Project Manager Roles

Question: Critically evaluate the role and responsibility of the project manager and analyse the tools and techniques employed in the field of project management. Answer: Critical review of Journal article under consideration: Abiodun, E.J.A., 2009. Human Resources management, an overview. 110-121: Concept Publication. Andries, A.M., Apetri, A.N. Cocris, V., 2012. The impact of the banking system reform on banks performance. African Journal of Business Management Vol 6(6), pp.2278-84. Armstrong, M., 2006. A handbook of Human Resource Management Practice (10th edition). London: Kogan Page. Baker, D.C., 2014. Great Project Managers. [Online] Available at: https://99u.com/articles/6946/top-10-characteristics-of-great-project-managers. Barney, J., 2001. The resource-based view of the firm: Ten years after 1991. Journal of Management, Vol. 27, pp.625-41. Barron, W., 2014. Flexibility and work-life balance: who benefits? In Human Resource Management in Australia. 5th ed. Sydney: McGraw-Hill Australia. pp.315-16. Besner, C. Hobb, B., 2004. An empirical investigation of project management practice: In reality what tools do practitioners use? In D.P. Slevin, D.I. Cleland J.K. Pinto, eds. Innovations: Project Management Research. Newton Square: Project Management Institute. pp.337-51. Businessballs, 2014. Project Management. [Online] Available at: https://www.businessballs.com/project.htm [Accessed 27 April 2015]. CEB information Technology, 2012. Rules to Live By: 10 Guiding Principles for Project Management. [Online] Available at: https://www.executiveboard.com/blogs/rules-to-live-by-10-guiding-principles-for-project-management/. Dvir, D. Lechler, T., 2004. Plans are nothing, changing plans is everything: The impact of changes on project success. Research Policy, 33(1), pp.1-15. Fleming, Q.W. Koppelman, J.M., 2006. Earned Value Project Management. 3rd ed. Newton Square: Project Management Institute. Fray, A.M., 2007. Ethical behavior and social responsibility in organizations: process and evaluation. Management Decisions., 45(1), pp.76-88. Ganaway Nick, B., 2006. Construction business management: A guide to contracting for business success. Auchmuty. Gill, R., 2002. Change management or change leadership? Journal of Change Management, pp.3 (4), 307-318. Hillson, D., 2009. Managing Risk in Projects (Fundamentals of Project Management). Gower. Ika, L.A., Diallo, A. Thuillier, D., 2010. Project Management in the International development industry: The project coordinator's perspective. International Journal of Managing Projects in Business., 3(1), pp.61-93. Institiute, P.M., 2009. A Guide to the Project Management Body of Knowledge: PMBOK Guide. 4th ed. Project Management Institute. Kerzner, H., 2009. Project Management: A Systems Approach to Planning, Scheduling and Controlling. 9th ed. John Wiley and Sons. LT Construction, 2014. International projects. [Online] Available at: https://www.lntecc.com/homepage/common/interprojects.htm. Meredith, J.R., 2014. Project management in practice. (Fifth Edition). Wiley. MetropolitanWashingtonAirportAuthority, 2008. Dulles Corridor Metrorail Project. [Online] Available at: https://www.dullesmetro.com/pdfs/FinalPMPV6-0.pdf [Accessed 03 February 2015]. Nokes, S., 2007. The Definitive Guide to Project Management. Financial Times. Schwabe, K., 2014. Information technology project management. (Seventh Edition). Cenage Learning. Smith, K.A., 2014. Teamwork and project management.(Fourth Edition). McGraw-Hill Education. Steadman, M.E.a.R.F.G., 2005. Implementing accounting education change: Bringing accounting graduates into the management mainstream. Managerial Auditing Journal, pp.10(3), 3-7. SupplyManagement.com, 2004. Oxfam targets better procurement. [Online] Available at: https://www.supplymanagement.com/news/2004/oxfam-targets-better-procurement [Accessed 11 December 2014]. Background: The study is about comparing and finding out relations between the project management efforts and project success following proper success criteria. This study has been done to give support to the idea that the success of a project does not only depends on its prior project planning but also on its monitoring and evaluation using right mix of tools and techniques in the project management. This way the project monitoring and evaluation helps in leaving long term impact on the project completion which proves to be more appropriate as per the project plans. The study has been carried by Lavagnon A. Ika, AmadouDiallo and Denis Thuiller. They carried out the study on 26 different countries in Africa. They actually used the method of questionnaire filling that was actually delivered to the sample population of 600 respondents through mail. There exists no hypothesis or research question in this research work; however the purpose or objective of the study is present. The purpose of the stu dy or main objective is stated as to analyze the empirical relationship among various Project Manager Efforts in the aid industry sector to accomplish project success using a definite set of success criteria and applying various Project Management tools. Literature Review: The researchers reviewed more relevant research studies that have been carried out earlier. These include the followings. According to Dvir and Lechler (2004) various known factors of the project management includes project mission, schedule, budget, scope, plan, and goal, progress measurement, monitoring and reporting. Out of these various factors, the project planning and monitoring is considered as vital factors that needs to be taken under consideration for successful project management. His research made in various companies during the early twenty first century proved that there exist various benefits of applying project management tools which enhances planning and monitoring of the projects. This way the project management techniques help in measuring quality of project to keep control and execute as per the plans. These techniques also help in achieving higher output and gains for the project but still does not ensures success of the project in the end. The reason can be the execution of the project management technique after careful selection and appropriate application. Therefore a proper Proj ect Life Cycle is suggested to be followed through evaluation of the data and information received through research process. This includes to add monitoring, controlling and report as an essential part after the planning process is over. The right monitoring, controlling and reporting can ensure that the project meets its planned outcome and will achieve its targets in the coming future. This way plans are nothing, but changing plans is everything. That is plans are formulated when the project work has not started. Later after the monitoring, controlling and evaluating process starts the project plan needs to apply changes to meet the new requirements. Various project management techniques are also suggested which includes the followings. Log frame or LF, Critical path method or CRM, Scheduling, Budgeting, Program Evaluation Review Technique or PERT. Etc. (Dvir Lechler, 2004) Fleming and Koppelman (2006), the process of implementation phase consisting of monitoring, controlling and reporting have proved to be a critical factor for the large projects to complete on time and as per the requirements. But the same approach has not proved completely effective for moderate size organizations. This is due to the fact that the project stakeholders interest and expectations varies from moderate to large organization. The large organization tends to achieve sustenance in the long run. On the other hand, moderate organization stakeholders has the main interest in earning profits and revenue from the project. Due to this reason the implementation phase of the project observes following a particular project plan in the large organizations but the changes are often seen to meet requirements in the short run by moderate organizations (Fleming Koppelman, 2006). Bersner and Hobbs (2004) identified seventy kinds of project management tools and techniques. They found out that the project managers often uses these different kinds of project management tools at different levels as per the project requirements without considering about the project characteristics. Thus the methods of application in the form of project management tools and techniques are varied but its selections as per the project characteristics depend on the project manager. This way the efficient and effective selection of the project management tools and techniques helps in achieving higher gains and profits for the organization by fulfilling the project and reaching its completion on time and within the available financial constraints. Any wrong selection made by the project management in deciding the project management tools and techniques will certainly cause unnecessary delays and over cost in the project plans(Besner Hobb, 2004). Literature review establishing research needs: The literature review establishes the base as of why the research was necessary or needed. Research was needed actually to take a next step towards the prior research by identifying the factors that could help in successful project completion other than project planning. These way ten factors were identified in the research. These would actually help in acting as a deciding measure to achieve project targets. This way the use of latest project management tools and techniques were made to analyze the factors and find out the desired outcome from them. The research therefore suggested various project management tools and techniques which can be used as measures that were used in the research were as follows. Log frame or LF. Work breakdown structure or (WBS). Activities/responsibilities (CHART). Codification of tasks (CODFIT). Budgeting of tasks (BUDGT). Critical Path Method (CPM). Work Progress Monitoring (MONITW). Monitoring of disbursements (MONITD). Performance indicators (PI). Microsoft project software (MSP). (Ganaway Nick, 2006) These way different measures of project management were actually utilized to achieve the desired outcome from the research. Sample and Data collection: Sample: The sample is a small group which should represent the total study population. When looking at the sample you should pose the following questions: The sample population was 600 recipients of questionnaires in 26 different countries in Africa. These were actually project managers who were taking up with one or other project management task for their respective organization. This way the study population in this journal research paper includes the project managers in 26 countries in Africa. These are the people who are a vital part of the research as the research intends to find out their response to evaluate the practical implications that are followed for any project completion and how it gets affected by different factors. The sample chosen from the study population is done at random. That is the smaple rare slected from the population of project managers in 26 countries. In this Journal research hpaper the sample chose are from the target population of the project managers who are taking up one or other project management project. A total of 600 samples were chosen from the population to get the desired response and output from them. The size of the sample is 600. They are selected from the population of project managers who takes not hand various projects meant to fulfill a particular target or support business process to the organization. The sample is representative as it has taken into consideration the project managers from different countries with different professional status in the organization. These way efforts are made to achieve a more generally acceptable outcome from the research. Data Collection: The researchers have justified in their choice of data collection tools. The tools used by the researchers include the followings. Log frame or LF. Work breakdown structure or (WBS). Activities/responsibilities (CHART). Codification of tasks (CODFIT). Budgeting of tasks (BUDGT). Critical Path Method (CPM). Work Progress Monitoring (MONITW). Monitoring of disbursements (MONITD). Performance indicators (PI). Microsoft project software (MSP). All the above stated statistical methods can help in getting the most appropriate outcome and could help in finding out correlation and variance between different factors under consideration in this research. Strength and Weaknesses: The strength and weakness of this method are as follows. Strength Use of latest techniques and tools of project management has been used. The questionnaires were designed efficiently to meet the desired outcomes. The questionnaires were asked from a good number of people which were termed as sample population consisting of 600 respondents. Efforts made to reach a far effective outcome through getting feedback from sample population from nearly 26 countries in Africa. The selection of various techniques in application has been applied in research. This includes Log frame, Codification of tasks, Budgeting of tasks, Critical Path Method, Work breakdown structure etc. The outcome is clearly stated in statistical form so that the evaluation can related the correlation between the various factors under consideration of the research work. Weakness: 1. Pilot survey was missing. 2. The sample population was disbursed in 26 countries which actually made it difficult to handle them. 3. The use of different techniques and tools was made instead of selecting on a few and most appropriate one for the research work. 4. In this world mailing is considered an old process and instead of that use of email was required to be done for this work this purpose. Data Analysis: The data collection method used was mailing of questionnaires to the 600 sample population which was selected at random so that the desired outcome can be achieved. The data is collected by following a below stated format for data collection. Identification of the project. Project appraisal. Negotiations and approval. Execution and supervision. Execution and completion. Ex-post evaluation. Assistance strategy. Hence the usage of mailing techniques for survey was used on 600 sample population consisting mostly of country in the Sahara region. The questions were mailed in English and French language as well. Nearly 350 questionnaires were in French while the rest 250 were in English. This way data if collected and later validated using the International Development Project Management or IDPM tools using extraction techniques which consider maximum likelihood. Also the use of x^2 test was done for further factor analysis and achieving correlation between the project success measures and Project managers efforts. There is no evidence of a pilot study which helps in getting applied the survey on few people response and compare it with the desired outcome before it is actually applied to whole sample population. Hence a lot of risk was taken while sending questionnaires which could have been curbed through pilot survey. The pilot survey actually could have helped in getting knowledge about the actual survey outcome when the response in pilot survey would have matched the requirements and helped in identifying the issues and problem that might have became obstacle in the actual research process(Nokes, 2007). Study results: The researchers conclusions about the literature are justified up to great extent. He actually wants to convey that mere making plans for the project do not ensure its successful completion. Therefore the plans must follow a definite method or tools of monitoring, controlling and reporting. These tools include methods like Log frame or LF, Critical path method or CRM, Program Evaluation Review Technique or PERT, Scheduling, budgeting etc. These are among the most common techniques that are developed overtime to efficiently and effectively manage the project completion through monitoring, controlling and reporting. There is a need for this study as it helps in further identification of the particular factors that are part of the monitoring, controlling and reporting process which could ensure completion of project and its accomplishment of desired goals. This research takes into consideration ten project success measures which could be responsible for the completion of the project in a stipulated time frame and within the constraints. These include the followings. Identification of the initial objectives of the project. Fixing project time. Fixing project budget. Output as per the estimates. Stakeholders interest is given due important.| Project has an opportunity of getting developed overtime through more time and money investment. Project meets the expectations of the planners. The beneficiaries achieve the satisfactory level of gains. The project shows visible benefits the organization. The project supports the organization process. Thus the above ten factors which are part of the project profile and project impact are considered in this research which will help in analyzing the benefits of monitoring, controlling and reporting to the organization other than just project planning. The main findings of the study were as follows. There existed a not so significant correlation that is between 15 to 31 percent for the project success and project manager tools. Project re-formulation and re-planning tools are among the vital tools that could help in achieving higher success rate. Project monitoring and evaluation helps in easy accomplishment of the project goals and objectives. Therefore there exists high correlation between the project manager efforts on one side and project success variables on the other side. Finally the project profile needs to include the respondents characteristics for further decision making process. (SupplyManagement.com, 2004) Discussion and Conclusions: The researcher made attempts to compare their findings with other research studies but the in-depth analysis and comparison was missing that could spell the main difference or similarities between the research outcomes. The researchers have answered the research question by identifying the main factor that are closely associated with the success rate and efforts of the project manager. The hypothesis were absent, however the research aim was achieved as it found out that the planning has lower correlation in comparison to the monitoring, controlling and reporting. The limitations of their study include the followings. There are not specific columns for research aim, research questions and research objectives. Project hypothesis is completely missing. The prior research does not consist of any qualitative or quantitative outcome that could actually be compared with the outcome of this study. The study findings therefore states that planning plays a lesser important role in project completion and its success. The major factor that correlates with the project success includes the project success factors and project manager efforts. This way an accurate conclusion has been drawn based on the study findings that planning is lesser important than execution, monitoring and reporting(Schwabe, 2014). Own Conclusions and recommendations: The data collection approach used by the researcher was a proper format as per the Baums cycle that can be displayed as follows. Image 1 Thus we see a proper planning and execution method had been followed for the research. The first step was the identification of the project. That is what the project meant to and what its motives were. The second step was project appraisal so that the pre-requisites for project can be easily identified well in advance. The next step was negotiations and approval of the main topics of research. The execution and supervision was later followed to achieve the most appropriate outcome from the research. The next followed was completion of the project and ex-post evaluation was followed so that the desired outcome was achieved and the research meet its target outcome. Finally assistance strategy was followed to reach outstanding outcome. This way proper handling of the survey of 600 people in 26 countries were handled with 350 French questionnaires and 250 English questionnaires. Also the uses of X^2 test was made along with the correlation analysis to measure the relation between the va rious project success measures discussed above with the project managers efforts. This way the study was easy to read as it used easy language to interpret and discuss the outcomes. The use of references at appropriate places further helped in identifying the context of various researchers in this journal research for the same purpose. The study was easy to interpret and the quantitative research methodology further helped in getting the first hand information and outcomes for the research work. The quantitative data was analyzed using the various statistical tools and techniques. These include the usage of followings. Log frame or LF. Work breakdown structure or (WBS). Activities/responsibilities (CHART). Codification of tasks (CODFIT). Budgeting of tasks (BUDGT). Critical Path Method (CPM). Work Progress Monitoring (MONITW). Monitoring of disbursements (MONITD). Performance indicators (PI). Microsoft project software (MSP). (Kerzner, 2009) The outcome of these research methods were used to get the x^2 test and correlation analysis to figure out the possible relation between the project success measures identified above with the efforts of the project manager. The study results were discussed under heading data analysis and results which was actually counted as sixth chapter. The results were presented clearly under different headings such as factor analysis consisting of principal component analysis like LF, WBS, and CPM, PERT etc. Then the correlation analysis was displayed along with different measures. These way efforts were made to showcase the coordinates of the toolboxes on the initial items. Finally the use of descriptive statistics study was made for the average composite to fetch the Project managers tools scores. The benefits of the findings be to the Project Management profession includes the following guidelines for the project manager to achieve high success in their project work. The project manager should consider all the factors that could affect the project. Not only planning for the project but also its effective monitoring, controlling and reporting should be given equal weight age while considering project related requirements. Project success depends on the selection of the most appropriate project management techniques and tools. The project manager responsibility starts with the project identification and planning. This continues till monitoring and controlling and finally ends up with the achievement of various project related goals and objectives. Proper steps are required to be followed to achieve fulfillment in different stages of project development and completion. (Businessballs, 2014) Recommendations: A number of recommendations can be given for the research. The use of hypothesis should be done in research work. The research should consist of prior studies. The research should compare the prior studies with the outcome of the study. The conclusion should be enhanced and made more reflective. The use of data facts and figures should be made along with the diagrams so that the attractive display of outcome can be made. (Barron, 2014) Bibliography Abiodun, E.J.A., 2009. Human Resources management, an overview. 110-121: Concept Publication. Andries, A.M., Apetri, A.N. Cocris, V., 2012. The impact of the banking system reform on banks performance. African Journal of Business Management Vol 6(6), pp.2278-84. Armstrong, M., 2006. A handbook of Human Resource Management Practice (10th edition). London: Kogan Page. Baker, D.C., 2014. Great Project Managers. [Online] Available at: https://99u.com/articles/6946/top-10-characteristics-of-great-project-managers. Barney, J., 2001. The resource-based view of the firm: Ten years after 1991. Journal of Management, Vol. 27, pp.625-41. Barron, W., 2014. Flexibility and work-life balance: who benefits? In Human Resource Management in Australia. 5th ed. Sydney: McGraw-Hill Australia. pp.315-16. Besner, C. Hobb, B., 2004. An empirical investigation of project management practice: In reality what tools do practitioners use? In D.P. Slevin, D.I. Cleland J.K. Pinto, eds. Innovations: Project Management Research. Newton Square: Project Management Institute. pp.337-51. Businessballs, 2014. Project Management. [Online] Available at: https://www.businessballs.com/project.htm [Accessed 27 April 2015]. CEB information Technology, 2012. Rules to Live By: 10 Guiding Principles for Project Management. [Online] Available at: https://www.executiveboard.com/blogs/rules-to-live-by-10-guiding-principles-for-project-management/. Dvir, D. Lechler, T., 2004. Plans are nothing, changing plans is everything: The impact of changes on project success. Research Policy, 33(1), pp.1-15. Fleming, Q.W. Koppelman, J.M., 2006. Earned Value Project Management. 3rd ed. Newton Square: Project Management Institute. Fray, A.M., 2007. Ethical behavior and social responsibility in organizations: process and evaluation. Management Decisions., 45(1), pp.76-88. Ganaway Nick, B., 2006. Construction business management: A guide to contracting for business success. Auchmuty. Gill, R., 2002. Change management or change leadership? Journal of Change Management, pp.3 (4), 307-318. Hillson, D., 2009. Managing Risk in Projects (Fundamentals of Project Management). Gower. Ika, L.A., Diallo, A. Thuillier, D., 2010. Project Management in the International development industry: The project coordinator's perspective. International Journal of Managing Projects in Business., 3(1), pp.61-93. Institiute, P.M., 2009. A Guide to the Project Management Body of Knowledge: PMBOK Guide. 4th ed. Project Management Institute. Kerzner, H., 2009. Project Management: A Systems Approach to Planning, Scheduling and Controlling. 9th ed. John Wiley and Sons. LT Construction, 2014. International projects. [Online] Available at: https://www.lntecc.com/homepage/common/interprojects.htm. Meredith, J.R., 2014. Project management in practice. (Fifth Edition). Wiley. MetropolitanWashingtonAirportAuthority, 2008. Dulles Corridor Metrorail Project. [Online] Available at: https://www.dullesmetro.com/pdfs/FinalPMPV6-0.pdf [Accessed 03 February 2015]. Nokes, S., 2007. The Definitive Guide to Project Management. Financial Times. Schwabe, K., 2014. Information technology project management. (Seventh Edition). Cenage Learning. Smith, K.A., 2014. Teamwork and project management.(Fourth Edition). McGraw-Hill Education. Steadman, M.E.a.R.F.G., 2005. Implementing accounting education change: Bringing accounting graduates into the management mainstream. Managerial Auditing Journal, pp.10(3), 3-7. SupplyManagement.com, 2004. Oxfam targets better procurement. [Online] Available at: https://www.supplymanagement.com/news/2004/oxfam-targets-better-procurement [Accessed 11 December 2014].

What Is Housework and What Changes Are Occurring in This Area of Work Today free essay sample

What is ‘housework’, and what changes are occurring in this area of work today? Broadly speaking, the term ‘housework’ is used to describe the management of the home, which ‘involves a range of activities, the purpose of which is to maintain household members’ (Hatt 1997: 39). Hatt discusses how the industrial revolution and the rise of capitalism created a tidal wave of mass social change; causing production to shift from within the household to the factory. The home is now the site of the ‘reproduction’ of labour, a role which has become strongly gendered; shaped by social policies and ideologies that maintain gender roles(Malos, 1980, Cooke, 2009). There have been a lot of significant changes occurring in the area of housework since the mid 20th century following feminist challenges to the gendered division of labour and social changes that have allowed women more equal opportunities into paid work. However, despite this men have not taken on their fair share of the housework leaving the women to do a ‘second shift’ (Edmond and Fleming, 1975, Craig, 2007). We will write a custom essay sample on What Is Housework and What Changes Are Occurring in This Area of Work Today? or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Today the growing answer to the double shift for many middle class families is the paid domestic worker; and as a result of the growing demand for this service, large domestic leaning companies are commoditising domestic labour. Ehrenreich and Hochschild (2003) argue that despite technological advancements and lower standards of upkeep in the home, domestic cleaning companies strive to provide hard intensive domestic labour ‘the old fashioned way’. The home has become a paid workplace where a Taylorist standardised approach to cleaning is obligatory. Low paid domestic work has long been associated with certain ethnic minorities however; globalisation is intensifying such assertions by employing workers from underdeveloped countries who are willing to accept low wage work. These migrant domestic workers are also further exploited in an emotional sense. In this essay I am going to analyse and further discuss the changes that I have highlighted above, with a lot of reference to Ehrenreich and Hochschild (2003). The gendered division of labour and the gender stereotypes in respect to housework and domestic labour that we identify with today are a product of the capitalist society that we live in. Prior to the industrial revolution the home was itself a site of production for subsistence, and men and women shared domestic labour tasks, despite the fact that they had clearly defined roles both parties still made a near equal contribution to the well-being of the family (Hatt, 1997). Small scale production was also still prevalent in most working class homes at the beginning of the industrial revolution however, as consumption and production patterns changed and capitalism absorbed society and the state, the home became a site for the ‘reproduction’ of labour power (Malos, 1980). As Meillassoux (1972) argued this was the backbone of capitalist society as men were needed for their labour power, and women were encouraged to support the existing workforce; and provide and raise the future workforce (the children); by doing unpaid work in the form of ‘housework’. Malos (1980) argued that several social policies emerged in the wake of capitalism which drove women and children out of the realm of production; and the welfare state further supported that a woman’s place was in the home. Malos also recognised how unequal pay, education and employment opportunities kept women out of the labour market. The film Far from Heaven, Haynes (2002) illustrates how ideologies of femininity, masculinity and family played a significant part in shaping gender roles in the past. The woman is expected to run every single aspect of home life from morning till night, whilst the man plays no role in unpaid housework. The film highlights how advertisements and popular culture shaped the ideal family and shows the high standard of living that was the norm in those days. It also draws on the association of low paid domestic work and race; the black maid is the silent ‘help’ in the home, she does the more labour intensive domestic tasks and supports the impression of the ideal home (Bradshaw, 2003). Feminist movement in the 1960s and 70s sparked ground-breaking changes with regard to women’s employment and other social factors associated with the traditional housewife role. Although not all of these demands were met, women were still granted significantly better opportunities allowing them to more equally enter the realm of production (Malos, 1980). Though many households today are dual earning, and men are doing 240% more housework this is only 1. 7 hours per week, whilst women are doing 7% less this is still on average 6. hours per week (Ehrenreich and Hochschild, 2003). Malos (1980) argues that the struggle with the ‘second shift’ is still very much a burden for working class women, however the global middle class women can afford to pursue their career and maintain their marital home by employing a domestic cleaner. The growing demand for domestic labour is down to many economic and demographic forces however it is also a reflection of changes in society as modern couples want to avoid ‘gender and generational conflict over domestic work’ (Anderson 2003: 106). Women also want to convey the image that they can ‘do it all’, no longer is the simple housewife role socially accepted (Ehrenreich and Hochschild, 2003). The increase in demand is also an indicator of growing inequalities in society, as Ehrenreich (2003) argues in Maid to Order that 40 percent of wealth is owned by 1 percent of households, whilst the bottom 20 percent reports negative assets. These inequalities mean that more wage workers will readily accept low paid domestic work. The growing gap between rich and poor nations is also a significant factor and the growth of globalisation means that wealthy families can afford to essentially outsource labour from less developed countries, and ‘the degradation of others is readily purchased’ (Ehrenreich 2003: 85) Far from Heaven illustrates how the use of paid domestic workers is nothing new (Haynes, 2002); however, the commodification of this service is an altogether new and significant development in the area of housework today. The new corporate-run cleaning services advertise an older model of cleaning; ‘the old fashioned way’ (Ehrenreich, 2003). Ehrenreich and Hochschild (2003) argue that these companies pride themselves on their high standards of cleanliness for the home; and they achieve this by conveying associations with the traditional idea of the ideal home and ideal housewife of the fifties, as illustrated in Far from Heaven (Haynes, 2002). These companies are so successful because of the illusion that many modern women want to preserve of being able to â€Å"do it all†; by hiring a cleaner through an agency they have no personal human contact with the workers (Ehrenreich, 2003). As Ehrenreich (2003) argues; asking an independent hired housecleaners to scrub the floor on their hands and knees would be seen as degrading and unacceptable so these companies provide the service without the hassle. These cleaning agencies also ensure that homemakers do not have to rely on only one cleaner who may have other commitments or may need time off due to illness. For the householder the home is ‘home however for the paid domestic worker the home is essentially now ‘work’ and housework is their job. Domestic cleaning companies have implemented practises to ensure rder and division of labour in a Taylorist fashion (Ehrenreich, 2003). Whilst men are doing more in terms of housework, there are many women still doing the double shift especially in working class homes. However, the middle class are hiring paid domestic workers to do it for them, the home as a workplace is not a new development but the commodification of this service has led to huge changes in the area of housework today. The taylorisation of the home is one of the most significant developments. Globalisation has also led to more migrant workers than ever and resultantly the racialization of low paid domestic work. Bibliography BRADSHAW, P. 2003. Far from Heaven. The Guardian [Online]. COOKE, L. 2009. The Politics of Housework. In: JUDITH TREAS, S. D. (ed. ) Dividing the Domestic: Men, Women and household work in Cross-National Perspective. Stanford: Stanford University Press. CRAIG, L. 2007. Is There Really a Second Shift, and If so, Who Does It? A Time-Diary Investigation. Feminist Review, 149-170. EDMOND, W. amp; FLEMING, S. 1975. All work and no pay: women, housework, and the wages due, Power of Women Collective. EHRENREICH, B. 2003. Maid to Order. In: BARBARA EHRENREICH, A. H. (ed. ) Global Woman: Nanies, Maids and Sex Workers in the New Economy. London: Granta Publications. EHRENREICH, B. amp; HOCHSCHILD, A. R. 2003. Introduction. Global Woman: Nannies, Maids and Sex Workers in the New Economy. Granta Books. HATT, S. 1997. Housework, Childcare and Employment. In: CAMPLING, J. (ed. ) Gender, Work and Labour Markets. Basingstoke: Macmillan Press. Far From Heaven, 2002. Directed by HAYNES, T. MALOS, E. 1980. The Politics of housework, Allison amp; Busby. MEILLASSOUX, C. 1972. From reproduction to production. Economy and Society, 1, 93-105.

Persuasive portfolio of Net

Piece One Chosen Service: Net-A-Porter, an online luxury fashion retailer (Net-A-Porter 2013).Advertising We will write a custom report sample on Persuasive portfolio of Net-A-Porter and Samsung Smart TV specifically for you for only $16.05 $11/page Learn More Target Audience: Online female customers, 18-55 years old. These women belong to the middle and upper-middle social classes, the customers are employed, and they have little time for shopping. The potential and existing female customers pay much attention to their look and appearance. The proposed piece is the 1-page advertisement which can be published in the magazines for women. Visuals: The provided visual is the high-quality photograph. The young woman worn the luxurious evening dress, a hat with feathers, and long gloves is depicted lying on a white sofa and looking directly into the lens. The woman is smiling. The colors and tones of the dress, hat, and gloves are purple. The background is da rk, with the focus on using dark-red and dark-purple colours, but it is possible to notice the elements of luxury in the room’s interior. On the right, there is a window. The white snow can be observed through the window. It is also possible to notice a laptop on the low table near the sofa because this modern laptop disharmonises with the whole picture and its style. The company’s logo is in the upper left corner of the page; the headline is centred on the page top. The body copy is presented in columns at the foot of the page. Copy: Headline: â€Å"Luxury is the must-have for your winter†. Body copy: â€Å"Net-A-Porter is the world-leading online fashion retailer which makes your days full of comfort and luxury because it is the first online retailer which combines the elements of luxury with the idea of comfort for women.Advertising Looking for report on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn Mo re Serving for women’s interests in the industry more than ten years, we know what women want to emphasise their elegance and to save their time. While visiting the Net-A-Porter website, the world of style and high fashion becomes closer, and luxury becomes your must-have with one click. Take a chance to make your winter warmer and more luxurious!† Explanation of Persuasive Techniques: The persuasive character of the piece is based on appealing to the target audience’s emotions. Thus, the main rhetoric appeal used in this form of the marketing communication is the pathos. The advertisement is effective to influence the female desire to receive the access to luxury in relation to fashion and style. The visual serves to develop the image of a successful woman for whom luxury related to clothing and style is something usual and available with the help of the Internet resources. The contrast in presenting the luxurious interior and dress along with the modern lapto p emphasises the idea of the fashion’s availability for each woman with the help of one click, as it is accentuated in the body copy. The observed contrast adds to appealing to the female customers’ emotions because they are expected to choose the online retailer as their source for high fashion items. The representatives of the target audience are expected to become interested in the high-quality photograph and to determine the connections between the idea of luxury and Net-A-Porter as the online luxury fashion retailer (Dahlen, Lange, Smith 2010, p. 103). The next step to affect the target audience’s behaviour is the manipulation of the notions typical for the fashion industry and observed in the magazines to develop associations. Thus, the headline states that â€Å"Luxury is the must-have for your winter†. ‘The must-have’ is associated with items which are discussed as fashionable during the certain season. The headline uses the pathos t o appeal to the women’s emotions and to make them believe that ‘luxury’ available with the help of Net-A-Porter resources is rather fashionable and popular during this winter. The combination of the pathos, ethos, and logos appeals is observed in the body copy of the advertisement. The logos and ethos appeals are used together to support each other in such a sentence as â€Å"Serving for women’s interests in the industry more than ten years, we know what women want to emphasise their elegance and to save their time†.Advertising We will write a custom report sample on Persuasive portfolio of Net-A-Porter and Samsung Smart TV specifically for you for only $16.05 $11/page Learn More The appeal to credibility depends on describing the company’s experience with the help of providing the years of working within the industry. Moreover, this appeal serves as the argument for the next part of the sentence to appeal to the reason and logic. Thus, the company has the great experience in the industry and can satisfy the women’s needs appropriately. The phrase that â€Å"we know what women want to emphasise their elegance and to save their time† sounds confidently and assertively while contributing to the idea of the company’s credibility and expertise in relation to retailing high-quality products online. The open call to action based on the pathos is provided in the final sentence where the potential customers are asked to take a chance and make their winter warmer and more luxurious with references to the central idea of combining luxury and comfort aspects. Piece Two Chosen Service: Samsung (Smart TV) (Samsung Smart TV 2013). Target Audience: The existing customers who choose Samsung technologies and potential female and male customers who orient to choosing innovation, 21-50 years old. The customers are interested in new technologies and innovations in the sphere of television and Internet. The customers are also interested in Samsung products and the company’s research and development’s base. The proposed piece is the street billboard which can be copied as the advertisement for newspapers and magazines. Visuals: The background of the billboard is the cosmic space with sparkling stars and vivid meteors presented in dark-blue tones. The logo of the company is provided in the upper left corner. The headline is provided in bold caps at the top of the page.Advertising Looking for report on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More The body copy is presented in a bullet form at the foot of the page, on the left. Multiple colourful images of modern TV sets are depicted as making a powerful space hopper. The image is located at the center of the billboard. Copy: Headline: â€Å"Power is in smartness: Widening the horizons with Samsung Smart TV†. Body copy: â€Å"- Samsung Smart TV is the new remarkable stage in the development of television and Internet technologies. Samsung Smart TV is based on knowledge and innovation. Samsung Smart TV is the source of power for you. Samsung Smart TV is your opportunity to widen the horizons and focus on new perspectives†. Explanation of Persuasive Techniques: The billboard works to persuade the target audience to choose Samsung products because the message is based on the AIDCA principle. The target audience consisting of men and women of 21-50 years old is expected to pay attention to the large and rather vivid billboard with the well-known company’s l ogo and bright image demonstrating the space hopper. The attention to the image of the space hopper made from TV sets using Samsung Smart TV is based on its unrealistic character. The next stage to persuade the target audience is in evoking the interest to the product. The headline works to provoke the customers’ interest with references to the ideas of power, smartness, and widened horizons. These concepts are closely associated with the people’s interests, needs, and desires. At this stage, the advertisement depends on the pathos because of appealing to the customers’ emotions and desires to become smarter, more powerful, and to learn more without being restricted by external forces. Furthermore, the target audience becomes more convinced that Samsung technologies can provide people with extreme opportunities in relation to power, knowledge, and smartness because the word ‘smartness’ is associated with the technologies’ name, Samsung Smart TV. This stylistic tautology serves to emphasise the meaning of Samsung Smart TV for creating the customers’ knowledge base and for widening their horizons with the help of these technologies. According to the AIDCA principle, the next stages are the stimulation of the customers’ desire to purchase the product and the call to action. Following the format of the billboard, the body copy information is provided in the bullet form in order to draw the target audience’s attention to the most important benefits and advantages of the product. In this case, the repetition of the product’s name at the beginning of the sentences as the anaphora also serves to draw the audience’s attention to the list of product’s advantages. The ideas listed in the bullet form reflect the idea presented in the headline while intensifying the persuasive effect (Yadin 2001, p. 38-42). From this point, all the rhetorical devices and communication techniques are combined to capture the attention and to produce the strong effect on the target audience. Reference List Dahlen, M, Lange, F, Smith, T 2010, Marketing communications: a brand narrative approach, John Wiley Sons, USA. Net-A-Porter 2013, https://www.net-a-porter.com/ua/en/. Samsung Smart TV 2013, https://www.samsung.com/us/. Yadin, D 2001, Creative marketing communications, Kogan Page Publishers, USA. This report on Persuasive portfolio of Net-A-Porter and Samsung Smart TV was written and submitted by user Jordyn D. to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.

Dragon ball z essays

Dragon ball z essays The characters that are drived from fiction and imagination consist of many different forms of character traits. They can have characteristics of courage, cleverness, strength, power, loyalty and other characteristics that make up him or her as a super hero, but the characteristics that he or she possesses will make him look masculine or feminine. The character I will be describing is Goku, a main character from a great cartoon Dragon Ball. Like Superman, he is from another planet sent by his father to Earth because his planet Vegita was destroyed. Goku is different from the people on Earth because he has extraordinary powers like Superman. He can fly, move mountains, run at a blitzing speed and has many other powers that puts him in a different class from the people on Earth. The characteristics that he embodies are undeniably a man's feature which he uses to save people's lives and use for the good of the people. The hero, Goku, is a seemingly invincible person with all the extraordinary traits required of a character of a male hero. He is able to use his super-human physical strength and courage to put his people before himself. He encounters hideous monsters and the most ferocious of beasts but he never fears the threat of death. His leadership skills are superb and he is even able to boast about all his achievements. He has little or no emotions that puts his work in the line of danger. His priority is always to save people and his friends. These characteristics of strength, courage, and loyalty are all characteristics that classifies him as masculine. ...

Describe a picture Essay Example | Topics and Well Written Essays - 250 words - 1

Describe a picture - Essay Example In particular, the use of red, black and dark blue serves to show how urban lifestyles leave individuals feeling secluded. The juxtaposition of dark and light hues gives the illusion of cramped spaces - both in geographic terms and as a metaphor for the state of mind of a city-dweller. We can also see in the painting how a cityscape is illustrated through the use of straight lines, sharp edges and angles. They could be interpreted as representing the rigid racial and class divisions that prevail in modern societies. They also stand for the harshness and monotony of contemporary livelihoods. It is instructive to look at the artist’s broader interests to better comprehend the painting. To note, Scarlett has had an active interest in art forms other than painting. These include jewelry designing and deco designing as well. As a result, his understanding of sense of space as a three-dimensional construct is unique. This is amply brought to bear in the Bird’s Eye

Clean Snows of Petawawa Assignment Example | Topics and Well Written Essays - 1000 words

Clean Snows of Petawawa - Assignment Example Captain Kearney, the unit’s C.O., dismissively ignores the atrocities committed by the forces under his command and only asks the community to move on, which is lack of empathy as a normal human being could have only offered an apology and duly compensate the villagers for the loss. In his discussion with the tribal leaders, the captain reflects the American Grand Narrative in which American policy focused on a commitment to global leadership whereby a policy of interventionism is the order of the day with any errors and misjudgments committed being carried out in good faith (Ashbrook, 2010). For this reason, the attitude shown by the captain, when talking with the tribal leaders, shows that he considered the errors committed by the platoon under his command as done in good faith. In this case, the soldiers accidentally killed innocent villagers although the overall the overall objective of helping the community live in peace after years of atrocities committed by the rebels that the coalition forces were fighting justified the killings. Peacekeepers in Somalia, the author engages in a discussion by tracing the story in which Canadian peacekeepers engaged in violence against Somalis with the atrocities committed by the Canadians disappearing from Canada’s legal and national cognizance. To Razack (2000) the Canadian grand national narrative of ‘clean snows’ and peacekeepers who are supposed to be innocent contributed to the disappearance of the atrocities committed since the Canadian forces could not commit such atrocious acts to other human beings based on the country’s grand narrative. To recap, the story involves Canadian forces from the base in Petawawa who were sent as peacekeepers to perform their duties in Somalia. As peacekeepers, they were expected to maintain peace, in the Somali War of 1992, and it was the expectation of the world and Canadians to have their soldiers act.

Effects of Drowning on the Body

Effects of Drowning on the Body According to the new definition adopted by the WHO in 2002, Drowning is the process of experiencing respiratory impairment from submersion/immersion in liquid. Drowning is defined as death from asphyxia that occurs within the first 24 hours of submersion in water. Near drowning refers to survival that lasts beyond 24 hours after a submersion episode. Hence, it connotes an immersion episode of sufficient severity to warrant medical attention that may lead to morbidity and death. Drowning is, by definition, fatal, but near drowning may also be fatal. (2) Drowning is the seventh leading cause of accidental death in the United States. Though the exact incidence in India can only be a crude estimate, one keeps coming across incidences of drowning fatalities. Many boating accidents lead to fatalities, possibly due to concomitant accidental injuries or trapping in submerged boat. Motor vehicle accidents with a fall in streams or ponds are also being reported with similar settings. Drowning can also occur in scuba divers but may be associated with cardiac event or arterial gas embolism. Other possibilities to be kept in mind include hypothermia, contaminated breathing gas, oxygen induced seizures. Even community swimming pool and home bathtubs and buckets are known to be adequate for young children to drown accidentally. Majority of such events are due to unsupervised swimming, esp in shallow pools or pools with inadequate safety measures. One look for features of closed head injury or occult neck fractures while management of such cases. Intentional hyperventilation before breath-hold diving is associated with drowning episodes.(3) Weak swimmers attempting to rescue other persons may themselves be at risk of drowning. Males are more likely than females to be involved in submersion injuries. This is consistent with increased risk-taking behavior in boys, especially in adolescence.(4) CAUSES OF DROWNING Alcohol consumption, which impairs coordination and judgement Failure to observe water safety rules e.g. having no life preserver or unsupervised swimming. Sustaining a head and neck injury while involved with a water sport Boating accidents Fatigue or exhaustion, muscle and stomach cramps Diving accidents including scuba diving Medical event while in the water e.g. seizure, stroke, and heart attack Suicide attempt Illicit drug use Incapacitating marine animal bite or sting Entanglement in underwater growth Drowning and near-drowning events must be thought of as primary versus secondary events. Secondary causes of drowning include seizures, head or spine trauma, cardiac arrhythmias, hypothermia, syncope, apnea, and hypoglycemia. PATHOPHYSIOLOGY Drowning occurs when a person is submerged in water. The principal physiologic consequences of immersion injury are prolonged hypoxemia and acidosis, as a result of immersion in any fluid medium. The most important contribution to morbidity and mortality resulting from near drowning is hypoxemia and its consequent metabolic effects. Immersion may produce panic with its respiratory responses or may produce breath holding in the individual. Beyond the breakpoint for breath-hold, the victim reflexly attempts to breathe and aspirates water. Asphyxia leads to relaxation of the airway, which permits the lungs to take in water in many individuals (wet drowning). Approximately 10-15% of individuals develop water-induced spasm of the air passage, laryngospasm, which is maintained until cardiac arrest occurs and inspiratory efforts have ceased. These victims do not aspirate any appreciable fluid (dry drowning). It is still controversial whether such a drowning occurs or not.(5) Wet drowning is caused by inhaling large amounts of water into the lungs. Wet drowning in fresh water differs from salt water drowning in terms of the mechanism for causing suffocation. However, in both cases water inhalation leads to damage to the lungs and interfere with the bodys ability to exchange gases. If fresh water is inhaled, it passes from the lungs to the bloodstream and destroys red blood cells. If salt water is inhaled, the salt causes fluid from the body to enter the lung tissue displacing the air. The pathophysiology of near drowning is intimately related to the multiorgan effects secondary to hypoxemia and ischemic acidosis. Depending upon the degree of hypoxemia and resultant acidosis, the person may develop cardiac arrest and central nervous system (CNS) ischemia.CNS damage may occur because of hypoxemia sustained during the drowning episode per se or may occur secondarily because of pulmonary damage and subsequent hypoxemia. Additional CNS insult may result from concomitant head or spinal cord injury. Although differences observed between freshwater and saltwater aspirations in electrolyte and fluid imbalances are frequently discussed, they rarely of clinical significance for people experiencing near drowning. Most patients aspirate less than 4 ml/kg of fluid. 11 ml/kg is required for alterations in blood volume, and more than 22 ml/kg of aspiration is required before significant electrolyte changes develop. Regardless, most patients are hypovolemic at presentation because of increased capillary permeability from hypoxia resulting in losses of fluid from the intravascular compartment. Hyponatremia may develop from swallowing large amounts of fresh water. The temperature of the water, not the patient, determines whether the submersion is categorized as a cold or warm drowning. Warm-water drowning occurs at a temperature greater than or equal to 20Â °C, cold-water drowning occurs in water temperatures less than 20Â °C, and very cold-water drowning refers to temperatures less than or equal to 5Â °C. Hypothermia reduces the persons ability to respond to immersion, finally leading to helplessness or unconsciousness. Pulmonary Effects Aspiration of only 1-3 ml/kg of fluid can result in significantly impaired gas exchange. Fresh water moves rapidly across the alveolar-capillary membrane into the microcirculation. It causes disruption of alveolar surfactant, producing alveolar instability, atelectasis, and decreased compliance with marked ventilation/perfusion (V/Q) mismatching. As much as 75% of blood flow may circulate through hypoventilated lungs which acts as a shunt. Salt water, which is hyperosmolar, increases the osmotic gradient, and therefore draws fluid into the alveoli. Surfactant washout occurs, and protein-rich fluid exudates rapidly into the alveoli and pulmonary interstitium. Compliance is reduced, alveolar-capillary basement membrane is damaged directly, and shunt occurs. This results in rapid induction of serious hypoxia. Both mechanisms cause pronounced injury to the alveoli/capillary unit resulting in pulmonary edema. Fluid-induced bronchospasm also may contribute to hypoxia. Increased airway resistance secondary to plugging of the patients airway with debris (vomitus, sand, silt, diatoms, or algae), as well as release of inflammatory mediators, result in vasoconstriction and reactive exudation, which impairs gas exchange. A high risk of death exists secondary to the development of adult respiratory distress syndrome (ARDS), which has been termed postimmersion syndrome or secondary drowning. Late effects include pneumonia, abscess formation, and inflammatory damage to alveolar capillary membranes. Postobstructive pulmonary edema following laryngeal spasm and hypoxic neuronal injury with resultant neurogenic pulmonary edema also may play roles. Cardiovascular Effects Hypovolemia is secondary to fluid losses from increased capillary permeability. Profound hypotension may occur during and after the initial resuscitation period. Ischemic metabolic acidosis due to lactic acid accumulation impairs cardiac function. This may often be a large component especially when the victim struggles violently trying to save himself. In addition, hypoxemia may directly damage the myocardium. Myocardial dysfunction result from ventricular dysrhythmias and asystole, decreasing cardiac output. Pulmonary hypertension may result from the release of pulmonary inflammatory mediators, which increase the right ventricular afterload, thus decreasing contractility. CNS Effects If hypoxemia and decreased cardiac output persists long enough, anoxic brain damage can ensue. Improvement in the management of pulmonary dysfunction caused by near drowning has left CNS injury the major determinant of subsequent survival and long-term morbidity. Hypothermia Thermal conduction of water is 25-30 times that of air. The temperature of thermally neutral water, in which a nude individuals heat production balances heat loss, is 33Â °C. Physical exertion increases heat loss secondary to convection/conduction. A significant risk of hypothermia usually develops in water temperatures less than 25Â °C. Other Effects The clinical course may be complicated by multiple organ failure resulting from prolonged hypoxia. Disseminated intravascular coagulation, hepatic and renal insufficiency, metabolic acidosis, and gastrointestinal injuries must be considered and appropriately managed. CLINICAL FEATURES (6) History All aspects leading to the submersion episode should be determined. Most patients are found after having been submerged in water for an unobserved period. Rarely does a patient present with the classic story of a novice swimmer stranded in water, frantically struggling and flapping arms in desperation. It is important to extract certain relevant factors in the beginning of resuscitative efforts, which include submersion time, associated trauma (especially cervical spine and head), drug or alcohol ingestion, type of water, degree of water contamination, water temperature, and response to initial resuscitation maneuvers. Pertinent past medical history must be obtained to look for secondary causes of drowning, particularly trauma, seizures, cardiac disease, syncope, exhaustion, alcohol and drug use, hypothermia, diabetes mellitus, psychiatric history with suicidal tendencies or panic disorder, poor neuromuscular control such as severe arthritis or neuromuscular disorder. Physical Examination The clinical presentation of people who experience submersion injuries varies greatly. A victim of a submersion incident may be classified initially into one of the following four groups: a) Asymptomatic b) Symptomatic, manifesting with: Altered vital signs (eg, hypothermia, tachycardia, bradycardia) Anxious appearance Tachypnea, dyspnea, or hypoxia Metabolic acidosis (may exist in asymptomatic patients as well) Altered level of consciousness, neurologic deficit. Vomiting. c) Cardiopulmonary arrest, manifesting as: Apnea Asystole, ventricular tachycardia or fibrillation, bradycardia Immersion syndrome d) Obviously dead, as noted by: Normothermic with asystole Apnea No apparent CNS function Rigor mortis Dependent lividity The following clinical conditions need to be excluded Spinal Cord Injuries Head trauma Cardiac Arrhythmias Seizures Laboratory workup An electrocardiogram is indicated if there is evidence of significant tachycardia, bradycardia, or dysrhythmia or risk of underlying cardiac disease. Arterial blood gas analysis is probably the most reliable clinical parameter in patients who are asymptomatic or mildly symptomatic. A surprising degree of hypoxia can exist without clinical signs. Draw blood for serum glucose levels, complete blood cell count, serum electrolyte levels, liver enzymes, lactate level, and coagulation profile, if indicated. Continuous pulse oximetry and cardiorespiratory monitoring may be needed. Chest radiography should be done for evidence of aspiration, pulmonary edema, or segmental atelectasis suggesting foreign body aspiration. Acute renal impairment is known to occur frequently in near drowning, and while usually mild, severe renal impairment requiring dialysis may occur. If initial tests show elevated serum creatinine, marked metabolic acidosis, abnormal urinalysis, or significant lymphocytosis, serial estimations of serum creatinine should be performed. Cervical spine radiograph or computerized tomography (CT) scanning is helpful in individuals with history of trauma, neck pain, or if doubt exists about the circumstances surrounding the submersion injury. Non contrast head CT scanning is helpful in an individual with altered mental status and a suggestive or unclear history of head trauma. Treatment Pre Hospital Care Optimal pre-hospital care is the most significant determinant of outcome in the management of immersion victims. The patient should be removed from water at the earliest opportunity. If spinal trauma is suspected the individual should be moved the least amount possible, with attention to cervical spine stabilization. The primary aims of treatment of the near drowning cases should be in the order of priority, as below.(7) Effective immediate relief of hypoxia. Restoration of cardiovascular stability. Prevention of heat loss. Speedy evacuation to hospital. As in any rescue initiative, initial treatment should be geared toward ensuring patency of the airway, breathing, and circulation. Initiate rescue breathing immediately, if feasible even while the patient is still in the water. Chest compressions are not effective in the water and waste valuable time. The Heimlich maneuver has not been shown to be effective in removing aspirated water. In the patient with an altered mental status, the airway should be checked for foreign material and vomitus and debris visible in the oropharynx should be removed with a finger-sweep maneuver. Higher pressures may be required for ventilation because of the poor compliance resulting from pulmonary edema. Supplemental 100% oxygen by mask should be administered as soon as available. The degree of hypoxemia may be difficult to determine on clinical observation. Begin rewarming; wet clothing is ideally removed before the victim is wrapped in warming blankets. Hospital Care (7-9) Even those victims who appear normal on arrival at hospital can deteriorate rapidly. An accurate and rapid initial assessment of the victim is essentialInitial management of near drowning should place emphasis on basic life support algorithms and on immediate resuscitation and treatment of respiratory failure, with establishment of an adequate airway and cardiopulmonary resuscitation, if necessary. Associated injuries must be considered, as in any other form of accidental injury. Consider potential spinal injuries, especially in diving accidents. The need for hospitalization is determined on clinical evaluation. Provide all victims of a submersion injury with supplemental oxygen during their evaluations. Noninvasive continuous pulse oximetry is valuable. Patients with completely normal findings on examination and trivial history may be discharged after a 6-hour observational period. Admit any patient with respiratory symptoms, altered oxygenation by pulse oximetry or blood gas analysis, or altered mental status. The most critical role in management is prompt correction of hypoxemia and acidosis. Immediate use of supplemental oxygen with laryngeal mask or other devices achieving high fractional inspired oxygen should be instituted. Consider intubation and mechanical ventilation in any patient with poor respiratory effort, altered sensorium, severe hypoxemia, severe acidosis, significant respiratory distress, if a patient is unable to maintain a PaO2 of greater than 60-70 mm Hg (>80 mm Hg in children) on 100% oxygen by face mask or PaCO2 is > 45 mm Hg. Endotracheal intubation and mechanical ventilation may be indicated in awake individuals unable to maintain adequate oxygenation on oxygen, by mask or via continuous positive airway pressure (CPAP) or in whom airway protection is warranted. Intubated victims of submersion injury may require 5-10cm H2O PEEP may improve oxygenationpositive end expiratory pressure (PEEP) with mechanical ventilation to maintain adequate oxygenation. PEEP has been shown to improve ventilation patterns in the noncompliant lung in several ways, including 1) shifting interstitial pulmonary water into the capillaries, 2) increasing lung volume via prevention of expiratory airway collapse, 3] providing better alveolar ventilation and decreasing capillary blood flow, and 4) increasing the diameter of both small and large airways to improve distribution of ventilation. Pulmonary insufficiency due to drowning may warrant use of surfactant, though its efficacy to be used routinely in all cases has not been demonstrated. Bronchoscopy may be necessary for removal of significant inhaled foreign bodies, such as water debris or aspirated food Intravascular volume depletion is common, secondary to pulmonary edema and intracompartmental fluid shifts, regardless of the type of fluid aspirated. Rapid volume expansion may be indicated using isotonic saline. Ventricular dysrhythmias (typically, ventricular tachycardia or ventricular fibrillation), bradycardia, and asystole may occur as a result of acidosis and hypoxemia, rather than due to electrolyte imbalances. Inotropic support may be required using dopamine or dobutamine. Central venous pressure monitoring may be warranted. Most acidosis is restored after correction of volume depletion and oxygenation. Sodium bicarbonate may be administered in cases of severe acidosis that do not correct using the above measures, but only administer it after adequate ventilation has been established. Most immersion victims become hypothermic gradually and are at risk for ventricular fibrillation and neurologic injury. Re-warming method is dependent on the degree of hypothermia and the patients response. Aggressively rewarm hypothermic patients to restore normal body temperature. Core rewarming with warmed oxygen, continuous bladder lavage with fluid at 40Â °C, and intravenous infusion of isotonic fluids at 40Â °C should be initiated during resuscitation. Warm peritoneal lavage may be required for core rewarming in severely hypothermic patients. Place a nasogastric tube for removal of swallowed water and debris and to assist in rewarming efforts. Urinary catheterization for ongoing urine output measurement may be warranted to assess urine output. The benefits of resuscitative efforts should be continuously reassessed in such situations. Initiate appropriate treatment of hypoglycemia and other electrolyte imbalances, seizures, bronchospasm, cold-induced bronchorrhea, dysrhythmias and hypotension as necessary. Corticosteroids have been shown to be of no benefit in the management of near drowning. Routine antibiotic prophylaxis is not indicated unless the patient was submerged in grossly contaminated water or sewage. Patient disposal depends on the history, presence of associated injuries, and degree of immersion injury. Victims, who only have mild symptoms that improve during observation and have no abnormalities on arterial blood gas studies or pulse oximetry and chest radiograph, should be observed for a more prolonged period of time in the emergency department (about 6 hours). Certain patients may display mild to moderately severe hypoxemia that is corrected easily with oxygen. Admit these patients to the hospital for observation and discharge only after resolution of hypoxemia, if they have no further complications. All patients requiring intubation and mechanical ventilation should be admitted to the Intensive Care Unit. Varying degrees of neurologic as well as pulmonary insults typically complicate their courses. COMPLICATIONS Immediate complications are secondary to hypoxia and acidosis. The immediate threat is the effect on the cardiovascular system. Hypoxia and acidosis may lead to cardiac dysrhythmias, including ventricular fibrillation and asystole. Myocardial damage may lead to cardiogenic shock. Monitor and maintain intravascular volume and blood pressure. Central venous pressure (CVP) monitoring is useful in those patients requiring intensive care. Aspiration of fresh or salt water alters the function of surfactant, causing injury to the alveoli and pulmonary capillaries. Increased capillary permeability can worsen the hypoxia. Continuous pulse oximetry is useful. The early use of supplemental oxygen with high levels of positive end-expiratory pressure is helpful in reversing hypoxemia. Central nervous system effects depend on the severity and duration of hypoxia. Post hypoxic cerebral hypo perfusion may occur. Cerebral edema and intracranial hypertension secondary to hypoxic neuronal injury is frequently observed, but studies have shown that invasive monitoring of intracranial pressure is neither useful nor necessary in near-drowning incidents. Near-drowning patients frequently develop pneumonia, often due to secondary bacterial infections. Whether prophylactic antibiotics are beneficial is still controversial. Chemical pneumonitis also is not infrequent, especially if the submersion occurs in chlorinated or severely contaminated pools. PROGNOSIS The most significant impact on morbidity and mortality occurs before the patient arrives at the hospital. The prognosis is related directly to the duration and magnitude of hypoxia. Poor survival is associated with the need for continued cardiopulmonary resuscitation efforts on arrival to the hospital. Many survivors have long-term neurologic sequelae. If they recover from the pulmonary effects of the submersion, patients who are fully awake on arrival to the hospital generally do very well. Neuro-protective effects only seem to occur if the hypothermia occurs at the time of submersion and only with very rapid cooling in water less than 5Â °C. PREVENTION In most instances, drowning and near drowning can be prevented with simple safety measures and common sense. Most young children enter a swimming pool directly adjacent to their home or one with inadequate fencing or unlatched gates or doors. Adult supervision is essential in the prevention of drowning. Because lapses of supervision are inevitable, other safety precautions must be in place. The use of adequate fencing around swimming pools decreases the number of immersion injuries significantly. The enclosure may be a wall or fence at least 4 feet tall that completely surrounds a pool on all four sides. Doors and gates to the pool should be self-closing and self-latching. The use of personal flotation devices may reduce the incidence of drowning among children when playing in natural bodies of water or when boating. Pool owners should be trained on basic life support. Both children and adults should be instructed to never swim alone or unsupervised. Alcohol and drugs should not be used when operating or riding in motorized watercraft.