Saturday, August 31, 2019

Database Needs for Early Learning Programs Essay

The Outcomes and Targets for the recently passed Families and Education Levy are very high. At the heart of the levy is accountability and using data in timely ways to improve annual outcomes. In the realm of Early Learning the dollars will double and the number of children and professional staff served will increase dramatically. The need for reliable, accessible data is great. An HSD IT web based data system (ELNIS) was created in 2006 for the previous levy. It was deployed in the summer of 2007 and began to be used in the 2007-2008 school year. Hosted by the state of Washington, it is accessible to each agency under contract with the city through a city purchased computer and digital certificate. Help desk support and training are also provided by the city. In 2009 the state ECEAP program substantially changed its enrollment form. ELNIS no longer matches the data elements required by the state. It was decided, because the change came so late in the year, that it was not feasible to make the changes in ELNIS. For the 2009-10 and 2010-11 school years the data has been out of sync with enrollment forms for ECEAP. ELNIS was designed in 2005 with the hope of having a single early learning data base for ECEAP, Step Ahead, and Child Care Subsidy. This proved to be unfeasible given the time constraints and limited resources available to accomplish the task. Children are entered into multiple data bases that do not connect with each other, but all ECEAP children are also in ELNIS. In 2010 Creative Curriculum substantially change the child assessment tool, such that in the final year of the levy 2010-2011 the child assessment data is no longer uploaded into ELNIS. Again it was decided not to reconfigure ELNIS to match the changes in the assessments because of time and cost, until the new levy passed. The OFE monthly report drives the immediate need for data. Each month OFE requires a data set of demographics, attendance and assessment data be delivered on the last day month following the month reported. In the MOA each year between OFE and HSD the data elements are negotiated. The data reporting required for early learning in 2010-2011 is on pages 5 – 8 of this report. These will still form a substantial part of the required data, but there will be additional items and number of records will increase substantially. Further, each year an analysis is completed by the data and evaluation strategic advisor in August/September for the previous school year. The data is used to help managers and education specialists to improve the performance of the agencies in the next school year. This process begins by creating a large data set of assessments matched to each child who has been served. The early vision was that the data would be stored in ELNIS and download for use in evaluations ready to be reported or analyzed. ELNIS is capable of containing the demographic data (although it no longer matches the data collected for ECEAP families) for each child, the agency, site and classroom data, and the ECERS assessment. It can no longer upload the Embedded Child Profile Assessment data, the PPVT- 4 child data, nor any data about professional development. All of this data must be managed separately in Excel spreadsheets and appended to the download from ELNIS. Increased needs for data and new data elements The new levy includes six components of which are three are new and three are expanded: †¢Professional Development †¢Family Engagement and Outreach †¢Preschool †¢Kindergarten Transition †¢Home Visiting Program †¢Health and Mental Health Support for Children The new required elements for reporting are expected to include the following indicators of progress toward the outcomes: †¢Parent-Child Home Program (PCHP) – Caregivers/Adults will demonstrate increased positive behavior on the Parent and Child Together tool (PACT). †¢PCHP – Children will meet standard on the Child Behavior Traits (CBT) and the Teacher Rating of Oral Language and Literacy (TROLL). †¢Family Friend and Neighbor’s (FFN†S) Care Providers – Caregivers/Adults will demonstrate increased positive behavior on the Parent and Child Together tool (PACT). †¢Step Ahead Preschool Programs – Children enrolled will meet the Standard Score and/or make gains on the Peabody Picture Vocabulary Test-4 (PPVT-4) of Receptive English by the end of the preschool year. †¢Step Ahead Preschool serving children who are English Language Learners: Children will make statistically significant gains in English Language Acquisition at the end of the preschool year on the PPVT-4. †¢Step Ahead Preschool – Children will meet age level expectations at the end of the preschool year on Teaching Strategies Gold Child (TSG) assessment. †¢Children served by Step Ahead and SEEC and enrolled in full-day kindergarten – Children will meet the age-level expectations on Washington Kindergarten Inventory of Developing Skills (WaKIDS) . †¢SEEC Pre-K – Classrooms will meet the Environmental Rating Scale (ERS) standard at the end of the program year. †¢SEEC Pre-K – Teachers will meet standard on the Classroom Assessment Scoring System (CLASS) at the end of the program year. †¢Children enrolled in Step Ahead pre-K program will have fewer than 5 absences per semester. †¢Children served by a Step Ahead Preschool will be assessed at level 2 or higher on the district English assessment test at the beginning of Kindergarten. †¢Number of early learning and child care settings receiving targeted consultation or training. †¢% of children who enroll in kindergarten on time. †¢% of children enrolled in full day kindergarten. †¢% of children who attend 90% of school days. †¢% of children who meet the birth to 3-year indicator for health (TBD). †¢% of 4 year olds who meet standard on the curriculum embedded assessment in preschool. Early Learning Health †¢Number of early learning and child care settings and providers receiving targeted consultation or training. †¢Number of children in early learning and child care settings receiving developmental assessments. †¢Number of children in early learning and child care referred for mental health therapy and/or medical follow-up. †¢Number of low-income families linked to a health care home, Medicaid coverage, and/or other health care resources. Assessment Tools used to provide outcome and indicator data Formative Assessments †¢Child: Teaching Strategies Gold (administered fall, winter and spring of the pre-k year) †¢Classroom: Curriculum-embedded classroom checklist (administered annually) †¢CLASS: Annual voluntary observation of pre-k and kindergarten- 3rd grade teachers to measure teacher effectiveness. Summative Assessments †¢Child – PPVT-4 (administered fall and spring of pre-k ) †¢Child – WaKIDS ( administered fall and spring of kindergarten) †¢Classroom – ECERS ( administered annually) Performance Payment with OFE will likely include these Outcomes (indicators) 2010-11 Indicator BaselinesNumber of Students Meeting IndicatorPercent of Students Meeting Indicator Families demonstrating increased positive behavior on the PACT and the CBT 35/4283. 3% Children making gains in the Standard Score from the fall pre-PPVT to the spring post-PPVT 657/93570. 3% Children with a minimum of two assessments meeting age-level expectations on Teaching Strategies Gold397/546 73. 0% Children are in classrooms meeting an ECERS standard of 5 in each subscale or an average of 6 in all subscales. 397/636 62. 4% Indicator Targets2010-20112012-132013-142014-152015-162016-172017-182018-19 Families demonstrating increased positive behavior on the PACT and the CBT 83. 3% 84% 85% 86% 87% 88% 89% 90% Children making gains in the Standard Score from the fall pre-PPVT to the spring post-PPVT 70. 3% 73% 76% 80% 83% 86% 89% 90%. Children with a minimum of two assessments meeting age-level expectations on Teaching Strategies Gold 73. 0% 75% 78% 81% 84% 87% 89% 90% Children are in classrooms meeting an ECERS standard of 4 in each subscale or an average of 6 in all subscales. 62. 4% 67% 71% 76% 80% 85% 89% 90% Conclusions: ELNIS as currently configured will not meet the needs of the Early Learning System to report data to the funder, to use data for improving outcomes, or to manage data for contract payment purposes and monitoring. Either work needs to begin ASAP on reconfiguring ELNIS or a new data system needs to be created or purchased. Options include an HSD IT build or a purchase of a configurable off the shelf software system, such as Adsystech or ETO. Data will need to begin being reported to OFE in the fall of 2012, eight months from now. What options exist for meeting this need? What resources are available? What planning team should be assembled? Data Set currently required to be reported by OFE (2010-2011) SEEC Early Learning – Pre-K Source: HSD (monthly) Data ElementData TypeNotes YearNumericThe year of the period that the data is reported for. e. g. 2006 for reporting period December 2006. MonthNumericThe month of the period that the data is reported for. e. g. 12 for reporting period December 2006 Child HSD IDNumeric1 = English 2 = Other than English 3 = English and another language 4 = not reported Student IDNumericEnter SPS Student ID after child is enrolled in Kindergarten Ethnicity CodeChar 25 categories from SPS Child’s Home LanguageNumeric Gender CodeChar 1 SEEC Agency CodeChar 4Corresponds with Agency name look-up table SEEC Site CodeChar 4Corresponds with classroom site look-up table SEEC Classroom Code Char 7Corresponds with classroom look-up table. SEEC StatusNumeric1 = Step-Ahead Pre-K 2 = Step Ahead Match SEEC TierNumericTier I – Step Ahead, Tiny Tots, Refugee Women’s Alliance, and Jose Marti Tier II – Denise Louie Education Center/Head Start Tier III – Non-Step Ahead Early Childhood Education and Assistance Programs (ECEAP) , Neighborhood House Head Start Tier IV – Comprehensive Child Care Program (CCCP), other Head Start Programs in the City of Seattle Days in Pre-K ProgramNumeric/NullTotal number of days the student has participated in the Pre-K program during the month. ECERS Average Subscale Scores and average totalNumericRange 1-7 ECERS – Met StandardYes/No/Null ECERS average score of 4 across all 7 elements Classroom Quality StandardYes/No/NullClassroom met quality standards Classroom LevelNumeric/NullClassroom score based on years of experience and training 1st Child Assessment – Social/Emotional DevelopmentNumeric/NullStudent’s level from the 1st Creative Curriculum child assessment or High/Scope COR 1st Child Assessment – Physical DevelopmentNumeric/NullStudent’s level from the 1st Creative Curriculum child assessment or High/Scope COR. 1st Child Assessment – Cognitive DevelopmentNumeric/NullStudent’s level from the 1st Creative Curriculum child assessment or High/Scope COR 1st Child Assessment – Language DevelopmentNumeric/NullStudent’s level from the 1st Creative Curriculum child assessment or High/Scope COR 2nd Child Assessment – Social/Emotional DevelopmentNumeric/NullStudent’s level from the 2nd Creative Curriculum child assessment or High/Scope COR 2nd Child Assessment – Physical DevelopmentNumeric/NullStudent’s level from the 2nd Creative Curriculum child assessment. or High/Scope COR 2nd Child Assessment. Cognitive DevelopmentNumeric/NullStudent’s level from the 2nd Creative Curriculum child assessment or High/Scope COR. 2nd Child Assessment – Language DevelopmentNumeric/NullStudent’s level from the 2nd Creative Curriculum child assessment or High/Scope COR. 3rd Child Assessment – Social/Emotional DevelopmentNumeric/NullStudent’s level from the 3rd Creative Curriculum child assessment or High/Scope COR. 3rd Child Assessment – Physical DevelopmentNumeric/NullStudent’s level from the 3rd Creative Curriculum child assessment or High/Scope COR. 3rd Child Assessment. Cognitive DevelopmentNumeric/NullStudent’s level from the 3rd Creative Curriculum child assessment. 3rd Child Assessment – Language DevelopmentNumeric/NullStudent’s level from the 3rd Creative Curriculum child assessment or High/Scope COR. Formative Assessment – ChildYes/No/NullChild met the standard in the final embedded assessment as adopted by the SEEC assessment workgroup. PCHPYes/No/NullParticipated in Parent-Child Home Program. SEEC Early Learning – Peabody Picture Vocabulary Test, Fourth Edition PPVT Source: HSD (twice yearly) Data ElementData TypeNotes Child HSD IDNumeric. Child AgeXX-XXChild’s age at time of test in years and months 1st assessment – standard scoreNumeric/NullStudent’s standard score from the 1st Peabody Picture Vocabulary Test. 1st assessment – raw scoreNumeric/NullStudent’s raw score from the 1st Peabody Picture Vocabulary Test 1st assessment – grade equivalent scoreNumeric/NullStudent’s grade equivalent score from the 1st Peabody Picture Vocabulary Test 1st assessment – age equivalent scoreNumeric/NullStudent’s age equivalent score from the 1st Peabody Picture Vocabulary Test 1st assessment – growth scale valueNumeric/NullStudent’s growth scale value from the 1st Peabody Picture. Vocabulary Test 1st assessment – percentile scoreNumeric/NullStudent’s percentile score from the 1st Peabody Picture Vocabulary Test 2nd assessment – standard scoreNumeric/NullStudent’s standard score from the 2nd Peabody Picture Vocabulary Test. 2nd assessment – raw scoreNumeric/NullStudent’s raw score from the 2nd Peabody Picture Vocabulary Test 2nd assessment – grade equivalent scoreNumeric/NullStudent’s grade equivalent score from the 2nd Peabody Picture Vocabulary Test 2nd assessment – age equivalent scoreNumeric/NullStudent’s age equivalent score from the 2nd Peabody Picture Vocabulary Test 2nd assessment – growth scale valueNumeric/NullStudent’s growth scale value from the 2nd Peabody Picture Vocabulary Test 2nd assessment – percentile scoreNumeric/NullStudent’s percentile score from the 2nd Peabody Picture Vocabulary Test. SEEC Early Learning – ECERS Source: HSD (twice yearly) Data ElementData TypeNotes SEEC Classroom Code Char 7Corresponds with classroom look-up table. 1st ECERS score – Space and FurnishingsNumeric/NullAverage score for subscale 1st ECERS score – Personal Care RoutinesNumeric/NullAverage score for subscale 1st ECERS score – Language and Reasoning Numeric/NullAverage score for subscale 1st ECERS score – Activities Numeric/NullAverage score for subscale 1st ECERS score – Interaction Numeric/NullAverage score for subscale 1st ECERS score – Program StructureNumeric/NullAverage score for subscale 1st ECERS score – Parents and StaffNumeric/NullAverage score for subscale 1st ECERS cumulative classroom scoreNumeric/ NullAverage score across all subscales 2nd ECERS Score – Space and FurnishingsNumeric/NullAverage score for subscale 2nd ECERS Score – Personal Care RoutinesNumeric/NullAverage score for subscale 2nd ECERS Score – Language and Reasoning Numeric/NullAverage score for subscale 2nd ECERS Score – ActivitiesNumeric/NullAverage score for subscale 2nd ECERS Score – InteractionNumeric/NullAverage score for subscale 2nd ECERS Score – Program StructureNumeric/NullAverage score for subscale 2nd ECERS Score – Parents and StaffNumeric/NullAverage score for subscale 2nd ECERS cumulative classroom scoreNumeric/NullAverage score across all subscales. Early Learning – Parent-Child Home Program Source: HSD (twice yearly) Data ElementData TypeNotes YearNumericThe year of the period that the data is reported for, e. g. , 2006 for reporting period December 2006. MonthNumericThe month of the period that the data is reported for, e. g. , 12 for reporting period December 2006. Child HSD IDNumeric Student IDNumericEnter SPS Student ID after child is enrolled in Kindergarten Ethnicity CodeChar 25 categories from SPS, Other, Bi-Racial/Multi Racial Gender CodeChar 1 AgeNumeric In Parent-Child Home Visitor ProgramYes/NoStudent has participated in the Parent-Child Home Visitor Program during the month. Parent-Child Home Visitor Program – Provider CodeNumeric292 = Atlantic Street Center 304 = Neighborhood House at Rainier Vista 305 = Neighborhood House at New Holly 310 = Southwest Youth and Family Services Parent-Child Home Visitor Program – Total Number of VisitsNumeric/NullCumulative number of visits during the month. 1st Child Behavior Traits (CBT) Assessment – Cooperation with Adults Domain Numeric/NullScore ranges 1-4: average score for items that make up the domain shown at left 1. Does not exhibit this behavior 2. Sometimes exhibits this behavior 3. Most of the time exhibits this behavior 4. Always exhibits this behavior 1st CBT Assessment – Attention to Task Domain. Numeric/NullScore ranges 1-4: average score for items that make up the domain shown at left 1. Does not exhibit this behavior 2. Sometimes exhibits this behavior 3. Most of the time exhibits this behavior 4. Always exhibits this behavior 1st CBT Assessment – Engagement in Developmentally Appropriate Tasks Domain Numeric/NullScore ranges 1-4: average score for items that make up the domain shown at left 1. Does not exhibit this behavior 2. Sometimes exhibits this behavior 3. Most of the time exhibits this behavior 4. Always exhibits this behavior 2nd CBT Assessment – Cooperation with Adults DomainNumeric/NullScore ranges 1-4 2nd CBT Assessment – Attention to Task DomainNumeric/NullScore ranges 1-4. 2nd CBT Assessment – Engagement in Developmentally Appropriate Tasks DomainNumeric/NullScore ranges 1-4 3rd CBT Assessment – Cooperation with Adults DomainNumeric/NullScore ranges 1-4 3rd CBT Assessment – Attention to Task DomainNumeric/NullScore ranges 1-4 3rd CBT Assessment – Engagement in Developmentally Appropriate Tasks DomainNumeric/NullScore ranges 1-4 1st Parent and Child Together (PACT) Assessment – Parent-Child Interactions Domain Numeric/NullScore ranges 1-4 average score for items that make up the domain shown at left 1. Does not exhibit this behavior 2. Sometimes exhibits this behavior 3. Most of the time exhibits this behavior 4. Always exhibits this behavior 1st PACT Assessment -Positive Parenting Behavior Domain Numeric/NullScore ranges 1-4: average score for items that make up the domain shown at left 1. Does not exhibit this behavior 2. Sometimes exhibits this behavior 3. Most of the time exhibits this behavior 4. Always exhibits this behavior 2nd PACT Assessment – Parent-Child Interactions Domain Numeric/NullScore ranges 1-4 2nd PACT Assessment – Positive Parenting Behavior Domain Numeric/NullScore ranges 1-4 3rd PACT Assessment – Parent-Child Interactions Domain Numeric/NullScore ranges 1-4 3rd PACT Assessment – Positive Parenting Behavior Domain Numeric/NullScore ranges 1-4. 1st Teacher Rating of Oral Language and Literacy (TROLL) Assessment – Language ScoreNumeric/NullScore ranges 0-20 (5 items with maximum of 4 points for each item) 1st TROLL Assessment – Reading ScoreNumeric/NullScore ranges 0-20 (5 items with maximum of 4 points for each item) 1st TROLL Assessment – Print Concept ScoreNumeric/NullScore ranges 0-12 (3 items with maximum of 4 points for each item) 2nd TROLL Assessment – Language ScoreNumeric/NullScore ranges 0-20 (5 items with maximum of 4 points for each item) 2nd TROLL Assessment – Reading ScoreNumeric/NullScore ranges 0-33 (8 items with maximum of 4 points for each item; one Yes/No item scored 1/0 ) 2nd TROLL Assessment – Print Concept ScoreNumeric/NullScore ranges 0-28 (7 items with maximum of 4 points for each item).

Friday, August 30, 2019

Principles of safeguarding and protection in health and social care Essay

Task A Booklet Create a booklet about safeguarding, which can be used as a reminder for people who work in the care profession. The booklet must: Ai Describe in your own words what is meant by the following types of abuse: †¢ Physical abuse – Body harm. Bruising, fear†¦ †¢ Sexual abuse – Forcing sexual behaviour. Bruising around genital areas, fear from p/care†¦ †¢ Emotional/psychological abuse –Verbal abuse to maintain power and control, taking empowerment away from an individual. Fear of guving opinions or speaking out loud†¦ †¢ Financial abuse –Taking money or making somebody financially dependant. Money keep on disappearing from a wallet. †¢ Institutional abuse – Setting unflexible time frames Having a strict schedule for diferent timings. †¢ Self neglect – Not taking care of ones needs by themself. Poor hygiene, dirty clothes†¦ †¢ Neglect by others – Needs being unattended to by people that could support & assist. Malnutrition, poor hygiene†¦ Aii Identify signs and symptoms of the different types of abuse Aiii Explain the correct actions to take if you suspect an individual is being abused If an individual is suspected of being abused, I should inform my superior and keep an eye out for any possible developments, try to bring the subject up in conversation with the individual in a sensitive & respectful way. Aiv Explain the correct actions to take if an individual tells you they are being abused Listen calmly and patiently, try to comfort them, inform the manager of the home of what is going on, call the care workers & the police. Av Identify how to ensure that any evidence of abuse is kept  safe Make an accurate written record of any conversations that are relevant between the service user & I, ensure written records are in a safe place, body map any kind of bruising or injuries, try to keep it all as it was until police investigators arrive Avi Identify the national policies that set out requirements for safeguarding individuals. the ADSS-led national, ‘Safeguarding Adults’ network Avii Identify the local and organisational systems for safeguarding Our Isle of Wight government is committed to the protection of any adult at risk of abuse as a high priority. Aviii Explain the roles of different agencies and professionals that are involved in safeguarding individuals Police, criminal (assault, fraud, theft, domestic violence) Council, to protect people using their service – make sure they’re safe. Extend help where needed to support those experiencing abuse and neglect in their own homes Social Workers, To investigate actual or suspected abuse or neglect CRB, to check an individuals past to see if they have any criminal convictions. I as a care worker to support the individual. Aix Identify sources of advice, support and information to help social care workers understand their own role in safeguarding Our company safeguarding file in the care office  National charity working to protect and prevent the abuse of vulnerable older adults: Action on –Elder Abuse National helpline offering advice and support to vulnerable people who have experienced crime or abuse: Voice UK A range of information, advice, advocacy, and practical help services for older people: Age Concern Southwark Support and advice for people living with a learning disability: Mencap Free and confidential help for victims of crime, witnesses and their family or friends: Victim Support Help for people with Down’s syndrome to live full and rewarding live: Downs Syndrome Association National charity providing services and support to deafblind people: Deafblind UK Task B Research and Account Identify two reports on serious failures to protect individuals from abuse. Write an account that describes the unsafe practices in the reviews. Abuse can happen anywhere anytime, but especially to vulnerable people, ie Children, elderly people, people with disabilities, people with learning difficulties. It can even happen in places people should be safe, ie hospitals, residential/ nursing homes, schools, daycare/ nurseries, centres etc. I researched two cases reported for abuse. The Winterbourne case which was nationally reported, and a local abuse case of East Sussex (Child G), the Winterbourne case was more of a physical an emotional abuse, whilst that Child Gs case was of sexual abuse of a child under 16 and abduction. The Winterbourne case was reported nationally because it was such a disgusting mistreatment of vulnerable people, 11 members of staff were caught on cctv after visitors and patients complained about mistreatments. The evidence that was captured showed physical abuse such as, slapping, poking eyes, pulling hair, even as unbelievable as trapping them under chairs, and soaking residents in freezing cold water. It also showed emotional and verbal abuse in the form of name calling. This was an inhumane mistreatment of vulnerable individuals, the effective and humane delivery of assessments and treatments was not provided. The report which is published finds that Castlebeck Care Ltd (Teesdale) was not compliant with 10 of the essential standards which the law requires providers must meet. CQC’s findings can be found below. The managers did not ensure that major incidents were reported to the Care Quality Commission as required. Planning and delivery of care did not meet people’s individual needs. They did not have robust systems to assess and monitor the quality of services. They did not identify, and manage, risks relating to the health, welfare and safety of patients. They had not responded to or considered complaints and views of people about the service. Investigations into the conduct of staff were not robust and had not safeguarded people. They did not take reasonable steps to identify the possibility of abuse and prevent it before it occurred. They did not respond appropriately to allegations of abuse. They did not have arrangements in place to protect the people against unlawful or excessive use of restraint. They did not operate effective  recruitment procedures or take appropriate steps in relation to persons who were not fit to work in care settings. They failed in their responsibilities to provide appropriate training and supervision to staff. The centre was closed after NHS and local commissioners had found alternative locations for the clients acting in their best interest, there was a failure to report any of these incedents, staff that were not involved in the abuse should have reported it, knowledge about a crime and not doing anything about it is just as being a criminal yourself. The other report I identified was of a young 15 year old girl in East Sussex named as child G, she was abducted by her teacher Mr K in 2012, with whom she had been maintaining a sexual relationship with since around her 15 birthday, identifies serious concerns relating to school’s actions, including: failure to identify the abuse and exploitation of Child G; fixed thinking; failure to hear concerns raised by students; failure to involve Child G’s mother; insufficient recognition of Mr K’s inappropriate use of Twitter to communicate with Child G; and serious concerns with the ways in which information was recorded, stored, retrieved and provided for the review. Identifies procedural failings in police handling of allegations relating to inappropriate images of Mr K on Child G’s phone. Makes various interagency and single agency recommendations covering: East Sussex Local Safeguarding Children Board, children’s services, school and police services. Mr K was found guilty of abduction and admitted a number of charges of sexual activity with a child under 16-years; he received a custodial sentence of 5-and-a-half-years. Task C – Short Answer Questions Ci Explain what a social care worker must do if they become aware of unsafe practice. Explain the correct way of practicing safely or directly whistleblow. Cii Describe what a social care worker must do if unsafe practice is reported but nothing is done to ensure it is corrected. Inform again about the issue not being mended, if nothing is still done, it would have to be reported. Ciii Describe three factors that may make individuals more vulnerable to abuse than others. Age Mental capacity Difficulty to be able to protect themselves from abuse Civ Explain how adopting a person centred approach which offers choices and upholds rights can empower an individual and help to reduce the likelihood of abuse. An empowered person is somebody that is not scared of expressing themselves, they are more likely to give there opinion and refuse or confront if there is any abuse directed to them. Cv Explain how encouraging and promoting active participation can help to reduce the likelihood of abuse. An individual by themselves is more prone to abuse, it is an easier victim, would have nobody to turn to for support or to confide in, nobody would really keep a close eye on somebody they don’t really have close. Cvi Explain how an effective and easy to use complaints procedure can help to reduce the likelihood of abuse. It makes it easier for the home and the care provider to be able to act fast and try to get a solution for any issue.

Thursday, August 29, 2019

Analysis, segmentation and marketing mix of Apple

Analysis, segmentation and marketing mix of Apple Introduction The aim of this report is to analyse the current position of the company which includes the products, current strategic position, and current financial strength. Different types of marketing tools are used in this report. PEST analysis and Porter’s five force model for looking into the external environment. SWOT analysis for looking into the internal environment of the organization. This report also looks into market segmentation and the marketing mix of the product. Apple was first introduced by Steve Jobs, Steve Wozniak, and Ronald Wayne on April 1, 1976 to market and sell the Apple personal computer kit. The first computer kits were hand built and was kept for a public display first at the homebrew computer lab. This computer kit consisted of Motherboard with RAM, CPU, and some video chips. Since then apple have come a long way in the market all over the world and they are one of the leading companies in electronic products. This can be known with the informat ion given below: Current Strategic Position Apple believes in continuous improvement and they look into all the key sectors like environment, health and safety management systems and the quality of our products, processes and services. Looking into the Principle and goals of Apple, Apple has set out their own principles where they look to meet all the health and safety requirements, promote energy efficiency, and their main goals are; innovation is the most important thing for apple, to increase the number of sales of the product in the education field, providing new and user friendly software for the customers, and last but not the least providing high quality products to the customers. Looking into the current strategic position of Apple, with the introduction of its own operating system, hardware, software application, and with a completely new design, Apple looks to meet all the customer requirements like new products, ease of use, and an innovative design of the product. Apple is currently focusing on, brand awareness and improving the product by increasing the financial investment on marketing and advertisement, they are looking at expanding the retail segment by opening more number of stores all over the world, they are looking at keeping it up with the competition by implementing a cost leadership strategy, and they are looking to continue the reputation of being the leader in innovation for new technology by implementing product differentiation strategy. Looking into the current finance position of Apple, on October 19, 2009 Apple announced the financial results for the year 2009. The company posted revenue of $9.87 billion and a net quarterly profit of $1.67 billion. These results can be compared to the revenue of $7.9 billion and net quarterly profit of $1.14 billion in the previous year quarter. International sales also helped 46% of the quarter’s revenue. Gross margin is 36.6% when compared to the previous year quarter which was 34.7%. Appl e reached 17% increase when compared to the previous year quarter by successfully selling 3.05 million Mac computers during the quarter. PEST analysis and Porter’s five forces are very important tools to establish the external environment of Apple:

Wednesday, August 28, 2019

Business Law Individual coursework Scenario 2 Essay

Business Law Individual coursework Scenario 2 - Essay Example The purpose of damages is to compensate the aggrieved party for its loss and put it in a financial position in which it would have been had the contract been performed. While awarding damages, the courts make sure that the damage or loss is not too remote. The defendants are held liable only for the loss that is attributable to their breach and for all the results of their actions. In Hadley v Baxendale,1the defendant contracted to take the plaintiff’s mill shaft to London. It was to be used as a pattern to make a new one. The defendant was unable to deliver the shaft on time due to his own fault. The plaintiff claimed damages for the loss of profits that would have been earned if the shaft was delivered on time. It was held that the loss was too remote as the plaintiff never indicated that there would be a loss of profit in case of a delay and so the defendant was not liable. In this case, the court made a very important distinction between usual damage and non-usual damage. Usual damage is the one which can be reasonably expected by anyone from the circumstances. Non-usual damage is one that arises due to circumstances that are unknown to the defendant and he is unable to anticipate the loss. In Victoria Laundry (Windsor) Ltd v Newman Industries Ltd2, the defendant had to deliver a boiler to the plaintiff and the delivery was five months late. Not having enough laundry capacity, the plaintiff lost a lucrative contract. The plaintiff sued for lost profits. It was held that the defendant was only liable for ordinary losses and not for the extraordinary ones as he did not have the knowledge of the extraordinary circumstances. The given facts indicate that Fred usually availed George’s services. This means that George could only have anticipated the loss of usual opportunities for Fred. There is no indication that Fred specifically brought the extraordinary circumstances to the knowledge of George. He did not have the

Tuesday, August 27, 2019

Organization Behavior - Different Approaches to Management and Leaders Essay

Organization Behavior - Different Approaches to Management and Leadership - Essay Example However, the structure of any organization can be adjusted by organizational design and change. Organizational culture is defined as a set of shared values and norms by an organization that controls the interaction between employees, customers, suppliers and with all other entities whose interest is at stake (Jones 2007). An organization’s culture is shaped by its structure, ethics, by employment rights and by the environment surrounding the individuals. However, any two organizations operating in a similar industry might have very different cultures. An example is Coca-Cola and PepsiCo. Coca-cola feels proud of its employees’ commitment to the organization and the role of top management in cautious and objective planning, provides them such an environment that most of the people spend their lifetime career duration in coca cola. On the other hand, in PepsiCo there occurs disputes; sometimes over the decision-making process and as a result, conflicts arise between top management and employees. However, organizational culture evolves just as the structure differentiates with the passage of time and can be adjusted by organizations’ change and design. In many organizations, managerial roles are categorized into three types of roles: informational, decisional and interpersonal role (Koontz and Weihrich 2006). Many of today’s multinational organizations and few other huge corporations are using this approach towards management. They became managers; aware of their roles and responsibility, and then they were responsible for achieving the organizational goals. This management approach focuses more on the decision-making process, both at the individual level and collective level (Koontz and Weihrich 2006). This management approach is adopted in organizations where the managers and employees have to make decisions regarding their work activities. However, it is criticized by most of the theorists that this approach to management is not effective because a managing organization is more than taking decisions.  Ã‚  

Monday, August 26, 2019

The Big Data Challenges Case Study Example | Topics and Well Written Essays - 1000 words

The Big Data Challenges - Case Study Example Additionally, Volvo also required a system that could deliver timely reports that are easier to recognize with the intention that Volvo managers and analysts could put together more effective and influential business scenarios for their proposals. In order to deal with these challenges Volvo Car Corporation decided to acquire and implement a Microsoft based data management solution. The basic purpose of implementing this solution was to make simpler its IT infrastructure, offer graphical self-service reporting functionalities, and enhance cooperation among other business employees (Microsoft Corporation, 2012; Business Cloud, 2010). This solution is based on Microsoft SQL Server 2012 Business Intelligence data management software and a wide variety of other BI tools and technologies such as Microsoft Office 2010 and Microsoft SharePoint Server 2010. The company decided to implement this cloud based solution for the reason that cloud computing offers a number of advantages. In fact, t he implementation of a cloud computing based infrastructure will allow business employees to get access to and make use of IT services that are very useful to them that they would otherwise have to develop and implement themselves. The implementation of cloud based infrastructure will also allow firm to go global for the reason that any of their existing or newly opened offices wherever in the globe can straight away take advantage of their IT environment and can make use of their latest services. In this scenario, they would not have to wait for the company’s endeavors for developing and implementing IT environment or to pipe it into their network; on the other hand they can start making use of it immediately. The implementation of cloud computing environment allows the business organizations to continue to be improved in due course, in this scenario, Volvo Car Corporation is expecting to a greater extent coming their way, and they can just take benefit of these opportunitie s (Microsoft Corporation, 2012; Business Cloud, 2010). One of the biggest reasons for deciding to choose products from Microsoft Corporation is that Microsoft products provide an excellent support for working in cooperation and collaboration. Additionally, Volvo Car Corporation is also going to implement the latest Power View feature in SQL Server 2012 Reporting Services. Basically, this is a self-service reporting tool that facilitates the users of data to deeply study and investigate their data themselves and get answers of informal queries without much effort. In addition, this tool provides the users with drag-and-drop graphical data displays and data-querying which are equally helpful for both skilled as well as nontechnical users. It is expected that this cloud based infrastructure will bring about an uncomplicated IT infrastructure as well as enhanced business efficiency that will help Volvo Car Corporation to run their business more competently as well as make it simple for business workers to work together. As the implementation of a cloud based infrastructure will improve communication and coordination between business workers by merging a wide variety of features such as data, reporting and business intelligence tools in a single online platform, which allows business employees to simply produce, share, save, update and deliver their work (Microsoft Corpor

Marketing Essay Example | Topics and Well Written Essays - 2250 words - 9

Marketing - Essay Example The main purpose of this exercise is to enforce marketing strategies that could allow the manager to take strategic decisions on various dynamics in the marketing of voice- recognition devices software (VRD) in the domestic market. â€Å"Interactive Voice Recognition or Voice Recognition Information is one of the most common telephone functions in use across the business community and is capable of bringing remarkable benefits to your company. Interactive Voice Recognition allow 24 hour access to a company from its customers Interactive Voice Recognition its phone system.† (Interactive voice recognition, 2005). Coming now to the actual exercise, what Marketing Games actually means to do is to put â€Å"you in the driving seat of a fictitious business. You have been brought in by the CEO to develop a winning market strategy that will turn the business around.† (The big marketing game, 2010). Thus the main objective of this game would be in terms of the overriding factors that contribute to profits/losses of the business, and the ways and means by which the losses could be turned around into profits. It also seeks to lower operating costs, increase productivity and ensure better all round performance. Another major consideration that needs to be taken up is also in terms of competitors, since our business development and growth is also dependent upon them, in that the business development of Speakeasy is also linked with that of its competitors who lay stakes on market shares, customer segments and volume of business and off takes. Thus, it is also necessary to predict possible competitive forays and adopt ways and means that could counter these effectively. Principally, â€Å"Voice recognition software programs work by analyzing sounds and converting them to text.† (Voice Recognition Software: An Introduction, 2009, p.1). There are only four makers of this VRD in the market. One is the product

Sunday, August 25, 2019

Action Plans Essay Example | Topics and Well Written Essays - 250 words

Action Plans - Essay Example As the groups vision suggests, this year we will ensure that Whirlpool’s Innovation Group get a proper name by ensuring that Whirlpool products are the most preferred brands in the associated home of the near future. We will also ensure that every activity that is being carried out in the organization is in line with the mission by ensuring that our products empower our clients in homes across the world. Ladies and gentlemen, Whirlpool’s Innovation Group has set various goals to ensure that the company achieves its mission including; identifying technologies central the connected goals, integrating Whirlpool products with the connected home and ensuring that new technologies make customer’s lives easier. In addition, Whirlpool’s Innovation Group has gone a step further developing various corporate ventures. For instance, Whirlpool’s Innovation Group recently developed a partnership with universities (Smart Zones) as well as Tech Scouting. To achieve its various goals and objectives, Whirlpool’s Innovation Group is planning to establish a presence at one or more Smart Zones for developing connected home technologies for Whirlpool. Additionally, it is planning to establish a scouting group with the purpose of investigating developments in connected homes. Last and not least, the Whirlpool’s Innovation Group is planning to Leverage Smart Zone presence to facilitate technology scouting. As I close, allow me to stress on the action plans, if Whirlpool’s Innovation Group manages to effectively implement these actions plans success will be automatic. The number of connected will determine the metric of our actions home our products release to the market (Whirlpool Corporation, 2015). Results and Updates Full-Year 2015 Guidance. Retrieved from PR Newswire:

Saturday, August 24, 2019

Banking Essay Example | Topics and Well Written Essays - 1500 words

Banking - Essay Example Mark Angelo, to repay the debt as well as his net asset value, in addition to the assets which Mr. Mark Angelo can offer to the bank as security against the debt . Financial Statement Analysis The financial statement analysis of Mark Equipment Pty Ltd for the present and the past year reveals the following ratios. The examination of the short-term liquidity of an organization can be accomplished through the current ratio, quick ratio and the cash ratio of the organization. The current ratio signifies the organization’s capability to meet its current liabilities and obligations comfortably. The quick ratio exhibits the capacity to meet the urgent liabilities. The cash ratio is beneficial for creditors to determine how quickly the organization can pay off its short-term debt . In this context, it can be observed that the company’s liquidity position had improved from that of the previous year, but it would be preferable if Mark Equipment Pty Ltd could increase the percentage of their current assets. The solvency of an organization can be evaluated through the debt to equity ratio. The debt to equity ratio signifies the amount of assets that were financed by debt relative to the amount financed by equity . Thus, Mark Equipment Pty Ltd had utilized comparatively lesser amount to debt to finance its assets and is less financially leveraged. The profitability of the company as indicated by the net profit margin and the return of equity as well as that on assets is very low. Therefore, it can be inferred that the company had not utilized its assets and equity proficiently4. In contrast the gross profit margin of the company is very high, implying that the company’s operating expenses are elevated. The fixed asset turnover ratio of the company indicates that it generates fairly decent value of revenue per unit currency of its fixed assets5. However, the total asset and the equity turnover ratios of the company are relatively low and have also decreased from the previous year. Consequently, the financial analysis reveals that though the company possesses decen t values of revenue as well as gross profit and

Friday, August 23, 2019

Teen Pregnancy Essay Example | Topics and Well Written Essays - 1000 words

Teen Pregnancy - Essay Example The ages of these girls ranged from 15 years to 19 years. These statistics declined and in the year 2005, the conceptions dropped to 40.5 in every 1000 teenage girls. It was further highlighted that in this era between 1991 and 2005, 750,000 teenagers conceived in the United States. It has been proved that the problem has a higher rate in the United States in comparison to other nations like England, Wales and Canada. There has been a decrease in the rates of teen pregnancy but still the issue is known to be present in the society. This has led to the analysis of the causes of teen pregnancy. Teen pregnancy is a serious issue of concern and the major contributing reasons for teen pregnancy include low socioeconomic status, lack of education and societal forces (Donaldson et al 2003; Miller 2006; Thomas 2009). The socioeconomic factor is a major causative factor of teen pregnancy. A low socio-economic status means that the parents have lower educational qualifications which do not war rant for a good job. This means that the heads of the families have to work for longer periods of time and stay away from home. Furthermore, despite of this increased working, the overall income of the house is not very high. These families survive in poor conditions. The long working hours of the parents result in a lack of regulation and command over the activities of the children as the parents tend to stay out of the house most of the time. This allows for opportunities for the teens to engage in sexual behavior without the approval of their parents. The parents who possess low educational qualifications may be less learned and they would not be able to explain their children about safe sex strategies owing to their own lack of knowledge. This would result in decreased sexual knowledge amongst the teenagers which would lead to higher cases of teen pregnancy. A low socioeconomic status also serves to result in living conditions beyond satisfactory and these tend to disturb the te enagers. These disturbances provoke them to opt for sexual pleasures and therefore teen pregnancy results. Thus it can be seen that a low socioeconomic status is a cause of teen pregnancy as it results in a lack of supervision over the teenagers accompanied with decreased parental guidance and poor living conditions which tend to result in teen pregnancy (Donaldson et al 2003; Thomas 2009). Teen pregnancy has also been associated with many societal forces that tend to promote sexual behaviors amongst the teenage groups. Cultural variations serve to provide as a major community factor that leads to teen pregnancies. Teenage pregnancies are considered to be normal in a few cultures and this trend continues from the parents to their children. Statistics have revealed that the teen conception rate is very high amongst the Mexican Americans and the blacks. This rate is considerably lower for the whites and the Asians. It has been seen that Mexicans and blacks have disturbed family lives which may be a leading cause for higher teen pregnancies in their communities. It has also been analyzed that the Mexican culture instills values of obedience and compliance amongst girls. The Mexican tradition also upholds the characteristics of â€Å"machismo† and â€Å"virility† amongst boys. This results in the indulgence of these teenagers

Thursday, August 22, 2019

Ralph Waldo Emerson Essay Example for Free

Ralph Waldo Emerson Essay Learning is a natural ability that is wired into many animals DNA; the way that humans should learn has been debated by the various educators because of the endless ways to teach. Teachers and parents take this matter seriously like Ralph Waldo Emerson in â€Å"From Education† and Todd Gitlin in â€Å"The Liberal Arts in an Age of Info-Glut† who created essays on education; and Billy Collins in â€Å"The History Teacher† entail for then and who wrote a poem concerned with the status of education. These people show what the importance of education is entailing what learning should and should not involve; a teacher should respect and have patience for children; a teacher should also let a child have creativity and lessons of the past. Many teens do not respect their teacher which might be because the teacher does not respect them; as the golden rule goes, â€Å"treat others the way you would treat yourself†; Ralph Waldo Emerson in â€Å"From Education† would probably agree with this quote because he strongly believes that, â€Å"the secret of [e]ducation lies in respecting the pupil,† (page 102). Shows that Emerson understood what children are thinking then did something to help them by simply respecting them. Another big issue with education is patience; some people do not have enough patience to guide children to what they are supposed to learn. Emerson also believes that patience is an important part in education, â€Å"to regard the young [children, they require] no doubt, rare patience: a patience that nothing but faith in medial forces of the soul can give,† Emerson was trying to say that someone has to really care in order to teach information to children (page 105). Some people do not see the point in having art classes or history classes; the reason why is because art assists students to express themselves in a way that words cannot along with helping them find out what kind of person they truly are; and history is needed to teach children where they originated from; and to show them mistakes that other people in the past made so they will not make them again. Todd Gitlin in â€Å"The Liberal Arts in an Age of Info-Glut† agrees with this â€Å"[students] need some orientation to philosophy, history, language, literature, music, and arts that have lasted more than 15 minutes,† (page 156) because students need the outlet to express themselves; or if they do not they would not learn morals then they would become exactly  what people were trying to stop; As shown in â€Å"The History Teacher† by Billy Collins who stated, â€Å"the children would leave his classroom for the playground to torment the weak and the smart,† all because â€Å"[the teacher tries] to protect his students’ innocence he told them the Ice Age was really just the Chilly Age, a period of a million years when everyone had to wear sweaters. And the Stone Age became the Gravel Age, named after the long driveways of time,† this demonstrates how not teaching children lessons of the past which are the brood violence’ that others committed in history; by not teaching this history it affects children’s behavior in real life (page 143). Morals are right and wrong many people’s morals will differ; this is why teaching them is tricky because the teacher’s morals might not be the same as the parent’s morals. This is why some of the history in textbooks is sometimes just the summary of what really happened but not enough for the main point to be set across unlike in â€Å"The History Teacher† where, â€Å"the Spanish Inquisition [is] nothing more than an outbreak of questions such as â€Å"How far is it from here to Madrid? †,† and â€Å"the War of the Roses took place in a garden, and the Enola Gay dropped one tiny atom on Japan,† explains when a teacher goes too far in trying to protect student’s mind from bad; when only good is taught and everything else is censored then the students become the opposite; because they do not know the consequences of doing bad, which is why history is taught. As teachers and parents they have to let their students make their own choices as shown in â€Å"From Education† Emerson says, â€Å"it is not for you to choose what he shall know, [or] what he shall do,† shows that sometimes a student needs to find out the consequences the hard way, and let them choose what they want to learn (page 143). Education is needed in modern day society to help students and children grow and help the nation; by giving students proper education the teacher are not really helping the students but they are helping themselves. Teaching creativity helps a student express themselves; respect should be given so the student can give it back; patience is needed to help them understand; morals need to be taught through history so the student will make fewer mistakes; these are essential to a good education and an even better future: as shown by the writings of Billy Collins, Ralph Waldo Emerson, and Todd Gitlin.

Wednesday, August 21, 2019

Current Political Dimensions and Issues of Globalization Essay Example for Free

Current Political Dimensions and Issues of Globalization Essay Globalization refers to those processes whereby geographically distant events and decisions impact to a growing degree on â€Å"local† university life. Also it can be viewed as link towards the growth of social interconnectedness across existing geographical and political boundaries. Globalization is the process of increasing interconnectedness interdependent ness of people and places as a result of improved transport and communication and information technologies that ensures countries stay together as one community. In globalization, political, economic, social, religious and cultural issues usually interplay in producing a globalize world.    The world is becoming one. most contemporary social theorists endorse the view that globalization refers to fundamental changes in the spatial and temporal contours of social existence, according to which the significance of space or territory undergoes shifts in the face of a no less dramatic acceleration in the temporal structure of crucial forms of human activity. Geographical distance is typically measured in time. (Brawley, 2002) The world’s globalization can be traced back to many decades when different countries of the world saw the need to have globalization of the economy, politics, and societies, religious through the creation of links that will ensure that there is coordination in all the aforementioned aspects that form the basis of any country. There has been great integration in the economic sector among countries in, this is what is commonly referred as economic globalization. The fast economic growth among many countries in the world can be attributed to globalization. This implies that globalization has helped reduce poverty in many developing counties. Western political theory has traditionally presupposed the existence of territorially bound communities, whose borders can be more or less neatly delineated from those of other communities. The contemporary liberal politics has it that to speak of bounded communities whose fundamental structure consists of self-sufficient schemes of cooperation for all the essential purposes of human life. (David, 1995) The current political issues in any given country are based on how to achieve and utilize globalization.   Most of the countries have resolved to form partnerships with most of the countries in the world so as to integrate their resources geared towards high production. The whole process of globalization promotes proper and easy access to the world market among the partners.   This role is played by internationals organizations that have tried to promote liberal markets. For instance business people on different continents now engage in electronic commerce; television allows people situated anywhere to observe the impact of terrible wars being waged far from the comfort of their living rooms; academics make use of the latest video conferencing equipment to organize seminars in which participants are located at disparate geographical locations; the Internet allows people to communicate instantaneously with each other notwithstanding vast geographical distances separating them. (Burchill Linklater, 1996). The whole process of globalization has its own challenges where the poor countries are not able to compete effectively in the world markets and as such the poor countries are unable to have economic growth.   There is great disparity between the developed and the developing countries and this is also inherent to the people of these countries where we have a big imbalance between the poor and the rich. Due to the process of globalization countries have a challenge on how to have political shifts that will enhance their global growth.   The political shift usually twisted towards the stakeholders of globalization. Corruption fighting is the key issue towards globalization for any country. Covering a wide range of distinct political, economic, and cultural trends, the term globalization has quickly become one of the most fashionable buzzwords of contemporary political and academic debate. In popular discourse, globalization often functions as little more than a synonym for one or more of the following phenomena: the pursuit of classical liberal free market policies in the world economy economic liberalization, the growing dominance of different forms of political, economic, and cultural life. The proliferation of new information technologies such as the Internet as well as the notion that humanity are in the anticipation of   realizing one single unified community in which major sources of social conflict have vanished through global integration. (David 1995) Ultimately globalization has been achieved through technological advancements.   It is a main challenge in the process of globalization as many counties are lagging behind in terms of technological advancements that are meant to promote fast and effective communication as well as boost high production.   The process of achieving the international development goals pays more emphasizes on reducing poverty levels in countries of the world by promoting sustainable growth by empowering the poor people. Globalization is just an opportunity that is associated with risks at the national and international level. One of the issues that has emitted from globalization is that there is freedom of movement which has made developed countries hire labour from lower cost countries this making the citizens of the country to lose their jobs.   It end result of this is that the country is focusing on its development. But globalization can not be dismissed at all but what is important is to lay good enabling structures that can enhance both an individual development as well as the country development.   This can only be done by putting in place good governance. Generally, globalization poses risks and challenges, but so far it has become a stabilizing force in Philippine politics. (Robertson, 1992) This is the only way the government could make serious headway in the fight against joblessness and poverty. There are indications that most of those uprisings in the past were supported by the business elite. They are concentrated in the banking, real estate, export, and trading. Most of these sectors now are raking in money from overseas remittances, outsourcing, and recovering exports. It means they now have a stake in the stability of the system. People in the world are encouraged to think as citizens of nations and as well global citizens if the global agenda is to be achieved.   Globalization is a force that is attaching people of countries in the world and as such globalization is the way forward. Generally, globalization is characterized by free market, new technologies internet revolution.   Due to this increased technologies little time is required to connect different geographical locations.   This has helped in reducing the issues of national boundaries as people can communicate without necessarily crossing over the national boundaries.   Many social activities can take place in the world without necessary considering the geographical location of the participants. This is done through telecommunication, digital computers, audiovisual media and this occurs everywhere in the contemporary world.   (Schorte, 1996).  Ã‚   Business is done through electronics, televisions. This has promoted both social and economic interconnectedness across the political and geographical boundaries.   This means that technical disregard to geographical boundaries is a major issue towards globalization. High speed technology plays a very crucial role in the process of globalization.   This is another issue that is hindering the achievement of globalization.   This is because most of the world’s countries and are not moving as per the dynamisms of technology thus creating slow inter border speed movements. (Scheuerman,2004) The high speed technologies minimize the significance of distance and as a result improving the interconnectedness. But in those areas where deterritorialization and social interconnectedness across national borders are especially striking, new transnational institutions (for example, cross-border referenda), along with a dramatic strengthening and further democratization of existing forms of supranational authority (in particular, the United Nations), are necessary if we are to assure that popular sovereignty remains an effective principle. Globalization guarantees sustainable competitiveness through leadership of technological improvements.   The attraction of many countries in need of investment has promoted the growth of economies in most countries that embrace globalization.   Good examples are the recent joint ventures of China with Japanese companies where the Chinese get skills directly by working the Japanese. High-speed technologies and organizational approaches are employed by transnational operating firms, the so-called â€Å"global players,† with great effectiveness. The emergence of â€Å"around-the-world, around-the-clock† financial markets, where major cross-border financial transactions are made in cyberspace at the blink of an eye, represents a familiar example of the economic face of globalization. (Mark Interline 2001) How Philippines is integrated in international economy at the global community. Philippines as far as the globalization is concerned is rated in the semi-globalize world.   The country has not achieved completely what it takes for a country to be globalized.   It is lacking integrated markets and economies with other countries.   This because it has not taken advantage of across borders integration.   Low cross borders coordination reduces the economic share activities which have an effect of reducing fast economic growth.   Philippines have now a new political shift aimed at promoting its economic growth.   One of the main issues of promoting globalization is through democratization.   This is an aspect that has been missing in Philippines, there is a tendency the country believing that poor countries should not depend on the foreign capital and for this reason the country believes in regional issues of development. Philippine is the latest country to be accepted in the global alliance nations sharing global information and economies.   The country’s software sector has greatly grown giving it advantage in global information technology.   In the year 2006, Philippines had established software innovation which aimed at creating a global centre of information.   The process of software innovation is based on good relations with other countries that have advanced technology.   This procedure has promoted individuals business within the integrated countries.   A good example is stag Philippines Company that developed an innovative online registration system for one of the domestic airlines, this is a positive movement towards globalizations. The country has moved from the traditional of doing things to the scientific and technological revolutions.   Philippines has achieved great integration in East Asia with countries such as Indonesia, Malaysia and Thailand.   This form of regional integration has promoted free market within the area hence improved economies. Globalization refers to increased possibilities for action between and among people in situations where latitudinal and longitudinal location seems immaterial to the social activity at hand. Even though geographical location remains crucial for many undertakings (for example, farming to satisfy the needs of a local market), deterritorialization manifests itself in many social spheres.. Territory in the sense of a traditional sense of a geographically identifiable location no longer constitutes the whole of â€Å"social space† in which human activity takes places. In this initial sense of the term, globalization refers to the spread of new forms of non-territorial social activity (Fred, 1998) There are great challenges for the government in trying to harmonize governance especially when there is integration of business bodies with other countries.   The process of liberalization and democratization enables the more advanced countries to take advantage of the free market.   The more developed countries use this opportunity in getting more profits which they take to their rich countries.   There is power mixing for the government as it not possible to control all the power diffusion. Each manifestation of globalization also generates distinct conflicts and dislocations. For example, there is substantial empirical evidence that cross-border flows and exchanges, as well as the emergence of directly transnational forms of production by means of which a single commodity is manufactured simultaneously in distant corners of the globe, are gaining in prominence (Castells, 1996). The whole process of Philippines involvement in international and global community is that the developed countries in term s of service provision on the onset there is un equal competition for the integrated market which the developed countries stand a better chance to exploit.   Despite the lower levels of poverty in most states, there is a general inequality in the overall income among the citizens. The inequality in Philippines occurs especially between rural and urban areas.   This has led to economic stagnation and civil instability which threatens the goal of reducing poverty by globalization.   Other places are overpopulated causing strain on the meager natural resources.   The fact that Philippines has moved global has not solved the internal disparities which threaten to increase poverty levels. The government has a great challenge of implementing certain agreements with the international community.   Such international conventions are so demanding in terms of implementation within the country.   When these legal conventions are integrated to the country they have the capacity to weaken the internal structures of the country. As an empirical matter, the decay of the domestic-foreign frontier seems highly ambivalent, since it might easily pave the way for the decay of the more attractive attributes of domestic political life: as â€Å"foreign† affairs collapse inward onto â€Å"domestic† political life, the relative lawlessness of the former potentially makes disturbing inroads onto the latter (Scheuerman, 2004) The government is also challenged by the rapidly expanding flow of goods services information and people which makes the country to be more interdependent.   This requires that the country sets global consensus to meet these challenges. Globalization-from-above is controlled by wealthy elites and driven by a hunger for more wealth and power. But there is another form of globalization in the Philippines that is made up of grassroots alliances of human rights activists, trade unions, womens organizations, and environmental coalitions and farmers’ organizations. This form of globalization however does not get as much publicity as the elite form of globalization but it is growing just as rapidly. The institutions such as the World Bank, the International Monetary Fund and transnational corporations have assisted in development and the integration of the world’s countries into the global system. The cross-boarder issues that require joint efforts have been very difficult for the Philippine government to manage.   Areas that require regional cooperation include drug supply reduction, prevention of HIV/AIDS, fight against illegal drugs.   Lack of such support has been a great set back to the government. Critics insist that local, regional, and national forms of self-government are being rapidly supplanted by insufficiently democratic forms of global governance remote from the needs of ordinary citizens, whereas their defenders describe new forms of supranational legal and political decision as indispensable forerunners to more inclusive and advanced forms of self-government. Global financial markets also challenge traditional attempts by liberal democratic nation-states to rein in the activities of bankers, spawning understandable anxieties about the growing power and influence of financial markets over democratically elected representative institutions Globalization has an effect on Philippines culture and traditions as the society’s norms and values as subject to change.   There are many ways in which the globalization may finally erode the cultural values of the people due to the volatile socialization a contribution of market liberalization and democratization. Market liberalization and the democratization has continued to adversely contributed to the deceleration in growth rate of the country because of the worsening terms of trade between the integrated countries and Philippines. There is a weak growth of exports to the developed countries but rather there are a big number of imports to the country. This means that the country spends more money to the outside countries than what it receives.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   There is a need for the developed countries to have a positive shift towards assisting the developing countries. This can be done by the removal of trade barrier to the developing countries. Philippine’s economy has been growing at 4-6% GDP due to the growth of the robust sector. Electrons and semiconductors contribute greatly to the country’s exports. There is variety of market for the Philippines products due to the globalization. A global citizen in this country is encouraged to participate actively by taking advantage of the available opportunities: outsourcing is an outcome of technological advancements. For instance, many people in the Philippines start their work at 9pm till five in the morning. Such jobs include call centers. This industry of out sources is growing at 57%per year. The Philippines has low or more open economy, a contribution of the economic reforms done as well as moving global. The linking together and expanding of social activities across borders is predicated on the possibility of relatively fast flows and movements of people, information, capital, and goods. Without these fast flows, it is difficult to see how distant events could possibly posses the influence they now enjoy. High-speed technology plays a pivotal role in the velocity of human affairs. But many other factors contribute to the overall pace and speed of social activity.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Globalization has completely changed the political and social situation of the country. The current crop of politicians believes that the future of the country depends on global connectivity and it is for this reason they support global dynamics and global competitiveness. The democratic model has been used in Philippines in the process of creating alliances with other countries. According to one influential strand within international relations theory, relations between states are fundamentally lawless. Since the achievement of justice or democracy, for example, presupposes an effective political sovereign, the lacuna of sovereignty at the global level means that justice and democracy are necessarily incomplete and probably unattainable there. In this â€Å"Realist† view of international politics, core features of the modern system of sovereign states relegate the pursuit of western political thoughts most noble normative goals primarily to the domestic arena. Other critics has that the dangers of global economy is that investors come into a particular country, present certain conditions and government often accept them without asking the people who will be affected, which is a violation of workers rights. It often happens under such deals when state companies are bought over by foreign companies, thousands of workers are laid off under so called structural adjustment program to cut the cost, while workers are pushed for longer hours and prohibited from labor unions. The whole purpose behind this way of working is exploitation of the foreign market to gain greater profit. Globalization is part of the changing world, but the way it is coming in developing countries lacks humanity. Contemporary analysts associate globalization with deterritorialization, according to which a growing variety of social activities takes place irrespective of the geographical location of participants. As Jan Aart Scholte observes, â€Å"global events can via telecommunication, digital computers, audiovisual media, rocketry and the like occur almost simultaneously anywhere and everywhere in the world. (Scholte Aart, 1996) In conclusion globalization is the way forward for Philippine’s economic and political growth. Technology is the key to the achievement of the globalization process and it is therefore very important for any country to embrace technological changes in order to be complacent with the fast changes in the world. A country that will not embrace technological changes is like lag behind in matters of development. Increased communication is panacea of any expanding economy as this promotes sharing of the international nature. Expanding free market promotes greater exchange of skills which has a net effect of improving the economy in terms of the factors maximizing the factors of production such as capital, land, entrepreneurship. Outsourcing is the contemporary form of globalization that is practiced in the contemporary Philippine and this has led to the improved social relation among the regional countries. Integration of different companies which produce similar products has enhanced the exchange of technologies by the virtue of direct contact. Finally globalization has reduced the social boundaries as well the geographical barriers and now people are staying as one big community. References Mark Randal Brawley (2002) the Politics of Globalization: Gaining Perspective, Assessing Consequences. Broadview Press. Crescenzi, Mark, and Andrew J. Interline. 2001. Time Remembered: A Dynamic Model of Interstate Interaction. International Studies Quarterly 45:409-431. Scott Burchill and Andrew Linklater, (1996). Theories of International Relations. New York: St. Martins Castells, Manuel (1996), The Rise of Network Society (Oxford: Blackwell). Dallmayr, Fred (1998), Alternative Visions: Paths in the Global Village (Lanham, Md.: Rowman Littlefield). Held, David (1995), Democracy and the Global Order: From the Modern State to Cosmopolitan Governance (Stanford: Stanford University Press). Robertson, R. (1992), Globalization: Social Theory and Global Culture, (London: Sage). Scheuerman, William E. (2004), Liberal Democracy and the Social Acceleration of Time (Baltimore: Johns Hopkins Press, 2004). Scholte, Jan Aart (2000), Globalization: A Critical Introduction (New York: St. Martins).

Tuesday, August 20, 2019

Role of therapeutic relationship within mental health nursing

Role of therapeutic relationship within mental health nursing Research is a significant component of the educational process and is essential for current and future professional nursing practice (Tingen, 2009). To describe what nursing research is, Tingen (2009) uses a definition by Polit and Beck (2006, p4) who describe it as a: Systematic inquiry designed to develop knowledge about issues of importance to nurses, including nursing practice, nursing education and nursing administration. Without research, nurses would not be able to practice evidence based care, the importance of which is stated within the Code of Conduct (Nursing and Midwifery Council 2008). According to Haynes and Haines (1998) evidence based practice aims to integrate current best evidence from research with clinical policy and practice. It is important to critically evaluate any research study to establish the significance and worth of each individual publication (Hek, 1996). For the purpose of this assignment I will use a universal critical appraisal tool that can be used to evaluate any type of research, which can be located in Appendix 1. It has been adapted and devised using appraisal tools from Hawker et al (2002) and the Critical Appraisal Skills Programme (CASP) (Public Health Resource Unit, 2007). Background I have chosen to review the topic of therapeutic relationships within the field of mental health nursing. I feel this is a vital component in the nursing role, and something every mental health nurse should be skilled in. Literature states that the therapeutic relationship is a central element of care through which many aspects of mental health nursing is carried out (Priebe and McCabe, 2006). Search strategy My question is what role does the therapeutic relationship have within mental health nursing? I carried out my literature search using the Cinahl database. Although there are a variety of database choices, Cinahl produced ample results so other database searches were not required. Table 1 summarises my literature search results. Table 1: literature search strategy database name key words/phrases used database headings used search limits (inclusions/exclusions) no. results Cinahl (Search was conducted on 1st April 2011) therapeutic relationship and mental health None Primary research English language Peer reviewed 64 Therapeutic relationship and psychiatric None Primary research English language Peer reviewed 68 I searched the terms mental health and psychiatric separately but in conjunction with the words therapeutic relationship to ensure a more in-depth search as both terms are used interchangeably within literature. The three papers I have selected to review are Johansson and Eklund (2003), Scanlon (2006) and Forchuk et al. (2005). They were chosen so that both qualitative and quantitative research is included and that differing perspectives on the therapeutic relationship were researched. A summary of the relevant information from each article can be found in a critical appraisal grid in Appendix 2. Elements of the summary will be referred to in the following discussion. Critical Review: Research aims Any research paper should make clear the purpose of the study being reported so that the reader can establish whether or not it is relevant to them (Couchman and Dawson, 1990). It is suggested that an abstract or summary is a good way to give a brief overview of the content of the paper (Couchman and Dawson, 1990). Greenhalgh (2010) recommends that the introductory sentence of a research paper should state the background to the research. All three highlighted papers clearly set out their aims and give background information as to the importance of their study and why it has been chosen. The Forchuk et al. (2005) study aims to replicate a successful pilot study conducted several years earlier, but seemingly on a larger scale. Research approach/design When assessing the methodological quality and approach of a paper Greenhalgh (2010) proposes five key questions. They are; was the study original, whom was it about, was it well designed, was systematic bias avoided and was it large enough and continued for long enough to make the results credible (Greenhalgh, 2010). Johansson and Eklund (2003) give good rationale for the research design using literature as evidence. Both authors are experienced in the field of psychiatry, but the first author conducted all interviews, which helped to maintain consistency and credibility. Scanlon (2006) appears to have spent time designing her study, using established literature as well as her own experience to develop an interview guide which was piloted to ensure its suitability. The Forchuk et al. (2005) study describes a clear and concise research design using cluster randomisation. The study had a control group to compare to a group receiving the model used in the aforementioned pilot study. Ethical issues Any research involving human participants and animal materials or specimens is subject to ethical review, whether it is clinical, biomedical or social research, including the secondary use (Sheffield Hallam University, 2011). Literature regarding ethical considerations varies in the areas they discuss but in general, there are four main areas of ethical concern where the rights and dignity of the participant must be preserved, namely ensuring consent; prevention of harm; protecting confidentiality (Behi and Nolan, 1995; Marion, 2004); and that the research process provides more benefit than harm (Behi and Nolan, 1995). The study by Johansson and Eklund (2003) was initiated by the ethics committee of the county council, so it is assumed they were recruited to complete the study, although no information is given other than the authors had no collaboration with either of the two settings used to recruit participants. Although written consent was sought it is not stated as to whether the participants understood the aims of the study. Both Scanlon (2006) and Forchuk et al. (2005) provide little information other than ethical principles being followed. Sampling For any study to take place, the subjects must be selected, and this is called sampling. The process used to select a group of people, events, behaviours or situations must ensure that the subjects are representative of the population being studied (Burns and Grove, 2007), or the research will not be credible. The population being studied will guide what process will be used to complete the sampling process (Burns and Grove, 2007). Johansson and Eklund (2003) give in-depth and referenced reasoning for their chosen sampling process. However their attempts at ensuring maximum variation can be argued to have failed with only 9 participants recruited. In contrast, little information is given by Scanlon (2006) as to her sampling process, but there is a clear inclusion criterion for the sample of six participants. The sampling process used by Forchuk et al. (2005) appears to be in-depth with attempts to reduce any potential limitations or barriers. A large sample size of 390 participants partook in the study, which was a year long. A dropout rate of 36% resulted in 249 completing the study. Data collection Burns and Grove (2007) define data collection as the precise, systematic gathering of information relevant to the research purpose or the specific objectives, questions, or hypotheses of a study. The choice of data collecting technique used will be determined by the type and purpose of the study being conducted (Burns and Grove, 2007). The data collection method utilised in the Johansson and Eklund (2003) study was an open-ended in-depth interview with a clear focus. The interview was hand written during discussion with no other recording equipment used. They themselves admit that this can introduce bias and the potential for data to be missed using this process. To maintain consistency the interviewer was the same person for all interviews, but the person transcribing is not stated. Other than developing a piloted interview guide, Scanlon (2006) does not give detail about the data collection technique, other than semi-structured interviews being conducted. The interview guide is attached as an appendix. Data collection methods in the Forchuk et al. (2005) study would appear to be very thorough involving 5 tools, 3 of which were designed solely for this research. Data analysis After the data is collated, the research will be of no use to anyone if it is not analysed as it will have no meaning or explanation (McMichael, 2007). Analysis transforms the data collected into new knowledge (Thorne, 2000) and with its primary purpose being to impose some order to data so that conclusions can be made and communicated (Massey, 1995). The analysis process in the Johansson and Eklund (2003) study would appear to be very thorough. However the interviewer was one of the researchers categorising, so the transcripts were known and analysis may have been affected. Scanlons (2006) research provides a good example of thorough data analysis, using a recognised coding procedure comprising of three sets of coding. In contrast Forchuk et al. (2005) give little information regarding their data analysis providing only one small paragraph explaining how t-tests were used to test hypothesis. Findings The findings or results of any study should be presented in a way that advises the reader of any significant outcomes (Burns and Grove, 2007). It is suggested that tables and discussion are separate to as to avoid confusion (Couchman and Dawson, 1990). Johansson and Eklund (2003) give a good example of separating the ways in which the data is presented, with an in-depth discussion about each category. Sub categories were created to provide further clarity and quotes from interview are used to emphasise points. However the table gives little information other than the headings for each category and brings little value to the report. Scanlon (2006) uses an in-depth discussion to relay her findings, with quotes from participants supporting literature on the topic area. The studys aims have clearly been achieved. Considering the extent of data collected, the findings are surprisingly sparse in the Forchuk et al. (2005) paper. Baseline data is presented in a table, but little information is available as the findings did not support the hypothesis. Generalisability/transferability Generalisability refers to the extent to which research findings are valid and relevant to other settings (Pibouleau, 2009) and how useful they are (Altman and Bland, 1998). Pibouleau (2009) explains how poor reporting of generalisability can be a barrier to research findings being introduced to clinical practice. If findings are not generalisable then they will not be suitable to be implemented into clinical practice. The small scale of the study by Johansson and Eklund (2003) indicates that it is weak and that its generalisability is limited. They attempt to argue that due to having no contrasting findings that it gives rise to a certain degree of representativeness, but their conclusion contradicts this by stating there was some variation, the culprit being a patient with psychosis. Scanlon (2006) reports her study to not be generalisable due to its small scale. However, it does discuss how therapeutic relationships fit in with the role of psychiatric nursing, so the study can be argued to be transferable to the wider population. The Forchuk et al. (2005) study failed to meet its aims, so is not generalisable in any way. This is despite it being based on a successful pilot study conducted some years previously. Implications for practice The research by Johansson and Eklund (2003) offers very little implication for practice other than to offer issues that should be addressed in future similar studies. The study is flawed, and has limitations and contradictions within the discussion. Both authors have previous experience in research in the topic area which is evident in the referencing of their own work, so it raises concerns that these issues have not been addressed in previous work. In contrast Scanlon (2006) recognises all flaws in her study, and gives several recommendations for future research. The fact that the interview guide is included and the findings discussed in such depth allows the study to be replicated. Very little can be gained from the Forchuk et al. (2005) research with regards to enhancing practice, but recommendations are made for future study, almost as a token gesture. However, the paper does highlight factors to consider when planning the discharge process to ensure success, so cannot be comple tely dismissed. Discussion Considering the significance of therapeutic relationships within the field of mental health and the importance it plays within the role of the nurse, the analysis of the highlighted papers is disappointing. The Johansson and Eklund (2003) paper is flawed offering nothing significant for clinical practice. The Forchuk et al. (2005) study failed to meet its aims and as a result provided very little information other than the importance of providing support in the transition from hospital to community. Although very valid, this is does not compensate for the complete failure of the research which was based on a successful pilot. It can be argued that the only paper critiqued that can offer anything to clinical practice is that published by Scanlon (2006), but then her conclusions infer the opposite. Despite the fact that her study can easily be replicated and recommendations for future research are offered, she casts doubt by having a negative focus on her findings. Conclusion This critical review has little to offer to address my question, but the background research and literature reviews within the reviewed papers does offer a rich source of secondary information. Despite that none of the studies have generalisability; they do highlight issues that future researchers should be aware of. From this review it seems that a qualitative approach is best suited to a study in this topic area. It is recommended that the flaws and limitations highlighted in the above research designs are used to establish an effective method for evaluating the role of the therapeutic relationship in mental health nursing. References ALTMAN, D.G. and BLAND, J.M. (1998). Generalisation and extrapolation. [online]. British Medical Journal, 317 (7155), 409-410. Article from British Medical Journal last accessed 1 April 2011 at: http://www.bmj.com.lcproxy.shu.ac.uk/content/317/7155/409.full.pdf BEHI, R. and NOLAN, M. (1995). Ethical issues in research. British Journal of Nursing, 4 (12), 712-716. BURNS, N. and GROVE, S.K. (2007). Understanding Nursing Research: Building an evidence-based practice. 4th ed., China, Saunders Elsevier. COUCHMAN, W. and DAWSON, J. (1990). Nursing and health-care research. London, Scutari Press. FORCHUK, C. et al. (2005). 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(2003). Patients opinion on what constitutes good psychiatric care. [online]. Scandinavian Journal of Caring Sciences, 17 (4), 339-346. Article from Ebscohost last accessed 1 April 2011 at: http://web.ebscohost.com.lcproxy.shu.ac.uk/ehost/pdfviewer/pdfviewer?sid=c7e46787-eb49-4138-85ac-a8a551792d91%40sessionmgr11vid=2hid=10 MARION, R. (2004). Ethics in research. [online] Last accessed 1 April 2011 at: http://www.sahs.utmb.edu/pellinore/intro_to_research/wad/ethics.htm MASSEY, V.H. (1995). Nursing research. Pennsylvania, Springhouse Corporation. MCMICHAEL, C. (2007). Qualitative data analysis. [online]. Last accessed 2 April 2011 at: http://www.latrobe.edu.au/publichealth/Units/phe6/phe6hrb/Week%206%202007%20Analysis.pdf NURSING and MIDWIFERY COUNCIL (2008). The Code in Full. [online]. Last accessed 1 April 2011 at: http://www.nmc-uk.org/Nurses-and-midwives/The-code/The-code-in-full/#standard PIBOULEAU, L. (2009). 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Psychiatric nurses perceptions of the constituents of the therapeutic relationship: a grounded theory study. [online]. Journal of Psychiatric and Mental Health Nursing, 13 (3), 319-329. Article from Ebscohost last accessed 1 April 2011 at: http://web.ebscohost.com.lcproxy.shu.ac.uk/ehost/pdfviewer/pdfviewer?sid=476f44a1-8cff-4a3c-a40f-c96bc336d3c3%40sessionmgr14vid=2hid=10 SHEFFIELD HALLAM UNIVERSITY (2011). Research ethics: 1. Research involving human participants. [online]. Last accessed 1 April 2011 at: http://students.shu.ac.uk/rightsrules/resethics1.html THORNE, S. (2000). Data analysis in qualitative research. Evidence Based Nursing, 3 (3), 68-70. TINGEN, M.S. et al. (2009). The importance of nursing research. Journal of Nursing Education, 48 (3) 167-170. Appendix 1 A Universal Critical Appraisal Tool Adapted from HAWKER, Sheila et al (2002) Appraising the Evidence: Reviewing Disparate Data Systematically. Qualitative Health Research, 12 (9), 1284-1299 and the Critical Appraisal Skills Programme (CASP) appraisal tools: http://www.phru.nhs.uk/Pages/PHD/CASP.htm 1: Research aims and research question: Is there a clear statement of aims and a research question? Consider: Is the goal of the research clearly stated? Are reasons given for why the research is relevant or important? 2: Research approach/design: Is the approach appropriate and clearly explained? Consider: Is the research approach/design justified? Is an explanation offered as to why it was chosen? 3: Ethics: have ethical issues been addressed and was necessary ethical approval obtained? Consider: Are issues of confidentiality, sensitivity and consent addressed? Are research governance processes clearly described? 4: Sampling: Is the sampling strategy appropriate to address the research aims? Consider: Is how the participants were recruited, selected or allocated explained? Are details provided (e.g. race, gender, age, context) of who was studied? Is the sample size for the study justified? 5: Data collection: Are the methods of data collection appropriate and clearly explained? Consider: Is it clear how the data were collected and are the methods chosen justified? 6: Data analysis: Is the description of the data analysis sufficiently rigorous? Consider: Is there a clear description of how analysis was done Qualitative Is there a description of how themes or concepts were derived? Quantitative Are reasons for the statistical tests selected described and statistical significance discussed? 7: Findings: Is there a clear description of the findings? Consider: Are findings explicit, easy to understand and in logical progression? Are tables, if present, explained in the text? Do results relate directly to the aims? Are sufficient data presented to support the findings? 8: Transferability or generalisability: Are the findings of this study transferable, or generalisable to a wider population? Consider: Are the context and setting of the study described sufficiently to allow comparison with other contexts and settings? Is there sufficient detail provided about the sample (as in section 4)? 9: Implications and usefulness: How important are these findings to policy and/or practice? Consider: Do the findings contribute something new and/or different in terms of understanding, insight or perspective? Are ideas for further research suggested? Are implications for policy and/or practice suggested?