Saturday, August 31, 2019

Interventions For Substance Abuse Amongst Young People

INTRODUCTION Despite the fact that young people are most often the healthiest group of people in the population (Emmelkamp, and Vedel, 2006), there is concern about the extent to which this group engages in risk-taking behaviours, including the consumption of drugs and alcohol and the abuse of these substances. Such activities expose them to problems ranging from the individual health level to the costs incurred during rehabilitation (Berglund, Thelander & Jonsson, 2003). Rehabilitation needs often include mental health and psychiatric solutions due to the mental health and social problems caused by drinking and the consumption of illegal drugs. In the UK, the use of psychoactive substances has become a major activity among the youth population. For example, it has been shown that 50% of young people in the age bracket 16-24 years have used an illicit drug on at least one occasion in their lives. This project also exposed that the most commonly used drug is cannabis which is used by 40% of youths aged 16-19 years and a shocking 47% of 20-24 year olds. Amphetamine then follows which is used by 18-14% of the above age groups. Between 2011 and 2012, 20,688 young people accessed substance misuse services, with the majority of this number accessing services for abuse of cannabis (64%) or alcohol (29%) (National Drug Treatment Monitoring System, 2012). Over half of the users were aged 16 to 18 (53%), whilst the rest were aged under 16 (National Drug Treatment Monitoring System, 2012). About two thirds (64%) of the young people who accessed specialist substance misuse services in 2010-11 were male. Overall, females accessing subst ance misuse services for young people are younger with 19% of males aged under 15 years compared to 27% of females. Almost half of the young people entering specialist substance misuse services are recorded as being in mainstream education, such as schools and further education colleges, followed by a further 19% in alternative education, such as schooling delivered in a pupil referral unit or home setting. A further 19% are recorded as not in education or employment. However, it should be noted that education and employment status was reported for only new young people entering specialist services during the year. Therefore, the total will be lower than that of all young people (National Drug Treatment Monitoring System, 2012). Referrals to drug and alcohol treatment services commonly come from youth offending teams, although around 14% of referrals come from mainstream education institutions and 7% are made up of self-referrals. Perhaps surprisingly referrals from the Child and Adolescent Mental Health service (CAHMS) make up only 3% of referrals (National Drug Treatment Monitoring System, 2012). These figures paint a perhaps surprising picture. For example, more young people are referred to specialist drug and alcohol services from mainstream education than specialist educational centres, suggesting that substance abuse could be far rifer amongst young people as might be expected. It could be argued that failure of school authorities to take a more effective preventative approach to drug and alcohol abuse may be contributing to the overall problem. These figures also suggest that immediate attention and intervention must be offered to young people to reduce negative outcomes associated with such high drug use. The statistics reveal that there is a high rate of drug and substance abuse among young people in the UK. The high of level concern about the use of illicit drugs and substances has an effect on health, educational and political discussions in the UK. The government’s national strategy for ten years on drug misuse views young people as a critical priority group in need of quick prevention and treatment intervention (Keegan and Moss, 2008) and recognises the need to improve our understanding of the role played by illicit drugs and substances in the lives of such young people. Educators, health practitioners and policy makers should have comprehensive understanding when it comes to discussions involving the abuse of illicit drugs. For example, the Government must take into account factors such as a lack of understanding amongst young people as to the laws that govern different classes of illegal drugs. Abuse of alcohol and other drugs leads to the destruction of cognitive and emotional development in young people and exposes them to an increased possibility of accidental injury or even death. Finally, there is also a risk of users becoming drug dependent. Abuse of drugs and alcohol by young people can also lead to such negative consequences as coronary heart diseases, lung cancer, AIDS, violent crime, child abuse and unemployment (Gurnack, Atkinson & Osgood, 2002). As a result, individuals indulging in the use of alcohol and other drugs incur tremendous costs in their individual lives, their family lives and even their future careers. Society is also not exempt as it pays a price in different ways. For instance, society incurs extra costs in health care, drug and alcohol treatment, law enforcement and supporting the seriously affected families who have been rendered helpless by the situation. There are many reasons why young people become involved in substance abuse. From a sociology perspective it has been argued that the recreational abuse of drugs has become ‘normalised’ (Parker, Measham and Aldridge, 1995) among certain groups of young people. However, Shiner and Newburn (1997) have argued that this theory is reductionist and simplifies the reasons behind a young person’s choice to abuse drugs. In reality, the reasons as to why a young person may begin to abuse drugs can range from having poor adult role models who may also use drugs and alcohol as a way of coping or even a genetic predisposition toward poor self-regulatory behaviours (Spooner and Hall, 2002). Evidence shows that adolescent alcohol and drug abuse is not influenced by a single factor but a large number of factors which are not necessarily confined to any single part of the an adolescent’s world (Connors, Donovan & DiClemente, 2001). Environment The environment in which a person lives is very instrumental when it comes to the kind of life that people lead, especially young people. If the environment is for example characterized by pronounced unemployment then young people in such an environment will indulge in activities that make them forget even for a moment the realities of the unemployment situation. If, for example, in their immediate environment young people face the situation of a large supply of drugs and everyone around them is abusing drugs or alcohol, then it is easy for such young people to adopt this kind of lifestyle and become drink or drug abusers. The above explanation shows that the kind of environment a young person stays in has a very direct influence on the habits that are finally adopted by this group of young people. Curiosity Young people naturally have the tendency to try new things and to find out how it feels doing something new. Young people in the United Kingdom are not an exception and most of them usually try drinking and drugs just to explore and find out what the experience is like. This however results in the young people becoming victims of the consequences that follow (Woo and Keatinge, 2008). The Defence Mechanism A good number of young people use drugs specifically to assist them in easing trauma that may result from unsatisfactory relationships and also physical or emotional abuse that may arise from families or homes that lack happiness. Promotion and Availability There is always a great amount of pressure from advertisement of alcohol over the media. The colourful nature of these promotions is often very enticing and mostly misleading. In the promotions or commercials, alcohol is glamorised hence the young people are influenced to indulge and as a result end up facing the dire consequences. This review will analyse the different interventions utilised when working with young people who abuse drugs and alcohol. These include those carried out by mental health workers, religion-orientated interventions, community based interventions and more psychiatric, medication based interventions. Motivational based interventions are also discussed. Aims and Objectives The aim of this project will be to review and critically evaluate the literature regarding different interventions for young people who abuse drugs and alcohol in the UK. To achieve this aim the project has set the following objectives: To critically examine the interventions for young people (aged 16 to 21) who use drugs and alcohol in UK, with the aim of providing recommendations to improve the care given to the youths who are addicted or at risk of substance abuse. To use secondary data to identify the importance of different interventions in dealing with young people (age 16 to 21) who use drugs and alcohol in the UK. Rationale Interventions for young people aged 16 to 21 who use drugs and alcohol has elicited varied opinions from professionals involved in their care. This has been a result of the often complex and varied needs of young people with substance abuse issues, such as mental health issues (Weaver et al., 2003), social exclusion (Fakhoury and Priebe, 2006) and involvement with the criminal justice system (Hamdi and Knight, 2012; Lundholm et al., 2013). Therefore, there is often disagreement on where the intervention should focus primarily. Various strategies have been advanced to address the involvement of young adults in drugs and substance abuse. For example, medication by mental health nurses in cases of addiction (Bennett and Holloway, 2005). However, due to the variety of interventions available for treating young people with substance abuse disorder, it is important to continuously review the literature in this area and pin point the most effective interventions for treating this group of individuals. [Client must write some words here on why they have chosen this topic (this is essential according to the assignment brief).] SEARCH STRATEGY In preparation for this critical literature review, a number of sources including journals, articles and health text books were used. The search was conducted using computerised databases which enabled access to literature on interventions for young people who abuse drugs and alcohol. Examples of such databases are given below: The Department of Health NHS Evidence (National Institute for Health and Clinical Excellence, 2012). PsycINFO (American Psychological Association, 2013). PubMed (National Center for Biotechnology Information, 2013). Google Scholar (Google, 2013). net (EMAP Publishing, 2013). Nursing and Midwifery Council publications (Nursing and Midwifery Council, 2010). Royal College of Psychiatrists useful resources (Royal College of Psychiatrists, 2013). Royal College of Nursing library services (Royal College of Nursing, 2013). These databases contained numerous useful sources such as journal articles, recommendations, guidelines and reviews that were used to gather evidence relevant to interventions for young people who abuse drugs and alcohol. Search terms used included; ‘drugs and substance abuse’, ‘alcohol abuse’, ‘effects of alcohol abuse’, and ‘intervention measures for drugs and substance abuse[1]’. It was not uncommon for a search to produce many results. Therefore, for any search that produced more than 50 results, the first 50 results were observed to pick out the most relevant and interesting studies. The remaining results were not looked at because of time constraints[2]. In addition to searching for relevant sources through online databases, reference lists within articles were also utilised to search for other relevant sources. Inclusion Criteria For an effective review of the subject area, there was a need to select relevant articles to achieve the set objectives. Therefore, only sources relevant to intervention for young people who abuse drugs and alcohol, papers published in the English language and papers published after the year 1999 were selected. Although sources pertaining to studies carried out in the USA were still considered relevant, a priority was given to sources from the UK. If a source had used an adult sample but was still considered relevant and useful then it was considered for inclusion. Exclusion Criteria General papers on drugs and substance abuse not specific to youths, papers published in languages other than English and published before the year 1999 were not included. An example search strategy when using one of these sources, the British Nursing Index, is given below. Search Strategy Example: British Nursing Index (BNI). Through citing the term ‘intervention for young people who abuse drugs and alcohol’, 5,000 articles were gathered without limiters. Limiters such as ‘role of mental health nurses’ and ‘only book and journals concerned with drugs and substance abuse’ were applied to the second search, which reduced the output to 2,034 books and journals. In the third search, additional limiters such as year of publication (2000-2012) were applied, which then reduced the number of books and journals to 734. After all further limiters were applied, such as articles that only used an age group of 16 to 21 years as participants, 70 journals and books were chosen for further analysis. Only 23 articles were considered relevant for this review and analysis due to their in depth exploration of the subject and their meeting of inclusion and exclusion criteria. LITERATURE REVIEW Interventions for substance abuse serve a number of purposes including reducing use of illicit or non-prescribed drugs and curbing problems related to drug misuse, including health, social, psychological and legal problems and last but not least tackling the dangers associated with drug misuse, including the risks of HIV, hepatitis B and C and other blood-borne infections and the risks of drug-related death. Prevention and intervention are usually categorised into primary (direct prevention), secondary (early identification of the problem and subsequent treatment) and tertiary levels (late identification and treatment). Furthermore, interventions are now often categorised into population wide interventions, selective interventions aimed at only high risk groups and early interventions for at-risk groups (Cuijpers, 2003). The nature of interventions has also evolved over the years. Twenty to thirty years ago the emphasis was on providing young people with information and buffering moral values whereas in the more modern era, a social dimension has been added and young people are taught resistance skills to avoid peer pressure (Gilvarry, 2000). Alcohol related deaths are rife in the UK, with 8,748 alcohol related deaths in the UK in 2011 (Office for National Statistics, 2013). However, there were 1,883 noted drug related deaths in 2010, a decrease of 299 from 2009 (Ghodse et al. 2012). These statistics reflect the importance of interventions for drug abusers, which could be protecting some individuals from the most extreme consequence of substance abuse. Mental Health Interventions Research has evidenced that Major Depressive Disorder (American Psychiatric Association, 1994) is often co-morbid in young people who abuse drugs and alcohol (Sutcliffe et al., 2009; Marshall and Werb, 2010; Marmorstein, Iacono and Malone, 2010). Due to the potentially devastating effects of depression at both the individual (Galaif et al., 2011; Petrie and Brook, 2011) and societal level (Sobocki et al., 2006), substance abuse is viewed as something that must be dealt with swiftly and effectively. This co-morbidity of mental illness and substance abuse means that mental health nurses are often involved in interventions with young people. Mental illness is a psychological anomaly that is generally associated with distress or disability that is usually not considered to be a component of an individual’s normal development (Nursing and Midwifery Council, 2008). Despite the fact that standard guideline criteria are used all over the world to define mental illness, diagnosis and i ntervention is often incredibly complex, especially when substance abuse is also a factor. Community services are offered to people with such problems through assessment by different psychiatrists and clinical psychologists, or sometimes social workers. All these professionals use methods of observation and inquiries through asking questions to help establish any given patient’s condition. Mental health nurses are often at the front line in providing care and support in both hospitals and the community. In the United Kingdom, mental health nurses play a great role in taking care of young people with mental disorders and mental illnesses that may have developed as a result of substance abuse (Department of Health, 2012). They offer counselling services in order to help people focus on their goals or outcomes; help people develop strategies that support self-care and enable individuals and their families to take responsibility for and participate in decisions about their health. They provide a range of services including education, research and knowledge sharing and e vidence informed practices. They also perform the role of addiction counsellors in order to provide intake co-ordination, assessment, treatment and follow-up care for youths with addictions, mental illness and mental health problems using common assessment tools. They can provide health promotion, prevention and early detection of problematic substance use; use core competencies and knowledge in addictions and a full range of withdrawal management services including detoxification services using best practice treatment protocols, outreach, prescribing, counselling, and harm reduction However, mental health nurses are often faced with challenges that hinder them from successfully achieving their goals. Challenges include non co-operation of the patients’ families and also the complex nature of patient problems (Nursing and Midwifery Council, 2008). In a comprehensive review, RachBeisel, Scott and Dixon (1999) found that there was a much higher prevalence of substance abuse amongst individuals with mental illness and that the course of mental illness was significantly negatively influenced by the abuse of illegal substances. These findings highlight a key issue in mental health interventions for young people who abuse substances, namely that it is important to determine the relationship between the substance abuse and mental illness before allocating a suitable intervention. For example, if a young person has developed a mental illness as a result of abusing substances, a mental health focused intervention may not be appropriate as it would not be treating the root of the problem or the reason why the young person started to use illegal substances in the first place. Psychiatric and Medical Interventions Psychiatric and medical based interventions refer to the treatment of substance abuse in a young person by a psychiatrist who is medically trained and able to provide an additional dimension of treatment than a psychologist or mental health worker is able to. An example of this is the prescription of methadone, a synthetic opiate that is used to help young people withdraw safely from heroin use. The National Institute for Health and Clinical Excellence (2007) recommend a psycho-social approach when treating individuals with substance abuse disorder and advocate the use of medication. However, use of medication with young people who are suffering from substance abuse disorders should be used with care due to the risk of dangerous side effects (Webster, 2005). Motivational Interventions Motivational interventions are brief interventions used by professionals to enhance a young person’s motivation to change and stop abusing substances (Tevyaw and Monti, 2004). In a review of the effectiveness of motivational interviewing (Smedslund et al., 2011) it was found that although motivational interviewing techniques were more effective at reducing the extent of future substance abuse when compared to no intervention, the technique was no more effective when compared to other types of intervention. For example, motivational interviewing was no better at reducing extent of substance abuse that simply assessing a patient and providing feedback. The authors reviewed 59 studies that had been accessed from a range of online databases. This is a reasonable number of studies as the body of literature on motivational interviewing as an intervention for substance abuse is quite limited. However, the authors failed to collect evidence on other measures of efficacy such as a redu ction in future criminal prosecution for drug offences or improvement in overall quality of life. The efficacy of motivational interviewing has been studied in young people in particular by McCambridge and Strang (2003). 200 young people from inner city London were randomly allocated to either a motivational interviewing condition or a non-intervention education control condition. All participants were aged between 16 and 20 and were using illegal drugs at the time of the study. The motivational interviewing intervention consisted of a brief, one hour face-to-face interview and self-reported changes in the use of cigarettes, cannabis, alcohol and other drugs was used as the outcome measure both immediately after the interview and at a three month follow up point. It was found that in comparison to the control group, young people who received motivational interviewing as a brief intervention reduced their use of cigarettes, alcohol and cannabis. Although these results initially seem in favour of motivational interviewing as an intervention for young people who have substance abuse issues, it should be noted that self-report measures are very open to bias and it is possible that the reported reduced use of drugs and alcohol was much higher than the actual reduction in use. This was reflected in a follow up study by the same authors 12 months later (McCambridge and Strang, 2005) where it was found that the difference in reduction in substance use between the experimental and control groups found after three months had completely disappeared. This result suggests that although motivational interviewing may be an effective short term intervention for treating young people with substance abuse issues, it has no enduring effectiveness over a long period of time. This may be due to a lack of follow-up support for young people and the brief nature of the intervention. Community-Based Interventions Community drug and alcohol services offer interventions such as comprehensive assessment and recovery care planning, support and care co-ordination, advice and information, stabilisation, counselling and relapse prevention and motivational interviewing (Nursing and Midwifery Council, 2008). Hepatitis B vaccinations, Hepatitis C testing and referral to treatment for these diseases, are also essential due to the risk of infections through needle sharing. Like most interventions, these community services are aimed at promoting recovery from addiction and enabling the achievement of individual goals, helping individuals to remain healthy, until, with appropriate support, they can achieve a drug-free life. This may involve stabilising service users on prescribed substitute medication to improve withdrawal symptoms and to reduce cravings. In their review of community-based interventions, Jones et al. (2006) found a limit on the effectiveness of such interventions, especially when it came to long term and enduring effect for reducing substance abuse. The results suggested that a change in community-based interventions was needed. Morgenstern et al. (2001) found a very high level of satisfaction among community based substance abuse counsellors who had received training in delivering cognitive behavioural therapy (CBT) to clients. This suggests that perhaps one way of increasing the effectiveness of community-based interventions would be to equip community-based workers with a wider range of skills with which they can help young people suffering from substance abuse. Supporting this recommendation was a study by Waldron and Kaminer (2004) who found that use of CBT was associated with clinically significant reductions in substance abuse amongst adolescents. Religious Interventions Some interventions are religious in nature. For instance, the United Methodist Church follows a holistic approach which stresses prevention, involvement, treatment, community organization, and advocacy of abstinence. The church could be argued to have a progressive role by offering a spiritual perception on the issue of substance abuse. Another popular religious based approach to tacking alcohol abuse in particular is the 12-step program offered by Alcoholics Anonymous. Individuals are commonly encouraged or possibly even required cut any acquaintances with friends who still use alcohol. The 12-step programme motivates addicts to stop consuming alcohol or other drugs and also it helps to scrutinize and modify the habits related to their cause of addiction. Numerous programs accentuate that recovery is a long-lasting process with no culmination. For drugs which are legal such as alcohol, complete abstinence is recommended rather than attempts at moderation which may cause relapses. Fi orentine and Hillhouse (2000) found that participants in a 12-step program stayed in future treatment for a much longer period of time and were much more likely to be able to complete a 24-week intervention programme. It was also found that a combination of a 12-step program and an alternative substance abuse intervention was more effective than either treatment alone. This suggests that providing young people with interventions in isolation may not be the most effective way of helping them overcome their substance abuse. However, literature on religious based interventions tends to focus on adults and although still applicable to the treatment of young people in many ways, young people may be put off by the religious nature of these 12-step programmes and may be intimidated by the group nature of the treatment. In support of this criticism, Engle and MacGowan (2009) found that only two out of 13 adolescent group treatments of substance abuse could be categorised as showing potentia l efficacy in treating young people with these problems. Family-Oriented Interventions It has been argued that the family has a central role in both increasing and reducing the risk of problem behaviours in young people such as substance abuse (Vimpani and Spooner, 2003). A review by Velleman, Templeton and Copello (2005) echoed this view that the family can have both a positive or negative impact on a young person’s risk of substance abuse. Kumpfer, Alvarado and Whiteside (2003) have identified that support for families based within the home, family education and skills training, improving parental behaviour and time-limited family therapy are all highly effective forms of family-based interventions for young people with substance abuse issues. However, as research has shown that the family can also play a role in increasing risk of substance abuse, professionals must be confident that family therapy is suitable and not run the risk of worsening a young person’s relationship with their family and in turn worsening their substance abuse. School-Based Interventions Education about the use of drugs and alcohol within schools has been advocated as a preventative intervention for young people at risk of substance abuse disorder. Fletcher, Bonell and Hargreaves (2008) found that interventions focused around encouraging a positive school environment and improving young peoples’ relationships was associated with a reduction in risky substance abuse. However, part of this conclusion was based on the review of observational studies, which are open to bias and subjectivity. CONCLUSIONS AND FUTURE RECOMMENDATIONS This essay has reviewed a number of sources regarding the efficacy and suitability of certain interventions for young people with substance abuse issues. A key limitation of much of the literature is the tendency to put emphasis on drugs as a generic material with very little distinction is made between different types of illicit substances. With the very varied effects of different drugs on the user, it could be argued that the specific reasons for a young person’s drug usage will have an impact on the effects that a drug has. For example, stimulant drugs will most likely be used for nervous system arousal, while other drugs such as alcohol and cannabis are sedatives and cause nervous system depression. These kinds of drugs can be termed as instrumental drugs since the reasons behind their usage correspond to the effect of the different kind of drug that is used (Brick, 2008). Therefore, it might be useful for professionals to base their interventions on the types of substanc e abused. From the above literature review it is evident that there is need for mental healthcare especially to help young people who are adversely affected by the use of drugs and other substance abuse. Some youths suffer from psychiatric disorders as a result of indulgence in drugs and substance abuse. Others experience mental problems that need serious rehabilitation measures taken in order to counter such problems hence emphasis should be laid on the care that is to be given to the young people affected by any of the above problems caused by the abuse of drugs and other substances. Therefore, mental health interventions remain an important intervention for young people. A number of recommended adjustments in healthcare to cater for young people struggling with abuse have been identified. For example, there should be an increased application of various musical strategies in helping patients suffering from various mental health conditions as a result of substance abuse (Connors, Donovan & DiClemente, 2001), as this kind of intervention appears to be lacking in use with young people. Another main limitation in research that aims to measure the effectiveness of intervention measures is the lack of control that researchers have. It would be considered unethical if young people with drug abuse problems were randomly allocated to intervention procedures, especially if one was chosen as a control condition and was not believed to be effective in treating substance abuse issues. This means that it can be difficult to compare intervention methods. Another limitation lies in the types of measure researchers’ use to measure effectiveness of intervention methods. For example, a self-report measure may be used to assess whether young people have either stopped or at least reduced their intake of illicit substances. This type of questionnaire may also be used to see if the young people are seeing a positive result from receiving an intervention. However, self-report measures are open to social desirability bias meaning that many young people may fabricate their answer s in order to either please the professionals who are involved with helping them or to conceal ongoing substance abuse. The review has also emphasized the causes or triggers of alcohol and drug abuse among young people in the United Kingdom showing that the environment a young person stays in is one of the greatest factors that lead to indulgence in alcohol, drug and substance abuse. Other factors like enjoyment, peer pressure, promotions in the media and rebellion are also causes of alcohol, drug and substance abuse among the youth in the United Kingdom (Gurnack, Atkinson and Osgood, 2002). More focus on these root causes could help improve prevention and reduce the need for later intervention, which has a poor track record of success. Finally, there is need according to the literature review to improve media perception of mental health patients in order to help alleviate the conditions of psychiatric disorders that are caused by the indulgence of young people in alcohol, drug and substance abuse (Berglund and Thelander, 2003). This doesn’t indicate failure in the mental nursing services but it just implies that mental health workers and psychiatrists need reinforcement in order to positively contribute to successful intervention (Califano, 2007). This suggestion is based on the need for a more holistic approach when it comes to treating young people with substance abuse issues, where the effect on all areas of their life including their mental health must be taken into account during intervention. Strengths of this Critical Literature Review Secondary data was reviewed in this project, which provided larger scope on choices of information for the project. In addition this review was able to identify key areas for improvement of health condition interventions for youths affected by substance abuse. Limitations of this Critical Literature Review This literature review was small in scale, since word and time limits were set. Although 23 articles were selected for review, this number could have been improved. 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London, UK: Office for National Statistics. Parker, H.J., Measham, F. and Aldridge, J. (1995) Drugs futures: changing patterns of drug use amongst English youth. London: Institute for the Study of Drug Dependence. Petrie, K. and Brook, R. (2011) Sense of coherence, self-esteem, depression and hopelessness as correlates of reattempting suicide. British Journal of Clinical Psychology, 31(3), pp. 293-300. RachBeisel, J., Scott, J. and Dixon, L. (1999) Co-occuring severe mental illness and substance use disorders: A review of recent research. Psychiatric Services, 50(11), pp. 3. Royal College of Nursing (2013) RCN library services and archives. [online] Available at: http://www.rcn.org.uk/development/library [Accessed 26 March 2013]. Royal College of Psychiatrists (2013) Useful Resources. [online] Available at: http://www.rcpsych.ac.uk/usefulresources.aspx [Accessed 26 March 2013]. Shiner, M. and Newburn, T. (1997) Definitely, maybe notThe normalisation of recreational drug use amongst young people. Sociology, 31(3), pp. 511-529. Smedslund, G., Berg, R.C., Hammerstrom, K.T., Steiro, A., Leiknes, K.A., Dahl, H.M. and Karlsen, K. (2011) Motivational interviewing for substance abuse. Cochrane Database for Systematic Reviews, Issue 5. Sobocki, P., Jonsson, B., Angst, J. and Rehnberg, C. (2006) Cost of depression in Europe. The Journal of Mental Health Policy and Economics, 9(2), pp. 87. Spooner, C. and Hall, W. (2002) Preventing drug misuse by young people: we need to do more than ‘just say no.’ Addiction, 97(5), 478-481. Sutcliffe, C.G., German, D., Sirirojn, B., Latkin, C., Aramrattana, A., Sherman, S.G. and Celentano, D. (2009) Patterns of methamphetamine use and symptoms of depression among young adults in Northern Thailand. Drug and Alcohol Dependence, 101(3), pp. 146-151. Tevyaw, T.O. and Monti, P.M. (2004) Motivational enhancement and other brief interventions for adolescent substance abuse: foundations, applications and evaluations. Addiction, 99, pp. 63-75. Velleman, R.D.B., Templeton, L.J. and Copello, A.G. (2005) The role of the family in preventing and intervening with substance use and misuse: a comprehensive review of family interventions, with a focus on young people. Drug and Alcohol Review, 24, pp. 93-109. Vimpani, G. and Spooner, C. (2003) Minimising substance misuse by strategies to strengthen families. Drug and Alcohol Review, 22, pp. 251-254. Waldron, H.B. and Kaminer, Y. (2004) On the learning curve: The emerging evidence supporting cognitive-behavioural therapies for adolescent substance abuse. Addiction, 99, pp. 93-105. Weaver, T., Madden, P., Charles, V., Stimson, G., Renton, A., Tyrer, P., Barnes, T., Bench, C., Middleton, H., Wright, N., Paterson, S., Shanahan, W., Seivewright, N. and Ford, C. (2003) Comorbidity of substance misuse and mental illness in community mental health and substance misuse services. The British Journal of Psychiatry, 183, pp. 304-313. Webster, L.R. (2005) Methadone-related deaths. Journal of Opioid Management, 1(4), pp, 211-217. Woo, S. M. and Keatinge, C. (2008) Diagnosis and treatment of mental disorders across the lifespan. Hoboken, N.J: John Wiley & Sons. APPENDICES Appendix A Search Term: â€Å"Drugs and substance abuse.† SourceNumber of Relevant Hits Department of Health0 NHS Evidence5597 PsychINFO22 PubMed2337 Google Scholar1,070,000 Nursing.net4435 Nursing and Midwifery Council59 Royal College of Psychiatrists477 Royal College of Nursing library services1,753 Search Term: â€Å"Alcohol Abuse.† SourceNumber of Relevant Hits Department of Health0 NHS Evidence6893 PsychINFO92 PubMed87,995 Google Scholar1,480,000 Nursing.net1760 Nursing and Midwifery Council138 Royal College of Psychiatrists629 Royal College of Nursing library services1,654 Search Term: â€Å"Effects of alcohol abuse.† SourceNumber of Relevant Hits Department of Health0 NHS Evidence5476 PsychINFO31 PubMed21,363 Google Scholar1,430,000 Nursing.net8502 Nursing and Midwifery Council40 Royal College of Psychiatrists531 Royal College of Nursing library services2,590 Search term: â€Å"Intervention measures for drugs and substance abuse.† SourceNumber of Relevant Hits Department of Health0 NHS Evidence3169 PsychINFO3 PubMed215 Google Scholar174,000 Nursing.net7672 Nursing and Midwifery Council23 Royal College of Psychiatrists302 Royal College of Nursing library services3,250 Appendix B TitleFirst AuthorPublication Year 1Drug treatment and twelve-step program participation: the additive effects of integrated recovery activities.Fiorentine2000 2A critical review of adolescent substance abuse group treatments.Engle2009 3Co-occuring severe mental illness and substance use disorders: A review of recent research.RachBeisel1999 4Statistics for young people in specialist drug and alcohol services in England 2011-12National Drug Treatment Monitoring System2012 5Substance abuse in young people.Gilvarry2000 6The efficacy of single-session motivational interviewing in reducing drug consumption and perceptions of drug-related risk and harm among young people: results from a multi-site cluster randomised trial.McCambridge2004 7The role of the family in preventing and interviewing with substance use and misuse: a comprehensive review of family intervention, with a focus on young people.Velleman2005 8School effects on young people’s drug use: a systematic review of interv ention and observational studies.Fletcher2008 9A review of community-based interventions to reduce substance misuse among vulnerable and disadvantaged young people.Jones2006 10Motivational enhancement and other brief interventions for adolescent substance abuse: foundations, applications and evaluations.Tevyaw2004 11Motivational interviewing for substance abuse.Smedslund2011 12On the learning curve: the emerging evidence supporting cognitive-behavioural therapies for adolescent substance abuse.Waldron2004 13Testing the effectiveness of cognitive-behavioral treatment for substance abuse in a community setting: within treatment and posttreatment findings.Morgenstern2001 14Family-based interventions for substance use and misuse prevention.Kumpfer2003 15Deterioration over time in effect of Motivational Interviewing in reducing drug consumption and related risk among young people.McCambridge2005 16Drug misuse: psychosocial interventions: full guideline.National Institute for Health and C linical Excellence2007 17Substance abuse treatment and the stages of change: Selecting and planning interventions.Connors2001

Friday, August 30, 2019

Assessment on Communication Skills in the Area of Speaking and Writing Essay

People talk face to face, and they listen to each other. They write emails and reports and read the documents that are sent to them Human beings are communicating. In both decoding and encoding messages, people spend almost 70% of communication time as speakers. (Jaime Gutierrez-Ang 2009). Communication is two way process by which information is exchanged between or among individuals through a common system of symbols, science and behavior (Martinez 1) Being a two way process, communication occurs in a orderly and systematic sequence wherein human beings are able to see and hear what transpires in their environment. As a process, communication is dynamic, adaptive and continuous. Being a survival mechanism, communication helps us develop to be unique persons, relating and cooperating with others. It satisfies our physical, ego, social and practical needs. It is indeed essential in life. (Mely M. Padilla et.al 2003) Speaking and writing are skills that have similarities. Both require the use of language symbols to express needs and feelings, they are both governed by the rules of semantics and syntax. Both are also expected to achieve communicative purpose- a degree of understanding, common knowledge and shared expectations. In speech, we monitor what we say by listening to the revised or connected ideas, while in writing, we monitor what we write by reading and rereading. Furthermore, the speaker and the writer should be able to determine how simple or complex and formal the statements should be. But there are differences in speaking and writing too. Writing differs in speech in several ways. According to Vygotsky ,e.f Hughey 1983, composing a written discourse is a â€Å"separate linguistic function differing from oral speech in both structure and mode of functioning. Even its minimal development requires a high level of abstraction†. Writing is significantly different from speaking because writing requires a more complex and difficult discourse. (Saymo, 2004.) In reflecting upon and surfing out communication skills, then think of communication as ways and means of gathering and relying information, and think of information as what there is to be gathered by any means that is consider the widest range of writing and speaking as you consider your communication skills. In relevance to the Department of College of Education, Communication skills of the students have to be enhanced. The researchers encouraged the department that through Speech Laboratory to measure the speaking skills of the students as well as the writing skills where in the teachers can identify where the strength of the students and of the their weaknesses are in the components communication skills in the area of speaking and writing. It is also an instrument to detect students’ potential in speech so that it can be developed and can be a product of the department in the area of speaking and writing. The researchers look forward for the program that can be developed based on the results of the study. It will be a universal program for the teachers to have the better and effective instructional materials. The researchers foresee the unbiased treatment of the teachers towards the students through the help of universal program. STATEMENT OF THE PROBLEM This study aims to determine the levels of communication skills of BEED Gen.Ed freshmen students of Carlos Hilado Memorial State College for the first semester academic year 2013-2014 as Basis for Program Development. Specifically, it will aim to answer the following specific questions. 1. What are the levels of Communication Skills of BEED Gen. Ed freshmen students in the area of speaking and writing when they are grouped according to: a) School Graduated b) Mental Ability c) Parents’ Educational Attainment 2. What are the difficulties in the components of Communication Skills of BEED Gen. Ed freshmen students when they are grouped according to: a) School Graduated b) Mental Ability c) Parents’ Educational Attainment 3. Is there a significant difference on the level of communication skills in the area of speaking and writing when they are compared according to: a) School Graduated b) Mental Ability c) Parents’ Educational Attainment 4. Based on the results, what program should be developed? HYPOTHESIS There is no significant difference on the level of communication skills of BEED Gen. Ed. freshmen students in the area of speaking and writing when they compared according to where school they graduated, mental ability and what their parents’ educational attainment. THEORETICAL FRAMEWORK Communication is the way to learn the person. If he is to be deprived of the chance to communicate with others, he should have sense of identity. It is through communication that one gets the chance for affirmation of self-concept and sharing of views about a variety of things among others. People relate socially with each other through communication. Personal communication is essential for a person’s well-being. Sufficiency or absence of communication has a bearing on one’s state of physical health. For one, stress is heightened or dissipated depending on communication or lack of it and the nature of its content. So as being a two-way process, communication occurs in an orderly and systematic sequence where in human beings are able to see and hear transpires in their environment (William Schutz). These statements emphasize the importance of communication in different area of human needs. Communication is very essential because human being develops their capability to speak through interaction with others. Especially the children ages 1-5, they are great imitators. They observe the actions of their parents, brother and sister, playmates and others. They tend to discover the words by their own through observation. According to George T. Wilkins Speech is the most important of all means of communication. In the great government politics, and in the expression of our own democratic rights, speech is also most important. Good speech is essential to participate in democracy. As to the students, speech can help express their feelings. It can help through participating in classroom discussions, reciting in classroom activities and reporting assigned tasks. Effectiveness in speaking is a climb to a ladder of seven steps (Eugine E. White and Claire K. Neudelider). The quote stated that the speaker should first analyze and know the audience that will listen. In connection to the communication skills assessment, the students that have difficulties in speaking will assess by the recommendations and develop program that this study aims to achieve. For further information, communication is the KEY which unlocks all the doors to a successful and fulfilling school life experience, to getting cooperation with your students, that allows us to feel understood, for resolving conflicts between teachers and students, to let students know what your needs are and how best to meet those needs, to fewer conflicts in the classroom and in the playground, to building self-confidence and self-esteem, to feeling listened to by your students, mutual respect in the classroom, to less resistance and more cooperation, to everyone feeling safe to be themselves and to have more fun in the classroom. (http://sydney.edu.au/science/uniserve_science/projects/skills/jantrial/communication/communication.htm) . These only prove that communication is really very important in life especially in the teaching and learning process. It is the key to open the teacher and student mind and their capabilities to speak and write well. C

Thursday, August 29, 2019

Children and Violent Video Games

â€Å"The worst thing a kid can say about homework is that it is too hard. The worst thing a kid can say about a game is it's too easy. † This was actually quoted by Henry Jenkins. Good Morning My Fellow Students and judges, as you all would know I would be discussing the topic video games cause violence and I would be talking in favor of this topic. More and more kids today are playing video and computer games — especially ultra-violent ones that are top sellers. A recent analysis shows that a majority of video games include violence and about half of the violent incidents would result in serious injuries or death in the real world.Violent video games can increase children's aggression. The number one negative effect is they tend to inappropriately resolve anxiety by externalizing it. So when kids have anxiety, which they do, instead of soothing themselves, calming themselves, talking about it or even expressing it emotionally by crying, they tend to externalize it. Th ey can attack something, they can kick a wall, they can be mean to a dog or a pet. Additionally, there's an increased frequency of violent responses from children who play these kinds of video games. Violent video games don't teach kids moral consequences.If you shoot somebody in one of these games, you don't go to jail, you don't get penalized in some way — you get extra points! This doesn't mean that children will go out into the world and shoot someone. â€Å"But they do use more aggressive language, they do use more aggressive expressions, they have less ability to control their anger and they externalize things in these violent ways. It's absolutely not good. The American Psychological Association says playing violent games correlates to children being less caring and helpful toward their peers.And these effects happen just as much for non-aggressive children as they do for children who already have aggressive tendencies. Children spend a great deal of time with violent video games at exactly the ages that they should be learning healthy ways to relate to other people and to resolve conflicts peacefully. Thus I think that playing violent video games is the same as watching violent movies, they are all scripted in the same way and they put you through the violence training. I would say that we should Jump off the video games and get a life! Children and Violent Video Games â€Å"The worst thing a kid can say about homework is that it is too hard. The worst thing a kid can say about a game is it's too easy. † This was actually quoted by Henry Jenkins. Good Morning My Fellow Students and judges, as you all would know I would be discussing the topic video games cause violence and I would be talking in favor of this topic. More and more kids today are playing video and computer games — especially ultra-violent ones that are top sellers. A recent analysis shows that a majority of video games include violence and about half of the violent incidents would result in serious injuries or death in the real world.Violent video games can increase children's aggression. The number one negative effect is they tend to inappropriately resolve anxiety by externalizing it. So when kids have anxiety, which they do, instead of soothing themselves, calming themselves, talking about it or even expressing it emotionally by crying, they tend to externalize it. Th ey can attack something, they can kick a wall, they can be mean to a dog or a pet. Additionally, there's an increased frequency of violent responses from children who play these kinds of video games. Violent video games don't teach kids moral consequences.If you shoot somebody in one of these games, you don't go to jail, you don't get penalized in some way — you get extra points! This doesn't mean that children will go out into the world and shoot someone. â€Å"But they do use more aggressive language, they do use more aggressive expressions, they have less ability to control their anger and they externalize things in these violent ways. It's absolutely not good. The American Psychological Association says playing violent games correlates to children being less caring and helpful toward their peers.And these effects happen just as much for non-aggressive children as they do for children who already have aggressive tendencies. Children spend a great deal of time with violent video games at exactly the ages that they should be learning healthy ways to relate to other people and to resolve conflicts peacefully. Thus I think that playing violent video games is the same as watching violent movies, they are all scripted in the same way and they put you through the violence training. I would say that we should Jump off the video games and get a life!

Wednesday, August 28, 2019

The Future of Cybersecurity Essay Example | Topics and Well Written Essays - 1750 words

The Future of Cybersecurity - Essay Example As we have seen $14 billion has been invested by the U.S federal government to empower its security sector (Amoroso & Amoroso, 2007). This research aims to answer some of the important questions that are associated with cyber security. In this scenario, this paper attempts to answer the questions such as what changes need to occur in the cyber security industry of the future and why. And is cyber security becoming more important to national security than the security of kinetic weaponry? The outburst of Cyber Assault The countries which are currently attacking United States include China and Russia. In fact, the chances of cyber security attacks have increased to a huge extent from these two nations because of their original revival in the global economy. The United States has been accusing both China and Russia of current attacks that the United States has been experiencing. The current technological advancement has greatly influenced several nations which have mainly exposed China, United States, UK and Bangladesh. It is quite expected that physical defense associated with countries particularly talking about USA will be affected which mainly with cyber terrors. Threats for controlling systems can be associated from various resources especially antagonistic governments, terrorist associations (staysafeonline.org, 2013). Additionally, for ensuring confidentiality and privacy in the informatics, it is exceedingly recommended that there should be a national level association to demeanor the in vogue studies and prepare reports on issues in the works at the crossroads of cyber attacks and privacy, society level suggested boards that would help speak to these issues from local or community perspectives. In addition, there is also a risk that even the restricted public cyber attacks that have been modeled after the ethics committees to take in hand the explicit situations concerning health data and privacy should be working in order to preserve the restrictions rel ated to the field of cyber security. In this scenario, some of the major suggestions regarding implementation of security measures to deal with these cyber attacks include adopting the restricted, well defined, well practiced and fruitful public security requirements, including a focused assessment of security attentiveness for all public systems, and contemplation for split funding of the work compulsory to achieve ample security. It is an admitted fact that securing the rights of the people and retaining their due confidence is the responsibility taken up by the government and this has been very intensely regulated by institutions (govtrack.us, 2012). President Obama perception on Cyber Attacks A Cyber security executive orders were issued by the president of the U.S.A, Barack Obama, drew the attention by proposing policies that could defend the country from the current torment of cyber attacks

Tate & Lyle Sugar to Be Fair-Trade Case Study Example | Topics and Well Written Essays - 1000 words - 15

Tate & Lyle Sugar to Be Fair-Trade - Case Study Example It is evidently clear from the discussion that during the growth stages of a product, the product manufacturers should focus more on devising specific strategies for maintaining growth. During this stage; â€Å"more competitors will enter the market, companies increase the number of product offerings in order to differentiate themselves from competitors, the prices may begin to fall and the emphasis may shift from moderate to heavy advertising and promotion activities†(Planning: Middle Growth Stage, 2010). Tate & Lyle’s product Granulated white sugar is in the growth stage of its product life cycle and hence it may severe completion from the market as more and more competitors may enter the market for reaping the profit. It is difficult for Tate & Lyle to sell their product for a higher price even though the sales volume and public awareness may increase.  Tate & Lyle needs to elaborate on their distribution or logistics channels in order to reach more remote customer s during the growth stage of their product, Granulated white sugar. Moreover, the expenditure on promotional activities and advertising should be increased in order to tackle the efforts of competitors. Even though the sales of Granulated white sugar may increase during the growth stage, the expenditure for maintaining the growth phase would be more than any other stages of the entire life cycle of the product.

Tuesday, August 27, 2019

International Politics Essay Example | Topics and Well Written Essays - 1500 words

International Politics - Essay Example This paper aims to critically review the book ‘Why Globalization Works’ which is written by Martin Wolf. In order to support the arguments, evidences from the text will also be presented. Author’s Argument Martin Wolf has presented the topic of globalization rationally. Defending globalization, the author argues that anti globalization, failure of governments and systems have been the cause of global market failures. Wolf also dismantles the argument that rich countries exploit smaller countries. He has drawn a clear picture where the problem exists (Wolf). â€Å"The failure of our world is not that there is too much globalization, but that there is too little† (Wolf 4). Thesis Statement   â€Å"For the greater good, globalization itself is a vibrant channel but as how the political system has mismanaged or mislead this channel of globalization, it has brought the worst affects throughout the world, to the world economies and to their systems†. Bod y The book has a strong appeal for those who are interested in globalization and its future; how democracies will make the most out of this phenomenon and how governments and their free markets will collapse due to its wrong or mere use. In order to understand the author’s argument and to prove the thesis statement, a critical analysis of the book is given below. The idea that distance, space, and technology matters is not disagreed but at the same time a territorial authority of states matter. Even though technology is noticed as a sound source which allows strong territorial control and monitoring of physical objects that crosses the borders, states should not emphasize and rely heavily on the regulation of markets; local or international. The state or a government will itself decide and plan to which extent it is going to utilize the opportunities presented by globalization (Wolf). Market failures are noticed not because of globalization but because of the system failure a nd the weak and ineffective policies. These failures are usually local. It is also due to the central planning as the author has termed it as ‘ludicrous’ as it does not reflect the consumer behavior or his taste, lacking the element of innovation (Wolf 59-60). It is the duty of the government to cater the basic needs of consumers by providing them the basic goods (Wolf). In order to prosper and grow, a state should realize that it needs to clean its debt and at the same time should also protect what belongs to the public. The state must show elements of ‘credibility, predictability, transparency, and consistency’ (Wolf 25). Moreover, the government must refrain itself in interfering in the business deals of merchants and investors. It should let them do business as they want because it is evident that all the Western societies have been crafted by these businessmen using the elements of ‘practicality, rationalism, and freedom of inquiry’ (Wolf) . The author of the book Martin Wolf comes with a very comprehensive definition of globalization that it is something which is meant for the greater good, for the good of the world, for the good of the world’s economies and their economic revivals. The author describes globalization as a method of free trade, and a method where free movement of goods, resources and opportunities are made possible. Globalization itself is an idea to promote the greater integration of the world as the author

Monday, August 26, 2019

WGST 400 Assignment 4 Research Paper Example | Topics and Well Written Essays - 5000 words

WGST 400 Assignment 4 - Research Paper Example of both self-emancipation and social emancipation.1 In England, the term was first employed in the1890s during women’s campaign for individual rights and the claim to citizenship, especially the right to vote. The campaign for suffrage challenged the denial of autonomy to women as citizens and feminists of the period stood for women’s right to ‘a democratic political voice and a social right to resources.’2 However, the meanings of feminism in England extended beyond the campaign for suffrage and encompass such aspects as the segregation and stigmatization of women’s gender roles, celebration of women’s uniqueness and differences, socio-economic and cultural issues of women, equal rights for women, education disparities of women, equality of opportunities and equal wages, antimilitarism and pacific movements, women emancipation movements, and so on. It is worthwhile to analyze the historical growth and development of feminist movements in Great Britain. Organized feminist movements in England can broadly be categorised into two phases-the first wave feminism and the second wave feminism. The first wave feminism consists of feminist movements in the nineteenth and early twentieth centuries, covering the campaign for suffrage as well as feminist experiences during and after the First and Second World Wars. The second-wave feminism covers feminist initiatives beginning from the mid-or late 1960s and extends itself to modern radical feminism. The nineteenth-century intellectual and economic developments, specifically liberalism and the industrial revolution, paved the way for the first wave feminism.3 While liberalism triggered the growth of liberal feminism the industrial revolution offered middle class women a unique opportunity to work out of home and earn money. Similarly, the theory of relative status deprivation has been part ly responsible for the rise of feminism as women strongly felt that they are negated of adequate opportunities whereas their

Sunday, August 25, 2019

Article - Evaluation methods Assignment Example | Topics and Well Written Essays - 250 words

Article - Evaluation methods - Assignment Example Cardinal Health Inc. would have mismanaged the company by looking at the numbers while entering the deal rather than the fit and culture of the acquisition. With the company attempting to expand its medical products portfolio, the management ought to evaluate the viability of acquiring the heart-product business from Johnson & Johnson rather than the figures in terms of profits. The author illustrates that Cardinal Health Inc. establishes standards of performance by setting fit and culture first to evaluate performance. The figures come later as parameters of actual performance. In the article, Cardinal Health Inc. relies on the standards of performance for the deal (fit and culture) to attain actual performance. Therefore, the evaluation method entails establishing the standards first to understand how actual performance is achievable. For example, by evaluating the fit and culture of the acquisition, the company expects that the heart-product business will be accretive in the fiscal year 2017 by approximately 20 cents or more. According to the model, the evaluation process may commence with comparing standard performance with actual performance. In the article, Cardinal Health Inc. appreciates that by adopting the fit and culture of the acquisition, the company will earn $100 million in synergies. Willhite, James. "The Morning Ledger: Why CFOs Should Look Past Numbers to Evaluate a Deal." The CFO Report RSS. Wall Street Journal, 6 Mar. 2015. Web.

Saturday, August 24, 2019

When does sexual identity begin Research Proposal

When does sexual identity begin - Research Proposal Example As puberty ensues, the human body and mind goes through a developmental quagmire that most adults will admit they barely survived. In adulthood, a human has, hopefully, navigated all of these influences to create their sexual identity. Hormonal influence in the womb can influence the sexual identity of a child. Testosterone levels have been proven to influence girls by the level to which the behave more feminine or masculine in their childhood. A study done by Melissa Hines, Charles Brook and Gerard S. Conway at City University in conjunction with Bristol University, discovered that girls exposed to higher levels of androgens, testosterone in the womb While this information was not relevant to boys in this test, this does indicate that the various hormones levels of a mother can have influence on the development of the child. As these type of studies progress, more information will come to light helping to identify the medical influences that help to create the fully developed adult sexual identity. Of course, the danger in this type of research is the possibility of allowing parents to try and use these influences to medically manipulate a fetus to a more â€Å"desirable† outcome. Sexual identity can be defined by two criteria. The first criteria is the simple (or at least usually simple) association made by physical characteristics. Ones sexual identity is first based on the physical gender characteristics that were evident at birth. A child is born with female genitals and is then immediately socialized as a female. The same is true for a male. This socialization is the first battlefield on which a child will stand. Comments will come from toddlers in American society such as ’ I won’t wear that - it’s pink! Pink is for girls!’ or ’I want a doll for Christmas because I want to be a mommy when I grow up.’. In an article

Friday, August 23, 2019

Response paper about an article called ''Cuba Revolutionary Essay

Response paper about an article called ''Cuba Revolutionary Projections - Essay Example its socio-political transformation that had witnessed changing social structure of Cuba along with changing international alliances with withdrawal of American influences, including Hollywood films and emergence of socialistic culture and its coalition with Soviet Union etc. Consequently, films became the major platform to showcase transforming picture Cuba and an important way to influence the taste and preferences of people of Cuba who had become addicted to Hollywood films. ICAIC had contributed to the creative evolution of Cuban cinema despite its limited resources. It had not only helped make permanent record of the Cuban revolution but also encouraged Cuban artists and filmmakers to experiment and exploit media. In 1962, Mobile cinema had reached communities who had previously no access to films and their undiluted enthusiasm was captured in Octavio Cortazar’s short film, Por Primera vez. Eminent filmmakers had made their mark in the decade with highly creative films that had showcased the theme of revolution in bourgeois setting. Thus, films like Death of a Bureaucrat (Garcia Espinoza), Memories of the Underdevelopent, 1968 (Tomas Gutierrez Alea), Lucla (Humberto Solaz), The First machete Charge (Octavio Gomez), NOW, Hanoi Tuesday 13th, Seventy Nine Springs etc. by Santiago Alvarez etc. had brought Cuban films into the center stage of International film arena. (words:

Thursday, August 22, 2019

1920s medicine Essay Example for Free

1920s medicine Essay The 1920s had many discoveries and innovations when it comes to medicine and science. Many of the things that we now take for granted were just getting their start during the 20s. Throughout the 1920s, new innovations in the medical and science field led to the discovery of vitamins and knowing more than ever before about the human body. New vital drugs and vaccines were created in this era that are hard to imagine not having today. The invention/discovery of the first anti-bacterial drugs saved more people from bacterial and viral infections than any previous time. Before the 1920s many medical conditions were untreatable or even deadly that we now consider to be easily cared for. Penicillin was one of the big medical discoveries of the 20s, the worlds first antibiotic. Penicillin was discovered by Alexander Flemming when he was examining mold and bacterial growth. This discovery opened up the possibilities for killing bacterial infections and without this many other medical innovations would not have occurred. Insulin was another major medical discovery in the 20s. Without this people with diebetes would not be able to properly treat their condition and thousands would die from a now treatable disorder. Various types of vitamins were also discovered in the 20s that help people today stay healthy. The medical field would not be what it is today if it wasnt for the research put in by people of the 1920s. Millions of lives were saved due to the medical discoveries that were made in the 1920s. Without Penicillin, there may have never been any antibiotics created and a bacterial infection would mean a slow death. Insulin saves those with diebetes lives daily and without it diebetes would be considered a deadly condition. Life just wouldnt be the same today if none of medical innovations of the 20s happened.

Wednesday, August 21, 2019

Approval Letters Essay Example for Free

Approval Letters Essay SAE-UMP Chapter Shell Eco-marathon Asia 2013 Team. 1) Nik Fadhil B Nik Mohammed 24-Jul-1990 23 Year Old EC09051 (Yr. 4) Bachelor of Electrical Engineering (Power System) Faculty of Electrical and Electronics Engineering 2) Muhammad Hisyamuddin b Jaafar 11-Jan-1990 23 Year Old MH09014 (Yr. 4) Bachelor of Mechanical Engineering with Automotive Engineering Faculty of Mechanical Engineering 3) Wan Nurul Syahirah Binti Wan Lanang 15-May-1992 21 Year Old FB11041 (Yr. 2) Bachelor of Mechatronics Engineering Faculty of Manufacturing Engineering 4) Mohd Najmi Bin Harith 19-Aug-1992 21 Year Old MH11099 (Yr. 2) Bachelor of Mechanical Engineering with Automotive Engineering Faculty of Mechanical Engineering 5) Muhammad Taufiq Bin Taha 6-Feb-1992 21 Year Old FA11025 (Yr. 2) Bachelor of Manufacturing Engineering Faculty of Manufacturing Engineering 6) Nur Aisvah Binti lsmail 2-Jan-1992 21 Year Old MH11062 (Yr. 2) Bachelor of Mechanical Engineering with Automotive Engineering Faculty of Mechanical Engineering 7) Muhammad Haziq Bin Mazlan 4-Sep-1992 21 Year Old MH11042 (Yr. 2) Bachelor of Mechanical Engineering with Automotive Engineering Faculty of Mechanical Engineering ) Muhammad Najmuddin Bin Moskori 13-Nov-1992 21 Year Old MH11020 (Yr. 2) Bachelor of Mechanical Engineering with Automotive Engineering Faculty of Mechanical Engineering 9) Wan Muhamad lzzudin Bin Wan lbrahim 4-Nov-1992 21 Year Old MH11038 (Yr. 2) Bachelor of Mechanical Engineering with Automotive Engineering Faculty of Mechanical Engineering 10) Loo Fu Hong 6-Dec-1991 22 Year Old MC12051 (Yr. 2) Bachelor of Mechanical Engineering with Automotive Engineering Faculty of Mechanical Engineering 11) Mohd Firdaus Bin Mohd Rosli 20-Nov-1989 24 Year Old MH09086 (Yr. 4) Bachelor of Mechanical Engineering with Automotive Engineering Faculty of Mechanical Engineering 12) Mohammad Hanif Bin Rameli 11-Sep-1992 21 Year Old MH11032 (Yr. 2) Bachelor of Mechanical Engineering with Automotive Engineering Faculty of Mechanical Engineering 13) Tang Shuen Cherng 15-March-1992 21 Year old FB12056 – (Yr. 2) Bachelor of Mechatronics Engineering Faculty of Manufacturing Engineering 14) Muhammad Khaidir B Azman 24-March-1994 19 Year Old MB12061 – (Yr. 1) Bachelor of Mechanical Engineering with Automotive Engineering Faculty of Mechanical Engineering 15) Muhammad Nabil Fikri B Mohamad -Dec-1993 20 Year old MA12070 – (Year 1) Bachelor of Mechatronics Engineering Faculty of Manufacturing Engineering 16) Nor Arina Binti Ali Kangsa 4-Jan-1992 22 Year Old MH11090 – (Year 2) Bachelor of Mechanical Engineering with Automotive Engineering Faculty of Mechanical Engineering 17) Wan Amir Haziq B. Wan Mohd Pandi 15-July-1994 19 Year Old MB12056 Bache lor of Mechanical Engineering with Automotive Engineering Faculty of Mechanical Engineering 18) Ng Yee Shian 25-April-1992 21 Year Old MC12054 – (Year 1) Bachelor of Mechanical Engineering with Automotive Engineering Faculty of Mechanical Engineering 9) Raja Imran Shah B. Raja Badrin Shah 24-Apr-1992 21 Year Old MH11036 (Yr. 2) Bachelor of Mechanical Engineering with Automotive Engineering Faculty of Mechanical Engineering 20) Muhammad Aiman Safwan B. Jubri 11-Jan-1994 19 Year Old MB12068 – (Year 1) Bachelor of Mechanical Engineering with Automotive Engineering Faculty of Mechanical Engineering 21) Ng Wei Ming 21-Jan-1992 21 Year Old MC12056 – (Year 1) Bachelor of Mechanical Engineering with Automotive Engineering Faculty of Mechanical Engineering 22) Nor Fadilah Binti Ahmad 19-June-1991 22 Year Old MH11097 – (Year 2) Bachelor of Mechanical Engineering with Automotive Engineering Faculty of Mechanical Engineering 23) Lee Shun Jian 25-June-1992 21 Year Old FB12043 – (Year 1) Bachelor of Manufacturing Engineering Faculty of Manufacturing Engineering 24) Chan Chao Shiung 24-August-1989 FB12061 – (Year 1) Bachelor of Manufacturing Engineering Faculty of Manufacturing Engineering 25) Mohd Aiman Bin Mahusin 19-Jan-1990 MH09068 (Yr. 4) Bachelor of Mechanical Engineering with Automotive Engineering Faculty of Mechanical Engineering 26) Mohd Amiruddin Bin Alias 14-Jan-1992 MH11076 (Yr. 2) Bachelor of Mechanical Engineering with Automotive Engineering Faculty of Mechanical Engineering 27) Nurul Hasnah binti Awang 24-May-1992 FB11011 (Yr. 2) Bachelor of Mechatronics Engineering Faculty of Manufacturing Engineering 28) Muhamad Syazwan Bin Zolkafli 6-Jul-1991 MH11074 (Yr. 2) Bachelor of Mechanical Engineering with Automotive Engineering Faculty of Mechanical Engineering 29) Che Wan Abdul Rashid Bin Che Wan Hitam 14-Jan-1992 MH11015 – Yr 2 Bachelor of Mechanical Engineering with Automotive Engineering Faculty of Mechanical Engineering

Planeación estratégica

Planeacià ³n estratà ©gica REPASO DE CONCEPTOS Bà SICOS Planeacià ³n: Proceso de establecer objetivos y escoger el medio mà ¡s apropiado para el logro de los mismos. Planeacià ³n estratà ©gica: Proceso por el cual los miembros guà ­a de una organizacià ³n prevà ©n su futuro y desarrolla los procedimientos y operaciones necesarias para alcanzarlo. La planeacià ³n estratà ©gica debe de responder a 3 preguntas:  ¿Hacia dà ³nde va?  ¿Cuà ¡l es el entorno?  ¿Cà ³mo lograrlo? La estrategia se involucra en 6 factores crà ­ticos Desarrollo consistente, explicito y proactivo Medio para establecer el propà ³sito en la organizacià ³n basado en los objetivos de largo plazo, planes de accià ³n y asignacià ³n de recursos En quà © tipo de negocio se està ¡ La estrategia representa una respuesta al FODA para la ventaja competitiva La estrategia ayuda a diferenciar las tareas ejecutivas y administrativas y los roles a nivel corporativo de negocio y funcionales. Constituye una forma de definir la contribucià ³n econà ³mica y no econà ³mica que la organizacià ³n harà ¡ a sus grupos de interà ©s, su razà ³n de ser. Administracià ³n estratà ©gica: Es la ejecucià ³n de la planeacià ³n estratà ©gica. Planeacià ³n tà ¡ctica y operativa: Se relacionan a cà ³mo hacer el trabajo, mientras que la planeacià ³n estratà ©gica se dedica a decir quà © se debe hacer. DIRECCIONAMIENTO ESTRATÉGICO: Es una disciplina que a travà ©s de un proceso denominado planeacià ³n estratà ©gica compila la estrategia de mercado que define la orientacià ³n de los productos y servicios hacia el mercado.  ¿Por quà © es importante desarrollar un plan estratà ©gico? La necesidad de contar con una visià ³n comà ºn y un sentido de trabajo en equipo El deseo de controlar el destino de la empresa El afà ¡n de obtener mà ¡s recursos para la operacià ³n. La percepcià ³n de que los à ©xitos operativos actuales de la compaà ±Ãƒ ­a no eran garantà ­a para el futuro La necesidad de salir de los problemas La oportunidad de explotar un nueva coyuntura o abordar una nueva amenaza. La necesidad de pasarse la antorcha y cargarla cuando hay relevos en la direccià ³n. La planeacià ³n puede tener 4 enfoques: Reactiva o planeacià ³n a travà ©s del espejo retrovisor Inactiva o que va con la corriente Preactiva o que se prepara para el futuro Proactiva o que diseà ±a el futuro y hace que à ©ste suceda. ESTRATEGIAS Para el diseà ±o de la estrategia del negocio se debe conocer el perfil estratà ©gico de la empresa, el cual incluye: Su enfoque de innovacià ³n Su orientacià ³n hacia la toma de riesgos Su capacidad de crear el futuro en forma proactiva Su posicià ³n competitiva Elementos del diseà ±o de la estrategia del negocio: Identificar las principales là ­neas de negocios o actividades estratà ©gicas que la empresa desarrollara para cumplir su misià ³n. Establecer los indicadores crà ­ticos de à ©xito que permitirà ¡n a la organizacià ³n al progreso en cada là ­nea de negocio. Identificar las acciones estratà ©gicas mediante las cuales la empresa lograrà ¡ su visià ³n de la condicià ³n futura ideal. Determinar la cultura necesaria para apoyar el logro de las là ­neas de negocio, los indicadores crà ­ticos de à ©xito y las acciones estratà ©gicas. Grandes estrategias: Una gran estrategia consiste en un enfoque amplio y general que guà ­a las acciones de una là ­nea de negocio. Las grandes estrategias indican la manera como se pretenden lograr los planes estratà ©gicos de cada là ­nea de negocio. Pierce y Robinson identifican 12 grandes estrategias: Crecimiento concentrado o concentrarse en un solo producto que haya sido el soporte rentable de la organizacià ³n. Desarrollo del mercado, es decir, agregar nuevos consumidores a los mercados relacionados. Desarrollo de productos, es decir, crear productos nuevos y relacionados que se puedan vender en los mercados existentes. Innovacià ³n, o generacià ³n de productos tan novedosos y superiores que los existentes se vuelvan obsoletos. Integracià ³n horizontal, es decir, adquirir o fusionarse con una organizacià ³n similar, para reducir la competencia. Integracià ³n vertical: desarrollar una red interna de suministros o desarrollar un sistema de distribucià ³n interna que acerque mà ¡s la compaà ±Ãƒ ­a a sus usuarios finales. Joint-venture o hacer equipo con otra organizacià ³n para desarrollar un nuevo producto o mercado. Diversificacià ³n concà ©ntrica: adquirir o fusionarse con otras empresas que sean compatibles con la tecnologà ­a, mercados o productos de la empresa. Diversificacià ³n: adquirir o fusionarse con una compaà ±Ãƒ ­a que equilibre sus fortalezas y debilidades. Atrincheramiento o reversar las tendencias negativas en las utilidades mediante una variedad de mà ©todos de reduccià ³n de costos. Desistimiento: vender por completo o cerrar definitivamente un segmento de la organizacià ³n. Liquidacià ³n o venta total de la compaà ±Ãƒ ­a de acuerdo con sus activos tangibles y cierre definitivo. MODELO DE PLANEACIÓN ESTRATÉGICA (PE) Para la realizacià ³n de un plan estratà ©gico es necesario seguir los siguientes pasos: 1. Planeacià ³n para planear: Obtener respuestas antes de la inicializacià ³n de cualquier proceso de planeacià ³n. (Quien, cuando, donde, como.) 2. Monitoreo del entorno: Se debe monitorear 4 entornos principales: Macroentorno Industrial Competitivo Interno de la organizacià ³n 3. Bà ºsqueda de valores: Consiste en un examen de los valores actuales, la filosofà ­a de trabajo, los supuestos en las operaciones, la cultura organizacional, los valores de los grupos de interà ©s en su futuro. Valor segà ºn Rokeach: una conviccià ³n permanente de que una forma especà ­fica de conducta o estado final de existencia se prefiere de manera personal o social ante una forma opuesta de conducta o condicià ³n final de existencia. 4. Formulacià ³n de la misià ³n: Desarrollar un enunciado claro del tipo de negocio en que se halla la compaà ±Ãƒ ­a. (Que, para quien, cà ³mo y por quà ©.) 5. Diseà ±o de la estrategia de negocio: Implica el intento inicial de la organizacià ³n para descubrir en detalle los pasos a travà ©s de los cuales se logra la misià ³n de la organizacià ³n. Acciones del proceso de diseà ±o: Identificar: LDN: productos o servicios que ofrecerà ¡ la organizacià ³n en el futuro. Establecer: ICE: indicadores crà ­ticos de à ©xito. Identificar acciones estratà ©gicas mediante las cuales la empresa lograrà ¡ su visià ³n de la condicià ³n futura ideal. Determinar la cultura necesaria para apoyar a las 3 anteriores. 6. Auditoria del desempeà ±o: Desarrollar una comprensià ³n clara de del desempeà ±o actual. FODA, el propà ³sito es poder proporcionar datos para el anà ¡lisis de brechas. 7. Anà ¡lisis de Brechas: Identificar las brechas entre el desempeà ±o actual y el desempeà ±o que se requiere para la exitosa realizacià ³n del modelo de estrategia del negocio. Evaluacià ³n de la realidad vs auditoria del desempeà ±o. El fin es cerrar las brechas entre lo actual y lo deseado en la estrategia de negocios, para ello està ¡n: Ampliar el tiempo para lograr el objetivo, Reducir el alcance del objetivo, Reasignar los recursos y obtener nuevos recursos. 8. Integracià ³n de los planes de accià ³n: Cada LDN debe desarrollar estrategias o planes maestros de negocios. Diversas unidades deben desarrollar planes operativos con base al plan. Pierce y Robinson hablan de 12 estrategias diferentes que se pueden implementar: Crecimiento Concentrado (en un solo producto) Desarrollo de Mercado Desarrollo del producto (crear nuevos bienes) Innovacià ³n Integracià ³n Horizontal Integracià ³n vertical Joint Venture ( Unirse solo para formar un nuevo producto) Diversificacià ³n concà ©ntrica ( adquirir o fusionarse con compaà ±Ãƒ ­as compatibles) Diversificacià ³n Atrincheramiento ( reduccià ³n de costos ) Desposeimiento Liquidacià ³n 9. Planeacià ³n de Contingencias: La planeacià ³n de contingencias implica: Identificar las amenazas y las oportunidades internas y externas Desarrollar puntos de partida a fin de iniciar acciones para cada contingencia Acordar los pasos respectivos para cada punto de partida 10. Implementacià ³n: Implica la iniciacià ³n concurrente de de varios planes tà ¡cticos y operativos diseà ±ados en el nivel funcional mas el monitoreo y la integracià ³n de los planes a nivel organizacional. DEFINICIÓN DE LOS VALORES DE LA ORGANIZACIÓN: La bà ºsqueda de valores en la planeacià ³n estratà ©gica aplicada involucra un anà ¡lisis profundo de los siguientes 5 elementos: Los valores personales del equipo de planeacià ³n Los valores de la organizacià ³n como un todo La filosofà ­a de la organizacià ³n La cultura de la organizacià ³n Los grupos de interà ©s de la organizacià ³n Como manejar las diferencias de valores personales: No pasar por alto un escozor Trabajar en la diferencia antes que se convierta en un problema. Las personas que tienen diferencias deben dialogar y tratar de resolverlas por sus propias cuentas Es bueno solicitar sugerencias al consultor sobre como acercarse a la otra persona o como definir el asunto de la mejor manera. Si alguien se acerca a usted con una diferencia de valores debe estar dispuesto a trabajar con ella sobre ese problema. Si despuà ©s de haber intentado solucionar el problema por su propia cuenta, no hay ningà ºn cambio, debe buscar la ayuda de un consultor. Si un individuo se queja ante usted de los valores de otra persona, motà ­velo a analizar el asunto con dicha persona. ANà LISIS Y MONITOREO DEL ENTORNO: Dos aspectos del proceso y alcance del monitoreo del entorno: a. Tipos de informacià ³n obtenida y la forma como se debe utilizar esta b. Efectividad del sistema de compilacià ³n, almacenamiento, procesamiento, integracià ³n y difusià ³n de la informacià ³n. La informacià ³n debe identificar oportunidades y amenazas emergentes en el entorno externo. Luego debe identificar sus fortalezas y debilidades para responder a estas oportunidades y amenazas. Se deben examinar con regularidad 4 entornos: Macroentorno Entorno industrial Entorno competitivo Entorno interno organizacional Aspectos econà ³micos: Tasas de interà ©s, Ciclo del negocio (afecta a la contraccià ³n expansià ³n) 5 pasos para el sistema de bà ºsqueda de informacià ³n estratà ©gica: Identificar las necesidades de informacià ³n de la empresa en especial para la siguiente fase de la planeacià ³n estratà ©gica. Generar una lista de fuentes de informacià ³n que proporcionen datos esenciales. Identificar a quienes participaran en el proceso de monitoreo del entorno (no miembros del equipo de planeacià ³n). Asignar tareas de monitoreo a varios miembros de la organizacià ³n Almacenar y difundir la informacià ³n AUDITORIA DEL DESEMPEÑO: El equipo de planeacià ³n debe evaluar donde se encuentra la organizacià ³n actualmente con respeto a: Perfil estratà ©gico  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   LDN  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Estrategias  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Cultura 1. Anà ¡lisis FODA: Fortalezas y debilidades internas: Identificar las debilidades que es necesario manejar o evitar cuando se formule el plan y asà ­ mismo las fortalezas que se pueden aprovechar para lograr el futuro deseado. Oportunidades y amenazas externas: El equipo de planeacià ³n debe estudiar competidores, proveedores, mercados y clientes, tendencias econà ³micas, condiciones del mercado laboral y reglamentos gubernamentales en todos los niveles que puedan influir en la empresa, en forma negativa o positiva. La auditoria del desempeà ±o interno debe cumplir con 5 à ¡reas clave: El estado de cada uno de las là ­neas de negocio actuales de la organizacià ³n y sus recursos no aprovechados con relacià ³n a cualquier là ­nea de negocio que se pueda agregar. El estado de sus sistemas de seguimiento, es decir, la disponibilidad de los indicadores crà ­ticos de à ©xito identificados en el diseà ±o de la estrategia del negocio. El perfil estratà ©gico de la organizacià ³n, en especial, sus niveles de creatividad, sus niveles usuales de toma de riesgos y su enfoque de la competencia. Los recursos del sistema para ejecutar las diversas estrategias que la empresa ha escogido a fin de lograr su misià ³n, incluidas su estructura y talento administrativo. Un anà ¡lisis de la cultura organizacional actual, incluida su actual forma de realizar los negocios. 2. Là ­neas de negocio: El primer paso en la auditoria del desempeà ±o interno consiste en analizar cada là ­nea de negocio existente. Se debe tratar de utilizar los indicadores crà ­ticos de à ©xito establecidos durante el diseà ±o de la estrategia de negocio. Esto permitirà ¡ determinar si hay un sistema de seguimiento adecuado o planear uno en caso de que sea necesario. 3. Sistemas de seguimiento: La auditoria del desempeà ±o interno, que requiere la compilacià ³n y estudio de una variedad de indicadores del desempeà ±o, representa un examen general del desempeà ±o recuente de la organizacià ³n en tà ©rminos de los à ­ndices bà ¡scios de desempeà ±o que se hayan identificado como decisivos en el perfil estratà ©gico. Algunos ejemplos son: Flujo de caja, crecimiento, contratacià ³n, tecnologà ­a, operaciones, TIR. 4. Perfil estratà ©gico Es necesario incluir los siguientes 4 factores en el perfil estratà ©gico de la compaà ±Ãƒ ­a: El nivel de creatividad Utilizacià ³n previa en la construccià ³n del futuro en forma proactiva Su orientacià ³n hacia la toma de riesgos Su posicià ³n competitiva tà ­pica Cuando la compaà ±Ãƒ ­a se fundamenta en estos factores su perfil estratà ©gico proporciona un contexto para comprender como empezara a ejecutar cualquier plan estratà ©gico. 5. Anà ¡lisis de los recursos: Para hacer este anà ¡lisis se debe hacer la siguiente pregunta:  ¿Cuà ¡les son los recursos actuales del sistema? Debe incluir competencias de personas, vacà ­os a llenar y cà ³mo hacerlo, recursos financieros para el crecimiento y como podrà ­an enfrentarse, etc. 6. Cultura Organizacional:  ¿De quà © manera ayuda o interfiere con la consecucià ³n de su misià ³n? Un mà ©todo para organizar las diversas impresiones de la cultura de la empresa consiste en utilizar el modelo de Harrison y Stokes hay 4 diferentes tipos de cultura organizacional: Cultura del poder Cultura del rol Cultura del logro Cultura del apoyo 7. Herramientas analà ­ticas adicionales: Ciclo de vida Los productos o servicios determinados progresan a travà ©s de una serie de etapas identificadas como un ciclo de vida. Las etapas son surgimiento, crecimiento, madurez y decadencia. Se debe identificar en que etapa del ciclo se encuentra cada LDN y en cual se hallan los productos o servicios clave. Anà ¡lisis de portafolio BCG: Los productos o servicios se catalogan en perro, vaca lechera, signo de interrogacià ³n o nià ±o problema, de acuerdo a las utilidades y volumen de ventas. 9. Oportunidades y amenazas externas: Se deben incluir los siguientes entornos: Entorno industrial: Cliente, disponibilidad MP, mezcla actual de marketing, ciclo de vida de la industria Competitivo: Intensidad de la rivalidad, amenaza de nuevos competidores, poder negociacià ³n de compradores, poder de negociacià ³n de los proveedores, la presià ³n de sustitutos. General: Econà ³mico, social, polà ­tico Especà ­fico: Aspectos no competitivos del entorno industrial, clientes, disponibilidad de materia prima, mezcla de marketing, ciclo de vida de la industria. ANà LISIS FODA: Despuà ©s de desarrollar el plan estratà ©gico, el equipo de planeacià ³n debe avaluar en donde se encuentra la organizacià ³n actualmente con respecto a cada uno de los aspectos. Es decir, se debe hacer una auditoria del desempeà ±o. Esto constituye un esfuerzo para identificar que es y donde se encuentra la organizacià ³n en la actualidad. Implica un estudio profundo y simultà ¡neo, tanto de sus debilidades y fortalezas internas, como de aquellos factores externos, es decir, oportunidades y amenazas que afronta la empresa. Una forma de hacer esta evaluacià ³n es utilizando la herramienta FODA: Fortalezas y debilidades internas: Identificar las debilidades que es necesario manejar o evitar cuando se formule el plan y asà ­ mismo las fortalezas que se pueden aprovechar para lograr el futuro deseado. Oportunidades y amenazas externas: El equipo de planeacià ³n debe estudiar competidores, proveedores, mercados y clientes, tendencias econà ³micas, condiciones del mercado laboral y reglamentos gubernamentales en todos los niveles que puedan influir en la empresa, en forma negativa o positiva. La auditoria del desempeà ±o interno debe cumplir con 5 à ¡reas clave: El estado de cada uno de las là ­neas de negocio actuales de la organizacià ³n y sus recursos no aprovechados con relacià ³n a cualquier là ­nea de negocio que se pueda agregar. El estado de sus sistemas de seguimiento, es decir, la disponibilidad de los indicadores crà ­ticos de à ©xito identificados en el diseà ±o de la estrategia del negocio. El perfil estratà ©gico de la organizacià ³n, en especial, sus niveles de creatividad, sus niveles usuales de toma de riesgos y su enfoque de la competencia. Los recursos del sistema para ejecutar las diversas estrategias que la empresa ha escogido a fin de lograr su misià ³n, incluidas su estructura y talento administrativo. Un anà ¡lisis de la cultura organizacional actual, incluida su actual forma de realizar los negocios. FORMULACIÓN DE LA VISIÓN Y LA MISIÓN: Este paso le sigue a la definicià ³n de los valores de la empresa, ya que tanto la misià ³n como la visià ³n deben ser congruentes con los valores establecidos. Una declaracià ³n de la misià ³n dirige la razà ³n de ser fundamental de la empresa y especifica el rol principal que esta va a desempeà ±ar en su entorno. Al formular la declaracià ³n de la misià ³n, una organizacià ³n debe responder 4 preguntas fundamentales:  ¿Quà © funciones desempeà ±a la compaà ±Ãƒ ­a?  ¿Para quià ©n desempeà ±a esta funcià ³n la compaà ±Ãƒ ­a?  ¿Cà ³mo va la compaà ±Ãƒ ­a en el cumplimiento de su funcià ³n?  ¿Por quà © existe la compaà ±Ãƒ ­a? Fuerzas conductoras Otro factor importante que se debe considerar es identificar y dar prioridad a las fuerzas conductoras de la empresa. Hay 8 categorà ­as bà ¡sicas: Productos ofrecidos Mercado atendido Tecnologà ­a Capacidad de produccià ³n a bajo costo Capacidad de operaciones Mà ©todo de distribucià ³n / venta Recursos naturales Utilidad / retorno