Zidovudine for the Prevention of HIV Transmission

Zidovudine for the Prevention of HIV Transmission Presentation Zidovudine is an antiretroviral sedate which is a nucleoside switch transcriptase inhibitor; it is utilized as treatment with other antiretroviral drugs against the Human Immunodeficiency Virus. Moreover, zidovudine can be used as a methods for diminishing the danger of move of HIV from a pregnant lady to her kid. Moreover, zidovudine is utilized in post presentation prophylaxis so as to bring down the opportunity of being contaminated with HIV in individuals who have been presented to the infection. (AHFS Drug Information, n.d.). Name Of Drug, Structure, Formula and Functional Groups Zidovudine is otherwise called azidothymidine and, to put it plainly, AZT (Joint Formulary Committee, 2010). The sub-atomic equation of the compound is C10H13N5O4 (The Merck Index, n.d.) and zidovudine has a sub-atomic load of 267.25, as determined utilizing the ISIS ChemDraw bundle (Cambridge Soft, n.d.). Breaking down the compound shows that zidovudine is comprised of a thymine bunch clung to a 2,3-dideoxyribose bunch with a connected azide gathering. In this way the deliberate name of zidovudine is 3†²-azido-2, 3†²-dideoxythymidine (The Merck Index, n.d.), as the oxygen of the hydroxyl bunch on the 3 carbon of the ribose ring has been evacuated, giving 3-deoxyribose, and has been supplanted with an azide gathering and the oxygen on the 2 carbon has additionally been expelled. The azide bunch on the ribose ring is the motivation behind why zidovudine goes about as a nucleoside invert transcriptase inhibitor (AHFS Drug Information, n.d.). With the end goal for zidovudine to do its job, it must be phosphorylated by a protein called thymidine kinase; this is because of the way that converse transcriptase incorporates the triphosphates delivered into the HIV DNA chain being framed during HIV replication. Thus, after the triphosphate has been incorporated, 5, 3-phosphodiester holding in the DNA chain is beyond the realm of imagination, as a result of azide bunch in the triphosphate, and in this manner DNA development can't proceed (Foye et al, 2008). Details and Packaging The nonexclusive type of zidovudine is accessible as hard cases (Electronic Medicines Compendium, n.d.) in two qualities of 100mg and 250mg (Joint Formulary Committee, 2010). The two qualities are bundled in foil rankle packs and plastic containers and should be kept in these; they have an expiry date of 2 years from the date of production (Electronic Medicines Compendium, n.d.). Zidovudine is likewise accessible under the brand name of Retrovirâ ® as cases, oral arrangement and infusion arrangement (Joint Formulary Committee, 2010). The entirety of the Retrovirâ ® plans should be kept underneath 30 degrees and in their unique external boxes (Electronic Medicines Compendium, n.d.). The containers are hard cases (Electronic Medicines Compendium, n.d.) in qualities of 100mg and 250mg (Joint Formulary Committee, 2010); they have an expiry date of five years from the date of production and are bundled in a rankle pack or a jug (Electronic Medicines Compendium, n.d.). The oral arrangement comprises of a 50mg in 5ml portion (Joint Formulary Committee, 2010) and is bundled in a golden container made of glass. The oral arrangement has an expiry date of two years from the date of production yet ought to be discarded after the jug has been opened for one month (Electronic Medicines Compendium, n.d.). The infusion arrangement is accessible in the portion of 10mg per 1ml and is utilized for intravenous implantation (Joint Formulary Committee, 2010). It is bundled in a glass vial which is golden or clear in shading. The arrangement has an expiry date of three years after the date of assembling in any case, when opened, it must be utilized immediately and any residual arrangement discarded (Electronic Medicines Compendium, n.d.). As indicated by Martindale: The Complete Drug Reference (n.d.), all the definitions of zidovudine should be protected from wellsprings of light and should be kept in sealed shut compartments. Stereochemistry and Conformation As featured in the graph drawn utilizing ISIS ChemDraw (Cambridge Soft, n.d.), zidovudine has a sum of three chiral focuses and subsequently zidovudine has eight potential stereoisomers. The 1 carbon of the ribose ring is of the R arrangement though the 3 and 4 carbons are of the S setup (Novak et al, 2003). Zidovudine has a particular optical turn estimation of +99â ° in water (Merck, n.d.) and thus pivots the plane of spellbound light clockwise; subsequently zidovudine is optically dynamic (Freeman, 2010). Combination Zidovudine was made by Jerome Horwitz in 1964 (Weeks et al, 2010). It tends to be shaped from thymidine, be that as it may, this is an exorbitant strategy and along these lines a more financially savvy procedure is utilized to make zidovudine for an enormous scope by utilizing D-Mannitol as the beginning compound (Saunders, 2000). The procedure has been drawn underneath utilizing ISIS ChemDraw (Cambridge Soft, n.d.) regarding Top Drugs (2000). In the main stage, a subordinate of D-glyceraldehyde is framed from D-mannitol utilizing CH3)2CO and a wellspring of protons and refluxing. Lead (IV) acetic acid derivation is then included. In the second stage a Wittig response is done and PH3P=CHCO2Et and methanol are included. In the third step hydrochloric corrosive is included, creating a lactone. In the fourth stage the lactone is ensured and the azide bunch is included through a Michael expansion response. The reagents used to ensure the lactone are t-Bu(Me)2SiCl, imidazole and dimethylformamide. The reagents for the Michael expansion response are lithium azide, tetrahydrofuran, acidic corrosive and water. In the fifth stage the lactone is diminished to a lactol at short 78 degrees utilizing Diisobutylaluminium hydride and dichloromethane. The hydroxyl bunch is actuated to frame a sugar middle utilizing acidic anhydride and pyridine. In the 6th step, Vorbruggen conditions are received and a buildup response is performed with t he sugar middle of the road and silylated thymine which produces alpha and beta anomers. The reagents are di-trimethylsilyl-thymine, trimethylsilyl trifluoromethanesulfonate and EDC. In the seventh step, the silyl ensuring bunch is taken off and the anomers are uncombined to acquire zidovudine. The reagents utilized in this progression are n-Bu4N+F-and tetrahydrofuran (Saunders, 2000). Medication security: Potential destinations of compound flimsiness and digestion Zidovudine deteriorates enormously within the sight of light as a result of the azide gathering and the item framed from the breakdown is thymine. This is on the grounds that two nitrogen particles are expelled from the azide gathering, framing nitrene. An addition response happens and aziridine is made. Water, as a nucleophile, assaults aziridine. The amide anion shaped causes the thymine gathering to be nucleophilically dislodged and thus thymine is delivered as the corruption item (Dunge et al, 2004). Thusly as zidovudine is for the most part influenced by light it is informed that the different details with respect to zidovudine are avoided light sources (British Pharmacopeia, 2010). Zidovudine has a bioavailability of 63%. This is because of the way that zidovudine experiences glucuronidation, giving zidovudine glucuronide which is more water dissolvable than zidovudine because of a sugar bunch being included, and is renally discharged (Burton et al, 2006). UDP-glucuronyl transferease is the catalyst which catalyzes the response (Veal et al, 1995). Zidovudine can likewise be changed over to 3-amino-3-deoxythymidine because of the azide bunch being decreased (Veal et al, 1995); 3-amino-3-deoxythymidine can influence the activity of zidovudine against HIV and is perhaps harmful (Burton et al, 2006). Lipinskis Rules For Orally Active Drugs As per Clarkes Analysis Of Drugs And Poisons (n.d.) the Log P estimation of Zidovudine is 0.05 and the atomic weight is 267.25 as determined on ISIS ChemDraw (Cambridge Soft, n.d.). Zidovudine has an aggregate of two hydrogen bond contributor locales and a sum of nine hydrogen bond acceptor destinations (Lipinski et al, 1997). Therefore, zidovudine observes Lipinskis Rules of Five as it has a sub-atomic load of under 500, a Log P estimation of under 5, there are under five hydrogen bond contributor locales and there are under ten hydrogen bond acceptor destinations (Lipinski et al, 1997). As the Log P estimation of zidovudine is 0.05 (Clarkes Analysis Of Drugs And Poisons, n.d.) it tends to be seen that the medication is somewhat polar. Zidovudine contains sweet-smelling and enormous aliphatic districts which are hydrophobic; the polar character emerges from the hydroxyl gathering, an amide locale, an ether connection and azide gathering, which are on the whole hydrophilic areas. In this way as there is a slight lopsidedness of increasingly hydrophilic gatherings to hydrophobic gatherings, zidovudine is marginally hydrophilic and somewhat polar and consequently is water solvent and has less fondness to cross the lipid layers (Bichenkova, 2010). pKa and Ionization State At pH 2, 7.4 and 10 and Solubility As indicated by the International Agency for Research on Cancer (n.d.), the pKa estimation of Zidovudine is 9.68 and henceforth it is feebly acidic. Utilizing the condition for the level of ionization, which has been gotten from the Henderson-Hasselbalch condition, I am ready to figure the rate measure of ionization of zidovudine at different pH esteems. The condition utilized comprises of: % ionization of a corrosive = 100/1 + antilog(pKa pH) (Freeman, 2010). At pH2, the condition will peruse % ionization = 100/1 + antilog (9.68 2). This gives the worth 2.0910^-6 %. Subsequently it tends to be seen that in the stomach just an extremely modest quantity of zidovudine will be ionized and for the most part it will be to a great extent unionized. The level of zidovudine unionized at pH2 is 99.99% and subsequently as zidovudine is exceptionally unionized at pH 2, it will be ingested from the stomach. At pH2 2.0910^-6% of zidovudine is ionized as the azide gathering can be protonated (Chemicalize, n.d.). At pH 7.4 the computation gives an estimation of 0.52%. Thus in the circulation system zidovudine will be to a great extent unionized as the level of zidovudine that is unionized in the circulatory system is 9

Business ethics dilemma that you have faced, either as an employee or Essay

Business morals predicament that you have confronted, either as a worker or a director - Essay Example In late August two years prior, I saw an issue with the way Kevin took care of different workers in our specialty. I saw that he was being savage to them like giving them a lot of work notwithstanding the hecticness of their calendars and more terrible, with no additional pay. The quantity of representatives whining about Kevin’s brutal arrangements was expanding to the point that they were all voicing out to me what they trust I ought to do. Everybody of them was disclosing to me that I should report Kevin to the higher bosses of the organization, and they accepted that it would prompt my advancement as the following supervisor. Word has arrived at the CEO that something was turning out badly in the division in spite of the fact that Kevin prevented all from securing these claims. Nonetheless, since the CEO didn't totally purchase what Kevin had said. He required a shut entryway meeting between different representatives who were some way or another inferring oppressed status just as me, being second in line for the situation of administrator. At the point when the CEO and his right hand entered, they helped us to remember two things †our devotion to them, in this manner suggesting that they anticipate the honesty of our declarations, and the direness of the circumstance, since a few workers have been voicing out their complaints over web based life. Besides, they underlined the way that the motivation behind the gathering was to decide reality and to decide the correct measures to moderate or take out the issue. Nonetheless, what happened was that the CEO saw that everything appeared to be reluctant to state anything during the shut entryway meeting. Therefore, the representative gave a report to be composed by me inside 24 hours. I was in this manner left with three decisions. The first was to come clean about the issue while simultaneously taking a chance with my companionship with Kevin and taking a chance with my own notoriety too since he would along these lines uncover to the CEO my past crimes. The subsequent option was to prevent the claims from securing different workers, therefore taking a chance with my fame among them and

The Hidden Secrets of How to Write an Informative Essay

The Hidden Secrets of How to Write an Informative Essay Informative essays, it is the most common form of the writing which is written in the colleges. In addition to this, writing an informative essay is comparatively easy, a number of the times that scholars find it hard to write. Frequently, students end up getting a fail or average grades. Lets uncover the secrets on how to write an informative essay. Outline of Informative essay Summary Outline of Informative essayStructure of Informative essayIntroductionThesis StatementBody paragraphConclusionIn what way to start an informative essay?Body paragraphsExactly how to end an informative essay?The Good informative essay TopicsIdeas for the Informative essayConclusion Outline of the essay is a vital part. The purpose of an essay outline is to begin the information as clearly as possible, and the reader must get as close as possible to the subject. The outline of the essay is constructed step by step as well as no need to add ample of information. Now we give you an outline example; it is straightforward as compare to another outline of the essay along with not hard. Structure of Informative essay Introduction In this part, you can catch your students. Thus they wont stop later the first section. Try to make it curious from the beginning and first sentence. Besides this, you know how to use several questions to incite an argument and include the reader to have extra concerns. Thesis Statement A thesis statement is one sentence that states the first idea of an essay, for example, an argumentative essay or expository essay. It makes a claim, straight replying a question. Body paragraph This section should be added to 2-3 long paragraphs. Along with it, you will have to notify your reader related to the thesis statement. Besides this, a body paragraph, it is a set of linked sentences associated with the particular idea or topic responsively linking to the thesis. Since essays are collections of various paragraphs of the corporate structure, it is one of the most critical aspects of creating a well-organized essay. Conclusion It is the last part of an informative essay, so you have to rewrite the thesis statement of your informative essay in a changing method. Create a summary of the clarifications of your essay. The part of the conclusion has to be definite in a single paragraph. And, the phrase, in conclusion, means finally, to sum up, and is used to familiarize several final comments at the end of an essay. In what way to start an informative essay? The easiest and best way to start an informative essay is to ask the reader about the details that you recommend in the next paragraphs.; therefore that he wont stop on your introduction of an informative essay. You will have a blessing chance to acquire the winning grade later turning in your essay. Besides this, it is continuously good for GPA. Dont forget to build a concise, informative essay on brief documents, so that your links can be easily read. Body paragraphs In the above explanation, it is all the reasons that make the thesis expressive. In an informative essay, the body paragraph should be included in a logical order. Exactly how to end an informative essay? It is the last and hardest part of an informative essay, later constructing the thesis statement. As a result, in what way to conclude an informative essay, it is the most often asked question. Nevertheless, you always be able to find a solution, right? The conclusion of the informative essay is only answers to the things that may be lacking after the passages. Rewrite all of your thesis statements and connect them. It doesnt sound too complicated. The Good informative essay Topics Undoubtedly, an outline is the most significant; on the other hand, and it is not the same from the outline for any other essay. Besides this, one of the hardest things is to discover the best topic, whom you can open as well as it must first be exciting to you because you can make the reader interested in the subject if you are interested Ideas for the Informative essay There are lots of examples of informative essay writing Global warmingCauses for tornadoThanksgiving historyCauses for tornadoGap year Conclusion Now you have seen how to write an informative essay. The writing of the essay is an essential part of the life of a student. Because of it an excellent idea for a homework project, the professors love to give it. It promotes the growth of skills assessment, critical thinking, and contemporary training. Get the best essay writing help from the experts at nominal charges.

In Cold Blood, the American Dream and Loss of Innocence

Hey, you, dearest reader, searching for an essay to write. Id just like some love, just some respect, you know nothing big, other than a thank you, thats all. So when you finish writing, just remember thanks mysterious keyboard writer, you saved my ass. With out further a due, my essay: The American Dream In the non-fiction novel In Cold Blood by Truman Capote, four horrific murders shock the small, innocent town of Holcomb, Kansas, the murders all occur on one night killing an entire family. Before the killings, the town felt like a family. The citizens of Holcomb were seen as good people, innocent and free of worry. However, after the Clutter murders take place, a community that seems so tightly knit quickly dissipates. The murder†¦show more content†¦Herb Clutter has risen from modest beginnings to becoming a ranch owner with a comfortable lifestyle. He encapsulates the concept of the self-made man, which is a central theme in the American dream.† Herb Clutter shows that the aspiration of becoming a self-made man can fall apart at any moment. The murder of the Clutter family serves as physical proof that in our society, a utopia does not exist. Every citizen in Holcomb wants success. In fact, Mr. Clutter surrounds himself with many other people who want to succeed. For instance, the Ashidas, a Japanese immigrant family, work tirelessly to gain respect from the citizens of Holcomb. Mrs. Ashida involves herself with the Four H club, Mr. Ashida aspires to own his own farm. Their children work hard in school and feel proud of their parents. The first time we see Mrs. Ashida assert her pursuit of the American Dream is when she mentions to Mr. Clutter a gift she plans to buy for her husband: two new gold fillings. Mr. Clutter and Mrs. Ashida then proceed to discuss how her family wants something better. â€Å"The farm here, the people we’re working for – Hideo thinks we could do better,† (22). Human beings never find themselves completely content. As humans we feel a notion to go gather more and more for ourselves, an intense desire for success. This desire has formed over time, becoming ingrained, when a prehistoric man needs to gather more food for his family so theyShow MoreRelatedThe Shack, a Discussion of Symbolism1504 Words   |  7 Pagesof his being to where his entire world is impacted by its presence.   It haunts his dreams, and leaves him in a state of almost perpetual fatigue and anguish.   It can be argued that this state was brought on solely because of his daughter’s disappearance; however that may just be one of the factors contributing to the â€Å"Great Sadness†. 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Biography of Mary Anderson, Windshield Wiper Inventor

Mary Anderson (February 19, 1866–June 27, 1953) was hardly a likely candidate to invent the windshield wiper—especially considering she filed her patent before Henry Ford even started manufacturing cars.  Unfortunately, Anderson failed to reap financial benefits from her invention during her lifetime, and as a result shes been relegated to a footnote in the history of automobiles. Fast Facts: Mary Anderson Known For: Inventing the windshield wiper, before a single one of Henry Fords automobiles was madeBorn: February 19, 1866 on Burton Hill Plantation, Greene County, AlabamaParents: John C. and Rebecca AndersonDied: June 27, 1953 in Monteagle, TennesseeEducation: UnknownSpouse(s): NoneChildren: None. Early Life Mary Anderson was born on February 19, 1866, to John C. and Rebecca Anderson on Burton Hill Plantation in Greene County, Alabama. She was one of at least two daughters; the other was Fannie, who remained close to Mary all her life. Their father died in 1870, and the young family was able to live on the proceeds of Johns estate. In 1889, Rebecca and her two daughters moved to Birmingham and built the Fairmont Apartments on Highland Avenue soon after their arrival. In 1893, Mary left home to operate a cattle ranch and vineyard in Fresno, California but returned in 1898 to help care for an ailing aunt. She and her aunt moved into the Fairmont Apartments with her mother, her sister Fannie, and Fannies husband G.P. Thornton. Andersons aunt brought an enormous trunk with her, which when opened contained a collection of gold and jewelry that allowed her family to live comfortably from that point forward. In the thick of winter in 1903, Anderson took some of that inheritance from her aunt and, eager to make exciting use of the money, took a trip to New York City. The Window Cleaning Device It was during this trip that inspiration struck. While riding a streetcar during a particularly snowy day, Anderson observed the agitated and uncomfortable behavior of the vehicle’s cold driver, who had to rely on all sorts of tricks—sticking his head out of the window, stopping the vehicle to clean the windshield—to see where he was driving. Following the trip, Anderson returned to Alabama and, in response to the problem she witnessed, drew up a practical solution: a design for a windshield blade that would connect itself to the interior of the car, allowing the driver to operate the windshield wiper from inside the vehicle. She filed an application for a patent on June 18, 1903. For her â€Å"window cleaning device for electric cars and other vehicles to remove snow, ice, or sleet from the window,† on November 10, 1903, Anderson was awarded U.S. Patent No. 743,801. However, Anderson was unable to get anyone to bite on her idea. All the corporations she approached—including a manufacturing firm in Canada—turned her wiper down, out of a perceived lack of demand. Discouraged, Anderson stopped pushing the product, and, after the contracted 17 years, her patent expired in 1920. By this time, the prevalence of automobiles (and, therefore, the demand for windshield wipers) had skyrocketed. But Anderson removed herself from the fold, allowing corporations and other business-people access to her original conception. Death and Legacy Although little is known about Mary Anderson, by the 1920s, her brother-in-law had died, and Mary, her sister Fannie, and their mother were again living in the Fairmont Apartments in Birmingham. Mary was managing the building where they lived when she died at their summer home in Monteagle, Tennessee on June 27, 1953. Mary Anderson was inducted into the National Inventors Hall of Fame in 2011. The windshield wiper, May Andersons legacy, was adapted for automotive use, and in 1922, Cadillac began installing the wiper as a piece of standard equipment on its cars. Sources Windshield Wiper Inventor, Miss Mary Anderson, Dies. Birmingham Post-Herald, June 29, 1953.  Carey Jr., Charles W. Anderson, Mary (1866–1953), inventory of the windshield wiper. American Inventors, Entrepreneurs, and Business Visionaries. New York: Facts on File, 2002.Mary Anderson: Windshield Wiper. National Inventors Hall of Fame.  Olive, J. Fred. Mary Anderson. Encyclopedia of Alabama, Business and Industry, February 21, 2019.  Palca, Joe. Alabama Woman Stuck in NYC Traffic in 1902 Invented the Windshield Wiper. National Public Radio, July 25, 2017.

President Rodrigo Duterte Inauguration Speech Free Essays

â€Å"I am here because I love my country and I love the people of the Philippines. I am here, why? Because I am ready to start my work for the nation.† – 16th President of the Philippines, former Mayor of Davao City, Rodrigo Roa Duterte took his oath on June 30 of year 2016 at Malacaà ±ang’s Rizal Hall before the guests and on national TV. We will write a custom essay sample on President Rodrigo Duterte Inauguration Speech or any similar topic only for you Order Now Duterte’s inaugural speech ran only for about 15 minutes and comprises of only 1,335 words. It was considered as one of the shortest in the list of inaugural speeches made by former Philippine presidents. In his speech he emphasized the importance of cooperation of the people he’s being task to serve. It is by doing their part in achieving the nation’s success. He also highlighted his firm fight against criminality, drugs and corruption which he believed as the main causes of the nation’s lack of progress to poverty. Moreover he also emphasized about the Erosion of faith and trust of the people in the government by having no faith from the country’s leaders, judiciary system and the capacity of public servants in making their lives better. For him, he was elected to the presidency to serve the entire country and was not elected only to serve the interests of any person. President Rodrigo Duterte’s speech was impressive. He was able to deliver it effectively. He well expressed his thoughts, concepts and plans and emphasized the main points of his speech which is the goal of real change towards achieving the country’s success. I like it on how he empowered his speech with the use of lot of effective quotations from different reliable sources. Some of these quotations are from the former Presidents of America like Franklin Delano Roosevelt and Abraham Lincoln and also from our National Artist for Literature Francisco Sionil Jose. These quotations he had mentioned were relevant in supporting his statements. But what I like the most in his speech is that he delivered it not just effectively but also with humor, which he never failed to do in every speech that it catches everyone’s attention to listen. On the other hand, he could have delivered his speech in tagalog for the reason that not all of the people in the Philippines were able to speak and understand the English language particularly the people in rural areas. How to cite President Rodrigo Duterte Inauguration Speech, Papers

Grace And Sin Essay Example For Students

Grace And Sin Essay Final EssaysJoe PadykulaSister SundermanTH 100 BDecember 14, 2000GraceIn order to completely understand the theology of graceyou have to take a look at Augustine, Aquinas, Luther,Rahner, Segundo, and Boff, and how they understood whatgrace was. Their theories on grace have some valid pointsand yet they also have some invalid points. Augustine took a personal approach to grace and hebelieved in the massa damnata, which basically means that onthe whole people are damned. He said before the originalsin, you had a choice to be good or evil. Also, Augustinesaid that there is a double predestination, which means onlysome people are chosen before they are born if they aregoing to go to heaven. I dont agree with this because itis basically saying that there is no salvation for allpeople. Aquinas thought that grace was added to nature and itelevates nature. He wrote the Summa, which demonstrates thebeatific vision. The beatific vision is when the mind isunified to God. Aquinas theology is dualistic whichdisplays natural and supernatural as separate entities. Idont believe in his beatific vision because I believe thatGod allows us to make our own choices out of free will soour mind cannot be unified with Him. Unless I am wrong,this is saying God knows what is going to happen before ithappens. If this is the case why do we have suffering;because God gave us free will. Luther viewed grace through his own view of himself asa sinner. He was so obsessed that he confessed his sinsseven times a day. He said that grace is a favor of God andit heals a persons sinfulness. He said that Jesus wordwas a vehicle of grace and that grace cannot be merited. Ithink his views on grace are not very good only because heviews God as an active member and humans as a passive one. In order to be truly graced I believe that both parties needto be active and involved. Rahner believes that grace is intrinsic to nature andhe also believes in Anonymous Christianity. This theory isthat every person on this Earth is a Christian even if youdo not know it. I dont agree with this theory because,once again God gives everyone free will and this allowspeople to believe the way they want to. Boff says grace is a relationship with the trinity. Iagree with this because it consists of showing love anddevotion to all three persons of our one God. He also saidthat liberation is the key to grace. I some what agree withthis because it is showing God that you are showing yourtotal love for Him, but you must also show love towardsothers because loving your neighbors is also important. Segundo was a Jesuit priest from Uruguay. He was aliberationist who said that the meaning of grace was to loveand you would be free and to be free was to love. I likethe idea behind this concept because it suggests that if youdevote yourself to God he will take care of you and allowyou to have your freedoms. This does not always happen yetit is a good theory. I think in order to be truly graced you have to loveeveryone and expect nothing in return. The reason I saythis is because you should know that God will take care ofyou no matter what. If your neighbors are good people theywill show you love and respect so you need not worry aboutit. I also feel that you need to show love towards thetrinity and be faithful to your faith no matter what it is. If you do these things I believe that you will be graced.

Therapeutic Approaches Essays (4369 words) - Clinical Psychology

1. Introduction Give me a dozen healthy infants, well-formed, and my own specified world to bring them up in and I?ll guarantee to take any one at random and train him to become any type of specialist I might select -- doctor, lawyer, artist, merchant-chief and, yes, even beggar-man and thief, regardless of his talents, penchants, tendencies, abilities, vocations, and race of his ancestors. ? John Watson, Behaviourism, 1930 (http://psychology.about.com/) The behavioural approach has a strong influence on our every day life, often without us realising it. Behaviour is the product of learning through conditioning, reinforcement or imitation. It is part of how we develop and grow into an individual with a unique identity. It is not only the environmental factors that influence our lives, but also our subjective interpretation of these factors. However, if one is able to control the environmental factors, it is possible to influence behaviour and even achieve what John Watson has mentioned in the quote above. Using behavioural therapy one will be able to eliminate unwanted behaviours and habits and in return develop behaviours that may enhance an individual?s life. With the setting of an orphanage the best approach will be the behavioural approach. Children come from various backgrounds, conditions, and influences. They often have very little or no routine in their lives and may also suffer from various psychological conditions. Children at a young age will respond well to behavioural methods mainly by using modelling. As they develop and reach teenage years, one will progress to a more complex method, namely cognitive behavioural method, in order to challenge them and let them understand why they engage in certain behaviours. 2. History of behaviourism Behaviourism (also known as the learning perspective) had its origin in the 1950?s, rejecting the focus on the conscious and unconscious and, instead, turned the focus to observable behaviour. It strove to make psychology more of a scientific discipline. It opposed the structuralist focus on the conscious and the functionalist focus on heredity (Skinner, 1984). The feeling was that environment determines behaviour. Therefore, behaviour can be predetermined if one can control environmental factors. Classical Conditioning The earliest form of behaviourism was by the Russian physiologist, Ivan Pavlov, and is known as Classical Conditioning, also known as instrumental conditioning. Classical conditioning is used to elicit certain behaviours from a passive organism. For example, a dog salivates (conditioned response) when it hears a bell ring (conditioned stimulus). It shows how learning can create a response through pairing. Pavlov demonstrated that through this learning process one is able to make an association between an environmental stimulus and a naturally occurring stimulus. A certain response can diminish and become extinct if the conditioned stimulus occurs repeatedly without the unconditioned stimulus. For example, if the bell rings several times without the food arriving. Eventually the dog will stop salivating whenever he hears the bell. This technique is often used to treat phobias or anxiety problems. John B Watson was one of the strongest advocates of behaviourism and he established the Psychological School of Behaviourism. He is most famous for his controversial experiment known as ?Little Albert? where he experimented the principles of classical conditioning on a young boy. Operant Conditioning Behaviourism had a very big influence on the psychological school thought and B.F. Skinner furthered this perspective by initiating what he called Operant Conditioning. Operant conditioning works on the basis that behaviour is influenced by the consequences that influence them. One will engage in behaviour that has a positive/reinforcing effect and refrain from behaviours that has no reinforcement or an aversive effect. For example, a child completes his/her homework in order to get a reward. According to Skinner behaviour cannot occur without some type of reinforcement whether it is positive or negative (Corey, 2005). This approach has the goal of identifying and controlling environmental factors that lead to behavioural change and can be used to develop pro-social and adaptive behaviours. Social Learning Theory Albert Bandura and Richard Walters developed the Social Learning Theory by using the concepts of the behavioural approach and included other approaches to make it interactional and multi-modal. It states that behaviour is influenced by an event, external reinforcement, and the cognitive process that occurs simultaneously. There is constant interaction among these three factors. This

A Biography of Notorious Auschwitz Doctor Josef Mengele

A Biography of Notorious Auschwitz Doctor Josef Mengele Josef Mengele (March 16, 1911 - February 7, 1979) was a Nazi SS doctor who experimented on twins, dwarves, and others at the Auschwitz Concentration Camp during the Holocaust. Although Mengele looked kind and handsome, his heinous, pseudoscientific medical experiments, often performed on young children, has placed Mengele as one of the most villainous and notorious Nazis. At the end of World War II, Mengele escaped capture and is believed to have died in Brazil 34 years later. Early Life Born March 16, 1911, in Gà ¼nzburg, GermanyParents were Karl (1881-1959) and Walburga (d. 1946), MengeleTwo younger brothers: Karl (1912-1949) and Alois (1914-1974)Nickname was Beppo1926 diagnosed with osteomyelitis Education and Beginning of WWII 1930 graduated from the GymnasiumMarch 1931 joined the Steel Helmuts (Stahlhelm)January 1934 SA absorbed StahlhelmOctober 1934 left SA because of kidney trouble1935 awarded Ph.D. from the University of MunichJanuary 1, 1937, appointed a research assistant at the Third Reich Institute for Heredity, Biology, and Racial Purity at the University of Frankfurt; worked with Professor Otmar Freiherr von VershuerMay 1937 joined the NSDAP (member #5574974)May 1938 admitted to the SSJuly 1938 awarded medical degree by University of FrankfurtOctober 1938 began basic training with the Wehrmacht (lasted three months)July 1939 married Irene SchoenbeinJune 1940 joined the medical corps (Sanittsinspektion) of the Waffen SSAugust 1940 appointed an Untersturmfà ¼hrerAttached to Genealogical Section of the Race and Resettlement Office in occupied PolandJune 1941, sent to Ukraine as part of the Waffen SS; received the Iron Cross, Second ClassJanuary 1942 joined the Waffen SSs Viking Division medical cor ps; earned the Iron Cross, First Class by pulling two soldiers out of a burning tank while under enemy fire; also awarded the Black Badge for the Wounded and the Medal for the Care of the German People; wounded End of 1942 reposted to the Race and Resettlement Office, this time in its headquarters in Berlinappointed to Haupsturmfà ¼hrer (captain) Auschwitz May 30, 1943, arrived at AuschwitzConducted medical experiments on  twins, dwarfs, giants, and many othersSeemingly constant presence and participation in the selections at the rampResponsible for selections in the womens campcalled Angele of DeathMarch 11, 1944, his son, Rolf, was bornSometime middle of January 1945, he fled Auschwitz On the Run Arrived at Gross-Rosen camp; then left before Russians liberated it on February 11, 1945Spotted at MauthausenCaptured as a prisoner of war and held in a POW camp near MunichReceived papers from fellow prisoner, Dr. Fritz Ulmann; for vanity reasons had not gotten blood type tattooed beneath arm, American Army did not realize he was a member of the SS and released himAliases include: Fritz Ullmann, Fritz Hollmann, Helmut Gregor, G. Helmuth, Jose Mengele, Ludwig Gregor, Wolfgang GerhardRemained on George Fischers farm for three years1949 escaped to Argentina1954 his father came to visit him1954 divorced from Irene1956 had his name officially changed to Josef Mengele1958 married his brother, Karls, widow - Martha MengeleJune 7, 1959, West Germany issued its first arrest warrant for Mengele1959 moved to Paraguay1964 the Universities of Frankfurt and Munich withdrew his academic degreesAssumed that his remains were buried in Embu, Brazil in a grave marked Wolfgang GerhardBelieved to have d ied on February 7, 1979, on the beach at Bertioga in Embu, Brazil while suffering a stroke while swimming in the ocean. February 1985 a public trial, in absentia, was held at Yad VashemIn June 1985, the body in the grave was exhumed for forensic identification.

Assessment questions for Global Marketing Essay

Assessment questions for Global Marketing - Essay Example lection of segmentation criteria, collection of relevant information, profiling of geographical location of the consumers as per the segmentation criteria, evaluation of the appropriateness or the attractiveness of the segmentation and updating and reassigning the segment membership. Identification of the purpose of global market segmentation involves the assessment of different segmentation strategies. These segmentation strategies assist global organizations to analyze the major objectives of market segmentation. These objectives consists the identification of customer needs to offer more suitable product for them, improvement of customer profitability by analyzing pricing process, identification of new target consumer groups, improvisation of customer retention and identification of growth opportunities to gather desired market share. The proper analysis of the marketing strategy will enable organization to adequately assess the market segmentation requirement. After identifying the major purposes, it is essential to analyse the suitable segmentation criteria. There are a number of based or methods which can be utilized to segment different global marketplace. The segmentation bases can be divided according to traditional process as well as the requirement of emerging market. The traditional segmentation bases include demographic, geographic, cultural, environmental, psychographic and behavioural criteria. On the other hand, the emerging segmentation bases focuses on response elasticises and product diffusion pattern. The choice of the bases of segmentation is one of the most important factors for global market segmentation. Global organisation need to focus on the selection of the right base for their market segmentation procedure in terms of their products/ services and customers profile. The segmentation bases for global market differs due to the differences in consumers responses and product features. The selection of wrong bases of th e segmentation can

Accounting for leases is problematic and the current standard (IAS 17) Essay

Accounting for leases is problematic and the current standard (IAS 17) does not always reflect the substance of transactions - Essay Example These arrangements have become increasingly unique and complex, both as stand-alone arrangements (i.e., leases only) and as part of more complicated contracts (i.e., power purchase contracts). Such uniqueness and complexity place enormous pressure on companies to capture and report these arrangements in their financial statements in such a way that the financial statement users understand these transactions and their impact on the companies’ balances. With such a demand for transparency and complete financial reporting, the companies and the rest of the business world have focused their attention on the accounting standards for leases as such standards set the tone for how these leases should be accounted for in the financial statements. One such standard formulated for leases is International Accounting Standards 17. International Accounting Standards (IAS) 17, Leases, the accounting standard for leases, was formulated by the IAS Board or IASB to stipulate the proper accounting policies and disclosures applicable to leases. Paragraph 4 of IAS 17 describes a lease as an arrangement or a contract wherein the lessee is given the right by the lessor to use a certain property for a given period of time. In return, under the same arrangement, the lessee will pay the lessor for the use of such property. Lease accounting and the related disclosures, for both the lessor and the lessee, are covered by IAS 17. According to IAS 17, there are two kinds of leases: the finance lease and the operating lease. A finance lease, as defined by IAS 17, is a lease wherein majority of â€Å"all the risks and rewards incidental to ownership of the asset† being leased is transferred by the lessor to the lessee. The substance of this kind of leasing arrangement is that the lessee, according to Alexander, et. al., â€Å"would be in the same position, both economically and in terms of production and

Leadership theories in the context of healthcare management

Leadership theories in the context of healthcare management Do healthcare mangers need leadership theories? Critically evaluate at least two leadership theories in the context of healthcare management. According to Huczynski and Buchanan (2007), Leadership is defined as the process of influencing the activities of an organised group in its effort towards goal setting and goal achievement. Grint (2005:2) describes leadership as a function of relationship between leaders and followers, rather than simply focused on the person of the leader. According to Bass (1990:19), leadership is an interaction between two or more members of the group that often involves a structuring or restructuring of the situations, perceptions and expectations of the members. Thus it can be said from the above definitions that leadership is enacted through relationships with others i.e. the followers and leadership is widely distributed throughout the organization. Healthcare organisations around the world spend enormous amount of money in infrastructure and renovating facilities in hospitals, but spend a relatively less time or effort for the management of people who work in it. Effective leadership is therefore necessary for the smooth functioning of healthcare organization. According to Gunderman R. (2009), healthcare leaders should understand the nature of the organization where they work and should work in harmony with physicians, nurses, technologists, administrators and other members of organization. The people who work in healthcare organizations as leaders should understand the needs of the people they work with and should motivate them in order to increase their performance. Thus the overall performance of the organization depends upon the behaviour of leaders with their followers. Failure to understand human motivation can result in downfall of the organization. Medical leaders should look at the following questions: Which is more effective way to deal with the workers, benefits such as salary raises and public praise, or sticks, such as threat of termination and reduction in compensation? How can we improve workers performance, through tighter control or by increasing autonomy and empowerment? If the crucial needs of the workers are not fulfill ed it can affect their commitment towards organization and may result in financial instability of the organization. Leadership and management are often compared under the same platform. People are often confused and ask a question, Are managers leaders? The answer is NO, they differ from each other in many ways. Leadership is one of the roles that managers have to play and is therefore a subset of management. According to Gopee and Galloway (2009), management is about measuring and monitoring performance against pre-determined goals, following policies and procedures, controlling and organizing the structure and systems, working within resource allocation and maximizing output and productivity for the organization. Whilst on the other side leadership is about being visionary, anticipating change, motivating and inspiring workers and focusing on development of individuals. Watson (1983), describes seven Ss models to distinguish between leaders and managers. According to Watson (1983), managers mainly rely upon 3 Ss namely strategy, structure and systems, whereas leaders depends on 4 soft Ss called style, staff, skills and shared goals. Hollingsworth (1999) suggests fundamental differences between leaders and managers. According to him managers do things right i.e. they are transactional, while leaders do the right things i.e. transformational, managers administer while leaders innovate, manager focus on systems and structure while leaders focus on people. Thus leadership is a two-way process based on leader-follower relationship while management is based on relationship between the people working in the organization as individuals or teams. (Gopee and Gathway, 2009). Theories of Leadership: Several leadership theories have emerged over the past suggesting practical applications of leadership and its concept. Different leadership theories that are developed since 1920s are listed below: Time period 1920s 1940s Theory Trait or Great man theory Barnard (1938) for prescriptives: Ghiselli and Wald Doty (1954) for the descriptives. Style or behavioural theory Blake and Mouton (1964), Likert (1961) and McGregor (1960) Focus Intelligence, initiative and self-assurance. Participative culture, Represented a more democratic humanistic approach to the use of man in organisations and come at the time of reaction against scientific management. 1960s Contingency theory Fielder (1967), Schein (1980) and Vroom and Yetton (1973) An integrative way of looking at leadership, more specific to task work group and position of leader within that work group. A best fit approach. 1980s Post contingencies theory Bennis (1992), Kotter (1982), Mant (1983) and Peters and Waterman (1982) This theory particularly focused on American Business leaders with some perceptive comments as well as Anglo-Saxon leadership habits. 1990s Transformational leadership Bass and Avolio (1993), Cunningham and Kitson (2000a, 2000b) and Sushter (1994) Four components. 1. Idealised influence; 2. Inspirational motivation; 3. Intellectual stimulation; and 4. Individualised consideration. Late 90s-2000s Contemporary theories. Goleman (1999), Jumaa (2001), Alleyne (2002), Goffee and Jones (2000) Charismatic leadership Connective leadership Servant leadership Transactional leadership Transformational leadership Adapted from- Jasper M. and Jumaa M (2005), Effective Healthcare Leadership,page-25-26 Trait or Great man leadership theory. According to this theory certain persons have inborn leadership traits. Many studies were conducted by the end of 1950s which explored specific characteristics of effective leaders. (Handy 1993). These studies described significant correlation between leadership effectiveness and following traits: Intelligence Self-confidence Knowledge Initiative Supervisory ability Integrity Bass (1990), based on several findings from studies developed a profile of traits that are marked in effective leaders. These are categorised in 3 areas mainly: Intelligence -Judgement -Decisiveness -Knowledge -Fluency Personality -Adaptability -Alertness -integrity -Nonconformity Ability -Cooperativeness Popularity -Tact However the trait theory has certain weakness and problems like; the traits are very difficult to define accurately or to understand fully; many exceptional leaders do not possess all identified leadership traits; it cannot be concluded that a person is better or worse as a manager or leader only by possessing one or two traits. It is still questionable whether an individual could have all the traits for being a leader. However despite of many other leadership theories emerged today, trait theory has not been completely disregarded. For example- Recent research study conducted by kouzes and Posner (2007) concluded that Admired Leaders were likely to draw out specific characteristics, whereas 50% or more respondents selected: Honest (88%), Forward looking (71%), Competent (66%) and inspiring (65%). Around 28-47% of respondents selected intelligent, broad minded, straightforward, co-operative, dependable and imaginative as specific characteristics of effective leaders; while less than 25% of people selected ambitious, caring, mature, courageous, loyal, self controlled and independent. However there is no evidence between the correlation of nature and the essential characteristics of leader nor on what an effective leader is. It can be seen as trait of position, or power or knowledge and wisdom. Kotter (1990) suggested the functional approach and focused on the fact that the performance can be improved can be improved by training and the leadership skills can be developed over a period of time and perfected. He also suggested that organisations should not wait for leaders to come by their own rather grow their own by identifying employees which have certain potential to be a good leader. Transactional and Transformational theories have gained popularity for Leadership in Healthcare Organizations out of the various leadership theories available. Transactional leadership theory. Transactional theory of leadership is based on leading people by the virtue of management position held in the organizational hierarchy. It is seen that in this theory leaders identify the needs of the followers and transact with them. Thus this theory is considered as a social exchange process based on the power and reward system. In healthcare organisations this theory is related to the achievement of organizational goals which also includes attending health of local population.( Gopee and Galloway, 2005) According to Bass and Riggio (2006), the transactional theory is based on the leaders who are successful or effective in such a way that they maintain equilibrium and harmony by fulfilling their roles according to the procedures and policies and use incentives to enhance employee loyalty and performance. The transactional leader sets goals, gives direction and uses rewards to strengthen employees behaviour towards meeting or exceeding established goals (McGuire and Kennerly 2006). Although this theory supports status quo and is more predictable but it has also been criticised by various authors as it is lacking vision for future of the healthcare organisation. Thus the transactional theory of leadership has a very narrow focus and the leader can have a high self interest which may eventually lead to disturbance in the organisational structure.(Gopee and Galloway, 2009) Transformational leadership theory Transformational leadership is widely supported leadership approach for healthcare. According to Burnes (1978), transformational leadership is identified as a process where one or more person engage in such a way that leaders and followers raise one another to higher level of motivation and morality. In transformational leadership leaders motivate their followers by transcending their own self interests, elevating their needs and making them aware of the mission of larger entity of the organisation where they belong. (Bass 1995). Transformational leadership is considered superior to the transactional leadership style as the whole workforce is developed as the part of the process whose main function is delivering organisations objective. This can be achieved by fostering identification, going beyond simple leader-follower transaction and developing and intellectually stimulating employees. (Vandenberghe et al. 2002). According to Murphy (2005), transformational leaders are visionary, self-confident, and self-aware in breaking professional boundaries to develop a multidisciplinary team approach towards patient care. Transformational leaders inspire the followers and motivate them to exercise leadership by encouraging their belief that have the potential to achieve high aims. Thus a transformational leader is the catalyst for creating new innovative organisational paradigms (Murphy 2005 :135). The transformational leadership style is described by Markham (1998) as collaborative, consultative and consensus seeking and attributing power to interpersonal skills and personal contact. Thus the transformational leadership allow the followers to develop ideas and aspirations on how things could be better in healthcare settings. It articulates a vision for betterment of the healthcare services and thus allows one to work for raising the standards of care and treatment. Manley (2001) identifies six transformational leadership processes in practice; Ability to develop a shared vision Inspiring and communicating Valuing others Challenging and stimulating Developing trust Enabling Using these processes, transformational leaders assist the people working with them to become empowered and take responsibility of ownership to practice challenges and solutions (Sashkin and Burke 1990). The impact of transformational leadership does not restrict to development of individuals but it can also produce significant changes in practice settings by influencing the organisational culture. One of the main features of the transformational leaders is that they can inspire other people to follow their clear vision and that they demonstrate self-confidence in their ability to articulate the vision and promote change.'( Mullally 2001). Transformational leadership is also compared to that of a leadership style previously called as charismaticleadership which is now out of fashion. For example, people like Hitler, Churchill, Mussolini, Mao Tse Tung and The Reverend Moon have been perceived as charismatic leaders in the past but in todays modern era it will be difficult to call them as transformational leaders. Charismatic leaders are assumed to use their magnetic personalities to attract the followers. They are usually good orators and share their imaginary ideas with followers to create a common purpose. For example-Barack Obama demonstrated this ability during his election campaign and is believed to demonstrate complex ideas in a comprehensible manner to his followers. The concept of transformational leadership and its applications in complex organisations such as healthcare is based on four central components (Bass 1998), (Plesek and Wilson 2001): Idealised influence (charisma) Inspirational motivation Intellectual stimulation Individualised consideration Transformational leadership topic has been debated since the past three decades because the above four components can reflect the potential for causing organisational harm and destruction if the leader in the framework is supported by emotional intelligence (Goleman 2000a) to guide them through the swampy lowlands of organisational life (Schon 1983). According to Manley (2000) the transformational leadership approach is highly beneficial for the healthcare organisations as it has positive effects in the organisational change. An analysis of transformational leadership style in North America has shown qualities of integrity and honesty all strengthen by strong core of moral and ethical values (Bashor 2000). The key principle required in applying the transformational leadership in healthcare organisation needs much openness and honesty in all interactions (Jasper 2005). The use of personal qualities (such as charisma, influencing skills and communication) needs to be equally balanced by high levels of understanding and personal insight. This can be achieved through self perception and feedback from other colleagues. The ability to inspire and motivate depends upon the process of visioning. The leaders should be able to describe their ideas with clarity and details and should explain about the future consequences. To achieve this vision one should start working for the future vision by learning from the past realities and should show a collective effort where everyone has an opportunity to participate in the creation (Fenton 2003). Intellectual stimulation can be achieved by maintaining mental and intellectual alertness and acuity which can be gained by encouraging open criticism and deba te of wide ranging evidence base thus it helps to form the foundation of substantive change. The development of all individual towards their potential is one of the goals of transformational leadership. This can only be achieved by sharing thoughts of power bases in both organisations and interpersonal relationships. (Jumma and Jasper 2005). Thus it is seen that the two leadership approaches i.e. transformational and transactional approach are different from each other. Transactional leadership mainly involves transaction between the managers and their managed people while transformational leadership mainly focuses on various radical changes that can present challenges and growth for all. Comparison of Transformational and Transactional leadership approaches Transformational leadership Transactional leadership Merges own, followers and the organisations goals, desire values into common goal. Generates employee commitment to the vision. Challenges subordinate Rewards informally and personally Is emotional passionate about existing and new ventures Sees home and work on a continuum Aims to maintain equilibrium and status quo Is task-centred and orderly Coaches and fosters sheltered learning Uses extrinsic rewards High self-interest Sees home and work as separate entities. Adapted from- Gallow and Gopee (2009), Leadership and Management in Healthcare, page-59 Limitations of transformational theory: Although transformational leadership skills are highly desirable for effective functioning of an organisation, many management theorists like Bass, Avoliio and Goodheim (1987) think that transformational leadership alone can cause problem in long time. According to them transformational qualities must be coupled with more transactional qualities of day to day managerial role. According to Bass and colleagues, the transformational leader will fail without the traditional management skills. (Marquis and Huston 2009). They believe both sets of characteristics should be present in same person in different proportion. In Johnsons (2005) research he suggested that highly effective managers require both vision as well as specific plan to carry out their plans for achieving goals. Concept of leadership within the British National Health Service The New Labour Government included leadership as the part of their modernisation of the NHS and has been enshrined in the work of the NHS Leadership Centre, created in 2001as a part of NHS Modernisation Agency (The NHS Plan, DH 2000). The centre launched the NHS Leadership Qualities Framework in 2002 (NHS Leadership centre 2003) the components of this framework contains 15 qualities organised in 3 clusters of setting direction, personal and delivering the service. Components of NHS Leadership Qualities Framework Setting direction Personal qualities Delivering the service Broad scanning Intellectual flexibility Seizing the future Political astuteness Drive for results Self belief Self awareness Self management Drive for achievement Personal integrity Empowering others Holding to account Leading change through people Effective and strategic influencing Collaborative working These qualities reflect the values and beliefs intrinsic within the Governments political stance. Here the emphasis is on personal attributes and qualities as opposed to that of traditional source of authority and power or target driven incentives derived from business culture (Jumaa 2005). These qualities are considered as a set of key characteristics, attitudes and behaviours that a leader must possess in order to deliver the NHS plan; Setting the standard for leadership in NHS Assessing and developing high performance in leadership Integrating leadership across the service and related agency Individual and organisational assessment Adapting leadership to suit changing context. Case studies to demonstrate effectiveness of leadership theories. Case study 1. To measure the effectiveness of the new leadership framework in NHS, healthcare commission (now-Care Quality Commission) conducted a NHS staff survey. It was conducted in October 2003 and is probably the largest workforce survey in world. Total 572 organisations took part and around 203,911 NHS employees responded to the survey questionnaire. (www.cqc.org.uk) Results were produced before Healthcare Commission Executive Anna Walker. According to the survey more than 200,000 staff people told they liked working with NHS. Most of them were satisfied with their jobs but some part of the staff reported poorer work-life balance and higher level of work related stress. Thus healthcare commission urged NHS organisations to investigate and address these issues and try to get solution for it through more effective leadership approach. The fifth annual national survey of NHS staff was conducted between October and December 2007. In this survey 156,000 employees from all 391 NHS trusts in England responded to a questionnaire asking about their views and experience of working with the NHS. The aim of this survey was to look at the attitudes and experience of NHS staff so that the employers can review their own staff and take necessary action. The results of the survey showed that job satisfaction remained high among most of the staff. 75% of staff was satisfied or very satisfied as well as satisfaction with the amount of responsibility. While in terms of staff engagement mixed results were seen. Around only 23% i.e. less than quarter of staff agreed that senior managers involve staff in important decisions and only 22% agreed that communication between staff and senior management is effective. While only 26% of staff were satisfied, or very satisfied with the extent to which trust values their work. This was the sing le most common reason given by those thinking of leaving their jobs. Along with this 8% of staff said they had experienced some discrimination at work in the previous 12 months. About 3% said they had been discriminated against their ethnic background. Thus it can be concluded from the above two studies that the NHS staff were generally satisfied with their jobs. However there were some areas where significant action is needed for improvement. The NHS should also make some effective plans to value staff and engage them successfully in important decisions-making. While NHS should also do more in order to improve the communication between staff and senior management. Case study 2. The Healthcare Commission also conducted 5 surveys in 2004 to find out patients overall experience about the new NHS. The questionnaires and methodology were designed by the NHS Surveys Advice Centre at Picker institute Europe. About 850 eligible people were identified from each trust that took part. A total of 568 NHS organisations and 312,348 patients took part. The response rate for the patients varied from 63% for the adult in patient survey and 42% for the mental health survey. Results were published in first week of august 2004 and the Commission reported that patients gave positive opinions about the high quality care they received at the NHS. Majority of patients said they have trust and confidence in the clinical staff. They are listened to and treated with lot of dignity. Thus a great improvement in communication between the NHS staff and patients was seen and people were allowed to give their own suggestions regarding the facilities they would like to see as an improvement for the organisation. (Jasper and Jumaa 2005) Case study 3. The following case study is based on my experience of working at a Multinational Pharmaceutical company, Zydus-Cadila healthcare limited, India. It is an innovative global pharmaceutical company that discovers, manufacture and markets a wide range of healthcare products. It produces products like Active Pharmaceutical Ingredients (API) to formulations like tablets, capsules, syrups etc Along with this it also manufactures various animal health products and cosmeceuticals. Headquarter of the company is located in Ahmedabad, India. It also has its offices spread across four continents and different countries including USA, Europe, Japan, Brazil, South Africa and 25 other emerging markets. They employ around 10,000 employees worldwide and have one of the best Research and Development centre for drug research. The motto of the group is Improving peoples lives through innovation. I had an opportunity to work there as a trainee for my under graduation internship for a duration of 6 months. My role included looking after the process involved in operation of different departments like production, packaging, storage, marketing and submitting daily report to the manager. The whole company was perfectly organised and the management was distributed in a systematic manner depending on the type of department. There were different mangers according to the department like for Human-Resource department, Production department, Quality-control department, RD (Research and development) department and the Marketing department. Each of the department had a head person above them under whose guidance all mangers used to work. According to me, the leadership approach in this organisation contained both transactional as well as transformational concepts of leadership theories. The manager under whom I used to work was a transactional leader. He was very particular about the work. Right from the first day of my training I found him a bit eccentric. He was not at all friendly with all of us working under him. He used to assign each of us a particular work for a day. For example- On the first day of my training I was told to go and check the ware house of the company where the finished goods were stored and to write the Standard Operating Procedure for dispensing the goods. Following his instructions we all went and did our report writing work. He came for a visit within 3 hours, gathered all of us and started asking questions about what we observed. Those who were unable to answer his question were scolded. He gave us first warning about our work and said those who will complete their work early and accuratel y will have the additional benefit i.e. they will be allowed to go home 1 hour early. This thing worked as an incentive amongst all of us and thus we became more enthusiastic towards our work. Slowly over a time it was realised that the way he was leading us was different from others. For him the sole purpose was getting the work done from us in such a way that each one of us feels excited about work. He was very professional at work while very jovial and friendly at home. He was totally task oriented and orderly person. He never accepted any ideas or suggestions from any of the followers. Thus he was more of a transactional type manager. The other type of manager under whom we were working is completely opposite of the above mentioned manager. He was our marketing department manager. He was a true example of transformational leader. The way he used to lead us was truly inspirational. He used to explain us the complete process before handling any work. He was very supportive at work and had a vision for companys success. His communication and motivation skills were excellent. Right from the first day of my training under him we liked working with him. He always welcomed new ideas and suggestions for marketing. He was very much focused about his vision and always strives hard to achieve it. He had good interactions with everybody in the team and always used to motivate us. He used to look at everybodys work personally and if he will notice any mistake in our work would teach how to correct it on the spot only. He used to ask for the feedback about his new ideas from each of us and correct himself if the feedback was no t satisfactory. This shows his eagerness to work with the team which created positive effects on each of the team members. He was never after rewards from the company. His only aim was taking companys sales to the epitome of success. He was fully dedicated to the company and worked with whole heartedness. Thus all of us used to work with great enthusiasm under his leadership. So he can be described as a perfect example of transformational leader. Hence the company Zydus-Cadila Healthcare limited has a mixture of transformational and transactional leaders which ultimately results in the success of company. Conclusion The essay here explains about various leadership theories in healthcare and its effectiveness by the use of some case studies. Healthcare organizations are complex in nature. It requires a well balanced management and leadership approaches to effectively run the organisation. Each individual in organisation should share their knowledge with others. This synergy among workers is the key part for generation of new ideas and concepts for the organisation. Many leadership theories have been developed since past and still it is continuously adapting a new change for the effective leadership theory. Considering leadership in healthcare it is seen from the example of NHS in the UK that the combination of both transactional and transformational leadership theory may be the most efficacious for an organisation. Thus the healthcare managers require leadership theories and put them in practice to make it work effectively. However, according to Grint (2005:105), one of the top secrets of leaders hip is not a list of innate skills and competences, or how much charisma you havebut whether you have a capacity to learn from you followers.

Effects of Women Incarceration on Young Children Essay

Number of women putting in prison has increased drastically in recent decades. Approximately 600,000 women were incarcerated in 1990. This number has increased to more than one million in 2000. Though women are less likely to get imprisonment, the rate of their imprisonment is rising drastically (Bureau of Justice Statistics, 2001). Majority of women put in prison are mothers. Families of incarcerated women are badly affected and face challenges such mental illness, poverty, substance abuse and child abuse. Sometimes, permanent changes in children of incarcerated women take place even when their mother has returned home. Such children lose the hope of having their mother for the rest of life with them. They think that their mother will go to jail sooner or later (Greene & Hurtado 2000). Children of incarcerated mother are subjected to go through troubles in their adolescence. Such children may commit a crime, may involve in substance abuse, mental illness may be profound in them, may leave schools in their early life and may receive inappropriate adult care. Criminal behavior of mothers brings damaging effects in children. They are badly affected when they see their mother arrested and put in prison (Young & Carrie 2000). This paper provides information about the effects of women incarceration on young children. Different age groups of children are taken into consideration and the effect of their mother’s incarceration on them is discussed in detail. This paper describes how children try to cope up with the incarceration of their mothers. Changes in policies are required and this paper recommends such changes to provide support to such children and to keep them away from the harm. Effect of Women Incarceration on Young Children Majority of the incarcerated women are mothers. The effects of mother’s incarceration on young children are not much known. Such children are not considered when their mothers are put in prison. Researchers, policy makers, communities and service providers do not think about the affected children and thus, nothing is being done for the well-being of those children. Children at different development stages are affected to a different extent. Infants and toddlers are affected in a different manner, where as, pre-schoolers, school-aged children and adolescents are affected in entirely different manner to a different extent (McClellan 1994). Impact of Mother’s Incarceration on Infants and Toddlers Babies are not able to understand the imprisonment of their mothers but people around them come under stress due to the incarceration of the baby’s mother. Such stressed people’s behavior tells the babies that something wrong has happened. The stress period begins when the mother is arrested, put in prison and the stress continues even after the mother’s return. Care givers do not take care of the babies the way a mother can do. Such babies do not receive breast feeding that is essential for their growth. Their routines are badly disrupted. Infants and toddlers are more likely to receive neglecting and abusive care. They are most likely to receive very less capacity to regulate them. They have to face severe stress that is often imposed by their family. They may also have to face poverty. Children of this age group are not able to understand the arrest and imprisonment of their mothers. Some children of this age group forget their mothers and become attached to the caregiver. So, the bond between mother and the child will be broken for ever. When children of this age group are taken to penal settings, they are unable to understand why they cannot touch their moms though their moms are in front of them (Marcus-Mendoza 2001). Impact of Mother’s Incarceration on Pre-Schoolers Pre-schoolers’ age ranges from three to five years. Children under this age group need the development of skills that are essential for them to get success in their academics and society. Individuality seems to be prominent and such children need to live independent life. Discipline development is essential at this stage and certain routines need to be set at this age. Children under this age group are also not able to understand much about the incarceration of their mother but they can catch the feelings by the notions of people surrounding them (Greene & Hurtado 2000). Children’s limited understanding power does not let them connect crime with imprisonment and thus they simply tend to focus on the results of the incarceration. For example, they start disliking the police just because their mother was taken away. They do not like judges because they are responsible for putting their mothers in jails. Sometimes, such children start disliking their mothers because they think that their mother has done something wrong. They need time to settle their minds again to have the same picture of their mother as they had before; the mother who was used to take good care of them. Children under such circumstances usually consider the criminal justice system quite unjust and they consider them as the victims of the criminal justice system (Hagan 1996). Impact of Mother’s Incarceration on School-Aged Children When children come to an age between 6 to 12 years, they become more aware of them and people. Their thinking abilities are enhanced and concepts about rights and wrongs become clearer to them. Such children begin to establish relations with their caregivers and go away from their mothers. In fact, such children should be able to rationalize that their mother is a good person. This can be done when the image of their mother is portrayed to them in a positive manner. They tend to justify that the acts of their mother were quite fair and the criminal justice system has been unfair to them or they may even complain of a biased behavior. Such behavioral developments in children of this age group are quite alarming as criminal behavior may also be developed in such children (Fejes & Miller 2002). Children of this age group do not share this bitter reality of their life with others. They hide as their weak point. Thus, they are less likely to receive any kind of support from others such as teachers, and care takers. They tend to minimize socialization. Aggressive behavior may also develop in such children and they feel difficulty in putting their efforts in their education resulting in more absences (Feldman et al. 1999). Development of Criminal Behavior in Young Children of Incarcerated Women Children of incarcerated women may develop criminal behavior. Following are some factors that determine the likelihood of criminal behavior. Coping Strategies Children of all ages go through extremely hurtful situations. They begin to implement coping strategies to get out of the awkward situations resulting from their mother’s incarceration. They begin to suffer from anxiety, feelings of shame and anger and financial problems. They begin to deny the reality, show aggressive behavior, blame themselves, get involved in substance and alcohol abuse and find ways to escape from the situation by running away. These strategies may benefit kids on temporary basis but they leave long lasting bad effects. These issues may lead to criminal behavior (Casey-Acevedo 2002). Giving Good Reasons This is another strategy that children of incarcerated mothers use to portray their mothers as very good persons. They do so to hide the reality of their mothers. They deny the fact that their mother had committed a crime and that is why she was sent to prison. They justify their mother’s position by insisting that people saying bad words about their mother are indeed bad themselves. They even begin to justify the crime committed by their mother. They insist that crime may be permissible in certain circumstances such as they justify that stealing is a right act if done to provide clothing and food for family. They consider themselves and their mother as a victim of situations such as poverty that had forced their mother to commit a crime. Criminal justice system seems unfair in their eyes. As a result, anti-social behavior begins to develop in such children (Feldman et al. 1999). Poverty Usually incarcerated mother had been the finance provider for children. Incarceration of mother results in lack of funds. They do not get proper nutrition and basic things that are the rights to get by all children. As children face poverty, they consider stealing as permissible and thus commit crimes to fulfill their needs. They want to get the things that children living with their mothers usually get; proper nutrition, good clothing, education, healthy environment etc. The absence of such facilities fosters the likelihood to commit a crime (Greene & Hurtado 2000). Absence of Adult Guidance When mother is sent to prison, children do not receive any guidance and supervision from an adult any more. Adults know better how to guide young children so that they become a part of a safer environment. The absence of adult supervision make children suffer and struggle in society and school. They stop going to school, face difficulties in their jobs, and get involved in relationships that exploit or abuse them. They may get involved in drug culture and even in the sex trade (Gabel & Shindledecker 1993). Strategies for the Minimization of Harm There is a great need to implement strategies that can minimize the harm posed to the children of incarcerated women. Following are some useful strategies to combat this issue: Mothers Should Not Be Incarcerated There is a need to keep the whole family together and for this purpose the mothers should not be incarcerated. In case they commit a crime, there should be some alternatives in place of incarceration. Community based interventions should be implemented. The threat of imprisonment will lead towards betterment. Conditional sentencing will not require any imprisonment and justice system will accomplish the goals that were expected to be obtained from the incarceration of women. Training should be provided to important professional groups Educators, child protection workers, mental health professionals should be trained in a way to support the children of incarcerated mothers. They should be able to explain the children about the connection of crime to punishment. Children should be taught about rights and wrongs. School attendance should be encouraged. Caregivers should be trained in a way to provide the children of incarcerated mothers the best nurturing environment. The visits of children to their mothers should be supervised and motivated in positive manners. Conclusion Children of incarcerated women are at a greatest risk of being traumatized and get involved in criminal behavior. Their personalities are badly affected due to the absence of their mother in the time of their needs. Caregivers are not providing the required care. Criminality of women can be reduced by using effective strategies. Children of incarcerated women should be given under the supervision of an adult to help them grow in a safer environment. Strategies to cope up with the bitter reality of their mother’s incarceration should be implemented in a positive way. Schools and society should be encouraged to help such children instead of making fun of them or taunting them. Good neighbors can also play good roles. Children should be provided with the basic facilities that are essential for nurturing them. Mothers with offensive background should be provided with the support to get reasonable jobs to fulfill their basic needs. This way the crime rate among women can be minimized. Society should let such women improve their criminal behavior by motivating them to quit their crimes. Such women should be appreciated to do meaningful activities that can help them become mentally healthy. Children should never be taken away from the children due to incarceration.

Development from Birth †19 Years Essay

The aspects of development are defined as Physical, Social & Emotional, Language and Intellectual. There are different stages of development for each category, 0-3 years, 3-7 years, 7-12 years and 12-19 years. All children will follow the same pattern of development but at different rates and will reach their milestones at different times. Physical During the 0-3 year period a child’s physical development will see them start to move and react to memorable sounds and voices. They recognise people, reach for brightly coloured or noisy items. Their ability to move begins with rolling over, moves to crawling, shuffling and finally the ability to walk. Fine motor skills will also increase, from being able to hold and shake interesting objects to using crayons to scribble and make marks. They will use body language to communicate, such as shaking the head to indicate ‘NO’. As they move into years 3-7 their skills become more refined, they will be able to walk up and down stairs, catch a ball, use paints. Then they will learn to pedal a bike start to draw basic pictures of people or houses. Movement continues to improve and they become confident at climbing and jumping and their fine motor skills allow them to write more clearly, sew and manage shoe laces. By ages 7-12 years children are generally able to hit a ball and participate in team sports although their ability may not meet their own expectations at first. During adolescence physical development becomes more about appearance and the process of puberty. Whilst girls begin this process earlier than boys all children will develop as individuals. This can be a very difficult time for teenagers, with insecurities about they way they look and how they compare to their peers. Some will suffer anxiety at some point and worry about being a late or early developer. Social and Emotional Social and emotional development begins by showing affection and becoming attached to parents or carers and becoming what we usually call ‘clingy’. Young children may become distressed when a parent leaves the room or is not in sight. Slightly older children may demand attention and use tantrums to get their own way. They will generally be easily distracted from unwanted behaviour. By age 2-3 years children enjoy playing with older people who provide them with attention and begin to enjoy time with children their own age. Over the next few years the child becomes more independent and coopertative and likes to help. They develop social skills and play with others is more comfortable as they begin to consider the feelings of others and make friends, although resolving disputes can still be an issue. Rules and routine are required to help the child feel secure and safe. In later years the child becomes less dependant on their parents and moves closer to their peers. They develop a sense of right and wrong by may still adult intervention to settle arguments. They become aware of their gender and normally prefer the company of their own sex. Their behaviour differs with their emotions depending upon circumstance. In the final stages of development puberty creates feelings of self-consciousness and insecurity about body image. Behaviour is very unsettled as they sway between the feelings of being a child and wanting to be an adult. Friendships become stronger and adolescents depend less on the parents. They are much more aware of the opposite sex and need to fit in social with their peer group. People of this age begin to think about their social environment and may start to form strong opinions about community, politics and religion. Language In the early stages of development language is more about making sounds to show feelings. Babies watch others to learn facial movements to help them to begin making their own sounds and will turn towards sound they hear. From making sounds, words develop and gradually increase in number. They begin to understand key words spoken to them and will repeat back what they hear building from single words, to phrases and then sentences. Children’s ability to understand develops faster than the ability to speak and this can cause frustration with not being able to express themselves. During the 3-7 year period children begin to question things more intently, use more accurate grammar and their vocabulary increases dramatically. Reading skills start to develop, first recognising a few frequently seen words and understanding stories and books. During the Key Stage 1 years learning and recognising letters and the sounds they make develops into reading and later into writing. The next stages of language development involves the vocabulary increasing further and learning to spell more difficult words. Adult interaction is important to help children learn fluency and progress towards telling more complicated stories and the correct use of grammar and tenses. During adolescence language becomes more mature and logical thinking begins to develop. They can be sarcastic and begin to experiment with humour or may wish to publicly demonstrate their new found skills. Intellectual Early intellectual development involves copying others through play and testing different styles of behaviour. Young children also begin to recognise that all people are separate from themselves. Next comes the ability to understand instructions and recognise things that are similar, for example, shapes and colours. Between 5-7 years children start to become aware of their environment and understand what is means when things are different or the same. Next a child will develop their own interests and reading becomes a skill used for entertainment. Finally the mind matures and young people learn responsibility for their own thoughts and actions. They begin to think about their future lives and things they might like to do like, jobs, marriage and children. The ability to make connections between pieces of information and the world around them also matures. The speed of development at this stage very much depends upon the amount of guidance received. The more guidance a person gets the quicker they are able to reflect upon how things relate to in practice to their lives. An individuals personal identity is formed from the things they learn at this stage which should be more moral and cultural. Adolescents begin to take more responsibility away from their parents with regard to managing their finances, employment and their personal relationships and becomes complete during adulthood.

Narrative Structure and Point of View in Julio Cortázar’s...

Narrative Structure and Point of View in Julio Cortà ¡zar’s Hopscotch Julio Cortà ¡zar’s Hopscotch is not simply non-linear fiction, as the novel provides an early precedent for many of the characteristics found in contemporary hypertext fiction. Readers familiar with electronic hypertext fiction will likely notice the similarities in narrative structure, point of view, and the postmodern tenet of form contributing to content. Cortà ¡zar writes in the Table of Instructions that Hopscotch contains 2 books mainly, likely meaning the different reading sequences; however, the first two sections, â€Å"From the Other Side† and â€Å"From This Side,† can be considered the different books to which Cortà ¡zar alludes. Just as distinct plot threads exist†¦show more content†¦As readers we can not disavow our knowledge of Oliveira’s experiences in Paris, particularly regarding La Maga, when reading â€Å"From This Side,† but we should certainly consider the significance of this knowledge, which, for example, creates dramatic irony in the context of Traveller and Talita. The narrative structures of the first two sections do not follow the typical dramatic arc, as no climax or resolution exist in either section. I caution readers against identifying as possible climaxes of â€Å"From the Other Side† Rocamadour’s dying (chapter 28, discussed across various pages) or Oliveira’s leaving La Maga, as the former serves primarily as a catalyst for change; more importantly, Chapter One begins with Oliveira’s asking, â€Å"Would I find La Maga?† (3) because he has already left her. When readers eventually ascertain the plot sequence of â€Å"From the Other Side,† they can see that they do not read along the traditional dramatic arc that develops over time, but rather read segments while immersed in a perpetual middle. This characteristic leaves readers in a continual present in which the passage of time does not progress the plot, much like in hypertext fiction. Although the plot of â€Å"From This Side† develop s linearly, the presumed ending of chapter 56 continues this perpetual present: readers