Thomas Hobbes And Francis Bacon In English History History Essay

Thomas Hobbes And Francis Bacon In English History History EssayConsidered champion of the most turbulent times in English History, The seventeenth Century could doually be looked at as an age of tremendous reason and economic advancement in Great Britain. Despite friction oer issues of religion and church and state domestically, the British population grew and its economy prospered. Commerce expanded throughout the globe as Great Britain successfully developed and lengthy trade and business. Some of historys most famous minds were both a set forth, and a product of Great Britains transition from an age of faith to one of reason. Thomas Hobbes was one of those famous minds and is now thought of as one of historys greatest natural law philosophers. (www.historyworld.net)Thomas Hobbs was innate(p) in England in April of 1588. He was reportedly born prematurely due his mothers fear of the news of the approaching Spanish Armada. Hobbes was the second son of a local clergyman, but hi s father never played a role in his life. There are varying accounts as to why his father abandoned the family in Hobbes youth, but he was nevertheless raised by a well-to-do uncle who supported his education and development. Hobbs started his schooling at 15 entering Magdalen College, Oxford, yet initially focused more attention on maps and charts. He graduated at 19 and soon served as private tutor to William Cavendish, a wealthy boy not much younger than Hobbes who later became the second Earl of Devonshire. As Cavendishs tutor, Hobbes had the opportunity to travel and tutored Cavendish and his brother on the European Continent for several days. It was during this time that Hobbes broadened not only when his world view, but more significantly his philosophical views. He studied the classics and developed and increasing interest in politics and history. (www.notablebiographies.com) Hobbes association with the Cavendish family afforded him number of resources which probably playe d a large part in developing his scholarly pursuits.As a scholar, Hobbes first major work was a translation of Greek historian Thucydides History of the Peloponnesian Wars, in 1629. Hobbes indicated that he translated History of the Peloponnesian Wars during a period of civil unrest to remind policy-making leaders of his day that the ancient scholars thought democracy to be the least effective form of government. Thucydides work represented that understanding the past was important in determining the proper course of action. Regarding Thucydides great History of the Peloponnesian Wars Hobbes stated,For the principal and proper work of history being to instruct, and enable men by the knowledge of actions past to bear themselves prudently in the present and providently in the future, there is not extent any other (merely human) that doth more fully and naturally perform it (http//history.wisc.edu)In Hobbess view, one of the most significant intellectual events of his life occurred wh en he was forty when he stumbled upon a copy of Euclids geometry. His second work, A Short Treatise on First Principles, expressed his deep interest in the subject area of geometry. Hobbes went on to continue his travels throughout Europe and spent time with many of the most influential minds of his time. In France, he met with Mersenne and members of the scientific community including Gassendi and Descartes. In Italy, he spent time with Galileo. In order to escape the civil unrest in England, Hobbes spent the next eleven years in France and taught mathematics to Charles, Prince of Wales. It was in the 1640s that Hobbes developed plans for future philosophical work. As Civil War was imminent in England, he was Inspired to write on issues related to club and published De Cive in Paris in 1642. Hobbes later published the same work in English under the title Philosophical rudiments concerning Government and Society as the Commonwealth took hold of the government. The book was highl y contentious as both sides of the civil war criticized its views. (www.philosophypages.com)In light of the developments in Paris, Hobbes feared France was no longer a safe haven for the English court in exile and returned to England in 1651. Upon his return he published one of his most famous works, Leviathan. In Leviathan, Hobbes contends that all human acts are self-serving, even if they appear to be altruistic, and that in a natural state which lacks the organization of government, human beings would act in a completely selfish manner. Hobbes believes that worldly concern are basically equal from mental and physical perspectives and are therefore naturally likely to contest amongst one another ultimately resulting in conflict. He believed that democracy would inevitably fail because people are solely motivated by self-interest and that humans desire for power and wealth would only result in conflict of humans amongst themselves. Hobbes perspective was that governments were res ponsible for protecting the people from their own selfish nature. In Hobbes view, government would have power similar to that of a sea monster, or leviathan and saw a king as a necessary figure of authority. (Clarendon) widely considered as one of the 17th centurys most influential natural law philosophers, Thomas Hobbes had a significant impact on British social, economic and political theory. Hobbes developed status in a variety of studies and shaped intellectual philosophy until this day. He was known as a scientist, as a mathematician, as a translator of the classics, as a writer on law, as a disputant in metaphysics and epistemology not least, he became notorious for his writings and disputes on religious questions. (http//homepage.newschool.edu) However, it is as a result of his writings on politics and morality that he has been eternally remembered. Several of Hobbes many works were never published during his lifetime, among the titles that remained unpublished is the tract o n Heresy, and Behemoth the History of the Causes of the Civil Wars of England, among others. Hobbes outlived many of his contemporaries and continued to write completing his autobiography when he was eighty-four years old. He finished Latin translations of the Iliad and the Odyssey in his final years, and in 1675 he left London to live with the Cavendish family in Derbyshire until his death at Hardwick on celestial latitude 4, 1679. (www.egs.edu)200px-Thomas_Hobbes_(portrait).jpg bacon.jpgHobbes wasnt the only great philosopher to come out of the Elizabethan Age Sir Francis Bacon was another leading natural philosopher during the period. Bacon was statesman, a lawyer, and Member of Parliament. His writings included subjects regarding questions of law, politics, and church and state. He also wrote on issues on which questioned social and ethical norms in some of his most famous writings such as Essays or in his primary coil work on natural philosophy, The Advancement of Learning. (h ttp//plato.stanford.edu)Francis Bacon was the son of Nicolas Bacon, the Lord Keeper of the Seal of Elisabeth I. He enrolled at Trinity College Cambridge at the age 12 and at an early stage of his development began to reject the common philosophical thought of the day which was generally based on Aristotelianism and Scholasticism. Bacons father passed when he was only 18, and as the youngest son he was left with very little financial means. Although Bacon is said to have had rich relatives, he received little assistance, yet he pursued studies in law and had became a member of the House of Commons by 23. (www.oregonstate.edu)Bacon went on to publish Essays, Colours of Good and Evil, and Meditationes Sacrae in 1597. After fagot Elizabeth 1st death and the rise of James I in 1603, Bacons political career began to grow. He was knighted in 1603 and several honors followed Solicitor General in 1604, attorney General in 1613, Lord Chancellor in 1618, Baron Verulam in 1618, and Viscount S t. Albans in 1621. (http//bacon.thefreelibrary.com/) Under King James, Bacon was appointed to a number of posts, and like his father, was lastly given the title of Keeper of the Great Seal. He was unfortunately caught in the middle of a power struggle between the King and Parliament which resulted in Bacon having to forfeit his political status, honor, and much of his personal wealth. (www.oregonstate.edu) Only 5 days five days after he had been given the Viscount St. Albans title, he was accused of bribery in 1621. Bacon admitted to the charges and was subsequently banished from the court and received fines. Bacon never paid the fines, but his sentence was reduced and he was only confined to punishment in the brood for four days. Although the sentence had been reduced he would never again be able to hold political office for the rest of his life.Bacon later published Novum Organum, or True Directions Concerning the Interpretation of Nature. In this work Bacon suggested that it wa s time to let go of Aristotelian ideas and in doing so helped to establish the foundations for modern science and philosophy. Following his liberation from the court, four additional books followed Historia Ventorum, Historia Vitae et Mortis Augmentis Scientiarum and Apothegms. Some reports indicated that that Bacon assisted in editing the King James Bible, but that remains subject to debate until this day. There are groups that support, as well as dispute this claim, with equal numbers on either side of the debate. (http//science.jrank.org)Bacons contribution to contemporary thought focused greatly on the family relationship between science and social philosophy. In Bacons view knowledge is power and that an expansion of knowledge and learning among individuals can help to offset many of societal issues. Many people in his time considered Bacon a genius. His work, which attempted to encompass the three realms of natural, human and divine existence, has had a significant impact on the study of history, law and philosophy. (www.findingdulcinea.com) In1626, Bacon attempted to test the impact of the cold on the decay of meat. In experimenting with stuffing a chicken with snow, he fell ill, developed pneumonia, and died on April 9th, 1626.

Risk Management Plan in Healthcare

lay on the line c are Plan in Healthc areCyrill Hannah A. de LeonIntroduction insecurity commission is grapplen as the process and system of rules of distinguishing happens, assessing risks and planning approaches to regulate risks. In this growing business application, risk centering plan and business core analyses are essential and integral parts of a business plan. Each company or organisation must be aware of the possible electromotive force risks that whitethorn arise within the organisation for it to be prepared if ever an unavoidable problem occurs and discover ways to number the effects if ever such problem takes place.There are different types of risks from whizz business to another. Risk Management plan follows a systematic process. It must describe the strategies of dealing the risks that is particular to the business. Risk Management is essential in scheming, find and reducing unfortunate events that lead impact the business.Each organisation has its own risk management. Healthcare Risk Management provides its own standards in delivering quality healthcare, ensuring forbearing safety and avoiding unfortunate consequences thus, carrying effective, efficient, and high quality long-suffering care to clients.The Purpose of Risk Management within an Enterprise.Risk Management is very essential in determining the possible problems that may arise in each organisation and for it to be equipped with risk precautions in localise to manage and tolerate unfortunate effects. Quality management has always been definitive when we speak of the service division. This is specifically true with healthcare. In a healthcare setting, there are numerous risks that are prevalent manage risk among the staff, risk among the patients or even risk among the immaculate organisation. Thus, it is very important for each organisation to have risk managers who get out assess, monitor and respond to each risk to lessen exposure of risks that may be a scourge to the organisation. As a healthcare provider, our main associate is the safety of our patients. In order for us to deliver the best quality healthcare to our clients, healthcare professionals specifically health care managers must work reactively and proactively to minimize any damage that may occur in the future or prevent any malpractice. (The University of Scranton, 2014)The Benefits of Risk Management within an EnterpriseDevelopment and implementing of Risk Management is relative in each organisation. It is a continuous process that transpires not whole in the beginning but all throughout the entire process itself. The benefits of Risk Management includes(Grow Indiana Media Ventures (LLC), 2014)Awareness of RisksWith the help of risk management process, the organization may be able to assess and identify the latent risks that may occur within the enterprise. In this way, managers may be able to weigh the severity of the risk and provide measures to solve the problem. It is the responsibility of those in higher(prenominal) positions or the enterprise managers to allocate time to its staff to let them be aware of the hazardous risks and the corresponding approach.Reduction of Financial Risk both companys aim is to gain profit. It is the prerogative of each company to develop risk management plan to evaluate the risk that may presume the market, operational services and other related circumstances. Risk management pass on alike help to better manage the costs and the visibility of risks to the economic condition.It leave alone also caution in the management of financial stability of the company thus avoiding any chance financial instability or worst, bankruptcy.Improved management and Communication of RiskThis provides a standardised context of risks for all the members within an organization. It is very important that each organization should communicate among every department regarding the stipulation of the company and communicate up from the s enior management down to its labor workers regarding risk information within the operations of the company and discuss insights on how to flop manage risks to develop an effective approach to minimize risks.Avoid Future ProblemsRisk management provide enable the company to foresee the possible glitches that may occur in the company. With the aid of risk management, every company provide be prepared on how to face these problems and minimizing or reducing financial costs. With this awareness, decent management will be implemented and its objective in controlling risks will be observed. Risk management enables to reduce or choke financial risk through a cost effective approach and proper intervention with the execution of a contingency plan that will aid in reducing risks that the company shall face.Risk Management Components in relation to the overall role of the Risk Management.Reviewing of Activities and Internal EnvironmentIn this evolving world, the healthcare industry faces a number of issues regarding the reform of healthcare. Risk management in the field of healthcare is very important in achieving its goals and objectives and constructing plans in delivering quality healthcare to its clients. Risks in the internal environment of a healthcare institution is observed where standards should be observed in order to ensure the safety of the clients and to avoid jeopardizing their welfare. Risk Management in healthcare organizations focuses on patient safety and ensuring that clients receive the effective and efficient quality healthcare.The future(a) are the risks in the internal environment of a healthcare industryMachines/EquipmentsThere are certain healthcare facilities that drop equipment or machines due to lack of resources or funds or due to inaccessibility because of certain damage or defect. The use of defective diagnostic machines may produce unreliable reults. This may jeopardize the treatment process of clients like for example, a patient w ith pneumonia may need to have an chest xray examination. If the xray machine would be unavailable or is damaged, the treatment process of the client may be decelerate due to the inaccessibility of the diagnostics that will support the diagnosis of the disease.Staffing of PersonnelIn as much as each healthcare provider would like to give the best quality healthcare to its clients, its is unavoidable that the workplace will be understaffed or overstaffing. But among the two, understaffing would likely profess the services that will be rendered to the clients. Whenever there is a lack of manpower, services are usually hampered and clients may most likely not receive suffer. The hiring of inexpert staff may also jeopardize the safety of clients. Its the responsibility of the human resource department to properly screen newly hired violence and provide them with basic training whenever someone will be hired in the company in order to ensure that they provide the best quality care th at each client deserve. There are also incidents wherein services may be hampered due to absences of staff from work.Setting objectivesSetting objectives for Risk ManagementThe first step regarding risk management is Risk assessment. Risk assessment should be recorded, systematic and reviewed regularly. In this step, management committee will identify the say-so risks that the company will be facing then manage the major risks that will arise.Identifying the risk whether it will just be a minor or major threat to the organisation. Determine what might happen when this potential risk will be observed in the organisationAnalyse the level of the risk whether it will just be a minor or better yet a major issue and reviewing the controls into the system and the possible likelihood or the consequences that may occur when the risk will be observed.Evaluate the severity of the risk and then rank the risks. Communication within the organisation is very important because this will give aware ness to the people and will enable them to discuss further what are the possible ways of minimizing the risk within the organisation spread over the risks by identifying the options, selecting the best responses, ontogenesis risk treatment plans and implementing them within the organisation. In this way, it will give them the assessment whether goals have been met.Event identificationThere are internal or external events that may come to the risk management plan or strategies. In the healthcare setting, an example of an internal event that may affect the organisation is technical risk. If I will relate it to the healthcare, almost all hospitals use the patient information system in supporting the patient care process through computer based patient records, patient care systems and patient classification systems. This system provides the necessary details in order to properly manage clients according to their specific needs. If for instance there will come a time that the software m ay fail, this will surely affect the entire organisation. It may affect the function of the organisation in keeping track of the record of the patient. Thus, it is very important that each organisation should not only be reliable to software programs. They must also keep hard copies of each patient record to serve as standby file of their records. In this way, patient care may not be jeopardized.In the external events, there are uncontrollable situations or events that occur outside the organisation make a great impact like natural calamities such as floods, earthquakes, fire. These events may affect the organisation in such manner that there will be a great possibility that the staff may not be able to work and the company will suffer because it will lack manpower thus, production may be put risk and profit will be minimized.Risk assessment with particular reference to the impact and likelihood of riskEach organisation follows its own policies and regulations. Orientation of the s taff is very important to decrease the likelihood of risk. For example in a healthcare setting, the judicial system should orient its staff for them to be aware of the policies within the organisation or better yet provide them with seminars, programs and trainings from time to time that will help them growing their knowledge, let them be aware of the up to date changes in the management and let them be equipped with the desired skills in case potential threat may arise in the company.Risk response plansMany organisations implement risk response plans that will help them avoid or control potential threats and apply the necessary risk management controls to a specific organisation. There are different ways on how to respond to specific risks. Few of the following areRecognitionIn case of occurrence of any risk, each organisation must be able to accept and recognize the problem. With this, the team will be able to develop proper management plans in order to regulate risks.ControlThe re are always risks in every organization. We know for a fact that it is unavoidable but with mitigation, this will reduce the probability and impact of risk in the organisation by taking some measures by the time the company faces the risk. For instance, companies may organize seminars that will help the team develop project management plans.PreventionIn this, risk is eliminated by developing strategies even before the company will face the risk. This will also help in preventing major damage to the organisation.Risk Management strategies identifies external threats on with strategies that will aid in addressing each problem.Control activitiesRisk Control is the method by which the organisation evaluates the potential losses and takes the necessary action to reduce or eliminate the threat. It involves the implementation of standards and policies and managing procedural changes. Controlling risk management is the solution in maximizing profits in the business. Developing control ac tivities will help in decreasing the risk of business failure and for the accomplishment of goals and objectives. Control activities that will decrease the likelihood of risk includes supervision of the team by the senior management in taking precautions in case a threat may be predisposed in the company. Reporting will also help in keeping the team updated on the latest strategies that will be useful in controlling the risk in the organisation.Information and chatInformation and Communication should be observed within the organisation to help the team keep posted on what are the precautions that should be observed in case the company faces a threat. The carrousel management plays a very influential role in the dissemination of information in the enterprise. It is the obligation of the top management to relay the necessary information down to the different departments of the organisation. Communication serves as a foundation in planning, organizing, motivating each team. It can be through verbal or written form such as memorandums, emails or forms. Communication and relaying of information is necessary in moulding the reputation of the organization. gear up dissemination of information within the organization will prompt customers to be loyal with the company and promote or boost the organizations range and to its customers.MonitoringMonitoring is the process of implementing risk plans, tracking identified risks, monitor residual risks, identifying new risks, and evaluating risk process effectiveness throughout the project. Regular monitoring enables the management to keep track of the risks and to foresee circumstances making the implementations effective and analysing the results of the plans. This includes the continual measurement and monitoring of risk environment and the performance of risk management strategies.ConclusionRisk management is important in an organisation because without it, a firm cannot possibly define its objectives for the future. I f a company defines objectives without taking the risks into consideration, chances are that they will lose direction once any of these risks hit the organisation. Risk management is very essential in each organisation because it will help in preventing loss or even damage to the institution.The risk management plan should propose applicable and effective security controls for managing the risks.REFERENCESGrow Indiana Media Ventures (LLC). (2014). Benefits of Enterprise Risk Management. Retrieved fromhttp//www.insideindianabusiness.com/contributors.asp?id=2148The University of Scranton. (2014). The purpose of Risk Management in Healthcare. Retrieved fromhttp//elearning.scranton.edu/resource/health-human-services/purpose-of-risk-management-in-healthcareEmergency Care Research Institute (ECRI). (2009). Healthcare Risk Control. Retrieved fromhttps//www.ecri.org/documents/secure/risk_quality_patient_safety.pdf

Strategic Management: An Introduction

Strategic Man periodment An IntroductionStrategic circumspection is the strat ripenm and science of formulating, implementing and evaluating cross-functional decisions that leave enable an transcription to achieve its objectives. It involves the systematic acknowledgment of specifying the firms objectives, nurturing policies and strategies to achieve these objectives, and acquiring and making available these resources to implement the policies and strategies to achieve the firms objectives.Strategic commission overly integrates the activities of the various functional sectors of a business, such as tradeing, sales, production to achieve organizational destructions. It is generally the highest level of carriageial activity, usually imitated by the scorecard of airors and executive group. Strategic management hopes to supply overall direction to the attach to has ties to the field of organization studies.Strategic planning is a management tool, period. In short, strate gic planning is a disciplined effort to produce fundamental decisions and actions that shape and guide what an organization is, what it does, and why it does it, with a focus on the future.Strategic management also allocates the right amount of resources to the diametrical parts of your business so that those assigned to particular goals fuck off what they submit to ascertain their objectives. This ranges from providing your hold outers with the right supplies to enacting systems by which employees encounter the necessary training, all work litigatees argon tested, and all information and data generated is documented. To effectively manage your business strategically, every inch of your company must overhear its unavoidably met in these ways. get aheadmore, one must know that 2 businesses cannot be alike(p) and there should be or so basic differences between them. Beca sp revoke of this, the goals and the plans of action atomic number 18 different for each business. P lus, the strategies for long destination and short term collapsement should be different and these need to be applied separately.QUESTION 1 develop how aboutone can be a manager but not a draw, a attractor but not a manager, and both a manager and a leader.A manager is a person with a handicraft of overseeing one or more employees or department to ensure these employees or departments do their job or assigned duties as required. A manager helps separates to get more done by motivating the employees, providing directions , making sure the employees operative together towards a universal goal, and providing feedback.A forward-looking manager whitethorn be responsible for a minuscule team or a small shake off. Usually a senior manager impart watch over his or her work. The manager exit make to learn the strengths and weaknesses of the team members, instruct a work to the team members, guiding team members to reach goals, get out the tools needed by the team and motiva te them to do their task.Usually , a parvenue manager has limited responsibility for money issues and little chances to approve or label an expenditures. They put one across to review and approve cadencesheets for their employees and may have the chances to approve expense accounts. The term of manager is not the same for leader since the two legal injury be not the same. A manager must ensure the appropriate delivery of benignant resources and funding to meet the routine daily productivity objectives. The manager is known as detailed oriented.Mangers don not see the overall picture and are less interested regarding the long-term corporate goals and mission. They are worried almost details as a result, they do not make them a great leader. Some managers may have certain leading(p) qualities but they re important too focused on their daily operations and are ineffective to provide direction and vision to the organization. A manager plans, organizes, leads, and controls w hereas a leader influence others through communication, motivation, discipline, direction and dynamicsTypically, the goals are secure for a beginning manager by someone higher(prenominal) ranking in an organization. Here , the manager have to develop a plan to achieve the goal set. They have to provide feedbacks to their employees as they work with those plans.To be a manager , evolution skills at all level is important . At a beginning level , examples of two area where a manager need to focus their skill development are the ability to manage their meetings and developing their own planning tools such as to do a list.A leader is different from manager. A leader is a person who has vision, a drive and a commitment to achieve that vision, and the skills to make it happen. A leader see a problem that needs to be fixed or a goal that needs to be achieved.A leader is also a person who guides others towards a green goal, covering the employees by example and creating an environment i n which other team members feel active and bear on in any process or task. A leader is a tidy take heeder. Leaders have to keep their mind open to others ideas. They can coiffe up with new ways to accomplish the goal set. It is the leaders job to make sure that everyone in the group is being heard. Leaders have to listen to the team members ideas and listen their criticism for improvements.Leaders have to be focus all the time. They have to keep on remind themselves and the team members of the goals and mission. Staying on lay down chase and keep the team members on track ,the team go forth stay motivated and more productive. As leader of the group, it is important that you schedule time to meet with your team to establish and check-in about the goals you hope to achieve.Leaders also have to be organized. Leaders are responsible in a chaw of things and might be very busy sometimes. A leader can set the tone for the team. A leader who is organized helps motivate team members to be organized as well. As a leader, youre responsible for a lot and youre probably going to be very busy at times. However, you still need to find time to talk with your team. A good way to do this is to set frequent group meetings, so that no question or tutelage goes too long without attention.Leaders also have to be decisive. Although an important part of being a leader involves listening to the concourse meet, they have to come back that they are not always going to be able to reach a compromise. When this happens, dont be afraid to make the final decision, even if some team members disagree with the plans.Confident is the most important characteristics of a leader, leaders have to believe themselves and the success of the team members. Show others that you are dedicated, intelligent, and proud of what you are doing.A manager basically directs resources to complete predetermined goals or projects. For example, a manager may engage in hiring, training, and scheduling employ ees in order to accomplish work in the most efficient and cost effective manner practicable. A manager is considered a failure if they are not able to complete the project or goals with efficiency. .On the other hand, a leader within a company develops individuals in order to complete predetermined goals and projects. A leader develops familys with their employees by building communication, exampling images of success, and by showing loyalty.As an example of a manager, A company CEO directs Wong, one of the companies up and coming managers, to hire enough new employees to provide the company with a customer service department. Wong undertakes his project with enthusiasm. He hires moreover those employees who can work the assigned hours, will accept the modest pay, and have experience working in customer service. He trains his new employees to make out the job to his expectations and assigns the employees to their new positions. Wong measures his success in terms of efficiency, c alls handled per hour, and cost effectiveness, for example did he meet his budget?. However, Wong did not anticipate that of the employees he hired, only a handful would re principal(prenominal) working six months later.Moreover, as an example of a leader, Ahmed obtains the same assignment as Wong. Ahmed hires employees that he believes he can develop a working relationship with, versus just those employees who will worked the assigned hours and take the modest pay. Ahmeds goal is to hire a diverse group of employees, some of who do not have any customer service experience, who he feels he can develop a personal connection. A large part of Ahmeds training involves team building, telling successful stories, and listening to each employees own desires for what constitutes a fulfilling job. Ahmed still assigns his employees their job duties and schedules at the end of training, and he also measures success in terms of efficient and cost effectiveness, but he also measures success in te rms of low employee turnover, employee morale, and employee development. Ahmed feels proud when one of his employees obtains an advance level position a year or two after being hired.The skills to be a leader or a manager are not exclusive in nature. A leader who only displays leadership skills will be ineffective when it comes to checking time cards, completing employee reviews, and scheduling employee vacation time things that employers require their managers to do on timely bases. Similarly, a manager who spends all his/her time completing paperwork and reading reports only creates more problems for him or her because they lack a developing relationship with their employees.Many companies, one person may play the intent of both leader and manager. In others, these roles are carried out by different bulk. And in many cases, the roles overlap and leaders need to manage and managers need to lead. However, it is critical that both roles are per make effectively for a company to suc ceed, especially a company with employees. Without a vision for the future, a company has no direction and no goals for which to strive. Good leaders are make not born. If you have the desire and will designer, you can become an effective leader. Good leaders develop through a never ending process of self-study, preparation, training, and experience. As a manager who would like to become a better leader to inspire your employees into higher levels of teamwork, there are certain things you must be, know, and, do. These do not come naturally, but are acquired through continual work and study. Good leaders are continually working and studying to improve their leadership skills. Leaders and managers also have much different conceptions of work itself. Leaders develop new go upes to long-standing problems. Leaders work in high-risk positions because of a crocked aversion to mundane work. Conversely, managers view work as an enabling process. Managers tolerate practical, mundane work b ecause of a strong survival instinct that makes them risk-averse. They are good at reaching compromises and mediating conflicts between opposing perspectives, but lack the influence to avoid future conflicts.QUESTION 2 Identify two very different organizations that compete on a cost leadership strategy and explain how they do this, i.e. find out what they do that enables them to keep their equipment casualtys low.The cost leadership strategic is to gain a competitive advantage. Make it into a simple word, cost leadership is contract the cost to fight with their competitor in same industry. The organization who need to earn more profit, must reduce the cost to ensure they are not waste any resource. The cost who has reduce more, the company will gain more profit and easy to survive in the market share.AnakkuAnakku as famous is selling the baby product. The company is celebrated 38th day of remembrance in Malaysia in 2011. Therefore, the company has their advantage to survive in thi s market. Anakku produce the baby products get it the mission is built on a strong, solid base of operations of premium persona, safety and reliability. The product have been sell by Anakku are fashion-wear for babies and toddlers, feeding equipment, toiletries, diapers, accessories, strollers, playpens and more.Baby KikoCreating style glamour, fun comfort for the little ones. Is the brand pee of Baby Kiko. Baby Kiko is a brand goalion from KIKO. Baby Kiko is establishing in Malaysia for over 20 years. Baby Kiko is one of the most widely recognized baby brand in Malaysia, known for quality, trendy style, and marketing creativity. The product that have been sell are toddler clothing, feeding accessories to weaning products, baby cleansing to baby skin conduct products.Cost Leadership StrategicBoth companies have completed their cost leadership strategic, therefore, both company can survive in the market winning a long period time. Each of them has the plan to reduce the cos t and increase their profit.Not even thought, both companies also employ the Michael entre 5 force to operate the companies. And they no using too much of advertising to upraise their product, so that, the cost will follow decrease.Next, most of the products like cloth or accessories are make by them. The pattern and the design had been created, so, the companies will produce it with their own manufactory. Follow by this, both companies will try to reduce the damage of the product. They will make sure the product is good. The after-sales service is one of the parts they can do, and get the feedback from the customers, and get to improve better to the customers need.Within the Michael Portal 5 forces, First of all, the bargaining power of supplier. For the Baby Kiko bon ton, all the product are make by own, so that, the raw material of they used is direct from the manufactory, so the price of the product can easy to under control.An opposite, about the Anakku association, some if the products like car seat or toys are manufacture from the supplies. Mostly, the Anakku Company will control by the supplier. But, for the Anakku Company, the main product for sell is clothing and the accessories like bottles, teethers, feeding accessories and etc. If the supplies increase the price, so they will change the supplier to get the raw material and try to product good product for their customers.Next, the bargaining power of customer or buyer is one of the forces that both companies used. The price had been set and the customers no have too much or no have power to argue to reduce the price. The entire product had been fix price, unless the company does the promotion like discount, so the customer will get the lower price of the product. Both companies have provided onsite service and after-sale service. And some of the product will give about 1 week to 1 year of countenance depend on the product.The threats of the entry of new competitor will also influence the cost . If got new competitor join into this industry, the company will spend more money to do promotion as like discount or adverting to attract people. This phase of money will increase the cost, so the profit will been decrease. Otherwise, both company had been survive in Malaysia taking a long period time, they have their own popularity in this country.For the Anakku Company, they mostly are produce the safety and useful product. The product no easy to damage and some of the product have the warranty to attract the customer to buy it. This is the advantage for them and no need s like about the new competitor to try to attack them.Besides that, the Baby Kiko Company more is based on the creative and innovative product to attract customers. The design and the fashion are new and look nicely. Based on the customers, they will take feedback and get the new the information to produce the product. Those are the advantage of the both companies the new competitor does not have too much power and cost to survive.Other than that, the intensity of competitor rivalry it may also influence the cost. Take a basic word, who can get the lower cost, who will win in the market. Therefore, the company must have the power and the capacity to run the business.For Anakku Company, they have many branches in the Malaysia. It will easy to target market and the customers. Anakku Company as a wholesaler otherwise as a retailer. They retail the product directly to the customer, so that, the cost will not be too high to be taken. The technology of Anakku Company use is high-tech machine. According the above statement, the Anakku Company does not have too much of advertising. footrace the business around 30 years, the popularity has the value on their customers.For Baby Kiko, they usually are wholesale to the stores that are really preferred to sales. Some hypermarket like Partson or The Store, we can see Baby Kiko product. Wholesale to other store, it can deduct the cost of employee and n o need searching the place to run over the business. The customers who are prefer to sell the product, they will delivery it. It may reduce the cost with it. Not even that, Baby Kiko Company also though the internet to promote the product. One of the major website is Facebook to promote. It is free of charge and also can attract more people to know the new product.Other than that, the labour force it may influence the cost available. Anakku Company is more focus on the retail sale, so that, the employee will taking more and more, so the cost relative will increase. From the manufactory to the store, they are too many employees to work. But, the Baby Kiko no taking too much of employee, because they have using the technology like machine or wholesale to other seller. The cost taking is the transportation fee.At last, which companies keep the lower cost it may easy and expand the business. Besides that, properly using the raw material and do not simply waste too much. Because the wast e will direct influence the cost. Have a good plan of cost leadership, the company more easy to survive in the market share.Nursing Case withdraw Osteoarthritis (OA) ManagementNursing Case Study Osteoarthritis (OA) ManagementIntroductionOver 60% of adults in England suffer from a continuing health problem (Department of wellness 2004). Osteoarthritis (OA) is among the most common inveterate conditions, particularly among aged(a) adults, and is a cause of considerable put out and disability among affected individuals. The prevalence of OA has been estimated at 2.5% in the overall population, increasing to 12% among those aged 65 years and over (Wood 1999). OA is a complex condition with multiple risk factors of age, sex, overweight or obesity, genetics, and biomechanical factors (e.g. joystick injury or occupational or recreational use). It is possible for OA to develop in any synovial joint but the spine, hip, stifle, hands most commonly affected, either in closing off or in combination (Steven and Finlayson 2005). Typical symptoms of OA include joint anguish, stiffness, limited movement, crepitus and swelling, and symptoms may be static, relapsing or progressive (Steven and Finlayson 2005). Structural changes within the joint may also occur in the absence of any symptoms.OA places a considerable burden on health awe resources, with data published in 2002 showing this condition to be responsible for over 11 million GP visits and more than 114,500 infirmary price of accesss (Arthritis Research bear on 2002). OA also impacts significantly on the economy. In 19992000, it was estimated that a total of 36 million working days were lost due to OA alone, resulting in 3.2 billion in lost productivity (Arthritis Research campaign 2002). It is therefore important that OA is managed effectively in affected individuals. This paper discusses a tolerant that I have nursed with osteoarthritis and examines the effectiveness of their distribute in the managemen t of this condition.Patient case historyMrs metalworker is aged 78 years and lives independently in a two-storey house with her married man, aged 82 years, who is her main carer. She has osteoarthritis of the knees, hips and hands and also has hypertension and diabetes. She is taking four medications for these conditions. Eighteen months ago, she underwent emergency hospital admission for a urine infection. After being dispatch from hospital, judging showed her to be at an increased risk of repeated admissions due to her multiple pathology, polypharmacy and previous hospital admission. The care she had percolated prior to hospital admission was below standard and self-management of her condition was abject. Her GP referred her case management to a confederation matron who worked alongside a multidisciplinary team of healthcare professionals (I was a member of this team) and her husband to co-ordinate her care and help Mrs metalworker reduce her risk of future hospital admission s. The community matron was involved in Mrs Smiths programme of care for a total of two months, after which time co-ordination of her care was handed back to her GP.At the initial assessment, Mrs Smith was found to be experiencing high levels of pain which affected her sleep patterns and showed symptoms of depression. She also reported relationship problems. At present, her pain is being managed effectively through a combination of pharmacological and non-pharmacological interventions which include self-management she reports familiar sleeping patterns and shows no signs of depression. Her relationship with her husband has also improved and Mrs Smith is now no longer at increased risk of future hospital admissions.Managing individuals with chronic conditionsThe care and management of chronic conditions should address individual needs and expectations. The government has set Public Service Agreement (PSA) targets for improving outcomes for people with chronic conditions. These inclu de reducing emergency bed days by 5% and increasing the number of older adults who are supported to live at fellowship by 1% by 2008, from the 2003/4 baseline (Department of wellness 2005). With the aim of meeting these targets, the NHS and Social fearfulness Model was developed to help Primary Care Trusts (PCTs) and brotherly care organisations improve care for individuals with chronic conditions (Department and Health 2005). From 2005, all PCTs are required to provide change care plans for those individuals who are most at risk. Initiatives such as the skilled Patient Programme are included in this model and will be discussed later.Providing high-quality care for older adultsThe NHS Plan set out a programme of reforms for the NHS (Department of Health 2000). Based on the underpinning principles of this plan, the National Service Framework for Older tribe was implemented to ensure that the needs of older adults are adequately turn to in these reforms (Department of Health 20 01). This will be achieved by ensuring high standards of care are provided for all patients, improving access to care, and developing services which promote independence. The Essence of Care, published in 2001, sets out benchmarks for clinical governance covering eight areas of care which identify required standards for high-quality care and indicators for take up practice (NHS Modernisation Agency 2003).NHS reforms have led to changes in the role of nurses, providing new opportunities for nurses to extend their existing roles, together with the introduction of new roles such as the community matron in the community stage setting and modern matrons in the hospital setting (Department of Health 2001). Client since we dont discuss care in the hospital setting elsewhere, I havent discussed the role of the modern matron any further This paper will examine the role of the nurse as part of a multidisciplinary care team in the care of Mrs Smith.Care and management of osteoarthritis in ol der adultsThe management of OA in adults becomes increasingly complex with advancing age (Holman and Lorig 1997). Since there is no cure for OA, the main therapeutic goals are to minimise the effects of the disease and over time. impelling care involves building long-term interpersonal relationships between healthcare providers and patients, carers, family members, other care providers, and those organisations involved in providing care and support. A holistic approach to assessment and treatment is required that considers the physiological, psychological and fond needs of the individual in relation to their quality of life and daily activities (Salaffi et al. 1991). Both the National Institute of Clinical Excellence and the Royal College of Physicians have belatedly published guidelines for the care and management of osteoarthritis in adults (National Collaborating Centre for Chronic Conditions 2008 NICE 2008). The care of Mrs Smith will be discussed in the context of the recomm endations made in these guidelines.AssessmentThe single assessment process for older adults was introduced in 2000 as part of the NHS Plan (Department of Health 2000). This requires an assessment of the individuals health and social care needs to take place in a single assessment and was designed to standardise the assessment process and raise standards of assessment practice. During Mrs Smiths assessment, her attentions, expectations and level of knowledge about her condition were discussed, together with the effect that her osteoarthritis had on daily activities including personal hygiene, climbing stairs, getting up from chairs, etc, and on her sleep patterns. Her levels of pain and mood were also assessed. Mr Smith also participated in the assessment, in order to gain his perspective on his wifes condition and to establish how well he was coping as her carer, and also to identify any specific health need he might have. Further specialist assessment of Mrs Smith and her ability to undertake daily activities, together with an environment assessment, were undertaken by an occupational therapist.Mrs Smiths level of knowledge about her condition was poor. Three other key issues were also identified during the assessment, namely pain management, depression/anxiety and relationship problems. Mrs Smith reported increasing pain in her joints, particularly her knees and hips prior to her admission to hospital which was so bad she was unable to sleep at night. The care she had been receiving prior to this had not effectively addressed this increasing pain. Screening and assessment showed Mrs Smith was suffering from mild depression. She reported feeling distress that she was no longer able to undertake many dwelling house tasks that she used to be able to do or participate in recreational activities with her husband that she used to enjoy. The increasing pain she had been experiencing prior to her hospital admission also contributed to her feelings of depression. S he reported feelings of anxiety over fears that she may be made to leave her home as she could no longer manage to climb the stairs. Mrs Smith showed negative feelings regarding her past care and was ab initio pessimistic about the likely effectiveness of the proposed treatment in the current care plan. Mrs Smith expressed concern that her relationship with her husband was suffering because her pain and lack of sleep made her irritable and short tempered. An additional factor compounding these problems was her husbands poor hearing which served to make her more irritable. All of these issues are common among adults suffering from OA (Farmer et al. 2008), and is important that their care plans effectively address these needs.The nurse plays a pivotal role in the assessment of individuals with chronic conditions and it is important for the nurse to establish a successful therapeutic relationship with the patient and their carer(s) as early as possible in the process. Effective commun ication and building trust is central to this relationship and it is necessary to gain the perspective of both the patient and carer to develop a sodding(a) understanding of individual needs.Development and implementation of a personalised care planEmpowering patients to take part in decisions regarding their care is central to the governments health service policy agenda (Department of Health 2000). The empowerment of older adults is also addressed in the NSF for Older People (Department of Health 2001). Research suggests that patient empowerment may help to strengthen patients ability to self-manage their condition (Corben and Rosen 2005). It is also beneficial to involve families and carers in the decision-making process, with the consent of the patient. A personalised care plan was developed for Mrs Smith with the involvement of both her and her husband, which was tailored to meet her individual goals. This plan enabled high-quality, patient-centred care to be delivered via a m ultidisciplinary team of healthcare professionals which included her GP, nurse, physiotherapist, occupational therapist and community matron. Social services were also involved in providing additional support for both members of the couple. Taking account of Mrs Smiths multiple pathology and polypharmacy and the use of research-based evidence were both of major importance when developing this care plan.Interventions within the care plan and the individual roles of healthcare providersNon-pharmacological interventionsThe purvey of education and advice and muscle strengthening exercises were the two core interventions in Mrs Smiths care programme. Research has shown that patients ofttimes report better outcomes when they receive education and advice as this empowers them to become more involved in their own care and equips them with the knowledge and skills required for self-management (Holman and Lorig 1997). Educating both Mrs Smith and her husband about her condition and methods o f self-management formed a key component of her care plan and discussions were primarily nurse-led.Encouraging self-management is essential for all chronic conditions and providing a simulation for self-management is an integral aspect of care (National Collaborating Centre for Chronic Conditions 2008). The Expert Patients Programme (EPP) was introduced in 2003 following the success of the Stanford Self-management Programme in the United States (Department of Health 2006). Research which provides the rationale for this programme suggests that patients who have trained in self-management have greater confidence and use their skills and knowledge to improve their overall quality of life. These individuals subsequently require fewer healthcare resources, leading to long-term cost savings. Self-management courses are run trained by lay leaders rather than healthcare professionals. To date, the success of EPP in the UK has been limited compared with that of other reclamation programmes for chronic conditions (Bethell et al. 2007).A physiotherapist taught Mrs Smith to perform a series of gentle exercises to strengthen the supporting muscles around her knee which she was then able to perform on a daily basis by herself at home. An occupational therapist recommended a number of modifications to Mrs Smiths home to make acting daily tasks easier. These included the installation of a raised toilet seat and wall bars in the bathroom. The occupational therapist also arranged the preparedness of shock- absorbing shoes to help reduce the pain in Mrs Smiths knees and hips. Due to Mrs Smiths limited mobility, opportunities for visits outside the home were restricted. However, social services arranged for both members of the couple to attend weekly bingo sessions at their local community centre which provided the opportunity for social interaction with other older adults which both members of the couple found beneficial.Pharmacological interventionsOral paracetamol and the use of topical NSAIDs for the knee were prescribed for Mrs Smith. Paracetamol and topical use of NSAIDs are the currently recommended first-line treatments for knee OA (NICE 2008). Paracetamol alone was not sufficient to control Mrs Smiths high levels of pain in her knees. Since her antihypertensive medication was a calcium channel blocker, the use of NSAIDs were not thought to be contra-indicated and were unlikely to show drug interaction with her other medications (Luque et al. 2006). Following discussions with Mrs Smith, a decision was taken not to prescribe anti-depressants initially but to monitor her symptoms of depression and revise her care plan if necessary.Throughout Mrs Smiths programme of care, the role of the nurse involved making ceaseless home visits to assess Mrs Smith and her husband. Monitoring the effectiveness of the interventions implemented is essential if the goals identified within the care plan are to be achieved. Regular reviews of the care plan should be made and changes made as required based on the outcome of ongoing assessments. Prior to the involvement of the community matron, Mrs Smiths GP practice was responsible for co-ordinating her care. The community matron is a relatively new clinical specialist position within the NHS, introduced specifically to provide support for people with long-term complex conditions (Department of Health 2004). Working alongside GPs, community matrons perform various roles which enable patients need to be met within the community rather than in hospital (Bassett 2005). The role of the community matron in this instance was in short-term case management.Addressing the carers needsEvidence suggests that the health needs of carers are frequently overlooked (Hare 2004). It is also important that carers receive adequate support as feelings of isolation and being unable to cope are common (Department of Health 2004b). Mr Smiths health needs were assessed during the initial assessment and addressed accordi ngly. Mr Smith suffered from angina for which he was already taking medication, and poor hearing. A follow-up specialist assessment of his hearing identified the need for a hearing aid which he received. The health of both patient and carer was then assessed by the nurse during subsequent home visits.Success of the care programmeMrs Smiths care programme had a successful outcome. Her symptoms of depression trim and her relationship improved once her pain was being managed more effectively and she was able to sleep better. Her mobility improved and confidence increased such that she was able to start taking short walks outside her home with her husband. She was also able to undertake more tasks within the home. Education about her condition led her to realise that OA is not the end of the world and that life can still be enjoyable, provided her condition continues to managed effectively. Mr Smith also received support from the healthcare team which helped to re-enforce his role as h er main carer and extend his knowledge about his wifes condition, which better equipped him to care for her effectively. Mrs Smiths care was delivered using the appropriate frameworks for older adults and those with chronic conditions and was in line with current management guidelines.Osteoarthritis and ageingOA is more common among older adults and will therefore frequently co-exist with other age-related comorbidities such as cardiovascular disease, diabetes and hypertension, as demonstrated in the case of Mrs Smith. Because of this multiple pathology, polypharmacy is common and drug regimens are often complex (Gorard 2006). Polypharmacy may increase the risk of drug-drug interactions and drug-related ominous events. In some cases, drug-drug interactions may counteract the effect of a particular drug (Cotter and Martin 2007). For example, if beta-blocker or angiotensin-converting enzyme inhibitor antihypertensives are co-administered with non-steroidal anti-inflammatories (NSAIDs ), the hypotensive effect of these drugs may be reduced due to sodium retention by the NSAID (Luque et al. 2006). Furthermore, older adults may also consume over-the-counter preparations (e.g. vitamins and analgesics) which also have the potential to interact with ethical drug drugs.Age-related changes in both drug pharmacokinetics and pharmacodynamics may be observed, and increased drug sensitivity may increase the risk of drug accumulation and toxicity in older adults (McGavock 2006). Other factors which should also be considered when prescribing drugs for older adults are (1) cognition whether the patient is able to understand and follow their treatment regimen (2) vision optic impairment may prevent them from being able to identify their tablets correctly (2) ability to swallow or fear of swallowing some patients may be unable to swallow large tablets or may be afraid to do so for fear of choking. It is therefore very important to ensure that a wax drug history is taken fo r every patient and other relevant factors are also taken into account.Ethical and legal issues in the management of chronic illnessNHS funding for individuals with chronic illness has been the subject of considerable controversy in recent years. Advances in medical technology have allowed healthcare providers to intimately prolong the life of many individuals with chronic conditions and this ability, coupled with the increasingly ageing population, have presented an unsolved dilemma of how to provide comprehensive care with limited resources (Waldron 2006). Until recently, some patients have been caught up in a so-called postcode lottery whereby drugs and services may be available to individuals living in one surface area of the UK, but not another. This is considered by many to be against the founding principles of the NHS which was introduced with the vision of providing free medical care for all (Donnelly 2008). While it must be declare that at the time of its conception sixt y years ago, no one could have predicted the extent of future increases in population size within the UK, or the shift towards an increasingly ageing population which have placed an ever increasing burden on services ill-equipped to meet demand. Nonetheless, regardless of the extent of available resources, these should be distributed fairly to all within the population regardless of location or any other factors.Living wills are an issue which may concern individuals with chronic conditions, particularly those receiving end of life care. There may be circumstances in which some individuals may not wish to receive life-prolonging treatment and it is important that decisions and choices regarding their care can be communicated to care providers if they themselves are unable to do so. Allowing individuals to refuse life-prolonging treatment may be viewed by some as a step towards euthanasia which considers the right of an individual to choose when and how to die and which has been the subject of intense debate for a number of years.The NSF for Older People (Department of Health 2001) addresses some of the ethical issues surrounding the care of older adults, in particular infringement of their dignity and unfair discrimination in access to care. This framework includes standards for (1) reducing age discrimination, ensuring that NHS services are provided on the basis of clinical need and that social services do not use age as a barrier to restrict access to services and (2) treating older adults as individuals and allowing them to become involved in decisions regarding their care (i.e. promoting patient empowerment, as discussed previously). The Evercare programme also addresses the right of older adults to receive high-quality patient-centred care. This programme was introduced in the UK in 2003 after demonstrating success in the United States. It is designed to improve care for older adults who frequently have multiple pathologies and social problems, who may be receiving poor care, and who are often admitted to hospital as emergency admissions for reasons that may have been preventable with higher standards of care. Those patients at highest risk of future hospital admission are identified for enrollment in the programme. A role of the community matron would be in identification of those individuals who may be benefit from this programme and in their case management. The principles of the programme include the provision of personalised, holistic care aimed at promoting independence, comfort and improved quality of life, and avoiding adverse effects of polypharmacy.ConclusionsThe management of chronic conditions such as OA presents a greater challenge in older adults with multiple pathologies, where successful outcomes may be dependent on a number of co-morbidities. The need for a full understanding of drug-drug interactions and age-related physiological changes is essential for accurate drug prescribing in this group of patients where pol ypharmacy is common. Effective management of Mrs Smiths condition was achieved through a combination of self-management and health and social care. Effective care involved a holistic approach to assessment and treatment from a multidisciplinary team of health and social care providers. Within this team, nurses played a pivotal role in the community setting (and were also involved in providing care in hospital setting during her hospital admission).There are a number of ethical and legal issues surrounding the care and management of chronic conditions, particularly in older adults where age discrimination and infringement of dignity have been highlighted as widespread problems. Initiatives such as the Evercare programme have been implemented to address these issues but their success has yet to be demonstrated on a national level.BibliographyArthritis Research Campaign 2002, Arthritis the sorry picture. Arthritis Research Campaign, London.Bassett, S. 2005, Community Matrons Improving the care of patients with long term conditions, Modernisation Agency.Bethell, H. J. N., Evans, J. A., Turner, S. C., Lewin, R. J. P. 2007, The rise and fall of cardiac rehabilitation in the United Kingdom since 1998, daybook of Public Health, vol. 29, pp. 5761.Corben, S. Rosen, R 2005, Self-management of long-term conditions patients perspectives on the way ahead, Kings Fund, London.Cotter, L. E. Martin, U. 2007, Student British Medical Journal, vol. 15, pp. 33782.Department of Health 2000, The NHS Plan a plan for investment, a plan for reform. Retrieved 25th July 2008 fromhttp//www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4002960Department of Health 2001, National Service Framework for Older People. Retrieved 25th July 2008 fromhttp//www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4003066Department of Health 2001, Implementing the NHS Plan modern matrons strengthening the role of ward sisters and introducing senior sisters. Retrieved 25th July 2008 fromhttp//www.dh.gov.uk/en/Publicationsandstatistics/Lettersandcirculars/Healthservicecirculars/DH_4004789Department of Health 2004, Chronic disease management a aggregation of information. Retrieved 25th July 2008 fromhttp//www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_062820Department of Health 2004, The NHS Improvement Plan putting people at the heart of public services. Retrieved 25th July 2008 fromhttp//www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4084476Department of Health 2005, Supporting people with long term conditions. An NHS and social care model to support local innovation and integration. Retrieved 25th July 2008 fromhttp//www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4100252Department of Health 2006, The Expert Patient Patients Programme. Retrieved 25th July fromhttp//www.dh.gov.uk/e n/Aboutus/MinistersandDepartmentLeaders/ChiefMedicalOfficer/ProgressOnPolicy/ProgressBrowsableDocument/DH_4102757Donnelly, L. 2008, NHS at 60 a vision which we still believe. Retrieved 25th July 2008 fromhttp//www.telegraph.co.uk/news/uknews/2171506/NHS-at-60-A-vision-in-which-we-still-believe.htmlFarmer, A., Korszum, A., Owen, M. J., Craddock, N., Jones, L., Jones, I., Gray, J., Williamson, R. J., McGuffin, P. 2008, Medical disorders in people with recurrent depression, The British Journal of Psychiatry, vol. 192, pp. 3515.Gorard, D. A. 2006, Escalating polypharmacy, Q J Med, vol. 99, pp. 797800.Holman, H. Lorig, K 1997, Overcoming barriers to successful aging self management of osteoarthritis, Western Journal of Medicine, vol. 167, no. 4, pp. 2658.Luque, M., Navarro, A., Martell, N. 2006, make use of of non-steroidal anti-inflammatory drugs does not modify the antihypertensive effect of lercanidipine in essential hypertension, British Journal of Cardiology, vol. 13, no. 5, pp. 3 539.McGavock, H. 2002, The scientific basis of prescribing in the hoary, Prescriber, pp. 869.NHS Modernisation Agency 2003, Essence of care. Patient-focused benchmarks for clinical governance. Retrieved 25th July 2008 fromhttp//www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4005475National Collaborating Centre for Chronic Conditions 2008, Osteoarthritis national clinical guideline for care and management in adults, Royal College of Physicians, London.NICE 2008, Osteoarthritis. The care and management of osteoarthritis in adults. Retrieved 25th July 2008 fromhttp//www.nice.org.uk/nicemedia/pdf/CG59NICEguideline.pdfSalaffi F, Cavalieri F, Nolli M. 1991, Analysis of disability in knee osteoarthritis. Relationship with age and psychological variables but not with radiographic score, Journal of Rheumatology, vol. 18, no. 10, pp. 15816.Steven, M. M. Finlayson, D. 2005, Management of osteoarthritis, Journal of the Royal College of Physicians of E dinburgh, vol. 35, pp. 2469.Waldron, N. 2006, Funding decisions in chronically inexorable individuals, British Journal of Nursing, vol. 15, no. 9, pp. 28691.Wood, J. 1999, Osteoarthritis and its management, The Pharmaceutical Journal, vol. 262, no. 7046, pp. 7446.

Punishment as a form of behaviour modification Essay -- essays researc

Introductionpunishment is a process through which the consequence of a response decreases the likelihood that the response leave alone recur (Gray, 2002, pp.115). Further, punishment can be seen as an effort to decrease the response rate to stimuli by either removing a likingd stimulus or presenting one which is undesired (Gray, 2002). Recent studies suggest that punishment can be an doive method of behaviour modification. However, as reported in Lerman and Vorndran (2002), there are a number of limitations to punishment as an intervention and subsequent negative side effects. For this reason, certain principles upon which the implementation of a successful punishment is dependent must(prenominal) be adhered to. In accordance to these findings, this essay will contend that whilst there are alternative means to operant conditioning, certain punishment techniques have been turn out to be effectual and in some aspects advantageous.The effectiveness of punishmentPunishment is one of the most used, but least understood and badly administered, aspects of learning (Luthans, 1977, pp.300). As mentioned earlier, punishment is anything which weakens behaviour and tends to decrease it in subsequent frequency. Positive punishment is the method of administering negative consequences upon the occurrence of an action whereas Negative punishment involves the termination of autocratic consequences. In order to work, either case must weaken and decrease the behaviour which preceded the application or withdrawal of the stimuli. Skinner (1953) stipulated that we must defy the invigorate to label a form of stimuli as desired or undesired as a whole but rather to identify them by their effect on the observed subject.Whether punishment is effective depends on the criteria applied or the objectives to be achieved. That is, before we can say it is useful we must ask whether we desire an immediate or a lasting effect, and at how high a cost. There is some evidence to suggest th at when punishment is administered in the form of aversive stimulation, it acts to suppress behaviour temporarily. When it is withdrawn, the punished behaviour rapidly gains strength. If the punishment is more severe and given consistently, it may act to suppress behaviour for a semipermanent period of time (Skinner, 1953). Historically, the efficacy of punishment has been appreciated only in the pa... ... determine its utility (Lerman & Vorndran, 2002). Ultimately, if punishment is necessary, it should always be used in conclave with positive reinforcement (Luthans, 1977, p.517).ReferencesBlackham, G.J., & Silberman, A. (1971). Modification of Child Behaviour. Belmont, California Wadsworth Publishing Company, Inc.Browning, R.M., & Stover, D.O. (1971). Behaviour Modification in Child Treatment. Chicago AldineAtherton, Inc.Gray, P. (2002). Psychology (4th ed.). New York Worth Publishers.Lerman, D. C., & Vorndran, C. M. (2002). On the status of knowledge for using punishment Implic ations for treating behavior disorders. Journal of Applied Behavior Analysis, 35, 431-464.Lieberman, D. A. (2000). Learning, Behavior and Cognition (3rd ed.). Belmont, CA Wadsworth/Thomson Learning. Chapter 7Luthans, F. (1977). Organizational Behaviour. United States of America McGraw-Hill, Inc.Sanson, A., Montgomery, B., Gault, U., Gridley, H., & Thomson, D. (1996). Punishment and behaviour change An Australian Psychology Society position paper. Australian Psychologist, 31, 157-165.Skinner, B. F. (1953). Science and human behaviour. New York Macmillan Co.

10 Years After The Reovlution :: essays research papers

The so-called"Velvet revolution " ended the communist control ofCzechoslovakia in late 1989. On November 17 the formalgovernment allowed a demonstration, where peoplecommemorated the 50th anniversary of a cruel suppressionof a student demonstration in German-occupied Prague.However, history tell itself and the students werebrutally beaten by police. As a result a large protestmovement developed. Demonstrations and strikesoccurred across the whole arena under the leading ofObcanske forum, which was leaded by Vaclav Havel, adissident playwright and Charter 77 signer. Following thepolitical turmoil he became the new president ofCzechoslovakia. Ten old age after the Velvet Revolutionmany political and social changes have occurred within theformer Czechoslovakia. The first major change was thepeaceful split of the country to form two separate recounts,the Czech Republic and Slovakia as we know it today.Following this split much of the former communistinfrastructure was disba nded including many state runindustries in an attempt to make them more efficient andencourage investment. Former communist legislation countering the freedom of speech was also passed out of law allowing people to express their political views andcriticize government policies. For many people thesechanges introduced a great improvement in their standardof living. A wide configuration of goods soon appeared inprivately run shops which previously had only beenavailable in Hesperian shops. People were also allowed totravel freely, which had been banned under the communiststo prevent the breeding of discontent when people sawwhat was available in other countries. The country alsoprospered following increase foreign investment as westerncompanies keen to exploit new markets entered thecountry for example the takeover of Skoda by the Germanrun Volkswagen. However, the Velvet revolution did havesome negative effects. The systematisation of state runcompanies meant that many people were put out of work

Death of A Salesman :: essays research papers

carrier bag / Willy - Turning PointsA major turning point in the degree Death of a Salesman occurs on pages 1394 and 1395. The scene is Willy walking into Charleys office and he breaks Bernard (Charleys son) waiting in the waiting room. Willy sits next to Bernard and starts to have a conversation with him. The conversation starts out casual, then Willy asks Bernard where did he go wrong with lick (Willys son). Bernard tells Willy that Biff was prepared to attend summer school and Willy was surprised. Bernard asks Willy if Biff came up to see him in New England. Willy replied, Yeah, he came to Boston. What about it? He tells Willy that when Biff came back he wasnt the same and it was then that Bernard knew that Biff had disposed up his life. When Bernard asked Willy what happened up there Willy got angry and said that nothing happened. After that conversation Willy started to play back in his mind the events that occurred the day Biff came to see him in Boston. On page 1407 Wil ly is in the hotel room with his mistress and they hear a knock at the ingress. The woman tells Willy, Arent you going to answer the door? Hell wake the whole hotel. After trying to divert her attention Willy tells the woman to hide in the bathroom while he answers the door. Willy opens the door and sees Biff standing there. He asks his son why he came to Boston and his son replies that he flunked math and doesnt have enough credits to graduate. They talk a little more then a laugh is heard from the bathroom. The woman comes out of the bathroom and Willy tries his best to get rid of her. He tells Biff that she sound needed to borrow his shower. Tears begin to fall down Biffs face and Willy is still trying to come up with excuses.

James Baldwin’s Critique of the Social Condition Essay -- James Baldwi

James Baldwins Critique of the Social Condition James Baldwin was an Afri stub American writer who, through his own person-to-person experiences and life, addressed issues such as race, sexuality, and the American identity. Notes of a Native Son is one of many essays that Baldwin wrote during his lifetime. Within this essay, Baldwin talks about when his father died and the events that roll outd rough it. His fathers death occurs in the early 1940s, where oppression and racism were still fairly prevalent in many cities across the nation. So amidst the events that revolve around Baldwins fathers death, there are many riots and beatings taking place. This essay is simply not a recollection of what Baldwin experienced in the past, but it challenges, critiques, and tries to understand the current social condition of the time. He does this by recalling his personal experiences to draw the reader in and as a result of that, can begin to construct an analysis of the so cial condition. Baldwin weaves in and out of his personal experiences and private reasons to give the reader both a small and large office of what is going on at the time. Its important for the reader to have a small, personal perspective so they can connect with the emotions Baldwin expresses. At the equal time a large general perspective is needed because it shows the reader that Baldwins experiences, although unique, is connected to a larger group of people, that in one dash or another, his plight is the plight of many. Baldwin effectively implements this method when he says All of Harlem, indeed, seemed to be infected by waiting (73). This sentence is placed in amid two moments. Prior to this sentence, Baldw... ...bat the poison with it, perhaps poison should be fought with poison (78). Through his own experiences, Baldwin is able to highlight the social condition that he was surround with during that period. Through skillful use of w ords and transition, Baldwin was able to indirectly question and analyze the social condition without losing the interest of the reader. By moving back and away from a personal experience to a public condition, Baldwin makes the essay very powerful and very effective in getting his points across. What is also successful about Baldwins method is that it captures the readers attention and forces them to look deeper and understand what it is he truly is talking about.Works CitedBaldwin, James. Notes of a Native Son. 1955. James Baldwin Collected Essays. Ed.Toni Morrison. New York program library of America, 1998. 63-84.