Sociology

Forgive and Remember Managing Medical Failure 2nd Edition

An Introduction to Ensuing Discussion
In this study, I intend to devote myself to discussing the medical profession and various related aspects. However, my discussion would not be a lay persons reference to the hallowed medical profession instead, it would be a considered reflection on what two of the best minds in the field have researched, cogitated and written upon, viz. Charles L. Bosk and Talcott Parsons.

The major topics that I shall discuss in the ensuing paragraphs pertain to the peculiar significance of the medical profession to the well-being of society, the growing specialization of medical knowledge and competence, the power that the medical community enjoys in society, the dominant type of the doctor-patient bond, the vulnerability of the patient to the doctors errors, the inevitability of errors in the medical profession as in any other branch of human endeavor, and other associated matters.

Types of Medical Errors Prevalent  
The prevalence of errors in the medical profession is a fact, as it is with any other area of human endeavor. Bosk classifies the medical errors into four categories. According to Bosk, errors could variously be technical, judgmental, normative and quasi-normative.

Judgmental errors or technical errors pertained to the occupational hazard of medical diagnosis going slightly off the mark, or a relatively inefficient prescription. Bosk appears to maintain that errors of a judgmental or technical nature, which are usually admitted, ought to be excused, whereas lapses of a graver normative or quasi-normative variety should be fundamentally abhorrent, unforgivable, and intolerable. Normative errors referred to mistakes wherein a surgeon may be deemed to be guilty of having failed to discharge her solemn duties in a moral, responsible and conscientious manner.

Within the medical field, it seems surgeons are more vulnerable to their errors getting pointed out because they are discernible almost instantly. It would take a doctor more knowledgeable and competent than the one to fault his prescription, but the surgeons error is obvious to even the untutored eye.

Bosks book ought to be of interest to readers beyond the pigeonholes of surgery or medical sociology. The issues of moral discharge of duties in life-saving -- or conversely,  life-imperiling  medical situations, of coordinated teamwork by the subordinates, and of an honest and objective evaluations of the role of everyone involved, cut across disciplines to be of interest to the lay reader as well.

Parsonss Worldview Remains Immensely Relevant
The surgical world can be better understood as a social system in the light of Parsons description of what constitutes a social system (Parsons, The Social System, pp. 1-14, 1951). A social system has a structure and the actors engage in activities that have a meaning in relation to one another. Hence, it is the relational aspect of actions that proves more significant than what the structure consists of per se. The actors in such a system develop their system of expectations that are relative to the various other actors and objects in the situation. Several elements in the situation gradually acquire especial meaning and significance to the various actors for their associated symbolic or indicative values.          

The system of expectations that an actor in a social system harbors motivates the actor to perform actions. Action is usually in response to a stimulus, is governed by the desire for gratification and the fear of deprivation. Besides, there is a definite value-orientation to the actors motivations and actions. Parsons discusses the normative aspect in the actors role-playing at length. He discusses how the evolved culture within a system can be variously transmitted, shared and learned. Bosks analysis of the surgeons role in society and of their normative, cooperative and goal-oriented functioning vividly illustrates just such an integrated and dynamic social system at work.

Parsons Discusses Medical Issues Aptly

Parsons has specifically dealt with the medical profession as a social system (Parsons, The Social System, pp. 288-322, 1951) and his words appear highly insightful and relevant, in the context of the issues of morality, competence and confession that Bosk discusses.

Parsons begins his discussion on the medical system by stressing the importance of the health of the actors, and of freedom from too high an incidence of disease in any system, as being pre-requisites for its effective functioning. Parsons continues his discussion by referring to the preventive role in medicine, beyond its more typical therapeutic aspect. It seems logical that in any system, there can be remedial and deterrent measures, For instance, even with regard to law and order and the crime situation, there is the reaction of arrest and punishment, as well as measures to help prevent the occurrence of crime altogether. A similar preemptive role of medicine perhaps would serve everyone better.

Parsons is aware that the medical profession is a caring profession. However, he observes that the requirements of technical and specialized competence might render the doctor  or surgeon, if we would rather  less than an expert in other areas of competence. The physician is not, by virtue of his modern role, a generalized wise man or sage  though there is considerable folklore to that effect  but a specialist whose superiority to his fellows is confined to the specific sphere of his technical training and experience.  (Parsons, The Social System, p. 292, 1951)

The Custodial Doctor-Patient Relationship
Parsons also discusses the doctor-patient relationship at great length. While discussing other professions and activities, Parsons emphasizes that a person who is ill and in need of treatment is ignorant of the cause of his condition, utterly helpless to improve his lot on his own, and remains unsure of the chances or speed of his recovery.

To the ailing, the doctor appears as the life-saver who is equipped with the specialized, technical knowledge to unravel the disease, as well as the competence to effect its cure. There has been growing specialization in almost every branch of knowledge, including medical science. The medical profession, therefore, is marked by a higher degree of specialization today than ever before.

The greater degree of specialization that doctors manifest these days has a corresponding influence on both the medical profession as well as the doctor-patient relationship. Specialized, professional bodies tend to form an elite club in society that remains devoted and loyal to its members and interests. Doctors have become a powerful lobby today in society.
   
The power that a doctor seems to have for the patient cannot be adequately described. A sick person is apparently at the mercy of how the doctor may heal her back to health, and even snatch a person from the very jaws of death by timely and precise remedies. There is the concomitant risk of the doctor causing exacerbation of a disease or leading to a patients death through negligence or other errors.          
Parsons also reflects on how private practice is getting offset by organizational roles in the medical profession. This demarcates the doctors role from that of the professional who seeks immediate compensation for her services rendered. Parsons discusses the values by which a doctor works in a hospital and the nature of his ethical responsibilities and duties towards a patient in his care. The doctors salary may be independent of how he treats a particular case, but the normative pattern that governs a hospital as a social system inspire him to do his best.

Has the world of doctors and surgeons changed dramatically in recent years or decades It would be difficult to make a well-informed and authoritative assertion on the subject, but the doctor or surgeon today perhaps remains as godlike as ever, attending to lesser mortals in helpless conditions.

The rigid hierarchy in the medical and surgical apparently cannot be replaced altogether, but there is a greater awareness of the issues of moral and responsible choices, the possibility of errors of both the normative or execution nature, and of individual confession and accountability.

By Way of a Conclusion
Both Bosk and Parsons focus on the medical profession. Bosk brings to bear on the subject perceptions and insights drawn from his own experiences and research. Both the writers agree that as a professional community, the doctors are powerful, since they represent the first as well as the last sanction in their area of competence. To reword, a doctor remains both the first appeal and the last resort to a patient. The peculiar nature of a sick persons vulnerability and dependence on the doctors specialized knowledge and efficiency make for a doctor-patient relationship in which the former is by far the dominant partner. Both Bosk and Parsons are concerned with matters of competence, values and accountability in the relation between the doctor  surgeon and the patient. These issues remain of universal and continuing interest and relevance to society.  

Female genital mutilation (FGM) is a pervasive practice that is performed in many African countries and in parts of Middle East and Asia. It involves the deliberate removal of the female genitalia either wholly or in part. Recognized worldwide as a violation of human rights, FGM is usually performed on young females who are less than 15 years old (WHO, 2009 IRIN 2005a IRIN 2005b).  In a bid to better understand the motivations and effects of this practice and how it can be eliminated, this paper uses discourse analysis to analyze an interview which was conducted with Faiza Mohammed, the Director of a non-governmental organization known as Equality Now on female genital mutilation (FGM). An interview with Kenyan men who favour FGM is also analyzed side by side.

The interviews were conducted by the Integrated Regional Information Networks (IRIN) which is a news agency that is sponsored by the UN Office for the Coordination of Humanitarian Affairs (OCHA). In the interviews, the cultural and religious contexts of the practice are explored as are its acceptability to society and the steps taken to eliminate it. The role of the government and other players in the elimination of FGM and the factors that make the practise to be widely practised in some societies are also discussed.

Research question
The following research question guided this study what are the causes of FGM and how can the practice be eliminated

Data collection methods
As indicated earlier, the data for this study was derived from open-ended interviews that were carried out by IRIN. The interviews were accessed by searching the internet using the Google search engine. To locate the data, a combination of key words including FGM and interview on FGM were queried using the search engine. Hits with the most relevant output were assessed and the IRIN text selected as the most ideal for this study. The data used is an example of secondary data as it is historical in nature and was collected by a person other than the original interviewer. Secondary data was preferred for this study as it is easier to collect and is comparatively inexpensive and less time consuming.

Analysis section
The selected text was analyzed using discourse analysis. Discourse analysis is a subjective and rhetorical technique whose main focus is on social problems. The discourse analysis method makes use of textual analysis and critical thinking in order to identify underlying and less obvious themes inherent in a particular text (Fairclough, 2003 Fairclough and Wodak, 1997 271-80 MacLure, 2003 Potter, 2003).

A critical discourse analysis of the IRIN text reveals that FGM is entrenched in many African societies due to several factors. These factors are many and varied and most have to do with the way in which society views women and their role. In these societies, FGM is perpetuated because it aids in virginity control, ensuring that females get married while they are still virgins. The practice is also used to reduce womens libido thus helping to make them less promiscuous and more faithful to their husbands (IRIN, 2005a IRIN 2005b).

These 2 drivers of FGM reveal the patriarchal nature of the societies where the practice is rampant. In such societies, sex before marriage, at least for the women, is taboo and society will do anything, the inherent dangers notwithstanding, just to keep women subjugated to the man. Traditions are also another driver of the practice and here those who practice FGM have a blind and unquestioning loyalty to their culture. The practice also persists because of the many misconceptions people have about its benefits. For instance, some societies believe that it is essential for the growth of the child. Additionally, government inaction and weak legislation have made FGM continue to be practised (IRIN 2005a, IRIN 2005b).

A very important reason as to why FGM is still popular in many societies has to do with conformity or the need to fit in the society. In such societies, uncircumcised girls are often ostracised, treated with disdain and looked down on by the society and thus have little option but to consent to undergo FGM. Incorrect interpretation of religion is also a factor behind FGM. For instance, in Somalia where the practice is rife, FGM is usually administered by religious groups and people believe that it is a core part of Hadith. Besides, FGM enables women to get married as uncircumcised women cannot get married in some communities (IRIN 2005a, IRIN 2005b).

While the practice has been vilified as outdated and inhumane, it may be that it helps to keep sanity in the society. To illustrate this point, many young girls are subjected to infibulation, a form of FGM which narrows the vaginal opening and makes it impossible for them to engage in sex. Their normal sexual function is then restored once they get married. This has helped reduce the incidences of teen pregnancies in these societies. It may also be that the caseload of sexually transmitted illnesses and divorce rates in societies such as these are comparatively lower. In summary, the pleasure of the women can be forfeited for the greater good of society (WHO, 2009).

This notion however betrays the perception that is prevalent in such societies about the mental abilities of women and their capacity to make rational choices. Apparently, young girls cannot be educated on sexual matters and must necessarily be subjected to FGM as an inhibition of their current and future sexual desires. This is indeed confirmed by the belief that FGM is intricately intertwined with the initiation of girls into womanhood. As stated by some of the respondents, it is impossible to separate FGM from initiation. Kenyas founding President who was also an avowed defender of FGM said it is impossible for a member of the tribe to imagine an initiation without clitoridectomy (IRIN 2005b). In other words, education without FGM cannot help mould a girl into the ideal woman. This is an evidently false supposition. Besides being a false supposition, it is inherently problematic, it has a less costly alternative and it needs to be ended.

It is problematic because young girls can be brought up to have sound moral virtues. A sound upbringing and education, rather than FGM, are the less costly alternatives. The words of the Kenyan President were spoken 71 years ago and they certainly do not represent the current thinking. It needs to be ended because it violates the rights of women, it endangers the health of women as it is of no medical value, it is very painful, and it can lead to many complications and difficulties in childbirth (IRIN, 2005b). Thus, the practice cannot be perpetuated by the false premise that it is an effective aid in fostering social cohesion.

The African Union (AU) has formulated an anti-FGM protocol which requires member states to outlaw the practice. Half of the countries where the practice is rampant do not however have such laws. Even though many African countries have legislated laws which ban FGM, the practice still persists in many of those countries. In many other countries such as Kenya, such laws have supposedly only succeeded in driving the practice underground and contributed to a drop in the age of girls eligible for FGM. However, it is difficult to say whether the respondents are accurate on this matter. This is because the IRIN text states, for instance, that the prevalence rate in the North Eastern Province of Kenya is 99 and about 4 in the western region of Kenya. This statement tells us nothing, for prevalence is a measure which describes a particular situation at a particular point in time. Use of the incidence rate would have been better as it would have given us more information such as the trends and distribution. Even if 99 of the population in the north-eastern area practice FGM, the ethnic groups which are resident there form less than 2 of the countrys population (IRIN 2005a, IRIN 2005b).

Besides, they state that many people in Kenya are against FGM but in the same breath state that many people perform the act (IRIN 2005a, IRIN 2005b). This is an inherent contradiction. Therefore, the argument that FGM is still widely practiced despite the enactment of anti-FGM laws needs to be further investigated so that it can be bolstered with more compelling facts. On the face of it however, it seems logical to conclude that no nation can legislate against the beliefs of its people and any such legislation is bound to meet with failure.

A more logical approach towards eliminating the practice would be to change the beliefs of these people through indoctrination and education. This is the path which non governmental organizations (NGOs) have taken. According to the respondents, civic education has not succeeded because these NGOs do not have sufficient resources to reach many people. The government, which has a much wider reach and more vast resources, has been accused of disinterest in eliminating the practice. To prove this point, one respondent cites countries such as Burkina Faso where there has been a dramatic decline in the practice as a result of the governments active role. The threats of prosecution, enforcement of these laws, follow up and education has reportedly led to an over 90 reduction in FGM activities. In other countries such as Tanzania, there is little fear of prosecution, there is no follow up, and there is no enforcement. Local authorities are disinterested or unwilling to act (IRIN 2005a, IRIN 2005b).

However, the Burkina Faso example is inherently problematic and hard to accept because it is also based on prevalence data, not incidence. Moreover, the respondent admits that the government has instilled fear in the people and this has nearly eliminated the practice. She says that
 They established a hotline where people can alert the authorities of an initiation happening. If you dont report it and are then found guilty of knowing of an initiation, then you are liable to go to jail, even though you didnt participate in the act. So this has created fear within the communities (IRIN, 2005 p.3).

However, it may be that due to this fear, many people in the country engaging in FGM were unable to admit it to the people who carried out the prevalence study. We are not told of how many credible calls were placed on the government hotline and what the outcomes were. We are not told, in quantitative terms, the impact of the radio messages on FGM. Only unsubstantiated claims are made. What is evident also is that this example cannot be generalized and conclusions made since each society is different and what works in one may not work in another (IRIN 2005a, IRIN 2005b).
In any case, the inability of NGOs to eliminate the practice through education cannot entirely be due to insufficient resources. Even with inadequate resources, these NGOs could have attained some success at, say, village level or at small local administrative units where not very much in terms of resources is needed. We dont see any of this in the text. The Tanzanian example illustrates the difficulty faced by African countries to enforce such laws (IRIN 2005a, IRIN 2005b). In many of these countries, the police force is seriously understaffed and ill-equipped and crime levels are very high. To expect them to follow up on cases of FGM is to expect too much. It is just not possible.

The text is peppered with the liberal use of subjective terms to drive home the authors point of view. For instance, the first respondent says that people are very aware of FGM. If it is true that they are very aware about FGM and that they often debate and hold educated discourse about it, why is there need for massive awareness campaigns It also asserts that the majority of Kenyan women are subjected to FGM, but go on to say that 32  of Kenyan women have undergone FGM (IRIN 2005a, IRIN 2005b). Thirty two percent cannot be a majority.

It can be concluded that the sole cause of FGM is economic and all the other reasons are secondary or mere excuses. As explained before, a key motivator for the practice is the need to keep women as virgins so that they can get married or reduce their sexual urges so that they can refrain from adultery and stay married. This is in the economic interests of the girls and their parents. Parents like to marry off their daughters because they will benefit from the dowry and the dowry will help them meet their everyday needs. A cursory look at the countries mentioned as practising FGM (Somalia, Burkina Faso, Ethiopia, and Kenya) also reveals that they are among the poorest countries in the world (Schwab, 2009).

Additionally, FGM is rarely practised in regions where urbanization has taken root and this may be due to the engagement of the citizenry in gainful productive activities. Therefore, the mere enactment of laws cannot eliminate the practice nor can education of the people. Threats of prosecution and enforcement are equally ineffective. The solution to this problem is economic, getting the people to acquire useful skills, formulating policies that would eliminate poverty and spur economic growth, and establishing industries and other productive ventures.

Reflexivity section
Both personal and epistemological reflexivity are presented in this section.

Personal reflexivity
The study was affected in a major way by my beliefs, political commitments and goals in life. I strongly believe in the equality of the sexes, in the right to self-determination, and I abhor sexual violence and raw paternalism. Whereas I also believe strongly that the right of people to religion should be jealously protected, this did little to make me view FGM positively. Similarly, my beliefs about the sanctity of marriage and the right of anyone to practise his or her culture did not affect my antipathy towards FGM. All these contributed in making me view FGM in a negative way and thus view it as a social problem that needs to be resolved. It did not however make me view those who practice FGM as inherently wrong or as lesser beings, but as people who need to be helped.

As a person, this research has shaped my views about FGM and cultural practices as a whole. Whereas previously I would condemn wholesale those who practice acts such as FGM, I now understand that they need to be understood first before any solution can be reached and these solutions must not be imposed on them for they wont work. The research has made me more objective as a person and more accommodating and this conforms to the work of Dickson-Swift, James, Kippen  Liamputtong (2009).

As a researcher, this study has sharpened my critical analysis skills and taught me not to accept any text at face value but to interrogate the contents and see whether the conclusions can hold (Fairclough and Wodak, 1997 271-80 MacLure, 2003 Potter, 2003). The study also revealed to me that one cannot afford to be cold and be driven by hard facts only but that one also needs to look at the study subjects as people first (Dickson-Swift, James, Kippen  Liamputtong, 2009 Liamputtong, 2007). In other words, one can remain objective but still look at the study subjects as real people living in a real world

Epistemological reflexivity
Regarding the definition of the research question, it sought to obtain a rational explanation of the causes of FGM and the specific steps that can be taken to eliminate it. The research question limited the study only to the causes of FGM and workable solutions. The merits, demerits, current status, and other relevant issues were not analyzed as they had little bearing on the research question. The chosen analysis method deconstructed the text in order to come up with the solution to the problem of FGM. This was done by interrogating the facts used to back the ideas in the text, rejecting the baseless ones and coming up with more rational ideas.

The research question could have been investigated differently using the Straussian grounded theory method where the key ideas are coded, concepts discovered and categories identified (Strauss  Corbin, 1998). Other methods that could have been used to answer the question include the Delphi study, focus studies, and phenomenological studies. In Delphi studies, experts on FGM could have been surveyed while in phenomenological studies, primary data could have been collected from victims who have had a first hand experience of FGM (Wilson, 2000). Quantitative studies in which variables are defined, hypotheses formulated and tested could also have been employed (Zikmund, 2003 Creswell, 2001).

The grounded theory method could have led to less subjective outcomes because the outcomes are entirely depended on the collected data and no pre-conceived hypotheses are formulated (Wiersma, 1986 Tuckmann, 1999 Nurani, 2008).  The Delphi study would have led to more academic solutions (Strauss  Corbin, 1998 Glaser  Strauss 1967). The phenomenological study would have been appropriate as it would have given outcomes based on the points of view of the victims while the quantitative study would have established correlation between the defined variables (Wilson, 2002 Zikmund, 2000 Liamputtong, 2007). The main assumption made in this study was that the text from IRIN was without blemishes and that it was an accurate representation of the interviews reported therein (Willig, 2008).

It has always been a mystery how groups of people behave, and how groups of people share a distinct similarity or sets of similarities when it comes to behaviors, or how the behaviors of groups of individuals contrast with one another. The explanation of particular behavior has been key in enabling professionals to understand better how people inside a group thinks, feels, behaves how they rationalize from right and wrong and what are the determining factors for such analysis and what are the roles that particular beliefs accomplish, what they are expected to result from as a consequence of the exercise and observation of such belief. One of the many different important and strongly significant characteristics of the social life is marriage. The selection of who to marry has been a complex practice. Often, there are too many complications that are involved with marriage. There are social pressures, the social role and function of marriage and the role and function of individual participating in it, and more importantly, the outcome. In the past, marriage is as much a personal decision as it is socio-political responsibility for a greater good. It was often centered on the society as benefiting from such roles of marriages and the participation of individuals in such arrangement and in the consideration of marriage. One of the prominent issues is whether to marry ones own kin or to marry from another bloodline. This resulted to the concept of incest, and how incest has been taboo or forbidden to some cultures, while in others it is something that has been socially accepted. One of the professionals who addressed the issue of incest is Claude Levi-Strauss, particularly in his explanation on kinship and the role of incest in this structure. Levi-Strauss ideas especially on kinship and incest has been an invaluable contribution to the knowledge available in addressing the arguments regarding incest and kinship. The thrust and focus of the discussion of the paper is focused on discussing and analyzing how Levi-Strauss explained incest in his kinship theory and other related and pertinent concepts.

Discussion
Many professional analysts relied on the idea and assumptions of Levi-Strauss regarding kinship and incest. They used Levi-Strauss ideas and explanations to simplify the concept of incest as it is explained in the kinship theory. For example, Ino Rossi, in the book The Logic of Culture advances in structural theory and methods noted how Louis Dumont explains the phenomenon inside the society consistent to the kinship theory that kinship is built in relation to understanding. The practice of incest through the fact that social groups efforts at building relationship with one another and establishing broader and wider kinship is achieved through the use of the concept of incest as taboo. By forbidding incest, the social groups discourage endogamy or inbreeding. This means people who are related to one another by blood inside the group cannot marry one another. Thus, the woman and the man have to marry those from outside the group which is then used as a tool to broaden and strengthen ties among groups. Louis Dumont summarizes Levi-Strauss theory as follows as exogamy prohibits incest among groups, so incest prohibition forbids relations among individuals (Rossi 1982, p. 45). Other individuals, like Robin Fox, explain that kinship is based on concepts including incest. According to him, the concept of incest clarifies a particular characteristic of kinship and that is this - people belonging to or sharing a similar kinship with one another through bloodlines should not marry one another (Meillassoux 1981, p. 11). Others presented ideas and postulates about kinship and its details based on their own reaction or interpretation of concepts and ideas that are nonetheless strongly affected by the kinship concept of Levi-Strauss. These are found in their own published works acting as relevant information source for this particular topic (Malinowski 2001, p. 186).

Claude Levi-Strauss
Claude-Levi Strauss is a world renowned specialist. Through his career, he has devoted his intelligence into developing ideas and theories that can help explain some of the important and significant social characteristics found in the society. One of the important contributions of Levi-Strauss is his explanation regarding kinship. In this paper, the focus of the discussion is about a particular detail in the idea of kinship as it is presented by Levi-Strauss that is, incest and how this figures prominently in the overall structure of kinship as it is exercised by individuals inside a group in the society.

Levi-Strauss, a renowned structuralist and is one of the pillars of structuralist thought in the modern era, approaches the idea of incest in a structuralist perspective. For example, Levi-Strauss believes that structural perspective can be used to explain a particular characteristic of incest - its being innately taboo in many different social groups despite the fact that there are no contact among these groups that can be the explanation for the transfer of such thought and behavior. It was as if they all had the same consciousness that incest should be taboo and kinship should survive not just on the dependence on blood relations but also on the consciousness on how these blood relations can be preserved and strengthened (Rossi 1982, p. 9). Levi-Strauss claims that only through structural perspective can one explain why the incest taboo is universal (Rossi 1982, p. 9).

Levi-Strauss works
Levi-Strauss works are often the important hinge of his ideas inside which his ideas are presented. One of the sources of his ideas that tackles and tries to explain the concept of incest in the structure of the kinship theory is found in the Tristes Tropiques as well as in his 1949 work The Elementary Structures of Kinship. Rossi explains that this work is used to answer the question of the sources and validity of Levi-Strauss orientation (1982, p. 9). It was in this particular work that Levi-Strauss explains how his ideas - influenced by individuals Lev-Strauss considers as his masters like Sigmund Freud and Saussure - are structured. The Elementary Structure of Kinship, also known as Les Structures elementaires de la parente and was intended to be an introduction to a general theory of kinship systems based on how Levi-Strauss saw it, was a seminal work on kinship and explained the role of taboo incest, with focus also on the role not just of kinship per se and incest per se, but also of language. Levi-Strauss The Elementary Structures of Kinship...dealt with a typically anthropological subject - marriage and descent - but in a typically semiological fashion, through the attempt to construct a grammar of kinship.

In these works, Levi-Strauss hoped to explain why the phenomenon existed as they did. According to him, one of the reasons for the spread of such characteristic of kinship (including the aspect of incest inside the kinship and the similar role it played in many societies) is because of the role and influence of linguistics and semiotics.

The influence of linguistics on the method of Levi-Strauss kinship analysis has been too greatly over interpreted or too easily dismissed. Yet, Levi-Strauss claims that the revolution of the semiotic approach was made possible precisely by structural linguistics... Levi Strauss begins his kinship
analysis from a long established insight of structural linguistics.

This idea was supported by other professionals and analysts that studied Levi-Strauss works (Parkin, Stone, p 125). It is important to note that as what Levi-Strauss stressed through his work and through his focus on kinship and the understanding of the systems, beliefs, practices and ideas involved in it, kinship is important in the study of anthropology, defining the role as crucial. Because kinship is crucial, its aspects, including the concept of incest and how it affects kinship, are also important and significant. Levi-Strauss, through his works and his ideas in incest and kinship and his theories about it, helped the people understand things better considering the fact that Levi-Strauss saw that traditional approaches to kinship lacked a secure theoretical foundation.

Incest
According to Levi-Strauss, every cultural practice around the world features in one way or another a means by which the selection of who to marry has limitations inclined at limiting the selection outside of those close in kin to the individual. Although there maybe variations, this practice is nonetheless observed by many different cultures. The prohibition against incest was a universal cultural phenomenon. In many parts of the world and among many groups of people, incest has been one of the social issues that have been approached in ways polar to one another. There are groups that encourage incest and consider incest as something that is not problematic, while there are groups who consider incest as a taboo. If incest is taken to mean copulation between offspring of the same genitors, or between genitors and their offspring, we know that such relations are practised and sometimes institutionalized in a certain number of societies.

Over time, there have been many reasons why incest has become taboo. There are moral, ethical, religious and socio-political concerns. Over time and as a result of endless practice among groups of people, the concept has been strengthened and has persisted strongly until today. Often, incest inside the concept of kinship is often considered as taboo. Many groups of people believe that marriage of two individuals should not be characterized by a couple that is related by blood to one another. Incest has been one of the issues tackled by many different professionals in the many different fields. Incest has also been an integral part of many ideas and school of thoughts.

In the more contemporary era, incest and the explanation on how incest is being received by the people is tackled in the kinship theory and related ideas as presented by Claude Levi-Strauss. The role of incest and the start of the consciousness towards the prohibition of incest are important in the concept of kinship theory. Kinship is dependent on the ability of the individual to socialize and to form the social aspect and capability of the individual inside a group or society. According to Turner, the ability to be social among people began once they started the move to prohibit incest. The prohibition of incest is the commencement of the social. Incest and how it should be a taboo was something that analysts like Philip Daniel Smith has considered as superseding the significance of kinship rules itself. The author explained that even more fundamental than kinship rules was the incest taboo, a universal prohibition which Levi-Strauss saw as being the point of origin for cultural life.

Incest as prohibition
One of the important characteristics of incest as it is being explained by Levi-Strauss through his kinship theory is the role of incest as a form of prohibition. Often, incest is highlighted based on its role as a prohibitive agent that stops the practice of inbreeding and encourages out breeding, and how this practice is connected to the establishment of the relationship of people with one another and the creation and sustenance of kinship inside and outside a particular society and group of people over a period of time. To be able to understand the relevance and significance of incest and its prohibitive characteristic and its significance, one must first be able to understand and comprehend the fact that the people in the earlier times relied heavily on the practice of exchanging things. Without the practice of exchanging with one another things that previously did not belong or was connected to them, professionals believed that the relationship among people and groups of people would break down and would not last and sustain itself. This is not to consider the fact that the urge to exchange was not merely a socially directed behavior but was also motivated by what many considers as the nature and primitive instinct of the individual, strengthening all the more the practice of trading and exchanging.
Where does incest fit into this Kinship is secured by the maintenance of the practices among humans, like the practice of exchanging things. For many observers, this practice also includes the exchanging of women among groups of people for marriage. This was something that was beneficial to them, and at the same time affected kinship positively. Because of this, incest, or marriage inside ones own group was prohibited so that the practice of exchanging women continue and persist, in the process, allowing the continuation as well of the kinship among people. Many people, including Levi-Strauss as well as other professionals were cognizant about it (Turner 2000, p. 166). Marcel Mauss, in The Gift, demonstrated that reciprocity is of great importance in primitive societies that the exchange of gifts in such societies is at the heart of the process of the maintenance of the social structures, and as such has much more than economic significance.

This idea was supported by Levi-Strauss. Levi-Strauss believes that the people are very particular with the aspect of exchange practice between people. Levi-Strauss also believes that selecting the partner in marriage is just one human experience and phenomena inside which this practice of exchange can also be exercised and expressed. This necessity made it imperative that incest becomes a taboo so that it will fit in the kinship system in the society. He argued that the taboo against incest was an expression of the fundamental cultural necessity for exchange to take place between groups.

Levi-Strauss, incest and the kinship theory
A significant contributor to the ideas in anthropology and a strong supporter of the structuralist and functionalist beliefs to which it has greatly contributed to, Levi-Strauss used as the basis of kinship theory. This is something that is difficult to understand for the ordinary individual without competent and necessary skills, how incest has stopped the practice of endogamy and has strengthened the practice of exogamy. In return, it allows the concept of the exchange of women, and thus, strengthened, broadened and widened the kinship of individuals and groups of people inside the different societies. This was explained in books addressing this particular issue, like Claude Meillassouxs Maidens, meal and money capitalism and the domestic community. The author explains that it is explicitly assumed, both by functionalists and structuralists, that the universal prohibition of incest is the primary cause of exogamy and the exchange of women, therefore accepted as the basis of kinship theory. The author also added that Levi-Strauss assumes that the incest prohibition is both rooted in natural or innate tendencies as well as sociological underpinnings.

Levi-Strauss explained the concept of incest in his kinship theory by presenting the idea of incest as something that is used by the people as a way or means for the group to be strengthened, enforced and to be broader and wider. Incest, according to Levi-Strauss is taboo, forces people to look for other partners outside the small social group.

If one cannot marry his own siblings or relatives, he has to find a marriage partner from outside his group. It is clear, then, that the essence of kinship relations cannot reside in the biological fact of consanguinity or descent, but only in consciousness as it entails an arbitrary system of representations.

As a result, the kinship of one group extends to another group. The new connection by marriage of one individual to the other group besides his or her own consequently gives the individuals old group a new ally to which the individual can rely on as well.

For example, Man A cannot marry inside his tribe (Tribe A) because incest here is taboo and the available women in Tribe A are all related by blood to Man A. Man A is thus constrained to look for a partner among the women in Tribe B, since the women there are not related to him by blood. Upon marriage of Man A and Woman B, the couple will be related and connected to both Tribe A and Tribe B, and more importantly, Tribe A and Tribe B will now have a connection, a bridge that connects the two tribes together. This is often a good reason and start for them to be in alliance or partner groups that interact well in commerce and support each other not just in peacetime activity but also in war. Because of the partnership and the marriage to an individual from another family, kinship extends outside wider and is not constricted inside one family. The set of relatives becomes broader and wider, which guarantees the extension of the bloodline and the establishment of the network of individuals related to one another not just by blood or consanguinity but also because of alliance forged by marriage.

This concept has been strongly exercised in many countries, in many groups of people (tribes, kingdoms, clans) for a long period of time. For example, kings sought to establish a strong political base and foundation for his bloodline by having his son or daughter married to the son or daughter of the king of another country or kingdom. It discourages incest because in incest, people know that the bloodline is in danger of decreasing and consuming itself and can contribute to the weakening and decreasing kinship with the bigger, broader group of people.

Conclusion
Today, Levi-Strauss and his works are still strongly used, for their merit and for the insight that it brings to the table. Levi-Strauss has provided the world a particular way of viewing and understanding a particular trait, behavior and perspective of the people. Today, it is easy for the ordinary individual to assume that incest is taboo or forbidden because it is immoral, unethical and is against customary and traditional beliefs as dictated by social institutions and religions. However, it does not say where the prohibition from such institutions came from, the deeper root and functionalist essence of such characteristic of this human practice (or non-practice). This is not to say that the truth is incest exists in many places and cultures nonetheless. In fact, incest has been practiced in some parts of Hawaii and within Pharaonic dynasties, between Azande fathers and daughters, Mbuti mothers and sons, and even among commoners in Roman Egypt.

Through individuals like Levi-Strauss and their works, issues such as this one is given a perceptive explanation and definition. This helps people understand what is happening to the society because of how the roles of individuals function and contribute to the preservation of the group which is one of the instincts of the individual other than self preservation. To help develop kinship, man, for many possible and yet undefined and concretized reasons opted to discourage incest because of the role of this social standard in the prohibition of endogamy and the encouragement of exogamy, which in turn, encourages extended, broadened and widened kinship. Although a taboo subject in itself, incest is something that Levi-Strauss nonetheless examined as a factor that contributes significantly to the development of the society. Through his efforts, Levi-Strauss has managed to provide a reason regarding what incest is based on its function in the society, and what incest is in relation to the kinship theory. Incest has been, above everything else, viewed from the kinship theory perspective, as something that prohibits one thing so that the other thing can prosper and affect a particular condition which is favorable to the people, to the group, to the society and to the idea of kinship among people. Incest, no doubt, has been a significant factor in defining the kinship theory. However, because of the fact that the limitation of the concept of prohibitive incest renders it as something that is not universal this too has its limitations. The universality of the incest prohibition is, however, far from being proved and remains too doubtful to serve as basis for the whole of kinship theory. But still, the fact is that it is significant in the kinship theory of Levi-Strauss and other professionals before or after him will continue to remain significant in the future. This is because of the degree of implication of the presence or absence of the condition of incest inside a society among individuals and groups of people.

Applying the perspective of learning styles to a sports bar setup, it can be argued that the fundamental aspect surrounding its application and relevance surrounds the capacity to induce interaction measures via a correlation among each party particularly in their specific interests in a sports endeavor. Since the overall objective of the group is to facilitate an environment where each member shall interact according to their personal knowledge and capacities, the venue then serves as an instrument shaping a new direction towards a dynamic and fruitful acquisition of information.

Under such idea, the method of interactionlearning would then surround the formal and informal process of communication among participants in the bar. Such dimension would then correspond to the way information is exchanged and the networking capacity of each member to provide their inputs over a sporting endeavor. This then solidifies a relationship pattern that correlates their particular inputs and then provides a new one.

At the same time, the communities that are to be created by the sports bar then provide the necessary motivation of choice on as to whom to go for. Such act then takes into account not only the available and observable statistical information available on each sporting teams but also let the venue facilitate such outcomes by encouraging openness and availability of ideas that can stimulate these interaction stages accordingly. This can be supplemented by creating new available technological devices that can induce amusement and learning at the same time.

Thus, the ability to induce socialization and learning in the chosen sports bar stems from the ability to foster and recognize patterns of interaction among participants in the environment. It involves the creation of not only activities that can induce their appreciation of the given activity but also shed new ways to gain insights on what they have missed in the process.

Conflict Issues
At the same time, the chosen organization may also entail areas of conflict and disputes. This can be argued to surround and apply due to the very nature and ability of the chosen environment (sports bar) to induce competitive and relatively winner-loser setup. Under such process, disputes can occur with parties conveying their relative ideas and perspectives on which sides they are in. Despite the overall intention to spread sportsmanship and camaraderie in the process, such actions cannot be prevented.

Due to this, management must look into applying strategies that shall look into its organizational behavior and stance over such issue. Knowing that perceptions such as that do exist, careful attention must be made in the creation of rules and standards towards behavior within the organization. This means that appropriate methods of interaction may be prescribed especially if the sporting endeavor would be too competitive or would raise tensions around.

At the same time, appropriate actions must be initiated to ensure that conflict-resolution strategies are given accordingly among employees and members of the sports bar. Under such proposition, management must have the responsibility and are accountable towards their customer base and their behavior inside. Allowing proper decorum and actions stipulated on their rules is a good way to achieve such familiarity and induce better chances for control. Overall, situations leading to conflict may indeed occur in the process. However, if given enough consideration and attention, the process of managing a sports bar can be effective as long as proper mandates are responsibly administered and provided.

Case study The Geeks of Chic evidently articulates that the problems of job attitude and job satisfaction have important consequences for both organisations and their employees.  From the case study perspective, satisfied employees of Geeks, excluding unsatisfied Ralph Ford and Millicent Brown, perform their jobs better, are less likely to engage in counterproductive behaviours, and are more likely to exhibit altruism and general compliance.  This particular analysis of case study aims to discuss the most critical issues regarding job satisfaction and job attitude occurring in it through the examples of Ralph Ford and Millicent Brown.  From the argument perspective, it is evident that Ralph Ford and Millicent Brown pose a significant human resource and organizational problem for The Geeks of Chic.

Job satisfaction represents a very important issue for every organization, because it decreases the chances of the employees withdrawal, intentions to leave and turnover incidents. Job satisfaction also was shown to be associated with the employees health and psychological well-being.  Studies show that this job attitude commonly correlates negatively with somatic complaints, depression and stress.  In addition, job satisfaction is related to satisfaction with life in general.  These statements are particularly important to the case of Ralph Ford, Geeks software developer, whose productivity and general attitude towards his work have been declining over the past few years.

Ralph Ford and Millicent Brown determine how positive or negative a job situation or organizational changes are by comparing their work experiences to personal standards. Weiss defined job satisfaction  as a positive (or negative) evaluative judgment one makes about ones job or job situation (Weiss 2002 175).  From the critical perspective, job satisfaction can be explained as individuals internal state that manifests itself in feeling of favor or disfavor towards an experienced job.  Job expectations influence the determination of whether or not one is satisfied at work.  Practically, from the very beginning every employee has certain job expectations upon entering a new organization, which may vary from the material or non-material rewards for good performance, self-actualization job opportunities, the availability of interpersonal contacts and networking, etc.  Therefore, it is evident that depending on ones values and needs occurring at a specific time, job expectation may have very unique and individualistic characteristics.  From the perspective of the case study, it is evident that the more Ralphs and Millicents expectations are in agreement with experiences at work, the higher their job satisfaction, and, consequently, the higher probability that they will stay with their organization.

Classical studies on job satisfaction and performance confirmed that fulfilled job expectations explain a significant proportion of variance in the levels of job satisfaction and other job-related attitudes.  Research suggests that expectations concerning jobs in general (for instance about kinds of jobs available to an individual, pay, or promotion opportunities) can also influence job satisfaction.  This statement is particularly characteristic for the situation with both Ralph Ford and Millicent Brown, because both employees publicly express their negative views on promotional decisions made by companys management.  Interestingly, in the case of Ralph Ford, research literature on job satisfaction and performance indicates that women experience higher levels of job satisfaction compared to men, even though they often hold jobs that are lower paid and less satisfying in terms of job content and promotion opportunities.  From the critical perspective, this difference could be explained by the fact that women have lower job expectations because of their traditionally poorer situation in the labor market.  However, this difference may be negligible in the case of women who are young, higher-educated, and work as professionals or in male-dominated workplaces.

From the case perspective, employees intentions to stay or leave the organization are important to organizations for a number of reasons, including, but not limited to, the separation and replacement costs absorbed by the organization, the learning curve or time it takes to train a new employee to function effectively and efficiently in the work environment, the potential innovation loss, productivity shortages and the like.  As the case suggests, Ralph Ford is getting to the point where he is seriously considering leaving the company and starting his own consultancy (The Geeks of Chic 2010).  In regard to this situation, Boshoff and Mels indicated that employee turnover has a detrimental effect on the employees job performance and thus on organizational effectiveness.

According to Chandrashekaran, McNeilly, Russ, and Marinova, voluntary turnover is not a desirable outcome in any organization (Chandrashekaran, McNeilly, Russ, and Marinova 2002  464). They discussed two distinct streams of intentions research, with one largely focused on the formation of intentions, and the other focused on the predictive ability of intentions data.  An employees intentions to leave were the focus of many studies because it is believed that intentions lead to actual behaviour and that the greater the stated intention to perform an act, the greater is the likelihood of engaging in the behavior (Chandrashekaran et al. 2002 467).  Practically, in the case of Ralph Ford, his intentions to leave the organisation lead to performance decrease, absenteeism and overall poor organizational commitment.

Concept of organization commitment holds that employees who are organizationally committed are less likely to be absent and to have intentions to leave their companies voluntarily.   Researchers still do not concur about the definition of organizational commitment, however, there is a consensus that organizational commitment includes attitudinal and behavioural commitment.  The former is a measure of an individuals loyalty to an organization and emphasizes an individuals identification and involvement in the organization, while the latter is the process that individuals use to link themselves to an organization and emphasizes their actions.  From the practical perspective, both Ralph Ford and Millicent Brown exhibit poor organizational commitment, which manifests in continuous resistance to change in the organization, absenteeism, poor performance while working in teams, etc.  As Ralph Ford points out, the Geeks is simply not the place it used to be and that he did not like the direction in which it is heading (The Geeks of Chic, 2010).  

Redman and Snape noted that organisational effectiveness will be enhanced where organisations are able to elicit high levels of commitment from their employees, since committed employees show higher work effectiveness and organisational citizenship behaviour, and lower absence and turnover (Redman and Snape 2005 301).  Furthermore, studies have linked commitment to a long list of positive work behaviours, including job satisfaction, attendance, voluntary turnover, absenteeism, employee performance, and extra-role and organizational citizenship behaviours.  However, from the critical perspective, it is important to emphasise that the extent to what an individual is organizationally committed necessarily depends on the nature of that commitment.  Both Ralph Ford and Millicent Brown demonstrated their organizational commitment as long as the companys management acted according to their expectations.  Ralph Fords organizational commitment has significantly declined when he did not receive an expected promotion Ralphs productivity and general attitude towards his work have been declining over the past few years. The rot seemed to commence when he was overlooked for promotion in the first round of re-structures of the new company (The Geeks of Chic 2010). Millicent Brown exhibits poor organizational commitment mainly during her interactions with other employees Millicent in particular often talks over the top of newer staff members and ridicules their suggestions (The Geeks of Chic 2010).

Regardless of the variation in conceptualization of organizational commitment by researchers, Wasti found an increasing consensus that organizational commitment is a multidimensional construct (Wasti 2003 304), including affective, normative, and continuance commitment.  Researchers consider affective commitment to be the most desirable form of commitment because it is based on an emotional attachment, which leads to positive behavioural outcomes performed by the employee for the benefit of the organisation (e.g. citizenship behaviours and employee performance).  Furthermore, affective commitment had the strongest and most consistent relationship with desirable outcomes (Wasti 2003 304).  Continuance commitment is considered to be the most undesirable form of commitment because it is based on the idea of sunken costs, in which an individual remains with the organization based on the costs they would incur upon leaving.  This type of commitment leads to lower levels of performance and satisfaction, as well as to decreased instances of citizenship performed by the employee.  From the critical perspective, Millicent Brown evidently demonstrates the continuance commitment to her organization, because, unlike Ralph Ford, she does not express the intention to leave, however, is deeply unsatisfied with her work.

Because the organization constitutes an abstraction for many employees, it is important to understand that practically it is represented through superiors, co-workers, subordinates, workgroups, customers and even virtual teams that collectively comprise the organization.  

Thompson and Heron (2005) state that a growing literature from a number of diverse fields, such as knowledge management, innovation and organizational behaviour, emphasizes the important part played by the quality of employee-manager relationships in creating the context within which employee behaviour and attitudes are fostered (p. 399).  This statement is particularly important in the light of the relationship between Ralph Ford and his superior Ursula Ryan.  Ralph exhibits an extremely poor level of commitment to supervisor (as a part of organizational commitment), having no intention of accepting Ursulas appointment graciously (The Geeks of Chic 2010).  Chen, Tsui, and Farh purported that among these foci of commitment, the supervisor could be most important for employees.  Acting as an agent of the organization, the supervisor often interacts with employees on a daily basis, enacting the formal and informal procedures of organized activities and, most importantly, serving as an administrator of rewards to subordinates (Chen, Tsui, and Farh 2002 339-340).  The idea of multiple foci of commitments at work is a relatively new concept in the field of organizational studies.  From this perspective, employees attidunal commitment to an organization cannot be understood only in terms of commitment to an organization alone as an abstract entity, and since any organization, as discussed above is comprised with many determinants (e.g. co-workers, interactions, networking, etc), organization commitment has multidimensional nature.

As the case demonstrates, both Ralph Ford and Millicent Brown represent a human resource problem, and one of the issues that significantly deepens it is their lack of organizational citizenship.  Organizational citizenship is individuals behaviour, voluntary and not formally rewarded, that contributes to the effective functioning of the organisation and its success.  Literature exploring the relationship of organizational citizenship with variables like job satisfaction, employee satisfaction and organizational commitment is well established.  Organizational citizenship can be manifested in organization in various situations and through different patterns, from aid to a coworker and voluntary assumption of ad-hoc tasks to punctuality and cooperation above the acceptable norms.  The case articulates that on the level of interpersonal communication Millicent Brown shows little organizational citizenship she poorly interacts with other team members while working on mutual projects and ridicules co-workers ideas.  Podsakoff  described helping behaviours as voluntarily helping others with, or preventing the occurrence of, work related problems (Podsakoff et al. 2002 515).

Organizational citizenship literature has identified and focused on four categories of antecedents individual (or employee) characteristics, task characteristics, organizational characteristics, and leadership behaviours (Podsakoff et al. 2000).  Organizational citizenship may contribute to the organizational success by (a) enhancing coworker and managerial productivity (b) freeing up resources so they can be used for more productive purposes (c) reducing the need to devote scarce resources to purely maintenance functions (d) helping to coordinate activities both within and across work groups (e) strengthening the organizations ability to attract and retain the best employees (f) increasing the stability of the organizations performance and (g) enabling the organization to adapt more effectively to environmental changes (Podsakoff et al. 2000 523).  Unfortunately for the organization, Ralph Ford demonstrates poor organizational citizenship as a result of his low job satisfaction, poor organizational commitment, overall job attitude and resistance to change.  The latter is evidently manifested in his expression it should be the people who have been there from the outset who should reap the benefit of the companys current prosperity (The Geeks of Chic, 2010).  This statement is succinct explanation why both Millicent Brown and Ralph Ford represent a human resource problem in Geeks.

The US Public Health Service Commission Corps as well as the National Disaster Medical System US has been activated by the United States Department of Health and Human Services (HHS). More than 200 employees could probably be of assistance in future. The Department of Health and Human Services is the foremost agency for defending the health of American citizens. It comprises of eleven operating divisions and the Office of the Secretary (U.S. Department of Health and Human Services, 2002). This paper is going to report on health and human services. It will build an organization basing on these two perspectives, by instilling a plan in action and completing the ethical framework of the organization. Moreover, this report will have a mission and a value statement, a code of ethics, the organization leadership and culture, how to measure the organizations performance in maintaining an ethical standard.

The ethical framework of the Health and Services organization
The organization ought to ensure that the welfare and rights of its personnel are protected when everybody involved in worker-studies applies and understands the ethical principles and common rules of respect, beneficence, and justice for individuals as described in various professional codes of ethics and in the Belmont Report. Furthermore, it is anticipated that employees who are requested to take part in a study ought not to face reprisal or coercion for their decision to withdraw, participate, or not to participate to a study. With regard to the informed process consent process, they ought to receive understandable and adequate descriptions of the purpose of study, why they were selected, what is expected from them and any risks or benefits they may go through if they decide to participate. All employee studies ought to go through local-review by an Institutional Review Board (IRB) that is familiar with both the workplace and the workforce.

Mission Statement
The mission statement of the Health and Services organization is to provide the greatest probable dispute-resolution services for the individuals, who rely on our decision, who appear before us, and the public. The principles that guide us will encompass the following Doing our job as promptly as possible delivering products that are well-reasoned, meticulous and written in a manner that is concise and clear being impartial and fair, and always attempting to ensure that our customers recognizes us valuing innovation and creativity, and always seeking better ways of doing things assisting parties to resolve and narrow issues with the help of mediation or on their own and treating one another wit respect through provision a great-environment for one another.

Value Statement
The personnel are requested to sustain the foundation of value driven health care and promote the health insurance policies, third-party providers, administrators and others with which they indenture to take steady actions to attain these goals.

The healthcare system of the United States has an unprecedented chance to lay foundations that are new for increased value, better patient care and higher quality services. The value actions that are of value ought to be supported in order to achieve these goals and they include Support Health Information Technology provide quality information provide pricing information and prop up quality and efficiency of care.  
 
Code of Ethics
All volunteers, staff and board members of the organization act with openness, honesty and integrity in all their transactions as organizational representatives. The organization supports a working-environment that values integrity, respect and fairness.

Existing codes of ethics provides useful references, models and ideas that can be used to Measure research experts against their own codes design approaches and work study programs for addressing the risks to employees providing guidance in designing codes. Examples of code of ethics are The Council for International Organizations of Medical Sciences, the codes of the American College of Environmental and Occupational Medicine and the International Society for Environmental Epidemiology.

The organization leadership and culture
The personnel should maintain their authority by having specialized rules, language and rituals. The concepts of culture are transformed into a practical tool that workers can use to understand the dynamics of change and organizations. The culture of the organization provides information on the topic of work-related cultures, and displays the critical role leaders play in applying successfully the standards of culture so as to attain organizational goals. Though, the toughest challenge of leadership is dealing with the intricate query of how an existing culture can be altered. This results to a fundamental resource for practicing and understanding the effectiveness of the organization. A pioneer of organizational development uses an approach that is anthropological to address a leaders role in organizational dynamics and shaping group.

How to measure the Health and Services organizations performance in maintaining an ethical standard
The Healthcare amenities ought to uphold an organizational commitment to guarantee that every action taken by staff and leaders consistently delivers a care that is ethical. The great demand for personnel might influence leaders to make quick-hiring decisions in order to fill positions with no thorough investigation of the work history of a candidate. The organization ought to have in mind that their primary responsibility is to hire practitioners who are morally honorable and competent. According to the US Department of Health and Human Services (2002), it is anticipated that the demand will increase all through this decade and will result to 29 percent RN shortage by the year 2010. This demand is likely to escalate due to less-prepared candidates inflowing the profession, aging patient demographics, aging personnel workforce, and an escalated life expectancy leading to more patients with medical conditions that are chronic.

The organization should immediately take action the moment it recognizes that an employee has reached at hisher stress limit so as to sustain care quality and practice integrity. Unethical behavior in the organization can attain proportions that are epidemic. According to the American Nurses Association (2001), a recent personnel survey indicated that almost all of the respondents concurred that unethical behavior has been in existence, and it encompassed conducts such as discriminating, forging signature, and lying against colleagues. Moreover, unethical behavior can be triggered by a poor work-environment, and that organizational workers ought to be accustomed to these inclining factors to develop prevention values. Thus, the organization ought to identify the problem first.    

Conclusion
The management of the Health and Human Services ought to integrate behavioral hallmarks such as high ethical standard, honesty, and a maintained moral standard that defines work force integrity. This will ensure that the value and mission statement of the organization are well met, the ethical framework is standard, the code of ethics are followed, and the culture and leadership of the organization are transformed in practical-tools that the personnel can use to understand organizational dynamics and change.

Socialization starts at the primary stage of life courseduring childhood. Socializing children therefore entails the direct participation and valuable guidance of family members especially the parents. Parents have the significant influence and great duty of socializing children in order for them to learn and exemplify the standards which the society dictates.

It is the parents who must answer when correct socialization is not carried-out. The parents therefore, as the head of the family, have the responsibility of socializing children to a basic understanding of societal norms. Hence when such socialization fails, it is the parents who should be held accountable.
Such is my position due to childrens dependence on the acceptance and affection of their family. A proof to support such point is that children are compelled to obey and be consistent with what the family members do especially the parents expectations. In the socialization process, children learn and hold on to the values and norms of the society through their parents. It is my opinion that parents are the ones responsible and answerable when their childrens socialization failed to make them understand the norms of the society.

But there is still the possibility that such claim is refuted. An argument may be the position that the family or the parents are not the sole liable for the success or failure of socializing children. This is because the decision remains to be with the children themselves. Beyond the responsibility of parents, the children can have the mind of their own which could affect their socialization. But this objection is refuted because it is essential for parents to force or impose the correct way of socializing children. In short, parents need to insist to their children that they need to understand and follow their teachings on societal norms.

Summing up, it is clear that parents have the responsibility of socializing children into living up to societal standards. Hence, when it fails, it is definitely only the parents who should be held accountable.

Fatal road accidents violence which can even lead to death, poor performance in academics, irresponsible sexual behavior are some of the vices that are associated with abuse of alcohol in dorms by youth. Abuse of alcohol is manifested by excessive consumption of alcohol which may also be accompanied by abuse of other substances. Alcohol abuse in dorms is a very serious problem because it involves underage individuals who are dependent on parents or guardians for everything. These youth live carefree lives because they dont work for anything and therefore do not feel the pinch of any money wasted. This is a major problem that is of much concern and that should be addressed amicably to prevent this habit which can be life threatening. Alcoholism in dorms involves residing students.

The majority of the affected lot comprises of students who reside in college or university dormitories and training camps such as military and technical schools.  The most threatening issue is that this group is made up of young men and women who should be focusing on having a bright future instead of endangering their health and life. One of the factors, in my opinion, that can attribute to alcohol abuse includes the role of campus lifestyle in influencing student behavior but not limited to the sense of personality and other environmental factors involved. There are a number of reasons that lead to abuse of alcohol in dorms.

Excessive drinking among on-campus students is more evident owing to the fact that these students have plenty of free time. Incase they experience boredom at any given time, they resort to drinking. In contrast, trainees and or students who live on their own outside institutions drink less and I attribute this to their having access to a number of other recreational facilities such that they are exposed to integrating with other members of society. The abuse of alcohol therefore is robbing the young generation of its human-resources for the future and in the long term this will have adverse effects on any countrys economy. This is the group of people who are expected replace the older generation in various fields of profession. However, the major task lies not on how to deal with repercussions of this menace such as sexually transmitted diseases, low output in work and addiction, but on how to avert this culture of alcohol abuse.

A number of mechanisms can be applied by various institutional administrations and other stakeholders who have direct relations with students as they are in a better position to influence them directly. Education of students way before they join tertiary institutions is one way of dealing with this menace with an aim of helping them shun the habit when they grow up.

These mechanisms are however applicable if and only if, factors leading to alcoholism are established first. Students who freshly join institutions of higher learning are the most vulnerable group to abusing alcohol as they try to adapt with campus lifestyle. For most of them, they embrace drinking alcohol while in the process of making new friends. In addition, the feeling that they now have a sense of autonomy far away from their parents and an opportunity to manage their finances makes them feel at liberty. They therefore become addicted to alcohol. Also, I can attribute to some extent availability of pubs inside campuses to increase access to alcohol. Many students can afford to pass by these pubs comfortably as they leave lecture halls. In contrast, their counterparts -off-campus students- hurry to catch up with any transport means while others go to accomplish certain chores different from academics at their places of residence. Hence, this deprives them of necessary time to think about drinking. Other factors include the type of institutions of associations, clubs and the kind of activities they render to their members.

Some institutions for instance, are sports based whereas others are academic based and various clubs and associations render recreational activities that incite members to take alcohol. It is therefore not strange to find out that most of their members are drunkards and will borrow this habit from year-end parties and other banquets that these associations offer them. In sports, drinking is one of the readily available ways to refresh after a long-days work and many students will start to consume gradually and end-up becoming addicted to alcohol. The varied and complex personality of students in institutions also influences to a large extent their behavioral conduct.

I hold the view that some students start consuming alcohol way back before joining their current institutions of higher learning. After joining, they influence those they interact with in classes, clubs and other associations. Many of these students are teenagers and emulate various personalities in their fields of interest such as sports and music industry and practice these celebrities lifestyle so as to gain fame that they belong to a certain clique. With respect to this, they are influenced to take alcohol and be recognized that they belong to a particular class. Therefore, life skills should be taught in these organizations so that the students identify with them and get influenced positively.

The Journal of American College Health (2000) states some of the effects of alcohol on young people include wasting time that would have been used for study. There is immediate need to mitigate this phenomenon, and this lies squarely on institution administrations, clubs and associations in which the student relate to upon admission. College administrations should enact curriculum programs that address alcohol abuse and implement them in the first year of study. I also recommend that these institutions should instigate campaigns through publications in academic journals targeting alcohol abuse on an on-going basis. In addition, relating alcohol with music and sports in media adverts needs to be restricted.

I also recommend that the age at which people start drinking alcohol be increased to around 21. Alongside this alcoholic beverages should be heavily taxed so that new prices can intimidate the youngsters.

Despite the great acknowledgement and weight on the significance of the media when it comes to influencing the opinion and perspective of the public in relation to drugs and drug use, very little research has been accomplished when it comes to the nature and extent of their influence. It is not unknown to many that the mass media plays a very crucial role in the construction of reality in the eyes of the people because the knowledge of almost all social events can be obtained only through media. Due to this overwhelming impact, the implications as well as the nature of the medias portrayal of drugs and drug users deserve to have a second look especially nowadays when drug use is regarded as a persisting problem that needs to be addressed.

The term  mass media  simply denotes all types of information relayed to a large group of people. There is no criterion for how many people must be reached before the communication becomes labelled as mass communication, and there are also no limitations on the types of information presented. In common parlance, media refers to a group of entities such as publishers, journalists, and others that consider  communication as their profession. This definition includes the entertainment as well as the news industries. Not only do they report the news, but they also create it by making a decision on what to report. This important decision makes them crucial in resolving conflicts because they are the leading source of information of many people. When something does not make the news, it means that it does not exist for many people. Conflicts attract viewers like moths to a flame. The bigger the conflict is, the bigger the audience will be, and large audience dictates the success of the media.

Mass media saturates the world today. The television in the living room, the newspaper and magazines in the coffee table, the radio in the car, and the computer in the bedroom and the office are but few of the numerous avenues for communication. Contrary to the common belief of many young people today, the media exists not only to entertain the audience. Its main purpose is to inform the people of what is happening in the society, to determine political agenda, and to provide a forum for communication.

One issue that has been in the centre of many debates and controversies is the issue that tackles drugs. Drugs and drug use have been the highlight of many news, entertainment, and print media because of their destructive and addictive effects to people from all ages. As the watchdog of the public, it is the duty of the media to give a report on the pressing concerns of the society today such as the worsening drug problems.

Formulating drug prevention strategies through the media is a very challenging task. It is even quite ironic that at times, the media reports promote the behaviour that they aim to prevent. Like many individuals, the drug users watch television, surf the net, and read the newspapers everyday, and by having access to these media outlets, they tend to learn more about new dealings. Many have long suspected that the news reports about where and how to buy different types of drugs serve as a free advertisement for those who are engaged in this kind of activity. Journalists, broadcasters, and other people who work for the media must come to a realization that they have an ethical responsibility for the effects of their reporting styles more, particularly when it comes to advertising the locations of where certain drugs may be bought. The media reporting of details like the time, price, and location of illegal drugs has grave implications for public health and safety. Some suggested that the detailed reports of overdose may heighten further tendencies of overdose by giving information about the source of the illegal drugs.

Another typical example of how the media dictates the perception of the people can be seen in the way they deal with celebrities. A study examined more than a hundred television and print articles about popular celebrities and their drunk driving. Most of the details of the stories focus on the prison time and the damage of the event to the career of the said celebrities, and even though there are many chances to mention the health consequences drug abuse, only a few articles did (eDrugRehab.com, 2009). This just goes to show that stories about drug users do not put a fright in the hearts of young people instead, there are pieces of evidence that suggest that it generates opposite results. Research shows that the popularity given to ecstasy encouraged teenagers more to switch their drugs from ecstasy to cocaine, which is a drug that is known to be more harmful. The scare stories about drugs and its use may also cause parents to panic and react in a way that drives the children away from help.

Even the popular series entitled House is one of the examples of how the media contradicts itself by promoting drug use. Dr. House is greatly addicted to a painkiller named Vicodin. The viewers fail to realize that the abuse of this drug may lead to destructive health consequences for the addict such as permanent deafness, but unfortunately, they are blinded by the charm and humour of this witty doctor, so they cannot see the damning effects of his addiction.

Whether it is in the aspect of drugs, drug abuse, or other social issues, the media has a great tendency, be it intentional or not, to exaggerate and sensationalise events that are isolated in order to encourage and mould the perception of the public about a particular topic when in truth and in fact, the situation is not as grave as they say it is. Despite the glamorous presentation of the media, drug addiction is devastating not only for the addicts but for their families as well. From the point of view of the media, their news has to sell because of the pressure coming from their CEOs to generate a big return on their investments. This is not to say that every information coming from them is tainted. Without the existence of the mass communication outlets, the world would be lost in translation as to what is happening both locally and internationally. There is no better way to spread any information quickly than to use any type of media.

Thus, while the media hype about drug abuse definitely sells the newspapers, this kind of reporting is definitely dangerous. For one, drug scares that blame the immorality and the behaviour of the people for the many problems can divert the attention as well as the resources of the government from even bigger crises. In cases where no distinction is made as to those with problems and those who are the problems themselves, there is a great chance for the victims of social injustice to be blamed. Another example of media exaggeration is the racial statistics of the actual drug users, who are mainly white, and the racial statistics of those portrayed to have been using these drugs, who are mainly the African Americans.

I agree with the observation of many people that the reason behind these portrayals is that sensationalised stories are the highlight of the medias successful career. The nature of their work creates an intense pressure on the journalists to make sure that their style and manner of reporting attract plenty of attention in order to pay for their advertisements. A certain amount of distortion and bias cannot be avoided in journalism, but oftentimes, this is the very fact that defeats the purpose of the medias existence which is to aid the journalists in accurate reporting and not to censure or downplay the devastating effects of drugs.

The ratio of the articles that cite research findings is becoming smaller and smaller. This fact clearly paves the way for the researchers who study and publish works on some aspects of crime to take the place of the media as a more credible source of information. Reports show that the media uses several resources. For instance, 865 articles used about 1,238 sources. The primary sources of details were the police and the courts. When the officials such as the police, politicians, and local government are named as the  official sources,  they, in fact, form three quarters of the entire sources. Research was also able to show that there is a close relationship between the crime reporters and their sources. The concern about drugs and its usage seem to have heightened nowadays, and it can be observed that the perception about the drugs and its usage have changed over the years.
 
An analysis of media clippings and other resources lead many to conclude that the media needs to enact more stringent and formal guidelines when it comes to making reports about crime and drugs. These new policies will discourage journalists to avoid sensationalising and sugar-coating their reports. This is extremely important due to the fact that even though the policy developments are constrained by the opinion of the public, the media may not change their own opinion and by doing so, they set the very agenda and parameters of many controversial issues. The way in which the media portrays drugs and drug users has very huge policy ramifications because media is the number one source of information on the subjects outside the scope of human experience.

Deciding what the news will be is a crucial judgement that depends solely on the journalists discretion and this is where the discussion of responsible journalism comes in. The men behind the media must not abuse the protection given by the First Amendment of the Constitution to work for their own benefit. The freedom of speech and expression gives them the leeway to express and air their sentiments, but it is not without limitation.

Information that tends to be misleading may cause far more damage than help by making the problems worse. In contrast, accurate reporting has the opportunity to make a difference for the better. Responsible media and journalism must aim to explore the deeper issues behind every conflict in order to give the public a more accurate and valuable information as to what a conflict is all about. This change cannot be done overnight. It requires a lot of dedication and commitment from the people behind the stories. Drug usage is not a joke that must be treated lightly. This destructive habit has already destroyed a lot of families and killed millions of people. What Dr. House and the other celebrities are displaying in front of the camera does not even touch the tip of the iceberg when it comes to the effects of drug abuse, and it would do well for everybody if the media played their part in disseminating the dark side effects of this nasty habit without sugar-coating anything. The truth is sometimes harder to accept, but if drugs come into the scenario, one is better off knowing the truth right away than losing his or her life to them without knowing the reality behind them all.

Upon assessment, it was rationalized that a family therapy program is the recommended form of counseling service to be taken. There were a lot of factors that were considered before referring this type of therapy.

First, the nature of the problem or the chief complaint of the client was carefully considered. It was determined that it has a strong inclination towards the clients immediate interactions with those around him.

Second, the quality of each of his relationship to his family was also taken into consideration due to the fact that these daily interactions have a great bearing to the personality development and character of the client. Upon further interactions with each member of the family, the root of the problem may be extracted and could lead to a realistic solution that fits the needs of the client.

Third, the views, beliefs, religious orientations, and culture of the client and his family were also looked upon. It will help in understanding the general orientation of clients way of dealing with things.

Lastly, the support system was also checked. It is an important aspect because counseling could eventually be life altering. It is important that those he is living with understands the changes that he could and would undergo and be prepared because covertly or overtly, it will change them also.

Family therapy is being recommended because family ties are being emphasized as important to the general well-being of the client. Although in the end, everyone in the family will benefit because an environment of open communication and understanding will be nurtured. It allows an opportunity for all members to truthfully verbalize each of their thoughts and feelings that would eventually lead to solving the problem that the client has presented.

In the past decades, many changes have been observable in the society and one of the most notable developments is the greater interconnectedness and interdependence of different countries. Despite the existence of territorial boundaries, people with different nationality are able to greatly interact with people in different parts of the world. The interaction among people is not merely limited in the form of communication but rather they are more capable in going to different parts of the globe.
Nevertheless, the interrelation of countries also comes with it observable problems such as the emergence of transnational issues. Transnational issues are recognized as problems that transcend territorial boundaries and an example of which is the issue of immigration. In relation to this, Filipino citizens are recognized as one of the leading immigrants in other countries, especially in the United States. Filipino immigrants and refugees in the United States may they legally or illegally enter the country, are recognized as a concern of the United States government, especially when it comes to their welfare. Being the case, it is necessary that the specific social and health issues that affect the Filipino population in the United States are given due attention and importance.

Human, Social, and Health Problems among Filipino Immigrants and Refugees
In order to understand the social and health problems that affect the Filipino population, it is essential that a greater understanding about the background of this people is properly discussed. Filipinos are defined as a multicultural people with Chinese, Spanish, Malayan, Indonesian, South Asia, American, and, in the south, Muslim cultural influences (McGoldrick et al., 2005, p. 319). Due to these influences, the concept of shared identity and connectedness is given focus among Filipinos. In addition to this, certain values are also observable among Filipinos such as, centrality of the family, acceptance of uncertainty, ability to relate to others, respect offered according to the individuals place in the structure of hierarchical relations, adaptability, and religiosity (McGoldrick et al., 2005, p. 319). Filipinos ranked as the second largest Asian-descent group in the United States. The Filipino population in the United States amounted to about 2.4 million, which compromises 18.3 of the Asian population in America. Majority of all Asian Americans are located in six metropolitan areas in the United States namely, Los Angeles, New York, San Francisco, Honolulu, Washington, D.C., Baltimore, and Chicago. From the different groups with Asia origin, the Filipinos have more similarities with Pacific Islanders because of the high rates of English proficiency. Furthermore, attitude and norms of Filipinos are related to a constellation of variables, which include multigenerational households, sharing of resources, proficiency in language, and education. As a result, Filipinos in America are recognized to belong to the highest median family incomes and they also have the lowest number of people living in poverty (McGoldrick et al., 2005).

Nevertheless, despite the fact that Filipinos in the United States are regarded to belong in the highest median family incomes, they still face social and health issues in this foreign land that they are situated. One of the most notable social issues that Filipinos have to face is the way by which they could adapt their respective norms and behaviors with that of a foreign land, which has an important role in the mental health of these people. Filipinos, who belong to the Asian American group have to sensitized to their environment and make an effort in order to maintain harmony and equilibrium in their various levels of experience. In relation to this studies, show that Asian and Pacific Americans express more concern and sensitivity when it comes to social situation as compared with white Americans. The main objective of most Asians and Pacific Americans is to establish social and emotional balance by means of the mutual system of give and take. In relation to this, Filipinos also look for balance when it comes to their external world. This is rooted from the Eastern philosophy that is related to the way by which Asian and Pacific Americans accept the natural course of life events. Finding the balance in the emotional economy and the significant others of Asians and Pacific Americans, which includes Filipinos, is necessary in order for this population to maintain metal well-being and to diminish cases of neurosis among these people.

In addition to this, Filipinos also suffer from numerous health issues that are not properly address as compared with their other Asian and Pacific Islander counterparts. The FilipinoFilipino American in the United States, especially the youth and adolescents population of this minority group, show disparities in comparison with Anglo and other Asian and Pacific Islander groups when it comes to gestational diabetes, rates of neonatal mortality, and low birth weight, malnutrition in young children, overweight, physical inactivity and fitness, tuberculosis, dental caries and substance abuse.  
       
In line with this, there is also a discrepancy across groups when it comes to health insurance, health care use, and health status. Filipinos are not regarded as a discrete subpopulation but there arte notable differences regarding this minority group in the United States when it comes to the prevalence of chronic health conditions as compared with the other minority groups in the country. This is exemplified in the case of Filipinos in the Los Angeles Country wherein Filipinos are recorded to have more chronic illnesses as compared with the other Asian and Pacific Islanders. One possible reason for this aforementioned situation is that in neighborhoods that are co-populated densely by Latinos and FilipinoFilipino Americans, both of these groups have the same earnings and employment characteristics, which also shows that Filipinos also suffer the same rate of chronic disease as Latinos. It demonstrates that the working class and lower-income FilipinoFilipino American households suffer from health problems more than other Asians and Pacific Islanders in the United States (Semics LLC, 2007).

Resources and Service Gaps in the Healthcare of Filipino in the United States
The social and health issues that concern the FilipinoFilipino Americans in the United States clearly show that there are persistent disparities in health and health care for this minority group in America. In relation to this, the accessibility of healthcare resources among FilipinoFilipino Americans in the United States also varies depending upon the income of the family. FilipinoFilipino Americans who belong to the higher income rate has the capability to avail of healthcare services and more so, if they have healthcare insurance. However, Filipinos who belong to the lower income group have more difficulty in accessing healthcare services, especially with the expensive healthcare in the United States.

In relation to this, FilipinoFilipino American patients also have a hard time in properly communicating with health care providers. In most cases, mainstream health care providers failed to give culturally relevant services and advice. This finding is based on the level of comfort and confidence that patients feel in expressing themselves in English when it comes to specific health concerns.

Another gap that is observable when it comes to Filipinos access to healthcare is their reliance on traditional providers, which make them reluctant to avail the services of doctors and hospitals. This kind of attitude is rooted from the medical and health service situation in the Philippines wherein healthcare services is expensive and demands ready cash. In addition, the lack of sound insurance and other financial protection also made health services in the Philippines very expensive as well as medicine prescriptions. Due to this, most patients will not go to the doctor unless they are already acutely ill. The concept of accessing health services is alien to many Filipinos even if the services are already available at low or no cost at all. Being the case, this perception and attitude of Filipinos about health services could turn into a pressing problem when FilipinoFilipino Americans suffer from high incidence of chronic diseases.

Selected Health Services and Barriers
In the United States, migration of Filipinos had in its highest for the past few years, in fact, there are over 2 million Filipinos who are currently living and working in the country. Therefore, these set of migrants are the responsibility of the United States government in their healthcare. Thus, the United States offers different kinds of health benefits for Filipinos and other migrant workers as a privilege in order to encourage these people to work and stay in the United States. Hence, the entire healthcare benefits which are able to receive by legal citizens are also offered for Filipinos. Moreover, healthcare services are a privilege to which different individuals must have because health is one of the aspects in life where in the support of the government is truly needed.

In the view of the culture of Filipinos to have a great interest in freebies, and cheaper priced goods, Filipinos would not give up a chance to have different kinds of free privileges which could lessen their expenses.  Although some might put this as a joke, it is true that Filipinos have this character due to the lifestyle that they had in the Philippines which is mostly filled with poverty and inequality of resources due to corruption. However, Filipinos who are living in the United States are mostly professionals who are also working as healthcare providers.

In the written work of Greg Yamashiro and Jon Matsuoka (1997), they stated that different cultures have various perspectives with regards to health care services and what kind of health care services they will indulge. One of the most questionable health services which the Filipinos would not want to experience being within a psychological health services. Moreover, the authors mentioned that the concept of psychological issues is somehow questionable for the first generation Filipino-Americans as well as other minor ethnicities due to the concept which is very unacceptable for these people. Moreover, there are different ethnicities in the United States are limited to different health services available. Looking into the culture of the Filipinos which are known to be happy and cheerful most of the time thus, there is a concept of the community where in psychological health services only is required to those that are extremely requires health service such as mentally ill patients who are already violent. Furthermore, aspects of health care for Filipinos are only limited for within the problems of the physical health and not mental aspects. Thus, compared to the Filipinos, the security of their health care are mainly connected to their health care providers.

Another factor to which the Filipino-Americans are hindered to seek health care services is due to the factors of racial discrimination within the community. Although Filipino-Americans are the second highest Asian migrants in the United States there are cases in which racial discrimination is upheld due to the skin color or the accent of the people. There are moments in which people in the United States do not give immediate attention to other ethnicities due to their own beliefs. Thus different health providers prioritize other ethnicities which cause more deaths and sickness with Filipinos. Furthermore, the fear of being discriminated against only creates much sickness within the society. In fact, many Filipinos lead to personal medication rather than go to physicians which could accurately determine the sickness. Hence, this types of issues related to discrimination is also one aspect to which health problems are not addressed.

Other forms of barriers are the economic capabilities of Filipinos. Although many studies present that most Filipinos are in the middle class, health priority is still in question. In order to take care of their health, Filipinos are much more preventive and not inclined to curing different kinds of sickness or disease. Moreover, health care in the United States is similar to a gold mine due to the very expensive price which is needed to be paid for the insurance and the likes. Going back, the case of economic capabilities, Filipinos by nature do not consider health as a priority. The main concern of the people Filipinos is to provide money for their family to use. Thus, the responsibility for the family is much needed to be addressed rather than the psychical health.

Mobilization of Community Resources and Enhancing Service Utilization
In order to mobilize and enhance service utilization is to address the concept of culture. Given that different cultures have different perspectives with regards to healthcare. All the various types of medical services are from the perspective of the westerners which are highly unique with Filipinos. In the perspective of psychology and mental health Filipinos are very much hesitant to different kinds of medications for it is a taboo or a shame to the whole clan. Thus, there should be different kinds of approaches with regards to healthcare. Moreover, variety of studies must also be conducted to the relationship of health care services and the culture of Filipinos.

In order to make health care much accessible groups of persons who also relates to the same issues and cultural background. Moreover, in order to have enhanced and mobilized health care services there should be hospitals in which Filipinos must be present in the area. Health providers must be Filipinos who would have the same language and understand the qualms of patients in varying situations. Therefore, it would be best to suggest that different health care providers must have varying ethnicities to address the needs of the people.

In addition to this, health care services must be accessible and open to people who are of different ethnicities. Provided that one of the problems in the Filipino community is discrimination such issues must be lessened. Therefore, health care providers must have knowledge in handling various types of ethnicities. Openness and equality must be one of the main values to which health care providers, hospitals, and clinics should have.

Case Study
In this research a short story regarding an old Filipino man and his younger relatives is presented in order to present the main point of healthcare services.

In the Carson, Los Angeles there is an old Filipino man who had been experiencing heavy coughing for a week. Although he had been told by his relative that he needed to go to a physician where in he could truly know the real problem. As a traditional Filipino, the old man did not want to go to a physician for he only believes that coughing is only a normal type of sickness which would immediately disappear. However, the old man was still coughing until the following week. Thus, the old man lead to personal medication in which he drank boiled ginger and drank that for a week. Although the cough lessened for a few days, the cough is still goes back.

In this short story, the old man knew that he had a problem in coughing however he is not convinced that coughing is a health problem that should be consulted to a doctor. Thus, he led to personal medication which does not seem to have helped at all.  The patient might be helped immediately if he was also cooperating with the suggestion of his relative to immediately go to a doctor to address the problem instantly. In addition, other diseases might also be addressed without taking too much time or worsening the situation.

Conclusion
In conclusion, the problem of attaining health care services is due to the issues with regards to economic capabilities, discrimination, and cultural differences. Moreover, there is a need for different health providers to be more flexible and understanding towards the situation of Filipinos. In addition to this, health care providers must realize that health does not choose color. Although different individuals have varying perspectives, health problems do not choose color or race. People have the same anatomy which means that all the health problems and issues of white Americans are also similar to the minorities. Moreover, health issues should not be chosen yet it must be given equally.