Nursing and Mrs. Newman

Mrs. Newman has been experiencing hoarseness and a change in her voice, but she did not seek medical help until she began to have difficulty swallowing. After being seen by her healthcare provider, she is scheduled for outpatient surgery for a direct laryngoscope to obtain a culture and take a biopsy. Mrs. Newman arrives at the outpatient surgical department at 6:30 am and is escorted to her room. The admitting nurse begins her assessment; 1. Which question is most important for the nurse to ask Mrs. Newman? A) Have you had anything to eat or drink since midnight?B) Are you taking any medications? C) Have you smoked any cigarettes in the last 24 hours? D) When was the last time you drank any alcohol? The admission nurse completes the admission assessment and starts an IV. Mrs. Newman is taken to the operating room for the biopsy. Sifter the procedure, Mrs. Newman is admitted into the PACU. 2. Which intervention will the PACU nurse implant first? A) Check the healthcare providerâ€⠄¢s prescriptions B) Monitors Mrs. Newman’s pulse OX C) Contain Mrs. Newman’s vital signs D) Assess Mrs. Newman’s gag reflex After 2 days Mrs.Newman calls the oncologist and reluctantly agrees to a total laryngectomy. Mrs. Newman comes to the oncology office to meet with the oncology nurse specializations to discuss the preoperative and postoperative care. Mrs. Newman tells them that she is very scared about having this surgery. She says that she has no questions about the medical aspects of the procedure, but states she is concerned about how her life will change. She tells the nurse she realizes she need to have the surgery but is ambivalent and doesn’t know is she will be able to go through with it after all. . Which nursing intervention is most helpful to mars Newman? A) Refer mars Newman to a psychologist to discuss her fears about having this surgery B) Give Mrs. Newman literature provided by the American cancer society C) Ask Mrs. Newman if she wou ld like to talk to someone who has had this surgery D) Tell Mrs. Newman iota is OK to be scared and hold her hands Mrs. Newman is concerned about singing in the country and western club and asks the ONS â€Å"how long do you think it will be before I can sing with my band again† 4. How should the ONS RESPOND?A) Request that the oncologist visit with Mrs. Newman and explain the procedure to her again B) Explain that her vocal cords will be removed, and that she will not be able to sing C) Reassure her that she will be able to sing with the band, but her voice may be different D) Ask Mrs. Newman if she understands what a total laryngectomy is The ONS has given verbal and written information to Mrs Newman answered any questions and is completing the physical assessment 5. Which question is important for the nurse to ask Mrs. Newman?A) When did you first notice any hoarseness in your voice? B) How long did you say have you been singing w/the band? C) How much alcohol do u drink a week? D) What foods are difficult for you to wallow? Mrs. Newman reports that she drinks occasionally, mainly on the weekends with friends. The nurse is more concerned that Ms Newman smokes one pack of cigarettes a day. She discusses this issue with mars Newman, who says â€Å"Don’t worry about my smoking. I will never smoke another cigarette again† 6. How should the nurse respond to help Mrs.Newman in her attempt to stop smoking? A) I know it will be hard and I am very proud of u B) You will kit be able to smoke after urn surgery C) anyone else in urn household smoke D) What steps is u going to take to stop smoking? Mrs. Newman discusses the surgery with her family and a woman from a laryngectomy support group. Mrs. Newman decides to go ahead and he a total larygectomy. 7. A referral to which member of the indiciplinary team will be most important for mars Newman prior to surgery: A) Case mangerB) Social worker C) Physical therapist D) Speech therapist The speech the rapist discusses with mars Newman alternative tech inquest for restoring her speech after surgery. Selection of the best techniques varies from person to person depending on their age and personal preferences. Esophageal speech is popular among laryngectomies because it costs less and can provide a more normal sounding voice than some of the other options. 8. Which statement describes esophageal speech?A) Generator held to the neck creates vibrations those form words when the client speaks B) Swallowed air used to create around and words in a controlled belch C) Vibration and sound are used to form words by occluding a valve over the stoma D) A handheld device delivers tone via a plastic tube that is inserted into the mouth After discussing her options with a speech therapist mars Newman demonstrates her ability to use esophageal speech she comments† I used to hear my son and his friends rack like this. Won’t he be surprised? Two days later, mars Newman is admitted to t he hospital accompanied by her husband and her two grown children.She is in the preoperative holding area. 9. Which interventions will the nurse implement? A) ask mars Newman if she has any concerns about the upcoming surgery B) Notify the surgeon that mars Newman has been admitted to the hospital C) Reassure mars Newman that her family can stay with her until surgery D) Retrained if mars Newman has any problems hearing or writing Mrs. Newman shares with the nurse that she is scared that no one will help her if she needs help and that she will not be able to talk anymore. 10. Which intervention should the nurse implement? A) Assure Mrs.Newman that someone will be with her at all times B) Provide a bell that she can ring as another means of communication C) Show her how to work the nurses call light and have her perform a return demonstration D) Tell her that whiles her fears are justified; she should not try to worry. Following a seven –hour surgery mars Newman was first plac ed in the PACU, before being transferred to the intensive care unit. 11. Which nursing intervention should the ICU nurse implement? A) Discourage coughing for the first 24 hrs B) Notify the healthcare provider during roundsC) Determine when mars Newman received her last antibiotic D) Assist mars Newman to gargle w/warm salty water The nurse is completing the shift assessment and notes that Mrs. Newman has white and dark brown patchy areas on her tongue and oral mucosa. 12. Which action should the nurse implement? A) Document this finding and take no action B) Notify the health care provider during rounds C) Determine when Mrs. Newman received her last antibiotic D) Assist Mrs. Newman to gargle with warm water, salty water Because of the cancer mars Newman is at risk for potential complications, such as neck would fistula and carotid arty blowout 13.When anticipating these possible complications, the nurse should place which equipment at miss newness bedside? A) Several packages of s terile 4Ãâ€"4 gauze B) Two non sterile hemostats C) A syringe filled w/calcium glaciate D) The intensive care unit crash cart While assessing mars Newman, the nurse notices that Mrs. Newman’s blood pressure is 92/60 and her pulse is 112. Mrs. Newman reports feeling very tired. 14 What action should the nurse implement first? A) Check mars Newman’s pervious vital signs B) Suction mars Newman tracheotomy C) Administer oxygen via nasal cannula D) Slip a gloved hand under the client’s neckThe nurse also calls the nurses’ station and requests a CBC stat 15 which laboratory result consistent w/blood loss through hemorrhaging A) A hematocrit 40 % B) Erythrocyte sedimentation rate 8 mm/hr C) Red blood cell count 5. 2 million/mm^3 D) Hemoglobin 11. 3g/dl. Mrs. Newman’s gag reflex has returned and she is preparing to eat her first meal. 16 which action should the nurse implement A) Place cold packs around the clients neck prior to eating B) Remind her to pl ace the food on the front of the tongue and flex her head backward to swallow C) Ensure the client has a variety of thin liquids to drink D) Provide Mrs.Newman with soft foods when eating for the first time after surgery 17. What action should the nurse take regarding Mrs. Newman’s concern? A) Explain to the client that this is normal following this type of surgery B) He the client smell a variety of aromas to ensure that the client cannot smell C) Reassure he client that these senses will return after post-operative edema subsides D) Notify the healthcare provider about these findings when making rounds Mrs.Newman has a tracheotomy that has an inner canola. The nurse is performing routine tracheotomy care 18 Which action should the nurse implement first? A) wash the flange of the outer cannula with normal saline B) Pour hydrogen peroxide and normal saline into separate containers C) Cleanse the inner cannula using a small pipe brush D) Remove the tracheotomy dressing with cl ean disposable gloves What should the nurse do before inserting the inner canola? A) Tap or shake inner cannula to remove excess moistureB) Dry the outside of the inner cannula with non sterile gauze C) Remove the outer cannula, reinsert the inner cannula, then place back into stoma D) Clean it w/hydrogen peroxide An unlicensed assistive personnel UAP is assisting the surgical floor nurse w/morning care for mars Newman 20. Which task should the nurse delegate to the UAP? A) Empty the Foley and record the output B) Clean Mrs. Newman’s bathroom C) Change the intravenous bag on the pump D) Perform the routine tracheotomy careThe charge nurse notices that the primary nurse caring for mars Newman is cutting 4Ãâ€"4 gauze to use as a tracheotomy dressing 21. What action should the charge nurse implant? A) Praise the primary nurse for using a cost saving technique B) Instruct the primary nurse not to cut gauze for the tracheotomy dressing C) Take no action since Mrs. Newman is the p rimary nurse’s responsibility D) Determine why commercially prepared dressings aren’t being used The night nurse is preparing to administer the 12:00 midnight dose of gentamicin, an intravenous amino glycoside antibiotic that was started when Mrs.Newman was in the PACU. The nurse notices the empty IV antibiotic bag that was administered during the day shift is labeled ampicilllin. The nurse checks the medication administration record and realizes client does not have a prescription for ampicillin. 22. Which action should the night nurse implement? A) Notify the pharmacist about the medication error B) Complete a medication error report c) Call the day nurse to determine what occurred D) Asses Mrs. Newman’s white blood cell count WBC The next time the nurse enters Mrs. Newman room Mrs.Newman writes on the communication inboard is there something wrong? I heard someone in the hall say something about me receiving the wrong medication? 23. How should the nurse resp ond? A) Please don’t worry about anything. I am sorry you overheard that conversation B) No Mrs. Newman you did not receive the wrong medication C) C) You are concerned that you might have received the wrong medication D) you were supposed to receive gentamcin but you received ampicillin 24. Which intervention should the nurse provide to Mrs. Newman?A) Insert a suction tube into the stoma while applying suction, the remove while twisting the tube B) Take a deep breath, occlude the tracheotomy with urn finger cough and remove your finger C) Insert a small amount of sterile normal saline into the stoma and cough in a normal manner D) Take a deep broth in through the nose, cough and expel the secretions through the tracheostomy The nurse is discussing activities of daily living with Mrs. Newman. Which instruction should the nurse include? A) Caution Mrs. Newman to take only tub baths B) Encourage Mrs.Newman to use aerosol deodorants C) Advise Mrs. Newman not to wear any types of perfumes D) Explain the need to wear a plastic bib when showing 26. Which intervention has highest priority to discharge? A) encourage the client to wear attractive coverings over stoma B) Ensure that Mrs. Newman carries a special identification card C) Stress the importance of returning to as normal a lifestyle as possible D) Discuss the importance of attending support group meetings Mrs. Newman is being discharged home today after five days in the hospital.Mr. Newman stops the nurse in the hallway and says that he is really scared about taking his wife home 27 what is the best response by the nurse? A) Have you discussed your fears w/ur wife B) It sounds like you can’t take care of her C) I know this must be very scary but u and ur wife are strong D) Let’s sit down and discuss what u are worried about Mr. Newman hesitantly shares with the nurse that he is afraid to touch his wife How should the nurse respond? A) Would u like to talk to your wife’s doctor, I c an call him for u?B) You can touch ur wife all u want, u will not hurt her C) You are worried about touching ur wife but she needs ur support right now D) Tell me more about what you mean by touching ur wife A home healthcare nurse has been assigned to care for Mrs. Newman and is making the initial visit. After completing the admission assessment the home healthcare nurse develops a nursing care plan for Mrs. Newman 29 of the nursing diagnosis included in Mrs. Newman’s careplan, which one has the highest priority? A) Deficient of knowledge B) Anticipatory grievingC) Ineffective airway clearance D) Impaired verbal communication Then home healthcare nurse is discussing the plan of care with Mrs. Newman and her husband, she instructs them to keep the rooms humidified at all times. Mr. Newman asks why this is important. 30. Which explanation should the nurse provide? A) It will decrease the amt of foreign material that enters the stoma B) Humidified air decreases the need for ora l fluids C) Humidified air will keep mucous membranes and secretions moist D) The lower airway responsible for humidification was removed during surgery

Phenomenal Woman Essay

I’ve read this poem, â€Å"Phenomenal Woman† years ago but I have never forgotten it ever since—such is the power of Maya Angelou’s words. Whenever I feel sad, or experience anything that blows my self-esteem to smithereens, I think about this poem—it is one of the few that can instantly make me feel uplifted and empowered. It stirs the soul and affirms the human spirit. â€Å"Phenomenal Woman† is all about feeling good about oneself. It sends a positive message to women and is a kind of affirmation of the female identity. Upon reading the poem, there is a shock of recognition, the recognition of the identity that all too often lies defeated under the weight of oppressive tradition. The first line, ‘Pretty women wonder where my secret lies, I am not cute or built to fit a fashion model sizes’ pretty much sums up Angelou’s message—that a woman’s true essence isn’t something that can be judged through outward appearances alone. Angelou uses very simple and unsophisticated wording to convey a deep message: that identity and sexuality are not all about the aspects of a woman that she has no control over (her looks) but also about what she feels, and chooses to feel, and in how she chooses to convey her feelings. One can truly be phenomenal if one believes herself to be. The poem does not only apply to women but transcends gender, race, and social status. Angelou’s message is universal, one that touches on the very basic fabric humanity: A person’s worth is not something that is ought to be dictated by society’s standards. The poem makes me love the body I’m blessed with, asserts my identity, affirms my sexuality, and paves the way to a deeper understanding of myself. A woman need not have Barbie’s vital statistics or a perfect bone structure—it’s good to have these characteristics but a â€Å"real† woman is more. Those traits that men â€Å"can’t touch†Ã¢â‚¬â€a woman’s â€Å"inner mystery†Ã¢â‚¬â€however unfathomable, truly makes us special and unique. â€Å"Phenomenal Woman† is a reminder of our power to control our own outlook. We are not mere slaves to circumstance, but participants in the game of life. And the most important thing is—to love myself unconditionally, because I’m a woman. Phenomenally. Phenomenal woman. That’s me.

Business Law in Action Essay Example | Topics and Well Written Essays - 250 words

Business Law in Action - Essay Example There was a mutual agreement between the parties and they had agreed to bind themselves by the terms and conditions of the contract. One of the basic principles of contract law is that once a contract is framed and drafted, the parties are duty bound to follow the contract. Therefore, in this case, since the contract was modified by the parties, the owner of the building is duty bound to follow the new terms and condition of the contract. Alpha computers can succeed over Beta Computers for fraud. Beta computers were aware of the overstated inventory for the previous financial year. They did not disclose this inventory to Alpha computers knowing that this might lead to a problem with respect to the buyout. The financial statements are very important whenever a business deal is taking place between two parties since there was a contract being formed; it was pertinent that Beta computers should have divulged all their details. Since they did not do that and went ahead with the contract knowing that they were hiding valuable information, they are liable for fraud.

Summary Assignment Example | Topics and Well Written Essays - 750 words - 6

Summary - Assignment Example In every organization, communication should be tailored to serve these four functions effectively. As highlighted, failure of communication to effectively carry out these functions only means that an organization needs to have more focus on developing its communication channels. The chapter also discussed the differences between the formal and the informal communication, highlighting the communication process. The communication process begins from the message to be sent, the encoding process, the choice of the appropriate channel, reception of the message and its decoding by the receiver (Robbins 370). The chapter highlighted how information flows from one level to another in different organizations. In some organizations, downward communication exists which involves the flow of information from the higher levels to the lower ones (373). Usually, information that is passed down the levels concerns the assigning of goals, policies, procedures and instructions from the top to the lower level. Moreover, feedback from higher office is passed down to the employees. In other organizations, upward communication exists which entails the flow of information from employees and other lower levels to the top management. In this case, the lower level staffs usually communicate in a specific manner that will attract the attention of the top management. This kind of communication is effective when employees are seeking to express their grievances or are giving feedback concerning their tasks. The third flow of communication may occur in a literal manner. Lateral communication involves people of the same level who may either be employees or managers. It is critical for the appropriate small group network of communication to be chosen depending on the criteria given priority in an organization. These networks may be chain, wheel or the all channel

Financial Markets and Institutions Assignment Example | Topics and Well Written Essays - 2250 words

Financial Markets and Institutions - Assignment Example The basic foundation of a central bank serving as a lender of last resort is that in an economy, panics can occur which leads to bank runs. In such a situation, those maintaining deposits in commercial banks withdraw their funds from the bank as a result of economic speculation or fear over negative economic consequences. During a bank run, commercial banks can become insolvent, requiring the assistance of an institution (the central bank) to ensure that banks maintain liquidity is such a phenomenon occurs. Being the lender of last resort has become controversial, especially considering events during the recent global economic recession where many central banks injected capital into banks that were facing insolvency. Over-reliance on the central bank impacts other sectors in an economy. This essay explores the role of the central bank, emphasising why being a lender of last resort maintains many controversial implications from multiple perspectives. Evidence is that the controversy hails from irresponsible banking management and from poor fiscal policy developments concocted by the central bank itself. Central banks supply liquidity insurance to the commercial banking system which consequently endows liquidity insurance to other aspects of an economy, including corporations. Funds available for this action in a central bank encompasses notes held by public investors and reserves (deposits) sustained by a nation’s banks. These funds are manifested by the central bank as a result of autonomous will assuring that its value is comparable to products and services value in the economy. It is through these activities that an economy achieves macroeconomic stability. Concurrently, the central bank mandates the reserves that must be held by banks to insulate them from potential bank runs. Therefore, the central bank guarantees that commercial banks meet stringent standards of ensuring solvency. However, in 2007, many commercial

Toxicology Case Study Example | Topics and Well Written Essays - 1250 words

Toxicology - Case Study Example These are antibiotics, miticides and neonicotinoid pesticides. This paper analyzes these three classes of chemicals. Neonicotinoids, commonly referred to as neonics, are a rather new variety of pesticides, having been manufactured and marketed for the last twenty or so years. Neonics are systemic pesticides(Hopwood, Vaughan and Shepherd 3). Contrary to contact pesticides that remain on the surface of the plant, systemics are absorbed by the plant and moved to all the tissues of the plant. Neonics can be sprayed at the root of a plant or sprayed onto its foliage. Once applied, neonics remain active for many weeks, protecting the plant throughout the season. Several neonics are sold for application to lawns, pot plants and crops raised in a greenhouse. A miticide, also known as acaricide, is any chemical substance used to control ticks and mites that are not affected by regular pesticides. Miticides are specifically designed to destroy those species of ticks and mites that damage food crops and ornamental plants(Burley 5). Some of the most commonly used miticides include tetradifon, azobenzene and dicofol. Most miticides are designed to kill the eggs and larvae of pests, but some also kill adult pests. Some miticides are known to be poisonous to honeybees and other useful insects. Despite knowledge of this adverse effect of miticides on honeybees, these substances continue to be manufactured and applied to crops widely in the country. An antibiotic is defined as a molecule or an agent that either kills or interferes with the growth of a living thing that is too tiny for the naked eye, also called a microorganism(Hawthorne and Dively 26). These microorganisms include both fungi and bacteria. Selman Waksman first coined the term in 1942 in their journal articles. They used the term to describe any substance that a microorganism produces and inhibits the growth of other microorganisms. "Bactericidal" antibiotics kill bacteria

Cloud Migration Research Paper Example | Topics and Well Written Essays - 1000 words

Cloud Migration - Research Paper Example The Amazon may be able to exploit the service opportunity provided by the Amazon Web Services (HORNE, 2011). In the year 2011, the Amazon Web Services (AWS) was responsible for the profit gain of approximately $1.19 billion as estimated in a report. In October, same year the business was estimated as a billion-dollar run rate and out of which around $108 million or 9% was mentioned as a pure profit for Amazon Web Services. However the company was able to maintain its profit gaining history constantly by lowering the cost spent on cloud services. This is acknowledged because the company utilizes a cost-plus pricing model. In addition, the cost of delivering the services adds up to 10% premium that continues to fall as, Amazon leverages its economies of scale to purchase and operate more gear and bandwidth at less prices. Though, the margin related to profit remains flat as mentioned in a report. Conversely, the Amazon Web Services (AWS) compromises on a particular portion of Amazonâ⠂¬â„¢s overall technology expense in order to drive slowly, predictable profit from it is a good thing. The analysts estimate that the non-AWS technology expenditures is approximately 4 percent of the total sales â€Å"representing the largest opportunity for operating margin expansion in the near-term.† The cost lowering technique leads the company towards great percentage of profit. Conversely, the report submitted by the Morgan Stanley does not represent the possibility for the Amazon Web Service (AWS) to actually start rising on a margin because the company is expanding its services beyond pure infrastructure and managed services (HORNE, 2011). The database services NoSQL DynamoDB for instance; it provides a service for the Amazon that helps the company to add value or cost outside the delivery services of Cloud-based infrastructure. There is also stories of a huge data analytics services that are able to provide higher-level services as compared to Amazon Web Service (AW S) and its current Elastic Map Reduce offerings. However, there is still a possibility of AWS expanding its licensing activities as it is embedded as the de facto clod computing platforms for several companies, other service providers and software specialist. Adobe The Adobe has announced two new achievements in order to remain relevant as a desktop computing. Following are the two new acquisitions a creative cloud to augment its Creative Suite software and a handful of touch-based tablets apps. Equally, the company has launched its existing released Flash Player 11 and Air 33 updates. Adobe said that it had acquired Type kit, an online font provider, and that it has signed an agreement  to acquire Nitobi, creator of the open-source HTML5-based mobile development framework Phone Gap and Build, a hosted development and app creation service (Rossello, 2011). In a conference call for the press, Adobe VP of product management Lea Hickman described the company's news as a major initiat ive that radically redefines the creative process. CTO Kevin Lynch called the company's Creative Cloud "a major component in the transformation of

Music Contracts & Negotiations Essay Example | Topics and Well Written Essays - 2000 words

Music Contracts & Negotiations - Essay Example cessful negotiating process might look like, what the best negotiation techniques might be and how to achieve satisfactory results for both sides of negotiation when interests of negotiating parties come into contradiction with each other. In this essay I will focus on two key types of negotiation, such as so-called win-lose or zero-sum negotiation (also known as positional or distributive) and win-win or integrative negotiation, as well as the importance of confidence and good communication skills to successful negotiation. I am going to elaborate on pros and cons of the employment of integrative and distributive types of negotiation and dwell on the concept of issues, positions and interests within the context of negotiation in the field of music industry. On top of that, I will invent a scenario of negotiation between a music act and a record label in order to illustrate some aspects of negotiation and communication theories covered in this essay. When entering any negotiation, in order to achieve desirable goals a negotiating party must stick to some rules based on a certain negotiation structure, which is not that complex as one think a successful negotiating paradigm might be. There are four key stages of negotiation, which are preparation for a negotiation, exchanging information between negotiators on different aspects of the future agreement between them, bargaining per say and closing or commitment of an agreement (Shell, 2008, n. p.). Any negotiation may be of at least two types depending upon the intentions of negotiators to fully use their advantage in resources and power in order to influence final decision or upon a particular nature of the deal to be reached between the parties of a negotiation. As a rule, if negotiating parties are not interested in mutual satisfaction for each and every party involved in the negotiation and do not seek out benefit for all parties from the deal they are set to make, then they ar e most likely to enter distributive

Discuss the findings of the OFGEM report with regards to the UK energy Assignment

Discuss the findings of the OFGEM report with regards to the UK energy market; and discuss if more competition between the big six UK energy firms may benefit UK consumers - Assignment Example as proposed a number of reforms that should be employed in order to make the market more transparent, functional, and effective and consumer oriented in nature. The main objective for this essay is to study the report prepared and published by the OFGEM about the United Kingdom energy sector and analyze the proposals and reforms suggested by the same. This would be done by evaluating the economic aspects of this sector like the market structure, the price and demand elasticity, the present condition of the sector, the entry barriers and common strategies, the areas of the sector that need immediate interference and change and the propose reforms as suggested by the OFGEM. The UK energy sector is an intensely concentrated market in which the Big Six energy suppliers control the way the market functions. Also, the pricing strategies of one of these companies tend to affect that of the other companies in a direct and significant manner. The consumer groups for this market have been identified to have low involvement and low level of trust since the influence of the customers have become restrained due to the less number of options available to them. The low degree of consumer engagement has stemmed from a number of factors like the intrinsic nature of the energy products, the long periods required for switching suppliers, the excessive influence of the energy suppliers on the market and the lack of proper government interference and regulations for monitoring and supporting the interests of the consumer groups. These factors are identified to be hazardous for the future sustainability and health of the market structure because a significant lack of comp etition among the enmities in the market, a lack of interest and engagement of the consumers and excessive control of a handful of energy suppliers are noted in this sector. Other data given in Appendices 1-5 are suggestive of the above identified factors and features of this sector. The Herfindahl-Hirschman Index

African American Musuem Essay Example for Free

African American Musuem Essay The African Museum in Philadelphia is notable as the first museum funded and built by a municipality to help preserve, interpret and exhibit the heritage of African Americans. Opened during the 1976 Bicentennial celebrations, the AAMP is located in historic Philadelphia, a few blocks away from the Liberty Bell. Charles H. Wesley was a noted African American historian, educator, and author. He was the fourth African American to receive a Ph. D. from Harvard University. An ordained minister, Wesley’s distinguished career included 40 years of leadership with the African Methodist Episcopal Church. In 1976, he served as Director of the Afro-American Historical and Cultural Museum in Philadelphia, now known as the African American Museum in Philadelphia. Programs The African American Museum that is located in Philadelphia, Pennsylvania has some interesting education programs. These education programs focus on arts, culture, and heritage education. They place a major emphasis on the interests of the students, educators, artists, historians, scholars, and community organizations. These programs offer diversity with scheduling. The programs explore various African forms of cultural expressions. In these programs there are literary performances, hands on demonstrations, workshops, and storytelling performances as well. The African American Museum in Philadelphia feels its programs can be a vital link between the permanent and visiting collections for the many communities they serve. Exhibitions The exhibitions in the African American Museum in Philadelphia can some to be pleasing to the eye and stimulating to the mind. According to the African American Museum of Philadelphia these exhibitions invoke a deep collection of emotion ranging from pride and passion to excitement and enthusiasm. When visitors enter the museum they will come to Gallery 1, which includes a interactive timeline, images draw from historical record, that spans 100 years of history. In Gallery 2 there are full size video projections in which visitors can in engage in them. Once they are activated, a monologue about life in Philadelphia will begin. Some other aspects of the exhibit include an experience where you can walk the streets of Philadelphia through a large scale map, which is located between galleries 1 and 2 .

Cultural Heritage Tourism In India Tourism Essay

Cultural Heritage Tourism In India Tourism Essay Heritage is property of the world. It has important evidences of past incidents and changes and it is the necessity to conserve without political involvement and racial discrimination (UNESCO, 2004). So far Graham et al. (2000, p40) suggested Heritage is tremendously concerned in the construction and legitimating of collective constructs of uniqueness, such as group, gender, religion, civilization and nationalism. When we talk about the relation of heritage into tourism industry, at first, holy cities such as Rome are acknowledged as a highly multifunctional and even multi heritage place, as a result, the heritage attractions positively become the feature of Italy for tourist. To manifest the implication of heritage is consequently the key point of managing a heritage sites. As cultural heritage tourism is mostly dependant on the history, the events of the past has abundant evidence that how the past travels had been changing the entire pages of each century and affected our past life. Much of it is also passed on form age to age occasionally in the form in which it actually happened but more often as myth or fable. In whichever form it is of prime importance to a tourism professional, particularly in the circumstances such as the one obtaining in India with wealthy cultural heritage having continuity from the ancient (IGNOU, 2002). The process of finding will continue into the future because nobody can predict the number of real stories that have been buried in the earth and still not found. But somehow scholars have been able to find the real incidents of past with the help of evidences of literature which are still present all over the world as well as the role of scientists and researchers. Archaeology department of each country is encouraging the re searchers to find out about our past. These particular reasons have encouraged in selection of the dissertation topic, so at first this will focus on past history and development of Ajanta and Ellora caves and then it will look at the past record of tourist information and the with the help of available secondary data from Books, Journal articles, news papers past surveys and the information available on the internet, respective governments intergovernmental organization and non government agencies such as UNESCO, ICOMOS, IUCN, GHF, etc. Introduction Cultural heritage conservation is always a centre of discussion in the form of developing economy of various nations. Cultural heritage tourism product is becoming a prime source for developed and developing countries though it is a subsidized product of tourism. The reason of subsidizing may be underpinning of heritage tourism is attractions. Huge number of examples currently in practice throughout the world of natural and cultural heritage sites that are of internationally approved and many more thousands of local notoriety. All of these play an important role in the supply of tourism although they may draw different market segment e.g. international tourist and local recreational users. The present expansion of the Asias tourism market has many challenges, one of the main difficulties lie in understanding how cultural and religious heritage of Asians could be linked to the overall development of tourism. Asian countries which consider their religious, artistic, and general resources of heritage have unique features that has been attracting tourist around the world. The challenges of cultural and heritage base tourism created would require different choices about strategy, policies that are simultaneously both learning and teaching opportunities (United Nation, 2004). Countries like India where every tourist gets glimpses of diverse culture in his/her entire journey. India is primarily a cultural destination in international tourism. These are the features of India marketed as tourism product in international as well as domestic circuit. Domestic tourism competition already has begun in India from past decades as every state government has been developing their strategies with the help of international organization to improve the tourism. In result, due to sudden changes the competition can be seen among service providers as from hawkers to large scale stakeholders. In scenario market everyones mind has been diverting towards the heritage sites in India, thus it is creating trafficking of tourists as well as service providers. So it is affecting the quality of services and facilities. This shows a different picture of hospitality and tourism industry in India. Tourism industries are solely dependent on the visitors/ tourists who are the main drivers of this industry. Different demands and requirement of individuals is affecting on tourism industry. Also the issues and understanding of heritage tourism by different group of people as it may be visitors/tourists or local communities are different. To overcome from various aspects and issues which are related to heritage tourism require a better management system. Many cultural and natural heritage sites around the world are putting more focuses on issues regarding to visitors, maintenance and management of heritage site, analysis of monuments, flora and fauna, environment and lastly the sustainability. The tourist typology is boosting overall development of touristic market. The most important part of tourism is a cultural as well as natural heritage property. So it always remains prime attraction to most of the people to come and enjoy their holidays. This dissertation will focus on every aspect of cultural heritage tourism industry such as supply, demand, conservation and heritage visitors management, interpretation, authenticity and politics of cultural heritage site. The primary data can be retrieved with the help of some questionnaires to understand the real nature and find out what can be done more to achieve the overall development at Ajanta and Ellora Caves at Aurangabad. To understand the World cultural heritage site here the UNESCO has mentioned that it as a monuments, architectural works, works of monumental sculpture and painting, elements or structures of an archaeological nature, inscriptions, cave dwellings and combinations of features, which are of outstanding universal value from the point of view of history, art or science; groups of buildings: groups of separate or connected buildings which, because of their architecture, their homogeneity or their place in the landscape, are of exceptional universal importance from the point of view of history, art or science; sites: works of man or the combined works of nature and man, and areas including archaeological sites which has excellent universal value from the historical, aesthetic, ethnological or anthropological point of view (UNESCO, 2011). Here, In the Krakow Charter (2000), a monument is defined as a clearly determined entity, the bearer of values, which represent a support to memory. In it, memory recognises the aspects that are relevant to human performance and feelings, associated with the historic time-line (Vecco, M 2010). Apart from this many scholars considers that World Heritage Sites should not only be exemplary situations for the pursuit of research but also be closely identified with the creation and maintenance of different kinds of knowledge (Darvill, T., 2007). Tourists are always willing to learn new things as well as eager to exchange knowledge between each other. It is the fact to become aware about surroundings and changing of trends and practices in the world. Literature Review: Introduction: This chapter will investigate the perception of cultural heritage tourism and visitor management as well as development of tourism at site by reviewing several concerned literatures. The review will start with the overview of cultural heritage tourism including the concept of Culture, heritage, cultural heritage tourism and cave architecture from different World Heritage Sites to understand the their current scenario of cultural heritage tourism management. The review will be followed by the discussion on visitor impacts, their experience and management. Also it will focus on the intermediaries of cultural heritage tourism. Culture: Kalman, (2010) has given a simple definition of culture that, it is the way we live, it is the clothes which we wear, the food which we eat, the language which we speak, the stories which we tell and the ways we celebrate or express to each other; also it is a way we show our imagination by tradition which we have learnt from our ancestors. It includes arts, music, and literature. According to Pedersen, (2002) the culture has originated from group psychology behaviour, and the effect of surrounding environment, here is the example: since beginning all human being love to live in group it include people as well as animal, the effect of surroundings, interacting with other culture and regular exposure to outside groups incorporated new practices in to their way they live. Thus people have been moving away from their daily routine work and travel at various places to gain experience or exchange culture with each other. But currently it can see that influence of external culture is damag ing the traditional way of life. For example in the social cultural context women working outside the traditional family system can weaken interest in cultural traditions such as storytelling (Pedersen, 2002). Further from tourism point of view Singh (2004 in Imbal, 2010) explained that culture is creative artistic activities, goods and services produced by it, and the preservation of human heritage. According to this definition Imbal (2010) put a lime light as this it has brought attention not only indigenous or original culture of destinations to create value but also the impact on the economy and productive activities originate from or contributing to particular culture sector results in further value creating activities (Imbal, 2010). Cultural tourism: Cultural Tourism is the subset of tourism that is defined as travels concentrating toward experience the traditional and contemporary culture, arts, and special character of a place. This includes the performing, visual and literary arts, language, museums, heritage, crafts, architecture, design, film and broadcasting. The primary benefit of cultural tourism is economic impact. There are plenty of statistics that talk about the fact that travellers who participate in cultural activities spend more money and stay longer than leisure travellers. A good strategic planning of cultural heritage tourism shapes and defines a communitys image, in domestic as well as international tourism. According to McKercher and Du Cros, (2002) cultural tourism and cultural heritage management work as equivalent activities in most places with really little conversation between the two, also it shows common interest between the cultural and cultural heritage is such as the management, conservation, and preservation of the cultural and heritage properties. So the results of this many lost opportunities to provide value to visitor experiences even though managing rare and weak resources in a social context, environmentally and ethically responsible and in sustainable manner. They stated that occasionally this loss results in some unprincipled tourism operator who exploring the local culture and heritage assets for their own personal gains (McKercher and Du Cros, 2002). Hall and Zeppel (1990a:87 in Timothy and Boyd, 2003) stated that relation between cultural and heritage tourism is: Cultural heritage is experiential tourism based on being involved in and stimulated by the performing arts and festivals. Heritage tourism, whether in the form of visiting preferred landscapes, historic sites, buildings or monuments is also experiential tourism in the sense of seeking an encounter with nature or feeling part of the history of a place. Most researchers believe that heritage is linked to the past which symbolizes some sort of gift to be passed down to current as well as future generations, both in terms of cultural traditions and physical objects (Hardy, 1988 cited in Timothy and Boyd 2003). But in contrast many authors have pointed out that what elements of past a society need to maintain (Fladmark 1998; Graham et al., 2000; Hall and McArthur 1998 in Timothy and Boyd 2003). As there are many incidents all cannot link to the cultural aspects. This makes selective sort of heritage it assumes some aspect of value, that which is of personal value is labelled as personal or family heritage, whereas those values dictated by nations or communities become our heritage (Hall and McArthur 1998 cited in Timothy and Boyd 2003). Hall and Zappel (1990) observed differently that the connections between cultural and heritage tourism, stating that Cultural tourism is experiential tourism based on being involved in and stimulated by the performing arts, visual arts and festivals. Heritage tourism whether in the form of visiting preferred landscapes, historic sites, building or monuments, is also experiential tourism in the sense of seeking an encounter with nature or feeling part of the history of a place. However the most internationally accepted definition of heritage was defined by UNESCO that Heritage is our legacy from the past, what we live with today, and what we pass on to the future generations (UNESCO 2008a, p.5). Timothy and Boyd (2003) define that heritage tourism as an immersion in the natural history human heritage, arts, philosophy and institutions of another region or country. According to them heritage can be divided into tangible immovable resources (e.g. national park, sanctuaries, monuments, buildings), tangible movable resources (e.g. objects in museums) and intangible resources including values, customs, ceremonies, lifestyles and experiences such as cultural events. The concept of intangible heritage; according to (Schmitt, 2008) safeguarding intangible heritage resource has derived from Government of Bolivia to protect the intellectual property rights of popular culture 1973; then in 1989, UNESCO put limelight on the safeguarding rights on traditional culture and Folklore. However this project started to collect CD about the culture and 90 objects were proclaimed as such masterpieces in three proclamations between 2001 and 2005. For example of the new UNESCO category of intangibl e heritage is the Kutiyattam Sanskrit Theatre in the southern Indian province of Kerala (Schmitt, 2008). Cultural heritage tourism a different market segment: To recognize in minutiae cultural heritage tourism market segment which is associated with visits to historical sites, monuments, and artistic scientific or heritage attraction? WTO has mentioned two definition of cultural heritage tourism in narrow sense it include movement of person for essentially cultural motivations such as study tours, performing art, and pilgrimages. In broader manner it is defined as all movements of persons, because of satisfy the human need for diversity, tending to raise the cultural level of the individual and giving rise to new knowledge experience and encounters. Since cultural is prejudiced definition of cultural tends to the extensive as well as narrow, depending on the practical uses in the field (Pedersen, 2002). The importance of Heritage The importance of heritage is highly depending on their value and attitude as type of heritage resources which significant to different communities, groups and individuals. Hall and McArthur (1993) have explained the importance of heritage tourism divided in to four as social, economical, scientifically and political (Hall and McArthur 1993a). In social significance, heritage refers to personal and collective identity people and society have which can lead to create a sense of belonging. The sense of belonging and social conscience is a driver to consider preservation in the first place. Social science such as anthropology and cultural studies involve artefact of heritage or cultural heritage as presenting folkloric traditions or dance. Apart from this historical monuments and natural heritage are creating more opportunities to the scientist and researchers to find out the method and types of material they used in making of sites. The archaeological department of each country try to preserve the wall paintings and sculpture at various world heritage sites (Hall and McArthur 1993a) according to them sites can provide the history lesson for not only students and visitor who related or have interest in the history but also local communities to know the importance of sites sometime lack of initiatives and interest shown by local people which affect on conservation of heritage properties. Under the social context Baig, A., (2011 in Times of India, 2011) points out that the importance of health and education only in local communities can helps to achieve possible sustainability of cultural heritage tourism. She has given example how the impact of massive tourism affects as Taj Mahal, Indias most iconic site, which is situated in Agra, but it is one of the most dismal destinations in the world. One side of the industry is ensure that the Taj Mahal is protected but another side shows the current status of city economy is in decline, and its people have paid an unwanted high price. Further Baig and Morgan, 2011 in Times of India, 2011, emphasis on the empowerment of local communities can help to achieve inclusive development of heritage sites throughout the world (Times of India, 2011). In terms of economic importance, heritage is preserved because of its value for tourism and recreation. As being a large scale business, heritage tourism can generate incomes for the sites either from visitor spending or sponsorship from various stakeholders (Hall and McArthur 1993a). According to an article which was released in Times of India (2011) Sethi (2011) has mentioned that Heritage can become a serious economic driver for developing countries, if the country is able to get its act together. The global heritage fund organizations 2010 report says that developing countries like India can tap a $ 100 billion a year opportunity by 2025, if they make sincere attempt to preserve and responsibly develop their heritage sites. Further scientifically and educational importance of heritage attractions where both natural and cultural heritage sites such as national parks may have rare habitat and endangered species which will be useful for scientific researches. As research may consists of ecosystem dynamics, comparative ecology, surveys of fauna and flora, and the association of base ecological data, environment change and human impacts on the ecosystem of cultural and natural world heritage sites (Hall and McArthur 1993). In terms of political importance, Hall and McArthur (1993a, p. 9) state that the meaning and symbolism of heritage may serve political ends. As the conservation and understanding of certain heritage attractions may serve to emphasize on a particular version of history or to promote existing political values. Furthermore, the ownership of heritage and the institutional arrangement also have political implication as the rights and wishes of private owners may place conflict with government or public interests (Hall and McArthur 1993a; Timothy and Boyd 2003). Then, there is the question about political will. Jain, 2011 in Times of India, 2011 stated that culture is often considered a soft subject and that shows in the bundling of the portfolio with other ministries like youth or sports affairs. The governments schemes are often well-intentioned, but there is rarely any follow-through. For instance, under the public-private partnership adopt-a monument project a good idea for corporate to do their bit for conservation, but it fell through, because of red tape (Times of India, 2011). To understand the nature of the scheme Archaeological department of Scotland Adopt-a-Monument project based on providing volunteer groups with all the practical guidance and training they want to play a leading role in caring for their local archaeology. For example Scotland adopt-a monument scheme putting more focus on helping volunteers which includes children and young people to improve sites which they are really passionate about it. This practice will equip the volunteers with new skill in archaeological fieldwork and conservation and can get chance to access educational literature resources about the heritage. Which help to create awareness among local area and it effect to promote of heritage site, this way the respective government try to keep them active which helps to enjoy teamwork with practical result (Archaeology Scotland, 2011). Current tourist demand: According to (Pavlic, 2009) up gradation in the standard of living is become a main cause of rises in fluctuation of tourists spending, for example: the income generating from the modern tourism commodities. Modern tourists behaviour is the main factor in current tourism industry. As currently many of travel operations that could be from demand side or supply side are in boom because ease of accessing Information through internet and infrastructure developments. So the importance of information technology in the current industry is the main factor while considering the supply and demand of tourism industry it can be assumed that the personal needs of the modern tourism have more influence compare to old masses of tourism. The current tourism mostly depended on economic mass and production to consume mass, standardized and rigidly packaged holidays. The current tourists from a modern age are following the pace and direction of industry changes (Poon, 1993 in Pavlic, 2009). To find out the main factors and consequences of cultural heritage tourism demand changes. So firstly, need to identify types of tourist come under this category around the world. Religious heritage and pilgrimage: Sacred travel is commonly regarded as the oldest form of non economic travel (Jackowski and Smith, 1992 in Timothy and Boyd, 2003).The common travel trend has been travel from western to eastern Mediterranean region was religiously motivated before and during the Roman Empire era. This trend currently exists and in future as well within the devotees of worlds major religions (Timothy and Boyd, 2003). Further, Timothy and Boyd, 2003 explained that the historic sites associated with the development of a religion, and various points along spiritual routes and the pathways. Further, Shackley (2001 in Timothy and Boyd, 2003) made two basic groups according to their purpose of visits. As whose primary purpose is to gain religious experience and another one is who come to visit in large number and their prime motto is to visit an elements of the worlds religious cultural heritage so called secular tourist. This shows variation between the tourists motivation who visits heritage sites. Many tourist visit heritage sites with curiosity about historic sites not of their own faiths, for example non -tourists visiting Buddhist religious cultural heritage sites around the Asia may fit in to the secondary group of heritage tourist. To understand the concept behind this motivation of these cultural tourist many scholars fails to find out the differences between pilgrims and tourists but Smith (1992) proposed typology of the relationships and differences between the tourist and pilgrims. The Pilgrim- tourist continuum Source: Smith (1992 in Timothy and Boyd) From the figure______ she Smith explained that on one end of a spectrum are devout pilgrim, while at the other end are secular tourist, with some variations between the two located somewhere in the middle (Timothy and Boyd, 2003). From the heritage tourism viewpoint, pilgrimage is a type of tourism under the huge headline of religious tourism. Source: McKercher, B and Du Cros, H (2002) According to above figure _____ it is clear that there are mainly five kinds of tourists who come under the cultural and heritage tourism these are: Purposeful cultural tourist: who has purpose to visit to cultural tourist site and these are eager to learn about a destinations culture and heritage as well as who has high sense of history, education, religious and the culture from around the world. Sightseeing cultural tourist: cultural tourism is a key motive for visiting a specific destination however the experience is less deep. Serendipitous cultural tourist: the tourist who does not travel for specific cultural motives, but ultimately does have a deep cultural tourism experience. Casual cultural tourist: cultural tourism is a weak travel motivation and the resulting cultural experience is shallow. Incidental cultural tourist: who however visits cultural attraction with very little experience or by an incident and these cultural tourist who also not motivated to travel for cultural reason but due to unexpected visit to the cultural heritage site they get the deep experience about the cultural and heritage sites (McKercher et al., 2002). Further from supply point of view the requirement of different services and facilities provide by the stakeholders necessitate a different marketing approach to motivate cultural and heritage tourist. In general, supply means the tourism resources services of a region. Supply, has categorized as primary, secondary and tertiary elements (Jobson-Verbeke and Lievois, 1999 in Timothy and Boyd 2003). The primary elements involve the attractions such as cultural, sport and amusements facilities and their leisure setting ensuring physical characteristics and sociocultural features. After this secondary elements focuses on the service aspects which provide to the tourist as accommodation, food shopping and market. Further tertiary or additional elements are those which are relating to infrastructure development to connect the tourists sites and attractions. Currently, 21st century tourists behaviour is the most important factor which influencing the cultural heritage tourism market throughou t the world (Pavlic, 2009) such as transportation, providing information to the tourist form offices and information kiosks at sites as well as parking facilities at sites (Timothy and Boyd, 2003). Cultural heritage market: The Criteria for Selection According to UNESCO site must be of outstanding universal value and meet at least one out of ten selection criteria. These criteria are explained in the Operational Guidelines for the Implementation of the World Heritage Convention which has explained below the convention table. The criteria are regularly revised by the Committee to reflect the evolution of the Wold Heritage concept itself. Until the end of 2004, World Heritage sites were selected on the basis of six cultural and four natural criteria. With the adoption of the revised Operational Guidelines for the Implementation of the World Heritage Convention, only one set of ten criteria exists (UNESCO, 2011) Source: UNESCO Selection criteria: To represent a masterpiece of human creative genius; To exhibit an important interchange of human values, over a span of time or within a cultural area of the world, on developments in architecture or technology, monumental arts, town-planning or landscape design; To be a unique or at least exceptional testimony to a cultural tradition or to a civilization which is living or which has disappeared; To be an outstanding example of a type of building, architectural or technological ensemble or landscape which illustrates (a) significant stage(s) in human history; To be an outstanding example of a traditional human settlement, land-use, or sea-use which is representative of a culture (or cultures), or human interaction with the environment especially when it has become vulnerable under the impact of irreversible change; To be directly or tangibly associated with events or living traditions, with ideas, or with beliefs, with artistic and literary works of outstanding universal significance. (The Committee considers that this criterion should preferably be used in conjunction with other criteria); To contain superlative natural phenomena or areas of exceptional natural beauty and aesthetic importance; To be outstanding examples representing major stages of earths history, including the record of life, significant on-going geological processes in the development of landforms, or significant geomorphic or physiographic features; To be outstanding examples representing significant on-going ecological and biological processes in the evolution and development of terrestrial, fresh water, coastal and marine ecosystems and communities of plants and animals; To contain the most important and significant natural habitats for in-situ conservation of biological diversity, including those containing threatened species of outstanding universal value from the point of view of science or conservation. The protection, management, authenticity and integrity of properties are also important considerations. Since 1992 significant interactions between people and the natural environment have been recognized as cultural landscapes (UNESCO, 2011). Heritage visitor attractions classification: The classification of heritage attractions considers the commonly accepted definition or agreed typology included the three different perspectives were outside commentator or observer of the heritage product; the outside or inside protagonist of the tourism product, and the inside exponent of conservation (Leask and Yeoman, 1999) but in fact these typology were not supported to the manager to recognized the tools for an operations. Therefore Prentice (1993 in Leask and Yeoman 1999) considered the enormous variety of heritage visitor attractions is highlighted. The heterogeneity of present day heritage is mirrored in the heterogeneity of heritage attractions, as site, themes and areas promoted heritage as a product and utilization by tourist or visitor from home though it has broad sense as site, theme and area but he considers that attractions may not itself be attractive, and cites as example of field of sport and genocide monuments; so this could be used for an analysis of supply a nd demand patterns, the typology is of partial value in heritage visitor attraction management on the ground. Further Swarbrook (1995 in Leask and Yeoman) explained the difference between destination and attraction that Attractions are generally single units, individual sites or very small, easily delimited geographical areas based on a single key feature. Destinations are larger areas that include a number of individual attractions together with the support services required by tourist. Cultural heritage visitors attraction management: The cultural heritage tourism requires a careful understanding. Because of the quality issues which lie in the cultural heritage tourism. Managers should maintain a balance between a demand and supply. Typology of tourist has significant value in the management because every tourist is unique in nature. As mentioned above quality management has vital role to create an experience lasting value. Visitors perceptions about the quality is solely depend diverse range of factors, from site interest and the quality of services provided to the visitor experience (Vitterso et al., 2000) as what happens in his/ her entire visits rather than gaining a knowledge about the culture, getting facilities and services which normally available. Therefore Rouse (1998 in Leask and Yeomen, 1999) emphasis on the treatments by the service providers has a signific