Book Report on Farewell to Manzanar Essay Example for Free

Book Report on Farewell to Manzanar Essay In the early year of 1942, the families of Japanese people are being ordered to start a move to Manzanar, California; the Wakatsuki family is one of them. Many Japanese accept the move because they are afraid of Caucasian aggression, but some simply see it as an adventure. Families have to put on identification number tags on their collars. Riding on buses to Manzanar, Jeanne falls asleep on the bus, nearly half of which is filled with her relatives, and wakes up to the â€Å"setting sun and the yellow, billowing dust of Owens Valley. (pg 19) As they enter the camp, the new arrivals stare silently at the families already waiting in the wind and sand. Upon arriving, just in time for dinner, â€Å"the mess halls weren’t completed yet† (pg 19) seeing a line formed around the soon to be finished building blocking a good part of the wind. Only seeing tents and barracks, half built buildings that were unending. There were cracks in the floors, only one light bulb per room, gaps in the walls, an oil stove for heat, and not very much space at all. â€Å"We were assigned two of these for the twelve people in our family group. † (pg. 1) With all the confined spacing for the families, you can tell there was a lot of tension between everyone. The food they had made for us to eat was not in our culture at all. â€Å"The Caucasian servers were thinking that the fruit poured over rice would make a good desert. Among the Japanese, of course, rice is never eaten with sweet foods, only with salty or savory foods. † (pg. 20) On top of the food being served wrong, their latrines were not very useable. â€Å"The smell of it spoiled what little appetite we had. † (pg. 31) â€Å"My mother was a very modest person, and this was going to be agony for her, sitting down in public, among strangers.   (pg. 32). What some of the other women did was drag in a big cardboard carton and put up as walls so no one could see. The reservoir shack was just outside of camp. â€Å"My brother-in-law Kaz was foreman of a reservoir maintenance detail, the only crew permitted to work or to leave the camp limits the night of the riot. † (pg. 78) The guys that were on this detail slept on cots in a shack. When they turned off the lights in the shack at night and everyone was laying down it was so dark that you couldn’t see anyone or anything in the shack.

Humanity Is The Only Religion Theology Religion Essay

Humanity Is The Only Religion Theology Religion Essay Humanity is an important part of life which tells that to help others, try to understand other and realize the people problems with our own eyes and try to help them For showing humanity you dont need to be a rich person, even a poor person can sow humanity by helping someone or sharing his or her food, etc. When you show humanity you have a feel click or a pinch from your inner soul which you cannot get from something else. Every religion tells us about humanity, peace and love that is why no religion is higher than humanity. I should like to help everyone if possible, Muslims, Hindus, Christines, Jew, gentile, black men, white. We all want to help one another; human beings are like that. We all want to live by each others happiness, not by each others misery. We dont want to hate and despise one another. In this world there is room for everyone and the earth is rich and can provide for everyone. Charlie Chaplin (http://www.quotes.net/mquote/38952) Yeah today I will tell stories of three people who are the biggest example of humanity and they are human lover. Firstly just imagine yourself I fill this class with garbage how will you feel like you will not stay in this but there is one who go in that garbage search there and you what he found. He found a dead body of child he took that body washed it and buried that body and from that day he used to search in garbage with his wife this man is no other than Mr. Abdul Sattar Edhi the lover of humanity . He is the founder and head of the Edhi Foundation, a non-profit social welfare organization in Pakistan. He is the man who serve is whole life serving for humanity without any selfishness. He has bathed and buried over a thousand unclaimed bodies in a time when selfishness and greed are at their peak and nobody seems to know the meaning of words like altruism and selflessness. His achievements in the field of charity are bound to make one think that his name is synonymous to nobility and humanity. And today he is running Pakistan biggest network of ambulances and shelter. Moreover his charity does not discriminate based on religion, race or gender. For him, religion is human rights. Edhi has spent many sleepless nights working and serving for humanity whether it is to bury unclaimed bodies or feeding any poor. Besides it he lives a simple life living in small house many of times he used to sleep on the concrete or on the small batch outside his shop his qualities makes him the man of simplicity and human being lover. As Edhi Said: No religion is higher than Humanity Secondly I will talk tell you about a person who is basically a Pakistani but he is living in Canada he had son named as Ali and his son was 18 years old this man lost his son in accident. The accident was like that his son was working part time as pizza delivery boy when he was on the way for the delivery one black guy who was also of his age come before him and said him money but Ali was honest with his job he refuse that and that guy shoot him that time. When Alis father came to know about his sons death he was in shock and after few days police caught the person who killed his son and called Alis father to come when he reach there he came to know that boy who killed his son is 18 years old he is orphan u people know at that time what he said u guys cant believe it Alis father said I dont want to do any case on this boy I want to adopt this boy and want to take all responsibilities of this boy because today I lost my son I dont want tomorrow somebody else lose his 18 years old son . Just for a minute place yourself on the place of Alis father what will be you feeling your 18 years old son shoot dead. Alis father this act of humanity raise whole mankind and today he has 4 orphanages in Canada where he take responsibility of around 800 children. Thirdly the person I am talking about is the well-known personality the person who give us world cup in 1992 he is great leader and humanity lover he is Imran Khan. Most notable among his humanitarian efforts has been the establishment of Shaukat Khanum Memorial Cancer Hospital and Research Centre, named after his late mother. It is Pakistans first and only cancer hospital that provides 75% free health care, and was built on public donations. Imran is now building a second hospital in Karachi, based on the successful Lahore model. In 1994, he inaugurated Namal College, a technical college which is now an associated college of University of Bradford. (http://www.imrankhanfoundation.org/about-ikf/the-board/) Although these people do things for humanity on larger scale we should come on ourselves what we have do for humanity every day we spend our time hanging around with friends going outside for parties have we ever feed a poor person on the road have we ever realize how poor people live their lives no we havent because we never realize that for what we are in this world we never realize our duties towards humanity. We should must realize for what we are in this world because every religion teach us humanity and one who serve humanity is the happiest man on the globe real happiness is your inner satisfaction which you can get by serving humanity what so ever how much you are rich you cant buy inner happiness. In last I would only say to any religion you belong be a human first be a human lover strive for humanity as every religion teach us humanity and share your life with others as life is all about living for others and serving humanity that is why no religion is higher than Humanity so start serving for humanity from today by doing a small of act of kind what gives you inner happiness and satisfactions Thank you

Leadership and Management in Changing Context of Healthcare

Leadership and Management in Changing Context of Healthcare INTRODUCTION The National Health Service (NHS) Trusts face a range of challenges arising from a national approach to the modernisation of services as laid out in the NHS Plan. (DOH, 2000) The NHS Plan recognises that the NHS is capable of providing more effective and accessible care by the rationalisation of service delivery through merged organisations. Mergers illustrate the focus on organisational restructuring as the key lever for change as indicated by the ninety nine health care provider mergers in England between 1996 and 2001. (Fulop, Protsopsaltis, King, Allen, Hutchings, and Normand, 2004) However, in many cases, mergers have unexpected consequences and drawbacks including problems in integrating staff, services, systems and working practices, clashing organisational cultures and poor leadership capacity. This essay considers leadership and management in the context of a problematic merger of services from two hospitals onto one site. The essay focuses on the change management process within one department to highlight key leadership, team, and cultural issues that negatively affected the newly merged department. The microcosm of the department mirrors similar occurrences across the two merged hospitals. The essay concludes with a comment on the organisational consequences if a macro intervention is not implemented. Confidentiality has been preserved by anonymising the identity of the hospitals and departments concerned. BACKGROUND This essay explores a recent change process involving the creation of a psychiatric liaison team based in a NHS hospital Accident and Emergency Department. (A E) in January 2004. The change occurred because of the merger of two hospitals that resulted in a number of structural changes, including the amalgamation of a traditionally split emergency service into a one site A E department. The liaison team replaced the existing deliberate self-harm service which had operated in the one hospital for two decades. The new liaison team consisted of eight newly appointed G-grade mental health nurses, a team leader, and a consultant psychiatrist who had both previously worked in the deliberate self-harm service. The hours of operation initially were 08:00 to 22:00 and there were two nurses on duty on early and late shifts. During a four week induction period, the team participated in team building and training exercises and developed into a cohesive, effective group. The team created clear key performance indicators specific to the psychiatric liaison team, established an action plan to achieve the set objectives, and planned to carry out six-monthly reviews. The team developed a shared vision to provide high quality, person centred care to the A E department without breaching government’s four hour targets (DOH, 2001). The team leader’s leadership style was democratic, and she fostered collaboration and involvement within the team (Walton, 1999). The team members considered her an expert in the field, and respected her for it. In July 2004, the service manager attended a monthly team meeting. At the meeting she was informed that a major change was expected to the hours of operation. The service would be extended to a 24-hour service starting in September 2004. In order for the liaison team to cover a 24-hour roster there was initially be a reduction in the number of nurses on duty, however, more staff would be recruited if necessary after a six month service review. An exact date for the review was not given. The change had not been communicated as part of the strategy for the greater merger. The Department of Health (DOH) modernisation agenda for the NHS, (DOH, 2002) sets out to modernise services in the NHS, and introduced a three star rating scale against which each NHS Trust’s performance is compared against benchmark standards. Funding in turn is dependant on the star rating achieved. One such standard relates to delays in A E departments, and stipulates that mental health patients should have 24 hour access to services, and that patients should be assessed and treated within four hours of arrival. (DOH, 2001) The underlying rationale for the change was therefore that the psychiatric liaison service had to provide a 24-hour service in order for the hospital to comply with the benchmark. Management of the merged hospitals did not consider staff shortages or how the four hour target might affect the quality of service provision, particularly when staff are under constant pressure to discharge patients before they exceed the benchmark standard. (RCP, 2004) In th e service described above, reaching the necessary 98 % four hour target proved impossible, because the staff numbers did not match the requirements of the service. The service was therefore to be expanded without additional staff, implying not only changes in hours and shifts, but also changes in work patterns. The team members reacted negatively to how the change process was introduced. Concerns were expressed about the reduction in staff numbers and questions were raised as to how the staff would be able to cope. The sense of security and continuity were put at risk. (Walton, 1999) The service manager was not available to address the concerns due to an increased scope of responsibility because of the merger that was beyond her normal remit. Lack of two way communication between the manager and the employees meant that the manager lost a valuable opportunity to resolve the negative reactions, and laid the foundation for resistance to change (Johnson, Scholes, and Whittington, 2005). Within a month of the announcement, the team leader had resigned. A new team leader was appointed and was tasked to lead the team through the change. The team started gradually becoming fragmented, staff sickness rates soared, and morale plummeted. The situation reached a crisis point by December 2005, by which time two more staff members had resigned. The majority of staff had taken sick leave, and the psychiatric liaison service was left uncovered for several days. A number of mental health patients in A E waited for hours, sometimes all night, to be seen by a mental health professional. The A E department laid a formal complaint about the liaison team’s performance. In March 2005, following discussion with a union representative, the team took out a grievance against the team leader. The key issues of concern were the way the change process had been introduced, lack of two-way communication and the team leader’s unsuitable task-oriented, directive leadership style. The team leader was suspended and the Trust commenced a lengthy investigation into the change process. The investigation continues to date. ANALYSIS Cameron and Green (2004) suggest McKinsey’s 7S model as a diagnostic tool to identify interconnected and related aspects of organisational change. The model is problem rather than solution focussed, and hence useful for pointing out retrospectively why change did not work. The weakness of the model is that it does not explicit identify drivers from the external environment and accordingly key forces have been described by way of explanation. According to Burke and Litwin (1992), the external environment is any outside condition or situation that influences the performance of the organisation. Systems, Staff and Strategy Systems refer to standardised policies and mechanisms that facilitate work, primarily manifested in the organisations reward systems, management information systems, and in such control systems as performance appraisal, goal and budget development, and human resource allocation. (Burke and Litwin, 1992) Systems are the mechanisms through which strategy is achieved. Strategy is how the organisation intends to achieve a purpose over an extended time scale. Johnson, Scholes, and Whittington (2005) link it directly to environment (industry structure), organisational structure, and corporate culture. Leaders are the executives and managers providing overall organisational direction and serving as behavioural role models for all employees. (Burke and Litwin, 1992) The systems that the service had in place to support the staff prior to the merger had functioned efficiently. The psychiatric liaison team had monthly team meetings, weekly ward rounds and supervision, and twice daily handovers to ensure high quality service. Teams in this context mean â€Å"a group who share a common health goal and common objectives, determined by community needs, to the achievement of which each member of the team contributes, in accordance with his or her competencies and skill and in co-ordination with the functions of others.† (WHO, 1984) Under the previous team leader’s management, the team had achieved a mature and productive level of performance that fell within Tuckman’s model of team development of a performing team. (Mullins, 2002) The leader demonstrated characteristics of an effective team leader (e.g. good communication) and ensured that the team members’ views were passed on to the management. (Marquis and Huston, 2003) The team also developed team specific performance indicators to fit the Trust’s strategy, such as the goal to provide high quality care within four hours of service users presenting to the A E department. However, the new management of the merged hospitals did not take into account that the reduction in staff numbers would make it difficult for staff to find time to attend ward rounds and to supervise care. Lack of supervision had a negative impact on the quality of care provided, and staff shortages meant that the team did not reach the four-hour targets in A E department. The change process indicated a lack of sincere stakeholder consultation which would have alleviated the crisis in the department. (Iles and Sutherland, 2001) Structure and Style Structure is the arrangement of functions and people into specific areas and levels of responsibility, decision-making authority, communication, and relationships to assure effective implementation of the organisations mission and strategy. (Burke and Litwin, 1992) The NHS Leadership Qualities Framework (DOH, 2002, p34) suggests â€Å"leading change through people† with â€Å"effective and strategic influencing† is essential in a merger environment. This is supported by Johnson, Scholes and Whittington (2005) who suggest that strategic, transformational leadership is a key element within an organisation staffed by professionals and that a collaborative style is required to achieve transformational, lasting change. However, the new team leader’s leadership style was autocratic and the team members were no longer consulted about matters concerning it, which was inappropriate in team nursing approach associated with collaborative patient centric care. Marquis and Huston (2003) suggest that a democratic leadership style works best with a mature experienced team with shared responsibility and accountability. The change in leadership style meant that the team felt disempowered and uninvolved in decision making which did not allow ownership of the change process to emerge. Furthermore, the flow of information to the team slowed down and the team’s concerns about the change did not reach top management implying that communication channels in the new organisational structure were not functioning efficiently. Management style equally affects culture. Johnson, Scholes and Whittington (2005) state that culture is the â€Å"taken for granted† assumptions that are accepted by an organisation or team. These work routines are not explicit, but are essential for effective performance. Ignoring these as the new team leader did, reduces motivation and performance, and stiffens resistance to change. Skills Skills are the distinctive capabilities of key people. (Cameron and Green, 2003) The nature of the team membership implied a range of key skills interdependent on the other for effective performance. A problem area in the skills portfolio was information technology skills. The Trust managing the merged hospitals had introduced a Trust wide electronic patient record system in accordance with NHS requirements. (DOH, 2003) This was implemented simultaneously with the decision to extend the working hours. The change aimed to improve the service user experience by allowing staff a 24-hour access to service user’s care and crisis plans. (DOH, 2003) The staff shortage meant that team members did not receive appropriate training on the system and the use of the electronic patient record system became a source of frustration and confusion. Lack of computer skills contributed to staff’s frustration and negative attitudes with the change process. Superordinate goals Superordinate goals are the longer term vision of the organisation and the shared values and guiding principles that that shape the future of the organisation and motivation achievement of strategy. (Cameron and Green, 2003) The team’s superordinate goals were initially created during the four-week team building period and aligned with those of the larger organisation. The team’s vision was to provide high quality, service user centred care. The team also considered change as a natural part of organisational development. However, the team became increasingly resistant to change when it felt that the organisation did not really care about its employees, their concerns, and the ultimate reason for the organisation’s purpose, being the patient. DISCUSSION OF CHANGE PROCESS Change management is art of influencing people and organisations in a desired direction to achieve an agreed future state to the benefit of that organisation and its stakeholders. (Cameron and Green, 2003) A number of models can be used to model a change management process. A popular model is Kurt Lewin’s forcefield analysis. A forcefield analysis is a useful tool to understand the driving and resisting forces in a change situation as a basis for change management. This technique identifies forces that might work for the change process, and forces that are against the change. Lewin’s model suggests that once these conflicting forces are identified, it becomes easier to build on forces that work for the change and reduce forces that are against the change (Cameron and Green, 2003). The difficulty is the assessment of strength or duration of a force, partlicularly when the human dimension is considered. The key resisting force in the change process was a lack of staff and poor leadership. The change process under discussion was largely motivated by external factors. However, due to poor project planning, Trust management failed to consider the internal factors that had a major impact on the change. In particular, the management failed to involve the necessary stakeholders at a local level to increase ownership of the change thus failed to consider the human dimension (Walton, 1999 and DOH, 2004). The new team leader’s autocratic leadership style did not fit the requirements of the task, or the culture of the team and thus sowed the seeds of resistance to change. (Hogg and Vaughan, 2002). The poorly managed change process became costly to the Trust due to the loss of human resources, reduced staff morale and lowered the credibility of the management. The change left the psychiatric liaison team feeling betrayed, and individual team members traumatised. As the change process progressed, it became evident that a thorough analysis of current resources and various dimensions of organisational change had not been carried out (Johnson, Scholes and Whittington, 2005). The management had not prepared a clear plan for launching and executing the change at a local level. The NHS Modernisation Agency Improvement Leaders’ Guide (DOH, 2004) stresses the importance of taking into consideration the human aspect when planning a change project. Similarly, Walton (1999) argues that change initiatives should be thought through and planned as far as possible taking into account the psychological bonds that staff form with their work groups and their organisation as a whole. It follows then that no precautions had been taken to address resistance to change. Johnson, Scholes and Whittington, (2005) state that there should be a clear communication plan to state how information about the change project will be communicated inside and outside the organisation. The team members were not given an opportunity to challenge and test the change proposal, or clarify what aspects of the change they could or could not influence. (Walton, 1995) Fulop, Protsopsaltis et al, (2004) suggest that change project should be presented as an opportunity to improve the quality of performance and that clinicians should should be involved on a consultative basis. Team members were aware of the consequences of extending the hours of operation without increasing the resources, however, there were no systems in place to communicate these views to the Trust management, a key aspect of the change process. The lack of key stakeholder involvement in the change meant that the management did not have access to the psychiatric liaison team’s valuable experience on the immediate and wider implications of cutting down resources. (Henderson, 2002) The team members felt that their concerns about the lack of resources had not been taken seriously, and this inevitably led to a feeling that the Trust did not care about it’s employees or their views. Strong emotions such as anger and frustration were expressed by the team members. The lack of formal communication channels, meant that the team members took them out on each other. Johnson, Scholes and Whittington, (2005) confirm that at times of change, rumours, gossip and storytelling increases in importance and that team members engage in countercommunication, thus unconsiously spreading distrust, suspicion and negativity which leads to lowered staff morale and job satisfaction. Although the rationale for change was clear to everyone, the change was executed at such short notice that the team members did not have time to develop strategies to deal with it. The NHS Improvement Leaders Guide to Managing the Human Dimension of Change (DOH, 2004) suggests that clinicians go through phases of shock, denial, anger, betrayal, conformance and understanding before they finally develop comitment to the change. The team members were left in a state of shock after the service manager’s initial announcement of the impending change in July 2004 and then moved into a state of denial. The general opinion was that the management would sooner or later realise that the change could not be executed without increasing the resources and accordingly delayed the change process until more staff would be employed. When there was no indication of this in the weeks that followed, the team members became demotivated. The team failed to move on to the next stages in their reaction s to change, and commitment to the change process did not develop. The team leader’s task-oriented leadership style did not suit the context of the change process, and partly contributed to it’s failing. Cameron and Green (2003) suggest that leadership will be most effective when the leader’s leadership style, the subordinates’ preferred leadership style and the requirements of the task fit together. A directive leadership style therefore is ineffective if the subordinates’ preferred leadership style is democratic, even though the task is well defined within tight parameters. In addition, Hogg and Vaughan (2002) argued that the most effective leaders are those who are able to combine task and socio-emotional leadership styles, and organise team members to work towards achieving goals at the same time promoting harmonious relationships. The new team leader paid no attention to the team culture and failed to communicate to management about the impending issue. Johnson, Scholes and Whittington (2005) suggest that power is a key element in a change process. Power is the ability of individuals to persuade or coerce others into following a course of action. The new team leader’s source of power was based on his hierarchal position in the Trust rather than on expertise or knowledge as shown by the previous team leader. The team members did not consider that the new team leader possessed appropriate expertise or personal characteristics. The team leader exercised coercion which was met with resistance by the team and for this reason the team members lacked respect for him. He was seen as an executor of decisions made by the management. The new team leader appeared to be more concerned about a successful completion of the change, was target driven and lacked sensitivity to employees feelings and concerns. The team leader used his positional power in a negative way, filtered information and gave the management a distorted view of how the staff were coping with the change process. The relationship between the team leader and the staff members eventually deteriorated to a point where communication broke down. Two staff members went on a long term sick leave, and two other staff members resigned. Following a meeting with a union representative in March 2005 the team members, including those who had resigned, made a decision to take grievance out against the teamleader. The key issues brought up in the meeting were the way the change had been introduced, poor project management and the team leader’s autocratic management style (Walton, 1999). CONCLUSION In conclusion, lack of stakeholder involvement, poor project planning and the teamleader’s unsuitable leadership style lead to the psychiatric liaison team becomimg fragmented, and resistant to change. No systems were put in place to ensure two-way communication with the employees. Lack of communication reduced the staff’s commitment to, and ownership of the change, and lead to a lower quality service provision and increased long waits in A E. The poorly managed change process became costly to the Trust due to loss of trained human resources, staff morale and credibility of the management. Similar incidents occurred in other areas of the hospital indicating that the change processes associated with the merger had created organisational wide problems that were indicative of failure at a top management and strategic level. Strategic leadership is a key element of the change process. A successful merger will only be achieved with consistent communication and the establishment of a vision that percolates throughout an organisation as a basis for effective change to realise the stated benefits of all stakeholders. References Brooks, I. (2002) The Role of Ritualistic Ceremonial in Removing Barriers between Subcultures in the NHS. Journal of Advanced Nursing. Volume 38, 4. Burke, W. W. and Litwin, G H. (1992) A Causal Model of Organisational Performance and Change. Journal of Management. Volume 18, 3. Cameron, E. and Green, M. (2004) Making Sense of Change Management. Kogan Page. Carr, D. K., Hard, K. J. and Trahant, W. J. (1996) Managing The Change Process: A Field Book For Change Agents, Consultants, Team Members And Re-Engineering Managers. McGraw-Hill. Crawford D., Rutter M. Thelwall, S. (2003) User Involvement In Change Management: A Review Of The Literature. National Co-ordinating Centre for NHS Service Delivery and Organisation. Davies H. T. O., Nutley, S. M. and Mannion, R. (2000.) Organisational Culture and Quality of Health Care. Quality in Health Care. Volume 9. DOH (1998) A First Class Service: Quality in the New NHS. Department of Health. The Stationery Office DOH (2000) The NHS Plan. Department of Health. The Stationery Office DOH (2001) National Service Framework for Mental Health. Department of Health. The Stationery Office. DOH (2002) NHS Leadership Qualities Framework. www.nhsleadershipqualities.nhs.uk Accessed 4 July 2005. DOH (2002) Star Ratings System for Hospital Performance Has Improved Services For Patients. NHS Modernisation Agency. www.dh.gov.uk. Accessed 4 July 2005. DOH (2003) National Programme for IT Announces Further Contracts to Run NHS Care Record Services. www.dh.gov.uk. Accessed 4 July 2005. DOH (2004) NHS Modernisation Agency Improvement Leaders Guide. www.modern.nhs.uk. Accessed 4 July 2005. ESHT. (2000) Safeguarding Hospitals in East Sussex: Consultation Document. www.esht.nhs.uk. Accessed 4 July 2005. ESHT. (2002) Merger of Hastings and Rother NHS Trust and Eastbourne Hospitals NHS Trust. www.esht.nhs.uk. Accessed 4 July 2005. Fulop, N., Protopsaltis, G. King, A. Allen, P. Hutchings, A. and Normand, C. (2002) Process and Impact of Mergers of NHS Trusts: Multicentre Case Study and Management Cost Analysis. British Medical Journal. Volume 325. Fulop, N., Protopsaltis, G. King, A. Allen, P. Hutchings, A. and Normand, C. (2004) Changing Organisations: Study of the context and Processes of Mergers of Healthcare Providers in England. Elsevier Ltd. Garside P. (1999) Evidence Based Mergers? British Medical Journal. Volume 318. Henderson, E. (2002) Communication and Managerial Effectiveness. Nursing Management. Volume 9, 9. Higgs, M. and Rowland, D. (2000) Building Change Leadership Capability: The Quest for Change Competence. Journal of Change Management. Volume 1 Number 2. Heron, J. (1999) The Complete Facilitator’s Handbook. Kogan Page Limited. Hogg, M. and Vaughan, G. (2002) Social Psychology. Prentice Hall. Iles, V. and Sutherland, K. (2001) Managing Change in the NHS: Organisational Change. NHS Service Delivery and Organisation. Johnson, G., Scholes, K. and Whittington, R. (2005) Exploring Corporate Strategy. Text and Cases. Seventh Edition. Prentice Hall. Marquis, B. L. and Huston, C. J. (2003) Leadership Roles and Management Functions in Nursing. Lippincott, Williams and Wilkins. Miller, D. (2002) Successful Change Leaders: What Makes Them? What Do They Do That Is Different? Journal of Change Management. Volume 2, 4. Mullins, L. J. (2002) Management and Organisational Behaviour. Pitman Publishing. Stock, J. (2002) Case Study: Hastings and Rother NHS Trust. NHS Modernisation Agency. www.modern.nhs.uk. Accessed 4 July 2005. RCP. (2004) Psychiatric Services To Accident And Emergency Departments. Royal College of Psychiatrists Council Report CR118. London. Stroebe, W. and Diehl, M. (1994) Why Groups Are Less Effective Than Their Members: On Productivity Losses In Idea-Generating Groups. European Review of Social Psychology, Volume 5. Studin, I. (1995) Strategic Healthcare Management. Irwin Professional Publishing. Thomas, N. (2004) The John Adair Handbook of Leadership and Management. Thorogood Publishing. UHCW. (2005). Coventry City Centre AE Department is Being Relocated to Walsgrave Hospital from Saturday 15th Jan. www.uhcw.nhs.uk. Accessed 4 July 2005. Walton, M. (1995) Managing Yourself On and Off the Ward. Blackwell Science Ltd. Webster, R. (2001) An Assessment of the Substance Misuse Treatment Needs of WHO (1984) Glossary of Terms Used in the ‘Health for All. 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Essays --

This essay will assess research into the impact of globalization on inflation and discuss whether it has weekend the ability of central banks to control the dynamics of inflation. The ability of central banks to control the rates of inflation may be substantially complicated by the increased globalization of the goods markets, factor markets and the financial markets (Woodford, 2007). The ability of national banks to influence the dynamics of inflation through monetary policy may be undermined by globalization. The central bank’s primary goal is to maintain price stability by regulating the level of inflation through monetary policy. Globalization increases trade both within and across countries (Schwerhoff & Sy, 2013). Through communicating their policy intentions regarding the future short-term interest rates, central banks can affect also the current longer-term rates (Tang, 2011). The new consensus (DSGE) Model incorporates four components, the output gap equation, the Phillip’s curve, the exchange rate equation and the Policy Rule (Woodford, 2007). The policy rule incorporates the Taylor rule which stipulates the amount a central bank should change the nominal interest rates in response to changes in inflation, output or other economic conditions. It also incorporates the idea of the inconsistent trinity, (sovereign monetary policy, fixed exchange rate and free capital flow) where only two of these can be possible at any given time. The impact of globalization on the effectiveness of monetary policy is now at the center of international macroeconomics literature with the recent experience of inflation accelerating the large number of industrial and emerging market countries (Ãâ€"zatay & Ãâ€"zmen, 2008). They support the idea tha... ...lely on their domestic economy (The Economist, 2005). Even though this may suggest that globalization has been able to combat the nature of inflation mistakes by central banks could allow it to break out again. (The Economist, 2005). This is partly due to the fact that a number of central banks make their decisions based on the actions of other central banks such as the Federal Reserve in the US (Rogoff, 2006). An example of this would be with number of Asian and oil producing countries will stabilize their currencies against the US dollar, which implies that the policies enacted by the Fed can still have an impact on global interest rates. (Fisher, 2006) Suggests that central banks should be conditioned on changes in foreign potential output and questions why, for instance, the output gap is calculated without taking into account the Chinese and Indian economies.

Affirmation of Adulthood in John Updikes A&P Essay -- A&P Essays

Affirmation of Adulthood in Updike’s A&P  Ã‚     Ã‚  Ã‚   Researching John Updike’s story, "A&P", I found many readers agreed that the main character Sammy is viewed as a hero or martyr for quitting his job at an A&P store in a northern beach town. I did, however, find that critics disagreed on why Sammy quit. Initially it appears that Sammy quits his job to impress girls who were reprimanded for wearing bathing suits in the A&P.   Sammy did not ultimately quit his job to be the hero for three girls who happened to walk into this A&P. This is not just a story about a nineteen-year-old guy trying to impress a group of girls by quitting his job, but it is also a story describing in detail the day this nineteen-year-old realizes that sometimes, in the transition from boyhood to adulthood, one must take a stand and ultimately follow through with this affirmation of adulthood. From the beginning of the story Updike "uses Sammy’s youth and unromantic descriptive powers" to show his immaturity and apparent boyish nature (Uphaus 373). We see this in the opening line of the story: "In walks three girls in nothing but bathing suits" (Updike 1026). Even the voice of Sammy is very "familiar and colloquial" (Uphaus 373). Much of the information that Sammy relays about the three girls is sexually descriptive in a nineteen-year-old boy’s way: "and a sweet broad looking can [rear] with those two crescents of white under it, where the sun never seems to hit" (Updike 1026). It is apparent that Sammy looks at the three girls who happen to walk into the A&P only as objects of lust or possibly boyish desire. Thus, on the surface it is easy to take this story as that of a boy who would do something like quit his job to "impress" these girls. It is even ... ...omach kind of fell as I felt how hard the world was going to be to me hereafter" (Updike 1030). This was the day that Sammy grew up. Works Cited Greiner, Donald J. Short Story Criticism. Vol. 13 Detroit: Gale Research Inc., 1991. 398-399. Updike, John. "A&P." The Harper Anthology of Fiction. Ed. Sylvan Barnet. New York: HarperCollins, 1991.1026-1030. Uphaus, Suzanne Henning. Short Story Criticism. Vol. 13 Detroit: Gale Research Inc., 1991. 372-373. Works Consulted Coffman, Kelly. "A Turning Point." Ode To Friendship & Other Essays. Ed. Connie Bellamy. Virginia Beach, 1997. 190-191. Hatcher, Nathan. "Sammy’s Motive." Ode To Friendship . Ed. Connie Bellamy. Virginia Beach 1997. 188-189. Luscher, Robert M. John Updike: A Study of the Short Fiction. New York: Twayne, 1993. Uphaus, Suzanne. John Updike. N Y: Frederick Ungar, 1986.   

The One Truth Of Reality Essay -- essays research papers

The One Truth of Reality The one single truth of reality is not measured or distinguished -- it is the ultimate paradox. The journey by which one achieves this truth can be a journey of increasing realizations of paradoxes, and finally, freedom from the bubble of limitation of a mind that would perceive such paradoxes as paradoxes in the first place. Truth is the same as spiritual feeling. Of spiritual perception. Of clear perception. Of freedom of the mind. Freedom of the soul. Freedom of the Heart. It is ultimate love and empathy. The end of struggle. Fully knowing the truth is to be enlightened. Fully realizing the truth is having transcended the distortions of the Machine (see The Machine at my web site given below). Truth means complete fulfillment and true happiness. Truth is impossible to change or destroy -- doing so contradicts the very nature of a single truth from which all things seen through distorted perception stem. Finding truth (and thus everything that it is) is the ultimate subconscious goal of all struggling. The search for truth, the want of truth, paradoxically, most often leads to illusion and darkness and pain. This is the case for the general spiritual state of humanity in the late Twentieth Century. In this way, truth, freedom, love, clear perception, purity, transcendence, and enlightenment are all the very same thing. During the journey, one will no doubt see many facets of truth and see them as separate, distinguished, or part of a duality; but in time, one will see how they all link up and ultimately, how everything is a part of the same thing, and how perceiving everything in terms of truth is transcendence of distinguishment and knowing the truth; and in this way, being enlightened, free, and fulfilled -- attaining the ultimate happiness. Transcendent of the Measurable What is perceived tangibly through the primary five senses (sight, hearing, touch, taste, and smell) contradicts the nature of truth which is actually transcendent of all distinguishments in the "more tangible" environment. When a person focuses on what he (or she) sees and reacts to it and especially seeks to control his environment, he lives in a dualistic (or polyistic) state wherein lives his struggle to find non-struggle and peace and fulfillment. The illusion is what is sensed through these five senses and having perceived this as somethin... ... the transcendent planes, including the Mindscape. The Journey The journey is the process of the growth of awareness and insight into ultimate truth. Eventually, this means awareness beyond simple intellectual facts, but an awareness of one's truest self, and thus an awareness into the truest nature of everything. Mentally, this can be perceived, just as feelings can be perceived. To feel free of the struggle of pain and pleasure is to feel the currents of the one's entire being, and in this know oneself; and in this, know the truth; and in this, be truly free; and given an end to the quest for self there is an end to the deepest loneliness (which ultimately is confusion regarding oneself) and the greatest sense of fulfillment. The goal, then, should be to find and submit oneself completely to, like water, the feelings that may be perceived (visualized or seen) by the mind as white light. This is a journey through the maze of walls that are a result of the struggling of the psyche in the midst of the darkness and confusion. The easiest way to find the way out of a maze is to rise above (transcend) it and, seeing the light of the universe beyond, find a path leading to the exit.

Advanced Microeconomics Essay

Question 1: Consumer Theory 1.1: In both the Marshallian and Hicksian consumer optimisation problems, it is assumed that consumers are supposed to be rational. The main focus of these problems are cost minimisation and utility maximisation, which play a huge part in consumer demand, but in real life, these are not the only problems that are considered. Also, it is assumed that every consumer’s indifference curve for two goods would be the same – they are very generalised models, and do not take into account other factors. For example, not many consumers would spend their entire budget on said goods – one thing to consider would be a consumer’s marginal propensity to consume and save. Though both of the problems provide a framework and model of consumer decisions, they are not plausible when applying them to real-life terms, because we have imperfect knowledge. 1.2: The expression given in the question, is the rearranged derivative of the Hicksian demand being equal to the Marshallian demand, when income from the budget constraint is equal to minimised expenditure, whereby m=ep, ÃŽ ¼. This is given by: dDdp= dHdp- dDdm . dedp using m = e. Shephard’s Lemma provides us an alternative way of deriving Hicksian demand functions, using e. It is given by: dedp= x* It is important to note that e is strictly increasing in p, due to Shephard’s Lemma, and x* >0,by assumption. Substituting this into the above expression gives: dDdp= dHdp- dDdm x*  This expression now represents a complete law of demand, as it has combined both Marshallian and Hicksian demand, whereby income from the budget constraint of Marshallian demand, is equal to minimised expenditure of Hicksian demand. Therefore, it has maximised utility and minimised cost simultaneously, to create an optimal quantity of demand in x*. The first term, dDdp, means that Marshallian demand (maximising utility) increases, relative to the price of the good. dHdp represents the Hicksian part of the expression, whereby expenditure is minimised, relative to the price of the good. Question 3: Adverse Selection, Moral Hazard and Insurance 3.1: Insurance markets are needed when risk is present. Risk occurs when there is uncertainty about the state of the world. For example, car drivers do not know if they will crash their car in future, and suffer a loss of wealth – so they would purchase insurance to eliminate this risk of loss, and protect them if they were to ever crash their car. Agents (buyers of insurance) will use insurance markets to transfer their income between different states of the world. This allows insurance markets to trade risk between high-risk and low-risk agents/states. These can be described as Pareto movements. A Pareto improvement is the allocation, or reallocation of resources to make one individual better off, without making another individual worse off. Another term for this is multi-criteria optimisation, where variables and parameters are manipulated to result in an optimal situation, where no further improvements can be made. When the situation occurs that no more improvements can be made , it is Pareto efficient. A condition for efficiency is the least risk-averse agent bears all the risk in an insurance market. If a risk-averse agent bears risk, they would be willing to pay to remove it. A risk-averse agent has a diminishing marginal utility of income; whereby his marginal utility is different across states, if his income is different across states. The agent would give up income in high-income states, in which his marginal utility is low, to have more income in low-income states (e.g. bad state of the world causing a loss of wealth), where his marginal utility would be high. If the insurance market is risk neutral, they will sell insurance to the customer, as long as the payment received is higher than the expected value of pay-outs that the insurer is contracted to give to the customer in different states of the world. Whenever the agent bears some risk, unexploited gains from trade exist. Absence of unexploited gains from trade is a requirement in an efficient insurance market, therefore the situation must arise, whereby the agent’s income is equalised across the states of the world. A risk neutral insurance company can charge a premium to equalise the agent’s income across states of the world, in the best interests of the risk-averse agent. Also, for an insurance market to be  efficient, a tangency condition is implied. The tangency of the indifference curves of a risk-averse agent, and a risk-neutral agent, is where efficiency occurs. At this point, one cannot be made better off, without the other being made worse off (Pareto efficiency). However, an insurance company will never be completely efficient in real life, as information asymmetry exists. The first type of information asymmetry to arise in an insurance market is moral hazard, whereby the actions that an agent may take after signing the contract cannot be observed. This gives the company a trade-off decision between giving full insurance or offering incentives for the agent. Full insurance is first-best in the absence of asymmetric information, when the insurance company is risk-neutral and the agent is risk-averse. However, if the agent is fully insured by the company, they have no reason to prevent a bad state of the world from happening. To solve this problem, the insurance company will not offer full insurance, in order to provide the agent with an incentive to avoid losses. The second type of information asymmetry to occur in an insurance market, is adverse selection. This is when the agent has private information about his risk type and characteristics, and agents in the market are heterogenous. As the insurer doesn’t know which agents are high-risk or low risk, the company will not offer different types of full insurance to match risk-types, as high-risk agents will prefer contracts that are designed for low-risk agents. To solve this, the insurer will offer low-risk agents less insurance – this ensures that high-risk types do not have the incentive to choose a contract for low-risk customers, as they will want more insurance, because they know they will need to claim more. This ensures that the insurance company maintains non-negative profit, as high-risk individuals cost more to insure. However, these solutions carry agency costs, because the result is less efficient than if symmetric information was present. I believe that risk neutrality of an insurance company is a sufficient condition for insurance to take place. Insurance companies are risk-neutral to maximise expected profits, therefore as the principal, will design contracts to achieve this, as well as making certain that the agent picks the desired effort (i.e to prevent a bad state of the world) for that contract, and to make sure that the agent even picks the  contract in the first place. Making sure incentives are compatible, and ensuring participation by the correct risk types, are constraints on maximising expected profits. If an insurance company was risk-averse, without the availability of symmetric information, they cannot differentiate between different risk-types, and therefore would not want to take on the risk of possible high-risk agents buying low-risk contracts. They would charge a higher premium to offset this, which would discourage low-risk customers to sign a contract with the company, as it would not be maximising their own utility. This would lead to a missing market, where trade would be prevented, because other risk-neutral companies would offer better contracts, and they would be able to steal all the low-risk customers. The magnitude of this would depend on the number of low- and high-risk people in the population. This leads me to believe that risk neutrality is also a necessary condition for insurance to take place. 3.2: An insurance company will sell a policy, c, r, if it makes non-negative profits, then:  Ã¢â€ â€™ r-pic ≠¥0,  where c = payout, pi = probability of the loss state, r = premium. Competition in the market drives profit down to zero, therefore r-pic = 0 in equilibrium. For the contract to be at equilibrium, it must satisfy two conditions: the break-even condition, whereby no contract makes negative profits; and absence of unexploited opportunities for profit, because if there was a contract outside of the offered set, with non-negative profit, would mean the offered set is not in equilibrium. If all agents are homogenous, if all agents face the same probability of loss, pi=p, insurance companies would know each buyer’s pi. The firm must maximise each agent’s utility subject to the firm breaking even. This would be at the point of tangency of the agent’s indifference curve and zero-profit constraint. This would be in equilibrium as another profit-making polic y could not be offered. Therefore, as they can observe agent’s risk types, they can offer different policies, to different types: ÃŽ ¸i= ri, ci. It follows that each is offered full and fair insurance. In real life, heterogeneity is usually the case. This is when pi varies with all individuals. Assuming that there are two types: high-risk types, H, and low-risk types, L, where the probability  of loss for H is higher than for L. Individuals know their own probability of loss i=H, L, but insurance companies are unable to observe this. In this case, there are two different kinds of equilibria that insurance companies could opt with: the candidate pooling equilibrium and the candidate separating equilibrium. The pooling equilibrium is where all risk types buy the same policy. In contrary, the separating equilibrium is based on each risk type buying a different policy. In the pooling equilibrium, if both H and L risk-types choose the same policy, the probability of loss is p and the probability of no l oss is 1- p. Therefore, the slope of the ‘aggregate fair-odds line is -1-pp. The pooling contract must lie on this line to be in equilibrium, to ensure the firm breaks even exactly. The contract must also ensure both types want to buy it – it must take both L and H to higher indifference curve than the indifference curve they would be on if they stayed uninsured. Agent L ends up below his fair odds line, and H above his, which means L pays more than expected costs, and H pays less – both pay the fair pooled premium, but H claims on the policy more. So if L prefers to buy the contract, so will H. This leads me to believe both L and H will be able to get full insurance, though it’s not completely fair, as the firm does not need H to choose a different policy to remain breaking even. However, this brings to mind the notion that if full insurance is offered, the agent will not have the incentive to prevent a loss state. Therefore, less insurance will probably be offered, and as both risk types are paying the same premium of the same policy, neither will receive full insurance, as it impossible to differentiate between the two – they will both choose the same policy offered. In the separating equilibrium, one contract would be offered to L, and another to H. Each risk type must prefer the contract designed for that type (i.e. the incentives must be compatible). The contracts offered should give each type the highest possible utility, subject to the firm breaking even. If full insurance contracts were offered to both L and H, where their respective indifference curves are tangent with their respective zero-profit constraints/fair-odds lines, low risk customers would prefer the policy designed for them, but high-risk customers would also prefer the same policy, not the policy designed for them. So they would not both be offered full insurance, as this gives rise to the problem of preventing H from imitating L – low-risk agents are cheaper to insure for the firm (claim less  often) so they get a better rate. Therefore, instead of offering L full insurance, they are offered C, which is still on their fair odds line, but on a lower indifference curve, still ensuring the zero-profit constraint. Now, if the high-risk agents were to choose between the policy designed for them, and C, they will choose the policy designed for them, because they prefer to have more insurance for less money. So, in conclusion, in the separating equilibrium, high-risk (H) customers receive full insurance, and low-risk (L) customers only receive partial insurance – they pay the price to prevent H from imitating them. L is worse off than if there was symmetric information in the market, but no difference to H.