Qualitative and Quantitative Studies Within Mental Health Care

Qualitative and Quantitative Studies Within Mental Health Care Free Online Research Papers This essay will look at a critical review of research of one qualitative paper and one quantitative paper (Cohen 2002) says that qualitative research study can mean the analysis of open-ended questions where respondents are asked to write on a survey. It also can refer to what is thought of as naturalistic research. Parahoo (1997) describes quantitative research as providing hard, objective facts that can be statistically analysed and interpreted. Those who support a quantitative approach point to the value of objective, systemic observations for nursing practice. The main aim of research is to help us gain knowledge in the field we study, in this case nursing. As Cormack (2000), explains that ‘it is done through a process of systemic enquiry governed by scientific principle’. A definition of research was offered by Macleod and Clark (1989) cited in Cormack (2000) as ‘an attempt to increase the sum of what is known, usually referred to as â€Å" a body of knowledge†, by the discovery of new facts or relationships through a process of systemic scientific enquiry, the research process.’ The articles will be critiqued separately, with each section of the Rees (2001) critiquing framework applied (see appendices 3). For the purpose of this essay, I will explore the related literature on schizophrenia and the associated problems involved as an aspect in mental health. There will be a written reflection on the two articles to help support findings which relate to mental health issues. The author used the Cardiff University database web site, such as the Calmative Index of Nursing and Allied Healthcare (CINAHL), British Medical Journal, and Ovid Medline in the university Library. The author was able to find two research articles relating to Schizophrenia. The first article is of Australian origin by Rene Geanellos (2005) entitled ‘Adversity as opportunity: Living with Schizophrenia and Developing a Resilient Self’. Article two is Barker and Trenchard (2005) which is a quantitative article of British origin entitled, ‘Positive Practice and Psychosis Care and the Role of the Community Mental Health Nurse’. Key words were used to help assist the author in the research process such as: psychosis schizophrenia qualitative quantitative research critiquing psychosis ARTICLE ONE QUALITATIVE CRITQUE Heading Adversity as Opportunity: Living with Schizophrenia and Developing a Resilient Self. Focus Geanellos, firstly says that living with schizophrenia develops resilience (meaning how you as a person, your personality, your character), handles the disorder and adapts this unwanted disease. Key words used are: Resilience Adaptation Adversity Schizophrenia Self It also goes on to mention words such as: Hermeneutically Wisely Mindfully Recovery Background The author states that this study sought to understand people’s intersubjective experience of living with schizophrenia using Gadamerian Hermeneutics for guidance. The author also states that schizophrenia is a costly disorder, which is personal, social and vocational. The costs result from disabling symptoms, medication side effects, inadequate treatment, factors relating to mental health clinicians/services. To rationalize the research, the author considers three points. Firstly, most research on schizophrenia is biomedical, seeking to explicate cause and effect and most treatment is pharmacological, which is seeking to remedy cause and effect. Secondly, a biomedical focus marginalizes issues like poverty, unemployment, housing and health and results in a dominant bio-medical view of schizophrenia. Thirdly, research focuses on some aspects of the disorder instead of people’s experiences of it; therefore, the authors present study contribution is an attempt to bridge this gap. It appears to this writer that the author (Geanellos) is trying to highlight that the bio medical and pharmacological model predominates with little or no psychological input. The bio-medical model stands accused of taking little or no account of a person’s strengths and resilience to overcome his or her condition. This writer can now start to understand the reasons why the author has used Gadamerian Hermeneutics, which is to try and understand, feel, and explore these individual texts, as Phillips (2002) explains that ‘Gadermeriun Hermeneutics concentrates on expanding horizons of understanding through dialogue, between people or between researcher and text, in which taken for granted assumptions are examined and opinions willingly put at risk’. A definition of hermeneutics is explained by Oxford dictionary (1988) ‘as the interpretation of scripture’. Gadermerian Hermeneutics is the brainchild of philosopher Hans- Georg Gadamer’s personal theory of interpretation. Gadamer saw the work of hermeneutics not as ‘developing a procedure of understanding, but to clarify further the conditions in which understanding itself takes place’ (Laverty 2006). The author chose Gadamerian Hermeneutics as his choice of interpreting people’s lived experience. This helps give structure to the phenomenological meaning and to help categorise these people’s meanings of words. Terms of Reference The aim of the study is to understand people’s intersubjective experience of living with schizophrenia (the phenomena). The phenomenological research method is unlike most other research methods in that it has no scientific framework. It places sole credibility on a persons own lived experience and his or her own perceptions of events, emotions, outcomes etc. The person can be the only expert on him or herself. Study Design The author uses Gadamerian Hermeneutics to guide the study and the stories were hermeneutically interpreted, seeking to understand the individual meaning (single stories) and collective meaning (all the stories). This is his representation of the phenomenon. Wilson and Hutchinson (1991) cited in (Laverty 2003) hermeneutic phenomenology as being ‘concerned with the life, world or human experience as it is lived’. This would be classed as phenomenological. This research uses the ability and willingness of people who suffer with schizophrenia to write their stories and have them published, and then reflect on the written experience. Therefore, this is the phenomenological, qualitative specific approach, Tool of Data Collection The author’s data was collected from The Schizophrenia Bulletin, between 1990 and 2003. They are published articles which consist of nineteen personal accounts, some of them were anonymous. There were also carers, family members, and health professionals published. The author’s tool of collecting data was to understand each story told and its individual meaning, and then read all the stories to give a collective meaning. There appears to be no factual evidence to suggest that these published articles are convincing enough to give any imaginable depth to the reader. The writer feels that these words could simply be from a book, which anyone could have written. This writer feels that this is a main weakness of trying to research using an intersubjective approach, as trust is paramount from the client and clinician if this particular study is going to work. Also another area to consider is that the articles are from numerous resources, which accumulates to the potential of being past through a numerous amounts of hands before they were published. It has the potential to be diluted. Even so, the beauty of this type of research is it would allow the individual researcher to investigate what ever was written resulting in an individual outcome. As Geanellos says, ‘Because of interpreter misunderstandings and the plurality of language, however, my understanding and representation of the phenomenon is one of many.’ However, Rees says that, ‘to contribute to the credibility in the data collected, areas such as the environment, the period of time and any other details that allows us to visualize the conduct of data are helpful and often necessary’ (Rees 2001).’ The author has used a bracketing type system in order to clarify his role in the process of meaning and give a constructed approach. Bracketing is a mathematical metaphor that involves putting ones attitude to the world in brackets in order to place it temporarily out of the question, which helps the reader / researcher assistants to arrive at a more adequate knowledge of reality (Spinelli 1992). The research article takes Meta themes of the client’s experiences to explore the development of resilience. For example: The faà §ade of normalcy: desperately trying to appear normal. Considerable anguish: the pain of suffering and enduring alone. The researcher has classed these under the theme one of fragmentation. This may be contrary to the correct usage of phenomenology in research, because the basis of this philosophy is about a better understanding of individual experience and not group perceptions. Although it is worth noting, that the author in describing his methodology does state his ‘representation of the phenomena’s are one of many’. In other words it’s the individual’s perceptual understanding of context. Ethical Consideration What the writer appears to have noticed is the lack of ethical consideration towards the use of people’s names and their words, with no written evidence of permission from them. It also doesn’t mention at what stage of illness or recovery they are in, as the writer feels this would alter the interpretation of people’s expression of words. Even though this study was conducted in Australia and not in the UK, the writer would assume that similar confidentiality rights would apply. Sample The researcher used nineteen people’s stories randomly from The Schizophrenia Bulletin. It is a journal, which publishes first person accounts of people’s experiences of mental illness. At first reading, the subjects appeared to have the required background, i.e. all have schizophrenia and describe their experiences and living with it. As already discussed, it is then difficult to see that the subjects aren’t biased, as the author states at the outset, it is a subjective study and that the author is interpreting their stories in script (hermeneutics). The author or the writer has no knowledge of who they are, or their characteristics. This vague information on such a diverse group, may then limit the research being utilised in practice, i.e. its fittingness to be applied elsewhere Rees (2001). However, this could be a good thing, as it helps eliminate a biased or prejudiced approach. Data Presentation The data presented were split up into eighteen sub-themes and these are categorised into four themes. Theme 1 Fragmentation Theme 2 Disintegration Table 3 Reintegration Table 4 Reconstruction The sub themes cover the interpretation of words used by the people’s letters that have been published. The researcher has then broken down the meaning of each sentence and has then categorised them into a Meta theme which incorporates all the themes and is named – Adversity as Opportunity, Living with Schizophrenia and Developing a Resilient Self. In each story told, the person is explaining what it is like to live with schizophrenia in his or her own words. The researcher has then subjectively categorised these words into what they perceive the person is saying. This reader finds the dialogue and description heavy with terminology and definitions, which lead’s the reader to look for background definition and detail of terminology. Accuracy of data presented may be flawed as it is based on a previous article and a diverse group of subjects whose stories were told subjectively. However, we don’t necessarily consider this a problem in phenomenology. One individual’s account of an event or an illness for the phenomenologist. It is not about masses of data, that’s quantitative. So what is true for qualitative research is as important as many people’s accounts need not necessarily be true for the phenomenological approach because it focuses on the individual. Main Findings The core effect of the main findings is the level of resilience, as Geanellos divides the sufferer’s resilience into high and low. Resilience as explained, (Oxford dictionary 1984) as ‘readily recovering from something like depression’. Have they got used to their difficulties and just live with them and not cope? Or have they become more resilient through developing self found skills and abilities that provide coping strategies? The Meta theme does not illustrate this. We all might have to live with a disability, but it is our own personal resilience to cope is the core fundamental issue. The Meta theme incorporates all the themes and is named – Adversity as opportunity: Living with Schizophrenia and Developing a Resilient Self. This appears to cover the entire data finding. The author uses Gadamerian Hermeneutics to interpret the main findings; the writer finds it a complex methodological way to interpret data. There appears to be no evidence of any content check by the people who wrote the stories, which decreases validity in the way this study was conducted. As Rees (2001) asks in his critiquing model, were their findings checked by the respondents (members check) or examined by other experts in the field? This writer asks experts in the field of what? Can someone be an expert in how someone else feels? There appears to be no evidence check, only the author’s interpretation. The writer feels that it is biased towards the author’s interpretation and not the participants. So, therefore its claim to be phenomenological in its approach must be treated with caution, because if the focus is the researchers and not the subjects (meaning the client’s), then it has broken a cardinal rule in phenomenology. Conclusion Sub themes are focused on these words, which are integral to the author’s research methodology, i.e. Meta themes, 19 persons with schizophrenia and their individual stories. In conclusion, this reader is unconvinced that the article clearly identifies the development of resilience to their illness simply by utilising collected patient experience and stories. Then uses Meta themes to highlight this increased ability to live with schizophrenia. This clearly does not pin point the development of resilience. There is no explanation of the achieved resilience by the author in the context of the article, i.e. the patient’s stories. Geanellos in his conclusion identifies resilience as ‘the ability to mediate adaptation, indeed this resilience is mindfulness, prudent and purposeful action built on foundations of tenacity and courage’. He further goes on to state that ‘they have the capacity to withstand the unexpected and to prosper despite adversity’. To finalise the conclusion, this different and non-scientific research methodology, uncertain evidence of developing resilience, do not ultimately illustrate that the story tellers have gained these laudable abilities and determinations that enhance their life and capacity to live with schizophrenia. Readability One is tempted to make assumptions about the readability of this article. Its fluency is affected by the complex use of terminology. However, this writer takes into account that complex terminology is unavoidable, but certain areas could be made simpler for the more common lay person, such as this writer. The reader could be distracted by continued movement between reading story excerpts and then examining research to better understand the article. Minimal background knowledge of the storytellers means we have no knowledge of their circumstances, i.e. elderly, young, acutely ill, chronically ill, religious or ethnic backgrounds; hence, there are no parameters in which to assess their stories, against the research themes and the evidence in practice. One could even query if evidence practice occurred, i.e. the stories do not indicate that there is any input from professional mental health workers (Mental Health Community Nurses) CMHN‘s, or even semi voluntary support. However, one or two stories mention relative care input. There also seems to be no time line of events. This makes it difficult, particularly to read the main findings. Do the storytellers relapse quickly? And gain resilience quickly? Or do they spend years chronically ill? As in losing years. As one subject describe as losing track of time by not gaining enough insight or resilience. This back and forth within the article occurs when describing patients stories where one moment the author describes an individuals experience or conditions and in the next sentence makes global statements on schizophrenia such as: ‘Schizophrenia alters life and self in such all encompassing and fundamental ways that it shatters preciously held understandings’ (Geanellos 2005). And yet, this writer feels Geanellos is showing that who ever reads peoples understanding in text, can take their own view on that interpretation. This writer concludes that there appears to be no right or wrong as many different views can be taken on what someone is trying to communicate. Relevance to Practice This qualitative study, with all its flaws gives this writer clearer insight. There appears to be no clear, straight forward answers to the understanding of others, as individual’s interpretation appears to not allow it. This qualitative paper could not be any further from a quantitative paper, as there are no statistical figures with clear percentages to follow. The author used a Meta theme to categorise the text, which gives some structure to the paper for the reader to follow, but no graphs or any other structured models used. Phenomenology is concerned with life world experience and not statistical figures with only logical explanations to hand. This article has tried to illuminate details in the account of others which may seem in the lives of ordinary people (Laverty 2003). However, I feel that it does humanise the experience of schizophrenia for the lay reader and helps to provide both the reader of this research and the subjects themselves with a greater understanding of this tragic condition in a way that quantitative research may not. ARTICLE TWO QUANTITATIVE CRITIQUE Heading ’Positive Practice in Psychosis Care’. Barker D. Trenchard S (2005). Focus The focus of this quantitative paper is the study of how Community Mental Health Nurse’s (CMHNs) become aware of their role within the Community Mental Health Team’s (CMHTs), and how community teams fit into mental health team care delivery. Key words of focus are: Caseload composition, Clinical interventions, Staff attitudes, Preparation and supervision. Background The author has justified his research on the introduction of the National Service Framework (NSF 2002) for Mental Health, with further backing by the (NICE guidelines 2002) explaining how these guidelines develop further by good underpinned practice guidelines (NICE 2002). Its focus is to examine their knowledge of CMHN’s within CMHT’s and see if they are capable of using old and newly developed knowledge, while changing with the times. Compared to the qualitative paper in appendix one, this paper has given clear and direct instructions to the reader in the area of research the author has taken. It is also explained in simple language that the novice can understand. Perhaps if the qualitative paper had taken a similar approach, it may have been easier to understand. Terms of Reference Two key words were used i.e., ‘explore and describe’. The purpose of this research is to explore CMHN’s knowledge of working with people who suffer with schizophrenia. To explore attitudes towards change and policy proposals. Also to describe CMHN’s clinical practice and confidences skills. The role of the community mental team members can be defined and understood within the changing needs of the service user and the resultant service provision required. Study Design The author used a quantitative study approach using a self – completion questionnaire, the author states that it ‘would allow for collection of large volumes of information in a systemic and standard way.’ The researchers also say that questionnaires promote honest answers, but this writer argues that completed questionnaires are only as honest as the person who completes it. Trust issues appear to be just as important in this quantitative paper as the qualitative paper, which prove to be a common denominator in both papers. Some of the areas covered to help establish a structured report was to describe the function of their team. To identify the personal attributes CMHN’s considered important with diagnosis of schizophrenia. In addition, the article identifies the consolidation and ongoing development of specific theme of knowledge and skill, engagement and relationship building communication skills, and attitudes of nurse’s towards approaches to specific patients with psychosis. The utilisation of current and recent evidence based intervention are highlighted to underpin these interventions. Date Collection Method Thoroughness appears in this area, as the researchers used this quantitative article as the pilot study ‘to identify any potential weaknesses that may be replicated at a later date’ (Trenchard and Barker 2005). Face value was also checked prior to distributing the questionnaires, by a small number of applicants for face and construct validity. However, the author’s have failed to explain the meaning of face and construct validity, i.e. face of what? Also the researchers don’t mention who has checked it (other nurses, the public etc) and what was the outcome from their point of view? Even though this writer feels that this paper appears to be ahead in its rigour compared to the previous qualitative paper. Yet it would appear ahead when any paper is guided with figures (quantitative method) to a paper that is dealing with single figures (qualitative method). So the question this writer asks, is it really a better paper? As numbers don’t count to the phenomenologist, it’s the personal experiences that count. Ethical Consideration The essay appears to retain objectivity towards their team and honesty towards the whole research study. Results were specific in their use, but as previously mentioned, the whole research paper does rely on the honesty of the questionnaires returned. Is this a major flaw in the whole of the paper? Apparently not, as Barker (1996) cited in (Barker and Trenchard 2005) suggest that when exploring sensitive topics, questionnaires are most appropriate, sparing embarrassment and promoting honest responses. Sample The inclusion and exclusion reflects the aim to develop a sample, which consists of 71 identified CMHN’s who work with people diagnosed with schizophrenia, with ages between 16 and 65 years. Of the 71 questionnaires distributed 48% responded, indicating this was a sufficient number of applicants to carry on with the research, but this writer feels that the percentage 48% 35 questionnaires is quite small to provide definitive results. However, the author acknowledges this is a small scale study ‘that offers a snapshot of CMHN practice’ though is supported by earlier and subsequent studies. The writer feels the validity is sufficient for this article content. So, at least, in terms of numbers it would appear that the quantitative research is more valid. However, one might be able to argue that this paper is more researchers centred. The researcher sets the questions. At least in the first paper the sufferers were writing their own accounts rather than just responding to questions by researchers and it is always possible that the questionnaire is pursuing an agenda set by the researchers, or even following an agenda that he or she may not be conscious of. Data Presentation The data presented is in basic layout using numbers and percentages in text. It clearly discusses the analysis and then uses a concise graph chart, pie chart and rating scales to clarify its findings. There is a clear explanation of the results obtained, enabling easy understanding of the paper and easy to read unlike the qualitative paper. The writer feels that if Geanellos had taken a simpler approach to writing, it may have made more sense to the reader. Main Findings The researchers main findings are that most of the CMHN’s (54.5%) have no specific training at all in the management of schizophrenia. However 45.5% are receiving additional supervision in additional skills, i.e. Psychosocial Intervention (PSI) Cognitive Behavioural Therapy (CBT) Family Intervention (FI) Creative Therapy (CT) One of the main findings in this research paper is that 97.1% agreed on further training, as a necessity to provide successful service. 95% preferred smaller case loads which appear to be one of the main subjects in providing a quality care to those with schizophrenia and the expectations for recovery – focused interventions. Conclusion Even though the author’s say that it is a small scale study, the findings offer a snap shot of current CMHN practice in psychosis care. The author’s mention many of the findings support earlier and subsequent studies into the dissemination of evidence based practice. They conclude that 75% felt that they could not meet all the needs of clients. Nearly all 97% agreed to further requirements to provide more effective service. They recognise recovery approaches are becoming identified but recommend that recovery is underpinned by good practice and to deter it from being the buzz word as it is not fully supported because the systems are under developed. Readability This article is straight forward to read. It has displayed its text clearly and with understandable graphs. It describes complex issues of services development, the needs of CMHN’s and services in a clear and understood format. However, it does appear to lack any sort of insight into the way the nurses themselves feel, as qualitative tries to give an understanding in trying to be that person almost, even though the method might be some what complex. Practice Implications The study offered insight into the lack of training for CMHN’s. It also goes on to report the lack of unified assessment tools used throughout this CMHT. This writer feels the article is relevant to nursing and highlights how important training and evidence based practice are. However quite a big percentage felt confident without suitable training in the field of schizophrenia. The article does not definitely state the reason why CMHN’s felt so confident without suitable training. Why CMHN,s feel so confident in their abilities despite any supporting evidence remains a mystery and the authors do not address this important issue. Perhaps a quantitative approach is not suitable to address it anyway. Quantitative research has uncovered an interesting phenomenon that could be followed through with the phenomenological approach and thus yield very valuable information which may help training practice and ultimately patients themselves. A phenomenological approach might yield important information in exploring the feelings of skilled adequacy despite there being little evidence for holding such views of competency. One could say there is room for both here. REFLECTION The qualitative article is a confusing article of mixed patients stories and unclear research findings that do not progress to a clear or even easily understood conclusion. The pre-conclusion discussion consolidates this information with its description of ‘a resilience continuum’ and the schizophrenia self. However, the quantitative paper clearly and simply sets purpose and study context. It progresses informatively, presenting results in easily understood graphs and charts, underpinning discussion topics within the article with reasonable argument and evidence based information. The author’s recommendations are realistic and reflect both the needs of the clients and the service. REFERRENCES Barker, D.Trenchard, S. (2005) Positive Practice and Psychosis care. Mental Health Nursing, l (24), 4-8. Cormack, D. (2000) The Research Process in Nursing, Black Well Science. Geanello, R. (2005) Adversity as opportunity : Living with schizophrenia and developing a resilient self. International Journal of Mental Health Nursing, 14, 7-15. Laverty, S. M. (2006) The University of Calgary, Calgary, AB. Hermeneutic Phenomenology and Phenomenology: A comparison of Historical and Methodological Consideration. HYPERLINK ualberta.ca/~iiqm/backissues/2_3final/htmal/laverty.htmal ualberta.ca/~iiqm/backissues/2_3final/htmal/laverty.htmal . 16/09/2006 LoBiondo-Wood, et al. (2002) Nursing Research Methods, Critical Appraisal and Utilization. 5th Edition. Mosby Publishing’s. Macleod Clark, J and Hockey, L. (1989) Cited in Cormack, D. (2000). The Research Process in Nursing, 4th Edition. Black Well Science. Nursing and Midwifery Council (2002) Code of Professional Conduct. 8 6.1 Parahoo, K. (1997) Nursing Research. Principles, Process and Issues. Palgrave Macmillan publishing. The National; Service Framework (DOH 1999), as cited in Article 540. Stevenson, C, Fletcher, E (2002) The Tidal Model: the questions answered. Mental Health Practice. 5, 8, 29-38 The Oxford Dictionary, (1984). Oxford University Press. Rees, C. (2001). An Introduction to Research for Midwives. Chapter 4, page 44. Spinelli, E. (1992). The Interpreted World: An Introduction to Phenomenological Psychology. London, Sage Publishing. Research Papers on Qualitative and Quantitative Studies Within Mental Health CareInfluences of Socio-Economic Status of Married MalesEffects of Television Violence on ChildrenResearch Process Part OneArguments for Physician-Assisted Suicide (PAS)The Relationship Between Delinquency and Drug UseThree Concepts of PsychodynamicThe Project Managment Office SystemPersonal Experience with Teen PregnancyNever Been Kicked Out of a Place This NiceGenetic Engineering

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Ludwig van Beethoven Essay Ludwig van Beethoven was a German composer who brought about gigantic alterations in the nature and techniques of music—an achievement matched by few other artists. He found music a rococo-dramatic art, the orchestra a relatively small ensemble, and the piano a newly established successor to the harpsichord. By his aggressive, iconoclastic, even egotistic nature, and by his huge ability to manipulate and balance musical ideas and forces, Beethoven marked his later creations with his own stormy, tender, lyrical, and intellectual character. By employing text less music to communicate philosophical ideas and to serve as autobiography, he pushed music far along the road toward 19th century romanticism and bequeathed to his successors the portrait of the great creator as culture hero (Bekker, 2005). 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Beethoven used the Classical forms but enlarged their formal structure and enriched their emotional content with a personal expressiveness (Grove, 2003). III. Discussion A. His contributions †¢ Middle Period Beethoven’s personal eccentricities, his proud boorishness, and even his lack of personal cleanliness were accepted as the marks of the genius he was. A short, muscular, stocky man, he had a bush of wild hair and fierce, piercing black eyes in a notably ruddy face. His upper-class friends suffered at his hands but stubbornly remained faithful to him. They supported him by providing comfortable lodgings, by giving him money, and by patronizing his concerts and publications. By 1804, he was composing such of his great piano sonatas as the Waldstein and the Appassionata, and probably had embarked on his only opera, Fidelio (Newman, 2004). Meanwhile, by 1805, Beethoven had begun to sketch his Fifth (C Minor) Symphony, his Fourth (G Major) Piano Concerto, and the first of his Rasoumovsky string quartets. In 1806, in the midst of the Napoleonic disorders, he composed his only violin concerto, first heard on December 23 of that year. While Beethoven worked on the concerto, his desk was littered with advanced sketches of his Fourth Fifth, and Sixth symphonies. The Fourth was first heard in the spring of 1807; the Fifth (C Minor) and Sixth (Pastoral, F Major) were played at a concert on December 22, 1808, which included half a dozen others of his works (the premieres of the Choral Fantasy and the Fourth Piano Concerto)(Grove, 2003). On completing his Third (Eroica) Symphony, in E Flat, in 1804, Beethoven had inscribed it to Napoleon, thinking of him as a democratic liberator; this inscription he later angrily struck out. Nevertheless, he seriously considered, as late as 1808-1089, an offer from Jerome Bonaparte, king of Westphalis, to become his Kapellmeister at Kassel. Hearing of this, three of Beethoven’s Viennese patrons, including the young Archduke Rudolf, joined to offer him a yearly income, and he decided not to emigrate (Anderson, 2001). †¢ Last Works Between 1817 and 1823, Beethoven completed the last 5 of his 32 piano sonatas. In 1818, he began a mass intended for use at the installation of his friend Archduke Rudolf as archbishop of Olmutz (Olomouc). He did not complete it until February 27, 1823; the Missa solemnis was first sung at a private performance in ST. Petersburg on April 6, 1824. Beethoven had planned a symphony in F minor. He worked at it desultorily in 1823, when he seriously set to work to complete it. He decided to make its last movement a choral setting of Friedrich von Schiller’s Ode to Joy and pronounced the Ninth Symphony complete on September 5, 1823. He had accepted 250 from the Philharmonic Society of London in return for a promise that it would receive his new symphony in manuscript. But he had also promised the premiere to Berlin and had dedicated the symphony to the King of Prussia. When his Viennese patrons insisted that it be heard in Vienna first, he yielded, salving his conscience by sending the actual autograph score at London. The first hearing of the Ninth Symphony occurred in Vienna on May 7, 1824. When the audience broke into frantic applause, the deaf Beethoven was unaware of the enthusiasm until someone turned him around so that he could see the demonstration (Anderson, 2001). IV. Conclusion As a conclusion, custom long has divided Beethoven’s numerous works into three periods. These inexact, overlapping categories represent actual changes in styles. The first period shows Beethoven as the direct heir and imitator of Haydn and Mozart. Opening about 1800, the second period, far more idiosyncratic, includes the majority of his most popular works: symphonies Nos. 2 to 8 inclusive, Fidelio, the last three piano concertos, the violin concerto, the Leonore, Egmont, and Coriolan overtures, the Rasoumovsky string quartets, other chamber music, and 14 of the piano sonatas. The third of the Beethoven periods, one of distillation and summation, encompasses the Ninth Symphony, the five final string quartets, and the Missa solemnis (Anderson, 2001). Critics still discuss whether or not Beethoven’s deafness influenced the special character of his later works. Reference: 1. Anderson, Emily. (2001). The Letters of Beethoven, 5 vols. Pp. 23-27. London and New York. 2. Bekker, Paul. (2005)Beethoven, tr. By M. M. Bozman, pp. 114-116, London. 3. Grove, George. (2003). The Life and Works of Beethoven, pp. 24-36, New York. 4. Newman, Romain. (2004). The Unconsciousness Beethoven, pp. 67-68, London and New York.

Essay --

Imagine having to work a 100 hour work week as a slave, being so desperate for food that you eat snakes, rats, and human corpses to stay alive, and being forced to witness public executions of your closest family members. This is the reality for the 176,000 political and associative prisoners living in North Korean prisons with no rights, no trial, and no reason. The world will have to regard the human rights abuses in North Korean as an important issue if we wish to stop the torture, murder, and starvation that it enforces on its people. Recognition for our need for basic human rights is required to understand how North Korea deprives its people from the choices we as citizens of the USA take for granted. The United Nation’s office of the High Commissioner of Human Rights says that â€Å"human rights are rights inherent to all human beings†. These rights include the rights to life, liberty, property, movement, expression, and security. The United States has different rights engrained in its Bill of Rights, like the right to a speedy trial, freedom from harboring soldiers, and the freedom to a militia. North Korea has had its prisons for more than 5 decades, and its background goes back to the Korean War, when they stored their Prisoners of War and the members of the opposition in the camps. They have continued to today, despite the fact that the North Korean government denies their existence. Those on the outside mainly get their information from prison escapees and satellite imagery, and by these testimonies we can only make educated guesses on the population, location, and size of the camps. Shin Dong-hyuk has helped the rest of the world understand what prison life was like, for his story is haunting. He was born in a prison camp... ...t? Indeed, one of the biggest pitfalls that we as people have subsided from is publicizing the rejection of rights from the North Korean peoples, and we have forgotten that we can get out the word to top diplomatic officials on how and when we wish to combat the violations. Spreading the word is one of the most helpful things you can currently do to, as you, as an American, have the right to democracy and the people’s choice in matters, a right that North Korean citizens have been blatantly denied. Get educated on these matters through books, websites and documentaries, then go spread the information you have been given. As support for the prisoners grows, so will support for the human race as a whole, it will be only then that the issue of North Korea’s concentration camps will be brought to the diplomatic table for and by the people wherever they shall reside.

Organizational structure as a determinant of performance: Evidence from mutual funds Essay

Management Introduction   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Management is an important aspect of any organization. For an organization to be successful, it is important that there should solid management carried out by managers. All companies that are successful have often ensured that they have a sound and strong management system as well as capable managers that can help in achieving the objectives of companies. Task 1   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   A manager can be described as an individual that has been placed in a position of authority to oversee the operations of an organization. Management is the art of overseeing the operations of an organization by ensuring that all operations are in line with the objectives of the company (Csaszar, 2012). An organization is any entity that is focused in achieving a collective objective. Managers as mentioned are persons in positions of authority within an organization that are tasked with the responsibility of overseeing the operations of a particular organization. Managers are the decision makers within an organization and every decision that they make is often implemented with an aim of meeting the objectives of the organization(Aquinas, 2010). The success of any organization greatly depends on the managers as they are the decisions makers that influence success. For example, when there are operational changes to be made such as the rate of production within an organization, a manager is deeply involved in providing the much needed guidance as well as making the final decision on what steps to undertake (Aghina, Smet,& Heywood, 2014). With the approval of the manager, the rate of production can be increased which can then help the company to attain more revenue.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Furthermore, managers are important within organizations since they perform the function of planning. It is the duty of the manager to plan how operations will be carried out and how each project within the organization will be undertaken. For example, if an organization has an objective of improving on its sales, the manager will be involved in the planning process by deciding the necessary steps that need to be taken for the project to be accomplished(Aquinas, 2010). Furthermore, it is important to note that managers are important in that they play the role of organizing. This involves formation of teams as well as providing the appropriate resources that can be used in completing tasks(Janićijević, 2013). Organizing also involves giving authority as well as assigning the staffs in the company respective duties. Managers are also important within organizations because they provide the staffing and make decisions on human resource s. After assessing the needs that certain operations within an organization require, a manager will take the responsibility of sourcing for the right employees, recruiting as well as ensuring that they are capable of handling the duties(Aghina, Smet, & Heywood, 2014). The human resource manager is often the person in charge of staffing and ensures that there are enough staffs that can carry out the operations for the success of an organization.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Apart from the above important roles of a manager, they are also important because they provide leadership. The success of an organization will greatly depend on the type of leadership that is offered within the company(Koontz, &Weihrich, 2007). Managers often motivate, guide, communicate as well as encourage the employees under their leadership to perform well within the company. The managers also are important towards the success of an organization since they help employees in solving problems that they may face in the course of carrying out their duties. Therefore, through the leadership qualities, managers are able to help a company or business become successful. Finally, managers are importance within an organization since they provide control within an organization(Janićijević, 2013). It is important that there must be frequent and continuous checks to ensure that operations of an organization are in line for the success of t he company. Therefore, to ensure that all things run as required and that there are no loopholes in the operations of an organization, a manager must be available. Task 2   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Organizational structure refers to the arrangement in a hierarchical order which depicts the lines of authority as they are supposed to be within an organization. Furthermore, organizational structure depicts the channels of communication, duties as well as the rights as they should flow within the organization from the top ranking officers to the lower or junior employees. Organizational structure is of great importance because it helps in outlining how an organization operates in terms of roles, responsibilities as well as the powers and how they are assigned to each person in the company (Koontz, &Weihrich, 2007). It helps in ensuring that there is proper coordination of operations within an organization and proper control is maintained to avoid conflicts. Furthermore, it is also to be noted that organizational structures within organizations are important in identifying how information flows within the organization. PRESIDENT/CEO Figure 1: Organizational chart VP-PRODUCTION VP-MARJKETING VP-SALES MANAGER1 MANAGER1 MANAGER1 MANAGER2 MANAGER2 MANAGER2   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The different levels of management, that is the top level, middle level, as well as the bottom level management often work closely with each other to ensure that the primary objectives of an organization are net both in the short run and in the long run. It is important to observe that the organizational structure of any given company will primarily depend on the objectives of the organization as well as its strategies (Krot, &Lewicka, 2012). When an organization has a centralized structure, it means that the overall decision making within the organization is made at the top level management of the company. Furthermore, under a centralized structure, the top management has great and tight control over all the divisions as well as the departments within the organization and often those departments have different levels of independence.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   An organizational structure is important in that it helps to outline what steps different stakeholders need to take when dealing with the organization. Furthermore, it is to be noted that organizational structure helps in maintaining accountability(Aquinas, 2010). Through an organizational structure, one is able to know who is supposed to be held responsible in case certain things happen in the company. Every person has their roles outlined in the structure hence high level of accountability is maintained. It is also important in the success of an organization because it helps in the maximization of resources (Rolà ­nek, Vrchota, Kubecovà ¡, &Ã…  varovà ¡, 2014). The organizational structure is important because the resources can be allocated properly by following the right channel of communication as outlined by the structure.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In an organizational structure, the different levels of management are involved in making different types of decisions for the benefit of the organization (Chisa, 2014). It is to be noted that the strategic decisions which are often long term decisions of an organization are made by the top level management. These are decisions which shape as well as direct the operations of an organization as a whole and therefore the senior managers are the ones that make such decisions. The top level management often make their decisions which affect the stakeholders of the organization such as the shareholders as well as the internal stakeholders. The impact of the strategic decisions can be said to be greater than the impact of the operational decisions since the strategic decisions influence the tactical and the operational decisions to be made by other managers. On the other hand, the tactical decisions within an organization are often made by the m iddle level management. These are decisions which are made and help in the implementation of the strategies of an organization(Aquinas, 2010). The middle level management work closely with the top level management so that the strategies formulated and the tactical decisions made by the middle level management can result in to positive results.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The tactical decisions will often rely on market research and data to ensure that the implementation of the strategies provide positive results in the long run. Finally, the operational decisions within an organization are often made by the middle or the junior management in an organization (Takahara, &Mesarovic, 2003). These decisions often involve the daily routine activities that are performed within the organization. For example the decision to change shift for employees from time to time is an operational decision made by a junior manager. Task 3   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Unilever Plcis one of the multinational corporations that deal in consumer products as well as services across the globe. The vision and mission of Unilever Plc is â€Å"helping people to look good, feel good and get more out of life.† The vision and mission of the company is to provide customer with consumer products that are of high quality and affordable (own website). The corporate strategy which Unilever has continued to use is that of providing products that meet the expectations of the consumers as well as ensuring that the prices are affordable hence attractive to customers. Packaging and branding is another corporate strategy the company has been using, ensuring that all its products are packaged in a unique way(own website).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   SWOT analysis refers to the analysis conducted on a company to check on its strengths, weaknesses, the various opportunities it has as well as the threats that it faces in the course of carrying out its operations (Unilever SWOT Analysis, 2012). This analysis helps in determining whether a company is in a better position as compared to its competitors and can help in making important decisions. It helps in identifying opportunities which a company can take on as well as the weaknesses which a company can build on to improve its performance. Unilever makes use of the SWOT analysis to help make major business decisions such as the pricing of its products as well as packaging and how to handle competition(Unilever SWOT Analysis, 2012). Under SWOT analysis, the strengths of the company include innovation and new products launching, a strong portfolio for its brands as well as it has made strategic acquisitions. The weakness of the company is r ecalling of its products which affects its revenue. The opportunities include growing new markets such as home and personal care(Unilever SWOT Analysis, 2012). However, it is faced with the threat of counterfeit products in the market. Organizational culture is also important in performance of a company. In the case of Unilever, the company can improve its performance if its changes its culture of having a wide range of products under one brand (Unilever SWOT Analysis, 2012). The company needs to rebrand and have different portfolios for its products categorized for each consumer group. References Aghina, W., De Smet, A., & Heywood, S. (2014).The past and future of global organizations. Mckinsey Quarterly, (3), 97-106. Aquinas, P. G. (2010).Organization structure and design: Applications and challenges. New Delhi: Excel Books. Chisa, E. (2014). Evolution of the Product Manager.Communications Of The ACM, 57(11), 48-52. doi:10.1145/2669480 Csaszar, F. A. (2012). Organizational structure as a determinant of performance: Evidence from mutual funds. Strategic Management Journal, 33(6), 611-632. doi:10.1002/smj.1969 Janićijević, N. (2013). THE MUTUAL IMPACT OF ORGANIZATIONAL CULTURE AND STRUCTURE.EkonomskiAnali / Economic Annals, 58(198), 35-60. doi:10.2298/EKA1398035J Koontz, H., &Weihrich, H. (2007).Essentials of management: An international perspective. New Delhi: Tata McGraw-Hill. Krot, K., &Lewicka, D. (2012).THE IMPORTANCE OF TRUST IN MANAGER-EMPLOYEE RELATIONSHIPS.International Journal Of Electronic Business Management, 10(3), 224-233. Rolà ­nek, L., Vrchota, J., Kubecovà ¡, J., &Ã…  varovà ¡, M. (2014).THE LEVEL OF PROCESS MANAGEMENT PRINCIPLES APPLICATION IN SMEs IN THE SELECTED REGION OF THE CZECH REPUBLIC.Serbian Journal Of Management, 9(2), 203-217. doi:10.5937/sjm9-6376 Takahara, Y., &Mesarovic, M. (2003).Organization structure: Cybernetic systems foundation. London: Kluwer Academic/Plenum. Unilever SWOT Analysis. (2012). Unilever SWOT Analysis, 1-10. Source document

Hiv And Human Immunodeficiency Virus - 1430 Words

Yasaswi Vengalasetti 10 March 2013 UWP 104F Theresa Walsh Vaginal Virus Pandemonium HIV, Human Immunodeficiency virus first became known to us in the early 1980s. HIV dominated the news front as its societal repercussions were enormous. It compromised ones immune system and jeopardized an individual’s ability to have relationships. It was a physically and socially debilitating disease, and getting infected meant becoming ostracized and having a reduced life expectancy. In the early years of the epidemic, AIDS was unfamiliar. No one was quite sure of what is was, and it was feared, without any available treatment and often lead to death. The fact that it was prevalent among the gay communities only further stimulated social stigma against†¦show more content†¦In fact roughly 19 million of these AIDS patients do not even know they are living with this sentence according to a UNAIDS report. More than 95% of HIV infections are in developing countries, two-thirds of them in sub-Saharan Africa, where over 28 million people are living with HIV. While infection rates are lower in Asia and the Pacific, where over 7 million are infected, there is a risk that localized epidemics involving mainly high-risk groups could spark off major epidemics in some of the world’s most populous countries. The disease continues to have a major and disproportionate impact on social and economic development. Poverty rises in developing countries as households lose one or more breadwinners to AIDS, whereas industrialized nations like the United States see its rates leveling off and dropping. In light of its prevalence, researchers have not stopped searching for a cure for AIDS. Many labs have renewed their efforts to understand and eradicate this disease and have refocused to developing countries. Many researchers have continued to advance our understanding of the biology of the disease. 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