Cause and effect early pregnancy Essay

Early Pregnancy is one of the problems in today’s society. Many teenagers today don’t know how big responsibility to raise a child when they are young too. Becoming a parent is a big responsibility that should give priority, but how can teenagers can handle this big responsibility if she was too young too? To raise a child involves a lot of patient and sacrifices which lot teens don’t have. The risk of pregnancy among teenagers is largely increasing. Some teenagers who get pregnant early may experience anxiety, depression and other emotional problem. We know that teenager’s ages of 15-19 are still young so emotion and other feelings of being teenagers might occur. Some of the causes of early pregnancy among teenagers are lack of education especially sexual education, poverty, undergraduate, or problem with their family. Lack of Education among teenagers should be given priority; I am agreeing that sexual education should be learned in school. To aware them from the effect that may occur. Problem with family is another issue, some of the teenagers are not provided with their own family, and most of the teenagers get rebelled. These are some of the cause why they are so many teenagers’ gets pregnant early, which I think the government should look in to it. Government should look forward on how to resolve this issue. Teenagers should be educated with this kind of problem, especially those teenagers who are already sexually active. If the Government should not give chances to these issues, teenage pregnancy will increase rapidly. This can cause a lot of endless problems in the life of the teen and the newborn child. There are a lot of things that can cause an unplanned teen pregnancy, such as teens experimenting with sexual encounters at a young age. Another major cause is the lack of guidance due to guardians that are blind or do not want to believe in such activities. These causes can have devastating effects on the teen and the newborn in the household. Some effects of early pregnancy will include an unexpected rise of responsibility for the teen and can cause many health concerns for both teen and newborn child. Teens experimenting are the leading cause in the unplanned pregnancies. As a teenager in high school ages there are a lot of peer pressures. Such as experimenting with alcohol and unprotected sexual intercourse. Drinking and the use of narcotics also largely have an impact on the judgment of the teen before the pre-pregnancy comes about. Experimenting can cause many effects on the teen and the relationships at hand, including the relationships with the baby’s mom or dad and also the parents of the teens. Another way of experimenting is the pregnancy caused in the sequel of either a long-time dating of the boyfriend or the other case of those random one night stands or hook-ups. Experimenting can be well avoided which can cause less of a chance of the unplanned pregnancy. Another very important concern for preventing teen pregnancy is having a good guidance throughout the teenager’s teen years. The guardians of the teens play a crucial role in guiding the teen to making the right choices in his/her life. The teenager then is faced with obstacles that would normally happen to a 20-30 year old woman. Not having the proper guidance will cause the teen to find the alternatives. For example, finding someone to be with to be cared for by in replace of a strong guidance, by the guardians in the teenager’s life. For not having the proper guidance the teenager has a higher chance of dropping out or failing out of a school, such as being a high school dropout to have time to give birth and time to raise the young child. So by becoming pregnant at a young age and not finishing your education. It definitely doesn’t sound like too much fun, now does it? The guidance in life is the most important thing throughout so this can be less of an issue. It is then caused, in effect, to put a lot of responsibility in the teenager’s life once they find out that they are pregnant. There is 100% more responsibility in the teenager’s life. The early responsibility causes changes the teenagers overall personality. Going from being in school full time getting your education to having the responsibility to bringing a child into the world, then being alone able to possibly finish your high school education. Finishing your education in a regular 4 years of your high school years will be hard. Not even to mention the financial costs it has to have a newborn. What makes it hard is when you need money for the simple things for the child, but you don’t have the time to get a job because you’re nursing and getting ready to bring a child into the world. So as a teenager you need a support system so that a newborn is taken care of in the safest, best place for the child. A lot of this early responsibility can be unbearable for some teens, expesically the ones that choose to get pregnant while they are still in high school. With all of this going on in their lives it’s affecting the health risks and medical negatives a teenage pregnancy can cause. For example, there is an increased chance of mothers from ages 15-19 of birthing a child that is underweight at birth. A low birth weight will increase the chance of the newborn to have health risks. It is definitely not a great thing to have the chance of health risks in you or the child. Another way that the health problems can start is because teens might not have all the knowledge of proper behavior in knowing how to nurse the child or the proper ways during the growth of the child. Teenage adolescents tend to develop poor eating habits during pregnancy, they tend not to take the proper vitamins, and in the worst scenario the teen drinking and/ to doing drugs during the pregnancy. That is the worst that can be done; it will increase the chance greatly of the baby being born with some type of birth defect or a weak part of the baby. Now that can be t he worst you can possibly do to an unborn child. To wrap it all up, teen pregnancy is a major issue that should try to be prevented as much as it can. It causes countless, dodge able problems if the right choices are made and you have a good support system around you. It would be in the best advice to not take the chances to get pregnant as a teenager. It is not the age to get pregnant. Teens are not fully ready to become adults like the stress that follows during the pregnancy.

Ethical Decisions Essay

Every individual is faces with ethical decisions every day in both their personal and professional lives. To avoid making unethical decisions, one must know what leads to poor decision making. Once a person knows what leads to the poor decision, they must find ways to resist making an unethical act. A person cannot make the right choice if they do not know how to avoid it. A leader must also know how to inspire ethical decisions within their staff. This paper covers ways to avoid making poor decisions and ways to making ethical ones. Poor Decision Characteristics While there are many ways one can be ethical, Mallor, Barnes, Bowers, & Langvardt suggest there are three essential traits one makes when a poor decision is made (1966/2010, p. 115). The fist common mistake of poor decision-making is when one forgets the goal that was previous set by him or herself or the organization. A person or the organization must keep all of their goals in mind when making decision, and many times individuals forget these goals. Overconfidence is another trait of poor decision-making. One aspect of overconfidence being that nobody will notice a little mistake made for correction later. For example, a manager may take a few dollars from the business expecting to put it back later and then a few more and later still more. However tomorrow never comes and before long, that first few dollars turns into hundreds or thousands. In the organization of my employment a small loan company as well as the owner’s stock car team on the side exists. The loan company sponsors the racing, and a year ago, the organization moved from the Midwest to the heart of NASCAR country. Once the owner arrived, he decided to buy the best equipment for the race team using funds from the loan company. While the spending spree may have been ok in the past, the owner did not take into account that need of hiring and training of new employees. When the new employees made poor lending decisions, combined with his spending, the organization almost went bankrupt. The other aspect of overconfidence is confirmation bias or â€Å"we  must be doing things the right way because all has gone well in the past† (Mallor et al., 1966/2010, p. 116). The overconfidence shows in the example of the overspending by the owner of the organization’s statement: â€Å"Oh, it will all work out, because it always has†. The last trait of poor decision-making occurs when the issues are too complex and not realized for their complexity. Individuals may not realize the complexity of the issue and underestimate the issue. In the lending business, should we as an organization not know the laws of each state when it comes to lending, we can face serious legal issues should we make a loan to a resident of a state in which short term lending, such as we do, is illegal. Resisting Unethical Acts Resisting unethical acts, many times, is easier said than done. In order to do so, a person must first recognize that what they are about to do is unethical (Mallor et al., 1966/2010, p. 116). The first way to avoid making an unethical decision is to buy some time before acting. An individual must take some time, analyze the situation, and if need be, find other ways to accomplish the task at hand without being unethical. The next tactic is to seek out help from a mentor or support group. While an individual may not have the ethical solution to a problem at hand, many times others will. There have been many times when I have sought the advice of others prior to making a decision, which I think may be unethical. Using the previous example of making a loan to someone in a state in which it is illegal, I may ask the advice of a co-worker before I make the loan. The last way to resist making an unethical act is to find a better solution in which everyone wins. This goes hand in hand with one buying some time before acting upon an unethical act. Analyzing the situation, and getting all the facts may lead to a decision in which one makes an ethical decision while meeting the requirements of the direction one has been given. Leading Ethically When leading other individuals, it is imperative that one be ethical themselves, in order to lead ethically. A person, who is unethical, is going to inspire unethical behaviors in others. When members of an organization see that nothing happens to their leaders, others will fall  into the same unethical behavior and rationalize that what they are doing is ok as well (Mallor et al., 1966/2010, p. 119). Leaders must set the example of ethical behavior for others. Leaders must also communicate ethical values of the organization to the staff. How can an individual know what they are doing is unethical in the eyes of the organization, if they do not know what is expected of them? The leader must continually communicate to the staff and remind them of what is ethical behavior. Another way to lead other ethically is to reinforce ethical behavior in the staff. When a leader sees an ethical decision made by a staff member, recognize their action. This will help that employee continue to make the right decision, and show others what is ethical behavior. Conclusion In order to be ethical, one must know what makes ethical and unethical decisions in their lives. Recognizing what makes an unethical decision, and ways to avoid making them, will help one to makes the right choice. Analyzing the situation, weighing other options and alternatives will help one to make an ethical decision. For a leader, these tools will also help their staff make ethical decisions as well. References Mallor, J., Barnes, A. J., Bowers, T., & Langvardt, A. W. (2010). Business law; The ethical, global, and e-commerce environment (14th ed.). New York: McGraw-Hill Irwin. (Original work published 1966)

NSU Financial Aid Essay

Your impression about NSU FINANCIAL AID in comparison with the best Universities of home and abroad Private University Act was authorized in 1992 which obligates private universities to offer scholarships of its poor but worthy students. This act is followed by most of the private universities; however some universities go beyond and do more than the minimum requirements to comply with this act. Among these liberal universities is North South University. Every year, NSU grants a total of around more than 500 students’ full or partial scholarships. Some other private universities like BRAC University, Independent University, Bangladesh (IUB), East West University also has financial aiding opportunities for their students. While they offer generous and reasonable aid to students, they do not seem as enthusiastic as NSU in this program. Researching personally, I found that their websites are not equally as helpful and informative as NSU’s website. NSU’s website provides detail information about the requirements and procedures to apply for financial aid. EWU provides aid either during admissions or after completing one whole year. While BRACU did not state how it aids its current students based on performance. IUB offers aid only through admissions and not on university performance. Abroad, only USA provides good financial support for foreign student. Other countries provide very limited offer to international students. For example Universities in Australia are only lenient in providing scholarship to students who holds Australian passport. Universities like Harvard, MIT and Yale offer full scholarships on needs and merit basis. But then again, universities like Harvard, MIT and rest of the Ivy League colleges, what are the chances for an international student from this part of the world. Also abroad universities/colleges in USA, Canada provide financial assistances for students who may not be academically talented but talented in other fields like sports, music, drama and other activities. However, neither NSU nor any other private universities have this opportunity provided for their students. After going through the whole application process, I found the process to some extent smooth except for collection the form from the bank and also standing in the long queue for four hours just to submit my form. Aid is offered among the highest scorers of the admission test, the current students who perform well and has a healthy CGPA and siblings who currently are studying in NSU. This acts as an incentive for students to concentrate on their studies and do well in their courses to maintain a GPA of 2.75, to me that’s relatively easy. So after doing my research my impression is that even though there are certain areas of improvement, unless I am going abroad, which I am not, NSU is my best offer. I am glad to be in NSU and get this financial aid offer; it is way better than any other offers in any other private university in Bangladesh.

Do men or women have more uncomitted, heterosexual sexual intercourse Research Proposal

Do men or women have more uncomitted, heterosexual sexual intercourse - Research Proposal Example Social learning theory explains the double standard on uncommitted sexual intercourse on the basis of the cultural norm that punished or isolated women for behaving in a sexually permissive manner while men gain admiration and popularity for similar behaviors. On the basis of sexual learning theory, the pattern of sexual behavior is explained by sexual script theory. A 1982 research points out that women were more probable to label sexual behavior of other women as immoral to suggest that women support the double standard that they should have less sex or no sex in uncommitted relationships (Milhausen, R.R. & Herold, E.S. 1999 pp.361-368). Uncommitted sexual intercourse is a topic of interest in recent times due to the evolution of sex differences and their relationship to sexual attraction. A research led by Michael Bailey found that men in the past enhanced their mating opportunities by indulging in uncommitted, casual sexual encounters. With respect to this supposition, men have more frequent yearning for sex with new partners when compared to women. Further, men are more willing than women to indulge in impersonal and casual sex. On the basis of this argument, it is considered that women commit more resources for reproduction and they gain very less advantage from casual frequent sexual action unless it is an extra effort taken for occasional copulation with a superior male to improve reproductive success. The researcher points out that heterosexual man has a high desire for sexual activity with a number of sexual partners. While comparing the frequent sexual activity of women, Bailey and colleagues consider the f requent sexual activity of heterosexual women as accommodating to the demands of male partners rather than the women’s true yearning for frequent intercourse. Another explanation indicates that women generally are socialized in a way that they are assertive in prompting sexual

Protecting the homeland Essay Example | Topics and Well Written Essays - 3000 words

Protecting the homeland - Essay Example There is no specific way to determine that being prepared will eliminate signs of trouble, disaster, or negative effects. The process simply adjusts the mindset of the individuals involved to meet the adversity head on and with as much resistance that can be managed. In the nations past a preparedness program was successfully demonstrated by President Woodrow Wilson. President Wilson was against the United States being involved in World War I. However, he was denied any advances for an agreement of peace amongst the U.S. and Germany. When terms were not agreed upon the President decided to focus attentions on preparing the Army, marines, and navy for being forced into the war. At the time some individuals felt as though Wilson was planning to push the U.S. into war because of his strategy. In 1917, the President was drawn into the war on Germany despite his â€Å"He Kept Us Out of War†, campaign. The major event here was the amount of readiness the President possessed on behal f of the U.S. With the determination of his armies, Wilson retrieved an Armistice from Germany in efforts to further a peace agreement. With these efforts the President was able to deliver his Fourteen Points speech that would be a big factor to ending the war completely (Woodrow Wilson, p. 1). Based on earlier arguments, it is conceived at this point that although President Wilson took necessary steps to avoid the United States interaction in World War I, he also prepared us for war. Not only did he get his troops in line, the President was well enabled to produce a solution to the issues that spawned a full war in the first place. Wilson was not able to stay out of battle. It actually took him well over a year to get Congress to sign off on his Fourteen Points. This tactic is a good example of what preparedness is about. Fighting and disagreement may not always be completely avoidable, but a solution and plan should readily be prepared to produce a means for an end. It should also be acknowledged that even with preparedness concept efforts there have been several terrorist attacks focused on United States soil. More importantly, there have been attacks directed at symbols of the nations success and power such as the World Trade Center. These types of attack demonstrate a will of terrorists to damage the United States image as a major authority. Being able to defy that authority at whatever level is a specific aim by any attack. The message that terrorists deliver will not be one that seeks to minimize damage to the U.S. or its citizens. In February of 1993 a bombing attack was demonstrated on the World Trade Center. There was a truck positioned beneath the North Tower intended to collapse the North and South Towers of the Trade Center. The bomb did not successfully kill thousands but it did manage to kill nearly ten individuals and injure over one thousand. Then again on September 11 of 2001 there was another significant attack on the World Trade Center. In this case planes hijacked by terrorists were aimed at taking out the Towers. Of the four planes taken two hit the mark and leveled the Twin Towers. This time the terrorists attempts managed to bring about the demise of over three thousand individuals. Attacks like these have attempted to crumble the United States position for decades. In light of all the attempts at the expense of

The Relationship Between Self-Efficacy and Employee Commitment Among Essay

The Relationship Between Self-Efficacy and Employee Commitment Among Perfusionists - Essay Example IV. This study shall establish the relationship between self-efficacy and employee commitment among CCPs. It shall also investigate the role of age, gender, workload, experience, education and self-efficacy on CCP commitment. V. The research design is that of a quantitative correlational study. Two survey instruments would be used. One would measure organizational commitment through the organizational commitment questionnaire and the other would be the work self-efficacy inventory. Data would be analyzed using t-tests and multiple regression analyses as well as non-parametric tests. VII. With positive social change, better societal outcomes can be gained, in this case, better outcomes for patients and better working scenarios for CCPs. This study would benefit CCPs primarily, improving their work conditions and commitment. It would also benefit the patients with improved quality of care. This is an optional page for a dedication. If you include a dedication, use regular paragraph spacing as shown here (not centered, italicized, or otherwise formatted). If you do not wish to include this page, delete the heading, the body text, and the page break below the end of the text. No page number appears on any of the pages up to this point. If you do not wish to include this page, delete the heading and the body text; if a blank page remains, delete the page break above but leave the section break that you see below this text. Perceived self-efficacy refers to an is an individual’s beliefs in about accomplishing a specific task successfully (Bandura (1977). The theory of self-efficacy is a component of the social cognitive theory, which emphasizesd that cognitive, behavioral, personal, and environmental factors interact impact on to determine motivation and behavior. Beliefs in personal efficacy affect individual personal choices, including the quality of their performance, their resilience, and their level of motivationimpact the choices

Science Standards Essay Example | Topics and Well Written Essays - 500 words

Science Standards - Essay Example This is the relationship that is also seen between social studies and English, where students can implement English into global essays and so on. However, it is important for them to be able to cross link their studies in math and science because they are so interwoven into each other curriculums. One of the first methods from the math standards that I would immediately adopt is the use of technology to help student learn. Science is another technical learning area, and be incorporating as much technology as possible teachers can allow students to work hands on certain areas that they may not otherwise be able to understand completely. One of these pieces of technology would be the scientific calculator, which is used quite a bit during math curriculum. Using this tool in science class helps students take the calculator technology they already know from math class and much more easily implement it into science class. The other technological part of the math curriculum that I believe would also help students in science class would be the use of computers. The math standards have students starting in computer as low as the elementary grades, which are shown to greatly benefit student achievement.

First modern decade Essay Example | Topics and Well Written Essays - 500 words

First modern decade - Essay Example ty of New York, Woodrow Wilson from the Democratic party of New Jersey, William H Taft from the Republican party of Ohio and Eugene V Debs from the socialist party from Indiana. In the election process held in the year 1912 Woodrow Wilson won and was elected as the President of United States. Roosevelt was previously working for the Republican Party however after getting detached from the Republican he formed is owns party the Progressive. According to Roosevelt there was no initiative taken by the political members regarding progress hence he challenged Taft was the candidate of his former party, the Republican. The election was conducted with majority contenders Wilson and Roosevelt. Taft was never a challenge for Roosevelt. The major issues during the election included trust, tariffs and women. Both Roosevelt and Wilson had different opinion regarding these issues. Wilson mainly focused on the short term issues like price rise and trust of people by reducing monopoly of industries. These concerns were taken care of after Wilson won the election. The main reason behind his winning was his democratic party which got elected for the very first time leading to positive expectation in people. On the other hand Roosevelt mostly considered on the long term issues like women empowerment and he partially supported tariffs because it was beneficiary for wage labors. Roosevelt’s major concern was women empowerment because he knew that his country can be developed all over only by providing equal rights to women so that there could be a social balance in the society and this was the place from where the modern society emerged. Despite of these issues Wilson won the election with 42% of the popular vote (Fer guson 64). Roosevelt definitely had very strong opinions and he was able to form good campaigning and won the election with 27% votes. The long term significance of this election was the mode of approach to people by the four candidates. All the candidates spoke for a

Liberalisation that Triggered the Asian Crisis and the Apparent Essay

Liberalisation that Triggered the Asian Crisis and the Apparent Insulation of China and India - Essay Example Least expected is that, in a very short period of time, a financial crisis sprouted in Thailand and spread like epidemic to the neighbouring countries of Southeast Asia and eventually triggered serious turmoil in the currency and financial markets of Japan and South Korea. While the extent of crisis differed from country to country, the Asian economies were brought face to face with serious difficulties that came from over-reliance on short-term foreign capital, speculative investments, and poor supervision by financial authorities. Even the resilient economies of Singapore, Taiwan, and Hong Kong have shown related problems, slowly being eroded by the persistent weaknesses of their neighbouring economies. What may have gone wrong that spelled the unfortunate events to take place? Why did some countries in the region, like China and India, have been unaffected by the crisis? What measures did these affected countries do to thwart the eventual downfall of their economies? What did policies did India and China foster in order to insulate them from the said crisis? As this paper explored answers to these questions, further recommendations by experts will also be tackled in order to prevent the same crisis from ever happening again. Liberalisation is termed as a programme of changes in the direction of moving towards a free-market economy. This normally includes the reduction of direct controls on both internal and international transactions, and a shift towards relying on the price mechanism to co-ordinate economic activities. In such a programme less use is made of licences, permits and price controls, and there is more reliance on prices to clear markets.

Telecommuting Essay Example for Free

Telecommuting Essay Historically, Americans have slavishly followed the corporate structure of working in an office and relaxing at home. In the 1980’s when computers begin to catch on so did the idea of a flexible work arrangement. In researching, one found that the implementation of telecommuting in the workforce has greatly improved the performance of businesses, increased employee satisfaction, and helped the environment. This research is based on historical data recorded from the 1990’s to present day in reference books, journals, and web based articles. This paper intends to expound on the ways telecommuting can be harmful or beneficial in the workplace. Telecommuting refers to workers doing their jobs from home for part of each week and communicating with their office using computer technology. Telecommuting is growing in many countries and is expected to be common for most office workers in the coming decades. This paper will discuss the origins of telecommuting, define the term telecommuting, and predict the future of telecommuting in the U.S. How will society be affected by the growth of telecommuting? One will discuss the benefits and hindering aspects of telecommuting in the work place. Will companies save money initially and hurt their business in the future? Often times before looking to the future it is helpful to glance at the past. States without labor laws relating to homework fall under the jurisdiction of the US Department of labor and its Fair Labor Standards Act (FLSA) of 1938. The work-at-home sourcebook by Lynie Arden discussed how the FLSA initially prohibited seven industries from using home workers. Congresswoman Olympia Snowe of Maine introduced the Home Employment Enterprise Act in the House of Representatives. Congresswoman Snowe told the House, â€Å"cottage industries play a vital role in the economy of the state of Maine, large parts of New England, and other areas of the nation. The independent nature of homework and the unavailability of alternative employment opportunities make working at home ideal. It is time to safeguard the freedom to choose to work at home† (Arden, 4). Before the bill was voted on, prohibitions on industrial homework in five of six industries were lifted by the U.S. Department of Labor in 1989. This along with Alvin Tofflers image of the electric cottage helped change the social construction of the workplace. Between 1980 and 1990 the annual consumption of personal computers rose by approximately 900 percent and expenditures on personal computers rose by 1100 percent (Biocca, 1993: 81). Professional occupations clutched onto the idea of using the computer as a space-flexible work tool. Eventually a new identity was carved out for this employee niche as well. People who work at home are enjoying a newfound respectability. In the early 1980s, many executives shied away from being called home workers. But it is now increasingly accepted behavior. With this acceptance the identity of home workers has changed (Braus, 1993a: 42). Respectability as a computer operator, according to this view, has been regained and has been transferred into the home as well as in the office. Ann McLaughlin, Secretary of Labor, said â€Å"Workforce flexibility is a critical element of our effort to create jobs, enhance the quality of work life for American workers and improve our competitive edge in the world markets. The changing workforce demographics demand that we provide employment opportunities that allow workers the freedom to choose flexible alternatives including the ability to work in one’s own home† (Arden, 5). Politicians with foresight were in tune with the coming change and the introduction of telecommuting into the workforce world. Many people define a telecommuter as anyone who works outside of a traditional office, whether at home, in a satellite office, or even out of a car. The Midway Institute for telecommuting education, a group that consults with businesses by conducting feasibility studies and implementation seminars, defined telecommuting as â€Å"an off-site work arrangement and that permits employees to work in or near their homes for all or part of the work week. Thus they commute to work by telephone and other telecommunications equipment rather than by car or transit† (Shaw, 6). Telecommuters can work from home, work from a telework center, or use a concept called hoteling. When working from home employees may have a home office that may contain the same kind of equipment that you get in a central office. Telework centers are typically satellite offices located some distance from the companys main office. Telework centers have an advantage over home offices in that technology and computer equipment can be shared rather than purchased separately for each telecommuter. Telecommuting employees work a couple of days a week from the telework center on a rotating basis, ensuring that computer terminals and workstations are in constant use. Equipment in home offices lies dormant when the telecommuter comes to work at the main office. Hoteling is a form of telecommuting used most often by sales staff who dont need a fixed desk in an office, but must have somewhere once a week to pick up mail, plug into the companys main database, or meet a client. This employee may check in an office in the north of a region one week, using a vacant desk or conference room for a couple of hours, and telecommute from the southern part of the region the next week. These three kinds of telecommuting are defined by location and structure. Telecommuting can have a downside and is not for everyone. Some people feel isolated without the regular social contact of the office and find it difficult to be motivated. Other obstacles include not being able to stop working at the end of the day, being distracted by the refrigerator or TV, and friends and family that don’t respect work time. There is no direct supervision of teleworkers, which could cause diminished productivity. The remote access needs of telecommuters could cause a security issue depending on the nature of the business. Sometimes removing the presence of a very positive or knowledgeable employee out of the office to telecommute could affect the morale of other team members (Career Builder). There are several reasons why employees and employers are thinking about telecommuting. The number one reason for employees is that people have begun to see that work isnt everything. They want to be better integrated with work and personal lives, and telecommuting is one way to free up more time. Other reasons include the desire to break through the glass ceiling, increased job stability, or just dislike for the traditional corporate structure. Telework give companies another avenue to do their part with reducing air pollution and being compliant with the Clean Air Act mandated by the federal government. One of the largest sources of pollution is the automobile. In heavy traffic automobiles are moving slower and causing even more problem to our environment. In most cities construction is taking place on roads to increase the size to help with this problem, but an even better solution is to encourage people who can to telecommute, so we will not need additional highways, parking lots, and airports in the future. Companies can enhance their recruiting efforts because they are not limited to hiring employees in a specific geographic area. Telecommuting helps companies achieve savings with real estate costs and overhead (Career Builder). Companies can grow without the need to create additional workstations or build new office spaces. The option to telecommute eliminates the number of employees who resign because they want or need to move to a new location. It is predicted that telecommuting will become an increasingly popular work option in many businesses and industries, and its usage is expected to increase in the future due to new innovations in computer and communication technology. This trend is driven by several factors. Linda Shaw, author of Telecommute! Go to Work without Leaving Home, wrote that the labor pool of employees with specific talents will shrink, making employers more willing to make concessions to keep valued employees happy. A smaller labor pool combined with an increasing demand for highly skilled laborers has fueled employee-driven change in working environments. Scarce, highly skilled workers have begun to demand more flexible work arrangements, especially as they choose to live farther and farther from their employers (Shaw 18). Shaw and other observers also note demographic changes within the American work force as a factor in the growth of telecommuting. These analysts contend that new generations of workers are less willing to sacrifice time with family than their counterparts of previous eras. This desire to spend more time at home and avoid long commutes is advertized as a key factor in making telecommuting an attractive benefit. Finally, new technologies have made working from home a viable alternative. With the advent of high speed modems, fax machines, voice mail, powerful personal computers, electronic mail, and cell phones to name a few, workers can now perform their jobs without losing touch with employers and customers. We are on the edge of a new era of telecommunications that will impact our lives and how we work and how we become productive in the 21st century. Society will be enhanced with workers that are happy with their work and life balance, the environment will be made better and companies that invest time in their telecommuters will continue to help their bottom line. Telecommuting may prove to be an effective means to enhance our lives and improve our productivity on this new frontier and I conclude that the strategy should be to find ways to enhance the capabilities for future telecommuters.

The Showtime Sound Lighting System Information Technology Essay

The Showtime Sound Lighting System Information Technology Essay The Showtime Sound Lighting System undertaken as a project is based on relevant technologies. The main aim of this project is to develop software for sound lighting System. This project has been developed to carry out the processes easily and quickly, which is not possible with the manuals systems, which are overcome by this software. Hence it provides the complete solution to provide customer services and time management. The software provides good services and remove the repetitions in order to nurture the needs of the customer by providing various ways tasks. Also, to improve time management to handle large volume of business. Current Problems faced by the system Currently, the traditional manual system holds the information on clipboards until it is entered on the computer system. The current system is the one that evolved as the company grew from a part-time, one-man business to a full-time operation with permanent employees. The system does not ensure that the services can be provided to the customers needs. They are using computers to store the information or customer data i.e. Proposals, orders and invoices, in MS-WORD documents and thus redundancy of data is created which leads to inefficient programming and also decrease in the productivity. System Requirements Showtime Sound Lighting System is intended to help the user keep account of his customers in an efficient way. Thus provide good services and increase the productivity. It helps to handle the large volume of business, to provide good services to the customers, to remove the redundancy by providing various technicalities. The system is required to run in a more efficient way thus save time. If it is not feasible for customer to get the proper services then he has got no option left. The main aim of project will be to minimize these limitations and provide customer with better functionalities and services. Requirements Specification Requirement analysis is the first technical step in the software engineering process. It is at this point that a general statement of software scope is redefined into concrete a specification that forms the foundation for all software engineering activities that follow. There is no doubt that the presentation of specification has much to do with quality of the solution. Developers working with incomplete, inconsistent, or misleading specifications have to ultimately deal with confusion and frustration. The quality, timeliness and completeness of the software suffer as a consequence. Software Requirement Specification is developed as a consequence of analysis and market surveys. Review is essential to ensure that the developers and customers have the same perception of the problem. Unfortunately, even with the best of the methods, the problem is that the requirements keep on changing conditions. So it is necessary that during the requirement specification, user should know competence of the software. Requirements are prone to issues of ambiguity, incompleteness, and inconsistency. Techniques such as rigorous inspection have been shown to help deal with these issues. Ambiguities, incompleteness, and inconsistencies that can be resolved in the requirements phase typically cost orders of magnitude less to correct than when these same issues are found in later stages of product development. Requirements analysis strives to address these issues. Take a long time to produce Begin to limit the implementation option available Are costly to produce Requirements for both the system and the software are documented and reviewed with the customer. Scope of Project Today, the information technology has become the very advance and so the convenient means of handling the lots of information. The Showtime Lighting System is an application for maintaining a customers account in a company. The system provides the access to the customer to create a request, validate provide services to customers. Project Objectives And Deliverables: The objective is to design a tool which consists of all basic functionalities of an organization that holds all information of the customer using this application, value added services provided by the company that can be accessed by the users (customer and administration) through a user-friendly interface. There can be a possibility of online business. Target Customer Base: This system is made in such a way that this will be able to meet the basic requirements of advanced user as well as for the user those who are new to the system. Having a user friendly GUI, this application is a good option to used by a large section Feasibility Analysis Feasibility studies aim to objectively and rationally uncover the strengths and weaknesses of the existing business or proposed venture, opportunities and threats as presented by the environment, the resources required to carry through, and ultimately the prospects for success. In its simplest term, the two criteria to judge feasibility are cost required and value to be attained. As such, a well-designed feasibility study should provide a historical background of the business or project, description of the product or service, accounting statements, details of the operations and management, marketing research and policies, financial data, legal requirements and tax obligations. Generally, feasibility studies precede technical development and project implementation. Technical Feasibility Technical Feasibility centers on the existing manual system and to what extent it can support the proposed system. According to the feasibility analysis procedure, the technical feasibility of the proposed system is analyzed and the technical requirements such as software facilities, hardware facilities, procedures, inputs and outputs are identified. It is one of the important phases of the system development. In technical feasibility the following issues are taken into consideration. Whether the required technology is available or not Whether the required resources are available Manpower- programmers, testers debuggers Software and hardware Once the technical feasibility is established, it is important to consider the monetary factors also. Since it might happen that developing a particular system may be technically possible but it may require huge investments and benefits may be less. For evaluating this, economic feasibility of the proposed system is carried out. Showtime Sound Lighting System requires only the software to be installed on the system and the information can be accessed by authorized user in the organization. Economic Feasibility An economic feasibility test focuses on returns and costs of a proposed plan in both the short and long-term. An economic feasibility study (EFS) should consider investment and operating costs, the time value of money, risk and uncertainty, quality of available data, and the sensitivity of assumptions. An economic feasibility study should demonstrate the net benefit of the proposed course of action in the context of direct and indirect benefits and costs to the organization and to the general public as a whole. An EFS makes a business case, prepares analytical worksheets and other necessary supporting documentation. An EFS should be required for both pilot and long-term activities, plans and projects. For any system if the expected benefits equal or exceed the expected costs, the system can be judged to be economically feasible. In economic feasibility, cost benefit analysis is done in which expected costs and benefits are evaluated. Economic analysis is used for evaluating the effectiveness of the proposed system. In economic feasibility, the most important is cost-benefit analysis. As the name suggests, it is an analysis of the costs to be incurred in the system and benefits derivable out of the system. Showtime Sound Lighting System requires the software to be economically feasible. It should be according to the cost benefit analysis of the company. Organizational Feasibility The success of investment projects depend to a large extent on the capability of those responsible for managing them. The feasibility analysis should investigate the legal status of the organization, the level of staffing and the capability of the management and staff. Organizational Feasibility is conducted to determine whether a proposed business has sufficient management expertise, organizational competence, and resources to successfully launch its business. This also involves questions as whether it brings an excessive amount of change, and whether the organization is changing too rapidly to absorb it. It involves the questions as: Is the current organisational structure able to provide the necessary support during the implementation phase? How can a managing scheme for the project be crafted out of this structure and effectively interface with it? Will the systems introduction create new needs that cannot be accommodated by the current organisational structure? Is it possible to plan and implement all needed organisational changes in time, so as not to delay the systems implementation and operation? Showtime Sound Lighting System requires the software to be designed according to the needs of the organization Schedule Feasibility The schedule feasibility shows the estimated time to complete the project. This includes the schedules of each process in a project and the total project time. This can change if unexpected challenges occur. A project will fail if it takes too long to be completed before it is useful. Typically this means estimating how long the system will take to develop, and if it can be completed in a given time period using some methods like payback period. Schedule feasibility is a measure of how reasonable the project timetable is. Given our technical expertise, are the project deadlines reasonable? Some projects are initiated with specific deadlines. You need to determine whether the deadlines are mandatory or desirable. Showtime Sound Lighting System requires the software to be built within the stipulated time in an efficient way. Resource feasibility This involves questions such as how much time is available to build the new system, when it can be built, whether it interferes with normal business operations, type and amount of resources required, dependencies, do you have enough resources, what resources will be required, what facilities will be required for the project, etc. Showtime Sound Lighting System requires the software to be built by skilled and expert resources. Not only should the software be handled further by expert resources. Current Systems Specification UML Case Diagram This diagram displays the brief description of the current existing system. In this SSL System receive request from customers, then the request is validated, it will check for the equipment availability, after the equipments available then generate proposal, after that generate order and then the bill is provided to the customer. Major Description This diagram describes all the scenarios in detail with all possibilities of the current prevailing system SSL System gathers information from customers, put it on the clipboard, then validate customer request, then enter into the computer system maintaining the customer information. If existing customer then update the information otherwise create a new customer. After that, check for the mode of request. Whether it rental or information is for purchase or operators support. Accordingly the equipments availability is checked by the user. If the equipment is available and the associated employee is also available, the order is generated. Then the services are provided to the customer. Structural Model (Class Diagram) The below diagram displays all the classes and their relationship of the existing current system. In this diagram, different classes have been generated with attributes and methods. First is customer class with attributes and methods getcustomerdetails(), addnewcustomer() and updatecustomer(). Then the class event is created with methods addnewevent(), updateebent(). There is 1 to many relationship between customer and event. Employee class is created with methods getemployee(). One customer can deal with only one employee at a time depends upon the availability of employee. Then order class is generated with methods generateorder(), generatebill(). One employee can generate many orders at a time. . Activity Diagram This diagram shows all the activities of the prevailing system. In this diagram, first get the request from customer, check for the equipment availability, then process the request mode i.e. whether it is rental request, or request for purchase or request for the operators support. After taking the decision the information is first written on the clipboard, and then stored in the computer. After checking the time requirement and employee availability, the proposal is generated. Once the proposal is confirmed, the order is generated and the services are provided to the customer. Structured Design Models A Context Analysis Diagram A Context Diagram confines project scope to an agreed limit by obtaining agreement from the customer on the data flows that are included in the scope of a project. The Context Diagram focuses on relationships with external entities and identifies the information that is exchanged between these external entities and the business system under review. The external entities themselves are outside the scope of the project but the data flows between the entities and the business system are within the project scope. Customer SSL SYSTEM Customer Provide services Generate Proposal Equipment Availability Information request Equipment details validate request Generate Order Request Type request details validate proposal A LEVEL 0 DFD On Level 0, a DFD shows all the data flows from the system to the external entities, with the whole system being represented as one large process. A Level 0 diagram is sometimes created to show the interaction of the system with external entities, some of which may also be systems. Process Request CUSTOMER CUSTOMER Information Services A LEVEL 1 DFD Customer request information Collect information on clipboard Process Request Provide Services Update Information Generate Order details check for equipment Generate proposal Process Equipment availability validate information equipment available Employee availability Schedule Timing Mode of request rental,purchase,operator support A LEVEL 2 DFD 1.2 Check for equipment availability 1.1 Process Request Customer send request details 1.3 Process Request Type provide services equipment details 1.4 Generate order order details A Level 1 DFD A Level 1 DFD normally shows very few (8 10) processes, and is intended to explain the basic functioning of the system. A Level 1 diagram should show all the processes of the system and the external entities that the system actively interacts with (and in some rare cases exchange of data between those external entities, when absolutely necessary). A Level 2 DFD This level is a decomposition of a process shown in a level-1 diagram, as such there should be a level-2 diagram for each and every process shown in a level-1 diagram. In this example, processes 1.1, 1.2 1.3 are all vital of process 1. Together they wholly and completely describe process 1, and combined must perform the full capacity of this parent process. Proposed System Specificaion UML Model Detailed Use Case Model Problem Situation Showtime Sound Lighting (SSL) Inc is an organization deals with the equipments related with sound and lighting systems. SSL deals with wide range of customers. Many local organizations, churches, and entertainment businesses have contracts for support of sound, projection, and lighting in their facilities. SSL provides different types of services such as provide equipments on rent, for purchase; they also provide operators support to the customers. To produce a large amount of business, they frequently upgrade the cost of equipment but this leads to their loss. They also occasionally upgrade damaged or obsolete equipment. Currently SSL system is divided into four major business activities in providing services and products to its customers. Collect and process customer information and requests. A customer provides a request to SSL. If the request is from an existing customer, it is compared to previous requests. This process requires information from the customer file. The information of the customer is then updated. If the customer is new, a customer file is created that records the newly obtained customer information. Match customer requirements with equipment availability. The customers order information is collected, specifically listing the customers needs. Customer requirements can range from a simple set of items to purchase to a request for consulting services resulting in recommended alternative system solutions to a request for a full set of equipment complete with operators. After availability of equipment, the order can be generated. After that match the details with customer time requirements as well with the availability of employee. There are two types of employees working in the organization i.e. Permanent employees and contractors which are again full time part time. If the employee schedules match with the customer requirements, then the proposal will be raised. Customers want SSL to bid. To prepare the bid SSL must compare needs with equipment and personnel availability. Equipment and personnel requirements must be planned for and reserved in the event that the proposal is accepted. This is often the case for organizations that must obtain approval from finance committees. When the organization accepts the proposal, the order is then created, and the equipment and personnel are scheduled to support the event. After that the service provides to the customer. In current environment or system there is no proper database being maintained. All the information gathered from the customer is stored on the clipboard and then written on MS-WORD to convert and store data electronically. In this way, the data can be repeated. It means the same order, information of the customers, etc. can be repeated which is not an efficient way of programming. Moreover, redundancy leads to the confusion in the system. There can be the confusion that which equipment is available, or which of the equipments has been given to which customer etc. Then Provide services and products. The process entails the actual support of the event. SSL management prepares a list of all support needed for the event so that the technician delivers everything SSL has agreed to provide. This list is essential because the support needed for a large gathering must be on hand and functional at the time of the event. All order information is provided to the technician. This allows the tech nician to load all necessary equipment and to ensure that the proper contract workers, if required, are available for the event. At the conclusion of the event, the technician must report that the order was successfully completed. If any overtime was required, the technician must report this as well so that the contract workers are properly paid. The technician also evaluates the performance of the contract workers; this information helps SSL decide which workers to hire for future events. Finally, the technician notes any equipment problems that may require immediate attention or routine maintenance. Comparison and Analysis SSL provides different types of services such as provide equipments on rent, for purchase; they also provide operators support to the customers. To produce a large amount of business, they frequently upgrade the cost of equipment but this leads to their loss. A manual system stores the information on clipboards and later on enters the information in computer system. In this way an efficient data and accurate data cannot be stored for later use.. Moreover there can be redundancy of data that leads to confusion. The system currently does not ensure that customer information is readily available to support daily operations, nor does it provide information needed for decision making by management. As a result, much of the information in the set of customer files is repetitious. The business currently does not have a system for assigning customer numbers or cross-referencing documents. Locating information about a specific order, previous customer service provided, and other business acti vities are time-consuming and difficult. This deficiency in turn has a negative impact on servicing customer. All order information is provided to the technician. On the contrary, the Proposed Showtime Sound Lighting System is a system based on relevant technologies. The main aim of this project is to develop software for sound lighting System. The software provides good services and remove the repetitions in order to nurture the needs of the customer by providing various ways tasks. Also to improve time management to handle large volume of business. The traditional manual is being overcome by the information stord in proper databases in the proposed system.Currently, the traditional manual system hold the information on clipboards until it is entered on the computer system but in the proposed system , the data will be stored in the databases for all the functions and activities take place in the organization. There should be more permanent employees which are of full time to increase the productivity.Collect and process customer information and requests. For this a separate customer database should be created with the relevant fields. Cust_id should be the key field. That it stores only unique records, not more than one same record can be stored. A customer provides a request to SSL. Check for the existing customer in customer database and update the information.. If the customer is new, add his information in the database through addnewcustomer() method. Match customer requirements with equipment availability. The details of the equipments should be stored in another database called item .If the equipment is available then (check for the availability from the database) then validate request. In validation, check for the genuine order being placed by the customer. After this check which type of request is being made, i.e the order is for rental, purchase or the operators support is needed. Again this information is also stored in separate database. If all the information is stored in separate database, then there would be no chances of redundancy and smooth functioning of the system. As far relationship is concerned, relation can be with the cust_id. Many customers can place the orders at the time and all the details should be stored in their respective databases. Only one equipment should be provided to one customer. For the availability of the equipments, check the database and update the database side by side. Match the requirement with the employee availability and also with the time required. Update the database of the employee for the same to validate the request. The customers order information is collected, specifically listing the customers needs. Order should be generated and the details should be stored in order database along with its type and the shipping details of the customer To increase the productivity and goodwill , the company should appoint more and more full time skilled employees. In this way they can provide good services to the customers.

Quality Care In The NHS

Quality Care In The NHS 1. What is meant by quality in the phrase quality of care? Quality, broadly speaking, is a subjective measure of excellence and when applied to health care, quality can be understood as systems and provisions of care said to be free from defects, deficiencies, and significant variations. Within the NHS, this encompasses the provision of high quality primary, secondary and community care in which the interests of patients are protected through a comprehensive set of nationally aligned policies. Lord Darzi defines quality of care as clinically effective, personal and safe. How is this achieved? Within the NHS, quality is achieved through robust regulation, inspection, standard setting, change management, community and patient advocacy, alongside continual assessment of clinical competency (Leatherman and Sunderland, 2003). Quality is about effectiveness of care, from the clinical procedure the patient receives to their quality of life after treatment. The Equity and excellence: Liberat ing the NHS white papers assertion is that to achieve our ambition for world-class healthcare outcomes, the service must be focused on outcomes and quality standards that deliver them. Leatherman S, Sutherland K, (2003) The quest for quality in the NHS: a mid term evaluation of the ten year quality agenda. London: The Stationery Office, 2. In 2008, the Department of Health published the report High quality care for all: NHS Next Stage Review final report. 30 June 2008. (a) Please summarise the main approaches to improving quality proposed by the report (b) compare and contrast these approaches to those described in Gwyn Bevans editorial (quoted from above). The Department of Health report approaches improving quality by: High Quality Care for All proposes that all providers of NHS healthcare services should produce a Quality Account: an annual report to the public about the quality of services delivered. The Health Act 2009 places this requirement onto a statutory footing. Stringent regulation from bodies with increased statutory powers. The Care Quality Commission will have new enforcement powers. NICE will be expanded to set and approve more independent quality standards. New Quality Observatories will be established in every NHS region to inform local quality improvement efforts Strategic health authorities will have a new legal duty to promote innovation. This will be twinned with a portal to share evidence-based, best practice among clinicians and other NHS staff. Devolvement of power to ensure the involvement of clinicians in decision making at every level of the NHS. The introduction of medical directors and quality boards feature at regional and national level Increasing patient information and choice will be introduced in the first NHS Constitution. Patient information will include the systematically measure and publish information about the quality of care from the frontline up. Individualisation will become the key to the way in which patients are handled with a personalised care plan. Noting that one size doesnt fit all. Incentivisation of care outcomes will include a new best practice tariff and the paper suggests this will make funding reflect quality of care. Partnership will be embraced, utilising local authorities, with the services offered personalised to meet the specific needs of their local populations Prevention not just treatment will be paramount with focus on improving health as well as treating sickness. Bevans editorial evaluates the internal market systems that have been tested within the NHS according to the Audit Commission and the Health Care Commissions paper Is treatment working? Suggesting that despite the core intention of the internal market models to improve quality and efficiency of services for patients, as Black insists, there is little evidence to suggest that this has resulted from past models or alternatively the scrapping of the internal market when Labour came to power in 1997; i.e. formation of foundation trusts, increased commissioning autonomy, patient choice or the incentivisation of health outcomes (payment by results). The NHS internal market models aimed to keep healthcare costs low by forcing providers to compete for patients not compete on the basis of quality. A stark contrast in rhetoric is seen in the proposals that are raised in the report, where marketization is the key driver of systemic improvement in quality of care. The High quality care for all: NHS Next Stage Review final report shows the need for a more market-orientated strategy: a patient choice-led approach to hospital funding, the removal of barriers preventing the use of private health providers to carry out NHS work, and the devolution of management and budgetary control from Whitehall to local communities. It appears reform is circular and the report bears a resemblances to pre-1991 measures where received funding was based on local populations. While the Report is indicative of the need for a tripartite arrangement for achieving quality, with stakeholders as informants and agents for change, Bevan argues that the internal market model proposed, although attractive, relies on the assumptions that purchasers can be effective commissioners and that failing providers will be removed from the market. The centrepiece of the White Paper reforms and Operating Framework is the handing over of decisions on care, treatments and commissioning solely to GPs, ultimately creating a stable internal model where there will be a quality equilibrium. GPs will be burdened with the challenge of acting as a middleman between the patient and provider, ultimately as a gateway to funding and care. They with fundamentally be dismantling the current monopoly of care provision. Their decision making will be accountable to local communities and a board. This new buyer position is thought to remove duplication of population care commissioning and streaml ine decision making to where the Government foresees a natural place to put this responsibility. Propper et al, (2003) noted that in 1991, the Conservatives created a set of buyers, funded by central government, who were free to purchase health care for their populations from both public and private sector suppliers. Public sector suppliers were therefore not given direct funding, but were set to compete with each other, alongside a small private sector, for contracts from these public buyers. The autonomy of Foundation Trusts as buyers, in Bevans opinion, has led to a free market of care with little standardisation, with the private sector benefitting from the poor levels of governance most. Bevanss editorial suggests this may have benefit to the population because so much healthcare cost is driven by decisions that GPs make and should not be guided by ministerial change. Unviable providers will be pushed out of the market by new entrants, creating a self-regulated, internal market. The White Paper suggests there is evidence that health systems work better where budgets and spending power are moved as close to patients as possible. Providers will be paid according to their performance. Furthermore, that a bottleneck on the road to driving the quality agenda is linked to ministerial involvement in the day-to-day running of the NHS. This new public management gives GPs greater autonomy, placed them at arms length from the government, interlinks purchasing and providing functions, and increases competition with quality in mind. GPs will be responsible for all aspects of performance; acting as bureaucratic gatekeepers for all care needs their patients, and potential scapegoa ts for ministerial politicking. As it stands, effectiveness of this system is being hindered by hierarchical bureaucracy and political micromanagement on both a local and national level, including politically driven reforms with each new government. The report suggests the forced autonomy of GP Consortia, comparatively to Bevan whom notes the earned autonomy system, in which, the independent health care inspectorate awarded each NHS provider an annual star rating of zero to three stars. Providers that scored well on the star ratings gain small financial bonuses but win much greater operational freedom, and the ability to apply to become an independent not-for-profit NHS foundation trust status. Autonomy was the incentive as this gave managers more choice. At the other end of the spectrum, providers that score zero stars are placed on special measures, and if progress is not soon forthcoming, their management is replaced. Bevan suggests that measures of Provider performance (cost, equity of access, outcomes, patient satisfaction etc.) have proved difficult to progress forward and that only patients acting as consumers has left a marked change on the system. I think it is questionable whether in the short term, GP buying powers wi ll drive quality in a market in which there are few providers. The 2008 DH report takes note of such and relays the importance of an individualised service in which patient information to inform choice will breed quality. Patient choice and measures of satisfaction will simultaneously puts more pressure on providers to increase performance of measured care outcomes, which in turn become incentivised by cash rewards. They foresee GP consortia, evaluating Services considered to be sub-standard and withdrawing them from service if patient satisfaction and quality care outcomes are not met. Propper, C., Burgess, S., and Gossage, D. (2003).Competition and quality: Evidence from the NHS internal market 1991-1999. Unpublished paper, University of Bristol. 3. As one of the accompanying papers to the White Paper Liberating the NHS, the DH has recently published Transparency in outcomes a framework for the NHS.http://www.dh.gov.uk/en/Consultations/Liveconsultations/DH_117583 Please summarise the main approaches to improving quality proposed by this consultation. The NHS Operating Frame is an accountability framework which should, if followed, ensure that the NHS Commissioning Board works to deliver better healthcare outcomes. This will be through measures that are valid, reliable and sensitive to change, notably evidence-based outcome measures, not process targets. The outcomes and incentives emerging from the frameworks will be organised around 5 national outcome goals /domains that cover all treatment activity for which the NHS is responsible. Outcomes appear to be related to feasibility, cost of improvements and pre-existing data sets. Quality of care as advocated by Lord Darzi in realised in three of the domains; patient experience, safety and effectiveness. The domains fail to include outcomes of access/equity, expediency in service or efficiency, which seems to underlie previous national reforms imposed by the Labour Government in 1997. The Operating Framework fails to identify purposeful ways of addressing deficiencies and poor outcom e performance. Incentives and regulation are suggested but may not be drivers. Each of these five areas will have: outcome indicators improvement areas according to evidence (collected data, patient surveying of experience, etc) Quality standards, developed by NICE, will inform the commissioning of all NHS care and payment systems. Measuring and reporting on outcomes will focus the attention of clinicians and managers on how well they are doing, where the gaps might be between actual performance and the high aspirations of those who use the NHS. I dont believe all the outcomes are necessarily reliable measures of quality. In Domain 2, for example, there is a focus on functional outcomes and qualities of life for long term illness, which may lead to patients to receive care they do not want. A great deal of the outcomes will be developed through incrementalism, for example those related to compassion, dignity and respect as indicators of the quality of care. The measured outcomes should represent the overall quality of healthcare provided by the NHS, as well as being responsive to population need and demand. The outcomes should also be attributable directly to the actions of health care provided within the NHS, to enable accountability. Best practice should be identified and used as a basis for ensuring that the framework itself does not propagate practice that in itself leads, however indirectly, to inequalities. Key to the five high level outcome/domains is the need for a whole system approach in aspiring for complete transparency, effectiveness and patients exercising appropriate choices, alongside a need to balance local priorities. Seven principles underpin the framework which are intended to improve the quality of health care, these are: Balanced between need and demand Accountability and transparency Internationally comparability Patient and clinician centred environments and service delivery. Excellence and equality promotion Adaptability and focus on outcomes that can be forged in partnership with other public services. International comparability The Health Secretary will be able to hold the new independent NHS Commissioning Board to account for securing improved health outcomes, and measuring the outcomes that are most important to patients and healthcare professionals. These will be backed up by authoritative, evidence-based quality standards that will ensure everyone understands how those outcomes can be achieved Based on past experience, what do you think are the likelihoods of success of this latest initiative? Please ensure that you consider these in the context of the likely challenges for the NHS over the next few years. (Please cite references if referring to evidence of the impact of previous initiatives). The attention of policymakers is always firmly fixed on the future and rarely on documented measures of progress to assess the impact of one set of reforms, before the next wave of organizational change. Political values dominate empirical evidence for reform. With such levels of political uncertainty, it is hard to evaluate if in five years time, a general election will lead to a change in leadership and new Health Minister. With this in mind, change often does not necessarily make best use of available resources, skills and knowledge. The direct influence of research evidence on decision making is often tempered by factors such as financial constraints, shifting timescales and decision makers own experiential knowledge (Elliott 1999). With devolvement of power to local government, there is need for a precise balance to be struck between strategies based on choice and competition on the one hand, and local voice and democratization on the other. On its own, I dont think the NHS reforms will create a patient-led system. It is the people, the leaders and staff of the NHS, who will make or break the change process. Central to this, is the way in which the White Paper reforms will radically change the way in with GPs work collaboratively with providers to better the health and social care of the population they serve. Reorganisation will ultimately mean GPs will have to create new organisations and learn new skills. This will take behavioural change that is likely to be unwelcomed, as theres a shift towards increased paperwork and decreased patient time. GPs have shown considerable levels of apathy towards working reforms and changes in service delivery in the past, including contracted hours. For example, previously published opinion has indicated that the medical profession were predominantly opposed to the package of NHS reforms outlined in the Working for Patients and were especially opposed to the administration of hospital s by self-governing trusts (Lister, 1990). GP consortia will be exactly that, self-operating. As the Operating Framework enters its live consultation it will be important to gather evidence as to strength of feeling with which those opinions, either for or against various aspects of the NHS reforms are held. Reform is costly, since managers and other NHS professionals invest a huge amount of time and effort with each re-organization. The NHS faces the need to make cost savings of  £15-20 billion over the next four years. It is faced with the challenge to create better health outcomes with less resources. Moving to the new system, maintaining control of day-to-day services, and implementing these savings is going to require skilled management. This at time when the NHS is shedding much of its management workforce and when managers have been under political attack. Introduced in 2004 as part of the General Medical Services Contract, the QOF is a voluntary incentive scheme for GP practices in the UK, rewarding them for how well they care for patients. the higher the score, the higher the financial reward for the practice. The very suggestion that this was voluntary implies that not everyone welcomed such change. The introduction of a free market, in which providers can tender for supplying a service as opposed to an internal market, could serve to drive efficiency savings and quality of care. However, accountability and patient choice would require considerably management and information sharing across GP consortia. Department of Health. Payment by Results. London: DoH, 2002. 5. One of the differences in the current UK coalition governments approach to improving quality, compared to previous governments, is in the use of targets. Targets are defined by the DH (DH 2004) as: Targets refer to a defined level of performance that is being aimed for, often with a numerical and time dimension. The purpose of a target is to incentivise improvement in the specific area covered by the target over a particular timeframe. List the possible benefits of using targets to improve health/health services and then list the potential disadvantages of using targets. Use examples (either from your experience or from what youve heard on the media) to illustrate your points. On balance, are you for or against publication? The benefits of health/ health services targets include: Supports priority setting Promotes consistency Improves commitment and fosters accountability Guides allocation of resources Milestones for incremental improvements The disadvantages of health/ health services targets include: Priorities may be misdirected and are often politically engineered Not always evidence based Hard to measure/quantify Not always related to health care outcomes Often cost related, not need related. Clouded by bureaucracy Often incentive driven ie pay to treat. One such health target in the Labour Governments Health Policy, the four-hour target, imposed in Accident and Emergency Departments has received mixed reviews. It was just one of a range of centrally imposed standards, most of them designed to speed up treatment. With such a target, volume of patients being treated and the expediency of their treatment is implied to be of greater importance that the quality of care or health outcomes of patients. The Guardian, (2010) reports In opposition Lansley had been critical of the way that targets distorted the behaviour of doctors, saying in the case of AE that people should be treated in relation to the severity of their injury not an arbitrary time limit. 6. The current government is strengthening the role of the regulator. Please summarise the role of the Care Quality Commission (CQC). What challenges do you think the CQC will face over the next few years? In April 2009, as the result of passing of the Health and Social Care Act 2008 (2008 Act), the outcome-based regulator, Care Quality Commission (CQC) was officially established. Their primary role is to act as an independent regulator of the quality and capacity of health and adult social care. They are responsible for registering, reviewing and inspecting health, adult social care and mental health services to judge the clinical quality of healthcare. Regulation directly relates to the quality of care experienced by people, so called end users, who use the services and align to the Coalitions vision of a user-centred, integrated service with a strong focus on quality (CDC, 2010). Indeed, when services fail to meet the health and safety legal requirements of their compulsory registration, action against them is taken through strict enforcement powers. In the next few years, as we transition from one governance model to the next, exchanging power to a local level, improvements must be closely aligned to quality and substantial, evidence-based research. Research grants are being cut and it is likely public sector research, including health research, will suffer as result of such austerity. The CDCs broad remit to oversee NHS organisations is not limited to particular service areas or functions, like that of many of the existing regulators. They may find themselves over extending and unable to fully engage with the public in a transparent and meaningful way. As quality of care is embedded to offer assurance and to deliver improvements over time, there is potential for major disruption to be caused by the scale of the change management discussed within the White Paper. The CQCs model of regulation puts user involvement and community level accountability at the core of their actions. Though this is consistent with the changes implied within both the White Paper and Operational Framework, there is still considerable ambiguity surrounded where responsibility will lie across all regulated services, especially with the introduction of GP consortia. Until this is resolved and clarity found, ambiguity will only be escalated by poor engagement of stakeholders and insufficient information dissemination through the crucial transitional points. As patterns of service provision change, consistently identifying providers and commissioners, and then allowing for local communities to hold them to account for the services they provide may prove difficult. Once established within a professional capacity, the CDC will need to be aware of the information on outcomes and how it should be presented in a format that is accessible and meaningful to influence patient choice. Furthermore, in their role as an advocate of patients, as a consumer champion, the CDC will also be required to ensure that people who use services understand the care choices available to them and are involved in making decisions about their own care and support. The CDC (2010) note that Patient and public involvement in health organisation will be strengthened by the creation of HealthWatch England a new independent consumer champion within the Care Quality Commission. As a so called consumer champion, this suggests end user expectations may be heightened. Questions must be asked of how HealthWatch England shall be regulated.

Xmas Gift :: essays research papers

Christmas Gift   Ã‚  Ã‚  Ã‚  Ã‚  It was the holiday season, and Christmas was fast approaching. With the twenty-fifth only a few days away there was no more time for procrastination. I decided to go to the mall in an attempt to complete all the Christmas shopping at once. While wandering around the uniquely decorated mall, I noticed a particular store that caught my attention. Pausing for a moment to stare into the window of the shop I came across the perfect gift for my father. Stepping inside I asked the shop keeper what the price would be if I purchased item on display in the window. The shop keeper, speaking with a thick Russian accent said â€Å"For you my boy the item is free.† Being Christmas, I did not want to press my good fortune, so I left the shop quickly as possible. As I got a farther away I could hear the shop clerk laughing manically. Hesitating for a moment I thought to myself â€Å"perhaps the old Russian shop keeper was insane, or rather that the holiday season was gett ing to himâ€Å". I did not give this matter of a â€Å" free present† another thought. Besides I had more shopping to do, so I braved the screaming kids, irritated parents and an assortment of mall rats to get the rest of the shopping done. I did the holiday gift buying in an hour or less. Deciding that my trip to the mall was over, I set off for home.   Ã‚  Ã‚  Ã‚  Ã‚  When I arrived at home I ran straight to my room and found the wrapping paper and ribbons inside a huge bag. Realizing I needed tape to complete the task , I went looking for the remnants of the scotch tape I had thrown into the depths of the enormous bag the night before when I had helped wrap my mothers gifts to the family. As soon as I found it I went to work on the job of wrapping the gift. The gift wrapping took a while and several attempts to wrap the object since it was so oddly shaped. When I had finished, the present resembled a clump of wrapping paper more so than an actual Christmas gift. I was very proud of myself since my father would never be able to guess the contents of the box now. I stashed the gift away under our tree and left it there for what seemed like ages, although it was in reality only a couple of days.

Marlow’s Metamorphosis in Joseph Conrads Heart of Darkness Essay

Marlow’s Metamorphosis in Heart of Darkness Conrad's novel, Heart of Darkness, relies on the historical period of imperialism to illuminate its protagonist, Charlie Marlow, and his struggle with two opposite value systems. Marlow undergoes a catharsis during his trip to the Congo and learns of the effects of imperialism. I will analyze Marlow's change, which is caused by his exposure to the imperialistic nature of the historical period in which he lived. Marlow goes to the Congo River to report on Mr. Kurtz, a valuable officer, to their employer. When he sets sail, he does not know what to expect. When his journey is complete, his experiences have changed him forever. Heart of Darkness is a story of one man's journey through the African Congo and the enlightenment of his soul. Marlow begins his voyage as an ordinary English sailor who is traveling to the African Congo to work. He is an Englishmen through and through. He has never been exposed to any culture similar to the one he will encounter in Africa, and he has no idea about the drastically different culture that exists there. Throughout the book, Conrad, via Marlow's observations, reveals to the reader the naive mentality of Europeans. Marlow also shares this naivetà © in the beginning of his voyage. However, after his first few moments in the Congo, he realizes the ignorance he and all his comrades possess. We first recognize the general naivetà © of the Europeans when Marlow's aunt sees him for the last time before he embarks on his journey. She assumes that the voyage is a mission of "weaning those ignorant millions from their horrid ways [. . .]" (line 16). In reality, however, the Euro peans are there in the name of imperialism and their sole objective is to earn... ... Johnson, Bruce. â€Å"Conrad’s Impressionism and Watt’s â€Å"Delayed Decoding.† Conrad Revisited: Essays for the Eighties: 51-70. By Ross C Murfin. University: The Univ. of Alabama, 1985. Rpt. in Heart of Darkness: An Authoritative Text, Backgrounds and Sources, Criticism. Ed. Kimbrough, Robert. 3rd ed. Norton Critical Edition, New York: Norton, 1988. McLauchlan, Juliet. â€Å"The Value and Significance of Heart of Darkness.† Conradia 15 (1983): 3-21. Rpt. in Heart of Darkness: An Authoritative Text, Backgrounds and Sources, Criticism. Ed. Kimbrough, Robert. 3rd ed. Norton Critical Edition, New York: Norton, 1988. Stewart, Garrett. â€Å"Lying as Dying in Heart of Darkness.† PMLA 95 (1980): 319-31. Rpt. in Heart of Darkness: An Authoritative Text, Backgrounds and Sources, Criticism. Ed. Kimbrough, Robert. 3rd ed. Norton Critical Edition, New York: Norton, 1988.

Relationship between continental drift and the formation of the Earth’s Oceans

1) Explain the relationship between continental drift and the formation of the Earth’s Oceans?-The relationship between continental drift and the formation of the Earth’s Oceans stems from plate movement that occurred on Earth. There is a theory that all the continents were once all one big piece of land named Pangaea, and over millions and millions of years the land of Pangaea started to split apart into many different continents. It divided Panthalassa, the large global ocean that surrounded the supercontinent Pangaea, into many different oceans instead of just one big one and now we have many various oceans around the world.2) How did volcanoes affect the origins of the seas?-Volcanoes affected the origins of the seas because many gasses are released during a volcantic eruption including water vapor. Water vapor was the main contributor to where the primary ocean waters originated from. This is because the water vapor condensates after being gassed out of the volcano es, once the condensation occurs then precipitation is created.3) Describe the hydrologic cycle as if you were a particle of water going through it.If I were a particle traveling though the hydrologic cycle I would being by floating on top of the ocean and soaking up the suns heat, slowly after absorbing the heat I would lift up into the air as water vapor. After chilling in the sky for a little bit I would find a nice crowded dark cloud to sit inside and eventually once it got too full I would fall back onto the ground as a snow flake on to a tall mountain. After resting on the mountain all winter once spring came along I would melt off the side of the mountain and into a lake.

Evolution of Detective Fiction Essay

Twenty-first century detective stories are blooming with action, conflict, mystery and so on. But this is only recent development. There is a lot more to it than most people think. From a French man named Vidocq to the creation of modern detective fiction by Edgar Allan Poe, until today’s development of detective stories and its characters. So what made Poe such an important figure in detective fiction history, and in what way did his creation develop after his death? In my study I will try to answer these questions to the best of my capabilities. People started to take interest in crime stories in the early 1800, caused by their fascination and fear of crime. It was the town folks that started to romanticize criminals, as well those who stood up against them: â€Å"The first writing on urban crime pretended to be documentary, but it was filled with archetypes and plots from preceding fiction, particularly the gothic novel† (Marling 2). The detective as a figure first saw light in the early nineteenth century. Eugà ¨ne Franà §ois Vidocq who is considered to be the father of modern criminology and the first private detective wrote Memoirs of Vidocq which inspired writers like Viktor Hugo’s Les Misà ©rables and Honorà © de Balzac’s Le Pere Goriot in creating first of many detective figures based on Vidocq. Of course there were other writers, not just crime stories but novels as well, to whom Vidocq served as an inspiration. A good example to this is Charles Dickens novel Great Expectations. The main and most important difference between the earlier mentioned crime stories and Poe’s Murders in the Rue Morgue is that they didn’t construct their story/case around the detectives: â€Å"Before Poe, the early crime stories did not revolve around the individual detective â€Å"(freewebs editor 3). Crime Fiction is essentially about the solving of a crime, usually a mystery of murder. Crime Fiction texts question what it is to be human and raise questions about identity. (freewebs editor 1) When Poe created Dupin, most of his very own traits were given to the character. Since Poe himself didn’t believe in the supernatural neither did Dupin, giving him a far more realistic view of things, which I believe essentially gave the detective a big step ahead of others when solving a case. In â€Å"The Murders in the Rue Morgue† Poe introduces three of the basic motifs of detective fiction. First is the wrongly suspected man, secondly the crime in the close d room and  finally the solution by unexpected means. It is also important to note the Dupin outsmarts the police by solving the case, which is an element that if not all but certainly most detective storie’s adopted. In The Purloined Letter the reader gets to know another favored element of the detective fiction: recovery and safe keeping of the â€Å"document(s)† needed to ensure the safety of one or more important individuals. In order to make sure Dupin succeeds in this task, Poe introduces yet again important motifs known to the detective fiction: the outsmartingdeceiving of other genius minds, the finding of the evidence in the most obvious place and the use of disguise. Although the element of disguise might not seem so evident at first reading, I am most certain that the use of the green spectacles in order to deceive D—serves as an early version of using clothing or other accessories in order to misguide another character. In the third story of Dupin, The Mystery of Marie Rogà ªt, Poe introduces the method of recreating a crime by recollecting and putting together newspaper reports of the same case. While Poe’s greatest detective fiction will be the one’s pres enting Dupin, we must take a step in taking in to notice Poe’s other two works Thou Art the Man and The Gold Bug readers are familiarized with new motifs from the repertory of detective fiction: the criminals spirit breaks and confesses when he is faced with the enormity of his crime, misguidance by following the wrong clues and the climaxing moment when that the criminal is the least likely suspected person. And of course all five stories have the common unexpected ending which was common to gothic novels in Poe’s time. We must not forget however that there were a few other detective stories in which Dupin makes his appearance even though they weren’t written by Poe. Such stories are like: The Vanished Treasure and The Fires in the Rue St. Honorà © which appeared in a collection of seven short stories by the publisher Mycroft & Moran, The Murder of Edgar Allen Poe by George Egon Hatvary, etc. The interesting fact about most of these stories in which Dupin makes an appearance is that he either meets or gets regarded as being Poe himself Just as Vidocq in his own time, Poe’s writings served as role model for the new detective fiction, but unlike Poe who introduced the reader to a new type, a reformed detective story, the new generation of writers kept and used the new motifs and elements which Poe created. None other could serve as a better example for this than the m ost widely known detective in world,  namely Sir Arthur Conan Doyle’s Sherlock Holmes. In my personal opinion Holmes serves as the best comparison to Dupin. They represent the perfect rivals in what I’d like to call â€Å"who’s the better detective†. In order to make my point in why Dupin is the superior I’ll point out a few of their similarities. First and most likely observed by all readers that both detectives are presented by a narrator who just happens to be their best friend. Like Dupin, Holmes uses cold logic in the solving of the cases. While today’s detectives seem to be more calm and appear to have part in way more action, Dupin and Holmes isolate themselves, they are eccentric, somewhat egoistic and they both enjoy smoking the pipe. But most importantly in their stories the focus is on the case and the solving of the puzzle rather than putting the main protagonists in the middle of the action. While few say that Holmes is a copy of Dupin, most would consider Holmes to be the perfected version of his superior. In A Study in Scarlett Holmes sidekick Dr. Watson makes a comparison between the two detectives: â€Å"Now, in my opinion, Dupin was a very inferior fellow †¦ He had some analytical genius, no doubt; but he was by no means such a phenomenon as Poe appeared to imagine.†(Doyle 24). I believe that most important trait of Dupin that separates him from the other detectives is that he wasn’t exactly a role model for the mentally stable. This of course is the effect of the loss of his inheritance. While Holmes himself wasn’t the charming kind of fellow one might choose as friend(he was addicted to cocaine, stayed up for hours walking around or playing on his violin, making smelly chemical experiments and he even fired off his gone sometimes), his bad habits were of his choosing and making so it wasn’t nearly as bad as Dupins case. Of course Holmes isn’t the only one to be created in Dupins image. Hercule Poirot created by Agatha Christie in one of the characters on which Dupin had a huge impact. In the 20th century the detective fictions have considerably changed in the way they are seen. This of course is due to the new generation. Most of the younger generation lack the imagination to fully understand and enjoy such works as The Murders In The Rue Morgue or Sherlock Holmes due to the fact that they lack action. Today’s generation is used to all the constant action and violence thanks to TV and PC games. So as these factors changed society  entertainment industries took on new elements. Since recent years haven’t produced any film adaptations about Dupin, I’ll have to stick with Sherlock Holmes. The new movie, while still being a detective story, can be easily put into the genre of action. Consider the movie to be most enjoyable despite the fact that it completely lost the book’s magic. With all its stunning visuals and extreme action scenes it is hard for me to find it anything nearly as the book. I believe that the only thing which is kept in it is Holmes himself. Holmes remained the same seemingly mad but genius and efficient detective I got to like from the book while Watson became a 19th century action hero. One must know the detective fiction motifs in order to identify them in the movie, but I assure that they are present. In conclusion, detective fiction is a genre still under development, since new elements are only starting to emerge and all is thanks to the drastic change of technology and way of thinking. But this doesn’t mean that it will surely develop in a positive way. There are way too many factors that play a part in it, however we take our part in preserving the bases of this great genre and putting our own ideas to it in while to make it even greater. But this is question only time will answer and the people who work on it.