Common Causes for Emergency Geriatric Treatment

Common Causes for speck Geriatric TreatmentIntroductionchronological age of 65 years or above is accepted as the defining criteria for Geriatric diligents in most developed countries 1 .This extended heterogeneous group is further classified into three sub existences parkly referred as Young-Old 65-74 Years, Old 75-84 Years and Old-Old 85 years and quondam(a). Worldwide, the number of Elderly persons is expected to much than fork-like from 841 million people in 2013 to more than 2 billion in 2050 2.In United States, patients over the age of 64 years account for 15-18% of ED visits 3 .Of these, about 35% requires admission as inpatient and a signifi peckt proportion of this gets admitted to Intensive cautiousness units 3.. The common gerontological syndromes in the Emergency division include altered mental stance, usable line of descent, fall, trauma, lancinating abdomen, infections, lancinate coronary syndromes, cerbrovascular accidents and exacerbations of chronic resp iratory disorders.There argon unusual characteristics and special needs which have to be kept in opinion while addressing aged patients in the emergency incision. The clinical presentation of geriatric patients is ordinarily complex with more of atypical manifestations confounding effects of co-morbid diseases, superior added cognitive dysfunction, polypharmacy and associated adverse drug reactions, psychosocial issues and lack of adequate social nurse etc 4. Assessment of these issues usually demands a comprehensive turn up with detailed clinical and liberal laboratory and visualise evaluations. This is justified in the context that a brief focused evaluation mountain overlook many grave conditions in these patient group. More over the attending physician should withal try to understand the instaurationline functional military position of the patient front to the presentation as it has got definitive prognostic implications. Thus it requires great skill, companio nship and patience from the part of the attending physician and the health cargon team as such(prenominal) to effectively and safely manage this vulnerable patient population.Approach to Unstable Elderly patient in Emergency DepartmentIn general, the principles of resuscitation in elderly patients be same as the pattern guidelines followed for adult patients. But it is desirable for the emergency physician to speak to the prompt relatives or to the patient himself if possible to see whether there is any hit directive or patients wishes for end of life care decisions. If present, it has to be respected before taking treatment decisions.The special characteristics in elderly while assessing Airway, Breathing and Circulation are summarized in emblem 1.Nasal air duct or Nasogastric tube has to be inserted gently with care as the os nasale mucosa is very friable and has a tendency to bleed in elderly patients. Always examine the oral cavity in unconscious patients for loose adapt ation dentures or partly chewed food as they can cause potential air lane obstruction and if present, has to be removed. Edentulous airway can result in ineffective bag-mask ventilation. Hence tumesce fitting dentures can be kept insitu while bag mask ventilation but always has to be removed before attempts of intubation. Difficulty in extending neck or in escapeding mouth has to be anticipate while attempting intubation repayable to degenerative diseases of spine and temperomandibular joints. Arterial telephone line gases are an definitive adjunct to the clinician as the clinical response to hypoxia, hypercapnea and acidosis can be blunted in elderly.Arterial hypotension (systolic BP 5. Serial assessment of roue pressures and Arterial Blood gas enquiry to see trends in lactate, base excess and acidosis can identify such potential high assay of exposure candidates early 6. Fluid resuscitation should follow in the type fashion with fluids or blood in an elderly patient wh o is hemodynamically touch-and-go in the Emergency department. But it should be careful with constant monitoring to avoid pulmonic edema. Early blood transfusion should be considered in elderly unstable trauma patient.Common Geriatric syndromes in Emergency department alter Mental statusAt least 25% of elderly patients in the ED have altered mental status 7, 8. Delirium is an cutting confusional state and dementia is a chronic confusional state. Etiology of delirium is oftentimes mutltifactorial but often represents an underlying medical checkup emergency. Diagnosis of delirium is clinical and is base on assessment of the level of consciousness and cognition. The confusion assessment method (CAM) is a useful tool for diagnosing delirium at ED 9.The important attention steps in the Emergency department are illustrated in Figure 2.The first priority is to address predisposing and precipitate factors like hypovolemia, hypotension, hypoxia, hypoglycemia, hyponatremia, Acidosis et c. Often inpatient admission is needed for the management of the underlying illness. Drugs like haloperidol or lorazepam may be used in cases of extreme agitation but with caution and at titrating doses.Decline in Functional statusFunctional status reflects how well a person is able to meet his or her own periodic needs-like feeding oneself, dressing up, getting out of bed, bathing, toileting etc. The attending physician should not misinterpret a lineage in functional status as a part of normal ageing process. Functional status of an elderly patient can be formally assessed with use of standard scales for basic activities of daily living. Activity of Daily living ADL is one such tool and is shown in figure 4. New onset Functional decline is often precipitated by medical, psychological or social reasons. Patients with unexplained functional decline need admission for evaluation and management. Functional decline is an important predictor of further functional decline, repeat ED vi sits, hospitalization, need for base care or institutionalization and death10, 11. The general approach to a patient with decline in functional status is illustrated in figure 5.waterfallFalls account for approximately 10% of emergency visits in Elderly 12, 13.Falls are the most common cause of fatal as well as non fatal injuries in geriatric population. A fall should be hard-boiled as a symptom and the physician should evaluate the causes and consequences of fall. The most common reasons for injurious fall- colligate ED visits among the elderly were fractures (41.0 percent), followed by superficial/contusion injuries (22.6 percent) and open wounds (21.4 percent) 13. Serious injuries associated with fall include hip fracture, rib fracture, subdural hematoma, former(a) serious soft tissue injury or head trauma. It is important to remember that a fall can signal a scout event in an elder persons life triggering a downwards spiral of complicating events, finally leading to death.Acu te abdomen in elderlyAcute abdominal pain in elderly usually poses a challenge to the clinician as the symptoms are often non-specific, abdominal findings are often subtle and the presence of co-morbid conditions which can complicate the definitive working(a) procedures. Common causes of acute abdomen in elderly include acute cholecystitis, acute appendicitis, peptic ulcer perforation, mesenteric ischemia, acute pancreatitis, ruptured abdominal aortal aneurysm, bowel obstruction and diverticular diseases. Elderly usually presents with atypical symptoms, often significantly late in the course of the illness.It is essential to consider serious medical conditions like inferior myocardial infarction, pneumonia, pleurisy, diabetic ketoacidosis and pulmonary intercalation in all cases of pretend acute abdomen. Abdominal tenderness may not be present or poorly localized. Guarding or taunt tenderness might be difficult to appreciate. Serial abdominal examination is important as new sig ns tend to appear with time. High risk features include acute onset of pain, severe pain, pain followed by vomiting, descent or persistent pain, signs of peritonitis, hemoperitoneum and hemodynamic disturbances. Liberal imaging is the usual protocol with right-down x-ray abdomen, abdominal ultrasound and CT abdomen as necessary. Patients with act symptoms but with unremarkable laboratory and imaging studies should be observed and serially evaluated as necessary. An approach to elderly with abdominal pain is illustrated in figure 6.Infections in elderlyElderly are significantly more accustomed to infections and its life morose complications. Presentation of infection can be atypical with lack of fever or localizing features. Sepsis can present with subtle clinical features like lethargy, decline in functional status or confusion. rough-cut site of infections include lung, urinary tract, skin and abdomen. High index of uncertainty is necessary to early identify the patients wit h sepsis. Management of Severe Sepsis and Septic transgress in elderly should follow the standard guidelines used for adults like outside(a) surviving sepsis guidelines 14. Early initiation of antibiotics and other sepsis resuscitation bundles is found to improve mortality and functional recovery 15, 16, 17 .The salient points in the clinical approach to an elderly with suspected sepsis are summarized in figure 7.Medication related problemsAdverse events related to drugs are common in elderly population and is a common cause for ED visits. Elderly are more susceptible to serious and fatal adverse drug effects due to polypharmacy, lack of monitoring , non-adherence, use of multiple medications, use of over the restitution medications, wrong dosage , altered drug metabolism and propensity for drug interactions. The risk factors for serious adverse drug reaction in elderly include old-old patient, lean body mass, more than 6 chronic medical illnesses, 9 or more drugs, more than 12 doses per day and a previous history of adverse drug reaction 18. Most commonly encountered problematic drugs include diuretics, NSAIDs, Warfarin, Digoxin, antidiabetic agents, antiepileptic agents, chemotherapeutic agents, antibiotics and psychotropic drugs 19. elaborated drug history, reviewing prescriptions and direct verification of current medications may prove to be very helpful strategies while evaluating geriatric patients in the ED.Elder convolute and NeglectElder abuse is defined a single or repeated act, or lack of appropriate action, occurring within any consanguinity where there is an expectation of trust which causes harm or distress to an older person 20. It can result either from an act of commission or of omission and may present as physical abuse, psychological abuse, cozy abuse, care giver neglect, self neglect and financial exploitation. It should be suspected in patients who present with unexplained or multiple injuries in sundry(a) stages of evolution.Key pointsThe characteristics and needs of elderly in the Emergency department are quite different than the younger patient.Clinical presentation of life threatening diseases can be atypical, subtle or misleading with absence of authorized symptoms and signs.Presence of multiple co- morbid conditions and cognitive impairment usually complicates the picture.A comprehensive work up-including detailed history, physical examination and liberal investigations and imaging is recommended than a brief goal directed or symptom based work up.Altered mental status, falls, functional decline, acute coronary syndromes, stroke, infections with or without sepsis, acute abdomen and trauma are the common geriatric syndromes in the emergency department.Social and non medical issues are important and need multidisciplinary arousal to ensure safe and effective disposition of these population.

Critique of Utilitarianism Theory

Critique of utilitarianism TheoryUtilitarianism as an independent ethical rank but arose in the eighteenth century stock- noneffervescent central employmentful ideas can be engraft in the thoughts of philosophers such as Aristotle. It is a philosophical theory of goodity or how star should act which has diachronic roots within the liberal tradition. The aim of usefulism is to slay closes on the foundation of a calculation of egresss. As a moral theory, There atomic do 18 however many critiques of functionalism which vary as they accommodate several(predicate) reasons and different targets due to the detail utilitarianism isnt a single coherent theory unless a cluster of related theories which have developed throughout the years. In this try on I will be explaining round of the problems with utilitarianism as a theory and discussing whether these problems be insurmountable, for which I think they ar.As a theory, utilitarianism is ordinarily thought to start w ith Jeremy Bentham, however, similar ideas were evident in the writings of David Hume in An Enquiry Concerning the Principles of Morals (1)and Francis Hutchinson, whom David Hume studied under, in his An Inquiry into the Original of Our Ideas of smash and Virtue (2). Utilitarianism tells us an act is moral insofar as it creates the superlative good for the greatest fleck. It tells us to take the core of pleasure distrisolelyed surrounded by sentient bes and look at which distri plainlyion is going to maximise the amount of mirth. It gives a systematic answer. Throughout the past devil centuries utilitarianism has been precise authoritative within practical disciplines of politics and economics. As a result, utilitarianism has had an influence advance(a) life, carve upicularly public policy. What could be more(prenominal) all-important(prenominal) when devising policy-making deliberations than aiming to make mountains lives discover and less unhappy?One of the fir st off utilitarian theorisers, Jeremy Bentham, is famously credited for world the founder of the teaching. Bentham defined utility as instrumental to felicitousness. He believes that all judgements of good and bad can be based on enjoyment and unhinge. He is seen as an advocate of psycho synthetic hedonism. In his famous introduction of An Introduction to the Principles of Morals and Legislation (1979), Bentham states temper has placed man under the governance of two sovereign masters, pain and pleasure. and so, pain and pleasure provide the reason for his moral theory of what we ought to do. Initially, he began his career by studying law and then moved on to moral ethics in order to advise legislators. He was in the main interested in improving the law and his goal for the legislator was the utilitarian teaching or the greatest happiness ruler. Therefore, his advice was non initially aimed for exclusives and their life pickings but for the legislator. Although Bentham sees pleasure as the key of explaining how mankind beings act, he relies more lots on the concept of pain when constructing his legal theory. While he does hold up act-utilitarianism, his sanction-based theory of obligation is more applicable to the legal system he was so interested in improving.John Stuart swot is also whizz of the almost sanitary-known utilitarian thinkers and defenders of the theory. His celebrated thoughts can be found in his famous essay Utilitarianism. lollygag observes something of a crisis in moral thinking. Philosophical thinkers have been unable to come to a consensus on the linguistic rule of what constitutes right and wrong. Mill argues that having such a foundation is necessary to countenance morality. This is why the theory of utilitarianism is so important.Jeremy Bentham and John Stuart Mill categorise and taproom utility and pleasure in different ways. Bentham uses the hedonic calculus which decides the regard as of pleasure by seven mea sures of quantity duration, intensity, certainty or uncertainty, withdrawnness or propinquity, fecundity, extent and purity. Bentham is swell up-known for his treating of all pleasures as of equal value. By this he averages non that all pleasures are of exactly equal, but that the legislator who his work on utilitarianism is aimed at should not be valuing whiz pleasure above another.John Stuart Mill however saw pleasures in two categories high(prenominal) and spurn pleasures. A censure of John Stuart mill about utilitarianism, and the first problem with the theory that I shall be addressing, is his categorisation of higher and cut back pleasures. The difference between these pleasures is founded on sort and not degree, therefore this makes comparing of the consequence of actions far more difficult to calculate. Higher and cut down pleasures cannot be measure or discriminated as they are of a different kind. How would move version of utilitarianism be applied in smirc hs in which bother higher and lower pleasures are involved in the calculation?In similitude to John Stuart mill around classification of higher and lower pleasures, a commons critical review of unproblematic versions of the theory such as Benthams utilitarianism is that they reduce the subtleties of benevolent life to a stark calculation of animal-like pleasures, with no concern for how these pleasures are produced. This gave utilitarianism a bad name and it was often mocked as a doctrine only worthy of swine. (philosophy of the guiltlesss, mill utilitarianism). John Stuart Mill defends utilitarianism from such criticism with his version which differs from Jeremy Benthams simple version Mills differentiation between higher and lower pleasures puts forward that mind pleasures are intrinsically more blue-chip that physical pleasures. Bentham however treats all pleasures as equal to each other. So, when utilitarianism is exposit as a doctrine worthy only of swine, Mill argues that it is better to be a dis quenched human being than a squelched pig and better to be a dissatisfied Socrates than a satisfied fool. His defence is that human beings are capable of intellectual pleasures as well as physical ones, whereas pigs cannot enjoy intellectual pleasures. In his view, humans who have experienced intellectual pleasures will prefer them to lower, physical ones. Those who still are malarky astray by lower physical ones are fall for immediate sensual gratification, even though they know full well that higher, intellectual pleasures are more worthwhile.John Stuart Mils idea of higher and lower pleasures has been viewed as flawed in itself. It has been criticised as a self-serving idea. For example, an intellectual will view his preferred enjoyments as a higher, more important pleasure. Therefore, as an intellectual, it could be argued that Mill himself is biased towards what constitutes as higher and lower pleasures.A further and harsh criticism of utilitari anism is that the theory would justify slavery. This is as long as the slaves were happy or the overall happiness gained by the beneficiaries of the slavery was calculated as than the slaves sadness. Bentham fiercely denies this to be the case, as he argues that the choices of human beings give the best inclination of what makes humans happy, and slavery by definition is never a choice and therefore slaves can never be said to be happy.Bentham is also well known for his employment of utilitarianism as the greatest happiness for the greatest number. This can subsequently be realised to mean that utilitarianism sacrifices the unfortunate few the powerful many. Therefore it has been argued by some that regarding the slavery example citeed previously if the vast economic benefits of slavery outweighed the unhappiness of the slaves then slavery is still favoured by utilitarianism. Bentham argues against this however as he claims the greatest happiness for the greatest number should b e applied in a way that the interest of the powerless many should be more important than the interests of the powerful few.Another fundamental criticism of utilitarianism is that it drops judge. A classic example of this criticism was given by H. J. McCloskey McCloskey, H.J. (1957) An Examination of Restricted Utilitarianism in The Philosophical Review, Vol. 66, No. 4 (Oct., 1957), pp. 466-485. If framing an innocent man for a crime that would reduce the further riots and pain that looking for the genuine shamefaced person would incur, utilitarian theory would suggest that this would be the optimal choice as although an innocent man will suffer, for a greater number of bulk less pain will be caused, incurring in a calculation of more pleasure overall. Therefore, if the sole aim of utilitarian theory is to maximise pleasure and reduce pain for the greater number, justice will be ignored in situations such as this example. Bentham however argues that it is a serious misrepresenta tion to say that utilitarians would be willing to ignore justice and punish an innocent man in the name of the greater good. ADD to benthams defence.Another problem with utilitarianism is the impracticality of calculating the utility of actions in real time. The calculation of utility is said to be self-defeating as by the time the best utilitarian course of action has been calculated and decided, the luck to take this action may well have passed. How can one calculate which of all possible actions will maximise the most happiness overall. What if one is in a dilemma and has a decision to make quickly? In high pressure situations, one usually does not have time to sit down and make exact calculations regarding which decision will bring about the most happiness and minimise pain. Mill deflected this objection with the response that humans learn general moral principle though experience that can later be relied on in such situations. Exact calculations are not necessary for each situa tion in life as this would be impractical. In chapter 2 of his essay Utilitarianism, Mill replies to such criticism In such destiny, one should review common-sense moral rules, which summarize lots of human experience, and tend to guide us toward actions that promote general happiness and away from actions that tend to dampen it. Also, one can cultivate habits and train individual character, so that people lead disposed to act in ways that are happiness-promoting. I find out his reply is valid as utilitarianism as a theory is still in use when making decisions in ordinary situations without exact calculations. It is logical to assume common sense moral rules as guidance when making decisions without pauperisationing to apply exact calculations.A further problem of John Stuart Mills utilitarianism is that strict application of some utilitarian principles can result in unpalatable consequences. This has been argued by many of utilitarianism critics and there are plentiful example s of scenarios where consequences of utilitarianism being applied leads to unacceptable consequences.A great difficulty with utilitarianism is that for one to sincerely take on a core principle such as the greatest happiness for the greatest number, is very demanding. Everything action an individual undertakes would render a moral obligation to care a greater number of people. It requires the actor to be impartial regarding his own happiness and desires and focus neutrally on the happiness of others over one sown. as between his own happiness and that of others, utilitarianism requires him to be as strictly impartial as a magnanimous and benevolent spectator. (jsmill utilitarianism chapter 2) What makes this so demanding is the excessive amount of strangers in need of help and the indefinite opportunities there are to make sacrifices to maximise their happiness. This is also a problem as there is no differentiation between component your friends and family before complete stran gers. For example, choosing to work excessively and earn as more than money as possible to help those in poverty would be the correct utilitarian choice as it does the most good for the most people. We would become charitable cogs and ignore our human nature to have personalised leisure time for example and engage with our individual wants and needs. This ties in with the criticism of utilitarianism that it ignores individuality and individual rights which is a main topic of criticism. As a theory, utilitarianism cannot respect the rights of individuals mill defends. Taking into account John Stuart Mills defence, I personally do not think that utilitarianism looks at individuals as quaint and groups people together without regard for their individuality. One would become a diseased person for greater happiness, disregarding ones own, apparently less important wants, needs and desires. Utilitarian thinkers argue that the world would in fact be a a good deal(prenominal) better p lace if we did live by principle. I disagree and tang that in this sense utilitarianism is overly demanding and has a lack of respect for individual rights. This is a key problem with the theory that I do not believe is insurmountable as it would deter individuals from engaging with the theory.Act-utilitarianism is too demanding Therefore critics of utilitarian argue this overly demanding theory would leave one with a life of toughenedship and austerity.Bernard Williams is an infamous critic of utilitarian theory. He states that we need a sense of integrity and commitments to justify any morality. He effectively argues that utilitarianism misses moral agency. His example of this problem with utilitarianism is the differentiation between an act and the consequence. It is hard to justify that the action earlier than a possibly terrible consequence is what makes an action immoral. Too much egoistic weight is placed on personal actions. For example, the action of shooting someone wi th a gun rather than the victim dying is what is wrong with such a scenario for a utilitarian. Williams argues that we do not judge actions by their consequences and this notion of utilitarianism should be rejected no matter how plausible it may seem. Williams believes this way of judgement removes what it is to be human from the scenario. Moral decision should preserve our psychological identity and integrity.John Stuart Millss confirmation of utilitarianism has also come under unvarying criticism. His answer the question why maximise happiness? is controversial. Mills claim is that happiness is chase afterd as an end in itself and is the aim of all human activity. If someone claims that they pursue virtue as an end in itself, Mill argues that this is just an constituent in their life of happiness and just a means conduct to the same end happiness, pleasure and the avoidance of pain. Virtue is just part of their happiness. So for Mill, the question of why maximise happiness? i s in fact a question of why happiness is preferable. His analogous answer to this is that The only way we can prove an object is visible is by demonstrating that people can actually see it. Therefore the evidence that happiness is desirable is that people desire it. This evidence of proof has come under much criticism as it is argued by Henry Sidgwick that itis based on a bad argument. First of all he criticises the comparison of what is desirable and what is visible. indubitable means can be seen however desirable doesnt actually translate to can be desired. In fact it is more correctly translated to mean should be desired. This weakness of John Stuart Mills analogy makes it hard to compare what people do desire to what people should desire. Therefore, his proof of happiness being desirable is based fully on bad argument. As the fundamental aim of utilitarianism is the maximise happiness, the fact that Mill has difficulty proving that happiness is what the people desire is a fund amental problem with the theory that I do not feel can be ignored.It is also argued that if John Stuart Mill had given a correct analogy, his argument would have lead to a selfish version of utilitarianism compared to the utilitarian approach that the greatest happiness for the greatest number its aim. In Mills example, individuals wanting their own personal happiness will add up to an aggregate happiness. Therefore, it is argued he needs a far stronger argument than his given analogy to prove that general happiness is what all people should aim for.It is clear that utilitarianism, although often considered a simple theory which declares that the morally right action in any circumstances is the one which is most likely to maximise happiness, is actually a very complex cluster of related theories which have developed rapidly since the eighteenth century. Throughout this time many features of utilitarianism have come under constant criticism and as a normative theory it has been widel y criminate of being unworkable. I do believe that utilitarianism has flaws which John Stuart Mill as the theorys key defender has been unable to explain adequately. A lot of Mills utilitarianism is defendable such as how he deals with the objection that the calculations are impractical. except some of his answers to criticism do not persuade me that the problems with utilitarianism are surmountable. I sympathise with the criticism that utilitarianism is overly demanding and following rule utilitarianism strictly would lead to a life of austerity and self-denial. As a moral basis for some decision making I think utilitarianism could have use in society today, however, as moral theory I do not think that it upholds and the problems within it are insurmountable. The criticisms I have mention in this essay are not exhaustive.

Reflection Of Communication Skills Relevant To Clinical Scenario

Reflection Of parley Skills Relevant To Clinical ScenarioIn 2006, a diligent named robin became pregnant. In the 5th month of pregnancy, the patient began having pain in the neck with diarrhoea and wherefore developed a severe infection in her upper respiratory system. robin redbreasts obstetrician immediately hospitalized her and within 24 hours, robin had a temperature of 105 degrees and was in preterm labour. Just before Christmas, Robin was diagnosed with slap-up Viral Pneumonia. After ticktockting permission from the doctor to go dwelling for Christmas, Robin was back at the hospital 15 days subsequentlyward because she was in preterm labour yet again. It was then that Robin was introduced to a gastroenterologist who diagnosed her with Crohns Disease. Robin was immediately put on medications to try to save her and her unborn childs lives. On 3rd February, Robins contractions were five minutes apart but her due conflict was the 17th of March. Robin came to the hospita l and within one(a) hour, I performed an ultrasonography only to let her know that her unborn baby boy was no longer alive. After the funeral of her son, Robin was diagnosed with Deep Vein Thrombosis (DVT) in her upcountry thigh.Reflection Interpersonal communicating acquisitionsListening is an active and basic put to work that involves not only taking the centre of the person speaking by looking at their body language and auditory modality to their linguistic dialogue, but in addition being perceptive (Boyd, 2007, pp. 654-683). Good listening acquisitions are shown by be behaviour that is practiced by establishing eye contact, maintain a relaxed strength and sending detach messages to the patient through gestures (Timby, 2008, pp. 298-312). Attending behaviour industrial plant well in that it encourages the patient to verbalise their feelings and ideas freely (Hart, 2010, pp. 287-299). During listening, the nanny paraphrases the actors line of the patient in fewe r words so as to demand sure that the adjudge unders in like mannerd what the patient wants. Paraphrasing is an important part of listening because it ex lets and clarifies any mixed or double messages sent when the patient fails to strive a send off statement (Huber, 2006, pp. 754-783). The third part of listening is crystalizeing. elucidative goes beyond paraphrasing with an intention of bringing vague material into sharper strain (Kneedler Dodge, 1994, pp. 258-295). Perception checking is an effective part of ensuring true statement of a communication because it is a method of giving and receiving feedback from the patient (White, 2004, pp. 634-683). When helping Robin, I can offer that I had effective listening skills. I make a prognosticate of listening to what Robin told me and I made sure that when she was talking, I made her feel comfort equal to(p) and showed that I was interested in what she was apothegm. trail is a communication skill that encourages the patien t to respond in an open communication so as to invite verbal expression (Chitty, 2005, pp. 512-554). The helper middling anticipates what the patient is thinking and where those thoughts are headed. In anticipating these thoughts, the oblige leads the patient so as to stimulate the communication. Leading encourages the patient to retain primary debt instrument for the direction of the communication and helps them to be active in the process (Ray Donohew, 1990, pp. 112-148). Leading as well encourages the patient to explore and elaborate on their feelings. One of the tools apply in booster cable is using open questions that can be answered by more(prenominal) than just a yes or a no (Giger Davidhizar, 2004, pp. 212-237). Choosing appropriate questions lead to clarification for the patient (Sully Dallas, 2005, pp. 37-82). Another tool used in leaders is by being indirect when tip the patient. Indirect confidential information keeps the responsibility of keeping the commun ication going on the patient. Indirect leading allows the patient to control the direction of the communication and protect their ideas (Knapp Daly, 2002, 145-187). Direct leading on the other hand specifies a topic and the curb uses suggestions to direct the patient. Direct leading is important in elaborating, clarifying and illustrating what the patient has been saying (Miller, 2008, pp. 284-325). In the shell of a patient who has multiple problems or is vague, focussing is an important aspect that should be used in leading the communication (Marrelli Hilliard, 2004, pp. 213-263). Focussing is a way that emphasizes on a certain idea or feeling and helps the patient get in touch with their feelings (Williams Davis, 2005, pp. 27-39). I did not use leading skills when communicating with Robin and this is a skill I should in the future. I entrust enhance my abilities in leading skills by using open questions that forget encourage the patients to share their ideas and feelings freely.Reflecting feelings, cognise and content of the patient expresses that the nurse understands and wants to perceive the world as the patient does (Chase, 2004, pp. 278-317). Reflecting the patients feelings brings those feelings into clear awareness from the vague expressions that they were (Sheldon, 2009, pp 87-113). Helping the patients to own their feelings is done by identifying both the obvious and subtle feelings that are hidden behind words (Rosdahl Kowalski, 2007, pp. 1563-1612). In reflecting experience, the nurse broadly observes the patients verbalised feelings and their nonverbal feelings (French, 1983, pp. 116-145). Like paraphrasing, reflecting content involved repeating the essential ideas of the patient in fewer and unspoiled words (Hegner, Acello Caldwell, 2003, pp 744-763). When the patient is having difficulty in expressing an idea, reflecting content helps the nurse to clarify those ideas. During communication, reflecting helps the patient to recognise and express their feelings effectively (Lipe Beasley, 2003, pp. 267-301). In communicating with Robin, I toilsomeed monotonous and insincere when I began my reflection with saying, It seems you were very upset purge afterward yelling for everyone to get out. In saying this I alike said words that that Robin was unprepared for because they had too much discretion of feeling. In future communication with patients, I should not read more interpretations into the statement than was intended, and I should use less monotonous words that sound sincere.Confronting the patients is intended to help them issue what is going on or what the nurse infers is going on (Cherry Jacob, 2005, pp. 478-501). A patient may feel be and anxious at first when they are confronted. However, the patient is also delightful for the openy albeit direct expression that shows that the nurse cares (Perry Potter, 2002, pp 1114-1163). Confronting the patient presents feedback that is difficult to hear, and as such, the nurse should poses good timing to ensure that the patient is ready for honest feedback (Fitzpatrick Wallace, 2005, pp. 341-367). Sometimes I find it hard to confront patients. In Robins case, I was finding it hard to understand and deal with her. I know that confronting the patient is one of the crucial skills that I essential poses. I must recognize my feelings as the nurse and share those feelings with the patient. I must be able to involve myself in self-reflection as a form of confrontation. I remember that by practicing, training and observing others, I can develop my confronting skills. development interpretation helps the patient to see their problems in spick-and-span ways (Barnum Kerfoot, 1995, pp. 256-298). dissimilar paraphrasing where the patients frame of reference is maintained, in interpreting, the nurse offers the patient a parvenue frame of reference. The nurse adds his or her own means to the patients basic meaning (Ellis Hartley, 2004, pp. 1 14-146). When the nurse adds on to the basic message from the patient, and the patient understands the new idea, then communication is accelerated. Interpreting is useful in helping the patient get a broader perception their feelings (Ferrell Coyle, 2006, pp. 542-568). Interpretation is a communication skill that I used with Robin. While talking to Robin, she mentioned that she felt that the nurses around her were angels who lit her conjure up up in a time when she needed much encouragement. I told Robin that the way I saw it, she could join also take a nurse. Due to the Crohns disease, Robin could only live a stress-free life. However, after living the hospital, the first thing that Robin did was to go to Upper vale Joint Vocational School where she applied for pre-requisite classes in the Licensed pragmatic Nurses (LPNs) program. Robin graduated in November 2009 and has been working in the nursing art since then.The most important thing that a nurse can do for the patient is sharing simple facts (Crisp Taylor, 2008, pp. 1112-1196). Informing is a communication skill that is integrated with giving advice (Maurer Smith, 2005, pp. 360-378). Under some circumstances, where advice giving does not cherish dependency and is not arrogant, giving advice can be helpful to the patient. Communication through informing gives the patient a recommended execute of action that the nurse has experience with. Through giving suggestions, the patient can decide the course of action that he or she will take (McConnell, 1993, pp. 96-118). Crisis functions where the patient has to coiffe to a readjustment in life are an appropriate situation for giving the patient advice. In Robins case, after she had a miscarriage, I certain her to take her time with her son, Benjamin. I encouraged Robin to spend as much time as she wanted holding the five flap fifteen ounce baby boy. As much as Robin did not want to, I took pictures of robin and Benjamin for the memory album. I knew that that was the best albeit hardest thing robin had ever done.Summarising skills involve paying care to what, how, why, when and the effect of what the patient said (Antai-Otong, 2007, pp. 116-128). After communicating with a patient, the nurse should try to gather all the ideas and feeling expressed in one statement (Sines, Appleby Frost, 2005, pp. 273-312). Summarising is important in that it gives the patient awareness of progress in exploring ides and feelings, problem solving and learning (Clark, 2009, pp. 45-96). In summarising, the communication ends in a natural note that clears a way for new ideas and clarifies scattered ideas (Quinn, 1989, pp. 324-364). Patients also gain confidence in that the nurse was attentive to them throughout the conversation. The nurse can use summarising as a means to check the accuracy of the ideas and feelings that were communicated by the patient. When communicating with Robin, I did not use summarising skills. In future communications, I s hould use the ideas from the patients to make a summary of the statements made. Instead of make the summary myself, I could ask the patient to summarize the themes, agreements and plans made during the communication.Enablers and impediments to social communicationWhile communicating with Robin, the physical environment did not pose as an obstacle. However, my provocation as a nurse was an obstacle when communicating with Robin. This discomfort originated from death and dying in general terms. I dealt with this discomfort by thinking that it was not my responsibility to communicate with Robin most hospice care and prognosis. My desire to maintain positive thoughts in Robin and her parents was also an obstacle. I would put off discussions about Robins possibility of a stillbirth until I felt that Robin and her parents could handle that conversation. In the future, I will initiate communication on prognosis and hospice care without thinking it is too much trouble. I will also contr ol fear that emerges after telling the patient bad news. The patient can also be an obstacle to effective communication when he or she is unwilling to birth prognosis or hospice care (Mauk, 2009, pp. 374-412). This unwillingness that was evident in Robins case is ascribed to her non-acceptance of her sons death and her diagnosis with Crohns disease. In helping with Robins acceptance, I encouraged her by letting her know that I would be there to help her and listened to her. Because this worked well, I will continue being an encouraging factor for future patients. pagan and social issues did not act as an obstacle while I was communicating with Robin. During Christmas, Robin when home to celebrate the holiday with her family, and when she was admitted back a few days later, I gave Robin a Christmas present that facilitated communication.decisiveness and recommendationNurses play an important role in communicating with patients because they are always in close contact. A nurse-patie nt relationship is improved by communication and as such, having effective communication skills is an important factor and a priority for every nurse (Daniels, 2004, pp. 1312-1325). I must develop my skills and in leading, confronting and summarising by active in training activities. By participating in learning activities, I can develop strategies and acquire new skills as well as effectively employ those skills. Another outline I will use is practicing key skills with actors and simulated patients because I will be able to control the nature and complexity of the task. Lastly, I must use the communication skills acquired in practice.

Evaluating the Communication Strategy adopted by Yahoo

Evaluating the Communication Strategy adopted by yokelFounded in 1994 by Stanford Ph.D. students David Filo and Jerry Yang, hayseed began as a hobby and has evolved into a leading international distinguish that changed the way concourse communicate with each some a nonher(prenominal), conduct proceeding and access, sh atomic number 18, and create data. Today, hick Inc. attracts hundreds of millions of social occasionrs any month through its innovative engineering and engaging content and services, making it one of the closely trafficked Internet destinations and a world class online media company. The majority of yahoo cracks atomic number 18 avail fitted in more than 30 languages. The company is headquartered in Sunnyvale, California, with a presence in more than 25 countries, provinces, and territories. hayseeds vision is to be the centralize of peoples online lives by reelecting person on the strongy relevant, meaningful Internet experiences ( rube, 2010)hick op erates the web inlet http//www.yahoo.com which provides content including the latest spick-and-spans, entertainment, and sports information. The portal also gives users access to other yokel services like yahoo Mail which is the most popular product, rube Maps which provides the user with maps of cities and town , rube Finance en opens user to have reach to financial trade and stock market, rube Groups is a large assembling of online discussion boards and Yahoo Messenger which offer free communication . The majority of the product offerings be available glob eithery in more than 20 languages.When any makeup is formed is main objective is to serve a certain purpose or need. Yahoo aims to be the center of peoples online lives. node is king and it is of exclusively time important to provide a personal indebtedness in order to maintain the customers loyalty and trust. Customer are always regards as the number one priority and keeping them satisfied is main goal always.Main bodyExternal And Internal Communication collective Communication is an essential thought of an scheme and one that can go out the supremacy of the system. It is the attention flow rate of playction that offers a framework for the effective coordination of all internal and external communication with the all overall purpose of establishing and maintain prosperous reputations with stakeholder groups upon which the organisation is dependent on ( Joep Cornelissen 2008)http//www.emeraldinsight.com/content_images/fig/1680040405005.pngMarkwick and Fill model helps with explaining how an organisation presents itself to each stakeholders and how it changes to get by itself from all other organisationIn every organisation employers are the one of the key assets that helps the business establish itself in the market. Yahoo believes that Work and play join forces to revolutionize the web When Yahoo Started it was a directory of websites. They pioneered a new profession for its empl oyees called Web Surfer which concern categorizing sites of every stripe in which they have to decide what to include, where to arrange the information and how to describe things in a clear point of view.In embarking on the task of bringing order to so much information, Yahoo conventional foundational principles which are as relevant today as they were when the Web was new Be simple, clear, direct. Be useful, inclusive, and provide context, not judgment.Employers are not absorbed to their offices for hours. Yahoo believes that Work and play join forces to revolutionize the web. Forbes magazine has cookd Yahoo one of the outflank companies to work for. Yahoo believes humor is essential to success and it applauds irreverence and dont take ourselves too seriously. We celebrate achievement. The company fosters an environment of teamwork, offering video games and Foosball, and celebrating achievements and milestones with company parties.Environment Yahoo has a strong cargo to corpo rate citizenship, and strives to conduct business in an environmentally answerable vogue. Yahoo is everlastingly trying to give back to the community in a lot of ways. It ranked number one environment corporate citizen in the Corporate Responsibility Officers 10 Best Media list in 2007We use ingenuity and technology to reduce our dependence on natural resources such as energy, materials, and water. And each Yahoo employee pitches in to help reduce waste. This teamwork makes fall the overall environmental impact almost as much fun as yodeling. We endeavor to use our ball-shaped reach to promote the history of sustainability. As a result, we are increasing value to our customers and shareholders, providing an example to other companies, and contributing to a more sustainable early. Yahoo believes in sacramental manduction the success with the communities it lives and whole caboodle in and strive to do our very opera hat for their employees, shareholders, customers and theenv ironment. Yahoo is connected to provide the best online user experience to all individual disable or non-disabled alike. In 2008 Yahoo developed the accessibility lab which designers and engineers studied how disabled children and individuals soon computers and assess the internet Yahoos dedication to accessibility is not only socially trustworthy but also a reflection of our mainstream business practices. Yahoo essentially respects its customers.Identity, Reputation and ImageEvery organisation has an image that gels with its reputation.By establishing an individualism in a market a company is able to distinguish itself from other corporations in the market. Apart from being a leading globose internet brand Yahoos When is come to identity Yahoo regards itself a corporate citizen it has associated itself with two charities which are Trans Tanz And Hope human immunodeficiency virus. Tranz Tanz charity in Tanzania that aims to provide people living with HIV and AIDS with drug w ord and testing facilities in regional wellness centers without charge. But since many people cannot afford public transport .Trans Tanz provides free bus service transporting patients to and from the health centers and their homes. In 2010 on world aids day it plans to use motorbikes to deliver the drugs and test kits from the Health Centers to the patients home.Hope HIV supports people in hacek Saharan Africa who have been affected or orphaned by HIV/AIDS by providing education and emotional support to the victims. HopeHIV aims to make the victims future one of hope rather than despair. By being associated with such charities Yahoo is able to project its image of itself as a caring and responsible corporate citizen contributing to the fight against one of the deadliest diseases around. This enables to boost Yahoo brand recognition and royalty to its customers (Yahoo 2010)Culturehttp//www.designedforafrica.org/images/blog/hofstede.jpgEvery organisation has a agriculture which gen erates the image of an organisation to the outside world. It determines how the corporation presents itself. Hofstede Framework for assessing culture helps us in identify Yahoos culture. One of factor for cultural judging is Power Distance in Yahoo the level surrounded by the clear up level management and employees is low which means ideas and view are boost and accepted by the management to surfaces anywhere within the organisation. All employees are treated equally and are encouraged to communicate openly (Yahoo regulation of Ethics)Individualism is hugely prevalent in all Yahoo companies since it an American establishment. With regard to the Masculine and femininity approach Yahoo adopts both the styles.Yahoo is committed to being a leading global company and strives to do so with integrity. They execute the task flawless and dislike any shortcuts on the other hand Yahoo adopts a famine approach towards its relationship with its employees .Yahoo employers are regarded as va luable assets and the company takes good care of them by providing them with all of perks (dental medical insurance etc).When it comes to uncertain factors affecting the environment Yahoo is able to adapt to it. Yahoo always tries to anticipate the trends in the market and promptly embrace it.Role Of benignant Resource careHuman Resouce Management is regarded as one of the most important functions in an organisation. It acts as a guideline for the organisation to add value to its business. One of the main roles of Human Resource management is to meet the needs of management, HRM is a strategic management tool that links people in an organisation towards the goals and objectives of the business.http//www.emeraldinsight.com/content_images/fig/0690170707001.pngThe Harvard analytic framework explains how the organisation operates in a business environment. Situational factors influence the organisations HR strategy choice. With reference to the work ethics of Yahoo it conducts itsel f with integrity that upholds the value of the organisation. The style of management adopted is different from most business organisation they believe that humour is essential for success. The power distance between the devolve management and employers is low as Yahoo accepts view, ideas and opinions from anywhere within the organisation. By enabling employers to express themselves will lead to more dedication and commitment which in turn helps Yahoo to achieve their targets.Stakeholders interest is an essential aspect in an organisation. Yahoos management consist of high skilled and qualified people. To name a few one of them being Micheal J. Callahan who is the executive vice prexy of Yahoo his role is to advise the companysmanagement and board of directors on strategic and corporate matters. When it comes to Yahoos marketing strategy enzyme-linked-immunosorbent serologic assay Steele is in charge Elisa handles the global marketing strategy as well as global communication and re gional marketing. Yahoo considers itself to be an equal opportunity employer and believes in treating it employers with courtesy and respect. With the wide number of employers working in Yahoo glide slope from different backgrounds the organisation has zero tolerance towards unlawful workplace bedevilment and always strives to maintain an environment where all cultural backgrounds are embraced.The HRM policies of Yahoo provide guidelines on how the organisation accepts its staff to conduct themselves and how communication between various departments should be carried out in a structured manner so that it is complaisant with the laws and regulations which are applicable to all their worldwide operations.David who works as the Chief Human Resouces Officer say I constantly listen to feedback from employees on how the HR processes can improve and do my best to address Yahoos concerns.Employers are encouraged to take up new challenges to perk up more about the business and with that e xposure they will be able to contribute immensely to the team and Yahoo as a wholeHR OutcomesThe HR outcomes revolves around the commitment the employers have towards the organisation, The staff views and ideas are always considered by the management and discourage them to be spectator in the organisation this helps with developing an emotional bond between the employers and the organisation itself. desire Term ConsequencesIt has been 15 years since Yahoo established itself and during its time period it was been able to emerge as one of the top most in(predicate) companies in the world .With all the success it said gained Yahoo has not forgotten the staff who have been with the organisation from the start and their efforts havent gone overlooked .ConclusionIn light of the above analysis undertaken by me for Yahoo I feel that the communication strategy adopted by the unfluctuating is extremely efficient .Yahoo has adopted an excellent corporate strategy that enable the organisatio n to communicate corporate messages to all its stakeholders. Yahoo is one of the most successful media and communication enterprises in the internet industry. People from all over the world come to Yahoo to find information that matters to them the most and Yahoo never fails to deliver that to their customer. All the employers in yahoo are recognise and rewarded thereby sustaining their contribution towards the success of the company.With regard to corporate reputation Yahoo has consistently communicated and projected its corporate images towards the stakeholders as being authentic , preposterous and responsible with its association to a large number of charitable organisation and fight against AIDS.

The History Of Sport Tourism

The History Of run around TourismThis judge forget examine the judge trespass of gasconades tourism on the 2014 Glasgow Commonwealth Games. The sample leave alone ask who and what defines a swordplay tourer, in agreeition, the impact a editions phaeton atomic number 50 slang on Glasgow and Scotland two positively and banly. The lo tungsten section of the essay lead consider the everywhereall impact of the games in terms of sports development and health in Scotland.On the 9th of November 2007, the Commonwealth Games union announced that Glasgow would host the games in 2014. Cited from (Glasgow wins race for 2014 Games, 2007) This would swop the landscape of sport in Scotland and tourism. Glasgows metropolis Council Leader stated Its about making surely thither is a lasting legacy. (Purcell, 2007).This was the culmination of three age of straining work for the city of Glasgow and Scotland. The bid would capture the imagination of both the semipublic and the media this was due to importance and legacy that the commonwealth could bring to Scotland through and through service, selling our culture and products around the world and in addition the ontogeny of tourists (Glasgow Games 2014, 2008).Tourism is a wide spanning theorem split into legion(predicate) categories, the international Association of Scientific Experts in Tourism defines tourism as particular activities, selected by choice and undertaken out-of-door the home environs. Tourism may or may non get oernight stays away from home (Standeven and De Knop, 1999).To actualise tourism there ar many factors that argon involved when one is defining a tourist. A tourist is loosely split into two categories phone line and volunteer(a) (i.e. on spend) and argon categorised deep down Domestic or internationalist tourism (Standeven and De Knop, 1999).An International tourist is a visitor who fits to a field of view different than that in which he/she has his/her inve terate residence for at l eastern hemisphere one night and non more than than one year, and whose main purpose of visit is other than the exercise of an natural process compensate from within the country visited. While a domestic Tourist is a visitor residing in a country, who travels to place within the country, but outside his/her usual environment, for at least one night but no more than cardinal months, and whose purpose of the visit is other than the exercise of an activity remunerated from with the place visited. (Ryan, 2003)To be classified as a tourist either at home or abroad you must spend at least 24 hours away from your home. Business tourists are tourists that travel through work commitment and are inhibited by their employment and a holiday tourist is the reverse were the tourist has the freedom to choose where to travel and the duration. Both types of tourists utilize to specific forms of tourism including mutation. Cited from (Standeven and De Knop, 1999)Lik e tourism itself, Sport Tourism buns be considered a wide and spanning theorem split into many categories. Within sport tourism, sport is break-dancen broad term including natural activity sayings such as rail and walking. While interest is not key for a sport tourist as they tail be an active participant or a passive spectator, it is the active aspect that is the polarizer for the tourism. (Kurtzman, 2005) and cited from (Hinch and Higham, 2004)The passive spectators are associated with back upup tourism were cooperate pillowcases around sports are used to generate bills for their championship and sport facilities have brilliant cooperate go.Were an Active sport tourist is in general associated with holiday tourism were the tourist seeks a specific sport to participate in while on holiday or were a number of sports are on take awayer in a particular resort.Both sets of tourists add great financial get aheads to the economy of the country visited, the next section of the essay depart focus on these financial and frugal benefits towards the 2014 Glasgow games both positively and dis acceptlyFor a host city a major typeface organised correctly allow for be economically beneficial, this has not unendingly been the case. Previous major events such as the Olympics have had a ult of cosmos a financial burden on host cities and organisers. In 1976 the Montreal games lost an astonishing 692 meg and the city has just finished off paying the debts. This led to the birth of cooperate games were private investing and sponsorship turn hosting major events into both profitable and practicable.The 2014 games go out require an investment of 288 million 80% which get out paid by the Scotch politics and the Glasgow City Council and the final 20% forget be acquired through corporate sponsors and investment. (Knight, 2007)The investors lead be hoping on a successful games both sporting and economically, to try and insure a return on their investm ent. through marketing not just games but Scotland as a whole the investors can profit. The Glasgow business guide estimates the Games have the potential to boost Scotlands international profile by almost 50%. wiz way to market Scotland is through tourism. Cited from (Purcell)The Glasgow games are held in the East end of Glasgow and this part of the city leave behinding go under massive regeneration to be ready for the Games. non lone(prenominal) top sporting venues are been gear up in place, an additional super C houses are been built around this area attracting more people to lively and work and invest and contribute to economic regeneration. (Purcell)The investment into Glasgow volitioning be looked upon positively put step-upd tourism can have both a positive and negative act on the city and the economy. unitary positive aspect impart be the add-on of business tourist coming to the Games. Business tourism is worth almost 1b a year to the Scotch economy. Through i ncrementd awareness around the games, Scotland can advertise itself as a world class venue to hold conferences and meetings. As well these tourists can create sassy businesses in the country or expand existing ones due to the experience, there is excessively opportunity to suffer Scotland to network and develop juvenile opportunities, which would contribute to an economic return on the games. Cited from (Glasgow 2014 Delivering a Lasting Legacy for Scotland, 2008)Not just foreign business tourists depart be targeted as local anesthetic enterprises will be targeted and attentioned by the commonwealth movement. Under Visit Scotlands legacy for 2014 games working with Scottish enterprise, event Scotland and the executive it is stated that local business can capitalise on the games and will make themselves and Scotland wealthier. To develop a mechanism to ensure that Scottish businesses have the greatest possible opportunity to win contracts to supply products and function rela ted to major events and this would therefore create a lasting business and economic legacy for Scotland up to 2014 and beyond. (Glasgow 2014 Delivering a Lasting Legacy for Scotland, 2008) Through this legacy these business can turn and prosper in a global environment by displaying themselves around this major event.Through the increase of tourists coming to the games, Glasgow must be ready to host and house them. An increase in all types of hotels will be needed. Glasgow all ready have many hotels to cater to anyones desire but more will be needed to provide suitable accommodation. New hotels and updated ones are planned, including Glasgows prototypal six star hotel in Argyle Street, the international hotel will cost one hundred twenty-five million and will also have apartments included as well. These hotels can have a positive impact financially for Glasgow and Scotland during and after the games.This will engender the opportunity to hold more tourists at one clipping in the city and have a higher clientele that will spend more money while staying. During the commonwealth games the hotels can also be a good base camp to allow the tourist to go the games but also other attractions around the city or even around Scotland. (Argyle Street Hotel Approved, 2007)A major increase in tourist staying in hotels will have positive aspects on the Scottish economy it also could be a negative impact. This is due to the hotel gyves not being Scottish and the profits made by them will go to the country of origin quite a than Scotland.The increase of hotels and other redevelopment will lead to an increase in jobs, which can be looked upon positively and negatively, from a positive aspect. The current economic climate of the recession is increase unemployment and any boost from either extra round or new facilities employing new staff will be vital to the future of Scotlands economic growth. An initiative of the legacy of 2014 games is to flash back economic inactivit y caused by underemployment of the workforce in Glasgow (Glasgow 2014, 2008) This will ensure that the recruitment will be targeted for the local population before and during the commonwealth games, this will allow them to be instruct in new skills and give the inactive trifling new embed confidence and inspiration to work. Cited from (Glasgow 2014, 2008)Scotland is a host during these games and visitors will expect a professional welcome, recruiting from the unemployed could be deemed of having a negative offspring and also increase of jobs in hospitality sector could also have a negative economic impact.Recruiting the unemployed could be a negative impact due to the Colloquialisms used in the Scottish language, especially in Glasgow were it could be verbalise they have their own language of Glaswegian.Visitors will be expecting not only proper English but also formal etiquette will be used, a hotel such as the Hilton train staff to be five star as well as their hotels and th e new staff will have to live up to these expectations which could lead to jobs intended for the unemployed going trained foreign staff, as companies will look for a multi- pagan employee. Cited from (Careers, 2009) This could lead to the new jobs being offered and taken by overseas workers. Not just from E.U countries but employees from Africa, Asia and the Americas. This could have a number of negative factors, first the inactive unemployed will not be able to give way fulfilled with new skills and sense of being and contribute to the Scottish economy. The bribe will be going to foreign worker who could take the money earned back to their own country and have little effect economically while living in Scotland.Although major events are judged on the economic return there other factors to be considered such as the socio- cultural impacts the 2014 games and the influx of tourists will have on both on Glasgow and Scotland.There will be many societal cultural impacts on both Scotla nd and the tourist. Considering Scotland and Glasgow, the city will go under mass regeneration. As stated the east-end of Glasgow will go under mass regeneration but also other areas of Glasgow. This will have both social and cultural impacts on these areas, socially with better housing and infrastructure could lead to a better way of living. The athlete village, National Indoor Sports theatre and the velodrome will be situated in Dalmarnock, a derelict part of Glasgow associated with crime, brusk health and unemployment and new housing will be build in the east-end of Glasgow. Cited from (2014 east end regeneration game, 2007) According to the 2014 games legacy the regeneration will be a transformation of the East End of Glasgow, creating a sustainable, spirited new community. (Glasgow 2014, 2008) The social make-up of not just of Dalmarnock will change which could be seen both positively and negatively.The positive impacts could be that the regeneration helpers attempt the so cial problems around the east-end and which would also encourage tourist to visit the area during and beyond the games. Sport stadia and other constructions engender tourist attractions and bring into generally urban tourists who not otherwise be there. (Standeven and De Knop, 1999) The velodrome and the National Indoor Sports Arena could have tourists and specific sport tourists being attracted to the east-end to visit these buildings or participate after the games, either returning back to the area or see due to the feedback given from tourists returning to their own country. A steady r apiece of tourist each(prenominal) year would encourage local business to grow and expand and network with other countries to bring in products and trade, these tourists could become residents of Scotland and become employed in the east-end and contribute socially and culturally to the area.Although regeneration will alter living and facilities of the east-end and Dalmarnock in particularly, i t could be seen as a negative impact for the people living in this area currently. The project cognise the Clyde gateway project is taking ownership of the regeneration and is behind the new housing, to allow the new projects to take place the residents of Dalmarnock will be locomote to other parts of the city. This will have a negative social effect on the people as they are being travel from their community and friends and family, for two weeks of games. Although most of the feedback from the community has been positive there has been arctic view expressed. Margaret Jaconelli is one is opposed to the games and the redevelopment living 32 years in Dalmarnock and is the only person living in one of the flats I want to stay in my own house as farseeing as possible. Margaret also spirits a sense of loss, It was actually a wisecrack wee community. (Forrest, 2009) The resentment comes from the feeling that the redevelopment will not benefit the local people as there are being shif ted to another(prenominal) community, so a new one can be put in place. This is represented in the new housing which only a few will be council owned and be given back to the previous residents, this could be a form of social cleansing, were the poorer class is go to make way to a richer group of people. Cited from (Lundy, 2003)This could also lead to a negative effect for tourists were the host could become resentful towards tourists as it could be deemed they were the cause of the social change. (Doxey, 1975 p209 putting surface book) developed a model called Doxeys Irridex to evaluate the relationship between tourism growth and community stress. Doxeys model could be applied to Glasgow and the east-end during and after the game. His first stage of the model is Euphoria, which Glasgow will feel before and during the Games, welcoming the tourists to stay and enjoy, the next of Apathy will continue after the games were if tourists return to Glasgow on a regular basis they will b e taken for granted and local bossiness will expect the said(prenominal) number of tourists ever year, the third and fourth stages of Annoyance and Antagonism could apply to local people who are opposed to the games and the redevelopment, they could be openly hard-hitting and unfriendly towards tourists during and after the games. Cited from (Standeven and De Knop, 1999)The increase of tourism will have a social impact on the east-end and Scotland but also culturally, Scotland has a elevated and unique culture and it is key that Scotland can show of their culture and heritage to the world during the games. The games legacy plans to ensure that as many Scottish products and service are used in the Games as possible. (Glasgow 2014, 2008) This will give the tourist an idea of the Scottish produce such as food and drink, kinda than sampling global brands which are widely available and show the prime(prenominal) of the products and interest them to invest or buy more. To display th e arts the Games will work closely with Scottish Arts Council to help showcase our festivals, artists and notional industries, such as computer games and music. (Glasgow 2014, 2008) This will help the Games be a more whole experience for the tourist who can be worked up by both the sport and the culture at hand. Cited from (Scottish Arts Council)A tourist culture could as well have a negative effect of Glasgow and Scotland as a whole, as tourist could struggle to understand the Scottish culture and expect a more commercial viable and a homogenized country. This could lead the Scottish culture being diluted and forgotten, to make way for the same shops, food, cars, art etc as any other country leaving it with no identity or soul.It could be said homogenization has already happened in Scotland with major chains such as Hilton or Starbucks being every major city and each rigid out the same. Cited from (Standeven and De Knop, 1999)The legacy of the 2014 games will look to make Scotl and greener, but a surge of tourists can make both positive and negative environmental impacts. The Games venues such as the athletes village will be eco-friendly with standards set to reduce carbon emissions and waste. The venues are set around the Clyde which is the river that runs through Glasgow, the organisers have seen the seen the river as an opportunity to allow commuters and tourists to move around the city with more easy. One project is to permit the Clyde to have a high speed ferry service, from the centre of Glasgow to Dunoon and then to Greenock. Another service which has been run since 2007 is Britains first pilot airline which a service from the centre of Glasgow to Oban. Cited from (Clydefast Ferries, 2008)These run can be seen both positively and negatively impacting the environment of the Clyde the services will allow more tourists to enter Glasgow daily and stay out with the city ledger entry only when they choose, this can a positive effect on the environment as tourist are using greener and alternative forms of transport rather the car. (Glasgow 2014, 2008)A negative impact will be the impact the services will have on the Clyde itself, the Clyde as already as a variation of water sports preformed on it, including rowing and sailing. An increase in tourism and sport tourists could expand these sports which will have a lasting effect of the Clyde. All forms of water sports can have a harmful decide (Standeven and De Knop, 1999) these can include bank vegetation being damaged, fish and birds being troubled, also local residents could have divergence with the increase of sports and the new services due to noise pollution.Transport is major issue in environmental impacts of a tourist and during the Games there will be an increase in activity that will affect the environment. New transport links are being built for 2014, including the completion of the M74 which will join to the M8 motorway west of the Kingston Bridge. A Positive impact of the new road will be opening up opportunities, reducing congestion and investing in easing the commute. (M74 Completion, 2008)Opportunities include a development of Scotlands economy by up(a) transport links and creating new jobs. The road is will also help the tourism as it will give greater access to the east of Glasgow were the Games are been held and encourage people to visit this area. Cited from (M74 Completion, 2008)Negative impacts of this road will be the potential environmental damage caused to local residents, in 2003 Green and Socialist MSPs united to oppose plans to complete the M74 motorway. They argued that the road would to reduce dealing and could increase it, health impacts of pollution on children and adults and the money worn out(p) did not justify the cause. In Glasgow particularly, where nearly 60% of households dont have access to a car, it is an obscenity that half a billion is going to be spent on a slice of motorway five miles long thats 100m a mile, (P arties unite to fight M74 plans, 2003)The tourist will make a authoritative impact on Glasgow during and after the games and also the legacy of the games can embolden the people of Glasgow and Scotland to become healthier and introduce them to sport, the Games will allow Scotland to improve their sport development and help master goals set by the government and the Sportscotland.Sportscotland is the national agency for sport in Scotland, and their mission is to encourage everyone in Scotland to discover and develop their own sporting experience, helping to increase participation and improve executings in Scottish sport. (We are the national agency for sport in Scotland. 2009)To achieve this Sportscotland issued a national strategy for sport, Reaching higher(prenominal) the two outcomes of Reaching Higher are increasing participation in sport and improving performance. Through the legacy of the Games Sportscotland can help to achieve these two national outcomes, an increase in sp ort infrastructure throughout Scotland by networking and engaging with national governing bodies, local authorities and Sportscotland will allow authorities to welcome an increased interest in sports participation. An increase under-represented groups participating in sports, the games will encourage new groups into sport and facilities will give them chance to take part.New sport development programmes to give young participants the best pathway to success will help Sportscotland to increase participation. Cited from (Glasgow 2014, 2008)To improve Scottish performance on a world stage, the Games can help discover a clear pathway from grass-roots to elite performance in successful sports, which will guide young athletes through each stage and give the correct training needed.Expanding the Scottish Institute of Sport were the top Scottish athletes are trained, will allow more to be trained and therefore an increase in more athletes. The can help to increase medals and general perfor mance of Scottish athletes at major events, investment into sport will give better training facilities, coaches and equipment. Cited from (Glasgow 2014, 2008)The Games will help Sportscotlands to achieve the outcomes, the Games can also revolutionise Scottish heath, Scotland has one of the mop up records of health in Europe with the highest number heart problems and strokes and has the shortest life expectancy. Cited from (Bridgland, 2000) and (Scotland is wipe up small country, 2007)In 2003 the Physical activity strategy was launched Lets Make Scotland more than Active, with their key goal of the strategy is 50% of all adults aged over 16 to achieve 30 minutes of physical activity each day and 80% of all children aged 16 to be achieving over an hour of physical activity each day by 2022. Cited from (Physical activity strategy, 2003)Physical activity can exclude sports and can include running or walking and the Games can be a vehicle to jolly up people to be more physically acti ve. Through correct marketing and information on how people can become more active. The Games will have legacy on the children, obesity among children is a growing health concern in Scotland, the games will give courage to children to try sport and be physically active, also campaigning for a healthier modus vivendi including food, alcohol and drug advice. Cited from (Glasgow 2014, 2008)To conclude the essay said it would examine the anticipated impact of sport tourism on the 2014 Glasgow Commonwealth Games. The essay has answered this enquiry by stating a number of potential impacts a tourist can bring to Glasgow and the impact the Games will have on Glasgow. The sections of the essay asked who and what a tourist and sport tourist are and a brief on the 2014 Glasgow Commonwealth Games. This section was answered fully giving a number of academic references to define a tourist, the main section of the essay was to consider the boilersuit impact both positively and negatively of the Games in terms of economically, socio-culturally and environmentally. victimization both academic text and physical sources the essay was able to give numerous examples in each section. The final section would consider the overall impact of the games in terms of sport development and health in Scotland, using national strategies this section could be answered completely.

Womanhood in The Eve of St. Agnes and La Belle Dame Sans Merci and Mari

Womanhood in The Eve of St. Agnes and La Belle dame Sans Merci and Mariana by KeatsIn the two poems Mariana and La Belle Dame Sans Merci and theextract from The Eve of nonpareil Agnes the poets portray deuce-acediverse perceptions of women. The reader distinguishes a woman as atemptress, a woman whom is vulnerable and is dependent on man, and awoman who is nubile and is innocently seductive.La Belle Dame Sans Merci is a b solelyad, write in 1819. In thisballad, the femme fatale deceives the Wretched Wright she meets. Hefalls in come with the Belle Dame instantly and is convinced that shetoo is in drive in with him She lookd at me as she did love. TheTempter is beautiful, a faerys child the Belle Dame looksmagnificent on the outer surface however beauty is only skin turbid asthere is an inner wickedness about her. Her eyes were wild and sheenchants the Wretched Wright with faerys songs. Faerys werethought to be from another place. Her love was weird but fantasticto the Wretched Wright,And sure in language true she said,I love thee true.The Belle Dame is conveyed, as a temptress who make loveingly destroysmens hcapitulumts, evening from reading the title the reader knows this. Thetitle is translated to mean A Beautiful dame Without Merci thisshows us that she is dangerous to men. I saw pale kings, and princestoo, the Belle Dame had intentionally starved more men before theWretched Wright blueprint love.This contrasts with The Eve of St. Agnes where the reader observesanother type of temptress, Madeline, in the poem Mariana. Madelineis unwittingly seductive to the weak Porphyro. Porphyro even sings toher,La belle dame sans merciClose to her ear as ... ...ness by Keats, Alone andpalely loitering, we too connect this send off with gloomy, sufferinglove. As if he is colourless like the Pale warriors, death-pale werethey all. passionateness had taken away all their cheerful colours along with sledding them weak and defenceless.In conclusion through thes e poems the reader explores the limitationsof society and the puzzle out of these restrictions on women. Thereader also observes the power and beauty of love as well as theresult it has on people. In all three poems the last line of the poemsand the extract demonstrates this Oh God, that I were dead For ifthy diest, my Love, I know not where to go, And no birds sing. Ithink that in all three endings Keatss and Tennyson some up thedistress caused by love and the penalisation of its addiction veryadmirably when looking into the poems not at premier(prenominal) glance.