Septic Shock And Kidney Injury Health And Social Care Essay

Systemic inflammatory response syndrome ( SIRS ) is expressed as febrility or hypothermia, tachycardia, tachypnea which may be associated with leucocytosis or leukopenia. SIRS generates broad spread inflammatory reaction in organic structure in response to external abuse which is protective for an person when its effects are restricted to pathogens, in other state of affairss inflammatory reactions are hurtful when they are directed against normal tissues in add-on to pathogens. [ 1,2 ] SIRS can ensue from legion conditions but termed as Sepsis, merely when infection sets in and morbific agent is detected. Sepsis consequences from an single response to external infection, which begins with systemic redness ab initio, followed by curdling abnormalcies and eventually deranged fibrinolysis. When sepsis causes one or more organ disfunction, the syndrome is termed Multiple Organ Dysfunction Syndrome ( MODS ) or terrible sepsis. [ 3 ] Sepsis-induced hypotension which is furnace lining to f luid boluses is termed Septic daze. Hypothermia associated with infected daze indicates hapless tegument and visceral perfusion, is normally associated with hapless forecast and high mortality rates of up to 30 to 40 % . Several serum biomarkers suggested holding diagnostic or predictive value in infected daze, but a unequivocal biomarker for everyday clinical usage is yet to be identified. One such marker is serum lactate which indicates pronounced hypoperfusion and tissue hypoxia in infected daze. Similarly serum Creatinine should besides be considered as marker of lessening organ perfusion in sepsis and Acute Kidney Injury should be regarded as index of ongoing organ harm and likely possibility of oncoming of infected daze. [ 4 ] AKI is due to sudden and drastic decrease in kidney map ( within 48 hours ) characterized by absolute addition in serum Creatinine ( & gt ; 50 % from baseline ) or a decrease in urine end product ( oliguria of & lt ; 0.5 ml/kg/hour for & gt ; 6 hours ) . Nephritic hypoperfusion and ischaemia during infected daze amendss nephritic tubules taking to acute cannular mortification ( ATN ) and have been demonstrated to be a common etiologic factor for AKI development during sepsis [ 5,6 ] . ATN was found to be a consistent histopathological determination in these patients, this would strongly propose that ischaemia and nephritic tubular cell mortification are likely an of import pathogenetic mechanism. [ 7,8 ] Acute kidney hurt have marked impact on the result of critically sick patients. Disease badness tonss such as the Acute Physiology and Chronic Health Evaluation ( APACHE II ) and Sequential Organ Failure Assessment mark ( SOFA ) both have included nephritic disfunction as forecaster of morbidity and mortality ; on the other manus liver disfunction tonss, coagulopathy, thrombocytes and other critical organ maps are non much stressed in APACHE II hiting system. To set up a unvarying definition of nephritic harm, RIFLE categorization was formulated which characterizes Risk, Injury, Failure, Loss and End-stage Kidney ( RIFLE ) . [ 9 ] An of import facet of the RIFLE categorization is that it grades the badness of acute kidney hurt on the footing of alterations in serum creatinine and urine end product from the baseline status. [ 10 ] Urine end product is an of import physiologic mark of organic structure fluid position, and unstable instability is common in critically sick patients due to extravasation of fluid into extravascular infinite or due to 3rd infinite losingss and eventually the nephritic disfunction. This farther suggest that reduced organ perfusion in infected daze plays a cardinal function in development of AKI taking to cut down creatinine clearance and increased serum creatinine degrees. [ 11,12 ] In this survey we compared increasing serum creatinine degrees with plasma lactates and SOFA tonss to observe oncoming of sepsis and infected daze and to prove the hypothesis that ongoing acute kidney hurt can bespeak reduced organ perfusion and oncoming of infected daze in critically sick patients.Patients and Methods:This survey was carried out to happen a correlativity between lifting serum creatinine degrees and oncoming of infected daze in 115 critically sick patients admitted in ICU and were managed following Surviving Sepsis guidelines. [ 13 ] Human ethical blessing was taken by the institutional moralss commission. Written informed consents were obtained from control topics and patients or their relations. The control groups were the healthy relations attach toing the patient. Entire 90 controls were taken, among them 65 were males and 25 females with a mean ( SD ) age of 36.5 ( 8 ) old ages. Among patient group 67 were males and 48 females with mean ( SD ) age 37.5 ( 6 ) old ages. Patients included in our survey had either of the undermentioned characteristics: ( 1 ) Clinical characteristics proposing infection ; ( 2 ) Core temperature & gt ; 38AÂ °C or & lt ; 35AÂ °C ; ( 3 ) Heart beats & gt ; 100/min ; ( 4 ) Respiratory rates & gt ; 30 breaths/min or demand for supportive mechanical airing and ( 5 ) Inadequate organ map or daze within 12 hours of registration. Patients excluded were: ( 1 ) aged patients older than 75 old ages ; ( 2 ) NYHA category III or IV patients ; ( 3 ) liver inadequacy ( Child C ) ; ( 4 ) HIV, HBsAg positive serology, Cancer patients. Demographic characteristics like age, sex, primary site of infection, morbific beings and disease badness scores including Acute Physiology and Chronic Health Evaluation Scores ( APACHE II ) and Sequential Organ system Failure Assessment mark ( SOFA ) were recorded for each patient ‘s at the clip of admittance in ICU and later. The plasma of these patients was tested for serum creatinine and lactates degrees at the clip of entry in ICU, so after every 24 hours till their stay in ICU. All the samples collected and patient inside informations gathered during the survey were coded to look into for prejudice and patient confidentiality was maintained as per the guidelines for surveies of human patients. Blood sample aggregation: First blood sample was collected prior to get down of antimicrobic, steroid therapy or vasopressors. Blood samples were collected from cardinal venous line ( 9 milliliter ) into sterilized tubings incorporating 1ml trisodium citrate ( TSC ) at the clip of patient admittance I ICU and later. Plasma was separated by extractor at 10,000 revolutions per minute for 15 min. The plasma was stored at -70AÂ °C for farther analysis and repeated freezing melt of samples was avoided in order to forestall debasement of plasma.Statistical analysis:The informations were analyzed by nonparametric analysis of discrepancy ( ANOVA ) with Newman-Keuls multiple comparing post-test. The relation between serum creatinine degrees, plasma lactates and APACHE & A ; SOFA mark was tested by finding the Pearson correlativity coefficient ( R ) . A P-value of less than 0.05 was considered important. Entire information recordings were obtained in triplicate and consequences of computation s are reported as agencies and criterion divergence up to two denary points. All statistical analyses were performed with the Graph Pad InStat 5.0 demo plan ( Graph Pad Software, USA ) .Consequences:Among 115 patients admitted in ICU during the period April 2009 to May 2010, 45 patients were of SIRS, 39 patients were in sepsis and 31 patients in province of infected daze ( Table 1 ) . Sepsis was diagnosed on the footing of specific civilization studies from assorted possible sites of infection, including blood civilization study. Out of 115 patients studied there were 67 male patients and 48 females with a mean ( SD ) age of 37.5 ( 6 ) old ages. Mean serum creatinine degrees in healthy control group was 0.83 AÂ ± 0.26 mg/dl, runing from 0.4 to 1.6 mg/dl. In SIRS group, the average serum creatinine degrees were 3.45 AÂ ± 1.26 mg/dl, runing from 1.2 to 6.2 mg/dl ( Figure 1 ) . The APACHE II and SOFA score correlated linearly with serum creatinine degrees ( r2=0.74, P & lt ; 0.001 for APACHE & A ; r2=0.69, P & lt ; 0.001 for SOFA ; Figure2 ) bespeaking nephritic hurt with badness of redness. In sepsis patients average degrees were 7.15 AÂ ± 1.3, runing from 4.0 to 9.3 mg/dl. Pearson ‘s coefficient showed additive correlativity of serum creatinine and sepsis badness tonss ( r2 = 0.65, P & lt ; 0.001 for APACHE and r2 = 0.62, P & lt ; 0.001 for SOFA ; Figure2 ) . In patients of infected daze with nephritic disfunction really high serum creatinine degrees were observed with mean of 10.31 AÂ ± 2.29 mg/dl with values runing from 6.0 to 15.2 mg/dl, these values were significantly ( P & lt ; 0.01 ) higher than those with sep sis ( 7.01 AÂ ± 1.3 mg/dl ) , SIRS ( 3.49 AÂ ± 1.10 mg/dl ) and the control group ( 0.83 AÂ ± 0.26 mg/dl ) . Detection of metabolic acidosis in arterial blood gas analysis was evaluated farther by blood lactate appraisal ( Figure 3 ) . Blood lactate degrees in SIRS group were ( 5.14 AÂ ± 1.24mmol/L ) with scope from 2.2 to 7.8 mmol/L. Similarly blood lactate degrees in sepsis ( 7.73 AÂ ± 1.4mmol/L ) and infected daze group ( 9.53 AÂ ± 1.2mmol/L ) were significantly high ( 95 % CI in sepsis 7.25 to 8.21 ; daze 8.9 to 10.16 mmol/L ) . In control group mean values were 0.93 AÂ ± 0.39mmol/L ( 95 % CI 0.84 to 1.0 mmol/L ) . In order to detect a relation between extent of nephritic hurt and oncoming of infected daze, creatinine clearance ( taken as step of nephritic map ) was so compared with blood lactate degrees ( taken as index of anaerobiotic metamorphosis and daze ) , Pearson ‘s coefficient showed reverse relation between lifting lactate degrees and Creatinine clearance in patients with terrible sepsis and infected daze ( Figure 4 ; r2=0.48, P & lt ; 0.001in sepsis ; r2=0.56, P & l t ; 0.001in infected daze ) . The patients included in this survey were non given any nephrotoxic drugs and drug dose were modified as per criterion chronic nephritic disease guideline to forestall farther nephritic hurt [ 14 ] .Discussion:Patients come oning to infected daze during their stay in ICU may hold altered sensorium, deranged liver map, malabsorption syndrome or may hold respiratory trouble. It was observed in our survey that all such patients with infected daze have one common characteristic of crazed kidney map with AKI. The pathophysiology of AKI in infected daze is ill understood due to miss of histopathologic information, which in bend requires nephritic biopsy to observe any parenchymal or vascular alterations in nephritic tissue ; such biopsies are non routinely performed in most ICU set up. [ 15,16 ] In absence of such information, we performed an indirect appraisal of nephritic map during oncoming of infected daze. These observations were based on serum creatinin e degrees and creatinine clearance which was so correlated with disease badness tonss ( APACHE II and SOFA ) and serum lactate degrees ( index of anaerobiotic metamorphosis and daze ) . Assorted carnal surveies of AKI have been done which helps in more complex and invasive measurings of nephritic maps. [ 17 ] Most of these carnal surveies were based on either ischemia-reperfusion hurt or drug induced hurt and informations generated from such surveies may assist us in understanding the pathophysiology in a infected patient with AKI. A major paradigm developed from these observations in animate beings and worlds with daze is that AKI is due to nephritic hypoperfusion and ischaemia. This fact supported our position of utilizing AKI as index for decreased organ perfusion and oncoming of infected daze. [ 18 ] Under basal conditions blood flow to kidney is 360 ml/min/100gm of tissue where as blood flow to encephalon ( 50ml/min/100gm ) , bosom ( 70ml/min/100gm ) , lungs ( 25ml/min/100gm ) and liver ( 95ml/min/100gm ) . [ 19 ] Among all the variety meats, kidneys have really high flow rates, approximately three times higher than other critical variety meats, therefore metab olic maps of kidneys were more likely to be affected earliest by decrease in blood flow during infected daze, this may ensue non merely in a decrease in glomerular filtration but besides, in metabolic impairment perchance doing cell decease, acute cannular mortification and terrible AKI. [ 20 ] Glomerular filtration rate ( GFR ) is governed by glomerular filtration force per unit area, which in bend is determined by the relationship between the sensory nerve and motorial arteriolas. When the sensory nerve arteriola constricts due to hypoxia in infected daze, glomerular filtration force per unit area will fall and urine end product and GFR will besides diminish, ensuing reduced creatinine clearance and increased serum creatinine. [ 21 ] Arterial lactate concentration correlates with badness of infected daze and reflects metabolic changes associated with hemodynamic via media. Therefore, the association between high lactate degree and diminishing creatinine clearance are built-in to the badness of the daze and of multi-organ failure. [ 22 ] In add-on, epinephrine extract during infected daze besides enhances lactate production by itself ; the higher adrenaline dosage required in more terrible patients may besides hold contributed to this association. Following the natural history of infected daze in most ICU, it is impossible to happen patients deceasing of infected daze but without nephritic failure, the huge bulk of patients deceasing of multiorgan failure has a outstanding nephritic constituent and requires nephritic replacing therapy during their class in ICU. Renal biopsy during infected daze is non performed routinely because of important hazards owing to azotemic or infected coagulopathy and patient instability. However, this restriction does non impair the relevancy of our observations sing the pathophysiology of infected daze, as kidneys have highest blood flow per gm of tissue and AKI is changeless characteristic of terminal phase multiorgan failure so any via media in nephritic map in critically sick patients should be considered as indicant of decreased organ map and likely oncoming of infected daze.Decision:Kidneies are invariably involved in multiorgan failure of infected daze. Nephritic lesions associated with AKI in infected daze are more complex than the simple ague cannular hurt, so reduced creatinine clearance should be regarded as index of underlying mechanism of decreased organ perfusion and likely possibility of oncoming of infected daze in critically sick patients. Recognition: We thank ICMR, New Delhi for patronizing the MD PhD undertaking. Furthermore we thank Professor Shally Awasthi, Faculty Incharge, Research Cell CSMMU, Lucknow for her changeless moral support and counsel to research chaps.Table 1:Control( n=90 )Sir( n=45 )Sepsis( n=39 )Septic daze( n=31 )Age ( old ages ) 38.5AÂ ±8 37.3AÂ ±4 36.2AÂ ±7 39.1AÂ ±4 Heart rate ( beats/min ) 94AÂ ±2.3 116 AÂ ± 16 118 AÂ ± 32 124 AÂ ± 32 Respiratory rate ( breaths/min ) 16AÂ ±3.2 30 AÂ ± 8 24 AÂ ± 6 28 AÂ ± 4 Mean Blood Pressure ( mm Hg ) 90 AÂ ±10.2 89.2 AÂ ± 14.3 98.3 AÂ ± 12.5 68.8 AÂ ± 23.3 Serum Creatinine ( mg/dl ) 0.8AÂ ±2.3 3.49 AÂ ± 1.1 7.0 AÂ ± 1.3 10.12 AÂ ± 2.2 Lactates ( mM/L ) 0.93 AÂ ± 0.39 5.14 AÂ ± 1.24 7.73 AÂ ± 1.4 9.53 AÂ ± 1.2 APACHE II mark–25.23AÂ ±6.6 28.03AÂ ±6.2 30.0AÂ ±6.3 SOFA mark–10.89AÂ ±3.4 13.52AÂ ±3.2 13.11AÂ ±2.8Legends:Table 1: Patients demographic features ( Mean AÂ ± SD ) Figure 1: Average serum creatinine ( mg/dl ) . Differences in average plasma degrees among each group was statistically important ( ** P & lt ; 0.001 ) Figure 2: Serum creatinine degrees increased as the badness of disease increased, it correlated linearly with disease badness tonss ( APACHE II & A ; SOFA ) . Figure 3: Average blood lactate ( mM/L ) . Differences in average blood degrees among each group was statistically important ( ** P & lt ; 0.001 ) . Figure 4: Creatinine clearance compared with lifting blood lactate degrees. It correlated reciprocally with blood lactate degrees.

The Benefits and Hinderance of Assessments

Appraisal in primary instruction involves geting information and doing formal or informal opinions about kids ‘s advancement and attainments, including countries for farther development. The chief facets that are normally assessed in kids ‘s larning include: cognition, apprehension, accomplishments, behavior, attitudes and values in relation to the National Curriculum ( Wragg, 2001 ) . Assessment is indispensable as it can unearth of import information. For illustration, it can ; place spreads in kids ‘s acquisition and where support may be required, supply information that can be shared with parents, inform instructor ‘s planning and teaching method and bespeak the effectivity of schools. However, this is non an inclusive list and there are other indispensable grounds why appraisal is required, which shall be reinforced throughout this treatment. We shall concentrate on appraisal schemes and how this information is utilized ; in peculiar this will be cross referenced with my experience in school. We will get down by researching summational appraisal schemes. This is besides known as ‘Assessment of Learning ‘ ( AOL ) and is an analysis of the appraisal to day of the month, which occurs at the terminal of the twelvemonth or block of survey. Examples of summational appraisals include: the Foundation Stage Profile ( FSP ) , Standards Assessment Tests ( SATS ) and formal instructor appraisals. The empirical grounds collated from this is used to look into the advancement or attainment of the scholar in relation to countries of the National Curriculum. The cardinal intent of this type of appraisal is to supply informations for national and local benchmarking intents. Using this information is indispensable as it enables schools to infer whether kids are run intoing the age-related outlooks. If they have deviated, marks are reviewed and the necessary commissariats or intercessions are implemented. This is to guarantee kids remain on path to run into the national outlooks of doing at least two National Curriculum degrees advancement over each cardinal phase. In my base-school at Robin Hood Primary, information analysis is of import to inform their tracking systems so that they can take action and measure kids ‘s advancement and attainment. The anterior attainment informations is besides used at the start of term to put marks and inform average term planning. This is a cardinal focal point for learning and acquisition. The Contextual Value-Added ( CVA ) theoretical account is a national step which quantifies schools public presentation compared to others with similar features. This theoretical account considers a scope of factors such as ; anterior attainment, Particular Educational Needs ( SEN ) and Free School Meals that can impact kids ‘s public presentation ; therefore provides a flat playing field. The school ‘s CVA tonss are presented on RAISEonline, which is of import in puting the model for schools and bespeaking its accomplishment and attainment ( Weston, 2007 ) . This information enables Local Educational Authorities and schools to: place tendencies, underachieving groups, set realistic marks, and reexamine overall effectivity and criterions. This is peculiarly of import sing the: ‘breaking the nexus between disadvantage and low attainment ‘ certification. This is an enterprise to extenuate under-performance issues in disadvantaged communities. But it should be not ed that the recent White Paper: importance of instruction has indicated a reform into assessment coverage. In peculiar, the CVA theoretical account will discontinue and the hereafter reformed course of study will move as a benchmark for all schools, with a focal point on ‘pupils ‘ premium ‘ to raise accomplishment. There has been negativity towards external summational appraisals in footings of their dependability and whether it benefits the kid ‘s acquisition and advancement. SATS are classed as ‘high bets ‘ , which can ensue in ‘teaching to the trials ‘ and rote instead than deep larning being assessed ( James and Gipps 1998 ) . Hall ( 2010 ) noted that instructors can besides be inclined to follow ‘transmission manners ‘ of instruction, which reduces creativeness in the course of study ; and could finally impact kids ‘s acquisition. SATS are undertaken at Robin Hood Primary along with instructor appraisals. They continue to advance a originative course of study as they recognise the importance of making rich acquisition experiences and orienting kids ‘s demands. This is so they can bask larning and develop new accomplishments whilst still fixing kids for SATS in an effectual mode. In footings of my pattern, I will necessitate to use simil ar teaching methods to run into the larning demands of kids ( Q28 ) . The instructor appraisals officially consider kids ‘s public presentation in each country of acquisition ; and provides them a National Curriculum degree that ‘best-fits ‘ the kid. These have proved to be more popular than SATS in footings of their dependability. To some extent this can be used formatively to inform the teaching method of the schoolroom ( Hall, 2003 ) . The advantage is that the whole- course of study can be assessed in footings of the attainment marks instead than the specific focal point on nucleus topics. More significantly, learning is non specifically geared toward trials but can be adapted by prosecuting larning ends that meet kids ‘s demands ( Alexander, 2010 ) . Robin Hood Primary uses a assortment of grounds from different contexts to measure students as they recognise that kids learn in different ways. This is of import if we consider Gardner ‘s theory of multiple intelligences, where different instruction contexts leverage the ir strengths. The school ethos is a collaborative planning attack. This enables twelvemonth group instructors to discourse their appraisal attacks, what they are measuring in relation to their programmes of work and whether there is a common apprehension of the degree descriptions for moderateness intents. Hall and Harding ( 2002 ) noted that teacher appraisals can be enhanced if a ‘collaborative attack ‘ is envisioned. This is where an ‘assessment community ‘ is created affecting staff, students and even parents. In footings of my ain pattern, it will be indispensable that I discuss instructors ‘ appraisals with experient co-workers to guarantee that kids ‘s advancement and attainments are moderated ( Q11 ) . This information would besides be of import to inform planning and personalise acquisition to assist raise degree of accomplishments ; and contract any attainment spreads ( Q13, Q19 ) . This besides highlights how of import appraisal informations is to supervise kids ‘s advancement and raise attainment degrees. Now that we have discussed summational appraisal schemes, it is of import to research the normally preferable attack ; formative appraisal. Appraisal for Learning ( AFL ) and Assessment as Learning ( AAL ) are formative attacks and is a cardinal portion of the instruction, larning and be aftering procedure. It is a uninterrupted procedure of placing and reacting to kids ‘s acquisition in order for them to do effectual advancement. Therefore it enables instructors to reevaluate their teaching method and planning in visible radiation of whether the intended acquisition results have been achieved. In comparing to summational attacks, AFL recognises the importance of the scholar being included in the appraisal procedure. Hall ( 2003 ) reinforced this impression: ‘†¦ Just as acquisition is a societal procedure, so excessively assessment is a societal procedure. The manner the learner interprets the acquisition context is vitally of import to their success in that context ‘ . ( Hall, 2003, p. 12 ) Black and William ‘s ( 1998 ) research have proven that AFL does raise criterions of attainment. In peculiar, easing the lower abilities more than others, which minimises the spread of attainment. This links with the Assessment Reform Group ‘s ( 2002 ) research of AFL patterns. They highlighted 10 rules to maneuver instructors in implementing this in their schoolroom to advance effectual instruction and acquisition. The cardinal intent of AFL is to raise accomplishment. It involves kids to develop their ain acquisition, which makes them active agents in the appraisal procedure. Planning is critical to its success to guarantee that relevant information is collated to heighten kids ‘s advancement. Alexander ( 2010 ) emphasised that AFL lucifers modern positions of how kids learn as they actively construct their acquisition and take ownership. Key characteristics associated with AFL ( but non inclusive ) include: sharing the acquisition aims and success standards, supplying feedback, effectual inquiring, affecting kids in equal and self-assessment, and Assessing Pupils Progress ( APP ) . Robin Hood Primary extremely respects AFL as a mechanism to supervise kids ‘s advancement and attainment so that any barriers can be lifted to guarantee that they all reach their possible. This is reinforced by their purpose: ‘†¦Raise criterions of attainment and accomplishment by holding high outlooks of the instruction and larning ‘ . ( Robin Hood Primary School ‘s Policy, 2010 ) AFL is embedded within their school civilization to gain this purpose. The celebrated formative illustrations are some which are used within the school and shall now be discussed. Sharing larning aims is a whole-school attack and is made visually and verbally explicit to the kids in all topics. The kids besides write the acquisition aims in their work to reenforce outlooks. This pattern enables kids to be clear on the purpose of the lesson and more significantly what they need to make to be successful, which is the success standard. This so promotes self-assessment, which links to an of import impression made by Black and William ( 1998b ) : ‘†¦When scholars do come to a sense of how their work is judged they are far more effectual and committed as scholars. They can self-evaluate ‘ . ( Cited in Hall and Burke, 2003, p. 55 ) Sharing the success standard is every bit of import as the acquisition aims. Children recognize what the instructor ‘s outlooks are in footings of judging attainment and they can supervise their advancement towards these ends. At Robin Hood Primary, they normally make this visually explicit such as on the Interactive Whiteboard and is besides reinforced verbally throughout the lesson to do outlooks clear. In add-on, I have observed the instructor to underscore the intent of what they are making, which is of import if we consider the cognitive behavior attack to larning. This theory states that scholars actively construct their acquisition. By supplying a intent they are motivated to larn, which interlinks with the ‘what ‘s in it for me ‘ construct ( Hughes 2010 ) . In footings of pattern, it will be of import for me to go on to portion the acquisition aims and success standards with the category, by guaranting that it is besides expressed suitably to those with SEN and EAL needs. This would enable all kids to be engaged with the undertaking and basically their ain appraisal. It would besides allow me to concentrate on the acquisition results and therefore quality instead than merely acquiring the activities complete ( Q10, Q12, Q26b ) . Self-assessment is an built-in portion of the acquisition aims and success standards. This can merely be successful if kids assess and reflect on their ain ability and understand what they need to make to better instead than merely being told what to make. From my experience, oppugning throughout and during plenaries are utile manners to measure whether acquisition has taken topographic point. It besides enables kids ‘s to reflect whether they have fulfilled the success standards and larning aims. Robin Hood Primary considers effectual oppugning in self-assessment to be of import to get an penetration into kids ‘s acquisition. Open-ended inquiries are important to guarantee that it is inclusive of all scholars. Hall ( 2010 ) emphasised that kids need clip to believe to develop higher order believing accomplishments. From my experience, I have noticed the instructor to utilize ‘positive linguistic communication ‘ in the schoolroom if kids experience troubles or misconceptions, particularly in numeracy. The civilization is to handle errors as chances. I think this is an of import scheme to use so that kids are non de-motivated and increases their self-esteem ; but basically influences their acquisition positively. The school besides uses peer-assessment, which is more than marker trials and can reenforce self-assessment. For illustration, during certain speech production and listening group exercisings, the kids had to explicate inquiries sing a book, which was so discussed and evaluated as a category. This can be effectual as kids can get confidence in making their ain inquiries and sing a scope of differing responses. It besides enables them to develop an penetration into their ain public presentation and what they need to make to better by measuring the work of others. Clarke ( 2001 ) besides reinforced the importance of these appraisals as it raises their self-esteem as they are in control of their acquisition. It should be noted that there can be disadvantages with this type of appraisal in footings of sensitiveness or kids ‘s fight, but if used in the right context if can be powerful. In footings of my pattern, I will necessitate to guarantee that I present self and peer appraisal chances, in concurrence with effectual inquiring and feedback. This is so kids can reflect on their ain acquisition and be motivated to come on. This will besides supply me an penetration into their acquisition, which so informs short-tem planning in footings of the learning sequence of lessons ( Q29 ) . In relation to this, understanding the kids will be indispensable to provide for their demands efficaciously. This reinforces how these elements are closely interlinked with appraisal ( Q25a, Q25c, Q26a, Q27, Q28 ) . From the above treatment, we can see how formative appraisal schemes are more child-centred compared to summational attacks. This enables them to see how good they are making and more significantly for instructors to put marks. As mentioned earlier, Robin Hood Primary has pupil tracking systems, which enables them to measure whether kids are run intoing the age- related outlooks. These tracking systems consist of the National Curriculum degrees the kids obtained in the old old ages based on the SATS, instructor appraisals, APP informations and their anticipations for the terminal of the twelvemonth. The instructors besides have review meetings with the Head Teacher to look into that the students are on path. It enables instructors to put marks and commissariats to ease kids to do the 2 sub-level betterments within the twelvemonth. It besides deduces whether any intercessions are required to shut attainment spreads. This reinforces the importance of appraisal as pupil- degree informat ions is of import to inform acquisition, learning and be aftering so that attainment degrees can be raised. The ‘breaking the nexus between disadvantage and low attainment ‘ certification high spots that using informations can extenuate these links and encourages personalised learning commissariats. In footings of my pattern, it will be critical that this information is used for these intents so that kids can accomplish their possible ( Q10, Q13, Q19, Q25b, vitamin D, Q26b, Q29 ) . Robin Hood Primary besides have qualitative marks in literacy and numeracy, which are explicitly shared with the kids so they know how good they are making and what they need to make to better. This is of import so they can take ownership for their propensity. They have a mark sheet ( see appendix 1a and B ) in their numeracy and literacy books, which translate into ‘I can ‘ statements ; and are more child-friendly. This is a mechanism to portion marks with the kids so they know what they need to make to come on to their expected National Curriculum degrees by the terminal of the twelvemonth. The marks for EAL kids normally differ in literacy ( and other topics ) to guarantee they come on within their capablenesss. Children in Key Stage 1 and 2 besides complete an assessed piece of composing known as the ‘Big Write ‘ ; this is portion of the current school ‘s betterment program which places an accent on composing. This is normally undertaken at the termi nal of stage results to supervise kids in these specific countries of larning. Equally good as composing marks in their book, they are visually placed on their tabular arraies as a reminder. There are besides ocular shows such as ‘VCOP ‘ pyramids to foreground what they need to make to obtain a peculiar degree, which reinforces the criterions to take for. In footings of reading, the kids are informed of their degree at the beginning of the twelvemonth and where they are expected to be at the terminal of the twelvemonth. This is tracked by the instructor and instructor helper who monitor advancement. In footings of tracking other topics, the instructors provide feedback through constructive marker and general observations in the schoolroom. This is besides built-in to the self-assessment procedure so kids know how to bridge the spreads in their acquisition. Feedback is of import so instructors can assist scaffold their acquisition to shut the spread between what they know and need to cognize ( Clarke, 2003 ) . The instructor besides acquires feedback from the learning helpers as a manner of monitoring advancement. This besides demonstrates the importance of working closely with the support staff ( Q30 ) . I will necessitate to guarantee that I give constructive feedback to ease acquisition, particularly by associating their acquisition to prior experiences to do this meaningful. Feedback will besides enable me to set and inform hereafter planning and instruction ; which reinforces the appraisal, planning, learning rhythm and the importance of planning and monitoring kids ‘s advancement. ( Q12, Q27 ) The appraisal schemes across the age ranges are similar for Key Stage 1 and 2. However, in Key Stage 1 they have a phonics tracker to supervise advancement and inform ability groups. They besides use the ‘bubble and block ‘ attack, which specifies the positive component of their work and marks for betterment. There is besides the FSP which is a summational attack used in the Foundation Stage. This assesses kids ‘s patterned advance and the degree of attainment achieved in each of the six countries of larning. There are13 appraisal graduated tables covering these countries, which promotes instructors to used focused observations as a agency of the documented accomplishments ( DCFS, 2008 ) . This leads to a summational record at the terminal of the Foundation Stage. The FSP is used by the Key Stage 1 instructors to enable them to inform their hereafter planning. This reinforces the importance of appraisal informations in easing acquisition and raising attainment degre es. In footings of supervising the advancement and attainment of SEN kids ( or those working below the National Curriculum degrees ) , Robin Hood Primary uses p- degree informations and PIVATS in appraisal. These kids and those with learning troubles are still expected to do a similar rate of advancement compared to national outlooks of other kids. The school recognises that high outlooks, quality foremost learning ( as in all categories ) is important to raise their attainment degrees. The p-level information is used to set up good advancement for these scholars below the age-related outlooks. The information from these appraisal tools are used to inform Individual Education Plan marks ( for some kids ) and foregrounding their strengths excessively. Working with the SENCO will be of import to personalize and supervise the acquisition of these kids in footings of my pattern ( Q19 ) . APP is a mechanism they use to track single advancement, which is portion of AFL. By making so, they can place where kids are in their acquisition and set marks for patterned advance. It besides informs instructors ‘ capable cognition to infer what gaps they need to make full to enable kids to accomplish the expected degree. The school uses a representative sample in APP as it would be inefficient to supervise the advancement of each kid. For illustration, in my base-class they track a sum of six kids from the higher, middle and lower ability group for literacy ( excepting composing ) and numeracy. The school uses the APP appraisal guidelines from the Primary Nation Strategy certification to supervise kids ‘s advancement, although in some cases they use their ain stuffs. To measure reading, the kids are grouped harmonizing to ability for guided reading Sessionss. This enables the instructor to choose appropriate reading stuff and measure their word acknowledgment and comp rehension accomplishments. Targets are shared with the kids so they know what they have to make to come on to the following reading degree. More significantly, it facilitates instructors to reexamine planning, larning aims and place which group would profit from accelerated acquisition to acquire them on the right flight. APP will be indispensable to utilize in my pattern to inform planning to bridge any learning spreads and to personalize larning excessively ( Q19, Q22 ) . Thus It reinforces how AFL is of import is to pull off and be after the instruction and acquisition to acquire kids to where they need to be. Overall, we can see how appraisal is of import and an built-in portion of the planning and learning rhythm to raise attainment degrees. Assessment is of import to infer whether kids are run intoing the intended acquisition results or experience troubles ; which later inform be aftering. Planing and the sequence of lessons may so necessitate accommodations such by revisiting the larning aims or traveling in front based on the kids ‘s advancement. In bend, this informs the instructor ‘s teaching method as techniques may necessitate to be adapted or larning personalised to get the better of barriers. This may affect alterations in the distinction schemes to orient kids ‘s demands in the given context. Teaching besides enables appraisals to be made of the category, which informs planning ; hence this demonstrates how these elements are built-in. In footings of my pattern, I will necessitate to utilize appraisal to inform my planning and present high quality instruction. But most significantly, I will necessitate to cognize my category good and have high outlooks to raise attainment degrees so that they can all make their possible.Word Count: 3,312

HRM Models

This report is about human resource management. Betcherman et al. (1994) defined human resource into three aspects: organizational and job design, organizational culture, and personnel policies and techniques as to ensure that the workers full prospective or potential can be achieved. According to Storey (2001:5) Human Resource management is defined as ‘a distinctive approach to employment management which seeks to achieve competitive advantage through the strategic deployment of a highly committed and capable workforce, using an integrated array of cultural, structural and personnel techniques. Marchington and Wilkinson, (2002) identified through research that people really do make the difference in human resource management. The truth behind this is that it’s supported on ‘high-commitment’ model which ensures that investing in people/human resource makes good business. This lay a foundation for the human resource professionals to make point that people rea lly are their most important resources to the organization which now leads to work out how principals can be then turned into practice. This report will show how human resource works in sports industry and there will be critical examine on hard and soft model followed in the Bolton Wanderers case study and which model is more prevalent and successful in day to day operations and management activities. Human resource management is the most important department in any organisation to improve their knowledge and increase a good strategy towards employees. Mainbody According to Storey (1992) there are two ideal and essential models of Human resource management one is ‘hard’ also known as Michigan model and other one is ‘soft’, i. . , Harvard model. The hard model of human resource management highlights the term ‘resource’ which adopts a logical approach in the management of employees in which people are taken as financial factor where cost must be controlled. Whereas, the soft model accentuate ‘human’ and hence training and development is given more emphasis in this model on a closer look to ensure the employee development and that the employees are adopting the strategies and policies so that a high level of staff can be achieved who can deliver their skills and give a better turnover in the competitive environment. Bratton and Gold, 1999) Michigan Model Legge (1995) states that in hard model there is a trend to see employees as to be supervised and mastered following quantitative, intellectual and calculative approach to get ensured that the work force is expeditiously positioned to get the maximum advantage. It is concerned with the no of employees and whether every single person is meeting the goals of the organisation. (Fombrun et al. , 1984). While planning the policies one part of hard model; administration need to know what is the turnover rate and is based more on statistics rather than behavioural science of human being (employees) and is more appropriate in sports sector where pressure of work is much more. Furthermore Michigan model is the human resource cycle, which starts from development, move forward to selection, performance, and appraisal and than back to development or to Reward. Related to Bolton Wanderers football club case study The development of the football club is the important part, but at Bolton Wanderers, it was not a good situation, because those were posted financially and have a high debt burden. The reason was a newly formed football stadium, when in 1999 Sam Allardyce was appointed as manager with the premises to promote the club from First Division to Premier League and to establish there with given opportunity. Moreover Bolton Wanderers ensure that every member was feeling to be a part of Bolton ‘family’. Furthermore the heavy debt burden effected on selection highly, because they could not attract the best players with huge salary. Thereby they decided to expand their scouting network and academic facilities to afford their own youth to be selected for the first team and prepared to play in a high level. So that many players, who was playing in first team came from their own team. So the club was trying to gain the commitment and goals of the players. The purpose of managing the system of rewards within the organisation is to attract and retain the human resources the organisation needs to achieve its objectives. To retain the services of players and maintain a high level of performance it is necessary to increase their motivation, commitment and flexibility by a variety of means, including appropriate management style, competitive compensation package and supportive culture (Armstrong and Murlis, 1994). This way clubs align their player and organisational objectives while the reward management is highlighted. Rewards not only comprise of just wages or salaries, bonus, commission, profit sharing but also non-financial rewards like for e. g. opportunities for career development. McKenna and Beech, 2002) Bolton Wanderers offered pay and a reward package to players and coaching staff, which was one of the some lowest costs within the Premier League. In addition the high investment in sport science was made that the player should be fit and can play and also the performance should be good. This technique was attracting some outstanding players because through the operation of these technique was for them possible to expand their playing careers. In addition players could advertise themselves for best club due to good performance. According to Cowling and mailer (1998) appraisals are essential to get a brief idea about the course of information which constantly elucidates the purpose and aims in pursuit of mutually agreed target between managers and subordinates. There are contradiction like people who support limiting its use, argues that linking it to pay can demoralize attempts to provide genuine criticism and an emotion-free review of strengths and weakness while the others who do think that the pay should be linked to appraisals debate that it helps in motivation and the employee involvement. In the sports context, employees in those cases receive appraisal from the news-channel, radio, newspaper and public. The satisfaction of the public is very important so they try to receive a good appraisal, which sometimes are not possible. A 360-degree performance based feedback can be done to obtain a collective review of the individual’s performance. A 360 degree, also known as multi-ratter feedback, is an appraisal technique in which ratings from numerous people like peers, boss, customers, team members, staff and self is taken and then from that feedback appraisals are done for the individual. Stone, 1998) Harvard Model In soft model alternative approaches through which problems can be solved are followed. (Beer et al. , 1984). The organisation attempts to balance the needs of the employees with the organisational requirements. The feelings of the employees are kept in mind rather than just thinking them as a mode of earning profit. The employees consent is seen notably. Staff dedication towards work is increased when they are involved in decision making and job design process. Furthermore Harvard model is the human resource system, where employees influence on human resource flow, reward and work system. Related to Bolton Wanderers Football Club case study As we can find out in the Bolton Wanderers case study training and development has been focused; to understand and learn about the organisation, their policies and implement them in the right way. Training comes under the soft model of human resource management. Training basically means learning the skills that are required in the organisation which is generally structured by the policy makers in such a way that it will develop the individual for the required work. There are two types of learning- learning as acquisition in which qualifications and skills attained are from formal structured courses; and learning as participation in which learning takes place while participating within the set of fellow workers. (Bach, 2005) Moreover the players and coaching staff influence the work system, through the decision if the player or the coach will work with each other. In Bolton Wanderers was the operation that the player from the youth has not any chance to choose the coach, because the still need a chance to play in first team and think afterwards to move to another club if there is any offer. Furthermore the reward is influenced by players to deliver a good performance, e. g. Bolton Wanderers was playing in season 2004-5 since 4 Years in Premier League and they also was attend in UEFA cup. Human resource flow conduced to motivated players from other players or coach. It is a high impact of employee staff such as coaching staff and players. Due to it increase the team work and every one is for each other there. Talking about hard model and soft model in the report, when we apply hard model which just focuses on placing skilled people required for the organisations objectives. Application of this model to the Bolton Wanderers which aims at reducing the costs ultimately leading to control and decrease the debt by following feedback method tells us that even when its important, applying Hard model does help in this case, as skills are required, rather than production. Finding right applicant for the right job is necessary rather than getting them in the job. Right recognition of an applicant is also very important as it saves the time for another recruitment it turns fail and thus, adds up to another cost in the accounts of an organization. Millmore et al. 2007) Conclusion To conclude the report it is better understood and observed that the applications of different models, practices and strategies have different implications depending on which industry we analyse the working and performance of the employees. Industries like banking or financial sectors have different set of rules to handle their employees inclining more on hard models of human resource mana gement. Where the sport industry also being success oriented centring the employees through their performance is inclined towards hard models.

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Deconstruction component of the 1998 and 2001 film RUSH HOUR Essay

Deconstruction component of the 1998 and 2001 film RUSH HOUR - Essay Example However, the two films also portrayed negative aspects of films, including the fact that they both perpetuate stereotypes of the two characters – Tucker's character is the stereotypical black man, and Chan's character is the stereotypical clueless foreigner. Another negative aspect is that the two films minimize Chinese culture, despite the fact that one of the leads is Chinese, and much of the action in both films takes place in Hong Kong. This paper will attempt to show scenes in which the stereotyping, the cultural differences, and the overall disrespect for Chinese culture are more pronounced. Analysis of the films The two movies are very similar in tone, but different at the same time. The biggest difference is that, in the first film, the two men become acquainted with one another. In the second film, there is not a need to build the relationship between the two men, as the relationship is already established. This is how the two movies differ in how they build tension. For instance, in the first movie, the tension at the start of the movie comes from the fact that the two men do not know one another, and that there are cultural differences between them (Min, 2011). ... In Los Angeles, it is the opposite. This change in culture is apparent in two different scenes, one in the first movie, and one in the second movie. The two sequences that will be described are important, because they each show how culture, and not knowing the language and culture of the non-native country, can get people into trouble. The first sequence is in the first movie, and this is a sequence when Chan gets into trouble because he does not know colloquialisms or the customs of the African-American male in the United States. Specifically, Chan did not know the term â€Å"nigger,† and did not understand that this term is offensive, as Tucker used the term to identify people in the bar. Chan, just getting in to this country, knowing very little English and no slang, was just emulating Tucker when he casually goes to a bartender and refers to the bartender as â€Å"my nigger.† This, of course, leads to a fight. Why the term would not be offensive when Tucker uses it, but is offensive when Chan would use it, it is difference in culture, in and of itself. Naylor (1986) explains why. She states that the term is used amongst African-Americans as a term of approval, a term of endearment, or a term of disapproval. For instance, an African-American may state, approvingly, that a certain â€Å"nigger† worked so hard that he was able to put a down-payment on a house. Or another African-American may refer to her husband as â€Å"my nigger.† For the disapproval, an African-American may refer to somebody as a â€Å"trifling nigger.† Kennedy (1999/2000) agrees with this, stating that blacks in America use the term to simply identify other blacks, as a term of disapproval, or a term that refers to somebody who is the very

Winning isnt evrything Essay Example for Free

Winning isnt evrything Essay Vince Lombardis famous saying Winning isnt the most important thing. Its the only thing is unfortunately the motto of too many athletes today. Although winning is important and sports are, and should be taken seriously, by far, winning isnt the only thing. Putting everything you have and giving one hundred percent to the effort is also very important to competition. A team that puts everything they have into a game and comes out the losers, has a lot more to be proud of than a team who comes in first but only gave some effort. Over the years many teams have lost important games due to a few inches, one pitch or a strike of bad luck although these teams lost, they take it into the next game and gave one hundred and ten percent. Last month at the Erie Mayors Cup 10K and 5K race, competitors from around the tri-state area were in competition. Trophies and plaques were to be awarded to the first, second and third place runners. A 10K is a 6.2 mile long race across the streets of downtown Erie in 85 degree heat and humidity. Runners who are running in the 10K have to show tremendous determination, stamina, speed and physical agility not to mention surviving in grueling temperatures and humidity. Great Olympic and Boston Marathon runners have dropped out of a 10K due to its intense strain. I was on hand to witness the race and saw many great athletes finish the race with great times. These are runners who put every day into running and run every race. Soon after these runners had crossed the finish line and been handed their trophies, the last runner in the race came through the finish line with his hands in the air and to thunderous applause. He was 87 years old, and had taken up the sport after his doctors told him he had a cholesterol problem when he was 67. The runner in this story was not out to win the Mayors Cup 10K, he wasnt out to set a record time or come in first. He came in dead last, but finished the race. If he would have listened to Vince Lombardi and say Oh, I cant win, their are professional runners from colleges and high schools competing against me! he wouldnt have completed his life long goal of running in a 10K. Better late than never. The most important thing is for all who participate is to have fun and do it with pride and determination, to set a goal and reach it. Two good sayings that contradict Vince Lomabardi stateIt doesnt matter if you win or lose, its how you play the game and If at first you dont succeed, try, try again Words to live by.

Committing suicide Essay Example for Free

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Impacts of Drug Related Crime

Impacts of Drug Related Crime Within this module the author is going to explore the impact of drug related crime, anti- social behaviour and drug abuse within society. The author is also going to investigate theories that increase the risk of an individual misusing an illegal substance. (Weisheit, 1990)   Moreover how nature vs nurture biological and environmental factors can contribute to drug abuse. This will include areas such parenting skills and the community in which a person lives can play a major role in enhancing the risk factors. (Ungar, 2004)  The gateway model focuses on how an individual will start using an illegal substance and move on to harder illegal substances. Furthermore, by implementing methods this will reduce the risk factors within substance misuse. The author is going to investigate methods and theories for reducing the impact of drug abuse. This will include the governments implementation of the 1998 10 year drug strategy. Moreover, how the drug strategy has progressed over the ten y ear period. (Drugscope.org, 2012) Drug abuse is a major problem within the UK from the individuals personal circumstances to war against organised crime. There are many factors why people initially take illegal drugs. Such as peer pressure, to escape or to experiment but can initially to addiction which can have a massive effect within society. An addict will have to maintain their addiction which will be done through committing petty and serious crimes. (Rasmussen. 200) Such as; shoplifting lifting, burglary and theft as most addicts, cannot maintain full time employment due to not being able to function properly within society. Although, some addicts will start to supply their drug of choice so they now they have a constant supply. Many drug dealers already live within the community to where they sell illegal drugs. This is another major impact within an area in need of urban regeneration as individuals are selling illegal drug on street corners. That is now having a snow ball effect and causing gang culture and ga ng related crimes. As inner city gangs become larger and try attaining additional territory Knife and gun crime is at all time high. (Bean, 2002)   A clear indication of the severity of drug related crime within the UK as it drains  £13.3 billion pounds out of public resources. (Gov.uk 2013) Furthermore, with a rise in anti- social behaviour local residents are feeling alienated and have nowhere to turn within their own communities. Due to being in fear of becoming targeted by local gangs and being attacked in the street our having their home targeted. (Hallsworth, 2005) As the individual drug addiction spirals out of control, family members are going to notice significant changes within their son our daughter. Such as mood swings, electrical items are missing such as ipods and mobile phones. Moreover, an untidy appearance and new friends, because an addict will associate themselves with other users to be able to access drug more frequently. (Harrell and Peterson, 1992) Banduras Social learning theory reinforces this notion and referrers to observational learning and this is done by observing the behaviour of others. The client has been encoding the behaviour of their peers, which have been influential to the individual. The client has encoded this information and later on imitates this behaviour to bond with their peers associated with their drug use. The individual does this without any regard for the own health or safety as suggested by Eysenck and Keane. (2010) Furthermore, the strain on the individuals family would also be a significant impact a s there being labelled within their local community. These actions could inevitably lead to arguments physical abuse and divorce within their home life. As their son our daughter may have been cut off from their own family due to being deceitful and dishonest. A person will initially use cannabis and is the most widely drug available within the UK. As indicated by H.M Government (2010) cannabis is used by more than 22,152,000 in 2009/10 and is classed as the gateway drug. This model was developed to explain how three factors associated with cannabis can lead on to harder substances. Firstly, a cannabis smoker is at a higher risk of using harder drugs than non -users. Second factor relates to how the national framework of drugs works as an individual will normally work their way up from softer drug to harder drugs. However, there are less than 1% of users who started using harder drugs first. The third factor indicates individuals who smoke cannabis more than 50 times a year are significantly at higher risk to progress onto harder illegal substances and is called dose-response effect. (Jrf.org, 2008) There are many factors that have to be taken in to consideration that contribute to an individual self harming with illegal drugs which will include: the biological and environmental factors of the individual. These factors play a significant role in an individuals personal development and are called Nature vs Nurture. Nature relates to the genetic factors in an individuals behaviour. However, genetics only play a small role as there is no actual gene that will make an individual an addict. But if a gene is missing others factors such as genetic and biological aspects that will make an individual more susceptible to drug use. (Fitzduff, and Stout, 2006)  This is because if a gene is not present the protein that controls the function of a physiological structure may not be formed. This is clearly evident within certain diseases however; others are less obvious such as the impact of genes on behaviour can influence and individuals disorders or traits including drug addiction. (Chasno ff, 2001)   Nurture relates to the environment in which the individual has been raised up in. There are many factors which need to be considered that could contribute to drug addiction. Such as the family environment the individual may have not been raised within a stable environment. There may been an indication of domestic abuse, history of substance misuse or criminal activity. If the individual has been brought up in a chaotic environment all increase the risk of substance misuse. (Chasnoff, 2001)   Furthermore, the community in which the individual lives is going to be a major factor. If they live in area with high drug rates, drugs are going to be easily acceptable and peer pressure will be a significant problem to resist. Individuals who lived in areas with no safe place to play or activities for people to engage in. All these factors contribute in a higher risk of substance misuse. (Fitzduff, and Stout, 2006) However, these high risk factors can all be reduced by the individual by having positive peer relationships. By having positive relationships the individual will build their social skills and confidence within society and is done by social learning. Also having self control, being able to assess a situation and realise when to say no. Furthermore by taking part in activities within your local community and continuing their academic studies can contribute to having a positive mind. (Buchroth and Parkin, 2010)   Moreover, by having a stable family environment, the protective factors of the parents all contribute to lowering the risk factors. Such as good parenting skills, communicating effectively and offering their child encouragement and support will also help develop their confidence and social skills. By reducing all of the high risk factors the child will be able to make a positive contribution to society. (Inciardi, and Horowitz, et al.1993)   Substance misuse costs the British government  £373 million pounds every year as they try to eradicate illegal drugs from our UK borders. Furthermore, fighting street suppliers and funding multidisciplinary teams to support service users receive treatment and abstain from their addiction altogether. (Goodman. 2009) The National treatment Agency created the models of care; this is the national frame work for adults in the treatment of drug addiction in England. The model or care was created to help a number of diverse communities all around the country. The services for treatment of addiction first came available in 1998 within the NHS. (H.M Government, 2010)  Furthermore, was part of the ten year drug strategy which is divided into four main categories and include: educating and prevention, support, treatment and counselling for people with substance misuse, using the law to combat the war against drug and fight the supply of illegal substance arriving in the UK. (Drugscope.org.u k 2012)   By 2008 the National Treatment Agency predicted a 100% increase in service users into treatment. In the treatment of substance misuse the services were delivered by Drug Action Teams within local areas. These services are arranged in to four different tiers depending on the service users level of need and mental health issues. Tier one service includes the initial assessment of the client to move onto specialist tiers within the service. Tier one also includes giving advice and information on a range of services such as housing, benefits and vocational qualifications. (Addictiontoday.org 2008)   Tier two services include harm reduction services such as needle exchanges by supplying clean equipment to inject with. Furthermore, advice and guidance and genera support without the need for a care plan. Tier three and four are specialist services for individuals who have a structured care plan. (Goodman. 2009) This can be community based treatment and residential rehabilitation. The bio-psychosocial model is very effective within the treatment of addiction. It focuses on a multiple pathways on how a person became an addict; this model acknowledges treating the person as a whole. It relates to biological, psychological and sociocultural theories within this model. The assessment, diagnosis, treatment planning and interventions all relate to this model. The practitioner will have to take into consideration the biological, psychological and sociocultural factors when assessing the client. (Rasmussen, 2000) In 2008 a review was taken within the drug strategy to target the most deprived areas and those who are significantly at a higher risk and need. By 2005 the government will spend a staggering 1.5 billion pounds on the war against drugs. Since 1998 there has been a major change in the prevention and education in substance misuse as 80% of primary and 96% of secondary schools have it within their curriculum. (Addictiontoday.org, 2008)  Furthermore, within the 2002 drug strategy reducing the supply of drug within local communities is another major priority. There has been a significant increase within the seizures including cocaine and heroin by 53% and 30% since the strategy began in 1998. The 2008 drug strategy aim to reducing drug related crime and how they affect local communities by making available  £100 million pounds. This has been made ready available to strengthen communities by disrupting local drug suppliers and reducing drug related crime. (Strong, and Gossop, eds. 2005) Furthermore, for every  £1 spent on tackling substance misuse a further  £3 pound is saved within the criminal justice system. This shows how effective war against illegal drugs is progressing. (Weisheit, 1990) With a range of interventions to help and support an individual who is in need. The interventions will include; rehabilitation, advice for the client, prescribing and harm reduction. As the drug strategy has developed over the years, the government assesses and reviews the strategy to improve the efficiency of it services within the UK. In 2008 Drug Strategy recorded the lowest level of drug use in over ten years. Gov.uk (2013)   Conclusion As indicated within the 2008 drug strategy for the campaign against drugs to be successful education and prevention are the key strategies. By educating the younger generations of the dangerous effects and the serious harm illegal drugs can do. Play a major factor in reducing the devastating effects drugs have on society. By getting adolescents to say no to drugs, the supply will reduce within communities. This will inevitably reduce drug related crime and anti-social behaviour and will also reduce the substantial costs within the criminal justice system. The police will be able to effectively save thousands of man hours and use their time more efficiently. (H.M Government, 2010)   The nature vs nurture is an excellent theory in examining the biological and significant number of environmental factors that need to be taking into consideration if a person is at risk of substance misuse. However, the bio-psychosocial model is an excellent tool to combat these factors. As indicated earlier this model concentrates on the biological psychological and sociocultural aspects within the model. Furthermore, is widely used within the treatment in substance misuse in tier 3 and tier 4 community based and residential rehabilitation across the country. (Chasnoff, 2001)   However, the fight on illegal drugs is going to be an extensive campaign, as there will always be a supply if there is a need for illegal drugs within deprived areas. On the other hand, the drug strategy is making significant progress in cutting the supply by within communities across the UK with 186,028 drug seizures. Criminal Assets have also been seized worth a staggering  £135.7 million pounds which has gone back into the war in fighting drugs. (Gov.uk 2013)   As within the gateway model suggests that cannabis is the normally the first illegal substance a person will try. Due to cannabis being readily available and regarded as being a less harmful substance. The drug strategy have seized within the UK over a half million plants worth an astonishing  £60 million pounds. This indicates that the drug strategy is effective but at a staggering cost to the tax payer  £20 billion pounds.  £13, 3 billion pounds is on drug related crimes and  £7.3 billion pounds and health iss ues. These are staggering amounts of money which could go into education and the NHS. (Jrf.org, 2008)  

Willy Russells Our Day Out Essay -- Willy Russell Our Day Out Essays

Willy Russell's "Our Day Out" Willy Russell has written many plays over the last thirty years, but there is one feature that is common to all of them: the issue of social and cultural background. This is the situation of the characters; their surroundings; their class; the society in which they are brought up, and the culture of that society. It is this that can lead to the behaviour, feelings, opinions and general outlook of the characters. Russell explores the effects that society and culture can have on people in all his plays, but in none is it so poignant as in 'Our Day Out', the story of what happens when Mrs Kay takes her Progress class out of inner-city Liverpool on a school trip to Conwy Castle, Wales. Throughout 'Our Day Out' the issue of social and cultural background is ever-present, but it is discussed and conveyed in many different forms; the colloquial dialect Russell uses; the symbolism that is featured; the behaviour and attitudes of the children; the way that people react to these children, and the insights we get into their family lives. Willy Russell himself said that he writes for the theatre because 'it's concerned with the spoken rather than the written word'. In 'Our Day Out' we see the importance of the spoken word through the language that the children use. Having grown up and taught at a Comprehensive school in Liverpool, Russell knows the Liverpudlian dialect perfectly, and he uses his knowledge to give a truly representative feel to the play. The children use words such as 'agh'ey', 'ooer', and 'nott'n', and the authentic language that the children use help to make the play feel more real. Because Russell writes the words as they would be spoken in a Liverpudlian acce... ...ry isn't. The poignancy and intensity of the play is somewhat masked in places by the comedy, but we do catch glimpses of the hopeless, desperate situation these children are facing. As Mrs Kay says, 'Ten years ago you could teach them to stand in a line, you could teach them to obey, to expect little more than a lousy factory job. But now they haven't even got that to aim for. There's nothing for them to do, any of them; most of them were born for factory fodder, but the factories have closed down.' Throughout the play this is the underlying tone, and the subtle way that Russell conveys this message heightens the effect when it comes. This day out is simply an oasis; one day of fun out of their whole lives, and at the end of it we see how the glimmer of something bright and beautiful makes it all the harder to turn your eyes back to the grey and mundane.

The Future of Social Security :: Papers Politics Welfare Essays Papers

The Future of Social Security Social Security is a system that was set up in 1935 after the Great depression to help people get through tough times. "Social Security is now used by nearly 44 million Americans"(policy.com). Only people who payed into social security are eligible to collect when they retire. Many people think that they receive the money they pay in but that is not total true. The money that you pay in is used for the people that are receiving it now. "In 1950 there were 16 workers for every beneficiary; today there are only three workers per beneficiary"(policy.com). There is more money going into social security then coming out now. The extra money goes into a trust to be used when it is needed. By the year 2032 those numbers are going to drop. By this time most baby boomers will be retired and collecting social security. This will put a big strain on the funds. There will be more money going out then coming in. And it will not take long to use all the money that is in the trust. By th e year 2034 they will only be able to pay 75 percent of the beneficiaries. "The projected average monthly Social Security benefit in 2032 of about 1,100 (in 1998 dollars) would fall to about $800, and would drop further in later years. Average benefits for low-wage earners would drop from $670 to $480"(www.ssab). Theses cut would effect the people just starting to receive benefits and those who are already receiving benefits. And with each year these benefits will decrease. As these benefits continue to decrease "the percentage of aged people living in poverty would rise"(www.ssab).Most people believe this is happening because of the baby boomers generation. There will be more people taking from social security then giving in. By the time my generation is eliable to receive social security there may not be any money to give. Everyone is worried about the future of the social security system. They wonder how long it can last after the year 2030. There are many ways people are suggesting to deal with the problem. Some suggest to raise taxes on social security "In order to continue paying full benefits in 2032 and for about 40 therefore, the law would have to be changed to increase social security taxes by almost one-half, from the current 12.

American Public Education - Obsessed with Being Average Essay -- Teach

American Public Education - Obsessed with Being Average A country's educational system is typically influenced by a variety of factors. Racial and ethnic attitudes, for example, can play an important role in policy formation and school administration. Language is a significant factor as well. Political and religious ideologies also are potent influences on the educational system. An average student’s registration into the educational system may be affected by such factors. What is the definition of an average student? What constitutes such a student to receive an â€Å"average† education? Mike Rose’s article â€Å"Tracking†, focused on the educational system and its effects on both normal and abnormal students. One student affected by this system was Ken Harvey. He was placed in the vocational track due to the labeling of the educational system. Ken Harvey’s statement, â€Å"I just wanna be average†, was a desperate call for help. No doubt, his placement in the educational system had a negative effect on his life. â€Å"Ken Harvey was gasping for air†. As brought out in the article, â€Å"schoo...

A Review of Fonterra Group’s Strategy and Business Model

Fonterra was formed in the October 2001 merger of the New Zealand Dairy Group (NZDG), Kiwi Cooperative Dairies, and the New Zealand Dairy Board (NZDB). It has become the world’s leading exporter of dairy products, responsible for over a third of international dairy trade. The Group is co-operatively owned by over 10,500 dairy farmers whose products make their way to customers in approximately 140 countries. Fonterra aims for global dairy leadership and its purpose is to sell their farmer shareholders’ milk (Fonterra Co-operative Group, 2011). Analysis of the Dairy Industry using Porter’s Five Forces Porter's first force describes the threat of potential entrants. Barriers to entry and economies of scale are significant for new entrants. However, New Zealand’s deregulated market structure and relatively low cost might attract entrants as a base of export oriented supply and processing. The threat of new entrant is medium (Vallyon, 2003). Porter's second force is bargaining power of buyers. The New Zealand dairy industry exports 95% of the country’s dairy production. Continued consolidation of food manufacturing and retailers has the effect of reducing overall numbers of buyers in the industry and increasing their purchasing power (Vallyon, 2003). Faced with the fact that buyers face few switching costs, it is fair to say that buyers have high bargaining power in the industry. Porter's next force is bargaining power of suppliers. The dairy industry is a seller’s market with global demand exceeding supply. This opens up opportunities for other uprising overseas markets to the industry with suppliers from India, China and Brazil. Fonterra supplies are secured through the co-operatives structure and a significant threat exists if Fonterra fail to make competitive milk payouts to its farmer shareholders (Vallyon, 2003). It is clear that Fonterra suppliers have some bargaining power in the industry. Porter's fourth industry force is the threat of substitute products. Dairy milk is a unique natural product without any artificial substitutes. However there is development of alternatives including soya milks and non-dairy milks such as goat, buffalo and sheep. Danone, Unilever and Coca-cola have also made significant acquisitions or partnerships with organic milk producers. Although a dairy product, organic milk can be considered as a parallel value chain as it requires different knowledge and techniques at each stage of the process (Vallyon, 2003). In this sense, the force is low to medium. Porter’s final force is the intensity of competitive rivalry. As a global leading dairy exporter, Fonterra faces increasing threats as global competitors become aware of its size and influence in the industry. Continued consolidation of industry could see competing dairy resources being merged into larger, more efficient competitors. In the evolution of trade liberalisation, competitors may respond through increasing global growth strategies (Vallyon, 2003). Hence this force is high. Fonterra’s Strategies Fonterra’s business model is a farmer-owned co-operative, widely spread around the vertically integrated New Zealand Dairy Industry. At Fonterra, the goal is to build a business that pays the farmer shareholders the maximum sustainable price for their milk and that maximises profits from the capital invested in the Co-operative (Fonterra Co-operative Group, 2010). To achieve this, Fonterra has three key strategies in becoming the company that is the source of natural dairy nutrition to the world. Firstly they intend to deliver sustainable co-operative performance. With its scale and reach of operations, Fonterra creates enormous logistics complexities. However, when it comes to processing, recent projects like Drier 4 at Edendale (ED4) in Southland are said to be the most efficient milk powder unit in the world. Likewise, in order to optimise the supply chain at home so to deliver product to their customers as efficiently as possible, Fonterra expanded a key cool and dry store logistics hub that has taken more than 50,000 truck movements off local roads and has largely eliminated the need for contracted storage around the Waikato (Fonterra Co-operative Group, 2010). This is working alongside with the enhanced use of rails to move products around the country. Then elsewhere, the Group has also taken its development online with the launch of globalDairyTrade (gDT), an internet-based auction platform through which sellers offer to sell commodity dairy products (Q&As: globalDairyTrade Information Portal, 2011). In 2010 gDT has sold 359,000 metric tonnes on the platform (Fonterra Co-operative Group, 2010). Fonterra’s second strategic goal is to build trusted brands in chosen markets. Fonterra has a strategy to strengthen their positions in key regional markets where ownership of the supply chain gives a degree of competitive advantage (Fonterra Co-operative Group, 2010). The focus has been on high growth markets within Asia/Africa/Middle East (Asia/AME) and Latin America, and the existing strong market franchises in ANZ. Anlene provides a great insight to Fonterra’s brand strategy at work. Created in Asia in 1991 to support bone health, Anlene is now the clear number one high-calcium milk brand across Asia. Priced at 30-50% above regular milks, Anlene is a trusted premium brand in the Asia market, which has an expanding middle class that is caring more about healthy nutrition for the whole family (Fonterra Co-operative Group, 2010). Additionally, Fonterra has continually restructured their investment portfolio to ensure they can capitalise on the most promising market opportunities. To support its expansion in Africa and the Middle East, they have purchased the remaining 51 per cent stake in Saudi New Zealand Milk Products (SNZMP), a dairy manufacturing facility in Saudi Arabia, has secured manufacturing capacity to support growth plans in the Middle East. Currently packing Anchor and Anlene milk powders and producing processed cheese, SNZMP supplies 20 countries in the region (Fonterra Co-operative Group, 2010). The third strategy Fonterra have adopted is to grow lasting customer partnership with the world’s leading food and nutritional companies. The company looks to improve their ability to source and add value to dairy supply so to strengthen their position as the supplier of choice from around the world. In order to achieve it, they have focused on developing customer partnerships in premium ingredients and in foodservice solutions. Premium ingredients are products that are more advanced than standard dairy ingredients. Examples are nutritional bases for infant formula and growing-up milk powders (Fonterra Co-operative Group, 2010). Fonterra is already the preferred supplier of all five of the world’s largest infant formula companies with stronger demand from their customers to partner them. Key customers have strong growth ambitions and they are looking to Fonterra as a preferred source of high-quality paediatric nutrition products. A premium ingredients category with exciting prospects is pharmaceutical lactose, with Fonterra a world leader in lactose excipients through their joint venture with RoyalFrieslandCampina which develops, produces and markets high quality lactose used in the pharmaceutical, nutrition and food industries (Fonterra Co-operative Group, 2010).