The Legacy Of Pompey The Great - 1183 Words

Introduction Gnaeus Pompeius Magnus, known as ‘Pompey’ or ‘Pompey the Great’, was a military leader and a politician, who along with Crassus and Caesar formed the first Triumvirate, making him one of the most powerful men in Rome. A man who demanded respect from all, he gained power through his military prowess and influence, and even had the gall to give himself the title Magnus, which was Latin for the word ‘Great’. Pompey obviously was following the steps of the Macedonian General and leader Alexander the Great. Pompey’s life was littered with amazing military feats and achievements, yet despite his connections and military might, Pompey had an army of veterans, and in particular was strong in the naval area, the ever popular and legendary Julius Caesar triumphed between the titans for the right to rule. Pompey’s motivations Pompey was an intelligent and ambitious person who from the beginning had aimed for glory. 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Gender Inequality Throughout Middle School And High School

F****ism Gender inequality is an issue that has been affecting our world for a very long time. We see it all throughout history, from women entering the workforce for the first time, to women protesting on the street, fighting for the right to vote. An article in the Wall Street Journal reports that a man who works full time earns a median of $889 a week, a woman who works full-time earns a median of $721 a week. That s a $168 difference between males and females in the workforce. Also, what about the horrible names that girls are called throughout middle school and high school? Slut, hoe, whore, skank, all of these judgmental names are what women are called every day, whether it s true or not. Gender inequality is everywhere, but most†¦show more content†¦Therefore/ I will push Montague’s men from the wall, and/ thrust his maids to the wall† (1.1. 16-19). This not only states that women are weaker and should be thrown to the side, but the use of â€Å"thrust to the wal l† suggests that they feel that women are only good for sex. Romeo and Juliet took place in the middle to late fourteenth century. Some people today still have the same views on women, and this happened more than 650 years ago. The fact that these views are still in existence in regards to women shows that even though we are trying to change, we still have a long way to go. As the books were set closer to the present, we began to learn about injustices in the 1930s. In Harper Lee’s To kill a Mockingbird, Scout, Jem, and Dill are playing with a tire near the Radley’s house. Scout got in the tire and Jem pushes her, but she couldn t stop and ended up on the Radley’s front steps. Scout gets scared and runs back to Jem and Dill without the tire, and Jem had to get it. â€Å" ‘See there?’ Jem was scowling triumphantly. ‘Nothin’ to it. I swear, Scout, sometimes you act so much like a girl it s mortifyin’ ’ † (50). The message this quote sends us is that being a girl is a bad thing. Anyone can get scared, but Jem is saying that just because Scout is scared, she s acting like a girl. Not only did he say that, but he s mortified about it. One last example of sexual innuendo that puts

International Entrepreneurship Management -Myassignmenthelp.Com

Question: Discuss About The International Entrepreneurship Management? Answer: Introducation Strategic management is the methods that help the organizations to manage their resources in an appropriate way so that they can achieve their goals or objectives. strategic management includes few steps like setting of the objectives, analysis of internal organization, evaluation of strategies and assuring that the management implement these strategies across the institution (Xi et al. 2015). For the present world, management strategies have become business buzzwords. Top executives in the top international companies have started to ponder the strategic missions and objectives, the managers rough out market strategies, operational chiefs find strategies from research and development to raw materials sourcing as well as distributor relations. The strategic management includes identification of the methods how the companies stack up in compared to their competitors (Ghezzi, Cortimiglia and Frank 2015). It also involves the appropriate recognition of the available opportunities and thr eats faced by the organizations which either come from the competitors or the organizations within. In most of the organizations, there are several levels of management. Strategic management is the most important because it approaches all the segment of a firm. It aids the corporations with guidance to corporate values, culture, goals and missions. The positioning approach of strategic management helps the corporation to understand its position in the market and the ways through which it will get proper exposure (Debicki, Van de Graaff Randolph and Sobczak 2017). The approach involves the branding plan based on business data. The dynamic approach helps the companies to translate the strategic ambitions of the leadership into required specific actions so that it can overcome the strategic execution failures. The learning approach focusses on the learning from the complex and unpredictable nature of the environment of the organizations. Positioning approach: The positioning approach is a plan which distinguishes an organization from a sea of similar competing organizations in a way that designs the corporation to be more attractive to the potential consumers in compared to its competitors. The chief elements of the positioning approach are first it differentiates the firm itself from others and secondly it appeals to the potential group of buyers (Debicki, Van de Graaff Randolph and Sobczak 2017). Viability: in order to differentiate the firms from others, they follow some specific ideology that marketing belief that their people as well as process are the best. Professorial services corporations are build around their employees because their success largely depends on the talents and qualities of their employees. Every companies demand that their own processes are the best and offers best exposure (Ghezzi, Cortimiglia and Frank 2015). The firms often claim to be100% committed to do exceptional works in order to create differentiation but many of their competitors also claim the same which increases competition. However, the claims of excellent services and best products often becomes clich as all the firms claim the same therefore the business complete depends on the appreciation of the clients. Benefits: the positioning approach aids the firms to hire exceptional people for differentiating the firm in the market (Marvel, Davis and Sproul 2016). It allows to realise the underperforming departments so that they can be easily checked and strengthened. In positioning strategies, the superior process allows for flawless communication, task completion before deadline and mistakes are checked and sorted before the clients check them. It builds reputation and provides competitive advantage as the firms feel encouragement to provide best and excellent works every time (Hammond, Pearson and Holt 2016). Customer service is the chief approach of the companies which builds great relationship with the customers. This is why the operational teams become more responsive, good listeners, dynamic and proactive. Through this approach the entire firm becomes market oriented. They find out the demands of the clients and customers to differentiating them from their competitors. It helps the firms to cope up with the constantly changing markets, its new developments, new scopes for competitive advantages to suit the customers changing expectations (Bettis et al. 2016). It makes the firm potent enough to win the attention as well as attractions of the customers by the means of suitable advertisements. They reach more consumers and clients and earn their loyalty. Making the firm different from the others the management always try to communicate with the clients as well as different kinds of customers do that they can add more and varied features to their products or services (Daspit et al. 2017). Product positioning is one of the important aspect of positioning approach where the consumers are allowed to consider products advantages before purchasing it. Therefore, product positioning has proved superiority of offers by the company over its competitors. It may also help consumers in choosing the right product. Implementation issues: positioning approach is difficult as the fact that even if the firms appreciate the employees talents, they do not get appreciation from the stakeholders. The complex services are difficult to process as the firms has to choose different service providers. The less qualified clients ask for seeing their process as well as the indicators. The firms often fail to maintain what they claim due to losing tenacity and dedication (Daspit et al. 2017). Exemplary services are quite hard to prove therefore building better customer relationships becomes challenge. Strong positioning needs to be built on self-evident attributes or else service remains only as a word but most of the firms do not possess credible supporting evidences. Limitations: There are various problems in positioning approach. financial of all, the corporations lose reliability for differentiating themselves by focussing on their stakeholders (Hammond, Pearson and Holt 2016). The client often stops believing such assurance. Secondly, the companies themselves announce that their people are the best but lose when they do not get the same appreciation from their customers or the clients (ONeill 2016). In positioning approach, the firms are to show their references and testimonials but even the meddling firms have few satisfied customers. Dynamic capabilities: The dynamic capability strategy analyses the firms sources and devices of wealth creation by capturing the firms operation in the rapid and technologically changing environment. the competitive advantages of the firms have been seen to be resting in its distinctive processes such as its coordination, designed by the asset positions of the firm and adopted evolution paths. The method and reason of gaining the competitive advantage largely depends on the market demands, imitability and replicability of the firms (Hill, Jones and Schilling 2014). The necessity of path dependencies gets simplified when conditions of growing returns exists. The dynamic strategies involve identification of new opportunities and embracing them by strengthening internal organizational and technological aspects of the firm. Viability: Dynamic approach aids the organizations to discover the opportunities and organise them efficiently and effectively in the organization so that they can be embraced fundamentally to private wealth creation (Pearson, Bergiel and Barnett 2014). Strategizing help the companies engaged in the business conduct in order to keep the competitors off balance, increases costs of the rivals and excludes fresh entrants (Hill, Jones and Schilling 2014). Dynamics speak to mastery, process as well as speed through which the firms adapt their resources for responding to the changes in marketplace and to the constant emerging opportunities. These include excellent technical methodologies, intellectual property or Patents, business process knowledge and speed, the eminence of customer or business relationships, strength of culture and values of the organizations and the strength of their resources such as human, assets and economy (Kramar 2014). Benefits: The chief benefits of being dynamic evolves round gaining competitive advantages over the rivals (Pearson, Bergiel and Barnett 2014). It allows the companies to incorporate innovations so that they can respond to specific situations or environment of the market for instance the appropriate time to rent the market. The dynamic strategies allow the firms to introduce swift alterations in the arena of technology so that they can gain more advantages and upgrade fast with changing market. It creates scopes for prospective competition where the market ascertains the dynamic nature which eventually prove to be vital for sustained competitive advantages (Rosemann and vom Brocke 2015). Dynamic capabilities strategy reflects the strategic ambitions of the leaders into particular actions, clearly designing the activities for enabling the administrations to adapt to the changing conditions as well as investing in exertions. It encourages the corporations to embed newer and upgraded skills and organizational behaviours. This methodology enables the management teams to establish and sustain a vibrant and engaging information system strategies to confidently assure to handle complex as well as nuanced strategies efficiently (Kramar 2014). Dynamic capabilities allow the firms check and correct the weak sections of the organizations. New information is gathered by identifying problems which require rapid course corrections or the leading indicators signalling that some changes in direction is needed. It increases the contextual awareness of the leaders by imploring diverse perspectives. They leverage the scenario-planning as well as environment-scanning apparatuses to anticipate the changes (Mahto and Khanin 2015). The dynamic capabilities approach helps the individuals develop newer competencies as well as results to gain the sustained performance improvements. This strategy can help to address the organizational resistance which often torpedoes the implementation efforts (Simsek et al. 2015). dynamic approach of strategic management adopts different mixture of moderate activities in initial stages of implementation by highlighting the ones which set the stages for managerial learning. Dynamic capability approach produces concrete deliverables as well as value in the initial stages, increase learning, alignments and enthusiasm (Bettis et al. 2016). dynamic approach for strategy implementation, the companies can possibly upsurge the odds of efficiently translating, adapting as well as sustaining innovative strategies. Implementation issues: Enhancing dynamic capabilities in a firm is the toughest aspect of setting and implementing strategies. It often becomes difficult for the companies to adapt, integrate or build new changes in the firms (Mahto and Khanin 2015). Reconfiguring internal as well as external competences for addressing the rapidly changing market environments pose to be threat for the small and medium corporations as they have limited resources to react sufficiently and judiciously to the external changes (Short et al. 2016). Limitations: Building institutional capabilities necessitates significant efforts from evidently defining current as well as desired capabilities for designing the integrated systems of assets including activities which build and sustain them (Rosemann and vom Brocke 2015). As mentioned before the adaptation procedure needs complete or partial changes in the technical systems to grow and sustain it but not all the organizations can be able to bring such changes in limited time (Bergh et al. 2016). Therefore, without proper and adequate structure it will initiate a negative effect on the firm. Learning focussed approach: Learning focus approach of strategic management focuses on the origin of the strategies emerging from learning process. This process involves the experiences from which the people of an operations learns to gain knowledge and face the similar situations in future (Tarakci, Ates and Wooldridge 2015). It captures the experiences both individual as well as collective build common patterns for paving way to learning (Moura-Leite, Padgett and Galn 2014). The organizational learning approach helps the companies to know all the tricks of the trade therefore beneficial for gaining more competitive advantages. Viability: Learning approach strengthens to companies in such a way that they become able to approach the organizational processes. The strategy of organizational learning is the most important of all as a minute change in the organization can be effective to bring disaster. Therefore, learning all internal and external elements is essential for the management teams (Bergmann and Stephan 2013). This approach views the organizational change both from psychological as well as relational perspectives. The leaders of the firms can be able to approach the organizational processes and eventually the attain the organizational changes from the standpoint of three main communities such as academics, consultants and the actors involvedin the operation of an organization (Georgakakis and Ruigrok 2017). Benefits: Learning approach helps the organizations to gain knowledge as well as insight through the evolved theories, methodologies and the models in the field of organizational development and learning. The organizational learning makes the organizations capable to integrate, relate, compare finally critically evaluate the acquired knowledgeand skills (Moura-Leite, Padgett and Galn 2014). This approach aims to change the people of an organization including their shared thought as well as actions. These are often moulded and embedded by the demands of the institutions. As learning process is essential to recognise the requirements of the clients and the stakeholders, it increases the resources of the organizations according to the demands. This is the primary stage through which the constant changes can be recorded and thus involves facilitation of learning. By supporting as well as increasing individual knowledge, embedding them into teams through discussion, experiences sharing, dialogues and more particularly through observation (Moura-Leite, Padgett and Galn 2014). Implementation issues: Despite the fact that the learning approach of strategic management is not very difficult to implemented for the heads of the organizations but the studies reveal that the learning approach plays a very trivial role in formation of the organizational strategies in reality (Bergh et al. 2016). Limitations: Learning focussed approach has imitations in formulating effective strategies as they delinked the management firm operations. The organizations have a great variety of people therefore, applying learning approach do not have proper reach to all the employees. small actions or decisions which are often born out of chance over time become key drivers of the change in strategic directions of the firm. Conclusion: Therefore, it can be concluded that this paper discusses three of the most important approaches used for developing the businessstrategyin the organizations. It indicates that strategy management tactics in diverse organizations has been developed through various strategic approaches. These approaches are normally different from one another in terms of their scopes, complexity and strategic focus. In addition, the report also reveals that every approach has their own sets of limitations. The importance of these three approaches to the organizations depend on the methods of utilization in business strategy. These strategic approaches refer to the specific arenas which the particular strategy aims to target. All of these approaches have difficulties in implication in the organization but also have numerous benefits which mainly help the organizations to gain the competitive advantages. according to the researchers in their field, the organizations need to first identify their own strategic focus then extend the scopes before attempting to adopt them. The most important fact is that the organizations stand an improved chance of expressing their own operative business strategy through developing their own abilities for sizing up and realise the sense of business activities. The companies are becoming more conscious of the incessant changes taking place in their corporate environment. More importantly, for the organizations increasing their capabilities, they need to prim arily develop proper competencies then seek innovative strategic directions as well as identify strategic initiatives. The organizations will be able to identify and develop the most suitable approaches to formulate as well as implement more operative business strategies with the help of competencies, strategic directions supported by initiatives. References: Bergh, D.D., Aguinis, H., Heavey, C., Ketchen, D.J., Boyd, B.K., Su, P., Lau, C.L. and Joo, H., 2016. Using meta?analytic structural equation modeling to advance strategic management research: Guidelines and an empirical illustration via the strategic leadership?performance relationship.Strategic Management Journal,37(3), pp.477-497. Bergmann, H. and Stephan, U., 2013. Moving on from nascent entrepreneurship: Measuring cross-national differences in the transition to new business ownership.Small business economics,41(4), pp.945-959. Bettis, R.A., Ethiraj, S., Gambardella, A., Helfat, C. and Mitchell, W., 2016. Creating repeatable cumulative knowledge in strategic management.Strategic Management Journal,37(2), pp.257-261. Daspit, J.J., Chrisman, J.J., Sharma, P., Pearson, A.W. and Long, R.G., 2017. A Strategic Management Perspective of the Family Firm: Past Trends, New Insights, and Future Directions.Journal of Managerial Issues,29(1), pp.6-29. Debicki, B.J., Van de Graaff Randolph, R. and Sobczak, M., 2017. Socioemotional wealth and family firm performance: A stakeholder approach.Strategic Issues in the Family Firm,29(1), pp.82-111. Georgakakis, D. and Ruigrok, W., 2017. CEO succession origin and firm performance: A multilevel study.Journal of Management Studies,54(1), pp.58-87. Ghezzi, A., Cortimiglia, M.N. and Frank, A.G., 2015. Strategy and business model design in dynamic telecommunications industries: A study on Italian mobile network operators.Technological Forecasting and Social Change,90, pp.346-354. Hammond, N.L., Pearson, A.W. and Holt, D.T., 2016. The quagmire of legacy in family firms: Definition and implications of family and family firm legacy orientations.Entrepreneurship Theory and Practice,40(6), pp.1209-1231. Hill, C.W., Jones, G.R. and Schilling, M.A., 2014.Strategic management: theory: an integrated approach. Cengage Learning. Kramar, R., 2014. Beyond strategic human resource management: is sustainable human resource management the next approach?.The International Journal of Human Resource Management,25(8), pp.1069-1089. Mahto, R.V. and Khanin, D., 2015. Satisfaction with past financial performance, risk taking, and future performance expectations in the family business.Journal of Small Business Management,53(3), pp.801-818. Marvel, M.R., Davis, J.L. and Sproul, C.R., 2016. Human capital and entrepreneurship research: A critical review and future directions.Entrepreneurship Theory and Practice,40(3), pp.599-626. MK, H. (2018).Approaches to Formulating Business Strategy: A Review. [online] OMICS International. Available at: https://www.omicsonline.org/open-access/approaches-to-formulating-business-strategy-a-review-.php?aid=85973 Moura-Leite, R.C., Padgett, R.C. and Galn, J.I., 2014. Stakeholder management and nonparticipation in controversial business.Business Society,53(1), pp.45-70. ONeill, J.W., 2016. The role of storytelling in affecting organizational reality in the strategic management process.Journal of Behavioral and Applied Management,4(1). Pearson, A.W., Bergiel, E. and Barnett, T., 2014. Expanding the study of organizational behaviour in family business: Adapting team theory to explore family firms.European Journal of Work and Organizational Psychology,23(5), pp.657-664. Short, J.C., McKenny, A.F., Ketchen, D.J., Snow, C.C. and Hult, G.T.M., 2016. An empirical examination of firm, industry, and temporal effects on corporate social performance.Business Society,55(8), pp.1122-1156. Simsek, Z., Jansen, J.J., Minichilli, A. and Escriba?Esteve, A., 2015. Strategic leadership and leaders in entrepreneurial contexts: A nexus for innovation and impact missed?.Journal of Management Studies,52(4), pp.463-478. Tarakci, M., Ates, N.Y. and Wooldridge, B., 2015, January. Performance feedback and middle managers divergent strategic behavior. InAcademy of Management Proceedings(Vol. 2015, No. 1, p. 16577). Xi, J.M., Kraus, S., Filser, M. and Kellermanns, F.W., 2015. Mapping the field of family business research: past trends and future directions.International Entrepreneurship and Management Journal,11(1), pp.113-132.

Religion Healthy Aging Essay Example

Religion Healthy Aging Essay A STUDY OF THE IMPACT OF SPIRITUALITY, RELIGION AND FUNCTIONAL HEALTH OF THE ELDERLY A Dissertation Presented to the Faculty of the School of Health Administration Kennedy-Western University In Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy in Health Administration by Kendall Brune St. Louis, Missouri Table of Contents Chapter 1 – Introduction†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 1 Introduction†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 1 Statement of the Problem†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 2 Purpose of the Study†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 3 Importance of the Study†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦4 Scope of the Study†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 6 Rationale of the Study†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦9 Overview of the Study†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 1 Definition of Terms†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 141 Chapter 2 – Review of Related Literature†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 13 History of Religious Studies-Health Care†¦15 Demographic Trends in Health Care†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦16 Science Religion†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 23 Review-Religion in Medical School †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 26 The Relaxation Response: Harvard. †¦Ã¢â‚¬ ¦26 Aging as a Spiritual Journey: Loyola†¦Ã¢â‚¬ ¦27 Faith- life-promoting: Emory†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 30 Physician Religion: St. Louis†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦31 International Center for the Integration of Health and Spirituality†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ †¦. 34 Centers for Disease Control†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦35 Joint Commission on Accreditation of Healthcare Or ganizations (JCAHO) †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 37 A Review of: Patient Satisfaction†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 41 Spiritual Directives†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 42 ii Health Outcomes†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 38 Spiritual Emotional Needs†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. †¦Ã¢â‚¬ ¦.. 40 Clinical Cohorts from Benjamins†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦44 Clinical Cohorts from Daaleman†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 45 Patients Desire for Religion†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 47 Clergy Issues in Healthcare†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦53 Ethical Issues in Healthcare †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. †¦. 56 Summaries Conclusions. †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 57 Chapter 3 – Methodology†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 59 Approach of the Benjamins’ Study†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 61 Benjamins’ Conceptual Framework†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦61 Benjamins’ Study Mechanisms†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦61 Benjamins’ Control Mechanisms†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 62 Benjamins’ Social Resources †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 3 The Database of the Study†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 66 Variables in the Benjamins Study†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 71 The Approach of the Daaleman Study†¦.. 75 Daaleman’s Conceptual Framework†¦Ã¢â‚¬ ¦.. 76 Daaleman’s Study Variables†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦77 Daaleman’s Well Being Questionnaire†¦.. 79 Summary†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 86 Chapter 4†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 87 Demographics and Statistics†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 89 The Data Analysis for Daaleman†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 92 The Data Analysis for Daalema n†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 94 Data Charts†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 96 Chapter 5†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦108 Theory on Aging†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 109 iii Recommendations/Action Items†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 112 Spiritual Care Assessment†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 121 Role of the Physician†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 21 Conclusion: National Impact of Studies†¦132 Final Comment†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 136 Bibliography†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. I Tables and Charts†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. XVIII Chart 1: Faith Support Flowchart†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦XVIII Table 1: Relative Risk of Dying, Strawbridge†¦XXI Table 2: Life Expectancy Religious Activity†¦XXI Table 3: JCAHO RI. 1. 13 Care @ End of Life†¦. XX Table 4: JCAHO Reading Referrals to Patients. XXII Table 5: Benjamins Statistical Results†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. XXIII Table 6: Daaleman – Demographics†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦XXV Table 7: Spirituality Index of Well Being†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. XXVII Appendices†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. XXVIII A: Joint Commission Regulations†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦XXVII We will write a custom essay sample on Religion Healthy Aging specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Religion Healthy Aging specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Religion Healthy Aging specifically for you FOR ONLY $16.38 $13.9/page Hire Writer B: SF – 12v1 Survey Description†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. LIII C: SES Descriptive Charts †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. LXIII D: Health Retirement and Survey Data†¦. LXVI E: JCAHO Spiritual Assessment Tool†¦Ã¢â‚¬ ¦CXXII F: Geriatric Depression Scale†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. CXXVI G: Spirituality Survey – 12-item Scale†¦Ã¢â‚¬ ¦CXXII iv Abstract of Dissertation A STUDY OF THE IMPACT OF SPIRITUALITY, RELIGION AND FUNCTIONAL HEALTH OF THE ELDERLY By KENDALL BRUNE Kennedy-Western University THE PROBLEM Religion is a source of comfort to some and a conflict to others. A study done by Gallop at Princeton claimed a vast majority of Americans (94%) claim to believe in God. Koenig’s study found among older Americans, 98% believe in God, and pray. Maungans, et al. found physicians tend to ignore religious issues in the care of their patients (Maugans, 1991. pp. 210-13). However, this trend is changing. As reported by Koenig (1999, p. 25) Hundreds of major scientific studies by other researchers have found statistical benefits to the consistant exposure to religion. The risk of dying from all causes is up to 35 percent lower for people who attend religious services once or more a week than for those who attend less frequently. This statistical significance has rompted two thirds of the medical schools to offer required or elective courses on religion, spirituality, and medicine. In the published medical literature, there is a conflict regarding the effects of religion on the functional health of older Americans. Sloan et al. reviewed the literature and found inconsistent and weak links between religion and health. In v contrast, the reviews by Levi n and Schiller and by Larson et al. found positive effects of religion on physical and mental health. Koenig and Benjamins found in their clinical research that religion has a direct relationship with functional health. Given this conflict, this study is a critical review of the medical literature and how two particular studies focus on whether the attendance at religious services has an inverse association with functional health among the elderly. The Daaleman study is a regional review of geriatric patients participating in a program at the University of Kansas Medical Center. Daaleman performed a cross-sectional analysis of 277 geriatric outpatients participating in a cohort study in the Comparatively, Maureen Benjamins from Kansas City area. the University of Texas at Austin developed a less involved tudy that is a longitudinal and cross sectional analysis of national data sets. Benjamins states it is critical to examine the possible differing effects of religion and functional health with the elderly population, because this age is rapidly expanding. More information on religion and functional health is also needed because the information is not conclusive, but rather conflictive. METHOD The go al of this study is to assess the impact (positive or negative) of religion on functional health outcomes. The Daaleman Study was a secondary analysis of cross-sectional data from a larger cohort study. The parent study was designed to determine the feasibility of performance measures in predicting future health service utilization, health status, and functional status in older, community-dwelling primary care patients (Studenski, 2003). Patients underwent a home assessment of multiple health status, performance, and functional indicators by trained research assistants. A previously validated five-item measure of religiosity was utilized from the National Opinion Research Center in Chicago, and a twelve-item spirituality instrument developed in an earlier vi Daaleman Study (2002) were embedded during the final data ollection. The current study represents data collected 36 months after enrollment. Participants were older adults who were screened and recruited for the parent study between April and November of 1996 from primary care sites within a Veteran’s Affairs (VA) network (n = 142) and a Medicare health management organization (HMO) (n = 350) serving the Kansas City metro politan area. The Benjamins Study used the Assets and Health Dynamics Among the Oldest Old Survey, a nationally representative, longitudinal data set, to estimate the effects of religious attendance and salience on functional health in the elderly. The primary study hypothesis proposes that religious attendance and salience will be associated with a decrease in functional limitations for older respondents. FINDINGS In conclusion, the researcher presents the results of this study as a contribution to the growing body of knowledge regarding the issue of religion services and its positive impact on functional health of the elderly. The results of the current studies in review were consistent with the previous studies by Idler and Kast (1997), which also found that â€Å"more frequent church attendance is associated with lower levels of disability. Despite the limitations of the various studies, the preponderance of evidence supports the beneficial effects of religion on health outcomes. The need for ongoing research in this area is evident. Considering the elderly think religion is important, religion likely benefits health outcomes, and religion is without financial cost, health care providers should include religion in the care of their elderly patients. vii Chapter 1: Introduction Spirituality and Faith Communities Throughout history, humans have suffered ills and sought healing. In response, the two healing traditions— religion and medicine—historically have joined hands in aring for the sick. The same person often conducted these efforts; the spiritual leader was also the healer. Hospitals, which were first established in monasteries then spread by missionaries, often carry the names of saints or faith communities. As medical science matured, healing and religion diverged. Rather than simply asking God to spare their children from smallpox, people began vaccinating them. Rather than seeking a spiritual healer when burning with bacterial fever, they turned to antibiotics. It was a very logical progression, but has lacked the human compassion experience. However, the separation between religion and medicine is now shrinking. Spirituality has made a comeback (Koenig, 2001, p. 25): †¢ †¢ †¢ Since 1995, Harvard Medical School has annually attracted 1000 to 2000 health professionals to its Spirituality and Healing in Medicine conferences. Duke University, a leading Research Medical Institution in the United States, has established a Center for the Study of Religion/Spirituality and Health. 86 of Americas 126 medical schools offered spirituality and health courses in 2002, up from 5 in 1992 (Koenig, 2001). 1 †¢ †¢ 94 percent of HMO professionals and 99 percent of amily physicians agreeing that personal prayer, meditation, or other spiritual and religious practices can enhance medical treatment. (Yankelovich,1997) This renewed convergence of religion and medicine appears in such books as The Faith Factor (Viking, 1998), The Healing Power of Faith (Simon Schuster, 1999), Religion and Health (Oxford University Press , 2000), and Faith and Health (Guilford, 2001). Is there fire underneath all this smoke? Do religion and spirituality actually relate to health, as polls show four out of five Americans have believed (Matthews, 1997)? Statement of Problem: Does Faith Impact Health Healing? More than a thousand studies have sought to correlate the faith factor with health and healing. Does religion significantly influence the health outcomes of the elderly? Very few studies have followed cohorts long enough to examine a cause and effect relationship. It is possible the increasing levels of religious participation may strengthen the functional health of the elderly (Benjamins, 2004, pp. 355-74). Kark and his colleagues in 1996 compared the death rates for 3900 Israelis either in 1 of 11 religiously orthodox or in 1 of 11 matched nonreligious collective communities (Kark, 1996, pp. 341-46). The researchers reported that over a 16-year period, belonging to a religious collective was associated with a strong protective effect not 2 explained by age or economic differences (Kark, 1996, p. 345). Koenig and Larson have found religion has a salutary or protective effect on a variety of health outcomes. Despite numerous studies that indicate positive benefits from religious involvement, Sloan states the evidence is not empirical. It is the â€Å"Sharp Shooters Accuracy† model of study. If you take a sharp shooter out and have him fire six rounds into a concrete wall and then draw a target, the accuracy will be incredible. Sloan believes it is hard to control for all the variables involved in religious beliefs. Purpose of the study The purpose of this study is to review two significant different cohort groups that were focused on the impact of religion on the health outcomes of elderly individuals. The first study was a large national longitudinal study completed by Benjamins at the University of Texas at Austin. One of the concluding remarks was that smaller, regional studies should be completed to accommodate for denominational influences over lifestyle and environmental variations. The second study in comparison is a small regional nalysis completed in a large midwestern metropolitan area. Daaleman and colleagues from the University of Kansas Medical Center completed a smaller regional study focused on elderly clients served through its outpatient clinics. In every age group, those belonging to the religious communities were about half as likely as their nonreligious counterparts to have died. To fu rther understand the 3 relationship among religion, spirituality, and self-reported health status, Daaleman performed a secondary analysis of the parent studies cross-sectional data. Daaleman utilized a health status model developed by Johnson and Wolinsky s the research model to examine the relationship between self-reported health status and religiosity (Johnson, 1994). A similar large cohort study of 91,909 persons in one Maryland county found those who attended religious services weekly were less likely to die during the study period than those who did not—53 percent less from coronary disease, 53 percent less due to suicide, and 74 percent less from psoriasis of the liver (Comstock Partridge, 1972). In response to such findings, Sloan and his skeptical colleagues remind us that mere correlations can leave many factors uncontrolled (Sloan, 1999). Consider one bvious possibility: Women are more religiously active than men, and women outlive men. So perhaps this might sugg est religious involvement is merely an expression of the gender effect on longevity. Importance of the Study Epidemiologist Strawbridge and his co-workers followed 5286 Alameda, California, adults over 28 years. After adjusting for age and education, the researchers found that not smoking, regular exercise, and religious attendance all predicted a lowered risk of death in any given year. Women attending weekly religious services, for example, were only 4 54 percent as likely to die in a typical study-year, as were non-attendees. With the focus of health maintenance organizations centered on prevention and profit, religious activity might soon become a question for new insured’s (Strawbridge et al. , 1997, 1999; Oman et al. , 2002). A National Health Interview Survey (Hummer et al. , 1999) followed 21,204 people over 8 years. After controlling for age, sex, race, and religion, researchers found nonattendees were 1. 87 times more likely (See Table 1) to have died than were those attending more than weekly. This translated into a life expectancy at age 20 of 83 years for frequent attendees and 75 years for infrequent attendees. Hummer showed regular attendance at religious services is associated with an additional eight years of life expectancy when compared to never attending. These effects of religious attendance were consistent across all age, gender, and race/ethnicity groups and for all major causes of death (Hummer et al. , 1999, pp. 273-85). Dychtwald, psychologist, gerontologist and entrepreneur, suggests the educated senior consumer desires to take charge of the quality of life by participating in his/her mental and physical well-being. If there is an increased awareness of positive mental and physical health enefits for seniors, marketing dollars will be redirected toward spiritual health in this growing demographic (Dychtwald, 2005). The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has acknowledged that patients’ â€Å"psychosocial, spiritual, and cultural values affect 5 how they respond to their care† (Joint Commission Resources: 2003 Comprehensive Accredi tation Manual for Hospitals: The Official Handbook. 2003, p. RI-8) and has addressed spirituality and emotional well-being as aspects of patient care. Researchers’ interest in the connections between mind and body (Damasio, 1999; Penrose, 1999) oincides with increasing interest in the holistic view of health care, in which emotional and spiritual needs are considered inextricable from physical and psychological needs (Sherbourne et al. , 1999, pp. 357-63). For example, Standard RI. 1. 3. 5 refers to â€Å"pastoral care and other spiritual services† (p. RI-15). The intent for Standard RI. 1. 2. 8, â€Å"The hospital addresses care at the end of life† (p. RI-13), refers to â€Å"responding to the psychological, social, emotional, spiritual, and cultural concerns of the patient and family† (p. RI-13). Scope of the Study The purpose of the Benjamins Study is to examine the nteraction of religion and spirituality with self-reported health status in a community -dwelling geriatric population. The two main studies in review differ in scope and breadth of patients sampled. The Benjamins Study utilizes the national data base AHEAD, developed by the University of Michigan. The Benjamins Study review found over 1200 comprehensive reviews (Koenig, 2001 Larson, 1998) have focused on the association between religion and physical and mental health (Chatter, 2000, pp. 355-67; Ellison Levin, 1998, pp. 700-20; Jarvis Northcott, 1987, pp. 813-24). The Daaleman Study is a regional review of geriatric patients participating in a program at the University of Kansas Medical Center. Daaleman performed a crosssectional analysis of 277 geriatric outpatients participating in a cohort study in the Kansas City area. This study tested the hypothesis from a large continental longitudinal study design to a focused univariate and multivariate logistical regression analysis study design from a specific region of the United States. In a national health survey financ ed by the U. S. Centers for Disease Control and Prevention, religiously active people had longer life expectancies (Hummer, et al. 1999). These co-relational findings do not indicate non-attendees who start attending services and change nothing else will live eight years longer (See Table 2), but they do indicate as a predictor of health and longevity, religious involvement rivals nonsmoking and exercise effects. Such findings demand explanation. First, religiously active people tend to have healthier life-styles; for example, they smoke and drink less (Koenig, 1999, p. 24; Strawbridge et al. , 2001, pp. 957-61). Religiously orthodox Israelis eat less fat than do their nonreligious compatriots. But such differences are not reat enough to explain the dramatically reduced mortality in the religious kibbutzim, argued the Israeli researchers. In the recent American studies, too, about 75 percent of the longevity difference remains after controlling for unhealthy behaviors such as inacti vity and smoking (Musick et al. , 1999, pp. 73-86). Social support is another variable that helps explain the faith factor (George et al. , 2002, p. 115). For Judaism, Christianity, and Islam, faith is not solo spirituality but a 7 communal experience that helps satisfy the need to belong. The more than 350,000 faith communities in North America nd the millions more elsewhere provide support networks for their active participants—people who are there for one another when misfortune strikes. Moreover, religion encourages another predictor of health and longevity— marriage. In the religious kibbutzim, for example, divorce is almost nonexistent. But even after controlling for gender, unhealthy behaviors, social ties, and preexisting health problems, the mortality studies find much of the mortality reduction remaining (George et al. , 2000, pp. 102-116). Healthy Behaviors Religious Involvement Social Support (Faith Groups) Health (Absence of Illness) Positive Emotions Hope /optimism (Adapted from: Koenig Larson, 1998) Researchers therefore speculate a third set of intervening variables is the stress protection and enhanced well-being associated with a coherent worldview, a sense of hope for the long-term future, feelings of ultimate 8 acceptance, and the relaxed meditation of prayer or Sabbath observance. These variables might also help to explain other recent findings, such as healthier immune functioning and fewer hospital admissions among religiously active people (Koenig, 1999, p. 25; Koenig et al. , 1995, pp. 365-75). Rationale of the study Hospitals have often assigned the responsibility of ddressing emotional and spiritual issues to chaplains or to pastoral teams. Yet others—nurses, physicians, clinicians, and other caregivers—play equally important roles. The hospital staff’s ability to address patients’ emotional and spiritual needs factors into patients’ perceptions of the overall experience of care, the p rovider, and the organization. Patients have a desire to feel their circumstances and feelings are appreciated and understood by the health care team professionals. Shojania states it as follows, â€Å"If patients feel that the attention they receive is genuinely caring and tailored to eet their needs, it is far more likely that they will develop trust and confidence in the organization† (Shojania Bero, 2001, p. 160). A comprehensive literature review was completed by JCAHO staff to guide hospital administrators’ management of patients’ emotional and spiritual needs. This review provided the national literature benchmark for hospitalized patients’ emotional and spiritual needs and presents JCAHO’s survey findings on the importance of these needs in patients’ perceptions of care. Three questions are 9 addressed: (Values and Beliefs Respected; RI. 2. 10. May, 2005. Appendices A) 1. Are patients’ emotional and spiritual needs important? 2. Are hospitals effective in addressing these needs? 3. What strategies should guide improvement in the near future and long-term? The religion factor is multidimensional and therefore, very hard to measure. Although the religion-health correlation is yet to be fully explained Pincus, deputy medical director of the American Psychiatric Association, believes these findings have made clear that anyone involved in providing health care services . . . cannot ignore . . . the important connections between spirituality, religion, and health (Pincus, 1995). Consider the fact that older Americans will more than double in number from 35 million today to 70 million by year 2030. Already, some 6,000 Americans turn age 65 every day in our country. In just 10 years, the number reaching that personal milestone will rise to about 10,000 Americans each day. As hard as it may be for some to admit, the very icons of American youth and the Baby Boom generation will soon become part of the largest Medicare generation in history (Alliance for Aging Research. â€Å"Social Security Widow(er) Insurance Benefits† Web site report, 2005). 10 Overview of the study Religion and spirituality have entered the agenda of research on psychosocial factors in health. Benjamins found over 1200 comprehensive reviews have focused on the association between religion and physical and mental health (Chatters, 2000, pp. 335-67; Ellison Levin, 1998, pp. 700-20; Jarvis Northcott, 1987, pp. 813-24). These studies have separately reported both long-term and shortterm beneficial effects of individual religiousness on physical health status. The goal of this study is to assess the impact (positive or negative) of religion on functional health outcomes. The Daaleman Study performed a crosssectional analysis of 277 geriatric outpatients participating in a cohort study in the Kansas City area. Patients underwent a home assessment of multiple health status and functional indicators by trained research assistants. A previously validated 5-item measure of religiosity and 12item spirituality instrument were embedded during the final data collection. Univariate and multivariate analyses were performed to determine the relationship between each factor and self-reported health status. The Benjamins Study used the Assets and Health Dynamics Among the Oldest Old Survey, a nationally epresentative, longitudinal data set, to estimate the effects of religious attendance and salience on functional health in the elderly. The primary study hypothesis proposes that religious attendance and salience will be associated with a decrease in functional limitations for older respondents. This review of literature is a small snapshot of findings that represe nts a variety of national population groups, 11 validated outcome measures, different study designs, various analytical techniques, multiple follow-up periods, and focused geographic regions. 12 Chapter 2: Review of Related Literature A History of Religious Studies in Health Care Most of the time, a doctors advice for successful aging would offer the familiar mantras of good health: quit smoking, exercise regularly, and eat five to seven helpings of fruits and vegetables a day. Yet perhaps the day could be coming when your family physician might prescribe some unusual advice: go to your house of worship, meditate, and pray. In the United States, the traditional boundaries between church and state are blurring with President George W. Bushs recent initiative to allow faithbased charities to compete for government funding. Family medical providers emphasize medical care for the whole erson, which includes the complete understanding of a patient’s family and living environment. Daaleman completed a survey in 1998 that showed 72% of the physicians interviewed were interested in training in prayer, but only 33% believed in prayer as a legitimate medical practice. King’s research within healthcare settings found that â€Å"religious and spiritual bel iefs wield substantial influence on patient health benefits, and some may directly affect clinical outcomes† (King, 1994, p. 351). Might the boundaries between medicine and religion be blurring as well? Does the Baby Boomer generation eally want to know this information? According to Keyes (2002) the Baby Boomer generations are better economic consumers and civic citizens, investing in methods and products that improve health outcomes (Keyes, 2002, p. 55) January 1, 2011, is more than just a 65th birthday for the first of the 76 million Baby Boomers in the United 13 States. On this date, Baby Boomers will begin to enter the rolls of many federal programs. This will undoubtedly place a substantial economic burden onto both the government and taxpayers alike. However, it is important to strengthen our research on medicine and religion now in order to repare the nation for the influx of older Americans, as they help to preserve the independence and quality of life of our nationâ €™s seniors (Alliance for Aging: Medicare Report, 2005). Demographics Economic Impact So many creative and innovative programs are being implemented by faith communities throughout the nation that we can begin to think in terms of a faith and health movement in America. The objective of the Interfaith Health Program is to nurture this movement, because health is central to the mission of every faith tradition (Gunderson, 2002). The contributions of faith communities to health and ealing have been relatively insignificant in this century. This was due largely to the scientific breakthroughs that gave modern medicine enormous prestige and power. However, concern for healing was never lost in faith communities. This concern was evident in prayers for the sick, the establishment of Jewish and Christian hospitals, medical missions, and the practice of faith healing. Until recently, however, both medical and faith groups have focused almost exclusively on the treatment of disease. Th e emphasis in the last two decades has shifted from healing to health, from a narrow focus on physical ailments, 14 o the health of the whole person. This shift of emphasis, as welcome as it is, still reflects a narrow individualism within our culture. The leading edge of the faith and health movement is focusing attention on the health of communities. A bipartisan effort in congress was pushed by the United Jewish Federation in partnership with other faith groups to pass a critical piece of legislation call â€Å"The Return to Home† bill. Under the â€Å"Return to Home† legislation, most hospitalized elderly patients of all faith groups living in senior facilities and who are temporarily hospitalized will not be prohibited by their HMO s from eturning to their local communities for post-hospitalization recovery and rehabilitation (Koenig, 2004, p. 43). Promoting health is the challenge both religious and health leaders face as America ages into the next century. No Am ericans want to be without modern medical advances, but health is more than the absence of disease. It involves mental and spiritual well-being as well as physical health. It involves the health of communities as well as the health of individuals. Physicians should be aware of the role religion plays in how patients cope with illness. Scientists are only now beginning to discover the owerful effects the mind and social relationships can have on health outcomes. By reclaiming health as part of their mission, faith groups once again are partners with other community agencies in improving health (Koenig, 1999, pp. 42-43). Where do the healthcare policy makers need to focus their efforts? First, more than half of the leading causes of death in this country are preventable. Deaths 15 due to alcohol, tobacco, and inactivity would decrease significantly if lifestyles were modified. The 10 Leading Medical Causes of Death Deaths Lifestyle Factors Deaths Leading to Half of Them Heart Disease 20,000 Tobacco Cancer 505,000 Diet, Sedentary 300,000 Lifestyle Cerebrovascular Disease 144,000 Alcohol 100,000 Accidents 92,000 Infections 90,000 Chronic Pulmonary Disease 87,000 Toxic Agents 60,000 Pneumonia and Influenza 80,000 Firearms 35,000 Diabetes 48,000 Sexual Behavior 30,000 Suicide 31,000 Motor Vehicles 25,000 Liver Disease, Cirrhosis 26,000 Illicit Drug Use 20,000 AIDS 25,000 400,000 16 Total 2,148,000 Total 1,060,000 (McGinnis Foege, 1993). In addition to promoting lifestyle changes, faith groups share with public health agencies a commitment to social justice as this relates to health. There is a clear connection between socioeconomic status (SES) and health. No matter how SES is measured, persons who are impoverished, homeless, or vulnerable are likely to have negative health patterns. Health is a goal for everybody, but socioeconomic status factors undermine it in spite of personal efforts. Because health is a goal for all, community members have a moral imperative to address socioeconomic status (McGinnis, 1993, pp. 2207-2211). Public health agencies and faith communities share social justice as a fundamental core value. This provides a basis for collaboration. Community-level systemic change n addressing problems like substance abuse and violence can best be achieved through partnership. Aging Stats: †¢ In 10 years, 10,000 Americans will turn 65 each day. †¢ By 2030, the older population of the United States will have doubled to more than 70 million people. †¢ By 2050, the â€Å"oldest old† (over age 85) will increase almost fourfold, from 4 million today, to nearly 19 million by 2050. 17 Boomer Health Care Needs: †¢ †¢ †¢ †¢ †¢ †¢ In 2011, hospital spending is expected to reach $885. 2 billion (CMS, National Health Expenditures, 2002). Prescription drug expenditures for 2011 are expected to reach $435. 2 billion (CMS, National Health Expenditures, 2002). Nursing home expenditures will reach an expected $164. 4 billion in 2011 (CMS, National Health Expenditures, 2002). It is estimated that by 2010, 2. 6 million Americans will be moved to a nursing home (Data from Bureau of US Census, 2005). By 2010, expenses related to Alzheimer’s disease are expected to increase by 54. 5% to $49. 3 billion (Medicare and Medicaid Costs for People with Alzheimer’s disease. Washington, D. C. : April 2001: The Lewin Group). By 2050, the need for direct care/long-term care workers will grow from 4. 2 million workers to 8. 6 million, though this workforce is expected to increase nly slightly (HH

Definition of Chinese Exclusion Act

Definition of Chinese Exclusion Act The Chinese Exclusion Act was the first United States law to restrict immigration of a specific ethnic group. Signed into law by President Chester A. Arthur in 1882, it was a response to a nativist backlash against Chinese immigration to the American West Coast. The law was passed after a campaign against Chinese workers, which included violent assaults. A faction of American workers felt that the Chinese provided unfair competition, claiming they were brought into the country to provide cheap labor. Chinese Workers Arrived During the Gold Rush The discovery of gold in California in the late 1840s created a need for workers who would perform grueling and often dangerous work for low wages. Brokers working with mine operators began to bring Chinese laborers to California, and in the early 1850s as many as 20,000 Chinese workers arrived each year. By the 1860s the Chinese population constituted a considerable number of workers in California. It was estimated that approximately 100,000 Chinese males were in California by 1880. A series of economic downturns in the 1870s created an atmosphere in which Chinese workers were blamed for the loss of work by white, generally immigrant, laborers. A financial crisis that began in 1873 with the collapse of a prominent New York City bank, Jay Cooke and Company, rippled through the economy and hit California. Up to that point, railroad construction had been booming in the West. In the railroad business, Chinese workers had earned a reputation for taking on difficult and often very dangerous labor. The railroad companies openly discriminated against the Chinese in some ways, such as not allowing them to attend the ceremony when the golden spike was driven to make the completion of the transcontinental railroad. But the railroads relied on Chinese labor. The banking collapse in the east put an end to railroad construction in California, and in the mid-1870s many thousands of Chinese workers were suddenly idled. As they sought other work, white workers began to bitterly complain that they were taking their jobs. Hard Times Led to Violence With competition for work, the situation became tense and often violent. American workers, many of them Irish immigrants, felt they were at an unfair disadvantage as the Chinese were willing to work for very low pay in dismal conditions. The Chinese were also targeted as they tended to be far outside the mainstream of American society. They tended to live in enclaves which became known as Chinatowns. They often didnt wear American clothing, and few learned English. They were seen as very different than European immigrants, and were generally mocked as being inferior. Economic downturns in the 1870s led to job losses and wage cuts. White workers blamed the Chinese and persecution of Chinese workers accelerated. A mob in Los Angeles killed 19 Chinese in 1871. Other incidents of mob violence occurred throughout the 1870s. In 1877 an Irish-born businessman in San Francisco, Denis Kearney, formed the Workingmans Party of California. Though ostensibly a political party, similar to the Know-Nothing Party of earlier decades, it also functioned as an effective pressure group focused on anti-Chinese legislation. Kearneys group succeeded in attaining political power in California, and began to be considered the real opposition party to the Republican Party. Making no secret of his racism, Kearney referred to Chinese laborers as Asiatic pests. Anti-Chinese Legislation Appeared in Congress In 1879 the U.S. Congress, spurred on by activists such as Kearney, passed a law known as the 15 Passenger Act. It would have limited Chinese immigration, but President Rutherford B. Hayes vetoed it. The objection Hayes voiced to the law was that it violated the 1868 Burlingame Treaty the United States had signed with China. In 1880 the United States negotiated a new treaty with China that would allow some immigration restrictions. And new legislation, which became the Chinese Exclusion Act, was drafted. The new law suspended Chinese immigration for ten years, and also made Chinese citizens ineligible to become American citizens. The law was challenged by Chinese workers, but was held to be valid. And it was renewed in 1892, and again in 1902, when the exclusion of Chinese immigration was made indefinite. The Chinese Exclusion Act was finally repealed by Congress in 1943, at the height of World War II. Sources: Chinese Exclusion Act of 1882. Gale Encyclopedia of American Law, edited by Donna Batten, 3rd ed., vol. 2, Gale, 2010, pp. 385-386. Gale Virtual Reference Library. Chinese Exclusion Act of 1882. U.S. Immigration and Migration Reference Library, edited by Lawrence W. Baker, et al., vol. 5: Primary Sources, UXL, 2004, pp. 75-87. Gale Virtual Reference Library.

Commercial Property Development in London Essay

Commercial Property Development in London - Essay Example A report by Ball, Lizieri, and Macgregor (2012, p.41) indicate that the city has witnessed a faster growth of commercial properties in the recent past. In this regard, the report showed that many property developers have been targeting central London as the best place to put up a commercial property. Nevertheless, this growth in commercial property, in London, is taking place at the backdrop of the recent financial crisis that did affect the U.K. adversely. Research has shown that the recent financial crisis of 2007/2008 did affect all the economic sectors in the nation including the property market, which dropped to an all-time low as many people could not afford to invest in commercial properties due to lack of enough funds required for the project. In fact, the U.K. is still struggling to recover from the effects of the financial crisis, by introducing measures aimed at improving the state of the economy such as opening up the country for investments. O’Kelly (2012) noted t hat the economy of the U.K. shrunk by about 4.9% in 2009 due to the effects of the 2007/2008 financial crisis. In fact, the economy of the U.K. has not been able to experience any significant improvement since then. Only recently, in 2012, did the economy registered a growth rate of about 1%. However, economists remain positive that the economy is on the right course and is likely to enjoy significant growth over the next few years. However, as earlier stated, central London has overcome all these odds and has been experiencing increased growth in commercial property development over the last six years.

King leopold's destruction of the Congo followed the themes of Essay

King leopold's destruction of the Congo followed the themes of dehumanization and greed - Essay Example Some very land mark issues of the world seem to fade from memory and become invisible to powers that be. The Congo story is a good example of such. The rule was characterized by exploitation of Africa. Hochschild notes, â€Å"There is no trade going on here. Little or nothing is being exchanged for the rubber and ivory. † 1 The colonization of Africa had elicited mixed results. The prominent impact was the exploitation. Davidson points out that, â€Å"On one side, the colonial systems had continually drained Africa of the wealth produced by African labor, land, and natural resources.†2 Twain says, â€Å"Rape was routine, but so was the mutilation of the male and female genitalia in the presence of family members†3. Adam Hochschild captures this very well in his book King Leopolds’s Ghost. Belgium's King Leopold II and his ownership of the Congo from the late 1800 until after the turn of the 20th century is a perfect example of bad leadership and governance . Hochschild asserts, â€Å"... the Congo Free State, as it is then called, the huge territory in central Africa that is the world’s only colony claimed by one man†4. He managed the Congo as his own property; this was at a time when the Congo was arguably one of the biggest colonies in Africa. Through lies, crafty political manipulations, tricks and simple ignored activities, the monarch who wanted to rule more than small Belgium, found himself ruling a colony which was to be a good example of how not to run a country. It is stated, â€Å"Leopold formed the ironically named Congo Free State and set in place a bureaucratic-sadistic operation to extract rubber and other raw materials†5. What was being experienced in Congo under his leadership was akin to slavery. Hochschild notes, â€Å"More than two hundred mass meetings to protest slave labor in the Congo would be held across the United States†6. King Leopold, a young king who could never have enough of a nything. He continually exploited Africa, Congo in this case, to fulfill his desires. These activities were carried out using crude means backed by ludicrous paper work such as having village chiefs sign (or rather, "X") complicated, legalese-filled documents some of whose content they did not understand. The term "Association" was a term he used to confuse the African into believing that the contracts they were singing were for their own. This gave him an upper hand against the rest of the explorers especially the Arabs and Indians. The Belgian King Leopold capitalized on the image of the Congolese as being "in need of help" back in the late 1800s when he wanted to colonize the area. This idea carried the day because a conventionally-accepted perception at the time was that Africans had to be saved from each other and themselves though legislation and imposed measures of western civilization The exploitation of Congo by Leopold is one of the worst in history. It is recorded,  "This is the story of that movement, of the savage crime that was the savage crime that was its target.† 7 Few Europeans could stand in Leopold’s way let alone the naive Africans. The public in their naivety, continued to praise the new machine gun created by Hiram Maxim. The world at the time was not any different from Leopold's vision, through his exemplary political maneuverings, Leopold succeeded in convincing the United States to recognize his Congo with little if any investigation. The impact in terms of economic gains on Africa was not one sided. Davidson notes, â€Å"