PLEASE SEE ATTACHED DOCUMENT FOR TOPIC AND SPECIAL INSTRUCTIONS Essay

PLEASE SEE ATTACHED DOCUMENT FOR TOPIC AND SPECIAL INSTRUCTIONS - Essay Example Despite the fact that the New York State Department of Education has embodied the belief that art education held the potential to be invaluable in the lives of children and adolescents, it has systematically been the first area targeted in times of budgetary need. The fight for and over arts education has been one that has effectively and efficiently led to a longstanding advocacy for its inclusion in the daily curriculum. Ultimately, the arts in the schools became something to fight for and over the next ten years, arts activists associated with New York City's vast array of cultural organizations and arts institutions emerged to do so. They began using artists to fill in the breach. They used the financial support of arts funders to develop existing arts outreach programs and to create new institutions whose mission was to educate public school children. Over time, more than one hundred of the city's arts organizations, from the major institutions down to the tiniest fragile dance ensembles, developed a roster of "teaching-artists" in a wide range of art forms — collage, African drumming, Chinese calligraphy, modem dance, opera, flamenco, and puppetry, to name a few — who would visit public school classrooms. In the early years, they would visit each classroom several times and present performances. As time went on, the teaching rather than the performance took precedence and teacher engagements got longer until they involved typically ten to sixteen visits (Horowitz & Ingram, 2005).

What do we mean by fair trade Can free trade be fair trade Essay

What do we mean by fair trade Can free trade be fair trade - Essay Example ironmental sustainability, the citification mechanism of producers in exporting countries and certification of products in importing countries and creating awareness of such products among consumers of the developed world (Singh, 2001). On the other hand free trade is a global effort to carry out international trade free of negative protectionist practices such as higher tariffs on imports, subsidies to domestic producers, foreign exchange restrictions, dumping cheaper goods abroad, imposing dubious standards on imports and import substitution by propping up unwieldy domestic industries. Theoretically free trade is based on neoliberal economic principles dating back to Ricardo’s argument on the principle of comparative advantage. Free trade and fair trade aren’t necessarily the same though some of the ultimate outcomes would converge. In fact divergences between the two are many and if free trade were practiced with full force indeed, fair trade would take a back seat. Globalization has been the catch word used by many who advocate free trade. Such people vehemently support all and everything in the name of free trade. On the other hand fair trade is a distant cousin of free trade. An inevitable aspect of this relationship between the two is that the former is marginalized while the latter is well placed at the center of the global market. Fair trade is essentially replete with intricate nuances ranging from market access facilitation processes to marginalized producers to sustainability efforts. Such noble principles need some theoretical and conceptual frameworks to support them though. Free trade theories are many while the principle of comparative advantage is the most predominant among them. The basis on which free trade is advocated by its supporters is determined by a series of arguments which in turn are associated with neoliberal perspectives. In the first place globalization is the logical premise used by supporters of international free trade to

Importance Of Improving Nursing Assessments Of Postnatal Newborn Essay

Importance Of Improving Nursing Assessments Of Postnatal Newborn Jaundice - Essay Example The following stand for a set of strategies suitable to the clinical circumstances and patient inhabitants of the Well Baby Nursery (deCarvalho M, 2001, 568-69). "Devices that provide a noninvasive transcutaneous bilirubin (TcB) measurement have proven very useful as screening tools and newer instruments give measurements that provide a valid estimate of the TSB level. Studies using the new TcB measurement instruments are limited, but the data published thus far suggest that in most newborn populations, these instruments generally provide measurements within 2 to 3 mg/dL of the TSB and can replace a measurement of serum bilirubin in many circumstances, particularly for TSB levels less than 15 mg/dL.The limitations of the accuracy and reproducibility of TSB measurements in the clinical laboratory must also be recognized" (AAP Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks Gestation) b. When the consequences of the bilirubin are obtained, a few newborns will require instigation of phototherapy right away. The table underneath is planned to guide the nurse in make a decision which babies require immediate initiation of phototherapy and announcement of the presence pediatrician. ... b. When the consequences of the bilirubin are obtained, a few newborns will require instigation of phototherapy right away. The table underneath is planned to guide the nurse in make a decision which babies require immediate initiation of phototherapy and announcement of the presence pediatrician. The criterion are based on development and attendance of risk issue in the first 24 hours of life (deCarvalho M, 2001, 568-69). Section B: Innovation DescriptionBilirubin Risk Determination for Well Newborns at 36 or further weeks' gestational age by birth weight 2,000 gm or more or 35 or further weeks' gestational age and birth weight of 2,500 gm or more* (James ML, 2001; 434-8) (Bhutani et al) Parent Education. No doubt, Written and verbal information will be offer to parents concerning the natural world of jaundice, the require to monitor infants for jaundice, and counsel on how monitoring ought to be done. Clinicians ought to counsel mothers to nurse their infants at least 8 to 12 times per day for the primary several days. Poor caloric intake and / or dehydration linked with insufficient breastfeeding may give to the growth of hyperbilirubinemia. Increasing the occurrence of nursing decreases the likelihood of following important hyper bilirubinemia in breast fed infants. Providing suitable support and counsel to breastfeeding mothers augment the probability that breastfeeding will be winning (Maisels MJ, 2001, 505-11). Section C: Research SupportMore often than not people are less frightened of overlooking signs evocative of jaundice due to a lack of knowledge or of being challenged in excess of their clinical assessment. The put into practice of home nursing is

Reflection on Placebo Effect Essay Example for Free

Reflection on Placebo Effect Essay Does a Supportive Patient-Therapist Relationship Enhance Clinical Improvement? Kaptchuk (2008), Components of Placebo Effect: Randomised Controlled Trial in Patients with Irritable Bowel Syndrome. (PRO) Argument 1: Kaptchuk (2008) suggested that placebo effects (non-specific effects) include three components: a patient’s response to observation and assessment, the patient’s response to the administration of placebo treatment, and the patient’s response to the patient-practitioner interaction. Kaptchuk (2008) found that the symptoms of IBS patients in the condition with placebo treatment and supportive patient-therapist relationship ameliorated the most across all measures compared to patients with having only observation and the patients with only placebo treatment. Thus he claimed that a supportive patient-therapist relationship is the most potent component of placebo effects. Argument 2: After three and six weeks, only in the condition with placebo treatment and supportive patient-therapist relationship, the symptom severity score of 60% patients decreased 50. Also Kaptchuk (2008) found that after six weeks, the change in life quality of patient in condition with only observation and the life quality of patient in condition with placebo treatment was similar, but the life quality change of patient with placebo treatment and supportive patient-therapist relationship was observable. So Kaptchuk (2008) suggested that a supportive patient-therapist relationship can enhance clinical improvement. Argument 3: Kaptchuk (2008) also compared these IBS patients to the patients who received IBS drug treatment. He found that the patients with placebo treatment and supportive relationship had comparable symptom relief as those who with drug treatment. His finding was only applied to IBS patients with supportive patient-therapist relationship, thus he indicated that a supportive patient-therapist relationship could enhance the efficiency of clinical treatment. Critique (or Strength): The result of the study done by Kaptchuk (2008) clearly demonstrated the importance of supportive patient-therapist relationship in medical treatment. However, Kaptchuk conducted the study on IBS patients, because he believed that placebo effects are most likely to be demonstrable in disorders defined by subjective symptoms. As Kaptchuk (2008) stated in limitation that he did not know if his finding could be applied to other illnesses, I also think that if Kaptchuk conducted his study on patients with the disease that has external causes, the results will be more convincing. One of important causes of IBS is stress, a subjective etiology. Thus a supportive patient-therapist relationship may have greater influence on IBS patient than the patient with other diseases, like flu.

Jackie Robinson Essays -- Sports, Dodgers, First Black Player

Throughout his professional career, Jackie Robinson, received criticism for being the first â€Å"black† player to play the game. Not only did Jackie Robinson manage to live up to the criticism, he also changed the face of America’s greatest past time forever. With his entrance into the MLB he opened the path for great black players like Hank Aaron, Roberto Clemente, Willie Mays, and Ozzie Smith just to name a few. In crossing the color-barrier in baseball Robinson not only strived as a great player on the field, but also a inspiration to the black community of the field with his humility, and willingness to move forward in a time where blacks were not considered â€Å"equal†. Jackie Robinson was one of the most profound individuals to ever walk on this earth. Robinson established a reputation as a man who never tolerated insults to his dignity (Kahn 6). One of his accomplishments was entering the major leagues and is one of the most remarkable and inspiring accomplishments in sports history. When Robinson became the first black to play in Major League Baseball, he changed Americans’ views on racism forever. Robinson was born the youngest of five children near Cairo, Georgia, on January 31, 1919. Robinson’s father, a sharecropper, left the family when Robinson was only about 2 years old. His mother, named Mallie McGriff Robinson, moved to Pasadena, California, to find work. (James 5) Trouble found Robinson at an early age, when he became a member of the Pasadena gang (7). At that school, he played several sports. He even lettered in: track, baseball, football, and basketball. His largest inspiration was most likely his older brother Matthew. He was a shortstop and catcher on the baseball team, a quarterback on the football team, a guard... ...a lifetime batting average of .311. He appeared in six All-Star Games and six World Series with the Dodgers. At the 1972 World Series, which commemorated the 25th anniversary of his rookie season, a physically deteriorating but still crusading Robinson, a diabetic, said he hoped to live to see blacks in baseball management jobs. Nine days later, he died of a heart attack at the young age of 53. Today, with the dominance of black players in professional sports, it seems unfathomable that a mere 50 years ago, not only were black athletes absent in all mainstream sporting arenas, it was simply not an option and even illegal in some states. His legacy is the inspiration he gives to athletes and people of all color. Robinson is heroic, in part, because of the excellence of his athletic achievement and equally important, for his political commitment to racial equality.

End of History Economics Essay

The set of short essays in question–compiled into a single essay by Foreign Policy–states the facts correctly about the current economic depression (they refuse to call it that, they opt for the less alarmist term of â€Å"recession†). But merely stating the facts correctly completely misses the point. Most couch-potato news junkies already know everything that is present in this essay. But that’s exactly the point: the essays in question here cover up more than they reveal. Their job–or so it seems–is to calm a public that might begin to ask fundamental questions about capitalism and globalization. The facts are clear: the structures and attitudes behind the facts are not. This is the purpose of this review. The facts are the following: that the economic depression will continue. Due to globalization, a depression or recession is not merely American or western, but it is global. Many economies in the developing world, through pressure from the US and the IMF, have linked their economies to the US market, which means, as a result, to the US dollar. These economies are talking given the fall in American consumer spending. The dollar has been wildly overvalued in recent years, but, in a recession of global proportions, running to the dollar for protection seems to be a popular–albeit irrational–option. The increase in the value of the US dollar means several things. On top of the already deep depression, food prices will begin to go up. This is social disaster, and not just for the US. Rises in food and transport mean that millions of economically marginal families will go into permanent decline and default. It means that the families that have already seen their homes foreclosed and dreams dashed will not be able to recover. As banks no longer lend as much, investment and spending are choked off, making recovery that much harder. The conclusion of all this is that the depression is here to stay. But the very last thing the writers in this essay want to deal with are the structural reasons for this decline and its global scope. The objections to the approach of this essay will now follow: 1. Not a single one of these writers mentions the word â€Å"gold. † For a long time, prices of gold have skyrocketed. The reason is not hard to see: gold is stable, it retains its value, it is a universal signal that something is not right with the globalist economy. God is a safe investment, far more safe than the dollar. But apparently, this is invisible to the authors. 2. The above authors have adeptly avoided the basic structural issues at work. a. First, that the basic contradiction in American capitalism is that excess production needs to be continually mopped up by wild consumption. As a result, American capital has gone insane in hiring PR firms and advertising agencies to create demand. b. The global economy is dependent on this artificially expanded and inflated demand, since these economies are export oriented, and that is economic code for â€Å"dumb Americans need to go into debt. † Without constant and deepening debt, the production not merely of American firms, but also the economies of the development world (largely shaped by American financial and political power), cannot sell their wares to the US and EU markets. c. Therefore, the basic contradiction is clear: debt drives the economy, but debt cannot last forever or get infinitely deeper. Therefore, global depressions and radical structural â€Å"re-adjustments† are a â€Å"normal† part of economic life. Put more succinctly, the entire artificial creation of demand is a scam designed to make a handful wealthy, while the remainder of the population drown in debt. Such a situation can only but deepen the already outrageous distinctions among classes in American and European life, as the majority default, while the liquidity becomes more and more monopolized by an oligarchy. The money here is not â€Å"lost, it merely changes hands. Well then, who now has it? The question is not even brought up, let alone answered. Money in these things is never â€Å"lost,† gone down some financial black hole: it changes hands. But the political and social implications of such a question cannot be realistically dealt with by major establishment publications such as FP. 3. But it gets worse: the contradiction in the relations between consumption and debt at the root of the economy is also related to the US dollar and its foreign holdings. Stephen Roach reminds American readers that home construction and personal consumption make up a whopping 80% of the US GDP. This means that no amount of â€Å"restructuring† can deal with the contradiction above. The contradiction lies at the very heart of the US economy and the global system, itself fashioned by the US. But its relation to the dollar is another matter. Most major trading states with the US such as China, South Korea or Saudi Arabia have been stocking dollars for decades for the purpose of facilitating trade with the US as well as maintaining a safe investment. But this is a major crisis that is closely connected to the credit contradiction, and the fact that it is avoided in the article mentioned cannot be an accident. The major trading partners of the US have trillions of liquid dollars in its banks. If the dollar weakens, or is replaced by the Euro for global trade, or that financial markets become regionalized (e. g. locally dependent on the Yuan or ruble), that liquid remains relatively worthless in foreign banks. Therefore, if the American economy is no longer the market of choice, due to the fact that credit cannot be extended any farther, then those now useless dollars will be ejected. That ejection, even by the most optimistic economist, can only means not merely the collapse of the US economy, but the collapse of the globalized economy as well. The notion, common to all the above authors, that the economy will eventually â€Å"recover† is a matter of dogma: it is not argued, merely assumed. But this is an assumption with a strong base. It is assumed because the alternative in unthinkable: a restructuring of the global economy based on regional or national lines, based around local production and occasional import substitution. Most economists are not even trained to handle such contingencies, and it is just not part of their vocabularies. But it is a necessity if the global recession turns into a major depression, and national states and regions begin being forced to protect their own populations instead of being part of the IMF/US led global economic system, where the irrationality of the American consumer and the amoral manipulation of the American elites mean the destruction of families and societies across the globe. They assume that globalization is â€Å"inevitable† and morally correct, and hence, that there is no other option. Theirs is the infamous â€Å"end of history† thesis of the official American ideologies at George Mason University: American empire is providential and has been crated by the â€Å"forces of history. † All moral problems have been solved and liberal democracy, anti-nationalism and globalism are here to stay. The subconscious acceptance of this fantastic view of history and American life colors all establishment writing on this subject. There is no real connection between university based economics and the average American. The former does not write for the latter, but for the system as a unit, more and more isolated from the average American family. Therefore, the question here is not merely an economic one, but a political one: there are now two Americas: the wealthy elite, university professors and TV talking heads on the one side, and the vast bulk of the (globe’s) population, on the other. They live two different lives: one suffers for the enrichment of the other. The global economy will not â€Å"bounce back,† as the nature of the current recession is built right into its assumptions and maxims. The job of modern economics, or so it seems, it to make sure that the average American consumer does not know that.

Drawing from the K303 materials critically discuss the issues, challenges and benefits in involving the service user to shape and develop services Essay

Involving the service user in shaping services continues to be an important activity within government policy. Drawing from the K303 materials critically discuss the issues, challenges and benefits in involving the service user to shape and develop services. Introduction Health and social care services strive to maintain, increase people’s wellbeing and provide the best care practice to individuals and the community. However, discrepancies arise because generalisations about what people need and how services should operate is still an everyday issue that affects the provision of services. People’s circumstances and opinions differ from one another despite having similar needs on the surface. Therefore, different kinds of support are expected. That is the main reason why people need to become participants in designing and shaping care services. When it comes to user’s involvement, policies have shaped the way social services are delivered as they represent an essential framework to the implementation of consistent and quality practices. As a result, it is utmost for frontline managers and healthcare professionals to adhere to them. However, this process is not straight forward and difficulties emerge (Book 1, pp. 27-28). This essa y will explore the issues, challenges and benefits of engaging service users in shaping and developing services. In order to do this, I will attempt to define the terms policy and service user involvement. Subsequently, I will identify the barriers faced by managers; discuss ways to overcome these challenges. And finally, the benefits of service user involvement will be identified. Policy and Practice Policy can be defined as a plan of action adopted by a person, group or government (Collins Language, 2011). In the history of health and social care, service providers have been influenced by the legacy of paternalism that developed in Victorian times. However, it was only until the 1970 s when emphasis on participation and service user involvement took placed. Through the years, the growing significance of service user involvement helped to eradicate the paternalist approach previously adopted by the government and service providers. Thus, generating a partnership-based  approach. Service user involvement or participation is listening to what people say about the services to have an impact on the way they are delivered. This has also become a key feature of government policies (Book1, p.28). In the course materials, Jane Rees made reference to this statement by emphasizing that ensuring genuine service user involvement was fundamental to her managing role at Redcar and Cleveland MIND (K303, DVD1, Band 2). It is also important to mention that service user involvement derives from two approaches –consumerist and democratic. The first approach refers to service users as customers and consumers of welfare much as they are consumers of other products. This approach, mainly developed by the state, aims to improve efficiency, economy and effectiveness of organisations and services. By drawing on the ideas and experience of service users, it is possible to improve management and decision making (Leggett et al, 1999, quoted in Course Reader, p.22). On the other hand, the democratic/citizenship approach is related to people as citizens as it was developed by users of health and social care services. This model has to do with enabling people to have more input over what happens to them in order to bring about direct change in their lives through both collective and individual action (Priestly, 1999, quoted in Course Reader, p. 22). Why is it important to adhere to policies? And what are the consequences of not adhering to them? Recognition of the importance of service user involvement is at a higher level. Service user’s view are becoming accepted by the government as an important element of evidenced based practice and a critical component when assessing the performance of health and social care agencies (DoH2000b; Scottish Office,1999, quoted in Book1, p.29). User involvement or participation is a complex, heavily politicised and value-based activity that can be related to basic ideas of best practice. At the same time, the experience developed by organisations, service users and supportive providers provides a source of principles for good practice. Although they do not guarantee success they do impact those who ignore them (Course Reader, p 24). It could be mentioned that one of the outcomes of not adhering to policies is the move away from considering the service user’s satisfaction. When an organisation does not take into account the views of the service user’s it will find itself open to criticism and it is  likely to be told to make changes (Stallard, 2011). For example, ignoring the views of service users who are involved in services again their wishes such as adults sectioned under the Mental Health Act 1983 (DoH, 2007) or the right of young people and children to be consulted about their views under the Children Act 1989 (DoH 2001c, quoted in Book1, p.41) could prevent valuable understanding regarding the fairness and equality of the service user’s involvement process. Also, difficulties when measuring and monitoring the quality of the services offered can be encountered when organisations and managers do not adhere to policies. Consequently, this could lead to the miss of any practice that needs to be highlighted or resolved. Moreover, not adhering to policies prevents social care organisations from being inclusive and developing a partnership with people who use the services. This has a direct effect on carers and service users as their right to have a voice and express their individual view is denied (Book1, p.37). Issues, challenges and benefits Issues Frontline staff and managers need to bear in mind that their daily job objective is to maintain a person’s well-being and quality of life. However, that is not an easy task. Taking into consideration that user involvement is paramount to develop good care practices; it is also possible to establish that many difficulties arise when this approach is put into practice. The first issue to be considered is the amount of time it takes to manage and apply the integration of service user’s views into all phases of the social care process and, not as a ‘one off’ consultation session. As an example, considering, listening and understanding children and young people’s views about their lives as well as other people who could help is a time consuming process where preparation is the key. Albeit, preparation requires time; therefore the process can result on management exercising pressure on staff to meet time deadlines. Thus, making the procedure more difficult for practitioners and service users (Book1, p. 37) Another matter that could affect the way the service is provided has to do with power dynamics. Put simply, whether managers are ready to work in conjunction with service users instead of for them and to adopt a practice-led approach (Book1,p. 37). This means that practice could be seen as a joint product where the service users  can contribute at all stages or as long as they wish to (Course Reader, p. 24). However, this may lead to power issues as managers or owners of private social care agencies might face difficulties in relation to the shift of power, resources and engaging service users successfully. On the other hand, service users may not wish to participate or are sceptical of manager’s motives (Book1, p. 37). It could also be argued that the shift of power could place the managers into a position where they feel have little power to empower people. As a result, service users may feel powerless in front of professionals and organisations and this could prevent them from willing to participate (SCIE, 2011). Other inconsistencies may be the concerns expressed b y managers in regards to service user’s expectations as these could be unrealistic, unattainable and unsatisfactory which can result in difficulties to decide appropriate aims(Book1, pp. 37-38).On top of that, managers attitudes towards the service users competence in making decisions can affect the relationship between both parties. Managers may fear saying the wrong thing, exposing the service user’s lack of knowledge or being encountered by with anger or criticism (Harding and Oldman, 1996; Morris, 1994, quoted in Book1, p. 38). Furthermore, it is also worth to mention that in the mainstream of service users involvement to decide ‘who to involve’ represents a dilemma as well. A manager might want to find a ‘representative’ service user. However, this imposes great difficulties due to several reasons such as the diversity of service users groups in terms of culture, race, sexuality and in some cases age (older people or young groups) and different disabilities. On top of that, minority groups, for instance, can feel marginalised as they may feel under or unrepresented in the participation process. It could also be mentioned that marginalisation can occur due to lack of knowledge about user participation too (SCIE, 2011). Challenges As a result of participation challenges have emerged for both managers and service users. Firstly, elements such as time, support and financial costs represent a challenge for managers. To address these issues, it is necessary to recognise that it is imperative to allow sufficient time and support help to build trust between managers and service users. Support refers to the  provision of any help, encouragement, skills and assistant (Course Reader, p.27) Moreover, minimising the costs of participation for service users by paying for their time and travelling expenses could be appropriate. A budget should be allocated to finance the costs of those service users who have a real commitment to participate (Course Reader, p. 26). Secondly, managers encounter challenges in regards to monitoring and evaluating techniques. For example, sending questionnaires to service users is a good way to get feedback. However, a problem is experienced when questionnaires are not returned. A possible solution to this problem would be to ask the service users to fill the questionnaires at the end of a meeting, for example, to ensure they come back or to make a commitment to collect feedback. Thirdly, it is worth to mention that even when service groups reunite with professionals it doesn’t necessarily mean that there is proactive participation. In some cases, participants don’t contribute to the communication process. This could be triggered by services filing away reports about what people said. As people do not get to see the information they do not know what has been said by others or if any changes have been made. Consequently, they are reluctant to have an input as they may feel their opinions are not taken into account (Course Reader, p. 30).A course of action could be to write reports and provide feedback to user groups. These reports should inform what changes have been made in relation to the information given as well as an explanation to why chan ges have not been made (Course Reader, p. 30). Benefits Participation provides exclusive advantages for managers, service users and carers. Among the benefits for managers is the acquisition of new knowledge and experience obtained from service user’s engagement. This knowledge could help managers to understand (or improve) the different methods for involving service users and carers in the individual decision making. Moreover, this could prove to be beneficial for the development of an organisation’s structure when it comes to making changes or improving services that are being delivered. The benefits for service users and carers can be associated not only to an individual level but to a community level as well. That is to say, service users and carers can benefit on a personal level by  increasing confidence as they get to know their rights and how to access services. Service users can also take part in planning care that fulfills their individual needs. Moreover, carers might improve their skills and gain job satisfacti on as they are delivering better tailored care. They can also develop the necessary skills, experience and knowledge regarding the importance of participation trough training (Course Reader, p. 44). Conclusion Health and social care services policies have changed through the years. Current policies emphasise on the implementation of consistent and quality practices through service user involvement. Nevertheless, as there is no single user’s view managers face a series of practical issues and challenges when implementing participation. To tackle these problems, managers must find methods to address these challenges effectively. By doing this, what is considered a challenge can be turned into a series of benefits as successful user involvement proves to be a useful tool to identify issues, make changes and improve the service provided. References Collins Language (2011) [online] http://www.collinslanguage.com/results.aspx?context=3&reversed=False&action=define&homonym=1&text=policy (Accessed 3rd November, 2011) Department of Health (2007) Mental Health Act 1983[online] http://www.dh.gov.uk/en/publicationsandstadistics/legislation/Actsandbills/DH_4002034 (Accessed 17th November, 2011) Stallard, D. (5th November, 2011, 14:07) ‘Block 1Forum Activity’, forum message to K303 2011. The Open University (2003) K303, Managing Care in Context, DVD 1, Band 2 ‘A meeting of Minds’, Milton Keynes, The Open University. The Open University (2003) K303, Managing Care in Context, Chapter 2, ‘What service users say about services: the implications for managers’, Unit 2.1 ‘Introduction’, Milton Keynes, The Open University. The Open University (2003) K303, Managing Care in Context, Chapter 2.