Differences Between Pediatric and Adult Patients

Differences Between Pediatric and Adult Patients Sabrija Cerimovic Introduction The primary focus of this essay will be based upon the unique anatomical and physiological differences between a pediatric patient and an adult one, and how these differences may affect the treatment and/or presentation of a child in a pre-hospital environment. Furthermore, this essay will include and explore how these differences can affect the A-E assessment most importantly the underlying airway and breathing differences. Although one may think that treating a child is the as treating a grown adult, it is not. They differ in weight, shape, anatomical size and major bodily systems such as cardiovascular and respiratory. Similarly another aspect to consider is that children are often psychologically different to adults in many ways. For example, in interpreting pain; all which play a critical part in providing the best care for the patient. One of the biggest priorities and challenges when it comes to treatment as a paramedic is being able to maintain and control the airway of the individual regardless if its pediatrics or not, due to the anatomical challenges that are more prevalent in pediatric patients. Therefore, it is essential to understand and recognize these differences as they will have a direct impact towards the treatment/management of the patient. Respiratory failure is a frequent cause of cardiac arrest in children, regardless if it’s pre-hospital or not, consequently being able to r ecognize early respiratory compromise from airway obstruction is critical to prevent respiratory failure thus reducing the chance of cardiac arrest. The goal of airway management is to predict and recognize potential respiratory compromise and to provide support and stabilization of the airway in a timely manner. (Derek, 2007) Young infants/children have a relatively large occiput (back of skull); which when lying supine on a flat surface results in neck flexion and potential airway obstruction. Even a small degree of obstruction can significantly affect the pediatric patient’s oxygenation and ventilation (Seid, 2012). Along with this, neonates naturally breathe through their nose for the first 6 months, thus their narrow nasal passages are easily blocked by secretions or congestion and can be damaged by treatment methods such as a nasogastric tube (Macfarlane). Furthermore, pediatric patients have a smaller internal diameter when it comes to the upper and lower airways which in return predispose children to have a higher airway resistance. An example of this is described by Ponselle’s law where it is explained that if the radius is decreased by half the resistance is increased by sixteen times, this in its self is an example of how delicate the pediatric airway/breathing system is, where mild airway obstruction or even inflammation can present moderate or severe respiratory distress. (Weathers, 2010) Infants are largely reliant on a functional diaphragm for proper ventilation as opposed to the accessory muscles compared to adults which depend more on accessory muscles than infants. Therefore, a non-functional diaphragm often leads to respiratory failure.Additionally, the probability of respiratory difficulties in infants and younger children can be attributed due to infants having a relatively lower percentage of type 1 muscle fibers or slow-twitch skeletal muscle in their intercostal muscles and diaphragm; these fibers are much more unlikely to fatigue. (Santillanes, 2008) The position of the larynx can play a vital role of visualization of the airway, compared to the larynx of an adult which sits between 6th -7th cervical cerebrate. A young child’s larynx sits higher than an adults around the 2nd–3rd cervical veritable, making intubation much more difficult compared to an adult. (Adewale, 2010) Breathing differences not only vary between adults and young children but can vary greatly between different age groups of children. This is presented by the following example where the breathing rate for an infant of 1-3 years old can be between 30 to 60 breaths per minute compared to an adolescence teenager who has a breathing rate close to adult’s 12-16 breaths per minute (Anatomical and Physiological Differences in Children, 2012). Furthermore children have a much higher metabolic rate compared to adults, by body surface area children have much higher oxygen consumption in relation to their body size which can result in rapid hypoxia if respiratory distress is present. Pediatric patients breathing can account for up to 40% of the cardiac output, particularly in stressed conditions (Kache, 2013). Along with this smaller children are also at risk of developing acute hypoglycemia due to their livers being unable to store glycogen and usually have a reduced supply of glucose, coupled with the fact that the metabolic rate is typically higher in children puts the children in a much higher risk of hypoglycemic. Compared to adults and older children, infants produce approximately twice as much carbon dioxide and consume twice the amount of oxygen relative to body weight.(Davey, 2012) In some situations the simplest factors can be over looked if you are not aware of the differences between adults and pediatrics. For exa mple, pediatrics patients can develop hypothermia much easier compared to their adult counterparts due to pediatric bodies having a surface area to volume ratio four times higher than adults and only one and a half times heat production compared to adults. This difference in ratio can leave children much more predisposed to hypothermia. Pediatric patients may have not fully developed the muscular system to deal with this drop in temperature, such as having the ability to shiver or vasoconstriction which is essential to produce muscular heat in such a situation. Furthermore children have smaller amounts of adipose tissue stored which is essential for insulation which results in the core body temperature dropping further.Interesting anatomical difference in children is that the head is comparably larger than the rest of the body and tend to balance out around the type of adolescence; this in return causes an unbalanced weight distribution between the body and the head, which can cause the head to act as a projectile and due to the larger head its prone to head larger head loss (Pediatric Assesment, 2012). Conclusion When it comes to the presentation of a pediatric patient in comparison to an adult patient, it is essential to be able to differ between the two. Although more can be said about the anatomical and physiological differences and how these affect further treatment, it is quite clear from a paramedic point of view that just from the airway and breathing aspect that pediatric patients are not like miniature adults. References Anatomical and Physiological Differences in Children. (2012). Retrieved 4 1, 2014, from Emergency Medical Paramedic: http://www.emergencymedicalparamedic.com/anatomical-and-physiological-differences-in-children/ Pediatric Assesment. (2012). Retrieved March 30, 2014, from Long Beach Regional Fire Training Center: http://www.lbfdtraining.com/Pages/emt/sectiond/pediatricassessment.html Adewale, D. L. (2010). Anatomical Considerations of the Paedatircs Airway. Retrieved 4 1, 2014, from Europian Society for PAediatric Anaesthesiolgy: http://www.euroespa.org/klant_uploads/berlinlectures/ANATOMICAL CONSIDERATIONS OF THE PAEDIATRIC AIRWAY.pdf Davey, A. J. (2012). Wards Anaesthetic Equipment. Elsevier. Derek, S. (2007). Pediatric Critical Care Medicine: Basic Science And Clinical Evidence. Springer. Kache, S. (2013). Pediatric Airway Respiratory Physiology. Retrieved 3 28, 2014, from Standford School of Medicine: http://peds.stanford.edu/Rotations/picu/pdfs/10_Peds_Airway.pdf Krost, W. (2006). Beyond the Basics: Pediatric Assessment. Retrieved March 30, 2014, from EMS World: http://www.emsworld.com/article/10322897/beyond-the-basics-pediatric-assessment?page=2 Macfarlane, F. (n.d.). Paediatric Anatomy and PHysiology and the Basic of Paediatic Anaesthesia. Retrieved 4 1, 2014, from Anaesthesia UK: http://www.anaesthesiauk.com/documents/paedsphysiol.pdf Santillanes, G. (2008). Pediatric Airway Managment. Retrieved 4 1, 2014, from Departments of Emergency Medicine and Pediatrics,: http://blog.utp.edu.co/maternoinfantil/files/2010/08/V%C3%ADa-a%C3%A9rea-en-pediatr%C3%ADa.pdf Seid, T. (2012). Pre–hospital care of pediatric patients with trauma. International Journal of Critical Illness and Injury Science, 1-2. Weathers, E. (2010). The Anatomy of the Pediactic Airway. Retrieved 4 1, 2014, from Respiratory Care Educational Consulting Service, Inc: http://www.rcecs.com/MyCE/PDFDocs/course/V7110.pdf

Child abuse/child protection and welfare: Client needs

Child abuse/child protection and welfare: Client needs Child abuse/child protection and welfare: The client needs and the role of the social care practitioner in responding to those needs. Many countries in the developed world, including Ireland, have seen a significant shift in attitudes to what constitutes as child abuse. Society has become more knowledgeable about different types of child abuse and about the impact the abuse can have on the child throughout their lives. The child’s needs and the role of the social care practitioner will be the main focus of the essay. The essay will discuss the needs of a child who has suffered abuse and propose an intervention to address the importance of care for the child and education for the carer. The role of the Social care practitioner in relation to child abuse will also be a central part of this discussion. Types of child abuse include emotional abuse, neglect, physical abuse and sexual abuse. However, this essay will focus mainly on emotional and physical abuse. Suggestions on interventions will be put forth as the different types of child abuse are being discussed. Relevant policies and guidelines will be discusse d in regards to how these policies have helped children by giving them rights whilst also giving them hope for a better future. Child abuse can be defined as ‘any act of commission or omission which deprives children of equal rights and liberties and/ or interferes with their optimal development’ Gil 1975 (cited in Daniel and Ivatts 1998, p.196). The above definition accords with the spirit of Article 19 of the United Nations Convention on the rights of the child which states that it is the duty of the state to safeguard children from all types of abuse and neglect, to give ‘support to those who have been abused and to investigate instances of abuse’(Children’s Rights Alliance 2013). However, it can be difficult to give a precise or exact definition of child abuse because there are many different types of child abuse. Some types, such as physical abuse can be much more noticeable but may not have the same impact on the child as emotional abuse. Bensley et al (2004) argues that if a parent calls their child stupid and belittles them on a regular basis, the child will start perc eiving these comments to be true, and will carry them into their teens and adulthood. Children’s First, the national guidance that promotes the protection of children from abuse and neglect, describe emotional abuse as generally to be established in the ‘relationship between a parent or guardian and a child rather than in a specific event or pattern of events’. It arises when a child’s need for love, support, stability and security are not met (Children’s First 2011 p.8) Social care practitioners work closely with the child, their family and other professionals to ensure the child’s needs are being met. Social care practitioners should possess a wide range of personal and professional attributes. A health or social care profession is any profession in which a person exercises skill or judgment relating to the preservation or improvement of the health or wellbeing of others, the diagnosis, treatment or care of those who are injured, sick, disabled or infirm, the resolution, through guidance, counselling or otherwise, of personal, social or psychological problems. (Health and Social Care Act 2005, p.09) Professional attributes of a social care practitioner should include a comprehensive awareness of the social care field, to be able to work on their own initiative, and as part of a team, research skills and problem solving. On a personal level, social care practitioners should be open-minded, reliable, trustworthy, and empathetic and compassionate (Lalor and Share, 2013). Social care practitioners might find it more difficult to recognise and substantiate emotional neglect or abuse as there are no physical injuries or abrasions (Nauert 2014). Evaluation of what is occurring to a child ‘requires that each aspect of a child’s developmental progress is examined, in the context of the child’s age and stage of development’ (Department of Health 2000, p.18). By doing an assessment wheel or triangle with the child, the practitioner will get a good sense of the child, which involves more than just factual data (Buckley et al 2006 p. 40). The assessment process is designed by way of three concurrent activities and five steps. The three concurrent activities are Engaging, Safeguarding and collaborating and the five steps are Responding, Protecting, Devising, Gathering Reflecting and Sharing/analysing/planning. The child is at the spiral in the middle. See Appendix A for diagram of The Assessment Wheel and Triangle. The aim is to deli ver a consistent and organised way of collecting, recording, studying and figuring out the information required to inform ‘effective and appropriate levels of child protection and welfare interventions’ (Buckley et al 2006 p.10). Such as with Bronfenbrenner’s ecological systems theory 1969. The theory states that that we come across diverse environments during our life that can affect our behaviour in various ways. The different environments include the ‘micro system, the mesosystem, the exosystem, the macro system, and the chronosystem’ (Mae Sincero 2012). Yet, child abuse can be hidden from professionals and the outside world for many years before the child in need is discovered. One of the most famous cases of severe and wilful neglect is the case of Genie Wiley. For the first thirteen years of her life, Genie was kept locked in a small room, naked and quite often tied to a potty. Her family rarely spoke to her and the times that her father did communicate with her it was through barking and growling (Rymer 1994 p.46). She was discovered by a nurse when her mother brought her to the doctors at age thirteen. The nurse believed her to be no more than seven years old. Rymer (1994) stated that extreme neglect and physical abuse had prevented Genie from developing cognitively and physically. See appendix B for the indicators of neglect from the Tusla’s practice handbook. One of the roles of the social care practitioner in cases of child emotional abuse or neglect is to be vigilant and look out for signs as noted in appendix B and to contact the necessary authorities. The main emphasis and concern of any enquiry into the emotional abuse or neglect of a chil d is the child (Platt and Shemmings 1997). Under the Child Care Act 1991, the HSE has certain statutory obligations for the protection and welfare of children such as taking the appropriate action to promote the welfare of the child (Children’s First 2011 p.19). When carers show kindness, love and affection in meeting the child’s needs, they support the child to develop into a ‘stable, caring, healthy and independent’ adult (LaMeaux 2014). As with neglect and emotional abuse of a child, physical abuse can have a detrimental effect on a child. Physical abuse can be described as someone intentionally injuring or hurting a child and it can cover an assortment of negative behaviours such as smacking, shaking, repeatedly hitting, burning, cutting and the suffocation of a child (Beaver et al 1999, p. 207). Citizens Information (2014) describe physical abuse as any injury inflicted on a child due to the ‘deliberate failure of the child’s carer to protect the child’. Over the years, many Irish people have heard and read the harrowing stories and reports on the physical abuse perpetrated on countless children at the hands of their â€Å"so called† carers in Irish industrial schools. One of the major reports is the Ryan Report. The Ryan Report (2009) is an inquiry into the abuse in which children in the industrial schools in Ireland suffered while under state supervision. The litany of terrible wrongs inflicted on our children, who were placed by the State in residential institutions run by religious orders, was collated by the Commission and presented for Ireland and the world to read. The healing process involves listening to, understanding and consulting with survivors on how the wrongs of the past can be addressed and how their needs can be catered for into the future. (Report of the Commission to Inquire into Child Abuse, 2009 p.9) The Ryan report, brought light to the severe physical, emotional and sexual abuse of many children. Following the report, the state was pressured to draw up a plan with the articulated aim of replying to all of the 20 separate recommendations, outlined in the Ryan Report, which were grouped into six categories. This plan also brought about the implementation of the Children’s First guidelines (Ryan 2009) (See Appendix C for the full 20 recommendations and six categories). In light of these recommendations, policies and procedures such as garda vetting and reviews into serious incidences have been implemented. However, it is not just industrial schools and services that have caused major concern, for social care practitioners regarding child abuse. Child abuse can happen in any part of society and, rich, poor or whatever the family circumstance, any child may be subjected to the awfulness of child abuse (Childline 2015). This can have a detrimental effect on the child throughout their lifespan if not dealt with or handled appropriately. Abraham Maslow’s hierarchy of needs theory shows that if one’s physiological needs such as food, shelter and clothing are not being met they cannot reach their safety needs such health and family security or reach a sense of belongingness (Gawel 1997). See Appendix D for Maslow’s hierarchy of needs triangle. According to Maslow (1970 p.38) a person’s most important need is the lowermost unmet need in the pyramid. The assessment triangle analyses the child’s condition and state of affairs and gives the social care practitioner a good and informed plan of action to safeguard the best outcome for the child (Department of Health 2000). To conclude, as mentioned above, the impact of neglect, emotional abuse and physical abuse can have a harmful and damaging effect on a child. The aim of the essay was to outline the client needs and the role of the social care practitioner in responding to these needs in cases of child abuse. â€Å"Childhood should be carefree, playing in the sun; not living a nightmare in the darkness of the soul† (Pelzer 1995 p.98). Children need love, support and affection to grow to be confident and happy adults. In an ideal world, all parents and caregivers would give this love and support to the child in order for the child to grow contently. However, in reality many children face unwarranted hardships on a daily basis, through no fault of their own. It is our role as social care practitioners to help and support these children who need help, so they can be assured a deserved brighter future. REFERENCE LIST Nauert, R. (2014). For Kids, Mental Abuse Can Be Worse than Sexual, Physical Abuse. Psych Central. Retrieved on February 16, 2015, from http://psychcentral.com/news/2014/10/09/for-kids-mental-abuse-can-be-worse-than-sexual-physical-abuse/75945.html [accessed 16 Feb. 15] Daniel, P. and Ivatts, J. (1998) Children and Social Policy, London: Palgrave Children’s First (2011) National Guidance for the protection and welfare of children [online] available: http://www.dcya.gov.ie/documents/Publications/ChildrenFirst.pdf [accessed 16 Feb. 15] Rymer, R. (1994) Genie: A scientific tragedy, New York: Harper Collins Health Service Executive 2011) Child protection and welfare Practice handbook, pp19-21, [Online] available: http://www.tusla.ie/uploads/content/CF_WelfarePracticehandbook.pdf [accessed 17 Feb. 15] LaMeaux, E.C. (2014) ‘5 Needs your child must have met at home’, Gaiam Life: Your Guide to Better Living. [Online] available: http://life.gaiam.com/article/5-needs-your-child-must-have-met-home [accessed 17 Feb. 15] Beaver, M., Brewster, J., Jones, P., Keene, A., Neaums, S. and Tallack J. (1999) Babies and Young Children: Early years care and education, Cheltenham: Stanley Thornes Citizens Information (2014) Child Abuse: What is child abuse? [Online] available: http://www.citizensinformation.ie/en/birth_family_relationships/services_and_supports_for_children/child_abuse.html [accessed 18 Feb. 15] Report of the Commission to Inquire into Child Abuse (2009) Implementation Plan, Dublin: The Stationary Office Mae Sincero, S. (2012). Ecological Systems Theory.(Mar 14) Retrieved Feb 19, 2015 from Explorable.com: https://explorable.com/ecological-systems-theory Maslow, A. (1970) Motivation and Personality, (2nd ed), New York: Harper and Row Children’s Rights Alliance (2013) Uniting Voices for Children: Summary of the UN Convention on the Rights of the Child [Online] available: http://www.childrensrights.ie/sites/default/files/information_sheets/files/SummaryUNCRC.pdf [accessed 19 Feb. 15] Department of Health (2000) ‘Framework for the Assessment of Children in Need and their Families’ , Department for Education and Employment Home Office, London: The Stationary Office Bensley, L., Ruggles, D., Simmons, K.W., Harris, C., Williams, K., Putvin, T., Allen, M. (2004) ‘General population norms about child abuse and neglect and associations with childhood experiences’,Child Abuse Neglect, 28(12), 1321–1337. Health and Social Care Professionals Act 2005, No. 27/2005, s.3, Dublin: Stationary Office Childline (2015) Physical Abuse | Abuse and Safety | Explore [online], available: http://www.childline.org.uk/Explore/AbuseSafety/Pages/Physical.aspx [accessed 24 Mar 2015]. Gawel, J. (1997) Herzbergs Theory of Motivation and Maslows Hierarchy of Needs, [Online] available: http://files.eric.ed.gov/fulltext/ED421486.pdf [accessed 24 Mar. 15] Van Devall, T. (2013) ‘Printable Maslow’s Hierarchy of Needs Chart / Maslows Pyramid Diagram’, available: http://timvandevall.com/printable-maslows-hierarchy-of-needs-chart/ [accessed 25 Mar 2015]. APPENDIX A The Assessment Wheel: The Assessment Triangle: APPENDIX B Indicators of Neglect Tusla (2011) Indicators of neglect are likely to be visible in the appearance or behaviour of the child. Individuals/agencies concerned should consider making a referral to the HSE Children and Family Services if they notice that a child: †¢ Wears soiled clothing or clothing that is significantly too small or large, or is often in need of repair; †¢ Seems inadequately dressed for the weather; †¢ Always seems to be hungry, hoards, steals or begs for food, comes to school with little or no food; †¢ Often appears listless and tired, with little energy; †¢ Frequently reports caring for younger siblings; †¢ Demonstrates poor hygiene, smells of urine or faeces, has dirty or decaying teeth; †¢ Seems emaciated or has a distended stomach (indicative of malnutrition); †¢ Has unattended medical or dental problems, such as infected sores; †¢Displaying apathy, unresponsive to affection; †¢ States that there is no one at home to provide care; †¢ Presents with frequent accidents and/or minor injuries †¢ Growth not within the expected range †¢ Signs of developmental delays, poor attention/concentration, lack of self-confidence/poor self-esteem, low academic achievement (including erratic or non-school attendance); †¢ Behavioural signs, e.g. overactive, aggressive, poor coping skills, impulsive behaviour, indiscriminate friendliness, withdrawn, poor social skills development, bed-wetting, soiling or destructive behaviours, substance misuse, running away, sexual promiscuity, self-harm, offending behaviours. APPENDIX C The Commission’s 20 Recommendations †¢Commission’s Recommendation 1: A memorial should be erected †¢Commission’s Recommendation 2: The lessons of the past should be learned. †¢Commission’s Recommendation 3: Counselling and educational services should be available. †¢Commission’s Recommendation 4: Family tracing services should be continued. †¢Commission’s Recommendation 5: Child care policy should be child-centred. †¢Commission’s Recommendation 6: National child care policy should be clearly articulated and reviewed on a regular basis. †¢Commission’s Recommendation 7: A method of evaluating the extent to which services meet the aims and objectives of the national child care policy should be devised. †¢Commission’s Recommendation 8: The provision of child care services should be reviewed on a regular basis. †¢Commission’s Recommendation 9: It is important that rules and regulations be enforced, breaches be reported and sanctions applied. †¢Commission’s Recommendation 10: A culture of respecting and implementing rules and regulations and of observing codes of conduct should be developed. †¢Commission’s Recommendation 11: Independent inspections are essential. †¢Commission’s Recommendation 12: Management at all levels should be accountable for the quality of services and care. †¢Commission’s Recommendation 13: Children in care should be able to communicate concerns without fear. †¢Commission’s Recommendation 14: Child care services depend on good communication. †¢Commission’s Recommendation 15: Children in care need a consistent care figure. †¢Commission’s Recommendation 16: Children who have been in State care should have access to support services. †¢Commission’s Recommendation 17: Children who have been in child care facilities are in a good position to identify failings and deficiencies in the system, and should be consulted. †¢Commission’s Recommendation 18: Children in care should not, save in exceptional circumstances, be cut off from their families. †¢Commission’s Recommendation 19: The full personal records of children in care must be maintained †¢Commission’s Recommendation 20: Children First: National Guidelines for the Protection and Welfare of Children should be uniformly and consistently implemented throughout the State in dealing with allegations of abuse. In examining the Commission’s 20 recommendations, it was decided to group them into six categories. 1.Addressing the effects of past abuse; 2. National child care policy and evaluation of its implementation; 3. Regulation and inspection; 4. Management of children’s services; 5. Voice of the child; 6. Children First, the national guidelines for the protection and welfare of children. (Ryan Report 2009) APPENDIX D Maslow’s Hierarchy of Needs (Tim’s Printables 2013) 1

The Home Changes With Time :: descriptive essay, observation essay

The Home Changes With Time Way up in the mountains, above the reaches of the hustle and bustle of the industrialized world, stands a large wooden house with loose shingles hanging off the roof, and the paint is chipping from years of wind and snow. The house was constructed on the slope of the mountain, and a long flight of stairs must be climbed to reach the first floor. The deck extends from the house on three sides, on both the first and second floors. It is a grand old house. Watching my step carefully, I climbed up the long flight of stairs to the first floor. I reached my hand out to grab the handrail, only to pull it away quickly as I received a sharp prick from the rough uncared-for wood. When I finally reach the first deck of the house, I have to stop to inflate my lungs with the barely oxygenated air of 10,000 feet. I walk across the twisted and contorted deck to the dirty-white door lined by turquoise trim. The trim color seems odd now; I don't remember it from my last visit. I stick the key into the brass handle knob and swing the door open; a rush of musty air makes my nostrils flare and twitch out of control. Looking across the neat unlived in room, memories of times when people actually lived in this house fill my mind. Spider webs tangle themselves around my head as I walk across the room towards the stairs that lead up to the second floor. I look up the dark, tight passageway of stairs, then search for the light switch that is connected to the bubble light hanging from the slanted ceiling above. After turning it to the on position, I wrap my hands around the handrails on each side and slowly pull myself up the stairs. After reaching the second floor I turned right into an open room lit brightly by the sunlight that pours in through the large windows. There are a couple of couches placed around the room. A large floral couch, backed up against the wall, is a perfect seat to relax and stare out through the treetops at the large snow capped peaks of the Rocky Mountains. Across the room sits a smaller black futon that folds down into a double bed. Next to the futon, is a tall china cabinet filled with magnificently colored wineglasses and china plates.

18th century :: essays research papers

The Eighteenth Century During the 18th century, Louis XV became the King of France at age 5. A new style, Rococo, was introduced which created a more slender and delicate appearance with an asymmetrical balance. Also, during this period of time France was involved in many wars which caused the country to go into debt. Louis XV died in 1774 who was known to be the most hated king. His grandson, Louis XVI became king. At the age of 14, he married an Austrian princess, Marie Antoinette, who did not like the customs and etiquette of the French court. Due to the success of the American Revolution, which France assisted in the financing of, Frenchmen were encouraged to reform the government and society. In 1789, the French government went bankrupt resulting in the writing of the constitution. The center of France became Paris. Louis XV, at the age of 13, returned to Versailles and the palace was once again the center of royal life. It became not as important during the reign of Louis XVI, because of Queen Marie Antoinette and her dislike of the French etiquette. She was extravagant in her spending when France was having financial difficulty. Marie and her friend created a fashion for peasant-style dresses and hats. Her lifestyle was a cause in the decline of support for the monarchy. For England, the center of fashion was London, but small towns and country estates had their own social class structure and had an interest in fashion. Fashionable clothing was divided based on the time of day. Men’s garments were divided by undress or lounging clothes, dress was daytime or evening wear, and full dress was the most formal evening dress. Nightgown was not for sleeping but a dressing gown or informal robe that was worn indoors. A powdering jacket was worn when the men had their wigs powdered. Women’s clothing was divided as undress, half dress or morning dress. Habit was a riding costume or a tailor-made costume. Her coat was not for outdoors, but was the petticoat. Her coat was called a greatcoat. The Flying Shuttle was invented in 1733, which increased the production of clothing. Cotton became less expensive. Textiles that had elaborate and sophisticated patterns were manufactured in Europe. The 18th century influenced male tailors to make men’s suits and coasts and women make dresses for women. The 18th century styles reflected the increased trade between Europe and the Far East.

A Poets History :: essays research papers fc

Erik Uriegas  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Ms, Sharp English 4 Period 7 10-31-03 A Poet’s History William Shakespeare was a very mysterious man. Most of the information about his life is unknown. Some information is lost and never to be found. His plays are continuously being performed today. William Shakespeare was not just a playwriter but also a poet and actor. All of these accomplishment without ever attending a college or university. His early life was at Stratford on Avon and he was educated at a free gramer school in Stratford. Treated well by his father and mother who was middle class. Grown to have marriages, kids, and become one of historys best play writers. Stratford on Avon at a time of William Shakespeare’s birth was a village of about two thousand inhabitants. Stratford on Avon is about eighty miles away from London. William Shakespeares year of birth was 1564. He was baptized the twenty-sixed of April. William was the third child to be born. He had twin sisters who were elder but died at infancy. The name Shakespeare appears to have been common in the west midlands. William Shakespeare left his family about four years after his marriage to Anna Hathaway at the age of eighteen, and came to London for better family fortunes. At this time London had gone prosperous under the reign. Shakespeare hoped upward Stratford could have held little for him now that his father’s enterprises had faded. During the years William Shakespeare detached himself gradually from his London Associates (â€Å"William†, 3). Irving Robner quoted,†Shakespeare growth as a tragicdramastic growth in moral vision (â€Å"Bergeron†, 74). Shakespeare grandfather was a tenant farmer; his daughter’s husband was altered knighthood (â€Å"Kay†, 17). The Shakespeare family history is a textbook case of that upward social mobility that was so common in Renaissance England. William Shakespeare’s education is known to be vague. There was a free grammer school at Stratford, to which, as the, son of his father he would have been entitled to free admission. Aubrey, who is entirely unsupported even states that William Shakespeare was a schoolmaster himself. When William was about thirteen years old his father took him out of school and put him to work so he can help the family who got onto some financial difficulties. William Shakespeare has never been proven to have attended a college or a university. His mentality and work has been proven to be a solid education (â€Å"William†, 2).

Wall Mart of the Internet

From â€Å"Earth’s Biggest Bookstore† to â€Å"everything to everybody† to â€Å"Wall Mart of the Internet† to â€Å"World’s most customer-centric company†, Amazon has been tagged with these kinds of labels by its customers and followers. The reason for these many labels is because of the Amazon changing business model. Starting from Single-product and an intermediary with little inventory in 1995-1997 to Multi-product, profit-making, customer-oriented, investor, Services provider in 2000 Amazon has been changing its business model according to market conditions.One indication of a smart company is to continuously change its business model; it is an indication of smart company and ultimately the smart management team. It is also an indication that the company is learning and adopting itself to the external and internal environment. Amazon is the clear market leader for the largest US e-retailing categories of books, CDs and DVD movies. In var ious consumers’ polls, when respondents are asked for their experiences of e-shopping, Amazon â€Å"streaked ahead† of all others as the world’s favorite e-retailer.This means that Amazon is the undisputed favorite on considerations such as convenience, reliability and customer service. Amazon has achieved worldwide success and brand recognition due to paying attention to extensive offline advertising, which helped the company to become one of only three dot. com brands in the Interbrand world league table. It is an illustration of the power of branding that Amazon is the world’s top e-retailer. Before the dot. com downturn in the spring of 2000, the word â€Å"Internet† keyed into what seemed pervasive optimism for a new century.It meant youth, new possibilities and an opportunity to break with traditional business and create new rules. However, in 2000 things drastically changed as many e-commerce start-ups failed to return expected profits and w ent bankrupt. After this came valuable lessons across e-commerce, and evidence for incumbent retailers that factors such as having an established brand provide significant advantages in e-retail and play a part in customer loyalty and increased profit. Analysis of dot.com failures and comparison with traditional retailers in the same industry, for example eToys, which folded in 2000 and was subsequently bought by an established toy retailer, vs. Toys R Us, which successfully opened an e-retail channel through collaboration with Amazon, has revealed several advantages for the established retailer. Newcomers usually build their initial strategy on attracting new customers through aggressive marketing, brand-building and advertising, which logically lead to massive expenses and cash shortages.Amazon, however, has an existing customer base and can build on brand values that are already in place. Amazon’s marketing budgets allow the company to attempt new online projects or busine ss lines, unlike many start-ups. Founder of Amazon. com, J. Bezos rejected the traditional model for retailing. Having known that the usage of Internet is increasing every year with gigantic steps, – some resources report about 2000% usage increase annually, – Bezos decided that his retailing model should be intrinsically connected to Internet.While opening new physical retail outlets can expand the geographical reach of a business and add convenience for consumers, retailing online not only carries these benefits, but also offers further returns that are more specific to online trading. Bezos put books as Amazon’s core product, because they almost ideally correspond for the model of e-retailing. Low unit price, low risk cost, easy to pack and ship, and finally in a high and growing demand, books have become a perfect solution for Amazon’s model. Now books are by far the largest e-retailing category in the US.Research carried out by many companies illustr ates that about 65 per cent of the purchases made by Web shoppers in the US consisted of books. For newly created company, the Internet had global reach and provided the opportunity to trade internationally. For Bezos, Amazon’s broad benefits included the ability to trade 24 hours a day and seven days a week, and operate with lower overheads in terms of staff and space, while more particular advantages included the ability to increase the number of customer â€Å"touch points† and build more personalized customer experiences, products and relationships.However, again for J. Bezos these e-retail advantages did not imply that an online presence is a recipe in itself for success; that kind of thinking was tried and failed with the dot. com boom and bust. Instead, if there was any recipe for successful integration, Bezos found it in variants of established business practices, such as an understanding of the strengths and weaknesses of the business, for example in relation to technology awareness, which is a good indicator of e-commerce success.Amazon’s mission and strategy is quite simply â€Å"to offer Earth’s Biggest Selection and to be Earth’s most customer-centric company, where customers can find and discover anything they may want to buy online and [we] endeavor to offer our customers the lowest possible price. † The company accomplishes this by operating six global internet sites: www. amazon. com, www. amazon. ca, www. amazon. de, www. amazon. jp, www. amazon. co. fr and www. amazon. co. uk.Through their zShops, auctions, affiliate program, [email  protected] and Amazon Marketplace programs, Amazon, and their sellers and partners, offer new and used collectibles and products in categories such as apparel and accessories, DVDs, electronics, computers, books, music, videos, cell phones, tools and hardware, the list is almost endless. In order to maintain quality, the company packages and ships all of its merchandis e. They also continue to negotiate volume deals with suppliers to meet their goal of lowering prices.Additionally, Amazon has formed partnerships and alliances with publishers, other on-line retailers, technology providers, either handling their web site operations or linking them to its virtual portal. As part of their diversification strategy, Amazon recently acquired Internet Movie Database www. imdb. com (IMDb), which is an authoritative source of information on movie and entertainment (Dennis et al, 2004). This acquisition is one of many Amazon is making expand its product and service offerings.The company is also preparing to sell internet domain names and already has received the Internet Corporation for Assigned Names and Numbers (ICANN) approval. In order to improve customer service the company is investing in operational facilities, like its multi-lingual customer service support center in the Netherlands, to meet its rapid growth, increase selection and meet future operat ional needs while building efficiencies. This strategy helps Amazon increase its low profit margin, decrease its operational cost, increase customer response and order processing services and pass that savings on to the customer.Amazon strives to provide customers with the best possible online shopping experience by leveraging their powerful and innovative technologies. Part of the company’s competitiveness lies in their proprietary technology, which is licensed to companies like Target to run their e-commerce site. Its patented portal technology allows the customer to customize their on-line experience with personalized home page, product recommendations, email notifications on orders and new products, the ability to post reviews, 1-click ordering, search functions, up selling, and secure shopping cart functions, to name a few.Furthermore, they use technology to drive customer relationships. As an example, the company uses pop up daughter windows to quiz customers about Amaz on. These pop up windows survey the customer about Amazon related facts and in return the customer can get up to . 25 cents a day put in their account for answering questions. Building on this use of technology the company recently received patent approval and plans to add a chat function to enhance the customer experience and help consumers find products through each other.Through its Web Services development and affiliate program it encourages web site owners and developers to create applications capable of interacting with Amazon’s catalog, search engine, shopping cart and merchandising tools. In an effort to remain competitive and preempt new technology Amazon has an ongoing program to develop, update and add software and hardware including partnerships like it’s recently inked deal with Google. com. This will allow them to avoid service disruptions; slow response times, poor levels of customer service, and delays in information delivery.Amazon uses its proprietary technology to transform the online purchasing experience into the easiest and most enjoyable shopping experience online. The site communicates to the customer a visual feel of being in a one stop shop where they can find and purchase virtually anything they want. The site loads quickly, is easily navigated, allows the customer to instantly see an array of products, and provides a host of other customer driven enhancements designed to drive customer satisfaction. Amazon’s site conveys to the customers they can have it their way, all day.And by placing its image on everything it touches Amazon continually reinforces its brand, making it one of the most recognized customer-centric brands in the world. For the first time in year 2000, Amazon management has set its focus on making profit. Again, it is an indication of nothing but smart, opportunistic management that utilized its strength to grow. It is very clear that Amazon management team is very focused. In order to meets its future targets, Amazon has implemented a restructuring plan.It will allow Amazon to reduce operating costs, reduce employee staff, and strengthen some of its fulfillment and customer service operations. According to the quarterly report released by amazon. com for quarter ended September 30, 2004 â€Å"There has been a steep decline in operating costs† (Amazon, Quarterly results, 2004). This has improved the performance of the company. Since its beginning, Amazon has adopted various e-Business model to increase its customer base and recently set its focus on making profit. Given below are the strategies adopted by Amazon.Amazon has a track recording of first gaining expertise in the market and then scaling into other areas. For example, Amazon started with a web-based bookstore model and after gaining expertise in various operations expanded to other segments and geographies. Another example is, after capturing the US market; it expanded its business to Europe, namely the U. K, France and Germany and then to Japan. One advantage of this approach is that the incremental costs to expand the business, whether to multiple product line or geographically are small.This strategy of perfecting before scaling helps in long-term survival and growth of the company. Since its beginning, Amazon has always kept focus on the needs of its customer and never lost sight of it. This gives Amazon a strong foothold of the internet retail business. Playing on this customer strength, Amazon has struck deals with industry leaders retailers Toysrus. com, Borders, Drugstore. com, and Target to help them draw customers to their Web sites, thereby giving birth to its services segment. Amazon is playing on its strength here and in the process creating a place for itself as a provider of e-tail services.Under Amazon’s cooperative model, the partners do not compete with each other and try to lessen each other risks. This cooperation represents a symbiotic relationship, where t he two partners do what they do best while depending on each other to eliminate respective weaknesses. On August 10 2000, Amazon and Toyrus announced a strategic alliance. According to the press release by Amazon â€Å"The two companies have entered into a strategic alliance under which each company will assume responsibility for specific aspects of the toy and video games and baby products stores.Toysrus. com, in collaboration with its majority shareholder, Toys â€Å"R† Us, Inc. , will identify, buy and manage inventory; Amazon. com will handle site development, order fulfillment, and customer service, housing both Toysrus. com's and its own inventory in Amazon. com’s U. S. distribution centers† (Dennis et al. , 2004:118). This alliance helped Amazon in eliminating its inventory risk, as it does not have to purchase or store any toys until the customer have ordered and paid for the goods. Under Amazon’s coopetitive model the two parties act as provider and customer.Both the parties compete with each other but one party tries to lessen other risks and in return gets the share of others business. On Apr 11, 2001 Amazon and Border announced strategic alliance. According to the press release by Amazon on Apr 11, 2001, â€Å"Amazon. com will be the seller of record, providing inventory, fulfillment, site content and customer service for the co-branded site. The new site will continue to offer content unique to Borders. com, including store location information and in-store event calendars† (Prior, 20001:6).In this case Amazon will continue to sell books on its own, but will also provide services to Border. In return Amazon will get a share of every sale by Border. According to an article on Informit. com â€Å"The Click and Brick model allows an existing offline business to profit from partnering with an emerging online presence†. [5] In this regard, Amazon has struck a deal with electronic retailer Circuit city. This wil l give the customer, the advantages of picking up their purchases from hundreds of stores rather then paying for shipment charges.Amazon will receive a share of the revenues for all Circuit City electronics goods sold through Amazon. Amazon will be responsible for processing the transaction while Circuit City will be responsible for order fulfillment and product-related customer service. In all these cases, Amazon is extending its channel expertise in Web retailing to â€Å"e-nable† other retailers. With a full year’s experienced retailers under its belt, Amazon is set to scale the service model. The Borders and Circuit City deals are important steps in that direction.The coopetitive model is converting Amazon into a â€Å"product-less platform provider†, directly impacting its bottom line, with no inventory costs. The business model adopted by Amazon has given it a boost in its online business. By making strategic alliances with the industry leader and making t he life of customer has made Amazon a profit making company. According to 2004, financial results Amazons’ â€Å"Operating cash flow was $567 million for 2004, compared with $392 million for 2003. Free cash flow grew 38% to $477 million for 2004, compared with $346 million for 2003.Common shares outstanding plus shares underlying stock-based awards outstanding totaled 434 million at December 31, 2004, compared with 433 million a year ago. Net sales were $2. 54 billion in the fourth quarter, compared with $1. 95 billion in fourth quarter 2003, an increase of 31%. Net sales, excluding the $85 million benefit from changes in foreign exchange rates, grew 26% compared with fourth quarter 2003† (Amazon, 2005). Amazon business model has steadily evolved and over the years the large retailers have realized the importance of Business-to-consumer e-commerce.In contemporary context, along with other e-commerce companies Amazon experiences several problems. Financial and marketing analytics indicate that due to increased online competition, Amazon is gradually loosing its market share. Experts and investors indicate that Amazon’s technology and content costs soared 59% in the quarter, while the company keeps spending heavily on marketing campaigns, free-shipping promotions and other marketing activities to attract customers to shop regularly on its site.It is not surprising that Amazon is spending estimated 60 percent of their revenue on numerous marketing activities and building an appropriate brand image. Amazon’s brand allows company to be known, distinct, and credible in the minds of existent and potential customers, consumers, and stakeholders. Amazon’s brand facilitate the building of relationships with existing and potential customers, consumers, and stakeholders. In addition, company’s brand communicates the benefits offered to buyers and stakeholders that embody the value system of the company.Due to increased online comp etition, the brand image strategy utilized by Amazon is justified because it helps to retain existing customers and to attract new ones, gradually making them returning. For every business, particularly online e-retailing, good customers’ returning rate is an indication of a healthy business. That’s why Amazon should pursue this aggressive marketing and branding strategy to keep its customers. Many analysts discuss merger opportunities for Amazon. The merger will help Amazon. com expand the market share in E-commerce and create a new passageway.For instance, Amazon. com can merge with Wal-Mart, which has $26 billion market value and only $756 million debt. Now Wal-Mart is interested in E-commerce and online shopping. If Amazon. com merges with Wal-Mart, they will become the largest retail company in E-commerce. Amazon. com will also increase its market share. In addition, after the merger, Amazon. com can gain more marketing resources from Wal-Mart to create a new sale s passageway. For instance, customers can purchase the products from Amazon. com on the Internet and pick the items, or return them at Wal-Mart.It will provide additional choose for customers. The merger may help Amazon to create new customers and products. Bertelsmann has $14 billion market value and the company’s strategy now is focusing on music retailing and book sales. Their business is related to Amazon’s business. The CEO of Bertelsmann is also trying to open their business in American market (Brynjolfsson & Urban, 2001). If Amazon. com merges with this company, it will gain the new customers from Bertelsmann. Furthermore, integrating the products from Bertelsmann, Amazon.com can create new products on their website. Finally, a merger can improve and cover the financial loss of Amazon such as net sales loss, long-dept and cash loss. For instance, if Amazon merges with General Growth Properties, which has 136 malls in 37 states and owns $2. 8 billion market value , Amazon. com can still keep the power of operation and exercise the new marketing strategies (Brynjolfsson & Urban, 2001). Moreover, Amazon. com can gain the financial support from this company to cover its long-debt $2 billion. In addition, the merger will help Amazon.com increase the financial resources such as the amount of cash flow, and also decrease the cost and expense of the company. Another future prospect is to invent a new E-business strategy. E-commerce is one way that people can trade on the Internet. This trading system is very important, but it is not the only thing that the e-commerce enterprises should focus on. Amazon. com is a giant in E-commerce and the company uses Secure Sockets Layer (SSL) to trade, but Amazon cannot make profits even though the company has very strong technological support.Some specialists point out that communication, resources allocation, and project management guarantees success in E-commerce. Effective communication, which can improve bu siness performance, is one of the objectives that Amazon. com should fulfill. Effective communication includes two aspects: internal and external. First of all, internal communication emphasizes negotiation. Necessary and correct information must be communicated precisely between the employees or the departments. Secondly, external communication emphasizes on empowerment and good timing.For instance, Customer Services is a department that helps customers to solve problems. They have to communicate with the customers and understand what the customers want and need, and then report to the departments or the board. If the customer service department has the power to react immediately from the problems of customers and has good communication and relationship with the customers, it will create more business opportunities for Amazon. com. The second key that helps industry to succeed in E-commerce is resources allocation. There are various resources in the enterprises such as human resour ces and customer resources.First of all, concerning human resources, Amazon. com should understand employees’ particularities and arrange them in appropriate positions. If the employees are set in the right positions, the company should become more efficient. Secondly, in regard to customer resources, Amazon should collect information, such as suggestion, complaint or demand from the customers and then try to improve their products or services to provide better services to the customers. If the services satisfy the customers, Amazon will create more and more opportunities and new customers in the near future.For example, new outsourcing strategies should be used to collect focus group to survey customers’ opinions. The third key that may become helpful for Amazon is project management. A successful E-commerce enterprise should focus on project management. Project management emphasizes teamwork (Epstein, 2004). There are many teams in the company and each team has its d ifferent project and goal. Each team also has its power to make the decision. The responsibility of the team is to achieve the product. The responsibility of the enterprise is to manage the teams and make sure that the projects can be finished effectively.Distributing the limited resources to different teams and projects is the great challenge to the project management. The best way to overcome this challenge is to emphasize effective communication and negotiation Amazon. com is now considered as the world’s largest e-retailer of books, CDs and DVDs. The Amazon’s web portal is user-friendly, enabling e-Shoppers to find books quickly by title, author or subject. Users can find their title in seconds from a few keywords. Synopses and contents lists are provided, along with a list of other relevant books.Amazon keeps a record of customers’ preferences and advises when new books likely to be of interest are published. During many years, Amazon is renowned for custom er service, security and fast delivery. However, in current business context, the company is loosing market share, though is still well-recognized leader in online industry. The company keeps heavily investing in its brand through aggressive online and offline marking, building appropriate brand awareness among its current and potential clients. References Amazon, Inc. (2004). Quarterly results, Available at < http://media. corporate-ir.net/media_files/irol/97/97664/reports/91338ACL. pdf> Amazon, Inc. (2005). Press release Q4 Financial Results, Available at < http://media. corporate-ir. net/media_files/irol/97/97664/news/Release_Q4_04. pdf> Retrieved June 5, 2006 Dennis C. , Fenech T. , Merrilees B. (2004). E-Retailing, Routledge, London Brynjolfsson E. and Urban G. (2001). Strategies for E-Business Success, Jossey-Bass Epstein M. (2004). Implementing E-Commerce Strategies: A Guide to Corporate Success after the Dot. Com Bust, Praeger Prior, M. (2001). â€Å"Amazon to Operate Borde rs. com. † DSN Retailing Today, May 1, 40(9): 6.

Divorce Research Paper Essay

Pondering question to get reader thinking about topic II. What the problem is d. â€Å"Children do not fall behind their peers in these areas during the potentially disruptive period before their parents divorce, the study revealed. Instead, it’s after the split that kids seem to have the most trouble coping. Include this from Healthday reporter Alan mozes e. What the child feels, they feel its their fault and makes them more upset III. Statistics f. What classes children with divorced parents are struggling in g. Average grades for the kids h. What it does to teens IV. My personal experience i. How my grades were before and after j. What classes I was struggling in k. My personal feelings about it V. Conclusion l. Say how parents really need to think about how it will affect their child before going through with it. m. My views on the statistics and why it is valid info n. Opinion about parents being more involved in children’s schoolwork. Christian Startt Mrs. Pantusa English 1 A. P Prep April 26, 2013 Divorce and How It Affects Children Introduction Divorce can be the most inconvenient and hardest long-term problem of a child’s life, affecting all parts of his or her life all because of the parent’s failing marriage. 41% of first marriages end in divorce (Irvin, M), which is a substantial percentage of marriage that has not followed through with their vows and left their kid’s normality in the dust. Grades, emotions, and innocence all are changed in the process of the divorce, as well as a new set of challenge and problems these kids have to face in everyday life. Divorce isn’t just a split between a family, it’s more of a life changer. â€Å"As soon as me and my wife Terri divorced†, explains Chris Startt, â€Å"basic life changed heavily. Laundry, cooking dinner everyday, and constantly worrying about my son’s grades has really kept me busy and stressed†. I asked Chris how his son’s grades were after his divorce. â€Å"When me and my ex were still together, Christian’s grades were outstanding, strait A’s. But later (a year passes) his grades went from strait A’s to B’s and C’s later on in middle school†. According to Healthday reporter Alan Mozes, â€Å"Children do not fall behind their peers in these areas during the potentially disruptive period before their parents divorce, the study revealed. Instead, it’s after the split that kids seem to have the most trouble coping†. Research suggests that the odds of a divorce occurring in a household before the children become grown rest at about 50% (Ahilburg and DeVita, 1992), with divorce rates beginning to soar in 1963 (Jeynes, 1999). A 60-year literature review of 347 experimental studies confirmed that many studies have concluded that divorce has negative consequences for children’s academic achievement (Kunz, 1992). Most research shows that the child’s math scores were the ones that were mostly affected. â€Å"Kim found that while a divorce is in progress, first, second and third-graders experience a dip in math test scores — a decline that holds steady once the divorce is final†. (Mozes) But, at the same time reading scores didn’t really seem to be changing, as research from (Mozes) shows that â€Å"†¦however, Kim found that reading scores remain unaffected†. When my parents divorced, about 6 years ago, I was 9 years old in 3rd grade and that’s when my grades went from strait A’s, to A’s and B’s, and then a C here and there. Mathematics really begun to get more and more difficult to concentrate to and the tests were getting harder to understand. Reading, however, was my strength in elementary school, and it remained un-affected after my parents divorce. Researcher Hyun Sik Kim explains, â€Å"Reading is not that cumulative. But with math, you must understand previous things to develop. For example, if I do not understand that one plus one is two, then I cannot understand multiplication. Divorce really puts a child’s mind in motion. After the divorce the child may feel like it was his/her fault, causing stress and emotional problems. By this happening, the child will become more stressed by the moving between houses, therefor making it harder to concentrate on schoolwork and thus grades beginning to lower. My personal experiences also help support my argument. Divorce should be decided with caution; you have to think about how its going to affect your child and how its going to affect their future.