Thursday, August 22, 2019

Lord of Flies (Evil Nature) Essay Example for Free

Lord of Flies (Evil Nature) Essay In life, there are a lot of things that hold people back from doing what they want to do. One of the major things is the laws of society. William Goldings novel, Lord of the Flies, illustrates what would happen without society. The boys behaviors change significantly throughout the novel. The boys carry their civilized behaviors with them to the island but, as time goes by without society, those behaviors are lost. When the boys are first dropped off on the island, they still have their civilized behaviors with them. Shortly after Jack is given the responsibility of leading the hunters, he is given the opportunity to kill a pig. However, Jack hesitates as he begins to â€Å"understand what an enormity the downward stroke would be† (etext) and misses his chance. Jack is still too civilized to kill the pig. The boys are also unable to come to terms with death in general at the beginning of the novel. When the boy with the mulberry birthmark dies, the boys never really talk about it and Ralph doesn’t do a count of the boys because he doesn’t want his death to become real. This illustrates how the boys still feel how normal, young boys feel and that their societal ways are still very much present on the island. As the novel progresses, the boys’ evil nature begins to become more and more present. It starts off with their hunting. Jack goes from not being able to kill a pig because he is hesitant to killing them very violently. The hunters chant, â€Å"Kill the pig. Cut her throat. Spill her blood† (etext). Although killing an animal doesn’t seem bad, especially because they need to in order to survive, it allows the boys to think that killing is acceptable in general. Which leads to the hunters murdering Piggy and the near death of Ralph. The author of the novel, William Golding, states that the theme of the novel involves the evil nature humans naturally have that is held inside of them because of society. This is true to a certain extent because some of the boys evil nature may be coming from the circumstance they are in. However, this is true because Golding shows as society and civilization deteriorate, so does the boys good human nature. As the boys start to realize there are no laws or other people on the island to hold them back, they start to show their true colors which is the evil nature they possess. The way humans behave is very much controlled by the type of society they are in. In the novel, Lord of the Flies by William Golding, the normal society is not present causing the natural evil behaviors humans have to be presented. Eventually, as the boys begin to realize their are no laws holding them back from doing wrong, the boys start to display this evil nature.

Wednesday, August 21, 2019

Patient Safety in Healthcare

Patient Safety in Healthcare Introduction and background Patient safety has always been the heart of healthcare practice and nursing through the history of medicine. However, all through the world occasional non-deliberate accidental harm occurs to patients looking for care. Such unfavourable incidents can occur at all levels of healthcare whether clinical or managerial, curative or preventive, and in general healthcare, or private. It may occur at any stage of management (radiology, laboratory, operating room, ward, or ICU). The WHO, at the meeting held on July 2006, in New Delhi, India, identified an adverse event as a separate unconnected incident associated with health care, which results in in-deliberate injury, illness, or death. Such incidents can be preventable as with contaminated injections. Published surveys on patient safety show that in industrialized advanced countries, more than half of these adverse events are preventable and occur because of a shortage in system or organization design or operation rather than because of poor performance of healthcare providing staff (WHO report, 2006). Harvard Medical Centre study in 1991 (after WHO report, 2006) was the first to draw the attention to the volume of patient safety problem. Based on medical records review, the rate of adverse event in three US medical centres ranged between 3.2 to 5.4 percent. In UK, the rate was 11.7 percent and in Denmark, the rate was 9 percent (WHO report, 2002). Results of recent studies suggest the rate is between 3.2 and 16.6 percent (per 100 hospital admissions). The situation in the less well-documented health care centres in the developing countries is more serious (WHO report, 2006). The cost of adverse events that endanger patient safety can be very high, considering all the aspects. It includes, loss of confidence and credibility and reputation of health care institutions, loss of enthusiasm and job gratification among the working staff. In addition, the cost includes damage to the patients and their relatives especially when taking defensive attitudes and keeping information hidden from patients families. Other added costs are those of prolonged hospital stay and increased medical expenses and those of lawsuit demands (WHO report, 2006). Objective The objective of this paper is to review, in brief, the problem of patient safety with particular attention to patient safety in the ICU being one of the essential patient care systems in a health care organization. Besides, the vulnerability of ICU patients augments the importance of patient safety concept. Methodology This thesis is a literature review study. The researcher performed an article search using the following internet databases: National Centre for Biotechnology – National Library of Medicine – National Institutes for Health (NCBI), at Medscape database, at Amedeo: The Medical Literature Guide, at British Medical Journals, at World health organization – Publications, at Yahoo and Google scholar general databases, site of .org, .gov only considered. Terms of search were patient safety, basics, and principles of patient safety, review of patient safety, patient safety in the ICU and the critically ill patient safety. Findings Patient safety event is a wide term; it does not only mean a medical error during the course of medical management and nursing. The Department of Health and Human Services, 2008, defined a patient safety event as an incident, which takes place during providing a health care service. It causes or may have caused a harmful outcome to the patient. It includes errors of not doing (omission) or errors of doing (commission), it also includes faults and mistakes of the patient care processes (involving drugs and equipments) or the environment where these processes are carried out. The phrase, one cannot manage what cannot be measured hold true for patient safety. One of the reasons of the lack of effective patient safety strategies is the need for a measurement tool to provide measures, consequently, reduce medical errors and improve patient safety. The Agency for Healthcare Research and Quality (AHRQ) developed an array of Patient Safety Indicators planned to screen administrative data for events related to patient safety. This list of indicators includes 16 situations where a threat to patient safety may occur during the course of healthcare delivery. Using this measurement tool shows that patient safety incident of highest rates are failure to rescue, decubitus ulcers and postoperative wound infection (which is specifically increased by 35% during the period 2002-2006) (Health Grades Inc, 2006). Infection control: An important part of patient safety Bruke, 2006, has provided a comprehensive review of infection control as an important aspect in patient safety strategy. Based on many studies, hospital acquired infection; in this context, alternatively called health care associated infection, is one the most frequent risks for patient safety in patients admitted to hospitals. The answer to the question of why it is an important aspect for patient safety lies in the fact that 5-10 percent of patients admitted to acute care hospitals acquire one or more nosocomial infection. In the US, 2 million patients acquire hospital infection every year with 90.000 deaths. This adds a cost of 4.5 to 5.7 billion US $ to the health care cost (Bruke, 2006). There are four types of hospital-acquired infections, which account for 80% of the total rate. These are infection associated with urinary catheterization, blood borne infection (usually with vascular invasive procedures), surgical wounds infections, and pneumonia (usually associated with the use of ventilators). Therefore, it is understandable that 25 per cent of these infections occur in the ICU (Bruke, 2006). The increased awareness of patient safety resulted in reorganizing the concepts of infection control and placing it in the domain of public health with consequent increased surveillance and epidemiological studies. It is true that recognizing risk factors allows clarification of what is adjustable and what is not, however modification of some terms is advisable. Instead of saying avoiding the use of catheters, we should recommend reducing the duration of use of catheters. Many other terms as use antibiotics intelligently, and training and staff education are hazy and indistinct, accordingly, tricky to employ (Bruke, 2006). Nursing practice and patient safety The report of the Institute of Medicine, 2004 (after Armstrong and Laschinger, 2006) recognized nursing role as pivotal to patient safety. The report suggests the degree of activity of hospital nurses and the extent of giving them authority to take part in decisions, directly affects the quality and perception of patient safety. The results of Armstrong and Laschinger, 2006 supported this assumption; they recommended that nurses should enjoy better communication and participation in decision-making. The responsibility of nurse managers, at the unit level, is even greater. They take part to establish nursing practices, which support patient safety culture, they also sustain professional nursing practices, and they should listen carefully to nurses relevant affairs. If nursing managers achieve their direct responsibilities, then they work with others in the healthcare establishment to make the organizational process better as regards limiting the nurses competence towards better patient care. The result of Armstrong and Laschinger, 2006 suggested that nurse managers (nurse leaders) have the capability of developing patient safety in healthcare organizations. Medication management and patient safety Duthie and colleagues, 2004, analyzed the 108 reports submitted to the New York State Department of Health investigating the medical errors in New York State healthcare organizations. From quantitative viewpoint, their results suggested that nursing the first discipline to be involved in such errors and they provided the explanation that nurses are the end dispenser since they give the medications to patients directly. In addition, they showed that patients over 65 years are the most vulnerable to these errors, perhaps because of the increased number of medications prescribed at this age. From a qualitative viewpoint, they suggested that what may endanger patient safety is dispensing system malfunction, failure to rescue situations and working space limitations. They suggested the need to educational initiatives and pointing out possible dispensing system malfunctions. Adamski, 2005, suggested the following precautions to minimize medication errors: Monitoring how patients respond to medications as long as it is dispensed in the healthcare organization. Diagnosis and indication for a particular medication should be available in the patients progress notes, history or examination sheets. Clear order forms to dispense medications in order to ensure clear and mutual understanding among the prescribing physician, pharmacist, and thenurse who administers the medication. Davis and colleagues, 2006, examined the patient role in medication errors. They suggested that low literacy patients (up to 6th  grade level) are more liable to misunderstand medications label instructions. However, they suggested that lower reading and writing skills and high number of medications prescriptions link separately to misunderstanding of instructions on medications labels. Hospital design and device purchase in patient safety strategies Reiling, 2005, suggested that building a hospital (whether new or relocated) around the principles of patient safety would have two important impacts on return of investment. First, it combines safety and efficiency, second, it reduces the costs of adverse effect and hospital stay therefore; reduces the patients cost on discharge. To achieve a safety cantered hospital design, Reiling, 2005, suggested that architects, engineers, contractors, heads of departments and executive managers should participate in discussions around what they need. There is no specific design but contributions of the whole team from the perspectives of patient safety culture are mandatory. Johnson and colleagues, 2004, examined the patient safety in purchasing equipment. They analysed purchasing decisions taken at three different healthcare centres. Johnson and other, 2004, assumed there were points of strengths and others of weaknesses. The points of weaknesses draw the attention to the necessity of having guidelines to help healthcare providers to assess issues of patient safety when purchasing medical devices. Patient safety in the ICU There are many reasons that make the ICU a special unit to look at specifically as regards patient safety. Of these reason, the patients are critically ill, which renders them vulnerable to the adverse effect of medical errors. Second, the great effort performed by nurses and internists with sometimes exhaustive shift work, which may result in sleep deprivation and possibly lack of concentration. Third, the diverse use of equipment (ventilators, catheters, monitors etc) and the invasive procedures sometimes adopted (emergency tracheotomy, central venous pressure or arterial-venous cannulation) which add to the risk of hospital-acquired infection or increase the incidence of adverse effects (Rothschild and others, 2005). Rothschild and colleagues, 2005 conducted a one-year prospective observation study as a part of Harvard Hours and Health Study (2002-2003). They designed their study as a multidisciplinary epidemiological study to portray both frequency and types of adverse effects in the ICU. The result were informative, there were 120 adverse events reported (80.5 per 1000 patient-day). Of the patients who suffered adverse effects, 13.8% suffered one adverse effect, and there were 16 life-threatening adverse effects. The commonest were respiratory, infection, and cardiovascular system (19%, 15%, and 12% respectively). The incidence of serious medical errors was 149.7 per 1000 patient-day of which, 11% were life threatening. Incident discovery was by direct observation in 62% of the cases and the patients nurses discovered 36 % of the cases. In 74.8% of cases, errors occurred during the course of treatment or a procedure. An intern failure to wash hands after attending a patient formed 51% of sterility hazards related to procedures. Although their results cannot be applied to all ICU units, yet it draws the attention to how frequent and how serious patient safety can be compromised in ICU units. At the same time, their result show how results of treatment in the ICU would improve, despite the hard work, if teams stick to unit protocols and principle of patient safety (Rothschild and others, 2005). Kho and others, 2005, used the Safety Climate Survey (a tool approved by the Institute of Health Care Improvement) to measure patient safety in four ICU units, 56.9% of those responded to the survey were nurses. Based on their results, they assumed that Safety climate survey and Safety culture scales are reliable tools to measure patient safety in ICU. Chang and other, 2005, suggest that reform of patient safety in the ICU should start by establishing physician and nurse leadership, once this is achieved, carrying out patient safety protocols becomes a matter of team effort and commitment to the concept. Identifying a specific group of patients to start with (as an example, patients on ventilators), planning carefully the procedures, and opening a communication channel among the staff should reach the best results. Following evaluation of what progress made, the next move is for another group of patients. At the end, this should provide synchronization among the staff that makes decision making in shortage of time easier and provides better training and education to the newly coming staff. Obstacles facing the implementation of patient safety Cook and colleagues, 2000, considered the complexity of healthcare as an overwhelming obstacle to achieve desired patient safety levels. Technical work in healthcare needs appropriate and quick decision making, critical to the patients safety at times, moreover, it is risky by nature. It is true that health practitioners whether physicians, nurse, technicians or other staff are trying to cope with this complexity, however this complexity creates a disparity in healthcare practice and nursing (they called it gap). Cook and colleagues assumed the means of improving patient safety is by supporting practitioners ability to perceive and cross these disparities, rather than making changes in authority or different roles with possible division of professional work force. The search and detection of these disparities or gaps as a research goal should make the breakthrough in patient safety achievements. During this research pursuit, disparities indicate areas of weaknesses and susceptibility and may elicit the means complexity flows through health care systems to patients (Cook and colleagues, 2000). Amalberti and colleagues, 2005, identified five system barriers to even safer healthcare; the first is regulations, which significantly limit the risk allowed, thus, limiting maximum performance of healthcare givers. There is a real need for proper balance between the industrial notions to get a high productivity whatever it takes, and the concepts of patient safety culture. Doing that, researchers should take into consideration the economic troubles of the healthcare system and the spontaneous drive of productivity among healthcare workers. Second, other important issues need dealing with before or in conjunction with the issue of patient safety, an important example to these issues is the need for standardization of healthcare practice and nursing. Third, the core of healthcare work is synchronization among practitioners, therefore recommendations should stress on teamwork and opening communication channels among the healthcare staff, instead of trying to reach optimal performance of each organizational level separately. The fourth obstacle is the need for system-level mediation to improve patient safety planning. References WHO Regional Office for South-East Asia (2006). Working Paper: Promoting Patient Safety At Healthcare Institutions. Retrieved 28/04/2008, from WHO Secretariat report (2002). Quality of care: patient safety. Retrieved 30/04/2008, from Department of Health and Human Services. (2008). Patient Safety and Quality Improvement. Washington DC: Federal Register. Vol.73 (29): 8112-8183. Health Grades Inc. (2006). Third Annual Patient Safety in American Hospital Study. Golden, Colorado. Bruke, J. P. (2006). Infection Control A Problem for Patient Safety. The New England Journal of Medicine, 348 (7), 651-656. Armstrong. K J. and Laschinger H (2006). Structural Empowerment, Magnet Hospital Characteristics, and Patient Safety Culture: Making the Link. J Nurs Care Qual, 21 (2), 124-132. Duthie E, Favreau B, Ruperto A et al. (2004). Quantitative and Qualitative Analysis of Medication Errors: The New York Experience. Advances in Patient Safety, Vol. 1, 131-144. Adamski P (2005). Medication Management: A patient safety priority. Nurs Manag, 36 (10), 14. Davis T C. Wolf M S. Bass P F. et al (2006). Literacy and Misunderstanding Prescription Drug Labels. Annals of Internal Medicine, 145 (12), 887-894. Reiling J G. (2005). Creating a Culture of Patient Safety through Innovative Hospital Design. Advances in Patient Safety, Vol. 2, 425-439 Johnson T R., Zhang J., Patel V L. et al (2004). The Role of Patient Safety in the Device Purchasing Process. Advances in Patient Safety, Vol. 1, 341-352. Rothschild J M., Landrigan, C P., Cornin J W. et al (2005). The Critical Care Safety Study: The Incidence and Nature of Adverse Events and Serious Medical Errors in Intensive Care. Crit Care Med, 33 (8), 1694-1700. Kho M E, Carbone J M, Lucas J and Cook D J (2005). Safety Climate Survey: reliability of results from a multicenter ICU survey. Quality and Safety in Health Care, 14, 273-278. Chang, S.Y., Multz, A. S. and Hall, J. B (2005). Critical Care Organization. Critical Care Clinics. Vol. 21 (5), 43-53 Cook R I. Render M. and Woods D. D (2000). Gaps in the continuity of care and progress on patient safety. BMJ, 320 (7237), 791-794. Amalberti, A, Auroy, Y, Berwick, D and Barach, P (2005). Five System Barriers to Achieving Ultrasfe Health care. Annals of Internal Medicine. Vol. 142 (9), 756-764 Wilson, A R., Dowd, B E. and Kralweski, J E. (2005). Patient Safety Research in Medical Group Practices: Measurement and Data Challenges. Advances in Patient Safety, Vol. 2, 51-62 Woolf, S H. (2004). Patient Safety Is Not Enough: Targeting Quality Improvements To Optimize the Health of the Population. Ann Inter Med, Vol. 140, 33-36 Baxter, S K and Brumfitt, SM (2008). Benefits and Losses: a qualitative study exploring healthcare staff perception of teamworking. Quality and Safety in Health Care, Vol.17, 127-130 Pstay, B M. and Bruke, S P. (2006). Protecting the Health of the Public: Institute of Medicine Recommendations on Drug Safety. The New England Journal of Medicine, Vol. 355, 1753-1755

Tuesday, August 20, 2019

Drug Addiction In Pakistan Youths

Drug Addiction In Pakistan Youths Drug addiction is a state of periodic or constant intoxication produced by the repeated consumption of a drug. Its characteristics include Uncontrollable desire to continue taking the drugs, a tendency to increase the dose after interval of time, a psychological and physical dependence on drugs, effects of drugs on individual and society. Drug addiction is an abnormal condition which arises due to frequent drug use. The disorder of addiction involves the progression of sensitive drug use to the development of drug-seeking behavior, the openness to decline and the decreased, slowed ability to respond to naturally rewarding stimuli. Drug addiction is basically a chronic disease affecting the brain, heart and other parts of body. Youngster start taking drugs at their teen ages and the first step of addiction to drugs is smoking. Drugs affect different people in different ways. One person can take and abuse drugs, yet never become addicted, while another merely has one experience and is immediately hooked. It can be said that dugs addiction is just a state of mind. Drug addiction is often overshadowed by many of the countrys other human development problems, such as poverty, illiteracy, and lack of awareness and basic health care center. But the fact is that drug addiction is rapidly growing among the youth of Pakistan. Drug addiction is a complex brain disease. It is characterized by compulsive, at time uncontrollable, drug craving, seeking and use that persist even in the face of extremely negative consequences. Drug seeking becomes compulsive, in large part as a result of the effect of prolonged drug use on brain functioning and also on behavior. For many people, drugs addiction becomes chronic, with relapses possible even after long period of abstinence. I chose this topic because I think it is necessary for todays society which is taken over by the curse of drugs, mostly High School and university students are involved in it. It the main reason, today youth is distracted from their ambitions, and due to it today Pakistan, even after 63 years of independence, is 3rd world country. One of the reasons is that some people who want to quit but due to the lack of health care centre, they are unable to quit. Some people also involve in illegal activities to take drugs because they are not financially strong. This study will help us analyze the effects of drug addiction and will help us find better alternatives. Drug addiction is a state in which the body feel relax and comfortable. Drug addiction among youngsters is increasing day by day, which have a very negative effect on our society. Review of Literature This study help us to examine that individual who are addicted to drugs are viewed negatively overall in the society. This research indicate that negative attitude are clear among young generation and it gradually increase with the age, so that the literature review indicate that level and accuracy of knowledge about mental illness increase from childhood through adolescence, negative attitude in youth also raise with the passage of time. On the other hand, adolescence is often accompanied by peer pressure or by other recourses. According to the study, it is also found that current users Marijuana says that it is less dangerous than other drugs. The study show that drug addiction is found in males as well as females and this trend is gradually increasing especially in females, and it is also shown in the study that trend of drugs among adolescent is also increasing in urban and rural schools. Results show that age-stigma association is quite independent of sex and residence. It also shows one of a factor that who are addicted to drugs are due to their close friends or you can say due to bad company. This study shows the reasons and causes by which teenagers are motivated toward drugs. It show that who use drugs on a regular or occasionally are strongly supportive by personal choice due to lack of concentration from their parents and for enjoyment with their friends to eliminate their boredom. The reasons which are not using drugs in this study include lack of interest and fear from drugs and also from their parents and opposite reaction of their elders. The main purpose of this study is to emphasize the significance of parents in this regard. This research show the fact that increasing majority of children reported using drugs because they enjoyed them or they were bored and they want themselves to remain busy in some other alternative activities. The use of illegal drugs in children and teenagers are gradually increasing day by day. Result of this study showed that the main reason by which youth is motivating toward drugs is due to the peer pressure and their friends which were involved in such illegal activities. The other aspect to conduct this research was to finds the reasons that why some children do not use drugs. The first reason was lack of interest in the effects of drugs. Other main reasons included fear of immediate effect of substance, fear of physical and psychological harm and fear of becoming addicted to drugs. The finding and conclusion of this study is to get the reasons behind drug related decision especially in children and teenagers. Both who use drugs and who do not give lot of explanation and reasons. Children who do not use drugs reported that they are not involved in drugs are due to lack of interest in this activity, worries about the cost of getting caught by police or their parents. As we all know the health hazards of smoking. Everyone is familiar from this fact but this curse is rapidly increasing among youngster. The main objective of this study is to investigate the signs of tobacco use, smoking as well as snuffing, at the age when most of the young generation is diverted toward this curse. In this study, it is found that now a day, smoking is becoming very common in girls as well. Sweden has the highest frequency of smoking all over the world. It is found in the study that frequency of snuffing among teenagers has amplified since the early 1970s, whereas the graph of smoking has reduced slightly during last decade. The purpose of this research is to explore teenagers thinking of tobacco use, their shared ideas and images, how these design are reflected in their report about their own and other people tobacco use and also the ways understandings of tobacco use are related to the teenagers development of a gender identity. It is found in the study that smokin g cigarette offered males as well as females a short break from their daily routine and strains of family life. According to teenagers, smoking will ultimately lead to the break-down of the whole body. They also explain that invisible process inside the body, when smoking, will gradually be visible on the outside of the body. This research shows that youngsters think that snuffing has a positive effect as they increase their sports performance. But the fact is something else. Smoking and snuffing is just a mind satisfaction activity, as it affects lung and heart. On the other hand, it also affect externally like u see that the color of lip and teethes and even the color of face of smokers are also changed after a period of time. Some people are attracted to danger, and want to face risk, which is one of the reasons for them to start smoking. In addition, it is examined in the study that tobacco use is basically based on human nature. Smoking is a part of teenage lifestyle, such as b eing together with friends for hangout, parties etc. It is concluded from the analysis that now a days, new generation is well aware from all illegal activities such as, smoking, snuffing, drinking etc. This research paper shows the planned use of prescription drugs of intoxicating properties other than physicians description of specific drugs for intoxicating means or for bona fide medical condition, which is dangerous for human health. Research shows the rapidly increasing rate of abuse of such drug among youth, especially teenager. Such type of abuse of drugs is one of the biggest and main sources of drug addiction. In 2003, approximately 15 million US citizens were involved in using of prescription drugs for its intoxicating quality. For minimizing the rate of prescription drug misuse, government is making strategies to identify the early signs and effective clinical practices to prevent people from getting into it to avoid from massive problems in future. The most abundantly used drug in UK is Alcohol and teenagers use it more than the limit described for health which 21 and 14 units per week for males and female respectively. Those who are new to alcohol must use bellow the limit for the safe side. This study is about the relationship between excessive use of alcohol and its affect on human memory. It is identified from surveys among excessive use and low-dose user that those who use alcohol in excess amount face everyday memory errors than low-dose. Excessive use of alcohol has a direct relation on memory errors and neuropsychological deficits. Alcohol is very harmful for heart, liver and other sensitive parts of human body. The finding of this study is that use of substance is highly common among homeless and street-involved young people. Study confirmed that variables measuring psychological dysfunction and homeless culture predicted alcohol addiction, while institutional disaffiliation and homeless culture predicted drug addiction. Findings affirm distinct patterns of division related to alcohol compared to drug addiction. As homeless, street-involved young people continue to use drugs and alcohol as a strategy to cope with the various detrimental experiences associated with living on the streets, the result is often further societal estrangement. This study also show that engaging in criminal behaviors has been identified as an indicator of disaffiliation, especially among homeless population. Seeking drug-using friends and involvement in social networks that reinforce drug-related choices, attitudes and behaviors increases youths assimilation into homelessness culture. The purpose of this study was to determine whether domains of social estrangement are associated with homeless youths alcohol and drug addiction. Results show that specific domains of social estrangement do predict addiction, while others prevent from this activity. Purpose to conduct this study is to estimate the incidence rate of initiation into drug injection and to identify predictors of initiation into drug injection separately among street girls and boys. This research show that that injected drugs are rapidly increasing day by day in street youth of Northern America and Canada. This situation represents a significant public health issue as young injection drug users are known to be the population at highest risk for HIV and HCV infections. This is the first study to measure incidence rates of initiation into drug injection by gender among youth at risk. Observed incidence rates are similar for boys and girls, results found having no association between gender and having ever injected drugs. In a study of young Canadian offenders, more girls aged 16-19 injected than their male counterparts of the same age. In this study, it is noticeable that girls were more likely to report having started injection using heroin while more boys reported ha ving used cocaine as their first drug of injection. Results show that recent heroin use and recent cocaine use respectively tripled and doubled the risk of initiation for both girls and boys. Objective of this study is to observe social contexts and processes influencing evolution to drug injection among street youth. This study show that some combinations of street life and drug use trajectories seem to contribute to injection among street youth. This study clearly shows the pertinence of examining how drug use practices are influenced by the individuals relations with their social environments. This study is the first qualitative investigation of the social processes that lead street youth to adopt drug injection. One of main finding is that the manner in which drug injection inserts itself into a youths life trajectory varies depending on when youth come into contact with the street, as well as their relations with the street scene and drug use. In this respect, it should be pointed out how diverse the trajectories of street youth are. While it is not possible to state with certainty that a youth will never inject drugs, it appears that certain youth have trajectories that are more prone to injection drug use than others. This study is conducted on street youth on adolescent and young adults who spend their most time living and working on the streets. This socially and economically disadvantaged population is marked by perilous living conditions, including poverty, homelessness, and drug use. In study of homeless youth, the odds of an earlier suicide attempt were nearly four times greater among youth with an active diagnosis of depression, and nearly two times greater among youth who reported symptoms of hopelessness. In addition, depression is associated with high-risk behaviors, such as injection drug use and unprotected sexual intercourse that predispose youth to human immunodeficiency virus (HIV) infection. HIV infection is itself a well recognized risk factor for mortality among street youth. We observed a very high frequency of depressive symptoms among street youth, with more than four in 10 street youth reporting CES-D score _22. The greatest number of depressive symptoms was observed among we ekly heroin users, followed by weekly crystal methamphetamine users, then weekly cocaine/crack users, and finally, daily marijuana users. The research paper was on the impact of maternal alcohol and illicit drug use on childrens behavior problem and the objective of this study is to use a large, national sampling of mothers and children to test for evidence of casual relationship between maternal alcohol, marijuana and cocaine use and its effects on childrens health problem. This study provides some evidence that maternal substance use may be linked causally to childrens behavior problems. Although TSLS results are challenging due to the poor performance of the identifying instruments, OLS models, family fixed-effects models, and mother-child fixed-effects models all suggest that maternal marijuana and cocaine use are associated with increases in 4-15-year-old childrens BPI scores. Maternal alcohol use, as measured by the number of days the mother used alcohol in the past month, appears to affect behavior problems. This result is sensitive, however, to the addition of maternal depression and smoking measures. Moreover, the magnitude of this effect is very small, and maternal indulge drinking had no constant impact on childrens behavior problem. This study is about the depression and participation of youth in selling and use of illicit drugs. The argument starts with the theory that drug selling and drug use augment each other, both at the individual level and at the aggregate level. For example, someone who sells drugs has relatively cheap access to drugs. And, someone who uses drugs may sell to help finance his/her use. The conceptual framework postulates that a recession would have direct positive effects on the prevalence of youth drug selling but ambiguous direct effects on youth drug use. The conceptual framework also postulates that drug selling and drug use are inter-connected at the individual level and the cumulative level. Thus, any effect of a recession on one would likely affect the other in the same direction. The limited empirical evidence indicates that both drug selling and drug use among youth is higher when the economy is weaker. The current economic crisis will likely increase both youth drug selling and drug use relative to what they would have otherwise been. As we all are familiar that humans are routinely exposed to a vast array of environmental neurotoxicants, including pesticides, endocrine disrupters, and heavy metals. The long term consequences of exposure have become a major human health concern as research has indicated strong associations between neurotoxicants and a variety of dopamine-related neurological disorders. This study was conducted to know the effects of environmental neurotoxicants on the dopaminergic system and the possible role in drug addiction. A large variety of studies have demonstrated that a vast assortment of environmental neurotoxicants have deleterious effects on the dopaminergic system, consequently enhancing or impairing DA neurotransmission and disrupting DA-associated behaviors including motor control, motivation and attention, and potentially, vulnerability to drug addiction. Pesticides and insecticides, such as dihedron, parquet, and rotenone, tend to decrease DA activity and can lead to diseases such as PD, which are characterized by dopaminergic neurodegeneration. Studies appear to express a link between environmental neurotoxicity exposure and drug addiction although much work needs to be done to further identify and characterize the underlying mechanism involved. Bupropion is an effective medication in smoking cessation and has a good safety and side effect profile. The effects of bupropion on extracellular dopamine levels in the striatum were investigated using raclopride positron emission tomography (PET) imaging in rats administered saline, bupropion and in healthy human volunteers administered. A cognitive task was used to stimulate dopamine release in the human study. In rats, bupropion significantly decreased raclopride specific binding in the striatum, consistent with increases in extracellular dopamine concentrations. In man, no significant decreases in striatal raclopride specific binding were observed. Levels of dopamine transporter occupancy in the rat at bupropion were higher than predicted to occur in man at the dose used. Thus, these data indicate that, at the low levels of dopamine transporter occupancy achieved in man at clinical doses, bupropion does not increase extracellular dopamine levels. These findings have important im plications for understanding the mechanism of action underlying bupropions therapeutic efficacy and for the development of novel treatments for addiction and depression. For a long period of time, China implemented restraining drug policies to cope with drug-related problems but on the other hand, the situation of drug addiction has rapidly worsened since the early 1990s. For example, the number of registered illicit drug users in the country increased from approximately 70,000 in 1990 to 1.16 million by the end of 2005. This paper is projected to intricate on the general principles of Chinas latest Drug Control Law from the point of view of scholars who are involved in the field of drug addiction research and treatment in China. This paper also discussed the challenges we are currently facing, based on the observations and practical experiences the authors have obtained in China. It is hoped that by addressing these issues, we will be able to implement the new Drug Control Law more successfully and ensure that we deal more effectively with drug addiction in China. Methodology: This drug addiction survey is based on questionnaire from age (12 to 19) years, which is derived from 2005 cycle of Ontario student drug use survey. This research is conducted through questionnaire as mentioned above and the items of questionnaire are (1) Would you be afraid to talk or interact someone who is addicted to drugs. (2) Would you make friend someone who is addicted to drugs? (3) Would you feel embarrassed or ashamed if your friend knew that someone in your family was addicted to drugs? In this research, Ordinary least square regression is used to oversee and examine the relationship between age, sex, urban city, individuals and peer groups. Quadratic and linear age terms are included in this model. In this methodology, age variables were centered in order to reduce the correlation between the linear and quadratic term and interaction term. The data on which this study is based was collected under large study of pre-teenagers and schoolchildrens attitude and behavior toward illegal drugs and their experience. This research had both quantitative and qualitative components Data is basically collected by the survey which depends on questionnaire. Data is also gathered by interviews of individual to understand the thoughts and perception about drugs in children. Basically, the sample of this study is school in Glasgow and Newcastle. The quantitative element consisted of a survey of 2382 between ten to twelve year old children in 47 schools of Glasgow. To capture teenagers concepts of tobacco use, a qualitative approach with focused group interview was conducted for this research. Group discussion is the most useful and helpful way of sampling. The sample on which the research is conducted with 43 ninth grade students having age between 14 to 15 years old at two schools in inner Stockholm. Interviews are based on eight themes those are; (1) health and tobacco use, (2) the age limit of tobacco purchase, (3) school and tobacco use, (4) media and tobacco use, (5) the aesthetics of tobacco use (6) the pointless tobacco use, (7) presentation of self, peers and adults as tobacco-users, (8) presentation of self and peers who do not use tobacco. The majority of the 25 non-tobacco-users had tried smoking earlier, 12 boys and one girl had tried snuffing. Among the 18 tobacco users more girls than boys use tobacco on a daily basis. This research is conducted with the help of scientific questions. In this study, group discussion and interview are also conducted to read the state of minds of drug user that how these drugs affect their health and brain. Scientific questions highlights the need for research into the effects of prescription drugs on the developing brain, using both vitro and vivo models. Sample of this research is teenagers of United States. In this study, existing -groups design was adopted to compare existing groups of excessive alcohol users and low dose user. The sample on which this research is conducted is the students of colleges and universities of North-East of England and each participant was tested individually at their respective college and university. Forty-five participants were identified as excessive alcohol users having 28 females, 17 males, mean age of the participants is 17 years. Sixty-three were identified as low-dose/no-alcohol users having 41 females, 22 males and mean age is 16 years. Alcohol and other drug use were assessed using Recreational Drug Use Questionnaire. Prospective memory Questionnaire (PMQ) was administered first, followed by the drug-use questionnaire and the whole testing time per participant was approximately 25 minutes. Sample selected to conduct this research is three U.S. cities are Los Angeles, CA; Austin, TX and St. Louis, MO. Participate in the study, had to be 18-24 years old, have spent at least 2 weeks away from home in the month before the interview, and provide written informed consent. The dependent variable for the current study reflected alcohol or drug addiction as measured by the Mini International Neuropsychiatry Interview. Addiction to alcohol and various substances was measured by participant responses to a series of yes/no questions that identified those meeting criteria for abuse or dependence. Analyses were performed using SPSS, version 16 with statistical significance. In this study, chi-square, t-test and regression model is also used as a methodology. Data were collected using semi-annual interviewer-administered questionnaires. Variables from the following domains were considered in Cox regression models: socio-demographic characteristics, early and current substance abuse, marginalization, childhood traumatic sexual events and injection exposure. The sample on which this research is conducted is some specific areas of North America, Canada, Baltimore and Thailand. In this 95% confidence intervals were based on the Poisson distribution. Unvaried and multivariate Cox regression models with time-varying covariates were used to examine predictors of initiation into drug injection. The sample for this study is 42 street youth who participated in in-depth interviews. A typology of experiences was built founded on youths street life and drug use trajectories. The transition to drug injection was examined through these experiences. This research is conducted by a qualitative study grounded in symbolic interactions, a theoretical perspective through which, to understand the evolution of human behaviors, subjects are considered as creative social actors in their world. The study sample was composed of 42 street youth aged 15-25 years. 16 participants were girls, and 26 were boys. At the time of the interview, 17 of them had never injected drugs. Of the remaining 25 who had injected drugs, 8 had tried injection without pursuing it further, 8 had stopped after having injected regularly, and 9 were actively injecting, 1 of whom had been doing so for less than a year. Semi-structured, in-depth interviews were conducted in this research plan. This study was conducted between October 2005 and November 2007, data were collected from a cohort of street recruited youth aged 14-26 residing in Vancouver, Canada, for the At-Risk Youth Study. Active drug users were classified by predominant substance of use: daily marijuana use, weekly cocaine/crack use, weekly crystal methamphetamine use, or weekly heroin use. Adjusted mean number of depressive symptoms (measured by the Center for Epidemiological Studies Depression [CES-D] scale) was compared among the four groups using multiple linear regressions. Logistic regression was also used to assess adjusted odds of CES-D score _22. In this research paper, the child mental health production function is represented empirically by Equation. BP Iijt = ÃŽ ±0 + ÃŽ ±1Ajt + ÃŽ ±2Xit + ÃŽ ±3Xjt + ÃŽ ±4ui + ÃŽ ±5uj + ÃŽ µijt. The other equation for maternal demand for substances like alochal is: Ajt = ÃŽ ²0 + ÃŽ ²1Pt + ÃŽ ²2Yjt + ÃŽ ²3uj + ωjt. Bupropion administration was calculated as: Occupancy  ¼ SBRvehicle−SBRbupropion h I =SBRvehicle 100 Ten healthy participants were recruited by public advertisement (80% male; 90% right handed; average age: 47 ±6.7 years; age range 37-58 years). Nine of the 10 subjects were nonsmokers; the single participant who smoked consumed ∠¼10 cigarettes/day. None of the participants were currently taking any prescribed medication. All participants gave their written, informed consent to be included in the study.

Monday, August 19, 2019

A Comparison of Seamus Heaneys Mid-Term Break and Digging Essay

A Comparison of Seamus Heaney's Mid-Term Break and Digging I am comparing two poems by Seamus Heaney- `Mid-Term Break` and `Digging`. Both of the poems are written about his childhood and his family. The first poem I analysed was `Mid-Term Break`, where the simple and straight forward title `Break` caught my attention suggesting to me that this poem is going to be a positive experience, a break from work, a time to relax. The commencing stanza, the first line reads, ?I sat all morning in the college sick bay?, which has connotation of depression, illness and suffering suggested from the word `sick`. Also with the reference to college the reader gathers that the boy is in his late teens. Second line, ?Counting bells knelling classes to a close?, the word `knelling` in that line is associated with funerals and death so we get the feeling that something might be wrong and gather a sense of foreboding at what is to come. The final line, ?At two o?clock our neighbours drove me home?, is unusual, why are his neighbours driving him home and not his parents? The question why are his parents driving him home this increases the sense of foreboding. Also there is falling rhythm in this stanza. In the second stanza, the line begins, ?In the porch I met my father crying?, and this confirms to the reader that something is wrong, that something tragic has happened. The second line mentions that he takes `funerals` in his stride, so that says to me that he?s attended quite a lot of funerals even though he?s not that old. The final line, ?And Big Jim Evans saying it was a hard blow?, leads me to believe that Big Jim Evans is a close friend and also that he is quite large suggested by the adjective `Big` to descri... ...o poems `Mid-Term Break` and `Digging` are both good poems, which are both about families. `Mid-Term Break` is about when he leaves college and returns home to find out the news about his little brother. `Digging` is about his grandfather and how he?s getting old and finding work difficult, so both poems are about family, but quite different circumstances. The layout of the two poems is very different. `Mid-Term Break` being very straight forward, just having three lines to each stanza and `Digging` being completely opposite and following no strategic pattern. Overall I think that `Mid-Term Break` is a better poem, as I find it more serious and was personally more effective by this poem due to it being quite sad talking about his brother and that last line, ?A four foot box, a foot for every year?, which is a very emotional last line to finish a poem.

Sunday, August 18, 2019

Affirmative Action In The United States :: essays research papers

The writer Mary Anne Warren is focusing on describing the current practices in many organizations today in regards to the implementing a goal vs. a quota system for the purposes of affirmative action. She defines a quota as "Those who use the term "quotas" pejoratively tend to assume that the numerical standards will be set so high or enforced so rigidly that strong reverse discrimination-that is, the deliberate hiring of demonstrably less well qualified candidates-will be necessary to implement them." (Warren, 370). Warren then describes goal as "The term "goal", on the other hand, suggests that this will not be the case, and that good faith efforts to comply with the standards by means short of strong reverse discrimination will be acceptable." (Warren, 370). The critical thing that must be understood when exploring the subject is that the writer is describing how affirmative action is being applied in American organizations today in other words the current reality. However, she fails to speak to us about how the law designs this program to function. This is the critical component that American organizations must be educated to understand. Affirmative action as defined by law is most definitively not based on a quota system. In fact, what is not widely known is that this program can be equally used by all individuals provided that an inequality exists in the group that they belong to as not being reflected in the work force. So what is affirmative action? What is it designed to do? It is not designed to provide an opportunity to an unqualified candidate. It is designed as "a way of compensating individuals or groups for past injustices or for present disadvantages stemming form past injustices" (Warren, 373). It is further designed "as a means about bringing about further future goods-for example, raising the status of downtrodden groups." (Warren, 373). The keyword in these quotes is the word "group". Who are these groups? The law has identified them. Some of the groups identified are: race, religious beliefs, blood trait, gender, disability (whether physical or mental), veteran status, national origin, and the list continues. In no way does this require that you have to hire an unqualified person for a position because they fall into one or more of these groups. What it does mean is that you can not discriminate and exclude a person from getting a job, getting promoted, and other factors, just because they happen to fall into that group.

Ghost Stories Essay -- Literary Analysis, James, Gothic Tradition

Ghost stories are a truly timeless form of literature, the ghost, like death, has no end. Stories of the supernatural date back to early ancient manuscripts involving mythology, legend, and religion. The past few centuries have seen the supernatural flourish in Gothic romanticism through tales of fantastic creatures, demonic forces, and parallel dimensions (Scarborough). Interest in the immaterial has provoked many stories involving the interaction between the living and the returned dead. The well-engineered ghost stories of M.R. James encompass these settings and satisfy the appetite for eerie skin tingling reactions. James's narrative technique and folkloric superstitions in â€Å"the mezzotint†are aimed at involving and engaging the reader's awareness, imagination, and psyche. The realistic settings, supernatural elements, and sensational fiction that is doused in mystery, builds anticipation. James's clear an intelligent knowledge of human nerves elicits fear, excitement, and curiosity through imagery, the uncanny, and subtle suggestions that transform into personal supernatural experiences. The oratory nature of James's stories bring the characters and the drama to life and elevates fear in the reader with â€Å"disembodied texuality . . . fearing that these words on the page might spring to life† (Mulbey-Roberts 236). In contrast to supernatural Gothic tradition, James's short stories shy away from the elaborate romanticism and concentrate on basic elements of fear such as realism and victimization. The narrative style of James's â€Å"The Mezzotint† is similar to the original delivery of his ghost stories. With elements of direct speech, and candid conversation, the narrator awakens the readers awareness by controlling and regulating... ...rom the fear continues as the narrator states that the picture still hangs in the Ashliean Museum. James employs many techniques when he engages the reader. What is especially fascinating is that he makes it look effortless and the approach effectively intrudes upon the reader's emotions. The literary devices and compelling use of narrative works in unison to provoke fear, anxiety, and terror. In truly timeless tradition, James's ghost stories solicit eerie, supernatural settings that entice the reader into a realm of horror. James's well crafted encounters victimize the reader by invading their consciousness and imagination; while using realistic settings and believable characters he builds a rapport with the reader and uses it to his advantage. James is a master in his artistry and his stories will continue to be frightening for generations to come.

Saturday, August 17, 2019

Kitchen Best

Grade: 84/100 87/100 Challenges: 16/20 Causes: 16/20 PoA: 20/25. Be more specific Research: 20/20 Writing: 12/15. Work to organize your paper more concisely and coherently with more effective headings/subheadings/visual aides Grade update: I added 3 more points to make this section 15/15 based upon your re-draft.? Henry Chan, who is the CEO of Kitchen Best, has set some ambitious targets for the business in 2008. However, his plan suffered a setback when a series of crises happened in 2010.These incidents involved in serious management problems such as personal gains made at the expense of the company and kickbacks offered and accepted between Kitchen Best and its partners. Symptoms Deep rooted practices of kickbacks, bribing and corruption: Accepting kickbacks, bribing and corruption were common in business dealings of kitchen best. Chan dong, founder of kitchen best treated his employees as family, and turned blind eye on any such practices as long as they were helpful in business expansion.But later when Henry Chan took over the business, a series of incidents had led him to take a deeper look into the company and uncover serious instances of misconduct. Unethical means followed by kitchen best’s most trusted employee: The shago incident : Horatio Sze : Sze awarded the contract to a factory owned by his brother in law, for his personal gain. Knowing that the products were faulty, he hasn’t taken any remedial action or cancel the contract. Macy wei :Having known that the products showed faulty in the in-house testing and Sze’s negligence towards this for his personal gain, she hasn’t reported it to the higher management, considering the good relation between Sze and Li. Ignorance of Henry and Ma luk : Sze reported directly to Ma Luk. Neither Ma took the responsibility to enquire further on the issue, nor did Henry involve himself much in monitoring the decisions of sub-contracting made by Sze. Haus de metro :Henry Chan, after havin g learnt from an anonymous letter that a shipment for German retail chain HdM did not meet the company’s safety requirements, did not pursue the case any further for fear of losing the customer. Honghua appliances : Ma Luk: Ma has built good relations with Honghua’s general manager for greater china, through wining, entertainment, dining and offering kickbacks. But the changed management of Hanghua was strictly against these practices and reevaluated the competency of all its suppliers. So, kitchen best’s relations with Honghua were at risk.Also, Ma has misused the company expenses for his personal gain. Henry Chan: Henry Chan didn’t have much grip on the clients and relations with them. He was mostly dependent on the experience of the senior management, like Ma who were mainlanders, to build relations with the clients and customers and he saw such practices as inevitable part of Chinese business culture. Lack of well-designed financial policies: Kitchen best did not have any well-defined policies or guidelines to control the expenses for entertaining customers.Henry Chan’s Cultural barrier: Henry Chan found it difficult to deal with mainland customers due to his cultural barriers. He was born and brought up at Hong Kong, and had not much exposure to deal with the mainland customers. So he had difficulties to cope up with the business culture and dealings with mainlanders. He had to depend on senior management, hence had no proper grip on the business there. Causes: Unplanned/sudden shift in management: Kitchen best’s employees were not prepared for the sudden change in management from Chan dong to Henry Chan.Each of them had completely different managing styles. Chan followed a paternalistic managerial style, treating the employees as a family and maintaining good relations with them, while Henry followed the western style of management. This gave the employees a chance to misuse the liberty of taking decisions that w estern style invoked †¢ â€Å"In the west, the ideal boss is a â€Å"resourceful democrat†. He sets the vision and strategy for the business but empowers subordinates to execute. He encourages two-way communication with his employees and allows bottom-up input in decision-making. In China, the ideal boss is a â€Å"benevolent father†. He is like a parent (a Chinese parent, by the way) who supervises his children on everything that need to be done. He believes in discipline and attention to details and manages his people at a micro level. He also spends lots of time caring for the personal welfare of his employees and regards it as part of his job. † – reference; management style differences between china and U. S Author: Joy Huang Shift of focus on different set of customers: eastern and western management (business cultures)is for 95% the same and differs in every important aspect. †- Takeo Fujisawa (Honda) Kitchen best mostly focused on Asian market but Henry focused on extending the business to western customers. Till then the company had no experience with directly dealing with the customers of Europe and America, and hence has no grip over these regions. The dealings at mainland and decision making were completely left to trusted employees without Henry’s personal monitoring and they took advantage of it.Henry’s experience as compared to that of senior management: Henry’s experience was far less than most of the employees in senior management who have been working for the company from its very beginning. Employees like Ma, Sze were very much trusted by Chan dong and Henry couldn’t go completely against the practices they followed although they were unethical. Lack of control over decision making and financial management: Henry relied much on his senior management for decision-making. But unlike Chan, he did not involve himself much, in making important decisions in mainland business operat ions.Any other monitoring measures were not implemented in the company. Kitchen best did not have any well designed financial policies that checked the ineffective expenses like dining, wining or entertaining the clients. Employees faked invoices and used the expenses for their personal gains. This would have been controlled if there was frequent auditing. Henry’s cultural limitations: Henry was born and brought up in Hong Kong, studied at U. S. Although he had experience in marketing of electric and electronic appliances, it was the first time for him to work with kitchen best.He was not so familiar with the business culture of mainland nor did he have good relations with the mainland clients. He believed that some unethical practices were inevitable in Chinese business culture, so although determined to change these practices, he ignored some cases and hand not implemented strict measures to control them altogether. â€Å"Culture is more often a source of conflict than of synergy. cultural differences are nuicanse at best and often disaster† –Dr. Geert Hofstede Recommendations :A strong policy for internal contro l and financial management has to be designed and implemented. 2 months a strong policy †¢ to mitigate financial risks, continually asses new risks and minimize operational distractions to achieve the key results established in a commission's strategic plan †¢That should clearly and consistently maintain an internal control framework by developing a control policy and accompanying procedures that establish a commitment to reducing risk of loss and preserving commission resources.This document should briefly explain the objectives/goals of the commission, the ethical standard expected from employees, and the policies/procedures it is committed to adhering to in order to meet those objectives. Henry must first concentrate on getting a good grip on existing territory and then expansion of business to the west. Immediately 1-2 months †¢Henry Chan should start working more on the existing territory business operations, by involving himself in decision making, interacting directly with clients of mainland, rather than leaving it to Ma. Then strategically work on expanding direct business with the west, like getting to know the business culture and training a set of employees according to western business culture. Investigate and warn/ take disciplinary action Next one month †¢Ignoring the ethical breach of employees could lead to more corruption. Completing the investigation of cases and warning or taking disciplinary actions on employees responsible for it irrespective of their seniority could be substantial in reducing the corruption in business dealings.Set up a monitoring committee 15 days †¢Set up a monitoring committee that is headed by Henry, and includes legal , financial advisors of kitchen best, and auditing group. †¢This committee should constantly work on monitoring the activities, and flow of finance at different branches of the company Trial implementation of the policy made and make amendments if necessary 2 months †¢Implementing the designed policy for a period of two months and check for any loopholes, and make amendments if necessary. Managing the risk of fraud : The truth is you cannot defeat internal fraudsters if you are unfamiliar as to where and how they play their game of deceit and betrayal—you fail to know where your operation’s greatest risks and vulnerabilities are—or you fail to have enough knowledge to develop and implement a realistic anti-fraud action plan. † – reference book; business fraud – Jack L Hayes Ethics management : Keep the unique ethical climate of each market in mind when crafting your code of ethics to ensure that it is relevant to the international arena Apply standards equally in all markets, and among all subsidiaries.Stick to your standards, whatever they are. If yo u have a policy of following your home country's ethical standards around the world, be prepared to turn down opportunities in markets with unfavorable ethical climates. Make company-wide ethics training a regular activity, in addition to administering comprehensive ethics training programs for new hires. Use training sessions to highlight actual areas of concern in your organization, citing specific examples as often as possible. References Journal of Academic and Business Ethics: International Business Ethics †¢International Business Ethics Institute: Top Ten Mistakes References : http://www. f5ac. org/item. asp? id=3340 first five financial control guide; ch 6. Internal control http://www. slideshare. net/anandsubramaniam/cross-culture-east-west http://smallbusiness. chron. com/accounting-principles-general-financial-ethical-standards-36283. html http://www. copedia. com/internal_controls. html http://smallbusiness. chron. com/cultural-communication-barriers-workplace-13888. html