Macro Environmental Analysis Of Italy

Political facetsThe Italian political relations and authorities are a merger of democracy and democracy, with people ‘s representatives in the parliament governing the state. Italy ‘s Chief of province is President Giorgio Napolitano. Premier Minister Silvio Berlusconi is the caput of the province in Italy. He administrates a multi-party system for successful running of the political activities. Italy was a founding member of the European Union ( EU ) . Today Italy is a member of many important international organsations like MIF, UN, G8, NATO, OECD, GATT/WTO or the OSCE. Italy has been a member of WTO since 1995 and it is besides of import to state that all EU member provinces are WTO members. So Italy ‘s trade policy is about the same as that of other members of the European Union. This fact makes clear that WTO trading spouses have less jobs in trading because of the remotion of all barriers to international trade in goods and services.Demographical facetsItaly h as developed into an industrial state, which is divided in two parts. The first portion is the industrial developed North, which is dominated by private companies. The 2nd portion is the agricultural South. The unemployment in the South is reasonably high and it is clearly to see that this portion of Italy is less developed. The Gross Domestic Product ( GDP ) is one of the most of import economical indexs. For Italy the GDP is $ 1.823 trillion in 2008. But one has to maintain in head that this figure does non mention to the population. If one wants to take in this aspects one should look at the GDP ( PPP ) . For Italy this is $ 31,300 this means how much the mean individual life in Italy hast to pass. As an investor this figure might go really ready to hand because one can see how much money a state has to devour in luxury goods. Alternatively of being able to afford 1s basic demands. The existent GDP growing rate in Italy achieved an sum of -1 % in 2008. The chief industries in Ita ly are touristry, machinery, Fe and steel, chemicals, nutrient processing, fabrics, motor vehicles, vesture, footwear, ceramics. The chief resources of Italy are mined merchandises like coal, Zn, natural gas and a rough oil militias.Macro environmental analysis of IndiaPolitical facetsIndia is a democracy. The people of India elect their authoritiess at all degrees ( Union, State and local ) by a system of cosmopolitan grownup franchise ; popularly known as & A ; lsquo ; One adult male one ballot ‘ . The cardinal authorities exercises its wide administrative powers in the name of the President, whose responsibilities are mostly ceremonial. The fundamental law designates the administration of India under two subdivisions viz. the executive subdivision and Real national executive power is centered in the Council of Ministers, led by the Prime Minister of India. India suffered political instability for a few old ages due to the failure of any party to win an absolute bulk in Parliament. However, political stableness did non alter India ‘s economic class though it delayed certain determinations associating to the economic system.Membership of international organisations:ADB, AfDB ( nonregional member ) , ARF, ASEAN ( dialogue spouse ) , BIMSTEC, BIS, C, CERN ( observer ) , CP, EAS, FAO, G-15, G-20, G-24, G-77, IFAD, IMF, IMO, Interpol, IOC, LAS ( observer ) , NAM, OAS ( observer ) , PIF ( spouse ) , SCO ( observer ) , UN, UNESCO, UNWTO, WFTU, WHO, WMO, WTOInternational Relationss:International dealingss ships between India and a batch of the states in our universe have been comparatively good.Trade Policy:India is a member of the World Trade Organization and its predecessor the General Agreement on Tariffs and Trade ( GATT ) . While take parting in its council meetings, India has been important in voicing the concerns of the underdevelo ped universe. For case, India has continued its resistance to the inclusion of such affairs as labor and environment issues and other non-tariff barriers into the WTO policies. Despite cut downing import limitations several times in the 2000, India was evaluated by the World Trade Organization in 2008 as more restrictive than similar developing economic systems, such as Brazil, China, and Russia. The WTO besides identified electricity deficits and unequal transit substructure as important restraints on trade. Its restrictiveness has been cited as a factor which has isolated it from the planetary fiscal crisis of 2008-2009 more than other states, even though it has reduced on-going economic growing.Demographical facetsIndia has a entire population of 1,17 billion people in 2009 and growing rate of 1.5 % in 2009 with an mean age of 25 old ages. India has a batch of immature people and with a Birth rate of 21.76 births/1,000 it has the highest birth rate of the three states. Little over a one-fourth of the population in India lives in metropolis ‘s with 29 % this is comparatively low. However the grade of urbanisation in India is 2,4 % wich is besides th e highest urbanisation rate of our three states. The labour force in India is the 2nd largest in the universe with 523.5 million people in 2008 it is besides the biggest of our three states. There is a batch of difference in instruction degrees in India. There is a strong line between truly high instruction and people that are non or ill educated.Comparison between Italy and IndiaPolitical facetsIndia is a democracy, Italy is a merger of democracy and democracy. This means that both states are free and people who live at that place make the determinations. The people of India elect their authorities by a ballot, which have the map of a President. Italy ‘s leader is President Giorgio Napolitano and Premier Minister Silvio Berlusconi. India is one of the major bring forthing states of coal. It besides has important sedimentations of Fe, manganese, isinglass, bauxite, Ti, Br, natural gas, diamonds, crude oil and limestone. The natural resources for Italy are chiefly mined merchandises like coal, Zn, natural gas and a rough oil militias. India is non a member of the EU like Italy, which was a founding member of the EU, however international relationships between India and a batch of other states have been comparatively good.Demographical facetsIndia has a population of 1.166.079.217 dwellers. In comparing Italy ‘s population is 58.000.000. Apart from the major difference in population, the demographical facets for India and Italy are unequal. India has a population growing rate of 1.548 % whereas Italy has a growing rate of -0.047 % . The population in India is rather immature in comparing with the population of Italy. In twelvemonth 2005 India ‘s urbanisation had an one-year rate of 2.4 % , Italy merely 0.4 % . These facts show us that there are a batch of differences between the two states.Economic facetsAs an economical index, frequently it is reffered to the Gross Domestic Product ( GDP ) . For India the GPD is $ 3.297 trillion with an one-year growing of 6.7 % . In Italy this sum is $ 1.823 trillion with a clear smaller growing rate of -5.1 % per twelvemonth. Both states have in common that most of the GDP is made in the service sector. In Italy the service sector makes up 71 % of the entire GDP while in India it is 53.4 % . Italy ‘s major exports are precision machinery, motor vehicles ( utilitaries, luxury vehicles, bikes, scooters ) , chemicals and electric goods, but the state ‘s more celebrated exports are in the Fieldss of nutrient and vesture. India ‘s major export trade goods included technology goods, crude oil merchandises, chemicals and pharmaceuticals, treas ures and jewelry, fabrics and garments, agricultural merchandises, Fe ore and other minerals.Italy and India in comparing to The NetherlandsPolitical facetsIn the Netherlands the signifier of authorities is non similar to the 1s from India or Italy. It is a parliamentary representative democratic constitutional monarchy province. The disposal constitutionally consists of the Queen and the Cabinet Ministers. By the early eighties the Dutch public assistance province had become the most extended societal security system In the universe but the public assistance province came into crisis when disbursement rose due to dramatic high unemployment rates and hapless economic growing. The centre-right and centre-left alliances wanted the Dutch public assistance province to make new occupations and to convey the budget shortage under control. So that they reduced societal benefits, lowered the revenue enhancements and deregulated the concerns. With these solutions the economic system was recovered and the budget shortage and unemployment were reduced well. The Netherlands has a sum of 11 Parties and the major political parties are CDA ( Christian Democratic Appeal ) , PvdA ( Labour Party ) , SP ( Socialist Party ) , and VVD ( People ‘s Party for Freedom and Democracy ) . The Dutch Parliament consists of a Second Chamber and a First Chamber. Both Chamberss of parliament discuss proposed statute law and reappraisal of the actions of the cabinet. The CDA has the most seats in the Chambers.Membership of international organisations:The Netherlands is an active and responsible participant in the United Nations system every bit good as other many-sided organisations such as the Organization for Security and Cooperation in Europe, Organisation for Economic Co-operation and Development ( OECD ) , World Trade Organization ( WTO ) , and International Monetary Fund.Trade Policy:In 2007 the exports of the Netherlands were $ 457.2 billion. The chief export trade goods are machinery and equipment, fuels, chemicals and groceries. The Netherlands is a strong advocate of free trade and is a member of international forums like WTO and OECD. The portion of foreign trade in its GDP is more than 125 % . The Netherlands ‘ top three export spouses are Germany, Belgium and France.Demographical facetsWith 16.5 Million dwellers The Netherlands have a high population denseness of about 400 people per square kilometers. The birth rate exceeds the decease rate with 10.9/1000 people against 8.68 death/1000 population and a really high net in-migration rate with 2.72 migrants/1000 people besides contributes to this. Therefore the Dutch population increased by 50 % since the 1960 ‘s. Recently the population roar is easy worsening. The population is largely divided in middle-sized metropoliss.Economic facets between the different statesEconomic facets of the NetherlandsThe Netherlands has a comfortable and unfastened economic system, which depends to a great extent on foreign trade. Its economic system is besides noted for stabl e industrial dealingss, reasonably low unemployment and rising prices and a ample current history excess. From 2004 boulder clay 2006 the GDP went from about $ 610 billion up to $ 670 billion. The GDP per capita in the Netherlands is the highest of the tree reference states. The state has been one of the taking European states for pulling foreign direct investing and is one of the four largest investors in the US. The gait of occupation growing reached 10-year highs in 2007, but economic growing fell aggressively in 2008 as radioactive dust from the universe fiscal crisis constricted demand and raised the ghost of a recession in 2009.Main industries:Natural gas ; Dutch industry is diversified and includes a assortment of concerns that range from fabrication, excavation, and energy production to building and chemical fabrication.Economic facets of ItalyItaly has developed into an industrial state ranked by both the World Bank and the International Monetary Fund as the universe ‘s 7th largest economic system in USD exchange-rate footings and ten percent largest in footings of buying power para ( PPP ) by World Bank, IMF and the CIA World Factbook. More late, Italy has faced sulky economic growing and decreased international fight. Italy ‘s econ omic strength is in the processing and the fabrication of goods, chiefly in little and moderate-sized family-owned houses. The state has been less successful in footings of developing universe category transnational corporations.Economic facets of IndiaIndia has had a market based system from 1991 boulder clay now. Before that the authorities blocked a batch of the import/ export merchandises to protect the people. India achieved 9.6 % GDP growing in 2006, 9.0 % in 2007, and 6.6 % in 2008 this likely due to the planetary economic crisis seting the state on place 28 in the universe. The GDP ( buying power para ) did nevertheless turn from $ 2.816 trillion in 2006 to $ 3.069 trillion in 2007 to $ 3.297 trillion in 2008 puting India on place 5 harmonizing to the cia universe factbook.Most of this ( 53.4 % 2008 ) comes from the services sector in India.DecisionWhich state will hold the best market to export goods and merchandises to? India is a really interesting state to merchandise with. The economic system is on a strong growing flight and anticipations are that it keeps turning. All India has to make is maintain their market unfastened and maintain on working on bettering their substructure and educational system, this would besides better their GDP per capita. India has besides hardly been affected by the economic crisis of 2008/2009 Italy on the other manus has had a existent job since the beginning of the crisis, in the EU Italy has taken one of the hardest hits on GDP ( PPP ) and GDP Growth rate, nevertheless, even before the start of the crisis the Italian economic system had already been & amp ; lsquo ; sulky ‘ . In the terminal, it all depends on what goods and merchandises you are be aftering to export. Italy has few natural resources because Italy has specialized on industry and edifice luxury goods and for all this you need stuffs so exporting natural resources would be best here. In India we would export capital/consumer goods, if the economic system keeps turning as predicted than that combined with the fact that the liberalisation of import revenue enhancements continues besides adding a population of over 1 billion people. Brands it one of the biggest possible markets in the universe at this clip. Reasoning that both of the states have their advantages, the EU in Italy and the market potency of India, we prefer India to merchandise with.Beginnings:www.cia.govwww.demographic-research.orgwww.economist.comwww.geohive.comwww.oecd.orgwww.oup.comwww.wikipedia.orgwww.de.statista.comwww.economicshelp.orgwww.wiki.answers.com

Florida Department of Management Services Essay

Introduction In the early 1990s, the Florida Department of Management Services (DMS) had built up a large information systems network that served state government agencies in 10 regional sites and connected these to the data center in Tallahassee. The network was based on the use of the proprietary Systems Network Architecture (SNA) from IBM and a mainframe at the data center that housed most of the applications. Body 1. Analyze the security mechanisms needed to protect the DMS systems from both state employees and users accessing over the Internet. Two security mechanisms needed to protect the DMS systems are Virtual Private Networks and IP Security. According to Stalling (2009) Virtual Private Networks (VPN) makes use of encryption and special protocols to provide security for those using the Internet or some other public network to interconnect sites. These public networks provide an access path for telecommuters and other mobile employees to log on to corporate systems from remote sites. The state employees would have to use the VPN to access the DMS by authenticating using their work credentials. IP Security (IPSec) provides the capability to secure communications across a LAN, across private and public WANs and across the Internet. Some examples of IPSec are: (1) Secure branch office connectivity over the Internet: A company can build a secure virtual private network over the Internet or ove r a public WAN. This type of business rely heavily on the Internet and reduce its need for private networks, saving costs and network management overhead. (2) Secure remote access over the Internet: An end user whose system is equipped with IP security protocols can make a local call to an Internet service provider (ISP) and gain secure access to a company network. This reduces the cost of toll charges for traveling employees and telecommuters; (3) establishing extranet  and intranet connectivity with partners: IPSec can be used to secure communication with other organizations, ensuring authentication and confidentiality and providing a key exchange mechanism; (4) enhancing electronic commerce security: even though some Web and electronic commerce applications have built-in security protocols, the use of IPSec enhances that security. IPSec guarantees that all traffic designated by the network administrator is both encrypted and authenticated, adding an additional layer of security to whatever is provided at the application layer. Similarly, whether other industries give rise to spheres in which competition takes place in open, intellectual-property-free spaces depends on various factors including the existence in a space of companies with proprietary solutions and the presence of technologies so complex they are vulnerable to inadvertent patent infringement. (Alexy, O., & Reitzig, M. (2012). 2. Critique the transition process performed by the DMS in the case study. Then, recommend two (2) alternatives to the IP infrastructure or applications not already mentioned in the case study. What is there to critique? All DMS did was install some routers and configured them. Can someone please help with this? Maturing Enterprise Resource Planning (ERP) systems are able to integrate business systems with building management systems for improved management controls (such as consolidated dashboard-type reporting). Driven by business requirements for resource efficiencies and management by measurement’, this business intelligence adaptation has been essential for the business leadership to steer, priorities and justify new investment. Allocating costs for usage, amortizing capital towards specific business causes and employing financial wizardry to get best tax advantage – these all mean that the new generation of ERP tools needs to be ‘facilities-aware’. They should come with tools to digest ‘consumption’ data; so, whichever department had most use of video conferencing, or toner ink, or WAN bandwidth, or access to out-of-hours air conditioning – it’s all in the mix now. So many systems – integrated BMS (iBMS), facilities reservation systems, maintenance management systems, cashless vending and EPOS, CCTV and access control – are able to push the mountains of data they generate each day to other central management systems. Now IP networks are at the heart of enabling such data capture, collation and consolidation. (Manivannan, 2012) 3. Critique the merits of  the major services found on the DMS Website. According to the website, DMS is a shared service provider that supports state agencies and state employees through: Human Resource Support and Business Operations: the Department of Management Services is responsible for managing the state personnel system, including: Insurance Benefits, Florida Retirement System, Human Resource Management. DMS strives to provide the high-quality service our customers expect and deserve while decreasing the operating costs of state government so that more resources can be focused where they are needed most. Insurance Benefits-The Division of State Group Insurance (DSGI) offers and manages a comprehensive package of pre- and post-tax health and welfare insurance benefits for active and retired state employees and their families, including: a variety of health insurance options; flexible spending and health savings accounts; life insurance; dental, vision and kind of insurance p roducts. Florida Retirement System=The Division of Retirement (Division) was established to administer the Florida Retirement System (FRS), which was created in December 1970 to consolidate existing state-administered retirement systems. Since its creation, the Divisions responsibilities have expanded to include: administering; monitoring; overseeing; ensuring compliance. Human Resource Management- Florida’s state employees are our most valuable resource. They are the face of state government. The Division of Human Resource Management works with the agency personnel offices to develop human resource policies, practices and strategies. As human resource professionals, it is our responsibility to ensure that the State’s HR policies and practices are designed to attract and support the employees who serve the people of Florida. People First is the state’s self-service, secure, web-based personnel information system and enterprise-wide suite of human resource (HR) services. The system streamlines and automates many of the state’s HR functions and is comprised of the following modules: payroll preparation, attendance and leave, recruitment, benefits administration, human resources management, organizational management. 4. Recommend an additional service to add to the DMS Website. With technology today, there is a increased of the use of portable IP-enabled devices and group content distribution applications on Wireless Mesh Networks (WMNs). This surge is facilitated by its relative low cost of installation and as such is an attractive option in environments  lacking existing communication infrastructure and/or in times of natural emergencies. DMS would greatly benefits from this because, their employees will be able to access the website for information quicker when they are away from their desk. The WMNs is equally capable of providing high bandwidth access to the web. The capability of the WMNs can be enhanced by reinforcing the system with multicasting and mobility features. However, there are challenges of seamless integration when such existing multicasting and mobility features of MANET and fixed networks are migrated to the WMNs domain. Thus, a wide range of efforts have been directed at finding solutions to these challenges in order to increase the widespread deployment of the WMNs based communication infrastructure. By producing a one volume comprehensive account of incorporating multicasting with mobility support deployable via Wireless Mesh Networks, this work at aiming at research directions in the area of integrated mobile multicasting on Wireless Mesh Networks. (Sanni, Hashim, Anwar & etc,2011). Summary or Conclusion Florida DMS will benefit from the use of WMN added to their IP infrastructures. Every day technology is advancing with new ideas in dealing with communications between people. DMS will continue to succeed in the future. References Stallings, W. (2009). CIS 505: Business Data Communications: Custom edition (6th ed.). Upper Saddle River, NJ: Prentice Hall. Florida DMS http://www.dms.myflorida.com Manivannan, M. M. (2012). Building around IP. Engineering & Technology (17509637), 7(2), 78-81. doi:10.1049/et.2012.0211 Alexy, O., & Reitzig, M. (2012). Managing the business risks of open innovation. Mckinsey Quarterly, (1), 17-21. Sanni, M. L., Hashim, A. A., Anwar, F. F., Naji, A. W., & Ahmed, G. M. (2011). Mobile Multicast in Wireless Mesh Networks. Australian Journal Of Basic & Applied Sciences, 5(9), 957-966.

How to write a essay Essay

Getting into college could be as easy as memorizing the alphabet just like a preschooler. But, getting into college with a scholarship is a whole different thing. From the thousands of college applicants aiming for a scholarship, how will you make your essay application stand out? There are millions of essay examples over the internet but, you need to come up with an essay that will get you that scholarship. Tips on How to Write a Good Scholarship Essay: 1. Read instructions carefully College application can become a common thing for you. You might actually get the feeling of doing the same thing over and over like answering the same question for the nth number of times. No matter how similar college applications are, you have to read and understand the instructions well. If you want to land on a good school for college with a scholarship, everything starts with reading and comprehending the instructions. 2. Organize your thoughts After reading the instructions, it’s time to line up your thoughts to make an effective essay that will get you that scholarship. Look for essay samples on the internet or in books. Have a sort of survey from resources that will help you fill in the contents of your essay. It is difficult to start writing an essay, but with organized ideas, you can do it efficiently and effectively. 3. Make an outline When you get a general idea of the essay contents, you can now make an outline of specific details that will be included in your composition. Essay examples usually present general ideas down to the specific. Having an outline is very helpful to keep your essay consistent and focused on a particular topic. 4. Discuss every topic based on the instruction Paying attention to details or instructions is actually part of writing the essay for a scholarship application. Make sure that every topic asked in the essay questions is discussed in the whole composition. Remember that you only have one chance of writing an essay that will make a lasting impression on your college application. 5. Use simple language format and make sure your grammar is perfect Do not try to impress readers of your essay. Even if you are in college, you are not expected to use highfaluting words, but rather make your sentences simple and clear. No matter how technical your vocabulary is but poor grammar is an indication of a lousy essay. 6. Avoid bragging about your achievements Although it is important that you include your achievements as this will help your scholarship application, however you only need to do this if you are asked to do so. Avoid bragging, instead, talk about your achievements simply. It is also good to include the lessons you have learned in gaining such success. 7. Have someone edit and check your work To ensure that you are submitting an essay that will get you the scholarship, have an expert check your work. An editor or a previous professor can help you improve and validate how excellent or poor your essay is. Essay Writing First paragraph — Introduction The first paragraph is essential in capturing the attention of your readers. It is called an introduction as it gives an overview of what your essay is all about. The first paragraph should be similar to an â€Å"About Me† part of a reading material. Make it as simple as possible and dynamically connected to your next point. Second Paragraph – Important Details The second paragraph should support your introduction. This section includes more detail and usually the start of elaboration for every point or question. Say for example, state reasons why you should qualify for the scholarship; state your accomplishments; why are you choosing a particular course and the like. Third paragraph – Future Goals The third paragraph should speak of your future goals and your vision after pursuing a college degree. Goals have to be specific, and should reflect an action plan after your college graduation. Fourth paragraph – The Best Candidate End your essay by stating reasons why you are the best candidate to be chosen for the scholarship. State two to three main points from the previous paragraphs. Do not forget to note your appreciation for the readers of your essay for taking the time to read your essay. Composing your ideas and putting them in writing is never easy. It can be stressful and puts on a lot of pressure, especially when your future depends on this essay for a scholarship grant. There are many essay examples you can find on the web today.

Why do many small businesses fail Research Paper

Why do many small businesses fail - Research Paper Example From these Small Businesses are considered to be the most important economical contributors with respect to their social impact, and employment and innovation opportunities. In the US especially the perception of the small business owner is tied inexplicably to the ideals of hard work leading to success and the importance of the individual. Before verifying any such claims or talking in-depth about the problems and opportunities present for this sector, one must first define ‘Small Business’. While researchers provide their own specific parameters and variables for defining the term â€Å"There is no inherent definition of a "small" business.† (Priest 2003). For the US market, any business having 500 or less employees is considered a small business, with a significant amount of these having less than 20 workers. But the advantages associated with small businesses in general like more flexibility, an innovative environment, enhancing of entrepreneurial skills etc c annot be fully realized even in the relatively smaller size of 500 workers. For the purpose of this paper, the following description coined by the Wiltshire Committee (Australia) will be considered the standard for a small business â€Å"A business in which one or two persons are required to make all the critical management decisions: finance, accounting, personnel, purchasing, processing or servicing, marketing, selling, without the aid of internal specialists and with specific knowledge in only one or two functional areas† (1971). The decision about the ideal firm size in the economy is usually determined by the relationship between managerial efficiencies (costs) and market transaction costs- if a small person team can perform efficiently in a small market while keeping their transaction costs low the small business model will be suitable to them. From an academic point of view claims about the social and economic importance have to be empirically proved before any further discussion can be built upon them. At this time, there are no clear normative grounds which substantiate the claims about the significant contribution of Small businesses to overall revenue and employment generation (Priest, 2003); at the most the contributions are equal to that provided by large conglomerates and corporations. However, the rate of failure of small businesses is still a cause of concern for academics and professionals alike because there are some specific proven benefits associated with small businesses with cannot be provided by large firms working on economies of scale and mass production. These pertain to particularized customer demands in small demand markets; a small size market with demands for personalization can only be met by smaller businesses and the society benefits from the increased welfare provided by choice. Failure of the Small business is an accepted phenomenon in the market. In a study done by  Inc.  magazine and the National Business Incubat or Association (NBIA) Statistics it was shown that  80% of new businesses fail within their first year. According to the Small Business Association In 2002, an estimated 550,100 new businesses were established in the U.S., while an estimated 584,000 closed their doors for good bringing the growth rate of small businesses to negative. From those that survive the first year, 8 out of 10 new businesses fail within the first three years. (Mason, 2012). This trend is not associated with US alone; studies in diverse nations like South Africa, Australia, UK, South East Asia have shown the same. The reasons behind these failures can be broadly categorized into External and Internal factors. External factors are those which can only be

Concept Comparison and Analysis Across Theories Essay

Concept Comparison and Analysis Across Theories - Essay Example Subsequently, the emphasis on the health concept has affected the nursing concept. However, the health concept remains the nursing theory’s building block, with the aforementioned theories incorporating the concept of health as it is of major importance. This paper will present discussion of comparison analysis of health metaparadigm in General Systems, Self-Care Theories and the Human Caring Theory and highlight the main concepts in the Human Caring Theory. Discussion Health Concept Definition in King’s General Systems Theory Health metaparadigm refers to one’s dynamic experiences in life. When one optimally utilizes resources, he or she can attain full potential for daily life, which enables one to cope continuously with stressors within internal and external environment. Health can also be viewed as one’s capacity for social role functioning. According to Hanucharumkul (1989), King’s definition of health concept is equivocal. Health is viewed as how one is able to cope with growth and development stressors in internal and external environment, whereby one’s cultural inclination and efforts to conform are functional. This viewpoint seems to support Orem’s fundamentals for universal self-care and development. King’s view of social functionality of health is congruent with Orem’s viewpoint, although clinical model is not incorporated in King’s model. ... According to Hartweg (1990), Orem’s general theory has proven useful in health promotion activity by society. Health promotion concept focuses on illness. Orem’s concept of health promotion is correlated with concept of well-being and elevated wellness. The health promotion activity aims achieving high level of wellness for individuals, family, and community. The Self-Care Deficit Theory (SCDT) has been applicable in nursing context focusing on severe and chronic illnesses, such as rehabilitation, psychiatric and dialysis units. Health promotion concept enhances individual’s ability for general decision-making. Health promotion is only valid after attainment of stable health. Health promotion activity is conceptualized as an aspect of self-care activity. These activities must play integral role in life of an individual. Such activities might include positive nutritional practices, establishing systems for social support, coping with stressors, and involvement in physical exercises. The activities help in articulation of individual's potential (Hartweg, 1990). Self-care encompasses responsibility for adult’s own health, well-being, and existence. Self-care is initiated personally and must form important component of one’s lifestyle. King’s general conceptual framework echoes Orem’s pragmatic theory of self-care as deliberate practice. Health promotion behavior and practice of self-care tend to be congruent, with self-initiated self-care carried out with intention of attaining specific health targets. Orem attempts to distinguish health from well-being as two concepts that are related to state of humans. Orem defines health as condition

1965 Selma to Montgomery march Essay Example | Topics and Well Written Essays - 1500 words

1965 Selma to Montgomery march - Essay Example History 1). The civil war that had taken place previously had failed to eradicate the social barriers created by some institutions (U.S. History 1). In the south, after the war, there was the creation of laws that only highlighted issues of whites at the expense of African American (U.S. History 1). The situation remained until the beginning of the second part of 20th century. At this period various institutions begun to be sensitive to African American demands. The greatest progress was the school integration ruling of 1954 by the Supreme Court (U.S. History 1). Later, there was a development of peaceful protest by Dr. Martin Luther King Junior. Consequently, this led to increased marches, boycotts, sit-ins, and freedom rides in both the American south and parts of north (U.S. History 1). Moreover, public opinions changed and showed a significant deal of sympathy towards the African Americans. However, there remained obstacles to complete racial equality. Although legal equality had made progress for African Americans, there was reduced economic equality and social acceptance (U.S. History 1). Consequently, this led to increased activism in the 1960s. Malcolm X, the Black Power Movement leader, advocated for the policy of non-violence, and he inspired most of the movements in this period (U.S. History 1). A reflection on the civil rights movements helps in highlighting the role of Selma to Montgomery marches. ... History 1). Consequently, there was reduced hopes for achievements of equal rights among African Americans. Moreover, there was increased discrimination in various states, in the north and south. For example, there was approval of laws creating schools and public facilities for each race (U.S. History 2). One of such laws was the Jim Craw laws that reinforced the white supremacy that had diminished during the reconstruction era. The discrimination was seen as whites, and blacks carried activities in different areas such as in school and restaurants (U.S. History 2). In addition, there was also discrimination in public spending. For example, teachers in white schools were paid better wages, and white schools were well maintained while in black school teachers were paid poorly, and the situation was poor (U.S. History 2). Additionally, there was a failure of implementation of Brown decision on segregation in the south. In fact, one decade after the decision, fewer than ten percent in s outhern public schools had integrated (U.S. History 2). This is because the ruling failed to address the issue that led to segregation such as separate restrooms, bus seats, or hotel rooms (U.S. History 1). There are various reasons for the inspiration to revolution. One of the people that inspired revolution was Rosa Parks. She boarded a Montgomery bus and refused to pave the way for the white passengers (U.S. History 3). This was followed by her arrest, and she was fined $10 (U.S. History 3). Consequently, revolutions began in various parts of the country. One of the instrumental persons for the revolution was Martin Luther King Junior (U.S. History 3). After the Rosa Park development, he organized the boycott of Montgomery’s buses (U.S. History 3). They wanted for equal

Article Critique - Violence Essay Example | Topics and Well Written Essays - 750 words

Article Critique - Violence - Essay Example In general and in great detail, the literature review of the research study â€Å"The Associations Between Community Violence, Television Violence, Intimate Partner Violence, Parent-Child Aggression, and Aggression in Sibling Relationships of a Sample of Preschoolers† presents the prevailing studies and information concerning sibling aggression and the potential factors that are paving the way for its realization. The literature review provides significant information and potential gaps that will help enhance the actual research problem that the research study wanted to generate. The literature review presents the concept that in the high level of aggression between siblings, there is potential association with significant short-and-long-term effects. For this reason, the proponents were able to include relevant points concerning Intimate Partner Violence and sibling aggression, parent-child aggression and sibling aggression, community violence and sibling aggression, exposure to violence in the media and sibling aggression, and complex violence exposure. Therefore, the proponents want to identify if children’s exposure to these varying types of violence may have substantial impact on their actual aggressive behavior (Miller et al. 165). This is the study’s relevant statement of the problem as the potential remark that calls for the need to do the necessary study in order to provide a potential response to what may be lacking in the prevailing literature or studies so far. The focus therefore of this study is to contribute to the growing body of knowledge linked to violence by which there is a potential link to childhood’s aggressive behavior.... In other words, understanding this information will eventually pave the way on how to control the crime and delinquent behaviors the soonest possible. The ultimate point of this in the end is a substantial reduction of crimes and actual manifestations of delinquent behaviors. Second, the study will provide a remarkable empirical evidence to support the claim that one’s external context of the environment has important contribution to the creation of crimes, violence and other related delinquent behaviors. Finally, this study will provide the opportunity for the community to understand more about violence and other essential points that have substantial link to its inception at the early stage. In other words, if proven that children and their aggressive behaviors are influenced by other forms of violence, then the community will be able to emancipate significant actions that will lead to social organization and eradication of crimes or other potential delinquent behaviors. Qua litative data are obtained from the respondents and they can be both nominal and ordinal data. These are data that are not necessarily numbers, and the basic example might involve responses like ‘moderate’ and ‘severe’ just as what exactly employed in the research study. There are also some quantitative data obtained from the respondents when mothers were asked about the time range of TV watching of their children. In other words, the research study used a combination of qualitative and quantitative data that at the most specific category can be identified as belonging to either nominal, ordinal, ratio or interval type of data. These data are

Public Administration- Program Development Coursework

Public Administration- Program Development - Coursework Example purpose of the introduction of the Department of Human Resources in the company is to ensure that there is workforce diversity across all departments as the purpose of the department is always to ensure that all the matters regarding the employees as a company’s assets are taken care of. In this project that the introduction of the department is proposed, it is very important to ensure that the success or the level to which the initiative is effective is examined or evaluated. In this chapter, we are going to analyze the changes that are apparent in the introduction following the introduction of the department. This is going to be done by having the trend analysis of the average level of workforce diversity within the organization. This table shows an hypothetical trend analysis of the average level of workforce diversity for the company before and after the introduction or implementation of the department of human resources. In this hypothetical example, we find that the trend in the data shows that the workforce diversity ‘s level with the organization saw an increase from slightly to moderately during the two different periods of transition on average. However, the post data shows that the introduction of the Department of Human Resources greatly accelerated the rate of the increase to which the organization was becoming more diversity racially or ethnically. On top of reviewing the overall workforce diversity level for the organization, trend analysis can be done for individual departments. This analysis will help in examining the level or extend to which the individual departments have succeeded in hiring more qualified minority candidates and also the level to which they have been in rise in the overall workforce diversity level within their structures. In addition, the comparative trend analysis can be done to examine the performance across the departments. This can always be done both at micro and macro levels. The departments that have been chosen

Scholarship letter for Summer Energy School Essay

Scholarship letter for Summer Energy School - Essay Example I feel that I will do justice with the honour of being granted the scholarship since I shall be able to perform admirably well in the program. My confidence comes from the fat that I have already studied various aspects of the respective field with commitment and focus. Baku Summer Energy School will provide me opportunities to learn about environmental issues, laws, economic aspects etc that are related to the field and still have not been explored by me to a great extent. My present knowledge about the field comes from my Bachelor degree in the field of international relations and politics. I am currently pursuing my Masters education in the field of politics, security and integration. Numerous courses are predicted to help me in the anticipated program, some of them are; Peace, conflict and security Legal aspects of international relations The missing dimension Human rights in global politics Gender, justice and environment. A strong inclination towards the study of energy made me opt for energy related topics for my dissertations in Bachelor and Masters programs. I have also passed IELTS with a 7 score. Apart from my commitment to my academics, I have also attended Model United Nations Conferences for students in the UK, Georgia, Turkey and Azerbaijan, as well as ASAIF conference in Strasbourg. These conferences proved to be great learning experiences and have taught me the relevance of this field on an international level. I was able to acquire professional knowledge about the field and the latest developments that are taking place in the world. The interactive nature of the Baku Summer Energy School will give me another opportunity to interact and learn from the public and private sector leaders from around the world. I highly value such opportunities and experiences that are offered by colleges to train their students for their professional careers. I have even had the opportunity to work in the Ministry of Foreign Affairs in Azerbaijani Republic for two years as an interpreter and Press Service officer. I feel that my exposure to the professional line, as well as working experiences in the public sector will help me contribute valuable insights during the program. My peers shall be able to enhance their knowledge due to my professional exposure, just like I will be able to benefit from their achievements. My frequent travels to different countries with my parents have directed me towards another area of interest- learning about different cultures and origins. The passion for learning about different cultures and customs has derived me to learn three languages. I enjoy analyzing the differences among different nations of the world and their histories that direct them to follow their specific lifestyles. The nature of relations amongst different countries and nations has always attracted my attention and has provoked me to study deeply into the subject. I believe the global nature of the economy in the present world requires a comme ndable understanding of the field of international relations, especially in the energy sector. The field of energy of one country cannot be studied in isolation from the world; the global implications, laws and environmental impacts have to be discussed as well to present a logical perspective of the prevailing situation. I feel that the multi-faceted nature of my academic records will make me face the challenges and achieve objectives of this course in a commendable manner. I belong

Reflection on the The Political Morality of Race Work Essay - 1

Reflection on the The Political Morality of Race Work - Essay Example Having ‘racial label’ do shape the way people think of themselves. As stated with the same source, â€Å"what people can do depends on what concept they have available to them; and among the concepts that may shape one's action is the concept of a certain kind of person and the behavior appropriate to that kind†. Helping one person think he is inferior among others may add more insult to injury and this indeed will result in final self-breakdown. How devastating that would be! Culture and civilization also became an object in Kwame Anthony Appiah’s essay. These two has a function in further dividing individuals globally by racial differences. He defined culture as â€Å"the totality of socially transmitted behavior patterns, arts, beliefs, institutions, and all other products of human work and thought†. There have been Orientals, Africans, and Chinese people that were to adopt a culture and civilization different from their traditional one such as th at of Americans but still there the differences are noticeable. It is said that every race has its own common culture. Like black Americans have their own common culture on â€Å"values and beliefs and practices that they share and they do not share with others†, as stated in the essay. It is true that each nation and race has its own culture. This may lead to some racial gaps in our global society. Yet, it is not simply a hindrance in having a good relationship with them. Unless they wouldn’t do something terrorist act, what is wrong with dealing with them? All of us are both humans. We do need respect and equality. What is the United Nations for but to supposedly bring peace and equality globally? Why can’t other people bridge the differences and go on living life to the full together in accord? Civilization may play a great role in stereotyping minority race. However, it is not always good for some nations that view their race inferior to others. Countries th at are well-developed economically were viewed by many as greater than anybody else. To mention some, the USA and Britain are viewed as masters of the land. They run the world market.     

School bullying Essay Example | Topics and Well Written Essays - 1250 words

School bullying - Essay Example It is widely acknowledged by students, parents and educators that bullying in schools is a primary concern since it can undermine the academic climate (Whitted and Dupper 2005, p. 167). A nationwide survey conducted in the US indicates that at least 29.9% of US students in grades 6-10 are involved in some degree of bullying School intervention systems typically involve heightening the awareness of teachers, parents and children, publishing anti-bullying policies and ensuring that bully is presented as a serious matter and as such incorporated into the school’s curriculum (Woods and Wolke 2003, p. 382). All indications are therefore that bullying in schools is a serious issue and the professional counselor has a role to play in responding to the issue of bullying. The professional counselor’s role is best suited to addressing the underlying causes of bullying. Smith and Schneider (2004) present a useful profile of both victims and aggressors involved in bullying. These p rofiles are useful guidance for the professional counselor in addressing the underlying factors that contribute to bullying. According to Smith and Schneider (2004) the aggressor is typically involved in substance abuse, has a poor academic performance, has a need to be dominant and is not empathetic to victims. Bullying can also be a means of achieving or elevating the aggressor’s â€Å"social status and access to valued resources† (Smith and Schneider 2004, p. 547). ... op an understanding of themselves, the rights and needs of others† and how to deal with conflicts (Standards for School Counseling Programs in Virginia Public Schools, n.d.). The Standards for Personal/Social Development counseling are set out to prevent bulling and other forms of anti-social behavior. These standards call for a proactive and preventative approach to counseling that are by design intended to address the underlying issues and are consistent with the profiles designed by Smith and Schneider (2004). For instance the Standards for Personal/Social Development counseling provide a step by step approach which leads the counselor through the child’s social development beginning with K-3 and ending with Grades 9-12. At the K-3 level, the counselor should ensure that the student develops respect for himself and others and gains an understanding of unity and community with fellow students. The emphasis is on cooperation and empathy (Standards for School Counseling Programs in Virginia Public Schools, n.d.). These standards are obviously designed to address the underlying issues that contribute to the aggressor’s behavior. EP7 if the K-3 Counseling Standards for Personal/Social development targets the victim by guiding counselors to help the student learn to identify and seek resources in the school and the wider community (Standards for School Counseling Programs in Virginia Public Schools, n.d.). As the student moves up in school the counseling program standards for Personal/Social development require a proactive and preventative approach relative to peer influences and continued emphasis on self-respect and respect for others. The students are also counseled on the dangers of substance abuse. Both aggressors and victims should be counseled on making

Critique on What Ive Learned from Men Essay Example for Free

Critique on What Ive Learned from Men Essay In the article â€Å"What I’ve Learned from Men. † The author Barbara Ehrenreich defines and roots her essay on things women can learn from men. She upholds that men influence women to become tough because of all the conflicts and arguments between the genders that make women recognize they are too ladylike when they are in a battle with men. She also explains that women should learn to get tough and take credit when they have accomplished or succeeded in a certain task and not just blame it on luck. Unfortunately, the article â€Å"What I’ve Learned from Men† is fruitless because the author hasn’t displayed any credible sources that support what she is claiming and also exhibits an amount of logical fallacies. First of all, there are several logical fallacies found in the article, which shows us why Barbara’s article is ineffectual. â€Å"I, a full-grown feminist†¦had behaved like a ninny-or, as I now understand it, like a lady. † This sentence is an example of Ad Hominem. The reason is that she refers to herself as a ninny, a foolish person, or in other words as a lady. Thus, she is attacking herself and all the other ladies who experience a similar event rather than the argument. Identically, the sentence â€Å"we spend a great deal of time acting like a wimp. † is another example of Ad Hominem. Another example is the entire fifth paragraph, â€Å"Think, for example†¦fascination for us. † This is clearly an example of Hasty Generalization where the author has referred the actors Mel Gibson, John Travolta and Marlon Brando as people who don’t talk and care about others feelings so, therefore, this has to be the same situation with us. But, there is no relation between them and us. Moreover, a good example of slippery slope is also present in the article. â€Å"If you’re not sure what to do with your face in the meantime, study Clint Eastwood’s expressions—both of them. † The reason is that the solution (study Clint Eastwood’s expressions) has nothing to do with the problem (what to do with your face). The first step does not lead to the second step and there is no connection between the two steps. Finally, there is an example of a Post-Hoc fallacy in the article. â€Å"If you take the credit you deserve†¦fully intend to do so again. † There is a connection between two ideas in the sentence. That is, if you take the credit for accomplishing something then this will result to being confident and succeeding again and again. Following this further, we will shift to the other claim of why the article is ineffective, which is the lack of supportive and credible sources. The author is not credible since all the information she supplied in her article is from her own experience and not from a well-known book or study. Hence, people will face difficulties in trusting whatever the author is saying in the article and especially males, since the independent variable in the article is men. â€Å"Sociologists have observed that in male-female social interactions it’s the woman who throws out leading questions and verbal encouragements. † This sentence has no proof, evidence or reference. So the author cannot just state this point without backing it up with proof. Logically, you can find men who are similar to this statement and women who are as well. Finally, this shows that the author is not demonstrating information and details with evidence and proof. Thus, this is another reason why the author’s article is ineffective. In conclusion, the article is fruitless since the author hasn’t supplied it with credible and supportive sources and references; as well as the presence of several amounts of logical fallacies and also of different types. This affected her argument badly and her reasoning just showed that she is trying to strengthen her opinion rather than strengthening her argument. Likewise, if the author has a very good experience in such topics but fails to have a good logical reasoning, the article’s reputation will be disrupted critically. Finally, the article should contain all these points so that it can be strong; and so that she can promote in what she believes in.

Pulmonary Hypertension And Physical Therapy Health And Social Care Essay

Pulmonary Hypertension And Physical Therapy Health And Social Care Essay The aim of this study is to clarify physical therapys role in rehabilitating pulmonary hypertension (PH) patients, by explaining PH with regard to its history, etiology, prevalence, anatomy of pulmonary arteries, definition, subgroups, patophysiology, its causes, how it is diagnosed, and its signs and symptoms. History  Ã‚   Pulmonary Hypertension was first discovered in 1981 by Dr. Ernst Von (4), but it was already getting attention in 1970s in Europe (3), and in the 1990s PH arise again in the United States along with the release of weight loss drugs (3). The natural history of  primary pulmonary hypertension  was evaluated in the National Institutes of Health (NIH) registry from 1981-1987. Of the 194 patients included in the study, 63% were female and 37% were male. The mean age was 36 years, with no ethnic differences. The median survival after diagnosis was 2.5 years (2). Etiology Pulmonary hypertension can be a result of many conditions and drugs. These include: left heart failure (diastolic dysfunction), parenchymal lung disease with hypoxia, sleep apnea, connective tissue disorders, and pulmonary embolism (1). In addition using appetite suppressants such as fenfluramine and dexfenfluramine may be associated with an increased risk of P.H.; also cocaine or amphetamine ingestion may be another contributing factor (2). Prevalence One study has shown that the frequency of PH in adults is predicted to increase, based on the high proportion of pulmonary hypertensionrelated deaths and hospitalizations has occurred among adults aged >65 years, especially if the patient was diagnosed with chronic heart failure (6). Another study has indicated that PH is still rare, with a prevalence of 30-50 cases per million (7); the rate of primary pulmonary hypertension  is approximately 2 cases per million individuals in the general population; while secondary pulmonary arterial hypertension  is dependent on its etiology (2). Most of cases of primary PH are sporadic, but 10% of them are familial (2). According to the World Health Organization, idiopathic PAH is rare and has a prevalence of 6 per million in France. PAH that is associated with other conditions has prevalence of 15 per million (15); idiopathic PAH accounts for at least of 40% of cases, and associated PAH for most of the remaining cases. IPAH is twice as common in women as in men, with a mean age of diagnosis of 36 years (7). This prevalence is higher in specific risk groups: 0.5%, in HIV infected-patient, 0.5%, in patients with  sickle cell disease, and up to 16% in patients with systemic sclerosis (7). Pulmonary hypertension Pulmonary arteries It is critical to know the anatomy of the pulmonary arteries (PA), so the patho-physiology can be understood; the pulmonary arterys function is to carry venous blood from the right ventricle of the heart to the lungs (9). It is one of the terminal branches of pulmonary trunk, and it is divided into the right PA and left PA (8). The RPA is longer than the LPA. The LPA pierces the  pericardium and enters the hilum of the left lung, but the RPA passes transversely across the midline in the upper chest and passes below the  aortic arch  to enter the hilum of the right lung(8). Definition PH is defined as high blood pressure in the lungs arteries and the right side of the heart (10), which can damage the lungs irreversibly, and cause failure of right ventricle(8). In normal individuals, the pressure in the pulmonary arteries is lower than the pressure in the systemic circulation, and if it has increased abnormally, it is considered as PH, which is due to constricted or stiffening of the pulmonary arteries (11). PH groups A patient, who has pulmonary artery pressure which is higher than 25 mm Hg at rest, and more than 30 mm Hg during activity, is considered to have PH (12). The world health organization has divided PH in to five groups (12). The five group classification is a new system, because PH used to be classified into primary PH and secondary PH (12). This new system is based on the underlying cause of PH (12). The first group of PH is pulmonary arterial hypertension (PAH); it is divided into three subtypes: familial PH, idiopathic PH, and associated PH (1). Familial PAH is inherited and a person has it in his/her genes from parents (12). Idiopathic PAH has no known cause (12). The last subtype is the associated PAH, which is caused by different conditions, such as congenital heart disease, HIV infection, diet medications, drugs, toxins, portal hypertension, thyroid disorders, and connective tissue disorders (1, 12). The second group is PH with left heart disease (1, 11, 12). The problems that affect the left side of the heart are valvular heart disorders (mitral valve disease), and atrial or ventricular heart disorders (chronic high blood pressure) (11, 12). The third group is PH associated with lung disorders, hypoxemia, or both. These lung conditions can be alveolar hypoventilation disorders, COPD, chronic exposure to high altitude, developmental abnormalities, interstitial lung disease, or sleep-disordered breathing. The fourth group is pulmonary hypertension which is due to chronic thrombotic or embolic disorders, and it includes nonthrombotic pulmonary embolism (tumors, parasites, and foreign materials), thromboembolic obstruction of distal or proximal pulmonary arteries, and sickle cell anemia (1, 12). The fifth and last group of PH is the miscellaneous type (due to vario us other diseases or conditions), such as compression of pulmonary vessels by adenopathy, fibrosing mediastinitis, lymphangiomatosis, pulmonary langerhans cell granulomatosis (histiocytosis), sarcoidosis, or tumors (1, 12). Pathophysiology of PH As mentioned previously, PH occurs when the systolic and mean pressures in the pulmonary arteries exceed 30- 20 mm Hg, respectively (2). At some point, it hypertrophizes smooth muscles, remodels vascular walls and vasoconstricts vessels (1); this vasoconstriction is a result of increased activity of thromboxane and endothlin-1, which are considered as vasoconstrictors, and decreased activity of prostacycylin and nitric oxide as vasodilators (1). These changes and the imbalance in the production of endothelial-derived vasoactive-mediators are both vital for the causation of PH (13). The PH physiologic mechanism is either an increased pulmonary vascular resistance (PVR) or increased pulmonary venous pressure (PVP) (1). The damage of the pulmonary vascular bed or vasocnstriction due to hypoxia can lead to increased PVR, but vascular obstruction can cause PVP to increase, and increased PVP will further injure the endothelium (1), and that will develop dysfunction of the pulmonary vascula r endothelium, which may worsen PH (13), because injury on the endothelium will activate coagulation at its intimal surface (1). Causes PH is the result of variety of factors and conditions, although in the case of idiopathic PH, the causes are not known (1, 12). Lung and heart disorders are the most common cause of PH(1). Examples are emphysema, failure of left heart ventricle, recurrent pulmonary embolism (1,12), scleredoma,(12), mitral valve disease, (13), pulmonary fibrosis, cystic fibrosis, sarcoidosis, Langerhans cell granulomatosis (histiocytosis), neurologic diseases involving the respiratory muscles (1), chronic low blood oxygen levels with  sleep apnea. Left-sided heart failure as a cause of PH will not happen unless one of the heart valves does not work properly, the left ventricle is stressed by high blood pressure, or a heart attack or some other disorder involving the heart diminishes the ability of heart muscle to pump (1). Pulmonary and lung arteries linings undergo change at cellular level, and these changes affect artery functions, leading to lung diseases and pulmonary artery changes which includ e tightening of arteries walls, or these walls get stiffened at birth or from outgrowth of cells, or blood clots in the arteries; all these will make it harder for the heart to pump blood through the arteries in to the lungs (13). Other causes of PH include dermatomyositis, systemiclupuserythematosus,  sarcoidosis,  human immuno-deficiency virus  (HIV),  advanced  liver disease, Sickle cell anemia (12, 13), use of anti-obesity drugs; cocaine  and  methamphetaminescan (1,12, 13), obesity with reduced ability to breathe (pickwickian syndrome) , extensive loss of lung tissue from surgery or trauma(1). Also PH can be genically inherited through parents (12, 13). Diagnosing PH In a patient suspected of having PH, diagnosis is confirmed with a family history, a physical examination, and diagnostic tests, and procedures (11). The physical examination is done by auscultation, inspection of swelling in the legs and ankles (11), examination of the jugular vein in the neck for engorgement, examination of the abdomen, legs, and ankles for fluid retention, and nail beds for cyanosis (13). Diagnostic tests include electrocardiogram (ECG), chest radiography, echocardiography, testing for connective tissue disorders and other conditions, ventilation perfusion scan, pulmonary function testing, and assessment of functional status, right heart catheterization (13), pulmonary angiogram, blood test, and over night oximetry (13, 11). If the ECG indicates abnormality, it suggests right heart failure (12), and may indicate right ventricular hypertrophy and strain (13), or presence of PAH. Abnormalities include right axis deviation, right ventricular hypertrophy and strain pa tterns, and right atrial enlargement (13). Chest radiography indicates any enlargement in the right heart ventricle or pulmonary arteries (11, 13), and it is mostly found with idiopathic PAH patients; however asymptomatic PAH has normal radiographic findings (13). The testing of connective tissue disorders is by serologic testing, and to test the presence of conditions such as scleroderma, CREST syndrome mixed connective tissue disorder, and systemic lupus erythematosus (13). Ventilation perfusion scan is another diagnostic tool to detect blood clots in pulmonary arteries (11, 12) and it is used to diagnose and differentiate between thrombo-embolic PH and idiopathic PH (11, 13), with sensitivity of 90% to 100%, and specificity of 94% to 100% (13). Pulmonary function testing is used to diagnose chronic obstructive disease (COPD), which can be a cause of PH (11, 12); it is also used exclude airway and parenchymal lung diseases, which can contribute to the development of pulmonary hype rtension, but these findings are not specific (13). The functional status of PH patient should be assessed with a 6-minute walk test and cardiopulmonary exercise test (12, 13); the 6-minute walk test determines exercise tolerance level and blood oxygen saturation level during exercise (16). A cardiopulmonary exercise test measures heart and lung functions during exercise on a bicycle or treadmill (12). The gold standard to confirm the diagnosis of P.H. is right heart catheterization (11); it is useful in assessing the severity of pulmonary hypertension (13). It is done by inserting a catheter into the femoral nerve or into the subclavian nerve. The catheter is connected to a device that can monitor and measure blood pressure in the right side of the heart and pulmonary arteries (11). Right-heart catheterization can also determine mean pulmonary artery pressure, mean right atrial pressure, and cardiac index; another use of it is excluding other etiologies of pulmonary hypertension, s uch asintracardiac shunting and left-sided heart disease (13). The response of certain medications, such as acute vasodilators, can be assessed during right heart catheterization (11, 13). Other additional tests used in diagnosing PH are various types of blood testing. These are complete metabolic panel (CMP) to examine liver and kidney function, autoantibody blood tests, such as ANA, ESR, and others to screens for collagen vascular diseases, thyroid stimulating hormone (TSH) screening, HIV test, arterial blood gases (ABG), complete blood count (CBC) to test for infection, elevated hemoglobin, and anemia, and B-type natriuretic peptide (BNP) (16). To detect sleep apnea nocturnal oximetry or overnight oximetry may be used; it is common to have low oxygen level during sleep with P.H. patient (12, 13, 16). Signs and symptoms In the early stage, PH is asymptomatic or have no specific signs or symptoms (11, 14). These symptoms and signs include cough, fatigue (11) dizziness, fainting and a bluish cast on lips and skin (14), shortness of breath, tiredness, chest pain, a racing heartbeat, feeling lightheaded, swelling in legs and ankles (12). These can be indications for any other disease. As a consequence of non-specificity, diagnosis will be delayed; and the mean time from symptom onset to diagnosis is about two years (13). The symptoms of PH are manifestations of impaired oxygen transport and reduced cardiac output, and the most frequent symptom is dyspnea, which occurs in 60% of patients (13). As symptoms advance, patients complain of dyspnea, exercise intolerance, fatigue, chest pain, and angina (13, 11). Most PH patients get right ventricular hypertrophy, followed by dilation and right ventricular heart failure (1). The symptoms of right heart failure include peripheral edema, abdominal distension, dec reased appetite, early satiety, profound dyspnea, exercises intolerance (13). Other signs include systolic ejection murmur across the pulmonary valve, increased jugular venous pressure, tricuspid regurgitation, hepatomegaly and ascites, and peripheral edema (13). Other physical signs are cyanosis (point of presence of right to left shunting), decreased cardiac output, impairment in intrapulmonary gas transfer, and pulmonary congestion and left sided heart disease, while decreased breath sounds and wheezing are suggestive of fibrosis and pulmonary parenchymal disease (13). Treatment The medical treatment program starts with the avoidance of activities that may exacerbate condition (1), and it is generally includes taking medications, making lifestyle and dietary changes, and maybe having surgery (16). Medications are also used, depending on the type and severity of PH (16). PAH is treated by oral Ca channel blockers (verapamil), endothelin-receptor antagonist (bosentan-ambrisentan- sildenafil  ), ,  digoxin,  diuretics, and oral  anticoagulants (1, 4). The other PH types  involve management of the underlying disorder. Patients with pulmonary hypertension from left-sided heart disease may need surgery for valvular disease. Patients with lung disorders and hypoxia benefit from supplemental O2 as well as treatment of the primary disorder.Patients with severe pulmonary hypertension secondary to chronic thromboembolic disease should be considered for pulmonary thromboendarterectomy. Under cardiopulmonary bypass, organized endothelialized thrombus is dissected along the pulmonary trunk in a procedure more complex than acute surgical embolectomy (1). Vasoactive substances in general are used in treating different groups of PH. This category of medications includes prostaglandins, endothelin receptor antagonists, phosphodiesterase type 5 inhibitors, and activators of soluble guanylate cyclase (4). The surgical solution can be one of these options, either atrial septostomy, lung transplantation, or pulmonary thromboendarterectomy (4, 16). PT role The PT role in PH is more rehabilitative in nature more than therapeutic, and it has different programs customized to each patient, and depends on the clinic or hospital approach. Pulmonary rehabilitation, according to Salt lake regional medical centre, is an outpatient program which will help the patients to learn lung self care, and easier breathing (19). In this centre, complete diagnostic testing is provided, and it includes ECG, chest x-ray, echocardiogram, pulmonary function tests, 6-minute walk tests, nuclear lung scan, CT scanning of the chest, right heart catheterization (19). In the North West therapy centre, assessment is done at the beginning by a team, including respiratory therapist, physical therapist, and  social worker. The respiratory therapist focuses on breathing mechanics, education, aerobic conditioning and endurance for improved efficiency, pacing, and medication mechanics. The physical therapist helps in strengthening exercise, balance training, walking mech anics, postural education, energy conservation, assigning a home exercise program to maintain strength and coordination gains, looking for orthopedic complications to therapy, and makes appropriate adjustment to plans of treatment. The last member of the team is the social worker who is considered as a resource center for services in community. These services include helping in smoking cessation, supporting for adjustment, grief, depression, and socialization disorders, weight management, nutrition support, and cognitive behavioral therapy (20). Pulmonary rehabilitation (21) Since physical therapy provides rehabilitation role, the PH patient should go through a pulmonary rehabilitation program, which is an individually designed intervention program, including exercise  and education that helps patients manage the symptoms of their condition and improve their level of daily functioning and well-being (3). This program will be discussed from different aspects its purpose, basic components, precaution, process, patient preparation, and expected results. The goals The purpose of this program is to help increase the fitness level of the patient and independent functioning, reduce dyspnea, slow down or prevent the development of disease, and improve quality of life. Pulmonary rehabilitation and cardiac rehabilitation walk complement each other because the main purpose of cardiac rehabilitation is to reverse the de-conditioning and psychosocial enhancements of pulmonary disability. Components Pulmonary rehabilitation has basic treatment components and they are breathing exercise, coughing, percussion, postural drainage, and vibration. Breathing exercise helps in removing secretions, relaxation, and to increase thoracic cage mobility. This exercise is done by teaching the patient to produce a full inspiration followed by a controlled expiration, while placing a hand at the end of rib cage and under the chest for sensory feedback. Coughing is also for secretion removal but from larger airways and it is done through steps. The patient should inhale, close the glottis, contract the expiratory muscle, then open the glottis. Both breathing exercise and coughing are done when the patient restore the ability to breath normally. Percussion is usually used with postural drainage and both are used to mobilize secretions retained in lungs. Percussion is a rhythmic clapping of cupped hands over bare skin or thin material covering area of lung involvement, performed during inspiration and expiration. Postural drainage is a technique that involves gravity by positioning the patient to have the involved lung segment be the uppermost, which will assist in mobilizing the secretions. Another therapeutic technique is vibration, which is intermittent chest wall compression over area of lung involvement, performed during expiration only, and used along with postural drainage. The later three techniques are used when coughing or suctioning, breathing exercises, and patient mobilization are not adequate to clear retained secretions. Precautions and contraindications As with any other treatment precautions and contraindications should be taken in consideration in case of PH patients during their rehabilitation program. A patient should get full medical examination before setting the program. In some cases when a patient has a medical issue, it may interfere with the treatment and limit the exercises. In this case, the program should be modified. Conditions that may contraindicate participation in pulmonary rehabilitation include acute respiratory  infection,  ischemic cardiac disease, congestive  heart failure,  serious  liver  dysfunction, disabling stroke, severe psychiatric or cognitive disorders, severe pulmonary hypertension,  and metastatic  cancer. Rehabilitation process Pulmonary rehabilitation is a punitive, expansive program of education, exercise, and behavior alteration, individually designed for patients with lung diseases. The rehabilitation program is designed to help patients learn more about their condition and how to concert its symptoms, as well as to take active steps, such as smoking cessation, oxygen use, and exercise. This program aims to improve the patients level of physical functioning, stop the advancement of the disease as much as possible, and learn how to better live with the condition. Improved physical functioning, reduction in the symptoms of the disease, and ability to fulfill activities of daily living (ADLs) more easily and independently can add to improved quality of life. Rehabilitation program A typical program takes a few weeks to a few months, and takes to three hours per session for a few days each week. During these sessions the patient should learn to manage the program independently, as home program. Patients participating in rehabilitation could be inpatients or outpatients. A daily program should consist of two main components, and they are exercise and education. The purpose of the exercise is to maintain or improve muscle strength, endurance and overall fitness. In order to prescribe an exercise, blood pressure, heart  rate, oxygen saturation, and dyspnea levels should be evaluated, also exercise has to be monitored by physical therapists, respiratory nurses, or other qualified health care providers. A regular exercise program can upgrade overall fitness and energy, and make fulfillment of ADLs easier. The exercise program includes periods of warm-up and cool-down period, and aerobic activity. The warm-up and cool-down periods may include stretching and light strength or resistance training. Exercises involving upper and lower extremities are important for general fitness and for improvement in function during different activities. Some of the muscle groups used in arm and upper torso positioning serve respiratory functions, and thus upper limb exercises can also have a profitable effect on ventilation. The aerobic exercise component is composed of activities such as walking or using a stationary bicycle, treadmill, or other equipment. Exercise is controlled by physical therapists, respiratory nurses, or other qualified health care member. Ventilatory training may also be involved in the exercise program for certain patients. This therapy involves controlled breathing exercises,  chest physical therapy  techniques such as postural drainage, chest percussion, directed cough, and vibration, and training of the inspiratory muscles. The educational component of the rehabilitation program consists of classes, manuals, and counseling or training sessions that cover different subjects, procedures, and issues, which concern patients with PH or any other chronic pulmonary disease. Education is provided by a brand of professionals, including respiratory nurses, respiratory therapists, occupational therapists, physical therapists, social workers, and dieticians. A psychologist or other mental health professional may provide counseling and direction to address mark depression, anxiety, and social isolation, which are related to symptoms of pulmonary disease. Some of the educational subjects covered include anatomy and physiology related to pulmonary function and disease, exercise theory,  nutrition,  techniques for using oxygen and inhalers, and ways to conserve energy. Education related to proper nutrition and weight control can be helpful, because patients may be undernourished and have muscle wasting of the respi ratory muscles, which can make breathing more difficult. If anemia is present, it can decrease oxygen-carrying capacity. Electrolyte imbalances affect cardiopulmonary performance, so these and other deficits should be treated in order to enhance functioning. If patients are overweight, the extra weight increases oxygen and energy consumption and may increase fatigue. Patients who have not yet ceased smoking should be strongly encouraged to do so. Patient preparation After being referred and examined by a physician, a medical history of the patient should be taken by the rehabilitation team, and some tests must be done prior to the rehabilitation program. These tests are pulmonary function tests (PFTs), chest X-rays, arterial  blood  gas (ABG) analysis, pulse oximetry, and sputum examination. PFTs are performed with a spirometer to measure lung performance and indicate the presence and extent of lung disease. A chest X-ray can show emphysema and other lung disease, including  lung cancer,  for which there is increased risk among smokers with pulmonary disease. Pulse oximetry helps determine when supplemental oxygen is required and measures oxygen in the blood. Exercise tests may be used to prescribe the length and intensity of the exercise. Expected complications Risk of complications such as muscle injury or cardiac reactions is always come up with exercise, but will be eliminated by careful exercise prescription and monitoring. Disease-related complications that should be monitored include  fever,  unusual or extreme shortness of breath, irregular pulse, unanticipated weight changes, gastric complaints, or any other change that is unusual for the patient. Conclusion Pulmonary hypertension is indicated when pulmonary artery pressure is higher than 25 mm Hg at rest, and more than 30 mm Hg during activity. PH is due to constricted or stiffening of the pulmonary arteries. PH is classified in to five groups, based on the underlying cause. PH is asymptomatic or has no specific signs or symptoms, but later, the patient may complain of dyspnea, exercise intolerance, fatigue, chest pain, and angina. PH treatment protocol consists of making lifestyle and dietary changes, medications, rehabilitation program, and maybe having surgery. Physical therapy plays an important role in rehabilitating PH patients. PT aims to help increase the fitness level of the patient and independent functioning, through exercise programs and education.

The Values And Ethics Of The Profession Social Work Essay

The Values And Ethics Of The Profession Social Work Essay Social workers are put into difficult situations on a regular basis. The Health and care professions council (HCPC) set guidelines to aid the challenges social workers face. To remain registered, a social worker needs to abide by the HCPC code of ethics to ensure delivery of the best possible service for users. Working within the guidelines set can be challenging as it may cause conflict with the service users values or potentially the social workers own values. For the purpose of this essay, ethics will be defined as professional obligations and rules of conduct (Meacham, 2007). Social work values will be defined as a range of beliefs about what is regarded as worthy or valuable in a social work context (BASW, 2012 p17). This essay focuses on two areas of the personalisation agenda that can cause challenges for social workers; accommodation and personal budgets. The target service user group for the purposes of this essay is people with disabilities. Using the definition stated in t he Equality Act, (2010) A person is considered disabled if they have a physical or mental impairment that has a substantial and long-term negative effect on their ability to do normal daily activities. Legislation and requirements to support adults with disabilities is increasing for the over eleven million people with a limiting long term illness, impairment or disability in Great Britain (office for disability issues, 2012). However, disabled people report mixed feelings and reactions to the legislations and rules put in place regarding their care and allowances (Dalley, 1991). The social philosophical approaches to social work will be used to deal with the challenges and conflicts social workers face. This essay touches upon Kants deontology; Benthams and Mills utilitarianism and Biesteks 7 principles approach. Immanuel Kant (1785) developed the theory of deontology. This means that social workers need to be promoting good actions and the correct motive, however the consequence is not important and the idea of an acceptable motive is subject to judgement (Adapted by Hartsell, 2006; Banks, 2001; Reiman, 2009; Meacham, 2008). Subsequently, Kant introduced the idea of a categorical imperative (CI). A CI maintains a persons motives for their actions and they therefore should be acceptable as a universal law. Â  Thus people should act on motives that can be used by everyone in a moral society and lead to respect for people (Darwell, 2002 cited in Reiman, 2009). From this it is seen that people should be treated as an end, for example a choice or desire, rather than a means (object) to our own ends. He believed that everyone should be treated with respect regardless of their characteristics or behaviour (Banks, 2001). Kant talks about respect for the individual person and promoting self determination. Biestek (1961) produced 7 principles that over time have become highly influential to social workers looking at values and ethics within their practice. 5 main principles have been used: Individualisation; Recognition that each service user has unique qualities, good and bad. Purposeful expression of feeling; Recognition that service users need to express their feelings (especially negative ones) freely. Acceptance; The social worker should be able to work with a service user without passing judgement and accepting Individuals for who they are, including their strengths and their weaknesses. Non judgemental attitude; Social workers should be able to not pass judgement or assign guilt to the service user. It is about judging the service users behaviour User self determination; the social worker should be able to guide the service user, depending on their on their capacity, to have freedom in making their own decisions and choices (Adapted by Banks, 2001). Utilitarianism focuses on a consequentialist approach as it focuses on the consequences of the action, rather than the actions themselves. (Scheffler, 1994 cited in Reiman, 2009). Decisions should be made on the results and consequences it could have on society rather than on a personal and individual basis, and to promote maximum good within society. The right action produces the greatest balance of good over evil the principle of utility. (Banks, 2001). Utilitarianism is based on a theory developed by Bentham and Mills who looked into two branches of utilitarianism; hedonistic and ideal utilitarianism. Bentham explored hedonistic utilitarianism, where good was matched with happiness. Mills explored the idea of ideal utilitarianism. This focused on good being about virtues, truth and knowledge, not just happiness. (Banks, 2001). The theory promotes the greatest good for the greatest number of people. When making a decision it is imperative that the consequence is considered. Theref ore as a social worker, it would be beneficial to look at the consequences of the forthcoming action and evaluate what would be most beneficial and least harmful to the service user. In the late 1980s, the Government recognised that an improvement in access to community services was required. The Government were committed to providing more support for people with long term needs by assisting and supporting individuals to manage their conditions and providing services they require in the community rather than in long-stay hospitals.(Oliver, 1996) Morris (1993) conducted a study that looked into disabled individuals who needed day to day services. He found that disabled individuals were starting to feel a sense of hopelessness and helplessness when trying to access statutory services. Historically, social workers assessed and told service users what services they needed. Through the personalisation agenda, and the introduction of direct payments, service users told the social worker their needs. For the first time, the social worker had to accept the service users self-assessment and then use the assessment to see if the highlighted issues were eligible under Fair Access to Care (2003) legislation. Direct payments were introduced in 1997 and social workers had to translate service user needs into a monetary value to enable them to purchase their own service. The aim was to give individuals control over their care and their lives. Direct payments evolved into personalised budgets and have further evolved into a more individualised budget / service plan. The need for change and equality of service provision has been recognised as more views are being voiced by people with disabilities. In line with Beisteks theory, service users are using purposeful expression of feeling and self-determination to enable the social workers to know their wants and needs. This has resulted in changes which could reduce the potential for conflict in the future. A further challenge is budgetary control. Service users often want services that are financially unavailable to them. Although ethics state that service users should be encouraged to have self- determination, be treated as a whole and the social worker should promote and provide information regarding their care (BASW, 2012), the service users choice cannot always be guaranteed. Utilitarianism would suggest that this is because if service users always received the services they wanted, the social worker would not be promoting the greatest good for the greatest number, instead would be taking a more Kantian approach of promoting moral good. These two philosophical approaches cause conflict within themselves. The Mental Capacity Act (2005) says a person lacks capacity in relation to a matter if at the material time he is unable to make a decision for himself in relation to the matter because of an impairment of, or a disturbance in the functioning of, the mind or brain. (s2). This leads to challenges and conflicts for social workers. If the service user had capacity, there could be conflict over the way they spend their budget which could lead to the social worker treating that individual without respect. Following the BASW code of ethics (2012), it states that social workers should respect the right to self-determination. Kant would support this view as, by the social worker supporting the individual to meet their own self-defined needs, the social worker is promoting good actions that will in turn produce good outcomes for the individual. The social worker needs to recognise that the individual has human rights and freedom to voice their views. Burton (1996) showed that there was a fail ure to recognise the unequal power relations between the social worker in control of provision of services and the service user who relies on the services. This therefore would undermine Beisteks principles of self-determination as, although the service user is voicing their opinion, the social worker is not listening and this could be seen as jeopardising the principles of personalisation and the code of ethics that are imperative. The implementation of The Mental Capacity Act needs to be reviewed to ensure workers are following legislation and ethics. It should not be assumed someone lacks capacity because they have a disability. On the other hand, if the service user didnt have capacity, it could cause conflict between the social worker and the paid carer and/or unpaid carers. If the service user lacks capacity, how would the social worker or the carers be able to assess what was best for the individual? A social worker would have to uphold and promote human dignity and well-being as well as empowering the individual. (BASW, 2012). These ethics and values are supported by Beisteks theory. Workers need to treat the service user with respect, be non -judgemental and accept the situation the service user may be in. The social worker therefore would only be able to act upon their assessment which should include the carers views on what is best for the service user. Utilitarianism, an alternative argument, would argue whats the greatest good for the greatest number? What would benefit the service user more? The social workers views or the carers views? The outcomes need to ensure that the maximum people are happy . The social worker could reach the maximum happiness and reduce conflict by using empowerment. The social worker would respect the needs and preferences of the service user, via the carers and family members as well as recognising their own prejudices to ensure the correct services are offered. The Community Care Act (1990) promotes care in the community and people staying within their own home, allowing the individual to use their personal budget and have carers to promote independence. There is evidence to suggest for example, individuals who have fractured a limb, fare better when they recuperate in their own homes. (Pignolo, Keenan and Hebela, 2011). Accommodation is a major concern for many service users (Davis and Wainwright, 1996). One aspect that could cause conflict is the practice of placing young people in young disability units, properties that are specifically designed for people with learning disabilities. Although this could be seen as a solution for people to interact and have support, there is a potential conflict as the individual cannot choose where they want to live and may live a distance from family/friends. If placed in a purpose built establishment, the individuals are classed as being housed by the local authority and therefore do not get to choose alternative locations (Oliver, 1996). The dilemma for the social worker is the need to take the individuals views into account whilst balancing their needs and wants, particularly if the service user lacks the capacity to make the decision. It is unlawful for anyone to sign a tenancy agreement on behalf of an individual who lacks capacity. A capacity assessment needs to be undertaken to ensure the service user understands how to maintain that tenancy. In order to proceed, an application needs to be made to The Court of Protection. This could lead to conflict as the social worker and housing department need to uphold the law, however many families feel they have the right to sign a tenancy for their disabled family member and find it difficult to accept that this is not the case. According to BASW (2012), the social worker needs to develop professional relationships with the service user and the family, uphold the reputation and values of the profession as well as recognising diversity and treating the individual as a whole. Utilitarianism would recommend looking at what benefits the whole family, rather than just the service user. Challenges arise when the service user lacks capacity. Using the utilitarian approach, it could be said that the service user shouldnt be given a tenancy as it doesnt promote the greatest good for the greatest number. This view is in conflict with BASW codes of ethics. It could be seen as unethical practice and lead to further conflict. Beistek would support the view of BASW in using the specific value base that service users should be allowed to freely express their feelings, both positive and negative, and the social worker should listen and make a decision in an accepting and non-judgemental way. However, Kant would say that although the consequence of not getting a choice in where the service user lives is a negative outcome, the intention of placing them in a home, with other people to socialise is a good moral judgement that is solely benefitting the individual. Another potential conflict could be older disabled individuals being forced into care. The Sutherland Report (1999) claimed that older disabled people were being forced into institutional care too early due to the lack of alternative care at home. Sixsmith and Sixsmith (2008) provided evidence that by 2008 there had been a shift in care provision and that the Personalisation Agenda meant that people were remaining in their home for longer and receiving appropriate services. However there is a further potential for conflict when accommodating people, with disabilities, to stay in their homes. Individuals may want to grow old at home but is this possible for people with significantly reduced mobility? Many homes are inaccessible to wheelchair users and those with significant mobility impairments (Burns, 2004). There is a Government scheme whereby disabled people can apply for a disabled facility grant to have their homes adapted, and certain individuals have to re-pay the Government, t herefore the Government is not financing expensive care packages. The role of the social worker would be to negotiate, support and empower the service user to have their needs met in the most appropriate, desired way. According to Kants theory, having a loan is the moral good as people will be able to remain at home for longer, promoting happiness and community care. This would be supported by the values of BASW which states social workers need to treat the service user as a whole and respect their right to self-determination. In contrast to Kants theory, Utilitarianism would consider weighing up the consequences of removing the service user from their house and into an adapted and safe environment. I.e. a care home could be seen as an easier option for disabled people to receive care. This view could cause conflict because the social worker is going against the wishes and desires of the service user. Utilitarianism looks at the best outcome for society rather than on an individual level. Therefore, by moving individuals out of the house into the care home may provide maximum happiness for society, although it disregards the individuals views and opinions. This is a criticism of the model as many service users could potentially not have their needs met in a manner that is acceptable to them due to the focus being on the benefit to society. This could be particularly true e.g. for people with English as a second language or who follow a religious faith. However, Beistek would agree with Kant in promoting self-determination. A key theme running throughout this essay is respect for the individual person as a self determining being. Both Kant and Beistek promote this and therefore appear to be the social philosophical models best tailored towards social work values and ethics. There are clear conflicts between traditional social work and the personalisation agenda for people with disabilities. These conflicts have been reduced with the introduction of HCPC ethics. If the social worker consistently uses these theories whilst working with conflict and challenging service users then the BASW ethics will be maintained and the service users will receive the best appropriate service available within Fair access to care criteria.