Personal Reflection on My Dressing Essay Example | Topics and Well Written Essays - 750 words

Personal Reflection on My Dressing - Essay Example As such, I do not wear tight clothes, revealing clothes, or any clothes that disregard my cultural ethics. Indeed, my cultural beliefs and respect for my traditions define my dressing and body adornment. My personal beliefs and values forbid me from wearing clothes that will expose my masculinity. Moreover, I dress to satisfy my emotions and to remain fashionable. I also consider my position in the society and the need to respect others while dressing. As I seek to maintain my dignity, I do not envy body adornments like tattoos since they demean personal beliefs and cultural values, which forbid men from body adornments. I believe in time management and hence I wear watches and choose stylish dressing to keep pace with the modern fashions. Assuredly, I dress to please myself and remain ethical in the diverse society. The main factor that defines my choice of clothing is to express my feelings and represent my personal beliefs and values. Moreover, the need to remain ethical and manif est professionalism influences my dressing decisions and choices. In addition, my cultural values and parental guidance influence my choice of dressing as I seek to respect my parents and tradition through my dressing. Notably, my parents are the custodians of my cultural dressing beliefs. Nevertheless, the need to embrace modernity and remain fashionable forces me to balance between cultures and fashion in my dressing. The weather also influences my dressing choices as I seek to adapt to different climates and remain healthy. Moreover, my sporting needs and decency requirements define my dressing. The need to visit different venues also defines my dressing choices since the workplace and attending lectures will require specific clothing. I also choose my dressing with reference to the respect, ethics, and morality that I seek to present to the society.

Flat Tax in UK Essay Example | Topics and Well Written Essays - 1000 words

Flat Tax in UK - Essay Example Central government, however, generates its revenues mainly from income tax, national insurance contributions, value added tax, corporation tax and fuel duty. Definition: "A flat tax, also called a proportional tax, is a system that taxes all entities in a class (typically either citizens or corporations) at the same rate (as a proportion of income), as opposed to a graduated, or progressive, scheme. The term flat tax is most often discussed in the context of income taxes."(Expert Report 2005) At first confined to academic conversation and a few small islands, the flat tax has lately been introduced in numerous of the ex-communist countries of middle Europe, counting latest members of the European Union. Additionally, Poland has announced its intention to adopt a flat tax system. As a result far none of the 'old' EU nations has taken this step, though Ireland is introducing a flat tax for companies (Feldstein). Hypothetically we could calculate an average rate of tax under the current multi-rate system, and charge everyone this rate under the flat tax. Though this would consequence in taxpayers (mainly the lower earners) paying more tax. In practice so most flat tax systems propose a single rate approximately the similar as, or lower than, the existing standard rate. This means that no-one will pay additional tax on the transition to a flat tax. Remove most tax allowances and deductions One of the advantages of the flat rate is its minimalism, in that taxpayers and collectors only have to use one rate of tax in their calculations. This straightforwardness is usually extended by removing mainly of the exact tax deductions surrounded by the accessible system that try to give stipend for exact circumstances or incentives for exacting activities. In part this removal of allowances is sensible since once a single low flat rate is introduced they turn out to be less important (HM Treasury, 2003). Greatly increased personal allowance The individual allowance is the basic amount that every taxpayer is allowed to earn free of tax. The majority flat tax proposals engage an important augment in this amount, first and foremost to make sure that all low earners are better off under the flat tax system (in lots of cases by being taken out of the tax net in total), even subsequent abolishing a lot of the precise allowances (Richard Teather). Apparently a flat tax will decrease the largely tax take, at least originally, unless it is set at the present average rate (in which case a lot of taxpayers would pay additional under the reforms than they do at present). Certainly raising the individual allowance considerably will also result in a substantial loss of tax revenue. But how much The majority people

Reflection On Experience Working In Accident And Emergency

Reflection On Experience Working In Accident And Emergency This fieldwork exercise was a visit to the Minors Department within Accident and Emergency (AE) for a large London National Health Service (NHS) hospital, to observe and interview an Emergency Nurse Practitioner (ENP) within the Department, and link their role in relation to primary health care (PHC). I had expected to learn further about the main connection between PHC and an acute care setting such as AE, assuming that it would be due to poor PHC management and issues with accessibility. These assumptions were based on some experience in AE as an Agency Nurse, along with colleagues, patients and media reports. 2.0 VISIT TO MINORS IN ACCIDENT EMERGENCY My fieldwork exercise began with covert observation in the AE waiting room, waiting for my fellow Nurse Practitioner (NP) student to arrive for a Saturday night shift. There were around 15 people and one child within the waiting room; a relatively calm environment, albeit for quiet restlessness, sighing, guarding and rocking, questioning companions as to when they would be seen, alongside comparing with others who had got in. Reception was a glass-shielded counter staffed by two personnel, informing patients registering, that there was a three hour wait. An electronic sign above reception welcomed patients, friends and relatives to the hospital, also informing them that we endeavour to see you in 4 hours; a reference to the Department of Healths (DoH) target, for patients to be discharged, admitted or transferred within four hours of presenting, in 98% of cases. The sign also requested for those with a minor illness, to attend the adjacent walk-in centre (WIC). Of note, aside from a clear focus on hygiene, was a sign notifying patients that treatment may not be free if not a United Kingdom (UK)/European Union citizen or resident. Such signage brings a principle of the Alma Ata declaration into question. The Alma Ata declaration arose following a joint World Health Organisation-UNICEF international conference, with a vision for healthcare for all people worldwide, with PHC at the heart (World Health Organisation, 2010). Although it can be argued that international guests are not paying into the NHS, and healthcare in the UK is not essentially free, given the National Insurance levy, the declaration views healthcare as a right for all, and not just those who are in a position to pay. On arrival, my fellow NP student showed me around AE. Within the adults section, the Department can be broken down to: Table 1: AE layout Department/Room Cubicles/Rooms Additional/Other Information Resuscitation 5 +1 paediatric cubicle Majors 16 Including 1 psychiatric cubicle Minors 12 Assessment/Triage 3 Clinical Decisions 10 Investigations and short term treatment (not more than 24-36 hours) Eye 1 Ear, Nose Throat 1 Plaster 1 X-Ray 1 Adjacent CT room being built next to Resuscitation The hospital is one of Londons major hospitals, opening in the 1700s in central London and developing into a main teaching hospital. With the increase in healthcare demands, more space was needed, and the hospital relocated to its present day location in the 1950s. In the 1970s, construction on the present hospital building began, and by the early 2000s, building and the final relocation of one of its hospitals was complete (Hospital website, 2009a). The AE Department is a 24 hour service, seeing around 100 000 patients per year, and of those, around 21% are admitted to hospital. Twenty two percent are children, to which a separate paediatric AE between the hours of 9am and 2am is available (Hospital website, 2009b). From April this year, the AE Department will become one of Londons four major trauma centres (MTC), and one of eight acute stroke centres (Healthcare for London, 2010). Preparations for this new designation were evident by the building of a computerised tomography scanner next door to Resuscitation, enabling suspected stroke patients to be scanned within two minutes of arriving. I spent most of my visit in Minors, a Department with 12 cubicles, which is staffed by two to three ENPs, one Senior House Officer, Registrar support, and a General Practitioner (GP) on Saturday and Sunday evenings. Despite having an adjacent WIC, this section of AE is dedicated to patients with minor injuries and illnesses. The most common presentations are due to infections (mostly ears, nose and throat, and urology), foreign bodies, wounds, fractures and head injuries. Numbers seen can vary, and around 150 patients had already been seen that day. There is a difference between days and nights, with days mostly seeing occupational injuries and GP referrals, with alcohol, drugs, domestic violence, assaults and foreign bodies featuring in the nights. In addition, weekends and evenings can see Minors taking on the role of an extended hours GP practice; supporting my hypothesis of poor PHC management and accessibility, as being a key cause of PHC in AE. The Department closes at 3am to reduce costs, but is sometimes too busy to do so. From next year, Minors will be a 24 hour service, with the aim for a Nurse-led service with Registrar support. This is to release medical staff for the new MTC, and in response to recommendations in Lord Darzis review on healthcare for London, discussed further in this assignment. The most surprising element of my visit, was to find out that ENPs are viewed and treated as junior doctors. This was mirrored by the consultation: history taking, examination, assessment, plan of care and documentation was that of seeing a medical doctor. While I was aware of the advanced and autonomous role of a NP, enabling diagnosing, prescribing and referring, I was taken back that NPs, certainly in this Department, have shifted from the nursing side of healthcare, and are now affiliated with medicine. The ENPs line management is a Registrar, who also supervises and signs off competencies. Any problems or concerns which need to be escalated, are dealt with by the Consultant. The AE Matron, and ultimately, the Director of Nursing are nowhere in the ENPs reporting line. The role of NP, reviews of urgent care, and PHC management are the topics I have chosen to base my discussion on. 3.0 DISCUSSION 3.1 Urgent care reviews The key review of urgent care in London is Lord Darzis Healthcare for London: A Framework for Action report. It was commissioned by NHS London in December 2006, in order to fulfil Londons healthcare needs over the next 5 to 10 years. The report acknowledged that many patients presenting to AE for minor illnesses and injuries would be better looked after in polyclinics or urgent care centres (UCC) with longer opening hours. Patients presenting to AE is not optimal due to the waiting period and being seen by junior doctors rather than GPs, who more suited to these complaints along with managing long-term health conditions (Healthcare for London, 2007a). The report proposes UCC with diagnostic equipment, where patients will have access to a Nurse or GP, recommending 24 hour access if based in AE (ie. Minors), or to be open on weekends and afterhours for those not hospital based (Healthcare for London, 2007a). A co-located UCC within AE can be important, in diverting urgent care away from attending AE/MTCs (Healthcare for London, 2007b). However, the ENP reported problems recruiting fellow ENPs with appropriate qualifications and experience, and was unsure whether Minors would be a Nurse-led 24 hour UCC, to coincide with the transformation of the main part of AE into a MTC in April. The Darzi report received criticism, largely directed at cost cuttings, cashing in on privatisation, the demotion of acute hospital services, the question of elderly care, and that future predictions on PHC and AE usage was an understatement. There is also criticism that recommendations have been made without practicalities, including polyclinic staffing, failings and costs of minor injuries units, and the future of healthcare staff (London Health Emergency, 2007). The ENP reported a poor skills mix at the adjacent WIC, such as not being able to read x-rays or suture, with patients being referred on to Minors. Alongside the question of resources being doubled up, such referring on leads to disjointed care and greater waiting lengths to be treated. It could also be confusing for patients to know where the best place to attend is, especially having been diverted from AE to the WIC on the advice of the Reception sign, only to end back up in AE. Clarity and streamlining of services is needed to improve patient experience. The Royal College of Nursing (RCN) survey found that Emergency Nurses were under huge strain to meet the DoHs four hour target, termed as unrealistic (RCN, 2010: website). The survey also reported that the majority of respondents felt that patients with various and complicated needs, have had their care rushed to meet targets, and 59% of respondents feeling the responsibility lying solely within Nurses (RCN, 2010). Yet the ENP I spoke to was happy with the target, which gave momentum if a patient needed to be seen by a Registrar and had been waiting over an hour, this would then be escalated to a Consultant. On questioning, the ENP felt that the target was realistic, practical and they had the resources. 3.2 Primary health care management and accessibility London has the most AE attendances and admissions than anywhere else in England, and many of the 83% of patients not admitted could be treated elsewhere, with 40% of complaints able to be resolved through PHC. However, access to PHC services in London after hours is inadequate; a main thought behind AE attendance. AE patients are more likely to be fulltime workers and may take reassurance in knowing that they will be seen in four hours, rather than a wait of up to (or longer than) 48 hours to see their GP (Healthcare for London, 2007b). According to the ENP, patients report issues making GP appointments and that AE is quicker than seeing their GP, as the main reasons for presenting with PHC matters. The Healthcare Commissions (HCC, now the Care Quality Commission) review on urgent care in England, found that more than 50% of patients have problems calling their GP surgery, and a quarter of patients found GP hours were not convenient, and avoided going (HCC, 2008). Incentives for GP surgeries to provide afterhours care was a recommendation by The Royal College of General Practitioner (RCGP) in their review on urgent care (RCGP, 2007). Yet, the HCCs review found that where GP services provide afterhours care, less than half had organised a phone diversion with local GPs, to divert afterhours calls to their services. The majority of patients attending afterhours GP services are seen within two hours after an initial telephone assessment (HCC, 2008). This is not only faster than attending AE, but a more appropriate use of resources. The review found that many people are not aware of healthcare services other than their own GP and AE, or they might be unsure of using them. There were also examples of patients being referred to services that were not accessible. Work needs to be done to increase both patients and healthcare professionals understanding of alternative healthcare services, and when to use them (HCC, 2008). This is a view shared by the RCGP, along with GP practices implementing systems to deal with urgent care and GP training (RCGP, 2007). The ENP expressed frustrations with GPs making inappropriate referrals to AE, rather than to Specialists, generally noting the practice of defensive medicine. Despite referring back to the GP on discharge, patients were bouncing back for simple things, such as to have their dressings attended to. The ENP rarely had time to speak with GPs, but when they did, it was mostly to phone to question why they had referred. In respect to patients, the ENP felt that they were either not taking responsibility for their health or there was poor self management, possibly due to poor or no patient education, such as not taking analgesia and attending AE to request. The RCGP also note the need for improved patient education and self management promotion in their review (RCGP, 2007). The ENP was also very critical of NHS Direct, Englands telephone advice line for healthcare. They felt that the service was inadequate, as it was not possible to make an assessment over the phone, and defensively referring to AE. Yet half of callers to NHS Direct were given advice on self management at home (NHS Direct, 2010). 3.3 The role of the Nurse Practitioner 4.0 SUMMARY This fieldwork exercise has been a valuable experience. It has demonstrated the impact PHC has on AE, an already stretched resource, exacerbated by poor PHC management and accessibility. For these reasons, I will bear in mind my present practice and on qualification as a NP, to make seamless and appropriate referrals.

Teen Peer Pressure Causes Drinking and Driving Essay -- Peer Pressure

An average of one teen dies each hour in a car crash in the United States, and nearly 50 percent of those crashes involve alcohol, according to the National Highway Traffic and Safety Administration (NHSTA). Alcohol is the drug most widely abused by teens. Alcohol abuse occurs among all geographic, ethnic and racial groups. Teens easily succumb to peer pressure when deciding whether or not to use alcohol. Unfortunately, they lack the coping and judgment skills necessary to handle alcohol wisely. There are an estimated 3.3 million teen-age alcoholics in the United States. Adolescents who begin drinking before age 15 are four times more likely to develop alcoholism than those who begin drinking at age 21. Youth who drink alcohol are five times more likely to smoke cigarettes, four times more likely to smoke marijuana and three times more likely to use an illicit drug. Teens that use alcohol tend to become sexually active at earlier ages. Teens who use alcohol are more likely to be victims of violent crimes such as aggravated assault, robbery or rape. The use of alcohol by adolescen... Teen Peer Pressure Causes Drinking and Driving Essay -- Peer Pressure An average of one teen dies each hour in a car crash in the United States, and nearly 50 percent of those crashes involve alcohol, according to the National Highway Traffic and Safety Administration (NHSTA). Alcohol is the drug most widely abused by teens. Alcohol abuse occurs among all geographic, ethnic and racial groups. Teens easily succumb to peer pressure when deciding whether or not to use alcohol. Unfortunately, they lack the coping and judgment skills necessary to handle alcohol wisely. There are an estimated 3.3 million teen-age alcoholics in the United States. Adolescents who begin drinking before age 15 are four times more likely to develop alcoholism than those who begin drinking at age 21. Youth who drink alcohol are five times more likely to smoke cigarettes, four times more likely to smoke marijuana and three times more likely to use an illicit drug. Teens that use alcohol tend to become sexually active at earlier ages. Teens who use alcohol are more likely to be victims of violent crimes such as aggravated assault, robbery or rape. The use of alcohol by adolescen...

The Corporate Culture Between the Public and the Private Sectors

The foundations to organize company’s personnel are different between the public and the private sectors. These may also be different from one country to another or from one company to another according to the organization, the context of evolution and its environment. And from these foundations and values that are shared by all staff, a corporate culture is set. The corporate culture is a key variable to explain the daily life and strategic choices made by a social group. The corporate culture is in a sense, a product of national culture and therefore a set of values and signs shared by the majority of employees. Seen from the outside, all companies in a country are alike: workshops, warehouses, offices, constant movements of people and goods. Yet a detailed examination shows that no company is comparable to another, especially between public sector and private one, On the one hand there are for example statutes, recruitment through entrance exams and the automatic nature of salaries, and while on the other hand, there are for instance labour laws, individual goals expressed through contracts and the freedom to set pay scales, so each has its own personality, has a unique identity and image. This personality is forged around five themes: the status, recruitment, remuneration, the mindset of management and the environment in which the firm operates. One can see for example between a public sector company â€Å"assurance maladie† and a private company â€Å"axa†. Both operate in the same category of activity,  «assurance maladie † staff does not enjoy equal reassuring status than â€Å"axa† staff, the civil servant status is more securing than employee status. Even their recruitment are not the same, in the public sector recruitment is often done by concours what is not the case in the private sector. Another deference between the two sectors is shown in the system of remuneration, the latter is fixed by the state according to a pay scale with † assurance maladie † while in â€Å"axa† is set based on skills and level of responsibility added to motivations by objective system that is not the case in the private sector. The personality of a company also reflects the personality f its leaders, at â€Å"axa†, it is CEO who has a strong influence on the culture that the company wants to pass through goal setting and strategy of development. In assurance maladie even if it is managed by the state, each individual seeks to satisfy his need to belong without being dependent on the culture instilled by the state. In addition the public status of â€Å"assurance maladie † requires that it must be transparent about it s economic, financial or social situation which is not always the case with private businesses as â€Å"axa†. This lack of transparency oblige private company to suggest a human resources strategy that will seek to reconcile the interests of the company and the employees for a social peace, in order to show workers that they have an important place and an opportunity of promotion so they keep their motivation. The corporate culture is like a collection of complexes allowing each individual to identify with their organization. Facing an unstable environment and increasingly complex, firms seek to boost their human potential. The corporate culture seems to be a response to develop this potential. But we can still consider the fate of these concerns. The corporate culture, as strong as it is not eternal. Indeed the downsizing imposed to â€Å"axa† staff caused a sharp questioning of the culture because â€Å"axa† is shown as Paternalist Company that assured lifetime employment and high wages. If there there ‘s deference between â€Å"axa† corporate culture and † assurance maladie † culture is that it is also due to the model on which both businesses based, on one side â€Å"axa† being a private company that seeks to generate benefits inherited the U. S. management , in the other side model so that † assurance maladie † it follows the French model. The logical functional of American corporate culture is based on earnings so its organization is perceived primarily as a system of tasks, functions to perform and goals to achieve while in the business culture in France, the organization is designed primarily as a social system involving a community of people.

Geography Was the Primary Factor in Shaping the Development of the British Colonies in North America

Throughout the course of human history, geography has always played an essential role in the migration and development of various civilizations. It influenced the way people lived, the food they ate, and their entire life. For some colonies, the geography was perfect to live in, while others had to endure harsh conditions. When the Quakers first arrived to Pennsylvania, they were able to establish a successful colony through hard work, but their geography was what determined the success. The warm climate and fertile soil made it an excellent place to grow wheat, bread, and other profitable crops to supply more than enough for everyone. The Middle Colonies (New York, New Jersey, Pennsylvania, Delaware) did not only have fertile land, but they also had rivers and the sea for hunting fish and establishing ports. The ports made it accessible for the Middle Colonies to easily trade goods with Great Britain and other colonies, enticing foreigners such as the Germans and Scots Irish to settle down. On the other hand, the New England Colonies did not fare off as well as the Middle Colonies did, since the land wasn’t as fertile and the colonies was located on a rocky region, making it hard for plants to grow. When Jamestown was first established, the colonists faced a very difficult time because they were unprepared for the cold weather and lacked food to survive through the harsh climates. However, they were able to prevail and utilized the sea and abundance of trees, and eventually grew tobacco to become rich and successful. While geography played a significant factor in the development of colonies, one should also consider the influence of religion. People that wanted to escape religious persecution from the Anglican Church established colonies and soon, people flooded into the Americas. However, within these religious communities were those that had their own beliefs, and these people created their own colonies. For example, Roger Williams and Thomas Hooker had differentiating views of how the community should be run, and they were banished. Despite this banishment, Roger Williams eventually established Rhode Island, where he allowed complete religious tolerance and Thomas Hooker created Connecticut for much more lenient voting right requirements. Geography surely was a primary factor in the development of British colonies in North America as it determined the success or failure of the colonies, but religion also greatly influenced the development of the British colonies.