Thursday, October 31, 2019

The Buffalo Soldiers in World War II Essay Example | Topics and Well Written Essays - 500 words

The Buffalo Soldiers in World War II - Essay Example As expected, they were discriminated during their service in the army. Many officers did not wanted to command them including George Armstrong Custer. Their role eventually dwindled due to discrimination as their participation in World War I was limited. The idea of the Buffalo soldiers in 1866 was carried on to the Second World War when the 92nd Infantry Division which were composed of African American soldiers under the command of Maj. Gen. Edward M. Almond. They adapted the insignia of the Buffalo soldiers and were hence nicknamed the â€Å"Buffalo Soldiers Division†. This division fought in Europe in the Second World War particularly in Italy from 1944 until the war ended. Unlike in World War I where their role was diminished, the Buffalo soldier fought at the front line in the European Campaign with the tankers of the U.S. 1st Armored division and fought until the war ended. African American 92nd Infantry Division Fought in Italy During World War II. (n.d.). Retrieved February 25, 2015, from

Monday, October 28, 2019

Marketing and Converse Question Essay Example for Free

Marketing and Converse Question Essay Need: Protection for the feet Wants: Cheap shoes which are comfortable and customizable. Demands: Emerging artists, designers and musicians wearing Chucks because of their affordability, simplicity and classic look. Now, anti-establishment rock fans beg Converse to feature a shoe by their favourite artist. Question 3 Production concept: The idea that consumers will favour the products those are available and highly affordable, and the idea that the company focus on improving production and distribution efficiency. Product Concept: Costumers will favour the products that offer the most quality, performance and features. Therefore the company should focus on making constant product improvements Selling Concept: The idea that consumers will not buy enough of the products unless it undertakes a large-scale selling and promotion effort. Marketing concept: The marketing philosophy that holds that achieving organizational goals depends on knowing the needs and wants of target markets and delivering that desired satisfaction better than competitors does. Almost every red Chuck converse sold goes to Global Fund. Question 4 Converse sees its role as one of making great products that its costumers want to wear. Beyond that it participates in consumers discussions rather that dictating them. Drawbacks: Converse rides a fine line: How many limited editions and upscale design can the brand produce without losing its image as a non marketing marketer. How popular can the brand become without losing the core costumers who love the precisely because it isn’t popular Question 5 Converse has been very careful in all that it does to remember on very important things for a brand like Converse, where authenticity is the most important trait, the costumer experience should be driven by the costumer.

Saturday, October 26, 2019

America Needs More Government Programs to Pull Children Out of Poverty

The face of poverty is changing in the United States. When someone mentions that a person is living in poverty, we are inclined to think of a bum living on the street, eating at shelters, and using whatever money they have for alcohol, drugs and tobacco. Usually we visualize this person as being a middle-aged male with drab clothing and a long beard. This description may have fit the average person living in poverty or on the street a few years ago, but it is no longer a correct generalization. Children are the face of poverty in 2015. These children have little chance to rise up out of the lifestyle they are born into. Many of these children are born to teenage girls. The economic states of these mothers and their lifestyles many times put these children in a place of poverty at birth with little hope. The children as well as their parents are in need of assistance in order to stop the growing problem of child homelessness and poverty. There ar e many different opinions and ideas on how to deal with this problem and help these unfortunate children and their families. Unfortunately many of these programs are unsuccessful and do little to help while others are successful in combating the problem and really helping the children in need. First, I will describe the programs that have been ineffective and we must avoid. The first of these would be ignoring the problem and hoping it goes away. The problem is not going to go away. In fact, the numbers of poverty-stricken children are increasing rapidly. If we do not do anything to help these children, we could miss out on great scientists, future doctors, and many other contributions to society that these children are capable of making. Also, we have to remember that these children di... ...times it seems unfair that we are paying to support other people. It is expensive to try and care for all the poverty-stricken children, but it is something that is well worth the effort. We have to take the time to find out what works and w hat does not. After all, it is the future-our children- that we are trying to save. Works Cited Wood, David. "Effect of Child and Family Poverty on Child Health in the United States." Effect of Child and Family Poverty on Child Health in the United States. N.p., 14 Mar. 2013. Web. 25 Mar. 2014. Sources Consulted "11 Causes of Teen Homelessness." Do Something. N.p., n.d. Web. 24 Mar. 2014. "11 Facts About Homeless Teens." Do Something. N.p., n.d. Web. 24 Mar. 2014. Main, Thomas. "How to Think About Homelessness: Balancing Structural and Individual Causes." Springer Link. N.p., Jan. 1998. Web. 20 Mar. 2014.

Thursday, October 24, 2019

European Society During The Time of The Communist Manifesto :: History Historical Essays Communism

European Society During The Time of The Communist Manifesto At the time the Communist Manifesto was written, European life had become far more urbanized than the previous years. During this period, society in Europe was undergoing great change. This great change arose from many influential factors. Among these factors, modern education, social structure of the bourgeoisie and laborers, and Marxism had immense effects on the everyday life of European citizens. During the 1800’s, an integral step towards building a more modern society in Europe was the change in education. Formal learning and obligatory attendance began to take place in schools. The demand for children to attend school kept them out of the work place that they had inhabited for so many years. Another important aspect of schooling was the enforcement of teaching both sexes. The education of boys had been increasing for years, but at this point girls now had the opportunity to learn. As this change in education became more popular, literacy increased among young students. The ability to read and write became commonplace. The change in the way education was formatted increased the number of students willing to learn. The increase in the number of students caused even more change in the structure of education in Europe. Older schools were forced to offer new curriculum to keep up with the times. New schools had to keep bringing in new classes for students to choose from. It became hard for old universities to adapt to this societal change. As the schools began to change, they eventually became more expensive and necessary. Those who attended or worked for a university became more respected and honored in society. Professors were among those of the elite class and were thought of as extremely well educated. Their place in society was far ahead of that of pre-university teachers. They had a high salary, educational assistants, and good vacation time. Before this change in education, some teachers were not much farther ahead of their students and did not have the allowances of the professors in the late 19th century. The educational system change in Europe in the 19th century greatly improved the life of children. There were more agencies to help families and widows with children. The middle class became more considerate of their children and these children began to populate a large portion of the world.

Wednesday, October 23, 2019

Ciscos Organizational Change

Cisco Background Cisco is an IT enterprise that was founded in 1984 by Leonard Bosack and Sandy Lerner. Bosack and Lerner eventually got married and were the first to develop a multi- protocol router. McJunkin and Reynders (2000) describes the multi-protocol router as â€Å"a specialized microcomputer that sat between two or more networks and allowed them to talk to each other by deciphering, translating, and funneling data between them† (Mcjunkin & Reynders, 2000). The organization was responsible for opening and linking all the computer networks around the world together.This linking of all the computer networks was much like the way telephone networks are linked around the world. The local-area network (LAN) was the first market Cisco competed in and offered quality routers which became the â€Å"traffic cops of cyberspace† (Mcjunkin & Reynders, 2000). Cisco eventually became the leaders in this market with their data networking equipment and by 1997, McJunkin and Re ynders (2000) states â€Å"80% of the large scale routers that powered the Internet were made by Cisco† (Mcjunkin & Reynders, 2000).As the global Internet grew Cisco began to expand its product line, which included a wide range of networking solutions. Website management tools, dial-up and other remote access solutions, Internet appliances, and network management software were all apart of this expansion. In 1990 Cisco market value was an astonishing $222 million and the organization continued to grow into a multinational corporation with over 10,000 employees. Cisco revenues had more than tripled by 1997 and â€Å"revenues had increased over ninety-fold since the IPO, from $69. 8 million in fiscal 1990 to $6. billion in fiscal 1997† (Mcjunkin & Reynders, 2000). Organizational Problem Cisco is now a large IT enterprise with over 300 locations in 90 countries with a framework that makes its operation more efficient and responsive. The structure of Cisco is comprised of â€Å"46 data centers and server rooms supporting 65,00-plus employees† (â€Å"How Cisco IT†, 2009). The traditional structure of Cisco is one that has staffers doing both implementation and operational work. The traditional structure of Cisco was one that caused staffers to drop operational projects to complete deployment.According to Cisco â€Å"with the traditional organizational arrangement, there was much duplication of effort and lack of focus across the organization† (â€Å"How Cisco IT†, 2009). Cisco’s original organizational model (see exhibit 1) was comprised of regional network teams and regional voice teams. These teams were accountable for all aspects of operating and implementing services and their environment. A change in the organization was needed in order for Cisco to attain the levels of efficiency, additional scalability and agility the IT enterprise needed.The main challenge Cisco faced during this change process was the need f or the IT Network and Data Center Service (NDCS) to become more organizationally focused. Within Cisco there is an advanced service called Network Availability Improvement Services (NAIS), which identifies areas within the organization that need change. In order to do this NAIS â€Å"assesses and remediates the people, process, and tools needed to mitigate operational risk and network complexity by running an Operational Risk Management Analysis (ORMA)† (â€Å"How Cisco IT†, 2009).For the issue lack of focus, NAIS began by â€Å"interviewing business and IT leaders and senior engineers, and then gathers technical, process, tools and organizational documents and templates†. An assessment is then developed by NAIS, which outlined an achievable vision and a detailed road map for NDCS to follow (â€Å"How Cisco IT†, 2009). Organizational Change After the ORMA report vice president of NDCS John Manville had to restructure the NDCS department to â€Å"map to i ts own lifecycle business model† in order to solve the problems the department was facing (â€Å"How Cisco IT†, 2009).The new business lifecycle model the NDCS department had to map to was comprised of six phases; Prepare, Plan, Design, Implement, Operate, and Optimize. Manville’s approach to restructuring the NDCS group to improve efficiency and focus was an Action Research Approach. McShane and Steen (2009) define action research as â€Å"a problem-focused change process that combines action oriented and research orientation† (McShane & Steen, 2009). Manville formed a client-consultant relationship with the NAIS department within Cisco, which then determined the readiness for change in NDCS.NAIS then diagnosed the need for change after the department gathered and analyzed sufficient data to show the lack of focus and duplication of effort within NDCS. The NAIS department â€Å"begins the process by interviewing business and IT leaders and senior enginee rs, and then gathers technical, process, tools and organizational documents and templates† (â€Å"How Cisco IT†, 2009). The introduction of the restructuring intervention is an action that was needed to correct the problem NDCS was facing and to build a better organizational structure. Manville introduced this intervention to the department by testing the lifecycle methodology within it.This intervention involved â€Å"moving some resources from the former engineering and operations teams to the new implementations team† (â€Å"How Cisco IT†, 2009). This change was key to the operations team gaining more focus on task and not being distracted by deployments. The implementation of this change was over two years, which means that Manville’s restructuring was incremental. McShane and Steen (2009) define incremental change as when an â€Å"organization fine-tunes the system and takes small steps toward a desired state† (McShane & Steen, 2009).The change to the NDCS department was stabilized and results shows that the change was effective. The maturity of the department improved significantly from 2006 to 2008 (see exhibit 3). The results also showed that before this change was introduced in NDCS there were â€Å"150 client-impacting incidents per quarter† and a â€Å"defective root cause percentage consistently above 40 percent† (â€Å"How Cisco IT†, 2009). After this change was introduced, focus on operation excellence improved with client-impacting incidents reducing to 70 per quarter and defective root cause percentage is consistently below 10 percent (â€Å"How Cisco IT†, 2009).Not only did the maturity of the department improve through this change process but also customer satisfaction (see exhibit 4). Cisco (2009) explains, â€Å"NDCS has achieved customer satisfaction scores of 4. 856, with 5 being the best possible score† (â€Å"How Cisco IT†, 2009). Conclusion Cisco was abl e to improve efficiency, focus and results delivered each quarter by the NDCS department through organizational restructuring and change. Shawn Shafai, an IT manager of Network Services at Cisco stated, â€Å"The new organizational structure gave us the opportunity to focus on our core operational work.Our critical metrics quickly displayed the positive results from these changes, and outstanding results started consistently being delivered quarter after quarter† (â€Å"How Cisco IT†, 2009). The unfreezing of the organizational structure by Manville was essential to implement change in NDCS. After the results from restructuring NDCS were effective NAIS and Manville decided to refreeze the changes in order to reinforce and maintain the desired behaviors. Exhibit 1 Cisco’s original Organizational Model Exhibit 2 NDCS Lifecycle Model Exhibit 3 Cisco’s improvement from 2006 to 2008Exhibit 4 NDCS Customer Satisfaction References McShane, S. L. , Steen, S. L, ( 2009). Canadian Organizational Behaviour 7th Edition. McGraw-Hill Ryerson. McJunkin J. , and Reynders, T. (2000). Cisco Systems: A Novel Approach To Structuring Entrepreneurial Ventures. Retrieved from gsbapps. stanford. edu/cases/documents/EC%2015. pdf (2009). How Cisco IT implemented Organizational Change and Advanced Sevices for Operational Success. Retrieved from http://www. cisco. com/web/about/ciscoitatwork/downloads/ciscoitatwork/pdf/NDCS_Restructuring_AdvSvcs_Case_study. pdf

Tuesday, October 22, 2019

An Economic Analysis of Argentina and Its Future essays

An Economic Analysis of Argentina and Its Future essays Officially known as the Argentine Republic, Argentina occupies the majority of the southern portion of South America. Argentines have tended to disagree about why it has been so hard for them to prosper economically or collaborate politically. Over the years, they have claimed that it was due to their unfortunate victimization, insisting that they were exploited by foreigners who were always economically more powerful than themselves. The people who ran the world economy, they said, controlled the nation's governments. While this interpretation of the nation's economic condition today is appealing because of it is simple and appears plausible, it relies too much on a single cause to account for the way Argentines practice politics. Furthermore, this explanation ignores the fact that countries facing similar economic problems do not always share Argentina's types of political problems. Today, Argentina's recovery from such disappointments and its prospects for future development are based on the potential manifested in its excellent resources and its well-educated populace (Eidt Argentina, an examination of some of the factors underlying Argentina current financial and economic crisis, a recommended recovery strategy, followed by a summary of the research in the conclusion. People/Population. The population of Argentina has experienced enormous growth over the last century and a half, where it has witnessed a 20-fold increase since 1869, when 1.8 million people were recorded there by the first census (Eidt continued through the early part of the 20th century, but declined thereafter as both the birth rate and immigration also began to decline. The percentage of young people also declined during this period. Today, Argentina's birthrates and populati...

Monday, October 21, 2019

I Dont Play Golf (An Inspector Calls) Essays

I Dont Play Golf (An Inspector Calls) Essays I Dont Play Golf (An Inspector Calls) Paper I Dont Play Golf (An Inspector Calls) Paper Inspector Goole knocks on the door just when Arthur Birling is making a speech to the rest of the family about how a man has to make his own way so long as he does that he wont come to much harm. He also dismissively mentions that by the way some of these cranks talk and write now, youd think everybody has to look after everybody else. I feel that the reason the Inspector calls at that specific time is to ultimately prove Birling wrong, and try to show him that we are responsible for each other in this world, and how you cannot escape the fact that what goes around, comes around. Birling is quite outraged at the fact that the Inspector has rudely  interrupted their dinner party, and he constantly attempts to tackle  the Inspector with petty little comments: I ought to warn you that  [Colonel Roberts] is an old friend of mine, and that I see him fairly  frequently. We play golf together. Birling continually tries to  intimidate him by mentioning his apparent authority, and patronises  the Inspector look here, Inspector. I consider this uncalled-for  and officious. Ive half a mind to report you. Pompous personality shines through, but the Inspector seems to take it in his stride and merely brushes off the comments that Birling throws at him: I dont play golf. I feel that Priestley decided to portray Arthur Birling as taking the Inspectors arrival quite badly to demonstrate just how shallow and thick-skinned society can be, and how we cannot easily accept our mistakes. The Inspector is the one in the play who brings us back down to Earth and makes us realise that. As well as being the messenger, Inspector Goole is also the strongest character in the play, maintaining complete control of the situation at hand and demonstrating his authority frequently. Its not just his dialect that depicts this, but also his overall persona, which is shown through the stage directions he creates at once an impression of massiveness, solidity and purposefulness, and it comes across to the audience and reader in an array of different ways. For example, the stage directions repeatedly show the Inspector cutting through massively, cutting in massively, massively taking charge, with authority and taking charge, masterfully. This demonstrates to both the audience and reader that the Inspector has the authority to interrupt people without reason, and take charge of the conversation. He dominates the other characters, even Mr and Mrs Birling, who are used to commanding and others obeying: (As Birling tries to protest, turns on him) Dont stammer and yammer at me again, man. Im losing all patience with you people. After this outburst, Mrs Birling is rather cowed. Aside from his rather terrifying outbursts, the Inspector remains calm and collected throughout the play, though he sometimes speaks coolly and imperturbably. The language he uses is often blunt and sometimes deliberately harsh so as to gain a reaction from the Birlings, reader and audience: Two hours ago a young woman died in the Infirmary. Shed been taken there this afternoon because shed swallowed a lot of disinfectant. Burnt her inside out, of course. This kind of emotive  language is sure to trigger signs of emotion in the Birlings, and once  again illustrates the effect the Inspector is having on the family   once the initial shock has seeped in, the Birlings are too stunned to  deny anything about their involvement with Eva Smith/Daisy Renton, although they did frequently dismiss any knowledge they had about the girl as just coincidence.  However, I felt the Inspector overcame these problems with ease.  The Birlings, especially Mrs Birling, refuse to accept responsibility  for Evas death Im sorry she should have come to such a horrible  end. But I accept no blame for it at all. Realising that she will not  remove herself from this train of thought, the Inspector cleverly  turns the tables on Mrs Birling, luring her into a trap that will  consequently land her son into one of his own: Secondly, I blame the young man who was the father of the child she was going to have.  This, of course, is Eric Birling. Unaware of this, Mrs Birling insists  that the Inspector deals with him very severely, and is glad to  hear it when he grimly agrees with her. When it comes to light that  it is in fact her son who is to blame, Mrs Birling is stunned and  the Inspector has slyly incorporated her into the grisly tale, too. Despite her mothers ignorance, Sheila Birling is perhaps the most  sympathetic of the family. A perceptive character, she is the first to  realise that the Inspector is no ordinary policeman, and that he has  an almost supernatural knowledge: Why you fool he knows. Of  course he knows. And I hate to think how much he knows that we dont know yet. Similarly, she is the first to realise that the father of Evas baby is none other than Eric, and tries to get her mother to  stop insisting that he should be held responsible: (With sudden alarm) Mother stop stop! At the beginning of the play, Sheila is perceived as a character who  is quite contented with her life, and has no reason to worry. However, when the Inspector arrives, her opinions start to change. Sheila regards the Inspector differently from the others she stares at [Inspector Goole] wonderingly and dubiously. She begs her mother not to patronise him You mustnt try to build up a kind of wall between us and that girl as she knows that the Inspector will break it down. She warns her mother He hasnt started on you yet, realising that they are all going to be treated in the same way. Her mood becomes slightly hysterical, also; No, hes giving us the rope so that well hang ourselves. When Arthur Birling remarks that Inspector did not come to talk to me about my responsibilities, Sheila responds, Lets hope not. Though Im beginning to wonder. She seems to be the only one in the family to perceive that the Inspector is not just a police inspector, but a spiritual being or emissary with a  moral mission to punish selfish behaviour among the rich and shallow -in this case, the Birlings. The Inspectors dialogue also leaves quite an impression on the  family, audience and reader especially his final speech. This is the  most important remark the Inspector makes in the entire play, as it  sticks in the minds of everybody, and ultimately sums up his role in  the production.  Priestley has used a lot of emotive language in this specific passage,  such as hopes, fears, suffering, happiness, blood and  anguish. In turn, this causes the Inspectors speech to be quite  blunt, as the sentences that these words are woven into are short,  abrupt and straight to the point mirroring the Inspectors duration  at the Birlings residence. As well as this, the Inspectors speech  makes good use of the word we, uniting the Birlings with the people that they feel they are superior to poor people. By the way that the Inspector declares we are members of one body. We are responsible for each other, he makes clever use of the word are, which in turn finalises the idea that we are members of one body, and we are responsible for one another. It is also contradictory to a section of one of Arthur Birlings speeches: By the way some of these cranks talk and write now, youd think everybody has to look after everybody else which is the complete opposite to what the Inspector is announcing. The passage also anticipates World War One, in the sense that at the very end, the Inspector says if men will not learn that lesson, they will be taught it in fire and blood and anguish this, to the Birlings, is a prophetic statement, but the reader and audience are aware of it as it has already come to pass. To emphasise that idea,  the Inspector lengthens the list of words he mentions; instead of just using a comma between fire and blood, he chooses to use and, which sensationalises the comment and makes it sound somewhat more important than if he had just normally listed those specific words.

Sunday, October 20, 2019

The Human Genome Project

The Human Genome Project (HGP) is an international 13 year effort that began in October of 1990. The main objective of the project is to map the entire human DNA sequence. The project was planned to last 15 years, but rapid technological advances have moved the completion date to 2003. A rough draft of the human genome was completed in June 2000. Efforts are still underway to complete the finished high quality sequence. Many laboratories around the United States receive funding from either the Department of Energy (DOE) or the National Institutes of Health, or from both, for the HGP. Other researchers at colleges, universities, and laboratories throughout the United States also receive funding for the project. At any given time, the DOE Human Genome Project funds about 200 separate investigators. At least 18 countries have established human genome research programs. Some of the larger programs are in Australia, France, Sweden, China and the United Kingdom. Some developing countries are participating through studies of molecular biology techniques for genome research and studies of organisms that are particularly interesting to their geographic regions. The Human Genome Project Organization helps to coordinate international efforts in the genome project. There are many benefits and goals of the Human Genome Project. Rapid progress in genome science and a glimpse into its potential applications have helped observers to predict that biology will be the the most important science of the 21 century. Aside from its medical and scientific benefits, the development of genomics research presents U.S. industry with many opportunities. The Consulting Resources Corporation Newsletter (Spring 1999) said that the sale of DNA based products and technologies in the biotechnology industry are rejected to exceed $45 billion by 2009. One of the goals of the project is improved knowledge in the area of molecular medicine. Increasin

Saturday, October 19, 2019

Discuss the potential for small-scale, local or community-based Essay

Discuss the potential for small-scale, local or community-based initiatives to contribute to sustainable approaches to agricultu - Essay Example In the modern times, agriculture is practiced either under a demand-based agriculture model or resource-based agriculture model. Demand-based agriculture is operated keeping in mind market demand of agricultural goods by consumers and industries. Resource-based agriculture is driven on the logic of producing goods from the earth in a way that it does not harm ecosystem in the process. Thus special care is taken to use only those tools (seeds, fertilizers, etc.) that are not harmful for the ecosystem in the long-run (Sustainable Agriculture, n.d.; Sustainable Communities in Theory and Practice, n.d.). Green revolution beginning in the 1960s has added huge farm productivity, but to the detriment of the goal of sustenance. In Canada, output has increased by 175% since 1941. According to a report ‘Agriculture at a Crossroads’ by IAASTD (International Assessment of Agricultural Knowledge, Science, and Technology for Development), there has been less attention to some of the u nintended social and environmental consequences while achieving significant ability to increase agricultural productivity. In Canada, less than 10% of the country has the capacity to sustain agricultural food production.

Friday, October 18, 2019

How would you use the knowledge of incentives to manage a business Essay

How would you use the knowledge of incentives to manage a business - Essay Example To be effective for business, incentives should clearly link performance to pay and should directly link performance to specific standards and objectives. If a teams objective is customer satisfaction, that should be the measure of performance, rather than volume or duration of service calls, which may bear little relation to whether the customers needs were actually met (Laffont and Marthmort 45). Incentives (rewards and punishments) should relate directly to the nature of performance required at each level of the organization. For example, in order to develop a true team perspective among top executives, the bonus plan for each member of the senior team is based largely on the entire companys success in meeting certain specific financial goals, such as stock price (Campbell 61). In other situations -fund managers in an investment firm, for example -- its more appropriate to base rewards on each persons individual performance. Incentive plans should match measurement periods for rew ards to relevant performance periods; some goals can be assessed after three months, while it might not be practical to evaluate others in less than a year. Some incentive programs recognize that fact by containing both short- and long-term goals. Because performance Incentives can provide bonuses equaling up to 13 percent of a workers base pay, teams are sharply attuned not only to the performance of their own members but to other teams as well. Between each shift there is a brief "hand-off" meeting between the team thats leaving and the one thats coming on (Laffont and Marthmort 51). Some organizations may want to grant direct incentives for worker avoidance of nonwork, anti-work, and semi-work. Tying incentives directly to usage of time is not reward for performance. But in certain cases, particularly where effort distribution issues are involved,

Photovoltaic cells Research Paper Example | Topics and Well Written Essays - 1500 words

Photovoltaic cells - Research Paper Example PV cells energy conversion efficiency has now crossed mark of 20 percent. Several companies, universities and research institutions are doing intense research and development work to reduce the cost further so that its economics fare favorably to other competing energy systems. There has been considerable headway in the research and it is quite likely that it will become one of the most prominent technologies among all renewable sources of energy in next 10 years. Being eco friendly, it has the capacity to meet the current and future energy needs of mankind. Introduction Photovoltaic Cell is a technique to generate direct current through solar radiation using semiconductors. The PV cell technology is useful to produce electricity particularly, at the location where grid system is not available. This paper will study the technology, types of photovoltaic cells, current status, its economics, engineering issues, technological advances, future scope and the direction that the industry m ake take. Off-the-Grid Systems Off-the-grid system is useful when electricity demand cannot be met through grid due to its isolated locations. The benefit of the off-the-grid system is that it is self reliant, not dependent on any outside source, using some renewable source of energy such as solar. ... Solar radiation falls on PV cell to energize the electron producing DC current. Inverter converts DC current to AC. Energy is stored in array of batteries. The efficiency of photovoltaic cells is a key parameter to convert solar energy into usable energy. Van Geet home is a typical off-grid system for generating energy based on solar power. It is a remote location near Denver in Colorado. Several renewable-energy features along with energy-conservation measures have been incorporated in this home. The design of this home is studied as an ideal research home. It has photovoltaic based solar power system. The house is said to have achieved 89% energy savings. The system uses 1000-watt amorphous silicon PV with a tracking controller. It surpasses the norms of 70% HVAC and energy savings for Building America research homes. It has been now recognized as a model home and taken for further study and research as energy saving designs in US. (Barley et al 2004) Below mentioned diagram shows a typical off-grid energy system. Source: http://homepower.com/basics/solar/#MainDCDisconnect Mobile homes also use similar PV based energy system to meet their energy needs. Major components in such systems are PV Cells, Charge controller, Battery Bank, and inverter. PV Cells Working of Photovoltaics Solar energy is converted to electricity through photovoltaics. The technology exploits the photoelectric property of certain material that absorbs photons of light to release the electrons. These free electrons cause electric current to flow that can be used for our needs (Knier 2002). PV Cell is a chief component and the heart of such energy systems. More than 50 percent of the cost of the energy system is attributed to PV module. For this reason, the

Thursday, October 17, 2019

Performance Management Coursework Example | Topics and Well Written Essays - 4000 words

Performance Management - Coursework Example Various situations have been considered while making the research and a suggestive appraisal form has been framed for implementing in the company. The paper has distinctively two parts. The first part deals with a theoretical review of performance appraisal and the second part deals with alignment of the theories with the practical implications and its effects. The design of the suggested performance appraisal form has been explained in brief. Table of Contents Executive Summary 2 Part 1 – Critical Academic Discussion 6 Performance Management System – A Theoretical Overview 6 360 Degree Appraisal Method 8 The Way 360 Degree Appraisal Differs from the Other Appraisal Systems 9 Advantages of 360 Degree Appraisal 10 Disadvantages of 360 Degree Appraisal Method 11 A Successful 360 Degree Appraisal 12 Part 2 – Client Report 13 About the Company 13 Importance of Performance Management in Healthcare Industry 14 Prerequisites of Performance Management System in Healthcar e Sector 15 Performance Management for Bromley Healthcare 16 Conclusion 21 Self–Learning Analysis 22 References 23 Bibliography 26 Appendix 27 Introduction Performance is completion of assigned task that is measured against the set standards of perfection and cost. A good performance is the one that meets the set standards and caters to a cost effective completion of the task. In context of an organisation, where an employer – employee relationship exists, the performances of the employees are constantly monitored to ensure a timely completion of the tasks which can result in overall success related to the business unit (Pulakos, 2004). Performance management typically relates to the development of human resource of an organisation by appraisal of their performance. The performance management system can be termed as â€Å"Achilles’ heel† of the whole human resource system. The employees employed in an organization need to be enlightened about the objectiv es of the enterprise and an alignment to these objectives on the part of the employees would lead to achievement of the overall success of the company. Implementation of performance management system helps to measure the achievement of organizational strategy (Pulakos, 2004). Elaborately, a performance management system may be defined as a continuous process identifying the performances of the employees, measuring these performances using various methods and tools, developing the downsides of individual performance and finally aligning the same with the organization’s strategic goals (Health Service Executive, n.d.). Performance appraisal is the activity catering to the formation of performance management system as a whole. There are various performance appraisal systems available globally to measure the performance of any individual. A performance management system considers the various strategic planning initiatives of the organization, it follows an ongoing feedback proces s in order to facilitate the employees develop their performance and the whole process is driven by the line managers of the company (Health Service Executive, n.d.). Among the various methods available for appraising the performance of individuals, this paper intends to shed some light on the 360 degree performance appraisal method and its implications within an organization named Bromley Healthcare on practical basis. Part–2 of this paper deals with the implementation of the 360 degree appraisal method, for all

The U.S. Military Fighting Forces in World War II (European vs Research Paper

The U.S. Military Fighting Forces in World War II (European vs. Pacific Theaters) - Research Paper Example However, some of the technological differences made the United States more superior than most of their enemies. Furthermore, despite the disunity in the American military forces, the military of such countries as Japan, which was the strongest force in the eastern bloc, also exhibited such severe disunity thus contributing to the American victory. 1) Geographic and Environmental Conditions (i.e., effecting the style of warfare) Climatic condition played important role in earning America the victory in the war, with an effective knowledge of the pacific climate in summer, the American forces prepared adequately with appropriate attire and carried drugs and mosquito nets to cushion the soldiers from the adverse weather in the continental region. The warm and humid climatic condition of the pacific in summer presented several challenges to the Japanese who did not have adequate information of the climatic condition in the pacific region. The humid condition hastened the pace of metallic . The Japanese did not prepare for such radical ramifications and therefore lost most of their artillery as they rusted fast thus proved inefficient. Additionally, more Japanese soldiers died of rom such tropical diseases as malaria, which they had not prepared effectively for. The warm and humid climate in the region required light attire a feature that the American forces had learnt of thus leaving their Japanese counterparts ill dressed for the combat thus the ensuing inconveniences in the battlefields. The jungle environment in the pacific required specific tactic of warfare, the American formed small patrols hat would maneuver through the jungle more efficiently often relying on the efficient backup owing to the efficient communication among the small troops. Additionally, the American soldiers relied on the marines after they learnt that the terrain would not permit large military formations. American and Japanese soldiers would therefore run into each other unannounced in the ir daily patrols thus resulting in open warfare. The military combat with the infantry and artillery type of fighting this implied that fighting was at close range requiring the use of effective weaponry. 2) Type of Enemy (i.e., German's vs. Japanese soldier & tactics used); The American success in the war portrayed that the country invested a lot of resources in understanding their enemies. Information is often key in military since it helps formulate both the offenses and defenses. With the adequate information about the enemy, the American government often employed the best tactics in either attacking or resisting the advances of the enemy. Technological advancement in the war was important in the ending the war. America had to prove technological advancement in order to end the war. The eastern bloc had a renewed determination to foster the war but their evident technological inferiority influenced their decision to stop fighting. The nuclear bombing of Hiroshima and Nagasaki pr oved to the eastern forces that the United States had the best military technology and could annihilate their population thus influencing their decision to end the spirited fight. The Germans also proved greater

Corporate Cash holding Essay Example | Topics and Well Written Essays - 1500 words

Corporate Cash holding - Essay Example The suitability of a new model must be determined before carrying out any tests owing to the complex nature of the measurements involved. The correlations will need to be carried out between loss dummy and dividend payouts as well as between loss dummy and firm size and positive relationships will need to be determined (see Appendix 4 for reference). This means that large firms are more likely to be without loss while also managing to pay dividends, an observation consistent with the results obtained by most researchers and providing evidence that the loss dummy variable can function as a proxy for financial restraints. In line with the other various researchers, we found out that firms which incur a loss, most of the times hold more cash than financially stable firms. Further examination into the correlation between loss dummy, the investment opportunity and cash flow volatility, we were able to found out that a negative correlation exists between loss dummy and the investment opportunity as well as a negative correlation between loss dummy and cash flow volatility. From this examination we can assume that financial constraints (loss dummy=0) have a positive relationship with cash flow volatility investment opportunity set (see Appendix 5). Financial constrained firms should hold some cash so that they are able to invest in investment projects which are profitable. The estimate models show us that cash flow volatility does in fact affect a firm’s cash holdings. Cash volatility differs from industry to industry and in order to depict this, we add a dummy variable, industry, into our model so as to determine the differences in cash holdings in each industry. The variable for industry, I, shall be used in out sample meaning that for the 32 industries listed in the London Stock Exchange, we would need to create 21(k-1) dummy variables. According to the results of the test, we can see that not all dummy variables are of significance. The ones that

Wednesday, October 16, 2019

Net Present Value and Internal Rate of Return Assignment

Net Present Value and Internal Rate of Return - Assignment Example Table 1 shows the cash inflow expected to be generated and the cash outflow expected to be incurred should the proposed expansion be undertaken. During the first year, the company will incur expenses to finance the purchase of the new plant and equipment costing 5,000,000. It is assumed that this amount will be a one time expense fully incurred during the first year. This report also recognized the need to recognize the investment in research and development already incurred by the company. The rationale behind this is to fully and adequately evaluate the profitability of the project. It should be noted that in order to come up with a proper valuation, the company should account for all the revenues and expenses generated by the project. Thus, it is inclusive of all the expenses incurred to bring the project in operation. Research and development cost of 900,000 should be accounted for because without it, the expansion will be impossible to pursue. During 2005, the amount of 1,800,000 to cover additional working capital expenses is also included in the cash outlay required. However, management also expects that after five years, this amount will be freed up and can be readily used by other projects. Thus, Table 1 also shows that during 2005, the company will be needing 1,800,000 while this amount will be available during 2010. In the case of the overhead costs, this report decided to use the 300,000 per annum as estimated by the project development team advisor. This is deemed appropriate as allocating 50% of the wages is just an estimate. It should also be noted that depreciation expense will not be included in the computation of the NPV because cash flow is not directly affected by the account. As taxes and inflation are excluded in the analysis, tax shield from depreciation will not be considered. The computation for NPV is shown in Table 2. Since the company is using 14% as the required rate of return for the expansion, the cash flows are discounted at the same rate. According to the computation in Table 2, the NPV of the expansion using 14% cost of capital is (403.47). Table 2. Discounted Cash Flow and NPV for Expansion (2005-2010, in thousand) 2005 2006 2007 2008 2009 2010 Total Inflow/ (Outflow) (8500) 2,040 1,940 2,140 2,140 3,940 Present Value Factor (14%) 1.0000 0.8722 0.7695 0.6750 0.5921 0.5194 Present Value (8500) 1789.4 1492.8 1444.5 1267.0 2046.4 NET PRESE NT VALUE (403.47) Internal Rate of Return The internal rate of return is the cost of capital which equates the net present value of all cash flow to zero. The IRR can be computed by calculating the NPV at different interest rates. Utilizing this method, we come up with Figure 1 which shows that IRR is approximately 12%. Figure 1 . NPV at Different Cost of Capital Question 2. Prepare an informal report for the Board of

Tuesday, October 15, 2019

Corporate Cash holding Essay Example | Topics and Well Written Essays - 1500 words

Corporate Cash holding - Essay Example The suitability of a new model must be determined before carrying out any tests owing to the complex nature of the measurements involved. The correlations will need to be carried out between loss dummy and dividend payouts as well as between loss dummy and firm size and positive relationships will need to be determined (see Appendix 4 for reference). This means that large firms are more likely to be without loss while also managing to pay dividends, an observation consistent with the results obtained by most researchers and providing evidence that the loss dummy variable can function as a proxy for financial restraints. In line with the other various researchers, we found out that firms which incur a loss, most of the times hold more cash than financially stable firms. Further examination into the correlation between loss dummy, the investment opportunity and cash flow volatility, we were able to found out that a negative correlation exists between loss dummy and the investment opportunity as well as a negative correlation between loss dummy and cash flow volatility. From this examination we can assume that financial constraints (loss dummy=0) have a positive relationship with cash flow volatility investment opportunity set (see Appendix 5). Financial constrained firms should hold some cash so that they are able to invest in investment projects which are profitable. The estimate models show us that cash flow volatility does in fact affect a firm’s cash holdings. Cash volatility differs from industry to industry and in order to depict this, we add a dummy variable, industry, into our model so as to determine the differences in cash holdings in each industry. The variable for industry, I, shall be used in out sample meaning that for the 32 industries listed in the London Stock Exchange, we would need to create 21(k-1) dummy variables. According to the results of the test, we can see that not all dummy variables are of significance. The ones that

Ethical Leadership in the 21st Century Essay Example for Free

Ethical Leadership in the 21st Century Essay Leadership is a critical component of the organizations culture as leaders can create, maintain, or change culture. Thus, leadership is significant to establishing an ethically oriented culture. The idea that corporate leaders are accountable for organizational ethics is not a new one. In 1938, management theorist Chester I. Barnard described the executives role in â€Å"forming morals for others† in his book The Functions of the Executive. Barnard suggested that the purpose of developing organizational morals is a distinctive characteristic of executive work going far beyond the moral challenges faced by individuals usually. Besides superior technical skills, a high capability for responsibility, and an intricate personal morality, this task requires moral ingenuity in defining an organizations code of ethics and instilling the basic attitudes that support it. According to a report from the Business Roundtable, a group of senior executives from major American corporations, leadership is crucial to organizational ethics. To achieve results, the Chief Executive Officer and those around the CEO need to be explicitly and strongly committed to ethical conduct, and give constant leadership in tending and mending the values of the organization. † (Business Roundtable, 1988). In surveys of practicing managers, honesty and competence appear as the most important qualities identified as essential to good leadership (Barry Z. Posner and William H. Schmidt, 1992, 33). This view was echoed by Vin Sarni, former CEO of PPG Industries, a large multinational firm, in a 1992 speech to Penn State business school students. Sarni said that the title CEO stands for Chief Ethics Officer, a statement that recognizes how important it is for the organizations leader to set the firms ethical standards (Trevino and Nelson, 1995). If the organizations leaders seem to care only concerning the short-term bottom line, employees rapidly get that message too. John G. Rangos, Sr. , the founder of Chambers Development Co. a waste management firm, demanded bottom-line results. When executives reported to him in 1990 that profits would fall short of projections, he is quoted to have said, â€Å"Go find the rest of it. † And so they did, until an outside audit in 1992 found that the company had erroneously reported strong profits in every year since 1985, though it was losing money all the time. Former employees say that, in the pursuit of growth, influenced numbers were tolerated, or perhaps even encouraged. One former employee who found discrepancies in 1988 was told, â€Å"This is how the game is played. (Trevino and Nelson, 1995) Leaders symbolize significant others in the organizational lives of employees, with considerable power qua behavior role models or simply power, in the meaning of being able to force others to carry out ones own will. Leaders example and decisions affect not simply the employees who report to them, but also the stockholders, suppliers, customers, the community, the country, and even the world. Considerations of the ethical component in day-to-day decisions will set the tone for others who interrelate with the company. Thus, the image of the business leader will affect how others choose to deal with the company and will have continuing effects, as all managers and employees look to the highest level for their cues as to what is suitable. Top executives must live up to the ethical standards they are espousing and imply ethical behaviors in others. Leadership can make a difference in forming an ethical or unethical organizational culture. Work on ethical and unethical charismatic leaders also highlights the significance of the leader in the ethics equation. More particularly, charismatic leaders can be very effective leaders, yet they can vary in their ethical standards. Such differences determine the degree to which an organization builds an ethically oriented culture, the types of values followers will be exposed to, and the role models with whom employees will have their most direct personal contact (Howell and Avolino, 1992, 43-54). One way to pull together the contributions concerning how organizational culture is shaped and reinforced by leadership style is to understand organizational culture as ethical climate. One could also ask to what extent the moral maturity of organizational cultures or climates, controlling reference group types, or dominating ethics types are interdependent or interacting with leadership styles. One could also ask if unethical leadership styles encourage an unethical climate or vice versa, if the effect of unethical leadership is reinforced or counteracted by the organizations ethical climate. Ethical dilemmas will frequently result in unethical behavior if an organizations leadership furthers an immature, indistinct, or negative ethical climate. Such unethical behavior is, of course, not only furthered by an unethical climate, but also reproduces such an ethical climate, in a system feedback fashion, being contagious and self-reinforcing (or perhaps infuriating internal or external counter reactions). In such instances, an organizations culture predisposes its members to perform unethically. Kent Druyvesteyn, former staff vice president, ethics, General Dynamics Corporation, made a similar point concerning leaders as ethical role models. People in leadership need to†¦set the tone by instance of their own conduct. We could have had all the workshops in the world. We could have even had Jesus and Moses and Mohamed and Buddha come and speak at our workshops. But, if after all of that, someone in a leadership position then behaved in a means which was differing to the standards that instance of misbehavior by a person in a leadership position would teach more than all the experts in the world (Trevino and Nelson, 1995). Clearly, the development of an ethical corporate culture depends on the tone set at the top. The earliest and most continuing normative formulation has underlined the responsibilities of business corporations to those affected by a companys decisions and policies. From the beginning, it has been felt that business has fiduciary duties and compulsions of performance that extend beyond the companys legal boundaries and economic goals. This view is identical to declaring that those who own the company should run it, or hire professional managers to run it, with an eye to the interests of others as well as their own. Therefore, business owners and managers are said to have a range of social responsibilities additionally to being responsible for the normal economic functions that one expects to find in a well-organized and well-run firm (Shaw, W. H. Barry, V. 2004). To maintain and diminish this perspective, its advocates have drawn on various economic, political, ideological, and socio cultural sources, though rarely acknowledging them as such. The business mind easily transmogrified this hoary maxim into the corporate context by adopting for executives the mantle of steward of the public interest, trustee of business resources, and corporate statesman anticipated to manifest a broad social vision, while not refuting their companys economic purpose and objectives (nor, it might be added, did it disturb their power). For the most part, these attributions of moral peerage were what might be called self-coronations or simple declaration, since no visible public selection process had elevated these corporate worthies to such vaunted peaks of public influence and function. Thus capable with self-anointed, regal-like responsibilities, corporate executives everywhere were advocated to adopt an enlightened self-interest perspective in approaching business decisions and originating corporate policies. To act otherwise was to risk serious inroads on business-as-usual. As the Committee for Economic Development put it, The policy of enlightened self-interest is also based on the intention that if business does not accept a fair measure of responsibility for social improvement, the interests of the corporation might actually be jeopardized. . . . By acting on its own initiative, management preserves the flexibility needed to conduct the companys affairs in a positive, efficient, and adaptive manner. The report averred that looking beyond todays bottom line would pay off in the long run by reducing social costs, dampening radical antibusiness protest, and attenuation the likelihood of government intervention into business affairs. certainly, the stability and public acceptance of business itself were said to be at risk: Indiscriminate opposition to social change [by business] not simply jeopardizes the interest of the single corporation, but also affects negatively the interest all corporations have in maintaining a climate conducive to the effective functioning of the entire business system. (Frank Abrams, 1951, p. 33). Theorists have, generally, identified four broad areas of corporate responsibility: economic, legal, moral, and social. The major premise of the four areas is found in the basic nature of the corporation, which is a surreptitiously based, economic entity with jural standing, whose members are expected to make decisions that will have a noteworthy impact on a number of constituents (Brummer, 1991). Thinkers and researchers do not always agree that a corporation has all four responsibilities. Some do not consider that corporations have a moral responsibility; others believe that moral and social responsibilities come after economic and legal ones. The economic responsibilities of corporations have been distinct in many ways. Milton Freidman, for instance, states that the economic responsibility of a firm is distinct by the corporate intervening goal. To him, a corporate overriding goal is maximum returns to investors. As long as a corporation works on the way to achieving this goal, it is deemed economically responsible (Freidman, 1970). Based on the same philosophy, Manne (Manne and Wallich, 1972) argues that the intervening goal of the corporation is to maximize shareholders profits. In the majority of instances, maximizing investors returns would lead to utmost profits, and vice versa. Herbert Simon, on the other hand, disagrees with the perception of profit maximization and strongly argues for profit satisfying. He contends that because executives should respond to a number of other objectives, factors, and constraints, and must do so in the framework of what he calls bounded rationality, they in fact seek to reach a mere satisfactory level of profit. Whether maximization or satisfying, economic responsibility proponents consider that the number one responsibility of businesses is, first, its shareholders, and then other constituents. However, the dilemma concerning the issue of harmonizing the firms economic association with its social orientation still lingers. A step in the direction of easing the confusion was taken while an inclusive definition of corporate social responsibility (CSR) was developed. A four-part conceptualization of CSR integrated the idea that the corporation has not only economic and legal responsibilities but ethical and philanthropic responsibilities as well (Carroll, 1979). The major point here is that for social responsibility to be established as legitimate, it had to address the entire spectrum of compulsions that business has to society, including the most elemental economic. Organizational responsiveness to social needs had its unveiling when early industrialists reacted to the social problem that industrialization was seen to have caused. Early on, economists as well as philosophers began to argue regarding the role of business in society and regarding what responsibility business has to society. Later, social theorists for instance Bell (1976), Bellah (Bellah et al. , 1985), and Wolfe (1989) continued the debate and raised it to a higher level of concept. They were not just concerned about the responsibility of the corporation as a social body but even more concerned concerning how the corporate revolution has altered social life. A recent evaluation of the literature recognizes no less than nine meanings for social accountability. The nine meanings were categorized by Sethi (1997) into three categories: social obligation, social reaction, as well as social responsiveness. Social obligation entails that a corporation engages in communally responsible behavior when it follows a profit within the constraints of law as forced by society. Consequently legal behavior in pursuit of profit is a communally responsible behavior, and any behavior not legal is socially negligent. Proponents of social responsibility as social compulsion offer four primary arguments to support their views first, they retain that corporations are accountable to their shareholders. Consequently, managers have the responsibility to manage the corporation in a way that would exploit owners interests. Second, socially responsible projects such as social improvement programs must be determined by law and left to the contributions of private individuals. Consequently, the government, through legislation, is best equipped to determine the nature of social development programs and to comprehend social enhancements in society. Businesses contribute in this regard by paying taxes to the government that correctly determines how they should be allocated. Third, it is a violation of management contract to give out corporate profits for social improvement programs. These actions amount to taxation without representation, according to Friedman (1970). Management is taxing the shareholders by expenditure their money on activities, which does not contribute directly to maximizing shareholders interests. Additionally, because managers are not elected public officials, they are taking actions that affect society without being accountable to society. Fourth, many people who subscribe to this school of thought believe that social programs financed by corporate managers might work to the disadvantage of society. In this sense, financial costs of social activities can, eventually, cause the price of the companys goods and services to increase, and customers would pay the bill.

Monday, October 14, 2019

Effects of Adverse Perinatal Outcomes (APO)

Effects of Adverse Perinatal Outcomes (APO) Specific Aims Adverse perinatal outcomes (APO) include infants birth defects, maternal pregnant and obstetric complications. Birth defects, including major congenital malformation (MCM) and minor anomaly (MA), become the leading causes of infant morbidity, mortality, and years of potential life lost in the United States.1 Low birth weight (LBW), abnormal condition of new born (ACNB), preterm birth, and Developmental Delay or Disability (DDD) are also birth anomalies that impacts the infants health.2-5 The association of in utero exposure to teratogenic medications with infant birth defects and other anomalies has been widely investigated.6,7 The literature has shown that taking antiepileptic drugs (AEDs) poses an increased risk of having child with congenital malformations in women with epilepsy.79 The most common MCMs caused by in utero exposure to AEDs are orofacial clefts, cardiac abnormalities, neural tube defects, urologic defects, and skeletal abnormalities.80 In utero exposure to valproate, the most teratogenic AED, was associated with elevated risk of impaired cognitive function for children at 3 years of age, and reduced cognitive abilities for children at 6 years old.98,101 However, study results for many medications, such as antidepressants, opioids, antipsychotics, and antibiotics, are inconsistent for fetal safety.[1*-8*] The limited data source and rare incidence of birth defects, ACNBs, and other anomalies restrain the study power, and makes some studies inconclusiv e.8-10 Our long term goal is to determine the association between teratogenic effects of medications that mothers exposed during pregnancy and infants birth defects. The major objective of this study is to build a linked database in Rhode Island (RI) to facilitate the subsequent research on teratogenic effects of medication in RI population. The birth defects and birth certificates data from the Department of Health (DoH) and pharmacy claims from the Medicaid program offer an essential resource to investigate these aims. The availability of hospital diagnoses and birth records offers a significant advantage for investigating birth defects with corresponding clinical conditions in large population with a longitudinal approach. Our team is well suited to conduct this research given extensive expertise in contemporary pharmacoepidemiology, many years of experience on drug safety research, prior drug utilization and birth defects study with the linked data from another state, and clinical expertise from obstetric and gynecologic physicians. Our specific aims are to generate a linked data and investigate the medication utilization and assess the corresponding birth defects with the following efforts: Aim 1: To build a linked database that includes mothers medications prescribed during pregnancy and subsequent adverse perinatal outcomes. We hypothesize that the data from two state departments can be internally linked using identifiers. Mothers medication prescriptions will be extracted from Medicaid claims provided by the RI Executive Office of Health Human Services (EOHHS). The adverse perinatal outcomes include: MCMs, MAs, abnormal conditions of new born, fetal death, and low birth weight, and maternal adverse pregnancy and obstetrical complications. All of these outcomes will be obtained from birth certificates, institutional and professional claims that are collected and managed by RI Department of Health (DoH). These two parts of data will be linked by the deterministic or probabilistic linking strategy using mothers medical record number, name, and date of born. We will apply for IRB approval with a waiver of informed consent by RI DoH, EOHHS, Brown, and URI. Aim 2: To characterize the patterns of medication use in women during pregnancy. We hypothesize that medication use in women during pregnancy changes in recent years. Many medications, such as AEDs, statin, or angiotensin converting enzyme (ACE), have been classified as teratogens and categorized as D or X by the Food and Drug Administration (FDA). However, studies have found that these teratogenic drugs still have been prescribed to pregnant women.5-7 Some medications with contradictive results reported from the literature may have increased use in pregnant women. We will examine the prescribing patterns of these medications in pregnant women with varied age, race, comorbidities, co-medications, as well as medication types and doses. The utilization pattern will be delineated in secular trends and mapped geographically, as will facility, provider, and state-level variations. Aim 3: To assess infants birth defects and birth anomalies using advanced statistical model. We will identify all corresponding birth defects, including MCM, MA, LBW, ACNB, DDD, preterm birth, and fetal death and compare the birth defect rates in mothers with varied demographic characteristics and medication exposure. Previous studies have suggested that the LVM can be used to combine four specific birth defects together to create a severity index.16-18 We hypothesize that this LVM can be improved and optimized to combine any number of components with a proper weight on severity and frequency to evaluate the overall health status of infants. B. Significance and Innovation Birth defects occur in 3 5% of children born in the United States and account for 20% of all infant deaths.1,2 During 2010-2012, RI DoH identified 1,390 newborns with at least one birth defect.3 The rate of birth defects in RI increased by 14.2% from 2008 to 2012.3 It was reported that 2-3% of birth defects are due to teratogen-induced malformations, which refer to malformations resulting from environmental or in utero exposure to teratogens.4 In the United States, about 3 million people currently live with teratogen-induced malformations.4 The FDA defined the pregnancy category to enforce the labeling of drugs with respect to their effects on pregnant women. Some medications, such as AEDs, statin, or ACEs, have been classified in FDA pregnant category D or X due to their teratogenic effects. Previous studies reported a two- to three-fold increase in the malformation rate among infants with in utero exposure to AEDs.21,22,81,82 The incidence rates in infants with in utero exposure to AEDs were 3.1% to 9.0% for MCMs, 37% for one MA, and 11% for two MAs.21,80-83 The risk of malformations for infants with in utero exposure to valproate is 7.3-fold higher than that of non-exposed, and 4-fold higher than those exposed to all other AEDs.7 Some widely used medications, such as antidepressants, opioids, antipsychotics, and antibiotics, tend to have increased utilization in pregnant women while the results from teratogenic studies are controversial and inclusive.[1*-8*] It is difficult to distinguish between the real non-inferior results and power deficiency owing to rare outcomes. It has led to an urgent need to determine the fetal safety of these medications and prevent teratogenic medications prescribing to pregnant women. However, the limited data source and rare incidence of birth defect outcomes impact the study power, and makes studies inconclusive.8-10 Traditional claims data (data from Medicaid or private health plans) is not suitable for birth defect research as it only contains medical information for either mother or infant, not both. Birth certificates or birth defects data doesnt include mothers medication information. As such, to investigate utilization patterns and teratogenic effects of medications, we need to link mothers pharmacy claims with infants birth defects assessments. The linkage should be conducted in a secure data server with patients identifiers. The main goal of this proposed one-year pilot study is to collaborate with the RI EOHHS and RI DOH and generate a linked statewide dataset that includes mothers pharmacy claims and infants birth defect outcomes. This linked dataset will facilitate the researchers in Brown and URI to conduct studies regarding drug-induced birth defects in RI and provide a potential for combining RI linked data with the linked data from other states to conducting drug teratogenic studies in large population. Innovation This proposed study will generate a linked data with combining Medicaid pharmacy claims from the RI EOHHS and birth certificates and birth defects from the RI DOH. This would make RI become the fourth state that possesses the linked mother-infant data in the United States, besides California, Texas, and Florida. Our approach will provide a large linked dataset to facilitate the researchers from URI and Brown to conduct drug-induced birth defects studies. This linked dataset will provide a potential for future drug teratogenic research in large population with combining the RI linked data with the linked data from other states. Our approach will employ state of the art, innovative pharmacoepidemiologic study designs and statistical models, to improve the study power and efficiency. A latent variable model will be employed in this study to combine all birth defects outcomes into a continuous severity score to assess the overall infants morbidity and mortality. C. Approach Data Sources This study is based on a statewide, retrospective 11-year data sources: RI birth certificates and birth defects from January 1, 2006 to December 31, 2016. In Rhode Island, birth certificates are collected in the hospital within 24 to 48 hours after the baby birth. The RI DoH collects and manages birth certificate data for all infants born in RI. Birth dates and places for infants, and demographic characteristics for infants, mothers, and fathers are all recorded in birth certificates. The RI Birth Defects dataset consists of birth defects registry data prepared and maintained by RI DoH. Infant birth defects, including MCMs and MAs, were identified 0-365 days after live birth from hospital inpatient and outpatient claims. This study includes infants who were born in RI between January 01, 2006 and December 31, 2016. Medication information will be provided by the RI EOHHS. The data is comprised of eligibility, medical, and pharmacy claims for services from inpatient hospitals, outpatient clinics, emergency rooms, and pharmacies from January 01 2005 to December 31 2016. Brief demographics for enrolled members are included in Medicaid claims data, such as age, gender, race, residency, etc. Medicaid claims data do not include claims for managed care or Medicare enrollees. We excluded patients with dual eligibility, and thus restricted the drug exposure cohort to pregnant women who were only in the fee-for-service or primary care case management program. Each data source will be cleaned first, and then linked with other corresponding datasets using a multi-step linkage approach in which three methods of linkage are applied in sequence Deterministic, Fuzzy Matching, and Probabilistic.156 Records will be first matched deterministically, based on exact matches of unique combinations of personal identifiers including Social Security Numbers, Date of Birth, and Mothers Names (used for the linkage of BVS to Medicaid only). Records that cannot be exactly matched due to missing or poor data quality will be linked using Fuzzy Matching.156,157 Fuzzy Matching allows at least one occurrence of Social Security Number digit transpositions, name misspelling, or day or month errors in birth date fields.157 Remaining unmatched records will be linked using probabilistic techniques, based on statistical weighting of combinations of personal identifiers. Probabilistic linkage involved a two-step process. 1) Deterministic matching from the first merging step empirically derived weights to the non-missing fields based on successful linkages. 2) After the unlinked data matched with several records by weights, the matches with the highest statistical probability (indicating by high weights) will be chosen. The record remained unmatched when no high weights could be obtained. Study Cohort This study includes female Rhode Island Medicaid enrollees who were older than 15 years of age, delivered a live singleton infant between January 01, 2006 and December 31, 2016, and are enrolled in the Medicaid program as identified by pregnancy status. The study cohort of mother-infant pairs will be generated by linking the Rhode Island Medicaid claims data and Rhode Island Birth defects data using strategies described above. Many women joined the Medicaid program after becoming pregnant. We excluded the women who were enrolled in Medicaid program after a positive pregnant test. More exclusion criteria for maternal-infant pair include: mothers with less than 6 months of Medicaid eligibility before pregnancy; mothers who lost Medicaid eligibility during pregnancy; mothers with dual enrollment with Medicare, HMO, or other private health plans; mothers giving multiple births; mothers with diabetes mellitus (ICD-9-CM: 249.x, 250.x, 790.29, or used of any antidiabetics during baseline), hypertension (ICD-9-CM: 401.x, 416.x, 796.2, , 997.91, 459.3, or used of any antihypertensive drugs during baseline), or HIV pre-pregnancy (ICD-9-CM: 042, 079.53, V08, V01.79, 795.71, or used of any antiretroviral drugs); Infants who were twins, triplets, quadruplets or more; outliers involving infants with birth weight less than 350 g or above 6000 g; mothers or infants missing critical information, such as infants birth weigh t, mothers demographic information, or perinatal medical information. Only less than 1% of infants are missing birth weight records in the birth certificate, these will be excluded from the study.20 Overall Study Design This is a retrospective cohort study based on linked mothers Medicaid claims and state birth registry data. The infants birth date will be the study index date. The drug exposure window will be defined as the subsequent 9-month pregnancy period after the first day of mothers last menstrual date. We will use a 6-month baseline period prior to the first date of mothers last menstrual date to obtain the baseline demographic and clinical information. Birth defect outcomes will be detected 0-365 days after the live birth. The entire study period lasts from January 01 2005 to December 31 2016. Drug Exposure Pharmacy claims in Medicaid have been approved as an accurate source for the assessment of drug exposure in observational studies.158 Mothers medication exposure during pregnancy will be obtained from Medicaid pharmacy claims using NDC codes for filled prescription medications, and the number of days for which the medication is supplied.160 The birth anomalies are associated with exposure during entire pregnancy, MCM relates to the teratogen exposure during the first trimester, and MA and LBW associates with the maternal medication exposure at the third trimester.161 Maternal medication exposure during entire pregnancy period can affect the occurrence of varied birth defects. The exposure window, thus, will be established as a period of 14 days prior to the first day of the mothers last menstrual period (LMP) to the date when infant is born. The drug exposure will be defined as any one dose of study medications dispensed during the exposure window, including which the medication is d ispensed before the exposure window but its supply days cover at least 1 day of the exposure window. Adding 14 days prior to the pregnancy is to include the conception period and the residual effects of medications. Sensitivity study will be conducted to examine the different definitions of medication exposure windows. The mothers LMP will be obtained from birth certificates. If the dates are not available in birth certificates (about 13% of LMP in birth certificates are missing), then this information will be imputed from clinical estimates.163-165 The literature suggests that LMP from birth certificates and clinical estimates agrees within 2 weeks.166 Outcome Assessment In this study, we will identify all individual adverse infant outcomes: birth defects (involving MCM and MA), ACNB, LBW, DDD, and preterm birth from the DoH birth defects data. MCM is defined as an abnormality of an essential anatomic structure that is present at birth and interferes significantly with function and/or requires major intervention.38,39 MCM includes heart malformations, urological defects, oro-facial defects, neural tube defects, and skeletal abnormalities, etc..38,40,41 Drug-induced MCMs mostly occur between the third and eighth week of gestation.44 Any impairment before three weeks is more likely to result in fatality. The fetus becomes less sensitive to teratogenic effects after the eighth week, when the organs have developed. 2-1 delineates the time window of exposure to teratogens and associated MCMs and MAs.44 MA, also called minor congenital malformations, is the abnormal morphologic feature that does not cause serious medical or cosmetic consequences45. Identification of MA can be difficult due to the definition and the easy-variable occurrence area.46 Approximately 70% of MAs occur on the face or hands.46 The prevalence of MA is less than 4% in the general population, and varies by race, ethnicity, and gender.45,46 In healthy newborns, about 15% to 20% have one MA, 0.8% have two MAs, and 0.5% have three or more MAs.46 MA mostly occurs after the eighth week of gestation, which is so-called fetal period.44 The use of teratogens during this period may induce MAs by disturbing the growth of tissues or organs.44 ACNB includes seven medical conditions for new born infants. Infants birth weight less than 2500g, 1500g, and 1000g are categorized respectively as low birth weight (LBW), very low birth weight (VLBW), and extremely low birth weight (ELBW). Infants with low birth weight are likely to be born before 37 weeks of pregnancy. In 2009, 8.16% of live born infants showed low birth weight.50 The high risk of infant mortality and morbidity associated with low birth weight has been documented.51 Although this positive association has been ameliorated over time with improved perinatal technology and intensive care, low birth weight and prematurity still have been identified as risk factors predisposing to cardiovascular dysfunction, lung disorder, hypertension, type 2 diabetes, renal diseases, autism, and developmental delay.52-56 MCM, MA, DDD, and fetal death will be collected from birth to the first 365 days of life using the ICD-9 CM code (740-759.9, 315, 768.0, 768.1) from inpatient and outpatient claims. ACNB and preterm birth will be identified from Rhode Island birth certificatedata, and one year follow ups in infant hospital discharge data. Infant birth weight is accurately recorded in the birth certificate.19 It was noted in previous studies that these birth defects outcomes are highly related to each other.59,70-75 MCM, MA, VLBW, and ELBW relate to significant morbidity, mortality, and childhood disability or serious pregnancy or obstetric complications. 58,70-75 About 6-42% of evolving cognitive dysfunction, 9-26% of neurosensory disabilities, 1-15% of blindness, and 0-9% of deafness occurred in infants born with VLBW and ELBW.71 A significantly higher risk of DDD was found in infants born with MCM (prevalence rate: 8.3, 95%CI: 7.6-9.0).72 A 44% 86% of mortality rate occurs in infants with ELBW (500-750g).73 Moreover, infants with 1, 2, or 3 MAs had a risk rate of corresponding MCMs at 3%, 10%, or 20%, respectively.46 Some risk factors, such as infant gender, maternal age, race, social-economic status, BMI, smoking, alcohol use, nulliparity, comorbidity, and comedication during pregnancy are risk factors for all of these outcomes.75-78 Latent Variable Model Liu and Roth developed an LVM to incorporate four important BD outcomes into a single measurement, the infant morbidity index, to describe an infants overall tendency to BD.13 We will apply this model to combine all birth defects outcomes defined in this study into a continuous index of overall adverse perinatal outcome (APO) in this study. The combined outcome will be evaluated in terms of validity and reliability to ensure the appropriate use of this new methodology. MCM, MA, ACNB, Fetal Death, and DDD will be categorized as a binary variable, and assumed Bernoulli distributed.21 Four levels of LBW will be modeled as a multinomial variable since the four birth weight categories are mutually exclusive and each has its own probability. The summation of the individual probabilities of birth defects outcomes equals one. The unobserved index score will be assumed log-normally distributed. Based upon the assumption of local independence, responses of individual component outcomes are independent given the latent variable.22,23 Thus, the overall probabilities of component outcomes conditional on the latent variable are equal to the products of conditional probability for each individual component outcome.21 Based on the local independence and Bayes rule, the joint distribution for component outcomes can be expressed as an integral of product of multinomial variable for conditional distribution of each component outcome and marginal distribution of latent variable.22-24 Marginal distribution of the latent variable is described as log normal. Given the observed outcomes, we can obtain the posterior distribution of the latent severity score. Furthermore, we assume that the conditional distribution of each categorical observed outcome is nonlinear function of the latent variable.13 The conditional distribution of observed outcome and the latent variable will be linked by two parameters in the non-linear function.The probability of any specific observed outcome equals to 0 when the value of the latent variable equals to 0 because the latent variable accounts for all variation of the observed component outcomes and the relationship among these component outcomes.13 In the non-linear function, the probability of an infant having an individual birth defect outcome is assumed zero if the latent variable is zero, and every normal level (no birth defect or normal weight) will be treated as a reference. The latent variable positively associates with observed outcomes. The larger the latent variable, the higher the probability of the observed outcome.13 Latent Trait Model will be conducted using SAS Proc IML. The proportion of each outcome combination will be calculated. Then each parameter will be estimated using the iteration function for EGNLS starting from iteration 0 with initialized value until the stepping coefficient is less than 10-9. The final results are the estimates of all parameters. The estimate of latent variable will be obtained by entering the computed parameters into posterior function.13 Sensitivity Studies In order to examine the proper definition of exposure window, sensitive studies will be conducted with the exposure window defined as the period of 3, 7, 21, or 30 days prior to the first day of the mothers LMP to the infants birth date. D. Timeline Table. Study Timeline of the Study. Time Period Study Progress Before 07/01/2017 Obtain IRB approval from URI, Brown, RI DoH, and RI EOHHS. Complete DUA with RI DoH and RI EOHHS. 07/01/2017 08/01/2017 Complete data linkage for specific aim 1 08/01/2017 10/01/2017 Complete data cleaning, manipulating, variable editing, and analyses for demographic and clinical characteristics 10/01/2017 01/31/2018 Complete specific aim 2 02/01/2018 02/28/2018 Submit an abstract to the annual meeting of International Society of Pharmacoepidemiology (ISPE) 03/01/2018 06/30/2018 Complete specific aim 3 and submit a journal article

Sunday, October 13, 2019

The Great Plague of Europe Essay -- Diseases/Disorders

The deadly rapidly progressing disease known as the Great Plague of Europe or what is often referred to as the Black Death that swept through the European population between 1347 and 1353 initially began in China. Throughout human discourse, all three forms of the infectious disease have played a devastating role in the epidemics that resulted in high death rates in 14th century Europe. The Black Death of Europe that occurred was the second of the three great waves to hit throughout history. The first plague broke out in the 6th century during the reign of the Byzantine under the Emperor Justinian, reaching his capital in Constantinople. The third great wave of the plague began in China’s Yunnan province in 1894, emerging in Hong Kong and then spread via shipping routes throughout the world. The plague reached the United States from a ship containing rodents carrying the plague from Hong Kong that docked at Hawaii, where the plague broke out in December 1899, and then San Fran cisco, whose plague epidemic began in the early 1900’s. A team of medical geneticists led by Mark Achtman of University College Cork in Ireland conclude that all three of the great waves of plague originated from China (Wade, 2010). The empirical evidence from their findings points out that the plague would have reached Europe across the Silk Road. Although there were three great waves of plague, the Great Plague of Europe in the 14th century was the most devastating, violent, and most viral out of the three waves. The main cause of the Great Plague of Europe came from a deadly bacterium known as Yersinia Pestis. A smear of the bubonic plague is evades the human body and concentrates itself in the lymph node. A plague patient’s blood profile would contain or... ...Diseases, 49(10), i. 4. The Black Death, 1348," EyeWitness to History, www.eyewitnesstohistory.com (2001). http://www.the-orb.net/textbooks/westciv/blackdeath.html 5. "The black death: a plague that brought change to Europe." Calliope May-June 2011: 42+. General OneFile. Web. 8 May 2012. Document URL http://go.galegroup.com/ps/i.do?id=GALE%7CA259679369&v=2.1&u=nysl_sc_sshs&it=r&p=ITOF&sw=w 6. "The Black Death." Nationalgeographic.com. N.p., n.d. Web. 19 May 2012. http://science.nationalgeographic.com/science/health-and-human-body/human-diseases/plague-article/ 7. â€Å"The Black Death Begins.† 2012. The History Channel website. May 19 2012, 9:58 http://www.history.com/videos/the-black-death-begins. 8. Wade, Nicholus. Europe’s Plagues Came From China, Study Finds. N.p.: n.p., 2010. Web. 25 Apr. 2012. .

Saturday, October 12, 2019

World War I :: World War I

World War I, also known as the Great War, was a global war which took place primarily in Europe from 1914 to 1918. The immediate cause of the World War I was the June 28, 1914 assassination of Archduke Franz Ferdinand, heir to the Austro-Hungarian throne, by Gavrilo Princip, a Bosnian Serb citizen of Austria-Hungary and member of the Black Hand. The retaliation by Austria-Hungary against the monarchy of Serbia activated a series of alliances that set off a chain reaction of war declarations. Within a month, much of Europe was in a state of open warfare. And World War II or the Second World War was a global military conflict, the joining of what had initially been two separate conflicts. The first began in Asia in 1937 as the Second Sino-Japanese War; the other began in Europe in 1939 with the German invasion of Poland World War I was fought by two major alliances. The Entente Powers initially consisted of France, England, Russia, and their associated empires. Numerous other states joined these allies, most notably Italy in April 1915, and the United States in April 1917. The Central Powers, named because of their central location on the European continent, initially consisted of Germany and Austria-Hungary and their associated empires. The Ottoman Empire joined the Central Powers in October 1914, followed a year later by Bulgaria. By the conclusion of the war; only The Netherlands, Switzerland, Spain and the Scandinavian nations remained officially neutral among the European countries, though many of those provided financial and material support to one side or the other. World War II was also fought by two major alliances, the Allied and Axis power. The AXIS powers consisted of Germany, Italy (changed sides and split in half 1943) Hungary, Romania Bulgaria, Finland (changed sides 1945) Spain was meant to be neutral but they helped Nazi Germany and Fascist Italy and sent troops to fight alongside the Germans in Russia. The major Allied Powers were Great Britain, France, the Soviet Union, the United States, and China. The fighting of World War I mostly took place along several fronts that broadly encircled the European continent. The Western Front was marked by a system of trenches, breastworks, and fortifications separated by an area known as no man's land. These defenses stretched 475 miles and precipitated a style of fighting known as trench warfare. On the Eastern Front, the vastness of the eastern plains and the limited railroad network prevented the stalemate of the Western Front, though the scale of the conflict was just as large.

Friday, October 11, 2019

Solution Focused Therapy

Social Work Department Faculty of Humanities University of Johannesburg Student Surname| Le Roux| Student Initials| C| Student First Name| Charlene| Student Number| 201170104| Assignment Title| Practice Model| Date of Submission| 15 March 2013| Course Title| B Social work| Lecturers Name| Prof. Adrian Van Breda| Course Code| SW2A11| Plagiarism Declaration| I, Charlene Le Roux 201170104, declare that this assignment is my own original work. Where secondary material has been used (either from a printed source or from the internet), this has been carefully acknowledged and referenced in accordance with departmental requirements.I understand what plagiarism is and aware of the department’s policy in this regard. | Name| Charlene Le Roux| Signature| | Index Page 1. 2. 3. 4. 5. 5. 15. 25. 35. 45. 55. 65. 767. 8. | Introduction History of Solution Focused TherapyUnderlying theoryKey principlesApplication to the PCPEngagementAssessmentPlanningImplementingEvaluationTerminationFollow-up Critical reflectionConclusionReference list| Page 334-55-66-116-77-88991010-11111213| 1. Introduction I have chosen to do the Solution focused therapy practice model (Hereafter referred to as SFT).I chose this model because I was interested in finding out more about how to use one’s own resources and strengths to empower oneself. My hardest issue with counseling is learning how to teach clients how to use their own resources instead of supplying it myself and also encouraging clients to come up with their own solutions and just giving them advice and my opinion. SFT discusses the different techniques one can use to ensure they are empowering their clients and not doing everything for them. 2. History The two founding theorists for SFT are Insoo Kim Berg and Steve De Shazer.Together they adapted existing theories to mold into a theory of their own. They strongly believed that true positive change lies within the client themselves and not in the relationship between the client and worker. Berg was the cofounder of a center in Milwaukee in 1978 whose intention was to launch the mental research institute and it used Brief Family therapy. This was an organization that made no profit and was used to serve the needs of people in surrounding areas and people and families that were poor or living in poverty (O’Connell, 2005).Four years later this became the home of SFT (Lee, 2011). De Shazer later worked in the center and was thoroughly trained in brief family therapy. According to Milton Erikson, brief therapy models were hugely influenced by the strengths perspective and social constructivism. The strengths perspective is about using one’s own strengths, assets and resources to come up for solutions that are best suited for them and their problem rather than simply providing everything for one’s client.It goes with the famous saying â€Å"Give a man a fish and he will eat for a day, but teach him how to fish and he will eat for a lifetime †. Berg and De Shazer developed this model by listening to and using the feedback of their clients. They created this model by observing therapy sessions to observe the techniques and skills the therapist used, by listening to the feedback of their clients about what was or was not working for them and by observing the progress of their own clients (Lee, 2011). 3. Underlying theory of practice model Social constructivism strongly influences SFT (O ‘Connell, 2005).This perspective states that human beings create their own reality through different linguistic means. In other words, we create our own realities through conversations and by our own view of the truth so therefore each person has a different meaning that has been created which in turn means that there is no ‘objective truth’ that is true in any situation. This all implies that each person’s problems are constructed by the way in which they talk. As a result of each person having their own li nguistic style, there is no fixed meaning attached to a problem or a solution.In order for a person to see their created reality from another perspective, the therapist or practitioners main goal is to change the language the client uses. Practitioners encourage clients to use solution talk as opposed to problem talk. One thing that stands out from the social constructivist perspective is that the clients perception and experiences have main priority. This theory also takes into account the context in which the client lives and emphasizes that people do not exist in social isolation but rather are products of the interactions that surround them.The relationship between the practitioner and the client is of utmost importance in this perspective because it is within this relationship that a new style of language can be created for the client to build new realities. The systems theory is another perspective that influences solution focused therapy. The systems theory expects a practiti oner to look at all the systems surrounding an individual so that the best interventions can be used. To understand the systems theory fully there are some terms that are the most important (Kirst-Ashman & Hull, 2006).Every individual is viewed as the product of interactions between different micro systems in that individuals life and practitioners look at their clients as a person-in-environment where they are constantly interacting with the various systems around them. These systems function reciprocally and change in one system means there will be change in another. The systems approach is also dynamic. It is ever changing and evolving from one particular view to another yet maintains a relatively stable homeostasis. All systems are interrelated.The systems theory basically states that because no two client systems are alike, no two solutions will be alike either and therefore every problem needs a unique and suitable intervention (Kirst-Ashman & Hull, 2006). Lastly, the strength s perspective has had an influence on SFT. The main view of the strengths perspective is that every individual, family or community has already got strengths, resources and assets that should be used in intervention strategies and it is the responsibility of the practitioner to uncover these different strengths.The strength perspective doesn’t see hard times such as traumatic experiences, struggles and sicknesses as demotivating experiences but rather as opportunities and challenges that can be overcome and in the end be used to the benefit of the client even if it is just a lesson that was learned. A worker should never limit their clients capacities and capabilities but rather believe in their goals and dreams and help them achieve it in any way that they can and another important aspect to remember here is that their goals and dreams can only be achieved if the client and worker work together to achieve these.One last thing that is important for people to know about the st rengths perspective is that it believes that every environment also has strengths and that the client should always look for help in their own environments rather than other environments. 4. Key principles As seen above and as previously mentioned, SFT was founded by bringing many different theories together. In this section the main principles of SFT will be discussed. First and foremost, it is set on the notion that if something is not broken there is no need to fix it (O ‘Connell, 2005).In other words, workers should not look for problems where there are none. If a situation is working for a client the worker shouldn’t try fix it even if it is different to the way the worker thinks it should be working. This is a theory that believes in the strengths of clients and the fact that people are resilient and can bounce back from traumatic experiences with the right support and resources. It draws on the importance of people to emerge as stronger people after the traumas b y relying on their own resources and coping methods that they themselves have learned (Van Breda, 2011).If the client’s way of solving a problem is working then the worker should encourage the client to do it more often and if a resolution is not working then there is no point in continuing to try it so the worker should encourage the client to stop that way and try to find another way of dealing with the problem. It should be kept as simple as possible so as not to confuse the client but rather to encourage them to find new and improved solutions to dealing with individual problems. This process of therapy should not be drawn out longer than necessary and should be to the point with as little intervention from the therapist as possible.This theory believes that one change ultimately brings about another change until all the required change has been achieved. Therefore, this theory does not seek to make big changes but rather a chain of smaller changes. Another reason why sma ller changes are encourages is because it helps the client feel less intimidated as they would feel by implementing one big change at one time. As always with positive change, a worker needs to recognize it and praise the client for the change they themselves have implemented.Since language is such an important aspect in this theory, the worker should never assume that there is only one possible solution to a problem but the worker should be open-minded and should try using many different paths to try and find a suitable solution. Since this theory focuses on solutions rather than problems, the worker should not spend time analyzing the problems but should jump into finding solutions that will work for that specific client and their circumstances (Malherbe & Greef, 2005). . Application to the PCP The planned change process is a set of stages that a social worker can follow and the stages overlap and flows into one another (Kirst-Ashman & Hull, 2006). 5. 1Engagement â€Å"Engagement is when a social worker begins to establish communication and a relationship with other but also addressing the problem† (Kirst-Ashman & Hull, 2009, p. 34). Engagement starts from the very first interaction a worker has with a client.The main goal of engagement is to build rapport by using different skills such as acceptance and warmth. It is very important that the worker does not judge their client at any stage and shows acceptance as acceptance is a necessary tool for change. Part of engagement in SFT is for the worker to help the change process along from the very beginning. Change needs to be spoken about and visualized. In the engagement stage it is important for rules and expectations to be set and this can be done by a means of contracting.Contracting is when the client and the worker discuss the roles, norms and expectations for sessions and this is where the boundaries are set for the client-worker relationship (Kirst-Ashman & hull, 2006) Contracting also helps esta blish roles between the client and the worker which is important in the formal relationship so that boundaries can be set in place. Firstly, the worker needs to enquire about the â€Å"pre-session change†. Pre-session change is that happened in the clients life that pushed them to make the appointment in the first place.The worker can do this by asking questions like â€Å"Tell me more about why you are here today† or â€Å"What made you seek help? †. Giving compliments to the client eases their anxiety and affirms the belief that positive regard increases the chance of change for people (Rasheed, Rasheed & Marley, 2011). 5. 2 Assessment â€Å"Assessment is differential, individualized and accurate identification and evaluation of problems, people and situations and of their interrelations to serve as a sound basis for differential helping interventions† (Siporin as cited in Kirst-Ashman & Hull, 2009, p. 34).Assessment is usually when the worker assesses what the problems are that the client is facing but because SFT focuses on solutions the worker needs to change problem talk into solution talk and already start thinking about possible solutions to the problem. A worker using SFT needs to pay attention to detail and listen to the clients carefully during the assessment stage. Once the worker has heard the clients issues they need to respond empathically as this helps create empowerment for the client as well as lets the client know that the worker is paying attention and understanding the clients’ point of view.There are many different types of questions that should be used in the assessment stage of SFT. The miracle question is the first. The answer to this type of question is usually on the path of the fitted solution. This type of question helps the client vision their preferred future. These questions are asked to find out about the clients story, strengths and resources and their own expectations for the solution. This type of question would be something like â€Å"Imagine you were sleeping tonight and a miracle happens that solves the problem you came to speak to me about.When you wake up in the morning, what would be the change that would make you realize something must have happened to solve your problem? † a client could possibly reply with answers similar to this, â€Å"my children weren’t moody and crying, my husband and I were smiling and organized. We left on time for work and when we came home we had food on our plates and the children were playing. † Another type of question is an exception question. This type of question helps the worker to get an idea of the good times in a client’s life. It helps the client remember that there were times when they knew what to do nd how to do it in order for them to function normally. Helping a client remember times when they were managing better gives them hope that they can do it again. A worker would ask this question â €Å"can you think of a time in the past month, year or ever that you did not have this problem? What were you doing differently during those times that helped prevent the problem then? † (De Shazer as cited in Lee, 2011). Coping questions are also important questions when assessing and planning for implementation. This question is useful for clients who feel completely helpless because it can give ideas to solutions that could help serve their problems.This type of question helps the worker get to know more about the clients coping strategies. A coping question would be something along the lines of â€Å"wow, how have you managed to carry on during all of these hard times? † Lastly, scaling questions can be used. These questions can be used during the evaluation stage as well. This question helps the client track their own progress which helps them identify where they are at (Lee, 2011). This is a question that asks the clients to choose a number between 1 and 10 to de termine their progress.A worker would ask a question like â€Å"from a scale of 1 to 10, 10 being the best, how are you feeling now compared to when we started? † (Nichols & Schwartz, 2008). 5. 3 Planning â€Å"Planning specifies what should be done† (Kirst-Ashman & Hull, 2009, p. 370. Planning in this theory goes hand in hand with assessment because in assessment the worker will not spend too much time focused on the problem but rather on already finding possible solutions. It is also important to remember that changes should be planned as small rather than one big change. 5. 4 Implementation Implementation is the actual doing of the plan. The Client and worker follow their plan to achieve their goals. Progress during implementation must be constantly monitored and assessed. Sometimes, new issues, situations and conditions require the plan to be changed† (Kirst-Ashman & Hull, 2009, p. 40). The most important aspect to the implementation is the changes need to sm all so as to not overwhelm the client with major changes. When a small change is achieved, it leaves the client feeling empowered and motivated to start change in another dimension of their lives.It gives the client courage to try for new and bigger changes (Lee, 2011). The above mentioned questions can also be asked to stimulate change (Macdonald, 2011), therefore intervention starts during the assessment stage. Intervention by the worker should be limited ensuring that the changes will be as a result of the clients new ways of doing things while at the same time making sure the client gets a sense of independence rather than relying on the worker to do all the work. 5. 5 Evaluation â€Å"Each goal is evaluated in terms of the extent to which it has been achieved.The decision must be made about whether the case must be terminated or reassessed to establish new goals† (Kirst-Ashman & Hull, 2009, p. 41). Evaluation in SFT basically combines all the above mentioned techniques. The worker uses the questions to find out how much change and progress has been made. Once the worker realizes what those changes are he or she points these out and celebrates together with the client for making these changes (Macdonald, 2011). The miracle question is used to monitor the progress and to keep the client in a positive frame of mind in order for them to continue progressing to their full potential.It is important for the worker and client to reflect to evaluate what has been improved and how. Evaluation in SFT does not necessarily only occur after implementation. The worker also evaluates the client at the beginning of every session to see what changes have been made and how the client is progressing. 5. 6 Termination â€Å"The worker/client relationship must eventually come to an end. Termination in Generalist Practice involves specific skills and techniques† (Kirst-Ashman & Hull, 2009, p. 41). Termination begins from the very beginning in order to prepare clie nts for the ending of sessions.SFT is meant to be brief and not carry on for long periods of time. The worker needs to keep reminding the client that the therapy will not be long and the client should have the goals of finding new solutions quicker than in other types of therapy. In the last session, the client is asked to describe in detail what changes they experienced so the change can be maintained and the worker should point out what worked and what did not work in the clients’ progress. One way of knowing when a client is ready for termination is by asking them a scaling question (Macdonald, 2011).This is when a client answer from a scale of 1 to 10, 10 being the best level of functioning. If a client’s answer is 7 or higher then the client is ready to terminate. These types of questions can be â€Å"What would you rate your level of functioning as on a scale from 1 to 10, 10 being the best? † or â€Å"Consider that when we started you were on a level 3 s cale of functioning, what would you rate your level as now between 1 and 10? †. It is important to remember that terminating with an open door policy is of benefit to this client.This means that even though the sessions are over, you let the client know they are always welcome back should they encounter any other problems but the worker can also encourage the client to come visit in a few months to let the worker know how everything is going. this makes the client feel important and valuable and is a positive way to terminate. 5. 7 Follow-up Although not a stage of the planned change process I do think it is important for a social worker to follow up with their clients to ensure that everything is still going alright.Following-up with a client also empowers them in a way because it makes them feel like they are still cared for and worried about and not like they were just forgotten by the social worker. Following up can be done in many different ways. A worker can request that the client comes back for one last session just to follow-up and ensure that everything is okay. It can also be done telephonically or via e-mail. If a client does not respond to the email or does not come in for the session it is the responsibility of the worker to find out what the reason is just to make sure the client is still on track. . Critical reflection There are some concerns surrounding SFT. One of the concerns is that it is so focused on solutions that it does not focus on curing the root cause of the problems. A therapist using this model could say that the deep rooted cause was in fact also just a form of the clients’ distortion of reality. This therapy also relies too much on the client. In some cases people may not understand that what they want is not what they need and clients sometimes need a counselor to give them a new view point to look at their situation from.For example a married couple may sometimes not know what it is they need and a worker can step in to give some ideas for solutions they can try instead of relying on the client to recognize what it is they really need. I would use this practice model if I could change a few things. I would focus more on the way a client is feeling about their problems because sometimes all somebody needs is someone to listen to their problems and not just think of solutions. Sometimes it is important to try and understand a client in a bit more of an informal way rather than strictly professional.It is important though to remember boundaries and that a client may never be friend with a worker as there may then be conflict of interest. Although there are holes in this model, there are also things I really like about SFT. It is good to focus on the positive things rather than continuously analyzing the negative to get to a solution. Focusing on a solution puts the client in the future and motivates them to get to that level of functioning. It is a model that can help clients succeed a lot quic ker than other models.I also like the fact that SFT has specific types of questions that are direct because other models can sometimes take a long time just to assess the problem leaving the client feeling like there has been no progress over a period of time because the worker has just been assessing. With SFT the client will start to see changes quite soon and will feel empowered just by the questions that they will be asked. 7. Conclusion I like the idea of SFT because it focuses on strengths and it has always fascinated me to know how a client can use their own strengths.After researching this practice model I understand a lot more about how I can recognize what a client’s strengths are and how they can be used for solutions. It is a therapy that is direct and results can be seen soon after the first session. This therapy promotes the empowerment of people and is easy to follow in order to empower one’s own clients. It is a widely used therapy and has a high succes s rate. I am glad I have learned about this model because I can now apply it to my practice this year.Instead of focusing on my clients weaknesses (low self-esteem) we can focus on building confidence and not on what has caused the low self-esteem. This is great because often speaking about the causes can be re-traumatizing to the client when all they want to do is more forward instead of focus on the past. 8. Reference List Kirst-Ashman, K. K. , & Hull, G. H. (2009). Understanding Generalist Practice (5thed. ). Belmont, CA: Brooks/Cole, Cengage Learning. Lee, M. Y. (2011). Solution-focused theory. In F. J. turner (Ed. ), Social work treatment: Interlocking theoretical approaches (5th ed. pp. 460-476). New York: Oxford University Press. Macdonald, A. (2011). Solution focused therapy. In R. Nelson-Jones (Ed. ), Theory and practice of counselling and therapy (5th ed. , pp. 371-391). Los Angeles, CA: Sage. Nichols, M. P. , & Schwartz, R. C. (2008). Family therapy: concepts and methods (8th ed. ). Boston, MA: Pearson. O’Connell. B. (2005). Solution focused therapy (2nd ed. ). London: Sage Publications ltd. Rasheed, J. M. , Rasheed, M. N. , & Marley, J. A. (2011). Family therapy: models and techniques. Los Angeles, CA: Sage. Solution Focused Therapy Social Work Department Faculty of Humanities University of Johannesburg Student Surname| Le Roux| Student Initials| C| Student First Name| Charlene| Student Number| 201170104| Assignment Title| Practice Model| Date of Submission| 15 March 2013| Course Title| B Social work| Lecturers Name| Prof. Adrian Van Breda| Course Code| SW2A11| Plagiarism Declaration| I, Charlene Le Roux 201170104, declare that this assignment is my own original work. Where secondary material has been used (either from a printed source or from the internet), this has been carefully acknowledged and referenced in accordance with departmental requirements.I understand what plagiarism is and aware of the department’s policy in this regard. | Name| Charlene Le Roux| Signature| | Index Page 1. 2. 3. 4. 5. 5. 15. 25. 35. 45. 55. 65. 767. 8. | Introduction History of Solution Focused TherapyUnderlying theoryKey principlesApplication to the PCPEngagementAssessmentPlanningImplementingEvaluationTerminationFollow-up Critical reflectionConclusionReference list| Page 334-55-66-116-77-88991010-11111213| 1. Introduction I have chosen to do the Solution focused therapy practice model (Hereafter referred to as SFT).I chose this model because I was interested in finding out more about how to use one’s own resources and strengths to empower oneself. My hardest issue with counseling is learning how to teach clients how to use their own resources instead of supplying it myself and also encouraging clients to come up with their own solutions and just giving them advice and my opinion. SFT discusses the different techniques one can use to ensure they are empowering their clients and not doing everything for them. 2. History The two founding theorists for SFT are Insoo Kim Berg and Steve De Shazer.Together they adapted existing theories to mold into a theory of their own. They strongly believed that true positive change lies within the client themselves and not in the relationship between the client and worker. Berg was the cofounder of a center in Milwaukee in 1978 whose intention was to launch the mental research institute and it used Brief Family therapy. This was an organization that made no profit and was used to serve the needs of people in surrounding areas and people and families that were poor or living in poverty (O’Connell, 2005).Four years later this became the home of SFT (Lee, 2011). De Shazer later worked in the center and was thoroughly trained in brief family therapy. According to Milton Erikson, brief therapy models were hugely influenced by the strengths perspective and social constructivism. The strengths perspective is about using one’s own strengths, assets and resources to come up for solutions that are best suited for them and their problem rather than simply providing everything for one’s client.It goes with the famous saying â€Å"Give a man a fish and he will eat for a day, but teach him how to fish and he will eat for a lifetime †. Berg and De Shazer developed this model by listening to and using the feedback of their clients. They created this model by observing therapy sessions to observe the techniques and skills the therapist used, by listening to the feedback of their clients about what was or was not working for them and by observing the progress of their own clients (Lee, 2011). 3. Underlying theory of practice model Social constructivism strongly influences SFT (O ‘Connell, 2005).This perspective states that human beings create their own reality through different linguistic means. In other words, we create our own realities through conversations and by our own view of the truth so therefore each person has a different meaning that has been created which in turn means that there is no ‘objective truth’ that is true in any situation. This all implies that each person’s problems are constructed by the way in which they talk. As a result of each person having their own li nguistic style, there is no fixed meaning attached to a problem or a solution.In order for a person to see their created reality from another perspective, the therapist or practitioners main goal is to change the language the client uses. Practitioners encourage clients to use solution talk as opposed to problem talk. One thing that stands out from the social constructivist perspective is that the clients perception and experiences have main priority. This theory also takes into account the context in which the client lives and emphasizes that people do not exist in social isolation but rather are products of the interactions that surround them.The relationship between the practitioner and the client is of utmost importance in this perspective because it is within this relationship that a new style of language can be created for the client to build new realities. The systems theory is another perspective that influences solution focused therapy. The systems theory expects a practiti oner to look at all the systems surrounding an individual so that the best interventions can be used. To understand the systems theory fully there are some terms that are the most important (Kirst-Ashman & Hull, 2006).Every individual is viewed as the product of interactions between different micro systems in that individuals life and practitioners look at their clients as a person-in-environment where they are constantly interacting with the various systems around them. These systems function reciprocally and change in one system means there will be change in another. The systems approach is also dynamic. It is ever changing and evolving from one particular view to another yet maintains a relatively stable homeostasis. All systems are interrelated.The systems theory basically states that because no two client systems are alike, no two solutions will be alike either and therefore every problem needs a unique and suitable intervention (Kirst-Ashman & Hull, 2006). Lastly, the strength s perspective has had an influence on SFT. The main view of the strengths perspective is that every individual, family or community has already got strengths, resources and assets that should be used in intervention strategies and it is the responsibility of the practitioner to uncover these different strengths.The strength perspective doesn’t see hard times such as traumatic experiences, struggles and sicknesses as demotivating experiences but rather as opportunities and challenges that can be overcome and in the end be used to the benefit of the client even if it is just a lesson that was learned. A worker should never limit their clients capacities and capabilities but rather believe in their goals and dreams and help them achieve it in any way that they can and another important aspect to remember here is that their goals and dreams can only be achieved if the client and worker work together to achieve these.One last thing that is important for people to know about the st rengths perspective is that it believes that every environment also has strengths and that the client should always look for help in their own environments rather than other environments. 4. Key principles As seen above and as previously mentioned, SFT was founded by bringing many different theories together. In this section the main principles of SFT will be discussed. First and foremost, it is set on the notion that if something is not broken there is no need to fix it (O ‘Connell, 2005).In other words, workers should not look for problems where there are none. If a situation is working for a client the worker shouldn’t try fix it even if it is different to the way the worker thinks it should be working. This is a theory that believes in the strengths of clients and the fact that people are resilient and can bounce back from traumatic experiences with the right support and resources. It draws on the importance of people to emerge as stronger people after the traumas b y relying on their own resources and coping methods that they themselves have learned (Van Breda, 2011).If the client’s way of solving a problem is working then the worker should encourage the client to do it more often and if a resolution is not working then there is no point in continuing to try it so the worker should encourage the client to stop that way and try to find another way of dealing with the problem. It should be kept as simple as possible so as not to confuse the client but rather to encourage them to find new and improved solutions to dealing with individual problems. This process of therapy should not be drawn out longer than necessary and should be to the point with as little intervention from the therapist as possible.This theory believes that one change ultimately brings about another change until all the required change has been achieved. Therefore, this theory does not seek to make big changes but rather a chain of smaller changes. Another reason why sma ller changes are encourages is because it helps the client feel less intimidated as they would feel by implementing one big change at one time. As always with positive change, a worker needs to recognize it and praise the client for the change they themselves have implemented.Since language is such an important aspect in this theory, the worker should never assume that there is only one possible solution to a problem but the worker should be open-minded and should try using many different paths to try and find a suitable solution. Since this theory focuses on solutions rather than problems, the worker should not spend time analyzing the problems but should jump into finding solutions that will work for that specific client and their circumstances (Malherbe & Greef, 2005). . Application to the PCP The planned change process is a set of stages that a social worker can follow and the stages overlap and flows into one another (Kirst-Ashman & Hull, 2006). 5. 1Engagement â€Å"Engagement is when a social worker begins to establish communication and a relationship with other but also addressing the problem† (Kirst-Ashman & Hull, 2009, p. 34). Engagement starts from the very first interaction a worker has with a client.The main goal of engagement is to build rapport by using different skills such as acceptance and warmth. It is very important that the worker does not judge their client at any stage and shows acceptance as acceptance is a necessary tool for change. Part of engagement in SFT is for the worker to help the change process along from the very beginning. Change needs to be spoken about and visualized. In the engagement stage it is important for rules and expectations to be set and this can be done by a means of contracting.Contracting is when the client and the worker discuss the roles, norms and expectations for sessions and this is where the boundaries are set for the client-worker relationship (Kirst-Ashman & hull, 2006) Contracting also helps esta blish roles between the client and the worker which is important in the formal relationship so that boundaries can be set in place. Firstly, the worker needs to enquire about the â€Å"pre-session change†. Pre-session change is that happened in the clients life that pushed them to make the appointment in the first place.The worker can do this by asking questions like â€Å"Tell me more about why you are here today† or â€Å"What made you seek help? †. Giving compliments to the client eases their anxiety and affirms the belief that positive regard increases the chance of change for people (Rasheed, Rasheed & Marley, 2011). 5. 2 Assessment â€Å"Assessment is differential, individualized and accurate identification and evaluation of problems, people and situations and of their interrelations to serve as a sound basis for differential helping interventions† (Siporin as cited in Kirst-Ashman & Hull, 2009, p. 34).Assessment is usually when the worker assesses what the problems are that the client is facing but because SFT focuses on solutions the worker needs to change problem talk into solution talk and already start thinking about possible solutions to the problem. A worker using SFT needs to pay attention to detail and listen to the clients carefully during the assessment stage. Once the worker has heard the clients issues they need to respond empathically as this helps create empowerment for the client as well as lets the client know that the worker is paying attention and understanding the clients’ point of view.There are many different types of questions that should be used in the assessment stage of SFT. The miracle question is the first. The answer to this type of question is usually on the path of the fitted solution. This type of question helps the client vision their preferred future. These questions are asked to find out about the clients story, strengths and resources and their own expectations for the solution. This type of question would be something like â€Å"Imagine you were sleeping tonight and a miracle happens that solves the problem you came to speak to me about.When you wake up in the morning, what would be the change that would make you realize something must have happened to solve your problem? † a client could possibly reply with answers similar to this, â€Å"my children weren’t moody and crying, my husband and I were smiling and organized. We left on time for work and when we came home we had food on our plates and the children were playing. † Another type of question is an exception question. This type of question helps the worker to get an idea of the good times in a client’s life. It helps the client remember that there were times when they knew what to do nd how to do it in order for them to function normally. Helping a client remember times when they were managing better gives them hope that they can do it again. A worker would ask this question â €Å"can you think of a time in the past month, year or ever that you did not have this problem? What were you doing differently during those times that helped prevent the problem then? † (De Shazer as cited in Lee, 2011). Coping questions are also important questions when assessing and planning for implementation. This question is useful for clients who feel completely helpless because it can give ideas to solutions that could help serve their problems.This type of question helps the worker get to know more about the clients coping strategies. A coping question would be something along the lines of â€Å"wow, how have you managed to carry on during all of these hard times? † Lastly, scaling questions can be used. These questions can be used during the evaluation stage as well. This question helps the client track their own progress which helps them identify where they are at (Lee, 2011). This is a question that asks the clients to choose a number between 1 and 10 to de termine their progress.A worker would ask a question like â€Å"from a scale of 1 to 10, 10 being the best, how are you feeling now compared to when we started? † (Nichols & Schwartz, 2008). 5. 3 Planning â€Å"Planning specifies what should be done† (Kirst-Ashman & Hull, 2009, p. 370. Planning in this theory goes hand in hand with assessment because in assessment the worker will not spend too much time focused on the problem but rather on already finding possible solutions. It is also important to remember that changes should be planned as small rather than one big change. 5. 4 Implementation Implementation is the actual doing of the plan. The Client and worker follow their plan to achieve their goals. Progress during implementation must be constantly monitored and assessed. Sometimes, new issues, situations and conditions require the plan to be changed† (Kirst-Ashman & Hull, 2009, p. 40). The most important aspect to the implementation is the changes need to sm all so as to not overwhelm the client with major changes. When a small change is achieved, it leaves the client feeling empowered and motivated to start change in another dimension of their lives.It gives the client courage to try for new and bigger changes (Lee, 2011). The above mentioned questions can also be asked to stimulate change (Macdonald, 2011), therefore intervention starts during the assessment stage. Intervention by the worker should be limited ensuring that the changes will be as a result of the clients new ways of doing things while at the same time making sure the client gets a sense of independence rather than relying on the worker to do all the work. 5. 5 Evaluation â€Å"Each goal is evaluated in terms of the extent to which it has been achieved.The decision must be made about whether the case must be terminated or reassessed to establish new goals† (Kirst-Ashman & Hull, 2009, p. 41). Evaluation in SFT basically combines all the above mentioned techniques. The worker uses the questions to find out how much change and progress has been made. Once the worker realizes what those changes are he or she points these out and celebrates together with the client for making these changes (Macdonald, 2011). The miracle question is used to monitor the progress and to keep the client in a positive frame of mind in order for them to continue progressing to their full potential.It is important for the worker and client to reflect to evaluate what has been improved and how. Evaluation in SFT does not necessarily only occur after implementation. The worker also evaluates the client at the beginning of every session to see what changes have been made and how the client is progressing. 5. 6 Termination â€Å"The worker/client relationship must eventually come to an end. Termination in Generalist Practice involves specific skills and techniques† (Kirst-Ashman & Hull, 2009, p. 41). Termination begins from the very beginning in order to prepare clie nts for the ending of sessions.SFT is meant to be brief and not carry on for long periods of time. The worker needs to keep reminding the client that the therapy will not be long and the client should have the goals of finding new solutions quicker than in other types of therapy. In the last session, the client is asked to describe in detail what changes they experienced so the change can be maintained and the worker should point out what worked and what did not work in the clients’ progress. One way of knowing when a client is ready for termination is by asking them a scaling question (Macdonald, 2011).This is when a client answer from a scale of 1 to 10, 10 being the best level of functioning. If a client’s answer is 7 or higher then the client is ready to terminate. These types of questions can be â€Å"What would you rate your level of functioning as on a scale from 1 to 10, 10 being the best? † or â€Å"Consider that when we started you were on a level 3 s cale of functioning, what would you rate your level as now between 1 and 10? †. It is important to remember that terminating with an open door policy is of benefit to this client.This means that even though the sessions are over, you let the client know they are always welcome back should they encounter any other problems but the worker can also encourage the client to come visit in a few months to let the worker know how everything is going. this makes the client feel important and valuable and is a positive way to terminate. 5. 7 Follow-up Although not a stage of the planned change process I do think it is important for a social worker to follow up with their clients to ensure that everything is still going alright.Following-up with a client also empowers them in a way because it makes them feel like they are still cared for and worried about and not like they were just forgotten by the social worker. Following up can be done in many different ways. A worker can request that the client comes back for one last session just to follow-up and ensure that everything is okay. It can also be done telephonically or via e-mail. If a client does not respond to the email or does not come in for the session it is the responsibility of the worker to find out what the reason is just to make sure the client is still on track. . Critical reflection There are some concerns surrounding SFT. One of the concerns is that it is so focused on solutions that it does not focus on curing the root cause of the problems. A therapist using this model could say that the deep rooted cause was in fact also just a form of the clients’ distortion of reality. This therapy also relies too much on the client. In some cases people may not understand that what they want is not what they need and clients sometimes need a counselor to give them a new view point to look at their situation from.For example a married couple may sometimes not know what it is they need and a worker can step in to give some ideas for solutions they can try instead of relying on the client to recognize what it is they really need. I would use this practice model if I could change a few things. I would focus more on the way a client is feeling about their problems because sometimes all somebody needs is someone to listen to their problems and not just think of solutions. Sometimes it is important to try and understand a client in a bit more of an informal way rather than strictly professional.It is important though to remember boundaries and that a client may never be friend with a worker as there may then be conflict of interest. Although there are holes in this model, there are also things I really like about SFT. It is good to focus on the positive things rather than continuously analyzing the negative to get to a solution. Focusing on a solution puts the client in the future and motivates them to get to that level of functioning. It is a model that can help clients succeed a lot quic ker than other models.I also like the fact that SFT has specific types of questions that are direct because other models can sometimes take a long time just to assess the problem leaving the client feeling like there has been no progress over a period of time because the worker has just been assessing. With SFT the client will start to see changes quite soon and will feel empowered just by the questions that they will be asked. 7. Conclusion I like the idea of SFT because it focuses on strengths and it has always fascinated me to know how a client can use their own strengths.After researching this practice model I understand a lot more about how I can recognize what a client’s strengths are and how they can be used for solutions. It is a therapy that is direct and results can be seen soon after the first session. This therapy promotes the empowerment of people and is easy to follow in order to empower one’s own clients. It is a widely used therapy and has a high succes s rate. I am glad I have learned about this model because I can now apply it to my practice this year.Instead of focusing on my clients weaknesses (low self-esteem) we can focus on building confidence and not on what has caused the low self-esteem. This is great because often speaking about the causes can be re-traumatizing to the client when all they want to do is more forward instead of focus on the past. 8. Reference List Kirst-Ashman, K. K. , & Hull, G. H. (2009). Understanding Generalist Practice (5thed. ). Belmont, CA: Brooks/Cole, Cengage Learning. Lee, M. Y. (2011). Solution-focused theory. In F. J. turner (Ed. ), Social work treatment: Interlocking theoretical approaches (5th ed. pp. 460-476). New York: Oxford University Press. Macdonald, A. (2011). Solution focused therapy. In R. Nelson-Jones (Ed. ), Theory and practice of counselling and therapy (5th ed. , pp. 371-391). Los Angeles, CA: Sage. Nichols, M. P. , & Schwartz, R. C. (2008). Family therapy: concepts and methods (8th ed. ). Boston, MA: Pearson. O’Connell. B. (2005). Solution focused therapy (2nd ed. ). London: Sage Publications ltd. Rasheed, J. M. , Rasheed, M. N. , & Marley, J. A. (2011). Family therapy: models and techniques. Los Angeles, CA: Sage.