Challenges to Sexual Health Care in Todays Society

Challenges to Sexual Health Care in Todays Society Meeting the sexual health demands facing young people in todays society The issue of sexual health in adolescent people is a vast topic with an associated vast literature on the subject. In this essay we aim to consider some of the major themes and critically analyse some of the peer reviewed literature to act as an evidence base for further consideration. (Berwick D 2005) In broad terms, sexual health can be divided into areas of physical health and emotional (or psychological) health. The adolescent age is classically one of turmoil, of establishing identity, values and ideals. This is arguably the time when the emotional turmoil relating to sexual identity comes to the fore. We should remind ourselves, before perhaps dismissing the notion of psychological health as being on a different level of seriousness as an overtly physical problem such as a sexually transmitted disease, (Coyle KK et al 2001), that one of the commonly accepted definitions of health is a state of complete physical, mental, and social well being, and not just merely the absence of disease or infirmity. (UN 1995). One can argue that it is an essential component part of the developing person’s ability to become well adjusted, responsible and productive (in every sense of the word) members of society (UN 2002) Issues of sexuality have, ideally, to be resolved. The apparently eternal adolescent dilemmas of â€Å"am I sexually attractive?† â€Å"am I gay or straight?† or â€Å"am I ready to have sex?† clearly have a direct relevance to the psychological health of a person but the behaviour patterns that these questions can engender in an attempt to resolve them, can pose clear risk patterns to the physical sexual health of the adolescent. (Larson, R., et al. 2002.) To a large extent the issues that concern the adolescent have their origins in earlier life. As they progress through childhood, adults treat boys and girls differently, and thereby establish different expectations for their behaviour. These expectations are clearly influenced by their culture and a myriad of more subtle influences. They largely determine life outcomes. They also shape the adolescent’s introduction to sexual practices, sexuality and relationships generally. (Aarons SJ et al 2000) The reason for dwelling on these factors is that they have a fundamental bearing on the possibility of adverse reproductive and sexual health outcomes in later life, including events such as unwanted pregnancy, unsafe abortion and sexually transmitted diseases, all of which have major socio-economic components. (Churchill D et al 2000), Differential gender expectations and social treatment in childhood and the early adolescent period are thought to be frequent causal factors in adolescent problems. The bulk of this essay will be on the issues surrounding the major issues of STDs in the adolescent community. One of the most pressing issues in this regard (at least in terms of sheer numbers) is the issue of chlamydia. (Fenton KA et al 2001). In the specific terms of meeting the demands of the adolescent population we will begin this examination with a consideration of the National Chlamydia Screening programme. The programme was originally set up after the realisation that chlamydia was responsible for a large amount of morbidity in the community which had, hitherto been unrecognised (Cates W, et al. 1991). It is now seen as the single most commonly transmitted STD in the UK today. A huge proportion of what used to be called NSU is now recognised as being due to the chlamydia pathogen (Duncan 1998). If we consider the issues behind the screening programme, on one level the issues appear fairly straightforward and simple. Because we know that many cases of chlamydia are asymptomatic and that it can cause considerable damage and that it is also easily treatable, why not screen for it and minimise its impact? (Kufeji O et al 2003) On a more sophisticated level one must consider the cost-effectiveness considerations together with issues such as feasibility, efficiency and use of resources. If we examine the published rationale behind the National Chlamydia Screening programme as set out by The National Institute for Clinical Excellence (NICE) we can see that it states that: Genital Chlamydia trachomatis is the commonest Sexually Transmitted Infection (STI) in England Genital chlamydial infection is an important reproductive health problem ~ 10-30% of infected women develop pelvic inflammatory disease (PID). A significant proportion of cases, particularly amongst women, are asymptomatic and so, are liable to remain undetected, putting women at risk of developing PID. Screening for genital chlamydia infection may reduce PID and ectopic pregnancy. They also concluded that there was not a great deal of data on the cost effectiveness of the possible procedure (Harry et al 1994) The paper itself is extremely detailed and, in essence, it points to the fact that it is extremely cost effective to detect and treat asymptomatic patients before they develop complications that then need treatment. Complications are outlined in the paper by Berry (et al 1995) and include the sequelae of infertility, pelvic inflammatory disease and ectopic pregnancy in women together with the complications that can occur in the male partners (infertility and prostatitis). The authors point to the fact that their screening programme reduced both the incidence and prevalence of pelvic inflammatory disease by 60% when compared to the unscreened population. Of particular relevance to our theme, we note that the screening programme became cost effective when the incidence of infection in the population of asymptomatic women rose above 1.1%. Figures quoted by Pimenta J (et al 2001) suggest that in our target age range the prevalence is approaching 11%. If we examine the literature on the subject we can see that the adolescent age range has the fastest growing proportion of chlamydial infections (Gilson et al 2001). This finding is therefore at odds with the logic of the report commissioned by the Chief Medical Officer (CMO 1998) which suggests that the groups to be screened under the National Programme should be: Everyone with symptoms of chlamydia infection, All those attending genitourinary medicine clinics, Women seeking termination of pregnancy. Opportunistic screening of young sexually active women under 25 years Women over 25 with a new sexual partner or two or more sexual partners in the past year. It will therefore be immediately apparent that there is no provision for screening for asymptomatic men and also that the adolescent population are not to be specifically targeted unless they attend clinics. On the subject of screening young men, there are a number of well written papers on the subject. Notable amongst them is the Duncan paper (Duncan et al. 2001) which looks at the issues of male screening from both a Public Health viewpoint and it also considers it from a feminist sociological angle which makes it, (in our examination of the current literature), almost unique. It is a thoughtful and well written document and tackles the thorny issue of the fact that many young women are reluctant to attend screening clinics as being screened for STDs has overtones and perception of being dirty and unattractive. A positive screening result can be associated with considerations of promiscuity. Such feelings are clearly counterproductive, particularly in the light of our earlier comments relating to the developing psyche of the adolescent. Duncan puts forward the hypothesis that by not screening men, it not only fosters gender inequalities, but it sends of negative messages regarding the man’s responsibility for sexual health (Pierpoint et al 2000). Critical analysis of this point suggest that although it may be intuitively true, the authors don’t produce any counter evidence with regard to the cost effectiveness of screening adolescent males (or any other age group for that matter) in the population (Stephenson et al 2000) Other authors do also make the point that it appears to be a generally accepted fact that women are actually easier to target than men as they tend to be heavier health care users than men in this age range (Stokes T 2000). The main practical thrust of this paper however, is in its call for a greater understanding of the woman’s point of view when organising and running screening clinics in order to broaden their appeal to the intended target groups (Santer et al 2000). Clearly this point is central to our considerations here as clearly there is no point in providing services to meet a perceived need if there is no uptake from the targeted population. If we turn our attention to the second most common STD in this age range we need to consider genital herpes. (Schacker T et al 2000) There are many common arguments in the areas of screening for genital herpes and chlamydia. Qualitative studies have shown a greater level of concern relating to genital herpes amongst the adolescent population that there is for chlamydia, and it is second only to HIV/AIDS (Corey L et al 2001). The specific problem with the age range that we are specifically considering here is that there is a general perception that genital herpes is a nuisance and a comparatively trivial condition. Indeed the majority of infections are either mild or subclinical. Serious complications are actually comparatively common and there is an increasing body of evidence that suggests that genital herpes infection is a potent facilitator of sexual transmission of the HIV virus. (Tripp J et al 2005) The major epidemiological factor that is relevant with genital herpes is the fact that transmission can occur in a long-standing monogamous relationship. Its immediate problem is that the longer the period of infectivity, the greater the potential for transmission. In the adolescent years when there is a greater likelihood of a number of sexual partners, infections can be contracted only to be passed on at a considerably later time due to the fact that subclinical or unrecognised reactivation in the infected partner is intermittent. (Hopkins J 2005) There is another element of sexual health that is specific to the adolescent age range. As we have already observed, adolescence is a time of considerable turmoil not only in terms of psyche but also in terms of hormones. There is an eye-catching paper by Brabin (2001) which considers the impact of fluctuating hormone levels on the body’s susceptibility to STDs It is already established that sex hormones play a role in the host’s resistance to STDs (Hewitt RG et al 2001). We can show this by considering sex differences in susceptibility to infection, variations in the clinical manifestations of infection during the menstrual cycle (Greenblatt RM et al 2000) and also during pregnancy (Brown ZA et al 1997) and also by the fact that the OC Pill predisposes to some infections (Wang CC et al 1999) The paper considers the implications of these facts with particular reference to the adolescent age group. It points to the sex differences in the acquisition of STDs with the adolescent girl getting infections such as genital herpes and chlamydia with greater frequency than the adolescent boy. (Obasi A et al 1999) Sex differences also have an effect on the efficacy of a genital herpes vaccine trial which showed a limited protective efficacy against genital herpes in women but none in men. (Stephenson J 2000). The whole area of the ability of the NHS to meet the demands of the sexual health needs of the adolescent is vast. We have not presumed to cover all of the relevant areas in this particular essay. In the areas that we have selected for examination and consideration we have been at pains to critically assess the evidence base as this is fundamental to the acceptance of the comparative validity of the various papers used. The adolescent age group has certain unique characteristics which set its sexual health related problems apart from the rest of the population. In short, they can be encapsulated in the turmoil of the characteristic psychological and physical changes that are typical of the age. We have examined how the psychological issues impinge on both the sexual behaviour patterns and therefore the disease exposure risks and also the willingness to attend clinics if a sexually acquired disease process becomes apparent. We have contrasted this pattern with the pattern of screening that is currently advised and implemented under the auspices of the National Chlamydia Screening Programme. We have also examined the negative aspect of the disproportionate concentration of resources of the older female population and therefore, by inference, the impact that this will have on the adolescent population. Issues such as genital herpes also have unique implications for the adolescent, particularly with the long period of infectivity that is relevant to this disease process. We also have examined the implications of the hormonal differences that are amplified by the hormonal changes that are apparent in this age range. References Aarons SJ, Jenkins RR, Raine TR, El-Khorazaty MN, Woodward KM, Williams RL, et al. 2000 Postponing sexual intercourse among urban junior high school students. A randomised controlled evaluation. J Adolesc Health 2000; 27: 236-247 Berry J, Crowley T, Horner P, et al. 1995 Screening for asymptomatic Chlamydia trachomatis infection in male students by examination of first catch urine. Genitourin Med 1995;71:329–30. Berwick D 2005 Broadening the view of evidence-based medicine Qual. Saf. Health Care, Oct 2005; 14: 315 316. Brabin L 2001 Hormonal markers of susceptibility to sexually transmitted infections: are we taking them seriously? BMJ 2001;323:394-395 ( 18 August ) Brown ZA, Selke S, Zeh J, Kopelman J, Maslow A, Ashley RL, et al. 1997 The acquisition of herpes simplex virus during pregnancy. N Engl J Med 1997; 337: 509-515 Cates W, Wasserheit JN. 1991 Genital chlamydial infections: epidemiology and reproductive sequelae. Am J Obstet Gynecol 1991; 164: 1771-1781 Churchill D, Allen J, Pringle M, Hippisley-Cox J, Ebdon D, Macpherson M, et al. 2000 Consultation patterns and provision of contraception in general practice before teenage pregnancy: case-control study. BMJ 2000; 321: 486-489 CMO 1998 Chief Medical Officer. Main report of the Chief Medical Officers Expert Advisory Group on Chlamydia trachomatis. London: Department of Health , 1998. Corey L, Wald A. 2001 Genital herpes. In: Holmes KK, Mà ¥rdh PA, Sparling PF, eds. Sexually Transmitted Diseases. 4th ed. New York, NY: McGraw Hill; 2001:285-312. Coyle KK, Basen-Engquist KM, Kirby DB, Parcel GS, Banspach SW, Collins JL, et al. 2001 Safer choices: reducing teen pregnancy, HIV, and STDs. Public Health Rep 2001; 116(suppl 1): 82-93 Duncan B, Hart G. 1998 Screening for Chlamydia trachomatis: a qualitative study of womens views. Prevenir 1998; (suppl 24): 229. Duncan B, Graham Hart, Anne Scoular, and Alison Bigrigg 2001 Qualitative analysis of psychosocial impact of diagnosis of Chlamydia trachomatis: implications for screening BMJ, Jan 2001; 322: 195 – 199 Larson, R., et al. 2002. Changes in Adolescents’ Interpersonal Experiences: Are They being Prepared for Adult Relationships in the Twenty-first Century?† Journal of Research on Adolesence 12(1): 31-68; 2002 Fenton KA, Korovessis C, Johnson AM, et al. 2001 Sexual behaviour in Britain: reported sexually transmitted infections and prevalent genital Chlamydia trachomatis infection. Lancet 2001;358:1851–4. Gilson RJC and Mindel A 2001 Recent advances: Sexually transmitted infections BMJ, May 2001; 322: 1160 1164 Greenblatt RM, Ameli N, Grant RM, Bacchetti P, Taylor RN. 2000 Impact of the ovulatory cycle on virologic and immunologic markers in HIV-infected women. J Infect Dis 2000; 181: 82-90 Harry T, Saravanamuttu K, Rashid S, et al. 1994 Audit evaluating the value of routine screening of Chlamydia trachomatis urethral infections in men. Int J STD AIDS 1994;5:374–5 Hewitt RG, Parsa N, Gugino L. 2001 The role of gender in HIV progression. AIDS Reader 2001; 11: 29-33 Howell MR , TC Quinn, CA Gaydos. 1998 Screening for Chlamydia trachomatis in asymptomatic women attending family planning clinics. Annals of Internal Medicine 1998 128:277-84 Kufeji O, R Slack, J A Cassell, S Pugh, and A Hayward 2003 Who is being tested for genital chlamydia in primary care? Sex. Transm. Inf., June 1, 2003; 79(3): 234 236. Obasi A, Mosha F, Quigley M, Sekirassa Z, Gibbs T, Munguti K, et al. 1999 Antibody to herpes simplex virus type 2 as a marker of sexual risk behavior in rural Tanzania. J Infect Dis 1999; 179: 16-24 Pierpoint T, Thomas B, Judd A, et al. 2000 Prevalence of Chlamydia trachomatis in young men in north west London. Sex Transm Infect 2000;76:273–6. Pimenta J, Catchpole M, Gray M, Hopwood J, Randall S. 2001 Screening for genital chlamydial infection. BMJ 2001 321: 629-631 Santer M, Warner P, Wyke S, et al. 2000 Opportunistic screening for chlamydia infection in general practice: can we reach young women? J Med Screen 2000;7:175–6. Schacker T, Zeh J, Hu HL, et al. 2000 Frequency of symptomatic and asymptomatic herpes simplex virus type 2 reactivations among human immunodeficiency virus-infected men. J Infect Dis. 2000;178:1616-1622. Stephenson J. 2000 Genital herpes vaccine shows limited promise. JAMA 2000; 284: 1913-1914 Stephenson J, Carder C, Copas A, et al. 2000 Home screening for chlamydial genital infection: is it acceptable to young men and women? Sex Transm Infect 2000;76:25–7. Stokes T, Mears J. 2000 Sexual health and the practice nurse: a survey of reported practice and attitudes. Br J Fam Plann 2000;26:89–92 Tanne JH 2005 US teenagers think oral sex isnt real sex BMJ, Apr 2005; 330: 865 ; Tripp J and Viner R 2005 Sexual health, contraception, and teenage pregnancy BMJ, Mar 2005; 330: 590 593 ; UN 1995 United Nations. 1995. Population and Development, vol. 1: Programme of Action adopted at the International Conference on Population and Development: Cairo, 5-13 September 1994, paragraph 7.2. New York: Department of Economic and Social Information and Policy Analysis, United Nations. 1994 UN 2002 United Nations. 2002. World Youth Report 2003: Report of the Secretary- General (E/CN.5/2003/4), para. 16. New York: Commission for Social Development, United Nations. 2002 Wang CC, Kreiss JK, Reilly M. 1999 Risk of HIV infection in oral contraceptive pill users: a meta-analysis. J AIDS 1999; 21: 51-58 Wilson JS, Honey E, Templeton A, et al. 2002 A systematic review of the prevalence of Chlamydia trachomatis among European women. Human Reproduction Update 2002;8:385–94. ############################################################# 11.3.06 PDG Word count 3,100

The Life of Serial Killer, Theodore Robert Bundy Essay -- Expository E

   On a chilly afternoon in late 1977, a young, newly-wed woman of 26 was dropped off at her Volkswagen Beetle by her sister-in-law. Her name was Gini McNair. She waved goodbye to her companion, unlocked the driver's door, and stepped into her vehicle. Sitting at the wheel, with the key in the ignition, she glanced around the deserted Boulder Canyon Road located outside of Boulder, Colorado. While waiting for her dusty red Volkswagen to warm up, she saw another one, light blue, heading down Sugarloaf Road towards her. When she glanced at the driver as he went past, he took the opportunity to look her over as well. With piercing eyes, Ted Bundy quickly examined Gini as he drove by her. When his eye caught hers, Gini immediately felt like she had just been delivered a swift punch in the stomach. He turned around at the bottom of Sugarloaf Road and drove over to where she was parked. As he walked over to her window, she rolled it down. He leaned in close and asked, "Are you having car trou ble?" "No." she replied quickly. "Oh...well I am!" he retorted back in an alarming loud voice. She looked at him with surprise, she knew she had to get away. "Well, I'm sorry, but I don't really know anything about cars. I don't think that I would be able to help you." He got suddenly angry and said, "Well, maybe you COULD!" She told him again that she could not and rolled her window up and drove away. Gini didn't tell many people the story of that day, she figured that it was just one of those weird things that happen sometimes. One night, a few months later, she and her husband were watching the news and a story about Ted Bundy came on. While the young couple watched for a few minutes with a mixture of disgust and interest, it showed a p... ....html    Dobson, J. (1995). Fatal addiction. Pure Intimacy.org Retrieved March 12, 2003, from http://www.pureintimacy.org/online1/bundy.html    Larsen, R. W. (1980). Bundy: the deliberate stranger. Prentice-Hall, Inc.    Sands, R. Ted Bundy. Retrieved March 7, 2003, from http://web.ukonline.co.uk/ruth.buddell/bundy.htm    Summers, C. Ted Bundy. BBC - Crime Case Closed. Retrieved March 7, 2003, from http://www.bbc.co.uk/print/crime/caseclosed/tedbundy1.shtml    Ted Bundy: 10 years later. Angelfire.lycos.com. (1999) Retrieved March 12, 2003, from http://www.angelfire.com/oh/yodaspage/news36.html    Ted Bundy - A serial killer. Ted Bundy. Retrieved March 11, 2003, from http://www.auschwitz.dk/mcbundy.htm    Ted Bundy: psychiatric testimony. Serial Murder: Through the Looking Glass. Retrieved March 12, 2003, from http://serial- killers.virtualave.net/bundy2.htm

Power Struggles in Society

Mills, Schudson, and Gitlin show different approaches to society and the role of mass media. Each approach helps illustrate a different focus on society. They each hold special relevance in a discussion of the history of societal beliefs. The Mass Society refers to the overall belief C. Wright Mills held in relation to the type of society he believed we live in.Mills began The Power Elite with a bold statement saying, â€Å"The powers of ordinary men are circumscribed by the everyday words in which they live, yet even in these rounds of job, family, and neighborhood they often seem driven by forces they can neither understand nor govern† (Mills, 1956, p. 3). This opening sentence helps describe the attitude and beliefs of the entire book. A â€Å"power elite† exists in a society that is made up of three spheres. They are divided into economy, political, and military, with the same group of people interchanging between the three.This large group of elite is at the top ma king all the decisions, while the masses are at the bottom, unaware of the process that molds public opinion. Masses within this view of society are irrelevant and do not have any type of influence. The media functions as an entertainment source, keeping the masses entertained while the elite is taking care of all the important matters. It helps keep the reality and truth of the world obscured from the masses.Mills explained what the media does for the masses as â€Å"they distract him and obscure his chance to understand himself or his world, by fastening his attention upon artificial frenzies that are revolved within the program framework, usually by violent action or by what is called humor† (Mills, p. 315). This helps illuminate how the mass media guides, tries to control, and manipulates the masses. Mills describes the effect of mass media as â€Å"a sort of psychological illiteracy† to the extent that we â€Å"often do not believe what we see before us until we read about it in the paper or hear about it on the radio† (Mills, p. 311).The masses â€Å"standards of credulity, standards of reality, tend to be set by these media rather than by ‘the masses' own fragmentary experience† (Mills p. 311). Mass media's role helps prevent the questioning of the elite. â€Å"Families and churches and schools adapt to modern life; governments and armies and corporations shape it; and, as they do so, they turn these lesser institutions into means for their ends† (Mills, p. 6). The family into which someone was born or marries into helps improve or decrease their social status. The school where one is educated or the church where one worships also plays a major role in the social standing.Schools teach skills to the masses that enable them to function in society. Institutions shape life and the masses adapt to what institutions create. The masses in the theory are very disorganized and not connected to others. An excellent way to describe to masses can be shown by watching The Twilight Zone movie. It is a state of total confusion for everyone, with each doing their own thing. The elite enjoy the state of confusion with the masses, because they are able to control the major decisions that must be made. They determine the policies and the people enlist in them.In the mass society, the elite control the policies and ways of thinking for the confused masses. Schudson approaches the nature of society in a much different way, through the idea of the democratic society. In Discovering the News, he discussed â€Å"an even distribution of income† and described the 1800's as â€Å"more people acquired wealth and political power ‘bringing' with them a zeal for equal opportunity that led to the expansion of public education† (Schudson, 1978, p. 44). When looking at society as a whole, you have them socially, economically, and politically integrated. Economic development was promoted and shared by ma ny rather than few† (Schudson, p. 45). The press does not cause, but picks up elements, reflects, and builds from a democratic society. â€Å"The democratization of economic life brought with it attitudes that stressed economic gain to the exclusion of social aims; business practice more regularly began to reward strictly economic ties over broader ones† (Schudson, p. 46). Schudson believed that society was grounded in the perception of society, with the middle class dominating and developing.Media's relationship with its audience helped sustain them, but it did not create the worldview. The media cannot be proven to have many effects on society, and the ones that exist have to do with advertising as a cultural institution. Advertising functions more as a way of celebrating products and buying. It functions to remind and refocus as it orients people to the world and let them know that others share the same views. Advertising reminds us of things in society and reinforce s some social trends. The trends and cultural symbols make us aware while reminding us of what we already know.Objectivity occurred in writings as a response to a problem, not as a correct way to see the world. â€Å"As our minds become deeply aware of their own subjectivism, we find a zest in objective method that is not otherwise there† (Schudson, p. 151). Objectivity developed in response to crisis, when journalism became so overwhelmed with subjectivity. There are three views in reference to objectivity. â€Å"The first view, then, holds that form conceals content in the news story. A second position is that form constitutes content, that the form of the news story incorporates its own bias.A third sees the form of a news story, not as a literacy form, but as a social form tightly constrained by the routines of new gathering† (Schudson, pp. 184-185). The â€Å"moral wars† in journalism showed each class held differing beliefs on what was acceptable. The Time s wrote a speech by Reverend Dr. W. H. P. Faunce saying: â€Å"The press engages in a fearful struggle, one class against another. On one side stands the reputable papers and on the other, is what calls itself the new journalism, but which is in reality as old as sin itself† (Schudson, p. 114).Class conflict was the main reason for problems inside the newspaper industry. Different societal classes produced different types of newspapers. Schudson tracks the middle class because he fells it is the most important. He said the press emerged to serve the middle class audience. Schudson said the political aspects of society went from public to private. Reality was public, but became more concerned with what the individual was thinking instead of what everyone was thinking. Voting was one area effected by this new political and reality change.People began to vote in secrecy, such as in the separate voting booth presently used. This new secrecy allowed people to make decisions on the ir own instead of relying on others. Gitlin discusses how many aspects of society are the result of hegemony, defined as â€Å"the name given to a ruling class's domination through ideology, through the shaping of popular consent† (Gitlin, 1980, p. 9). â€Å"Hegemony is a historical process in which one picture of the world is systematically prefered over others, usually through practical routines and at times through extraordinary measures† (Gitlin, p. 57). Society is maintained by hegemony instead of class structure. This type of society is possible because it has a common reality, shared language, common cultural forms like mass media, shared government, common education and religion, and common transportation. Hegemony says we live in a society where all ideas are not treated equally. As a result, we are predisposed to accept some views and slower to accept others. It is not a conspiracy theory but it holds that everyone is doing their job. The ideas of the dominan t in society are being told.If someone outside the dominate group feels their idea is right, they must do something out of the ordinary to get attention. The dominate class is not particularly the elite or the middle class, but it is the group whose ideas are most important to be heard in society. We grow up in a world that already has meaning; we must therefore decide where we belong. In return, society produces the kind of people it needs. Many people spend their lives trying to figure out where to belong. The routines of journalists are the main way standardized frames are put into reporting. These routines are structured in the ways journalists are socialized from childhood, and then trained, recruited, assigned, edited, rewarded, and promoted on the job; they decisively shape the ways in which news is defined, events are considered newsworthy, and ‘objectivity' is secured† (Gitlin, pp. 11-12). People think the world is being reported, but it is actually being create d. Mills, Schudson, and Gitlin share few beliefs in relation to the nature of society. Each believes that separate social classes exist and that each class relates to society in a much different way.They also agree that problems do occur within society and its current division, but at that point their beliefs begin to diverge. Mills and Gitlin are the most similar among the three. They both believe there is a separation between one dominate class and the masses. Mills believes the one dominate is the elite and Gitlin does not feel it is any particular social class. Schudson, on the other hand, believes there are separate classes with the middle the most important. The most persuasive is a combination of Schudson and Gitlin. Different times make the separation on which is most important.Schudson is correct in saying the media and society play off each other. Things which occur in society would not be made as important without the media stressing its importance and society tuning in t o hear the details. Gitlin is also very true in his beliefs of hegemony with a ruling class being dominate over society. The world in which we live is very centered around the fact that one group's ideas are heard through the media more often than that of others. The nature of society is explained differently when looking at Mills, Schudson, and Gitlin. Each person is very persuasive in the views they express.There are also weaknesses that exist in some of the views. Gitlin's hegemony comes across as the most persuasive of the ideas. It can explain most things in society that the other two cannot. Society is complex in every way, but hegemony helps make it more simple to understand. References Gitlin, Todd. (1980). The Whole World Is Watching. Berkeley: University of California Press. Mills, C. Wright. (1956). The Power Elite. London: Oxford University Press. Schudson, Micheal. (1978). Discovering the News: A Social History of American Newspapers. USA: Basic Books.

Case Study the Human Resources Strategy Implemented by...

This particular case is centered around the Human Resources strategy that was implemented by Johnson Johnson in 1997. This strategy includes many key aspects of corporate culture, leadership and global strategy integrated into one single global human resources program. This program allowed Johnson Johnson to diversify their current employees, raise the standards for future employees, redefine the standards of leadership within JJ and improve global management overall. The first portion of this human resources plan was to redefine the standards of leadership within JJ. This was accomplished by creating a new credo set of company values with over 60 specific behaviors that will dictate how well the company will perform. This new†¦show more content†¦Integrity is how a person’s demeanor and actions inspire others to follow in the same footsteps as they have. For example, a manager is not judged by what they say but what they do and how well they adhere to what they have promised. If a manager cannot act with integrity then the employees cannot either; therefore lowering the expectations of employees. No organization can function properly without someone to inspire employees to work towards a common goal and to hold them to a high standard of effort. If a manager does not have integrity then his/her employees will follow therefore breaking down the corporate culture to the minimal requirements. The second credo value is to treat other with dignity and respect; this creates a corporate culture that respects ideas and innovations of others and creates an overall inspiration for innovation within the company. Having a lack of respect for others within an organization discourages employees from trying to work harder and come up with new ideas for example, an employee comes up with a new idea for improving customer relations and he brings it up to another employee for some feedback and that employee tells him/her that the idea is not good and laugh’s, this will discourage that employee from trying to come up with new effective ideas for the betterment of theShow MoreRelatedCase Study Of Citibank : Performance Evaluation1464 Words   |  6 PagesCase Study of Citibank:Performance Evaluation Introduction Performance evaluations are important parts of all employees and managers tools to ensure positive actions are rewarded while negative actions can be evaluated and fixed to decrease problems in the future. Performance evaluations benefit supervisors and employees by identifying how to bring out the employees best attributes for the company (Hamlett, nd.). 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