Domestic Violence: Beyond Patriarchy

Domestic Violence: Beyond Patriarchy In the Beginning The Battered Women's movement of the 1970's enlightened society about a much secreted, and what at the time, was considered a family matter, that of violence against women by their male intimate partners. Many lives have been saved as a direct result of society's public awareness of this much-hidden scourge on our families. Federal and state laws prohibiting Intimate Partner Violence (IPV) have been enacted, and funding has been put in place for battered women's shelter programs. These changes have made a significant difference in the lives of battered women and children over the last few decades. The feminist theoretical perspective of IPVIPV has been depicted throughout our society as well as how victim services, and batterers intervention programs (BIP) are modeled. â€Å"Our culture has historically exhibited certain patriarchal values observable in religion and social custom. Working against the backdrop of this history, feminism quite naturally saw an antidote in ending social oppression of women. Wife assault, kept largely out of the public view and tolerated by prevailing attitudes, was regarded by feminists as an evil symptom of patriarchy. † (Dutton, page 17, 2006) Feminist theory defines IPV as a social problem with a single type of victim i. e. heterosexual women and one root cause, that of male privilege and patriarchy, which supports male domination, power, and control and the oppression of women. The need for services for IPVBIP's for female perpetrators is obscured and trivialized by this â€Å"one size fits all† view. Dutton describes feminist theory on IPV as being a â€Å"‘paradigm:†Ã¢â‚¬Ëœ [A paradigm is] a set of guiding assumptions or worldview, commonly shared within a group and serving to ward off recognition of data that are dissonant with the paradigm's central tenets. This theory views all social relations through the prism of gender relations and holds that men hold power over women in patriarchal societies and that all domestic violence is either male physical abuse to maintain that power or female defensive violence used as a self protection. (p. 2, 2005) developed through the anti-rape and battered women's movements. This perspective has been the guiding light for how the social problem of against men by women and The violence against women by men paradigm is so entrenched that if anyone pursues any other theories or presents any data that is contrary to that perspective it is automatically considered anti-domestic violence movement. (Dutton, p. 44, 2005) Lucal (1995) found that attempts to discuss the idea of battered husbands started an emotionally charged and fiercely contested debate among researchers which has been the classic debate filled with claims and counterclaims. Much of the debate has been centered around whether or not there are very many battered husbands. Most of the debate has been about whether or not battered husbands are a social problem worthy of support. (pp. 95-96) Revealing Statistics Dr. Murray Straus, co-founder and co-director of the University of New Hampshire's Family Violence Research Laboratory, has studied IPV and child abuse for over thirty years. In study after study he has found that both men and women are capable of being victims and committing IPV. For instance: (I? E(Busing data from the National Family Violence Survey of 1975, Straus (l980) found that 11. 6 (2. 6 million nationwide) of husbands reported having been the victim of severe violence by their wives. Severe vio1ence was defined as behaviors, such as kicking, punching, beating, or using a knife or gun, that have a high probability of causing physical injury. (as cited in Hines Malley-Morrison, p. 77, 2001) Presenting data that defies feminist logic has caused Dr. Straus and his colleague's substantial risk. As a result of the depth of the objections to our finding on assaults by wives, some of us became the object of bitter scholarly and person attacks. These attack included obstruction of my public presentations by booing, shouting, and picketing. In elections for office in scientific societies I was labeled as antifeminist despite being a pioneer feminist researcher on wife beating (Straus, 1973, 1996 as cited in Straus, pp. 225-226, 1992). Suzanne K. Steinmetz, a co investigator in the first National Family Violence Survey, was the victim of more severe attacks. There was a letter-writing campaign opposing her promotion. There were phone calls threatening her and her family, and a bomb threat at a conference where she spoke. (pp. 225-226) Studies such as the National Violence Against Women Survey tend to filter out male reports of victimization because of the â€Å"‘set†Ã¢â‚¬Ëœ of the survey (criminal victimization of women) (Dutton, p. 4, in press). However, the National Violence Against Women Survey in 2000(a) reports that more than 834,000 men are raped or physically assaulted by an intimate partner each year in the United States. This translates into about(I? E(B32 assaults per 1,000 men. (Tjaden & Thoennes, p. 11) Since the respondents in this study were told they were being interviewed about â€Å"personal safety† issues it's quite possible that this number is an underestimate as many of the men may not have perceived the violence that their wives or girlfriends were perpetrating against them as a threat to their safety. (Hines & Malley-Morrison, p. 77, 2001) The Establishment of Services for Male Victims Spreading the word as news of the availability of DAHMW's helpline became more known, calls from men and those concerned about a male relative or friend whom they thought were in an abusive situation started coming in from around the country. A website was created with information on male victimization and other resources and tri-fold brochures specifically addressing IPV against men were designed, printed and distributed through mailings and placements on community bulletin boards. Consequently, two years after its inception, DAHMWDAHMWIPV. as highlighted in the National Crime Prevention Council's book, â€Å"50 Strategies to Prevent Violence Domestic Crimes. † (2002) as, â€Å"[one of] 50 promising programs [that offer] new and alternative methods to aid under-served victims of violent domestic crime including teens in dating relationships, elderly victims of late-life abuse, child witnesses to violence, battered immigrants, male victims, and survivors in the gay and lesbia n community. † In 2003 Verizon began to publish the crisis line in a number of their phone books. Incoming calls to helpline have grown exponentially from fourteen a month in 2001, to over three hundred calls a month in 2006. The vast majority of the calls continue to be from or about a male victim (and children) of female Information gathered from male callers to the helpline suggests that some violent women use highly physically disabling tactics on their victims. â€Å"According to qualitative accounts, several physical attacks [are] reported to have occurred to the groin area, as in the following examples: â€Å"‘G reports that his estranged wife frequently targeted his testicles in her attacks, which included head butting and choking. Police were called to his home six times, one call resulted in the wife's arrest. â€Å"‘ â€Å"‘I was writhing, crying in the corner, I couldn't get up for two hours she kicked me in the groin at least 12 times. â€Å"‘ â€Å"‘She held a knife to my balls and threatened to cut them off. â€Å"‘ (Hines etal, p. 66, 2007) The stigma attached to being a man abused by a woman is profound. Many men report that they were taught never to hit a girl, be strong, do not cry and do not tell your personal business to anyone from their parents and caregivers. There is also a cultural belief that men should be able to defend themselves. However, if a man does defend himself against his abusive female partner and the police are called, the man is the one that will be arrested. When Dwayne Bobbit had his penis cut off by his wife in 1993, it was a big joke for late night comedy. Lorena Bobbitt was found not guilty by reason of temporary insanity. The reaction would have been entirely different had the genders been reversed. (Dutton, p. 148, 2006) Law Enforcement and the Court's Response The concerned family members and the victims themselves to the DAHMW helpline have recounted reports of the lack of concern for male victims: Misconceptions and Realities Feminists' theorists assert that women's violence against men is less likely than men's violence against women to result in serious physical or psychological harm. (Dutton & Nichols, p. 697, 2005) They use this claim to dismiss women's violence against men and male victims. Women, in general, may not be as big or strong as men are, however, what women lack in size and strength they make up for with the use of weapons. Research conducted at an emergency clinic study in Ohio (Vasquez & Falcone, 1997, as cited in Dutton & Nichols, 2005 ) revealed that 72). The authors reported that burns obtained in intimate violence were as frequent for male victims as female victims. As this study demonstrates, community samples, unless they require subjects to self-report as crime victims, show a different and more equivalent pattern of violence by gender than that alleged by the(I? E(Bfeminist perspective(I? E(B. Regardless of the variations in the studies, two conclusions seem reasonable: (1) women are injured more than men, and (2) men are injured too, and are not immune to being seriously injured. Simply because the injury rates are lower, men should not be denied protection. (Dutton & Nichols pp. 97-678, 2005) The feminist perspective of IPV being predominantly patriarchal in nature also excludes much of the victims in LGBT community. The LGBT community has had to set up their own domestic violence shelter programs that primarily or exclusively protect, educate and serve LGBT individuals who are victims of IPV. (e. g. see the www. gmdvp. org, w ww. lagaycenter. org/FamilyViolence etc ) According to Helfrich & Simpson (2006) lesbians have a difficult time accessing services through the traditional battered women's shelter programs due to the lack of policies to screen lesbian survivors and identify batterers. Lesbian batterers may use deception to access services through the same agency as the survivor and there are little to no stopgap measures taken to deal with those situations. (p. 344) Beyond Patriarchy, Alternative Theories on IPV Dutton (2006) asserts that the best predictor of intimate partner violence is not gender but personality disorder (p. 153). Since the beginning of the battered women's movement, researchers who have studied maritally violent men have often treated batterers as a homogeneous group. They have measured violent husbands by comparing them to nonviolent ones. However, more recently they have found that violent husbands vary along a number of important dimensions, including severity of violence, anger, depression and alcohol abuse. (Holtzworth-Munroe & Stuart, p. 476, 1994) More recently, researchers have begun to investigate what attachment styles and personality disorders have to do with IPV. The focus for this paper regarding typologies of batterers is on the dysphoric/borderline subtype and so a full description of each subtype of batterer is beyond this review. For more information of the various subtypes please review, Holtzworth-Munroe & Stuart, 1994; Holtzworth-Munroe et al. 1997; Holtzworth-Munroe et al. , 2000; Waltz et al. , 2000; Babcock et al. , 2003; Carney & Buttell, 2004) Researchers have found that batterers are more likely a heterogeneous than a homogeneous group and within that heterogeneous grouping various subtypes of batterers exist. Seminal research done by Holtzworth-Munroe and Stuart (1994) studied violent men and ascertained various typologies of male batterers. Holtzworth-Munroe and Stuart categorized three major subtypes and they labeled them, family only, dysphoric/borderline, and generally violent/antisocial. (Holtworth-Munroe & Stuart, p. 76-482, 1994) Holtzworth-Munroe and Stuart described dysphoric/borderline batterers as those who engage in moderate to severe wife abuse as well as psychological and sexual abuse. Their violence is primarily towards the family; however, they suggested that some extra familial violence and criminal behavior may be evident. Additionally, they found that these men are the most dysphoric, psychologically distressed, and emotionally volatile and that they have evidence of borderline and schizoidal personally characteristics. The may also have problems with alcohol and drug abuse. (ibid. According to Dutton (2006), â€Å"Across several studies, implemented by independent researchers, the prevalence of personality disorder in wife assaulters has been found t o be extremely high. These men are not mere products of male sex role conditioning or â€Å"‘male privilege†Ã¢â‚¬Ëœ [as the feminist theory of IPV suggests]; they possess characteristics that differentiate them from the majority of men who are not repeat abusers. † (p. 185) In addition to research on subtypes of batterers, there is also evidence to suggest that early attachment has bearing on what type of person may have the propensity towards perpetrating IPV. Buttell et al (2005) states that the presence of batterer subtypes is widely accepted in the field and that findings from [their] study seem to suggest that issues of attachment and dependency may be related to the development of an abusive personality for one type of batterer. They state that if true, efforts to improve intervention may need to focus on distinguishing batterer subtypes and developing intervention strategies relevant to the need for each subtype. (p. 216) Attachment styles may be the key to unlock many doors for both female and male perpetrators of IPV. Dutton in his book, The Abusive Personality, reiterates Bowlby's findings on attachment styles: In his landmark series of books entitled Attachment and Loss, Bowlby developed the notion that human attachment was of ultimate importance for human emotional development. In his view, it had sociobiological significance. His views encompassed the possibility of individual differences that came to be called â€Å"‘attachment styles'† referr[ing] to entire constellations of thoughts and feelings about intimacy. Reactions to the satisfaction or dissatisfaction of early attempts at attachment set up life-long attachment styles described as secure, fearful, or dismissing. The dismissing people tend to be wary of and stay out of relationships. The secure ones are comfortable with closeness. The fearful ones are stuck in the middle, exhibiting ambivalence toward intimacy and to those with whom they are emotionally connected. (as cited in Dutton, p. 116, 1998) Dutton (1998) further postulates that this push-pull reaction of the fearful attachment styled person resembles the ebb and flow of what he has coined the â€Å"cyclical personality. Dutton reports that in his notes on phrases used by female victims to describe their male batterers (who were clients of Dutton's) there was a recurring theme. They would express that their partners would act like â€Å"Jekyll and Hyde† and appear to be two different people at times. They also said things like, â€Å"He's like living with an emotional roller-coaster,† and describe their mates as moody, irritable, jealous and changeable. (p. 53) This cycling was first recognized by Lenore Walker in her book, The Battered Women, as the â€Å"‘battering cycle. â€Å"‘ (as cited in Dutton, ibid. As Dutton set out to gain some understanding of a cyclical or phasic personality he came across a book by John G. Gunderdson entitled, Borderline Personality Disorder: Dutton's research regarding attachment, borderline and the batterer's cyclical personality has been focused on male on female IPV, however, in his recent book, Rethinking DV, he discusses female perpetrators: Recent research has begun to explore the role of [fearful attachment, borderline traits, and chronic trauma symptoms, which generates what Dutton calls the abusive personality] among female perpetrators of partner abuse. Follingstad, Bradley, Helff, and Laughlin (2002) generated a model for predicting dating violence in a sample of 412 college students. (as cited in Dutton, p. 201, 2006) They found that anxious attachment resulting from early life experiences led to the development of an â€Å"‘angry temperament,†Ã¢â‚¬Ëœ which in turn related to attempts to control and use abuse against an intimate partner. The model predicted abusiveness for both genders (ibid. ) Other researchers have also hypothesized about subtypes of abusive males and females. For instance, Buttell et al (2005), states that researchers are beginning to explore the role of attachment theory and develop hypotheses on abusive behaviors relevant to different subtypes of abuser in order to improve intervention efforts for batterers. (p. 211) Gormley (2005) concluded that, â€Å"Insecure adult attachment orientations affect half the adult population, helping to explain the prevalence of men's and women's IPV. Women with insecure adult attachment orientations may be as much at risk as similar men of psychologically and physically abusing romantic partners, oing damage to relationships they may be socialize to value highly(I? E(B. † (p. 793) Female Batterers Scant research has been done on female batterers; however, due to the changes in mandatory arrest policies more women are being arrested than ever before. The debate about whether or not women perpetrate IPV has changed noticeably of late due in part to the fact that women are increasingly being arreste d, prosecuted, and sentenced to intervention programs for domestic violence offenses. Women's arrest for IPV is a direct result of legislation that has mandated the arrest of perpetrators in cases where police become involved when a domestic dispute has occurred. Warrantless arrest legislation gives police the power to arrest the abuser and press charges themselves when called to a domestic dispute. The victim no longer needs to press charges against the perpetrator. The arrest of women was certainly an unintended consequence of this legislation and has had a dramatic impact on the national debate regarding female initiated IPV. Carney & Buttell, p. 249, 2004) Feminist theory of IPV has created a dilemma regarding intervention services for female batterers. At present, the most prevalent legislated BIP's the system has set up are for dealing with batterers comes from the feminist model of IPV. Female batterers who are convicted of domestic assault and court ordered to attend a BIP have little choice but than to attend the feminist model of BIP's when court ordered to do so. (Carney and Buttell, p. 50, 2004) In addition, research on these [Duluth Model] BIP's indicate that few men who complete treatment benefit from it to the extent that they demonstrate positive changes in their behaviors. Of course, if men are not benefiting from a program that is specifically designed for patriarchal batterers then certainly abusive women will benefit even less. (ibid. ) According to Babcock & Siard (2003) some of the women arrested could have been acting in self-defense and were therefore falsely arrested but others with extensive violent histories may in fact be primary aggressors. p. 153) Men who are arrested are not given the same latitude. Babcock et al. (2003) mentions that in a study of women arrested for IPV, Hamberger and Potente (1994) found women who could clearly be identified as primary aggressors of IPV, yet in the treatment setting they were generally treated the same as those women who used self defense. (as cited in Babcock & Siard, p. 154). B abcock et al. (2003) proposed two categories of female batterers, those that were partner-only and those that were generally violent. The partner-only category covered women who may be more likely to use violence in self-defense and the generally violent women (of more interest for this paper) were women who used violence in any manner of situations including against their romantic partners. (pp. 153-154) Many studies on male batterer's include reports from their female victims; however, the researchers in this study did not ask the male victims for reports of their partner's violence. Iit is interesting to note that violent women were asked to report on their male partner's violence against them. (p. 57) They further note that power and control seems to be an issue for some abusive women and they suggest that women's power and control issues, traumatic histories, and psychological distress should be explored and indicate that clinicians may want to assess for psychopathology (i. e. post-traumatic stress disorder, borderline personality disorder, etc. ) (ibid. ) Recent studies have found that women's and men's viol ence share similar correlates (Giordano, Millhollin, Cernkovich, Pugh, & Rudolph, 1999; Magdol, Moffittt, Caspi, & Silva, 1998; Moffitt, Robins, & Caspi, 2001 as cited in Babcock et al, p. 53, 2003) therefore, they may also share similar motivations and circumstances. Female Batterers from Victims Reports Hines et al's (2007) research provides some insight into female batterers from their male victims. â€Å"Female abusers likely have a history of childhood trauma, may be suffering from a mental illness, and are likely to use alcohol and/or drugs. Further, these women have a high rate of threatening either suicide and/or homicide. † (p. 9) As previously stated, women have been asked to report on their male batterers and although this is not the ideal way to obtain information on batterers, feminist researchers have been gathering information in this way from battered women in shelters for years. (e. g. Walker, 2000 as cited in Hines et al, p. 69, 2007) Conclusion Men are vict ims of female perpetrated IPV and need services such as shelter, legal aid, support and counseling much the same as their female counterparts. Additionally, men's reports of victimization should not be called into question but treated with the same respect as women's reports. Protocols should be put in place within the domestic violence shelters programs, for law enforcement and the courts that will screen out potential female and male batterers so that victims are not judged by their gender. There is a dearth of research of female batterers and what has been presented from the feminist theory suggests that violent females use violence in self-defense. As we move away from the feminist theory of IPV researchers are discovering that childhood trauma, insecure attachment styles, mental illness, and/or alcohol and substance abuse play a role in IPV for both genders. Not all male batterers fit into the feminist theory of IPV, there are subtypes of batterers and attachment style plays a role in who perpetrates IPV. The subtype that is the focus of this paper is that of the borderline, cyclical batterer. Female batterers also show symptoms of having subtypes evidenced by reports from male callers to the DAHMW. Studies are beginning to assess psychological factors that predict female intimate partner violence. What is emerging is evidence of personality disorder, attachment style, and constricted affect that has also been seen in male abusers. Female abusers share much of the same traits as male abusers especially antisocial and borderline personalities. (Dutton, p. 203, 2006) As Babcock et al. (2003) explain, â€Å"[the] feminist perspective should be holistic, examining both the positive and negative sides of women's behavior. Bringing attention to some women being in the role of perpetrators, not solely as the victims of intimate partner abuse, involves viewing women as they are, not as we would wish them to be. † (p. 160) References About The Author

A great earthquake Essay

The magnitude 8. 8 earthquake that occurred a month ago in Chile, as well as the impending tsunami along the Pacific Rim is the product of a fortuitous event. These are events which cannot be foreseen or which though foreseen are inevitable. The quake struck at 3:34 a. m. in central Chile. The capital Santiago is about 200 miles from the epicenter and Concepcion, Chile’s second-largest metropolitan area, is roughly 70 miles from the quake’s center. A magnitude of 8. 0 or greater is classified as a great earthquake which results to communities being destroyed. The 8. 8 magnitude earthquake in Chile has killed lesser people compared to the 7. 0 magnitude that struck Haiti on January 12 that killed more than 200,000 people. It was 32 times the energy higher and 64 times greater than what took place in Haiti. The difference in the death toll lies in the buildings’ structures and their construction. Unless a building is designed and engineered specifically to withstand an 8. 0 or greater earthquake it’s going to sustain considerable damage. Even buildings that are well built sustain significant damage. Buildings that are poorly built are completely destroyed. Chile, being a more industrialized nation came up with more stringent building codes. By designing a more flexible structure, we can lessen the effect of the disaster. It makes the buildings slide or sway but not crumble to the ground. Engineers who work on earthquake resistant buildings said that current technologies prevent well-designed buildings from cracking when the ground shakes beneath them Natural disasters such as floods, tsunami and earthquakes do occur. There is nothing we can do to prevent it. However, there is something we can do to lessen its impact. Earthquakes alone don’t actually kill people; it is the collapsed structures that do the damage. Disaster preparedness as well as earthquake-proof buildings are the keys to lessen the impact of such disaster.

Amputation Mishap

In the following paragraphs, negligence, gross negligence, and malpractice are discussed and determine if the newspaper’s statement of negligence is correct. Ethical principles in nursing and nursing documentation regarding such issues are also discussed. Negligence and malpractice fall under the tort laws definition. According to Guido (2010), â€Å"Torts are civil wrongs, not based on contracts, but on personal transgressions in that the responsible person performed an action incorrectly or omitted a necessary action† (p. 92). Tort laws are based on fault and in a health-care setting, tort laws are the most common. To determine if the above scenario results in negligence, gross negligence, or medical malpractice, one must understand the definition of each. According to Guido (2010), negligence is a general term and â€Å"equates with carelessness, a deviation from the standard of care that a reasonable person would use in a particular set of circumstances† (p. 2). According to Judson and Harrison (2006), four key elements (four D’s), must be present to prove negligence (p. 101): 1. Duty: The person charged has a duty to provide care to the patient. Neighborhood Hospital and staff have a duty to provide a standard of care that a reasonable person would use in a particular set of circumstances. 2. Dereliction: The person charged breaches the duty of care to the patient. The operating room team failed to identify the correct leg for amputation prior to proceeding with the operation; therefore a breach of duty has occurred. 3. Direct cause: The breach of duty is a direct cause of injury to the patient. The wrong leg is amputated as a direct result of failure to identify the correct leg for amputation. As a direct result, the patient will become a double amputee once the correct leg is amputated. 4. Damages: A recognizable injury to the patient is present. In this case, the wrong leg was amputated deeming a recognizable injury. Using the above criteria, negligence is present in this case scenario. Gross negligence occurs when medical practitioners perform an intentional act regardless of the negative, anticipated consequences. In this scenario, the patient must prove the medical staff at Neighborhood Hospital intentionally amputated the wrong leg. The medical staff at Neighborhood Hospital did not intentionally amputate the wrong leg, therefore ruling out gross negligence. According to Guido (2010), medical malpractice is â€Å"the failure of a professional person to act in accordance with the prevailing professional standards or failure to foresee consequences that a professional person, having the necessary skills and education, should foresee† (p. 93). Guido further states the difference between negligence and malpractice is licensure. If the act is by a non-professional person, it is negligence. If the act is by a professional person, it is malpractice. Six elements must be present to prove malpractice (Guido, 2010, p. 93): 1. Duty owed to the patient Neighborhood Hospital and staff have a duty to provide a standard of care that a reasonable person would use in a particular set of circumstances. 2. Breach of the duty owed to the patient. The operating room team failed to identify the correct leg for amputation prior to proceeding with the operation; therefore a breach of duty has occurred. 3. Foreseeability. The omission of identifying the correct leg for amputation prior to surgery. 4. Causation: breach of duty owed caused injury. The wrong leg is amputated as a direct result of failure to identify the correct leg for amputation. As a direct result, the patient will become a double amputee once the correct leg is amputated. 5. Injury. In this case, the wrong leg was amputated deeming a recognizable injury. 6. Damages. The amputated leg cannot be replaced; therefore the patient is entitled to compensatory damages regarding pain and suffering, permanent disability, disfigurement, emotional damages as well as financial loss and medical expenses. In this scenario, all six elements to prove malpractice are present. The negligence is by licensed personnel in a hospital setting. Using the definitions and criteria above, the newspaper incorrectly defines the mishap as negligence. The correct term to use in this case is professional negligence or malpractice. Nursing documentation should be reflective of the patient’s hospital stay. This includes identifying and addressing patient needs, assessments, problems, limitations, and responses to nursing interventions. According to Guido (2010), â€Å"Documentation must show continuity of care, interventions that were implemented, and patient responses to the therapies implemented. Nurses’ notes are to be concise, clear, timely, and complete† (p. 197). Guido (2010) lists the following guidelines for nurses to use to ensure documentation is complete and accurate (p. 197-209): 1. Make an entry for every observation. If documentation is absent, it can be assumed an observation did not take place. 2. Follow-up as needed. Evaluation and observations require follow up to ensure appropriate patient responses and optimal outcomes. . Read nurses notes prior to giving care. Reading nurses notes enable the nurse to know and understand patient diagnosis, response to treatment, and steps necessary to carry out the plan of care. 4. Always make an entry (even if it is late). Document immediately after the observation to reduce the risk of losing valuable information. A late entry is acceptable altho ugh risks omitting valuable information. Never document an event before it happens. 5. Use clear and objective language. Document using clear, objective, and definite terms to describe the observation. Vague terms lead to misinterpretation. 6. Be realistic and factual. It is important to document factual observations and assessments exactly as they happen. It is also recommended to document a realistic picture of the patient, especially if the patient is noncompliant with the plan of care. 7. Chart only one’s own observations. Charting observations of others is not accurate observations and can cause credibility of the nurse in question. 8. Chart all patient education 9. Correct chart errors. 10. Identify oneself after every entry. 11. Use standardized checklists or flow sheets. 2. Leave no room for liability. According to Guido (2010), â€Å"Understanding one’s ethics and values is the first step in understanding the ethics and values of others and in assuring the delivery of appropriate nursing care† (p. 4). Nurses and other healthcare providers face ethical issues daily. Together, law and ethics guide nursing practice to provide safe, effective care keeping patients free from harm. â€Å"Ethics are concerned with standards of behavior and the concept of right and wrong, over and above that which is legal in a given situation† (Judson Harrison, 2006, p. ). In addition, understanding law and ethics in nursing practice keeps nurses at their professional best and decreases the risk of legal litigation, such as the scenario described by the Neighborhood News. â€Å"Though malpractice is rare in the lives of individual healthcare professionals, the number of malpractice suits is on the rise† (Larson Elliott, 2010, p. 153). The nursing profession has more professional responsibility and accountability than any other time in the history of nursing. According to Weld and Garmon Bibb (2009), â€Å"nurses must confront the fact that they now owe a higher duty of care to their patients, and by extension, are more exposed to civil claims for negligence than ever before† (p. 2). Understanding ethical principles in nursing, importance of nursing documentation and how it relates to medical malpractice and negligence is imperative. References: Guido, G. W. (2010). Legal Ethical Issues in Nursing (5th ed. ). University of Phoenix eBook Collection database. Judson, K. , Harrison, C. (2006). Law Ethics for Medical Careers (5th ed. ). University of Phoenix eBook Collection database. Larson, K. , Elliott, R. (2010, March-April). The Emotional Impact of Malpractice. Nephrology Nursing Journal, 37(2), 153-156. Ebscohost. com. Prideaux, A. (2011). Issues in Nursing Documentation and Record Keeping Practice. British Journal of Nursing, 20(22), 1450-1454. Ebscohost. com The Neighborhood- Pearson Health Science. The Neighborhood News. Retrieved October 1, 2012, from http://pearsonneighborhood. ecollege. com/re/DotNextLaunch. asp? courseid=3609454 Weld, K. K. , Garmon Bibb, S. C. (2009, January-March). Concept Analysis: Malpractice and Modern-Day Nursing Practice. Nursing Forum, 44(1), 2-10. Ebscohost. com. Amputation Mishap In the following paragraphs, negligence, gross negligence, and malpractice are discussed and determine if the newspaper’s statement of negligence is correct. Ethical principles in nursing and nursing documentation regarding such issues are also discussed. Negligence and malpractice fall under the tort laws definition. According to Guido (2010), â€Å"Torts are civil wrongs, not based on contracts, but on personal transgressions in that the responsible person performed an action incorrectly or omitted a necessary action† (p. 92). Tort laws are based on fault and in a health-care setting, tort laws are the most common. To determine if the above scenario results in negligence, gross negligence, or medical malpractice, one must understand the definition of each. According to Guido (2010), negligence is a general term and â€Å"equates with carelessness, a deviation from the standard of care that a reasonable person would use in a particular set of circumstances† (p. 2). According to Judson and Harrison (2006), four key elements (four D’s), must be present to prove negligence (p. 101): 1. Duty: The person charged has a duty to provide care to the patient. Neighborhood Hospital and staff have a duty to provide a standard of care that a reasonable person would use in a particular set of circumstances. 2. Dereliction: The person charged breaches the duty of care to the patient. The operating room team failed to identify the correct leg for amputation prior to proceeding with the operation; therefore a breach of duty has occurred. 3. Direct cause: The breach of duty is a direct cause of injury to the patient. The wrong leg is amputated as a direct result of failure to identify the correct leg for amputation. As a direct result, the patient will become a double amputee once the correct leg is amputated. 4. Damages: A recognizable injury to the patient is present. In this case, the wrong leg was amputated deeming a recognizable injury. Using the above criteria, negligence is present in this case scenario. Gross negligence occurs when medical practitioners perform an intentional act regardless of the negative, anticipated consequences. In this scenario, the patient must prove the medical staff at Neighborhood Hospital intentionally amputated the wrong leg. The medical staff at Neighborhood Hospital did not intentionally amputate the wrong leg, therefore ruling out gross negligence. According to Guido (2010), medical malpractice is â€Å"the failure of a professional person to act in accordance with the prevailing professional standards or failure to foresee consequences that a professional person, having the necessary skills and education, should foresee† (p. 93). Guido further states the difference between negligence and malpractice is licensure. If the act is by a non-professional person, it is negligence. If the act is by a professional person, it is malpractice. Six elements must be present to prove malpractice (Guido, 2010, p. 93): 1. Duty owed to the patient Neighborhood Hospital and staff have a duty to provide a standard of care that a reasonable person would use in a particular set of circumstances. 2. Breach of the duty owed to the patient. The operating room team failed to identify the correct leg for amputation prior to proceeding with the operation; therefore a breach of duty has occurred. 3. Foreseeability. The omission of identifying the correct leg for amputation prior to surgery. 4. Causation: breach of duty owed caused injury. The wrong leg is amputated as a direct result of failure to identify the correct leg for amputation. As a direct result, the patient will become a double amputee once the correct leg is amputated. 5. Injury. In this case, the wrong leg was amputated deeming a recognizable injury. 6. Damages. The amputated leg cannot be replaced; therefore the patient is entitled to compensatory damages regarding pain and suffering, permanent disability, disfigurement, emotional damages as well as financial loss and medical expenses. In this scenario, all six elements to prove malpractice are present. The negligence is by licensed personnel in a hospital setting. Using the definitions and criteria above, the newspaper incorrectly defines the mishap as negligence. The correct term to use in this case is professional negligence or malpractice. Nursing documentation should be reflective of the patient’s hospital stay. This includes identifying and addressing patient needs, assessments, problems, limitations, and responses to nursing interventions. According to Guido (2010), â€Å"Documentation must show continuity of care, interventions that were implemented, and patient responses to the therapies implemented. Nurses’ notes are to be concise, clear, timely, and complete† (p. 197). Guido (2010) lists the following guidelines for nurses to use to ensure documentation is complete and accurate (p. 197-209): 1. Make an entry for every observation. If documentation is absent, it can be assumed an observation did not take place. 2. Follow-up as needed. Evaluation and observations require follow up to ensure appropriate patient responses and optimal outcomes. . Read nurses notes prior to giving care. Reading nurses notes enable the nurse to know and understand patient diagnosis, response to treatment, and steps necessary to carry out the plan of care. 4. Always make an entry (even if it is late). Document immediately after the observation to reduce the risk of losing valuable information. A late entry is acceptable altho ugh risks omitting valuable information. Never document an event before it happens. 5. Use clear and objective language. Document using clear, objective, and definite terms to describe the observation. Vague terms lead to misinterpretation. 6. Be realistic and factual. It is important to document factual observations and assessments exactly as they happen. It is also recommended to document a realistic picture of the patient, especially if the patient is noncompliant with the plan of care. 7. Chart only one’s own observations. Charting observations of others is not accurate observations and can cause credibility of the nurse in question. 8. Chart all patient education 9. Correct chart errors. 10. Identify oneself after every entry. 11. Use standardized checklists or flow sheets. 2. Leave no room for liability. According to Guido (2010), â€Å"Understanding one’s ethics and values is the first step in understanding the ethics and values of others and in assuring the delivery of appropriate nursing care† (p. 4). Nurses and other healthcare providers face ethical issues daily. Together, law and ethics guide nursing practice to provide safe, effective care keeping patients free from harm. â€Å"Ethics are concerned with standards of behavior and the concept of right and wrong, over and above that which is legal in a given situation† (Judson Harrison, 2006, p. ). In addition, understanding law and ethics in nursing practice keeps nurses at their professional best and decreases the risk of legal litigation, such as the scenario described by the Neighborhood News. â€Å"Though malpractice is rare in the lives of individual healthcare professionals, the number of malpractice suits is on the rise† (Larson Elliott, 2010, p. 153). The nursing profession has more professional responsibility and accountability than any other time in the history of nursing. According to Weld and Garmon Bibb (2009), â€Å"nurses must confront the fact that they now owe a higher duty of care to their patients, and by extension, are more exposed to civil claims for negligence than ever before† (p. 2). Understanding ethical principles in nursing, importance of nursing documentation and how it relates to medical malpractice and negligence is imperative. References: Guido, G. W. (2010). Legal Ethical Issues in Nursing (5th ed. ). University of Phoenix eBook Collection database. Judson, K. , Harrison, C. (2006). Law Ethics for Medical Careers (5th ed. ). University of Phoenix eBook Collection database. Larson, K. , Elliott, R. (2010, March-April). The Emotional Impact of Malpractice. Nephrology Nursing Journal, 37(2), 153-156. Ebscohost. com. Prideaux, A. (2011). Issues in Nursing Documentation and Record Keeping Practice. British Journal of Nursing, 20(22), 1450-1454. Ebscohost. com The Neighborhood- Pearson Health Science. The Neighborhood News. Retrieved October 1, 2012, from http://pearsonneighborhood. ecollege. com/re/DotNextLaunch. asp? courseid=3609454 Weld, K. K. , Garmon Bibb, S. C. (2009, January-March). Concept Analysis: Malpractice and Modern-Day Nursing Practice. Nursing Forum, 44(1), 2-10. Ebscohost. com.

Effect of Childhood Sexual Abuse Within Institutions Literature review

Effect of Childhood Sexual Abuse Within Institutions - Literature review Example udy Conclusions 29 Recommendations for Future Action 30 Chapter Summary 34 List of Works cited 35 CHAPTER ONE INTRODUCTION Overview Childhood sexual abuse is a human rights violation affecting all age groups within the childhood period globally. Effects of the Childhood sexual abuse on young lives are very devastating and have both short and long term consequences. Prevalence rate of sexual abuse has been difficult to determine for various reasons; estimates have broadly varied as a result of different definitions of the term and the sensitive nature of the phenomenon accompanied by shame and stigma experienced by victims (Julia, P.46). This makes it disincentive for victims to report its occurrence for fear of stigmatisation. World Health Organization (WHO) estimates that about 223 million children (150 million girls and 73 million boys) have experienced forced sexual intercourse or other forms of sexual violence globally as reported by (Dube and Anda, p.123). Recent research effort s suggest that sexual exploitation and abuse within institution is a widespread but largely unrecognized problem in many countries. The closed nature of the school environment means that children can be at great risk of sexual abuse in schools. There is a recognized child sexual abuse problem in schools. For this realization, the following dissertation seeks to establish the effects of childhood sexual abuse within institutions. The first chapter introduces the research problem by presenting background information, stating the objectives and significance of the study as well the research questions. Background to the study The UN Convention on the Rights of the Child (Article 34, CRC, 1990) prohibits child sexual abuse. Since UK is a signatory to this convention, (Brown, p.74) argues that... This study has established that Child Sexual Abuse exists in all the schools in the study areas. Child sexual abuse is intense and widespread mostly in SHS and JHS, manifesting itself in both contact and non-contact forms. Girls are more vulnerable than boys in a ratio of 11: 9 and children within age range of 14-16 years are more at risk of sexual abuse. Poverty, sexual pleasure, lack of protection and peer influence are found to be the main causes of child sexual abuse in schools in the areas studied. The weak protective environment is further complicated by the ineffective enforcement of laws and implementation of policies and programmes designed for child protection. This study employed both exploratory and descriptive survey. This research approach sought to elicit facts and data on the nature, distribution, degree and the reasons for perpetration of child sexual abuse in schools in the study areas, as well as respondents’ beliefs and perspectives and clearly describe the m. Additionally the present study employed library based research design whereby secondary information from multiple archival sources was also compiled to compare and validate the primary sources of empirical materials. This paper makes a conclusion that the study presented in the preceding chapter four and outlined the conclusions that the study found relevant. The chapter further highlighted several recommendations that can be adopted for conducting future research in an attempt to address the research problem under investigation. Several key issues that have emerged throughout the dissertation were revisited as highlighted in the foregoing sections.

Personal Ethical Statement Assignment Example | Topics and Well Written Essays - 250 words

Personal Ethical Statement - Assignment Example My blind spot, according to the inventory, is the belief that my motives will always justify the methods. Most of the time I fail when it comes to accountability; I have always placed my demands and needs first and I do not care explaining to those who depend on me so long as my needs are satisfied. In addition, sometimes I become complacent and leave many problems unsolved intentionally. People around me always get upset because I always focus on my own motives and ignore the obvious problems around us. My strength lies balancing my entrepreneurship with my responsibilities. I strongly value autonomy since I am self-reliant and accountable to my community. Thus, I avoid being rigid, stick to the usual duties and attempt to follow my dream whenever I get the slightest opportunity. On the other hand, my weakness is becoming greedy or judgmental in my expectations of others. Thus, I am always quick to criticize and label others unethical whenever my coworkers do not meet their job targets or rather fulfill their responsibilities. My values, as per this inventory are sensible and rational. I am a person with the full potential when it comes to finding solutions to societal problems. Managing a personal business is what I want to pursue because this inventory have taught me how to relate with people, regardless of age, social status, sex or race. I have bigger dreams that would benefit my community but in the meantime, working on my weaknesses is my priority since it will shape who I

Under non-ideal conditions, it is necessary to trade off between Essay

Under non-ideal conditions, it is necessary to trade off between relevance and reliability when estimating future cash flows. Critically appraise this statement - Essay Example In this regard, the reliability of accounting information as an apparatus for forecasting future cash flows require accreditation from the actual source to ascertain its relevance to the study of future trends concerning cash flows (Gandevani 74). For accounting information to be relevant in the estimation of future cash flows, it must be in accord with the established international accounting principle. Financial analysts argue that accounting transactions that are not supported by the reality in contextual market are defective and misleading, and their reliability is irrelevant in predicting future cash flows (Gandevani 73). In fact, failure to incorporate both reliability and relevance in decision making will always lead to unprofitable returns. For instance, unreliable information might lead to overestimation or underestimation of future cash flows, and this may result in poor planning of activities. It is important to recognize that accounting conservatisms is pro relevance at the expense of reliability which means that relevance of accounting figures and transaction is a vital tool for estimation of future cash flows. In summary, both reliability and relevance must be put into consideration when estimating future cash f lows for an

How a nurse's attendance can affect professionalism, pt. outcomes, etc Essay

How a nurse's attendance can affect professionalism, pt. outcomes, etc - Essay Example The availability of nurses during their shift is essential in a number of sectors in the hospital, and for this reason a glitch in this attendance may lead to various problems that may occur as a result. Areas Affected by a Nurse’s Attendance There are a number of areas within medical facilities that can be affected by the lack of proper attendance by a nurse, some of the more essential sectors that are affected include: Doctors Nurses can be considered to be a doctor’s right hand as they assist greatly in a large number of the activities they are involved in. Nurses in some cases have actually been known to do most of the work when compared to doctors in cases that do not require issues such as surgeries (Chin, 2008). A doctor will come in and evaluate the patient to determine what their ailment is and prescribe the required medication that is needed but a nurse will usually take over the responsibilities henceforth. This will include duties such as administering the p rescribed medicine, ensuring the dosage is as per the doctor’s instructions, handle any further complications that may occur such as ensuring the patient is comfortable as well regularly checking up n them to ensure that there are no unexpected changes. If a nurse does not have a proper attendance record, this may in effect cripple the doctor’s activities as it is hard to operate without the assistance of a nurse by their side (Chin, 2008). The lack of an available nurse may mean that a doctor will faced with extra responsibilities that they will have to handle themselves leading to interference in their schedule, which would mean they may not be capable of attending to as many patients as they usually would in cases where a nurse is available. Doctors handle all the responsibilities on their own which would in return reduce the effectiveness of the hospital in general as activities will be crippled as a result (Chin, 2008). The tardiness in a nurse may lead to the nee d for another to take up extra responsibilities, which would also reduce the quality of work that is done as the said nurse struggles to keep up with both their and their fellow nurse’s duties. Patients This group of people can be considered to be the ones that are mostly affected by a poor attendance by nurses as their wellbeing relies heavily on them. A patient wound not be able to have sufficient service offered to them without the availability of a nurse as a doctor is not accountable for a large number of things that are required by inpatients as well as outpatients and the lack of a proper attendance by a nurse will lead to this innocent group of people suffering as a result (DeWit, 2009). Nurses can be considered to be the ones who take care of the patients once the doctor has finished examining them and given their verdict of what needs to be done and thus without the availability of a nurse this care would not be attainable especially by inpatients. Nurses can be con sidered to be the groups that interacts the most with patients and perform a large number of duties such as the administering of medicine that has been prescribed to them (DeWit, 2009). In some cases, a doctor may examine a patient and write down a prescription leaving it for a nurse to come and read then administer it as per the instructions. A poor attendance may lead to situations where a patient does not receive their medication within the

Use of English Language Essay Example | Topics and Well Written Essays - 1000 words - 5

Use of English Language - Essay Example On the other hand, non-verbal surpasses verbal communication, given that people depend on non-verbal for expressing their ideas since when they are born. In this case, due to innate attributes of non-verbal behaviors, this leads to its significance in communication. For instance, some people use body gestures and facial expressions before uttering sentences, whereby they try making sense through symbolic messages. Furthermore, non-verbal cues are considered trustable they are elicited unconsciously by people through their behaviors. Moreover, there is the notion that non-verbal cues are not delusional; in fact, member of this community have a conviction that non-verbal messages are applicable where verbal messages are contradicting. In this case, people focus on creating the meaning of their non-verbal behaviors through attachment of meaning by observing what others are doing. Therefore, symbolic messages assist people in interpreting intentions of the speaker, and this is an indicat ion of the significance of non-verbal communication in the process of interpretation. In this case, non-verbal communications are considered very helpful in a situation whereby people do not understand messages communicated by a person through verbal communication. In addition, there is the deprivation of an interpreter to fall back on other ways of facilitating understanding of the speaker. In this situation, the non-verbal communication is utilized to offer subtle hints regarding the way a message should be understood.... In this case, people should avoid using gendered adjectives that are considered irrelevant such as â€Å"lady doctor†, â€Å"male nurse,† or â€Å"woman lawyer†. Issues of exclusion through language use involve explicit gender dichotomies, which are involved in social and linguistic awareness of speakers. In fact, this depends on whether there are social implications of gender non-stereotypical linguistic terminologies. Nevertheless, in order to identify this exclusion, there is need to analyze and pay attention on the stereotypical gender binarities, which are associated with social awareness and linguistic. For instance, there are divergent cultures and languages presented as indicative can lead to gender polarization, which is reflected in global and local trends of perception towards language. There are complex interdependencies, which exist between gender and languages can be explored in regard to theories associated with language and gender interplay; for i nstance, there are social cognitive approaches and social constructionism (Wolfgang, 23). Therefore, gender stereotypes are considered inherent based on the perception and application of language. Nonetheless, language and gender stereotypes may be assumed, while the discussion is based on the conceptualization of languages and gender, thereby referring to impact of gender stereotypes on language perceptions. Interesting Event Involving Language within the Community One of the most interesting events involving language within a community involves a special public or semi-public event, where an organization seeks to develop a sense of â€Å"political correctness†. In fact, this event starts with a short opening speech and

Capital structure and firm value Literature review

Capital structure and firm value - Literature review Example Finally, the relationship between various aspects like credit ratings, target leverage, short term financing etc and their influence on the firm’s financing policy have also been discussed. Introduction The financial managers of a company work towards achieving an optimal capital mix. In large companies there is a separate financial department that takes care of financing issues. The managers strive hard to achieve a right mix of debt and equity as the capital base of the firm determines the cost of capital. The point at which the average cost of capital is minimum, the value of the firm is maximum. This point is referred as ‘optimal’. Methodology The choice of capital structure and firm value is an important topic in financial literature. This paper examines various capital structure theories like pecking order, trade-off theory etc and its impact on capital structure decisions. Mostly, the secondary sources of data have been used to determine the relationship be tween the capital structure of the firm and its value. ... The significant components of the capital structure include both debt and equity. Back in the year 1958, Modigliani and Miller had established the modern theory of capital structure. According to this theory, the value of a firm does not depend on its capital structure decisions. The Modigliani-Miller theorem is a significant arena of contemporary corporate finance. At its centre, the theory refers to an irrelevance proposition. The Modigliani Miller theory offers cases under which the financial decision of a firm does not have an effect on its value. According to the theorem, â€Å"with well-functioning markets ... and rational investors, who can ‘undo’ the corporate financial structure by holding positive or negative amounts of debt, the market value of the firm – debt plus equity – depends only on the income stream generated by its assets† (Villamil, n.d., p.1). As per Modigliani, the firm value should not be dependent on the portion of debt withi n the financial structure. The Modigliani Miller theorem is comprised of four separate results which are fetched from a series of research papers. According to the first proposition, under some specific conditions, the debt-equity ratio of the firm would not have an impact on the market value. Among them, the first two are related to the firm’s capital structure. As per the second proposition, the leverage of any firm would not have any effect on the firm’s weighted average cost of capital. This means that cost of equity has a linear relationship with the firm’s debt equity ratio. Miller has given an example for a better understanding of the theorem. For an instance, one can think that the firm is a huge tub of

Theory Of Constaints Assignment Essay Example for Free

Theory Of Constaints Assignment Essay Question 1:  Ã‚  Ã‚   Highlight the production management philosophy and principles of TOC Any manufacturing company’s success is dependent on how well its resources perform, in other words the level of performance of its factory. The factory’s performance is in turn constrained by the manufacturing infrastructure and is hence designed so as to suit the company’s strategy related to the products and their quantities. Production management essentially takes the company’s strategic requirements in terms of its key competitive objectives, for instance shorter lead time, low cost etc. , and translates them into schedule for the factory environment in terms of inventory, job sequencing and time table etc., so that these objectives are met (Childe, 1997, p.28). In an industrial environment, there are always constraints that affect the throughput of a system in terms of quantity or quality of product delivered or the delivery time (Lange Ziegenbien, 2005, p.1).Some of these constraints are bottlenecks i.e. resources whose availability is less than the demand placed on them, while others are potential bottlenecks or Capacity Constrained Resources CCRs i.e. resources who utilization is close to capacity and in case of non-optimal utilization may become bottleneck (Telsang, 2002, p. 518). Theory of Constraints was developed to address such practical problems in manufacturing. This theory given by Goldman and Cox in their famous book Goal is basically a productions and operations management strategy dealing with the CCRs i.e. potential bottlenecks in an industry environment (Quassin, 2000, p.3). According to Goldman and Cox, the goal of all the manufacturing companies is to make money (quoted, Childe, 1997, p.29). Hence according to them the success for any manufacturing company would come if they can properly identify the aims to their business and then deal with the constraints which would prove to be present or potential bottlenecks in achieving the goal (Childe, 1997, p.115) The Theory of Constraints was developed in over a decade’s period, by the Israeli Physicist Dr. Eliyahu M Goldratt based on his observations of certain common characteristics that effect system operations (Dettmer, 1998, p.11). This combined with his thoughts comprises the Theory of Constraints TOC, which is a collection of principles, a set of generic tools and the specific applications of these tools. The principles explain the management actions and the various interactions between processes. The tools are methods that can be used to apply these principles in specific instances, while the applications are the instances where these tools have been successfully applied in these situations many times so that they can be considered as generic solutions to the problems. Hence, the TOC is still evolving to this day (Dettmer Schragenheim, 2000, p.13). Among the principles of TOC, the most basic are three key assumptions about constraint management, five focusing steps to guide the system and three measures to assess whether the actions being taken at the local level are producing the desired results at the global level. Assumptions – TOC is based on three interrelated premises:   Every system has a goal and asset of necessary conditions that must be satisfied if the goal has to be achieved, The overall system’s performance is more than just the sum of its component performances, and Very few factors or constraints, often only one, limit a system’s performance at any given time (Ronen, 2005, p.21) Five Focusing Steps – Goldratt created five steps as a way to make sure that the management focuses on the process for continuous improvement Identify the system’s constraint, Decide how to exploit the system’s constraint, Subordinate everything else to the decision taken in the step above Evaluate alternative ways to elevate the constraint Return to the 1st step in case the system constraints have been changed (Srinivasan, Jones Miller, n.d., p.136) Evaluation – The evaluation of the operating decisions can be done by the three financial yardsticks which are provided by the constraint theory – Throughput (T), Inventory or Investment (I), and Operation Expense (OE) (Dettmer Schragenheim, 2000, p.40). These form the yardsticks because as mentioned earlier, according to Goldman and Cox, the goal of all the manufacturing companies is to make money (quoted, Childe, 1997, p.29) Question 2:  Ã‚  Ã‚   Describe how TOC can help to prioritize the most profitable high impact initiatives within a production environment The use of Theory of Constraints in the production management was initially done to solve the problems of bottlenecks, scheduling and inventory reduction (Wang, 2002, p. 149). Industry’s aim to achieve the goal of making money has been traditionally achieved by reducing the operating costs. The logic is that every dollar that is saved adds up to the profit. A compelling reason for adopting such a measure is that the costs can be controlled. The next step is to reduce the inventory while increasing the throughput is the last priority with the production managers. Japanese saw the value that can be achieved by reducing the inventory and hence put this as their first priority. They developed what is known as the Just-in-Time philosophy. For doing this the pipeline needs to be kept flowing i.e. a pull phenomenon, which correspondingly increases the importance of increasing the throughput to being the second highest priority (Dettmer Schragenheim, 2000, p.44). However, according to Goldratt’s Constraint theory, the highest priority should be given to increasing the throughput, while reducing the inventory or investment should have the second priority and reducing the operating expense should be the last priority (Bushong Talbott, 1999, p. 2). The reason for this is in the traditional methods, the production managers were assuming that an infinite amount of hours were available in each factory’s work and machines, which is not practically possible. Hence, Goldratt began by assuming that the manufacturing company is essentially a system with machines and people available for finite periods of time per day or week or month. He further assumed that at any instant in time only one factory or resource could prove to be a bottleneck in achieving the goal of making money. Hence, it followed that if this bottleneck was running to its full capacity, increasing the speed of the other centers would not do any good, as the speed of this particular centre would not increase (McMullen, 1998, p.105). This can also be explained as follows. Theoretically the any of the constraints could vary from zero to infinity, but practically the operating expense and inventory cannot be reduced under zero, neither can the throughput be increased till infinity. However, the practical limits for reducing the operating expense and the inventory are actually much higher than zero. This is because the manufacturers have to spend money on them in order to make money from the end products using these investments as inputs. While the practical limits for increasing the throughput is still much less than infinity, but its potential for adding up to the profits is much higher than the potential to do the same using cost-cutting. Cost-cutting is also risky in nature, because there is always the danger of spending less than what is required which would directly impact on the quality, and hence the inventory too in the long run (Dettmer Schragenheim, 2000, p.44). The management philosophy of Theory of Constraints can hence be viewed into three separate areas which are interrelated: logistics, performance management and logical thinking. Logistics includes the drum-buffer-rope scheduling, buffer management and VAT analysis. Using these tools, the tasks are scheduled in a production environment and prioritized. The next area is the Performance measurement which includes the Throughput, Inventory, the operating expense and the five focusing steps which have been discussed earlier. The thinking process tools help in identifying the root-problem (current reality tree), identifying and expanding win-win solutions (evaporating clouds and the future reality tree), and developing the implementation plans (prerequisite tree and transition tree) (Stein, 1997, p. 199). .DBR Scheduling – The basis for the DBR or drum-buffer-rope scheduling is the factory’s primary constraint which could be a present or potential bottleneck. This primary constraint acts as the drum for the DB scheduling. This scheduling process produces the schedule of what jobs to be produced and in what order on the drum. A time element known as the buffer is then used to establish the realistic commitment dates for the operation and its deadline. Another time element called the rope determines the schedule for introducing additional tasks and materials into the work process flow of the operation. Each task or batch in the drum schedule has a buffer and a rope time element. There are other time elements in the buffer also which when taken as a group form the time buffers (McMullen, 1998, p.106). This DBR scheduling process synchronizes the entire work throughout the factory, and creates a synchronized manufacturing state by basing all the schedules on the drum schedule or the bottleneck. In addition to this, it also provides feedback and control process which is known as buffer management. The function of the buffer management system is to ensure that all the other factory resources which are non-constrained are working on the right jobs, at the right times in the sequence, and in the right production batch quantities such that the schedules are supported from the drum task and customer deliveries are met. Finally all the non-constrained by definition have some spare capacity. While this is not excess capacity and can be used in the productive or protective sense, the scheduling of these is also important so as not to have excess inventory or investment condition. This is taken care by introducing the time buffers, discussed earlier, in the DBR schedule such that no production is lost at the drum. The extension of this process into the dynamic buffering can be used for fine-tuning the extra capacity (McMullen, 1998, p.107). Hence, this scheduling process reliable delivery schedules for the customers, because the schedules are based on finite capacity assumption instead of the erroneous infinite capacity assumption (Bushong Talbott, 1999, p. 3). Question 3:  Ã‚  Ã‚   Discuss how you will implement the proposed philosophy in order to rescue a sick hypothetical organization The prior section dealt with the drum-buffer-rope i.e. DBR scheduling, which is the TOC production planning methodology. As the aim of the TOC is to see to it that the constraint does not effect the production schedule, the DBR takes care of the weakest link i.e. the drum, schedule i.e. the buffer, and deadline i.e. the rope (Greeff Ghoshal, 2003, p. 70). In addition to the DBR scheduling, a buffer management scheme was also described above, which is needed to monitor the entire process. In the tradition approach, the DBR scheduling was used as the planning process and the buffer management was used to monitor the plan’s progress. In the present scenario, the DBR and buffer management process are dynamic and offer continuous feed backs to the production manager so that he can improve upon the system. As was mentioned in the first section, throughput is the primary are of focus of the TOC arrangement. The throughput is the money generated by the system after taking out the external costs, and this should be maximized for the profits to increase according to the theory of constraints. However, the implementation of TOC is not very easy in a practical situation, and in many cases it necessitates a change in the entire way a company operates. This difficulty can be explained by a simple example as follows. A company has identified that for increasing the its throughput, there is a need for producing the product and selling it with the lower sale price per product unit. As of now the company compensated its sales forces on a commission basis, based on the percent of sales and the people in this department try to sell their products with the highest sales price. This means that the company would need to develop an entirely new way of compensating its sales force. There might be further problems if the arrangement is not satisfactory enough to the sales people, which might lead to a drop in the sales – quite opposite to the goal of the company. Care should also be taken to remember that TOC is a dynamic management process. This means that the task does not end after finding out the constraint. On the contrary, the management should continuously analyze to see if this factor can be increased or some other factor might become a constraint. Such analysis should be made regularly and the options should be revised. In addition to this, continuous analysis should be made to check the operating expenses and inventory and investments should also be minimized (Bushong Talbott, 1999, p. 4). Example The above theories will be explained by taking an example below. First the basic system application is given using the TOC to explain the various constraints of the system. After this the complete system is shifted to a plant, which is a sick unit and steps are given to convert this plant into a optimal unit. Basic System and Constraints The example has a manufacturing unit which is essentially a machine that cuts silicon wafers into individual chips (Anderson, 2003, p. 30). The number of wafer cut by this machine in a unit time without getting overloaded is the constraint of the machine and the primary constraint of the entire manufacturing system. For instance, the machine can cut on 100 wafers per hours. In this case, it would be immaterial to get more raw materials since the constraint would still not be affected in this case. Now that the constraint of the system has been identified, a decision must be made on how to minimize its constraining ability on the system. The utilizing capacity of the constraint must be maximized i.e. the Capacity Constrained Resource, in this case the machine, must be fully utilized and must never be idle. Every unit of production that is lost on this system is a unit lost to the complete system (Anderson, 2003, p. 29). This constraint can be protected from being idle by providing a buffer or queue of raw materials for it to cut. For this example, let us assume that each wafer can be cut into 25 chips. That is to say 4 wafers would be needed by the machine per hours. This follows the generalization that the constraints are protected by buffers. The queue of silicon wafers in this case would be physical buffer of inventory.   In addition to this protecting a constraint is a necessary part of exploiting a constraint to the full (Anderson, 2003, p. 29). In case of the manufacturing system, the manufacturing unit can be protected from starvation or idle moments, by providing a buffer of silicon wafers. The unit also needs to be protected from power interruptions and surges, by providing a uninterruptible power supplies, and further giving a backup generator. The manpower related constraint can be sorted out by working the machine in three shifts by people of eight hours each, so that the machine is utilized for 24 hours per day. Finally the quality related issues can be sorted out by performing a quality check on the wafers prior to being set on the queue, to ensure that only good quality wafers are passed on to the manufacturing unit. In case of TOC care should be taken to ensure that subordination of all the activities are obtained to take care of the constraint (Anderson, 2003, p. 31). As can be seen in the example a decision is taken to see that the manufacturing unit is the constraint of the system, a and hence steps have been taken to take care of this constraint and utilize he machine for obtaining the maximum productivity. Ti subordinate all other activities to this decision, the flow of inventory should be regulated from the factory gate to the wafer cutting machine. The rate of sending the wafer to the machine should be same as the rate of the machine to entirely cut the wafer. Here, the rate of the cutter is the drum. The inventory of the factory gate to the cutter is the rope and a buffer in front of the cutter to prevent it from getting idle is the buffer. Plant as a Sick Unit Suppose that there are 10 such systems in a plant which is a sick unit. There are problems with excess inventory, the quality of wafers produced, the throughout is varied and is not stable and there are problems with delays between the operations with long periods where the machines are idle and others where there is extra load on the machines. The primary problem here is to streamline the operations. The basic constraint is already mentioned in the prior section i.e. the number of wafers that can be cut by a unit. This cannot be changed and must be utilized to the maximum. All the remaining actions must be subordinate to this activity such that the constraint or the drum is taken care. First of all the machines as a total can process 1000*10 =1000 wafers in a hour, which means 4*10 = 40 wafers must be passed to the machines per hour (as each wafer can be cut into 25 chips). Now that this has been decided, the queuing systems should ensure that the wafers are taken from the resource gate and passed to the machines. The easiest way of doing this would be to pass 4 sets of wafers per hour, after every 45 minutes 4 more wafers would be passed to the machines. This means that there would be enough time for checking the quality of the wafers and passing them to the machines, without worrying about the exact synchronization of each wafer to rate at which a machine cuts them. This would also take care of the idle periods of the machines, as in this case the machines would always have one wafer to cuts, by which time the other 4 wafers would be sent to it. The inventory would be controlled too. In addition, the throughput would be at a constant rate. Finally, the technique would also ensure that the burden on the quality checkers and machine operators is minimal. In the former case, the quality checkers could have a quality check wafers ready for a couple of hours advance, which would be passed to the machines every three quarters of an hours, which means these people do not need to be on job 24 hours a day. Also, the machine operators would have more time to check the power supply and other maintenance issues, while checking if the new wafer lot has been passed or not. The above example gives the implementation of Theory of Constraints method to a sick unit, to make it operate in an optimized way. The example taken is a very simplistic application which can be solved easily using the single DB technique. References Books Anderson DJ, 2003, Agile Management for Software Engineering: Applying the Thoery of Constraints for Business Results, New Jersey: Prentice Hall PTR Childe SJ, 1997, An Introduction to Computer Aided Production Management, 1st Edition, London: Chapman Hall Dettmer HW, 1998, Breaking the Constraints to World-Class Performance, Milwaukee: ASQ Quality Press Dettmer HW, Schragenheim E, 2000, Manufacturing at Warp’s Speed: Optimizing Supply Chain Financial Performance, Florida: CRC Press Greeff G, Ghoshal R, 2004, Practical E-Manufacturing and Supply Chain Management, Oxford: Elsevier McMullen TB, 1998, Introduction to the Theory of Constraints (Toc) Management System, Florida:  CRC Press Ronen B, 2005, The Theory of Constraints: Practice and Research, Amsterdam: IOC Press Stein RE, 1999, The Theory of Constraints Applications in Quality and Manufacturing, New York: CRC Press Telsang M, 2002, Industrial Engineering and Production Management, New Delhi: S Chand Company Ltd. Wang JX, 2002, What Every Engineer Should know about Decision Making Under Uncertainty, New York: CRC Press Online Articles Bushong JG, Talbott JC, 1999, The CPA in Industry: An Application of the Theory of Constraints, The CPA Journal, April 1999 Issue, http://www.nysscpa.org/cpajournal/1999/0499/Departments/D530499.HTM, Article Accessed on 18th September 2007. Lange I, Ziegenbien A, 2005, The Constraints Game – Learning the Theory of Constraints with a Dice Game, 9th International Workshop on Experimental Interactive Learning in Industrial management New Approaches on Learning, Studying and Teaching, http://www.simlab.tkk.fi/events/lange.pdf, Article Accessed on 18th September 2007. Quassin RY, 2000, The Theory of Constraints in Manufacturing, Journal of the Brazilian Society of Mechanical Sciences, J. Braz. Soc. Mech. Sci.  vol.22  no.4  Rio de Janeiro, 2000, http://www.scielo.br/scielo.php?pid=S0100-73862000000400001script=sci_arttext, Article Accessed on 18th September 2007. Srinivasan M, Jones D, Miller A, n.d., Applying the Theory of Constraints Principles and Lean Thinking at the Marine Corps Maintenance Centre, Defense Acquisition Review Journal, http://www.dau.mil/pubs/arq/2004arq/Srinivasan.pdf, Article Accessed on 18th September 2007.

Multimedia Applications for Educational Purposes

Multimedia Applications for Educational Purposes Multimedia Applications for Educational Purposes Tan Ai Fen ABSTRACT Multimedia is a combination of text, graphic, animation, audio, and video which are everything we can see and hear in our daily life (Vaughan, 2006). Multimedia applications can be used in many areas, for example like educations, businesses, homes and public places. This paper surveys the multimedia applications for educational purposes. There are six main elements in multimedia applications for educational purposes which are texts, images, audios, videos, animations and user control. Besides that, this paper also discusses the advantages and disadvantages of multimedia applications in education. There also have few characteristics in education which are screen design, interaction and feedback, navigation, video and audio elements on the development in education. In education, multimedia applications are used as a source of information to deliver learning resources for students. Multimedia applications also used to improve the learning process and increase the interaction between stu dents and teachers or lecturers. Teachers or lecturers can make the lesson more interesting by using the multimedia applications. A multimedia applications can highlight certain important points rather than writing on the white board. There is no doubt that the role of multimedia applications for educational purposes. This new context of learning definitely will influence the way of teachers or lecturers teach and the way of students learn. They continually search for more effective ways to engage their students during learning as well as to increase student learning outcomes. Keywords: learning, multimedia applications, educational purposes. INTRODUCTION According to Vaughan (2006), multimedia is a combination of text, graphic, animation, audio, and video which are everything we can see and hear in our daily life. Multimedia also refers to the uses of computer technology to create, store and experience multimedia content (Singh, 2007). Multimedia applications play a crucial role in education which range from preschool education to postgraduate students and corporate training packages. Multimedia applications can be defined as an application that uses a combination of many media sources such as texts, graphics, audios, videos and animations. It is often use to deliver information which is more powerful than printed learning resources such as printed text book. It also allows users to interact with the information quickly and accurately. Educational multimedia applications enable students to get information in various formats. Examples of multimedia applications are World Wide Web, courseware, interactive TV, computer games, and virtual reality. In education, multimedia application is used to provide computer based training courses and reference books such as encyclopedia. A computer based training courses lets the students go through a series of presentation, text about a particular topic in various information format (Singh, 2007). Multimedia applications are used by teachers and lecturers to convey information such as lecture slides, assessment materials and others learning resources. It can also use by students to learn new skills and knowledge without lecturers guidance. According to Steinmetz and Nahrstedt (1995), â€Å"Multimedia applications are moving from a single PC environment to either a multi-user environment or to a personalized user environment.† The rapid innovation and development in information and communication technologies has been increased the used of multimedia applications in our daily life and brought the changes to computing, entertainment and education. However, educational multimedia applications will not going to replace the roles of teachers or lecturers, it will only allow students to learn more when compare with traditional teaching methods. Multimedia applications for educational purposes are similar like the printed text books and other teaching materials, but they can be come in a wider range of sources. The potential of multimedia applications for educational purposes is well-recognized by the universities, school, government and private organization. Educational multimedia applications can be more focused on specific objectives or in more comprehensive ways (Norhayati Siew, 2004). There has been an increase in demand of educational multimedia applications at all level of citizens for them to apply their knowledge in different field of study and situations. Multimedia applications had greatly influenced the education in many ways. They give teachers or lecturers to prepare study materials for students in a more clearly and comprehensive way such as demonstrate and visualize the study material in a multimedia presentation (Milkova, 2012). Multimedia applications can also be used as a source of information. Multimedia applications can be developed to enhance the learning process and increase the interaction between students and lecturers. Lecturers can make the lesson more interesting by using the multimedia presentations. As the information is presented in variety ways, multimedia applications enhance the user experience and make the learners easier to grasp the information (Singh, 2007). THE ELEMENTS OF MULTIMEDIA APPLICATION IN EDUCATION Although the definition of multimedia application is simple, making it work can be complicated. We need to understand how to make each multimedia element together using educational multimedia computer tools. The elements used in multimedia applications have all existed before. Educational multimedia applications combine those elements into a powerful new tool, especially in the hands of teachers or lecturers and students. Multimedia applications can be used in many areas, for example like educations, businesses, homes and public places. For educational purposes, students can explore variety of information for further understanding by using multimedia applications. Educational multimedia applications are used to improve learning effectiveness. A multimedia learning environment involves numbers of elements in order to enable learning process taking places. There are six main elements in multimedia applications for educational purposes which are texts, images, audio, video, animations a nd user control. Firstly, text is an important element in multimedia applications; it can use to provide information and emphasize specific point by using different styles, fonts, and colours. Secondly, image is an object that has more significant impact than merely reading about text in an educational session. Image can be added to multimedia applications by using colour scanner or digital camera. Examples of image are photographs, artworks, drawings. Thirdly, audio can be used to emphasize certain points and enables teachers to presents a lot of information at once rather than use printed learning resources. Audio allows students to use their imagination without being biased, so it will greatly increase the learning outcome. Fourthly, video can be used to present the information beyond the scope of the ordinary lecture room such as medical operations. The use of video to deliver information can be very powerful and immediately, it allows teachers or lecturers to highlight certain key points or tell the students what are going to do next and understand the real life situation. Fifthly, animation is used to demonstrate an idea or illustrate a concept; an object that appears blurry in video can be presented clearly in animation because it can view the changes of the object over time. Lastly, user control uses to provide students with the option to skip particular parts of the multimedia application and allow them to navigate other areas of that program. All of the elements are combined to provide a platform for students to maximize the effectiveness of educational purposes (Yadav, 2006). ADVANTAGES OF USING EDUCATIONAL MULTIMEDIA APPLICATIONS The growth in use of multimedia applications for educational purposes has accelerated in recent years, and looks set for continued expansion in the future. The multimedia applications play an undeniable role in education. Multimedia applications have many advantages that allow teachers and lecturers to provide other advice which tailored to particular group of learners’ needs (Cairncross and Mannion, 2001). Teachers or lecturers discover the ways to boost student’s interest and motivate them by using educational multimedia applications. Students can also active involve in the learning process by using multimedia applications such as CD-ROM based textbook, tutorials and laboratory experiments (Yadav, 2006). Multimedia applications increase the learning effectiveness and are more attractive than traditional-based learning methods. This new learning environment definitely influence the way of teachers or lecturers teach and the way students learn. Teachers or lecturers continually search for more effective ways to attract their students during learning as well as to increase student learning outcomes. People learn better from words and pictures than from words alone. Therefore, educational multimedia applications use a combination of multimedia elements to present and emphasize particular points only, thus it is more effective because the students are easier to put attention on it rather than on static printed learning materials. Students often split their attention when they are forced to focus information that is far apart, or it is presented at two separate points at the same time. Therefore, when the related content is presented in words and picture at the same time, the learning outcome is more effective. Research found that students will participate in the lesson more actively when teachers or lecturers integrates multimedia element in learning process because they will pay more attention as the lesson becomes more inter esting (Fatimah Puteh Siti Shuhaida, 2009). For example, when the animation and narration are presented simultaneously, students are easier to understand and that information can be quickly integrated into long term memory. A multimedia presentation is an example of multimedia application, it can highlight certain information that teachers or lecturers wants to deliver. Multimedia applications are used to grab student’s attention and generate interest during learning process. It can improve the student’s attitude toward content and learning. Multimedia applications enable students increase their memory of content and foster deeper learning when compared to traditional teaching ways that use by teachers and lecturers. Multimedia applications for educational purposes also can make the learning fun and decrease the anxiety and tension toward certain scary subjects. There is no doubt that the important role of multimedia applications for educational purposes because it can influence the way of teachers or lecturers teach and the way of students learn. Multimedia applications are easy to use by the students or lecturers. Students are able to navigate and retrieve the information quickly because they have the ability to interact with the multimedia applications. Students can learn more when they can control pace of the presentation such as slow down, start and stop at certain information as they want. Multimedia applications are tailored the information need to the individual because it can be presented in different ways to engage students with different learning styles and strengths. Every student may have different preferences and modes to learn about something. As an example, a student prefers to read certain learning materials from prints, while another student may prefer a visual presentation. Therefore, multimedia applications for educationa l purposes are effective to all particular students and lecturers because it is tailored to their needs. DISADVANTAGES OF USING EDUCATIONAL MULTIMEDIA APPLICATIONS Multimedia applications for educational purposes that delivered the learning materials via videos or images need computers, projectors and other electronic devices, so the expenses for these applications can be very expensive. Normally multimedia applications for educational purposes are more expensive than printed text book because it requires expensive hardware. Multimedia applications also not so easy for configuration and requires special hardware to run it. When lecturer uses educational multimedia application, he will shift his role from instructor to facilitator. As the amount of multimedia elements increase, it will slow down the delivery and pace of the learning process. For example, a student was allowed to complete the lesson at their own pace as they navigate the stage of learning materials or students works in a group to view multimedia applications, some of them maybe are not proficient with the technology, thus they need to spend more time on learning computer skills rather than access the information. Sometimes educational multimedia applications are not effective for those who have weak learning skills. From student’s perspective, there is disadvantage exist in educational multimedia applications. Multimedia applications have the limitation such as making an e-learning accessible to all students. For example, some of the applications may not suitable to certain students. A hearing impaired student cannot heard the streaming of audio, thus these multimedia applications are not accessible to all students (Nedeva, Dimova, Dineva, 2010). Another disadvantage of multimedia applications for educational purposes is that students feel isolated and unsupported by teachers or lecturers when they don’t understand certain topics. Teachers or lecturers are not always available when students need help from them; as a result they need to work independently without assistance. Hence, educational multimedia applications are least effective to those who need guidance and assistance from teachers or lecturers. CHARACTETISTICS OF EDUCATIONAL MULTIMEDIA APPLICATIONS There are few characteristics of multimedia applications in education which are screen design, interaction and feedback, navigation, video and audio elements on the development in education. Firstly, screen design is use to coordinate text and graphic elements in order to present sequenced content to facilitate learning and enhance student‘s understanding. Each instruction that display on screen in a multimedia application must provide effective instruction and navigation tools to the students. Screen design also use to boost the interest of the students and convey the required information to them. In short, a good screen design should require focusing student’s attention, maintaining their interest, promoting processing and engagement between student and lesson content, help student find and organize the information and facilitate lesson navigation. The second characteristic is interaction and feedback, it allows student to interact and control the flow of information and stage of learning with the multimedia application. Interaction and feedback also enable student active participant in the instruction learning process and provide feedback immediately following a student response. Feedback is information about the correctness or appropriateness of student’s response which usually displayed on screen. Third characteristic of multimedia applications for educational purposes is navigation. Navigation feature can enhance learning outcome and make an interactive multimedia applications easy to use by the students. Navigation provides students some control over the events and allows them to jump into new sections or revisit the information from earlier screen. Students can also learn and understand more when they can control the multimedia applications such as slow down, start and stop at certain information as they want. Lastly, video and audio elements on the development in education have advantages to present the information to those students who have poor reading and learning skills. Students are easier to understand the lessons which use audio and video to convey the information rather than static learning materials. When audio and video is used to support text, it can provide an opportunity for the students to pause and repeat the sound. (Stemler, 1997) CONCLUSION Multimedia applications are excellent tool for educational purposes. It can improve the effectiveness of learning outcome by deliver the information to the students. Multimedia applications can use to deliver information in an interesting way by combining the elements of texts, images, audios, videos, animations and user control. Multimedia applications have a lot of advantages for the education purposes which can help students have further understanding on certain information or topics. Screen design, interaction and feedback, navigation, video and audio elements are the characteristic of multimedia applications. There is no doubt that the multimedia applications can be used as a tool to assist teachers and lecturers to achieve educational effectiveness. However, multimedia applications for educational purposes have its disadvantages too. Developing a good multimedia application has high cost that involves time and effort of the developer. There are few characteristic that a develop er tries to improve the effectiveness of educational multimedia applications which are attract student’s attention, help students organize the information and facilitate lesson navigation and integrate all the information into knowledge. REFERENCES Cairncross, S., Mannion, M. (2001). Interactive Multimedia and Learning: Realizing the Benefits. 156-164. Fatimah Puteh Siti Shuhaida Shukor. (2009). The Integration Of Multimedia Elements In Classroom Teaching Among TESL Teacher-Trainees. 1-6. Milkova, E. (2012). Multimedia Application Effective Support of  Education.13-21. Nedeva, V., Dimova, E., Dineva, S. (2010). Overcome Disadvantages of E-learning for Training English as Foreign Language. 275-281. Norhayati Abd Mukti, Siew, P. H. (2004). Malaysian Perspective: Designing Interactive Multimedia Learning Environment for Moral Values Education. 143-152. Singh, V. P. (2007). A Text Book of Multimedia. United Stated: Global Media. Steinmetz, R., Nahrstedt, K. (1995). Multimedia: computing, communications, and applications. New York: Prentice Hall. Stemler, L. K. (1997). Educational Characteristics of Multimedia: A Literature Review. 339-359. Vaughan, T. (2010). Multimedia Making It Work, 8th Edition. McGraw Hill Yadav, V. (2006). Using Multimedia in Education. United Stated:  Global Media.