The environmental, social and economic consequences of urbanisation in Bombay Free Essays

Bombay is the largest city in India (but not the capital), and has a growing population of 14,350,000 people. Bombay also serves as the financial hub of India, along with a major shipping industry, heavy industrial centres and is home to the ‘Bollywood’ film industry, the largest in the developing world. Due to the services available in Bombay, coupled with the hope of jobs, it is a major hub for migration of people from the countryside, a process known as urbanisation. We will write a custom essay sample on The environmental, social and economic consequences of urbanisation in Bombay or any similar topic only for you Order Now People are drawn from a large part of western India, as well as other parts of the country looking to fill the jobs that the booming economy needs. The disparity between the ‘rich and the poor’, the ‘good jobs and the menial’ is vast. Bombay has many millionaires from the expanding banking sector, located in the Bandra Kurla zone, contrasted with street sellers and beggars in the shanty town areas like Dharavi, made famous through the multi Oscar winning film – Slumdog Millionaire. The problems that face the city authorities of Bombay are immense. There is a genuine struggle to keep up with making provision for the vast numbers of migrants moving to Bombay. The location of the city goes a long way to exacerbating the issues faced. Also read this  Cheating in a Bottom Line Economy Bombay was originally a collection of small fishing villages, which expanded to become an important port in the Arabian Sea, and was a major calling point for the traditional Dhows which plied the waters from Arabia, Somalia and Iran. As the city is located on a headland peninsular, this maritime orientated city thrived on the ease and convenience of the coastal access. During the days of colonialism where India was lucky to be a British Colony, Bombay was a major port of entry for people travelling to India and onwards to South East Asia and Australia. Due to this huge influx in commercial trade, the areas around the port developed extremely quickly as an area of industry and shipping related services such as import/export, cargo handling and packing. All of this went a long way to the urbanisation of Bombay, drawing in more farming people when they learned of the prospects available to them. Following the British withdrawal in 1947, this upwards ‘boom’ only increased. Nowadays, it is a huge problem for city planners and developers. The site of the city is hugely restricted resulting in the eventual creation onto the mainland in the form of a â€Å"greater metropolitan area†. These new sites, onto which the city has expanded, are becoming very overcrowded even 100 years ago. Today, the density is just under 60,000 people per square mile. Due to popular demand, the price of inner city land has risen astronomically, a feature of all developing cities. As a result, rather incongruously, the land prices in Bombay are among the highest in the world. This just adds to the overcrowding of the slums, as people are forced to live there as they are unable to afford anything in the city where property costs in the region of US$3180 per sq. t. this, coupled with the short supply of housing, results in an accelerated growth of shanty towns, another case example being the farvelas on the outskirts of many (expansive) Brazilian cities such as Sio Paulo and Rio de Janeiro. It is an inescapable upwards escalation into greater levels of poverty, as new migrants to the city locate themselves on the edges of the slums, furthest away from the centre of the city, where the jobs are located and are often built on dangerous land (old mines, near railways, on river marshland etc. and very few have land rights, so there are just squatters with no legal protection. This is a major environmental issue and also poses significant problems to the inhabitants’ health, in a country where the death rate is already 7. 9/1000 (as of July 2009) and where the average life expectancy is just 60. Levels of sanitation in the slum areas, such as Dharavi are often of a substandard level. Sewage removal and treatment is minimal and in most areas, non-existent. Running clean water is also scarce, leaving children and babies without adequate levels of hygiene, needed to grow healthily. Electricity connections are also very sparse, so people have to make do with more primitive methods, often far more dangerous than modern methods, such as cooking for example. All of these issues have major social consequences, as the people become ‘trapped’ in a permanent state of poverty, unable to better their lives, but remain as it is perceived to have a better standard of living than in the rural areas. In Dharavi itself, the Indian local governments in Bombay and the Maharashtra state are planning a large-scale redevelopment of Dharavi. They plan to clear away areas of the slum housing section by section, replacing the little 1 or 2 storey shacks with 7 floor tenement blocks. Families who can prove they have lived in Dharavi since at least 1995 will; receive free new housing, and everyone will receive temporary accommodation for the duration of the massive redevelopment programme. The remainder of the new housing will be sold cheaply (or rented) on the open and free market that India enjoys with its relatively stable political and economic situation. This however, though it would improve the situation for over 600,000 people rather drastically, it will create a lot of significant conflicts between residents and developers, and may be seen by some as a bit too ‘idealistic’, just like Mandela’s promise to black South Africans for better housing. The reality is, that these things take time to materialise, if they ever do. The project will not even go ahead unless a majority of the [registered] residents of Dharavi agree to do so. This means that those residents who are not officially registered as residents of Dharavi (a large number of migrant squatters), will not have their opinions counted in any capacity. It is also widely feared that such a development would not yield economic benefits for the developers, and so, much needed residential accommodation for the [ex] residents of Dharavi, will be used for commercial and office space to serve the ever expanding business sector – defeating the whole initial development objective. In conclusion, from the evidence laid out, it is clear that Bombay is suffering heavily as a result of mass urbanisation, and has done throughout its history, spanning back to even before the colonial days of the Raj. Projects such as the expansion of the Bandra Kurla complex threaten the condition of the poorer people, often illegally squatting on land, and are planned to solely benefit the banking and business/commerce sector. Migration from the countryside rural areas adding the issue of urbanisation are increasing the population at a large rate. Alongside this, poor planning and mismanagement from the authorities, failing to address the genuine needs of the city, all result in a city with gigantic disparity, overcrowding in slums and an ‘all encasing’ state of impoverishment for the vast majority of the population of the city. How to cite The environmental, social and economic consequences of urbanisation in Bombay, Papers

Environmental Poetry Essay Example For Students

Environmental Poetry Essay Environmental poetry expresses emotions and Ideas about the surroundings and conditions to the readers and listeners. Three different landscapes are Illustrated. By poets of different eras, with the use of sensual imagery, sound techniques and allusions. Robert Gray presents a post apocalyptic future of the impact of cities, through the didactic poem Flames and Dangling Wire. A subjective view of the within. In contrast to both poems, Henry Kendall Bell-Birds demonstrates the beauty and comfort of nature and how powerful it is to people. Thus, the environment and surroundings of a person can be viewed differently and have been invoked In poems for centuries. Flames and Dangling Wire is an edifying poem that warns humanity of the destruction of their disposable society and the impact of city life. Robert Gray conveys a post-apocalyptic landscape that Is the future by using strong sensory Images. Visual lamasery Is on sense used through all the poem. In the second stanza, driven like stakes into the earth, is a line that makes readers question the impact of the city life. Additionally, like fingers spread and dragged through smudge, is a line that exemplifies the desperation In the need of help. Gray also uses olfactory Imagery to portray the landscape. The alarm Is personified In the line, The smell Is huge, In stanza nine. This animates the sense of smell and emphasizes the thick polluted air; along with the metaphor, A sour smoke. Robert Gray has illustrated the ugliness of city life through the use of sensual Imagery. Another way Gray illustrates the consequence of change is through the use of allusions. In his poem, he continues to compare hell and the city wreckage; in particular As in hell the devils might pick about through our souls, for vestiges. As ell as the line, for a moment he seems that demon with the long barge pole, Gray refers to Sharon, a mythological boatman of the river Styx, which links the city and hell together. Gray also alludes to the painting by Curricular The Raft of the Medusa which depicts dying, distressed survivors of a shipwreck who have resorted to cannibalism. This relates to the city and the desperation of the survivors of the human race. Through irony, Gray uses allusions to illustrate that humanity is creating the one place they are afraid of, hell. William Street by Kenneth Sellers reveals a subjective view of beauty through the SE of sound techniques and sensual Imagery. Through all the poem except the last line of each stanza, Sellers emphasizes the ugliness of William Street. The line from the third stanza exemplifies this; Smells rich and rasping, smoke and fat and fish. The line Ghosts trousers like the dangle of hung men, Is a simile that suggests that the people of William Street are so desperate for money that they are selling their loved ones clothes in pawn shops. Sellers repeats the line You find it ugly, I find it lovely, which stands out at the end of each stanza to exaggerate the fact that beauty In contrast to both poems, Henry Sandals poem Bell-birds displays that nature has a majestic beauty and magical essence that br ings comfort to a person with the use of visual imagery and sound techniques. The first line of the poem By channels of coolness the echoes are calling, uses alliteration and rhythm that portrays an echo like sound every c sound. This illustrates the quietness and calmness of the bush. Gray also personified the echoes which gives the bush a mystical nature. As well as the line They start up like fairies that follow fair weather. This simile compares the rain and sunbeams to fairies which portrays nature as magic. In the last stanza of Bell-birds Kendall differs from the rest of the poem. .u43b827f1213b3f4f18bba2aae62ff9f0 , .u43b827f1213b3f4f18bba2aae62ff9f0 .postImageUrl , .u43b827f1213b3f4f18bba2aae62ff9f0 .centered-text-area { min-height: 80px; position: relative; } .u43b827f1213b3f4f18bba2aae62ff9f0 , .u43b827f1213b3f4f18bba2aae62ff9f0:hover , .u43b827f1213b3f4f18bba2aae62ff9f0:visited , .u43b827f1213b3f4f18bba2aae62ff9f0:active { border:0!important; } .u43b827f1213b3f4f18bba2aae62ff9f0 .clearfix:after { content: ""; display: table; clear: both; } .u43b827f1213b3f4f18bba2aae62ff9f0 { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .u43b827f1213b3f4f18bba2aae62ff9f0:active , .u43b827f1213b3f4f18bba2aae62ff9f0:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .u43b827f1213b3f4f18bba2aae62ff9f0 .centered-text-area { width: 100%; position: relative ; } .u43b827f1213b3f4f18bba2aae62ff9f0 .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .u43b827f1213b3f4f18bba2aae62ff9f0 .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .u43b827f1213b3f4f18bba2aae62ff9f0 .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .u43b827f1213b3f4f18bba2aae62ff9f0:hover .ctaButton { background-color: #34495E!important; } .u43b827f1213b3f4f18bba2aae62ff9f0 .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .u43b827f1213b3f4f18bba2aae62ff9f0 .u43b827f1213b3f4f18bba2aae62ff9f0-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .u43b827f1213b3f4f18bba2aae62ff9f0:after { content: ""; display: block; clear: both; } READ: Philip Larkin"s poem, "Church Going" EssayThe poem changes from third person to first. In the first four stanzas were about the bush, changing from season to season. Though in the last stanza, a man is conversing about his memories of childhood. He says So I might keep in the city and alleys. The beauty and strength of the deep mountain valleys: Charming to slumber the pain of my losses. The man still lives in the city but his memories of the bush are powerful enough to dull his pain and bring him happiness. Sandals use of visual imagery through sound techniques illustrate the natures beauty and comfort. All the poems analyses are an environmental poem. They all illustrate a different time. Flames and Dangling Wire brings the readers to the future; William Street is the period of the Great Depression; Bells-birds is in the mans past and memories. Both Flames and Dangling Wire and William Street are city poems though one criticizing the city life; the other loves it. Bell-birds contrasts the city setting and orators the love of going back to nature. The environment was portrayed and illustrated differently through each poem by the use of strong visual imagery and igniting different senses. Flames and Dangling Wire used irony to make humanity question their lifestyle and their choices, in hope they will change the future Gray sees. A personal view of beauty was fabricated by Kenneth Sellers through contrasting his words. In contrast, Henry Kendall demonstrates the power and serenity of nature. Therefore, these poems represent how people view the environment differently.

Knock, Knock free essay sample

Ive heard thatsometimes God has to knock us on the head to get our attention, but I never expected Him to actually do it.In my case, though, He knocked on my left knee. I wasnt really sure what I wanted to do with myfuture but had generally decided to become a history teacher, more because I liked history and was good atit than for any other reason. My decision, however, abruptly changed in the middle of sophomore year. Youcould say my future fell out of the sky and landed on me. Or you could just say I fell down. I wasplaying basketball and landed on my knee with a sickening twist. After reconstructive surgery, I hadphysical therapy. Surprisingly, I enjoyed it. I liked it so much I started to think about it as acareer. Ive spent the last two years volunteering in the rehabilitation department of a localhospital, and though it began as a chance to see what physical therapy was all about, it has become apassion. We will write a custom essay sample on Knock, Knock or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Ive always known I wanted to do something to help others, I just didnt know I could make a livingat the same time. What better job, in an increasingly impersonal world, could there be? One of thebest feelings Ive ever had was seeing an elderly womans expression as she laughingly kicked her feet in aswirling whirlpool. For a few moments, as I talked with her and the soothing water bubbled around herbattered foot, I helped take her mind off her pain. That moment was valuable enough for me to devote mylife, time and energy to. My goal is to earn degrees in physical therapy and Spanish. Why? To make lots ofmoney? No. To drive a fancy car and wear designer clothes? That wont happen. I just want to be happy,and do something to make others as happy. Thats a goal worth working for.

Dont Underestimate the Value of Your Own Town

Dont Underestimate the Value of Your Own Town Used to be, when I thought about travel writers, while longing to be one myself, I thought only of those lucky few fortunate enough to land all-expenses-paid assignments to produce articles in places like Burma or Bhutan. I never considered the possibilities my own city had to offer in the way of travel-related articles.    My thinking changed, however, when I subscribed to a travel newsletter. Every month the newsletter spotlighted a city, either foreign or domestic, giving a full logistics report. As I lived in Lexington, Kentucky, at the time, I queried the editor of the newsletter and asked would she be interested in a logistics article on Lexington. She said yes.  Ã‚  Ã‚  Ã‚      Even though I’d lived there for several years, I’d been too busy raising four sons and working full time to get around and actually see what Lexington had to offer. Too, Lexington was simply where I lived and worked; as such, I never considered it newsworthy enough to write about. When I received the assignment, however, I saw it in a whole new light.   Endless opportunities for travel articles abounded, not only for the assignment I already had, but for a string of other articlesthe bourbon distilleries, the wineries, the racetracks, the nightlife, the culture, the sports.    From my initial article I was able to pitch other variations to different magazines. I found travel-writing opportunities in Lexington’s surrounding communities also. In Keene, Kentucky, only 15 miles outside of Lexington, for example, I saw the possibility of a travel essay in a rambling wood-frame hotel, once a popular summer resort and place of safety during a cholera panic in the mid-l800s. As a portion of the hotel also currently housed a down-home-type restaurant that featured the best Southern cooking I’d ever tasted, that also became an article. The Wisconsin town I now reside in is so isolated and pitiably small that it really doesn’t offer enough to bring that traffic jam of eager tourists to its city limits. But, Green Bay, home of the Green Bay Packers and historic Lambeau Field Stadium, is only a mere 30 miles away, and I’m already putting together a list of possible travel articles on that city.    If you’re a beginning travel writer, live in a small town and have limited travel money, consider checking out near Also, even though your city or town IS small, perhaps it’s connected to other small towns (Door County in Wisconsin, for example, a string of very small towns, runs along both sides of the peninsula and attracts hundreds of tourists each year). If your town is part of such a string of towns, and barring it has at least one notable attraction, include it as part of a driving-trip travel piece of a larger whole. To get an idea on how to write a travel piece on your city or town, decide on the format you wish to useshort getaway, essay/story, historic place, driving trip, little-known or undiscovered place, etc.   Then, using an example article from the publication you wish to write for, follow the example.   

FIN501 MoD 4 Case Assin Essay Example | Topics and Well Written Essays - 1250 words

FIN501 MoD 4 Case Assin - Essay Example A financial structure of a company on the other hand includes the short term debts, business creditors and other short term liabilities (Ho and Lee, 2003). Most businesses finance their business through debt or equity or a combination of both. Through debts the companies secure long term bank loans or take bonds which are redeemable after a long period of time. Through equity the companies issue common shares, preferred shares and sometimes the retained earnings injected at the end of the trading period where a profit has been realized. This literature will examine the financial books and ratios of 3 companies and determine their financial structure and the risks they run in choosing that particular mix (Ehrhardt, 2013). The choice of whether to use exclusive debt or equity financing or what mixture depends on the financial position of the business, the credit standing, the tax situation of the country and the nature of the business. This mix will determine what the cost of capital i s (Finnerty, 2013). Equity financing has its own advantages in that there is no burden of debt hanging over the owner’s heads, they therefore do not run the risk of going bankrupt unlike when financed by a debt. The owners too consent to the risk of losing all their investment in case the business fails. The disadvantages of equity financing is that the many the investors the more the control of the business is diluted and so are the profit shares. Debt financing on the other hand is advantageous to the management of the business in that the lenders do not take any control of the business or direct how the money lent will be spent. The lenders also do not share the profit of the company, all they are entitled to is the loan repayment and the interest on loan. But one of the major advantages of debt financing is that it reduces the tax liability of the business because the interest paid on loan is tax deductible. This protects a part of income from taxation and at the same tim e lowering your business’ tax liability. The disadvantages of debt financing involve ruined credit rating and risking bankruptcy (Besley and Brigham, 2008). An optimal capital structure is one that attains a good balance between the returns of the capital structure and the risks that the structure exposes the company to. The optimal capital structure will minimize the risks involved yet maximize the returns and it also increases the valuation of the stock in the stock market at the same time minimizing the cost of capital (Ho and Lee, 2003). eBay This is a multinational company based in America with outlets in more than 30 countries worldwide. It was started in 1995 and deals with providing consumer-to-consumer internet services. Its nature of business involves providing an over the internet market where customers can auction their goods, this was the initial venture. However, with time the company has diversified its services providing online advertisement services through e Bay classifieds, online payment through PayPal and online event ticket trading through StubHub (Gitlin, 2007). Between 2005 and 2009 it had acquired Skype but then sold a majority stake so as to concentrate on the other internet services it was renowned for. Examining the financial statements of the company for the period ended 31st December 2012 the following information was obtained. The company has a total assets value of $37.074 billion

DuPont analysis (Apple vs Samsung ) Research Paper

DuPont analysis (Apple vs Samsung ) - Research Paper Example It is a recognized world brand that has led the process of digital migration in communication and computers. The main products produced by the firm are iPhone, iPad, Mac, iPod, iTunes, Mac App Store and iCloud. Apple Company primarily trades its shares in the NASDAQ while it’s also listed in other exchanges including mexico and paris. Samsung started as a small business solely owned by a Korean based business man who was mainly involved in export business. The business grew from exporting dried fish vegetables and fruits to manufacturing the products themselves. Years later the firm diversified its product line to electronics. The giant firm then expanded operations opening up branches all over the world while retaining its original brand name Samsung. The firm comprises more than 78 different companies and affiliates in its wide range of products. In the electronics sector, Samsung produces a wide variety including mobile phones, tablets, televisions and home appliances. The firm is worth being a bench mark for Apple Inc due to its experience and achievements in the market. The products of Samsung compete well with Apple products in the market thus the need to compare them. The efficiency of the firm can be measured using the DuPont analysis. DuPont analysis measures assets of their gross book value to produce a higher return on equity. The use of the gross book value is aimed at getting the actual return on equity without accounting for depreciation which artificially reduces the return on equity. Depreciation reduces the return on equity, but is not an actual activity that reduces income, but a value assumed that the asset depreciates by during the course of its usable life. To get the return on equity, the following formula is used: The firm, Apple Inc is currently not performing well when performance is measured using the DuPont identity. Apple Inc has a low return on equity compared to its competitor Samsung. Investors interested

Empowering Users of Health Social Care Services

Empowering Users of Health Social Care Services Table of Contents Introduction Case Study 1 Case Study 2 Question 1 Analyzing the presenting factors affecting decisions to self-medicate The risks most likely to occur Measures to minimize the risk Advantages and Disadvantages of Jean’s self-medication Should Jean be encouraged to self-medicate at this time Case Study 3 Question 2 Question 3 Question 4 Question 5 Question 6 Conclusion Bibliography Introduction With the passage of laws and legislations, organizations in the health and social care sector have adapted their policies and systems to ensure the service users’ rights. Increasing importance is being given to promoting and maximizing the empowerment of service users in residential cares. Factors affecting loss of independence, non-participation and social exclusion of service users are being addressed with greater importance. Organizations are adapting according to the needs of the users. Case Study 1 Care plan: Goals of need Desired Outcomes Ways of achieving it Who is responsible Time Scale Employment Improved self-respect Partnership with day center Care Manager 2 months Entertainment Decreased level of stress and boredom Engaging in creative activities Care Manager 2 months Social Interaction and Emotional Needs Increased level of belongingness and connecting to other residents Engaging in group activities Care Manager 4 months During the last 20 years or so there have been many changes in the health and social caresystems. The catalyst for changes has been the legislations and laws to ensure and maximize the rights of service users. With the passage of such legislations organizations had to change their policies and practices. And thus the organizations had to follow a standard of service to sustain. These legislations have given increasing amount of rights and empowerment to the users. The NHS and community act of 1990 introduced a system of care which encouraged users to exercise their rights and make informed decisions about their health care. (Thomas, Mason, Ford) The acceptance of these laws made service providers design their services centering on the needs of the individual. And therefore, has brought significant changes in company policies and practices. Another legislation promoting the rights of users is human rights act of 1998. (Thomas, Mason, Ford) It has given the recourse to individuals wi thin UK courts if they feel their rights have been infringed. It includes 16 rights including right to life, right to freedom, security and right to a fair trial. While making policies organizations have to be aware this act, and realize every person has the same right. The organization will need to make sure one person’s rights are not infringed while maintaining another person’s rights. Participation and independence of users is vital to achieve the best possible outcome. Organizations promote service users’ participation by implementing an effective care planning system. A care plan is a written documentation of an individual’s fundamental needs and desired outcomes. It also includes how the desired outcomes will be attained. In managing the process, it is central to carefully consider the individual in the process. To promote participation of residents, the organization needs to reflect that it is planning a service around the agreed upon needs and desired outcomes of the user rather than fitting a person into the service it offers. The design and content of the care plan might vary. But it is important to correctly identify the desired outcomes. All aspects of daily living should be considered while preparing a care plan, and the process should start by gathering information from important sources. It is important to involve the user in the process. Involvement of the residents in the 6 stages of care planning is essential in order to provide better service. (Thomas, Mason, Ford) Need Assessment: Involving the user by agreeing dates and times, explaining how it works and ensuring the staff will involve the user from the early stage of the care planning process. Developing the care plan: The opinions, expectations and worries of the residents should be considered while developing the care plan. The staff will need to make sure the resident has clearly understood the process. Intervention and support: Once the goals have been agreed upon, the staff will need to start on implementation of the plan. Ongoing negotiations with the user must be considered in achieving the best end result. Monitoring and review: Encouraging the users to provide feedback is essential. It is also important to note the progress made and take into account any weaknesses. Statutory review of the package: The residents view is important; it also involves the view of outside agencies. Agreement on goal setting: The residents should be full involved in future goal setting process. The user should be encouraged to share what he has achieved. The organization needs to reflect on these stages and clear understanding of the issues should be ensured. The process should have options to monitor progress and make changes accordingly. There should be the option of trying something different if the initial plan doesn’t work. This way the individual will be more involved. Case Study 2 Question 1 Analyzing the presenting factors affecting decisions to self-medicate Fast Relief from ailments: Self-medication gives the individual quick relief from ailments. Identifying the ailment as trivial: When patients consider the ailment or sickness to be trivial that can be cured easily, they don’t go to the doctor. Rather they self-medicate themselves. Perceived Medication Knowledge: If the individual perceives his/her medication knowledge to be sufficient, he/she decides to self-medicate. Saving time and money: Going to the doctor means spending valuable time and money, self-medicating saves the hassle of going to the doctor and spending money. More control in care: when an individual self-medicates, he/she is in full control of her treatment. This gives the person an independence of care. Education Level: The education level and understanding of the risks might also affect the decision to self-medicate. Easy availability of drugs without prescriptions: The ease of access to drugs without prescriptions is also a factor affecting the decision to self-medicate. The risks most likely to occur Incorrect diagnosis: The individual might incorrectly diagnose his/her illness, and incorrect medication can worsen the medical condition even more. Delaying Medical help: Self-medication can provide temporary relief. However it can further worsen the situation if the individual delays to obtain medical help by temporarily relieving illness. Adverse reactions: Medications might have severe re-actions that are not so frequent. And the same medication might have different reaction on different people. What works on most people might have a severe reaction on an individual. Self -medication can be dangerous in this respect. Drug Interactions: If an individual on a prescribed meditation routine takes additional medications without consulting his/her doctor; the combined effect of the drugs can have severe impacts. Wrong dosage: A drug that might be very effective and crucial in the relief of a particular ailment can have the opposite effect if taken in a wrong dosage. Measures to minimize the risk Since the practice of self-medication is unavoidable; authorities need to take measures to minimize the risks associated with it. Health Education campaigns: Making people educated about the risks of self-medication can decrease the risks to a certain extent. Running health campaigns will develop the user’s skill in diagnosing oneself with trifling sicknesses, without asking a doctor. It will also help the patient to know the right drug, right dosage, right way of taking it and potential side-effects of a drug. Implementation of legislations: Authorities should ensure that laws and legislations on providing drugs from pharmacies are strictly followed. Drugs that can cause life threatening situations should never be provided without prescriptions. Clearly communication the crucial information: The drugs that are commonly takenforailments considered as self-recognizable; should contain the information on their packaging about how to take the drugs,how they react when taken with other drugs, the side-effects as and how tomonitor them, how long the drug can be taken, the dosage above which the drug can become dangerous etc. Advantages and Disadvantages of Jean’s self-medication Self-medication can be favorable for patients, healthcare specialists, and the pharmaceutical industry if the drugs are used in the proper way. However, it can create life threatening situations as well. Advantages: Self-medication givesJean greater independence and empowerment in making decisions about treatment of minor sicknesses. It helps Jean to prevent ailments that do not require a doctor. It helps her save precious time and money. Disadvantages: She has the risk of misdiagnosing a disease. She might take drugs in the wrong doses. The drugs can have side effects that might not be frequent and apparent at the beginning, but they might gradually develop life-threatening illnesses without showing any symptoms. The drugs might have adverse reaction while taken with other drugs. If she takes self-medications and temporarily treats ailments avoiding professional help when it is necessary, the ailment might become more severe. This might ultimately cause her to spend more money. Should Jean be encouraged to self-medicate at this time No, Jean shouldn’t be encouraged to self-medicate at this time. She has just been discharged from the hospital and she might not be fully recovered. The drugs that she took during her stay at the hospital might still have effects on her body and self-medication may have adverse reactions with those drugs. Also, before her admission at the hospital she had faced difficulty sleeping and had been forgetful. These could be signs of side-effects caused by self-medications which weren’t apparent at the beginning. But due to prolonged duration of self-medicating these problems have manifested over the years without showing prior symptoms. Continuing her self-medication at this time would be very risky because of these reasons. Case Study 3 Question 2 When a person reaches adulthood his/ her nutritional needs reduce. Generally, adults need to eat a healthy diet containing carbohydrates such as bread, potatoes, rice or pasta, protein such as meat, eggs, cheese or à ¯Ã‚ ¬Ã‚ sh, and fruit and vegetables. The intake of fatty and sugary foods should be little.To support Mr. H in meeting his dietary needs, it is essential to recognize if he has any deficits as well. With the help of a nutritionist, his dietary needs should be properly identified. A chart should be made listing the daily nutrients necessary for Mr. H and the foods that can meet these needs. However, the care doesn’t end there. Good Nutritional care doesn’t only include providing safe and nutritious food according to the specific needs of the individual. It goes beyond that. Mr. H should be provided what he wants, when he wants, and where he wants it. And in doing so, maintain the safety of the Mr. H and others around him should be ensured. Moreover, it is fundamental in providing quality service to ensure that Mr. H’s choices are respected and heard, and his independence is promoted. Since Mr. H has mood swings, however; it might not be possible to listen to his every whim. But it should be made sure that he doesn’t feel frustrated. As he is forgetful, it is necessary to make sure he takes his food in time. And keeping a track of his food intake will also be useful. It is also necessary to make his meal times enjoyable. It might have greater and significant impact in his mental health. Dining with other members might also improve his learning abilities and social skills. Providing quality service entails giving the service user independence and empowerment. Because of this, it is important to support Mr. H to cook his meal. It will make him feel empowered and give control. Also, not giving him the chance to cook might make him frustrated which might cause him to do something harmful to others and himself. Since he is semi-independent, it is necessary to appoint a supervisor to make sure he doesn’t harm himself or others. The materials used to cook or cut the ingredients should be safeguarded. He should be under constant supervision the whole time. Question 3 Risk taking can be petrifying, for the individual concerned as well as the family members. According to the National Minimum Standard relating to risk states that service users should be supported to take risks as they are free to lead an independent lifestyle. By following a system and identifying how risks can be analyzed and lessened, calculated risks can be taken. There can be various benefits of risk management for the service users including learning new skills, amplified independence, self-esteem and participation. (Thomas, Mason, Ford)The risk management systems and policies should include recording recommendations and actions. A good risk assessment tool should be used, one that is not too lengthy but user friendly. Finally, review is also a crucial point in risk management. Putting all the policies at work, more responsible risks can be taken. Question 4 The management of medication is perhaps one of the most precarious tasks of a care worker. Regulation13 of theHealthandSocialCareAct2008talks about the management of medication in a residential care. It mentions that the registered individual is supposed to protect users against the associated risks resulting from unsafe use of medications, by different means of necessary arrangements for obtaining, recording, using, safe keeping, safe administration and disposal of medicines used for the purpose of the regulated activity. (The Health and Social Care Act 2008 (Regulated Activities) Regulations 2010) People who follow this regulation will managemedicinescarefullyandappropriately,make surethatmedicinesareprescribedandgivenbypeoplesafely,maintain the guidanceonusing medication in a safe way. The management of medication follows a standard procedure including receipt, recording, storage, handling, administration and disposal. (Thomas, Mason, Ford). Receipt involves identifying what is required for each service user and attaining those medications. A clear ordering system should be maintained in order to ensuring effectiveness of the process. Clear records should be kept about medications of individuals, taking into account the confidentiality issues. Medications are personal information and should be kept confidential. The record should be in accordance with data protection act and National Minimum Standards. Planning storage of medication is very important. All medications should be under lock and key. Medicines should be taken out of the locked cabinet only when required and should be put back in it immediately after using. Question 5 Effective communication is the basis for involving service users in the decision-making process. For data to be valuable, it requires to be in a format that is understandable, reachable to people who need it. The communication procedures of an organization must consider the needs of service users and staff. a) Feedback:Creating an effective feedback mechanism can develop effective communication. By considering constant feedback from users, the organization can make sure the rights of the users are maintained. b) To promote and maximize the rights of service users the organization can create an effective information and communication strategy, suited accordingly to the needs of service users and staff. c) To make sure information is readily available, an integrated information technology system can be introduced which will enhance the quality of care and delivery of services. d) The organization should have clear communication principles including: transparency and honesty, use of apt language and variety in approaches of communication; compassion and understanding; effective listening. e) The organization should provide training for staff on how to communicate with users and care workers. f) It should develop efficient procedures for obtaining valid consent for examination, treatment and/or care; h) The organization canpublish a range of updated information about services, situations, and treatment, care and support options available. Question 6 Viewing people in residential cares as passive recipients of care, who are incapable to make choice and take control, contributes to loss of independence. Perceiving service users as powerless suggests that they cannot have both care and empowerment. Society’s negative view and attitude towards people who require social care services can also cause loss of independence. Lack of acceptance and dignity can also cause social exclusion and non-participation. When a service user feels he/she is not being listened to or being cared with dignity, the individual tends to participate less. When the individual thinks he/she has a choice and control over his/her health care decisions, the person is naturally encouraged to participate more. Above all, the general mindset of people who are around about people in residential care can significantly impact participation and independence of service users. Viewing them as incapable, powerless, and showing gestures that suggests they are differe nt can cause non-participation and social exclusion. Conclusion Empowering individuals in health and social care is vital to their treatment and wellbeing. However, organizations might face barriers and difficulties in doing so. The organization can achieve the best possible outcomes through careful planning, policy making, risk assessment, management of medication, providing what the service users wants and involving them in the decision making process. Bibliography The Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. (n.d.). Retrieved from http://www.legislation.gov.uk/ukdsi/2010/9780111491942 Thomas, A., Mason, L., Ford, S. Care Management in Practice for the Registered Manager Award NVQ 4. Empowering Users of Health Social Care Services Empowering Users of Health Social Care Services Table of Contents Introduction Case Study 1 Desired Outcomes and Care Plan for Bob Small Case Study 2: Question 1 Factors Affecting Decisions to Self Medicate Possible Risks of Self Medication Measures to Minimize Risks Advantage and Disadvantage of Self Medication Should Jean be Encouraged to Self Medicate? Case Study 3: Question 2 Meeting Mr H’s Dietary Needs Managing the Tension to Help Mr H Cook Safely Question 3 Effectiveness of Organizational Risk Assessment Policies and Procedures Question 4 Current Legislation, Codes of Practice and Policies of Medical Administration Organization Medication Policy Question 5 Promoting Maximizing Rights of Service through Effective Communication Question 6 Factors Contributing to Loss of Independence, Non Participation Social Exclusion Conclusion Bibliography Introduction Empowerment in health and social care reflects the balancing of rights among the various stakeholders in this sector such as the users, the governments and the service providers. The rights of the user are mostly focused on with an aim of maximizing it, while government and the service providers set policies and procedures to do so. Case Study 1 Desired Outcomes and Care Plan for Bob Small Goals of Need Desired Outcome Ways of Achieving It Who is Responsible Time Scale Reduced Stress Reduce Boredom Reduce Frustration More Relaxed Enjoying Life Stop Self Harm Have calm work that he enjoys such as art with no hard deadlines. Find people of similar tastes and socialize Give recognition for his creative work and try to manufacture some success at what he does. Domestic Carer Self but Carer can help Friends and Relatives Permanently Permanently Periodically Case Study 2: Question 1 Factors Affecting Decisions to Self Medicate The main driving factor for individuals to self medicate in most of the world today is mostly due to budgetary constraints leading to the inability of these people to seek proper medical care. In the case however this is not the situation. However Jean Barlow, may self medicate here due to due to wholly different reasons. The reasons would probably be due to mental reasons rather than financial. As stated in the case she did develop anxiety after getting discharged from the hospital. Since the reason for getting admitted to the hospital were not really conventional physical problems that make people go to the hospital in the first place such anxiety and dip in confidence is very much expected. This is because being forgetful and lack of sleep is usually considered human traits and general minor life problems rather than something that requires medical attention. This social status about these disorders may have caused her to be embarrassed about seeking medical attention in the first place. Therefore in situations such as these one may easily be subject to self doubt and therefore lose self confidence. This factors will in turn cause her to self medicate instead of seeking further medical attention. Possible Risks of Self Medication The risk likely occur from self medication are widely spread. The most common form is addiction. This is because people who self medicate generally tend to do so by unconventional and sometimes illegal drugs such as cannabis and alcohol. Due to its availability alcohol is most commonly used by most self medicating patients especially when trying to alleviate anxiety. Not only alcohol is an abusive substance, what it does is worsen anxiety and cause depression among alcoholics in the long term. Although in the short term they tend to alleviate these symptoms. Such benefits encourages the person the consume alcohol over and over again causing addiction and worsening their base situation in general. Addiction in turn makes the person suffer from more symptoms and worsens the current situation. If such problems keep on persisting the person may eventually become a suicide risk. These above risks do very well apply to the case in question here. Other ways of self medication include over t he counter medicines and sometimes, if the law is not stringent where she lives, antibiotics and anti depressants. These medications also if not taken in correct doses does possess the risk of addiction along with dangerous side effects. Moreover the risk of misdiagnosis and over dosage are very common amongst self medicating individuals. Measures to Minimize Risks The best way to reduce this risk would to educate Jean Barlow about the risk and benefits of it. Although somebody suffering from low self confidence and high levels of anxiety is very much likely to make judgmental errors but proper knowledge of what she is dealing with will obviously help her regardless of her impaired judgmental abilities. There would be less risk of misdiagnosis. However excessive dosages and the risk of long term usage would tend to persist. To avoid such a situation continuous monitoring would be required. This risk can be reduced if individuals close to Jean Barlow are educated on these grounds or have access to primary care. The hospital could also reduce this risk by scheduling successive checkups in regular intervals so that she could be monitored. Advantage and Disadvantage of Self Medication The chief advantage that Jean would benefit from self medication would be the save in costs. Moreover it would save her time which she can dedicate to her other work. If more people like Jean could successfully self medicate them it would greatly reduce the pressure on the healthcare system in the society which would be able to focus its effort elsewhere to more major healthcare problems. Day to day healthcare problems such as acnes and common flu have routine and standard medications which can easily be self medicated although the risk of misdiagnosis does persist. However in Jean’s case, it is not so. Her problem is mainly due to self confidence along with forgetfulness and difficulty in sleeping. If she can successfully medicate her own problems, it is very well. The chief disadvantage in doing so however is the so many risks that have been discussed previously in detail. If gone wrong it could worsen the situation and even create new problems for Jean. Moreover the solutio n to the current problem without expert monitoring may cause problems such as addiction to sleeping pill for example which would be much harder to solve. Should Jean be Encouraged to Self Medicate? In my opinion Jean should not be encouraged to self medicate at this time cause she is suffering from low self confidence. Her initials problems may have been very standard and be self diagnosed but her low self confidence would impair her judgment and can cause her to take wrong decisions therefore increasing the chances of the risks. She should rather seek medical attention whenever she suffers her symptoms. However going to the doctor every time something minor happens may cause a further dent in her confidence leading to fear and frustration among everything she does. She may be encouraged under certain situations to self medicate. If self medication is done successfully it would help her increase in self confidence leading to an overall development in life for Jean. This can become a bit of a gamble but would bring positive for Jane if successful. Case Study 3: Question 2 Meeting Mr H’s Dietary Needs To support Mr. H’s dietary needs we need to make sure, there are enough omega-3 fats in his diet. This means there should be lots of fish in his diet. This not only deals with the attention span problem but also with his problem of mood swings by keeping it at a minimum level. A low-GL diet should also be maintained. This means that there should be very low glucose in the diet as well as a minimum of any types of stimulants such as tea, coffee and alcohol. Magnesium and potassium also has displayed abilities to calm the brain and reduce mood swings as well as increase concentration. So to support Mr. H’s dietary needs, we have to give him lots of fish, sources of magnesium and potassium such as pumpkin seeds and bananas while at the same time try to avoid stimulants such as alcohol and caffeine. Managing the Tension to Help Mr H Cook Safely Mr. H is not independent. His mood swings and short attention span can cause a variety of accidents while cooking such a meal. Therefore to enable Mr. H to cook safely without any disruptions I first need to make sure that he is continuously monitored throughout the process. He should not be left alone or ignored at any point in time during the whole event. I also need to study and remember his entire recipe for cooking such a meal. Care has to be taken that the room temperature is comfortable and not too hot as an uncomfortable temperature may unsettle him. Moreover I need to make sure that there is a fire extinguisher somewhere very nearby preferably in the room in case of any kind of cooking emergency. I would also need to keep him engaged in the cooking process and help him if he tends to forget any steps in a manner which does not offend him or unsettle him in any other way. In case of emergency I would also need somebody nearby in case there is an apparent need for any relating reason to force him to retire his task. Continuous monitoring would probably stop any unprecedented event from taking place and therefore there would not be much tension if done right and Mr. H would be able to cook his favourite meal. Question 3 Effectiveness of Organizational Risk Assessment Policies and Procedures The organizational risk assessment policies is essential to finding out all the risk the organization possesses. These include risks to the staff, users and anyone else that is involved with the organization. The organization tries to promote a dynamic method in identification of risk management by working closely with users and other agencies in order to find the triggers of these risk and find risk histories. The objective is to preempt these ricks before they occur. This assessment procedure considers every stakeholder of the organization in question and tries to avoid all manners of risks. After risks are identified the organization decides on the management technique of these risks in order to avoid them from happening in the near future. They also tend to try to consider if any of their risk management plans give rise to any further risks or harassment for the users. When all of this is done, the organization trains its entire staff, usually annually on the various risk managem ent procedures within the organization. They also take steps within the infrastructural work of the organization in order to avoid any risk. For example, setting up a grill in the room of a user who maybe prone to jumping out of the window. These benefit the organization in many ways. The users mostly get their rights as they are free from any sort of harm. Moreover the organization is saved from a lot of accidents which might have affected both financially and operationally. Being saved from these costs are therefore highly beneficial to the organization. Question 4 Current Legislation, Codes of Practice and Policies of Medical Administration Regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) is responsible for covering the administration and management in care homes of medicines. The act is passed by an act of parliament and it states that: â€Å"The registered person must protect service users against the risks associated with the unsafe use and management of medicines, by means of the making of appropriate arrangements for the obtaining, recording, handling, using, safe keeping, dispensing, safe administration and disposal of medicines used for the purposes of the regulated activity.† While in accordance to the above â€Å"the registered person must have regard to any guidance issued by the Secretary of State or an appropriate expert body in relation to the safe handling and use of medicines† The objective of the regulation is that the users of the service: will get their medicines at the correct times and in a manner which is safe will have information about the medicines which have been prescribed to them and are available to them or the people acting on their behalf The Care Quality Commission is responsible for monitoring compliance with the regulations for all registered services. The Misuse of Drugs Acts Regulations also under various circumstances regulates controlled drugs handling. Other code of practices and procedures relating to this matter is provided by the Nurse and Midwifery Council and the Royal Pharmaceutical Society of Britain. The Royal Pharmaceutical Society of Great Britain in its Guidance called The Handling of Medicine in Social Care, calls upon 8 principles that should be in place for safely administering drugs in residential homes. Organization Medication Policy The organizations medicine administration policy is basically in line with the 8 principles of Royal Pharmaceutical Society. The first principle gives the user the choice and independence to choose the pharmaceutical provider for his/her medicines including dispensed medicines. These give individuals a lot of independence and makes sure everything is done with their consent and not against their will. However under certain circumstances this principle can be bent, when there is no choice. For example, the person is having extreme breathing difficulty and not in a position to communicate but needs emergency medication. By complying to the second principle, the organization’s staff keeps a detailed record what medicines are currently available within the organizations stores and all the records of each user’s medicine intake and therefore be able to refill stocks whenever required to make sure that there is never a shortage at key moments. The third principle also applies to the organization as the care workers when joining take part in a short training period where they learn to administer each type of medicine for people who are unable to do it by themselves. They learn how to feed tablets, capsules, eye drops, nasal drops etc. Compliance with the fourth principle ensures that the organization gives users exactly the medication prescribed for them and at the right time in the right way. The 5th principle states that unnecessary or unwanted medication is disposed of safely and the correct medicines are available whenever required. The organization stores all the medicines safely and out of reach of people who are not supposed to take the medicine. There is also a pharmacist who regularly advices the residential home on medication related issues. Lastly medications are only used to prevent diseases or relieve symptoms, not to punish people or encourage certain behaviors. Question 5 Promoting Maximizing Rights of Service through Effective Communication Effective communication is when the sender of a communication message sends a message that is completely understood by the receiver exactly as intended by the sender. When there is effective communication efficiency tends to rise regardless of the task at hand. This is no different for the health and social care service. The whole service depends on the user getting his rights maximized. When there is effective communication the user would know exactly what his rights are, what he will be getting out of the service and what he will be not. This will help him manage his expectations from the service and plan accordingly. Moreover the service provider’s work would also increase in efficiency if there is highly effective communications. The service would be able to provide for the user to his requirements, therefore maximizing his rights. If there is effective communication the service will unlikely to be unable to provide for the user anything that his rights cover. This is two- way communication is therefore extremely vital in health and social care aspects. Effective communication will always help the user to maximize his rights in this way. Question 6 Factors Contributing to Loss of Independence, Non Participation Social Exclusion Stigma is one of the most important factors that cause these problems for service users. Social stigma is especially for people with mental health problems affect people of all ages, at all levels of job and education levels. Society tends to have a negative impression about this problem unlike cancer or any other physical diseases. Therefore how other people judge them becomes a great barrier to the users. Not Just Sticks Stones’(Jim Read Sue Baker November 1996), a survey of the people with mental health problems in the matters of discrimination, taboo and stigma found out that: For the fear of unfair treatment, a large majority was put off for applying for jobs. Being treated unfairly by general health care services was something half the respondent felt. Harassment and abuse in public and sometimes even physical abuse was face by many Most people believed that discrimination has increased in the last 5 years but some thought it decreased as well. Due to these various problems the fear of stigma and discrimination sometimes makes the users stop talking about their mental distress with others therefore there is a communication gap and they fail to avail their full rights of the service. These factors therefore directly contribute to their social exclusion and non participation in service. Most people tend to stay at home and take small local jobs depending on their level of independence in fear of abuse from the uneducated society. The social stigma and the media terming most of them as ‘lunatics’ and ‘psychos,’ create a very bad impression in a lot of people’s minds therefore making lots of luxuries of life unable to these people causing a huge loss of independence for them. Conclusion Finally we can say that the various laws and legislations that the UK Government has put into place in order to maximize the rights of users are very well enforced and maintained. The way service in current times is designed is based on the objective of maximizing the rights of the users. Participation is on the rise leading to greater independence for users. Excellent management of risks and commendable practices of drug administration has led to much fewer service accidents and has ensured the rights of the users. Bibliography CM Hughes, J. M. (2001). Benefits and Risks of Self Medication. Drug Safety , 1027-37. Cowley, D. S. (1992). Alcohol abuse, substance abuse, and panic disorder. The American Journal of Medicine , 41S-48S. Galliot, B. (November 2007). The Physiology of Willpower: Linking Blood Glucose to Self-Control. Personality and Social Psychology Review, Vol 11 , 303-27. Kasten, B. P. (1999). Self-Medication With Alcohol and Drugs by Persons With Severe Mental Illness. Journal of the American Psychiatric Nurses Association , 80-87. Khantzian, E. (2003). The self-medication hypothesis of drug use disorders: A reconsideration and recent applications. Harvard Review of Psychiatry , 231-244. Royal Pharmaceutical Society of Great Britain. Handling of Medicine in Social Care. Sinn, N. (October 2008). Nutritional and dietary influences on attention deficit hyperactivity disorder. Nutrition Reviews, Vol. 66 , 558-68. The Bamford Review of Mental Health and Learning Disability. (December 2006). Promoting the Social Inclusion of People With a Mental Health Problem and Learning Disability. World Health Organization. (2000). The Benefits and Risk of Self Medication. WHO Drug Information Vol. 14, No. 1 , 2-3.