Wednesday, December 25, 2019

The Bombing Of September 11th 2001 - 947 Words

Where were you on the morning of September 11th 2001? Most people over the age 20 can tell you exactly where they were and what they were doing when they found out about the events that occurred that historic September day. I, for example, was in the middle of the Pacific Ocean on a United States Naval Ship. The goal of the terrorist attacks may have been to break Americas resolve, however, the attacks actually united the American people. The attacks that occurred on September 11th 2001 killed 2,843 people including those on the airplanes, in the towers, in the Pentagon, police officers, firefighters, paramedics and bystanders in New York, Washington D.C. and Pennsylvania.1 The events that occurred on September 11, 2001, affected many people in the United States and abroad, and began the War on Terror. â€Å"On a sunny September morning, nineteen Islamic terrorists from Al Qaeda hijacked four commercial jets and flew two of them into New York City’s World Trade Center, destroying its twin towers and killing more than 2,900 people.†2 September 11th 2001 at 8:45 in the morning, a high jacked commercial airplane crashed into the 80th floor of North Tower of the World Trade Towers instantly killing hundreds of people and trapping even more people in the floors above the crash.3 Then less than 20 minutes later a second airplane crashed into the 60th floor of the South Tower of the World Trade Towers.4 The second airplane crash caused a huge explosion and prompted the evacuation ofShow MoreRelatedWhat Happened in September 11th, 2001 Essay889 Words   |  4 Pages September 11th, 2001 What happened on September 11th, 2001? A day that will be remembered and never forgotten, a day that many innocent people died because of a terrible tragedy that happened on September 11th, 2001 at the World Trade Center in New York City. To many people it probably just looked like another regular work day, but didn’t expect the worst that day. On September 11, 2001, nearly 3,000 people were killed in the terrorist attacks at the World Trade Center in New York City (†11Read More9/11: Why It Could Happen Again Essay1165 Words   |  5 PagesSeptember 11th 2001, the day that changed America forever. On this day, 3,000 Americans including civilians, police officers, firefighters and paramedics were innocently murdered by al-Qaeda terrorist. Commercial airline planes were used as missiles and flown into the World Trade Center in NY, the Pentagon in the nations capital, and in a open field in Pennsylvania. For America being the most technology advanced nation in the world, along with having the largest, strongest and most advance militaryRead MoreTerrorism and Political Violence by Alex Schmid1312 Words   |  5 Pagesand international (FBI.gov). Domestic terrorism happens within the United States’ jurisdiction. These terrorist acts will take place on our soil and attack the people of the United States. Examples would be the Boston Bombings, which happened exactly one year ago, or September 11, 2001. These two examples happen to be the doings of people who are trying to harm the government, with religious and political motives, but there are other examples of domestic terrorism that took place by people of thisRead MoreTerrorist Attacks On The United States1453 Words   |  6 Pages September 11th, 2001, alleged Al-Qaeda members attacked the United States of America with four passenger planes, Boeing 757s. Two planes flew into the North and South Towers of the World Trade Center in New York, one plane flew into the Pentagon, and the remaining plane was possibly targeting the White House but was unsuccessful. People all over America felt an utter shock and disbelief after this tragic event as people demanded answers. After the terrorist attacks, a portion of AmericansRead MoreThe Following Reading Will Contain Background Information923 Words   |  4 Pageswithdrawal of Afghanistan in 1988. The organization was started in Pakistan by then leader Osama Bin-Laden. Al-Qaeda had been responsible for attacking the World Trade Center in 1993 and 2001, as well as bombings of U.S. Embassies in Kenya and Tanzania, which killed 224 people from 1991 to 1998. After the September 11, 2001 attacks, U.S. and British forces drove Al-Qaeda out of Afghanistan in to neighboring Pa kistan. The unrest in the region due to being forced out of Afghanistan had never been greaterRead MoreThe Terrorist Attack 9 / 11 Essay1668 Words   |  7 Pages Conservatisms believe that terrorism posses one of the greatest threats to the United States of America (34). During the attacks George W.Bush responded by trying to prevent further hijack attacks, which meant forcing down all flights on September 11th 2001, any flight that didn’t cooperate would be viewed as hostile therefore be shot down by the air force. When he heard about Flight 93 he believed that it had occurred because of his orders given, later finding out it was because of the heroicnessRead MoreThe War Of 1812 And Its Effects On American Soil983 Words   |  4 Pagesblue sky, as a slight breeze made its way through the maze of skyscrapers in New York City on a cool Tuesday morning. Who could have guessed a morning as benevolent as this could be a source of such inexplicable cruelty? This particular day in September of 2001 would change the world forever. Without warning, an explosion rang out. A puff of black smoke bellowed upward from the north tower of the World Trade Centers. An unpleasant silence ensued. As the bystanders below tried to make sense of what theyRead More Terrorism : The Threat Of Terrorism Essay1098 Words   |  5 Pagesthough these extremist use religious symbolism to seek a wider audience and resort to violent acts to prove their point. The terrorist’s events leading up to September 11, 2001 can be analyzed for the purpose of uncovering such a pattern to shed light on the possibility of preventing another horrific terrorist attack in the future. September 11, 2001 is known today as the darkest day in aviation history because the attacks resulted in extensive death and destruction which led to significant U.S. initiatesRead MoreTerrorism: A Defining Moment in Our Recent History1576 Words   |  6 Pagesglobal. The history of terrorism is rooted in its use by revolutionaries and governments, its influence on domestic affairs and the various methods used to instill fear and control. But since the end of the Cold War and more importantly after September 11, 2001, terrorism has been used by organizations to exert political and extreme religious agendas across the globe using new tactics with the advancement of technology The end result of World War I created revolutionary groups that would start theRead MoreCombatting Against Terrorism Essay1591 Words   |  7 Pagesactivity such as the Boston Marathon bombing, the 9/11 terrorist attacks, and the anthrax letter mailings of 2001. The definition of Terrorism according to Dictionary.com is â€Å"the use of violence and threats to intimidate or coerce, especially for political purposes†. As one looks back upon the United States history of Terrorism, one might find that almost one-hundred percent of the time they fit the definition. For example, the attacks on September 11th, 2001 were, according to many politicians and

Tuesday, December 17, 2019

The Sun Is Shining Bright Upon Your Skin - 1088 Words

You are casually walking down the street. The sun is shining bright upon your skin. You watch the cars quickly driving by hearing the sound of speed. It washes wind onto your warm face. You glance at the people in the cars observing the differing expressions. You look down at your feet noticing the crunch of the orange and yellow leaves beneath them. You look up and you are at a crosswalk. The light still shows a red hand. You patiently wait. The light turns into a walking white figure and you cautiously cross the road. As you are walking a white jeep speeds down the street you look at the vehicle and it is obvious to you that the driver is not paying attention. Before you know it the women in the car, young with chocolate brown hair, slams on her breaks aggressively. Panic danced through her eyes. What do you do in this moment? This person almost hit you when you were considerately following the laws in place. Do you look up with anger in your eyes, your lips letting out words of ra ge? Seeing the drivers eyes grow big with remorse and fear. Or do you pause, not letting yourself fall into the arms of impulse and put yourself in the women’s shoes. Contemplating your intent before you act. Karma pertains to action driven my intention (cetanÄ ). Before learning about Buddhism I thought about karma as a certain energy angrily coming for someone at some point in time that would force him or her to pay for his or her bad actions. It was more of a nonchalant saying thrown out thereShow MoreRelatedThe Slave Ship J.M.W Turner1588 Words   |  7 PagesTurner, John Mallord William  (1775-1851) Romantic Landscape Painter 1840; Oil on canvas, 90.8 x 122.6 cm; Museum of Fine Arts, Boston Aloft all hands, strike the top-masts and belay; Yon angry setting sun and fierce-edged clouds Declare the Typhons coming. Before it sweeps your decks, throw overboard The dead and dying - neer heed their chains Hope, Hope, fallacious Hope! Where is thy market now? JMW Turner displayed this poem with his Slave Ship in 1812 Poem by Robert Bloomfield Read MoreDescriptive Essay : My Favorite Camping Spots1304 Words   |  6 Pagespassions of mine. I love the aroma of pine needles, and the sounds of birds chirping as the sun greets a new day. There is a sense of calmness in the wilderness lost from the bustling city life. One of my favorite camping spots is on the shores of Timothy Lake, an oasis near the base of Mount Hood. To reach Timothy Lake, you stroll through the woods on a small dirt path littered with fallen leaves that rustle under your footsteps. Sunlight, filtering through a thick canopy of trees, dances on the groundRead MoreWish For A Young Wife, by Theodore Roethke1466 Words   |  6 Pagesout the beauty of a woman. It is defined in the Oxford English Dictionary as a verb, â€Å"to burn with a bright, fervent flame†. This definition seems to indicate that the poet wishes that his wifes hair may always have a bright, shining quality to it, which further enhances her beauty. As a matter of fact, to fully clear up the fog for his reader, the poet makes certain to state the clause, â€Å"in the sun† twice, in subsequence, in the tenth line of the poem, which implies that he hopes that his readerRead MoreReligious Art During The Renaissance1200 Words   |  5 Pagesof the picture in terms of color. Her clothes are bright purple, yellow and blue and her skin is fair compared to t he dark green of the background. Jesus and Saint John are also both light in color compared to the dark background due to their fair skin. Addition, the lighting in the gallery that is directed at the painting actually makes it look as though sun is shining down, illuminating Mary’s face and the children, even though there is no sun in the painting. The lines and the contrast betweenRead MoreThe Knight Of Light By The Greenest Grass3272 Words   |  14 PagesChapter 1: The Knight of Light The Knight of Light Once upon a time, in a land far, far away, there was a small kingdom that had a sky of the bluest blue, and was surrounded by the greenest grass which was decorated by every flower you could imagine. Within this kingdom there was a village that was filled with happiness, and everyone who lived there was always smiling, for they loved their little village. They loved the blue skies, they loved the green grass that was decorated by every flower youRead MoreDescriptive Essay On In Loving Memory1357 Words   |  6 Pagesuntouched, bright green, especially with all the rain in April; instead, it always gave off the look to me as being half-dead. As if it could tell it resided in a graveyard, so it, of course, mirrored the only thing it knew. Death. It was a weathered day. Wind pulled on my jacket collar, a sharp breeze passing completely through me. The air howled into my ears, screaming things I could not make sense of. The grey sky was two large stretched-out hands reaching for each other. Layers upon layers ofRead MoreThe Intolerable Island1696 Words   |  7 Pagesa second or two. As soon as the wind died down I felt goosebumps arise on my skin as I took my first clear look at the enormous buildings in front of me. There were tour guides standing in front of them, smiling and greeting people as they walked by, but the large structures leering behind them did not mirror the jovial persona put on by the workers. Instead, they looked hateful and threatening, daring you enter at your own risk. The ever-present cracks trailing along all sides of them and the chippingRead MoreDescriptive Essay About Love2096 Words   |  9 PagesThank You, Emmeline One late morning in 1914, I leaned against the newly painted silver railings of the large Majestic, a beautiful ship with a black bottom and a bright white top. Murky, charcoal-black smoke came out of the three enormous, grey, cylinder-shaped chimneys, which began combining with the fresh sea air. The thunderous boat horn was then suddenly blasted, interrupting the beautiful, calming noises of the sea. I heard the screeches of the white seagulls choke as they flied throughRead More We Must Put an End to Gender-related Stereotypes and Stereotyping1629 Words   |  7 Pagesdominated by technology, television especially, it is hard not to be aware of such issues. Women have always been exploited in movies, television, and magazines, with sex selling all. We are told what we should look like: thin, long legs, flawless skin, and big breasts. We are told what we should act like: the woman of the nineties being practically superwoman, being aggressive in the business world, and a lov ing tender mother and wife at home. Needless to say it is hard to live up to these expectationsRead MoreWomen s Independence And Self Assertion1788 Words   |  8 Pagesstory is not only â€Å"big† but also is unexpected just like the actual thunder and rain were. The unexpected â€Å"storm† also brings Alcee unexpectedly at Bobinot and Calixta’s gate. Chopin shows entrance of the affair’s beginning by stating, â€Å"The rain beat upon the low, shingled roof with a force and clatter that threatened to break an entrance and deluge them there† (Chopin 35). The words â€Å"breaking an entrance† can allow readers to assume Alcee is making an entrance into Calixta’s home and breaking her marital

Sunday, December 8, 2019

Rural Community Health Workers In Afghanistan

Question: Describe the Designing A Training Package Of Rural Community Health Workers In Afghanistan. Answer: Introduction and Background The greatest difficulties in conveying health services in the territory of Urozgan, Afghanistan are the lack of group health laborers, deficiency of safe conveyance practices and deficiency of female health specialists. Additionally, social standards rehearsed in the locale in addition to social hindrance confine healthiness administration in far-flung as well as separated areas of Uruzgan area, Afghanistan. It is a country, which often fights for a critical period, accomplishing the pounding of several communal structures counting their prosperity framework. Following the intercession of NATO obliges in 2003, the innovative regime in the midst of aid from its general embellishments made an essential bundle out of wellbeing services to offer associations to the overwhelming countryside regular masses; its picky focus is on nearby youths and women. The workforce to pass on these associations contains Community Health Workers (CHWs). In this article, the fact of the matter is to arrange and making a training bundle for wellbeing laborers in the provincial zones of Afghanistan. This report will delineate the method or system to develop the readiness program close by examination of progression as far as sex of the workforce. The dialogs related to this venture will perceive facilitators and troubles to the framework. For the headway of preparing system, particular subjective study is used that incorporates an examination of approach and administrative reports, all around gatherings and focus social affairs, and non-affiliate recognition. The maternal losses in town locale of the Afghanistan are over 15.9% reliably whereas the state of natural districts is substantially more awful in commonplace zones approximating Urugan area. As indicated by Arwal, (2015) the extent of motherly transience has been indicated as the most astonishing amid 1,513 passings (deaths) for each 21,555 deliveries. Alternatively, Arwal, (2015) portrayed that Afghanistan was indicated as the third most essential for seeing 148 and 256 passings for every 999 kids. An outrageous absence is there of secure transport applications as well as inadequacy of womanly-gathering Health Workers in the countryside. Communal standards put into practice in the area increase this issue of similar number of women just permitted to be in closeness of a man relative who limits their passageway to wellbeing administration. These days, there is a call for of no fewer than 5,100 birthing colleagues if 81% of birthing occurring in the countryside must be secured. There is a sensible need updates in wellbeing sharpens in Afghanistan and this wander means to tackle this necessity through researching distinctive choices open for gathering Health Workers for guidance which may be given in the area. Ayoubi Todd (2013) characterized Afghanistan as a nation that has been included in real clashes and wars that have brought about noteworthy demolition of the foundation and society of the nation. The significant annihilation and misfortune was distinguished in the wellbeing arrangement of the nation. The US drove NATO drive's mediation has driven the Afghanistan's legislature to step up and bolster the rustic populace of Afghanistan. The social insurance administrations and instructional meetings are for the most part centered to the kids and ladies of Uruzgan. The preparation bundles created for the kids and maternity care of the ladies concentrates on giving preparing, direction, investigating the sexual orientation progression and helping the rustic groups to defeat the difficulties and issues confronted in the country-side. Aims of the study The point of this examination is to build up an arrangement for a venture that includes Development of a Training Program for Rural Health Workers of Afghanistan for development in youngster and motherly social insurance administrations. This point might be accomplished by satisfying certain destinations of this examination including: Increase the accessibility of the essential health examination provided by the community health workers. Improve the training quality of the community health workers. Enhance CHWs skill and knowledge and upgrade their expertise as well as enhance their role in health promotion and general care services. Share documents, introduce general health care package and also inform about facilities and packages of the Health Services BPHS policy and guidelines Literature Review Barss (2012) referred to that since 2001; the Public Health Ministry in Afghanistan has seen demolition in the wellbeing part and organization of provision of health care. In his study, Barss, (2012) ensured that the fold of Taliban begun the hazard in addition to possible tests on upgrading the healthiness of the nation. The wellbeing coordination was hammered possibly with the diverse testing-markers who were not tended to because of the organization. Bartlett (2013) sketched out three gigantic markers, which influence the wellbeing of the countryside workforce in Afghanistan. Figure 1: Issues shaping the wellbeing of Afghanistan women As showed by Colvin (2014) the extent of motherly transience is often indicated as the most imperative amid 1,578 losses for each of the 21,550 deliveries. In contrast, Goldie (2012) exhibited that Afghanistan was the most elevated for seeing 168 going for each 1,545 in infant and child transience as of 2002. As showed by the records at Public Health Agency, the nation watched that fewer than 11% of the people were offered leeway to the health facilities. Empowering the prosperity associations was not remarkable when judged by the wellspring of the condition, which is the rising and reliable clash the nation has confronted in the years before. Unexpectedly, Goldie (2012) confirmed that the medicinal services associations and circumstance in the provincial spots at Afghanistan were upgraded at a critical rate amidst the period of 2003 to 2011. Disregarding the way that, it cannot be dismissed that the question and Taliban oversee has hit the social structure and squashed the soundness of the nation at a miserable level. The proceeding with effect of the debate has diminished the rate of pay that has understood the lower infrastructural change particularly in the rustic territories. Furthermore, the absence of the HR amidst the post fight period was seen as one of the gigantic obstruction of the change of Afghanistan. Goldie (2012) articulated that the dysfunctions of the general wellbeing part at Afghanistan reliably pulled in different NGOs (Non-Governmental Organization) to work in Afghanistan working for their own inclination. Furthermore, the qualified wellbeing staff, wellbeing workplaces and assets were not open to the provincial social event of the nation. The gathering for helping the rustic young people and ladies from beating the condition in a general sense passed on CHWs (Community Health Workers). Faiz et al., (2012) alluded to that the CHW were set up for supporting and regulating the social affairs with the formal medicinal services associations to the comprehensive group. As a freshest division of general society human services benefits, the lawmaking body has wandered up concerning present CHWs. With an aggregate people of around 30 million of multilingual and multi-ethnic individuals, Afghanistan has been considered as a nation with the insignificant HDI (Human Development Index). Regardless of that, the HDI was recorded in a general sense against the ladies in the nation. A study composed by Faiz et al., (2012) have uncovered that tip top 6% of the aggregate masses of ladies have optional preparing in the nation, notwithstanding that, 16% of the ladies individuals was recorded for acknowledging work. Hamid Skena (2014) refereed to that throughput the nation; the way of life of sexual presentation disengagement was completely tackles relying upon the urban-country unpredictability, ethnicity and financial condition. Hamid, Skena (2014) shown that amidst the Taliban and Civil war the ladies of Afghanistan were limited to value the political, cash related and social life and were introduced to their family works out. In addition, the nonattendance of standard information and overhauled data about the examination of disease transmission have made the teenagers and ladies powerless against different perishes that can be effectively killed and treated with the right asset progression healing gear. Researchers alluded to that the antibodies can block the greater part of the defilements were seen at Afghanistan. Methodology This venture has been evaluated to take up to seven months that starts from March 2016 to 14 October 2016. The underlying stage was to decide the major partners and members needed for the fruitful achievement of the venture. The outline of the research included different key territories, for example, viewpoint, and Data accumulation in addition to investigation techniques. Exploration Viewpoint The research is directed in the company of the assistance of Post-Positivism rational manner. This manner is viewed as proper for this research because it includes both uses of logic as well as a logical manner. It helps the specialist to decide the logical technique to be utilized as a part of the study alongside assurance of effect upon the prosperity of the public. Investigation Methods There are two sorts of examination technique for specific researches contemplate. The absence of information to distinguish the best possible investigation technique may come about into accumulation of wrong information hence coming about into unseemly results. The two investigation techniques are Qualitative and Quantitative. This study takes after the Qualitative technique as it includes social affair of information frame auxiliary sources implies investigation of different accessible contextual investigations and consequences of different studies identified with the specific point. Information Compilation For a specific study, two sorts of strategy there are for information accumulation. Here, the information is gathered from optional resources to distinguish the current along with the previous condition of the clinical frameworks in pastoral regions of Afghanistan. The information is being gathered in setting to each BPHS (Basic Package of Health Services) office for deciding the dynamic clinics and healthiness centers alongside rustic along with the aggregate populace. CHW Training in remote and under-served communities The CHW Training is partitioned into three primary stages. Each has three weeks of classroom and viable training, and these are isolated by times of maybe a couple months pragmatic involvement in the group. Amid these periods in the group, the coach will visit frequently to help and direct the down to earth experience of CHWs. These three stages are as per the following: Stage 1 of Training of CHW concentrates on anticipating transferable maladies and begins by encouraging the CHWs to recognize a large number of the most well-known sicknesses in the group as irresistible infections and figure out how they spread amongst individuals and how to stop the spread of these illnesses. They likewise find out about basic approaches to advance individual, family and natural cleanliness, and the significance of vaccinations. Stage 2, concentrates on advancing Maternal and Child Health and shows CHWs how they can help ladies in their groups to have healthy pregnancies and safe labor however birth readiness at home and through looking for services of group birthing specialists and making great utilization of antenatal, safe conveyance and postnatal care services at the health office. This stage likewise concentrates on showing CHWs youthful youngsters and infant care and family arranging. Stage 3 shows CHWs the abilities of perceiving and dealing with the essential adolescence sicknesses, home care and the significance of looking for gifted health mind on time. Every mentor will orchestrate CHW training sessions in gatherings of 10 to 15 CHWs. Every stage will be directed over a time of 18 days with 8 weeks interim between every stage, during which CHWs will practice what they learn. These training sessions will be held in a community setting organized by DMT in consultation with shura members. Keeping the number of CHWs being trained limited to 10 or 15 is meant to ensure focused attention during the education process, including provision of adequate time to each CHW to practice what they learn. This will not only enhance their knowledge and skills to do their job, but also build their confidence to carry out this important task. Transportation, accommodation and food costs for CHWs coming from other villages will be covered. The cost of mehrams accompanying female CHWs will also be covered. To ensure that CHW training is of good quality, AARDO and BPHS manager and its partner AARDO s staff will use an observation checklist to evaluate tra inings. Regular comprehensive feedback will be provided on overall quality of teaching, including adherence to methods in the CHW training manual; gaps in teaching; ideas for leading particular topics and/or using teaching aids; and recommendations for making changes in the lesson plan, if needed. After CHWs successfully graduate from phase 1, 2 and 3 of CHW training, they will be provided with a CHW kit. A list of trained CHWs will be provided to the BPHS implementing NGO so that they are able to guide the health facility staff to start supporting these CHWs. To ensure that CHWs continue to gain the confidence, knowledge and skills necessary to do their job, their supervising CHSs will also attend CHW trainings. This will allow CHSs to provide supportive supervision and coaching to all CHWs on a regular basis. Results or Project outcome Based the beneath audit topics for the venture were distinguished for giving substance and confirmation to shape beyond any doubt prescribed system for group wellbeing laborers preparing and strategy and substance that are effectively working for provincial group were considered. Booklet of the preparation plan, share the whole arrangement for the lesson and screen the rundown and examiners. Experience the evaluation structures and screen the gifts A usage plan is finished with Gantt diagram are appended A strategy for conveyance instructional meetings Crucial asset, (Budget of the venture, preparing plan, representatives transportation, lodging and preparing present) is furnished Sorts of arrangements incorporate getting ready for training, dealing with the hazard, as well as anticipating regulations and so on Finish a particular program and after that share proposition for execution Evaluating dangers connected with the venture and moderation. Incorporate society mapping and situational investigation. The survey points of interest are given underneath; The total number of element Basic Package of Health Services BPHS workplaces extended from 1200 to 1829 in 2011 a 66% extension. The BPHS workplaces oftentimes reports extension of more than 400%, from 1088 to 1497. The typical figure of commonplace masses for every active BPHS office reduced from 14,878 to 10,738. The amount of described element prosperity extended from 9,613 to 12,324 in similar time; a bit is a direct result of the extension in quantity of coverage workplaces; notwithstanding, subsequent to change this will regardless show an addition in prosperity centers. The whole graph exhibits the examples annually. Every figure prescribes extended entrance of the people to the organizations given by BPHS workplaces and prosperity centers. The analysis particulars are shown beneath: Figure 2: Pastoral inhabitants seeking treatment for Pneumonia annually The outline above demonstrates the detailed estimation of rural populace per BPHS office information. Each of the qualities has been escalating annually. In 2010, the aggregate estimation of rural populace seeking treatment for pneumonia was just 20%. The following year they were 40%. In 2012, the rural populace looking for the treatment increased to 60%. In the year subsequent year, they amplified to 80%, and this was a bit overwhelming for the community health workers (CHW). Figure 3: Total population seeking antibiotics for Malaria annually As indicated in the diagram, the detailed estimation of aggregate populace is seeking antibiotics for malaria. Each of the qualities appears annually. In 2010, the aggregate estimation of aggregate populace per BPHS office seeking malaria antibiotics was 23%. The following year, they were 31%. In 2012, the estimation the populace looking to alleviate malaria was 57%. Lastly, the aggregate estimation of aggregate populace in 2013 per BPHS office looking for the anti-biotic was 71%. Discussion In this area, the examinations are done to decide the current condition as well as accomplishment of the different deliverables of the venture. As indicated by the course of events produced for the venture it has progressed towards finish in any case, there are sure exercises left, for example, setting up the lesson arrangements and advancement of an arrangement to actualize the training bundle for Rural Health Workers in Afghanistan. The exercises up to conducting writing audit as well as accumulation of information have been accomplished up to this point for headway of the venture. From the preceding accomplishment of the venture deliverables, it may possibly be guaranteed that the venture is resolved to be effective in the midst of the best possible execution of the instruction bundle amid the Afghanistan Rural Health Workers. All Training Packages contain endorsed components. The government body responsible for quality assurance of the VET sector formally recognizes these parts of the Training Package. Training Package endorsed components include: Competency Units: These are depictions of the particular aptitudes and information required by people to play out a vocation to the standard expected in the working environment. Units of competency are otherwise called competency guidelines. Guidelines for evaluation /appraisal needs: These embark on the kind of proof required to affirm an individual's competency and how appraisal ought to be led. Capabilities: These are formal accreditation that a man has accomplished the skills applicable to distinguished industry or expert needs. Every Training Package contains various capabilities, made up of various units of competency, and contains runs about which units of competency can be bundled together to make every capability. Conclusions and Recommendations The preparation of the Rural Health Workers is an essential angle for accomplishment of the venture. The Rural Health Workers are to be prepared by the government association, which is dealt for usage of the guidance bundle. The center ought to be made available to pull in the group pioneers since they may help with passing on the significance of wellbeing along with usage of the guidance bundle. It will contain three rounds for three weeks including two-months of hands on work in every instruction. Rural Health Workers are to be furnished with straightforward pleasant guidebook, which comprises of wide range mindfulness on general wellbeing and in addition instructive errands. It will likewise contain different direct administrations like arranging of family, sustenance alongside enrollment of motherly and kid health. The Rural Health Workers who may effectively distinguished as fit following the guidance will begin to serve the populace. Then again, there a few hindrances that may influence extend values, for example, time lime, deficiency of important venture significant data and additionally procedure of accumulation information, thus more examinations is prescribed to comprehend personal requirements. References Arwal, S. H. (2015) Toward universal coverage in Afghanistan: a multi-stakeholder assessment of capacity investments in the community health worker system, Social Science Medicine, 145, 173-183 Ayoubi, S. F. and Todd, C. S (2013) Factors influencing the retention of midwives in the public sector in Afghanistan: a qualitative assessment of midwives in eight provinces, Midwifery, 29(10), 1137-1144 Barss, P. (2012) Midwifery training in post-conflict Afghanistan: tensions between educational standards and rural community needs, Health policy and planning, 27(1), 60-68 Bartlett, L. (2013) Midwives are the backbone of our health system: lessons from Afghanistan to guide expansion of midwifery in challenging settings, Midwifery, 29(10), 1166-1172 Burke, T. F (2013) Development of a community-based maternal, newborn and child emergency training package in South Sudan, public health, 127(9), 797-805 Burnham, G. (2012) Can community health workers increase coverage of reproductive health services. Journal of epidemiology and community health, 66(10), 894-900 Colvin, D. (2014) What motivates community health workers? Designing programs that incentivize community health worker performance and retention, Developing and strengthening community health worker programs at scale: a reference guide for program managers and policy makers. Washington, DC: USAID/Maternal and Child Health Integrated Project (MCHIP) Faiz, H., van Mierlo, B., Siddiqi, M., Komproe, I. H. (2012) Improving access to mental health care and psychosocial support within a fragile context: a case study from Afghanistan, PLoS Med, 9(5) Goldie, S. J (2012) National and sub-national analysis of the health benefits and cost- effectiveness of strategies to reduce maternal mortality in Afghanistan, Health policy and planning Hamajima N. (2014) Knowledge and practice of universal precautions among health care workers in four national hospitals in Kabul, Afghanistan, The Journal of Infection in Developing Countries, 8(04), 535-542. Hamid, N., Skena, N. B. (2014) Barriers to appropriate care for mothers and infants during the perinatal period in rural Afghanistan: a qualitative assessment, Global public health, 9 (sup1), Hashemy, P., Gohar, F., Wood, M. E., Ayoubi, S. F., Todd, C. S. (2013) Midwifery retention, coverage, and impact on service utilization in Afghanistan, Midwifery, 29(10), 1088- 1094 Hekmati, A. K. (2014) Engaging frontline health providers in improving the quality of health care using facility-based improvement collaboration in Afghanistan: case study, Conflict and Health, 8(1), 1 Howard, N., Woodward, A., Patel, D., Shafi, A., Oddy, L., Veen, A. and Roberts, B. (2014) Perspectives on reproductive healthcare delivered through a basic package of health services in Afghanistan: a qualitative study, BMC health services research, 14(1), 1 Kagoma, J., Haver, J., Brieger, W., Zoungrana, J., and Ansari, N., (2015) Experiences engaging community health workers to provide maternal and newborn health services: implementation of four programs, International Journal of Gynecology Obstetrics, 130 Khalid, S. M., Taufique, R., Habibullah, H. (2014) Does task shifting in tuberculosis microscopy services to non-certified technicians in Afghanistan affect quality? Public health action, 4(1), 56-59 Mohmand, K. A. (2013) Community Midwifery Education Program in Afghanistan, Health, Nutrition and Population (HNP) Discussion Paper, World Bank, Washington, DC. Morgan, A. (2014) What works? Strategies to increase reproductive, maternal and child health in difficult to access mountainous locations, a systematic literature review, (2) Naeem, A. J (2015) Enhancing governance and health system accountability for people centered healthcare: an exploratory study of community scorecards in Afghanistan, BMC health services research, 15(1), 1 Najafizada, S. A. M., Labont, R., Bourgeault, I. L. (2014) Community health workers of Afghanistan: a qualitative study of a national program, Conflict and health, 8(1), 1 Noormal, B. and Shadoul, A. (2014) Success in reducing maternal and child mortality in Afghanistan, Global public health, 9 Rogers, M. M (2014) Community health workers in low-, middle-, and high-income countries: an overview of their history, recent evolution, and current effectiveness, Annual review of public health, 35, 399-421 Roura, M., and Roberts, B. (2013) Implementing a Basic Package of Health Services in post- conflict Liberia: Perceptions of key stakeholders, Social science medicine, 78, 42-49 Rozario, A. (2014) Job satisfaction and retention of health-care providers in Afghanistan and Malawi, Human resources for health, 12(1), 1 Samuel, S. (2015) Importance of community engagement in primary health care: the case of Afghan refugees, Australian journal of primary health, 21(3), 262-267 Stanekzai, H. (2014) Afghanistan's basic package of health services: its development and effects on rebuilding the health system, Global public health, 9 (sup 1), S 6-S 28 Taegtmeyer, M., Broerse, J. E., Kane, S. S., Ormel, H., and de Koning, K. A. (2015) Which intervention design factors influence performance of community health workers in low- and middle-income countries? A systematic review, Health policy and planning, 30(9), 1207-1227 Zulliger, R. (2012) How effective are community health workers. An overview of current evidence with recommendations for strengthening community health worker programs to accelerate progress in achieving the health-related Millennium Development Goals. Baltimore: Johns Hopkins Bloomberg School of Public Health

Sunday, December 1, 2019

Operational Decision Making Dubal Company (Dubai Aluminum Ltd)

Company description Dubal is a major manufacturer and supplier of aluminum products. The company’s mission is to be the leading company in global aluminum production. The company also aims to lead in marketing of aluminum products by the year 2020.Advertising We will write a custom case study sample on Operational Decision Making Dubal Company (Dubai Aluminum Ltd) specifically for you for only $16.05 $11/page Learn More The company is perceived to be a major supplier of alloy products to the automotive industry. Moreover, the company also supplies billet, foundry alloys to construction, electronics and aerospace industries. The company is also renowned for producing water products through thermal desalination. The company’s major markets are located globally, with China, Europe, North America and Middle East being major market destinations. Description of operations Aluminum smelting This is the initial aluminium production process that inv olves extraction of aluminium from its oxide (Davis 1). This procedure takes place in stages, where bauxite is turned into Alumina and then through an aluminium smelter where it is eventually turned into aluminium. Raw material handling The company procures high quality materials from various parts of the world. The company sources raw materials like alumina, aluminium fluoride and calcined petroleum coke from Australia, India and the United States respectively. Sourced imports pass through Jebel Ali Port. This is because the company has storage facilities for its raw materials at the port. Moreover, the company import raw materials in bulk and later transport the materials to the manufacturing plant by road tankers. Carbon anode manufacturing This is an on-site manufacturing process. The carbon anodes are necessary for the electrolysis process used in aluminum reduction process (Kvande Haupin 29). Apparently, the company has the capacity to produce more than 380,000 carbon anodes annually.Advertising Looking for case study on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More Casting operations This is the final process of making aluminium. It entails casting molten aluminum and alloying the same with magnesium, silicon and manganese. Casting is important in adding metal properties like corrosion resistance and strength (Kaufman Rooy 1). The company’s annual casting capacity is 1.2 million tonnes of aluminium. Supply chains decisions Dubal’s supply chain takes the format of a typical Porter’s value chain. Inbound logistics Procured materials from Australia, India, and the United States pass through Jebel Ali Port, where the company has storage facilities. The presence of storage facilities at the port is critical for constant supplies, storage and transportation of materials. Operations Main operations inside the company’s manufacturing plant include aluminium manufactur ing processes. Operation managers make critical decisions on the quantity and quality of products manufactured. Outbound logistics Operation managers are required to decide the mode of transportation in delivering products and services. Decision on company transport, outsourced transport is critical. Decisions on distribution channels and delivery locations to the company’s outlets across the world are also critical. Marketing and sales Marketing and sales initiatives are globally focused. Operation managers insist on manufacturing products that are environmentally sensitive.Advertising We will write a custom case study sample on Operational Decision Making Dubal Company (Dubai Aluminum Ltd) specifically for you for only $16.05 $11/page Learn More The company uses the aspect of quality as a marketing strategy in generating demand for its products. In addition, the inclusion of competitive prices for its products and services in relation to compet itors has been integral in generating sales. Service The company treasures its relationship with the customers. In this respect, constant communication with existing customers has been an organizational culture. Moreover, the company offers value-additional services to the customer who want consultation on aluminium products and services. Procurement This is a supporting activity for the company’s supply chain primary activities. Operation managers make outsourcing decisions based on suppliers and vendors convenience, reliability and prices. Human resource management Human resource personnel are recruited on merits of skills and competence. To ensure that human resource is competent enough, the human resource manager motivates, organizes frequent training and conducts performance appraisal on staff members. Technological development The company uses information communication systems, in harnessing its operations. Operation managers have resorted to using Material Resource Pla nning (MRP) and Enterprise Resource Planning (ERP) software in making critical decisions on resource planning and allocations. Another form of information technology used is Computer Aided Designs (CAD) for purposes of manufacturing and mass production. Infrastructure Operation managers need to determine the organizational structure of the company. This means that critical support systems like accounting, procurement, transport, administration, marketing, legislative and general management are required.Advertising Looking for case study on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More Organizational support systems are critical in harnessing the flow of information and operations within the organization. Operational decisions Human resources and job design This operation decision requires identification of skills required to produce the company’s products and services. In this respect, decision on the job design and requirement is integral before recruitment of personnel. The recruitment process of human resource is also necessary to consider. This is because a flawed recruitment process may negatively affect the productivity of the organization. A decision on how to make the working environment favorable to the employee is necessary after hiring the employee. This means that the working environment should not pose health risks to the employees. Moreover, a metal manufacturing environment is highly hazardous and requires the use of protective gear while working. This should be provided to all employees. This is critical in ensuring that manufacturing of pr oducts and services achieves quality goals. Wages and salaries allocated to employees should be reasonable in relation to the amount or level of job assigned (Rynes Gerhart 16). An operation decision to decide the expected productivity from employees is crucial. In this respect, employee performance appraisal is necessary to determine whether employees are delivering to their expectations (Bowen Ostroff 217). This is the only way the company can remain highly productive and competitive among other industrial players. Productivity Productivity can be measured by finding the average output of the company’s workers (Bloom Van Reneen 1362). This requires a unit of measurement. In this respect, the company can use units of products produced as a unit of measurement. In general, productivity will be determined by total units produced in relation to input used. Input is always represented as the amount of labor used. In a manufacturing company like Dubal, outputs are considered a s workers-hours required in manufacturing a single unit product. In order to determine the production cost of a single product unit and hours required of the same, total paid hours in a month are divided by the number of units produced in the same month. Productivity can be increased through constant monitoring of operations and employees (Johnson Peter 208). A technological strategy like the use of email monitoring is necessary in evaluating employees’ attendance to responsibilities. In this case, employees are to submit daily or weekly reports on work performance. Eliminating distractions such as unnecessary meetings and watching television is also necessary. Another way to increase productivity is delegation of duties or outsourcing operations (Young Johanna 141). Making a list of activities that require priority is essential. This makes it easier for the operation manager to arrange required tools of work and amount of workforce required in completing a job. Works Cited Bloom, Nicholas and Van Reenen, John. Measuring and explaining management practices across firms and countries. The Quarterly Journal of Economics 122.4 (2007): 1351-1408. Print. Bowen, E., David and Ostroff, Cheri. Understanding HRM–firm performance linkages: The role of the â€Å"strength† of the HRM system. Academy of management review 29.2 (2004): 203-221. Print. Davis, R., Joseph. Corrosion of aluminum and aluminum alloys. Arizona: ASM International, 1999. Print. Johnston, Robert and Peter Jones. Service productivity: towards understanding the relationship between operational and customer productivity. International Journal of Productivity and Performance Management 53.3 (2004): 201-213. Print. Kaufman, J., Gilbert and Rooy L., Elwin. Aluminum alloy castings: properties, processes and applications. Arizona: ASM International, 2004. Print. Kvande, Halvor and Haupin, Warren. Inert anodes for AI smelters: Energy balances and environmental impact. Jom 53.5 (2001): 29 -33. Print. Rynes, L., Sara and Gerhart A., Barry. Compensation in organizations. New Jersey: Jossey-Bass, 2000. Print. Young, Suzanne and Macneil, Johanna. When performance fails to meet expectations: managers’ objectives for outsourcing. The Economic and Labor Relations Review 11.1 (2000): 136-168. Print. This case study on Operational Decision Making Dubal Company (Dubai Aluminum Ltd) was written and submitted by user Amelia Morin to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. 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Tuesday, November 26, 2019

Leukemia essays

Leukemia essays Leukemia is one of the most deadly forms of cancer known today. For some reason it doesn't get the amount of media attention other forms of cancer. For example, if someone has breast cancer they are much more likely to survive than a person diagnosed with an acute or chronic leukemia. I think the reason for that is because they are making much more progress on treating breast cancer then on the treatment of leukemia. There are many different types of symptoms associated with leukemia. Many of the symptoms make the person fell as if they have the flu. Many people don't go to the doctor until their leukemia is in much more advanced stages because they think they have a bad case of the flu. This greatly reduces the patient's chances of survival. The most apparent symptoms of leukemia are weakness or chronic fatigue, fever of unknown origin, weight loss that is not due to dieting or exercise, frequent bacterial or viral infections, headaches, skin rashes, nonspecific bone pain, easy bruising, bleeding from the gums or nose, blood in urine or stools, enlarged lymph node and/or spleen, abdominal fullness, and petechiae. Petechiae is the sudden appearance of small red marks on the skin. There are many different types of treatments for leukemia. The most effective treatment is chemotherapy. Bone marrow transplants are also helpful in treating leukemia. Unfortunately it is had to find a donor with the same blood type, (it usually has to be a close relative) little over half of the people that receive them survive for more than three years. Various anti-cancer drugs are used many times in combination with chemotherapy. The drugs are often antioxidants. These antioxidants stop the dividing of the cells and so the number of white blood cells goes down. There are a large number of alternative treatments to choose from. There are traditional Chinese medicine, juice therapy, homeopathy, acupuncture, meditation, gigong ...

Friday, November 22, 2019

How to Perfect Your Manuscript Submission Tips from a Publisher

How to Perfect Your Manuscript Submission Tips from a Publisher How to Perfect Your Submission: Tips From a Publisher Last updated: 07/12/2017Scott Pack is Associate Editor at  Unbound, the world's first crowdfunding publisher. He is also co-founder of  Abandoned Bookshop, an ebook imprint that publishes neglected and forgotten classics. On Reedsy he offers editorial services including developmental and structural edits, editorial reviews, critiques of query letters and submission packages as well as author mentoring. In this post, he'll share his top tips on submitting a manuscript to publishers.As a publisher, I receive a hell of a lot of submissions. That probably doesn't surprise you. What may surprise you is that around 50% of the authors who send their manuscripts to me make simple errors that drastically reduce their chances of being published. How to Perfect Your Submission  is available as an ebook from  Amazon UK,  Amazon US and all other Amazon sites. To collaborate with Scott on your next manuscript, head over to his Reedsy profile page.What has been your approach to submitting manuscripts to publishers in the past? What has the response been? Share your thoughts and experiences in the comments below.

Thursday, November 21, 2019

Permanent Pair Bonding Research Paper Example | Topics and Well Written Essays - 1750 words

Permanent Pair Bonding - Research Paper Example 227). Pair-bonds can be defined as long-term affiliation between two individuals that also includes a sexual relationship. This relationship is relatively enduring irrespective of whether it is monogamous or polygamous. Various hypotheses have surfaced regarding the evolution of human pair-bonds, with some considering it a consequence of the competition of male mating while others considering it paternal provisioning’s adaptation. This paper explores the evolution of permanent pair bonding in humans. Pair bonding is one of the most fundamental behaviors in humans like it is in all other primates and mammals. The importance of pair bonding is secondary probably only to such physiological needs as food and air. It is a natural behavior because of which it is commonly exhibited by both humans and non-human living beings, though in humans, a wide range of factors influence humans’ perceptions about and trends in pair bonding. Humans’ pair bonding patterns and behaviors are considerably different from those of other primates, humans being superior to them. Although the bond between a child and a mother in humans is homologous with the bond seen in other primates as well as mammals, yet the pair bond between a man and a woman and the pair bond between a man and a child in humans are not comparable to any terrestrial primate’s or mammals’ bonds (Immerman, 2003, p. 138). ... mother and a child in humans is similar to other terrestrial primates but the bases of affiliative bond between a man and a woman or between a child and a man is dissimilar between humans and primates. The biological explanation of the evolution of pair-bonding is explained by the research on the monogamous rodents that has led to the emergence of a neurobiological model of formation of pair-bond (Young and Wang, 2004). The neuropeptides oxytocin and vasopressin play an important role in dealing with the social cues that help in individual recognition. Reward learning and reinforcement is caused by mesolimbic dopamine. During the process of mating, dopamine receptors and neuropeptide get activated concurrently in the brain’s reward centers which leads to the conditioned preference for partner in pair-bonding. The differences observed in the tendency to develop pair bonds across different species is explained by the differential regulation of the expression of neuropeptide rece ptor. A very important perspective of the evolution of human pairing is grounded in religion. This is the perspective believed by a vast majority of people that believe in God and typically those that belong to an Abrahamic religion. It is mentioned in the religious scriptures that God made Adam and Eve as a pair and the entire generations of humans that have born ever since evolved from this first pair. For instance, in Surah Al-Nisa, it is mentioned, â€Å"O humans! Be pious (careful of your duty) to your Lord, Who created you from a single self (soul), and from it He created its mate, and from them He has spread a multitude of men and women† (Al-Nisa 4:1 cited in El-Najjar, 2007). This verse reveals about the commencement of life with one soul from which, its mate was made. Over the passage of

Tuesday, November 19, 2019

Globalization and Technological Revolution Term Paper

Globalization and Technological Revolution - Term Paper Example Organizations in the international arena typically follow low cost, low-risk entry strategies. Apart from low-risk organizations always consider the political, legal and economic factors of national environments. Accordingly, the competition for FDI would be based increasingly on cost differences between locations, the quality of infrastructure and business-related services, the ease of doing business, and the availability of skills. Organizations are attracted to FDI when they offered a competitive advantage over locals, a lower cost for labor and/or physical resources, secure access to physical resources, proximity to major markets and increased market share, Countries attract FDI if they provide certain facilities to organizations. In this regard, UNCTAD (2002) developed a 12 point criteria, named the inward FDI potential index capture several factors apart from market size (Appendix -1). Now we will analyze the case study- Ireland 2004. Starting with the concept of GDP as it refl ects the income of the people within the country; it also shows the capacity especially purchasing power of the people; it also reflects the demand for the commodities and services. As provided in the case study, the GDP per head (US$: market exchange rate) Ireland in 2003 is $ 37,911 and GDP per head (US$: Purchasing power parity) is 32, 916. Even the real GDP growth rate during 1999-2003 stood around 7.1%. Irish GDP grew at 9.9% per annum during the period 1996-2000. But the GDP growth has slowed down during 2003 due to weak global demand and several other factors. Now if we analyze Irish real GDP growth with most of the countries in Europe, US or Japan we find that GDP growth rate is much higher in Ireland in comparison to UK, France, Germany, US or Japan. So it shows that Ireland economy is expanding and the income level of people are going up which may result in an increase in demand. So companies have enough opportunities to invest in Ireland. The rate of growth of GPD over th e last 5 years when the reforms actually started is around 7-8% which could be seen as a remarkable growth rate if we compare it with other countries in the vicinity.

Sunday, November 17, 2019

Alzheimers Essay Example for Free

Alzheimers Essay Alzheimer’s disease is an irreversible, progressive brain disease that slowly destroys memory and thinking skills, and eventually even the ability to carry out the simplest tasks. In most people with Alzheimer’s, symptoms first appear after age 60. Alzheimer’s disease is the most common cause of dementia among older people. Dementia is the loss of cognitive functioning—thinking, remembering, and reasoning—and behavioral abilities, to such an extent that it interferes with a person’s daily life and activities. Dementia ranges in severity from the mildest stage, when it is just beginning to affect a person’s functioning, to the most severe stage, when the person must depend completely on others for basic activities of daily living. What are the stages of Alzheimer’s? There are five stages associated with Alzheimers disease: preclinical Alzheimers disease, mild cognitive impairment, mild dementia due to Alzheimers, moderate dementia due to Alzheimers and severe dementia due to Alzheimers. 1.Preclinical Alzheimers disease Alzheimers disease begins long before any symptoms become apparent. This stage is called preclinical Alzheimers disease. You wont notice symptoms during this stage, nor will those around you. This stage of Alzheimers can last for years, possibly even decades. Although you wont notice any changes, new imaging technologies can now identify deposits of a substance called amyloid beta that have been associated with Alzheimers disease. The ability to identify these early deposits may be especially important as new treatments are developed for Alzheimers disease. 2.Mild cognitive impairment (MCI) due to Alzheimers disease People with mild cognitive impairment have mild changes in their memory and thinking ability. These changes arent significant enough to affect work or relationships yet. People with MCI may have memory lapses when it comes to information that is usually easily remembered, such as conversations, recent events or appointments. People with MCI may also have trouble judging t he amount of time needed for a task, or they may have difficulty correctly judging the number or sequence of steps needed to complete a task. The ability to make  sound decisions can become harder for people with MCI. Not everyone with mild cognitive impairment has Alzheimers disease. In some cases, MCI is due to depression or a temporary medical complication. The same procedures used to identify preclinical Alzheimers disease can help determine whether MCI is due to Alzheimers disease or something else. 3.Mild dementia due to Alzheimers disease Alzheimers disease is often diagnosed in the mild dementia stage, when it becomes clear to family and doctors that a person is having significant trouble with memory and thinking. In the mild Alzheimers stage, people may experience: Memory loss for recent events. Individuals may have an especially hard time remembering newly learned information and repeatedly ask the same question. Difficulty with problem-solving, complex tasks and sound judgments. Planning a family event or balancing a checkbook may become overwhelming. Many people experience lapses in judgment, such as when making financial decisions. Changes in personality. People may become subdued or withdrawn — especially in socially challenging situations — or show uncharacteristic irritability or anger. Decreased attention span and reduced motivation to complete tasks also are common. Difficulty organizing and expressing thoughts. Finding the right words to describe objects or clearly express ideas becomes increasingly challenging. Getting lost or misplacing belongings. Individuals have increasing trouble finding their way around, even in familiar places. Its also common to lose or misplace things, including valuable items. 4.Moderate dementia due to Alzheimers disease During the moderate stage of Alzheimers, people grow more confused and forgetful and begin to need help with daily activities and self-care. People with moderate Alzheimers disease may: Show increasingly poor judgment and deepening confusion. Individuals lose track of where they are, the day of the week or the season. They often lose the ability to recognize their own belongings and may inadvertently take things that dont belong to them. They may confuse family members or close friends with one another, or mistake strangers for family. They often  wander, possibly in search of surroundings that feel more familiar and right. These difficulties make it unsafe to leave those in the moderate Alzheimers stage on their own. Experience even greater memory loss. People may forget details of their personal history, such as their address or phone number, or where they attended school. They repeat favorite stories or make up stories to fill gaps in memory. Need help with some daily activities. Assistance may be required with choosing proper clothing for the occasion or the weather and with bathing, grooming, using the bathroom and other self-care. Some individuals occasional ly lose control of their urine or bowel movements. Undergo significant changes in personality and behavior. Its not unusual for people with moderate Alzheimers to develop unfounded suspicions — for example, to become convinced that friends, family or professional caregivers are stealing from them or that a spouse is having an affair. Others may see or hear things that arent really there. Individuals often grow restless or agitated, especially late in the day. People may have outbursts of aggressive physical behavior. 5.Severe dementia due to Alzheimers disease In the severe (late) stage of Alzheimers, mental function continues to decline and the disease has a growing impact on movement and physical capabilities. In severe Alzheimers, people generally: Lose the ability to communicate coherently. An individual can no longer converse or speak coherently, although he or she may occasionally say words or phrases. Require daily assistance with personal care. This includes total assistance with eating, dressing, using the bathroom and all other daily self-care tasks. Experience a decline in physical abilities. A person may become unable to walk without assistance, then unable to sit or hold up his or her head without support. Muscles may become rigid and reflexes abnormal. Eventually, a person loses the ability to swallow and to control bladder and bowel functions. Treatment: Alzheimer’s disease is complex, and it is unlikely that any one intervention will be found to delay, prevent, or cure it. That’s why current approaches in treatment and research focus on several different aspects, including  helping people maintain mental function, managing behavioral symptoms, and slowing or delaying the symptoms of disease. Maintaining mental function Four medications are approved by the U.S. Food and Drug Administration to treat Alzheimer’s. They may help maintain thinking, memory, and speaking skills, and help with certain behavioral problems. However, these drugs don’t change the underlying disease process, are effective for some but not all people, and may help only for a limited time. Managing Behavioral Symptoms Common behavioral symptoms of Alzheimer’s include sleeplessness, agitation, wandering, anxiety, anger, and depression. Scientists are learning why these symptoms occur and are studying new treatments—drug and non-drug—to manage them. Treating behavioral symptoms often makes people with Alzheimer’s more comfortable and makes their care easier for caregivers. Slowing, Delaying, or Preventing Alzheimer’s Disease Alzheimer’s disease research has developed to a point where scientists can look beyond treating symptoms to think about addressing underlying disease processes. In ongoing clinical trials, scientists are looking at many possible interventions, such as immunization therapy, cognitive training, physical activity, antioxidants, and the effects of cardiovascular and diabetes treatments. Alzheimer’s References http://www.alz.org/alzheimers_disease_what_is_alzheimers.asp http://www.nia.nih.gov/alzheimers/publication/alzheimers-disease-fact-sheet http://www.mayoclinic.org/diseases-conditions/alzheimers-disease/in-depth/alzheimers-stages/art-20048448?pg=1 https://www.alz.org/what-is-dementia.asp http://umm.edu/health/medical/reports/articles/alzheimers-disease

Thursday, November 14, 2019

gender and prestige :: essays papers

gender and prestige The purpose of this essay is to show embeddedness of prestige system into subsystems of the cultures. We will discuss four cultures which represent four different types of social organizations; !Kung San represents band organization, Mundurucu represents village type, Polynesia - Chiefdom, and Andalusia represents state type of social organization. In all of these cultures prestige system, which is the gender system, is imbedded into other subsystems. Three of these cultures: Mundurucu, Polynesia, and Andalusia, have hierarchical type of ideology, meaning in this culture males have more power then females. !Kung San culture, on the other hand, has egalitarian type of ideology, where there is no significant difference in power between males and females. We first start by defining prestige system, which consists of prestige itself. Prestige is level of respect at which one is regarded by others. Every person in prestige system has status, by which other people value your prestige. Status it determined by following factors: economical, political, personal, and historical. When we talk about the prestige system we have to say that prestige system is supported by ideology, and since cultures have different ideologies, the prestige systems vary from one culture to another. Polynesia, discussed by Sherry Ortner, consists of large numbers of islands in the Pacific Ocean, which include Hawaii, Samoa, Tahiti, and many more. The islands in their majority have the same prestige system. The prestige systems in Polynesia is the system of hereditary ranking which is embedded in political system, kinship system, and economic system. The type of social organization in Polynesia, as we mentioned above, is chiefdom. Chiefdom is characterized by numbe r of villages, where each village has its own chief, and the whole village system has one chief, higher in rank then other chiefs. This fact is important when we discuss the embeddedness of prestige system in the political system. Every village, that is the part of the chiefdom, has a goal to get on the top of the symbolic pyramid, with main chief and fono, the governing council, on the top. Sometimes, statuses can be brought higher with the right type of marriage, however, most of the villages have endogamy type of marriages, meaning the spouse comes from inside of the village. In case of exogamy marriage, where spouse comes from outside, the groom's family will have to share part of the land with the bride's family.

Tuesday, November 12, 2019

Environmental pragmatism Essay

Pluralism, environmental pragmatism and eco feminism represent differing perspectives on the subject of moral ethics. The paper seeks to look into the details surrounding some of these issues and comparisons between them will be made. Major principles As the name suggests, eco-feminism refers to a merger between feminism and environmentalism. In other words, the term refers to a social movement that connects female oppression and the degradation of nature to similar attitudes that are related to masculine domination. The latter principle asserts that there must be some sort of interrelation between women, race, class and the environment. While the oppression of women may be the main concern within this field of study, eco feminism asserts that environmentalism, animal rights, class struggles, age oppressions, human supremacism and racism all have one thing in common; they all signify oppression driven by the same social mentality. (Thoma-Slayter & Rocheleau, 1995) One of the most interesting aspects about eco feminism is that this particular movement has merged thoughts and views in seemingly different fields to come up with a comprehensive analysis of current environmental problems. Eco feminists assert that male land ownership has led to patriarchy hence resulting in a manifestation of the following environmental problems †¢ Viewing animals and land as material resources †¢ Abusing land †¢ Exploiting people †¢ Overgrazing †¢ Excessive food export even when local residents lack adequate food The latter adherents also propose that this abuse of land and environmental degradation has eventually led to female oppression. Such an assertion was made by Thoma-Slayter, B. & Rocheleau, D. (1995) in their book â€Å"Gender, Environment and Development in Kenya† McMillan. The latter authors illustrated how exports in this East African country have been driven by a capitalist culture that has led to soil erosion, deforestation, excessive pesticide use and less productive land. In the end, families have been forced to move from such areas and this is especially visible among the women. Other authors claim that the reason why nature has been undergoing excessive degradation is because nature has been treated as something that is only valuable if it has material benefits. Again, such proponents claim that this is the same view held about women; that they have little value since they are not the major wealth creators. However, eco-feminists assert that such beliefs are quite misleading owing to the fact that nature is still useful even without man’s interference. An example of such a perspective is when one analyzes a forest. The former attitude would assume that a forest is useful for fuel, food and the like. However, even without tampering with it, a forest can still be useful in terms of protecting ground water, circulating oxygen or providing a habitat for other animals. On the other hand environmental pragmatism is founded on the beliefs held within pragmatism; that there is no absolute truth in the process of seeking for knowledge. Instead, pragmatists assert that there are only relatively stable ones that assist people in the process of making sense of their world and their surrounding. Experience plays a central role in pragmatism because through it one can either affirm or reject previously held beliefs about how their world works. Given this background, then it is possible to understand some of the perspectives put forward by environmental pragmatists. The latter school of thought put forward the idea that the environment forms a central part of our experiences. Consequently, it needs to be held in high regard. It asserts that every part of the environment needs to be treated with as much seriousness as the next. For instance, oceans are jut as important as deserts or just as important as buildings and bridges. (Lucas, 2002) Environmental pragmatism rejects the notion that man can dominate the earth. Since nature is an important part of one’s experience, then it is essential for man to look for the most feasible ways of co-existing with nature. In fact, adherents to this philosophy claim that understanding or cultivating meaning in the earth is quite crucial, however, imagining that man can do anything with nature without dealing with any consequences is self defeating. Additionally, the latter adherents put forward the notion that exerting care within the environment is a crucial element in preserving it. They claim that in the process of determining what constitutes good things or what constitutes right things, it is indeed necessary for human beings to implement environmental ethics through the foundations of certain beliefs and ideas. One can therefore assert that environmental pragmatism has elements of interrelatedness with other concepts. In this regard, there is a connection between eco feminism and environmental pragmatism owing to the fact it refers to the concept of caring for one’s environment. Environmental pragmatism also brings in new concepts of environmental philosophy owing to the fact that it opposes the notion of trying to decide constituents of value. In other words, the latter adherents claim that it is impossible to determine whether man holds greater precedence over nature. Instead, both issues need not be treated as mutually exclusive as they both need one another. (Lucas, 2002) Pluralism on the other hand refers to the acceptance of diversity of thought within ethical endorsements. Adherents to this school of thought claim that it is possible for different perspectives to exist within a particular ethical system owing to the fact that morality is an ensemble of many things. This means that nature as it is cannot provide an underlying and thoroughly conclusive explanation for things; consequently, it is best to settle for a series of explanations that can provide a more comprehensive framework for these matters. In this regard, pluralism can be related to eco feminism owing to the fact that the latter theory attempts to merge concepts from different fields. Additionally, environmental pragmatism is another form of pluralism because in the former philosophy, there is the belief that there is more than one way to understand nature. Pluralism can occur in three forms i.e. †¢ First order †¢ Second order †¢ Third order In first order pluralism, environmentalists believe that the value in something can be described in more than one way i. e. beauty, diversity etc. In second order pluralism, there is the belief that nature can be described in so many ways that there is no single method that is appropriate. In third order pluralism, there is the belief that other views should be tolerated because it is almost impossible to account for forms of value within nature. In this regard, pluralism advocates for an overlap of explanations. (Lucas, 2002) Conclusion Eco feminism is the view that falls in line with my belief system owing to the fact that it is the most practically rooted environmental theory. Additionally, its interrelatedness with other concepts is less abstract than in pluralism or environmental pragmatism. The latter two theories are quite related because of their adherence to multiplicity of beliefs. References Lucas, P. (2002): Environmental ethics – between inconsequential philosophy and unphilosophical consequesialism; Journal of environmental ethics, 24, 353-369 Rocheleau, D. (1995): Gender, Environment and Development in Kenya; McMillan.

Saturday, November 9, 2019

Ambition Essay 11

?Ambition Nowadays, many people think ambition is antisocial, it is never a pretty prospect to ponder. But in my opinion, ambition is important and necessary for our society. Ambition is a fundamental skill of accumulating power and living a good life. It produces action. It makes choice possible. It is a narrative or context of concerns and commitments that brings forth moods of passion, assessments of situations and actions, strategies and tactics, requirements for power, and skill. What if a person does not have an ambition? A person without ambition has no commitment to take care of their future. They may want, desire or prefer a good future, but they lack commitment to do so. They do not act in the present to produce favorable consequences in the future. And to think of it, what the world will be like without ambition? The highly developed society hangs back and new invention disappears. New discovery vanishes. All of which human beings creates will never come to our life. That's an unbelievable phenomenon. So in my opinion, ambition is so important and necessary for both individuals and our society that we will never abandon falling in it. To begin with, I think if one's ambition is greater than the others, he or she will get more at last. For example, In the Three States conflicts, a famous leader named Cao Cao, whose ambition is to climb up to the summit of great rights. Through a list of methods such as absorbing some knowledgeable person makes him succeed finally. Secondly, some ambitious ideas contribute to the success of our society. If we don't dream flying like the bird, we'll never invent the plane. f we don't want to stay in the waters for a long time, we'll never make the first submarine. If we don't want to step on the moon, we'll never create the spaceship. Ambition is like a flower, whose smell is so sweet that lure people to get it. Ambition is like a hawking, whose expectation is to fly high and high to the blue sky. If a person doesn’t have ambition, his life will be dull. If a person doesn’t have ambition, his colorful world will fade. a person don't have ambition, he will achieve nothing. Someone will say, ambition may be destroy the building of modern moral society, which built by our ancestor. To the contrary, it's because of the ambition that the building could be existed. I don't think that someone is an ambitious person is wrong. In a word, I am totally agree that ambition propels our life and make our world go around. It's so important and necessary that we'll all have to stick to it if we want to make a difference.

Thursday, November 7, 2019

Free Essays on Civil Rights 1964

in 1964, a month and a day before the historic Civil Rights Act of 1964 would be signed into law by President Lyndon B. Johnson. She speaks for the mood of a race, a race that for centuries has built the nation of America, literally, with blood, sweat, and passive acceptance. She speaks for black Americans who have been second class citizens in their own home too long. She speaks for the race that would be patient no longer that would be accepting no more. Mrs. Hamer speaks for the African Americans who stood up in the 1950's and refused to sit down. They were the people who led the greatest movement in modern American history - the civil rights movement. It was a movement that would be more than a fragment of history, it was a movement that would become a measure of our lives (Shipler 12). When Martin Luther King Jr. stirred up the conscience of a nation, he gave voice to a long lain dormant morality in America, a voice that the government could no longer ignore. The government fin ally answered on July 2nd with the Civil Rights Act of 1964. The Civil Rights Act of 1964 is historically significant because it stands as a defining piece of civil rights legislation, being the first time the national government had declared equality for blacks. The civil rights movement was a campaign led by a number of organizations, supported by many individuals, to end discrimination and achieve equality for American Blacks (Mooney 776). The forefront of the struggle came during the 1950's and the 1960's when the feeling of oppression intensified and efforts increased to gain access to public accommodations, increased voting rights, and better educational opportunities (Mooney... Free Essays on Civil Rights 1964 Free Essays on Civil Rights 1964 When the Government Stood Up For Civil Rights "All my life I've been sick and tired, and now I'm just sick and tired of being sick and tired. No one can honestly say Negroes are satisfied. We've only been patient, but how much more patience can we have?" Mrs. Hamer said these words in 1964, a month and a day before the historic Civil Rights Act of 1964 would be signed into law by President Lyndon B. Johnson. She speaks for the mood of a race, a race that for centuries has built the nation of America, literally, with blood, sweat, and passive acceptance. She speaks for black Americans who have been second class citizens in their own home too long. She speaks for the race that would be patient no longer that would be accepting no more. Mrs. Hamer speaks for the African Americans who stood up in the 1950's and refused to sit down. They were the people who led the greatest movement in modern American history - the civil rights movement. It was a movement that would be more than a fragmen t of history, it was a movement that would become a measure of our lives (Shipler 12). When Martin Luther King Jr. stirred up the conscience of a nation, he gave voice to a long lain dormant morality in America, a voice that the government could no longer ignore. The government finally answered on July 2nd with the Civil Rights Act of 1964. The Civil Rights Act of 1964 is historically significant because it stands as a defining piece of civil rights legislation, being the first time the national government had declared equality for blacks. The civil rights movement was a campaign led by a number of organizations, supported by many individuals, to end discrimination and achieve equality for American Blacks (Mooney 776). The forefront of the struggle came during the 1950's and the 1960's when the feeling of oppression intensified and efforts increased to gain access to public accommodations, increased voting rights, and better educational opportunities (Mooney...

Tuesday, November 5, 2019

Difference Between a Book Report and A Book Review

Difference Between a Book Report and A Book Review The difference between book report and book review is critical, so you have to pay close attention to what you are expected to come up with: if you need to sum up and enumerate, youre in for a book summary (book report), but if you need to analyze, you want to write a book review. There is a great deal of confusion when it comes to discussing book reports and book reviews. As a matter of fact, these two terms keep used quite interchangeably, while a deeper dig-in shows some principal differences between the two. If you submit a book report and you were asked to write a book review, your grade is most likely to go down. The opposite situation, i.e. when you submit a book review instead of a book report, may also entail adverse consequences. Book review writing is believed to require greater intellectual effort than book reports, thats why your marker will most likely forgive you this mistake. HOW TO WRITE A BOOK REVIEW Speaking of differences, first of all, you will have to understand that a book report is simpler (a more primitive if you will) kind of writing, where you have to narrate re-tell the story. A book report is practically identical to a book summary  and they can be used interchangeably. In contrast,  a book review requires you to analyze the book and see beyond the obvious. In it, you will need to examine its contents, understand the plot, the main message of the book, see if the author has managed to convey the message to the reader; you will also have to state strong and weak sides of the book and say whether or not you like it. More differences between the two terms are as follows: LENGTH.  Book report will usually take 200-250 words. Book reviews will range from 200 words if its a simple book to 1000+ words if its a piece of scholarly literature that needs thorough analysis and evaluation. ACADEMIC LEVEL.  Book report is considered to be a K-12 level assignment. Book review is more of a college-level type of assignment. STRUCTURE.  The structure of two papers resemble one another: first off, you would need to introduce the author, the book, state when and who the book was published by. You would need to mention characters, mention the plot, genre, and major themes. MESSAGE.  If you write a book report, you would need to simply sum up the book plot, characters, state major themes and say a few words about the major characters. If you are writing a book summary, the main idea is to say whether or not you like the book, whether or not you would recommend this book to other readers and why. HOW TO WRITE A BOOK REPORT Either of these assignments is generally easy to write, however, each has its own nuances that you need to know. If you have either a book report or a book review to write, feel free to contact us for assistance and we will be happy to help. Our team of professional writers will be glad to help you through book report or book review writing. In the end of our cooperation, you will have learned how to tackle these assignments effectively and ace your assignments.

Sunday, November 3, 2019

Bullying Essay Example | Topics and Well Written Essays - 2000 words - 2

Bullying - Essay Example Bullying is still widely prevalent across many schools in the US according to recent statistics. This form of behavior has a negative impact on those who are being victimized and also promotes aggressive and violent behavior among those who take on the role of a bully. Bullying can have several physical, social, emotional and psychological consequences on those who are being victimized (Bullying Overview, 2014). Bullying which was thought to have originated in Scandinavia is now widespread in many countries around the world including the United States, Australia, Canada, Japan and the United Kingdom (Olweus, 2001). In the United States, several policies and laws are being implemented in schools across the country to prevent and protect children from the effects of bullying (Analysis of State Bullying Laws and Policies, 2011). School authorities play a major role in implementing and coordinating the various anti-bullying policies and laws along with the support of teachers, parents an d support staff such as practicing school psychologists. The main objectives of the anti-bullying policies in schools involve establishment of a school mission statement, code of conduct and a student bill of rights. Any updates on the policies need to be incorporated in the school rules and passed on to the staff, students and parents. These policies provide a means of early intervention in preventing bullying and they do not propose any kind of harsh punishments to those who involve in bullying their peers. Instead it recommends using a restorative justice approach in correcting the behavior of the perpetrators and offers suitable counseling to them as well as to those who have been victimized (Bullying, n.d; Sherer & Nickerson, 2010) 5. Analysis of these policies has revealed that they have been effective in reducing the rate of bullying in schools (Effective Evidence -based Practices, n.d). Bullying, which is defined as repeated exposure to

Thursday, October 31, 2019

Diversion Is Better than Prison Assignment Example | Topics and Well Written Essays - 250 words

Diversion Is Better than Prison - Assignment Example Diversion Is Of Great Importance To The Child, The Criminal System, And The Society In General. Diversion Is Of Great Importance To The Child, The Criminal System, And The Society In General. Mistakes are made, anger is sometimes not controlled properly and at the end crime is done. Many young offenders fall into criminal activities for various reasons: peer pressure, broken homes, drug addiction, and many more vices. To admit fault is a bold step in life and that is one of the key requirements for diversion.  Diversion is â€Å"the halting or suspension before conviction of formal criminal proceedings against a person, conditioned on some form of counter-performance by the defendant.†(Geroge, 1984) therefore, this gives an undeserving second to young offenders where the criminal justice system is being fair in giving such services. The criminal justice system not only gives a second chance to the offenders but also reduces to the minimum the rate of crime and the rule of la w is perfectly placed in the hearts of its citizens. Law enforcement is the practical use of the rule of law and diversion makes every individual respect the law and law enforcement officers. Diversion is justified and backed by law enforcement it is a fear means of handling crime. Diversion is cost effective as it promotes the use of community service, making a potential criminal a better person, preventing future crime, bringing to a minimum the cost of building more prisons, and saves a lot of possible future crime.

Tuesday, October 29, 2019

Girl in a Mirror Research Paper Example | Topics and Well Written Essays - 750 words

Girl in a Mirror - Research Paper Example His works include art collection inspired from the works of Renaissance, Baroque and Rocco artists (Gottileb, The Journal Of Aesthetics & Art Criticism.). The uniqueness in Picasso’s work existed not in the discovery of new themes, but in the way he portrayed the existing stuff. Picasso not only popularized the art of Cubism by combining geometrical shapes and abstract forms, but also was a believer of symbolism like the famous quote he said that â€Å"It is not necessary to paint a man with a gun. An apple can be just as revolutionary†. Picasso gave a new dimension to cubist paintings by adding human emotions to the multi faceted figure. With time Picasso experimented with Synthetic Cubism and included human forms and events with his symbolic styles. Picasso painted many women that came in his life, his famous painting â€Å"Girl before a Mirror† is from the series of paintings he made with the model Marie-Therese Walter. Marie was very young when she met Picass o, and served as his mistress for many years. The particular painting â€Å"Girl before a Mirror†, was painted during Picasso’s cubism period and reflects his bold display with forms and colors. The painting is based upon a girl looking herself in the mirror, but the reflection she sees is in complete contrast to herself. The painting represents Picasso’s style and highlights an image of vanity. ... The beautiful almond shape of her eyes is transformed into deep maroon circles. Her forehead and the upper part of the nose are in bright red color. This distortion of her reflection makes her look ethereal and fearsome (Gottileb, The Journal Of Aesthetics & Art Criticism.). The face of the girl is composed in two parts; the profile section is in lavender pink with slight blush on the cheek while the frontal view of her face is like a crescent shaped moon with bright yellow color with makeup such as lip stick and green eye shadow applied to it. Similarly the body of the girl is also formed in two parts which visually complement each other. These are the profile and front figure. If we see closely, there are dark black thick lines on light green base in the profile section and red curvilinear lines in the front. These might represent the ribs and vertebrae of the girl seen through flesh (Gottileb, The Journal Of Aesthetics & Art Criticism.) â€Å"Girl in a Mirror† depicts the v anity of a woman and sees herself as a death’s head. It shows Marie Walter’s self during the day and at night, it also highlights her transition from a young innocent girl to a woman who is conscious of her sexuality. The mirror in which the girl sees her reflection is device through which we can look into her sole and inner mysteries and ambiguities. The face of the girl in the reflection is dark with hollow eyes. The feminine contours of her body are twisted and knotted. Her reflection seems older and withered. The girl reaches out to unite and embrace herself with her reflection and is in an effort to become whole. The differences in the girl’s reflections can also suggest to the fact that she is anxious and

Sunday, October 27, 2019

Description of a Maintenance Organisation

Description of a Maintenance Organisation Description of a Maintenance Organisation with Suggested Developments to Improve Cost Effectiveness    Table 1: Key Terms and Abbreviations Term / Abbreviation Definition CM Corrective Maintenance CMMS Computerised Maintenance Management System DCC Dublin City Centre FM Facilities Manager FT Facilities Technician GO General Operator HR Human Resources IFM Integrated Facilities Management IR Industrial Relations IT Information Technology KPI Key Performance Indicator NSC National Services Centre OCS One Complete Solution or Outsourced Client Solutions PM Preventive Maintenance RIME Ranking Index for Maintenance Expenditures TUPE Transfer of Undertakings (Protection of Employment) WIOF Water Industry Operating Framework WO Work Order This report provides analysis of the Ervia Facilities department and investigates options for improving cost effectiveness. Ervia is Irelands biggest utility provider and has 2,000 office based employees in 19 locations across the country. Ervia has availed of the Integrated Facilities Management (IFM) model for delivery of maintenance with OCS Management Services being the chosen provider. The cost to Ervia of this service is  £3,000,000 per annum. This 3 year contract is set to expire at the end of 2017. Industrial relations (IR) Mention overall savings expected.  £500,000 in total with a  £100,000 reduction of the IFM contract value. The Maintenance Organisation that I have chosen to base this report on exists within the facilities department of Ervia. Ervia is Irelands biggest utility provider. It is a semi-state body, formed in 2014 and is the parent company of Irish Water and Gas Networks Ireland. Through its business, Aurora Telecom, it is also a provider of dark fibre broadband infrastructure. A Shared Services business unit was created within Ervia that comprises of Facilities, Human Resources (HR), Information Technology (IT), Accounts Payable, Procurement and Major Projects departments. Shared Services would count Irish Water and Gas Networks Ireland as de facto customers. The Facilities department are responsible for the maintenance and upkeep of 19 offices throughout Ireland. There are some 2,000 employees working from these offices. Site security, cleaning, catering, capital projects and fleet management also fall within the remit of the department but for this report, we will focus solely on the maintenance of the office buildings. The maintenance or hard services of the offices is outsourced to the IFM company, OCS Management Services as part of a 3 year contract that is due to expire at the end of 2017. OCS Management Services is part of the wider OCS group. The acronym was originally defined as Office Cleaning Services but is now interchangeably explained as being either One Complete Solution or Outsourced Client Solutions. It has a truly global reach with operations in over 50 countries and provides a full range of facilities related services. For simplicity, we will refer to the OCS Management Services team as OCS for the remainder of this report. The changes I suggest will be recommended for implementation at the beginning of the next IFM contract in January, 2018 and will involve structural overhaul of both Ervia and OCSs facilities maintenance teams. This next IFM contract is set to last 5 years. 2.1 Office Locations One of the main challenges for managing maintenance on the Ervia contract is the geographical spread with offices dotted throughout the country. See Figure 1 for all office locations. It would be far easier to deliver Facilities service if the office staff were more centrally located but being a national utility, Ervia must tie in with the multitude of county and city councils spread throughout the country. Figure 1: Ervia Offices Locations Figure 1 shows the locations of Ervia offices throughout Ireland. 2.2 Contract Value The hard services maintenance contract comes at a cost of  £3,000,000 per year to Ervia. It is based on a Cost Plus model i.e. all Preventive Maintenance (PM) is delivered as part of the contract value with Corrective Maintenance (CM) activities charged as additional costs. Additional costs can accumulate up to a value of  £500,000 per year. 2.3 Work Quantities and Types Facilities maintenance differs from industrial maintenance in that items that require attention may be observed by either office or maintenance staff. Office staff will generally tend to report less serious matters, while maintenance staff typically report the issues which require more urgent attention. In order to separate the noise of often trivial matters observed by office staff from the technical issues observed by maintenance staff, Ervia has developed an Incident Management process. Issues are raised by the office staff using an online incident management system. The raised incidents are dealt with by the maintenance staff along the following lines: If the item involves a non-technical fix e.g. increase in room temperature or lubricating a squeaking door hinge, the incident can be closed once this action is completed. If the item requires a technical fix e.g. a water leak or failed light fitting, the incident is escalated by raising a CM Work Order (WO) in the Computerised Maintenance Management System (CMMS). Equipment running issues or breakdowns are raised directly as CM WOs in the CMMS by Facilities staff. In terms of PM, there are 903 schedules across the Ervia office portfolio. These in turn generate multiples of weekly and monthly PM WOs. The following charts break out the annual mix of maintenance activities by types, quantities and whether they are actioned through self-delivery or out-sourcing. Figure 2: Quantities of Maintenance Activities by Type Figure 2 shows the various types and approximate quantities of Maintenance Activities that are raised annually within the Ervia Facilities department. Figure 3: Self Delivered v Outsourced Maintenance Activities Figure 3 shows the percentage split in terms of delivery of Maintenance Activities. Figure 4: Ervia Organisation Chart Figure 4 displays the Ervia maintenance team Organisation Chart. The 6 employees in the above chart are the Ervia staff in the Facilities department that have responsibility over the maintenance function. There are other staff in the department but we will only consider the above for this report. The Systems Engineer, despite the implication in the job title, sits at a middle management level and is considered to be a peer of the Facilities Managers. The General Operator (GO) stands out as being the only person of that rank that is a member of the Ervia team. The GO in question is a long serving staff member of Gas Networks Ireland and chose not to transfer to OCS when the first IFM contract was awarded. This situation presents a complication as the GO will not take direction from OCS staff and instead all orders have to be channelled through the NSC Regional Sites Facilities Manager. Figure 5: OCS Organisation Chart Figure 5 displays the OCS maintenance team Organisation Chart (based on the Ervia FM contract). The 24 employees in the above chart are the OCS staff that are embedded on the Ervia IFM contract. All roles are subject to Transfer of Undertakings (Protection of Employment) (TUPE) regulations and will move to the new service provider should OCS not be successful in their efforts at contract renewal in 2018. As with Ervia, the OCS Systems Engineer sits at a middle management level and is considered to be a peer of the Facilities Managers. We can see from the above chart that the DCC Facilities Manager has a far bigger team at his disposal than the other mangers. This is because over half of the Ervia office staff are situated in the buildings within his remit. In isolation, the Ervia and OCS organisation charts seem to represent an acceptable scenario. However when we combine them in Figure 6, we can instantly see that improvement steps need to be taken. There is obvious duplication of roles at Facilities Manager and Systems Engineer level. Dual reporting is also apparent with the OCS Facilities Managers and Systems Engineers having to answer to both Ervia and OCS management. Figure 6: Combined Ervia and OCS Organisation Chart Figure 6 displays the Combined Ervia and OCS maintenance team Organisation Chart. The above Organisation Chart may in parts seem both confusing and utterly unbelievable, especially when linking the OCS structure to Ervia. The aim of Table 2 is to further explain the duality of the reporting structure. Table 2: OCS to Ervia Reporting Structure OCS Staff Members Report To OCS Senior Key Account Manager Ervia National Facilities Operations Manager NSC Facilities Manager OCS Senior Key Account Manager Ervia NSC Regional Sites Facilities Manager Regional Sites Facilities Manager OCS Senior Key Account Manager Ervia NSC Regional Sites Facilities Manager DCC Facilities Manager OCS Senior Key Account Manager Ervia DCC Facilities Manager Southern Region Facilities Manager OCS Senior Key Account Manager Ervia Southern Region Facilities Manager Systems Engineer OCS Senior Key Account Manager Ervia Systems Engineer The most remarkable fact about this combined structure is that, somehow, it actually works. It can be safely said that it is both collaborative and operationally effective. Even though each mid-level manager has two persons to report to, somehow the contract proceeds with very little conflict to the extent that at times the relationship between Ervia and OCS has been described as incestuous! However it is clear that it could not be effective from a cost perspective. For instance there are more managers than technicians. The superfluous layer of middle management will be the initial focus when it comes to suggesting improvements in cost effectiveness. From the above we can also conclude, with certainty, that operational efficiency requires improvement. For example, if any of the OCS Facilities Managers or Systems Engineer needs approval to take an action, they will have to seek this from two persons. This can turn into a game of ping-pong as the approving managers may not initially agree on the same course of action. Usually in this scenario, the Ervia approving managers opinion will prevail due to the customer is always right philosophy. The structure as portrayed in Figure 4 is not unknown in the Irish semi-state/public sectors where there have long been accusations by print and broadcast media of wasteful spending (McConnell, 2015). It is a fair question to ask as to how this situation developed. Among the reasons are: As Ervia came into being by virtue of decisions made at government level, the result was the virtual overnight creation of the biggest utility company in Ireland that had rapidly expanding responsibilities. Employees transferred from the Gas Networks Ireland Facilities department to Ervia without an assessment being made on whether they were required or not. Because of the above, it was more pressing at the time to simply get a Facilities department up and running without considering the most efficient means of doing so. 6.1 Phase 1 Development Losing Fat in the Midsection Figure 7: Proposed Phase 1 Combined Ervia and OCS Organisation Chart Figure 7 displays the Proposed Combined Ervia and OCS maintenance team Organisation Chart at the Phase 1 level of development. We can see in Figure 7 that the structure looks less convoluted and is starting to develop a balance. The first task in this development will be to remove the duplicate layer of middle management. The second task will be to change who the Ervia GO reports to. The following two actions will have to be taken to enable this: The Ervia Facilities Managers and Systems Engineer roles will have to be made redundant. The Ervia GO will have to transfer to OCS. 6.2 Phase 2 Development The Rise of the Systems Engineer Figure 8: Proposed Phase 2 Combined Ervia and OCS Organisation Chart Figure 8 displays the Proposed Combined Ervia and OCS maintenance team Organisation Chart at the Phase 2 level of development. We can see in Figure 8 that the maintenance organisation now looks to be much more ordered and has a well-balanced structure. Duplication of roles and dual reporting has been removed. To enable this change, the role of the Systems Engineer will have to be considerably expanded. Up to this point the focus of this role was to collate asset data, install both a CMMS and an incident management system. The Systems Engineer can now fully take the reins regarding a systematic approach to improving work management. To do this, the support of an administrator will be required once the system becomes operational. Once fully realised, this system will negate the need for the 3 administrators that report to the Facilities managers. The reduction in administrators is possible because the new CMMS is configured for paperless WOs and much increased automation of reporting. The maintenance staff will now carry tablet computers to execute completion of WOs. From this point onwards, the Systems Engineers office will become the nerve centre of maintenance activities for the Facilities department with the following items featured prominently: Planning and scheduling of maintenance activities will be managed from there in conjunction with the site based technical staff. This is detailed further in Section 7. The CMMS will be fully managed from there with PM WOs for all sites generated by the administrator on a weekly basis. Reports from the Incident Management systems and CMMS will also be compiled at this office. These will be channelled directly to senior management at OCS and Ervia. The Systems Engineer will chair a monthly meeting with the Facilities Managers and cover upcoming works and resources requirements/availability. Implementation of work prioritisation. Again this is drilled into further in Section 7. 6.3 Phase 3 Development Breaking Down the Barriers Something that is not visible from the above organisation charts is the discreet walls that exist between the various site teams. It could even be said that they operate almost as autonomous groups. It is hoped that Systems Engineers increasing prominence will organically bring about change in this area and pull the teams together. There is much to be gained by sharing both knowledge and resources when possible. For instance one of the Facilities Technicians in the Dublin City Centre (DCC) sites is a qualified refrigeration engineer, he could provide technical assistance and advice regarding air conditioning equipment to the other sites. In the longer term, once the maintenance organisation has settled following the period of enforced change, consideration should be given to reviewing how maintenance activities are performed. There are likely to be opportunities for improvement of cost effectiveness in this area also. 7.1 Ranking Index for Maintenance Expenditure (RIME) It is envisaged that a system for prioritisation of maintenance activities will be introduced to the Facilities organisation. In RIME, expenditure refers to both time and cost. RIME works by assigning scores for the following factors: Asset criticality. WO criticality. Amount of time a WO is open. These scores are then multiplied which will, if the system is configured properly, ensure the most important work gets the highest total score. The newly installed CMMS at Ervia supports RIME and automatically provides total scores for WOs. This will allow maintenance staff to see a list of activities assigned to them in high-to-low order of priority. 7.2 Developing the Planning Function Sound planning practices are essential for any maintenance organisation and implementation of such is considered best practice. In the Ervia Facilities department, the OCS Systems Engineer will lead the charge in rolling out planning across the maintenance team. As detailed earlier, The Systems Engineer will chair a monthly meeting with the Facilities Managers and work planning will take centre stage at this meeting. A further aim of these meetings will be to knock down the discreet walls that exist between the different site teams. There should be opportunities to share both learning and indeed resources but proper lines of communication need to be established first. The changes that can be implemented have now been suggested but what are they going to achieve in terms of improving cost effectiveness? The bullet points below will attempt to quantify expected savings: Removing Layer of Middle Management The Facilities Managers and System Engineer each come at a cost of  £100,000 to Ervia. Removing the 4 as proposed, will bring a saving of  £400,000. Reducing Number of Administrators Each administrator comes at a cost of  £50,000 to Ervia. Removing 3 as proposed, while transferring 1 to support the Systems Engineer will bring a saving of  £100,000. Introducing RIME Any savings to be generated here are difficult to quantify at this juncture but a system for prioritising work can only be a good thing and will surely result in at least some cost avoidance by getting the important work done at the right time. Developing Work Planning Again any savings garnered by taking this measure are difficult to quantify at present but will help ensure maintenance best practice is followed. It is worth noting however that the rule of thumb in industry is unplanned maintenance can cost at least 3 times as much as planned maintenance (Strawn, n.d.). Points to note In terms of staff resources, savings are calculated based on the cost to Ervia which takes into account such items as Pay Related Social Insurance and Management Fees charged by OCS as part of the IFM contract. Detailed resource costs are tabulated in Appendix A. It must be noted that only the savings in relation to reducing the number of administrators will impact the IFM contract costs. The removal of the Ervia middle management does not impact the IFM contract value. To quote Jack Welch (2001), the person regarded by many as the greatest company leader of his generation Change before you have to. Ervia needs to get its house in order if there are external changes introduced such as reduced budgets and/or an increase in the number of sites to maintain. At present there is much volatility in Irish political circles with funding of public/semi state companies a constant hot topic. Ervia could be faced with the possibility of having its funding slashed at government level and in tough times the maintenance department of any organisation is often seen as a soft target. Since there is an IFM contract renewal coming at the beginning of 2018, this could be used as an opportunity to begin the implementation of changes. It would mean that the proposed structures could be built in to the new contract which would avoid having to use the change control process that applies during contract run time. Again, to draw from the famed former head of General Electric (GE), Jack Welch, Willingness to change is a strength, even if it means plunging part of the company into total confusion for a while (Slater, 1998). Lets consider, in the following sub-sections, the two main points of impact as a result of implementing the proposed changes. We will also consider on how to mitigate the effects. 10.1 Staff Reductions and Transfers These decisions will not be easy to implement. There will be considerable resistance from the Ervia Facilities Managers and Systems Engineer. Should the situation become intractable, it may be necessary to remove the layer of middle management from OCS instead. The Ervia staff would then transfer to OCS and report to the Senior Key Account Manager. The path of least resistance may have to be followed. It could well turn out that the Facilities Managers and Systems Engineer team are made up out of a combination of OCS and former Ervia staff that have transferred. The Ervia GO may take umbrage at having to transfer to OCS. The last time these attempts were made resulted in failure. The shakeup at administration level could also cause rancour. Because the Systems Engineer is based in one of the Cork offices, the administrator that supports this role will likely come as a transfer from the Southern Regional Sites Facilities Managers team. The two Dublin based administrators will have to be made redundant. Willing to make changes is one thing but successfully managing the change will be crucial. A rocky road will have to be travelled with the possibility of staff morale taking a hit. Potential resentment from the soon-to-be unemployed staff towards retained staff is also likely during the transition phase. The strength that Welch speaks of will have to come from senior management in both Ervia and OCS. Considerable resolve will have to be displayed when communicating to employees that they no longer have a job. A silver lining can be added to the cloud by ensuring favourable severance packages for those made redundant and committing to TUPE regulations for any employee that transfers to OCS. 10.2 Introduction of Work Management Systems It could be perceived by the Facilities Mangers that a power grab is taking place by the Systems Engineer. The onus will be on the Senior Key Account Manager to sell the benefits of the changes in practice. Over time, the benefits should then start to become self-evident as management of work improves, shared learnings disseminate and client contentment increases as a result of a better run contract. 10.3 Industrial Relations Concerns The changes proposed above will not be encumbered by IR action. Neither Ervia nor OCS staff are union affiliated so as long as the employees legally held rights are observed, there should be no issue. The Facilities department could be presented with a dramatic widening of its scope in the next number of years. It is envisaged that Ervia, through Irish Water, will eventually absorb all county and city council staff that are currently involved in maintaining the water services infrastructure. This could involve the transfer of up to an additional 2,500 staff. The knock-on effects for the maintenance team within the Facilities department would be considerable. The multitude of premises that house all these employees would then be in scope for upkeep and repair. There is currently a team charged with developing a plan to allow for the transfer of these staff and premises to the Ervia parent utility group. The Water Industry Operating Framework (WIOF) will contain the new obligations that the Facilities department will be required to meet. Both Ervia and OCS, should they retain the IFM contract, will have to ready themselves for the huge challenges coming down the tracks. The best way to achieve this is to allow for scalability in the systems that are designed and built. While extra staff will no doubt have to be recruited, duplication of roles as per the current situation will have to be avoided. The time is right at present to ensure a solid foundation is laid to accommodate this forecasted expansion. In the predicted scenario, additional costs are going to be incurred. The measures proposed in this report, if implemented, will serve to keep these extra costs to a minimum. At a higher level, there are additional changes that could be made to improve cost effectiveness. As mentioned earlier, the current IFM contract with OCS falls under the Cost Plus model. Detailed below is an alternative to this contract type known as Fixed Price/Output Based. The author of this report has previous experience of this type of IFM contract. The bullet points below show advantages and potential shortcomings: Headline Information (based on example): 10% up-front savings guaranteed over costs incurred by client to deliver maintenance. Built in glide path which consisted of a 1% year-on-year reduction in cost of overall contract. IFM absorbed costs of up to  £5,000 per breakdown. IFM had full authority on staff numbers and how maintenance was delivered. Contract was 5 + 5 i.e. initial duration of 5 years with option by client to extend for a further 5 years without re-tendering. Advantages: Costs for client are tied down. Incentive for IFM provider to implement cost effective maintenance. Disadvantages: Instead of what Emmet and Wheelhouse (2011) describe as collaborative, the relationship can instead become transactional and often even adversarial. Risk that IFM may cut corners regarding maintenance in order to deliver on-budget. Race to the bottom mentality can pervade during tendering where prospective service providers will submit unrealistically low pricing in order to win the contract. Requirements to make it work: Watertight contract with relevant Key Performance Indicators (KPIs) to accurately monitor IFM contract compliance. Condition of equipment in contract scope needs to be thoroughly evaluated during the tender process and the client must have an open book policy regarding historical failure data. Enough financial head room in the contract to allow the IFM provider to make a profit. If this is not present, the contract will inevitably collapse with possible adverse consequences for business continuity. In the example above, the contract was terminated by the client after 2 years due to poor service delivery and repeated KPI failures. The main cause of this, in the authors opinion, would be that the IFM provider submitted such a low price at tendering that they could not meet the agreed contract conditions while generating a profit. To open the conclusion, its fair to say the above analysis may seem cold but it is approached from a business perspective with a view to achieving a sustainable maintenance organisation that is capable of surviving more stringent cost controls that may lie ahead. On the face of it, it would seem that the maintenance organisation within the Ervia Facilities department is ripe for change. And to sustain the analogy, there may even be some low hanging fruit! Listed below are the positives that will come with introducing change: Staff reductions alone will bring  £500,000 in savings and if all goes according to plan, there will no reduction in the level of service to the wider organisation. The introduction of advanced Work Management systems should also improve cost effectiveness but its hard to quantify the level of such at present. Ultimately what is required is to achieve the same level of performance for reduced expenditure or in the utopian situation, an increas