Friday, November 29, 2019

Marketing Analysis Polyphonic HMI free essay sample

Uncertain Attractive Yet Challenging Music Industry Landscape The music Industry is a 32 billion dollar industry, offering a huge opportunity if it can be penetrated. However, it is fraught with challenges. Arthritiss, producers, and record companies have little idea on how to find and create success in the industrys ABA. The dominant players, I. E. Record companies outfit pursuing the production of teethe next big hit by producing In masses and hoping hope that one turns out good, . This Is shown evidenced by the low hit success rate of 10%. A song topping music charts (Peg. 1, PA). What entails is an Industrial marketing practice of huge inefficiencies and unwise budget expenditure (Peg. 8, PA4). These problems stem from the market interactions of the industry, such as theistic is dictated by popular culture. There is constant and rapid evolution due to both volatility of popular music culture and lack of fail-safe apparatus to accurately predict upcoming trends. We will write a custom essay sample on Marketing Analysis Polyphonic HMI or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Hence, all segments need a tool that Improver tool that Improves their chances of landing a hit song and reduce the need for excessive marketing expenditure..The satisfaction gratification of this need is ever more urgent due to falling sales and increasing music piracy (Peg. 5, PA). Can HAS be the answer to the industry needs? 2. Harnessing Overcoming Polyphonic HIM Barriers Opportunities Polyphonic HIM has significant barriers to overcome. Upon failing to impress hardware providers, HIM is lacking capital and time. In an Industry that Is normally associated with art, they have not found a way to make science and music mesh.However, they possess the potential to revolutionize the music industry. Polyphonic Whims core competencies IEEE in its technical expertise in artificial intelligence and natural science applications (Peg. 2, PA). Even though it does not provide specific feedback on how to improve a song, Haste HAS scientific product has the ability to revolutionize the music industry Phelps to eliminateeliminating the uncertainties of relying on instinct while incorporating humanistic music preferences In predicting future successes..It will serve to reduce marketing Inefficiencies, thereby allocating concentrated efforts and budgets to refocus efforts and budgets towards hits that have a A wheelwright likelihood of success of making the next big hit. Below are further issues of consideration, specific to HIM. What stand in its way is the minor issues detailed below. Minor Issues 1. Shoestring Marketing Budget HIM operates on a limited budget of $1 50,000 and this creates two Implications. First, HIM Is unable to reach out to the entire market and It limits them to target only 1 segment at this juncture..Pricing is critical as well, given that it needs to ensure that it recovers its operating fixed costs. Secondly, HIM is in dire need of a off cost efficient marketing plan is unable to do advertising and has to strategically come up with a feasible selling process. What is Hisss ideal marketing mix? 2. Dealing with Competition In Dalton to the budget constraints, HIM cannot simply Consigliore are competitors compartmentalizing forces, which lies in the substitutes of HAS which are traditional call-out studies and individuals gut instincts (preference surveys).These conventional substitutes depended on human instincts and thus it makes consumers highly skeptical of the abrupt replacement with machines. Depending on the different uses of spectrophotometer, it is pertinent to note that levels of skepticism Mould differ across segments and in turn affect the adaptability of HAS. Thus, based on the target market, how should HIM needs to position itself using an optimal marketing strategy to minimize skepticism and ensure highest possible profits?. Strategic Options: Option 1 : Target Unsi gned artists (AU). The AU segment comprises of hundreds of thousands of hopefuls that dream of a shot at fame and who are willing to spend money to further their dreams. Value Drivers: For AAAS, nothing gets in the way of pursuing their dreams. In addition, they form a mostly technologically as. N. Y crowd ho are willing to adopt new technologies like HAS. The potential of this segment is age where 300-400 demos are sent to a record label per week. Approximately 187,200 demos (350 demos per week) are sent in per year to the dozen or so ARCS under Universal Music Group for the US market (Peg. , PA). Risk Drivers: The core needs of CIA is to get a contract from Arcs, but as ARCS might not align their tastes and preferences to the scoring criteria of HAS (Peg. 12, AS), a good report from HAS does not directly translate to the CIA being signed by the RCA. USA have financial constraints Inch have prevented them from seeking available avenues like Internet Polls and Call-out surveys that costs above $1000 (Peg. 0, Pl). The shoestring budget does not allow for extensive advertising as it is costly for outreach to the massive number of USA (Peg. 1, PA). Lastly, the reports may be too complex for USA to understand, resulting in low adaptability. Option 2: Target Producers. This segment comprises 20-30 successful producers, few hundred producers with occasional hits and thousands of minor producers. Value Drivers: The use of HAS can help to diminish uncertainty to a certain extent, giving producers a better gauge of the potential of their songs. Risk Drivers: There are a few noteworthy risks. Outfits, there is a disconnection with the primary needs of the producers.Producers need to create hit songs but HAS merely suggests whether the songs that have the potential to become hits, showing limited effectiveness in tweaking songs. Therefore, HAS can only be seen as a subordinate tool in meeting producers needs. Secondly, thereafter is a high level of skepticism as producers pride themselves as artists with skills that cannot be replaced by a machine. Lastly, they might feel threatened that the software Nail replace their Job and hence refuse to adopt it.Risk Drivers: The core needs of AU s to get a contract from Arcs, but as ARCS might not align their tastes and preferences to the scoring criteria of HAS (Peg. 12, AS), a good report from HAS does not directly translate to the CIA being signed by the RCA. Thus, HAS is unable to meet the needs of this segment. Next, CIA have financial constraints which had prevented them from seeking available avenues like Internet Polls and Call-out surveys that costs above $1000 (Peg. 10, Pl). Thus, this is a highly price sensitive segment.In addition, Polyphonic does not have the full registry of CIA. The shoestring budget does not low for extensive advertising as it is costly for outreach to the massive number of in low adaptability. Option 3: Target Record Companies(RCA). This segment comprises of five major ARCS with combined share of 84% in the U. S. Market, each being home to at least a dozen labels. In addition, there are also tens of thousands of other small and midsized ARCS (Peg. 6, Pl). Value Drivers: The core needs for of ARCS is to reduce fixed costs that mainly stem from marketing initiatives(Peg. , PA). Hence, the core competency of HAS can directly address the by helping them filter hits and needs of Arcs, which is to predict hit songs with high accuracy for better allocation of baccalaureate budget to support likely hits and generate higher expected revenues. In addition, ARCS areas more a price insensitive, segment predisposed with higher budget and resources. A partial ACCORD analysis shows that this segment has high adaptability: HAS with an accuracy of 80% would be perceived to be more superior to traditional research methods of fairly low accuracy of 10% (Peg. 0, PA3). HAS is highly compatible as it suits the labels current behavior of sending songs for in-depth analysis in the form of reports. And since ARCS have familiarity with interpreting reports, complexity is low. The massive use of HAS in the music industry will definitely allow HAS to get noticed and tributes will spread by word-of-mouth, ensuring high communicability. Risk Drivers: However, Record labels under the same record company have significant collective buyer power to congregate and pressurize Polyphonic to reduce prices for their reports.In addition, major ARCS are hierarchical and operate with red tape, so the process of implementing HAS would be cumbersome. Recommendation: Option 3 is recommended. As the music industry faces a decline in album sales, the ARCS are forced to practice caution in launching albums. Consumers have become more discerning with their product expenditure. Every album launch requires a gamble on the part of the RCA marketing expenditure of $300,000 and upwards do not guarantee success in recouping the costs and profitability.An axiom of the industry is that less than 15% of released music titles generate profit, meaning the bulk of marketing investment are moot. Therefore, HAS brings about intervention to support the inner workings of Arcs. HAS sifts out the albums that do not make the cut room the manufacturing line, which avoids wastage of marketing budget. On the other hand, HAS could direct the ARCS to focus their endeavors on potential hit albums by allocating the bulk of budget to support likely hits. As such, HAS helps the ARCS to streamline marketing initiatives, and extract higher values from marketing investments.The ARCS can then reap higher margins from a reduction of fixed marketing costs. With predictive accuracy of about 80%, ARCS will perceive HAS as instrumental in turning their performance around. Justification of Recommendation Positioning Statement: Balance between Science and Art Within the business of research technologies in the pop music industry available to Arcs, Hit Song Science deviates from subjective preference sampling of limited individuals by Juxtaposing the test song and mathematical attributes of past hits alliterated by masses.HAS is thus the new-edge scientific humanistic tool that engages a million cultured ears to increase the likelihood of producing hits and reduce marketing expenditure. Generate u nbiased and technical assessments of songs, regardless of the reputation of the artiste. Financial Attractiveness Option 2: Producers option 3: RCA Target Volume 0,000 songs 5,500 songs 1 1 ,OHO songs Marketing Cost $1. 51 Unsigned artist $98. 41 Producer $2,500/ label target top 5 first) areas Even Price (BEEP) $95/ song $130/ song $89. 1 song above PVC) $30,000 $19,500 $33,000 Assumptions for all segments: Annual Fixed Cost=$500,OHO, Marketing budget= per song = $30, 10 songs/artist, Figures are for North America. Assumptions for CIA: 100,000 unsigned artists (Peg. 5, PA), Penetration Rate (PR)=I% Assumptions for Producers: 25 top producers(20 artists each) (Peg. 7 PA),500 one hit producers(10 artists each)l ,OHO aspiring producers (1 artist each) PR=I% Assumptions for RCA: 12 labels per record company (Peg. , PA), 5 major Arcs, 10,000 small Arcs, 2,500 unique albums and 3,000 unique singles, PR=50% Unit Contribution Analyzing the financial of each segment, it corroborates that targeting major ARCS Option 3) is the optimal choice. The $1 50,000 marketing budget is sufficient due to the least outreach that needs to be marketed to (12 labels or 5 Arcs). It Justifies the higher arbitrary market penetration rate set at 50%. Comparing with Option 2 and 3, marketing budget will be overstretched due to the much larger base of interested parties. Egg: only $1. Racketing dollars can be spent per unsigned artist which is probably close to production cost of a leaflet for promotion. Even though Option 1 and 2 have higher gross song volumes, the higher market penetration in Option 3 ensures the highest effective volume of songs that HAS technology captures (11,000 songs). Option 3 is also the most financially viable because it delivers the lowest areas-Even Price ($89/song) and highest Total Unit Contribution ($33,000). ), assuming that each song is priced 10% above Variable Cost of $30 for all 3 options.Value Sharing between ARCS and Humiliated by HAS for Record Companies To Justify he premium pricing of HAS(see later), we first considered Hisss value add for to the two main sources: (1) Marketing Cost Savings and (2) Increase in Expected Revenues. Marketing Cost Savings Before HAS After HAS Success rate of marketing to get hits Singles to market 2 Marketing and Promotion cost/singles Total marketing cost Marketing cost savings Assumptions: (1) Peg. 10 PA, Assume conservative 50% success rate instead of 80%. (2) Peg. 9 PA, Assume HAS capture only 50% of 3000 new singles. (3) Peg. PA, Assume $300,000 marketing cost and $100,000 promotion fees (1): Usage of HAS dramatically educes Marketing Expenses of newly released singles. Traditionally, there are about 3000 singles released per year, of which HAS technology captures half due to the 50% market penetration rate. Given that the HAS software increases success rate of marketing hits from 10% to 50%, we only have to promote 300 singles (instead of 1,500) to get 150 hits. Assuming each single is marketed and promoted at $400,000 per single (Peg. 8 PA), this results in 80% decrease in marketing expenditure from MM to $MM, generating potential cost savings of $MM. 2): Assuming hit success rate remains at 10%, there will also be an increase of expected revenues of MM. With the implementation of HAS technology, there is now 80%there is 40% probabilistically predictability (50% instead of 10% based on AR) that 1 out of 10 albums/singles marketed will become hits, generating increased probability- Knighted expected revenues of $776. MM for albums and $65. MM for singles. Increase in Expected Revenues Hit Success Rate (Fixed) Success rate of marketing to get hits Number of hit albums 125 381 Number of non-hit albums 1,375 Probability weighted revenues from non-hit albums (Table A)Increase in expected revenues from albums Number of non-hit singles 150 Probability weighted revenues from hit singles (Table A)Weighted expected revenues from hit singles 11,500,000 1,350 Probability weighted revenues from non-hit singles (Table A)Weighted expected revenues from non-hit singles 4,950,000 Total Increase in Expected Revenues Assumptions: Hit albums = Hit Success unique albums-?125 ton-hit albums-2500-125) Hit singles = Hit success * *3000 unique singles-?1 50 (Non-hit singles=3000-1 50) Probability weighted revenues from hit-singles/albums= Success rate of marketing /3)*Low Estimate+(l /3)*Med Est 3)*High Est] *Hit singles/liberalnesss in expected revenues from singles Sensitivity Analysis to Determine Optimal Procrastinating hit success rate remains at 10%, there will also be an increase of expected revenues of $MM. With the implementation of HAS technology, there is now 80% probability (instead of 10% based on A) that 1 out of 10 albums/singles marketed will become hits, generating increased probability-weighted expected revenues of $776. MM for albums and 565. MM for singles. Sensitivity SVGA Market Penetration Rate 75% Success Rate of Marketing to get hits 37801,477 1 51 337,931 ,250 1 ere sensitivity table proves that implementing HAS technology improves success rate of marketing, which in turn increases the SVGA for the Arcs. However, we observe that SVGA is limited by the market penetration rate, depending on how best HIM utilizes its marketing budget to capture the largest possible portion of the market, reinforcing the importance of Promotion and Distribution strategies. Its marketing mix. SVGA was then utilized to derive the price ceiling, price floor and target price of HAS technology on a per song basis. Based on target price of $60,105 per song or $600,105 per album, HIM is able to achieve a profit margin of 99. 85%.Price Ceiling Price Floor Target Price Assumptions 100% Penetration Rate Success Rate 1% Penetration Rate 11% Success Rate Penetration Rate Share of GAVE Price/songs $181,730 $6,873 $60,105 Net Value Add to Arcs 1$2. 68 bill) $1. 32 bill $661 mil Profit Margin of HIM(PM) 39. 97% 56. 58% 39. 85% Assumptions: (1) SVGA divided by target volume(market penetration * total volume of songs) (2) Net Value Add= Gross Value Add- Cost of Reports; Cost of Reports = Price per song * Market Penetration Rate * Volume of Songs (3) Assume that HIM will share alee created with record companies equally The sensitivity table proves that implementing HAS technology improves success rate of marketing, which in turn increases the SVGA for the Arcs.However, we observe that SVGA is limited by the market penetration rate, depending on how best HIM utilizes its marketing budget to capture the largest possible portion of the market, reinforcing the importance of Promotion and Distribution strategies. SVGA was then utilized to derive the price ceiling, price floor and target price of HAS technology on a per song basis. Based on target price of 60,105 per song or $600,105 per album, HIM is able to achieve a profit margin of 39. 85%. To analyze the mutual benefit of implementing HAS, we analyzed Hisss deducting all the relevant costs (Peg. 8 PA). With the implementation of HAS technology target price and assuming that Universal claims 32% the $661 M net value created See Pricing of HAS), this results in 8% increase in profit margin. PM.Suggested Marketing Mix for HAS Short Term: HIM should first target one major RCA to the top Major ARCS and hope to achieve industry awareness and accreditation of the technology and capture the ailing with at least one major Record Company. Patenting the HAS technology and giving competitive exclusive rights to one RCA will diminish buyer power that major ARCS hold when they congregate. Seethe suggested Pricing is standardized at $60,000 per song. The Product is homogeneous and utilized on master recordings of established artists. Pertaining Promotion and Place, HIM would seek the management of ARCS management via professional connections of HIM board members.Advertising leaflets are published to inform about the product. Salesmen and technical satisfactoriness would execute On-site Demonstrations to entice and enlighten Interested Arcs. Follow-ups are conducted to update ARCS on changing market trends and consumer preferences. For further market awareness, HAS guaranteed stickers Nail be placed on record label albums to enhance visibility of product. Mid-term and needed:Hem would now target small/medium sized Arcs, Producers and Unsigned Artists. The aim is to increase sales volume in other segments using the Market and Product Development strategy. Pricing is discriminated between Producers and Unsigned Artists.The Product is licensed as a software to major Arcs, while reports re personalized and simplified for USA and aspiring producers. Promotion and Place Initiatives are done via personal selling and one-to-one consultation with ARCS with the incentive of volume discounts. HIM can also offer trials of one unreleased song and four recently released songs to validate predictive and post-deceive accuracy. A chart release of Top 100 songs screened through by HAS technology and online retailers reviews increases product visibility. HIM will pursue the development of mobile APS and DID online websites for unsigned artists and producers to encourage easier consumer adoption.

Monday, November 25, 2019

To Be Or Not To Be Essays - English-language Films, Free Essays

To Be Or Not To Be Essays - English-language Films, Free Essays To Be Or Not To Be To Be or Not To Be This is a question I ask myself Do I live to be or not to be Do I die to be or not to be What exactly is to be anyway to be in what frame of mind when i murder to be in love when i get married do i have to be in order to be something?

Friday, November 22, 2019

The Company of Wolves Essay Example | Topics and Well Written Essays - 1000 words

The Company of Wolves - Essay Example While her mother mourns, she goes to spend some time with her grandmother (Angela Lansbury), who tells her stories and warns about wolves and men, intuitively and effortlessly drawing parallels between both species; After she returns to her parents, and while taking a walk in the woods with a friend, they find that a wolf has entered town to lay siege on their cattle. They run into town to alert the men, who hunt down the wolf and kill it. However, the carcass transforms into a human corpse. The rest of the story is reminiscent and full of the symbolisms from Perrault’s Little Red Riding Hood. It also includes the usual suspects – huntsman, wolf, granny etc. But that is where the likeness ends – it does not end or even proceed as would be expected. Based on Carter’s short stories, which, according to Merja Makinen, are (in)famous for the â€Å"excessiveness of their violence and, latterly, the almost violent exuberance of their excess,† The Company of Wolves delivers on its promise of violence and morbid dispositions. It is also very vicious in its attack on and reversal of the damsel-in-distress tradition present not only in Perrault’s Little Red Riding Hood, but in fairy tales, generally. For example, in one scene, where Rosaleen is cornered by a wolf, she has the courage to grab a rifle and shoot at it (as opposed to the helpless/hapless young girl crying for help). It is also ‘laden’ with sexual innuendo and symbolic portraits of female sexual liberation, which can be deduced in the scenewhere she gives up her bright red shawl (which is said to symbolise her virginity) of her own volition, not out of coercion. The wholesomeness of the plot, however, is brought to question by the director’s barely comfortable employment of the â€Å"Chinese Box† structure in the film. Throughout all four stories narrated in the movie, I was conscious of the separateness of the

Wednesday, November 20, 2019

Utilization Management and Models of Care Research Paper

Utilization Management and Models of Care - Research Paper Example It is also a whole person centered approach that offers a comprehensive care strategies for chronic, acute and end of life care. Finally, the PCHM facilitates the integration and coordination of care thus ensuring that the patients receive the best care and services from their medical neighborhood thus improving quality and safety of the services. Health care facilities that have employed the Chronic Care Model have also been able to achieve their quality and safety goals due to the various beneficial elements inherent in the model. Glasgow, Orleans & Wagner (2001) informs that one of the key ways through which the Chronic Care Model facilitates the achievement of quality and safety goals by coordinating the care delivery process and offering clinical decision support. The model coordinated coordinates decisions and actions of different care givers leading to glycemic control, health care utilization and patient satisfaction. Evidence based decision making is vital in the achievement of safety and quality goals (Coleman, Austin, Brach & Wagner, 2009). The model facilitates the incorporation of evidence based practices into various registries and patient assessment tools thus improving the quality of care offered by the care givers. Shojania, K., Kathryn, M., Grimshaw, J., Sundaram, V., Rushakoff, R. (2006). Effects of quality improvement strategies for type 2 diabetes on glycemic control: a meta-regression analysis.  Journal of the American Medical Association  296(4), 427–440.

Monday, November 18, 2019

Peer review process assignment Example | Topics and Well Written Essays - 500 words

Peer review process - Assignment Example This is a very useful proposal for educational institutions since the factors that affect XYZ are the same factors that influence other institutions that offer the same services. I appeal for funding because management hired fire captains based of their technical competence and high motivational attitudes. However, this does not necessarily translate in to leadership ability, as many would think. Further, I think promoting managers that have not been trained, nor have had the opportunities to be mentored by experienced leaders, leaves an experience gap between upper level management and lower level supervisors that will soon be asked step into upper level leadership positions. It is significant to note that as upper level management leaves and younger supervisors step up there will certainly be a lack of transformational leadership and vision that was possessed by the leaders that left. Therefore funding such a project will improve leadership styles in organizations. The proposal has critically looked at the firefighting career field, which is technical field where firefighters are given individual tasks in order to accomplish an overall objective. When there is an emergency each individual knows what he or she as an individual must due to contribute to the team success of the mission. However, this causes problems when a firefighter is now put in the position of supervisor and they must keep up with the technical competencies of firefighting while also managing the administrative, political, and human resources issues that comes along with the day-to-day activities of running a fire station. In making this transition, one is often required to alter their paradigm or worldview. I appeal for funding for this project because the emphasis on efficiency, customer-service, and consistent communication are all-important components of an HRPP. Building trust between the research community and the HRPP indirectly serves as a

Saturday, November 16, 2019

Effectiveness of Support Services for Reducing Poverty

Effectiveness of Support Services for Reducing Poverty A 6000 word literature review project which critically analyses and evaluates the effectiveness of family support services aimed at reducing stress and poverty for the parents of children in need. Introduction The whole issue of parents and children in need is a vast, complex and ethically challenging one. This review is specifically charged with an examination of those issues which impinge upon the stresses and strains that are experienced by parents of children in need. A superficial examination of these issues that are involved in this particular area would suggest that there are a number of â€Å"sub-texts† which can all give rise to this particular situation. Firstly, to have a child in need is clearly a stressful situation for any parent. (Meltzer H et al. 1999) This can clearly be purely a financial concern and a reflection of the fact that the whole family is in financial hardship, perhaps due to the economic situation or perhaps due to the actions of the parents themselves. Equally the need of the child can be a result of a non-financial need, so we should also consider the child who is in some way handicapped, ill, emotionally disturbed or perhaps in need in some other way. This produces another type of stress on the parent, and these stresses are typically longer lasting and, in general, less easily rectified than a purely financial consideration of need. (Hall D 1996). It is part of the basic ethos of the welfare state that it should look after its less able and disadvantaged members. (Welsh Office 1997). Parents of children in need will often qualify in this definition. We shall therefore examine the various aspects of this problem. Literature Review We will make a start by considering one type of child in need. The first paper that we will consider is that of Prof. Vostanis (Vostanis 2002), which looks at the mental health problems that are faced by deprived children and their families together with the effectiveness of the resources that are available to them. It is a well written and well researched paper, if rather complex and confusing in places. We will consider this paper in some detail as it provides an excellent overview of the whole area. The paper starts with a rather useful definition for our purposes. It qualifies the deprived child, initially in terms of a homeless family, that being : A family of any number of adults with dependent children who are statutorily accepted by local authorities (housing departments) in the UK, and are usually accommodated for a brief period in voluntary agency, local authority or housing association hostels. This period of temporary accommodation can vary enormously depending on the time of year and the area considered, and can range from a few days to perhaps several months. The target in Greater London is currently to rehouse homeless families within 4-6 weeks. In London particularly, the homeless families can be placed in Bed Breakfast accommodation. (D of H 1998) In this respect, the immediate family support mechanisms do appear to be in place. Vostranis however, goes on to make the observation that despite the fact that the definition of the homeless family is rather broad, it does not cover all of the potential children in need, as those children and their carers who have lost their homes but have managed to live with relatives, on the streets or perhaps live as travellers, are not covered by the statutory obligation to provide housing. The official figures therefore, he observes, are generally an underestimate of the true situation. The official figures for the homeless families are put (in this paper) at 140,000. (Vostanis Cumella, 1999) The authors give us further information in that many families will become homeless again within one year of rehousing and the typical family seen is the single mother and at least two children who are generally under the age of 11 yrs. They also observe that the typical father and adolescent child tend to be placed in homeless centres. (D of H 1995) In exploration of the particular topic that we are considering, the authors give us the situations that typically have given rise to the degree of parental stress that may have led to the homelessness. They point to the fact that a homeless family is usually homeless for different reasons to the single homeless adult. Vostanis (et al 1997) is quoted as showing that 50% of the cases studied were homeless as a direct result of domestic violence and 25% as a result of harassment from neighbours. The authors observe that the numbers in this category (and therefore the problems), are rising. (Welsh Office 1999). There are a number of section to this paper which are not directly referable to our considerations. We shall therefore direct our attention purely to those parts that have a direct bearing on the subject. One particularly useful and analytical part of the paper is the section that details the characteristics and needs of the target group. This is a very detailed section, but it makes the point that the children in need in this group are particularly heterogeneous, generally all with multiple and inter-related needs. Homelessness is seldom a one off event. This particular observation, (say the authors), is crucially important for the development and provision of services. Most families have histories of previous chronic adversities that constitute risk factors for both children and parents (Bassuk et al, 1997). Such events include family conflict, violence and breakdown; limited or absent networks for family and social support; recurring moves; poverty; and unemployment. Mothers are more likely to have suffered abuse in their own childhood and adult life and children have increased rates of placement on the at-risk child protection register, because of neglect, physical and/or sexual abuse. If we specifically consider the health needs of this population, the authors categorise them thus: The children are more likely to have a history of low birthweight, anaemia, dental decay and delayed immunisations, to be of lower stature and have a greater degree of nutritional stress. They are also more likely to suffer accidents, injuries and burns. (BPA 1999) Some studies have found that child health problems increase with the duration of homelessness, although this finding is not consistent. A substantial proportion of homeless children have delayed development compared with the general population of children of a similar chronological age. This includes both specific developmental delays, such as in receptive and expressive language and visual, motor and reading skills, as well as general skills and educational status (Webb et al. 2001). It is for this reason specifically, that it has proved extremely difficult to assess the effectiveness of the family support services because of the multivariate nature of the problems that are presented. The authors point to the fact that one of the prime determinants of the degree of support available, is the actual access that the families have to these services. Many sources (viz. Wilkinson R 1996), equate the poor health of the disadvantaged primarily with the lack of access to services. One immediate difficulty is the current registration system in the UK. In order to be seen in the primary healthcare team setting, one must be registered with a named doctor. In the majority of cases that we are dealing with here, they have moved area and registration is probably not high on their list of priorities. One can argue that there is the access to the A E departments of the local hospitals but there is virtually no continuity here and they are no geared up to provide anything other than immediate treatment. (Hall D 1996). This fact restricts their access to primary healthcare team procedures such as immunisations and other preventative medicine health clinics. (Lissauer et al, 1993) . By the same token these groups also have restricted access to the social services, whether they be the access teams, the family teams or the family support units and other agencies. The authors also point to other more disruptive trends in this group such as an inability to attend a particular school for fear of being traced by an abusive partner. It follows that these children do not have a stable social support of a school. They are denied such factors as peer groups, routines and challenges which are both important protective and developmental factors. (Shankleman J et al 2000). The summation of all of these factors, and others, is that the effectiveness of the family support services is greatly reduced by the mobility and the transient nature of the family unit. Quite apart from the difficulties outlined above relating to the problems of access to avenues of help open to the child in need and their families there are the problems engendered by the fact that social service departments in different areas of the country may not have immediate access to the previous records giving rise to many potential, and real, problems with continuity of care. This problem is brought into more immediate focus when one considers the increased frequency of child protection registrations in this particular group. (Hall D et al 1998). One specific analysis of the family support services of this particular group comes in the form of the psychiatric services. In the context of the title of this piece, it demonstrates how these particular services, (but not these alone), are failing to deal with the totality of the problem. All of the aspects that we have outlined so far are conspiring to dilute the effectiveness of the services provided. The fact that they are a mobile population with no fixed address means that some of the services may choose to invoke this as a reason for not making provision for them, particularly if resources are stretched. If more resources are given, then they are typically preferentially targeted at the single adult homeless population where the need is arguably greater. The authors of this paper point to the fact that this may not actually be true as some studies have shown that homeless single mothers and their children have a 49% psychopathy rate and only an 11% contact with the support services. (Cumella et al, 1998). The impact of this fact on the children can only be imagined. To an extent however, it can be quantified as the authors cite other studies which show a 30% need rating for children, (they do not actually define exactly what their perceived level of need was), contrasted with a 3% contact rate for children and adolescents in this area. (viz. Power S et al. 1995). Putting these considerations together, the authors outline a set of proposals which are designed to help improve the access to some of the essential services. The model that they propose could, if successful and with a degree of modification, prove suitable for adaptation to other areas of the family support services. It is not appropriate to discuss this model in detail, but suffice it to say that it has a tiered structure so that the degree of distress and need is titrated against the degree of input generated. One of the reasons that we have selected this particular paper to present in this context is for its last section. It proposes a â€Å"family support services model† which has been developed and pioneered in the Leicester area. In the context of our review, it is worth considering in some detail. A service provided through a family support team (four family support assistants).This is designed to detect a range of problems at the time of crisis; manage a degree of mental health problems (behavioural and emotional); provide parenting-training; support and train housing (hostel) staff; co-ordinate the work of different agencies; and provide some continuity after rehousing by ensuring intake by appropriate local services. The family workers are based at the main hostel for homeless children and families. Other, predominantly voluntary, services have established alternative posts, such as advocates and key workers. Whatever the title of the post, it is essential that the post-holder has some experience and ongoing training in mental health and child protection, so that he or she can hold a substantial case-load, rather than merely mediate between already limited services. The family support workers have direct access to the local child and adult mental health services, whose staff provide weekly outreach clinics. Their role is to work with the family support workers and other agencies, assess selected children and families, and provide treatment for more severe problems or disorders such as depression, self-harm and PTSD. A weekly inter-agency liaison meeting at the main hostel is attended by a health visitor, representatives of the local domestic violence service and Sure Start, There are also close, regular links with education welfare and social services. The aim is to effectively utilise specialist skills by discussing family situations from all perspectives at the liaison meeting. A bimonthly steering group, led by the housing department, involves senior managers representing these agencies, as well as the education and social services departments and the voluntary sector, and they oversee and co-ordinate the service. This appears to be something of an exemplar in relation to services provided elsewhere. The paper does not provide any element of costings in this area neither does it provide any figures in relation to its success rates, contact rates or overall effectiveness. In conclusion this paper is an extremely well written and authoritative overview of the situation relating to the stresses of the homeless parent with children and the effectiveness (or lack of it) in its ability to reduce the stresses experienced by the homeless children in need and their parents. It proposes remedies but sadly it does not evaluate the effectiveness of those remedies. In order to address these shortcomings we can consider another paper by Tischler (et al 2000). This looks at a similar outreach set up which has been designed to capture the families of children in need who might otherwise slip through the net. This paper is written from a different perspective and specifically analyses the effectiveness of these services as they pertain to an entry cohort of 40 families. This particular study was set up after preliminary work was done in the Birmingham area with 114 homeless families and this study defined the needs of the families but did not quantify their support systems.(Vostanis et al 1998). This paper set out to identify and measure the support systems available and their effectiveness as far as the families were concerned. The stresses encountered were partly reflected by the incidence of psychiatric morbidity. The mothers in the group were found to have over 50% more morbidity than a matched control group. The children in the group were found to have â€Å"histories of abuse, living in care, being on the at-risk protection register, delayed communication and higher reported mental health problems.† All of which adds to the general background stress levels. (Kerouac S et al. 1996). This particular study found that despite the psychiatric morbidity in the children, (estimated to be about 30%), and the psychiatric morbidity in the parents, (estimated at about 50%), only 3% of the children and 10% of the parents had had any significant contact or support from the social services. In this respect, this paper is very useful to our purpose as it quantifies the levels of intervention and access to healthcare resources that this particular group has. By any appreciation, it would be considered woefully inadequate in any society that calls itself civilised. In the terms of the title of this piece, the effectiveness of the family support services is minimal. Like the last paper discussed, this one also considered how best to tackle the problem, and this one is of much greater value to us, as it specifies a response, or intervention, to the problem in much the same way as the Vostranis 2002 paper did, but it makes the same measurements as it did prior to the intervention, and therefore allows us an insight into the actual effectiveness of the intervention. The way this particular study worked was to assess the problem (as it has been presented above), devise an intervention strategy and then to measure its effect. This particular study goes to great lengths to actively involve all the appropriate agencies that could help the situation by having a central assessment station that acted as a liaison between all of the other resources. In brief, it actively involved liaison with the following: Education, social services, child protection, local mental health services, voluntary and community organisations to facilitate the re-integration of the family into the community, and particularly their engagement with local services following rehousing; and training of staff of homeless centres in the understanding, recognition and management of mental illness in children and parents. This is essential, as hostel staff often work in isolation and have little knowledge of the potential severity and consequences of mental health problems in children. It was hoped that, by doing this, it would maximise the impact that the limited resources had on reducing the levels of morbidity and stress in the families of the children in need. The post intervention results were, by any estimate, impressive considering the historical difficulty of working with this particular group (OHara M 1995). 40 families (including 122 children) were studied in detail. The paper gives a detailed breakdown of the ethnic and demographic breakdown of the group. By far the biggest group were single mothers and children (72%) The results showed that the majority of referrals were seen between 1-3 times (55%), with a further 22% being seen 4-6 times. It is a reflection of the difficulty in engaging this type of family in need that over 25% did not actually keep their appointments despite the obvious potential benefits that could have been utilised. The authors investigated this group further and ascertained that a common reason for non attendance was the perception that the psychological welfare of the children was not actually the main concern. The families perceived that their primary needs were rehousing and financial stability. Other priorities identified were that physical health was a greater priority than mental health. The authors also identify another common failing in the social services provision, and that is the general lack of regular contact. They cite the situation where some families cope well initially, apparently glad to have escaped an abusive or violent home situation, but a prolonged stay in a hostel or temporary accommodation may soon precipitate a bout of depression in the parents and behavioural problems in the children of such parents. (Brooks RM et al 1998). They suggest that regular re-visiting of families who have been in temporary accommodation for any significant length of time should be mandatory. This paper takes a very practical overview by pointing out that workability of the system is, to a large extent, dependent on the goodwill of a number of committed professionals. The authors state that this has to be nurtured and they call for sufficient funding must be given to enable this particular model to be extended to a National level. Thus far in the review we have considered the effectiveness of the service provision in the support of the families of the children in need in one specific target grouping, those who are stressed by virtue of the fact that they are homeless. We will now consider the literature on a different kind of family stress, and that is when a parent dies. This leaves the children with a considerable amount of potential emotional â€Å"baggage† and the surviving parent with an enormous amount of stress. (Webb E 1998). An excellent paper by Downey (et al 1999) tackles this particular problem with both sensitivity and also considerable rigour. It is a long and complex paper, but the overall aims and objectives are clear from the outset. The structure of the paper is a prospective case study which aims to assess whether the degree of distress suffered by a family during a time of bereavement is in any way linked to the degree of service provision that is utilised. The base line for this study is set out in its first two paragraphs. Parentally bereaved children and surviving parents showed a greater than predicted level of psychiatric morbidity. Boys had greater levels of demonstrable morbidity than did girls, but bereaved mothers showed more morbidity than did bereaved fathers. Children were more likely to show signs of behavioural disturbance when the surviving parent manifested some kind of psychiatric disorder. (Kranzler EM et al 1990). The authors point to the fact that their study shows that the service provision is statistically related to a number of (arguably unexpected [Fristad MA et al 1993]) factors namely: The age of the children and the manner of parental death. Children under 5 years of age were less likely to be offered services than older children even though their parents desired it. Children were significantly more likely to be offered services when the parent had committed suicide or when the death was expected. Children least likely to receive service support were those who were not in touch with services before parental death. Paradoxically the level of service provision was not found to be statistically significantly related to either the parental wishes or the degree of the psychiatric disturbance in either the parent or child. (Sanchez L et al 1994) The service provision did have some statistical relationships but that was only found to be the manner of the parental death and the actual age of the child at the time. The authors therefore are able to identify a mismatch between the perceived need for support and the actual service provision made. Part of that mismatch is found to be due to the inability of the social services and other related agencies to take a dispassionate overview. Elsewhere in the paper the authors suggest that there are other factors that add to this inequality and they include lack of resources and a lack of specificity in identifying children at greatest risk. (Harrington R 1996) The authors examine other literature to back up their initial precept that bereaved children have greater levels of morbidity. They cite many other papers who have found distress manifesting in the form of â€Å"anxiety, depression, withdrawal, sleep disturbance, and aggression.† (Worden JW et al. 1996) and also psychological problems in later life (Harris T et al. 1996). In terms of study structure, the authors point to methodological problems with other papers in the area including a common failing of either having a standardised measure or no matched control group (Mohammed D et al 2003). They also point to the fact that this is probably the first UK study to investigate the subject using a properly representative sample and certainly the first to investigate whether service provision is actually related to the degree of the problems experienced. The entry cohort involved nearly 550 families with 94 having children in the target range (2-18). With certain exclusions (such as two families where one parent had murdered the other etc.) and non respondents, the final cohort was reduced to 45 families and one target child was randomly selected from each family. It has to be noted that the comparatively large number of non-respondents may have introduced a large element of bias, insofar as it is possible that the families most in need of support were those who were most distressed by the death of a family member and these could have been the very ones who chose not to participate. (Morton V et al 2003) The authors make no comment on this particular fact. The authors should be commended for a particularly ingenious control measure for the children. They were matched by asking their school teacher to complete an inventory of disturbed behaviour on the next child in the school register after the target child. A large part of the paper is taken up with methodological issues which ( apart form the comments above) cannot be faulted. In terms of being children in need, 60% of children were found to have â€Å"significant behavioural abnormalities† with 28% having scores above the 95th centile. In terms of specific service support provision, 82% of parents identified a perceived need for support by virtue of the behaviour of their children. Only 49% of these actually received it in any degree. Perhaps the most surprising statistic to come out of this study was the fact that of the parents who were offered support 44% were in the group who asked for it and 56% were in the group who didn’t want it. The levels of support offered were independent of the degree of behavioural disturbance in the child. As with the majority of papers that we have either presented here or read in preparation for this review, the authors call for a more rationally targeted approach to the utilisation of limited resources. The study also provides us with a very pertinent comment which many experienced healthcare professionals will empathise with, (Black D 1996), and that is: Practitioners should also be aware that child disturbance may reflect undetected psychological distress in the surviving parent. While not suggesting that this is a reflection of Munchausen’s syndrome by proxy, the comment is a valid reflection of the fact that parental distress may be well hidden from people outside of the family and may only present as a manifestation of the child’s behaviour. (Feldman MD et al. 1994) The conclusions that can be drawn from this study are that there is a considerable gap in the support offered ( quite apart form the effectiveness of that support) in this area of obvious stress for both parents and children. (Black D 1998). This study goes some way to quantifying the level of support actually given in these circumstances. We have considered the role of the effectiveness and indeed, even the existence, of adequate support services for the children in need and their parents in a number of different social circumstances. The next paper that we wish to present is an excellent review of the support that is given to another specific sub-group and that is women and children who suffer from domestic violence. Webb and her group (et al 2001) considered the problem in considerable (and commendable) depth The study itself had an entry cohort of nearly 150 children and their mothers who were resident in a number of hostels and women’s refuges that had been the victims of family violence at some stage in the recent past. The study subjected the cohort to a battery of tests designed to assess their physical, emotional and psychological health, and then quantified their access to, and support gained from, the primary healthcare teams and other social service-based support agencies. This study is presented in a long and sometimes difficult to read format. Much of the presentation is (understandably) taken up with statistical, ethical and methodological matters – all of which appear to be largely of excellent quality and the result of careful consideration. The results make for interesting and, (in the context of this review), very relevant reading. Perhaps one of the more original findings was that nearly 60% of the child health data held by the various refuges was factually incorrect. This clearly has grave implications for studies that base their evidence base on that data set (Berwick D 2005). Of great implication for the social services support mechanisms was the finding that 76% of the mothers in the study expressed concerns about the health of their children. Once they had left the refuge there was a significant loss to the follow up systems as 15% were untraceable and 25% returned to the home of the original perpetrator. The study documents the fact that this particular group had both a high level of need for support and also a poor level of access to appropriate services. In the study conclusions, the authors make the pertinent comment that the time spent in the refuge offers a â€Å"window of opportunity† for the family support services to make contact and to review health and child developmental status. This is not a demographically small group. In the UK, over 35,000 children and a parent, are recorded as passing through the refuges each year, with at least a similar number also being refered to other types of safe accommodation. Such measures are clearly not undertaken lightly with the average woman only entering a refuge after an average of 28 separate assaults. One can only speculate at the long term effects that this can have on both the mother and the children. In common with the other papers reviewed, this paper also calls for greater levels of support for the families concerned as, by inference, the current levels of effectiveness of the family support services is clearly inadequate. Conclusions This review has specifically presented a number of papers which have been chosen from a much larger number that have been accessed and assessed, because of the fact that each has a particularly important issue or factor in its construction or results. The issue that we have set out to evaluate is the effectiveness of the family support services which are specifically aimed at reducing the stress levels for the parents of children in need. Almost without exception, all of the papers that have been accessed (quite apart from those presented) have demonstrated the fact that the levels of support from the statutory bodies is â€Å"less than optimum† and in some cases it can only be described as â€Å"dire†. Another factor that is a common finding, is that, given the fact that any welfare system is, by its very nature, a rationed system, the provision of the services that are provided is seldom targeted at the groups that need it the most. One can cite the Tischler (et al 2000) and Downey (et al 1999) papers in particular as demonstrating that a substantial proportion of the resources mobilised are actually being directed to groups that are either not requesting support or who demonstrably need it less than other sectors of the community. Some of the papers (actually a small proportion) make positive suggestions about the models for redirecting and targeting support. Sadly, the majority do little more than call for â€Å"more research to be done on the issue†. In overview, we would have to conclude that the evidence suggests that the effectiveness of the family support services in reducing stress and poverty for the parents of children in need is poor at best and certainly capable of considerable improvement. References Bassuk, E. Buckner, J. Weinreb, L. et al (1997),  Homelessness in female-headed families: childhood and adult risk and protective factors.   American Journal of Public Health, 87, 241–248 1997 Berwick D 2005 Broadening the view of evidence-based medicine Qual. Saf. Health Care, Oct 2005; 14: 315 316. Black D. 1996,  Childhood bereavement: distress and long term sequelae can be lessened by early intervention.   BMJ 1996; 312: 1496,   Black D. 1998,  Coping with loss: bereavement in childhood.   BMJ 1998; 316: 931-933,   BPA 1999,  British Paediatric Association. Outcome measures for child health.   London: Royal College of Paediatrics and Child Health, 1999.    Brooks RM, Ferguson T, Webb E. 1998,  Health services to children resident in domestic violence shelters.   Ambulatory Child Health 1998; 4: 369-374.    Cumella, S. Grattan, E. Vostanis, P.

Thursday, November 14, 2019

A Tan to Die For by Claire Oliver :: Letter to Editor Melanoma Tanning Solarium

â€Å"A tan to die for† written by Claire Oliver is a letter to the editor that shows that the use of solariums can greatly increase the potential for life-threatening melanoma. Claire Oliver’s tone shows a composed, collected and complacent frame of mind at her imminent death, stating that â€Å"[she is] at peace†. Her composed tone when discussing the certainty of her impending death appeals to a sense of rationality, and writes optimistically about the remainder of her life. This optimism, and personal responsibility, comes from her wish of helping those who do not know of the health risks involved in the beauty young teens crave to acquire. Ms Oliver states factually how little life she has remaining. â€Å"If I really fight it out, I may even have six weeks left.† She puts her life in perspective, and follows by showcasing her emotions more obviously. â€Å"It’s scary, because I feel myself getting more tired and it worries me that I might not wake up.† This fear evokes the sympathies of the reader. The writer then transfers her focus from her story to the risks involved with solariums and how she appeals to the government to educate the general public especially to the younger generation. She also demands some answers from the government and wants some honesty from them on how the dangers on solarium can kill you. Through her letter to the editor she implies that the solariums should be banned but for the first time she gives her opinion saying â€Å"Obviously, I think they should be banned.† She also implies the government is more concerned about business profits rather then the general public’s health. Ms Oliver tries to not focus her attentions on the government but to raise awareness and the sense of responsibility. The writer shifts her focus to her life background and how she was like any other normally 25 year old. She implies how â€Å"normal† she is because she wants to everybody to know that she was just as â€Å"normal† as everyone else. This disease can happen to anyone at any age.