Elements and Characteristics of a Clinical Micro System

I was once a support services team member in Lebanon at the Dartmouth-Hitchcock Spine Centre. This centre collects information from healthcare recipients using touch pads. Hence, clinicians make decisions based on the data collected from patients. The medical symptoms of patients who visit this clinical micro system are determined using a computer through a sensitive touch screen. Hence, results on previous treatments, anticipations for care, functional status and body symptoms are obtained from a computer.Advertising We will write a custom essay sample on Elements and Characteristics of a Clinical Micro System specifically for you for only $16.05 $11/page Learn More A clinical staff may also apply other methodologies in order to offer directions on the management and assessment of patient’s needs. Moreover, pre-planning of needs of a healthcare recipient is largely preferred in order to improve efficiency. Follow-ups on the progress of patients a re also encouraged especially through phone calls in order to ensure that all the management information has been adequately comprehended. After sharing the reading, my experience with the above clinical micro system has been greatly enlightened. For instance, I have realized that teamwork is integral when handling patients with myriads of medical problems that need urgent attention (Charlesa, Gafnia and Whelana 650). Additionally, the adaptive challenge that may assist my team in the final project is the ability to apply medical technology when evaluating patients and also being consistent throughout the project. In order to be a well informed team member, the above experience has indeed added value in my ability to choose the right person to interview. The person should be knowledgeable on specific area of specialization and also a team player (Charlesa, Gafnia and Whelana 655). Works Cited Charlesa Cathy, Amiram Gafnia and Tim Whelana. â€Å"Decision-making in the physician†“ patient encounter: revisiting the shared treatment decision-making model.† Social Science Medicine 49 (1999): 651-661. Print. This essay on Elements and Characteristics of a Clinical Micro System was written and submitted by user Cailyn Cruz to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.

Lies, damned lies and statistics - Emphasis

Lies, damned lies and statistics Lies, damned lies and statistics There are three kinds of lies: lies, damned lies and statistics. So said Benjamin Disraeli (and later Mark Twain, who was quoting him). Yet the public (and thats all of us, at one time or another) continues to be sucked in by reports based on spurious logic and facts of dubious provenance. If youve ever wondered why, you should read Risk, by Dan Gardner. Its a fascinating explanation of why we fall for sensationalist writing every time. The link between the MMR triple vaccine and autism is one of the latest examples of the triumph of hype over reality. Reports of a link were based on a study involving just a handful of children. And countless subsequent and much bigger studies failed to confirm it. So the UK Government issued a statement saying that there was no link. And thats when it all kicked off probably helped by the Governments denial. (After all, if the Governments denying it, then it must be true, right?) The newspapers began filling up with studies of children whod received the triple jab and then went on to develop the condition. Queues formed at clinics offering measles, mumps and rubella vaccination in three separate injections (a method that unlike the triple jab had never been tested on a large scale for either safety or efficacy). More and more people sought alternatives, such as homoeopathic vaccination. And crucially vaccination rates plummeted, to way below that required to produce herd immunity. Now, years later, measles infection rates have climbed dramatically more than 1300 last year in the UK alone, compared with just 56 ten years ago. The World Health Organization has abandoned its hope of eradicating the disease in the short term. And all because of a dubious, almost certainly unrepresentative study. So why did we fall for it? It would be tempting to say that most people lack the technical knowledge to assess statistics properly. That may be true, but theres more to it than that. Psychology plays a huge part. Our emotions are produced in the parts of the brain that evolved long before the parts that enable us to reason. And we make judgements usually subconsciously based on emotion (or gut feel) long before we use logic to work out if our gut feeling is right. Then theres innumeracy. According to French neuroscientist Stanislas Dehaene, were slower to compute 4+5 than 2+3. In fact, humans innate skill with numbers isnt much better than that of rats and dolphins. Its just that weve learned how to overcome it with a lot of effort. (When polled, 45 per cent of Canadians didnt know how many millions there are in a billion, for example.) So instead, people rely on gut feel: autism is a Bad Thing, so MMR must be bad. Logic never really gets a look in. Risk explains in a clear and compelling way why our lives are dominated by irrational fears (as well as why we dont worry about the things we should worry about). Its the perfect antidote to the current epidemic of negative news. And if you dont want to read that, heres another statistic for you, this time from the late comedian George Carlin: Think about how stupid the average person is; now realise half of them are dumber than that.

Are social media and increasing access to virtual reality altering our Essay

Are social media and increasing access to virtual reality altering our social interactions and expectations - Essay Example The social/cultural and ethical aspects that I will concentrate on pertain to privacy issues and the development of friendships, as well a social circles on-line. These are activities that Americans previously loved to do in real time using physical interaction but has now migrated to virtual settings within the context of social media. 3. What are the opponents of your position likely to claim? My opponents will be most likely to claim that social media has enhanced the social lives of people and allowed for a greater degree of friendship development since social media is used as a world wide connectivity and discussion tool. 4. What is your response or reason that suggests your opponents are incorrect? Simply put, we may have a large friends list in our social media accounts but we do not really know anything about them. Social media creates shallow friendships that do not last beyond a shared interest in a particular activity. These are simply friendships suggested by the social m edia based upon our perceived likes and dislikes. 5. Cite at least TWO outside resources that support your position and one that expresses the objection to your position. Two outside sources that support my position will come from Jay Baer's article â€Å"Social Media, Pretend Friends, and the Lie of False Intimacy† along with Kathleen C. and Anuhea R.'s â€Å"Free Speech: Benefit or Liability?†. ... For those living far apart from friends, postal mail was the way to go in terms of keeping in touch. Needless to say, making and keeping friends during the time of our parents really required effort in order to get to know each other and stay in touch. but all of that changed with the advent of social media. Twitter, Facebook, Myspace, all of these social channels allowed for instant connectivity among friends. It also allowed people to make friends with other people based upon shared likes and interests. The time had come for the rise of easy contact and making friends all over the world. Sadly, even though social media has created an excellent virtual reality setting that allows us to interact across the seas, it has also altered our social interactions and expectations in a negative manner. This paper will look at two of the main reasons for the negative influence of social media over our lives and methods of interacting with people as opposed to those who believe that social medi a has provided a tremendous benefit to our social interactions using various articles and journals that support and opposed the issue respectively. Let me start off this discussion with the reasons that people say social media has positively affected our social interaction and expectations. Proponents of social media say that the instant communication allowed by the system makes part of the conversation by allowing them to participate in discussions rather than talking at them (Folkens, Dave â€Å"3 Ways Social Media is Changing Public Relations†). By allowing people to have their say via social media, the group interaction helps to remove the communication barriers that used to exist for people during the infancy of the internet. As such, the internet has become a

Orientalism Movie Review Example | Topics and Well Written Essays - 1250 words

Orientalism - Movie Review Example In â€Å"Orientalism,† Edward Said, wanted to explain to the western world, especially the United States, some of the cultural and ideological differences between the â€Å"orient,† by which he means the Middle East, and the United States. Said’s â€Å"Orientalism† is divided into six sections, and in each section, he tackles one of the significant aspects of the relationship between the Middle East, representing the East, and the United States, representing the West. The five sections of â€Å"Orientalism† are designed under the titles: â€Å"The Repertory of orientalism,† â€Å"Orietalism and Empire,† â€Å"American orientalism,† â€Å"Orientalism Today : The Demonization of lslam in the News and Popular Culture,† â€Å"Oklahoma city Bombing,† and â€Å"Orientalism and Palestinian Question.† The dominating theme in the six sections is the notion that Orientalism constitutes a package of thoughts , beliefs, cultures, and traditions that are unique to the orient, and have to be adequately absorbed and understood by the East. According to Said, Orientalism does not connote a political or a social aspect alone. Rather, to understand the concept of Orientalis m according to Said, one has to develop deep understanding of many aspects that are unique to the orient. This idea is clearly expressed by Said when he introduces Orientalism as â€Å"a distribution of geopolitical awareness into aesthetic scholarly, economic, sociological, historical, and philological texts.† (Chapter 4) So, by using this set of â€Å"aspects,† Said approaches Orientalism as â€Å"a whole series of ‘interests’,† not a single entity. Among the various aspects of Orientalism, the cultural aspect remains the most distinguished and unique to the orient. The diversity of the cultures of the orient is stressed by Said, who believes that â€Å"cultural strength is not something we can discuss very easily.† Said declared that New York "plays an important role in the kind of

Support use of the medication. Essay Example for Free

Support use of the medication. Essay 1. Identify legislation that governs the use of medication in the social care settings. The Medicines Act 1968, the Misuse of Drugs Act 1971 (and later amendments), the Misuse of Drugs (Safe Custody) Regulations 1973 (and later amendments), the Health and Safety at Work Act (1974), COSHH, the Mental Capacity Act (2005) the Access to health records Act (1990), the Data Protection Act (1998) plus equality legislation. 2. Outline the legal classification system for medication. The classification of medicines are all related to the medicines act 1968, while working with medication it is good to have an understanding and working knowledge of the common types of medication by training that should be provided by you company that you work for. 3. Explain how and why policies and procedures or agreed ways of working must reflect and incorporate legislative requirements. The polices and procedures are put in place to make sure that legislation is being followed so that all people in the setting, staff and the people who need care are being cared for are safe, all needs are being met, inclusive practise and diversity is being followed out and that the setting is staying within the law. They must reflect on legislation so that the polices and procedures are correct and are the correct way of doing things. For example if a health and safety procedure was put in place and was not inline with legislation then this could cause the setting to get in trouble with the law and could cause harm to the person who was in need of health and safety requirements could become harmed. Read more: Essay About  Administer Medication and Monitor the Effects 4. Identify common types of medication. Antibiotics, Antipsychotic and anti depressants. 5. List conditions for which each type of medication may be prescribed? Antibiotics They can be used to treat relatively mild conditions such as acne as well as potentially life-threatening conditions such as pneumonia. Antipsychotic medications are often prescribed for the treatment of bipolar disorder. Psychotic symptoms are common in bipolar I disorder, and antipsychotic medications are the standard treatment for these symptoms. There are also some antipsychotic that have direct effects on mania and/or depression and are therefore used as mood stabilizers. Anti depressants Antidepressants are used to treat several conditions. They include, but are not limited to: depression, generalized anxiety disorder, agitation, obsessive compulsive disorders (OCD), manic-depressive disorders, childhood enuresis (bedwetting), major depressive disorder, , naturopathic pain, social anxiety disorder, posttraumatic stress disorder (PTSD). 6. Describe changes to an individuals physical or mental well being that may indicate an adverse reaction to the medication. Antibiotics possible adverse reactions: Being sick feeling sick diarrhoea bloating and indigestion abdominal pain loss of appetite. Antipsychotic possible adverse reactions. Stiffness and shakiness – this can often be reduced by lowering the dose. However, if a high dose is necessary, the shakiness can be treated with the same kind of medication that is used for Parkinson’s disease. Uncomfortable restlessness (akathisia) Persistent abnormal movement, usually of jaw, lips and tongue () Make the problem worse before it makes it better. Anti depressants possible adverse reactions. SSRIs and SNRIs Common side effects of selective serotonin reuptake inhibitors (SSRIs) and serotonin- reuptake inhibitors (SNRIs) include: feeling sick diarrhoea or constipation dizziness dry mouth feeling agitated or shaky not sleeping well (insomnia) or, alternatively, feeling very sleepy loss of appetite excessive sweating 7. Describe the roles and responsibilities of those involved in prescribing dispensing and supporting use of medication. The prescriber must be trained appropriately (may be a GP or nurse prescriber for example) and update themselves as required by any professional body that they might belong to prescriptions should be written clearly, ensuring the patient understands any side effects and the reasons for the prescription be given to them and how long they should take it for. Medication should only be prescribed after careful consideration of the patients best interests. The prescriber should have access to the most up to date version of the British National Formulary (BNF). Dispensing must also be appropriately trained, follow safe systems of work and understand the side effects of various drugs; be able to access appropriate information and understand when to access advice or further information (the dispenser may not necessarily be a trained pharmacist but should be working alongside one). By supporting medication this is through following care plans or support plans; staying with the person to support them to take it; using appropriate equipment (spoon etc) and a drink of water or any other way to help the medication go down like a yoghurt and of course reassuring communication. 8. Explain were responsibilities lie in relation to use of over the counter remedies and supplements Many medicines can be purchased through wholesalers and retail outlets by anyone. People may decide to buy and keep remedies to take themselves, including herbal remedies and products that they purchase from other countries. When the care provider keeps a range of ‘homely remedies’, it is care workers who will decide whether to give them to a resident or not. Homely remedies are used to provide immediate relief for mild to moderate symptoms. They are treatments that people would use themselves without consulting their GP, for example to treat toothache or indigestion. These medicines are potent and may interact with medicines that the doctor has prescribed for residents. The care provider is under no obligation to provide this treatment. But if homely remedies are purchased for occasional use by residents, the care provider must have a written policy that details the following: †¢ which medicines are kept for immediate relief of mild symptoms that a resident may choose to self-treat in their own home †¢ the indications for offering the medicines †¢ the dose to give and how often it may be repeated before referring to the resident’s doctor †¢ how to establish with the resident’s GP that the remedies will not interact with other prescribed medicines †¢ how to obtain the resident’s consent to treatment that the doctor has not prescribed †¢ how the administration will be recorded. 9. Describe the routes by which medication can be administered. Oral Nasal Transdermal Rectal sub-cutaneous intra-muscular intravenous 10. Describe different forms in which medication may be presented. tablet or capsule sublingual (SL) under the tongue buccal in the cheek Suppository vaginal [per vagina (PV)] inserted in the vagina rectal [per rectum (PR)] inserted in the rectum inhalation inhaled through the nose or mouth aerosol -spray (fluid) nebulizer device used to produce a fine spray or mist, often in a metered dose (fluid) intradermal within the skin intramuscular within the muscle intravenous within the vein subcutaneous under the skin Related to skin topical applied to the surface of the skin cream, lotion, ointment transdermal absorption of drug through unbroken skin. 11. Describe materials and equipment that can assist in administering medication. Gloves Aprons Spoons Medication pots Syringes Inhalers Peg tubes. 12. Explain the importance of the following principles in the use of medication. Consent, self administration, dignity and privacy and confidentiality. If someone self-medicates or is actively encouraged to participate in the whole process of taking their medication, depending on their ability, e.g. knowing when they need to repeat their prescription, knowing the time to take their meds, or getting a glass of water to take their tablets then they are being empowered to be active in the process, not a passive recipient who has no understanding/control over a part of their life, its about being person-centred, doing things with the individual, promoting their independence, feelings of self-worth esteem, hopefully less chance of mistakes being made. An individuals right to have their dignity privacy respected, following organisations Policies Procedures, National Standards, Codes of Conduct, Essential Standards of Quality Safety, this also relates to consent (Mental Capacity Act 2005) the right to confidentiality (Data Protection Act.) 13. Explain how risk assessment can be used to promote an individuals independence in managing medication. You have to think how a risk assessment finds the best way to manage something so that the individual is as independent as possible. For example it can find the best equipment for the individual to use to take a liquid medication foe example a spoon, cup, syringe etc so that they dont have to rely on others. Or it can reveal the individuals ability to remember what to take and when to take it.

Development of Health Care Strategies and Policy in the UK

Development of Health Care Strategies and Policy in the UK Health and Social Policy Introduction: In this essay we will discuss the health care plans and objectives, beginning with the definition of health and an analysis of the Constitution of the World Health Organization highlighting which are the areas of health care policy that seems to have received greatest attention. Health relates to physical and emotional well being and this is emphasized even further in the British idea of a welfare state were health relates to social policy and serves as one of the most important areas of governmental concerns. The health care sector of the UK government represented by the NHS and department of health is discussed extensively with health care programs, implementations of change within the health care settings, modernization, collaborative working approaches and a general improvement of health care services being emphasized as essential to realization of a successful health care policy in the UK. We also discuss obesity and smoking related problems within this general context of health care and social policy to show how polices or administrative aspects are related to health care services implementation in general Defining Health and Healthcare The World Health Organization defines Health as a state of complete mental, physical and social well-being and not just a condition free from disease and abnormality. The Constitution of the WHO is given as follows: Source: WHO constitution, 2005 THE STATES Parties to this Constitution declare, in conformity with the Charter of the United Nations, that the following principles are basic to the happiness, harmonious relations and security of all peoples: Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, and political belief, economic or social condition. The health of all peoples is fundamental to the attainment of peace and security and is dependent upon the fullest co-operation of individuals and States. The achievement of any State in the promotion and protection of health is of value to all. Unequal development in different countries in the promotion of health and control of disease, especially communicable disease, is a common danger. Healthy development of the child is of basic importance; the ability to live harmoniously in a changing total environment is essential to such development. The extension to all peoples of the benefits of medical, psychological and related knowledge is essential to the fullest attainment of health. Informed opinion and active co-operation on the part of the public are of the utmost importance in the improvement of the health of the people. Governments have a responsibility for the health of their peoples, which can be fulfilled only by the provision of adequate health and social measures. Worldwide Health Policies: The legislative and administrative measures on health policy within the divisions of WHO are carried out by Health Policy Analysis Programme (HPA) which is now fully integrated into that of the European Observatory on Health Systems and Policies. Among the Health policies, the Health Impact Assessment (HIA) program adopted by the WHO is a major opportunity to integrate health concerns into all other related policies. HIA influences the decision-making process, and addresses all determinants of health, providing a new direction for participation and empowerment in health related issues and decisions. The overall aim of health policies is to track the use of HIA and to evaluate its effectiveness identifying what are the factors that can help in successful implementation. Along with the Health impact assessment which serves as a decision making tool, the health targets are instruments that can facilitate achievement of certain health policies as they represent commitments of reaching or fulfilling specified outcomes in health care objectives within a defined time frame. Health targets have been identified by the member states of the WHO European Union and OECD countries as tools for both policy formulation and implementation. Health targets have been the focus of several health related discussions and have contributed substantially to national and sub-national health polices (WHO report on Health Policy, 2005). In order to maintain the effectiveness of health target programs and health impact assessment, the European Observatory on Health Systems and Policies launched a three year multi-country project on the effectiveness of HIA in August 2004, and this was co-funded by the European Commission under the Public Health Programme. As far as the WHO Environmental Health Policy is concerned, most European countries have addressed national health policies through the national environment and health action plans (NEHAPs). The WHO reports that Poor environmental quality contributes to 25 -33% of global ill health. Environmental health policy involves collaborative working different sectors and ministries, and the policy-making procedure itself involves many stakeholders in the phases of planning and consultation (WHO report, 2005). One of the important health policies is the evidence on health needs and interventions (ENI) Programme at the WHO Europe committee which helps assure staff and programmes which uses available evidence in providing advice and recommendations to member states. One of the goals of WHO is to ensure that there is a link between potential interventions programmes or policies and improvements in public health for the primary areas of advice and recommendations. The ENI programme is an important part of the European Advisory Committee on Health Research (EACHR)and is a division of the WHO advisory mechanism on health research, the primary role of which is to advise the WHO regional director for Europe on priorities and policies for development of research. WHO/Europe defines evidence as follows: findings from research and other knowledge that may serve as a useful basis for decision-making in public health and health care. (WHO report, 2005) The ENI policy makes WHO/Europe accountable toWHOs Member Statesas WHO is expected to make use of best available evidence to provide advice and recommendations for health policies to member states and it would be unethical if WHPO could not keep up to the requirement. Health and Social Policy in the UK A Policy has been defined as: ‘The process by which governments translate their political vision into programmes and actions to deliver ‘outcomes’ – desired changes in the real world’ Modernizing Government White Paper (2001) See DH report 2005, Health Policy A more working definition for policy is as follows: â€Å"A course of action with general applicability, requiring agreement at ministerial or ‘top of the office’ level† (Professor Mike Richards 2003) See DH report 2005, Health Policy The Department of Health suggests a Policy is usually developed within complex systems and with many deadlines and pressures; the DH Policy Collaborative is a unique collaborative approach in which health professionals and administrators need to work within the constraints of this restrictive and complex health environment and despite this be able produce benefits to the teams involved. In this period when the Department of Health (DH) is undergoing major organizational changes the Policy Collaborative complements the downsides of organizational change through promoting learning of new and innovative ways of addressing health issues. With public demands up for a faster and better NHS and social service, and for improved levels of public safety, the health department is working towards developing the right leadership for the whole healthcare system and also to secure delivery (Stephens 2004; Castledine 2004). The different health policy teams involved in health care implementation plans in different departments and their foci of work are given below: Source: DH report on Health Policy, 2005 Policy teams involved in phase 1 of the DH Policy Collaborative Policy team Focus of the work as part of the Collaborative Envisaged distinctive learning Transplant team Policy regarding tissue banking and the development of EU legislation Working with the NHS and other stakeholders on a high-risk, esoteric issue with a European dimension Cancer team The introduction of the NHS Bowel Cancer Screening Programme Developing a bowel cancer programme fit for implementation, whilst taking account of the issues for symptomatic services Older people’s NHS/social care policy teams and workforce team To ensure the availability of an integrated health and social care workforce to help older people to maintain their independence Integration of workforce and service policy making and health and social care expertise NHS Standards team The preparation and publishing of statements of standards in relation to the provision of healthcare by and for English NHS bodies and cross-border SHAs Policy making around a ‘bright idea’ with urgent deadlines and devil in the detail Within the UK the NHS and Department of Health including the NHS executive set a national framework within which healthcare services are delivered and implemented. The health department uses several different policy measures and tools such as legislation, circulars and guidance, corporate contracts, financial levers and review meetings. Many national level departments and organizations such as the Audit Commission, Clinical Standards Advisory Group, parliamentary committees, the royal colleges and specialist associations, and the Mental Health Act Commission have an impact on research implementation (Klein 1989). As the DH reports, policy measures can have unanticipated consequences and can conflict with policy goals and their may be many obstacles to evidence based practice. There is a growing awareness for the need to identify solutions to problems within the NHS ad health policy initiatives and certain reforms on evidence based care also need evaluation. The aims of the DH policy for improvement of healthcare services are given as follows (DH report on Health Policy, 2005) †¢ To support the policy teams in reaching their objectives set within a specified time period †¢ To include wider stakeholder involvement in the process of developing health policy further †¢ To make implementation the primary measure of the DH policy making process †¢ To help project teams and wider stakeholders with handling of issues relating to implementation throughout the policy development process. †¢ To ensure a coherent, integrated set of policies supporting an agreed strategy. †¢ To take learning and experiences from the policy implementation programme and use that learning to develop an improved policy development and management process †¢ To improve ways of working and learning from experiences within DH †¢ To be informed of the ‘policy management toolkit’ †¢ To involve participation and support of colleagues in managing change in policies within the DH †¢ To develop measures that can demonstrate real progress of the ‘Excellence in Policy Making’ criteria set out in the NHS management objective. †¢ To give time for creative thinking and implementation of policies, testing small changes, using examples of best practice and achievement †¢ To be brave in testing new ways of working and striving for excellence in policy making and challenging the ‘status quo’. †¢ To take measured risks in the quest for continuous improvement in policies and to achieve an excellent policy. Health policy within the UK is incorporated within the concept of a British welfare State. The concept of a welfare state refers to government policies and objectives that strive for an ideal model of provision where the state accepts responsibility for providing comprehensive welfare in all areas to its citizens (Brown, 1995). Within the UK, the idea of a welfare state suggests government objective to provide its citizens with guaranteed minimum income, social protection and provision of healthcare and other services at the best possible level. The health care sector of the UK government is largely controlled by the Department of Health with the policy decisions taken by the DH and implemented in association with the NHS. The key elements considered within a welfare state framework are Health, Housing, Welfare, Employment and Social Security. Healthcare Management in the UK – Evidence and Studies Eccles et al (2005) suggested behavioral changes of health care professionals as an important factor of policy implementation. They write that routine healthcare is a haphazard and unpredictable process and the usefulness of results of implementation is quite limited. Their study explored the role of a theory based framework and suggests that some methods that could be used to operationalize the framework in the context of designing and conducting interventions which are aimed at improving the use of research findings by individual healthcare professionals or teams. This particular research aims o understand the importance of theory based research of health care services and emphasize on the role of behaviors and attitudes of health care professionals in successful implementation of health care plans. Cauchi (2005) highlights the challenges of integrated governance in the NHS with emphasis on collaborative and multi-agency working beginning from April 2005 and this according to him poses a challenge for all medical personnel with the nurses being given a leading and more responsible role in the management of clinical cases. Glen (2004) offers a wide ranging analysis and scrutiny of roles of professionals in the medical, nursing and healthcare sectors. Glen suggests that a coherent vision of the future is needed to shape the future of the health workforce and also argues that this requires moving beyond the presumption that medical reforms are primarily focused on shifting the responsibilities of doctors on to the nurses. The paper claims that the implications of changes in health care roles and the ability of existing professionals to function effectively in the future will require education, training and human resource investments which are supportive of these changes implied. The need to have a clear definition of competence and a national standard to practice has been recognized as essential especially as nurses work in acute critical care settings. A correlation between levels of practice, education ad remuneration has been suggested as important in management of health care. The author suggests tha t educational programmes for senior nurses should be in coherence with educational programmes required for modernizing medical careers. The paper also suggests that the NHS modernization agenda and government’s health services improvement require certain changes within the culture at higher educational institutions, professional organizations, workforce development agencies and NHS trusts. The NHS healthcare policy on obesity have made several suggestion on whether junk food advertisements should be banned (Patchell and Paterson 2004) to spreading awareness on the need to have a balanced diet (Price, 2005). A balanced healthy diet cuts down on risks of obesity, diabetes and heart diseases and keeps the citizens healthy and active if it is also combined with a healthy and active lifestyle and this approach has been taken up by the Department of Health to promote awareness and reduce health problems. For reducing other problems such as smoking, several measures have been taken up by the DH and NHS and these policies and initiatives range from community interventions using co-ordinated, widespread, multi-component programmes to try and influence behavior that would help in preventing smoking in young adults (Sowden et al., 2003) to effectively addressing tobacco control within health promoting NHS trusts as part of its network of health promoting hospitals (HPH) (Quinn et al, 2001). Conclusion: In this paper approached the problem of health and health care implementation program using worldwide and British perspectives of welfare and discussed related social policies and plans for implementation of these policies. We discussed in brief, the objectives of the WHO and the NHS, the different departments involved in a new collaborative framework of healthcare within the NHS, the aims of health care policy and the associated problems and obstacles in implementation of these policies. In this context we discussed specific cases of health care policies related to two major problems of obesity and smoking. We suggested along with evidential studies that maintaining modernized health care services and collaborative approach in the NHS are key elements of future health care improvement plan and also involve promoting awareness of the needs of an active and healthy lifestyle in individuals. Thus along with governmental efforts, individual awareness are key to better health and future well being and seem to form an obvious part of social policy. Bibliography Annandale, Ellen.  The sociology of health and medicine :a critical introduction /Ellen Annandale.  Cambridge :Polity Press,1998. Brown, John,  The British welfare state :a critical history /John Brown.  Oxford :Blackwell,1995. Inequalities in health :the Black report /Sir Douglas Black [et al.] ; edited and with an introduction by Peter Townsend and Nick Davidson.  Harmondsworth :Penguin,1982, c1980. Checkland K, Harrison S.  Policy implementation in practice: the case of national service frameworks in general practice. J Tissue Viability. 2004 Oct;14(4):133-6. Castledine G.  A nursing perspective on the new plan for the NHS. Br J Nurs. 2004 Aug 12-Sep 8;13(15):926. Cauchi S.  Integrated governance: is this the future? Prof Nurse. 2005 Mar;20(7):53-5. Eccles M, Grimshaw J, Walker A, Johnston M, Pitts N.  Changing the behavior of healthcare professionals: the use of theory in promoting the uptake of research findings. J Clin Epidemiol. 2005 Feb;58(2):107-12. Glen S.  Healthcare reforms: implications for the education and training of acute and critical care nurses. Postgrad Med J. 2004 Dec;80(950):706-10. Ham C J (1992). Health policy in Britain. Macmillan, London   Hayes J.  Time to change. Nurs Stand. 2005 Feb 23-Mar 1;19(24):78. Klein R E (1989).  The politics of the NHS. Longman, London   Dilemmas in UK health care /edited by Carol Komaromy  3rd ed. Buckingham :Open University Press,2001.   Health and disease series ;bk. 7  Previous ed.: 1993.   Lea, Ruth,  Healthcare in the UK :the need for reform : IOD policy paper /Ruth Lea.  London :Institute of Directors,2000. Price S.  Understanding the importance to health of a balanced diet. Nurs Times. 2005 Jan 4-10;101(1):30-1. Patchell C, Paterson M.  Should junk food advertisements be banned? Nurs Times. 2004 Jan 20-26;100(3):19. Quinn J, Sengupta S, Cleary H.  The challenge of effectively addressing tobacco control within a health promoting NHS Trust. Patient Educ Couns. 2001 Dec 15;45(4):255-9. Sowden A, Arblaster L, Stead L.  Community interventions for preventing smoking in young people. Cochrane Database Syst Rev. 2003;(1):CD001291. Stephens R.  A new era of health care. Nurs Manag (Harrow). 2004 Sep;11(5):12-3. Stevens S.  Reform strategies for the English NHS. Health Aff (Millwood). 2004 May-Jun;23(3):37-44. Taylor RT.  Effecting change in the NHS. Hosp Med. 2004 Sep;65(9):568. Turner JJ.  The GMC: expediency before principle: GMC reforms may damage the NHS. BMJ. 2005 Jan 29;330(7485):252; discussion 254. Timmins, Nicholas.  The five giants :a biography of the Welfare State /Nicholas Timmins.  London :HarperCollins,1995. Ujah EU, Bradshaw L, Fishwick D, Curran AD.  An evaluation of occupational health services within the NHS in London. Occup Med (Lond). 2004 May;54(3):159-64. Wilson T, Buck D, Ham C.  Rising to the challenge: will the NHS support people with long term conditions? BMJ. 2005 Mar 19;330(7492):657-61. Review. Webster J.  Leading the switch to patient-centred care. Prof Nurse. 2004 Oct;20(2):20-1. Websites: www.who.org http://www.euro.who.int/healthtopics/HT2ndLvlPage?HTCode=health_policy www.nhs.uk www.dh.gov.uk – for DH reports http://www.dh.gov.uk/PolicyAndGuidance/HealthAndSocialCareTopics/MentalHealth/MentalHealthList/fs/en?CONTENT_ID=4031694chk=87%2BXMM

Arthur Miller’s “Death of a Salesman” Essay

Who does not want to live the perfect life, the American Dream? Throughout Arthur Miller’s Death of a Salesman, Willy Loman is in pursuit of this Dream. Willy focuses on the idealistic American dream his entire life, associating it with financial success, an excellent reputation and being well liked. He makes victims of his wife and of his sons by subjecting them to mistreatment and deprivation of a strong male role model. According to the Webster’s Dictionary a victim is one who is subjected to oppression, hardship or mistreatment. Willy puts far too much pressure on his elder son Biff, not enough on his younger son Happy, and he makes a â€Å"yes-woman† out of his doting wife Linda. Willy’s ideas of the American Dream outweigh the realistic trials and tribulations that need to be overcome in order to achieve the Dream. The American Dream is one of success and Willy views success as being well liked. He wants Biff to be well liked and hence puts much pressure on him to be popular. During Willy’s flashbacks to 1929, Willy encourages Biff to be a good football player rather than a good student. Willy pays so much attention to Biff and puts so much pressure on him to succeed and to be well liked that Biff does not have anything concrete (such as marks) as a backup. Willy believes that even though Bernard can get the best marks in school, that he will not survive in the business world because he is not well liked (Miller 33). Biff wants to live up to his father’s dreams. He wants his dad to be proud of him. Before the football game at Ebbets Field, Biff promises â€Å"to break through for a touchdown,† just for his dad (32). As a teenager, and right up until he catches Willy cheating, Biff does everything he can to get into Willy’s good books. He is the star football player and popular enough to order his friends around: â€Å"Fellas! Everybody sweep out the furnace room!† (34). Then, all of a sudden, things change. After finding Willy and Miss Francis together, Biff comes to the conclusion that his father is not as important as he makes himself out to be: â€Å"he [Mr. Birnbaum] wouldn’t listen to you [Willy]† (120). This is the turning point in Biff’s life because he becomes a victim of Willy’s actions. At this point, in a hotel room in Boston, Biff gives up on his life and the dream of success when he decides that he is â€Å"not going there [the University of Virginia]† (120). Willy has ruined his son’s chances at getting a good education and a  successful career. Willy puts so much emphasis on Biff’s success, that he neglects Happy. As a result, Happy feels the need to follow in Willy’s footsteps in order to gain the level of respect and attention from his father that is given to Biff. Happy feels this neglect as a teenager and feels the need to satisfy his dad: â€Å"I’m losing weight, you notice, Pop?† (33). Happy wants to be popular and well liked in order to get some positive attention from Willy. Even as an adult, Happy holds on to the need to impress his dad and to keep him content with his life. Happy wants Biff to lie to their father about seeing Bill Oliver because Willy â€Å"is never so happy as when he’s looking forward to something† (105). Happy wants Willy to be pleased with Biff because that would keep Willy happy and could stop him from having flashbacks and talking to himself. Success in business is one of Willy’s goals for the American Dream and thus, Happy wants to be a businessman because he is seeking his father’s approval. While in pursuit of the American Dream, Willy needs someone to support him and to agree with all of his decisions. Linda is there for him throughout the hard times. She guides him by being supportive of his decisions and even supports his lying. She knows that he goes to Charley to â€Å"borrow fifty dollars a week and pretend[s] to [her] that it’s his pay† (57). Linda allows him to feel important, at least in front of his own family. Not only does she defend him in front of their sons, but she also tries to keep the peace between her husband and Biff. Willy doesn’t appreciate this as he should, turning on her when she tries to get him to listen to Biff, telling her † don’t take his [Biff’s] side all the time† (65 ). Later, when she tries to comfort him, he tells her to â€Å"get to bed† (134). She endures him yelling, â€Å"stop interrupting† (64) without breaking down, only to ask him whether she â€Å"should?sing† (68) to soothe him. He has trained her to take his harsh words and act like nothing has happened. Linda is the glue that keeps the Loman family together as she tries to get Willy and her sons to speak calmly and peacefully and to see the best in each other. Ultimately, the Loman family is affected by the American Dream gone awry.  Willy Loman is very focused on this dream and his family’s success in business. Consequently, he mistreats his sons and his wife, making victims of them. His sons do not have a strong male role model who they can look up to during their maturing years. Instead, they have a daydreaming, failing salesman for a father, whose sole objective in life is to live the American Dream. He has also trained their mother to agree and comply with everything he says. The American Dream implies happiness and for Willy Loman that happiness is to die the death of a salesman. We have to wonder how the idea of death can bring happiness to someone’s life.