Cttls Level 4 free essay sample

Certificate in Teaching in the Lifelong Sector. Planning   Enabling Learning. Assignment 1- What is the purpose of initial assessment and what kind of methods could be used? Evaluate these methods with reference to the ways they can help in the overall objective of achieving learning goals. How can you ensure learners are kept motivated and working towards these goals? Name: Date: 21st October 2010 Word Count: All learners are entitled to undergo a period of initial assessment. Initial assessment is the process of identifying an individual’s learning and support needs to enable the design of an individual learning plan which will provide the structure for their learning. Initial assessment is a critical process because it represents the first stage in the learning cycle. The Learner Failure to accurately identify an individual’s learning needs may result in a learning plan, and a learning programme, which does not address those learning needs. The learner lies at the centre of the learning process and needs to be fully engaged with the initial assessment process. It is important that they feel that it is done with them and not to them. An individual’s learning and support needs are identified from the collection and analysis of a wide range of information. The different types of information which need to be considered during the initial assessment process are shown in figure 1. 1 below. There are a number of Initial assessment methods available. The methods fall into six groups: * Appraisals of written information, such as learners’ application forms, records of achievement, progress files and references. * Individual interviews. Formal tests. * Learner questionnaires. * Observed group activities. * Practical vocational activities. We do not normally use all the methods but chose those which are appropriate to the needs and circumstances of the learner. Typically you should use a combination of methods to assess an individual, in order to gain an accurate, overall picture of their needs. Information collected through one method well may reinforce information collected through a different method. In the some instances it may be contradictory and require the use of additional methods. Application Forms: Application forms are completed prior to entry onto learning programmes and are often used for selection purposes at that stage. They contain information that can be used to determine the individual’s learning plan and therefore useful in the initial assessment. The application form includes: * The courses the learner has studied and the qualifications that he or she has achieved. These are helpful in selecting whether a pre vocational, foundation or advance learning programme is appropriate. Eg, GSCE in English may give the learner exemption from part of the key skill requirements. Employment and work experience, which may include their current work. This information is useful in matching the learner to the appropriate occupational area and in deciding the level of qualifications to target. * Career interests and aspirations. Learners would expected these to be reflected in their learning plans * Previous work based learning. The learning plan should build on previous learnin g. If it is in a different occupational area there may be parts of that learning that are common and therefore do not need to be repeated. For learners with literacy difficulties, specific disabilities or where English is a second language, asking them to complete an application form may not prove beneficial. Suitable arrangements may need to be made for prospective learners where help can be provided. Interviews Interviews provide opportunity to discuss and gather information on: * The accuracy of the information contained in the learners’ application form. * Learners’ knowledge and understanding and suitability to undertake particular types of careers and jobs * Expected examination grades if these are unknown. This may help in the identification of the level of programme to be undertaken. * The results of any formal â€Å"tests† which have been undertaken prior to the interview such as psychometric tests or basic skills or key skills assessments. * Learners’ personal effectiveness. Where gaps are identified they need to be addressed within individual learning plans * Any health problems which might affect the type of job which they do. * Travel to work areas. Interviewing young people and adults who have been long term unemployed is a skilled process. If you are to get the best out of learner interviews, which forms an important part of the initial assessment process, we must ensure that we have a well developed and effective processes in place, and staff who are competent at conducting interviews Record of Achievement and Progress file Learner’s record of achievement can be used to both support and verify information recorded in the application forms and provided during the interviews. They can provide a focus for discussion during interview and give the learner confidence in talking about themselves. The progress file aims to build on the good practise from the National Record of Achievement. Progress file is a set of materials which are designed to help young people and adults make the most of themselves and their opportunities. It is a useful way of identifying learning and supporting requirements during the initial assessment process. References Gathering information from other sources about a learner is useful. It can be used to verify or support the information which has been gathered during the initial assessment. It may also provide another person’s viewpoint which may be contrary to your own. It may also reduce the likelyhood that the same information is repeatedly asked of learners. References sources include schools, colleges, careers services, employers, and voluntary groups, clubs. Basic Skills Assessment. Basic skills are the ability to speak, read and write in English and to use mathematics at a level sufficient to function and progress at work and in society. The initial assessment of basic skills is therefore crucial. Learners with a lack of basic skills are liable to make poor progress in their training and to have difficulty sustaining employment. Each and accurate assessment of their basic skills learning needs, followed by a learning plan to address those needs, can make a substantial difference to the learner. Tests are available for use in the initial assessment of basic skills. The tests fall into two categories: * Initial Screening. * Diagnostic assessment. Screening tests aim to identify those who may need support and to indicate an approximate level of their skill. Diagnostic test aim to identify the specific nature of an individual’s strengths and weaknesses and to clearly identify the learning needs. Key skills Initial Assessment Key skills are generic skills which can help individuals to improve their own learning and performance in education and training, work and life in general. Key skills are linked to basic skills in that they require their application in a wide range of contexts and the ability to transfer skills learnt in one environment to another. There are six key skills, performance in each of which is graded level 1-4: * Communication * Application of Number * Information Technology * Improving own learning and Performance * Working with Others Problem Solving Initial assessment of learner â€Å"key skills† on entry measures the distance each learner has to travel to reach that minimum target. Accurate initial assessment of key skills can lead to substantially different individual learning plans. Initial assessment of key skills may also determine the level of key skills an individual is capable of achieving during the learning programme. An assessment of a le arner’s existing level of key skills maybe possible from other initial assessment methods such as by looking at the application form. Psychometric Tests Psychometric tests are widely used in giving guidance on careers and in the selection of staff by employers. They are not used in isolation, but as a source of information alongside others, such as interviews. They can form a useful basis for discussion about a person’s career or about his or her suitability for a job. The impact of psychometric testing on an individual’s learning plan is more likely to be in the choice of occupational area, and the level of programme, than in the structure of the learning plan itself. Learning Styles Assessment Assessing learners’ learning styles is important in ensuring that they learn quickly and efficiently during their learning programme. Individuals learn best in a variety of different ways and have preferences for certain ways of learning. Some for example, learn best by doing things as opposed to thinking about them. Others prefer to learn by listening and sharing ideas with others. Learners are at risk of their training being ineffective, where the trainer’s own dominant learning style is in conflict with their own preferred learning style. There are some different learning style assessment tools which can be used. Learner Questionnaires. Learner questionnaires are often used to help learners indentify their own strengths and weaknesses and assess their own learning support needs. The results contribute, along with other sources of information, to the individual learning plan. Questionnaires can be designed to collect information on almost any aspect of a learner’s experience. This may include eg, A self assessment of their perceived skills and current performance. The outcomes are based on the learners’ perception of themselves which may not always be accurate. They are however an effective way of involving the learner in the identification of their own strengths, weaknesses and learning needs. Group Activities Observing a learner engaging in a group activity with others learners helps to measure specific attributes and to identify personal strengths and weakness. To be successful, group activities rely on having a number of observers who are properly trained and clearly defined criteria on which to ase their judgements. Eg Self confidence. Practical Vocational Activities It is often not until the learner actually experiences a job first hand that they know whether they like it or not. One of the reasons why many young people drop out of their learning programme is because the occupational area in which they are placed does not match their expectation. Allowing â€Å"taster or trials† allow the learner to experience at first hand a number of different occupations and helps them decide which most suits them. It also provides the opportunity for the employer to assess the learner’s vocational skills and suitability for the job as well as his or her learner and support needs Summarising the Outcomes of Initial Assessment The Initial Assessment involves the collection of a substantial amount of information about each individual, using a range of different methods and with often more than one member of staff involved. It is essential that the information is brought together to form a picture of the whole person. Information should be brought together on: * Career preferences and suitability * Achievements and Qualifications Attitude and potential * Prior learning and experience * Any basic skills assessments and their results * Any Key Skills assessment and their results * Any learning difficulty * Interests of the learner * Learning style * Job role * Personal effectiveness and areas which need to be addressed * Any personal circumstances which may affect learning All members of staf f involved in collecting the information should jointly agree the learner’s learning and support needs from the information which is available. The information should be used to set learning goals and used to develop each individual learning plan.

Describing an Experience With a Sample - Describing an Experience About a Place

Describing an Experience With a Sample - Describing an Experience About a PlaceDescribing an experience can be an incredibly difficult task. Not only does the phrase 'describe an experience' give you problems when you use it in a sentence form, but it also can actually put you off from using that term when you're writing a creative essay on your own. You don't have to have all the details or even the name of the place to know it's a place, but writing about your experiences will make a big difference to how you feel about yourself and that place.Writing is about exploring your surroundings and the elements that surround you. When you're describing an experience you're providing a glimpse into your world for other people to see. Describing a place is usually not as explicit as this, but the idea is similar enough that it doesn't really matter whether it's a place in itself or a part of a larger context. Using the phrase 'describe an experience' is more than just being unclear about th e experience.We all know that it takes more than just a mere description to make an experience stick in our minds, and a writing sample of a place is often better at this than just a phrase. Reading a whole paragraph that contains your 'word' or phrase can be misleading, especially if you've just written a paragraph that includes a very brief description. A different way to describe a place can draw people into the experience and make them want to read more.In addition to pulling you into the experience, the paragraph can add impact to your writing. Experiences happen in a relatively small space, and by reading a paragraph that clearly describes your experiences can have a different effect from reading the same paragraph but with very little information. By pulling readers in your experiences can get them to ask more questions and start to explore more about what you're talking about. This will help you establish the confidence you need to continue your story.If you don't know anyth ing about places, consider giving a short description of what you've experienced and how it felt before you got to write. Then break your experience down into a few components such as weather, places to eat, and weather and food combination to get some clarity to how you experience the experience. For an example of a unique experience, imagine someone telling you about their ride on the roller coaster and how the ride made them feel while on the ride.Describing an experience without getting too specific can work for more experienced writers. Try describing your story with plenty of detail and you'll find that you're able to stay on track and stay focused. The main benefit is you'll be less likely to skip over parts of your story that you don't want to have, but keep this in mind that you don't want to use too much detail. Make it clear and simple to follow.Remember to break up the information and keep your sentences short. Many writers will stop short of including as much detail, be cause they feel that it might clutter up the piece and it will make it harder to understand. If you keep the concept simple and can comfortably tell a story in a few sentences, the experience can flow much easier.

Great Gatsby Analysis Essay Example

Great Gatsby Analysis Paper The descriptions of individual characters and settings convey ethical and moral judgments of a society. In the Great Gatsby, the descriptions of the Eggs, the â€Å"valley of ashes†, Gatsby, and the Buchanans all convey the judgment that the upper class of the society are shallow, empty and hollow and therefore, lacking morals and ethics and because of this, that the American dream has failed as citizens have become obsessed with the material aspect of the American dream rather than the spiritual aspect. Firstly, one of the settings described in the Great Gatsby is the contrast of West and East Egg. The descriptions are highly symbolic and convey that the upper class of the society is lacking in morality and ethics because it has been corrupted by material wealth and power that comes from this wealth. In the novel, West Egg and its citizens represent the newly rich, while East Egg and its citizens represent the old aristocracy. East is symbolic of wealth and corruption, west of morality. In the story, east is symbolic of wealth and the corruption it causes. In the east, having money is having power, and that power corrupts. Indeed, in the east, few truly take responsibility for their actions. Early in the story, Jordan Baker is nearly suggested in the newspapers to have moved her ball from a bad lie in the semi-finals of a golf tournament. Witnesses later said they might have been wrong, no doubt with the encouragement of Jordans money. Also, when Daisy ran into Myrtle, she didn’t stop the car. We will write a custom essay sample on Great Gatsby Analysis specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Great Gatsby Analysis specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Great Gatsby Analysis specifically for you FOR ONLY $16.38 $13.9/page Hire Writer In the corrupt East, people don’t take responsibility for their actions. The west, on the other hand, is symbolic for morality. The west was known for its values and its work ethic. Nick refers to the place as the warm center of the world. Nick later talks of the west as the place where â€Å"houses are called by the name of the family†. With all of its morality, the west was still unfashionable, people (eg. Gatsby and Nick) wanted to move to East Egg drawn by the wealth and care-free attitude. However, as Nick says, â€Å"we possessed some deficiency in common which made us subtly inadaptable to Eastern life. This means that Nick and Gatsby will never get there because they lacked taste. Fitzgerald portrays the newly rich (west eggers) as being vulgar, gaudy, ostentatious, and lacking in social graces and taste. Gatsby, for example, lives in a monstrously ornate, gothic mansion, wears a pink suit, drives a Rolls-Royce, and does not pick up on subtle social signals, such as the insincerity of the Sloane’s’ invitation to lunch. In contrast, the old aristocracy (east eggers) possesses grace, taste, subtlety, and elegance, epitomized by the Buchanan’s’ tasteful home and the flowing white dresses of Daisy and Jordan Baker. What the old aristocracy possesses in taste, however, it seems to lack in heart, as the East Eggers prove themselves careless, inconsiderate bullies who are so used to money’s ability to ease their minds that they never worry about hurting others. The Buchanan’s exemplify this stereotype when, at the end of the novel, they simply move to a new house far away rather than condescend to attend Gatsby’s funeral. Gatsby, on the other hand, whose recent wealth derives from criminal activity, has a sincere and loyal heart, remaining outside Daisy’s window until four in the morning in Chapter VII simply to make sure that Tom does not hurt her. Ironically, Gatsby’s good qualities (loyalty and love) lead to his death, as he takes the blame for killing Myrtle rather than letting Daisy be punished, and the Buchanan’s bad qualities (fickleness and selfishness) allow them to remove themselves from the tragedy not only physically but psychologically. This shows that the upper class of the society has no morals or ethics because they have been corrupted with excessive materialistic wealth. This conveys the materialistic excesses the 1920s and the decline of the American dream. Secondly, the road from West Egg to New York City exemplifies decay. It is a valley of ashes, a place of uninterrupted desolation. It is where the rich dump their troubles and this conveys that the rich are immoral and unethical because they’re living in luxury using the valley of ashes as a â€Å"bin† whilst the lower class people living in the valley are poor and living in poverty. It is described as; â€Å"a fantastic farm where ashes grow like wheat into ridges and hills and grotesque gardens, where ashes take the forms of houses and chimneys and rising smoke and finally, with a transcendent effort, of men who move dimly and already crumbling through the powdery air† (p. 27) The valley was first introduced in chapter 2. Described as a gloomy land created by the dumping of â€Å"industrial ashes,† the valley acquires a sense of decay. It seems as if the rich, men like Tom Buchanan and Gatsby dump their â€Å"ashes† (their troubles) in the valley, with nothing but concern for themselves. This connects with the rest of the book, as Tom and Daisy are seen as a â€Å"reckless† couple, and one that only care about themselves. The eyes of Dr. Eckleburg symbolize in this chapter advertising and materialism gone mad, one of the central themes of the plot. Fitzgeralds description of the drawbridge and passing barges makes an allusion to the River Styx, a mythological river which one crosses to enter the realm of the dead. This descriptions shows that this is a place of poverty and troubles where troubles â€Å"dumped† by the rich eggers to rot and die; the valley was the place of murder (Myrtle getting run over by Daisy, chapter 8). The murder was also the result of two rich men, Tom (had an affair with Myrtle) and Gatsby (let Daisy drive). So, the valley of ashes does in fact represent a place of decadence; a place where the rich dump their â€Å"ashes† (or troubles). The novels only non-wealthy characters live in the valley of ashes; it is the grim underside to the self-indulgence of the Eggs, and of New York City. George Wilson, Myrtles dejected husband, seems almost already dead â€Å"walking through her husband as if he were a ghost. † (p. 28) and made of ashes: ashen dust veiled his dark suit and pale hair. This dust that is around and the fact that Wilson is ghostlike portrays how desolate and dead the valley of ashes is. Everything is grey and covered by ashes and in contrast to the rich vibrant colours in East and West Egg, the â€Å"valley of ashes† can be seen as a very grim place where people live in poverty even though they live right next door to people with more wealth than th ey need (the eggers) This can be related back to the failure of the American dream because even though there is great wealth in the society, it has not been distributed evenly and people are still in poverty. Fitzgerald represents poverty as lying beneath wealth and providing the wealthy with a dumping ground. It is what the wealthy wish to avoid seeing at all costs. Through the descriptions of the â€Å"valley of ashes,† we see how immoral the rich upper class are to just dump their troubles there without thinking about what it might mean for the people living there. They are only caring about their personal comfort. Thirdly, through the descriptions made of Gatsby, we see the immorality of the society at the time through the illusion of Gatsby’s dream and how the original spiritual aspect of the American dream has gone and made way for xcessive materialism. He stretched out his arms towards the dark water in a curious way, and, far as I was from him, I could have sworn he was trembling. Involuntarily I glanced seaward and distinguished nothing except a single green light, minute and far away, that might have been the end of a dock. When I looked once more for Gatsby he ha d vanished, and I was alone again in the unquiet darkness. (p. 16) In our first acquaintance with the green light, we see Gatsby reaching out for it, almost, in a way, worshipping it. We find out later that this green light is at the end of Daisys dock, and is a symbol for Gatsbys dream and the hope for the future. Green is the color of promise, hope, and renewal so it is fitting that Gatsbys dream of a future with Daisy be represented physically in the novel by this green light. Later, in the final chapter of this novel, Fitzgerald compares Gatsbys green light to the green breast of the new world (115), comparing Gatsbys dream of rediscovering Daisy to the explorers discovery of America and the promise of a new continent. However, Gatsbys dream is tarnished by his material possessions, â€Å"the colossal significance of that green light had vanished forever,† (p. 90) The means corrupt the end, and Gatsbys dream dies because of Daisy, Gatsby, and Toms carelessness and superficiality, as does Gatsby for the same reasons. At the end of the first chapter, we see Gatsby reaching out for the green light, a symbol for the hope and promise of the future, almost in the attitude of a worshiper. This is the first suggestion Fitzgerald gives us that Gatsbys quest for Daisy is more than just a physical endeavor, but a spiritual one as well. Also in this chapter, we see Gatsby, after the car accident, looking over Daisy from her yard, trying to protect her. His watch over her window is compared to a vigil, and while Nick talked to Gatsby that night, he sensed that his presence was ruining the sacredness of the moment. However, Gatsbys vigil was over nothing Daisy was never in her room that night much like Gatsbys dream is over a nonexistent person. The Daisy he met and fell in love with years ago is not the same person anymore, and as much as Gatsby thinks that he can repeat the past, in the real world it is proven to be impossible. On one level, Fitzgerald gives us Gatsbys dream as a spiritual quest, but on another level, we find out that this is yet another reason why his dream fails. His faith is misplaced, because the object of his quest is nothing more than Daisy Buchanan. Gatsby is also associated with moonlight/starlight and artificial light. For example when Jordan is talking about Gatsby with Nick, Gatsby is described as dispensing, â€Å"starlight to casual moths,† The starlight/moonlight is representative of the fantasy/illusion or unreachable quality of Gatsby’s dream, this quote is saying that his dream is unreachable and doomed from the beginning because he wants Daisy (the â€Å"casual moth†) who is attracted to artificial light which is representative of the material means that he hopes to attract Daisy. There is a lot of proof of this in chapter 5 when Daisy and Gatsby meet for the first time, Gatsby describes the front of his house as, â€Å"catching the light,† (p. 7) the front of his house faces Daisy so he is trying to attract Daisy with his vast material wealth which is represented by the artificial light. Even though Gatsby is an, â€Å"ecstatic patron of recurring light,† he is giving lots of light to attract Daisy, we know his dream is doomed from the start because Dais y has, â€Å"snapped out the lights,† (p. 17) Therefore, Fitzgerald is saying that the spirituality of the American dream is misplaced because of our obsession with material wealth, which creates a sort of national delusion and this conveys an immoral judgment of the society. Fourthly, the descriptions of the Daisy convey an immoral and unethical judgment of the upper class in society by showing the shallowness, hollowness and idleness of them. When we first meet Daisy at the Buchanan’s mansion, she is described as; â€Å"Buoyed up as though upon an anchored balloon†¦their dresses were rippling and fluttering. † This quote establishes the fact that Daisy is shallow and hollow because they are so purposeless that they just sit there and go where the wind â€Å"blows them. † This is reinforced when it says, â€Å"sometimes she and Miss Baker talked at once†¦their impersonal eyes in the absence of all desire. (p. 17) And when Daisy remarks that, â€Å"I’ve been lying on the sofa for as long as I can remember. † (p. 16) This conveys the idleness and purposeless way of life the Daisy follows. The description of Daisy’s voice also conveys the hollowness and shallowness of Daisy. For example, Nick says that, à ¢â‚¬Å"her voice compelled me forward breathlessly as I listened-then the glow faded, each light deserting her with lingering regret†¦her voice glowing and singing. † (pg. 19) and â€Å"as if each speech is an arrangement of notes that will never be played again. † (p. 14). These suggest the hollowness of Daisy Buchanan because although her voice and her stunning beauty draw people in. When they â€Å"lean in† to hear what she actually has to say, they hear â€Å"nothing† because she is empty and hollow. Also, a lot of Daisy’s descriptions are associated with white light. In the Great Gatsby, white represents emptiness or hollowness. This is associated with Daisy a lot because she is empty and hollow, for example Nick describes Daisy at Daisy’s house, â€Å"They were both in white,† (p. 13) and â€Å"white dresses† (p. 17). Another theme that Daisy is associated with is materialistic wealth. For example, Nick says that, â€Å"Her voice is full of money. †(p. 115) She is attracted to money, she is not pure, she is yellow (has a dazzling appeal) eg. â€Å"two rows of brass buttons on her dress gleamed in the sunlight. † We see that the only reason that she is attracted to Gatsby is because of his great material wealth. We know this because Daisy tells Gatsby that he, â€Å"resembles the advertisement of the man,† (p. 114). This statement confirms that Daisy does not like Gatsby for himself, but for the wealth and superficial illusion he represents. Daisy is associated with darkness/twilight, for example she is at the beginning of the novel, she says â€Å"why candles? † and then, â€Å"snapped them out with her fingers. †(p. 17) also while Gatsby is watching for Daisy in case Tom acts violently to her, she, â€Å"comes to the window†¦then turned out the light. † (p. 140) This is symbolic of Daisy’s â€Å"snapping out,† or destruction or Gatsby’s dream because she is turning off the light on Gatsby’s dream and not giving him a chance of fulfilling, therefore the dream is doomed from the start. Daisy is also representative of the American Dream and because she has snapped out the light on Gatsby’s dream, it shows the disintegration of the American Dream. This shows the immorality of Daisy who is representative of the upper class in society because she is so obsessed with materialistic aspect of the American dream rather than the spiritual aspect. Lastly, we can say that Tom Buchanan, who is another representative of the upper class, is also hollow because of the descriptions given of him. For example, at Tom’s house when Nick first goes over, he suddenly exclaims, â€Å"If we don’t look out, the white race will be utterly submerged. It’s scientific stuff; it’s been proved. † (p. 18) This racism and utter nonsense shows the shallowness of Tom because not only does he make racist remarks, he doesn’t know what he is talking about when he says that, â€Å"it’s been proven. † Tom’s beliefs are hypocritical but lack moral caliber, compassions and idealism. In the same section, Tom is described as, â€Å"hovering restlessly around the room,† (p. 15). This shows like Daisy, he seems to want to do something but is unsure of what to do. Also, we notice that Tom is associated with words of movement (â€Å"shifting and moved by â€Å") and this can again be seen in relation to Fitzgerald’s description of him and his wife as wealthy drifters. What is interesting about Tom’s cruel body is that normally cruel is referred to a person and not to a body. Fitzgerald doesn’t write that Tom is cruel but that his body is cruel, suggesting problematically a separation between his body and his character, as if Tom’s cruel sensuality may assert itself despite his will. The fact that Tom’s cruel body comes so close in the text to the description of his muscles almost bursting through his clothes suggests that the purely animal, physical part of his nature (his cruel body) is capable of bursting out instinctively at any moment, as indeed it does. In fact Tom bruises Daisy’s finger and breaks Myrtle Wilson’s nose in a rage. This shows the hollowness of Tom because he can’t control his violence or actions. Tom never considers living up to the standards he expects of people around him. For example, he doesn’t want Gatsby to take Daisy away from him going to great length to â€Å"investigate him,† while he is oblivious to the double standard in his practice of maintaining sexual relationships with other women, like Myrtle. Therefore, Tom has values, but they’re conveniences, easily disposed of as the whim takes him and he is only physically powerful. This shows the shallowness, hollowness of the upper class and conveys the judgment that they are lacking in ethics and morals.

Industrialization and The Jungle essays

Industrialization and The Jungle essays Immigration in America came as a result of the industrialization of the United States. The American business class needed a larger working class to perform the extra labor the country now needed to have done in order to have a strong economic system, especially with the construction of railroads. Between the 1860s and 1890s ten million immigrants had come to the United States. It wasnt very difficult for American companies to attract immigrants, they advertised the American Dream to the people of Europe and Asia. Once one person from a community did well in America, word spread throughout their homeland and many more would come. The problem with this is that too many people had come to America and there would soon be a shortage of jobs and the corruption of the business owners towards the immigrants. The Jungle goes into the overpopulation of small cities and the exploitation of immigrants, in particular Jurgis and his family from Lithuania. Sinclair had a cynical view of industrialization, The Jungle portrays the American Industrialization at its worst. He shows the working conditions and corruption, in particular the meat packing industry, as they actually were in the late 1800s. Sinclair showed the terrible working conditions that Jurgis, his family and all the other immigrant workers had to endure. He shows how the American employers, and others, took advantage of immigrants who werent well educated, knew little English, or just had no other alternative but to agree to the terms of the higher class. Most immigrants were paid next to nothing by their employers, which made just about every member of the family go out and get a job. Jurgis did not let Ona, Teta Elzbieta or the kids work, Jurgis wanted the children to get an education so they didnt have to work in the stockyard their whole lives like he will have to. The upper class would do almost anything to stay in the upper class, ...

Piager's Cognitive Developmental Theory Research Paper

Piager's Cognitive Developmental Theory - Research Paper Example The sensorimotor stage is representative of the early-aged youth, from birth to age two. It is a period where the child begins to recognize basic mobility and hand-eye coordination as well as a variety of foundational mental representations accumulated through vision, touch, and motor conditioning. The preoperational stage is a period where more formal logic is developed, ranging between age two through seven, in which the child maintains rather egocentric behaviors and attitudes. It is in this stage where the youth maintains centric-style thinking, which is placing all of their focus and attention on a singular characteristic rather than thinking abstractly about various alternatives. Centration in this stage will often have a child stating that the volume of liquid in two similar beakers, when poured into a taller and more slender container, remains the same even though there was a transition. Thus, broader logic has not yet been developed. The next stage is the concrete operationa l stage, appropriate for youths between seven and 12 years of age, where conservation is now understood, comprehending concepts of reversibility, the ability to classify objects based on common shapes and sizes, and the youth begins to reject their previous egocentric thought. The final stage is formal operations, occurring between the ages of 12 to late adolescence. This stage involves maintaining an understanding of abstract moral and ethical principles, where the child is able to reasonably determine potential consequences to an action, and where some egocentric behaviors and attitudes re-emerge as a product of identify formation. Having provided a brief summation of the different stages, the one particular stage of development appropriate for more intensive examination is the concrete operational stage, the stage where egocentric behavior begins to diminish and where elementary logic begins to surface. In order to facilitate more effective learning, a child in the concrete opera tional stage of development requires a tactical approach to learning, using hands-on methodologies to gain attention and comprehension. Shaikh (2003) suggests that youths in this stage must have recurrent trial-and-error in experimentation where knowledge findings are repeated with instructor-generated feedback in order to retain learning from experiential lessons. Shaikh (2003) further emphasizes that lectures as a tool for imparting knowledge will be ineffective during this stage of development due to the rationalization processes within the child between seven and twelve. The child in the concrete operational stage gains more curiosity about the world around them as they are able to establish logical patterns and shape distinctions with the shedding of their self-motivated thought patterns. Their curiosity will demand hands-on applications to learn complex concepts such as mathematics, thus students being taught in the classroom will require dice, algebra blocks, spinners, or oth er appropriate experiential tools (Burns & Silbey, 2000). Why is this? Students have not yet developed the verbal capabilities to express their newfound logic and reasoning (e.g. classification and conservation), thus they require more fundamental learning tools to fill this void in self-expression (Santrock, 2008). Thus, to properly

International Business - COACH Essay Example | Topics and Well Written Essays - 1250 words

International Business - COACH - Essay Example These include indirect and direct-to-consumer. In its global operations, these segments can be regarded as channels of distribution. Through direct-to-consumer segment facilitates Coach with instant access to consumers, thus providing it with an opportunity to understand the tastes and preferences of its wide consumer bases especially in regions such as mainland China, Japan, Hong Kong, North America and Singapore among others. This segment facilitated Coach with around 89% of the entire net sales in the year 2012. With regard to any future expansion strategy in a new market segment as well, direct-to-consumer strategy can be fruitful for Coach. In terms of its indirect segment of operations, royalties obtained from licensing of products is a major component. Moreover, wholesale channel is a critical aspect which also includes sales through online websites. One of the major prospects for Coach can arrive from emerging markets as it has already started to sell its offerings through au thorized retailers and distributors in a number of new markets. Shop-in-shops option created by the company can also facilitate the growth of the company in its global business operations. The company’s e-commerce strategy is also a major beneficial aspect in its global operations. In nations such as Japan, Canada and the US, a large number of visitors prefer to use online mode to purchase the products of Coach. Coach rules the global market for its fashionable handbags as well as attractive accessories. Coach focuses on merchandising and designing through team work and through having a close collaboration its licensed business partners to ensure quality offerings. Coach uses new technologies such as social networking sites like Facebook as well as Twitter to create awareness and to enhance its customer base. Coach also ensures its compliance with its Global Business Integrity Program which can enable it to maintain its legal and ethical responsibilities thus facilitating wit h significant opportunities in its business operations globally (EDGAR Online, Inc, 2013). B. Analyzing International Competitors Majority of organizations are changing their operating functions to global scale. This is likely to create a fiercely competitive global fashion retail industry. The competition against the operating firms in the global market can be analyzed by the intensity of the competition and by determining the growing competition between the fashion brands globally. Coach has significant number of major competitors in the luxury fashion products industry. Coach competes in global market with Gucci, Louis Vuitton, Prada and Hermes. The competition in the fashion industry is densely intense, for having very less market-entry barriers. One of the world’s reputed fashionable luxury manufacturing product companies is Louis Vuitton. As of the year 2008, Louis Vuitton had a brand value of about â‚ ¬16.718 billion. One of the most competitive advantages of Hermes International S.A. is that it provides its consumer hand-made products, which ensures their uniqueness as well as quality. Gucci, an Italian luxury product designer brand, is a leading name in the global market, consequently having revenue of around â‚ ¬4.2 billion as of 2008 (Dickinson State University, 2011). Thus, it can be ascertained

Refractory Monosymptomatic Nocturnal Enuresis Treatment

Refractory Monosymptomatic Nocturnal Enuresis Treatment Role of Posterior Tibial Nerve Stimulation in the Treatment of  Refractory Monosymptomatic Nocturnal Enuresis: A Pilot Study Ali Abdel Raheem,* Yasser Farahat, Osama El-Gamal, Maged Ragab,  Mohamed Radwan, Abdel Hamid El-Bahnasy, Abdel Naser El-Gamasy  and Mohamed Rasheed Purpose: We evaluated the early clinical and urodynamic results of posterior tibial  nerve stimulation in patients with refractory monosymptomatic nocturnal enuresis. Materials and Methods: We randomly assigned 28 patients with refractory  monosymptomatic nocturnal enuresis to 2 equal groups. Group 1 received a  weekly session of posterior tibial nerve stimulation for 12 weeks and group 2 was  the placebo group. Evaluation was performed in each group at baseline and after  posterior tibial nerve stimulation to compare clinical and urodynamic findings. Another clinical assessment was done 3 months after the first followup. Results: The 2 groups were comparable in baseline clinical and urodynamic data. Overall, 13 patients (46.4%) had detrusor overactivity and 14 (50%) had decreased  bladder capacity. After treatment 11 group 1 patients (78.6%) had a partial or full  response to posterior tibial nerve stimulation but only 2 (14.3%) in group 2 had a  partial response (p 0.002). Also, the average number of wet nights in group 1 was  significantly lower than at baseline (p 0.002). All urodynamic parameters significantly  improved in group 1. In contrast, the number of wet nights and urodynamic  parameters did not change significantly in group 2. At 3-month followup the number  of patients with a partial or full response in group 1 had decreased from 11 (78.6%)  to 6 (42.9%). No change was evident in group 2. Conclusions: Posterior tibial nerve stimulation can be a viable treatment option  in some patients with refractory monosymptomatic nocturnal enuresis. However,  deterioration in some responders with time suggests the need for maintenance  protocols. Key Words: urinary bladder, nocturnal enuresis, transcutaneous electric  nerve stimulation, urodynamics, treatment outcome  NOCTURNAL enuresis is usually associated  with severe psychological and social  distress to children and their families. 1 In recent years several treatment  modalities emerged to treat NE, such  as behavioral therapy,2 alarm treatment,  3 medical therapy with desmopressin,  oxybutynin and imipramine,  and combination therapy.4–6 However,  none has been completely successful and  the relapse rate of all of them is significant. 7–9 Therefore, there is a great need  to find other treatments that could be  more effective and durable than current  therapy.  The pathogenesis of refractory NE  was discussed in many studies and attributed  to decreased bladder capacity  and/or PTNS was introduced with early  promising results as neuromodulative  therapy for diseases that involve the  lower urinary tract and for refractory conditions in  adults and children.15–19 These beneficial effects of  PTNS for controlling various bladder disorders led  us to try it in patients with refractory primary MNE.   MATERIALS AND METHODS A total of 28 patients were included in this prospective,  randomized, placebo controlled, single blind study from  January 2010 to March 2012 at the urology department at  Tanta University Hospital. The study protocol was reviewed  and approved by the Tanta University institutional  review board. Informed consent was obtained from  all participants or from parents if the patient was younger  than 18 years. We recruited patients with severe (3 or more wet nights  per week) primary MNE at least 6 months in duration in  whom available conventional and combination therapies  had failed, including desmopressin, anticholinergics and  an alarm. We excluded those with secondary NE, nonMNE,  nocturnal polyuria and any neurological abnormality. All patients provided a detailed history and underwent  complete physical examination, urinalysis, x-ray of the  lumbo-sacral spine and ultrasound of the urinary system.   All patients were asked to keep a nocturnal enuresis diary  for 2 weeks, which included the time of sleep and arousal,  and whether they had a dry or wet bed in the morning. Nocturnal urinary output was measured as the total urine  volume collected in the diaper after voiding during the last  night (assessed by weighing the diaper in the morning)  plus the first morning urine volume. Nocturnal polyuria  was defined as nocturnal urine output 130% or greater of   EBC for age.20 The Arabic version of a 2-day frequency-volume chart  (adapted from the Pan Arab Continence Society, www.pacsoffice.com) was obtained from all patients to confirm  that the problem was MNE. Daytime functional bladder capacity was considered the recorded MVV. EBC for age  was calculated by the formula, 30 _ (age in years _ 30). Children with MVV less than 65% of EBC for age were  considered to have a small bladder.20 All patients also underwent urodynamic tests, as performed  by the same urodynamicist using a Delphis-KT  device (Laborie, Toronto, Ontario, Canada), including  1) uroflowmetry with PVR estimation by ultrasound for at  least 2 voids and 2) cystometrogram, including 1 filling  cycle using an 8Fr double lumen urethral catheter with  the patient supine and a slow filling rate of 10 ml per  minute. Patients were randomly divided into 2 equal groups by  method. Randomization was done blindly by having an  independent nurse randomly take a card from an envelope  containing 14 cards for group 1 and 14 for group 2. Group  1 received active PTNS treatment sessions using the  Urgent ® PC Neuromodulation System, while group 2 underwent  a sham procedure. Treatment Protocol We applied the technique described by Stoller.21 The patient  lay supine with the soles of the feet together, and the  knees abducted and flexed (frog position). A 34 gauge  needle was inserted percutaneously approximately 2  inches (5 cm) cephalad to the medial malleolus and 1 cm  from the posterior margin of the tibia at an angle of 60  degrees from the skin surface and the lead wire attached  to it. The surface electrode was placed on the same leg  near the arch of the foot over the calcaneus bone. The  device was turned on and amplitude was slowly increased  until the largest toe of the patient began to curl, the digits  fanned or the entire foot extended, indicating proximity to  the nerve bundle (see figure). If this response was not  achieved or pain occurred near the insertion site, the  device was turned off and the procedure was repeated. When the needle was inserted in the correct position, the  current was set at a tolerable level (pain threshold) and  the session continued for 30 minutes. For the sham procedure we tested only the foot response  to the electrical impulse and then turned off the  apparatus during the whole session. To avoid patient  identification of the type of procedure all participants  were informed that they may or may not feel a sensory  stimulus in the lower extremities during the treatment  sessions. Groups 1 and 2 underwent 12 weekly outpatient treatment  sessions. All participants were advised to stop all  medical treatment for NE at least 1 month before starting  PTNS but to continue behavioral therapy, including fluid  A, neuromodulation system. B, system in use with flexion of left largest toe.   restriction at night, complete bladder emptying before  sleep and awakening 2 hours after sleep to void. Patient Assessment The first patient evaluation was done in the first 2 weeks  after the last session. This evaluation involved repeating  the clinical and urodynamic assessments. The clinical part  included a nocturnal enuresis diary for 2 weeks in which  the number of wet nights/week was reported as well as a  2-day frequency-volume chart. The clinical response to treatment was assessed as  outlined by the International Children’s Continence Society,  including no response—less than a 50% decrease in  the total number of wet nights, partial response—50% to  89% decrease, response—90% or greater decrease and full  response—100% decrease.20 Urodynamic assessment included  uroflowmetry, PVR measurement and cystometry. The second evaluation was done 3 months after the last  session. It involved clinical evaluation using nocturnal  and voiding diaries only. Statistical Analysis All statistical analysis was performed using SPSS ® 17.   Data are shown as the mean SD unless otherwise specified. The Student t and paired sample t tests were used  for comparison between groups and in the same group,  respectively. Nonparametric data were compared by the  Wilcoxon signed ranks or Mann-Whitney U test. Statistical  significance was considered at p 0.05. RESULTS Recruited for this study were 28 patients with refractory  NE who met inclusion criteria. Initial assessment  and baseline characteristics of each group  showed no significant difference in clinical and urodynamic  parameters (table 1). Overall, in the 2  groups DO was present in 13 patients (46.4%) and  14 (50%) had decreased bladder capacity.   The procedure was performed easily with no adverse  effects in all cases. No patient discontinued  the planned sessions. At the end of the PTNS sessions clinical assessment  revealed significant improvement in the average number  of wet nights per week in group 1 (decrease from  4.7 to 2.6, p 0.002, table 2). Compared to the placebo  group, the number of wet nights after treatment was  significantly lower in group 1 (p 0.041, table 2). At  that time 4 group 1 patients (28.6%) had a complete  response to PTNS, 7 (50%) had a partial response and  3 were nonresponders. However, in group 2 there were  2 patients (14.3%) with a partial response, while the  remainder did not respond. When we compared the 2  groups, the difference in this response rate was statistically  significant (p 0.002, table 2). At first evaluation after the end of treatment, the  active group showed significant improvement in all  urodynamic parameters compared to baseline, including  first and strong desire to void, and MCC  (p 0.002, 0.01 and 0.000, respectively, table 2). In  group 2 these parameters did not significantly differ  compared to baseline (table 2). Also, DO disappeared  in 2 of 7 group 1 patients but this improvement was  not noted in the sham treated group (table 2). Statistical  analysis revealed that the difference be- Table 1. Patient characteristics Active Placebo p Value No. boys/girls 8/6 9/5 1 Mean SD age (yrs) 13.7 2.8 14 2.8 0.8 Mean SD body mass index (kg/m2) 24.95 4.40 26.27 4.23 0.43 Mean SD max urine flow (ml/sec) 26.85 6.74 23.28 5.49 0.13 Mean SD PVR (ml) 6.21 7.11 5.86 5.48 0.9 Mean SD daytime frequency 3.9 0.67 4.29 0.64 0.07 Mean SD MVV (ml) 266.57 82 288.93 106.29 0.27 Mean SD No. wet nights/wk 4.7 1.3 5.1 1.4 0.42 No. detrusor overactivity: Present 7 6 1 Absent 7 8 — Mean SD void desire (ml): 1st 148.46 25.89 153.50 21.65 0.59 Strong 260.43 84.18 271.79 75.43 0.71 Mean SD MCC (ml) 291.21 86.82 322.21 76.04 0.32 Table 2. Intragroup and intergroup comparisons of clinical and urodynamic findings after PTNS at first evaluation Active Placebo Baseline After Treatment p Value Baseline After Treatment p Value Posttreatment p Value Mean SD void desire (ml): 1st 148.46 25.89 177.71 35.48 0.002 153.50 21.65 154.14 20.71 0.59 0.041 Strong 260.43 84.18 283.64 72.03 0.01 271.79 75.43 271.6 72.8 0.94 0.67 Mean SD MCC (ml) 291.21 86.82 322.5 65.89 0.000 322.21 76.04 323.57 77.44 0.57 0.97 No. detrusor overactivity: Present 7 5 0.44 6 6 1 0.7 Absent 7 9 8 8 Mean SD MVV (ml) 266.57 82 280.14 71.81 0.022 288.93 106.29 291.07 96.84 0.73 0.6 Mean SD No. wet nights/wk 4.7 1.3 2.6 2.2 0.002 5.1 1.4 4.7 2.1 0.08 0.041 No. response: — — — — Full 4 0 0.002 Partial 7 2 None 3 12 1516 POSTERIOR TIBIAL NERVE STIMULATION FOR REFRACTORY NOCTURNAL ENURESIS tween the 2 groups in this regard was not statistically  significant (p 0.7, table 2). Furthermore, in  this evaluation urodynamic parameters showed that  bladder volume at first desire to void was significantly  higher in group 1 than in group 2 (p 0.041). On the other hand, bladder volume at strong desire  to void and MCC did not significantly differ between  the groups (p 0.67 and 0.97, respectively, table 2). Five of the 8 group 1 patients with decreased EBC  showed improved capacity. MVV also significantly  increased after treatment from a mean of 266.57  82 to 280.14 71.81 cc (p 0.022, table 2). When we studied the relationship between the response  to PTNS and initial urodynamic findings, we  noted that all 10 group 1 patients with small bladder  capacity and/or DO showed a good response to treatment,  including 4 and 6 with a full and partial response,  respectively. However, when we compared the type of  response in those with normal vs abnormal urodynamic  results, the 4 patients with normal urodynamic findings  in this group had a poor response to the sessions, including  3 with no response and 1 with only a partial response. This difference was significant (p 0.007). Clinical results at 3 months after the last session  showed some deterioration in early results in the  active group. In this group the number of patients     ith a full response decreased from 4 to 2 and the  number of those with a partial response decreased  from 7 to 4. No change was detected in the other  group. However, when we compared the response  rate in the 2 groups at this time, we detected no  significant difference (p 0.13). In addition, the  average number of wet nights per week at that time  was 2.9 in group 1 and 4.2 in group 2, which did not  significantly differ (p 0.07). DISCUSSION This study demonstrates that PTNS could be of value  in some patients with primaryMNEin whom previous  conventional therapies failed. To our knowledge this  treatment modality has not been tried before in such  cases but it has been successfully used for overactive  bladder syndrome,22,23 lower urinary tract dysfunction  in adults and children,15,18 refractory overactive bladder,  16 refractory vesical dysfunction19 and refractory  nonneurogenic bladder sphincter dysfunction.17   Absent daytime lower urinary tract symptoms in  patients with NE does not necessarily mean that the  bladder functions well because DO and/or decreased  bladder capacity was previously reported in such  patients.10,11 The clinical response to desmopressin  therapy is less satisfactory when NE is associated  with decreased bladder capacity and/or DO.12–14 In  our study we detected DO and decreased bladder  capacity in 46.4% and 50% of patients, respectively,  although patients with MNE only were included in  analysis. These values agree with previous reports  showing bladder overactivity24 and small bladder  capacity25 in 49% and 50% of children with MNE,  respectively. These findings may partially explain  the mechanism of resistance to the previous treatment  trials in our patients. Our results and those of others reveal that PTNS  can be applied easily and safely in children.18,19  After the 12 PTNS sessions in our series, patients  showed a significant increase in MVV and urodynamic  parameters, including first and strong desire  to void, and MCC, compared to the placebo group. These results agree with those in previous reports  demonstrating that PTNS increased cystometric capacity  from 197 to 252 cc26 and from 243 to 340 cc,27  and increased MVV by 39 cc, which was statistically  significant.23 However, at 3-month followup we detected some  deterioration in the response rate compared to early  results. The overall number of full and partial responders  decreased from 11 (78.6%) to 6 (42.9%) in  group 1. This deterioration during followup suggests  that PTNS may have temporary efficacy and its effect  decreases gradually with time. This finding was also  noted in patients with overactive bladder treated with  PTNS. van der Pal reported that 7 of 11 patients with  an initially good response had evidence of subjective  and objective deterioration after PTNS.28 They suggested  the need for maintenance treatment. The early promising results of this study encouraged  us to suggest that PTNS might be effective  in patients with refractory primary MNE in  whom nocturnal polyuria is not an etiological factor  but in whom the main underlying pathological  condition is decreased bladder capacity and/or DO. However, the exact mechanism that could explain  the mode of action of this treatment modality is  still unknown. PTNS may induce some inhibitory  effects on DO. The existence of this functional  abnormality in the bladder implies that the detrusor  is not completely relaxed between voids.   Therefore, the capacity of the overactive bladder is  usually smaller than that of the bladder with a  normal detrusor. Consequently, the clinical response  usually occurs when bladder capacity increases  and DO improves after PTNS. This explanation  may be supported by the improvement in  bladder capacity (functional and cystometric) and  the disappearance of DO in patients who responded  to PTNS in our study. The main limitations of this study are the small  sample size and the short 3-month followup. In  addition, we did not repeat urodynamic tests at  the second followup at 3 months to avoid patient  discomfort but depended only on the patient clinical  response. However, this information could be important for assessing the cause of the deterioration in PTNS efficacy after treatment was  stopped. CONCLUSIONS PTNS appears to be a viable treatment option in  some patients with refractory primary MNE. However,  deterioration in the response rate with time  raises important questions about the long-term  efficacy of this therapy and the need for further  maintenance sessions. More studies are needed to  support our findings and select patients who  would be good candidates for this therapy.