The Global Financial Crisis and The Regulation of...

Lessons of GFC for the regulation of Investment Bank Investment Banks enable individuals, institutions such companies, governments to raise capital by offering underwriting services or working as an agents of the client in offering securities or in both roles. Investments banks play a very important role in stimulating investments in the United States both from individuals and corporate. The global financial environment has over the last decade experienced enough changes as can be witnessed from the key economic indicators. These changes have significantly impacted various stakeholders such as financial markets, money markets, capital markets and the general micro and macro economics players. Countries have been hit by recession and†¦show more content†¦The investment banks changed some of the products that they were offering to the market especially those which were considered highly risky. These are the products which were blamed as have led to increased speculations among the consumers. For example some of the derivative products that were in the market prior to the financial crisis have since been discontinued because they were highly risky and that over exposed the banks to higher level of risk. Lessons of Global financial Crisis for the financial products created by investment Banks. As mentioned above, some of the products that were being offered by the investments banks prior to the global financial crisis overexposed them to financial risks such liquidity risk. For an investment banks to be successful, they need to always predict the financial patterns and opportunities and then put in position resources so that they use these opportunities in the best possible ways. Following the global financial crisis and other challenges that have affected the financial sector, investment banks have employed revenue diversification trend. Traditionally, investment banks used to offer their customers variety of services such as retail and investment fund management, money lending, securities services and structured finances. Currently, investment banks have changed their business focus and doShow MoreRelatedThe Global Financial Crisis And The Crisis Essay1244 Words   |  5 PagesIntroduction The Global Financial Crisis, also known as The Great Recession, broke out in the United States of America in the middle of 2007 and continued on until 2008. There were many factors that contributed to the cause of The Global Financial Crisis and many effects that emerged, because the impact it had on the financial system. The Global Financial Crisis started because of house market crash in 2007. There were many factors that contributed to the housing market crash in 2007. 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This financial crisis also referred to as the greatRead MoreThe Main Structural Changes Implementation Of The Uk Financial System1708 Words   |  7 Pagesargued that the financial markets in the UK have failed to provide adequate support for industry. Identify the main structural changes implemented in the UK financial system over the last two decades and explain how these changes have affected the supply of funds in the industry. The financial system is defined by Investopedia as the system that enables lenders and borrowers to exchange funds. The global financial system is basically a broader regional system that encompasses all financial institutionsRead MoreShadow Banking1034 Words   |  5 PagesShadow Banking System and its role in the global financial crisis What is shadow banking system Shadow Banking System (SBS) refers to a collection of financial entities, infrastructures and practices which support financial transactions but beyond the regulation and monitor from the government or official regulators. Some financial institutions, like investment banks, may conduct some their transactions in the shadow banking system, but they are not SBS institutions themselves. The term was

What is Nursing - 885 Words

â€Å"Nursing is†¦Ã¢â‚¬  Nursing has been a field in which new rules are being constantly enforced. It is also a field that requires the nurses to constantly review their material in order to be current with the changes in health profession. Nursing has always been around, but in different standards. Nursing began as a basic care and then it gradually expanded into a more critical and in-depth care. There are several definitions of what nursing is, but in my own perspective, I think nursing is the act of caring, comforting, respecting, and disciplining caring for an individual. To begin, the first most important point of what â€Å"nursing† is caring. Care giving is one of the most essential parts in the health field because it helps people to regain their strength and to improve their health. Nurses are required to take proper care of their patients by helping them recover from their illnesses, prevent additional illnesses, and also help them remain and maintain a heal thy living style. Nursing from the very beginning was built on care giving, assisting and taking care of people who couldn’t take care of themselves. In other words, I may say that care giving is the foundation of nursing. Without caregiving, nursing wouldn’t be as important as it is now, people will be dying of diseases that they know absolutely nothing about. That’s why nurses are being trusted and regarded as saviors because people know that the nurses are going to take proper care of them and also constantly give themShow MoreRelatedWhat Are Nursing Research?1359 Words   |  6 PagesWhat is nursing research and why is it important to nursing? Research is essential in all aspects of life. 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It is one of the most visible and easily identifiable occupations as comparedRead MoreWhat Is Nursing Profession?1835 Words   |  8 PagesWHAT IS NURSING PROFESSION INTRODUCTION What dose Nursing profession mean to a student Nurse? To answer this question as a student Nurse will break it down into four subject areas starting off with the professional and ethical influences that will include the United Kingdom central council for nursing and midwifery and changing to the (NMC) Nursing and Midwifery council today and what is expected the Nursing should follow code of conduct and looking at the accountability and responsibility of theRead MoreWhat Is Care For Nursing?3206 Words   |  13 PagesWhat is care in nursing? To me care in nursing is being empathetic to patients’ feelings, and providing the patient care like the professional caregiver would find beneficial. First of all, the term and meaning of caring in nursing can have a universal commonality which the giver of care is the nurse, and the receiver is the patient (Tonges, M., Ray, J. 2011). Second, there were findings by (Butts, J. B., Rich, K., MN., 2011), which â€Å"caring is a belief or value (Watson, 1979, 1985, 1990)Read MoreWhat Makes Nursing A Profession?1656 Words   |  7 PagesNursing is a multidisciplinary profession in which caring, holism, endurance, effective patient care and patient safety are simultaneously executed. Nursing is a unique profession whereby personal experience and a personal philosophy contribute to great nursing care. In this paper, I will review my view of nursing and what makes it a unique profession. Nursing as a Profession What makes nursing a profession? Definition. According to the ANA, the requirements for nursing profession are educationRead MoreWhat Nursing Means to Me708 Words   |  3 PagesWhat nursing means to me My philosophy of nursing comes directly from my desire to help people. I want to be a nurse because I enjoy being around people in their times of need and I get internal satisfaction by serving those that need help. I remember when I did some volunteer work for a hospital and that is when I realized my passion for nursing. I believe that the cure for many of the peoples ailments is not just in medicine, it is in the care that they receive as patients in hospitals andRead MoreWhat is Nursing Informatics? Essay1207 Words   |  5 Pagesthis concept when making the decisions of which of the information will be used and what the potential outcomes of the information chosen will have on my reasearch question; will it favor the topic or will it unfavor it? The final concept of the plan is the use of wisdom. â€Å"Wisdom focuses on the appropriate application of knwledge† (McGonigle Garver, 2012, p.99). The use of wisdom guides the decisions about what would be the most appropriate use of information. Through the use of wisdom I will beRead MoreWhat Is The Impact Of Nursing And Health1109 Words   |  5 PagesThis written easy will be taking a look at the health profile within a particular community and will aim to provide an understanding of nursing and health by critically analysing the environment, socio economic and cultural factors that could be influencing the health of the individuals and the community as a whole. 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I find myself at the mercy of a long drawn out discussion of the evolution of nursing, is it a science or is it an art? I ask myself, why am I doing this to myself? Am I prepared to care for someone else’s life? Health? Medical needs? Do I have a philosophy? Do I even know what a theory of nursing is? This is probably one of the hardest journeys I have ever been on in my life so what does my future

Implement Liberal Immigration Policies †Free Samples to Students

Question: Discuss about the Implement Liberal Immigration Policies. Answer: Introduction: The aim of the assignment is to create a talent management plan for HSBC Bank Australia to align their current practices with the best practices of the banking industry. The assignment has two sections which delve into the banking sector of Australia and its best practices in detail. The first section points out the three sub factors impacting the HSBC bank while the second section contains steps of talent management. The talent management section outline ways in which the international bank can acquire and manage talents to retain its position in the banking industry. The three most important sub factors in the banking industry in the field o talent management are the knowledge economy, globalisation and skill gaps and structural employment. These three most important factors can be linked to key factors driving organisational and economic changes like demographic factors, technological factors and economic factors. These factors play a very significant role in talent acquisition and management in international banking organisations like HSBC Bank Australia. The three important sub factors and their relation to the key factors are discussed as follows: The developed knowledge economies like Australia and their international banking institutions like HSBC Bank Australia consider knowledge as an important form of capital. They emphasise on talent acquisition and retention to maintain their strategic position in the market. HSBC Australia is a subsidiary of the leading British international bank chain, HSBC Bank(Globalconnections.hsbc.com. 2017). The banking industry is undergoing massive changes owing to technological changes which have made it possible for banks to acquire, manage, share and hold an almost endless body of knowledge. The demographical factors affecting the banking industry particularly in Australia shows that as the standard of life and health care facilities allow employees to postpone their retirement. They serve HSBC Bank for longer tenure which allow the bank to form long term business strategies where it can utilise the talented senior employees. Another factor which is strongly influencing knowledge management and talent retention is technological advancements like telecommunication and digitization(Gungor et al. 2013). These advanced technological help HSBC Bank to communicate with business partners all across Australia, gain knowledge from and coordinate between employees stationed in geographically dispersed location. This advanced technology and communication facilities help the banks to integrate the talents of both on role and outsourced employees to attain greater business excellence and business performance. Thus, factors like advancements in technology and demographical factors like increasing working age among people have resulted in more extensive knowledge management and talent acquisition at HSBC Bank Australia(Natek and Zwilling 2014). The banking industry and its practices in Australia are influenced deeply by globalisation. Globalisation has demographic, technological and economic implications on the working of HSBC bank Australia. The demography of Australia toady consists of immigrants from all the leading market nations in the world like the US, the UK, Canada, India, France and China. As a result HSBC Australia can use human resources from these countries to attain high level of work place diversity performances and organisational excellence(Mortimer et al. 2015). This diverse work culture and talent acquisition from various countries results in acquiring diverse knowledge which encourages innovation in the banking practices followed by the international bank in Australia. However, this availability of human resources from several host countries of HSBC has its own challenge and impact on the banks operations. Its diverse groups of employees have increasing expectations from the management which is compelling the take steps to control issues like cultural bias and conflicts among different cultural groups of employees. The advancements in technology has helped the bank to form virtual teams to which motivate employees from diverse cultural backgrounds to achieve high level of performances(Akinnusi, Sonubi and Oyewunmi 2017). Skill gaps and structural unemployment: The banking organisations of Australia like HSBC Bank Australia is experiencing gaps in skills and structural unemployment which is the outcome of change in demographic, technological and economic trends in Australia. The people in Australia owing to improve standard of lives work till longer tenure which allows the organisations like NSBC Bank Australia to utilise their talent for longer periods. Thus the organisation has huge talented workforce whom it has to allocate in strategic job areas(Connell and Stanton 2014). This failure to provide sufficient jobs to this growing population of employees creates large scale structural unemployment. Technological factors like advancements in banking methods and advent of online virtual banking in the banking sector requires the bank employees to have deep knowledge about latest banking technology. This requires often renders senior employees of HSBC Bank Australia without technical knowledge employed. The demographic factors of Australia lik e longer work tenure of employees prevents the bank from conducting career palknni8ng for the junior employees. The bank loses considerable portion of the work force due to this structural unemployment. The bank has resorted to re-skilling and peer to peer training to bridge these increasing gaps between skills like technical skills among old employees and strategic unemployment(Wright 2014). The above discussion shows that HSBC Bank in Australia suffers from three main issues, namely, advent of Australia into a knowledge economy, globalisation and gaps in skills and structural unemployment. The factors have significant impact on the talent acquisition and talent management of the international bank in Australia. The following are the steps to talent management for HSBC Bank Australia to solve these issues aligned with the best practices in the banking industry: HSBC Bank should align its total work force according to the business needs and the industry best practices. The bank is one of the best international banks in Australia and around the world which is recognised for its acquisition and management of talented employees. The increase in the tenure of the employment of employees will help the bank to use their knowledge and talent for longer period of time. The apex management, the departmental heads and the human department should align the employees according to their specialisation and area of expertise(Jackson, Sibson and Riebe 2014). For example, the younger employees could be allocated to sales and customer acquisition since they have knowledge about latest technology in banking and can use it as unique selling proposition to attract customers. The experienced senior employees can be allocated towards senior positions where they can utilise their knowledge and experience to lead their subordinates. This would also give opportunity to the company to train its junior employees to fill in the gaps of the senior employees after the latters retirement and minimise loss of knowledge due to resignation of experienced employees. This alignment of employees towards business needs would bring about career development and retention of both groups of employees(Basili et al. 2014) Create highly skilled pools of internal talents: The senior managers and the human resource departments should create a pool of talented employees who would contribute towards business development of the international bank. The senior managers and the human resource department should provide training to the employees to develop- their competencies and skills as bankers. There should be training sessions which would develop the knowledge of the employees about the best practices of the banking industry, law and customer relations. These trainings will enhance the competencies of the employees and help them to serve the customers better. The banking industry is dependent on the skills and competencies of the employees to offer financial services according to the requirements and expectations of the customers. Training would enable the employees to serve the customers better and yield high revenue for the bank. Thus creating a pool of talented employees would enable the banking organisation to deal with issues like structural unemploy ment(Silberman and Biech 2015). HSBC bank should create a performance linked payment scheme which would recognise the high performances of the employees and provide them with legitimate compensation packages. The company should first provide training to the employees to upgrade their skills and then apply the PLP scheme. The scheme would motivate the employees to over achieve their target levels of performances to get higher salaries and recognitions. This will also help the human resource departments to judge the performances of the employees while considering their appraisals and promotions. PLP would also help the bank to terminate poorly performing and irresponsible employees. This will leave posts vacant giving scope to the bank to acquire talented and highly skilled employees to maintain best practice standards prevalent in the banking industry(Zaleha Abdul Rasid, Ruhana Isa and Khairuzzaman Wan Ismail 2014). Thus PLP would help the bank to encourage the employees to increase their competencies, knowledge and talents to achieve high performance levels. These high levels of performances would enable them to gain promotion, career development and job satisfaction. This will help HSBC Bank Australia to retain and manage talented employees to achieve high market performances in the competitive bank industry. HSBC Bank Australia should exercise efficient management of knowledge within the organisation. The employees of all levels of the organisation should have access to certain extent with prior approval of the reporting managers. This would on one hand increase the level of knowledge and expertise among employees and prevent unauthorised access and misuse of data on the other hand. Conclusion: HSBC Bank should manage its human resources more efficiently to maintain its dominance over Australias financial market. It should give emphasis on making policies to ensure that the employees are motivated to perform and bring about their career growth. The policies and parameters to measure the employee performances should be aligned with the organisational goal. References: Akinnusi, D.M., Sonubi, O.O. and Oyewunmi, A.E., 2017. Fostering Effective Workforce Diversity Management in Nigerian Organizations: The Challenge of Human Resource Management.International Review of Management and Marketing,7(2), pp.108-116. Al-Zahrani, A.A. and Almazari, A.A., 2014. The impact of affective human resources management practices on the financial performance of the Saudi banks.Review of Integrative Business and Economics Research,3(1), p.327. Basili, V., Heidrich, J., Lindvall, M., Mnch, J., Regardie, M., Rombach, D., Seaman, C. and Trendowicz, A., 2014. GQM+ Strategies: A comprehensive methodology for aligning business strategies with software measurement.arXiv preprint arXiv:1402.0292. Bassett?Jones, N., 2005. The paradox of diversity management, creativity and innovation.Creativity and innovation management,14(2), pp.169-175. Connell, J. and Stanton, P., 2014. Skills and the role of HRM: towards a research agenda for the Asia Pacific region.Asia Pacific Journal of Human Resources,52(1), pp.4-22. Globalconnections.hsbc.com. (2017). Talent Management HSBC Global Connections. [online] Available at: https://globalconnections.hsbc.com/united-kingdom/en/topics/talent-management [Accessed 31 Aug. 2017]. Gungor, V.C., Sahin, D., Kocak, T., Ergut, S., Buccella, C., Cecati, C. and Hancke, G.P., 2013. A survey on smart grid potential applications and communication requirements.IEEE Transactions on Industrial Informatics,9(1), pp.28-42. Jackson, D., Sibson, R. and Riebe, L., 2014. Undergraduate perceptions of the development of team-working skills.Education+ Training,56(1), pp.7-20. Mortimer, G., Neale, L., Hasan, S.F.E. and Dunphy, B., 2015. Investigating the factors influencing the adoption of m-banking: a cross cultural study.International Journal of Bank Marketing,33(4), pp.545-570. Natek, S. and Zwilling, M., 2014. Student data mining solutionknowledge management system related to higher education institutions.Expert systems with applications,41(14), pp.6400-6407. Silberman, M.L. and Biech, E., 2015.Active training: A handbook of techniques, designs, case examples and tips. John Wiley Sons. Wright, C.F., 2014. How do states implement liberal immigration policies? Control signals and skilled immigration reform in Australia.Governance,27(3), pp.397-421. Zaleha Abdul Rasid, S., Ruhana Isa, C. and Khairuzzaman Wan Ismail, W., 2014. Management accounting systems, enterprise risk management and organizational performance in financial institutions.Asian Review of Accounting,22(2), pp.128-144.

The Sweet Side of Bittersweet free essay sample

After 21 years of marriage to the United States Air force, my family has lived in and experienced a variety of communities and cultures. My Father, a now retired lieutenant colonel, has served the air force his entire adult life. Attending Nursery in Texas, Preschool in Alabama, elementary school in New Mexico, Middle school in California, ninth and tenth grade in Alabama, and eleventh and twelfth grade in Fayetteville, Georgia has molded me into quite an adaptive individual. Despite all the amazing aspects of living as a daughter of the air force, moving has made it bittersweet. Tears, stress, and a dash of excitement engraved the moving days into my memory. As the last box was crammed into the moving van, we said goodbye the dear friends that have made our time at that base so special. Although the goodbyes hurt, they forced us to trust that God had a plan, a plan for us to Prosper and lift us up. We will write a custom essay sample on The Sweet Side of Bittersweet or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page And as we pulled into our new home after several claustrophobic hours in the car, the restless little butterflies occupying my stomach reminded me of the new beginning that this home offered. New friends, new schools, new churches, new communities, and entirely new cultures proposed a chance for me to learn more about myself, and encouraged me to reach out to those who have to experience new for the first time. Attending college in the fall of 2013 will be yet another new for me, and I look forward to the chance to reach out to the fellow freshmen and offer a chance to make this adjustment together, because the first new ought to be a good one.

I have a dream. Speech Analysis

I have a dream. Speech Analysis Introduction â€Å"I have a dream† speech was given by Martin Luther King on 28th August 1963. There was an audience of about 250,000 people at the Lincoln Memorial in Washington where the speech was given. This speech was mainly based on the freedom for the black’s referred to as Negros.Advertising We will write a custom essay sample on â€Å"I have a dream†. Speech Analysis specifically for you for only $16.05 $11/page Learn More He was much concerned about the oppression and exploitation of the black Americans at that time and he wished that people would understand that they were all equal. Unfortunately, Martin Luther king was assassinated on 4th of April 1968 when he was thirty nine years old. However, Martin Luther king left a legacy and is remembered on Martin Luther King Day every year. Significance of the Speech in the world today In the course of delivering his speech, Martin Luther King said, â€Å"I am happy to join with you today in what will go down in history as the greatest demonstration for freedom in the history of our nation† (King speeches 1). This statement as he said has remained in our times and this is what has been happening all over the world. People are fighting for their freedom. He viewed it as an end to all oppression that was continuously being witnessed. This is a sign of new life of freedom and equality. Since he was a theologian, Martin Luther King addressed many injustices according to the Bible. Martin Luther King was enlightened and was tired of seeing blacks being exploited. He saw that the blacks were enslaved by the whites and yet they were helping them. He said, One hundred years later, the Negro is still sadly crippled by the manacles of segregation and the chains of discrimination. One hundred years later, the Negro lives on a lonely Island of poverty in the midst of a vast ocean of material prosperity. (Speech 1) Today many people are being exploited because of the ir race, tribe and even their origin. Many are living in poverty in the midst of the rich. Martin Luther King had spoken about this in his speech. He regretted that even after the country got a constitution; it did not accomplish the purpose it was meant to accomplish: â€Å"This note was a promise that all men would be guaranteed the unalienable rights of life, liberty and the pursuit of happiness† (Speech 1).Advertising Looking for essay on rhetoric? Let's see if we can help you! Get your first paper with 15% OFF Learn More This is a fact even in today’s society. Many countries have constitutions made up so as to bring about justice to the people. However, it is very unfortunate because many people are experiencing injustice in form of labor, race and tribe. Martin Luther King said that, â€Å"It would be fatal for the nation to overlook the urgency of the moment† (Speech 1). This signifies that it was a matter that needed to be address ed in urgency; otherwise it would bring great destruction to the society at large. The same applies to the world today. If nations do not put away their differences it may lead to great losses to many people, for instance the mass killings which were witnessed in Rwanda, Yugoslavia and even currently the conflicts in the Middle East are consequences of injustices not being addressed urgently (United Human Rights Council 1). Martin Luther King said, that he had a dream, that every valley shall be exalted, every hill and mountain shall be made low meaning that he hoped for a future with equality. This is believed to have become the reality of the dream when, black American Barack Obama became the president of America. Criticism of the Speech Although the speech is of great significance in our society today critics say that King was excessively rhetorical and that he did not provide a way to solve the many problems he addressed. Others say that some of his work in his doctoral disserta tion was plagiarized. This was followed by other responses that disagreed with the statement and said that it had nothing to do with his contribution in the civil rights movement (E-notes 1). Conclusion Martin Luther King’s Speech remains important in the modern society. It consists of well founded goals which if well addressed will take many countries up the ladder. However, critics will always be there to search for the wrongs. E-notes. Martin Luther King, Jr. 1929-1968. E-NOTES, 2011. Web.Advertising We will write a custom essay sample on â€Å"I have a dream†. Speech Analysis specifically for you for only $16.05 $11/page Learn More King speeches. Martin Luther King Jr-I have a Dream speech. Writers Reviews, 2011. Web. Speech. The I Have a Dream Speech Analysis. Speech topics Help, Advice Ideas, 2011. Web. United Human Rights Council. Genocide in Rwanda. United Human Rights Council, 2011. Web.

Effects Of Cognitive Impairment And Low Health Literacy On Medication Adherence Essays

Effects Of Cognitive Impairment And Low Health Literacy On Medication Adherence Essays Effects Of Cognitive Impairment And Low Health Literacy On Medication Adherence Paper Effects Of Cognitive Impairment And Low Health Literacy On Medication Adherence Paper Scientific and social changes of the 21st century have brought a radical change in the Health care delivery system. Medical intervention is an important component of the health care delivery system and the role of a health care professional in patient welfare has no boundaries for praise. The health care profession has evolved through time to establish a firm role in the medical domain based on strong ethical, moral and professional principles. The medical professionals are ‘accountable’ today. The civil war (1860-65) enhanced the growth of health care in United States and the two World Wars saw the ‘nobility’ of the medical practice. The changing role of these professionals as significant members of the health care team has brought about radical change in Health Care delivery system. Practice methods like â€Å"The collaborative model† shows a radical shift from the past. â€Å"Evidence based Practice† is another model in practice today. In such a scenario, clinical care of cognitively impaired is a complex practice and involves the key concepts of knowing the patient and reflective thinking. BACKGROUND Communication is the pulse of medical practice with the elements of intimacy and reflective practice. Communication barriers of the mentally and cognitively impaired patients seem to erode the quality of medical care due to assumptions and attitudes. Lack of communication due to cognitive impairment and lack of health literacy clearly affects the medication adherence of the older patients, especially ethnic minority in origin. More than sixty percent of the minority population does not comply with the prescribed drug regimen in the USA. Non-verbal communication seems to be effective in such settings. Effects of cognitive impairment on the reliability of geriatric assessments has been studied recently (Phillips et. al, 1993) to explore the relationship between cognitive status and reliability of multidimensional assessment data. The studies have proved that the reliability of the patients communication and sensory ability are affected by cognitive status. Hence caution should be exercised in treating cognitively impaired patients. The cognitive impairment that contributes to unreliable assessment of patients includes those related to communicating, vision and hearing. Communication problems of hearing impaired patients have been studied as well (Hines, 2000). The studies have proved that such patients are seriously disadvantaged by the disability. The major factor contributing to the disadvantage has been the inadequacy in training of both health care professionals in deaf awareness and associated communication skills. Other factors include the patient’s concealing their disability, work pressure and poor communication of the staff. Monolingual and Bilingual communication between patients with dementia and their care givers have been studied and have shown that the relationship between a demented terminally ill patient and the care giver is an important factor which forms the foundation of the interaction between them. This communications is complex with different aspects of perception and practice (Sirkka, 1996). Non-speaking patients are the worst affected and it is important to improve their communication to allow them receive care and comfort. The ethnic old patients in Canada have been shown to have remained an isolated group as aliens in their own land. This ethnic population has been shown to be unable to communicate with their care givers (Saldovt, al 1994). Problems developed in such patients without interpreter services have been termed serious. Thus, the problems encountered in communication between health care professionals and patients can be based on cultural needs and cognitive status; Cognitively impaired or comatose are often neglected. Studies on demented terminally ill patients to evaluate the time care givers provide for direct patient care have showed that more time is being spent with non demented than with the demented. The patients were shown to react in five categories of communication types during interactions The patients enjoyed contact, Patient avoided contact, The patient was aggressive, Showed only slight reaction and Does not react. Studies pertaining to specific verbal communication interactions in such elderly patients have been carried out (Jones et. al 1986). The studies were carried out under the categories ‘words spoken’, ‘commands given’, ‘statements made’, ‘Questions asked and answered’ with there ethnic groups namely immigrant, Canadian born and Anglo-born. The studies highlighted the need for health care professionals be aware of the implications of differences with there groups. Another studies on communication with severely demented patients by the health care professionals have shown that care of such patients need clear communication during care procedures. Thus, use of non-verbal communication skills (NVC) to improve care, especially with people who have learning disability has been assessed in a study (Chambers, 2003). The study outlines a health care professionals’ diagnosis of altered non-verbal communication and a new wellness diagnoses for enhanced non-verbal communication with detailed discussion on use of NVC with people with comprehension difficulties. The study stresses on the fact that health care professionals can be important in enhancing the non-verbal skills of the patient to help them communicate. Adding support to the view, the importance of improving communication by touch has been documented (Vortherms, 1991). The article views touch as an integral aspect of care, with the language of touch including tactile symbols of duration, location, action, intensity, frequency and sensation. The article classifies touch as affectional, functional and protective. The article stress that age is not a category to decide upon touch in terms of reduced needs of touch. An examination of touch between health care professionals’ and elderly patients (McCann et. al, 1993) has shown that most touch interactions in a care of the elderly are instrumental in nature and expressive touches are usually given to body extremities like the forehead, arms and the legs. Caring mentally ill patients undergoing therapy with antipsychotic drugs like clozapine and benzodiazepines involves careful monitoring of the patient’s physiological condition as well. Such drugs have marked side effects like sedation, hyper salivation, increase in transaminases, EEG changes, cardiovascular respiratory dysregulation, overweight, mild Parkinsonism, akathisia, tardive dysakinesia, increase of liver enzymes, hypotension, fever, ECG alterations, tachycardia, and delirious states. These drugs also pose the risk of seizures. With medical litigations on the rise, the interventions should be based on the competence of the patient. However in psychiatric cases there seems to be a group of individuals who are marginally competent. This group seems to lie in-between the two extremes of competence and incompetence and competence in this case thus appears to be a matter of degree. Mentally retarded persons who have some understanding of the reality and are able to express their wishes and desires can also be considered marginally competent. Mentally ill individuals whose illness has not completely impaired their understanding and capacity to express their wishes and desires are also considered marginally competent. These individuals are not incompetent though they suffer from specific deficits due to destroyed faculties. These marginally competent individuals make a significant group and recognizing the existence of such group of marginally competent individuals will help define competence better towards the documentation of informed consent and advance directives during interventions. A Psychological well being was shown to be enhanced by the humanistic personal interaction with the health care professionals and the professional interaction was shown to enhance physical well being. The patient’s feelings of well being always depended on the psychological well being according to the study. (Jane, 2002). Another studies on communication with severely demented patients by the health care professionals have shown that care of such patients need clear communication during care procedure and the health care professionals were vogue in their verbal communication and some patients were verbally active after the health care professionals leaving the bed side. A small scale pilot study has explored the educational base and needs of qualified care givers with reference to terminally ill patients with learning disability. The study has shown the lack of knowledge and skills in health care professionals to deal with the LD patients. The study has also recommended the introduction of communication and interpersonal skills in the care and Management of terminally ill patients with LD in the curriculum. The role of communication in care for elderly as documented by a literature review (Varhellan et, al. 1997) indicate a lack of observational instruments to effectively evaluate the interactive nature of patients communication especially with reference to reliability and validity. LIMITATIONS AND RECOMMENDATIONS The negative influence of elderly patients mental impairment on patient interaction has been documented in a study using the Clifton Assessment Procedure (Armstrong et, al 1986). 23 students were assessed under three categories of lucid, slightly confused and demented. Data on interactions with nursing staff were gained by direct observation. Studies concluded that health care professionals interact less with confused category them lucid category. Most of the health care professionals were more directed in the physical care of the patients them the psychological interaction or restorative activity. The patient’s inability to provide an accurate history of his problem and to participate in self-care blocks the usual process of care, often resulting in medical uncertainty inadequacy and frustration for the physician (Wendy L. , et. al, 2005). This shifts the goal from cure to care and shifting the goal of care from curing the patients illness to caring for the patients quality of life is problematic. The doctor–patient relationship changes dramatically often with ethical dilemmas related to patient autonomy and decision-making. Communication problems seem to erode health care professional’s commitment to care (Ekman et. al, 1991). Continuity of care seems to be a significant factor in psychiatric care as documented by research studies (Backrush, 1981). Continuity of caregivers where a single, continuous treatment team is responsible for patients in both inpatient and outpatient settings (Fuller Torrey 1986) seem also to complement continuity of care with improved cognitive function self-care skills. Cognitive impairments and low health literacy pose a serious barrier on the reliability of patient assessments. Hence, there is a need for training the health care professionals on communication skills with reference to cognitive impairments and designing awareness programs for such patients towards better health care. GOALS AND OBJECTIVES The main Objective of the study is to evaluate self-reported medication compliance in patients 50+ years of age and to compare physician assessments of patient’s adherence to a prescribed drug regimen provided on the â€Å"Predictive Score Sheet† to data obtained in telephone survey. The main goal of the study is to administer Medication Adherence Telephone Survey to all patients that completed the initial RAND SF-36 Survey, to complete double entry of data using SPSS software, to design and implement a statistical analysis plan to address the stated research question and to understand the effects of self-reported data on the validity of a research study MATERIALS AND METHOD In such a context, a demographic survey and two health assessments were administered to a convenient sample for a consecutive two week period utilizing CLOX, an executive clock drawing test to screen for cognitive impairment and the Rapid Estimate of Adult Literacy in Medicine (REALM) test to measure health literacy. A stimulated patient chart reviews and a telephone survey to record medication adherence behavior was conducted. One hundred cognitively impaired patients with treatment-resistant schizophrenia referred for Clozapine therapy were studied over the period of two weeks of treatment. Clozapine is a tricyclic dibenzodiazepine derivative 8-chloro-11- (4-methyl-1-piperazinyl)-5H-dibenzo [b, e] [1,4] diazepine. It is available as 25mg and 100 mg tablets for oral administration. Clozapine is widely used in refractory Schizophrenia. There seems to be a cultural and geographical variations in dose response relationship and tolerability to the drug making the dose response unpredictable. The effective and tolerable range is between 100 mg to 900 mg, which makes it difficult to make a predictive, significant and valid correlation. There has been no positive correlation with serum level too. Adherence to medication is important in clozapine therapy for results. The study was open level, naturalistic, and prospective, involving all patients, consecutive one hundred, referred for Clozapine during the year 2006. Data was obtained from patients and key relatives after informed consent. After therapy began, patients received a follow-up evaluation on day 4, 8 and again on the last day of treatment. The patients included 62 men and 38 women of low to middle socio-economical class, ranging in age from 52 to 56 years, averaging 54 years of age. 38% were married, 43% were single, and 19% were separated. The duration of illness prior to the study ranged from 5 to 21 years, averaging 7 years. Patients’ duration of illness before first psychiatric contact ranged between 5 months and 46 months, averaging 20 months. Prior to the study, 55% of the patients had a history of hospitalization, averaging 2 prior hospitalizations and the mean duration of hospitalization was 2 months. A history of violence was recorded in 46% of patients and 72% had a history of behavioral disruption. 28% of the patients had attempted suicide. Some were unable to function in society- 66% were socially disabled and 74% had little or no occupational functionality. One fourth of the patients had a positive family history of some psychological disorder. Schizophrenia was diagnosed in 16% of those relatives: 5% in siblings, 8% in parents, and 3% among offspring. Other psychological disorders, including alcoholism, depression, and suicide attempts were confirmed in first-degree relatives among 9% of the patients.

Difficulties in Basic Non-Syntactic Cognitive Processes Essay

Difficulties in Basic Non-Syntactic Cognitive Processes - Essay Example According to this theory, language acquisition must occur early in life if native-like mastery is to be achieved. After the critical period has passed, the age of acquisition is no longer supposed to have an effect, and native-like performance is no longer achievable. (Birdsong, 2005) Not all L2 data conform to a strict interpretation of Critical Period Hypothesis. The age at which L2 grammatical performance begins to differ from native speakers varies widely from early childhood to late adolescence, depending on the combinations of first and second languages. ( Bialystok and Miller, 199; Mc DONALD, 2000) Recent research has also studied the grammatical performance of native speakers under memory load. Using a grammaticality judgment task, Blackwell and Bates (1995) found native speakers were impaired in their judgment ability on sentences containing agreement violations with a low concurrent memory load and showed impairment on sentences containing omissions and word order errors at a much higher memory load. The compressed speech did not affect the interpretation of active and subject-cleft structures, which follow the normal subject-verb-object word order, but it did impact the interpretation of passives and object-clefts which have non-canonical word order. A.U. Knightly, Jun, and Oh (2002) found that early passive exposure to a language spoken in the home allowed people who then learned the language in adulthood to perform well in this language on phonological measures, but did not help with syntactic mastery. The age of acquisition at which L2 learners are significantly worse than native speakers is earlier if the L1 and L2 are dissimilar than if they have more similarity. (Johnson and Newport, 189 found this age to be 7 for Chinese/English and Korean speakers.)