Academic Patient Communication for Nursing Students

Academic Patient Communication for Nursing Students The Patient Care (Feel-Link) Project (PCP(FL)) is to help students to develop a patient-centered approach to the practice of medicine. To achieve this, I and a medical student, Nicole need to follow and interview a patient in an effort to discover the patient lived experience regarding issues of health and illness. In this essay, the first PCP(FL) visit, my thoughts and feelings will be described and evaluated based on evidence from the literature sources. Griffiths and Crookes (2006, p.186) suggest that multidisciplinary teams are needed in the health care system to provide holistic care to patients with optimal use of existing resources, and limited cost. This project is the first step in enhancing interdisciplinary co-operation and understanding between nursing and medical students. Both I and Nicole are required to fill in a problem-oriented patient record (POPR) after each visit. We have to co-operate with each other to recruit and interview one patient with the help of nurse specialist (diabetes), Ms. Shimen Au at the Ruttonjee and Tang Shiu Kin Hospitals. The patient that we had recruited called Mrs. Leung who is a 52-year-old housewife. She is currently married and lives with her husband. Her husband was unemployed and they had financial support offered from the government. She was suffered from diabetes mellitus, hypertension, and rheumatoid arthritis about ten years ago and first diagnosed to have bipolar affective disorder at age of 22. After we had explained the aims of this project to Mrs. Leung, she signed two identical consent forms, one copy to be kept by the patient whilst the other to be returned to the tutor. Then, Nicole asked some basic demographic data based on the personal particular form. Mrs. Leung answered one by one accordingly. The POPR also requires us to gather very specific information, such as the past medical history and family backgrounds. When I had asked Mrs. Leung whether she had any children, suddenly the atmosphere in the room became silence. Mrs. Leung was not saying anything for a few seconds, and then she stated she did not have any children. I felt surprised that a married woman at her age should have more than one child already. She explained that doctors had recommended her not to be pregnant in the past. So she was currently living with her husband only but she claimed that the relationship between she and her husband was poor. She had a conflict with her husband just before taking taxi to the hospital. She honestly knew that the reasons why her husband always grumbled about her because of her laziness to cook and buy the necessities. There were quarrels with her husband almost every day. She felt guilty about it. I thought this might be caused by her mental illness and chronic diseases. According to Friedman (2002, p.193), social isolation is a major problem that chronically ill patients experience. Social relationships are often disrupted and jeopardized because of the patientà ¢Ã¢â€š ¬Ã¢â€ž ¢s decreased energy, limitations in mobility, communication impairment, or time required for symptom control. Mrs. Leung usually slept for 13-14 hours per day but she graded the quality of sleep was poor. Even she rated her current level of health as very poor. She described her mobility in daily life had been affected by rheumatoid arthritis causing the swelling the knee joints and interphalangeal joints of hands. Therefore she never did any exercise. I was worried that she would become obese and thus increase the risks of falling and having cardiovascular diseases. I felt regret I had not encouraged Mrs. Leung to do some simple exercise regularly so as to keeping active and not staying in bed for all days. I needed to find some suitable exercise for her and advise her to do exercise in the next visit. Friedman (2002) points out à ¢Ã¢â€š ¬Ã…“illness is especially likely to be subject to the influence of other people since it usually has important implications for a personà ¢Ã¢â€š ¬Ã¢â€ž ¢s friends and associatesà ¢Ã¢â€š ¬Ã‚  (p.64); Mrs. Leung was concerned that her first love with a Japanese man at the tender age of 19. She was still thinking about him and she had tried to commit suicide in the past. When her husband heard about she was talking about that Japanese man, they would have quarrels for a long period of time. The negative emotions could really influence people around the patient. I was speechless at that time and I could only say to Mrs. Leung that her husband was care about her and tell her not to think about the past anymore. I thought I would perform better in the next visit as I had known some basic information of Mrs. Leung already. In conclusion, I think it is right that a nurse must be able to express opinions clearly and confidently. Good communication skills are essential for nurses, and are important in nearly all aspects of medicine. I feel that I will be more confident in dealing with patients and more effective in taking a patient medical history, for example. Developing greater confidence in how I communicate can lead to patients having greater trust in me as their nurse. Improving my skills in this area will also make me more effective in discussing cases with colleagues, and in participating in teams when necessary. This visit made me realized that I can talk confidently once I overcome my initial fears. It demonstrated to me that in order to make progress or create positive change you must first acknowledge that a problem exists. This is a lesson which may be useful in better understanding patient behaviour and attitudes. Often the first step to improving a situation, or dealing with a problem, is accepting that some change is necessary; and I might be more able to impart this information to patients having experienced this visit. Overall, this visit has had a positive impact on both my studies and on the development of skills needed in my future career. (Word count: 988words)

The Turbidity Test for Pasteurized Milk

The Turbidity Test for Pasteurized Milk Milk and dairy products, such as cream and yoghurt, are an important food group in the food pyramid. This food group provides us with calcium, which is not only crucial in strengthening our bones, but also important in many biological processes, such as facilitating the release of neurotransmitters that transmit nerve impulses across a synapse. Since dairy products serve such importance in our diet, dairy products manufacturing industry takes extra precaution in ensuring that these products meet the guidelines set by statutory bodies, one of which is that the maximum lactic acid content allowed in milk is 0.15% w/w. Hence, the industry will employ various methods to determine the quality of milk. As such, in order to better understand these industrial methods, 2 groups of experiments relating to titratable acidity (TA) of selected foods and turbidity test for pasteurized, UHT and sterilized milk were carried out. The titratable acidity test allows us to determine the titratable acidi ty of a sample as lactic acid (for dairy products) or citric acid (for lemon curd) equivalent. Basically, TA, as an acid equivalent, of a food product measures the total amount of that particular reference acid in the selected food. This reference acid is the major acid component, amongst all types of acid present in the food, which we want to quantify. TA is different from pH as pH only measures the [H+] dissociated from the acid molecules. Hence, TA is a more accurate measure of the degree of spoilage of dairy products than pH. The turbidity test however, serves a different function in terms of quality control. It is usually used by the industry to test if sterilized milk products have been sufficiently sterilized. Titratable Acidity of Selected Foods Materials Phenolphthalein as indicator 50.00ml burette 10.0ml graduated pipette White porcelain basin Magnetic stirrer Experiment 1: Titratable Acidity of Milk Pasteurized milk (Farmhouse Fresh Milk), expires on 20/9/12 UHT milk (Marigold UHT Full Cream), expires on 15/6/13 0.01M sodium hydroxide (actual concentration is 0.0107M) Experiment 2: Titratable Acidity of Cream Sour cream (Bulla Sour Cream), expires on 14/9/12 Yoghurt (FN Alive Yoghurt), expires on 11/9/12 0.1M sodium hydroxide (actual concentration is 0.105M) pH meter Experiment 3: Titratable Acidity of Lemon Curd Lemon curd (Waitrose lemon curd), expired on Feb 12 0.1M sodium hydroxide (actual concentration is 0.105M) Methods Titration of selected food products against NaOH of known concentrations were carried out in order to determine the titratable acidity of these food products. The titratable acidity in lactic acid or citric acid equivalent was then determined by via stoichiometric ratio of the acid to the amount of NaOH, as seen in the stoichiometric calculations below. 3 sets of titrations for 3 different groups of food products, mainly pasteurized milk and UHT milk, sour cream and yoghurt, and lemon curd, were carried. Experiment 1: Titratable Acidity of Milk 10.0 ml of pasteurized milk was transferred to a white porcelain basin. 1.0 ml of phenolphthalein indicator was then added to this sample. The burette was filled up with 0.01M NaOH and then titrated against the pasteurized milk sample. End-point of titration was identified when a pale pink colouration persisted for at least 10 s. Initial and final burette readings were recorded in Table 1 below. The procedure was repeated thrice for both pasteurized and UHT milk. Experiment 2: Titratable Acidity of Cream 10.00 g of sour cream was transferred to a white porcelain basin. 10.0 ml of water was added to the sample and mixed and pH was then measured. 1.0 ml of phenolphthalein indicator was added to the diluted sample. The burette was filled up with 0.1M NaOH and then titrated against the sour cream sample. End-point of titration was identified when a pale pink colouration persisted for at least 10 s. Initial and final burette readings were recorded in Table 2 below. The procedure was repeated thrice for both sour cream and yoghurt. Experiment 3: Titratable Acidity of Lemon Curd 10.00 g of lemon curd was transferred to a white porcelain basin. 10.0 ml of water was added to the sample and mixed. 1.0 ml of phenolphthalein indicator was added to the diluted sample. The burette was filled up with 0.1M NaOH and then titrated against the lemon curd sample. End-point of titration was identified when a pale pink colouration persisted for at least 10 s. Initial and final burette readings were recorded in Table 3 below. The procedure was repeated two more times. Results Experiment 1: Titratable Acidity of Milk Table 1: Titration of pasteurized and UHT milk against 0.01M NaOH Milk sample vol. of milk measured (ml) average vol. of milk (ml) initial burette reading (ml) final burette reading (ml) vol. of NaOH used (ml) average vol. of NaOH used* (ml) ÂÂ  Pasteurized Milk 10.0 10.0 50.00 37.65 12.35 12.35 10.0 37.65 25.15 12.50 10.0 25.15 12.80 12.35 ÂÂ  UHT Milk 10.0 10.0 50.00 37.70 12.30 12.30 10.0 37.70 25.30 12.40 10.0 25.30 13.00 12.30 Pasteurized Milk CH 3 CH OH C O- Na+ O CH 3 CH OH C OH O + NaOH Ã   + H2O (1) Amount of NaOH used = (Average vol. of NaOH used) x [NaOH] = (12.35/1000)(0.0107) = 1.32 x 10-4 mol From (1), lactic acid : NaOH is 1:1 amount of lactic acid in 10.0ml of pasteurized milk = 1.32 x 10-4 mol Concentration of lactic acid (in mol/100mL) equivalent in pasteurized milk = (1.32 x 10-4) / (10/100) = 1.32 x 10-3 mol/100mL Concentration of lactic acid equivalent in g/100mL in pasteurized milk = (molar concentration (in mol/100mL) of lactic acid equivalent) x (molar mass of lactic acid) = (1.32 x 10-3)(90.08) = 0.119 g/100mL UHT Milk Amount of NaOH used = (Average vol. of NaOH used) x [NaOH] = (12.30/1000)(0.0107) = 1.31 x 10-4 mol From (1), lactic acid : NaOH is 1:1 amount of lactic acid in 10.0ml of UHT milk = 1.31 x 10-4 mol Concentration of lactic acid (in mol/100mL) equivalent in UHT milk = (1.31 x 10-4) / (10/100) = 1.31 x 10-3 mol/100mL Concentration of lactic acid equivalent in g/100mL in UHT milk = (molar concentration (in mol/100mL) of lactic acid equivalent) x (molar mass of lactic acid) = (1.31 x 10-3)(90.08) = 0.118 g/100mL From the calculations, it can be seen that both the titratable acidities of pasteurized milk and UHT milk in lactic acid equivalent are below 0.15%, the maximum allowed titratable acidity of milk in lactic acid equivalent. As such, both samples are deemed safe for consumption. The titratable acidity of pasteurized milk is also observed to be slightly above that of UHT milk by a very minute concentration of 0.001 g/100mL. This suggests that pasteurized milk contains slightly more microbes than UHT milk, which goes in tandem with the properties of pasteurized milk. This is because pasteurized milk is heated to about 65oC for at least 30 minutes in order to preserve the flavor of milk, while UHT milk is heated at 135oC for about 2 seconds6. Hence, fewer microbes are killed in pasteurized milk than UHT milk. As such, pasteurized milk will have slightly higher lactic acid concentration which is produced from the fermentation of lactose by microbes. However, the magnitude of difference of 0.001 g/100mL obtained from the titration results is too small to make the above conclusive deduction. The average vol. of NaOH used is almost identical for both milk samples as there is only a difference of 0.05 ml, making the titration results somewhat anomalous. The main reason for this anomaly is the subjectivity of the end-point of titration. The colour change of phenolphthalein from colourless to pale pink is very difficult to ascertain by naked eye for the inexperienced, unlike workers in this industry who carry out large volumes of titrations every day. As such, the faint pink that I observed in pasteurized milk is most probably not the true end-point of titration or it could be that the faint pink I observed in UHT milk is over the end-point of titration for UHT milk. Experiment 2: Titratable Acidity of Cream Table 2: Titration of sour cream and yoghurt against 0.1M NaOH Cream sample pH of sample average pH mass of sample (g) average mass of sample (g) initial burette reading (ml) final burette reading (ml) vol. of NaOH used (ml) average vol. of NaOH used* (ml) ÂÂ  Sour Cream 4.48 4.49 10.00 10.00 50.00 44.60 5.40 5.40 4.50 10.01 44.60 39.20 5.40 4.50 9.99 39.20 33.80 5.40 ÂÂ  Yoghurt 4.43 4.38 10.01 9.99 50.00 37.90 12.10 12.30 4.34 10.00 37.90 25.60 12.30 4.38 9.98 25.60 13.30 12.30 Sour Cream Amount of NaOH used = (Average vol. of NaOH used) x [NaOH] = (5.40/1000)(0.105) = 5.67 x 10-4 mol From (1), lactic acid : NaOH is 1:1 amount of lactic acid in 10.00g of sour cream = 5.67 x 10-4 mol Mass of lactic acid in 10.00g of sour cream = (amount of lactic acid) x (molar mass of lactic acid) = (5.67 x 10-4)(90.08) = 0.0511g Concentration of lactic acid equivalent (in %w/w) in sour cream = (mass of lactic acid in 10.00g of sour cream) / (average mass of sour cream) x 100% = (0.0511) / (10.00) x 100% = 0.511% (w/w) Yoghurt Amount of NaOH used = (Average vol. of NaOH used) x [NaOH] = (12.30/1000)(0.105) = 1.29 x 10-3 mol From (1), lactic acid : NaOH is 1:1 amount of lactic acid in 9.99g of yoghurt = 1.29 x 10-3 mol Mass of lactic acid in 9.99g of yoghurt = (amount of lactic acid) x (molar mass of lactic acid) = (1.29 x 10-3)(90.08) = 0.116 g Concentration of lactic acid equivalent (in %w/w) in yoghurt = (mass of lactic acid in 9.99g of yoghurt) / (average mass of yoghurt) x 100% = (0.116) / (9.99) x 100% = 1.16% (w/w) From the results of this experiment in Table 2, we can see that titratable acidity is not equal to pH, and it shares an inverse relationship with pH, where pH = -lg[H+]. This is because lactic acid is an organic acid and hence it is a weak acid. As such, lactic acid only partially dissociates, giving a [H+] that is lower than the total lactic acid concentration. This is due to the low acid dissociation constant, Ka, of lactic acid. However, by proportionality, it is observed that higher concentrations of lactic acid molecules will give a higher deprotonated [H+]. This is observed in Table 2 where the lower pH of yoghurt corresponds to a higher average volume of NaOH required to neutralize the lactic acid present. In addition, another observation is that yoghurt requires more than twice the volume of 0.1M NaOH to neutralize the lactic acid present as compared to sour cream even though yoghurt is lower in pH by 0.11. This is mainly attributed to the presence of probiotics added into yoghurt. As such, this means that more lactose in yoghurt is converted into lactic acid, resulting in the marked difference in average vol. of NaOH required for neutralization. This second observation also proves that pH is not a true measure of total lactic acid content in dairy products as this small difference in pH is accompanied by a larger than proportionate difference in volume of NaOH required for neutralization. Experiment 3: Titratable Acidity of Lemon Curd Table 3: Titration of lemon curd against 0.105M NaOH Sample mass of sample (g) average mass of sample (g) initial burette reading (ml) final burette reading (ml) vol. of NaOH used (ml) average vol. of NaOH used* (ml) Lemon Curd 10.00 10.00 50.00 29.20 20.80 20.35 10.00 29.20 8.90 20.30 10.00 50.00 29.60 20.40 *As 3 sets of titration were conducted for each sample in order to improve the precision and reproducibility of the titration results, the average volume of NaOH was taken as the average of the 2 closest values of vol. of NaOH used in titration so as to be more precise. C Na+O- O CH 2 C OH C O- Na+ O CH 2 C O- Na+ O C HO O CH 2 C OH C OH O CH 2 C OH O + 3NaOH Ã   + 3H2O (2) Amount of NaOH used = (Average vol. of NaOH used) x [NaOH] = (20.35/1000)(0.105) = 2.14 x 10-3 mol From (2), citric acid : NaOH is 1:3 amount of citric acid in 10.00g of lemon curd = (amount of NaOH used) / 3 = 7.13 x 10-4 mol Molar mass of citric acid = 6(12) + 8(1) + 7(16) = 192 g mol-1 mass of citric acid in 10.00g of lemon curd = (amount of citric acid) x (molar mass of citric acid) = (7.13 x 10-4)(192) = 0.137 g Concentration of citric acid equivalent (in % w/w) in lemon curd = (mass of citric acid in 10.00g of lemon curd) / (average mass of lemon curd) x 100% = (0.137) / (10.00) x 100% = 1.37% (w/w) As calculated above, the concentration of citric acid equivalent in lemon curd is 1.37% (w/w), which is well above the minimum standard of 0.33% (w/w) set by legislation in some parts of the world. Hence, it can be deduced that this sample of lemon curd has passed the quality control measure. Citric acid is used as the reference for quality control of lemon curd mainly because citric acid is present in the largest quantity in lemons. Hence, measuring citric acid concentration present will be a good measure of the quality of the lemon curd. As such, this is a quality lemon curd sample. Even though this lemon curd product expired on February 2012, the citric acid content should not be significantly affected by microbial decomposition mainly because the acidic environment due to citric acid is not suitable for most bacteria to thrive. Discussion There are a few experimental procedures which can be improved on. Firstly, as mentioned in the results of experiment 1, the faint pink observed to mark the end-point of titration is subject to a large margin of human error. As such, a better method to solve the issue of colour subjectivity is to use a colorimeter to determine an intensity of pink as the end-point of titration, thus eliminating any inaccuracies that result from human error. Secondly, it was observed that the dilution of products of a more viscous consistency, such as sour cream and lemon curd, did not yield a homogenous consistency as compared with the milk samples and yoghurt. As such, the titrated NaOH may not have actually reacted with all the acid molecules as some acid molecules may be trapped inside the granular particles. This can be overcome by vortexing the cream and water mixture in a sealed round-bottom conical flask to ensure a homogenous solution is obtained, allowing us to obtain more accurate titration results. Thirdly, for runny liquid samples such as milk, there is a risk of spillage due to splashing when the magnetic stirrer operates probably due to the large exposed opening of the porcelain basin. Splashing can be overcome by using a conical flask to contain the samples and place a white tile under the conical flask so that the change in colour of milk can be made more obvious. This is because a conical flask has a much narrower neck and therefore a significantly narrower opening, thus minimizing spillage from splashing. In this way, more accurate titration results can be obtained. For lemon curd, simply measuring the citric acid concentration is insufficient to conclude a quality product. This is mainly due to the possibility of adulteration of lemon curd by adding more citric acid chemical, just like how milk was adulterated by the adding melamine. As such, additional qualitative methods can be employed, such as measuring the concentration of certain chemical substances more unique to lemon, such as limonene. Turbidity test for pasteurized, UHT and sterilized milk Materials Ammonium sulphate powder Pasteurized milk UHT milk Sterilized milk Method 4.0g of ammonium sulphate, (NH4)2SO4, was dissolved in 20.0 ml of pasteurized milk. The mixture was allowed to stand for at least 5 min and subsequently filtered. 5 ml of the filtrate was collected in a test-tube and then placed in boiling water bath for at least 5 min. The test-tube containing filtrate was then cooled in cold water and the contents were examined for presence of turbidity. Results Discussion Table 4: Turbidity test results Sample Observation Pasteurized milk A cloudy pale yellow solution with precipitation was observed. UHT milk A cloudy pale yellow solution was observed. Sterilized milk A clear pale yellow solution was observed. The turbidity test is useful in telling us if a sample of milk is sufficiently sterilized, whereby a clear solution will be observed. The turbidity test is first carried out by adding a denaturing agent, usually ammonium sulphate, (NH4)2SO4, to the milk sample. As NH4+ exhibits acidic properties, as shown in the following equation, NH4+ + H2O Ã   NH3 + H3O+ this addition of ammonium ions will bring about an increase in [H+], resulting in the disruption of casein micelle structure. This causes casein proteins to precipitate and coagulate as they interact with the ammonium and sulphate ions. For those casein and whey proteins that are already denatured by heat treatment during processing, ammonium and sulphate ions will form interactions with the charged R-groups of the acidic and basic amino acid residues, causing them to precipitate out of the solution. These precipitate are obtained as the residue from filtration. The filtrate obtained contains mostly undenatured whey proteins and probably some unprecipitated protein molecules encapsulated in the casein micelle structure amidst a solution of ammonium sulphate and other soluble milk products such as lactose. Upon heat treatment in a 100oC water bath, the milk proteins denature and are thus exposed to ammonium sulphate. They undergo the same mode of action with ammonium sulphate as described above, resulting in the observed precipitation. Referring to AVA regulations, pasteurised milk is defined to be milk that has been subjected to a single heat-treatment of 62.8 65.6oC for at least 30 min or 72 73.5oC for at least 15 s; UHT milk is defined as milk that has been heated at a temperature of at least 135oC for at least 2 s; sterilized milk is milk heated to 100oC long enough to sufficiently kill all microbes. As such, sterilized milk will have all the casein and whey proteins fully denatured and free in the milk due to prolonged heating. Whereas UHT milk will have a slight concentration of undenatured proteins present due to a short high heat treatment. For pasteurized milk however, it will contain the highest concentration of undenatured proteins due to lowest heat treatment temperature. Hence, the experimental observation in Table 4 clearly fits the hypothesis. On a side note, the yellow pale solution observed is most likely due to the Maillard reaction between lactose in and amino compounds in milk. Conclusion Titratable acidity and the turbidity test for milk is but only 2 out of the many methods that the milk processing industry employs to ensure that the heat treatments have produced milk that are safe for human consumption. The main disadvantage that lies with milk treated with higher heat processes is the loss of flavour. The nutrients that are lost during heat are usually replaced (e.g. enriched milk) and hence this is less of a concern for milk. As such, it is the companys decision on whether to process milk with an emphasis on taste or shelf-life. Nevertheless, it is of utmost importance that the milk products remain well within the margin of safety as stated by regulations. At the same time, regulatory bodies need to stay alert and play a part in ensuring that companies follow the safety guidelines, less an incident like the adulteration of dairy products through melamine addition may occur again.

Radical Feminism and Hip Hop Essay examples -- Music Analysis

Since its emergence in the South Bronx in the 1970’s, hip hop has spread to both urban and suburban communities throughout the world. Once an underground genre of music, it is seen in commercials, movies, television shows, etc. It has transformed from music and expanded into a full culture. It has even made its way into fashion and art. Men have always been on the front line of Hip Hop. However, the lyrics and images have changed tremendously. Lyrics and images that once spoke upon the injustices and empowerment for the African American people is now filled with money, cars, jewelry, and of course women. Today’s hip hop generation is criticized for its negative portrayal of women. Every music video that is produced features scantily clad women with dancing sensually. Feminists speak against them because they are continuing to sexualize the female form, degrade women by using terms such as â€Å"bitch† and â€Å"hoe† to describe them, and in all continuing to make them second class citizens. Radical feminism focuses on such oppression in society and the existence of patriarchy/male dominance. All of which is evident in Hip Hop. Patriarchy creates a social division. It is often used to describe the power between a male and a woman. This idea is important in Radical Feminism. Seen as the root of female oppression, Radical Feminists recognize that patriarchy is everywhere. Radical feminist came about because they were not happy with the course of action taken by the first wave of feminists. Radical feminists wanted a revolution, not just reform; they wanted to do things their way as opposed to following â€Å"the system†. So they came up with their own theories that fit their way of thinking and often were at odds with the reformer feminists... ...lackademics.org. Word Press, 2006. Web. 01 May 2012. . Burke, Colleen. "Women and Militarism." Women and Militarism. Women's International League for Peace and Freedom. Web. 05 May 2012. . Hooks, Bell. "Sexism and Misogyny: Who Takes the Rap?" Race & Ethnicity. Web. 06 May 2012. . Hooks, Bell. We Real Cool: Black Men and Masculinity. New York: Routledge, 2004. Mgadmi, Mahassen. "Black Women’s Identity: Stereotypes, Respectability and Passionlessness (1890-1930)." LISA E-Journal. Web. 06 May 2012. . Zieber, Maureen. "Definition of Radical Feminism." Suite101.com. Web. 08 May 2012. .

William Butler Yeats :: Biography

William Butler Yeats was born in Dublin, Ireland, on June 13, 1865. He was the eldest son of a painter. In 1867 his family moved to London, but he frequently visited his grandparents in Northern Ireland. There he was greatly influenced by the folklore of the region. In 1881 his family returned to Dublin. Their Yeats studied at the Metropolitan School of Art. During school he became more focused on literature.   Ã‚  Ã‚  Ã‚  Ã‚  Yeats made his debut in 1885, with the publication of his first poems in The Dublin University Review. In 1887, his family returned to Bedford Park in London, and Yeats devoted himself to writing. In 1889 he met Maud Gonne, an actress and Irish revolutionary. He soon fell in love with her and she became a major landmark in his writing. She later married Major John MacBride and inspired Yeats's poem 'No Second Troy'   Ã‚  Ã‚  Ã‚  Ã‚  Yeats's early work did not reflect his Irish heritage but soon he turned towards his Irish culture for inspiration. Yeats studied many Irish folktales and in 1888 published a book of tales titled Fairy and Folk Tales of the Irish Peasantry. He also published a less detailed version for children titled Irish Fairy Tales in 1892.   Ã‚  Ã‚  Ã‚  Ã‚  In 1897, Yeats's met Lady Gregory, an aristocrat and playwright, who shared the same interest in Ireland's past. In 1899 they formed the Irish Literary Theater. Yeats worked as a director and writer for the theater. Some of his most famous dramas were CATHLEEN NI HOULIHAN and THE LAND OF HEART'S DESIRE.   Ã‚  Ã‚  Ã‚  Ã‚   Yeats later proposed to Lady Gregory, but she refused his offer. Again in the same year he proposed to her daughter but she also declined. Lady Gregory's passion for a free Ireland kindled Yeats's interest in the political struggles of Ireland.   Ã‚  Ã‚  Ã‚  Ã‚  In 1917, Yeats bought an old stone tower near Coole Park. After he restored the tower it became his summer home and a symbol in his writing. Also in 1917,Yeats married Georgie Hyde-Lee. Later they had a son and a daughter together, Anne and Michael. During their honeymoon they compiled their notebooks and formed the basis of A VISION.

Collaborative Working †Case Study Essay

The aim of this essay is to examine the significance of collaborative working to achieve positive outcomes for service users. â€Å"Collaboration is a dynamic inter-professional process which two or more professionals make a commitment to solve problems and to learn from each other in order to accomplish identified goals, purposes or outcomes† (Hamric, Spross and Hanson, 2000, p.318). Since the publication of Every Child Matters (2004), social care, health, voluntary sectors and other children’s services have been joining forces to work more collaboratively around an early intervention and preventative agenda (Department for Education and Skills, 2004). This essay will focus on the National Childhood Measurement Programme (NCMP) and by drawing on the author’s experiences as a Nursery Nurse in the School Nursing team it will demonstrate the skills and knowledge required for successful implementation of this service and how to promote seamless working. The NCMP was established in 2005 and involves weighing and measuring all eligible children aged 4-5 years and 10-11 years. Research shows that it is difficult to visually tell if a child is overweight, which is why an objective measure if essential (Department of Health, 2012). The data gathered provides a picture about how children are growing nationally, therefore this information is used by the NHS to plan and provide better health services for children (NHS Choices, 2012). According to the NHS Information Centre (2010) one in four, 4-5 year olds, are overweight or obese; furthermore, these rates are higher among some black and minority ethnic communities and lower socio-econo mic groups. Although the Primary Care Trust (PCT) oversee the delivery of the programme effective partnership working is essential, therefore this essay will explore what partnerships are required and the factors that facilitate or hinder collaborative working in this area of work. Finally, this report will provide evidence from literature and published papers to support the identified barriers and benefits of collaborative working throughout this process. Setting The School Nursing team comprises of a range of skill mix which consists of a Head of Service, one team leader, seven School Nurses, five of which have obtained the Specialist Community Public Health Nurse qualification (Degree or Masters Degree) and three Nursery Nurses evenly spread in three different localities around the City. The team covers fifty two Primary Schools and ten Secondary Schools, mainly in the inner City but also in the rural surrounding areas, therefore an extremely diverse region with varying socio-economic backgrounds. This City has a very large Asian population, however recently there has been an increase in Eastern European, Afro-Caribbean, Chinese and travellers all presenting a multitude of cultures, values and beliefs. Measuring the children takes place in the school setting. Each individual school will be contacted to arrange a suitable date and time as well as organising a private area with adequate space for the ease of measuring and comfort for the children. Every school in this district has its individuality, not only do they vary in size but numerous schools have a large proportion of pupils with English as an additional language (EAL). There three special needs schools, furthermore schools with varying socio-economic backgrounds such as families experiencing poverty within the inner city and in contrast more affluent areas where the school attainment is generally higher. Knowledge and Skills of the Health Professional in the Setting The Knowledge and skills discussed in this section relate to the author’s role as a Nursery Nurse within the School Nursing Team and the planning, implementation and follow-up work required for the growth measurements of all eligible Reception and Yr 6 children as required by the Governments National Childhood Measurement Programme (NCMP). The skills required for successful delivery of this program not only depend on accurate weighing and measuring children but several other elements such as engaging with various professionals, inputting data, maximising the effective delivery of the program which is dependent on excellent communication skills, administration management, IT skills and clinical knowledge. These skills are required from the very beginning at the planning stage; high-quality organisational skills are essential when planning and booking in the measurement sessions with the schools. The Nursery Nurse requires good organisational skills as it is her responsibility to organise the logistics of these sessions; by liaising with the School Nurses a timetable is generated to complete the programme over the year, ensuring there is sufficient staff available for each school. Following this, the Nursery Nurse will contact all the Primary Schools to book in the sessions, good communication skills are necessary to request a suitable room to maintain the privacy and dignity of the children and ensure the session creates as little disruption as possible to the educatio n of the children. Generally, the booking is made with either the School Secretary or the Head Teacher who then cascades this information to the relevant teachers and staff. It is crucial to acquire the knowledge and understanding of the NCMP protocol regarding consent and confidentiality. Parents and children are issued with information prior to the session, subsequently the NCMP operate an opt-out basis, and therefore the parents are given the opportunity to withdraw (Department of Health, 2011). The refusal notification is sent to the Child Health Department who then records this on the specific child’s medical record; therefore communication and information sharing skills are essential for this to be implemented successfully. It is paramount to respect the parent’s choice to refuse and ensure that no pressure is placed on the family to participate (Schwab and Gelfman, 2001), by possessing the knowledge of the ethical considerations of children will assist situations where a child decides they would not like to be measured. According to Lord Scarman, children have the right to make their own decisions when they reach sufficient understan ding and intelligence to be capable of making up their own mind (Children’s Legal Centre, 1985). Annual training is mandatory which ensures competency in the accurate measurement of children to obtain reliable results. It is the Nursery Nurses responsibility to supply the relevant equipment to the sessions ensuring that the height measure is complete, clean and in good working order, furthermore the scales are required to be calibrated as required by the trusts policy therefore good time management and organisational skills are beneficial. Upon arrival, the school will direct the team to a suitable area to perform the growth checks and notify the relevant staff members of our arrival. The team normally consists of a School Nurse and two Nursery Nurses, however if the School Nurse has been requested to attend a Safeguarding issue then the Nursery Nurses will complete the task, so having the ability to adapt to different situations is fundamental. Being able to work as part of a team as well as work independently is a major requirement not only to this particular task but working within the School Nursing team in general. Normally the School Nurse will discuss the process with the class teacher and then talk to the children, explaining what will happen and that the measurements will be confidential and not shared with teachers or other children, furthermore any concerns they have will be addressed. However, if the School Nurse is not in attendance the Nursery Nurse will complete this task, therefore excellent verbal and non-verbal communication skills (Philippot, Feldman and Coats, 2003), empathy and an understanding on how to reduce anxiety is imperative to ease any worries or concerns. Knowledge of the health implications from being overweight or obese would be beneficial, furthermore a general knowledge of how to achieve a healthy lifestyle by eating a balanced diet and regular exercise would be necessary to provide advice if requested. Accurate recording of the measurements is paramount and knowledge of the correct procedure for information sharing is imperative. The trust adheres to the Data Protection Act (1998) furthermore to keep up to date with this information and gain the relevant knowledge, Information Governance training is completed annually. Normally the School Nurse will input the information onto each child’s medical record and send the records off to the Child Health Department via secure internal mail, however according to the trusts policy it is compulsory for the information to be inputted within 24 hours after the measurements have been taken. As School Nurses have more medical responsibilities they might ask the Nursery Nurse to complete this task therefore good IT skills to input accurate and concise information is essential as well as the ability to prioritise workload according to the needs of the project are essential. The final component of this process is responding to calls from parents after they have received the results letters from the NCMP department. Excellent communication skills and being able to calm a conversation if the parent gets upset, angry or has taken offense to the information in the letter is vital (Whitaker and Fiore, 2001). Additionally, it is important to understand the implications of different cultures and the impact they may have on diet and size of children. Knowledge of the programs of support available will enable the Nursery Nurse to advise the parents so they can seek the relevant help and support not only for their child but for the whole family. Obtaining this extensive knowledge is fundamental to ensuring that parent’s receives the correct information, help and support to contribute to understanding the necessity of healthy lifestyles for the long-term well-being of their child. Finally, it is important for the Nursery Nurse to refer any concerns or compla ints to the named School Nurse who will then either contact the parent or report the situation to the specific organisation (Lynn, 2010). There is a plethora of professional’s whom the Nursery Nurse may collaborate with throughout the NCMP process, several of which will be liaised with on a regular basis, such as the one’s named above. HHHnnjjjnjnjnslfjfljjjfieiedddeeergggggeeee333e3e3owever, further interagency working may be required to meet the needs of the children and families, these may include Dietician, Paediatrician, Social Workers, Leisure Centre Staff and MoreLife Weight Management staff. Legislation Legislation has the impetus for collaborative working, transformation in the structure and delivery of services for children and young people initiated new alliances between statutory, public and voluntary agencies (Children Act, 2004). There are numerous Government and Local policies stating the importance of implementing interagency, partnership or collaborative working and that practitioners are required to work more closely together and form integrated teams around children and families (Department for Children, School and Families, 2007). The Governments green paper, Every Child Matters (2004) emphasised that for each child to fulfil their potential there must be a greater deal of co-operation, not only between government agencies but schools, GP’s, sports organisations and voluntary sectors. To help meet the Government strategy of multi-agency collaboration, the Common Core of Skills and Knowledge (HM Government, 2006) was introduced to work alongside the Every Child Mat ters agenda. This emphasised six areas of expertise that are expected to be put into practice by all practitioners who work with children and families. Factors that facilitate or hinder collaborative working Collaborative working is a complex and multi-faceted concept, the Latin translation â€Å"together in Labour† signifies that to meet the individual needs of children and families, successful joint working between services in a more streamlined way is required. However, although collaborative working is regarded as desirable, nevertheless, it is difficult to attain. When the NCMP was established in 2005 the PCT set up a NCMP agency to oversee the programme with joint working with the School Nursing service, therefore clarity of the aims and objectives were to be recognised and understood by all parties for this programme to be successful (Denman, 2002). Lack of formal structure and agreed outcomes may cause confusion and can result in blaming others for inaction and lack of progress (Cameron et al, 2009), therefore clarity of roles and expectation were defined by producing a clear and comprehensive policy based upon the shared vision of all organisations (Rushmer and Pallis, 2002). The Children Act (2004) gives all statutory partners wide powers to pool their budgets in pursuit of improved outcomes for children, furthermore sharing resources reduces cost and prevents unnecessary duplication of work (Atwal and Caldwell, 2005). However, time constraints due to other work commitments by the School Nursing team make it difficult to achieve the 85% participation rate (NMCP, 2012) particularly when children are absent and parents or children refuse. This may cause conflict due to NCMP’s ignorance of the School Nursing complex role and other significant priorities such a safeguarding (Department for Children, Schools and Families, 2010). Working in partnership with Schools is essential for the successful delivery of the programme, maintaining high participation rates by pupils and robustness of data (NCMP, 2012). A good system of communication and information sharing is required to book a convenient date and time to complete the measurements which will enable smooth running of the program with little interruption to the teachers or pupils (Integrated Care Network, 2003). Howeve r, when office staff fails to relay this information to the relevant teachers disruption to class activities, failure to provide suitable facilities and time constraints may occur which impact on the quality of service provided to the children. Factors that aid multi-agency working between schools and health services are willingness to work together, acknowledgement of professional differences, mutual respect and sharing a common purpose. Overall, the collaboration between the schools and School Nursing team is extremely good. However, occasionally conflict of interest may occur when teachers see the measurement programme as an interruption to education rather than acknowledging that children’s health status is related to their ability to learn and that children with unmet health needs have difficulties in engaging in the education process (Board et al, 2011). Therefore, creating a common purpose and employing a whole system approach (Miles and Trott, 2011) will facilitate ea rly intervention for childhood obesity will reduce health implications such as diabetes and heart disease, improve self-esteem and enhance well-being which contributes to better educational achievement. Therefore, mutual respect for each profession is paramount for successful collaboration and better outcomes for children. The Child Health Department works closely with the NCMP, School Nursing team, schools, parents and other professional bodies. Their main responsibility during the NCMP process is distribution of information to parents to explain the purpose of the programme and give parents the opportunity to withdraw. This information is recorded onto each child’s medical record and then highlighted on the lists issued to the School Nurses prior to the sessions. If the withdrawal of consent is not forwarded to the School Nurse in time for the session, then errors may occur, leading to legal and ethical issues, therefore to facilitate collaborative working improved communication and improved information sharing is vital for co-ordinating safe provision of care (Samuel, 2011). It is also the responsibility of Child Health to input the data onto each of the children’s medical record, however due to the NCMP agency possessing a different IT systems this task is duplicated therefore integrated services are hindered (Atwal and Caldwell, 2005). Within the School Nursing team roles and responsibilities are established, the School Nurse takes the lead role in the programme, however the Nursery Nurse will ensure that all the necessary equipment and paper work is present, both will perform the accurate weighing and measuring and recording of the data. According to Rushmer and Pallis (2002) positive joint working relies upon the merging of skills, knowledge and expertise from different professional hierarchies and reliance on team members can contribute to positive attitudes to other professionals. Dilemmas arise when there is a shortage of staff due to staff turnover, lack of trained staff to perform the task or competing priorities which may result in poor staff morale and impact on the accuracy of the task (Maguire and Trustcott, 2006). Furthermore, challenges may occur when there are status issues and blurring of professional boundaries, according to Wall (1998) when staff operates outside their area of expertise there will be loss of efficiency. The author recognises her role in the NCMP process; therefore any queries will be referred to the named School Nurse to respond to. Health and Clinical Excellence, NICE (2006) and Cochrane Collaboration (Summerbell et al, 2005) state there is an urgent need for evidence of effective strategies for reducing childhood obesity, therefore annual weighing and measuring data collected can be shared at National and Local levels to analyse the efficacy of the regional weight management programmes to receive continued funding to sustain the initiative to provide better health services for children (NHS Choices, 2012). Parents will be provided with feedback of their child’s weight status from the NCMP, effective information sharing raise awareness of potential associated health risks and provides parents with the opportunity to seek advice and support if they choose to (NCMP, 2012). However, complications arise when policies and guidelines differ; the School Nursing team employ a different guideline to the NCMP resulting in complex telephone conversations regarding the letter sent by the NCMP stating their child is overweight. Subsequently, for competent collaboration to exist, clarity of referral criteria’s is needed to be standardised across boundaries (NICE, 2013). The Laming Report (2009) stated a need for significant shifts in working relationships between schools, health services and parents and engaging with parents to enabling them to feel valued and encourage decision making will engage parent participation which is essential for positive outcomes to be achieved (Every Child Matters, 2004). Parents are important influences on children’s eating and physical activity behaviour (Golan, 2006) therefore collaboration with parents is vital (Whitaker et al, 1997). School based interventions such as MoreLife are effective when the whole family participate, furthermore NICE Clinical guideline 43 (2006) states that school based interventions engage families regardless of socio-economic status, cultural background and ethnicity, this is evident with the number of participants for this weight management programme in this diverse region. In contrast, barriers may occur with the lack of partnership working, power struggles, lack of commitment an d lack of equal representation, these will decrease opportunities for working together, therefore creating a shared responsibility to reduce obesity will increase the health outcomes for children. Multi disciplinary team work will identify children at risk from obesity and promote quicker and easy access to services (ECM, 2004). Additionally, the Common Assessment Framework (CAF) can be shared between practitioners to refer children to appropriate services, promote information sharing and reduce duplication of and streamline assessments (CAF, 2012). However, collaboration with other professionals can be hampered when there are variations in working conditions, such as the School Nursing team and Schools working on term time only contracts. Furthermore many GP’s and Paediatricians have a professional hierarchy and delegate work to other agencies which in turn may have an effect on job satisfaction. Conversely, working with other professionals can be rewarding, stimulating, improve working relationships and increase knowledge and understanding of specialist practitioners.

Organizational Outputs Essay

In reviewing the article in reference to the Nadler-Tushman Congruence Model. Another quote from the article, struck me very strongly in regards to the observed organization; ‘The bigger the gap between the formal and informal systems within the organization, the less effective the organization is. ‘ This is from the Weisbord’s Six Box Model and this aspect is quite apparent in the organization observed. A negative output is one of the things that should be avoided, especially regarding consumers. An agreed statistic within many business marketing modules that a dissatisfied consumer will often tell more people than a satisfied consumer. A frustrating fact, however true. Outputs are those products which are dispensed from the organization. These can include product, as already mentioned, the way consumers are treated is another factor. Outputs also include, how the organization interacts with the environment. Technically an output is any factor that the organization ‘puts out’ whether through marketing, whether intentionally or unintentionally. Consumer Satisfaction There is an old saying, ‘You can’t please people all of the time. ‘ In an organization where the internal culture is to ‘never’ say ‘no. ‘ Because, we have also heard the saying, ‘The customer is always right. ‘ An automatic conflict is built between consumer and employee. Someone, is usually wrong. And if a person is doing their job as required under organizational policy, the possibility of ‘pleasing all of the people all of the time’ becomes quite low. However, in an organization ‘pleasing’ every person is a near impossibility. In fact, I believe, it was Menecke who said, ‘I don’t know the sure way to success. I do know the sure way to failure, trying to please everyone all the time. ‘ Certainly a risk every organization takes is how to tell the consumer, ‘no’, while keeping that person as a consumer. Somewhat of a conundrum, as no one likes to hear the word ‘no. ‘ This is where the earlier quote from ‘Weisford’s Six Box Model’ caught my particular attention. Faulty policy or the failure of an organization to uphold it’s own policy, creates extreme difficulties for personnel. In the organization observed, a policy would be set forth, such as a limit to the type or number of courses a student could take in an eight week period. Personnel, following policy and even double checking policy with the Director would refuse the student as directed under policy. The stated policy would then be, completely undermined if the student decided to complain. In most cases, if not all, the student was allowed the ‘exception’ to having policy overturned. When a situation such as this occurs on a recurring basis, morale is severely weakened. Personnel are not trusted to do their jobs with integrity. As well as the fact, that when policy is regularly undermined, what then becomes the point of attempting to enforce any type of policy. Worse, the employee begins to give up altogether in performing their tasks with any independence. As the result is and has been personnel are wrong and can be completely overridden. The result is an organization without compass. And ultimately, in this organizational situation, it is the consumers that are hurt the worst. Personnel become surly and unwilling to help. After all, how can personnel be perceived as being helpful when every decision, no matter how small can be overturned? The situation becomes unbearable, and any attempt at creating consumer loyalty is lost. Policy should serve as that mechanism to provide the means toward providing consumer needs. When that attempt to follow policy is constantly undermined, the result, undoubtedly is weak, powerless leadership and an unwilling personnel to follow any ‘policy’ that is developed. Personnel should be one of the most enthusiastic ‘ambassadors’ to the community when representing the organization. The odd thing about serving the organization in this way, is that a certain pride should be taken in the work one does. A continuous undermining of the personnel’s ability to do the job one has been hired to accomplish. This type of output creates a hostile atmosphere, distrust is built and maintained through this constant turmoil between management, personnel and consumers. Summary Only one type of output has been mentioned in this report. The reason being that personnel are crucial to the way consumers and the public perceive the function ability of an organization. A dissatisfied representative or employee becomes complacent and extremely unwilling to attempt new devices for serving the consumer. Much less becoming innovative in the process. Frustrating employees to the point of powerlessness, is not a recommended means toward the success of an organization. Another reason, I believe in the importance of personnel and their ability is that most organization’s neglect the fact that a sound, successful organization is built on the competence of employees. Yet, this seems to have become the accepted methodology among many organizations, especially older organizations. A basic principle is that personnel are the most valuable investment an organization can make. Personnel, especially those in the front line are those that have the ability to positively affect a second most important resource, consumers.

Impact of Recent Changes in Capitalism on Social and Economic Status of Women

Introduction The history of women and their oppression has been well documented in literature. Several authors have explored the origin of women oppression. Women’s oppression has its roots in capitalism which has existed for many centuries (Stuart & Martin 1989). Their oppression is of course not unique to capitalism as it has been there since the colonial times and through the 19th century and 20th. However, over the past few decades, we have observed significant changes in capitalism which has impacted on the status of women. Many changes have been observed some of which are positive and others which take a more gloomy view. In this respect, this paper explores how the recent changes in capitalism have affected the social and economic status of women. In particular, the paper considers how post-Fordism and neoliberalism have altered women’s socio-economic position. Changes such as industrialization, urbanization, internationalization, globalization and modernization will be discu ssed in detail. The paper will examine how the concurrent cultural shifts have interacted with these socio-economic transformations and determine what the overall impact of these different factors has been. An exploration of this topic will be incomplete without examining the origin of capitalism and the rise of post fordism and neoliberalism. History of capitalism and crisis of fordism The origin of capitalism remains shrouded in the mists of history. Its exact birth date is speculated to be anywhere between the 14th century and the 17th century (Stuart & Martin 1989). Capitalism emerged from a feudal society and is linked to Europe’s economic system of the late 1700s (Price 2005). It is argued to have begun with the enclosure of common land used by peasants, and development of merchant capital and slave trade in western Europe (Price 2005). Rich landowners appropriated public land and made it their own private land, thereby creating a landless working class which provided the needed labour to develop industries (Harvey 1989). Fordism, a regime characterized by mass production, emerged in the early 20th century. It became dominant in the advanced capitalism during the postwar reconstruction. It was characterized by the mass production of homogenous consumer products, use of rigid technology, increased productivity, rising income which is dependent on product ivity, increased profitability and investments, and homogenization and intensification of labour (Clarke 1990). Fordism gave birth to the current phenomenon of ‘mass worker’. The fordist regime adopted a set of cultural norms and values which continued to oppress women. The regime supported the male breadwinner model where women were seen as mothers and house wives while men worked in paid labour (Castell 1996). Gender relations under this regime required women to work without pay while the male subject was remunerated. However, fordist regime had its limits which were technical, social and economic in nature. Technical limits were mainly the exhaustion and the intensification of labour (Clarke 1990). The economic limits included decrease in profitability which was a result of the rising wages and declining productivity. Social limits were related to the growing demands of mass worker. Post-fordism and neoliberalism Given the crisis of fordism, a new form of ‘post-fordist regime’ emerged which was characterized by the growing differentiation of products, new technologies, more flexible production methods, and greater skill and flexibility, and increased involvement of women in paid labour (Burrow & Loader 2003). Post-fordism emerged primarily due to three main driving forces: internationalization, technology revolution, and as a result of the paradigm shift from fordism to post-fordism (Broomhill 2001). Introduction of the welfare system and the rise of women movement in the post-fordist regime led to the abandonment of the male breadwinner model and women’s financial independence (Broomhill 2001). Several historical events have transformed the social landscape including technological revolution, demise of international communist movement and the collapse of Soviet statism (Castell 1996). Proliferation of technologies centred on information systems have reshaped the social la ndscape and accelerated the pace of development of the society. Moreover, the rise of globalization has led to a new form of relationship between states and economies (Castell 1996). All these changes have been driven and shaped by the neo-liberal thought. Neoliberalism has led to the increasing globalization, decentralization, de-regulation of the market, organizational restructuring, growth and consolidation of transnational corporations, and ‘free marketization’ which has reduced the old state and contractual controls (Acker 2004). Furthermore, new forms of flexibility in employment relations including part-time and online forms of working have emerged, changing the working environment. Post-fordism and neoliberal policies have resulted in the feminization of labour and made men and women both similar in the public sphere (Broomhill 2001). Impact on women’s economic and social status These changes in capitalism have had profound yet contradictory impact on the economic and social status of women. While it has to a large extent improved women’s socio-economic status by undermining older forms of male dominance, it has to some extent worsened their life conditions (Beck et al. 2001). On the positive side, post-Fordism and neoliberalism have altered women’s socio-economic position and disrupted the settled economies that supported patriarchy structures. Post-fordist relations of production have resulted in the inclusion of women in paid labour force. Neoliberal policies have increased flexibility in employment. These changes have changed the way women view themselves and challenged the patriarchic view of domination of women by the men (McRobbie 2008). And since domination essentially occurs through construction of reality, if the women subjects do not internalize patriarchalism, then its demise is just a matter of time. While some religion in some cou ntries, especially Islam, continue to re-state the sanctity of the patriarchal family, its disintegrations is evident in many countries. Women in many countries have joined the paid workforce and even conquered legal parity at work. However, their inclusion in the paid labour force does not necessarily imply that they were relieved of the burden of Partriachalism. It might be that despite working for pay, women still continue with their role of providing domestic and caring labour at home. Nonetheless, their liberation from oppression is clearly evident across the globe. The number of women in paid workforce has been increasing gradually over the years. Estimates indicate that women currently account for about 42% of the global workforce with majority of them employed in the health sector (75%) (WHO 2008). Not only has their economic status improved, their social status has improved as well. Women are increasingly being seen as equals to men including in politics where they were ess entially absent. The political system in many countries has opened up to female leadership. The participation of women in leadership positions and politics is clearly evident in the recent presidential elections in the US where Hillary Clinton contested against President Barack Obama. Many more women leaders have emerged all over the world with President Ellen Johnson Sirleaf of Liberia being the most popularly known in Africa, having won as the first ever female president in Africa. Others include the German chancellor Angela Merkel, President Cristina Fernandez of Argentina, Prime minister Sheikh Hasina of Bangladesh, President Dilma Rousseff of Brazil and many more (Aguirre et al. 2012). The list is certainly endless. In addition, the education system has become more open to the girl child including in fundamentalist countries such as Iran which have seen a growing number of women graduates (Castell 1996). The affirmation and recognition of women’s values, the growing wome n movements and critique of patriarchalism are some of the most important transformations that have contributed to the new status of women. Feminism As women movements continue to fight for their autonomy and recognition of women’s values, the more has feminism diversified. A new frontier has emerged based on the notion of ‘degendering’ of the society which implies a society free from gender associations or rather one that moves beyond gender (Murphy 2011). This new frontier in feminism has superseded the old battles that existed between equality feminism and difference feminism. By mobilizing women to oppose patriarchalism and to defend their rights, feminism has transformed to the point of canceling the distinction between men and women (Sulivan 2007). Men and women are now largely viewed as individuals with meaningful existence, liberating them from the patriarchic burden of responsibilities. This has certainly been very helpful in achieving a more equal society. Women’s role in the development of the economy is increasingly being recognized. Available evidence indicates women to be powerful drivers of economic growth. A study by the Center for Economic and Policy Research found the high rate of women employment to be the driving force of the US economy. The study found that, if women had not entered the workforce over the last 30 years, the economy would have been 11% less. Today, we see several institutions including the World Bank and the Department for International Development (DFID) campaigning for more involvement of women in economic development (Aguirre et al. 2012). According to the World Bank, encouraging the growth of women entrepreneurs is as sure way of fighting poverty. Women are poised to drive the global economy in the next coming decades. Estimates indicate that nearly 1 billion of women across the world might join paid labour over the coming decade (Aguirre et al. 2012). Criticism While there seems to be a progress in women’s socio-economic status driven by post-fordist relations and the neoliberal policies pursued by the several states, some countries continue to follow partriarchalism. Despite its inevitable demise, some countries tend to still follow partriarchal lines which subordinate women under men’s dominance. A good example can be seen with Saudi Arabia. A woman’s place in Saudi Arabia is still in the home. Saudi women continue to walk in the shadow of their men. For example, despite their obvious presence, they are not allowed to participate in the public sphere (Hamdan 2005). They are viewed as non-existing in the public sphere and are silenced in public life. They continue to be subordinated to male individuals in both private and public sectors despite their qualifications. While a progress seems to have been made with respect to their education, at the core of women’s education is sex segregation. Education in Saudi co ntinues to support the prevailing gender structures, implying lower social status of Saudi women (Hamdan 2005). Perhaps more shocking news is the fact that Saudi Women are not allowed to drive. While religious reasons are generally given for denying women the right to drive, it is clear that their place is still in the home. Also, even though many women have progressed economically due to their inclusion in workforce, only a few of them work in the management positions. In spite of the increasing number of women in workplace, many of them are concentrated in the lower-status occupations. For example, while the health sector comprise of 75% of the women workforce, they are concentrated n the lower status working either as nurses and midwifery personnel or as ‘caring’ cadres (WHO 2008). They are largely underrepresented at the managerial level and specialist categories such as dentists, pharmacists, and physicians. Feminist critique of sexism seems to have given justifica tion to new forms of exploitation and oppression. With more women joining the paid workforce, the ‘family wage’ model central to state-organized capitalism which viewed men as the ‘breadwinners’ and women as ‘home makers’ has now been replaced by the newer, more modern norm of ‘two-earner’ family (Fraser 2013). While this may sound like good news, the reality is that post-fordism and neoliberal ideas have resulted in depressed wage levels, increased job insecurity, exacerbation of double shifts and the increase in the number of working hours (Fraser 2013). What was once the ‘family wage’ in capitalism has now been replaced by a low-waged work. Majority of their work has not really brought liberation rather a ‘tedious reality’ far from the perceived image of a working woman (Frank 1999). They remain relegated to lower positions at work. Even with many women being employed either in full or part-time positio ns, they are not getting to the ‘top’. Also, where their role is clearly evident, women continue to suffer from some level of hostility and public disapproval. For example, when it comes to journalism, women have proved flexible and able to forge new approaches. Their adaptability to new approaches is clearly evident with their news coverage of the September 11 events, the overthrow of Taliban forces and the bombing of Afghanistan (Chambers 2004). Women journalists developed different angles in their approach to war journalism, thereby attracting more news audiences. Yet despite the critical role that they played, a heated public debate emerged about the risks of reporting in war zones. It is clear that despite their liberation from oppression, women are still defined in terms of men. As wives and mothers, women clearly continue to suffer from some level of hostility and public disapproval that men with families do not ( Chambers 2004 p.13) In addition, some recent even ts have pointed to the renewed crisis of capitalism. There is currently a crisis of profitability which is facing capitalism. The profit rates are falling and many firms have been laying off workers. British capitalism is particularly in a crisis given its relatively weak position compared to other imperialist nations (FRFI 2013). The current focus on the growth of the private sector implies that priority has been placed on industrial development over social objectives. Workers wages have been cut to a massive extent and unemployment seems to be growing. Given this crisis, capitalism is now insisting on women returning to their traditional roles as domestic workers (FRFI 2013). Neoliberal ideas contributing to sexism While the recent changes experienced by capitalism seem to have contributed to the recognition of women as gender equals, recent developments continue to enact sexism. For example, many advertisements of today show nude pictures of women. What this means is that the male gaze is invited and encouraged as women continue to become objects of the gaze. Moreover, many clubs continue to feature young women stripping, lap-dancing and flashing out their breasts in public (McRobbie 2009). A hyper-culture of commercial sexuality seem to be growing, an aspect that is clearly a repudiation of feminism. Even the young women journalists who through their education are ‘gender aware’ refuse to condemn such acts of commercial sexuality. It seems like the new female Subject is called upon by the society to withhold critique and to remain silent despite her freedom. Consumer and popular culture seem to be introducing invidious forms of gender re-stabilization by pretending to support fem ale success yet tying the female subject to new post-feminist neurotic dependencies (McRobbie 2009). In order to be considered a modern sophisticated girl, the female subjects choose to withhold their critique despite their obvious image as sexual objects of men’s gaze. With the progress seen with women’s socio-economic status, one might think that the feminists are happy to see the things they fought so hard to have come true. However, what has emerged is different from what was desired (Cornwall et al 2008). Neoliberal values seem to have created space under which women can be further oppressed and their core values undermined. The culture of neoliberalism has led to the idea of self-sufficiency and free choice. All that one has to do is to compete in the market place. Some women have even gone to great lengths to make themselves acceptable to the world of work by performing cosmetic surgery under the illusion of having freedom choice to make their own decisions (Gup ta 2012). Yet some of their work goes against their core values. Many women have ventured into the sex industry under the illusion of having control over their lives. They have chosen this kind of work in the spirit of freedom of expression of their sexuality and believe that the work is liberation from the drudgery of cleaning jobs (Gupta 2012). However, the so called freedom of expression is actually reducing them to the status of ‘commodity’ and as objects of ‘men gaze’. Feminism which once fought for the liberation of women from oppression has become entangled in a dangerous liaison with neoliberal efforts to build a free market society (Fraser 2013). It has led to the notion of ‘freedom of choice’ which ultimately has given rise to prostitution. Feminists’ perspective on prostitution, however, is an interesting one. Feminists argue that prostitutes are social workers and have in fact used their social concepts to contend for decrimi nalization of prostitution (Sullivan 2007). Feminists have formed strong links with prostitutes resulting in advances in the area of prostitution law reform. The feminist position of the sex industry is one that empowers women as long as they choose to participate. But what is progressive about women’s participation in prostitutionCan women really progress by becoming sexual objects and objects of male gazeWhat is revolutionary about legalizing prostitutionIn fact, legalizing prostitution just makes women to become sexual commodities. The fight against sexism that has long been fought for by feminists seems to have ended up again to encouraging it. The progress in women that we have seen so far will not continue if women continue to follow neoliberal ideology that values individual ‘choice’ and ‘freedom’ over emancipation. Selling their bodies will not provide them with independence and empowerment that they seek but rather it will just reinforce mal e power and privilege. Trafficking of women and children Further, neoliberal ideology has led to the growing trafficking of women and children. This is particularly evident in Asia and the pacific region where human trafficking has grown to become a booming business. Millions of children in the pacific region are traded to work in brothels or sweatshops. Human trafficking has not grown by accident but as a result of free trade and structural adjustments brought about by neo-liberalism. Sex trafficking is currently a growing market in some parts of Eastern Europe, most notably Romania and Albania (FRFI 2013) Conclusion There is no doubt that the socio-economic status of women has improved following the recent changes in capitalism. This is evident in their inclusion in the paid workforce, their enrollment in eductation and increased participation in the public sphere including in politics. However, to some extent, these changes have painted a gloomy picture with regard to the status of women. A vast majority of them continue to occupy positions at the low levels of the organization. Also they continue to suffer from some level of hostility and public disapproval. Neoliberal ideology has led to their increasing commodification and increased trafficking of women and children. A hyper-culture of commercial sexuality seem to be growing, an aspect that is clearly a repudiation of feminism. Nonetheless, a huge progress has been made. Today, there are many successful women in the capitalist society. In fact, many women seem to have embraced the capitalism and showed support of it due to their improved soc ial and economic status. If their status is to be further improved in post-fordist employment, policy initiatives must address the issues of women’s employment, skills and training (Burrows & Loader 2003). Furthermore, there is need for public policy to challenge the polarized labour market that has emerged from post-fordism. Neo-liberal policies which support the development of a polarized market are socially divisive. Also, feminist scholars need to caution Women against prostitution. Selling their bodies will not provide them with independence and empowerment that they seek but rather it will just reinforce male power and privilege Reference Acker, J., 2004. ‘Gender, capitalism and globalization’. Critical Sociology, vol. 30 (1), pp.17-41 Aguirre, D., Hoteit, L., Rupp, C. and Sabbagh, K., 2012. Empowering the third billion women and the world of work in 2012. Booz & Company McRobbie, A., 2008. The Aftermath of Feminism: Gender, culture and social change, pp. 1-95. Zygmunt, B., 2001. The Individualized Society. Polity press. Beck, Ulrich & Elizabeth Beck-Gernsheim, 2001. Individualization: institutionalized individualism and its social and political consequences. Sage publishers. Broomhill, R., 2001. ‘Neoliberal globalism and the local state: a regulation approach’. Journal of Australian Political Economy , No.48 Burrow, R. and Loader, B.D., 2003. Towards a post-fordist welfare stateLondon: Routledge Castells, M., 1996. The Power of Identity. Blackwell Castells, M., 1996. The Rise of the Network Society. Blackwell Chambers, D., Steiner, L and Fleming, C., 2004. Women and journalism. Routledge Clarke, S., 1990. The crisis of Fordism and the crisis of capitalism. University of Warwick. Cornwall, A., Gideon, J. and Wilson, K., 2008. ‘Introduction: reclaiming feminism: gender and neoliberalism’. IDS Bulletin, vol. 39 (6) Franks, S., 1999. Having None of It: Men, Women and the Future of Work, Granta. FRFI, 2013. Women’s oppression under capitalism. Revolutionary Communist Group [viewed on 3rd May 2014] available from http://www.revolutionarycommunist.org/index.php/women-s-oppression/2850-women-s-oppression-under-capitalism Gupta, R., 2012. Has neoliberalism knocked feminism sideways[viewed on 3rd May 2014] available from http://www.opendemocracy.net/5050/rahila-gupta/has-neoliberalism-knocked-feminism-sideways Hamdan, A., 2005. ‘Women and education in Saudi Arabia: challenges and achievements’. International Education Journal, vol.6 (1), pp.42-64 Harvey, Da., 1989. The Condition of Postmodernity. Blackwell. Jessop, B., 2008. Post-fordism and the state, UK, Lancaster Murphy, M., 2011. A progressive dialogue: building a progressive feminist movement in neo-liberal times. [viewed on 3rd May 2014] available from http://rabble.ca/news/2011/10/progressive-dialogue-building-progressive-feminist-movement-neo-liberal-times Price, R.G., 2005. Understanding capitalism part IV: Capitalism, culture and society. [Viewed on 2nd May 2014] available from http://www.rationalrevolution.net/articles/capitalism_culture.htm Stuart, H and Martin J, 1989. New Times: The Changing Face of Politics in the 1990s. Lawrence & Wishart Whelan, Imelda, 2000. Overloaded: Popular Culture and the Future of Feminism, The Women’s Press. Sullivan, B., 2007. Feminist approaches to the sex industry. Australia: University of Queensland World Health Organization (WHO), 2008. Gender and health workforce statistics. World Health Organization.