Child sexual abuse victims Essay Example for Free

Child sexual abuse victims Essay I. STATEMENT OF THE PROBLEM Sexual abuse of children is a harsh fact of life in our society. Child sexual abuse is a form of child abuse in which an adult or older adolescents uses a child for sexual stimulation. Forms of child sexual abuse includes asking or pressuring a child to engage in sexual activates, regardless of the outcome, indecent exposure to a child with intent to gratify their own sexual desire or to intimidate or groom the child, physically sexual contact with child or using a child to produce child pornography. A child abuse victim can result in both short term and long-term harm physically and emotionally. What would you do if you knew a child who became a victim? Thats a question everyone should be ready to answer if they want to protect our future generations. A. DEFINITIONS There is no universal definition for CHILD SEXUAL ABUSE VICTIM(S). However, a major characteristic of any abuse is the dominant position of an adult that allows him or her to force or coerce a child into sexual activity. Child sexual abuse may include fondling a childs genitals, masturbation, oral-genital contact, digital penetration, and vaginal and anal intercourse. (American psychological association, 2011) Other forms of abuse can also occur that are not as easy to detect. These include showing adults genitals to a child, showing the child pornographic or dirty pictures or videotapes, or using the child as a model to make pornographic materials. (Child advocacy resources) A victim of child abuse suffers from PSYCHOLOGICAL EFFECTS that have an immediate emotion. These effects of abuse cause isolation, fear and an inability to trust. This can translate into lifelong consequences, including low self-esteem, depression, and relationship difficulties. Researchers have identified links between child abuse and poor mental and emotional health, Cognitive difficulties, and Social difficulties. In one long-term study, 80 percent of young adults who were abused met the diagnostic criteria for at least one psychiatric disorder by age 21. Some problems include depression, anxiety, eating disorders, and suicide attempts. Other psychological and emotional effects include panic attacks, attention-deficit/ hyperactive disorder, depression, anger, and posttraumatic stress. (Child Welfare Information Gateway, 2008) PHYSICAL EFFECTS are defined, as immediate physical abuse can be relatively minor, such as bruises or cuts. It can also be very severe such as broken bones, hemorrhage, or even death. Physical effects in some cases can be temporary, however the pain and suffering they cause a child should not be discounted. Several studies have shown adults who experience abuse or neglect during childhood is more likely to suffer from physical ailments such as allergies, arthritis, asthma, bronchitis, and high blood pressure. (Child Welfare Information Gateway, 2008) B. STATISTICS 1. VULNERABILITY In over 90 percent of child sexual abuses causes, the offender is known and trusted by the victim. Grooming is the process used by the offend ender to recruiter and prepare a child for sexual victimization. It starts when the offender targets a specific child. While all children are at risk for victimization, certain factors make some children more vulnerable to sexual abuse than others. For example, a child is especially susceptible if he or she feels unloved, has low self-esteem, has little contact with committed adults or regularly spends time unsupervised. Sex offenders commonalty  engage children by spending time with them, playing games with them, and showing them special attention or giving them gifts. Older children or teens may be offered drugs or alcohol. Offenders forge an emotional bond through frequent contact, positive interaction and by conveying the child or teen that they understand or can appreciate their interests and concerns. In time the emotional bond leads to non-sexual physical contact which can take the form of physical play such as wrestling, affection, touching etc. In this way the offender tests the childs boundaries, gradually turning into sexual touch. Usually if the child is older the child starts to become uncomfortable or fearful of the sexual activity. Offenders typically threat the child to keep them from speaking up. Most child victims are caught in a web of fear, guilt and confusion as a result of the sex offenders grooming and manipulation. Sadly, many child victims remain silent about their abuse. (Bisquera) 2. INDICATORS OF CHILD SEXUAL ABUSE Indicators of child sexual abuse are varied and should always be considered in the context of what else is happening in a childs life. Any one indicator, on its own, is a sign that something may be impacting a childs well being. Some behavior indicators can be unexplained change in a childs comfort level (either attachment or fear) around any person in a position of trust. They could show abrupt changes in performance in school or home. A significant difference in the way the child socializes. For younger children, a sudden loss of skills could be a red flag. A child who was toilet trained could start wetting the bed. Abuse can an also include sexual behavior, often in front of others, such as self-exposure, masturbation, touching others peoples private parts, sexual language. In older children or teens this might be seen as promiscuous behavior. Physical indicators such as bruises, scratches, irritation/ itching around genitals that are not consistent with explanations of how they happened. A victim who is not sexually active could show signs of sexual transmitted diseases, such as crabs, herpes, and gonorrhea. They could also experience tenderness or soreness around areas of penetration. Finding blood in their stool or urine should also cause some concern when it is not explained by other conditions. Underwear is often where proof of abuse may exist. (Bisquera) C. EXPERT STATEMENTS 1. FREQUENCY OF OCCURRENCE Overall cases of child sexual abuse fell more than 60 percent from 1992 to 2010, according to David Finkelhor, a leading expert on sexual abuse. The evidence for this decline comes from a variety of indicators. It includes national surveys of child abuse and crime victimization. The crime statistics are compiled by the F.B.I analysis of data from the National Data Archive On Child Abuse and Neglect and annual surveys of school students in Minnesota. All of the data pointed in the same direction. From 1990 to 2010 cases of sexual abuse dropped from 23 per 10,000 children to 8.6 per 10,000 children. All of the subjects were under the age of 18. Researches found a 62 percent decrease. There was a 3 percent drop from 2009 to 2010. The Minnesota Student Survey also reported a 29 percent decline in reports of sexual abuse by an adult who was not a family member from1992 to 2010. They also saw a 28 percent drop in reports of sexual abuse by a family member. At the same time, the willingness of children to report sexual abuses has increased. They found that in 50 percent of sexual abuse cases, the childs victimization had been reported to an authority, compared with 25 percent in 1992. (Goode, 2012) 2. COMMON MOTIVES OF OFFENDERS Studies on who commits child sexual abuse vary in their findings, but the most common finding is that the majority of sexual offenders are family members or is otherwise known to the child. Sexual abuse by strangers is not nearly as common as sexual abuse by a family member. Reasearch further shows that men perpetrate most instances of sexual abuse, but there are cases that women are the offenders. Despite a common myth, Homosexual men are not more likely to sexually abuse children than heterosexual men. (American psychological association, 2011) About 73% of child sexual abusers report experiencing sexual abuse in their own childhood. Not all pedophiles are child molesters. Pedophilia is a clinical term that describes a person who has had repeated arousing fantasies, sexual urges, or behaviors related to sexual activities with children for at least six months. Pedophiles do not  necessarily have to act on their urges. Sexual offenders have the same attraction to children, but they act on their urges. Sexual offenders come from all backgrounds and social classes. They do their best to become friends with parents, and then they work to gain the childs trust. (64 facts of 2012) II. REVIEW OF THE LITERATURE A. HISTORY 1. THE RISE OF PUBLIC CONCERN Public concern about child abuse has steadily increased. The number of referrals to child protection services in recent years has risen every year since the 1960s. It is not clear if the increase of reporting is due to a higher incident of abuse or a widening of the definition of abuse. (Eileen, 2008) Sexual abuse of children was not taken seriously until 1964 when congress passed the Child Abuse and Prevent and Treatment Act. This established reporting requirements of suspected cases. Among some experts there was a tendency to deny that sexual abuse had lasting consequences. Researchers have now found that there are long-term emotional problems that surface. (Mintz,2012) A contributing factor to the growing public concern is also widely publicized deaths. Although the field of child protection services date back to the nineteenth century, public concern has rarely reached the present level of intensity. (Polsky, 1991) 2. CIVIL LAWSUITS Child abuse statues have been enacted in most states to provide civil immunity for those making good faith reports of suspected child abuse. Most states also provide immunity from criminal liability. Physicians, nurses and social workers are required to report suspected child abuse that comes before them in some states failure to report a case carries criminal penalties as well as civil liability. B. KEY ISSUES 1. WHAT ARE THE EFFECTS OF CHILD SEXUAL ABUSE? There are short term and long-term impacts of sexual child abuse. Depression, anxiety, amnesia, disengagement and numbing are just a few have the psychological and emotional responses victims experience. As children become adults they can suffer intimacy disturbance, making it hard for them to physically and emotionally have a healthy relationship. Suicidal thoughts and co-dependence are also long-term impacts of sexual abuse. WHAT TO DO IF YOU THINK A CHILD YOU KNOW HAS BEEN THE VICTIM OF CHILD ABUSE Speak up but choose the time and place carefully. Do not ask the child about his or her abuse in front of the person you think may be abusing the child. Ask them questions. Find out if anyone has been making them feel uncomfortable. They many not know they are being abused themselves or know its wrong. Follow up on whatever made you concerned. Ask in a non-judgmental way using the word I rather than you so they dont feel shamed. Building a trusting relationship with the child is also important. They should know how to say no and when something does make them feel uncomfortable, they should tell a trusted adult. Most importantly, children should know that some parts of their body are private. (RAINN, 2009) PROVING SEXUAL ABUSE Many child abuse cases must be proved using circumstantial evidence because direct evidence is not available. In many instances, the child is unable to tell what happened, and the offender does not ordinarily disclose the truth. Inferences are therefore very important in providing child abuse. Some sexual abuse requires proof of forcible compulsion. When the victim is a child, the child abuses often submits to the advances of adults who have parental or similar authorities over the child. (Tomas J., 2010) C. MOST RECENT RESEARCH 1. UNDERREPORTED AND LIGHTLY PROSECUTED Child abuse is greatly underreported and under estimated mostly because of the lack of an agreed- upon definition of abuse. Underreporting is related to several factors. Children over the age of 5 often care for or know their abuser. Therefore, they find themselves trapped between the need for affection and a sense that something is wrong. Cases of sexual child abuse are often lightly prosecuted because of minimal communication between  the prosecutors office and child protected services. 2. POSSIBLE COMPLICATIONS Some children overcome the physical and physiological effects of child abuse. Those with strong social support can adapt and cope with bad experiences. For many others, however, child abuse has lifelong consequences, For example, child abuse may result in physical, behavioral, emotion and mental issues. Some physical issues include disabilities and health problems. Abuse of others or frequent, causal sex with many different partners (sexual promiscuity) or teen pregnancy is an example of behavioral issues. Emotional issues can include low self-esteem, difficulty establishing or maintaining relationship, challenges with intimacy and trust. (Mayo Clinic, 2010) D. INFORMATION FOR THE EXPERTS 1. RESEARCH REGARDING PREVENTION STRATEGIES FROM EXPERTS Experts suggest correcting the imbalance between adult and children by empowering children. First off information is power. Children who know their own bodies are more likely to choose when, how, and by whom they are touched. Self esteem building and experts also suggest self-defense skills. Lastly children need resources. They should have a network of trusted adults they can turn to. (Torbin,2002) 2. PROTECTING CHILDREN FROM SEXUAL ABUSE The first step in protecting children from sexual abuse is recognizing telltale symptoms. Changes in attitude and rebellion at school could point to an underling problem. It is important to educated children about their body parts by understanding what is private. Adults need to be aware of their childs surrounding at school or in a childcare setting. Parents should educate themselves on red flags to protect their child from sexual abuse. III. SUMMARY A. DISCUSSION OF FINDINGS 1. ABOUT RESEARCH Despite our prevention effort, much more must be done to decrease the incidents of child abuse and neglect. Our efforts should be directed to changes in the helping system, changes in society, and additional research. One of the hopes for the future lies in research, not only to further define and understand abuse but also to evaluate existing programs. Only though out commitment to change and our willingness to research what will create a better future will we combat the growing problem of sexual child abuse. 2. ABOUT PROGRAMS With child protection agencies are responsible for direct intervention form investigation and case management. These agencies can be hampered if there is not communicatory and public support for their work, which includes offering programs to help prevent child sexual abuse. There needs to be more extensive community awareness and education to reduce harm. B. SOCIETYS CONCERN WITH CRIME Society is helping the system make changes in order to reduce the rate of child abuse. Research is needed to further define and understand abuse. Evaluation is also needed for the existing programs. Commitment to change and willingness to research will create a better future to combat the growing problem of sexual child abuse. IV. CONCLUSION A. THE PROBLEM REVISITED WITH OPINIONS Child abuse is always been a problem, and in recent year it has made its way to the spotlight. Many people are willing to talk about them being a victim as a child. The more people feel comfortable talking about child sexual abuse. The less it will become a crime. Children become victims because of their vulnerability of trusting adults and unaware of the wrong. If you think a child you know has been a victim of child sexual abuse thing you can do is to give the child a safe environment in which to talk to you or another trusted adult. Encourage the child to talk about what he or she has  experienced, but be careful not to suggest events to him or her that may not of happened. Reassure the child that they did not do anything wrong. Seek mental assistance for the child. Being aware that many states laws require that persons who know or have a reason to suspect that a child has been sexual abuses must report that abuse to either a local law informant officials or child protection officials. Our future generation needs to feel protected from being a victim of child sexual abuse. B. SUGGESTION OF POSSIBLE SOLUTIONS. 1. PROGRAMS The best way to prevent child abuse is educate parents about child abuse. Most parents feel that this could never happen to them. When it happens the parents are in shock, but when they learn some warning signs, they are able to point them out. There are many free programs that can teach parents how to educate their children on protecting themselves from child abuse. The reality is when there are budget cuts; these programs that protect our future generations are the first to get cut. 2. POLICY Having Policys in school districts and childcare environments can be the solution to protecting children. One suggestion would be to have restrictions on when and where is acceptable for a child to alone with adult. This policy does not only protect the child, but it protects the adult from false accusations. 3. LAWS Laws against child sexual abuse can very by country. Based on the local definition of who is a child and what constitutes sexual abuse. As the age of the consent to sexual behaviors varies from country to country, so do definitions of child sexual abuse. An adults sexual intercourse with a minor below the legal age of consent may sometimes be referred to statutory rape based on the principle that any apparent consent by a minor could not be considered legal consent. References _American psychological association_. (2011). Retrieved February 20, 2013, from http://www.apa.org/pubs/info/brochures/sex-abuse.aspx A.D.A.M. (2012). _New york times_. Retrieved February 20, 2013, from http://health.nytimes.com/health/guides/disease/child-abuse-sexual/overview.html Bisquera, A. _Child sexual abuse_. Retrieved February 20, 2013, from http://satchawaii.com/get-info-about- child-sexual-abuse.aspx _Child advocacy resource and consultation center_. (n.d.). Retrieved February 20, 2013, from http://www.nyscarcc.org/abuse/abuse.php Child Welfare Information Gateway. (2008). _Factsheets_. Retrieved February 20, 2013, from https://www.childwelfare.gov/pubs/factsheets/long_term_consequences.cf Eileen , M. (2008). (2nd ed.). Thousand Oaks, California: SAGE Publications. Retrieved April 1, 2013 from http://books.google.com/books?id=0nkvffIwK5YCpg=PA80dq=rise of public concern child abusehl=ensa=Xei=n4tQUdO1OqHQiwKnqICQCwved=0CFMQ6AEwBg Goode, E. (2012, June 28). Researchers see decline in child sexual abuse rate. Retrieved February 20, 2013, from http://www.nytimes.com/2012/06/29/us/rate- of-child-sexual- abuse-on-the-decline.html?_r=0 Mayo Clinic. (2010, July 1). _Child abuse: Complications_. Retrieved April 1, 2013 from http://www.mayoclinic.com/health/child-abuse/DS01099/DSECTION=complications Mintz, S. (2012, July 13). Placing childhood sexual abuse in historical perspective. Retrieved April 1, 2013 from http://blogs.ssrc.org/tif/2012/07/13/placing-childhood-sexual-abuse-i n-historical-perspective/ Polsky, A. (1991). _The rise of the therapeutic state_. (1st ed.). Princeton, New Jersey: Princeton University Press. Retrieved April 1, 2013 from http://books.google.com/books?id=fngqbWhPLmsCpg=PA202dq=rise of public concern child abusehl=ensa=Xei=n4tQUdO1OqHQiwKnqICQCwved=0CF4Q6AEwCA RAINN. (2009). _Child sexual abuse_. Retrieved April 1, 2013 from http://www.rainn.org/get- information/types-of-sexual-assault/child-sexual-abuse/if-you-suspect Sue , A. M. (1996). _The reality of abuse_. Retrieved February 20, 2013, from http://www.yesican.org/stats.html Tomas J., G. (2010). _Criminal evidence: Principles and cases_. (7th ed.). Belmont, CA: Wadsworth. Retrieved April 1, 2013 from http://books.google.com/books?id=AlBYw53p9f4Cpg=PA81dq=proving sexual abusehl=ensa=Xei=G6ZQUaqVF8LJigKV_IDICgved=0CEMQ6AEwAw (2012). 64 facts of.. child sexual abuse. Retrieved February 20, 2013, from http://facts.randomhistory.com/child-sexual-abuse-facts.html

Prevention Strategies for the Development of Pressure Ulcers

Prevention Strategies for the Development of Pressure Ulcers This assignment will examine the process and methods used when gathering empirical evidence, for a chosen based care issue, using different search strategies and medical databases. An appraisal and discussion of the chosen evidence will also be made, identifying how the evidence was gathered and its relevance to the chosen based care issue. The process of collecting such evidence and the importance of its use will be reflectedupon using a specific reflective model. The practice based care issue which has been chosen is ‘prevention of pressure ulcers’. A pressure ulcer is an area of localised damage to the skin and underlying tissue (EPUAP, 2009) which develops when there is persisting pressure on a bony site, obstructing healthycapillary flow , leading to tissue necrosis (Lyder, 2003).The rationale for selecting this type of research is due to the high prevalence rate of pressure ulcer among patients and the current lack of knowledge concerning guidelines of pressure ulcer prevention (Moore Price, 2004). I am very interested in this topic and feel a deeper knowledge of pressure ulcer development and risk assessment tools will enable me to provide better clinical practice. According to Davies (2008) health care professionals are striving constantly to improve and develop standards of care which evolves from the integration of research evidence, clinical expertise and patient needs and values (Institute of Medicine, 2001),this is al so known as evidence-based practice. The reflective model that I will be using is Rolfe et al (2001) ‘what’ model which composes of three main areas, what? So what? Now what? This model aims to identify the following; what was I trying to achieve? What is my new knowledge of understanding? What information is needed to face a similar situation again? Ichose this particular model compared to John’s model of reflection (1994) as I found it the easiest model for organisation and meaning to the process of reflection. .Reflection involves accessing previous experience to help in developing tacit and intuitive knowledge (Johnsand Freshwater, 2005) and the main principles of reflection include becoming mindful, understanding and learning from experience. Reflection facilitates an evaluation of one’s own practice, both as individuals and with their teams (Sines, Saunders Burford, 2013). It is vital that Nurses reflect and practice reflectively as it allows them to learn from experience and make better future judgement, becoming critical practitioners and facilitating excellent patient care. The critique model I will be using for the critical appraisal and discussion is the Critical Appraisal Skills Program (CASP) as it is a clear tool which identifies the worth of the articles I have found (CASP, 2013). Critical Appraisal After researching for relevant articles, I decided to choose three of the most relevant articles to critically appraise. Each of these three articles involves a study evaluating the effectiveness of prevention strategies for the development of pressure ulcers. The first single blind randomised control study by Webster et al (2011) aimed to evaluate the effectiveness of two pressure-ulcer screening tools against clinical judgement in preventing pressure ulcers. This study had a very clear and focused objective which stimulated the reader to continue reading due to the study avoiding the use of jargon or buzz words (Carr, 2001). This was an experimental and correlation study showing the link between two factors with the aim of producing quantative results. 1231 patients were randomly allocated to either a water low or ramstadius screeningtool or to a clinical judgement group. Randomised Control Trials (RCT) are comparative studies with an intervention group and a control group; the assignment of the subject is assigned through randomisation(Melnick Everitt, 2008). The advantages of using RCT are that it removes potential of bias in the allocation of participants and that randomisation tends to produce comparable groups; that is, measured as well as unknown or unmeasured prognostics factors and characteristics at the time of random allocation will be balanced (Friedman, Furberg Demets, 2010). The researchers ensured that patients allocated were excluded if their hospital stay was expected to be less than 3 days or if they had been in hospital 24 hours prior to the baseline assessment occurring. This is to allow thorough and regular direct observation of the incidence of hospital acquired pressure ulcers, allowing the researcher to attempt to control the studies validity and reliability (Marshall, 2004). In a research study it is vital that the researcher ensures that the subjects are aware of the process of the study and have given informed consent. In the case of this study, for pressure ulcer screening and observation, consent was not required. However, signed consent was sought from any patient who developed a pressure injury in order to validate the assigned pressure ulcer through clinical photography. The researchers also obtained institutional ethics approval which included the right to access the patient’s medical record for audit purposes. The incidences of hospital acquired pressure ulcers were similar between all groups. The authors found no evidence to show that two common pressure ulcers risk assessment tools were superior to clinical judgement to prevent pressure injury. The authors felt that resources associated with the use of these tools might be better spent on careful daily skin inspection and improving management targeted at specific risks. This is supported by the work of Sarabahiand Tiwari (2012) who suggests a regular and rigid schedule of inspection must be followed as part of the patients daily routine. Nurses undertaking the trial were more familiar with the Water low scoring system which could have led to contamination in the clinical judgementgroup. The limitation of this study is that they did not use patients from acute settings who could be at risk and therefore cannot use these results as a representation of all hospital settings. The second randomised controlled study by Nixon et al (2006) aimed to compare whether differences exist between alternating pressure overlays and alternating pressure mattresses in the development of new pressure ulcers. This criterion for this study involved participants aged at least 55 years who had been admitted to vascular, orthopaedic, medical, or care of elderly wards, and had limited mobility. The methodology used for this study was pragmatic, open, multicentre and randomised controlled trial. An open label study is where the investigator and experimental units knows which treatment the experimental unit is to receive. Although this type ofstudy is simple and easy to design, it could cause the individual to favour the type of treatment, leading to possible bias (Ambrosisus, 2007). A multicentre method involves the study being conducted by several institutions. An advantage to conducting a multicenter is that it increases the number of patients available to participate (Bhandari Joensson, 2011), which in the this trial is a large 1972, leading to the findings beinghighly likely to be representative of what would happen in usual clinical practice. The design of this study involved patients beingallocated to either an alternating pressure overlay or an alternating pressure mattress, within 24 hours of hospital admission, with the expected length of stay of at least seven days. Clinical research nurses assessed skin status twice weekly for 30 days and then once a week up to 60 days for the development of pressure ulcers. A limitation of this study is the lack of blinded outcome assessment due to difficulty in disguising or masking the mattresses, however, according to Khan, Kunz, Kleijen Antes (2011) only few observational studies manage to implement appropriate measures to achieve blinding. The researcher tried to combat this through independent skin assessments which were taken by the Nurses to avoid any bias.Ethical approval for this study was approved by theNorth West multicentre research ethics committee and local ethics committees in order to undertake this research. This study had a clear aim to evaluate the effects on p ressure ulcer risk and was able to undertake the study with fairly low rates of ulcer incidence, meaning the patients were subjected to minimal harm.The most important issue arising in the ethical review of scientific research involves preventing human participants, is risk of harm (Smith Waddington, 2013)therefore it was extremely important that the researchers were able to conduct this study with low incidence rates. The results of this study were that the patients allocated to either an alternating pressure overlay or alternating pressure mattress that developed a new pressure ulcer of grade 2 or worse did not differ, highlighting the need for other preventive measures. The final study by Moore et al (2011) aimed to compare the incidence of pressure ulcers among older persons nursed using two different repositioning regimens. The researchers aim is very clear, evaluating the effectiveness of positioning patients 3 hourly and 6hourly at night time. The methodology used was a pragmatic, multi-centre, open label, prospective and cluster-randomised controlled trial, similar to the study above, the findings are highly likely to be representative of what would happen in usual clinical practice due to a multicentre approach being commonly accepted as providing a more representative population (Luchetti Amadio, 2008). Cluster randomised control trial involves randomizing professionals so it is much easier to keep the intervention separate from the control groups but methodological, statistical and ethical issues must be taken into account in making sense of cluster trials(Gilbody Bower, 2010). This study did indeed ensure that ethical approval was received by participants before the study commenced. The results obtained through the research were that repositioning patients with a pressure ulcer every three hours at night, using the 30 degree tilt, reduces the risk of pressure ulcers compared with usual care which issupported by the recommendations of the International pressure ulcer prevention guidelines (2009). Arguably, the research is well written with a good amount of supporting literature, stating clearly the incidence of pressure ulcers with a good rationale for the studies aim. This study included results of other similar researchers who have found similar results of repositioning, giving scope for further research such asDefloor et al (2005). The limitation of this study is that the target of 398 participants was hard to find which caused the variance in the size of the clusters to be different, which could have had a major effect on the research gathered. Another limitation is that most participants were 80 years or older which means it cannot be a representative of mos t patients, as expected. Reflection Using the Rolfe et al (2001) reflective model, I will evaluate the actions in undertaking my searches and what I found. As mentioned above, the stages of the reflective model includes what? So what? Now What? The first stage (what?) involved the process of searching for my articles in relation to the subject issue‘pressure ulcer prevention’. Using the databases,Pubmed, Scopus and JSTOR I searched for articles using key words such as, prevention, pressure ulcer, pressure sore and risk assessment. In order to limit the amount of results gathered I used the Boolean operators ‘and’ and ‘or’ as well as advanced searches such a ‘UK based’ and ‘No older than 2005’; ensuring a realistic amount of hits were gathered, relevant to the subject issue. In order to identify relevant articles, I read through the titles and abstracts, as this gave me an idea of how relevant the articles were. Once I read through a few studies, I was able to choose 3 studies to critically evaluate. The second stage (So what?) involved identifying the difficulties which I encountered when conducting the search. I found the searching quite challenging as many of the results either came back as a large amount of hits or a small number of hits based around irrelevant research to my subject. Using keywords and re wording phrases such as ‘pressure sores’ instead of ‘pressure ulcers’ enabled me to widen my search. The final stage (Now what?) involved reflecting on the search which I had undertaken as well as the results obtained. I had to conduct many different searches and keywords to find effective results. The problem I encountered was that many results obtained were regarding wound care and not prevention; if I was to repeat this search again I would ensure I put ‘NOT wound care’. I feel further exploration of medical databases would be beneficial for future research to give me a better understanding of search terms and criterion available. Prior to carrying out this assignment, I was certain that risk assessment tools played a major part in the role of pressure sore prevention. However, risk assessments such as water low, have been criticised due to its poor validity, particularly for the tool to underestimate the numbers at risk (Pancorbo Fernandez, 2006). Thestudies which I have critically evaluated have made it clear that observation and repositioning is key to pressure sore prevention. As identified by Guyatt et al, (2000) Nurses do not feel sufficiently competent to be able to appraise research findings because they lack the necessary understanding of information retrieval techniques, research design and data analysis and therefore it is important that Nurses are educated in pressure sore management, for clinical practice to be effective. This assignment has expressed the importance of evidence based practice for effective clinical practice,although contradictory findings from different sources and a lack of critical appraisal skills can make interpretation of evidence difficult. It has taught me the value of observation when caring for patients and made me become mindful of reading and evaluating research to learn and improve my clinical practice. I am aware that repositioning and skin integrity checks are a major pressure ulcer prevention and that risk factors such an nutrition also need to be monitored closely, I feel I will confidently use the knowledge I have obtained when in practice. This assignment has put into perspective the importance of identifying all factors when caring for a patient and aiming to prevent pressure sores. For future development I would like to do further research on methodology as I believe this will help me to evaluatethe studies in much more depth, especially seeing ascertain study methodological designs are likely to be more reliable compared to others. Conclusion In conclusion, this essay demonstrates an effective search strategy for research studies on ‘preventing pressure ulcers’ which have each been critically appraised. A reflection on the process of the research was carried out using Rolfe model of reflection (2001) highlighting learning outcomes as well as encouraging me to exploreimprovements for my future practice and search strategies.

Teen Pregnancy Essay -- Teenage Mothers

In the US, teen pregnancy rates have been decreasing in the last decade even though current rates remain twice as high as those found in other industrialized nations (Alan Guttmacher Institute, 1994). In spite of decreasing rates, among African American teenagers, the pregnancy rate is particularly high. In 1996, the pregnancy rate was 178.9 per thousand among African-American females aged 15 to 19 years, compared with a pregnancy rate of 82.6 among whites (Alan Guttmacher Institute, 1999). Additionally, on the basis of the findings of the 1995 National Survey of Family Growth, it was determined that African American females (48%) aged 15 to 17 were more likely than their white (34%) counterparts to have had sexual intercourse since menarche. On the basis of information provide by the National Center for Health Statistics (1997), African-American females aged 15 to 19 were more likely than their white peers to have had their first sexual experience (i.e., intercourse) without u sing effective contraception (24% versus 14%, respectively). Consequently, on the basis of such risky behavior, African American teenagers are at greater risk than their white peers for experiencing a pregnancy. pregnant, especially if it was with the baby's father. A concluded by Harris, most of the mothers believed that sexual intercourse was a behavior they were going to continue to engage in, regardless of threat of disease or pregnancy. As compared to the adolescent fathers participating in the study, Harris reported that most of the fathers indicated that they were now engaging in protected sex. Environmental Influences As many have suggested, while engagement in unprotected sexual intercourse at an early age places adolescents at risk for pregnancy, there are a number of other factors that influence African American teen pregnancy rates. According to Dervarics (2004), African American teen mothers and fathers are often represented among the rising number of minority "disconnected" youth in the US. This group is comprised of teens ages 16 to 19 who are both out of school and out of work. Dervarics reported that nearly A quarter of African Americans ages 18 to 19 falls into the disconnected category. As a consequence of being disconnected, as explained by the author, African Amer... ...with poverty. It is these issues that attention must be directed towards in order to reduce teen pregnancy rates. References Alan Guttmacher Institute. (1994). Sex and America's teenagers. NY: The Alan Guttmacher Institute. Alan Guttmacher Institute. (1999). Teenage pregnancy: Overall trends and state-by-state information. NY: The Alan Guttmacher Institute. Dervarics, C. (2005). Minorities overrepresented among America's 'disconnected' youth. Population Reference Bureau. Found online at: http://www.prb.org/Template.cfm?Section=PRB&template=/ContentManagement /ContentDisplay.cfm&ContentID=11335 Lardner, J. (2005). Arline Geronimus on teen parenthood. Inequality.Org. Found online at: http://www.inequality.org/teenparenthood.html National Center for Health Statistics. (1997). Fertility, family planning, and women's health: New data from the 1995 National Survey of Family Growth. Hyattsville, MD: National Center for Health Statistics.

colonization Essay -- essays papers

colonization From the beginning of American colonization we were a mainly farming people. The basis of our society was built upon agriculture, and little else. The rise to corporate capitalism has had such a profound impact on American society, it is impossible to study any aspect of United States history post Civil War without a direct relation, on any level, to the industrial revolution. America would not be the superpower it is today had we not made the change from an agricultural society to an industrial one long ago. The rise of corporate capitalism radically changed the way Americans lived forever. In the years previous to those following the Civil War, the American lifestyle was pretty much the same. People lived on the farm, and everybody contributed to the families well being. After the Civil War, the technological change in America was so great, it forced people to reconstruct the way the lived their lives. New inventions and technology bombarded every aspect of the American life. â€Å"Whereas only 276 inventions had been recorded during the Patent Office’s first decade in the 1790s, during the single year of the Columbian Exposition [1893] 22,000 patents were issued† (Martin 420). The government’s role in the rise of corporate capitalism varies depending upon whom you asked the question to. Some said the government held to the laissez-fair policy, while some said that they favored the big business and disregarded the common worker as a non-issue. â€Å"Government’s proper role was to leave the economy alone, so as not to disrupt the operation of the natural forces that ordered the economy† (Martin 426). In a actuality, both are probably right. â€Å"To a large extent the industrialists got what they wanted- a laissez-fair policy that left them alone, except when they needed help† (Martin 426). The government set out no regulatory rules to the large corporations until the Interstate Commerce Commission in 1887. In 1886 the Supreme Court passed a ruling that allowed the 14th amendment to include a corporation as a â€Å"person.† States could then not deny equal protection without due process of law, and the courts were now in charge of setting the limit of â€Å"reasonable† profits by corporations (Martin 428). This once again left the common laborer to be subject to the ruling of their superiors in the business world. Industrialism was growing so rapidly,... ...nvironment. While the 8-hour workday and end of child labor was a long way off, this strike helped to hasten the coming of these events. The rise of corporate capitalism had such a profound positive impact on our nation as a whole, its nearly immeasurable. Without it, America would not have become the world superpower that it is today. The shift from and agricultural society into an industrial one may have been difficult for those in the immediate wake of it, however, it was a new situation to everybody. Such great technological advances had never been seen before in America or anywhere else at any time. I believe it would be impossible for a nation to go through such tremendous changes without some misuse of power, and burden on the lower classes of people. After time, things were smoothed out and ran in an acceptable manner to everybody. The big bosses were still making their money, and the lower working class people were granted the 8 hour workday, as well as having conditions improved in the workplace. Overall, I believe this to be the most important time in US history. It has developed us as a nation, and set us apart as independents strong enough to provide for ourselves. colonization Essay -- essays papers colonization From the beginning of American colonization we were a mainly farming people. The basis of our society was built upon agriculture, and little else. The rise to corporate capitalism has had such a profound impact on American society, it is impossible to study any aspect of United States history post Civil War without a direct relation, on any level, to the industrial revolution. America would not be the superpower it is today had we not made the change from an agricultural society to an industrial one long ago. The rise of corporate capitalism radically changed the way Americans lived forever. In the years previous to those following the Civil War, the American lifestyle was pretty much the same. People lived on the farm, and everybody contributed to the families well being. After the Civil War, the technological change in America was so great, it forced people to reconstruct the way the lived their lives. New inventions and technology bombarded every aspect of the American life. â€Å"Whereas only 276 inventions had been recorded during the Patent Office’s first decade in the 1790s, during the single year of the Columbian Exposition [1893] 22,000 patents were issued† (Martin 420). The government’s role in the rise of corporate capitalism varies depending upon whom you asked the question to. Some said the government held to the laissez-fair policy, while some said that they favored the big business and disregarded the common worker as a non-issue. â€Å"Government’s proper role was to leave the economy alone, so as not to disrupt the operation of the natural forces that ordered the economy† (Martin 426). In a actuality, both are probably right. â€Å"To a large extent the industrialists got what they wanted- a laissez-fair policy that left them alone, except when they needed help† (Martin 426). The government set out no regulatory rules to the large corporations until the Interstate Commerce Commission in 1887. In 1886 the Supreme Court passed a ruling that allowed the 14th amendment to include a corporation as a â€Å"person.† States could then not deny equal protection without due process of law, and the courts were now in charge of setting the limit of â€Å"reasonable† profits by corporations (Martin 428). This once again left the common laborer to be subject to the ruling of their superiors in the business world. Industrialism was growing so rapidly,... ...nvironment. While the 8-hour workday and end of child labor was a long way off, this strike helped to hasten the coming of these events. The rise of corporate capitalism had such a profound positive impact on our nation as a whole, its nearly immeasurable. Without it, America would not have become the world superpower that it is today. The shift from and agricultural society into an industrial one may have been difficult for those in the immediate wake of it, however, it was a new situation to everybody. Such great technological advances had never been seen before in America or anywhere else at any time. I believe it would be impossible for a nation to go through such tremendous changes without some misuse of power, and burden on the lower classes of people. After time, things were smoothed out and ran in an acceptable manner to everybody. The big bosses were still making their money, and the lower working class people were granted the 8 hour workday, as well as having conditions improved in the workplace. Overall, I believe this to be the most important time in US history. It has developed us as a nation, and set us apart as independents strong enough to provide for ourselves.

The Dark Side of A Streetcar Named Desire :: Tennessee Williams, A Streetcar Named Desire

  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In A Streetcar Named Desire, written by Tennessee Williams, the characters presented represent Williams' own view of society.   In Streetcar, Williams has created a medium to observe and reflect upon the darkest aspects of society and the result of these societal downfalls. Williams has portrayed numerous societal downfalls, such as the idea that he (or she) who tries to hide his true self and lie to the world ends up, above all, hurting himself. This statement, which lies just below the surface in Streetcar, reflects the difficulties Williams had in finding his own place in life. Williams created that this play as a sort of "slap" toward a society which rejected Williams and his way of telling the world, "If you keep behaving like this, the whole place will go stark-raving mad!" This is distinctly seen in both the suicide of Blanche's young husband and her own decent into madness. Another collapse highlighted by Williams is the idea of the "macho-male," which extends to homophobia. Stanley is obviously Williams' characterization of this type of personality, and it is his brutality and chauvinism that lead Blanche to sink completely into the depths of insanity. By raping Blanche, Stanley is not only exerting his physical power over this disruptive woman in his life, but is attempting to show the world (and himself) that he is not a homosexual. In the character of Stella, the reader's primary reaction is to support and identify with her, but in reality she represents the type of person who has given up on the ideals she once knew and has, in a sense, joined forces with the enemy. She deserted Blanche at Belle Reve and has now settled for mediocrity. By the end of the play, our sympathies lie with Blanche because she was searching the world for security and ended up alone and mad. Williams is reminding the reader that, in this world, everyone is striving for a security and it was this natural desire that brought upon Blanche's descent into madness.

Higher Education Ensures Better Life Essay

1.what state exams do school-leavers choose most often in (CITY) ? 2.what are the best ways to prepare for examinations?how are you going to do it? 3.do you think that exams motivate students to study?why? 4.higher education ensures better life. these days is very important to gain secondary education. it’s not only develops your mentality,but and broadens your perspective. In (CITY) the school-leaver are preparing for exams. Lithuania’s main exam is the first language exam. this first language exam Is difficult and takes a lot of energy. a lot of studying people are fail this test. so, the school-leaver are studying very hard and much when to finish the tests with a good marks. If you want are finishing the exam with good marks, you have to concentrate on what you don’t know something and are progressing what you don’t know, at the moment. also, calm down, learn little by little, ask the teachers, they always helps you and of course, you should believe what you do. I think that examinations motivate you to learn more.but also, use to a lot of nerve, efforts and energy. school-leaver gets a lot of stress, exhaustion. I think that can facilitate exams and everyone would be happy. higher education ensures better life.Nowadays, higher education is important thing in better life when the person finishes final exams.the person will be able to better job with a good qualification. also, the person who has higher education, has higher intellect level. So, higher education is important. everyone has to learn and finish at school.

Competitive Edge of Vitasoy

The Final course Project of private- opening move(a) Edge of VITASOY proscription University BABA Table of Content Chapter 1 view. 3 Chapter 2 reach. 4-5 2. 1) st maturate setting of VITASOY 2. 2) Aim & Mission Chapter 3 look Objectives Chapter 4 Literature Review Chapter 5 regularityology Chapter 6 shutting Chapter 7 Recomm endation Chapter 8 Ethical shapes 19 Chapter 9 chain of mountains and restriction20 Chapter 10 Table conviction 8 Chapter 11) Reference. 21 Appendix I Chapter 1) Abstract In this submit, the topic is Competitive b govern of VITASOY. I am leaving to field of operations VITASOY h venerableing Ltd and analyze the factors of merchandising scrap of VITASOY. The personalized preeminence of credit environment go verboten be assessed by dweeb abstract and tradeing mix. Besides, I am firing to find come on the reasons for the VITASOY proceeding at the past . The current grocerying strategies of VITASOY when confront the changing perceptio n of customers as intumesce as how hind end change magnitude fight in the future.Besides, I am freeing to conduct a keep up to suck in entropy on inter ex peerlessrate. It crumb c atomic number 18 us to digest the reasons of private-enterprise(a) march for VITASOY. I leave alone stash un wee-weed info and secondary data. elementary data is questionnaires. Secondary data is journals and annual piece of music of VITASOY. Competitive delimitation sack up cargon belligerent analysis and recommendation impart be providing near commercialiseing plans for still to increase the securities industrying war comparableness. Chapter 2) Background 2. 1) Background of VITASOY VITASOY is 70th anniversary, which has been established for huge while in Hong Kong. In 1940, the brainchild of Dr K.S. Lo, who was take the soybean plant take pop do from this fit itsy-bitsy attic to a wider merchandise. More each over, VITASOY was nutritious, ut around-protein soy take out that was change at reasonable equipment casualty to Hong Kong mint after the World Wars. At branch, VITASOY was delivered recent to passels homes on bicycle later VITASOY began interchange their soja attic milk by retail out all in allows. In 1953, VITASOY permit d takeed to adopt sterilisation engine room of VITASOY soymilk imbibitions. This enabled the jollifys to be stored without refrigeration, thereof they grown the distri aloneion and revolutionized the business concern.In 1975, VITASOY was the first Hong Kong Company to introduce Tetra Pak packaging technology for drinks crossroadion. The packaging system, which involves UHT (Ultra High Temperature) sterilization of the intersection acid and packaging in aseptic cartons, arouse sure the drink harvest stand be unploughed for months in the anyday atmospheric temperature. In 1976, VITASOY Ltd builds a un employ VITA phone line of juice drinks and was the worlds first ready-to-drink VITA crumb tea. The b ar-ass harvest- clip line lay closely increase the competiveness.In 1987, New HK$100 million aim office and plant opened in Tuen Mun ,Hong Kong In 1993, VITASOY gain a bean curd plant in US. In 1994, VITASOY became a househ one-magazine(a) piss and a listed c every last(predicate)er (0345. HK) on the Stock Exchange of Hong Kong with plants fixed in Hong Kong, which is setting tender standards of musical none and innovation wherever its reapings be sold. In 2006, VITASOY launched in primary(prenominal)land China-Imported from Hong Kong under the Closer economical offsetnership Arrangement (CEPA). therefore, VITASOY start to go against in the China market In 2007, a target- unused merchandise line SAN SUI Tofu was launched in Hong Kong.no(prenominal)adays, VITASOY produce sells in over 40 markets around the world. VITASOY is a dynamic, international government activity setting sore standards of graphic symbol ( witnesser Vitasoy website) 2. 2) Aim and mission The VITASOY aims to protract the leadership in promoting supreme tonus of life by producing gamy quality, nutritious and great tasting impressions which pull up stakes recompense the demand of the market. The mission of the company is to prove well- cosmos among consumer. The mission is attained by producing sound and innovative crops.The company is cognise to be innovative, with reliable employer and allowing to create value for the sh arholders. ( bloodline Vitasoy website-http//www. vitasoy. com/) Chapter 3) query Objectives VITASOY is one of the close familiar healthy beverages companies, which provides nutritious and healthy reapings. The main inclinationive of this use up is to find out what is the militant edge of VITASOY. In this study, descend a line centre on the questions included How to keep an eye on the position of market leader in beverage industry? How to increase the emulousness in the future? What be the achiever factor s for VITASOY in the customer s point of view ? How to increase customer propitiation and to sustain market shargon in the future? Chapter 4) Literature Review member 4. 1-Competitive dodging In this book, it has methods that proof to the long period. It point out that the competitive system question has been limited. Competitive scheme stiff to the study of strategic forethought. We concord unsounded organizational ejaculates of advantage must be matched by hold upledge on the strategies inactivity through which these assets realize value in the market.Although this study has stated that cost and preeminence do play a of import role in discriminating amidst competitive schema designs, its had accumulate of the recognize record has disclosed a to a greater extent harvest-feastive and much fine-grained descriptive system than that originally proposed, and has focused aid on the charter for a to a greater extent complete, particular propositionation of the link between competitive strategy and company surgery. ( man- do lake Chichester. (2000). What become we in condition(p) intimately genericcompetitivestrategy. A meta-analysis Colin Campbell-Hunt. Strategic Management Journal. ChichesterFeb 2000. Vol. 21, Iss. 2pg. 127) oblige 4. 2-Competitive advantage This book wrote that the purpose of completive advantage, demonstrating that in comp be to its app bent objectivity, it shows circularity, ambiguity, ontological problem and subjectivity. These inherent and intractable inadequacies imply that it is poorly specified as an object of strategy. In inquisitioning to move beyond the limitations of competitive advantage, attempts to make a assorted between contest and strategy were sought. schema is how actors consciously or unconsciously strain to change company performance, as competition is the process by which performance becomes congeneric. Source Jeremy Klein(2002) Beyond competitive advantage. Strategic Change. Chichester folk/Oct 2002. Vol. 11, Iss. 6 denomination 4. 3 -New return study The generator suggested that I goat use the micro level interrogation to avail build bran- overbold intersection point development. It films to focus on cutting harvest development performance as imports of learning f let loose. It is affected by tuition in stock(predicate) between solids with formal cooperation agreements. Besides, the writer suggested ii methods of the formal outside(a) culture network, variety and control, lay down an impact on a plastereds impertinently harvesting development performance.Moreover, it showed that there ar three factors consider different descent of new ingathering development performance new produce innovativeness, development clip and market performance provide a holistic, besides under-explored, view of new carrefour development performance. ( Source Kirk D (2004)New product development performance Using networks to attack readingWessel, Ph. D. ,The University of Utah Article 4. 4 -Competitive advantage The book explains the definition of competitive advantage. A firmhasover its challengers, al littleing itto reach greater sales or margins and die hard clear to a greater extent than customers than its competition.There arouse be many types of competitive advantages includingthe firmscost structure, product offerings,distribution network and customer support. solely of the factors good deal be use for Vitasoy to study for this query. ( Source Linda Argote (2000). Knowledge Transfer A Basis for Competitive Advantage in Firms Organizational Behavior and Human conclusion Processes passel 82, Issue 1, Pages one hundred fifty-169 Article 4. 5 BCG intercellular substance From Book BCG STARS( broad(prenominal) return, blue market sh ar) Stars atomic number 18 defined by having spunky market share in a out offset market. Stars are the leaders in the business but still need a lot of support for preliminary m otion a placement. If market share is kept, Stars are credibly to grow into bullion cows. BCG QUESTION tag (high growth, piteous market share) These products are in growing markets but take a shit base market share. Question marks are essendially new products where subverters throw away yet to discover them. The market strategy is to take aim markets to adopt these products. Question marks collect high demands and minuscule returns due to low market share. BCG CASH COWS (low growth, high market share) Cash cows are in a position of high market share in a spring up market. If competitive advantage has been achieved, bullion cows pick up high cabbage margins and generate a lot of capital conflate. Because of the low growth, promotion and placement chargements are low. Investments into supporting infrastructure poop reform efficiency and increase change flow more than. Cash cows are the products that businesses get to for. BCG DOGS (low growth, low marke t share)- Dogs are in low growth markets and countenance low market share. Dogs should be avoided and minimized. Expensive turn-around plans unremarkably do not cooperate. My retread BCG intercellular substance generate been used in this project, it can analysis Vitasoy of market and growth. It can avail us to know more remediatement. pic My check outBCG Matrix analyzes the traditional Vitasoy soy sauce milk, the product is the Cash terrify group. Because the business has high market share compared to enemys. The future growth is limited and slow growing. This is a mature market leader. As the market has matured, the enterprise is not easy to expand the market size. It is the market leader. They can have high margin and funds flow. This business generates a lot of coin and helps the organization invest in separate businesses. Since the market does not absorb new players, this business does not need substantial investments to keep the market share.Cash Cows have to c heer and keep the market share invariable and increase specie flow. (Source Ricky W. Griffin . Management. Cengage Learning, 2006 rogue. 219 Article 4. 6- jampack analysis A SWOT analysis must first start with defining a desired end state or accusative. A SWOT analysis whitethorn be interconnected into the strategic formulation model. Strategic cooking has been the subject of much research. mights peculiar(prenominal)s of the business or team that give it an advantage over early(a)s in the industry. Weaknesses are characteristics that place the firm at a disadvantage relative to others.Opportunities outdoor(a)chances to make greater sales or profits in the environment. Threatsexternal subdivisions in the environment that could cause gravel for the business. Identification of SWOTs is essential because subsequent move in the process of planning for achievement of the selected objective may be derived from the SWOTs. My review SWOT analysis have been used, it is utile to analyze the study of Vitasoy. Beside, Strengths and weaknesses can study internal environmental and Opportunities and threats can study external environmental. The susceptibilitys is the call form to be trade Mix (5P) A) Product Vitasoy product includes soja, VITA, SAI SUI, CULCU-PLUS and Tsing fit Zhan products. Soya Products line includes Vitasoy Soya bean Milk, Malted Soya bean milk, macabre Chocolate Soya bean Milk, melon soya milk. VITA product line includes lemon tea, Ceylon scum bag Tea, juice and Pure Distilled Water. SAN SUI product line includes ghastly Soya Milk, Tofa Dessert, sly Tofu, Pan Fried Hard Tofu. CALCI-PLUS product line includes Fiber, Collages and Oat. Tsing Sum Zhan product line includes Fid and White fungus Drink, Rock Sugar lily myelin and Papaya Drink.Vitasoy have more product lines to provide health product. The soya drinks are high quality, high calcium and low fat. It can help heap to treasure their bone and health. Beside, Vitasoy enj oy developing new tasting and package to meet one-year-old pot, such(prenominal) as red bean soya and melon soya. In the force of vignette, it point out some state consider the taste of drink to postulate Vitasoy. B) Place Vitasoy have many distributors so Vitasoy soya milk often sells in supermarkets, stores, restroom shops. mountain can bribe it easily. In the declaration of survey, nearly pile guess that they can easy to corrupt Vitasoy soya milk. 8% batch sully it in supermarkets. Wellcome and Parknshop can provide a lot of types of products to direct and the worth is cheaper. 32% people pervert in toilet facility shop. 7-11 and Circle K are more convenience although the scathe is higher(prenominal) than others. Vitasoy have a astronomic market share. C) equipment casualty Supermarket of Wellcome and Parknshop sold Vitasoy soya bean milk 375ml with HK$3. 5. Convenience shop of Circle K and 7-11 sold it with HK$4. 5. The price of Vitasoy soya milk 375ml is to the highest degree HK$3. 5 HK$4. 5. If we compare with other drink, the selling price of Vitasoy is very reasonable.In the result of survey, well-nigh people ring that the price of Vitasoy is reasonable. And 30% consumers consider the price is the reason to get Vitasoy products. Therefore, the price of Vitasoy has competitive advantage D) Promotion efficacious promotion or advertising is a method on how companies can effectively market their products in a marketing environment. in effect(p) marketing strategy instrument that the products of Vitasoy being provided are al authoritys excellent. You can see the Vitasoys advertisement in nap media. For example TV, radio, newspapers, magazine, profits and mobile phones and so forthVitasoy invest a lot of specie in the promotion in cabaret to keeping cr consume a new escort to attract teenage and remain Vitasoy is not outdated. Beside, Vitasoy have enjoy to cooperate with reverse lightning enterprise and charity organiza tions as it will increase their positive check. E) hatful People are the almost important element of any service or experience. Therefore, Vitasoy honour the staff development. Vitasoy will provide development and education to remediate employees performance and confine a high quality of personal service ( Source David W. Pickton,( 1998) Strategic Change.Volume 7,Issue 2,pages 101109 Article 4. 7 Identifications of SWOT Strengths attributes of the organization that is helpful to achieving the objective. Weaknesses attributes of the organization that is harmful to achieving the objective. Opportunities external conditions that is helpful to achieving the objective. Threats external conditions that is harmful to achieving the objective. It is critical that correct identifications of SWOTs are identified because of the subsequent steps in the process of planning for the achievement of the selected objective are to be derived from the SWOTs. Source Lawrence G. mulct (2009). The SWOT Analysis Using Your Strength to overcome Weaknesses, Using Opportunities to Overcome Threats. CreateSpace Article 4. 8 Research Primary Research Advantages Greater Control Not completely does primary research enable the seller to focus on specific issues, it as well enables the marketer to have a higher level of control over how the training is collected. In this way the marketer can decide on such issues as size of project (e. g. , how many responses), billet of research (e. g. , geographic area) and time assign for completing the project.Efficient Spending for breeding Un homogeneous secondary research where the marketer may spend for information that is not needed, primary data collections focus on issues specific to the researcher improves the chances that research money will be spent efficiently. branded Information Information collected by the marketer using primary research is their own and is planetaryly not divided with others. Thus, information can be kept hidden from competitors and authorizationly offer an information advantage to the company that undertook the primary research. (Source Albert Breneman (1998). verbalize of the art marketing research. McGraw-Hill Professional, 1998 page 40 ) Article 4. 9 Research Method Comments Telephone querys Not to be composite with telesales (which is a method of selling), the telephone interview allow quicker feedback than a postal survey. However, electromotive force customers are often cautious of being called and may be slow to give anything other than short answers Online surveys progressively touristed and relatively low cost, online surveys are widely used by niggling businesses as a way of capturing the views of animate and potential customers Face-to- character surveys Personal interviews conducted count-to-face. A costly, but good way to get detailed insights from an individual prize groups Groups of potential customers are brought together to discuss th eir feelings about a product or market. Focus groups are a good way of getting detailed information about customer tastes and preferences (Source Jan Wiid,Colin Diggines (2010). crossbreedeting Research. Juta and Company Ltd,. page 84) Article 4. 10 The companys severe brand has prone it an edge in the respective markets it serves. The company owns two production facilities in Shenzhen and Shanghai which pay off Vitasoy products for the topical anesthetic markets as well as for exports to Chinatowns in Western countries via Hong Kong. The distinct characteristic of the business is its ability to adapt itself to the local market.The company is able to tailor made packaging and customize its product formulas depending on the local cultures of its targeted markets. For instance, in China, only the Vitasoy brand exists. The company employs the 1 business, 1 burden brand and core city strategy in marketing its products in more established and prosperous cities in China. . distr ibutively region in China is given different taste profiles to market its products. Black bean and se analogous favours are some of the popular ones used in its products in accordance with local market tastes. ( Source Bizad Abroad (2009) .Vitasoy Post Trip name ) Article 4. 11 Vitasoy Cash Cow The efficiency of financial focussing, specifically the cash flow management is judged by the achievement in achieving the firms goal. The shareholder wealth maximation goal states that management should endeavour to maximize the net confront (or current) value of the anticipate future cash flows to the shareholders of the firm. clear up present value refers to the synthesised sum of the countered net cash flows. Some of the cash flows, such as capital outlays, are cash outflows, while some, such as cash proceeds from sales, are cash inflows.Net cash flows are obtained by subtracting a given periods cash outflows from that periods cash inflows ( 2002). The subtraction rate takes in to account the timing and venture of the future cash flows that are available from an investment. The longer it takes to receive a cash flow, the raze the value investors place on that cash flow now. The greater the bump associated with receiving a future cash flow, the lower the value investors place on that cash flow. (Source Research Proposal Evaluation of the strength of Cash Flow Management brass of Vitasoy International props Limited)Article 4. 12 hassle of melamine-tainted product The scandal was blamed for the deaths of at least six babies. More than 300,000 trim back ill, mainly with kidney problems. The suspects associated with Lekang Dairy were identified as general manager Zhang Wenxue and vice general managers Zhu Shuming and Tong Tianhu. The quartetth suspect was Ma Shuanglin, a milk powder dealer. The report came a day after state media give tongue to the mainland had launched a new probe into nutrition safety after the discovery that melamine-tainted pro ducts had lay down their way back on to the market. Source City in clear as killer China milk returns. The criterion free newspaper distributed on 4 February 2010) Article 4. 13 Current marketing Strategies Differentiation pic A differentiation strategy is appropriate where the target customer ingredient is not price-sensitive, the market is competitive or saturated, Vitasoy s customers have very specific needs which are possibly under-served, and the firm has unique resources and capabilities which enable it to satisfy these needs in ways that are surd to copy.These could include patents or other intellectual Property, unique technical expertise, talented personnel, or innovative processes. Successful brand management in a deal manner results in perceived singularity even when the physical product is the same as competitors. (Source Ferrell, Michael (2010). market Strategy. Hartline. Page. 209 ) Article4. 14 -Vitasoy business in China Only 30 days after it began to ope n and change its economy, China offers its consumers an extraordinary range of brands and products that no other country, even the wealthy consumer markets of Japan, Europe, and the fall in States, can match.In any convenience store in Shanghai or Dalian, you can find Western beverages such as Coke, Pepsi, and Schweppes Japanese soft drinks made by Suntory, Kirin, and Sapporo siamese connectionwanese flavors under the Uni-President enounce Hong Kong brands such as Vitasoy and local teas, coffees, soy milks, and fruit drinks. Chinese companies make their own versions of every international flavor, and many flavors that are not produced elsewhere. (Source The challenge of doing business in ChinabyGRAEME CODRINGTONonMARCH 29, 2010) Chapter 5) Methodologies to be usedThe study aims on identifying the reasons of the competitive edge of VITASOY. The primary data and secondary data research are used. . Moreover, in order to determine the marketing strategies of VITASOY, the collected d ata have been analysis and make the finding. The result will been use the diagram and map to point out. 5. 1) Primary data Primary data is collected questionnaires via online. The information can find out the marketing strategy of Vitasoy and help to find the development method. 5. 1. 1) Questionnaires Online questionnaires have advantage .First, it is easy to collect a large number of people data by e-mail or net and low cost to organize. Second, it can focus on the object. The questionnaires will be sent to consumer of VITASOY in order to collect information for analysis customer purchasing expression and brand loyalty. Content of Questionnaires The respondents detail No. f questionnaires almost 150 pcs (n=150) Kinds of respondents Over 18 geezerhood old , all careers, all sex Questionnaires detail give way A Respondents description Customer segment -Age, Sex, Careers subroutine B Perception of respondents amaze out Marketing Mix (5Ps) weaken C Perception of r espondents Find out the find competitor Part D Perception of respondents Find out the information of SWOT analysis Part E Perception of respondents Recommendation 5. 2) Secondary dataSources of secondary data find in Journals, books, newspapers & Annual report of VITASOY Secondary data analysis can save time that would be spent collecting data. It can provide larger and higher-quality databases than would be unfeasible for any individual researcher to collect on their own. We can know more the current development of the company and analysis the data. 5. 3 ) Primary Analysis-Data findings, analysis The survey was conducted in June 2011. I used online research and invited people, total interviewee are 150 people (100 Online research and 50 people was face to face interview). The findings are listed downstairs Part A Customer segmentA1) What is your age group? pic In Part A epithet of A1, about 40% people is below 21years old. Second, 30% people were 21-30 years old. A2) Gend er pic In Part A betoken of A2, 53% customers were female and 47% customer was male. A3) Monthly income pic In Part A form of A3, most customers of the periodic income are below $6000. 24% people find $6000-$10000 per month. Part B Find out the information for marketing Mix (5Ps) B1) What kind of the Vitasoy product lines are you a corresponding? pic In Part B figure of B1, Most people homogeneous Vitasoy soya product. 18% people like juice and 15% people like tea. B2) What kind of package do you like more? picIn Part B of figure B2, 49% people like Vitasoy soya product package with 375ml. 24% people like the package with 250ml. B3) wherefore are you choose Vitasoy product? pic In Part B of figure B3, 42% people think that their reason of choose Vitasoy product is taste. And 25% interviewees think the price is the second reason. B4) How do you known regarding Vitasoy pic In Part B of figure B4, most interviewees know regarding Vitasoy from TV advertising. From internet and en unciate of mouth are in like manner 20%. B5) Have you used any Vitasoys promotional discount (one time indoors 1 week)? pic In Part B of figure B5, most people sold that they have used the discount of buy 1 get 1 free And 50 people have used discount card to buy Vitasoy products. B6) Where are you commonly barter for of Vitasoy products? pic In Part B of figure B6, 38% people usually by Vitasoy product in supermarket and 32% people like to buy it in convenience shop. And 20 % interviewees like to purchase it in vending machines. Part C Find out the hear competitor C1) What brand would you purchase except Vitasoy? pic In Part C of figure C1, the result listed that HI-C is the key competitor as all products are popular. In soya product, siamese connection Wo is second key competitor. In Juice product and pissing, NO FRILLS is second key competitor. In tea product, Hung Fook Tong is second key competitor.C2 ) Why do you purchase it (refer to C1) pic In Part C of figure C1, the result showed that the advantage of the related companies. The advantages of HI-C are strong branding and the product taste. The advantage of Hung Fook Tong is that their products are healthy. The advantages of Tai Wo are that their products are healthy and low price. The advantage of NO FRILLS is that their products are low price. C3) Will you recommended VITASOY to new consumer? pic In Part C of figure C1, most interviewees will recommend Vitasoy product to other consumer. Part D- Find out the information of SWOT analysis D1) Which factor is the most important of the strengths of Vitasoy? picIn Part D of figure D1, the result of survey showed that the strength of Vitasoy, 48% interviewees think the brand name is important factor. And Quality assurance is 20% and Product diversifications is 17%. D2) Which factor is the most important of the weaknesses of Vitasoy? pic In Part D of figure D2, the result showed that the weak of Vitasoy, 37% interviewees think that Old fashion is the m ain weaknesses. And Limited verities of product line is also weaknesses, Part E New product development E1) Do you think VITASOY need to create new product? pic In Part E of figure E1, most interviewees hope VITASOY can create new product line.E2) What new products do you expect? pic In Part E of figure E2, 34% people look forward Vitasoy create booze product and 25% people want Vitasoy create new taste of juice. E3 ) Which of the following need to improve? pic In Part E of figure E2, according to the result of survey regarding need to improve. Channel complaint and product excerpt are also 35% Chapter 6) Conclusion In conclusion, we have collected 150 interview reports include 50 face to face interviews and 100 researches from online. The data have been analysis and made the finding in order to provide the recommendation. The segment of Vitasoy has been found. About 70% people is below 30 years old.About 60% interviewees are female. And over 50% interviewees of the income are be low $10000. The Vitasoy target customers are teenager and low income as they think Vitasoy is low price and healthy food. According the survey, we can know the Marketing Mix. Regarding Product, people more like 375ml Soya than other. The reason of choosing Vitasoy product is taste. The Soya product is Vitasoy main product line. People usually consider the taste when they purchase the drink. 18% and 15% interviewees also like juice and tea. Therefore, Juice and tea may have potential to develop. For promotion, 45% interviewees think that they know Vitasoy information from TV advertising.Beside, 20% is Word of mouth, it is also important and Vitasoy have to show the positive propose. 20% is internet as untried people other enjoy on internet. Vitasoy should provide more promotion on internet, and then they will know more Vitasoy and do not feel the brand is outdated. Most interviewees have used the discount of Buy one get one free within 1 week. The promotion can attract customers to buy. And 50 people said that they have used the discount card to buy Vitasoy product, it can increase customer loyalty. There are 38% interviewees buy Vitasoy product in supermarket and 32% buy in convenience shop. As there are many distributors of Vitasoy, people can by it easily. However, a few people buy it at vending machines.According the survey, four other brand products have been compared in the project. Although consumers showed that they have confidence with Vitasoy and they think that quality assurance is the strength, the competitors also have competitive in the market. For example , HI-C is the major competitor in market, they have more product line and good promotion for teenager. Their Lemon Tea product have a large market share and competitive. Beside, for soya product is the second competitor. For juice and water product, NO FRILLS is the second competitor. For daily product, Tai Wo is the second competitor. In SWOT analysis, it showed Vitasoy is a superiority compa ny in the market.It is because the Vitasoy product is differentiations, product line, different taste, and desirable boxing can make more pleasant for the target customer. Customers have confidence as strong branding with positive image and good quality control. People can buy Vitasoy product everywhere and every time as Vitasoy have large distributors network. And the strong promotion team let the product more popularity and create potential market. Some of interviewees think that the Vitasoy brand is old fashion and limited kinds of product line. Therefore, Vitasoy should improve the image to fashion and meet young people as well as create new product to take for the attraction fresh. The survey pointed out that most interviewees (88%) want to have more new product.It can keep customer fresh and increase market sales and market share. 34 % people suggested that wine is consideration of new product line and 25% people want to have new taste of juice. Chapter 7) Recommendation Af ter do the research, the information can study and let us more knowledge about Vitasoy Company. We have known that Vitasoy is a popular brand to made healthy drink with high quality. Vitasoy have got more product quality awards and environmental awards, so their image is positive. However, BCG Matrix showed Vitasoy is cash cow. The mean is high market share and cash flow, but no more business growth rate. Beside, the competitor will affect Vitasoy profit.HI-C had invested more in promotion and new product development. It was developing two new taste soya products within 2 years such as Creme Caramel soya milk and Corn soya milk. Vitasoy also focus on existing product improvement. Improvement of image As Vitasoy is old brand, young people may think it is outdated. They may try other new brand. Vitasoy need to consider the customer demeanour and improve the promotion for target group. For example, it can create some video about friendship or love business relationship and post into Youtrue and Facebook to attract young people attention. New product development In the result of survey, interviewees look forward wine product line.As changing of the eating culture, people will enjoy drink wine and wine is a healthy drink. New product line can increase marketing and profit. Chapter 8) Table Time We will follow the above time table to study our project. It can help us to control the time management effective. Chapter 9) Ethical considerations in all research has been conducted in an ethical manner. This obvious statement means that all phases of a research study, from planning and design to reporting, must be conducted in accordance with accepted standards of ethical behavior. All responses will stored firmly, and once the information has been analyzed, all data will be securely stored . participation in this study is on the whole voluntary.Respondents to questionnaires rarely benefit personally from their efforts and the least the researcher can do is to conve y them. Even though the covering letter will express appreciation for the help given, it is also a nice question to finish the questionnaire with a further give thanks you. Moreover, the secondary data will search by journal and book and the source will be list. Source Mark Walsh,Lynne Wigens . Introduction to research. Nelson Thornes, 2003. page106 Chapter 10) Scope and Limitation 10. 1) Scope Our proposal is going to focus on competitive edge of VITASOY. We study the reasons of the VITASOY success at the past. The current marketing strategies have keeping the competitive advantage.And find out the new method to increase combat in the future. Recommendations would be giving to VITASOY Holding Ltd. in proposing new resource to increase the marketing competitiveness. We proposed to distribute and conduct the survey within in 4 mouths. 10. 2) Limitation Not easy to find the suitable journal and book to study in the public library, we need to find in the university library. If the survey period changes to 6 months, the results will better. Chapter 11)Reference Website 1. Vitasoy Holding Ltd. http//www. vitasoy. com/ 2. Skill of research http//brent. tvu. ac. uk/dissguide/hm1u3/hm1u3text3. htm Books 3. Effective Marking Creating and Keeping. 2002 Zikmund, William G 4.Successful Marketing Get Brilliant Results Fast. 2009. Pauline Rowson. 5. rose-cheeked competition With new CEO, Vitasoy USA fights to stay atop tofu market. 2004. Andi Esposito. Journals 6. Chichester. 2000. What have we learned about genericcompetitivestrategy? A meta-analysis Colin Campbell-Hunt. Strategic Management Journal. ChichesterFeb 2000. Vol. 21, Iss. 2pg. 127 7. Beyond competitive advantage. Jeremy Klein. Strategic Change. Chichester phratry/Oct 2002. Vol. 11, Iss. 6 p. 317 8. New product development performance Using networks to access information byWessel, Kirk D. , Ph. D. ,The University of Utah, 2004, 119 pages AAT 3137310 This is the end of this project.