Ethernet Cabling Category

The charter school's CEO has requested your help in updating the network to meet the demands of the building's faculty members and students. Your job is to interview the key stakeholders and to take action to remedy the issues that they have. Write a two to three page proposal addressing each of the stakeholder concerns. Use the technologies below for the areas of concern. All of the technologies listed below will not be used, so be careful with your choices. You must use one of the solutions below to address each area of concern.Be specific in your responses, and justify the use of each technology based upon the concern. Category 2 UTP 10Base – T Ethernet Cabling Category 5 UTP 100Base – T Ethernet Cabling Category 6 UTP 1000Base – T Ethernet Cabling Server Farm File Server Print Server 8 port hub 16 port hub 24 port hub 8 port switch 16 port switch 24 port switch Storage area network RAID Fiber 1000Based-F Domain controllers Bus topology Topology Microwave wire less media Infrared wireless media Radio wireless media K E Y P L A Y E R SHelen Ross, Network Technician, Female â€Å"I don't know who designed our old network or what they were thinking. You see, my job is to support the faculty in the building and to fix minor network issues. Well, we often have major issues in our building, and I'm hoping that you can make things better. Printing is a really problematic area for us. You see, we have over 50 networked printers in this building. Although we do need the printers, we need some way to consolidate the management of print jobs, as the queues on these printers often are filled.We also need to navigate to each printer individually to clear them. There has to be a better way because this is ridiculous. Collisions have become a problem for us as well since we started to add new computers a few years ago. In the morning when everyone gets in, network performance slows to a crawl because everyone is busy on the network with their morning a ttendance and checking e-mail. After performing a network analysis, I figured out that there were way too many collisions on the network. There has to be a way to fix this. â€Å" Ethernet Cabling Category The charter school's CEO has requested your help in updating the network to meet the demands of the building's faculty members and students. Your job is to interview the key stakeholders and to take action to remedy the issues that they have. Write a two to three page proposal addressing each of the stakeholder concerns. Use the technologies below for the areas of concern. All of the technologies listed below will not be used, so be careful with your choices. You must use one of the solutions below to address each area of concern.Be specific in your responses, and justify the use of each technology based upon the concern. Category 2 UTP 10Base – T Ethernet Cabling Category 5 UTP 100Base – T Ethernet Cabling Category 6 UTP 1000Base – T Ethernet Cabling Server Farm File Server Print Server 8 port hub 16 port hub 24 port hub 8 port switch 16 port switch 24 port switch Storage area network RAID Fiber 1000Based-F Domain controllers Bus topology Topology Microwave wire less media Infrared wireless media Radio wireless media K E Y P L A Y E R SHelen Ross, Network Technician, Female â€Å"I don't know who designed our old network or what they were thinking. You see, my job is to support the faculty in the building and to fix minor network issues. Well, we often have major issues in our building, and I'm hoping that you can make things better. Printing is a really problematic area for us. You see, we have over 50 networked printers in this building. Although we do need the printers, we need some way to consolidate the management of print jobs, as the queues on these printers often are filled.We also need to navigate to each printer individually to clear them. There has to be a better way because this is ridiculous. Collisions have become a problem for us as well since we started to add new computers a few years ago. In the morning when everyone gets in, network performance slows to a crawl because everyone is busy on the network with their morning a ttendance and checking e-mail. After performing a network analysis, I figured out that there were way too many collisions on the network. There has to be a way to fix this. â€Å"

Bridgeton Industries Essay

1. Describe the competitive environment for Bridgeton as well as the cost accounting system currently in use. When foreign competition and scarce, expensive gasoline began to play an important role in the market, Bridgeton began to lose domestic market share. The ACF Bridgeton plant faced new challenges in their production that led them to serious cutbacks like the closing of the ACF plant for manufacture of fuel-efficient diesel engines. By 1987, they classified their products in terms of â€Å"world class† competitive position and potential. With four criteria (quality, customer service, technical capability and competitive cost position) they classified their products in Class I (remain), II (observe) and III (outsource). The classification allowed Bridgeton to take decisions on how to better manage their products performance compared to their competitors. The cost accounting system was product costing, a mixed between job costing and process costing. 2. Explain why manifolds moved from Class II to Class III after oil pans and muffler-exhaust systems had been outsourced from the AC F. Despite improvements in the production process manifolds were downgraded from Class II to III. The results were not sufficient, even though they increased the uptime from an average of 30% to 65% they were behind their Japanese competitors that reached a â€Å"world class† goal of 80% uptime. In addition, as seen in Exhibit 2, the direct material costs for manifolds (based on stainless steel) is extremely high as a percentage of sales (around 40%) compared to the other products manufactured at ACF and at a better Class level. However, there was a doubt on this move due to the possibility of new market requirements for lighter weight (more efficient manifolds). This represented a good opportunity for ACF because as they manufactured manifolds with stainless steel, demand could increase and therefore selling price too.

Business Ethics and Social Responsibility Assignment

Business Ethics and Social Responsibility - Assignment Example The forty-seven-year-old Betty Vinson together with the 35-year-old Normand would face a sentence of fifteen maximum years, in jail. The sentence, however, can reduce to become years less than fifteen. Also among those who admitted the guilt, according to reports by the US TODAY, are Buford Yates and David Myers. The former was a former accounting director and the latter a former controller. The two pleaded guilty during the case of the government against WorldCom. The two were former low-level accountants at the collapsed firm. The sentence was not just. Ms. Vinson made the ethical decision as a way of cooperating with the prosecutor. The confession of guilt was a way of cooperation with the prosecutors. This was in exchange for possible leniency. The prosecutor, therefore, should leave Ms. Betty Vinson without putting then to the sentence. The two ex-WorldCom accountants were following the orders of the Chief Financial Officer, Scott Sullivan. Madoff was a Wall Street cognoscente and led the Nasdaq Stock Market. He also was a money manager that many sought-after. Clients believed to have the secret to investment success. He logged 10 percent of the yearly returns and set little down month. He got returns, in the end. He exploited three things. He took advantage of the fact that a significant number of investors sophisticated funds of hedge funds as well as advisers on investment issues. He exploited the fact that a considerable portion of the investors forgot that if something looks too good, then it is questionable. Madoff also took advantage of regulators’ failure to view his real image. The regulators considered Madoff an influential investment advisor as well as a broker. The discovery of Madoff’s dealings came long after he practiced them for a considerable period. This came with the collapse of markets and a stagnating economy.

Persuasive paper Research Example | Topics and Well Written Essays - 1500 words - 1

Persuasive - Research Paper Example been a subject of a great number of discussions, debates, and arguments, especially since euthanasia and assisted suicide became legal in a range of countries. While the opponents of legalization claims that is its, in fact, legalization of a murder as well as devaluation of a person’s life, I believe it should be legalized because it frees people of pain and suffering they cannot endure. History of euthanasia extends back over thousands of years, namely to the 5th century BCE. Despite the fact that in Ancient Rome and Greece doctors were obliged to follow the Hippocratic Oath, a lot of them could give poison to their patients if the latter asked them to. In the times of the Middle Ages, the issue of euthanasia and assisted suicide was not even discussed due to the fact that the church was quite an influential institution. With the rise of the Enlightenment in the 17th and 18th centuries, euthanasia again became the question for discussions and debates; the majority of people were against it. However, there was no law that made it illegal until the 1830s when the first American law on the illegal status of euthanasia was passed (The Life Sources Charitable Trust). In the first half of the 20th century, euthanasia started gaining support in the American society as well as in England. With the beginning of World War II, the global society changed its attitude towards the issue due to the fact that the Nazis killed a great number of people with the help of euthanasia (The Life Sources Charitable Trust). In the late 20th, the points of view on the matter under consideration changed again; in fact, the last several decades may be regarded as the revival of the discussion as well as the reconsideration of the necessity of euthanasia legalization as the modern society is getting more and more supportive of making it legal. The following are the arguments for legalization of euthanasia; most of them are based on the needs of those who call for it. The first reason

Marine Aquaculture Development and Distribution Assignment

Marine Aquaculture Development and Distribution - Assignment Example Salmon and shrimp are accredited for the growth of global mariculture (Stickney, 1999). In recent years, many developing countries have made significant accomplishments in mariculture production. However, there are increased concerns regarding the increased culture of salmon, shrimp and other carnivorous mariculture species that affect the wild fish stocks. They are fed on processed wild capture fishes, which may have a negative impact on food security even though they are economically viable. The economic gains for the cultured carnivorous species are short-lived compared to sustainable capture fishes that are significant for food security. Many countries have developed policies to enhance eco-friendly mariculture. China, Russia, South Africa and Honduras in Latin America are among the nations that have put in place policies to support mariculture projects. USAID and other environmental stakeholders have contributed to the establishment of sustainable environmental friendly mariculture in various countries. This has been accomplished through capacity building in some selected third world countries such as Indonesia, Republic of Tanzania and Honduras among others. These projects are aimed at improving the food security of the poor coastal communities as well as acting as a source of income for improved standards of living (Stanley, 2003). In Asia where aquaculture is a significant source of food and income, mariculture contributes 37% of the overall finish and shellfish production, totaling 10.8 million tons (Stickney, 1999). In recent years, China’s mariculture production has been on the rise, with close to 60% of the global production coming from the country in 2005. India and Japan are also major producers of mariculture products, as well as Bangladesh. Japan’s production has been facilitated by the improvements in techniques for seed production as well as the practice of cage culture.

Substance Abuse Research Paper Example | Topics and Well Written Essays - 1000 words

Substance Abuse - Research Paper Example However, according to National Institute on Drug Abuse (NIDA 2011), it is a common misreading that drug abusers lack moral principles or will power essential for changing their behavioral traits. In reality, drug addiction is a complicated state of health which encourages compulsive drug abuse in individuals. As a result, it becomes very difficult for users to give up the habit despite their aspiration to do so. This paper will evaluate various causes and implications of substance abuse specifically about the use of alcohol, prescribed drugs, and illegal drugs. Alcohol abuse To begin with, in American society, numerous beliefs persist regarding alcohol consumption. In the colonial era, the American community believed that alcohol was the â€Å"good gift of god† solely meant enjoyment. However, decades later, US government prohibited alcohol sale and consumption in the country as the science proved that alcohol consumption raised serious issues such as poverty, violence, and he alth problems. However, now US regulations allow people to enjoy alcohol beverage. Subsequently, the number of younger alcoholics is alarmingly increasing in the present US society. As per the reports of Centers for Disease Control and Prevention (Oct 22, 2010), 14,046 people die each year due to alcoholic liver diseases; and at the same time, alcohol induced deaths excluding accidents and homicides constitutes 23,199. Prescription drugs abuse From the legal point of view, a prescription drug is a licensed medicine which can be legally used with the prescription of a physician. Heroin and aspirin are the examples of prescription drugs. Although they are licensed medicine, they also can cause many health issues. Generally, dispensation of prescription drugs includes a detailed description regarding its contents. In United States, a special regulation called Federal Food, Drug, and Cosmetic Act defines prescription drug requirements. According to this act, medical practitioners who pr escribe a drug must possess specific qualifications. Furthermore, while prescribing medical drugs, a physician must make his patient aware of the intended effects of the drugs and its expected side effects. However, prescription drugs are largely misused for intoxication purposes across the States, which has evoked the governmental attention to the issue. Obviously, unethical drug marketing plays a major role in the rampant growth of prescription drug abuse. Illegal drug abuse Illegal drug trade offers large opportunities to global black markets as it includes the manufacture, distribution, and sale of substances which are prohibited by drug prevention laws. Hashish, Cocaine, and Crack are some of the examples of illegal drugs. According to the UN report, â€Å"global drug trade generated an estimated $321.6 billion in 2003† (Pollard, 2005). The drug prevention laws were the main causes that persuaded international black markets to trade drugs illegally. Despite the strict re gulations and penalties imposed on illegal drug traders and users, the US government has not yet succeeded to control this illegal activity. Illegal drugs leave more dreadful impacts than legal drugs on users because the illicit drug manufacturers add excessive addictives to their products with intent to attract and retain more users. Causes of substance abuse Undoubtedly substance abuse is a serious problem that affects a person both mentally and

Eusebius authorial goals in the Life of Constantine Essay

Eusebius authorial goals in the Life of Constantine - Essay Example He thinks that Constantine should be highly rewarded for the hectic work he did in spreading the gospel. Therefore, his goal is that Constantine was devoted worshiper of God as witnessed from his scripts. Secondly, He states that Constantine received a reward from God Himself for the work he did in spreading the gospel. Even though he was widely detested by the public for the work, he was doing he proclaims that Constantine was favored by God in the work he did in the after life as he was widely detested by those whom he spread the gospel. His goal here is to prove that God rewards those who are devoted to him and continue with his works. Thirdly, Eusebius believes Constantine was one of his own in the service of the lord. This was because he was instrumental in spreading the gospel and encouraged many believers to come out and proclaim the victory of the Lord despite the wide denial that they were experiencing. His goal her is to prove that Constantine was a devoted worshipper and w orshipped only God alone not the other gods that were being worshipped by members of his society. Fourthly, his goals point out to the fact the Constantine used his political office to encourage the spread of the gospel as he had managed to convince the army to help him in his task of spreading the gospel. ... He uses Constantine as an example by saying that he was thankful to God even after his baptism; thus he was not corrupted in his works to God. Eighthly, His goals on Constantine were that he was a true servant who believed in his work and even requested for an opportunity to be allowed to serve God by requesting the Bishops to allow him to be baptized and baptize people. Reflecting on the life of Constantine, he believes that he was a true giver to God as he contributed in the spread of the gospel by contributing to such things like building monuments for the work of God. Moreover, he travelled for the sake of the church by carrying along Bishops for expedition and celebrating various religious ceremonies like the night vigil. Lastly, Eusebius believes that God protected Constantine health as he lived the normal years that was expected of man according to the mortality rate at the time ("Eusebius of Caesarea the Life of the Blessed Emperor Constantine"). Eusebius’ authorial go al in the life of Constantine also suggests that God was responsible for fighting many of the battles and challenges that Constantine faced. With those who had faith in him and with God’s support, Constantine succeeded in conquering nations and spreading the gospel of God amidst denial and betrayal. Eusebius authoritatively states that his victories would not have been if it were not for God’s protection and love. His love and zeal in spreading the word of God earned him favors in the presence of the lord and his reward was protection against his enemies who opposed him and planned against him. Eusebius also states that Constantine conquered the entire world as he ruled for many years. He also categorically points out that all his undertakings turned out

How the scientific method is illustrated by the development of the Essay

How the scientific method is illustrated by the development of the atomic model - Essay Example Nevertheless, atomic model is an important concept that helps in illustrating a scientific method. Take for example; it is very easy to illustrate the stoichiometric process, by the use of atoms, as opposed to the use of absolute mass. Take for instance; it is easier to explain that 2 atoms of Hydrogen, when they are joined with 2 atoms of Chlorine, will form 2 molecules of hydrogen chloride (McLean, 17). This is as opposed to saying, 2 grams of hydrogen, when they are reacting with 70.9 grams of chlorine, would form 72.9 grams of hydrogen chloride. Because the use of atomic model was easier to illustrate the scientific methods of inquiry, majority of chemists began using the concepts of atomic theory (Stewart, 22). The acceptance of this theory further grew, when scientists began using it in explaining a variety of issues, including the structure of molecules, in the field of organic chemistry, to the movement and spacing of molecules, in the field of gas physics. All these are scientific methods and processes used that are illustrated by the atomic scientific model (Stewart,

CRIMINOLOGICAL THEORIES Essay Example | Topics and Well Written Essays - 250 words

CRIMINOLOGICAL THEORIES - Essay Example The KU students’ deviant may also be a product of the social disorganization theory that explains that one’s environment may lure them into making wrong choices such as their university having no follow up on such students (Siegel 188). Williams’ article focuses on adultery of Tiger Woods (1). The article gives scientific evidence to explain the working of the male brain so as to understand Tiger Woods behavior. Tiger Woods behavior can be understood on the grounds of biological, genetical and evolution theory that explains criminal conduct as a product of mental issues, bad brain chemistry as causative agents of crime (Siegel 147). Tiger Wood’s adultery may also be defined through the chromosome theory that emphasizes on Tiger Woods having the Supermale gene (XYY) that leads to his adulterous behavior (Burke 35). The extra Y gene has been said to be found in violent males, especially criminals. Tiger Woods possessed the same

Styles of Two Great American Writers Essay Example for Free

Styles of Two Great American Writers Essay A writer’s style distinguishes him from other writers. The style a writer uses to write a story clearly indicates the tone of a story,vital for the reader to understand the story. The style of a writer is made up of different traits and characteristics used to write the story. These traits and characteristics include and are not limited to symbolism, characterization, and other elements. When evaluating a literature piece for style one should analyze the following five elements: diction, images, details, language, and sentence structure. Two well-known American writers with completely different styles are Ernest Hemingway and William Faulkner. Hemingway and Faulkner’s similarities and differences in style become apparent when comparing and contrasting two of their famous short stories, â€Å"A Clean, Well-Lighted Place† by Ernest Hemingway and â€Å"Barn Burning† by William Faulkner. Diction involve word choices a writer makes for his story. These word choices may be used to achieve an overall feeling from a reader toward a story. Diction also reflects the writer’s attitude toward his subject. Ernest Hemingway’s choice of diction in â€Å"A Clean, Well-Lighted Place† are simple words that directly mean what they stand for. Hemingway uses simple, less complex words to describe both characters and setting. Examples of diction usage for setting are found in the title, â€Å"A Clean, Well-Lighted Place† (Hemingway 141) and â€Å"pleasant† (Hemingway 143). The two waiters describe the customer as a â€Å"clean old man a good client† (Hemingway 141). Hemingway’s choice of diction was blunt and to the point. The diction usage does not let the reader get funny ideas or leeway to think anything other than what Hemingway says. This element of Hemingway’s style reflects when the young waiter states the old man is â€Å"drunk† (Hemingway 141). The young waiter does not suggest he was tipsy or that he seemed intoxicated, he simply meant he was drunk. Hemingway uses the Spanish word for nothing, â€Å"nada† (Faulkner 145) to substitute words from the Lord’s prayer, in the old waiter’s speech of despair and loneliness to interrelate the theme. Building a sympathetic feeling from the reader toward the character’s way of seeing his lonely world as nothing, was Hemingway’s intention in doing so. In comparison to Ernest Hemingway, William Faulkner’s use of diction involves more complicated words due to the fact they’re slang and misspelled. Some misspelled words and slang are â€Å"kin hisn [and] hit† (Faulkner 145) which stand for the words can, his, and it. The reason for the use of a southern accent as diction is to set the mood of where the story takes place. Racist slurs such as â€Å"nigger† (Faulkner 146) also make up the diction of the story. Such racist slurs are used to build a certain attitude toward the character who says them. Faulkner describes Abner’s walk as â€Å"stiffly† (Faulkner 146) which also affects the reader’s feelings about a character. Sarty uses the word â€Å"bovine† (Faulkner 152) to describe his fat sisters. For many readers who are not familiar with the south or the last century the complex word usage in â€Å"Barn Burning† mean many things and nothing at times, this affects the reader’s attitude toward the story as a whole. The overall use of language in an entire story also makes up the writer’s style. Different types of language would be formal or informal, scientific or abstract, etc. There are no rules to correct language for a writer’s style. â€Å"A Clean, Well-Lighted Place† uses informal and conversational overall language. Incomplete statements and fragments that cast full scenes in form of conversation create informality of the story . â€Å"‘He hung himself with a rope. ’† (Hemingway 142) Also, a device Hemingway uses when a characters pauses and then speaks again in the following line make up the informal language. ‘â€Å"He’s drunk now,’ he said. ‘He’s drunk every night. †Ã¢â‚¬â„¢ (Hemingway 142) The language used in â€Å"Barn Burning† by William Faulkner includes colloquial, informal, with some interior monologue. The southern drawl creates a particular colloquial dialect. â€Å"‘Naw,’ he said. â€Å"Hit don’t hurt. Lemme be. ’† (Faulkner 147) Interior Monologue also makes up the element of language. â€Å"I could run on and on and never look back, never need to see his face again. † (Faulkner 155) is Sarty’s interior monologue. Faulkner uses interior monologue to prove Sarty was not allowed to express himself freely out of fear. The sentence structure used in a story has an impact on the reader’s attitude. The sentences may be structured in a variety of ways to get certain points and feelings across. Types of sentence structure include short, long, simple, complex, and even interrupted sentences. Sentence structure in Ernest Hemingway’s â€Å"A Clean, Well-Lighted Place† includes regular speech patterns. This would include short, choppy, simple and direct sentences. Examples of these types of sentences include, ‘â€Å"He has plenty of money. †Ã¢â‚¬â„¢ (Hemingway 141) and â€Å"‘Nothing. †Ã¢â‚¬â„¢ (Hemingway 141) Hemingway’s sentence structure also includes long, compound but simple sentences. â€Å"In the day the street was dusty, but at night the dew settled the dust and the old man liked to sit late because he was deaf and now at night it was quiet and he felt the difference. † (Faulkner 141) Formal, complex and long drawn-out sentences make up the sentence structure in â€Å"Barn Burning† by William Faulkner. Faulkner’s style, most of the time formal and excessively detailed, creates sentences extremely complicated that many times the best way to understand them is to go back and reread the sentence. â€Å"The boy, crouched on his nail keg at the back of the crowded room, knew he smelled cheese, and more: from where he sat he could see the ranked shelves close-packed with the solid, squat, dynamic shapes of tin cans whose labels his stomach read, not from the lettering which meant nothing to his mind but from the scarlet devils and the silver curve of fish-this, the cheese which he knew he smelled and the hermetic meat which his intestines believed he smelled coming in intermittent gusts momentary and brief between the other constant one, the smell and sense just a little of fear because mostly of despair and grief, the old fierce pull of blood. † (Faulkner 145) The five basic elements interrelate to create the style of a writer. After the reader understands style, the tone and the true meaning of a story become apparent. The style of both Ernest Hemingway and William Faulkner are different with only a few similarities. One style (Hemingway) being simple and to the point, the other (Faulkner) complicated and full of details. Although the differences are many, one apparent similarity is the informality in the overall language of both stories. Neither style ranks better than the other. The reader changes the value of each style depending on what they appreciate reading.

A Family Affected By Elderly Dementia

A Family Affected By Elderly Dementia Introduction This is a case study of a gentleman with dementia, a condition defined by the World Health Organisation (WHO, 2003) as a syndrome caused by a range of illnesses and which affects memory, thinking, orientation, comprehension, calculation, learning capacity, language, and judgment (p.1). Dementia can have a huge impact on health, well-being and quality life for both the person with dementia and their family. It can result in deep feelings of loss for the person with dementia, who often can no longer do all of those activities that were once an enjoyable part of their life. Similarly, family can feel a sense of bereavement at losing loved ones to dementia, a condition that often changes the personality of the person who develops it (Doka, 2004). This provides the rationale for gaining further insight into the care and support needs of people with dementia and their families via case studies such as this one. In particular, this case study will focus on every day and night decisions that affect the person with dementia, including activities of daily living, social activities, and most importantly communication and inclusion. The case study will be formed from a review of case notes for which permission was initially sought from the appropriate line manager as well as from the client with dementia and his family. The client was shown his case notes in order to ensure that he was fully informed as to the documents being requested for use. The client can read and communicate verbally, supporting this method of establishing informed consent. He was also given the opportunity to ask questions. The case study will commence with an introduction to the gentleman with dementia, as well as a description of the current circumstances surrounding his care and the involvement of both himself and his family in care plans and decision-making. Theories and models related to communication and inclusion will be reviewed, followed by the rationale for the participatory approach utilised when working with the client and his family. The case study will conclude with a summary of the key issues identified within the case study, as well as any reflections for future work. Client Profile For the purpose of this case study, the gentleman with dementia will be referred to as Bob. His real identity and that of anyone else within this case study will remain anonymous in order to maintain confidentiality. Bob lives in residential accommodation with other people who have dementia. His profile is presented in Box 1, using the Roper, Logan and Tierney Activities of Living Model (Roper et al, 2000) to present a holistic overview of Bobs care needs on 12 activities of living (ALs) relevant to communication and inclusion and essential to health and well-being. Box 1: Bobs Profile CLIENT PROFILE Patients Name: Bob Stephens Age: 95-years old (Date of birth: 22nd October, 1915) Ethnicity: Jewish (non-practicing) Activities of Living (D=dependent; I=independent): Maintaining a safe environment D I Communication D I Breathing D I Eating and drinking D I Elimination D I Personal grooming D I Controlling body temperature D I Mobilising D I Working and playing D I Expressing sexuality D I Sleeping D I Dying D I Comments: Bob shows dependency in two ALs (i.e. maintaining a safe environment; working and playing) and requires support in four ALs: (i.e. communication; personal grooming; mobilising; elimination). Influencing Factors Biological: Bob is 95-years of age. He requires a hearing aid and walking stick. Psychological: Bobs dementia can sometimes result in confusion and disorientation. He also becomes tearful frequently and does not participate in residential activities. Socio-cultural: Bob is Jewish, but non-practicing and with no preference for Kosher food. He has a wife, Sue, who visits twice a week and with whom he has a close and affectionate relationship with. He also has a son, John, who visits him regularly. Environmental: Bob does not like noisy environments. Politico-economic: No current issues. Additional Notes: Bob has a care plan devised to reduce the risk of harm to himself and others. Despite this, Bobs carers have noted that he is polite and charming when his situation and circumstances are to his preference. Bob was born in the East End of London. He retired from the Royal Air Force (RAF) 15-years ago and expresses that this was my life. Sue has shared that it was after retirement that Bob lost interest in all activities, including socialising. Relevant Theories and Models The theories and models relevant to this case study are those pertaining to communication and inclusion. These two issues are complementary in that communication is an important component of working with people who have dementia and their families in a participatory way that encourages inclusion. Theories of communication are described, followed by a definition and outline of social inclusion. Communication There tends to be two broad perspectives on communication, these being Transmission Models and Communication-as-Interaction Models. Transmission Models purport that communication is the transference of information from the sender to the receiver, with the sending hearing or reading the message as they interpret it. Although this model of communication is limited in its simplistic view of communication, it does hold some relevancy to Bobs situation. Within the Transmission Model, the concept of noise is used to refer to the wide variety of different factors that can affect the success of transmitting a message from one person to another. Since Bob is hard of hearing and wears a hearing aid, he can find noisy environments difficult to cope with. He does not like noise and thus it is important to communicate with him in a quiet environment where there is little distraction. Communication-as-Interaction theories view communication as a shared process with active participation from all parties, thus recognising the complexity of human interaction. This model of communication proposes that the meanings that emerge from the interaction are affected by a wide range of psychological and social factors. As with the Transmission Model, this model is also relevant to Bob. In particular, it provides insight into why Bob might shout or become verbally aggressive in noisy environments. In such situations, psychologically Bob is likely to be overwhelmed. Furthermore, due to social withdrawal following retirement, it is plausible that Bob becomes anxious in social situations that are no longer familiar to him. Robb et al. (2004) note that in the case of dementia care, Communication-as-Interaction perspectives, which take a biopsychosocial approach, provide a more person-centred element to caring for an individual with dementia. Therefore, whilst Transmission Models are also relevant to Bobs situation, it is important to also apply elements of Communication-as-Interaction, especially in efforts to promote inclusion. Indeed, viewing communication as a shared process is productive of supporting social interaction. To expand on the role of interaction in communication and inclusion, the Symbolic Interaction perspective provides further insight. This perspective posits that in individuals identity is formed on the basis of messages they receive from other people about the kind of person they are and the nature of the world they live in (Kontos, 2005). Bob does experience agitation and frustration and it is important to be aware that if carers or family react to this in a consistently negative way, it is likely that Bob will use this information to form a self-identity that promotes social exclusion through the avoidance of interaction with others. Bob, as do other people, has a daily regime and if this is changed he can feel unsettled. An understanding of this via insight into the theory of Symbolic Interaction can facilitate better management of Bobs care needs. Utilising the Symbolic Interaction approach further, there needs to be an emphasis on positive communication being about talking with the individual rather than at them, as has been the case with Bob (Parker, 2003). Inclusion Social inclusion has been defined by the Local Government Improvement and Development Group (2010) as relating to the ability to fully participate in normal social activities, and engage in political and civic life (p.1). In contrast, social exclusion has been defined as relating to being unable to participate fully in normal social activities, or to engage in political and civic life (p.1). Using these definitions it becomes clear that social inclusion is a broad concept involving a wide range of social and political activities. In terms of mental health and dementia, inclusion involves maximises opportunity personally and within the wider community (MIND, 2008). Thus, social inclusion is about ensuring that people have the opportunity to get involved in the activities they want to get involved in and are not excluded from society on the basis of any disability. It is believed that in the field of dementia care, social inclusion begins by changing attitudes towards people with demen tia and considering what people can and want to do, i.e. giving them a choice in their care, in the way they live, as well as helping them develop the tools to self-manage effectively and thus maintain their independence. As described within this case study, maximising opportunities and providing Bob with choices are a key part of communication and interaction with him. Participatory Approach A person-centred approach has been taken in supporting Bob and his family with issues of communication and inclusion. This has been essential in ensuring that the issues important to Bob and his family have been targeted, as opposed to care being based on assumptions or preconceptions of carers (Whitworth et al., 1999). The Participation Ladder, developed by Arnstein (1969), has been applied in work with Bob and his family. This model is based on the observation that the fundamental point [is] that participation without redistribution of power is an empty and frustrating process for the powerless. It allows the power holders to claim that all sides were considered, but makes it possible for only some of those sides to benefit. It maintains the status quo (pp. 216-233). This Ladder is particularly pertinent in dementia care, where an imbalance of power comes from the person with dementia being in a vulnerable position compared to their carer. The Ladder comprises eight levels, as follows: Manipulation this is a non-participative level where the aim would be to cure or educate Bob. Therapy this is also a non-participative level where the aim would be to cure or educate Bob. Informing this is an important first step to legitimate participation, but often the emphasis is on a one-way flow of information from the carer to the individual with dementia. Consultation another important step towards participation, which would comprise surveys, meetings and enquiries with Bob and his family. Placation this step would enable Bob and his family to be involved in planning his care, but the power would still reside with the carer as they would make the final decisions. Partnership this is when power is redistributed through negotiation, in this case, between Bob, his family, and professionals involved in his care. Planning and decision-making responsibilities are shared, supporting the co-creating health initiative currently underway by the Health Foundation (Health Foundation, 2010). This initiative promotes active partnership between individuals receiving care and their carers. This is the step of the Participation Ladder utilised within Bobs care. Delegated Power Bob would hold the majority of power for certain decisions. Citizen Control Bob would have complete control and power over his own care, which is not always feasible within healthcare, especially in the care of people with dementia. Work with Bob resides on level 6 of the Ladder, partnership, as Bob can communicate verbally and shows clear preferences and needs, which demonstrates a capacity to identify his own needs, voice these needs, and make decisions accordingly. However, there are instances where Bob can become confused and agitated and might not make the most appropriate decisions; this is when carers and family become more involved in the decision-making. In particular, in order to promote social inclusion there are some instances where Bob does need encouragement or motivation to interact with others or with the community. Input from carers and family on such matters are vital for Bob to maintain his independence and quality of life. Bobs family have been included in every day and night decisions that affect themselves and Bob. Families can experience the same power imbalance as those with dementia in that once the person with dementia enters care the family lose a sense of control. They also lose an established role within the relationship. Involving them in care plans regarding communication and inclusion initiatives can help them maintain a satisfactory role and remain involved in the persons life. It also adds some structure and meaning to their visits, which is important because some families can find this a stressful situation. Loss of control is heightened by being excluded from decisions, difficulty in getting information, lack of interest in their special knowledge of the person, and negative reactions to their worries and concerns (Woods et al., 1999). The family have a good relationship with Bobs carers and in particular with the manager of the residential home, who has developed a unique bond with Bob that others have not been able to establish. Thus, Bobs family are comfortable asking questions and raising concerns. They are also closely involved in planning activities and opportunities with Bob, which has greatly facilitated the trust built between Bob and the manager of the residential home. Discussion of Case Bobs case notes and care plan highlight a key issue with communication and inclusion being that he can become agitated and frustrated, resulting in him striking out at carers and other residents. The goal of his care plan has been to reduce the risk of harm to others and keep Bob and others safe in order to enhance inclusion. Bob is most likely to become a risk when he becomes agitated or frustrated, which most often arises when he experiences confusion and disorientation. This can result in him shouting at carers and other residents. It is noted within the literature that feelings of confusion can be a way of people with dementia retreating from an overload of painful information; it is not always caused by neurological impairment (Cheston and Bender, 2000). It could be that Bob is struggling to make sense of his life and might even be experiencing feelings of fear and grief at the loss of past activities and living circumstances that have resulted from dementia. Bobs care plan advises that in these situations, when Bob becomes a risk to himself and others, that carers speak to him in a calm and polite manner. It is important that they do not use challenging or confrontational language or gestures, so as to avoid arguments and disagreements. It is also advised that efforts are made to divert Bobs attention from the situation that has caused his agitation. However, Bob does pick up on these diversion tactics and will challenge them, thus carers try to divert him with activities he enjoys and that involve him in communication with others. For example, Bob enjoys reminiscing about the past, talking about his birthplace, and his time in the RAF as a pilot. His family have helped with locating his flying logbooks and Bob enjoys talking about these at length. Indeed, these are instances were Bob engages well and according to the Communication-as-Interaction model discussed previously. In particular, Bob becomes verbally enthused by the interaction, but can also focus on listening to others. An important component of enabling communication and inclusion in dementia care is getting to know someone and forming a relationship. One way in which this has been achieved with Bob has been to listen to his stories about the past and to engage his family in this process. The literature suggests that such an approach can also help build trust and balance power (Bartlett and OConner, 2010). It is easy to get to know Bob as he enjoys talking about his past experiences. It has thus been vital that carers hone listening skills (i.e. attentive listening and person-centred listening skills). It has been found that using this technique to divert Bob away from frustrating situations has also helped carers in their reactions to Bobs outbursts. This is extremely important as, according to the Symbolic Interaction model discussed previously, repetitive negative reactions could be used by Bob to form a self-identity that promotes social exclusion through the avoidance of interaction with others. Rather than raising ones voice with Bob or provoking further agitation, carers identify the reasons behind Bobs frustration. For example, it could be the result of an inability to communicate need in the social context. Evidence of this can be seen in the way that Bob can become easily frustrated if his morning routine is changed. An understanding of this as opposed to a focus on his abusive verbal response facilitates better management of these situations when they arise. This approach supports the biopsychosocial approach, which suggests that behaviour and non-verbal communication has a meaning and provides insight into how a person is feeling or what they might be thinking. Indeed, Stoke (2002) suggests that meeting needs requires some flexibility in the care environment; even if needs cannot be met or behaviour changed, understanding what it means can make it easier for staff and family to accept. Working out the meaning of behaviour can be facilitated by taking into consideration a persons history, physical and mental health, social context, and their abilities and disabilities. For example, talking to Bob in an inclusive way has been important. In particular, being mindful of phrases used to refer to Bob, either to him or his family, and the implications of this have been considered (e.g. referring to Bob in a personal and individualised way as opposed to as a dementia sufferer, or patient, both of which could promote a victim role). Bobs hearing difficulties and dislike of noise are likely to explain some of the agitation and frustration experienced when others are around. Bob can be offered one-to-one sessions in a quieter room when other residents around, but it is important not to isolate him and to encourage reintegration with the group afterwards. Bobs other interests, such as reading the newspaper with his breakfast each morning, is also used to facilitate communication and inclusion. The fact that Bob enjoys reading newspapers provides him with knowledge of current affairs and what is going on within his local community. In order to maintain and promote this activity, special care is taken to ensure Bob has choice in which newspapers he reads and when he reads them. In particular, when Bob receives his newspaper he prefers that all cutlery, teapots and crockery are placed at his table. Choice is very important to Bob and carers make every effort to provide choice in every day and night activities, including the provision of a menu so that he can select his choice of lunchtime sandwich on a daily basis. This provides more than choice, but also promotes continued independence. In order to facilitate communication, a communication log has been devised for Bob in order to ensure that all carers are sensitive to the way in which he communicates. For example, when Bob says that he needs an appointment, this means that he needs the toilet. Making all carers aware of this ensures that Bobs dignity and is preserved and he is not confronted by embarrassing situations that might make him withdraw. Another sensitive area for Bob is that he does need assistance with personal hygiene. Bob is aware of his appearance and becomes agitated if he is not clean-shaven or if his clothes are unkempt. It is known that people with dementia can avoid situations that might cause embarrassment or shame, which might explain Bobs social isolation. It also provides emphasis on resolving any issues that might further prevent social interaction through shame or similar feelings. Social well-being is a core aspect of inclusive care practice and involving people, as well as making sure they feel in control and connected to the world around them. The literature suggests that social well-being is achieved through social relationships, involvement in social activities and participation in the society (Victor and Scharf, 2005). It is believed that a lack of social well-being occurs when people do not have opportunities for social contact and relationships, lack friends and support networks and are socially excluded. Bob does need encouragement and motivation to keep physically active and interact socially, but including his wife and family in this process has enhanced the effectiveness of any efforts made to assist Bob with inclusion. Furthermore, opportunities are made available to Bob, such as going to the coffee shop or visiting places of interest, such as RAF establishments. Since Bob requires a walking stick, the locations of planned outings are first checked for accessibility in order to ensure Bob is not confronted by problems of exclusion when accessing the community. There are many interventions that can be used to improve communication and enhance inclusion for people with dementia. One such intervention is advocacy (Cheston, Bender, and Byatt, 2000). The need for dementia advocacy is becoming more recognised in the field and it is evolving to enable people with dementia to have more self-determination (Cantley and Steven, 2004) and to protect them from harm and abuse (OPAAL UK, 2009). There are a variety of models and approaches to advocacy, including professional advocacy that can be received from the professional carer and self-advocacy which is when someone with dementia speaks up for themselves. Both of these are pertinent to Bobs situation as there are some areas where he can act as self-advocate, such as expressing his preferences for his morning regime. However, there are instances where the professionals caring for Bob need to act as his advocate, such as when informing new staff of Bobs communication needs, etc. There are also instance s where Bobs family can act as his advocate, for example, in circumstances where they know more about Bob than the professional carers do but where Bob is unable to express his needs. By including Bobs family in his care, the importance of Bobs time in the RAF and the impact that retirement had on his health and well-being have provided key information on ways to communicate and include Bob. The need to offer more support for family carers has been recognised in the National Dementia Strategy (2011), where increasing emphasis has been placed on working with and supporting families of people with dementia. Furthermore, the literature and public policy encourages ways of working that take more account of the wider family, empower rather than disempower family members, and build partnerships between professionals, families and people with dementia (Moriarty and Webb, 2000). This is promoted due to the well-documented benefits to people with dementia of working with their family, which has also been evidenced in work with Bob and his family (Oyebode, 2005). Overall, Bobs care involves a great deal of facilitation, which has been defined by Kitwood (1997) as enabling a person to do what otherwise he or she would not be able to do, by providing those parts of the action that are missing (p. 91). Facilitation is aimed at helping the person with dementia to maximise their own potential and express themselves as fully as possible. Facilitation can also, as has been the case with Bob, act as a safety net, helping to reduce fear of failure that may prevent some people with dementia from initiating or participating in an activity. It is an important aspect of the person-centred approach taken within Bobs care and is further referred to by Kitwood (1997) as positive person work. In terms of the communication and inclusion support provided to Bob, facilitation has meant not just providing or organising activities, but being involved in helping the activity to take place. To achieve this, it has been crucial to be aware of how Bob is feeling, how he is responding to what is happening, and sharing the experience with him. It has also involved being sensitive to the parts of the activities that Bob can no longer partake in, such as flying aeroplanes. In this sense, Kitwoods (1997) theory of dementia care and the interpersonal process utilises the Communication-as-Interaction approach. Interacting with Bob and his family on an interpersonal level has facilitated communication and inclusion. Conclusion and Final Reflections This case study has provided a detailed description, exploration and analysis of every day and night decisions that affect a gentleman with dementia, Bob, and his family in regard to communication and inclusion. A key point emerging from this case study is the link between communication and inclusion and the importance of recognising that one cannot exist without the other. Communication is needed to facilitate inclusion and vice versa. Furthermore, the importance of involving family in every day and night decisions that affect the person with dementia have been highlighted as not only improving the well-being of the family and the person with dementia, but also as being a way in which a deeper and more trusting relationship can be built between the carer and the person with dementia. On establishing this bond, communication and inclusion become easier to support and facilitate when working in partnership with the person who has dementia. This has been the case with Bob and his famil y. A partnership approach to working with Bob has been vital in maintaining his autonomy and independence, which in turn has helped form a supportive relationship productive of communication and inclusion.