Role of Triage in Emergency Care

Role of Triage in Emergency Care OVERVIEW There is a consensus on the fact that there has been a significant increase in traffic to emergency rooms which has resulted in rapidly growing demand on the limited resources of emergency rooms worldwide. In 1980, there were more than 82 million visit to hospital Emergency rooms in the USA, and a large percentage were for non urgent medical conditions. One reason for this trend is that people know they can get medical attention immediately in the Emergency departments without the long wait for appointments. This has led to very high load of patients visit to emergency rooms; a pattern that holds true globally for non urgent patient visits to most pediatric emergency rooms ( Wilson FO etal ). Another reason given for overcrowding is the increase rural to urban migration of populations and also the increase in the standard of care provided in most emergency room. However, the resulting increase in demand for emergency medical care has not been matched by availability of resources in most healthcare systems and hence there is need for emergency room managers to adopt or develop tools and protocols to prioritize the urgency and acuity of conditions to allocate appropriate level of care. If this is not done, then there is a likelihood that very ill patients may end up waiting long hours with increased risk of morbidity and some may even die as a result of delay in life saving treatment or interventions. (Mirjam van veen and Harriette a Moll) DEFINITION Triage as a term actually originates from the French verb ‘trier’, which translates ‘to sort’. It was originally used by the military as a concept to deal with large number of casualties managed by very few human and material resources. The decision is made to prioritize who had the best chance of survival, and what level of care for the survivors (LE Slay,WG Rislan ) In the last 20 years, this concept has become applicable in response to the increasing traffic to the emergency rooms and several tools have been developed to assess, prioritize and sort patients coming to the emergency department according to a determined severity of illness or injury, the level of suffering, the likely prognosis and need for intervention with available resources. It must be clarified, that triage in itself is not a diagnostic tool but a systematically structured and methodical way of assessing the severity of patients conditions to determine their clinical priorities using their presenting symptoms and measurable physiological parameters and it aims to optimize the provision of emergency care efficiently to produce the best outcome for every patient by channeling patients to appropriate level and quality of care. Hence the factors that are considered are severity of illness, level of urgency and impact of life saving intervention to reduce mortality, as well as level of care needed baring limited resources. These factors can be measured objectively using mortality rate, number of admissions to critical care unit and wards as well as patients referred to low urgency care services. The development of different assessment scoring systems and other pediatric-specific scales were attempts to have an objective approach to the assessment of severity acuity and to help predict illness or injury outcomes in children. Hence the Pediatric Glasgow Coma Scale, the Yale Observation Scale, the Pediatric Trauma Score, the PRISM score (Pediatric Risk of Mortality score), different pain scales and various respiratory severity scoring systems were all attempts to provide common nomenclature and standardize the assessment of severity of sickness and to predict prognosis in the pediatric age group. However in practice the emergency room triage nurse needs a comprehensive, simple and efficient acuity stratificaton of the severity, to make rapid and effective decisions(Dieckmann, 2002). These led to development of various decision making tools or triage scales. Gerber Zimmerman and McNair had tried to described triage as simply a rating of patients clinical urgency, that eventually evolved into 2 levels of urgent, and non urgent. Triage scales are hence developed with the aim to rapidly identify very urgent cases requiring immediate or urgent life saving treatment, or efficiently direct them to appropriate level of care, and the variations of triage scales are due to functional differences in service provision as well as availability of resources. Though there is no fail proof scale of stratification because invariably cultural adaptations, level of sophistication of data collection, personal and environmental factors do influence every measurement tool. (Christ et al 2010 as per Azeredo et al) Fittzgerald in his doctoral thesis in 1989, showed it is actually a far more complex decision making tool using defined criteria to classify patients as either a simple 3, 4 or 5 level urgency scale, pioneering the objective distinction of the earlier urgency scales(Fitzgerald GT. Emergency department triage. Department of Medicine. Queensland, Australia: University of Queensland, 1989.) TRIAGE IN CHILDREN Laskowski-Jones and Salati (2000) had strongly elucidated that children should not be seen as little adults and must not be treated as such by healthcare professionals. This is because of obvious anatomical, physiological, as well as emotional and intellectual differences between children and adults which directly alter the presentation of this group of patients in the emergency department[Laskowski-Jones]. This makes it inapplicable to use adult triage criteria for children of pediatric age due to unique clinic-pathological characteristics that creates the potential for sudden and rapid deterioration when children present to the Emergency department, creating an absolute necesity for very accurate focused triage. There are evidence that in mixed emergency departments, adults tend to ‘be seen earlier than equally ill children resulting in unacceptable waiting times for very ill children, therefore again creating a need for specific pediatric triage scales.(Cain P, Waldrop RD, Jones J; improved pediatric patient flow in a general emergency department by altering triage criteria. Acad Emerg Med 3:65-71, 1996) The UKs Manchester Triage Systems MTS, the USAs Emergency Severity Index ESI, the Canadian Triage and Acuity Scale CTAS, and the Australian(National ) Triage Scale, the most widely used triage scales and by consensus the most studied were all eventually modified to contain specific parts for children, are all also made of five level of triage urgencies (van Veen and Moll) It is important to note that none of them had been developed ‘de novo’ specifically for the pediatric age group. The initial three-level systems which predominated in the United States typically used either levels 1, 2, and 3 or emergent–urgent–nonurgent classification assignments. These methods are driven by the underlying question, ‘‘How long can patients wait?’’ When evaluated, these three-level methods had been found to be highly unreliable and have been criticized because they lack validation with clinical outcomes. (Travers DA, Waller AE, Bowling JM, Flowers D,) The 5-level scales provided a better discriminated tool for pediatric patient triage in emergency department, which was shown to be more efficient in predicting resources utilizations including hospital admissions, length of stay, and resourse utilization.(Chang, Hsu) Though 5-level scales are similar to the adults, but they have pediatric clinic-pathological parameters. Level 1 is critical, level 2 is emergent, level 3 is urgent, level 4 is non-urgent and level 5 is fast track.(O’Neil KA, Molczan K: Pediatric triage: a tier, 5-level system in the United States. Pediatr Emerg Care 19:285-290, 2003) The MTS is a five-level scale that incorporates the UK National Triage Scale. It was developed in 1996 and then revised ten years later after thorough input by various experts.(Mackway-Jones et al 2006). Though it was designed predominantly for adults, the MTS eventually adapted six flow charts that relate specifically to children and hence in 2007 it became endorsed by the Royal College of Pediatrics and Child Health. WHAT IS ALREADY KNOWN? What is already established is that the true functional capability of an effective triage system is determined by their reliability and validity. Reliability is measured as both inter rater reliability which is a measure of the agreement between two or more separate individuals using the same scale. It is an affirmation that the agreement is beyond that presented by chance, and this can be statistically determined and analyzed using Cohen’s kappa k. Where K is equal to 1 if the raters are in perfect agreement, and K is equal to 0 if their agreement is absolutely by chance. So k is rated from 0.1-0.9 ( as poor to excellent agreement). Intra rater reliability measures the agreement of one triage rater agreeing on the same level of urgency when two different cases of same scenario present on separate occasions. Validity is a determination that a conclusion of a true urgency is in fact the true value for every clinical presentation. Whereas internal validity measures of the ability of the triage system to predict this true urgency within a system, external validity measures its reproducibility in a different setting. Hence experts agree that any triage has to have these characteristics to be seen as a legitimate tool of assessment and to perform as intended [Fernandez C]. It is also known that the four major triage scales, the MTS, ESI, CTAS, and ATS have been studied and validated for both internal validity and reliability in adults and have been used in ED triage by different health institutions. Some studies reported that the MTS and the Pediatric-CTAS both seem to be valid and reliable to triage children in pediatric emergency care. (Ma, Gafni and Goldman)This has been confirmed by van Veen and Moll in another review in 2009. The CTAS enables rapid stratification of patients at the time of first encounter based on 5 levels of urgency (risk and symptom severity). Each level has a targeted waiting period until the patient is examined by the doctor or to be reassessed again in the triage area to consider the possibility of waiting longer or to be seen immediately by the physician. The standards recommended by CTAS is that waiting time is 0 minutes for level 1, 15 minutes for level 2, 30 minutes for level 3, 60 minutes for level 4, and 120 minutes for level 5. (Murray M, Bullard M, Grafstein E; CTAS National Working Group; CEDIS National Working Group. Revisions to the Canadian Emergency Department Triage and Acuity Scale implementation guidelines. CJEM 2004, 6: 421-427.)

The Black Death

Black Death refers to a bubonic and pneumonic plague believed to have come from rats and which spread throughout Western Europe during the 14th century resulting to the death of millions, drastically decreasing the overall population of Europe, and changing the economic and cultural landscape of the region. It came in periodic epidemics from 1300s to the 1700s in the various places where it struck. The plague is said to have originated in Central Asia when the Mongol army, in an attempt to take siege of the Caffa in the Crimea during the early 1300s, catapulted plague-infested corpses into the city. The fleeing traders carried the disease with them to Sicily. From Italy, it immediately spread into peopled towns and cities around neighboring France, Spain, Portugal, England, and other parts of Europe. It caused the total disappearance of villages as about one-third of the entire population of Europe died in the epidemic which ensued. It was most virulent in England where it claimed about half of its population. It spread quickly because doctors did not have enough knowledge then on how to cure the disease and any purpose of finding a cure was defeated by the fact that the plague claimed its victim within a week. Poor hygiene and sanitation practices among the crowded European cities also contributed to the outbreak. Aside from the dramatic decrease in Europe's population, the Black Death stopped on-going wars and caused a slump in trade. It decreased available labor in the farmlands. It even affected the Catholic Church as people turned to superstition to explain the cause of the plague when their faith could not do anything to cure it. There was mass slaughter and burning of Jews who were accused of spreading the plague. A good effect of the epidemic, however, is that the shortage of workers resulted to better remuneration for the peasants as farm owners tried to outdo each other in luring the peasantry to work for them. These resulted to social mobility which would eventually lessen the power of the nobility and clergy in succeeding centuries. The Black Death experience illustrates how disease could change the history of humankind especially if it affects multitudes of populations around the world. With the advanced technology in the field of medicine today however, and the presence of international organizations like the World Health Organization, it has become easier to contain epidemics before they could become as widespread as the Black Death experience. The Black Death â€Å"The Black Death: Natural and Human Disaster in Medieval Europe† by Robert S. Gottfried is known as â€Å"A fascinating work of detective history, The Black Death traces the causes and far-reaching consequences of this infamous outbreak of plague that spread across the continent of Europe from 1347 to 1351. Drawing on sources as diverse as monastic manuscripts and dendrochronological studies (which measure growth rings in trees), historian Robert S. Gottfried demonstrates how a bacillus transmitted by rat fleas brought on an ecological reign of terror — killing one European in three, wiping out entire villages and towns, and rocking the foundation of medieval society and civilization. † The Black Death was an epidemic which spread across almost all of Europe in the years 1346 –1353; the plague killed over a third of the entire population. It has been described as the worst natural disaster in European history.The Black Death discusses the causes and r esults of the plague that devastated medieval Europe. It focuses on the many effects it had on the culture of medieval Europe and the possibility that it expedited cultural change. Robert S. Gottfried argued that rodent and insect life cycles, as well as the changing of weather systems affect plague. He claimed that the devastation plague causes is partly due to its perpetual recurrences. Plague ravaged Europe in cycles, devastated the people when they were recuperating.As can be later discovered in the book, the cycles of plague consumed the European population. A second thesis, which he described in greater detail, was that the plagues expedited the process of cultural change. The plagues killed a large percentage of each generation, leaving room for change. Why the name, Black Death? â€Å"The traditional belief is that it was so called because the putrefying flesh of the victims blackened in the final hours before death supervened. The trouble about this otherwise plausible the ory is that no such phenomenon occurred.It is true that, in cases of septicemic plague, small black or purple blotches formed on the bodies of the sick and this symptom must have made a vivid impression on beholders† (Ziegler) Coming out of the East, the Black Death reached the shores of Italy in the spring of 1348 unleashing a rampage of death across Europe unprecedented in recorded history. By the time the epidemic played itself out three years later, anywhere between 25% and 50% of Europe's population had fallen victim to the pestilence. The plague presented itself in three interrelated forms.The symptoms were not the same as in the East, where a gush of blood from the nose was the plain sign of inevitable death; but it began both in men and women with certain swellings in the groin or under the armpit. They grew to the size of a small apple or an egg, more or less, and were vulgarly called tumors. In a short space of time these tumors spread from the two parts named all ov er the body. Soon after this the symptoms changed and black or purple spots appeared on the arms or thighs or any other part of the body, sometimes a few large ones, sometimes many little ones.These spots were a certain sign of death, just as the original tumors had been and still remained. The bubonic variant (the most common) derives its name from the swellings or buboes that appeared on a victim's neck, armpits or groin. These tumors could range in size from that of an egg to that of an apple. Although some survived the painful ordeal, the manifestation of these lesions usually signaled the victim had a life expectancy of up to a week. Infected fleas that attached themselves to rats and then to humans spread this bubonic type of the plague.A second variation, pneumonic plague, attacked the respiratory system and was spread by merely breathing the exhaled air of a victim. It was much more virulent than its bubonic cousin – life expectancy was measured in one or two days. Fi nally, the septicemic version of the disease attacked the blood system. Having no defense and no understanding of the cause of the pestilence, the men, women and children caught in its onslaught were bewildered, panicked, and finally devastated. The Black Death covers the affects that numerous plagues had on the culture.There appear to have been several separate introductions into Europe. It reached Sicily in October 1347 carried by twelve Genoese galleys where it rapidly spread all over the island. Galleys from Caffa reached Genoa and Venice in January 1348 but it was the outbreak in Pisa a few weeks later that was the entry point to northern Italy. Towards the end of January one of the galleys expelled from Italy arrived in Marseilles. From Italy the disease spread northwest across Europe, striking France, Spain, Portugal and England by June 1348, then turned and spread east through Germany and Scandinavia from 1348 to 1350.It was introduced in Norway in 1349 when a ship landed at Askoy, then proceeded to spread to Bjorgvin but never reached Iceland. Finally it spread to north-western Russia in 1351; however, the plague largely spared some parts of Europe, including the Kingdom of Poland and isolated parts of Belgium and the Netherlands. The cycle of the plagues struck each generation. After a plague ravaged Europe from 599-699, plague killed in 608, 618, 628, 640, 654, 684-686, 694-700, 718, and 740-750. In the early stages of the above series, intervals are apparent.These intervals demonstrate the cycles of the rodent and insect life. Robert S. Gottfried also argues, rightfully so, that plague may have hastened cultural change. Along with plagues came the need for a cure. Plague destroyed the existing medical systems, and was replaced by a modern heir. Previous to the plague, scientists based their knowledge on early scientists such as Hippocrates and Galen. Scientists knew little about what they were doing. The medical community was divided into five part s. These divisions were physicians, surgeons, barber-surgeons, apothecaries, and unlicensed practitioners.These divisions were adequate when Europe was without plague, but were obviously not prepared for plague. Doctors responded with a series of changes are to thank for the development of modern science. Although the government had medical workers try to prevent the plague, the plague persisted. Most medical workers quit and journeyed away because they feared getting the plague themselves. There were methods that did work. Cities were hardest hit and tried to take measures to control an epidemic no one understood.In Milan, to take one of the most successful examples, city officials immediately walled up houses found to have the plague, isolating the healthy in them along with the sick. Venice took sophisticated and stringent quarantine and health measures, including isolating all incoming ships on a separate island. But people died anyway, though fewer in Milan and Venice than in c ities that took no such measures. Pope Clement VI, living at Avignon, sat between two large fires to breath pure air. The plague bacillus actually is destroyed by heat, so this was one of the few truly effective measures taken.Gottfried succeeded in convincing me that his thesis was truth. The opening chapters gave me a solid background of plague, explaining why he believes it had such an impact on medieval population and culture. Next, it delves into the affect that changing weather had on the plagues, explaining the European environment during 1050-1347; the time of plagues greatest destruction. That complete, Gottfried describes the consequences immediately following the plague. It is said that the disease killed 25% to 40% of Eurasia and part of Africa. By this point, it is more than obvious hat plague had a tragic affect on Medieval Europe, The Consequences and effects of the Black Death plague were prices and wages rose, greater value was placed on labor, farming land was give n over to pasturing, which was much less labor-intensive, this change in farming led to a boost in the cloth and woolen industry, peasants moved from the country to the towns, the Black Death was therefore also responsible for the decline of the Feudal system, people became disillusioned with the church and its power and influence went into decline, this resulted in the English reformation.After giving a full background on plague and European culture and environment, Gottfried gives solid details to support his theses. According to Gottfried, the Medical structure of Medieval Europe, adopted from that of the Romans, was nearly eliminated in the search for ways to cure plague. The spread of plague, successfully stated by Gottfried, directly depends on climate. Plague can only spread under certain climate conditions. In order for Y. Pestis, a series of complex bacterial strains, to survive, it mustn’t be too hot nor too cold.Too cold can kill the bacteria, and too hot can slow its progress. During the plague’s most devastating times, the temperature was perfect for the spread of Y. Pestis. Gottfried also describes that spread of plague can also depend on the strength of animals. Humans are merely secondary hosts to the fleas carrying Y. Pestis. The fleas afflict their host with the plague when they regurgitate the bacteria. These fleas prefer an animal host, not humans. When their animal host dies, they move on to a secondary host, possibly humans, but not necessarily.When the generation of bacteria-carrying fleas dies, or the temperatures prevent the plague from spreading, the cycle continues until all the variables once again allow for the plague to spread. Gottfried successfully conveys his point. Robert S. Gottfried achieved in getting his two theses across. His methods were to educate the reader on the topic, giving only the facts necessary to convey his point. After giving the reader information on plague and Medieval Europe, he argued his th esis, making frequent references to points he had made earlier in the book.Gottfried also made it obvious that others supported his theories. At the end of each important point, he marked it with a number corresponding to the reference in the back of the book. â€Å"Neither physicians nor medicines were effective. Whether because these illnesses were previously unknown or because physicians had not previously studied them, there seemed to be no cure. There was such a fear that no one seemed to know what to do. When it took hold in a house it often happened that no one remained who had not died. And it was not just that men and women died, but even sentient animals died.Dogs, cats, chickens, oxen, donkeys sheep showed the same symptoms and died of the same disease. And almost none, or very few, who showed these symptoms, were cured. The symptoms were the following: a bubo in the groin, where the thigh meets the trunk; or a small swelling under the armpit; sudden fever; spitting bloo d and saliva (and no one who spit blood survived it). It was such a frightful thing that when it got into a house, as was said, no one remained. Frightened people abandoned the house and fled to another. -Marchione di Coppo Stefani In conclusion, The Black Death successfully proves that a great deal of tragedy in the 13th century had much to do with animals in the environment. Death was a habitual visitor to fourteenth century Europe. Never before had humanity seen such widespread dying. Famines, wars, and a host of deadly diseases all took millions of lives during the 1300s. But the worst single calamity to wrack this troubled century was the Black Death—a plague that killed anywhere from 24-25 million Europeans between 1347 and 1351.As Frederick F. Cartwright and Michael D. Biddis, authors of Disease and History, observe, â€Å"The Black Death was not just another incident in the long list of epidemics which have smitten the world. It was probably the greatest European cat astrophe in history. † Anywhere from 25 to 40 percent of the total population of Europe died from this plague. Similar death rates took place in Asia, the Mideast, the Mediterranean, Africa, and as far away as Greenland and Iceland, thus making the Black Death the greatest ecological calamity in human history.It also conveyed that plague accelerated the progress of culture, bringing the need for modern medicine. Gottfried makes it apparent that man did not understand enough about the environment to prevent plague, maybe a message to the world today. Dense population, as Gottfried suggested, breeds plague. Early plague has educated us, and we should focus on this, plague seems to be inevitable with certain circumstances and lack of knowledge. Not only did Gottfried educate us on the past, but may have prepared us for the future.Works Citiedâ€Å"Efforts to Stop the Plague. † Insecta Inspecta World. Web. 27 Apr. 2011. . Gottfried, Robert Steven. The Black Death: Natural a nd Human Disaster in Medieval Europe. New York: Free, 1983. Print. â€Å"The Black Death, 1348. † EyeWitness to History – History through the Eyes of Those Who Lived It. Web. 27 Apr. 2011. .

Imc- Communication Plan for Aer Lingus

Table of Contents Introduction & Scenario We have been given an assignment about Aer Lingus. Our task is to develop an integrated marketing communication campaign for Aer Lingus. The assignment should focus to deliver the following Objectives: â€Å"To revitalize the declining Aer Lingus brand in order to increase airline travel in the Irish market† Following Question shell been answer; Segmentation, targeting and positioning Strategy to be defined for the IMC Campaign. Advertising must be chosen with two other promotional tools. Contemporary and Traditional promotional tools that you will use to achieve this objective and the rationale behind selecting these tools. You must discuss the relationship of the promotional tools selected to the hierarchy of Effects model. The media vehicles that you would select to effectively influence your target market. Linking Marketing Communication Tools to Response stages. When we chose our segment and target groups we tried to exploit Aer Lingus real position at the airline market. Aer Lingus position at the moment is between, low fare company Ryanair and BMI, SAS (Hoovers, 2010). Younger people and students nearly almost chose Ryan Air because of the low price. In the last couple of years it has been showed that the competition from Ryanair is too tough for Aer Lingus. Aer Lingus Group Plc will stop trying to undercut larger Irish rival Ryanair Holdings Plc and offer enhancements including better food and faster check-in times to customers willing to pay more, according Rothwell & Fahy, 2010. Then you have the older people, who have more money. For the most they choose airlines that can offer them even better standards and services. They may also have families and choose different alternatives. That’s why we chose two target groups between 24-35 years. They work, have an income and come from the same generation. They fit into Aer Lingus concept to offer very good service at a smart price, according The Post, 2007. Our goals with the campaign will be: {draw:frame} Our campaign is more about to establish Aer Lingus as a brand and to show the benefits derived from their products. To make people think and feel about the company in a good way. In a long term view we think that these measures will increase all areas of Aer Lingus business. . 2 Aer Lingus Aer Lingus was founded by the Irish government in April 1936. They are the second biggest Airline Company in Ireland after their main competitors Ryan Air. The headquarter is based in Dublin Airport and they are serving Europe, Northern Africa and North America. Aer Lingus is a Low Fare Airline company, but according to themselves, they offer better service and more comfortable travelling. Their main competitors besides Ryan Air are BMI, Easy Jet and City Jet. The last two are also Low Fare Airline Companies (Aer Lingus limited. 2001-2009). Question 1 2. 1 Segmentation and Target Group â€Å"_Marketing segmentation and the identification of a target group is a very important step in a business opportunity analysis. With the tough competition that exists today, business cannot reach everyone. A more focused and audience- centered approach is necessary. A market can be segmented in many ways, and the segmentation will change when costumers reason for purchase change†. (Wright, R. 2000). _ According to us, Aer Lingus most central issue today is that they are relatively unknown at the market. They need to separate from the other airlines and focus on their own segment and target group and communicate right to them. People do not know what the company stand for today. Aer Lingus business concept is to offer cheep flights but still keep good standard and service. Aer Lingus is not a very well- established brand today and the industry for flight is broad. That`s why we have chosen a broad segment; people in the age 24-35. They are working and have a steady income. Our segment is from the same generation; they bond together, think in the same way and have similar experience from life. This makes it much easier to reach them and influence them. Our concept will be to attract the chosen target groups. We have chosen two target groups to focus on. *Profile Target Group/Customer* 1: Age: 23-30 Income: 15 000- 25 000 Gender: Male/ Female Profession: Workers Education: Uneducated and Low Educated Family Size: Family of two or three Homeowner: Apartment Marital Status: Not married *Profile Target Group/Customer* 2: Age: 31-35 Income: 26 000- 38 000 Gender: Male/ Female Profession: Workers or people who are in the beginning of their careers Education: Uneducated or Low Educated Family Size: Family of three or four Homeowner: Yes (House) Marital Status: Yes/ No Our target groups are in the same generation, have the same interest and think similar. The reason why we have chosen two types of target customers is because when people reach their early thirties, their perspective of life can somewhat change. They might have children and get promoted in their careers. We believe that our target groups are the kind of people who are willing to pay extra, compared to Ryan Air, to get faster to their end destination and have a more smooth and comfortable flight with good service. The fact that Aer Lingus fly to more central locations make the journey shorter and more comfortable. {text:list-item} Positioning can be made in different ways. The most effective way is to use one approach; otherwise the costumer can get confused. One common tactic is to contrast the company? s product against competitors_. (_Clow & Baack. 2010_). _We consider that the tactic who is defined above is one Aer Lingus can use. They should establish a position through showing the costumers that they have better service and quality that e. g. Ryan air and that they are cheaper than e. g. SAS and BMI. 3. Question 2 3. 1 Promotional Tools 3. 1. 1 Advertising â€Å"_The essence of an integrated marketing communications program is designing messages that effectively reach the target audience. They are designed to change or shape attitudes. They should lead to some kind of short- or long- term action†. (Clow & Baack. 2010). _ When it comes to advertising we recommend that Aer Lingus choose communications objectives. It’s very important for both the company and our target groups that they decide and send out the right message. Two types of advertising that will help Aer Lingus to succeed are Informative advertising and Persuasive advertising. Informative advertising will describe the product, available services and the benefits of Aer Lingus and it also build up the company’s image. The second one, Persuasive advertising will help Aer Lingus to build brand preferences and change customer’s perceptions of product attribute (Kotler, P. 2005). This advertising will suit Aer Lingus. We think that this type of advertising will not only give our target groups a clear picture about the product, but also the show the benefits by flying with Aer Lingus. Another advantage for our customers is that this kind of advertising changes their view of Aer Lingus and hopefully give Aer Lingus better brand preferences. When it comes to message strategies we recommend Aer Lingus to use Cognitive Ads to fulfill their goals against their target customers. The two message strategies that will suit Aer Lingus best are Generic and Comparative message strategies. Generic are the direct promotion of the products benefits. By using this kind of message you give knowledge about the product/service and show the positive features about it. The other alternative is Comparative message strategy; Aer Lingus should use this strategy to compare themselves in a good way against competitors (Clow & Baack. 2010). This will give our customers even more information about the company, their positioning and their image. All these factors are very important for the customer before they choose which product/service they should go with. The media tools we recommend Aer Lingus to use are; Internet, TV and different type of newspapers. Internet has a big impact on our target groups; all of them know computers and are using the Internet daily. Internet also has a high reach and high frequency. In Aer Lingus case, to reach the customers through the Internet with offers and information should be very effective. In 2004 travelling was the top cyber shopping category by far (52. 4 Billion Dollars) according to License 7, No. 10, 2004. That shows the impact and the power of the Internet as a tool. TV advertising will give the Aer Lingus brand a â€Å"better face† because of the emotions you can reach through TV ads. For Aer Lingus to use sounds, motion and senses into their ads will be very effective on people. The last one, Newspaper is very good for Aer Lingus because of the high believability. To mix that with good publicity will be very effective against the company’s targets groups. We think that this mix will establish and increase Aer Lingus brand and image, but also give the customers knowledge about the company and the product (More specific information about media tools and vehicles in question 3). Conclusion; Cognitive Strategies will give our customers more awareness and knowledge about the company, brand and product. These two variables are our main goals to mediate to the customers. By mediate this to our target groups; they will hopefully change their attitude and feelings about the product/service. In a long term action it will increase Aer Lingus business and establish their brand. This through the media channels that suits Aer Lingus, but most importantly their customers. 3. 1. 2 Public Relations and Publicity â€Å"_Public Relations building good relations with the company`s various publics by obtaining favourable publicity, building up a good corporate image and handling off unfavourable rumours , stories and events†. (Kotler, Phil. 2005). {draw:frame} Public Relation and good publicity are good in many ways. We believe that Aer Lingus will established their brand/image by using this promotional tool and that our target group will take notice about the company in a positive way. In the last couple of years Aer Lingus has been in economic troubles and the publicity has been bad. The customers have turned them down (Business Week. 2006-2010). To estab lish their brand and build up a new image, they will get their customers back. Aer Lingus have to: All these three subjects are very important to develop for Aer Lingus as a company. To make sure that the internal communication is good and that the staff knows what Aer Lingus stand for is a very important. The stuff has to know what the customers expect when they are flying with Aer Lingus. An advantage for the company by using this tool in an economic perspective is that getting good publicity in e. g. newspapers and business papers are free. Our target groups most perceive Aer Lingus as an Airline company with cheap prices, but most of all with good service and good comfort for the price. We want to get that message out throw e. g. newspapers so people get interested and positive about Aer Lingus as a brand. A good worth of mouth and a good repetition will help to catch our target group’s interest. Aer Lingus will reach this goals throw: {draw:frame} (Kotler, et al. 2005). Other activities we recommend Aer Lingus tu use to creating positive image, awareness and knowledge about the company throw this promotion tool should be sponsorship (e. g. sport), supporting events and charity. This type of activities could be use as Cause- Related Marketing. It has been proved that Cause- Related Marketing has a very strong effect on people and it’s also a tool to create a stronger brand and brand loyalty. {draw:frame} (Clow & Baack. 2010) Public relations have a strong impact on public awareness and gives knowledge about the company to the customer (Armstrong, G. 2005). When you create good publicity and activities, people can link their knowledge about the company and in the end prefer (get a good feeling about) the brand or the product/Service. In the end hopefully the customers are that convinced to test or buy the Product/ Service. In our campaign we use Public Relations not only as a promotional tool, but also like a â€Å"tactic† tool. To push out information and good things about the company/ product, will make the other promotional tools more effective. text:list-item} â€Å"_Direct marketing brings the market directly into the home or office of an individual buyer instead of the buyer having to go to the market. Direct marketing techniques can be used to move buyers through various stages of the buying process†. (Smith & Taylor. 2002). _ Direct mail is the most common and one of the most success ful direct marketing tools. To make good results by doing direct mailing, it’s of great significance for the company to have a high quality and relevant mailing list (Smith & Taylor. 2002). The list we think Aer Lingus should use, is the Compiled list. This mailing list provides information about a specific customer profile. In Aer Lingus case, it’s a way to communicate with both current customers and target groups. To send out information about the company, prices offers and keep your customers/ target groups up to date about positive things that happen around the company. This is an easy way to get your customers closer to you, that they all the time get new knowledge’s about the Aer Lingus brand. In a long term aspect, we also think that the customers will get better preferences about the company and that Aer Lingus will increase their sales online. Question 3 4. 1 Media Tools and Vehicles Aer Lingus first priority is to increase people’s awareness and knowledge of their brand. To do this they have to make sure that the target audience sees the brand as much as possible. This message needs to be delivered through all marketing channels. We think that the most effective media to use for Aer Lingus are internet, TV and newspapers. 4. 2 Internet The using of internet has become a natural thing for many people, it is access on personal computers and through telephone services. Internet especially attracts young people. Our target groups are very influenced of internet and use it many times every day. It is of great significance for Aer Lingus that they develop their internet marketing for future success. A huge benefit for Aer Linguas with using internet marketing is that they reach their target audience all over the world. This, naturally, is very important for an airline. Our target groups are in that age (24-35) when internet has had a big impact on their life’s for a couple of years. To meet friends, communicate with people all over the world, read newspapers/magazines and buy things (online shopping) are natural for our target audience. People use internet because it’s easy, comfortable and you get what you looking for very quick. For our target customer’s internet is a way to keep themselves up to date with everything that happens around them. Online advertising can be made in four different ways, banner ads, classified ads, search advertising and media/video ads. We think that Aer Lingus goals with internet marketing should be as we mentioned before, to give the company`s target groups awareness and knowledge of the bran and make them notice the benefits of the Aer Lingus product. Banner ads are a very good tool to use in many occasions. 2007 banner ads was the third biggest interactive tactic online, according to Jaffee, L, 2007. We think that banner ads at websites such as Facebook , Twitter, Ebay, different travel/sport magazines and newspapers will get high impact on our target audience, because they visit this types of websites several times a week. Some in the target groups visit same internet sites several times every day. It is also very significant that Aer Linguas expand banners that, in the best possible way, catch the website visitor’s attention. They should use banners that really remind people of the brand, e. g. use the green â€Å"Aer Lingus shamrock†. The banner should in one way or another tell something about the company, product or the benefits by travelling with Aer Lingus. When our target groups start to think about going away, or just want to dream away, we are convinced that the first thing they do is to visit Google and search for trips. Therefore, it is important for Aer Lingus to also have their advertising on search engines. In that way the costumer look for Aer Lingus and not the other way round. To be on top when people search on Google it is very important and we think Aer Lingus should put a little bit of their money to make sure that they are well positioned on Google. At the same time that online advertising has become more and more common people have become more immune to the advertising. People have â€Å"learned† to click- through and just not see it. That is one reason that it is significant that Aer Lingus also develop other market channels. Again, Aer Lingus needs to be seen often. Studies have also showed that traditional advertising such as TV, Magazines and Radio inspire people, according to Smith, 2002. . 3 Television TV has a huge impact on most of people. TV has good mass- market coverage and combines of sight, sound and motion (Armstrong, G. 2005). Other advantages with TV advertising are the low cost per contact and the quality creative opportunities (Clow & Baack, 2010). We think that Aer Lingus should take advantage of the creative opportunities to make an ad that people notice and with a good message theme. The ad should either say something about Aer Lingus as a company and brand or have a slogan that shows the product benefits. Here again we think Aer Lingus can use the shamrock to present themselves, but also to get the potential customer attention. For Aer Lingus to reach the right target groups and get out much attention as possible from TV ads, we think that they should do commercial connected to sports, travels and some lifestyle programs. We also think that our target audience will see and respond positively when they feel that Aer Lingus is connected with some of their interests. Another thing that will give Aer Lingus good publicity is to through TV sponsor special events. Such as concerts and big sport events. For Aer Lingus to be connected in this kind of contexts will give their company an image boost. 4. 4 Newspapers The last media tool Aer Lingus should use is the newspaper. A lot of people still read newspapers. We think that the mix between good publicity and ads in some of the big daily newspapers e. g. Irish Post, Irish Independent will give Aer Lingus much higher reliability. To reach the target groups and build a good image is important that the people believe in the company. The ads in the newspaper should only focus on the benefits by flying with Aer Lingus and the price. By showing the benefits compare to the low price, will distance Aer Lingus from Ryan Air. To be seeing in bigger daily newspapers will also give a good worth of mouse and a growing reputation. Aer Lingus should first of all try to get out in the Irish and British newspapers with their ads. It’s always much more effective by starting with influence your â€Å"own people†, according to Kotler, 2005. Question 4 To date Aer Lingus is a company that has a lot of problems. The internal and external communication does not work and that lead to that the customers do not know what the company stands for. Aer Lingus brand and image are deeply damage. With our â€Å"campaign†, we think that Aer Lingus will increase the business, get a good hype around their brand and showing the benefits by travelling with the company. Under here we try to denounce and show the possibly responses to the communication tools that we chosen. 5. 1 Promotional Tools Public Relation; we think that this tool is one of the most important tools for Aer Lingus. First of all if they get a better internal communication, that will lead to a better and more service minded staff. When the stuff knows what’s expected of them the service going to be better and the costumers get satisfied. If Aer Lingus get good publicity the target audience will take good notice about the company and their brand/image will be better. Through publicity the customers also gets knowledge about the company and the product. This is the two very important steps in the buyer process. We think also that the Cause-Related Marketing will lead to that people/ our target customer will prefer Aer Lingus. Cause-Related Marketing will also give the Aer Lingus brand a boost. Direct Marketing; By using this tool, we think that Aer Lingus will come closer to their customers and target groups. By using a specific demographic mail list to connect the target audience, will give the potential customer a chance to know the product and the benefit about travelling with Aer Lingus. Whit this type of marketing Aer Lingus can give their Potential customers offers and price information. We think that in a long term view this tool will help the company to increase their business. Advertising; By using advertising that inform the target groups about the company and the product people will get to know what Aer Lingus as a brand stand for. This will give the company a higher reliability and a better image. Aer Lingus must also use advertising that brings the best out of their service and shows the benefits by travelling with the company. The message strategy will be to show the benefits about the product and distance themselves from the competitor. We thing that our target groups will get a better overall knowledge about the company and hopefully see the benefits of the product. We think by using this strategies will increase their business. 5. 2 Media tools and vehicles Media tools we have chosen is online advertising (Internet), TV and Newspapers. This is a good mix. Trough Internet Aer Lingus increase the awareness by the target audience. They will see the brand o lot, both conscious and unconscious. This gives Aer Lingus a better position, people will have Aer Lingus brand in their minds when they thinking about traveling. By advertising in TV Aer Lingus can communicate their message better, with colors, pictures and information they will develop their position. People will not only recognized the brand, they will also get knowledge of the company’s concept, and get good feelings when they think of the company and brand. By doing ads on Internet and TV Aer Lingus can show the benefits of the product in a advantageous way. By using booth those creative media tools, will have a big impact on our target groups. By using newspapers as a tool, we think that the customer will see the ad and connect it with reliability, it’s important for the company after the last year’s bad publicity. In the paper you can also form a ad that will give the potential customer knowledge about the company, product and brand. When Aer Lingus succeed with attract the chosen target group a good circle will be formed. The brand gets bigger which will lead to that more and more people chose to go with them. Bibliography 6. 1 Books Clow, E, K, Baack, D. Integrated Advertising, Promotion, And Marketing Communication, 4th edt. 2010. Pearson Education, New Jersey, USA. Wright, R. Advertising. 2000. Pearson Education Limited, Edinburgh, Scotland. Kotler, P, Wong, V, Saunders, J, Armstrong, G. Principles Of Marketing, 4th edt. 2005. Pearson Education Limited, Essex, England. Smith, P, R, Taylor, J. Marketing Communications An Intergrated Approach, 3rd edt. 2002. Kogan Page Limited, London, England. 6. Electronic Sources Rothwell & Fahy. _â€Å"Aer Lingus Switches to Imitating EasyJet, Not Ryanair. †. Business Week. Com . January 26, 2010. Available: _ http://www. businessweek. com/news/2010-01-26/aer-lingus-drops-ryanair-strategy-in-effort-to-imitate-easyjet. html_ _ Aer Lingus Limited. 2001-2009. Available: http://www. aerlingus. com/cgi-bin/obel01im1Corporate/mediaCorpProfile. jsp? [email  pro tected]@@@2017366715. [email  protected]@@@&BV_EngineID=ccddadekefljdmhcefecfigdffgdfkl. 0&P_OID=-536880294&Category=0#history The Post. _â€Å"Aer Lingus plan to build Tesco-like image†__. _ThePost. ie. September 30, 2007. Available: http://archives. tcm. ie/ businesspost/2007/09/30/story26973. asp Business Week, Bloomberg L. P. 2006-2010. Available: http://search. businessweek. com/Search? searchTerm=aer+lingus&resultsPerPage=20 License 7, No. 10. â€Å"Cyber Shopping†. P. 12. November, 2004. Available: Clow, K, E, Baack, D. Intergrated Advertising, Promotion And Marketing Communications, 4th edt. 2010. P. 268. Jaffee, L. â€Å"Follow The Money†. Promo 20, No. 11. P. 5-10. November, 2007. Hoover`s, Inc, 2010. Available: http://www. hoovers. com/aer-lingus-group-plc/–ID__91296–/freeuk-co-factsheet. xhtml

The Civil Rights Movement Dr. Martin Luther King Jr. And...

It was the was the beginning of a new decade, Americans believed the 1960’s were going to be the dawn of the golden age. Many historical feats are occurring, John Steinbeck wins a noble peace prize, Nixon and Kennedy have the first televised debate, Mohamed Ali wins a gold medal and the Civil Rights Movement is at the precipice in America. Dr. Martin Luther King Jr. and Governor George C. Wallace are two prominent figures throughout the Civil Rights Movement. Individually, they deliver historical speeches concerning civil rights, however the dialogue encompasses completely different messages. Comparatively, the two speeches will be presented side by side using Aristotle’s, Kairos, Ethos, Logos, and Pathos. The year was 1963, as the chaos†¦show more content†¦Likewise, Dr. King stood in a place of great significance. Here, in front of the statue of President Lincoln, is where he will present his infamous â€Å"I Have a Dream† speech and it is evident of the great significance it represents. It was in 1863 that President Lincoln fought to abolish slavery and by coincidence, one hundred years later, Dr. King will be addressing more than 200,000 demonstrators fighting the same fight. On this day Dr. King will articulately responds to Governor Wallace’s speech that had taken place seven months prior. As the prominent Dr. King put it, â€Å"Now is the time to make justice a reality for all of God’s children† (archives.gov). In other words, Dr. King is stating, that equality and fair justice should not be based on, ethnicity, color, or status, but in essence we are all created equal and ought to live harmoniously. Throughout these two speeches, Dr. King and Governor Wallace, both use strong evidence to strengthen their credibility and appeal to Ethos. Comparatively, both men are well educated, from the South and are well respected within their community. Governor Wallace was born a farmer’s son in the year 1919. Though he received a law degree from the University of Alabama, he joined the military and was involved in a combat mission over Japan. Upon returning, he became an Assistant States Attorney, and later a judge of the Third Judicial Circuit of Alabama. WallaceShow MoreRelatedAnalysis Of I Have A Dream Speech1199 Words   |  5 Pagesin the Southern states, Governor George C. Wallace and Dr. Martin Luther King Jr, are at the forefront of the Civil Rights Movement. In the beginning of the year, Governor Wallace will be addressing his constituents with his well-known, â€Å"Segregation Now, Segregation Forever† speech. Nevertheless, it will be seven months later, that Dr. King will convey his message in his famous, â€Å"I Have a Dream† speech. Individually, they deliver historical speeches concerning civil rights, however, the dialogueRead MoreAnalysis Of I Have A Dream Speech1419 Words   |  6 Pageste levised debate, Mohamed Ali wins a gold medal and the Civil Rights Movement at its climax in America. As the chaos of segregation was unfolding in the Southern states, Governor George C. Wallace and Dr. Martin Luther King Jr, were at the forefront of the Civil Rights Movement. In the beginning of the year, Governor Wallace will address his constituents with his, â€Å"Segregation Now, Segregation Forever† speech and seven months later, Dr. King will deliver his famous, â€Å"I Have a Dream† speech. The twoRead More Vietnam: The Mixture of Protests and Politics1659 Words   |  7 Pagesfought. Many Americans on the home front protested their government’s involvement in the war. Many young Americans felt that there was no reason to fight for a cause they did not believe in, especially in such a strange foreign country. The civil rights movement also strongly influenced many of the war protests. This was because such a large percentage of minority soldiers sent o ver to fight were being unfairly treated. The African American soldiers were being ordered to the frontlines more often thanRead MoreAfrican Americans from 18652319 Words   |  10 Pagesexisting before the war. The Union army could offer only limited protection to the ex-slaves, and Lincoln’s successor, Andrew Johnson of Tennessee, clearly had no interest in ensuring the freedom of southern blacks. The new president’s appointments as governors of southern states formed conservative, proslavery governments. The new state legislatures passed laws designed to keep blacks in poverty and in positions of servitude. Under these so-called black codes, ex-slaves who had no steady employment couldRead MoreWhat Would You Do?2272 Words   |  10 Pagesgovernment intervention to resolve racial inequality, racism, as a mentality, continues to exist in many segments of American society and preventing complete integration. After the height of the civil rights movement, many Americans assumed that integration was successful. Due to the Civil Rights movement in the 1960s, the government took legal action in an effort to eradicate segregation in educational institutions, housing, and economic differences amongst black and white Americans. According toRead MoreStephen P. Robbins Timothy A. Judge (2011) Organizational Behaviour 15th Edition New Jersey: Prentice Hall393164 Words   |  1573 PagesCredits and acknowledgments borrowed from other sources and reproduced, with permission, in this textbook appear on the appropriate page within text. Copyright  © 2013, 2011, 2009, 2007, 2005 by Pearson Education, Inc., publishing as Prentice Hall. All rights reserved. Manufactured in the United States of America. This publication is protected by Copyright, and permission should be obtained from the publisher prior to any prohibited reproduction, storage in a retrieval system, or transmission in any formRea d MoreProject Mgmt296381 Words   |  1186 PagesUniversity PROJECT MANAGEMENT: THE MANAGERIAL PROCESS Published by McGraw-Hill/Irwin, a business unit of The McGraw-Hill Companies, Inc., 1221 Avenue of the Americas, New York, NY, 10020. Copyright  © 2011 by The McGraw-Hill Companies, Inc. All rights reserved. No part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written consent of The McGraw-Hill Companies, Inc., including, but not limited to, in