Living Alone at an Old Age Essay

Living alone has many advantages as well as disadvantages especially when at the old age. Being 80 years old is no easy task staying alone, according to the Administration on Aging, approximately 11 million aged-adults lived alone in the US in the year 2010 and the numbers are soaring up at a swift pace (Stevenson). However, many argue that age is just but a number and the older one becomes the wiser he or she gets thus can be able to take good care of self. The next paragraph will focus on the various cons and pros of living alone at an old age. Unlike living in a nursing home or with the children, living alone grants one the opportunity to make rules in the house reducing accountability responsibility to others. One is able to decorate the house as he or she pleases without receiving judgments or criticisms from others. In nursing homes one lacks the privacy he or she needs, there are people all over and the noise is too much, when alone one does not need to compromise with such situations. However, there are cons of living alone such as when one has poor eyesight it is risky to live alone. Additionally, when on medication or sick living alone is not an option. One may experience some social isolation when alone and at times forget important appointments as well as keeping up with the daily chores. Though it may sound promising to live alone when in good health at an old age, when ailments start kicking in, it is advisable to live in a Nursing home or with the children in order to live safely(Stratford). References Stevenson, Sarah. ‘Dangers Of Seniors Living Alone’.  Senior Living News and Trends | A Place for Mom. N. p., 2013. Web. 26 May. 2014. Stratford, Kathryn. ‘Many Of The Benefits Of Living Alone’.HubPages. N. p., 2013. Web. 26 May. 2014. Source document

Inigo Jones and the Classical Language of Architecture

Inigo Jones and the Classical Language of Architecture Classical architecture elements can be traced from early Greek and Roman styles. Classici refer to the highest rank of Roman social structure. Classical norms are based on a formal hierarchal system of clarity, symmetry, deceptive simplicity, harmonious proportion and completeness. (Curl, 12) There is a difference seen between the inside and the outside of a building. Classical architecture develops every part individually as these parts become a larger whole. Orders, or columns, play an important role in the development of classical architecture.The parts of the order include a pedestal, but not always, a column and some type of horizontal element above the column. Within the structure of orders a composition pattern and proportional system develop. Although Greek and Italian architecture used the name Doric, Ionic and Corinthian orders there were distinct differences between the appearances of the columns. In classical architec ture a Doric order is slender, usually with a base and a smooth shaft. One can see an elegant molded base on Ionic orders. Ionic orders also have fluted shafts and some type of cornice ornamentation.The Corinthian order is the most elaborate and may have engaged columns that are partially attached to a wall. Many of the classical orders are straight lines meeting at right angles with an equal distance between orders creating a piece with equal parts. There is symmetry from left to right and right to left that is not seen when looking top to bottom and bottom to top. (Tzonis 9) Inigo Jones is regarded as the first significant English classical architect. Jones combined his personality and understanding of classical architecture in his designs.His admiration of Italian architects and architecture is evident as many of his designs look more like Italian villas than traditional English buildings. Jones pursued his building projects to further his own political and personal interests. (A nderson 41) One of Inigo Jones’ first projects was building a stable, brewhouse and doghouse for King James at his royal hunting site. The Queen’s House, Queen’s Chapel and the Banqueting House are some of Inigo Jones works that are still standing. Other Jones designs include Covent Garden and Wilton House.The Queen’s House, once named the House of Delight, was built in Greenwich. The house looks like two Italian palaces facing one another connected by a narrow passage lined with equally spaced orders on each side. The orders appear to be Doric because of the simple base and smooth shaft. The exterior sides of the building show the classical norm of being symmetrical left to right and right to left. Following classical lines there is no up and down symmetry having one arched window on the second story. The wall facing south also has a center second floor balcony with orders.Materials used on the outside vary from floor to floor. Brick and stone work were used for the first floor while the second story walls are plastered and limewashed. Inside the main halls are shaped like a cube with flat ceilings. Surrounding rooms are symmetrical with cornice work showing an Italian influence with very ornate chimney sculptures. Orazio Gentileschi’s canvases originally filled the ceilings of the house. The Duchess of Marlborough had them taken down and brought to Marlborough House. (Lees-Milne 70) The Banqueting House is regarded by many as Jones’ masterpiece.Jones was commissioned to re-build the structure after a fire destroyed the original building. Jones based his design on Venetian palaces so Banqueting House would stand apart. The outside gives the appearance of a multi-story building. Two cherubs support a large shield in the pediment which was intended to contain a coat of arms. (Anderson 157) Ionic and engaged Corinthian orders are used. The orders on the exterior side walls combine flat and rounded columns with a pair of coupled pilasters at the end of each facade. Exterior street facade show the classical element of symmetry matching left to right and right to left.One can view the differences from top to bottom and bottom to top. Lower window tops alternate rounded and pointed where upper windows are all flat topped. Each window and order section is a separate design but is also part of the complete building. The interior of the Banqueting House is not multi-storied but a single double cube room. The space has Ionic orders under and Corinthian orders over a cantilevered gallery. (Summerson 53) The flat ceiling is covered with Ruben panels. The Banqueting House is still in use today for concerts, government function and private parties.Inigo Jones was picked to design a new Chapel at St. James Palace. The Queen’s Chapel is a double cube hall with a coffered ceiling that has an adjoining Queen’s Closet. There is a triple window rising behind the altar. The center rounded window rises h igher than the two flanking windows and is topped with carved angels and falling garlands. The Queen’s Closet is a gallery separated from the chapel by Corinthian pilasters and festoons. The Closet chimney piece and over mantel portrays classical Italian interior decoration. Harris and Higgott 184) The front exterior of the building is done with Portland-stone masonry. Side to side symmetry is present but there are no orders in the design. Wilton House is another Inigo Jones design. The main front dimension ratio is almost identical to his design for the Prince’s Lodging but on a larger scale. Wilton’s south front has side to side symmetry. The grand portico is in keeping with the classical association of royalty. Ionic orders are in front of the portico’s central Serlian windows which are surrounded with carved figures. There are corner towers and balustrades.The main interior room is a double-cube. Very ornate moldings, carvings and ceilings are present . Wilton House is one case where symmetry is not followed. The fireplace is not central on the main wall but gives the illusion that symmetry is maintained. (Lees-Milne 102) There are matching king’s and queen’s apartments for royalty use. Wilton House seemed out of place surrounded by smaller houses. This building provided Jones a bridge between his smaller and grander royal works. (Worsley 82) The Covent Garden project by Inigo included a new church, houses and gates leading to the square.Simple and classical Tuscan design variations were used in the arcade surrounding the houses. The entrance to the square is a false doorway and the church is entered through an enclosed yard. Classical architecture was used to update homes. Jones’ drawings show the use of banded columns and smooth columns against a rusticated wall. (Anderson 206) Jones designed a Tuscan portico on the east end of St. Paul’s church comprised of two central columns flanked by piers attac hed to a sidewall with arched openings. The Tuscan order throughout Covent Garden brought bout simplicity for urban life. As an architect Inigo Jones gave England a classical, innovative style using his love of Italy and Italian design. His use of orders was based on the specific function of the building, the context in which it was to be built and his own interpretation. (Anderson 208) Jones wanted his identity as an architect to be defined by The Banqueting House and St. Paul’s Cathedral. (Anderson 25)Works Cited Anderson, Christy. Inigo Jones and the Classical Tradition. New York, Cambridge University Press, 2007. Curl, James. Classical Architecture. New York, Van Nostrand Reinhold,1992. Harris, John and Higgott, Gordon. Inigo Jones Complete Architectural Drawings. London, A. Zwemmer Ltd, 1989. Lees-Milne, James. The Age of Inigo Jones. London, B. T. Batsford Ltd. , 1953. Summerson, John. Inigo Jones. Middlesex, Penguin Books Ltd. , 1966. Tzonis, Alexander and Lefaivre, Li ane. Classical Architecture the Poetics of Order. Cambridge, MIT Press, 19986. Worsley, Giles. Inigo Jones and the European Classicist Tradtion. New Have, Yale University Press, 2007.

Ten-Year History on Merck (MRK) and Eli Lily (LLY) Essay

Ten-Year History on Merck (MRK) and Eli Lily (LLY) - Essay Example Eli Lily and Company emerged in 1876 and currently has over $20 billion in annual revenue. This report constitutes a broad ranging analysis on these companies over the last ten years and provides a recommendation of which company would be a more desirable acquisition. Qualitative, Cultural, Social There are a number of notable incidents that have occurred in the last ten years of these companies’ histories. While the 2008 economic recession is a prominent consideration that had a detrimental impact on both organizations, there are other problems that have been encountered. For Merck perhaps the most prominent such issue is the 2007 price fixing settlement the company reached, as the company had to pay over $20 million dollar out-of-court settlement with the Department of Health over oligopolistic price fixing in terms of its pharmaceutical drugs (Bowers 2005). Eli Lilly found similar legal troubles as they had to pay a reported $1.42 billion in fines levied by the United State s Justice Department for improper marketing techniques in relation to the company’s anti-psychotic drug Zyprexa. ... From this period the equity valuation went on a steady decline until its November 16th, 2004 trading price of $26.41. While the stock is dividend driven, it’s clear that during this three years period there was a substantial market correction. From the November 16th, 2004 trading price made a steady climb and three years later on November 16th, 2007 the equity had largely regained its equity valuation and was trading at $58.38 ("Financial statement," 2011). The subsequent economic recession and the company price crashed to a ten year low of $25.43 by December 28th, 2009. Since then the stock has slowly climbed and is not trading at $35.67 ("Financial statement," 2011). The clear implication is that the company has demonstrated a past top over $60.00 and that there is strong historical precedent for the current $35 trading price to continue to grow. The Merck equity financials can be compared to those of Eli Lily in an attempt to determine both companies’ financial stren gths in relation to each other as market as macro-concerns within the health care sector. In this context of understanding it’s demonstrated that both companies share slightly similar trends in terms of equity valuation. In November 16th, 2001 Eli Lilly was trading at $79.02. The company witnessed a steady decline in this market price that was topped off by the 2008 recession. By November 16th 2009 the company was trading at $35.36, greatly similar to its current market price of $37.65 ("Financial statement," 2011). While both companies are dividend driven and currently share a similar market valuation, one of the prominent concerns is that while Merck experienced significant ups and downs in valuation, Eli Lilly has demonstrated a steady

Organisation's entry into a foreign market - internationalisation Essay

Organisation's entry into a foreign market - internationalisation process - Essay Example As these factors could be influenced by local cultural, political, social and economic issues, they have to be studied in an in-depth manner before entering the foreign market, and that will be focus of this report. Introduction Organizations wanting to achieve optimal success will always want to expand their geographical and financial ‘boundaries’, thus going on the path of internationalization. That is, organizations could think of entering newer or foreign markets after achieving sizable success in their domestic markets or due to strong competition or saturation in their domestic market or importantly after seeing feasible and good opportunities in foreign market or markets particularly due globalization facilitated opportunities, etc. Thus, internationalisation is kind of becoming a happening concept used by many organizations to expand their reach globally. â€Å"As the global economy expands, as more products and services compete on a global basis and as more and more firms operate outside their countries of origin, the impact on various business functions becomes more pronounced† (Briscoe and Schuler 2004). Whatever be the motivations or objectives for the organizations to enter foreign markets, it is of crucial importance for that organization to study that foreign market in a deep and extensive manner. According to Hill (2009), if a firm wants to expand its business to overseas markets, it must evaluate the potential of country and the country specific factors. Recruitment process After the organizations make its entry, to start their operations there organizations will have to send their own employees who are working in their home operations, then will initiate the recruitment process to recruit the local qualified employees and could also bring in employees from other Third countries. This factor of recruitment is in line with the theoretical concept of recruiting the three types of employees, Parent Country nationals (PCNs) who are brought from home operations, Host country nationals (HCNs) who are local employees and finally Third Country nationals (TCNs) (Scullion & Collings 2006). Among these three groups of employees, organizations has to focus maximally on the HCNs. Entering organizations are duty bound to recruit high number of HCNs because they have to give something to the population that host their organization and also for practical purposes including low cost labour, logistical reasons, etc. Thus, when qualified at the same time low cost labour is available, entering organizations can achieve two objectives in one stroke. Peng and Meyer (2011) discusses about this recruitment process by stating how it involves â€Å"identification of suitable local employees, convincing them to apply for a job, and selecting the most suitable candidates for each job.† Management of recruited employees After recruitment process, organizations have to consider the factor of aptly managing culturally differe nt employees. That is, as each country will have certain distinct cultural traditions, and as the local employees would have imbued those traditions, it could be visible during their functioning, thereby necessitating apt management. Like the above mentioned recruitment process, during organization functioning, it would be better for the organization to prepare and promote local employees to managerial positions. This is line with the theoretical concept that the organizations operating in foreign soils should follow polycentric

Communication College Assignment Example | Topics and Well Written Essays - 1500 words

Communication College - Assignment Example There are many other qualities these are among the qualities essential for effective communication. My personal communication goal is to become more confident and more open with my feelings to my parents and to my friends. There are many times that I feel quite frustrated but I cannot find the words to express my thoughts and my feelings because I am afraid that I may not be understood well. I am trying to learn to be more confident in my choice of words. I should want to express my feelings and emotions without using offensive words. I should learn to use more euphemistic terms so that I can tell them what I do no like without necessarily courting disaster. I should learn to be more open and to communicate with them constantly rather than shun away because this will not do any good. Keeping quiet and keeping a distance are nonverbal expressions of my indifference and I should work that out if I want to have a better relationship with anyone that come across my life. A client you work with is constantly rude and obtrusive: This is a psychological barrier to communication. I will not be able to understand my co-worker well because of I have a negative perception as a result of his attitude double meaning may result. He might mean well but because I find him rude I will have no way of telling if he is genuine and truthful in what he is saying. The clinic I practice in becomes humid during the day. When the window is opened the sound of traffic disturbs the consultation: This is an example of a mechanical barrier. The noise and humidity are obstruction to effective communication. It is difficult to be understood well because of the noise and the patient may not be comfortable because of the humid temperature. This makes the patients not very ready to listen to what I say. A client stands very close to you when they are speaking: This is an example of organic barrier. I may be disturbed with the loudness of the voice of the client or uncomfortable with his smell or nearness and that blocks my attention to what he is saying. You are a practitioner that has a speech impediment and wears contact lenses: There is an organic barrier here. I may not be able to produce the correct sound of the words and I might not see my listeners well so they may misunderstand what I am

Goldman Sachs Term Paper Example | Topics and Well Written Essays - 2250 words

Goldman Sachs - Term Paper Example 2.A.i. Key Products and Services 7 2.A.ii.Function of Products and Services in the World of Investments 7 2.A.iii. Goldman Sachs’ Role in IPOs 8 2.B. Goldman Sachs’ Influence on the Capital Markets 8 2.B.i. Positive Influences 8 2.B.ii. Debated Influences Among Investors and other Firms/Companies 9 3. Role of Goldman Sachs in China 10 3.A. Key Investment Areas in China 10 3.A.i. Key Areas of Interest of Goldman Sachs in China 10 3.A.ii. Successful Cases/Engagements in China 11 3.B. Valuing China’s Present Economic Situation 11 3.B.i. Current Investment Climate in China- Views 11 3.B.ii. Forecasts for Future Prospects in China 11 4. Conclusion 12 4.A. Goldman Sachs’ Performance in the World of Investments 12 4.B. Goldman Sachs’ Role in China 12 References 13 1. Introduction to Goldman Sachs 1.A. Goldman Sachs History Goldman Sachs is an American investment bank that has its roots in Manhattan in New York City, having been founded there in 1869, with its key competencies being in general investment banking, financial services, the management of investments, and securities. It leads the world in the management of mergers and acquisitions, the provision of services tied to underwriting, the management of assets, as well as prime brokerage services that it is able to provide to individuals, companies, and countries. Once unassailable and with a pristine reputation built over its lifetime, the bank had seen its reputation and standing in the banking community tarnished as a result of its actuations during the financial crisis that erupted from 2007 and whose after effects are still being felt up to the present day. From its founding by Marcus Goldman in 1869, the firm emerged by the early part of the 20th century as one of the premier banking entities in the US, with expertise and market leadership in the establishment of the market for initial public offerings or IPOs. It was during the time after that, however, that the firm evolved from a trading company to an investment banking entity. The firm further evolved and developed into the 1999’s, to the point where it was able to launch its IPO of its own shares in 1999, transferring about 12 percent ownership of the firm into the hands of the investing public. Throughout this time and after, key personnel in Goldman Sachs went on to become key public officials managing the nation’s finances, as well as key executives in some of the country’s and the world’s major financial institutions, including Merrill Lynch and Citigroup. On the other hand, the controversies surrounding the alleged role of Goldman Sachs in inducing the financial crisis in 2007 and of aggravating the crisis have largely resulted in the reputation and fortunes of the investment bank being heavily hit in recent years, putting into doub t even its future prospects as a going concern and as a bastion of the capitalist system (Answers Corporation, 2012; Google, 2012; Thomson Reuters, 2012; Goldman Sachs, 2012; Taibbi, 2011; Taibbi, 2009; Smith, 2012). 1.B. Goldman Sachs Background The key activities of Goldman Sachs worldwide revolve around the management of investments, investment banking and securities management, as well as the provision of related financial services to countries, rich people, individuals, as well as corporations and other related entities. Its four business segments reflect its core businesses, which are Investment Management, Lending and Investing, Investment Banking, and Institutional Client Services. It has presence in key financial centers all over the world by way of vital offices, while being present likewise in a total of 30 countries Its key officers are the following (Google, 2012; Reuters Thomson, 2012): Lloyd C. Blankfein Chairman of the Board, Chief

Outcast Theme in American Literature Essay Example | Topics and Well Written Essays - 2000 words

Outcast Theme in American Literature - Essay Example The leader was well aware of how much supportive press leaders who were behind him, such as John F. Kennedy, has gotten for their political support of arts, as well as how much goodwill the support of arts has generated home and internationally (Mihalache 34). He anticipated that through establishing a federal art agency that he might gunner more endorsement from the East Coast liberal development, which opposed most of his policies. The endorsement of arts is what constituted to the American outcast. Americas, prior to the â€Å"arts act,† were not always kind to the artists or people who basically opted to pull out of the traditional way of life so as to arrive at some knowledge and some individual integrity. The scientists, on the other hand, always seemed to receive all the praise whereas arts and humanities received mostly negatively reviews (Mihalache 34). The American outcast theme is also portrayed infamous American literature such as Rye, Huckleberry Finn, The Great G atsby, Scarlet Letter, Star Wars and Finding Nemo (Mihalache 35). All these works have the major theme of the main protagonist breaking away from the traditional way of life to living by trying to fulfil way the society has set for them but instead fulfil what they have set for themselves. Historically, the outcast arose from the mystique concerning frontier life (Mihalache 35). The Frontier Life, also referred to as the Turner Thesis, was an argument developed by historian Frederick Turner back in 1893, which held that American democracy was developed by the country’s frontier. As the 1774 to 1778 Governor of Virginia argued, Americans, at all times, think of a land that is far off even though they seem content with the one that they are already settled. The governor went on to say that if Americans attained paradise, they would still move on with the slightest chance of being promised an advanced place (Mihalache 35).

Making a Script for ENGL presentation Essay Example | Topics and Well Written Essays - 750 words

Making a Script for ENGL presentation - Essay Example In the late 1950s and 1960s, the beginning of postmodernism came into scene as a ‘new sensibility’ by attacking modernism’s official status and through canonization in the museum and the academy, as the high culture of the modern capitalist world. It was therefore a populist attack on the elitism of modernism and signaled a refusal of what Andreas Huyssen (1986) calls ‘the great divide’. The American and the British pop art of the 1950s and 1960s also presented a clear rejection of the ‘great divide’, preferring William’s social definition of culture as ‘a whole way of life’. This was proven in the late 1970s when the debate about the postmodernism crossed the Atlantic. Different cultural theorists also debated on the advent of postmodernism in various aspects. For Lyotard, the postmodern condition is the collapse of certainty and the dissolution of the metanarrative of ‘truth’. God, knowledge, higher education, science, the working class, all have lost their authority as centers of authenticity and truth. Popular culture of the postmodern condition is therefore, a culture of ‘slackening’, where taste is irrelevant and money is the only sign of value. For Baudrillard, postmodernism is a culture of the ‘simulacrum’ i.e. an identical copy without an original. Over the years we have seen a historical shift from a metallurgic society to a semiurgic society; destroying the very distinction between the original and copy. The result of this is not a treat from the ‘real’, but the collapse of the real into hyperrealism, where reality and stimulation are experienced as without difference, e.g. Disneyland, for it allows a concentrated experience of ‘real’ America. For Fredic Jameson, postmodernism is theorized from within a Marxist or neo-Marxist framework. It is referred to as the ‘cultural

Criminal law- Actus Rea and Mens Rea Essay Example | Topics and Well Written Essays - 1000 words

Criminal law- Actus Rea and Mens Rea - Essay Example In criminal law it is the basic principle that a crime consists of a mental element and a physical element.A person's awareness of the fact that his or her conduct is criminal is the mental element, and 'Actus Reas' is the physical element and 'Actus Reas' (the act itself) is the physical element.The concept of Mens Rea started its development in the 1600s in England when judges started to say that an act alone could not create criminality unless it was adjunct with a guilty state of mind. The degree for a particular common law crime varied for Mens Rea. Murder required a malicious state of mind, whereas larceny required a felonious state of mind.Mens Rea is generally used along with the words general intent, however this creates confusion since general intent is used to describe criminal liability when a defendant does not intend to bring about a particular result. On the other hand specific intent describes a particular state of mind above and beyond what is generally required. (An swers, 2008)To secure a conviction, the prosecution side must prove that the defendant committed the crime while in a certain state of mind. The definition is specified of every crime before a person can be convicted as a prerequisite for Mens Rea. There are three states of mind which constitute the necessary Mens Rea for a criminal offence. These are intention, recklessness and negligence and are described below. (Law Teacher, 2006)Direct intent is the normal situation where the consequences of a person's actions are desired. Oblique intent comes in the situation where the consequence is known by the defendant as virtually certain, although it is not desired for its own sake, and the defendant goes ahead with his actions anyway. (Law Teacher, 2006) Intention Based On Foresight of Consequences For a person to get acquitted for some charges, then that person should have the full knowledge that his/her actions would definitely result in a specific consequence. A probability that something can occur or might occur is not enough to subject a person on criminality. The Section 8 of the Criminal Justice Act 1967 explains how intention or foresight must be proved by the following paragraph: "A court or jury in determining whether a person has committed an offence, (a) shall not be bound in law to infer that he intended or foresaw a result of his actions by reason only of its being a natural and probable consequence of those actions; but (b) shall decide whether he did intend or foresee that result by reference to all the evidence drawing such inferences from the evidence as appear proper in the circumstances." (Law Teacher, 2006) The cases where they were applied are listed below. The relationship between foresight and intention was considered by the House of Lords in: Hyam v DPP [1975] AC 55 R v Moloney [1985] 1 All ER 1025 It is important to note that foresight of consequences is not the same as intention but only evidence of intention: R v Scalley [1995] Crim LR 504. The most recent case in this area is the decision of the House of Lords in: R v Woollin [1998] 4 All ER 103. The law says - For the prosecutors to come up with evidence that the defendant had directly intended to perform a certain action to get a specific result would be extremely difficult (R v Moloney, 1985). This is because one cannot know what is or what was inside the defendant's mind when the action was taken. Therefore in criminal law, the proof of only the foresight intent is required as opposed to direct intent. (Law Teacher, 2006) Recklessness Recklessness is taking an unjustified risk. In most cases, there is clear subjective evidence that the accused predicted but did not desire the particular outcome. When the accused committed the act, the risk of causing the given loss or damage was taken. There is always some

Assessment Individual workbook (70%) 3000 words Assignment - 1

Assessment Individual workbook (70%) 3000 words - Assignment Example It acts in accordance with all the legal as well as other requirements essential for political involvement and dealings (Pan & Goodier, 2011). Political decisions of the government decide fiscal and regulatory policies which have to be taken into account at the time developing the strategy. For instance, the government’s ‘Mortgage Support Policy Scheme’ supports home owners who have fulfilled the set criteria to pay back their mortgages by offering around 80 percent of total interest assured. This policy will somehow decide part of Bryant-homes’ policy since the more individuals who can find the money to pay back mortgages, the more houses will be sold. Economic: The general economic view for the last six quarters has been that of a contracting financial system. Even with the small intensification attained, the majority of sectors of the economy are still suffering from the outcomes of the recession. The result, together with increasing unemployment level, is that individuals have smaller amount money to use, and are likely to spend their restricted resources on necessary products. This invariably indicates that the high end market where Bryant-homes is represented may suffer. Nonetheless, the government has made attempts to ensure ascertain that additional credit is accessible to individuals via the banks â€Å"by issuing bailout funds† (Barlow et al, 2003, p. 139). These developments indicate that the company may have to sell its significant stock of developed houses at prices quite below to what was actually estimated, with the purpose of raising cash and enhance liquidity. Social: The business has started different societal campaigns to support learning, secure operational environment and job assurance to the individuals. Social factors as well influence the policies Bryant-homes adopts since alteration in â€Å"patterns of living may dictate what sort of houses increase in demand† (Pan et al, 2007, p. 190),

Ayurvedic Medicine Essay Example for Free

Ayurvedic Medicine Essay Class name Date Introduction Ayurveda, the ancient Sanskrit word (Ayus/living and Veda/revealed wisdom) comes from the traditions of the ancient Indian sages, also known as Rishis. The word â€Å"denotes the enlightened knowledge of all aspects of optimal, healthy, everyday living, and longevity† and, its followers believe Ayurveda to be a â€Å"fortress of wisdom† (Ninivaggi 2008, xvi). Being that the medical practice of Ayurveda goes back as far as 6,000 years, 3,000 of those years recorded and verifiable, it is worth inquiring about why the seemingly successful methodologies and medical practices have not been adopted into the Western framework of scientific medicine. Although Ayurvedic methods and its practitioners are becoming more popular in the United States, with the increased interest by North American patients in preventative and holistic treatments, there appears to be a disconnect about these procedures as validated by providers within North America and our system of payers (i. . , the insurance agencies). As indicated by the Rocky Mountain Institute of Yoga and Ayurveda website, a Boulder, Colorado agency, it was learned that although reimbursements can be found, it often times requires a unique â€Å"system of billing and coding† to ensure payment. There are numerous reports and studies being done that show how Ayurvedic medicine is not just an ancient version of complementary and alternative medicine, but rather these studies demonstrate the validity for support of the treatments. One example of this would be in cancer treatment, there are herbal and traditional medicines that are being studied worldwide to validate their effect on cancer. Alternative and more natural approaches to curing and managing cancers are becoming more popular and common. With the existing regulatory policies and perceptions surrounding Complimentary and Alternative Medicine in the United States, it is my goal to show and provide statistics that will increase awareness and acceptance of the medical wisdom of Ancient Ayurveda. There will be an investigation and explanation showing how Eastern Indian healthcare treatments have been scientifically examined and how they can successfully be adopted into the U. S. healthcare model, via a more global perspective on illness, disease and the prevention of disease from a wellness and holistic approach. Review of Literature The following section summarizes the history of Ayurveda, describes major trends and holes found in the existing research, and explores the evidence both supporting and disproving Ayurveda as a viable and proven healthcare strategy. The History of Ayurveda The concept of Ayurveda was developed sometime around 2500 and 500 BC in India. Ayurveda is rooted in Buddhist and Hindu traditions, but it has been said to connect with Asian medicine (Warrier 2011). Essentially, Ayurveda suggests that the body’s ability to heal itself â€Å"acts through three forces called doshas. These are vata (space and air), pitta (fire and water), and kapha (water and earth)† (Yeager 1998). In order to live a healthy life, these doshas must remain balanced. Typically, Ayurveda is most often used to prevent disease, and has proven beneficial in the treatment of high blood pressure, cholesterol and stress (Yeager 1998). Ayurveda is also helpful in everyday life. Translated, Ayurveda means â€Å"science of life. † This definition is relevant because the ancient Indian system of health care focuses views of man and his illness evolving from the body and its external factors (Yeager 1998). In the present context, the Ayurvedic system of medicine is becoming more widely accepted. It is practiced in India and also in the more economically evolved countries such as Europe, the United States and Japan (Samy, Pushparaj and Gopalakrishnakone 2008). In the mid-1990’s, The World Health Organization also recognized Ayurveda as a system of sophisticated traditional medicine that involved the study of life stimulating observation, and fostering scientific research (Berra and Molho 2010). With the existing and evolving global healthcare crisis that is also currently plaguing the United States (U. S. ), one would believe that an affordable, safe and proven health system so globally recognized would have been able to pass at minimum the test of time but, this is not the case. Although the recent decade has brought about many observations that have added to the scientific credentialing of Ayurveda and other forms of Complementary and Alternative Medicine (CAM), there are still concerns about the ancient Indian treatment and its scientific validity, this is especially true in the U. S. (Rastogi 2010). â€Å"Before the recent upsurge of traditional medicine in a global perspective, Ayurveda was persistently criticized for its ambiguity and philosophical tenants incomprehensible to occidental mind† (Rastogi 2010, 1). Ayurvedic Research Methods Ayurveda is arguably an under researched topic, as scholarly research did not truly begin until the 1970s. This stunted research can be separated into three distinct categories: the examination of traditional Ayurveda in pre-colonial South Asia, the examination of Ayurveda in colonial and post-colonial times in South Asia, and an examination of Ayurvedic practices outside of South Asia (Warrier 2011). The first wave of Ayurvedic research used treatises written in Sanskrit to decipher the origins of Ayurveda. This research helped to conceptualize and understand the Ayurvedic understanding of the body, health and practice, which heavily differed from other representations during that time (Warrier 2011). The second wave of research showed that Ayurvedic practices were encouraged in India until 1835 when British policy changed. When India gained its independence in 1947, the government took immediate steps to standardize Ayurveda; however, the practice was still poorly funded. The effects of British colonialism and favoritism for biomedical has been long lasting. Current practices of Ayurveda are much of hybrid between the two medical practices (Warrier 2011). The third wave of research focused on the advent of Ayurveda in the West (the United States and the United Kingdom) beginning in the 1980s. Deepak Chopra and Maharishi Mahesh Yogi are cited as influential individuals who popularized Ayurveda in the West. Although Ayurveda became more popular, it was discounted as a â€Å"New Age† fad. The third wave of research largely avoids discussions of healthcare reform, or conversations on the â€Å"legitimacy and authenticity of their [Ayurveda] practice† (Warrier 2011). Ayurvedic research presents additional problems. Firstly, â€Å"It’s difficult to conduct double-blind placebo-controlled trials, [ ], because Ayurveda is a holistic system that treats individuals differently with multiple methods† (Hontz 2004). However, these modern scientific studies often ignore the primary objective of Ayurveda, which is to see patients as individuals in need of unique care. Secondly, the new and emerging research has not been disseminated, and the new textbooks on the practice have not been updated. Because this new wealth of information has not yet made it to professionals or students, it is of little use. Within the study of Ayurveda, numerous scholars are calling for new research methodologies (Baghel 2011). In the past, many studies have focused on the use of the plants and herbs (herbal pharmacology) in Ayurveda. Despite the screening of over 2000 medicinal plants over ten years, no conclusive data emerged. Based on the inconclusive findings, other researchers continued to suggest that Ayurvedic research should address the uses and benefits of plants. This research has led to advances in traditional medicine, such as the use of certain plants when modern medicine is unavailable (Baghel 2011). Currently, Ayurvedic research is concerned with altering the research methodologies, separating itself from traditional scientific practices. Another issue with Ayurvedic research is the translation of terminologies. â€Å"For instance, Vata is not air, Pitta is not fire and Bhasma is not oxide- they have much deeper scientific meaning† (Patwardhan 2009). Because Western scientists fail to grasp the full meaning of certain terms, the scientific research of Ayurveda falls short and its reputation has actually been damaged. These failures concerning Ayurvedic research have resulted in certain consequences. Scientists have simply viewed Ayurveda as a means to bolster modern medicine, rather than a unique practice. In addition, eastern Ayurvedic practices have reached a standstill in the midst of the research and implementation controversies. This has severely paralyzed the Ayurvedic educational system, along with its practice (Patwardhan 2009). Many scholars and practitioners conclude that Ayurveda needs to define itself and establish a universal methodology (Baghel 2011). Unless this occurs, Ayurveda will continue to loose momentum. Scholars have suggested adopting a transnational approach to Ayurveda in order to refocus the research. Evaluating Ayurveda from a transnational perspective means looking at, â€Å"[ ]where personnel, ideas, meanings, symbols, products, and practices are constantly crossing boundaries [ ]† (Warrier 2011). This viewpoint would ideally look at the influence of of local practices on global traditions. The American Healthcare System: Evolution? There is evidence in the U. S. nd throughout the world of a growing demand for alternative healthcare choices, based upon the best practices from varying healthcare models. This demand for options appears to be based on an opinion that any single system of healthcare has its inadequacies and will not be able to solve all contemporary health care needs (Shankar 2010). It is this perhaps this assessment that has brought about the dramatic growth of the Complementary and Alternative movement as well as the awareness and evolution of myriad methods of Integrative Medicine (I. M. ) in the last ten to fifteen years. Luckily for proponents and practitioners of Ayurvedic medicine and research, governments and regulatory bodies appear to have also begun to understand the need for varied approaches to health and wellness with the intent that all new models must also establish their safety, quality and efficacy (Shankar 2010). Agencies such as the National Center for Complementary and Alternative Medicine (NCCAM) and The Food and Drug Administration (FDA) are just a few of the institutions in the United States that are starting to provide guidance and policy around C. A. M. and I. M. , which is a positive step because without these policies and approvals, there would be no evolutionary progress whatsoever in terms of Ayurveda in delivery in the U. S. Over the past two decades, U. S. mainstream medicine has become more accepting of Ayurveda and other alternative medical practices. â€Å"A widely quoted study in the New England Journal of Medicine suggests that a third of Americans spend $14 billion a year on alternative medical methods† (Perry 1994). Yet much of this money comes from consumers’ pockets. Although the interest in alternative medicine has increased in recent years, it is still difficult to find insurance coverage, but some companies are offering group and individual policies (Dharamsi 2011). Although the coverage is substantial, it is not full coverage. The need for insurance companies to alter their plans is becoming more pressing as the prevalence of Ayurveda increases in the U. S. Despite this acceptance, many questions and controversies remain. Doctors in India and the U. S. are concerned with the standardization of the practice of Ayurveda in the U. S.. In India, practitioners of Ayurveda are required to obtain a Bachelor of Ayurvedic Medicine and Surgery (BAMS) degree, which is the equivalent of five and a half years in medical school (Yeager 1998). However, no such lengthy certification exists (or is required) to practice in the United States. This is further problematic because many of the herbs and treatments used in Ayurveda are relatively untested or unregulated. This means that a person seeking Ayurvedic treatment is left with the responsibility to conduct their own research and find a reliable practitioner. In order to mediate this issue, some U. S. medical schools are beginning to offer courses in Ayurveda similar to those seen in India (Swapan 2007). Yet, these courses are seminars and are completed in a matter of days. Ultimately, standardization is also necessary to price services so that they can be covered by insurance conglomerates. Medical scholars are investigating the potential of an integrative medicine (IM) approach (Patwardhan 2009). These same scholars often look to China as a successful example of integrative medicine. China has accomplished this feat by requiring medical students to complete coursework in Western and traditional medicine (Patwardhan 2009). This dualistic approach means that doctors can provide patients with a combination of treatments. A similar situation is arising in India at the Banaras Hindu University where students integrate modern medicine with Ayurveda and Yoga (Patwardhan 2009). However, integration is sometimes difficult because implementation and methodologies have to be developed and agreed upon. Further, many risks are involved with integration, including the potential to lose identity; conversely, there is the possibility of Ayurveda being overtaken by modern medicine. To be successful in the integrative endeavor, Ayurveda must â€Å"recognize, respect and maintain the respective identities, philosophies, foundations, methodologies, and strengths of all systems† (Patwardhan 2009). Research Approach Form of Knowledge Chronic disease in the United States (U. S. ) is now more of a challenge. The number of Americans suffering from chronic disease has increased rapidly in the past two plus decades, and today 51 percent of the U.S. population is struggling from conditions such as heart disease, cancer, diabetes, and stroke. Chronic disease in the U. S. is so prevalent that it is largely accepted as a part of everyday life. Unfortunately, conventional Western medicine is largely focused on treating the symptoms of chronic disease and prevention often goes ignored. According to the Centers for Disease Control and Prevention, Chronic diseases such as heart disease, stroke, cancer, diabetes and, arthritis are among the most â€Å"common, costly and preventable of all health problems in the U. S. Yet, they account for â€Å"7 out of 10 deaths or 51% of deaths† annually, according to a 2008 report of 2005 mortality data. The Problem. With the traditional Western model of healthcare in America being as financially lucrative as it has been historically (i. e. , reactive disease processes, hospitalizations, pharmaceuticals, insurance plans) one can only imagine that there is not much of a desire by these money making industries to move toward a model of preventative medicine. It is also less likely that these industries would consider Complementary and Alternative Medicine (CAM). The proposed research study aims to explore the ancient art of traditional Eastern Indian Ayurvedic medicine, its validity as a scientifically proven means of symptom prevention, daily healthcare regimen, disease curative and whether or not this form of CAM has a current presence in the U. S. or any potential future in our existing healthcare system. Research questions. The research will address the following questions: 1. What is the Ayurvedic philosophy of health, healing and medicine? 2. What does Ayurveda in North American U. S. culture consist of? Who are the practitioners? Who are the patients? 3. What does current research say about the outcomes of chronic diseases treated with Ayurvedic methods? 4. Are Ayurvedic treatments currently being paid for by U. S. insurance plans, if not, why not? 5. What are the trends with regard to CAM treatments in the American healthcare model? Target Audience The audience for this research and those that will benefit from its findings would be the United States population as a whole. Not only will the current and potential patients of the ancient practice benefit by a growing and increased awareness and hopeful change in insurance policy if needed but, current practitioners and those considering the study and certification of Ayurvedic medicine should be relieved and assured of their futures as proven through reports of clinical outcomes and accepted methods of Ayurvedic delivery in Western culture. Controlling Factors Since Ayurveda is a somewhat recent discovery in The United States , the expanse of its historical data originates from India. The majority of its practitioners and patients are native Eastern Indians and the information found within academic reports can mostly be traced back to organizations hailing from India. Since a determination about the effectiveness and utilization in The United States is the goal of the research, the information may be difficult to locate. The healthcare publications and journals that will report Ayurvedic outcomes will likely be written by Indian physicians based upon Indian lifestyles and dynamics of health within the country of India. I would assume without further research and investigation, that there will be some conflicting if not incomplete and/or possibly biased information being reported. Data Collection Methods A dual approach of qualitative and quantitative research review will be done. I will use the world wide web and other library resources to locate industry white papers and respected journal articles that show specific recordable and scientific data about Ayurvedic deliveries and outcomes, statistics on use and trends, specific to the United States. Since the Boulder, Colorado area is a well-known community of those who seek or practice CAM therapies some information can be obtained by agencies willing to share their experiences, knowledge and clinical data. IRB approval will be required to perform any type of survey or case study that will be implemented with these approving agencies.

Strengths And Weaknesses Of Neighbourhoods Young People Essay

Strengths And Weaknesses Of Neighbourhoods Young People Essay The phrase neighbourhood renewal/regeneration relates to a series of programmes in place to ascertain local needs and develop ways to deal with poverty and deprivation in the United Kingdom which are known as Super Output Areas (SOAs).   Local area based initiatives have been a universal approach to the problems that deprived neighbourhoods have endured in Britain since the 1960s. The majority of programmes at that time were very short term and tended to focus on single issues. In the late 1980s an integrated approach was tried. (Imrie and Raco, 2003). Initiatives started to increase in the 1990s and as a result of this, the number of the governance of neighbourhood regeneration came to be characterised by a series of interlinked and spatially overlapping partnerships (Imrie and Raco, 2003: 85). Labour introduced the neighbourhood renewal strategy plan in 2001, this was a new approach to tackle social exclusion and poverty in the most poorest neighbourhoods in UK. Tony Blair talked about the purpose of The Neighbourhood Renewal Strategy in his speech to the nation: where no-one is seriously disadvantaged by where they live, where power, wealth and opportunity are in the hands of the many not the few. This action plan is a crucial step in creating one nation, not separated by class, race or where people live   the purpose of the strategy was to narrow the gap between outcomes in deprived areas and the rest (Social Exclusion Unit, 2001:1)    The main aims of local based anti-poverty and community development programmes are to tackle the issue of social exclusion in the more deprived areas of the country. In relation to British social policy, the term social exclusion is relatively new. The government has described social exclusion as a shorthand term for what can happen when people or areas suffer from a combination of linked problems such as unemployment, poor skills, low incomes, poor housing, high crime, bad health and family breakdown. (www.socialexclusion.gov.uk). There are many different explanations for social exclusion, and many different factors which add to social exclusion, by examining the different factors programmes can be developed in order to address the problems and try to promote a more cohesive community. The individual can contribute to social exclusion by the nature of their race, gender, culture, beliefs, disability etc. Lack of resources Lack of opportunities to work Learning opportunities Health issues Decent housing Disruption of family life. Living in disadvantaged neighbourhoods (Haralambos and Holbron, 2004:253) Anti-poverty and community development programmes are targeting these areas with improvements in social housing, re-developing existing social housing, increasing education opportunities (such as access to education and grant schemes for students), making health care more available, targeting the younger generation to educate on matters that will effect their future, raising the profile of neighbourhoods. One of the projects I am more familiar with is the Sure Start programme (now known as Childrens Centres) and I am going to discuss the strengths and weakness of the centres. Governments Policies In 2003, the Government published a green paper called Every Child Matters. This was published alongside the report into the death of Victoria Climbie. The Green Paper prompted discussions about current services for children, young people and families. There was a wide consultation with staff that worked in childrens services, and with parents, children and young people. Following the consultation, the Government published Every Child Matters: the Next Steps, and passed the Children Act 2004. The Act provides a legislative spine for the wider strategy for improving childrens lives. This covers the universal services which every child accesses, and more targeted services for those with additional needs Department of Education and Skills, Children Act 2004. http://www.dfes.gov.uk/publications/childrenactreport Indeed, the Chancellor of the Exchequer, Gordon Brown MP, speaking about child poverty at the Sure Start Conference on 7 July 1999, acknowledges that poverty is a many-sided problem which requires many-sided solutions: First, we must tackle child poverty at its source the absence of work, in work poverty and providing increased financial support for families to tackle child poverty, so that by our actions we lift a million and more children out of poverty. Second, what I want to concentrate on today, because improving public services health visitors, nurseries, playgroups, childcare, learning support in the poorest communities is vital to tackling child poverty, our Sure Start programme will invest in young children in areas of greatest need. Third, we must mobilize not just government, local and national, but voluntary help and community action and in the programmes we are introducing not only in Sure Start but in the New Deal for Communities and our expansion of childcare provision we must mobilize the forces of concern and compassion in new partnerships to tackle child poverty. Fourth, as David Blunkett has said, we must make sure that all our schools are as good as our best. In the old economy it was possible to survive with the old inequalities an education system that advanced only the ambitions of the few. http://www.hm-treasury.gov.uk/633.htm Key achievements: Labour has undertaken the biggest expansion in early years education since 1945; investing  £21 billion since 1997. Every three and four year old has the right to a free nursery place, which we will extend from 12.5 hours a week to 15 hours by 2010. Since 1997, the number of registered childcare places is up by around 644,000 from a place for one in eight children to one in four children. Delivered nearly 3,000 Sure Start Childrens centres, reaching two million children and their families. Labour has expanded nationally the Bookstart scheme which gives every one and two year old a satchel of books and every three and four year old a treasure chest of books and crayons. http://www.labour.org.uk/early_years Sure Start Sure Start was the Labour Governments programme that aimed to deliver the best start in life for every child. They bring together early education, family support, childcare, health and welfare advice. It aims to develop services in some of the more disadvantaged areas (identified by the multiple of deprivation indices. In Sure Start there is a normally a central office where all the team work together to support children and families in the local areas. The sure start programme was initially a ten year programme but was abolished in favour of childrens Centres. The change from Sure Start has not really been noticed and is still referred to as Sure Start. Amid all the hullabaloo about the governments 10-year childcare strategy, one quite momentous change has gone relatively unnoticed: the governments much-lauded Sure Start programme has been abolished. N. Glass, The Guardian, Wednesday January 5 2005 The Sure Start centres, provided integrated services including health services and family support services, as well as childcare. The different services that children centres provide for children and families contribute to the Every Child Matters outcomes. Local authorities lead in planning and implementing centres. Some of the services I have seen implemented at RoseHill include, support that has been individually tailored to meet the families and their childrens needs such as, parenting assessment, working with families in the home or at the centre based on a one to one basis, providing parenting courses that aim to improve parental skills so improve the life and chances for children. There are also family workers at the centre that deal with over 11s and their families and carers, this service aims to work through problems the family may have and keep the children at their homes with their parents. One big issue the centre faces in relation to families is that of extended families and the centre provides a much needed support framework and advice for children and families that are going through divorce and separation issues, given the families a safe environment to discuss issues and problems. Along side this are the other services normally associated with a Children Centre, education courses , healthy eating, reading and writing support, I.T. help, employment help such as C.V. writing and interview techniques, and childcare support. Some of the members include:   Education advisers Activities Volunteer co-coordinators Midwives Crà ¨che Workers Health Visitors Play workers Speech and language therapist Child care advisors Family Support (Social Services PEEP Workers IT Trainers One of the most important facts that impacted on the programme was that the Sure Start programme was not allowed to run its full ten years span, and little or no follow-up evidence was available for analysis, before expansion. With principal responsibility for Sure Start alongside my DfES colleagues, I had to argue against its immediate expansion on the grounds that it would be better to accumulate some experience of running it first. (By the October 1999, when I first discussed the scheme with the chancellor there were only two local projects actually running). My arguments did not win the day and in July 2000 the programme was extended to 550 local projects. Norman Glass Society Guardian, 2005:1 The Sure Start programme was very generously funded and when the programme was agreed to be spread around a further 3,500 centres, the money had to come from somewhere. This meant that the generous funding had to be more evenly distributed. This has meant that the centres had very limited funding and cuts had to be made. Although the Sure Start programme did not continue for the full planned ten year term and lost most of the generous funding, many of the good practice is carried out in the Children Centres that followed the Sure Start initiatives one of which is PEEP. PEEP is an early learning intervention, which aims to contribute towards improving the life chances of children, particularly in disadvantaged areas.  It concentrates on supporting parents/carers to develop three particular aspects of learning with their children: literacy and numeracy self-esteem learning dispositions The PEEP Learning Together programme  focuses on how to make the most of the learning opportunities in everyday life at home listening, talking, playing, singing, sharing books and having fun!  PEEP supports parents and carers  in their role as the first educators of their children. It works with adults about their childrens very early learning. http://www.peep.org.uk/section.asp?id=5 Another flaw of the Sure Start centres was that although Sure Start centres were based in deprived areas not all deprived children lived in these neighbourhoods. Because not all disadvantaged children live in deprived areas each small sure start programme could serve only a minority of disadvantaged children: those from adjacent areas could not could not participate and local authorities and health agencies were faced with relatively well-financed early years programmes in one part of their domain and much less well provided areas next door. This was very difficult to handle. Norman Glass Society Guardian, 2005:1 We know that children who grow up in poor families are less likely to reach their full potential, less likely to stay on at school, or even attend school, more likely to fall into the dead end of unemployment and poverty as an adult, more likely to become unmarried teenage mothers, more likely to be in the worst jobs or no jobs at all, more likely to be trapped in a no win situation poor when young, unemployed when older. http://www.hm-treasury.gov.uk/633.htm Another weakness of the centres is that it involves trying to motivate and empower the local community to identify their needs and participate in the management side of the day to day running. This requires community workers who have good community and social skills to encourage local community members to actively take part. The concerns were that after the ten years were up that the community centres would not have been taken on by the local members and the centres would eventually be closed down. The Childrens Centre at Rosehill was formerly a Sure Start Centre and the differences are striking. The centre has lost a vast amount of staff members and the funding has been cut considerably. The workers continue to provide opportunities for the local parents and children so the principles of Sure Start are being maintained. Some of the local projects are working well such as the Reclaim your garden for food, Further education for parents, IT sessions, and one particular programme that I am involved with is Without Walls. Without Walls aims to network within the community to bring people together and try out new activities. It aims to break down barriers between people by organising little trips and coffee mornings with a view to a residential trip in the near future. The strengths of this project are that it encourages members of the community to mix with different groups within the community and to form a bond between them. Encouraging and empowering people to try different activ ities in a comfortable and safe environment. The only draw back is that Community Development takes time, patience and enthusiasm. Disadvantaged communities have to be persuaded to participate and their natural suspicious leads them to hang back until there is something to show. Norman Glass Society Guardian, 2005:1 The childrens centre network is still being expanded, and there will be up to 2,500 childrens centre throughout the country. Centers will be established to provide the most disadvantaged areas with links to local childcare networks and Job centre Plus. The ten-year strategy for childcare recommends that more local area based and to ensure that services are more accessible. The Strengths of Local based and community development programs are: The strengths of these projects are:- Brings diversity to local areas Raises education within the community Builds social capital Promotes a more healthy lifestyle Facilitates more parents to be able to return to work Develops individual social skills Encourages participation of community members Promotes cohesiveness Uses a bottom up approach as opposed to top down Creates Job opportunities Attracts other resources Has local government involvement The Limitations of Local based and community development programs are: It doesnt always reach those that vulnerable and excluded Resources limited opportunities Can cause discrimination over resources Funding limitations Can be difficult to evaluate/target and identify objectives Time consuming Can have funding limitations The project was aimed at parents to enable them to raise their children themselves, this in itself can prove difficult as many different cultures, races and societies have different views on what is considered successful parenting. Some of the more successful local projects seen at Rosehill/Littlemore Childrens Centre have been the parenting courses and Baby G, a group set up specifically to target under 25s with young children and childcare courses. This has brought a diverse group from the community together and is still successfully recruiting members that might not have attended the centre for various reasons. Again outreach work has enabled this to happen. In conclusion, local based area projects are as successful so long as participation is encouraged and that the projects are based on the communities needs. Community workers must continue to empower local residents to take part and in part, own the projects themselves in order for it to be sustainable. The most important part of any project is to reach the more vulnerable members of the local population; this can be achieved by successful outreach work. The success of any local area based projects depends entirely on the community workers personal skills and support from local authorities, along with a good community based knowledge. To be able to continue with all the work at Childrens Centres) I believe the projects need more funding to grow and sustain the important work carried out by these centres. Only with more government funding will they survive and be successful. Bibliographies and Referencing www.socialexclusion.gov.uk, 3rd November 2008 Haralambos and Holborn, 2004, Sociology, Themes and Perspective, Sixth Edition, HarperCollins Publishers Limited. Brown, G., (1999) Speech by the Chancellor of the Exchequer, Gordon Brown MP, at the Sure Start Conference, 7 Jul. 1999, London: HM Treasury (online). http://www.hm-treasury.gov.uk/633.htm November 3rd 2008 Glass, N., 2005 Surely some mistake? Society Guardian 5th January, pg1 Glass, N., The Guardian, Wednesday January 5 2005, pg 1 http://www.dfes.gov.uk/publications/childrenactreport 20th October 2008, 10.23am http://www.labour.org.uk/early_years 21st October 2008, 10.39am http://www.peep.org.uk/section.asp?id=5 20th October 2008, 10.13am Imrie, R. and Raco, M. (2003), Urban Renaissance. New Labour, community and urban policy. Bristol, The Policy Press

Outpatient Treatment for Mental Health in New York

Outpatient Treatment for Mental Health in New York Michael Woodworth   For many individuals in the United States, mental and behavioral illness is something they must deal with on a daily basis. For many of those, the depression, anxiety, and feeling of powerlessness has become the norm due to a lack of treatment options. As the number of affected individuals grows, outpatient clinics are becoming the treatment of choice for many Americans and in New York this trend also holds true. With the third highest population in the United States, New York is home to over one million individuals suffering from mental illness. According to the 2015 census, the number of individuals suffering from mental illness had reached an all-time high of 900,000 adults and 528,000 adolescents (Friedman, Woods, LaPorte, 2016, p. 4). Despite the alarming increase in numbers, less than 20% of those affected by mental illness receive adequate, if any treatment at all (Friedman, Woods, LaPorte, 2016, p. 4). Although this may be partly due to the individual choosing not to receive care, I believe there is a direct correlation between the policies and procedures New York has put in place that govern the access, cost, and quality of mental health care. The New York State Office of Mental Health currently has over 50 categories of policies and procedures that govern treatment options, approved providers, medication, and criteria patients must meet to be treated, just to name a few (Office of Mental Health, 2017). As a result, many individuals choose to self-medicate or simply ignore their symptom rather than deal with the bureaucracy that surrounds behavioral health as well as the negative stigma associated with anyone receiving the treatment. Of the 20% of individuals receiving mental health services in New York, nearly 71% are through outpatient treatment services. Outpatient treatment exist as a way of providing access to individuals who are suffering from disorders that may not require intensive inpatient treatment. They are capable of treating disorders such as depression, anxiety, grief, phobias, trauma, and so forth. Overview on Outpatient Care Systems Outpatient care can provide a wide variety of services to individuals seeking assistance with their mental and behavioral health. These services include, but are not limited to: individual counseling, group therapy, acupuncture, massage therapy, DBT, art therapy, interventions, couples and family therapy, and alcohol and drug detox. These services are based on severity and need and are often delivered by peer advocates, licensed counselors, nurse practitioners, case managers, clinical psychologists, psychiatrists, and medical doctors. New York State offers two main avenues of treatment to those seeking outpatient care; these are the hospital systems and the health programs available within the community. For many people in New York, there are only two ways into these outpatient programs. The first being through a referral from a qualified healthcare professional (QHP). This can include a primary care physician, clinician, psychologist, nurse practitioner, among others (Friedman, Woods, LaPorte, 2009). The second is through court mandated supervision and treatment, and with one in 52 adults in New York on probation or parole, this accounts for many outpatient treatment referrals. The question now becomes, with such incredible services available why are only 20% able to get them? The answer lies within the policies. Although the policies do provide expectations and restrictions regarding cost and quality, the majority of outpatient policies focus on access. These policies not only determine who is eligible to receive services, but also what services are covered by Medicaid and other insurance. So lets take a look at just how these policies hinder so many New Yorkers from receiving adequate services. Hospital Systems With the hospital system, as with any business, accessibility comes down to resources; and in many hospitals the resources are limited. As a result, outpatient care is reserved for those that will not only benefit from it the most, but also those who will bring the hospital the most profit. Most of the individuals in New York who are receiving mental health treatment are covered by Medicaid. Those covered by Medicaid are by definition poor, and despite the need for the treatment are unable to pay the out of pocket expenses associated with it (Garfield, 2016). This fact has had significant influence on the policy makers to establish a list of criteria that must be met in order for Medicaid to pay for the total treatment. In addition, they developed a list of reasons that a hospital can deny mental health services to patients. Unfortunately in New York, many of the hospitals have a board of directors that have little to no medical experience. Instead they are comprised of wealthy and powerful business professionals from within the community. For example, one prominent hospital in Upstate New York has a board of directors that consists of several CEOs and presidents of companies that have direct ties to the local congressmen and assemblymen. One of the members of the board is actually a longtime friend of the current Governor of New York. These ties to politicians along with a lack of medical knowledge often result in policies and decisions being made for the sole purpose of profit rather than care and in turn make access much more difficult. Community Based Services The second healthcare system is that of community based resources. This is where the bulk of outpatient mental health treatment occurs. Many of these resources are non-profit organizations that rely heavily on funding from the state. Accessibility to these resources are governed by the overall state budget and is solely based on where the money needs to be allocated that year. As a result, many community resources are limited in the number of patients they can treat due to the limited annual funds available. Much like the hospitals, this causes the community resources to deny service to many individuals that need treatment. In general, these services are delivered in three ways and are typically based on the severity of the need. Hospitals offer outpatient mental health counseling for individuals who may require a higher level of intensity. Hospitals often utilize psychiatrists who have the ability to recommend and prescribe psychotropic medications for those suffering from severe mental disorders such as schizophrenia. The second option for patients is a privately or publically run outpatient clinic. These facilities usually employ licensed clinicians who are supervised by a clinical psychologist. Although they can offer the same level of counseling services as the hospital, they are not equipped to prescribe or monitor medications. These facilities are primarily used to focus on the less intensive mental health disorders such as depression, anxiety, PTSD, and addiction. The third option is counseling and guidance through a religious leader. Although this option can provide assistance with minor mental health issues, it is seldom covered under insurance. This is due to the fact that in most cases, the religious leader does not possess the required education or credentials to be recognized by the state as a legitimate form of mental health treatment. However, as a result many religious leaders choose to pursue degrees in mental health so they can better serve their congregation. Barriers to Care New York has several different levels of care which include intensive outpatient treatment, outpatient treatment, step down treatment, continuing day treatment, and assertive community treatment (Friedman, Woods, LaPorte, 2009, p. 12). Each of which is a step within the continuum of care provided by New York State Office of Mental Health. Generally speaking, these steps are effective when utilized appropriately by the patient and followed through with by the provider. Unfortunately the greatest barrier falls in the follow through of both the patient and the provider. With over 380,000 adults and 575,000 adolescents in New York suffering from severe and persistent mental illness (Friedman, Woods, LaPorte, 2009, p. 12), it is easy for a patient to fall through the cracks of the system. Many providers have limited time and resources to track down a patient that missed an appointment, or just check in on a regular basis to see if they are alright. As a result, many patients will feel unsupported and stop treatment all together. As previously stated, outpatient is usually reserved for those with a professional referral and as such the access can at times seem quite limited. In the clinics that I have worked in, a patient could arrive only after a referral had been received. After they have arrived, they would undergo several interviews and assessments to determine if they would benefit from the treatments the clinic offered. If they would, then they could begin treatment. If however they were thought to not benefit, they would be referred to another clinic or to the local hospital for further consideration. In New York, the need for mental health services are far greater than the resources available and therefore every clinic and outpatient service does seem to have an extensive waitlist for services. I was a case manager for a supportive living program working with veterans suffering from mental health disorders as well as addiction and chronic homelessness. My program was a 12 month intensive treatment program and had 24 beds/apartments available. At any given time, the waitlist for this program had well over 50 individuals listed on it. Outpatient access is a serious concern in New York and so far has left much to be desired. For many individuals who require outpatient mental health services, access comes with three major barriers: Finding a clinic, getting approval from Medicaid and insurance, and physically getting to the clinic. Far too often these barriers hinder individuals from receiving adequate, if any services they so desperately need. With the constant change to Medicaid waiver services and insurance, it is difficult for clinics to accept every patient in need. With private insurance, managed care, and straight Medicaid placing strict eligibility and billing restrictions on the clinics, it is amazing that they are able to stay open at all. These regulations are causing the clinics to become more business focused instead of focusing on the real reason they exist. As a result of the clinics focusing more on the business, they are more inclined to accept patients that they can profit from the most. This ultimately tends to sway more towards those with private insurance as they are more likely to get approval for ongoing treatment. This leaves the majority of individuals suffering from mental health disorders to fend for themselves. As with any treatment, a referral is required to receive treatment in an outpatient setting. Attempting to get this referral poses the second struggle to accessibility. Many of those suffering from these disorders do not have a primary physician and are likely to go to free clinics if they seek assistance at all. As a result, many individuals are simply prescribed medications like Zoloft by the attending physician and told that they have a cookie cutter diagnosis of depression or anxiety. On average, it takes nearly six months of trial and error in medication before a referral is given and accepted by insurance or Medicaid. In far too many situations, the individual has given up on treatment before reaching the six months. Getting to a clinic often poses a barrier to those in a low income bracket. These individuals are unable to purchase transportation on their own and rely heavily on others or public transportation to maintain mobility. This requires them to find clinics that are on bus or subway line if they live in the city, or friends and family if they live in a more rural location. This causes unnecessary instability in treatment due to the patients inability to commit to a treatment schedule. For the more than 30 million adults in the United States that require but do not receive mental health services, 45 percent claim that the cost is the biggest deterrent. The average outpatient service can cost between $100 and $5,000 based on the service and the credentials of the provider (Babakian, 2013). In New York City the average rates for outpatient services are as follows: $80 $120 for a 45-55 minute standard counseling session (Babakian, 2013). $200 $300 for a 45 minute session with a psychologist or psychiatrist (Babakian, 2013). $60 $100 for group sessions facilitated by a licensed provider (Babakian, 2013). $300 $ 460 for individual art, music, and/or recreation therapy sessions with a licensed provider (Babakian, 2013). As with any healthcare service these can be paid for using self-pay, private insurance, and government insurance such as Medicaid and Medicare. Unfortunately due to the restrictions imposed by the mental health policies in New York, many individuals are forced to pay a significant amount out of pocket. As a result, many outpatient providers offer patients sliding scale charges which can be 30 percent lower than standard fees, payment plans with and without interest, and in some situations income based fees (Babakian, 2013). Although outpatient treatment is covered by most insurance, it is seldom covered in full. This causes many patients to stop treatment as a result of an inability to pay the deductible or co-pay. At this time, New York does not offer any additional assistance with co-pays or medical bills for individuals receiving outpatient services. However, if the patient were to be admitted to an inpatient clinic as a result of a mental hygiene arrest or emergency room visit, it would be covered in full by many insurance providers including Medicaid. This creates a situation that is counterproductive in that we do not offer treatment as an early intervention but rather offer it after the individual has reached a breaking point. In order to get an insiders opinion of the current barriers within outpatient care, I was able to interview Megan Cortese, LCAT. Ms. Cortese is a licensed art therapist and senior clinician in a very prominent outpatient clinic in Rochester, NY. During the interview I simply asked her what she sees as a barrier to her current and future clients. When asked what she would want to change about the overall way mental health services are provided, she had the following to say. The current system of mental health services has two major flaws; funding and accountability. Ms. Cortese stated that due to budgetary restrictions, lack of government funding, and overall economy struggles the quality of care is becoming lower. She stated that the clinical staff are underpaid and told to meet with as many clients as possible in a day. She stated that this causes many clinicians to burn out and therefore provide a subpar level of treatment. Ms. Cortese also stated that the lack of accountability from patients on Medicaid is ridiculous. She stated that when a patient on Medicaid does not show to an appointment that there are no penalties to the patient such as the cancelation fee that those of us with private insurance would have. Ms. Cortese stated that this causes patients to continuously miss appointments and therefore miss out on beneficial treatments. Quality of Care As for quality of care, New York does seem to excel at regulating the providers and clinics. The New York State Justice Center monitors, regulates, investigates, and enforces all policies regarding the fair treatment of individuals under care. As a result, every clinic is held to the same standards and accountability in regards to the treatment of patients. Although this is beneficial in providing adequate and proper treatment to all those involved in outpatient clinics, it is only effective if the patients are able to receive services. Policy and Influence So now that we have reviewed how these polices can hinder treatment, we must next understand not only how the policies come to be, but also who has the power to influence them. Health policy in todays modern world poses several complex legal, ethical, and social questions and as such require qualified individuals to write, approve, and integrate them into the current healthcare systems. As with the nation as a whole, New York relies heavily on Government officials to accomplish this objective while simultaneously respect and protect the rights of patients. As a result, several highly diverse and complicated groups are tasked with the oversight of these policies. Healthcare policies in New York are developed through the three branches of government; the judiciary, legislature, and executive branches. The judiciary branch is responsible for overseeing new policies to ensure that they do not violate any human rights as well meet all legal and financial guidelines. The legislature reserves the right to conduct hearings in an attempt to gather sufficient data from all parties involved with the policy. This ultimately provides additional checks and balances to ensure the legality and effectiveness of the proposed policy. The executive branch, or Governors office retains the power to sign the new proposed policy into law after it has made it through the checks and balances from the judicial and legislative branch (Gostin, 1995). Now despite a significant set of checks and balances within New York, policies are not always reviewed as they should be. Far too often members of the three government branches are influenced by outside factors and groups. As previously mentioned, outpatient treatment in New York has many governing bodies; which along with providers, insurance companies, and several special interest groups all have a way of influencing the current policies. Each of these groups have a significant impact on the access, cost, and quality of care that patients receive while participating in outpatient services. The real question is who has the power and are they using it to benefit the patient or are they simply looking out for their bottom line. So lets start from the bottom of the hierarchy and work our way up. At the bottom of the outpatient ladder are the small and seldom heard from special interest groups. In New York these are groups such as; NAMI (National Alliance on Mental Illness), NMHA (National Mental Health Association), as well as smaller support groups located throughout the state. The main focus of these groups is to educate the public, influence change and improvement, and advocate for the patients. Many of these groups rely heavily on petitions and public outcry to influence change and policy at the higher levels of the state government. Even though these groups do not carry the influence of some other groups, with a mass of concerned voters behind them, they are usually quite effective. Sitting on the next rung of the ladder are the providers who influence treatment and policy by acting as a deciding factor as to what if any treatment is recommended. The providers are in essence the frontline of the outpatient world. The providers conduct the assessments that provide the information to choose the most beneficial treatment option. The providers are able to influence policy by simply choosing a course of action. If the majority of providers choose the same treatment for a particular diagnosis, then it is likely that the governing bodies will consider that to be the go-to treatment. Once this is the case, it is very likely that policies will be rewritten to reflect this treatment as the acceptable one. Sitting on the next rung is the insurance companies. The insurance companies have significant influence over policy simply because they pay for it. Insurance controls who gets treatment, where they get treatment, and what quality of treatment they can receive. This is of course all based on what tier level the patients insurance plan is on. Ultimately, the insurance company has the ability to approve or deny treatments simply based on the overall cost and as a result many patients are unable to access necessary treatments and medications. Now, at the top of the ladder is the state agencies such as Department of Health (DOH), Office of Mental Health (OMH), State Legislature, and the Governor. It is implied that these people have the ultimate influence over access, cost, and quality of outpatient mental health treatment. Policy recommendations are delivered from the DOH and OMH to the legislature who then agrees and passes them along to the Governor, or disagrees and sends them back to the agencies for revision. Once in the hands of the Governor, the policy is either approved or denied. As most healthcare in New York is Medicaid funded, the Governor has significant influence over who gets treatment and what treatments are offered simply by approving the state budget. If the Governor approves a policy that allows more access to treatment, he must also approve an increase in taxes to maintain funding. However, if the Governor does not pass a policy for increased care, they may lose ratings and therefore votes. As a result, it is a very complex balancing act when influencing health care policy. Although the aforementioned groups seem to have the most influence over health care in New York, I stumbled across a group of individuals that seem to have influence over the Governor himself. The United Healthcare Workers Union (1199SEIU) is a union of pharmacists, nurses, and physicians located throughout the nation. The influential power of this group is astounding. In 2009, the full power of this organization was felt by then Governor David Paterson. With a severe surge in Medicaid costs in New York, Governor Paterson proposed $3.5 billion in cuts to the Medicaid program. The Governor proposed shifting monies away from inpatient hospitals and into outpatient clinics which were significantly less expensive (Eide DiSalvo, 2015). This would have resulted in a 2% loss in revenue for the inpatient hospitals annually. Medicaid is the primary source of funding for the inpatient hospitals which employ a majority of 1199SEIU members. The union responded to the Governors proposal with a serious ad blitz which cost over $1 million per week. After a month of adds belittling the Governor, Paterson retreated and instead approved tax increases and cuts to other programs (Eide DiSalvo, 2015). As a result of the serious influence by the 1199SEIU, the overall quality, access, and cost of care suffered. In an act that simply secured their own interests, the patients suffered. Overall, the diverse and effective variety of outpatient treatments available in New York is quite impressive and could provide much needed assistance to many individuals. However, the lack of accessibility and increasing out of pocket costs create significant barriers to those individuals who need the treatment the most. In order for New York to effectively serve those needing mental health treatment, it is necessary for the policymakers to begin thinking in terms of care rather than profit. References Babakian, G. (2013, December 17). How Much Does Mental Health Care Cost? Retrieved from Clear Health Costs: https://clearhealthcosts.com/blog/2013/12/how-much-does-mental-health-care-cost-part-1-series/ Cortese, M. (2017, January 29). Outpatient Barriers. (M. Woodworth, Interviewer) Garfield, R. (2016, October 19). The Coverage Gap: Uninsured Poor Adults in States that Do Not Expand Medicaid. Retrieved from Kaiser Family Foundation: http://kff.org/uninsured/issue-brief/the-coverage-gap-uninsured-poor-adults-in-states-that-do-not-expand-medicaid/ Lawrence Gostin, J. L. (1995). The formulation of health policy by the three branches of government. Retrieved from The National Academies of Sciences Engineering Medicine: https://www.nap.edu/read/4771/chapter/17 Michael B. Friedman, G. W. (2009). New York States Mental Health System. New York: Mental Health Association of New York City. Office of Mental Health. (2017, January 1). OMH Official Policy Manual. Retrieved from Office of Mental Health: https://www.omh.ny.gov/omhweb/policymanual/contents.htm Stephen Eide, D. D. (2015). The Union That Rules New York. The City Journal.

Reading Log for The Scarlet Letter :: Scarlet Letter Literature Reading Logs Essays

Reading Log for The Scarlet Letter 1. Chapter one thoroughly describes the Jailhouse and the surrounding landscape. Tells of the huge wooden edifices whose threshold is timbered and iron barred. Gives the description of the peoples clothing who were congregating outside of the prison. It also describes the necessity of a new colony first building a prison and graveyard. In the last paragraph it tells of a rose bush outside of the oaken doors. The author describes the awkwardness of having such a beautiful plant surrounded by weeds and shrubs. 2. (Page 50) The rose-bush, by a strange chance, has been kept alive in history; but whether it had merely survived out of the stern old wilderness, so long after the fall of the gigantic pines and oaks that originally overshadowed it, --or whether, as there is fair authority for believing, it had sprung up under the footsteps of the sainted Anne Hutchinson, --we shall not take upon us to determine. I believe these lines are important because they illustrate some of the mythology of the times in which this book was set. The author also goes on to describe how this rose bush could symbolize two different things depending on the readers perspective; A tale of morals blossoming; or a tale of human frailty and sorrow. 3. I think chapter one should have been more obvious to the setting and time frame in which the story takes place. By text one assumes it is set in a new colony in early American history, however it should give a precise time in my opinion. Hawthorne does an excellent job of helping the reader visualize the story and is able to present a question of opinion in the first chapter, which shows great writing skills. 4. The first chapter reminds me of Where The Red Fern Grows. The rose bush that is mentioned briefly has much to do with the story even though there is little reference to it. In WTRFG the fern is actually not so much part of the story as an idea represented through a physical inanimate object, as I believe the rose bush to be. Later in the novel Pearl says she came from the rose bush by the prison door, that shows her beauty and resilience as a comparison to an object unable to show emotion. 25, 2001 Chapter 2 Pages 51 to 61 1. This chapter gives a little more setting of the town describing the short journey from the jail to the scaffold and town center.

Natural Reflection :: essays research papers

Jane Austen’s novel Sense and Sensibility illustrates a number of characteristics particular to Romantic Literature. Of these characteristics, few are better utilized to offer a view into the individual temperaments of her characters than the images of natural beauty present throughout the novel. In contrast to the Neo-classical ideal, which reserves no place for the appreciation of the sublime in nature in its structure and design, Romantic literature expresses a deep reverence and awe toward the natural world. In the case of Sense and Sensibility, this appreciation is manipulated to produce a subtle, but humorous reflection on the temperament of the Miss Dashwoods. Upon Edward Ferrars’ arrival at Barton, he joins Marianne and Elinor on their walk back to the cottage. During this walk, a discourse on the surroundings begins after Elinor comments that Norland â€Å"probably looks much as it always does at this time of year† (p. 77). Elinor’s comment comes as a somewhat perturbed response to Marianne’s overzealous inquiries concerning the appearance of Norland. Elinor also mentions that it is probably rather gloomy and untidy because of the dead leaves that cover the woods and walks. This prompts and even more dramatic exclamation from Marianne: â€Å"‘Oh!’ cried Marianne, ‘with what transporting sensations have I formerly seen them fall!’† (p. 77). In this line, and in those that follow, it seems that Marianne gets carried away with her appreciation of the dead leaves on the ground. In the description of them as inspiring â€Å"transporting sensations† in her, the extent of Maria nne’s â€Å"sensibility† is aptly conveyed in a very concise scene. The â€Å"sense† that is characteristic of Elinor is depicted in her response to Marianne’s exaggerated praises: â€Å"‘It is not every one,’ said Elinor, ‘who has your passion for dead leaves’† (p. 77). It is not that she is unmoved by the beauty of her surroundings, but she understands the difference between what is truly worthy of praise, and what would be an exaggeration or possibly even an affectation. She does not have the propensity to swoon when she thinks of the dead leaves at Norland, but she has the wit and sense to subtly joke about her sister.

Comparing Christina Rossetti’s Goblin Market and William Wordsworth’s T

Comparing Christina Rossetti’s Goblin Market and William Wordsworth’s The Thorn On the surface, the poems â€Å"Goblin Market† by Christina Rossetti and â€Å"The Thorn† by William Wordsworth appear to be very different literary works. â€Å"Goblin Market† was written by a young woman in the Victorian period about two sisters who develop a special bond through the rescue of one sister by the other. â€Å"The Thorn† was written by the Romantic poet William Wordsworth about a middle-aged man and his experience overlooking a woman’s emotional breakdown. Material to understanding the works â€Å"Goblin Market† and â€Å"The Thorn† is recognizing the common underlying themes of sex and gender and how these themes affect perspective in both poems. In Christina Rossetti’s â€Å"Goblin Market,† the main foci are on feminism and the oppression of women by men. The first part of Rossetti’s message is given through her thoughts on feminism, which is surely a major theme in this poem. For instance, the two main characters, Laura and Lizzie, reside free of any positive male interaction. Considering Rossetti’s background as part of Victorian society, the conclusion can be made that Rossetti longed for a place where she could be free of masculine overbearance. Even so, she understood the impossibility of any such personally ideal world. The poem illustrates this realization by including the Goblin men, who seem to haunt the female characters. The Goblin men’s low-pitched cries follow the girls. Laura and Lizzie constantly hear the goblins in the forest: â€Å"†¦Morning and evening / Maids heard the goblins cry†¦Ã¢â‚¬  (Rossetti, 1713.) Even while the characters were a lone or in the exclusive presence of women, the presence of the Goblin men exist... ...seful miscommunication between men and women. Lastly, when looking through the imagined perspective of the thoughtless male tricksters, the reader is shown the heartlessness of men. After this reader’s final consideration, the main theme in each of the presented poems is that both authors saw women as victims of a male dominated society. Works Cited: Jackson, Geoffrey. â€Å"Moral Dimensions of ‘The Thorn.’† Wordsworth Circle. 10 (1979): 91-96. Mermin, Dorothy. â€Å"Heroic Sisterhood in ‘Goblin Market.’† Victorian Poetry. 21 (1983): 107-118. Rossetti, Christina. â€Å"Goblin Market.† The Longman Anthology of British Literature: Vol. 2B. Ed. David Damrosch, et al. New York: Longman, 1999. 1712-1724. Wordsworth, William. â€Å"The Thorn.† The Longman Anthology of British Literature: Vol. 2B. Ed. David Damrosch, et al. New York: Longman, 1999. 319-325.