Norovirus: Strategies To Improve Terminal Cleaning

Norovirus: Strategies To Improve Terminal Cleaning This paper provides comprehensive background information related to norovirus outbreak and critically evaluate the implications of the issue by expounding on the adoption of infection control measures and effective management practices to minimise risk factors associated with the epidemic followed by terminal cleaning in an orthopaedic ward. The historical background of the infection was specified when an outbreak of gastro-enteritis was detected in a school in the town of Norwalk, Ohio, USA, more than 25 years ago, and Norovirus (NV) was then recognized as a potential ailment. The virus is derived from a genus within the family Caliciviridae consisting of a diverse group of non-enveloped RNA viruses that generally lead to infection. It was previously named as Small round structured virus (SRSV) infection and Norwalk-like virus (NLV) infection and is said to cause winter vomiting although it can occur at any time of year. Substantial increase has been observed in the outbreaks of nor ovirus infection in recent years and it has been reported that the GII.4 norovirus strain has increased transmissibility and virulence resulting in excess expected mortality and morbidity rates amongst affected patients (Harris et al. 2008). Although the disease is self limiting and is considered mild but elderly and immune-compromised patients are said to be at higher risk. Lopman et al, (2003) after analysing data from norovirus outbreaks in England and Wales during 1992-2000, disagreed to acknowledge norovirus as a trivial disease and emphasized that it is one of the contributing factor to the worsening condition of the immune-compromised patients. The instigation of the infection is acute which is initially characterized by abdominal cramps, diarrhoea, nausea, and vomiting followed by myalgia, headache, malaise and a low grade fever that might transpire in up to 50% of cases (Wilson 2001). The highly contagious viral gastroenteritis is spread by person to person contact through faecal oral route furthermore, aerosols or environmental contamination followed by faecal accidents or droplet transmission through projectile vomiting is another cause of infection as it spread viruses into the air as an indiscernible mist and especially targets the vulnerable individuals in a closed or semi-closed setting e.g. hospital wards and nursing homes. Noroviruses has the tendency to spread quiet easily and may also cause outbreaks due to contaminated food or drink as these viruses may settle on people or food present in the same room. The virus can also be widely spread due to negligence of healthcare staff to maintain hygiene or due to the c ontaminated surfaces especially commodes, toilet doors and chains, taps etc (Chadwick et al. 2000). The symptoms lasting for at least 48 hours indicate that the patient with viral gastroenteritis is considered to be potentially infectious. The symptoms may last longer in case of elderly patients and the severity of the vomiting may also result in dehydration. Test results of faeces or vomit determine the identification of viral gastroenteritis and it has been submitted that the onset of vomiting in a number of people over a period of 1-3 days indicate that the virus is continuously spreading within the setting. It has been studied by Love et al, (2002) that norovirus outbreaks can be devastating in closed or semi-closed communities as for example hospitals, nursing homes, child care centres and leisure industry settings such as hotels, restaurants and caravan camps are more susceptible to trigger the outbreak of infection. The daily routine within a closed or semi-closed setting can be seriously disrupted by the outbreaks due to relatively high attack rates as the transmission of virus is enormously swift. The outbreak of norovirus infection confers short term immunity with a rapid spread out and therefore, absolute prevention from the epidemic is unattainable however, the risk of norovirus outbreak can be mitigated by effective control measures in order to limit its impact and disruption of routine healthcare services. Every single healthcare unit shall prepare a logical series of steps followed by an outbreak plan agreed by the Infection Control Committee of the hospital or Director of Public Health, in order to recognize the risk of outbreak instantaneously and establish the effective control measures. As soon as norovirus outbreak is suspected, the outbreak control team that is usually comprised of consultant microbiologist or other medical staff members, need to take necessary initiatives to identify the extent of outbreak by coordinating the preliminary investigations and take all the necessary measures to impede the spread of infection, if the outbreak is declared (Said et al. 2 008). The most significant aspect after detecting an outbreak is effective communication that can be achieved by placing notices at the entrance to the ward, alerting the relevant and voluntary staff to take charge, distributing leaflets and educating the visitors to postpone their visits. One of the most preliminary preventive measures is stringent hand washing with water and soap followed by the use of gloves and plastic aprons by the healthcare staff while taking care of patients and finally the use of face masks when dealing with vomit or removal of exposed food. Moreover, immediate disinfection of the setting with chlorine releasing disinfectants, when contaminated with vomit or stool prevents embedding of the virus and further spread. Segregation and isolation of affected patients are useful preventive approaches however, it could be problematic due to over occupancy of the rooms and beds. On the other hand, patients might also be unwilling to move from their room to another as the isolated patients express greater dissatisfaction towards their treatment and seem to obtain less documented care however, it is crucial to keep the symptomatic people apart from asymptomatic ones. The uninfected patients could be discharged only if the patient is able to cope up with the situation in case if there is a likelihood of him/her becoming symptomatic. Closure of the entire orthopaedic ward is a wise alternative that significantly discourages the exchange of staff and patients between wards so that the probable spread of the infection to other wards can be prevented (Ayliffe et al. 2000). Exclusion of the symptomatic staff members is imperative and must not show up on work until 48 hours after normal bowel habits have returne d. The excessive admittance to the ward must also be reduced to avoid the over crowdedness and uninfected patients may be discharged to their homes provided their relatives are educated about the personal risk to themselves and also about the preventive measures so that the probable risk of infection can be minimised. As studied by Gallimore et al, (2006) norovirus can be found on a huge variety of hand-touch sites such as toilet taps, door-handles, hospital equipment, elevator and microwave buttons, switches and telephones and therefore additional efforts are anticipated from the cleaning staff during an outbreak. In order to control the outbreaks of norovirus the significance of environmental cleaning must be evidently acknowledged and specifically addressed. Cleaning does not necessarily means to clean the floors, the norovirus outbreak requires a comprehensive terminal cleaning program at least twice a day and the cleaning includes clinical equipment, floors, toilets and general surfaces (Damani 2003). Furthermore, curtains, bed covers and pillow cases should be removed and sent to the laundry, and the rest of the soft furnishings including carpets shall be either washed down or, preferably, steam-cleaned. All general cleaning agents especially those used for cleaning toilets and bathroom area s should be with a chlorine-containing disinfectant or bleach at a specified concentration which is usually 1000ppm chlorine (Horton Parker 2002). With some surfaces the use of 1000ppm chlorine is incompatible and requires correct safety measures to be taken by the cleaning team which sometimes becomes difficult due to lack of training or individual negligence however, no differences were found between disinfection with 250ppm chlorine and the use of no chlorine. Barker et al, (2004) suggested that the cleaning policies should always include the use of chlorine releasing disinfectants since detergent-based cleaning often fails to eradicate the virus from the environment. There are certain factors that significantly influence the management of the overall outbreak within a healthcare setting or an orthopaedic ward. The foremost factor that greatly affects the preventive measure is the delay in the identification of an outbreak as a result of which there could be chaos during the epidemic which could be extremely exasperating. The main reason of such a gaffe could be flawed infection control policy, inconsistent decision making, sheer negligence or simply false judgement. The administrative policy of a healthcare setting plays an important role to determine the success and failure of an organization to combat with complicated health crisis. A clear, concise and effectively documented framework enables the healthcare staff to carry out preventive and control interventions by adhering to the strict rules and regulations and thereby, mitigate the risks of mismanagement. The organizational policy provides a platform for the infection control team to carry out preliminary investigations to substantiate the outbreak and immediately take full control of the situation by integrating the early control measures as for example, segregation and isolation of affected patients and comprehensive cleaning. Regardless of the size and capacity, every closed and semi-closed setting must designate the infection control staff to manage the outbreak. The preliminary investigation should be led by the consultant microbiologist or infection control nurse or any other designated clinician to establish a tentative diagnosis and to convene an outbreak control team if norovirus is suspected (McCulloch 2001). The composition of the team may vary depending on the setting and the extent of the outbreak. The infection control team is responsible to develop a descriptive epidemiology along with environmental health investigation to quantify the extent of the outbreak with the help of survey questionnaires that additionally help to identify the outbreak in terms of an individual, place, time etc followed by which careful preventive measures are undertaken to exclude a sources of contamination. The organizational and structural policy helps the infection control team to compile and analyse data of the reported cases followed by microbiological investigations and complex analytical studies to determine possible exposures and methods of transmission (Pellowe et al. 2003). The role of senior management and decision makers of a healthcare setting is very crucial in addressing the complications raised by the norovirus outbreak within an orthopaedic ward. For an organization capital and revenue, recurring and non-recurring costs must be considered while developing an infection preventive and control policy. It is very important for a healthcare setting to assess the risk control planning process and compare it with the risk exposure costs with the cost of planned improvements to current controls (White et al. 2008). The norovirus outbreak within an orthopaedic ward demands additional staffing, training requirements capacity, cleaning equipment and several other resources. Extra staffing is required depending upon the size and capacity of the setting but usually additional drivers and substitute nurses are arranged prior to an outbreak. Furthermore, training requirements also increases as an outbreak of norovirus within an orthopaedic ward is an emergency situation where the need of highly skilled and trained healthcare staff becomes higher. The increase in resource requirements must also be considered and identified prior to draw infe ction management plan as it is quite possible that the impact in cost or resources required might outweigh the actual impact of the risk materialising on the organisation (Reason 2000). Therefore, it is essential for the policy makers to prioritize the needs and requirements of the issue and compare it with the budgetary restrictions and come up with a sensible and realistic plan that not only addresses the issue but also abide by with the fiscal arrangement of the organization. The preventive and control policy must ensure to respond to the increased demand for cleaning in the affected areas and for additional demand for cleaning supplies etc. The prioritisation of risks allows the organisation to characterise the potential health risks that require early attention on a cost and benefits basis and address them in the most effective way. Moreover, it is wise for the management to develop a partnership culture that guarantees the involvement and participation of all staff in risk ass essment so that the distribution of responsibilities is equally distributed and comprehensively understood. Staffing is yet another factor that subsequently influences the progression of preventive measures and management of infection. Increase workload can be observed followed by a norovirus outbreak within a healthcare setting as there is an incremental admission of patients and this may lead to unmanageable situation. When the workload increases it is quite obvious that the healthcare team is under extreme pressure and a lot of stress on an individual basis and therefore, it becomes vital to draw a sensible management plan to reduce traffic as it becomes very difficult for the healthcare staff to maintain absolute hygiene practices running parallel to incremental workload and visitors. The overcrowded wards shows a potential risk of accelerating the circulation of norovirus in the healthcare setting as well as a wide distribution of the virus in the environment outside a ward or hospital which is alarming. Furthermore, the spread of infection is not restricted to patients and the health care team especially those having direct contact with the patients are equally susceptible to catch the disease and hence there is a probability of shrinkage in staff members (Damani 2003). The increasing absences may lead to a difficult situation for the management as the size of the setting or the overall budgetary restrictions may result in downgrading the infection preventative and control measures. It is very important to retain highly trained staff and nurses in the ward at the time of an outbreak as the lack of trained and experienced staff may also result in the worsening of the overall development. By ensuring hygienic practices and the implementation of strict infection control measures the overall staff benefits as fewer staff members will fall ill, consequently there will be fewer costs for sick leave and the substitution of staff. Moreover, continuous care for the patients will also be guaranteed. The influential factor like human fallacy is another aspect which cannot be ignored. The patients and healthcare staff are both humans and it is quite possible for an individual to deliberately refuse to follow the specified guidelines and hygiene practices or an individual may unintentionally do something which might aggravate the issue (Reason 2000). On the other hand, poor structural and utility planning may also be an aggravating factor especially where there is a lack of wash hand basins in clinical areas then the possibility of virus spread becomes inevitable (Rayfield et al. 2003). The excessive workload and pressure due to rush season especially when there is a declared epidemic within a healthcare setting, the overstretched staff sometimes become ignorant to comply with the infection preventive and control measures that lead to severe consequences. Another significant aspect is the lack of education regarding the underlying issue which significantly becomes the prime cause o f spreading virus. The unhygienic or ignorant behaviour of the patients visitors also add to the worsening of the situation. The correct approach is to educate every single individual about the norovirus and the preventive measures and every possible means of communication as for example, advertisements through television, radio programs, newspapers and magazines must all be utilized to spread the message to common people. The management of closed and semi-closed settings must also ensure to educate people by pasting posters and distributing informative materials and leaflets about the norovirus. Collective human efforts to educate each other about the underlying issue would help to minimise the risk of spreading virus and would also facilitate in maintaining cleaner and healthier environment (Reason 2000). Once the outbreak has been declared the ward should be closed to admissions and the doors of the ward should also be kept closed to avoid the irrelevant visitors. There is a need to place an approved notice on the door indicating that a suspected norovirus outbreak, or outbreak of diarrhoea and vomiting within the orthopaedic ward followed by which the unnecessary traffic to the ward must be stopped. To conclude, the most integral aspect of improving the terminal cleaning of the ward is dependent upon how effectively the awareness has been created amongst the people. It is imperative to educate every individual who is particularly closer to the ward that includes, bed management, nurses, food handlers, waste management staff, cleaners, consultants, and health protection team. According to DoH (2003), daily updates must be circulated among the healthcare staff and the residents of the ward or healthcare setting during norovirus outbreaks. Education is an effective tool as the more individuals are aware of the facts the more they would adhere to preventive and control measures which subsequently result in progression of effective cleaning practices. Apart from educating people, the pragmatic approach should be adopted right after the discharge of patients followed by removing the linen on the beds and curtains to avoid any chances of left over virus attacks. The tangible surfaces s hall be cleaned with neutral detergent and water and then dried. During the terminal cleaning the beds shall not be re-made and every minute aspect shall be emphasized in order to attain a zero defect environment. Noroviruses has the tendency to survive for up to a week on cleaned beds and on clean bed linen and therefore, the terminal cleaning requires careful and thorough cleaning. An adequate amount of literature is available expounding on the infection preventive and control measures pertaining to the norovirus and there is not much difference in the recommended strategies to thwart the issue however, it is significant to realise that despite of such written about issue the prevention of the disease is still unattainable and this is because noroviruses are not visible to the naked eyes and the most critical factor i.e. human fallacy still persists and can never be prohibited. Therefore, to mitigate the spread of norovirus it is important not only to adhere with the specified pre ventive guidelines but also to increase awareness amongst the uninfected people so that the likelihood of virus spread out can be completely controlled and diminished. Barro-Gordon Model: Overview and Analysis Barro-Gordon Model: Overview and Analysis To what extent is there a disconnect between theoretical models of monetary policy, and how monetary policy is conducted in the real world? Your answer should draw on the theoretical models of monetary policy we have covered in lectures, and your knowledge of the monetary policy framework at the Bank of England (minimum 950 words, maximum 1000 words). The theories surrounding monetary policy have been radically transformed in recent decades, ultimately shaping the institutional structure and policies of central banks. The focus until recently was upon ‘a mandate, independence and accountability (Svensson, 2009) which closely reflected theoretical models, however the shifting nature of the economy with the current financial crisis has meant a greater disconnect between theory and practice. The Barro-Gordon model depicted the choices policy makers face when creating monetary policy. The incentive for policy-makers to create surprise inflation is shown below: (Taken from â€Å"The Barro Gordon model of rules vs. discretion†, Costain) This temptation of a temporary rise in employment is correlated with the pressure on governments to achieve high results before elections. The problem becomes time-inconsistent with rational expectations and a multi-period model. The optimal policy for government is positive inflation, which agents know and thus set expectations equal to. This demonstrates the optimal result of a binding rule. The rule vs. discretion debate highlighted the need to constrain government interference, resulting in increasing central bank independence and a focus upon long term horizons. However, rules cannot accommodate all possible events, and have created problems evident in the Thatcher government. The US policy between 1950-66, and 1985-2000 provides evidence that discretionary policy can produce good results. The assumptions of the distinction between only two types of central bankers and perfect control over the price level are deemed unrealistic. The granting of Central Bank independence within the UK in 1997 could be seen as a response to the impetus within theoretical literature such as Barro-Gordon to do so. Following this, the MPC was said to gain instant credibility with long-tern inflation expectations falling sharply. Empirical findings below support independent central banks ability to sustain lower inflation with no output cost. Central banks tend to follow Fischers theory of instrument independence and goal dependence. The idea of â€Å"constrained discretion† is seen in the UK with the Chancellors requirement of a remit letter if inflation strays by 1pp from target. The independence of the UKs Quantitative easing policy is seen by its status of â€Å"the business of the bank† (Mervyn King). However the democratic need for accountability is seen in the UKs allowance of a member of the treasury to sit in on meetings. Reputation and delegation are two theoretical commitment solutions to the dynamic-inconsistency problem. (Romer, 2001). Reputation plays a role in monetary policy, in a state of uncertainty such as the UK, where the image of central bankers of inflation fighting is important to establish credibility thus incentivising them to achieve targets. This issue is seen as being â€Å"near..to the hearts of real central bankers† (Blinder) and is achieved by processes such as publishing votes. Commitment solutions rely on the importance of expectations and are prominent in theory and practice of real world policy. This is reflected in the prominent role of the Bank of Englands inflation and output forecasts. However the New Keynesian Phillips Curve assumption that a rise in inflation expectations would give rise to inflation did not hold in recent times, as shown below. Rogoffs proposal of delegating monetary policy to ‘Conservative central bankers that are more inflation-averse than the general public provided the â€Å"intellectual framework for the redesign of the central banks† (Clement, 2008). It has been influential in the Bank of Englands appointment choices with the Conservative views of insiders dominating monetary policy (Spencer, 2009). The need for the ‘optimal level of conservatism explains ‘flexible inflation targets in many central banks, and the inclusion of ‘outsiders within the MPC. The use of a one-shot game and its exclusion of a disinflation possibility (Hallett, Libich Stehlik) disconnects it from reality. Although there is no such inclusion of a ‘performance contract (Walsh, 1995) within monetary policy, the theory drew attention to optimal incentive structures for central banks, which is a current focus in the financial crisis literature. The use of an inflation target which allows for output stabilisation, seen in the Svensson model (1997), is correlates with this theory and is evident in most central banks. Svensson proposes an optimal reaction function similar to the Taylor Rule, which the UKs MPC is said to follow (Spencer 2009). However due its ‘individualistic (Blinder) nature consolidated in the ‘one member one vote system, one rule could never account for the heterogeneous views within the MPC. However Harris Spencer model (2009) state that â€Å"the institutional status of Bank of England MPC members† holds more importance than differing reaction functions, The MPC contains five insiders appointed from within the bank, and four outsiders, appointed from other professions and academia. Theory correlates with practice, with insiders more likely to hold conservative views and vote as a block, when compared to outsiders. The rapid change of the economy in the recent financial crisis has led to a disconnection between theory and practice. The ‘one tool, one target approach has proved inadequate in dealing with the financial crisis. Blanchflower (2009) stipulated the exclusion of the financial sector as the reason the Central Bank was slow to realise the severity of the crisis. The effect of the financial crisis confirms the view that theory arises from events, and their unpredictability means models will always contain shortfalls. Shortfalls are also evident in healthy economies. The complete markets assumption seen in such influential models like the DSGE and the ones discussed above does not hold in a world â€Å"characterised by herding behaviour speculative bubbles† (Blanchflower, 2009). Critics cite the inclusion of fiscal policy within models as likely to alter results. In conclusion, the models I have discussed have been influential in determining the institutional structure of the bank, the type of central banker appointed and how they are done so. They have signified the importance of the role of bank incentives and expectations in forming policy. However as the recent financial crisis has shown, in such a dynamic complicated world littered with uncertainties, generalised models can never satisfy all the demands of practical monetary policy. Bibliography Books Blinder (1999), â€Å"Central Banking in Theory Practice† Romer (2001), â€Å"Advanced Macroeconomics† Articles Barro, (1977), â€Å"Unanticipated Money Growth and Unemployment in the United States†, The American Economic Review Barro, (1978), â€Å"Unanticipated Money, Output, and the Price Level in the United States†, The Journal of Political Economy Fischer (1994), How independent should a central bank be? Working Papers in Applied Economic Theory Hallett, Libich Stehlik (2007), Rogoff Revisited: The Conservative Central Banker Proposition Under Active Fiscal Policies, CAMA Working Papers Herrendorf, Berthold and Lockwood (1997), â€Å"Rogoff ´s conservative central banker restored†, Journal of Money, Credit, and Banking Spencer Harris (2009), â€Å"The Policy Choices and Reaction Functions of Bank of England MPC Members†, Southern Economic Journal Spencer (2009), Lectures Notes for Loughborough University Svensson (2009), â€Å"Optimal Inflation Targets, ‘Conservative Central Banks and Linear Inflation Contracts†, American Economic Review Walsh (1995), â€Å"Optimal Contracts for Central Bankers†, The American Economic Review Websites Bank of England, â€Å"Monetary Policy†, accessed at http://www.bankofengland.co.uk/monetarypolicy/overview.htm on 22/11/2009 Bank of England, â€Å"Treasury Committee enquiry into the Monetary Policy Committee of the Bank of England†, accessed at http://www.bankofengland.co.uk/publications/other/treasurycommittee/mpc/tsc070219.pdf on 23/11/2009 Bean , â€Å"Is there a New Consensus In Monetary Policy?†, accessed at http://www.bankofengland.co.uk/publications/other/monetary/bean070413.pdf on 23/11/2009 Blanchflower, â€Å"The Future of Monetary Policy† accessed at http://www.bankofengland.co.uk/publications/speeches/2009/speech382.pdf on 24/11/2009 Clements, â€Å"A Rogoff Interview†, accessed at http://www.minneapolisfed.org/publications_papers/pub_display.cfm?id=4117 on 22/11/2009 Costain, â€Å"The Barro-Gordon model of Rules vs Discretion†, accessed at http://www.econ.upf.edu/~costain/theory4/bg.pdf on 22/11/2009 on 22/11/2009 Duncan, â€Å"King rounds on Cameron for trying to interfere in Quantitative Easing†, accessed at http://www.thisislondon.co.uk/standard-business/article-23767982-king-rounds-on-cameron-for-trying-to-interfere-in-quantitative-easing.do on 22/11/2009 Spencer Dale 2009  «Inflation targeting: Learning the lessons from the financial crisis » http://www.bankofengland.co.uk/publications/speeches/2009/speech395.pdf Svensson (2009), â€Å"Flexible Inflation Targeting: Lessons from Financial Targeting†, accessed at http://people.su.se/~leosven/papers/090921e.pdf on 21/11/2009

History of La Cosa Nostra

Running Header: {History of La Cosa Nostra} History of La Cosa Nostra UNK Dr. Neal CJ 380 12. 01. 2011 Envision a world where crime is king; a world where mobsters were more influential than political figures, controlled law enforcement, and ran cities to line their own pockets. They stole from whom they wanted and murdered those that got in their way. While it sounds like something out of a movie, it actually happened here in the United States in the first half of the 20th century. The American Mafia has evolved over the years as various gangs assumed and lost dominance: the Black Hand gangs around 1900; the Five Points Gang in the 1910s and ‘20s in New York City; Al Capone’s Syndicate in Chicago in the 1920s. Since the 1900s, thousands of Italian organized crime figures, mostly Sicilian Mafiosi, have come illegally to this country. The Italian Immigrants crowded into older lower class neighborhoods of American cities, sometimes given names such as â€Å"Little Italy†. These neighborhoods suffered from overcrowding and poor sanitary conditions. Living together in such closed communities created little more than a microcosm of the society they had left in Europe (par. 3, Black Hand). Some criminals exploited this fact, and began to extort the more prosperous Italian’s in their neighborhood creating a crime that would eventually snow-ball into an epidemic known as ‘The Black Hand’ (par. 3, Black Hand). The extortions were done anonymously by delivering threatening letters demanding money, signed with crudely drawn symbols, such as a knife or a skull. People paid the Black Hand extortionists in the fear that American law had no understanding, or power, to help them (par. , Black Hand). Many who fled here in the early 1920’s helped establish what is known today as La Cosa Nostra or the American Mafia (par. 10, FBI). La Cosa Nostra, or the LCN as it is known by the FBI, consists of different â€Å"families† or groups that are generally arranged geographically and engaged in significant and organ ized racketeering activity (par. 30, FBI). The LCN is most active in the New York metropolitan area, parts of New Jersey, Philadelphia, Detroit, Chicago, and New England. It has members in other major cities and is involved in international crimes (par. 1, FBI). During the 1920s Prohibition era, when the 18th Amendment to the U. S. Constitution banned the sale, manufacture and transportation of alcoholic beverages, Italian-American gangs along with other ethnic gangs entered the booming bootleg liquor business and transformed themselves into sophisticated criminal enterprises, skilled at smuggling, money laundering and bribing police and other public officials (par 2, History Channel). By the end of the ‘20s, two primary factions had emerged, leading to a war for control of organized crime in New York City. The murder of faction leader Joseph Masseria brought an end to the gang warfare and in 1931 Sicilian-born crime boss Salvatore Maranzano crowned himself the â€Å"capo di tutti capi,† or boss of all bosses, in New York (par 3, History Channel). Two of the most powerful La Cosa Nostra families, known today as the Genovese and Gambino families emerged from Maranzano’s restructuring efforts. Maranzano named Luciano the first boss of what would later be known as the Genovese family. Unhappy with Maranzano’s power grab, Lucky Luciano had him murdered that same year (par 3, History Channel). Charles â€Å"Lucky† Luciano became the new leader. Luciano then masterminded the formation of a central organization called the Commission to serve as a sort of national board of directors for the American Mafia, which by then consisted of at least 20 crime families across the country (par 3, History Channel). New York, which had become America’s organized-crime capital, had been divided into five main Mafia families; everywhere else the Mafia operated, there was just one crime family per city. The Commission’s role was to set policies and mediate disagreements among the families (par 3, History Channel). In 1936, Luciano was sentenced to 30 to 50 years in prison. Ten years later, he was released from prison and deported to Italy, never to return. When he was convicted, Frank Costello became acting boss (par. 49, FBI). Costello led the family for approximately 20 years until May of 1957 when Genovese took control by sending soldier Vincent â€Å"the Chin† Gigante to murder him. Costello survived the attack but relinquished control of the family to Genovese. Attempted murder charges against Gigante were dismissed when Costello refused to identify him as the shooter (par. 50, FBI). In 1959, it was Genovese’s turn to go to prison following a conviction of conspiracy to violate narcotics laws. He received a 15-year sentence but continued to run the family through his underlings from his prison cell in Atlanta, Georgia (par. 51, FBI). The Genovese family went through a succession of bosses until Lombardo, his two captains in prison and his health failing, turned full control of the Genovese family over to Gigante, the man who tried to kill Costello 30 years earlier (par. 56, FBI). Gigante ran the family from behind the scenes while pretending to be mentally ill until he was convicted of racketeering and murder conspiracy in December 1997. Gigante’s odd behavior and mumbling while he walked around New York’s East Village in a bathrobe earned him the nickname â€Å"the Odd Father† (par. 58, FBI). The other powerful New York mafia family was the Gambino Family. The Gambino family was named for its most powerful boss, Carlo Gambino, a smart, cunning individual with a fascination for the works of Prince Machiavelli. His sharp business sense, and traditional values, earned him the respect of his allies. Don Carlo was never arrested during his career as boss, and he died of natural causes in 1976, leaving brother-in-law Paul Castellano in charge of operations. From 1976 until his assassination by John Gotti in 1985, Castellano would come to be known as the â€Å"Boss of Bosses†. Big Paulie Castellano was never a mobster in the classic sense, but rather a racketeer. He didn't even hang out with other gangsters, preferring the company of businessmen, and other â€Å"important† individuals. Castellano had few enemies, but John Gotti believed Aniello Dellacroce should have been made boss, and he had often been chastised by Castellano for dealing drugs and conducting operations without prior consultation. When Big Paulie was arrested by the FBI after bugs planted in the mobsters home had provided several hours of recorded evidence, rumors began to circulate as to whether he would rat out fellow Gambino Family members, John Gotti, now acting in lieu of Dellacroce who had recently died of brain cancer, decided it was time to plan Big Paulie's retirement (par. 1, Gambino Family/Paul Castellano). Castellano was gunned down outside Sparks Steakhouse in Manhatten as Gottie and Sammy the Bull Gravano watched from a nearby car. Throughout the 80s, Gotti earned the nickname, the â€Å"Teflon Don†; for none of the charges brought against him would stick†¦ At least until the early 90s, when he was indicted and tried on a RICO (Racketeer Influenced, and Corrupt Organizations) case; this time facing a prosecution armed with mobster turned informant Sammy â€Å"The Bull† Gravano, who had been Gotti's own underboss, and who provided damning testimony against his former boss, particularly about about the Castellano murder. Gotti was sentenced to life imprisonment, and later made several attempts at a second trial, all of which were denied. John Gotti died of cancer in the Springfield, Missouri federal prison hospital, on June 10th, 2002 (par. 1, Gambino Family/ John Gotti). Another of the five families is the Bonanno crime family, originally headed by then twenty-six-year-old Joseph â€Å"Joe Bananas† Bonanno, Sicilian-born and one of the youngest bosses of all time. The Bonanno War or â€Å"Banana Split† occurred when the Commission demoted Bonanno to underboss, sparking fervent family in-fighting among those who sided with Bonanno and those who sided with the new boss, Paul Sciacca. The fighting continued until 1968, when Bonanno suffered a heart attack and retired, though by this point the Commission had stripped the Bonanno family of its seat (par. 3, Investigation and Discovery). Troubles with the law have plagued the family, leading one newspaper to report that 75 of its 150 members have been indicted on various charges (par. 5, Investigation and Discovery/ Bonanno). The Columbo Family is the fourth of the five families. Following the Castellamarese War of 1929-1931, the family emerged as the Profaci family. It was headed by Joseph Profaci, without much threat to his leadership, until the 1950s. After Profaci’s death, Joseph Magliocco took over for a short time before the family was handed over to Joe Colombo, and the family bears his namesake to this day (par. , Investigation and Discovery/ Columbo). The family has been greatly depleted from its heyday, and continues to be ruled by Carmine Persico, now 73 years old, from prison with help from those family members who remain on the ground (par. 6, Investigation and Discovery/ Columbo). The Fifth Family, the Lucchese crime family, as it is known today, emerged out of the Castellamarese War of 1929-1931 , with Gaetano â€Å"Tommy† Gagliano serving as the appointed boss and Gaetano â€Å"Tommy† Lucchese as the appointed underboss. The family was known for its successful forays into industries such as trucking and clothing. Following Gagliano’s death in 1953, Lucchese took over and successfully ran the organization for many years with an excellent reputation. He never received a criminal conviction in his 44 years in the Mafia (par. 1, Investigation and Discovery/ Lucchese). By the mid-20th century, there were 24 known crime families in America, comprised of an estimated 5,000 full-fledged members and thousands of associates across the country. Prior to the 1960s, some government leaders, including FBI Director J. Edgar Hoover, voiced skepticism about the existence of a national Italian-American organized crime network and suggested instead that crime gangs operated strictly on a local level. As a result, law enforcement agencies made few inroads in stopping the Mafia’s rise during this period (par. 6, History Channel). Since its beginnings La Cosa Nostra has been involved in a variety of rackets including gambling, loan sharking, labor union corruption, prostitution, and drug trafficking to name a few. Labor unions provide a rich source for organized criminal groups to exploit: their pension, welfare, and health funds. There are approximately 75,000 union locals in the U. S. , and many of them maintain their own benefit funds. In the mid-1980s, the Teamsters controlled more than 1,000 funds with total assets of more than $9 billion (par. 66, FBI). Labor racketeers attempt to control health, welfare, and pension plans by offering â€Å"sweetheart† contracts, peaceful labor relations, and relaxed work rules to companies, or by rigging union elections (par. 67, FBI). Labor law violations occur primarily in large cities with both a strong industrial base and strong labor unions, like New York, Buffalo, Chicago, Cleveland, Detroit, and Philadelphia. Senator Estes Kefauver’s Special Committee to Investigate Organized Crime did not out rightly expose the complete, brutal reality of the Mafia to the American public. Nor did the Appalachian incident ignite immediate action on the part of the federal government. However, something changed when dozens of Mafia bosses met one 1957 November day at Joseph Barbara’s estate to select Vito Genovese as the boss of bosses. The response by law enforcement of the past had been to try to take down the bosses. But what became evident with the realization of the existence of such a â€Å"syndicate† was that even if Mr. Big were removed, his family would remain intact; it would simply transfer hands, usually resulting in the family being renamed. New legislation would have to be of an entirely different mold in order to be of any use to law enforcement, and such a campaign wouldn’t come into play until after the death of FBI Director Edgar J. Hoover (par. 9, The Mafia and American Law). In 1970, Congress passed the Racketeer Influenced and Corrupt Organizations (RICO) Act, this proved to be a powerful tool in the government’s war on the Mafia, as it allowed prosecutors to go after crime families and their sources of revenue, both legal and illegal. During the 1980s and 1990s, RICO laws were used to convict numerous high-level mobsters. Some Mafiosi, faced with long prison sentences, broke the once-sacred code of omerta and testified against their fellow mobsters in exchange for a place in the federal witness-protection program. At the same time, Mafia membership declined as insular Italian-American neighborhoods, once a traditional recruiting ground for mobsters, underwent demographic shifts and became more assimilated into society at large (par. 7, History Channel). References GangRule. com, The Black Hand. (2011). Retrieved 6:52, December 7, 2011, from http://www. gangrule. com/gangs/the-black-hand Italian Organized Crime, (2011). The Federal Bureau of Investigation website. Retrieved 2:32, December 7, 2011, from http://www. fbi. ov/aboutus/investigate/organizedcrime/italian_mafia Mafia in the United States. (2011). The History Channel website. Retrieved 5:25, December 7, 2011, from http://www. history. com/topics/mafia-in-the-united-states. The Five Families. (2011). The Investigation Discovery website. Retrieved 2:32, December 7, 2011, from http://investigation. discovery. com/investigation/mobs-gangsters/five-families-03. html The Gambino Family. (2002). The Gambino Family website. Retrieved 6:52, Dece mber 7, 2011, from http://www. gambinofamily. com/carlo_gambino. htm

Platos Theory of Human Knowledge Essay - 662 Words

Platos Theory of Human Knowledge Plato contended that all true knowledge is recollection. He stated that we all have innate knowledge that tells us about the things we experience in our world. This knowledge, Plato believed, was gained when the soul resided in the invisible realm, the realm of The Forms and The Good. Platos theory of The Forms argued that everything in the natural world is representative of the ideal of that form. For example, a table is representative of the ideal form Table. The form is the perfect ideal on which the physical table is modeled. These forms do not exist in the natural world, as they are perfect, and there is nothing perfect in the natural world. Rather the forms exist in the invisible realm,†¦show more content†¦is recollected. However, in proving that what we call learning is actually recollection, Plato also proved that the soul is immortal. As was stated, there is no example of true perfection in our world. Yet, we can imagine the idea of perfection. Where could this idea come from if we have not experienced it in our world? We must have experienced it at some point if the idea is within us. Thus, Plato argued that the soul must have existed outside of the natural world. In order for this to be so, it must be immortal, living before it came into this world. It only stands to reason, Plato contended, that it must continue to exist after it leaves this world. How else would it have been in existence before it came into this world? Plato believed that it was a rational assumption that our soul must continue to exist even after our death. Whether Plato believed that the soul migrates from one lifetime to another, one body to another, some would say is unclear. However, I believe that the idea of recollection leans heavily on the assumption that the soul is residing within the invisible realm before it comes into existence in the physical realm. If the soul migrates from one body to another at one persons death and anothers birth, then we would still have no explanation for the souls knowledge of the forms. For wouldnt the previous life have been spent in the natural world, just as this life is? As has already been argued,Show MoreRelatedWeaknesses Of Plato1262 Words   |  6 Pagesthe possibility for one’s mind to uncover knowledge. Knowing one can obtain knowledge motivates the mind to gain more knowledge. Plato explains the theory of recollection by first questioning what virtue is, then demonstrating the process through the questioning of a slave boy. Although a few weaknesses present themselves in Plato’s argument, Plato presents a valid theory on how our minds can obtain knowledge. This paper focuses on exploring Plato’s theory of recollection by examining the strengthsRead MorePlato and Aristotle: a Comparison Essay1641 Words   |  7 PagesComparing the political theories of any two great phi losophers is a complex task. Plato and Aristotle are two such philosophers who had ideas of how to improve existing societies during their individual lifetimes. While both Plato and Aristotle were great thinkers, perhaps it is necessary first to examine the ideas of each before showing how one has laid the groundwork and developed certain themes for the other. Plato is regarded by many experts as the first writer of political philosophy. Read MoreDistinctions and Comparisons between Aristotle and Plato Essay1681 Words   |  7 PagesThe ideas introduced by Plato on the theory of forms, where deducted and critiqued by Aristotle. Both philosophers can be viewed as having opposing ideologies. Nonetheless, Plato and Aristotle are in agreement on certain factors of their philosophy. Many have scrutinized and compared the dissimilarities and similarities of Aristotles doctrine of categories and Platos theory of forms. The observations found are of an interesting nature. The beauty behind the writings of Plato is to not acceptRead MoreThe Influence of Platos Theories on Chrisianity1169 Words   |  5 Pagesand demi-humans also played a significant role in the Hellenistic culture. The worship of these deities was the mainstream of religion during the Hellenistic period until the rise of the great philosophers. Amongst these philosophers, Plato emerged as one of the founding fathers of Western philosophy. Living from roughly 428 BCE until 348 BCE, Plato’s theories predated Christianity by at least four centuries. Because of this, it can be assumed that early Christian worshippers used Plato’s teachingsRead MorePlatos View in Human Knowledge Essay examples1392 Words   |  6 PagesPlatos View in Human Knowledge Plato presents three different views about knowledge in Meno, Republic, and Theaetetus. In Menos case, Plato believes knowledge as something innate in us when we are born; in his later view, in Republic, Plato believes we perceive things and gain knowledge; and from the last view, in Theaetus, Plato believes knowledge is the combination of a true opinion and a rational opinion. Strangely enough, Platos views in Meno, Republic, and Theaetetus are similar,Read MoreHume vs. Plato on Knowledge: A Comparative Analysis1541 Words   |  6 PagesHume vs. Plato on Knowledge Introduction Platos ideas on knowledge represent, perhaps, the most foundational and influential attempt to establish the boundaries of what can be known. His ideas have had an immense influence on successive philosophers as well as Western Civilization as a whole. David Hume, who came over two millennia after Plato, represents perhaps the most relevant attempt to establish the boundaries of what can be known. Thesis: According to Humes position on ideas and causationRead MorePlatos 4 Analogies Of The Republic Analysis1579 Words   |  7 Pagesrepresent his theory of justice in the ideal state. The four analogies include the ship, the sun, the divided line, and the cave. The analogies of the ship, and the cave are used by Plato to represent the people of the state and proving his argument that philosophers are the true rulers of the state. The divided line and the sun analogies also supports Plato’s point about philosophers obtaining intellectual knowledge apposed to the ordinary citizens who only have sensible knowledge. Plato arguesRead MorePlato s Theory Of Knowledge833 Words   |  4 PagesPhilosophers have conventionally defined knowledge as a belief that is both true and justified. Plato first introduces this concept of knowledge in Thaeaetetus where he presents knowledge, to be justified true belief. This definition sufficed until, Edmund Gettier, an American philosopher, pointed out that the conditions could be fulfilled inadvertently, in ways that did not amount to what Plato intuitively regarded to as knowledge. The goal of the Gettier problem is to showcase that one can haveRead MorePlato s Theory Of The Forms1704 Words   |  7 Pages Plato’s Theory of the Forms Travis Meyer PHI 1090 Introduction to Philosophy 12/16/2015 Plato was a Greek philosopher, mathematician, and theologian who lived from 424 BC to 348 BC in Athens, Greece. Plato was born into a high class family in Greece and therefore was very active in the Athenian community since he was from a high status family. He was the founder of the Academy in Athens, the first institution of higher learning in the Western world. He is known to be one of the bestRead MoreThe Ethics Of Plato And Aristotle977 Words   |  4 Pagesethics of Plato and Aristotle. I will explain the five fundamental concepts of Plato and Aristotle. I will focus on their theories on the good life as a life of justice, censorship, knowledge and the good life. I will first explain Plato’s ethics. Plato was a philosopher, both a rationalist and absolutist. According to Plato, people must be schooled to obtain certain kinds of knowledge for example mathematics, philosophy etc. The training will give them the ability to know the nature of the good life

About Daniel Libeskind, New Yorks Master Planner

Architects design more than buildings. An architects job is to design space, including the spaces around buildings and in cities. After the terrorist attacks of September 11, 2001, many architects submitted plans for reconstruction on Ground Zero in New York City. After heated discussion, judges selected the proposal submitted by Daniel Libeskinds firm, Studio Libeskind. Background: Born: May 12, 1946 in Là ³d’z, Poland Early Life: Daniel Libeskinds parents survived the Holocaust and met while in exile. As a child growing up in Poland, Daniel became a gifted player of the accordion--an instrument his parents had chosen because it was small enough to fit in their apartment. The family moved to Tel Aviv, Israel when Daniel was 11. He began playing piano and in 1959 won an America-Israel Cultural Foundation scholarship. The award made it possible for the family to move to the USA. Living with his family in a small apartment in the Bronx borough of New York City, Daniel continued to study music. He didnt want to become a performer, however, so he enrolled in Bronx High School of Science. In 1965, Daniel Libeskind became a naturalized citizen of the USA and decided to study architecture in college. Married: Nina Lewis, 1969 Education: 1970: Architecture degree, Cooper Union for the Advancement of Science and Art, NYC1972: Postgraduate degree, History and Theory of Architecture, Essex University, England Professional: 1970s: Various architectural firms, including Richard Meier, and various teaching appointments1978-1985: Head of School of Architecture, Cranbrook Academy of Art, Bloomfield Hills, Michigan1985: Founded Architecture Intermundium, Milan, Italy1989: Established Studio Daniel Libeskind, Berlin, Germany, with Nina Libeskind Selected Buildings Structures: 1989-1999: Jewish Museum, Berlin, Germany2001: Serpentine Gallery Pavilion, Kensington Gardens, London2002 (selected in February 2003): Ground Zero Master Plan2003: Studio Weil, Mallorca, Spain2005: The Wohl Centre, Ramat-Gan, Israel1998-2008: Contemporary Jewish Museum, San Francisco, CA2000-2006: Frederic C. Hamilton Building at the Denver Art Museum, Denver, CO2007: The Michael Lee-Chin Crystal at the Royal Ontario Museum (ROM), Toronto, Canada2008: Westside Shopping and Leisure Centre, Bern, Switzerland2008: The Ascent at Roeblings Bridge, Covington, Kentucky (near Cincinnati, Ohio)2009: The Villa, Libeskind Signature Series, prefabricated house available Worldwide2009: Crystals at CityCenter, Las Vegas , Nevada2010: 18.36.54 House, Connecticut2010: The Run Run Shaw Creative Media Centre, Hong Kong, China2010: Bord Gà ¡is Energy Theatre and Grand Canal Commercial Development, Dublin, Ireland2011: Reflections at Keppel Bay, Keppel Bay, Singapore2011: CABINN Metro Hotel, Copenhage n, Denmark2013: Haeundae Udong Hyundai IPark, Busan, South Korea2014: Ohio Statehouse Holocaust Memorial, Columbus, Ohio2014: Beyond the Wall, Almeria, Spain2015: Sapphire, Berlin, Germany2015: Centre De Congrà ¨s à   Mons, Mons, Belgium2015: Zhang ZhiDong And Modern Industrial Museum, Wuhan, China2015: CityLife Master Plan, Central Tower C, and Residences, Milan, Italy Winning the Competition: The NY World Trade Center: Libeskinds original plan called for a 1,776-foot (541m) spindle-shaped Freedom Tower with 7.5 million square feet of office space and room for indoor gardens above the 70th floor. At the center of the World Trade Center complex, a 70-foot pit would expose the concrete foundation walls of the former Twin Tower buildings. During the years that followed, Daniel Libeskinds plan underwent many changes. His dream of a Vertical World Gardens skyscraper became one of the buildings you wont see at Ground Zero. Another architect, David Childs, became the lead designer for Freedom Tower, which was later renamed 1 World Trade Center. Daniel Libeskind became the Master Planner for the entire World Trade Center complex, coordinating the overall design and reconstruction. See pictures: What Happened to the 2002 Plan for Ground Zero?One WTC, Evolution of Design, 2002 to 2014 In 2012 the American Institute of Architects (AIA) honored Libeskind with a Gold Medallion for his contributions as an Architect of Healing. In the Words of Daniel Libeskind: But to create a space that never existed is what interests me; to create something that has never been, a space that we have never entered except in our minds and our spirits. And I think thats really what architecture is based on. Architecture is not based on concrete and steel and the elements of the soil. Its based on wonder. And that wonder is really what has created the greatest cities, the greatest spaces that we have had. And I think that is indeed what architecture is. It is a story.—TED2009 But when I stopped teaching I realized you have a captive audience in an institution. People are stuck listening to you. It is easy to stand up and talk to students at Harvard, but try doing it in the marketplace. If you only speak to people who understand you, you get nowhere, you learn nothing.—2003, The New Yorker There is no reason that architecture should shy away and present this illusory world of the simple. It is complex. Space is complex. Space is something that folds out of itself into completely new worlds. And as wondrous as it is, it cannot be reduced to a kind of simplification that we have often come to be admired.—TED2009 More About Daniel Libeskind: Counterpoint: Daniel Libeskind in Conversation with Paul Goldberger, Monacelli Press, 2008Breaking Ground: An Immigrants Journey from Poland to Ground Zero by Daniel Libeskind Sources: 17 words of architectural inspiration, TED Talk, February 2009; Daniel Libeskind: Architect at Ground Zero by Stanley Meisler, Smithsonian Magazine, March 2003; Urban Warriors by Paul Goldberger, The New Yorker,, September 15, 2003 [accessed August 22, 2015]