Strategies for Patient Safety in Drug Administration

Strategies for Patient Safety in Drug Administration This essay will focus on the aspect of nurses providing quality care in relation to patient safety within the nursing context of safe practice of drug administration. It will further discuss the underlying risk factors that are related to drug administration error and also discuss how to maintain a good practice to ensure patient safety. Robert et al cited in the National Nursing Research Unit (NNRU 2012) that quality care can be defined as when a patient is satisfied with a service or treatment being given by healthcare professionals.To achieve thisresult nurses need support, providing them facilities such as a good workforce and understanding to help improve safe practice (NNRU 2008). As Griffith et al (2003) stated, medication administration is one of the most important duties that are commonly undertaken by nurses which requires official authorized professional mandatory in hospitals or any care settings where care is delivered. These also, are responsible for their own standard of how to care for their patients (NMC 2008). Consequent to this, NMC (2010)standards for pre-registration nursing education emphasise that nurses are expected to work along with patients andcarerswhen administering drugs by means of facilitating information in regards to their treatment so that the patient can choose the right medical treatment. Corben V (2009) recommended that if nurses provide patients with enough information as well as educating them will increase patient trust and courage to take their medications. NMC (2008) further suggested that nurses should work with the five rights of medication administration in delivering care in clinical settings. This involves; the specify patient, the right drug, route, time and dose thus preventing drug administration error. However, Elliot Liu (2010), emphasise on nine rights including right documentation, action, form and response of drug management to maximise safe drug administration. National Patient Safety Agency (2004) defines patient safety as an event that accidentally may cause damage or does not damage patients in clinical settings where care is delivered. Consequently, these nine rights are there to guide nurses, failure to do so may not onlyprotect the patient from harm thus could also lead to legal action against the registered nurse (Schelbred Nord 2007). This means the nurse is known to be competent in carrying  out such task (NNRU 2012). This can also cause the National Health Service (NHS) a huge amount of expenses (NPSA 2007). According to NPSA (2011a) in Tingle J (2011a) indicate that 11% of medication errors in hospital were reported including patients’ falls and trips. However, the rise of incidents reported does not mean that patients’ safety is at high risk. Nonetheless, this is to bring awareness for nurses to provide a good quality care. Therefore, the nurse should show concern in patient safety (NPSA 2011c cited in Tingle J). Elliot Liu (2010) highlighted that nurses are required to administer drugs to the right patient as prescribed. This involves verifying the patient’s name alongside by asking him or her to state their names, date of birth and hospital identity number on the wristband as well as drug chart which shows a safe practice. Nonetheless, calling patients’ by their name may not confirm the patient identity as some patient with cognitive impairment or having language barrier might respond with no doubt (Bunker Kowalski 2008). However, Elliot Liu (2010) cited that in some clinical environments, not all patients such as mental health and service userin nursing homes carry wristbands with the hospital identity number, as they may not be capableof identifyingthemselves individually. Therefore, Lynn P (2011) also argues that in general, the ideal method is that nurses should be checking patients’ wristband to identify their name. Nevertheless, Shulmeister L (2008)pointsout that nurses working under stress due to heavy work-load could lead to not verifying patients’ identity beforegiving medication as required. Although this does not justify for a staff nurse not to follow the guideline of patient safety (Gould 2009). Additionally, nurses are expected to give the right drug to the patient as being prescribed. In a situation where the nurse is in doubt or not familiar with the prescribe drug, the nurse administering medication should use the British National Formulary as a guide (Dimond 2003).Williams D.J.P (2007) cited that an error in drugadministering could occur when a patient is prescribed the wrong drug without understanding the patient’s medical status. Benjamin D (2003) emphasised that nurses should assess patients’ knowledge of any allergies from the right drug being prescribed.Where there is a good quality of safe drugadministration, staff administering drug are expected to do so. If an allergy is identified, it is thenurse’sduty to document it and address it to the prescriber. Although Elliot Liu (2010) cited that sometimes for the patient’s best interest, they are given medication in spite of any sensitive reaction that the patient may have experienced due to the benefits of administering the right drug is more than the allergy experience. As a result the nurse administering should take this into account. In addition to this, an effective team work within the multidisciplinary is essential as this contributes to patient safety (Miller et al 2001). Consequently, registered nurses inform the prescriber immediately when a patient surfers a possible reaction from the drug given and documented. Thus this prevents patient from danger which may have been caused by the medication given NMC (2008). Elliot Liu (2010) furthermore highlighted that safe drug administration does not only involve giving the right medication to a patient but also it is the duty of a nurse to observe if the patient is responding well to the drug given. Consequent to this, the nurse will have to assess the patient’s effectiveness of certain drugs being administered like anticoagulants; anti-arrhythmics and insulin which are so potential that the patient’s blood glucose level, pulse rate, respiratory or urine output will need to be checked. Wright K (2009) state that for nurses to administer medication to patients it involves knowledge in drug calculation as this will help the nurse to give the right drug dosage to patients. NMC (2008) further highlighted that even though nurses may find some drug calculations very tricky to solve, as a result to maintain a good nursing practice it is the duty for another member of registered professional nurse to verify the drug calculations autonomously to reduce possible errors in drug volume or quantity. Armitage Knapham (2003) in Agyemang R.E.O WhileA (2010) argue that, most common drug incidents in hospitals is that a number of senior nurses in clinical settings sometimes do not follow drug preparation guidelines to ensure that drug prepared by another memberofstaff is accurate or not due to the hierarchy that the senior nurse may have overajunior staff. According to Tang et al (2007) research has shown that more than a thirdof theerror in drug administration to patients is due to wrong dose. Williams D.J.P (2007 highlighted that approximately 5% of drug doses given to patient in hospital were caused by medication error even though it was not the intention of the prescriber. Elliot Liu (2010) highlighted that sometimes administering wrong drug to a patient may take place if a prescriber does not prescribe the correct unit such as mg (milligram) in its place for mcg (microgram). Therefore, nurses are accountable to ensure patients’ safety and that they should be able to interpret patient’s drug chart cautiously.Therefore to prevent wrong drug calculation the nurse must make every effort to give the correct dose (Elliot Liu 2010). A safe medication administration can improve patient safety if nurses administer drug on the correct route as indicated by the prescriber. This action is a must to nurses and where the right route is not identified on the prescription, the nurse understands that the drug should not be administered but reported to the prescriber (Jones 2010). According to NPSA (2007) approximately 2.1% of drug administration errors from clinical settings were accounted for drug given mistakenly via the wrong route. King’s College Medication administration policy (2010) further recommended nurses to perform safe medication administration; therefore, it is not acceptable for nurses to prepare at the same point in time drugs such as oral, intravenous and intramuscular as this can cause giving drugs to patients on the wrong route. For example, this safe practice was well recognised during my clinical placement. Registered nurses were administering medication according to the NMC (2008) Standard for Medicines Management as well as Kings College Hospital Medication policies which involve the nine rights. Even though sometimes nurses had heavy work-load on the ward yet this did not justify an unsafe medication practice. NMC (2008) highlighted that as nurses are accountable for promoting patient wellbeing, also the nurse administering drug shouldbeaware to give patients medications at the right time. By doing so will enhance the effectiveness of the drug being prescribed for the patient. On the other hand, in some institutions drugs administrations are sometimes given in between half an hour before or in a while than the prescribed time dosage (Boundy Stockert 2008). Dean S (2005) in Elliot Liu (2010) mentioned that an investigation carried out in clinical  settings showed 31% of drug administration errors were due to those patients who have been given their drug dose at the wrong prescribe time. Additionally, documentation is another core element of nursing quality of care. Nurses are aware of recording and signing patients’ drug chart including the common drug name (generic), prescribed dosage, time, route and the purpose of the prescribe drugs as emphasised (Woodrow 2007). Also, the nurse is known to document whether if the patient rejects their drug as well as the possibility of not remembering to take the drug. Failing to do so could lead patients to be administered the same drug two times since there is no indication which can show that it has been administered. Therefore, the role of the nurse is to maintain an accurate record keeping maximising safe drug administration topatients(Woodrow 2007). Gladstone J (1995) in Agyemang R.E.O While A (2010) cited that even though patients are always the victim of drug administration error, nonetheless, nurses committing drug error are psychologically affected of remorse and have less trust or fear in legal action raised against him or her. Nevertheless, nurses recognize that addressing a medication error is a must. Also, reporting an incident may not only protect the nurse’s imagebut prevent another possible error from occurring and can be addressedin the local trust where the nurse is employed (NPSA 2010). Thus nurses by doing this, manifest their sincerity of theirprofessional character (NMC 208). According to Fry Dacey (2007) a survey carried out in the United Kingdom 94% participant of 127 out of 135 highlighted interruptions as a major factor that causes drug administration errors. However, Hitchen L (2008) in Jones SW (2009) stated that a number of NHS trustshave introducedthe use of putting on red sleeveless coat to minimise interruptions during drug rounds. Drug administration has always been an important task in the nursing care with factors contributing to medication error which affects patient safety. Therefore, it is necessary that preventive measures should be taken to minimise drug error in clinical settings. This means nurses must develop their knowledge in medication along with patient’s medical care plan as well as following hospital drug guiding principles (Agyemang While 2010). Although nurses are putting into practice the five or nine rights of medication administration in clinical settings, it is still difficult to achieve good quality of care as drug errors are still occurring in hospitals. Therefore registered nurses should consider patient safety as a major concern in delivering care in clinical settings and to achieve this, the nurse should continue to focus and provide a safe atmosphere when administering drug (Elliot Liu 2010).

The changes in ethnic cultures over the years in America

The USA is consists of a wide variety of cultural and ethic groups. Such diversity has variously been described as being a â€Å"melting pot†, â€Å"cultural mosaic† or evens still a â€Å"tossed salad†. Such ethnicities include Chicano, Afro-Latin American, Asian American, American-Indian and African-American. Such peoples exhibit different cultural elements through clothing, food, ceremonies and recreation. Native Americans have evolved from the interaction of typical US culture plus subjection to alien government structures, ideology, and social arrangement with different Native Americans’ traditional civilizations.Present Native Americans exhibit certain common features which, to some extent, may be a merger of conventional elements, adaptive tactics, as well as different acculturation levels to prevailing cultures. Such elements include: a persisting feeling of pride regarding cultural legacy; a conviction in spirit and body interrelatedness; dependen ce upon relationship networks and extended society and culturally unique communication methods (Amoko, 2000, 377). The communication style so depicted is less spoken and less direct compared to that of mainstream USA culture.It exhibits courtesy standards and suitable interaction standards. African Americans are in touch with some conscious knowledge of existing as an ingredient of a grouping having a specific historical position and some political association with different groups in the USA. Additionally, particular African Americans have common world viewpoints and affiliations which are based upon aspects of Protestantism, conventional African culture and indenturehood, subordination and slavery within United States society.Every African American does not embrace a black uniqueness. Possession of such identity implies that reference grouping functions within individual identity become grounded within an individual’s blackness (Tamase, 2007, 476). The values, cultural favo rites, artistic flavors, leisure actions, food preferences and cooking methods, religious and secular musical preferences, church association, group membership, plus social associations or close friends all are prejudiced by individual apparent relationship with black persons.Therefore, several or majority of the hope and meaning individuals have for leading purposeful lifestyle’s are related to personal self-perception as African-Americans (Azoulay, 1999, 364). Africentric viewpoints of the world are characterized by common responsibility, interdependence and cooperation. Protestantism within black civilization promotes collectivity and group unity. Extended families are the suitable examination for African American family studies. With no regard to revenue levels, African Americans exhibit more probability of living together with extended family relatives.African American place substantially more value to spiritual matters in treating and causing developmental plus other ph ysical disabilities. Rather that, or on top of, seeking medical help or consulting rehabilitation schemes, numerous African Americans greatly depend upon community assistance, especially church aid. Parents of African American children exhibit wider perceptions regarding normalcy plus they possess a broader variety of expectations regarding developmental landmarks in the behavior of children as compared to numerous educational experts (Pincheon, 2000, 273).The Hispanic culture exhibits high diversity as regards ethnicity, Culture, economic and education levels, and geographic source. However, certain commonalities as regards beliefs, customs as well as world viewpoints exist. Conventional Hispanics exhibit a culture founded on catholic philosophy with inextricable intertwining of native South American and central ideologies concerning the world.Characteristics identified from Hispanic cultures include: the dominance of the family concept having a obviously defined authority hierarch y; an individualized though ritualistic admiration based upon selfhood as opposed to achievement, and that which makes persons from conventional Hispanic civilization to feel at ease amid north American-type professionalism that accords respect based on a person’s possession of particular skills and devaluation of persons with darker skin and according of more value to social standing (Amoko, 2000, 376)Viewpoints regarding disability among Hispanics are prejudiced by convictions regarding the interaction of spiritual and physical realms. Families, acting as very influential support organizations, regard certain situations as being only reflections of personal differences as opposed to disability. They thus adapt work and family roles in order to put up with such differences (Anderson, 2004, 346). Nevertheless, extreme disability, particularly developmental types, is regarded as a shame within traditional Hispanic families.Numerous conventional families, despite the fact that they could look for aid from conventional health structures, also could look for assistance from traditional healers and clergy members. However, acculturated, urbanized Hispanics do not exhibit much utilization of traditional healers’ services. A 1991 survey involving seventy five Mexican women revealed that 97% were conversant with traditional healing and in excess of 50% had already been subjected to folk healing (Dernbach, 2005, 503).Thus, for numerous Mexican Americans, traditional medical services as well as folk therapy are crucial, with each tackling various requirements in various ways. The Asian American group is very difficult to explain owing to huge racial disparities among groupings and disparities regarding language, culture and religion. It comprises close to 5 percent of the American population. However, certain commonalities exhibit themselves because the core of eastern civilizations is harmony and collectivity.Such cultures exhibit characteristics such as: social regulation; harmony; regulations regarding propriety; benevolence; filial faithfulness; cooperation; loyalty; obligation and reciprocity. Such qualities exist in a structure of arranged relationships and roles which focus on interdependence and subordination. A conviction regarding the preeminence of the collective harmony over the individual is further exhibited in respect to history (Amoko, 2000, 382). American having Chinese lineage exhibit high levels of social harmony (collectivism) as opposed to individualism portrayed within mainstream USA culture.Such concern for harmony-within-hierarchy borrows heavily from Confucian ideology and usually persists to influence American with Chinese lineage. Such preoccupation with conventional Chinese culture regarding operation in structured and well-defined social linkages could result to certain Chinese Americans expecting similar well-defined system and function within a counseling (rehabilitation) relationship (Simon-Klutz, 2002 , 284). The client-oriented viewpoint employed by numerous USA rehabilitation therapists could be regarded as too ambiguous by clients of Chinese descent.Pacific civilization exhibits cultural observations like observing humility, respect, family involvement and choice and being and living with ones family. Conventional pacific Culture reveres family life plus the safeguarding of family respect. For instance, within conventional Samoan traditions, individuals are conferred identity only if they can illustrate their relationships to â€Å"alga† or the extended family (Tamase, 2007, 472). Individual requirements, eccentricities and objectives should be suppressed to benefit the family grouping.Within Samoa as well as in the greater Pacific region, strong restraints against exposure of family issues to outside parties exist. The language used among American Samoans originates from the Austronesian linguistic family. The subgroups are Tuvalu, Tokelu and Samoan. Residents of Ameri can Samoa speak both English and Samoan languages. Symbolism among Samoans exists in from of ‘the Samoan way† or ‘fa’samoa’. This includes beliefs, traditions and attitudes symbolizing a world viewpoint explaining suitable way of life, common through out the archipelago (Anderson, 2004, 349).Ancient Samoans cultivated taro and yams, kept chickens, dogs and pigs and practiced lapita pottery. They sailed using double-hulled sea vessels. Under United States navy government, Samoan culture was preserved when it was not counter to us regulations. Hereditary and talking chiefs had permission to continue assemblage forms to handle local politics. Up to the 1900s, Samoans practiced rural lifestyles and this still is the case within many villages out of Pago Pago Bay and outlying isles. Urbanization has been slightly attained near the airfield and Pago Pago bay.Up to the 1950s, ‘fale’ or traditional homes consisted of elliptical structures having corral pebble floors plus round wood prop underneath a beehive-like roof enveloped by sugarcane leaves thatch. Such open residences promoted contact with members of the public and offered little privacy (Esbenshade, 2004, 351). Many households had a sleeping plus a cooking house of smaller size located at the rear, several owned guest houses for hosting visitors. Starting in the 1970s, construction of ‘hurricane’ concrete houses having corrugated metallic roofs has been encouraged by the American administration to reduce tempest damage.Such rectangular houses exhibit increased privacy since they have windows, doors, and at times room dividers. Houses may also be constructed from brick or wood (Amoko, 2000, 385). Traditional homes had minimal furnishings consisting only of sleeping and sitting mats however, contemporary houses exhibit full furnishing with most having telephones and television. Parliamentary structures are of the conventional elliptical shape, as well as community school structures, sections of the airfield terminal and the growers market.Several business buildings at present depict American building designs. Staple foodstuffs in American Samoa include breadfruit, taro, coconuts, bananas, mangoes, papayas, chicken, canned corned beef, seafood and pork. Occasional foods include potatoes, onions, lettuce, carrots, cabbages, tomatoes and beans. Mostly foodstuffs found within us markets are in stock in supermarkets (Anderson, 2004, 356). Long ago, food was eaten during the mid-morning plus early dusk. Food gets cooked although it could be eaten raw. Majority of families sat on mats down on the ground in the traditional times.Guests and elders get served initially and children and women eat last. Owing to changing work cycle, now families have three mealtimes per day. Majority of Tutuila restaurants concentrate on American plus other alien foods, however several present more conventional Samoan foodstuffs (Pincheon, 2000, 277). Foods dis hed up during ceremonial functions include: entire pigs plus daily fare; potato salad; puddings; palusami; chop suey; ice cream and cakes. A lot of food is prepared and served during special occasions as guest may carry home excess servings.Kava, which is a slightly narcotic, none-alcoholic drink, is given to chiefs during ceremonial events. Majority of land is possessed by Samoans except for a little church and government owned land. Traditional communal land ownership was done through ‘aiga’ and was governed by ‘matai’ and this remains the case up to now. Several whites who were spouses to women from Samoa obtained land ownership prior to the 1930s at the time land selling was prohibited by the USA navy (Esbenshade, 2004, 351). Personal land buying is currently allowed only fro individuals having a minimum of 50% Samoan ancestry.Majority of business is related to trading in imported commodities and the American dollar is the exchange medium. Eating places are the most popular retail business ventures followed by grocery shops especially little family-operated general shops. Fish handling and canning is the biggest industry. Tuna is canned and exported to the USA. Age is crucial in determining work functions; young people undertake strenuous undertakings and elderly persons have more inactive, educational and supervisory roles. Children responsibilities are bases in the household while older and middle-aged people assume leadership functions.Formerly a number of persons possess special skills regarding making traditional houses and boats, medicine and fishing (Dernbach, 2005, 511). No real class systems exist within American Samoa. The titles of chiefs are classified to some extent on the basis of ancient traditions. Such titles are reserved to particular families, called ‘aiga’; however, a number of them are positioned higher and get more respect compared to others. Such ranking is basically important ceremonially becau se it decides membership to the ‘village council’ or ‘fono’ and the order of serving kava, however everyone gets a speaking opportunity (Azoulay, 1999, 369).Any man can vie to become a â€Å"matai, because titles get obtained through democratic elections held by the â€Å"aiga†. Prior to adoption of currency economic systems, men performed strenuous agriculture, house building and fishing. Young males prepared most of normal meals and cooked during ceremonial occasions. Women’ chores included weaving mats, sewing, child nurturing, laundry and afterwards preparing meals using contemporary appliances. Majority of such traditional chores persist to date, however, fresh alternatives are significant.Women and men currently work within banks, tuna factories, stores, schools and tourist ventures. Men are employed in transportation, construction, government organizations and shipping. Historically, men have dominated Samoan society with women exertin g much behind-the-scenes authority authoritative and professional posts are mostly held by males, however females occupy significant positions within government organizations and sometimes act as â€Å"matai† (Simon-Klutz, 2002, 282). The youth select wedding partners; however marriage remains basically a financial alliance joining families.Previously, chiefs’ children intermarried, while those having lower statuses usually eloped. Individuals may not marry or date close relatives. Almost all persons marry, often during mid towards late 20s, and marriages involve intricate exchange of gifts by two family units. Divorce cases are uncommon; however remarriages among the youth are quite common. Households average 7 persons consisting of a single or additional nuclear family units plus relatives. They involve 3 generations and exhibits flexibility as regards composition. Members are linked by blood, adoption and marriage.Following marriage, reside at the groom’s or bride’s household. Each household is led by a ‘matai’. All economic and social activities are governed by ‘matai’ (Anderson, 2004, 350). The biggest kin grouping remains ‘aiga’ that involves every person having a shared ancestor. Such extensive family could have family units in various sections of the village or within a number of villages. Such households’ matai exert different authority levels in the ‘aiga’. Matai resolves family disputes and decides regarding fiscal contributions of a family to funerals, church gifts and weddings.The complete aiga primarily intermingles during funerals, weddings, elections plus matai installation and emergencies within families (http://www. everyculture. com/A-Bo/American-Samoa. html). Infants are accorded much attention and affection and are carried or held in the initial year. Household usually have grandmothers who often act as key babysitters. Usually young kids are overseen by grandmothers or other household females and usually by elder siblings. Respect and reverence for authority and age are instilled from early ages.Educational programs for nursery kids plus universal community school schooling is in place. America Samoans exhibit meticulousness regarding courtesy, especially to chiefs and elderly persons. It is not proper to stand up when other people are sitting. In case an individual gets into a room and finds other persons seated on the ground, they ought to slightly bend and utter â€Å"tulouna† or ‘excuse me’. Respectful terms are employed when holding discussions with chiefs. Etiquette plus reciprocal politeness are used during political and ceremonial events.Prior to influx of missionaries by 1830, the maker of the isles plus the people therein was taken to be Tagaloa and religious headship from families was provided by matai (Tamase, 2007, 475). Initial missionaries were from the London Missionary Society and they establis hed the congregation of Christian Church of American Samoa to which 5% of Samoans belong. The Catholic Church has 20% of Samoan followers while the other 30% is taken by Methodist, Pentecostal and Mormon denominations. Western rites are involved during church proceedings with vocal music being a vital element.Devotion of fresh churches has supreme significance and vocal competitions and feasts mark it. Visitors from the USA and close by islands come for such celebrations. Death is regarded as the will of God and the customary conviction that when one dies at a far away location from their residence such person’s spirits trouble survivors continues. Up to the 1980s, funeral services were held one day after one died. Introduction of morgue services permits delayed interment to cater for elatives abroad. During burials, the deceased family is offered gifts.Interment happens on relations’ land (Dernbach, 2005, 515). April 17th Flag Day is marked by activities like customar y grouping singing and dancing, cricket matches, canoe races and speeches. This commemorates the time when the Samoan isles became part of the USA in 1900. Oratory remains a vital custom, and numerous mythology, poetry and legends have survived owing to usage by talking chiefs during village committee deliberation as well as during ceremonial events (http://www. ncddr. org/products/researchexchange/v04n01/cultures. html).The people of Samoa treasure bark cloth wall-hangings (siapo) plus finemats and regard them as family possessions for exchanging during ceremonial events. Finemat and siapo production increasingly is becoming rare. Formerly having tattoos was a prerequisite for being admitted into aumage or qualification fro the title of ac chief. Such art was outlawed within American Samoa a long time ago. However, fresh interest recently draws young males to previously Western Samoa to have the intricate knee-to-upper-abdomen tattoos done on them.Dancing and singing in groups rema in popular forms of art. Huge women or men dancing groups perform unified movements characterized by body and hand claps. Village ritual princesses (taupou) perform Solo dances at times accompanied by men prop dancers (http://www. everyculture. com/A-Bo/American-Samoa. html). The ‘face’ notion, originating from Confucian ideology, among traditional Pacific and Asian Americans makes people’s belief that â€Å"losing face† owing to mental diseases within families could subject families or the person to spiritual or religious crisis.Asians exhibit the least optimistic attitudes towards disabled persons. Numerous Asian Americans are convinced that metaphysical or supernatural forces have a function in disease and health and in misfortune and fortune (Anderson, 2004, 357). Such convictions greatly influence perceptions regarding reasons for disability, therapy of such disability and guilt feelings and shame or responsibility related to having a disabled family member. Conventional Asian Pacific citizens usually source for assistance from sources different from, or on top of, western rehabilitation or medical system.Families will usually desire to seek customary Asian therapies, like herbal medication, or perform particular actions with a view to restoring the equilibrium of the natural world. Asian Americans depend more upon casual social associations as compared to other minorities. American Indians comprise of in excess of five hundred tribal groupings that exhibit great diversity within. Majority of conventional Indian dialects have no word for disabled, handicapped or retarded. Instead of utilizing such classifications, phrases regarding persons descriptive of disabilities, for instance, â€Å"one-who-walks-with-a-limp† or â€Å"one-arm,† may be assigned.Convictions regarding spirit and body interrelatedness contrasts with mainstream belief systems. Strongly traditional American Indians could source for assistance form t raditional healers and also the typical rehabilitation and medical systems (http://www. ncddr. org/products/researchexchange/v04n01/cultures. html). Paradigm modifications happen within all disciplines as technology or knowledge advances. Key shifts within such cultural models are comprehensive, rare and significantly impact on cultural, social as well as political precedence within society.Industrial revolution’s second stage resulted to contemporary society which is characterized by capitalism, humanist principles, political democratic systems, Newton’s physics and transcendental romanticism. Contemporary regimes witnessed the appearance of bourgeoisie, contemporary art plus the conviction that it is possible to understand the earth by applying reason. Modern age also incorporated cultural, economic and political policies on the basis of freedom and equality ideals and progress. Postmodernism’s arrival within the 1960s led to slight alterations within contempo rary society.Despite the fact that postmodernism dislodged occidental theories plus numerous other ideals related to the contemporary period, it failed to offer the momentum needed to restructure society. This impetus required some circumstances which exposed social injustices prevailed within existing economic and political systems and at the same time offer alternative solutions (Anderson, 2004, 359). America has ceased to be a â€Å"melting point† because it does not incorporate minorities within majority cultures. Currently, there exists diverse pluralism of culture developed by way of acculturation.Such pluralism is described in regard to minorities’ liberties relative to prevailing culture. Minorities contribute within majority cultures while disregarding the threat of losing their sub-culture uniqueness. Racial minorities, religious groupings, and philosophical subcultures exist side by side and stand other groups’ customs. A non-hierarchical democratic p luralism supported through communication expertise is substituting the prevailing culture. The notion of regarding product utilization as being an end is dying away and focus is directed locally.The majority has discarded its fixation upon consumerism to embrace fresh attention to friends, family plus social groupings having comparable interests. Owing to divisions emanating from cultural wars and facing economic stagnation, the majority culture started self-realignment on the basis of sub-cultural schemes that offer belonging and equality (Amoko, 2000, 388). While America is enduring economic woes, fresh social systems are developing within the debris offered by disenfranchised cultures.Majority cultures are experiencing transition from a community of financial classes, credit expenditure and consumer principles to an extra group-centered society. Such shift involves change from getting cultural significance out of purchasing and possessing media-produced patterns’ consumer commodities, to promoting an extra individualized participatory and personality culture. Such change of priorities emancipates a stressed community and offers a feeling of dignity and authority to society (http://www.culturewars. org. uk/index. php/site/article/changing_cultural_paradigm/). The principal culture has ditched the business sponsored political programs, because of the wickedness within oppressive economic and social policies and also owing to the absence of prestige and gratification exhibited by buyer indulgence within the financial crisis. While the principal culture was losing confidence within consumer principles, the pluralism of culture metamorphosed to become pluralism free of hierarchies.Within such fresh systems, privileges and rights existent within a democracy get expressed within society with no oppression to lower castes. This seems to be a result of free market financial systems having their majority cultures being hierarchically- arranged. The divisions g enerated through culture wars merged the diverse and vast multicultural system of hyphenated citizens and subcultures to form a political grouping united through democratic principles, humanitarian standards, and the requirement to make the playing arena even.Pluralism, which necessarily is not liberal owing to its incorporation of every political viewpoint, also existed alongside the cultural war. Such a multicultural grouping became prominent when consumerism faded away from the principal culture, and assumed the role of acting as a representation of the fresh social arrangement (http://www. culturewars. org. uk/index. php/site/article/changing_cultural_paradigm/). Works cited Amoko, Apollo O. Resilient Imaginations: No-no Boy, Obasan and the Limits of Minority Discourse. Mosaic, vol.33. 2000; pp. 375-390 Anderson, Crystal S. Racial Discourse and Black-Japanese Dynamics in Ishmael Reed’s Japanese by Spring. MELUS, vol. 29, 2004; pp. 345-360 Azoulay, Katya Gibel. The New Col ored People: The Mixed-race Movement in America. African American Review, vol. 33. 1999; pp. 360-374. Crank, R ip. (April 17th 2009). Culture Wars. Changing Cultural Paradigm. Retrieved on 5th may 2009 from http://www. culturewars. org. uk/index. php/site/article/changing_cultural_paradigm/ Culture of American Samoa Forum. (2007).Culture of American Samoa History and Ethnic Relations, Urbanism, Architecture, and the Use of . retrieved on 5th may 2009 from http://www. everyculture. com/A-Bo/American-Samoa. html Dernbach, Katherine Boris. Spirits of the Hereafter: Death, Funeral Procession, and the Hereafter in Chuuk, Micronesia. Ethnology, vol. 44, 2005; pp. 502-517 Esbenshade, Jill. Codes of Conduct: Challenges and Opportunities for Workers Rights. Social Justice, vol. 31, 2004; pp. 340-355. Pincheon, Bill. â€Å"A Deeper Territory†; Race, Gender, Historical Narrative and the Recorded Field Blues.The Western Journal of Black Studies, vol. 24, 2000; pp. 270-283. Simon-Klutz, L ufuata. On Being Samoan, on Being Woman (E Au Pea Ina’ilau a Tama’itai) (1). Frontier- A Journal of Women’s Studies, vol. 23, 2002; pp. 275-291. Southwest Educational Development Laboratory. (2004). Descriptions of Ethnic Cultures in the United States. Vol. 4, no. 1. Retrieved on 5th may 2009 from http://www. ncddr. org/products/researchexchange/v04n01/cultures. html Tamase, Tui Atua Tupua. In Search of Tagaloa, Samoan Mythology and Science. Archaeology in Oceania, vol. 42, 2007; pp. 462-478.

Htc Corp 2009

Question 2: How should HTC pursue growth? HTC was facing a couple of strategic challenges. First of all, there was an intense rivalry in the market. HTC was facing intense competition from big players such as Nokia, Samsung, LG and Apple. These companies had a couple of advantages over HTC. Because these companies could enjoy from economies of scale, they were able to deliver well-designed phones at attractive prices. Next to the cost advantage, some of the competitors held numerous patents and intellectual property licenses in contrast to HTC.Moreover, these competitors had obtained a higher brand value due to their marketing activities and reputation. Nokia, for example, had been the world’s number one mobile phone company for more than a decade, with the world’s fifth most valued brand. The brand HTC was still relatively unknown. Second, due to the global recession in 2009 network operators were tightening their inventory levels and became more selective in their pro duct offerings, especially in terms of identifying which phones they believed were worthy of providing a substantial subsidy.This in combination with the price ceiling Apple had created (80% of U. S. consumers wanted a phone that cost less than $200), made HTC, especially for its success in the U. S. ‘locked’ maket, very dependent on the operators’ willingness to subsidize its products and offer co-marketing support. There were also some opportunities in the mobile phone market. First, despite the onset of a global recession in 2009, smartphones were expected to grow while the overall cell phone market shrank.Market research firm eMarketer predicted that by 2013 smartphones would represent a third of the world’s mobile phone market, and that mobile Internet penetration would more than double to nearly 30% in 2012 from 13% in 2007. Second, China had recently opened up its doors to 3G networks and was offering great potential for smartphones as only 5% of th e Chinese mobile phone market consisted of smartphones at the time. We recommend that HTC should focus on delivering innovative, cutting-edge smartphones at an attractive price for the ‘prosumer’ market.As CMO Wang put it, the focus of HTC is to ‘build a reputation of making the BMW of phones, slightly more expensive but still affordable, the ‘better’ product. ’ In this way, HTC’s products should stay attractive for network operators to provide subsidies. With its strengths (especially the Silicon Valley-like culture, the short development cycle and experience in cutting-edge smartphone hardware design) and strong focus on R&D, HTC should pursue growth through innovation. At the basis of a strategic focus lies a value discipline. The concept of value disciplines is proposed by Treacy and Wiersema (1993).HTC should focus on the value discipline of product leadership where a product leader focuses on offering leading-edge products and serv ices to customers that consistently enhance the customer’s use or application of the product, thereby making rivals’ goods obsolete (Treacy & Wiersema; 1993). HTC has to be creative and open-minded to new ideas and be quick in commercializing them. To overcome the strategic challenges it’s crucial for HTC to lower average sale price (ASP). In order to lower ASP, HTC should increase the portion of common components in the product portfolio and pursue economies of scale.To obtain economies of scale rapid penetration of the Chinese phone market it essential. A faster, more aggressive brand-promotion approach to heighten brand awareness is needed. HTC should continue using the Android platform as it has a high growth potential and utilizes no licensing fee. As production increases, HTC should keep on moving manufacturing to mainland China to reduce production costs, but the main production facility should stay in Taiwan. In time, HTC could consider manufacturing low -end smartphones in their production facilities in China. A sub-branding strategy should then be used.

THE DREAM ACT Free Essay Example, 1000 words

However, with the Obama administration’s change in policy, they will get the opportunity to discover their full potential as future doctors, teachers, and entrepreneurs, among other professions, who would greatly benefit the American economy. According to the â€Å"Congressional Record† (1026) proponents of the DREAM Act state that it would contribute to the military’s enrollment efforts and preparedness because it would expand the recruiting group to the benefit of the American military. Furthermore, it would make America more competitive in the global economy because the young people who would be the beneficiaries of this Act would be able to live up to their fullest potential. They would also contribute a great deal to America’s efforts to have the highest number of graduates in the globe by the year 2020, which is something very important if America is to remain in the increasingly competitive international economy. Moreover, the immigration and borde r security experts will be able to focus on those who pose a serious threat to the security of America because this legislation provides a firm but fair way of dealing with innocent children brought to America at a young age so that the Department of Homeland Security can dedicate more of its resources to detaining and deporting criminals and those who pose a threat to America. We will write a custom essay sample on THE DREAM ACT or any topic specifically for you Only $17.96 $11.86/page This claim is not true because those involved in the process of naturalization will not be able to petition for their relatives until such a time as they have met all the requirements stated in the DREAM Act, and this is not a guarantee. The opponents of this legislation further claim that it would result in the use of taxpayer’s money being use to subsidize student loans and grants for those who are registered through the DREAM Act. This claim has also been found to be untrue because those registered under this act will not be eligible for any federal funding towards their studies.