The Simple Gift

Why is belonging significant to each and every one of us? What benefits does belonging impart for the individual? The real question is what is belonging? Belonging is a sense of acceptance felt when an individual gains an understanding of themselves in relation to others and the wider world. Sense of acceptance can be experience through time and different types of relationships or connections with their family, friends, and community, which may enhance the ability to belong or feel as though they belong.Good morning teachers and my fellow students, today, I am going to discuss with you my interpretation of acceptance in the environment of the individual and how it has been represented through the two significant texts including, free verse book The Simple Gift by Steven Herrick and wordless picture book The Arrival by Shaun Tan. Each one of these texts’ discusses and portrays the idea of being accepted or not being accepted in the environment through different circumstances bu t in a similar way.The first text is The Simple Gift by Steven Herrick which examines the life of a 16-years-old boy called Billy Luckett, who ran away from home because of the sense of isolation which shapes his identity and value. In ‘longlands road’ the imagery of the dilapidated house portray the sense of denial that Billy has experienced in past. The disconnect relationship between the place and his father, led Billy to move away from his environment to gain the sense of connection he never experienced.The isolation caused by an abusive father is seen in quote ‘‘gave me one hard backhander across the face, so hard I fell down†¦ and slammed the door on my sporting childhood. † pg. 15-16’. The technique that is used here is a metaphor explaining how Billy stopped playing sport. Billy journey of alienation ends when he moves and meets an old alcoholic man called Bill and a rich caring 17-year-old girl called Caitlin. Billy felt a physical and emotional sense of belonging to his new environment in the way its more welcoming and friendly then his hometown.Even though Billy does not belong physically, he feels he belongs emotionally because he’s away from his dad’s merciless treatment and he feels safe. The sense of acceptance of Bendarat can be seen in the quote â€Å"Bendarat is the perfect town† and this portrays that even though it’s not a perfect town but Billy sees it as a faultless town due to the connection that this town his provide Billy though old Billy and Caitlin. When Old Billy gives the key to house and Billy are not homeless boy that is not accepted but a boy that has a family and is secure.At the end of the book Belonging reaches beyond boundaries ‘and I looked up into the sky, the deep blue sky that Old Bill and I shared. ’(p. 205). This quote demonstrates the technique of symbolism the start of new journey of acceptance that comes from the connections that the individual gains through their relation with place, family or time. The second text that I have selected to portray ideas understanding and importance of belonging is The Arrival by Shaun Tan. Similar to the Simple Gift the migrant character in The Arrival leaves sense of isolation to look for and environment that would accept him.The story is told as a series of wordless images that might seem to come from a long forgotten time. Nameless man leaves his wife and child in an impoverished town that was destroyed because of the war. The man travels to an unknown country seeking better prospects for him and his family. This is seen when the visual techniques represent the family coming together. The most significant technique used on every single page of the book that lets the responder not only be in the characters shoes, but also contemplate what it would be like to be in a migrants situation, is the lack of words.This lack of words helps the responder contemplate the alienation felt by not only the character but by all migrants entering a foreign land and culture with a completely different language. Other than the responders’ contemplation of the alienation felt by the character and migrants, it also forces the responder to interpret the visual without the guidance that only words can provide finally the joy shown by the protagonist s daughter in the final chapter of the book shows the safety that has been resulted.The Simple Gift and the Arrival are similar in the way both of the main characters left their homes to look for a place that will provide them the acceptance and the belongings they need. Both of the characters environments did not provide these individual with the sense of fellowship. In The Arrival the man travels and leaves his wife and daughter to look for a better life for them in a new town.He was not force to leave but chose to leave to search for a better life for him and his family, even though he was accepted in that place but the circumstances of the war led to his movement. Much like the Simple Gift, Billy left his town for a better life away from his abusive and unaccepted father again he was not forced to leave but chose to look for a place that acknowledged him. Billy did not associate with his family or town but in The Arrival the man belonged but chose to leave for a better existence. Both characters went to search for a better and acceptance life.When Billy left he did not care about his father because he was the reason Billy left to find acceptance in the new experience where as the character in The Arrival was accepted in the town but chose to leave because of what the trouble and obstacles that the war produced. Family was a big part of the character life in the arrival where as in the simple gift Billy’s real family had no part in his life. In both texts the characters did belong in their first towns but in the simple Gift Billy chose not to belong where as in the arrival the character chos e to belong.This shows that the barrier to belonging is linked to the action of the individual interacting to the community and place to gain the feeling of acceptance. Lastly status had played a role in the movement of the both character, this is seen when the nameless man and Billy left because the poor conditions they lived in. Both books have similar technique in the way they both portray the symbolism of new journey of acceptance. In conclusion belonging is a lifelong requirement for the individual.Although how and where we experience a sense of kinship can change, but it remains a key contributor to our wellbeing and participation throughout our lives. Our sense of association can emerge from the connections we make with people, places, culture and groups. The Simple Gift and the arrival portray a clear understand of the importance and significance of belonging. Each character wants to feel belonged and they go and look for belonging. This shows that belonging is imperative in each and every one of us for our wellbeing.

Gender Imbalance

If such a large gender imbalance continues, effects on Asian society will include having a bad economy, a slower birthrate and many detrimental psychological effects especially on Asian men. Firstly, there will be a bad economy if the trend of a large gender imbalance whereby there are many woman short, continues. This is due to two main reasons. Men will very likely subject to frustration based on the fact that they have no one to release any sexual pleasure on, hence many stay bachelors, despite the want to find a partner and settle down. Men will also lose any focus on work as they constantly think about â€Å"sex† and what-nots so when there is no focus put on their jobs, there will be no improvements or progress made, thus the economy is bound to slow down. Also, many men will stay unmarried as there is not enough women. Hence, if men do not get married, they would not need to purchase any additional supplies for both marriage and children needs, thus these industries sup plying such products will have loses as the demand will be lesser than the supply. Secondly, Asia will meet with a slower birthrate.Take Singapore for example, already there is a huge problem with the slow birthrate – thus the government are stepping up efforts to kerb this problem. However, with the current gender imbalance, things will only detiororate. This is mainly due to men, who many stay bachelors , as they cannot find a suitable partner, they won't get married thus they would not produce any babies. If this trend continues, the birthrates will fall by a lot, as for every woman Asia is short of , that is the possible number of men that will stay as bachelors , in this case 160 million – which is 40 times Singapore's population, hence it is a very big number.Also, 160 million times the replacement rate of Asia will be the number of babies that can be given birth to , if there is no gender imbalance, thus there would be a huge difference and the birthrate will be very slow as these babies are not given birth to, based on the absence of 160 million women. Thirdly, Asian men will face with many negative psychological and sexual effects. They will have sexual frustration as they would have no place to let out their sexual desire- hence possibly turning to prostitution, which is wrong.Also, they will let out any sexual desires in the wrong place, leading to a wrong sexual orientation, which will also lead them to committing crimes and sins. The fact that a large majority will never get married will be a huge blow to them as they will never find a partner for life. This is due to the lack of 160 million women in Asian, thus these men will definitely face such effects. In conclusion, a large gender imbalance will lead to a bad economy, a slower birthrate and detrimental psychological effects , in the long run.

The Moldau

Connie Ju| [The Moldau] Smetana | Year 11 Music 2 Musicology Essay| | Smetana’s Moldau is a musical portrayal of the main river which runs through the countryside of Bohemia (present day Czech Republic). The piece begins with a sweet one bar theme that is played by two solo flutes, representing the trickle of a small creek. The soft melody played in piano and â€Å"lusingando†, which means to be played in a coaxing style, convey the delicate and smoothness of the water.The ascending semi-quavers accompanied with a slight crescendo at the beginning of the phrase as well as a two quaver rests at the end of the bar create a rippling effect, symbolising the slight waves of a stream. Furthermore, the lone plucked pizzicato quavers by the strings add small splashes of colour to decorate the continuously flowing melody of the airy flutes. The light, fluttering tone colour of the solo flutes and the thin texture portray the clear appearance of the water as it makes its way acro ss the land.Bar 1 -2 (solo flutes) Bar 1 -2 (accompanying strings) The first bar theme is repeated to become the basis of this extract, however there are also variations of the theme were the starting note is changed to indicate a different scenery or perhaps some animals, such as small fishes, that are swimming through the water that make the river full of life. Bar 5 (repeat of the theme)Bar 8 (variation of theme) Bar 10 (variation of theme)The texture of this work begins as very thin as there are only solo flutes that play the melody that portray the simple and tiny stream accompanied with light pizzicato of strings that add to the tone colour. This means that the start of this piece is played in a thin homophonic texture. Bar 1 -4 (homophony) However, when the texture at bar 16 is compared to the first four bars, it is thicker as there is the addition of clarinets that play an alternate melody. This new melody is in a contrary motion to the existing flute melody and plucking st rings which represent widening of the tiny creek so the water is moving a bit more wildly.The polyphonic texture consists of two major layers and the randomly placed pizzicato chords which are a reminder of water’s unpredictable motions. Bar 16 (flutes, clarinets, strings – polyphonic texture) The two small rivers that make up the larger Moldau meets at bar 28 where the clarinets stop for a bar and the violas begin their melody. This short bar acts as a bridge, the connection where the bodies of water finally merge to create a great river. The bigger river in bar 29 is conveyed by the three different layers, flutes, clarinets, and violas.Continuous semi-quavers that rise and fall in pitch still represent the fluidity and continuity of the water but now the extra layer means that the river is wilder with bigger waves and other movements. Bar 28 (melodies played by flutes and strings) Bar 29-30 (flutes, clarinets, viola) Bar 36 sees even more layers as the strings begin to play the flowing melody of the river. The start of the larger body of water is indicated by a strong perfect cadence by the lower strings (bar 36). At the widest point of the river, bar 40, the whole orchestra plays.All the instruments playing together expresses the notion that this is the climax of the river and it is wildest at this point. The wind instruments, however, play a slower melody of slurred crochets and quavers with a drawn out crescendo and the instruction of â€Å"dolce†. The new melody presents the idea that the river is experiencing different landscapes, such as quiet, peaceful pastoral lands or rolling hills in the distance. This polyphonic texture continues until the end of the excerpt. These additional tone colours further build upon the majestic nature of the river as well as its more powerful movements.Bar 36-37 (increased layers) Bar 40 (different melodies, thick texture) The dynamics of this piece correspondingly represent the growth of the river. I n both bars 1 and 2, there is a lone crescendo plus an accent, this is the river just starting out so it is not very dramatic compared to bar 20 and 21 where there is a crescendo and a decrescendo within one bar. Moreover, in bars 41-42, not only are there crescendos and decrescendos but the additional sforzando sign.The â€Å"p† for piano in the bar directly after (bar 43) simply adds to the tempestuous nature of the water as there are more dramatic things happening in a faster-flowing large river. Bar 1 (slight crescendo, â€Å"lusingando†, accent, â€Å"p†) Bar 20-21 (crescendo and descrendo) Bars 41-43 (dramatic dynamics) The tone colour of the instruments also changes as the river grows. The solo flutes at the beginning create a sweet, airy, light sound of a stream but the orchestral playing altogether from bar 40 onwards makes a stormy sound much like the torrents of a wild river.Having the lower strings playing the melody instead of the winds depicts the strength of the matured river compared to the higher pitched flutes that represented the fragility and daintiness of a stream. Bar 40 (full orchestra playing – polyphonic texture and extra tone colour) This musical program by Smetana artistically conveys the development of the iconic Moldau River through the use of various techniques such as texture, structure, rhythm, tone colour, and dynamics. He is able to represent all the aspects of the constantly moving river, beginning with a delicate stream and finishing with a majestic river. Word Count: 940

Civil Rights Era Essay Example | Topics and Well Written Essays - 750 words

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Sicilian Mafia Essay Example | Topics and Well Written Essays - 2250 words

Sicilian Mafia - Essay Example Sicilian Mafia (Cosa Nostra) is among the highly dangerous organized criminal groups of Italy. This research paper will discuss regarding the background, history, and formation, past and present criminal activities of the Sicilian Mafia. It will highlight how it has impacted the social and economic life of the people in the world and which policies have been made by the authorities to restrict the mafia from affecting the lives of the people. Whether there has been any restriction policy on this major mafia group or not is another big question which will be answered by this research paper (Sinai, 2007). The paper will start with background information following the related theories regarding the Sicilian Mafia. The current situations of the criminal group along with their economic impact on the entire world will be discussed. The methodology of the research paper will also be presented and the results will be drawn out of the economic statistics. The main objective of this research p aper is to check the association of the origin of Sicilian Mafia with the higher profits earned in the lemon and citrus fruits markets. The work has basically been done by taking the data from the imperfect market situations of the 19th century. The paper is going to highlight the facts regarding the Italian imperfect markets of citrus fruits where the fixed costs of growing citrus fruits were very high. This entry barrier caused only a few people to grow these fruits, thus earning significantly higher profits as well (Dimico, 2012). At that time the government rule was also very poor, but in order to prevent the people from earning higher profit

Ethnic Diversity at Workplace Research Paper Example | Topics and Well Written Essays - 750 words

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Presentation Essay Example | Topics and Well Written Essays - 250 words - 2

Presentation - Essay Example Ernie Davis’s refusal to do this caused all his white teammates to boycott the banquet. Ernie Davis also won the MVP title in the Liberty Bowl. One year yare, in 1961, Ernie Davis won the Heisman Trophy. This trophy meant a lot for Ernie Davis given he was the first athlete of the African American race ever to win the Heisman Trophy. In the year 1979, Ernie Davis was introduced into the College Football Hall of Fame. All his achievements, titles, and awards carried a special meaning for Ernie Davis because he had won them by fighting dual challenge of showing marvelous performance in the games and prejudice against the black athletes in the south. John F. Kennedy passed a salute to Ernie Davis saying, â€Å"Seldom has an athlete been more deserving of such a tribute. Your high standards of performance on the field and off the field, reflect the finest qualities of competition, sportsmanship and citizenship†¦I salute you† (Kennedy cited in â€Å"Ernie

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Predictors of socio-cultural and psychological adjustment of Polish Essay

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What is the essence of philosophy Essay Example | Topics and Well Written Essays - 750 words

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Summary The Health Care Quality Book Essay Example for Free

Summary The Health Care Quality Book Essay Chapter 1: science and knowledge foundation Two notable contributions to the industry from the Journal of American Medical Association: 1. Assessment of the state of quality ïÆ'   serious and widespread quality problems 2. Categorization of three defects: a. Underuse: many scientifically sound practices are not used as often as they should be b. Overuse: can be seen in areas such as imaging studies for diagnosis in acute asymptomatic low back pain or prescription of antibiotics when not indicated for infections. c. Misuse: when the proper clinical care process is not executed appropriately, such as giving the wrong drug to a patients. To Err Is Human: publication that shows the severity of the quality problems in a way that captured the attention of all key stakeholders for the first time ïÆ'   this report spoke about the negative, not how it should be improved. Crossing the quality chasm: provided a blueprint for the future that classified and unified the components of quality through six aims for improvement, chain of effect and simple rules for redesign of health care. Six dimensions of quality (Berwick): Outcome measures and goals (IOM) = Institute of Medicine’s Safe Percentage of overall mortality rates/patients experiencing adverse events or harm Effective: science and evidence should be applied and serve as the standard for delivery of care. How well are evidence based practices followed? Percentage of time diabetic patients receive all recommended care at each doctor visit.. Efficient: Care and service should be cost effective, and waste should be removed. Analyzing the costs of care by patient, organization, provider or community Timely: no waits or delays in receiving care Measured by waits and delays in receiving needed care, service, and test results. Patient centered: system should revolve around the patient, respect its preferences and put the patient in control Patient or family satisfaction with care and service Equitable: Disparities should be eradicated. Examining differences in quality measures by race, gender, income or other factors. The underlying framework for achieving these aims depicts the health care system in four levels: Level A: what happens with the patient Level B: the micro system where care is delivered by small provider teams Level C: organizational level: the macro system or aggregation of the Microsystems and supporting functions. Level D: external environment where payment mechanisms, policy and regulatory factors reside (verblijven) Chapter 2: Basic concepts of health care quality The following attributes relevant to the definition of quality of care are important: Technical performance ïÆ'   refers to how well current scientific medical knowledge and technology are applied in a given situation (it is usually assessed in terms of timeliness and accuracy of the diagnosis, appropriateness in of therapy) Management of the interpersonal relationship ïÆ'   refers to how well the clinician relates to the patient on a human level. The quality of this relationship is important because: By establishing a good relationship with the patient the clinician is able to fully address the patient’s concerns, reassure the patient and relieve the patient’s suffering It can affect technical performance: the clinician is better able to elicit from that patient are more complete and accurate medical history, which can result in a better diagnosis Amenities (voorzieningen) ïÆ'   refers to the characteristics of the setting in which the encounter between patient and clinician takes place, such as comfort, convenience and privacy. Amenities are valued both in their own right and for their effect on the technical and interpersonal aspects of care. Amenities can yield (opleveren) benefits that are more indirect. Access ïÆ'   refers to the degree to which individuals and groups are able to obtain needed services. Responsiveness to patient preferences ïÆ'   respect for patients’ values, preferences and expressed needs affects quality of care as a factor in its own right. Equity ïÆ'   the amount, type or quality of health care provided can be related systematically to an individual’s characteristics, particularly race and ethnicity, rather than to the individual’s need for care or healthcare preferences, have heightened concern about equity in health care. Medicine does not fulfill its function adequately until the same perfection is within the reach of all individuals. Efficiency ïÆ'   refers to how well resources are used in achieving a given result. Cost-effectiveness ïÆ'   how much benefit, typically measured in terms of improvement in health status, the intervention yields for a particular level of expenditure. For each stakeholder in health care, quality can be differently defined: page 30 + 31. These definitions have a great deal in common: Each definition emphasizes different aspects of care Definitions conflict only in relation to cost-effectiveness All evaluations of quality of care can be classified in terms of one of the three aspects of caregiving they measure: Structure: when quality is measured in terms of structure, the focus is on the relatively static characteristics of the individuals who provide care and of the settings where the care is delivered. These characteristics include the education, training and certification of professionals. Process: refers to what takes place during the delivery of care, also can be the basis for evaluating quality of care. Outcomes: Outcome measures, which capture whether healthcare goals were achieved, are another way of assessment of quality of care. Outcome measures have to include the costs of care as well as patients’ satisfaction with care. Which one is better to use? ïÆ'   none of them, all depends on the circumstances. To assess quality using structure, process or outcome measures, we need to know what constitutes good structure, good process and good outcomes. We need criteria and standards we can apply to those measures of care: Criteria = specific attributes that are the basis for assessing quality Standards = express quantitatively what level the attributes must reach to satisfy preexisting expectations about quality. For example ïÆ'   type of measure: structure and focus on primary care group practice: Criterion: percentage of board-certified physicians in internal or family medicine – Standard: 100% of physicians in the practice must be board certified in internal or family medicine. Optimal standards: denote the level of quality that can be reached under the best conditions, typically conditions similar to those under which efficacy is determined ïÆ'   useful as reference point. Structural measures are well suited to detecting lack of capacity to deliver care of acceptable quality. They are also only as good and useful as strength of their relation to desired processes and outcomes. To evaluate structure, process and outcome measures criteria and standards are essential. Whereas the formulation of criteria is expected to be evidence driven (efficacy). The setting of standards is not similarly tied to scientific literature. The decision to set standards at a minimal, ideal or achievable level is most meaningful if driven by the goals behind the specific quality of care evaluation for which the standards are to be used. Chapter 3: Variation in medical practice and implications for quality Variation ïÆ'   the difference between an observed event and a standard or norm. Without this standard, or best practice, measurement of variation offers little beyond (biedt niet meer dan) a description of the observations. Random variation = physical attribute of the event or process, adheres to the laws of probability and cannot be traced to a root cause. (houdt zich aan de wetten van waarschijnlijkheid en kan niet worden herleid tot een oorzaak). It is not worth to study it in detail. Assignable variation = arises from a single or small set of causes that are not part of the event or process and therefore can be traced, identified, and implemented and eliminated ïÆ'   subject to potential misunderstanding because of complexity of design and interpretation. 1. Process variation = the difference in procedure throughout an organization (use of various screening methods for colorectal cancer) Technique ïÆ'   multitude of ways in which a procedure can be performed within the realm of acceptable medical practice. 2. Outcome variation = difference in the result of a single process (mostly focus on this measure) the process yielding optimal results ïÆ'   outcomes research 3. Performance variation = the difference between any given result and the optimal ideal result. This threshold or best practice is the standard against which all other measurements of variation are compared. Performance variation tells us where we are and how far we are from where we want to be, and suggests ways to achieve the desired goal. Variation can be desirable? ïÆ'   a successful procedure that differs from other, less successful procedures is by definition variation. The objective then for quality improvement is not simply to identify variation but to determine its value. How can the variation be eliminated or reduced in the ways that focus on the variation rather than on the people involved? So, understanding the implications for quality of variation in medical practice is not simply learning how eliminate variation but learning how to improve performance by identifying and accommodating good or suboptimal variation from a predefined best practice. Variability plays a role in identifying, measuring and reporting quality indicators (effective, efficient, equitable..) and process-of-care improvements. Some hospitals are reluctant to use quality improvement measures (they perceive them as biased towards academic medical research centers or large health care organization) ïÆ'   untrue! Quality improvements efforts can be and have been successfully applied to small organization and practices. The size of an organization also effects the ability to disseminate (verspreiden) best practices. Large organization tend to have rigid frameworks or bureaucracies; change is slow and requires perseverance (doorzettingsvermogen) and the ability to make clear to skeptics and enthusiasts the value of the new procedure in their group and across the system. An organization ‘s commitment to paying for quality improvement studies and implementation is equally affected by its size and infrastructure, but there are some minimum standard levels of quality and linked reimbursement schemes to achieving goals established by the Joint Commission, CMS and Medicare ïÆ'   all organizations obligated to meet these standards. Quality improvement effort must consider organizational mind-set, administrative and physician worldviews, and patient knowledge and expectations. Physician buy-in is critical to reducing undesired variation or creating new and succesfull preventive systems of clinical care, therefore: training physician champions and inciting (aanzetten) them to serve as models, mentors and motivators and it reduces the risk of alienating (vervreemden) the key participants in quality improvement efforts. Patient education in quality of care is equally subject to variation; patients are aware of the status of health care providers in terms of national rankings, public news of quality successes and so on. Educating patients about a health care organization and its commitment to quality makes variation and process-of-care measures available to the public. Organizational mind set ïÆ'   organizational infrastructure is an essential component in minimizing variation, disseminating best practices and supporting a research agenda associated with quality improvements. Economic incentives may be effective in addressing variation in health care by awarding financial bonuses to physicians and administrators who meet quality targets or withholding bonuses from those who do not. Goals of incentives: to help people understand that their organization is serious about implementing quality changes and minimizing unwanted variation to ensure alignment with national standards an directions in quality of care and to encourage them to use the resources of the organization to achieve this alignment . Chapter 4: Quality improvement: the foundation, processes, tools and knowledge transfer techniques Different leaders of quality improvement systems: page 63 – 67 Quality improvement approaches (derivatives and models of the ideas and theories developed by thought leaders): PDCA/PDSA, Associates for Process Improvement’s Model for Improvement, FOCUS PDCA, Baldrige criteria, ISO 9000, Lean, Six Sigma. PDCA/PDSA cycle Basis for planning and directing performance improvement efforts. 1 Plan: Objective: what are you trying to accomplish? What is the goal? Questions and predictions: What do you think will happen? Plan to carry out the cycle: Who? What? When? Where? 2 Do Educate and train staff Carry out the plan (try out the change on a small scale) Document the problems and unexpected observations? Begin analysis of the data 3 Study/Check Assess the effect of the change and determine the level of success as compared to the goal/objective Compare results to predictions Determine what changes need to be made and what actions will be taken next 4 Act Act on what you have learned Determine whether the plan should be repeated with modifications or a new plan should be created Perform necessary changes Identify remaining gaps in process or performance Carry out additional PDCA/PDSA cycles until the agreed-upon goal or objective is met API improvement model Simple model for improvement based on Deming’s PDSA cycle. The model contains three fundamental questions that form the basis of improvement: What are we trying to accomplish? How will we know that a change is an improvement? What change can we make that will results in improvement? FOCUS/PDCA model Building on de PDCA cycle the FOCUS PDCA model is created: more specific and defined approach to process improvement. The key feature of this model is the preexistence of a process that needs improvement. The intent of this model is to maximize the performance of a preexisting process, although the inclusion of PDCA provides the option of using this model for new or redesign process. F: FIND a process to improve O: ORGANIZE a team that knows the process C: CLARIFY current knowledge of the existing or redesigned process U: UNDERSTAND the variables and causes of process variation within the chosen process S: SELECT the process improvement and identify the potential action for improvement Baldrige criteria The criteria can be used to assess performance on a wide range of key indicators: health care outcomes; patient satisfaction; and operational, staff and financial indicators. The Baldrige healthcare criteria are built on the following set of interrelated core values and concepts (page 70). The criteria are organized into seven interdependent categories: Leadership Strategic planning Focus on patients, other customers, and markets Measurement, analysis and knowledge management Staff focus Process management Organizational performance results Baldrige’s scoring system is based on a 1000 point scale. Each of the seven criteria is assigned a maximum value ranging from 85 to 450 maximum points. The most heavily weighted criterion is the results category (450). The weight of this category is based on an emphasis Baldrige places on results and an organization’s ability to demonstrate performance and improvement in the following areas: Product and service outcomes, customer-focused outcomes, financial and market outcomes, workforce-focused outcomes, process effectiveness outcomes, leadership outcomes. ISO 9000 The international Organization for Standardization (ISO) issued the original 9000 series of voluntary technical standards in 1987 to facilitate the development and maintenance of quality control programs in the manufacturing industry. In 2000, ISO made major changes to the standards to make them more relevant to service and health care settings. Focused more on quality management systems, process approach, and the role of top management, the most recent standards include eight common quality management principles: Customer-focused organization Leadership Involvement of people Process approach System approach to management Continual improvement Factual approach to decision making Mutually beneficial supplier relationships Lean thinking Lean ïÆ'   to describe production methods and product development that, when compared to traditional mass production processes, produce more products, with fewer defects, in a shorter time. The focus of Lean methodology is a ‘back to basics’ approach that places the needs of the customer first through the following five steps: 1. Define value as determined by the customer, identified by the provider’s ability to deliver the right product or service at an appropriate price. 2. Identify the value stream: the set of specific actions required to bring a specific product or service from concept to completion 3. Make value added steps flow from beginning to end 4. Let the customer pull the product from the supplier, rather than push products 5. Pursue perfection of the process Six sigma The aim of six sigma is to reduce variation (eliminate defects) in key business processes. By using a set of statistical tools to understand the fluctuation of a process, management can predict the expected outcome of that process. Six sigma incluses five steps, commonly known as DMAIC: Define: Identify the customers and their problems. Determine the key characteristics important to the customer along with the processes that support those key characteristics. Identify existing output conditions along with process elements. Measure: Categorize key characteristics, verify measurement systems and collect data Analyze: Convert raw data into information that provides insights into the process. These insights include identify the fundamental and most important causes of the defects or problems. Improve: Develop solutions to the problem, and make changes to the process. Measure process changes and judge whether the changes are beneficial or another set of changes is necessary. Control: If the process is performing at a desired and predictable level, monitor the process to ensure that no unexpected changes occur. The primary tool of six sigma is that focus on variation reduction will lead to more uniform process output. Secondary effects include less waste, less throughput time and less inventory. Quality tools: three categories (also six categories distinguishing on page 74) Basic quality tools Control chart: upper and lower control boundaries that define the limits of common cause variation. It is used to monitor and analyze variation from a process to determine whether that process is stable and predictable or unstable and not predictable Histogram Cause-and-Effect/Fishbone diagram: the problem is stated on the right side of the cart, and likely causes are listed around major headings that lead to the effect. It can help organize the causes contributing to a complex problem. Pareto chart: 80% of the variation of any characteristic is caused by only 20% of the possible variables. Management and planning tools (75) Affinity diagram: a list of ideas is created, and then individual ideas are written on small note cards. Team members study the cards and group the ideas into common categories. The affinity diagram is a way to create order of a brainstorm session. Matrix diagram: helps us to answer two important questions when sets of data are compared: Are the data related? How strong is the relationship? Priorities matrix: uses a series of planning tools built around the matrix chart. Other quality tools Benchmarking: compares the processes and successes of you competitor of similar top-performing organizations to your current processes to define, through gap analysis, process variation and organizational opportunities for improvement. Benchmarking defines not only organizations that perform better but also how they perform better. Failure mode and effect analysis: examines potential problems and their causes and predicts undesired results. FMEA normally is used to predict product failure form past part failure, but it also can be used to analyze future system failures ïÆ'   both in patient safety toolbox. 5S: is a systematic program that helps workers take control of their workspace so that is actually works for them instead of being a neutral or, as is quite common, competing factor. Sort: means to keep only necessary items Straighten: means to arrange and identify items so they can be easily retrieved when needed. Shine: means to keep items and workspaces clean and in working order Standardize: means to use best practices consistently Sustain: means to maintain the gains and make a commitment to continue the first four S. Theory of Transfer of Learning ïÆ'   page 77 Rapid cycle testing/improvement Developed by IHI, rapid cycle testing/improvement was designed to create various small tests involving small sample sizes and using multiple PDSA cycles that build on the lessons learned in short period while gaining buy-in from staff involved in the change. It is designed to reduce the cycle time of new process implementation from months to days. Read 78/79/80/81 Chapter 5: Milestones in the quality measurement journey Many health care providers struggle to address the measurement mandate proactively, which leads organizations to assume a defensive posture when external organizations release the data. In such cases, the provider usually responds in one of the following ways: data are old, data are not stratified and do not represent appropriate comparisons, our patients are sicker than those in other hospitals. A more proactive posture would be to develop an organization-wide approach to quality measurement that meets both internal and external demands. This approach is not a task, but a journey that has many potential pitfalls and detours. Key milestones exist that mark your progress and chart your direction. Milestone 1: Develop a measurement philosophy (strategic step): What is/should be the role of performance measurement in the organization? Should it be done periodically or a day-to-day function? The first step toward this milestone should be the creation of an organizational statement on the role of measurement. Three simply questions should be explored when developing a measurement philosophy: 1. Do we know our data better than anyone else does? 2. Do we have a balanced set of measures that encompasses clinical, operational, customer service and resource allocations? 3. Do we have a plan for using the data to make improvements? Milestone 2: Identify the concepts to be measured (types and categories of measures) (strategic and operational step) The second milestone consists of deciding which concepts the organization wishes to monitor. There are three basic categories of measures: structure (s): represents the physical and organizational aspects of the organization processes (p): every activity, every job, is part of a process. outcomes (o): structure combine with processes to produce outcomes. The relationship between these categories usually is shown as follows: s + p = o Another categorization that can be made is (more specific) according to the six aims for improvement: 1 Safe, 2 Effective, 3 Patient centered, 4 Timely, 5 Efficient, 6 Equitable Regardless of the method used, an organization must decide which concepts, types, or categories of measures it wishes to track. Milestone 3: Select specific measures What aspect of (patient safety) do we want to measure? What specific measures could we track? Choose a specific indicator In this step you need to specifying what aspect of for example patient safety you intend to measure and the actual measures. Within the patient safety, you could focus on medication errors, patient falls, wrong site surgeries etc. Within the medication error you can measure different things: number of medication orders that had an error, total number of errors caught each day, percentage of orders with an error etc. Milestone 4: Develop operational definitions for each measure An operational definition is a description, in quantifiable terms, of what to measure and the specific steps needed to measure it consistently. A good operational definition: Gives communicable meaning to a concept or an idea Is clear and unambiguous Specifies the measurement method, procedures and equipment Provides decision-making criteria when necessary and Enables consistency in data collection The problem created by poor operational definitions should be obvious: if you do not use the same operational definition each time you record and plot data on a chart, you will either miss a true change in the data or think a change has occurred when in fact one has not. Using the same operational definition becomes even more critical if you are trying to compare several hospitals or clinics in a system. Milestone 5: Develop a data collection plan and gather data (giving special consideration to stratification and sampling) Direct start with data collection may cause teams to collect the wrong data in the wrong amounts. The data collection phase consists of two parts: Planning for data collection: what process will be monitored? What specific measures will be collected? What are the operational definitions of measures?.. The actual data gathering: how will you collect the data? Will you conduct a pilot study? Who will collect the data? (page 94) Once you have resolved these issues, the data collection should go smoothly. Sometimes improvement teams do not spend enough time on data collection plans. This can lead to the following problems: (1) collect too much, or too little data (2) collect the wrong data (3) become frustrated with the entire measurement journey. Consequences can be: the team tends to (1) distort (verdraaien) the data (2) distort the process that is produced the data or (3) kill the messenger. Two key data collection skills – stratification and sampling enhance any data collection effort. Stratification = the separation and classification of data into reasonably homogeneous categories. The objective of stratification is to create strata, or categories, within the data that are mutually exclusive and facilitate discovery of patterns that would not be observed if the data were aggregated. Stratification allows understanding of differences in the data caused by different factors (page 95). If you do not think about how these factors could influence your data you run the risk of making incorrect conclusions and having to filter out the stratification effect manually after you have collected the data. Sampling (steekproef) ïÆ'   the most important thing you can do to reduce the amount of time and resources spent on data collection. There are four conditions for developing a sampling plan: accuracy, reliability, speed and economy. Sampling consists of a series of comprom ises and trade-offs. The basic purpose of sampling is to be able to draw a limited number of observations and be reasonably confident that they represent the larger population from which they were drawn. There are two basic approach to sampling: Probability sampling techniques: based on statistical probability (systematic sampling, simple random sampling, stratified random sampling, stratified proportional random sampling) Non-probability sampling techniques: should be used when estimating the reliability of the selected sample or generally applying the results of the sample to larger population is not the principal concern. The basic objective is of this type of sampling is to select a sample that the researchers believe is typical of the larger population. (convenience sampling, quota sampling and judgement sampling) 99-102 Milestone 6: Analyze the data using statistical process control methods (especially run and control charts) Translate data into information. Milestone 7: Use the analytic results to take action (implement cycles of change, test theories and make improvements) Chapter 6: Data collection Quality measurements can be grouped into four categories: Clinical quality Financial performance Patient satisfaction Functional status To report on each of these categories, several spate data sources may be required. The challenge is to collect as much data as possible from the fewest sources with the objectives of consistency and continuity in mind. Retro prospective data collection: involves identification and selection of a patient’s medical record or group of records after the patient has been discharged. Prospective data collection: relies on medical record review, but it is completed during a patient’s hospitalization or visit rather than retrospectively. Disadvantage: time consuming and can distract nurse from their direct patient care responsibilities, expensive method, mostly full time data analyst needed. Source for data for quality improvements: Administrative databases: are information collected, processed and stored in automated information systems. Excellent source of data for reporting on clinical quality, financial performance, and certain patient outcomes. Advantages: less expensive source of data, they incorporate transaction systems, moest of the code sets embedded are standardized, the database are staffed by individuals who are skilled, the volume is great, data reporting tools are available.. Disadvantages: some argue that these data is less reliable than data gathered by chart review. Patient surveys: especially when teams are interested in the perceptions of patients, either in terms of the quality of care or the quality of service provided. A team can design the survey itself, hire an expert to design a survey, or purchase an existing survey/survey service. Functional status surveys: usually measured before and at several points following the treatment or procedure. (for example a baseline before the knee procedure and then assessments are made at regular intervals after the surgery) Health plan databases: excellent source of data for quality improvement projects, particularly projects that have a population health management f ocus. These databases are valuable because they contain detailed information on all care received by health plan members. It provides a comprehensive record of patient activity and can be used to identify and select patients for enrollment in disease management programs. Used properly: rich source of data for population management, disease management and quality improvement projects. Health plan databases limitations: considerations include accuracy, detail and timeliness. Recoding may make some data inaccurate, they do not contain detailed information on outcomes of care . Patient registries: powerful source of quality improvement data. Advantages: rich source of information because they are customized, can collect all the data that the physician or health system determines are most important, can be used for quality improvements, they are not subject to the shortcomings of administrative or health plan databases, collection techniques can be combined to provide a complete picture of the patient experience. They are versatile and flexible. Example case study in clinical reporting: page 123-127 Conclusion: there are many sources and data collection approaches from which to choose. Rarely does one method serve purposes, so it is important to understand the advantages and disadvantages of all methods. A combination is also possible. Knowledge of different sources and techniques will help you to use data more effectively and efficiently in your clinical improvement effort. Chapter 7: Statistical tools for quality improvement Three fundamental purposes for performance measurement: Assessment of current performance: identify strengths and weaknesses of current processes Demonstration and verification of performance improvement And control of performance Performance measurement benefits organizations in several ways: provides factual evidence of performance, promotes ongoing organization self-evaluation and improvement, illustrates improvement, facilitates cost-benefit analysis, helps to meet external requirements and demands for performance evaluation, may facilitate the establishment of long-term relationships with various external stakeholders. May differentiate the organization from competitors, may contribute to the awarding of business contacts and fosters organizational survival. .. Chapter 13: Leadership for quality Leadership = working with people and systems to produce needed change. Individual leadership = this set of leadership is about what people must be and what they must know how to do, if they are to influence others to bring about needed changes. Both being and doing are needed, especially when the changes required for quality improvement involve reframing core value or remaking professional teams. Many improvements in health care will require these kinds of deep changes in values. These changes are sometimes labeled as transformational changes to distinguish them from transactional changes, which do not require changes in values and patterns of behavior. Organizational leadership = about creating a supportive organizational environment in which hundreds of capable individual leaders’ work can thrive (groeien). One way to view this level (system-of-leadership level) is as a complex set of interrelated activities in five broad categories: Set direction: every organization has a sense of direction, a future self-image. A leader should set that direction. Establish the foundation: leaders must prepare themselves and their leadership teams with the knowledge and skills necessary to improve systems and lead change (and reframe values) Build will: to initiate and sustain change takes will, which seem to be highly sensitive to discord and often grind to a halt because of one loud voice opposing change ïÆ'   therefore making logical and quantitative links should be made between improvement and key business goals. Generate ideas: quality challenges require innovation. Page 313 Implementing quality as the core organizational strategy Implementing a culture that has quality improvement at its core is an important goal for providers who want to serve patients better, gain the support of healthcare providers, stay ahead of government regulation, meet consumer’s demand for transparent information on quality and costs, an gain a competitive advantage in the marketplace. Recent history: many efforts have not resulted in the sustainable quality improvements that the leaders hoped to see. Quality improvement strategy should start with leadership from the board of trustees, the CEO and the executive team, but it is a challenge for health care organizations because of the many internal competing agendas, the rapidly changing environment, employees and so on. First step: to establish an organizational culture that will support the hospital on their journey to quality ïÆ'   starting point: leadership! Kaplan Norton: Balanced Scorecard ïÆ'   this approach includes the perspective of the patient and family, internal processes such as clinical pathways, learning and growth opportunities that focus on employees and financial performance. Role of leadership: leaders ask financial questions about market share, margins and quality implications. They raise questions related to the satisfaction of their internal and external customers and the way in which business processes must change to improve and sustain quality. Primary focus on creating a culture of quality. Baldrige National Quality Program Creating the change towards quality starts with leadership. Road map for change Eight stage change process, modified form Kotter’s seminal work (Leading Change 1996) serves as a realistic and viable framework to guide leaders who are managing a change to quality: 1. Unfreezing the old culture This is the most difficult step because of culture’s influence on employee behavior and some employee’s to desire to resist change and impede progress. 2. Forming a powerful guiding coalition 3. Developing a vision and strategy 4. Communicating a vision and strategy 5. Empowering employees to act on the vision and strategy 6. Generating short-term wins 7. Consolidating gains and producing more change 8. Refreezing new approaches in the culture View as multi-pages

Strategy of Channelization in River Systems

Strategy of Channelization in River Systems The purpose of this essay is to analyze the strategy of channelization in river systems in order to reduce flooding, and other purposes such as navigation. Also the importance of channel forms and the value of the systems approach are evaluated within this essay when considering the pros and cons of restoration activities and whether these schemes are beneficial to the environment. Overall this essay will look at the environmental degradation caused by channelization and determine whether channelization is the most beneficial strategy in reducing flooding or are there alternatives that lead to less environmental degradation. Channel forms: Channel forms help humans comprehend the behaviour of rivers. This is vital as one can foresee how rivers may be affected by various changes and restoration schemes. Thus, the ability to protect and restore river health is enhanced. Channel forms are regulated by convoluted interactions between profuse environmental variables. This is why the systems approach is a useful method when analysing channel systems, as it does not just look at one variable but all of the linked variables involved. Even with this system shaping channel forms is highly dependent on geology; directly and indirectly over a prolonged period. Human interactions have also had an impact on the change of channel form for instance channelization (Water and river commissions, 2002). Channelization and its implementation: Human interaction with river systems is both the reason why channelization was implemented for example as a result of flooding and the cause of environmental degradation of the river systems. Humans interact with river systems in many ways and have impacted flooding of river channels due to increased population pressure, which has put a growing demand on water supply systems leading to environmental degradation. Deforestation around river channels have also increased flooding as deforestation impacts the interaction between precipitation and the drainage basin response. Due to increased awareness of river behaviour and dynamics new strategies were implemented and overtime humans modernised engineering structures and built broad structures to control and regulate river flows, such as channelization. Channelization according to Brookes is a type of â€Å"river engineering whereby the natural river channels are modified to control flooding, drain wetlands, and improve river channels for navigation, control stream-bank erosion and to improve river alignment† (Brookes, 1988). River channelization has seven types of alterations (Gregory, 2006). These are â€Å"(1) re-sectioning and realignment, (2) Dredging, (3) Snagging and clearing, (4) Levees or artificial embankments, (5) Bank protection, (6) Bed protection and (7) River training† (Charlton, 2008). An example where these alterations have been implemented is during the channelization of the River Raba in Carpathians, Poland (Wyzga, 1993). However, these engineering structures tend to have a large impact on river and the natural ecology and hydrology of the channel system. For years humans have interacted with channels and altered the natural geology of the systems and thus have lead to severe impacts on the â€Å"physical, chemical and ecological condition of the channel systems† (Brookes, 1988). The impacts of channelization usually involve the alteration of river hydraulics and the decrease of instream habitat. Other impacts discovered as a result of these alterations include increased water temp, erosion, elimination of bankside habitat. These impacts can cause severe environmental degradation (Gregory, 2006). Environmental degradation: The deterioration of systems within the environment by either natural or human influence is considered environmental degradation and as channelization alters the natural river system it leads to extreme environmental degradation. Impacts on the environment associated with human interference are usually quite complex and are mostly long term effects. Nevertheless, few studies have been conducted on the long term effects of channelization (Brooker, 1985). Swales (1982a) however inspected several environmental effects on channel engineering systems, in particular the impact on stream habitat and discovered that channelization has a major impact on instream and bankside habitat (Brooker, 1985), as well as the hydrology, aspects of flow and suspended sediment within river systems (Wilcock, 1991). Effects of channelization can also occur downstream in a channel system which broadens the extent of ecological disturbance (Brooker, 1985). The increase of flow velocity and its carrying capacity as a result of shortening and straightening the channels has an immediate ecological effect on instream habitat as many ecosystems need particular conditions in terms water velocity (Gore, 1978). This destruction within the channel systems leads to erosion of bankside vegetation which increases sediment loads in the channel (Keller, 1976; Karr and Schlosser, 1978). Sediment loads in channel systems are usually low (Lewin, 1981), however, in channelized rivers se the loads are increased as bed/channel wall sediments are scraped up. This release of sediment has major effects on the ecology of the river (Wilcock, 1991) as removal of bankside vegetation leads to temp changes and in results affects the ecosystem as well as reducing energy flow (Brooker, 1985). In some cases channel slopes have also seen as increase whilst channel roughness is seen to reduce. An example of environmental degradation was shown in Gregory (2006) which involved the Channelization of the Blackwater River in Johnson County, Missouri. This channel was shortened in 1910 in order to reduce flooding by deepening and widening the channel by â€Å"up to four times its original size† (Emerson, 1971). This subsequent lowering and increase of channel width lead to increased erosion in the river system, also bridge repairs have had to be carried out and there has been a severe loss of farmland. â€Å"Downstream reduction in channel capacity has caused suspended sediment in turn increased flooding rather than reducing it due to termination of dredging† (Emerson, 1971). Alternatives: Channelization was initially implemented to straighten and shorten river channels to reduce flooding. It was also implemented to decrease flow velocity and prevent flooding, however, this lead to environmental degradation which resulted in the depletion of instream habitats and depleted drainage function. As channelization has had problems leading to environmental degradation, alternative channel schemes have been developed to enhance water quality functions whilst preserving drainage function and lessening environmental degradation (Evans, Bass, Burchell, Hinson, Johnson and Doxey, 2007). There are many alternatives to channelization that environmentalists could install; one such method is stream renovation which has been implemented on â€Å"streams in Charlotte, North Carolina† (Nunnally, 1978). Unlike channelization stream restoration aims to decrease the risk of flooding and drainage problems â€Å"by employing channel design guidelines that do not destroy the hydraulic and morphologic equilibria that natural streams possess† (Nunnally, 1978). Minimal straightening which promotes bank stability by leaving trees is employed in this scheme. Also the reduction of channel reshaping and the use of bank stabilization techniques are used here to reduce flooding and control erosion as well as sedimentation problems (Nunnally, 1879). Other alternatives involve the formation of in-stream wetlands and â€Å"lowering of the floodplain to reconnect the channel with the floodplain, redesign of channels using natural channel design principles, and establishment of conservation easements† (Evans, Bass, Burchell, Hinson, Johnson and Doxey, 2007). Restoration: Recognising channel forms and understanding how they behave and change is crucial for managing and protecting channel systems, especially for river restoration activities. Due to severe environmental degradation restoration schemes have been implemented. Though, it is not known whether these schemes are beneficial. Restoration activities generally improve bank stabilization (Florsheim, Mount, and Chin, 2008) and have positively increased depth and flow variety and velocity as well as increasing habitat diversity in channel systems (Pretty, Harrison, Shepherd, Smith, Hildrew and Hey, 2003). Other benefits include the protection of infrastructure around river channels, and in relation to instream habitat it guarantees overall ecological system. Restoration schemes allow the natural process in the channel systems to redevelop and surrounding landscapes to restore. Restoration schemes are constructive in counteracting the environmental degradation caused by channelization; yet there are a few cons. For instance natural processes may not necessarily be enhanced. Also a clear understanding of channel process is important in implementing these schemes, as they may sacrifice natural conditions in order to protect infrastructure. Restoration schemes are extremely expensive and very complicated therefore it is generally impossible to remove all human influences meaning restoration may not lead to higher biological diversity. Channelization is commonly used to prevent flooding of channel systems; however, it has been found that the adverse impacts created by channelization projects far outweigh the benefits they intend to create. It is for this reason that alternative strategies are being developed so that in the long run creates less environmental degradation. The use of the systems approach is important as the use of all variables regulated by channel forms is necessary in making the new strategies environmentally acceptable. Also increased knowledge of channel systems and its dynamics have helped better restoration schemes and thus leading to the recuperation of many already channelized systems.

The Socio Cultural Forces Economics Essay

The Socio Cultural Forces Economics Essay As discussed earlier also, the Al Ain Diary is planning to expand its business overseas market of Germany by launching its new camel product within the foreign country. Thus, the launching of new products in the new market gave rise to development of the new international strategy which requires the external environmental analysis of the Germany market in comparison to the UAE market. The business environmental analysis of the Germany is done as under: Socio-Cultural Forces: Socio cultural forces have great impact over the international business as it is directly related with the external and the internal customers of the country. Germany is considered as the most popular nation of Europe and contributes a lot to the national culture of Europe, such as the German culture. In order to establish the international business within Germany, it is very essential for Al Ain to induce the cultural and social factor of the country within the international strategy. The key cultural and social features of the country are as follows: Ordnung: German living and the working style is regulated by the structures such as with the help of laws, rules, procedures linked with the economic, political and social factors. Thus, the German business is regulated by the strict and prescribed rules and regulations of having low degree of flexibility and spontaneity. Focussed Facts: The decision making and the problem solving process are based on the objective facts within the country. So, such processes are governed by logical analysis of information rather than perception. Focussed Tasks: Germans believe that they have to achieve the task that is in their hands rather than future tasks. They have well defined structure of their tasks and the interpersonal relationship plays a secondary role in the business. Communication Style: Germans follow direct and confrontational communication style. Therefore, the business discussions are followed by the open criticism and the project problems are not taken as the personal issues. Punctuality is the essential and vital part of doing business in Germany. German Business culture is well defined and strictly followed on the structures and hierarchy. There is a clear description of roles and responsibilities for each and every person. Personal life is never mixed in the professional life by the Germans. Business relationships are often made for mutual advantage. The level of formality is even maintained within the business and the colleagues. The first name is only taken by the closed ones, however within the professional environment, the last names and appropriate titles are used. Business meetings are totally formal procedures and greeting is initiated with the firm and brief handshake. Body language and eye contact plays a very vital role in business communications. The official language of the country is German and most of the Germans follow Christianity (Gorrill, 2007). Hofstedeà ¢Ã¢â€š ¬Ã¢â€ž ¢s Cultural dimensions of Germany in comparison to UAE: Power Distance: The power distance in Germany is highly decentralised and supported by the strong middle class. The score for the power distance is 35, which shows that the co-determination rights of the country is comparatively extensive and requires management. While in the UAE, power distance is highly centralised and governed by the upper middle class. Individualism: German society is truly individualistic and controlled by the short families with parent child relationship. While the UAE society is mostly grabbed by the expatriates and the migrants from the different countries. Masculanity/ Feminity: Germany has a very high score in this factor and performance is highly valued in the country with transparency. The people in Germany have high standard of living and managers are decisive and assertive. While in the UAE, the society strongly follows the male dominance and women are restricted to work outside. The high level of standards is also maintained in the UAE society. Uncertainty Avoidance: Germany is among the uncertainty avoidant country and the UAE also falls in the same category. To avoid uncertainty, they plan everything wisely and try to set rules, laws and regulations to rely on. The above analysis depicts that there is a great cultural differences between the culture of UAE and Germany and thus for the expansion of Al Ain within Germany all the cultural factors must be kept in mind as it directly related the internal and external customers of the company. Operation in Germany comprises of local employees following the German culture so the whole HRM should be designed within the cultural paradigms of Germany. The Major area of focus is the customers of Germany as they also believe in German culture and thus much concentration should be given on the cultural areas as these factors directly affects the loyalty of the customers. Economic and Socio-Economic Forces: The economy of UAE have witnessed a significant rise in the past decade, wherein they have been considered with an adequate economic stability and viable growth rates which are inclusive by their increased GDP and Fiscal Balance. On the other hand, the economic growth statistics of the UAE which was reported to be 2.9% owing to the impact of depreciated oil prices evident on a global scale will subject to vulnerability. Germanyà ¢Ã¢â€š ¬Ã¢â€ž ¢s economic freedom score is 71.0 which make the German economy as the 26th freest economy in the index of 2012. German economy has ranked as the 12th among the 43 countries of the European Region. The foundation behind such long term competitiveness and dynamic growth is based on the high quality legal regime of the country and strongest rule of the law. Regulatory efficiency of the market and the open market polices benefits Germany to contribute within the global economic business and market. The economy has been emerged from the effects of the global economic downturn which has negatively affected the financial and economic management. The budget deficit of the country has been pushed over the 3 % of the GDP (Germany). The population of Germany 81.726 million which makes it 16th most populated country. 13.7 % of the total population accounts for the people of age group 0-14 while 66.1 % of the total population accounts for the age group of 15-64 and 65 and above age group accounts for 20.3 % of the total population. The sex ratio within the economy is 0.97 Male/Female. The local German citizens within the total population accounts for 73.63 %, while German citizens with immigrant background accounts for 10 % of the total population and 8 % of the total population are foreigners without German citizenship. The literacy level within the country is 90 % and over 10 % of the German youngsters are functionally illiterate. The government of the country is democratic, parliamentary republic and federal republic and the GDP accounts for 3.571 trillion USD. The economic analysis depicts that there is a great scope for the business in the German economy as the economic structure of country strongly supports the business environment. The expansion of Al Ain in the German market i therefore beneficial for both the countries in economic respect. Legal Forces: The Federal government of the Germany is recognized as the constitutional state that ensures the stability within the laws and the protection of liberty and equality within the country. Basic law acts as the standard for the democratic constitutional state. The federal constitutional court monitors the management and maintenance of the rights and the preservation of the justice within the country. The administration of the country is being divided into five branches namely: Ordinary. Labour. Administrative. Social Financial Courts. Generally there are three tiers that re-analyse the decision of the court. 20000 independent judges pass the justice who are bounded by law and passes the judgement. There are 5000 public prosecutors and 15000 lawyers in the country. The internationally stabilised and recognized legal environment is able to attract the foreign countries to trade and operate the entrepreneurial activities within the country (The Legal System). The above analysis depicts that the strong and structural legal system is being followed in the German constitution and thus the expansion of Al Ain Group within German market should be done with all the standard legal norms and regulations. Political Forces: The Emirate of Abu Dhabi has been developed as an industrially fertile hub which has attracted various multinational corporations, diplomatic relations and investments made by the government in the various initiatives. The impact of Emiratisation policy may be seen in the Labor law which requires private sector organizations to employ 20% of their work force from the domestic population compulsorily. This means that any private sector organization which fails to obey to the recruitment regulations would be banned from undertaking any further recruitment of additional foreign employees in their organization. The Germany is the unified country which does not represents and depends for the decisions on two different type of government i.e. state and central government and thus the political stability of the government is very high. The Basic Law initiates the Supremacy of political parties in the government system which results to the development of all the government policies through the organizational structure of political parties that ultimately adds stability to the political environment. The trade restrictions within the country of Germany are restricted by the norms of WTO and EU Community. WTO trying to ensure that minimal technical or the non-tariff barriers are faced by the traders to smoothen the trade and economy. The above analysis depicts that the political environment of Germany is quite stable which supports the expansion of Al Ain through fulfilling all the political norms. Labour Forces: As per the data revealed by the labour ministry of UAE in the year 2010, the number of expatriate workers in the UAE symbolizing the stamina of the oil-rich economy is 3.8 million. A hasty financial and economic boom in the region of Gulf led to more than replication of the number of expatriate workers from 1.8 million in the year 2001 to four million in the climax year of 2007 prior to it slumped to 3.8 million by 2010 due to economic tightening in the stir of the global economic meltdown of 2009. (3.8 million foreign workers in the UAE, labor minister says, 2011). There are lot many issues due to the expatriate workers in the UAE. The first and foremost issue is that the immigrant or expatriate workforce may act as barrier and challenge the country by endorsing their own governments welfare or that of a planned crime within the alliance or federation. Secondly the expatriate employees frequently require a higher rate of payment for rendering their services and practically they tran sfer all the revenues and income to their countries rather than expanding or investing that amount in UAE. This affects the economy of UAE very badly in terms of revenue deficit, fiscal deficit, balance of payment, gross domestic product and gross national product etc. Last but not the least, immigrants or expatriate workforce exaggerate pre existing segments of society within the country since they learn to be the chief workers in non-oil industrial sector of the UAE, while the local Emiratis of UAE usually prefer to get employed for the government sector. (United Arab Emirates Overview of economy). The domination of expatriates over the UAE nationals is projected to have developed in around 8.2 million with UAE local citizens making only 11.47%. The UAE attracts personnel from across the globe, primarily from the Asian subcontinent and the Arab region. The key issues pertaining to the expatriate workers in the UAE are the Remittance of local revenue to the other countries. The do minance of expatriates in the employment sector affects the career and growth opportunities of the local Emiratis people a lot. (Suter, 2005) The employee employer relationship within the country of Germany is strongly being regulated by strong and tightly controlled legal processes. Various amendments in the law have resulted to the Germany as the system focussing on the industrial democracy and harmony. But still there are some problems in the system which results to economic difficulties. The above analysis depicts that strong labour laws and regulations must be followed by Al Ain to expand its operations in the country of Germany.

Learning Disabilities Essay -- A Level Essays

Learning Disabilities Eleven-year-old Anna is outgoing and bright. She attempts to work hard, but her progress in school has always been slow. She is a year behind her peers, particularly in her English class and her teachers have slowly begun to reduce their expectations of her. Her parents are worried because her confidence for learning is decreasing, and there is less motivation for her to do homework and class assignments. A psychologist found that her intelligence is in the gifted range, but she has difficulty in making out written symbols. It is easy to make the assumption that Anna seems merely as a child who is slow intellectually, but when taking a closer look, it shows that she is just as intelligent but happens to suffer from a learning disorder. Students with learning disorders have brain impairments that make it difficult for them to acquire skills and knowledge accurately and fast enough to keep pace with average academic progress (Encarta, 2003, p.1). The purpose of this research paper is t o investigate the causes of learning disorders, various types of disabilities, their causes, and finally how in today’s modern era assistive technology is able to reduce the frustration of students and increase their level of performance. Defining Learning Disorders/Disabilities The IDEA (The Health & Fitness Association) 1997 Definition of Learning Disabilities is: â€Å"A disorder in one or more of the basic psychological processes involved in understanding or using language, spoken or written, that may manifest itself in imperfect ability to listen, think, speak, read, write spell, or to do mathematical calculations. The term includes such conditions as perceptual handicaps, brain injury, minimal brain dysfunction, d... ...p://www.ldanatl.org/aboutld/teachers/social_emotional/socialacceptance.asp Addresses the fact that health professionals, special educators, and parents must make real efforts to promote the social acceptance of children suffering with learning disabilities. Crossen, C. (1997). Studies suggest phonics help children learning to read. Wall Street Journal. Retrieved April 16, 2005 from http://barrier-free.arch.gatech.edu/Articles/wsj_learning.html Talks about how the earlier reading disabilities are detected the better. With proper encouragement and tools students will have more motivation for reading throughout their lives. Sack, J.L. (1999). Schools advised to catch, treat disabilities as early as possible. Education Week, 18, 7. Received April 16, 2005 from EBSO-host. Emphasizes importance of treating a learning disability as early as possible.

Gypsies Essay -- essays research papers

Gypsies: The last nomads, the free-spirited, passionate bohemians with their mysterious rituals and powers. This romanticism is nearly as unfair as the fear and hate distracting us from recognizing the hardships and persecution these â€Å"carefree† people have undergone for centuries. In Europe, the Roma (as they wish to be call) have been cast out, burned at the stake, sterilized, ghettoized, forced to give up their traditional way of life, caught in other people’s wars, and more than half a million were slaughtered in the Holocaust. Roma misfortune can be attributed to the vicious cycle of poverty that paralyzes so many minorities situated in an unforgiving society. This cycle of poverty began and still exists today due to the discrimination that the Roma face because of, among other things, their skin color and unorthodox ways of making a living. Through out history the largest complaint about the Roma, however, has been their wandering lifestyle. What is interesting though, is that the Rom are no longer nomads. The few that do move from place to place are migrant and are forced across boarders by the very authorities that complain about their way of life. While some sources speculate that gypsies originally migrated from Egypt, it is usually agreed upon by most scholars that the gypsies came from India to Eastern Europe about a thousand years ago. The true reason for this move remains a mystery but many theories exist that they my have moved as a result of changes in the government, the economic situation or perhaps they have always been wonderers. Whatever the reason for their move, we will probably never know the truth. One gypsy lady learned during her childhood that â€Å"We were being punished for stealing the fourth nail that was needed in Christ’s crucifixion. That’s why his feet are crossed and nailed together. We were forced into wondering for taking this nail.† Whether gypsies were responsible for Christ’s missing nail one thing is certain: the gypsy’s dark Indian skin has made them the subject of ridicule for centuries; for it has been a European tradition to detest the non-ayrean. The Persian poet Firdausi is said to have written, â€Å"No washing ever whitens the black gypsy.† Even within religion the gypsies are not free from contempt. In his writings a German monk described gypsies as having â€Å"the most ugly faces, black like those of Tartars.† A... ... in the making,† most of the Roma feel that to exist in a ghetto is preferable to expulsion. As with non-European citizens in Italy, Roma have been given the label of extraexcommunitari, meaning they come from outside of the European Union, although most Roma have lived within the Union all their lives. The reason for this title is because the government still considers them nomadic. â€Å"Not even my grandfather was part of the traveling culture,† say Luigi Lusi a Rom. â€Å"It is obvious that we no longer harness up the horse and move from place to place daily,† he continued. Forcing gypsies to integrate has always failed because it is impossible to force a group of people who have spent their entire lives on the fringes of society to adapt to new educational and social environments, especially when they are very poor. Aside from their dark skin, the gypsy life that many Europeans find distasteful stems almost completely from the poverty that they have forced the gypsies into. The government will never receive their desired results from education programs and housing projects unless the deeply rooted discrimination against the Roma stops—something that will be very difficult to undo.

Leadership That Gets Results Essay

The article Leadership That Gets Results by Daniel Goleman provided an interesting view on leadership in the workplace. In a recent study by consulting firm Hay/McBer, data was gathered from a random sample of 3,871 executives from a database consisting of 20,000 executives, taking the mystery out of effective leadership. The study revealed that effective leadership is composed of six distinct styles – all draw from components of emotional intelligence. The six style of effective leadership are: Coercive, Authoritative, Affiliative, Democratic, Pacesetting, and Coaching. Coercive demands immediate compliance; it is a â€Å"Do what I tell you† style. Authoritative mobilizes people towards a vision, a â€Å"Come with me† style. Affiliative creates harmony and builds emotional bonds; it a â€Å"People come first† style. Democratic forges consensus through participation: â€Å"What does the group think?† Pacesetting sets high standards for performance, as in â€Å"Do as I do, now.† Finally, Coaching develops people for the future; it is â€Å"Try this† style. The study found an effective leader uses each one of these styles at the right time for the right reason. An example of this right time – right reason ideology is most often seen in golf. A good golfer knows how and when to choose the right club for the hole. Additionally, the study showed that a combination of styles could be used in effective leadership. However, the study did confirm there are a few styles that are more effective than others. Authoritative ranked the highest among the six leadership styles. Affiliative was ranked second followed by Democratic ranking third. In contrast, Coercive and Pacesetting were ranked the lowest and produced a negative effect when not used in the right context. In summary, the study did take the mystery out of effective leadership. It concluded that there are six leadership styles and each one can be used individually or in a combination to achieve maximum results. Throughout the article I was able to determine my personal style leans towards Affiliative; however, I would like explore the vision of the Authoritative and collectiveness of the Democratic leadership styles.