Effects of Music in Advertising

Music has been recognized as a powerful stimulus affecting people’s mood and even health since times immemorial. Realizing the potential of using the music elements in advertizing for affecting the consumers’ perception and purchasing behavior, marketers use music in supermarkets and as a background feature in commercials.Advertising We will write a custom essay sample on Effects of Music in Advertising specifically for you for only $16.05 $11/page Learn More The findings of the latest empirical studies have revealed a positive relationship between the use of music elements, concentration of attention and proper perception and interpretation of commercial messages by consumers. The music in the supermarkets helps to create the consumers’ favorable mood and encourages them to make purchases. Taking into account the findings of the previous researches, this study will conduct semi-structured interviews and test the hypothesis whether t here is a positive relationship between the use of music elements in advertisements and their brand preferences and purchasing decisions. Literature review Modern marketers view music as an important background feature which can be effectively used for enhancing the viewers’ arousal and effects produced by advertisements. Even though most consumers denied the impact of music upon their brand preferences, the findings of empirical studies have shown that there are significant differences in the brand attitudes, purchase decisions and emotional responses of viewers to the advertisements of music and non-music groups (1). The results of experiments conducted by Gorn have shown that pleasant music, humor and attractive colors are important background features which can influence the consumers’ perceptions and attitudes (1). Even though Gorn’s experiments were criticized by other scholars, the conclusions regarding appeal of music upon viewers remained unchanged. Kel laris and Cox who replicated Gorn’s experiments admitted that his findings could have been influenced by demand artifacts (2).Advertising Looking for essay on advertising? Let's see if we can help you! Get your first paper with 15% OFF Learn More However, Gorn’s premise regarding the positive relationship between product choice and music appeal was not disclaimed. Additionally, Kellaris and Cox measured the strength of different unconditioned stimuli by using different sets of classical and popular music but did not receive any significant differences in results (2). A more in-depth investigation of music characteristics and their impact upon the consumer’s emotional responses, brand awareness and purchasing decisions was conducted by Park and Young (3). Assuming that music can activate the brain and affect the mood of listeners, the researchers attempted to develop a complex taxonomy of music elements, including tempo, pitch, texture and duration and their impact upon individuals’ emotional reactions. The findings of empirical research have demonstrated that there is a positive relationship between the music tempo and its emotional appeal to listeners (3). Particularly, music with low pitch can arouse the emotions of sadness in listeners, whereas the music with high pitch can be associated with happiness. Louder music is interpreted as a mood of happiness, and soft music is attributed to the seriousness of the message. Therefore, consumers view the content of the commercial message through the lens of the overall mood of the advertisement that depends upon the tempo and volume of the background music. The maximum effect can be achieved if pleasant music is used as a background melody (3). Success of a commercial in creating brand awareness and influencing the consumers’ purchasing decisions depends upon a wide array of factors, including the visual elements, major message, music, humor and others. However, as i t can be seen from the findings of the recent studies, the use of music can be effective for concentrating the consumers’ attention and creating a positive image of the advertized brand. Berger and Mitchell concluded that auditory persuasion in the form of pleasant background music plays an important role in communicating the key message of the commercial to the target audience (4). It is possible to use popular hits to draw the consumers’ attention or unknown melodies created specially for the commercial which can become recognizable and associated with a particular brand in the course of the repetition of the advertisement in the media. Consumers tend to recall more details from advertisements using background music as compared to those without music (1).Advertising We will write a custom essay sample on Effects of Music in Advertising specifically for you for only $16.05 $11/page Learn More Research method A semi-structured interview wa s conducted with eight college students for the purpose of establishing a relationship between the use of music background and their mood and brand preferences if any. The structure of the interview was flexible, and the questions were open-ended and enabled the participants to express their personal opinions and attitudes. The main objectives of this study included the investigation of the influence of music upon he consumers’ purchasing decision and brand attitudes and individuals’ acceptance of this influence. The participants were asked a series of questions regarding their attitudes towards commercials in general, their favorite advertisement and least preferred advertisement. A convenient sampling was used for selecting the participants for this research. The interviews were conducted in the form of a friendly conversation, but the participants were informed on the purpose of study and gave their consent for participation. Semi-structured interviews usually have a quite flexible structure which can vary according to the answers of the participants. However, it is necessary to work out the interview guide which helps the researcher to conduct the interview effectively. To make the required investigation and conduct the interview, the interview guide including general and concrete open-ended questions was developed. According to the participants’ answers to general questions, concrete questions could be different. The group of general questions requested for such information as the participants’ attitude to using background music in advertisements and its influence on their intentions and decisions to buy this or that product or on their mood. Thus, at the first stage of the interview the students were asked the questions from the first group, â€Å"Do you pay much attention to the background music used in advertisements?†, â€Å"Do you prefer advertisements with background music or without any music?†, â€Å"Can the music used in advertisements influence your mood?†, â€Å"Can the music in advertisements influence your decision to buy the product which is presented in it?†. According to the answers of the participants to the questions from the first group, they were offered to answer more concrete questions which were specially developed in relation to the answers for the general questions. If the answer to the question from the first group was negative, the series of more concrete questions was not offered to the participants of the interview.Advertising Looking for essay on advertising? Let's see if we can help you! Get your first paper with 15% OFF Learn More When the participants answered to such a question as â€Å"Do you pay much attention to the background music used in advertisements?† positively, they were offered to answer some more questions on this subject, â€Å"What kind of music can attract your attention?†, â€Å"Do you pay attention to the fact to what genre this music belong?†, â€Å"Do you remember music from those advertisements which have drawn your attention?†. When the participants gave the positive answers to such a question as â€Å"Do you prefer advertisements with background music or without any music?†, they were asked to concentrate on the emotions which advertisements with or without music can arouse. Moreover, they could develop the problem of the effectiveness of using music in advertisements as the factor of the impact on the consumers’ purchasing behavior when answered such a question as â€Å"Can the music in advertisements influence your decision to buy the produ ct which is presented in it?†. The participants’ answers helped to complete the picture of the situation in marketing and proved the fact that today consumers pay more attention to the quality of the goods than to the peculiarities of their advertisements. The participants of the interview also paid much attention to the series of questions connected with such a question as â€Å"Can the music used in advertisements influence your mood?†. To develop the issue of the music’s impact on consumers’ mood and behaviour, the participants were asked about the tempo, pitch, and loudness of the music which can be presented in the advertisements which they consider as successful or unpleasant for them. Thus, the participants accentuate their attention on music which can irritate them or on that music which can give them pleasant emotions and increase their mood. However, according to the students’ answers to the questions about their mood and emotions, pleasant music can be perceived by them with less emotion than unpleasant melodies which can influence their mood negatively. Research findings Most of the interviewees denied the influence of the background features upon their brand preferences and purchasing behavior. Seven of eight participants claimed that they try to overcome the influence of marketing measures and make informed choices. When asked directly, the participants admitted that the background features such as pleasant music and humor in the commercial cannot influence their attitudes to a particular brand, not to mention their purchasing behavior. Describing their favorite commercials, six of the interviewees attempted to reproduce the songs or background melodies used in the advertisement. The remaining two participants could not say for sure if there was music in their favorite advertisement. When checked, it was cleared out that the favorite commercials of the participants, who hesitated whether there was music in the advertisement or not, contained background music. The interviewees could recall a lot of details contained in these commercials and demonstrated a profound understanding of the key message of the advertisement. Moreover, the attitude of the interviewees to the advertized brands was positive. However, the interviewees emphasized the importance of the quality of products upon their attitudes and denied the effect produced by the background features. Eight interviewees admitted that modern commercials using pleasant music and humor do not irritate them and can have a positive impact upon their mood. Discussing the least preferred commercial, the interviewees pointed out at the main features irritating them. Among the traits having a negative impact upon the consumers’ perception was shameless self-promotion of certain brands and banality of the commercial message. Therefore, most of the least preferred commercials were based on the mere statements of the advantages offered by particular brands and belonged to a non-music group. The participants could not recall specific details of the advertisements not using music as a background feature. Additionally, four participants admitted that they were irritated with songs used in one of the commercials, saying that it was getting on their nerve every time they heard it. Discussion Analyzing the research findings, it can be stated that the participants deny the impact of background music upon their perception of the commercial message, not to mention their brand preferences and purchasing decisions. These answers clearly demonstrate that present day sophisticated consumers are aware of the marketers’ efforts to influence their perceptions and make attempts to resist this influence. However, taking into account the fact that all of the most preferred commercials mentioned by the respondents contained music elements and interviewees could recall the slightest details of those commercials, it can be state d that there is a positive relationship between the use of background music in the commercial and the viewers’ emotional responses to the commercial and understanding of the main message of the advertisement. Music became an integral element of the commercials because even not been asked to, most of the interviewees made attempts to reproduce the melodies and songs used in their favorite commercials. There is a strong association between a particular brand and music used in the advertisement. As a background feature, music affects the listeners’ mood and concentrates their attention because all of the interviewees could recall specific details of the advertisements belonging to the music group. Regarding those participants who were not certain about the use of background music in their favorite advertisements, this peculiarity can be explained with the specifics of their individual perception of information and the preferred mode of communication. Additionally, even th ough these respondents did not notice the presence of background music, they were able to reproduce the rest of details of the plot and the main message of the commercials. Therefore, the music elements can remain unnoticed but still have impact upon the consumers’ perceptions and attitudes. Regarding the least preferred commercials, it can be stated that most of them belonged to non-music group. Though the music elements are widely used in modern marketing, the instances of non-music commercials can still be found in the media. Though the interviewees pointed out at shameless self-promotion and banality of the message as the main features they disliked about the least preferred commercials, there is a relationship between the lack of the music background and the consumers’ negative attitude towards it. Additionally, some of the least preferred commercials contained music elements which however irritated the listeners causing their dissatisfaction. Therefore, music ele ments can become a powerful tool in producing an impression which can be either positive or negative. In that regard, bearing in mind the potential influence of this choice, marketers should be careful in selecting the most appropriate tunes for their commercials and deciding between well-known and unfamiliar songs (4). Analyzing the brand preferences of the interviewees in their relation to the commercials and the use of background music in them, it can be stated that there is a positive relationship between the use of music as a background feature in advertisements and the consumers’ purchasing decisions. Event though the vast majority of the participants of the study emphasized their objectivity in making purchasing decisions and denied the impact of particular advertisements and their elements upon their attitudes and behaviors, most of them agreed that they appreciate the quality of the products produced by the brands advertized in their preferred commercials. Thus, the consumers’ purchasing decisions depend upon a wide range of influential factors, and music used in advertizing can have a significant impact upon their mood and perception of the main message of the commercial and contribute to their awareness and positive attitude towards the advertized brands and their products. Conclusion Analyzing the results of the semi-structured interviews in their relation to the findings of the previous studies, it can be concluded that there is a positive relationship between the use of music as a background feature in advertisements and the consumers’ brand preferences and purchasing decisions. Regardless of the fact that most of the participants denied the impact of music in commercials upon their attitudes and brand preferences, it can be stated that music is a powerful tool affecting the consumers’ mood, perception and impression from particular commercials and advertized brands and products. Taking into account the potential impac t of music elements, marketers should be careful in selecting the tunes and songs for particular commercials. References 1. Berger IE, Mitchell AA. The effect of advertising on attitude accessibility, attitude confidence, and the attitude behavior relationship. Journal of Consumer Research. 1989 Dec;16(3):269-279. 2. Gorn GJ. The effects of music in advertising on choice behavior: a classical conditioning approach. The Journal of Marketing. 1982 winter;46(1):94-101. 3. Kellaris JJ, Cox AD. The effects of background music in advertising: a reassessment. Journal of Consumer Research. 1989 Jun;16(1):113-18. 4. Park CW, Young SM. Consumer response to television commercials: the impact of involvement and background music on brand attitude formation. Journal of Marketing Research. 1986 Feb; 23(1):11-24. This essay on Effects of Music in Advertising was written and submitted by user Malice to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here. Effects of Music in Advertising

Please Write 1 Page About (two Ways To Belong In America Bharati

Please Write 1 Page About (two Ways To Belong In America Bharati Please Write 1 Page About (two Ways To Belong In America Bharati Mukherjee – Book Report/Review Example Bharati Mukherjee illustrates how the adaptation of the American culture impacts an individual’s identity in the essay "Two Ways to Belong in America." The essay revolves around Mukherjee and her sister who grew up in Calcutta, India; held same values as taught and nurtured be same family, held similar goals and were almost identical in physical appearance and attitude. With their stay in America, their attitudes, lifestyles, future plans and views on a myriad of topics are totally different. Mukherjee adopted the American culture and she says "America spoke to me-I married it" (455) while the sister Mira argues "some kind of irrational attachment to India that I dont to America (455). According to Mukherjee, Mira is a pleasant well educated woman that has deliberately not adopted the American culture, despite the posed requirements on immigrants. She states that the sister is "professionally generous and creative, socially courteous and gracious,   (455) but, "thats as far as her Americanization can go. She is here to maintain an identity, not to transform it. (455).The importance of the essay is that, despite the fact that Mira felt to the American dream, she remained true to what she was and never lost the Indian background. The author presents struggles faced by immigrants in their quest for an American dream. The tone of the essay is reflective and sympathetic while the style adopted is anecdote. Mukherjee reflects her life and compares it to the sister’s through a persuasive voice intended to convince the people to vote against the decision by the congress. The author also adopts pathos to achieve the emotional appeal in the essay. From the essay, we learn that we can vehemently disagree over an issue but through a civilized discussion we learn to respect others opinion even if we don’t accept them. I have also appreciated the impact of community’s speech on social connections, culture, language, dialects, ethnicity, politic s and lifestyles. Bharati Mukherjee Crossings Culture - Boston, New York City - Houghton Mifflin Compnay - 2008 - Vol. 7

Market Strategy Essay Example | Topics and Well Written Essays - 500 words

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Becoming a Father Essay Example | Topics and Well Written Essays - 500 words

Becoming a Father - Essay Example Probably the greatest test of a man is his strength and power not on physical things but on his character, to be able to face the challenges and responsibilities of being the head of the family. Being a husband is one thing, pretty much easier than being a father, for the latter calls for a responsibility done on top of the former. The presence of a child or children in a home is commonly seen as that factor which completes a family and yes, it is probably true. All fathers experienced being a child and whatever knowledge and observation they had that molded their opinions of fatherhood is manifested when they exercise being a father as well. Thus, fatherhood calls for an opportunity for a man to prove himself like his father, be better or worse, depending on what principles his character has been founded on. The magic of a baby makes wonders in a man, though. No matter what one would have been through, would just be changed with the thought of becoming the best father one could be f or a sweet innocent child who drives the clouds away. Satisfaction of one’s self is completed when given the chance to give back the best things given him and impart more of the good things deprived from him.

Changes in theoretical paradigms have predominantly been driven by Coursework

Changes in theoretical paradigms have predominantly been driven by black swan events rather than resulting from proven paradigm - Coursework Example In the world of finance, these events are those that effect dramatic market movements, such as, for instance, the 2001 terrorist attacks, as well as the 2007 financial crisis, which both drove the markets dramatically lower. The recommended financial strategies to accommodate large market failures precipitated by black swan events are, of course, centered on allocating a small percentage of a total portfolio towards investment instruments that are to spike when the markets crash, while keeping the large share of the portfolio in the safest, black swan-proof, investment vehicles. This is part of a broader strategy aimed at spreading the risk among a greater number of vehicles for investment. One can say that these investing strategies may be an offshoot of an economic theoretical paradigm that may not be superior, but is conditioned by the painful experience of previous black swan events. The paper explores the dynamics of shifts in theoretical paradigm springing from black swan event s (Kim 2010; Bloch 2013; Sood 2013). II. Discussion A history of tectonic changes in macroeconomic paradigms can be summarized as tales of existing economic thinking, such as classical economics and fundamental supply and demand models being upended by black swan events, such as the Great Depression in the case of classical economics. ... During the Depression this amounted to heavy spending by the US government to get the economy out of its hole. One can argue from this that the new paradigm is adopted not because it is necessarily superior, but because it adequately addressed the black swan event of the Depression, and showed good results in spurring the economy back on a track to growth. This new paradigm fixed demand, but was not particularly suited for instance to the black swan event of stagflation, where the economy was stagnant even as inflation spiked. The problem in this latter black swan event was that supply fell, leading to spikes in the prices of fuel and of food. This black swan event then led to a shift in paradigm back to classical economics, with Milton Friedman arguing that market forces are the best determinants of market efficiency, and are best left to their own devices, with the emphasis this time not on demand, as in Keynes, but on supply-side economics. Here then, from two successive black swa n events, is proof that changes in economic paradigms are not necessarily driven by the shift to superior paradigms, but rather are borne out of the need to correct the imbalances and inherent problems in economic policies that were made evident by the black swan events. In these two examples it can be argued that classical economics and the efficiency of market forces is the superior paradigm, but as a result of the Great Depression it was junked in favor of Keynes, only to be re-adopted, tweaked, after the stagflation crisis in the 1970’s (Sood 2013; Bloch 2013). On the other hand, fast-forward to 2007-2008, the global financial crisis again put into question the validity of the Friedman model, given that the

Pressure Ulcer on Sacrum

Pressure Ulcer on Sacrum The purpose of this assignment is to identify a patient, under the care of the district nursing team, with a Grade 1 pressure ulcer, to their sacral area. To begin with, it will give a brief overview of the patient and their clinical history. Throughout the assignment the patient will be referred to as Mrs A, in order to protect the patients identity and maintain confidentiality, in accordance with the guidelines set out by the Nursing and Midwifery Council (NMC 2008). A brief description of a Grade 1 pressure ulcer will be given, along with a description of the steps taken in assessing the wound, using The Waterlow Scale (1985). This assignment will discuss the literature review that was carried out, along with other methods of research used, to gather vital information on wound care , such as the different classifications of wounds and the different risk assessment tools available. This assignment, will include brief overviews, of some the other commonly used pressure ulcer risk as sessment tools, that are put to use by practitioners and how they compare to the Waterlow Scale. This assignment will also seek to highlight the importance of using a combination of clinical judgement, by carefully monitoring the patients physical and psychological conditions, alongside the at risk score calculated from the Waterlow Scale, in order to deliver holistic care to the patient. Mrs A is a 84 year old lady who has been referred to the district nurses by her General Practitioner, as he has concerns regarding her pressure areas . Following a recent fall she lost her confidence and is now house bound. She now spends more time in her chair as she has become nervous when mobilising around the house and in her garden. She has a history of high blood pressure and occasional angina for which she currently takes Nicorandil 30mg b.d. as prescribed by her General Practitioner , Nicorandil has been recognised as an aetiological aspect of non healing ulcers and wounds (Watson, 2002), this has to be taken into consideration during the assessment and throughout the management of her wound. Mrs A has no history of previous falls or problems with her balance. She has always been a confident and independent lady, with no current issues surrounding continence or diet. She has always enjoyed a large network of friends who visit her regularly. It is recommended by National Inst itute for Health and Clinical Excellence (NICE) that patients should receive an Initial assessment (within the first 6 hours of inpatient care) and ongoing risk assessments and so referrals of this nature are seen on the day, if it is received if not within 24 hrs. In order to establish Mrs As current risk of developing a pressure area, an assessment must take place. An initial holistic assessment, looking at all contributing factors such as mobility, continence and nutrition will provide a baseline that will identify her level of risk as well as identifying any existing pressure damage. A pressure ulcer is defined as, a localised injury to the skin and / or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear. A number of contributing, or confounding factors, are also associated with pressure ulcers. According to the European Pressure Ulcer Advisory Panel (EPUAP 2009), the significance of these factors, is yet to be elucidated. Mrs A is more vulnerable to pressure damage, as her skin has become more fragile and thinner with age (NICE 2005). There are risk factors associated to the integrity of the patients skin and also to the patients general health. Skin that is already damaged, has a higher incidence of developing a pressure ulcer, than that of healthy skin. Skin that becomes too dry, or is more moist due to possible incontinence, is also at higher risk of developing a pressure ulcer than healthy skin. An elderly persons skin is at increased risk, because it is more fragile and thinner than the skin of a younger person. Boore et al (1987) identified the following principles in caring for the skin to prevent pressure damage, skin should be kept clean and dry and not left to remain wet. The skin should also not be left to dry out to prevent any accidental damage . Due to Mrs A spending more time sitting in her chair, she has become at a higher risk of developing a pressure sore, as she is less mobile. The reason being It becomes difficult for the blood to circulate causing a lack of oxygen and nutrients to the tissue cells. Furthermore, the lymphatic system also begins to suffer and becomes unable, to properly remove waste products. If the pressure continues to increase and is not relieved by equipment or movement. The cells can begin to die, leaving an area of dead tissue resulting in pressure damage. Nelson et al (2009) states, pressure ulcers can cause patients functional limitations, emotional distress, and pain for persons affected. The development of pressure ulcers, in various healthcare settings, is often seen as a reflection of the quality of care which is being provided (Nakrem 2009). Pressure ulcer prevention is very important in everyday clinical practise, as pressure ulcer treatment is expensive and factors such as legal issues have become more important. EPAUP (2009) have recommended strategies, which include frequent repositioning the use of special support surfaces, o r providing nutritional support to be included in the prevention. In order to gather evidence based research, to support my assignment. I undertook a literature review of the Waterlow Scale and Classifications of Grade 1 pressure sores. The databases used were the Culmulative Index to Nursing and Allied Health Literature (CINAHL) and OpenAthens. I used a variety of search terms including pressure sores, Grade 1 classification, Waterlow Scale, and How pressure sore risk assessment tools compare. Throughout the literature review the information was gathered from sources using a date range between the years of 2000 2011, although some references were found from sources of information that are from a much later date. This method of research ensured a plethora of articles and guidelines were collated and analysed. The trust guidelines in wound care were used, to show how we implement theory into practise in the community, using the wound care formulary. There was a vast amount of information available, as pressure area care is such a broad subject. The search criteria had to be narrowed down, in some cases to ensure the information gathered was relevant and not beyond the scope of the assignment. The evidence used throughout this assignment, is based on guidelines and recommendations given by NICE (2001), EPUAP (2001) and articles sourced from The Journal of Community Nursing (JCN). This was the most accurate information and guidance on pressure ulcer classifications and assessment although, some articles may not have been the most recent. The assessment tool used throughout my area of work, is the Waterlow Scale. The Waterlow Scale was developed by Judy Waterlow in 1985, while working as a clinical nurse teacher. It was originally designed for use by her student and is used to measure a patients risk of developing a pressure sore. It can also be used as a guide, for the ordering of effective pressure relieving equipment. All National Health Service (NHS) trusts have their own pressure ulcer prevention policy, or guidelines and practitioners are expected to use the risk assessment tool, specified in their trusts policy. NICE (2003), guidance states, that all trusts should have a pressure ulcer policy, which should include a pressure ulcer risk assessment tool. However, it reminds practitioners that the use of risk assessment tools, should be thought of as an aid to the clinical judgement of the practitioner. The use of the Waterlow tool enables, the nurse to assess each patient according to their individual risk of dev eloping pressure sores (Pancorbo-Hidalgo et al 2006). The scale illustrates a risk assessment scoring system and on the reverse side, provides information and guidance on wound assessment, dressings and preventative aids. There is information regarding pressure relieving equipment surrounding, the three levels of risk highlighted on the scale, and also provides guidance, concerning the nursing care given to patients. Although the Waterlow score is used in the community setting, when calculating the risk assessment score, it is vital that the nurse is aware of the difference in environment the tool was originally developed for. The tool uses a combination of core and external risk factors that contribute to the development of pressure ulcers. These are used to determine the risk level for an individual patient. The fundamental factors include disease, medication, malnourishment, age, dehydration / fluid status, lack of mobility, incontinence, skin condition and weight. The external factors, which refer to external influences which can cause skin distortion, include pressure, shearing forces, friction, and moisture. There is also a special risk section of the tool, which can be used if the patient is on certain medication or recently had surgery. This contributes to a holistic assessment of a patient and enables the practitioner to provide the most effective care and appropriate pressure relieving equipment. The score is calculated, by counting the scores given in each category, which apply to your patients current condition. Once these have been added up, you will have your at risk score. This will then ind icate the steps that need to be taken, in order to provide the appropriate level of care to the patient. Identification of a patients risk of developing a pressure sore is often considered the most important stage in pressure sore prevention (Davis 1994). During the assessment a skin inspection takes place of the most vulnerable areas of risk, typically these are heels, sacrum and parts of the body, where sheer or friction could take place. Elbows, shoulders, back of head and toes are also considered to be more vulnerable areas (NICE 2001). When using the Waterlow tool to assess Mrs As pressure risk, I found she had a score of 9. According to the Waterlow scoring system she is not considered as being at risk as her score is less than 10. As I had identified in my assessment, she had a score of 2, for her skin condition due to Grade 1 pressure ulcer to her sacrum. I felt it necessary, to highlight her as being at risk. A grade 1 pressure ulcer on her sacral area, maybe due to her recent loss of confidence and reduced mobility which has left Mrs A spending more time in her chair. Pressure ulcers are assessed and graded, according to the degree of damage to the tissue. The National Pressure Ulcer Advisory Panel (NPUAP), classifies pressure ulcers based on the depth of the wound. There are four classifications (Category/Stage I through IV) of pressure damage. In addition to these, two other categories have been defined, unstageable pressure ulcers and deep tissue injury (EPUAP, 2009) Grade 1 pressure damage is defined, as a non-blanchable erythema of intact skin. Indicators can be, discolouration of the skin, warmth, oedema, induration or hardness, particularly in people with darker pigmentation (EPUAP, 2003). It is believed by some practitioners, that blanching erythema indicates Grade 1 pressure damage (Hitch 1995) although others suggest that, Grade 1 pressure damage is present, when there is non-blanching erythema (Maklebust and Margolis, 1995; Yarkony et al, 1990). The majority of practitioners, agree that temperature and colour play an important role, in identifying grade 1 pressure ulcers (EPUAP, 1999) and erythema, is a factor in alm ost all classifications (Lyder, 1991). The pressure damage usually occurs, over boney prominences (Barton and Barton 1981). The skin in a Grade 1 pressure ulcer, is not broken, but it requires protection and monitoring. At this stage, it will not be known how deep the pressure damage is, regular monitoring and assessment is essential. The pressure ulcer may fade, but if the damage is deeper than the superficial layers of the skin, this wound could eventually develop into a much deeper pressure ulcer over, the following days or weeks. A Grade 1 pressure ulcer, is classed as a wound and so I have commenced a wound care plan and also a pressure area care plan. I will also ensure, Mrs A has regular pressure area checks in order to prevent the area breaking down. The pressure area checks will take place weekly until the pressure relieving equipment arrives, this will then be reduced to 3 monthly checks. Dressings can be applied to a Grade 1 pressure ulcer. They should be simple and offer some level of protection. Also, to prevent any further skin damage a film dressing is often used, or a hydrocolloid to protect the wound area (EPAUP, 2009) . These dressings will assist in reducing further friction, or shearing, if these factors are involved. It is considered the best way to treat a wound, is to prevent it from ever occurring. Removing the existing external pressure, reducing any moisture, which can occur if the patient is incontinent and employing pressure relief devices, may contribute to wound healing. Along with adequate nutrition, hydration and addressing any underlying medical conditions. The advice given to practitioners, on the reverse of the Waterlow tool is to provide a 100mm foam cushion, if a patients risk score is above 10. As Mrs A has an at risk score of 9, with a Grade 1 pressure sore evident, I feel it appropriate to provide the pressure relieving mattress and cushion to prevent any further pressure damage developing. All individuals, assessed as being vulnerable to pressure ulcers should, as a minimum provision, be placed on a high specification foam mattress with pressure relieving properties (NICE, 2001). As I am providing a cushion and a mattress, it is not felt necessary to apply a dressing at this point. However, the area will need regular monitoring, as at this stage it is unknown how deep the pressure damage is. If proactive care is given in the prevention and treatment of pressure ulcers, with the use of risk assessments and providing pressure relieving resources, the pressure area may resolve. Pressure ulcers can be costly for the NHS, debilitating and painful for the patient. With basic and effective nursing care offered to the patients, this can often be the key to success. Bliss (2000) suggests that the majority of Grade I ulcers heal, or resolve without breaking down if pressure relief is put into place immediately. However, experiences in a clinical settings supports observations, that non-blanching erythema can often result in irreversible damage (James, 1998; Dailey, 1992). McGough (1999) during a literature search, highlighted 40 pressure ulcer risk assessment tools, but not all have be considered suitable, or reliable for all clinical environments. As there are many different patient groups this often results in a wide spectrum of different patient needs. The three most commonly used tools in the United Kingdom (U.K.) are, The Norton scale, The Braden Scale and The Waterlow Scale. The first pressure ulcer risk assessment tool was the Norton scale. It was devised by Doreen Norton in 1962. The tool was used for estimating a patients risk for developing pressure ulcers by giving the patient a rating from 1 to 4 on five different factors. A patients with a score of 14 or more, was identified as being at high risk. Initially, this tool was aimed at elderly patients and there is little evidence from research gathered over the years, to support its use outside of an elderly care setting. Due to increased research over the years, concerning the identification and risk of developing pressure ulcers, a modified version of the Norton scale was created in 1987. The Braden Scale was created in the mid 1980s, in America and based on a conceptual schema of aetiological factors. Tissue tolerance and pressure where identified, as being significant factors in pressure ulcer development. However, the validity of the Braden Scale is not considered to be high in all clinical areas (Capobianco and McDonald, 1996). However, EPAUP (2003) state The Braden Risk Assessment Scale is considered by many, to be the most valid and reliable scoring system for a wide age range of patients. The Waterlow Scale, first devised in 1987, identifies more risk factors than the Braden and the Norton Scale. However, even though it is used widely across the U.K., it has still be criticised for its ability to over predict risk and ultimately result in the misuse of resources (Edwards 1995; McGough, 1999). Although there are various tools, which have been developed to identify a patients individual risk, of developing pressure sores. The majority of scales have been developed, based on ad hoc opinions, of the importance of possible risk factors, according to the Effective Healthcare Bulletins (EHCB, 1995). The predictive validity of these tools, has also been challenged (Franks et al, 2003; Nixon and Mc Gough, 2001) suggesting they may over predict the risk, incurring expensive cost implications, as preventative equipment is put in place, when it may not always be necessary. Or they may under predict risk, so that someone assessed as not being at high risk develops a pressure ulcer. Although The Waterlow scoring system, now includes more objective measurements such as Body Mass Index (BMI) and weight loss after a recent update. It is still unknown, due to no published information, whether the inter-rater reliability of the tool, has been improved by these changes. It has been acknowled ged, that this is a fundamental flaw of these tools and due to this clinical judgement, must always support the decisions made by the results, of the risk assessment. This is clearly recognised by NICE, as they advise their use as an aide-mà ©moire (2001). The aim of Pressure ulcer risk assessment tools, is to measure and quantify pressure ulcer risk. To determine the quality of these measurements the evaluation of validity and reliability would usually take place. The validity and reliability limitations, of pressure ulcer risk tools are widely acknowledged. To overcome these problems, the solution that is recommended is to combine the scores of pressure ulcer risk tools, with clinical judgment (EPAUP 2009). This recommendation, which is often seen in the literature, unfortunately is inconsistent as Papanikolaou et al (2007) states: If pressure ulcer risk assessment tools have such limitations, what contribution can they make to our confidence in clinical judgment, other than prom pting us about the items, which should be considered when making such judgments?. Investigations of the validity and reliability, of pressure ulcer risk tools are important, in evaluating the quality, but they are not sufficient to judge their clinical value. In the research of pressure ulcer tools, there have been few attempts made to compare, the different pressure ulcer risk assessment strategies. Referring to literature until 2003, Pancorbo Hidalgo et al (2006) identified three studies, investigating the Norton scale compared to clinical judgment and the impact on pressure ulcer incidence. From these studies, it was concluded that there was no evidence, that the risk of pressure ulcer incidence was reduced by the use of the risk assessment tools. The Cochrane review (2008), set out to determine, whether the use of pressure ulcer risk assessment , in all health care settings , reduced the incidence of pressure ulcers. As no studies met the criteria, the authors have been unable to answer the review question. At present there is only weak evidence to support the validity, of pressure ulcer risk assessment scale tools and obtained scores contain varying amounts of measurement error. To improve our clinical practise, it is suggested that although tools such as the Waterlow Scale are used to distinguish a patients pressure ulcer risk, other investigations and tests, may need to be carried out to ensure a effective assessment is taking place. Practitioners may consider, various blood tests and more in depth history taking, including previous pressure damage and medications. Patients lifestyle and diet should also be taken into consideration and where appropriate, a nutritional assessment should be done if recent weight loss, or reduced appetite is evident. Nutritional assessment and screening tools are being used more readily and appear to be becoming more relevant in managing patients who are at risk of or have a pressure ulcer. The assessment tools should be reliable and valid, and as discussed previously with other risk assessment tools they should not replace clinical judgement. However, the use of nutritional assessment tools can help to bring the nutritional status of the patient to the attention of the practitioner, they should then consider nutrition when assessing the patients vulnerability to pressure ulcer development. The nutritional status of the patient should be updated and re-assessed at regular intervals following a assessment plan which is individual to the patient and includes an evaluation date. The condition of the individual will then allow the practitioner to decide how frequent the assessments will occur. The EPUAP (2003) recommends that as a minimum, assessment of nutritional status should include regu lar weighing of patients, skin assessment, documentation of food and fluid intake. As Mrs A currently has a balanced diet, it is not felt necessary to undertake, a nutritional assessment at this point. Her weight can be updated on each review visit, to assess any weight loss during each visit. If there is any deterioration in her condition, an assessment can be done when required. Continence should also be taken into consideration and where necessary a continence assessment should take place. Incontinence and pressure ulcers are common and often occur together. Patients who are incontinent are generally more likely to have difficulties with their mobility and elderly, both of which have a strong association with the development of pressure ulcers (Lyder, 2003).   The education of staff, surrounding pressure ulcer management and prevention, is also very important. NICE (2001) suggest, that all health care professionals, should receive relevant training and education, in pressure ulcer risk assessment and prevention. The information, skills and knowledge, gained from these training sessions, should then be cascaded down, to other members of the team. The training and education sessions, which are provided by the trust, are expected to cover a number of topics. These should include, risk factors for pressure ulcer development, skin assessment, and the selection of pressure equipment. Staff are also updated on policies, guidelines and the latest patient educational information (NICE 2001). Education of the patient, carers and family, is essential in order to achieve optimum pressure area care. Mrs A is encouraged to mobilise regularly, in order to relieve the pressure as a Grade 1 pressure sore has been identified, she is at a significant risk of developing a more severe ulcer. Interventions to prevent deterioration, are crucial at this point. It is thought, that this could prevent the pressure sore from developing into a Grade 2 or worse. NICE (2001) have suggested, that individuals vulnerable to or at elevated risk of developing pressure ulcers, who are able and willing, should be informed and educated about the risk assessment and resulting prevention strategies. NICE have devised a booklet for patients and relatives, called Pressure Ulcers Prevention and Treatment (NICE Clinical Guidance 29), which gives information and guidance on the treatment of pressure ulcers. It encourages patients to check their skin and change their position regularly. As a part of good practise, this booklet is given to Mrs A at the time of assessment, in order for her to develop some understanding of her pressure sore. This booklet is also given to the care givers or relatives so they can also gain understanding, regarding the care and prevention, of her pressure ulcer. An essential part of nursing documentation, is care planning. It demonstrates the care, that the individual patient requires and can be used to include patients and carers or relatives in the patients care. Involvement of the patient and their relative, or carer is advisable, as this could be invaluable, to the nurse planning the patients care. The National Health Service Modernisation Agency (NHSMA 2005) states clearly that person centred care is vital and that care planning involves negotiation, discussion and shared decision making, between the nurse and the patient. There were a number of improvements that I feel could have been made to the holistic care of Mrs A. I feel that one of the fundamental factors that needed to be considered, were the social needs of the patient. As I feel they are a large contributing factor, towards why the patient may have developed her pressure sore. The patient was previously known to be a very sociable lady, who gradually lost her confidence, resulting in her not leaving the house. There are various schemes and services available, which are provided by the local council or volunteer services, to enable the elderly or people unable to get around. For example, an option which could of been suggested to Mrs A are services such as Ring and Ride, or Werneth Communicare. Using these services or being involved in these types of schemes, may have empowered Mrs A to leave the house on a more regular basis. This would enable her to build up the confidence, she lost following her fall. This would have also led to positive i mpact on the patients psychological care, as Mrs A would have been able to overcome her fears of leaving the house, enabling her to see friends and gain communications lost. As previously mentioned in this assignment, although Mrs A had a score of 9, which is not considered an at risk score. I still felt it necessary to act on this score, even though the wound was a not considered to be critical. If it is felt the patient is at a higher risk than that shown on the assessment tool, the practitioner should use their clinical judgement, to make crucial care decisions. It should also be considered, by the practitioner that risk assessment tools such as The Waterlow scale, may not have been developed, for their area of practise. Throughout the duration of Mrs As wound healing process, a holistic assessment of her pressure areas and general health assessment were carried and all relevant factors, were taken into consideration. The assessment tool used to assess her pressure areas, is the most common tool used currently in practise and the tool recommended by the Trust. To conclude, there is evidence prove that pressure ulcer risk assessment tools are useful, when used as a guide for the procurement of equipment. However, they cannot be relied upon solely to provide holistic care to a patient. It has been highlighted, that to ensure a holistic assessment of patients, it is necessary to complete a variety of assessments, to create a complete picture. Although The Waterlow scale covers a number of factors that need to be considered, throughout the assessment, it has become evident that the at risk score, can often be over or under scored depending on the practitioner. Clinical judgement has proved to be, a very important aspect of pressure ulcer prevention and treatment. The education of the patient, carer and relatives has also been highlighted, as an important aspect of care. Empowering the patient with information regarding their illness, may decrease the healing time and help prevent has further issues.

Cultural Criticism in W.B.Yeats’ An Irish Airman Foresees His Death Ess

Cultural Criticism in W.B.Yeats’ An Irish Airman Foresees His Death The various levels of interpretation that a poet, such as W.B.Yeats, welcomes to his poems is difficult to grasp upon first reading his poetry.   What appears to be a straight forward poem, such as, An Irish Airman Foresees His Death, is actually an intellectual cultural criticism of Yeats’ modern day society.   The poem, written as a testament to Lady Gregory’s son, captures the innermost concerns and perceptions of an Irish airman in World War I.   However, through Yeats’ sentimental and poetic style, the poem incorporates a double meaning, and hence, focuses on Irish nationalism and its lack of an international consciencesness.   The airman is Ireland personified, and his outlook on war and society is a window into the desolate situation that Ireland faces. As the title suggests, there is a sense of imminent doom for the soldier (Ireland).   He foresees his death, but has not yet experienced it and does nothing to prevent it.   The poem is written in the first person which gives a first hand feel for the tragic loss that the Irish soldier will experience.   (i.e. his own death).   Yeats is making a subtle commentary on the state of his modern Ireland.   He can foresee her doom, yet, unlike the subject of his poem, does not sit back and accept his fate.   The lack of a unified republic in Ireland and the ominous presence of English colonization, stand in the way of   progression for the Irish people.   Yeats writes a poetry (specifically, An Irish Airman Foresees His Death) to open the eyes of the world to the shadow of desolation that covers Ireland like an umbrella.   Lady Gregory’s son is used as a catalyst to project Yeats’ imagery of Ireland’s desperate situati... ...otism is established in a seemingly simple testament to a dead soldier.   What better way to honor the dead than to personify Lady Ireland through his character!   The passion that Yeats subconsciously incorporates into his poem equals that of his love for Ireland.   An Irish Airman Foresees His Death begins on a low and desperate note, but reaches its’ climax upon Gregory answering Ireland’s call, and ends by, essentially, posing a question to the reader.   ‘As a collective people, which side of the teeter-totter do we belong?’   He leaves his hero (Gregory) hanging in the balance of an important national question.   The poem may be about Yeats’ character foreseeing his death, but the fact remains: he is in the act of ‘foreseeing,’ he is not dead yet†¦and neither is Ireland.    Works Cited Townshend, Charles.   Ireland: The 20th Century.   New York: Oxford UP, 1998.