Emergencies Are Both Life Threatening And Detrimental On A...

Oncologic Emergencies are both life threatening and detrimental to a patient’s health. As stated by (Tan), â€Å"An oncologic emergency is a clinical condition resulting from a structural or metabolic change caused by cancer or its treatment that requires immediate medical intervention to prevent loss of life or quality of life.† Oncologic emergencies can be further classified as metabolic, hematologic, neurologic, or cardiovascular. Superior vena cava syndrome and spinal cord compression can be considered oncologic emergencies. Superior vena cava syndrome is classified as cardiovascular while spinal cord compression is classified as neurologic and/or structural. Treatment options vary depending on the severity of the disease. When†¦show more content†¦Invasion or external compression can cause an SVC blockage. One way external compression can occur is by the involvement of lymph nodes. When cancer is present in the body, there is a chance that it can spr ead to surrounding lymph nodes. If this occurs, the lymph nodes can enlarge and compress the SVC and cause an obstruction. Other ways external compression can occur are by the right lung, other mediastinal structures, or by thrombosis of blood within the vein itself. As blood flow becomes blocked, the blood from the upper body is unable to drain back into the heart correctly. These collaterals provide an alternate pathway so the blood can ultimately reach the right atrium. Collateral veins can originate from the azygos vein, lateral thoracic, inter mammary, and esophageal venous systems. Over a time period of several weeks, the alternate pathways begin to dilate which results in venous pressure in the upper body to elevate. By the venous pressure remaining elevated, signs and symptoms will become noticeable. How quickly the signs and symptoms manifest is dependent upon how fast the SVC becomes congested in relation to the formation of venous collaterals. Research states that â€Å"Patients with malignant disease may develop symptoms of SVC syndrome within weeks to months because rapid tumor growth does not allow adequate time to develop collateral flow.† (Drews and Rabkin) Out of all the signs and symptoms that can occur,

Analysis Of The Cartoon I Looked At My Cartoon ``

While analyzing my cartoon, I looked for symbolism, the use of labels and words, the intended irony, and where and why Kal exaggerated a certain characteristic in his cartoon. As I looked at my cartoon I quickly marked down every part that I found interesting or unique and noted in which category it fell under as well as the significance of this observation. By looking at the different aspects of the cartoon, rather than at the cartoon as a whole, I was able interpret multiple subliminal meanings that could be applied. One After further analyzation, I found that Kal’s most significant claims were about the â€Å"difficulty students face during standardized testing† but also about the way that â€Å"modern-day school systems are working to ensure the passing of their students in standardized testing while not preparing their students for higher-level tests such as college entrance and college-level exams.† (Rhetorical Analysis, Gabriela Brooks). When examining symbolism, I tried to look at more than just the human-characters; I analyzed the different shapes, patterns, and even looked at the style in which Kal drew his lines. When observing that his lines were not exactly straight and were drawn free handed I thought this emulate a child’s mind and the way that children, and education, cannot be pre-defined. When looking at the children in comparison to the adults, noticing that â€Å"each child has an identical square-shaped head† encouraged me to dig deeper into the â€Å"so what?† or theShow MoreRelatedFirefighting Stereotypes Of The Media Essay1777 Words   |  8 PagesFirefighting Stereotypes in the Media – An Analysis In 2014, a firefighting equipment manufacturer, released an advertisement utilizing ethos and pathos appeals which reinforce and dispel a variety of firefighting stereotypes namely, strong bonds to fellow firemen, inherent trustworthiness and credible status, and assertive, inexpressive demeanors. 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Social Determinants of Health for Live and Age- myassignmenthelp

Question: Discuss about theSocial Determinants of Health for Live and Age. Answer: Social determinants of health(SDOHorSDH) refer to range of conditions in which all individuals are born, they grow, live and age. These determinants are often related to a plethora of social and economic conditions, in addition to the distribution of these conditions among the population. These determinants are thought to exert significant impacts on the differences in health status between an individual or group of individuals.These social determinants are considered as majorhealth promotingfactors that prevail primarily in the living and working conditions of the target population. These often encompass wealth, distribution of income, power, and influence (Braveman and Gottlieb 2014). Unlike individualrisk factorsthat govern the overall health and wellbeing of an individual, such as, genetic or behavioural risk factors, social determinants of health are found to be primarily responsible for inequities in health. In other words, these inequities are a direct manifestation of toxic c ombination of unfair economic arrangements and poor social policies (Marmot and Allen 2014). The assignment is an evidence based parliamentary submission on an inquiry into housing for asylum seekers in Victoria. Asylum seekers refer to individuals who flee their native land or country and are found to spontaneously enter other country, where they apply for asylum or right to international protection. These individuals often report educational opportunities or employment as the reasons that make them seek asylum or refuge in other countries. Victims of trafficking, political disturbances and war also lead to the development of events that make these people seek refuge in other states or nations. Thus, the circumstances in which these sub-population lives, creates a major influence in shaping their social determinants of health, which in turn increases their vulnerability to experiencing health inequity. Research studies have provided evidence for the fact that most asylum seekers often face a combination of social, legal, economic, cultural, behavioral, and communication related barriers that put the mental, physical, and social well-being of those individuals at risk (Ferrer 2018). Research evidences emphasise on the fact that these social determinants are quite severe for specific vulnerable population such as, minors, women, and lower skilled migrants. This increases their likelihood of getting affected by the determinants and seeks refuge in another region, with the aim of enhancing their wellbeing and standard of living. In addition, there are a range of structural and institutional psycho-social stressors or obstacles that affect the wellbeing and health outcomes of the target population (Marmot and Allen 2014). Usually, social determinants of the health of asylum or refuge seekers are quite distinct from their biological or genetic factors that determine the health outcomes of the individuals. Traditionally, much focus has been given on observing the socio-economic gradient that exists in the society, thereby affecting health equity among the people. This gradient is often shaped by social class, individual socio-economic positions or area deprivation. Major indicators of area deprivation include increased prevalence of mortality that is associated with a range of diseases such as, cancer, cardiovascular disease, lung disorder, stroke, or hepatic diseases among people living in regions that are socially deprived. Poor economic conditions and lack of health literatcy has also been linked with increased obesity rates among men as well as women. Thus, a comparison between the migration variables such as, birth country, legal status and length of residence in the condition with other socio-econ omic factors that determine health outcomes is essential (Bozorgmehr and Razum 2015). According to researchers, involuntary migration experiences, experiences of war and/or political unrest and insecure legal status in the society are the major risk factors that increase the likelihood of asylum seekers and refugees of reporting poor health outcomes (Rechel et al. 013).Moreover, the conditions that surround migration have often been found to fuel several health inequities. Anti-migrant sentiments often reduce their access to appropriate education facilities, healthcare resources, and dignified and safe living and working conditions (Semenza et al. 016). Thus, it can be stated that migration acts as a key social determinant that affects the health of asylum seekers. Other social determinants that act as risk factors are related to deterioration of reproductive health outcomes that are closely linked to substance abuse and human trafficking. These factors increase risks of sexually tr ansmitted infections and unintended pregnancies (Keygnaert et al. 014). Poor standards of living and inadequate access to proper nutrition and healthcare facilities also lead to the development of learning disabilities among minor refugees. Stressful pre-migration incidents and experiences often encompass being a witness to all forms of violence and cruelty. These create post-traumatic stress disorder for the migrant children who have been exposed to warfare, collisions or trafficking (Song et al. 2015). This creates significant negative impacts on the physical and mental health of those children by giving rise to disturbing thoughts, nightmares, depression, social isolation, anxiety, panic attacks and mental distress. Thus, the traumatic experiences often affect the health and overall wellness of those persons (Alpak et al. 2015). While pre-migration traumatic experiences and incidents acts as major risk factors, life circumstances associated with post-migration events have shown greater impacts in worsening the long term health status of most asylum seekers. Large number of stressful incidents that occur after arrival of the asylum seekers to a new nation, and the stereotypes and discrimination that they are subjected to, often leads to poor mental outcomes. Furthermore, the host nation where they arrive, also displays lack of integration and stability in its society. Severe PTSD or related symptoms have been associated with perceived discrimination by host society or community (Li, Liddell and Nickerson 2016). Lack of adequate community and family support also increases the risks of suffering from psychological distress. Post-migration stress is further heightened by administrative processes that lead to the development of depression, anxiety, and somatoform disorders among all asylum seekers. Moreover, asylum seeking adolescents or children most commonly experience protracted stays at refuge or asylum centres. This often increases risks of poor mental and physical health. Policies that exist at the state, federal or local levels also play essential roles in affecting the health of an individual or the entire population. Several policy recommendations must be followed by the Victorian State government to enhance the overall health and wellbeing of the asylum seekers, for whom housing initiatives are being taken. The policies must be enforced by the public health workers and the government with the aim of targeting the high priority social determinants of health. One major recommendation involves creating provisions for the community residents (minors as well) to make their health a part of the renewal process. This can be brought about by identifying the issues that are faced by the community of asylum seekers (Manne 2013). This will encompass identification of major factors that affect the wellbeing of the individuals, such as, exposure to discriminating attitudes and behaviour, increased crime and violence rates towards them, lack of appropriate empl oyment options, lower educational levels, and lack of provisions to participate in the labour force. Presence of poorly maintained or vacant buildings and environmental health hazards must also be recognized by these policies. The policies must respect the international rights of asylum seekers to seek refuge in the concerned country and should also adhere to the rules and systems of refugee and asylum seeker protection that are envisaged by international organizations. The enforced policies and legislation should also create provisions for enacting in a robust manner with the aim of safeguarding the asylum seekers against refoulement, which refers to their forcible return to their nation where they are liable to get persecuted (Yaron, Hashimshony?Yaffe and Campbell 2013). Access to independent or community migration advice must be made available for all people who are seeking refuge in Victoria. Furthermore, the policies should also allow the people an equal access of reviewing the decisions for the administration, related to safeguarding the formers status in the new environment. A consistent legal process must be enacted and applied in the state, with the ultimate aim of determining the protection status of the asylum seekers. This will help the Victorian State government to prevent all forms of discrimination against the individuals, which is often based on their demographic or ethnic backgrounds (Trauner 2016). Recommendations also emphasise on the fact that all asylum seekers who enter Victoria should not be subjected to heavy penalization for migrating to the region without appropriate visa. The government should explicitly recognise housing as an essential dimension of the policies that encompass refugee integration. This will help in realizing the goal of assisting migrants for accessing a safe, decent, affordable and secure accommodation. Owing to the fact that most research evidences experience insecurity due to housing deprivation, the government should promote the rights of the asylum seekers to find a suitable place to live in. Access to properhousingfacilities is imperative for asylum seekersin order to facilitate the process of getting healed from their traumatic experiences. Appropriate housing facilities also help them rebuild their lives. Therefore, formulation of policies that grants the asylum seekers a resident permit will help them join the existing community and enhance their overall wellbeing (Nethery and Gordyn 2014). Disgraceful housing conditions that have been brought about by several forms of systematic neglect often give rise to shortage of social housing. This makes the vulnerable families live in accommodations that are of an extremely low standard. Thus, in order to address the negative effects of living in poor condition on the health of these people, the government should enforce policies tha t offers emergency accommodation or keeps the asylum seekers in induction centres. Such housing facilities should also enable conduction of health checks in order to determine the major risk factors that are taking a toll on their health. Furthermore, the policies must also include regular visits of the government officials at the induction centres to explain the refuge seekers about their rights and responsibilities (Robinson 2013). The policies should identify similar rights of the refugees as other citizens of the state. Homeless refugees who qualify for financial support just receive appropriate monetary help from the government that would help these people to meet the essential living needs. They should be entitled to similar housing benefits and rights of family reunion that would require the government to bring other family members with them for joining. Legal assistance should also be provided to all asylum seekers regarding the legal processes that can be applied for determ ining their protection status. This will increase their access to equal health, employment and educational facilities, while safeguarding them in private lodgings or permanent accommodations, thereby improving the health status (Newman, Proctor and Dudley 2013). Despite major challenges that might arise in relation to the period that is allowed to the refugees for finding housing, upon formulation of an asylum decision, liaison measures must be put by the government in place for minimizing risks associated with homelessness, self-building renovation projects that involve refugees and making use of private sector accommodations. Effective policies should also be designed for establishing links between personal integration and measures that promote community cohesion. Moreover, support services need to be implemented for ensuring presence of tolerable standards that all housing facilities must reach before allowing the asylum seekers to live in them (Bakker, Dagevos and Engbersen 2014). In order to meet these standards, the government policies must focus on surveillance of houses that are structurally sound, have adequate natural light, suitable drainage system, sinks, showers, toilets that are not shared by other households and drinking water facilities. Strengthening collaboration between the member states will foster technical cooperation and will also contribute to the national action on improving the social determinants (Conlon and Gill 2013). To conclude, it can be stated that distributions of social determinants are often shaped by a plethora of public policies and legislation, which have been associated with reflecting the influence of political ideologies of the concerned jurisdiction. Moreover, unequal distribution of experiences that are health-damaging cannot be correlated to occurrence of any natural phenomenon. Thus, there is a need for the Victoria State government to provide social support and shelter to the asylum seekers to welcome them in the communities. Providing assistance with accommodation after migration will help to combat the major social determinants of health and improve the overall wellbeing of the target population. References Alpak, G., Unal, A., Bulbul, F., Sagaltici, E., Bez, Y., Altindag, A., Dalkilic, A. and Savas, H.A., 2015. Post-traumatic stress disorder among Syrian refugees in Turkey: a cross-sectional study.International journal of psychiatry in clinical practice,19(1), pp.45-50. Bakker, L., Dagevos, J. and Engbersen, G., 2014. The importance of resources and security in the socio-economic integration of refugees. A study on the impact of length of stay in asylum accommodation and residence status on socio-economic integration for the four largest refugee groups in the Netherlands.Journal of International Migration and Integration,15(3), pp.431-448. Bozorgmehr, K. and Razum, O., 2015. Effect of restricting access to health care on health expenditures among asylum-seekers and refugees: a quasi-experimental study in Germany, 19942013.PLoS One,10(7), p.e0131483. Braveman, P. and Gottlieb, L., 2014. The social determinants of health: it's time to consider the causes of the causes.Public health reports,129(1_suppl2), pp.19-31. Conlon, D. and Gill, N., 2013. Gagging orders: asylum seekers and paradoxes of freedom and protest in liberal society.Citizenship studies,17(2), pp.241-259. Ferrer, R.L., 2018. Social Determinants of Health. InChronic Illness Care. Springer, Cham, pp. 435-449. Keygnaert, I., Guieu, A., Ooms, G., Vettenburg, N., Temmerman, M. and Roelens, K., 2014. Sexual and reproductive health of migrants: Does the EU care?.Health policy,114(2), pp.215-225. Li, S.S., Liddell, B.J. and Nickerson, A., 2016. The relationship between post-migration stress and psychological disorders in refugees and asylum seekers.Current psychiatry reports,18(9), p.82. Manne, R., 2013. Tragedy of errors: The shambolic cruelty of Australia's asylum seeker policy.Monthly, The, (Mar 2013), p.18. Marmot, M. and Allen, J.J., 2014. Social determinants of health equity, American Journal of Public Health, 104(S4), pp.S517-S519. Nethery, A. and Gordyn, C., 2014. AustraliaIndonesia cooperation on asylum-seekers: a case of incentivised policy transfer.Australian Journal of International Affairs,68(2), pp.177-193. Newman, L., Proctor, N. and Dudley, M., 2013. Seeking asylum in Australia: immigration detention, human rights and mental health care.Australasian Psychiatry,21(4), pp.315-320. Rechel, B., Mladovsky, P., Ingleby, D., Mackenbach, J.P. and McKee, M., 2013. Migration and health in an increasingly diverse Europe.The Lancet,381(9873), pp.1235-1245. Robinson, K., 2013. Voices from the front line: Social work with refugees and asylum seekers in Australia and the UK.British Journal of social work,44(6), pp.1602-1620. Semenza, J.C., Carrillo-Santisteve, P., Zeller, H., Sandgren, A., van der Werf, M.J., Severi, E., Pastore Celentano, L., Wiltshire, E., Suk, J.E., Dinca, I. and Noori, T., 2016. Public health needs of migrants, refugees and asylum seekers in Europe, 2015: Infectious disease aspects.The European Journal of Public Health,26(3), pp.372-373. Song, S.J., Kaplan, C., Tol, W.A., Subica, A. and de Jong, J., 2015. Psychological distress in torture survivors: pre-and post-migration risk factors in a US sample.Social psychiatry and psychiatric epidemiology,50(4), pp.549-560. Trauner, F., 2016. Asylum policy: the EUs crises and the looming policy regime failure.Journal of European Integration,38(3), pp.311-325. Yaron, H., Hashimshony?Yaffe, N. and Campbell, J., 2013. Infiltrators or Refugees? An Analysis of Israel's Policy Towards African Asylum?Seekers.International Migration,51(4), pp.144-157.

Sex Education In The Classroom Essays - Midwifery, Sex Education

Sex Education in the Classroom Ignorance of sex education has left our world suffering from a variety of venereal diseases, abortion, neglected children, and sadly enough, even death. This is a very serious problem not only for our children today but also for children of the future generations. Sources of education are available almost everywhere, but there are not useful if they go unnoticed. Sex education should begin at home with the parents, but if the parents are uncomfortable speaking about the subject or not unwilling to take control of this sensitive subject, there needs to be an outside source to help fill this void: the school. Children need to know the basics, such as what diseases are threats, which ones are curable and which are not, just how real these diseases are, pregnancy, and responsibility. Therefore, sex education should be a part of the curriculum for children in the junior high Many children in junior high know there are sexually transmitted diseases, but many do not realize just how threatening these diseases are. Living in a small community, many youth believe that getting a sexually transmitted disease will never happen to them. But our children need to know that there are diseases in our country like Syphilis, Gonorrhea, Chlamydia, Genital Herpes, Genital Warts, Hepatitis, and even AIDS. Since 1986, Syphilis cases have increased by 100 percent (Haas and Haas 441). These kinds of facts need to be brought to students' attention. However, just because we inform our children of these diseases does not mean that they will not catch them, but they still need to be informed of the number of diseases that are incurable and can lead to death. Diseases, though, are not all our youths have to worry about. Pregnancy is another major concern. "The United States has the highest rate of teen pregnancy and births in the Western civilized world" (Shake Heights). Our teens need to know that infants born to teen mothers are much more likely to have health problems (Shake Heights). By informing them of birth control, we are not necessarily saying it is ok to go and have sex, but if they choose to, they will at least be knowledgeable. If we choose not to inform them, it then becomes at least partly our responsibility that they became pregnant. In addition to informing children of diseases and pregnancy, we can teach them responsibility, and avoid having to deal with a decision on abortion. In Arizona alone last year, there were 11,738 reported cases of abortion (AZ Abortion). Today the simplest abortion procedure that can be performed generally costs around 300 dollars (Glazer). Also, 83% of our counties here in the United States do not even provide facilities where abortions may be performed (Glazer). The decision to abort a pregnancy can scar a teenage mother's life no matter what decision she make. To keep the child means hardship, but not to keep the child can also be mentally frightening. Teaching our children about sexuality and making them more knowledgeable about it does not convey the message that sex is ok. How much can we really control our children when we cannot be with them every minute of the day? Some parents are scared to talk to their children, so the help at school could benefit the child and parents, and possibly stop a major hardship from occurring in the child's life. These topics can be taught in a sensitive manner, but it seems clear that if our children know more about diseases, birth control, and the responsibilities of sex, they will at least be a little wiser when making their decision. Works Cited Glazer, Sarah. "Sex Education: How Well Does It Work?" Editorial Research Reports. 23 June 1989. Haas, Dr. Kurt, and Dr. Adelaide Haas. Understanding Sexuality. 3rd ed. New York: Mosby, 1993. Planned Parenthood. AZ Fact Sheet. 3 Feb. 1999. 12 Feb.1999 . Shaker Heights Teen Health Corps. Teen Pregnancy. 3 Jan. 1999. 12 Feb. 1999 .

Hello everybody , Essays - Brad Pitt, California, Film,

Hello everybody , So Today I'am going to give a presentaion about a memorable celebrity who is considered as hero for many people. I guess you know it . It is Brad Pitt . Brad Pitt may be one of the most talented and attractive men on the planet, but he hasn't let success go to his head. In fact, with the millions he wins in every year, a large sum of the money goes toward his many charitable causes, including several organizations that he founded himself. First of all I am going to speak about his biography then I will develop five remarkable and inspiring things that Brad Pitt has done for the world and finally I will do a quiz for you with a good surprise to the key . Now let's talk about his biography . Globen winner , film producer, owner of production company Plan B Entertainment - which produced the 2007 Academy Award winner for Best Picture, The Departed -, father to six children and cited as one of the world's most attractive men. As you can see hier . Brad Pitt has become increasingly involved in social issues both in the United States and internationally. As I said , the next point deals with the five remarkable and inspiring things that Brad Pitt has done for the world . In the first place The Brad Pitt foundation "Make It Right" was established in 2007 by Brad Pitt to help the victims of Hurricane Katrina who lost their homes . , Pitt started a project with ellen in New Orleans to help build environmental friendly housing in the Ninth Ward Now, the Make It Right foundation helps build homes, communities and buildings all across the country. Interestingly enough, Pitt has long had an interest in architecture and eco-friendly products, so this foundation was the perfect combination for the social activist and star. To date, 100 homes have been completed. In September 2009, Pitt received an award from the U.S. Green Building Council, a non-profit trade organization that promotes sustainability in how buildings are designed, built and operated, in recognition of the green housing concept used for the Make It Right foundation. The Not On Our Watch organization sheds light on cases of genocide and other atrocities throughout the world, particularly in Darfur. It is interesting to note that over 480,000 people have been killed, and over 2.8 million people are displaced. Brad Pitt, along with several other stars, founded the organization. More important however ,is the fact that " Not On Our Watch " provides humanitarian aid, protection and awareness in areas where the government often fails to protect its people. Both Angelina Jolie and Brad Pitt's charity efforts often focus on Africa. They have adopted a daughter from Ethiopia, and one of their biological children was born in an African country. Pitt has made donations to the African Children's Choir, the Alliance for the Lost Boys of Sudan, Ante Up for Africa, Not On Our Watch and several other organizations that benefit the poor and unprotected people of Africa. In 2004, Pitt joined the One Campaign as a spokesman alongside Bono to help advocate for an additional 1 percent of the U.S. budget to go towards supplying Africa with basic needs such as clean water, education, medicine, and food. Pitt has made frequent trips to Africa using his celebrity status to successfully draw media attention and support for the campaign. Along with his wife Angelina Jolie, Pitt helps fund the Jolie-Pitt Foundation. This charity is dedicated to helping impoverished people, conserving wildlife and protecting natural resources. The pair has donated to Doctors without Borders and Global Action for Ch ildren to provide medical care in impoverished and war-torn countries. Pitt and Jolie have also funded the MJP Millennium project, a large conservation area and community in Cambodia where the organization built s chools roads and provides jobs. In addition to physically joining the ranks of advocacy campaigns and organizations, Pitt and Jolie continually show their support for global issues by do nating to various foundations. In 2006 alone, the couple is reported to have donated more than $8 million to charity. Last on the list

Electromagnetic radiation and health Essays - Radiobiology

Electromagnetic radiation and health Essays - Radiobiology Electromagnetic radiation and health The preponderance of evidence does not suggest that the low-power, low-frequency, electromagnetic radiation associated with household current constitutes a short or long term health hazard. Some studies have found statistical correlations between various diseases and living or working near power lines, but no adverse health effects have been substantiated for people not living close to powerlines.[19] There are established biological effects for acute high level exposure to magnetic fields well above 100 ?T. In a residential setting, there is "limited evidence of carcinogenicity in humans and less than sufficient evidence for carcinogenicity in experimental animals", in particular, childhood leukaemia, associated with average exposure to residential power-frequency magnetic field above 0.3 to 0.4 ?T. These levels exceed average residential power-frequency magnetic fields in homes which are about 0.07 ?T in Europe and 0.11 ?T in North America.[20][21] 19.^ Electromagnetic fields and public health, World Health Organization 20.^ "Electromagnetic fields and public health". Fact sheet No. 322. World Health Organization. June 2007. Retrieved 2008-01-23. 21.^ "Electric and Magnetic Fields Associated with the Use of Power" (PDF). National Institute of Environmental Health Sciences. 2002-06. Retrieved 2008-01-29.

The Crucible Theatre Case Study Essay Example | Topics and Well Written Essays - 4250 words

The Crucible Theatre Case Study - Essay Example What is the basis of strategy formulation in the Crucible Theatre Trust Comment on the management of the risk and the crises evident in the Case Study. The Crucible Theatre (from hereon referred to as "Crucible") is an enterprise that is owned, operated, and managed by a legally registered company with the Trust as its board of directors (or, strictly speaking, trustees). Like any other enterprise, the theatre receives income, has expenditures, hires employees, and faces many problems. As part of its strategic management function, the Trust should have focused on the long-term identification, development, and exploitation of the Crucible's core competencies, thought about the concept of the corporation and its mission, and designed the management processes to achieve the mission, which is why the Crucible existed in the first place. In effect, the Trust's main function is to set the strategy: give an over-all "direction" and "destination" for the business and the guidelines on how to get there. Then, operating management takes care of the details that are part of making the business enterprise succeed. It is understandable that at the beginning, the Crucible's management had problems as shown by the theatre's construction cost over-runs (by 184,000 or 26 percent over budget) and the low theatre attendance. But as the years passed, the number of "empty" seats, the financial losses (if not for the increasing amount of grants), the recurring cycles of financial crises, and a general lack of direction showed that the Trust could improve the way it did strategic management. In its first decade (1971-1981), the Trust may have done well in identifying and developing the Crucible's concept, core competencies, and its mission, but it had not done well in exploiting those core competencies and in managing the processes of marketing (audience development) and finance (non-government sources). As a result, its resources were under-utilised and the Crucible became a financial burden to the government. The second decade (1982-1991) saw "improvements" in the Trust's management, hitting "lower" attendance targets, increasing box office income (average annual growth of 23 percent) and its percentage (from 40 to 50 percent) of total income, and decreasing the growth rate of income from grants (average annual growth dropped from 16 percent from 1971-1981 to 7 percent from 1982-1991) for its operations. However, the financial burden remained for reasons easy to see: the "strategic" decision to bring down attendance targets made it easy to achieve, and as expenses rose, it was only due to effective lobbying by the Trust in the Arts Council and with Sheffield's local government that the Crucible secured the grants that allowed its financial survival. Balancing accounts and fund-raising could be