Four Steps for Business Analysis Essay

4. Four steps for business analysis are discussed in the chapter (strategy analysis, accounting analysis, financial analysis, and prospective analysis). As a financial analysts, explain why each of these steps is a critical part of your job and how they relate to one another? Answers: a. Business Strategy Analysis This analysis is help managers to identify key profit driver and strategy risk. Business strategy analysis includes analyzing a firm’s strategy and its strategy in order to create competitive strategy. Most managers set corporate goals and then start to formulate the strategies that help to achieve those goals. However the most critical is how two fundamental problems is the connection in approaching the strategic management. First, most business are engage in concerns and have set in certain activities that are a reflection from decision made in the past. Second, managers are tempted to engage in a strategic of the firm without understanding the health of their existing strategy. This can create a new problem for present strategy. After indicate a strategy process complete, the manager then can assess the quality of the strategy. b. Accounting Analysis The purpose of this analysis is to evaluate accounting quality system in a company by assessing of the stability, viability, and profitability of a business or a project. An accounting analysis carried out by professionals who know how to prepare reports and how to use of info obtained from financial statements and other reports. One of the key areas of accounting analysis is to conclude of company’s past performance into an estimate of future performance. Accounting analysis is includes of calculating ratios from the data to compare with other companies. c. Financial Analysis This analysis is use to calculate the investment value of a business, stock or other asset. There are two important skills need related to financial analysis. First the analysis has to be systematic and efficient. Second, allow the analysis to use financial data to explore company issues. Financial analysis can help an investor to get wealth of information about a company. Knowing relationship between ratios and what the function for future are key to determine future success. Financial statements are essential for business because this can help management to find information and knowledge for investor. d. Prospective Analysis This analysis is focus on forecasting analysis of future financial information of a company and the last step from business analysis. The key areas in this analysis are projecting income statement and projecting the balance sheet. The most important element is the forecasting of the revenue growth. This is based on PEST analysis; industry analysis; company-wide analysis. Forecasting has to be comprehensive including all financial statements. The key should be the key measures such as sales growth, ROE, and earnings. 3 Questions for discussion 1. What is the biggest effect after Dot-Com crash in 2000 for investors? 2. What are the primary factors that led to the burst of the Internet bubble? 3. What is the different between buy side analysts and sell side analysts?

Learning Theories Essay

Analytical and Sequential Learning. The student learns through a step-by-step method. He works out a problem in stages. He uses logic in his initial analysis as he looks at every single angle of the equation like in Algebra. He does it in sequence. He is very detailed and has to understand the problem right from the start, before he moves on to the next step. A Power Point Presentation will not work out with the Analytical and Sequential learner because of his attachment to details. He is not likely to appreciate and learn from a very generalized and summarized presentation. He would rather finish with the first step only when he has fully understood it before he will move to the next step. 2. Visual Learning. In this style, the student learns from what he sees. His focus is primarily on the visual aspects of the method like written words and figures, colorful designs and charts. He has to see things first before he understands them through other means or medium. It would be slightly difficult for him to understand a lecture in itself without some sort of illustration of the lessons. A Power Point Presentation will appeal to the Visual type of learner because of the pictures and figures in it, for him to digest the lesson further and easier. 3. Auditory Learning. Auditory learners are those who assimilate things through what they see. They learn best from oral lectures and verbal discussion. They are not distracted by sounds, like music, when studying. They understand directions better when these are given verbally. They are adept at grammar and foreign language skills mostly from just listening. Power Point Presentations may be partly effective only because of the sound effects that jolt them into attention, before they can be expected to absorb the written part of the presentation. The Auditory learners are on the slow side with visuals and written concepts. 4. Kinesthetic Learning. The Kinesthetic learners are those who learn best through the use of their hands, or the learning-by-doing style. They are the physically active persons who can not stay put for long and who need to take breaks every once in a while. As sit down lectures are not for them, Power Point Presentations will not be an effective learning tool for them. They are the kinds who are more into the observation tours outside of the classrooms. References Fleming, G. (2009). Analytical and Sequential Learning. About. Com. Retrieved May 1, 2009 from http://homeworktips. about. com/od/homeworkhelp/a/analytic. htm Fleming, G. (2009). Learning Styles. About. Com. Retrieved May 1, 2009 from http://homeworktips. about. com/od/homeworkhelp/a/learningstyle. htm

John Locke Questions Essay

1. John Locke describes the â€Å"state of nature† as a sort of equality between men. No man has any rights over the other, and they can be free in doing what they want. All being able to use the same faculties. Locke also explains that although they are free it does not give them the right to hurt one another because the â€Å"natural law† still exists even through the â€Å"state of nature†. Locke defines the state of nature as political power. This â€Å"state of nature† is basically where humans can exist without a government or social contract. And that people would follow this â€Å"law of nature† and would protect it against anyone who did not follow it. â€Å"The execution of the law of Nature is in that state put into every man’s hands, whereby everyone has a right to punish the transgressors of that law to such a degree as may hinder its violation. † Locke also mentions that eventually people would try to form a government to try to protect their rights further. The â€Å"state of nature† is more of a thought rather than something that actually happened in history. 2. John Locke explains that the reason why people leave this â€Å"state of nature† is because this â€Å"paradise† is uncertain and insecure. There is no guarantee that people will always go along with the â€Å"laws of nature† and everyone will think of others as equals. So it makes it harder for individuals to enjoy this â€Å"paradise† because they fear something might go wrong so they want to quit and become part of a political society where someone can tell them what to do with there freedom. This feeling is because of the â€Å"mutual preservation† of their lives, estates, liberties and a big part, property. Men want to join a government to protect their properties; it says that they would want a known law that is a standard for right and wrong. Also another issue with the â€Å"laws of nature† is the judging system it would cause a lot of anarchy within the people because if everything was so â€Å"equal† then wouldn’t you be equal with the judge and not have to abide by their rules and regulations? In addition Locke also states â€Å" there often wants power to back and support the sentence when right, and to give it due execution. † With this being said, if something were to go wrong they would not know what the consequence would be. Overall the â€Å"state of nature† system has a lot of flaws and would cause many conflicts. 3. The social contract that is laid out by john Locke is a contract between the legislature and the people. The people’s side of the contract Is that they follow the rules and regulations that the legislature creates. In addition the legislatures part of the contract is separated into four different promises. One of the promises they make is to make the laws apply to every class, rich and poor. Another promise that they made was not to raise taxes without having the consent of the people. The people must be fully aware of the tax changes. Thirdly all the laws have to be beneficial to everyone, not just one class or group of people. Lastly the legislature promises that only they can create laws for the good of the people. They decided this because if everyone was allowed to voice there own opinion about what the laws would be nothing would actually get established and there would be nothing but chaos among the people. Above all the contract is just to be for the good of everyone. 4. The government can be dissolved if the social contract is breached in certain scenarios. The basis of the society is the constitution. The constitutions purpose is to protect the ones within the society. When a member of the legislature goes against any of the four agreements that were made the people have a right to protest, peacefully that is. And if its serious enough fight against the legislative, thus â€Å"dissolving† the government. So basically the people have a right to â€Å"cancel ties† and create a new legislative that they feel will be more beneficial for the people, since the legislative before were not doing things that were fair or went out of their rights of being in the legislature. Since the people were the ones who were in control and ultimately chose them to be in power, they have the right to dissolve the government if there choices aren’t for the good of the people. 5. Locke’s philosophy is remarkably similar to the Declaration of Independence. Both articles have the same ideas of everything being for the people, and things being equal. It states â€Å"of the people, for the people, and by the people. † I believe that Thomas Jefferson made what he put in the Declaration with similar viewpoints that’s in â€Å"The Second Treatise of Civil Government. † Both talk about government and the society in the same way. The government was made to â€Å"secure natural rights†. If the government goes against their rights the people have a right to rebel in a certain way. And express how they feel about the matter at hand, to make a difference and change it. You can tell that Locke’s ideas influenced Thomas Jefferson, and that both go hand in hand when the Declaration of Independence was created. One similarity between the two is when Locke’s main ideas were â€Å"life, liberty, and property. † But Jefferson states â€Å"life, liberty, and the pursuit of happiness†. These statements are almost identical, with a minor change.

Impact of implementing clinical practice guidelines to prevent Literature review

Impact of implementing clinical practice guidelines to prevent pressure ulcers - Literature review Example The paper tells that over the years, researches and similar works have recognised the ill effects of extended immobility. In fact, Clavet, et al. found that immobility leads to skeletal degeneration, while Smorawiński, et al. found that immobility causes oxygenation problem. In addition, Paddon-Jones, et al. revealed that patients who stay bedridden for a long period of time experience loss of muscle mass, the severity of which depends on the length of immobility. Still, among the most adverse effects of immobility is the development of pressure or decubitus ulcers. Pressure ulcers are usually caused by the shearing effects of friction against the skin surface constantly in contact with the bed or mattress. They are a major concern for healthcare professionals because of their impact on the patient, the costs and challenges they present to the healthcare delivery system, and because of their prevalence and severity. Indeed, in the United States alone, around one million individua ls develop pressure ulcers. Bedsores are also most commonly found in elderly individuals, both in hospitals and nursing homes or similar institutions. According to Park-Lee and Caffrey, 11 percent of nursing home residents (or 159,000 patients) developed pressure ulcers in 2004. Patients who are around 64 years of age are more prone to developing pressure ulcers, the most common of which is Stage 2 bedsores. Moreover, in terms of severity, the same authors noted that pressure ulcers have been observed as the direct cause of death in around eight percent of paraplegic patients. Finally for the United States, Cuddigan, Berlowitz and Ayello (2001) revealed that around 60% of quadriplegics, 25% of nursing home residents, and 10% if all hospital patients all develop bedsores. In the United Kingdom (UK), Clark, et al. (2004) found that one in five admitted hospital patients has, or is developing, a pressure ulcer. This statistic translates to around 20,000 inpatients in the UK at any give n time. As for residential settings, although not much documentation is available, patients are constantly referred to the healthcare system for solutions or interventions. Moreover, around 400,000 patients develop a new bedsore every year in the United Kingdom. This high prevalence of pressure ulcers has also been observed in hospitals and other settings in Ireland. In the study by Gallagher, et al. (2008), the authors found that in three university teaching hospitals, around 18.5% of patients have developed pressure ulcers. Of these, 77% are hospital-acquired, and 49% are grade one. Also, in another study by Moore and Cowman (2011), it was revealed that in the Republic of Ireland, the prevalence rate of pressure ulcers is nine percent. Although relatively low, this percentage is made complicated by the fact that the greatest percentage of the documented cases are grade two sores (33%), mainly located on the heel (25%) and on the sacrum (58%). Also, around 53% of the study’s respondents were completely immobile or had very limited mobility. Other than the risk posed by its prevalence, pressure ulcers also present challenges to the individual and the community. For the patient and his/her family, much pain and discomfort is caused by the presence of pressure ulcers. Indeed, according to the Institute of Medicine (2001), pressure ulcers hamper the patient’s recovery, as well as cause unnecessary strain on the caregiver. For the community, pressure ulcers also present challenges in terms of costs. In terms of costs, pressure ulcers drain a lot of financial resources for the healthcare sector. In the US, for example, around $1 billion was used in 2004 for the treatment of pressure ulcers. Similarly, in the UK, the NHS spends around ?1.8-2.6 billion on hospitalisations and treatments involving pressure ulcers or

Advertisement Analysis Essay Example | Topics and Well Written Essays - 1250 words

Advertisement Analysis - Essay Example In short, consumer culture has largely influenced the way of living today. In the light of these, the following study text seeks to support the impact of consumer culture on society by analysing an advertisement based on the relationships between the aesthetic strategy and ideological message applied in creating it. In analysing an advert, two major aspects come into play; the aesthetic and ideological portrayals. The aesthetic aspect represents the overall visual sensation which is portrayed by the advertisement’s overall appearance. In short, it is the visual appeal, and plays an overly important role in marketing. The ideological message represents an advanced meaning of the advert and is a simulated â€Å"feeling† which is transferred from the advert to the consumer upon buying (possession) of the product being marketed. These two are closely related. In an advertisement, there are three main constituting understandings; the overall (surface) meaning, the advertiser’s intended meaning, and the ideological (cultural) meaning. The relationship between the three is that the aesthetic sensation adds up to the surface meaning while the ideological message represents the advertiser’s intention. These two combined, they create the cultural meaning of the advert thus its interpretation and execution of the intended purpose (Botterill, MacRury & Richards 2013, p. 81). Figure 1 above is a Vive Cuervo Advertisement. Vive Cuervo is an alcoholic drink. The aesthetic strategy is evidenced by the inclusion of different elements which create a composition. The composition is made up of both images and text. There is the image of a happy couple in beachwear wherein man is carrying his lady at chest level. They are in embrace as he holds her around her buttock area and her legs embrace his abdomen. The lady’s hands are clutching the man’s neck tightly and they are both laughing out loud.

Complete the following discussion questions Essay

Complete the following discussion questions - Essay Example Even when you think you understand the text through this approach, the approach itself indicates that there can be no understanding. I think gender criticism is perhaps the best approach to take for either of Kate Chopin’s stories. This is because she presents her characters with such feeling as she attacks some of the social customs that have managed to come between the genders. In â€Å"The Storm†, for example, Chopin presents her main character, Calixta, as a frustrated woman trapped in a less than fully satisfying relationship with a man who is kind and simple but not the man she was in love with. That man is the one she has passionate sex with on the day of the storm, finally fulfilling a desire she’d carried since she had known him in Assumption but not been able to fulfill because he left her. Gender criticism would examine the circumstances of her life, the role she is expected to play and the lack of choice she was given. At the same time, gender criticism allows one to examine the men who appear in the story as well. Bobinot is seen as simple and accepting and truly in love with his wife. He is sensitive to her moods and tries to do what he can to keep her happy, not understanding what it is that makes her upset. He is even sensitive enough to take their son with him when he goes shopping in order to give her some time to herself, but has nevertheless managed to trap his wife within the social roles expected of women regardless of her own inclinations. Alcee also provides Calixta with no free choice when he leaves her in Assumption, but is seen to have been acting with her best interests at heart, knowing he could not be with her and that to do anything then would have damaged her reputation and her chance for a better life. Both men are seen to be trapped in social conventions as much as Calixta within this approach, which increases understanding of the

Anti Drinking Campaign Essay Example | Topics and Well Written Essays - 1000 words

Anti Drinking Campaign - Essay Example The purpose of the college is to develop all round persons through following the college’s core values such as excellence and efficiency, responsiveness, positive collaborations, hard work, teamwork, diversity as well as honesty and adherence to ethical practices. This paper presents an anti-drinking campaign proposal for Kings College board of directors regarding the college’s reputation for being a party college notorious for underage drinking for so long. Underage drinking remains a leading problem in Kings College as well as a public health problem in America. About five thousand young people under twenty one years of age die each year as a result of underage drinking from alcohol related poisoning, car crushes, suicides, injuries and homicides. Besides being illegal, underage drinking remains widespread with youths within age 12-20 reported to undertake binge drinking in a 2009 underage drinking statistics representing 10.4 million youths in the United States. It c ould be attributed to, but not limited to, peer pressure, stress and the desire for or increased independence. The observed signs of underage drinking in Kings College encompass behavioral and academic problems in school, less care in physical appearance and/or interest in college activities, coordination problems and varying groups of friends. In addition, college students have problems relating to slurred speech, memory and concentration, mood swipes, little energy levels as well as getting a scent of alcohol on their breath and finding alcohol in their belongings. The dangers of underage drinking include impaired judgment, serious injuries, increased risks of sexual and physical assault, interference with brain development, increased risks of future alcohol related problems, the use of other drugs and trouble with the law and in school (NIAAA, 2012; Hanes, 2012). This ant-drinking campaign hailed as ‘Underage Drinking!!! Think Again’ remains an impactful advertisemen t which intends to stimulate personal review of drinking conduct and resilient condemnation of public drunkenness that could cause both emotional and physical harm, especially of innocent persons. The ‘Underage Drinking!!! Think Again’ campaign became well-versed by extensive consultation and research about how underage students feel about the deep-rooted cultural insights existing in America regarding alcohol consumption, public drunkenness and excessive drinking. The campaign builds on the positive comebacks to the successful drinking awareness campaigns. It would establish an innovative thought and meaning in relation to a certain aspects of alcohol consumption among underage college students, that is, to emphasize the disadvantage of losing control of one’s sense of self, a widely held drinking myth in contemporary American society. The advertisement campaign features taped laughter, reflecting the point that lots of underage college students do regard certai n drunken tricks as being rather funny. Then it progresses to a dramatic end where the laughter discontinues, and the viewer becomes challenged through a question: â€Å"Are you honest with yourself?†. The ‘Underage Drinking!!! Think Again’ campaign would go on for the next one year. The CCTV based advertisement would run on the college’

Critical Thinking and Language Essay Example | Topics and Well Written Essays - 1250 words

Critical Thinking and Language - Essay Example Today, we have the powerful desire to know what is going on and how we fit in the larger picture of the society. More than before, we need to engage in systematic and extensive communications in upward, downward, and lateral directions. By being able to acquire language mastery which involves grammar, spelling, use of words, intonation and others, we will be able to make good use of our language skills to our advantage. This will be a powerful tool for us to successfully resolve conflicts, make sound decisions and provide smart solutions as well as improve the statues of our social relationships. Social organizations cannot exist without language and communication. Language has already become a part of different cultures for different nations have their own national language and even their own set of dialects. Language has already been a part of every country's national heritage and also one of the pillars of their national identity. Since language may vary from one nation to another, this brings about the diversity in language. With this characteristic of language, people are able to interact with other people from different nationalities and having different cultural backgrounds. We are also able to communicate with people from any age, gender, ethnicity and religion due to diversity in language. This way, we are able to share our knowledge and expertise to people from across the globe. As an example, diversity in language can be exemplified by the communication between men and women. Research on gender-based communication styles has begun to show more fascinating diversity between two groups. Numerous studies have explored whether men and women use different communication styles. In general, men and women display marked diversity in the way in which they communicate. Men emphasize power, while women stress rapport; men are more likely than women to claim credit for accomplishments; men tend to downplay their uncertainty rather than admit it; women asks questions to learn more, while men fear that asking questions will make them look ignorant. How does language empower or limit the expression of our thoughts Language serves as our medium for communication and expression. Every idea that our mind perceives and process will be rendered useless unless they are expressed though language. Language can work to our advantage or disadvantage depending on how well we know how to make language work for us. The more we know about language such as semantics, phonetics, use of words and grammar, the higher the possibility of getting our message or ideas across successfully. Nearly language is considered symbolic; that is it is achieved using symbols, (words, pictures, actions) that suggest certain meanings. Semantic barriers are examples of how language may limit our expression of thoughts as well understanding other people's thoughts. Semantic barriers arise from limitations in symbols with which we communicate. Symbols usually have a variety of meanings, and we have to choose one meaning from many. Sometimes we choose the wrong meaning and misunderstanding occurs. This is particularly likely with use of jargons, which is the specialized language of a group. Jargon can include the use of acronyms, slang (words unique to an ethnic or racial group), or

How to teach literacy and Multi-literacy Essay Example | Topics and Well Written Essays - 250 words

How to teach literacy and Multi-literacy - Essay Example Multi-literacy requires students to integrate technological educational tools. One of the ways teachers can teach literary and multi-literacy is by integrating them teaching. This means that teachers should integrate four essential components of multi-literacy teaching. These are overt instructions, situated practices, transformed action and critical framing (Gambrell, Marrow & Pressley, 2011). Situated practice focuses students to meaningful learning through the integration of primary knowledge. Overt instruction directs students to systematic processes of learning. Critical framing enables students to learn how to approach the diverse environment in order to improve their learning experiences. Teachers can also use transformed action teaching to teach students how to apply lessons to real life experiences. Teaching literacy and multi-literacy can lead to the adoption of new ideas and practices. It can also help in overcoming the limitations experienced in traditional learning approaches. Teaching literacy and multi-literacy introduces teachers to new pedagogical approaches and practices, which creates opportunities for future learning and teaching. The four ways in which teachers can teach literary and multi-literacy are the use of situated practices, critical framing, overt instructions and transformed actions. These methods have the potential to guide teachers to provide equal access to teaching and learning

Selling Our Future - Sense of Place Essay Example | Topics and Well Written Essays - 500 words

Selling Our Future - Sense of Place - Essay Example This is mostly so especially in the developing countries like Kenya where land is scarce and the population is constantly growing (Brown, 2009). Economically the figures show that the economy of such a country is growing through the measure of GDP. However, if the trend in population growth being experienced continues then this would be like we are poaching from the future. This is because as it is currently, the resources are already at a strain as illustrated by Brown (2009) and in future then this GDP growth will start to decline. This greatly relate with me as an accounting student in that it helps understand how ecological factors affect the growth of economy. The Kenyan experience is an interesting one because surprisingly, in the past Kenyans have enjoyed good rich soils and rainfall patterns. This has however changed due high population that in turn has cleared a huge part of land that was previously forest cover for settlements. This has led to changes in rainfall pattern and drought occurrences are very common and thus hurting the country even more economically. This thus greatly relates to what Brown (2009) says that trees are very valuable in terms of rainfall and the environment in general. Land is viewed as a property that is mainly for economic gain and ethically there are no rules that guide the owners of the land on how to use it (Leopold, 1948). The conservation ethics should be steered to each and every person if the trend is to change for the better. The animals are also part of this population because as the human population increase, so is the animal population and this occupancy has led to less and less space available. This has caused the continuous the depletion of the lands and in the long run the economy. Like Brown (2009) expresses that the world’s economy behaves like a ponzi economy in that at a glance the economy may improve. This may be due to certain activities like excessive fishing where the lives of the

Assignment Dissertation Example | Topics and Well Written Essays - 1000 words

Assignment - Dissertation Example Evaluate its overall physical infrastructure, accompanied by its marketing and compatibility factor consideration with other technologies. The dissertation would further allow for clear understanding of the technology incorporated in VOIP, which will be done so through critical analysis and comparison with other technologies present. Abstract: Using the broadband to better services in form of telephone options define the core purpose of VOIP. Outlines: Understanding the working of VOIP, the technologies incorporated its strengths and weakness, potential advantages and possible areas of improvement would be investigated in the overall dissertation. The project will broadly consist of the introduction and abstract part, followed by the literature review part which would investigate the methodical and periodical work that has been conducted over period of time in the field of VOIP and other communication technologies. Work of different experts and technologists who have researched in th is field would be brought to light. This would be followed by the research methodology phase of the dissertation which would include the explanation and discussion of the ground level activities and facts related to VOIP. Finally the last part of the dissertation would constitute the findings and analysis portion which would allow for better implementation of the technology in the physical domain. Using the software is also part of the overall project for purpose of pilot test and evaluation. Software tool application would enable for practical demonstration of the VOIP features, its services and its compatibility with other underlying technologies and hardware applications. Software compatibility and designing a software manual according to the desired technological requirements is another core function contained in the overall project. Literature review: The concept of VOIP gained prominence in the early days of 21st century when the technology took a shift towards further enhance d means of communication in form of the video enabled services and remote connectivity. With focus on virtualization and making use of digital means to avoid the physical journeys VOIP was adopted. VOIP was the main demand of the business enterprises who sought online activities in order to avoid the physical travelling and other physical activities associated with dealing with the partners. The earlier traces of VOIP can be traced to the mid 1990s (Kelly 2011, 74) when a sound card set of headphones and internet connection would allow for connection establishment. With time, the overall domain got expanded and the business enterprises gained interest in this field and also the common users and thereby it started expanding and a new set of standard in form of VOIP. Evaluation Criteria: VOIP is a complete set of technology that incorporates various software packages and elements, along with hardware components. It has a complete infrastructure in its own which facilitates the service s that are being provided over the infrastructure of VOIP. Configuration: VOIP entails the use of adapters, routers, soft phones; dedicated VOIP phones are few of the elements that constitute the physical layer configuration requirements of VOIP. Criteria for determining the success: The success would be gauged in terms of its implementation, its overall affectivity and impact on the overall

Western Civilization Essay Example for Free

Western Civilization Essay Between the fifteenth and eighteenth centuries, early modern European society began to fear the possibility that witches existed in their midst. The resultant panic led to massive persecution in the form of the trial and torture and subsequent execution of a 40,000 to 50,000 suspected witches, about 75% of which were women, over a period of 100,000 trials between 1450 and 1750. While estimates written in the mid-1970s place the figures at about 9 million women, this is an exaggerated estimate derived from extremist or polemical feminist accounts which seek to create a proto-feminist depiction of this period. Still, it is difficult to cite any other period in which women were persecuted and subject to atrocities of a similar or larger scale. In any case, it was rapid social, economic and religious transformation in Europe during this time that ‘helped’ set the stage for these witch hunts. Gibbons (1998) notes that the spread of Christianity led to a religious homogeneity that gave way to a declining tolerance towards pagan religions and witchcraft. Additionally, Europe in the early 14th century was crippled by rumors of a ‘malign conspiracy’ to bring down Christianized nations. In essence, the decline of religious diversity that comes with the hegemonic presence of Christianity as spiritual way of life of the common European meant that acceptance of other religions was rapidly diminished. The Black Death or bubonic plague which struck Europe during the mid 14th century intensified the rumors of the aforementioned conspiracy under the allegation that the plague was the creation of witches and other pagans who ostensibly sought to destabilize Christian rule. The implicit impact of the Reformation upon European Christendom also supports this view. During this period, the number of witch trials actually dropped, notes Gibbons (1998). As such, the conflict between the entrenched Catholicism and the emerging Protestant movement resulted in the collapse of Christian orthodoxy. Also, it is interesting to note that only the nations in which rapid development was occurring that the witch hunt panic was at its strongest. Spain, Italy and Portugal did not experience as much panic as the nations of Germany and Switzerland. In any case, the prevailing instability of Europe during this time exacerbated the witch panic. Because European civilization depended heavily on a homogenous grain-based agriculture – but without many of the industrial (albeit environmentally unsustainable) advances and insurances that it enjoys today – it was much more susceptible to the dangers of crop failure. Sociologists have noted that such crop failures are correlated with the occurrence of witch hunts, with the explanation being that there is a tendency within humans to blame inexplicable disaster on a much more ‘known’ variable (albeit one that is not well understood). Communities which experienced the crop failure would take their anxieties out on the community members who were considered deviant and therefore concluded to be responsible for such crop failures. Such a sociological explanation is not far removed from the same conditions which gave rise to the anti-Semitic sentiment that gave rise to Nazism, which blamed the Jewish people for economic problems. By the 18th century, the witch hunts began to subside. Perhaps the most significant macro explanation for this decline was the restoration of stability to Europe, which Hannam (2007) describes as creating an absence of the reasons that started them in the first place. For example, the height of the Salem witch trials occurred when theocratic authority was in question. Greater protections were given to impoverished women when England implemented the Poor Law. Also, radical new works in social thought led to greater acceptance of cultural and religious diversity and pluralism. REFERENCES Kagan, D. , Ozment, S. , Turner, F. (2007) The Western Heritage. 9th Edition. Pearson Prentice Hall. Gibson, J. (1998) â€Å"Recent Developments In The Study of the Great European Witch Hunt. † Pomegranate, Issue 5 Hannam, J. (2007) â€Å"The Decline of Witch Trials in Europe. † Medieval Science and Philosophy. Retrieved May 23, 2008 from: http://jameshannam. com/witchtrial. htm

Preventing Deliberate Self Harm in Prison: Review of Methods

Preventing Deliberate Self Harm in Prison: Review of Methods Systematic review of the efficacy of methods  of preventing deliberate self harm in prison In delving into an examination of a ‘Systematic review of the efficacy of methods of preventing deliberate self-harm’ it is important to understand that the scope of the examination takes in a broad range of considerations, views and methodologies that are aligned with the main subject matter. Thus, having a clear understanding of what self-harm is represents a necessary facet in order to be able to determine the context within the scope of this examination. Hawton (1) states that â€Å"deliberate self-harm† entails â€Å"intentional self-positioning or self injury, irrespective of the apparent purpose of the act†. The most common forms, and or actions usually entail self-poisoning, overdosing on drugs, and the cutting of oneself (2). The preceding, self-harm, in a prison environment represents â€Å"a significant problem† that â€Å"requires the coordinated input of a number of agencies†, which includes â€Å"acute medical and psychiatric ca re (3)†. The subject of deliberate self-harm represents a broad subject area that includes alcohol abuse, deliberate self-injury by means of cutting, and other techniques. It also entails drug use, starvation, and other means via which individuals seek to harm, and or damage themselves. Harrison and Sharman (4) advise that self-injury represents a manner in expressing deep distress as represented by the cutting, burning, or other injury to oneself. They continue that frequently individuals do not know, or understand why they inflict harm upon themselves, and add that it is frequently a means to communicate what one cannot put into either words or thoughts (4). Harrison and Sharman (4) indicate that self-harm can be described â€Å"as expressing an inner scream†, which after the harm has been inflicted, then individuals are frequently able to cope with life, for a period of time. The preceding is expressed by many studies and articles that self-harm and self-injury represents a broad se t of acts that can, and does emanate from one not looking after their own needs from either an emotional and or physical standpoint (4). The infliction if self-injury can include cutting oneself, scratching, burning, hitting oneself, swallowing, and or putting harmful things inside one’s body, as well as the use of drugs to hide, and or mask distress, for escapism, and or relief (4). Self-harm also can include becoming involved in as well as staying in a relationship that is abusive, taking unneeded and unnecessary risks, eating disorders such as anorexia and bulimia, and as mentioned drugs, along with alcohol abuse (4). The preceding are manifestations of excess that almost all individuals exhibit in some limited form or another as also represented by overeating. Overwork is an illustration of the foregoing whereby one attempts and or tries to lose themselves in an activity as opposed to being alone with their thoughts, and or feelings (4). The foregoing explanation of self-harm, and self-injury spans a broad range of descriptions, and has been utilized to draw attention to the depth of methods that a systematic review of the subject matter entails. In equating a ‘systematic review of the efficacy of methods for preventing deliberate self-harm in prison, it is critical to understand the terms utilized in the preceding title, focusing first on ‘efficacy’ as the core word defining the context. The Merriam-Webster online dictionary (5) defines ‘efficacy’ as â€Å"the power to produce an effect†. This definition is mirrored by Houghton Mifflin (6) that states it, efficacy, is the â€Å"power or capacity to produce a desired effect; effectiveness†. The foregoing represents a significant contribution to the understanding of the range this examination will cover in terms of its systematic review. The core of the problem represent identification, treatment, and follow up, which is r eferred to as interventions at varying stages in the process of uncovering and dealing with individuals exhibiting the traits, and or recorded histories of self-harm. The primary objectives concerning intervention is to identify, and manage self-injurious behaviour, enacting where possible improvement in the individual’s mental state, behaviour patterns, and functioning over the short, medium and long term. The preceding is manifested by less than six weeks, six weeks to six months, and more than six months respectively. The typical manner in which the foregoing is handled in a prison environment is via: the utilization of conventional as well as newer antipsychotic drugs, use of non-pharmacological interventions as represented by dialectical behaviour therapy, and the removal of identified individuals to safe cells whereby they can be placed under close observation. The secondary objectives represent the determination of the invention(s) that might have a beneficial effect. Such also entails understanding the diagnosis of treatable illnesses as evidenced by: severe depression episodes that include psychotic symptoms, as well as post-schizophrenic depression, and the diagnosis of individuals suffering from emotionally unstable disorders of the personality that are borderline This examination shall delve into the understanding of self-harm, and self-injury as it relates to individuals that are incarcerated, along with treatments, evaluation of intervention methodologies, common treatments, strategies in treatment and the efficacy of the methods utilized in prevention of the condition of deliberate self-harm. Jackson and Waters (7) inform us that there is no singular method that provides the necessary scope to answer the broad array of questions concerning â€Å"†¦ public health, health promotion problems and interventions†. They point to Pettigrew and Roberts (8) who advise that when the problem is known, then the types of studies to answer, and hone in on the problem can be deduced. The preceding thus sets the parameters for this examination concerning a ‘systematic review of the efficacy of methods of preventing deliberates self-harm in prison’. Garner (9) advises that in general, â€Å"people who deliberately hurt themselves do so because they feel that they need to, and that the act itself makes them feel better for a while, and more able to cope†. She adds that â€Å"People report overwhelming feelings of misery, emotional distress and hopelessness which lead them to the apparent solution of inflicting pain on their bodies†, and thus harming themselves. For a great many individuals, the preceding, self-harm, represents the solution, but however, it is in the reality a facet of the problem that is unresolved within themselves (9). Harrsion (10) advises that in the â€Å"strictest terms† Deliberate Self-Harm represents the general terminology describing activities that are self-damaging. The foregoing includes activities such as alcohol abuse along with bulimia to add to the other manifestations thus far mentioned. He also advises that Self-Injury makes more specific reference to the activities entailing the utilization of cutting, positioning, bruising, burning, and over-dosing with the intent of suicide as well as other activities directed at self-injury (10). In the preponderance of instances, it has been observed that the infliction of self-injury often means self-protection as opposed to self-destruction, representing a â€Å"way of copping †¦ when things get really bad (11).† Bywaters and Rolfe (11) continue that â€Å"People deal with things in different ways and, unfortunately or not, this is my way†. The preceding is an important understanding in the issue, which is highly com plex. The phenomenon, deliberate self-harm, represents a subject that has, and is entailing â€Å"extensive sociological, epidemiological, psychological, biological and clinical study† along with research as well as speculation as to its causes, reasons and roots (12). Jackson (13) published a set of guidelines which added to the ‘Handbook’ that provide â€Å"a working framework to conduct a systematic review of health promotion or public health intervention† to be utilized in conjunction with other source materials in the conducting of reviews concerning health interventions. There are two types of ‘reviews’ referred to by Jackson (13), which consist of: â€Å"traditional literature reviews/narrative reviews†, and â€Å"systematic reviews (with or without) meta-analysis† The first, â€Å"traditional literature reviews/narrative reviews† is generally conducted as well as interpreted by experts in the field utilizing â€Å"informal, unsystematic and subjective methods †¦ which is often summarised subjectively and narratively† (13). Jackson (13) explains that such processes representing â€Å"searching, quality appraisal and data synthesis are not usually described and as such, they are prone to bias†. The advantage of the preceding is the participation by said experts â€Å"who may have a thorough knowledge of the research field†, however it is also pointed out that the disadvantage is represented by the fact that these individuals and or authors â€Å"may have preconceived notions or biases and may overestimate the value of some studies† (13). In conducting a ‘systematic review’ of an individual with the condition of self-harm and self-injury, Jackson (13) defines the process as one that is â€Å"a review that is â€Å"very much driven†, in today’s terms, â€Å"by the evidence-based medicine movement†. She continues that a systematic review is thus defined as â€Å"a review of the evidence on a clearly formulated question that uses systematic and explicit methods to identify, select and critically appraise relevant primary research† (13). She adds that said systematic review is utilized to â€Å"extract and analyse data from the studies that are included in the review†(13). A meta-analysis represents when two or more studies are combined statistically â€Å"to produce a single estimate of the effect of the health care intervention under consideration† (13). Jackson (13) cautions us that the preceding, a meta-analysis, represents simply the statistical combination conc erning the result from the studies utilized, and that as such the final estimate concerning the effect might not necessarily represent the result found in the systematic review as done via the literature. Accordingly, the preceding should thus â€Å"not be considered as a type of review† (13). The following represents a comparison of the varied types of reviews: Table 1 – Different Types of Reviews, A Comparison (13) The Department of Health, under its â€Å"Delivering the Future† guidelines concerning self-harm (14) state that in many instances, acts of self-harm are not connected with attempts to commit an act of suicide. It states that such may represent instead an attempt to either influence, and or secure aid and help from others as well as a means to obtain relief from what is an unpleasant, and or overwhelming emotional state and or situation (14). Chapter 2 – Clinical Guidelines and Interventions As advised by Jackson and Waters (7), there is no singular method that provides the scope of information, and or definitions to answer the broad array of questions concerning interventions. As indicated by Pettigrew and Roberts (8), the foregoing requires a determination of what the problem is as a means to select the types of studies and information needed to hone in on the problem so that answers can be deduced. Therefore, in order to reach a determination, and or closer approximation of the potential type, or types of intervention needed, a â€Å"preliminary scooping search† (7) represents a means aids in gaining familiarity with the type(s) in interventions. This entails utilizing the questions that are asked, and answered in the interview session as the basis for the preceding. Jackson and Waters (7) in referring to Popay et al (15), as well as Dixson-Woods and Fitzpatrick (16) argue â€Å"†¦ qualitative research should have a role in systematic reviews†. Spen ser et al (17), as cited in Jackson and Waters (7), advises that the purpose of qualitative research is to provide a deeper understanding of the experience that individuals have, along with their experience factors, histories and importantly, their perspectives within their individual settings, and circumstances in an attempt to glean why people behave in the manner they do. The preceding represents the attempt to understand behavioural patterns, and social actions. In a study conducted in the United States representing a small group of just 21 adults that were receiving aid for deliberate self-harm, it was found that the most promising intervention methodology entailed ‘problem solving therapy’ (18). The preceding found that the most promising type of intervention entailed short-term problem solving therapy, that was cognitively oriented psychotherapy. The foregoing, as represented in five studies versus that standard aftercare indicated a trend that showed decreasing self-harm, with the treatment time varying among all five participants (18). In another set of interventions conducted that entailed twenty adults in each study group indicated a reduction concerning the repetition of self-harm incidents (18). The methodology utilized represented what is termed ‘dialectical behaviour therapy (DBT), which is a treatment program that is comprehensive, and was developed to see to individuals with severe dysfunctional problems. It a lso was designed to uncover those who exhibit borderline personality disorder along with recent incidents of deliberate self-harm (18). In addition, the study revealed that the â€Å"administration of antipsychotic flupenthixol† was shown to significantly reduce the percentage of repeated incidents of deliberate self-harm among individuals that had a prior history of at least two previous suicide attempts as opposed to testing the preceding on another trial group whereby a placebo was used (18). Hogg and Burke (19) advise that self-harm represents more in the attempt to relieve distress and or tension than anything else. Clinical Guidelines Nationally, in the United Kingdom, there are ‘clinical practice guidelines’ as represented by what are termed systematically developed statements developed to assist clinicians, and patients in making decisions concerning the appropriate treatment as represented by differing specific conditions (14). And while the aspects of conditions, circumstances, and related criteria differ in a prison environment, it is important to understand that there are national clinical practice guidelines in place that have some applicability. The preceding guidelines have been devised from available research, and evidence that utilized both predetermined as well as systematic methodologies for the identification, and evaluation of evidence concerning the varied specific conditions (14). In those instances whereby sufficient evidence is either lacking, or not compiled in meaningful numbers, and or conclusions, the guidelines incorporate recommendations as well as statements that have been ba sed upon a consensus as arrived at by the development group responsible for the guidelines (14). The National Institute for Clinical Excellence (20) approach the subject of intervention by stating that the management of self-harm calls for the utilisation of both primary as well as secondary care services in order to provide a complete assessment of the individual’s mental health as well as social needs, along with factors that precipitated the situation, and the factors of risk entailing future and further self-harm incidents. This approach is also supported by Green and Sinclair (21) who add that the appropriate treatment methodologies should be sensitive in terms of the differences that exist between patients exhibiting self-harm characteristics, therefore interventions must be mindful as well as acknowledge the diverse needs as represented by differing circumstances. Thomas and Faulkner (22) add that what is termed as â€Å"user led† evidence is increasingly being recognized in both policy making as well as research, and that perspectives of self-harm treatment following incidents should be investigated thoroughly to correlated findings to further establish care pattern guidelines based upon similar lines of historical facets. Such, however has not been the case, as present evidence relies strongly upon patient studies based upon preventing, and managing self-harm based on a medical perspective. The National Institute for Clinical Excellence (20) in its NICE guidelines, recommend that such a study should be implemented whereby qualitative methodology is applied in a rigorous fashion to examine user experiences, and results. The utilization, and importance of clinical guidelines has been devised as a means via which to improve the outcomes along with processes for the treatment, and intervention of individuals demonstrating a tendency, and or actual history of self-harm and self-injury. It is important to understand that the reasons, and causes for self-harm as well as self-injury are not entirely understood, and that each case and instance represents its own unique set of causes, histories, backgrounds, and rationales. As such, the Department of Health in developing said guidelines has cautioned that the preceding does not represent a substitution for either clinical judgment, or professional knowledge (14). In addition, the guidelines indicate that they are not meant to replace, and or supercede the responsibility of qualified health professionals in their rendering of decisions with respect to their patients. The purpose of the guidelines are to aid professionals in good practice points as well as recommendations for medical treatment, along with psychosocial ,and interventions, with the aims to (14): reach an evaluation of the specific medical as well as surgical interventions undertaken during the first forty-eight hours following an episode reach an evaluation, where possible, of risk assessment for the individual involved make an evaluation of the utilization, and role concerning the psychological as well as pharmacological interventions utilized in said episode reach an evaluation concerning the role as represented by service delivery systems, along with service-level interventions regarding the treatment and care of individuals who have committed self-harm acts to integrate all of the preceding to reach a determination of best practice representing the care, and treatment of those persons whom have committed an act or acts of self-harm. The following guidelines are intended to focus upon those individuals that have committed act(s) of self-harm representing an expression that demonstrates personal distress, along with those situations whereby an individual specifically intends to injure themselves (14). It should be noted that the prison systems fall under the guidelines of the NHS, and the guidelines are applicable to these types of situations as such falls under what are termed statutory services (14). Guidelines The HM Prison Service (23) set forth a â€Å"Prison Drug Treatment and Self-Harm† â€Å"to introduce new procedures†¦Ã¢â‚¬  devised to â€Å"minimize the risk of self-harm† from occurring as a result of â€Å"reaction to the stresses† associated with certain drug treatments. It further stated that compliance with the guidelines requires (23): appropriate information sharing to ensure that proper treatments are being conducted as well as to gather database information on treatment effectiveness inventions. That under ‘Mandatory Action’ That the Directors along with Governors ensure: That managers and staff in drug treatment positions are informed of the treatment guidance contents, and are following the prescribed outlines, That case history information shall be detailed, including prior drug treatment as well as mental state, and such provided to a CARAT team while the assessment is being conducted. The preceding is also to be shared with other intervention treatment programs to further the informational base of how differing case histories, and approaches fair in terms of effectiveness to build the historical base of improved interventions in the future. That prisoners under treatment are monitored for emotional as well as mental well being during the drug treatment process. That providers administering drug treatment must have familiarity concerning the ‘multi-disciplinary risk management process’, termed ACCT, or F2052SH, as well as invoking these procedures upon the identification of someone found as being at risk concerning self-harm, and or suicide. Lastly, drug treatment as administered by providers needs to actively promote as well as facilitate healthcare services access, along with the broad array of support services that are in prisons. The national guidelines for prison treatment of self-harm and drugs, as set forth in â€Å"Prison Drug Treatment and Self-Harm† (23), advises that there are a number of important considerations which must be taken into account during the assessment of the potential utilization of treatment for individuals being treated for self-harm as well as the types of support needed. It advises that the management of the process for self-harm, and suicide represents a multi-disciplinary process that must include CARAT, ACCT, and or F2052SH in the risk management process after the identification of an individual with suicide, and or self-harm tendencies as well as a demonstrated history (23). The treatment of self-harm entails the inclusion of any and all prior treatment, and event histories that should be sought concerning the informational basis for the engagement of intervention (23). The intervention process needs to be cognizant of the individual’s prior treatment along with so cial, mental, and family problems as the concerns underlying the issue may lie in these areas. The guidelines, and information as set forth under â€Å"Prison Drug Treatment and Self-Harm† (23) specify that the treatment programs as represented by CARATs, clinical services as well as Intensive Rehabilitation I are collectively the responsibility of the UK Prison system. CARAT represents the care coordinators for prisons with drug problems, and this agency maintains contact with each prisoner identified in their database. CARAT also maintains contact those instances whereby prisoners are transferred between institutions as well as treatment intervention transfers. Increased effectiveness under the shared informational context is seen as a result of the availability of prior history on prisoners, thus providing data on the path(s) taken, and the results achieved. The preceding also aids in the implementation of more effective intervention techniques. A mandatory facet of the guideline calls for the opening of an ACCT, and or F2052SH as soon as they are aware of an individ ual’s suicide, and or self-harm tendencies and or past actions (23). Under the â€Å"Prison Drug Treatment and Self-Harm† (23), the former treatment, medical, and personal histories of individuals represent an important aspect in continuing as well as prescribing new treatment as it aids those in delivering care to build upon past information. Continuity of care is a vital facet in the setting forth of treatment and allied routines, and it also adds that the delivery of treatment, and intervention in isolation is unacceptable (23). Information with respect to the preceding historical aspects can be obtained by those administering treatment from (23): Oasys assessments, LIDS records that record prior episodes as contained in the ACCT or F2052SH database, Healthcare services The â€Å"Prison Drug Treatment and Self-Harm† (23) document states that prisons need to ensure that a written as well as observed policy on the institution’s â€Å"substance misuse service† that covers the following (23): the clinical services that are provided as a result of healthcare, the guidelines for detoxification for opiates, alcohol as well as bebzodiazepines, that information representing assessment, the setting for treatment and overdose, along with essential observations are in keeping with the guidelines as set forth by the Department of Health, that the health care treatment has been and is being administered in accordance with CARAT drug care plans, as well as the fact that an NHS specialist is involved in the guideline preparations. The foregoing procedural guidelines have been devised to reduce incidences associated with self-harm behaviour. The use of drugs is also considered as a self-harm behavioural pattern. As such, clinical assessment concerning the misuse of substances represents an area definable through the first reception into the prison system as represented by initial medical examines as well as screening of the individual’s personal medical files, and sentencing records (23). The foregoing also applies to incidents of self-harm. Identified individuals that have self-harm, and drug use problems are thus referred for clinical misuse assessments (23). Under the â€Å"Prison Drug Treatment and Self-Harm† (23) guideline, prison systems have the responsibility to provide the appropriate settings for clinical interventions that permit unrestricted observation for patients that exhibit complex needs, with such observation available at all times (23). The â€Å"Prison Drug Treatment and Self-Harm† (23) also provides for healthcare and CARAT teams to work jointly on protocols concerning the referral of individuals that exhibit self-harm risk as well as suicide, and other mental health facets. The preceding, protocols, require in addition to prison referral concerning the aforementioned to CARAT teams, that an ACCT, and or F2052SH must be opened concerning any case that has these symptoms (23). The CARAT assessment framework contains elements that are utilized to provide detailed information concerning individual records of treatment as well as health areas as such relates to self-harm. The following specifies the drug intervention record asks and or records the following under the: A. Treatment Section (23): If the individual is presently receiving drug use treatments, under section 5.12 This aspect represents the opportunity to determine the type(s) of treatment administered to the prisoner, and whether such prior treatment records should be obtained. If the individual has had any drug use over the past two years, under section 5.13 Under this segment of questioning the CARAT worker should determine the type(s) of treatment the prisoner received, from the individual themselves as well as the treatment agency. Such data is useful in determining the treatment intervention(s) utilized and how such affected the prisoner, in addition to identifying if the individual had and or has any problems related to coping and related areas. Has the individual had any treatment for drug use in prison, under section 5.13 Details representing prior treatment, help options and other relevant contact details, under section 5.15 B. Health Section (23): If the individual has any mental and or physical health issues, under section 6.2 Under this facet, the CARAT worker seeks information from various agencies as well as healthcare concerning if prior treatment has either caused, and or raised any problems that might contribute to the prisoner’s physical, and or mental health areas. C. Disclosure Form (23): Informed Consent Under the disclosure form, it is indicted clearly that the prisoner’s consent is not a requirement if the CARAT team thinks that the prisoner may be at the risk of committing self-harm. The consent form also permits that information can be shared between agencies, as well as disclosing the treatment the prisoner is receiving. D. Referral Form (23): This form is devised to allow for any other relevant information, such as risk to the prisoner as well as others, access problems, and related areas, to be recorded as part of the assessment, thus resulting treatment formulation. E. Comprehensive Substance Misuse Assessment (CSMA) (23): Under the ‘National Treatment Agency Model of Care’, a Comprehensive Substance Misuse Assessment (CSMA), along with the preparation of a corresponding care plan must be concluded before the administration of drug treatment. However, the foregoing is noted as to potentially not being possible for those individuals whose stay inside the prison system is relatively short. History of Substance Abuse – Under section 1 Under this segment, the CARAT worker’s responsibility is to seek detailed information concerning the prisoner’s prior treatment through asking direct, and informed questions. In the exploration of the preceding, the CARAT worker needs to be mindful of as well as to take into consideration the processes utilised to achieve said outcomes as discovered

Anxiety Among Patients Receiving Radiation Therapy

Anxiety Among Patients Receiving Radiation Therapy REVIEW OF LITERATURE The review of literature in a research report is a summary of current knowledge about a particular practice- problem. (Nancy Burns 2002). A literature review is an organized writers presentation of what has been published on a topic by the scholars. The task of reviewing literature involves the identification, selection, critical analysis and reporting of existing information on topic of interest. The literatures found relevant and useful for the present study have been organized under the following headings. Literature related to prevalence of anxiety among patients receiving radiation therapy. Literature related to interventions used to reduce anxiety of patient receiving radiation therapy. Literature related to prevalence of anxiety among patients receiving radiation therapy. Donna B. Jeffe (2010) conducted a study among women who received radiation therapy over a period of five years in United Kingdom. The results showed that 35% of women had significant levels of anxiety or depression prior to radiation therapy. 75% women with high levels of anxiety prior to treatment recorded further high scores over the time period of five years. Out of six women who received radiation therapy, one had high anxiety scores during every follow-up. Very few of the womens with initial normal anxiety scores developed significant level of anxiety or depression over time. The study concluded that patients with little education showed higher levels of anxiety and depression over time and emphasized the need for education before radiation therapy. Andersen BL,Tewfik HH (2006) conducted a study to find the psychological reactions towards radiation therapy. Totally 45 patients undergoing external radiation therapy were included in this study. Pre and post radiation assessments of the subjects were done in the areas of state and trait anxiety, somatic complaints, and treatment side effects. Results showed increase in complaints and side effects reported by all patients at the treatment conclusion. Results also showed that (a) patients with an initial high level of anxiety reported a significant reduction, but they remained the most anxious subgroup; (b) patients with a moderate level of treatment anxiety before radiation therapy reported no change; and (c) patients with low levels of anxiety reported significant increase. The study concludes that patients who were either low or high in state anxiety were also characterized by more anger or hostility than patients with moderate level of treatment anxiety. Hans Geinitz, FrankB (2003) conducted a study to evaluate fatigue 2.5ÂÂ  years after radiation treatment in patients with breast cancer and to assess its relation to pre- and immediate post-treatment fatigue values. Totally 41 patients were included in this study whose fatigue value was evaluated during the time of radiation therapy. Out of these 41 patients, 38 were alive and free of cancer 2.5ÂÂ  years after radiation therapies, received the Fatigue Assessment Questionnaire, a visual analog scale on fatigue intensity as well as on cancer-related distress scale, the Hospital Anxiety and Depression Scale, and Health Survey per mail. All 38 patients returned their questionnaires. The values were compared to pretreatment and immediate post-treatment levels. Cancer-related distress values correlated with the patient fatigue scores. Results showed that Patients with functional impairment had slightly higher fatigue values. Patients with pretreatment elevated fatigue, anxiety or depression levels were at high risk for chronic fatigue. Barrie R. Cassileth Ph.D (2009) conducted a study to assess the effectiveness of experience on radiation therapy patients desire for information. Information giving and seeking were explored among 160 cancer patients who were receiving or about to receive radiation therapy. Eighty-two new patients and 78 experienced patients completed a questionnaire to find their knowledge of diagnosis and radiation therapy, expectations about treatment, self-assessment of the adequacy of their knowledge, and desire for additional information. Analysis showed that 92% of the patients reported detailed knowledge of diagnoses. Patients were optimistic about treatment: only one person thought that radiation might not be helpful; 50 percent of the patients had a thought that radiation therapy might cure their disease. Patients who had experience with radiation therapy shown with increased knowledge but they had diminished desire to seek information. Most experienced patients had accurate information, bu t many did not feel well informed. The desire among knowledgeable patients for more information might show the patients uncertainty about the radiation treatment. Lynn kilbride (2007) conducted a study to assess the frequency, severity of anxiety and depression among brain tumor patients between the period of surgery and radiation therapy. Totally 51 patients were included in this study whose anxiety and depression were assessed at three time points; post surgery, three weeks post surgery and prior to radiation therapy. Hospital Anxiety and Depression scale was used. Results indicated a heightened level of anxiety prior to radiation therapy. Five patients had significant depression at the time period between surgery and radiation therapy. Four of the five patients with scores consistent with depression had past histories of depression. The study concluded that a past medical history of depression is a significant predictor of depression before radiation therapy. Arthur peck, MD (2006) conducted a study to assess the emotional reactions of patients receiving radiation therapy. Totally 55 patients were included in this study. They were interviewed by a psychiatrist. The focus of initial interview was what they told when they were referred to have radiation therapy. Although 60% were informed by their doctors that they had cancer, all arrived at the treatment center without any preparation for the frequency, number, and the procedure of radiation treatment. Most of the patients believed that requiring radiation therapy was very bad news. They had the fear that radiation might cause further damage and possibly cancer. Few of them only expected it to be curative. Again the patients were interviewed after the completion of radiation treatment. The results showed that the incidence of depression and anxiety was even greater than their pretreatment interviews. More than one third of the patients judged the treatment to be ineffective; they were not realizing that their new distress resulted from the side effects of radiation treatment. In this study only one patient suffered damage due to radiation therapy and 60% were free of signs of cancer at follow up, 1 to 2 years later. This study concluded that patients before radiation therapy suffered from irrational fears of disability and death mainly due to their misconceptions about the radiation therapy. Thomas w.decker (2006) conducted a study to assess the impact of stress, anxiety and depression on quality of life of cancer patients undergoing radiation therapy. Totally 82 outpatients who were undergoing radiation therapy were included in this study. The experimental group (34 patients) received some relaxation training and the control group (29 patients) received the standard education and counseling along with the radiation therapy. The results showed that there was significant (p Yu P. Chen, Ngan M. Tsang (2002) conducted a study to find the causes of interruption of Radiation therapy in patients with Nasopharyngeal Carcinoma in Taiwan. A total of 3273 nasopharyngeal carcinoma patients were treated at the Radiation Oncology Department from 1979 to 1996 were included in this study. Among these patients, 276 did not complete the full course of radiation treatment. The medical records of these patients were reviewed to determine the factors contributing to treatment interruption. Results showed that the acute side effects and complications caused by radiation therapy were the major factors influencing patients decisions to discontinue the treatment. This study suggested that more attention should be paid to take care of acute side effects of radiation ÂÂ ­therapy and also reinforcing the patient with education is important. Santhosh K.Chaturvedi (1998) conducted a study to assess the prevalence of anxiety and depression in patients receiving radiation therapy in India. A total of 100 patients referred to radiation therapy were included. All patients were administered the hospital anxiety and depression scale before starting the radiation therapy, after the completion of radiation therapy, and at 3-4 months follow-up. Anxiety and depression were detected frequently in patients receiving radiation therapy both prior to treatment and later during follow up. Frequency of anxiety significantly increased after initiating radiation therapy, but later reduced during follow up assessment. Hoyle Leigh (1987) conducted a study to assess the psychological factors affecting survival in cancer patients receiving radiation therapy. Totally 101 patients receiving radiation therapy were evaluated for anxiety, depression, and perception of the seriousness of their condition. In 3 years, the survivors were compared to the non survivors. The survivors had significantly higher mean trait anxiety (p Literature related to interventions used to reduce anxiety of patient receiving radiation therapy. Georgia K.B Halkett (2010) conducted a study to assess the effective communication and provision in radiation therapy and role of the radiation therapists. Health professionals have a duty of care to radiotherapy patients in providing them with adequate information before treatment. The aim of the study was to (a) explore how radiation therapists communicate with breast cancer patients during a radiation therapy planning appointment (b) determine what information is provided during this appointment and (c) explore radiation therapists perspectives on their role in providing patient information and support. A total of 110 radiation therapists were participated in this survey. They simulated 2 radiotherapy planning appointments and held 2 forums. The study concluded that Radiation therapists play an important role in communicating with patients and providing information, especially if patients exhibit anxiety and distress. Christie R. Eheman (2010) conducted a study to assess the information-seeking styles among cancer patients before and after treatment by demographics and use of information sources. Totally 731 cancer patients attending outpatient clinics for cancer treatments were surveyed during the pre treatment and post treatment period. The study evaluated the relationships between information-seeking style (active, moderately active, and passive styles) and demographics, cancer type, and health status for the pretreatment and post treatment periods and overall. The generalized estimating equations approach was used to model the log odds of more active to more passive information-seeking preferences taking into consideration both the pretreatment and post treatment periods. The results showed that prior to treatment, 17% reported an active information-seeking style, 69% were moderately active, and 14% were passive. Raymond Chan (2009) conducted a study to assess the effectiveness of orientation program on levels of anxiety and self efficacy among newly registered cancer patients who were waiting for chemotherapy or radiation therapy in a cancer centre in Australia. A randomized control study was used and interventions given like a face-to-face program which includes introduction to the hospital facilities, introduction to the multi-disciplinary team and an overview of treatment side effects and self care strategies. The aim of the study was to orientate patients to the cancer centre and to meet the health care team. Results showed improvement in self-efficacy of patients and demonstrated potential improvement in health outcomes. The study also reported that there were only limited studies on orientation program for cancer patients particularly with respect to the use of multidisciplinary team members. YvonneÂÂ  Zissiadisa (2009) conducted a study to assess the impact of more intensive written information in patients receiving radiation therapy. Totally 194 patients were included in this study. The experimental group (102) received more intensive information and control group (92) received the standard consultation. State trait anxiety scale was completed prior to their first consultation at the time of simulation and at the completion of radiotherapy. Information satisfaction questionnaire to assess the patients satisfaction was also completed at the time of simulation prior to radiation therapy. The results showed that there was no significant difference between the groups with regard to mean satisfaction scores with the overall information given. Results showed that more intensive information did not significantly change the patients satisfaction, anxiety scores. But the patients were generally very satisfied with the information they received but they were less satisfied w ith the information on lifestyle issues. Eva J.E. Christensen, B.Sc (2006) conducted a study to find the effectiveness of interventions to relieve pain and anxiety during radiation therapy. The main objective of this study was to assess the discomfort and anxiety during radiation therapy, which can increase patient motion leading to decreased treatment accuracy. Totally 2051 subjects were included in this study. They were given different interventions like placebo, hypnotherapy, aromatherapy, music therapy and guided imagery including pharmacological interventions. Results showed that guided imagery showed benefits in terms of pain. And the study concluded that relaxation therapies may decrease anxiety during radiation therapy, evidence supports the benefit of pharmacological interventions for pain and anxiety for specific radiological procedures and selection of common criteria for reporting pain and anxiety is valuable for further studies. Cartledge Hoff A, Haaga DA(2005) conducted a study to find the effectiveness of an education program on radiation oncology patients and family. Information was presented in oral and in written form. After the intervention, orientation program participants did not differ significantly from control group members in state anxiety, general distress, treatment adherence, or knowledge of radiation therapy. Orientation group patients reported greater satisfaction with clinic care, and the orientation group had significant utilization of the psychological counseling services within the clinic, as well as outside support. Jeff Dunnab,(2004) conducted a study to assess the effectiveness of targeted treatment education for cancer patients to promote adjustment through assisting patients to participate in treatment decision making, comply with treatment regimens and cope more effectively with treatment side effects. Totally 92 patients included in this study, randomized into experimental and control groups. The experimental group patients were given video information about radiation therapy. Pre test post test and follow up design was used. Results showed that there were no significant difference between the control and experimental group. However, patients in the intervention group reported high levels of satisfaction with the video and all reported that they would recommend the video to other patients waiting for radiation therapy. In the experimental group 90% of patients reported that most of the information received through the video was new to them. C.D.Linde, A.D.Stuart (2002) conducted a study to find the effectiveness of cognitive relaxation-visualization intervention in reducing the anxiety of patients receiving radiation therapy. Totally 88 female patients were taken for this study. The aim of the study was to find the effectiveness of the intervention in two groups. One group (N = 72) waiting for being pre-diagnosis and the other group (N = 16) before beginning radiation therapy treatment. Personal anxiety inventory was used to assess the anxiety. The results indicated that the intervention was effective in reducing anxiety for both the groups. It also concluded that patients had perceived the presence of an empathic individual during the time of diagnosis and before radiation treatment as being of greatest value. Taking interventions to reduce the anxiety before diagnosis and cancer treatment was very important. Lundberg pranne C.PhD,RN (2001) conducted a study among Buddhist patients with cancer undergoing radiation therapy to assess their feelings, satisfaction and coping with nurse provided education and support before radiation therapy. In this study 90 males and 89 females participated. The results showed that the most common feelings about radiation therapy of both the genders were acceptance and womens felt more anxiety compared to men. The most common ways of coping with the radiation therapy for both genders were rest, relaxation and communicate with their family or friends. The result showed that the satisfaction of patients with nurse provided education and support was higher among the men. The study concluded that when oncology nurses provide education to radiation therapy patients, it is very important that they should be well known about their patients characteristics including their cultural values and religious beliefs. D Haese S, Vinh-Hung (2000) conducted a study to assess the timing of provision of information to reduce anxiety and to improve satisfaction of cancer patients receiving radiation treatment. Two sources of informations were used (a) a booklet with a stepwise overall description of radiation treatment (b) teaching sheets with all the information about the radiation treatment site. Totally 68 patients were included in this study. They were randomly assigned to simultaneous information group and stepwise information group. Assessments were recorded before the simulation (p=0.02) and more satisfied (p=0.0001). Results showed that information given through a stepwise format leads to less anxiety towards the radiation treatment and patients were satisfied more before the simulation procedure. D haese S, Vinh-Hung (2000) conducted a study to assess the timing of provision of information to reduce anxiety and to improve satisfaction of cancer patients receiving radiation treatment. Two sources of informations were used (a) a booklet with a stepwise overall description of radiation procedure (b) teaching sheets with all the information about the radiation treatment site. Totally 68 patients were included in this study. They were randomly assigned to simultaneous information group and stepwise information group. Assessments were recorded before the simulation, 2nd week and at the end of radiation treatment. Results showed that information given through a stepwise format leads to less anxiety (p=0.002) and satisfaction (0.00001) towards the radiation treatment before the simulation procedure. Conclusion The review of literature enlightened the investigator to develop an insight into the radiation therapy anxiety, orientation program and its effects in the review of literature. Many studies were conducted to reduce the level of pre radiation therapy anxiety, particularly the education before radiation therapy have shown more significant results throughout the entire course of treatment. These reviews helped the investigator to gain a deeper knowledge of the research problem and guided in designing the study.

Why AFI is the best band :: Music Performing Artists Persuasive Essays

"A Fire Inside, to me, means these three other guys who drink all the soymilk backstage before I get a damn drop of it." Jade Puget, the guitarist for AFI, jokes. AFI is the greatest band. Of course, the music is also great. Those factors are topped, though, by the hardcore dedication of their fans. AFI is composed of Davey Havok ? vocals, Jade Puget ? guitar, Adam Carson ? drums, and Hunter Burgan playing bass. Davey and Jade are both very funny and often make stupid statements and inside jokes that only a true fan would understand. ?Davey doesn?t watch the damn road when he?s driving.? Jade commented once. ?I?m sure if we crashed he would be fine and I would end up embedded in a tree. If her ever kills me with his driving, though, I?m gonna come back as a squirrel and run up his pant leg.? The band often references homosexuality in their quotes, but none of them are gay. The band gets along well, and gets along with their fans. AFI has released seven full-length albums, along with a number of EPs. Their music changes with every CD, sometimes drastically. The shift from their 2000 album ?The Art of Drowning? to their 2003 ?Sing the Sorrow? took the band in a completely different musical direction. Their style changed from old-school punk to more of a horrorpunk ? electrogoth sound. No matter what they decide to do with their music, though, they are extremely talented musicians and have never produced a bad album. What keeps AFI going the most, however, is the loyalty of its fans. The league of the followers that they have established is known as The Despair Faction. In the song ?Miss Murder?, The Despair Faction provides backing vocals. Hundreds of fans were invited to chant the ?hey? in the background of the chorus. AFI loves its fans, and even let some of them have a segment in their ?I Heard A Voice? DVD. They get to actively participate in the band?s music. Being an AFI fan is the greatest thing in the world.

Present Day Detention Camps: North Korea Vs. The United States Essay

Present Day Detention Camps: North Korea Vs. The United States Abstract The purpose of this research was to determine how similar detention facilities run by the U.S. government are to the gulags of North Korea. The research spanned many different media sources from online news articles to reports in scholarly journals to an anthology of memoirs and articles concerning the treatment of prisoners in U.S. detention facilities. Although some of the specific details of the camps were inconsistent across sources, this can be attributed to the secret nature of the prison system. However, despite those inconsistencies, an overall theme present in all the sources was the secret nature of the camps as well as U.S. lack of cooperation with human rights standards presented by the United Nations. The research also showed that the U.S. in fact had imprisoned innocent persons. Because of the similarities to North Korea camps in terms of secrecy, the incarceration of innocent people and the deliberate avoidance of compliance with human rights laws, it is possible to compare the U.S. â€Å"democratic† government with North Korea’s communist regime. Review of the Literature Kang Chol-Hwan’s The Aquariums of Pyongyang, a memoir of life in a North Korean gulag, presents the stark reality that concentration camps do still exist to this day. However, the existence of these camps alone is not the only harsh reality. Not only do these detention camps exist under the communist regime of North Korea, but such camps are also present under the supervision of the democratic United States government. Therefore I wonder: how do the U.S. detention camps compare to North Korean gulags? The research of information on U.S. camps included a variety... ...s Disappeared: Secret Imprisonment, Detainees, and the â€Å"War on Terror.† New York: Seven Stories Press, 2005. Priest, Dana. â€Å"CIA Holds Terror Suspects in Secret Prisons.† Washington Post 2 November 2005. 5 October 2006 R2005110101644.html>. Reuters. â€Å"US has secret prisons: rights groups.† ABC News Online 18 June 2004. 6 October 2006 . Thorne, Kym, Alexander Kouzmin. â€Å"Borders in an (In)Visible World: Revisiting Communities, Recognizing Gulags.† Administrative Theory & Praxis 26.3 (2004): 408-429. Academic Search Premier. EBSCO. W.E.B. Du Bois Library, University of Massachusetts. 6 October 2006 18&sid=eabd6560-ec4b-458e-b598-c2bc9c9ee450%40sessionmgr101>.

A Portfolio of Atlantis Casino Resort

Abstract This portfolio pertains to Atlantis Casino Resort in Reno, Nevada. It discusses the facility mix adopted by the resort. Its unique selling point (USP) is drawn from its excellent customer service, reputation for luxury, and a range of activities it offers for adults, children, and the whole family. The Atlantis partners with transport companies that promote environmental sustainability, specifically those that use advanced technology in transport system. The Miossec model is applied in analysing how the resort might be a focus of destination development. This portfolio identifies problems and challenges faced by the Atlantis, as well as the means through which the resort addresses them Introduction This portfolio is about Atlantis Casino Resort. It provides a discussion of an outline of the facility mix of this resort and whether its facilities have helped in creating a unique selling point (USP). It also tackles the utilisation of sustainable transport alternatives and how the chosen resort has responded to this. Moreover, this portfolio looks at how Atlantis Casino Resort has been a focus of destination development, addressing this point by employing a resort-destination development model, the Miossec Model. Finally, the brief discusses development problems and management challenges identified by the resort and how they are being addressed. An Outline of the Facility Mix of Atlantis Casino Resort Atlantis Casino Resort is a deluxe hotel and casino located in Reno, Nevada. Its facility mix includes approximately 1,000 rooms and Jacuzzi suites, nine operating restaurants, a night club that plays live music, a concierge hotel tower, a spa, a salon, and a family entertainment room. It also offers more than 150 table games and 1,400 slots in its casino (Dallas, 2006). Aside from these, its facility mix includes Las Vegas-type shows and water sports, such as windsurfing. The resort has a tropical theme that complements its excellent customer service, apart from its reputation for luxury. It has a 14-acre waterscape that serves as its centerpiece with grottos, lagoons, and other attractions. What is unique about its facilities is this combination of adult, children, and family activities, which other casino resorts nearby do not offer (Kraus, 2007). These facilities have helped the Atlantis in creating a unique selling point (USP). USP refers to an understanding of the products or services’ uniqueness from that of the competitors (King, Kerr, Jefferies, et al, 2005). In the case of the Atlantis, such USP can be initially seen in the combination of deluxe hotel and casino, as well as its other unique features described above. It would not be common for a casino to also have a complex resort system and other facilities that the Atlantis offers, making the entire business case to cater to various ages, including adults and children. The Atlantis has hence captured these target markets in its product offering. The casino and the night club are certainly places for older people, whilst the family entertainment centre, the waterscapes, and the water sports are for children and the whole family. This would mean that a family who wants to stay in a place that offers a range of activities would choose to come to the Atlantis over some others because of its unique features. It is worth-mentioning why resorts like the Atlantis need a unique selling point. This is because the USP serves as the reason why one’s product differs from everyone else’s, which draws customers toward the resort, thereby selecting it over all the others. According to King et al. (2005), USP can be as simple as offering the friendliest welcome or the easiest booking system. In the case of the Atlantis, its unique selling points are its reputation for luxury, excellent customer service, and various product offerings, as mentioned above. Moreover, why a resort needs a USP is because it serves as a clear benefit for the resort, whereby it enables the clients to be willing to pay to satisfy their needs (King et al., 2005). An important point to consider in line with the above heading is the idea that repositioning – or changing the current position of a certain business – can take place because of various circumstances, such as the emergence of a new competitor. This is seen in an example where conference venues in some UK resorts failed to continue to fulfill the needs of customers due to lack of maintenance and product enhancement (Davidson and Rogers, 2007). In the case of the Atlantis, it may be analysed that how it has responded to the use of sustainable transport alternatives has contributed to the resort’s reputation for excellent customer service. Problems and Challenges The problems that the resort faces are the unavailability of seasonal employees during peak season and lack of job security, which is a big concern amongst employees (Glass Door, 2014). The challenges include how it can attract visitors for its family-oriented activities during lean season and increase its revenues from these activities during this period (Glass Door, 2014). How Atlantis Casino Resort Has Responded to the Use of Sustainable Transport Alternatives In terms of the use of sustainable transportation alternatives, the Atlantis Casino Resort uses transport vehicles with latest technology and low carbon emission to protect the environment (Atlas Choice, 2014) in order to accrue with its existing sustainability policy. Encouraging its employees and visitors to use public transportation will contribute to reduction in automobile pollution, a green option for transport utilisation. The Atlantis partners with green transport companies that use the latest technology for environmental friendliness. This is in accordance with the resort’s green ethos and carbon footprint (Atlas Choice, 2014). Since the Atlantis safeguards its reputation for excellent customer service, its transport service is free, fast, and convenient, and guests do not have to wait a long queue in order to enjoy the service, (Airport Shuttles, 2014), neither do they have to be bothered by carbon emissions that can be exhumed by its vehicles. This is because the resort adopts the latest non-carbon emission technology in its transport system (Atlas Choice, 2014). The transport alternative system used by the Atlantis may be viewed as sustainable because of the environmental friendliness it offers. How the Resort Might be a Focus of Destination Development This section discusses the means through which Atlantis Casino resort might be a focus of destination development, using a resort destination development model – the Miossec model. First to consider is the fact that Atlantis Casino Hotel might be a focus of destination development since it is located in a region (Reno, Nevada) with many other resorts that offer more or less similar services. Examples of these are the Aquarius Casino Resort, the Avi Resort and Casino, and the Downstream Casino Resort, which are all a combination of casino and resort. Hence, the reason for the Atlantis to be a focus of destination development is the fact that it competes with others for similar markets and must identify a suitable market positioning based on its relative strengths (e.g. Murphy, 2008). According to the Miossec model, the development of a resort area in a peripheral location starts from its initial establishment towards being a composite hierarchical tourism area in terms of historical dimensions (Krakover and Gradus, 2002). This model may be considered the most logical geographical description of destination development as it depicts a progression of such destination from its infancy through maturity (Gunn, 2014). Along with the stages of development, the reaction of prospective and actual tourists on one hand, and transportation developments on the other, are two separate aspects. The Miossec model depicts the parallel development taking place in the Atlantis Casino Resort, transportation, and number of customers. Hence, this model impliedly assumes a direct relationship amongst the growing number of attractions, transportation improvements, and increasing customer demand in the Atlantis (Krakover and Gradus, 2002). The model in fact focuses on the spatial and te mporal development of destination in relation to physical change. It identifies the interaction of four major elements influencing the resort’s destination development: (1) â€Å"the characteristics of the destination; (2) tourist behaviour; (3) mode of transportation; and (4) attitudes of residents and decision-makers† (Latkova, 2008, p. 19). Taking the Miossec model, Atlantis Casino Resort has gone through minimal developments in its initial phase. During the second phase, it went through a development as a pioneer resort in its area. In the third phase, it presented noticeable changes through which there has been expansion of a system of resorts (where the Atlantis is part) to serve an increasing number of tourists, and where residents either accept or reject the presence of such tourism development. The last stage has seen further development of the area (Latkova, 2008). Since the Atlantis is already an established luxury hotel resort in Reno, the Moissec model of destination development is relevant, particularly in this fourth stage. In terms of where the Atlantis Casino Resort would be positioned in the Moissec model, such positioning is in its destination characteristics (being a casino resort that also features family-oriented activities), analysis of tourist behaviour, considerations for an alternative transport system, and the way it takes into account the attitudes of decision-makers, such as the local government with whom it partners for environment-related matters (e.g. Latkova, 2008). In order to be different from all the others and strengthen its USP as described earlier, Atlantis could pursue the development of a visitor attraction that harmonises with its adjoining environment, such as an aquarium park that can showcase the destination and add to the number of customer activities. It could also ‘adopt’ an adjacent natural attraction and take steps to ensure it can be adequately maintained, for example, by sourcing outside funding. Here, one can see the attitudes of decision-makers being considered and applied to the development, which is the model’s key element influencing the destination development (e.g. Latkova, 2008). It has been noted that the value creation of resorts does not match that of Porter’s value chain configuration due to the non-sequential operational process embodied in a resort destination (Murphy, 2008). Hence, the destination development that Atlantis Casino Resort shall pursue does not adopt Porter’s principle but a ‘value fan,’ (Murphy, 2008) which considers a site and individual focus for its destination activities, sustained by administrative functions that are tasked to aid the entire destination. In order to assimilate the value fan into the resort’s strategic management approach, the resort must manage its tourism product mix configuration (Murphy, 2008), where the right blend of products are being developed to fulfill customer expectations and thereby create the best value prospects for them. In the Atlantis’ destination development pursuit, it is necessary to address some major principles, such as ensuring the purpose of every development item; designing for people; satisfying both functional and aesthetic aspects of the development; establishing substantial and appropriate experiences; fulfilling technical requirements; and meeting customer needs for the lowest possible cost, to mention a few (Murphy, 2008). Development Problems and Management Challenges The identified development problems for Atlantis Casino Resort are the following: (1) a possible lack of balance/leverage between financial costs and revenue from the development (Vogel, 2012); and (2) lack of sufficient knowledge and skills of existing employees for new areas of development, i.e. the aquarium park that features exhibition shows inside the aquarium, which require skillful staff (Robinson, Luck, and Smith, 2013). The Atlantis addresses the first problem by conducting a financial feasibility study, which can situate the new development within measurable and realisable goals without incurring costs that exceed the returns. For the second problem, this is tackled by providing training to staff to match the requirements of the new developments (e.g. Zainai, Radzi, Hashim et al., 2012). The management is challenged by the presence of various hotel resorts within the same area where it is located, which offer similar activities to visitors. It is therefore faced with the task of differentiating its range of product offering and activities, but is further delimited by the nature of the business, where the Porter’s value chain principle is not applicable (e.g. Murphy, 2008). This is addressed by conducting an effective marketing strategy that features the resort’s uniqueness and leverage. The Atlantis is also challenged by the need to identify excellent programmes and product schemes for the lowest price possible (Murphy, 2008). This will be addressed by doing a financial study to ensure revenue despite the lower cost offering. Conclusion This brief provides a discussion of the facility mix offered by Atlantis Casino Resort; how it responded to the utilisation of sustainable transport alternatives; how it might be a focus of destination development; and development problems and management challenges thus identified. The Atlantis is a complex facility mixing hotel and casino, with a reputation for luxury and customer service. These aspects have contributed to its USP. The resort has responded to the use of sustainable transport alternatives by partnering with environmentally friendly transport companies. The Miossec model is used to explain how the Atlantis might be a focus of destination development. This model states that there is a parallel development occurring in the resort, the transportation, and the number of customers. Development problems include a potential lack of balance/leverage between financial costs and revenue; and lack of sufficient knowledge and skills of existing employees for the new development. The Atlantis is also challenged by the presence of casino resorts within its area that offer similar services, as well as the identification of excellent programmes and product schemes for the lowest price possible. References Airport Shuttles (2014) Concierge Tower at Atlantis Casino Resort Spa. Retrieved on April 23, 2014 from http://www.airportshuttles.com/reno/concierge-tower-at-atlantis-casino-resort-spa.html Atlas Choice (2014) Reno Atlantis Casino Hotel. Retrieved on April 25, 2014 from http://www.atlaschoice.us/cheap-car-hire/nevada/reno/reno_atlantis_casino_resort/address/41910/3800-s-virginia-street-reno-nv-89502-usa-nevada Dallas, J. (2006) Casino Shrine. FL: Kai Dee Marketing. Davidson, R. and Rogers, T. (2007) Marketing Destinations and Venues for Conferences, Conventions and Business Events. UK: Butterworth-Heinemann. Glass Door (2014) Atlantis Casino Resort Spa. Retrieved on May 5, 2014 from http://www.glassdoor.com/Reviews/Atlantis-Casino-Resort-Spa-Reviews-E348105.htm Gunn, C. A. (2014) Vacationscape: Developing Tourist Areas. London: Routledge. King, B. (1997) Creating Island Resorts. London: Routledge. King, C., Kerr, A., Jefferies, M., and Brombley, D. (2005) Travel and Tourism. Oxford: Heinemann Educational Publishers. Krakover, S. and Gradus, Y. (2002) Tourism in Frontier Areas. England: Lexington Books. Kraus, N. P. (Ed.) (2007) Frommer’s USA. NJ: Wiley Publishing. Latkova, P. (2008) An Examination of Factors Predicting Residents; Support For Tourism Development. Ann Arbor: ProQuest LLC. Murphy, P. (2008) The Business of Resort Management. London: Elsevier Ltd. Robinson, P., Luck, M., and Smith, S. (2013) Tourism. Oxfordshire: CABI International. Vogel, H. L. (2012) Travel Industry Economics: A Guide for Financial Analysis. NY: Cambridge University Press. Zainai, A., Radzi, R., Hashim, R., Chik, C. T., and Abu, R. (2012) Current Issues in Hospitality and Tourism: Research and Innovations. UK: Taylor & Francis Group.