Tuesday, January 29, 2013

Globalisation And Primary Education Development In Tanzania: Prospects And Challenges

1. Overview of the Country and Primary Education System:
Tanzania covers 945,000 square kilometres, including approximately 60,000 square kilometres of inland water. The population is about 32 million people with an average annual growth rate of 2.8 percent per year. Females comprise 51% of the total population. The majority of the population resides on the Mainland, while the rest of the population resides in Zanzibar. The life expectancy is 50 years and the mortality rate is 8.8%. The economy depends upon Agriculture, Tourism, Manufacturing, Mining and Fishing. Agriculture contributes about 50% of GDP and accounting for about two-thirds of Tanzania's exports. Tourism contributes 15.8%; and manufacturing, 8.1% and mining, 1.7%. The school system is a 2-7-4-2-3+ consisting of pre-primary, primary school, ordinary level secondary education, Advanced level secondary, Technical and Higher Education. Primary School Education is compulsory whereby parents are supposed to take their children to school for enrollment. The medium of instruction in primary is Kiswahili.

One of the key objectives of the first president J.K. Nyerere was development strategy for Tanzania as reflected in the 1967 Arusha Declaration, which to be ensuring that basic social services were available equitably to all members of society. In the education sector, this goal was translated into the 1974 Universal Primary Education Movement, whose goal was to make primary education universally available, compulsory, and provided free of cost to users to ensure it reached the poorest. As the strategy was implemented, large-scale increases in the numbers of primary schools and teachers were brought about through campaign-style programs with the help of donor financing. By the beginning of the 1980s, each village in Tanzania had a primary school and gross primary school enrollment reached nearly 100 percent, although the quality of education provided was not very high. From 1996 the education sector proceeded through the launch and operation of Primary Education Development Plan - PEDP in 2001 to date.

2. Globalization
To different scholars, the definition of globalization may be different. According to Cheng (2000), it may refer to the transfer, adaptation, and development of values, knowledge, technology, and behavioral norms across countries and societies in different parts of the world. The typical phenomena and characteristics associated with globalization include growth of global networking (e.g. internet, world wide e-communication, and transportation), global transfer and interflow in technological, economic, social, political, cultural, and learning areas, international alliances and competitions, international collaboration and exchange, global village, multi-cultural integration, and use of international standards and benchmarks. See also Makule (2008) and MoEC (2000).

Globalisation And Primary Education Development In Tanzania: Prospects And Challenges

3. Globalization in Education
In education discipline globalization can mean the same as the above meanings as is concern, but most specifically all the key words directed in education matters. Dimmock & Walker (2005) argue that in a globalizing and internalizing world, it is not only business and industry that are changing, education, too, is caught up in that new order. This situation provides each nation a new empirical challenge of how to respond to this new order. Since this responsibility is within a national and that there is inequality in terms of economic level and perhaps in cultural variations in the world, globalization seems to affect others positively and the vice versa (Bush 2005). In most of developing countries, these forces come as imposing forces from the outside and are implemented unquestionably because they do not have enough resource to ensure its implementation (Arnove 2003; Crossley & Watson, 2004).

There is misinterpretation that globalization has no much impact on education because the traditional ways of delivering education is still persisting within a national state. But, it has been observed that while globalization continues to restructure the world economy, there are also powerful ideological packages that reshape education system in different ways (Carnoy, 1999; Carnoy & Rhoten, 2002). While others seem to increase access, equity and quality in education, others affect the nature of educational management. Bush (2005) and Lauglo (1997) observe that decentralization of education is one of the global trends in the world which enable to reform educational leadership and management at different levels. They also argue that Decentralization forces help different level of educational management to have power of decision making related to the allocation of resources. Carnoy (1999) further portrays that the global ideologies and economic changes are increasingly intertwined in the international institutions that broadcast particular strategies for educational change. These include western governments, multilateral and bilateral development agencies and NGOs (Crossley & Watson 2004). Also these agencies are the ones which develop global policies and transfer them through funds, conferences and other means. Certainly, with these powerful forces education reforms and to be more specifically, the current reforms on school leadership to a large extent are influenced by globalization.

4. The School Leadership
In Tanzania the leadership and management of education systems and processes is increasingly seen as one area where improvement can and need to be made in order to ensure that education is delivered not only efficiently but also efficaciously. Although literatures for education leadership in Tanzania are inadequate, Komba in EdQual (2006) pointed out that research in various aspects of leadership and management of education, such as the structures and delivery stems of education; financing and alternative sources of support to education; preparation, nurturing and professional development of education leaders; the role of female educational leaders in improvement of educational quality; as will as the link between education and poverty eradication, are deemed necessary in approaching issues of educational quality in any sense and at any level. The nature of out of school factors that may render support to the quality of education e.g. traditional leadership institutions may also need to be looked into.

5. Impact of Globalization
As mentioned above, globalization is creating numerous opportunities for sharing knowledge, technology, social values, and behavioral norms and promoting developments at different levels including individuals, organizations, communities, and societies across different countries and cultures. Cheng (2000); Brown, (1999); Waters, (1995) pointed out the advantages of globalization as follows: Firstly it enable global sharing of knowledge, skills, and intellectual assets that are necessary to multiple developments at different levels. The second is the mutual support, supplement and benefit to produce synergy for various developments of countries, communities, and individuals. The third positive impact is creation of values and enhancing efficiency through the above global sharing and mutual support to serving local needs and growth. The fourth is the promotion of international understanding, collaboration, harmony and acceptance to cultural diversity across countries and regions. The fifth is facilitating multi-way communications and interactions, and encouraging multi-cultural contributions at different levels among countries.

The potential negative impacts of globalization are educationally concerned in various types of political, economic, and cultural colonization and overwhelming influences of advanced countries to developing countries and rapidly increasing gaps between rich areas and poor areas in different parts of the world. The first impact is increasing the technological gaps and digital divides between advanced countries and less developed countries that are hindering equal opportunities for fair global sharing. The second is creation of more legitimate opportunities for a few advanced countries to economically and politically colonize other countries globally. Thirdly is exploitation of local resources which destroy indigenous cultures of less advanced countries to benefit a few advanced countries. Fourthly is the increase of inequalities and conflicts between areas and cultures. And fifthly is the promotion of the dominant cultures and values of some advanced areas and accelerating cultural transplant from advanced areas to less developed areas.

The management and control of the impacts of globalization are related to some complicated macro and international issues that may be far beyond the scope of which I did not include in this paper. Cheng (2002) pointed out that in general, many people believe, education is one of key local factors that can be used to moderate some impacts of globalization from negative to positive and convert threats into opportunities for the development of individuals and local community in the inevitable process of globalization. How to maximize the positive effects but minimize the negative impacts of globalization is a major concern in current educational reform for national and local developments.

6. Globalization of Education and Multiple Theories
The thought of writing this paper was influenced by the multiple theories propounded by Yin Cheng, (2002). He proposed a typology of multiple theories that can be used to conceptualize and practice fostering local knowledge in globalization particularly through globalized education. These theories of fostering local knowledge is proposed to address this key concern, namely as the theory of tree, theory of crystal, theory of birdcage, theory of DNA, theory of fungus, and theory of amoeba. Their implications for design of curriculum and instruction and their expected educational outcomes in globalized education are correspondingly different.

The theory of tree assumes that the process of fostering local knowledge should have its roots in local values and traditions but absorb external useful and relevant resources from the global knowledge system to grow the whole local knowledge system inwards and outwards. The expected outcome in globalized education will be to develop a local person with international outlook, who will act locally and develop globally. The strength of this theory is that the local community can maintain and even further develop its traditional values and cultural identity as it grows and interacts with the input of external resources and energy in accumulating local knowledge for local developments.

The theory of crystal is the key of the fostering process to have "local seeds" to crystallize and accumulate the global knowledge along a given local expectation and demand. Therefore, fostering local knowledge is to accumulate global knowledge around some "local seeds" that may be to exist local demands and values to be fulfilled in these years. According to this theory, the design of curriculum and instruction is to identify the core local needs and values as the fundamental seeds to accumulate those relevant global knowledge and resources for education. The expected educational outcome is to develop a local person who remains a local person with some global knowledge and can act locally and think locally with increasing global techniques. With local seeds to crystallize the global knowledge, there will be no conflict between local needs and the external knowledge to be absorbed and accumulated in the development of local community and individuals.

The theory of birdcage is about how to avoid the overwhelming and dominating global influences on the nation or local community. This theory contends that the process of fostering local knowledge can be open for incoming global knowledge and resources but at the same time efforts should be made to limit or converge the local developments and related interactions with the outside world to a fixed framework. In globalized education, it is necessary to set up a framework with clear ideological boundaries and social norms for curriculum design such that all educational activities can have a clear local focus when benefiting from the exposure of wide global knowledge and inputs. The expected educational outcome is to develop a local person with bounded global outlook, who can act locally with filtered global knowledge. The theory can help to ensure local relevance in globalized education and avoid any loss of local identity and concerns during globalization or international exposure.

The theory of DNA represents numerous initiatives and reforms have made to remove dysfunctional local traditions and structures in country of periphery and replace them with new ideas borrowed from core countries. This theory emphasizes on identifying and transplanting the better key elements from the global knowledge to replace the existing weaker local components in the local developments. In globalizing education, the curriculum design should be very selective to both local and global knowledge with aims to choose the best elements from them. The expected educational outcome is to develop a person with locally and globally mixed elements, who can act and think with mixed local and global knowledge. The strength of this theory is its openness for any rational investigation and transplant of valid knowledge and elements without any local barrier or cultural burden. It can provide an efficient way to learn and improve the existing local practices and developments.

The theory of fungus reflects the mode of fostering local knowledge in globalization. This theory assumes that it is a faster and easier way to digest and absorb certain relevant types of global knowledge for nutrition of individual and local developments, than to create their own local knowledge from the beginning. From this theory, the curriculum and instruction should aim at enabling students to identify and learn what global knowledge is valuable and necessary to their own developments as well as significant to the local community. In globalizing education, the design of education activities should aim at digesting the complex global knowledge into appropriate forms that can feed the needs of individuals and their growth. The expected educational outcome is to develop a person equipped certain types of global knowledge, who can act and think dependently of relevant global knowledge and wisdom. Strengths of the theory is for some small countries, easily digest and absorb the useful elements of global knowledge than to produce their own local knowledge from the beginning. The roots for growth and development are based on the global knowledge instead of local culture or value.

The theory of amoeba is about the adaptation to the fasting changing global environment and the economic survival in serious international competitions. This theory considers that fostering local knowledge is only a process to fully use and accumulate global knowledge in the local context. Whether the accumulated knowledge is really local or the local values can be preserved is not a major concern. According to this theory, the curriculum design should include the full range of global perspectives and knowledge to totally globalize education in order to maximize the benefit from global knowledge and become more adaptive to changing environment. Therefore, to achieve broad international outlook and apply global knowledge locally and globally is crucial in education. And, cultural burdens and local values can be minimized in the design of curriculum and instruction in order to let students be totally open for global learning. The expected educational outcome is to develop a flexible and open person without any local identity, who can act and think globally and fluidly. The strengths of this theory are also its limitations particularly in some culturally fruit countries. There will be potential loss of local values and cultural identity in the country and the local community will potentially lose its direction and social solidarity during overwhelming globalization.

Each country or local community may have its unique social, economic and cultural contexts and therefore, its tendency to using one theory or a combination of theories from the typology in globalized education may be different from the other. To a great extent, it is difficult to say one is better than other even though the theories of tree, birdcage and crystal may be more preferred in some culturally rich countries. For those countries with less cultural assets or local values, the theories of amoeba and fungus may be an appropriate choice for development. However, this typology can provide a wide spectrum of alternatives for policy-makers and educators to conceptualize and formulate their strategies and practices in fostering local knowledge for the local developments. See more about the theories in Cheng (2002; 11-18)

7. Education Progress since Independence in Tanzania
During the first phase of Tanzania political governance (1961-1985) the Arusha Declaration, focusing on "Ujamaa" (African socialism) and self-reliance was the major philosophy. The nationalization of the production and provision of goods and services by the state and the dominance of ruling party in community mobilization and participation highlighted the "Ujamaa" ideology, which dominated most of the 1967-1985 eras. In early 1970s, the first phase government embarked on an enormous national campaign for universal access to primary education, of all children of school going age. It was resolved that the nation should have attained universal primary education by 1977. The ruling party by that time Tanganyika African National Union (TANU), under the leadership of the former and first president of Tanzania Mwalimu Julius K. Nyerere, directed the government to put in place mechanisms for ensuring that the directive, commonly known as the Musoma Resolution, was implemented. The argument behind that move was essentially that, as much as education was a right to each and every citizen, a government that is committed to the development of an egalitarian socialist society cannot segregate and discriminate her people in the provision of education, especially at the basic level.

7.1. The Presidential Commission on Education
In 1981, a Presidential Commission on education was appointed to review the existing system of education and propose necessary changes to be realized by the country towards the year 2000. The Commission submitted its report in March 1982 and the government has implemented most of its recommendation. The most significant ones related to this paper were the establishment of the Teachers' Service Commission (TSC), the Tanzania Professional Teachers Association, the introduction of new curriculum packages at primary, secondary and teacher education levels, the establishment of the Faculty of Education (FoE) at the University of Dar-es-Salaam, the introduction of pre-primary teacher education programme; and the expansion of secondary education.

7.2. Education during the Second Phase Government of Tanzania
The second phase government of Tanzania spanning from 1985 to 1995, was characterized by new liberal ideas such as free choice, market-oriented schooling and cost efficiency, reduced the government control of the UPE and other social services. The education sector lacked quality teachers as well as teaching/learning materials and infrastructure to address the expansion of the UPE. A vacuum was created while fragmented donor driven projects dominated primary education support. The introduced cost sharing in the provision of social services like education and health hit most the poorest of the poor. This decrease in government support in the provision of social services including education as well as cost-sharing policies were not taken well, given that most of the incomes were below the poverty line. In 1990, the government constituted a National Task Force on education to review the existing education system and recommend a suitable education system for the 21st century.

The report of this task force, the Tanzania Education System for the 21st Century, was submitted to the government in November 1992. Recommendations of the report have been taken into consideration in the formulation of the Tanzania Education and Training Policy (TETP). In spite of the very impressive expansionary education policies and reforms in the 1970s, the goal to achieve UPE, which was once targeted for achievement in 1980, is way out of reach. Similarly, the Jomtien objective to achieve Basic Education for all in 2000 is on the part of Tanzania unrealistic. The participation and access level have declined to the point that attainment of UPE is once again an issue in itself. Other developments and trends indicate a decline in the quantitative goals set rather than being closer to them (Cooksey and Reidmiller, 1997; Mbilinyi, 2000). At the same time serious doubt is being raised about school quality and relevance of education provided (Galabawa, Senkoro and Lwaitama, (eds), 2000).

7.3. Outcomes of UPE
According to Galabawa (2001), the UPE describing, analysis and discussing explored three measures in Tanzania: (1) the measure of access to first year of primary education namely, the apparent intake rate. This is based on the total number of new entrants in the first grade regardless of age. This number is in turn expressed as a percentage of the population at the official primary school entrance age and the net intake rate based on the number of new entrants in the first grade who are of the official primary school entrance age expressed as percentage of the population of corresponding age. (2) The measure of participation, namely, gross enrolment ratio representing the number of children enrolled in primary education, regardless of age, expressed as a percentage of the official primary school age population; while the net enrolment ratio corresponds to the number of children of the official primary school age enrolled in primary school expressed as a percentage of corresponding population. (3) The measure of internal efficiency of education system, which reflect the dynamics of different operational decision making events over the school cycle like dropouts, promotions and repetitions.

7.3.1. Access to Primary Education
The absolute numbers of new entrants to grade one of primary school cycles have grown steadily since 1970s. The number of new entrants increased from around 400,000 in 1975 to 617,000 in 1990 and to 851,743 in 2000, a rise of 212.9 percent in relative terms. The apparent (gross) intake rate was high at around 80% in the 1970s dropping to 70% in 1975 and rise up to 77% in 2000. This level reflects the shortcomings in primary education provision. Tanzania is marked by wide variations in both apparent and net intake rates-between urban and rural districts with former performing higher. Low intake rates in rural areas reflect the fact that many children do not enter schools at the official age of seven years.

7.3.2. Participation in Primary Education
The regression in the gross and net primary school enrolment ratios; the exceptionally low intake at secondary and vocational levels; and, the general low internal efficiency of the education sector have combined to create a UPE crisis in Tanzania's education system (Education Status Report, 2001). There were 3,161,079 primary pupils in Tanzania in 1985 and, in the subsequent decade primary enrolment rose dramatically by 30% to 4,112,167 in 1999. These absolute increases were not translated into gross/net enrolment rates, which actually experienced a decline threatening the sustainability of quantitative gains. The gross enrolment rate, which was 35.1% in late 1960's and early 1970s', grew appreciably to 98.0% in 1980 when the net enrolment rate was 68%. (ibid)

7.3.3. Internal Efficiency in Primary Education
The input/output ratio shows that it takes an average of 9.4 years (instead of planned 7 years) for a pupil to complete primary education. The extra years are due to starting late, drop-outs, repetition and high failure rate which is pronounced at standard four where a competency/mastery examination is administered (ESDP, 1999, p.84). The drive towards UPE has been hampered by high wastage rates.

7.4. Education during the Third Phase Government of Tanzania
The third phase government spanning the period from 1995 to date, intends to address both income and non-income poverty so as to generate capacity for provision and consumption of better social services. In order to address these income and non-income poverty the government formed the Tanzania Vision 2025. Vision 2025 targets at high quality livelihood for all Tanzanians through the realization of UPE, the eradication of illiteracy and the attainment of a level of tertiary education and training commensurate with a critical mass of high quality human resources required to effectively respond to the developmental challenges at all level. In order to revitalize the whole education system the government established the Education Sector Development Programme (ESDP) in this period. Within the ESDP, there two education development plans already in implementation, namely: (a) The Primary Education Development Plan (PEDP); and (b) The Secondary Education Development Plan (SEDP).

8. Prospects and Challenges of Primary of Education Sector
Since independence, The government has recognised the central role of education in achieving the overall development goal of improving the quality of life of Tanzanians through economic growth and poverty reduction. Several policies and structural reforms have been initiated by the Government to improve the quality of education at all levels. These include: Education for Self-Reliance, 1967; Musoma Resolution, 1974; Universal Primary Education (UPE), 1977; Education and Training Policy (ETP), 1995; National Science and Technology Policy, 1995; Technical Education and Training Policy, 1996; Education Sector Development Programme, 1996 and National Higher Education Policy, 1999. The ESDP of 1996 represented for the first time a Sector-Wide Approach to education development to redress the problem of fragmented interventions. It called for pooling together of resources (human, financial and materials) through the involvement of all key stakeholders in education planning, implementation, monitoring and evaluation (URT, 1998 quoted in MoEC 2005b). The Local Government Reform Programme (LGRP) provided the institutional framework.

Challenges include the considerable shortage of classrooms, a shortage of well qualified and expert teachers competent to lead their learners through the new competency based curriculum and learning styles, and the absence of an assessment and examination regime able to reinforce the new approaches and reward students for their ability to demonstrate what they know understand and can do. At secondary level there is a need to expand facilities necessary as a result of increased transition rates. A major challenge is the funding gap, but the government is calling on its development partners to honour the commitments made at Dakar, Abuja, etc, to respond positively to its draft Ten Year Plan. A number of systemic changes are at a critical stage, including decentralisation, public service reform, strengthening of financial management and mainstreaming of ongoing project and programmes. The various measures and interventions introduced over the last few years have been uncoordinated and unsynchronised. Commitment to a sector wide approach needs to be accompanied by careful attention to secure coherence and synergy across sub-sectoral elements. (Woods, 2007).

9. Education and School Leadership in Tanzania and the Impacts
Education and leadership in primary education sector in Tanzania has passed through various periods as explained in the stages above. The school leadership major reformation was maintained and more decentralized in the implementation of the PEDP from the year 2000 to date. This paper is also more concerned with the implementation of globalization driven policies that influence the subjectivity of education changes. It is changing to receive what Tjeldvoll et al. (2004:1; quoted in Makule, 2008) considers as "the new managerial responsibilities". These responsibilities are focused to increase accountability, equity and quality in education which are global agenda, because it is through these, the global demands in education will be achieved. In that case school leadership in Tanzania has changed. The change observed is due to the implementation of decentralization of both power and fund to the low levels such as schools. School leadership now has more autonomy over the resources allocated to school than it was before decentralization. It also involves community in all the issues concerning the school improvement.

10. Prospects and Challenges of School Leadership

10.1. Prospects
The decentralization of both power and funds from the central level to the low level of education such as school and community brought about various opportunities. Openness, community participation and improved efficiency mentioned as among the opportunities obtained with the current changes on school leadership. There is improved accountability, capacity building and educational access to the current changes on school leadership. This is viewed in strong communication network established in most of the schools in the country. Makule (2008) in her study found out that the network was effective where every head teacher has to send to the district various school reports such as monthly report, three month report, half a year report, nine month report and one year report. In each report there is a special form in which a head teacher has to feel information about school. The form therefore, give account of activities that takes place at school such as information about the uses of the funds and the information about attendance both teacher and students, school buildings, school assets, meetings, academic report, and school achievement and problems encountered. The effect of globalization forces on school leadership in Tanzania has in turn forced the government to provide training and workshop for school leadership (MoEC, 2005b). The availability of school leadership training, whether through workshop or training course, considered to be among the opportunities available for school leadership in Tanzania

10.2. Challenges
Like all countries, Tanzania is bracing itself for a new century in every respect. The dawn of the new millennium brings in new changes and challenges of all sectors. The Education and Training sector has not been spared for these challenges. This is, particularly important in recognition of adverse/implications of globalisation for developing states including Tanzania. For example, in the case of Tanzania, globalisation entails the risks of increased dependence and marginalisation and thus human resource development needs to play a central role to redress the situation. Specifically, the challenges include the globalisation challenges, access and equity, inclusive or special needs education, institutional capacity building and the HIV/aids challenge.

11. Conclusion
There are five types of local knowledge and wisdom to be pursued in globalized education, including the economic and technical knowledge, human and social knowledge, political knowledge, cultural knowledge, and educational knowledge for the developments of individuals, school institutions, communities, and the society. Although globalisation is linked to a number of technological and other changes which have helped to link the world more closely, there are also ideological elements which have strongly influenced its development. A "free market" dogma has emerged which exaggerates both the wisdom and role of markets, and of the actors in those markets, in the organisation of human society. Fashioning a strategy for responsible globalisation requires an analysis which separates that which is dogma from that which is inevitable. Otherwise, globalisation is an all too convenient excuse and explanation for anti-social policies and actions including education which undermine progress and break down community. Globalisation as we know it has profound social and political implications. It can bring the threat of exclusion for a large portion of the world's population, severe problems of unemployment, and growing wage and income disparities. It makes it more and more difficult to deal with economic policy or corporate behaviour on a purely national basis. It also has brought a certain loss of control by democratic institutions of development and economic policy.

Globalisation And Primary Education Development In Tanzania: Prospects And Challenges
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Friday, January 25, 2013

Differences Between Nursing Homes, Assisted Living & Continuing Care Retirement Communities

Benjamin Franklin said it best - “nothing in life is certain except death and taxes” but with daily advancements in science, technology and health care, Americans are living longer than ever before*. This blessing however, has created a unique dilemma for modern American families: How to plan for and prepare for one's retirement years.

Have you taken a road-trip lately? Almost every highway is graced with large bill-boards providing the locations of new planned communities where couples can spend their retirement years dedicated to recreational pursuits. I doubt you will find a local newspaper that doesn’t have at least one ad promoting the amenities found at a local assisted living facility. Try to search for “nursing homes in Virginia” on the Internet and thousands of web pages will appear. Each and every day new facilities offering different programs are being built and marketed across the state.

Is such a facility right for you and your family? If so, which facility? We often hear the terms “retirement community,” “nursing home,” and “assisted living facility” but rarely consider what these terms actually mean. The differences however, are striking and it is imperative to understand these differences when making choices for yourself or your loved ones.

Differences Between Nursing Homes, Assisted Living & Continuing Care Retirement Communities

NURSING HOMES

In Virginia, a nursing home means any facility with the primary function of providing long-term nursing care, nursing services and health-related services on a continuing basis, for the treatment and inpatient care of two or more non-related individuals**. Put simply, a nursing home is a facility designed for someone who needs less care than a hospital, but requires daily health care assistance.

The Virginia Department of Health licenses such facilities and has established guidelines regulating various aspects of their operations, programs, and staffing needs, etc***. For example, a nursing home must: (a) have written policies and procedures regarding the treatment of residents and the management of resident care which are available to residents and their families (12VAC5-360-20); (b) provide emergency medical services within 15 minutes, under normal conditions (12VAC5-360-50); (c) be subject to unannounced on-site inspections of the nursing facility by State employees (12VAC5-371-60); (d) have a written agreement with one or more physicians licensed by the Virginia Board of Medicine to serve as medical director (12VAC5-371-230); and (e) each resident shall be under the care of a physician licensed by the Virginia Board of Medicine (12VAC5-371-240).

In addition, residents of nursing homes are also given certain rights as defined by Virginia Code §32.1-138. See http://leg1.state.va.us/cgi-bin/legp504.exe?000+cod+32.1-138. Nursing homes are the most regulated and structured residential options for our Seniors requiring some level of daily health care. If the facility provides care through Medicare and Medicaid programs, it is deemed a "Certified nursing facility" (Virginia Code §32.1-123; Virginia Code §32.1-127) and must be in compliance with both federal and state laws.

Of course, the more rules and regulations that define and control the daily operations of a nursing home, the greater the responsibility of the staff. These are the people who will be charged with the daily task of caring for your loved one, and making sure they are in compliance with state and federal laws. No matter how nice and or attractive the facility might be, the staff will make the difference between your loved one being cared for and encouraged, or not.

A nursing home is best suited for someone:

Who requires daily health care – such as assistance getting in and out of bed; taking medicine; or using the restroom. Who may have dementia or Alzheimer’s and as a result, is unable to eat and or bathe daily without reminder or assistance; Who is recovering from a fall or accident and is therefore unable to walk, dress and or eat without assistance
ASSISTED LIVING FACILITY

“Assisted living facility” means an adult care residence which has been licensed by the Virginia Department of Social Services to provide a level of service for adults who may have physical or mental impairments and require at least moderate assistance with the activities of daily living. Within assisted living, there are two types: regular assisted living for those seniors (typically) who need assistance with one or more daily activity; and intensive assisted living for someone who may be incapable of performing activities due to mental and/or severe physical impairment (12VAC30-120-450).

The Virginia Department of Social Services licenses assisted living facilities but does not regulate in the way the Department of Health regulates nursing homes. While there are Virginia guidelines regulating aspects of assisted living facilities, they are limited: An assisted living facility must: (a) provide or coordinate personal and health care services; and (b) provide 24-hour supervision.

As reflected in the table below, assisted living facilities have no obligation to provide health care and/or have health care staff available to assist your loved one. In addition, with no obligation to provide such services, there is the question as to whether or not they owe a duty to warn or treat residents with illnesses or diseases that could be transmitted from other residents.

While a nursing home will have many nurses on staff and doctors hired to monitor the residents, assisted living is more analogous to an apartment building or college dorm where laundry and food services are provided and residents are on their own for the rest of the day.

An assisted living Facility is best suited for someone:

Who is basically independent but may not be able or willing to prepare their own food or drive to doctors’ appointments; Someone who wants to scale back and anticipates needing assistance with laundry, cooking, etc. in the near future. A couple where one spouse is independent but may need assistance in feeding and or providing for needs of other spouse.
CONTINUING CARE RETIREMENT COMMUNITY

In Virginia you may also see advertisements for a retirement community. They are popping up all around our favorite College Towns and Tourist destinations.

A Continuing Care Retirement Community provides care depending on your current needs. Like an insurance policy, the resident pays an entrance fee and periodic adjustable payments, which in turn gives the resident a package of residential and healthcare services that the CCRC is obligated to provide at the time these residential and health care services are required. For example, if upon entering, all you want is help with your meals, that is the only service which will be provided. If you require intensive physical therapy or God forbid, daily assistance for a Dementia patient, the CCRC has assisted living services or nursing home services available under your contract. Continuing care contracts are regulated by the Virginia Bureau of Insurance of the Virginia State Corporation Commission.

Many CCRCs can have nursing home services available either on-site, or at licensed facilities off-site (12VAC5-360-10). While you may be entering the Retirement Community as a very healthy independent and capable resident, as your needs change, so will your contract with the Community and in turn, the facility’s obligations to you.

A Continuing Care Retirement Community Facility is best suited for someone:

Who is basically independent but anticipates the need for daily health care for themselves or a spouse in the near future; Someone who is physically disabled and would be unable to care for themselves or a spouse if the disability grew worse. With at least three very different choices, it is very important to do your research:

To research assisted living facilities in Virginia, go to Department of Social Services website: http://www.dss.state.va.us/facility/search/alf.cgi.

To research nursing homes, go to Medicare’s website: http://www.medicare.gov

AND LAST BUT NOT LEAST

It is always best to speak to a family member of a current resident and spend time getting to know the staff, no matter what type of facility you are looking into. If looking and researching is not enough, then consider the chart below – a comparison of the legal duties of a nursing home compared to the legal duties of an assisted living facility in Virginia.

DUTY or REQUIREMENT

NURSING HOME

ASSISTED LIVING

Duty to provide nursing care and or monitor resident’s health?

YES

NO

Doctor required to supervise residents?

YES

NO

Each resident shall be under the care of a physician licensed by the Virginia Board of Medicine?

YES

NO

Must have nurses on staff?

YES

NO

Must offer rehabilitative services?

YES

NO

Must have ongoing consultation from a registered dietitian or dietitian on staff?

YES

NO

24 Hour Supervision required?

YES

YES

Must develop a written plan upon admission of resident?

YES

YES

Staff must undergo criminal background check?

YES

YES

Monitored by Virginia Center for Quality Health Care Services and Consumer Protection

YES

NO

Monitored by Department of Social Services

NO

YES

*Life expectancy increased dramatically during the past century, from 47 years for Americans born in 1900 to 77 years for those born in 2001. These same factors—improved medical care and prevention efforts— that are partly responsible for the dramatic increases in life expectancy have also produced a major shift in the leading causes of death in the United States in the past century, from infectious diseases and acute illnesses to chronic diseases and degenerative illnesses.” The State of Aging and Health in America 2004, published by the Center for Disease Control, available at http://www.cdc.gov/aging/pdf/State_of_Aging_and_Health_in_America_2004.pdf.

**See generally, Virginia Code §32.1-123, as amended and Virginia Administrative Code § 12VAC5-360-10.

***It is a Felony under Virginia law to operate a nursing facility without a license. See generally, 12VAC5-371-30.

Differences Between Nursing Homes, Assisted Living & Continuing Care Retirement Communities
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Lauren Ellerman is an attorney with Frith Law Firm in Roanoke, Virginia. She concentrates her practice on medical malpractice, nursing home abuse, nursing home neglect, lead paint poisoning, and business torts. You may view her complete profile at [http://www.frithlawfirm.com/lauren.htm] and the firm’s home page at http://www.frithlawfirm.com

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Tuesday, January 22, 2013

Living in the Philippines - Most Popular Urban Retirement Cities of Foreign Retirees

When it comes to retirement locations in the Philippines, one has many options - major urban cities, larger rural cities, beach resorts, mountain retreats. Each has its own unique and attractive features. The major advantage of retirement in a major urban Philippines city are (i) international airport accessibility, (ii) excellent healthcare accessibility, (iii) all major sports activities, and (iv) secure, upscale shopping, night life and entertainment. In this category of major urban cities are the Manila metropolitan area, Cebu City in the Visayas area of the country, and Davao City in Mindanao.

MANILA

Manila is the capital of the country, and the primary port of entry for every foreigner flying to the Philippines. It is the gateway to the Philippines. For a foreigner seeking quick access in and out of the country, Manila is the place to be. Travel to Manila from California is 15 hours, from Hawaii it is 10 hours, from Tokyo it is a little over 4 hours, from Hong Kong it is less than 2 hours, from Singapore it is 3 hours, and from Europe it is basically 20 hours. Once you are in Asia, sitting in the China Sea, Manila is at the center. Trips to Hong Kong, Singapore, Thailand, Viet Nam, and Indonesia are quick and easy from Manila.

Living in the Philippines - Most Popular Urban Retirement Cities of Foreign Retirees

Manila is actually part of a major metropolitan area with an overall population of over 11 million people. So yes, it is crowded overall, yet, like all major cities in the world, there are areas within the metropolitan area which are quite diverse from one another.

Depending on one's retirement income, retiring foreigners tend to favor either the upscale, highly westernized Makati, Ortigas/Mandaluyong, or Alabang areas. These areas have all the amenities westerners are accustomed to, including all the biggest and most upscale shopping malls in the country. Makati is the financial hub of the Philippines, and it is full of western style upscale condominiums with all the latest amenities.

For those wanting an upscale, big city living, with access to the best entertainment, sporting events, unlimited shopping options, and most westernized lifestyle, within easy reach of foreign destinations, Manila is your best choice. The downside is that it is the most expensive than Cebu City and Davao City.

CEBU CITY

Cebu City is located on the island of Cebu in the chain of islands known as the Visayas. It is more centrally located in the country and is a domestic trading and transportation hub. It is much smaller than Manila, with a population less than 1 million, yet its people have a higher per capita income level. It is very pro business, and a more efficiently run city than Manila. It is very progressive and has become a large center of commerce. It has aggressively expanded its airport, which does receive certain direct international flights, though few in number.

Cebu has a large population of foreign retirees in relation to its population. Foreigners are drawn to its abundance of beaches and resorts. It is a beautiful city, surrounded by mountains on one side and the ocean on the other. Like Manila, it too has its upscale, modern shopping malls, casinos, and a great night life. Being a smaller city, getting around the city is much easier. It is now only beginning to see construction of high rise condominiums, which are abundant in Manila, and a favorite of western retirees.

Cebu has great medical facilities and it has just recently launched an effort in conjunction with the national government to further develop Cebu as a major medical tourism and retirement center for foreigners.

All in all, it has most of the westernized benefits of Manila, yet a lower cost of living, combined with the presence of many, many beautiful white sand beach resorts. Those who love living near the seaside, have interests in diving and other water sports, yet like the efficiency and amenities of a smaller modern city, then Cebu City would be your choice.

DAVAO CITY

Davao City is THE city of Mindanao, and by square miles it is the second largest city in the world. Its population is approximately 1.4 million. Located on the southern of Mindanao, it is the most rural of the three major urban cities, and it has the lowest cost of living. So, if you enjoy the lifestyle of a large city, but have limitations on your cost of living, Davao is the place for you.

Davao City does not get large numbers of foreign travelers, yet for those seeking outdoor adventures, the options are plentiful. Living in Davao is a bit like living in both an urban and a rural city, as the city has modern shopping centers, upscale gated communities and hotels, yet living there you become deeply rooted to the land outside the city. Just outside the city is Mt Apo with forested slopes and abundance of hiking opportunities, and located on a gulf, it is only a short boat ride to white sand beaches. Most of the land outside the city has been turned over to massive plantations growing pineapples, bananas, and other citrus. The city has a new, great world class golf course, and low rise condominiums are newly being built. It has committed itself to the development of a world class medical center, and is aggressively pursuing medical tourism.

In conclusion, it has been my experience that for a person who wants to retire in a major urban city in the Philippines, the choice between Manila, Cebu and Davao usually comes down to one's pension and/or other monthly retirement income. Manila is the most expensive, Cebu is next, and Davao has the lowest cost of living. Manila is the most cosmopolitan, and the Davao the most rural. All three are attractive spots for a foreigner seeking retirement in the Philippines in an urban environment.

Living in the Philippines - Most Popular Urban Retirement Cities of Foreign Retirees
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Do you want more in depth information about retirement living available to foreigners in the Philippines? I have just completed my new book on "Retirement Living in the Philippines", which provides a comprehensive study of opportunities for fun, adventure, love and great friendships living in the Philippines.

Download it at http://www.retirementlivinginthephilippines.com

Or it can be downloaded at: http://www.howtobeahappyhusband.com

Will Irwin is a powerful entrepreneur and business and life coach. He has started many online and offline businesses both in the USA and in the Philippines, residing in both Hawaii and the Philippines.

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Sunday, January 20, 2013

Discreet Married Women - Get a List of Them in Your Area For Free

Discreet married women have become highly sought after by men "in the know". This article explains how you can find lists of married women seeking men in your area. It them goes on to tell you how to contact them for almost immediate results.

Married women, those seeking affairs, have low standards. Lower than single women looking for life-partners, in any case. This attracts a lot of men who find it hard to get a date or a one night stand. A woman seeking an affair is less picky because most men will not date married women. This leaves the field wide open for men like yourself who are willing to date them.

Finding them is easy - if you know where to look. A married woman will not advertise in a place where friends and family may find out. What she does, ordinarily, is hunt for lovers or dates on any number of the most popular dating communities. These afford her anonymity because her husband or Mother is unlikely to be surfing a dating community. It is also a great place for her to find guys like yourself and chat to them in order to decide if she wants to meet up.

Discreet Married Women - Get a List of Them in Your Area For Free

What you have to do is simply choose any well-known dating community. Most of them even have free communities if you have no budget. A lot of people spend lots of time making a great profile. In all honesty, this is not really necessary. Just upload a decent picture and make sure you say in your description that you want to date discreet married women. That way they will find you in the search.

Once you're on the site you just need to make a search for local married women. This will give you a huge list with those online right now at the head of the list. To get almost immediate results, you should "instant message" women who are online. It won't take but a minute or so before you get replies. And, remember, these women are here for one thing: to find a man like you.

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You can join the free community of my favorite dating community here: Browse Married Women

This place is teeming with married women. You can email them, instant message chat to them, talk to them on webcam or just watch if you do not have your own cam. They also have about 10 million members, making them one of the biggest date communities going.

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Monday, January 14, 2013

Wedding Master Of Ceremonies - 10 Sure-Fire Tips For Success

Most people are so thrilled when a friend or family member asks them to be their wedding master of ceremonies. It's only later that they wonder what does a mc do at a wedding?

The wedding master of ceremonies is basically responsible for ensuring the various events that take place during the wedding reception run in a smooth and orderly fashion and on time.

It is at this point many a prospective wedding mc will start to panic. There is a lot of standing up in front of the wedding guests and making announcements.

Wedding Master Of Ceremonies - 10 Sure-Fire Tips For Success

After all the wedding mc duties will include making announcements for the arrival of the bridal party, the serving of dinner, the cutting of the wedding cake, the bridal waltz, the tossing of the bouquet and the departure of the bridal couple.

And of course you will also introduce each person who is making a speech or toast.

Even though the wedding master of ceremonies does not make a speech (unless they are also the best man) the thought of speaking up in public fills many with fear and trepidation.

Here are some wedding mc tips to help
Don't forget your notes and reading glasses if you need them; Take some long deep breaths beforehand. As you exhale tell yourself to relax; Hold your head up, look around the room and give everyone a big smile; Don't mumble. If there is no microphone speak loud and clear so everyone can hear you. In the days and weeks before the reception practice projecting your voice. If using a microphone make sure you know how it works. Establish eye contact with a person, hold for a few seconds then find someone else to look at; Keep your introductions short; Wedding mc jokes must not offend or embarrass anyone; Speak naturally and in terms all the wedding guests will understand; Try to look confident even if you are not feeling it; and Accept it is natural to feel a little nervous

And remember the more time you spend planning and organizing for the big day the easier it will be for you to relax and enjoy the occasion.

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Learn wedding mc jokes and one liners that are sure to amuse, not offend, the guests;

Plan correctly for your wedding emcee role by using this checklist for mc at wedding;

Be organized, get templates covering all the duties of a wedding master of ceremonies.

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Thursday, January 3, 2013

Benefits of Leisure and Recreation

Although it may not seem so, in reality, Leisure and Recreation is the largest industry in the world. The benefits of leisure and recreation as an important part of life are easy to see. As an industry, it offers a variety of related employment and creates billions of dollars in revenue. Workers in parks and recreation, community agencies, sports agencies, youth development organizations, non-profit organizations, rehab and hospital agencies, the travel and entertainment industries all utilize and benefit from parks and recreation facilities world-wide. Additional benefits of leisure and recreation include environmental improvements from expanding green spaces, health benefits, and personal satisfaction benefits.

There are many civic benefits of leisure and recreation activities. Sports and youth activities offer leadership development for adults and children. Strong communities are built as parks become a hub of community life. Benefits extend to all ages, childhood, youth, young adults, families, and seniors. Both care for environment and wellness through green spaces are enhanced by beauty. This same beauty helps combat stress through the opportunity for mild exercise and mediation upon natural beauty. Wilderness experiences are available in some locations.

For personal benefits, leisure activities may include:
Hobbies
Exercise
Sports
Gardening
Crafts
Health
Coping
Family Bonding

Benefits of Leisure and Recreation

Physical benefits include increased lung capacity from sports participation, plus reducing serum cholesterol and hypertension, increasing bone mass, strengthening the spine, reducing disease, increase in feelings of well being, reduction in stress hormones, improved attitudes and performances, and improved social skills. For childhood development, recreational areas assist in learning, can keep kids off the streets, and enhance their confidence. Studies confirm that physical activity can aid the learning process in children. Sports activities enhance large motor skill development and social skills. Adult leaders offer positive role models to children. Group sports are well known for promoting social support, networking, and developing friendships.

As if all the above is not enough to encourage support of leisure and recreational activities, consider the following additional benefits:

Stress management - the mild stress of leisure activity can reduce overall negative stress by contributing to relaxation.

Self esteem - especially in children and seniors, mild exercise, group activities, and hobbies and crafts will help create positive self images.

Positive lifestyle development - contributing to society, social interaction, development of leaders, being part of organized sports all encourage good lifetime activities.

Personal satisfaction - any creative outlet will enhance personal satisfaction. Being part of the leadership offers self satisfaction, and those who work in the recreational areas can feel the pride in keeping these areas vital and available to others.

Quality of life - fresh air, sunshine, social interaction, health benefits and self esteem all will improve quality of life.

Preventative health - regular exercise, physiological benefits from mild exercise, and stress reduction all are made easier by having leisure and recreational activities readily available.

Since the future seems to be headed for a shorter work week and more extra time, support of leisure and recreational outlets and locations would be prudent, and benefit all involved.

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Matthew Finn is an accomplished niche website developer and author. To learn more about leisure and recreation [http://exoticrecreation.info/benefits-of-leisure-and-recreation/] please visit Exotic Recreation [http://exoticrecreation.info/] for current articles and discussions.

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