Therapeutic Hypothermia for Cardiac Arrest Patients

Therapeutic Hypothermia for Cardiac Arrest Jaime Bromley Jefferson College of Health Sciences Hypothermia is a decrease in the core temperature below 35 degrees Celsius or 95 degrees Fahrenheit. There are various medical uses for hypothermia. Therapeutic hypothermia is the only proven effective treatment for post cardiac arrest patients. Hypothermia decreases the amount of cerebral oxygen needed and also lessens the inflammatory response post cardiac arrest. This prevents brain damage and death in patients.There were two major studies done on this topic. One in Europe and one in Australia; they showed very positive outcomes for the patients who were treated with therapeutic hypothermia. More of the patients who received the hypothermic treatment survived compared to those who did not; also patients treated with hypothermia had less brain damage upon hospital discharge. Sudden cardiac arrest is a major health concern in the United States; there are more than 400,000 incidents annually (AHA, 2011).Only five to thirty percent of patients survive hospitalization and make it to hospital discharge (AHA, 2011). Doctors are now discovering the highly effective treatment of doctor induced hypothermia for cardiac arrest patients. Hypothermia is defined as a decrease in the core body temperature below 35 degrees Celsius or 95 degrees Fahrenheit (Ward, 2011). It is then characterized by whether it occurred accidentally or if it was induced purposefully. There are multiple uses for medically induced hypothermia.Doctor induced hypothermia is the most effective therapeutic treatment for out-of-hospital sudden cardiac arrest. Cardiac arrest patients suffer from ischemic brain injury leading to poor neurologic outcomes and death. Doctors will begin to cool patients as soon as recirculation begins. Therapeutic hypothermia works by decreasing the cerebral oxygen consumption. During cardiac arrest circulation does not occur, therefor the vital organs are not adequately perfused. W hen resuscitation happens circulation resumes and reperfusion occurs.Reperfusion is associates with free radical formation (AHA, 2011). Mild hypothermia blocks intracellular effects from high calcium concentrations and lessens the inflammatory response after cardiac arrest (Ward, 2011). In 2002 the results of two randomized trials were published that compared mild hypothermia with normothermia in comatose survivors of out-of-hospital cardiac arrest. One study was done in five European countries; the other was conducted in four hospitals in Australia (University of Chicago, 2008).In the European study the patients were cooled to the target range of 32 to 34 degrees Celsius (University of Chicago, 2008). They were kept at that temperature for 24 hours, and then passive warming would begin (University of Chicago, 2008). Six months after cardiac arrest 75 of the 137 hypothermic patients had positive results; and were able to live independently and able to work (University of Chicago, 20 08). Whereas with the normothermia patients only 54 of the 137 patients survived six months after their cardiac arrest (University of Chicago, 2008).With the Australian study the patients were cooled to 33 degrees Celsius, kept at that temperature for 18 then active rewarming would begin (University of Chicago, 2008). The results of the Australian study, 21 of the 43 patients treated with hypothermia had good neurological function at discharge compared to nine of 34 patients who were normothermic post cardiac arrest (University of Chicago, 2008). There are various techniques used to cool patients; currently there is not one technique that stands out over the rest in ease of use and high efficiency.Before the cooling procedure can begin the patient is given a sedative and a neuromuscular blocker to prevent shivering. There are multiple external techniques such as cooling blankets, ice packs, wet towels, and a cooling helmet; however all of these are slow to cool core temperature (Uni versity of Chicago, 2008). An intravascular heat exchange device has recently become available; this machine enables rapid cooling and precise temperature control (University of Chicago, 2008).During the whole cooling and rewarming process the patient is closely monitored and their temperature is taken regularly. Not every person who has sudden cardiac arrest is able to receive hypothermic therapy. There are multiple restrictions, and each hospital has its own protocol to follow. Some of the common exclusions are pregnancy, core temperature of less than 30 degrees Celsius post arrest, and known clotting disorders (AHA, 2011).In order to receive hypothermic treatment the patient must be at least 18 years of age, female patients must have a documented negative pregnancy test, cardiac arrest with return of spontaneous circulation, and the blood pressure can be maintained at 90mmHg (AHA, 2011). With the use of therapeutic hypothermia treatment many people have been given a second chance at life. Doctors and scientists are making great strides in refining the technique needed to successfully treat patients with hypothermic therapy. Ward, J. 2011). Therapeutic hypothermia for victims of cardiopulmonary arrest. AARC Times. 35 (10), 36-46. American Heart Association. (2011). Therapeutic hypothermia after cardiac arrest. Retrieved April 15, 2011 from http://circ. ahajournals. org/content/108/1/118. full#sec-9 University of Chicago CPR committee. (2008). Therapeutic hypothermia after cardiac arrest. Retrieved April 14, 2011 from http://www. med. upenn. edu/resuscitation/hypothermia/documents/Hypothermia%20Protocol%20Univ%20of%20Chicago%202008. pdf

Mental Retardation and Child Abuse

Sling Blade is a film about a mentally retarded individual by the name of Karl, who murders his mother and her lover – Karl’s classmate – at the age of twelve.   Subsequently, Karl is institutionalized.   Upon release, Karl returns to his hometown where he befriends a young boy, Frank.   The boy’s father had committed suicide, and his mother is dating Doyle, who abuses both Frank and his mother.   Eventually, Karl is responsible for the murder of Doyle as well, as he must put an end to the abuse that he is witnessing in the lives of Frank and his mother. The story of the film is atypical seeing that Karl is a mentally retarded individual who takes action against child abuse.   Scientific research, on the other hand, has revealed that it is usually the mentally retarded individual who must suffer abuse simply because he cannot take care of himself. As an example, Morse, Sahler, and Friedman studied twenty five children who had been abused, out of which forty two percent were mentally retarded.   All except one of the mentally retarded children in the study had already been diagnosed as mentally retarded before they were abused.   Hence, it is obvious that the abusers knew that the mentally retarded children are vulnerable to abuse. According to Morse, Sahler, and Friedman, people who spend time with mentally retarded children are usually aware that these children are not always able to physically or verbally defend themselves.   Moreover, these children are not always able to describe their abuse to others.   Typically, they are also unable to differentiate between proper and improper verbal communication and/or physical contact, regardless of whether the physical contact is sexual or violent in nature. Lastly, mentally retarded children are truly dependent on other people for all manners of assistance.   This makes them more trusting toward their caretakers as well as others.   Also according to the authors, passivity as well as compliance stem from the trust and dependency of the mentally retarded child.   Those who abuse mentally retarded children are, therefore, taking undue advantage of the trust shown by these children. Sandgrund, Gaines, and Green have also conducted a study on children.   Out of one hundred and twenty children studied by the authors, sixty had been abused, thirty had been neglected, and another thirty had not been abused at all.   The authors reported that twenty five percent of the abused children in their study had been diagnosed as mentally retarded. Twenty percent of the neglected children had similarly been recognized as mentally retarded, while only three percent of the children who had never been abused were mentally retarded.   The findings of this study reveal that mentally retarded children are quite likely to be abused.   The fact that Karl of Sling Blade was never abused – rather, he had the intelligence to differentiate between proper and improper verbal communication and/or physical contact – shows that the film is about an unusual mentally retarded individual.   Sandgrund, Gaines, and Green write that mentally retarded children are normally hesitant to report instances of abuse because they fear losing the essential relationships with their caretakers. Furthermore, these children are not always believed if they manage to report abuse.   Seeing that Karl was not afraid to lose his caretaker at the time he killed his mother reveals that this mentally retarded child was definitely not a typical one. McFadden has also written about the abuse of mentally ill children, including those who are mentally retarded.   Reporting a study conducted by the New York State Commission on Quality of Care for the Mentally Disabled, McFadden writes that abuse in institutions for mentally retarded children is higher than abuse in institutions for children who are mentally fit.   Also according to the author: In analyzing those cases, the commission found that abuse most often occurred in leisure-  time areas, such as recreation rooms and sleeping quarters, where children congregate without  structured activities.   It also found that boys over 12 years of age and children who exhibited  disturbing conduct were at the highest risk of abuse. In 16 percent of the cases, the study said, a finding of abuse or neglect was made by the  reporting facility.   In another 18 percent, the facility found misconduct by an employee but no  evidence of abuse.   In 66 percent, some corrective action was taken and in nearly 20 percent  disciplinary action was taken against at least one employee. Most of those responsible for the abuse or neglect were not new employees.   The study said  80 percent of them had worked at the facility at least one year and 50 percent had been  employed more than three years (McFadden). Karl was fortunate because his mother did not abuse him.   He was not abused in an institution either.   All the same, research evidence suggests that mentally retarded children are highly vulnerable to abuse.   In unusual cases, perhaps mentally retarded individuals like Karl may be able to struggle against child abuse.   Then again, they might have to take drastic actions such as those of Karl in order to end child abuse.   After all, mentally retarded individuals are not considered credible if they simply manage to report abuse. Works Cited McFadden, Robert D. â€Å"Child Abuse High in New York Mental Centers.† New York Times. 1 Dec 1987. 17 Nov 2007. . Morse, C.W., O.Z. Sahler, and S.B. Friedman. â€Å"A Three-Year Follow-Up Study of Abused and Neglected Children.† American Journal of Diseases of Children. Vol. 120 (1970): pp. 439-446. Sandgrund, H., R. Gaines, and A. Green. â€Å"Child Abuse and Mental Retardation: A Problem of Cause and Effect.† American Journal of Mental Deficiency. Vol. 79 (1974): pp. 327-330. Sling Blade. Dir. Billy Bob Thorton. 1996.            

Grandparents Raising Grandchildren Essay Example | Topics and Well Written Essays - 3500 words

Grandparents Raising Grandchildren - Essay Example In the present family system, where separation between the partners is becoming very prevalent, grandparents take the charge to rear their grandchildren. Moreover, due to work schedule or career of the parents or due to single parenting, grandparents come forward to support their grandchildren. The present article discusses in detail about the grandparents raising grandchildren, the problems both face, their struggle over various issues and achievements of the child. "Grandparents raising their grandchildren", "grandparent caregivers", "grandparents-as-parents" and "grandparent-headed families" are interchangeable terminologies which refer to the families where grandparents provide full time parental care to their grandchildren in the absence of the children's biological parents. In this era of recession where the people are losing their jobs at a much faster rate, parenting is becoming a big worry and therefore parents are becoming more inclined and turning to their own parents to rear their children because of several reasons including the financial insecurity and also because they are seeking jobs elsewhere and therefore grandparents raise their grandchildren due to the inability of the children's parents to effectively meet their parenting responsibilities. There are other conditions when grandparents become the full-time parent, may be either because of the death of the parent or a parent is away in the military, or because of the career of the parent(s) demand support to rear their kids, and rarely because of the grandparents living along with their children as a single joint family or under the rarest circumstances when the parent/s may be mentally ill, incarcerated, or merely and regrettably incapable of caring for their children (Proud Grandparents). In many Western societies grandparents have play a dual role- as care providers of their grandchildren and also as grandchild's parents. And therefore provide full-time parenting role for their grandchildren. This includes a number of changes in family structure and social conditions (Kornhaber, 1996). Grandparents raising grandchildren is not a new phenomenon. Historically, they have always stood to take over the care of their grandchildren in times of family crisis and have played major roles in raising their grandchildren (Kornhaber, 1996). The growing social phenomenon in USA showed 44% increase over the preceding decade in the number of children living with their grandparents or other relatives. According to the Census 2000 Supplementary survey between 2.3 and 2.4 million grandparents have primary responsibility for the care and upbringing of 4.5 million children (Hayslip & Patrick, 2003a). This phenomenon has captured the attention of researchers, service providers and policy makers in the USA, resulting in a number of interventions to assist grandparents raising grandchildren (Hayslip & Kaminski, 2005). The U.S. 2000 Census displays that around 2.5 million families with grandparents raising their grandchildren (Kornhaber, 1996). The number is on rise as many families do support other relatives, who act as parents, for e.g. raising their brother or sister's children or, even yet, raising their niece or nephew's children. It is an observation that at times grandparents are at work also and still raising their grandchildren. There is a kind of mental, emotional, or financial boding between grandparents and their grandchildr

What Does It Mean To Be a Democrat an a Republican in 2012 Research Paper

What Does It Mean To Be a Democrat an a Republican in 2012 - Research Paper Example The United States first began to experience what could be termed political parties nearly as soon as our government was established. At this time we had many political debates between what were deemed federalists and anti-federalists. Ironically, this would serve as a harbinger of the two party system that invariably developed within the United States. Although third parties existed and successfully sought office as last as the 1830s, their lifespan was short-lived by the emergence of two leviathans of political power that have successfully dominated the political environment in the United States for the better part of the past two hundred years. For the casual observer, party affiliation has a strong connotation with regards to what belief systems the voter identifies himself/herself with. However, party affiliation is a figment of a given election cycle. This is mainly due to the fact that there are no discernible party values or issues which can be definitively traced throughout h istory and once analyzed – deemed as either firmly Republican or firmly Democratic issues/values. This intrinsic lack of definable/discernible values has disheartened many voters and forced them to become apolitical and/or apathetic. The Republican Party (Grand Ole Party) as we know it today hardly resembles the party that was born in 1854 out of an opposition to slavery. Elements of the nation’s political forces, fed up with the â€Å"sin of slavery† and determined to forge a path ahead for the United States that was free from this vice, opted to create their own political entity. This Republican Party elected its first President in Abraham Lincoln. What is interesting to note, as far as an irony is concerned, is that the Republican Party’s slogan in 1854 read, â€Å"Free Labor, Free Land, Free Men†. This slogan had strong connection with the time due to the ongoing battle over slavery; however, there appeared within it a uniquely socialist concep t that most individuals have not considered. The statement â€Å"free land† referred to the fact that rich plantation owners were buying up all of the good farm land and leaving the poorer farmers left with the unwanted scraps and rejects/unviable land. The fact that the original Republican Party was entirely against the ability of a few wealthy individuals to lord over and control the fate of the poor was, at that time, an issue worthy of polarization between the Democratic and Republican Party; interestingly, this is no longer the case as it appears as if both parties only perennially work towards the benefits of those entities and corporations/individuals that bankroll their electoral campaigns. The Democratic Party on the other hand was born out of the Anti-Federalist movement of the 1790s. The Democratic Party of that time was of course defined by its rabid disagreement with Hamiltonian economics. Similarly, the party was promoted originally as what would become known as the â€Å"Democratic-Republican Party† and had a decidedly constitutionalist approach as well as one that advocated the supreme authority of state’s rights as a doctrine of further self-determination among the young republic. This traditional understanding of the Democratic party survived more or less in tact up until the Civil War. At this time, the Democratic Party, under the leadership of key firebrands in the South, pushed for the continuation of slavery as well as

What Part Does Cultural Compatibility Play in Determining The Success Essay

What Part Does Cultural Compatibility Play in Determining The Success of Cross-Border Mergers & Acquisitions - Essay Example Most often, considerations in relation to financing and strategies have become the main concern in obtaining the acquisition targets or merger partners that are most suitable for a company’s purpose. Usually, decisions are made depending on certain issues such as availability, price and probable earnings. When their activity fails, the analysis of merger failure or weak performance is often focused on the re-examination of certain factors that initiated the decision for selection (Schweiger & Goulet 2005). Often, poor selection decisions for mergers and acquisitions are associated with an overly high purchase price, incompetence of managers in achieving goals, or that the companies simply do not match each other. These factors have been continuously examined yet M & A activity has not obtained the necessary improvements (Teerikangas 2007; Seo & Hill 2005). Because of this, international acquisitions make up inconsistencies: despite the fact that business practice and academic research have reported that many of these activities fail to achieve their objectives, cross-cultural acquisitions still remain to be a popular strategy for multinational companies. Therefore, it is necessary that the causes of international merger and acquisition failure are examined as well as the strategies for addressing such problems. As reported by Galpin & Herndon (2007), in a study of 190 top executives who were involved in the global acquisition, it was believed that cultural incompatibility was viewed as the greatest barrier to the success of their M & A activities. Furthermore, the 1996 British Institute of Management survey reported that when merging two cultures is underestimated, it becomes a significant factor for failure (Carleton and Lineberry 2004).

Hamas - Terrorist Organization, Popular Amongst Its Populace Case Study

Hamas - Terrorist Organization, Popular Amongst Its Populace - Case Study Example This case study will make an attempt to delineate the fundamental nature, reality, existence and objectives of an approach, popularly termed as â€Å"terrorism†, that is radically opposite to the Gandhian philosophy. In order to achieve the goal of this study, a terrorist group called â€Å"HAMAS† has been selected to be studied as the case. At the outset, it may be pertinent to understand the term â€Å"terrorism†. As per Federal Bureau of Investigation, Terrorism has been defined as the unlawful use of force and violence against persons or property to intimidate or coerce a government, the civilian population, or any segment thereof, in furtherance of political or social objectives. Usually, terrorists - the proponents and practitioners of terrorism, aim unlawful use of force to terrorise the group that, in normal conditions, does not endorse their ideologies. In recent times, organizational terrorism, one of the variants of terrorism has arisen in almost all parts of the globe and have remained in the spotlight from quite sometime. Majorly, terrorism is centred around the effort to draw the attention of the governments to the cause of these organizations. Universally it is believed that such terrorist groups or organizations lack political support or social backing. As per one of the Hadiths (utterances and practices/decisions of Prophet Mohammed, Hadiths were collected after his death and they help with respect to the interpretation and understanding of the Quran – the Holy Book): â€Å"The Day of Judgment will not come about until Moslems fight Jews, when Jew will hide behind stones and trees. The stones and trees will say, O Moslems, O Abdullah there is a Jew behind me, come and kill him. Only Gharkad tree, would not do that because it is one of the trees of the Jews† (Hamas Covenant 1988). Article Seven of 1988 covenant as per which the radical Islam group called Islamic Resistance Movement or Harakat al-Muqawama al-Islamiyya – Hamas in abbreviated form, was formed.  

How to feel Happiness Essay Example | Topics and Well Written Essays - 1000 words - 1

How to feel Happiness - Essay Example Some say that they believe they could be happy if only they had more money, some say that they would be happier if they found love, still others say they would be happy in a different place or a different time. The end result is that each of these points of view is delaying happiness into the future until such a time as a given goal or milestone is able t be reached. Unfortunately, once this goal is reached, oftentimes the individual has a new goal or milestone – or has even forgotten about the old one- so that they are never able to achieve that happiness which they so desire. In this way, shaping one’s environment in order to create peace and contentment is a powerful way in which happiness can be achieved. Many world religions speak of this. Most notably the Bible counsels, â€Å"I have learned in whatsoever state I am therewith to be content† (The Holy Bible Philippians 4:11). Though many of the world’s major religions teach this, it seems to be a precept that has been lost on humanity. As such, it is perhaps this very reason that has meant that spiritual teachers have for so long attempted to change people’s minds with respect to their surroundings a nd particular situation in life; as compared to the way that people oftentimes see this. Therefore, thinking of happiness as a journey and not a destination is the most powerful tool in changing the environment we find ourselves in. Naturally it is human nature to be dissatisfied, discontent, and generally unhappy with the state of affairs. In truth, this discontent nature is one of the factures that drives us out of our comfort zone and encourages us to make changes in the world. Oftentimes these changes lead to good things; sometimes to bad. Regardless, a healthy dose of contentment in one’s given situation can greatly assist the individual in achieving a

Development of American Society between the early seventeenth century Essay

Development of American Society between the early seventeenth century and the ratification of the American Constitution in 1787 - Essay Example time witnessed an original compact formed by the free and deliberate voices of the individuals disposed to unite in the same social bonds; thus exhibiting a political phenomenon unknown to former ages. James Madison (1789) During this period radical idealists in all spheres of the American society were very much determined to bringing about revolution changes; the cause they stood for infused meaning into their lives as the revolution was inclined on the notion that ‘the people’ governed, that ‘the people’ supplied government with its energy and direction, and that monarchical institutions were to be abolished since they were not owned and accountable to the people at the same time. Robert C. & Reval Siegel (2003) Madison was categorical in making the government work and he dedicated him in actualizing this dream. He instituted winning strategies that were pragmatic and passionately pursued the cause; he formed alliance with Jefferson though he was opposed to Hamilton. He also was the brainchild to the Republican Party, which earned him popularity by clinching the Presidency. All these well-documented stratagems are so difficult to reconcile this fact with the conservative anti-democrat. James Madison (1789) By 1780 through 1790 the historical world experienced a consistent array of constitutional crisis; controversies followed suit in a raw until the republican capsized beyond salvage. Financing the war detrimentally hampered, the fight over negotiating with Spain to open the Mississippi, the failure of the Articles of confederation, Shay’s Rebellion, Ratification, Hamilton’s plan for assumption and financing the debt etc resolves the stalemate election of 1800. Numerous scandals smeared the Republicans image, which led Jefferson to label them as ‘monocrats’. The idea that a citizen became a subject only during elections era was outrageous. Madison, Winthrop and Paine were frontiers of the American dream the American Revolution to eliminate

Gastric Bypass Term Paper Example | Topics and Well Written Essays - 1250 words

Gastric Bypass - Term Paper Example Gastric bypass has also been determined to be more effective than dieting in case of diabetic patients. In addition, other conditions such as sleep apnea, asthma, high blood pressure, gastroesophageal disease and heart disease risk have also found to improve with weight loss. However, the surgery is also associated with many risks. Hence, following a gastric bypass, an individual will be able to feel lighter and more efficient (Bhimji). Gastric bypass surgery is mainly performed to help people reduce weight only in case of obese people who are unable to lose weight through diet and exercise. However, this bypass surgery does not guarantee permanent weight loss as both diet restrictions and exercise should be continued even after surgery. The surgery is mainly recommended for individuals who are mentally strong with an inclination to reduce weight and stay healthy and who do not consume alcohol or other drugs. In addition, their body mass index (BMI) should be more than 40 as these in dividuals tend to have a 100 pound excess weight than others. In cases where the BMI is 35 or more and if the individual suffers from problems such as apnea, diabetes and heart problems surgery is recommended for these individuals (Bhimji). Any type of gastric bypass surgery involves two basic steps: the stomach is first shortened into a shorter upper region, which is referred to as a pouch, and a larger lower section with the help of staples and then a bypass is made between the lower end of the jejunum of the small intestine and a hole created in the pouch. As the jejunum is the region of the small intestine that connects it to the stomach, food entering the small pouch of the stomach will now enter the jejunum bypassing the remaining larger portion of the stomach (Bhimji). There are two major types of gastric bypass surgery, the most commonly performed Roux-en-Y gastric bypass (RGB) and extensive gastric bypass surgery (biliopancreatic diversion). The first type of surgery involv es connecting the pouch region of the stomach with the lower end of the jejunum thus bypassing the duodenum and the initial portion of the jejunum. This procedure is now effectively carried out by laparoscopy, which is a less invasive procedure involving smaller incisions and the recovery time is also rapid (Goldstone). Thinner surgical instruments are passed via a laparoscope to carry out the bypass. Both the hospital stay and the recovery period are quicker along with the advantage of reduced pain and lesser scars from the surgery (Bhimji). The extensive bypass procedure is a more complicated surgery in which the lower portion of the stomach is removed completely and the small pouch region of the stomach is directly connected to the last segment of the small intestine thereby bypassing both the duodenum and the jejunum regions. While this method aids in weight loss more effectively, it is also associated with nutritional deficiencies to the lack of absorption of important nutrient s (Goldstone). Both the above surgeries are carried out under general anesthesia. Following the surgery the size of the stomach will be considerably reduced and satiety levels will be reached with lesser food intake (Bhimji). Despite the various advantages associated with the surgery, it also suffers from several risks encountered either during the surgery or post-surgery. The risk of surgery increases if the individual is unable to walk even for short distances, in case

Problems on the KTM Trains and KRT Buses in Malaysia Essay Example for Free

Problems on the KTM Trains and KRT Buses in Malaysia Essay This is our recommendation report on the problems that frequently face by passengers on the KTM Trains and KRT Buses. Our company is experiencing declining number of passengers for the past six months since February. The unit of tickets sold drops dramatically from month to month since February. Investigations had been conducted and the problems are found out and recommended solution should be carried out to avoid the declining numbers of passengers in the coming days. The problems are identified based on our observations as well as the questionnaire’s results from our loyal customers of both of the transportation vehicles. Procedure In order to investigate the reason of this declining in numbers of users on both transportation, we have created a few questions that may be the reason of declining numbers of user on trains and buses. Next, our group is organized into 2 small group which one group consist of three members to distribute the questionnaires and questionnaires are collect back after the individuals have finished the questionnaires. After the questionnaires are collect back, the result are interpreted and analyzed. Then the findings will be present in term of charts and percentages. Moreover, our group members will also experience the services that provided by both of the transports. First and foremost, one of our group members will pretend as an ordinary passenger in order to observe the behaviors and attitudes of the staffs and workers on duty. We will also check on the punctuality of the transportation by matching the standard time and the actual time of the transports depart and arrive at most of the locations. Findings After all our questionnaires are collect back and we have conduct observation on the behaviors and attitudes of the staffs and workers, we would like to present the reason and factor that causes the decline in term of sales unit of both trains and buses First and foremost, the seats inside of the train are old, dirty and dusty. The seats are badly damaged by the vandalism of irresponsible passengers. Through our observation, we could noticed that some of the seat are drawn by some irresponsible passengers and some of the cushions of the seats have been torn off using sharp equipment. Some of the windows are also full with cracks that probably damage that cause by accident or passengers unmoral action. Secondly, the train-stewards and stewardess did not serve each and every passengers on the train. Only the first and second coaches which is classified as first class coaches of the train’s customers are being served. Although services are provided, we found that the services provided by them are bad. The passengers needs are not fulfilled and most of the first class passengers also claimed that they were ignored most of the time. We also witness that one of the workers is very rude towards an old man and vulgar words are scolded by the workers. Thirdly, most of the passengers at the bus terminal claimed that the buses are not punctual and the buses tends to delay most of the time. We also interview some of the passengers at the bus terminal, they said that the buses delay frequently, and the time period that buses delay are within half an hour to more than one hour. We also interview the worker on duty and found out that some of the reason that cause the buses to delay are technical problem on the buses and traffic jam that happened frequently. Some of the passengers also claimed that although they have sent complain letter to the headquarter of buses terminal, but no improvement or action taken by the upper management. Fourthly, as we also get some information from the regular passengers for the bus, they claimed that bus drivers tends to drive recklessly on the road especially during night time. One of the regular customers added that majority of the drivers’ always exceed the speed limit allowed especially on the hill near Malim Nawar. They increase their speed even though the road is narrow and full of dangerous turn. Besides, some of the driver tends to neglect the safety of the passengers on whether the passenger has safely get off the bus before continue driving the bus. Moreover, there are also some regular passengers of trains claiming that foods are sold only on gold class trains. However, most of the passengers of the gold class trains told us that although foods are sold on the trains, the taste of the food is bad and some of it said that the food is sometime too oily, salty and spicy. They also added that the taste of the food is not only bad, the price of the food are also costly and expensive, they also provide us with some true example, which is a packet of Nasi Lemak usually cost around RM1.50 per packets, however the Nasi Lemak on trains are sold around RM5.00 per packets. There are also some other religions passengers saying that it is inconvenient as the train management restrict that passengers are not allowed to bring any non Halal foods or beverages into the trains as some of them wanted to prepare their own meals in order to enjoyed during the trip. There are also platinum class passenger complaining that it is unfair to platinum cla ss passenger as they pay a high price and extra amount are to be paid if they need food on the trains. Next, there are also trains passengers complaining to us that the prices of the trains are costly and expensive. As it is cost around RM16-RM25 for silver class trains, RM30-RM40 for gold class trains and RM37-RM60 for platinum trains. As the prices of the trains are expensive, most of the citizen of Malaysia claim that they unable to afford to buy the trains ticket. We also aware that there is no extra accommodation are provided for the second class passengers, the accommodation only are provided for first class passenger and platinum class passengers. In addition, there are also some bus passengers complaining that the air-conditioner in the bus are often not working and some of them describe that the buses without a well-function air-conditioner are similar as the passengers are locked in an oven. The passengers said that complained has been made however the bus services still disappoint them all the time. Majority of the bus passengers claimed that they are poor and given no choice to take buses to work and to school. Besides, greater part of the passengers also complaining to us that the coaches provided by the trains are very limited. Most of the passengers need to pack into a coaches although it is full in order not to be late for work or school during the peak hours. Most of the old passengers also complained that the teenagers and adults nowadays do not offer seats to them as they are senior citizen. As part of our interview, most of the female individuals also complained that they are sexually harassed when packing in the trains during peak hours. There are also some of the passengers claiming that the passengers does not give ways to some passengers when they reached their destination and causes them to miss their stations and terminal. This caused them to waste a lot of time and also cause them to waste money to buy another train ticket and at the meantime they also need to pay a total of RM50.00 as it is remedy claim by the train management for some passengers who lost their ticket or did not went down from train when they reached their destination. Recommendations Based on the customers’ questionnaires result as well as the observation from our own staff, we strongly agree that the following steps should be implementing in order to improve the numbers of users on our transportations. We need to: a) Renew the seats of the train and try to motivate customers through posters that it is their responsibility as well to keep the seats’ cushion in good conditions. b) Give a better training to the stewards and stewardess so they have a better performance in servicing the customers on the whole train. c) The company should have more strict regulations on the bus drivers. The drivers who are always late to pick up the customers should be punished by reducing their pay. d) The company should offer talks about the road safety and force all the bus drivers to attend them. It is for the benefits of both passenger and driver himself. Conclusion The survey that had been done by our group as well as observations has proven that the problems stated above reduce the number of passenger to take our transportation. The reason is because of bad customer services and safety not assured.

The Strengths And Weaknesses Of Liberal World Politics Politics Essay

The Strengths And Weaknesses Of Liberal World Politics Politics Essay Liberalism is a principle in Global politics theory that that is based on the hope of diligence, reason and universal ethics and that with the application of this the world will become a more orderly, ethical and cooperative. By achieving this it is hoped that international war can monitored by Non-governmental organisations. Liberalism is a philosophy championed by western nations such as the United Kingdom and the USA and some Non- Governmental organisations such as the United Nations. Liberals advocate the use of military force in order to help people for example Tony Blair invaded Iraq because Saddam Hussein inflicted pain and violence on his population. Infringing peoples rights is typically against Liberal thinking because they believe in the sanctity of human rights and an end to human suffering. Another Liberal philosophy is to export their own domestic policies into the foreign arena, for example in Britain the current government wants to eradicate poverty, it exports this d omestic policy to third world countries to try and eliminate poverty. But as with every international paradigm there are strengths and weaknesses. Collective security is a strength of the liberal perspective on world politics. Collective security replaces the realist idea of self help. For example in 1990 Iraq invaded Kuwait. The international community responded to expel Iraq from Kuwait. The Liberal countries did this to preserve liberty and resolve security in the Middle East. John Baylis and Steve Smith argue that Liberalism is primarily a theory of government, one that seeks to reconcile order (security) and justice (equality) within a particular community. (Baylis and Smith, 2001, pg 163.) Liberals argue the need for collective security as to prevent the world falling into international anarchism and up hold human rights, democracy and a free market where people are free to trade. Liberals believe in international cooperation as a way to great global harmony this can be seen to be coupled with collective security as a way to achieve this. Liberal ideas and trends often over take local ideas which can be viewed as totalitarian, a view taken by Booth and Smith, the assumption that universal norms and values will triumph over those based on particular local contexts is a feature which contemporary liberalism, (Booth and Smith, 1995, pg 92). The harmonising of greater international cooperation can be seen through the creation of the United Nations which tries to peacefully sort out countries disputes; it also tries to promote liberalism. A strong case for Liberalism is that it can be viewed as peaceful due to the history of liberalism, never have two liberal democracies gone to war which shows the level of cooperation between them and that the balance of power within the world has been upset by authoritarian regimes and outdated ideas and polices, the strand in li beral thinking which holds that the natural order has been corrupted by undemocratic state leaders and outdate polices, (Baylis and Smith, 2001, pg 178). Liberal politics has shown to protect the harmony of interests, through commerce and travel. For example the European Union can be seen as the official regulator of interests in Europe because they try to harmonise trade and travel to prevent any disputes. Liberal perspective on world politics is that they believe in minimal state intervention in peoples lifes they believe that this is the fundamental as it does not pose the risk of infringing on people human rights or interfere with the free market. Liberals argue about the preservation of individual liberty such as the freedom of free speech and freedom to trade. These are some fundamental guidelines which Liberal democracies adhere to. F. A. Hayek argues that Liberals try not to repress or discriminate their populace, every individual should be protected against all attempts to enforce them by violence or aimed discrimination. (Hayek, 1975, page 75). The preservation of liberties is seen to liberals as the basis of society and that they want to export it as it is way in which in reducing world anarchism and prevent war. Liberal trade markets are also a way of keeping state intervention to a minimum. This is so to create international harmony and cooperation as countries are allowed to trade with each other. F.A. Hayek takes into account liberalism has to have some sort of minimal state intervention as to ensure there is perfect competition and no barriers to entry within the economy, it also tries to prevent the monopolisation of areas within the economy, economic theory calls perfect competition but that there are no obstacles to entry into each trade and that the market functions adequately in spreading information about opportunities, (Hayek, 1975, page 71). Liberals always argue that for minimal state intervention in peoples lives but increasingly state centralisation is taking root within society as a result of the state trying to eliminate poverty and providing health care for the masses. J. S. Mill argues that the more the state increases its intervention in peoples lives the more they seem to look to the state for direction which eliminates independent thought, if government offices were universally filled by ablest men to whom the rest of the community would look for all things: the multitude of direction and dictation in all they had to do. (Mill, 1989, pg 111) A weakness of Liberalism is that western democracies try exporting it to other countries that are sometimes unwilling to adopt. Liberalism only takes into account western values for example democracy, free speech and equality, amongst others. à ¢Ã¢â€š ¬Ã‚ ¦ universalising mission of liberal values such as democracyà ¢Ã¢â€š ¬Ã‚ ¦ undermine the traditions and practices of non-western cultures, (Baylis and Smith, 2001, pg 179). This shows that Liberal and typically western foreign policy has the ability to alienate other cultures. An example of the west trying to export democratic values in an ever internationally politicised world is on Iraq and Afghanistan, through the military intervention in Iraq 2003 and the attack on the Taliban in Afghanistan in 2001. A critique of the liberal perspective is that it wants to achieve world peace through international cooperation and the upholding of civil liberties, it operates with the goal of achieving world peace through cooperation and respect for human rights, (Larry Wilde, 2009, pg 4). Some countries see this as weakness and are prepared to exploit this to try and achieve concessions through taking advantage of Liberalism for example North Korea trying to get concessions for giving up nuclear weapons. A weakness of the liberal perspective on the world is that of the Liberal institutionalism. This is the liberalisation of world institutions such as the European Union. Many countries see the benefits of joining the European Union such as the freedom to access European trade markets and expand their economies that they are willing to risk and give up national sovereignty to join, The development of the European Union the benefits of membership have proved so great that states have been prepared to pool sovereignty and adjust their legal systems (Larry Wilde, 2009, pg 2). Realists view this much scepticism as they dont see why a country would want give up their own national sovereignty. A liberal perspective on the world has its strengths and weakness. Its strengths out way the weaknesses because Liberalism has influenced countries across the globe to operate free market economies which have adapted to globalisation and are now integrated into the global economy. The freedom of the economy has in some cases led to countries allowing freedom of speech and other basic human rights but it has also helped to alleviate poverty in certain areas of the world. Liberalism has also produced a network of greater collective security that helps protect nation states from attacks by aggressors such as in the 1990s when states stepped in to stop the bloodshed of the Balkan civil war. International cooperation has also helped harmonised trade and security agreements amongst states; an example of this is the development of the European Union in Europe and led to greater bonds and peace between nations. The belief of Liberals to give aid to those in third world countries has greatly helped and improved the lives of so many. Word count- 1389