Post-operative Psychological Adjustment to Stoma

Post-operative Psychological Adjustment to Stoma The essay is based on a patient who had surgery to have an ileostomy formed. This essay will attempt to define support and identify what the patients specific support needs may be within the context of the patients post-operative psychological adjustment to her new stoma with special focus on the issue of flatus and odour on the patients recovery. Black (2001) states that for the patient with a newly formed stoma, thoughts of talking to others, eating, working, sleeping or making love while bowel motion and flatus fill the appliance is horrific. A literature review will identify the most recommended suggestions for support of the person anxious about odour and flatus and the information will be considered within the context of the support that was given to Jane*. In accordance with the Nursing Midwifery Council Code of Professional Conduct (2008), the name and any identifying details of my patient on which this study is based will be withheld. Jane* is a 44 years old mother of three, including 16 years old Adam* who lives with her at home. Jane is in a long term relationship with Peter* and they have been planning to move in together. She is a teacher of Economics in the local secondary school. Jane was diagnosed with Ulcerative colitis about 18 years ago. Ulcerative colitis is a disease that causes inflammation of the large intestine or colon (Colitis UK, 2008). This is the last meter or so of the intestine closest to the anus. Symptoms are vary in severity from pain and discomfort, through mucous in the stools is in the most severe cases blood in the stools. It is generally diagnosed by inspection of the colon by the procedure colonoscopy by uses an endoscope. Porrett and McGrath (2005) suggest, ileostomies are formed to treat conditions such as inflammatory bowel disease, diverticular disease, carcinoma of the bladder, carcinoma of the bowel, traumatic injury to the abdominal area, and inadequate blood flow to the bowel, incontinence and obstruction. An ileostomy is a surgically created abdominal opening from the terminal small intestine (ileum), made because the entire colon has been removed or must be bypassed. An ileostomy stoma is usually on the lower-right abdomen. Its output has passed through all or most of the small intestine, but none of the large intestine; consistency of this output may vary from very liquid to a semi-solid paste (Porrett and McGrath, 2005). Simmons K et al (2007) state that more than 13,000 patients have stoma surgery yearly in the United Kingdom and reports psychological and social dysfunction in patients whose surgery end with stoma. Patients undergoing stoma surgery face a number of stress related circumstances leading to threats to body integrity, alerted body image, loss of autonomy, and loss of function and control (Williams, 2005). Annells (2006), suggests that fear of rejection by friends and family as well as being ostracized by society is constant for this group of patients and that support, guidance and information can assist them in adapting to their new way of life. Patients were reported to have feelings of loneliness, low self-esteem, thoughts of suicide and depression are higher in stoma patients compared with patients without a stoma (Norton, 2004). Patients who have had ileostomies, often have a distorted body image which has a knock on impact on the patients’ physical integrity and self-concept (Black and Hyde, 2004). When I was talking to Jane, before and after surgery, one of her major anxieties was flatus and odour – common concern for those with a new established stoma is flatus and odour which can result in psychological distress, stigma and embarrassment (Annells, 2006). She was also anxious about how Peter would react to the stoma and whether he would still find her beautiful and attractive. But mostly, she was concerned that people would smell her and she was worried, that she would be unable to control her flatus and being stigmatized by Peter and people who found out that she had stoma. Coping with stigma involves a variety of strategies, and Jane was at the stage where she was deciding whether to disclose the condition and suffer further stigma or attempt to conceal the condition or aspects of the condition and pass for normal (Joachim and Acorn, 2000), but felt certain that there was no way she could conceal the odour or the involuntary flatus. Flatus and odour that cannot be co ntrolled by the individual for medical reasons affect how these individuals feel about their bodies (Black, 2001). A stoma does not have a sphincter muscle; and so persons with stomas are unable to control the elimination of faeces or flatus via the stoma (Breckman, 2005). Rozmovits and Ziebland (2004), in a compilation of narratives from new stoma patients cited many as expressing difficulties in returning to work following surgery due to the â€Å"uncontrollable and unpredictable bowel movements and foul-smelling gas†. Simmons K et al (2007) state social aspect has a major impact on patients. A background study reported a decrease in social and leisure activities, increase in marital problems and less contact with relatives and friends. Mosby (2006), defines support as â€Å"to sustain, hold up, or maintain in a desired position or condition, as in physically supporting the abdominal muscles with a binder or emotionally supporting a client under stress†. There are several definitions for support. The Cambridge Advanced, Learners Dictionary (2008), define support as â€Å"to encourage someone because you want them to succeed†, â€Å"to help someone emotionally or practically†, or â€Å"a group of people who provide emotional and practical help to someone in serious difficulty†. Gale (2001) tells us social support consist of friends, family members, co-workers who provide assistance to the individual in need. Support found from friends, family and co-workers has a beneficial effect on physical and psychological well-being. Jane has had counselling from the stoma care nurse and assessed before surgery. Janes partner, Peter was not included initially in her pre-operative period as she did not wish to have him there. Peter was aware about the operation but she had not told many of her family and friends. Myers (1996) state psychological preparation and counselling of patients in the pre-operative period is of great importance. Myers (1996) further states the stoma nurse together with the patients partners and other health professionals help to rehabilitate the patient. The nurse and healthcare professionals must look at the patient and the patients needs holistically to include all aspects: physical, emotional, mental, social and economical. Faulkner and Davies (2005) state, that there is a range of definitions of the concept of support. It implies it is the exchange of resources between at least two people, intending to enhance the well-being of the person receiving. Faulkner and Davies (2005) illustrate the four broad support mechanisms they are emotional, informational, appraisal and instrumental support. Emotional support is about improving self-esteem, encouraging the person and aiming to have a feeling of belonging, accepted, loved and needed. Informational support provides information for individuals which enables them to be involved in dealing with their problems and problem solving. It can involve suggestions of where they can acquire further advice. Instrumental support involves tangible resources to remove, or significantly reduce, the stressful situation experienced by an individual. This also may include the provision of financial aid or services. Appraisal support helps the person to evaluate the impact of their circumstance, and level the threat posed by the stressful event or availability of personal coping resources. Post-operatively, Jane required all the identified types of support in dealing with her anxiety about her flatus and odour. Sirota (2006) states that support is important at all levels of care of the stoma patient and is especially critical in the early postoperative stages following stoma surgery when patients are experiencing grief reactions to loss. Emotionally, the support had already begun with the pre-operative chats that involved not only Jane, but her partner, Peter as well. The nurse, in offering support to the patient following a stoma formation must be conscious of the fact that even though the patient is extremely self-conscious about odours related to the newly-formed stoma, odours from the stoma should never be smelled by anyone but the patient (Williams, 2005). Emotional support to Jane was provided by developing a rapport with her which helped to alleviate her anxiety and embarrassment by putting the issue of flatulence and odour into context and teaching the patient techniques that could help control the issues e.g. deodorants, diets (Williams, 2005). Informational support was given to Jane about the types of food that will reduce odours and flatulence. Information such as which foods and fluids will produce flatus and which are likely to cause odour; how to manage a noticeable bulge created by flatus and how to remove flatus from appliance without causing unnecessary embarrassment in terms of odour or spillage are crucial to developing the patients confidence in managing his/her stoma (Breckman, 2005). In addition, leaflets obtained from the Ileostomy Internal Pouch Support Group gave a list of foods that increase and decrease flatulence and faecal odour as well as hints on reducing flatus. Instrumental support for Jane took the form of the deodorants that were provided to her to deal with the odours from her stoma. Cottam and Porrett (2005) recommend that in instances where odour is a problem, such as when changing the appliance, deodorants can be used to mask faecal odours and these are available in atomizers, drops or powders that can be sprayed into the atmosphere or placed inside the appliance. Jane was given the opportunity to try different samples of different fragrances by the stoma care nurse and then advised how she could order them in the future. She was also able to examine the different costs so that she could order deodorants that suited her budgets. She also advised to use the silicon-based adhesive remover which was proven to be gentler on the skin (Cutting, 2006). The final aspect of support that was provided to Jane in alleviating her anxiety about flatus and odour was appraisal support. Any disruption to the workings of the persons body is bound to cause concern and in Western society the pressures placed on us by media and peers mean that the patient that has to live with a stoma has to live with a stigma and all the anxieties associated with this (Williams, 2005). With the informational, emotional and instrumental support that was given to Jane, the rest of support needed by her can only be identified and accessed by her. Support groups and their contact details were provided to Jane, so that she can access a group or forum, if she determined that she needed further support of more specific, or even generic, type. The success of Janes adjustment will now be dependent on her own coping strategies and her own support networks (Williams, 2005). Salter (1997) stated that the support a nurse needs to give the patient with newly formed stoma is emotional, informational and practical. Jane received all of the above during her immediate post-operative period. Price (1993) says that how Jane copes now will be affected by the opinions and attitudes of the people with whom she has close relationships. Informational and appraisal support will continue via support group and forums and emotional support will come from family and friends. In the end, Jane will increase her self-confidence and become more independent with dealing with her stoma and stoma care. But in the end, as with everyone, even those without a stoma, support of all kinds will always be needed in some degree, form or fashion.

How Technology Effects Our Everyday Lives Essay

Technology in Society Today Today in society technology is used in every individual’s life. Society reacts to technology in many different ways, and technology plays the major role in everyone’s everyday life. One example is that there is a new iPhone coming out, the IPhone 5s and IPhone 5c. Individuals are waiting for this phone to come out, just for the upgrades that are not drastic from the iPhone 4. People use technology in their everyday life- cell phones for everything (calculators, calendars, alarm clocks, mail/texts) and I even use my cell phone to complete school work, like this discussion board in our class. Society depends on technology for new information, television, and even farmers use technology in their new tractors to keep up to date with prices of wheat and even may set a tractor to plant or spray in a certain area. Most individuals, including me, depend on technology to get through their everyday life. Today in society technology is used in every individual’s life. Society reacts to technology in many different ways, and technology plays the major role in everyone’s everyday life. One example is that there is a new iPhone coming out, the IPhone 5s and IPhone 5c. Individuals are waiting for this phone to come out, just for the upgrades that are not drastic from the iPhone 4. People use technology in their everyday life- cell phones for everything (calculators, calendars, alarm clocks, mail/texts) and I even use my cell phone to complete school work, like this discussion board in our class. Society depends on technology for new information, television, and even farmers use technology in their new tractors to keep up to date with prices of wheat and even may set a tractor to plant or spray in a certain area. Most individuals, including me, depend on technology to get through their everyday life. Today in society technology is used in every individual’s life. Society reacts to technology in many different ways, and technology plays the major role in everyone’s everyday life. One example is that there is a new iPhone coming out, the IPhone 5s and IPhone 5c. Individuals are waiting for this phone to come out, just for the upgrades that are not drastic from the iPhone 4. People use technology in their everyday life- cell phones for everything (calculators, calendars, alarm clocks, mail/texts) and I even use my cell phone to complete school work, like this discussion board in our class. Society depends on technology for new information, television, and even farm ers use  technology in their new tractors to keep up to date with prices of wheat and even may set a tractor to plant or spray in a certain area. Most individuals, including me, depend on technology to get through their everyday life. Today in society technology is used in every individual’s life. Society reacts to technology in many different ways, and technology plays the major role in everyone’s everyday life. One example is that there is a new iPhone coming out, the IPhone 5s and IPhone 5c. Individuals are waiting for this phone to come out, just for the upgrades that are not drastic from the iPhone 4. People use technology in their everyday life- cell phones for everything (calculators, calendars, alarm clocks, mail/texts) and I even use my cell phone to complete school work, like this discussion board in our class. Society depends on technology for new information, television, and even farmers use technology in their new tractors to keep up to date with prices of wheat and even may set a tractor to plant or spray in a certain area. Most individuals, including me, depend on technology to get through their everyday life.

The Impact Of Media On Society And The Media s Beauty...

As a young woman I know the pressures to conform to society and the media’s beauty standards. The media communicates to consumers how and what to think, how to dress, act, and that we, as buyers, should care how others perceive us. The communication channels through which news, entertainment, education, data, or promotional messages are circulated is known as media. Media includes every broadcasting and narrowcasting medium such as newspapers, magazines, TV, radio, billboards, and more (What Is Media? Definition and Meaning). People interact with these channels of communication so extensively that sometimes they forget the media is being used to persuade and advertise society’s ideals. Ideals that are formed through various institutions and shape a social construct that consumers willingly participate in. A social construct is understood as a social mechanism, phenomenon, or category created and developed by society; a perception of an individual, group, or idea that is constructed through cultural or social practices (Boghossian). The general public is immersed in today’s beauty standard because of the nonstop bombardment of media focused towards them. Media that has deeper meaning than the movement of products to the masses. A meaning that exhibits it is more valuable to be physically attractive than not. There is simply benefits in beauty. The idea of the beauty standard. Azadeh Aalai, an author and professor of Psychology at Queensborough Community College, believesShow MoreRelatedSocial Media Has a Negative Effect on Body Image and Self Esteem1202 Words   |  5 Pages Social media has become one of the most popular sources of communication for the upcoming generation. 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This paper will further support the notion that societies perceptionRead MoreBeauty Culture: An Examination the Effects Media Has on Society 1440 Words   |  6 PagesSociety is obsessed with being beautiful. One just has to examine the amount differing beauty industries earn early for this fact to be evident. For example, the diet industry is a thirty-three billion dollar industry, with the cosmetic industry following close behind with twenty billion yearly (Wolf 16). However, this obsession with beauty is not without cause. As stated in Body Image: Understanding Body Dissatisfaction in Men, Women, and Children, â€Å"In affluent Western societies, slenderness isRead MoreThe Role Of Social Media On Women1001 Words   |  5 PagesMoreover, has media taken into consideration that the influenced constructed standards affect women long term and what exactly influences how girls act, look and think about themselves? Starting f rom a youth age through adolescence, which is the average age of still trying to figure out their identity, and in many cases lasting until adulthood, girls compare themselves and set their mindset to look like the celebrities they watch in T.V., magazines, music videos or movies.Yet, the issue is that byRead MoreMedia s Influence On Beauty Standards Of Women1213 Words   |  5 PagesInfluence on Beauty Standards of Women There are several types of social standards that are held in the world today. Among those standards are the beauty standards of how women should look. This is one of the most talked about topic of discussions today. It is safe to say that the media is the reason to blame for these undocumented sets of beauty standards that women should abide by because of the types of women that are portrayed through the media. The unrealistic beauty standards the media has helpedRead MoreThe Media Is Responsible For The Increase Of Eating Disorders1452 Words   |  6 Pages A cultural fixation on female thinness is not an obsession about female beauty, but an obsession about female obedience (wolf, 1991). The purpose of my research paper is to demonstrate different viewpoints on how the media plays a role in today’s era. My research will study the influence of media on eating behaviors and the significant studies regarding this topic. My paper will also cover the outcomes of media portraying unhealthy body images, weight loss ads, and the influence of the internetRead MoreMedia and Feminine Beauty1497 Words   |  6 PagesMass Media such as films, advertisements and magazines are the huge influence on the definition of feminine beauty. From watching movie to passing through the subway station, it is quite often to see numerous images of female faces and bodies. Women are exposed in the world where most women display in films and on subway advertising boards are striking poses with little clothes on. Moreover, every image showed is airbrushed with Photoshop. Women are exposed with images produced by the media on whatRead MoreMass Media s Influence On Society962 Words   |  4 PagesOver the years mass media has become more available and favored by society through avenues such as magazines, television, newspapers, print ads, internet, and including social media. According to U.S. Census Bureau (2007), individuals spend nearly a total of 3,518 hours of their time on mas s media outlets. Mass media has become widely popular among individuals, in particularly young adults.73% of U.S adults aged 18–29, have been reported regularly visit at least one of these outlet, and 42% use moreRead MoreThe Impact Of Media On Society Today911 Words   |  4 Pagesto Dictionary.com, â€Å"media† is defined as means of communication that reach and influence society or people widely. For instance, radios, televisions, newspapers, and magazines are forms of media. The influence the media has around the globe is profound, therefore, in this essay, I am going to discuss the impact that media has on the society today. Although social media can connect all people in the world instantly, the negative effects have a great impact on the society because it decreasesRead MoreThe Beauty Standards Of America1099 Words   |  5 PagesCommon standards set by society are deemed as appropriate for all people no matter what race. American people are very diverse and what is acceptable to gender, age or race differs from person to person. More specifically, American women share complaints regarding the unrealistic beauty standards that are set by the media and society. Many women complain that it is not fair that they are judged by their outer appearance and are viewed as not beautiful enough, or not normal when they do not conform

Essay on Compare and Contrast Literary Text and...

Non-literary text forms an independent part of a publication .Non-literary texts are informational writing: factual material, informational explanations, newspaper articles, textbooks, journal and diary entries, and so forth that are published in newspapers, Informative magazines current affairs news and educative articles. Non-literary composition uses facts and figures to proof a point. Examples of non-literary texts are personal diaries, current affairs news, journals, text books and articles. Non-literary composition is written objectively. In contrast, literary texts are fictional compositions based on the artist’s will and imaginations and are therefore subjective. Poetry, novels, short stories and dramas are written in a particular†¦show more content†¦Above all, poetry involves aspects of language that appeal to, and communicate by sound and sight. In literary text the meaning is linked to the purpose, and it means that the character in the poem is fed up with boredom, loneliness and social isolation. In contrast, the meaning which is linked to the purpose of the article in the newspaper has to do with the wave of knife crime among the youth in United Kingdom. Articles and poems always have meanings for their readers. A poem and an article share similarities when it comes to the choice, use of stock of words in a language and order of words in a sentence. Authors and/or narrators make correct choice of words from in a language and arrange them properly in sentences to express clearly the intended meaning. Writers’ aim is to get the readers’ attention, so syntax and lexis are manner of speaking when used properly in literature. However, Poetry is often a fluid and personal passion without the necessary need to adhere to certain grammar rules or stanza styles. The structure, as seen in the article is more pronounced in that; a good title is created, an introduction that outlined the main features of the subject and described how the subject is all about was explained in a clear way. It had a conclusion. However, the poem has no beginning, middle and ending. Poetry differs in visual form from articles. It has been noticed that theShow MoreRelatedLiterary and Non Literary Texts Essay example1368 Words   |  6 PagesIn this paper I am going to compare and contrast a literary text (Education for Leisure by Carol Ann Duffy) and a non literary text (Newspaper article from â€Å"The Independent† by Nigel Morris) focussing on the language features used, the structural and presentational devices, the use of correct punctuations, analyse the structure of the non literary text for bias and the techniques used to convey meaning and ideas by both authors. The objective of literary texts is to teach the readers a life lessonRead MoreTop Girls B y Caryl Churchill1337 Words   |  6 Pages Beauvoirian and Marxist ideas have be used to compare and contrast these ideas, further supporting this an assortment of literary techniques. Caryl Churchill explores the Beauvoirian idea of women â€Å"denying [their] feminine weakness† in order to justify their strength, while the â€Å"militant male... she wish[es] to be† may be the catalyst of her masculine qualities dying; literary techniques are utilised to exploit these ideas. Within Churchill’s text, Isabella says â€Å"our Marlene’s got far more balls†Read MoreCritical Analysis of Romanticism1387 Words   |  6 PagesThis literature review will critically analyse a range of arguments and perspectives by literary critics and historians and their views will be pertinent to the study of Romanticism . Due to the scale of research in Romantic literature as a discipline, the main focus in this paper will concentrate primarily on two major paradigms in Romantic literature. These two aspects are referred to as Romantic nature and Romantic sublime. The paper will be organised and divided into twoRead MoreTop Girls By Caryl Churchill1388 Words   |  6 Pagesideas from The Communist Manifesto are used to compare and contrast these ideas, further supporting this an assortment of literary techniques. Caryl Churchill explores the Beauvoirian idea of women â€Å"denying [their] feminine weakness† in order to justify their strength, while the â€Å"militant male... she wish[es] to be† may be the catalyst of her masculine qualities dying; literary techniques are utilised to exploit these ideas. 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The Historical Critical Method is the comparing of text with other text from the same region and time period wh ich would affect the text, and could cause question. Sola Scriptura is the teaching that Scripture is the Church s only infallible and sufficient rule for deciding issues of faith and practices that involve doctrines. While the

Climate Change And The Geographies Of Objectivity Essay

Culture and its interaction with different geographical spaces unite different types of research together in how culture can influence the research. To return to Research Tutorial 2, ‘Climate Change and the Geographies of Objectivity: the case of the IPCC’s Burning Embers Diagram’ (Mahony, 2011) investigates the history of the Intergovernmental Panel on Climate Change s (IPCC) ‘burning embers’ diagram, and the future of it in the cultural circuits of climate science, policy and advocacy. Mahony (2011) argues that climate change is as much as a social and political process as much as it is a scientific process, through cultural and human processes occurring in different places around the world. It is because of this, that the science of climate change appears differently from different places. Climate change occurs spatially across the globe, however with space itself being passive. ‘Geographical work at the boundaries: Human actions alter the fu nctioning of the climate system’ Hulme (2007), also from Research Tutorial 2 gives thought to what climate change and the risks mean to different people and to diverse cultures. Geographers recognise that human-environment relations are strongly influenced by the ideas and attitudes that different societies hold about the environment (National Research Council, 1997). In being situated in a particular place, the importance of climate change and the politics and decision-making around it are perceived in different ways. 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The short story, Winter Dreams, by F. Scott Fitzgerald Free Essays

The short story, Winter Dreams, by F. Scott Fitzgerald holds lasting impact today, mainly for the author’s ability to weave love, desire, emotion, and the moral fiber of an individual into a story. The underlying theme is centered on how charisma can drives a person to lose sight of their true goal in life, thereby finding pleasure in selfish gain which results in eventual loss. We will write a custom essay sample on The short story, Winter Dreams, by F. Scott Fitzgerald or any similar topic only for you Order Now I will develop an analysis of characterization and theme in this famed short story. The story is a narrative account of Dexter Green, a reliable, self-assured individual who falls into the web of infatuation of a beautiful woman, Judy Jones. Ms. Jones is also a self-assured individual. She, however, bases her confidence on her outer beauty, a beauty that intoxicates men, bringing them to her knees. Judy represents intense passion, and she brings it out in men, empowering her own life. She leads Dexter to rather abruptly quit is work as a caddy because he yearns to impress Judy, and working as a caddy doesn’t meet her expectations. At the time Judy is only eleven years old. From a very young age, we see that Dexter is the kind of person who goes after his dreams, makes a plan and follows through, but Judy alters this. The characteristics of Dexter’s personality are made clear by F. Scott Fitzgerald in quick fashion. Dexter’s personality comes to light as Fitzgerald displays how astute, intelligent and confident the boy can be. Like Dexter, most of Fitzgerald ‘s male characters choose to feel empowered at the expense of the real. Only a world of illusion, such as Judy Jones’, that can handle her emotional intensity. For one, the story unfolds by casting a scene between a nurse and a young girl on the golf course. These women are having a heated conversation. Although Dexter is at a distance from the scene, he clearly witnesses the incident as troublesome. In the end, one girl raises a club at the other woman, a nurse. She raises the club as if she was going to pound her. But she doesn’t follow through with her threat. Dexter finds humor in this. His ability to find the comedy behind such childish behavior adds to his own youthful wisdom. Here’s a snippet of this scene, as written by the author: Realizing that the elements of the comedy were implied in the scene, Dexter several times began to laugh, but each time restrained the laugh before it reached audibility. Not only is Dexter smart enough to recognize this altercation as a staged situation, which is merely the ego of two people butting heads, but he does so without allowing this incident to alter his own mood. What’s even more humorous is that Fitzgerald uses two females in this physical altercation on the golf course. Normally, the stereotype would be to place two men arguing while playing a sport. Not only does Fitzgerald squash the stereotyping, but he does so by having one woman threatening to nearly behead another woman with a raised club. This displays Fitzgerald creative knack for bringing humor into a potentially disastrous scene. Beyond this, Dexter is not concerned that this altercation might result in physical injury. He realizes their childish threats will go nowhere. This further strengthens his character. Not only is Dexter able to see that the fracas is not going to actually become violent, but, at fourteen years of age, his analysis of the scene adds to his character. Dexter’s characteristics come across as a young boy who can speak for himself. For instance, he is shown having a conversation with a very established man of the community. Dexter is not the least bit intimidated by this adult presence. Dexter, instead, is perceived by members of the golf course to be one of the best caddies. Dexter, then, makes a decision to quit his caddying job. He has higher aspirations and realizes that he’s gotten all can out of caddying. A golf member hears of this and pleas for the young Dexter to continue to caddy for him, stating that he can make if very worthwhile to Dexter. In response to this plea, Fitzgerald wrote: â€Å"You’re not more than fourteen. Why the devil did you decide just this morning that you wanted to quit? You promised that next week you’d go over to the State tournament with me. † I decided I was too old. † Dexter stands up for what he believes. He is not swayed by an adult figure with a high-standing position in, both, the business world and on the golf course. The reader sees that elitism cannot sway the young Dexter from going after what he really wants in life. This is, in fact, very ironic; for Dexter wants to be one of the elite. Years later, Dexter falls into the lustful vision of the very beautiful Ms. Jones. Ms. Jones is more that willing to use her outer beauty to gain countless new lovers. She does begin a relationship with Dexter when he is in his twenties. Judy Jones is even boasted about by three other men that Dexter plays golf with one day. These are, again, some of the elite men in society. They almost salivate as they discuss Judy Jones. â€Å"Good-looking! † cried Mr. Hedrick contemptuously, â€Å"she always looks as if she wanted to be kissed! Turning those big cow-eyes on every calf in town! † Here, we can see Fitzgerald’s light-hearted, almost comical, means of showing how man’s desire can rule a person on certain levels. After this golf outing, Judy and Dexter begin a relationship. Dexter is ecstatic about her. He is—apparently for the first time—overwhelmed with a new appreciation over having Judy in his life. Judy, however, is a hollow person and Dexter doesn’t see this. This shallow characteristic in Judy represents people who are self-centered and seek to make gains by using their physical appearance instead of becoming more knowledgeable. Her hollow personality is at the center of her world. All Dexter sees is her physical characteristics which nearly melt him into submission. She has the same affect on many other men in her life. Near the end of the story, Judy breaks off their relationship. She is too easily swayed by other men’s advances and his financial status. Dexter is crushed by her departure, but he begins to renew his life and starts a relationship with a nice girl. This girl is less than glamorous but is filled with other worthwhile characteristics. Judy, then, runs back to Dexter but he does not take her bait. Dexter then discovers through Delvin, that Judy has since gotten married and is raising a family. Now, however, Judy has lost her beauty and is being treated unfairly by her husband. This husband runs off with other women, leaving Judy alone to raise the kids. In closing, we see who cleverly Fitzgerald develops theme and storyline. Fitzgerald also learned how to shape his short stories to meet the needs of magazine readers while, at the same time, using these serious themes as springboards into longer fiction. Winter Dream is centered around characterization. It’s the characters and their interactions with one another that make this story so empowering. Its impact is still felt today because so much of society continues to be tricked by external beauty’s advances. For, the true beauty comes from deep within the heart and soul of a person who shares their life instead of taking advantage of others. SOURCES F. Scott Fitzgerald  Ã‚   http://people.brandeis.edu/~teuber/fitzgeraldbio.html#winterdreams Introduction to the Short Story  Ã‚   dhttp://www.people.vcu.edu/~bmangum/fitzstories.html How to cite The short story, Winter Dreams, by F. Scott Fitzgerald, Papers

Marketing Operations and Management

Question: Discuss about the Marketing Operations and Management. Answer: Introduction In business operation, there are two critical stages involved. First, there is front stage where the client facing activities of a business occur: marketing, sales and service or product delivery. This is the part of a business operation that the client directly experience. Second, there is back stage which makes up all the administrative and support activities that must be followed and undertaken to adequately deliver the Front Stage processes (Buckingham, 2008). Back stage activities are invisible and support front stage. Herein is discussion of the front and back stage activities of a restaurant. Front stage activities In restaurants, this is a crucial stage that determines how huge the business grows. Analysis of front stage activities is necessary in any business. Absolute cleanliness in the restaurant, customer care is paramount. Customers coming to the restaurants must be well received. Customers requests and orders they give must be taken well and food provided in a timely manner (Goffman, 1999). The program for the day dictates the arrangement of chairs in a restaurant. Customers are required to enter the restaurant and identify convenient seats. Customer look at the menu to choose a meal or drink that suits them. Here, customers and attendants meet and communicate. Attendant notes down the meal that the customer wants such as drinks, snacks, main course meal etc. Back and front stage personnel interact at this stage. Attendant goes to the chef with an order from the customer. The chef promptly works on the order by the customer and gives it back to the attendant. The responsibility of the chef is to package the food in a manner most attractive to customer (Lovelock, 1991). The front stage personnel (customer attendant) take food as packaged by the back stage personnel (chef) to the customer. When the customer has eaten and is satisfied, he/she interacts with another back stage personnel who is the cashier. The cashier ensures prompt payment for the meals consumed. The cashier is supposed to handle the customer in an esteemed manner. In a restaurant with modern technological advances like Wi-Fi, television, music system etc. some support personnel are required to connect the customers phones or laptops so that they can enjoy internet services. They must ensure that relevant channels and entertaining music is played at any given time. Restaurants toilets cleanliness and maintenance must be assigned to a staff. Toilet cleanliness must never be ignored. In front stage great care is supposed to be observed to ensure that everything happens fast without customers waiting longer. Supplies required at the restaurant must be timely procured. For business to grow employees absenteeism of must be discouraged for business to grow. Standards of operation must be laid and followed. The management must set to suppliers clear quality standards for foodstuffs (Menear Hawkins, 1999). Only what is available in the restaurant should appear on the menu. General hygiene of the restaurants staff should be adhered to. Easy identification dictates that staff wears tag or uniform. Back stage activities Back stage processes include: human resource (HR), marketing process, accounting process, customer service, and customer retention services. In the restaurant the human resource manager is responsible for ensuring smooth relationship between employees and in interviewing and recruiting competent people to run various departments of the restaurant. At times the human resource manager will solve disputes between employees and customers or employees alone. Customers sometimes raise complaints concerning mistreatment by certain employees which must be responded to in a timely manner (Pine Gilmore, 2011). This strategy keeps customers. Adoption of diligent marketing is necessary. This is done by having a dedicated team to advertise the restaurant through mainstream and social media. The marketing team must therefore update regular and potential customers on new developments and changes within the restaurant. Customer suggestions and recommendations on the business should be thoroughly considered. A key role is played by the accounting section of a restaurant. This is a key department and ensures that employees are paid in time and hence deliver to their best. The accounting process pays suppliers of the restaurants foodstuff; drinks and other convince products in a time. Suppliers are therefore able to deliver goods in time. Great customer satisfaction will be ensured. The restaurants stock levels are monitored by accountants. Accounts contact suppliers and order for items. This way they are able to detect goods that are few in stock and alert suppliers. Keeping and caring for customers is paramount. The customer care must be done by professionals who understand the organic structure of the place and systems and can direct customers accordingly in case of queries. They take of calls first time or regular customer interested in booking meals. They are supposed to be adequately informed on every service and items available in the restaurant. Adoption of proper initiatives to keep customers is necessary. Occasionally, regular customers can be rewarded by being given some special treatments like free meal, a discount or wished well during their birthdays. The customer retention desk must develop a strategy for getting feedbacks from customers (Schlenker, 1980). Managerial implications From the discourse above, we can say that both front and back stage processes are crucial in business operations. Front and back stage operations have many managerial implications. In front stage, customers and their expectations must be managed. The staffs that interact with customers directly must be well trained and followed up to give the restaurant a good image (Shoemaker and Cynthia, 2013). The problems that might arise between customers and employees must be dealt with amicably and timely. In the back stage, market management strategies to retain and attract customers must be laid. For customers to enjoy, suppliers and bills must be paid. Payment of employees must be done in time to avoid go-slows, absenteeism or poor service. Conclusion Front and back stage are crucial business operations which must be outlined at the start of a business. The two stages are interdependent and a failure in one stage directly affects the other. Employment of a competent manager is critical to facilitate and coordinate operations. References Buckingham, D. (2008). Youth, identity, and digital media. Cambridge, Mass: MIT Press. Goffman, E. (1999). Presentation of self in everyday life. Place of publication not identified: Peter Smith Pub, Inc. Lovelock, C. H. (1991). Services marketing. Englewood Cliffs, N.J: Prentice Hall. Menear, P., Hawkins, T. (1999). Stage management and theatre administration. Oxford: Phaidon. Pine, B. J., Gilmore, J. H. (2011). The experience economy. Boston, Mass: Harvard Business Review Press. Schlenker, B. R. (1980). Impression Management: The self-concept, social indentty and interpersonal relations. Monterey: Brooks/Cole Publishing Company. Shoemaker, Cynthia. (2013). Making Sense of Life Stages, the Workplace and Tmi. Xlibris Corp. Teboul, J., Palgrave Connect (Online service). (2006). Service is front stage: Positioning services for value advantage. Houndmills [England: Palgrave Macmillan.