on from this, the evidence pertaining to the chosen area of health care will be critically appraised to identify its merit in informing the diagnostic analysis assessment. Diagnostic analysis is the process of gathering information prior to the implementation of change, and is designed to identify the barriers and facilitators for change within an organisation; assessing organisational readiness for change (Hamilton, McLaren and Hamilton 2007). Theories and models relating to organisational change will be discussed; with the aim to informing and developing a strategy or action plan tailored to the local context for implementation. Background Dementia care is generally often overlooked on the acute inpatient hospital wards (Leung and Todd 2010). Up to 70% of acute hospital beds are occupied by older people (Department of Health (DOH) 2001; Alzheimers Society 2009). It is estimated that up to a of these patients, up to half of these patients in general acute care at any one time may have cognitive impairment including delirium and dementia (Royal College of Psychiatrists 2005). The unacceptable variation in the quality of dementia care provided on general wards in hospitals across England is well documented in numerous reports such as the Counting the Cost: Caring for people with Dementia on Hospital Wards report(Alzheimers Society 2009). The Healthcare for London: A framework for Action document (2007) and the National Audit Office report Improving services and support for people with dementia (2007), highlight the fact that services were not provided consistently well across London for people with dementia and their care rs; that people with dementia in general hospitals have worst outcomes in terms of length of stay, mortality and institutionalisation. Patients with dementia and their carers experience, have confirmed the above reports: patient feedback has highlighted an urgent need for research into care for older persons in general hospitals as is recently reported in media reports and Parliamentary and Health Service Ombudsman(2011) report investigating ten complaints into National Health Service(NHS) care of older people. Furthermore the National Audit Office(NOA) report (NOA 2007) provides potent evidence of the current costs of care for those with dementia diagnosis in the hospital setting; and highlights that acute general hospitals are not delivering a value for money service. As results of all this evidence the National Dementia Strategy (DOH 2009) (- a five year plan to transform dementia care) was developed by the Department of Health. It is against this backdrop that this paper was developed; to focus on the improving dementia nursing care provided on the inpatient wards by implementing a dementia nursing care bundle.. Definition of key terms: For the purpose of this paper key terms have been defined in particular the meaning of Dementia and care bundles. What is Dementia? The term dementia is used to describe a collection of symptoms, a syndrome which includes changes in memory, reasoning and communication skills, with a gradual loss of ability to carry out daily activities (Alzheimers Society 2009, Commissioning Support for London 2009; DOH 2009 NDS-a/b). There are a number of different types of dementia; with the most common being Alzheimers disease that accounts for about 60% of cases (Gupta, Fiertag and Warner 2009). The different types of dementia are outlined in Appendix one. Dementia in Havering- the local picture Dementia presents a unique challenge for London; with estimates of around 65000 people over the age of 65 in London diagnosed with dementia(Commissioning Support for London 2009); projections suggest that the number of people over 80 in London with dementia can be expected to rise by almost 50 per cent to 96000 by 2030(POPPI 2010). Dementia is an under-diagnosed condition in the London Borough of Havering. This paper focuses on improving inpatient nursing care delivered for dementia patients at St Georges Hospital. St Georges Hospital is a community hospital within Havering. Predominately for patients aged 65 and over it consists of a day hospital and 45 in-patient beds across two wards. There is one rehabilitation/assessment ward; and a stroke unit. In common with all members of the community, people with dementia can become physically unwell and require general hospital care. St Georges Hospital admits patients with dementia from the neighbouring acute hospital, Barking Havering and Redbridge University Hospital NHS Trust. Demographic changes and an ageing population in Havering mean there will be a disproportionate increase in the common conditions of old age, such as cancer, stroke, and dementia. A Freedom of Information (FOI) Request revealed that the estimated number of people with dementia is 1015. this represents 0.4% of all registered General Practitioner population and is below the national average of 1.1%. This figure is anticipated to rise and as is outlined by Appendix two. The evidenced based change to be introduced is a nursing dementia care bundle with the aim of improving the nursing care provided on the inpatient wards. What Is A Care Bundle? A care bundle is an evidence based protocol (Resar, Pronovost and Haraden, Simmonds, Rainey and Nolan 2005). Successfully used in Critical Care; it is a collection of interventions (usually three to five) that may be applied to the management of a particular condition (Fulbrook, and Mooney 2003, Resar, Pronovost Harden et al 2005; Belt 2006). The theory behind care bundles is that when several evidence-based interventions are grouped together in a single protocol, it will improve patient outcome (Resar, Pronovost and Haraden, et al 2005). The concept of care bundles was introduced by the NHS Modernisation Agency (DOH 2004) and continues to be fully supported by the Department of Health. A heavy reliance on the use of care bundles is evidenced the development and recent review of High Impact Interventions in reducing Healthcare Associated Infections by the Department of Health(DOH 2010). Although most specialities are using care bundles for the dementia care they are relatively a new concept. It is expected that by grouping dementia related evidence based practices or interventions together, within a single protocol that guides patient management, the overall quality of care nursing care delivered to dementia patients will improve. A dementia nursing care bundle has been developed by the Royal Wolverhampton Hospitals NHS Trust, through a freedom of Information (FOI) Request (Appendix three); a copy was requested and was to be locally adapted for the inpatient unit at St Georges Hospital ONELCS-Havering. Method of Searching for Literature An electronic search of the literature was undertaken on dementia care on hospital wards on the 30th of January 2011. Using an Athens NHS Log in details and advanced search of healthcare databases using the  Cumulative Index to Nursing and Allied Health Literature (CINAHL) was completed. Appendix four outlines how literature was identified and selected for appraisal. Literature Review: The evidenced based change to be introduced is a nursing dementia care bundle with the aim of improving the nursing care provided on the inpatient wards. The current health care policy context and recent national reports along with initiatives, have recognised the need to improve care in hospitals on general wards; these include the Lord Darzi report, High Quality Care for all (DOH 2008); the National Service Framework for Older People'(DOH) and the National Institute of Clinical Excellence(NICE) dementia clinical guidelines(NICE/Social Care Institute of Excellence(SCIE) 2006). Increasingly there has been a move towards a more focused attention on dementia care in the acute setting (Alzheimers Society 2009). Delivering nursing care for people with dementia is a challenging (Borbasi , Jones , Lockwood and Emden 2006) and stressful task (Cunningham and Archibald 2006). Behaviours associated with dementia include wandering, agitation, aggression and resistance to care (Prtichard and Dewing 2001, Cunningham 2006, Cordwell 2010). It is expected that these behaviours will change with time however this is dependent on the type of dementia (Insel and Badger 2002). As a patients dependency increases, their care becomes more complex and demands more direct nursing time for both patients, relatives and or carer(Cunningham 2006). Given the challenges of caring for patients with dementia and their at most time their inability to communicate care needs or report concerns about care, they are at risk of suboptimal care, neglect, or abuse(Ballard, Fossey, Chithramohan, Howard, Burns, Thompson, Tadros and Fairbairn 2001, Ouldred and Roberts 2004, Sturdy 2010). This can leave nurses experiencing stress wh en trying to respond to such behaviour (Burgess and Page 2003). Following on from this, researchers (Cunningham and Archibald 2006, James and Hodnett 2009) write that the rapid nature and capacity demands of general hospital care; the focus of care is strongly geared towards treating acute medical problems, discharging patients and meeting the demands of the service such as staffing levels, fast turnover of patients; these alone present challenges to nursing staff in the hospital environment. Patients with dementia may find this difficult to conform and adapt to rapid treatment protocols and to a dominant culture of curing the patient(Archibald 2002, 2003); for example they may find the regular ward moves confusing; the busy, noisy clinical wards frightening and stressful for people with dementia; adversely affecting how they behave (Schofield and Dewing 2001, Cunningham and Christie 2009, Dewing 2009). Cunningham (2006) goes so far as to suggest that dementia patients can feel disempowered, infantilized and intimidated; and the likelihood of thi s increases in busy hospital settings. What is clear is that the hospital staff; faced with the challenges of decreasing length of stay statistics, creating capacity, meeting other performance targets dementia patients present a challenge to nursing staff; leaving them at risk of receiving sub-optimal care. Sub-optimal care- for someone who is frail and vulnerable with a dementia diagnosis, and needing additional time and support from nursing staff, with perhaps displaying behavior which is not perceived as normal by staff, can be seen as difficult(Cunningham 2006). Norman (2006) found that nurses perceptions of the person with dementia were central to whether their experience was positive or negative in hospitals settings. A study conducted by the Alzheimers Society (2009) reported that almost nine out of ten respondents working with dementia patients do not have enough time to spend with patients and provide one to one care. Nolan (2006, 2007) and Cordwell(2010) recognize that although nurses strive to provide optimum care they find that practically day to day- this is not always achievable. It is interesting that Archibald (2006a, 2006b) in his work noted that outcomes for dementia patients are usually poor, they note that nutrition, hydration, pain management, communication needs a re often overlooked. Other studies confirm that dementia patients have the worst outcomes in relation to length of stay and mortality(Sampson, Gould and Lee 2006, Sampson, Blanchard and Jones 2009) Whilst this is not surprising, the Parliamentary and Health Ombudsman report (2011)Care and Compassion found similar outcomes for in their report on ten investigations into NHS care of older people. Fennessy (2007) writes that this should be expected as dementia care is often carried out in general hospital settings and not in designated dementia units where specialist knowledge is available to help manage these challenges effectively. Furthermore, a lack of knowledge and understanding among nurses on how to respond to dementia-related challenging behaviour is also likely to contribute to the provision of sub-optimal care (Fennessey 2007). Packer (2001) suggests that few staff understand what dementia is and how to cope with the behaviour that can ensue. The primary aim of this work is to support frontline staff in changing practice-improving dementia care delivered within the inpatient unit by introducing a dementia care bundle. Completing a diagnostic analysis will identify barriers and facilitators to implementing this tool. METHODOLOGY NICE (2007) guidance on changing practice, suggests that a number of methods can be used to assess barriers to change. They suggest that a choice of methods should be based upon local context, resources and the number of staff(NICE 2007). Previous studies (Pollock, Legg, Langhorne and Sellars 2000; Davis, Jamison , Brumley, Engu and Danos 2006; Solomons,and Spross 2011) in their work exploring barriers and facilitators to implementing evidence based change; utilising diagnostic analysis identified a mixed methods approach to be of benefit in planning for successful implementation of the planned change. Following on from this Solomons and Spross (2011) write that the chosen method should be valid and reliable; the choice of model will depend mostly on what the target for change is and the group involved in changing (Lewin 1951, Bennis, Benne and Chinn 1985, Haffer 1986). The mixed method approach was therefore chosen for this diagnostic analysis. The premise behind the use of both qualitative and quantitative methods would allow the researcher to best answer the research question or problem(Andrew and Halcomb 2009); specifically for this paper, it would allow the researcher to capture the multiple realities and the various individual staff perspectives that made up the social situation of dementia care at the Trust. The notion of multiple realities was important in this work (Lincoln and Guba 1985), the use of a mixed methodology, would allow the researcher to capture the views of both the powerful stakeholders/decision makers as well as the frontline staff. Furthermore it had the potential to add breadth, rigor and credibility (Cresswell 2002/2009). Cresswell, Vicki and Clark (2011) write that mixed method designs combine the benefits of qualitative methods and quantitative methods to create a more complete picture. The study received Audit approval from the ONEL CS Audit department as well as sign off by the Associate Director of Operations Havering. Three data collection methods were used: as part of the triangulation of data, documentary analysis was conducted; focus groups was held along with a questionnaire, that was circulated to all staff involved with dementia care at the 2 inpatient wards at St Georges Hospital Documentary analysis: Documentary analysis was completed on six authentic, verifiable Trust documents in the public domain to obtain evidence on supporting evidence-based practice, clinical effectiveness, organisational priorities and quality outcomes. The range of documents analysed included the ONEL CS Monthly Board report for December 2010, ONELCS Trust profile online, Havering Primary Care Trust (PCT) Human Resources and Organisational development strategy(2005-2008);ONELCS Clinical Audit and Policy strategy(2009), Havering PCT Education Training and Development Strategy( 2008-2011) and the ONEL CS five-year vision for health service delivery-Intergrated Business plan(2009-2014). Documentary data was abstracted and analysed thematically. Focus groups: Focus groups were used to elicit the views and experiences of professional staff who would be affected by changes in implementing the dementia care bundle. Andrew and Halcomb(2009) write that focus groups can capture the particularities and breadths of opinions about a particular topic; and are useful as they provide the social context of how opinions are formulated. The participants, eight staff with strategic or operational accountability for aspects of inpatient care were purposively sampled. In attendance was a Ward Manager, Modern Matron, Medical Senior House Officer, Practice Development Lead, Physiotherapist and 3 ward- based staff nurses. The focus group focused on organisational culture, dementia assessment, and documentation. The focus group schedule was semi- structured, containing sequential questions exploring staff experiences caring for dementia patients from the time of admission to discharge, focusing on care processes, satisfaction with care delivered, activities of daily living, physical problems/challenges encountered, and the awareness of these potential problems on assessment. The focus group was tape-recorded and transcribed with the permission of the participants, and analysed thematically. Questionnaire The study population consisted of 90 staff members who regularly participated in the care of dementia patients. This included registered nurses, nursing health care assistants, clinical administration staff and inpatient therapy staff. The questionnaire chosen for this work used was the approved Approaches to Dementia Questionnaire developed by Lintern, Woods Phair (2000); a Likert-type instrument with 19 items. The ADQ measures hopefulness and person-centered approaches. The ADQ questions were graded on a Likert scale of response alternatives including: strongly agree, agree, uncertain, disagree and strongly disagree. A copy of the questionnaire is included in appendix five. The ADQ is made up of two domains: the hope attitude items and the person -centred attitude items (Lintern 2001). The hope attitude items were measured with eight questions, whereas the person-centred caring attitude items were measured with 11 questions. The dimension of hope is made up of questions relating to the participants thoughts about characteristic disease-related features, for example there is no hope for people with dementia, or dementia sufferers are sick and need to be looked after. A person-centred attitude was indicated by a response in the positive to questions such as It is important for people with dementia to have stimulating and enjoyable activities to occupy their time and people with dementia are more likely to be contented when treated with understanding and reassurance. Questionnaires, with an accompanying memorandum, were then sent to the Ward Managers to distribute the memorandum to staff, who were directly involved in the daily care of persons with dementia; including administration staff. The memorandum outlined the aim of the project, provided brief information about the aims of the questionnaire. The questionnaires were collected after two weeks. Reminder letters were sent to non-respondents with another copy of the questionnaire. Results Data Analysis The researcher took an interpretative approach to analyse the data for themes (Grbich 2007). Following verbatim transcription of the focus groups, each transcript was read several times to determine what is going on here. That is, what meanings, values and intentions were coming through and what competing or alternative perspectives are being put forward? The Data were then classified into themes. Results Documentary analysis: three themes were identified: 1. Innovative forward thinking organisation 2. Staff training, development and empowerment 3. Improving patient health and care Theme one Innovative forward thinking organisation The ONELCS Trust Profile on online provides a clear and concise vision; ONELCS clearly pride themselves as forward thinking and innovative; this is noted in their Integrated Business Plan and online profile, so much so that the organisation is described as: In our view ONEL CS is an exemplar of a community provider organisation. It is believed that this ethos benefits both patients and staff; with delivering quality care to patients at the heart of the organisation. Theme two Staff training, development and empowerment A strong emphasis on staff training and development was identified in all the documents analysed, explicit commitment to training and development was demonstrated in all documents reviewed. A high profile was given to education as part of continuing professional development, and explicit links were made between education and improved patient care. Education was also presented as creating a positive environment that would improve staff recruitment. ONELCS is committed to involving staff engagement in shaping the organisation and ensuring improvements in patient care. Valuing people involves developing education, training and career pathways that focus on individual as well as organisational need and demonstrate an appreciation of the staff and the vital role they have in ensuring quality services. (Organisational Development and Human Resources Strategy 2005-2008) Strategically the Trust publicly shows its support from board level to ensuring all staff have equal access to training and development opportunities to meet the requirements of the Knowledge and Skills Framework. This commitment to the ethos of lifelong learning is demonstrated in their Training and development policys the online Trust profile. Again staff development is linked to delivering and developing a quality service for patients: à ¢Ã¢â€š ¬Ã‚ ¦ It should enable the Trust to deliver its strategic aims and objectives, through a workforce and organisation that is competent, motivated and confident to continuously learn, change and develop in order to deliver high quality and responsive patient care and services. (Education, Training and Development Strategy 2008-2011) While there was clear support for education and training none was demonstrated for research and research development. Theme three Improving patient health and care The Integrated Business Plan (2009-2011) ONELCS shows a commitment to Improving patient health and care; it hasà ¢Ã¢â€š ¬Ã‚ ¦ always been our priority. Our vision is that ONELCS will be an independent organisation that delivers consistent and excellent healthcare, proven to be safe and effective. The organisation emonstrates that it supports evidence-based practice and initiatives identifying opportunities to change practice and to improve the quality of patient care. The Clinical Audit Policy (ONEL CS 2009)is concise in describing the organisations objectives: It is the responsibility of all health professionals to critically review their work to ensure care is given according to the best available evidence. à ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦.The Objectives for 2009-2011 are: Ensure that audit results lead to changes in clinical practice and inform policy and training needs. Focus groups Four themes were identified: dementia knowledge and skills, attitude towards dementia patients and organisational change- constant change at the Trust Theme one: dementia knowledge: skills and assessments Lack of knowledge and understanding about dementia and the needs of dementia was strong theme. Both qualified and unqualified staff (HCSW and RGN) expressed: I am not even sure what having dementia meansà ¢Ã¢â€š ¬Ã‚ ¦.are there different types of dementia Staff commented that they had not received dementia specific training The assessment of dementia patients was fragmented, separately documented, and lacked cohesion. Medical staff in their patient clerking- noted a diagnosis; nursing and therapy staff in their individual initial assessments noted dementia diagnosis. One Registered Nurse asked the following: do we actually provide personalised dementia care that we can evidence; for example in our care plans? Currently the teams have no specific dementia documentation such as care plans for dementia care. The medical teams utilise The Abbreviated Mental Test( Hodkinson 1972) whilst the therapy teams utilise the Mini Mental State Examination(Folstein, Folstein and McHugh 1975) validated assessment tools Furthermore the staff felt that the teams could have specialist links with the community mental health teams to obtain specialist training and assessments and to develop dementia champions. Theme two: Multidisciplinary working Staff expressed the multidisciplinary team working was not working well and would impact on improving dementia care. Staff present at the focus group, acknowledged that comprehensive multidisciplinary working did not occur, The level of multidisciplinary working varies, they could work better on the for dementia patients'(registered nurse) Lack of communication was highlighted as a major issues as part of multidisciplinary working, with mixed views expressed :the nursing staff expressed that .. Its hard keeping track of patients, theres no dedicated Dementia care pathway, thats the problem, if there was a specific pathway/guidance it would be so much easier for all staff to liaise with therapists and other professionalsà ¢Ã¢â€š ¬Ã‚ ¦ Theme three: Organisational change Participants expressed that organisation changes were most recently frequent and difficult to understand; the concept of Change fatigue came to mind. Currently the organisation has a new management structure, at present the inpatient wards are participating in an consultation with reduction in substantive posts Staff do not feel they are involved in current management decisions Staff expressed that there was limited communication and moral amongst staff was very low; furthermore, shortages of nursing staff were evident. we do not know what is going on Too many changes at present and these are poorly communicated first TUPE transfer to NELFT, then Reducing managing costs consultation, now inpatient reduction beds consultation all within 3 monthsà ¢Ã¢â€š ¬Ã‚ ¦. No one listens to usà ¢Ã¢â€š ¬Ã‚ ¦staffing levels are being reduced and we cannot provide the care we want to The general consensus from participants was that the Trust responded positively to change and that this was a constant feature of working in the NHS. Staff are open to change and understand that change is the nature of the NHS Many exemplars of well-managed change were cited, including the implementation of the Productive Ward Series, where staff were fully involved in the programme. Key characteristics of these changes were good communication, planning, involvement of staff, and training provided prior to implementation. Questionnaires: A total of 90 questionnaires were distributed. Initially, there were 33 respondents (36.7%), however, this rose to 43.3% after the reminder memorundum was sent (n = 39). Hence, a total of 39 (43.3%) respondents were included in the study. Thirty of the respondents (76.9%) were clinical staff, 4 (10.3%) were Non clinical administration staff and 5 (12.8%) respondents did not identify their role. . Hope attitude Items Where the positive hope attitude was obvious, more staff members selected it and this is evident in the response to statement 5- Nothing can be done for people with dementia, except for keeping them clean and comfortable where 62.9% of the respondents strongly disagreed. However when it was not so obvious, there emerged a variety of responses. Consider the statement People with dementia are unable to make decisions for themselves; a variety of responses are obtained. People with dementia are unable to make decisions for themselves Answer Options Response Percent 1 strongly disagree 25.7% 2 disagree 25.7% 3 neither agree nor disagree 25.7% 4 agree 14.3% 5 strongly agree 8.6% dont know 0.0% answered question skipped question This is a similar outcome for the remaining 7 hope attitude questions. With the remaining 7 of the questions, almost equal numbers of respondents agreed or disagreed with hope and non-hope approaches. Consider the question Dementia sufferers are sick and need to be looked after- are dementia sufferers sick? And in what sense are they sick? Those questions pose a dilemma and therefore it is not surprising that the respondents show this in the data below. Dementia sufferers are sick and need to be looked after Answer Options Response Percent 1 strongly disagree 17.1% 2 disagree 17.1% 3 neither agree not disagree 20.0% 4 Agree 14.3% 5 Strongly agree 31.4% dont know 0.0% answered question skipped question This again demonstrates the lack of consistency in the choices of approach, with some choosing the best considered approach and some not. It also highlights a need for further development of understanding and knowledge of the best available approach to caring for those with dementia as almost half the respondents agreed or strongly agreed the non-hope items for each of these questions. This indicated that staff have some knowledge and ability in delivering dementia positive care, but that this is usually only evident where this is a clear option. When it is a less obvious choice, some dilemmas are raised. The hope attitude items are characteristics of disease related features;, the responses suggest that indeed, some staff may have limited specific dementia care awareness and skills or perhaps there are areas of practice or experience that gives them some understanding of the dementia; it is remains clear that there is a gap in their knowledge. This supports the premise that more learning is required. Person Centred Attitude Items Responses to 9 out of the 11 person centred attitude items were strongly positive; and as they were obvious the responses were selected by most staff members. The questions raised issues of trying to maintain independence, choice and dignity while attending to physical care needs and managing the care. The responses suggest that as these were standards of caret hat healthcare staff strive for, in their day to day practice; however these are aspects of

Pricing and Distribution Channels: Hilton Amsterdam

Pricing and Distribution Channels: Hilton Amsterdam Selling a hotel room used to be simple; business would literally walk in off the street. No more. As the number of channels a customer can use to book a hotel room grows, hoteliers will be forced to take a more holistic view of their technological infrastructure, as quoted by Bruno des Fontaines (2007), Vice President for Amadeus Hospitality Group Asia Pacific. Revenue Management is a complex phenomenon with many factors affecting the final outcome. Out of these innumerous factors, playing their role in revenue management, price is indeed one the most powerful tools a hotel can use to increase revenue. The key however is to know how to set the right prices and which distribution channels to use in order to maximize your revenue. Tools using which, any product or service is provided to end consumer, constitute Distribution Channel of that product or service. Success or failure of a product relies greatly upon distribution channels. In hospitality business, a successful channel management strategy consists of selling inventory at the highest possible rates, while pushing reservations through the lowest-cost channels. (Barash 2005) It is therefore of prime importance that a hotel chooses most effective distribution channels in order to manage prices and eventually to maximize its revenue. There is, however, a great array of approaches available to manage distribution channels which makes it a very challenging task for hoteliers, requiring for them to understand all distribution options available. In past hotel distribution channels used to be most simplistic, the traditional main distribution channels were: Brochures Advertising guide books mail shots call centers and Travel agencies. All of these modes, even though very simple and easy to manage, are extremely expensive and have a very limited range. They could be effective for local clientele only. With the passage of time and advancement in technology, other sophisticated and complex distribution channels originated that were never even thought of, such as Central reservations Global Distribution systems Hotel Booking Agent Tour Operator Online wholesalers However most of these channels only acted as a go-between hotel and the global-distribution-system (GDS)/travel agent. (Barash 2005). This wide array of distribution channels no doubt provide a great deal of benefit to the hotel in the sense that its availability to customers increases infinitely, customers all over the world can get to know about any hotel anywhere in the world through a travel agent or website etc. however at the very same time this phenomenon makes hotel distribution channels most complex and difficult to manage. Reasons for decline of GDS as an effective distribution channel as reported by HeBS (2002) can be due to following reasons: Slower than expected travel industry recovery and the weak economy Channel shifting from traditional Consumer-Travel Agent hotel reservations to online bookings (leisure and unmanaged business travelers) and self-booking corporate systems. Growing popularity of online business models (e.g. merchant) that do not utilize the GDS. The emergence of direct interfaces between major online agencies and major travel suppliers thus bypassing the GDS. Services like WorldRes, which utilize direct interfaces to the major hotel brands CRSs also undermine GDS distribution. Decreased corporate travel: the latest survey by NBTA (September 2002) showed that 68% of corporate travel managers said travel was down in their companies from last year, in some cases by as much as 20%. Also, 72% of them said that current travel is below the 2000 levels-the last time travel was at normal volumes. Distribution of hotel rooms through traditional distribution channels such as GDS/travel agent and call center/reservation office, proves to be inefficient and extremely expensive, especially in light of the current weak economic situation. Focusing only on traditional distribution channels will result in lower occupancy rates, and higher distribution and operational costs. In this current scenario internet channels are emerging as more popular distribution channels that are being given increasing preference over traditional channels of distribution. Internet distribution of hotels is of two types: Direct Online Distribution Indirect or Third party online distribution Direct online distribution is where hotel pushes its property through a website constructed and owned by the hotel itself. Whereas third party web-based travel intermediaries such as online travel agents, have a certain number of rooms allocated to them that they sell through their own sites where mostly air tickets and car rentals are also offered among other things. The indirect distribution channel can be further subdivided into further subcategories such as channel to sell distressed inventory such as priceline. (HeBS 2002) A hotels revenue is greatly affected by the method that a customer uses to book his/her room. If a lot of middle parties are involved in booking process then hotels share, in the amount that a guest pays for booking a room, can reduce to a great extent. According to Marvel (2004) a room booked through a travel agent and the GDS (global distribution system) typically costs the hotel 15% of the reservations total. Contrary to popular belief, third-party websites are no bargain either for the hotelier, as they keep about 13% of a bookings value. So-called merchant websites (such as Priceline.com or Hotwire) which basically buy inventory from hotels usually average a 33% mark-up on the rooms they sell. Bookings arriving via the central reservation system of voluntary chains (such as Minotel) can cream over 25% of the clients original payment between travel agent, tour operator and chain fees. Many tour operators working in mass leisure destinations only pay 50%-60% of the normal room pri ce to the hotelier who is lodging their clients. Looking at Hilton Amsterdams site also reveals similar facts, as can be observed from following table: ADVANCE PURCHASE FULL PREPAYMENT, NO REFUND OR CHANGES (price in GBP) Hilton website 243 Laterooms.com 258.76 Orbitz 243.5 Booking.com 254.871 (Rate differences between Hotels website and other online sources: The rate for Twin Hilton Deluxe Amsterdam room, on different booking sites available online, for one day 30th April 1st May 2011. These rates were observed on 4th April 2011) The fact can be clearly observed that best rates for room bookings are given by hotels own website, and obviously so because direct online booking on hotels own website has proven to be the best and cheapest source of distribution for a hotel. eTRAK Full Year 2009 report on hotel bookings by distribution channel as quoted by Starkov (2010) shows that the online channel is the only channel that is growing even in todays difficult economic conditions where demand for rooms is far less than the supply, Internet bookings for the top 30 hotel brands increased by a remarkable 6.6% in 2009 vs. 2008. Whereas hotel room bookings through GDS and Voice Channels, decreased considerably. HeBS findings based on the latest eTRAK benchmark report, surveys and industry data from PhoCusWright and ARC as quoted by Starkov (2010) are as follows: 1) GDS Channel Is in Steady Decline: GDS hotel bookings via the CRS of the top 30 hotel brands declined by 3.7% 2009 vs. 2008, and constitute 23.6% of total CRS bookings in 2009 vs. 27.3% in 2008 (eTRAK). Back in 2006, GDS CRS reservations constituted 31.3% of total CRS bookings for the top 30 brands. GDS share has decreased by 24.6% from 2006 to 2009, when it was reported at the 23.6% level. Travel Agency Share from Total Travel Market in the U.S. dropped from 41% in 2006 to 33% in 2009 (PhoCusWright). U.S. Travel Agency Locations decreased by 7% in 2009 vs. 2008. The number of locations has been decreasing at an average rate of 4% every year since 2001, and the number of travel agencies has declined from as high as 35,000 in 1995 to less than 16,450 in September 2009 (ARC, HeBS). 2) The Voice Channel Contribution Is Decreasing: Voice channel hotel bookings via the CRS of the top 30 hotel brands declined by 2.9% in 2009 vs. 2008, and now constitute 22.2% of total CRS booking in 2009 (eTRAK). Last years decrease is in addition to a decline of 2.8% for the full 2008 vs. 2007 (eTRAK). The Voice Channel is in decline for the 6th consecutive year (HeBS). 3) The Shift from Offline to Online Channel is Permanent: 54.2% of overall CRS bookings for the top 30 hotel brands come from the online channel, which is an increase of 6.6% vs. 2008 (eTRAK). 60% of leisure and 40% of business travel will be booked online in the U.S. this year (PhoCusWright). 45% of hotel bookings in 2010 will be via the Internet (direct + indirect online channels) (HeBS). 4) Direct online bookings are on the rise: In 2009, 70.9% of online bookings came from the direct online channel (i.e. the major hotel brands own websites), while 29.1% came from the indirect online channel i.e. the Online Travel Agencies. Whereas in 2008 direct online bookings constituted 75.2% part of online bookings and indirect bookings were 24.8%. This represent a great increase in the number of bookings made directly on the hotels website as compared to indirect bookings. (Starkov 2010) Hotel management perceptibly has greater interest in promoting the online booking, especially direct booking on the hotels own site, because it is far cheaper. According to a report on E-commerce estimated cost of direct reservations by traditional means (i.e. fax, telephone, e-mail, etc.) could be as much as 300% higher than processing the same reservation through the GDS, which costs between $3-$5.Furthermore, most reservations, passing through the GDS, are generated by travel agents who charge an average fee of 10%. Bookings via a chain central reservation system cost the hotel $6 to $10 and reservations by a toll free telephone number $4 to $8. However for hoteliers the cheapest and most satisfactory mode of booking a room is direct online booking variable cost of which is only about $1.50. (Marvel 2004). Even though GDS still constitutes the major distribution channel for hotel rooms with a 68% share in 2003, their share is diminishing fast due to higher growth rate of the internet, according to Marvel (2004) overall electronic booking increased by only 1.6%, while online reservations rose by 35.5%. However the best source of distribution for any hotel is direct online booking because in indirect bookings the third party intermediaries take away the major chunk of hotels revenue in the form of commission. Therefore the major concern of hoteliers nowadays is to devise ways to attract customers to make room bookings directly to the hotels website. Several examples of such efforts are as follows: Four Seasons do not allow any direct bookings over third-party websites. Hilton (USA) declines HHonors points or air miles for online bookings to all the bookings that are made indirectly i.e. not on Hiltons own website. As of January 1, 2004, Starwood has also take a step in this regard i.e. all bookings made through indirect internet channels will not be eligible for any in-house benefits. Marvel, M. (2004). Therefore all in all direct online bookings are on the rise and they appear to be the preferred mode in present conditions of recession. However in order to take advantage of this growth in the online distribution channel especially the direct online channel, hoteliers need to make strong and proactive Direct Online Channel Strategy. This strategy should be backed by funds. Hoteliers must carefully employ ROI-centric initiatives, including website redesign, website optimization and SEO, paid search, email marketing, online display advertising and proven social media initiatives. (Starkov 2010) Even in this economy, the budget for internet marketing, and most importantly of direct online channel, should not be decreased or even diminished, because after observing past trends and results of various researches it can be safely said that online channel is the only growth channel for hoteliers and the only light at the end of the tunnel in this environment. Even in these difficult times we see Return on ad spend (ROAS) as high as 3500% from Internet marketing campaigns we run for our clients. (Starkov 2010) Another obvious pattern in Hilton Amsterdams direct online pricing is that the rates given on hotels website are the most expensive when the booking is completely flexible (customer has complete liberty to alter his/her plans as well as they get their full money returned if cancellation is made before or on the day of arrival) whereas other sites give cheaper rates in this situation. However on the other end Hotel website gives best rates in case of fixed reservations i.e. reservations in which no room is available for any changes and in case of cancellation hotel keeps all the money. This could be due to the reason that in case of cancellation hotel has to bear the entire cost whereas booking sites that usually have rooms allocated to them do not have to face any such penalties. ADVANCE PURCHASE FULL PREPAYMENT, NO REFUND OR CHANGES (price in GBP) FLEXIBLE RATE, (Price in GBP) Hilton website 243.524 278.438 Laterooms.com 258.76 277.31 Orbitz 243 262 Booking.com 254.871 273.201 Another observation is that Advance booking rates are different from immediate booking rates. It is an effective tactic to increase confirmed sales. Customers are encouraged to book their rooms well in advance, by offering them lower than usual rates. Booking cycle of a hotel determines how well in advance customers can book rooms, a hotel offers greater discount at the beginning of a cycle whereas higher rates are offered towards the end. (Ismail, 2001). This also helps in managing the bookings in lean seasons i.e. in off seasons lower booking rates are offered to attract greater distribution. Best rate for Hilton deluxe twin room decreases to  £202 from  £243 if the booking date was moved from 30th April to 31st April. Hilton also offers package rates, hotel package comprise of a hotels room combined with any other service of the hotel, most commonly it is room and meal package that hotels offer. There are many kinds of package deals available at Hilton hotel, such as: Bread and breakfast package, where room is bundled with breakfast for two at a discounted price. Another package combines air ticket, car rental and room all three in one package price. Beside package pricing Hilton also offers group rates, i.e. booking a larger number of rooms for a party mostly at a lower rate. Keeping in view the benefits and complexities of using multiple channels in hotel distribution we can say that the key to adopting best distribution channels and increasing revenues is to choose distribution channels as per hotels needs without falling prey to an increasingly convoluted snakes nest of technology. Managing these distribution channels also costs money and considerable time of hotel employees. . (Fontaines 2007) Complex hotel distribution systems are strategically dangerous for a hotel as managing a complex distribution may raise the price for customer who may switch to low cost channels. Spend Analysis: Application and Strategies Spend Analysis: Application and Strategies In spend analysis, skills to do with data analysis are extremely important. However, experts in related fields question the use of a software application to automatically generate the required data. In most cases, automated application does not necessarily give the accurate data as some processes require practical skills needed in the respective field. In everyday life, individuals come across a lot of information and data that is less likely important in decision making. This implies that an individual must possess data analysis skills to identify the information that is required and the less vital. In decision making, some major characteristics of vital information are; consistency, having a pattern and without errors. â€Å"Spend analysis is referred to as the systematic review of historical purchase data† (Pandit Marmanis, 2008). One of the major reasons why spend analysis is carried out is to be able to identify savings opportunities. Despite the fact that there are several indicators used to identify such opportunities, an automated software application would be incapable of successfully identifying such opportunities depending on the order of accuracy and precision. Some of the key indicators in spending analysis require analytical skills such as in price and applying best practice in various processes in an organization or household setting. If there is a consistent increment of prices of goods and services with time, it would be prudent for an individual or an organization to pay more attention to the purchases in specific categories and ensure that the factors leading to the rise in prices is well addressed. Such a process would require data analysis skills with specific attention to identifying a pattern of price increase. The application of best practice has over the years not been fully adopted by businesses. This is because, this technique is considered as simplified and less likely to come up with a saving opportunity. However, there is always the likelihood that an organization or an individual is overpaying for goods and services. Best practice requires data analysis skills which are applied to areas that provide the best cost saving strategy. Other indicators in spending analysis, such as the purchase price variance (PPV) can use software application to identify patterns or any irregularities from the data collected. According to Barone Franco. (2012) the six sigma methadolo0gy is used to enhance organizational performance through the use of statistical process meant to reduce process variation that characterizes most organizations. Currently, the six sigma methodology is commonly used by many organizations to identify areas of wastage in addition to improving the overall productivity of the organization through the improvement of business processes. The six sigma indicator shows the variation in parts, processes and products. However, of importance to note is that the six sigma method is not used independently in an organization. Most of the businesses that use six sigma also incorporate other lean methods. The six sigma methodology has over the years evolved to become a dynamic process that is used to improve performance and also maintain the process environment. Whats the strategy does is identify the major causes of performance gaps, then propose appropriate methods of addressing the performance gaps with an overall aim of increasing performance. The six sigma uses a sequential method known as the DMAIC, which stands for define, measure, analyze, improve and control. This is the guide that is used to identify the performance gaps and propose remedies to the gaps. Define: This step is expected to identify the performance gaps and develop alternatives that would lead to a higher sigma. Measure: In the step of measuring, there’s the use of metrics to come up with the baseline data to be used to identify the major cause of the problem. In addition, information must be gathered first before any data is incorporated. Analyze: In this step, statistical tools are used to confirm that the problem identified is admissible and that the factors found to cause the problem are the root causes of the problem. Improve: This step seeks to offer alternative solutions aimed at addressing the problem. Some of the key questions that are frequently in this step include; which way is cheaper, which way is faster? There are many solutions that are commonly identified as the alternatives to performance gaps. The most common solutions under this step include; mistake proofing and cellular manufacturing. Control: The control stage is also known as the institutionalization stage. This stage modifies parts, processes or products in accordance to the proposed solutions and also periodically monitor the changes that arise from such substitution. When carried out effectively, spend analysis can be greatly beneficial to an organization. This is because in addition to maximizing productivity and efficiency of business processes, spend analysis also encourages insightful decision making that is backed by both facts and figures. In addition, spend analysis is responsible for viable, cost-saving techniques that assists businesses identify areas of wastage and address the issue for better performance. These roles on spend analysis are more inclined to the financial aspect of business. Most of the problems that spend analysis aims to solve are issues to do with the expenditure and supply management. While most business processes seem intertwined and thus cannot occur individually, the financial aspect of business is the hub of all the performance gaps that spend analysis seeks to solve. By analyzing the concept of ‘spend’ most businesses are able to compare the spending behaviour with the production output and identify areas that need to be improved so that the organization can achieve higher performance. As stated by Ramsey and Silverman, (2002) research has established that businesses that use spend analysis are more likely to improve on performance with an approximated improvement rate of 24% in terms of general efficiency. With such statistics, there is no doubt that spend analysis has immense benefits to an organization in terms of driving performance and through the establishment of viable cost-saving techniques. Considering that spend analysis is a process that is meant to improve on the efficiency of products, processes and parts, there are numerous challenges that most organizations face during the implementation stage. Most organizations consider the spend analysis to be a dynamic process that is difficult to initiate and manage. More importantly, the processes involved in spend analysis require a high level of accuracy. For a business to develop a well leveraging spend analysis, integration of data from various different sources is required. However, a spend analysis is not only made possible by accurate data. There are various other factors that complement the methodology including finance, supply chain and IT. The prevailing economic times dictate that organization take advantage of any spending opportunity that comes across. The best technique to do this would therefore be through spend analysis. References Barone, S., Franco, E. L. (2012). Six Sigma methodology. Statistical and Managerial Techniques for Six Sigma Methodology: Theory and Application, 1-21. Ramsay, J. O., Silverman, B. W. (2002). Applied functional data analysis: methods and case studies (Vol. 77). New York: Springer. Pandit, K., Marmanis, H. (2008). Spend analysis: the window into strategic sourcing. J. Ross Publishing.

Raise the Red Lantern Essay -- Women Raise Red Lantern Essays

Raise the Red Lantern â€Å"All the world’s a stage; all of us are taking the elements of plot, character, and costume and turning into performances of possibilities†(Ward1999: 5) Raise the Red Lantern tells a compelling and sorrowful story of a young woman whose life is destined to be ruined in a male-dominated society. This can be an awakening of some sort to any woman. As Ward states in her text, women learn the rules of our half of the world as well as those of the other half, since we regularly move in and out of the male world. There she defines women’s culture. The term has also been used in its anthropological sense to encompass the familial and friendship networks of women, their affective ties, their rituals. It is important to understand that woman’s culture is never a subculture. It would hardly be appropriate to define the culture of half of humanity as a subculture. Women live social existence within the general culture. Whenever they are confined by patriarchal restraint or segregation into separateness, they transform this restraint into complementarily and redefine it. Thus, women live a duality- as members of the general culture and as partakers of woman’s culture. (Lerner 1986:242) Much like the quote stated, Raise the Red Lantern is set in Northern China in the 1920’s. For thousands of years the people of China have formed family life around patrilineal decent. The assessment of traditional China life was patriarchal. A basis of this set up would be from Confucius. In childhood, Before marriage, Obey your father In adulthood, During marriage, Obey your husband In widowhood, After marriage, Obey your son States in the text, the lowest moment of a woman’s life was her wedding day. Cut off from her natal family, the young bride was an outsider and the object of deep suspicion in her new husband’s household. The only was to earn a place for herself was to have sons. Songlian quits college after her father has passed away and becomes Zuoquian Chen’s fourth wife. When Songlian, who chooses to walk from her house to Chen’s house instead of riding in the wedding carriage, arrives at Chen’s house, there is no sign of a celebration, an omen of things to come. Bound by tradition and inflamed with jealousy, none of the three wives come out to greet the new bride. An old housekeeper welcomes and acknowledges ... ...y. Much as the film was, as it was structured, this film could be a parable of some sort. Songlian would be the individual, the woman. The master would be the government and the customs of the house are the laws of the country. It is an archaic system that always rewards those that play and pay but destroys those who violate. One thing I found appealing about "Red Lantern" is that while the film portrays a brutally patriarchal system in which women are clearly very oppressed and dependent on their lord and master for everything, it does not idealize the women or turn them into doe-eyed, sweet, saintly victims. The wives and concubines are resourceful, smart, competitive, and very determined to make the best of their situation... in any way they can. They can even be cruel and downright evil. Forget the cliche that men are interested in power and women are interested in love. These women are definitely interested in power and status -- though, of course, the only way they can obtain it is by winning the husband's favor. Yet their power struggles are just as ruthless as anything that happens in the "male" world of politics, business, or war, and just as fascinating to watch.

Capital Punishment Essay: Death Penalty Distribution - Is It Unfair? :: Argumentative Persuasive Topics

Death Penalty Distribution - Is It Unfair?   Ã‚     The subject of this essay should be obvious from the title. Considerable detail is included in this presentation of the facts on the issue.    In an average year about 20,000 homicides occur in the United States. Fewer than 300 convicted murderers are sentenced to death. But because no more than thirty murderers have been executed in any recent year, most convicts sentenced to death are likely to die of old age (1). Nonetheless, the death penalty looms large in discussions: it raises important moral questions independent of the number of executions (2).    The death penalty is our harshest punishment (3). It is irrevocable: it ends the existence of those punished, instead of temporarily imprisoning them. Further, although not intended to cause physical pain, execution is the only corporal punishment still applied to adults (4). These singular characteristics contribute to the perennial, impassioned controversy about capital punishment.    Consideration of the justice, morality, or usefulness, of capital punishment is often conflated with objections to its alleged discriminatory or capricious distribution among the guilty. Wrongly so. If capital punishment is immoral in se, no distribution cannot affect the quality of what is distributed, be it punishments or rewards. Discriminatory or capricious distribution thus could not justify abolition of the death penalty. Further, maldistribution inheres no more in capital punishment than in any other punishment. Maldistribution between the guilty and the innocent is, by definition, unjust. But the injustice does not lie in the nature of the punishment. Because of the finality of the death penalty, the most grievous maldistribution occurs when it is imposed upon the innocent. However, the frequent allegations of discrimination and capriciousness refer to maldistribution among the guilty and not to the punishment of the innocent (5). Maldistribution of any punishment among those who deserves it is irrelevant to its justice or morality. Even if poor or black convicts guilty of capital offenses suffer capital punishment, and other convicts equally guilty of the same crimes do not, a more equal distribution, however desirable, would merely be more equal. It would not be more just to the convicts under sentence of death.    Punishments are imposed on person, not on racial or economic groups. Guilt is personal. The only relevant question is: does the person to be executed deserve the punishment? Whether or not others who deserved the same punishment, whatever their economic or racial group, have avoided execution is irrelevant.

Fair & Lovely

in newspapers or on the Web that are used by families to arrange suitable alliances, and you will see that most potential grooms and their families are looking for â€Å"fair† brides; some even are progressive enough to invite responses from women belonging to a different caste. These ads, hundreds of which appear in India’s daily newspapers, re? ect attempts to solicit individuals with the appropriate religion, caste, regional ancestry, professional and educational quali? cations, and, frequently, skin color. Even in the growing numbers of ads that announce â€Å"caste no bar,† the adjective â€Å"fair† regularly precedes professional quali? ations. In everyday conversation, the ultimate compliment on someone’s looks is to say someone is gora (fair). â€Å"I have no problem with people wanting to be lighter,† said a Delhi beauty parlor owner, Saroj Nath. â€Å"It doesn’t make you racist, any more than trying to make yourself look you nger makes you ageist. † Bollywood (India’s Hollywood) glori? es conventions on beauty by always casting a fair-skinned actress in the role of heroine, surrounded by the darkest extras. Women want to use whiteners because it is â€Å"aspirational, like losing weight. Even the gods supposedly lament their dark complexion— Krishna sings plaintively, â€Å"Radha kyoon gori, main kyoon kala? (Why is Radha so fair when I’m dark? ). † A skin de? cient in melanin (the pigment that determines the skin’s brown color) is an ancient predilection. More than 3,500 years ago, Charaka, the famous sage, wrote about herbs that could help make the skin fair. Indian dermatologists maintain that fairness products cannot truly work as they reach only the upper layers of the skin and so do not affect melanin production. Nevertheless, for some, Fair & Lovely is a â€Å"miracle worker. A user gushes that â€Å"The last time I went to my parents’ home, I go t compliments on my fair skin from everyone. † For others, there is only disappointment. One 26-year-old working woman has been a regular user for the past eight years but to no avail. â€Å"I should have turned into Snow White by now but my skin is still the same wheatish color. † As an owner of a public relations ? rm commented, â€Å"My maid has been using Fair and Lovely for years and I still can’t see her in the dark . . .. But she goes on using it. Hope springs eternal, I suppose. † The number of Indians who think lighter skin is more beautiful may be shrinking. Sumit Isralni, a 22-year-old hair designer in his father’s salon, thinks things have changed in the last two years, at least in India’s most cosmopolitan cities, Delhi, Mumbai, and Bangalore. Women now â€Å"prefer their own complexion, their natural way† Isralni says; he prefers a more â€Å"Indian beauty† himself: â€Å"I won’t judge my wife on how fair her complexion is. † Sunita Gupta, a beautician in the same salon, is more critical. â€Å"It’s just foolishness! † she exclaimed. The premise of the ads that women could not become airline attendants if they are dark-skinned was wrong, she said. Nowadays people like black beauty. † It is a truism that women, especially in the tropics, desire to be a shade fairer, no matter what their skin color. Yet, unlike the approach used in India, advertisements elsewhere usually show how to use the product and how it works. Cultural Norms, Fair & Lovely, and Advertising CASE 2? 2 Fa ir & Lovely, a branded product of Hindustan Lever Ltd. (HLL), is touted as a cosmetic that lightens skin color. On its Web site (www. hll. com), the company calls its product â€Å"the miracle worker,† â€Å"proven to deliver one to three shades of change. While tanning is the rage in Western countries, skin lightening treatments are popular in Asia. According to industry sources, the top-selling skin lightening cream in India is Fair & Lovely from Hindustan Lever Ltd. (HLL), followed by CavinKare’s Fairever brand. HLL’s Fair & Lovely brand dominated the market with a 90 percent share until CavinKare Ltd. (CKL) launched Fairever. In just two years, the Fairever brand gained an impressive 15 percent market share. HLL’s share of market for the Fair & Lovely line generates about $60 million annually. The product sells for about 23 rupees ($0. 9) for a 25-gram tube of cream. The rapid growth of CavinKare’s Fairever (www. cavinkare .com) brand prompted HLL to increase its advertising effort and to launch a series of ads depicting a â€Å"fairer girl gets the boy theme. † One advertisement featured a ? nancially strapped father lamenting his fate, saying, â€Å"If only I had a son,† while his dark-skinned daughter looks on, helpless and demoralized because she can’t bear the ? – nancial responsibility of her family. Fast-forward and plain Jane has been transformed into a gorgeous light-skinned woman through the use of a â€Å"fairness cream,† Fair & Lovely. Now clad in a miniskirt, the woman is a successful ? ight attendant and can take her father to dine at a ? ve-star hotel. She’s happy and so is her father. In another ad, two attractive young women are sitting in a bedroom; one has a boyfriend and, consequently, is happy. The darkerskinned woman, lacking a boyfriend, is not happy. Her friend’s advice—Use a bar of soap to wash away the dark skin that’s keeping men from ? ocking to her. HLL’s series of ads provoked CavinKare Ltd. to counter with an ad that takes a dig at HLL’s Fair & Lovely ad. CavinKare’s ad has a father–daughter duo as the protagonists, with the father shown encouraging the daughter to be an achiever irrespective of her complexion. CavinKare maintained that the objective of its new commercial is not to take a dig at Fair & Lovely but to â€Å"reinforce Fairever’s positioning. † Skin color is a powerful theme in India, and much of Asia, where a lighter color represents a higher status. While Americans and Europeans ? ock to tanning salons, many across Asia seek ways to have â€Å"fair† complexions. Culturally, fair skin is associated with positive values that relate to class and beauty. One Indian lady commented that when she was growing up, her mother forbade her to go outdoors. She was not trying to keep her daughter out of trouble but was trying to keep her skin from getting dark. Brahmins, the priestly caste at the top of the social hierarchy, are considered fair because they traditionally stayed inside, poring over books. The undercaste at the bottom of the ladder are regarded as the darkest people because they customarily worked in the searing sun. Ancient Hindu scriptures and modern poetry eulogize women endowed with skin made of white marble. Skin color is closely identi? ed with caste and is laden with symbolism. Pursue any of the â€Å"grooms† and â€Å"brides wanted† ads cat2994X_case2_019-046. indd 25 cat2994X_case2_019-046. indd 25 8/27/10 2:05 PM 8/27/10 2:05 PM Part 6 Supplementary Material three-month Home Healthcare Nursing Assistant course catering to young women between the ages of 18 and 30 years. According to HLL, the Fair & Lovely Academy for Home Care Nursing Assistants offers a unique training opportunity for young women who possess no entry-level skills and therefore are not employable in the new economy job market. The Fair & Lovely Foundation plans to serve as a catalyst for the economic empowerment for women across India. The Fair & Lovely Foundation will showcase the achievements of these women not only to honor them but also to set an example for other women to follow. AIDWA’s campaign against ads that convey the message, â€Å"if she is not fair in color, she won’t get married or won’t get promoted,† also has resulted in some adjustment to fairness cream ads. In revised versions of the fairness cream ads, the â€Å"get fair to attract a groom† theme is being reworked with â€Å"enhance your selfcon? ence† so that a potential groom himself begs for attention. It is an attempt at typifying the modern Indian woman, who has more than just marriage on her mind. Advertising focus is now on the message that lighter skin enables women to obtain jobs conventionally held by men. She is career-oriented, has high aspirations, and, at the same time, wants to lo ok good. AIDWA concedes that the current crop of television ads for fairness creams are â€Å"not as demeaning† as ones in the past. However, it remains against the product; as the president of AIDWA stated, â€Å"It is downright racist to denigrate dark skin. † Although AIWDA’s campaign against fairness creams seems to have had a modest impact on changing the advertising message, it has not slowed the demand for fairness creams. Sales of Fair & Lovely, for example, have been growing 15 to 20 percent year over year, and the $318 million market for skin care has grown by 42. 7 percent in the last three years. Says Euromonitor International, a research ? rm: â€Å"Half of the skin care market in India is fairness creams and 60 to 65 percent of Indian women use these products daily. † Recently, several Indian companies were extending their marketing of fairness creams beyond urban and rural markets. CavinKare’s launch of Fairever, a fairness cream in a small sachet pack priced at Rs 5, aimed at rural markets where some 320 million Indians reside. Most marketers have found rural markets impossible to penetrate pro? tably due to low income levels and inadequate distribution systems, among other problems. However, HLL is approaching the market through Project Shakti, a rural initiative that targets small villages with populations of 2,000 people or less. It empowers underprivileged rural women by providing income-generating opportunities to sell small, lower priced packets of its brands in villages. Special packaging for the rural market was designed to provide single-use sachet packets at 50 paise for a sachet of shampoo to Rs 5 for a fairness cream (for a week’s usage). The aim is to have 100,000 â€Å"Shakti Ammas,† as they are called, spread across 500,000 villages in India by year end. CavinKare is growing at 25 percent in rural areas compared with 15 percent in urban centers. In addition to expanding market effort into rural markets, an unexpected market arose when a research study revealed Indian men were applying girlie fairness potions in droves—but on the sly. It was estimated that 40 percent of boyfriends/husbands of girlfriends/wives were applying white magic solutions that came in little tubes. Indian companies spotted a business opportunity, and Fair & Handsome, Menz Active, Fair One Man, and a male bleach called Saka were introduced to the male market. The sector expanded dramatically when Shah Rukh Khan, a highly acclaimed Commenting on the cultural bias toward fair skin, one critic states, â€Å"There are attractive people who go through life feeling inferior to their fairer sisters. And all because of charming grandmothers and aunts who do not hesitate to make un? attering comparisons. Kalee Kalooti is an oft-heard comment about women who happen to have darker skin. They get humiliated and morti? ed over the color of their skin, a fact over which they have no control. Are societal values responsible? Or advertising campaigns? Advertising moguls claim they only re? ect prevailing attitudes in India. This is possibly true but what about ethics in advertising? Is it correct to make advertisements that openly denigrate a majority of Indian people—the dark-skinned populace? The advertising is blatant in their strategy. Mock anyone who is not the right color and shoot down their self-image. † A dermatologist comments, â€Å"Fairness obtained with the help of creams is short-lived. The main reason being, most of these creams contain a certain amount of bleaching agent, which whitens facial hair, and not the skin, which leads people to believe that the cream worked. † Furthermore, â€Å"In India the popularity of a product depends totally on the success of its advertising. HLL launched its television ad campaign to promote Fair & Lovely but withdrew it after four months amid severe criticism for its portrayal of women. Activists argued that one of the messages the company sends through its â€Å"air hostess† ads demonstrating the preference for a son who would be able to take on the ? nancial responsibility for his parents is especially harmful in a country such as India where gender discrimination is rampant. Another offense is perpet uating a culture of discrimination in a society where â€Å"fair† is synonymous with â€Å"beautiful. AIDWA (All India Women’s Democratic Association) lodged a complaint at the time with HLL about their offensive ads, but Hindustan Lever failed to respond. The women’s association then appealed to the National Human Rights Commission alleging that the ad demeaned women. AIDWA objected to three things: (1) the ads were racist, (2) they were promoting son preference, and (3) they were insulting to working women. â€Å"The way they portrayed the young woman who, after using Fair & Lovely, became attractive and therefore lands a job suggested that the main quali? ation for a woman to get a job is the way she looks. † The Human Rights Commission passed AIDWA’s complaints on to the Ministry of Information and Broadcasting, which said the campaign violated the Cable and Television Network Act of 1995—provisions in the act state that no advertisemen t shall be permitted which â€Å"derides any race, caste, color, creed and nationality† and that â€Å"Women must not be portrayed in a manner that emphasized passive, submissive qualities and encourages them to play a subordinate secondary role in the family and society. † The government issued notices of the complaints to HLL. After a year-long campaign led by the AIDWA, Hindustan Lever Limited discontinued two of its television advertisements for Fair & Lovely fairness cold cream. Shortly after pulling its ads off the air, HLL launched its Fair & Lovely Foundation, vowing to â€Å"encourage economic empowerment of women across India† by providing resources in education and business to millions of women â€Å"who, though immensely talented and capable, need a guiding hand to help them take the leap forward,† presumably into a fairer future. HLL sponsored career fairs in over 20 cities across the country offering counseling in as many as 110 careers. It supported 100 rural scholarships for women students passing their 10th grade, a professional course for aspiring beauticians, and a cat2994X_case2_019-046. indd 26 cat2994X_case2_019-046. indd 26 8/27/10 2:05 PM 8/27/10 2:05 PM Cases 2 The Cultural Environment of Global Marketing 2. Is it ethical to exploit cultural norms and values to promote a product? Discuss. 3. Is the advertising of Fair & Lovely demeaning to women, or is it promoting the fairness cream in a way not too dissimilar from how most cosmetics are promoted? 4. Will HLL’s Fair & Lovely Foundation be enough to counter charges made by AIDWA? Discuss. 5. In light of AIDWA’s charges, how would you suggest Fair & Lovely promote its product? Discuss. Would your response be different if Fairever continued to use â€Å"fairness† as a theme of its promotion? Discuss. 6. Propose a promotion/marketing program that will counter all the arguments and charges against Fair & Lovely and be an effective program. 7. Now that a male market for fairness cream exists, is the strength of AIDWA’s argument weakened? 8. Comment on using â€Å"Shakti Ammas† to introduce â€Å"fairness cream for the masses† in light of AIDWA’s charges. Sources: Nicole Leistikow, â€Å"Indian Women Criticize ‘Fair and Lovely’ Ideal,† Women’s eNews , April 28, 2003; Arundhati Parmar, â€Å"Objections to Indian Ad Not Taken Lightly,† Marketing News , June 9, 2003, p. 4; â€Å"Fair & Lovely Launches Foundation to Promote Economic Empowerment of Women,† press release, Fair & Lovely Foundation, http:// www. hll. com (search for foundation), March 11, 2003; Rina Chandran, â€Å"All for SelfControl,† Business Line (The Hindu), April 24, 2003; Khozem Merchant and Edward Luce, â€Å"Not So Fair and Lovely,† Financial Times , March 19, 2003; â€Å"Fair & Lovely Rede? es Fairness with Multivitamin Total Fairness Cream,† press release, Hindustan Lever Ltd. , May 3, 2005; Dr. Deepa Kanchankoti, â€Å"Do You Think Fairness Creams Work? † http://www. mid-day. com/metro, July 13, 2005; †CavinKare Launches Small Sachet Packs,† Business India , December 7, 2006; â€Å"A nalysis of Skin Care Advertising on TV During January–August 2006,† Indiantelevision. com Media, Advertising, Marketing Watch, October 17, 2006; â€Å"Women Power Gets Full Play in CavinKare’s Brand Strategy. The Economic Times (New Delhi, India), December 8, 2006; Heather Timmons, â€Å"Telling India’s Modern Women They Have Power, Even Over Their Skin Tone,† The New York Times , May 30, 2007; â€Å"The Year We Almost Lost Tall (or Short or Medium-Height), Dark and Handsome,† The Hindustan Times , December 29, 2007; â€Å"India’s Hue and Cry Over Paler Skin,† The Sunday Telegraph (London), July 1, 2007; â€Å"Fair and Lovely? † University Wire , June 4, 2007; â€Å"The Race to Keep up with Modern India,† Media, June 29, 2007; Aneel Karnani, â€Å"Doing Well by Doing Good—Case Study: ‘Fair & Lovely’ Whitening Cream,† Strategic Management Journal 28, no. 3 (2007), pp. 1351–57. Boll ywood actor likened to an Indian Tom Cruise, decided to endorse Fair & Handsome. Euromonitor International forecasts that in the next ? ve years, spending on men’s grooming products will rise 24 percent to 14. 5 billion rupees, or US$320 million. A recent product review in www. mouthshut. com, praises Fair & Lovely fairness cream: â€Å"[Fair & Lovely] contains fairness vitamins which penetrate deep down our skin to give us radiant fairness. â€Å"I don’t know if it can change the skin color from dark to fair, but my personal experience is that it works very well, if you have a naturally fair color and want to preserve it without much headache. † â€Å"I think Riya Sen has the best skin right now in Bollywood. It appears to be really soft and tender. So, to have a soft and fair skin like her I recommend Fair & Lovely Fairness Lotion or Cream. † Yet â€Å"skin color isn’t a proof of greatness. Those with wheatish or dark skin are by no way inferio r to those who have fair skin. † Here are a few facts from Hindustan Lever Ltd. s homepage: Lever Limited is India’s largest Packaged Mass Consumption Goods Company. We are leaders in Home and Personal Care Products and Food and Beverages including such products as Ponds and Pepsodent. We seek to meet everyday needs of people everywhere—to anticipate the aspirations of our consumers and customers and to respond creatively and competitively with branded products and services which raise the quality of life. It is this purpose which inspires us to build brands. Over the past 70 years, we have introduced about 110 brands. Fair & Lovely has been specially designed and proven to eliver one to three shades of change in most people. Also its sunscreen system is specially optimized for Indian skin. Indian skin, unlike Caucasian skin, tends to â€Å"tan† rather than â€Å"burn† and, hence, requires a different combination of UVA and UVB sunscreens. You may w ant to visit HLL’s homepage (www. hhl. com) for additional information about the company. QUESTIONS 1. Is it ethical to sell a product that is, at best, only mildly effective? Discuss. cat2994X_case2_019-046. indd 27 cat2994X_case2_019-046. indd 27 8/27/10 2:05 PM 8/27/10 2:05 PM