Hemp - The Truth About The Earths Greatest Plant

Hemp - The Truth About The Earths Greatest Plant Convincing Essay on the benifits of hemp Exclellent - An ideally there would be an item that could fill in as a fuel source, a food source, a paper source, a material source, and this item would be anything but difficult to create in any of its structures. In all honesty such an item exists; it is the plant known as hemp. No tree or plant species on earth has the business, financial, and natural capability of hemp. More than 30,000 realized items can be made from hemp.Hemp was a typical yield developed in the U.S. until 1937 when it was unreasonably prohibited. A typical misguided judgment about hemp is that it was restricted in light of the fact that it was a broadly manhandled, destructive medication. Hemp was restricted in light of the fact that it was a serious danger to the wood business. Enterprises that benefitted from the downfall of hemp spread gossipy tidbits that weed was a significant medication issue, which it was not at the time.English: Cultivation of mechanical hemp f or fiber ...They likewise engendered a crusade that it was a medication that prompted wild savagery, another total falsehood.Hemp is the plant experimentally known as cannabis sativa. It is alluded to as hemp when it is developed for its strands, stem, and seeds. Its leaves and blossoms produce the medications maryjane and hashish. Nonetheless, sterile types of the plant are as yet illicit to develop in the U.S. Truly a large number of wild hemp plants develop all through the whole Midwest today. Wild hemp, similar to hemp utilized for industry objects, is pointless as an intoxicant. However U.S. tranquilize law expresses that one section of land of this can bring about the proprietor being condemned to death. Capital punishment exists for growing one section of land of totally innocuous, non-inebriating weeds!Hemp can deliver any item that paper can create. The thing that matters is that one section of land of hemp...

Urban Poor Free Essays

The vagrants in the Philippines have unleashed devastation in the nation and they are crazy. The issue is very evident and the arrangement is gazing everybody in the face; there are sufficiently not local officials with enough guts to address the issue. In any case, somebody needs to stop the endless loop of hunching down especially in Metro Manila where most poor Filipinos from the regions appear to merge. We will compose a custom article test on Urban Poor or on the other hand any comparative subject just for you Request Now Egotistical Filipino vagrants The vagrants or unlawful pioneers need to move out of any place they have been crouching for quite a long time or even decades since they just don't have a place there. They have since quite a while ago making the most of their remain, living on deserted or abandoned territories of land without being approached to move out. Some of them obstruct the waterways with their trash, yet in addition with their human waste, which in the long run bring about the flooding of the roads and local locations of the urban areas uncommonly in the midst of overwhelming precipitation. For whatever length of time that the vagrants remain where they are and are permitted to thrive, the Philippines won't arrive at its maximum capacity as a business center point that discovers favor according to outside financial specialists. Vagrants aimlessly dump squander onto Manila’s conduits. As it were, the exercises of the individuals crouching are foul. They have no worry or regard for the rights or property of others and have all out negligence for nature and government assistance of others. A few vagrants can likewise be very pompous, resistant and egotistical when law authorization organizations at long last brace down on their criminal operations. One video shows unlawful pioneers castigating the court sheriffand requesting to know when and on the off chance that they will be paid with money or check before they consent to being migrated. Some even kidded that the check better not bob. They gave off an impression of being making the most of their couple of moments of popularity before the camera relating their stories of burdens. One miracles why the news group will in general spotlight just on their situation and not the story behind why they were permitted to remain there for such a long time. There is a ton to be said regarding why they were permitted to remain hunching down in the first place. The vagrant issue in the Philippines has been made muddled by misinformed Filipinos who believe that it is the Philippine government’s sole duty to give lodging, instruction and wellbeing for them. Not exclusively is this idea impractical, it is an out of line trouble on citizens. Resigned Chief Justice Reynato Puno as of late said that â€Å"Filipinos must have the option to request from their legislature their entitlement to lodging, training and wellbeing, or these financial rights would stay simple words on paper. † While Puno’s estimations appear to be respectable, Filipino citizens just can't stand to support the developing number of Filipinos living beneath the neediness line. A portion of these vagrants, regardless of living in small quarters no greater than a case, have no second thoughts about duplicating at a quick rate. Maybe they have been persuaded that their youngsters can be utilized to access hand outs from the administration. Filipino government officials don't help take care of the issue of vagrants by any means. On the off chance that anything, they really add to their multiplication. The main driver of the vagrant issue is by all accounts the absence of urban arranging from each Barangay and powerless requirement of the law by individuals from different offices who are not carrying out their responsibilities appropriately. Clearly, they didn't stop the issue from the beginning. Had they been carrying out their responsibilities, they could have effectively removed the primary vagrant before they duplicated and turned into the huge issue they are today. Obviously, there are times when the law requirement offices that incorporate the police and the court sheriff are defenseless in specific circumstances. They should act autonomously from chose authorities however can't carry out their responsibilities until they get directions from city Mayors who hold off on removing vagrants during political race season or when their ubiquity is winding down. This was obvious when Davao Mayor Sara Duterte attacked a court sheriff 2011 in light of the fact that the last started the destruction of shanties in Davao’s Agdao area without her go signal. She said that she felt constrained to punch the sheriff to keep savagery from following. The incongruity in defending the Mayor’s activities got away from her and many individuals who bolstered her when she pulled in analysis. Duterte’s activities presumably made a great deal of vagrants think they should be taken care of with kids’ gloves. These legislators have encouraged vagrants who rush to pitch a fit and use viciousness at whatever point they are disappointed with the government’s approaches and courses of action to migrate them. Bianca Gonzalez: the hotly anticipated savior of hostile to vagrant activism! Recently, the squatters’ feeling of qualification and intense position have at last grabbed the eye of a portion of the individuals from the upper and working class who are tired of the difficulties they are causing. A big name and web based life extremist, Bianca Gonzalez have stood in opposition to the manner in which the Philippine government treats vagrants like â€Å"babies†. She is getting a great deal of credit for her relentless remain against the absence of decency in how the issue is being taken care of. She featured that honest residents make a solid effort to set aside cash to have the option to purchase property legitimately yet at the same time get burdened for it while vagrants don’t even compensation anything to remain in unlawfully involved grounds. It’s been noticed that a ton of the vagrants show their haughtiness while requesting pay from the citizens. Talking about infants so far as that is concerned, a few people who can’t bear to take care of themselves shouldn’t have more children. It has gone to the consideration of numerous Filipinos too that a tangled law on vagrants presented in 1997 has made it hard for the legislature to expel vagrants. Republic Act 7279 just rebuffs the â€Å"professional squatters†. They are characterized by law as the individuals who can stand to pay for real lodging or the individuals who have gotten lodging units from the legislature however have sold or rented it to other people so they themselves can settle wrongfully again in another urban territory so as to beguile the framework by requesting more pay. At the end of the day, most vagrants don’t even get punished any longer for their criminal operations. They even get compensated for unleashing devastation in the network. No big surprise a great deal of Filipinos would prefer to remain as vagrants and have received a vagrant mindset. Who can take care of the vagrant issue in the Philippines? Surely, the officeholder President Benigno Simeon â€Å"BS† Aquino can't understand it. Somebody even said that the Aquino-Conjuangco families likewise act like vagrants who have involved Hacienda Luisita for a considerable length of time. Brutality and terrorizing were vital to helping them keep the grounds that were intended for the poor ranchers. BS Aquino appears to be more engrossed with his fame than giving a lasting answer for the country’s long-standing issues. He won't hazard the fierceness of the vagrants in light of the fact that the Liberal Party despite everything needs to get their votes in the following Presidential political decision. The President could even expand the quantity of beneficiaries of the Conditional Cash Transfer (CCT) or give outs to the poor as a way diverting them from the absence of progress during his term. The response of the individuals from the reasoning class is long past due. They have to step up and get out what the administration is doing, which is just indulging the vagrants. Philippine lawmakers need to stop being overprotective of individuals who misuse the framework just to get the votes in the following political decision. This harsh conduct from both the open authorities who pay off votes utilizing charge payer’s cash and vagrants who exploit the circumstance need to end in case each side of the nation get run over by vagrants. [Photos graciousness Australia News Network, Lucy Who, and Asia Society. ] Related Posts: * A manageable answer for the vagrant issue in the†¦ * The issue of vagrants in the Philippines can't be comprehended * Land possession Hell: The Philippines is Squatter Central†¦ * Party-List government officials look for crowd with Anti-Squatter†¦ * Bianca Gonzalez’s Tweet Reveals The Pinoy Middle Class n Step by step instructions to refer to Urban Poor, Papers

Book Riots Deals of the Day for December 19th, 2019

Book Riot’s Deals of the Day for December 19th, 2019 Sponsored by Read Harder Journal, a reading log brought to you by Book Riot. These deals were active as of this writing, but may expire soon, so get them while they’re hot! Todays  Featured Deals We Set the Dark on Fire by Tehlor Kay Mejia for $1.99. Get it here,  or just click on the cover image below. Summer Hours at the Robbers Library by Sue Halpern for $0.99. Get it here,  or just click on the cover image below. The Double: A Novel by José Saramago, translated by Margaret Costa for $1.99. Get it here,  or just click on the cover image below. Shadowshaper by Daniel José Older for $1.99. Get it here,  or just click on the cover image below. In Case You Missed Yesterdays Most Popular Deals American Royals by Katharine McGee for $4.99. Get it here,  or just click on the cover image below. The Secret, Book Scone Society by  Ellery Adams for $1.99. Get it here,  or just click on the cover image below. Previous Daily Deals That Are Still Active As Of This Writing (Get em While Theyre hot!): Patternmaster by Octavia E. Butler for $1.99 Birthday by Meredith Russo for $2.99 The Duchess of Bloomsbury Street by  Helene Hanff for $1.99 All This Could Be Yours by Jami Attenberg for $2.99 All About Love by bell hooks for $1.99 The Color of Water by James McBride for $1.99 The Unlikely Adventures of the Shergill Sisters by Balli Kaur Jaswal for $2.99 The Likeness by Tana French for $1.99 The Hole: A Novel by Hye-young Pyun and translated by Sora Kim-Russell for $1.99 The Serpent of Venice by Christopher Moore for $1.99 Florida by Lauren Groff for $4.99 The Dragon Republic (The Poppy War Book 2) by R. F. Kuang for $2.99. Goldie Vance Vol. 1 by Hope Larson, illustrated by Brittney Williams for $4.49 Guapa by Saleem Haddad for $1.99 The Unlikely Escape of Uriah Heep by H. G. Parry for $2.99 The Future of the Mind: The Scientific Quest to Understand, Enhance, and Empower the Mind by Michio Kaku for $2.99 What Doesnt Kill You Makes You Blacker: A Memoir in Essays by Damon Young for $2.99 The Rage of Dragons by Evan Winter for $2.99 Empire of Sand by Tasha Suri for $4.99 Queen of the Conquered by Kacen Callender for $2.99 Blackfish City by Sam J. Miller for $1.99 Travels by Michael Crichton for $1.99 A Prince on Paper by Alyssa Cole for $1.99 Invasive by Chuck Wendig for $1.99 The Dragon Republic by R.F. Kuang for $2.99 Slayer by Kiersten White for $1.99 Chasing Down a Dream by Beverly Jenkins for $2.99 The Field Guide to the North American Teenager by Ben Philippe for $1.99 I Believe in a Thing Called Love by Maurene Goo for $2.99 Im Telling the Truth, but Im Lying by Bassey Ikpi for $2.99 Upstream: Selected Essays by Mary Oliver for $4.99 Vita Nostra by Marina and Sergey Dyachenko, translated by Julia Meitov Hersey for $1.99 Opposite of Always by Justin A. Reynolds for $1.99 How to Live Safely in a Science Fictional Universe by Charles Yu for $2.99 News of the World by Paulette Jiles for $2.99 A Woman is No Man by Etaf Rum for $2.99 Dont Call Us Dead by Danez Smith for $2.99 Wild Beauty by Anna-Marie McLemore for $2.99 The Gilded Wolves by Roshani Chokshi for $2.99 Fatality in F (A Gethsemane Brown Mystery Book 4) by Alexia Gordon for $4.99 Reckless by Selena Montgomery for $3.99 Fruit of the Drunken Tree by Ingrid Rojas Contreras for $4.99 Black Water Rising by Attica Locke for $1.99 Revelation Space by Alastair Reynolds for $2.99 The Ensemble: A Novel by Aja Gabel for $4.99 Cant Escape Love by Alyssa Cole for $1.99 Brown Girl in the Ring by Nalo Hopkinson for $5.99 Ark by Veronica Roth for $1.99 Ten Women by Marcela Serrano for $3.99 Flights by Olga Tokarczuk for $4.99 The Price of Salt by Patricia Highsmith for $0.99 Ormeshadow by Priya Sharma for $3.99 Sisters of the Vast Black by Lina Rather for $3.99 Prophecy  by Ellen Oh for $2.99 Along for the Ride  by Mimi Grace for $2.99 Sign up for our Book Deals newsletter and get up to 80% off books you actually want to read.

Discrimination And Prejudice And Discrimination - 1638 Words

Discrimination comes in a number of forms. We have age discrimination, employment or job discrimination, racial discrimination, gender discrimination, reverse discrimination, sexual discrimination, and others. Prejudice is a negative attitude toward a socially defined group and toward any person perceived to be a member of that group (Burgess, 2003). The purpose of her research was to talk about discrimination and prejudices and the affect they have on our day to day lives. She also defines prejudice and discrimination and takes a look at their relationship to stereotyping and racism. According to Burgess, stereotyping often leads to prejudice and discrimination, with its definition almost mirroring that of prejudice. Stereotypes or characterizations are generalizations or assumptions that people make about the characteristics of all members of a group, based on an image, often wrong, about what people in that group are like. We are told that it does not allow for individuals to be d ifferent, but names them all as one group (Burgess, 2003). Much as her research does, I’d like to discuss the different types of discrimination and prejudice and how we might eliminate it. In the text chosen for this course, Managing Diversity- People Skills for a Multicultural Workplace,† the author reminds its readers that America has been a segmented society and that de facto segregation is still common. Rumor, suspicion, and stereotyping result if a group is competing too earnestlyShow MoreRelatedDiscrimination And Prejudice And Discrimination1608 Words   |  7 PagesDiscrimination comes in all forms. There is age discrimination, employment or job discrimination, racial discrimination, gender discrimination, reverse discrimination, sexual discrimination, and then there is also positive discrimination such as a guy letting an attractive woman out in traffic; he is then positively discriminating against her. Prejudice is a negative attitude toward a socially define d group and toward any person perceived to be a member of that group. The purpose of my research isRead MorePrejudice, Discrimination, And Discrimination1050 Words   |  5 PagesWhat is Aversive Prejudice/Discrimination All types of prejudice vary in some ways , some people are very blunt and some people merely whisper under their breath or secretly avoid the people they dislike. This falls more in between those line with this being an example of averise racism specifically â€Å" Aversive racists, in contrast, sympathize with victims of past injustice,support principles of racial equality, and genuinely regard themselves as non-prejudiced, but at the same time possess conflictingRead MoreDiscrimination And Prejudice And Discrimination Essay1672 Words   |  7 PagesPeople can be can be prejudice or be discriminatory towards anyone for any reason. Prejudice and discrimination are two very different things, prejudice is the unfair feeling of dislike for a person or group because of their race, sex religion, etc. Discrimination is the unjust or prejudicial treatment of different categories of people or things, especially on the grounds of race, age, or sex. It can occur anywhere, in the workplace , shops, restaurants, schools or just walking down the street. OneRead MoreDiscrimination : Prejudice And Discrimination Essay2081 Words   |  9 PagesRunning Head: PREJUDICE AND DISCRIMINATION 1 PREJUDICE AND DISCRIMINATION 8 Prejudice and Discrimination: What?s the Difference? Emily B. Hutchins Salem College Prejudice and Discrimination: What?s the Difference? Prejudice and discrimination are two different actions with similar meanings. A person can have prejudice without acting in a discriminatory manner; however, if someone is discriminating against someone, they have prejudices. A prejudice can start from a stereotype andRead MoreDiscrimination And Prejudice : Discrimination1719 Words   |  7 PagesKendrah Lopez CS – 420 12 Sep. 2017 Discrimination and Prejudice Discrimination and Prejudice I chose discrimination and prejudice for my multicultural paper, because I feel that discrimination and prejudice is the main reason for all the hate in the world. People are discriminated against because of reasons such as race, ethnicity, religion, looks, sex, sexual orientation, class, and other ridiculous reasons. I feel that if discrimination could be eradicated, then this world would be a peacefulRead MorePrejudice And Discrimination : Prejudice Essay1527 Words   |  7 PagesPrejudice and Discrimination Prejudice and discrimination can take several different forms. The first item I would like to delineate in this essay is the correlations between prejudice, racism, and discrimination. Prejudices quite often stem from ignorance or a lack of understanding. Essentially, prejudice strips away any individualism that belongs to a person and creates a negative opinion as soon as a connection is made to the group with which the person belongs. This happens because the prejudiceRead MorePrejudice and Discrimination1551 Words   |  7 PagesAnalytical Factsheet on Prejudice amp; Discrimination on Class Inequality Section 1: Executive Summary This essay is about prejudice and discrimination occurring in Singapore context to address Class discrimination. This essay will also show reasons to why prejudice and discrimination occurs and the effects of such inequity can cause to the society. In this case studies possible measures and solutions will be highlighted and suggested. Section 2: The issues and who are involved This essay willRead MorePrejudice, Discrimination, And Institutional Discrimination Essay1438 Words   |  6 Pagestoday’s society may believe that prejudice and discrimination mean the same thing and most people may not pay attention to the fact that there is a huge difference between the two terms. The main difference between these terms is, prejudice is a negative idea about a certain group of people or people of a particular race. The person usually doesn’t act on the idea, they mainly just keep it to themselves. Most would describe it as being a â€Å"pre-judgement†. Discrimination, on the other hand, is far muchRead MorePrejudice and Discrimination Essay913 Words   |  4 PagesPrejudice and Discrimination Prejudice: 1) an opinion formed without careful thought.2) an unreasonable or unfair feeling (in favour of, or against something). Discrimination : 1) to be the difference between. 2) (with favour of, against ) to treat favourably or unfairly. These are the dictionaries definitions of what the two words mean, obviously very briefly. Different forms of prejudice and discrimination are the underlining of racism, sexism, ageism, nationalismRead MorePrejudice and Discrimination Essay1621 Words   |  7 PagesBethany Norris – Unit 1 – Prejudice and Discrimination Part One Prejudice: The dictionary defines prejudice as an unfair and unreasonable opinion or feeling, especially when formed without enough thought or knowledge. This means that a person may form an opinion on a person or a particular group of people without having any facts or knowledge about that person or group. Prejudice is normally perceived as being bad but there are some instances where prejudice is an aid to survival for example

Marriage and Family Counseling - 823 Words

Marriage and family counselors are counselors distinctively trained to work with family systems and provide therapy for people who wish to solve emotional conflicts. Their goal, with therapy, is to revise peoples perceptions and behavior, expand communication, and prevent individual and family crises. Although marriage and family counseling has a broad history, formal recognition of the professional counseling specialization can be traced to the establishment in 1989 of the International Association of Marriage and Family Counseling (IAMFC), which is a division of the American Counseling Association. Requirements for marriage and family counselors typically include a master’s degree in counseling, two years or three thousand hours of†¦show more content†¦Therapy in the field of marriage and family counseling usually consists of talk sessions, lasting about an hour. Using techniques learned in classrooms and in fieldwork, counselors guide their clients through a se quence of conversations that reveal their clients anger, fears, and needs. When couples are considering divorce, for example, counselors work to uncover the underlying reasons for the divorce and discover whether reconciliation is possible. Marriage counselors usually speak with a husband and wife at the same time, although they may have some sessions with them separately as well. They may also counsel groups of married couples, groups of husbands, or groups of wives depending on the setting. Family counselors work with entire families or with individual family members, using similar methods of therapy. Although today, marriage and family is taught together, this was not always the case. Family counseling and marriage counseling had different beginnings. The beginning of family therapy was established in the early 1900s with the development of the child guidance movement in 1909 and marriage counseling in the 1920s. Psychoanalytic treatment was applied in similar, private sessions with spouses and provided a strong theoretical foundation for early family and marital investigations. The formal development of family therapy dates back to the late 1940s or early 1950s for different parts of the country. Early pioneers of family therapy includedShow MoreRelatedMarriage and Family Counseling1777 Words   |  8 Pagesexperiencing life struggles when it comes to family. These issues can range from problems in a marriage, how to deal with your children issues and understand yourself and how to deal with your family and certain issues. The area of marriage and family counseling/therapy has had an out break over the past decade. The counselors are expected to work effectively with families experiencing a variety of issues and problems. In marriage and family therapy/counseling there are so many different types of techniquesRead MoreFamily Systems Theory And Its Impact On The Practices Of Marriage And Family Counseling2975 Words   |  12 PagesBowen Family Systems Theory and its impact on the practices of Marriage and Family Counseling. Dr. Murray Bowen is credited with being one of the founders of family systems theory. This paper will discuss the eight concepts which Bowen deemed causes anxiety within the family system. Also, the goals and practices which have been utilized by professionals within the psychology field relation to the Bowen Family Systems Theory. Analysis provides that anxiety is passed along through the family systemRead MoreProfessional Preparation And Credentials : Marriage, Couple, And Family Counseling Essay1249 Words   |  5 Pages Professional Preparation and Credentials: Marriage, Couple and Family Counseling Nataly Gomez Walden University Abstract Professional counselors with the expertise in marriage, couple, and family counseling have certain standards to go by in order to become a licensure counselor. The CACREP is both a process and a status, it is a guide with specific standards to help with the preparation of becoming a licensure counselor. In order to become a counselor, there are certainRead MoreMeasuring Counselors For An Organization That Provides Marriage And Family Counseling1337 Words   |  6 Pagessetting up an assessment center to measure the competencies of current or potential counselors for an organization that provides marriage and family counseling for a population that consists primarily of immigrants and people with low-incomes. What types of assessments might you use? What competencies would you be looking for? An agency that provides marriage and family counseling will need all counselors to participate in assessments to help measure their competencies. The assessments will focus on knowledgeRead MoreThe Divorce : An Addiction Specialist1414 Words   |  6 Pagesskyrocketing as the years go on. Most marriages don’t even think about seeking help to improve their marriage and they wait too long to even consider help. Marriage is something that people do when they are committed to each other and want to be happy and in love. Many things change this along the way throughout the marriage and solutions to these marital problems are available. Many people think that their solutions are going to work, but they haven’t tried marriage counseling, its easily one of the mostRead MoreRelationship Between Family And Family789 Words   |  4 PagesIntroduction Many would agree that the dynamics of the family structure have changed drastically. Families are faced with many challenges, often times outside intervention is necessary in coping with the plethora of issues families face. We are living in a time of increased racial tensions, stress, bullying, domestic violence, mental illness, same-sex marriage, drug abuse, increased divorce rates, blended families, and cohabitation. The use of Marriage and family therapists appears to be increasing. AccordingRead MoreDivorce Is A Problem Of Being Proven Essential For Healthy Marriages968 Words   |  4 Pagescannot count on one hand families I know who have never been affected by divorce. Divorce is growing more and more common throughout the world today. It is a problem in need of a solution. Divorce will never be completely eliminated, but it can’t hurt to give it a shot, right? I thought to myself the other day about who all I know who has never been divorced, and all I came up with was my very own parents. Later on I asked them why, and turns out prior to their marriage, they had gone through somewhatRead MoreHow Divorce Is Affected Much More Significantly Than Those From Two Parent Families987 Words   |  4 PagesI am writing you because of a serious problem I see in our society. This problem has gotten out of hand with close to fifty percent of all marriages ending in divorce and it is affecting every aspect of our culture including churches such as your own. It is often seen as an easy choice with few consequences when in reality it is having devastating effects. Divorce is the problem of which I speak. Not only is it directly affecting those involved by wreaking havoc on their lives but it is also tearingRead MoreThe Backbone Of The Health Care System1427 Words   |  6 Pagesof California. 2. Antioch University Counseling Center http://www.antiochla.edu/campus-life/au-counseling-center/ The Antioch University Counseling Center is run by Antioch University Los Angeles. The Antioch University Counseling Center is staffed by authorized Marriage and Family (MFT) therapists and clinicians. AUCC offers counseling services to the communities of West Los Angeles, Venice, Marina del Rey, and Culver City. The Antioch University Counseling Center gives psychotherapy administrationsRead MoreA Research Study On Open Communication1678 Words   |  7 Pageshelp married couples steer their differences and resolve their conflicts more positively. When it comes to conducting research involving married couples and family research there are regulations and ethical standards that need to be monitored. Margolin, Chien, Duman, Fauchier, Gordis, Oliver Vickerman, (2005) expounds that Couple and family research presents unique challenges in terms of interpretation and application of ethical principles to psychosocial research. As with all psychosocial research

Case Analysis of Sutton Health Free Essays

string(24) " that this is achieved\." CASE ANALYSIS OF SUTTER HEALTH 1 Case Analysis of Sutter Health CASE ANALYSIS OF SUTTER HEALTH 2 Sutter Health is a non-profit network that is made up by community-based health care providers based in Northern California. This network introduced an interface that was aimed at enhancing revenue collection of the facilities from the self-pay patient. This network identified that traditional payment processing system had limitations that hindered the effective collecting of revenue. We will write a custom essay sample on Case Analysis of Sutton Health or any similar topic only for you Order Now What with the recession, healthcare organizations have seen an increase in the inability to collect debt from the self-pay, the uninsured and underinsured patients. This has caused a lot of struggle when it comes to the organizations to meet the operational margins and the profits. I find there are a number of reasons for the new increase in patient’s debts, the most common are, poor accounting practices, lack of patient information and correct demographics. There is new governance that is designed to provide more coordinated care to said patients (Gleeson,2010). There are five geographic regions that reflects the health care access to the customers of Northern California. Each of the five regions will have governance structure and it will oversee many of the Sutter affiliated medical facilities and also the hospitals. In its effort to increase point of service collections and improve the overall revenue cycle Sutter health took steps to measure performance using a handful of specific primary benchmarks, empowering PFS staff to assume responsibility for every individual account they handle, ensure each registration is analyzed using a rules engine to identify problems before patients leave the registration desk and ensure PFS staff receive appropriate co mprehensive training to excel under the new system† (Souza, McCarty, 2007). Obtaining the correct patient information plays a large part on non-collectable debt because patients are not able to be reached. These limitations were associated with limited access to accurate information by the account representatives, ineffective performance measures and fragmented centers of the service provision. The Sutter Health program developed a system that was comprised of solutions that were geared towards overcoming these limitations. I will be CASE ANALYSIS OF SUTTER HEALTH 3 discussing the new system that was created by Sutter Health. The key problems and issues, is that the United States healthcare system is characterized by huge upkeep from collecting revenue from patients. This situation is brought about by a health care insurance system which entails high deductible pay health plans and as well as higher co-payments plan. (Souza, McCarty, 2007). This situation has been made worse through the large proportion of the population not having healthcare coverage. The traditional health care system has had a hard time meeting their target revenue collection. This is due to several problems that attached along with the traditional payment system. Unlike when dealing with the payments through insurance claims but also dealing with the up-front payments that are required by the hospital for payment of services before the patient could even receive the service (Souza, Mccarty, 2007). So this means that the patient services staff (PFS) has to have complete and accurate information about above said client. This presented a problem for the traditional payment system where much of the customer payment system was processed in the back end. This system also required that the PFS staff ask for money from self-pay patients, but the PFS were not accustomed to this under the traditional system. The PFS staff found it hard to wait for the back end section to process customer information and to provide a breakdown of the patients payment details. So this became a tedious task for hospital accounting departments as well as for patients that had to wait a longer period before receiving services. The inefficiency of the traditional system not only resulted in low quality services, but also in low revenue collections. The system provides such a broad range of health care services, which include acute, sub- acute, home health, long term, outpatient care as well as physician delivery systems. These services are provided through an integrated health care delivery approach that gives the system the ability to deliver a full range of healthcare products and services. CASE ANALYSIS OF SUTTER HEALTH 4 Sutter also identified that PFS staff could not get ahold of real time information in operational and financial indicators such as cash collections and A/R (Souza, McCarty, 2007). So in the long run this meant that the managers and staff had to wait until the end of the month in order to identify the benchmarks. Sutter also recognized that the traditional system did not provide a means for analyzing selected data nor did it generate required detailed report on demand. This led to more cost as the hospital had to rely on programmers to generate such reports. The front desk staff also lacked real time information which hindered their ability to serve the client without consulting the back end staff. It also meant that the front desk staff could not monitor the patients progress (Souza, McCarty, 2007). Another challenge was that the PFS members were not empowered enough to be held accountable for each patients accounts they dealt with and it reduced the amount of accountability among the staff. These are some of the key challenges that the Sutter system were meant to address. The solutions that were employed by Sutter Health was an attempt to overcome the challenges stated above. Sutter Health implemented certain changes in the fore mentioned system that would make their operation more efficient. The strategies identified by the Sutter program entailed transferring most of the back end tasking to the front desk; providing accurate and complete information to managers and upfront staff; providing more effective performance evaluation and integrating all data elements within the system (Souza, McCarty, 2007). Allowing front desk staff to handle much of the payment process was deemed to have an effect on the efficiency of the process. Various solutions were employed to ensure that this is achieved. You read "Case Analysis of Sutton Health" in category "Essay examples" One of these solutions entailed using benchmarks to measure performance by the Patient Service Staff (PFS). Sutter identified a handful of primary benchmarks which included; Unbilled A/R days, Gross A/R days, Major A/R days, Cash Collection, Billed A/R days, and CASE ANALYSIS OF SUTTER HEALTH 5 percentage of A/R over 90, 180, 360 days (Souza, McCarty, 2007). This benchmark introduced shorter periods with which staff performances could be evaluated. This move was timely especially when onsidering that the industry has changed and things happen in terms of hours and days but not months. Another solution involved empowering the PFS members to have full responsibility over the accounts they are dealing with. This move was meant to increase a sense of responsibility and accountability as each individual members will be responsible for his or her own account (Souza, McCarty, 2007). This also gave the PFS members more autonomy to act as they saw fit and this improved the speed and efficient of service delivery by these staff members. The program also provided the PFS members with tools, that enabled them to automate their accounts, sort out their accounting using various means and seen their performances based on the achievement of the target. PFS and other accountant representatives were presented with individual dashboards that helped in the tracking of their progress in meeting targets. This also helped in enforcing the benchmarks set by this program. Sutter’s health program also introduced a front end collecting system as means of overcoming the mentioned problems. The pint of access collecting system introduced an opportunity for the health care facilities to reduce claims and denials. Though this system the patient records are analyzed before the patient leaves the registration desk. This enables the front desk staff to identify problems such as bad debt, patient or invalid patient type early enough and take the necessary corrective action. The Sutter health program also embarked on a comprehensive training program that was designed to support the existing PFS members and the registration staff. This gave staff the necessary competence to deal with the tools provided by this system. The training program also eliminated the need to hire formally educated staff to operate the system that would CASE ANALSIS OF SUTTER HEALTH 6 demand more than the $10-$20 an hour paid to current registration and PFS staff. For example, registration staff who were not used to asking patients for money were trained in effective communication skills. The training was also designed to introduce autonomy and effectiveness which acted as a motivator to the employee. The Sutter system allows staff to act with more independence which has made them active in owning the system. Autonomy is a critical element that enables workers to work effectively and deliver the best when it comes to their ability. The efficiency of the system has also made the work of the staff easier, acting as a further motivating factor for the staff. Another solution involved getting patients on board with this program. The POS collection system is not only beneficial to hospitals but also to the health care customers as well. (Souza, McCarty, 2007). This system provides a patient friendly billings which ensures transparency in the way customers are asked to pay for health care services. The payment system that is in force in other parts, bills the patient after he or she has already received the services and has already left the hospital. However, the Sutter program introduced transparency as the patient then gets to know what the services will cost him or her before they receive the services. It has become evident that patients would love to know how much the care they receive will cost them and this is what the Sutter program has provided. This system also offers a simplified system of settling hospital bills thereby making things easier for customers using said hospital system, customers are usually compelled to produce a lot of records and documentations in order to have their payment processed which introduces a lot of inconveniences. There is more accounting practices that are used by Sutter in identifying and solving problems, such as Sutter was discontented with the amount of revenue being collected from the self-pay patients (Souza, McCarty, 2007). The management team understood that the self-pay CASE ANALYSIS OF SUTTER HEALTH 7 patients were capable of meeting their medical expenses and therefore the problem was in their system. Sutter then resorted to evaluate the accountability and transparency in the process involved in the collection of revenue. It is through this evaluation that most of the traditional system did encourage responsibility and accountability to the people handling the revenue collection. Another accounting practice that was adopted was cost reduction. Accounting principles dictate that there are two major ways for increasing the margin; increasing profits or reducing costs. After exhausting all the avenues they could use in increasing revenue, Sutter embarked on a campaign that would reduce the cost of operation. This saw the collection process being integrated into a unified system. The methods used were also cost conscious, is why they opted for comprehensive training of their existing PFS and registration staff rather than hiring specially trained professionals, who would have demanded higher pay. Another alternative would be that Sutter’s strategies focused on improving accountability and autonomy of the staff in order to enhance revenue collection. Sutter health relied on solutions such as setting benchmarks and the empowering of staff. What they found to work was a full cycle of the amount payable. Amount payable refers to money owed to the institution by other parties while the full cycle refers to the amount of time it takes for the patients to settle their debt. (Rauscher, Wheeler, 2008). Reducing the full cycle may help to reduce the number of bad debts that a health institution suffers from. Traditionally a patient cycle followed procedures such as organizing schedule, registration, treatment, billing and collection (Solomon, 2011). The collection part is why the health institution is able to recover the debt owed to it by the patients. This section comes along after the treatment process is concluded and therefore increases the chances for bad debt. This paper proposes a system where bills are settled on a pre-service basis. The pre-service CASE ANALYSIS OF SUTTER HEALTH 8 system will be enabled by developing a system that standardized serves to make billing before the client receives services easier (Trans Union, 2007). A per item standardized billing is advised. This is why a standard is set for each and every hospital procedure and the patient is billed by summing up the cost of all service items he or she has utilized. In my informed opinion the approach used by Sutter Health was effective. This is because their approach was able to address the concerns raised by the network. Sutter health was concerned with the growing number of self-pay payments and the diminishing of the amount of revenue. The need to increase the amount of collecting from this section of market was the primary objective of developing this strategy. The success of every strategy is able to deliver the set goals. When it comes to Sutter Health it is estimated that revenue collection from the self-pay patients increased by an additional $78 million after the implementation of the strategy (Souza, McCarty, 2007). This is a clear indicator of the program’s success. One of the benefits is improved quality of care for the patient. One of the solutions identified by Sutter was bringing the health customer onboard. This system did this by factoring the customer’s needs into the system, making it customer friendly. The customer’s now spend less time processing payment while at the same time, the patient’s get to know of the cost they will incur before receiving the services. The system has also reduced the number of patients being denied treatment as a result of a streamlined inventory system. In conclusion Sutter Health is a non-profit network based in California and is made up of community based health care providers. This case discussed how Sutter developed a system that was able to improve revenue collection from the self-pay patients. Sutter recognized that the number of bad debts was rising along with the rising number of self-pay patients, This network conducted an evaluation on its facilities and identified that the problem of low revenue collection was linked to a disintegrated system of collection, in adequate accurate information CASE ANALYSIS OF SUTTER HEALTH 9 and poor performance indicators. Sutter Health employed solutions that entailed setting new benchmarks, empowering employees, factoring the customer’s interest and compressive training. References Rauscher, S. Wheeler, J. (2008). Effective Hospital Revenue Cycle Management. Journal of Healthcare Management Robertson, K. (Oct, 16, 1995). Sacramento Business Journal 12, 30: 3 Solomon, P. (2011). State of Healthcare Reform Revenue Cycle Retrieved from http://philcsolomon. om/2011/04/the-state-of-healthcare-revenue-cycle-an-insi ders- perspective-part-2/ Souza, M. McCarty, B. (2007). From bottom to top: How one provider retooled collection. Healthcare Financial Management 61 (9). 67-73 Trans Union (2007). Healthcare Collections: How Full Cycle Improvements Reduce Bad Debt. http://www. tranunion. com/docs/healthcare/businessneeds/healthcarecollectionsWP. pdf How to cite Case Analysis of Sutton Health, Essay examples

Human Resource Management of Constructive Relation at Top Trucking

Question: Discuss about the Human Resource Management of Constructive Relation at Top Trucking Company. Answer: Introduction: This report takes into consideration the inference of Human Resource Management and its relevance through the comprehensive examination of the case study of Constructive relation at top trucking company. The process of HRM assists organization in collating the available resources and distributing it in the productive track. This paper would be analyzing the significance of HR management in an organization that is challenging in nature, the practices, theories and models practical in similar sort of situations. Moving on, this paper would provide in-depth information of various practices of Human Resource Management, labor laws, transport workers union and along with behaviors. The case study would be properly analyzed with proper discussions on the same, highlighting the workplace observations initiated by the management for increasing productivity and proper coordination between workers and managers. It would also focus on the imperative role participatde by the new manager and the associated risks with the association and acceptability of union with its flexibility to such changes. Human Resource Management Role: Human resource management can be defined as a method that is being used by the organizations where human capital, an important resource is being cautiously managed, resourced and allocated to areas where it is required. The HR management in the trucking organization related to the case study was in the phase of transition. The companys Wollongong yard was the most popular in the area with a high performance manager having difficult nature. Within that particular region, the yard was getting enough admiration and the most significant provider of its high routine was George Psaros, their union delegate. He has been the main witness to the phase of evolution of the organization, offering support to both the union workers as well as the management. The organization was a popular one, though working there was an issue, as the manager who was positioned there was demanding along with being autocratic and dictating. The managements unwillingness to fund the infrastructure of the company led to it being acquired by a big national group transport. As per Caligiuri, (2014), the company was facing many dispute under the previous management with due respect to the approach of the manager who was authoritative and reluctant to recognize the perspectives of others. The drivers were unenthusiastic in changing that resulted in lack of participation along with causative to changes. Once acquisition was completed, the new management procuring numerous changes in the model along with practices at workplace within the company. HRM Model: The trucking organization established The Harvard Framework inside the organization with this model symptomatic of the line managers needing to admit more related to responsibilities in ensuring harmonization of individual policies and strategies related to competitiveness (Anurose Subrahamanyam, 2013). The model takes in the policies that are being positioned to govern the expansion of personal activities along with the implementation and the ways they can be allied with the objectives of organization. This model highlights employees as the key stakeholders other than the shareholders and customers. The Harvard Framework generates a source of four policies related to human resource which are human resource flow considering selection, recruitment, termination and promotional facet of the employees within the organization. Work system takes in scheming and administration workflow among the people and the Reward System that is being accomplished through motivating employees with respe ctive rewards along with recognition (Ahlvik Bjrkman, 2015). HRM Model Application: The management approved the Harvard Framework model, keeping prime focus on their workers and espousing various workplace observations in creating a prolific surroundings for them. The prevalent dispute faced by workers was with the line manager who was oppressive in nature and not willing to recognize critique. Appointed New Line Manager: As part of the flow of human resource, the administration recruited a new manager having the knowledge about the precedent behavior and conflict between the union and the old manager. The new line manager was open-minded unlike the previous one, appealing new ideas along with the workers perspectives. His selection was based on the competence level of handling tough situations and incensed union members along with their entrust George who has been the part of this system for long. The new line manager insisted on open conversation with drivers who were showing reluctance to change. He tried discovering issues realistically and allotted responsibilities to each depending on their ability. Infrastructure Change: The new management showed enough interest in investing capital in the infrastructure of the organization like purchasing new trucks unlike the old management. The truck drivers were adamant in discussing this major issue with their new manager. The new manager bought new uniforms for their drivers and invested added capital in the implementation of new computer system at Wollongong warehouse yard (Meijerink, Bondarouk Lepak, 2016). During the initial stages the workers did not accept these changes, but later on they did seeing the betterment of such changes. Health, Hygiene and Safety: The new manager strived hard in developing the health and safety related issues of the workers that would enable him to win their confidence. The management was constantly investing money in clearing out the dockyard for creating disinfected working conditions for workers. Training Development: The drivers along with the union delegates and the workers have been the part of the organization for long. From the companys perspective, it was significant in nurturing their talent and enhancing their skills of new progression and systems initiated in the organization. Therefore, the manager brought in certain developmental programs along with guidance for drivers, on the both technical aspect as well as the segment of customer service. Risk of Supporting Changes if manager or Union delegate move: An important facet that is being managed by the Human Resource Department is shifting to a new organization or to a new height in the same organization. This shift or movement is generally seen as the integral part of career growth or expectation of any sort of financial upliftment (Veloso, Tzafrir Enosh, 2015). In the given case study both George and the manager was a significant key source to the company. The manager was being assigned with a challenging task and he was successful in achieving that, whereas George was an older part of the system without any sort of promotion. Losing out on any of these two persons would jeopardize the performance and existing coordination among the various work flows within the company (Moore, Grunberg Krause, 2014). Risks with such decision are: -Sense of Insecurity: The manager was relatively new to this organizational system, though he worked hard in winning the workers confidence. His faction a bring in some sort of insecurity among workers in expecting future growth along with smooth operational flow between the workers and management. -Lack in confidence: In organization labor unions, the union delegate is considered with high respect with workers pinning their hopes on him. His movement can generate issues unsolved and not conversed to the needy channel in time. -Unbiased communication: It was in the habit of the line manager to share information related to the performance of the yard with the drivers, with this concept being a new one that enhanced greater level of synchronization among each other (Armstrong Taylor 2014). He kept the communication level straight and simple for everyone to prosper. In organizations, one of the important jobs for the HR management is retention of employees. It guarantees the staying of best talent within the organization as introducing a new member involves costs and time, lowering productivity. There may be various reasons on ways a person might opt for moving forward or moving out to a new level inside the company. The reasons for this might be better compensation, opportunities for working in challenging venture, dissatisfaction of employees and higher designation. Compliance of Workplace modifications- Blue Collar Union: The HR management journalism proposes that the transport workers are much acclimatized towards the changes in the workplace than as compared to the Service sector. The Blue Collar Union has been known as the workers union working as drivers, fire fighters and workers at shop floor. These workers in support of the union enjoy work life more as compared to people involved in private and service sector. The main categorizations of blue workers are those having manual skills with lower academic acquaintance (Form, 2015). These workers are regularly paid on the hourly basis or at times in weekly or monthly basis depending on the structure of the work. They are closer and more concerned about the union as an alternative of the management of the company they have been working. The job they perform have greater degree of demand in the market as their job needs more manual labor as compared to the workers in the service or private sector where importance is given on knowledge (Anurose Subrahamanyam, 2013). In some of the countries, it has been witnessed that the employees or workers working under the blue-collar union receives more payments than their white-collar counterparts do. Such people are mostly selected for the production department, having minimal management interface. A union representative gets chosen who negotiates and communicates with the top level executives on their beha lf. Employees those who have been working in the service and public sector can be classified among professionals related to their core academic along with experience professionally. Their professional degree plays a supporting role in their compensation and job responsibility designed in the organization. Such people do not enjoy much support from the union and their contribution and participation in union is minimal. Their views and opinions are varying regarding changes at workplace as compared to people in union, like the organizational workers union or transport workers union. The people those who are working for the public sector are much nearer to management and gets involved in the decision making process as balanced to transport union workers (Creese, 2015). For transport union, the administration has the power of bringing the changes similar to what was done in the top trucking company with prior consultation with the line manager, with union mostly agreeing to it along with the little availability of scope. Transport union workers acclimatize to the changes at the workplace in an accepting manner than those who have been working for service sector. Conclusion: According to the case study analysis performed on the Constructive relation at top trucking company, the accessing part has been on the new managements adoption of the Harvard Framework model in revamping the organization, implementing changes at workplace within the company. The manager was replaced along with bringing in of uniforms, new computer systems and training for required workers. The two important resources behind the trucking companys success is the new line manager and George, the union delegate. The contribution of both has been immense along with the risk associated with their shifting and movements that was evaluated in this paper. HR managements job retention has been restirring the best possible resources available within the organization, have been briefly analyzed in avoiding risk. It can be concluded that the workers who have been functioning for the transport union were much adequate with the workplace changes instigated by the executives. The line of conclusion have been drawn on the basis of categorization of blue collar worker related to their set of skills and differences in wage, having a say in unions along with their immediacy with management. References: Ahlvik, C., Bjrkman, I. (2015). Towards explaining subsidiary implementation, integration, and internalization of MNC headquarters HRM practices.International Business Review,24(3), 497-505. Alfes, K., Truss, C., Soane, E. C., Rees, C., Gatenby, M. (2013). The relationship between line manager behavior, perceived HRM practices, and individual performance: Examining the mediating role of engagement.Human resource management,52(6), 839-859. Anurose, T. J., Subrahamanyam, D. B. (2013). Improvements in sensible heat-flux parametrization in the high-resolution regional model (HRM) through the modified treatment of the roughness length for heat.Boundary-layer meteorology,147(3), 569-578. Armstrong, M., Taylor, S. (2014).Armstrong's handbook of human resource management practice. Kogan Page Publishers. Caligiuri, P. (2014). Many moving parts: Factors influencing the effectiveness of HRM practices designed to improve knowledge transfer within MNCs.Journal of International Business Studies,45(1), 63-72. Creese, G. (2015).Contracting masculinity: Gender, class, and race in a white-collar union, 1944-1994. University of Toronto Press. Form, W. H. (2015).Blue-collar stratification: Autoworkers in four countries. Princeton University Press. Meijerink, J. G., Bondarouk, T., Lepak, D. P. (2016). Employees as Active Consumers of HRM: Linking Employees HRM Competences with Their Perceptions of HRM Service Value.Human resource management,55(2), 219-240. Morris, M., Schindehutte, M., Richardson, J., Allen, J. (2015). Is the business model a useful strategic concept? Conceptual, theoretical, and empirical insights.Journal of Small Business Strategy,17(1), 27-50. Veloso, A., Tzafrir, S., Enosh, G. (2015). How employees perceive HRM practices: Differences between public and private organizations.Human resource management challenges and changes, 19-36. Moore, S. Y., Grunberg, L., Krause, A. J. (2014). The Relationship between Work and Home: Examination of White and Blue-Collar Generational Differences in a Large US Organization.Psychology,5(15), 1768.

Vietnam How Australia Got Involved Essays - Vietnam War

Vietnam ? How Australia Got Involved 1. In what way was Australia involved in Vietnam in 1965 ? In 1962 the Government of Australia decided in, response to a request from the South Vietnamese Government, to supply them with military aid. At that time, 30 instructors were sent to assist in the training of the South Vietnamese defense forces. Unofficially, in 1962, troops were sent in to train the South Vietnamese and act as a militia. The Australian public was not made aware of this until many years later after the conclusion of the war in 1972. In 1965, the war was officially declared and the public was made aware of this through the media. During this time (1965 to 1972) Australia supported the US and South Vietnam. However, Australia and the US were more concerned about the threat of a possible spread of communism rather than the well being of the South Vietnamese. In 1965, conscription was introduced to the Australian public in order to provide further assistance to the South Vietnamese. This was not widely supported by the public with many people refusing to attend the war and being putt in jail for a minimum of two years. 2. What were the reasons that Prime Minister Menzies gave that we should be fighting in Vietnam ? Both Robert Menzies and Lyndon Johnson were willing to send in troops for one main reason. Both Menzies and Johnson feared or were concerned about a possible spread of communism within South-East Asia and even as far south as Australia. They were not too particularly concerned about the well being of the Southern Vietnamese. This is portrayed further in ?For Australia's Sake' as a drawing of a communist man fighting in Vietnam with his shadow stretching down almost to northern Australia. Standing on the mainland of Australia is Menzies pointing at the threat. On top of this there is a comment in the drawing, ? A murky shadow has fallen over this part of the world, reaching to our very shores ?

the coldest winter ever essays

the coldest winter ever essays The Coldest Winter Ever is about a ghetto-born girl named Winter Santiaga. Winter is the young, wealthy daughter of a prominent Brooklyn drug dealing family. Winter is the oldest of four born daughters to Ricky and Momma Santiaga. (they dont mention her mothers real name.) Winter is quick-witted, sexy, business-minded, and she knows and loves the streets of Brooklyn like the curves on her body. (back cover of TCWE) Ricky Santiaga, Winters father, works his way up through the drug ring in Brooklyn until he is the top dog in the Brooklyn drug world. Even though Winter and her family live in the projects, the inside of their apartment is huge and is decorated extravagantly. For example, they have royal red carpets on the floors, top of the line furniture, a fully loaded entertainment center, equipment, and other luxurious things that they dont quite mention. Winter and her mother are both conceited and fashionable at the same time, they shop and spend lots of money all the time. When ever her mother goes out somewhere she was very well coordinated. For example, if she had on a zebra hat, she would wear zebra patterned Victoria Secret bra and panties, zebra patterned camisole, zebra skin pants, and even have a zebra design on her nails. Her mother didnt work because she believed that beauty was a full time occupation that left no room for everything else. She even got her hair done once every three days. Winter was the same way when she shopped, but she mostly bought sneakers, jewelry, and the expensive name brand clothing. Winter has three younger sisters in which she adored but sometimes hates babysitting and taking care of. She has two twin sisters, Mercedes and Lexus and another sister named Porsche, all named after cars. Winter often enjoyed babysitting her sisters because she didnt have to go to school. Winter only attended school just enough times so the authorities wouldn&ap...

Stress Management in the Workplace Essay Example | Topics and Well Written Essays - 750 words

Stress Management in the Workplace - Essay Example An incident that went in front of my eyes was when one of my peers had to face a very stressful situation at the hands of her boss who was constantly harassing her in one way or the other. This meant that she had to undergo immense mental and psychological torture which was bracketed under the heading of both sexual harassment as well as stress that she was taking almost on a daily basis. It left her into resigning soon after but with the help and assistance of a few friends that even included me; she went back to work and spoke to the human resources department about the same as well (Warn, 2003). This made her feel good because her irony was documented for and she felt valuable within the domains of the organization nonetheless. The reason why she was holding back her thoughts and feelings was due to the fact that she was her subordinate and did not know how to go about dealing with such a delicate matter involving her superior. Once her friends exclaimed to her that she had to get her act together and take back her resignation because it was uncalled for, things were set right immediately. The workplace stress was such that she had started to believe that the mistake was hers and that she was a victim of some form of shortcoming on her own part, which was simply not the case at all. Her friends made her realize that she needed to get her act together and speak to the human resources department to bring an end to both her stressful regimes as well as the harassment ordeal that she was going through. I found out that she got the courage after her friends at the workplace found out and they helped her get through to the relevant individual within the human resources department which was a very quintessential aspect of the whole debate nonetheless. There were quite a few learning that were done on my part. I found out that the stress

Catholiicism Assignment Example | Topics and Well Written Essays - 250 words - 1

Catholiicism - Assignment Example Another form of modern religious discrimination is generalization of traits, where an isolated case of irresponsibility is used to judge an entire religion. An example can be given of the child abuse scandal committed by catholic priests that was used to express disapproval of the entire Catholic Church and its teachings (Taylor 1). This case demonstrated that despite the tremendous efforts made by both the government and the various religious groups in the country, religious discrimination remains prevalent and there is need for increased efforts to sensitize people on the implications this form of discrimination has on the peaceful coexistence of communities. Although I have not experienced discrimination because of my religious beliefs, there remains a possibility of it happening. However, I plan to use the chance positively, to sensitize the other party on the importance of accommodating the beliefs of others even when those beliefs contradict with ours. It is only through continuous education that sustainable interventions on eradicating religious discrimination will be achieved. Taylor, Pamela. Catholics More Likely to Face Ethnic Bias than Religious Discrimination. Onfaith, 16 March 2007. Web. 18 Sept. 2014.

Nurse-led Clinics in Respiratory Care: a Literature Review

Nurse-led Clinics in Respiratory Care: a Literature Review INTRODUCTION 1. What is a nurse-led clinic? As the coined term suggests, a nurse-led clinic is a health care centre in which nurses are involved in high level specialist procedures and assessments. In such centres, nurses are the critical decision makers, being involved in patient care at the micro-, meso-, and macro-levels. While the role of the physician in the provision of health care is undisputable, the deity-like status that medical practitioners typically have in the mind of patients, coupled with the limited time available for individual patient consultations, make it hard for these group of health care professionals to tackle the ‘softer’ side of patient care. Nurses, on the other hand, defined by the Oxford Medical Dictionary as health care professionals that are trained and experienced in nursing matters and entrusted with the care of the sick and the carrying out of medical and surgical routines, are better placed to provide this essential follow-up, especially in the care of patients with chronic dise ases. According to Hatchett (2003), a nurse-led clinic is a clinic in which nurses have their own patient case loads of whom they take complete charge. Hatchett broadly describes the components of such a clinic. There would be an increase in autonomy associated with the nursing role in the nurse-led clinic, with the power to admit, discharge or refer patients, as appropriate. In Hatchett’s own words, the roles which nurses adopt in these revolutionary settings can be broadly classified as follows (Hatchett, 2003): Education Psychological support Patient monitoring The initiation of nurse-led initiatives probably owes its origins to the rise in nursing specialties in the United Kingdom. Throughout primary and secondary care, nurses are taking senior positions in health care institutions, such as nurse specialists, nurse practitioners, nurse consultants, nurse prescribers, etc, leading to a marked change in service delivery and the profile of the nursing profession. In addition to the usual registered nurse training, nurses working at higher levels of practice receive training to acquire a range of other medical skills such as physical examination and medical history taking in order to recognise abnormal clinical findings. In a two-phase exploratory study to evaluate the domains of structure, process and outcome of nurse-led clinics in supporting intermediate care after the acute phase of disease, Wong et al (2006) interviewed nurses from 34 clinics and 16 physicians and observed 162 nurse-led clinic sessions. Their findings demonstrated the high level of skill and experience of the nurses who ran the clinics. Their work involved skills such as adjusting medications and initiating therapies, and diagnostic tests according to protocols. Interventions included assessments and evaluations, and health counselling. All patients studied showed improvement after the nurse clinic consultation, with the best rates reported in wound and continence clinics; satisfaction scores for both nurses and clients were high. However, although physicians valued their partnership in care with the nurses, they were concerned about possible legal liability resulting from the advanced roles assumed by these nurses. Ultimately, nurse-led clinics provide an integral and invaluable patient-centred approach to the management of chronic disease which build upon skills such as counselling, teaching and health promotion which are key to contemporary nursing practice, as well as newly acquired medical skills. The advent if nurse-led clinics provides an opportunity for nurses to develop enhanced roles in which they can achieve more autonomy in their practice. This can be made a reality if adequate training and education, as well as effective leadership are in place (Wiles et al, 2001). 2. The general roles of nurses in chronic care management The chief nursing officer, Sarah Mullally has proposed ten key roles for nurses in autonomous patient care. These are outlined below as cited by Hatchett (2003): Order diagnostic interventions: just like a medical practitioner would, the present-day nurse is able to ask for laboratory or clinical diagnostic tests to aid the process of diagnosis. Furthermore, a well-trained nurse will also be able to read and interpret laboratory results effectively Make and receive referrals directly: while the all-important roles of nurses are recognised, the need for a multidisciplinary approach to patient care remains key in order to optimise patient outcomes. Accordingly, nurses should be able to recognise the patients’ needs and refer them to the appropriate health care service as required. Similarly, nurses should be ready to accept referrals from other health care disciplines as necessary. Admit and discharge patients for specified conditions, within agreed protocols: in order to make the best use of the often limited hospital resources, a nurse should have the power to recommend patients for hospital admission and subsequent discharge Manage patient case loads: in nurse-led clinics, nurses are also responsible for managing their individual case loads. It is important to delegate patient cases to other members of the team, when necessary to ensure that patients receive the best care possible. Run clinics: the autonomous role of the nurse in a nurse-led clinic includes all aspects of the management and day-to-day running of the clinic. Prescribe medications and treatments: nurse prescribers are able to advise patients on appropriate treatment, based on diagnosis of ailment and individual characteristics and laboratory findings. Carry out a wide range of resuscitation procedures, including defribillation Perform minor surgery and outpatient procedures: especially in injury clinics. While nurses are probably not equipped to carry out full-fledged surgical operations alone, they are trained to conduct emergency processes as appropriate. Triage patients, using the latest information technology, to the most appropriate health care professional Take a lead in the way local health services are organised and in the way they are run Nurses have always been considered as a supplement to the fundamental care provided by medical doctors. In fact, in some geographical regions, nursing roles are limited to menial tasks such as changing bedpans etc. In the new age, the nursing role as we know it is becoming increasingly important with nurses taking on infinitely more clinical roles. This has led to controversial debates with critics arguing that nurses cannot replace doctors in the provision of health care services. As Richard Hatchett very astutely pointed out (2003), the increased autonomy being acquired by nurses is not a bid to compete with medical doctors. Instead, â€Å"it is a case of considering who can provide the most appropriate service to the patient† (Hatchett, 2003). Thus, it is clear that the roles of nurses in chronic care management is very diverse and can be integrated into any nurse-led clinic intervention to the utmost benefit of the patient and all stakeholders. There have been numerous studies on the role of nurses in the care of patients with chronic diseases. In addition, and more specifically, the feasibility and benefits of implementing nurse-led clinics in practice have also been investigated to some extent. In the subsequent sections, we will review the evidence to support these innovative nursing interventions in an attempt to make the best use of health care resources. 3. Nurse-led clinics in the management of chronic care diseases: the evidence The World Health Organization (2002) defines chronic diseases as health care problems that require ongoing management over a period of years or decades. The nature of these disease conditions make it necessary to provide long term care and follow-up for the afflicted patients. Nurse-led interventions have been investigated a wide range of chronic diseases. It could be a logical, user-friendly, cost-effective and practical approach to improving long-term patient outcomes and should be explored fully to maximise the contributions of nurses to the chronic care management. Although this review aims to analyse the effectiveness of nurse-led clinics in the treatment of respiratory diseases, a prior look at the role of these interventions in the management of other chronic care diseases will provide an insight to the general contributory roles of nurses and will serve as a foundation for complete understanding of this state of the art intervention. 3.1 Nurse-led interventions in the management of diabetes Numerous studies have evaluated the benefits and practicalities of nurse-led clinics in the long-term management of diabetes. The renal diabetic nurse specialist is described as an â€Å"essential player† in organising the management of, and to meet, all aspects of need of this group of patients (Marchant, 2002). An unintended benefit of a nurse-led clinic to reduce cardiovascular risk is improved glycaemic control, HbA1c (Woodward et al, 2005). In particular, nurse-led diabetic clinics have been shown to benefit specific ethnic groups. Matthias et al (1998) identified the needs of diabetic patients from minority ethnic groups, such as blacks and Asians and postulated that nurse-led clinics were of particular benefit in this patient group. As epidemiological data show that diabetes is most common in minority ethnic groups (Carter et al, 1996), the importance of these innovative interventions is further emphasised. 3.2 Nurse-led interventions in the management of cardiovascular disease Care of patients with cardiovascular diseases is broad and involves many aspects, from risk factor management (non pharmacological interventions), primary and secondary prevention of clinical events, pharmacological therapy, surgical procedures, etc. Through a large well-designed randomised controlled trial in Scotland, Campbell et al (1998) showed that nurse-led clinics were practical to implement general practice and led to an significant increase in various aspects of the secondary prevention of coronary heart disease. Significant improvements were noted in aspirin management, blood pressure management, lipid profile management, diet and physical activity, regardless of the individual patient’s baseline cardio performance or status. However, surprisingly, there was no recorded improvement on smoking cessation, which would have been a beneficial intervention in most acute and chronic disease states, including respiratory diseases. In addition to the apparent effectiveness of the nurse-led clinics in the long-term primary and secondary prevention of coronary heart disease, the optimal use of nurses in the care of these patients has been shown to be cost-effective in terms of quality adjusted life years (QALYs) (Raftery et al, 2005). In this large cost-effectiveness analysis, although the cost of the nurse-led clinic intervention was  £136 higher per patient, the differences in other National Health Service (NHS) costs was not statistically significant. Furthermore, there were 28 more deaths in the non-intervention group leading to a gain, in the intervention group, in mean life-years per patient of 0.110 and of 0.124 QALYs. 3.3 Nurse-led interventions in rheumatology The role of clinical specialist medical doctors in the care of their patients is unquestionable; however, the role of nurses in the therapy area of rheumatology (i.e. in patients with rheumatoid arthritis) is also well documented. Hill and colleagues (1994) clearly demonstrated the effectiveness, safety and acceptability of a nurse practitioner in a rheumatology outpatient clinic. Although this was a small study with a sample size that only included 70 patients, the statistical significance of the findings of this randomised controlled trial cannot be ignored. In patients managed in the Rheumatology Nurse Practitioner clinic, pain, morning stiffness, psychological status, patient management and satisfaction all improved significantly (p = 0.001; p = 0.028; p = 0.0005; p In addition, patient satisfaction is frequently higher in patients who are allocated to nurse care than those allocated to standard medical care (Hill, 1997). In yet another study by Dr Jackie Hill, a registered nurse at the Academic and Clinical Unit for Musculoskeletal Nursing in the Chapel Allerton Hospital in Leeds, the researchers concluded that a nurse-led clinic is effective and safe and is associated with additional benefits, such as greater symptom control and enhanced patient self-care, compared with standard outpatient care. 3.4 Nurse-led interventions in cancer care The effectiveness of nurse-led care in different common cancer afflictions has been researched variously. An extensive review article by Loftus and Weston (2001) discussed the patient needs that could be met by nurses working in nurse-led clinics and highlighted the experience and skills of advanced nursing practice that make such innovative care a reality. The types of nurse-led interventions are as varied as the different types of cancers for which they are used. These range from nurse-led telephone clinics in patients with malignant glioma (Sardell et al, 2001); nurse-led follow up in patients receiving therapy for breast cancer (Koinberg et al, 2004); and nurse-led screening programmes in Hong Kong Chinese women with cervical cancer (Twinn and Cheung, 1999). In a randomised controlled trial in a specialist cancer hospital and three cancer units in southeastern England, Moore et al (2002) assessed the effectiveness of nurse-led follow-up in the management of patients with lung cancer. The findings of the study showed high levels (75%) of patient acceptability. This negates the possibility of patients’ reduced confidence in nurses’ ability and preference for standard medical doctor care. Clinical outcomes were also greatly improved as shown by less severe dyspnoea at three months (p=0.03), better scores for emotional functioning (p=0.03), and less peripheral neuropathy at 12 months (p=0.05). 3.5 Nurse-led interventions in the management of HIV infection Using a rigorous model of comprehensive care nurse-led clinic in genitourinary medicine to compare nurse-led and doctor-led clinics at a central London medicine clinic, Miles and colleagues (2003) reported reliable and valid results to support the use of the nurse-led variety as an acceptable alternative to the existing doctor-led clinics. More specifically, the British HIV Association (BHIVA)/British Association for Sexual Health and HIV (BASHH) advocate the benefits that can be accrued from a nurse-led educational intervention in the care of patients with HIV infection (Poppa et al, 2003). A small pilot study that investigated the effects of a 6-month nurse-led educational programme reported that improved virological responses were seen in treatment-experienced patients (Alexander et al, 2001). While a majority of the studies on nurse-led clinics in other chronic diseases can be broadly applied to nurse-led care in patients with respiratory diseases, differences in the nature of these diseases and the necessary care pathways mean that the extent to which these tested interventions can be applied to other therapy areas is, in actual fact, limited. Government policies that advocate the clinical and economic effectiveness of nurse-led interventions frequently pool together evidence from all therapeutic areas. Indeed, it can be hypothesised that, if nursing interventions are shown be practical alternatives for medical care in complex diseases with poor prognoses, such as cancer, HIV and coronary heart diseases, care of patients with respiratory diseases which generally have better prognoses should be easily, effectively and safely undertaken by qualified and well-trained nurses. Nevertheless, these findings of the effectiveness of nurse-led interventions in the numerous chronic diseases explored in previous sections, should be applied to the different patient population with respiratory diseases. As much as possible, research findings from similar patient groups should be applied in clinical practice in order to ensure that evidence-based practice in this case is relevant. 4. Government policies influencing the establishment of nurse-led clinics Government health policies in the United Kingdom actively support the extension of nurses’ skills into areas such as nurse prescribing and the development of nurse practitioner posts (NHS Plan 2000; Department of Health). Government initiatives that that strive to reduce consultation waiting times and optimise the use of medical practitioners indirectly support the establishment of nurse-led clinics. The Government has endorsed the implementation of nurse-led clinics as a means of increasing access to specialist health care and treatment more quickly and also as an effective way to manage chronic conditions (Hatchett, 2003). In the Department of Health (1999) document, ‘Making a difference’, government plans for strengthening nursing contribution to health care is presented. The Government has launched an ambitious programme of measures to improve the National Health Service and the health of the public, and the role of the nursing profession in this initiative cannot be overemphasised. The key nurse-related points of the document are outlined below: To extend the roles of nurses, midwives and health visitors to make better use of their knowledge an skills – including making it easier for them to prescribe To modernise the roles of school nurses and health visitors in supporting the new health strategy and other policies To see more nurse-led primary care services to improve accessibility and responsiveness The document highlights numerous nurse-led initiatives that have been effectively implemented all around the United Kingdom. A nurse-led minor injury service in rural Cornwall has provided patients with a number of benefits: easier accessibility, reduced waiting times, reduced need for on-site medical; attendance, increased patient satisfaction and reduced need for transfers to local Accident and Emergency departments. Similarly, a nurse-led rapid response team in Peterborough responds to acute crisis cases and allows patients to be nursed at home. Evaluation has shown that 71% of patients referred to this ‘hospital at home’ service would have been admitted to hospital if the service did not exist. Other effective live nurse-led services include a nurse-led rheumatology service in Merseyside and a nurse-led intermediate care unit in Liverpool. Furthermore, several nurse interventions are advocated in the document for contributing to the management of cardiovascular disease. Several of these are also applicable to respiratory diseases; these include: Smoking cessation clinics using national smoking cessation guidelines Healthy lifestyle clinics in collaboration with other health professionals to address factors such as diet, nutrition and exercise, thus improving overall health Care for patients with congestive cardiac failure under ‘home-based’ initiatives Nurse-led chest pain clinics or risk factor screening and reduction clinics Nurse-led blood pressure clinics to identify and help manage blood pressure disorders and medication adherence 5. Review objectives The objectives of this review are: To briefly summarise various studies on effectiveness and cost-effectiveness of nurse-led interventions in common respiratory diseases To critically appraise the methods employed by these studies To evaluate, interpret, and where possible, compare the findings of the various studies To explore the applicability and generalisability of the results to practice in the appropriate patient population To make suggestions for future studies in this area. METHODS Literature search A search of two major databases, MEDLINE and EMBASE, was conducted to identify articles published from 1990 through 2008. Search terms that were used include nurse, nurse-led clinic, nurse-led interventions, respiratory diseases, asthma, chronic obstructive pulmonary disease, bronchiectasis, tuberculosis, cystic fibrosis, cost-effectiveness analysis, cost-benefit analysis, and economics. A secondary search of the reference lists was then conducted to identify relevant articles, editorials, and other unoriginal reports that may have been missed in the primary search. Some studies were excluded based on the following criteria: They were not conducted in patient populations with respiratory diseases Independent nurse-led interventions were not investigated The study populations being investigated were mixed in terms of diagnosis, which would affect the integrity of the study findings for respiratory diseases The methodology and/ or statistical analysis methods were not clearly elucidated 6. Nurse-led clinics in the management of respiratory diseases: a review of the evidence The role of the specialist respiratory nurse has evolved since the early 1980’s with the support of the Royal College of Physicians (RCP 1981). The possible complexity of respiratory patients’ regimens necessitates support with various aspects of their care plans, such as: Supervising nebuliser and inhaler techniques Monitoring progress, i.e. by periodical assessment of lung function and exercise capacity Education on the specific disorder, medications, potential adverse events, etc Counselling and education on positive lifestyle, or non-pharmacological, changes Adherence support and monitoring The role has developed further with nurses providing nurse-led clinics in chronic obstructive pulmonary disease (COPD) and asthma along with nurses providing early supportive discharge and ’hospital at home’ for patients with COPD (French et al, 2003). Some schools of thought argue that nurse-led clinics would culminate in the neglect of the more traditional nursing roles, as nurses focus on a more medical-focused aspect of patient care. However, research in other therapy areas, such as rheumatology (Hill et al, 1994) and mental health (Reynolds et al, 2000) shows that nurses can effectively combine the medical role with the traditional nursing approach. Nursing care strives to provide a holistic approach to care through practical management of disability, education and counselling and referral to other health care services as required (Rafferty and Elborn 2002). 6.1 Bronchiectasis Nurse-led clinics have been evaluated, compared with regular doctor-led clinics, in a single randomised controlled trial in patients with bronchiectasis, a respiratory condition in which there is widening of the bronchi or their branches (Sharples et al, 2002). The study was a randomised controlled crossover trial including 80 patients in a bronchiectasis outpatient clinic. Patients received 1 year of nurse led care and 1 year of doctor led care in random order, and were followed up for 2 years. Various outcome indicators were used in the comparison, including lung function and exercise capacity, infective exacerbations, hospital admissions, quality of life and cost-effectiveness of the intervention. The results of this study are illustrated in Table 1 below. Table 1: Nurse-led and doctor-led care in care of patients with bronchiectasis (Sharples et al, 2002) Measurement outcome Nurse-led Doctor-led Mean difference (95% CI) p-value Forced expiratory volume in one second (FEV1) (%) 1.87 1.86 0.01 (-0.04 to 0.06) Forced expiratory volume in one second (FEV1) (L) 69.7 69.5 0.2 (-1.6 to 2.0) Forced vital capacity (FVC) (%) 87.6 87.6 -0.02 (-1.5 to 1.4) 12 minute walk distance (m) 765 746 18 (-13 to 48) Infective exacerbations (patient years of follow up) 262 (79.4) 238 (77.8) 0.34 Hospital admissions attributable to patient’s bronchiectasis 43 23 0.22 As the table above clearly shows, there was no statistical difference in FEV1/FVC percent predicted or distance walked between nurse led and doctor led care in the two treatment periods. Furthermore, 262 episodes of infective exacerbations were recorded by patients in the nurse practitioner-led care group in 79.4 patient years of follow up, compared with 238 in 77.8 years in the doctor-led care group. Thus, nurse practitioner-led care is associated with a relative rate of exacerbations of 1.09 (95% CI 0.91 to 1.30), p=0.34. Using the St Georges Respiratory Disease questionnaire to assess differences in health-related quality of life between the two groups, there was no statistically significant differences in each of the scores for Symptoms, Control, Impact or total score. Also, the study showed that nurse-led care resulted in significantly higher costs per patient compared with doctor-led care; this was largely due to the difference in the number of hospital admissions and intravenous and nebulised antibiotic costs. The authors concluded that nurse practitioner-led care for stable patients within a chronic chest clinic is safe and is as effective as doctor led care, but may use more resources. This study has several potential limitations which could invalidate the findings. As the study relied on patient report to record the prescriptions issued by general practitioners, these may have been underestimated and could grossly affect the cost analysis. Conversely, the nurse practitioner was required to record prescriptions and tests issued at the clinic, and thus these records are probably more reliable and she would be more likely to have ensured that patients left with supplies of routine treatment. Another possible drawback of this study is the use of a crossover design in the methodology. Unless a wash-out period is incorporated in the study design, there is the possibility of a carryover effect with crossover study designs, with the danger that the effects of the earlier treatment is falsely attributed to the final experimental treatment. In this study, there was no allowance for a washout period and thus this could affect the reliability and validity of the study results. This order and time effect needs to be checked for within the analyses but it can rarely be excluded as potential biasing factors (Pocock 1983). However, as recruited patients received the interventions in random order, this may negate the carryover effect. Despite the possible limitations of the study that could potentially hinder its applicability in practice, the findings support the implementation of a nurse-led clinic in patients with chronic cases of bronchiectasis as an alternative to the standard rigid medical care. 6.2 Asthma Similar to the findings in the study by Sharples and colleagues (2002) in patients with bronchiectasis, Nathan et al (2006) more recently compared the effect of follow-up by a nurse specialist with follow-up by a respiratory doctor following an acute asthma admission. In a single centre prospective randomised controlled trial, 154 patients admitted with acute asthma were randomly assigned to receive an initial 30-min follow-up clinic appointment within 2 weeks of hospital discharge with either a specialist nurse or respiratory doctor. The intervention comprised a medical review, patient education, and a self-management asthma plan. Further follow-up was then arranged as was deemed appropriate by the corresponding doctor or nurse, and all patients were asked to attend a 6-month appointment. Despite hospital outpatient follow-up, there was a significant proportion of patients in both groups who had exacerbations. However, there was no statistically significant difference between the two groups (Table 2). In the same manner, there was no statistically significant difference in quality of life assessed with two different validated questionnaires, the Asthma Questionnaire and the St George Respiratory Questionnaire. Mean change in peak flow at 6 months was similar between the two groups, probably indicating equivalence of the two tested interventions. Nathan et al (2006) concluded that follow-up care by a nurse specialist for patients admitted with acute asthma can be delivered equivocally with comparable safety and effectiveness to that traditionally provided by a doctor practitioner. Table 2: Nurse-led and doctor-led care in follow-up care of patients admitted with acute asthma (Nathan et al, 2006) Measurement outcome Nurse-led Doctor-led Odds ratio (95% CI) Mean difference (95% CI) p-value Change in peak flow 1.39 (-3.84 to 6.63) 0.122 Infective exacerbations (%) 45.6 49.2 0.86 (0.44 to 1.71) 0.674 Quality of life 87.6 87.6 -0.02 (-1.5 to 1.4) Asthma Questionnaire 0.78 (-0.64 to 2.19) 0.285 St George Respiratory Questionnaire 1.08 (5.05 to 7.21) 0.891 The possible limitations associated with this study is the large amount of missing data for some outcomes, especially peak flow and quality of life

Do you think that Mary Tudor deserved her title “Bloody Mary”?

History has not been kind to Mary Tudor. Compared to what followed, her reign seems like a brief but misguided attempt to hold back England's inevitable transformation to Protestantism. Compared to what came before, her regime looks like the regressive episode of a hysterical woman. Considered on its own terms, however, the regime appears much more complex, leading contributors to this volume of essays to reach far different conclusions about her reign: reestablishing traditional religion in England was an enormous undertaking that required rebuilding the Marian Church from the bottom up.Moreover, given more time it might have succeeded. Finally, as these essays continually remind us, concepts differentiating Catholicism from Protestantism — ideas taken for granted today — were still being sorted out during this period. David Loades's introduction begins the volume by surveying the disturbance in religion during Mary's lifetime. He links the spread of humanism and class ical scholarship to a substantial portion of this disturbance because it created an educated populace capable of raising questions about religious practices for which the traditional Church had no answers.Mary herself received a first-rate humanistic education and contemporaries even considered her well-educated. Loades suggests that, instead of unquestioningly embracing the tenants of the traditional Catholic faith, Mary was a â€Å"conservative humanist with an extremely insular point of view† (18). Nevertheless, her humanistic training did not extend to her devotion to the sacrament of the altar and her uncritical acceptance of the doctrine of transubstantiation. Ultimately, her uncompromising position on the latter would cause the downfall of many.After this introduction, the first section of the volume, entitled â€Å"The Process,† explores obstacles confronting the restoration of Catholicism in England, beginning with David Loades's examination of the degraded st ate of the episcopacy upon Mary's accession, and her administration's attempts to restore it. Next, Claire Cross discusses Marian efforts to enact Catholic reforms in those strongholds of Protestant dissent, the English universities. The queen's decision to restore a community of monks at Westminster is the subject of a study by C.S. Knighton, who includes a detailed appendix identifying members of this community.In the section's last essay, Ralph Houlbrooke argues that swift acquiescence by one of Norwich's leading evangelical ministers, and the diligence of clergy and Church courts in upholding the Marian restoration, helped Norwich avoid large-scale persecution. Essays in the volume's second section, â€Å"Cardinal Pole,† focus on his role in reestablishing the legitimacy of the restored Church. Thomas F.Mayer begins with an analysis of various court documents, and concludes that even though Paul IV had apparently revoked Pole's legatine office, the matter remained unsettl ed, and Pole probably continued to function in that capacity until the end of Mary's reign. In the following chapter, Pole's 1557 St. Andrew's Day sermon provides evidence for Eamon Duffy's defense of the cardinal's record — not only as an outspoken advocate for the importance of preaching, but also as a hard-nosed realist confronting an entire population of apostatized Londoners.In the final essay of this section, John Edwards reveals that, unlike English documents, records from the Spanish and Roman Inquisitions indicate greater Spanish involvement in the restoration of English Catholicism than has been previously recognized. The subject of the final section of this book, â€Å"The Culture,† undertakes issues regarding the Marian Church and its people. Lucy Wooding's essay considers how the multiple layers of symbolism found in the Mass provided a wide focal point for popular piety in the restored Church.In his essay on the theological works of Thomas Watson, William Wizeman, S. J. , discusses Marian efforts to reeducate worshipers who, after a generation of religious turmoil, were unfamiliar with even the basic tenets of Catholicism. In the following chapter, Gary G. Gibbs reconsiders the eyewitness evidence provided by one Henry Machyn, Merchant Taylor of London, concluding that the Marian regime had indeed connected with enough loyal subjects to provide the queen with an effective base of power