Resources Linear Programming Model †Free Samples to Students

Question: Discuss about the Resources Linear Programming Model. Answer: Introduction: There are several insights that can be gleaned from the video on linear programming. The rational decision making process involves different steps before the final decision is made logically. The rationality of the decision made is based on making choices between alternatives which is made using logic and rationality (Eisenfuhr, Weber Langer 2010, p.3). The other consideration that is factored in the process of decision making is to be objective and analytical. This is in contrast to using insight and subjectivity in the decision making process. The assumptions used are that the person making the decision has the time, ability and resources to evaluate the available alternatives. The rationality for making the decision is dependent on information which is perfect and unambiguous. The information available should avail all relevant data that will be used in making a rational decision (Eisenfuhr, Weber Langer 2010, p.10).In the case of the linear programming word problem, the relevant data are the costs of fat and protein and the content in each brand of cattle feed available (Patrick 2010). The decision is then made using five steps: formulating the goal, identifying criteria, analysis and decision making. The range of costs is reached as the goal that will guide the final decision made. There are several limitations in using linear programming. Determining the objective set out is often a complex undertaking in linear programming. Other constraints which are not set out within the variables may affect the final outcome of the programming (Gupta 2015, p.3). Some constraints used within the programming may not be expressible as inequalities in the linear programming. Another limitation is the hypothesis that assumes linear relations of the variables used. This may not be applicable for real life situations. Estimating the values of the constant co-efficient that are varied poses another limitation in using linear programming. The assumption that there is perfect competition in products and markets limits the use of this technique of analysis. The reality of life is that perfect competition is seldom achieved. The assumption based on the hypothesis of constant returns in a firm is wrong based on practical experience of production. Returns are either diminishing or increasing for most firms. The solutions presented with this technique are mostly presented as trial and error. It also has limitation for complex problems that require optimal solutions such as in economics. Practical application of linear programming Linear programming may be useful in several situations of decision making. In production processes, it can be used to solve problems of planning for production (Kanu, Ozurumba Emerole 2014). This helps the operations manager of a production facility to make decisions of how best to allocate resources that will maximize profit. The resources available may be in the form of raw materials, labour, and money. The outcomes that will be presented as solutions may be the profits return on investment and costs. The clearly defined variables will then assist in making a rational and logical decision. After the TED talk presentation by Ghemawat, my views on globalization have changed drastically. My previous assumptions were that the world was more integrated due to the use of technology. The term globalization was synonymous in my mind with increased global trade and normative cosmopolitanism (Sterri 2014, p.71). The use of social media was main driver of globalization that created new global citizens. The efficacy of the use of social media has been shown to have a small reach in creating global citizens based on friendship. Technology rests on frameworks of friendships already established and does necessarily create new friendships. The official data that has always been published as the metrics to show how globalized we are how been debunked as being wrong on different factors. Data on international calls, cross-border migration, export-to GDP ratio and investments have all been shown to be significantly lower than the official data (Ghemawat 2012). These statistical anomalies have been used to propagate the wrong assumptions that people have on globalization. The real figures which the talk presented are much lower and reflect the true state on globalization. We are not as globalized as we think, or the world is not flat according the presenter of the talk. The distorted view on globalization can be narrowed to several reasons. These reasons contribute to the wrong assumptions that people have on globalization, including me. The lack of credible data is one critical contributing reason (Ghemawat 2012). Peer pressure is another reason that makes people to postulate on a topic that they are ill informed. The last reason is what Ghemawat states is techno-trances (Ghemawat 2012).Having heard the same thing said over time, people tend to believe it in a form of subliminal programming and therefore may accept the lie on globalization. I agree that all my previous views have been wrong, ill informed and myopic. Question two- Fears on Globalization One of the fears is on immigration. The current wave of immigration from Africa and the Middle East has raised concerns in some counties as to the effect such immigration has on their populations. A good example is France which has a sizeable number of immigrants amongst all European countries. People in France have the assumption that currently immigrants account for around 24% of their population (Ghemawat 2012). Adida, Laitin Valfort (2014) state that this raises issues of internal security due to terrorism, religious intolerance and unemployment which may lead to problems of extremism and racism. Knowing the true figure which is 8% may assist in social inclusivity and reduce racial tensions in France. Another area of fear is in the sensitive topic of foreign aid. Most citizens of countries which engage in giving aid to less developed nations have misconceptions about the true figures spent by their government. Most Americans assume that the foreign aid from the federal budget is close to 30% while the true figure is about 1% (Ghemawat 2012). This includes military and other assistance on security (McBride 2017). Knowing the true material facts may push for the case of more money being allocated towards foreign aid. Ghemawat (2012), states that more aid that is channeled to developing nations may actualize the targets set out at the Rio Summit which was 20 years ago. Conclusion Rational decision making can be helpful for the management in making decisions in organizations. It assumes the person making the decision has cognitive ability and uses rationality and logic. Linear programming is a tool that can be used by mangers in making rational decisions. Available figures have tended to show that globalization has a greater impact on trade and immigration than is the reality. The true figures show the contrary and may help in reducing wrong fears and assumptions on aid given to poor countries and immigration. References Adida, C., Laitin, D., Lafort, M, 2014, The Muslim effect on integration and integration in France, The Washington Post, viewed 18 August 2017, https://www.washingtonpost.com/news/monkey-cage/wp/2014/09/30/the-muslim-effect-on-immigrant-integration-in-france-2/?utm_term=.76a33d2e70b6 Eisenfuhr, F., Weber, M., Langer, T, 2010, Rational decision making, Berlin, Springer. Ghemawat, P, 2012, Actually, the world isnt flat, TEDGlobal, viewed 18 August 2017, https://www.ted.com/talks/pankaj_ghemawat_actually_the_world_isn_t_flat/details Gupta, D, 2015,Strategic allocation of resources using linear programming model with parametric analysis: in MATLAB and Excel Solver, Hamburg, Anchor Academic Publishing. Kanu, I., Ozurumba, B., Emerole, C, 2014, Application of linear programming techniques to practical decision making, viewed 18 August, https://iiste.org/Journals/index.php/MTM/article/viewFile/15080/15205 McBride, J, 2017, How does the US spend its foreign aid, CFR, viewed on 18 August 2017, https://www.cfr.org/backgrounder/how-does-us-spend-its-foreign-aid Patrick, JMT, 2010, Linear programming word problem -Example 1, viewed 18 August, https://www.youtube.com/watch?v=2ACJ9ewUC6U Sterri, A., B, 2014, Global citizen-- challenges and responsibility in an interconnected world, Rotterdam, Sense Publishers.

Historical Political Event The Marshall Plan

Table of Contents Abstract Introduction Overview of the Marshall Plan Motivations Behind the Plan Impact of the Marshall Plan Conclusion References Abstract The paper discusses the Marshall plan of 1947 as a major historical political event of the United States. It begins by acknowledging that this plan was developed from the realization by American policy makers that Europe required aid in order to recover form the devastations caused by the war.Advertising We will write a custom term paper sample on Historical Political Event: The Marshall Plan specifically for you for only $16.05 $11/page Learn More The plan was proposed by the then secretary of state, George Marshall who stated that Europe’s weakened economy made her vulnerable to economic and political collapse (Cox Kennedy-Pipe, 2005). European countries were required to collectively come up with a proposal on the type of aid required and then notify the US. As such, European cooperatio n was a prerequisite for receiving aid through the plan (Scott, 1995). The paper recognizes that the Marshall Plan was a comprehensive scheme that was proposed for a number of reasons. The first was that the rate of recovery following the War was very slow. Cox and Kennedy-Pipe (2005) state that the US had interest in the recovery of European economy since such a recovery had impacts on its long term economic well being. The aid would also strengthen economies and thus prevent the outbreak of another war. The Marshall plan was also used as a tool for the containment policy which sought to curb Soviet expansionism and influence in the continent. The plan also hoped to prevent nationalistic sentiments that had previously led to the rise of the NAZI party. The paper also reviews some of the positive and negative outcomes of the Marshall Plan. On the positive, the plan is seen to have resulted in the successful reconstruction of Western Europe. The plan also lad the ground works for the integration of European nations, a plan which has culminated in the emergence of the European Union.Advertising Looking for term paper on history? Let's see if we can help you! Get your first paper with 15% OFF Learn More The plan also acted as a reconciliation tool and former wartime enemies were able to work together in cooperation for the development of the continent. American capitalism was also embedded in European values as a result of the Marshall Plan. On the negative, the paper notes that the plan was a catalyst to the outbreak of the Cold War. The plan also led to the division of Germany into East and West (Chollet Goldgeier, 2006). The paper concludes by reasserting that the Marshall plan played a monumental role in the revival of Europe and is to be credited with the lasting peace and prosperity that the European countries enjoy. Introduction In its history, the United States of America has had a number of significant political events which have had major consequences for the country and even the international community. One of these monumental events in the political history of the US is the Marshall Plan of 1947. This plan which was designed by the then Secretary of State, George Marshall, is considered by many to be the most successful aid plan implemented by the US. Through the Marshall Plan, American leaders were able to recast the war-torn Europe in the image of American neocapitalism (Hogan, 1985). As a result of this plan, West Europe was able to quickly recover from the wartime devastations. This paper will set out to articulate what the Marshall Plan was and the reasons for its implementation. The impacts that this plan had on the recipient countries in Europe will also be discussed so as to reaffirm the significance of this political event.Advertising We will write a custom term paper sample on Historical Political Event: The Marshall Plan specifically for you for only $16.05 $11/page Learn Mor e Overview of the Marshall Plan What became known as the Marshall Plan was announced during the Harvard University address by George Marshall in 5 June, 1947. The US government was concerned that the economic deterioration experienced by Europe after the war had made the continent weak and therefore vulnerable to economic and political collapse. President Truman engaged in active delegation by relying on the expertise of Marshall to come up with the European Recovery Program (ERP) (Cottam et al., 2009). This plan would be a comprehensive scheme that provided â€Å"mutual aid† and joint action in Europe as a whole with the intention of pointing Europeans in the right direction (Hogan, 1985, p.46). European countries were therefore called upon to consult with each other on the type of aid that they needed in order to recover and then notify the US which was prepared to offer financial aid to assist in the recovery. An assessment of the conditions in Europe revealed that the c ontinent was in genuine need of assistance. May (1948) states that the US had a sufficient margin to offer this assistance since the US had been experiencing economic growth since the prewar years and even during the war years. Adopting a capitalistic economy was a major precondition that a country had to fulfill before it could be eligible for aid from the US. Motivations Behind the Plan Two years after the end of the Second World War, Europe was still lagging behind economically and reconstruction efforts were going on at a slow pace.Advertising Looking for term paper on history? Let's see if we can help you! Get your first paper with 15% OFF Learn More Following these deteriorating economic and political realities in Europe following the war, the US felt compelled to act. Cox and Kennedy-Pipe (2005) contend that while the motives behind the generous offer by the US were complex, the primary objective was to stabilize Western Europe. This stabilization was to be achieved through economic reconstruction and political cooperation among the Western European states. A huge motivation for the ERP was US self-interest. Hogan (1985) who was a chief historian of the plan declared that the measure â€Å"rested squarely on an American conviction that European economic recovery was essential to the long-term interests of the United States† (49). The US recognized that a stable Europe was best for her prosperity since any European war would involve the US (Cottam et al., 2009). Assisting Europe through the ERP was therefore seen as a partly self-serving act. The Marshall Plan effectively promised American aid to a European Recovery Prog ram that would be designed to establish a solid economic foundation for European States (May, 1948). The ERP also aimed at curtailing Soviet influence in Europe. In the postwar years, the Soviet Union was the most economically and politically potent force in Europe. The US was concerned that the Soviet Union would make attempts to influence the weakened European states and export her communist ideals to these countries. The British Foreign Secretary, Ernest Bevin made the case that without economic aid, Britain and indeed the whole of Europe would be unable to resist Soviet pressure (Cox Kennedy-Pipe, 2005). As such, the Marshall plan was to be used as a tool by the US to combat Soviet influence without resorting to military action. The Marshall Plan hoped to prevent nationalistic sentiments among European citizens. Cottam et al (2009) declare that nationalism is one of the most dangerous sources of political behavior in the 20th century. The poor economic state of Europe resulted in inflation and decreased quality of living which were conditions that encouraged nationalistic tendencies. Nationalistic tendencies could result in popular support for militant nationalism which would be detrimental to European peace (Hogan, 1985). For example, German nationalism had been to blame for WWII since it was nationalistic sentiments which had led to mass voting for the Nazis. The Marshall plan recognized the link between economics and militant nationalism and therefore sort to prevent nationalism by easing the burdens of the war devastated Europe. Ekovich (2006) proposes that the US was interested in seeing an integrated European since the country owed its success to the political and economic integration which had come about from the unification of the colonies. American politicians therefore hoped to influence the unification of Europe through the aid plan. While it was emphasized that the initiatives towards unification should come from the European countries themsel ves, the US attempted to influence this with the Truman Administration pushing for European integration at least on an economic level. Impact of the Marshall Plan Positive Impacts The Marshall Plan had a number of positive impacts on Europe. Perhaps the most important outcome of the Marshall Plan is that it led to the successful reconstruction of Western Europe with the countries achieving significant economic growth. While there is disagreement as to the effectiveness of the plan with some opponents suggesting that it resulted in the wasted of over $12 billion of tax payer money, there is general agreement that the plan provided the necessary support to revive the European economy (Hogan, 1985). The plan laid the ground works for the integration of European nations. Through the Marshall Plan, American policy makers attempted to integrate Europe in order to create the era of â€Å"lasting peace and prosperity† (Hogan, 1985). Cottam et al. (2009) demonstrate that long-term s olutions to conflicts can be achieved through developing common identities. Integration strategies are therefore best suited to restore harmony between antagonistic parties. These integration efforts were pushed forward through strategies such as the establishment of collective responsibility for reviewing national requirements for all the countries that received aid under the Marshall Plan. European countries were required to form an international economic infrastructure before they could be eligible for aid from the US. The Marshall Plan also acted as a reconciliation tool for the former war-time enemies. Cottam et al. (2009) state that reconciliation calls for a changed psychological orientation towards the other. The Marshall plan forced the European nations to regard each others as partners in development. Through the plan, the US forced the major antagonists in the war, German, France, and Britain to come up with a way to work together (Ekovich, 2006). At the onset of negotiat ions, France was opposed to having Germany as part of the proposed European Economic Union and it sought to have the country excluded from the aid plans. However, US applied diplomatic pressure to foster peaceful cooperation between the former enemies and by the end; France and Germany were able to work together in a mutually beneficial way. The Marshal Plan increased confidence in the American capitalism ideal which had not been fully embraced by Western European countries such as France. From the onset, the plan required recipient states to adopt a capitalistic economy to make them eligible for aid. By the end of the plan, Western Europe emerged as the economic power which increased the continent’s faith in a capitalistic economic system. The plan was therefore instrumental in saving the European states which had suffered huge devastations in the war from the influence of the Soviet Union. Negative Impacts Historians agree that the Marshall plan was the key catalyst to th e outbreak of the Cold War which lasted for decades. This is because the Cold War began after the plan was announced the Soviet Union together with East European states decided not to participate. Scott (1995) asserts that the Marshall Plan effectively â€Å"divided Europe into two competing blocs, each led by one of the emergent superpowers† (p.22). The adversity between these two blocs lasted for over 5 decades and resulted in many proxy wars and establishment of spheres of influence by the two powers. The cold war resulted in massive military buildups on both sides due to the suspicion with which each side regarded the other (Cottam et al., 2009). The Marshall Plan was also responsible for the splitting of Germany into two parts. Chollet and Goldgeier (2006) argue that since US and British officials hoped to keep Moscow out of the plan, they were unable to gain the cooperation of the Soviet Union and therefore keep Germany intact. This move had negative impacts on the peop le of Eastern Germany who were left vulnerable to the Communist forces. East Germany continued to lag behind economically compared to West German and this situation only started to reverse itself after the fall of the Berlin Wall. Conclusion This paper set out to discuss the Marshall Plan of 1947 as a significant historical political event. It has shown that a major goal of the plan was to stabilize Western Europe and foster future peace and prosperity for the region. The Plan achieved its objectives and led to the emergence of a strong and stable Europe. The paper has demonstrated how the US used the Marshall plan as a tool for reconciliation among the former wartime enemies with great success. However, not all the impacts of the plan were positive and it has been noted that the Marshall plan precipitated the Cold War due to Russia’s refusal to associate herself with the plan. From this paper, it is clear that the purposes of the Marshall Plan were multiple and the consequen ces of the plan were monumental. References Chollet, D. Goldgeier, J.M. (2006). The Faulty Premises of the Next Marshall Plan. Washington Quarterly, 29(1), 7-19. Cottam, M., Dietz-Uhler, B. Mastors, E. (2009). Introduction to Political Psychology. NY: Psychology Press. Cox, M. Kennedy-Pipe, C. (2005). The Tragedy of American Diplomacy? Rethinking the Marshall Plan. Journal of Cold War Studies, 7(1), 97-134. Ekovich, S. (2006). American views of European Integration: A Brief History. NY: JEL. Hogan, J.M. (1985). American Marshall Planners and the Search for a European Neocapitalism. Journal of American Historical Review. 90(1), 44-73 May, S. (1948). Measuring the Marshall Plan. Foreign Affairs. 26(3), 457-469. Scott, P. (1995). Soviet reaction to the Marshall Plan: Opportunity or Threat? Problems of Post-communism, 42(5), 22-31. This term paper on Historical Political Event: The Marshall Plan was written and submitted by user Heath Hahn to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.

Volcanoes, Active essays

Volcanoes, Active essays Throughout the world, there are various volcanoes that erupt daily. Scientists called vulcanologists study these volcanoes rigorously. These scientists, from either the United States Geological Survey or other foreign groups, study and observe these volcanoes to ensure that people in close proximity to these natural disasters are not put in any immediate danger. One active volcano is named Shiveluch. This volcano lies on the Kamchatka Peninsula, and is one of Russias largest volcanoes. Along with being one of Russias largest volcanoes, it is also one of the Holocenes (the earliest epoch in the Cenozoic era) most active volcanoes accredited with over 60 large eruptions. Its most recent major eruption was recorded back in 1997. Since then it has emitted several major and minor plumes of smoke, ash, and other volcanic debris. Such expulsions are deemed normal and as such the volcano retains the level-of-concern color code of yellow. Shiveluch is an andesitic volcano. Its mostly made up of plagioclase feldspar, clinopyroxene or orthopyroxene, and a small amount of hornblende. While these are the primary minerals, Andesite lava is also known to contain olivine. The andesitic magma that is usually expelled from stratovolcanoes emerges as thick lava flows that grow to be very large in length. It can also produce massive explosive bursts that turn into pyroclastic flows and surges and enormous eruption columns. The erupting point of Andesite lava tends to fluctuate anywhere from 900 and 1100 degrees Celsius. Shiveluch is a stratovolcano that stands 3,283 meters above sea level. While this volcano has never taken any human lives in the past, there is a small town that sits at the base of the volcano a mere 50 km away. Since this volcano is located along many major aircraft routes across eastern Russia, it is watched and monitored very closely by the Civil Defense Department of Russia. This...

Homework Essay Example | Topics and Well Written Essays - 500 words - 13

Homework - Essay Example She feared about how she would go about her life if Marty got married. This is also emphasized by the words of her sister who is a widow when she sought Marty’s mother’s companionship. She asked what her sister would do if her son, Marty got married. Therefore, in addition, Marty’s mother also represents the old-aged loners, not only to the singles but separated, divorced or widowed wives as well who would know and understand the difficulties people with similar circumstances undergo. In response to this character, Marty’s mother became like his son in the story who bore the burden of having a family living with him/her. The woman also portrays the fears of those approaching their old age as they think about their children having their own families. They worry about who would take care of them when they would be sick or helpless. Perhaps for one reason, Marty’s mother agreed to the request of her sister because she made sense in saying that in case Marty were to marry, they would be there for each other. It is also possible that she considered her because she wants to do to others as she would want them to do, knowing that she is in a similar dire situation as her sister. It is ridiculous to consider how prejudiced people have been during the 1950s. I always thought that racism was the worst during those times but knowing about how people looked at unmarried men, it just strikes me as senseless. The portrayal of the relationship between Marty and Angie is an effect of the prejudice that happened during that time. Being single at an age when they were supposed to be raising children, perhaps Angie considered himself made for his male friends who had the same dilemma that is why he acted strangely towards Marty. It could also be possible that he felt jealous of Marty or threatened that soon, his friend will be leaving him when his relationship with Clara

Death Penalty in the US Essay Example | Topics and Well Written Essays - 1500 words - 1

Death Penalty in the US - Essay Example er hand proponents believe that criminals who is a liability to the society or those who do not live based on the rules of the society needs to be punished and in extreme cases they must be executed if no other options succeeded in correcting the criminal. â€Å"Around 137 countries have abolished the death penalty in law or practice. Despite international human rights standards, some nations still execute people.† (Death Penalty) â€Å"In US, as of April 1, 2008, the Death Penalty was authorized by 37 states, the Federal Government, and the U.S. Military†. (The death penalty in the US) In fact United States is one of the toughest countries in the world as far as death penalty is concerned even though they speak out loudly against all kind of human right violations around the world. They never accept that the first and most important human right is live and let others live. This paper analyses the different aspects of death penalty system in United States. In 2004 four (China, Iran, Vietnam and the US) accounted for 97 percent of all global executions. On average, every 9-10 days a government in the United States executes a prisoner. Since the 1976 Supreme Court decision that re-instated the death penalty in the United States, the governments of the United States had executed 1,136, as of December 2008(Pros and Cons of the Death Penalty (Capital  Punishment)) The statistics clearly reveals that the US attitude towards human life is not so great compared to other countries. In fact it is a failure from the part of the governments that they were not able to control the crimes without capital punishment even in the twenty first century. For a civilized nation like United Sates the above statistics is not a satisfying one. The interesting thing is that even though capital punishment is implemented, the crime rates have not been come down and moreover it is on its upward journey. Most of the American people are actually against capital p unishment. But the governments

Nurse Strategies to Prevent Elderly Suicide Attempts

Nurse Strategies to Prevent Elderly Suicide Attempts Investigation into nurse strategies to prevent or minimise attempted suicide in patients aged 65 and over. Abstract This dissertation considers the rationale for positive nurse-based intervention in consideration of issues relating to suicide in the elderly. The introduction sets the context, including the historical context, of the issues and discusses the negative effects of ageism on issues relating to suicide in the elderly. The literature review considers selected texts which have been chosen for their specific relevance to the issue and particularly those that espouse the view that ageism is counter productive to a satisfactory quality of life outcome for the elderly person. Conclusions are drawn and discussed with specific emphasis on those measures that are of particular relevance to the nursing profession whether it is in a secondary care facility, a residential home setting or in the primary healthcare team and the community. We can observe, from a recent paper (O’Connell H et al. 2004), the comments that, although there is no doubt that the elderly present a higher risk of completed suicide than any other age group, this fact receives comparatively little attention with factors such as media interest, medical research and public health measures being disproportionately focused on the younger age groups (Uncapher H et al. 2000). Perhaps we should not be surprised at the fact that both suicidal feelings and thoughts of hopelessness have been considered part of the social context of growing old and becoming progressively less capable. This is not a phenomenon that is just confined to our society. We know that the Ancient Greeks tolerated these feelings in their society and actively condoned the option of assisted suicide if the person involved had come to the conclusion that they had no more useful role to play in society (Carrick P 2000). Society largely took the view that once an individual had reached old age they no longer had a purpose in life and would be better off dead. In a more modern context, we note the writings of Sigmund Freud who observed (while he was suffering from an incurable malignancy of the palate: It may be that the gods are merciful when they make our lives more unpleasant as we grow old. In the end, death seems less intolerable than the many burdens we have to bear. (cited in McClain et al. 2003) We would suggest that one of the explanations of this apparent phenomenon of comparative indifference to the plight of the elderly in this regard is due to the fact that the social burden of suicide is often refered to in purely economic terms, specifically relating to loss of social contribution and loss of productivity. (Brechin A et al. 2000). This purely economic assessment would have to observe that the young are much more likely to be in employment and less likely to be a burden on the economic status of the country whereas with the elderly exactly the converse is likely to be true. This results in economic prominence being give to the death of a younger person in many reviews. (Alcock P, 2003). There is also the fact that, despite the fact that we have already highlighted the increase in relative frequency of suicide in the elderly, because of the demographic distributions of the population in the UK, the absolute numbers of both attempted suicides and actual suicides are greater in the younger age ranges and therefore more readily apparent and obvious. The elderly are a particularly vulnerable group from the risk of suicide. In the industrialised world males over the age of 75 represent the single largest demographic group in terms of suicide attempts. Interestingly (and for reasons that we shall shortly discuss) although there is a general trend of increasing suicide rate with age the excess rates associated with the elderly are slowly declining in the recent past (Cattell 2000). We can quantify this statement by considering the statistics. If we consider the period 1983 to 1995 in the UK then we can show that: The suicide rates for men reduced by between 30% and 40% in the age groups 55–64, 65–74 and 75–84 The rates for the most elderly men (males over 85 years) remained fairly static, this group still having the highest rates of any group By way of contrast, the 25- to 34-year-old male group exhibited a 30% increase in suicide rate during the same period, this group are becoming the group with the second highest rate, while the 15- to 24-year-old male group demonstrated a 55% increase in suicide rates. (WHO 2001) Female suicide rates have shown a similar overall decrease, reducing by between 45 and 60% in the 45–84 age group. Elderly women, however, retain the highest rates throughout the life span (Cattell 2000) The ratio of male to female elderly suicide deaths remains approximately 3:1 (Fischer L R et al. 2003) We can suggest that these trends in reduction of suicide, particularly in the elderly are likely to be due, amongst other things, to: The improved detection of those at risk together with the advent of aggressive treatment policies relating to mental illness in the elderly. (Waern M et al. 2003) One of the main reasons, we would suggest, for this obviously changing pattern and the discrepancies in the suicide rates between the age ranges, is the fact that, in direct consideration of the context of our topic, the elderly are more likely to be both amenable to professional help and also, by virtue that a higher proportion are likely to be in direct contact with healthcare professionals either through failing health or nursing homes and hospitals, (Suominen K et al. 2003), have the warning signs of impending suicide recognised and acted upon more promptly than the younger, arguably more independent age group. In specific consideration of the elderly group we should also note that attempted suicide is more likely to be a failed suicide attempt rather than a parasuicide. (Rubenowitz E et al. 2001). There is considerable evidence that the incidence of depression is increased in the presence of a concurrent physical illness (Conwell Y et al. 2002) and clearly this is going to be more likely in the elderly age group. Some sources have cited association rates of between 60-70% of major depression with physical illness in the over 70yr olds. (Conwell Y et al. 2000). Another significant factor is that it is commonly accepted that an attempted suicide is a strong independent risk factor in the aetiology of further suicide attempts. (Conwell Y et al. 1996) This trend is much more marked in the elderly group with a ratio of about 4:1 which compares very badly with the ratios in the younger age groups of between 8:1 and 200:1 (depending on age range, definition and study). (Hepple J et al. 1997) In this dissertation it is intended to gain evidence based knowledge of the scope and significance of the phenomenon of attempted suicide in the elderly. In addition it is intended to gain evidence based knowledge in the use of strategies to ameliorate attempted suicide in the elderly to highlight gaps in the literature available and to suggest recommendations for change in nursing practice It is hoped to be able to suggest areas for research into the phenomenon of attempted suicide in the elderly. The initial strategy was to undertake a library search at the local post graduate library and the local university library (Client: you might like to personalise this) on the key words â€Å"suicide, elderly, prevention strategies, industrialised societies†. This presented a great many papers. About 40 were selected and read to provide an overview of the literature in this area. During this phase, references were noted and followed up and key literary works were assimilated. The bulk of the papers accessed and read were published within the last decade, however a number of significant older references were also accessed if they had a specific bearing on a particular issue. The most significant references were accessed and digested. The dissertation was written referencing a selected sub-set of these works. To increase nurses knowledge and understanding of attempted suicide in the older age group and to highlight through the literature review, evidence based strategies that an be employed to ameliorate attempted suicide amongst the elderly. Literature review Before commencing the literature review, it is acknowledged that the literature on this subject is huge. The parameters of the initial search have been defined above. In addition it should be noted that there is a considerable literature on the subject of assisted suicide which has been specifically excluded from these considerations The literature base for suicide in the elderly is quite extensive and provides a good evidence base for understanding, appropriate action and treatment. (Berwick D 2005) One of the landmark papers in this area is by Hepple and Quinton (Hepple J et al. 1997) which provided a benchmark, not only on the aetiology of the subject, but also in the long term outcomes, which, in terms of potential nursing care input, is extremely important. The paper points to the fact that there is a good understanding of the absolute risk factors for suicide in the elderly but a comparative lack of good quality follow up studies in the area. It set out to identify 100 cases of attempted suicide in the elderly and then follow them up over a period of years. The study was a retrospective examination of 100 consecutive cases of attempted suicide that were referred to the psychiatric services over a four year period. The authors were able to make a detailed investigation (including an interview of many of the survivors), about four years later. Their findings have been widely quoted in the literature. Of particular relevance to our considerations here we note that they found that of the 100 cases identified, 42 were dead at the time of follow up. Of these, 12 were suspected suicides and five more had died as a result of complications of their initial attempt. There were 17 further attempts at suicide in the remaining group. Significantly, the twelve women in the group all made non-lethal attempts whereas all five of the men made successful attempts. The authors were able to establish that the risk of further attempts at suicide (having made one attempt) was in excess of 5% per year and the â€Å"success† rate was 1.5% per year in this group. From this study we can also conclude that the risk of successful repeat attempted suicide is very much greater if the subject is male. The authors were also able to establish that, because of their initial attempt, those at risk of self harm were likely to be in contact with the Psychiatric services and also suffering from persistent se vere depression. We can examine the paper by Dennis (M et al. 2005) for a further insight into the risk factors that are identifiable in the at risk groups. This paper is not so detailed as the Hepple paper, but it differs in its construction as it is a control matched study which specifically considered the non-fatal self harm scenario. The study compared two groups of age matched elderly people both groups had a history of depression but the active study group had, in addition, a history of self harm. The significant differences highlighted by this study were that those in the self harm group were characterised by a poorly integrated social network and had a significantly more hopeless ideation. This clearly has implications for intervention as, in the context of a care home or warden assisted setting, there is scope for improving the social integration of the isolated elderly, and in the domestic setting community support can provide a number of options to remove factors that mitigate towards soci al isolation. This would appear to be a positive step towards reducing the risk of further self harm. The O’Connell paper (O’Connell et al. 2004) is effectively a tour de force on the pertinent issues. It is a review paper that cherry-picks the important information from other, quite disparate, studies and combines them into a coherent whole. It is extremely well written, very detailed, quite long and extremely informative. While it is not appropriate to consider the paper in its entirety, there are a number of factors that are directly relevant to our considerations here and we shall restrict our comments to this aspect of the paper. In terms of the identification of the risk factors associated with attempted suicide in the elderly, it highlights psychiatric illnesses, most notably depression, and certain personality traits, together with physical factors which include neurological illnesses and malignancies. The social risk factors identified in the Dennis paper are expanded to include â€Å"social isolation, being divorced, widowed, or long term single†. The authors point to the fact that many of the papers refered to tend to treat the fact of suicide in reductionist terms, analysing it to its basic fundamentals. They suggest that the actual burden of suicide should also be considered in more human terms with consideration of the consequences for the family and community being understood and assessed. (Mason T et al. 2003) In terms of nursing intervention for suicide prevention, we note that the authors express the hypothesis that suicidality exists along a continuum from suicidal ideation, through attempted suicide, to completed suicide. It follows from this that a nurse, picking up the possibility of suicidal ideation, should consider and act on this as a significant warning sign of possible impending action on the part of the patient. The authors point to the fact that the estimation of the actual significance of the various prevalences of suicide varies depending on the study (and therefore the definition) (Kirby M et al. 1997). In this context we should note that the findings do not support the ageist assumptions expounded earlier, on the grounds that the prevalence of either hopelessness or suicidal ideation in the elderly is reported as up to 17% (Kirby M et al. 1997), and there was a universal association with psychiatric illness, especially depressive illness. If we consider the prevalence of suicidal feelings in those elderly people who have no evidence of mental disorder, then it is as low as 4%. It therefore seems clear that hopelessness and suicidality are not the natural and understandable consequences of the ageing process as Freud and others would have us believe. This has obvious repercussions as far as nursing (and other healthcare) professionals are concerned, as it appears to be clearly inappropriate to assume that suicidality is, in most cases, anything other than one of many manifestations of a mental illness. It also follows from this, and this again has distinct nursing implications, that suicidal ideation and intent is only the tip of the iceberg when one considers the weight of psychological, physical and social health problems for the older person. (Waern M et al. 2002) If one considers evidence from studies that involve psychological autopsies, there is further evidence that psychopathology is involved. Depressive disorders were found in 95% in one study. (Duberstein P R et al. 1994) Psychotic disorders and anxiety states were found to be poorly correlated with suicidal completion. Further evidence for this viewpoint comes from the only study to date which is a prospective cohort study in which completed suicide was the outcome measure. (Ross R K et al. 1990). This shows that the most reliable predictor of suicide was the self-rated severity of depressive symptoms. This particular study showed that those clients with the highest ratings were 23 times more likely to die as the result of suicide than those with the lowest ratings. It also noted that other independent risk factors (although not as strong), were drinking more than 3 units of alcohol per day and sleeping more than 9 hours a night. One further relevant point that comes from the O’Connell paper is the fact that expression of suicidal intent should never be taken lightly in the older age group. The authors cite evidence to show that this has a completely different pattern in the elderly when compared to the younger age groups. (Beautrais A L 2002). The figures quoted show that if an elderly person undertakes a suicide attempt they are very much more likely to be successful than a younger one. The ratio of parasuicides to completed suicides in the adolescent age range is 200:1, in the general population it is between 8:1 and 33:1 and in the elderly it is about 4:1. (Waern M et al. 2003). It follows that suicidal behaviour in the elderly carries a much higher degree of intent. This finding correlates with other findings of preferential methods of suicide in the elderly that have a much higher degree of lethality such as firearms and the use of hanging. (Jorm A F et al. 1995). The paper by Cornwell (Y et al. 2001) considers preventative measures that can be put in place and suggests that independent risk factors commonly associated with suicide in the elderly can be expanded to include psychiatric and physical illnesses, functional impairment, personality traits of neuroticism and low openness to experience, and social isolation. And of these, t is affective illness that has the strongest correlation with suicide attempts. We have discussed (elsewhere) the correlation between impending suicide and contact with the primary care providers. Cornwell cites the fact that 70% of elderly suicides have seen a member of the primary healthcare team within 30 days of their death and therefore proposes that the primary healthcare setting is an important venue for screening and intervention. It is suggested that mood disorders are commonplace in primary healthcare practice but, because they are comparatively common, are underdiagnosed and often inadequately treated (ag eism again). The authors suggest that this fact alone points to the fact that one of the suicide prevention strategies that can be adopted by the primary healthcare team. they suggest that clinicians, whether they are medically qualified or nursing qualified, should be trained to identify this group and mobilise appropriate intervention accordingly. Obviously the community nurses can help in this regard as they are ideally placed to maximise their contact with vulnerable and high risk groups. We have identified the role of a major depressive illness in the aetiology of suicide in the elderly. Bruce (M L et al. 2002) considered the role of both reactive and idiopathic major depression in the population of the elderly in a nursing home setting. This has particular relevance to our considerations as firstly, on an intuitive level, one can possibly empathise with the reactive depressive elements of the elderly person finding themselves without independence in a residential or nursing home and secondly, this is perhaps the prime setting where the nurse is optimally placed to monitor the mood and other risk factors of the patient and continual close quarters. The salient facts that we can take from this study are that there was a substantial burden of major depressive symptomatology in this study group (13.5%). The majority (84%) were experiencing their first major depressive episode and therefore were at greatest risk of suicide. The depression was associated with comorbidity in the majority of cases including â€Å"medical morbidity, instrumental activities of daily living disability, reported pain, and a past history of depression but not with cognitive function or sociodemographic factors.† All of these positive associations which could have been recognised as significant risk factors of suicide in the elderly. Significantly, in this study, only 22% of all of the seriously depressed patients were receiving antidepressant therapy and none were receiving any sort of psychotherapy. In addition to this the authors point to the fact that 31% of the patients who were put on antidepressants were taking a subtherapeutic dose (18% because they were purposely not complying with the dosage instructions). The conclusions that the authors were able to draw from this study were that major depression in the elderly was twice as common in the residential setting as opposed to those elderly patients still in the community. The majority of these depressed patients were effectively left untreated and therefore at significant risk of suicide. There was the obvious conclusion that a great deal more could be done for this study population in terms of relieving their social isolation and depressive illnesses. And, by extrapolation, for their risk of suicide. Ethical considerations. In consideration of the issue of suicide in the elderly we note that there are a number of ethical considerations but these are primarily in the field of assisted suicide which we have specifically excluded from this study. (Pabst Battin, M 1996) Having established the evidence base in the literature that defines the risk factors that are known to be particularly associated with suicide in the elderly, we take it as read that this will form part of the knowledge base for the nurse to be alert to, and to identify those patients who are at particular risk of suicide. It is equally important to be aware of those factors that appear to confer a degree of protection against suicide. This will clearly also help to inform strategies of intervention for the nurse. Studies such as that by Gunnell (D et al. 1994) point to the fact that religiosity and life satisfaction were independent protective factors against suicidal ideation, and this factor was particularly noted in another study involving the terminally ill elderly where the authors noted that higher degrees of spiritual well-being and life satisfaction scores both independently predicted lower suicidal feelings. (McClain et al. 2003). The presence of a spouse or significant friend is a major protective factor against suicide. Although clearly it may not be an appropriate intervention for nursing care to facilitate the presence of a spouse (!) it may well be appropriate, particularly in residential settings, to facilitate social interactions and the setting up of possible friendships within that setting (Bertolote J M et al. 2003) This Dissertation has considered the rationale behind the evidence base for nursing intervention and strategies to prevent or minimise suicide attempts in the elderly age group. We have outlined the literature which is directed at identification of the greatest â€Å"at risk† groups and this highlights the importance of the detection and treatment of both psychiatric disorders (especially major depression), and physical disorders (especially Diabetes Mellitus and gastric ulceration). (Thomas A J et al. 2004) Although we have been at pains to point out the relatively high and disproportionate incidence of suicide in the elderly, we should not loose sight of the fact that it is not a common event. One should not take the comments and evidence presented in this dissertation as being of sufficient severity to merit screening the entire elderly population. (Erlangsen A et al. 2003) The thrust of the findings in this dissertation are that the screening should be entirely opportunistic. The evidence base that we have defined should be utilised to identify those who are in high risk groups, for example, those with overt depressive illnesses, significant psychological and social factors, especially those who have a history of previous attempted suicide. The healthcare professional should not necessarily expect the elderly person to volunteer such information and if the person concerned is naturally withdrawn or reserved, minor degrees of depressive symptoms may not be immediately obvious. (Callah an C M et al. 1996). In terms of direct nursing intervention, this must translate into the need to be aware of such eventualities and the need to enquire directly about them. The nurse should also be aware that the presence of suicidal feelings in a patient with any degree of depression is associated with a lower response rate to treatment and also an increase in the need for augmentation strategies. The nurse should also be aware of the fact that these factors may indicate the need for secondary referral. (Gunnell D et al. 1994). If we accept the findings of Conwell (Y et al. 1991), then the estimated population at risk from significant mood disorder and therefore the possibility of attempted suicide in the elderly, is 74%. This can be extrapolated to suggest that if mood disorders were eliminated from the population then 74% of suicides would be prevented in the elderly age group. Clearly this is a theoretical viewpoint and has to be weighed against the facts that firstly â€Å"elimination† of mood disorders (even if it were possible), would only be achieved by treatment of all existing cases as well as prevention of new cases, and the secondary prevention of sub-clinical cases. We know, from other work, that the detection and treatment of depression in all age ranges is low, and even so only 52% of cases that reach medical attention make a significant response to treatment (Bertolote J M et al. 2003). These statistics reflect findings from the whole population and the detection rates and response rates are likely to lower in the elderly. (Wei F et al. 2003). It follows that although treatment of depressive illness is still the mainstay of treatment intervention as far as suicide prevention is concerned, preventative measures and vigilance at an individual level are also essential. Nursing interventions can include measures aimed at improving physical and emotional health together with improved social integration. Sometimes modification of lifestyle can also promote successful ageing and lead to an overall decrease in the likelihood of suicidal feelings. (Fischer L R et al. 2003) On a population level, public health measures designed to promote social contact, support where necessary, and integration into the community are likely to help reduce the incidence of suicide in the elderly, particularly if we consider the study by Cornwell (Y et al. 1991) which estimated the independent risk factor for low levels of social contact in the elderly population as being 27%. Some communities have provided telephone lines and this has been associated with a significant reduction in the completed suicide in the elderly (Fischer L R et al. 2003) To return to specific nursing interventions, one can also suggest measures aimed at reducing access to, or availability of the means for suicide such as restricting access to over the counter medicines. (Skoog I et al. 1996), Some sources (Cattell H 2000) point to the possibility of introducing opportunistic screening in the primary healthcare setting. The rationale behind this suggestion is the realisation that there is a high level of contact between the suicidal elderly person and their primary healthcare team in the week before suicide (20-50%) and in the month before suicide (40-70% make contact). This is particularly appropriate to our considerations here because of the progressively increasing significance of the role of the nurse within the primary healthcare team particularly at the first point of contact. (Hogston, R et al. 2002) The evidence base for this point of view is strengthened by reference to the landmark Gotland study (Rutz W et al. 1989) which examined the effect of specific training in suicide awareness and prevention in the primary healthcare team by providing extensive suicide awareness training and measures to increase the facilitation of opportunistic screening of the population. Prior to the intervention, the authors noted that, when compared to young adults, the elderly were only 6% as likely to be asked about suicide and 20% as likely to be asked if they felt depressed and 25% as likely to be refered to a mental health specialist. This balance was restored almost to normality after the intervention. Suicide in the elderly is a multifaceted and complex phenomenon. It appears to be the case that the elderly tend to be treated with different guidelines from the young suicidal patient insofar as the increased risk is not met with increased assistance. (Lykouras L et al. 2002). We have presented evidence that the factors included in this discrepancy may include the higher overall number of young suicides, the higher economic burden that society appears to carry for each young suicide together with ageist beliefs about the factors concerning suicide in the elderly. From the point of view of nursing intervention, both in a hospital and in a community setting, there should be greater emphasis placed on measures such as screening and prevention programmes targeted at the at risk elderly. There is equally a need for aggressive intervention if depression or suicidal feelings are overtly expressed, particularly in the relevant subgroups where additional risk factors may be active, for example those with comorbid medical conditions or social isolation or recent bereavement. (Harwood D et al. 2001), Many of the elderly spend their last years in some form of sheltered accommodation, whether this is a nursing home, a hospital, warden assisted housing or being cared for by the family. (Haupt B J et al. 1999) In the vast majority of cases this is associated with a loss of independence, increasing frailty and an increasing predisposition to illness that comes with increasing age. (Juurlink D N et al. 2004). This loss of independence and increasing predisposition to illness is also associated with depressive illnesses of varying degrees. (Bruce M L et al. 2002). These patients are arguably, by a large, more likely to come into contact with the nurses in the community. (Munson M L 1999) The comments that we have made elsewhere relating to the nurse’s role in being aware of the implications for the depressed elderly patient are particularly appropriate in this demographic subgroup. As a general rule, it may be easier to keep a watchful eye on patients who are exhibiting early sig ns of depressive illness or mood disorder in this situation by making arrangements to visit on a regular basis or on â€Å"significant anniversaries† such as the death of a spouse or a wedding anniversary. (Nagatomo I et al. 1998) when the risk factors for suicide increase dramatically (Schulberg H C et al. 1998) The literature in this area is quite extensive and covers many of the aspects of suicide in the elderly. It is noticeable however, that there is a great deal of literature on the subject of risk factors and associations of suicide together with plenty of papers which quote statistics that relate the various trends and incidences. There are, by comparison, only a few papers which emphasise and reflect on the positive aspects of nursing care. The positive steps that can be taken by the nursing profession specifically to help to minimise the burden of suicidal morbidity. There is clearly scope for studies in areas such as the impact that a dedicated community nurse might have on the levels of depression in the community if regular visits were timetabled. It is fair to observe that the community mental health nurses fulfil this role to a degree, but are severely hampered in most cases by sheer weight of numbers in the caseload. (Mason T et al. 2003) Having made these observations, we must conclude that there appears to be an overwhelming case for opportunistic screening of the at risk elderly at any point of contact with a healthcare professional. It is part of the professional remit of any nurse to disseminate their specific professional learning with others. (Yura H et al. 1998). This can either be done on an informal professional basis in terms of mentorship or, if appropriate in a lecture or seminar situation. (Hogston, R et al. 2002). There clearly is little merit in critically evalua

Qualia, Robots and Complementarity of Subject and Object :: Philosophy Papers

Qualia, Robots and Complementarity of Subject and Object Jackson claims that a person who sees colors for the first time by this very fact acquires a certain knowledge which she or he could not have learned in a black and white world. This argument can be generalized to other secondary qualities. I argue that this claim is indefensible without implicit recourse to the first-person experience; also Nagel’s "what it is like" argument is polemically weak. Hence, we have no argument able to dismiss physicalism by consideration of first-person qualia (contra Jackson); however, it does not force us to endorse qualia-reductionism. In the second part of my paper I defend non-reductionism in a different way. Following Nagel and Harman, I try to avoid criticisms usually presented against Nagel, seeing subjectivity and objectivity as two complementary structures of the subjective and objective element of our language. I refer to classical German philosophy, phenomenology and Marxist dialectics which have developed a complementary approach cruc ial in the reductionist/anti-reductionist controversy in the philosophy of mind. "Opinion says hot and cold, but the reality is atoms and empty space." Democritus Jackson’s Black and White Mary (1) case illustrates an argument that our first-person experience of qualia provides knowledge not accessible through third-person means. This argument seems suspicious: if ‘knowledge’, by definition, needs to be grasped in third-person terms, it is inconceivable how an exclusively first-person experience may give us knowledge. Harman (92) develops complementarity of subjective and objective aspects within his functionalism of concepts. This notion needs to be extended to epistemic complementarity. I refer to Classical German Philosophy, Phenomenology and Marxism which have developed a complementary approach crucial in the reductionist anti-reductionist controversy in philosophy of mind. I. The Knowledge Argument As Jackson (86) emphasizes in his polemics with Churchland (85) the main point of the case of Black and White Mary is not that Mary cannot ‘imagine’ what it is like to sense red but that "she would not know" (2) how red things look. I accept this argument, but not the next step. Jackson argues: "But if physicalism is true she would know; and no great powers of imagination would be called for." (3) There are two versions of physicalism: the first, against which Jackson has something to say, maintains that every instance of knowledge can be couched in third-person language. (4) But the assumption that physical information is solely what "you can tell" is not a necessary condition of physicalism. Qualia, Robots and Complementarity of Subject and Object :: Philosophy Papers Qualia, Robots and Complementarity of Subject and Object Jackson claims that a person who sees colors for the first time by this very fact acquires a certain knowledge which she or he could not have learned in a black and white world. This argument can be generalized to other secondary qualities. I argue that this claim is indefensible without implicit recourse to the first-person experience; also Nagel’s "what it is like" argument is polemically weak. Hence, we have no argument able to dismiss physicalism by consideration of first-person qualia (contra Jackson); however, it does not force us to endorse qualia-reductionism. In the second part of my paper I defend non-reductionism in a different way. Following Nagel and Harman, I try to avoid criticisms usually presented against Nagel, seeing subjectivity and objectivity as two complementary structures of the subjective and objective element of our language. I refer to classical German philosophy, phenomenology and Marxist dialectics which have developed a complementary approach cruc ial in the reductionist/anti-reductionist controversy in the philosophy of mind. "Opinion says hot and cold, but the reality is atoms and empty space." Democritus Jackson’s Black and White Mary (1) case illustrates an argument that our first-person experience of qualia provides knowledge not accessible through third-person means. This argument seems suspicious: if ‘knowledge’, by definition, needs to be grasped in third-person terms, it is inconceivable how an exclusively first-person experience may give us knowledge. Harman (92) develops complementarity of subjective and objective aspects within his functionalism of concepts. This notion needs to be extended to epistemic complementarity. I refer to Classical German Philosophy, Phenomenology and Marxism which have developed a complementary approach crucial in the reductionist anti-reductionist controversy in philosophy of mind. I. The Knowledge Argument As Jackson (86) emphasizes in his polemics with Churchland (85) the main point of the case of Black and White Mary is not that Mary cannot ‘imagine’ what it is like to sense red but that "she would not know" (2) how red things look. I accept this argument, but not the next step. Jackson argues: "But if physicalism is true she would know; and no great powers of imagination would be called for." (3) There are two versions of physicalism: the first, against which Jackson has something to say, maintains that every instance of knowledge can be couched in third-person language. (4) But the assumption that physical information is solely what "you can tell" is not a necessary condition of physicalism.