Unit 13&14 Essay Example | Topics and Well Written Essays - 750 words

Unit 13 - Essay Example The film scenario exemplified Andrew being discriminated from undertaking his responsibilities as a lawyer upon the discovery of his affliction. Besides being unfairly and unjustly prejudiced towards his condition, the case affected senior management, who wrongfully dismissed him, and society, in general, who scorned people afflicted with the disease. The lawyer, who Andrew initially approached to defend him, Joe Miller, played by Denzel Washington, was first apprehensive to take the case given the sensitivity of the issues. As it turned out, the court ruled in favor of Andrew and ordered the firm to award him for damages for wrongful dismissal. It is fortunate for Beckett to have been remunerated for the discrimination case filed in court. According to the Organisation for Economic Co-operation and Development (OECD) (2008) â€Å"proving a discrimination claim is inherently difficult, since the elements of proof are generally in the hands of the defendant, i.e. the employer† (5). Most victims choose to ignore the matter of filing appropriate cases due to the costs involved in pursuing discrimination cases. Regular-average-everyday Americans can make a profound difference to transform this country by acts of random kindness to others. With no thought of reward, the Good Samaritan in the Bible stops to help a man who has been beaten and robbed. That is the essence of an altruistic act: unselfishly giving help when it is needed, no strings attached. If each and every American believes in simple, unselfish acts, then each would be instrumental in making this nation a more conscientious one. Most men do some thing or behave in a certain way because we expect to get a reward for doing so. Naturally, one does not do something because the cost of doing it would be great. The leadership model that must be manifested in contemporary societies should assist in transforming the society through focusing on encouraging others

Discuss the view that increased regulation will not necessarily lead Essay - 1

Discuss the view that increased regulation will not necessarily lead to higher ethical standards - Essay Example t would have been so then companies to maintain the conduct of its employees ethically sound would have been competing on number of regulations than their effectiveness. Hence, this paper is aimed to support the view that increased regulation does not necessarily increase the ethical standards. On developing the general argument, this paper will also attempt to develop support from variation in accounting and auditing treatments with level of compliance to financial regulation and ethical standard. In the end, it would suggest ways to increase ethical standard of firms and especially accounting and auditing professionals. Concerns regarding the ethical conduct of the business have gained increased attention since recent past. Accurate to state would be to mention the point in time when corporate scandals mainly Enron scandal unveiled and resulted in huge fines, reputational loss and even sentenced to jail (BBC News, 2002). It proved to be the earthquake in trust of stakeholders on the validity of information presented by firms and increased cynicism about the accounting practices worldwide (Enderle, 2004). This shake accounted the top management of the firm for the fraudulent act mainly and the question to be posed to entire mechanism that remained in-capable to indentify the deceiving accounting practices were given least or no punishments (Enderle, 2004). In the mentioned case, it was desirable to correct the existing regulation with focus to eliminate the flaws. This exercise presumably was expected to have more constructive results. The role of auditors in particular became a question mark after this scandal. Moreover on adoption of the corrective measures, the impact of current financial crises was also expected to have been mitigated to some extent; if couldn’t be eliminated in full (Argandona, 2012).Contrary to this and without taking lessons from Enron case, increased regulations were imposed on businesses. Increased regulation provided more options to

Social Work Counselling in Social Work

Social Work Counselling in Social Work The Role and Applicability of Counselling in Social Work Practice Introduction and Overview Social work originated as a community help measure in the 19th century and has since then become an organised discipline that aims to support and empower those who suffer from social unfairness. Apart from helping the disadvantaged to live with dignity, social work aims at achieving social inclusion and has been found to be effective in correcting disparities and in helping individuals to overcome impediments that arise from different aspects of life; apart from those that require knowledge of the physical and medical sciences. Social work practice has, over the years, become integral to Britain’s working life and current estimates put the number of active social workers in the country at significantly more than one million. (Parrott, 2002) Whilst social workers can be called upon to assist all sections of the community, the majority of their assignments concern helping individuals in stressful situations and those experiencing difficulties with issues that relate to emotions, relationships, unemployment, work, disabilities, discrimination, substance abuse, finances, housing, domestic violence, poverty, and social exclusion. Such a range of applications has necessitated the development of (a) a variety of skills and techniques, (b) methods to transfer these skills to social workers, and (c) procedures for the delivery of social work in a variety of settings, which include schools and colleges, households, hospitals, prisons and secured homes, and training and community centres. (Parton, 1996) Social work practice focuses on dealing with the problems of service users. The maintenance and improvement of their social, physical, and mental states is often dependent upon the effectiveness of social work intervention. (Miller, 2005) Users of social work services are largely economically and/or socially disadvantaged, and the vulnerabilities, which arise from these circumstances, frequently contribute to the nature of their relationships with service providers. (Miller, 2005) Social work makes use of a broad range of knowledge and incorporates information obtained from several disciplines; it empowers social workers in practice to use their acquired knowledge and skills first to engage service users and then to bring about positive changes in undesirable emotional states and behavioural attitudes, or in positions of social disempowerment. (Miller, 2005) Counselling forms one of the main planks of social work practice and constitutes the chief mode through which social workers directly engage service users; it is considered to be the public face of the activity and is an integrative course of action between a service user, who is vulnerable and who needs support, and a counsellor who is trained and educated to give this help. Face to face and 121 interactions between social workers and service users take place mostly through counselling activities. Apart from the directly beneficial effect that occurs through counselling, much of the social work approach that needs to be adopted in specific cases for other interventionist activity is decided on the basis of feedback provided by counsellors. This assignment aims to study and analyse the importance of counselling in social work practice. Commentary and Analysis Social work practice, in the UK, has evolved along with the development of the profession, and with the progression of social policy, ever since the first social workers were trained at the London School of Economics, at the beginning of the 20th century. (Parton, 1996) Whilst social policy, formulated at the level of policy makers, defines the broad routes taken to alleviate social inequalities, the actual delivery of social work occurs through social work practice, an activity carried out by thousands of social workers all over the United Kingdom. (Harris, 2002) Social work makes use of a range of skills, methods, and actions that are aligned to its holistic concentration on individuals and their environments. (Harris, 2002) Social work interventions vary from person-focused psychosocial processes that are focused on individuals, to participation in social policy, planning and development. (Harris, 2002) These interventions include counselling, clinical social work, group work, soc ial academic work, and family treatment and psychotherapy, as well as efforts to assist people in accessing services and resources within the community. (Harris, 2002) Social workers, in their everyday activity, need to assume multiple roles that aim to balance empowerment and emancipation with protection and support. (Harris, 2002) Balancing this dilemma is often a difficult process; it depends upon the needs of service users and requires social workers to assume more than one role. (Harris, 2002) These roles, whilst being versatile and flexible, broadly consist of seven broad categories, namely those of planners, assessors, evaluators, supporters, advocates, managers, and counsellors. (Harris, 2002) Whilst social work practice is spread over these broad functions, this assignment aims to examine and analyse the significance and application of counselling in social work, especially with reference to (a) the complexities involved in its practice, (b) combating oppression and discrimination, and (c) from the viewpoint of service users. Counselling, whilst being a catch-all term, used for describing of various professions, is, an important component of social work practice. (Rowland, 1993) It is a developmental process in which one individual (the social work counsellor) provides to another individual or group (the client), guidance and encouragement, as well as challenge and inspiration, in creatively managing and resolving practical, personal and relationship issues, in achieving goals, and in self realisation. (Rowland, 1993) Whilst the relationship of social work with poverty and deprivation necessitates that most counselling activities relate to such issues, counselling has now become an active and interventionist method to achieve change in social situations and empower people to improve the quality of heir lives. (Rowland, 1993) The activity depends upon client-counsellor relationships and includes a range of theoretical approaches, skills and modes of practice. The British Association for Counselling defined the activity thus in 1991: â€Å"Counselling is the skilled and principled use of relationships to develop self knowledge, emotional acceptance and growth, and personal resources. The overall aim is to live more fully and satisfyingly. Counselling may be concerned with addressing and resolving specific problems, making decisions, coping with crisis, working through feelings or inner conflict or improving relationships with others. The counsellors role is to facilitate the clients work in ways that respect the clients values, personal resources and capacity for self determination.† (Rowland, 1993, p 18) Part of the confusion regarding the actual nature of counselling activity stems from the fact that the phenomenon is of recent origin and is becoming increasingly popular both as a widely sought service and as a professional career. (Dryden Mytton, 1999) Whilst social researchers have floated a number of theories to explain the growth in counselling in social work, most experts ascribe its increasing usage to the diminishing impact of religion, the breaking and scattering of family life, and the removal of previously existing family and community social structures. (Dryden Mytton, 1999) Priests have ceased to become confidantes and advisors; New modes of disempowerment have also led to the creation of a vast range of emotional and physical stresses with adverse effects on the psycho-emotional states of numerous people and their consequent need for counselling. (Dryden Mytton, 1999) Counselling has its origins, both in the past, and as an up-and-coming discipline, in various professions. It fills the intermediate gap between psychotherapy and amity, and thus becomes a particularly useful tool for intervening and touching upon the private, societal, professional, medical, and educational aspects of people. (Rowland, 1993) Whilst it grew organically, its effectiveness in diminishing distress led to its progressive assimilation in social work practice. Again the idea of the social worker as a person, who works with or counsels persons, has been a persistent concept in social work all through its emergence. (Pease Fook, 1999) Counselling has also been connected with some of the critical principles of social work, particularly with regard to recognising the innate value of the individual and respecting the human being. (Pease Fook, 1999) Counselling and casework also find favour with those who look at social work, in its entirety, as a process where different compo nents work synergistically with each other in helping and supporting individuals. (Pease Fook, 1999) Also inherent in the role of the social worker, as a counsellor, is the idea that change will be involved in the behaviour or outlook of the service user. It is in fact the diminution on the role of counselling role, which has been one of the major apprehensions regarding provision of social work through services. (Pease Fook, 1999) Counselling, in its basic form, involves the meeting of a counsellor and a service user in a private and confidential setting to investigate the emotional and mental difficulties, and distress, the service user may be having because of varying person-specific reasons. (Rowland, 1993) Counselling, as is evident from its increasing usage, has been found to be of great help in a variety of situations; in treating people with mental problems of varying severity; in helping those suffering from trauma, anxiety or depression; and in aiding people with emotional or decision making issues. (Rowland, 1993) Whilst it has been found to be applicable across different locales, for example, in schools and colleges, disturbed domestic settings, and in workplaces, it has also proved to be effective in helping people afflicted with serious illnesses like cancer and aids, victims of road and industrial accidents, and people in various stages of rehabilitation. (Coney Jenkins, 1993) Counsellors meet the requirements of people who experience traumatic or sudden interruptions to their life development and to their social roles. (Dryden Mytton, 1999) Prominent among these counselling functions are those in areas of marital breakdown, rape and bereavement. (Dryden Mytton, 1999) The work of the counsellors in such cases can be clearly seen to arise from social problems, namely from shifting social perceptions of marriage, reassessments of male and female roles, and new patterns of marriage and family life. (Dryden Mytton, 1999) Counselling provides a route to helping individuals to negotiate this changing social landscape. Counselling has also been found to be helpful in the area of addictions. Specific counselling approaches have been developed to assist people with problems related to substance abuse, gluttony and for giving up smoking. (Pease Fook, 1999) In some areas of counselling, which deal with addiction, for example, with users of hard drugs, counsellors engaged in social work practice, function side by side, with sets of legal restrictions and moral issues. (Pease Fook, 1999) The possession and use of cocaine, for example, is not just viewed to be morally incorrect but also a criminal activity. (Pease Fook, 1999) â€Å"The counsellor working with a heroin addict, therefore, is not merely exploring ‘ways of living more satisfyingly and resourcefully’ but is also mediating between competing social definitions of what an acceptable ‘way of living’ entails.† (Pease Fook, 1999, p72) Some of the different objectives counsellors try to achieve in their dealing with service users relate to (a) providing them with an understanding of the origins of emotional difficulties, (b) enabling them to build meaningful relationships with other people, (c) allowing them to become more aware of blocked thoughts and feelings, (d) enabling them to develop a more positive attitude towards their own selves, (e) encourag ing them to move towards more fulfilment of their potential and (f) helping them in solving particular problems. (Pease Fook, 1999) The following example provides an instance of how counselling helps individuals to overcome serious personal traumas. â€Å"Paula had been driving her car. Her friend, Marian, was a passenger. Without any warning they were hit by another vehicle, the car spun down the road, and Paula thought ‘this is it’. Following this frightening event, Paula experienced intense flashbacks to the incident. She had nightmares which disturbed her sleep. She became irritable and hyper vigilant, always on the alert. She became increasingly detached from her family and friends, and stopped using her car. Paula worked hard at trying to forget the accident, but without success. When she went to see a counsellor, Paula was given some questionnaires to fill in, and he gave her a homework sheet that asked her to write about the incident for ten minutes each day at a fixed time. In the next counselling session, she was asked to dictate an account of the event into a tape recorder, speaking in the first person as if it was happening now. She was told to play the trauma tape over and over again, at home, until sh e got bored with it. In session 3, the counsellor suggested a way of dealing with her bad dreams, by turning the accident into an imaginary game between two cartoon characters. In session 4 she was invited to remember her positive, pre-accident memories. She was given advice on starting to drive her car again, beginning with a short five-minute drive, and then gradually increasing the time behind the wheel. Throughout all this, her counsellor listened carefully to what she had to say, treated her with great respect and was very positive about her prospects for improvement. After nine sessions her symptoms of post-traumatic stress had almost entirely disappeared, and she was able to live her life as before.† (Starkey, 2000, p37) Counsellors need to keep in mind that socialisation leads to the development of perspectives on issues like race and gender. (Moore, 2003) Many of these perspectives are assimilated to such an extent that people have little control over them and are bound to impact the working of counsellors if not understood, isolated and overcome. (Moore, 2003) â€Å"In an anti-oppressive framework, these views are broken into six main lenses; racism, sexism, heterosexism, ableism, ageism, and class oppression.† (Moore, 2003) People are regularly excluded on account of their colour, gender, sexual orientation, abilities, age, and class. (Moore, 2003) Most of these factors do not occur in isolation and thus lead to multi-oppression, for example an aged female from a minority background could face oppression because of three factors, the whole of which becomes stronger than the sum of individual components. Oppressive perspectives occur through a common origin, namely economic power and contro l, and employ common methods of limiting, controlling, and destroying lives. The PCS model developed by Thompson, in 2001, argues, in similar vein that inequalities, prejudice and discrimination operate at three levels, Personal, Cultural, and Structural, and by constantly strengthening each other, create powerful mental biases and prejudices against members of out-groups, people who are disadvantaged by way of colour, race, ethnicity, religion and language. Individual views, at the personal level, interact with shared cultural, historical and traditional beliefs to create powerful prejudices. (Thompson, 2001) Dominant groups within society constantly reinforce their superiority by driving home the inferiority of other groups through a number of overt and covert methods. (Harris, 2002) Whilst movements that aim to dismantle such stereotypes are emerging slowly, the biggest conflict is still within. (Harris, 2002) Internalised oppression is the oppression that we impose on our own selves due to environmental pressures. (Harris, 2002) The oppression is internal ised from the prevailing society’s message through various institutions like the media, existing religious infrastructure, and other forms of socialisation. (Harris, 2002) Examples of such oppressive practices are the pressure put on working mothers to run an efficient household, in addition to putting in a full day at the office, or expecting mothers who stay at home to work from dawn until late night. (Harris, 2002) These prejudices are further strengthened by structural discriminations that are created by social and governmental structures, (as evinced by diminished employment opportunities for people with histories of substance abuse or the refusal of landlords to rent houses to members of certain communities), and create a complex web of mutually reinforcing social processes. Counsellors are prone to be oppressive because of assimilated perspectives, stereotyping, and because they hold power over service users. It is imperative that they recognise these imbalances and wo rk towards eliminating them in their work as well as in the promotion of change to redress the balance of power. Looking at social issues through the perspectives of service users is thus critical to counselling activity. Social workers often face ethical challenges in their dealing with service users. There are many instances in social work where simple answers are not available to resolve complex ethical issues. Clients, for example, can inform counsellors about their intention to commit suicide or inflict physical harm on their own selves, ask for reassuring physical contact in the nature of hugs, and confide about their intentions to harm others. (Langs, 1998) There is a strong possibility of sexual attraction developing between counsellor and service user. (Langs, 1998) Such situations can lead to the development of dichotomies between personal and professional ethics, and to extremely uncomfortable choices. (Langs, 1998) Conclusion Counselling is a complex and demanding activity that demands knowledge, experience and people skills, as well as compassion, empathy and understanding. Above all counselling activity, as an integral component of social work, requires commitment to social good. Counselling theories have evolved over the last half century; they have multiple origins, are complex in their formulation, and whilst having common features, need to be individually adapted to the needs of service users. Whilst it is not easy to grasp and apply these theories, their comprehensive understanding and application are essential to the effectiveness of counselling work. Counsellors, by virtue of the nature of their work and their power in counsellor-service user relationships exercise enormous influence over the decisions of service users. The diversity and heterogeneity of counselling reflects the sensitivity of counselling to the enormous variations in human experience. Whilst understanding of theory helps in discharging of responsibilities, counsellors are also limited by assimilated perspectives on oppression, career and money demands, and their own emotions. Their responsibilities are manifold, and include duties towards service users, towards the profession, and towards the wider community. Apart from being challenging, satisfying and rewarding, counselling also provides the opportunity to make profound differences to the lives of other human beings. References Bond, T, 2000, Standards and Ethics for Counselling in Action, Sage Publications Ltd. London Corney, R. Jenkins, R, (Eds.), 1993, Counselling in General Practice. London: Routledge Counselling saves British business millions every year, 2003, British Association for Counselling and Therapy, Retrieved December 3, 2007 from www.instituteofwelfare.co.uk/downloads/welfare_world_24_full.pdf Dryden, W, 2006, Counselling in a nutshell, Sage Publications Ltd. London Dryden, W., Mytton, J, 1999, Four Approaches to Counselling and Psychotherapy, London: Routledge Feltham, C, 1995, What Is Counselling? The Promise and Problem of the Talking Therapies, Sage Publications Ltd. London Harrow, J, 2001, Working Models: theories of counselling, Retrieved December 3, 2007 from http://www.draknet.com/proteus/models.htm Harris, J, 2002, The Social Work Business /. London: Routledge Hornby, G., Hall, C., Hall, E. (Eds.), 2003, Counselling Pupils in Schools: Skills and Strategies for Teachers, London: RoutledgeFalmer Langs, R, 1998, Ground Rules in Psychotherapy and Counselling. London: Karnac Books Miller, L, 2005, Counselling Skills for Social Work, Sage Publications Ltd. London Moore, P, 2003, Critical components of an anti-oppressive framework, The International Child and Youth Care Framework, Retrieved December 3, 2007 from www.cyc-net.org/cyc-online/cycol-1203-moore.html Nelson-Jones, R, 2000, Six key approaches to counselling and therapy, Sage Publications Ltd. London Noonan, E, 1983, Counselling Young People. London: Tavistock Routledge Now Youre Talking; Counselling Has Become a Big Business Employing Thousands. but Is It a Job for You? Bonnie Estridge Talks It through London Jobs/Opportunities, 2004, October 14, The Evening Standard (London, England), p. 61 Parrott, L, 2002, Social Work and Social Care, London: Routledge Parton, N. (Ed.), 1996, Social Theory, Social Change and Social Work, London: Routledge Pease, B. Fook, J. (Eds.), 1999, Transforming Social Work Practice: Postmodern Critical Perspectives. London: Routledge Retail Therapy: Beauty So Tell Me, Whats the Problem? Laura Davis Investigates the Growing Trend for Counselling, 2004, October 28, Daily Post (Liverpool, England), p. 8 Rowland, N, 1993, Chapter 3 What is Counselling? In Counselling in General Practice, Corney, R. Jenkins, R. (Eds.) (pp. 17-30) London: Routledge Shardlow, S. (Ed.), 1989, The Values of Change in Social Work. London: Tavistock/Routledge Starkey, P, 2000, Families and Social Workers : The Work of Family Service Units, 1940-1985 /. Liverpool, England: Liverpool University Press Thompson, N (2001) Anti-Discriminatory Practice, Third Edition, London: Palgrave Urofsky, R. I., Engels, D. W, 2003, Philosophy, Moral Philosophy, and Counselling Ethics: Not an Abstraction. Counselling and Values, 47(2), 118+

The Importance of a Business Plan Essay -- Business Management, Busine

When it comes to starting a business it is important to have Business Plan. The value of a business plan is important in the startup of an organization. The value of proper business plan in an organization can determine if the organization will withstand over of time or for years to come for that matter. In implementing a proper business plan, proper planning in it self is important and valuable to the process. Planning helps in ensuring that the organization can withstand and remain as an essential asset to the needs of the community and helps in providing an impact on the city tax base. A valuable business plan can also allow the company to look at ahead at its projected profits and loss to be able to give their shareholders the return on their investment. The business plan can be the measuring rod to how the company will perform from the inside and out. The plan will show the roles of all their employees and what will be required and expected of them and what they can expect in return from there employer. The supply and demand of a company needs to be looked at from a short-ran...

A Positive Approach to the Future

A Positive Approach Towards the Future The issue of mandatory school uniforms has taken on several debates over the past decade; it is believed that this issue will plague public schools for decades to come. Students who wear uniforms feel a sense of being superior with their fellow classmates. This feeling of being part of a group boosts morale and individual confidence, thus leading to higher grades. Children will be more focused in a uniform classroom. There is no more distraction as to what the other kids are wearing or who has the name brand shoes. Girls will be dressed appropriately and clothing will fit properly. This adds to the learning experience. There is no more competition. There is no more rivalry and the children are able to focus on their schoolwork and not on the latest trends ( Bodine 67-69). Former President Clinton made a state of the union address in 1996; in that address, the subject of mandatory school uniforms was mentioned. â€Å"If it means that teenagers will stop killing each other over designer jackets, then our public schools should be able to require their students to wear uniforms† (Williams). In fact, that year in Long Beach, California, the first district to implement mandatory uniform policies, assault dropped by sixty-seven percent, vandalism by eighty-two percent, and robbery by thirty-five percent. Overall crime was reduced by seventy-three percent the first year the policy was in place (Williams). This was a direct reflection of the uniform policy. Students were more disciplined and behaved in a more mature manner. These students took pride in themselves and others. With the lack of material items to fight over, students no longer felt the need to use aggression towards others, proving that school uniforms do in fact improve student behavior. Also when it comes to crime, a student wearing a school logo, is less apt to commit a crime outside of school while in uniform because it would be easier to track him based off of the school information on the uniform? This lowers the crime rate for the general public as well as the in school instances. Not only do mandatory uniform policies for public schools offer the potential for higher educational benefits and improved student discipline, school uniforms dissolve social boundaries between classmates. Students are no longer judged based off their appearance but by who they are on the inside. There is no more competition between social classes that these students may have otherwise felt and they work together as a team and share a common pride. All students will feel a sense of belonging. No longer will lower income children be labeled as poor based off of their clothing. All children will appear as equals in the classroom and will be treated as such. However, some may argue that uniformity takes away from the student's individuality. Many children, especially teens, express themselves through their personal styles and the way they dress. Sometimes children need to feel special or unique and dressing a certain way is how they accomplish this. Uniformity takes away from the First Amendment by taking away freedom of expression. If we take away the freedom of expression, we are taking away our children's creativity and conforming them into a society where free thinking is not accepted. However this is not the case. The uniform does not change who the child is on the inside or how he thinks creatively. Students will still be able to focus creative energy through activities such as art, music, writing or sports. There are several creative outlets besides the choice of clothing options. When it comes to our economy, we as Americans must pinch our pennies where we can. Many parents are faced with the dilemma of outfitting their children in the latest trends or putting money towards more important things like saving for their children's college education. Some families are unable to afford the popular named brand clothing that their children desires, which make the children, feel inadequate in school when they are forced to wear lesser brand clothes or second hand outfits. School uniforms would take away that hassle of finding bargains to ensure that their children feel confident in their attire. Uniforms are generally more durable than the average street clothes. Granted, the cost may be a bit more substantial in the beginning, but the uniforms will last longer which means there is less out of pocket expense for replacement articles. With uniforms, the parents may only have to purchase two or three sets compared to several pairs of bottoms and tops. Uniforms are more durable and can be washed more frequently compared to regular clothes. This makes them the better option not only for lower income families, but all families in general (Romero C4+). Critics claim that uniforms will cost the families more money in the long run because parents will be forced to buy the uniforms and regular clothing for their children to wear when they are not in school. The cost for parents may double that of just buying traditional school clothes. Although this is partly true, that yes, parents will be faced to make additional purchases for their children, in reality, they really won't be spending that much more money if any. Since uniforms are more durable, the parents only need to buy a limited supply and since the children will only be wearing their regular clothes outside of school, parents will not have to buy as many outfits. Most children wear out their clothes while in school. Since this is not an issue with the uniforms, the traditional street clothes will last longer, hence saving the parents money in the long run. Also without the constant competition in schools, children may not feel the need to have the latest brands and styles as they would if they were wearing the clothes to school on a daily basis around other social classes (King 3-5). With all of the advantages and disadvantages of implementing mandatory uniform wear into our public schools, there needs to be a compromise. Some schools have decided that it is best to make minor changes to the dress code policy. When it comes to school uniforms, there is a never-ending debate as to what the right approach and the wrong approach may be for our public schools. Works Cited Bodine,A.. aâ‚ ¬? School uniforms, academic achievement, and uses of researchaâ‚ ¬?. The Journal ofEducational Research 19 Feb. 2008: 67-73. Print. King, K. A. Should school uniforms be mandated in elementary school?. 2010: 3+. Print. Romero, E. aâ‚ ¬? School uniform countdownaâ‚ ¬?. Daily News Record, 16 Aug. 1999, C2+. Print. Williams, D. aâ‚ ¬? School uniforms: The raging debateaâ‚ ¬?. n. d. Web. 5 Aug. 2011.

Video Laryngoscopes For Intubations Health And Social Care Essay

Difficult and failed tracheal cannulation remains a taking cause of anaesthetic morbidity and mortality despite progresss in schemes both to predict and to pull off [ 5 ] the hard air passage. Many hard cannulations are non recognized until after initiation of anaesthesia [ 3 ] . Despite the handiness of options, the Macintosh Laryngoscope remains the most widely used. Endotracheal cannulation, considered to be the gilded criterion in procuring the air passage, is normally performed utilizing a direct Laryngoscope. In add-on to hapless light, troubles in executing conventional direct laryngoscopy normally arise from the limited position angle of about 10-15 [ 5 ] . Standard direct laryngoscopy requires alliance of the unwritten, pharyngeal, and laryngeal axes in order to see the vocal cords. In contrast, indirect Laryngoscopes merely requires alliance of the guttural and laryngeal axes, which lie along similar angles as compared with the unwritten axis [ 6 ] . Insufficient laryngoscopic position constitutes the chief ground for hard cannulations.Without equal visual image, cannulation remains insecure and associated with elevated hazard for injury [ 7 ] . Therefore, different blade designs such as the McCoy purchase blade, DoA?rges cosmopolitan blade and so on were developed to better cannulation success. [ 8,9 ] Owing to staying cannulation troubles in some patients, instruments leting indirect glottic position such as flexible and stiff fiberscope, cannulations endoscopes and optical stylets were introduced [ 10-12 ] . However, extended costs and the demand for particular preparation basically contributed to a limited spread of many of these devices [ 13 ] . Therefore, anesthesiologists are still seeking for cannulation devices uniting first-class glottic visual image with simple and efficient usage. Over the last few old ages, video-assisted endoscopic techniques have successfully been introduced into assorted surgical subjects. In contrast, anesthesiologists have been loath to take up the advantages of the picture technique for their intents. The first efforts were undertaken with jury-rigged instruments uniting Laryngoscopes and flexible fiberscopes [ 14 ] . Today, several luxuriant picture Laryng oscopes are commercially available [ 15-18 ] . Whereas some devices feature a conventional Macintosh blade signifier, others show a distinguishable blade design. A marked curvature resembling oropharyngeal and hypopharyngeal anatomy enables a widened position. As a affair of fact, airway direction in injury patients has turned out to be exceptionally critical [ 19 ] . In instance of hurt and instability, motion of the cervical spinal column can do irreversible harm to the spinal cord [ 20 ] . Attachment of stiff or semi-rigid cervical neckbands are a compulsory measure in exigency medical attention but makes ETI by standard laryngoscopy much more hard or even non possible [ 21 ] . Video Laryngoscopes ( VLs ) , which allow an indirect position of the glottis, may therefore ease ETI even when the direct glottic position can non be obtained and better visibleness of the vocal cords [ 22 ] . The broad handiness of VLs poses the inquiry whether their usage can ease ETI safe and speedy even without remotion of the cervical neckband.AIM OF THE WORKTo measure the safety and utility of glidescope, Airtraq and UE video-Laryngoscope use in anesthetized patients with fake ( with an immobilized cervical spinal column ) and expected hard cannulation con ditions in comparing to the Macintosh Laryngoscope.Patients and methodsEthical blessing was obtained from the Ethical commission in HUST, and written informed consent was obtained from all participants before registration in the survey. .Target population Patients which showing for elected surgery necessitating orotracheal cannulation, were recruited and indiscriminately assigned into two chief groups, each chief group include four subgroups of 20 patients. Type of the survey: Comparative, prospective, random clinical test survey An helper who was non involved in the survey obtained numbered opaque pre-sealed envelopes incorporating the randomized group allocations after each patient was enrolled into the survey. Anesthetists non involved in the aggregation or analysis of the informations performed all cannulation. GROUPE ( 1 ) : { expected hard cannulation } macintosh laryngoscope- – glidescope – Airtraq – UE video-laryngoscope GROUPE ( 2 ) : { fake hard cannulation } macintosh laryngoscope- – glidescope – Airtraq – UE video-laryngoscopeInclusion standards & A ; Exclusion standards: –GROUP ( 1 ) :Inclusion standards:Both sexi?†º Patients are ASA I or ASA IIi?†º Age 20-60 yearsi?†º Consent from patients about the nature of the survey and techniquei?†º Expected hard airway upon appraisal.Exclusion standards:Patient refused to inscribe in the research survey Ear, nose or throat surgery A demand for rapid sequence initiation or exigency surgery Any upset of the cardiovascular, pneumonic, hepatic, nephritic, or GI systems known from history or general scrutiny Patients with unstable cervical spinal column If the patient at hazard of pneumonic aspiration.GROUP ( 2 ) :Inclusion standards:Both sex Patients are ASA I or ASAIIi?†º Age 20-60 old ages. Consent from patients about the nature of the survey and technique.Exclusion standards:Patient refused to inscribe in the research survey Ear, nose or throat surgery A demand for rapid sequence initiation or exigency surgery. Any upset of the cardiovascular, pneumonic, hepatic, nephritic, or GI systems known from history or general scrutiny. Patients with unstable cervical spinal column If the patient at hazard of pneumonic aspiration. Expected hard airway upon appraisal. Morbid Obesity ( organic structure mass index & gt ; 35 ) . Study results: will be in the signifier of cannulation clip, laryngoscope clip, success rates, figure of tests, failure rate, air manner injury, hemodynamic response and glottic visual image grads with all picture assisted devices. A-Preoperative appraisalMedical history:History of chronic medical unwellness. Drug history. Anaesthetic history: including old anaesthesia, air passage troubles, and household jobs related to anaesthesias.Physical scrutiny:General scrutiny: Pulse, arterial blood force per unit area, respiratory rate and temperature. Heart, thorax and abdominal scrutiny. Local scrutiny Air manner appraisal for any troubles or any oropharyngeal hurt was noted before surgery Laboratory probes: Complete blood count. Prothrombin clip ( PT ) , INR, partial thrombokinase clip ( PTT ) , shed blooding clip. Electrocardiogram: for patients above 40years old. Anaesthetic appraisal: To except marks of hard cannulation 1 ) Airway Physical Examination ( Signs of expected hard cannulation ) A ) Interincisor distance: Less than 3 centimeter. B ) Visibility of uvula: Not seeable when lingua is protruded with patient in sitting place ( Mallampati category greater than II ) C ) Thyromental distance: Less than three ordinary fingers. D ) Length of cervix: Short. Tocopherol ) Thickness of cervix: Midst. F ) Range of gesture of caput and cervix: Patient can non touch tip of mentum to chest or can non widen cervix. [ 23 ] Demographic informations: The patient ‘s age, sex, ASA position and BMI was recordedB-Methods:Patients were prepared by fasting for at least 6 – 8 hours. Airway devices and anesthesia machine, ventilator, flowmeters and equipments checked were checked preoperatively. After canulation monitoring equipments will be attached to the patient including 5 leads ECG, non-invasive blood force per unit area, pulse oximetry and anaesthetic gas proctor.Initiation of anaesthesia & A ; cannulation:Patients were preoxygenated with 100 % Oxygen for 3 proceedingss, No sedation was given to the patients.Then all patients receivedi?s propofol 2-3 mg.kg i.v fentanyl 1.5 A µg.kg i.v cis- atracurium 0.5 mg.kg i.vDevicess:One of the helpers will help the anesthesiologist who will execute the cannulations. A Magill tracheal tubing with 7.5 millimeters internal diameter ( ID ) was used for all efforts. Lubricant was already applied to the tracheal tubing, and a 10 milliliter syringe to barricade the tubing ‘s turnup. The devices used for the survey were: ( 1 ) Standard Macintosh laryngoscope, blade 3 ( gold-standard ; HEINE Optotechnik, Munich, Germany ) . ( 2 ) Glidescope Ranger, Cobalt blade # 3 ( Verathon Inc, Bothell, WA, USA ) . ( 3 ) Airtraq, Size 3 ( Prodol, Madrid, Spain ) . ( 4 ) UE Video Laryngoscope, medium size blade ( China ) A semi-rigid stylet was inserted in the tracheal tubing when intu-bation was performed with Macintosh and UE laryngeaoscope. The GlideRite stiff stylet was used for efforts with GlideScope. As the Airtraq have integrated counsel channels for the tracheal tubing, they were non designed to be used with a stylet and were accordingly used without any extra counsel.IN Group ( 2 )The patients ‘ lungs will so manually air out for 3 min before a stiff cervical neckband will be applied maintaining the cervix in a impersonal place. This is an established technique for imitating a hard air passage. Tracheal cannulation will so execute with one of the three picture laryngoscopes or mackintoshs laryngoscope, in conformity to the randomized allocation. IN Group ( 1 ) , the same thing as group ( 2 ) without apply the stiff cervical neckband.Parameter will mensurate1-Laryngoscope clip:Timess from the first contact with the device until accomplishment of a successful position of the glottis.2-Time to intubationWill be recorded as the clip from interpolation of one of the videolaryngoscope to visual aspect of an end-tidal C dioxide hint on the capnograph.3,4-Number of tests & A ; failure rate:If cannulation is unsuccessful at the first effort, or took longer than 180 s, or if desaturation is note on the pulsation oximeter ( defined as SpO2 & lt ; 93 % ) , the cannulation effort will halt and the lungs ventilate with an oxygen-volatile anesthetic mixture for 3 min. A 2nd effort will be allowed with the randomly allocated airway device. If cannulation is unsuccessful after two efforts, the protocol allow for the cervical neckband to be take and the patient ‘s windpipe to be intubated with the anesthesiologist ‘s instrument of pick. 5-Hemodynamics response: ( bosom rate, systolic and diastolic blood force per unit areas ) Will be recorded during the cannulation procedure with readings taken pre-induction, pre-intubation and at 3 and 5 min after cannulation 6-Glottic visual image mark: ( categorization of Cormack and Lehane, as modified by Yentis and Lee ) class I – full position of the glottis ; class IIa – partial position of the glottis ; class IIb – arytaenoids or posterior part of the cords seeable ; class III -only the epiglottis seeable ; class IV – neither epiglottis nor glottis visible.7- Airway injury:A careful scrutiny of the oropharynx, will be performed after cannulation to find any lip or mucosal injury. The presence of any of the followers will taken to be grounds of mucosal hurt: blood discolorations on the tracheal tubing upon extubation ; seeable lacerations in the oropharynx ; or any hemorrhage noted on the lips or oropharyngeal mucous membrane.8-Number of optimisation manoeuvres before tracheal cannulation.Each option technique add 1 point: repositioning of the patient, alteration of stuffs ( blade, Endo-tracheal tubing, alteration in stylette form ) , need for ( raising force, laryngeal force per unit area, jaw push )Statistical AnalysisThe IBM SPSS Statistics ( version 20 ) will be used for statistical analysis. The sample size of n = 20 participants was calculated to be sufficient to observe a standardised mean difference of ( 1.4 ) in the cannulation clip with a power of 80 % and reversible sig nificance degree of 5 % . All consequences are shown as agencies A ± standard divergence ( SD ) or figure ( % ) .The normal distribution of informations will be tested utilizing the Kolmogorov-Smirnov trial. Student ‘s t-test will be used for statistical significance of the difference in the average cannulation and laryngeal clip between the MAC group and each of the other groups ; Mann-Whitney trial will be used for non-parametric informations. One-way ANOVA will be used for statistical significance of difference in quantitative variables ( e.g. age, BMI, laryngeal & A ; cannulation clip and hemodynamic parametric quantities ) between the 4-devices groups. Paired t-test will be used for statistical significance of the average difference in hemodynamic parametric quantities ( in each group ) at pre-induction/pre-intubation clip and each of the other clip points ( 1-min, 3-min & amp ; 5-min ) . Categorical variables will be tested for statistical significance utilizing Chi-square trial ; Fischer Ã¢â‚¬Ë œs exact trial will be used when any expected frequence is less than 1 or 20 % of expected frequences are less than or equal to 5.A