The Medical Elective Medical Training Health And Social Care Essay

The medical elective is an of import portion of medical preparation and calling. It can besides be an exciting chance to see wellness attention systems of different states and research countries of medical specialty that I have peculiar involvements in. My initial programs are to hold the elected arrangement abroad, ideally in two separate locations. Language is an of import factor in taking the states as I would wish to be able to pass on with the patients and physicians. Out of all the English speech production states, I think it would be an interesting experience to see a less developed state or a less developed part within a developed state. The other half of the elected I would take a developed state and comparison and contrast the two wellness systems. I want the fond regards to be chiefly clinical based as I can use the accomplishments in general medical specialty and other forte I have learnt during the two old ages of clinical preparation. I would non wholly decline the chance to blend in some clinical based research, but I am cognizant that research undertakings may take some clip to organize and may besides necessitate excess resources input, such as permission from patients and aid from other staff, from the finish infirmary and establishments. In footings of safety during travel, although I have travelled to assorted states, but I have ne'er travelled or organised travel on my ain. Safety in footings of personal properties, nutrient and drink and personal safety should be put into consideration. If possible, holding the arrangement with a friend would be ideal. As all the 4th twelvemonth King ‘s medical pupils are traveling on electives this summer, happening a spouse traveling to the same topographic points should be rather possible. Having merely came back from vacation in America, the idea of traveling back for the elective to hold a on the job experience over in the States appeared rather attractive. The US has a really different wellness attention system comparison to the UK. To see their physicians, the patients over in America would necessitate to hold private wellness insurance which can be a really dearly-won payment. It would be interesting to see how the in private funded wellness system impacting patient experience compared to the NHS in the UK. America is a large state and this makes taking the location a spot more hard. To acquire an thought about where usually make medical pupils travel for electives in America, I searched on the Elective Abstract System on Virtual Campus. USA seems to be a really popular state for King ‘s pupils to travel for electives as there is a immense list of infirmary and establishment for all fortes. The popular finishs are the major metropoliss like New York, Los Angeles, San Francisco and etc. Majority of the infirmaries do non accept international pupils for elected straight, a few smaller clinics do, but the cost is really high and they seem to be really specialized. Feedbacks from pupils are besides assorted, most are happy with their experience, but non everyone had a hands-on experience. Access to patients can be a job sometimes in some forte clinics, and most times are spent on detecting. Using to medical schools can besides be hard as a batch of American medical pupil are besides l ooking for elected arrangements and the disposal fee entirely can be $ 100 for the application entirely. After those research and farther idea, I was somewhat put off by the thought of traveling to the States. Alternatively of traveling entirely, it would be a better manner to go with a friend. Culadeeban ( Deeban ) Ratneswaran, another King ‘s 4th medical pupil was looking for a spouse for electives and I have worked with him during my abdominal rotary motion in 3rd twelvemonth. Deeban was in the procedure of organizing a research undertaking about respiratory medical specialty in Singapore which involved some informations aggregation. He needed a spouse to work with on the undertaking and we decided to make the elected arrangements together. We came across a paper written by Dr Deborah Ng and her co-workers, titled: â€Å" consciousness of smoking hazards and attitudes towards in writing wellness warning labels on coffin nail battalions: a cross-cultural survey of two populations in Singapore and Scotland † . We were believing about emulating this survey ourselves, looking into the cross-cultural differences between Singapore and London, alternatively of Scotland. We will utilize a questionnaire attack to roll up the information as oppose to interviews because we want to roll up as much informations as possible while still working on the clinical side of the arrangement during the elected period. We besides emailed Dr Ng on farther advice about her survey and she kindly contacted the caput of respiratory section she was working under in Singapore, Professor Sin Fai Lam. Professor Sin agreed to give us 4 hebdomads arrangement in Khoo Teck Puat Hospital in the respiratory section and at the same clip let us entree to patients for the research undertaking. In order to transport out this undertaking we besides require moralss blessing and this demand to be applied by a qualified physician. We were told that Professor Sin ‘s squad is instead busy and unable to perpetrate their clip for the ethical blessing. We are still committed for the clinical arrangement in Khoo Teck Puat Hospital, and at this phase we are seeking alternate ways to acquire the ethical blessing, perchance from another section or another infirmary. For the 2nd half of the elected, we did non desire to go excessively far out of the parts. This is partially to salvage cost and besides clip spent on travel. So we applied for a few posters in Kuala Lumpur in Malaysia. Hospital Kuala Lumpur kindly accepted our applications for a 4 hebdomad long posting in the general medical specialty section. This would cover a big assortment of medical specialty, and it would be good to hold a broad scope of experience after a really specialized surgical arrangement. I can besides utilize this clip to acquire more experience in fortes that we merely had limited exposure so far, for illustration, ENT, dermatology and ophthalmology. Word Count: 1004Career SectionSelf-assessmentDuring my pre-clinical surveies in Cambridge, I had really limited exposure to existent clinical pattern so I kept an unfastened head about which forte I would wish to prosecute for future calling. I exhaustively enjoyed larning anatomy in first twelvemonth of medical specialty, and peculiarly the clip spent in dissection lab. What appealed to me is that I would read about certain parts of the organic structure and the following twenty-four hours I can hold the hands-on chance to recap the cognition to visualize it in existent life. The clinical survey offered better chances in calling geographic expedition. Throughout the assorted rotary motions, I found surgery fascinating and I ‘m ever enthusiastic to go to theatre Sessionss. Although, as a medical pupil, most of the clip spent in theater is to detect the operations but I was more than lament to scour in to help when asked. I besides enjoyed the type of squad work in surgery where each person has a clearly defined and alone function in the operating theater.Career research geographic expedition and treatmentsThe Medical Specialty Training web site ( 1 ) is a good starting point for callings research as it provides information on all fortes within medical specialty. After medical school, every physician has to travel through two foundation old ages and use for forte preparations, these can be medical, surgical, psychopathology and list of run through fortes. For the surgical fortes, there are two Core Surgical Training old ages to be completed foremost. Then there is another application procedure for the 3rd twelvemonth ( CT3 ) , which is for a sub-specialty, for illustration, cardiothoracic surgery. The competition information shows that surgery is a extremely popular pick, though the competition for other fortes can be every bit ferocious. I have besides attended the Specialty Fair hosted by Royal College of Medicine. It was aimed for both medical pupils and foundation twelvemonth physicians and it had a whole scope of fortes on show. Having talked to a figure of the physicians from assorted fortes, orthopedic surgery peculiarly stood out for me. It is a surgical forte concerned with castanetss, articulations and their motion. It covers both hurt and other diseases, for illustration, congenital and degenerative. I think it can be an highly rewarding calling where I can set patients back after terrible injury or reconstruct independency by alleviating creaky articulation hurting, both can genuinely transform the patient ‘s life. Figure 1. Orthopedic surgery. From www.sussexotc.nhs.uk Having non done the rotary motion for orthopedic surgery and injury, I wanted some early gustatory sensation for the forte and the 2011 National Undergraduate Trauma Conference provided the perfect juncture. The conference gave great penetration into the calling options available in injury and orthopedic surgery. The workshops lead by experient physicians in the field besides allowed the pupil to pattern some of the skilled involved, for illustration, laparoscopy.Using your elected to research your optionsI think the elected period will be an first-class clip to research my country of involvement and callings option. For the first half of my elected in Singapore, I will be passing four hebdomads in the orthopedic section in a really modern infirmary. There are five advisers in the section, all of which are trained in the UK so they will hold a reasonably good apprehension of the degree of preparation I ‘m presently at and what would profit me the most during this poster. By thi s phase I would hold done my orthopedic surgery fond regard, and extra exposure in this field will reinforcement and hopefully farther develop the cognition and accomplishment I already have. I should besides do the most out of this chance to acquire every bit much practical experience as possible in larning the basic surgical techniques and direction of the common instances encountered in orthopedicss. For the 2nd half the elected in Kuala Lumpur, although I ‘m officially posted under general medical specialty, in world the infirmary is really flexible for the elected pupils. The adviser who is oversing me during the poster has no job with elected pupils doing usage of the clip in Hospital Kuala Lumpur to acquire a broad scope of experience.Personal contemplation on calling thoughts/decisions to day of the monthThe big calling pick medical specialty offers makes the determination really hard, particularly most fortes requires drawn-out preparation. In order to do a steadfast determination on which way to take, careful research needs to be done to do certain that I am clear in my ends, altering calling way in medical specialty and re-start preparation can be really boring. I think at this phase of developing it is really hard to hold a clear image of what I want to make. While larning about the different subjects in medical specialty can be rather different when work on them. Although it does give some penetration about what it is like to work in that field. To this day of the month, I am really inclined towards surgery for my future calling. Bing able to straight see the job, keeping the breakage or experiencing the obstruction so repairing the job utilizing your custodies is really hearty. It requires drawn-out preparation and new accomplishments are invariably acquired even after making. I ever find it exciting to scrubbing-up, operating, or largely as a medical pupil, helping in theater. There is a huge array of subspecialties on offer, from urogenital medicine to plastic surgery. Some factors will be common to all fortes, but each will hold their ain set of challenges and demands. Orthopedic surgery is the most appealing subspecialties in surgery, it can be really physical but there are many specialist tools available to cut down the demand for inordinate force. The on-call agenda is comparatively demanding as accidents can go on any clip of the twenty-four hours. In contrast with ENT surgery where more of the surgeries are elected with really small exigency work so the working hours can be rather flexible. Through the class, I am going more informed about the different calling options and have got a better thought of what kind of calling I want, though non confident plenty to do a concluding determination. At the same clip I should non go narrow minded and ignore the other countries of medical specialty, because I may yet detect other new involvements. Word Count: 1018Global Health SectionGlobal wellness is a subject in medical specialty derived from public wellness and international wellness. It has been defined as â€Å" an country for survey, research and pattern that places a precedence on bettering wellness and accomplishing equity in wellness for all people worldwide ( 2 ) † . It is a field joins the medical and societal scientific discipline subjects, including human ecology, economic sciences, epidemiology and many others. It uses wellness informations such as life anticipation and infant mortality rate to mensurate the wellness jobs present in an country. It besides emphasises on wellness issues such as HIV/AIDS and malaria that can hold a planetary economical and political impact.What is equity in wellness?Health equity among states and within a state or community is a major issue in planetary wellness. The publicity of societal and economic equity and decrease of wellness disparities has been a cardinal subject in domestic public wellness, international wellness, and planetary wellness ( 2 ) . Equity of wellness can be confused with equality of wellness. Health equity focuses on the distribution of resources and other procedures that drive a peculiar sort of inequality between more and less advantaged groups, in other words, wellness inequality that is unjust or unfair ( 3 ) . Not all wellness disparities are unjust ( 4 ) , for illustration, we would anticipate immature grownups are healthier than the aged and work forces have prostate jobs whereas adult females do n't. However, if the difference arises from immunization degree or nutritionary position, so it would do concern from an equity position ( 3 ) . More late, Braveman and Gruskin defined wellness equity as â€Å" absence of systematic disparities in wellness between different societal groups. Unfairnesss in wellness consistently put groups of people who are already socially disadvantaged ( for illustration, by virtuousness of being hapless, female, and/or members of a disfranchised racial ethnic or spiritual group ) at farther disadvantage with regard to their wellness ; wellness is indispensable to wellbeing and to get the better ofing other effects of societal disadvantage. † ( 3 )Financing of wellness attentionFinancing of wellness attention is a major factor in equity of wellness attent ion, it is the activity of raising or roll uping gross to pay for the operation of a wellness attention system ( 5 ) . The conventional classs for fiscal beginnings are revenue enhancement, societal wellness insurance, private wellness insurance and out-of-pocket payments. Depending on the wellness attention system there are many fluctuations in the funding beginnings, for illustration, societal wellness attention insurance can be implemented on a national degree or a community degree and it can either be compulsory or voluntary ( 6 ) . Equity in wellness attention funding is assessed by the grade of inequality in paying for wellness attention between families of unequal Ability To Pay ( ATP ) ( 7 ) . Policy shapers in assorted states seem to be building wellness attention financing harmonizing to ATP. The Ministry of Health ( MOH ) in Malaysia subscribes to this scheme by suggesting that the state ‘s part to the new national wellness financing strategy to be related to ATP ( 8 ) .Malayan wellness attention systemThe cardinal rule of the Malaysian wellness attention system is that the handiness to wellness attention is non to be related to ATP, peculiarly in the event of illness ( 9 ) . The Malayan wellness attention system has seen great betterment over the past old ages. During the period of 1990 to 2005, life anticipation at birth increased significantly: males from 69.0 to 71.8 old ages and females from 73.5 to 76.2 old ages ; infant mortality rate fallen from 13.5 to 5.1 per 1000 ( 8 ) . Malaysia was ranked at 49 from 191 WHO member states ( 10 ) , which assessed the overall wellness public presentation against the three aims of good wellness, reactivity and just fiscal part. Malaysia ‘s public presentation at just fiscal part is comparatively low ( 122-123 out of 191 WHO member states ) compared to the other two aims ( 10 ) . In Malaysia, the populace and private wellness services co-exist. The authorities provides public wellness services through public infirmaries and wellness clinics. Private wellness attention complement the medical services provided by the authorities and its outgrowth is driven by demand. The wellness system overall is preponderantly revenue enhancement financed. The national outgo showed that authorities subsidises 58.2 % of the support in public sector whilst the balance of 41.8 % is financed by the private sector in 2003 ( 11 ) . The support are from five chief beginnings: direct revenue enhancements, indirect revenue enhancements, Employee Provident Fund ( EPF ) and Social Security Organisation ( SOCSO ) parts, private insurance premiums and out-of-pocket payments ( 6 ) . Those financess are transferred straight or indirectly to either public or private installations. Figure 2. Households ‘ Financial Contributions to Health Care System in Malaysia. From ( 6 ) . Many parametric quantities and techniques are available in the appraisal of equity of funding in a peculiar wellness attention system. Progressivity measures the divergence from proportionality in the relationship between wellness payment and ATP ( 12 ) . A progressive system means that the persons or families with greater ATP are paying more proportionately in funding wellness attention. The Kakwani ‘s progressiveness index ( 13 ) is a widely used tool in public finance to measure equity. The value ranges from -2 in the most regressive system to +1 in the most progressive system, 0 agencies that the system is relative and wellness payments account for the same proportion of income, irrespective of the person ‘s income ( 14 ) . A research carried out by Yu et Al ( 6 ) employed information from Household Expenditure Survey ( HES ) Malaysia 1998/99 indicated that the five finance beginnings in Malaysia have produced a imperfect system which is regarded as just. Malaysia â⠂¬Ëœs Kakwani ‘s progressiveness index mark compares really favorably to other revenue enhancement financed wellness attention systems in both development and developed states ( 6 ) . This determination contradicts the WHO World Health Report 2000, in which an older informations beginning from 1980s was used compared to the 1998/99 figures used in the new study. The two different findings besides indicate betterment in the equity of fiscal part in the wellness attention system during this clip. Although the finance of wellness attention can be regarded as just in Malaysia, there are other unfairnesss. Many among the hapless fail to seek wellness service due to go and chance costs. The private travel costs incurred to seek intervention have been high and besides increased at a higher rate compared to household income ( 15 ) . The hapless besides live farther from medical installations and have to pass more to go compared to the rich ( 15 ) . From the instance of Malaysia we can see that achieve equity in wellness attention can be really hard. The state has a really just manner to finance the wellness attention system but jobs remains in the distribution of service. Besides the turning proportion of private finance beginnings will do an escape of skill medical forces from the populace sector which will make farther entree unfairnesss. Word count: 1104Final Aims and AimsExperience wellness attention systems in different states. The two states that I ‘m sing will hold rather different systems to each other and the UK. It would be interesting to see what can be learnt from each and what can we make to better our ain wellness system. Practice the clinical accomplishments acquired in the past two old ages and hopefully get some new accomplishments that can be used in the hereafter. This can be a good clip to retouch on all the clinical accomplishments which will be needed during fond regards in the 5th twelvemonth and foundation occupations. Use this chance to research calling options. More exposure in orthopedic surgery will hopefully beef up my aspiration towards surgical callings. Use the clip in Kuala Lumpur to acquire more exposure to fortes that I have n't had much exposure, for illustration, ENT and dermatology. To carry on the research undertaking, this is still pending on ethical blessing. This is an chance to pattern how to transport out clinical researches, which is a utile accomplishment to hold regardless of the forte I will be come ining. If the research is approved and everything else goes good, it can be a good opportunity to hold some work published early in the calling. Word count: 207History of Elective PlansSingaporeSince my elective is split into two halves, I shall speak about each individually. My first finish is Singapore. Officially known as the Republic of Singapore, it is a metropolis province and besides an island state. Situated off the southern tip of the Malay peninsula, separated from Malaya by the Strait of Johor. It is the universe ‘s 4th taking finance Centre and the 3rd busiest port. Figure 3. Singapore skyline at dark from www.panorami.com With a population of merely over 5 million and being one of the smallest states in the universe, its population denseness is the 3rd highest in the universe. Merely 2.9 million of its population are born locally, 43 % ( 16 ) . Singapore is a multicultural state, the 2010 nose count ( 17 ) indicates that bulk of population being cultural Chinese ( 74.1 % ) , with 13.4 % Malays, 9.2 % Indians. There are four official linguistic communications in Singapore: English, Mandarin, Tamil and Malay. English is the on the job linguistic communication and all physicians are trained in English. The largest faith is Buddhism ( 44.2 % ) , Christianity and Islam are the other chief faiths with 18.3 % and 14.7 % severally ( 17 ) . Figure 4. The Merlion, a symbol of Singapore. This fabulous animal is a capturing loanblend of a king of beasts and a fish. From www.travelerfolio.com Singapore has a cosmopolitan health care system where the authorities ensures affordability. Most care outgo ( 68.1 % ) ( 18 ) is provided by the private sector, and the remainder is from the authorities. Harmonizing to the World Health Organisation ( 18 ) , Singapore has the lowest infant mortality rate ( 3 in 1000 ) and it besides has one of the highest life anticipations at birth ( 80 old ages ) . Singapore has â€Å" one of the most successful health care systems in the universe, in footings of both efficiency in funding and the consequences achieved in community wellness results † ( 19 ) . The system uses a combination of mandatory nest eggs from salary tax write-offs, founded by the workers and employers, a means-tested authorities subsidies for those in fiscal adversity and a national insurance strategy to cover major and drawn-out unwellnesss ( 19 ) . Although really successful, this peculiar health care system is â€Å" hard to retroflex in other states † , chi efly because the comparatively little population of 5 million on a concentrated piece of land, so the planning of the health care substructure is much easier comparing to larger states ( 19 ) . There are 13 private infirmaries, 10 authorities founded infirmaries and a figure of other specializer clinics. Khoo Teck Puat Hospital ( KTPH ) is the newest public infirmary in Singapore, built to function the health care needs of more than 650,000 peopleA who live and work in the North of the city.A The infirmary was officially opened in November 2010, the entire cost of development was $ 674m ( 20 ) , $ 125m of which was donated by the late Khoo Teck Puat ‘s household, who was wealthiest adult male in Singapore. KTPH is a territory general infirmary consists of 19 wards with 550 beds, with a six-storey Specialist Outpatient Clinic block, and an eight-storey edifice lodging the private wards and a 10-storey subsidized tower ( 20 ) . KTPH is besides actively involved in medical instruction and supply clinical instruction to medical pupils from Yong Loo Lin School of Medicine at the National University of Singapore ( 20 ) . Figure 5. Khoo Teck Puat Hospital. From www.flickr.comKuala Lumpur, MalaysiaMalaysia is situated in South East Asia, separated into two parts by the South China Sea into Peninsular Malaysia and Malaysian Borneo, besides known as West and East Malaysia severally. The Peninsular Malaysia was known as Malaya, gained independency from Britain in 1975, so united with Sabah, Sarawak and Singapore to organize Malaysia in 1963. However in 1965, Singapore withdrew from the federation and formed an independent state. The entire population of Malaysia is merely over 28 million ( 21 ) , Malays and other Bumiputera groups make up 65 % of the population, Chinese 26 % , Indians 7.1 % and other cultural groups 1 % ( 22 ) . The distribution of population across the state is instead uneven with approximately 80 % life in Peninsular Malaysia ( 21 ) . There are 137 living linguistic communications spoken in Malaysia ( 23 ) . Bahasa Malaysia, a standardised from of Malay is the official linguistic communication. English was the official administrative linguistic communication before Malaysia ‘s independency and remained to be widely used, particularly in service industries and other work topographic points. So communicating should non be an issue during the elected. Islam is the largest and the official faith with 60.4 % of the population, Buddhism and Christianity are the other chief faiths with 19.2 % and 9.1 % followerss severally. Figure 6. Map of Malaysia. From www.cia.gov Kuala Lumpur is the capital and the largest metropolis in the state with a population of 8 million in the metropolitan country ( 24 ) . The name literally means â€Å" boggy estuary † in Malay It has developed from a hovel town lodging mineworkers from the nearby Sn mine in mid nineteenth century to be dominated by the tallest skyscrapers in Southeast Asia and flower with the returns of international trade and commercialism. Kuala Lumpur is a really diverse metropolis in footings of human ecology, faith and civilization with historic temples and mosques sitting aboard futuristic towers. This diverseness attracts tourers from all over the universe, and I am certain I will hold plentifulness to make and see in my free clip. Figure 7. Kuala Lumpur at dawn with Petronas Towers ruling the skyline. From kualalumpurhotels.travel Hospital Kuala Lumpur is the largest infirmary in Malaysia and one of the largest in Asia. It is situated on 150 estates of land with 83 wards and 2302 beds. It employs a immense staff of 7000 workers, including 200 advisers and specializers with 500 registrars and house officers ( 25 ) . The infirmary is situated at the Centre of the metropolis, and was built in 1870 and consisted of merely 3 wards. Since so, it has been invariably upgraded and in 1997 it has completed upgrading its Institute of Radiotherapy, Oncology and Nuclear Medicine ( 25 ) . HKL besides plays an of import function in developing wellness professionals. As it is the chief instruction infirmary for medical pupils from the National University of Malaysia the staff will be more than capable to supply a worthwhile acquisition experience and hence it is a really popular pick among elected pupils. Many fifth pupils spent their electives in HKL exhaustively enjoyed their posters. As it is a immense infirmary there are so many different sections I can see and most physicians are more than happy for you to fall in their squad for a twenty-four hours regardless the section you are posted under. Figure 8. The Thean Hou Temple is one of the largest Chinese Buddhist temples in Kuala Lumpur. Officially opened in 1989, it is dedicated to Tian Hou ( The Heavenly Mother ) . From www.flickr.com Word count: 1092Personal Safety, Health and WellbeingFor personal safety issues about the states I am about to see for the electives, I foremost checked the Foreign and Commonwealth Office web site for some general advice. For Singapore, â€Å" there is an underlying menace from terrorist act. Attacks could be indiscriminate, including in topographic points frequented by exiles and foreign travelers † ( 26 ) .This means there is a low degree of known terrorist activity. So from terrorist act concern point of position, Singapore is possibly safer than the UK. FCO besides states that violent offense is rare, but travelers should be cognizant of street offense such as bag-snatching. This sort of activity occurs more often in tourist country such as airdromes, I think I should exert same sort of cautiousness as I would in all big metropoliss. The FCO peculiarly highlighted that â€Å" the offenses of indignation of modestness ( molestation ) can ensue in a all right, gaol or bodily penalty ( the Calamus rotang cane ) . Travelers are advised to avoid any action that could be interpreted as molestation. Scams affecting false claims of molest are thought to be † ( 26 ) . This should non be a major concern as most people would exert common sense non to do any offense, though this does alarm traveler to the state that certain misbehaviors that would be dealt laxly in the UK can take to really serious penalty in Singapore. The menace of terrorist act is somewhat more serious in Malaysia, FCO listed it as a state with â€Å" general menace of terrorist act † and â€Å" some degree of known terrorist activity † ( 26 ) .The FCO besides warned against travel to the east Sabah part of the state as there â€Å" are indicants that both condemnable and terrorist groups are be aftering violent Acts of the Apostless against foreign tourers † ( 26 ) in that country. The last incidence affecting foreign subjects was in 2003 and there are no other reported incidences since. East Sabah is in east Malaysia, far from the capital metropolis Kuala Lumpur, and I have no programs to go to that portion of the state. In footings of insurance during elected period and other travels that may follow, I have ever purchased travel insurance to cover my flights to and from place during the holiday period. I have been with Insure & A ; Go for a figure of old ages, it ‘s a really dependable company and their one-year multi-trip policy is really comprehensive. The insurance bundle costs ?70 per twelvemonth, which includes cancellation, personal properties, luggage, paperss and whole scope of other screens. One of import screen I should foreground is the medical screen. As if for any ground I fall ill during the elected or the period spent going after the elected, I would be cover for the local wellness service if it ‘s needed. The wellness attention systems in Singapore is mostly in private founded so the cost it would be rather expensive, and the National University of Singapore requires all incoming elected pupils to hold medical insurance during the elected period. I have besides checked wi th the insurance company that the â€Å" medical elective † is covered as portion of the travel insurance as it can be a gray country between vacation travel and working travel. They have confirmed that the elective is covered by this policy. Professional insurance or malpractice insurance is besides required by the arrangement in Singapore. I have joined the Medical Protection Society since first twelvemonth of medical school but I have ne'er required their service. If I keep on following the counsel as I have been in the UK during the clinical surveies, professional insurance should non be of concern. I understand the medical pattern in different wellness systems and different civilization can change, patients ‘ outlook and apprehension of the function of medical pupil can besides be rather different. While working with patients, whether on ward or clinic, I should explicate my function and do certain the patients understand who I am and what I ‘m making. At any point, if I am diffident about the ethical deductions of a certain pattern, for illustration, inquiring for consent from patient for scrutiny, I should confer with a senior member of the squad and inquire for advice for the recognized criterion of pa ttern in that peculiar infirmary. Dengue febrility is known to happen in both Singapore and Malaysia ( 27 ) . There is no available inoculation or medical specialty to forestall this disease. The best step is to avoid mosquito bites by utilizing anti-mosquito sprays and picks. There is besides a hazard of malaria in Malaysia ( 27 ) , once more anti-mosquito steps should be used. In add-on, chemoprophylaxis should be used in concurrence. Chloroquine opposition is present in peninsular Malaysia, I shall take proguanil along with chloroquine. These drugs are available from most pharmaceuticss. Another major wellness concern for pupils traveling abroad for elected arrangement is the hazard of HIV exposure. The prevalence of HIV in Singapore and Malaysia are both really low. The latest figure shows that the prevalence of HIV in Malaysia is approximately 0.5 % and 0.15 % in Singapore, comparing to 0.35 % in the UK ( 28 ) . For the orthopedic surgery fond regard in Singapore, I will likely be in contact with blood while detecting or helping in theaters. Since the prevalence of HIV in Singapore is lower than this state, the hazard of exposure is really little. The fond regard in Kuala Lumpur would be based in the general medical specialty section, so the opportunities of contact with blood is minimum along with the low prevalence of HIV, the hazard of HIV exposure is once more really low. Hence, I ‘m non sing taking a post-exposure prophylaxis kit with me during the elected fond regard. One unwellness which I ‘m likely to endure from is traveler ‘s diarrhea. From experience, during about every abroad trip, I would hold traveler ‘s diarrhea at some phase. This is likely because I frequently like to seek the local nutrient and drinks and non afraid of eating unfamiliar things. To understate the hazard of holding diarrhea, of any kind, I should avoid feeding and imbibing in less reputable constitutions. As a safeguard I would besides take some loperamide tablets and anti-emetics in instance of diarrhea or more serious nutrient toxic condition. Word count: 998

Kate Chopin “The story of an hour”

Kate Chopin, in her short-story `the story of an hour`, presents to the reader the frustration of a woman who is suppressed by her husband’s will. In `six feet of the country`, Nadine Gordimer shows how time changes a relationship between a husband and wife. Although both these stories do not have negative or villain characters, they have elements which show mundane difficulties of everyday life. Both the stories intricately depict the complexities in married life, arising out of restrictions in freedom and feeling of discontent in each other’s company. This may cause one to ponder that the evil does not necessarily lie in the minds of married people, but in the institution of marriage itself.When the main character Louise in `the story of an hour’ is informed of the death of her husband, the reader’s mind is conditioned to expect tremendous grief and sorrow. She rushes into her room with tears and locks herself up. However, after the initial shock, she fe els extremely free. She is relieved that she does not have to feel suppressed anymore. She gazes out of the window and looks forward to the simple joys of life. The start of spring season is meant to indicate the end of her stifling marriage and the dawn of a new beginning in her life. The line â€Å"And yet she loved him – sometimes† (Chopin 8) shows that her husband was not necessarily a bad person. She just wants to live for herself, without the kneeling down to the whim of her husband.Until that day, she feared how she was going to live a painfully long life of repression. But, now she hopes to live a long life to savor life and cherish her long-lost freedom. The phrase â€Å"A kind intention or a cruel intention made the act seem no less a crime† (Chopin 8) goes to show that the bond of marriage causes one another to pose undue restrictions on each other’s personal freedoms. Louise is overjoyed with her new-found appreciation for life, but fate strik es back when her supposedly dead husband returns back without a scratch in his body. This eventually turns out to be one shock too many for Louise, as she suffers from a fatal heart attack. But, the doctor consoles everyone by saying that Louise’s heart was shocked by the happiness of seeing her husband alive. Feature Article – Short Story  The Plane of the Sleeping BeautyIn `six feet of the country’, Nadine Gordimer tells the tale of a married white man in apartheid-stricken South Africa. The story revolves around a multitude of themes including a dysfunctional marriage, urban vs. town life, bureaucracy and racial oppression. The central character and his wife own a farm. He is really not good at farming and hence the wife takes care of the farm. The wife expects more of out of her husband and immediately expresses her disapproval when he fails to do so.The husband, on the other hand, feels inadequate and is not entirely satisfied with his career. But, he just continues to live his life filled with frequent disputes with his wife. He quite is critical of his wife being messy and says â€Å"I had come home and been infuriated to find her in a pair of filthy old sacks and her hair uncombed† (Gordimer 122), while the same did not seem too unattractive a few years back. This shows that marriages over time can get monotonous and boring.   Although this might seem quite a cynical view of life, it is an honest portrayal of the true nature of human beings.One night, a black immigrant boy dies of pneumonia. But, during the funeral, it is uncovered that a different body was handed-over to them, indicating bureaucratic lapses in the government. His wife compels him to be more helpful and communicative, which essentially goes against his true nature and will. Although he is reluctant to stand up against his own â€Å"race†, he represses his own will to please his wife and tries to help his black employees by petitioning against the administration but eventually gives up. The husband character feels helpless and disgusted not only at the bureaucratic system, but also at the system of marriage that keeps him tied down.Chopin uses symbolism as an effective tool to convey the protagonist’s deepest emotions. The phrase ‘comfortable, roomy armchair’ signifies that Louise has accepted the death of her husband and prepared to live a free life. The author also ends the story by sprinkling a dash of irony. When Louise comes out of the room after mourning the death of her husband, she walks out as a new person full of hope. But, the fact that her husband is still alive kills her dream of being free from the treachery of married of life. On the other hand, Gordimer uses metaphor effectively in `six feet of the country’. The main character says â€Å"she and Petrus both kept their eyes on me as I spoke, and, oddly for those moments they looked exactly alike.†(Gordimer 124) The eyes look alike to the husband because he feels regret and guilt for letting down his wife and his black employee.Both the stories emphasize the saying ‘Marriage is the only war where you sleep with the enemy`. However, Chopin’s `the story of an hour’ gives a much deeper insight into a married person’s p syche and thus stands as stronger evidence for the aforementioned quote compared to `six feet of the country’ by Gordimer. Although the latter also has several elements describing marital problems, it tends to mainly focus on issues racial discrimination and other societal problems. Nonetheless, both the stories effectively show how a common man or woman is stifled by institutions such as marriage and societal pressures.Works CitedChopin, Kate. (1894). â€Å"The story of an Hour†. The International Story: An Anthology with Guidelines for Reading and Writing about Fiction.Gordimer, Nadine. (1986). â€Å"Six feet of the country.† Anthology of Short Stories.

Celebrity Endorsement in India Essay

In India, celebrities are idolized as Gods and marketers have been trying their best to tap on this emotional connect of the people with the celebrities. Today, most of the popular brands are being endorsed by a famous personality either from entertainment industry or sports arena. Strategic brand positioning and effective communication are the keys to success in today’s market where many brands compete in the same category for the market share. Companies are employing their maximum might to promote their brands and occupy a long lasting image in the minds of the consumers. In India, television is the most popular and effective means of the mass communication. There are over three million television commercials being aired every year. However, 80 percent of them are forgotten by the people in a day or two. So, it is imperative for the marketers to ensure that their ad campaign stands out amongst the crowd (Suhalka, n.d.). Since advertising is a highly critical tool for luring customers to make purchases, Indian firms are investing millions of rupees on celebrity advertising (Khatri, 2006). Celebrity endorsements are also an easy option for Indian marketers because of the disparities of the Indian consumer base in terms of religion, ethinicity, value system and most importantly economic variations. Therefore, advertisers in India emphasis a lot on brand recall and customer persuasion for differentiating their ad campaigns from those of the counterparts. It is here that celebrity endorsement provides a tremendous boost (Surana, 2008). For instance, one of the strongest celebrity endorser is cricketer Sachin Tendulkar who is a youth icon and endorses many successful brands like, Pepsi, Boost, Aviva Life Insurance, TVS, Britannia Biscuits, Visa, Airtel etc. Like, Shahrukh Khan, Amitabh Bac hchan, Kareena Kapoor also have many brands in their kitties. Indians love their celebrities and blindly follow their suit. This has proved to be a boon for the marketers and celebrity endorsement is just getting better by the day. It has now become an indispensible part of the marketing communication strategy. It is a win ?win situation for both the celebrities and the brands. However, the consumers are ones who are least benefitted as they end up paying more for the products and services. References: †¢ Khatri, P., 2006. Celebrity Endorsement: A Strategic Promotion Perspective. Indian Media Studies Journal, 1(1).Pp. 25-37 †¢ Suhalka,G.n.d. Celebrity Endorsers and Endorsements in India- The Rise and the Impact [pdf] Available at: http://www.ndtvmi.com/b4/dopesheets/garima.pdf [Accessed 18 February 2012] †¢ Surana,R., 2008. The Effectiveness of Celebrity Endorsement in India [pdf] Available at: http://edissertations.nottingham.ac.uk/2069/1/08MAlixrs13.pdf [Accessed 18 February 2012] Commentary | Theses | Dissertations | Journals & Articles | Proposals & Synopsis | Essays | Promotional Writing | Press Release Copyright  © 2005 – 2012 Project Guru India. All rights reserved. www.ProjectGuru.in

Sustainable Solutions Paper (Answering Questions) Essay

Sustainable Solutions Paper (Answering Questions) - Essay Example This indicates a challenge that the company faces in its supply chain business. This paper represents an analysis of the company using traditional strategic thinking tools. Stakeholder Identification and Value Analysis Stakeholders refer to organization, persons, or groups of persons who may be affected by a company’s decision. Customers are the main stakeholders of the company. This is because the company has a responsibility of meeting their perfume and fragrance requirements. Thus, any decision made by the company concerning the nature of the product is likely to affect the customers. The customers define the corporate-level strategy of the company. This is because customer’s satisfaction indicates `Albani’s main business. Business-level strategy is the other significant enterprise level strategy. The strategy defines the company’s competitiveness and sustainability in the perfume industry. The company’s employees have contributed to the companyà ¢â‚¬â„¢s sustainability through the creation of high quality products. The company’s lenders and promoters have also contributed to the company’s growth and sustainability by ensuring that the company has sufficient capital. Albani promoters and lenders fulfil the functional-level strategy of the business. Finally, the company has a social responsibility that is beyond making of profits. These responsibilities define the role of the organization and the basic perception of the public towards the organization. The society, which is a bigger set that contains the company’s customers represent Albani’s public image. Culture: Organizational culture refers to â€Å"a collection of values and norms within an organization which are shared by all stakeholders and they determine or control how people interact (Macmillan, 2007). According to the article, Albani’s organizational culture can be classified as â€Å"bet your company culture.† The company ’s decisions have a major impact on its customers. Thus, big decisions are taken after considering the views of all the stakeholders. For instance changing the brand name of a particular perfume will require the approval of the customers and other relevant stakeholders. Such decisions require market research that might take a long time to materialize. Integrated Concepts from Readings According to the previous documents, the success of a company depends on various factors. Each of these factors has a role to play in determining the overall nature of the company’s external or internal environment. The enterprise level strategies define the role of the business and its perception according to the society. Thus, enterprise strategies are concerned with the corporate social responsibility of the business. The company’s culture and enterprise strategies are congruent despite not been closely related. This indicates that a company might have mission statement that is not aligned to its enterprise strategies. However, the company’s vision should be congruent to its enterprise strategies. Otherwise, its vision will not be significant to its operations. General Force Analysis General forces are factors that affect all business operating in a certain industry. This indicates that the general forces define the overall business environment. General forces relate to the society and the country’

Transition to Democracy in Africa Essay Example | Topics and Well Written Essays - 1250 words

Transition to Democracy in Africa - Essay Example The first part analyzes the decisive transition to democracy by South Africa and the policies adopted by the country, and the second part examines the difficulties and challenges that hinder the transition to democracy for many African nations. Part 1 The decisive democratic transformation by South Africa has been a source of inspiration for civilization across the world. Only a few analysts predicted such radical progress, considering the bloody and long history of the country against apartheid. Indeed, majority of the experts expected the country to succumb to ethnic violence common in many African nations when repression begins to transform to revolution. Today, many parts of the African continent and across the world are experiencing civil wars, with international terrorism plugging both developing and developed world into a state of anarchy. There is need to design democratic preventive and resolution methods to create a peaceful world free from hatred, bitterness, wars, enmity, and oppression (Donaldson and Marais, 2002). The experiences by South Africa may provide some invaluable insights for transition to democracy for other countries. The apartheid regime responsible for the reign of terror for more than four decades and the subsequent incarceration of thousand of people is among the most ruthless and heartless regimes to ever occur since Hitler’s reign in Germany. This is why the peaceful transition to democracy by South Africa remains one of the most significant democratic transitions in the world. The racial prejudice and discrimination against the natives of the country began in 1652 with the first Europeans from Holland. The intensity of racial discrimination against the indigenous people, particularly the San and the Khoikhoi increased during the subsequent domination by the British and Dutch in Cape Colony. However, the Dutch established inland colonies, resulting to clashes with the British coastal colonies, and ultimately culminated to the Boer war between 1899 and 1902. Nevertheless, there was some power sharing between the British and the Dutch (now refereeing to themselves Afrikaners) until in 1940s when the Afrikaner National Party gained a stronger majority (Nathan, 2004). The African National Party institutionalized discrimination after coming into power in 1948. The strategists in the party invented apartheid to enable them cement their control over the social and economic system. The concept of apartheid was to ensure white dominance and extending racial separation. Thus, the â€Å"Grand Apartheid† plan was set in motion in the 1960s, focusing on police regression and territorial separation. The party enacted apartheid laws touching all aspects of life. With the assistance of the European Community and the United States, the pressure began on the South African President Botha to dismantle apartheid in 1980s. The end of 1991 saw the revoke of the legal apartheid framework. However, internal violence continued, but Nelson Mandela and F. W. de Klerk reached an agreement for the implementation of majority rule in 1993. Mandela was able to convince the United Nation to lift the remaining sanctions on the country.

Science Meets Real Life Assignment Example | Topics and Well Written Essays - 1500 words

Science Meets Real Life - Assignment Example In order to fulfill this step, I must try to turn on the light switch again and see if it is really broken. If it really seems so, then I must go to the back of the house and try to turn on another light switch there. The next sequence of events will then depend on whether this second light switch makes the light come on or not. Then, if this second switch does not work either, the next thing to do is to look for the same pattern in the neighborhood. If all the houses have their lights off, then there must be a power cut, and this specific part is the development of the theory, which is the third step. If there is at least one house with a light on, then there is no regularity in the phenomenon that involves switches that are not working. I then look around the neighborhood and notice that all of the houses near my house already have their lights turned off. Just because this is so does not give me a reason to conclude that there is indeed a power cut because everyone might just simply be asleep because it is almost midnight and most of the neighbors are elderly people. Then I notice one neighbor’s house with the lights on, and so I have then discarded the idea or theory that there is a power cut. I then have to look for another possible regularity, which is However, after giving up on the regularities, I have theorized that it is only my house that has a problem. Since my daughters are not at home now as I left them with a relative a week ago, then I am sure that it is not they who are playing this very annoying practical joke with me – especially since I believe they are too young to be able to do that. I then proceed to the next step, prediction. After eliminating the possibility of a power cut, my daughters playing a prank on me, and other incredible possibilities like a UFO interfering with my lights or a possible terrorist attack, I

Contemporary Social Policy and the Welfare of Children and their Essay

Contemporary Social Policy and the Welfare of Children and their Families in the UK - Essay Example Hence, just like in the past, according to Hodgson and Spours (1999), present-day ‘childhoods’ and contemporary children are marked by a political aspect. The history of child welfare policies in the UK can be described in terms of a steady and restricted intrusion into the family as a reaction to a nation’s evolving needs and perceptions. The acceptance of particular roles and duties by the state towards child welfare, specifically with regard to health and education, has become entrenched (Great Britain Department of Health, 2006). On the contrary, the more focused policies like those involved in the criminal justice system and in the protection of children have obliged to take action in response to certain issues and problems that seem critical then, issues which mainly concern particular families and communities (Hallet & Prout, 2003), while neglecting most families and communities. Hence, this essay will also analyse the effect of the modern children’s rights movement on social policy and law involving children. New Labour: The ‘Social Investment’ Approach The concept of ‘the social investment state’ has arisen as the Third Way ideology’s normative principle and a practical response to the problems and issues of the welfare state recognised by Third Way scholars and policymakers (Lewis & Surender, 2004). The practical response and normative principle are interlocked. The community and the child are viewed as symbols of the social investment state (Lewis & Surender, 2004). Particularly, the child assumes an iconic position. Yet, it has been argued by Hendrick (2005) that the social investment’s new... This essay analyses the effect of the modern children’s rights movement on social policy and law involving children. This paper stresses that the government, in relation to the problem of Child Abuse, formed the Every Child Matters agenda, aimed at enhancing the quality of child services, but particularly children at risk. In addition to having a common focus on self-sufficiency and choice, these policies and guidelines have another common feature: they all nearly entirely overlook the requirement for defenceless children to be safeguarded from abuse (Leira & Saraceno, 2008). Similarly, the Green and White papers on child care fall short in comprising any mentions of child protection plans This report makes a conclusion that the policy responses to the mounting concerns over the rights of children and granting children ‘expression’ or ‘voice’ could have the result, expected or otherwise, of expanding the importance of the individual obligation of children as well as the duties of their parents. In encouraging children and young people to become more accountable for their own behaviours, the punishments given by adults can be viewed to be even more repressing. Paradoxically, the expansion of the concept of children’s rights could have the outcome of soliciting children into dynamically controlling their own freedom and thus exposing them to a much more advanced kind of adult control, guidance, and monitoring.

The Trouble with Celebrity Endorsers Article Example | Topics and Well Written Essays - 2000 words

The Trouble with Celebrity Endorsers - Article Example Another point raised is brand equity. Brand equity is something that the company builds over time in order to differentiate itself from the other competitors in the market. The article suggests that instead of leveraging on celebrity’s image, the brand should be able to develop its own equity through leaving out costly promotion into adding more product features, etc. Having learned in marketing that promotion is a key to creating customer awareness, I believe that companies should invest in promotion especially in the first months or years of a brand in order to introduce it to consumers. However, in the latter life, the real value should be delivered to customers. This article opens my eyes to the challenges faced by marketing strategist. Promotion is far more complicated than having celebrity wears the product or recommends the brand. There should be an alignment in the image of the celebrity as well as the celebrity being used for promotion. The article highlights how Nokia is faring through the economic downturn in industrialized economies especially the United States. The past months have witnessed how the world economic leader in the past is undergoing the recession. As a consumer, I have read and seen how investment firms collapse, laborers laid-off, and even the more profitable retailers’ close down. Looking at in a marketing viewpoint, this change in the business environment challenges businesses to reinvent themselves and their various strategies in order to survive. Nokia’s response to the situation is to cut cost in order to maintain profitability. However, the low demand brought about by the bleak economic outlook and lower purchasing power of customers remains the key consideration. Thus, companies should focus on strategies other than minimizing operations and marketing costs.

An Energy Management or Efficiency Essay Example | Topics and Well Written Essays - 500 words

An Energy Management or Efficiency - Essay Example In today’s world, thanks to the great technological strides; wind turbines have been developed to wring electricity from the breeze. Thus as more and more people resort to wind energy over the past decade: wind turbine use has increased at more than twenty five percent a year-though only still proving a fraction of the world’s energy. Undoubtedly, most wind energy comes from turbines that can be as tall as a twenty story building and have three 200- foot- long (60-meter-long) blades. These contraptions look like giant airplane propellers on a massive stick. The wind spins the blades, which turns a shaft connected to a generator that produces electricity. Other turbines work on the same principle, but the turbine rests on a vertical axis (Burton, 2011, 57). Interestingly, the biggest wind turbines generate enough electricity to supply about 600 United States homes. Furthermore wind farms can contain tens and sometimes hundreds of these turbines lined up together in particular windy spots, for example along a ridge where the wind is blowing strong. However smaller turbines erected in a back-yard can produce electricity enough to power a single home or meet power needs of a small business. Wind is a clean source of renewable energy that produces no air or water pollution. Interestingly since the wind is free, there are minimal if not, nearly zero operational costs once a turbine is erected. Mass production coupled with technology advances are making turbines cheaper, and many governments are offering tax incentives to spur wind-energy development. Even so, not all people look at wind energy favorably. Some think that the turbines look ugly and complain about the noise generated by the machine. The slowly rotating blades can also kill birds and bats. But this cannot be compared to road carnage, destruction by power lines, and high-rise buildings. The wind is also variable in