How Communication Affects Relationships Essay Example for Free

How Communication Affects Relationships Essay Communication affects relationships at work in a big way. Communicating in a positive manner will give me a very different response to communicating in a negative manner, it is also important that I alter the way i communicate dependant on who I am speaking to as everybody will respond differently to different styles and variations of communication. One of the parts of my job is to communicate with my colleagues. I must insure that as the environment I work in can and often is stressful, that I speak in a calm manner and that I am clear and concise. By doing this I lessen the chance of information that I passed on being misheard or misunderstood and by being calm I have a reassuring effect on my colleagues. When speaking to families of patient I must insure that I an understanding and come across friendly and professional as a good relationship with a patient’s family can have positive effects on the patients because it is important that families understand the patients treatment plan and how they can have positive influence on the patient. I must communicate with the patients in the most effective way possible. As a health Care worker I need to be able to build trust and a good relationship with those I look after. It is important that I use variation of communication skills to relay what I am trying to get across, this will help the patient understand what is be communicated and in turn will help the patient communicate there needs.

How health care has changed Essay Example for Free

How health care has changed Essay With about 10 years of experience, as a secretary, in healthcare industry, I’ve noticed a multitude of changes within the medical field. On many levels, the medical system has changed, from paper charts to computerized patient files, the way prescriptions are handled and distributed, to file and/or medical documentation; even the paging method has found its place in a new technical era. Email, and employee intranet, has made communication between employers and employees, department to department, even employee to employee much easier and effective. The only thing that hasn’t made too much of a noticeable change is the employee time clock, and even that has managed to find itself an upgrade. Nonetheless, a host of inevitable changes, given the social status of technology, and the best service available by healthcare standards and expectations, it’s easy to see where the future of healthcare and technology lie. Given the past 10 years, technology has gained its own credit in the advancement of the medical industry. Robots have become the gateway to a better healthcare. I feel that within the next 10 years, we’ll begin to see a great deal of technical influence. In a field, where there are already advancements in technology, and its uses, it is fair to say that we could gradually become an almost ‘hands free’ industry. Medical advancements, in general, seem to have been primarily in the use of technology, and/or going green. Therefore the next 10 years, may still prove to be a breeze for the development of a relationship between medicine and technology. Even from my position, the change has been constant and obvious. Having been a secretary, since high school, I am currently in pursuit of my associates in medical administrations. My contribution to the industry has always come through my capabilities with a computer, and over the phone. Staying technically savvy, certainly is carrying its perks in weight with me. Within my experience, the secretary is the ‘go to’ person to get something to work proper y, or for better understanding of a technical meltdown, and if not the person to fix it, certainly the person to find the one who can. From nurses, doctors, patients, and parents, the secretary is the most knowledgeable resource, with a friendly face. As secretaries, we practically hold the key within the medical field. Always there to offer a helping hand, we operate behind the scene in some cases, having my own experience of pulling off many last minutes miracles. In medical terms, we’re essentially the central nervous systems of any and many departments operations. Though, now, being on my path to higher learning, in addition to, my contributions are becoming much greater, and giving my future the fuel to go much further. Like many jobs, the growth of change is inevitable, so to make sure this change is effective; insuring that employees are kept up to date with the latest in changes, adjustments, and updates is key. Having worked within the healthcare industry, I’m aware of the time and efforts invested into insuring that their employees are knowledgeable and capable of managing through company changes. I’ve had the opportunity to take a course or two, in order to insure I’m working at my fullest potent; cardiopulmonary resuscitation (CPR) courses, to employee safety/self defense classes, system program changes, and new program usage. With my efforts, and the aid of my employers, my skills will remain polished and productive. Putting forth my best efforts and keeping the thirst for being successful in all my endeavors, along with the assistance provided through my employer; I will always be able and capable to perform all duties expected of me. With the growth of the medical industry, its employees have to be resourceful and reliable. Furthermore, within this growth, my perceptions haven’t changed, more they’ve evolved. The time within my courses have given me the opportunity to research and better understand the work and efforts that go into running a successful medical establishment. Watching the change over the past decade, leaves me no choice, and certainly gives me the advantage at being a highly adaptable candidate within my position. Growing with the industry, as a secretary I’ve learned so much, and watched a lot change for the better. In turn, my perceptions remain optimistic about the direction myself and healthcare or headed in. In a nutshell, any perception of an ever changing industry is certain to change. In any case, healthcare is changing for the better and the sake of providing the best, quickest, most effective ways to treatment and cure. In a sense, this change is creating a glimpse in the future of healthcare along with its and human longevity. With the healthcare industry taking on the demands of a modern day society, technology has a great deal to do with its future. Technology is set to play such a huge role in the development of healthcare. With the demands on the healthcare industry to offer the most effective methods of diagnosis, and treatments, along with healing time, the approach to technical advances are highly beneficial. Androids that perform, and aid in performing surgeries, the development in medical equipment and their advances/upgrades, the renewal of how patient charts are stored are all evolving, along with many more aspects of the medical industry. Leaving such a wide variety of development in just about every department, looking into the next 10 years of medicine vs. technology, the combinations are endless and sure to be exceptional. Though, with any development and need for change, there’s a cost to be paid. Given the state of a slowly stabilizing economy, the future of all the developments depends on the availability of funds, and people in need of care. Though, very beneficial, the cost of accurate medical attention can come at a higher cost, and at a time when finances are scarious and rising, some are unable to afford the best in healthcare. With the benefits of insurance, there is still only so much that can be covered.

Neurobiological Mechanisms that Cause Aggression

Neurobiological Mechanisms that Cause Aggression Review of the Neurobiological Mechanisms Which Underpin Reactive Aggression in Humans: a Closer Look at Monoamine Oxidase A (MAOA) Module 1: Prosocial and antisocial behaviours across the lifespan Violent acts have a significant toll on human societies: annually over 1.6 million deaths worldwide occur due to human violence (Viding Frith, 2006). Although acts of aggression have an important adaptive purpose, when overexpressed, they may result in destructive consequences. Conventionally, aggression has been defined as an intentional action with a purpose to inflict physical damage on another individual (Nelson Trainor, 2007). Currently two forms of aggression have been recognized in humans: controlled aggression instrumental subtype, and reactive aggression impulsive subtype (Vatiello Stoff, 1997). Instrumental aggression, also referred to as premeditated and predatory, is generally planned and goal-oriented and has often been linked to psychopathy (Blair, 2001). This kind of aggression is thought to be regulated primarily by higher cortical systems and is characterized by diminished amygdala response (Nelson Trainor, 2007). Reactive aggression on the other hand, is depen dent on the limbic and hypothalamic systems, and is characterized by high autonomic arousal (Siever, 2008). Impulsive aggression generally represents a direct response to stimuli and accounts for the majority of violent acts. Individuals with borderline personality disorder, intermittent explosive disorder, or ADHD are particularly prone to reactive aggression and impulsivity. Previous research on the neurobiology of aggression pointed out that for such individuals, repetitive acts of aggression are often influenced by the underlying neurobiological susceptibility (Nelson Trainor, 2007). Indeed, one remarkable feature of aggression is its apparent heritability. Twin and adoption studies suggest that genetic factors account for between 40% and 50% of population variance in risk of antisocial aggression (Buckholtz Meyer-Lindenberg, 2008). However, the relationship between aggression and the underlying neurobiology is far from being simple (Nelson Trainor, 2007; Siever, 2008). Previous research in individuals prone to impulsivity and reactive aggression as well as a number of studies based on animal models identified numerous genetic loci and neurotransmitters associated with reactive violence, including, but not limited to, Dopaminergic genes (DRD4, DRD5, and DAT1), Serotonergic genes (5HTT, HTR1B), and genes responsible for encoding enzymes involved in regulating the levels of these neurotransmitters, particularly catechol-O-methyltransferase (COMT), and Monoamine Oxidase A (MAOA), often referred to as â€Å"the warrior gene†. However, the association between genotype and phenotype of aggression is only beginning to be properly understood (Caspi, McClay, Moffitt, Mill, Martin, Craig, Taylor, Poulton, 2002; Nelson Trainor, 2007; Siever, 2008). While there have been many studies showing the association between different genes and aggression, results were often mixed and inconclusive. Currently, the best candidate gene with the most supportive evid ence appears to be Monoamine Oxidase A (see: Brunner, Nelen, Breakefield, Ropers, van Oost, 1993; Byrd Manuck, 2014; Cases, Seif, Grimsby, Gaspar, Chen, Pournin, Muller, et al.,1995; Caspi, et al., 2002). The MAOA gene, located on the X chromosome, is a functional polymorphism with high activity (MAOA-H) and low activity (MAOA-L) variants, which encodes the MAOA enzyme, responsible for breaking-down neurotransmitters such as serotonin, dopamine, and norepinephrine (Shih, Chen, Ridd, 1999; Viding Frith, 2006). Previous research using animal models as well as humans demonstrated an association between aggression and genetic deficiency in MAOA activity (Rowe, 2001). Transgenic mice without the gene encoding MAOA had higher amounts of brain serotonin (5-HT), dopamine (DA), and norepinephrine (NE), and displayed increased aggression (Cases, et al., 1995). After restoring MAOA activity, mice aggression was stabilized (Shih Thompson, 1999). In humans, point mutation in the MAOA gene led to MAOA deficiency and was found to be associated with reactive aggression in several men from the Dutch family. Moreover, across generations, these men with MAOA knockout also showed frequent violent outb ursts, particularly in response to mild provocation, and impulsive antisocial behaviour such as assault, rape, and attempted murder. (Brunner, et al., 1993). This condition, however, is quite uncommon and is unlikely to explain much variation in human violence and aggression. Findings of the studies that only looked at levels of MAOA activity and antisocial outcomes in adulthood have been mixed and thus problematic to interpret since both MAOA-H and MAOA-L were linked to reactive aggression (Ficks Waldman, 2014; Nelson Trainor, 2007; Siever, 2008). The study that produced very robust findings in that area and has later proven seminal was conducted by Caspi and colleagues (2002). This study was the first to look at the effects of MAOA activity in combination with childhood maltreatment on reactive aggression in adulthood. Indeed, adverse childhood experiences were found to affect the development and functioning of neural pathways involving the neurotransmitters metabolised by MAOA which can potentially result in increased aggression (Caspi, et al., 2002). Thus, Caspi and colleagues (2002) hypothesised that childhood maltreatment can predict reactive aggression in adulthood, and that this relationship is moderated by levels of MAOA expression. Results of this study demonstrated the dose-response effect of childhood maltreatment on the aggressive behaviour in adulthood, which was consistent with prior findings. However, this effect was much smaller in participants with the high-activity version of the MAOA gene as compared to men with low MAOA activity, suggesting the protective property of MAOA-H (Caspi et al, 2002). Moreover, as levels of maltreatment increased, so did the protective effect of the MAOA-H variant. A low-activity MAOA gene combined with a history of childhood maltreatment increased the risk of aggressive behaviour in adulthood sevenfold. These results supported the predicted hypothesis that MAOA activity would act as a moderator of the effects of childhood maltreatment on antisocial outcomes in adulthood. This study paved the way to a number of subsequent studies looking at gene and environment interaction. A recently published meta-analysis, which looked at 27 peer-reviewed studies on adverse childhood experiences, MAOA genotype, and aggressive and antisocial behaviour showed that results across 20 male cohorts (11064 participants) were largely consistent with findings from the original study by Caspi and colleagues (2002) (Byrd Manuck, 2014). These findings remained robust even after removing each study individually. However, the question remains, how does low activity MAOA gene in combination with childhood stressors translate to antisocial behaviours in adulthood? Several theories have been proposed to answer this question. On one hand, the association between low activity MAOA gene and aggression appears paradoxical, since MAOA-L leads to increased levels of serotonin, which has been found to be positively correlated with impulse control and negatively correlated with aggression (Manuch, Flory, Ferrell, Mann, Muldoon, 2000; Siever, 2008). However, MAOA also plays a role in regulating dopamine and norepinephrine, which were shown to lower thresholds for violent response to perceived threat (Manuch, et al., 2000). High levels of DA and NE, resulting from MAOA dysfunction, would activate a fight or flight response, and indirectly enhance aggression (Volavka, Bilder, Nolan, 2004). Indeed, previous studies showed a similar association between COMT gene (also responsible for breakdown of NE and DA ) and aggression (Siever, 2007; Volavka, et al., 2004). Therefore the elevated levels of NE and DA, due to low expression of MAOA, would be consistent with the results of previous studies, showing an association between low activity MAOA gene and aggression. Nevertheless, this theory does not account for the role of childhood maltreatment on aggression, and as it was mentioned previously, results of studies looking solely at MAOA activity and aggression are mixed and inconclusive, showing both high and low activity MAOA gene being associated with impulsive aggression (Ficks Waldman, 2014; Nelson Trainor, 2007; Siever, 2008). Another theory that sheds more light on the mechanism through which MAOA deficiency in combination with childhood maltreatment influences aggression in adulthood relies on the findings that high concentrations of intracellular serotonin have been associated with increased reactivity to stress and elevated anxiety (Seif De Maeyer, 1999, Viding Frith, 2006). Therefore, it is possible that MAOA deficiency might predispose individuals to neural hyper-reactivity to a threat (maltreatment). While genetic predisposition alone rarely results in adverse outcomes in adulthood, when combined with childhood stressors, it might potentially have consequences on brain function (Meyer-Lindenberg, Buckholtz, Kolachana, Hariri, Pezawas, Blasi, Wabnitz, et al., 2006). Previous findings in populations prone to impulsive violence demonstrated functional and structural abnormalities in brain areas associated with perception and regulation of emotions, particularly in the amygdala, orbitofrontal cortex, and the interconnected regions (Davidson, Putnam, Larson, 2000). Neuropsychological functions associated with these brain regions were also compromised in the aforementioned populations (Blair, Peschardt, Budhani, Mitchell, Pine, 2006). Previous work using animal models and clinic samples seems to suggest that maltreatment negatively affects the functioning of the neural structures involved during an individual’s reaction to threat (i.e., pariaquaductal gray and amygdala) and the regulation of the triggered threat response (i.e., orbitofrontal cortex and anterior cingulate). Therefore, the genetic risk (MAOA-L) along with childhood maltreatment may result in changes to brain function, and subsequently increases the risk of impulsive aggression (Viding Frith, 2006). These speculations imply that there is no one clear explanation for the findings we currently have regarding genetic variation and its effect on aggression. The human brain and the effects of genetic and environmental factors on its development are too complex to assume that one specific gene, or neurotransmitter levels are responsible for aggression. More likely, it is the gradual change in neural pathways that regulate aggression. As of this moment, it still remains unclear if aggression in adulthood that is observed in many of the aforementioned studies is due to developmental change in neural circuits or to a change in neurotransmitter function. Moreover, the effects of these changes for adults are very different than for children. Therefore, it is possible that low MAOA activity resulted in compensatory changes which transformed the organisation of the nervous system in children during the sensitive period of brain development, and was later reflected in antisocial outcomes in a dulthood (Lesch Merschdorf, 2000). Attempts to replicate Caspi et. al. (2002) findings in female populations yielded significantly different results. Recent meta-analysis that looked at 11 studies with female samples produced inconclusive results: even though MAOA activity had a significant association with adverse childhood events, high, as opposed to low, MAOA activity in combination with childhood maltreatment was associated with antisocial behaviour in adulthood. Moreover, this interaction was weaker, and after removing a few individual studies, it lost its significance (Byrd Manuck, 2014). Replicating Caspi and colleagues’ study using female cohorts has proven to be significantly more complicated for two main reasons. First of all, dividing females into two groups based on MAOA activity is challenging due to uncertain inactivation of heterozygous alleles. Secondly, severe personality disorders and antisocial outcomes are quite rare in women, thus it is difficult to get a large enough sample to demonstrate dose-response relationships. In sum, taking into account findings from previous studies it is unclear what relationship MAOA activity plays in antisocial outcomes in women, and calls for further investigation (Caspi, et al., 2002; Byrd Manuck, 2014). In attempts to understand the relationship between genes, environment, and aggression, the study by Caspi and colleagues (2002), as well as numerous studies that came out afterward, certainly advanced our understanding in the field. However, it is important to point out the limitations that characterise many of the research studies investigating the relationship between gene-environment interaction and adult antisocial behaviour. First of all, lack of published articles reporting null findings due to publication bias still remains a big problem in the field. As a result, published findings seem more robust than they actually are (Duncane Keller, 2011). Secondly, the samples of many studies, primarily those with female subjects, are often too small resulting in inadequate statistical power (Byrk Manuck, 2014). Indeed, negative findings had larger sample sizes compared to positive ones. These limitations make it difficult to correct for potential false-positive results (Duncan Kelle r, 2011). This is especially the case in replication attempts using female populations, and in neuroimaging studies. Finally, due to the difficulty recruiting participants for these studies, samples are often not easily comparable and consist of individuals with many comorbid psychiatric conditions, making it difficult to tease apart effects of certain genetic variations and maltreatment on specific psychopathology (McCrory, DeBrito, Viding, 2010). While there is strong evidence to suggest that genotype, particularly variants of the Monoamine Oxidase A gene, in combination with childhood maltreatment, plays an important role in reactive aggression in human adulthood, the exact underlying mechanism remains unclear. The aforementioned controversies call for caution when making any strong conclusions regarding the effects of genetic variation on antisocial outcomes. Further research, including longitudinal studies, genome-wide association studies, gene-environment-sex and gene-gene interaction studies, and neuroimaging studies, is necessary to better understand the underlying neurobiological mechanisms which underpin reactive aggression in humans. References: Blair, R. J. (2001). Neurocognitive models of aggression, the antisocial personality disorders, and psychopathy. Journal of Neurology, Neurosurgery and Psychiatry, 71, 727-731. Blair, R. J. R., Peschardt, K. S., Budhani, S., Mitchell, D. G., Pine, D. S. J. (2006). The development of psychopathy. Journal of Chid. Psychology and Psychiatry and allied disciplines, 47(3-4), 262-276. Brunner, H. G., Nelen, M., Breakefield, X. O., Ropers, H. H., van Oost, B. A. (1993). Abnormal behaviour associated with point mutation in the structural gene for monoamine oxidase A. Science, 262(5133), 578-580. Buckholtz J. W. Meyer-Lindenberg, A. (2008). MAO and the neurogenetic architecture of human aggression. Trends in Neuroscience, 31(3), 120-129. Byrd, A. L. Manuck, S. B. (2014). MAOA, Childhood Maltreatment, and Antisocial Behavior: Meta-analysis of a gene-Environment Interaction. Biological Psychiatry, 75(1), 9-17. Cases, O., Seif, I., Grimsby, J., Gaspar, P., Chen, K., Pournin, S., Muller, U., et al. (1995). Aggressive behaviour and altered amounts of brain serotonin and norepinephrine in mice macking MAOA. Science, 268(5218), 1763-1766. Caspi, A., McClay, J. Moffitt, T. E., Mill, J., Martin, J., Craig, I. W., Taylor, A., Poulton, R. (2002). Role of Genotype in the Cycle of Violence in Maltreated Children. Science, 297(2), 851-853. Davidson, R. J., Putnam, K. M., Larson, C. L. (2000). Dysfunction in the neural circuitry of emotion regulation- a possible prelude to violence. Science, 289(5479), 591-594. Duncan, L. Keller, M. (2011). A critical review of the first 10 years of candidate gene-by-environment interaction research in psychiatry. The American Journal of Psychiatry, 168, 1041-1049. Ficks, C. Waldman, I. (2014). Candidate Genes for Aggression and Antisocial Behavior: A Meta-analysis of Association Studies of the 5HTTLPR and MAOA-uVNTR. Behavioral Genetics, 44(5), 427-444. Lesch, K. P. Merschdorf, U. (2000). Impulsivity, aggression, and serotonin: A molecular psychobiological perspective. Behavioral Sciences and the Law, 18, 581-604. Manuch, S. B., Flory, J. D., Ferrell, R. E., Mann, J. J., Muldoon, M. F. (2000). A regulatory polymorphism of the monoamine oxidase- A gene may be association with variability in aggression, impulsivity, and central nervous system serotonergic responsivity. Psychiatry Research, 95, 9-23. McCrory, E., De Brito, S. A., Viding, E. (2010). Research Review: The neurobiology and genetics of maltreatment and adversity. The Journal of Child Psychology and Psychiatry, 51(10), 1079-1095. Meyer-Lindenberg, A., Buckholtz, J. W., Kolachana, B., Hariri, A. R., Pezawas, L., Blasi, G., Wabnitz, A., Honea, R., Verchinski, B., Callicott, J., et al. (2006). Neural mechanisms of genetic risk for impulsivity and violence in humans. Proceedings of Natlional Academy of Sciences of the United States of America, 103(16), 6269-6274. Nelson, R. J., Trainor, B. C. (2007). Neural mechanisms of aggression. Nature, 8, 536-546. Shih J. C. Thompson, R. F. (1999). Monoamine oxidase in neuropsychiatry and behaviour. American Journal of Human Genetics, 65(3), 593-598. Seif, I. De Maeyer, E. (1999). Knockout corner: Knockout mice for monoamine oxidase A. International Journal of Neuropsychopharmacology, 12, 241-243. Shih, J. C., Chen, K., Ridd, M. J. (1999). Monoamine Oxidase: from genes to behaviour. Annual Review of Neuroscience, 11, 197-217. Siever, L. J. (2008). Neurobiology of Aggression and Violence. American Journal of Psychiatry, 165, 429-442. Vatiello, B., Stoff, D. M. (1997). Subtypes of aggression and their relevance to child psychiatry. Journal of American Academy of Child and Adolescent Psychiatry, 36, 307-315. Viding, E. Frith, U. (2006). Genes for susceptibility to violence lurk in the brain. Proceedings of the National Academy of Sciences of the United States, 103(16), 6085-6086. Volavka, J., Bilder, R. J., Nolan, K. (2004). Catecholamines and aggression: The role of COMT and MAO polymorphism. Annals of the New York Academy of Sciences, 1036, 393-398.

William Faulkner Essay -- Biography

The South is known for its many astounding artists, novelists, and writers; however, William Faulkner is uniquely categorized by many as one of the most influential writers of the twentieth century. Faulkner became known for his diction and literary techniques. William Faulkner chronicled the history of Mississippi: however, his choice of universal themes made him a literary giant around the world. Faulkner achieved many great accomplishments without a high school diploma or college degree. Faulkner had proved to the world that Southern writers were not as substandard as many viewed them to be. They were, in fact, quite phenomenal. William Faulkner born on September 25, 1897 to Murry Cuthbert Falkner, a railroad employee and Maud Butler, an amateur painter (Minter, 755). Faulkner was born in New Albany, Mississippi ; however, he spent most of his life in Oxford, Mississippi (Polk, 55). In Oxford, Faulkner began listening to many stories told at small family gatherings as well as large reunions. Many stories told by Faulkner’s family originated from adventures of Faulkner’s great-grandfather, Colonel William Clark Falkner . Since Faulkner was disappointed and embarrassed by the meager success of his own father, he drew closer to his grandfather, but it was his great-grandfather who he saw as a model and rival ( Minter, 755). Faulkner was an excellent student throughout the first several grades; however, he quit school in 1915 without a diploma disappointing his family. Even though Faulkner dropped out of school, he read avidly (Minter, 755). Faulkner made a habit of hanging around places where people gathered to swap tales ; After Faulkner began writing about north Mississippi , a friend remarked that, â€Å" he seemed to know e... ...y two of his novels received Pulitzer Prizes. In 1924 Faulkner received the Nobel Prize for literature for his unique contribution to the modern American novel. After Faulkner donated his Nobel winnings to establish a fund to support and encourage new fiction writers, the PEN/Faulkner Award for fiction was established. Whenever Faulkner’s involvement in the early phases of the civil rights movement evoked, he and Estelle moved to Charlottesville, Virginia , where Faulkner became writer-in-residence at the university of Virginia (minter, 760). In conclusion, William Faulkner, the Southern writer , Nobel and Pulitzer prize winner, sweep the nation with his diction and literary techniques. With his fictional stories he laid literary hands on Mississippi and narrated the universe throughout its culture. His universal themes made him a literary giant around the world.

A True Code Hero :: essays research papers

Hemingway a bright and simple man. A man who writes stories with characters who control their emotions or don’t complain about what’s going on in their life, other wise know as being stoic. People who seem to come to life when they show grace under preasure, have dignity for themselves and are committed to play by the rules. Four characters of Hemingway who show and have all these traits other wise know as the code of honor are Manuel Garcia, Francis Macomber, Ole Anderson, and an Old Waiter who is unnamed.   Ã‚  Ã‚  Ã‚  Ã‚  Manuel Garcia is a man who enjoys bullfighting. He tries to convince others as well as himself that he’s still an incredible bullfighter. He’s given a chance to prove himself worthy by a little man named Retana. When Garcia is given this chance he takes advantage of it and asks Zurito, an old friend and skillful bullfighter if he will â€Å"[pick] two bulls for [him] tomorrow night,† (The Undefeated). Zurito is persuaded to pick two bulls for Garcia, but Zurito explains that â€Å"if [he] [doesn’t] go big tomorrow night [he’ll] quit,† (The Undefeated). Garcia has shown that he has the courage to bullfight once more despite his age. The day Garcia has been waiting for came; the bullfight that will determine whether or not he’s as good as he says. He enters the arena confident, but not all goes as he had planned. As the bull fight begins Garcia’s sword flies from his hand and is thrown into the audience. Garcia looks around for his sword, only to have it thrown at him. Despite another misfortune, this code hero keeps his grace under pressure when cushions and the sword are thrown at him by thanking them and bowing. This also shows that he is stoic by not showing others what he truly feels in his heart, sadness of being beat. Towards the end of the story, when the doctor is tying to rehabilitate Garcia, he keeps his dignity by saying he was good out there â€Å"[he] [just] didn’t have any luck was all,† (The Undefeated).   Ã‚  Ã‚  Ã‚  Ã‚  Francis Macomber is another man who held the code of honor, though it might seem so at first. Macomber and a hunter by the name of Robert Wilson are out hunting, when they encounter a furious lion. A lion that frightens Macomber, which makes him unable to react to shoot the lion.

Lean Thinking and Accounting Issues Essay

Womack and Jones (1990 1-6) famously used the term â€Å"lean† on Toyota Motors Corporation referred to Toyota Production System (TPS) in the book The Machine That Changed the World. In the year 1990, the two authors toured various companies in North America, Europe and Japan advocating for companies to convert their mass production practices to lean practices, through presentation of ideas on how to do the same. A movement of management thinkers then emerged which clearly advocates for organizations to identify and if possible completely cut the huge wastes found in mass production. Lean movement supporters opine that forecasts are always wrong, and therefore they advocate managers to work to reduce order-to-delivery time. They also say that there are no more powerful tools available to companies for eliminating waste and creating value than lean ideas, according to Marchwinski and Shook (2003 21-23). Lean Manufacturing; Toyota Motors Corporation Case Toyota Motors Corporation is the most notable successful company in implementation of lean thinking. As a matter of fact, the motor vehicle maker is often used a reference in studying the operations and triumphs of the Lean Thinking management concept. The company introduced the concept of lean manufacturing in its now famous production system, the TPS (Toyota Production System) in the 1980s. The introduction of the concept of lean manufacturing was a move against the grain of the day as the trend of the day by companies was mass production, as Womack and Jones (1996 82-83) mentioned in their book. Toyota Motors Corp became very successful in the wake of implementation of this shake-up in its processes as to become the largest vehicle manufacturer in the world. One important section where lean thinking was applied by TPS is in processing method. A batch-and-queue system was converted into to a continuous flow, which had the effect of doubling labor productivity, cut 90% through output time, reduced injuries and cut errors by fifty percent. The introducing a lean manufacturing strategy was brought about by the need to eliminate the huge waste that the company’s chief executive Ohno (1988 17-31) had observed in the production processes of the company, which he pointed out as to be in the processes of Inventory, waiting, transportation, overproduction, over-processing, motion and over-processing. Lean Principles; In lean thinking, the first step to understand what lean thinking is and the resources-together with the activities- that are necessary in creation of that value. Everything else becomes waste once value is identified. The job of determining what value is and what activities add value should be done at a high level, because nobody would want to consider what he or she does as waste. If any breakthroughs are to be made in lean thinking the ability to see waste should be strong. Something is waste if it does not add value directly. A Toyota Executive, Taiichi Ohno, identified and described the following seven as the types of wastes that are found in any process: Inventory, waiting, transportation, overproduction, over-processing, motion and over-processing. Some authors have added goods and services that do not meet customer’s needs and underutilization of people. There are five lean principles; Value: This principle deals with the value that an organization offers to its clients. It is the complete package of services and products that a business enterprise makes use of to serve its customers and penetrate the market from the angle of view of the clients. Only the ultimate customer can define value (Womack and Jones 1996 218). In line with accounting practices, for instance target costing approach, the price the client is willing to pay is a reflection of the value he derives from the product/service. In turn, the value translates to the service and product costs the enterprise must achieve for the clients as well as the stakeholders to be satisfied. Value stream: It reckons that the processes of an enterprise crate customer-driven performance as well as excellence. The structures of conventional departmental controls contravene lean thinking as it was it posited by Poppendieck (2002 1-2). A business enterprise must comprehend, control and manage its operations through the value steams or processes of the enterprise. In manufacturing companies, there are three top-level value streams; the design and problem solve value stream, the value stream of the product, and the value stream that encompasses the enterprise’s controls and transactions. These value streams more often than not extend to cover entities outside the enterprise such as suppliers, partner firms and the customers. In general terms, all the actions that are required to bring a product to the customer are what are referred to as the stream values. Flow: The ideas connected to â€Å"flow† have their origins in the Toyota Production System. The lean movement is of the stance that anything that interferes with the flow of services as well as goods out to the customer through the value stream should be designated as waste. The value stream must be studied by an enterprise in order to achieve smooth, uninterrupted flow from production materials to delivered services and products. In this way, an enterprise ruthlessly, eliminates waste from its processes.

Grand Canyon University Essay

I look forward to getting the best out of this online nursing program from Grand Canyon University and come out a better nurse equipped with the skill and the knowledge that I need to meet with the challenges in today’s healthcare system. My greatest fear is time management. Time management is very important in any area of life as success and failures are built upon it. It is a big responsibility to juggle school, work and family all at the same time. Working five days a week, two different hospitals, twelve-thirteen hour shifts in high stress intensive care environment, then try to find quality time to spend with family and fulfill your responsibility as a parent puts you in a high stress mode environment. As a parent you do not want to ignore your responsibilities. Since I have been residing in the states I learned that you can not manage time, you manage the events in your life in relation to time. . And how you use that time depends on your skills you learned throughout self analysis, self planning, self evaluation and self control. So , My plan to overcome this fear is to be organized from day one which involves from the beginning to know my weekly schedule and all the required assignments and tasks that are due. I will also allow myself enough flexible time for any unforeseen or unexpected circumstances that might come up along the way. I already planned to cut my work schedule to four day where I can concentrate on my academic requirements. Specific educational experience I encountered here was when I started nursing school; I have major anxiety of test taking. My first step was to meet with my instructors after class and tell them about my problems. Second step I had to explain how I chose the answer to a particular question during test taking since English is not my primary language. Besides meeting with my instructors I had to utilize the learning resources available at the college and attend series of classes for international students. I even took English as a second language courses in the beginning. My family has and always been a huge support in my life. They were 100% understanding and supportive in every aspect of my academic requirements. All these resources helped me overcome and achieve good grades at the end and graduate from nursing school.