Lloyds Banking Group Integration Essay Example | Topics and Well Written Essays - 2000 words

Lloyds Banking Group Integration - Essay Example Organisational Structures Special Issues for Banks Martin and Fellenz (2010, p.592) define organisation structure as â€Å"the formal arrangement of task, communication and authority relationships that influence and control how people co-ordinate and conduct their work†. It is assumed that organisations can choose their structures and change them through what Brunsson and Olsen (1993, p.211) refer to as â€Å"administrative reforms†, which they define as â€Å"expert attempts at changing organisational forms† (ibid). They claim the belief that formal organisations can be changed originates in â€Å"a rational, instrumental tradition† which assumes a hierarchical approach to leadership and power with an unequal distribution of work and working conditions, among other things (ibid, p.212). They question how much choice, in reality, organisational leaders have when they decide to change the organisational structure. For Lloyds Group, this is a particularly pe rtinent issue as consideration is being given to breaking up the larger banks to avoid the â€Å"too big to fail† belief following the global economic crisis of 2007-2008 (Treanor, 2011). The USA had, until 1999, regulations in place imposed by the Glass-Steagall Act 1934, which required different banking functions to be kept separate. Following the crisis, several commentators suggested the UK might consider such an approach (Goddard et al, 2009, p.374), although some believe it is unlikely to be implemented (Hindle, 2009, p.422). For Lloyds, such a break-up would be change imposed by the environment rather than a choice for senior management, something that Brunsson and Olsen see as a key issue for those who look to change organisational structures. They believe any organisational change is affected to a greater or lesser extent by the context within which that change takes place and organisational structure can simply be the result of a series of unconnected events that we re not originated by the organisation (1993, p.219). As the banking industry is currently subject to heavy scrutiny by both government and the public, any changes Lloyds Group decide to make will be affected by that scrutiny and the prevailing culture of risk avoidance. In addition to the possibility of an imposed break-up, Lloyds must also consider the current regulatory requirements that insist on divisions, whether real or virtual, between different functions within the Group (â€Å"Chinese walls†) to avoid issues such as insider trading and dealing with privileged information, something the USA have recently reconsidered within the Dodd-Frank Wall Street Reform and Consumer Protection Act (Hay and Goebel 2010). This analysis must therefore be considered in the light of the specific requirements of the banking industry currently in place and the likelihood that further changes will be required in the immediate short term. Possible Organisational Structures The structure of an organisation should be determined by the strategy the organisation pursues and the business undertaken to deliver products and services to customers (Mullins 2010). Lloyds Group needs to determine what business it is in and how it intends doing that business, before it can decide how to integrate the different parts of the Group. On the assumption that the purpose of the integration

Variation in Real Estate Prices and Macroeconomic Performance Assignment

Variation in Real Estate Prices and Macroeconomic Performance - Assignment Example The performance of the housing sector significantly affects the general economy’s performance. Most theories, however, presume that it is only the macroeconomic factors that affect the variations in house prices and not the reverse. According to the vector autoregressive (VAR) model built by Baffoe - Bonnie, there are complete relations between the housing sector and the general economy (Case et al. 15). The theory asserts that macroeconomic variables usually cause cycles in the prices of houses and the number of houses sold. If not brought to control, these effects may have adverse implications on the economy. Historically, changes in the prices of the real estate have been linked to changes in consumption in various ways. In the past, the slump in housing led to many empty houses and growing joblessness. Uncertainty about the consequences of declining home prices was also common in the past years. In the past - just like today, consumption or rather spending has been subject to people’s income. Economists Karl E. Case, John M. Quigley and Robert J. Shiller made annual observations in 14 countries since the past 25 years and in some U.S. states quarterly in the 1980s and 1990s. Their observation was that some the future incomes were kept in the assets, stocks, bonds, and property, where most people keep their riches (Case et al. 15). A drop in asset values made many homeowners poorer, so they lowered their expenditure and raised savings. When the assets grew, they spent more. The theoretical arguments of the vector autoregressive (VAR) model are thus valid. Economists have varying opinions on the consequences of varying house prices among the consumers. According to Carroll et al. (69), they disagree as to whether Americans will reduce their spending slowly or rapidly. On one side optimists, argue that the links between housing wealth and spending are much the same as for any other type of wealth, such as shares. They say

Benign Prostatic Hyperplasia Causes, Signs and Treatments

Benign Prostatic Hyperplasia Causes, Signs and Treatments As a man matures, the prostate goes through two main periods of growth. The first occurs early in puberty, when the prostate doubles in size. Around of the age 25, the gland begins to grow again. This second growth phase often results, years later, in BPH. Though the prostate continues to grow during most of a mans life, the enlargement doesnt usually cause problems until late in life. BPH rarely causes symptoms before age 40, but more than half of men in their sixties and as many as 90 percent in their seventies and eighties have some symptoms of BPH. As the prostate enlarges, the layer of tissue surrounding it stops it from expanding, causing the gland to press against the urethra like a clamp on a garden hose. The bladder wall becomes irritable and thicker. The bladder begins to contract even when it contains small amounts of urine, causing more frequent urination. Eventually, the bladder weakens and loses the ability to empty itself. Urine remains in the bladder. The narrowing of the urethra and partial emptying of the bladder cause many of the problems associated with BPH. Prostate enlargement is as common a part of aging as gray hair. As life expectancy rises, so does the occurrence of BPH (NucleusMedicalMedia, 2013). Clinical Findings Most men with BPH complain of symptoms of the lower urinary tract. Doctors should ascertain whether the symptoms are really caused by BPH or by another pathology. In the assessment, distinction needs to be made between obligatory and optional investigations which follow in the cases where diagnostic uncertainties persist after the basic examination (Dr. med. Matthias Oelke, 2013). Obligatory Examinations Patient history: A family history of prostatic disease and prostatic cancer, a history of lower urinary tract disease such as bladder stones, cystoscopic examination, transurethral surgery, and systemic disease and a history of alpha-blockers, 5-alpha-reductase inhibitors, antimuscarinics, or neurological medications should be recorded (Dr Hann Chorng Kuo, 2008). In addition to the general and neurourological history, a detailed history with regard to micturition should be taken. In the micturition history, obstructive and irritative symptoms are elicited and possibly quantified (Table 1). The history should also clarify whether drugs are being taken that might affect the functioning of the lower urinary tract (Dr. med. Matthias Oelke, 2013). Symptom and quality of life questionnaires: The frequency and extent of symptoms can be quantified by using a questionnaire, and changes during therapy can thus be documented. The International Prostate Symptom Score (IPSS) is the most commonly used questionnaire (Table 2). The first 7 questions capture the frequency of symptoms of the lower urinary tract within the preceding 4 weeks, the 8th question the extent to which the patients quality of life is compromised. The symptom score is obtained by adding up the answers to questions 1 to 7 and will be a number between 0 and 35 (Dr. med. Matthias Oelke, 2013). On the basis of this score, the symptoms can be classed as mild (IPSS score 0-7), moderate (IPSS score 8-19), or severe (IPSS score 20-35) as shown in the Table 3. Physical Examination: Patients should be examined systemically and locally. Examination of the abdomen includes checking for a palpable bladder. This may indicate chronic outflow obstruction or a neurogenic bladder. The presence of an abdominal scar, a palpable, distended bladder and genital lesions should be carefully examined. Obviously, any further abnormalities require a full neurological history and examination. In addition to a general physical examination, the patients neurourological status should be assessed. This provides information on the anal sphincter muscle tone and the sensorimotor state of the lower extremities, the perineum, and the genitals. During the basic neurological examination, the reflex pathways of the lower extremities should also be assessed (Table 3), to enable conclusions about the functional fitness of the neural pathways in the bladder and the bladder sphincter (Dr. med. Matthias Oelke, 2013). A digital rectal examination (DRE) of prostatic consistency, prostatic size, surface and abnormal nodularity should be carefully done. It includes noting the tone of the anal sphincter and the pelvic floor (Diagram 2.2.1A). It may be poor with a neurogenic bladder. Urologists report their findings in terms of the size of the prostate, a normal gland in a young adult weighing about 20 g. A useful guide for those less familiar with prostates is that a fingers breadth represents about 15 to 20 g and so a gland that is three fingers in breadth across is 45 to 60 g. Symptoms are unusual below two fingers in breadth. It is also important to note the texture and contour of the gland. It should be firm but not hard, and smooth without nodules. The median sulcus should be clearly defined. A gland that is hard rather than firm, nodular and lacks a clear median sulcus suggests carcinoma of prostate (Dr Laurence Knott, 2012). Compared with transrectal ultrasonography, the prostate volume is usua lly underestimated by 10 to 20% on digital rectal examination (Dr. med. Matthias Oelke, 2013). A Digital rectal exam (DRE) is done to assess the prostate size and shape. After putting on a lubricated glove, the physician gently inserts a finger through the anus into the rectum and assesses the size and hardness of the prostate gland. Laboratory tests: Urine test (urinalysis). When a patient complains of urethral symptoms (micturition pain, burning sensation) a urinalysis should be performed (Dr Hann Chorng Kuo, 2008). Analyzing a sample of the urine in the laboratory can help rule out an infection or other conditions that can cause similar symptoms (MayoClinic, 2011). When the urinalysis shows a miscroscopic hematuria or pyuria, a KUB radiograpgh should be done to investigate whether there are bladder or lower ureteral stone. Blood urea nitrogen and creatinine levels should be investigated when chronic urinary retention is noted (Dr Hann Chorng Kuo, 2008). Prostate-specific antigen (PSA) blood test. The prostatic specific antigen (PSA) level is indicated in all patients with an enlarged prostate or abnormal DRE findings (Dr Hann Chorng Kuo, 2008). Its normal for the prostate gland to produce PSA, which helps liquefy semen. PSA levels increase with an enlarged prostate. However, PSA levels can also be elevated due to prostate cancer, recent tests, surgery or infection (prostatitis) (MayoClinic, 2011). Men with high PSA levels have a higher risk of future growth of the prostate, symptom and flow rate deterioration, acute urinary retention and BPH-related surgery. BPH levels increase with age and approximately 25% of men with BPH have a PSA of >4ng/ml. PSA testing is more appropriate for patients whose future natural life span is likely to be more than 10 years (Dr Hann Chorng Kuo, 2008). Uroflowmetry. It is a dynamic test that measures the volume of urine released from the body, the speed with which it is released, and how long the release takes. Both average and maximum flow rates can be measured (U.S National Library of Medicine, 2012). As shown in the Diagram 2.2.1B and Graph 2.2.1A, the patient will be asked to urinate into a funnel connected to the electronic uroflowmeter, which records and translates the urine flow into a graph which gives a good indication of the degree of bladder blockage (Chin Chong Min Urology Robotic Surgery Centre, 2013). The peak flow rate, also known as Qmax is generally used as the basis for determining the severity of any blockage or obstruction. Low flow may indicate such conditions as obstruction of the urethra, enlarged prostate or poor bladder function (UrologyCare, 2011). This technique, which is used to detect an obstruction of the  urethra and  bladder neck, is widely used in the diagnosis of BPH (EhealthMD, 2012). A Qmax value over 15 mL/s is usually considered normal. A Qmax below 7 mL/s is accepted as low. Results can vary according to effort and volume and so the usual compromise is to obtain at least two readings with at least 150 mL of urine each time (Dr Laurence Knott, 2012). Postvoid residual urine: One of the important subjects of tests for urinary incontinence is the postvoid residual urine volume (PVR), the amount of urine left after urination. Normally, about 50 mL or less of urine is left; more than 200 mL is a definite sign of abnormalities. Measurements in between require further tests. This test is done using  ultrasonography  or it can also be done with a small tube (catheter), being put into the bladder through the urethra. By using the transabdominal ultrasonography, it uses a device placed over the abdomen. It can give an accurate measure of postvoid residual urine and is less invasive and expensive than transrectal ultrasonography (TRUS) (UrologyCare, 2012). Postvoid residual urine can occur in bladder outlet obstruction in BHP, but also in other forms of bladder outlet obstruction or detrusor underactivity. (Dr. med. Matthias Oelke, 2013). Urosonography: The bladder and kidneys should be examined in every patient. Since a raised serum creatinine concentration occurs only after about 50% of nephrons have failed, an ultrasound investigation of the kidneys can diagnose upper urinary tract dilatation even in the absence of raised creatinine. Since bladder outlet obstruction results in compensatory hypertrophy of the detrusor muscle, ultrasound measurements of the detrusor thickness when the bladder contains at least 250 ml urine can be used as an additional variable in assessing the degree of obstruction. A detrusor wall thickness of †°Ã‚ ¥ 2 mm indicates a bladder outlet obstruction with 95% certainty (Dr. med. Matthias Oelke, 2013). Optional Examinations TRUS: Transrectal ultrasonography (TRUS) can determine the volume of the prostate more precisely than transabdominal volumetry, the methods differ by about 10%. Only TRUS can visualize and assess the zonal anatomy of the prostate (Dr. med. Matthias Oelke, 2013). Transrectal ultrasonography (TRUS) uses a rectal probe for assessing the prostate. TRUS is significantly the most accurate method for determining prostate volume. It can sometimes detect cancer (UrologyCare, 2012). Urodynamic studies and pressure flow studies.  With these procedures, a catheter is threaded through your urethra into your bladder. Water is slowly injected into your bladder. This allows doctor to measure bladder pressures and to determine how well your bladder muscles are working (MayoClinic, 2011). These should be used only if standard diagnostic tests have not been able to assess the degree of obstruction. (Dr. med. Matthias Oelke, 2013). Cystoscopy.  Also called urethrocystoscopy, may be performed in men diagnosed with BPH, particularly if they are surgical candidates or if other urinary tract problems are suspected (Chin Chong Min Urology Robotic Surgery Centre, 2013). This procedure allows your doctor to see inside your urethra and bladder. After you receive a local anesthetic, a lighted flexible telescope (cystoscope) is inserted into your urethra to look for signs of problems as shown in the Diagram 2.2.2A (MayoClinic, 2011). Intravenous pyelogram or CT urogram.  These tests can help detect urinary tract stones, tumors or blockages above the bladder. First, dye is injected into a vein, and X-rays or CT scans are taken of your kidneys, bladder and the tubes that connect your kidneys to your bladder (ureters). The dye helps outline the drainage systems of the kidneys (MayoClinic, 2011). Etiology of Benign Prostate Hyperplasia The actual cause of prostate enlargement is unknown.  However, most urologists agree that age is most definitely a factor in the development of an enlarged prostate (ProstateHealthGuide, 2012). Several theories have been proposed to explain benign cell growth in older men (University of Maryland Medical Center, 2009). Benign prostatic hyperplasia is probably a normal part of the aging process in men, caused by changes in hormone balance and in cell growth (Healthwise, 2012). Hormonal Changes Male Hormones.  Androgens (male hormones) most likely play a role in prostate growth. The most important androgen is  testosterone, which is produced in the testes throughout a mans lifetime. The prostate converts testosterone to a more powerful androgen,  dihydrotestosterone  (DHT). DHT stimulates cell growth in the tissue that lines the prostate gland (the glandular epithelium) and is the major cause of the rapid prostate enlargement that occurs between puberty and young adulthood. DHT is a prime suspect in prostate enlargement in later adulthood (University of Maryland Medical Center, 2009). Female Hormones.  The female hormone estrogen may also play a role in BPH. (Some estrogen is always present in men.) As men age, testosterone levels drop, and the proportion of estrogen increases, possibly triggering prostate growth (University of Maryland Medical Center, 2009). Late Activation of Cell Growth Another theory focuses on cells in a certain section of the gland that may become active late in life, signaling other prostate cells to replicate or causing them to be sensitive to growth-stimulating hormones (University of Maryland Medical Center, 2009). The incidence of Benign Prostate Hyperplasia Interest in alternative treatments for BPH increased after epidemiologic studies showed a lower incidence of BPH and prostate cancer in Asians compared with persons from Western countries.   The incidence of BPH is also low in vegetarian men. It is an interesting finding that BPH incidence is lower in Asian countries than in Western countries whereas Asian immigrants in the United States have the same incidence of clinical BPH as their white American counterparts. It is also to note that the lower incidence of clinical BPH of Asian men increases in immigrant generations after they have started to live in North America. One postulated explanation is the higher soy content of the typical Asian diet. Genistein, a major isoflavone ingredient of tofu, has been found to decrease the growth of hyperplastic prostate tissue in histoculture. Dietary factors are accused to explain this phenomenon since Asian people consume low-fat, high-fiber diets than Western people. In different series, it was shown that high energy and animal product diet increase the risk of BPH while fruit and vegetable based diet has a protective effect against BPH (Dr Praveen R, 2008). The incidence of BPH is 34.4 per 1,000 persons per year in the U.S. in men over age 55. The prevalence of lower urinary tract symptoms secondary to BPH in the U.S. population is 41% in black men and 34% in white men. The prevalence of BPH increases with age. Histologic BPH is present in approximately 8% of men aged 31 to 40, 50% of men aged 51 to 60, 70% of men aged 61 to 70, and 90% of men aged 81 to 90. Correspondingly, symptomatic (clinical) BPH is present in approximately 26% of men in the fifth decade of life, 33% of men in the sixth decade, 41% of men in the seventh decade, and 46% of men in the eighth decade of life and beyond (Elsevier, 2012). Mortality and Morbidity Benign prostatic hyperplasia (BPH) is a common problem among older men, and is responsible for considerable disability. However, it is an infrequent cause of death. According to the World Health Organization database, the mortality rates for most developed countries in the 1980s were 0.5 to 1.5/100,000. Death from BPH is rare in the United States. The large number of men with the symptoms of this disorder, the easy access to diagnostic tests, and the availability of drug therapy make it appropriate for the primary care provider to participate in the management of men with this disorder (Wolters Kluwer Health, 2012). BPH associated mortality is rare and serious complications are uncommon (Dr. Dan Van Syoc, 2010). Benign prostatic hyperplasia (BPH) is a common cause of morbidity among older men, (Annual Reviews, 2013) causing morbidity primarily through lower urinary tract symptoms (LUTS). The primary physician should attempt to distinguish LUTS due to BPH from the other causes of such symptoms, objectively determine symptom severity, and, when the symptoms are bothersome enough, work with the patient on a therapeutic approach to reducing symptoms while minimizing side effects (Lippincott Williams Wilkins, 2009). Surgery  consists of various approaches that resect or ablate prostate tissue.   While effective in expanding the urethral lumen and relieving symptoms, tissue resection or ablation also contributes to significant morbidity (NeoTract, 2011). However, because of the morbidity associated with the surgical treatment of this condition, alternative treatments are being developed and are coming into increasing use (National Health and Medical Research Council, 2011). Histopathology Microscopically, the prostate consists of glandular epithelium and fibromuscular stroma elements. Smooth muscle cells, fibroblasts and endothelial cells are in the stroma and the epithelial cells are secretory cells, basal cells and neuroendocrine cells (Diagram 2.6A) (Mark Frydenberg, Nathan Lawrentschuk, 2012). Both the glandular epithelial cells and the stromal cells (including muscular fibers) undergo hyperplasia in BPH. Most sources agree that of the two tissues, stromal hyperplasia predominates, but the exact ratio of the two is unclear (Wikipedia, 2013). The columnar secretory cells are tall with pale to clear cytoplasm. These cells stain positively with prostate specific antigen. Basal cells are less differentiated than secretory cells and so are devoid of secretory products such as prostate-specific antigen (PSA). Finally, neuroendocrine cells are irregularly distributed throughout ducts and acini, with a greater proportion in the ducts .The prostate has the greatest number of neuroendocrine cells of any of the genitourinary organs. Glands are structured with open and closed cell types with the open type facing the inside of the duct having a monitoring role over its contents. Most cells contain serotonin but other peptides present include somatostatin, calcitonin, gene-related peptides and katacalcin. The cells co-express PSA and prostatic acid phosphatase. Their function is unclear but it is speculated that these cells are involved with local regulation by paracrine release of peptides. Prostatic ducts and acini are distinguished by architectural pattern at low power magnification. The prostate becomes more complex with ducts and branching glands arranged in lobules and surrounded by stroma with advancing age (Mark Frydenberg, Nathan Lawrentschuk, 2012). Pathophysiology Prostatic enlargement depends on the potent androgen dihydrotestosterone (DHT). In the prostate gland, type II 5-alpha-reductase metabolizes circulating testosterone into DHT, which works locally, not systemically. DHT binds to androgen receptors in the cell nuclei, potentially resulting in BPH. In vitro studies have shown that large numbers of alpha-1-adrenergic receptors are located in the smooth muscle of the stroma and capsule of the prostate, as well as in the bladder neck. Stimulation of these receptors causes an increase in smooth-muscle tone, which can worsen LUTS. Conversely, blockade of these receptors (see Treatment and Management) can reversibly relax these muscles, with subsequent relief of LUTS. Microscopically, BPH is characterized as a hyperplastic process. The hyperplasia results in enlargement of the prostate that may restrict the flow of urine from the bladder, resulting in clinical manifestations of BPH. The prostate enlarges with age in a hormonally dependent manner. Therefore, castrated males (ie, who are unable to make testosterone) do not develop BPH. The traditional theory behind BPH is that, as the prostate enlarges, the surrounding capsule prevents it from radially expanding, potentially resulting in urethral compression. However, obstruction-induced bladder dysfunction contributes significantly to LUTS. The bladder wall becomes thickened, trabeculated, and irritable when it is forced to hypertrophy and increase its own contractile force. With the increased sensitivity (detrusor overactivity [DO]), even with small volumes of urine in the bladder, is believed to contribute to urinary frequency and LUTS. The bladder may gradually weaken and lose the ability to empty completely, leading to increased residual urine volume and, possibly, acute or chronic urinary retention. 25In the bladder, obstruction leads to smooth-muscle-cell hypertrophy. Biopsy specimens of trabeculated bladders demonstrate evidence of scarce smooth-muscle fibers with an increase in collagen. The collagen fibers limit compliance, leading to higher bladder pressures upon filling. In addition, their presence limits shortening of adjacent smooth muscle cells, leading to impaired emptying and the development of residual urine. Signs and Symptoms     When symptoms (known as lower urinary tract symptoms, or LUTS) occur, they may range from mild and barely noticeable to serious and disruptive. The amount of prostate enlargement not always related to the severity of the symptoms. Some men with only slight enlargement have serious symptoms, and some men with a great deal of enlargement have few symptoms (WebMD, 2010). The signs and symptoms of BPH (benign prostatic hyperplasia) can vary, but usually involve changes or problems with urination (eMedTV, September 2008). According to eMedTV, the following are the most common symptoms of benign prostatic hyperplasia. However, each individual may experience symptoms differently. Symptoms may include: Leaking or dribbling of urine More frequent urination, especially at night A strong or sudden urge to urinate Urine retention inability to urinate A hesitant, interrupted, weak stream of urine Trouble starting a urine stream or making more than a dribble Feeling that the bladder has not fully emptied Stopping and starting again several times while passing urine At their worst, common BPH symptoms can lead to severe symptoms such as: A weak bladder Backflow of urine causing bladder or kidney infections Complete block in the flow of urine Kidney failure. Symptoms can be quantitated by scores, such as the 7-question American Urological Association Symptom Score in Table 2.   As shown in Table 3, this score also allows doctors to monitor symptom progression from mild to severe. Sometimes these symptoms can reduce the quality of life to such a great extent that those affected build their daily routines around the condition. They avoid drinking or plan their errands around easy access to toilet facilities. If BPH is not treated, it holds considerable risks (Roehrborn CG, McConnell JD, et al. 2010).

The Concepts Of Knowledge And Happiness In Mary Shelleys Frankenstein

â€Å"Learn from me, if not by my precepts, at least by my example, how dangerous is the acquirement of knowledge, and how much happier that man is who believes his native town to be the world, than he who aspires to become greater than his nature will allow† (Shelley 60). In Mary Shelley’s Frankenstein, she expresses her beliefs regarding the danger of pursuing happiness through the attainment of knowledge, because true happiness is found in the emotional connections established between people. The pursuit of knowledge is not necessarily an evil thing, but it can cause destruction when it is pursued beyond natural limits. Victor Frankenstein becomes a slave to his passion for learning in more than one way; first his life is controlled by his obsession to create life, and later he becomes a slave to the monster he has created.   Ã‚  Ã‚  Ã‚  Ã‚  Frankenstein describes the beginning of his life as a happy time with his family. During his childhood, Frankenstein was passionate about learning, but his emotional connection with Elizabeth kept him from completely engrossing himself in his studies (Shelley 38). When Frankenstein left home to study at the university of Ingolstadt, he became intent on his quest to uncover the mystery of life. He tells of working in the laboratory until sunrise and being indifferent to the beauty of the world around him (Shelley 56-63). These changes in Frankenstein’s way of life represent Shelley’s belief that one’s passions must be controlled or the passions wi...

Social Problems Essay

The family is a social institution that has been underestimated and placed in a box for generations. In America, television and media has portrayed the â€Å"typical† family to be a Caucasian bread winning father, homemaker wife, and there 2 kids all living under one roof. But according to Eitzner’s book â€Å"Social Problems†, the actualization of how a family looks under one roof is based on economic conditions, and the typical family portrait never applied to immigrants and racial minorities because these people were denied equal opportunities to earn a family wage, and denied support of such grants as the GI Bill.Extended families as well as extended households grew in the light of immigration and socioeconomic reform. Now there is no longer a single culturally dominant family pattern. The idea of family has to be reconstituted frequently to relate to ever changing personal and occupational circumstances. Some of the social problems that the family institutio n is dealing with are gay marriages, multi-generational households, and teenage pregnancy. In this essay, I will briefly discuss each problem, but also I will develop a program for change.The collective variety of the family in the U. S. has led researchers to study if and how different family systems are linked with different groups of people who then may experience different results. Research has found that not all racial groups participate in each family type equally, thus not all family forms are equally available to all people Intellectuals have also found that each type of family (e. g. , married with kids, married with no kids, single-parent with young children, etc. ) is associated with different economic, child, and health outcomes.This may be a stereotype but researchers say that children who grow up with only one of their parents â€Å"are more likely to drop out of high school, to become teenage and single mothers, and to have trouble finding and keeping a steady job in young adulthood, even after adjusting for differences in parents' socioeconomic background (McLanahan & Sandefur, 1994). I will now discuss each of my topics further. Gay marriage is a hot topic right now in America because there are a lot of states deciding whether to legalize homosexual marriages.The debate over legalizing gay marriages is to do with religion; it's against everything that it says about marriage in the Bible. But it also goes against everything that we are familiar with when it comes to marriage (husband and bride). It is a hot debate as many already know, but, there are far worse things happening in the world today such as Catholic Priest molesting innocent children. The solution, in my opinion, is for gay people to be accorded all the civil rights and social benefits heterosexual people enjoy, without regard for popular sentiment or other people's religious beliefs.The decline of the traditional family nucleus should only prove that option was only for a few. I have to admit that I come from that type of nucleus. My dad worked and my mom stayed home with me and my sister. Times were very different in the 1970’s and 1980’s. The economy to day is teaching families how to adjust to new trends and new ways of living. We should appreciate the new forms of family and community that are occurring. Since the onset of the financial crisis there has been an increase in the number of multi-generational families.It’s the new normal. Younger adults live with their parents into their 30’s now and approximately 50 million Americans are in multigenerational households, that’s a 10% increase from 2007. Economic circumstances, as well as other cultural factors, have no doubt influenced families to start incorporating widowed grandparents, unemployed in-laws and adult children back into a common home. Life on life’s terms has incorporated the return of extended family formations. Another reason for extended families is the current epidemic of teenage pregnancies.And while the teenage mother is affected by the circumstance, this issue affects the entire family. Issues of trust, financial stress, and decision making are all factors involved. Some research suggests that women who have children at an early age are no worse off than similar women who wait to have children. According to this research, many of the disadvantages set up for young mothers are related to their own lack of everything during upbringing. This research suggests that it would be unwise to relate all of the problems faced by teen mothers to their youth.But the truth is that other research proves that teen mothers are less likely to finish high school, less likely to ever marry, and more likely to have additional children outside marriage. Thus, an early birth is not just a marker of preexisting problems but it may prove to be a barrier to successive upward mobility. I have seen success stories with teenage girls who choose to k eep their children. But even if married, these women face much higher rates of poverty and dependence on government assistance than those decide to wait.And early marriages are much more likely to end in divorce. So marriage, while it may be helpful in establishing the family nucleus that is so longed for in Western civilization, is no verified solution. Now I would like to discuss my idea on a program for change in the family. Social inequality will continue to exist without bold action. We need to empower families to take charge of their lives and shift perception of people to understand that families that come from an unconventional family nucleus are still valued citizens.Government, business, community, education are all sectors that can benefit from an improvement in circumstance of the institution of family. What is needed is a re-invigoration of the â€Å"family movement† to works towards building stronger, more inclusive communities. Remember that united we stand, an d divided we fall. One major setback for America is the division in every aspect, be it race, social class, gender. I don’t want to say I am a communist, but I do understand how a communist society may be the best to incorporate equality for all.

Mental Health Case Study

According to The Free Dictionary, mental illness is defined as, â€Å"Any of various psychiatric conditions, usually characterized by impairment of an individual's normal cognitive, emotional, or behavioral functioning, and caused by physiological or psychosocial factors â€Å"(The Free Dictionary, 2007). Mental illness can certainly be a physical illness, but is not as easily diagnosed like a disease such as diabetes. In a disease like diabetes, physicians can run tests to look for certain indicators of the disease in the blood like the levels of blood glucose and hemoglobin A1C. Sometimes physical conditions can cause mental illnesses. Unlike diseases like diabetes, mental health diagnoses’ often rely more on the patient relaying their symptoms to their physician or health care provider. This could not be as accurate because the patient may be unable to distinguish all of their symptoms or they may not think to tell the health care provider every symptom that they are suffering. According to John Grohol PsyD, â€Å"Treating mental illness rarely results in a â€Å"cure,† per se. What it does result in is a person feeling better, getting better, and eventually no longer needing treatment (in most cases). But even then, rarely will a professional say, â€Å"Yes, you’re cured of your depression. †Ã¢â‚¬ (Grohol PsyD, 2009). The deinstitutionalization of the mentally ill began with the introduction of the use of psychotropic drugs for mental health treatment in the 1950’s. It was embraced as a way of saving money because the patients would be able to be treated on an outpatient basis and in theory also be able to function in the world while on medications. This has not been as successful of a plan as originally intended. Crystal Riberio makes this point by stating, â€Å"The programs thought to replace care given in institutions were not nearly adequate. These programs, attempts to place the mentally ill back in society to be helped by the community members, day programs, and medications were not fully implemented to the full extent needed to replace institutions. This process led to an overwhelming number of mentally ill loose in society, becoming criminals due to lack of treatment† (Riberio, 2006). It is important to acknowledge that mental health services are often administered by a patient’s primary care physician. The patient may make tell their primary physician about problems that they are suffering from in order to seek help there first. The primary physician can prescribe anti-depressants for a patient that is suffering from anxiety or depression. They can also run tests to make sure a problem is not organic in nature versus purely mental. If mental health and physical health care are kept separate, a physician could miss a medical diagnoses that could be causing a mental problem. Some of the services that could be needed for the mentally ill are safe places for them to stay that will help protect mentally ill people from themselves if they are that unstable. There is also a need for therapy to help patients learn about their illnesses and how to cope with it. Managed Healthcare poses more challenges to the treatment of mental illness because they often impose more hoops to jump through in order for the patient to get approved coverage. Managed care organizations reduce health care costs of mental health treatments by imposing limits on the amount of care a person can receive. They may also cover the treatments at a lower percentage, making the patient liable for a larger portion of the cost of care. In order to determine what kind of facility a mentally ill person should go to, one would have to be evaluated by a mental health professional. If the person is a danger to themselves or others, it would probably be best to have them admitted to a psychiatric hospital. If they are simply depressed, they may be able to be treated with medicine and therapy. ? References The Free Dictionary . (2007). Medical Dictionary. Retrieved from http://medical-dictionary. thefreedictionary. com/mental+illness Grohol PsyD, J. M. (2009). Psych Central. Pysch Central. Retrieved from http://psychcentral. com/blog/archives/2009/05/22/how-do-you-cure-mental-illness/ Riberio, C. (2006). Deinstitutionalization of the Mentally Ill. Associated Content. Retrieved from http://www. associatedcontent. com/article/47201/deinstitutionalization_of_the_mentally_pg2. html? cat=17