The use of poetic devices is one of the ways a poet creates a memorable and beautiful poem. Unlike any other form of creative writing, a short poem can use theses poetic devices to convey much more meaning and depth of emotion than the length of the piece would typically allow. An emotional poem can be analyzed to determine how each device is powerfully utilized on its own, yet the effect is even more compelling in combination. In his poem “My Papa’s Waltz,” Theodore Roethke (1941) uses symbolism, metaphors and imagery to convey a childhood memory, real or imagined, along with the deep emotional feelings of helplessness, dependence and love that are brought out in the poem.
Use of Imagery
When a poet uses imagery, he is using words in a powerful way to convey a specific image in the readers’ minds. Although it is common to think of this device as only being used to convey visual imagery, imagery can also include sound, tactile feel or even smell. In “My Papa’s Waltz,” Theodore Roethke begins the poem with a powerful use of imagery by saying, “The whiskey on your breath/Could make a small boy dizzy:” I found this imagery, using the sense of smell, to be very effective in setting the stage. Perhaps this is because scientific studies have shown that the olfactory bulb, where smells are processed in the brain, has direct ties to the amygdala and hippocampus, which are two brain areas that play a strong role in memory and emotional function (Lewis, 2015). Anyone who ever encountered a drunken adult has a child can relate to this imagery instantly. It can bring with in an emotional reaction of fear, confusion or sadness that runs deep. This powerful use of imagery continues in later lines, including the last line of “My Papa’s Waltz” where Roethke says, “Then waltzed me off to bed/still clinging to your shirt.” The image here is of a young boy holding on tight to his father. Whether the underlying emotion is fear or love, the imagery of this line is powerful enough to ignite both emotions in the reader.
Symbolism as a Device
Symbolism is observed when an object or a subject in the poem actually represents something else. Sometimes this symbolism can be evident immediately and at other times more thought and insight is required to see it. When Roethke writes, “But I hung on like death,” in the first verse of “My Papa’s Waltz,” he is using the word death to symbolize the strength of his grip using the power of the word death, rather than talking about death itself. The symbolism in this case is obvious and direct. Other lines of the poem may or may not be symbolic. Since we cannot know the poets thoughts, they remain powerful whether or not they were intended to have added meaning.
Meter in Poetry
Meter is a poetic device used to provide a rhythm or beat to the poem. Perhaps even more than rhyming, meter in poetry is what instantly clues in the reader to poetry vs. ordinary prose. There are many different ways that meter can be used to enhance a poem’s beauty and meaning. In “My Papa’s Waltz,” Theodore Roethke seems to be using a fairly simple form of meter, similar to a limerick. In each verse, the first and second lines rhyme, and the rhythm of the poems structure places emphasis on the last word of each line. These words seem to have been deliberately emphasized to enhance their meaning. For example, the rhyming words “knuckle” and “buckle” are emphasized by the meter of the poem, and seem to convey an undertone of violence to the subject. Other verses are structured similarly, with the use of meter consistently pointing the reader towards the emotional meaning of the poem.
Feeling of Helplessness
In reading this poem, it is easy to conclude that the thoughts and feelings of the author were the same or similar to those of the reader. The feelings of helplessness, fear and love are clearly conveyed by the poetic devices and the words themselves. I suppose what we cannot know for certain is whether this poem recounts an actual memory or is more collection of feelings about the author’s father or some other figure from his childhood.
In Conclusion, I think that “My Papa’s Waltz” by Theodore Roethke (1961) is a poem that not only requires the reader to use their imagination to place themselves in the scenario, but skillfully leads them into it through the clever use of poetic devices. By using imagery, symbolism and meter in powerful ways, Roethke is painting a clear picture in our minds. The picture may be very different for each reader, but the universal themes and emotions will produce a similarly memorable reading experience for anyone.
Lewis, J. G. (2015). Smells Ring Bells: How Smell Triggers Memories and Emotions
Canadians take pride in the Medicare system that enhances their access to healthcare. There are numerous mechanisms put in place to work hand in hand with this scheme to ensure that drug prices are well regulated and drugs are affordable. Despite these measures, the overall expenditure on drugs has risen drastically over the last three decades (Gagnon, 2014). Prices, on the other hand, have fluctuated with increases and decreases experienced at different periods and provinces. These fluctuations have been causes of major inconveniences for healthcare providers and patients. The lack of a uniform drug control approach across provinces and conflicts between federal and provincial level policies is the primary cause of inefficiencies in drug price regulation in Canada.
The policy challenge
It is rational to admit that there is drug price control problem in Canada. According to Gagnon (2014), prices for both inpatient and outpatient prescription drugs have been on the rise over the last three decades. Inpatient prescription drugs are covered for by the public healthcare system, but outpatient prescription drugs are not. Though there exist numerous public health plans that make outpatient prescription drugs more affordable, a considerable portion of the population is not covered by any of these schemes. Morgan and Boothe (2016) confirm that fluctuations in drug prices have a grave effect on healthcare provision. The major cause of this challenge has been an ineffective pharmaceutical policy concerning drug prices at both the federal and provincial level. There exists a complex system of pharmaceutical regulatory systems at both levels that complicate price regulation.
Despite the various actions taken at both the federal and financial level, drug prices in Canada have continued to rise with a corresponding increase in per capita expenditure. Compared to other developed countries, Canada ranks among the top three nations with the highest drug prices – only performs better than the US and Italy (Lexchin, 2014). Regarding overall expenditure on drugs, Canada has the second largest expenditure after the US (Babar, 2015). High drug prices compromise the quality of healthcare in Canada.
Current Canadian Policy Approaches Meant to Control Prices
Federal Government’s Role in Drug Price Control
The federal government has a significant role to play in the regulation of drug prices. The Patented Medicine Prices Review Board (PMPRB) is the national body that charged with the responsibility of controlling drug costs (Anis, 2000). It is quasi-judicial in nature and responsible for ensuring that manufacturers do not charge excessive prices for their drugs. The PMPRB does not set drug prices but instead reviews the prices of various products to determine whether they are excessive. It has the power to conduct investigations and enforce decisions that it deems appropriate to control prices.
The first step by PMPRB towards the regulation of drug prices is drug classification. In order to classify drugs, PMPRB relies on data submitted by manufacturers for classification of drugs (Anis, 2000). Currently, the board classifies drugs into three categories. Category 1 drugs include any drug that is an extension or improvement of existing drugs also referred to as line extensions. Category 2 includes all first drugs to treat a given illness effectively. Category 3 drugs consist of any new dosage form that results in moderate or little improvement of the existing drugs (Anis, 2000).
After this classification, drug’s price is then reviewed against prices of other drugs to determine if it is excessive. In order to determine if the cost of a drug is excessive, it is compared with the Consumer Price Index (CPI). As Bonner and Daley (2010) note, an exorbitant drug price is any price increase for a patented drug that is more than the CPI. It uses a metric referred to as the Patented Medicine Price Index (PMPI). Prices for new drugs are supposed to be in the range of other existing drugs in the same therapeutic classes. Drug prices are reviewed on a yearly basis, but at times, a drug price review can be initiated due to a complaint from a stakeholder. Each year, manufacturers are supposed to submit price and sales information with the PMPRB for review (Anis, 2000). The board has the power to order a manufacturer to lower prices so that they are no longer considered to be excessive.
The Provincial Government’s Role in Drug Price Regulation
Many approaches are available for use by the provincial government in drug price control. The most common method is the use of formularies. A formulary is a form of arrangement in which a given drug is included in given provincial drug plan (Grootendorst & Matteo, 2007). After a drug is approved and reviewed by the PMPRB, the manufacturer is supposed to make a filing with the provincial government for its inclusion in a given drug plan. After the submission, the provincial government reviews the effectiveness of the drug by comparing its costs to its therapeutic advantage (Grootendorst & Matteo, 2007). A new drug that has a therapeutic value will be added to a plan only when it does not increase program costs. Also, a drug can be added to a plan under specific conditions.
The other strategy that provincial governments use to regulate the prices of drugs in the markets is the use of generics. Generics are a major part of the pharmaceutical patent policy. A generic drug is an exact copy of an original brand drug (Anis, 2000). The major advantage of generics is that they have lower prices than the original drugs due to lower research and development costs. Provincial drug programs at times opt for generic substitution drugs to lower and control expenditure on drugs. Since generic drugs function in a similar way to the original, innovative products, provincial drug programs can substitute a drug with its cheapest generic form.
Reference-based pricing is also used by provincial administrators to control and regulate drug prices. Reference-based pricing is an extension of the generic substitution concept (Anis, 2000). In this case, a panel of pharmacists establishes a reference product in every category of drugs and its price. It is then what the provincial government will use as reimbursement price for all products in this category.
Data Collection Techniques
Data was gathered primarily through traditional means. Academic journals and gray sources were used as the principal sources of data. Academic journals and peer reviewed gray sources are credible sources of information due to their peer review nature. The sources used were Canadian and international. The international sources used were aimed at comparing the approaches employed in Canada with those used in other countries.
Analysis of Findings
With the entire above-stated drug price control mechanisms in use, it may seem obvious that drug prices in Canada would be low. However, this is not the case because drugs in Canada are not cheap (Thakkar, 2016). Canada has made bold steps in controlling pharmaceutical drug prices, but still, its price regulation measures need to be enhanced. Canada has high per capita spending on drugs, and this is an indicator of inefficient drug price control mechanisms. Canada’s prescription drug prices are among the highest in OECD countries. As of 2015, Canada had the second-highest per capita spending on drugs after the US (Lexchin, 2014). Similarly, between 2000 and 2009, Canada’s average annual growth in per capita spending was 4.3 % which is almost 1% higher than the OECD average for that period, which was 3.5% (Lexchin, 2014). Prices of generic drugs in Canada are also higher than those in most other developed countries despite the recent moves in some provinces that were seen as a solution to price increases.
The various provincial drug plans that are supposed to subsidize on drug costs do not cover everyone, and a significant portion of the public is left out in coverage. In most provinces, drug benefits programs help the needy, the elderly, and other minority groups that require social assistance (Babar, 2015). The general population is therefore covered only to some extent. Private insurance companies also complicate the issue for they seem to support increment in drug costs. Since they are paid as a percentage of the total plan expenditure, they would make more profits with higher drug price (Babar, 2015). The primary reason for the ineffectiveness of drug price control mechanisms in Canada is complexities that arise from federal and provincial governments’ price regulation measures going in opposite direction.
The federal government makes policies, yet it does not suffer their consequences. It is the provincial governments who suffer these consequences for it is them who bear the larger health care cost burden. The manner in which price regulation policies at the federal and provincial level mesh with each other has changed substantially since the enactment of Bills C-22 and C-91 (Grootendorst & Matteo, 2007). Before the passing of these two bills, federal and provincial drug policies were unidirectional. The federal compulsory licensing policy made generic drugs cheaper while policies such substitution laws at the provincial level encouraged the use of generic medicines (Grootendorst & Matteo, 2007). It had the favorable effect of lowering drug prices as well as government expenditure on drugs. Grootendorst and Matteo (2007) add that in the period between 1969 and 1987, federal spending on drugs was, for example, more than $400 million lower than it would have been without these policies.
The introduction of bills C-22 and C-91 had a major effect on Canadian drug prices. These two bills worked together to eliminate compulsory licensing and thus led to federal and provincial policies moving in the opposite directions. Anis (2000) mentions that federal regulations seem to be allowing for longer patent terms, less generic competition, and higher prices while provincial policies such as requiring cost-effectiveness, reference pricing, and formulary listings are aimed at lowering and containing drug acquisition costs.
The provincial government’s efforts to lower drug prices have been significantly compromised by these two bills (Anis, 2000). The increasing expenditure on drugs is enough proof of this. In the period between 1988 and 2002, after the Bills C-22 and C-91 (1987 & 1993 respectively) were effected, drug spending increased by more than $3.9 billion (Grootendorst & Matteo, 2007).
There also seems to be a lack of uniformity by provinces regarding drug price regulation. Different provinces use those approaches that they deem to be the most efficient for them. With minimal federal interference, each province has its own approach towards planning for meeting drug costs. According to Lexchin (2014), rules regarding who is covered in what plan, the type of drugs that are listed in formularies, and how much people are supposed to pay out of pocket for drugs varies significantly across provinces.
Evidently, Canada’s rising drug prices per capital expenditure on drugs are an indicator of inefficiencies in price control at both the federal and provincial level. Many strategies have been put in place at both levels to regulate drug prices, but they seem to be ineffective as the rising costs of drugs indicate. The primary cause of this inefficiency is the current conflict between federal and provincial price control policies as well as the lack of a common price regulation to be used across provinces. There is a need for the federal government to work together with the provincial governments to put up new measures to curb drug prices.
Anis, A. H. (2000). Pharmaceutical policies in Canada: Another example of federal-provincial discord. Canadian Medical Association Journal, 162(4), 52-526.
Babar, Z. (2015). Pharmaceutical prices in the 21st century. New York, NY: Springer.
Gagnon, M. (2014). A roadmap to a rational pharmacare policy in Canada. Ottawa, ON: Canadian Federation of Nurses Unions.
Grootendorst, P., & Matteo, L. (2007). The effect of pharmaceutical patent term length on research and development and drug expenditures in Canada. Healthcare Policy, 2(3), 63-84. http://dx.doi.org/10.12927/hcpol.2007.18677
Lexchin, J. (2014). Drug pricing in Canada. In Z. Babar (Ed.), Pharmaceutical prices in the 21st century (pp. 24-41). Springer: New York, NY.
Part 1 – Integrated Marketing Communications, and the Changing Media Landscape
Integrated Marketing Communication
Considering that Samsung’s active target group is of the age between 20 and 50 years, the only way to develop would be by targeting individuals over the age of 55. Since people within this age are not actively involved with some of the current and intricate technologies, integrated marketing communication with them is crucial. In this case, six tools will be used in the marketing campaign as promotional methods. These include advertising, sales promotion, personal selling, public relations and direct marketing efforts. The communication message is vertical in nature and fits with the overall and marketing objectives of the company. Since the target market is the more elderly population, the marketing message will be “THE FUTURE IN YOUR HANDS!” which will suggest a movement to the future with current technology. To succeed in marketing, communication strategies like Guerilla and ambush marketing and sponsored consumers will be used to communicate to the target population effectively since they have already been proven to work in the past (Yeshin, 2012).
Marketing Communication Objectives
The main marketing communication objectives of the company include the maintenance of customer loyalty among the elderly population of the country as well. The other objective is increasing the company’s market shares in the country hence improving the revenues of the country. Also, the company also aims at improving its brand presence within the elderly population, which has been largely neglected since most of the products are focused on satisfying the needs and desires of the younger and active population. These objectives will be accomplished by capitalizing on making the individuals aware of the existence of a new line of product that suits their need. This will increase their interests in the product and increase the desire for the product, hence increasing customer loyalty and ensuring that people start to value the product. Finally, the action will follow where people will try out the product leading to a direct increase in the company’s market share.
Different tools will be used to accomplish the three marketing objectives. The tools to be used are namely, advertising, sales promotion, direct marketing, personal selling, and public relations. Advertisement will be the main tool used to accomplish these objectives and increase the brand’s awareness and increase its market share (Belch & Belch, 2015). Public relations, sales promotion, and direct marketing, will also be crucial. As for increasing customer loyalty and retention, direct selling, sales promotion and personal selling, the promotional tools will be crucial. Finally, increasing the company’s brand presence is the final objectives, and it will be accomplished by traditional advertising techniques (newspaper, television, etc.), guerrilla and ambush marketing techniques and sponsored consumers. The sponsored consumers are individuals that have already used the products, and express their experience with the product hence attracting other people to purchase the product.
Traditional advertising will be the most effective media strategy used. This is considering that within the elderly in the community, people remain conservative and prefer using media that they familiar with. Hence, strategies such as promotional consumers will be communicated through magazines and newspapers like Senior Times Magazine, New York Times and Reader’s Digest. Sales promotion is also a major channel to be used to promote products within the target market. However, this will only work effectively if integrated with other non-traditional tools like product placement (Belch & Belch, 2015). This will be carried out by using popular TV series including those aired through Netflix could be used to promote products by airing characters use these products, especially the seniors. This will attract people to purchase the products and ensure that the company accomplishes its main objectives.
Part 2 – Special Topics in Marketing
Business-to-business marketing (B2B) refers to commercial transactions between businesses especially when the business decides to outsource products from other sources. As a company, the best markets where the company could expand to include health, finance, and sports, which are some of the growing markets in the world at the moment (Hadjikhani & LaPlaca, 2013). For instance, recent reports have suggested that there is a growing need to improve health and live by the health standards, hence ensuring its sustenance. As a result, investing in such a growing field would ensure that the company’s revenue continues growing. The fact that mobile devices have been increasingly used to monitor health conditions for individuals makes it ideal for them since their research and development team is already advanced and could be used for the purpose. Also, the company could also get into the finance markets and enter into businesses with different financial companies and assist individuals to make the necessary financial decisions that they need.
Segmenting B2B Markets
Research suggests that habit-based behavioral segmentation is the one that segments the market by studying customer behavior and understanding their desires and actions. Determining how to segment the market starts with the analysis of different segments based on purchases (Simkin, 2008). The buyers, in this case, are segmented by behavior, geography, demographics and psychographics. By behavior, it is evident that Samsung would most likely benefit from getting into business with companies within the health market. This is because the elderly in the community are mostly seeking to maximize their health benefits, the extent to which they require health attentions and their daily need to monitor health situations. The individual’s situation, in most cases, put them at risk of different health dangers they are exposed to. As a result, a mobile device that helps people to monitor their health conditions and even get health assistance or guidelines as to how to deal with different issues. Hence, their behavior proves that they are more in need of enhanced devices with features they need to carry out their day-to-day activities.
Marketing Information Systems
A marketing information system is crucial to the making marketing decisions by helping manage information systems within organizations. Different types of data could be used in the decision-making process. The information could be either internal or external to the company. Internal data includes the sales data, competitive information, as well as the stock level data. Sales data is necessary since it gives information on the trends of sales and the whether the target market selected would be prospective. As for the competitive information, the company could analyze its competitor’s communication and strategy and judge from its success they can decide the most appropriate strategy to embark on. The next type of information necessary to create the most appropriate marketing strategy is the stock level data. It indicates whether the company needs to focus on making its outlets more effective and even provide market share information necessary in any subsequent expansion strategies.
After implementing a particular marketing mix, companies need to keep track of developments to ensure that these strategies are effective. Hence, the marketing metrics are usually used to assess/evaluate whether the steps taken are successful or necessary for that matter. Both performance and financial metrics could be used to evaluate the effectiveness of the strategy. The main financial metric that could be used to assess its effectiveness is the Customer Acquisition Cost, which is the total sales and marketing cost divided by the number of new customers (Srivastava, Reibstein, & Woodside, 2005). The performance metrics, on the other hand, include the marketing originated customers, marketing influences customers, sales growth and customer retention rate.
Effects of the High Costs of College
As a result of the high cost of college education, the education of future generations will be affected negatively. As Oachs (54) explains, the children of the current and recent graduates will be affected negatively because many graduates now take loans on a 20 to 30-year repayment plan (Oachs 54). What this means is that these graduates will have problems financing the education of their children because instead of investing money in their children’s education, they will still be paying their own student debts (Oachs 55). If the current high cost persists, the future generations will be required to pay even higher and their parents will not be able to afford that.
Secondly, many college graduates have to result to living with their parents (Oachs 56). The debts and the high costs of repayment have made independent living almost impossible for many of the recent graduates. Coupled with the high unemployment rate, many struggle to live independently initially and at last make the decision to go back home because the financial situation leaves them without no other viable option (Oachs 55). Living with parents not only robs one of the independence of living alone but also affects the ability of the parents to educate the other children in the family.
Due to the high costs of college, poorer students have to distort their career choices as they have to choose careers that they would otherwise have chosen had they had more money. Moreover, even after choosing these courses, they have to spent a lot of time working rather than studying and it’s is no surprise that many are struggling to graduate. Other poorer students also have to go to colleges that they don’t want to be in (Zhang 3).
Oachs, Rose Emily. The Rising Cost of Education. New York, NY: ABDO, 2016. Print.
Zhang, Liang. Does Quality Pay?: Benefits of Attending a High-Cost, Prestigious College. New York, NY: Routledge, 2012. Print.
Belch, G. E., & Belch, M. A. (2015). Advertising and promotion: An integrated marketing communications perspective (10th ed.). New York, NY: McGraw-Hill.
The Korean written language known as Hangul has gained popularity due to its relatively simple phonetic nature. Many people say Hangul can be learned in a few hours, and they’re not wrong, for some, picking up this language is incredibly easy. If you have some time on your hands and you’re looking to be able to write Hangul here are some fun ways to learn.
Compare The Letters To Real Life Objects
The Korean letter that creates sound like the English b is and seems similar to a bed and therefore produces the “buh” sound. These sorts of comparisons can be used for a huge array of the Korean alphabet and are one of the reasons why Hangul can be easily taught and learned. By remembering an object associated with each letter you’ll increase your own understanding of the alphabet. The letter that makes the English “t” sound looks similar to teeth, and the same goes for “k” as the letter is shaped like a key. This can be a fun sort of game you play with yourself in order to develop your understanding.
Use A Self-Study Learning Program
As much as you may want to be entirely self-taught, having a program that outlines goals and provides structured learning definitely takes the frustration out of learning Hangul. The experts at 90 Day Korean, show how you can learn the elemental foundations of Hangul, click here for a review of lessons. Having professionals teach you the best methodology of approaching learning is going to reduce your learning curve. The faster you learn Hangul the more able you’ll be able to incorporate it into your understanding of speaking Korean as well.
Look In The Mirror While Pronouncing Words
Most of the consonants pronounced in Korean are going to be similar to the shape your mouth makes when pronouncing the letter. This is a huge asset when you’re attempting to learn the written language as you can mouth your way through it. If you get a visualization for how your mouth looks when you’re making certain sounds this will help solidify the shape of characters for you. This is what makes Hangul so much easier to learn to read and write in when compared to other languages.
Use The Letters As A Frame Of Reference To One Another
The letters “b” and “p” as well as “g” and “k” are extremely similar visually in the Korean alphabet. They just have an additional insertion of a line through them, and this frame of reference helps with understanding the letters. Create a comparison sheet of similar looking letters and then review it. By memorizing at least half of these letters, as long as you remember the counterpart pairing, you’ll have the entire Korean alphabet at your disposal. This is a fun and easy way to create a memory pattern.
If you’re attempting to learn how to write Hangul, a good portion of the process is to remember what the characters look like and not just recognizing what they are. In order to do this, create flashcards with the objects associated with the letter. In the case of chimdae, have a flashcard ready with a bed on it.
When you review the flashcard, attempt to create the letter to the best of your ability and then check to see if you’re right. With a little bit of practice you’ll soon be associating the picture with being able to write the letter. The hardest part of writing Hangul is being able to recall what the image looks like and putting pen to paper.
Practicing Writing Syllable Chunks
The Korean alphabet is written in syllable blocks as opposed to being written with one letter after the other like English is. Each syllable chunk is going to represent a different sound for that syllable. The syllables are read clockwise from left to right, to the bottom letter. Practice creating your own syllable blocks with various letters from the Korean alphabet and see how they would function. Writing this out on your own is going to increase your capacity to remember the symbols a lot better.
Learning Hangul can be a super fun experience if you have the right imagination, and it doesn’t take long to pick things up. Don’t worry if you’re having trouble remembering a few characters it will come in time, but using a professional learning service is seriously going to help with your learning curve. Just remember to have fun during the whole experience. In a couple of days, you’ll be a master at both reading and writing in Hangul.
The meat industry in the United States has significantly changed due to the rising demand. This industry provides essential nutrients to over 318 million Americans with an estimated meat production of more than 93 billion pounds having been consumed in 2012 (North American Meat Institute n.p). In addition to providing essential nutrients, the meat industry also feeds the economy where it employs more than 482,100 workers in the packaging and processing industries. According to Cole et al (162), the poultry and meat industry’s economic ripple effect produces over $864.2 billion every year to the US economy. However, the increased demand for meat has contributed to the devastating impacts of climatic change as well as ethical issues of animal treatment.
Raising animals for food plays a significant role in the production of greenhouse gases leading to climate change. Commercial farming practices that involve confining animals indoors at high stocking densities, selective breeding through the use of hormone drugs as well as poor handling of animals in transit and in slaughter houses impacts negatively on animal welfare (Gjerris et al. 332). The global meat consumption has been estimated to double by the year 2050 which will result into massive amounts of food, land, water, and energy required in raising animals (North American Meat Institute n.p). Additionally, this will contribute to immense animal suffering. Research studies attribute a global shift towards vegetarian diet as critical in combating the adverse effects of climatic change and ethical issues in animal treatment. On the other hand, feeding the world’s population as well as economic growth relies on increased and effective animal farming methods.
This paper argues that maximizing the co-benefits of sustainability and animal welfare while avoiding the negative tradeoffs will ensure that the meat industry meets the needs of the growing population as well as mitigate the impacts of climate change. This calls for effective meat production technologies and alternative strategies for animal welfare and climatic change solutions.
According to North American Meat Institute (n.p), meat and poultry industries in the US processed over 8.6 billion, 33.2 million, 239.4 million, 2.3 million, and 112 million of chicken, cattle, turkeys, sheep, and hogs respectively. The meat industry in the country has been experiencing drastic expansion that has resulted into consolidation. Shields and Geoffrey (370) notes that the industry is now dominated by few large corporations that are involved in the processing of over 80% of the country’s total demand.
A healthy diet that contains at least 5.7 ounces of meat everyday has always been recommended by nutritionists. Shields and Geoffrey (362) note that meat provides about 160-200 calories in addition to significant amounts of other nutrients such as proteins. Other minerals contained in meat such as zinc, selenium and iron are equally essential for overall general health and growth. With the world population estimated to exceed 9 billion by 2050, meeting the needs of this ever-growing population cannot be ignored. In a study by Chulayo and Muchenje (454), high economic growth rates especially in the developing countries has seen an upsurge in the consumption of meat. Economic growth enhances the consumption power of the citizens thereby increasing the consumption of foods that would often be regarded as luxuries. Chulayo and Muchenje alludes to this notion arguing that meat and other animal products are considered superior and nutritious and act as a symbol of social status and wealth (456).
In the quest to meet this increased demand, advancement in technology has also been adopted in meat production. Gjerris et al. (335) notes that industrialization in agriculture has taken root since the World War II out of the concerns to ensure food security. More importantly automated technologies in the production of abundant and cheap food has changed the way animals are reared and processed. Shields and Geoffrey (366) posit that the country has inherited a system of agriculture that only focuses on meeting the narrow human centric goals of food production. The gains from the scientific revolution in animal agriculture have also been tremendous occasioned by the economic ripple effect. However, the intensity to produce more and cheaper food has led to deleterious and unsustainable environmental and animal welfare issues.
Animal Welfare Dilemma
The extent to which animals end up suffering due to modern farming practices presents an ethical dilemma for the consumers and the producers alike. The public concern for the animal welfare has been on the rise in the past two decades prompting animal protection registrations across different countries. According to Cole et al (362), animal welfare has primarily been understood in terms of productivity and health. However, scientific revolutions within animal farming have led to the exposure on animal feelings and mental states. This has been occasioned by the need for cheap ways of meat production that have led to animal confinement both at the farms and in the slaughterhouses.
Gjerris et al. (336), defines animal welfare as the ability of the animal to cope with different environmental conditions that contribute to its wellbeing thorough means such as diseases control and humane slaughter. Animals go through daily and other one-off routine management procedures at the farms such as physical health examinations, weighing, castrating, dehorning, and vaccinations. While these practices may contribute to the wellbeing of the animals, in other cases they may be a source of stress and pain.
The aspect of animal ethics tend to be overshadowed by the need for food security. The society is more concerned with the means of increasing output as arable land and worsening climatic conditions continue to be experienced. This has therefore led to little attention on how the food consumed is produced. The welfare of the billions of animals reared for food thus rests in jeopardy if measures are not adopted to strike a balance between ethics and meat production (Shields & Geoffrey 364).
In the US, the business mentality in meat production has been discouraged by animal rights activists noting of the need for optimal housing conditions, optimal feeds, as well as adequate levels of veterinary services. Gjerris et al. (337), argues that whereas biotechnological breeding and intensive high tech production systems can help solve ethical and food production dilemmas, the industry should also focus on the ethical aspect where animals are more than resources for use.
Chulayo and Muchenje (456), examines the animal welfare during transportation and enclosure in the abattoirs noting that the increased demand for meat has put pressure on the available transportation methods as well as slaughter houses. The animals are thus put through considerable stress, spread of diseases, noise, vibrations, prolonged standing as well as feed deprivation which not only impact negatively on their welfare but also on the quality of meat. Long hours of transportation for instance cause changes in animal behavior as well as their immune and circulatory systems. On the other hand, hot exposure to hot weather coupled with less air circulation during transportation leads to an increase in the animals’ respiratory rate. Metabolic heat and the heat from the environment are major causes of heat stress in animals and are noted to be an indicator of poor animal welfare.
Whereas debate ranges on whether animals are sentient, Shields and Geoffrey (365), argue that current research studies have led to a widespread recognition of the animal’s possession of consciousness to the extent that human beings are. Farmers and meat processors thus need to be aware of the animal welfare in order to achieve economic results on one hand and satisfying ethical and moral considerations on the other.
Climate change has become a critical environmental issue in the modern era. In particular, the widespread destructive effects occasioned by human activities have led to the threatening of the ecological systems, species survival, and people’s livelihoods (Cole et al. 162). In particular, animal agriculture has been one of the leading source of greenhouse gas emissions. Additionally, the meat industry has increased the use of water in growing crops for feeding the animals, drinking, and cleaning farm and factory farms.
Shields and Geoffrey (380) argue that the animals raised for food in the US creates more excrement as compared to the entire human population in the country. With the country having less animal sewage processing plants, such animal waste ends up in waste lagoons, rivers, and lakes. Runoff of animal waste into the water bodies on the other hand leads to the spread of viruses and bacteria’s. The increased demand of meat products has also seen more land space being utilized to grow crops for the animal feeds. According to Cole et al. (162), the production of one pound of meat consumes more than 10 pounds of grains which has dexterous impact on the ecosystem.
Livestock farming contribute both directly and indirectly to climate change. For example, manures and enteric fermentation are associated with direct emissions, while on the other hand transportation of animals, feeds and well as their productions through the use of fossil fuels contribute to indirect greenhouse gases emissions. According to Cole et al. (163), approximately 56 billion animals are slaughtered every year. With the prospects of meat production expected to increase, the effects of GHG not only affect animal agriculture but also on people’s livelihoods. Cole et al (163) therefore note that measures to maintain a reliable source of food obtained from animals and a reduction in the GHG emissions should therefore be emphasized.
A balanced perspective on Meat production, Climate Change and Animal Welfare
Ensuring food security, reducing the impacts of climatic change, and achieving animal welfare are critical and interrelated facets whose balance will reduce human-animal impacts as well as increase sustainability. To begin with, intensification of food production has been regarded as an effective method of meeting the demands for the growing population. Gjerris et al. (340) notes that advancement in technology that leads to a higher output of food per unit can help meet both food security and environmental demands.
A simple way of reducing greenhouse gas emissions requires a reconsideration of the animal species being farmed. For example, a reduction of ruminants which contribute to high emissions of methane and an increase in the production of broilers, fish as well as other aquaculture products will be effective in curbing the impacts of climatic changes and food insecurity. More importantly, the country ought to result into organic farming that will lead to a reduction of dairy and meat products. Organic farming has been noted to have a higher resilience to changes in environmental factors and thus becomes more sustainable in the long run. However, with an increasing world population, organic farming methods lead to lower output as compared to conventional farming methods.
Each farming method on the other hand differs in the way animal welfare is handled. Intensification of meat production is likely to inhibit on the animal welfare as farmers and producers seek to maximize output as well as reduce costs of production. Shields and Geoffrey (380) note that from a utilitarian perspective the impact of increased food output and environmental conservation should be weighed against the effects of animal welfare. In this case, utilitarian’s argue that at a time of acute food security, the human needs ought to trump those of animals with regards to freedom of movement and enclosures sizes.
Whereas the issue of climate change, food production, and animal welfare creates a critical problem for all stakeholders, a most promising way of striking a balance will involve the improvement of efficiency and productivity of livestock production. More importantly, the meat industry should embark on ways to provide better nutrition and genetics that will lead to greater portions of energy in farm animals being directed into creation of useful products such as meat and milk. This will on the on the other hand translate to reduced methane gas emissions per unit of output.
Production efficiency due to high performing animals will also lead to a reduction in the size of animals required to produce a particular level of output. Lesser animals are thus easier to manage and cater for, due to the less constrain on the available space in the farms, transit, and at the abattoirs. More importantly, substantial emissions reductions within the industry will be achieved by adapting the current systems rather than a complete shift in the industrialized systems.
Reducing the consumption of meat products on the other hand can contribute to a balance between animal welfare, food production, and climate change. This thus call for a change in the people’s attitudes towards animal products and an increase in non-meat products. Cole et al. (367) notes that individuals can help reduce the impacts of GHG emissions by advocating for food that is organically grown. Developing a culture of lower meat consumption will thus help conserve land use, water, and pollution as well as ensure better animal protection.
The meat industry plays a vital role in meeting the growing food demand in the country and the world at large. The rising demand has therefore led to increased intensification of animal agriculture that seeks to maximize output per unit at the expense of animal welfare. Additionally, meat production leads to adverse climate changes due to direct and indirect GHG emissions. Maximizing the co-benefits of sustainability and animal welfare while at the same time reducing the negative tradeoff of climate change creates a dilemma on the best strategy in meeting all the stakeholders’ needs. Striking a balance between these conflicting issues can however be achieved by having effective meat production technologies that not only lower greenhouse gas emissions but also contribute to animal welfare. More importantly, a change in the people’s attitudes in substituting meat products for other foods can help strike a sustainable balance.
Chulayo, A. Y. and V. Muchenje. “A Balanced Perspective on Animal Welfare for Improved Meat and Meat Products.” South African Journal of Animal Science, vol. 45, no. 5, Dec. 2015, pp. 452-469. EBSCOhost, doi:10.4314/sajas.v45i5.2.
Cole, Matthew, et al. “Animal Foods and Climate Change: Shadowing Eating Practices.” International Journal of Consumer Studies, vol. 33, no. 2, Mar. 2009, pp. 162- 167. EBSCOhost, doi:10.1111/j.1470-6431.2009.00751.x.
Gjerris, M., et al. “The Price of Responsibility: Ethics of Animal Husbandry in a Time of Climate Change.” Journal of Agricultural & Environmental Ethics, vol. 24, no. 4, Aug. 2011, pp. 331-350. EBSCOhost, doi:10.1007/s10806-010-9270-6.
North America Meat Institute. “The United States Meat Industry at a Glance.” Web. 3 Mar. 2017.
Shields, S & Geoffrey, O. “The Impacts of Climate Change Mitigation Strategies on Animal Welfare.” Ed. Clive Phillips. Animals?: an Open Access Journal from MDPI 5.2 (2015): 361–394. PMC. Web. 3 Mar. 2017.
Clinical Problem: Within hospitals, bacterial infections are the cause of many unnecessary illnesses, deaths, and lengthened hospital stays. Due to the infrequency of hand-washing by healthcare professionals, the risk of these infections has increased.
Objective: To determine if using alcohol-based sanitizers will lower the frequency of infections within hospitals. ScienceDirect, PubMed, NCBI, and Research Gate were used to research clinical trials and research studies on the topic. The key search terms used were bacteria, infections, hospital infections, frequency of hospital infections, hand-washing, and hand-sanitizers.
Results: The CDC recommends the use of soap and water to wash hands when they are visibly dirty, but states that alcohol-based sanitizers may be used if they are not (CDC, 2002). This literature stated that the use of alcohol for routine decontamination can reduce the likelihood of infections in health care settings (CDC, 2002).
Conclusion: Through supplementing regular hand-washing with alcohol-based sanitizers, we can reduce the rates of infection in hospitals.
Improving Hand Hygiene and Reducing Bacterial Growth on Hands by Using Alcohol Based Hand Sanitizer Opposed to Hand Soap
In hospitals, bacteria are easily spread to patients, causing infections and lengthening hospital stays unnecessarily. Doctors and nurses are not washing their hands as frequently as necessary due to lack of accessibility to water and time (Luby, et al, 2010). Use of alcohol-based hand sanitizer may increase likelihood of handwashing and may decrease more bacteria per wash than soap (Girou, et al., 2002). Some existing concerns regarding this topic include: Does hand sanitizer reduce the growth of bacteria more than soap? Is there a large difference between the bacteria killed by soap and hand sanitizer? The PICOT question of importance is (P) In the general patient population (I) does the use of alcohol based hand sanitizer (C) compared to hand soap washing (O) reduce bacterial growth and overall hand hygiene (T) within a period of two months? The expected outcome is lowered bacterial infections with increased use of alcohol-based hand sanitizer.
ScienceDirect, Research Gate, PubMed, and NCBI were utilized for searching for clinical trials and research studies on the use of alcohol-based sanitizers in clinical settings. The key search terms used were bacteria, infections, hospital infections, frequency of hospital infections, handwashing, and hand sanitizers.
To determine if alcohol-based sanitizers are a sufficient supplement for handwashing, three randomly controlled trials were analyzed in conjunction with sanitation guidelines put forth by the CDC. In their study on sanitizers versus handwashing, Girou, et al. partook in a randomly controlled trial with a sample size of 23 (n=23) (Girou, et al., 2002). Within this trial, there existed two groups of subjects: 1) hand hygiene using alcohol-based solution, and 2) hand hygiene using soap. The first group had a sample size of 12 (n=12), while the second had a sample size of 11 (n=11). The purpose of this study was to observe whether hand sanitizer would reduce hand contamination as opposed to washing hands with soap (Girou, et al., 2002). Since the subjects were randomly assigned and the data collected was measured blindly, this study was not strongly accurate because of the small sample size (below 30). The description of the methodologies of data collection were well presented, easy to understand, and easy to build off. One weakness is the length of the study is not clear; another was that a small sample size was selected. The result was that hand sanitizer significantly reduces the presence of colony forming units (counts bacteria) by 83% vs 58% with handwashing (Girou, et al., 2002). These statistics gave a p-value of 0.012 (P=0.012), and a median difference in the percentage reduction of 26%, where the median duration of hand-rubbing during both cleaning procedures was 30 seconds (Girou, et al., 2002). For this percentage reduction, there existed a 95% confidence internal of 8% to 44% (Girou, et al., 2002). In addition, it shows that using hand sanitizer reduces CFU increasingly with every use.
In their study on waterless hand sanitizers in international medicine, Luby, et al. created another randomly controlled trial with the purpose of initiating hand hygiene into low-income residents of Bangladesh, and to increase the use of hygiene methods so that a subsequent study can measure the effects of hand hygiene on health (Luby, et al., 2010). The study was conducted by introducing soap and hand sanitizer, in a randomized controlled trial design, to thirty different housing compounds within Bangladesh. The subjects, or the thirty different housing compounds, where randomized and designated into three different groups, each containing ten different housing compounds: 1) handwashing with soap, 2) handwashing with sanitizer, or 3) no intervention. Field workers recorded use of hand hygiene methods by these groups before and after intervention (Luby, et al., 2010). One strength of this study is it measured varying age groups separately. This study also measured separate points of exposure with opportunity for cleansing before and after intervention. One weakness of this study was the observation of hand hygiene by the field workers could have distorted the actual tendency of the people to use hand hygiene when unobserved. Before the study, the baseline results of hand hygiene within the housing compounds was that after defecation, individuals washed their hands 26% of the time, and after cleaning a child’s anus, they washed their hands 30% of the time (Luby, et al., 2010). Outside of these two occurrences, those within the housing compounds tended to wash their hands <1% of the time (Luby, et al., 2010). Following the study, it was shown that individuals in the first group (soap and water) now washed their hands 85-91% of the time after coming into contact with fecal matter, 26% of the time before preparing food, and 26% of the time before eating (Luby, et al., 2010). In contrast to this, it was shown that those individuals in the second group (hand sanitizer), washed their hands more than the control group (10.4% versus 2.3%), but 25% less than the first group (soap and water) (Luby, et al., 2010). The p-value of the study from the sample of thirty housing compounds was 1.2 (Luby, et al., 2010). It was established that waterless sanitizer increased the frequency of hand hygiene when compared with the control group, but not at prime contamination times, where individuals preferred to use soap and water. With this in mind, it is suggested that combining the two group factors would create the greatest frequency of handwashing, where sanitizer was used for lightly dirty hands, and soap was used otherwise.
In the study in Indian Pediatrics on hand hygiene within the neonatal ICU, Sharma, et al. investigated alcohol-based sanitizers with the purpose of comparing the efficacy of hand hygiene from the use of plain non-antimicrobial bar soap, alcohol hand rub, and povidone-iodine hand scrub on nurses in the Neonatal Intensive Care Unit (Sharma, et al., 2013). The study’s design was randomized cross-over and controlled trial which used a three-armed implementation. This study also measured the outcome blindly. A sample of 35 nurses was used and split into three groups: 1) handwashing with soap, 2) alcohol hand rub, and 3) povidone-iodine hand scrub. To measure the results, cultures were taken before and after each hand hygiene use, to measure the colony-forming unit count (CFU-C). The strengths of this study include extensive measures to avoid unnatural data such as: 14-day neutral periods, exclusion from specific tasks that would lead to over contamination, and special care instructions for neutral periods. Also, the subjects were vetted to include only people who were seasoned nurses and people who had at least 1 year working in the NICU to control natural hand flora was even and stable within the group. One of the weaknesses of this study is the failure to disclose the time frame in which this study was conducted. The study was also lacking detailed information about the process of the data collection. The results found differences between the three groups through the differing CFU-C numbers. For post-hygiene, it was found that the CFU-C was 60 for the first group, 8 for the second, and 10.5 for the third, giving a p-value of less than 0.001, and indicating that the alcohol rub gave the best results immediately following hand hygiene (Sharma, et al., 2013). For absolute reduction in the CFU-C values, it was shown that the median values were 15, 100, and 40, respectively, again with a p-value of less than 0.001 (Sharma, et al., 2013). In this case, it again showed the alcohol rub to be superior to the other two. With these results in mind, the study found that hand rubbing alcohol increased hand hygiene more than that of non-microbial bar soap and povidone-iodine when looking at the colony forming unit counts of bacteria over time (Sharma, et al., 2013).
The guidelines for the prevention of infections within health care facilities by the CDC, recommends that soap and be used to wash hands when they are visibly dirty, but states that alcohol-based sanitizers may be used if they are not (CDC, 2002). These recommendations received Category IA strength grades, which means that they are supported by extensive experimental, clinical, and epidemiological studies (CDC, 2002).
The PICOT question of our study asks if the use of alcohol-based hand sanitizers will reduce bacterial growth and overall hand hygiene in the general population when compared to hand washing within a two-month period. Girou, et al. (2002) demonstrated that alcohol-based sanitizers reduced the counts of bacteria by 26% as compared to handwashing. While this study produces promising results for answering the PICOT question of importance—that hand sanitizers are better as compared to hand washing, its blind data collection combined with its small sample size makes us question its accuracy. In addition to this, Luby, et al. (2010) showed that waterless sanitizers increased the frequency of hand hygiene (p-value=1.2), where water access is an issue. This study took place in Bangladesh, a low-income area where water access has been shown to be a problem. This relates to our initial study of hand hygiene within healthcare facilities because of the concern that the health care professionals themselves do not practice frequent enough hand hygiene. While the individuals within these two places are vastly different, they are similar in terms of the fact that the reason they are not practicing frequent enough hand hygiene is because of their lack of access to cleaning mechanisms. With this in mind, the study by Luby, et al. (2010) shows that for individuals who do not practice frequent hand hygiene, hand sanitizers are an effective method of increasing the frequency and decreasing bacterial growth. Further, Sharma, et al. (2013) established that alcohol-based sanitizers increased hand hygiene more than soap, water, and iodine-based measures. This study took place in an Indian Pediatrics facility, and focused on comparing the efficacy of hand hygiene between the different methods for accomplishing it. In contrast to the first two studies analyzed, which related to the PICOT question itself, but did not directly relate to the field of healthcare, the study by Sharma, et al. (2013) directly relates to both our PICOT question, as well as to our reasoning for completing it–to increase hand hygiene in healthcare facilities. Finally, the Centers for Disease Control and Prevention’s (2002) guideline recommends that health care professionals should supplement handwashing with alcohol rubs when hands are not visibly dirty, to reduce rates of infection. This complements the previous studies, which discussed how hand sanitizers increased the frequency of hand hygiene, because it functions to combine the two methods to create the most efficient method of cleaning hands. If simply switching to hand sanitizers would increase hand hygiene frequency, then utilizing both hand sanitizers as well as soap and water should even further increase its frequency.
Across the studies, it was shown that alcohol-based sanitizers worked to increase the rates at which hands were washed and sanitized. The study by Girou, et al. (2002) was determined to have a lower rate of accuracy, due to the blind data collection and small sample size, however, the studies by Luby, et al. (2010) and Sharma, et al. (2013) were both randomly controlled with larger sample sizes, indicating relatively higher rates of accuracy. In addition to this, since the three studies, as well as the CDC guideline (2002), reinforce each other, we should assume that the general facts and suggestions they put forward are true, and can all be used to answer the proposed PICOT question. In terms of the PICOT question, we can say that in the general patient population, the use of alcohol based hand sanitizer has the potential to reduce bacterial growth and overall hand hygiene over two months. However, we do not have clearly defined evidence as to whether it would be able to completely replace hand washing as a hygiene measure. While more research is required to determine if alcohol-based sanitizers are superior to handwashing, it is clear that its prevalence can reduce infection overall through increasing frequency.
The CDC (2002) guidelines state that within hospitals, hands should be decontaminated as frequently as possible to reduce the rates of infection. To make this easier on health care professionals, they state that visibly dirty hands should be washed, otherwise sanitizers can be used. Research confirms that alcohol-based sanitizers can increase hand hygiene, however supplemental evidence-based research is required to determine if alcohol-based sanitizers could exclusively be used by health care personnel.
CDC. (2002, October 25). Guideline for Hand Hygiene in Health-Care Settings. Retrieved from CDC: https://www.cdc.gov/mmwr/PDF/rr/rr5116.pdf
Girou, E., Loyeau, S., Legrand, P., Oppein, F., & Brun-Buisson, C. (2002). Efficacy of hand rubbing with alcohol based solution versus standard handwashing with antiseptic soap: Randomized clinical trial. Retrieved from BMJ, 325-362: https://doi.org/10.1136/bmj.325.7360.362
Luby, S., Kadir, M., Yushuf Sharker, M., Yeasmin, F., Unicomb, L., & Sirajul Islam, M. (2010). A community-randomised controlled trial promoting waterless hand sanitizer and handwashing with soap, Dhaka, Bangladesh. Tropical Medicine & International Health, 15, 1508-1516.
Sharma, V., Dutta, S., Taneja, N., & Narang, A. (2013). Comparing hand hygiene measures in a neonatal ICU: a randomized crossover trial. Indian Pediatrics, 50, 917-921.
My favorite character in the novel ‘From a Buick 8’ by Stephen King is Ned because he displays a level of curiosity and bravery that is almost unmatched in the novel. Ned is the son of the deceased police officer Curtis Wilcox who was killed by a drunk driver; however, after befriending he police officers at Troop D, a state police barracks in western Pennsylvania, he finds out that mysterious powers of a 1953 Buick Roadmaster that has been parked in a shed next to the barracks from 1979 might be responsible (King 41). His friendliness and likeability enable him to fit into the barracks seamlessly, and his character is intriguing enough to make the reader follow on what he will do next.
This results in Ned taking the single action that no other police officer has attempted before, trying to destroy the car by pouring gasoline on it. However, Sergeant Sandy Dearborn, in charge of the barracks, stops Ned and pulls him out when the car attempts to teleport Ned to another universe (King 86). Ned is not frightened, and the skillful combination of his friendly nature and his courage guide the readers excellently through the story. Ned is the best character in the book for me because his actions are determined by the narration of the sergeant and other police officers at Troop D. The mysteries surrounding the Buick Roadmaster are brought out excellently through the courageous actions of Ned in his determination to seek the truth for himself.
Circle of friends
My favorite character in the novel ‘Circle of friends’ by Maeve Binchy is Eve because she is ferocious and has a very friendly nature almost at the same time. As an orphan, it is surprising that she manages to express a high level of friendliness, and the fact that she becomes best friends with Benny, an over-weight girl, emphasizes this point. Their friendship blossoms into their teens when they go to Dublin and have to face different choices in their lives (Binchy 27). The kindheartedness of Eve is evident because she does not stop Benny from going to university at first even though she has money problems preventing her from doing so.
Instead of looking at life from a negative perspective, Eve takes it on as it comes, and she decides to do a secretarial job instead. However, all is well when one of her more affluent relatives decides to pay her university tuition fee, thereby managing to get an education. Her kindheartedness is reflected in her happiness for Benny when she manages to win the heart of Jack Foley, the son of a doctor. Eve also displays her temper and anger at those who go behind her back when Nan tries to use her family connections to her own advantage (Binchy 64). The character of Eve, in terms of the complexities of the book, is complete because she is courageous and full of life.
Harold and Maude by Colin Higgins
My favorite character in the novel ‘Harold and Maude’ by Colin Higgins is Harold because his character excellently combines comedy with tragedy. His negative approach to life where he likes everything to do with death, gothic scenarios and funerals quickly ostracizes him from the community (Higgins 8). Instead of taking it seriously and changing his ways, considering everybody, including his mother is disgusted with him, he takes it a notch higher when he meets Maude, a 79-year old woman who seemingly shares Harold’s hobby of talking about death and attending funerals.
Harold’s character is quite laughable because he forms a bond with the old lady that allows him to learn different things, such as art and music, that conventional society could not teach him. The manner in which he scares away his potential wives one by one is laughable despite the fact that they depict fake self-mutilation acts, seppuku and self-immolation staging (Higgins 16). The character of Harold becomes even more exciting and inspiring when he decides to marry Maude as she is turning 80, much to the displeasure of his mother and the rest of the community. However, when Harold finds out that Maude is committing suicide, citing that 80 is the right age to die, he takes it to heart, staging an apparent suicide by driving off a seaside cliff. However, he is spotted on top of the cliff after the crash playing a banjo, one of the legacies that Maude leaves behind.
Literary Review: Getting to Grips with Stress in the Workplace
The article Getting to grips with stress in the workplace brings into perspective the issue of stress in the workplace and the several dynamics that are incorporated in the process. It is argued that a stressful workplace not only causes harm to the employee but the organization is also affected. Stress in the workplace, or occupational stress, has been described as the perceived difference that exists between an employer’s demand and the employee’s ability to meet the demands in question (Carr et al., 2011). Employees’ health eventually gets affected and they start exhibiting stress symptoms such as migraines, aggressive behavior or losing one’s temper on colleagues and customers. Corporate stress might appear to be a complicated issue, but the article in question approaches it from a specific perspective and provides recommendations on how to deal with the issue. The main concepts that are addressed include causes of stress, the manifestation of stress in the workplace and the role of management as far as occupational stress is concerned.
The theoretical framework of the article is established on the rationale that without proper programs designed to deal with occupational stress, both individual and organization performance will constantly be muffled. It makes the argument that occupational stress continues to become a growing problem in organizations and needs to be addressed to avoid employees being subjected to health problems. Some of the causes of stress that have been highlighted within the article’s theoretical framework include individual differences, social demands, and job demands. The stress eventually manifests itself and affects employees’ reasoning, physical symptoms, emotional symptoms, and behavioral symptoms. The role of management, in this case, is to get to the source of the problem and offer peer support to the employees.
There are three main central concepts in the article, and they have been clearly defined to describe its scope. The concept of stress, in this case, is defined as occupational stress, and it refers to the strain in the relationship between employer’s demand and an employee’s capabilities to meet the same demands. Secondly, the manifestation of stress is defined in reference to how people respond to stressful situations at the workplace. Some of the responses have been described as ‘foot on the brake,’ ‘foot on the gas’ and ‘foot on both’ (Carr et al., 2014). Finally, the management’s role in stress management has been described to be more of preventive rather than reactive. For example, developing corporate policies and culture that accommodate work and life balance is one way that is used to ensure that the employees do not plunge into stress.
The article incorporates sufficient evidence from different sources that help support the argument it is trying to posit. For example, the article incorporates a report done by the Department of Public Health, Western Health Board, in 2003. The findings of the report highlight the main causes of occupational stress to be job dissatisfaction, poor communication and understaffing.
There is also evidence from a survey conducted by a university in Spain where it was found that 29% of the respondents had noted that they had observed stress symptoms among their colleagues at higher levels compared to the previous years. Perspectives from different notable professionals in the field were also included in the article shedding more light on the issue of stress and how to manage it in the workplace environment.
The article creates a strong argument that fits into the field of psychology and aims to create awareness regarding stress management. Narrowing its focus down to occupational stress gives it a more specific approach in terms of problem identification and recommendations on how an organization can tackle the issue at hand. In addition, stress has been noted to be a prevalent issue that rarely gets the attention that it needs. This is based on the fact that people are living in a fast-paced society and the affected individuals barely take the time to note that they are being subjected to stress. Therefore, the article advances knowledge in its respective field by placing its main focus on the corporate world. It is not only significant for individuals who are employees in different organizations, but also to the management levels as far as optimizing organizational performance is concerned.
The authors’ approach is clear and specific in the entire article. Dividing the article into various sections and subsections allow a reader to have a clear flow of the issues being addressed. In addition, the rationale that is used to pinpoint the issue of occupational stress creates a platform upon which different entities can weigh in on whether it is rational or otherwise. Arguably, it can be noted that different people react differently to stressful situations. Therefore, it might be difficult when it comes to organizations developing a blanket approach on how to deal with occupational stress.
However, this does not necessarily mean that it is a problem that cannot be solved. Each of these issues is well highlighted in the article with effective recommendations being provided. I agree with the author’s’ approach of encouraging individual stress strategies and not heaping all the blame on organizations’ management.
Conclusively, the article serves a significant purpose in addressing the issue of occupational stress in relation to both individual and corporate perspectives. It is an issue that has not been dealt with accordingly, and as a result, the impact of occupational stress continues to worsen. It is also highlighted that stress is a very serious threat that subjects the body to react the same way it would do in a life or death situation. Therefore, the conceptualization of stress, in this case, is not simply based on the feeling of strain but how an individual reacts when faced with intense stress. Either way, the negative effect of stress cannot be undermined, and the role of an organization’s management is to ensure that its employees are not stressed. Inaction from the management would eventually affect the organization’s performance, and it will eventually lose competitive advantage in the market. There is no specific strategy that can work in one situation, and it is important that an organization’s management develops effective approaches that help deal with unique circumstances. Most importantly it is more effective for an organization to apply permanent solutions rather than quick fixes. For example, after an individual receives counseling, it is illogical to allow him to go back to the same working environment.
Carr, J., Kelley, B., Keaton, R. & Albrecht, C. (2011). Getting to grips with stress in the workplace: Strategies for promoting a healthier, more productive environment. Human Resource Management International Digest, Vol. 19 (4), 32-38.
Binchy, Maeve. Circle of Friends. Seltice Way, Post Falls, ID: Century Publishing, 1990. Print
Higgins, Colinn. Harold and Maude. Dir. Hal Ashby. Perf. Bud Cort, Vivian Pickles Ruth Gordon. 1971. VHS, DVD.
King, Stephen. From a Buick 8. New York: Scribner, 2002. Print
Emotional intelligence, as an organizational behavior concept, has gained a lot of attention in the recent past due to its perceived benefits. Emotional intelligence is believed to bolster relations between different stakeholders in an organization and hence improving organizational performance. Emotional intelligence is a person’s ability to recognize the feelings of their employees and those of other stakeholders and to manage their emotions to cultivate favorable relationships with these significant others (Moeller & Kwantes, 2015). Emotional intelligence enhances the strategic performance of principals in schools by helping them understand the feelings of various stakeholders in schools and adjust their emotions accordingly to bolster relationships with these significant others.
The Importance of Emotional Intelligence (Sample Essay) in Leadership
Emotional intelligence enables leaders to recognize and respond appropriately to the emotions of subordinates. It empowers them to take better control of their feelings and tune them for better relations with subordinates in consideration of the employees’ current emotional state. According to Cook (2006), emotional intelligence comprises of four primary competencies. The first competency is self-awareness which is the ability of a person to accurately recognize their emotions and remain aware of them as they change. This emotional awareness enables a person to stay in control of how they respond to various situations and individuals. The second competency is self-management, which is the ability of a person to be emotionally flexibility and to control emotional reactions when interacting with different people and facing different situations. Self-management is the competency that prevents a person from emotionally overreacting to individuals and situations. Leaders with second self-management rarely conceal their negative emotions to their subordinates.
Cook (2006) further notes that the third competency is social awareness which is the ability to accurately identify other people’s emotions, their effects and how they are likely to affect relations with these people. Social awareness enables one to understand what others are feeling and thinking. Relationship management is the fourth competency, and is the ability of a leader to combine all the other three emotional intelligence skills to initiate and sustain successful relations with others (Cook, 2006). Relationship management is characterized by abilities such as clear communication, effective conflict handling, and trust in relationships.
The effect of emotional intelligence on leaders has been extensively studied in the recent past. The results of most of these studies have established a positive correlation between emotional intelligence and leadership. Leaders with higher emotional intelligence scores were found to be more productive than those with low emotional intelligence (Moeller & Kwantes, 2015). A global 2003 study involving 358 Johnson and Johnson group to establish differences in leadership competencies found that high-performing employees had higher emotional intelligence scores than average performers (Cook, 2006). Emotional intelligence therefore positively influences leadership performance. Highly emotionally intelligent leaders will have a greater effect on an organization than leaders with low emotional intelligence.
In light of the effect emotional intelligence has on leadership, organizations are placing a higher emphasis on hiring emotionally intelligent leaders. In the contemporary organizational leadership environment where organizations are required to quickly adapt to change, emotional intelligence is even more critical. Leaders need to be able to deal with their emotions and other people’s emotions if they are to guide them in the right direction. Fleming (2014) observes that the ability to work through emotional situations distinguishes great leaders from average leaders.
The Importance of Principal’s Strategic Leadership
School principals are supposed to be strategic leaders. They are the figures charged with the responsibility of drawing future strategic plans for schools and mobilizing the required conditions to ensure that schools achieve their strategic goals in regards to emotional intelligence sample essay. As leaders, principals face numerous challenges and performance issues such as dealing with teachers and students and supporting their staff. Conflicts arise in the course of running schools, and this brings the risk of decreased motivation. School principals need to have high levels of emotional intelligence to enable them to be productive with students and all other stakeholders in the education system. Berkovich and Eyal (2017) add that emotional intelligence is thus an important success factor in educational leadership. It can help principals to reach high levels of performance.
A study conducted to establish the relationship between leadership abilities of principals and students’ academic achievement found out that the leadership skills of principals have an effect on students’ academic performance. The performance of principals increases student achievement and influences school success (Cliffe, 2011). Successful schools are the ones that have a sense of direction and purpose. It is only principals who are effective in leadership that can provide the support needed to achieve this success. Principals face the persistent challenge to create an enabling environment for students to ensure that their performance improves steadily. They are therefore supposed to demonstrate strong leadership skills and create a clear mission statement for the school.
Emotional Intelligence and the Productivity of Principals
The transformational leadership theory focuses on how leaders can secure the loyalty of their followers by meeting their pressing needs and fully engaging them in their work (Berkovich & Eyal, 2017). Transformational leaders are change oriented and strive to create something new from the old. In the long run, transformational leaders help themselves, their employees and the organization to become efficient and better. One unique aspect of transformational leadership is the ability of the leader to build secure and meaningful relationships with staff while at the same time supporting them to attain the highest levels of individual development (Berkovich & Eyal, 2017). Transformational leaders might not be many, but the effects they have on their organizations are great.
In organizations that embrace transformational leadership, leaders are perceived as members of a wider team and not as centers of power (Cook, 2006). The primary conclusion that can be drawn from transformational leadership is that the skills, traits, and behavior of a leader as well as their ability to deal with various situational factors determine their overall effectiveness.
Emotional intelligence is one of the abilities that leaders in transformational organizations need to have. Emotional intelligence enables leaders in transformational organizations to efficiently assume their roles as members of a team (Cook, 2006). In a setting where transformational leadership is practiced, the leader needs to be able to identify the emotions of the significant others as well as their own emotions and respond to them effectively. A decrease in the loyalty of employees towards an organization can be partially associated with incompetent leadership.
Leadership is not always about being tough and strict as the principles of transformational leadership suggest; it is more about cultivating integrity, empathy, and motivation in employees. All these are building blocks of emotional intelligence. Moore (2009) argues that leaders are supposed to establish a real connection with staff to enable them to give the best for their sake and the sake of the organization. Leaders who fail to cultivate productive relationships with employees are likely to witness a decrease in loyalty. Emotional intelligence can enable leaders to develop productive relationships with employees. Trust and openness characterize such relationships.
As strategic managers, school principals and leaders in schools need emotional intelligence in equal proportions to other elements of leadership. Emotional intelligence can set successful school principals apart from the rest. An understanding of the role of emotional intelligence can enable them to create a prime good feeling in teachers and pupils at the school. High emotional intelligence enables school principals to create and maintain an environment of openness and positivity that frees the best in people (Moore, 2009). Principals as strategic leaders can no longer ignore the role of emotions and consider them insignificant. They need to embrace emotional intelligence for it holds positive outcomes for them, their students and schools in general.
In conclusion, emotional intelligence is the ability of a person to identify and effectively deal with their emotions as well as emotions of other people whom they interact with. Emotional intelligence has become one of the most widely studied areas of organizational leadership due to its perceived benefits. Research has linked emotional intelligence with improved leadership performance. As strategic leaders, principals can reap numerous benefits from the understanding and proper utilization of emotional intelligence. Research has linked high emotional intelligence in school leaders with better educational outcomes for students. As the theory of transformational leadership postulates, the most successful leaders are the ones who can create the most conducive environment for their employees to give their best. Emotional intelligence is one of the abilities that can enable leaders to create this conducive and productive environment. Emotional intelligence thus improves the performance of school principals as strategic managers.
A Note on Secondary Sources
Secondary sources are a valuable form of material to use in literary analyses for several reasons. The primary reason is that secondary sources provide an author with information that has already been researched. This is significant so students and scholars do not unintentionally plagiarize another’s work. Secondary sources are also necessary to bolster the claims of a student who is becoming involved in research in an area of literature for the first time. A student can make critical claims about a text, but their lack of expertise may undermine their arguments. However the experience and knowledge of a scholar quoted in a student’s work lends the argument some credibility and concepts that the paper would not have otherwise.
Having secondary material included in a written work is also necessary to develop scholarly resources. Having one person write about a literary work is very useful for writing about the intricacies of the text and discovering various interpretations of the work. However, a valuable perspective of literature is based upon criticizing those initial interpretations of the work so as to further arguments or refute points that were previously made. Scholarly work is based upon creating an ongoing means of evaluating literary works to find discover new meanings for works and then extend the ideas that are found to other works. After all, scholarly works about literature are most useful when they can find common threads between literature to reveal something unique about the authors and the people about whom they write. Therefore, utilizing secondary sources as a way to help develop a larger body of work in the realm of literature represents the most basic form of advancing scholarly knowledge.
Berkovich, I., & Eyal, O. (2017). The mediating role of principals’ transformational leadership behaviors in promoting teachers’ emotional wellness at work. Educational Management Administration & Leadership, 45(2), 316-335. http://dx.doi.org/10.1177/1741143215617947
The importance of access to health care services in society determines the standards and state of health within a population. Health disparities is a big issue in the United States and is defined as inequality of the care that a person or community get due to certain factors. Some believe that these factors are just racial related but there are many more factors that are considered. Disparities in health do not refer only to ethnic and racial disparities, but rather the general health situation in the community. Access to health care services determines the disparities that exist in society, and this affects all ethnic and racial groups in the country.
The disparity is determined by the extent of health outcomes within a population, meaning that all factors around an individual including their environment, age and even socioeconomic status will play a key role in determining their health (HealthyPeople2020, 2014). According to Obama Facts, in the course of 5 years, more than one hundred thousand Americans died in the United States because of lack of access to health care services (Facts on Deaths Due to Lack of Health Insurance in US). Unfortunately, this number also includes infants and children that are affected as well by the lack of healthcare due to disparities. In the following essay, it will be further discussed why some children face barriers to accessing health care services because of different factors and the policy that has been established to help with this issue.
Barriers for Children
There are many factors that can influence whether a child receives healthcare or not. One of the first mentioned factors is the geographic location. If the parent or guardians of that child have no means to get to a medical facility, then how are they supposed to get the needed care? A second factor that is taken into consideration is the financial aspect especially those that are considered poor. “The opportunity cost of seeking health care is likewise relatively higher for poorer than wealthier households. This is because the poor often earn income directly from their labor. Caring for sick children may divert the labor and time of poor parents away from income-generating activities, thereby reducing household income” (BARRIERS TO ACCESS TO CHILD HEALTH CARE). Culture plays a big role as well when it comes to somebody receiving healthcare. If that child’s religion or culture have traditions that prevent them from receiving healthcare, then this is something the child has no control over. A big challenge that healthcare professionals face is the patient’s lack of knowledge and importance of bringing one’s child for checkups and/or when to bring them in to get seen for an acute visit. Approximately 70 percent of child deaths is down to delays in delivering health care services, and this means that caregivers have to be familiar with specific health institutions where they know they will get good service (BARRIERS TO ACCESS TO CHILD HEALTH CARE).
When they are brought in but don’t have the finances to pay for the services, the quality of care lowers. Inequality of care in not something that is rare in the healthcare system. A child with an expensive healthcare insurance will receive high quality care compared to the child that came through the emergency room and has no type of coverage. Healthy People 2020 have chosen Health Disparities as one of their overarching goals and are working to end this in the world. The objective of ‘Healthy People 2000’ was to reduce health disparities among Americans. The focus of this group was not just the reduction of health disparities that exist in the community, but achieving health equity for all the relevant groups in society to guarantee equal access to health services (HealthyPeople2020, 2014).
Children’s Health Insurance Program
There are families that are financially unable to pay for healthcare insurance and are covered under Medicaid benefits. Although this is fortunate, there are the middle-class families that just make a little more about the cut off to be considered under Medicaid. In 1997, Children’s Health Insurance program was developed and establish to help these families with children so they could be covered and receive care. The two programs have helped reduce the uninsured rate among children and, from 1997 after the enactment of CHIP, to 2012, the uninsured rate among children dropped from 14 percent to 7 percent. Several millions of children accessed health insurance covers, and this new low in the number of uninsured children was a positive breakthrough in getting more children access to health services. The group of children specifically targeted were those below the federal poverty level, and the general uninsured rate during this period would drop from 25 percent to15 percent. (Paradise, 2014). This program has greatly reduced the percentage of children that go without receiving care because poor children continue to suffer as cost-effective child health interventions fail to reach them.
The not-for-profit sector which is a subset of the civil society plays a crucial role in the economy. Its structure and institutional existence does not only act to bridge gaps left by the activities of the government and private sector players but also serve as a regulator of their functions. The non-profit sector‘s non-profit seeking tendencies and its inclination voluntary justify it being referred to as the voluntary sector. This non-profit seeking tendency also calls for a different management approach. Kong (2007) states that the conventional strategic management approaches include but are not limited to resource-based view (RBV), industrial organization (IO), balanced scorecard (BSC), and intellectual capital (IC). All these strategic management approaches can be used in both profit and non-profit sectors and yield different results. The intellectual capital (IC) strategic management approach is not only a general strategic management tool but a unique strategic planning conceptual framework that is most suitable for non-profits.
An Assessment of the Applicability of the Five Strategic Management Approaches to the Non-Profit Sector
Industrial Organization (IO)
The industrial organization approach emphasizes on determinants of organizational performance that are perceived to be external to an organization. Organizations that choose to implement the IO strategy are supposed to pick an industry and then position themselves in that industry through either the low cost or product differentiation strategy (Kong, 2007). The IO strategy is, therefore, inappropriate for the nonprofit sector for it would induce NPO’s to demonstrate using one of the two generic on approaches how different their services are from those of their competitors. The primary justification for such a demonstration of differentiation would be the need to convince donors that they deserve to be allocated more resources.
Such an occurrence would be counterproductive in the nonprofit sector for it would result in the creation of a hierarchy in the NPO sector. Such a hierarchy would stimulate competition and in the long run compromise the amorphous goal of NPO’s which is offering intangible services. It is prudent that the success of NGO’s is not measured financially by looking at how closely they stick to their budgets but from a social perspective whereby the impact of their operations is considered (Bhatti & Zaheer, 2014). The IO approach is thus not appropriate for non-profits.
Resource-Based View (RBV)
RBV is also referred to as the core competency-based approach. As Kong (2007) writes, RBV focuses on the attributes that are considered costly to copy as the fundamental drivers of organizational performance. Both the RBV view and the core competency approach concentrate on the internal environment of an organization. They are criticized for their failure to clearly explain how organizations can use resources to create value and gain a competitive edge. When applied to the NPO’s context, RBV fails since it fails to consider any of the unique characteristics of these organizations (Kong, 2007). A good example of features that are ignored by the theory is the combination of volunteers and paid staff. Thus, it is not suitable for strategic management in NPO’s due to its failure to provide a full picture of NGO’s that includes the external environment.
Knowledge-Based View (KBV)
Knowledge has historically held a lot of significance as a planning resource. In the modern economy that is knowledge-based, knowledge plays a significant economic role as a resource, and organizations that can effectively utilize it prosper than their counterparts (Reddy, Krishna, & Rao, 2012). Knowledge as a resource enables organizations to combine and coordinate the utilization of other resources in new distinctive ways that allow them to provide more value for their customers and gain an edge over competitors. KBV is thus a traditional approach to strategic planning.
The main weakness with the KBV is that knowledge resources are objectively quantifiable and can be explicitly defined (Kong, 2007). KBV perceives knowledge to be similar to other physical resources that can be controlled and traded. The reality, however, is that knowledge is not easy to quantify and control due to its tacit nature. It is the main reason why most organizations invest heavily in capturing, analyzing, storing and sharing data between departments. Kong (2007) adds that the major limitation with the application of this approach to NPO’s is that this overemphasis on data leads to over-development of ICT at the expense of other services, which has a constricting effect on their growth.
Balanced Score Card (BSC)
The balanced scorecard approach helps organizations to control and utilize intellectual resources. According to Kong (2003), the BSC approach consists of four metrics to measure performance: internal process measures, financial resources measures, customer relations measures, and learning and growth measures. The balanced scorecard is distinguished from the other approaches discussed earlier by the financial and non-financial measures of the relationships among these four perspectives. The balanced scorecard approach makes it possible for an organization to bridge between its mission and strategy statements. However, despite its strengths, several weaknesses paint the BSC approach as inferior when applied in the context of non-profit organizations.
First, NPOs exist for society betterment, and their mission is thus moral as opposed to absolute. They do not have an economic motive that can be subject to a cost-benefit calculus as in the case of profit organizations (Kong, 2007). Any strategy that sacrifices mission for improvement of profit margins thus becomes untenable. Additionally, the BSC is relatively rigid for the four linked perspectives are limiting. They also do not adequately consider the external environment. The only consideration for the external environment is the customers. The problem is that the managers of NPOs focus on only the four perspectives and ignore other important elements of management (Kong, 2007).
The four perspective analyzed were all found to have some limitations that make them inferior and not adequate to the NPO operating environment. The intellectual capital strategy has several elements that make it suitable for NPOs. The approach focuses on the process through which an organization can improve performance and gain a competitive edge over competitors through investment in intellectual resources which include knowledge, experience, and information (Reddy et al., 2012). Intellectual capital comprises three related components that are the structural capital, human capital, and relational capital. According to Kong (2007), human capital includes all human resource elements such as talents, skills, competencies experience, skills, and innovativeness.
Structural capital, on the other hand, comprises of knowledge and learning that are utilized in the routine activities of an organization (Kong, 2007). It includes the organization culture, process manuals, routines, publications, strategies, and copyrights. It represents an organization’s knowledge reserve after the removal of all elements of human capital. Structural capital acts as supportive infrastructure for human capital.
Similarly, relational capital comprises of the processes and activities that bolster an organization’s relations with all its stakeholders that are considered external (Kong, 2007). Knowledge exchanges between the organization and its external stakeholders are also part of its relational capital. Organizations that effectively utilize their relational capital can multiply their value through a better connection with their external environment.
Through the skillful alignment and balance between the three components of IC, organizations can create the maximum value for organizations. As Kong (2003) notes, IC first emerged as a conceptual framework to be applied in the management of organizational intellectual resources. With time, it has however come to be accepted as a strategic tool due to its effectiveness and particularly in the NPO context. The intelligence capital strategy is best suited to NPOs for it enables them to adapt well to all challenges linked to the external and internal environment in which it operates.
IC further helps NPOs to focus on to intellectual resources and gain a competitive edge in the long run (Kong, 2007). Greater focus on intellectual capital and resources, as opposed to other resources, enables NPOs to squeeze the best from both paid employees and volunteers. This way, they can achieve their primary goal of service provision better. As stated earlier, NPOs do not put a lot of focus on profits but are rather driven by internal initiatives intended to fulfill community needs in a voluntary manner (Kong, 2007). In NPOs, achievement of objectives is more important, unlike profit organizations where profit is the sole language of communication.
In conclusion, several strategic management approaches can be applied to both profit and nonprofit organizations. They include the IO, KBV, RBV, BSC, and intellectual capital. The intellectual capital (IC) strategy which had initially been intended to be a framework for the management of intellectual resources has emerged to be the best strategic management tool for NPOs in general. It enables these NPOs to effectively utilize their intellectual resources while at the same time considering all the external resources.
Bhatti, W. A., & Zaheer, A. (2014). The role of intellectual capital in creating and adding value to organizational performance: A conceptual analysis. Electronic Journal of Knowledge Management Volume, 12(3), 187-194.
Kong, E. (2003). Using intellectual capital as a strategic tool for non-profit organisations. The International Journal of Knowledge, Culture and Change Management, 3. Retrieved from https://core.ac.uk/download/pdf/11039534.pdf