Adrienne Rich on Power in Society

Adrienne Rich on power in society Introduction The theme that interested me most in the poems by Adrienne Rich was the inadequacy of language as a means of communication. Rich shows that the reason for this lies in the way language expresses power relationships in society. Often this means the unequal relationship between women and men, but also between the powerful and the powerless. This theme is touched upon in almost every poem we studied, from Rich’s early poems to those written later. To illustrate how Rich explores this theme I will look in detail at â€Å"Aunt Jennifer’s Tigers†, â€Å"The Uncle Speaks in the Drawing Room†, â€Å"Our Whole Life†.Paragraph 1 In â€Å"Aunt Jennifer’s Tigers†, Rich creates a fantastic image of the aunt’s nonverbal communication through her tapestry. The poem opens with a vivid picture of the colourful, energetic alive world depicted on the tapestry. The aunt infuses the world of the tigers with many of the attributes she misses in her own life: a sense of being truly alive and in tune with the environment, and a state of fearlessness: â€Å"They do not fear the men beneath the tree/ They pace in sleek chivalric certainty. The ee- sound in these lines introduces a note of terror that heralds what is to come. Indeed the phrasing suggests a reason for fear from men. The feelings that the aunt is projecting into her artwork, her own fears and desires are developed in the middle stanza. Her shaking, fearful hands â€Å"fingers fluttering† are very vivid and the fact that they find the â€Å"needle hard to pull† suggests physical weakness and contrasts very much with the tigers. Paragraph 2 The reason for this weakness is â€Å"Uncle’s wedding band/ Sits heavily† on her â€Å"hand†.The possessive â€Å"Uncle’s† suggests that this is a one-way marriage that drains all life out of the aunt. Her hands come to represent her pers on in this poem and it is the hands that do the ‘talking’. The Uncle’s power over her seems to continue in death â€Å"When Aunt is dead, her terrified hands will lie/ Still ringed with the ordeals she was mastered by. † However, her unspoken, yet very articulate legacy remains: â€Å"The tigers in the panel that she made/ Will go on prancing, proud and unafraid. The tigers represent happiness, confidence and thereby beauty. Interestingly, this image of self-determination and sense of entitlement to the world is projected into the jungle, i. e. outside of society. This is where freedom exists and Aunt’s art gives expression to this. Paragraph 3 In contrast to Aunt Jennifer’s indirect communication, â€Å"The Uncle Speaks in the Drawing Room† is the dramatic monologue of a wealthy, powerful man. He speaks as a representative of the ruling class looking out at a group of discontent working people.These people have neither wealth nor pow er. They have gathered outside his big house to express their anger at this inequality. The uncle’s attempt to convey confidence and reassurance to his family is undermined by the images of anger outside. The poem’s sound expresses this threat. O- sounds and S-sounds dominate: â€Å"Standing sullen in the square [†¦] Some have held and fingered stones. † As the poem develops, the Uncle’s own fear becomes clear. The image of â€Å"glass† echoes and comes to symbolise â€Å"class†.He admits that the â€Å"frailties of glass [†¦] Lead in times like these to fear/ For crystal vase and chandelier. † Even his reassurance â€Å"None as yet dare lift an arm† achieves the opposite – the suggestion of an uncertain future, â€Å"arm† in fact has two meanings in this context! Paragraph 4 In fact the two most vivid images in the poem are the angry crowd outdoors on the one hand and the terrified forefather (indoors à ¢â‚¬â€œ like this family) on the other: â€Å"When our grandsire stood aghast/ To see his antique ruby bowl/ Shivered in a thunder-roll. Despite his attempts to reassure, the Uncle admits to deep unease at the end of the poem regarding the precarious position of his class as â€Å"We stand between the dead glass-blowers/ And murmurings of missile-throwers. † In terms of the theme of language, the Uncle uses it to express his position as a powerful wealthy man. Although his fears still become clear, it is still a useful tool for him. The workers outside do not have a voice, their language is not verbal: â€Å"sullen stares†, â€Å"bitter tones† and holding â€Å"stones†. There is no common language between the powerful and the powerless.Paragraph 5 â€Å"Our Whole Life† was written later. There is a stark change in terms of form to the previous two poems. It is written in free verse and uses no punctuation whatever. This in itself indicates Richâ⠂¬â„¢s thinking about language and the ability to express truth. Here, she strips it of its traditional appearance. In terms of theme, â€Å"Our Whole Life† explores the shocking gulf between the powerful and the powerless at a new level. Language has failed the powerless completely. Language is used to manipulate people’s thoughts about the world, â€Å"rendered into the oppressor’s language†.In an incredibly vivid image Rich depicts language as a violent and self-destructive wild animal: â€Å"and now a knot of lies/ eating at itself to get undone/ Words bitten thru words†. The biting and eating is enacted in the abbreviated spelling â€Å"thru†. People’s actual lives and experience cannot be told: â€Å"meanings burnt-off like paint/ under the blowtorch/ All those dead letters/ rendered into the oppressor’s language†. Paragraph 6 This poem places one shocking image after the other and language has become an instrument in a very violent world.The vision goes much further than in â€Å"The Uncle Speaks†, it encompasses the whole world and is in essence apocalyptic. The image of the burning Algerian walking away from his village to a doctor with no words to describe is pain is haunting: â€Å"his whole body a cloud of pain/ and there are no words for this/ except himself†. The absence of punctuation and in particular of a concluding full stop suggests the ongoing nature of the problem. Language has completely and disastrously failed its purpose as a means of communication between humans.In conclusion, Rich has opened up for me a way of looking at language that in some ways coincides with my own thinking and experience. However, she takes it unflinchingly and with amazing honesty and courage to a final analysis. She creates in her poetry unforgettable images for how women and all the powerless have been deprived of a means of expressing themselves. Language is an instrument of the powe rful. Although Rich’s poetry is a reflection of radical feminism and political struggle in the USA during the 6os and 70s I feel that what if conveys is as true now as it was then. Adrienne Rich on Power in Society Adrienne Rich on power in society Introduction The theme that interested me most in the poems by Adrienne Rich was the inadequacy of language as a means of communication. Rich shows that the reason for this lies in the way language expresses power relationships in society. Often this means the unequal relationship between women and men, but also between the powerful and the powerless. This theme is touched upon in almost every poem we studied, from Rich’s early poems to those written later. To illustrate how Rich explores this theme I will look in detail at â€Å"Aunt Jennifer’s Tigers†, â€Å"The Uncle Speaks in the Drawing Room†, â€Å"Our Whole Life†.Paragraph 1 In â€Å"Aunt Jennifer’s Tigers†, Rich creates a fantastic image of the aunt’s nonverbal communication through her tapestry. The poem opens with a vivid picture of the colourful, energetic alive world depicted on the tapestry. The aunt infuses the world of the tigers with many of the attributes she misses in her own life: a sense of being truly alive and in tune with the environment, and a state of fearlessness: â€Å"They do not fear the men beneath the tree/ They pace in sleek chivalric certainty. The ee- sound in these lines introduces a note of terror that heralds what is to come. Indeed the phrasing suggests a reason for fear from men. The feelings that the aunt is projecting into her artwork, her own fears and desires are developed in the middle stanza. Her shaking, fearful hands â€Å"fingers fluttering† are very vivid and the fact that they find the â€Å"needle hard to pull† suggests physical weakness and contrasts very much with the tigers. Paragraph 2 The reason for this weakness is â€Å"Uncle’s wedding band/ Sits heavily† on her â€Å"hand†.The possessive â€Å"Uncle’s† suggests that this is a one-way marriage that drains all life out of the aunt. Her hands come to represent her pers on in this poem and it is the hands that do the ‘talking’. The Uncle’s power over her seems to continue in death â€Å"When Aunt is dead, her terrified hands will lie/ Still ringed with the ordeals she was mastered by. † However, her unspoken, yet very articulate legacy remains: â€Å"The tigers in the panel that she made/ Will go on prancing, proud and unafraid. The tigers represent happiness, confidence and thereby beauty. Interestingly, this image of self-determination and sense of entitlement to the world is projected into the jungle, i. e. outside of society. This is where freedom exists and Aunt’s art gives expression to this. Paragraph 3 In contrast to Aunt Jennifer’s indirect communication, â€Å"The Uncle Speaks in the Drawing Room† is the dramatic monologue of a wealthy, powerful man. He speaks as a representative of the ruling class looking out at a group of discontent working people.These people have neither wealth nor pow er. They have gathered outside his big house to express their anger at this inequality. The uncle’s attempt to convey confidence and reassurance to his family is undermined by the images of anger outside. The poem’s sound expresses this threat. O- sounds and S-sounds dominate: â€Å"Standing sullen in the square [†¦] Some have held and fingered stones. † As the poem develops, the Uncle’s own fear becomes clear. The image of â€Å"glass† echoes and comes to symbolise â€Å"class†.He admits that the â€Å"frailties of glass [†¦] Lead in times like these to fear/ For crystal vase and chandelier. † Even his reassurance â€Å"None as yet dare lift an arm† achieves the opposite – the suggestion of an uncertain future, â€Å"arm† in fact has two meanings in this context! Paragraph 4 In fact the two most vivid images in the poem are the angry crowd outdoors on the one hand and the terrified forefather (indoors à ¢â‚¬â€œ like this family) on the other: â€Å"When our grandsire stood aghast/ To see his antique ruby bowl/ Shivered in a thunder-roll. Despite his attempts to reassure, the Uncle admits to deep unease at the end of the poem regarding the precarious position of his class as â€Å"We stand between the dead glass-blowers/ And murmurings of missile-throwers. † In terms of the theme of language, the Uncle uses it to express his position as a powerful wealthy man. Although his fears still become clear, it is still a useful tool for him. The workers outside do not have a voice, their language is not verbal: â€Å"sullen stares†, â€Å"bitter tones† and holding â€Å"stones†. There is no common language between the powerful and the powerless.Paragraph 5 â€Å"Our Whole Life† was written later. There is a stark change in terms of form to the previous two poems. It is written in free verse and uses no punctuation whatever. This in itself indicates Richâ⠂¬â„¢s thinking about language and the ability to express truth. Here, she strips it of its traditional appearance. In terms of theme, â€Å"Our Whole Life† explores the shocking gulf between the powerful and the powerless at a new level. Language has failed the powerless completely. Language is used to manipulate people’s thoughts about the world, â€Å"rendered into the oppressor’s language†.In an incredibly vivid image Rich depicts language as a violent and self-destructive wild animal: â€Å"and now a knot of lies/ eating at itself to get undone/ Words bitten thru words†. The biting and eating is enacted in the abbreviated spelling â€Å"thru†. People’s actual lives and experience cannot be told: â€Å"meanings burnt-off like paint/ under the blowtorch/ All those dead letters/ rendered into the oppressor’s language†. Paragraph 6 This poem places one shocking image after the other and language has become an instrument in a very violent world.The vision goes much further than in â€Å"The Uncle Speaks†, it encompasses the whole world and is in essence apocalyptic. The image of the burning Algerian walking away from his village to a doctor with no words to describe is pain is haunting: â€Å"his whole body a cloud of pain/ and there are no words for this/ except himself†. The absence of punctuation and in particular of a concluding full stop suggests the ongoing nature of the problem. Language has completely and disastrously failed its purpose as a means of communication between humans.In conclusion, Rich has opened up for me a way of looking at language that in some ways coincides with my own thinking and experience. However, she takes it unflinchingly and with amazing honesty and courage to a final analysis. She creates in her poetry unforgettable images for how women and all the powerless have been deprived of a means of expressing themselves. Language is an instrument of the powe rful. Although Rich’s poetry is a reflection of radical feminism and political struggle in the USA during the 6os and 70s I feel that what if conveys is as true now as it was then.

Poetry Analysis Essay

The poem is quick to assert that, maybe even provide a caveat, that one should take their life seriously and live their life to the fullest. It’s interesting that Byron beings to reflect on his life at this age, and I find it even more interesting that the poem was written on the last year he would live. One thing Byron emphasizes heavily on this poem is love and compassion. His first lines are an admittance that he does not have a partner by his side (lines 5-8). Many people fear dying alone, and Byron is not immune to such anxiety. Byron is even envious for those who have found love (lines 13-15). The â€Å"Chain† Byron says he wears symbolizes loneliness, perhaps even failure. He fears that his ultimate failure in life would be his lack of a companion, and that he cannot fill that void. I think Byron than goes on to say that love is happiness: and to have an absence in love would leave a person empty. Byron realizes he has failed in the one area he defines to be the most important and to recover from that and at least die in an honorable/memorable way is to take the soldier’s death. Since he has no significant other to speak highly of him when he is gone, he could at least have his fellow brothers-in-arms speak of him when he’s gone (most likely due to the soldier’s death). Overall, I’d say Byron is quite malcontented with how he’s lived his life. But I would say he was rather too harsh on himself, he fails to recognize all the great and wonderful things he has achieved in his life. But I also know that no one can determine whether or not someone was successful in life; that can only be determined by how that individual perceives themselves. The poem as a whole seems to be a reflection, but also a sad epiphany that Byron has not done all that he could have done with his life. This leads to the reoccurring theme that has been illustrated by almost all poets of this age: The ‘carpe diem’ seize the day/moment mentality. Darkness At the beginning lines of the poem, Byron sets up the reader to understand that this vision of the future, while not a current reality, could easily become so if mankind does not change his interaction with the environment. A cataclysmic event has occurred in which the sun is destroyed. For the eco-critic, this could be representative of any sort of environmental issue that is the result of man’s irreverence for the Earth – nuclear war, pollution, overpopulation. The poem does not need to explain how the sun was destroyed, just that the event happened and as a result, mankind’s decent into chaos and death was imminent. Mankind’s reaction to the event is to burn both civilization and nature in order to provide fuel to continue its existence. The next section forewarns the reader that following environmental catastrophe will be nothing but destruction. The destruction of nature occurs in the form of the overuse of resources, such as animals for food and trees for fuel. Men and animals would seemingly succumb to an almost hysteric state in which the law of survival becomes the only law, which is heralded as truth. This state of kill or be killed ultimately produced more concerns for the fate of mankind. Not only has the environment begun to be destroyed, here represented by the loss of the sun, but what few resources remain are being consumed at an unsustainable rate. The eco-critic understands that the population of the Earth can and should only become as large as is sustainable by the resources available to it. Byron illustrates this concept through the introduction of famine in the next section of his text. â€Å"The crowd was famish’d by degrees; but two of an enormous city did survive, and they were enemies. † The ultimate warning of eco-criticism is that the result of the widespread destruction of the environment is the widespread destruction of the human race. Byron has created a world in which the only two remaining humans cling to whatever life they have left in the form of a metaphorical flame. The last section of â€Å"Darkness† leaves the reader with a haunting image of a world in which nothing living exists. According to the eco-critic, this is the warning that Byron is delivering to us: either we change our ways and amend our neglect of environmental duty and responsibility, or we eventually perish. The destruction of mankind will come at its own hands, whether it is through environmental cataclysm, overpopulation and the subsequent war and famine, or through the slow poisoning of the Earth. Darkness† is a vehicle by which the eco-critic can forewarn the reader to change. Eco-Criticism, then, becomes a vehicle for change and hope. It is not merely about the destruction of the world, but hope that destruction can be avoided. Epitaph on an Infant This is a short poem, but still has a lot of meaning behind it, pertaining to the circle of life and death. Coleridge is saying that death can come at anytime and any moment, and seize anyone it pleases. Taking the b aby’s life shouldn’t be viewed as an evil or injustice, but rather part of the cycle. The first line can be interpreted to mean that the baby was never able to become exposed to the horrors of the world (sin) or be in the world for too long to have its loss be heart-breaking (sorrow). Not saying the loss of the baby was not a saddening thing, but Coleridge is saying the baby was not in this world long enough for it to be a huge loss. The last line is hopeful, saying the baby was able to â€Å"blossom there†, with there meaning heaven obviously. This, I feel, is how Coleridge viewed situations where the cycle of life seemed to break its own norms with taking a life that many would view as too early to take. This is for those who never got to grasp the mentality that many Romantic embraced during this time, of seizing the day, and living life to its fullest, not having any regrets. Of course, the baby (or any other youngling) is unable to even encounter such mentalities or form its own attitude for life. Even the length of the poem is symbolic; it represents the life span of the young babe, and how short life can ultimately be if one does not take their time to sit back and enjoy it a bit. Human Life Here’s how I interpreted this poem to be, line (cluster) by line (cluster). Lines 1-4: if the human body dies, the soul lives on forever. Lines 5-6: A human is comprised of three things, mind, body, and spirit. Lines 7-9: Everybody dies at some point in their life, and while to may try to prolong it, it is ultimately unavoidable. Lines 10-14: Nature will choose when everyone dies, it does not discriminate. Lines 15-17: When everything does not seem to be going your way, look through your previous dreams, hopes, and fears. Then reflect, and see if everything is as bad as you are making things out to be. Lines 18-22: remember though that each previous event echoes other ones and to be honest why do we wallow in things that are not important, and yet we hide ourselves from matters of much more importance? Lines 23-26: Why do we compare ourselves to events in the past instead of matters in the present moment or future? The past does not change, but we are shaped from it. Lines 27-28: Humans feel what they feel for no apparent reason; yet they seek reasons for why they feel the way they do. And the final line (29): All of a human’s life is nothing but a contradiction. A human will seek answers to many of life’s questions within themselves, but will always have conflict within. With this poem, Coleridge takes a more dark approach to the cycle of life, with his central theme of the poem being clearly stated at the very end â€Å"A beings being is contradiction†. He takes the approach to life of many people spend hours, days, weeks even contemplating the reasons for the seasons, our existence, why we die, and all other philosophical questions; and he asks â€Å"Why even bother seeking such answers? †. Death is unavoidable, and those who try to prolong it or even avoid it, are just walking contradictions. Why try to go against what is everyone’s fate in the end? Coleridge purposes such ideas and asks provocative questions to get his readers to think: Is it wiser to spend one’s life contemplating matters that way over everyone’s head, or rather just accept that your life as you know it will end one day, but in the meantime do your best to live it and not let anything shackle you to the bonds of â€Å"I can’t therefore I won’t†. Once again, the Romantic theme of ‘carpe-diem’ is sensed as a undertone to this poem, as Coleridge is warning people to not let the worldly matters trouble them, instead seek out the best in your life. Ode On The Death Of A Favorite Cat Drowned In A Tub Of Goldfishes This poem was quite uncommon for its time, but it still shared the qualities that make the readers think about life, death, and the cycle of the two. The reader is taken on a journey into the life of this cat, Selima, experiencing not only the beauty that is said creature, but also the sad end she came to, quite undeservingly. The third person view Grey utilizes helps show the struggle between life (the cat) versus nature. With the tone being deadly erious, Grey is showing a portrait of the cat as a cat with her â€Å"conscious tale† and â€Å"ears of jet† ( lines 7,11), trying to accomplish no more than procuring a goldfish for lunch. However, the tale takes a deadly turn when the fated Selima goes a paw too far and tumbles face-first into the goldfish tub. The reader, through this tone (which some might call mock-heroic, could they not see the utter tragedy and seriousness of Selima’s fate), is t aken into the life and death of a cat who was merely hungry; alas, she ends up swimming with the fishes. The golden hue of the fish is what catches the tabby’s attention, and the cat then tries to catch it’s lunch. Eventually, the cat falls into the pond, and struggles for a while, with no help coming. This can be seen as no matter what you do in your life, when things really matter (such as a life and death situation), the only person one can rely on is themselves. Unfortunately, Grey has a grim way to convey that. The cat surfaces eight times, each time her life force growing weaker and weaker against the struggle†¦ ntil eventually Selima, having exhausted all her life, sinks amidst the objects of her lunchtime ambitions. Grey’s powerful message here is clear; be careful where you step, as you may fall into a pond of goldfish and drown. Furthermore, Gray implies, what you covet, though it may be beautiful, may lead you to your death. This can be tied back to the theme of not taking life for granted, and making each day yours. Should one be weighed down with m aterial possessions and worldly goods, they are depriving themselves of the ultimate ‘good’, life itself.

Qualitative analysis Essay Example | Topics and Well Written Essays - 1500 words

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Management of Technology - Essay Example The company has a slew of innovations, most in different stages of patenting. It assiduously protects its intellectual property. Its business model relies on license fees accruing from the deployment of its technology in the Wave Energy Projects. Apart from license fees, the company participates in equity of the Special Purpose Companies that implement the projects. Being an innovation driven company in the frontiers of technology, technology management is its area of special emphasis. Carnegie Corp. acquired CETO technologies from REH. CETO, named after a Greek god, is the only technology that enables pumping high pressure sea water ashore. This method is the most efficient method to desalinate sea water (PESWiki.com). The acquisition was in return for REH taking 35% stake in Carnegie. In addition to the intellectual property, Carnegie acquired REH’s commercial site pipeline. REH’s agreements with EDF EN also devolved upon Carnegie. Consequent to the agreement with REH, Carnegie would Build, Own and Operate CETO wave forms in the southern hemisphere, which was the domain of REH (CETO over View). The relationship with EDF EN is a joint venture license relationship to own and operate CETO Wave Power Projects in the northern hemisphere and Reunion Island in the Indian Ocean. While Carnegie will have the right, it is not bound by any obligation to participate in any CETO wave power project developed by EDF EN in the Territory of Exclusivity. In the event REH does not exercise its right to participate in any such project, EDF EN can exercise the right in developing such project with a partner of its choice. Carnegie’s project with EDF EN, will be implemented by a Special Purpose Company (SPC). In this SPC, Carnegie receives an equity interest between 25% and 49% related to the scale of the project. The financing of the project will be through equity and debt instruments. The equity

Efficiency of Clustering algorithms for mining large biological data Research Paper

Efficiency of Clustering algorithms for mining large biological data bases - Research Paper Example They are categorized into portioning, hierarchical and graph-based techniques. The most widely used of the three algorithms are the graph-based technique, and the hierarchical technique. However, the partitioning techniques are used in other disciplines; it is less used in gene sequence clustering and as such, there is no substantial theory of whether the partitioning methods are efficient. This study analyzes four clustering mining algorithms using four large protein sequence data sets. The analysis highlights the weakness and shortcomings of the four and proposes a new algorithm based on the shortcomings of the four algorithms. Introduction Today, protein sequences are more than one million (Sasson et al., 2002) and as such, there is need in bioinformatics for identifying meaningful patterns for the purposes of understanding their functions. For a long time, protein and gene sequences have been analyzed, compared and grouped using alignment methods. According to Cai et al. (2000), alignment methods are algorithms constructed to arrange, RNA, DNA, and protein sequences to detect similarities that may be as a result of evolutionary, functional or structural sequence relationships. Mount (2002) asserts that comparing and clustering sequences is done using pair-wise alignment method, which are of two types, global and local. Consequently, local alignment algorithm proposed by Waterman and Smith (Bolten et al., 2001) is utilized in identifying amino acid patterns that have been conserved in protein sequences. The global alignment algorithm proposed by Wunsh and Needleman (Bolten et al., 2001) is used to try and align many characters of the entire sequence. It is clear from the above that; the pair-wise alignment method is expensive when it comes to comparing and clustering a large protein data set. This is because there are very many comparisons performed during computation, since every single protein in a data set is compared to all the proteins in the data set ( Bolten et al., 2001). This brings into question the efficiency of the pair-wise alignment methods in comparing and clustering of large protein data sets. The pair-wise alignment method, both local and global, do not put into consideration the size of the data set, especially too large data sets that may overwhelm the computer memory. Han & Kamber (2000) argues that, unsupervised learning is aimed at identifying from a data set, a sensible partition or a natural pattern with the help of a distance function. Biology and life science fields have extensively exploited clustering techniques in sequence analysis to classify similar sequences into either protein or gen families (Galperin & Koonin, 2001). Currently, protein sequences can be classified in similar patterns using various, readily available sequencing and clustering methods. As had earlier been mentioned, these methods can be grouped as graph-based, partitioning and hierarchical methods. These methods, especially graph-based an d hierarchical methods, have been used consecutively or together to complement each other as argued by Sasson et al. (2002), Sperisen & Pagni (2005), Essoussi & Fayech (2007) and Enright & Ouzounis (2000). In the field of protein comparison and sequence clustering, there are very few instances in which partitioning techniques have been used. For instance, Guralnik & Karypis (2001) proposed an algorithm or sequencing method-on the

See the dic Essay Example | Topics and Well Written Essays - 250 words

See the dic - Essay Example is no new requirement with a harmful effect to the project is added; Time Management, which involves ensuring that the deadline of the project is met; Cost Management, which sees the project completed within the budget; Quality Management, which ensures the project does what it was intended to and is completed according to the requirements; Human Resource Management, which involves all processes for managing, developing and putting the team together; Communication Management, which determines the type of information needed and the medium of sending that information as well as how the performance of the project will be reported; Risk Management, which includes identification, controlling and management of risks associated with the project; and Procurement Management, which involves processes for acquisition of services and materials required for successful completion of the project. In summary, there are nine major knowledge areas of a project and each knowledge area covers an important part of the project. One knowledge area may cover various phases of groups of processes in the project. A project manager must therefore excel in all the nine knowledge areas even though some knowledge areas may be more pivotal than the others. Each area must however be executed with professionalism and care in order to have a successful project

BUS499 MOD 1 CA Essay Example | Topics and Well Written Essays - 750 words

BUS499 MOD 1 CA - Essay Example The new management also planned to convert the organization’s 30 percent of the incremental revenue to operating profit. The company’s third goal was to double its earnings per share. On the basis of which agencies were making money for the company and which were not, the company categorized its business units into three categories namely ‘lead, drive, and prosper’ (Melter). Each agency category has been assigned with different strategic charges. The business units that had less than 50 employees and were less likely to become a gigantic agency ever were categorized as prospers. The company’s most business units fell under the prosper category. Since prosper units were not expected to attain a tremendous growth rate, the strategy chosen for this type of business unit was to achieve high profit margins. The business units that had 50-150 employees were categorized as drive agencies which were assigned with the goal of maintaining or gradually improving their revenue base in addition to expanding their margins. Finally, the largest business units like New York, UK, and China were given the lead agency status. Since lead agencies were expected to achieve rapid growth and to allocate lion’s share of the investment, the company management paid particular attention to this type of business agency. The strategy specifically created for lead agencies was to develop ‘permanently infatuated clients’ and to particularly focus on large revenue earning clients. In addition, the organization also developed several strategies that greatly related to a customer perspective. One of those strategies was to create ‘big fabulous ideas’ or BFIs that are able to â€Å"transform the businesses, brands, and reputations† of the clients (Melter). For this, the organization stated the need of an ideal environment and inspirational leadership in every unit. The firm’s key strategy was to

Work of Art History Essay Example | Topics and Well Written Essays - 750 words

Work of Art History - Essay Example At the same time he was developing his own style, Rodin was joined by Realists and Impressionists who brought new perspectives to painting, and thus public perception of art changed as well. In 1907, Rodin crafted The Hand of God, which he had modeled around 1896. The sculpture shows a single hand as its central subject, and it holds within it a raw stone. This stone also features the smooth figures of man and woman, who are being fashioned into organic forms from the rough material, showing God in the process of creation much as the sculptor goes through such a process. In analyzing this sculpture, it is first necessary to use one's eyes to see what it presents—the content, the subject matter, the forms and shapes. The sculpture, as mentioned, features a large, strong hand, set apart from the body so that the hand itself is the subject. The hand juts forth from a rough base, an uncut and unpolished piece of stone marble. Within the hand, we see a smaller version of the same c ontrast—there are two human bodies, intertwined, one man and one woman, and they are attached to a backdrop of raw marble with no deliberation alterations. Examining the sculpture from different angles reveals different contrasts, as one side shows only the fingers gripping the stone, while another angle would put the focus on the human figures within the stone and the hand. The texture of the human elements is smooth and curved, while the rest of the marble is straight, jagged, and not at all organic. The sculpture can be seen as divided into three parts—the largest part being the hand, the next mot important being the two human figures, and then the backdrop of uncut stone being the supplementary part. As a sculpture, color is not used, but form doubles its centrality by gaining a third dimension that is not quite present in any painting. The artist was able to create a center of a attention with ease by having the hand sit squarely in the center of its base and come upward, with the fingers slightly curled in order to create a cylindrical shape that also suggest motion. The lack of rigidity in the hand gives it a more lifelike appearance, just as the somewhat fetal and relaxed human forms of the man and woman give an impression that they are alive and movable, rather than striking any sort of pose that lacks life and flexibility. The artist also creates a contrast between the live and non live parts of the sculpture by having a deep groove between the body parts and the rough stone. In a way, there is a sort of trench, and this has the effect of making the body parts pop out from the stone, not specifically separated but still having a clear gap and change of depth. This is his way of establishing an aesthetic difference between the two elements, while the scale is used to develop a difference between the bodies and the hand. The texture of the body parts helps to create a beauty that is set apart from the stone as well, so the viewer clearly considers the difference between the two and realizes which is more attractive. The meaning of the sculpture is rather easy to interpret on the surface, but perhaps has deeper parts. Foremost, it shows symbolic process of creation of humanity by the more powerful and larger â€Å"hand of God†. The difference between textures shows that life comes from something raw, and God cleaves life out of what is lifeless. The lack of body for God shows that the hands are the focus, as the hand of God is the doing and creating part of him, the tools that he used to change earth into man. On top of this basic theme of creation by God from rough material into life and beauty, we also get a second meaning of creation—that of the artist or the sculptor. The symbolism about divinity is displayed in

The Effects of Government Intervention Essay Example for Free

The Effects of Government Intervention Essay What is the government? What is the role of the government? How does the government influence the economy? What can we say about the effects of the government influence in Romania? These are some of the questions that we  will try to answer during our case of study. We are citizens of a society, and our society is based on proper rules enacted and enforced by the high powers of our states. We need to act responsibly and inform ourselves, as much as we can, regarding this problem. The people from the government, how did they get there? How is the government organized? How are they elected? By which criteria are these people elected? What are their attributes and what are their initiatives? We must know if they directly influence our lives, our economy! Taxes, import and export restrictions, tariffs, wholesale interest rates are only a part of the government’s duties to be established. Is the government’s money, in fact our money? And if they are our money, how do they spend it, on what, and why? These are some things that must concern us. And now, we should focus on our country, Romania, and, of course, on ourselves. Even though Romania is a country of considerable potential in most of the fields, its economy is very fragile. Our economy is strong related to the European economy, and some of these connections between our economy and the international economy are made by the government. Most of the people tend to blemish the president, the government, the parliament etc. for the fragility of our economy, and to us it might seem not to work, but we have to bear in mind that this is the effect of the whole nation’s actions and of the world’s as well. In the pages that follow we presented subjectively and objectively our ideas concerning the effects of the government’s influence on Romania’s economy, starting with explaining that is the government and which is the government’s role in the economy. The Government Government refers to the legislators, administrators, and arbitrators in the administrative bureaucracy who control a state at a given time, and to the system of government by which they are organized. Government is the means by  which state policy is enforced, as well as the mechanism for determining the policy of the state. A form of government, or form of state governance, refers to the set of political institutions by which a government of a state is organized. Synonyms include regime type and system of government. The word government is derived from the Latin verb gubernare, an infinitive meaning to govern or to manage. The Government is the public authority of executive power that functions on the basis of the vote of confidence granted by Parliament, ensures the achievement of the countrys domestic and foreign policy and that exercises the general leadership of public administration. The Government is appointed by the President of Romania on the basis of the vote of confidence granted to the Government by Parliament. Objectives The Government has the role of ensuring balanced functioning and development of national economic and social system, and its connection to the world economic system while promoting national interests. The Government is organized and operates in accordance with constitutional provisions, on the basis of the Government program approved by Parliament. Organization The Government consists of Prime Minister and Ministers. Prime Minister leads the Government and coordinates the activities of its members, in compliance with their legal duties. The working apparatus of the Government is composed of the working apparatus of the Prime Minister, Secretariat General of the Government, departments and other similar organizational structures with specific tasks set by Government Decision. Legislative process The Government adopts decisions and ordinances. Decisions are issued for law enforcement organization. Ordinances are issued under a special enabling law, within the limits and conditions specified by it. The decisions and ordinances adopted by the Government are signed by Prime Minister, countersigned by the Ministers who are duty bound to implement them and are published in the Official Gazette. The non publication entails the absence of a decision or ordinance. Decisions with military character shall be conveyed only to the institutions concerned. Legislative initiatives The following public authorities have the right to initiate draft public policy documents and draft legislative acts for adoption / approval by the Government, according to their tasks and activity field: Ministries and other specialized bodies of central public administration, subordinated to the Government, and autonomous administrative authorities; specialized bodies of central public administration subordinated or coordinated by Ministries, by the Ministries under whose subordination or coordination they are; Prefects, county councils, the General Council of Bucharest, according to the law, through the Ministry of Interior and Administrative Reform. Governments Role in the Economy While consumers and producers make most decisions that mold the economy, government activities have a powerful effect on the Romanian economy in at least five areas. Stabilization and Growth. Perhaps most importantly, the federal government guides the overall pace of economic activity, attempting to maintain steady growth, high levels of employment, and price stability. By adjusting spending and tax rates (fiscal policy) or managing the money supply and controlling the use of credit (monetary policy), it can slow down or speed up the economys rate of growth in the process, affecting the level of prices and employment. The government could affect the economy in multiple ways, but the most common changes that can be made to influence the economy are: (1) Taxes; (2) Import Restrictions; (3) Wholesale Interest Rates; and (4) Government Speeding. TAXES Taxation understandably affects the economy by redistributing money from consumers and producers to the government coffers. The higher the tax, the less people have to spend, the less aggregate demand [total demand] there is in the economy. IMPORT RESTRICTIONS When a country uses protectionism to shield domestic producers from their own inefficiency and inability to compete with foreign firms, they may enact quotas or tariffs. A quota is when there is a maximum amount of a good that can be imported into the country, where imports that exceed the limit have either the responsible parties prosecuted for breaking the law or the goods being turned away. Tariffs are when the price of imports is artificially inflated with a tax, in order to make them less attractive to consumers that are price sensitive. The higher the quotas and tariffs, the higher the prices of those penalised goods in the economy, which in turn will negatively affect aggregate demand. WHOLESALE INTEREST RATES Wholesale interest rates are the rates at which the central bank loans out money to retail banks, which in turn loan out their money to consumers and producers at a higher rate (the difference, in a very basic sense, is their profit margin, or revenue minus costs). If the wholesale interest rates are increased, then retail banks must also increase their rates, otherwise their business would become less profitable (or unprofitable). For large purchases, producers (e.g. investments) and consumers (e.g. buying a home) need loans, since they do not have sufficient cash on-hand. Interest rates are effectively the price of borrowing money and hence affects the Consumption and Investment components of GDP (Consumption + Investment + Govt. Spending + Net Exports). (A small caveat, however, that central banks are created by legislation but are not run by government their actions are independent of politicians agendas.) GOVERNMENT SPENDING Government Speeding (revenues taken from taxes, mentioned above) creates what is known as the Spending Multiplier. When the government consumes, called Government Spending, it is demanding goods and services in the economy. However, that demand in turn generates more demand than a single consume, because of not only the size of the demand (the government has a lot more money than you do) but also the type of demand (e.g. building infrastructure benefits everybody, as opposed to building a private mansion); government spending affects aggregate demand. The spending  multiplier, or how much additional demand is generated from each dollar of government spending, is calculated as follows: Change in Equilibrium divided by Change in Investment. Case Study – Romania Romania is a country of considerable potential: rich agricultural lands, diverse energy sources (coal, oil, natural gas, hydro, and nuclear), a substantial industrial base encompassing almost the full range of manufacturing activities, an educated work force, and opportunities for expanded development in tourism on the Black Sea and in the Carpathian Mountains. The Romanian Government borrowed heavily from the West in the 1970s to build a substantial state-owned industrial base. Following the 1979 oil price shock and a debt rescheduling in 1981, Ceausescu decreed that Romania would no longer be subject to foreign creditors. By the end of 1989, Romania had paid off a foreign debt of about $10.5 billion through an unprecedented effort that wreaked havoc on the economy and living standards. Vital imports were slashed and food and fuel strictly rationed, while the government exported everything it could to earn hard currency. With investment slashed, Romanias infrastructure fell behind its historically poorer Balkan neighbours. Since the fall of the Ceausescu regime in 1989, successive governments sought to build a Western-style market economy. The pace of restructuring was slow, but by 1994 the legal basis for a market economy was largely in place. After the 1996 elections, the coalition government attempted to eliminate consumer subsidies, float prices, liberalize exchange rates, and put in place a tight monetary policy. The Parliament enacted laws permitting foreign entities incorporated in Romania to purchase land. Foreign capital investment in Romania had been increasing rapidly until 2008, although it remained less in per capita terms than in some other countries of East and Central Europe. Romania was the largest U.S. trading partner in Eastern Europe until Ceausescus 1988 renunciation of most favoured nation (MFN, or non-discriminatory) trading status resulted in high U.S. tariffs on Romanian products. Congress approved restoration of MFN status effective November 8, 1993, as part of a new bilateral trade agreement. Tariffs on most Romanian products dropped to zero in February 1994, with the inclusion of Romania in the Generalized System of Preferences (GSP). Major Romanian exports to the U.S. include shoes, clothing, steel, and chemicals. Romania signed an Association Agreement with the European Union (EU) in 1992 and a free trade agreement with the European Free Trade Association (EFTA) in 1993, codifying Romanias access to European markets and creating the basic framework for further economic integration. At its Helsinki Summit in December 1999, the European Union invited Romania to formally begin accession negotiations. In December 2004, the European Commission concluded pre-accession negotiations with Romania. In April 2005, the EU signed an accession treaty with Romania and its neighbour, Bulgaria, and in January 2007, they were both welcomed as new EU members. Romania suffered through a deep economic recession beginning with the 2008 global financial crisis, but should return to positive if very modest growth by the end of 2011. Due to rapidly deteriorating economic conditions, a ballooning budget deficit, and large external imbalances, the Romanian Government was forced to conclude a 2-year, $27 billion financial assistance package with the International Monetary Fund (IMF), the European Commission, and the World Bank in March 2009. Under the terms agreed with the IMF, the Romanian Government embarked on a difficult austerity program to reduce the budget deficit, cut public sector employment, and restructure local and national government agencies. Austerity measures included a 25% cut in public sector wages, a hike in the national value added tax (VAT) rate from 19% to 24%, and thousands of layoffs. GDP declined by 7.1% in 2009 and a further 1.3% in 2010, but the government succeeded in meeting IMF-agreed deficit targets despite strong op position to the austerity measures from labour unions. In late 2010 and early 2011 the government also pushed several important pieces of reform legislation through Parliament, including  pension reforms, an overhaul of public sector pay systems, and modernization of the labour code. The final IMF review under the 2009 agreement, conducted in February 2011, declared the agreement a â€Å"success† in stabilizing the economy and setting the stage for a return to growth. A new 2-year â€Å"precautionary† agreement between Romania and the IMF, effective March 2011, focuses on deepening structural reforms and restructuring or privatizing unprofitable state-owned enterprises. Privatization of industry was first pursued with the transfer in 1992 of 30% of the shares of some 6,000 state-owned enterprises to five private ownership funds, in which each adult citizen received certificates of ownership. The remaining 70% ownership of the enterprises was transferred to a state ownership fund. With the assistance of the World Bank, European Union, and IMF, Romania succeeded in privatizing most industrial state-owned enterprises, including some large state-owned energy companies. Romania completed the privatization of the largest commercial bank (BCR) in 2006. Two state-owned banks remain in Romania, Eximbank and the National Savings Bank (CEC), after an attempt to privatize CEC Bank was indefinitely postponed in 2006. Four of the countrys eight regional electricity distributors have now been privatized. Privatization of natural gas distribution companies also progressed with the sale of Romanias two regional gas distributors, Distrigaz Nord (to E.ON Ruhrgas of Germany) and Distrigaz Sud (to Gaz de France). Further progress in energy sector privatization has been delayed as the government is contemplating the creation of two integrated, state-owned energy producers. However, this â€Å"bundling† scheme has been challenged in court and is also under review by the Romanian Competition Council and by competition authorities at the European Commission. Romania has a nuclear power plant at Cernavoda, with one nuclear reactor in operation since 1996 and a second one commissioned in the fall of 2007. The return of collectivized farmland to its cultivators, one of the first initiatives of the post-December 1989 revolution government, resulted in a short-term decrease in agricultural production. Some four million small parcels representing 80% of the arable surface were returned to original  owners or their heirs. Many of the recipients were elderly or city dwellers, and the slow progress of granting formal land titles remains an obstacle to leasing or selling land to active farmers. Financial and technical assistance continues to flow from the U.S., European Union, other industrial nations, and international financial institutions facilitating Romanias reintegration into the world economy. The IMF, World Bank, European Bank for Reconstruction and Development (EBRD), and European Investment Bank (EIB) all have programs and resident representatives in Romania. U.S. Agency for International Development (USAID) programs were phased out completely in 2008, except for Small Project Assistance Grants, which are still available through the Peace Corps. According to the National Office of the Trade Register, which measures foreign direct capital registered and disbursed to firms, between 1990 and November 2010 Romania attracted a total of $37.91 billion in foreign direct investment, of which the U.S. represented 2.59%. The actual level of U.S. investment, however, is underreported as much of it flows to Romania through European subsidiaries of U.S. companies. After years of consistently high inflation in the 1990s, Romanias inflation rate steadily decreased through 2004, only to rise again along with high GDP growth rates of 4% to 8% through 2008. The deep recession beginning in late 2008 dramatically reduced inflationary pressures, but the VAT tax hike from 19% to 24% imposed in mid-2010 reversed that trend and pushed prices higher. Stoked also by rising global food and energy prices, inflation hit an annualized rate of 8% at the end of 2010, the highest in the EU. The IMF has been critical of Romanias low rate of tax collection and poor enforcement mechanisms as a medium- to long-term impediment to growth. Tax arrears are slightly decreasing, but Romania still has one of the lowest percentages in the EU of revenues collected, at 33% of GDP in 2010. The current account deficit had been a concern, as it reached 13.6% of GDP in 2007 and 12.4% of GDP in 2008. However, due to the recession, the current account deficit dropped to 4.2% of GDP in 2010. Deteriorating education and health services and aging and inadequate physical infrastructure continue to be seen as threats to future growth. Sometimes a picture is worth a thousand words Conclusion As a conclusion we can say that government’s intervention in the economy can have both a positive and a negative influence on the market. Government intervention does not always end up the way it was intended or the way in which economist’s theories say it would. A fascinating part in the study of Economics is that the law of unintended consequences often comes into play – events can affect a particular policy, and consumers and businesses rarely behave precisely in the way in which the government might want! We will consider this in more detail when we consider government failure. One important thing to remember is that the effects of different forms of government intervention in markets are never neutral thus financial support given by the government to one set of producers rather than another will always create winners and losers. Taxing one product more than another will similarly have different effects on different groups of consumers. A concret example of too much government intervention is the following. Let’s assume that in a time of recession, a government makes and agreement with the banks to lower interest rates and people will start buying houses and other goods on loan. As time goes by, government debt also rises and thus they will be obliged to print out their own money. Printing their own money has a negative impact on the inflation rate and money value will go down. Also, after the recession, the interest rates will go up again and people will end up losing their previously bought goods. Nevertheless in most cases, the government’s intervention proved to be efficient and actually helped the market economy. It all depends on the people that take the decisions and they need to take into consideration any factors that can influence the result of their decision. The European Union provides me the best opportunity to connect with people Europe and to develop my ability of communication. I think is very important to get in touch with different people from different cultures and different countries.

What Is The Organizational Justice Theory Commerce Essay

What Is The Organizational Justice Theory Commerce Essay Organizational justice theory provides a model through which perceptions of fairness and equity by those affected by change can be explored and understood. OJT combines social psychological theories and psychological contract models to explain fairness judgments. Based on an individuals perception of fairness within their organization, three typologies of OJT have been defined; i) Distributive justice refers to the perceived fairness of decision outcomes and is judged by measuring whether rewards are proportional to costs (Homans, 1961, cited in Colquitt, 2006), whether outcomes stick to expectations (Blau, 1964, cited in Colquitt, 2006), and whether outcome/input ratios match those of a comparison other (Adams, 1965). ii) Procedural justice refers to the perceived fairness of decision-making procedures and is judged by gauging whether procedures are accurate, consistent, unbiased, and correctable (Leventhal, 1980, cited in Colquitt, 2006), and open to employee input (Thibaut Walker , 1975, cited in Colquitt, 2006); iii) Interactional justice refers to the perceived fairness of the performance or implementations of procedures (Bies Moag, 1986, cited in Colquitt, 2006). Implications of negative justice perceptions could be seen in an individuals behavioral response to perceived inequity of rewards. Based on exchange theories of organizational and social behavior, individuals will compare the ratio of their inputs (e.g. education, skills, effort, experiences) to outcomes (e.g. pay, promotion, recognition) with that of a referent other, and will strive to restore their perceived balance of rewards through a behavioral response. An organizations policies often signal what the organization believes to be important and can enhance employees trust and confidence in the organization (Tyler and Lind, 1992, cited in Brown. Et al., 2010). Individuals can look to the fairness of organizational policies in order to gain insight into the type of treatment they can expect to receive from the organization. Fair policies not only establish what the organization considers to be appropriate treatment but policies also build employees expectations that this treatment will occur (Sitkin and Bies, 1994, cited in Brown. Et al., 2010). Unfair policies, in contrast, can signal to employees that they might experience unfairness and/or have difficulty meeting their needs in the organizational environment. Although individuals may consider procedural justice to determine the probability of future mistreat ­ment, we argue that policies provide a more reliable source as policies are relatively stable, enduring, and often provide ex plicit guidelines for future treatment by the same or other managers in the organization. 2.1 Details of cases (Critical thinking questions no.5, pp 109) Several service representatives are upset that the newly hired representative with no previous experience will be paid $3,000 a year above the usual starting salary in the pay range. The department manager explained that the new hire would not accept the entry-level rate, so the company raised the offer by $3,000. All five reps currently earn salaries near the top of the scale ($15,000 higher than the new recruit), although they all started at the minimum starting salary a few years earlier. Use equity theory to explain why the five service representatives feel inequity in this situation. 3. Problem Identification by Niek Ling Keong Equity theory focuses on the concept of how hard a person is willing to work is dependent on their perception of what is fair or just when compared to others (Redmond, 2010).   In the early sixties, John Stacey Adams proposed that employee motivation is impacted by whether or not the employee believes that their employment benefit/rewards (output/outcomes) are at least equal to the amount of the effort they put into their work (input).   If an employee believes their outputs are not equal to or greater than their input, then the employee will become de-motivated.   Employees will often compare their inputs and outputs to a peer within the organization when judging whether or not the outputs that they receive are fair. In this case, five service representatives feel inequity in their company because they did not get high salary ($3,000) compared to those new recruits even though they all started at the minimum level few years earlier. When a person perceives his/her input/outcom e ratio to be unequal with a comparison other, inequity results, they may choose to use cognitive (e.g., adjust perceptions of referent others inputs or outcomes) or behavioral (e.g., increasing or decreasing inputs) approaches to resolve the inequity. However, individuals subjected to the same inequitable situations often respond in different ways, suggesting that there may be individual differences in sensitivity to inequity (Redmond, 2010). Specifically, research suggests that individuals are differentially sensitive to disparities in outcome/input ratios between themselves and their referents, which helps to explain why there are differences in reactions among individuals to the same unfair situations. Equity theory can be broken down into four basic schemes (Huseman, Hatfield, Miles, 1987, cited in Redmond 2010) 1.   Individuals develop their perception of fairness by calculating a ratio of their inputs and outcomes and then comparing this to the ratio of others (Huseman, et. al., 1987). Inputs are the value proposition of individuals, such as their productivity, time, and education. Other examples include the experience, knowledge, ability, qualifications and ambition of the individual (Cory, 2006). Outcomes are the rewards an individual receives. These rewards can be tangible, such as financial compensation, or intangible, such as recognition or job security. The comparable other could be a co-worker, a relative, the industry norm, a friend, or even a group of individuals (Adams, 1963). The comparable other can even be oneself in a past job (Adams, 1963). For example, an individual may not perceive he is being treated fairly when he works 40 hours per week (input) and receives $500 in pay (output) while his co-worker works 30 hours per week and receives $650 in pay. In this critical ques tion, the five representatives think that those new recruits dont have previous experience, same with them who start work at the minimum level few years ago. However, the salary earn by those newly hired representatives are higher than the salary earned by senior representatives. 2.   If the comparative ratios are perceived by the individual to be unequal, then inequity exists (Huseman, et. al., 1987). According to equity theory, an individual needs to perceive that the ratios of their contributions are weighted fairly: determined by equal ratios. Equity is all about balance (Spector 2008). Equity is present when a person feels that they are receiving the appropriate amount of outcomes from their inputs, when compared to their chosen comparison other. Inequity exists when there is a perceived difference in the ratios of inputs and outcomes. Two specific types of inequity exist: underpayment inequity and overpayment inequity. Underpayment inequity occurs when an individual perceives that their ratio is smaller than their comparison other: they are getting less for their inputs. For example, if someone feels they are putting in more effort or working harder than a co-worker, yet they earn equal or less compensation, their perceived ratios will be different an d that person will experience underpayment inequity. In contrast, overpayment inequity tips the scales in the other direction. For example, someone will feel they are being paid too much considering their work, when compared to the work and compensation of a co-worker. This can cause feelings of guilt and the ratios used for comparison are based upon the perception of an individual, and not an objective measure of inputs and outcomes. Additionally, the choice of a comparison other is also the subjective selection of the individual. While in this case, the senior representatives feel inequity of overpayment exists due to the higher salary in comparative ratios to the newly representatives. 3.  As the difference in inequity increases, the tension and distress felt by an individual will increase (Huseman, et. al., 1987). Smaller differences of inequity are more tolerable than significant differences of inequity. Not every person will experience equity or inequity in the same way because people have varying tolerance levels or sensitivity to perceived situations of inequity. Three types of individuals have been identified along an equity sensitivity scale: compassionate, equity sensitives, and entitled (Huseman, et. al.,  1987). Benevolents are more tolerant of underreward (Huseman, et. al., 1987). Equity sensitives follow the norm of equity theory and prefer their ratios to be equal to their comparison other (Huseman, et. al., 1987). Entitleds prefer to be in over-reward situations and want their ratio to exceed that of their comparison other (Huseman, et. al., 1987). Entitleds frequently have the attitude that the world owes them a favor, so they will freely accept and seek out over-reward situations. In this critical study of question, five representatives are perceived as entitleds since they still think the company owes them a good turn although they earn $15,000, which is near the top scale of salary and is higher than the new recruits. 4.  The greater tension an individual feels due to perceived inequity, the harder they will work to decrease their tension and increase perceived levels of equity (Huseman, et. al., 1987). Most individuals will try to achieve equity by adjusting their own inputs and outcomes, or attempting to change the inputs or outcomes of the comparison other. Individuals can use behavioral processes or cognitive processes in order to attempt to restore equity. Examples include decreasing productivity at work, finding a new job, asking for a wage increase, changing the comparative other, or attempting to distort or justify changes in their perceptions of inputs and/or outcomes (Adams, 1963). The means of reducing inequity will vary depending on the situation and will not all be equally satisfying to an individual (Adams, 1963). 4. Source of the problem by Ng Hui Ming a. Explanation Equity theory deals with two questions: (1) What do people think is fair and equitable? And (2) How do they respond when they feel they are getting far more or far less from their relationships than they deserve? How do they react when they see their fellows harvesting undeserved benefits or enduring undeserved suffering? Interestingly, Lind and Van den Bos (2002, cited in Sora, B. et al. 2010) conceptualized the integration of justice with stress through uncertainty management theory. This model can be summarized by the following principle: people use fairness to manage their reactions to uncertainty, finding comfort in related or even unrelated fair experiences and finding additional suffering in unfair experiences (Lind and Van den Bos, 2002: 216, cited in Sora, B. et al. 2010). In other words, work uncertainty is perceived as a threatening situation for employees. In this setting, employees tend to seek certainty and security, and one way to obtain them is through developing fai rness judgements that make the uncertain event more predictable. Organizational justice is an effective tool to reduce the feelings of uncertainty and, therefore, lessen the discom ­fort to a great extent (Elovainio et al., 2005; Judge and Colquitt, 2004; Thau et al., 2007, cited in Sora, B. et al. 2010). In this case, the inequity judgment by those five service representatives that new employees will be getting more pay of salary has caused them to feel unsecure. This is say so because the salaries earn by new recruits now are higher than the time senior representative earned. They worry that those newly hired workers will earn much than them in a very short time since the newly recruits starting salary already higher than them compare to the time they started at minimum level. b. Mind-map In this critical question, the five senior representatives feel they are facing underpayment equity, they feel that the salary they earn when working at the starting minimum level are lower than those newly recruits now. The senior representatives feel very upset and dissatisfy because manager explained that the newly hired would not accept the previous entry level rate. The newly representatives have no previous experience, but why still being paid $ 3,000 yearly above the usual staring salary in the pay range. Comparison between the situations faced by two groups of representatives 5. Learning outcomes by Ng Hui Ming After completing this study of paper, we should be able to: a. Identify what is Equity theory and under payment equity. b. Balance or correct the inequity feelings of employees towards co-workers. c. Know what managers can do to overcome/ reduce the perceptions of inequity by employees. 6. Responses to inequality by Ng Hui Ming Equity theory suggests that when individuals perceive inequality between their own outcome/input ratio and that of the comparison referent, they are motivated to respond. Specifically, equity theory outlined six possible responses that individuals may take to restore equity: a) change their inputs, b) adjust their outcomes, c) distorts their inputs and outcomes cognitively, d) leave the situation, e) act on the comparison referent to influence its inputs or outcomes, and f) compare to a different referent. There is little information, either in Adams (1965), or in subsequent work, that predicts when individuals will choose a particular response option. Equity theory comprises four linking suggestions: SUGGESTION I: Individuals try to maximize their outcomes (where outcomes equal rewards minus costs). SUGGESTION IIA: Groups can maximize collective reward by evolving accepted systems for equitably apportioning resources among members. Thus, groups will develop such systems of equity, and will try to persuade members to accept and stick to these systems. SUGGESTION IIB: Groups will generally reward members who treat other equitably, and generally punish (increase the costs for) members who treat others inequitably. SUGGESTION III: When individuals find themselves participating in inequitable relationships, they will become distressed. The more inequitable the relationship, the more suffering individuals will feel. SUGGESTION IV: Individuals who discover they are in an inequitable relationship will attempt to eliminate their distress by restoring equity. The greater the inequity that exists, the more distress they will feel, and the harder they will try to restore equity. 7. Choose alternatives to solve inequality by Loh Sin Yee One behavioural approach for an individual to balance equity is to either increase or decrease their inputs in order to achieve equity. If they feel underrewarded they will decrease their inputs. For example, an employee who feels underpaid at work compared to his coworkers (underreward) might start taking longer breaks in order to read the entire newspaper which decreases productivity (reduced input). By decreasing inputs, the perception of equity is restored. Underpayment Equity Thus, consistent with uncertainty management theory and with the assumption that job insecurity reflects uncertainty about job loss, we would expect that organizational justice related to organizational aspects such as resource distribution, personal treatment and processes could be related to employees outcomes and moderate the relationship between job insecurity and its outcomes. That is, organizational justice could help employees to deal with the uncertainty of job insecurity, justifying the negative outcomes of job insecurity and, therefore, preventing deterioration of job satisfaction. 8. Team reflection by Loh Sin Yee A concern with fairness or justice is critical to the management of numerous organizational issues (e.g., pay distribution, grievance resolution; Greenberg, 1990, cited in Kilbourne, L.M., OLeary-Kelly, A.M. (1994). In fact, in any distribution of outcomes (positive or negative) across individuals, employee perceptions of fairness are important. Because these perceptions of fairness are related to both organizational functioning and employee satisfaction (Greenberg, 1990; Leventhal, 1980, cited in Kilbourne, L.M., OLeary-Kelly, A.M. (1994), organizational scholars and practitioner equally are interested in understanding them. As a result, managers must try to communicate with their employees frequently to understand their feelings or perceptions towards inequity or any dissatisfaction on work. Adams (1965) equity theory proposes that an individual who believes an exchange is inequitable will be motivated to achieve equity or reduce inequity. According to the theory, individuals determine if exchanges are equitable by computing the ratio of perceived personal outcomes (rewards) to perceived inputs (contributions) and comparing this ratio with the perceived outcome/input ratio of some comparison referent that they have chosen. If inequality is perceived, the individual is expected to experience tension and to be motivated to respond either cognitively or behaviorally to restore equity. By the way, an employer can also prevent consequences from perceptions of inequity. For example, Skarlicki and Folger (1997, cited in Redmond 2010) found that employees that are treated with respect are more likely to tolerate unfair pay. Whether the pay or compensation is actually unfair might be irrelevant. To the employee a perception of unfair compensation is the same as actual unfair compensation. So, if an employee has a perception of inequity in their compensation they might be more willing to tolerate their perception of unfair pay if they are treated with respect by their employer. Then they will be less likely to decrease their inputs or engage in counter-productive work behaviours to compensate for a perception of underpayment inequity. So, in addition to establishing fair distribution and procedures in an organization, employers should always treat their employees with respect. This can help maintain or increase motivation and prevent problems that stem from perceptions o f under reward. Employers also need to remember that employees can value different outcomes. For example, younger employees tend to value more pay (Miles, et. al., 1994, cited in Redmond 2010). Even if an employee receives a higher salary than their co-worker they could still develop a perception of inequity if that co-worker has a flexible schedule, and a flexible schedule is more valuable to them than extra salary. To combat this problem, employers can implement two strategies. First, they could continually request feedback from employees to determine what they value and how they would prefer to be compensated. Another strategy used by employers is to offer a choice in benefits. For example, one employee might want to use a health flexible spending account while another employee might prefer to have a dependent care flexible spending account. Employers can offer choices on health or dental insurance as well as other choices among benefits. This type of plan, called a cafeteria sty le, allows employees to select outcomes that they value most. This can help prevent perceptions of inequity because each employee has the outcomes that they value the highest. This helps increase their ratio of inputs to outcomes when compared to their co-workers. Employers can also utilize intangible rewards such as a pat on the back, a luncheon, or even simple praise in front of co-workers. These simple intangible rewards can help balance a measure of inputs and outcomes. 9. Conclusion by Loh Sin Yee After we have studied the problem and revised on the research done by several researchers, we can now understand about Equity theory and underpayment equity. Additionally, the five senior representatives must know how to balance or correct the inequity feelings towards newly hired representatives. They are encouraged to use the behavioural approaches to change the input or outcome of their comparative other. Furthermore, it is important for managers to understand and prevent consequences from perceptions of inequity by employees. Equity theory of motivation, developed in the early 1960s by Adams (1965), recognizes that motivation can be affected through an individuals perception of fair treatment in social exchanges.  When compared to other people, individuals want to be compensated fairly for their contributions. The organization may need to recognize the different interpretations inherent with such group of employees and devise a strategy for effectively managing their different perceptions. 10. References by Ng Hui Ming Redmond, B.F. (2010).   Lesson 5:   Equity theory:   Is what I get for my work fair compared to others? Work Attitudes and Motivation.  The Pennsylvania State University World Campus. Adams, J.S. (1965). Inequality in social exchange. In L. Berkowitz (Ed.), Advances in experimental social psychology (pp.267-299). New York: Academic Press. Williamson, K., Williams, K.J. (2010). Organizational justice, trust and perceptions of fairness in the implementation of agenda for change. Elsevier Ltd on behalf of The College of Radiographers, United Kingdom. Radiography 17 (2011) 61-66. Retrieved February 23, 2011, from www.elsevier.com/locate/radi. Colquitt, J.A., Scott, B.A., Judge, T.A., Shaw, J.C. (2006). Justice and personality: Using integrative theories to derive moderators of justice effects. Journal of Organizational Behavior and Human Decision Processes 100 (2006) 110-127. Retrieved February 23, 2011, from www.elsevier.com/locate/obhdp. Brown, G., Bemmels, B., Barclay, L.J. (2010). The importance of policy in perceptions of organizational justice. Journal of human relations. 63(10) 1587-1609. Retrieved February 23, 2011, from http://hum.sagepub.com/content/63/10/1587. Sora, B., Caballer, A., Peiro, J.M., Silla, I., Gracia, F.J. (2010). Moderating influence of oganizational justice on the relationship between job insecurity and its outcomes: A multilevel analysis. Journal of Economic and Industrial Democracy. 31(4) 613-637. Retrieved February 23, 2011, from http://eid.sagepub.com/content/31/4/613. Karriker, J.H., Williams, M.L. (2009). Organizational Justice and Organizational Citizenship Behavior: A Mediated Multifoci Model. Journal of Management 2009. 35:112. Retrieved February 23, 2011, from http://jom.sagepub.com/content/35/1/112. Roch, S.G., Shanock, L.R. (2009). Organizational Justice in an Exchange Framework: Clarifying Organizational Justice Distinctions. Journal of Management 2006 32: 299. Retrieved February 23, 2011, from http://jom.sagepub.com/content/32/2/299. Kilbourne, L.M., OLeary-Kelly, A.M. (1994). A Reevaluation of Equity Theory: The Influence of Culture. Journal of Management Inquiry 1994 3: 177. Retrieved February 23, 2011, from http://jmi.sagepub.com/content/3/2/177. Paula W. P. (2006). Procedural justice and voice effects. Journal of Organizational Culture, Communications and Conflict. Retrieved 23 Feb, 2011, from http://findarticles.com/p/articles/mi_m1TOT/is_1_10/ai_n25009730/.

Sepsis An Overview Health And Social Care Essay

Sepsis An Overview Health And Social Care Essay Sepsis is an infection of the bloodstream. The infection tends to spread quickly and often is difficult to recognize. One of our roles as a nurse is that of patient advocate, and as such we are closest to the patient, placing us in a key position to identify any subtle changes at their earliest onset and prevent the spread of severe infection. Knowledge of the signs and symptoms of SIRS, sepsis, and septic shock is key to early recognition. Early recognition allows for appropriate treatment to begin sooner, decreasing the likelihood of septic shock and life-threatening organ failure. Once sepsis is diagnosed, early and aggressive treatment can begin, which greatly reduces mortality rates associated with sepsis. sepà ¢Ã¢â€š ¬Ã‚ ¢sis (ˈsep-sÉâ„ ¢s) n. Sometimes called blood poisoning, sepsis is the bodys often deadly response to infection or injury (Merriam-Webster, 2011) Sepsis is a potentially life-threatening condition caused by the immune systems reaction to an infection; it is the leading cause of death in intensive care units (Mayo Clinic Staff, Mayo Clinic 2010). It is defined by the presence of 2 or more SIRS (systemic inflammatory response syndrome) criteria in the setting of a documented or presumed infection (Rivers, McIntyre, Morro, Rivers, 2005 pg 1054). Chemicals that are released into the blood to fight infection trigger widespread inflammation which explains why injury can occur to body tissues far from the original infection. The body may develop the inflammatory response to microbes in the blood, urine, lungs, skin and other tissues. Manifestations of the systemic inflammatory response syndrome (SIRS) include abnormalities in temperature, heart, respiratory rates and leukocyte counts. This is a severe sepsis that arises from a noninfectious cause. The condition may manifest into severe sepsis or septic shock. Severe sepsis is characterized by organ dysfunction, while septic shock results when blood pressure decreases and the patient becomes extremely hypotensive, even with the administration of fluid resuscitation (Lewis, Heitkemper, Dirksen, OBrien and Bucher (2007), pg 1778). The initial presentation of severe sepsis and septic shock is usually nonspecific.    Patients admitted with relatively benign infection can progress in a few hours to a more devastating form of the disease. The transition usually occurs during the first 24 hours of hospitalization (Lewis, et al 2007, pg 1779). Severe sepsis is associated with acute organ dysfunction as inflammation may result in organ damage (Mayo Clinic Staff, Mayo Clinic 2010). As severe sepsis progresses, it begins to affect organ function and eventually can lead to septic shock; a sometimes fatal drop in blood pressure. People who are most at risk of developing sepsis include the very young and the very old, individuals with compromised immune systems, very sick people in the hospital and those who have invasive devices, such as urinary catheters or breathing tubes (Mayo Clinic Staff, Mayo Clinic, 2010). Black people are more likely than are white people to get sepsis and black men face the highest risk (Mayo Clinic Staff, Mayo Clinic 2010). Severe sepsis is diagnosed if at least one of the following signs and symptoms, which indicate organ dysfunction, are noted; areas of mottled skin, significantly decreased urine output, abrupt change in mental status, decrease in platelet count, difficulty breathing and abnormal heart function (Lewis et al, 2007 pg 1779). To be diagnosed with septic shock, a patient must have the signs and symptoms of severe sepsis plus extremely low blood pressure (Mayo Clinic Staff, Mayo Clinic 2010). Sepsis is usually treated in the ICU with antibiotic therapy and intravenous fluids. These patients require preventative measures for deep vein thrombosis, stress ulcer and pressure ulcers. Hunter (2006) explains that the reason why sepsis is rarely given attention and popularized for public information and attention is because it is not a disease in itself, but a reaction of the body to a lowered immunological response. Sepsis is the leading cause of death in non-coronary intensive care units (ICUs) and the 10th leading cause of death in the United States overall (Slade, Tamber and Vincent, 2010, pg 2).   The incidence of severe sepsis in the United States is between 650,000 and 750,000 cases. Over 10 million cases of sepsis have been reported in the United States based on a 22-year period study of discharge data from 750 million hospitalizations Annually, approximately 750,000 people develop sepsis and more than 200,000 cases are fatal (Slade, et al 2010, pg 1). More than 70% of these patients have underlying co-morbidities and more than 60% of these cases occur in those aged 65 years and older (Slade, et al 2010, pg 1). When patients with human immunodeficiency virus are excluded, the incidence of sepsis in men and women is similar. A greater number of sepsis cases are caused by infection with gram-positive organisms than gram-negative organisms, and fungal infections now account for 6% of cases (Slade, et al 2010, pg 1). After adjusting for population size, the annualized incidence of sepsis is increasing by 8%. The incidence of severe sepsis is increasing greatest in older adults and the nonwhite population. The rise in the number of cases is believed to be caused by the increased use of invasive procedures and immunosuppressive drugs, chemotherapy, transplantation, and prosthetic implants and devices, as well as the increasing problem of antimicrobial resistance (Slade, et al 2010, pg 1). Despite advances in critical care management, sepsis has a mortality rate of 30 to 50 percent and is among the primary causes of death in intensive care units ((Brunn and Platt, 2006, 12: 10-6). It is believed that the increasing incidence of severe sepsis is due to the growing population among the elderly as a result of increasing longevity among people with chronic diseases and the high prevalence of sepsis developing among patients with acquired immune deficiency syndrome (Slade, et al 2010, pg 1). During an infection, the bodys defense system is activated to fight the attacking pathogens. These invading pathogens, especially bacteria, possess receptive lipopolysaccharide (LPS) coverings or release exotoxins and endotoxins that activate the T-cells and macrophages and trigger the Toll-like receptors (TLRs) to respond by releasing antibodies, eicosanoids and cytokines such as tumor necrosis factor (TNF) and interleukins. The antigens may also result in the production of lysozymes and proteases, cationic proteins and lactoferrin that can recognize and kill invading pathogens. Different microbes also induce various profiles of TNF and interleukin to be released. These molecules results in a heightened inflammatory response of the body and vascular dilation. The TLRs also affect a different cascade that involves coagulation pathways, which results in preventing the bleeding to occur at the area of infection. With too much molecular responses and signals, the recognition of the molecules sometimes fails and attacks even the bodys endothelial cells. These compounded immune and inflammatory actions result in the development of the symptoms of sepsis (Hunter, 2006 pg 668; Van Amersfoort, 2001 pg 400). Brunn and Platt (2006) believes that events leading to breakdown of the tissue such as injuries or infection, that naturally results in the activation of the immune system, is a major event that causes sepsis. During host infection, the release of tumor necrosis factor and interlekin-1 signals the dilation of the arteries and inflammation. These released cytokines also activate the coagulation pathway to prevent fibrinolysis but an increase in the concentration of these molecules may result in abnormalities in the hosts defense system (Gropper, 2004 pg 568). The common belief that sepsis is caused by endotoxins released by pathogens has fully been established but genomic advancements is shedding light on current insights that sepsis can also occur without endotoxin triggers, that is even without microbial infections (Gropper, 2004 pg 568). Diagnosing sepsis can be difficult because its signs and symptoms can be caused by other disorders. Doctors often order a battery of tests to try to pinpoint the underlying infection. Blood tests and additional laboratory tests on fluids such as urine and cerebrospinal fluid to check for bacteria and infections and wound secretions, if an open wound appears infected. In addition, imaging tests to visualize problems such as x-ray, computerized tomography (ct), ultrasound and magnetic resonance imaging (mri) to locate the source of an infection are also ordered. Early, aggressive recognition boosts a patients chances of surviving sepsis. Sepsis should be treated as a medical emergency. In other words, sepsis should be treated as quickly and efficiently as possible as soon as it has been identified. This means rapid administration of antibiotics and fluids. A 2006 study showed that the risk of death from sepsis increases by 7.6% with every hour that passes before treatment begins. (Mayo Clinic Staff, Mayo Clinic 2010). Early, aggressive treatment boosts the chances of surviving sepsis. People with severe sepsis require close monitoring and treatment in a hospital intensive care unit. Lifesaving measures may be needed to stabilize breathing and heart function. (Mayo Clinic Staff, Mayo Clinic 2010). People with sepsis usually need to be in an intensive care unit (ICU). As soon as sepsis is suspected, broad spectrum intravenous antibiotic therapy is begun. The number of antibiotics may be decreased when blood tests reveal which particular bacteria are causing the infection. The source of the infection should be discovered, if possible. This could mean more testing. Infected intravenous lines or surgical drains should be removed, and any abscesses should be surgically drained. Oxygen, intravenous fluids, and medications that increase blood pressure may be needed. Dialysis may be necessary if there is kidney failure, and a breathing machine (mechanical ventilation) if there is respiratory failure (Mayo Clinic Staff, Mayo Clinic, 2010). While severe sepsis requires treatment in a critical care area, its recognition is often made outside of the Intensive Care Unit (ICU). With nurses being at the side of a patient from admission to discharge, this places them in an ideal position to be first to recognize sepsis. Thorough assessments are crucial and being able to recognize even the most minimal changes in a patient could be the difference between life and death. Once severe sepsis is confirmed, key aspects of nursing care are related to providing comprehensive treatment. Pain relief and sedation are important in promoting patients comfort. Meeting the needs of patients families is also an essential component of care. Research on the needs of patients families during critical illness supports provision of information as an important aspect of family care (Gropper et al, 2004 pg. 569). Teaching patients and their families is also essential to ensure that they understand various treatments and interventions provided in severe sepsis. Ultimately, prevention of sepsis may be the single most important measure for control (Mayo Clinic Staff, Mayo Clinic, 2010). Hand washing remains the most effective way to reduce the incidence of infection, especially the transmission of nosocomial infections in hospitalized patients (Mayo Clinic Staff, Mayo Clinic, 2010. Good hand hygiene can be achieved by using either a waterless, alcohol-based product or antibacterial soap and water with adequate rinsing. Using universal precautions, adhering to infection control practices, and instituting measures to prevent nosocomial infections can also help prevent sepsis (Lewis, et al 2007, pg 248). Nursing measures such as oral care, proper positioning, turning, and care of invasive catheters are important in decreasing the risk for infection in critically ill patients (Fourrier, Cau-Pottier, Boutigny, Roussel-Delvallez, Jourdain, Chopin, 2005 pg 1730). Newly released guidelines on the prevention of catheter-related infections stress the use of surveillance, cutaneous antisepsis during care of catheter sites, and catheter-site dressing regimens to minimize the risk of infection (Fourrier, 2005 pg. 1731). Other aspects of nursing care such as sending specimens for culture because of suspicious drainage or elevations in temperature, monitoring the characteristics of wounds and drainage material, and using astute clinical assessment to recognize patients at risk for sepsis can contribute to the early detection and treatment of infection to minimize the risk for sepsis. Critical care nurses are the healthcare providers most closely involved in the daily care of critically ill patients and so have the opportunity to identify patients at risk for and to look for signs and symptoms of severe sepsis (Kleinpell, Goyette, 2003 pg 120). In addition, critical care nurses are also the ones who continually monitor patients with severe sepsis to assess the effects of treatment and to detect adverse reactions to various therapeutic interventions. Use of an intensivist-led multidisciplinary team is designated as the best-practice model for the intensive care unit, and the value of team-led care has been shown (Kleinpell, et al 2003, pg 121). As key members of intensivist-led multidisciplinary teams, critical care nurses play an important role in the detection, monitoring, and treatment of sepsis and can affect outcomes in patients with severe sepsis (Kleinpell, et al 2003, pg 121). 5 Priority Nursing Diagnosis Diagnosis #1: Deficient fluid volume related to vasodilatation of peripheral vessels leaking of capillaries. Intervention #1: Watch for early signs of hypovolemia, including restlessness, weakness, muscle cramps, headaches, inability to concentrate and postural hypotension. . Rationale #1: Late signs include oliguria, abdominal or chest pain, cyanosis, cold clammy skin, and confusion (Kasper et al, 2005). : Intervention #2: Monitor for the existence of factors causing deficient fluid volume (e.g., vomiting, diarrhea, difficulty maintaining oral intake, fever, uncontrolled type 2 diabetes, diuretic therapy). Rationale #2: Early identification of risk factors and early intervention can decrease the occurrence and severity of complications from deficient fluid volume. The gastrointestinal system is a common site of abnormal fluid loss (Metheny, 2000). Intervention #3: Monitor daily weight for sudden decreases, especially in the presence of decreasing urine output or active fluid loss. Weigh the client on the same scale with the same type of clothing at same time of day, preferably before breakfast. Rationale #3: Body weight changes reflect changes in body fluid volume (Kasper et al, 2005). Weight loss of 2.2 pounds is equal to fluid loss of 1 liter (Linton Maebius, 2003). Diagnosis #2: Imbalanced nutrition less than body requirements related to anorexia generalized weakness. Intervention #1: Monitor for signs of malnutrition, including brittle hair that is easily plucked, bruise, dry skin, pale skin and conjunctiva, muscle wasting, smooth red tongue, cheilosis, flaky paint rash over lower extremities and disorientation (Kasper, 2005). Rationale #1: Untreated malnutrition can result in death (Kasper, 2005). Intervention #2: Recognize that severe protein calorie malnutrition can result in septicemia from impairment of the immune system or organ failure including heart failure, liver failure, respiratory dysfunction, especially in the critically ill client. Rationale #2: Untreated malnutrition can result in death (Kasper, 2005) Intervention #3: Note laboratory test results as available: serum albumin, prealbumin, serum total protein, serum ferritin, transferring, hemoglobin, hematocrit, and electrolytes. Rationale #3: A serum albumin level of less than 3.5 g/100 milliliters is considered and indicator of risk of poor nutritional status (DiMaria-Ghalli Amella, 2005). Prealbumin level was reliable in evaluating the existence of malnutrition (Devoto et al, 2006). Diagnosis #3: Ineffective tissue perfusion related to decreased systemic vascular resistance. Intervention #1: If the client has a period of syncope or other signs of a possible transient ischemic attack, assist the client to a resting position, perform a neurological assessment and report to the physician. Rationale #1: Syncope may be caused by dysrhythmias, hypotension caused by decreased tone or volume, cerebrovascular disease, or anxiety. Unexplained recurrent syncope, especially if associated with structural heart disease, is associated with a high risk of death (Kasper et al, 2005). Intervention#2: If the client experiences dizziness because of postural hypotension when getting up, teach methods to decrease dizziness, such as remaining seated for several minutes before standing, flexing feet upward several time while seated, rising slowly, sitting down immediately if feeling dizzy and trying to have someone present when standing. Rationale #2: Postural hypotension can be detected in up to 30% of elderly clients. These methods can help prevent falls (Tinetti, 2003). Intervention #3: If symptoms of a new cerebrovascular accident occur (e.g., slurred speech, change in vision, hemiparesis, hemiplegia, or dysphasia), notify a physician immediately. Rationale #3: New onset of these neurological symptoms can signify a stroke. If the stroke is caused by a thrombus and the client receives thrombolytic treatment within 3 hours, effects can often be reversed and function improved, although there is an increased risk of intracranial hemorrhage (Wardlaw, et al, 2003) Diagnosis #4: Ineffective thermoregulation related to infectious process, septic shock. Intervention #1: Monitor temperature every 1 to 4 hours or use continuous temperature monitoring as appropriate. Rationale #1: Normal adult temperature is usually identified as 98.6 degrees F (37 degrees C) but in actuality the normal temperature fluctuates throughout the day. In the early morning it may be as low as 96.4 degrees F (35.8 degrees C) and in the late afternoon or evening as high as 99.1 degrees F (37.3 degrees C). (Bickely Szilagyj, 2007). Disease injury and pharmacological agents may impair regulation of body temperature (Kasper et al, 2005). Intervention #2: Measure the temperature orally or rectally. Avoid using the axillary or tympanic site. Rationale #2: Oral temperature measurement provides a more accurate temperature than tympanic measurement (Fisk Arcona, 2001; Giuliano et al, 2000). Axillary temperatures are often inaccurate. The oral temperature is usually accurate even in an intubated clients (Fallis, 2000). The SolaTherm and DataTherm devices correlated strongly with core body temperatures obtained from a pulmonary artery catheter (Smith, 2004). A study performed in Turkey found that axillary and tympanic temperatures were less accurate than oral temperatures (Devrim, 2007). Intervention #3: Take vital signs every 1 to 4 hours, noting changes associated with hypothermia; first, increased blood pressure, pulse and respirations; then decreased values as hypothermia progresses. Rationale #3: Mild hypothermia activates the sympathetic nervous system, which can increase the levels of vital signs; as hypothermia progresses, the heart becomes suppress, with decreased cardiac output and lowering of vital sign readings (Ruffolo, 2002; Kaper et al, 2005). Diagnosis #5: Risk for impaired skin integrity related to desquamation caused by disseminated intravascular coagulation. Intervention #1: Monitor skin condition at least once a day for color or texture changes, dermatological conditions, or lesions. Determine whether the client is experiencing loss of sensation or pain. Rationale #1: Systemic inspection can identify impending problems early (Ayello Braden, 2002; Krasner, Rodeheaver Sibbald, 2001). Intervention #2: Identify clients at risk for impaired skin integrity as a result of immobility, chronological age, malnutrition, incontinence, compromised perfusion, immunocompromised status or chronic medical conditions such as diabetes mellitus, spinal cord injury or renal failure. Rationale #2: These client populations are known to be at high risk for impaired skin integrity (Maklebust Sieggreen, 2001: Stotts Wipke-Tevis, 2001). Targeting variables (such as age and Braden Scale Risk Category) can focus assessment on particular risk factors (e.g., pressure) and help guide the plan of prevention and care (Young et al, 2002). Intervention #3: Monitor the clients skin care practices, noting type of soap or other cleansing agents used, temperature of water and frequency of skin cleansing. Rationale #3: Individualize plan according to the clients skin condition, needs, and preference (Baranoski, 2000). As a nursing student with a strong interest in working with trauma patients, I am intrigued by the fact that as to why some trauma patients are more susceptible to contracting sepsis than others. Therefore my suggestion for future research would be to determine if there is an underlying factor that we, as healthcare professionals are overlooking. Apparently, I am not alone in my thinking and in performing additional reading on sepsis I was pleasantly surprised to learn that an investigation into this matter is underway. Hinley (2010), a staff writer for Medical News Today, reports how an emergency room nurses curiosity about why some trauma patients develop sepsis while others dont has led to an expanded career as a researcher studying the same, burning question. Dr. Beth NeSmith, assistant professor of physiological and technological nursing in the Medical College of Georgia School of Nursing received a three-year, $281,000 National Institutes of Health grant in September, 2010 to examine risk factors for sepsis and organ failure following trauma. Based on her own research, Dr. NeSmith concluded that trauma kills more than 13 million Americans annually and sepsis is the leading cause of in-hospital trauma deaths, yet little data existed to explain differences in population vulnerability to these deadly outcomes. NeSmith believes lifetime chronic stress may be the culprit and a simple test on hair may identify those at risk. Her theory is that a person who grows up with chronic stress, such as socio- economic stress or abuse, will have a different response to trauma in terms of their inflammation profile, NeSmith said. Inflammation is a normal body response to trauma, but if it gets out of hand its dangerous. The only care for it is supportive until if the body gets better. (Hinley, P., Medical News Today, 2010) As the trauma clinical nurse specialist at MCG Health System from 1997-2003, NeSmith was intrigued by the limited treatment options available for sepsis. Her grant will allow her to test the theory that people with existing chronic stress respond differently physiologically to trauma than non-stressed individuals. NeSmith spends three days a week in the lab working with basic science research techniques. Nurses play a critical role in improving outcomes for patients with sepsis. To save the lives of those with sepsis, all nurses, no matter where they work, must develop their skills for recognizing sepsis early and initiating appropriate therapy. With nurses dedicated to understanding and stopping this deadly disorder, the goal of reducing mortality will be realized.  Ã‚