Develop a three year professional action plan Essay

Build up a multi year proficient activity plan - Essay Example Medicinal services would in reality be the main business in the United States. Tasks research-type investigation and application for the mind boggling issues included would be helpful for any medicinal services framework. The biggest issue, there are insufficient individuals considering professions in the human services industry. As of now, the social insurance industry in the United States faces a significant number of similar issues going up against different ventures, yet there would be some huge political contrasts. All the while, medicinal services would be illustrative of a colossal section of the economy, and it needs our assistance. The individuals filling in as a feature of the medicinal services framework are commonly devoted to offering the most ideal support. The issue is, the workforce and, all the more critically, the executives, don't have the important preparing or information to utilize the accessible assets. Under these specific conditions, it would be far fetched that any private industry would make due with the degree of waste and wastefulness ordinarily found in social insurance. Human services is a systematic no other realized plan of action. There would be numerous chiefs with clashing objectives and targets. The primary thought ought to be the intense consideration emergency clinic. As of now, most emergency clinics in the United States, and on account of Canada basically all, are not-revenue driven, autonomous companies. Glouberman and Mintzberg would recognize four distinctive administration bunches for which they use the term four universes inside the emergency clinic condition. Clinical activities are overseen in a descending concentration because of specialists and attendants and their attention on tolerant consideration. Directors and trustees center in an upward thought toward the individuals who control or reserve the foundation. In addition, representatives, for this situation supervisors and medical caretakers, would rehearse some administration inside the foundation, while specialists and trustees would oversee outside the clinic as from the outside in, since they are in fact not workers and are subsequently free of its proper position. The universe of fix, which is described by short, concentrated and basically non-individual clinical intercessions, would be viewed as a quadrant of this specific perfect. Normally, North American specialists would not work legitimately for the emergency clinics. They are in truth private business people who have affirmation benefits at a medical clinic. There are a rare sorts of people who might comprise as salaried emergency clinic representatives, yet the dominant part would in certainty reliably take a shot at a charge for-administration premise with the medical clinic. To expand their salary, specialists would regularly show up at whatever point the patient requires a fix and intercession or treatment of some structure. Starting here they would push ahead. As a potential social insurance administrator it is ideal to comprehend the political and different interrelationships between specialists, medical attendants, emergency clinic staff and organization. Human services chiefs face another division, which speaks to the universe of care. This is the world spoken to by medical attendants. Medical attendants are suppliers who work legitimately for the clinic on compensation and regularly represent the biggest part of its working spending plan. They work in their own inner administration chain of command and have a one of a kind relationship with patients. They are

Kate Nash †“Made of Bricks” free essay sample

In spite of a portion of the severe surveys of Kate Nash’s  ­album â€Å"Made of Bricks,† the 20-year-old British vocalist and musician has completely prevailed upon me. I’m the sort of individual who cherishes any music that makes me need to chime in, and Kate has done quite recently this. Her single â€Å"Foundations†  ­begins with a vivacious, carefree sound that will undoubtedly paint a grin on anybody’s face and power one to pull out the  ­little bundle of verses to chime in. Nash’s British pronunciation joined with her delightful tone simply gobble me up. She takes the words directly from anyone’s mouth who has managed testing connections, and she builds up the verses in a bright, welcoming way. Despite the fact that her arbitrary, enthusiastic verses are for the most part beguiling, they are dulled by the normal utilization of swear words. Many accept the main accomplishment on her collection is the hit single â€Å"Foundations,† however the various beats of every melody attracted me. We will compose a custom paper test on Kate Nash †â€Å"Made of Bricks† or on the other hand any comparable subject explicitly for you Don't WasteYour Time Recruit WRITER Just 13.90/page Anyone searching for a high-vitality new style ought to doubtlessly pay special mind to Kate Nash. She has an alternate interpretation of music and paints the narrative of harmed hearts very well.

A Year End Review How Everything Can Change in a Year

A Year End Review How Everything Can Change in a Year Oh, what a difference a year can make! One year ago, on December 14, 2010, we started The Minimalists. Since then, almost everything in our lives has changed. A year ago we both worked for large corporations. Now we work for ourselves and pursue our passions every day. A year ago we were unhappy with our lives. Now were living meaningfully by contributing beyond ourselves in meaningful ways. A year ago we could hardly spell HTML, let alone build a website. Now we have a successful blog. A year ago we had zero people reading our words (other than some vapid corporate emails). Now we have over 100,000 monthly readers, and our essays have been read by over a million people in 151 countries this year. A year ago zero people subscribed to our site. Now tens of thousands of people subscribe via email to get our free essays. A year ago no one was interested in following us on Twitter or Facebook. Now we have thousands of people who interact with us through social media. A year ago we hadnt published anything. Now weve published a bestselling book. A year ago we had spreadsheets full of goals, and we would beat ourselves up when we didnt achieve those goals. Now Ryan lives with one goal at a time, and Joshua has no goals at all. A year ago we strived to make everything perfect. Now we embrace the imperfection of our daily lives. A year ago we were a couple of guys stuck in Dayton, Ohio. Now were traveling the country on a our first book tour and meeting the most amazing people weve ever met, dishing out hundreds of free hugs in the process. A year ago there was a considerable amount of discontent in our lives. Now were happy, and when we look in the rearview mirror, everything is different. Now, we arent trying to impress you with our accomplishments; rather, we want to impress upon you the power of a year. As human beings, we often overestimate what we can accomplish in a short period of time (e.g., six-pack abs in two weeks), but we drastically underestimate what we can accomplish in a year or two. Most of the above mentioned accomplishments  werent goals we developed at the beginning of the year. They just happened, organically, as we worked hard to add value to other peoples lives. Thus, we discovered that when we add value to other peoples lives, everything else tends to fall into place. The big life changes dont happen overnight: Give yourself some time. Put in the necessary effort. Keep at it. Youll be surprised with what can happen in a year. Subscribe to The Minimalists via email.

Character Analysis of Juliet From William Shakespeares...

Character Analysis of Juliet From William Shakespeares Romeo and Juliet Juliet is a young girl living in Elizabethan times. She is from a rich background. Although the play is set in Italy, it is really about English characters. Shakespeare is giving a glimpse of a thirteen year old girl (Juliet) living in the Sixteenth century. The nurse is like a mother to Juliet. She is very important in her life. When Lady Capulet is talking about Juliet, she says ...Thou knowest my daughters of a pretty age (p.25) and the nurse replies ... I can tell her age unto an hour. (p.25) showing she is close to Juliet as most parents would be conscious of the precise age of their children. This shows that Lady†¦show more content†¦Such as And stint thou too, I pray thee, Nurse say I (p.27) and It is an honour I dream not of (p.27). Juliet is very courteous to people. She calls her mother Madame (p.25) and is polite to people when she speaks. Juliet speaks to her nurse as a mother, even though Lady Capulet is her mother. She says such things to the nurse as Go ask his name... (p.45) at the Capulets feast. She is talking to the nurse and asking her to go up to Romeo and ask his name and whether or not he is marry. She is asking the nurse because the nurse is closer to Juliet than her mother. This is probably because the nurse has been with Juliet for a large part of her life. Juliet speaks to her mother as if she were just a friend, or distant relation. She calls her mother Madame... (p.25) which shows that she is not close at all with her mother. When Lady Capulet is talking about Juliet, she says ...Thou knowest my daughters of a pretty age (p.25) and the nurse replies ... I can tell her age unto an hour. (p.25) showing she is close to Juliet as most parents would be conscious of the precise age of their children. This shows that the nurse is closer to Juliet than Lady Capulet, and Lady Capulet has not spent a great deal of time with Juliet. SECTION 3: ========== Juliet falls in love with Romeo, the Capulet familys enemy. She marries Romeo inShow MoreRelatedTragic Hero in Othelo by William Shakespeare996 Words   |  4 Pagesmuch alike. He has written many plays including Othello and Romeo and Juliet. Shakespeare was a man who wrote plays that followed the same literary conventions. These conventions included tragic hero, fallacy, irony, and also suspense. A tragic hero is a male figure who is high in society and one who always has a tragic flaw. Most of them are rich and intelligent men. In the story of Othello, Othello is the tragic hero. He was a character of nobility. He was a high in class and had high standardsRead More Analysis of Act Three Scene Five of William Shakespeares Romeo and Juliet1540 Words   |  7 PagesAnalysis of Act Three Scene Five of William Shakespeares Romeo and Juliet William Shakespeares Romeo and Juliet is a dramatic tragedy, and was first performed in 1595. The novel is about two young lovers, Romeo Juliet and the struggle with their relationship. Romeo and Juliet are from opposing families, the Montagues and the Capulets. The conflict between their two families causes problems for their love of one another. Shakespeares main themes throughout the play are of love, conflictRead MoreRomeo And Juliet Analysis1384 Words   |  6 PagesAnalysis Essay #1: Romeo and Juliet Below write your essay based on the outline that you created. In William Shakespeare’s famous play, â€Å"Romeo and Juliet,† the supporting characters play enormous roles in the plot of the performance by helping Romeo and Juliet be together. The Nurse and Friar Laurence both cause dramatic changes to the play through the course of their actions, both with their own goals and reasons for their behavior. The Nurse is caring and pure, wishing simply for Juliet toRead MoreWilliam Shakespeare s Romeo And Juliet1287 Words   |  6 PagesComposition 2 Mr. Spera March 10, 2015 Romeo and Juliet Research Paper The movie Romeo and Juliet is a modern classic film that took place in 1996. Overall this is a timeless story that everyone should go and watch. This movie has an intriguing plot line that tells the story of two feuding families, The Montagues and The Capulets, and how the children of these two different families fall in love. The two children overcome various obstacles such as hiding their chemistry from their parents because it is forbiddenRead MoreWilliam Shakespeare s All The World s A Stage 1540 Words   |  7 PagesMegan Mackey Professor Raja Atallah English 1102 17 April 2017 Research Paper William Shakespeare once said, All the World’s a Stage —and now his quote can be applied to his literature within his tragedies (William Shakespeare 1). The generation of people today have a much different definition of tragedies than people did during the Shakespearean times. Shakespeare’s tragedies involve a protagonist whose character is developed so that it is clear that he is a heroic figure in the setting of theRead MoreWilliam Shakespeare s Romeo And Juliet923 Words   |  4 Pages Romeo and Juliet Analysis William Shakespeare often has a reputation among modern audiences as being antiquated and archaic. The first things that many people think of when contemplating Shakespeare are ancient locales, Early Modern English which is difficult to understand, and elaborate codpieces. Even modern productions, which often attempt to place the action in a more contemporary context, often can alienate prospective audiences with strange conceptual design choices. But, despite these preconceivedRead MoreAnalysis of Romeo and Juliets Exchange in William Shakespeares Romeo and Juliet593 Words   |  3 PagesAnalysis of Romeo and Juliets Exchange in William Shakespeares Romeo and Juliet Shakespeare explains 3 types of love, Courtly, arranged and spontaneous and even more. Love is one of the powerful emotions known by the human being. The most renown play Romeo + Juliet and has found its place in history. Shakespeare packs a great deal of meaning into each line. You can read Romeo + Juliet to find out about Elizabethan life, but in them you will also see reflected back atRead MoreRomeo And Juliet Film Analysis1647 Words   |  7 PagesDavies, Anthony. The film versions of Romeo and Juliet, Shakespeare Survey 49(1996):153-162 Web. 22 May 2017. 1. In this Journal articles by Anthony Davies, he attempts to trace, compare, and analyze the play of Romeo Juliet’s life throughout cinema. To do this, Anthony does a close reading of four different films directed by Cukor, Zeffirelli, Alvin Rakoff, and the BBC. With these films, Anthony delves into them while dissecting specific scenes to compare how they are different or similarRead MoreWilliam Shakespeare s Romeo And Juliet1236 Words   |  5 PagesMany associate the word with kindly feelings towards others and generally positive thoughts. It is a word that we use to describe our emotions of affection, devotion, fondness, and friendship. William Shakespeare s Romeo and Juliet centers around the epic, yet tragic, love of two adolescents. With Shakespeare’s use of figurative language and literary devices, he creates a central theme that love, no matter how strong or sweet, is poison. The term poison, although not commonly associated with love,Read MoreMercutio - a Monodimensional and Static Character in Shakespeares Romeo and Juliet?1718 Words   |  7 PagesDiscuss Mercutio in Shakespeare’s Romeo and Juliet in terms of character dimension, character development and his relation to major themes of the play. When looking at the content of characters in Shakespeare’s play „Romeo and Julietâ€Å" one can find a total of 21 people that are mentioned by name. While it is self-evident that characters such as Romeo and Juliet are essential to the play due to the fact that they form its title, a reader could ask what role the others might play in a literary context

Corruption Of Control In Animal Farm, By George Orwell

John Dalberg Acton once said, â€Å"Power tends to corrupt, and absolute power corrupts absolutely.† This seems similar in the case of Animal Farm, a book by George Orwell. In the story the tired animals rebel against their owner and set up their own government, but the pigs assume control and abuse their power which corrupts the whole system by oppressing the other animals and exploiting them. Even though the pigs abuse their power, the naive animals are the reason why the pigs rose to control because the working animals were tricked by the pig’s corruption of language, persuaded by their propaganda, and were naive time and time again. One reason why the pigs are still in control is because the animals were tricked by the pigs was when they†¦show more content†¦Another reason is that they could have tried to use their education and been smarter to realize what was going on in the farm. It clearly states in the novel that, â€Å"ALL â€Å"ANIMALS ARE EQUALâ €  (Orwell 13). It then changes for that to the same commandment, but with a twist. As shown in the last chapter â€Å"ALL ANIMALS ARE EQUAL, BUT SOME ANIMALS ARE MORE EQUAL THAN OTHERS† (Orwell 127). The slight change of all the commandments symbolizes how much the farm is being changed and twisted by the will of the pigs. This last change shows that the farm has reverted back to it’s former state. If the animals were smarter and not have been so naive, and could have stood up to the pigs, resulting in the decline of Napoleon’s dictatorship. This is important because if they were smarter and wiser as a whole, than it would have been easy for them to not get fooled, making it way harder on the pigs to keep control. This is true because without the working class of animals supporting Napoleon, the pigs would not be able to live so lavishly. Standing up to the pigs and questioning them was very key for the animals when they knew something was fishy was very imp ortant, but when Clover asks Muriel to read the commandments for him, and realizes the slight change at the end every time, he never seems to go straight to the pigs and confront them. The working animals were to passive in this situation and were the most responsible for the pig’s continuing tyranny. And Finally, the animalsShow MoreRelatedAnimal Farm Character Analysis713 Words   |  3 Pagesâ€Å"ALL ANIMALS ARE EQUAL BUT SOME ANIMALS ARE MORE EQUAL THAN OTHERS† (Orwell 134). In George Orwell’s allegorical fable, Animal Farm, a group of animals lived with their master, Jones. Jones was an unfair man who didn’t care too much about the animals. One day Jones forgot to feed the animals, so they revolted. The animals wanted a perfect place without the corruption of man. The currently animal controlled land of Animal Farm, the smartest of all animals, the pigs take control. To prevent a human-likeRead MoreAnimal Farm by George Orwell1100 Words   |  4 PagesIntroduction: Widely acknowledged as a powerful allegory, the 1945 novella Animal Farm, conceived from the satirical mind of acclaimed author George Orwell, is a harrowing fable of a fictional dystopia that critiques the socialist philosophy of Stalin in terms of his leadership of the Soviet Union. Tired of their servitude to man, a group of farm animals revolt and establish their own society, only to be betrayed into worse servitude by their leaders, the pigs, whose initial virtuous intentionsRead MoreAnimal Farm By George Orwell845 Words   |  4 Pages The Russian Revolution in 1917 was portrayed in Animal Farm, to show how the government is more unequal, totalitarian and brutal just like presently. Animal Farm is created by George Orwell, who displays this story as a ridicule, teaches a lesson by showing the dangers of propaganda, and uses animals to hide the original individuals. During the Revolution, Russians had lost hope in Czar Nicholas II due to his rampant behavior and how the government was slowing separating; thereforeRead MorePower Corruption. It Is A Never A Leader’S Ideal Is To1081 Words   |  5 PagesPower Corruption It is a never a leader’s ideal is to cause harm are any wrongdoing to his people. Sometimes in his or her attempts to protect their country, some go to the extreme in efforts to shield from external forces. In the end though as history has proven, power is perception. Corruption is due to happen when those who govern separate themselves from whom they govern. In the novel Animal Farm, by George Orwell, George uses an allegorical reference between the animals in the story to symbolizeRead MoreThe Key Themes In Animal Farm By George Orwell952 Words   |  4 PagesAnimal Farm, an allegorical novel by George Orwell, depicts a very clear picture of the events leading up to the 1917 Russian Revolution and the Stalinist era of the Soviet Union. The techniques Orwell has used when writing this piece allows his robust view points and prominent reoccurring themes to become clear. A couple of themes that stood out the most to me was the use of education and intelligence, as well as corr uption of power and leadership to fuel oppression. Orwell uses the imagery of aRead MoreLord of the Flies Compared to Animal Farm Essay994 Words   |  4 Pagesuse fear as a control tactic in their countries as they want to make sure they have total power over their people. Fear is defined as an unpleasant and often strong emotion caused by anticipation or awareness of danger, often causing a person to act according to what is necessary for survival. Although fear can be unpleasant, many people like it in different ways; some like the suspense that scary movies bring, while others like the thrill that is created when cliff jumping. George Orwell’s allegoryRead MoreAnimal Farm, By George Orwell1089 Words   |  5 PagesIn George Orwell’s â€Å"Animal Farm†, the pigs as the farm leaders, use unknown language, invoke scare tactics and create specific laws, thereby enabling them to control other animals, to suit their greedy desires, and to perform actions outside their realm of power. Because of the pigs’ use of broad language, and the implementation of these tactics they are able to get away with avoiding laws, and are able to convince other animals into believing untrue stories that are beneficial to the pigs. The firstRead More1984: Governments Attempt to Control the Mind and Bodies of Its Citiz1253 Words   |  6 Pages1984: Governments Attempt to Control The Mind and Bodies of Its Citizens The novel Nineteen Eighty-Four by George Orwell is an American classic which explores the human mind when it comes to power, corruption, control, and the ultimate utopian society. Orwell indirectly proposes that power given to the government will ultimately become corrupt and they will attempt to force all to conform to their one set standard. He also sets forth the idea that the corrupted government will attempt toRead MoreGeorge Orwell s Animal Farm1403 Words   |  6 PagesGeorge Orwell believes â€Å"What you get over and over again is a movement of the proletariat which is promptly characterized and betrayed by astute people at the top and then the growth of a new governing class. The one thing that never arrives is equality† (Letemendia 1). Orwell simply loathes revolution and thinks it is unfair to the majority, for the people. He thinks that while individuals change, the people in power are always corrupt and they will corrupt any attempt at change. He communicatesRead MoreAnimal Farm1555 Words   |  7 Pages Animal Farm written by George Orwell is an animal fable happens in a farm where animals start building a communism society, but end up being totalitarianism, hinting obliquely at the communists in the real world. The gaps between pigs and other common animals, demonstrate the theme that the corruption of power appears when majority is ruled. The intelligence superior allows the pigs placing themselves at a position which is closer to the power and which is more easily to corrupt. The inability

Gandhi the educator Free Essays

Gandhi was a prolific writer. One of Gandhi’s earliest publications, Hind SwaraJ, published in Gujarati in 1909, is recognised[by whom? ] as the intellectual blueprint of India’s freedom movement. The book was translated into English the next year, with a copyright legend that read â€Å"No Rights Reserved†. We will write a custom essay sample on Gandhi the educator or any similar topic only for you Order Now [206] For decades he edited several newspapers including Harijan in Gujarati, in Hindi and in the English language; Indian Opinion while in South Africa and, Young India, in English, and NavaJivan, a Gujarati monthly, on his return to India. Later, Nava]ivan was also published in Hindi. In addition, he wrote letters almost every day to individuals and newspapers. [207] Gandhi also wrote several books including his autobiography, The Story of My Experiments with Truth (GuJar ¤ti â€Å"acuu our-us-ed†), of which he bought the entire first edition to make sure it was reprinted. [77] His other autobiographies included: Satyagraha in South Africa about his struggle there, Hind SwaraJ or Indian Home Rule, a political pamphlet, and a paraphrase in Gujarati of John Ruskin’s Unto This Last. 208] This last essay can be considered his programme on economics. He also wrote extensively on vegetarianism, diet and health, religion, ocial reforms, etc. Gandhi usually wrote in Gujarat’, though he also revised the Hindi and English translations of his books. [209] Gandhi’s complete works were published by the Indian government under the name The Collected Works of Mahatma Gandhi in the 1960s. The writings com prise about 50,000 pages published In about a hundred volumes. In 2000, a revised edition of the complete works sparked a controversy, as It constituted large number of errors and omissions. [210] The Indian government later withdrew the revised edition Concrete Definition to Alms, Goals and Objectives of Education : If education Is the foundation of all growth and progress, then alms, goals and objectives are the four Interconnected and most significant components that gives direction to educational outcomes through the curricular content, syllabus and evaluations. These four components are highly Influenced by four Interconnected foundation blocks namely, epistemology (the nature of knowledge), society/culture, the Individual, and learning theories (Zals, 1976). But since alms, goals, and objectives, collectively as a component of curriculum provide direction and focus for the ntire education programme, they are particularly sensitive to these four fundamental forces. It was GandhlJl, who In 1937 first recognized the Interconnectedness of the eight curricular forces and questioned the futlllty of the British education system. Based on his wisdom and successful experiments with education In soutn ATrlca, ne put Tortn a Baslc toucatlon Plan which had the merit of achieving one aim of peace and freedom, for which all mankind yearns today. Also, recognizing the futility of a centralized plan and control in implementing programmes, he also utlined a comprehensive but decentralized model to be implemented by the village Republics. The vital objective of his model was to develop productive and social skills among the masses. To the centre, remained the overall responsibilities of coordinating and guiding the work of the states so that national policies could evolve from the grassroots. The Basic Philosophy (a) True education is all-round development of the faculties, best attained through action. It bases itself on the fact that knowledge and understanding develop in relation to problems set right by action. Information thrust on the mind only urdens the memory and causes intellectual indigestion, casting learning into oblivion. b) Education must be concrete and inter connected, not abstract or given in isolated sections. Concrete education allows the learner to manipulate problems or sets of problems and study their relationships, character and artistic sense. It allows the mind, heart, hand and eyes to work simultaneously in a correlated manner, resulting in a harmonious and well-balanced personality. (c) Education must be imparted in the child’s mother tongue and organically connected with the child’s Social and Cultural environment. How to cite Gandhi the educator, Papers

Conference Mobile Communication Healthcare -Myassignmenthelp.Com

Question: Discuss About The Conference Mobile Communication Healthcare? Answer: Introduction: Diabetes is the most common cause of death among elderly patients and other populations alike. Diabetes is also a multi-factorial disease that occurs in people associated with other health issues like obesity, chronic heart diseases, kidney diseases and the leading cause of hospitalizations among geriatric patients. The case study describes a female patient who is 65 years old, having a medical history of diabetes for twenty years. The patient was admitted in the hospital from the emergency department with a case of severe glycemic shock, difficulty in breathing and severe back pain. On diagnosis, the reports showed that the patient has cardiac blockage, is currently obese with hypertension symptoms. The patient was also asses by Beck depression Inventory and showed positive results suggesting she was suffering from clinical depression but did not take any medication prior to this admission. The back pain of the patient was treated with pain medication to minimize the pain score. The report summarizes the care plan set up for the patient with reference to the current condition to treat her glycemic shock, administration of management for the condition and address the heart blockage and depression as well. Patient education is also an important factor for the completion of the care plan and the family of the patient was taught so that the home care can be arranged properly so as to reduce risk of hospital readmission. The family of the patient was also taught to monitor the patient to avoid the risk of falling which might cause severe repercussions, which is commonly observed in geriatric patients. Objective Data Pulse ox: 89% showing low levels Cough: No such detection Sputum: not detected Oxygen: room temperature Respiratory rate: 140/90 mm Hg very high, as seen in hypertensive patients Tachypneic/Hypoventilation (too slow/shallow: Respiratory effort: effort required due to blockage in heart Respiratory rhythm: difficult, erratic and very high due to heart blockage Breath sounds: no wheezing is observed, but breath rate very high Skin: WNL, normal Skin Turgor: Tenting Weight: 90kg/lb, overweight Capillary refill: WNL Apical pulse rhythm: irregularity seen Apical pulse rate: Tachycardia beats noted Heart Sounds: (Arrhythmic sounds noted) caused by hypertension Apical/radial deficit: yes Peripheral pulses: 80mmHg R radical= Doppler, R femoral= yes, R pedal=yes, R post tib=yes; L radical = yes, L femoral= Doppler, L pedal= yes, L post tib= yes. Edema: none such detected in the chest or throat, so no possible pathogenesis is the cause of breathing trouble R Hand/arm= no, R knee to thigh= no, R ankle to knee= non-pitting, R foot/ankle=no; L Hand/arm= no, L knee to thigh= no, L ankle to knee= no, foot/ankle=non pitting, Sacrum=non-pitting. Heart blockage noticed and needs immediate assistance. Deprivation of sleep due to difficulty in breathing Neurological Oriented to : patient Communication : slow but expressive Pupils:round, with a sluggish reaction to light. Glasgow Coma Scale(score range 0-15, Coma=7): Eye opening to: spontaneous=3, verbal command =2, pain=0, no response=1. Verbal responses to: slow and effort, converses=4, disoriented, converses=3, uses inappropriate words=4, incomprehensible sounds=1, no response=1. Motor responses to: verbal command = 5, localized pain=6, flexes and withdraws=3, flexes abnormally (decorticate)=4, extends abnormally (decerebrate)=3, no response = 1. Muscle tone strength Head/ neck: flaccid, Right hand: spastic, L Hand: flaccid, RUE: LUE: flaccid, RLE: flaccid, LLE: flaccid. The muscle on the leg seem to be stressed due to her weight and mild oedema is noticed on the joints due to pressure of weight. Legs: unable to walk properly due to weight gain Depression measurement: scored out of Beck Depression Inventory Erratic mood Low self esteem Sense of failure Lack of self confidence Body image issues Pity on self Old age depression Lack of satisfaction Slow movement Constant sighs Inability to express Demotivated boredom Musculoskeletal Gait: Appearance and no movement Arms: Appearance and movement Legs: Appearance and cannot walk Spine: Appearance and difficulty in moving Location of pain: back pain and soreness in legs Loss of activity: walking is being affected by the pain Description of pain: sharp and located Pain rating on a scale of 0-10: 6 Acceptable level for this client: 5 What makes the pain worse: walking and movement What makes the pain decrease: medication, and sleep. Psychosocial (and other relevant data) patients name: Surinder Kaur gender: Female birth date/age: 65 Marital status: Married Race/ethnicity: Indian languages spoken: English No such mental illness but chronic depression History: diabetes for 20 years and takes daily insulin Obese: 90kg/lb Hypertension Weight gain is the cause of depression Currently no medication is provided for depression Unable to walk due to obesity Suffers from hypertension and back pain Inability to walk Case Study of Client: (Holistic) Among different domains of Nanda approved nursing diagnoses, this assignment will utilize actual diagnosis. The patent in the case study is a 65 year old woman named Surinder Kaur. The patient in the case study had a more or less sedentary lifestyle and stayed in home. The patient had diabetes and had been getting insulin every single day. Still her blood glucose level as per her assessment had been discovered to be extremely high. Hence it can be stated from the assessment that has been carried out for the patient, it has to be mentioned that the patient had been unable to manage her blood glucose levels properly and hence a few other health care concerns have accumulated as well. First and foremost, as an indirect result of her high blood glucose level and her sedentary lifestyle the patient had been gaining weight from the past 5 years and had been obese. Along with that, there is direct link between the cardiac complications and hypertension, and the patient had also been sufferi ng from heart blockages and the hypertension ( Kusnanto, 2017). Surinder also had excessive back pain with a pain score of and had difficulty walking due to peripheral neuropathy, a common complication that is associated with diabetes. According to the assessment data discovered about the patient in the case study, it can be mentioned that all of the different health acre complexities that the patient is suffering from had been a direct or indirect consequence of her poor management of type 2 diabetes and resultant high blood glucose at more than 200 mg/Dl. Hence based in the thorough assessment, the nursing diagnosis for the patient is high blood glucose level with severe risk for uns Extremely high blood glucose levels and severe risk for instability. Assessing the patient for vulnerability to glyceamic shock to the patient so that there is no immediate danger to the patient. Medication administration and facilitating better management of the type 2 diabetes along with educating the patient regarding the diabetes management techniques as well. Encouraging the patient to adopt a healthier life style by starting to eat healthy and maintaining a strict dietary plan with a strict yet attainable physical exercise regimen. Assessment of signs of hyperglycemia so that there is no immediate insulin- glucose level imbalances that the patient is under. Diligently assessing the blood glucose levels of the patient preferably before meal times and at bed time as well ( Franks McCarthy, 2016). Assssing and monitoring the HbA1c-glycosylated hemoglobin levels of the patient as well. Administration of basal and prandial insulin so that tissue perfusion is promoted and helps in reverting the glucose concentration to the normal levels which in turn will slow down the progression of the microvascular disease ( Diab, 2012). Administration of Sulfonylureas like Glucotrol and Diabeta, meglitinides like Prandin, Biguanides like metformin, Phenylalanine derivatives lie starlix, alpha glucose inhibitors like the acarbose and miglitol, thiazolinidiones like actos and avandia and lastly Incretin modifiers like sitagliptin. The medication will decrease insulin resistance, increase insulin production and will delay the absorption of glucose into the blood ( Paschou Leslie, 2013). Monitoring the hypertension of the patient and administer hypertensive drugs as prescribed to the patient which will help in reducing the high blood pressure of the patent and will also work to reducing the risk for strokes. Educating the patient on how to monitor blood glucose on her own using the nursing glucose meters (Modic et al., 2012). Encouraging the patient to develop a healthier lifestyle that includes both dietary changes and active and determined fitness initiative. Engaging in a therapeutic casual conversation with the patient with a cultural liaison assistance to extract information regarding her sedentary lifestyle and diet pattern ( Wexler et al., 2012). Consultation with a dietician for her to help her develop a diet plan that will sit her nutritional requirements along with facilitating eight loss and cholesterol concentration drop. Encouraging the patient to eat less junk food and maintain a protein rich and antioxidant rich diet plan with lesser carbohydrate and fat content ( Juul et al., 2012). Educating the patient with interactive and cognitive therapeutic intervention towards changing her health behaviors towards a promotional health behavior for diabetes control. Enhancing the health literacy of the patient regarding diabetes and the associated co- occurring disorders so that she can work towards managing or preventing it. Lastly, encouraging and helping the patient to begin with mild and least tiresome exercise regimen to help her build her tolerance towards physical exercise. As the patient is accustomed to physical exercise help the patient build towards more tiresome and effective exercise patterns that are targeted at quick weight loss ( Spanakis Chiarugi, 2011). The current case study here focuses upon the Surinder Kaur who is a 65 years old woman and suffering from a number of co-morbid health conditions. She is suffering from hypertension along with back pain; hear blockage and diabetes; depression and weight gain. She had been talking insulin for the past 20 years. In this respect, a care plan could be made for the patient based upon the North American nursing diagnosis association (NANDA). The NANDA diagnosis could be divided into following four types such as actual diagnosis, risks diagnosis, health promotion diagnosis and syndrome diagnosis. In this respect, the actual diagnosis has been taken into consideration where the present health responses shown by the patient are taken into consideration. For the current study, a range of complications depicted by the patient have been taken into consideration. Out of this, blood glucose monitoring have been taken onto consideration for the current study. The patient her had been suffering from type 2 diabetes and had been taking insulin for the past five years. As mentioned by Rosenberg et al. (2014), excessive dose of insulin can often lead to the deposition of body fat. Some of these have been seen to contribute to the worsening of already existent clinical condition in the patient. As the patient has heart blockage the presence of obesity could further worsen the condition. As mentioned by Jindal et al. (2017), obesity has been linked with high blood cholesterol levels. Some of these conditions restricted the life processes of the patient. This further developed depressive thoughts or feelings within the patient. However, one of the most important clinical conditions which were expressed within the patient and needed immediate clinical intervention are monitoring of high levels of blood glucose level. Therefore, the high levels of blood glucose level could lead to fatal consequences where the patient could develop glycaemia shocks. The hyperglycaemia could be associat ed with a range of symptomatic expressions, which could dishevel the normal life of the patients. Some of these are excessive urination, excessive thirst, weight gain, diabetic neuropathy and diabetic retinopathy. As mentioned by Ng, Finnigan, Connellan, Kiernan Coward (2014), high levels of blood glucose can lead to a condition of nerve damage known as diabetic neuropathy. The diabetic neuropathy can have much serious consequences such as development of leg amputations in the patient. The leg amputations can disrupt the normal day to day movement making the patient dependent upon medication and aid. In this stage, additional level of support and care is required for the patient. Hence, the patient looses autonomy over their activities of daily living (ADL) which could further aggaravate the presence and expression of depression in the patient. The high blood glucose level has been associated with the development of retinopathy conditions which can affect the vision in the patient considerably. Therefore, the daily care activities of the patient need to be effectively monitored for the reduction in the clinical manifestations of the patient. Further complications The patient also had hypertension and was suggested regular medications for the control and management of depression. However, the patient hardly followed the medications pattern and doses. This increased the severity of clinical symptoms such as sleep deprivation in the patient. Moreover, the patient could not sleep owing to pain which was also aggravated due to psychological reasons ion the patient. Therefore, in order to control the pain and sleeo deprivation in the patient, the patient was suggested metformin and oxazepam, which could effectively control the rate of depression within the patient. In the lack of effective medication intake by the patient, she could be struck with lethal consequences such as myocardial infarction (MI). Therefore, in order to relieve the overall condition of the patient a holistic care regimen could be developed for the patient (Rossom et al., 2014). Discussion of interventions One of the most important nursing interventions and strategies which could be developed for the patient is implementation of physical exercises. Some of the physical exercises could include light walking, jogging along with light stretching. This could restore the movement and agility patterns in the patient. Additionally, provision of effective medication to the patient could also help in controlling and monitoring the blood glucose level. As mentioned by Zhou et al. (2017), provision of fresh food and supplements to the patient can also be effective in controlling the blood glucose level. The areas which had been highlighted as requiring care management in the above discussion are blood glucose monitoring and reduction in the symptomatic expression of several health co-morbidities. This area of care management was highlighted as the patient had expressed a number of physical abnormalities which impaired the daily life of the patient along with dependence upon insulin. Research and evidences have proved that too much of dependence upon insulin can impair the functioning of the heart and the patient was already suffering from heart blockage (Feigenbaum, 2012). Therefore, the patient had to be provided with a balanced care treatment plan which will help in reducing the daily life grievances of the patient. The focus has to be more upon a holistic care regimen. Additionally, diabetes could also stem unto a number of major health complications such as movement disability, retinopathy and cardiac shock. Therefore, in order to prevent such conditions from the disrupting the life of the patient an effective and balanced car plan is required. Additionally, the patient was also suffering from depressions which affected the rate of recovery of the patient. Hence, providing the patient with a holistic care regimen can help in infusing positive spirit in the life of the patient which could speed the recovery rate (Plat, 2017). Additionally, provision of effective counselling measures along with community based development program can also help in reducing the stress in the life of the patient. The community development program can also motivate Surinder Kaur to lose weight as she was suffering from obesity. Conclusion The above discussion makes it clear that the geriatric patients like Surinder Kaur, need to be closely monitored to avoid rick of glycemic shock. The care plan organized for the patient needs to holistic providing the medication with the respective rationale. Obesity is an indirect effect of diabetes, which needs to be controlled from early signs as weight gain had severe repercussions like cardiac blockage, which is very risky. The patient had also developed depression due to her prolonged illness, which needed to be addressed to help her recover. The glycemic shock was assessed and nutritive as well as pharmaceutical help was provided to her to minimize further risk leading to fatality. The main criteria of the care plan was to control the blood glucose level and control weigh gain to reduce her weight to help her improve her blocked heart condition and improve her ability to walk which she was then facing due to obesity. Obesity and diabetes are correlated with each other and crea te co-morbid conditions in geriatric patients. Cases like this require patient education planning after care plan management, which would help minimize the risk of hospital readmission and falling in these cases. The hypertensive condition clubbed with depression in the patient makes the situation serious and she needs to be well monitored in even home care facilities to minimize the risk of falling. References American Diabetes Association. (2015). Standards of medical care in diabetes2015 abridged for primary care providers. Clinical diabetes: a publication of the American Diabetes Association, 33(2), 97. Bray, G. A., Popkin, B. M. (2014). Dietary sugar and body weight: have we reached a crisis in the epidemic of obesity and diabetes?: healthcare be damned! Pour on the sugar. Diabetes care, 37(4), 950-956. Diab, P. (2012). Communication in diabetes management: overcoming the challenges. Journal of Endocrinology, Metabolism and Diabetes of South Africa, 17(1), 52-54. Feigenbaum, K., Brooks, P. G., Chamberlain, C. E., Cochran, E., Adams-McLean, A., Malek, R., Harlan, D. M. (2012). The Clinical Centers Blood Glucose Management Service: A Story in Quality Integrated Care. The Diabetes Educator, 38(2), 194-206. Franks, P. W., McCarthy, M. I. (2016). Exposing the exposures responsible for type 2 diabetes and obesity. Science, 354(6308), 69-73. Jindal, D., Gupta, P., Jha, D., Ajay, V. S., Jacob, P., Mehrotra, K., ... Prabhakaran, D. (2017). The Development of mWellcare, an mHealth System for the Integrated Management of Hypertension and Diabetes in Primary Care. Studies in health technology and informatics, 245, 1230. Juul, L., Maindal, H. T., Frydenberg, M., Kristensen, J. K., Sandbaek, A. (2012). Quality of type 2 diabetes management in general practice is associated with involvement of general practice nurses. Primary care diabetes, 6(3), 221-228. Kusnanto, K. (2017). Self Care Management-holistic Psychospiritual Care on Independence, Glucose Level, and Hba1c of Type 2 Diabetes Mellitus Patient. Jurnal Ners, 7(2), 99-106. Modic, M. B., Canfield, C., Kaser, N., Sauvey, R., Kukla, A. (2012). A diabetes management mentor program: outcomes of a clinical nurse specialist initiative to empower staff nurses. Clinical Nurse Specialist, 26(5), 263-271. Ng, S. M., Finnigan, L., Connellan, L., Kiernan, C., Coward, S. (2014). Improving paediatric diabetes care with the use of an integrated paediatric electronic diabetes information management system and routine uploading of blood glucose meters and insulin pumps in outpatient clinics. Archives of disease in childhood, 99(11), 1059-1059. Paschou, S. A., Leslie, R. D. (2013). Personalizing guidelines for diabetes management: twilight or dawn of the expert?. BMC medicine, 11(1), 161. Plat, L. (2017). Diabetes care pathways and the diabetic convention in 2017. Revue medicale de Bruxelles, 38(4), 347-352. Rosenberg, D., Lin, E., Peterson, D., Ludman, E., Von Korff, M., Katon, W. (2014). Integrated medical care management and behavioral risk factor reduction for multicondition patients: behavioral outcomes of the TEAMcare trial. General hospital psychiatry, 36(2), 129-134. Rossom, R. C., Solberg, L. I., Magnan, S., Crain, A. L., Beck, A., Coleman, K. J., ... Whitebird, R. (2017). Impact of a national collaborative care initiative for patients with depression and diabetes or cardiovascular disease. Focus, 15(3), 324-332. Spanakis, E. G., Chiarugi, F. (2011, October). Diabetes management: Devices, ICT technologies and future perspectives. In International Conference on Wireless Mobile Communication and Healthcare (pp. 197-202). Springer, Berlin, Heidelberg. Wexler, D. J., Beauharnais, C. C., Regan, S., Nathan, D. M., Cagliero, E., Larkin, M. E. (2012). Impact of inpatient diabetes management, education, and improved discharge transition on glycemic control 12 months after discharge. Diabetes research and clinical practice, 98(2), 249-256. Zhou, H., Zhu, J., Liu, L., Li, F., Fish, A. F., Chen, T., Lou, Q. (2017). Diabetes-related distress and its associated factors among patients with type 2 diabetes mellitus in China. Psychiatry research, 252, 45-50.

Pyrrhus (319-272 B.C.) free essay sample

This paper describes in detail the life of Pyrrhus, one of the three greatest Greek generals. This paper summarizes the life of Pyrrhus, a great warrior of immense skill and strength who was killed in a humiliating fashion.The author points out how his victories were Pyrrhic meaning costly to the point of negating or outweighing expected benefits. Table of Contents Character Sketch Pyrrhus Relationships Major Events in Pyrrhus Life Comparison with Alexander Pyrrhus Fate Pyrrhus was a celebrated general who possessed great personal valor and strength. He took personal part in his battles and was admired for his fighting skills by his own troops and enemies alike. His military acumen was comparable to that of Alexander the Great and his innovative tactics in battle (e.g. the use of elephants) were copied by several military commanders later. Hannibal has called him the greatest commander of all time (and placed himself in third place). We will write a custom essay sample on Pyrrhus (319-272 B.C.) or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page

Idiot box essays

Idiot box essays In the article titled Television Addiction, Marie Winn argues that TV viewing is comparable to alcoholism and drug addiction in terms of its negative effects on human behavior. Winn states that when one thinks about an addiction to drugs or alcohol, he frequently focuses on the negative aspects, ignoring the pleasures that accompany drinking or drug taking. She points out that an addict craves an experience and yet one is never really satisfied. Winn asserts that an addict leads a distorted, damaged, narrowed and dehumanized life. Winn opines that television viewing is similar to serious addictions like alcoholism and drug consumption. She discloses that watching television allows one to escape from the real world and enter into a pleasurable and passive mental state. She maintains that television programs prompt one to put off worries and anxieties, just like drugs and alcohol. People overestimate their control over television watching, says the author. Winn discloses that one is living in a holding pattern that she describes as a passing activity that hinders growth or development or a sense of accomplishment. She suggests that people know that television viewing is an unproductive experience that renders other experiences vague. Winn says that television viewing distorts ones sense of time and weakens relationships. She concedes that television programs dont satisfy and thus one finds that one cannot stop watching them. Winn cites a college English instructor, who comments, As I reach out to turn off the set, the strength goes out of my arms. So I sit there for hours and hours. Before diagnosing or analyzing the effect of television has on society, a certain position has to be taken on whether or not that correlation is positive or negative. On the one hand, television can teach and amuse; it can reach aesthetic heights; it can provide much need ...

Supply and Demand Essay Example | Topics and Well Written Essays - 500 words

Supply and Demand - Essay Example Rent control, the worst planning by governments lacking courage and vision, has been spearheaded by upstate lawmakers such as Assemblyman The consequences of price control on apartments are that entrepreneurs who see inadequate return on their investment are not motivated to invest in rental housing; landlords whose rent do not cover cost of operations stop maintain units or abandon them; despite rent controls, New York City renters pay the higher average rents in the country; demand for excessive space remains high because rents are artificially low; and rent control does not provide affordable housing for low to moderate income tenants. Rent control, like all other government-mandated price controls, is a law placing a maximum price, or a "rent ceiling," on what landlords may charge tenants. To have any effect, the rent level must be set at a rate below that which would otherwise have prevailed. And if rents are established at less than their equilibrium levels, demand will necessarily exceed supply, and rent control will lead to a shortage of dwelling spaces. In the absence of controls on prices, the amount of a commodity or service demanded is larger than the amount supplied, prices rise to eliminate the shortage (by both bringing forth new supply and by reducing the amount demanded). But controls prevent rents from attaining market-clearing levels and shortages result. Existi

Magnet Hospital Characteristics Research Proposal

Magnet Hospital Characteristics - Research Proposal Example This study will seek to explore the various ways in which magnet characteristics could be appropriated towards the objectives of empowerment, reduction of burnout and enhancing employee satisfaction within the healthcare facilities. Problem Statement The matter of job dissatisfaction and work related stress continues to engage the concern of stakeholders in the nursing profession. Nurses are continually subjected to adverse working conditions that affect their levels of production and dedication to duty (Earie & Denny, 2005). Despite the consistent improvements of other areas of the healthcare sector, there seems to be insufficient focus on the challenges that afflict the nursing fraternity. The general perception is that the healthcare system, as presently constituted, lays obstacles to the empowerment of nurses. The system is structured in such a way that assigns a subservient role to the nurses despite various research findings that emphasize the centrality of nurses to the succes s levels of every health care system. Among the many suggestions on the improvement of the nursing industry is the inclusion of magnet hospital characteristics. This study seeks to explore the possible effect of magnet hospital characteristics in solving the challenges of empowerment, work-related stress and burn-out within the nursing industry. Objectives of the Study The general objective of the study is to explore the impact of utilizing magnet hospital characteristics on fostering nursing empowerment, reducing the levels of burnout and job dissatisfaction. Specific Objectives 1. To determine the relationship between magnet hospital characteristics and power relationships within a healthcare institution with specific focus on the nurses and the... This paper stresses that researchers on nursing have established that fragmented systems often promote negative competition and conflict between the nursing fraternity and the doctors. Systems that exclude nurses from decision-making processes often foster non-cooperation. Naturally, lack of cooperation between nurses and doctors will impact negatively in quality matters. Poor coordination could result in accidents and other elements of professional malpractice in the nursing community. Generally, nurses will tend to operate in ways that do not promote the general good of the hospitals due to the detached interest that follows. The need for harmonization of systems is consistent with the realization that quality service must involve processes of collaboration and delegation of roles. Technology also helps in the decongesting of hospitals thus promoting ample working environment for the nurses. This report makes a conclusion that poor staffing is usually associated with the negative impacts of staff burnout and stress. Generally, the aim of magnet hospital characteristics is the improvement of all the processes, associations and arrangements in the hospital for the benefit of all the stakeholders. Other studies have associated it with the concept of total quality management as understood within the framework of management. Harmonization of the different systems, processes, and individuals within the framework of the core mission of the hospital is the chief objective of magnet hospital characteristics.

Consumer Perceptions of Private Label Brands in China and UK

Consumer Perceptions of Private Label Brands in China and UK CONSUMER PERCEPTIONS OF PRIVATE LABEL BRANDS IN CHINA COMPARED WITH THE UK Summary In China there are fewer studies of private label brands (PLBs) that take up less market share than generic brands and national brands. However, there is a successful development of PLBs in the UK. Therefore, this thesis aims to explore the difference of consumer perceptions on PLBs between China and the UK with national brands as a standard. The literature review will review theories like brand equity/image, PLBs and double jeopardy; PLBs development compared with national brands in China and the UK; the influencing factors of consumer purchase behaviour and previous researches of consumers perceptions about PLBs in China and the UK. The main objective of this part is to ascertain the difference of consumers perceptions between PLBs and national brands in the UK. Primary research will take the form of a non probability convenience sampling method to randomly select 200 members of the public from two shopping malls of Xidan and Wangfujing and several large-scale supermarkets in Beijing. Questionnaires will be used for data collection, and data is analysed by Snap statistical programme. The finding shows that there is a significant difference of PLBs perception between China and the UK. Before the evaluation of brand image, the awareness of PLBs in China is understood and just less than half of respondents know the own-label biscuits. With reference to the literature reviewed on consumer perception in the UK, it can get the result that Chinese PLBs are perceived lower than British PLBs on the all attributes except â€Å"cheap† and â€Å"good value†. Chapter 1: Introduction 1.1 The topic of research The aim of this thesis is to better investigate how private label brands (PLBs) are perceived by consumers in China, and compare it with the UKs. 1.2 Principle research question To understand how Chinese consumers perceptions of private label brands differ from the UKs. 1.3 Overall research objective The primary purpose for this research is to discover the main difference of consumers assessment of private label brands between China and the UK. This thesis will explore if there are significant differences between Chinese consumers evaluation on PLBs and the UKs, and analyse the relevant factors that cause the distinctness of consumers evaluation roundly on the basis of prior research in this subject scope. 1.4 Individual research objectives In order to achieve the principle objective of this study, it will intend to fulfil the following objectives: To identify the actual development of PLBs in China and the UK To establish the influence factors of consumer purchase behaviour in China and the UK To determine consumers perception of PLBs and national brands in the UK To determine consumers perception of Chinese PLBs and national brands To ascertain the different brand perceptions of PLBs in China and the UK 1.5 Report Structure This thesis contains eight chapters. Chapter2 to 4 are based on a literature review about theories and relevant knowledge of marketing background. Chapter2 outlines the theories about branding, and then chapter3 introduces the private label brands and their development in the UK and China. Chapter4 refers to consumer perception of PLBs review between two countries based on analysing the determining factors of purchase. The research method is explained in chapter5 with some specific designing scheme. The results of surveying Chinese biscuit category is presented, interpreted and analysed in chapter6, and discussed relating with the UKs market of literature review in chapter7 before conclusion and recommendations are given in chapter8. Chapter 2: Branding Chapter 2 introduces the definition of branding with its importance in the retail market, and moves to realize â€Å"brand image† and â€Å"brand equity† as well as the shift between them. In addition, the Double Jeopardy (DJ) Effect is identified finally. The aim of this thesis is to evaluate Chinese consumers perceptions of private label brands (PLBs) in comparison to UKs. Therefore, it is necessary to understand the background knowledge about â€Å"brand† first. 2.1 The conception of branding A brand was defined as â€Å"a name, term, sign, symbol, or design, or a combination of them, intended to identify the goods or services of one seller or group of sellers and to differentiate them from those of competitors† (p.404, Kotler, 2000). Aaker (1996) indicated that brand was used for suppliers to reflect the consumers purchase information and make communicate with customers easier, so that it is helpful to build a long-term relationship of belief between buyers and sellers. Wileman and Jary (1997) had realized that retail branding was playing an important role in the modern retail market gradually. Managers and executives also perceived that retail branding could be used to increase benefits as a strong vehicle in the competitive retail industry (Carpenter, et al. 2005). The reason is that the relationship between a product and consumers is personified by the brand name (organizations name) on the product itself, like Microsoft and Nescafe (de Chernatony and McDonald, 2003). The difference between a brand and a commodity is shown below in figure1, which describes the process of decline from brand to commodity. Following the disappearance of brand characteristic, a reduction in the differentiation of price and product/image is demanded to achieve the likeness of product offerings in the particular category. Thus the â€Å"added values† is the main difference between a brand and a commodity. The result proved the strong power of added values in the blind (brand cancelled) and open (brand revealed) test of Coke and Pepsi preference (de Chernatony and McDonald, 2003). 2.2 Brand image Brand image is explained as the integrated effect of brand associations (Biel, 1992). Also, Faircloth et al. (2001) cited Engel et al. (1993) as claiming that brand image refers to consumers perceptions of brand tangible and intangible association. Keller (1993) stated that brand image, a part of brand knowledge, belongs to the perceptions about a brand that is reflected by the brands attribute, benefit, and attitude association in the memory of consumers. Besides, consumers brand image is derived from the accumulative effects of marketing mix actions of companies (Roth, 1994). Wulf el al. (2005) has argued that image is one prerequisite for the presence of brand equity. Brand image in the consumers memory network that is decisive to make decision, provides preferred brand reminding and evaluation (Holden, 1992), and so it can contributes the positive effect on brand equity (Yoo et al. 2000). Furthermore, Winchester and Fletcher (2000) argued that measuring brand image was one of the most important research projects undertaken by a company, because it could help firms to understand their products perceptions in consumers memory. For example, retailers have the cheaper brand image than the manufacturers in most of consumers memory. Also, they suggest that consumers consider retailer brands as â€Å"me too† products compared with manufacture brands (IGD, 2003). Thus it demonstrates that retailers are trying hard to build up a strong image for their own brands to shoppers. The enhancement of brand image will be beneficial to drive the sales, brand equity and increase the gross margin of private label products (Quelch and Harding, 1996). Therefore, brand image is an important determinant of consumers perception about private label brands. 2.3 Brand equity Brand equity, like the concept of brand, has been identified as having multiple meanings. For instances, people have debated the concept of brand equity both in the accounting and marketing literature for several years (Wool, 2000). The original concept of brand equity is the added value that a brand name offers to the fundamental product (Quelch and Harding, 1996; Wulf el al 2005). Wood (2000) also cited Feldwick (1996) as claiming a classification of different meanings of brand equity as: â€Å"- the total value of a brand as a separable asset when it is sold, or included on a balance sheet; a measure of the strength of consumers attachment to a brand; a description of the associations and beliefs the consumer has about the brand.† (p. 662, Wood, 2000) According to the statement of Wood (2000), brand equity rests on financial accounting no longer, but extends to the measure of brand strength (brand loyalty) and the description of brand image. Additionally, Aaker (1996) identified the major asset categories of brand equity to include brand name awareness, brand loyalty, perceived quality and brand associations (brand image). It reflected the value supplied by a product or service to a firm and/or customers in the various different ways. If the name and symbol of the brand change, the assets or liabilities will be affected and even lost due to the link between both sides. To brand awareness, the strength of a brands presence is mentioned in the consumers minds, ranging from recognition to recall to â€Å"top of mind† to domination. Recognition is more important than others due to the perception obtained from the past exposure. Also, recall can be a deciding factor of the purchasing of products. Otherwise, Chou (2002) also insisted on two categories of definition of brand equity—the customer-based and financial brand equity. The customer-based one is defined as the different effect of brand knowledge on consumers response to the purchase of brand (Keller, 1993; Lassar, et al. 1995), and the financial one refers to the intangible asset of the value of brand name to the firm (Chou, 2002). Through understanding the multiple concepts of brand equity, it can deduce that brand equity has attracted more attention in the marketing literature over the last decade, because it reflects if a brand would be repurchased by consumers. As Shapiro (1982) has demonstrated, certain brand equity offered genial value even though the appearance of products is uncertain. Nowadays Broniarczyk and Gershoff (2003) still emphasise the importance of brand equity; also, as one of the most valuable assets, it should be maximised to manage brands for the company (Keller and Lehmann, 2003). High brand equity can increase the opportunity on consumer choice of a common sales promotion (Simonson et al., 1994) and reduce the negative debates of consumers for a price increase (Campbell, 1999), because consumers lean to buy the brand more than the real product. Consequently, brand equity is also a factor to evaluate consumers perception of own brands. 2.4 The Double Jeopardy Effect In recent years, more authors (Sharp et al. 2002; Ehrenberg and Goodhardt, 2002) have been interested in understanding, developing and reinforcing the concept of Double Jeopardy (DJ), which represents a natural constraint on customer loyalty, which cannot be increased by marketing inputs much or for long unless a significant benefit increases the brands penetration (Ehrenberg and Goodhardt, 2002). The DJ effect is that â€Å"small share brands have fewer customers, but these customers buy the brand less often than the larger brands get bought by their customers† (p. 17, Sharp et al. 2002). A conceptual model of the DJ effect is showed in the figure2, which illustrates if a small firm would have higher turnover of their customer base if they lost the same number of customers as a large firm. The DJ effect is fit for the discussion of national brands and PLBs. Bigger brand will be known by more customers, and have more opportunities to be purchased and receive more responses than smaller brand. It will be an essential theory to support the last result of investigation about the comparison between own labels and national labels. Chapter 3: Private Label Brands This chapter attempts to understand private-label brands, their development in UK and China and the reason for focusing on them. National brands will be also mentioned as the scale for the validity of comparison between Chinese and UKs own labels. 3.1 The definition of private label brands â€Å"Retailer brands are designed to provide consumers with an alternative to manufacturer brands, to build customer loyalty to a retailer or improve margins.† (p.11, IGD, 2003) They are particular to a definite retailer, and may have a same or different name of the retailer but exclude other retailers name (IGD, 2003). The terms â€Å"own label† and â€Å"own brand† are always used together; also private label, retail brands or distributor brands are in common used (Fernie and Pierrel, 1996). Own brands can help retailers reduce the direct impact of price competition, since retailers carry their own brands instead of national brands that are sold in the most of the stores (Carpenter, et al. 2005). Furthermore, according to IGD (2003) study, doing own brands can provide competitively priced products, increased profitability and loyalty due to the special store, establishes store image, drives innovation and targets specific consumer groups. 3.2 The development of PLBs in UK Based on more previous researches about UKs PLBs, it will specify them as the base to compare with Chinese growing PLBs. 3.2.1 The history of development The generation of own brands in the UK can date back to the end of the nineteenth century (Key Note Market Review, 2001). Until mid-1960s, manufacturers perceived that the development of store brands could be a direct threat for them (Ogbonna and Wilkinson, 1998). After that, own brands rose to penetrate into grocery markets gradually (Fernie and Pierrel, 1996), because supermarket had to implement a new strategy under the tough economic crisis (Ogbonna and Wilkinson, 1998). The growth of own labels in the UK had been rapid during 1980s, and slowing down in the 1990s (Laaksonen, 1994). After 1980, the UKs retailing had a big metamorphosis to change their own-label products from previous low-price/low-quality/poor-packaging to current high quality, competitive price and good packaging (Burt and Davis, 1999; Key Note Market Review, 2001). Especially from 1990, more retailers began to provide own brand lines in stores and penetrated towards the grocery field (Veloutsou et al., 2004), and even innovated in product categories to be consistent with branded-products, such as the expansion from grocery to clothing (Quelch and Harding, 1996). Fernie and Pierrel (1996) illuminated that Marks Spencer, Sainsburys, Tesco and Safeway had developed their own brands, which competed successfully with other brands in the UK. Otherwise, there were more private labels on the shelves of supermarkets than ever before (Quelch and Harding, 1996). The main reasons for growth of own-label products include lower pricing (60%-85% of branded products), improved quality and higher profits for retailers (Ashley, 1998). Through the review of historical evolvement of PLBs, the current bloom of PLBs development in UK that is built on the basis of constant change can be seen. Also, it can be a good explanation for the condition, in which customers choose more own brands of supermarket rather than manufactures brands. 3.2.2 Current development At present, private label brands have taken up a significant share of nearly 29% in the UK food market. It is expected to increase further in 2009. Especially since 2008, own label has been gaining popularity following accelerating economic downturn. As consumers have begun to feel the pitch, so they have bought own-label products instead of branded products to save money. Thus the competition between own-labels and brands is reinforced. There is the highest own-label consumption in the FMCG sectors, like milk and frozen vegetables, or some products without emotional appeal. However, manufacturer brands still account for the majority of sales in the most of grocery categories (Mintel, 2009). Table1 shows the share of brands and own-labels in the following different categories. From this table, it can see that own label is the most dominant in the category of ready meals; and it has the least share in the crisp category. Also, more share own labels account for, more increasing opportunities they have. In addition, UKs supermarkets recognise that consumers have a wide range of product needs, so they segment the market by providing the brands that cater for the best, healthy, valuable, kids and organic requirements as table2 shows. 3.2.3 The feature of development The development of PLBs, a competitive strategy adopted by retailers, is necessary for them within the current retail market of high competition in the UK (Carpenter et al. 2005). Own brands are developing fast and winning a better share of the food market with definite advantage in the supermarket product ranges, because retailers can offer their private label products with high-quality and low-price (Wulf et al., 2005). Also, own-brand products exceeding 40% of market share have expanded their presence across markets—from low-priced, value-for-money items to the premium and lifestyle arenas so as to cater for consumers concern about healthy eating (Drewer, P. 2006). Therefore, it can fetch up the limitation of national brands that segment the market less, and target desired consumers more narrowly. For instance, figure3 shows Sainsburys Be Good to Yourself range of lower fat which is one kind of â€Å"healthier† own-label ranges; and Asdas value (Smartprice), healthy (Good for You) and Premium (Extra Special). Furthermore, the feature difference of own brands has been gradually shortened from national brands in terms of aspects such as packaging, size, and label (Choi and Coughlan, 2006). In figure4, Sainsbury instant coffee products are taken as an example of private labels with reduced feature differentiation as national labels inside FMCG sector. Some of the UKs retailers such as Sainsburys and Tesco have set up own brands focusing on quality and taste due to more consumers regards on flavour and aroma. Production methods have become diversified, and manufacturers have been found around the world to get various products with exotic flavours. For instance, the recipes of multiple ready-meal foods are derived from characteristic foods of different countries, like Waitrose chicken chow mein, which is developed from Chinese stir-fried noodles. Thus it is common for retailers to compete by developing premium own brands (Fenn, 2007), yet the majority of retailers changed their attention from premium ranges to the promotion of value ranges in 2008 (Mintel, 2009). 3.2.4 Marketing support The increase of own-label products is supported by the gradually concentrated nature of the retail market. Retailers control own brand marketing, which has obtained higher promotional support than national brands since there are better space and location for private labels on supermarket shelves (Cataluna et al. 2006). Retailers have got bargaining power in the market and more confidence to invest in their own brands, which bring higher profits than generic brands (Fenn, 2007). In addition, own-label food and drink has been supported strongly in the competitive market, although the main retailers began to promote the potential of saving money on PLBs purchase in 2008 and early 2009. For example, own-label brands are promoted principally in the main retailers like Morrisons. Marks Spencer also spent a third of its total budget on MS brands in 2008 (Mintel, 2009). Table3 shows the market support on foods in the form of media advertising expenditure. Generally, an increasing trend is shown for the retailers spending on foods in this table. However, depending on the retailers spending share, it can ascertain that branded manufacturers are still the biggest spenders on advertising for food and drink. They use the â€Å"Reassurance† and â€Å"tradition† as the key themes of promotion to fight against PLBs (Mintel, 2009). 3.2.5 The biscuit category Own-label biscuits take up a fifth of the UK market, where it has remained the share stably over previous 5 years. The biscuits category has increased substantially since 2002, although there is an unhealthy high sugar content in the most biscuits. The benefits can be obtained from defying all advice of nutrition, because consumers regard biscuits as a reward for their efforts on healthy eating most of the time. Moreover, the development of biscuit market is likely to be influenced by three key factors: requirement for healthy foods, indulgent products and convenient products. The indulgent demand can benefits the branded biscuits, as consumers believe premium-branded products more than PLBs (Kidd, ed. 2007). Figure5 shows the UK biscuits market shares in 2007. From this figure, it can see own labels account for more share than any one manufacturer brand, but it is less than the total share of main large manufacturers. In short, UKs PLBs market has been described and compared with manufacturers brands specifically, so that it can be as the firm foundation for the later comparison with Chinese PLBs market. 3.3 The development of PLBs in China Private label in China is still in an emergent stage, where many retailers had increased the place of own label development in 2004, but most do not have their own brands until they have greater scale in the market. According to IGDs estimation, own brand only takes up 2% of sales at Wal-mart and less than 6% at Carrefour, which is the strongest retailer in China. Although the foreign retailers have a long history to sell private label brands, this is a big challenge for them to sell in China, where own brand is a new concept for the Chinese consumers. They just believe the value and quality of local branded products. Thus retailers need to prove their own products are not only cheaper, but also provide better value to consumers (IGD, 2005b). Auchan, Carrefour and Wal-mart will be chosen as the example of private label development, because they have wider range of own label products than others. â€Å"Pouce†, â€Å"Auchan† and â€Å"First Price† ranges were introduced by Auchan in 2003. And they were developed across both food and non-food categories by the end of 2004. In Carrefour, own labels can be found in most categories, especially strong in non-food. Its private label brands include â€Å"Great Value†, â€Å"Equate† and â€Å"Kids Connection†. Wal-mart is developing their own brands including â€Å"Simply Basic†, â€Å"Equate† and â€Å"Great Value† in China, where the quantity is more limited than other developed international markets (IGD, 2005b). But actually, most of supermarkets usually just focus on the value with low price, and use the name of supermarket as their own brands name to attract consumers attention, such as â€Å"Ito-yokado†, â€Å"Dia%† and â€Å"Tesco†. 3.4 Why the focus on PLBs Veloutsou et al (2004) indicated that all grocery retailers have been entangled by private brands in Great Britain in the last decade. Also, the growth of private labels is one of the most obvious successes to the retail stores (Drewer, P. 2006); own brands have been seen as the strategic weapon to provide retailers with more powers and opportunities to distinguish themselves from national brands and build store image (Juhl et al. 2006). Nevertheless, there is a completely different situation in China, where the study of PLBs is less than the UKs and is strongly encouraged (Song, 2007). PLBs is undeveloped with low sales account in China, even if some foreign retailers (e.g. Carrefour, Wal-mart) have launched their own brands (IGD, 2005b). Consequently, there is a need to expose why PLBs have little market in China, and understand the shortage of Chinese PLBs development through comparing consumers different perceptions between China and the UK. Chapter 4: Consumers Perception of PLBs in China and UK This chapter will evaluate private label brands and national brands based on a cognizance of factors determining purchase. A generality of different viewpoints about consumers perceptions on brands will be discussed and some factors influencing the PLBs purchase will be presented. 4.1 Determinant of Purchase behaviour Consumers purchase can be influenced by environment, personal preference and psychological factors. Customers who live in diverse regions have their own experience about private-label products (Veloutsou et al 2004). Individual consumers often choose certain brands that they know to be guaranteed due to their habits, instead of spending more time to re-evaluate the brands with different attributes when purchasing (Ehrenberg, 2004). Furthermore, consumers preferences are different following the change of age (IGD, 2005a). For example, young people high on the new things more than old people. From the psychological aspect, â€Å"the right customer mindset can be crucial to realizing brand equity benefits and value† (p29, Keller and Lehmann, 2003). During the decision making process, purchase can be influenced directly by several factors. Veloutsou et al (2004) cited Omar, Burt and Sparks (1995) as claiming that many consumers always consider their products characteristics, quality and perceived value instead of the prices of products when consumers make purchasing decisions. However, the price cannot be excluded from factors of decisions, because most of consumers go shopping after they have a budget in mind (Hogan, 1996). Additionally, a generalized private-label attitude is discovered to influence purchase behaviour; factors include: â€Å"consumer price consciousness, price-quality perception, deal proneness, shopping attitudes, impulsiveness, brand loyalty, familiarity with store brands, reliance on extrinsic cues, tolerance for ambiguity, perceptions of store brand value, and perceived differences between store brands and national brands† (p347, Collins-Dodd and Lindley, 2003). 4.2 Consumer perception in China Due to the limitation of consumption per capita, the market was driven by price instead of brand loyalty in China (IGD, 2005b). According to China Management Newspaper (2008) reported, it is a fact that consumers who realise the supermarket own labels account for rather low percentage of total population. Moreover, â€Å"low price† and â€Å"high quality† are the main motivations to drive consumers purchase. Thus national brands with better quality can attract more consumers, although they have higher price than own labels. This results from the increase of Chinese consumers purchase power and the improvement of living level in recent years. Moreover, PLBs and national brands were considered as less difference on price (Chen, 2009). Thus it can be deduced that â€Å"low price† strategy of own brands in China would be successful due to less brand loyalty. However, following the improved standard of living, people would increase their demand from low price to high quality, which could be a challenge for the PLBs. 4.3 Consumer perception in UK 4.3.1 Comparison of PLBs with national brands Following the quality improvement of PLBs, Richardson (1997) found that store brands could be compared with national brands from the aspect of quality and consumers preferred to buy store brands where they usually shopped. As Quelch and Harding (1996) discovered that this was similar for consumers to perceive and judge the manufacturer and retailer brands in the orange juice private-label test, because consumers had a low involvement activity on grocery shopping. Nevertheless, â€Å"If all retailers stock manufacturers brands, they can only differentiate on price or sales promotions; with own labels/brands, they can offer further differentiation in the market place.† (p49, Fernie and Pierrel, 1996) They supported that own labels/brands could bring retailers more differentiation in the market place than manufacturers brands that just differed on price or sales promotions from each other. However, there is a different understanding based on consumers mind. Dick et al. (1996) considered that private labels were less famous than national brands, which have a distinct identification with a particular manufacturer. Richardson (1997) also supported the unification of store brands without the speciality of national brands. In the research of Harris (2007), he also demonstrated a significant difference of brand image evaluation for national brands and store brands. He established that PLBs have the advantage of â€Å"cheap† and â€Å"good value† to compare with national brands, while national brands were used more with higher quality/superiority based on attributes than store brands. However, after breaking down PLBs into three relative positions (premium, standard and value), he discovered that premium private labels were overpriced more without better value for money than national labels; customers buy more value private labels than national labels due to their cheapness. This implicates that consumers prefer the high quality of national brands and the good value of value PLBs at the same time. Therefore, he identified the characteristic of â€Å"worth more† regarded by consumers mostly. The brand association strengths are summarized in the following figure7 from his study. Furthermore, his researching results (see Appendix3) will be used as the reference of British consumer perception of PLBs to compare with Chinas later. In addition, according to Mintel research (2009), it has been a long-term trend for more consumers thinking that own labels are better than national brands. 4.3.2 Evaluation of PLBs To the quality/value thinking, other authors have had same ideas. Quelch and Harding (1996) predicted that consumers would choose PLBs readily rather than the higher-priced name brand, if there were more quality PLBs in the market. Richardson (1997) cited Richardson et al. (1994) as claiming that store brand market share could be increased by successfully communicating a quality rather than a low price strategy. Moreover, according to the IGDs research, PLBs have become one of the important factors for shoppers to choose the supermarket they shop in. The satisfaction of quality with lower price has attracted more consumers. The proportion of main reasons is â€Å"45% lower price, 45% better value than branded equivalent, 26% the same as branded, 24% a good reputation for own brand (IGD, 2003). Furthermore, consumers are not confused about the increasing number of own-label brands, but the segmentation is beneficial for them to choose products that are fit for themselves. The clear d ifferentiation among brands is also the key for retailers to success (Mintel, 2006). Chapter 5: Methodology On the basis of the relevant literature review about the market analysis of PLBs and national brands, especially the UK market, this has been analysed for the final discussion to compare with Chinese PLBs. This chapter will look for the most appropriate approach to implement the needed research and achieve the objective of this thesis. 5.1 The objective of this study Perceptual variables related to consumers perception are investigated in this study. It needs to finish the following objectives: The difference of consumer perceptions between PLBs and national brands in the UK (achieved in literature review) The difference of consumer perceptions between PLBs and national brands in China The difference of consumer perceptions of PLBs in China and the UK Based on the understanding of the UKs markets and perceived PLBs compared with national brands by consumers in the literature review, the Chinese situatio

A Response to Mark Twain’s the Lowest Animal

What makes a being more evolved? Who are we to say that humans are the most evolved or even the least? It is believed by some that we are descended from the â€Å"higher animals†, whereas others believe that we have ascended from the â€Å"lower animals†. In Mark Twain's essay, â€Å"The Lowest Animal† (1896), he portrays the idea that the human race has no hope, as we have too many flaws. It is undeniable that we have our flaws, but what creature on this planet does not? The human race may not be perfect, or reaching perfection anytime soon, but it does progress and develop as time goes on.As humans, we are neither substantially higher nor lower than animals. Although foolish actions are performed towards each other and our planet, we have also accomplished plenty to accompany this. This can be seen through our use of moral sense, fight against slavery and dedicated medical help. Despite our faults, we do have our redeeming qualities and this is why were are not as Mark Twain says, â€Å"the lowest animal†. Having a moral sense can be a weakness in some aspects, however this is not always so. This sense shows that we acknowledge our boundaries and allows us to be civilized as human beings.It can be argued whether or not the human race is civilized, based on our faults. Our race is not innocent of murder and other cruel actions and this may seem to validate Mark Twain's (1896) accusation that â€Å"Man is the Cruel Animal† (pg. 236), but these actions do not define us because they are not considered to be the norm. Without this sense, these actions could nonetheless be the norm. Actually, it is this â€Å"great defect† known as our moral sense that holds us from being at our worst and as monstrous as we could be.Another example of what is known to be a fault of the human race is slavery. Twain (1896) states â€Å"Man is the only slave. And he is the only animal who enslaves. â€Å"(pg. 237) The fact that man takes par t in slavery cannot be denied, however it cannot be confirmed that he is the only animal that does. Studies show that other species of animals do indeed deal with this issue. A species of ants called Protomagnathus Americanus abduct the young of others and force them into labouring for their new masters.These ants conduct violent raids on nests of other species killing the adults. This is one of several examples that proves that man is surely not the only slave, neither the only animal that enslaves. Mark Twain(1896) claims about man that â€Å"he is always some man's slave for wages, and does that man's work.. â€Å"(pg. 237), however without this basis of hierarchy our communities and economy would not function. What Twain sees as the allowing of enslavement is how each part of the economy works together to keep it running and how each individual is able to afford to survive.Over time it is seen by many worldwide that forceful, unfair enslavement is considered unacceptable. This cruel act is not allowed with strong rules set against it in many areas. Although it still exists in certain countries, as previously stated Mark Twain's â€Å"higher animals† fail to be above this as well. Our bodies are not perfect and they do have their flaws that result into many different diseases, as Twain(1896) wrote, â€Å"†¦ man starts in as a child and lives on diseases till the end, as a regular diet. (pg. 240) However, it is man who also works and creates cures for these diseases. Although there is seemed to be more types of diseases common to man than animals, diseases and sicknesses are not uncommon to them. It is also humans that study animals and work as veterinarians to cure these problems for certain animals as well. The hard work put in by the human race to find these cures and successfully cure many should outweigh the fact that we are prone to more diseases that Twain's â€Å"higher animals†.We may be imperfect animals, as Twain had pointed out with his list of flaws of the human race, but we do strive for this so called â€Å"perfection† and work to improve ourselves to reach it. This is not a fast process, but through time we are developing and progressing. Why lose hope on humanity because of what is done wrong, when there is so much that is done right? These redeeming qualities should prove that unlike Mark Twain(1986) believed, we are an important species and should not be seen as failures when we have reached so much success.

Charlotte Beers at Ogilvy and Mather Worldwide Essay

1 Recommendations 1.Define Brand Stewardship work procedures, provide coaching and training to gain support in the middle/lower management. Create an O&M-brand, use BrandPrint for O&M itself. 2.Align the organizational structures of the company by establishing profit centers. Focus the ERP system on worldwide CRM. Adjust the compensation system to reward brand thinking and brand management. 3.Recraft and connect the vision to O&M’s core values, create a visible BHAG and specify tangible objectives. Establish symbols like the colour red and a brand hall of fame. 4.Create and man a global brand stewardship coordination officer position to support Beers and enable her to focus on selling the vision to the clients. 5.Resegmentize customers by focussing on building brands for large, globally operating Fortune 500 companies. 2 Rationales 2.1 Internal Propagation of the Vision Propagation has top priority because of unbalanced internal and external situation. To ensure a high quality of customer service, it is necessary to make sure that all parts of the service marketing triangle are equally prepared and committed to the new brand-oriented vision. Currently, the management has already attracted a number of clients with the concept of Brand Stewardship, but has fallen behind in communicating its ideas and implications to the middle and lower management and to the front-line employees. This is hazardous, because it has built up a service promise to the customers which the company cannot fully keep and deliver at the moment. This will directly  lead to significant customer dissatisfaction, hence it must be the top priority to propagate the vision internally. Missionaries, training and communication are most effective for a top-down approach. In order to find the most effective measures, it is essential to keep in mind that Beers has brought the vision to the company as an outsider and has installed it from the top. Therefore it is vital to broaden the community that carries this vision. The O&M’s employees, who developed a certain inertia during the successful eighties, must gain intrinsic motivation to adapt to the vision by understanding what is in it for them and what the way is to realize these benefits. This also includes that strong resisters who cannot identify themselves at all are to be convinced that it is best for them to leave the company. The Doral Arrowwood group should be appointed as â€Å"missionnaries† to spread and anchor the idea of Brand Stewardship in all O&M departments. Besides the vision idea, brand-oriented work procedures and concepts like the brand audit and BrandPrint must be formally defined and introduced by coaching and training sessions as well as by communicating them through channels like the corporate intranet, employee brochures and letters and company speeches and forums. The early visible successes of the new approach like the Jaguar BrandPrint and the American Express recapture should be used to illustrate its potential. Shaping O&M as an own brand by using BrandPrint is important for credibility. O&M as an advertising agency sells the development of brands as their primary service. This puts it in the somewhat delicate situation that in order to not lose credibility, it has to prove its abilities by developing the name O&M itself into a brand standing for strong brands. I recommend using the concepts of BrandPrint and brand audits for the twofold benefit that it yields valuable information about the change progress towards Brand Stewardship and gives the employees a deeper insight in how to apply these concepts appropriately. 2.2 Alignment of Organizational Structures Changes in the external industry conditions call for organizational changes. The advertising industry has changed dramatically over the last few years. Globalization had its impact, advertisement spending has been cut, the importance of mass media has decreased in favour of direct marketing and simple independent campaigns have become offered as a commodity. O&M’s organizational structure has not been adapted to these changes and is therefore not adequate to meet the requirements for a successful implementation of the new vision. The communication breakdown between local offices and international management reflects this as well as the prevailing disagreements about financial allocations. Turn offices and WCS into profit centers and put the ERP focus on CRM. A method to solve the problems about how to distribute the revenues and workload between WCS and local offices is to turn them into profit centers. The WCS will manage the direct account contacts and coordinate global brands and campaigns. The local offices are then subcontracted for local adaptation and implementation. This separation will also clarify the reporting relationships between the management-oriented WCS and the creativity-focused local offices. To remedy the communication problem, facilitate a thorough knowledge and information exchange and ensure consistency as necessary for global Brand Stewardship, the company’s ERP system must be refocused on Customer Relationship Management aspects. The data extracted from Beers’ client interviews will prove helpful in identifying these aspects. Company-wide accesses to this CRM system will empower front-line employees to fulfil the quality service promise given to the clients and will furthermore create a sense of network and community in the company. In addition, it will reduce transaction cost and boost efficiency, thus enabling O&M to maximize the profitability of voluminous global accounts. Make the incentive system reward brand thinking and brand management. The salary and incentive system must reflect the differences between the local offices and the WCS, but both must award efforts supporting the Brand Stewardship idea. Therefore it is advisable to grant WCS executives a bonus dependant on the world-wide reputation, volume and number of the brands they are responsible for. Incentives for local offices should be based on the current implementation and customization success of the brand, determined for example by local polls and changes in clients’ sales revenues. 2.3 Recraft the Vision and connect it to Symbols Attach the brand vision to the company’s core values. Since the mission did not evolve from the company but was brought from outside, it is necessary to make sure that it gets connected to the core values of O&M. In order to achieve this, those core values must be â€Å"re-identified†, specified and checked whether they still prevail in the company. The allusion of fiefdoms within O&M indicates that the statement of â€Å"not having time for prima donnas and politicians† is currently rather wishful thinking than reality. Erect a BHAG and a tangible milestone plan. Besides this, the vision catchphrase might be quite elegant, but is not specific and vivid enough to create directly visible targets and a so-called Big Hairy Audacious Goal, a long-term motivation point. â€Å"We will be the stewards for two thirds of the most valuable brands† is a more suitable formulation for such a kind of goal. Tangible objectives are also of great importance for creating motivation and sustaining the momentum of the organizational change. Therefore, a milestone plan should be set up, saying that within the next year the ten most important client accounts should be turned into fully-fledged Brand Stewardship relationships, and for an equal number of new clients a Brand Stewardship should be established. Symbolize the brand vision with the corporate colour red and a brand hall of fame. In order to anchor the vision in the company and to attach it emotionally to the employees, it must be connected to symbols. The distinctive red corporate colour can be exploited and should be made associated with the brand vision, for example by slogans like â€Å"Think red!†. Founding a representative â€Å"hall of fame† with well-known and successful brands that have been developed and stewarded by O&M will also help convincing and committing employees to the idea and will generate a sense of pride of what they created. 2.4 Appoint a global Brand Stewardship Officer Beers as a leader needs a capable operations manager besides her. The good success of Charlotte Beers’ first year as the leader and change agent of O&M indicates that she has the capability to fill the leadership vacuum which was opened when the founder David Ogilvy left the company and could so far not be successfully refilled by his successors. But in order to effectively implement the brand vision, it takes more than a good leader that stands for the right things to do. A dedicated manager to then do those things right is equally crucial for a sustained change process. Appoint an established O&M executive as CBSO. For this reason, Beers should create the position of a Chief Brand Stewardship Officer, responsible for the implementation of the brand concepts and for coordinating and steering the global operations. The country and zone managers should report to him, whereas he directly reports to Beers. This gives Beers the opportunity to fully dedicate her time on what she is best at: representing the vision inside the company and selling and communicating it to the clients and to the public. It is advisable to appoint an established O&M executive for this CBSO position, since a thorough understanding of the prevailing business processes and an anchored trust base will provide helpful for this task. 2.5 Resegmentation of Customers Globally operating Fortune 500 companies are the target clients for O&M. The investment into the CRM system and the organizational structure for world-wide brand coordination is substantial. To justify that expenditure, it is necessary to build volume by targeting the largest corporations which have a need for truly global brands. In case of scarce resources or busy local offices, small accounts and local clients have to be dropped first. This will also help to establish the company image as the brand steward of the giants and aid to fully turn the recently positively developing profit margin into substantial bottom-line results.