CARE OF CLIENT IN LABOR AND DELIVERY Essay Example for Free

CARE OF CLIENT IN LABOR AND DELIVERY Essay Within our care of the patient, we were able to identify several problems that correlated to affecting our client’s ability to carry out the labor and delivery process. We also have identified several risk factors that posed a danger to the client’s prenatal and postpartal state. Based on our analysis, problems such as fatigue related to labor and delivery process and deficient knowledge related to new condition, procedure, and treatment /delivery process. Not only have we identified problems such as the ones stated. We have also managed to identify that our client is noncompliant with regards to her health beliefs and value system, powerlessness related to inability to make decisions with respect to taking appropriate health actions and interrupted family processes related to conflict between family members. Characteristics such as this have managed to add an additional problem in affecting her health. Though we managed to provide nursing interventions on several problems, we had also identified several risks such as risk for inadequate tissue perfusion r/t decreased cellular components required for the delivery of oxygen or nutrients to the cells s/t anemia and another risk like anemia related to her ineffective health maintenance. In a time of in our care, all things identified were provided with an intervention. Interventions that are not merely dependent but also independent. And through evaluation, certain goals were met upon our care. Teenage pregnancy will always have higher risks for acquiring anemia. In our analysis of the case, Madam M’s noncompliance with taking recommended medications and inadequate prenatal check-ups may also be one of the factors that lead her to have anemia. That’s why we came up with how important the nurses’ roles are in educating the subject to being active and participative in every care of plan health workers and as well as the subject should mutually collaborate. We also have studied that her condition could have been prevented from being her current illness if only she had her adequate prenatal check-ups together with her proper diet. Although it will never be good for the nurses to coerce any individual to be obliged follow what is to  be done, but at least nurses should help the subject to realize the significance of each heath practices. We also have concluded that it will be best if the nurses should be a listener considering that the subject is a teenage r.

Meeting Childrens Needs Using A Holistic Approach Young People Essay

Meeting Childrens Needs Using A Holistic Approach Young People Essay Play is the only way the highest intelligence of human kind can unfold Joseph Chilton Pearce Critically discuss how practitioners can meet childrens all-round care, learning and development needs by adopting a holistic approach. Recent government publications have focused on frameworks which support a holistic approach to the care and development of children. This essay will explore recent and historical theories of holism and the merits of such in the context of early learning. It will investigate how differing approaches meet the individual needs of children. It will discuss how the Common Core of Skills and Knowledge for the Childrens Workforce enables the five outcomes of Every Child Matters: Change for Children (ECM) to be delivered through the Early Years Foundation Stage (EYFS); simultaneously embracing a holistic, play based approach to learning and development. It will also identify the need for practitioners to truly understand and fully embrace their principles in order to deliver a child centred curriculum. Additionally it will explore the writings of those who appose the EYFS and establish if these notions are justified. References will be made to the writers setting and this will be referred to as the setting. Through play, the holistic development of the child is encouraged. Holistic is a term devised from the Greek word meaning whole and entire. A true holistic approach is child centred, recognises that every child is individual and unique, and should be treated with respect, regardless of age, race, religion, social status, disability. Every child has the right to a safe, secure, happy childhood with accesses to outside agencies who can offer support if needed. Play is a means through which children explore and make sense of their world preparing them for adulthood. Children are naturally curious, and by providing space, resources, opportunities, positive interactions with adults, peers and a safe environment for them to explore, learning and development will take place. Research undertaken by play for change (2008) revealed that play is vital to a childs development and practitioners should hold a sound knowledge of it. It is through play that children learn from their mistakes and bui ld relationships with others. There is no right or wrong way to play, it is something that morphs and changes constantly. It becomes, evolves and is built upon by the child. Pound mentions that; Play encourages creativity and imagination. It is intellectually, socially, emotionally, physically and linguistically challenging and encourages children to work in depth (alone and with others). It can offer all children the chance to explore and learn at their own pace and stage of development. It has a crucial role in enabling children to consolidate learning (Pound 2008 p74) Children should all have the right to an individual, experience rich learning environment, which is provided by practitioners, who have a clear understanding of how to meet their learning needs and styles. This in turn will engage childrens learning and enable them to develop and reach their full potential. Lindon defines the term holistic in a child context as; A holistic or whole child approach stresses the importance of thinking about and behaving towards children as entire individuals, that all their skills are important and support their whole development. Lindon (2009) p10 And Miller (2000) describes holistic education as; each person finds identity, meaning, and purpose in life through connections to the community, to the natural world, and to spiritual values such as compassion and peace. Holistic education aims to call forth from young people an intrinsic reverence for life and a passionate love of learning. The Children Act (2004) and ECM underpinned all legal changes to the childrens services. The ECM document, aims to protect children from harm, keep them healthy and help them to achieve their goals in life. Prevention, intervention and protection are at the forefront of this wider vision by promoting multi-disciplinary working and effective protection for children. The EYFS is the framework central to a ten year strategy that brings together all other existing frameworks. Integrated within the EYFS are the five outcomes of ECM, which are, be healthy, stay safe, enjoy and achieve, make a positive contribution and achieve economic well- being. Also the principles of the Common Core of skills and knowledge, which are; effective communication and engagement with children and families, child development, safeguarding and promoting the welfare of the child, supporting transitions, multi agency and integrated working and information sharing. These combined frameworks provide a child centred approach to the care and education of children. This is underpinned by a holistic, play based approach. It will ensure that all children have access to a consistent approach to care, learning and development. It is essential that all practitioners have a sound understanding of current frameworks and how to relate them to every day practice thus ensuring they are me eting the needs of all children. Maslows theory of the hierarchy of needs forms the basis of a holistic approach. Maslow identified five levels of need, starting with food and water. The next stage is safety and love followed by self esteem. At the top of his pyramid is self actualization. He believed that a child can not progress to the next stage until all their current needs have been met. He considers it the priority of the curriculum to meet the needs of children inside the classroom. The practitioner must provide an environment where children are safe, secure and emotionally stable and have a sense of belonging. A safe and happy childhood is the bedrock for childrens future learning and development. This concurs with the principles of the EYFS when providing a holistic education for children and the DCSF write that; A secure, safe and happy childhood is important in its own right, and it provides the foundation for children to make the most of their abilities and talents when they grow up. (DCSF 2008, p7) Children begin learning and developing before they are born and research proved that; 90% of a childs brain connections will be made by the time they are five. That means that their development and learning from birth to the age of five has significant influence on their future lives. (CWDC, 2010) During this period children are more responsive to the care and experiences they encounter. Bertram and Pascal (2006) p.70 discuss how high quality effective experiences provided in the early years improve life chances. Looking at the child holistically, with distinctive needs, interests and learning styles is beneficial to their development, and it is the belief of Hutchin that; To ensure children are confident, happy and engaged in learning their individual needs must be met. Hutchin (2006) p30 The notion of a holistic approach to education is not a recent one, and was identified as far back as 1805 by Pestalozzi (Pound 2008 p8). He was of the opinion that education was personal, and must appeal to the learners interests. He stressed the importance of recognising the uniqueness of all, and believed everyone had the potential to succeed. The EYFS integrates these principles into the framework and believes that; The EYFS and the Early Learning Goalsprovide sufficient flexibility for practitioners to follow childrens interests, respond to their ideas for developing play activities, and provide structured activities (which can also be playful to teach specific knowledge and skills. DCSF (2009) p4 Te Whariki, the curriculum of New Zealand also stresses the importance recognising children as unique, and that working closely with families is crucial to a childs development. It emphasises the important role play has in learning and development, and through its holistic approach aims to ensure all children grow up competent and confident, and can contribute positively to society. It also aims to ensure children are physically and mentally healthy (Pound 2008 p67- 69). Howard (2010), pointed out that; Early Years Education today needs to be far more creative than it has been in the past, as it needs to equip children with the skills and processes for an unknown tomorrow. (Howard, 2010 p51) Addressing childrens individuality and uniqueness through a holistic approach will ensure they progress to healthy adults, and enable them to remain a confident, stable member of an unpredictable world. Palmer (2006) p198 discusses how every child has a desire to learn and has an indication of what they want to learn. If the adult is aware of the childs interests, they will incite their enthusiasm and desire to learn more. He also writes that a rigid curriculum which gives no thought to a childs interests, or what inspires them, will not facilitate learning. The core principles of the EYFS are that, children learn and understand the world in which they live through play. Purposeful play primarily facilitates the development of social and emotional skills. These skills then assist all other areas of learning. Learning must be pleasurable, stimulating and challenging and performed in surroundings that reinforce holistic development. It is essential that it provides them with enough skills and self assurance to become a competent learner. All childrens individual needs and interests should be planned, through analysis of careful non judgemental observation. Planning should be individual, and incorporate a childs unique interests and developmental stage. Some do not fully understand the principles of a holistic approach and the aims of the EYFS, or how to implement them correctly, to ensure the children are happy, engaged learners. This therefore, highlights a need for settings to ensure that all practitioners are suitably informed, and educated regarding its principles and delivery. A true understanding of its core values and aims is vital, and all who implement should understand that; Play underpins the delivery of all the EYFS. DCSF (2008) p 6-7 Many of the children within the setting can become restless in situations which are of no interest to them. The most common is during the extremely formal registration period. The relevance of such an activity, should, be considered to determine whether it holds any learning potential. The Setting Manager considers the formal approach to learning favourable, and insists all children gather together at the beginning of each session for thirty minutes carpet time and registration. It is believed, that this is an unrealistic time scale for children to sit quietly listening to one adult. Unfortunately, the Foundation Stage Manager has a differing opinion. She is of the belief that children do not learn through osmosis or child initiated play, and that an adult must have constant input in order for any learning to take place. Adult initiated activities are interpreted as; the children are given worksheets daily and asked to complete them following a model on the board. All children are gi ven the same worksheet regardless of their ability. These worksheets are then used as evidence to add to their port folios. It is her belief that the purpose of observation is for expanding the content of a port folio and not the main source of evidence for assessment. To try and counteract these issues the larger of the two areas in the Foundation Unit has been re-organised. Low level print and interactive displays have been added. All areas have been made more accessible and enhancements such as materials, pictures and books added, to provide a good continuity of provision. Mark making tools have been placed in baskets around the area, these can then be transported by the children into other areas to encourage, and promote early writing skills. Numbers have been placed around the unit in various forms and interactive displays where shapes, numbers and colours can be sorted, have been added to promote problem solving, reasoning and number as well as fine motor skills. Photographs have been added to shelving units to help children to when tidying away. All provision is now accessible at all times allowing the children free flow play whenever possible. The two outdoor areas have also been improved, adding various materials to support learning. There are still many more improvements to be made both indoors and outdoors. Contrary to the managers beliefs, children are observed when possible by all other staff members. These observations are used to inform the planning of some team members. More in depth training as to the holistic aims of the EYFS, and its correct delivery would be advantageous. However, following her retirement in July, September will bring new changes to the routines of the setting, and promote a more child centred approach to learning. It was the belief of Montessori (Pound 2008 p 29-31) that a childs natural ability to learn stems from solid experience and the use of objects to explain ideas and concepts. Observation played a major role in her work and a fundamental part of the EYFS is assessment through observation and it identifies; Providers must ensure that practitioners are observing children and .use these observations and assessments to identify learning priorities and plan relevant and motivating learning experiences for each child. DCSF(2009) p16 Italys Reggio Emila approach to learning not only agrees that all children have potential, and are individual and unique, but it also believes that observing and recording childrens experiences and play through various means e.g. photographs, videos, written observations is crucial to learning and development. (Pound 2008. P52, 53) Nutbrown and Carter (2010) p114 write that; Watching and learning are the essential tools of assessment with which practitioners can both establish the progress that has already taken place and explore the futureThe role of the adult in paying careful attention to childrens learning, and reflecting upon that learning, is crucial to the enhancement of childrens future learning. Observation plays a key part in establishing a childs developmental progress, interests and learning styles. Observing children in everyday activities enables practitioners to build up a precise image of the child, their understanding, and personal interests. These judgements should be based on childrens actions that are independent and uninfluenced by an adult. A holistic practitioner must be able to identify a childs individual learning needs and care requirements, as well as establish how their learning and development has progressed. Coates and Thompson agree that; In recording development and progress, relationships and actions become significant and illustrative of the progression in childrens learning. Coates Thomson(2010) p68 The holistic approach of the EYFS promotes the use of observations and maintains their importance in a childs development. It writes; observe childrens activities carefully, trying to discover what the child is thinking about and learning and the goals of the play, so they can accurately support and extend the childs learning focus either at the time, or later by changes to the environment or in planned activities. DCSF(2009) The project approach is a more recent approach to education and believes that all children have the desire to learn and want to make sense of their experiences through hands on experience. They must identify situations where learned skills will be useful and used appropriately to solve problems. Children build on their existing knowledge and they need the practitioner to aid the progression of these skills Classrooms must offer flexible learning which supports the needs of all children (Chard). A skilful practitioner will have the ability to engage with children and support these concepts. The EYFS recognises the importance of these ideologies and makes many references throughout the document on how to implement these measures and incorporate them into the curriculum successfully. It has been established that learning through play is central to the ideologies of the EYFS and indoors and outdoors are both equally as important as learning environments, and both equally as important in a childs development. It states that; Play underpins the delivery of all the EYFS. Children must have opportunities to play indoors and outdoors. . DCSF(2009) p7 The EYFS believes that children should be allowed to have responsibility for their learning and be able to make decisions and learn from their mistakes. A great deal of emphasis is placed on the fact that what a child can already do and are interested in, is a starting point for their learning Tassoni and Hucker agree that; Play is considered to be one of the primary needs of a child. Play is often said to be childs work Play is the main way in which children learn, and therefore play affects all aspects of a childs development. Tassoni Hucker (2000)p.1,5 The EYFS offers a developmentally, flexible continuum of goals for children from birth to five. For practitioners who agree with its principles and understand its true pedagogy implementation should be reasonably unproblematic. There are six areas of learning and development within the EYFS, which are broken down into, one hundred and seventeen scale points. Scale points four to eight are not hierarchical and can be achieved in any order. Scale point nine reflects those children who are beginning to move beyond the early learning goals. Many of the scale points interrelate and are often achievable together. The developmental stages of the EYFS overlap recognising that children are unique and will develop, grow and learn at differing rates. The children in the setting have a broad spectrum of abilities, and the flexibility and overlapping developmental phases of the EYFS enable practitioners to effectively identify where children are in relation to their development. It also assists s ome practitioners to plan and resource for individuals, as well as small groups who share similar abilities and interests. One member of staff works solely with a child who has special educational needs and she finds the EYFS guidance a valuable tool for establishing his progress when planning activities to support his learning, using the Look, listen and note section. This exemplifies the EYFS has a true understanding of the holistic approach to childrens development. Kelly agrees that; An important feature of the EYFS is the principle of it being a developmental framework. Rather than prescribing a set of learning objectives or targets, it is intended to provide a continuum of development (milestones) which acknowledges the fact that children are unique and may not progress in the same way or at a uniform rate. Kelly (2009) But is the EYFS as holistic and child centred as it claims to be, some think not, the Open Eye Campaign believes it is; overly prescriptive, potentially harmful to the development of children and a breach of the human right of parents to have their children educated in accordance with their own philosophies. Open Eye (2007) However, the DCSF counter argue that; There is no obligation in the EYFS for children to reach any particular standards The EYFS is founded on the importance of play. It doesnt require any formal approaches, and in fact discourages them, recognising that children need to play to have fun and to learn about the world around them, by playing freely with support from adults. DSCF(2008) p9 And the QCDA( Qualifications and Curriculum Development Agency) states that; Parents can apply for an exemption to the school that their child attends, if they consider that the learning and development requirements of the EYFS framework (or some element of them) are in conflict with their religious or philosophical beliefs. QCDA (2010) These statements reinforce that the core principles of the EYFS places the child at the centre of its practice, and any parent has the right to withdraw their child from any aspects of the curriculum they disapprove of. It also confirms that parents do have the casting vote on how their child is educated. Within the developmental stages are the early learning goals. These are not necessarily attainable by all children, and the goals cover a wide range of achievable objectives. In agreement with the earlier citation by Kelly (2009), it is believed that it ensures all children, whatever their stages of development have their learning needs identified and met. Most children will not have achieved all scale points at the end of their reception year and ideally implementation of the EYFS should continue into KS1. In their letter to the Department for Children, Schools and Families, Siraj-Blatchford,  Duffy  and Nelson request that the EYFS; Continues the Early Years Foundation Stage to the end of Key Stage 1. Siraj-Blatchford,  Duffy  and Nelson (2008) Kirklees are in agreement with this fact and write that; Teachers in Y1 can continue to use the EYFS Profile as their assessment tool for children where they consider this to be appropriate. This will be particularly the case for children who have not obtained any or most of the Early Learning Goals (ELG) scale points 4-8 in a particular EYFS Profile scale. Kirklees (2009) Transitions can sometimes prove stressful for children and this is recognised by the Common core of skills and knowledge. This asserts that, supporting a continued approach will enable the child to adapt more easily to stressful situations they encounter throughout their lives. These could be between classes or family issues. Within the setting a great deal of training and discussion has taken place to implement these measures, ensuring the Year One Teacher plans effective, responsive activities that support continued development. Many changes have been made to the set up and structure of the Years One classroom to guarantee a continuum of good practice which will enable children to carry on achieving. It is also essential that practitioners listen and respond to childrens needs and feelings. Assisting them to overcome difficulties and address any problems they face. Sharing these fears and worries with others will help them deal with them in a controlled, safe environment, with attentive, understanding impartial adults The children within the setting attend circle and nurture time on a weekly basis. This session allows the children a chance to discuss how their actions, and the actions of others impact, both positively and negatively on feelings. Children are given the opportunity to discuss their feelings, worries and concerns with a member of staff who is trained to deal with them. Any serious concerns are forwarded to the designated person in charge of child protection. They are dealt with in a tactful and sensitive manner following the relevant policies. This activity also reinforces social skills such as turn taking and sharing. One of the achievable goals outlined in the EYF S is; Work as part of a group or class, taking turns and sharing fairly, understanding that there needs to be agreed values and codes of behaviour for groups of people, including adults and children, to work together harmoniously. DCSF(2008) During this session they also participate in nurture time this is based on the premise of play therapy and the children are given the opportunity to address their feelings through carefully controlled play situations. It gives them a chance to deal with, and express their emotions in a calm controlled way, with staff who are trained to deal with and support the child through any difficult and emotional times. The EYFSs holistic aim puts the child at the centre of all practice and recognises their individuality. It welcomes and celebrates difference and diversity in all, and great importance is placed on communicating effectively with parents and involving them in every process of their development. Parents are recognised as the childs main educator. Part of this involves each child having a key worker who will help them to develop whilst offering support to both the child and the family. Key workers provide a safe and secure attachment for the child and their parents. They are a point of contact, with which parents can discuss any worries or concerns. They are responsible for a small group of children who they help to settle and observe. They liaise with parents and other outside agencies where necessary. This concept relates to Bowlby and Goldschmieds theory of attachment. Both believed that secure attachments are essential for positive social, emotional and intellectual development, and that children will show a preference to one adult, and that these attachments are a normal part of development. (Pound 2008 p44-45). Jackson (2009) draws our attention to this and writes; the key person system is designed to ensure that each child in a day nursery has a special relationship with an individual staff member. Jackson (2009) There are two Teachers, two Nursery Nurses and two Classroom Assistants within the setting and although certain children and parents have formed attachments with staff, there is currently no key worker system in place. This decision was not undertaken without due consideration. Many incidents have occurred, where one of the Classroom Assistants had miss informed parents and wrongly recorded information, she was offered the relevant training and self development but declined the offer, stating that she did not have the time or the confidence to drive to other locations. Other members of staff offered help and advice, but this too was declined. These concerns were brought to the attention of the Head Teacher, who recommended that a well informed member of the team should be readily available whenever parents are in the building, and all recorded information should be checked before being placed in the childrens profiles. At this present moment in time these issues are still been addres sed, and it is hoped that in the near future an effective key worker system will be established. Although children may appear the same and share similar interests they are all individual and unique. This not only relates to their interests, development, and learning styles but also their race, religion and cultural heritage. By celebrating and embracing difference and diversity the EYFS maintains that every child is included and not put at a disadvantage. It is important that every child must learn to value the differences and diversity in others and mature into confident adults that will make a positive contribution to society. In her introduction to diversity, inclusion and learning in the early years Siraj-Blachford identifies that; In modern, diverse societies, and a world that increasingly recognizes the realities of global interdependence, it is essential that children learn social competence to respect other groups and individuals, regardless of the difference. The learning must begin in the earliest years of a childs education. Siraj-Blachford (2010) p151 Pound (2009) p 9-11 discusses how Bronfenbrenner developed the Egological Systems this theory relates to how everything that surrounds a child has an influence on their development, and that practitioners must treat all children, their families, beliefs and culture with respect and create a setting that is both welcoming and accepting. In recent years the setting has become a more diverse environment and now welcomes families of differing religions, countries and heritages. In order to ensure each individual felt accepted and valued, a display which contained the words hello and welcome in several languages was added. This was displayed along side a talented wall which contained a picture of each child engaged in their favourite activities and the words I am talented, together we are awesome, because I can. The Leeds Gypsy Roma Traveller achievement service also provided a range of resources which were displayed around the setting. The aim was to raise awareness and overcome prejudice of the Gypsy, Roma and Travellers in the setting and highlight the values of their culture and heritage. A parent informed the setting that she had enjoyed looking at the displays and artefacts and had gained a great deal of knowledge and understanding from them. One child became greatly interested in the objects displayed on a table. He took ownership of the toy caravan and placed it into his pocket at the beginning of every session. He removed it at intervals during the day and used it to enhance his play in various areas. He then placed it back on the table before he left, usually hiding it behind a bigger object where it was safe for the next day. All current frameworks place a strong emphasis on safe guarding, multi-agency working and information sharing between settings, social services, health professionals and all those who come into contact with children. The common core of skills and knowledge emphasises the importance of practitioners holding a sound knowledge of how these agencies work and interrelate. Early intervention is vital. When effective, operational partnerships are formed between various organisations relevant information can be obtained and acted upon rapidly ensuring problems are detected and addressed before they become harmful to the child. A practitioner who recognises the holistic approach to the child must be aware of the policies and procedures when dealing with safe-guarding issues. The common core of skills and knowledge are not yet legal requirement any many settings and practitioners are unaware of its existence. Making this legal requirement will guarantee all practitioners are capable of deliver ing its aims in the correct manner with the child at the forefront of their practice. This outlines the necessity for practitioners to be reflective and undertake regular personal development to ensure they provide the best quality of care and learning. It also requires practitioners to regularly reflect on and develop their own practice, in order to improve the provision, learning potential and wellbeing of individuals in the setting ensuring their individual needs are met. Conclusion When delivered as intended the Common Core of Skills and Knowledge, ECM and the EYFSs principles do place the child at the centre of all good practise. They stress the importance of meeting a childs individual needs and care requirements. None the less it has been established that some do not comprehend how to deliver it effectively understanding truly the childs uniqueness. This has identified a need to further train practitioners in its aims and principles. Many theories and approaches have been considered when compiling the EYFS and the most vital components have been added. John Oates (2007) one of the writers of the EYFS, states that it recognises the importance of uniqueness and developmental differences between children. He claims that assessing children is not to establish success or failure, but to stress how the main areas of learning are built upon from previous experience. Although the school that the setting is attached to aims to provide a holistic approach to care and education, it has been established that the setting and its staff needs to go through man

Hal Riney & Partners, Inc :: essays research papers

Hal Riney & Partners, Inc Ownership/size/locations -   Ã‚  Ã‚  Ã‚  Ã‚  Hal Riney & Partners, Inc., one of the most famous privately-owned advertising agencies in San Francisco, CA, was founded in 1986 by chairman and CEO Hal P. Riney himself. With the branch office in Chicago, Hal Riney & Partners Heartland, reaches out to clients in different regions as well. Both San Francisco and Chicago offices employ a total number of approximately 350 employees. Income/profitability -   Ã‚  Ã‚  Ã‚  Ã‚  As of July 1996, Hal Riney & Partners, Inc., had an approximate annual billings of $475 million. The breakdown of gross billings by media are as followes: Newspaper - $38 million; Business Publication - $4.75 million; Transit - $4.75 million; Outdoor advertising - $19 million; TV - $275.5 million; Radio - $42.7 million; Collateral - $9.5 million; Consumer publication - $57 million; and cable TV - $23.75 million. Nowadays, the average percentage of earning for advertising agencies is approximately between .05% to 1% of the total billings. With a billing of $475 million, it would be logical to assume that Hal Riney & Partners earns approximately $2.375 million to $4.75 million. With the acquisition of several new accounts including Acer Group and Sprint Spectrum, Hal Riney’s billing is now approaching $600 million. Management Profiles -   Ã‚  Ã‚  Ã‚  Ã‚  The chairman and CEO of Hal Riney & Partners, Inc., is Mr. Hal Riney. There are over 30 Sr. VPs and VPs holding various positions at the San Francisco office alone. Some of the key personnel at the San Francisco office includes Vice Chairman - James Travis; Chief Financial Officer & Executive VP - Lyn Muegge; Executive VP & National Creative Director - Joe O’Neill; Executive VP, and Managing Director - David Verklin; Executive VP and Corporate Development - John Yost; and Creative Director - Gerald Andelin.   Ã‚  Ã‚  Ã‚  Ã‚  The Chicago office handles a set of different clients with its own different personnel such as Barray Krause - Executive V.P. and Managing Director; Jonathan Harries - Executive V.P. and Executive Creative Director; Catharine Gerber - Senior V.P. and Media Director; and Paul Janas - Senior V.P. and Creative Director. Hal Riney has recently added Scott Marshall as the president on his pay roll after several unsuccessful search for new partners. In the past 18 months, Hal Riney had also held conversations with Interpublic Group (who owns McCann-Erickson, Lintas, etc.) and W.Y. Choi (a majority owner of N.W. Ayer & Partners) in attempt to sale his agency. Clients -   Ã‚  Ã‚  Ã‚  Ã‚  Hal Riney & Partners serves a variety of clients from auto maker to fast food restaurant. Current major clients include Acer Group, Alamo car rental company, Birkenstock, The Walt Disney Company, Cox California PCS, GM Electric

interstellar pig :: essays research papers

Interstellar Pig :Funky Stuff by   Ã‚  Ã‚  Ã‚  Ã‚  Outrageously the most entertainingly fiction but yet real life book that I have ever read. This book was outstandingly filled with mysteries and packed with entertainment for the reader.   Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚  Barney, a teenage boy, and his parents rent a summer cabin on one of California’s beaches. They realize that their neighbors wanted this cabin very much but Barney and his parents ended up getting it. When Barney meets his neighbors he thinks that they are a little bit weird but his parents don’t think that they are too bad of people in fact they sort of like them. His neighbors also have a very strange game they play that’s called Interstellar Pig it is a very strange game. Their neighbors are about in their mid-twenties there is one girl, Zena, and two boys, Joe and Manny. Barney finds out that these neighbors wanted his house because there is some hidden secret in it ,which Barney doesn’t have a clue what it is but one day finds out about a little, well big, drawing that points to an island off of one of the coasts by his house about one or two miles away. When his neighbors find out about this they want to go there right away but wi thout Barney, but does Barney go, what do they find at this island, what happens after they find out what’s there? And what happens with this weird game they play?   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  The characters picked for this book couldn’t have been better. Their descriptions and everything else fit so perfectly. I don’t think anything could have fit better. William Sleator did a wonderful job of writing this book. He just fit everything including the characters in very well.   Ã‚  Ã‚  Ã‚  Ã‚  When I first got this book from the library I did it because I had about ten seconds left in my study hall and needed a book for English class so I just grabbed it off of the wall. My first intentions where what kind of stupid book is this by just looking at the cover but about two chapters into it I really got into it and liked it.

Free Essays: Language in Where Are You Going, Where Have You Been? :: Where Are You Going, Where Have You Been

When a person is put in an incredibly horrifying situation where the outcome is unpredictable many physical and emotional changes take place. Joyce Carol Oates’s story "Where Are You Going, Where Have You Been?" places Connie, a typical teenager, in this situation. Throughout the story, occasionally using religious undertones, Connie’s language of a typical teenager gradually changes, from calm and somewhat curious to nervous and terrified. Early in the story on a Sunday morning, Connie’s family leaves to go to a family barbeque down the street. Connie is left by herself and chooses to wash her hair instead of going to church. When she hears a car driving up to her house, her heart starts pounding, she pulls at her hair and says, "Christ. Christ.," not in reference to the Lord or religion in general but because she is worried about how bad she looks. This gives and indication of how the author interprets religion in the story, not important and not serious. As the story progresses, Connie’s language takes an obvious turn. When Arnold Friend, someone she has seen but never talked to, shows up on her doorstep, she is somewhat defensive, but curious. "I ain’t late, am I?" is the first thing he says to her when she opens the screen door. Connie replies by saying, "Who the hell do you think you are?", a typical response of someone in that situation. If a complete stranger showed up at my house and talked to me as though we were best friends I would respond the same way. Throughout the story Oates continues to use vulgar language to illustrate the story and show how much Arnold Friend knows about Connie. The more Arnold talks, the more he reveals about his knowledge of Connie and the things and people around her. Soon, Arnold starts naming off all of Connie’s friends, assuring her, "I know everybody." Arnold also knows things about her that he would know only if he was with her all the time, "I... found out all about you like I know your parents and sister are gone somewheres and I know where and how long they’re going to be gone, and I know who you were with last night..." Connie’s fear of the situation sends waves of dizziness through her body, makes her hands shake, and causes "Her heart [to be] too big now for her chest and its pumping made sweat break out all over her.

Rhetorical Devices in Great Gatsby

Gatsby Essay Honors English II Asura Louise Osborne In the 1920’s, the world was full of new inventions, dances, and drinks. The standards of even the most rigorously structured social classes were changed, allowing the rich to cut loose and throw elaborate and entertaining parties. Every day, the world was changing for the better. Author F. Scott Fitzgerald’s work â€Å"The Great Gatsby† reflects these ideas, communicating through various rhetorical devices that the world is a magical place, and that even in times of sadness, anything is possible. Prior to the Jazz Age, growing up was associated with a loss of happiness and hope.During the 20’s, however, this standard seemed to change, pushing the perception of adulthood into something magical and frivolous. Fitzgerald reflects this in the archetypal portrayal of a city, describing it as â€Å"in white heaps and sugar lumps†. White is an archetype for purity, innocence, and hope. It illuminates the hope that the young adults living in the 1920’s felt, as well as the innocent parties they danced at, innocent not because of what took place in them, but because they were blissfully unaware of the harsh realities that existed elsewhere in the world.Happiness is also communicated in the use of the word â€Å"sunlight†, because the sun is an archetype for energy and hope. Through the personification of the city â€Å"rising up†, it is illuminated that the roaring twenties came from seemingly nowhere, almost like a fairytale. The magic of the upper classes’ world was also portrayed in the hyperbole, â€Å"all built with a wish. † In reality, the city merely began as a wish, but Fitzgerald portrays it as something that sprung up from a thought.Potentially the most illuminatory literary device is the imagery in the sentence â€Å"its wild promise of all the mystery and the beauty in the world. † The picture painted is one of excitement, hope, and perhaps most importantly, the creation of a wonderful world borne from fancy. In times of loss, a traditional coping mechanism is bargaining. This is generally portrayed as â€Å"If I do such and such, so and so will come back. † It is usually a time when the bargainer believes in part that anything is possible. F. Scott Fitzgerald dives into that idea when Jay and Nick become part of a funeral procession.One way he communicates the idea that anything is possible is in the juxtaposition of life and death, â€Å"A dead man†¦in a hearse†¦heaped with blooms†¦Ã¢â‚¬  His diction also illuminates this concept through the use of the word â€Å"blinds†, suggesting that most people are blind to the presence of possibility. In addition to diction and juxtaposition, Nick’s reaction to seeing blacks in an affluent setting also illuminates that Fitzgerald is communicating through him, â€Å"Anything can happen now†¦anything at all. † Even in the presence of a â€Å"somber holiday†, the world is still coming up with new possibilities.The world is ever changing, which is one thing that makes life on Earth so exciting. All of the changes that are present today really began in the 1920’s though, a time of new ideas and hopes. F. Scott Fitzgerald led America’s run head-first into the Jazz Age, and gave future generations a peek inside what life was like at the time with his novels. In his book, â€Å"The Great Gatsby†, he uses many literary devices to illuminate the concepts that life is magical, and that even in times of sadness, the world is filling itself with new possibilities.

Health care Essay

1a. What model of healthcare does the US and your chosen country have (Japan)? Be very specific. The United States has a healthcare system that is different from almost every country in the world. I would call the United States health care system a hybrid type system. I would call our system a hybrid because we fall into almost every type of category possible when it comes to health care; for instance, people who are uninsured have to pay out-of-pocket when they want to see a doctor versus someone who is insured and only has to pay a deductable. Many companies in the United States offer free medical care for employers, or they make health care insurance fairly cheap to afford. Unlike many countries our healthcare system is a little rocky. Insurance companies can drop you for being to high risk leaving you stranded to find another insurance company or leaving you to pay out-of-pocket. Our system has forced many of our fellow citizens homeless, or with masses amount of debt. Japan on the other hand has a Universal healthcare, in which everyone is covered up to 70% of the cost. Japan’s healthcare is much cheaper than hear in America because in Japan, it is accustom to their culture that a family member acts as a nurse, in which they help assist with the patient. In Japan, they have separate hospital beds in the room for a person from the family to sleep in. The family member acts like a nurse by providing food, cleaning, and changing sheet just to name a few. People from Japan who are employed but do not receive health coverage from their company, can participate in a national health insurance program offered and controlled by their government. People in Japan cannot be denied coverage unlike our healthcare in America, and by law Japans hospitals have to be a non-profit hospital which is run by physicians. 1b. In 10 sentences or less [emphasis on less], describe the Beveridge, Bismarck, National Health Insurance and Out-of-Pocket models. The Beveridge model is named after William Beveridge and was designed/implemented in Britain’s National Health Service. This system is funded by the government through tax payments, similar to how a public library works. According to PBS, â€Å"Bismarck-type health insurance plans have to cover everybody, and they don’t make a profit. Doctors and hospitals tend to be private in Bismarck countries†(Health care system–the four basic models, 2008. ). â€Å"Universal health care is a term that refers to a governmental system meant to ensure that every citizen or resident of a region has access to the required medical services†(What is universal health care, 2003-2013). According to TLC, â€Å"An out-of-pocket expense is a no reimbursable expense paid by a patient. This could include any medical benefits that your health plan doesn’t consider â€Å"covered services. † But out-of-pocket expenses can also include covered expenses that you are responsible for before your health-plan benefits kick in at 100 percent coverage. When the insurance company pays all of your expenses and you have to pay only your monthly premium, you have reached the out-of-pocket maximum’’(Jeffries, M. , 2013). 2a. What types of healthcare plans are available in each country? You must discuss each in detail. The US has managed care plans [Health Maintenance Organizations, Preferred Provider Organizations, Exclusive Provider Organizations, Point of Service Plans], and indemnity coverage as well as Medicaid and Medicare and your country’s plan so you need to touch on them all in order to be detailed in your response. The United States has a managed care plan; managed care is used to help control cost. For instance, lets say you are rushed to the hospital, the first thing they EMT’s will ask you regardless how hurt you are â€Å"do you have insurance†. It is sad that the United States has such a terrible health care system. The United States utilizes HMO, which is health maintenance organization, this plans limits the amount of doctors you can see. This is where a person pays a monthly premium in exchange they are covered for hospital visits, pediatric care, x-rays, and many other services our health care has to offer. The person who utilizes this plan generally has to pay co-pay, which the cost varies depending on the type of plan you have. Many people like this type of plan because when you go to the doctor you don’t need to fill out claim forms. Members show a card when they go to the doctor or hospital. The downfall to this plan is that you might have to wait longer in the waiting room. Another plan the United States has is called point-of-service plan. This plan allows the members of the plan to refer themselves to an outside plan and still be able to obtain some coverage. A doctor can also make a referral out of the network and in-turn the health care plan will pay for most if not the entire bill. A preferred provider organization is another type of plan offered by the United States. Just like the health maintenance organization, the preferred provider organization limits you to the number of doctors you can see, but when you do find the right doctor most of your medical bills are covered. The preferred provider organization requires you to choose a primary care physician in order to monitor your health care. If you elect to go to a doctor who is not part of this plan, some of the medical expenses are covered. I deem some people like this plan because if their primary care doctor is not part of the plan, they don’t have to change doctors. According to Health Insurance. Info â€Å"An Exclusive Provider Organization (EPO) is a network of individual medical care providers, or groups of medical care providers, who have entered into written agreements with an insurer to provide health insurance to subscribers. In EPO, medical care providers enter a mutually beneficial relationship with an insurer. The insurer reimburses an insured subscriber only if the medical expenses are derived from the designated network of medical care providers. The established network of medical care providers in turn provide subscribed patients medical services at significantly lower rates than what would have been under normal circumstances. In exchange for reduced rates of medical services, medical care providers get a steady stream of business†(Exclusive provider organization, 2010. ). Japan has a national health insurance plan; this plan for people who are not covered by their employer. You can obtain this health care plan by living in Japan for a year. Japan does have universal health coverage as well, but this plan varies between each individual. Some factors that affect this plan are: visiting, studying, working, your age just to name a few. Your premium that you pay depends on your salary you make for the year, so the cost varies for every individual. In Japan their health care system provides free examinations for specific diseases, infectious diseases and parental care. The government pays up to 70% of the cost for every citizen and foreigners who have lived in the country for a year or longer. Japan has an awesome health care plan compared to the United States, and I deem this is why their economy is flourishing and they have one of the healthiest populations in the world. People in Japan have a longer life expectancy compared to any other county in the world; I deem this is due to the bombing health care, their life style choices, and knowledge. 3a. What alternatives are available if an individual loses their healthcare due to job loss? In the US there is more than one alternative. Please be specific for each country. People in Japan are covered no matter what happens to their job. They have a universal health care system in which their government pays up to 70% of their entire cost for any medical bill. People, who don’t have a job, hardly have to pay any coverage when they are ill no matter how severe their condition is. Unlike Japan, in the United States you generally will loose your health benefits, or you will have till the end of the month to utilize it. Some employers will allow you to have your benefits for 26 weeks, which is ample time to find another job with health benefits. You will have to file a claim through your place of work in order to do this action. 4a. The storage of healthcare records are evolving? Describe what EHR, EMR and the cloud are with respect to this evolving technology. We want to see a minimum of five points per explanation. â€Å"An electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be created, managed, and consulted by authorized clinicians and staff across more than one health care organization†(What is emr and ehr, 2013. ). EHR’s has some great benefits, one great benefit it has over paper records is that it can notify a doctor or physician that a patient is due for a routine check up. Another benefit is that it makes it almost virtually impossible to loose or misplace someone’s records. I like the fact that you can call your doctor and ask them to just simply print and mail you your medical records with all of your medical history; it makes it much easier for a patient to access. I deem one day that doctors will be able to email, or have an app where a patient can access their medical records electronically just for viewing or printing purposes. According to Healthit. gov â€Å"An electronic medical record (EMR) is a digital version of a paper chart that contains all of a patient’s medical history from one practice. An EMR is mostly used by providers for diagnosis and treatment†(What is an electronic medical record, 2012. ). This is not as beneficial in my opinion as EHR’s are. The reason I feel this way is because EMR’s can only access medical files from one practice. Many people have more than one doctor such as an eye doctor, physician, and even a dentist. All these different practices utilize some sort of medical history that you have compiled over a certain time span. The cloud is a database where every doctor you encounter can access you files. Many people have mixed views about this so called â€Å"cloud†. From a doctors point of view it is great! They can see your medical history for every doctor you have been to. Some people may deem this to be a violation of HIPPA. Many people find it an invasion to their privacy and why would a physician need access to any of my other files. One benefit is doctors can see specific medicines you maybe allergic to that you may have for got to inform them about. 5a. What problems are associated with each country’s healthcare plan(s)? Details please. The United States health care system has many flaws; one is hospitals tend to over price patients. I learned from my Health Law and Ethics class, that some hospitals charge unnecessary charges such as $10. 00 for a cup they carry you medicine in. If you are in the hospital for some time that really adds up quickly! Another flaw our health care system has is over spending on testing. Our country spends more money on test with their patients than any other country. I read an article that a patient was experiencing heart burn constantly and rather than giving a $1,200 stress test (way over priced if you ask me) the doctor charged the patient with a $8,000 CT scan. Many insurance companies will not accept a patient who has had previous records of specific diseases or any chronic condition in fear that they will have to pay too much for their care. If a person who is young and can’t qualify for Medicare, Medicade, and does not have company medical benefits, they have to pay out of pocket. Japan is known for having one of the most superior health care systems in the world. One flaw that it has is a surprisingly high suicide rate. One study showed that these suicides were due to health problems. Japan has a high cancer rate because of the obsessive smoking and drinking in their country.