Biofuels And Bioenergy

Biofuels And Bioenergy Introduction The use of fossil fuel as a source of energy has aided the development of the human race for many years. This technology has allowed for many benefits such as electricity, transportation, manufacturing machinery etc. The world is faced with the complex economic and environmental issues associated with energy use that must be addressed if we are to maintain and improve our lifestyle. Our economy depends on low cost energy. The idea of renewable energy has been around for quite some time but did not receive much attention mainly due to lower oil prices over half a century ago. However the time has now come when it can no longer be ignored as we enter a new level of consciousness about our fuel consumption and the lack of fossil fuels we have including awareness about the impact on the environment[i]. The pressure to have cheaper alternative energy has become more important especially at a time where we are facing a global recession. As pressing as these economic issues become, we are also faced with even greater environmental consequences if we do not change our energy use patterns. Looming in the background of everything is the mounting concern of carbon dioxide (CO2) build up and other so called greenhouse gases in the atmosphere, which trap the heat that usually radiates from the earth, and cause global climate change[ii]. Therefore clearly, developing alternatives to fuel should be one of the highest priorities of many nations. With record oil prices, the future of Biofuels made from biomass is of keen interest to the world. The global production of Biofuels has increased from 4.8 billion gallons in the year 2000 to about 16.0 billion in the year 2007, but this still accounts for less than 3 percent of the global transportation fuel supply[iii]. This literature reviews the technology of biofuels, their production, usage and impact on a global scale. What are Biofuels? A biofuel can be defined as fuel derived from biomass which is found in many living biological material. Living organisms and their metabolic byproducts such as manure have been successfully used as biomasses. Biomethane, Bioethanol, Biodiesel Biobutanol These fuels can be burnt to produce heat and power, used to run vehicles (Brazil has the highest proportion of road vehicles designed to run on biofuels which peaked at 90% in the 1980s) or powering fuel cells. The content by volume of a biofuel is a minimum of 80% biomass products. Biomass is a form of stored energy just like coal of petrol. The main advantage of biofuels compared with most other traditional fuel types is that this is a biodegradable technology, therefore it is comparatively harmless to the environment. A large amount of biofuels come from specifically grown agricultural crops such as sugar cane and corn. Another useful source is biodegradable by-products that come from industries, households and forestry e.g. timber and rice which can also be used to generate biofuel. There is a growing interest in the field renewable energy technology. And this has resulted in research currently being carried out on projects such as the large scale utilization of micro algae as an energy source. Brief History of Biofuels The initial use of biofuels was in the early days of the automobile industry. A German inventor known as Nikolaus August Otto came through with his invention of running the combustion engine using ethanol. Another historic invention was the powering of diesel engines using peanut oil was by Rudolf Diesel, the German inventor. But unfortunately however in the 19th century when crude oil became cheaper, cars began using fuels from oil which has led to where we are now. There is an increasingly importance in the use of biofuels as a replacement, now being considered by many countries such as the United Stated, by 2025 aim to replace 75% of the oil coming from the Middle East. Over the last century, the world has become accustomed to petroleum based transportation fuels, lubricants and other useful products derived from fossil fuels. However the recent oil prices have been escalating ever since the 1970s fuel crisis and the global climate has changing drastically. Perhaps the time has come to learn a lesson from history and adopt the idea of biofuels for the benefit of the living to save the planet instead of taking the easiest and cheapest way out, saving the planet for the next generations to come. Case Studies and practices of Biofuels We will now look at a few case studies where Biofuels have been successfully used and utilized. Case Study 1 A Lesson from Brazil The worlds second largest ethanol program is based in Brazil and they are capitalizing on bountiful soybean supplies to spread out into biodiesel. About 20 percent of the countrys fuel supply is obtained from the nations sugarcane crop which is processed into ethanol. Brazils policy program was changed to encourage the nations energy independence and creating a substitute value added market for sugar producers. The following was set off in the 1970s right after the famous OPEC oil embargo. Sugarcane producer have been well supported by the government which has spent billions to develop distilleries, build infrastructure and promote the production of pure ethanol and other transport fuels[iv]. It was shown that while the costs were high, this program benefited by saving far more in foreign exchange from the resulting reduced petroleum imports. Brazil in the mid to late 1990s pursed a less intrusive move towards the elimination of direct subsidies and price settings for ethanol with two main elements. Which were a blending requirement (which is now about 25%) and tax incentives favouring the use of ethanol and its purchase for flex-fuel vehicles. Today 80 percent automobiles produced in Brazil have flexible fuel capability[vi], up from 30 percent in 2004. Ethanol is widely available to consumers at nearly all of Brazils 32,000 gas stations; the consumers primarily have the choice between a 100-percent hydrous ethanol and a 25-percent ethanol-gasoline blend on the basis of relative prices[vii]. Roughly 20 percent of current fuel use in Brazil is ethanol, but it will be challenging to raise the share as Brazils fuel demands keep growing with the rest of the worldou. Brazil is a middle-income economy having a per capita energy consumption which is only 15 percent that of the United States and Canada. Unfortunately, the current biofuel production levels in Brazil are not much superior than they were in the late 1990s due to the limitations by the economy and environmentalist. Biofuels have however, come under serious attack recently saying that it is eating into farmlands meant for food production. And as a result last year the European Union backed out from a commitment which would introduce a 10 percent compulsory quota of biofuels in all transportation by 2020[viii]. While admitting that â€Å"biofuels are no silver bullet,† the authorities in Brazil understand and insist that biofuels are the best way forward for developing countries[ix]. A large expansion in ethanol production is underway in the United States, spurred by high oil prices and energy policies The production of ethanol is the U.S climbed to almost 5 billion gallons[x] in 2006, up nearly 1 billion gallons from 2005. Regardless of the speed and degree of this increase, the industry has stepped up the speed of expansion, with production expected go as high as 10 billion gallons by 2009[xi]. Market conditions and policy factors are fueling the rising interest in ethanol. A rapid run-up of oil prices over the past several years has combined with provisions of the Energy Policy Act of 2005 and already existing Federal and State biofuel programs to provide economic incentives for an expansion of U.S. ethanol production. This increase in prices reflects rising global demand for crude oil resulting from strong world economic growth, including rapid manufacturing gains in China and India. Further growth in global economic activity will continue to drive up world demand for oil, particularly in highly energy-dependent economies in Asia. Although the increase in demand is likely to be partly offset by future oil discoveries, more new technologies for discovery and extracting oil, and constant expansion and enhancement in renewable energy, the oil prices are expected to remain high by historical standards. As a result of these strong incentives, the ethanol production capacity has increased over the last year as more production plants have been built or are under construction. Once the constructions of the new plants are complete according to the Renewable Fuel Program of the Energy Policy Act of 2005 renewable fuel use should reach 7.5 billion gallons by year 2012[xii]. The vast expansion in biofuels production and use mandated by EISA will require the development of new methods and equipment to collect, store, and pre-process biomass in a manner acceptable to biorefineries. These activities, which constitute as much as 20% of the current cost of finished cellulosic ethanol, are comprised of four main elements: Harvesters collectors that remove feedstocks from cropland and out of forests. Storage facilities that support a steady supply of biomass to the biorefi nery, in a manner that prevents material spoilage. Preprocessing/grinding equipment that transform feedstocks to the proper moisture content, bulk density, viscosity, and quality. Transportation of feedstocks from the field to the biorefinery. Case Study 3 Biofuels in Senegal JATROPHA PROGRAM It all started in India when Jatropha Carcus-â€Å"Honduras† were carried in by Portuguese sailors a few hundred years ago. They were planted around other valuable plantations as a fence because animals and insects were repelled away from it. Meanwhile, Indian farmers found out that the nut contained oil which they used in their oil lamps. Over the years, these farmers bred the plant to have higher oil content as high as 40-50%. India has always been interested to produce biofuels however it had to come from non-food crops. The Biodiesel produced required certain characteristics for example it had to come from non-food crops and grown in non-prime agricultural land. Jatropha fulfilled these requirements as it is resistant to droughts, requiring minimum use of pesticides and fertilizers. Jatropha plants are very hardy and grow very fast producing seeds for extraction within a few months. The main objective of the program is to ensure Senegals self-sufficiency in biodiesel by 2012 with the production of 1 190 000 000 litres of crude Jatropha oil. This production will represent 1 134 000 000 litres of refined oil which can be used as biodiesel for vehicles as well as to generate power[xiii]. It is also the aim of the program to accelerate the modernisation of the agricultural sector, to create 100,000 direct employment opportunities for the local population particularly in the rural areas where the cultivation of jatropha will be mostly undertaken. The successful implementation of the jatropha program will ensure the diversification of the cultivation of cash crops, reduce the energy bill of households in the country as well as its heavy dependence on imported energy and improve the countrys international trade and balance of payment. Moreover, the program will contribute towards the reduction of environmental pollution caused by vehicle engines; and will also help alleviate poverty and inequality between rural and urban areas. BIOFUEL PRODUCTION TYPES SOURCES Biofuels can be classified in two ways, firstly by the state at which the fuel exists in their natural form which are mainly gas, liquid or solid. And secondly by the sources they have been produced from and the technology used to produce them. In this literature review, biofuels have been classified according the second way. FIRST GENERATION (food crops) First generation biofuels are derived from food crops such as starch, sugar and vegetable oil using conventional techniques discussed later on. Several types of first generation biofuels are discussed briefly below. Biodiesel Biodiesel is probably the most common and most popular type of biofuel in the world because it also is the easiest to produce from ordinary vegetable oil. Biodiesel is produced very simply by combining any type of oil or biomass with methanol and sodium hydroxide[xiv]. It can be used on any diesel engine without any changes to it by mixing with mineral diesel as was described earlier in the â€Å"History of Biofuels† section. Vegetable oil These kinds of oil can be either used for cooking purpose or even as fuel. The main fact that determines the usage of this oil is the quality. The oil with good quality is generally used for cooking purpose. Vegetable oil can even be used in most of the old diesel engines, but only in warm atmosphere. In most of the countries, vegetable oil is mainly used for the production of biodiesel. There has a been great interest shown by European countries and the USA, the graphs below show a rising trend of biodiesel production is USA and many countries of Europe. Biogas Syngas Biogas is produced from organic materials by anaerobic digestion. Waste materials which are biodegradable can also produce biogas if they are fed into anaerobic digesters[xv]. The resulting biomass can be used as fertiliser for agricultural usage. Biogas is rich in methane gas which can be recovered and used as burning fuel. Methane gas is also produced by the natural decay of garbage dumps over time. Another process to produce Syngas or biosyngas is by gasification of biomass into carbon monoxide and hydrogen. Hydrogen can be recovered from syngas or the syngas can be converted to diesel fuel using Fischer-Tropsch process[xvi]. Bioalcohols (bioethanol) Enzymes and micro-organisms are used to produce alcohols through the process of fermentation of starches and sugar[xvii]. Ethanol being the most common of those bioalcohol as in bioethanol produced from sugar cane in Brazil. A significant amount of ethanol is also produced from sugar beets and corn by fermentation in other parts of the world. SECOND GENERATION (non food crops) Second generation of biofuels had been developed to use biomass left from the non-food parts of current crops such as stems, leaves and husks left behind after the important parts of the crop has been taken. It also includes biomass from non food crops such as Jatropha plant (which are toxic), switch grass and industrial waste such as wood chips, skin and pulp from fruit pressings. This generation of biofuels is not cost competitive with existing fossil fuels, do not threaten food supplies and biodiversity[xviii]. THIRD GENERATION (agriculture) Third generation biofuels is obtained from algae and this is also called advanced biofuel. Algae is easy to grow and it is a high-yielding feedstock for the production of biofuel as it produces 30 times more energy per acre of land than traditional crops such as corn or soybean[xix]. They are biodegradable so it is environmentally friendly. Similar to obtaining the oil from vegetation, algae contains almost 40-50% oil which is squeezed out and the remaining biomass can be used as fertilizer or high protein animal feed. The oil from algae can be converted to biodiesel. FOURTH GENERATION (biodiesel to gasoline) Last but not least is fourth generation biofuels which is still undergoing research at the highest levels. The main aim is to convert biodiesel into gasoline similar to the one obtained from petroleum but it will be much cleaner with less harmful emissions. This is similar to how natural gas or methane is converted to petrol. However there is much more study required in this part and will probably not be available in 10-20 years time. First generation feedstocks include corn for ethanol and soybeans for biodiesel. These feedstocks are currently in use and their yields have been increasing. Second generation feedstocks consist of the residues or â€Å"left-overs† from crop and forest harvests. They show much promise for near-term adoption with the development of cellulosic conversion technologies. Third generation feedstocks are crops whichrequire further RD to commercialize, such as perennial grasses, fast growing trees, and algae. They are designed exclusively for fuels production and are commonly referred to as â€Å"energy crops†. They represent a key long-term component to a sustainable biofuels industry[xx]. BIBLIOGRAPHY Charles E. Wyman (1996) Handbook on Bioethanol Production and Utilization, Taylor Francis Publishers, pg 1 Intergovernmental Panel on Climate Change. 1990. J.T. Houghton, G.J.Jenkins, and J.J. Ephraums, eds. â€Å"Climate Change-the IPCC Scientific Assessment,† Cambridge, United Kingdom: Cambridge University Press. Amber Waves, November 2007, Volume 5, Issue 5, William Coyle â€Å"The Future of Biofuels A Global Perspective. Amber Waves, November 2007, Volume 5, Issue 5, William Coyle â€Å"The Future of Biofuels A Global Perspective. Market Research Analyst, â€Å"Worlds Ethanol Production Forecast 2008 2012† http://www.marketresearchanalyst.com/2008/01/26/world-ethanol-production-forecast-2008-2012/ Flex-fuel Vehicles inBrazil: http://alternativefuels.about.com/od/ethanol/a/ffvsbrazil.htm Amber Waves, November 2007, Volume 5, Issue 5, William Coyle â€Å"The Future of Biofuels A Global Perspective. CLIMATE CHANGE: â€Å"Brazil Defends Biofuels†, Claudia Ciobanu, http://ipsnews.net/news.asp?idnews=49597 CLIMATE CHANGE: â€Å"Brazil Defends Biofuels†, Claudia Ciobanu, http://ipsnews.net/news.asp?idnews=49597 Green Car Congress, â€Å"Energy, Technologies, Issues and Policies for Sustainable mobility†: http://www.greencarcongress.com/2007/08/us-ethanol-prod.html Amber Waves, September 2007, Volume 5, Issue 5, Paul. C. Westcot â€Å"U.S. Ethanol Expansion Driving Changes Throughout the agriculture sector.† Shurson, Jerry, Mindy Spiehs, Jennifer Wilson, and Mark Whitney. â€Å"Value and use of ‘new generation distillers dried grains with solubles in swine diets,† Alltechs 19th International Feed Industry Symposium Proceedings, May 2003. Ministry of Agriculture, New orientation for the Agriculture Sector Policy, REVA Plan, Special Biofuels Program, March 2007, â€Å"Biofuels in Senegal Jatropha Program 2007-2009.† Biofuel Organisation: http://biofuel.org.uk/first-generation-biofuels.html Biofuel Organisation: http://biofuel.org.uk/first-generation-biofuels.html Lee S., Lee L., Encyclopedia of Chemical Processing, CRC Press (2005), â€Å"Biofuels and Bioenergy† pp123 Biofuel Organisation: http://biofuel.org.uk/first-generation-biofuels.html RenewableEnergy.com News Article: Next generation of biofuels; http://www.renewableenergyworld.com/rea/news/story?id=49099 Washington Post News Article; http://www.washingtonpost.com/wp-dyn/content/article/2008/01/03/AR2008010303907.html United States Department of Agriculture, â€Å"National Biofuels Action Plan†, September 2008, Board Action Area 2: Feedstock production pg 5.

Dignity in Care for Adults with Learning Disabilities

Dignity in Care for Adults with Learning Disabilities The primary aim of the proposed research is to analyse the meaning, perceptions and quality of dignity in healthcare with respect to adults who have learning disabilities in the United Kingdom and study the range of healthcare services available for adults with learning disabilities. Specific Objectives To assess challenges of access, inclusion, choice, attitudes and legislation faced by adults with learning disabilities in healthcare. To determine whether dignity in care for adults with learning disabilities exists in reality as proposed and promoted by the UK Department of health or not. To understand and compare the types of health care services offered and available to adults with learning disabilities. To analyse the quality of healthcare provided to adults with learning disabilities in the United Kingdom and inequalities faced by them. Methodological Details The primary method that will be utilised in this research is based on systematic literature review whereby observations are made on the basis of data accessible in the respect of people with learning disabilities. Literature search will include key words such as about learning disabilities dignity and type of services offered and available for them in the United Kingdom. This method is implemented in this research because it would definitely be helpful because of various reasons identified in the proposal. The relevant literature will be gathered from various sources including journal articles, research reports and books. Ethical Issues Confidentiality and privacy of individuals participating in a research is quite important especially if the research topic is quite sensitive as the case is with dignity in care for adults with learning disabilities. The researcher needs to understand and realise the seriousness of ethical issues and considerations in such a research. Although there is a danger of participants being named or personal information being compromised, the approval from the ethical issues committee is not necessary, as the proposed study will only present a systematic literature review of the data already accessible by public. Relevance to Practice The entire research would be quite useful in enhancing the level of dignity in adults who are suffering from learning disabilities in United Kingdom. However, one of the major points that should be focused by different agencies and social workers would be how fast and effectively they can implement all these processes. Moreover, significant research has been carried out in this regard from different perspective and from different researchers but the reviewed literature shows several gaps in the standards laid down by different government health authorities and the current practices related to dignity in health care of adults with learning disabilities. Introduction: Dignity is a broad and complicated notion that can be used in legal, religious, bioethics, scientific and political contexts with different meanings. The term dignity signifies that a person has a birthright of being respected and treated morally and ethically by others. Dignity implies that people should be treated in such a manner that they feel their value and worth as individuals within the societal context (Soulen and Woodhead 2006). Dignity can be elevated and alleviated by several factors in a healthcare facility. These factors include the facility culture, surroundings and environment, attitudes and behaviour of caregivers and the practice of care being carried out in the facility. People feel more comfortable, confident and in control for making various decisions on their own in the presence of dignity but if there is a lack of dignity they may feel discomforted, devalued, embarrassed and humiliated (Weisstub and Pintos 2007). Dignity is concerned with how people feel, think and behave in relation to the worth or value of themselves and others. To treat someone with dignity is to treat them as being of worth, in a way that is respectful of them as valued individuals (RCN, 2008). As dignity creates a sense of comfort and control, it is quite important that caregivers in medical institutions realise the importance of dignity while giving care to adults with learning disabilities. The proposed research will analyse the literature associated with dignity in care for adults with learning disabilities in the United Kingdom. The study Aim: The primary aim of the proposed research is to analyse the meaning, perceptions and quality of dignity in healthcare with respect to adults who have learning disabilities in the United Kingdom and study the range of healthcare services available for adults with learning disabilities. The Study Objectives: To assess challenges of access, inclusion, choice, attitudes and legislation faced by adults with learning disabilities in healthcare. To determine whether dignity in care for adults with learning disabilities exists in reality as proposed and promoted by the UK Department of health or not. To understand and compare the types of health care services offered and available to adults with learning disabilities. To analyse the quality of healthcare provided to adults with learning disabilities in the United Kingdom and inequalities faced by them. The following section of the research proposal will discuss the literature as methods and methodology used to achieve the research aim. As it is systematic literature review in general and as it used to this study in research particular. Methodology: Research methodology is an important aspect through which researches are conducted. A research methodology will actually depict that what is the appropriate approach of conducting a research and which research strategy will be applied in this research. In the similar manner it would also depict that which data will be collected for the research and how it will be collected. This entire research would focus on learning disabilities with adults and the issue of dignity will also be addressed in this research. The main objective of this research is to understand the issues of meaning, perceptions and quality related to learning disabilities and how dignity of these individuals is affected. The primary method that will be utilised in this research is based on systematic literature review which is useful for several reasons such gives a genuine, clear idea about the issue being studied. This method is implemented in this research because it would definitely be helpful because of several reasons. First and the foremost reason is that it would give a clear about the issue that is being studied. Wolf (2008) presented an idea about that systematic literature review that philosophy of science, development of health related materials etc can be analysed through systematic literature review. In the similar manner it gives a genuine and a clear idea about the issue that is being studied. Through this approach findings can be properly analysed and systematic literature review helps the researchers in the decision making process. Wolf (2008) believed that through this approach the information that is collected for this research can easily be summarised. The benefits of this approach would be that past researches can easily be utilised and this would definitely reduce the cost of researching. Another important factor for choosing this approach is the benefit of time that is at tached with systematic literature review. According to Britton and Jonsson (2004) systematic literature review is actually a cost effective approach for conducting a research. Both the researchers agreed with Wolf (2008) that generalisation and collection of data in this approach is quite simple and easy as compared to other approaches. Therefore, it can be said that because of these benefits this approach of systematic literature review is selected for this research. Ethical Considerations: Ethics is the term used for differentiation of right over wrong, good over evil and signification of justice or equality in the general behaviour or actions of individuals in a society (Hinman 2007). Confidentiality and privacy of individuals participating in a research is quite important especially if the research topic is quite sensitive as the case is with dignity in care for adults with learning disabilities. The researcher needs to understand and realise the seriousness of ethical issues and considerations in such a research. Although there is a danger of participants being named or personal information being compromised, the approval from the ethical issues committee is not necessary, as the proposed study will only present a systematic literature review of the data already accessible by public. The information collected in the proposed research will only be used for research purposes and real identities will be replaced by codes or false names when required. The following sect ion provides an analysis of literature relevant to the research topic that will be used in the proposed research. In this research proposal, there is no need to seek the prior approval of the research ethical issues committee because the study will be beleaguered to summarise the related literature only. All the subjects included as a part of the literature review and studied / observed are free from any such biases. This research does not use any kind of personal information of patients or people suffering from learning disabilities and hence there is no incidence of violation of rights on moral or ethical grounds. Study of the Literature: According to The UK Department of Health (2001) learning disability is a combination or collection of several disabilities and disorders. These disabilities may include disability to understand new information or skills, impaired function in society and an onset of any disability that started before adulthood and had a lasting effect. Learning disability or intellectual disability also referred to as learning difficulty in the United Kingdom is quite difficult to explain as it covers a broad collection of disorders or disabilities that people may face. These disabilities include but are not limited to challenges in processing information, understanding written or spoken language and other challenges that may affect quality of life (Corley and Taymans 2002). This notion by Corley and Taymans (2002) is backed by Turnbull and Chapman (2010) who suggest that people with learning disabilities face several problems in understanding and processing complex information and face challenges in developing new skills. These descriptions of learning disabilities indicate that adults with such disabilities may have difficulties in processing information in several social circumstances including healthcare. This implies that adults with learning disabilities will have a higher degree of healthcare needs as opposed to people with no learning disabilities at all. McGrath (2010) argued in an extensive literature review that people with intellectual disabilities have greater healthcare requirements as compared to the general population. While explaining the nature and intensity of these healthcare needs he argues that the health care needs of people with intellectual disabilities are more complex in comparison with the general population and can result in premature death, which could otherwise be prevented through effective care. This argument by McGrath (2010) is also backed by several other researches conducted in the context of healthcare needs of people with learning disabilities (Michael 2008; Leyshon et al. 2004; Cooper, Melville and Morrison 2004; Paxton and Taylor, 1998; Nocon, Sayce and Nadirshaw 2008). Gaskell and Nightingale (2010) also agree with McGrath (2010) regarding the greater healthcare needs of people with learning disabilities. They suggest that healthcare needs of adults with learning disabilities tend to be higher in comp arison to the general population due to a variety of reasons including visual and hearing impairment, challenges in mobility, heart conditions, diabetes and osteoporosis. The greater needs for healthcare of adults with learning disabilities are also perceived by caregivers as Vecchio, Cybinski and Stevens (2009) in their study analysed the effect of disability on needs of caregivers. They implemented descriptive statistics and regression analysis to conclude that caregivers of adults with disabilities indicated that they required assistance while providing care to such adults. It was also concluded in the study that the needs of adults with learning disabilities were even greater than the needs of adults with physical disabilities with respect to healthcare (Vecchio, Cybinski and Stevens 2009). Adults with learning disabilities face several challenges with respect to societal factors including unethical treatment, abuse, undue pressure in interpersonal communication and biasness from the general population due to their specific disability (Slater 2005). Slater (2005) argued that the most prominent challenges with respect to societal factors in healthcare were neglect, poor treatment and abuse by caregivers. He argues that adults with learning disabilities have every right to dignity in life as the general population and should not be subject to abuse due to a specific disability. The Department of Health (2001) provides a clear strategy regarding treatment and care of elderly people especially when they face challenges due to learning disabilities. The recommendations presented by Slater (2005) are in line with the department of health framework with respect to poor treatment and abuse. The framework clearly outlines that dignity should be a top priority in healthcare where people should be treated in an ethical, moral and respectful manner. The importance of dignity and equality in healthcare services is iterated by another report of The Department of Health (2002) by implying the importance of fair access to care services irrespective of age and any disabilities a person may have. Philp (2007) recommended that dignity in care should not be an afterthought and caregivers should understand and realise the importance of dignity in healthcare of adults with learning disabilities. He suggests that caregivers are very busy and they need to incorporate dignity into the overall framework for providing care. In his study, Philp (2007) emphasised the need for treating adults with respect and integrity while giving them a sense of freedom and control over their actions and behaviour. He concluded that there are various forms of abuse and caregivers need to provide care with thorough understanding and realisation of dignity in care of adults with learning disabilities (Philp 2007). Holland (2000) on the other hand, analysed how ageing affects people with learning disabilities with respect to social, psychological and biological issues. He argued that adults with severe learning disabilities faced more challenges in later parts of life with respect to services as compared to adults without any disabilities. He concluded in his study that gaps were present in the healthcare and social services provided to learning disabilities and the standards established by the department of health (Holland 2000). This implies that albeit healthcare providers may focus on providing the most effective quality of services but improvements can still be made to make the quality of services more effective especially with respect to dignity in care. Batesa and Davis (2004) in their study of social inclusion and services for people with learning disabilities presented several societal challenges faced by adults with learning disabilities. These challenges include hindrance in local community participation, perceptions of general population, problems in safety and trust, limited access to social networks and limited access to services being offered. The study indicates that these challenges are faced by adults with learning disabilities mainly due to the perceptions of community and general population with respect to these people. The research concludes that social capital concept provides an effective model for services that focus on promoting social inclusion of adults with learning disabilities (Batesa and Davis 2004). The concept of social capital, which is based on social networks, and standards of trust and reciprocity Batesa and Davis (2004) can also be implemented in healthcare for adults with learning disabilities for bet ter outcomes. Health care services are of utmost importance to individuals who are suffering with different learning disabilities. McGrath (2010) believed that people with learning disabilities needs health checks to monitor the discrepancies they have. Annual health checks is a type of health care service that is offered and available to adults with learning disabilities. Usually, people who are facing these difficulties are less likely to receive continuous screening and they have less frequent routine checks. That is the reason why annual health checks should be offered by different health care institutions so that they can benefit from it in both the short and the long run. However, a concern is that whether these health checks are needed or not because if they are not viable enough so there is no need to have an exercise that would engage them in such activity. Albroze (2005) discussed that these annual health checks are very important because they assist the patients in every aspects and peo ple who are suffering from these difficulties can gauge that what is their current situation. People who have learning disabilities usually live in communities and they have the right to access different mainstream health care services. Deshler, Schumaker and Bulgren (2001) discussed that individual importance should be given to people who are suffering with learning disabilities and this can be considered as a health care service. Nurses should be effectively trained in this regard and they should help the individuals who are facing learning difficulties. These researchers also believed that equal health care services should be provided to patients who are suffering from learning disabilities. In the similar manner disability awareness should be given to them in different regards like trainings and workshops should be organised so that they can easily benefit from these activities. Certain special health care services should be allotted to those individuals that have complex and special needs (Bergmark, Parker, Thorslund, 2000). In the similar manner, certain action plans should be developed for this cause so that all these health care services would be implemented in a proactive manner. Besides certain annual che cks individuals suffering from learning disabilities should be offered regular checkups. This will provide an equal opportunity to learn about their health and they can lead a happy and a prosperous life. Certain picture-based books should be provided to them so that they can learn how they can face different complex situations (Deshler, Schumaker and Bulgren 2001). Emerson, Davies and Spencer (2005) analysed that learning disability in adults is a condition that is quite long lasting. A survey showed that about 62% of all the people who are suffering from this disability live with their parents or with their relatives. Similarly, 30% of the people especially adults live in certain form of residential care or they live with people who are also suffering from learning disabilities. However, only 7% of the people live with their partners or they live alone. There are different inequalities faced by adults when they are receiving health care facilities. Michael (2008) believed that at times people receive unequal health care treatment and this can be considered as an important issue for people who are providing learning disabilities and for those who are accessing it. People that are facing learning difficulties are not always offered the same level of services and treatment as the general population. People and health care service providers assume certain things when they are dealing with individuals facing learning disabilities (Kuntz, Minnes, Garcin, Martin, Lewis, Holden, 2005). In the similar manner the routine health care services received by these adults over the year in the United Kingdom is patchy too. Finally, people who are suffering from learning disabilities as not served and perceived as a priority (Michael 2008). Cooper, Melville and Morrison (2004) believed that people who are facing learning difficulties face unequal atmosphere. They are not treated as equal citizens in many conditions and this creates a sense of inequality in them. People with learning disabilities are discriminated in the society and there are different health care professionals who do not understand much about learning disabilities. In the similar manner many professionals in the society are not familiar with the laws associated with capacity to consent. There are certain professionals who are aware with this scenario but most of them do not consult the family of these individuals who are suffering with learning disabilities (Corley and Taymans 2002). Individuals that are suffering with learning disabilities may not understand the significance and importance of health care screening or it is highly probable that they may not recognise the symbols of ill health. This factor might create issues for the carers in both the s hort and the long run. Therefore, people with learning disabilities should be dealt with extreme care and the level of dignity should be maintained so that they can lead a healthy and a prosperous life. Summary: The primary aim of the proposed research is to analyse the issues related to dignity in healthcare with respect to adults who have learning disabilities in the United Kingdom and study the range of available healthcare services. This primary aim will be accomplished by achieving several underlying objectives. All the researches that were analysed in the literature review depict that adults with learning disabilities face several challenges especially with respect to dignity and they should be dealt with extreme care. There are certain discrepancies and difficulties in this regard and there should be a proper equal approach adopted to care for adults with learning disabilities. It was also stressed in this research paper that dignity of these individuals is the main issues and once the dignity of these individuals are present they can live with self respect in the society. Relevance to Practice: The entire research would be quite useful in enhancing the level of dignity in adults who are suffering from learning disabilities in United Kingdom. However, one of the major points that should be focused by different agencies and social workers would be how fast and effectively they can implement all these processes. A significant amount of research has been conducted in this regard but the reviewed literature shows several gaps in standards laid down by government health authorities and current practices. The proposed research will be helpful in filling these gaps. The proposed research would be beneficial for adults who are facing with learning disabilities and it would be beneficial for caregivers who are planning to implement these processes.

Sacrifice in A Tale of Two Cities Essay -- Charles Dickens

New Wark or New York A Tale of Two Cities by Charles Dickens is a story of great sacrifices being made for the sake of principle. There are many examples of this throughout the book made by many of the characters but some or more evident than others. In Book The First, entitled â€Å"Recalled to Life,† the most obvious sacrifice for the sake of principle was made by Dr. Manette. He is imprisoned for eighteen years in the Bastille, for no apparent reason. Another noticeable sacrifice made for the sake of principle was made in Book The Second, entitled â€Å"The Golden Thread,† also by Dr. Manette. Charles Darnay reveals the truth about himself and about his family history. He tells Dr. Manette his real identity and that he is heir to the Marquis St. Evremonde. In Book The Third, entitled â€Å"The Track of a Storm,† Sydney Carton makes an astounding sacrifice for the sake of principle when he fulfills his promise to Lucie Manette, his true love, that he will one day sacrifice himself for the person whom Lucie loves. In â€Å"Recalled to Life,† Dr. Manette makes a very great sacrifice for the sake of principle. â€Å"All through the cold and restless interval, until dawn, they once more whispered in the ears of Mr. Jarvis Lorry-sitting opposite the buried man who had been dug out, and wondering what subtle powers were for ever lost to him, and what were capable of restoration-the old inquiry: ‘I hope you care to be recalled to life?’ And the old answer: ‘I can’t say.’"(45). Dr. Manette is imprisoned in the French Bastille for eighteen years by the cruel French government and unknown to him those many years of pain and suffering serve as a great sacrifice in the eyes of the Revolutionists. He is recalled to life from the time he served when he meets Lu... ...ille. Another conspicuous sacrifice made for the sake of principle was made in Book The Second, also by Dr. Manette. Darnay revealed the truth about himself and about his family history. He lets Dr. Manette know his true identity and that he is the nephew to the Marquis St. Evremonde. In Book The Third, Sydney Carton makes an astonishing sacrifice for the sake of principle when he fulfills his promise to Lucie Manette, his true love, that he will one day sacrifice himself for the person whom Lucie loves. All of the above sacrifices were made with the intention of keeping morals and principles high in human life. Whether it is your life or your feelings towards someone, we have learned that it is always better to give for the greater cause. Works Cited Dickens, Charles. Hard Times. Ed. Fred Kaplan and Sylvà ©re Monod. New York: W.W. Norton & Company, Inc, 2001.

Why did King Victor Emmanuel II invite Mussolini to power in October 1 :: essays research papers

"Fascism...was a super-relativist movement with no fixed principles, ready for almost any alliance." (Denis Mack Smith in 'Mussolini' - 1981) Background Italian unification was in 1861, from this point up until Mussolini came into power in 1922 Italy was ruled by 'parliamentary liberals.' Liberals had never solved the problems of the economically backward South, therefore they were resented there. It can be suggested that the liberal regimes did little to raise the standard of living for the majority of Italians. Mussolini was a 'renegade socialist' with a strong desire for power. His aims and doctrine were difficult to pin down. He was intolerant and embraced violence, therefore diametrically opposed liberalism. Mussolini's Rise to Power Mussolini's fascist regime (an extreme change for the nation from years of liberalism) took control without any substantial opposition. There were many factions in Italian politics who absolutely opposed fascism but a 'united front' was never formed as the Communists, Socialists and the Catholics had too many unresolved differences with each other. They were too busy arguing amongst themselves to agree to fight fascism together, the one way they could defeat it. D'Annunzio's regime in Fiume had openly defied the liberal government and had been well supported by military officers and sections of the ruling classes. Mussolini witnessed this popular appeal to nationalism with great interest. Mussolini realised towards the end of 1920 that he had to make deals with certain parts of his opposition in order to succeed in parliament. Mussolini embraced the political right (despite his left wing background) as he knew it would unite his own party whose strength would appeal to many in Italy who had completely lost faith in the weak liberal government. Mussolini was an opportunist who gained the support of different parties with calculated concessions. For example, before the election of May 1921 he made 'conciliatory gestures' towards the Catholic Church. His turn away from the left had meanwhile also attracted many liberals who feared a Marxist revolution more than anything. Thus, as Mussolini looked like restoring the proper rule of law (rather than instigating a revolution) they began to see his accession as not so awful after all. He appealed to the Conservatives by assuring them that he was primarily in favour of the concepts of war and empire with far less emphasis on revolutionary tendencies. Mussolini had originally been a Republican but in a speech on the 20 September 1922 he 'grudgingly' accepted the monarchy. He knew that he must do this to get to power as although many in the military supported him their primary allegiance was to the throne.

Nick Carraway in Great Gatsby Essay -- essays research papers

NICK CARRAWAY has a special place in The Great Gatsby, by F. Scott Fitzgerald. He is not just one character among several; it is through his eyes and ears that the story takes place. In this novel, Nick goes to some length to establish his credibility, indeed his moral integrity, in telling this story about this "great" man called Gatsby. He begins with a reflection on his own upbringing, quoting his father's words about Nick's "advantages,† which we could assume were material but, he soon makes clear, were spiritual or moral advantages. Nick wants his reader to know that his upbringing gave him the moral fiber with which to withstand and pass judgment on an amoral world, such as the one he had observed the previous summer. He says, rather pompously, that as a consequence of such an upbringing, he is "inclined to reserve all judgments" about other people, but then goes on to say that such "tolerance . . . has a limit.† This is the first sign the narrator gives the reader to show he will give an even-handed insight to the story that is about to unfold. Later the reader learns he neither reserves all judgments nor does his tolerance reach its limit. Nick is very partial in his way of telling the story about several characters. He admits early into the story that he makes an exception of judging Gatsby, for whom he is prepared to suspend both the moral code of his upbringing and the limit of intolerance, because Gatsby had an "extraordinary gift for hope, a romantic readiness.† This inspired him to a level of friendship and loyalty that Nick seems unprepared to extend towards others in the novel. Nick overlooks the moral implications of Gatsby's bootlegging, his association with speakeasies, and with Meyer Wolfsheim, the man rumored to have fixed the World Series in 1919. Yet, he is contemptuous of Jordan Baker for cheating in a mere golf game. While he says that he is prepared to forgive this sort of behavior in a woman: "It made no difference to me. Dishonesty in a woman is a thing you never blame too deeply - I was casually sorry, and then I forgot," it seems that he cannot accept her for being "incurably dishonest" and then reflects that his one "cardinal virtue" is that he is "one of the few honest people" he has ever known. When it comes to judging women - or perhaps only pote... ...e said, even through his appalling sentimentality, I was reminded of something - an elusive rhythm, a fragment of lost words, that I had heard somewhere a long time ago . . ." These are Nick's words. Whose "appalling sentimentality" is operating here? Has Nick reported any of Gatsby's words - which comprise so little of the novel - to suggest that he would even begin to put his love for Daisy in these "sentimental" terms? Is not this excess of sentiment in fact Nick's sentiment for Gatsby or perhaps Nick's attempt at displaying those "rather literary" days he had in college? Or both? The reader should consider the distance that Fitzgerald has created between his presence in the story and Nick's and their implications. Fitzgerald has created a most interesting character in Nick because he is very much a fallible storyteller. When an author unsettles an accepted convention in the art of storytelling by creating a narrator like Nick, it draws attention to the story as fiction, as artifice. Ironically, in doing this, he has created in Nick a figure who more closely resembles an average human being and thus has heightened the realism of the novel

Person Centred Care MDT Essay

This essay will discuss the concept of person centred care, why ser-vice users are at the centre of any decisions made. The importance of this when developing a plan of care to an individual with dementia within a community care setting with limited mobility. What the structure of the mutli disciplinary is when involved in delivering a package of care and how the different roles involved contribute to the positive outcomes Principles of care as stated by the Royal College of Nursing (2013) outlines guidelines what service users should expect from the nurs-ing profession, whether you are a nurse, health care assistant, community nurse, a service user, family member. You are given the information of what to expect when you are in contact with any of the services or who actually are providing a service. Within the community sector this is important as it gives carers a guideline on how to deliver the best possible care and how they should conduct themselves when dealing with vulnerable people. The Royal College of nursing (2013) outlines 8 principles of care they consist of; that all health care assistants, nurses treat all service users with dignity, respect, show understanding of the service users needs. To be non judgemental in the care being provided, whilst showing compassion and sensitivity. Read more:  Person Centred Care Essay All nurses and health care assistants take responsibility for their actions in the care they are providing whilst also being answerable for any action and decision that they take. To manage and assess risk to ensure the safety of the service user and others. To promote the care that is being given putting the service user at the centre of that care, whilst also involving any family members. To ensure that the service user is fully informed of any treatment, to enable them to make an informed choice. All health care assistant and nurses are in the front line for communicating any changes of the service user, recording such things, communicating with other members on the care being provided, whilst maintaining confidentiality. Have up to date knowledge and skills in order to deliver the highest possible level of care to everyone. Work closely with other profes-sionals to ensure that continuity of care is followed to have the best possible outcome for the service user and the staff team . To develop themselves, to encourage and highlight to other professionals the importance of updating knowledge and skills. Many people have different definitions on what Person centred care approaches mean to each individual profession and what their  roles involve when implementing person centred care. The Health Foun-dation 2014 suggests that more person centered care is needed, so that people are supported to make informed decisions about manag-ing their own health and care. In order for this to happen changes in behavior and mindset from patients and clinicians supported by a service that has patients at the heart of it. Policies and practice guidelines need to support patients and clinicians to take on new roles and relationships. Ford 2012 wrote an article on what the value of patient care is this was described as the 6 C’s which stand for care, compassion, com-petence, communication, courage and commitment. Brooker (2007) states that by providing a supportive environment for interaction, whilst taking into account that all human life is mainly grounded by relationships. Within the community environment People suffering from dementia requires and need a fulfilling social environment which enables them to have opportunities for growth within the environment that compensa tes for their impairments. Brooker focuses on the actual diagnosis and how best to help service user to maintain a social connection within a safe environment with the help of staff who understands their condition. Whilst the article that Ford had written expands the key points on how professionals should take into consideration and act when looking after people and communicating with them also. Tuchman’s theory (1965) suggests that in order for a positive outcome to happen then 4 stages of process would need to be worked through within a group situation. These stages are forming, storming, norming and performing. Person centred care was first used in relation to people with demen-tia by a Professor called Tim Kitwood who founded the Bradford de-mentia Group in the 1980’s. His aim was to steer away from the medical diagnosis of dementia and to help those living with the ill-ness to live and be treated as an individual. To acknowledge that these people did have a voice even though in the medical eyes they were slowly losing their own mind. He wrote about the Enriched Model (1997) which detailed opportunities to maximise the well being of a person suffering from dementia whilst enha ncing their daily living of the other elements that affect the person. For example people suffering from dementia have many challenges to deal with. They have the gradual memory loss but also lose the interaction with others, communication becomes repetitive and in the past, how to eat, drink, co ordination, coping with mood changes, general daily  living skills become more difficult to complete along with depression. Buijssen 2005 suggests that depression is a main factor with dementia due to lots of feelings of helplessness and anxiety which can cause the service user to have challenging out bursts. To enable a person to remain in their home safely and independently other people will be involved. This depends on how advanced the dementia is, otherwise the service user would be placed within a residential or nursing home. Maureen Guirdham (1995) suggests that by practising empathy when communicating with a service user, seeing things from their point of view and not just by a medical point of view can build a positive professional relationship. Some professionals at times use their position to influence a service user to see things from the professional point of view; this can cause a barrier to communication because the service user feels that they are not being treated as an individual. That the professional is using a form of blanket suggestion and solution to their problem. Having a common ground of understanding of what it is to be achieved. Initially within the early stages social workers, mental health nurses, general practitioners, speech and language therapists, mobility spe-cialists, and the NHS. Within a community setting district nurses, general practitioners, and at times the emergency services such as the mobile paramedics and ambulance crew are the main sources of the multi disciplinary team that as carers we would normally work alongside with. Jefferies & Chan 2004 describes how multi disciplinary teams work â€Å"the main mechanism to ensure truly holistic care for patients and a seamless service for patie nts throughout their disease trajectory and across the boundaries of primary, secondary and tertiary care.† Carrier & Kendall 1995 also describes how inter disciplinary teams work â€Å"implying a willingness to share and indeed give up exclusive claims to specialist knowledge and authority, if the needs of the client can be met more effectively by other professional groups.† Not all of these will be involved but people with dementia require different specialists at different times of the diagnosis. Almost everyone is registered with a general practitioner. It is the job of the general practitioners to offer high standards of care to all their patients regardless of their health needs. To establish a continuing and long term relationship, with all their patients including those who are vulnerable (Pritchard 2001). More and more General Practitioners (GP’s) are working  within an extended team of professionals who they can refer to for advice and guidance. General Practitioner’s are the first people who are approached when a family member are feared to have the onset of dementia. GP’s will refer the person to the mental health team to have an assessment to see if there are any concerns to have (Mental Health Act 2005). Once the assessment has been done and the diagnosis had been confirmed then a social worker with the relevant experi ence of mental health issues will be assigned to implement further care decisions. A social worker works with people who have been socially isolated or who are experiencing crisis mentally or physically. Their role is to provide support to enable service users to help themselves. They maintain professional relationships with service users, acting as guides, advocates. Social workers work in a variety of settings within a framework of relevant legislation and procedures, supporting individuals, families and groups within the community. Settings may include the service user’s home or schools, hospitals or the premises of other public sector and voluntary organizations. This could be introducing carers from an agency to help with daily living needs, preparing food (Roper et al 1996) Day centres can be arranged for the person to be able continue interactions with others, by still being around professionals who understands their needs and condition. Dementia tears layer away at a person at each stage of its progression, (Alzheimer’s Society 2014) The World Bank 2011 describes what empowerment means â€Å"Em-powerment is the process of increasing the capacity of individuals or groups to make choices and to transform those choices into desired outcomes. Central to this process is actions which both build individ-ual and collective assets, and improves the efficiency and fairness of the organisation and institutional context which govern the use of these assets.† Mental health nurses work with people suffering from various mental health conditions, they also work alongside their family and careers to offer help and support in dealing with their condition. There work involves helping the patient to recover from their illness or to come to terms with it in order to lead a positive and full life. The nurses may specialize in working with children or older people, or in a specific area such as eating disorders. Mental health nurses often work in multidisciplinary teams, liaising with psychiatrists, psychologists, occupational therapists, GPs, social workers and other health professionals.  As a registered mental health nurse (RMN), they may work with pa-tients in a variety of settings including their own homes, community healthcare centre’s, hospital outpatients departments or specialist units, or secure residential units. Even though each professional has a specific area or expertise communication is always a key factor to delivering the best support and care to a service user and their families. District nurses have a crucial role in the primary health care team by visiting people in their own homes. District nurses also delive r care and support for patients and their families. With the differences in roles bought together as one within meetings or communication the process of care is flawless but in the real world this does not always happen. The Health Foundation (2013) states that they â€Å"See patients as equal partners in planning, developing and assessing care, to make sure it is appropriate for their needs, putting families and patients at the heart of all decisions†. Egan’s (2010) three stage model the skilled helper explains how professionals can help service users to focus their situation. To be able to ask questions and step by step understand the process. The model helps to empower the person and help them to move toward managing their problems and living more effectively. The Egan’s model enables the user to map out what the issues are that require discussion. To explore all possible solutions and what would best benefit the service user. It enables the professionals to have respect, genuineness to the subject and empathy to the service user. If good active listening skills are re-membered then the outcome will be the best that can be given to the service user. Egan’s model however all stages do not always have to be considered they are adapted to the situation that requires re solving. Another element that is considered is the SMART aspect which stands for specific, measurable, achievable, the mutli disciplinary team this is where individual roles are separated in order to fulfil their part of the plan of care for a service user. The Department of health (2011) outlines specific guidelines when treating someone with Dementia. These guidelines just like the one that the Department of health released and updated in June 2011 are guidelines and are there to help protect vulnerable people. Working within the community I found I was working alongside more people suffering from early stages of dementia and having more insight into how dementia affects the person enabled me to have a better approach to deal with the care that  was being provided. 1000 lives plus 2012 that was written by Davies stated that â€Å"Seeing the patient’s illness as a continuum between treatment and rehabilitation leads naturally to partnership between organisations. Departments across health and social services co-operate to fulfil the patient’s needs, and the relevant providers need to be working together at all stages of care to properly anticipate the next step, particularly the return home after in-patient care† . This report emphasised that even though Esther arriving at a NHS hospital was ok and the staff where very polite and caring. The sys-tem still had failures especially when Esther had to wait five and a half hours to be seen and after being in contact with thirty six people professionals and repeatedly repeating information for someone who could not breath caused a lot of distressed. By establishing some of the professionals roles within the multi dis-ciplinary team and how government legislation and guidelines impact on how care is provided. In the community for someone who has dementia and other physical needs how efficient are the multi disciplinary team? Sometimes available equipment is based on budget from local councils, so as availability of professional bodies. A person I looked after in the community had a diagnosis of dementia. Visiting them daily sometimes four times a day assessing their needs and any changes daily was important to maintain their safety within their home. Any personal care, breakfast, dinner, tea and bed time all had to follow a strict routine. There came a time when this service user was falling a lot so with the reports given by carers to their head office it was decided the social worker should make a visit they managed to get some adaptations put in place. A wheel frame that could be used to carry things on as it had a tray at the top and at the bottom, the social worker also got a waist alarm, similar to the wrist or necklace type alarm that is linked to a call centre. So if this service user fell the belt would activate automatically because the sensor knew it had to be vertical not horizontal. Within the guidelines of the company policy and given the rights of the person to choose to stay at home, every safety measure to reduce risk was taken by all parties. The service user felt at ease with everyday tasks as before they where a problem. The simple things that we take for granted are the things that need to be taken into account for others. (Human rights Act 1998). Jeremy Hughes, Chief Executive at Alzheimer’s Society said: ‘Today’s announcement  shows that by entering your postcode you enter a lottery. Depending on where you live you may be more or less likely to get a timely diagnosis of dementia and access to the support you need. This is simply unacceptable. Wherever you live, you should be entitled to care and support when you have Alz-heimer’s disease or any form of dementia. It is a National Health Service. It is time to stop treating people with dementia as second class citizens.’ (2013) By introducing the appropriate training and having diagnosis’s being given earlier then people will this diagnosis may stop feeling that they are just being a pain to society and that they still have a function within society. The NHS Wales (2010) five year plan included guidelines to em-power the professionals on the front line for example clinical and non clinical staff to lead changes and deliver the highest possible care available. All these proposals of improving the NHS and the services attached to them is a positive sign for change but as we all know changes can only happen if the funding is available which predominantly involves the tax payers. Some changes that will happen will be making primary care trusts and strategic health authorities abolished and replacing them with one organisation such as the clinical commissioning groups. Who will over sea and involve local authorities in a bigger role to handle budgets. How effective these changes will be to improve the entire system will only be seen in a report that will be released sometime in 2015 as stated in the NHS (2010) five year plan. Main reasoning for continual reviews is to establish a better link to all professions to enable the protection of the vulnerable and to have the sufficient resources to enable action to be taken so that the negative cases that are reported do not happen again.

Strategic Marketing Management

Guidelines for â€Å"Strategic Marketing Project† Elements: 1. Environmental Analysis (SWOT) 2. Identifying Customers 3. Competitor/Value Creation Analysis 4. Marketing Mix: The 4 P’s 5. Financial Analysis and Budget 6. Implementation and Control Plan 1. Know Your Marketplace †¢ Strengths, Weaknesses, Opportunities, and Threats (SWOT) †¢ Trends and changes: – Market analysis – Segmentation – Prioritizing target markets 1. Know who you are selling to (market analysis, segmentation, prioritizing targets) 2. Know what is important to targeted customers (customer analysis) 3. Make sure you are distinctively different from your competition in areas of importance to targeted segments (competitive analysis, reallocation of resources if necessary, positioning, market intelligence) 4. Focus attention of everyone on delivering what the customer wants (management of people, monitoring and control). 5. Constant monitoring of changes in the market (market intelligence, market analysis, internal feedback system) The most fundamental marketing concept is treating customers like you are truly interested in them. That means making sure you are meeting needs that customers perceive as important. Meeting needs is the heartland of every marketing program. A useful tool in assessing the marketplace is SWOT. Assessing the opportunities and threats and how the business can capitalize on them or avoid them using the firm’s strengths weaknesses 2. Who Are Your Customers? Customer/Consumer Trends Customers †¢ Just-in-time inventory †¢ Business to business (B2B) †¢ Manufacturing mentality †¢ Industrialization of agriculture Consumers †¢ Households with fewer people †¢ Active, on-the-go lifestyles Concern over the health aspect of food, with a desire for good taste †¢ Less time for meal prep Know What Is Important to Your Customer †¢ Get inside the mind of your customers †¢ Find out why they would buy from you. . . or why they would not †¢ Truly understand their needs – Intentional listening – Customer analysis – Solve their p roblems 3. Competitor/Value Creation Analysis Make sure you are distinctively different from your competition in areas of importance to your customers †¢ Competitive analysis †¢ Reallocation of resources if necessary †¢ Positioning The Value Chain The Value Chain, or value plate, does is breakdown the functions of a company into its activities to provide a way to assess the internal capacities of the business. The value chain categorizes the generic value-adding activities of an organization. The â€Å"primary activities† include: inbound logistics, operations (production), outbound logistics, marketing and sales (demand), and services (maintenance). The â€Å"support activities† include: administrative infrastructure management, human resource management, technology (R&D), and procurement. The costs and value drivers are identified for each value activity. The value chain framework quickly made its way to the forefront of management thought as a powerful analysis tool for strategic planning. 4. Determining the Marketing Mix †¢ The set of controllable variables that will accomplish the marketing objectives: †¢ Product strategy †¢ Place (distribution) strategy †¢ Promotion (communication) strategy †¢ Pricing strategy Product Strategy †¢ Portfolio of Products – Flavors, colors, variants, blends, genres etc – Fits your strengths and weaknesses – Provides acceptable risk/return trade off – Meets needs of a particular customer segment Quality – No. 1 versus No. 2 – †¢ Service – Timely custom operations – Pre-sorting of grain or livestock quality †¢ Volume – Large and small quantities – Guaranteed volumes (contract) Example: McDonald’s Product Package †¢ Food †¢ Fast service †¢ Fun for the kids †¢ Variety â € ¢ Non-smoking †¢ Consistent product Place/Distribution Strategy †¢ Location – Delivery to multiple points Promotion Strategy †¢ Advertising – Creating TVC, Radio copy, Print ads, outdoor/hoardings ad, Posters, brochures and other advertisements on the products – Creating a logo †¢ Personal Selling Telling your customers how you create value – Having lunch with the corporate customer/vendor †¢ Public Relations – Being a good neighbor – Being involved in the community – Open house days Price Strategy Price is the cost the customer must bear in order to obtain the product. It includes: †¢ list price †¢ discounts †¢ allowances †¢ payment period †¢ credit terms Pricing Methods †¢ Value-Based Pricing – Set price based on buyers’ perception of value (rather than on the seller’s costs) †¢ Cost-Based Pricing – Add a standard markup to the cost of the pr oduct †¢ Competition-Based Pricing Set price based on following competitors’ prices 5. Financial Analysis and Budgeting †¢ Estimate the demand given the pricing and promotion strategy. †¢ Determine expenses associated with production and marketing. †¢ Determine anticipated cash flows. †¢ Will strategy cash flow? When? †¢ What are the critical assumptions of the financial analysis and what are the impacts of changes in those assumptions? 6. Implementation and Control †¢ Focus attention of everyone on delivering what the customer wants – Management of people – Monitoring and control Good luck! Strategic Marketing Management Strategic Marketing Management Sample Exam Questions Question 1: a. Is the PLC (Product life cycle) concept useful in developing Marketing strategies? Describe why or why not? What are the limitations of the PLC concept? A strategy is a fundamental pattern of present and planned objectives, resource deployments, and interactions of an organisation with markets, competitors and other environmental factors. b. What are the advantages available to Google with their Google maps (as a Pioneer firm) in the Internet search engine market? What are the advantages available to any of the follower firms in the market? c. Under what conditions to pioneer and follower strategies each have the greatest probability of long-term success? Question 2: a. Explain the term ‘sustainable competitive advantage’ b. Discuss five (5) differentiation and five (5) overall cost leadership strategies a firm can pursuer to create sustainable competitive advantages c. What are four (4) different types of businesses based on their intended rate of product-market development as proposed by Miles and Snow? d. You are the marketing manager for a generic products division of a major pharmaceutical manufacturer. Your division is a low-cost defender that maintains its position in the generic drug market by holding down its costs and selling generic products to distributors and pharmacies at very low prices. What are the implications of this business strategy for each of the 4Ps in the strategic marketing programme you would develop for your division? Question 3: a. What is market orientation? What are the advantages and drawbacks of being ‘market oriented’ for a firm like Qantas Airways? Lecture 1: Market orientation is implementing a more customer-focused approach to marketing. This involves companies that make what they can sell as opposed to selling what they can make. Market oriented companies have a broad product line and base their pricing on perceived benefits provided as opposed to production and distribution costs as Product oriented firms do. Their research is focused on identifying new opportunities and applying new technology to satisfy customer needs as opposed to product improvement and cost cutting solutions like product oriented firms. Such companies design packaging for customer convenience and use it as a promotional tool rather than to merely protect the product or reduce costs involved and they emphasise their promotion on product benefits and ability to satisfy customer needs or solve problems (as opposed to product features, quality and price). Advantages include†¦ b. Discuss the factors that mediate a marketing’s strategic role within an organisation Lecture 1: Competitive factors affect a firms market orientation Influence of different development stages across industries and global markets Strategic Inertia . Outline the major levels of strategy in most large, multi-product organisations Lecture 1: 1. Corporate Strategy: Decisions about the organisation’s scope and resource deployments across its divisions or businesses 2. Business-level strategy: How a business unit competes within its industry 3. Marketing strategy (Functional) Effective allocation and coordination of marketing resourc es and activities d. List the five components of a well-developed strategy. Lecture 1: 1. Scope (breadth of the strategic domain) 2. Goals and Objectives (What is to be accomplished) 3. Resource deployments (Allocation of limited resources) 4. Identification of sustainable competitive advantage (How the organisation will compete) 5. Synergy (Whole greater than the sum of parts) Question 5: Apple computer’s iPods holds a commanding share of the rapidly growing global market for digital music players. To maintain its lead as the market continues to grow, what strategic marketing objectives should Apple focus on and why? Which specific marketing actions would you recommend for accomplishing Apple’s objectives? Be specific with regard to each of the 4Ps in the firm’s marketing programme. Question 6. While we have seen that a business may have a number of other strategic options, the conventional wisdom suggests that a declining business should either be divested or harvested for maximum cash flow. Under what kinds of market and competitive conditions do each of these two conventional strategies make good sense? What kinds of marketing actions are typically involved in successfully implementing a harvesting strategy? Strategic Marketing Management Strategic Marketing Management Sample Exam Questions Question 1: a. Is the PLC (Product life cycle) concept useful in developing Marketing strategies? Describe why or why not? What are the limitations of the PLC concept? A strategy is a fundamental pattern of present and planned objectives, resource deployments, and interactions of an organisation with markets, competitors and other environmental factors. b. What are the advantages available to Google with their Google maps (as a Pioneer firm) in the Internet search engine market? What are the advantages available to any of the follower firms in the market? c. Under what conditions to pioneer and follower strategies each have the greatest probability of long-term success? Question 2: a. Explain the term ‘sustainable competitive advantage’ b. Discuss five (5) differentiation and five (5) overall cost leadership strategies a firm can pursuer to create sustainable competitive advantages c. What are four (4) different types of businesses based on their intended rate of product-market development as proposed by Miles and Snow? d. You are the marketing manager for a generic products division of a major pharmaceutical manufacturer. Your division is a low-cost defender that maintains its position in the generic drug market by holding down its costs and selling generic products to distributors and pharmacies at very low prices. What are the implications of this business strategy for each of the 4Ps in the strategic marketing programme you would develop for your division? Question 3: a. What is market orientation? What are the advantages and drawbacks of being ‘market oriented’ for a firm like Qantas Airways? Lecture 1: Market orientation is implementing a more customer-focused approach to marketing. This involves companies that make what they can sell as opposed to selling what they can make. Market oriented companies have a broad product line and base their pricing on perceived benefits provided as opposed to production and distribution costs as Product oriented firms do. Their research is focused on identifying new opportunities and applying new technology to satisfy customer needs as opposed to product improvement and cost cutting solutions like product oriented firms. Such companies design packaging for customer convenience and use it as a promotional tool rather than to merely protect the product or reduce costs involved and they emphasise their promotion on product benefits and ability to satisfy customer needs or solve problems (as opposed to product features, quality and price). Advantages include†¦ b. Discuss the factors that mediate a marketing’s strategic role within an organisation Lecture 1: Competitive factors affect a firms market orientation Influence of different development stages across industries and global markets Strategic Inertia . Outline the major levels of strategy in most large, multi-product organisations Lecture 1: 1. Corporate Strategy: Decisions about the organisation’s scope and resource deployments across its divisions or businesses 2. Business-level strategy: How a business unit competes within its industry 3. Marketing strategy (Functional) Effective allocation and coordination of marketing resourc es and activities d. List the five components of a well-developed strategy. Lecture 1: 1. Scope (breadth of the strategic domain) 2. Goals and Objectives (What is to be accomplished) 3. Resource deployments (Allocation of limited resources) 4. Identification of sustainable competitive advantage (How the organisation will compete) 5. Synergy (Whole greater than the sum of parts) Question 5: Apple computer’s iPods holds a commanding share of the rapidly growing global market for digital music players. To maintain its lead as the market continues to grow, what strategic marketing objectives should Apple focus on and why? Which specific marketing actions would you recommend for accomplishing Apple’s objectives? Be specific with regard to each of the 4Ps in the firm’s marketing programme. Question 6. While we have seen that a business may have a number of other strategic options, the conventional wisdom suggests that a declining business should either be divested or harvested for maximum cash flow. Under what kinds of market and competitive conditions do each of these two conventional strategies make good sense? What kinds of marketing actions are typically involved in successfully implementing a harvesting strategy? Strategic Marketing Management Guidelines for â€Å"Strategic Marketing Project† Elements: 1. Environmental Analysis (SWOT) 2. Identifying Customers 3. Competitor/Value Creation Analysis 4. Marketing Mix: The 4 P’s 5. Financial Analysis and Budget 6. Implementation and Control Plan 1. Know Your Marketplace †¢ Strengths, Weaknesses, Opportunities, and Threats (SWOT) †¢ Trends and changes: – Market analysis – Segmentation – Prioritizing target markets 1. Know who you are selling to (market analysis, segmentation, prioritizing targets) 2. Know what is important to targeted customers (customer analysis) 3. Make sure you are distinctively different from your competition in areas of importance to targeted segments (competitive analysis, reallocation of resources if necessary, positioning, market intelligence) 4. Focus attention of everyone on delivering what the customer wants (management of people, monitoring and control). 5. Constant monitoring of changes in the market (market intelligence, market analysis, internal feedback system) The most fundamental marketing concept is treating customers like you are truly interested in them. That means making sure you are meeting needs that customers perceive as important. Meeting needs is the heartland of every marketing program. A useful tool in assessing the marketplace is SWOT. Assessing the opportunities and threats and how the business can capitalize on them or avoid them using the firm’s strengths weaknesses 2. Who Are Your Customers? Customer/Consumer Trends Customers †¢ Just-in-time inventory †¢ Business to business (B2B) †¢ Manufacturing mentality †¢ Industrialization of agriculture Consumers †¢ Households with fewer people †¢ Active, on-the-go lifestyles Concern over the health aspect of food, with a desire for good taste †¢ Less time for meal prep Know What Is Important to Your Customer †¢ Get inside the mind of your customers †¢ Find out why they would buy from you. . . or why they would not †¢ Truly understand their needs – Intentional listening – Customer analysis – Solve their p roblems 3. Competitor/Value Creation Analysis Make sure you are distinctively different from your competition in areas of importance to your customers †¢ Competitive analysis †¢ Reallocation of resources if necessary †¢ Positioning The Value Chain The Value Chain, or value plate, does is breakdown the functions of a company into its activities to provide a way to assess the internal capacities of the business. The value chain categorizes the generic value-adding activities of an organization. The â€Å"primary activities† include: inbound logistics, operations (production), outbound logistics, marketing and sales (demand), and services (maintenance). The â€Å"support activities† include: administrative infrastructure management, human resource management, technology (R&D), and procurement. The costs and value drivers are identified for each value activity. The value chain framework quickly made its way to the forefront of management thought as a powerful analysis tool for strategic planning. 4. Determining the Marketing Mix †¢ The set of controllable variables that will accomplish the marketing objectives: †¢ Product strategy †¢ Place (distribution) strategy †¢ Promotion (communication) strategy †¢ Pricing strategy Product Strategy †¢ Portfolio of Products – Flavors, colors, variants, blends, genres etc – Fits your strengths and weaknesses – Provides acceptable risk/return trade off – Meets needs of a particular customer segment Quality – No. 1 versus No. 2 – †¢ Service – Timely custom operations – Pre-sorting of grain or livestock quality †¢ Volume – Large and small quantities – Guaranteed volumes (contract) Example: McDonald’s Product Package †¢ Food †¢ Fast service †¢ Fun for the kids †¢ Variety â € ¢ Non-smoking †¢ Consistent product Place/Distribution Strategy †¢ Location – Delivery to multiple points Promotion Strategy †¢ Advertising – Creating TVC, Radio copy, Print ads, outdoor/hoardings ad, Posters, brochures and other advertisements on the products – Creating a logo †¢ Personal Selling Telling your customers how you create value – Having lunch with the corporate customer/vendor †¢ Public Relations – Being a good neighbor – Being involved in the community – Open house days Price Strategy Price is the cost the customer must bear in order to obtain the product. It includes: †¢ list price †¢ discounts †¢ allowances †¢ payment period †¢ credit terms Pricing Methods †¢ Value-Based Pricing – Set price based on buyers’ perception of value (rather than on the seller’s costs) †¢ Cost-Based Pricing – Add a standard markup to the cost of the pr oduct †¢ Competition-Based Pricing Set price based on following competitors’ prices 5. Financial Analysis and Budgeting †¢ Estimate the demand given the pricing and promotion strategy. †¢ Determine expenses associated with production and marketing. †¢ Determine anticipated cash flows. †¢ Will strategy cash flow? When? †¢ What are the critical assumptions of the financial analysis and what are the impacts of changes in those assumptions? 6. Implementation and Control †¢ Focus attention of everyone on delivering what the customer wants – Management of people – Monitoring and control Good luck! Strategic Marketing Management Guidelines for â€Å"Strategic Marketing Project† Elements: 1. Environmental Analysis (SWOT) 2. Identifying Customers 3. Competitor/Value Creation Analysis 4. Marketing Mix: The 4 P’s 5. Financial Analysis and Budget 6. Implementation and Control Plan 1. Know Your Marketplace †¢ Strengths, Weaknesses, Opportunities, and Threats (SWOT) †¢ Trends and changes: – Market analysis – Segmentation – Prioritizing target markets 1. Know who you are selling to (market analysis, segmentation, prioritizing targets) 2. Know what is important to targeted customers (customer analysis) 3. Make sure you are distinctively different from your competition in areas of importance to targeted segments (competitive analysis, reallocation of resources if necessary, positioning, market intelligence) 4. Focus attention of everyone on delivering what the customer wants (management of people, monitoring and control). 5. Constant monitoring of changes in the market (market intelligence, market analysis, internal feedback system) The most fundamental marketing concept is treating customers like you are truly interested in them. That means making sure you are meeting needs that customers perceive as important. Meeting needs is the heartland of every marketing program. A useful tool in assessing the marketplace is SWOT. Assessing the opportunities and threats and how the business can capitalize on them or avoid them using the firm’s strengths weaknesses 2. Who Are Your Customers? Customer/Consumer Trends Customers †¢ Just-in-time inventory †¢ Business to business (B2B) †¢ Manufacturing mentality †¢ Industrialization of agriculture Consumers †¢ Households with fewer people †¢ Active, on-the-go lifestyles Concern over the health aspect of food, with a desire for good taste †¢ Less time for meal prep Know What Is Important to Your Customer †¢ Get inside the mind of your customers †¢ Find out why they would buy from you. . . or why they would not †¢ Truly understand their needs – Intentional listening – Customer analysis – Solve their p roblems 3. Competitor/Value Creation Analysis Make sure you are distinctively different from your competition in areas of importance to your customers †¢ Competitive analysis †¢ Reallocation of resources if necessary †¢ Positioning The Value Chain The Value Chain, or value plate, does is breakdown the functions of a company into its activities to provide a way to assess the internal capacities of the business. The value chain categorizes the generic value-adding activities of an organization. The â€Å"primary activities† include: inbound logistics, operations (production), outbound logistics, marketing and sales (demand), and services (maintenance). The â€Å"support activities† include: administrative infrastructure management, human resource management, technology (R&D), and procurement. The costs and value drivers are identified for each value activity. The value chain framework quickly made its way to the forefront of management thought as a powerful analysis tool for strategic planning. 4. Determining the Marketing Mix †¢ The set of controllable variables that will accomplish the marketing objectives: †¢ Product strategy †¢ Place (distribution) strategy †¢ Promotion (communication) strategy †¢ Pricing strategy Product Strategy †¢ Portfolio of Products – Flavors, colors, variants, blends, genres etc – Fits your strengths and weaknesses – Provides acceptable risk/return trade off – Meets needs of a particular customer segment Quality – No. 1 versus No. 2 – †¢ Service – Timely custom operations – Pre-sorting of grain or livestock quality †¢ Volume – Large and small quantities – Guaranteed volumes (contract) Example: McDonald’s Product Package †¢ Food †¢ Fast service †¢ Fun for the kids †¢ Variety â € ¢ Non-smoking †¢ Consistent product Place/Distribution Strategy †¢ Location – Delivery to multiple points Promotion Strategy †¢ Advertising – Creating TVC, Radio copy, Print ads, outdoor/hoardings ad, Posters, brochures and other advertisements on the products – Creating a logo †¢ Personal Selling Telling your customers how you create value – Having lunch with the corporate customer/vendor †¢ Public Relations – Being a good neighbor – Being involved in the community – Open house days Price Strategy Price is the cost the customer must bear in order to obtain the product. It includes: †¢ list price †¢ discounts †¢ allowances †¢ payment period †¢ credit terms Pricing Methods †¢ Value-Based Pricing – Set price based on buyers’ perception of value (rather than on the seller’s costs) †¢ Cost-Based Pricing – Add a standard markup to the cost of the pr oduct †¢ Competition-Based Pricing Set price based on following competitors’ prices 5. Financial Analysis and Budgeting †¢ Estimate the demand given the pricing and promotion strategy. †¢ Determine expenses associated with production and marketing. †¢ Determine anticipated cash flows. †¢ Will strategy cash flow? When? †¢ What are the critical assumptions of the financial analysis and what are the impacts of changes in those assumptions? 6. Implementation and Control †¢ Focus attention of everyone on delivering what the customer wants – Management of people – Monitoring and control Good luck!