Tuesday, August 25, 2020
The Role of Mass-Media in the Contemporary World The intensity of the broad communications has once become so incredible that its without a doubt noteworthy job on the planet today remains past any inquiries. It is solid to such an extent that even governmental issues utilizes it as a methods for overseeing in any nation around the globe. The broad communications has political importance as well as it passes on wide information concerning every single imaginable part of human beingsÃ¢â¬â¢ lives and, what is completely evident, effects on peopleÃ¢â¬â¢s perspectives and their mentality to the general condition. It is totally pleasing about what sort of temperances the broad communications should complement. By the by, it isn't visit at all that the media furnishes social orders with such a substance, which is dubious regarding the job dispatched to it. Introducing viciousness and prejudice just as forming and controlling open are just a couple of instances of how the job of broad communications is misjudged by the individuals who characterize themselves as driving media creators. For whatever length of time that savage projects are appeared on TV, the job of the broad communications turns out to be totally not the same as how it was initially rewarded. Savagery is socially destructive and particularly the young are inclined to such scenes that may emphatically influence their minds. The facts confirm that projects including unfeeling pictures are set apart as Ã¢â¬Ëonly for adultsÃ¢â¬â¢ yet when they are transmitted is generally early and the entrance to them is by all accounts somewhat boundless to youngsters. Another issue that is very fre...
Saturday, August 22, 2020
January 20,1969 Richard M. Nixon chose the thirty-seventh leader of the United States 1969 Ehrlichman recommends to Caulfield that he go out and set up a private security business that would give security to the 1972 Nixon battle. This venture, Sandwedge, would be like the Kennedy security firm, Intertel. June 5, 1970 With the objective of expanding collaboration between different knowledge organizations inside the administration, a gathering was brought in the Oval Office. Those in Participation: Richard Nixon, J. Edgar Hoover, Richard Helms, and head of the NSA and the DIA. Nixon helper Tom Charles Huston was appointed to work with the leaders of these organizations to encourage expanded participation. early July, 1970 The Huston Plan sent to the President. This arrangement was an expansion made by Huston to an arrangement embraced by Hoover and Helms (NSA and DIA also?). Huston's expansion called for electronic observation, checking exercises, clandestine passages, enrollment of more grounds sources, et al. July 14, 1970 Nixon embraces the Huston Plan July 27, 1970 Hoover visits John Mitchell. Mitchell catches wind of the Huston plan for the first time. Mitchell later goes to Nixon and desires the President to Stop the arrangement. Nixon later dropped the arrangement. September 17, 1970 Mitchell met with John Dean. Mitchell talked about the poor employment that the FBI was doing in the region residential insight. This followed a discussion between Mitchell, Helms and others from the CIA on a comparable point. September 18, 1970 John Dean sends a notice to John Mitchell where he offers an arrangement for insight gathering. "The most proper system is settle on the sort of knowledge we need, in light of an evaluation of the proposals of this unit, and afterward to continue to expel the restrictions as neccessary to get such intelligence." May 3, 1971 Following Nixon's choice concerning Laos, Anti-Vietnam activists endeavor to shutdown Washington by blocking streets with slowed down vehicles, human barricades, trash jars, and different materials. The fights result in more than 12,000 captures. John Dean headed up the White House insight gathering during this dissent. June 13, 1971 The New York Times starts distribution of extracts from "The Pentagon Papers". The Pentagon Papers was a 7,000 page archive that was first authorized by Robert McNamara in June of 1967 for future researchers to utilize. The Papers were spilled to the Times by Daniel Ellsberg. Despite the fact that there were numerous critical reports that were excluded, the Papers included records from the Guard Department, the State Department, the CIA, and the White House. June 14, 1971 John Mitchell sends a wire to the New York Times. Arthur Ochs Sulzberger President and Publisher The New York Times
Sunday, August 9, 2020
Beauregard, Pierre Gustave Toutant Beauregard, Pierre Gustave Toutant bo ´rigÃ¤rd [key], 1818â"93, Confederate general, b. St. Bernard parish, La., grad. West Point, 1838. As engineer on the staff of Winfield Scott in the Mexican War, he figured prominently in the taking of Mexico City. He later did engineering work in Louisiana, and for five days in Jan., 1861, he was superintendent of West Point. Beauregard, resigning from the army in February, was soon made a Confederate brigadier general and was given command at Charleston, where he ordered the firing on Fort Sumter . Assuming command of the army in NE Virginia (June), he was second in command to J. E. Johnston at the first battle of Bull Run (July 16, 1861) and was promoted to full general. He was sent to the West in 1862 and succeeded to the command of the Army of Tennessee upon the death of A. S. Johnston at the battle of Shiloh . Ill health and friction with Jefferson Davis, whom he had criticized after Bull Run, resulted in his removal from command. A fter a rest he was charged with the defense of the South Carolina and Georgia coast, which he ably held against Union attacks, particularly those on Charleston in 1863. In May, 1864, Beauregard reinforced Lee in Virginia. He defeated B. F. Butler at Drewry's Bluff and held Petersburg against Grant until Lee arrived. In the closing months of the war he was in the Carolinas with J. E. Johnston. After the war Beauregard was a railroad president, manager of the Louisiana state lottery, and for many years adjutant general of that state. His superior engineering abilities overshadowed his deficiencies as a field commander. See his Mexican War reminiscences ed. by T. H. Williams (1956, repr. 1969); A. Roman, Military Operations of General Beauregard (1884); biographies by H. Basso (1933) and T. H. Williams (1955). The Columbia Electronic Encyclopedia, 6th ed. Copyright © 2012, Columbia University Press. All rights reserved. See more Encyclopedia articles on: U.S. History: Biogr aphies
Saturday, May 23, 2020
The action of falling asleep or going to bed can be described with the French verbÃ endormir. Literally to put to sleep or to send to sleep,Ã endormirÃ is a form ofÃ dormirÃ (to sleep). In order to say this in the past, present, or future tense, a verb conjugation is required. This one is a bit of a challenge, but if you study it along withÃ dormir, it will be just a little easier. Conjugating the French VerbÃ Endormir EndormirÃ is anÃ irregular verb, so it doesnt follow any of the most common verb conjugation patterns found in French. However, it is not entirely alone because most French verbs ending inÃ -mir,Ã -tir, orÃ -virÃ are conjugated with the same endings. That said, the conjugations ofÃ endormirÃ are not terribly difficult or abnormal. First, we must identify the verb stem, which isÃ endor-. Then we can begin to add the infinitive endings that pair the tense with the appropriate subject pronoun. For instance, adding an -sÃ in the present tenseÃ jeÃ creates jendors, meanings I am putting to sleep or, less literally, I am going to bed. Likewise, when we add the ending -mirons, we create theÃ nousÃ future tense nous endormirons, or we will put to sleep. Admittedly, conjugating the English to put to sleep is not simple and some interpretation in the translation is required. Subject Present Future Imperfect j endors endormirai endormais tu endors endormiras endormais il endort endormira endormait nous endormons endormirons endormions vous endormez endormirez endormiez ils endorment endormiront endormaient The Present Participle ofÃ Endormir When you add -antÃ to the verb stem ofÃ endormir, theÃ present participleÃ endormantÃ is formed. This can be an adjective, gerund, or noun as well as a verb. The Past Participle and PassÃ © ComposÃ © The past tense can also be formed with theÃ passÃ © composÃ ©. To construct this, begin by conjugating theÃ auxiliary verbÃ avoirÃ to fit the subject pronoun, then attach theÃ past participleÃ endormi. For example, I went to sleep is jai endormi while we went to sleep is nous avons endormi. More SimpleÃ EndormirÃ Conjugations At first, its recommended to focus on the conjugations above because theyre the most useful and common. Once you have those committed to memory, study these other simple forms ofÃ endormir. When there is no guarantee to the verbs action, the subjunctive verb mood may be used. In a similar manner, if the action will only happen if something else takes place, the conditional verb mood is employed. In formal writing, the passÃ © simple and the imperfect subjunctive are used. Subject Subjunctive Conditional Pass Simple Imperfect Subjunctive j endorme endormirais endormis endormisse tu endormes endormirais endormis endormisses il endorme endormirait endormit endormt nous endormions endormirions endormmes endormissions vous endormiez endormiriez endormtes endormissiez ils endorment endormiraient endormirent endormissent The imperative verb form is used for commands and direct requests. These are short statements and the subject pronoun is not required: use endors rather than tu endors. Imperative (tu) endors (nous) endormons (vous) endormez
Tuesday, May 12, 2020
The founding of the first laboratory by Wilhelm Wundt in 1879 began the fascination for psychological research. Psychology had not yet became a science until Wundt realized that human activities can be examined through careful observations, manipulations, descriptions, and control aimed at measuring/ predicting behavior. Early on psychology was about the study of behavior and mental processes. Today, psychology ranges from neural messages to cultural influences. Wundt adopted protocols from physiology and physics to guide his research because there were no designated guidelines in psychological research yet. The beginning of the 17th century Sir Francis Bacon brought attention that science should not rely on assumptions instead, it should start with the collection of facts. His stance lead scientists like John Locke and Thomas Reid to promote the fundamental principles of science such as empiricism and rationalism. Empiricism produces factual information while rationalism involves the development and elaboration of ideas. In 1881 Dr. Joseph Breuer was able to operate as a scientists and practitioner. However, today s society it is common for an individual to act as a scientist or practitioner. Both areas produce the findings and techniques that comprise the psychology field in today. Scientists in psychology aim to discover the ways of human beings and describe people in general, this task is described as a nomothesis. In contrast, practitioners commonly study aShow MoreRelatedWas Psychology Really Founded in 1879 or Was It in Existence Before Then?1387 Words Ã |Ã 6 PagesWas psychology really founded in 1879? Or was it in existence before that specific time? Wilhelm Wundt (1832-1920) officially opened an institution and laboratory for Psychology, in Leipzig, Germany. Many students were also taught here on experimental psychology. Wundt was touted as a great lecturer, and some of those taught, emulated Wundts work and made a significant contribution to psychology; for example Edward Titchner (1867-1927), who introduced structuralism to the United States ofRead MoreThe Theory Of Psychology And New Schools1057 Words Ã |Ã 5 Pagesthe years there have been various significant developments in psychology, and new schools have developed which try to fill the gaps of previous approaches and offer a new perspective. The timeline could be traced from Structuralism (Wundt, 1879), which was the first school of thought. It proposed breaking down of mental processes into its most fundamental components in trying to understand a person s mind. Then came functionalism (James,1902). Functionalists weren t concerned with mental processesRead MoreWundt And Miller s Theory Of Psychology2009 Words Ã |Ã 9 Pagesthe course of its beginnings. There were numerous contributors to the fieldÃ¢â¬âthe founders of psychology. This paper will focus on two of these founders: Wilhelm Wundt, the first to develop psychology as a formal discipline, and George A. Miller, the creator of cognitive psychology. This paper will compare and contrast the lives and works of Wundt and Miller. These psychology founders shared some similarities such as demonstrating expertise in other fields in addition to their work in psychologyRead MoreJames Mckeen Cattell Contributions to Psychology1740 Words Ã |Ã 7 PagesJohns Hopkins University. Returning to Leipzig in the fall of 1883, he earned his doctoral degree in experimental psychology under Wilhelm Wundt in 1886, with a dissertation that examined reaction times for various simple mental processes (Sokal, 1981). After completing his doctorate, Cattell spent two years at Cambridge University, where he f ounded Englands first laboratory in experimental psychology. While at Cambridge, Cattell married Josephine Owen, who became a lifelong partner in his research andRead MoreSnapshot1702 Words Ã |Ã 7 PagesBehaviorism Behaviorism arose partly due to the popularity of laboratory-based animal experimentation and partly in reaction to Freudian psychodynamics, which was difficult to test empirically because, among other reasons, it tended to rely on case studies and clinical experience, and dealt largely with intra-psychic phenomena that were difficult to quantify or to define operationally. Moreover, in contrast with early psychologists Wilhelm Wundt and William James, who studied the mind via introspectionRead MoreWhy Psychology Is Important For Mental Health Professionals2300 Words Ã |Ã 10 Pageshistorical contributions to psychology and brain research, will allow future psychologists to make more meaningful contributions to the field. Influences of Wundt, Herbart, Fechner, Ebbinghause and Kulpe The birth of psychology took place at the beginning of the 19th century and five of the founding fathers can be credited with its growth. The first of which, Johann Herbart, was born in 1776. Herbart can be credited with giving psychology Ã¢â¬Å"statusÃ¢â¬ (Goodwin, 2015). It was Herbart who established psychologyRead MoreThe Philosophical Roots Of Psychology Essay2901 Words Ã |Ã 12 Pagespsychology did not become a separate field of study until the late 1800s with Wilhelm Wundt. Psychology as a Science Wilhelm Wundt is who helped make psychology a science and is known as the father of experimental psychology. Wundt started an academic journal named Philosophische Studien and he began doing research on sensation and perception. Wundt deduced that introspection was the solution to analyze psychology. Wundt and his students deduced that the correlation in between sense experience andRead MoreThe History Of Psychology By Benjamin s Mainstream Narrative, Lecture Notes, And Other Readings From Class2287 Words Ã |Ã 10 Pageslife and the history of psychology and how they relate. We see a similar theme in both stories of the changing viewpoint of worldview and in the end hope that they will both become fully visible. The history of psychology began in 1636 with the founding of Harvard College as a Puritan University. Institutions like Harvard had a huge influence on the world and most of these institutions were filled with Protestant Preachers. It was a time where they were very open about their beliefs, mainly ChristianityRead MoreHow Psychology Has Developed Over The Centuries1773 Words Ã |Ã 8 Pages concluding with the conclusion. Psychology has developed from philosophy, science, medicine and theology (King 2015). Back between 664-554BC in Egypt the temple Ã¢â¬â university Ipet Isut in Karnak existed, where Thales (physicists) was one of the first to go and got introduced to the Kemetic mystery system (Clark, 2011). Many of the early Greeks philosophers/scholars studied in Egypt and bought their knowledge back to Greece (Clark, 2011). The other Greeks that contributed to psychology were AlcmaeonRead MoreEssay Mind and Body2624 Words Ã |Ã 11 Pagesback to the Greeks, it is due to the influential work of RenÃ © Descartes, (written around the 1630Ã¢â¬â¢s) that we owe the first systematic account of the mind/body relationship. When Descartes friend and frequent correspondent, Marin Mersenne, wrote to him of Galileos fate at the hands of the Inquisition, Descartes immediately suppressed his own treatise. As a result, the worlds first extended essay on physiological psychology was published only well after its authors death. In this essay, he proposed
Wednesday, May 6, 2020
Introduction Research is from the French word Ã¢â¬Å"researchÃ¢â¬ which literally means to investigate thoroughly. It is a process of systematic enquiry into a particular subject (phenomenon) which intends to create new knowledge and is governed by scientific principles (Cormack 1996). The department of health (DOH) defines research as: Ã¢â¬Å"the attempt to derive generalised new knowledge by addressing clearly defined questions with systematic and rigorous methodsÃ¢â¬ (DOH 2005). We will write a custom essay sample on Literature Review on Breast Reconstructive Surgery or any similar topic only for you Order Now The Nursing and Midwifery Council (NMC 2008) clearly states that nurses must deliver care based on the best available evidence or best practice. That any advice they give is evidence based if they suggest healthcare products or services and they must have the knowledge and skills for safe and effective practice. Nurses are expected to practice within an evidence based practice framework by utilising current, reliable and valid research (Smith Donze 2010). To achieve this, nurses should be familiar with the research process and how to incorporate findings into practice. Nurses who practice evidence based are fulfilling their responsibility to patients and their professional regulatory body. Nursing research can provide a hugely exciting and challenging facet to the concept that is nursing. Being the largest workforce within the National Health Service (NHS), they are the professionals with the most direct contact with patients it stands to reason that this workforce should have robust evidence to support their practice interventions (Parahoo2006). Patients can be asked to make decisions when they are emotionally fragile and thrust into an often unfamiliar world of doctors, nurses, hospital environments where the language used can seem unfamiliar. Working in the field of breast cancer can provide many opportunities to explore the experiences of women as they strive to make decisions about their physical and psychosocial wellbeing. Making a decision to undergo a breast reconstruction following mastectomy due to breast cancer can be harrowing and efforts must be made to ensure healthcare providers afford the best opportunities that enable women understand this process. A literature search using databases Medline, [email protected], British Nursing Index, Embase, CINAHL and PsycINFO was conducted to review previous research undertaken to determine influencing factors on decision making. The terms breast cancer, breast reconstruction, decision making, patient satisfaction and quality of life, Breast Care Nurse and Breast Clinical, Nurse Specialist were used. Results were limited to the English language, relevant to humans. Literature review A literature review should provide a rationale for the study, show why the study is required and how it will add to the body of knowledge already known about the phenomenon. (Parahoo 2006, Cormack1996). Adjusting to a diagnosis and the treatment options of breast cancer is a complex process (Brennan 2001). The process is influenced by numerous factors (Wenzel, Fairclough, Brady, Cella, Garret, Klushman 1999) and altered body image is one of the most significant (DeFrank, Mehta, Stein, Baker 2007). In the last few years there has been increasing attention paid to the role, perceived body image plays in patientÃ¢â¬â¢s, diagnosed with breast cancer has on this adjustment. Pikler and Winterowed (2003) prove that patients who essentially felt good about their body were more firm in their belief in their ability to cope with the disease and the subsequent treatments. WomenÃ¢â¬â¢s emotional and psychosocial functioning may be significantly affected when Coping with a diagnosis of breast cancer, which may impair their decision making ability. Reaby (1999) supports this view suggesting Ã¢â¬Å"their ability to make an informed decision about breast restoration is greatly reduced because of the emotional and physiological conditions created by their health crisisÃ¢â¬ . Literature supports the process of breast reconstruction following mastectomy as increasing long term health and wellbeing (Streu, Chung Alderman 2009). This assumption is refuted by Harcourt Rumsey (2001) who suggest this belief is not supported by evidence and further inquiry is required. However whilst there is much literature available highlighting the effects of timing of breast reconstruction, type of reconstruction (autologous or implant) and of the impact other treatment modalities may have on a technical success there is little robust evidence to support one method in favour of another in terms of quality of life or body image (Potter Winters 2008) . Guidelines have been produced by The Association of Breast Surgery, The British Association of Plastic, reconstructive and Anaesthetic Surgeons and the Training Interface Group which recognised that it is difficult to conduct controlled trials in this cohort and hopes the guidance will provide standards for safe breast reconstruction following mastectomy for breast cancer (Lee Bishop 2009). There remains a lack of consensus on when to perform the procedure, what procedure should be performed and which patients are/are not suitable to undergo the procedure. Without consensus guidance from professionals cannot be anything other than subjective and ultimately can lead to decisions which are not fully informed (Lee, Dominik, Levin, Barry,Cosenza, OÃ¢â¬â¢Connor, Mulley Sepucha 2010). The authors of this study report on the necessity of tools to assess the quality of the patientÃ¢â¬â¢s decision making which will reflect shared decision making. Quantitative studies The reviewed literature highlights various findings on the decisions women make regarding breast reconstruction. Chevray (2008) suggests that women are not adequately informed about the availability of this option. Older age and the less educated are less likely to opt for breast reconstruction according to (Greenberg, Schneider, Ko, Lipitz, Mallin, Epstein, Weeks Kahn 2007). Theses particular studies are American where the healthcare system is different from that in theUnited Kingdom. They were quantitative, retrospectively analysed from existing databases and neither study reflected the womenÃ¢â¬â¢s personal experiences of the process they found themselves having to make decisions within. Limitations to the study such as womenÃ¢â¬â¢s access to specialist centres for breast reconstruction and financial cost, if not adequately covered by insurance, which may have precluded them from breast reconstruction are not addressed in the findings. Falbijork, Karlsson, Salander, Rasussen (2010) concluded similar results with regard to age but did not take into consideration the meaning of mastectomy or body image to women although recognise these variables should be considered. They conclude that age is of paramount importance for further studies to enable understanding womenÃ¢â¬â¢s choices. Stacey, Spring, Breslin, Rao Gutowski (2008) reinforced the multifactorial nature of decision making regarding breast reconstruction following mastectomy for breast cancer. They evaluated the attitudes of circa 100 general surgeons to breast reconstruction; 40% did not refer all patients for breast reconstruction citing reasons which included refusal by patient, need for radiation treatment, may delay adjuvant oncological treatment, patient issues or the lack of available plastic surgeons. One of the conclusions they reached highlighted the need for education of the referring surgeon and patient about options and indications for reconstructive surgery. A related study by Reefy, Patani, Burgoyne Osman Mokbel (2010) reviewed 127 patients who underwent immediate breast reconstruction following skin sparing mastectomy for early breast cancer. The patients were followed up for 36 months the procedure was associated with low morbidity and deemed oncologically safe for T, T1 T2 tumours without extensive skin involvement. It stated that 85% of patients who required either prior or post mastectomy radiation treatment underwent capsulotomy for significant capsule formation. In keeping with Stacey et al (2008) focus should be on the education of surgeons and patients on the effective, safest management of breast reconstruction to guide informed decision making. Lee, Belkora, Chang, Moy Patridge Sepucha (2011) evaluated patient decision making about breast reconstruction (BR) and patient involvement in the process and concluded that patients were not well informed about BR and as such would benefit from interventions which supported their decision making. Winters, Benson Pusic (2010) systematically reviewed 1012 abstracts of which 34 papers included Health Related Quality of Life (HRQoL) outcomes in breast reconstruction. Their findings showed that robust scientific data is sparse in methodology on HRQoL studies and increasingly patients and healthcare providers seek meaningful information to guide decision making. They concur with Lee Bishop (2009) that randomised clinical trials are required to establish guidelines to inform decision making. Another study carried out by Jeevan, Cromwell, Brown Traveller Pereira, Caddy, Sheppard Van Der Mullen (2010) identified that of 44, 837 women who underwent mastectomy for breast cancer, 7375 underwent immediate reconstruction. (IR) They showed that the uptake rate for IR was highest in the younger age group (50 years of age) and lowest in those over 70 years, a finding which concurs with Greenberg et al (2007) Falbijork et al (2010). Jeevan et al focused on the regional variations of IR uptake and showed that women from more deprived areas were less likely to undergo IR as were non white women. This is direct contrast to Osborn, Hodin, Drew, Fielder, Vaughn-Williams Sweetland (2005) who found no association between deprivation and ethnicity and treatment choice but did find older age as an indicator of being less likely to undergo breast reconstruction. Qualitative studies Qualitative studies have attempted to establish patterns in women decision making when considering surgical options. Reaby (1998) developed a decision making model hope to enhance decision making capability of the women. It seems to be designed to essentially slow down the womenÃ¢â¬â¢s decision making to allow time for her to explore her understanding of the options that should have been presented to her, to alert that there may be options available and to explore the impact such decision making may be having on her and her family. The study Reaby conducted suggested that the specialist nurse was in a valuable position to undertake the role of providing physiological and psychological support, acting as their advocate thus enhancing the decision making process. Harcourt Rumsey (2001) conducted a literature review identified the need for further research into the experiences of women deciding for or against reconstruction and the process by which they decide. They highlight that studies in their review did not take cognisance of the nurse specialist. They identified the drawback of randomised controlled trials citing them as inappropriate in this area, and suggest that research in this area should be prospective and from the time of diagnosis. This is an identified gap this study seeks to address. Three years later Harcourt Rumsey (2004) followed up their previous research showing that individually, women need appropriate information, time to make decisions and ongoing emotional support. Limitations to the study were that interviews were conducted post decision which left the gathered information subject to recall and there were unidentified difficulties with the study being prospective. Lally (2009) study involving 18 women newly diagnosed with breast cancer who were to make decisions regarding surgical options, showed that women felt supported by specialist nurses and the surgeon in their decision making. This has implications for clinical practice providing evidence of the importance of the availability of these healthcare professionals to this patient cohort. Wolf (2004ab) identified the importance of the role of the breast clinical nurse specialist in facilitating the process of how patients receive information. Information giving has been associated with increased autonomy, moving away from a paternalistic approach and considered to help patients cope with cancer. Study Design Qualitative research seeks to lend understanding of how people think individually and as part of a group. The approach is one that is interactive, holistic and inductive, data collection is flexible and reflexive (Parahoo 2006). This results in data collection and analysis that has evolved as the researcher gains insight and new questions emerge throughout the process (Pollit Beck 2004). The following study design describes the approach to enquiry, the methods and methodology to be used to collect data, when, where and from whom the data will be collected and how the data will be analysed. Methods and Methodology In quantitative research comes from a philosophical paradigm which suggeststhat human phenomena can be subject to objective study (Parhaoo 2006). Historically quantitative researchers believed that human behaviour could be predicted, a belief based on the positivist approach to natural science that the world works according to fixed laws of cause and effect or causality by testing hypothesis and theories (Muijs 2011). This approach strives for objectivity and to avoid bias advocates distance between researcher and subject (Holloway Wheeler 2002). Quantitative research has been used by nurses dating back to the Crimean war (1853-1856) and can produce robust scientific data which is essential for evidence based practice (Parahoo 2006). However it has been criticised for being narrow and inflexible, of focussing on a small part of the human experience where nursing concerns itself with a holistic approach (Pollit Beck2004). In comparison qualitative research is flexible and the relationship between researcher and participant less formal. Phenomenology, grounded theory and ethnography are the main research traditions which underpin the philosophical approach to qualitative research (Polit Hungler 1997). Such research traditions explore the subjective nature of the human experience (Magilvy2003) and aim to collect data in naturalistic environments ensuring a holistic approach to data gathering which requires the researcher to be intensely involved in the fieldwork as Ã¢â¬Å"a full co-participantÃ¢â¬ (Polit Beck 2008). Each of the disciplines focuses on the experience of human beings and their interpretation of the experience (Holloway Wheeler 2002). The approaches demand careful collection and analysis of rich in-depth data to provide a comprehensive understanding of peoples thinking and behaviour which can improve efficiency and predict outcomes in the healthcare setting (Parahoo 2006). Qualitative research has been criticised as anecdotal, for producing findings that are neither scientific nor generalisable and, due to the intense involvement of the researcher, objectivity is lost (Parahoo2006). To reduce researcher bias or maintain objectivity in data collection a process known as bracketing may be used which enables the setting aside any personal beliefs, prior knowledge or expectations the researcher has regarding the study. Qualitative and quantitative research methods are appropriate for nursing research and both create or increase knowledge that may explain or describe the phenomenon being studied (Harper Hartman1997). The intent of this study is to explore and lend understanding about how women decide to uptake breast reconstruction or not following mastectomy for breast cancer therefore a qualitative approach will fit as it seeks to explore the experiences of decision making. Sample Sampling is the process of selecting a portion of the population from the total population of the subject of the enquiry; a sample is a subset of that population (Pollit Beck 2004). Sampling allows cost effective research as resources such as time and funds are likely to be limited and can provide robust information. There are two basic types of sample; probability and non-probability. A probability sample is randomly selected in contrast a non-probability sample is chosen to provide the sought data (Parahoo 2006). The selection of the sample should be robust enough to identify and use the participants who can supply the information to inform the study (Polit Hungler 1997).Qualitative researchers aim to gather data which is rich and in-depth; this is the underlying principle which guides the sampling technique. For the purpose of this study the researcher intends to recruit 8-10 participants using purposeful sampling technique. Polit and Beck (2008) describe this as using the researcherÃ¢â¬â¢s knowledge about the sample population to Ã¢â¬Å"hand pickÃ¢â¬ potential participants who will most benefit the study. These individuals will be sampled as those most likely to be able to provide information on decision to undergo reconstruction following mastectomy or not. Sample size does not determine importance of the study or the quality of the data, in qualitative research too large a sample size risks loss of depth and meaning and may reduce the richness of the data (Holloway Wheeler 2002).Some texts recommend between six and eight participants (Holloway Wheeler 2002) others suggest size should be based on informational needs (Polit Beck 2004). If saturation occurs before this number is achieved then recruitment will be limited to the saturation point. Saturation refers to the point when no further meaningful data is obtained and as such the number of participants can be led by the fullness of the data collected (Wood Ross-Kerr 2006). Access To address the research question, the researcher initially considered recruiting female patients requiring mastectomy to the study at the time of diagnosis when discussion regarding breast reconstruction cancer would occur. However, following discussion with the course leader and a period of reflection, it was decided that this was a vulnerable cohort and it would not be ethical to approach them at a time when they were trying to process information regarding a cancer diagnosis and subsequent treatments. A decision was taken to approach the women 3-6 months post diagnosis when their rationale for their decision was still clear to them and breast cancer support mechanisms were in place. The intention is to approach the consultants who are responsible for breast cancer patients in a specific regional area for permission to recruit the patients. Being part of the multidisciplinary team, as a breast clinical nurse specialist, involved in managing the care of these women, the researcher is known to the consultants and does not anticipate any objection to this. Individual participants will be approached by the researcher and given verbal and written information about the study, a suitable length of time to decide to take part or not will be agreed. The individual will be reassured that their decision will be respected and, regardless of outcome, they will continue to receive care without bias. The researcher may be the healthcare professional designated to fulfil a particular aspect of care of some of the sample group. It is anticipated that this would not bias any data collection as the same level of professional intervention is given to all patients undertaking this decision making process. Goodman Moule (2009) highlight the responsibility of the nurse researcher to inform the participant that they are acting as a researcher. Bracketing can be utilised to suspend any researcher beliefs or preconceptions. This theory will be tested in the pilot study and should any bias be revealed then the researcher will ensure the standard care of the study cohort is supplied by an independent practioner. Potential participants will be recruited at a planned follow up appointment where patients attend for review of their treatment. This negates the requirement of an extra appointment for participants. Ethics approval Research supports the development of nursing knowledge and as individuals and professionals nurses undertaking research must consider the ethical issues that can arise (Smith Hunt 1997). When participants in research are vulnerable, as in the health care system, their rights must be protected (Wood Ross-Kerr 2006). The Royal College of Nursing Research Society Ethics Guidance Group (2009) highlight that nurses can have a variety of roles in research including carrying out their own projects, that it is important the nurse understands the important issues in research practice and it is their role to protect the participant and their rights. Beauchamp Childress (1983) illustrate the concept of biomedical standards as four principles; respect for Autonomy, Beneficence, Nonmaleficence and Justice which underpin healthcare ethics. Without understandable information an individual is not able to make an autonomous decision to participate in research or not; they are therefore unable to give informed consent. Berendt, Golz, Bertz Wunsch (2011) conducted a qualitative study asking what patients understood about trial participation, specifically assessing their understanding of informed consent and discovered that patientsÃ¢â¬â¢ understanding was less than anticipated and the patientsÃ¢â¬â¢ identified needs including Ã¢â¬Å" clear informed consent consultationsÃ¢â¬ . The notion of informed consent encompasses; the right to be informed, consent to be given voluntarily and competence of the participant (Tschudin 2003). The participants anonymity and confidentiality must be protected therefore any information provided by interviewees will not identify them nor will it be accessible to others. For the purpose of the study suitable storage for data pertaining to the research will be sought. Prior to seeking approval for the study from the local National Health Service (NHS) research ethics committee and the local research and development department, the researcher will seek guidance from the appointed academic supervisor. To ensure informed consent participant information sheets about the study purpose which will include any benefits and risks, dissemination of results, assurance of participant anonymity and consent forms will be provided. Participants will be advised they are free to withdraw from the study at ant time without penalty and asked to sign a consent form a copy of which will be given to the participant and one retained by the researcher. Consent forms and information sheets will be utilised using guidance from the National Research Ethics Service website www.nres.npsa.nhs.uk/. Participants may recall experiences that cause emotional distress and as their needs are greater than those of the study the process would be suspended or discontinued ( Thompson, Melia Boyd 2000). Tools The intention is to generate data using in-depth unstructured interviews which enable the informant unlimited opportunity to convey their perception of events. This is an intentional approach to discovering the participants lived experience of the phenomenon and the interviewersÃ¢â¬â¢ ability to listen and convey respect and importance of the experience is crucial (Oman, Krugman Fink 2003). Unstructured interviews are purposeful conversations which enable rich but often unquantifiable information about the phenomenon (Smith Hunt 1997) the conversations are interactive and usually begin with general questions to enable truly unstructured interview, for example Ã¢â¬Å"What happened when you first learned you would need to undergo mastectomy?Ã¢â¬ (Polit Beck 2004). Interviews can last from thirty minutes to two hours and interviewer/interviewee interaction may vary therefore in qualitative interviews flexibility of the researcher is key to obtaining useful data (Parahoo 2006). Structuring data generated from unstructured interviews is known as content analysis and themes will be looked for in the data and divided into categories. The categories that will be developed are dependent on the researcher and can be further categorised into frequency tables to indicate the frequency of the response (Wood Ross-Kerr 2006). The qualitative interviewer is the tool of data collection as it will be she who analysis data in her mind during interviews thereafter transcribing and presenting the data in a way that can be easily understood (Parahoo 2006). Rigor Qualitative researchers recognise the subjective nature of the interview process and seek to ensure rigor by incorporating reflexivity and validation of data by the interviewee, reflexivity enables the respondent to report on the accurateness of the transcribed interview and can provide opportunity for clarification (Parahoo 2006). Others utilise four criteria to establish trustworthiness; credibility, dependability, confirmability and transferability (Polit Hungler 1997). Credibility refers to trust in the data enhanced by giving sufficient time to gather data to give in-depth understanding of the study cohort. Member checking is regarded as an important technique for establishing the credibility of qualitative data and involves feedback of the data and researchers findings and recording the respondentÃ¢â¬â¢s reactions. Peer debriefing relates to the exposure of the researcher to others who are experienced in either qualitative inquiry or the studied subject who can review aspec ts of the inquiry. Dependability refers to the ability of the data to stand the test of time regardless of the conditions and is liked to confirmability. Confirmability is a measure of the objectivity of the data and as such the researcher should present an audit trail of the data, methods and decisions to an external auditor to check trustworthiness. This strategy may offer some protection to support trustworthiness but caution should be used; the unique nature of inquiry may not lend themselves well to different interpretations of data. Transferability requires the researcher to demonstrate the extent their findings can be applied to other contexts (Goodman Moule 2009). Pilot Study A pilot study is a trial of the research method on a small scale the purpose of which is to ensure the study design is feasible (Presly 1996, Polit Beck2004). A pilot study will be conducted using an unstructured interview as planned for the main study. This will enable a trial of the interview process, gauge length of time interviews may take and allow the researcher to familiarise herself with technical equipment (Lacey 2006). Data collection analysis Data collection refers to the way information is collected, recorded and presented to address a research inquiry (Clamp, Gough Land 2004).High quality data increases the value of the research and the aim of the qualitative data analysis in this study is to structure the data into meaningful units using thematic analysis. This stepwise approach begins with the researcher identifying themes in the data, thereafter categorising the themes; this may be a natural occurrence or the researcher must decide the category. The final step is to structure the data and this can be achieved by developing a frequency table which serves to identify the frequency of every category, the response rate and number of participants who gave the same response (Brink Wood 2001). The researcher intends to audio tape participants during unstructured interviews, using field notes to complement data collection. Field notes can facilitate deeper understanding of the data as it enables conveyance intangible elements such as body language and feelings. They are also useful in the event of failure of audio equipment. Limitations Surgery for breast cancer is an emotional experience and mastectomy can be particularly harrowing as women face disfiguring surgery and a potentially life threatening disease. Making decisions at a difficult time may render potential study participants emotionally unavailable which may impact on recruitment to the study and delay the planned recruitment period. Should this situation evolve the intended cohort will be extended to include those women who underwent mastectomy more than six months previously but no longer that eight months to capture the freshness of their experience. The study forms part of a Masters programme which allows circa ten months for the completion of the study therefore any delay in the timeline could be crucial. As such ethical approval will be sought early to facilitate a prompt beginning to data collection. Timetable Details of the plan of work and timescales show the expected duration of each stage of the study and endeavour to show the feasibility of the study (Cormack1996). A Timetable for the proposed study has been prepared (appendix 2) and will be adhered to. It demonstrates the beginning and expected conclusion of the study activities and shows where they run simultaneously. Budget The budget estimation for this enquiry is as follows: Researcher time Agreed by local management / colleagues TranscribersÃ¢â¬â¢ time (agreed)? 40.00 Paper? Ink ? Transport costs? Postal costs ? Conclusion The reviewed literature reveals a variety of reasons why breast reconstructive surgery is undertaken by some women following mastectomy for breast cancer. These include age, socio economic status, ethnicity, availability of surgeon, potential effects of radiotherapy id required amongst others. It has been highlighted that decision making ability may be impaired due to emotional conditions caused by a health crisis. All of the research identified the need for further research. There was very limited inquiry into how the women made their choices and none of it captured the womenÃ¢â¬â¢s experiences of making the decision. This study provides an opportunity to discover how women feel about making decisions. It is anticipated such a study could enhance how healthcare providers attend to the needs of women who must make a decision to undergo breast reconstruction following mastectomy due to breast cancer. References Beauchamp TL, Childress JF (1983) Principles of Biomedical Ethics 4th Ed Oxford University Press.Oxford. Behrendt C, Golz T, Roesler C, Bertz H Wunsch A (2011) What do our patients understand about their trial participationAssessing patientsÃ¢â¬â¢ understanding of their informed consent consultation about randomised clinical trials. Journal of Medical Ethics 37: 2: 74- 80 Brennan J, (2001). Adjustment to cancer-coping or personal transitionPsycho-oncolgy 10 1-8. Brink JP, Wood MJ (2001) Basic Steps in Planning Nursing Research: From Question to proposal 5th Ed Jones and Bartlett Publishers.London. Chevray P, 2008. Timing of Breast Reconstruction: Immediate Versus Delayed. The Cancer Journal 14 (4), July/August, pp 223-229. Clamp CGL, Gough S, Land L (2004) Resources for Nursing Research: An Annotated Bibliography. 4th Ed Sage Publications.London Cormack DFS. (Ed) Research process in nursing 3rd ed. get updated version DeFrank J, Mehta C, Stein K, Baker F. (2007) Body image dissatisfaction in cancer survivors. Oncology Nursing Forum 34 (3), pp623-631 Department of Health (2005) Research Governance Framework for Health and Social Care, second edition pg 3.London. Department of Health. Fallbjork U, Karlsson S, Salander P, Birgit H, Rasmussen H, (2010) Differences between women who have and have not undergone breast reconstruction after mastectomy due to breast cancer. 49, no 2. pp 174-179. downloaded 28/12/2010. http://informahealthcare.com.doi/full/10.3109/02841960903490069. Greenberg CC, Schneider EC, Ko CY, Lipsitz SR, Malin JL, Epstein AM, Weeks JC, Kahn KL (2007). The influence of socioeconomics on post-mastectomy reconstruction: A study of the national initiative on cancer care quality. Journal of Surgical Research 137, (2), pp 217-218. Goodman M, Moule P (2009) Nursing Research: An Introduction. SageLondon. Harcourt D, Rumsey N (2001) Psychological aspects of breast reconstruction: a review of the literature Journal of Advanced Nursing 35: 4: 477-487 Harcourt D, Rumsey N (2004) Mastectomy patientsÃ¢â¬â¢ decision making for or against immediate breast reconstruction Psycho-oncology 13: 106-115 Harper M, Hartman N (1997) Research Paradigms in Research mindnedness for Practice An Interactive Approach for Nursing and Healthcare Eds Smith P, Hunt JM Churchill LivingstoneNew York p19 Holloway I, Wheeler S (2002) Qualitative Research in Nursing. 2nd Ed Blackwell Science LtdOxford Jeevan R, Cromwell DA, Brown JP, Trivella M, Pereira J, Caddy CM, Sheppard C van der Meulan JH (2010) Regional variation in the use of immediate breast reconstruction after mastectomy for breas cancer in England. European Journal of Surgical Oncology 36:8: 750-755 Lacey A (2006) The Research Process. In The Research Process in Nursing Eds Gerrish K Lacey A. Blackwell Publishing Limited.Oxford. Lee C, Belkora J, Yuchiao c, May B Patridge A Sepucha K (2011) Are Patients Making High Quality Decisions about Breast Reconstruction after Mastectomy. Plastic and Reconstructive Surgery 127:1: 18-26 Lee CN, Dominik R, Levin CA, Barry MJ, Cosenza C, OÃ¢â¬â¢Connor AM, Mulley AG Sepucha KR (2020) Development of instruments to measure the quality of breast cancer treatment decisions. Health Expectations 13:258-272 Muijs D (2011) Doing Quantitative Research in Education with SPSS. Sage Publications Ltd.London Macilvy JK (2003) Qualitative Designs in Nursing Research Secrets Eds Oman KS, Krugman ME Fink RM Henry Belvis Inc Philidelphia. Nursing and Midwifery Council (2008) The Code Standards of conduct, performance and ethics for nurses and midwives. pp7. Osborn GD, Hodin M, Drew PJ, Fielder Vaughn-Williams Sweetland (2005) Patient demographics and treatment for early breast cancer: An observational study. The Breast 15: 377-381 Parahoo, K (2006). Nursing Research Principles, Process and Issues. 2ng Ed pp 11. Palgrave Macmillan. Hampshire.New York Polit DF, Beck CT(2004) Nursing Research Principles and Methods. 7th Ed. Lippincott Williams Wilkins Philidelphia. Polit DF, Beck CT(2008) Nursing Research Generating and Assessing Evidence for Nursing Practice 8th Ed Lippincott Williams Wilkins Philidelphia. Polit DF, Hungler BP (1997) Essentials of Nursing Research: Methods, Appraisal and Utilisation 4th Ed Lippincott Ã¢â¬âRaven Philidelphia Presly AS (1996) Common Terms and Concepts in Nursing Research in The research Process in Nursing. Ed Cormack DFS Blackwell Science.Oxford. Reaby LL (1998) Breast restoration decision making: Enhancing the process Cancer Nursing 21:3: 196-204 Reaby LL (1999) Breast restoration decision making. Plastic Surgical Nursing 19:1: 22-29 Reefy S, Patani N, Burgoyne G, Osman H Mokbel K (2010) Oncological outcomes and patient satisfaction with skin-sparing mastectomy and immediate reconstruction: a prospective observational study. BMC Cancer 10: 171 Smith RS, Donze A (2010) Assessing Environmental Readiness. First Steps in Developing an Evidence Ã¢â¬â Based Practiced Implementation Culture. J Perinat Neonat Nurse. 24, (1) pp 61-71. Smith P Hunt MJ (1997) Research Mindedness for Practice: An Interactive Approach for Nursing and Health Care. Churchill LivingstoneNew York Stacey DH, Spring MA, Breslin TM, Rao VK Gutowski KA (2008) Exploring the effect of the referring general surgeonÃ¢â¬â¢s attitudes on breast reconstruction utilization. WMJ 106: 6: 292-297 Steu R, Chung KC, AldermanAK(2009) Understanding the importance of reconstructive surgery on quality of life. Progress in Palliative Care 17, (5) 245-249. The RoyalCollegeof Nursing Research Society Ethics Guidance Group (2009) Research Ethics: RCN Guidance for Nurses. Royal College of Nursing. London Thompson IE, Melia KM, Boyd KM (2000) Nursing Ethics Churchill Livingstone.Edinburgh. Tschudin V (2003) Ethics in Nursing: The Caring Relationship Butterworth Heineman.London Wenzel L, Fairclough D, Brady M, Cella D, Garret K, Kluhsman B, et al (1999). Age related differences in the quality of life of breast carcinoma patients after treatment. Cancer 86, 1768-1774. Winters Z, Benson JR Pusic AL (2010) A Systematic Review of the Clinical Evidence to Guide Treatment Recommendations Based on Patient- Reported Outcome Measures and Health- Related Quality of Life. Annals of Surgery 256:6: 929-942 Wolf L (a) (2004) The information needs of women who have undergone breast reconstruction. Part 1: decision making and sources of information European Journal of Oncology Nursing 8: 211-223 Wolf (b) (2004) The information needs of women who have undergone breast reconstruction. Part 11: Information giving and content of information 8: 315-324 Wood JM Ross-Kerr JC (2006) Basic Steps in Planning Nursing Research: From Question to Proposal 6th Ed Jones and Bartlet Publishers. London How to cite Literature Review on Breast Reconstructive Surgery, Essay examples
Saturday, May 2, 2020
Question: Discuss about the Importance Of Stakeholders In Creating Value In An Industry. Answer: Introduction The assignment focuses on the importance of stakeholders in creating value in an industry. According to Cho and Auger (2017), stakeholders form an integral part of an organisation and help in the decision-making process in order to make an organisation productive. The assignment focuses on the importance of the stakeholders in an educational industry. An organisation within the industry has also been considered in order to identify the impact of stakeholders. The organisation in focus is Federation Training, a training and education facility. The ways by which shared values are considered as the interest of stakeholders are analysed in this assignment. Identifying industry dependent upon creating value for stakeholders As stated by Noke, Kirkham and Mosey (2017) stakeholders help in the growth of an industry as well as an organisation. Value is created in an industry by formulating and presenting ideas that can help in solving problems. The risks involved in this regard are communicated with the stakeholders in order to receive support in the times of crisis (Wicks and Harrison 2017). Stakeholders can be both internal and external and the contributions depend upon the level of involvement of the stakeholders in the sector (Cardwell, Williams and Pyle 2017). In the case of an educational industry, the contribution of the stakeholders needs to be high. This is because an educational industry serves for educating the people in the society of its business (Stensaker, Persson and Pinheiro 2016). The value created by the engagement of the stakeholders involve the generation of new ideas in terms of knowledge that needs to be imparted to the learners. According to Missonier and Loufrani-Fedida (2014), analysis of the stakeholders is needed in order to understand the active way by which they can be involved. The active stakeholders concerned with the industry involve the students and Government. This is because these stakeholders dictate the ways required for improving the society. The value created by the involvement of these stakeholders can help the industry to progress and develop new ways to impart knowledge among the people (Smith and Lindsay, 2014). Identifying relevant information about the organisation Federation Training is a training centre that provides opportunities and outcomes for vocational education to students residing in South Eastern Victoria and Gippsland. The educational centre was established on 1st May 2014 and provides various courses to engage local students. The objective of the institution is to develop a proper relationship with the students that exist in the local region and provide an opportunity to learn about the regional teachings of the country. The vision is to set itself up with the best industries in the region and provide employment in these sectors (Federationtraining.edu.au 2017). In this regard, the role of the stakeholder plays an important role in the success of the centre. This is in order to gain a proper understanding of the industries, the role of the Government is essential (Pinheiro 2015). Thus, the involvement of the Government is essential to the success of the organisation. Apart from this, the contribution of the students is also required for its success. This can be evidenced by the fact that the institution aids the students involved in the training with a proper guide for a career growth (Pfitzer, Bockstette and Stamp 2013). Thus, the role of the students in the business model of the centre is also crucial. Ways to create shared values to consider interest of stakeholders According to Swanson (2017), the business model helps in the proper analysis of the operations of a business. In the case of Federation Training, the stakeholders involved help in creating values that can help in the proper growth of the business. The target customer is an important factor for the institution. In this case, the target is the students pursuing bachelor's degree from the various educational background (Porter and Kramer 2014). The involvement of the Government also helps the institution to gain access to many industries. According to Corner and Pavlovich (2016), the role of the Government in an educational industry is crucial as placements of the students after the completion of the course is an important factor. The Government can involve itself by providing opportunities for placement and engage in providing knowledge about the conditions of various industries. This can help Federation Training to get involved with deals only with reputed industries (Lienert, Schnetzer and Ingold 2013). Conclusion Hence, it can be concluded that in order to remain successful in the market, every business organisation needs to involve stakeholders. The value created by the stakeholders can help in the identification of the ways by which business can be conducted. In the case of Federation Training, the involvement of the students and the Government can help in the increasing the reputation of the organisation and maintain proper relations with the local community for expansion. References Cardwell, L.A., Williams, S. and Pyle, A., 2017. Corporate public relations dynamics: Internal vs. external stakeholders and the role of the practitioner.Public Relations Review,43(1), pp.152-162. Cho, M. and Auger, G.A., 2017. Extrovert and engaged? Exploring the connection between personality and involvement of stakeholders and the perceived relationship investment of nonprofit organizations.Public Relations Review. Corner, P.D. and Pavlovich, K., 2016. Shared value through inner knowledge creation.Journal of Business Ethics,135(3), pp.543-555. Federationtraining.edu.au. (2017).Home - Federation Training. [online] Available at: https://www.federationtraining.edu.au/ [Accessed 11 Sep. 2017]. Lienert, J., Schnetzer, F. and Ingold, K., 2013. Stakeholder analysis combined with social network analysis provides fine-grained insights into water infrastructure planning processes.Journal of environmental management,125, pp.134-148. Missonier, S. and Loufrani-Fedida, S., 2014. Stakeholder analysis and engagement in projects: From stakeholder relational perspective to stakeholder relational ontology.International Journal of Project Management,32(7), pp.1108-1122. Noke, H., Kirkham, P. and Mosey, S., 2017. Entrepreneurship with external stakeholders.Building an Entrepreneurial Organisation, p.73. Pfitzer, M., Bockstette, V. and Stamp, M., 2013. Innovating for shared value.Harvard Business Review,91(9), pp.100-107. Pinheiro, R., 2015. The role of internal and external stakeholders. InHigher Education in the BRICS Countriespp. 43-57 Porter, M.E. and Kramer, M.R., 2014. Creating Shared Value: Becoming a Movement. Smith, J.G. and Lindsay, J.B., 2014. External Stakeholders. InBeyond Inclusion, pp. 163-181. Stensaker, B., Persson, M. and Pinheiro, R., 2016. When mergers fail: a case study on the critical role of external stakeholders in merger initiatives.European Journal of Higher Education,6(1), pp.56-70. Swanson, D.L., 2017. Toward Shared Value Consciousness Through CSR Discovery Leadership. InCSR Discovery Leadership pp. 131-165. Wicks, A.C. and Harrison, J.S., 2017. Toward a More Productive Dialogue between Stakeholder Theory and Strategic Management. In Stakeholder Management, pp. 249-273.