Clinical Decision Making Skills for the Integrated Worker Essay

This assignment will define and analyse the need for a chosen service improvement within the pathway of mental health, as well as evaluating the suggested service. Demonstrating how this service can inform and benefit integrated practice, discussing the ways in which the agency’s statutory obligations and responsibilities impact on both individual and group decision making. The chosen service improvement for this assignment is the introduction of a mental health nurse into primary care services, for example, a GP Surgery. Focusing on service users with mental health issues in the community and therefore in the care of the local Primary Care Trust (PCT). There is an obvious need for movement towards better health and social care for individuals with mental health illnesses in primary care. No Health without Mental Health: A Guide for General Practice (Department of Health, DoH, 2012, online), sets out what General Practitioners (GPs) can do to improve mental health and enhance care and support offered to those with mental health conditions in the community. This document also states that one in four GP consultations account for mental health problems (DoH, 2012, pg8, online). Treatments for those with mental health issues cost the NHS in the United Kingdom approximately  £105 Billion per year (DoH, 2012, pg8, online). Primary care plays a pivotal role in caring for those with mental health illnesses in the community and in most cases this falls into the responsibility of the local GP surgeries. Therefore GPs are ideally placed to identify signs of distress and those with risk factors for poor mental health (NHS Confederation, 2011, online). Primary care providers, more specifically GPs are usually the first point of call for an individual experiencing some form of psychological distress (DoH, 2012, pg13, online). It is essential there is early recognition and referral to any specialist mental health services required, saving time, money and individual distress in the long-run. An area which remains problematic is the treatment of physical health care needs for those with mental health illnesses. Research continues to  highlight that the physical health of those with mental illnesses is frequently poor and people with long-term physical conditions experience higher levels of mental health issues (Nash, 2010, pg2). It is ironic that a great deal of the research carried out is with individuals that are currently in contact with either health or social care services (Nash, 2010, pg2). This issue could be tackled within primary care services, as GPs especially can treat the whole person linking rather than separating physical and mental health (Knapp, 2011, pg3, online). Professionals within the primary care sector could experience problems when trying to identify their role in relation to meeting the health needs of those with mental health issues, as well as offering interventions and support to those identified as high risk of developing mental health problems, such as, individuals with long-tem physical conditions (Nash, 2012, pg 10). Yamey (1999) found that a number of patients had actually been removed from GP registers at some point prior to accessing secondary mental health services. This causes suspicion that some mental health illnesses could be construed as a reason for being excluded from GP surgeries (Yamey, 1999). MIND (1996) carried out a survey which also showed that a large majority of individuals felt they had been treated unfairly by their GP due to their mental illness. This could be a consequence of lack of understanding and minimal training in the area of mental health in the primary care sector. Although this research is dated, it is relevant as Government white papers and initiatives currently being introduced are still recommending that more specialised training in mental health is required for professionals throughout the primary care sector. Each of the initiatives aim toward improved integrated working and lower hospital admissions due to deteriorating mental health by providing early access to services and early recognition of mental health issues in primary care. This highlights the importance of the chosen service improvement, not only for individuals with mental health issues but for those at risk of developing mental illness and the NHS as a whole. These recommendations are present in No Health without Mental Health: A Guide for General Practice (DoH, 2012, online), The NHS Outcomes Framework 2012/13 (DoH, 2011, online), and numerous others. It remains clear that professionals within the primary care sector are not  receiving adequate training in mental health care. They do not have sufficient knowledge of mental health and many do not possess the general skills required day to day when working with mental health service users (DoH, 2012, pg5, online). This is supported by Good Medical Practice (2006),(General Medical Council, GMC) which sets out the principle guidance for GPs offers no mention of individuals with mental health issues, suggesting that this document is based solely on the general population and does not taking into account the differing needs of those with mental health issues. A programme that was introduced in Wales in 2011 provides Mental Health First Aid Training to a large group of service providers including primary care. It teaches them to provide initial help to someone experiencing mental health problems, deal with a crisis situation or the first signs of someone developing mental ill health and guide people towards appropriate help (MIND 2011, online). This shows some progress towards increasing knowledge and awareness of mental health illnesses in a wider range of healthcare providers. There is evidence to show that in GP practices without mental health professionals, brief training for primary care providers have substantial benefits for patients who are mentally ill (Ross et al, 2001). This supports the need for specialist training and the chosen service improvement, as a mental health nurse in a GP surgery would be specially trained to work with individuals with mental health illnesses and would have an awareness of the difficulties service users may face when accessing services. There are many aspects that could present a barrier to mental health service users when accessing services. Communication difficulties can cause problems for individuals with mental health issues as they may not feel able to make themselves understood by healthcare professionals. They may suffer anxiety or panic disorders making it more difficult to communicate effectively. One of the most problematic areas in mental health and for those suffering mental health illnesses is stigma (Nash, 2010, pg10). Discrimination is not just confined to the general population as research has shown that healthcare professionals can hold stereotypical views towards their clients (Nash, 2010, pg10). This could prevent individuals from seeking help and support for both physical and mental health problems. Some service users  with mental health issues may have previously experienced some form of discrimination and had a negative experience when accessing primary care services. For example, experiences involving reception staff with bad attitudes or individuals being made to believe the physical symptoms they are experiencing are part of their mental illness (Nash, 2012, pg12). This shows that individuals with mental health issues suffer from inequality and discrimination regarding their healthcare reinforcing the need for improved access to primary care services. Previous negative experiences can cause individuals to fear returning causing them to avoid seeking help for a physical condition. Furthermore, if a person believes the may be mentally ill, they may avoid accessing any kind of support as they fear being labelled and discriminated against due to the stigma attached to having a mental health illness. Employing a mental health nurse in a GP surgery can bring services closer to eliminating barriers between primary care services and mental health, improving the healthcare of those in the general community suffering from some sort of mental illness. The proposed service improvement supports the need for reducing health inequalities and barriers to those with mental health issues wishing to access services. Barriers to healthcare specifically Primary care services can include communication difficulties, lack of understanding from both service user and professional perspective and there may be inadequate support available to mental health service users when accessing their local GP surgeries. GPs may lack the interpersonal skills required to manage some symptoms of mental illnesses. Such as inappropriate sexualised behaviour that can be expressed during psychotic episode (Norman & Ryrie, 2009, pg711).The professional may feel uncomfortable and embarrassed when examining an individual and unaware of how best to deal with this situation. Symptoms of mental illnesses can themselves often prevent individuals with a barrier to accessing services. An individual suffering depression will most likely lack motivation and volition (Norman & Ryrie, 2009, pg429) making it extremely difficult for them to self-refer or even care about their mental and/or physical health. Further supporting the need for the chosen service improvement as families, carers and friends of such individuals could support them in attending their local GP surgery enabling them to access specialist help at an initial stage of their illness. It may be necessary for a mental health nurse in a GP  surgery to be advertised; as individuals cannot access services if they are unaware they exist. Booklets and leaflets could be made available to raise awareness of mental health issues and the support available to individuals, their friends and families’ informing the community that specialist help is available first hand within their local GP surgery. Another barrier that is present in the provision of care by primary services and GP surgeries is the use of the medical model. The health professionals within a GP surgery adopt a medical approach when treating their patients. This aims to treat the medical illness and reduce the total number or patients attending the surgery. Although this is necessary within a GP surgery setting there remains a need to consider social factors when adopting the medical approach (Barbour, 1995, pg2). There are limitations when using the medical model, however as it can prevent healthcare professionals from treating patients individually in a person centred manner, treating only the obvious medical condition (Barbour, 1995, pg10). This could have a serious detrimental effect on an individual’s health and well-being, resulting in increased appointments with their GP causing more distress and prolonging their suffering. This in turn increases the likelihood of an individual requiring crisis intervention and ultimately costs the NHS more in the long-run (Norman & Ryrie, 2009, pg172). The Royal College of General Practitioners (RCPG) ‘Roadmap’ (2007) document supports the need for adopting a model in which health and social care needs are considered in general practice (RCPG, 2007, pg1). There has been confusion around which professionals role it is to provide physical health care to the mental health population for many years (Phelan et al, 2001). Government policy recognises the importance in considering physical health care needs of those with mental health illnesses in both primary and secondary care settings (Newell & Gournay, 2009, pg 322). General practice has transformed significantly over the past decade and current government policy is aiming to improve access to and the choice of services available to patients, expanding the role of a GP and improve quality of care overall (Gregory, 2009, Pg3, online). Government policy is implemented in the structure of clinical governance and is important in  highlighting improvements that are required in a wide range of services within the NHS including mental health and primary care (NHS Direct, 2011, pg12, online). Clinical governance is described as ‘a system in which NHS organisations are accountable for continuously improving the quality of their services’ (Scally & Donaldson, 1998, online). It is a framework that ensures professionals continuously develop and improve the quality of the services they provide. Clinical governance involves the research and development, risk management, promotion of openness, education and training for staff, clinical effectiven ess and clinical auditing of services within the NHS. It is extremely important that high quality care is provided in healthcare and clinical governance ensures professionals are individually accountable for the quality of care they provide (South Tees NHS Trust, 2013, online). Buetow and Roland (1999, pg184, online) suggest ‘there is a barrier between managerial, organisational and clinical approaches to quality of care’ denoting that the aim of clinical governance is to bridge the apparent gap by allowing all professionals within an organisation involvement and ‘freedom from the control of managerialism’ (Buetow & Roland, 1999, pg189, online). Although this suggests the aim is to promote equality throughout organisations when it comes to quality of care. There remains a need for one individual or a small group of people to accept the role and responsibility and become the clinical governance lead or team (Buetow & Roland, 1999, pg189, online). In a primary care setting such as a GP surgery this would entail being responsible for a large number of professionals who may have had little reason to communicate with each other previously. This could cause conflict within an organisations culture if the quality of care professionals provide is questioned. The Department of Health (2008) stated ‘the current system of NHS primary care does not ensure a consistent level of safety and represents insufficient quality across the country’. Resulting in GPs becoming required to hold a licence which is reviewed and renewed every five years and to register with the Care Quality Commission (CQC) from 2011 (GMC, 2009, online). This ensures up to date practice, competence and assures the provision of quality care. Clinical governance enables services to show how targets have been met within their organisation and how they meet the needs of their patients, supporting the decisions made by professionals and teams within the organisation (Buetow &  Roland, 1999, pg187, online). All organisations have what is known as an organisational or agency culture. Agency culture is made up of numerous aspects including, values and beliefs, language and communication, policies and procedures and rituals and routines within an organisation. Each organisation has a varied culture with a different set of beliefs and norms. It could be a result of these norms that staff members may not be willing to embrace change or take time to attend extra training for specialist service user groups such as the mental health population. It may appear that the service gains results and targets are met therefore may not want to change anything. This places organisations at risk of neglecting areas for improvement. Changes within agency culture can become a challenging process especially when there is disruption to traditional working routines (NHS Direct, 2011, online). Staff within a GP surgery may have been led by one individual or a small group of the same GPs for a long period of time and may feel the services they provide are sufficient. Newly qualified members of staff joining the workforce may feel their opinions and ideas are underappreciated or not even considered because the routines and procedures are already in place. An unwillingness to accept change could have detrimental effects on the mental health service user population. This is reflected in recommendations by government policy. No Health without Mental Health (DoH, 2012, online), Making it Happen (DoH, 2001, online) and Call to Action (DoH, 2011, online) each suggest recommendations for primary care services to develop the services provided to those with mental health illnesses and stress the importance of mental health promotion within primary care. The culture within a GP surgery may appear to be more superior to other NHS services as most GP surgeries are independently contracted and are not direct employees of the NHS (Gregory, 2009, pg 8, online). This enables them to provide enhanced services such as extended opening hours and specific services fo r those with learning difficulties (Gregory, 2009, pg 8, online). The above are components of General Medical Services (GMS) whereas Personal Medical Services (PMS) enable GP surgeries to cater for the specific needs of the local population (Gregory, 2009, pg 5, online). This could include drug and alcohol services or mental health services if there were a large number of the local  community presenting to their GP surgery with these issues. The cultures within each of these types of GP surgeries could be different completely. In a PMS GPs could have received specialist training in the areas large numbers of patients require support, resulting in patients feeling more valued and respected as well as staff members. GP surgeries can be seen as ‘providing a gateway to specialist care’ (Gregory, 2009, pg8, online). This view could be difficult to change. However by offering a wider range of services and treatment options, the gap between primary and secondary services as well as both an individual’s health and social care needs ca n be filled (Gregory, 2009, pg8, online). This service improvement aims to improve the health and social care needs of individuals with mental health illnesses in the community. However, not only are there barriers in place that service users must overcome to access primary care services there remains a lack of collaborative working between health and social care services. This has consequences on the service user and other professionals involved in their care denying the individual of adequate holistic care. Professionals from different areas such as nursing and social work may be bound by differing statutory obligations which can affect their decision making and the care they provide. Starting with the professional body they are registered with as a professional such as the Royal College of Nursing (RCN) or the Health and Care Professions Council (HCPC), these give professionals a value base they must work from and develop continuously. Legislation also has a huge impact on a professional’s decision making, for example the Mental Health Act (MHA, 2007). The law determines what a professional can and cannot do in a crisis situation. If a mental health nurse was based in a GP surgery they will have specialist training and awareness of the limits of their role determined by the MHA (2007), such as a patient being sectioned. They will be aware of who to contact if a patient is causing danger to themselves or others and need more suitable mental health care. If the mental health nurse was an Approved Mental Health Practitioner they could even have a role in detaining patients especially if a GP within the surgery was specially trained under the MHA (2007). This would save a lot of time and distress to individuals in crisis, members of the public and staff members. There are other noticeable difference between health and social care and the  standards of care provided. Social work would traditionally take a service-led approach to care whereas nursing has become more person-centred and individualised (SCIE, 2010, online). By using a person-centred approach the specific health and social care needs of patients with mental health issues are addressed (Hall et al, 2010, pg178). The service user is the centre of focus and care and support is planned around their specific needs. This is essential when caring for an individual with mental health issues as each condition, symptom and experience is different. Enabling an individual to be fully involved in every aspect of their care and make fully informed decisions regarding their treatment and social options. Continuity of care and positive therapeutic relationships are essential when making an individual feel valued and at ease, allowing them to feel comfortable and more willing to engage with professionals. An individual with mental health issues may feel anxious about attending their GP surgery and may need motivation or encouragement to do so. Having a therapeutic relationship with a particular professional within that surgery could reduce a person’s anxiety levels (Kettles et al, 2002, pg64). The chosen service improvement would be useful for this purpose as a mental health nurse based within a GP surgery could build positive relationships with patients enabling them to develop trust and engage with services and professionals. The mental health nurse would also take into account both the health and social care needs of the patients, decreasing the GPs workload and saving the practice money in the long run. They would also ensure the needs of the individual are fully met as satisfactorily as possible within primary care services or id required could refer them to the most suitable services available to them for their condition and needs. Whether they be health or social care needs. However this service improvement would only be successful with the cooperation and collaboration from GPs within the surgery. Joint decision making would be required as well an equal partnership between GP and mental health nurse. The Personalisation Agenda (Social Care Institute for Excellence, 2010, online) (SCIE) emphasises the need for integrated working, and the need for involvement from a wide range of services, such as; health, social care, housing, transportation and leisure, to ensure service users receive a  holistic, consistent and continuous care package (SCIE, 2010, online). The service user is put first rather than the service. This creates a person-centred rather than a service-led approach. A priority of the Health and Social Care Bill (2011) is improving integration within services. The Bill strives to provide better partnership, integration and collaboration across the government and all NHS services (DoH, 2011, pg1, online). There is evidence to suggest that integrating health and social care services saves a substantial amount of money (DoH, 2011, pg2, online). However in the current government climate there are financial pressures which may cause a barrier to effective integrated working (DoH, 2011, pg1, online). All aspects of the patient journey could benefit from effective integrated working resulting in a positive experience and all needs being met. The suggested service improvement of a mental health nurse in a GP surgery supports integration as there would be a variety of professionals within one building making multi-disciplinary team meeting easier to arrange and joint decisions could be made quickly. However there are barriers to integrated working including the breakdown of communication between staff and different organisations having a detrimental effect on patients (Trevithick, 2009, pg123). However by working in partnership there is a reduced need for specialist services ultimately cutting costs and having a positive effect on many other aspects of an organisation. Such as boosting staff moral and enhancing patient experience (Erstroff, 2010). If barriers to integrated working can be overcome more adequate care can be provided overall. A dual qualified practitioner in a GP surgery would be ideal allowing both health and social care needs to be addressed working in partnership with outside agencies and with patients to gain the best results, without the need for two professionals. It has been stated that services need to detect early signs of individual distress by working closely with primary care (Norman & Ryrie, 2009, pg172-173). By integrating the skills required in a mental health nurse and a social worker a more holistic approach can be taken. The introduction of community care impacted on various professions including general practitioners, social workers and nurses (Malin et al, 1999, pg158). Nurses have become increasingly empowered over time and have become more involved in commissioning alongside GPs. Within General practice more of a  purchase/provide relationship has been established (Malin et al, 1999, pg 159). GPs now have more power and control with funding and choice in the care they provide. However social workers may have felt deskilled by the purchase/provide divide (Malin et at, 1999, pg 159). The cultures of each professional’s organisation could cause conflict among a team. Employing a dual qualified social worker and mental health nurse in a GP surgery would eliminate the chance of conflict. It would become the responsibility of the dual qualified worker and the GP to work in partnership. There is evidence to support the need for the chosen service improvement. Mental health services are improvin g and developing continuously despite government cuts to funding, reflected in No decisions about us without us (DoH, 2012, pg6, online). The document states that primary care services, specifically GPs who play a part in supporting those with mental health issues are not making a difference to the mental health of their local communities. This creates an opportunity for the role of a mental health nurse to develop. The Care Services Improvement Partnership (CSIP, 2006) suggest that nurses are capable of delivering services within primary care settings as they have acquired the specialist knowledge to do so (Norman & Ryrie, 2009, pg 651). There is a need to modernise, develop and integrate services, primary care being a target area. The suggested service improvement would be cost effective and would provide early community intervention also lowering individual and family distress. Integrated working is an essential component in developing health and social care services (Trevithick, 2009, pg109). In conclusion there remains a need for improvements in the health care provided by primary care services to those with mental health issues. Statistics show that primary care services are the first point of contact for many individuals developing a physical or psychiatric condition (DoH, 2012, pg 6, online). The introduction of a mental health nurse into a GP surgery promotes integrated practice and modernises NHS services (DoH Factsheet, 2011, pg1, online), enhancing patient experience. There is evidence to show that this is an already effective role. Primary mental health workers have been introduced in Children and Adolescent Mental Health Teams (CAMHS) supporting colleagues in primary care services providing crisis intervention and contacts to specialist services (Norman & Ryrie,  2009, pg543). Primary care mental health Graduates have also been implemented in parts of London providing a range of interventions (Norman & Ryrie, 2009, pg 457). The suggested service improvement of a mental health nurse in a GP surgery would benefit the mental health service user population enormously. If the National Service Framework mental health standards (NSF, 2012, online) are to be met mental health promotion within primary care must be a focus (Newell& Gournay, 2009, pg 257). References Barbour, A. (1995); Caring for Patients: A Critique of the Medical Model. California, Sanford University Press. Estroff, J. (2010); Effective teamwork: Practical; lessons from organisational research. London: Blackwell Publishing. Hall, A. Wren, M & Kirby, S. (2010); Care planning in mental health: Promoting recovery. Blackwell Publishing. Oxford. Kettles, A. Woods, P & Collins, M. (2002); Therapeutic interventions for forensic mental health nurses. London: Jessica Kingsley Publications. Malin, N. Manthorpe, J, Race. D & Wilmot, S. (1999); Community care for nurses and the caring professions. Philadelphia: Open University Press. Nash, M. 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The Idea of Order at Key West

â€Å" The Idea of Order at Key West† Wallace Stevens, a imaginative poet, created a wonderful world of desire in the poem â€Å"The Idea of Order at Key West†. Line after line, new perspectives and curious thoughts popped into my head. Stevens creates the desire to want to decipher his puzzle of a poem. Stevens is a poet of many themes and perspectives, which led me to understand why I was coming up with so many different meanings behind this poem. In this particular poem, Key West being the muse, Stevens writes down the keys to the mystery, only to be unlocked if you dig deep into his poem.However, once unlocked, understanding the passion and mystery with each written word is a whole other activity. The speaker opens up the poem stating that â€Å"She sang beyond the genius of the sea. †Automatically, I am hit with a vision of a women standing on the shore, running away from the water as is grew closer to her toes, laughter being the song the sea couldn’ t amount to. The speaker then goes on to say that she was not mind nor voice. Nonexistent? No. This presence was very much alive in the sense of motion. The speaker, draw in by it's â€Å"empty†¦ mimic motion†, somehow understands the ovement. Emphasis on there being no physical form, but a being none the less. This possibly gives the speaker a sense of comfort. Being surrounded by a presence the speaker knew, but had a great desire to know more about it. In return, the speaker and company have empathy, constantly hearing a cry. The focus on a feminine figure was very obvious to me in the beginning of this poem. However, as the poem carries along, I am torn between what I think and what Stevens meant it to be. Continuing along, the presence becomes more mysterious. An open book for she was not a mask no more than was the sea.Water, for the most part, is a transparent substance. It makes sense that the speaker would use this metaphor, being in Key West where the water is crystal. The speaker makes it apparent that the sound is not that of the sea, but of the presence, â€Å"The song and water were not medleyed sound†. The speaker starts to clearly separate the presence from the surroundings of Key West. On the other hand, using the surroundings, the speaker defines the presence. Up to this point in the poem, I was sure that the feminine figure he so carefully described was a love of his. A women he longed for, but couldn't have.Once I read â€Å" she was the maker of the song she sang†, I changed my mind about who the muse was. It made sense that now, the feminine figure could possibly be a depiction of Mother Nature. A women who controlled the motion of the waves but herself had no motion. She was the cry they knew but was not of there own. The song was not the water, it was the wind as it crashed itself against the water, always pushing against that barrier. Every and all aspect led to this idea that the love was not a love of a woma n, but a love for the nature of women itself. The presence, something much larger than im, controlling all of the wonderful things he so desired and felt for. I was so sure about this notion, because I felt reassured by a verse. When the speaker said â€Å"it was she and not the sea we heard† I knew I had come across it all. Despite my reassurance, I instantly withdrew that notion when I came upon this verse, â€Å"repeated in a summer without end†. If the womanly figure was Mother Nature, then seasons would not be an issue. I was then left to recollect my thoughts. Sound, one of our five sense that allows us to soak up the chirping of the birds, crashing of the waves, and the beating of hearts.It seems to be the main drive of the speaker. Everything that the speaker explains comes from the song of Key West, the sound of Key West. Not knowing where it is from or what it is, the speaker so infatuatedly talks about a song and cry. I find it really ironic that the speaker creates a sense with the use of a sense. As you read you are painted a picture with the desire to listen to this song as well as ponder about the origin. The song, I believe, creates the desire to be at Key West and gives it life. To the speaker, the song becomes a song of tranquility amongst chaos, it calms him.The idea of order comes from the sounds that create the song of Key West. Once the song has stopped, the life it sang about trudges on. There is a kind of emptiness to the song, but it moves everyone who listens to it. It creates a connection with the listeners as well as brings their love of Key West to life â€Å"And when she sang†¦ whatever self it had, became the self†. This tune could be of their own life or the reason they come to Key West. It definitely paints the picture everyone goes there for. Sadly, when the song is over, it seems as if the love for the West isn't as strong.When the speaker turns away, the song no longer is a beautiful melody of the o cean, but a cry. The cry, a constant longing of Key West to have visitors and of the speaker to return again. Only during the summer does the speaker visit the Keys. Since he is only able to visit once every year, the need to visit as well as the Keys need for visitors builds up. Both with the longing to reunite, the cry is heard. There is a strong connection with the speaker and Key West. The speaker carefully describes the beauty of the beach as if it were a women. Every hour spent at the beach is precious. As the sun egins to set, the speaker gets an unsettling feeling. Even though he comes back every summer, it is painful for him to leave such a hypnotizing place. As the day comes to an end, the song seems as if it becomes slower. Creating everything that Key West is, as the song comes to an end, so does its surroundings. Fishing boats go back out to sea, the light begin to turn on, and the speaker has to tear himself away from his love. Time is of the essence and in no sense wa sted when the speaker visits Key West. â€Å"She measured it to the hour†, the song is perfectly measured out between sunrise and unset. This then makes it easier for the speaker to leave the beach, allowing him to go about his daily life. Then there is the mention of another man, Ramon Fernandez. The speaker looks up to him, asking if he knew why the melody was ending. I just came to the conclusion that Ramon was nothing but a man who was along for the ride. The speaker probably just asked him if he was interested in seeing Key West. Ramon has no deep connection with the coast unlike his chaotic friend. Although, he seems as if he is good company. He provides the speaker a chance to express his displacement with the song nding as well as the day coming to an end. Key West as a whole can be interpreted as something desired. Expressed like a love for a women, the beaches of Key West provides the speaker with a peaceful place. He longs for the passion, comfort, and peace that t he coast grants him. The possibility arises that the speaker was never able to truly express his love until arriving at the coast. There is no sure reason that the speaker feels such a deep connection with Florida. Maybe he lived there as a child, hearing the sounds of the ocean, wind, and creatures daily. Then when he would come back summer after summer, the sounds and sights hanged much like he did with each passing day. The speaker is constantly going back to a later time when things were as they picture them as a child. The song could represent the passing of time, as the day ended, he came to the realization that the beach was not what it used to be. The beach lifestyle being calm and easygoing, allowed the speaker to feel at peace. So then when the speaker left this lifestyle behind for another one, he realized the chaos was too much for him to handle. Sadly he was not able to return for whatever reason, except once a year, every year when the weather was at its hottest.A poss ibility could be that there was a job, family, and or life experience that was calling his name. Something of a forceful nature that caused him to leave. In his absence, the coast cried out for him, desperately trying to bring him back to peace. He did not know the cry was for him at the time, but once he came back, it became real. His love for Key West, for his old life was no longer in his grasp. The speaker could no longer turn back time and enjoy all those years he had flash before his eyes. Another interpretation could be that the need to be that Key West represents some sort of psychical or emotional need.Something that cannot be fulfilled by every day life. Key West is a tropical place, there are always exciting, fun, and new things to try. It is a freeing place where anything and everything is accepted. It is easy to find yourself in a social acceptable setting. Depending on the person, different settings can be more opening to others. For example, many people go to New York because they are widely accepted. All in all, Wallace Stevens wrote a cavern of a poem. Always going in deeper, seeing new perspectives, and discovering something new. The Idea of Order at Key West could be interpreted into ust about anything for anyone. Stevens so delicately thought out every single detail, making it such a beautiful read. Carefully unwrapping each sentence, I find myself longing to know more. In the end, what Stevens really wanted was an admirer. Someone who craved the words written by him. An adorer who would stop for nothing to know what his next thought would be. What creator doesn't want someone to admire their work ? Creating a vivid picture with every word, Stevens captured the essence of the thirst for love and desire. The Idea of Order at Key West was only just the foot in the door of this new way of writing.

WHap essay

First Civilizations began to dissolve, the Second-Wave Empires began to rise and take their place. While the similarities and continuities between the First Civilizations and the Second-Wave Empires are evident, the differences are also very clear. With the fall of the First Civilizations came a second wave of strikingly similar societies when viewed from afar. They were still ruled by monarchs and continued to include classes, caste, and discrimination; Elites were still on top with everyone else far below.The Elites continued to sit back and bathe In the riches while exploiting the peasant farmers and slaves. This made for no Innovation or effort due to lack of motivation. During the time of the Second-Wave Empires there were no technological or Industrial advancements from the first collocations. They were still based on agricultural societies with little to no other areas of Income. With Just a glance the similarities are noticeable, however when you take a closer look the differ ences are striking. Hen you start to really dig deep you discover several differences. In the Second-Wave population grew at a much more rapid pace due to the age of agrarian civilizations. The empires also were much larger. These empires and states included the Roman, Persian, Indian, and the Chinese empires. With the larger empires came more diversity however, with more diversity came more tension; resulting in the rising and falling of many of these great empires. With the Second-Wave also came more religion and culture.Confucianism, Hinduism, Buddhism, Greek rationalism, Judaism, Christianity, and Islam are all examples of the rising religions; they all have provided the structure for the way people live today. Although first civilizations had classes, caste, and slaves, the Second wave amplified the use of classes and slaves. But the largest change between he First-Civilizations and The Second-Wave Empires was rising of a far more intricate communication network allowing for co mmunication between states and empires.Through these two eras there were many changes, fluctuations, and lots of repeating cycles, although they did not hold any fundamental or revolutionary transformations. The major turning points had already occurred at the beginning of the first era with the agricultural revolution. Overall, through all the similarities and differences between the First-Civilization and the Second-Wave the world changed in drastic ways. The only question is was it for the better or worse? WHap essay By matched with everyone else far below.The Elites continued to sit back and bathe in the riches while exploiting the peasant farmers and slaves. This made for no innovation or were no technological or industrial advancements from the first civilizations. They were still based on agricultural societies with little to no other areas of income. With just a glance the similarities are noticeable, however when you take a closer look the When you start to really dig deep you the First-civilizations.

Cross Cultural Organizational Behaviour-&ltFear and Trembling&gt Assignment

Cross Cultural Organizational Behaviour-<Fear and Trembling> - Assignment Example In human resource management, the Herzberg’s two-factor theory states that both job dissatisfaction and job satisfaction exist, but work independently of another. This means it is guided by the fundamentals of attitudes and motivation to integrate practicality when enhancing workers’ productivity. The theory was advanced by Frederick Herzberg and it continues to streamline the human resource management in terms of recognition, advancement, achievement and even responsibility. On that account, the movie Fear and Trembling directed by Alain Corneau attempts to evoke Herzberg’s two-factor theory in particular scenes with emphasis on its numerous characters. This is exemplified in Amelie’s return to Japan after many years seeking a reconnection and a means of integration, but the circumstances and conditions are difficult. On that perspective, the protagonist’s behavior is an epitome of a reformed attitude and motivation to perform her duties in a diffe rent way that evokes a sense of responsibility and recognition. Amelie also intends to increase her satisfaction in serving her nation, but the retrogressive forces such as those depicted by Ms Mori acted by Kaori Tsuji are hell-bent on questioning her willingness to work. In the same account, the lead character’s embodiment of humility in facing her tasks as a translator at an import/export company does not favor her because she barely remembers the Japanese cultural norms (Sheldrake 164). Unfortunately, this negates her intentions that Herzberg asserts that are guided by higher-level gratification and other forms of psychological needs rather than mere competence. Contrastingly, Ms Mori’s callous trait represents the two-factor model of failing to offer the worker the set of job characteristics that will spur satisfaction. Instead, she belittles Amelia particularly in the scene where the protagonist requests for better work conditions to fully integrate in her native country. This clearly demonstrates Herzberg's motivation-hygiene theory of diminishing one’s job attitudes and eventual productivity. It is also evident when Ms Mori delegates Amelie to become a bathroom attendant not as a means of recognizing her efforts but as a revenge tactic to demoralize her efforts. The scene provokes a sense of defeat in the motivated worker and is further manifested when Amelie angrily tells refuses to renew her contract. Such a scenario in any job setting is a replication of worker subjugation and exploitation that cannot be prevented thus Herzberg’s conclusion on the two-sidedness of job satisfaction in various firms. According to Herzberg's motivation-hygiene theory, the plight of Amelie in the import/export company remains evident in the scene where the main character finally meets the company’s president. The office evokes a sense of cultural Japan when people addressed the Emperor and was a sign of reverence and contentment. In th e work context, it displays a renewed hope and motivation in the incompetent translator who has been thoroughly humiliated by Ms Mori in her quest to crush any form of productivity. Additionally, Ms Mori’s retrogressive display of converting a former translator to a bathroom attendant clearly proves her failure to distinguish the building blocks of Herzberg's

Can men be victims of rape Consider this question in relation to Essay

Can men be victims of rape Consider this question in relation to legislative changes and the evolution of the policing response - Essay Example Although many people may view this assertion as vague, there are some different and varying deliberations on how men undergo difficult times as victims of rape. The worst of it has been on the revelations of how the society would view this issue given that in the wider society, culture has it that men are not allowed to discuss such matters in public. In fact, in some instances, men fear reporting instances of rape with the consequence of being turned against and being the offender instead of being the victims. Some of the common instances of men’s rape are between men and men. This is evidenced by the increased instances of homosexuality. Nevertheless, deliberations have been on how to define men rape in the context of events that may have transpired during the incidence. However, just like in women, men’s rape is characterized by assault and use of force and being forced to perform the sexual act without ones consent. When this happens, a man, just like a woman feels diminished and less a man (Lea, Lanvers, & Shaw, 2003). In fact, to some extent, when men undergo rape, they have a feeling of fear that they end up being gay. There are also concerns that this act may affect their sexual orientation in future. In addition, the worst thing comes in when a man feels that the connection between him and women has been eroded. They get scared even to approach women. In another dimension, for those men that become victims of rape, they have problems having sexual intimacy with their wives. This greatly affects their marriage and may end up breaking up. This becomes worse when men victims stomach these deeds instead of sharing with their spouses. In addition, there have been instances of men’s victim developing avoidance emotions. They tend to kind of develop some psychological problems that keep them away from other people. Some have developed some assault traits that make them aggressive even to their own relatives and friends. In this regard,

Explain The ethical Issues when the board of directors must approve Essay

Explain The ethical Issues when the board of directors must approve plans for moving a company production facilities from a stateside location to an overseas location - Essay Example The utilitarian theory manifests its truest self here by discussing the happiness or the lack thereof, with concerns to the people who will lose out on their jobs and finances once the company decides to move its production facilities from a stateside location to an overseas one. The utilitarian theory will judge the exact amount of ethical considerations in line with the undertakings of the organization once it decides to change locations (Cornman, 1992). The utilitarian theory thus emphasizes a great deal on the workers’ understanding of the situation at hand and how they will cope up with the future implications of moving production facilities to an overseas location. The company’s leadership should balance the needs of the workers in line with the organizational goals, mission and vision. No one can take preference over the other and it is the duty of the organizational top management to comprehend how it can mesh the two factors to have a win-win situation at the very end. This will ensure success at all levels, as well as manifest growth and development at all possible levels and towards all workers who seem to miss out on the premise of working for this organization in the

What are some of the ways that metropolitan areas coordinate Essay

What are some of the ways that metropolitan areas coordinate governmental activites and services accross a region, while at the same timeprotecting the values of suburban independence - Essay Example This is a good example of the consolidated metropolitan area governance, where city and county divide and share the responsibility of providing core services and coordinating activities within its area. Thorough and organized planning between the city and the county helps to make the governance more efficient and economical. The biggest city in the area, Miami, and 34 other towns provide a lower level of services, such as fire, water/sewer, parking, zoning, etc. At the same time, the Dade County provides the higher level of services, such as school, emergency management, airport, regional transit, and public housing. At the same time, the County provides lower-level services for areas that are not incorporated under Miami-Dade County governance. There are some services that are provided at both levels, such as parks and recreation. Both levels of government that coordinate services and activities in the larger Miami area impose taxes. The Dade County operates under an Executive Mayor , who is appointed by the County Manager, and a County Commission. In some regions, however, the above mentioned formal form of governance is not politically feasible, thus some forms of functional governance emerge. An example of the functional governance is Portland, Oregon. Oregon has a Metropolitan Planning Organization (MPO). There are many MPO throughout metropolitan areas in the United States, which are considered an innovative form of functional governance. Their formal role is to develop and manage regional transportation plans. However, more and more responsibilities are delegated to MPOs by the local governments. Oregon has the most powerful MPO in the country, the power of which crosses 3 counties and 25 cities. Unlike typical MPOs, Oregon MPO manages not only transportation, but only parks and recreation, and public facilities, as well as oversees land use and urban growth boundary. Thus, I

Comments on DQ1 and DQ2,KS and CH Essay Example | Topics and Well Written Essays - 250 words

Comments on DQ1 and DQ2,KS and CH - Essay Example If a firm faces liquidity problem they can liquidate the investment portfolio of common stocks and turn it into cash instantly. Corporations invest in stock market to generate money from dividend income and to obtain equity appreciation. During the last 10 years the average return on stocks was 3.5% (Soundmoneymatters, 2011). DQ2 The fair market value argument is something that accountants have pondered for a long time. One would assume that the fair market value of a stock should be the absolute law when accounting for equity investment since the market value is the price that everyone uses when selling or buying a particular stock. The problem is that accountants must keep in mind the conservatism principle and the historical cost principle. In my opinion the best accounting practice is to value a common stock investment at historical cost independent of the fluctuations in market price of a stock. If a company does not intend on selling a stock in the near future the market value has no relevance. Making adjustments based on market value would be a troublesome task for accountants. At the moment that a company decides to sell a stock a company will either achieve a loss or gain based on the difference between historical cost and market value. References Soundmoneymatters.com (2011).

W8D 597 Reflecting Plans Essay Example | Topics and Well Written Essays - 250 words

W8D 597 Reflecting Plans - Essay Example This is contrary to the fact that most plans outline objectives, functional tactics and actions item. Change is a major factor in the implementation and planning of any given plan. The internal environment is essential towards these changes. Most firms exist in a stagnant internal environment. These environments are resistance to change thus compromise the planning and execution of any given plan (Sinofsky& Iansiti, 2009).The internal environment failure to acknowledge need for change is what attributes to failure of a given plan. Firms may interact well with the eternal environment and lay down models that will enhance communication and interaction with the external environment but may in marshalling the internal environment towards change (Berkun, 2008). Marshalling the internal environment requires a proper leadership model. The lack of leadership within a given organization could be the predicament in the implementation of a given plan (Kipp, 2004). Strategies plans are created to ensure a firm transforms in matters operations and control. The management is required to play an important role within an organization. Lack of a proper leadership models will result to forms not being able to implement plans they developed. Organizations need to acknowledge the setbacks within the internal environment to ensure strategic plans are implemented. PricewaterhouseCoopers. (2014). The new hire: How a new generation of robots is transforming manufacturing. Retrieved from

Literature review Essay Example | Topics and Well Written Essays - 4500 words

Literature review - Essay Example On the contrary, marketing is perhaps the only functional division of an enterprise which is solely concerned with the consumer. It is regarded by many critics that marketing is the most crucial of all the functional aspects of the business; it can be argued that marketing is the prime means for attracting a customer, and without customers, there is little that the other departments are going to do. Marketing is important in helping the company to construct upon their corporate and business foundations, and to use them to solidify their goals. In order to further the objectives of the business, the business needs to consider the bigger picture. From the perspective of launching a product in the market, the bigger picture would entail exploring the market potential for the product, researching the competitors in the market giving particular attention to their strengths and weaknesses, coming up with an appropriate marketing strategy for the product and selecting suitable marketing cha nnels. Moreover it is also important to develop apposite measures for managing and supervising the launch of the product in the market. ... Functioning businesses have two main purposes. Firstly, they are working for the retention of the customers that they have attracted. Secondly, businesses are endeavoring for attracting new customers and increasing their clientele. There are a number of philosophies that can be implemented for the attainment of these two goals of the business. The first philosophy relates to the production concept. This means that all consumers are going to consume those products that are not only within the range of affordability but are also easily and extensively found. One of the famous corporations who follow this strategy is Wal-Mart. According to the founder of Wal-Mart, Sam Walton, the company should work on the philosophy of ‘Pile ‘em high and sell ‘em cheap’ (Moore & Pareek 2009). On the other hand, the product concept entails that customers are going to buy that product which is the most promising in terms of its value after taking into account the worth and perfor mance of the product. Consumers are going to perform an evaluation of the product according to its various features, such as how durable it is or its serviceability; at times customers take into account a juxtaposition of the factors and their choice of different products depends on whether the products meet these juxtaposed product-based aspects. When referring to brands, customers also take into consideration whether the product is going to fulfill their psychological need or not. Five Forces Model Enterprises which operate on the selling concept support the notion that a large-scale effort is needed to promote a product; in the absence of a large-scale concept, customers are not going to consume enough products in order to

Cultural Analysis Essay Example | Topics and Well Written Essays - 500 words

Cultural Analysis - Essay Example Government statistics of Iceland note that 94 percent of the inhabitants of Iceland live in the urban regions whereas up to 63 percent are the residents of the Reykjavik metropolitan area ("People"). The history of Iceland can be understood to be based on survival prosperity. Iceland was discovered by the Scandinavian sailors around the mid-ninth century. The first settler arrived in Iceland in 874. Landnà ¡mabà ³k, the book of settlements, compiled in the 12th century contains information about the initial 400 settlers in Iceland. A famous story set down there is that Floki, a Norse Viking made a voyage to Iceland but he spent all his time and energy on fishing and hunting and thus could not lay up any hay for the livestock, because of which they died during the winters, thus giving the land its name as Iceland. Icelandic history is shaped by the Norsemen settlers from the British Isles, Celts, and Scandinavia around the 9th and 10th centuries and is significantly shaped by the events occurring on the Nordic Countries larger political stage (â€Å"History†). Christianity was adopted in Iceland around the year 1000 (â€Å"History†). Nearly 33 per cent Icelanders were wiped out during the Black Plague infection in 1402. In 1940, the British Troops occupied Iceland. The Republic of Iceland was formally established in 1944 (â€Å"History†). The Icelandic language has remained almost the same since the 12th century and its similar to the Old Norse language. Letters of the Icelandic alphabet are not recognized in the modern English. For example, Þ is an Icelandic alphabet that is pronounced as "th". The most prominent religion in Iceland is Christianity. This is evident from the fact that the population following the Lutheran Church in Iceland is 80.7 per cent, those following the Roman Catholic Church make 2.5 per cent of the total, and other populations include â€Å"Free Church 2.4%,

Surrogacy Legalisation in Australia Essay Example for Free

Surrogacy Legalisation in Australia Essay Women usually become a surrogate mother because they receive compensation in one form or another from doing it; others do it because a family member cannot produce a baby of their own. Homosexual couples tend to use surrogacy as an option to have a child of their own, as compared to adopting a child. Due to commercial surrogacy being illegal in Australia, it has driven homosexual couples to other countries such as India where the surrogate mothers are not as healthy as the ones in Australia. Commercial surrogacy should be legalised in Australia so people of all sexualities do not revert to other countries where poor women are exploited and help protect the legal status of children there. (Esther Han, December 9, 2012, Sydney Morning Herald) Through surrogacy, couples of either heterosexuals or homosexuals are able to have a family of their own if they cannot produce one for themselves. There are two types of surrogacy; traditional and gestational. A traditional surrogate is a woman who donates her own egg and then carries out the pregnancy. Their egg is donated from their own body with the sperm of the father or the sperm from a donor. A gestational surrogacy is when the surrogate isnt biologically or genetically related to the child that she is carrying. Through the process of in vitro fertilization, the carrier becomes pregnant. This fertilization is where an embryo or several embryos are created from the eggs and sperm of the intended parents are implanted in the uterus for the gestational period of 40 weeks. As in the grounds of nature it takes a man’s sperm and a womans egg to create a baby, it makes it impossible for homosexual people or couples to conceive a baby of their own and therefore surrogacy is an option for them. In gestational surrogacy, there is no direct genetic impact on the baby from the surrogate mother and there is no DNA from the surrogate mother to the baby. This is because the embryotic sack that the baby is in has already got the DNA from its’ mother and father through the in vitro fertilization procedure. However, if the surrogate mother is not getting enough nutrients in her diet or if she were to drink or take drugs, this would affect the health and development of the baby as if it would a traditional surrogacy. Homosexual couples tend to go for surrogacy as opposed to adoption due to the fact that many homosexual couples want a baby that is created from their own DNA (because they cannot create their own with a woman) and not bring up someone else’s child through adoption. Not only because of these reasons do they tend to go for surrogacy, but also because adoption for homosexuals either in a relationship or not and single people has now become prohibited in almost every country in the world. There are a few concerns that do influence the decision on whether a homosexual couple adopt (if they were able to in that particular country) or apply for a gestational surrogate. Some of the concerns that they have with adoption is that some mothers decide to change their minds at the last minute and keep their baby instead of giving it to the adoptive parents. The costs that are involved with adoption and surrogacy are around the same amount of money to pursue; so many homosexual and heterosexual couples tend to go for surrogacy because even with the slight price increase of surrogacy, the couple would have a baby that is created from their own DNA. For the homosexual couple however, the DNA would come from one of the parents (Janna Herron, Bank Rate, 2013). In Australia, the current laws have stated that commercial surrogacy is illegal. However, there is no current law that states in Australia that non-commercial surrogacy also known as altruistic surrogacy is illegal. According to the Surrogacy Act of 2010, any parties can enter into a non-commercial/altruistic surrogacy agreement regardless of their sex and relationship status. The surrogate mother of the intending parents is not allowed to receive money or any compensation from the intending parents, but are allowed to have any medical expenses that are related to the baby be compensated for by the intending parents. For a homosexual couple, finding a willing surrogate mother in Australia who doesn’t want to be compensated more than what the law states is almost impossible to find, and this therefore leads homosexual couples to apply for surrogacy in other countries such as India. Each year, India produces hundreds of babies through commercial gestational surrogacy to intending parents all around the world. A vast amount of these babies from India go to intending homosexual couples of Australia. Just before Christmas last year, India changed their law for surrogacy to now exclude homosexuals, singles and people of all genders that are in a de facto relationship. This new law has been put into place because there are people who access surrogacy, rather than assisting the surrogates and the way in which surrogacy is done (Janna Herron, Bank Rate, 2013). This new law in India has affected homosexual couples especially because they can no longer apply for commercial surrogacy because they no longer fit in with the new criteria. These laws have been passed because of the controversial issues that may occur and the psychological issues that child may receive from having two parents of the same sex raise them. There are many controversial issues with being in a same sex relationship, including that of same sex rights and children. Children are an important aspect of many people’s lives. One of the issues that have arisen is whether a child who is raised from same sex parents will suffer from psychological abnormalities or development issues. Studies have shown from The American Psychiatric Association that there are no development issues or differences between children who have been raised by either homosexual or heterosexual parents. The child’s intelligence, psychological adjustment, popularity with friends, development of social sex role identity or development of sexual orientation has not been negatively affected or influenced due to their parents’ sexual origin as many stereotypes may point out. Another controversial issue that same sex couples face is the nature vs. nurture theory. Some people believe that if a man and a woman cannot produce a baby of their own, then they should therefore not be having children. This same theory applies to homosexual couples. In the eyes of society, if a homosexual couples cannot produce a baby naturally, than they should not be allowed to participate in the surrogacy scheme. This shouldn’t be the case for anyone, homosexual or not (Surrogacy Controversy, 2009) Controversial issues aside, should the legalisation of commercial surrogacy for heterosexuals and homosexuals in Australia occur? The answer is yes. Homosexuals should be allowed to access commercial surrogacy in Australia because we know the environment the women are living in is much more sanitised and cleaner as opposed to the third world countries such as India where intending same sex parents have had to resort to in order to have a baby. The surrogate mothers of Australia should be allowed to be compensated for the physical hardships and mental discomforts that she may endure. Studies have shown that no mental development issues have occurred from children who have same sex parents and there are no negative effects on the children. Everyone has the right to have a child and by legalising commercial surrogacy in Australia, more people will be able to have the families they’ve always wanted instead of having to meet the new criteria of the Indian laws. And sure, two daddies cannot give a child a mothers’ love but they can definitely give them double daddy love and in the end all that matters to a child is that they are loved by their parents; even if that happens to be two mums or two dads (Rosemary Odgers and Margaret Wenham, Courier Mail, February 10,2010). Reference List; †¢ Esther Han, December 9, 2012, Sydney Morning Herald, accessed Thursday 22nd May, 2013) lt; http://www. smh. com. au/national/call-to-reform-surrogacy-laws-20121208-2b264. htmlgt; †¢ Farlex Inc. 013, The Free Dictionary, accessed Friday 10th May, 2013 †¢ Kerry Brewster, 2013, ABC News, accessed Friday 10th May, 2013 †¢ Professor Jenni Millbank, 2013, ABC News, accessed Friday 10th May, 2013 †¢ Janna Herron, Bank Rate, 2013, accessed Friday 17th May, 2013 †¢ Surrogacy Act of Australia, 2010, accessed on Friday 24th May, 2013 †¢ Surrogacy Controversy, April 2009, accessed Sunday 26th May, 2013 †¢ Rosemary Odgers an d Margaret Wenham, Courier Mail, February 10, 2010, accessed Sunday 26th May, 2013

Women Leadership In Public Sector History Essay

Women Leadership In Public Sector History Essay In a fast paced and changing environment, the focus of attention is increasingly on the need for effective leadership not just good management, and women have recently proved that they are not only good in making food and taking care of children, but also good in leading the society and promoting a better generations. Moreover, women made dramatic gains in electoral politics, winning a number of high profile positions of national leadership and a record number of seats in parliaments around the world. However, ladies who are aspiring to leadership positions are facing particular challenges; they often face far more meticulous tests to determine their suitability for promotion and must be active in seeking selection for leadership positions. Nevertheless, in order to create your own opportunities, you should acquire the characteristics and competencies of an effective leader and integrate these into your personal leadership style not caring about your identity or gender. Furthermore, through interactive exercises and group discussions, female will gain powerful communication, negotiation and influencing skills which will help them succeed in male oriented working environments. They will learn how to achieve an assertive but not aggressive response styles and create and sustain an image of authority. They will also acquire valuable techniques to help them lead, empower and motivate their staff to excel. To give an opportunity for women to develop practical leadership skills as well as to benefit from the breadth of knowledge and experience of their peers within a range of commercial and public organizations is an obligation and a duty in the hands of the government. In fact, a large number of women around the world have set up and managed their own businesses. It was not easy for those women to succeed in business. They had to face a lot of difficulties and overcome a number of barriers to become successful in their ventures. They had to deal with discrimination and endure the doubt of society, and also put in more effort than men to prove their credibility to others. The frequent mismatch that arose against women, on the one hand is because of societal discourses and media representations which often reproduced slim and highly stereotypical accounts of womens leadership, and on the other hand, because individual womens subjective experiences of leadership challenged such representations. Many experiences have been conducted concerning womens leadership, One of them was done through the Student Leadership Practices Inventory (Student LPI) and Leadership Competency Inventory (LCI), demographic questionnaire, and focus group interviews have been asked, the researchers explored the leadership training the women had received and their perception of their leadership abilities and development needs. The findings showed that the women reported frequently demonstrated exemplary leadership practices and many possessed significant leadership experience. Participants scored highest on competencies utilizing people skills and lowest in areas reflecting competence in cognitive or strategic skills. While exposed to formal leadership education, they reported receiving their leadership education primarily through observation and experience. Data from other studies were gathered in three diverse sample conditions to examine whether male and female managers differed in styles of leadership observed by their direct reports and they examined differences in both transformational and transactional leadership styles using the Multifactor Leadership Questionnaire. In three samples, women leaders were rated by both their female and male direct reports as displaying certain key aspects of transformational leadership (i.e. charisma, individualized consideration) more frequently than men. Although the effect sizes were generally small, the results of these studies suggest that women are no less transformational than their male counterparts, and may, in fact, be more so. The sex of the raters did not appear to make any difference in the results obtained. What studies and research have shown? According to  the new Deloitte Touche Tohmatsu report, Paths to  power: Advancing women in government, launched in advance of International Womens Day on March 8, governments have been more successful at advancing women than the  private sector. Globally, women are increasingly being elected and appointed to  positions of power within the  public sector such as heads of state, ministers and cabinet members, and legislators more so than in the  private sector. Furthermore, Talent and knowledge are the  most important resources a  nation can possess, said Greg Pellegrino, Deloitte Touche Tohmatsu, Global Public Sector Industry Leader, and one of the  authors of the  report. Womens progress has vital implications for the  health and growth of governments, companies, and nations. Therefore, it is crucial that governments and companies work together to  harness and cultivate global female talent, to  help create positive change and ensure continued growth and success. According to Diana Radl Roger, partner at Deloitte Czech Republic and Slovakia, creating appropriate conditions for women is a  very difficult task because it demands cooperation of the whole organization. In  my opinion, companies that take care of and support a  better work-life balance, win their employees loyalty, and not only their female employees. They provide incentives for higher performance and professional growth. Indeed, the number of women in a company suggests the companys culture and  values, Progress with respect to  womens participation in the  public sector serves as a  model for the  private sector. Countries that have women in government leadership positions have an  increased number of issues affecting women on the  legislative agenda, often resulting in positive societal and economic developments. For example, after ten women won parliamentary seats in Kenya, legislation relating to  womens issues, such as combating domestic violence, was passed into law. Likewise, research has shown companies with women in leadership positions perform better and achieve more economic rewards than those without women representation. The  top 500 multinational firms, which had at least three women on their boards, saw a  16.7  percent return on equity, while average companies just saw an  11.5  percent return. Evidence suggests that as female representation in government increases, their shared interests emerge, bringing about increased attention of issues affecting women. It also paves the  way for more women to  move up the  ranks, as their predecessors break down many of the  cultural and institutional biases still in existence. As the  world grows ever more interconnected, talent is becoming increasingly mobile. With the  exception of North America, regions throughout the  world are experiencing a  brain drain, in which educated women are emigrating at alarming rates in search of advancement opportunities. For example, in Africa alone, 27.7  percent of females with tertiary education emigrate 10  percent more than men. What are the steps to be taken to preserve women rights to leadership? An organization-wide culture shift is required to  nurture an  environment that is friendly to  women and encourages their advancement. In reality, women are a  critical national resource for economic growth  .Womens progress has vital implications for the  health and growth of governments, companies, and nations. Both the  private and public sectors must continue to  nurture and advance diverse talent including high-potential women in order to  stay competitive and grow. According to Anne Weisberg who is the director of Deloitte Services LP in the  United States, and one of the  authors of the  report, While women have used individual strategies to  achieve their ambitions, accelerating the  advancement of women into positions of leadership in the  government will require new organizational strategies led by those in senior positionsà ¢Ã¢â€š ¬Ã‚ ¦ Among others steps, it will require organizations to  establish metrics and accountability measures, focus on career development for women and promote work life integration. The insertion of women in the workforce is critically important to the economy. Research has shown that if you have women in leadership in a company, it performs better. The same is true for the public sector. In fact, having women in high levels of government according to Excellency Maha Nakib, Minister of Tourism and Antiquities for the Hashemite Kingdom of Jordan is important, but whats more important is having women who can make a difference. The United States Case: In the United States, women are increasingly praised for having excellent skills for leadership and, in fact, women, more than men, manifest leadership styles associated with effective performance as leaders. Nevertheless, more people prefer male than female bosses, and it is more difficult for women than men to become leaders and to succeed in Male dominated leadership roles. This mix of apparent advantage and disadvantage that women leaders experience reflects the considerable progress toward gender equality that has taken place in both attitudes and behavior, coupled with the lack of complete attainment of this goal. United States, where women constitute 24% of the chief executives of organizations, 37% of all managers, and 43% of individuals in management, financial, and financial operations occupations (U. S. Bureau of Labor Statistics, 2006,). Although no one would argue that gender equality has arrived or is even near at hand, such statistics reflect massive social change in womens roles and opportunities. Advantages mixed with disadvantages: Alice H. Eagly argues in her book Psychology of Women Quarterly that research has established a mixed picture for contemporary female leadership. Women leaders on average manifest valued, effective leadership styles, even somewhat more than men do, and are often associated with successful business organizations. Attitudinal prejudice against women leaders appears to have lessened substantially, although even now there are more Americans who prefer male than female bosses. People say that they would vote for a woman for president; however, only slightly more than half of Americans indicate that the country is ready to have a female president. Because of the remaining prejudicial barriers, women face challenges as leaders that men do not face, especially in settings where female leaders are nontraditional. Such signs of advantage mixed with disadvantage and trust mixed with distrust are contradictory only on the surface. They are manifestations of gender relations that have changed dramatically yet have not arrived at equality between the sexes. Changes occurring in the 21st century: Many women have contended successfully with barriers to their leadership, as shown by the fact that women now have far more access to leadership roles than at any other period in history. The inroads of women into positions of power and authority reflect many underlying changes (Eagly Carli, 2003, in press)-above all, womens high level of paid employment (U.S. Census Bureau, 2007) and a lessening of the time demands of womens housework, accompanied by greater sharing of childcare and housework with husbands and partners (Bianchi, Robinson, Milkie, 2006; U.S. Bureau of Labor Statistics, 2005). Associated with these shifts in roles is a large increase in womens education, whereby young women have become more educated than young men (U. S. National Center for Education Statistics, 2005). Because these changes in employment and education are accompanied by psychological changes in the form of increasing agency in women (e.g., Twenge, 1997, 2001) and greater career ambition (e.g., Astin, Oseguera, Sax,Korn,2002), women have achieved many more leadership positions than in the past. Women continue to encounter impediments to leadership within organizations, but many of these impediments can be removed or weakened by organizational changes designed to improve womens (and minorities) access to and success in leadership roles (e.g., Kalev, Dobbin,Kelly, 2006; Rapoport, Bailyn, Fletcher,Pruitt, 2002; Yoder, Schleicher, McDonald, 1998). On the other hand, the authors of Gender Equity or Bust! On the Road to Campus  Leadership  with Women in Higher Education argue that, Born of a patriarchal tradition, higher education continues to marginalize  women  at every turn as students, administrators, faculty, and athletic leaders. Whether the bias is conscious or unconscious,  women  are being penalized consistently for their gender (Wenniger and Conroy, 2001: 7) However, taking into consideration the deep changes taking place in womens roles and in the cultural explanation of good leadership, it is clear that women will continue their rise toward greater power and authority. The 20th-century shift toward gender equality has not ceased but is continuing (Jackson, 1998). The presence of more women in leadership positions is one of the clearest indicators of this transformation. Are women interested in political leadership? Women  would not be equally represented in student  government, much like they are not equally represented in the federal government, because they do not choose to run for office. One explanation is that  women  are not as interested in politics and  government  as men. The second explanation for not running for office could be that they do not believe they are qualified. Ultimately, these findings show that further research in which female student  government  representatives, candidates and the student body electorate are asked specifically why  women  might not be running for office or getting elected would offer more insight into this gender division of  leadership. Gender and Leadership: When it comes to gender and leadership, one thing is clear. Women can be successful in leading both private and public sector organizations. Women corporate leaders face a special set of challenges due to the male dominated nature of these things. Because women are members of the lower status minority group, for them assimilation creates problems with cultural adaption, the inability to maintain a positive sense of identity, feelings of marginalization and isolation and increased exposure to harassment and other stressors. (Korabik, 1997) What is the role of the media in all this? An analysis of media discourses on womens leadership, suggests the need for more nuanced ways of understanding women leaders identity formation that combine a range of macro and micro methodologies. It points to the importance of including an examination of both the specific organizational fields and the broader political, social and economic discourses of womens leadership, as mediating influences on the construction of womens leadership habits. It is our hoped that our study reveals the need for more complex ways of understanding women leaders identity formation and, in so doing, opens up productive spaces from which may flow subjugated knowledge of diverse womens leadership. Where is the female disadvantage? Our meta-analytic demonstration that women fare less well than men in male-dominated and masculine leadership roles identifies context-specific disadvantage (e.g., Eagly et al., 1995)-that is, in some leadership roles, women face obstacles that men do not face. If women who are in fact equal to their male counterparts are treated differently either in their access to male-dominated leader roles or in evaluations of their performance once they are in such roles, women would indeed face disadvantage as leaders. Such Disadvantage would be prejudicial, as defined by less favorable treatment of women than men, despite their objective equality (Eagly Diekman, 2005) one place to look for evidence of prejudicial disadvantage is in studies of attitudes toward female and male leaders. Especially informative are national polls that have asked representative samples of respondents for evaluations of men and women as leaders. Such polls have consistently shown favoritism toward male over female leaders. For example, for many years, pollsters have asked people what they think about personally having a job in which a woman or a man has authority over them. The specific Gallup Poll question is If you were taking a new job and had your choice of a boss, would you prefer to work for a man or woman? These data show a preference for male bosses over female bosses, although this differential in favor of men has decreased substantially through the years. What are the female advantages? Although revealing relatively small differences, findings indicate an advantage for women leaders. Women, more than men, appear to lead in styles that recommend them for leadership. In contrast, men, more than women, appear to lead in less advantageous styles by attending to subordinates failures to meet standards or by displaying behaviors that involve avoiding solving problems until they become acute and by being absent or uninvolved at critical times. What is clear from the meta-analysis is that women leaders, on average, exert leadership through behaviors considered appropriate for effective leadership under contemporary conditions. Why might women and men display somewhat different leadership styles within the limits set by their leader roles? Women are faced with accommodating the sometimes conflicting demands of their roles as women and their roles as leaders. In general, people expect and prefer that women be communal, manifesting traits such as kindness, concern for others, warmth, and gentleness and that man be agentic, manifesting traits such as confidence, aggressiveness, and self-direction (e.g., Newport, 2001; Williams and Best, 1990). Because leaders are thought to have more agentic than communal qualities (Powell, Butterfield, Parent, 2002; Schein, 2001), stereotypes about leaders generally resemble stereotypes of men more than stereotypes of women. As a result, men can seem usual or natural in most leadership roles, thereby placing women at a disadvantage (Eagly Karau, 2002; Heilman, 2001). Consequences of prejudice toward female leaders: Although prejudicial attitudes do not invariably produce discriminatory behavior, such attitudes can limit womens access to leadership roles and foster discriminatory evaluations when they occupy such positions. Social scientists have evaluated womens access to leadership roles through a large number of studies that implement regression methods. Finally, women have different opinions and views and having just one woman does not mean all are represented. We need to take more action in order to ensure that leadership women who have the style and the personality of a leader are taking their chance and are being represented. Moreover in order to ensure this right, we should provide women with education because in educating a woman, you educate a community. In the 21st century, many women are coming up in government and its really important to give them the mentorship they need to grow their careers and to motivate other women to act like them. This way, women will embrace a participative empowering consensus-building style of leadership and women will change the nature of power; power will not change the nature of women. (Bella Abzug, State of the World Forum, 1996)

Sleep Deprivation in America Essay -- Health Medical

Sleep Deprivation in America Research indicates that America’s sleep problems have increased and might be the number one health problem. The average amount of sleep that people get per night can range anywhere from three to twelve hours. According to Dr. David Dinges at the University of Pennsylvania, it is a fact that people who get fewer than six hours of sleep a night do not live as long as people who get seven hours or more. Most people do not realize the importance of sleep or even realize that it is needed to survive. Many people experience sleep deprivation; however it is commonly seen in college students. Irregular sleeping patterns tend to occur in students, which can later lead to long-term effects. Sleep deprivation can affect the normal and regular sleep patterns and cycles of many people. According to Lacks, â€Å"Normal adults gradually move through a sequence of regularly alternating stages of sleep† (17). Adults experience these different stages because of their own distinct patterns and behavioral activity. Sleep is divided into two categories non-rapid-eye-movement and rapid-eye-movement (Lacks 17). These stages of sleep range from the lightest sleep to the deepest sleep. This cycle is repeated over and over again while sleeping. These sleep stages are necessary to regulate the different states of wakefulness and sleep. According to Williams, â€Å"Insomnia or difficulty in initiating or maintaining sleep is almost part of everyone’s life† (29). Insomnia is a result of sleep deprivation, which can lead to further effects such as stress and aging. Regular sleeping patterns can drastically change for someone who is experiencing s leep deprivation. Circadian rhyt... ... exposed to and the only way for a student to avoid it is to find an individual way to motivate him or herself. Works Cited Bethesda MD: National Institute of Neurological Disorders and Stroke. Understanding Sleep. National Institutes of Health, 1998 Giannotti, Flavia. â€Å"Circadian Preference, Sleep and Daytime Behavior in Adolescence.† European Sleep Research Society (May 2002): 191-199. Lacks, Patricia. Behavioral Treatment for Persistent Insomnia. New York: Permagon Press, 1987. Urban, Christopher. â€Å"Sleep Deprivation Not Unusual For College Students.† The Tech .Write 3 Jun 1991.: 5. 23 Oct 2002 . Williams, Robert L. M.D., Ismet Karacan, and Constance Moore, Sleep Disorders: Diagnosis and Treatment. New York: John Wiley and Sons, Inc., 1988.

A Midsummer Night’s Dream Essay: Order and Disorder -- Midsummer Night

Order and Disorder in A Midsummer Night's Dream Order and disorder is a favorite theme of Shakespeare. In A Midsummer Night's Dream the apparently anarchic tendencies of the young lovers, of the mechanicals-as-actors, and of Puck are restrained by the "sharp Athenian law" and the law of the Palace Wood, by Theseus and Oberon, and their respective consorts. This tension within the world of the play is matched in its construction: in performance it can at times seem riotous and out of control, and yet the structure of the play shows a clear interest in symmetry and patterning. Confronted by the "sharp" law of Athens, and not wishing to obey it, Lysander thinks of escape. But he has no idea that the wood, which he sees merely as a rendezvous before he and Hermia fly to his aunt, has its own law and ruler. As Theseus is compromised by his own law, so is Oberon. Theseus wishes to overrule Egeus, but knows that his own authority derives from the law, that this cannot be set aside when it does not suit the ruler's wishes. He does discover a merciful provision of the law which Egeus has overlooked (for Hermia to choose "the livery of a nun") but hopes to persuade Demetrius to relinquish his claim, insisting that Hermia take time before choosing her fate. The lovers' difficulties are made clear by the law of Athens, but arise from their own passions: thus, when they enter the woods, they take their problems with them. Oberon is compromised because his quarrel with Titania has caused him and her to neglect their duties: Oberon, who should rule firmly over the enti re fairy kingdom cannot rule in his own domestic arrangements. We see how each ruler, in turn, resolves this problem, without further breaking of his law. In the lov... ...espeare's control of the play proper. This is shown both on the small and the large scale. The linguistic variety of the play (see below) and the control of the four narrative strands are such that the play has enjoyed great success in performance. In the wood, Shakespeare will leave a group of characters alone for as long as he needs to, but we never lose touch with their story. It is typical of Shakespeare that the mortals we see first in the wood are Demetrius and Helena; at once the playwright shows us the cause of Demetrius' rejection of Helena and lets us know that the other pair are also in the wood. We do not need to see Lysander and Hermia before they have lost their way, but we are ready for Puck's mistake as he seeks one in "Athenian garments". Works Cited: Shakespeare, William. A Midsummer Night's Dream. New York: Washington Square Press, 1993. Â   A Midsummer Night’s Dream Essay: Order and Disorder -- Midsummer Night Order and Disorder in A Midsummer Night's Dream Order and disorder is a favorite theme of Shakespeare. In A Midsummer Night's Dream the apparently anarchic tendencies of the young lovers, of the mechanicals-as-actors, and of Puck are restrained by the "sharp Athenian law" and the law of the Palace Wood, by Theseus and Oberon, and their respective consorts. This tension within the world of the play is matched in its construction: in performance it can at times seem riotous and out of control, and yet the structure of the play shows a clear interest in symmetry and patterning. Confronted by the "sharp" law of Athens, and not wishing to obey it, Lysander thinks of escape. But he has no idea that the wood, which he sees merely as a rendezvous before he and Hermia fly to his aunt, has its own law and ruler. As Theseus is compromised by his own law, so is Oberon. Theseus wishes to overrule Egeus, but knows that his own authority derives from the law, that this cannot be set aside when it does not suit the ruler's wishes. He does discover a merciful provision of the law which Egeus has overlooked (for Hermia to choose "the livery of a nun") but hopes to persuade Demetrius to relinquish his claim, insisting that Hermia take time before choosing her fate. The lovers' difficulties are made clear by the law of Athens, but arise from their own passions: thus, when they enter the woods, they take their problems with them. Oberon is compromised because his quarrel with Titania has caused him and her to neglect their duties: Oberon, who should rule firmly over the enti re fairy kingdom cannot rule in his own domestic arrangements. We see how each ruler, in turn, resolves this problem, without further breaking of his law. In the lov... ...espeare's control of the play proper. This is shown both on the small and the large scale. The linguistic variety of the play (see below) and the control of the four narrative strands are such that the play has enjoyed great success in performance. In the wood, Shakespeare will leave a group of characters alone for as long as he needs to, but we never lose touch with their story. It is typical of Shakespeare that the mortals we see first in the wood are Demetrius and Helena; at once the playwright shows us the cause of Demetrius' rejection of Helena and lets us know that the other pair are also in the wood. We do not need to see Lysander and Hermia before they have lost their way, but we are ready for Puck's mistake as he seeks one in "Athenian garments". Works Cited: Shakespeare, William. A Midsummer Night's Dream. New York: Washington Square Press, 1993. Â