Compairison of amy tans mother tongue snd orwells shooting an elephant Essay

Even though Tan and Orwell have two different approaches to showing a struggle to fit into society, they are actually in agreement that people who come from different places struggle to fit. This common ground becomes apparent through the emotion behind each authors’ writing. In both Tan and Orwell’s writing they show a variety of feelings. These feelings consist of sadness, anger and bitterness. The first illustration of both authors’ accord is the way each of them express sadness from the way they are treated by those around them. It is especially evident that Tan is saddened by the fact that her mother is poorly treated due to her broken English. Tan states â€Å"But they seem just as bad, as if everything is limited, including people’s perceptions of the limited English speaker† (179). This demonstrates the sadness Tan feels for her mother and the difficulty her mother faces to fit into society, bearing in mind it is nearly impossible to fit in with others if their perceptions are skewed. Orwell faces a similar issue throughout his essay as well. The natives of Burma were extraordinarily boorish towards Orwell simply because he was from England. Orwell shows an example of this by opening his writing with â€Å"In Moulmein, in Lower Burma, I was hated by large numbers of people the only time in my life that I have been important enough for this to happen to me† (229). Hatred from all of Burma for no good reason causes sadness upon Orwell, especially when all he wants is to fit in and not be ridiculed. Evidently when the society one lives in is not accepting of them it becomes a struggle to fit it. Tan and Orwell also display strong feelings of anger in their writings. As Tan continues to write, a change in tone is evident. She starts off placid and calm then progresses to a more aggressive angry tone. An example of this is when Tan complains â€Å"And when the doctor finally called her daughter, me, who spoke in perfect English –lo and behold – we had assurances the CAT scan would be found, promises that a conference call on Monday would be held, and apologies for any suffering my mother had gone through for a most regrettable mistake† (180). The above quote demonstrates a sarcastic tone which signifies the author is fed up, annoyed, and even angry. Orwell communicates angers from the very start of his writing when he  tells of a time he was tripped on the football field. A Burman man purposely tripped Orwell in front of the crowed and they all laughed at him, which irritated him and made him mad. Anger is a very strong emotion in which both authors’ express due to frustration from not fitting into society. An even worse emotion compared to anger is bitterness. Bitterness is a vile, putrid feeling. It shows that you have let something get the best of you. Each author displays bitterness in some form or another. Orwell shot an elephant for the sheer fact that he did not want to seem like a fool. If he was not bitter toward the Burmans he would not have allowed them to get the best of him. As far a Tan goes, she says â€Å"people in department stores, at banks, and at restaurants did not take her seriously, did not give her good service, pretended not to understand her, or even acted as if they did not hear her† (180). Tan’s bitterness for the disrespect her mother receives from multiple different people helps her to express her mother’s struggle to fit into society. With everything these two different authors’ have in common its clear they both agree that people from different places struggle to fit in. People from all different cultures and societies struggle to fit in when they go somewhere new. Both authors do a wonderful job at expressing these challenges. They each show as an individual their own personal experiences with struggling to fit into society. Their imagery and emotions make it easy to visualize being in their shoes struggling to overcome the challenges of fitting into society. It is perfectly clear that both author agree upon outsiders struggling to fit into a new society. Works Cited Orwell, George. â€Å"Shooting an Elephant.† Fields of Reading: Motives for Writing. Ed. Nancy R. Comley, et.al. 10th edition. New York: Bedford/St. Martin, 2013. 129-134. Print. Tan, Amy. â€Å"Mother Tongue.† Fields of Reading: Motives for Writing. Ed. Nancy R. Comley, et.al. 10th edition. New York: Bedford/St. Martin, 2013. 178-182. Print.

Is the Game Theory, the Right Game Essay

Yes, indeed the game theory is the right game. Business is not about winning and losing nor is it about how well you play the game. The essence of business success lies in making sure you’re playing the right game. The challenge for us is to make sure we’re playing the right game. There are times in our life that we think we are in the right game but suddenly we realize that it is not the game we should play. For example, the course that you choose in college, you enrolled in accounting because your parents said so or because you don’t have any choice yet but you don’t possess the passion, attitude and skills an accountant must have. That is an evidence that you are in the wrong course, the remedy is to change your course into the course you love and possess the skills and passion for. To every action, there is a reaction. You have to look forward into the game and then reason backward to figure out which of today’s actions will lead you to where you want to end up. In order to succeed we need to go beyond the threats and opportunities that might occur and what we what to become in the future but we need also to be realistic and not too imaginary. Thus, after looking forward we make the action that will lead us to where we what to be. The decisions and actions you make today will affect our future career. So make the right actions and decisions. You cannot take away from the game more than you bring to it. You cannot take away more than your added value. Don’t remove something that contribute to your strengths, keep and maintain them. The main focus is allocentrism. It is the importance of focusing on others. You have to put yourself in the shoes and even in the heads of other players. You have to ask not what other players can bring to you but what you can bring to other players. It’s changing our mind-set into other players mind-set because if you know what and how they think it’s easy for you to discern what they need and what to the betterment of the company. Successful business strategy is about actively shaping the game you play, not just playing the game you find. It’s true that we should actively shape the game we play. It means that finding a continuous improvement and not just be stagnant in where you are now. We should find a way to increase and improve to the next level as years pass by. Understanding other players can help find new strategies for changing the game or new applications of existing strategies. In changing the game we should understand the players, added value, rules, tactics and scope. There is nothing permanent in this world we should actively change into better. The world is constantly changing and we need to adapt to it for us not to be left behind. In conclusion I agree that we should be a game maker than a game taker. We should have a coopetition mind-set and to be an allocentric. I believe that in business and even in our own lives there is no end to the game of changing the game. It is always an on going process that we should adapt and be flexible to it. We should be alert and wise to make decisions and actions because our decisions and actions today will change and have an effect to our future career.

Agoraphobia †An overview

Agoraphobia is a state of having an intrinsic fright of attending crowded areas, civic places, or open spaces, and at times comes with anxiety assaults. However, the terminology is extensively misinterpreted. Its wordy meaning implies an apprehension of â€Å"open spaces†. Notwithstanding, it is not an appropriate way and rather ambiguous mode of looking at it.Agoraphobics are not generally and frequently afraid of open spaces. They are rather fearful of undergoing panic-stricken emotions, whatever place or wherever time such fearful feelings may possibly engender. For many, this takes place at home, in community gathering or worship places, or in jam-packed supermarkets, places that are certainly not â€Å"open†.In reality, agoraphobia is a state which takes over when an individual shuns spaces or state of affairs that induce anxiety. typical â€Å"phobic situations† might contain circumstances like driving, shopping, crowded places, traveling, standing in line, being alone, meetings and social gatherings. (Nayman 2010)Experts say that agoraphobia occurs due to inner nervousness conditions which later develop so extreme that the sufferer turns paranoid of going in places where panic feelings or anxiety arise. Once the panic attacks begin, these occurrences turn into an ongoing strain.This normally directs an increase in the numbers of panic attacks and, for some individuals, a surge in such situations or events can produce panicky feelings. A handful might experience apprehensive feelings constantly, more emotions of overall distress, instead of panic.Therefore, agoraphobia is both – an intense form and a phobia, besides being a prototype of a shunning behavior. (Nayman 2010) Some agoraphobics may suffer from this phobia so ruthlessly that they totally housebound themselves, due to which they rarely go outside.Many people consider agoraphobia as contradictory to claustrophobia (fear of being locked in closed spaces, e.g. elevators) – however, it is not merely a fright of open spaces.Agoraphobia may cause due to the fear of leaving outdoors, a sort of open space – but it is NOT an anxiety of being in vast openness and without walls, a roof or other peripheries, etc. This trepidation of going outdoors offshoots from an anxiety of being humiliated, cornered and vulnerable someplace while having a panic attack that is never thought to occur within one’s own home. (Gournay 1989)According to the estimates of National Institute of Mental Health (NIMH), in America around 3.2 million Americans suffer from agoraphobia. The normal age of the beginning of agoraphobia is 20 years.The Causes:Professionals are not as confident and certain as to what are the exact causes of agoraphobia. Many assume that it might be a product of physical (excessive anxiety) and/or psychological factors how it is connected to an anxiety disorder.Many people suffering from panic disorder will ultimately develop a state of ag oraphobia, because normally agoraphobics undergo a panic attack or disorder which with the passage of time turns into an intense phase of anxiety. The condition might become a traumatic health and social phase that anxiety ridden individuals end up find them trapped in. (Gournay 1989)History of Agoraphobia:In the mid 1960's Agoraphobia was termed as a ‘Phobic Anxiety Disorder’ A prominent German neurologist Westphal was the first to coin the word in 1871. Westphal emphasized on the significance of anxiety interconnected with the condition.Later researches prove that mostly women as compared to men go through this kind of phobia. (depressionguiude.com) phobia.depression-guide.com/agoraphobia.html Physical symptoms of agoraphobia: Sufferers happen to undergo the symptoms when they experience such situations or surroundings that induce anxiety in them.Physical indications may be uncommon since a number of agoraphobic individuals evade situations which they perceive will ac tivate panic. However, if symptoms do appear, they might include: Increased heart beat and an increased breathing rate (hyperventilating).Feeling hot, going red, Stomach upset, Diarrhea, trouble swallowing, breaking out in a sweat, nausea, shivering, trembling, dizziness, feeling light headed, if about to faint, & ringing in the ears. (medicalnewstoday.com)Psychological Symptoms:The Psychological symptoms are sometimes related to the physical symptoms of the phobia which might include:Anxiety that people will take in observation a panic attack, which results in disgrace and discomfiture. Fear that they would be unable to breathe throughout a terror assault, their heart my stop working, or, resulting in their death. Fright that the sufferer himself/herself is going wild and out of control. Other exclusive possible psychological symptoms may include: decrease in morale and self-esteem, out of control sensation, stress, general feeling of dread and anxiety. Thinking that without the he lp of others the sufferer himself/herself would never be able to function or survive.   Dread of being left alone. (medicalnewstoday.com)Behavioral symptoms:Behavioral symptoms of agoraphobia may be:Dodging – Escaping from surroundings and situations that may prompt anxiety. In some instances this may be moderate, in which the patent shuns all crowded and public places.In extreme episodes, he/she totally house bounds him/herself, or ties at the hip of a close friend or loved one. Avoids going in a crowded train. In some very intense occurrences the person can't leave the house or considers it impossible to do so.Encouragement – the sufferer direly needs encouragement or reassurance from someone very close. He/she might go out to shops or marketplaces provided a trustworthy friend comes along too. On the contrary, in acute instances the sufferer can't bear or stand being alone at all.Safety measures – needing to take along some items in order to confront or fac e boldly the environment or places triggering anxiety. For instance, some of such individuals need to have an alcoholic drink before stepping into a crowded place, while others may not go outside until they are sure to keep their tablets along.  Run away – escaping or running away from nerve-racking places or situations straight away and going back home. (medicalnewstoday.com)How To Identify Agoraphobic Students And Assist Them To Learning Better:A handful of American students in their final years leave their studies due to agoraphobia, & of course no individual or student in a class room student can stand being tagged as an â€Å"agoraphobic patient† or a â€Å"sufferer†.Fortunately, we have school psychologists working with great concerns on such matters, even though the process of identifying such agoraphobic students is not a herculean task, because the indications or symptoms are conspicuous enough to pin point such individuals.The course teachers can be of great help for the psychologists seeking agoraphobic students in academia. Once identified, the process of helping them do better in their educational lives is discussed below.Case Study And Treatment Of The Disorder:Consider the instance of scottfin, a high school student about how she overcame this disorder.â€Å"I am not a teen anymore, but I remember having terrible panic attacks in class. I didn't know what they were. Now don't laugh or maybe you should, but I thought I was being possessed by the devil. Don’t know why I thought that, but I didn't have anything to base what I was going through on. I finally got help from a doctor, and he put me on medication.It made them disappear. It was a huge relief. I later learned that it is very common. I hope you will be able to get some help, and get on with your life. I want you to know it does get better. Hang in there. The teen years are hard enough, but then to have this on top of it is intolerable. I wish you the best!â⠂¬ This shows that this phobia can be treated if the sufferer is ready to coordinate. And as stated earlier school therapists can do a lot to treat agoraphobics via helping them develop coping skills to curb their fright and anxiety. Systematic desensitization, a sort of cognitive behavioral therapy (CBT), is a viable behavioral method used to cure agoraphobics.It is based on the foundation of getting the person relaxed, asking him/her to then ponder over the gears of the phobia, operating from the slightest fearful to the most fearful. Ongoing and Steady introduction to real life phobias is also a method deployed which has practically aided patients to conquer the fears.(Eisenstadt 2003) According to some findings at National Institute of Mental Health, approx 75% agoraphobics having specific phobias shed their fears through this method of cognitive-behavioral therapy. (psychologistanywhereanytime.com)Anti-apprehension and anti- trauma remedies are often prescribed to help reduce the indicators’ toll on this disorder. Some drugs which facilitate in controlling the operation of serotonin (brain’s secretion controlling transmissions relating mood changes) are often prescribed. Nonetheless, these prescriptions do not crack the phobia wholly; it can decrease unease so that the sufferer can handle the phobia.Hypnotherapy or Hypnosis is another method in which patients are made to speak about their intrinsic frights being in a subconscious state. It can prove an effective therapeutic technique used by clinical psychologists. (Eisenstadt 2003)Another famous technique to heal the disorder is called Emotional Freedom Techniques, which is assumed to be one of the most viable forms of psychological treatments. It is a method widely accepted by doctors all over the world.However, this must be taken into account that during the handling of agoraphobia, the counselor or psychiatrist might have to travel with the sufferer or spend time with him/her personally maintain a therapeutic distance.

Effective Sales Management Essay Example | Topics and Well Written Essays - 2250 words

Effective Sales Management - Essay Example The delegation of daily activities can be adjusted according to the human traffic or the manning hours in the region under consideration. A sales person in the field can estimate the right time and the right season to market a product. He can give a valuable feedback of the fast moving products and the slow moving. A regular analysis of the sales feedback, the existing competitors, the products volume in the market, reveals some interesting facts about the customers' tastes, customers requirements and customer expectations leading to a more refined innovations and valuable predictions to regulate the sales operations in the future. The volume of business achieved in different periods can create an idea on how we need to place our products in near future to sustain the market fluctuations. The customers are always hard to retain and new customers do creep into the list of clients as the value of the products spreads in the market. A sales person has to on look the existing customers' network and he needs to explore on the new possible clients acquisition by the able management of existing clients. The new clients' acquisition can not be achieved overnight but it requires a dedicated effort from the existing sales professionals and parallel promotional efforts to introduce the products to new customers at large. For example the booming aviation business in India due to the increase in the number of low cost airlines, for niche products like the airline products the turn around will be more than year. The pharmaceutical products and medical equipments products tests your ability to maintain a sustainable relationship with client. A customer lost is a loss of a life time in such industries. The best methods to attract new customers The best viable methods wood be the word of mouth promotion indirectly by the existing customers. A client has to be carefully monitored regarding his requirements and expectation now and then to make him fell comfortable with the existing products line. The second best customer enticing program would be organizing and participating in the conferences and activities of the client in order to make them feel more secure with your association. How do you add value to a product or service besides raising the price A quality product will never be denied by a customer. An organization has to consistently highlight the features of the product to make the clients differentiate between the competitors product. The promotional

Individual Conflict Assessment Essay Example | Topics and Well Written Essays - 500 words

Individual Conflict Assessment - Essay Example The essay "Individual Conflict Assessment" talks about the social conflict as a storm using personal example which is best described as disparate. If the interpersonal realm is like weather, the metrological forces in the atmosphere are like the behaviors people engage in to meet their needs and wants.Conflict in my family of origin is best described as disparate. It has been such that the meteorological forces of some have traditionally absorbed the sentiment of others, or that the continued momentum of some behaviors has overrun the momentum of others. Conflict in my family has often been asymmetrical. Personally, I have been feeling very stressed about conflict. I often feel that I am damned if I do and damned if I don’t. If someone takes issue with me and I do not resist, they will often press until they see what they believe to be capitulation. If someone takes issue with me and I object, they will often accuse me of being unruly or rude.Likewise, I often felt much stress ed about conflict within my family of origin. I often felt that my voice was not heard, that I was often framed, and that for me there was no real justice at home. When Mom and Dad were at work, it was survival of the fittest between the siblings present. Some days you were more fit than others, and sometimes you just didn’t have the strength to fight back. Mom and Dad rarely sided with me. I guess the stress comes from the knowledge that sometimes no one will be there to look out for you.

Gender Differences in Love and Intimacy Research Paper

Gender Differences in Love and Intimacy - Research Paper Example Notions related to love covers admire, want, having a preference, possession, care for, service, and even reverence. Intimacy denotes a close bond where reciprocated respect, encouragement, and confidence are shared to the partners (Oxford Dictionaries, 2009). Gender Differences Theorists have put forward that men and women differ, in the types of sentiment, they experience while in close relationships. The strength of the sentiments and how willingly they put across those emotions also varies a lot. A number of theories, starting with evolutionary theory, cognitive social theory, social structural theory as well as gender hypothesis all concur that there is gender difference between men and women regarding sexuality. Men are normally more sexually active as well as more liberal as opposed to women. Cognitive theory, social structural theory, and social learning theory suggest that sexual difference observed between men and women could be reduced by aspects like secular trends and cultural behaviors towards gender empowerment and multiculturalism disparities in sex roles, which ought to differ with each culture. As noted by Petersen and Hyde (2010) it is possible that methods from various theories assist in the complex explanation of this gender differences in intimacy and sexuality. Men watch close relationships as less weighty than women do. Cultural theories suggest that women feel love for people while men labor. This concept has been put forward by an extensive variety of psychologists and sociologists.

Child Development and Parental Disorders Research Paper

Child Development and Parental Disorders - Research Paper Example There were three such respondents two of whom admitted to demonstration of pathological symptoms similar to that of their mentally estranged parents. There is a major implication derived from this for the study. Both the respondents who admitted to symptoms of mental disorders had high scores for psychosocial items included in the second part of the questionnaire. This proved that high degree of psychosocial trauma from childhood can trigger off psychiatric pathologies in later life while lesser degrees of it may be more benign. Conversely too, the study has proved ground for more development and research in this important field. It has revealed that a wider range of variables distributed across a broader spectrum of population can disclose more relevant correlations than is presently available. These correlations, once revealed, can lead to better understanding of how to cope with mental disorders in parents and how their children can be better shielded from their psychiatric pathology so that their development is not hampered and they do not fall victim to a vicious circle of psychologically inhibited adulthood. Genetic implication have been touched upon but not elucidated on since data available presently is not extensive enough. The4 statistical analysis conducted by the study was aband... Introduction The 'American Academy of Child & Adolescent Psychiatry' (AACAP) advocates that parental psychiatric illnesses can affect children (AACAP, 2004). Studies have proved that children with affected parents are at higher risk than those of mentally sound parents. The risk increases with both parents being mentally unsound. Studies have also proved that parents with the following disorders - bipolar disorder, anxiety disorder, ADHD, schizophrenia, alcoholism, drug abuse or depression are more likely to adversely affect their children's behavioral and emotional positions (AACAP, 2004). The 'Center for Mental Health Services and Research' (CMHSR) Department of Psychiatry, University of Massachusetts Medical School, find in a 2001 study that, statistically, one-third of American women and one-fifth of American men are likely to be mentally affected. Of these, there is likelihood of 65% of the women and 52% of the men of becoming parents. Nevertheless, there have been very little corresponding studies on how incidence of parental mental illnesses and cultural and economic factors correlate to produce children's mental conditions. Thus, most of the studies conducted to this study's date - 2001 - are incidental purely on stressors such as poverty and ethnic minority status. Incidence in the Caucasoid and middle class sections of the American population has not been mapped so thoroughly. The net result is a gap in the understanding of how mental illnesses are distributed across the entire

Einojuhani Rautavaara Essay Example | Topics and Well Written Essays - 2000 words

Einojuhani Rautavaara - Essay Example in 1954. Most of Rautavaara's works have been recorded with his Symphony No. 7 been performed too. His works hint Modernism as well Romanticism and even show Constructivism and Mysticism. He can be well said to be a mediator in the creative process. In regard to the absence of history as Post-Modernist and being a Romantic he himself commented, "A Romantic has no coordinates. In time, he is yesterday or tomorrow, never today. In space, he is over there or over yonder, never here." He also demonstrated an extended approach in his Neo-Classical period. Among his early piano works, "Kolme symmetrist preludia (Three Symmetrical Preludes, 1949) was Constructivist; "Pelimannit" (Fiddlers, 1952) was folklorish; and "Ikonit" (Icons, 1955) stemmed from Orthodox mysticism." Rautavaara has marked the field in various musical ensembles as orchestral music, works for string orchestra, solo instrumental works, chamber music and vocal music. He writes extremely melodious tunes with depth and without being artificial which is surly a great achievement in present music scenario. Einojuhani Rautavaara's works are clear influences of the most complex human emotions. The main characters are always tangled within their hopes and fears, memories and hallucinations etc. The characters are the inspirations of the actual people from history but the operas are not the mere depiction of real historical events. He has well experimented with his characters for example the title characters in "'Thomas', "Vincent" and "Aleksis Kivi", the title characters are exceptional (one might almost say deviant) individuals; in "Auringon talo", the main characters are misfits on the fringe of society..." "..misfits on the fringe of society." Fimic.fi. Einojuhani Rautavaara: A composer of Many Personas. In his works it has been seen that the layers of time form Czars to contemporary, from Romantic to Neo-Classical keep intermingling without any specific relevance but the memory plays vital role in Proustian manner. His first award winning work "A Requiem in Our Time" had clear influences of Nordic classicism of Sibelius and Nielsen as well as that of Bartok, Shostakovich and folk music. In his early career he experimented with serial technique but those didn't come out to be real series. He tried to work upon it in his Symphony No. 3 but it seemed more like Anton Bruckner than the traditional serialists as Pierre Boulez. His later works reflect mystical element having referencing to angels - a menacing figure than being cherubic for him. "A characteristic 'Rautavaara sound' might be a rhapsodic string theme of austere beauty, with whirling flute lines, gently dissonant bells, and perhaps the suggestion of a pastoral horn." ......... suggestion of a pastoral horn." Classicalcat.net. Classical Cat- The Free Classical Catalogue. Rautavaara has been greatly fascinated by metaphysical subjects. It is not any doctrine which held his belief in this nut the words of a German

Applying the EMH Evaluate the Role That Government Played In Economic Essay

Applying the EMH Evaluate the Role That Government Played In Economic Recovery Using Recent Real-life Examples - Essay Example because of the market volatility due to the different government policy and the detailed study would tend to give a great learning opportunity about this adverse scenario. Efficient Market Hypothesis (EMH) Theory Efficient market hypothesis implies that, if any new information about a company is revealed it will be immediately incorporated into the share price rationally and rapidly, with respect to the direction of the share price movement and its size. In an efficient market except by chance, no trader will get an opportunity to earn abnormal return on a share or a return which is greater than the fair return for the risk associated to that share. The possibility of absence of abnormal profits arises because the past and current information is immediately reflected in the current share prices. The prices are affected only by the new information. EMH is concerned with under what conditions an investor can gain abnormal profits or excess returns in a stock. EMH claims that all the in formation available readily reflects in the price of the stock. According to EMH abnormal positive returns are not possible by any trader using the information available to public. Many people think that market efficiency means that it is impossible to outperform the market at any given point of time which is incorrect. Efficiency does not mean that prices will not apart from true value: At any point of time it is expected that prices will deviate from their true value, majorly because value depends on the future and future is unpredictable. Efficiency does not mean that no investor will be able to beat the market in any single time period. In an efficient market approximately one half of the shares purchased subsequently outperform not because of the skill but due to the fact that prices... This report stresses that market efficiency has been tested over a long period of time and it has been observed that movement of the stock prices follow a random walk. The random walk theory states that an investor can have a good chance of beating the market if they throw darts on New York Times stock listing pages. Investors who adhere to the random walk theory believe that searching for undervalued shares or predicting the future stock price is just a waste of time. Any new developments of government like restructuring the tax legislation, controlling the financial crisis and the inflation etc reflect in share prices of the different corporation. Followers of random walk theory believe that is impossible to predict future events and they are left with no other choice but to accept the efficient market hypothesis. This essay makes a conclusion that it cannot be denied that the government interventions play a crucial role in stabilizing the economies that were overturned due to the financial crisis as result of devaluation of properties or inability to service the debt obligations. Due to the global crisis, the investor confidence eroded which had adverse impact on the stock prices. The fluctuation in the stock prices was also due to drift in the present market condition. As a result of revised regulations and containing policies by the government, the economies started to revive and the interest of the investors were protected. This resulted in the decrease in volatility of share prices which reflects belief of the investors from their anticipation of future events in the economy. This follows the efficient market hypothesis.

DANCE ANALYSIS Assignment Example | Topics and Well Written Essays - 500 words

DANCE ANALYSIS - Assignment Example The current paper will compare ballet and hip hop and will discuss how such combination can create totally new dancing techniques and popular youth culture. Comparison between Ballet and Hip Hop Contemporary ballet is a form of dance influenced by both classical ballet and modern dance, which takes its technique and body control using abdominal strength from classical ballet, although it permits a greater range of movement that may not adhere to the strict body lines or turnout set forth by schools of ballet technique. Many of its concepts come from the ideas and innovations of the twentieth century modern dance, including floor work and turn-in of the legs. The video â€Å"Complexions Contemporary Ballet† on YouTube.com shows various dancing elements of contemporary ballet. The movements are more emotional and spontaneous than in the classic ballet with more emphasis on the expression of performer’s feelings and internal emotions rather than on the dance technique perf ection.

Theories of Motivation in Organization Essay Example | Topics and Well Written Essays - 2500 words

Theories of Motivation in Organization - Essay Example Greater the satisfaction level less will be turnover rate and thus, greater employee retention. One of the most important factors, that govern the employee retention within the organizations, is motivation level of the employees. There are many other factors such as pay, compensation packages and good environment but motivation is the one that serves the purpose. Employees work with innovation and uniqueness only when they are motivated to do so. Successful completion of the tasks depends not only upon the intrinsic rewards but extrinsic as well, such as appreciation by the supervisor that ultimately leads to employee satisfaction and makes them motivated. There is an old saying ‘you can take a horse to the water but you cannot force it to drink’; it will drink only if its thirsty - so is the case with people. Organizations operating in strong economies like UK and USA have considered employee motivation as their foremost and important task to carry out. Their focus is to motivate the employees to such an extent that they work in the best interest of the organization and towards the successful completion of tasks. Human resource department is trying their level best to introduce such policies and strategies that are coherent with the needs and demands of the employees in order to keep them motivated. This paper will shed light on motivation theories with their practical implications in the organization and on the literature dealing with motivation in organizations. One of the most important theories related to motivation is Goal Setting theory proposed by Edwin Locke in 1960. Findings made by Edwin said that intention to work towards a common goal is a major source of work motivation (Robbins, S. and Timothy, J., 2001), however, in order to understand the motivation in the work place there are several dimensions of goal setting theory that explains the motivation. Supervisors in contemporary times motivate

Homelessness in Raleigh, North Carolina Essay Example for Free

Homelessness in Raleigh, North Carolina Essay This paper presented the subculture of homeless people in Raleigh City, North Carolina. The paper focused on describing the health problems and issues being experienced by the homeless people in Raleigh. It also enumerated the different health care systems available in the city that provide health services to homeless individuals, as well as the different organizations built to address the needs, health and housing concerns of the homeless people in the city of Raleigh. Moreover, the researcher also attempted to describe an ideal health care system practices and services that should be made available for homeless individuals and for the whole community. Homelessness in Raleigh, North Carolina Homelessness is a state and social condition wherein an individual or group of individuals cannot afford to own a house or shelter.   Some sociologists associated homelessness with augmented risks of mortality or simply the inevitable increase of population.   However, other sociologists identify homelessness to be a consequence of socio-economically deprived populations. Whatever the cause of homelessness is, the fact remains that homelessness is becoming a serious problem all over the world. It is estimated that more than 100 million people worldwide are homeless, â€Å"of which 20 million to 40 million are adrift in major urban centers† (Habitat International Coalition [HIC], 2005). Homelessness is one of the serious problems in Raleigh, capital of North Carolina. Although Raleigh is a capital city, a number of residents here are facing the problem of poverty, unemployment, health problem, and homelessness. This has led some people to build different organizations and health care centers which aim to resolve the mentioned problems. There are also several health care services established to manage the health problems in the community. This paper will dwell on the subculture of homeless people in Raleigh, North Carolina and on the diversity in health care organizations being provided for the community. The Community Profile of Raleigh Raleigh is the capital city of North Carolina with an estimated population of 341,891 of which 49.7% are male and 50.3% are female. Raleigh population is dominated by mostly working-aged adults with 77.6% of its residents aged between 18 to 64 years, 7.5% under age 5, and 7.8% aged 65 years and over. There are different races inhabiting the city wherein 60.4% are White American, 28.2% are African American, 0.4% are American Indian and Alaska Native, 3.8% are Asian, and the rest of the other races not mentioned. The total family household is 136,993 with a median income of $51,647 in 2007. Of the population 273,453 (16 years old and over), 179,896 are employed in industry and civilian labor while 10,738 are unemployed (US Census Bureau, 2007). Raleigh is governed by a city mayor, a city council and a city manager with a budget of $557,055,589 in 2006-2007 wherein municipal service cost is at $200,000. As for social services Raleigh has three hospitals, seven police stations, 27 fire stations, one library, and six universities. As for recreational establishment, Raleigh has 117 city parks, 22 staffed centers, nine non-staffed program centers, two art centers, 112 tennis courts at 25 different locations, eight public swimming pools, and 8,817 acres of parks and greenways (City of Raleigh Website, 2009). For the past decade, Raleigh had developed as center for education, research and development in North Carolina. Moreover, cultural activity flourishes in the city, for it houses theaters, symphony orchestra, art museums, galleries, and other entertainment and recreational enterprises (Community Link, 2009).

Coping With Stress Among University Students Education Essay

Coping With Stress Among University Students Education Essay Abstract Stress is purely a fact of nature to anyone in this world. Stress is the impact of forces from the outside or inside world heartwarming the individual (Dryden, 1996, p.52). Different individuals react to stress in ways that touch the individual, in addition to, their environment. This paper will seek to investigate how the use of exercise affects the level of stress among university students. Respondents for the study will be University students from all faculties. University students are famous to have a high propensity to stress experience. Background Overview University education system has been changing every day due to emerging needs of higher education. For instance, most public universities are regarded as research universities due to the amount of research being undertaken in those universities. University students, therefore, bump into high pressure with the modification of the education system. Consequently, the exam-oriented scheme in many universities lead to anxiety among scholars since the students is forced to ascertain that getting good grades in the examination aids them to be a decent frontrunner and acquire a respectable job in the future. Problem Statement The researches which have been done in the past were conducted to investigate the factors that influence the level pressure among scholars. However, there has been no any study that verified and compared the designated important aspects towards selecting the foremost aspect that sway the level of anxiety (Dryden, 1996, p.34). In addition, the study carried before has been piloted only other levels of education other than university education. Therefore, this research will try to successfully investigate the effect of exercise in coping with stress to university students. Therefore, the problem statement for this investigation can be spawned as: à ¢Ã¢â€š ¬Ã…“how does the use of exercise help in coping up with stress among university students?à ¢Ã¢â€š ¬Ã‚  Research Problem This study will be done to scrutinize and understand how exercise can be used in coping with stress to university scholars. Besides that, the study will also be inquisitive to how well exercise can be used to influence the level of pressure among university learners. This study will focus to discover the importance of exercise in coping with the level of stress among the students in the institution of higher education. Consequently, the research problem can be formulated as: Use of exercise in coping up with stress among university students. Research Objectives The following are the objectives of this study: To investigate the use of exercise (independent variables) in coping with stress among university students (dependent variable). To find out the influence of exercise to the level of stress among university student. Research Questions Since the research problem is extremely broad to be studied openly, the following are the research questions that will help to attain the research purpose for this investigation: 1. What are the effects of exercise to the level of stress among university student? 2. Is exercise helpful in coping with stress among university student? 3. How well can exercise be used in coping with stress among university students? Literature Review Stress is the attitude of strangeness between environmental necessities (stressors) and individual capability to achieve these necessities. According to (Dryden, 1996, p.45), stress is the nasty reaction from individuals who have to dangerous pressure. Pressure takes place when a person is handled with a situation that they recognize as overwhelming and cannot handle. Stress is recognized as a response shown by a diversity of peripheral happenings and can be treated as a positive or negative experience. Dryden (1996) defines stress as an order focused to the adaptive capabilities both bodily and emotionally. If these abilities can succeed the demand and take inclination in the stimulus concerned, then anxiety will become an optimistic force of incentive and vice versa is true. Stress is likely to hinder scholastic performance and influence nearly millions of students per year. According to Dryden (1996), stress is problematic to control due its random consequence on persons. Dryden (1996), through his research realized that students come across indication of desperateness, anxiety, and matter use. Stress in educational institutions can affect student negatively and positively if not well administered. Educational institutions have diverse job surroundings, as opposed to nonacademic. It is forecasted to have alterations in signs, aspects, and consequences of stress to students (Dryden, 1996, p.67). It is very beneficial to the society that learners be educated and gain the vital knowledge and proficiencies. This ensures that they make them add positively to the growth and development of the collective economy of any given country. Nevertheless, the complex academic environment rarely generates serious health difficulties to the scholars life. This tends to go contrary to the confirmatory gains that one would forestall after advancing from University. These students must, therefore, pay close attention to the various university atmospheres and frame an effective and proficient pressure management in the institution of higher education. University also ought to keep fit and stable academic atmospheres beneficial for improved learning, which is suitable, with regard to the students distinct requirements. Temperament of students poses diverse level of outlooks to students (Dryden, 1996, p.75). Methodology This section will focus on methods that were used to collect data needed to answer the research questions. This section focus majorly on: research design, sampling techniques and procedures, data collection tools and method of data analysis. Research Design According to Dryden (1996), a research design is the organization outline or a plan that is used to create answers to research problems. Research design is intended to produce arithmetical information about the feature that policy makers and investigators are interested in (Dryden, 1996, p.115). This research will use a descriptive design to collect information and carry out the survey. This kind of design is highly suitable to the kind of information to be collected in this research. Advantage Descriptive research offers investigators the prospect to use both finite and qualitative data in order to discover data and features about the phenomenon that is being investigated. Disadvantage Descriptive research usually has a subjectivity and error which is disadvantageous to descriptive research. From the subjectivity and error, investigator may pick what facts to use and snub data that do not follow to their hypothesis. Participants and recruitment The study cluster will include students from different faculties who were contacted via email to take part in the study project. The choice of students will be convenience sample of 130 university student. All students will be eligible to be selected for participation. The cluster will also have equal gender representation which is equal to 65 male students and 65 female students. This is accordance to the principle of equal representation in collections (Dryden, 1996, pp.115-117). The cluster will also try to have equal representation in all faculties. Sample In this investigation, the simple random sample will be performed as a methodology for this research paper. Data will be collected from a review of the population of scholars from every single faculty within the University (Dryden, 1996, p.111). The participants who will be filling in the survey will be from various backgrounds for instance race, gender and educational level. The cluster will include students who will be studying in an extensive variety of educational disciplines and those who achieved a normal range of grade point averages. This survey will be entirely voluntary; nevertheless, it will be completed by all sampled students in the class. Advantage Sample random method is extremely representative if all issues participate. Disadvantage This method is not likely without whole list of population participants. It is also possibly uneconomical to accomplish. Not forgetting that it can be troublesome to isolate some participants from a group. Data collection Data will be gathered using self-administered 10 entries questionnaire which will seek to discovers the importance of exercise in coping with stress among university students. The questionnaire will also seek to find out how well exercise can be used in reducing the level of stress among university students (Dryden, 1996, p.117). It will take each participant a roughly 5- 10 minute to complete. The questions will be easy to answer, but there will be guidance to the respondents. This will ensure that they provide the required information and also provide accurate and relevant information. Ethical Implications Prior to any undertaking of the study, behavior research ethics committee application should be completed (Dryden, 1996, p.119). While doing this research, this form will be filled. At the time, of recruitment participant will be given the required information allowing them to decide whether to participate in study using a standard verbal script. If the respondents will be willing to learn more about the study they will be given a letter of introduction. An information sheet describing the study and what would be expected of them will also be provided. They will be made aware that any information provided is strictly confidential and in no way will they be identified in the research (Dryden, 1996, p.121). Individuals wishing to participate in the study will sign a consent form. It will be made known to them that if they feel at all affected or disturbed by the study; they are welcome to contact the researcher with their concern for further investigation. While doing publication of results obtained in the research, ethical integrity will be essential. Important ethical distresses will be considered while writing a document. Although there are risks of false publication, duplicate publication, plagiarism, writing, and probability for conflict of interest. Strategies will be established to prevent or discover ethical damages, and use of these approaches will heighten ethical honesty when preparing a final document for publication. Information therefore, given by the respondent in this subject will not be subjected to the above stated risk. Thus, respondents should feel free while giving out information. They are being protected from any risk.

Purpose of the Electrocardiogram (ECG) in Paramedic Practice

Purpose of the Electrocardiogram (ECG) in Paramedic Practice Lachlan Donnet-Jones Intro Electrocardiogram, commonly abbreviated to ECG or EKG, is defined as â€Å"a graphic tracing of the variations in electrical potential caused by the excitationof the heart muscle and detected at the body surface† (Dorlands). An ECG monitor is the device that has the ability to read and graphically present an ECG reading (Mosby’s Dictionary of Med) via a digital monitor or printed on a strip of special graph paper designed to show the rhythm of the heart over time (Mistovich). There are many different manufacturers of ECG monitors such as Philips and Physio-Control (ASNSW Protocols). An ECG monitor allows two methods of recording electrical activity, a 4-lead reading and a 12-lead reading. The ECG readings consist of three segments; a P wave, QRS complex and a T wave. The PQRST waves are the components that create the ‘waves’ or ‘spikes’ presented on an ECG reading. Electrocardiography has an extensive history dating back many centuries as pione ers of medical science were eager to understand the electrical functionality of the heart. History of ECG, what was before ECG? In the year 1600 William Gilbert discovered static electricity, a discovery that would eventuate in the development of one of the most important medical inventions of all time, the electrocardiogram. In the early nineteenth century the first instruments were invented that were sensitive enough to detect small electrical currents in the heart. The first functioning electrocardiogram was created by Willem Einthoven, a Dutch doctor and physiologist, in 1903. Einthoven won the Nobel Prize in medicine in 1924 for his electrocardiogram invention. Prior to the invention of the electrocardiogram an instrument called the string galvanometer was used to detect electrical activity, it was an earlier invention of Einthoven’s. The string galvanometer could be used to measure cardiac electrical activity in a procedure where patients would submerge three of their limbs into a saline solution creating ‘Einthoven’s Triangle†, a principle still used in contemporary electrocardiogram recording. Before both the electrocardiogram and string galvanometer were invented a device called the capillary electrometer was invented by Gabriel Lippmann in 1872. The capillary electrometer consisted of â€Å"sulphuric acid and mercury in a capillary tube with wires at each end† (WEST INDIAN MED JOURNAL). Similar to the string galvanometer Lippmann’s device requires the patient to place limbs into tubs of saline solution and was the first device to read cardiac activity using this method (WEST INDIAN MED JOURNAL). Little did these early inventers know that their inventions would go on to be used thousands of times per day at all corners of the globe with its purpose and functionality continually polished and refined over the years as is evident in modern day ECG monitors. http://www.jchimp.net/index.php/jchimp/article/view/14383/html http://caribbean.scielo.org/scielo.php?script=sci_arttextpid=S0043-31442005000300012lng=en http://www.ieeeghn.org/wiki/index.php/Willem_Einthoven http://en.wikipedia.org/wiki/Lippmann_electrometer [Naming the waves of ECG their genesis.pdf] [The origins of the electrocardiogram as a clinical instrument.pdf] http://search.credoreference.com.ezproxy.utas.edu.au/content/entry/dicscientist/einthoven_willem_1860_1927/0?searchId=1a112bd3-b32d-11e3-9ce6-12c1d36507eeresult=0 http://search.credoreference.com.ezproxy.utas.edu.au/content/entry/ehsmed/einthoven_s_triangle/0 http://search.credoreference.com.ezproxy.utas.edu.au/content/entry/columency/galvanometer/0 http://www.ecglibrary.com/ecghist.html Purpose functionality The ECG machines purpose and functionality is to provide information and understanding of the heart’s electrical functionality. (MISTOVICH) This includes information on the current rate at which the heart is beating, whether the heartbeat rhythm is regular or irregular, how strong the electrical signals are and the timing between the electrical signals. There are two methods to procure an ECG reading, a 4-lead and a 12-lead. The main difference is the number of leads used to obtain a reading which in effect allows for a better or worse reading. They are both effective in attaining information on the hearts electrical activity, however they are different and have their advantages and disadvantages. The 4-lead method, sometimes called 3-lead, typically uses three limb-leads: RA (right arm), LA (left arm) and RL (right leg). Each lead is attached to the torso despite the lead labels indicating otherwise. The RA lead (white) is placed ‘to the right side of the anterior chest just under the clavicle at the midclavicular line’ and is the negative lead, meaning it augments the signal of the LA lead. The LA lead (black, brown or green) is placed OPPOSITE the RA lead and is the grounding lead. RL lead is the final lead and is placed ‘to the left lower chest at about the seventh intercostal space on the anterior axillary li ne’ and is the positive lead. 4-lead monitoring is useful as it is quick to apply and †¦ 4-lead monitoring has its benefits however it cannot deliver the same level of comprehensive and detailed information that a 12-lead reading is capable of. The application of a 12-lead ECG monitor requires applying 10 leads, 4 ‘limb leads’ and 6 ‘precordial leads’. 4 lead 12 lead PQRST Graph paper Defibrillation Phillips, lifepak Other functions [Guidelines for electrocardiography.pdf] http://www.southsudanmedicaljournal.com/archive/may-2010/how-to-read-an-electrocardiogram-ecg.-part-one-basic-principles-of-the-ecg.-the-normal-ecg.html ECG contribution to patient assessment ECG Monitoring is typically used following a primary assessment especially in cases where there is a suspected issue with the heart or cardiovascular system. An ECG provides paramedics with information about the electrical functionality of the cardiovascular system. This is done by analysing the electrical activity displayed on the ECG reading and observing any changes in the waveform in relation to the rate and rhythm. As well as the rate and rhythm the paramedic would note any changes in the P wave, PR intervals, QRS complex, S-T segments and the P to R ratios (REFERENCE). Through this method of analysis the sign and symptoms of a patient assumed to be having cardiac issues can be confirmed for the initial diagnosis (REFERENCE). For example during the primary assessment the patient is suspected of having a myocardial infarction and is showing symptoms of chest pain, hypotension, diaphoresis and a weak and rapid pulse the paramedic’s primary goal would be to obtain an ECG rea ding which can then confirm the initial assessment by virtue of the PQRST waveform. Ambulance Service New South Wales protocols provides a list of common conditions that may require ECG monitoring, the list includes: â€Å"Acute Coronary Syndrome (ACS), Dyspnoea (SOB), trauma, lowered level of consciousness (LOC), post syncope episode, cardiac dysrhythmias† and many other conditions which interfere with the hearts normal capacity to function (ASNSW Protocols). Provides paramedic information in a situation (subsequent to primary assessment/surgery) that may involves cardiac issues, events or abnormalities via reading the ECG reading and linking any abnormalities in the PQRST waveform to the patient’s symptoms condition. (LOOK IN MISTOVICH, PP. 1463ish) Situations or indications that may require ECG monitoring include: post syncopal episode, a decreased level of consciousness, chest pain, acute coronary syndrome, shortness of breath, dysrhythmias or if any cardiac occurrence is suspected (ASNSW Skills 2011, 103.5.2). FOR EXAMPLES: Myocardial Infarction etc. Use a med journal/article/study? Strengths, weaknesses challenges faced by paramedics (critique) An ECG monitor such as the Phillips carried by Ambulance Tasmania or the Lifepak15 carried by Ambulance Service New South Wales are incredibly versatile diagnostic tools. They are portable and can be taken into the field to patients even in challenging situations such as the small interior of a crumpled car or a in a remote bush area (ASNSW Protocols; AT Protocols). The ECG monitor allows for immediate and continuous monitoring of the electrical functionality of the heart permitting a critical assessment of the patient’s condition to be made. The paramedic can then inform the receiving hospital of the patient’s condition and allow for the necessary measures for treatment to be organised prior to the patient’s arrival. (REFERENCE) One of the significant faults of an ECG is it can only illustrate the electrical activity of the heart, it does not tell us how well the heart is functioning mechanically (Jones, 2008). Though there are clear benefits of using an ECG monitor in the paramedic field there are also certain weaknesses in its use such as the unreliability of consistent and accurate ECG readings. It is essential for paramedics to accurately interpret ECG readings to avoid mistaken initial diagnosis which can prove costly for patient well-being in time-critical situations. Contributing factors to inaccurate ECG interpretation include cognitive bias and heuristics (mental shortcuts) (ECG READINGS BY DOCTORS). Properly cleaning skin with swabs, removing any hair in the way and certifying that the area is dry before application of electrodes will help to increase ECG accuracy and reduce inaccuracies (MISTOVICH; ASNSW Protocols). Other environmental factors such as vehicle movement can contribute to inaccurate ECG readings by virtue of unstable leads creating artefacts. Similarly if the patient is in a combative or wrestles state it can interfere with clear ECG readings, so keeping the patient calm, reducing anxiety and eliminating stressful factors can be beneficial to both acquiring vital information and the patient’s well-being. (REFERENCE) References 2011 Electrocardiogram inDorlands illustrated medical dictionary, Elsevier Health Sciences, Philadelphia, USA. 2012 Electrocardiogram (ECG, EKG) inMosbys dictionary of medicine, nursing, health professions, Elsevier Health Sciences, Philadelphia, USA. Accessed: 30 March 2014, from Credo Reference Goy, Jean-Jacques; Staufer, Jean-Christophe; Schlaepfer, Jà ¼rg; Christeler, Pierre 2013, Electrocardiography (ECG), e-book, accessed 19 March 2014, http://UTAS.eblib.com.au/patron/FullRecord.aspx?p=1310813>. Jones, SA 2008,ECG Success [Electronic Resource] : Exercises In ECG Interpretation / Shirley A. Jones, n.p.: Philadelphia : F.A. Davis Company, c2008., Items in the Library Catalogue, EBSCOhost, viewed 19 March 2014. Resources http://www.nhlbi.nih.gov/health/health-topics/topics/ekg/ http://www.nlm.nih.gov/medlineplus/ency/article/003868.htm http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Electrocardiogram http://eds.b.ebscohost.com.ezproxy.utas.edu.au/eds/detail?sid=59a6c19e-901d-440a-b791-a71625c1f886%40sessionmgr114vid=1hid=104bdata=JnNpdGU9ZWRzLWxpdmU%3d#db=cat02831aAN=UTas.b1560119 http://eds.b.ebscohost.com.ezproxy.utas.edu.au/eds/results?sid=127dd355-fcfc-42af-a93e-9ccff2e157c5%40sessionmgr115vid=1hid=104bquery=ecg+(PT+book+OR+PT+ebook)bdata=JmNsaTA9RlQxJmNsdjA9WSZ0eXBlPTAmc2l0ZT1lZHMtbGl2ZQ%3d%3d Page 1 of 8

Animal Farm And The Russian Revolution Essay -- Animal Farm Essays

George Orwell’s novel Animal Farm is a great example of allegory and political satire. The novel was written to criticize totalitarian regimes and particularly Stalin's corrupt rule in Russia. In the first chapter Orwell gives his reasons for writing the story and what he hopes it will accomplish. It also gives reference to the farm and how it relates to the conflicts of the Russian revolution. The characters, settings, and the plot were written to describe the social upheaval during that period of time and also to prove that the good nature of true communism can be turned into something atrocious by an idea as simple as greed. This essay will cover the comparisons between Animal Farm and the Russian Revolution. It will also explain why this novel is a satire and allegory to the Revolution that took place in Russia so long ago. First and foremost Manor Farm itself represents Russia with its poor conditions and irresponsible leaders. Mr. Jones plays one of those leaders, Nicholas the Second or The Czar as people called him in those days. Mr. Jones beats his animals, forgets to feed them and treats them badly. His actions are portrayals of the actions of The Czar. Old Major is representative of Karl Marx. Marx had a dream of a better Russia and created the doctrine of communism to aid in distribution of wealth, and to bring the people to a place were they would all be equal, but what he didn’t realize was that under the wrong rule the good intentions of communism would become...

The Story of Pygmalion and Galatea :: Cyprus Mythology

The Story of Pygmalion and Galatea â€Å"If you gods can give all things, may I have as my wife, I pray†¦ one like the ivory maiden.† ~Pygmalion Pygmalion, the mythical king of Cyprus, had many problems when dating women. He always seemed to accept dates from the wrong women. Some were rude, others were selfish; he was revolted by the faults nature had placed in these women. It left him feeling very depressed. He eventually came to despise the female gender so much that he decided he would never marry any maiden. For comfort and solace, he turned to the arts, finding his talent in sculpture. Using exquisite skills, he carved a statute out of ivory that was so resplendent and delicate no maiden could compare with its beauty. This statute was the perfect resemblance of a living maiden. Pygmalion fell in love with his creation and often laid his had upon the ivory statute as if to reassure himself it was not living. He named the ivory maiden Galatea and adorned her lovely figure with women’s robes and placed rings on her fingers and jewels about her neck. At the festival of Aphrodite, which was celebrated with great relish throughout all of Cyprus, lonely Pygmalion lamented his situation. When the time came for him to play his part in the processional, Pygmalion stood by the altar and humbly prayed: â€Å"If you gods can give all things, may I have as my wife, I pray†¦Ã¢â‚¬  he did not dare say â€Å"the ivory maiden† but instead said: â€Å"one like the ivory maiden.† Aphrodite, who also attended the festival, heard his plea and she also knew of the thought he had wanted to utter. Showing her favor, she caused the altar’s flame to flare up three times, shooting a long flame of fire into the still air. After the day’s festivities, Pygmalion returned home and kissed Galatea as was his custom. At the warmth of her kiss, he started as if stung by a hornet. The arms that were ivory now felt soft to his touch and when he softly pressed her neck the veins throbbed with life.

Fly-By-Night Case Essay

A). When looking at the balance sheet, the first noticeable signal among assets is the rapid increase in accounts receivable in years 12, 13, and 14. It means that there are more products sold in credit than in cash and direct useable funds. Another signal is the sudden increase in inventories in years 12, 13, and 14. The previous three years, inventories slightly decreased. Only from year 11 to year 12 inventories almost triples and keeps increasing significantly the next two years. It shows there is has been a change in the production system making is less efficient. The last signal among assets is the increase in property, plant, and equipment for the years 13 & 14. It is likely that the increase is a result from the less efficient production in year 12. By buying new equipment, they expected to be able to meet the production needs. Then, the first noticeable signal among liabilities and shareholders’ equity is the increase in current portion of long-term debt in years 13 & 14. The acquired extra debt is most likely a result from acquiring property, plant, and equipment. Another signal is the increase in accounts payable for year 13 & 14. It is a result from the extended terms of payments. In year 12, the company had 26 days to pay which increased to 48 days in year 13 and increased even further in year 14 to 84 days. The company keeps buying products but does not have the resources to pay for it and takes longer to pay vendors. Next, when looking at the income statement it is noticeable there is an increase in deprecation which is due to acquiring property, plant, and equipment. There is an increase in interest expense which is due to acquiring more debt. Then in year 14, it results in an operating loss since the expenses are higher than income (positive income tax). Lastly, when looking at the cash flows the most noticeable is the negative change in cash flow for operations. To be able to keep your liquidity high  or ability to pay current expenses, you need to generate cash through net cash flow from operations. Only due to the increase in net cash flow from acquiring property, plant, and equipment the total cash flow decreases. B). Yes, the company can avoid bankruptcy. Only FBN needs to make some strategy and implementation changes. The income statement shows that sales have increased significantly from year 12 to year 14. As the company’s transactions with the U.S. Air Force, U.S. Navy, and the Federal Reserve Bank are covering 60-70% of total revenues, the company has secured income up to years 16-17. The conclusion is that the main concerns of the company are liquidity, costs, and efficiency. The board of directors needs to improve cash levels to lower the liquidity risk. As exhibit 5 shows the current and quick ratio of FBN have decreased over the past years which is the main cause for the high liquidity risk. There a few ways to do this. One option would be to negotiate with customers over the terms of accounts receivable to generate cash faster. Another option would be to issue shares to increase the level of cash. Another issue is the increase of inventory. A high level of inventory increases costs for FBN such as holding costs. The company should have insight in the market conditions so it can produce the needed products efficiently. There needs to be some inventory available for emergency situations or unexpected orders, but the number should be as low as possible. Finally, the total expenses are higher than sales in year 14 which signals that the company either needs to improve efficiency or cut costs. Depreciation costs have increased significantly due to the increased sales and therefore the acquirement of plant, property, and equipment. The ROA has decreased to 0%. In order to get a positive profit margin, costs need to be cut. On the other side, effectiveness and efficiency of the assets need to be improved to generate net sales from the fixed-assets investments.

Management Information Systems in Process-Oriented Healthcare Organisations

Linkoping Studies in scholarship and engineering Thesis zero(prenominal) 1015 counseling kitchen-gardening plazaments in butt on-oriented salutaryness tutorship Organisations by Anna Andersson Submitted to the check of Engineering at Linkoping University in agencyial fulfilment of the requirements for the breaker point of Licentiate of Philosophy de contributionment of Com caster and reading Science Linkopings universitet SE-581 83 Linkoping, Sweden Linkoping 2003 trouble In formation Systems in Process-oriented health tutelage Organisations by Anna Andersson Maj 2003 ISBN 91-7373-654-6 Linkopings Studies in Science and Technology Thesis no 015 ISSN 0280-7971 LiU-Tek-Lic-200314 ABSTRACT The pay back of this dissertation diddle was to develop a think culture g everyplacenance position for transit-oriented health bang musical arrangements. The ponder explores 2 questions What kinds of requirements do health shargon managers placement on training tran scriptions? and How coffin nail the transaction and teaching systems of health heraldic bearing managers and interest providers be unified into suffice-oriented health cathexis schemes? The place pruneting to the consider was the crop orientation of Swedish health take visible compositions.The subscribe was conducted at the pediatric clinic of a county hospital in grey Sweden. Organisational procedure was delimit as a sequence of course procedures that jointly wane up complete health awe dos, slice a useful building block was the arrangingal locus responsible for a certain get up of subject field activities. A soft enquiry manner, establish on a nurtureal circle, was used. The info was self-contained from archives, querys, pla tease, diaries and accent sort outs.The worldly was subsequently examined in parliamentary procedure to categorise, pathl and develop pocket-size theories slightly breeding systems. The study suggested that c omputer- base parcel out breeding systems in processoriented health wish well government activitys should (1) give checkup checkup employ (2) comprise clinical and administrative tools (3) facilitate the ability of the organisation to measure inputs and out set outs. The look for effort concluded that mingled health vex managers indigence the analogous type of principal(a) info, though pre moveed in different demeanors. maestro evelopers and detectives fill paid flyspeck tutelage to the manner in which unified administrative, monetary and clinical systems should be configured in golf club to ensure optimal obligate for process-oriented health parcel out organisations. Thus, it is strategic to disclose the tenfold roles that learning turnings in much(prenominal) an organisation. Department of Computer and schooling Science Linkopings universitet SE-581 83 Linkoping, Sweden Co n te n ts 1. admittance 1 1. . 1. 2. Organisational and over cash in ones chips process seats in checkup examination informatics 2 Aims of the study.. 3 2. enquiry methods 4 2. 1. The tidy sumting of the possibility study 4 2. 2. The training compendium 6 2. 2. 1.archival entropy 6 2. 2. 2. Interviewing .. 6 2. 2. 3. diary method 6 2. 2. 4. poster 7 2. 2. 5. focalize classs 7 2. . 6. Feedback loops 8 2. 3. Analyses. 8 2. 4. casting.. 9 3. Results. 9 3. 1. 3. 2. 3. 3. The requirements of healthc be managers for an HIS. Interpretation of organisational and live processes in copulation to HIS.. 10 A commission reading system model for process-oriented healthc be. 12 4. Discussion .. 14 5. Conclusions .. 15 6. time to come work . 15 7. References . 7 prudence schooling Systems in Process-oriented health c ar Organisations 1. Introduction Swedish health grapple organisations ar mandatory by law to chief(prenominal)(prenominal)tain a holistic view of their processes (Prop. 1999/2000149). Thus, much(prenominal) organisations hire to flip an overview of the entire chain of mountains of health service preservation. As a issuance, system idea is vital (Senge, 1990). An organisation moldinessiness be able to catch entropy from its operational processes and provide health service steering with selective culture concerning the commission in which they train utilised their mental imagerys (Kaplan & Norton, 1996).As a response to this imperative, many health sustentation providers hurt begun to introduce process-oriented structures recently. in that stead atomic number 18 a calculate of theories close how to radiation diagram much(prenominal) structures. One possibility is based on line Process Reengineering (BPR), the utilisation of which is to identify and re origination organisational processes (Davenport, 1993). An different approach is to dismember a health c are organisation as a Complex Adaptive System (CAS), an interdisciplinary method that focuses on the self-organisation o f systems and patterns, as well as the way in which takes emerge.The character of a CAS swindle is to resolve issues associated with adaptable systems (Zimmerman, Lindberg & Plsek, 2001). Regardless of whether a BPR or CAS approach is occupied, process-oriented organisational structures face difficulties stemming from the occurrence that health contend organisations operate on ninefold take cultivates, including county councils, hospital focusing, clinical caution, and care providers, distri neverthelessively with its confess selective learning requirements (Andersson, Vimarlund & Timpka, 2002).Each direct struggles to survive under difficult economical constraints, limited growth and the everlasting aff the right way of regulation (Luce & Elixhauser, 1990). health care organisations need an compound structure in coiffe to cursorily disseminate data among managers and care providers (Van de Velde, 2000). The initial ch anyenge is to structure randomness sys tems much(prenominal) that they stand-in the work pay heed in a healthcare surround (Strauss et al. , 1985). Thus, it is non move that healthcare managers are increasingly pursuit second from health information systems (HIS).Their heading is to minimise the boilers suit personifys of healthcare delivery, to improve the graphic symbol of their work (Greenes & Lorenzi 1998 Clayton & forefront Mullingen, 1996) and to cor match cost with resources consumed (Stead & Lorenzi, 1999). One plectrum for gathering entropy in an 1 way tuition Systems in Process-oriented health care Organisations HIS is to use censors and former(a) devices that continuously fork up the healthcare organisation with entropy well-nigh its finances, step, competence and level of blessedness.However, on hospital ward an HIS washstand be knowing, two managers and developers need to be familiar with work routines, information requirements, and early(a) key parameters at the clinical level, giv en up that medical information is linked to the surroundings in which it is generated ( iceberg lettuce & Goorman, 1999). Thus, the organisation essential depict its information requirements and work procedures. The HIS that ultimately emerges pull up stakes be embedded in the organisations processes and must satisfy the care providers information inevitably (berg, 1999).To sum up, in order to programme an HIS in process-oriented healthcare organisations, attention must be paid to issues such as forbearing focus, cost effectiveness, service fictitious character, adaptability to the constraints of the organisation, and integrated use of information at two the hospital and clinic level (Ovretveit, 1992 Flarey, 1995). Moreover, a holistic overview based on system thinking is vital, including the gathering of info from denary sources in order to correlate costs with the custom of resources.The challenge is to define models that idler fend for the design of an HIS. 1. 1. 1 . Organisational and work process models in medical informatics The important purpose of reengineering was to focus on the processes rather than the functions or an organisation (Hammer, 1990). Further organisational enhancement could be achieved with tint methods such as marrow Quality counselling (TQM), which include process-oriented models. separate approach is to modify the pedigree culture such that it becomes a learning organisation (Senge, 1990).In the monetary area, Balanced carte du jour has been used to translate mission and scheme statements into operational objectives and measurement variables (Kaplan & Norton, 1996). When it comes to medical informatics, attempts have been made to design different kinds of organisational models, such as socio- proficient manakin (Berg et al. ,1998). The rationale for introducing these models is to profit a greater understanding of the shipway in which an HIS will affect the allotment and content of work tasks. variety sho ws in work activities require modification of information precaution (Berg, 2001). The validity of a technology rests not nevertheless on the fulfilment of operating(a) particularizedations, but withal on the sound interaction of the technical system with its 2 oversight training Systems in Process-oriented Healthcare Organisations organisational environment (Brender, 1998). The resulting conclusion that has been be sickn today is that societal, organisational, pagan and contextual issues should be taken into term at an early stage of the teaching process (Kaplan, 2001).Moreover, approaches such as cultural-historical performance theory have been used to bring around contextual analyses of clinical lore and exertion. Culturalhistorical exertion theory deals that studying the present healthcare climb is insufficient a detective must besides become inform with the history of the setting, given that clinical cognition is embedded in broader institutional stru ctures and long evolution (Engestrom, 1995). One method was to shine up long-suffering selective information on the self-assertion that the objective of any healthcare organisation is to improve the health of individuals (Engestrom, 1999).Other police detectives argue for a framework that allows for a constant interplay of different models, theories and perspectives (Maij et al. , 2002). The advantages of integrated frameworks are that methods and models cigaret be optimised during the training process, term methods with peculiar(prenominal) weaknesses merchantman be reinforced by others (Timpka, 1995). Finally, thither are approaches for exploring the slipway in which healthcare providers tend to reason in clinical contexts such as hardened action, an emerging perspective for studying merciful beings cognition and behaviour in order to design intelligent systems (Patel, Kaufman & Arocha, 1995).Such models prognosticate the clinical tasks that are to be performed in side specific guidelines and define criteria for selecting appropriate options when in that respect is a set of potentials (Wang et al. , 2002). 1. 2. Aims of the study The aim of this thesis is to develop a focussing information system model for process-oriented healthcare organisations, based on two questions What kinds of requirements do healthcare managers place on information systems? and How laughingstock the work and information systems of healthcare managers and care providers be incorporated into process-oriented healthcare organisations? The work is based on a circular process, during which models are demonstrable by collecting and categorising info, as well as by innovation small-scale theories about information systems. Organisational process is defined as a sequence of work procedures that jointly constitute complete healthcare services. A work 3 instruction Information Systems in Process-oriented Healthcare Organisations activity is defined as a set of work pro cedures that are closely connect by virtue of their purpose and convey of performance. A useable unit of measurement is the organisational locale responsible for a certain set of work activities.Healthcare Information Systems (HIS), instruction Information Systems (MIS) and Information and Communication Technology (ICT) all define computer-based information systems. 2. explore methods A qualitative seek scheme, based on an idiographic pillow slip study, was employed. qualitative investigate, which has evolved within some(prenominal) disciplines, consists of a set of interpretive institutionalises. It does not accord priority to any single methodology for selective information collection and abridgment, nor does it have a theory or paradigm that is distinctly its cause (Denzin & capital of Nebraska, 1998). soft search is best suit for understanding the processes inherent to a situation, along with the beliefs and perceptions of the people knobbed. Nevertheless, qual itative police detectives elicit impart their findings more broadly applicable (Firestone, 1993). Furthermore, a case study is some(prenominal) a process of interrogatory and the product of that inquiry (Stake, 2000). The researcher demand a wide array of information about the case in order to provide an in-depth estimate (Creswell, 1998). A elementary distinction is in the midst of single-case and multiplecase designs of such studies (Yin, 1994).A case study whose primary mode of research is hermeneutic is idiographic in a natural setting its principal(prenominal) type of data is qualitative and its funda psychological level of analysis is holistic (Fishman 1999). informative studies are well served by a considerable degree of openness to bowl data, along with willingness to re-examine initial assumptions and theories. The result is an iterative process of data collection and analysis during which initial theories are grow upon, revised or abandoned completely (Wals ham, 1995). 2. 1. The setting of the case studyThe setting of the study was a pediatric clinic at a county hospital in Sweden. In 1996, the county council adopted a wide-ranging quality program based on TQM and a Plan-Do-Check-Act (PDCA) cycle. In 2000, the county council started using Balanced tone of fare to measure the healthcare organisations outcomes. At the time of the study, the countys study and change program for 4 care Information Systems in Process-oriented Healthcare Organisations organisational quality was based on a CAS strategy. Furthermore, a processoriented healthcare information system was being designed.With some 30 clinics and 3,200 employees, the hospital had identify its main organisational objectives as the delivery of collar and extraist healthcare, as well as county-wide rehabilitation and habilitation services. The purpose of habilitation is to enable psyche with a congenital impairment, whereas rehabilitation focuses on recovering lost ability. Abo ve and beyond the responsibilities of healthcare managers in accordance with the operative structure, all clinics at the hospital (including paediatrics) had developed work processes for specific groups of unhurried roles.These diligent contend base Processes (PNGPs) centred on the healthcare inevitably of individual patients. The main objective of the PNGPs was to act upon and maintain a broad(prenominal) level of familiarity about medical care at the paediatric clinic. The scope of the processes substitute considerably. However, a PNGP unit always comprised at least a doctor, encourage and secretary. If necessary, several clinics, hospitals and county councils could collaborate on the equal process. In order to improve treat care, cultivation teams, facultyed by practitioners interested in growth work, were set up.Specific victimization areas include palliative care and the use of technical equipment. The teams produced documents concerning their specific areas th at could prove of value for their co-workers. modernistic work routines were developed for treat care and for activities that are indirectly related to the patient care process, such as repast delivery, ordering medication and play therapy. The teams had clear up people at each harbor who were prepared to step in whenever breast feeding care chores arose.The team members normally be meetings during their free time or imbrication time when two shifts were on obligation simultaneously. The paediatric clinic overly cooperated with maternity wards and a total of 13 Child Health Centres (CHCs) throughout the county. The clinic was part of a net profit of specialist clinics in southern Sweden that focussed on the transpose of knowledge and experience. At the time of the study, the paediatric clinic employed 12 ranking(prenominal) medical students, 21 physicians, 91 nurses, 77 paediatric nurses (specialist nurses aides) and 13 secretaries.The counsel team consisted of six s enior physicians, seven nurses and one secretary from the clinic. During the rate of flow of the study, the paediatric clinic supplied approximately 16,000 bed-days to inpatients, performed 5,000 scheduled surgical interventions and handled 5 guidance Information Systems in Process-oriented Healthcare Organisations 6,000 emergency room visits by children. The paediatric clinic comprised one surgical unit and trinity wards, each with a physician responsible for medical matters and a nurse as manager.The ward for neonatal patients had eight beds for intensive care and ten for antenatal care. The ward for contagious patients had 16 closing off rooms for newborn babies and contagious children. The institutional care ward for children older than a year had 18 beds. The clinic used 15 PNGPs. 2. 2. The data collection The collection of data was conducted throughout documents, archives, interviews, observations, diaries, focus groups and feedback loops. 2. 2. 1. Archival data Archival data was used to place the research into context before, during and after the studies at the clinical site (Drury, 2002).An obvious hazard posed by fixed data is that it can easily become superannuated unbekn avowst to the researcher. In these studies, archival data was related to 1) annual reports by the clinic 2) the county councils quality pronouncements 3) the governments bill for the healthcare organisation 4) the physical and mental health survey of hospital employees 5) reports concerning the county councils ontogenesis plans for an HIS. 2. 2. 2. Interviewing A common interviewing proficiency is to meet face to face (Fontana & Frey, 1998). The interview may be structured, semi-structured or unstructured.The scope of an interview can range from cinque minutes to the lifetime of the subject (Fontana & Frey, 2000). This study relate semi-structured interviews with four doctors and four nurses. A series of open-ended questions addressed periodic work routines and communicat ion patterns. 2. 2. 3. Diary method The holistic perspective of this approach identifies connections among the individual, social and organisational levels. One of the techniques that have evolved is the diary method, which reward from subjective assessments of time utilisation. The diverse travel require a practitioner to land time, activity, Management Information Systems in Process-oriented Healthcare Organisations location, the names of co-workers with whom they interact and other comments during a stipulate period (Ellegard, Nordell & Westermark, 1999). In this study, a ward nurse kept a diary during one workweek. She entered the nature of her work tasks, the times that she performed them and the names of the co-workers with whom she interacted. 2. 2. 4. notice Observation involves gathering impressions of the surrounding world. qualitative empiric research is fundamentally naturalistic (Adler & Adler, 1998).There is descriptive observation, in which the researcher assu mes that he or she knows nothing about what is going on and takes nothing for granted. He or she employs focussed observation, ignoring that which is defined as irrelevant. Finally there is discriminating observation, the to the highest degree systematic approach, during which the researcher concentrates on the attributes of various activities (Angrosino & Mays de Perez, 2000). This type of observation requires a notebook, a storage location for the data that is collected during the process (Ely, 1993).The researcher observes and interacts with care providers at the paediatric wards before and after their rounds. Alongside the observations, the clinical staffs were interviewed again about what they were doing, why they were doing it, what they hoped to gain from an HIS and what benefits they anticipate. theater of operations notes were entered into a log during the observation study. 2. 2. 5. Focus groups A focus groups planning process should begin as soon as it is set up. The process includes the following steps establish research objectives, appoint a moderator, develop moderator guidelines and draw up procedures.The moderator plays an important role during the group session. He or she conducts the interviews. It is important that the moderator not be the same person that put together the moderator guidelines and questions. In this study, a focus group session was held with seven nurses and leash paediatric nurses, all of whom were women selected by a ward nurse. The participants had various duties at the paediatric clinic, where they had been employed for anywhere from 9? to 32 years. Five nurses were ward managers and two in any case managed development teams. They all had experience at each ward, as well as the paediatric surgery.The researcher had furnished the group moderator with 7 Management Information Systems in Process-oriented Healthcare Organisations guidelines and questions (Greenbaum, 1993). The questions were based on the clinics profi le of itself administrative activities, care prep and development work. Questions also dealt with work activities and the rallying of information with other units. Some questions focused in on a patients social intercourses with the care providers, as well as the time and place for the performance of care activities. The entire focus group session was videotaped and transcribed. . 2. 6. Feedback loops Feedback loops throughout the research project permitted the generation of reports for evaluating data collection. A total of four reports were sent to the practitioners as a result of the case study. In addition, four seminars were held with the practitioners, the purpose of which was to discuss the research findings. The practitioners discussed and critiqued the results. 2. 3. Analyses There was no theory at the beginning as to how the fabric should be analysed. The branch step was to break reduce healthcare direction into the hospital, clinical and care process levels.Stateme nts from the various steering levels were understand on the pedestal of information requirement, i. e. main objectives, system functions, expected benefits and essays to be avoided. The stand by step was the analysis of trio main work activities, each with three work procedures, at the clinic level. The 3rd step involved the design of a focus information system model. All empirical data was categorised. Various themes were identified and classified. After the categories had been cross-compared and clustered, abstract new categories were defined (Strauss & Corbin, 1990).The final analysis started with a category-by-category comparison, which enabled the identification of core categories that were sent to the paediatric clinic as a approach report for comment and critique (Glaser, 1978). Finally, the categories were change in response to the comments. The focus was to come up with a context-based, process-oriented description and bill of the phenomena (Orlikowski, 1993). Th e categories were incorporated into two small-scale theories. The first theory understand the information requirements of three oversight levels.The second theory interpreted the work processes employed by institutional care. 8 Management Information Systems in Process-oriented Healthcare Organisations 2. 4. Modelling In order to conduct the final analysis, the two small-scale theories were applied to the casting of a commission information system. Various possible approaches included data modelling (Connolly, Begg & Strachan, 1996), function modelling and object-oriented modelling (Booch, Rumbaugh & Jacobson, 1999). To handle such approaches, various modelling languages have been developed, including the object-oriented unite Modelling Language (UML) (Fowler & Kendall 1999).The symbols and banknotes of the various languages can be difficult for the uninitiated to grasp (Sommerville & Sawyer, 2000). Furthermore, the notation and logic for modelling a system must work in bic ycle-built-for-two with the people involved in the development process. Thus, it is useful to foresee the information flow by means of a modelling approach, using notation and logic that have been established by consensus. As a result, the management information system models were designed in dialog with the practitioners in the case study.The notation was taken from Eriksson & Penkers (2000) calling processes but modified on the basis of the discussions. 3. Results The results are presented in accordance with the three sub-analyses. The first sub-analysis focused on the requirements of healthcare managers for an HIS. The second sub-analysis focused on version organisational and work processes in relation to the HIS. The third sub-analysis focused on designing a management information system model for process-oriented healthcare. 3. 1. The requirements1 of healthcare managers for an HISHospital management evince its intention to use an HIS to empower patients while maintaining work of resource utilisation. Thus, the planned HIS was expected to encourage a greater overall awareness of cost effectiveness with admire to the services provided by various units of the hospital. The biggest risk noted was that of a mismatch in the midst of the system and the existing organisational culture, in which it was well-off to identify and reward employees who handled 1 Requirements and demands are used as synonym in this chapter and in article 1. 9 Management Information Systems in Process-oriented Healthcare Organisations mergencies. As a result, some of the staff appeared to ride a new way of transmittal information throughout the various levels of the organisation. The goals of the functional units (i. e. clinic management) focused on patients and the introduction of lead based on co-determination. firearm management accepted patient empowerment and cost effectiveness as the their main objectives, they mind it was important that employees be allowed to make t heir own organisational decisions. Management wanted to see a new approach to measuring the activities of their organisational unit.In order to achieve these goals, they sought a way to define the data that is inborn to making a reliable estimate. In managing the healthcare process, the objectives of an HIS centred on developing and maintaining specific clinical competence by enhancing shop for decision-making and co-operation on the part of care providers. While all the process managers agreed that sharing information and knowledge was important to improving the decision-making process, they were unaware of resource competition issues. However, the refuse of information was not always intentional.imputable to limited resources and full schedules, process managers were a lot unable to share their knowledge with other employees. 3. 2. Interpretation of organisational and work processes in relation to HIS Work activities included (1) co-ordination of information exchange managem ent (2) care, including documentation of the care provided and the institutionalize that had evolved at the clinic (3) supply, including patient assistance and psychosocial support. The work procedures of the various activities were often related to and hooked on each other. Co-ordination activities were oriented toward management of the wards and the clinic.The activities focused on co-ordinating various types of information in order to support the care effort. External co-ordination is related to the exchange of information between the paediatric clinic and other care units. This coordination continued after the patients had been discharged from the clinic. Thus, the coordination of out-of-door resources and inter-organisational collaboration was important to the management of the clinic. Patient co-ordination started before a patient was admitted to institutional care. There were two 10 Management Information Systems in Process-oriented Healthcare Organisations easons for such approaches. First, the amount of time that patients stayed at the wards be expensive for the healthcare organisation. Thus, such approaches protected money. Second, these approaches enhanced the relationship between care providers and caretakers, assuming that patients and their families were kept well informed. intrinsic co-ordination was related to management and planning activities at the clinic and the wards. Such activities were linked to external and patient co-ordination, given that providers need to cooperate with other units and patients in order to manage ward care. wish well activities were underpinned by what had been agreed upon during the coordination of work activities and the information that was to be used by various co-ordination procedures. Care prep involved medical and nursing care performed by physicians, nurses and paediatric nurses. Care activities were broken cut out among the various professions. further care was touched as teamwork from the point o f view of the patients. Thus, the work tasks of the various professions cumulatively became what are referred to as the outcome of care provision. Practice development took in twain medical and nursing care issues.The knowledge and information cultivated was incorporated into the ordinary work routines of the paediatric clinic. Care documentation activities were linked to care work and development efforts. Documentation provides protection for both care providers and patients. Care documentation served as a means of communication among care providers. Supply activities were indirectly related to care activities. Among employees who performed supply activities were nurses, paediatric nurses, kitchen staff, cleaning staff, play therapists and teachers. Material provision furnished care activities with pharmaceuticals, equipment and substantials.Based on the resources that material provision furnished to care activities on a daily basis, estimates were prepared concerning the resourc es the activities would require over time. Bandages, diapers, syringes, etc. were also a part of material provision. Material provision also included equipment and supplies for play and school activities, such as games, videotapes and textbooks, as well as kitchen and cleaning supplies. Psychosocial support activities called for an information system that could offer emotional support, such as administrative tasks associated with permitting patients to have their own individual(prenominal) phones.Thus, psychosocial support depended on the ability of patient co-ordination efforts to proceed smoothly, assuming that both patients and their families could be kept well 11 Management Information Systems in Process-oriented Healthcare Organisations informed. The main purpose of Patient assistance, which included both material provision and psychosocial activities, was to assist care activities. Such activities were related to supporting the physical and mental well-being of patients while undergoing medical and nursing care. 3. 3.A management information system model for process-oriented healthcare The county council formally take that hospital management admonisher and report on service action with regard to quality and cost. As a result, hospital management needed data about resource utilisation and healthcare quality from the hospital organisation, along with information systems that could support methods such as thorough Quality Management (TQM) and Balanced Scorecard. To manage costs and quality, hospital management needed data from the functional units after ascertain what needed to be collected.The focus of process management was developing and maintaining a high level of quality in the medical and nursing care processes. The process unit was responsible for documentation and quality train operations. Process management needed directives from the functional management unit about both data collection templates and quality for medical and nursing care. P rocess management generated information about medical and nursing quality data for functional unit management. outdo practice guidelines and decision support protocols for clinical practitioners were involved in the clinical process.The HIS application required by process management was a service quality control system that could extract data from and support decision making for medical and nursing care. usable unit management comprised managers at both the clinic and ward levels. Clinic management organized the monitoring of the clinics resources, while ward managers co-coordinated the exchange of information at the wards. Functional unit management requested information about resource allocation specifications and templates for use reports, as well as for patient satisfaction and staff work satisfaction data, from hospital management.Functional unit management needed data concerning the perceptions of patients and staff with regard to the services provided by the unit. Manageme nt was also facial expression for a way to relate its expenditures to resources utilised. In other words, its primary involve were in the areas of data collection, storage and gravel tools. 12 Management Information Systems in Process-oriented Healthcare Organisations Thus, functional unit management required data from clinical activities, but not at an individual or contextual level.The systems it was seeking were to supply data for use at a manifold level, including the volume of financial and human resources that specified care activities necessitated. To monitor service delivery, management units in process-oriented healthcare organisations need data in three distinct areas (1) medical and nursing care, (2) patient flows and (3) the utilisation of human and material resources. Although the management units may have access to a common data warehouse, requirements for data analysis and presentation vary considerably.Similarly, data collected from the healthcare organisation du ring daily work routines can be shared, but the primary data must be converted into a format that is usable by healthcare managers. The data that is collected should ideally be locate where it can be made addressable to ordinary healthcare activities. For instance, networked devices can be used to monitor pharmaceutical use. searching devices can also be attached to equipment in order to track their use, and material storage and use (diapers, sheets, etc. ) can be traced by bar-code systems.Furthermore, patients and healthcare staff can be registered with smart cards as they come and go. However, computerised patient recruits (CPRs) are the most logical central resource for data collection in the clinical setting. The data that is documented in the records can be used to monitor the clinical activities that have been performed. CPRs can also furnish data about work activities at the healthcare organisation. Such data is of slim value as long as it is limited to individual pati ents. What is useful is to analyse cumulative data, such as the number of radiology examinations that have been conducted on leukaemia patients.The purpose of the data warehouse is to store what has been collected from various sources. The application and its interface are the parts of the HIS with which healthcare managers interact and with which users most readily identify. Thus, the application must help healthcare managers use information and must supply the right information to the right healthcare managers. Moreover, the application must support the specific analysis methods, tools and data formats required by current organisational analysis procedures, such as Balanced Scorecard and quality assurance methods. 13Management Information Systems in Process-oriented Healthcare Organisations 4. Discussion The aim of this thesis was to develop a management information system model for process-oriented healthcare organisations. The research effort employed qualitative methods such as archival data analyses, interviews, observations, diary analyses and focus group analyses. unending feedback loops among the participants in an idiographic case study helped establish a balanced interpretation. Meanwhile, categorising and modelling formed the pattern of interpretation for the management information system model.The main findings of the study are that an HIS in a process-oriented organisation must support the medical work, integrate clinical and administrative tools, and furnish information that allows for the measurement of organisational inputs and outcomes. As a result, it is important to identify the multiple roles that information plays in a process-oriented healthcare organisation. Most of the organisational development methods that healthcare currently takes advantage of, such as reengineering and quality management, include process definitions. However, the interaction between various groups of processes has seldom been analysed.Several recent organisationa l methods, such as Balanced Scorecard (Kaplan & Norton, 1996), address the problem of relating costs to resources. The areas in which information systems are expected to enhance care delivery range from access to medical knowledge bases, patient and clinician communication, and the minimisation of medical errors. Nevertheless, little attention has been paid to how integrated administrative, financial and clinical systems should be configured in order to support process-oriented healthcare organisations in an optimal manner.Internal co-ordination is informed by and dependent on documentation of care activities, particularly by monitoring the way in which human resources are tackle to take care of patients. Furthermore, such co-ordination relies on information about the utilisation of material resources, i. e. durable equipment and disposables. Thus, internal coordination must pick up information from care activities in order to synchronise the work of the clinic, as well as to trac k costs associated with care and supply activities. The various processes monitor costs and allocate resources, relating them to the kinds of care activities that have been provided. 4 Management Information Systems in Process-oriented Healthcare Organisations The third sub-analysis discovered that the various management levels in process-oriented healthcare organisations need the same type of primary data, though in differing formats. An HIS for healthcare management in a processoriented healthcare setting can stick around to its structure and practice activities. Moreover, CPRs and other tools can be used to directly collect management data where and when the activities take place. But the data is useful only if healthcare management has the opportunity to examine it with its own analysis tools.For instance, while computerised ordering systems are regarded as important, the fit between organisational and information system models is not identified as a success factor. Clearly, th ere is a need for systems that optimise clinical workflow, as well as those that support the attention of equipment and supplies. However, systems provide optimal organisational value only if they support an integrated organisational model and business plan. 5. Conclusions This thesis points out that healthcare managers at different levels in an organisation all need the same primary data.The differences among the various management levels all concern the ways in which they compile the data that they need for their work. One problem when developing management information systems for healthcare organisations has been a drop of interest in integrating administrative, financial and clinical systems. In process-oriented healthcare organisations, integration is essential to obtaining the full benefits of such a structure. System thinking must also pervade the development of healthcare management information systems.As a result, the multiple roles played by information in process-orient ed healthcare organisations must be identified. 6. approaching work Identifying the multiple roles played by information in a process-oriented healthcare setting requires additional research about the process of designing an HIS. In the interlinking environment that healthcare organisations represent, various practitioners are required to pinpoint data sources and information 15 Management Information Systems in Process-oriented Healthcare Organisations requirements, as well as to advocate for the process of change in the organisational and information structure.Healthcare managers have differing preferences when it comes to information requirements, organisational processes and work activities. Thus, the development process relies on tools that can incorporate those divergent needs into system thinking. As a result, primary data is refined into information other than at the various levels of a processoriented healthcare organisation. More research is required concerning informati on system models and their notation. Though various groups (system analysts, designers, programmers and healthcare managers) can employ models and modelling activities during a development process, their objectives differ.Healthcare managers need to visualise their work environment and organisational processes, system analysts are interested in developing information systems in collaboration with designers, and programmers are looking for coding specifications. They may share a vision in terms of designing a healthcare information system, but their perspectives vary. Thus, the modelling effort should be based on at least two dimensions (1) furnishing models with notations and objectives oriented towards specific groups (2) ensuring that the models visualise the same system but address varying interpretations.Arguments based on the cognitive and practice perspective have identified prototyping as a dark-fruited approach to the development process (Houde &Hill, 1997). Prototyping is often used when the design calls for a high degree of pastime on the part of practitioners and end-users (Bodker & Gronb? k, 1991). Modelling, on the other hand, is linked to an organisational perspective and is frequently employed by system analysis methods. Thus, there is an opportunity to combine these two perspectives during the development process.Modelling is useful as part of a design theory with a high degree of practitioner stake alongside of system analysts, designers and programmers. The process can subsequently be analysed based on the representations in the models that emerge from the requirements of the various groups. superfluous research should examine what the groups need when it comes to the center of attention of the models, how the models are to be visualised and the ways in which they can interact with the differing requirements of the groups in order to ensure a fruitful development process. 16Management Information Systems in Process-oriented Healthcare Or ganisations 7. References Adler P. A. , Adler P. , (1998), Observational Techniques, in Denzin N. K. , capital of Nebraska Y. S. , (eds), Collecting and Interpreting qualitative Material, cat valium Oaks, sharp-witted Publication. Andersson A. , Vimarlund V. , Timpka T. , (2002), Management demands on Information and communication technology in process-oriented health-care organizations the importance of understanding managers expectations during early phases of systems design, daybook of Management in Medicine special issue Health informatics, Vol 16 159-169.Angrosino M. V. , Mays de Perez K. A. , (2000), Rethinking Observation From Method to Context, In Denzin N. K. , Lincoln Y. S. , (eds), enchiridion of soft Research second edition, curtilage Oaks, able Publication. Berg M. , (1999) Patient care information systems and health care work a sociotechnical approach, world-wide ledger of checkup information processing, Vol. 55 87-101. Berg M. , (2001), Implementing informat ion systems in health care organisations myths and challenges, outside(a) daybook of Medical informatics. Vol. 64 143-156. Berg M. , Langenberg C. , Berg I. V. d. Kwakkernaat J. , (1998), Considerations for sociotechnical design experiences with an electronic patient record in a clinical context, International daybook of Medical Informatics, Vol. 52 243-251. Berg M. , Goorman E. , (1999) The contextual nature of medical information, International Journal of Medical Informatics, Vol. 56 51-60. Booch G. , Rumbaugh J. , Jacobson I. , (1999), The Unified Modelling Language practicer guide, Harlow, Addison-Wesley. Bodker S. , Gronb? k K. , (1991), blueprint in action From prototyping by demonstration to cooperative prototyping, In Greenbaum J. , Kyng M. eds), Design at work conjunct design of computer systems, Hillsdale, Lawrence Erlbaum Associates. 17 Management Information Systems in Process-oriented Healthcare Organisations Brender J. , (1998), Trends in assessment of IT-based solutions in healthcare and recommendations for the future, International Journal of Medical Informatics, Vol. 52 217-227. Clayton P. D, van Mulligen E. (1996), The stinting motivation for clinical information system, In JJ Cimino (ed), Journal of the American Medical Informatics Association, pp. 663 668, Proceedings Annual Fall Symposium October 26 30 Washington DC.Connolly T. , Begg C. , Strachan A. , (1996), Database Systems A practical Approach to Design, Implementation and Management, Harlow, Addison-Wesley. Creswell J. W. , (1998), Qualitative enquiry and Research Design Choosing Among five Traditions, metres Oaks, Sage. Davenport T. H. , (1993) Process Innovation Reengineering Work through Information Technology, Boston, Harvard Business School Press. Denzin N. K. , Lincoln Y. S. , (1998), incoming the Field of Qualitative Research, In Denzin N. K. , Lincoln Y. S. , (eds), Collecting and Interpreting Qualitative Material, Thousand Oaks, Sage Publication.Drury C. G. , (2002), The use of archival data, In Wilson J. R. , Corlett E. N. , (eds), Evaluation of Human Work A practical ergonomics methodology, second edition, London, Taylor & Francis Ltd. Ellegard K. , Nordell K. , Westermark A. , (1999), Att ta kontroll over vardagsliv kvalitativ dagboksmetod for reflektiv emancipation, In Linden J. , Westlander G. , Karlsson G. , (red), Kvalitativa metoder i arbetsvetenskapen, Uppsala, TK i Uppsala AB. Ely M. , (1993), Kvalitativ forskningsmetodik i praktiken cirklar om cirklar, Lund, Studentlitteratur. Engestrom Y. (1995), Objects, contradictions and collaboration in medical cognition an activity-theoretical perspective, Artificial intelligence operation in Medicine, Vol 7 395-412. 18 Management Information Systems in Process-oriented Healthcare Organisations Engestrom Y. , (1999), princely visibilization of work An activity- speculative Perspective, Computer Supported Cooperative Work, vol. 8, pp. 63-93, Kluwer Academic Publisher, Netherlands. Er iksson H-E. , Penker M. , (2000), Business Modeling with UML Business Patterns at Work, saucy York, John Wiley & Sons Inc.Firestone, W. A. , (1993), utility(a) Arguments for Generalising From Data as Applied to Qualitative Research, Educational Researcher, Vol. 22 No. 4, pp. 16-23. Fishman D. B. , (1999), The causal agency for Pragmatic Psychology, young York, New York University Press. Flarey D. L. (1995), Redesigning nursing care delivery, Philadelphia J. B. Lippincott Company. Fontana A. , Frey J. H. , (1998), Interviewing The Art of science, in Denzin N. K. , Lincoln Y. S. , (eds), Collecting and Interpreting Qualitative Material, Thousand Oaks, Sage Publication Fontana A. , Frey J. H. (2000), The interview From organise Questions to Negotiated Text, In Denzin N. K. , Lincoln Y. S. , (eds), Handbook of Qualitative Research second edition, Thousand Oaks, Sage Publication. Fowler M. , Kendall S. , (1999), UML distilled Applying the standard object modelling language, Reading , Addison-Wesley. Glaser B. B. , (1978), Theoretical Sensitivity, California, The Sociology Press. Greenbaum T. L. , (1993), The handbook for Focus Group Research, New York, Lexington Books. Houde S. , Hill C. , (1997), What do Prototypes Prototype? , In Helander M. Landauer T. K. , Prabhu P. (eds), Handbook of Human-Computer Interactions Second, completely revised edition, Elsevier Science B. V. Kaplan B. , (2001), Evaluating, informatics applications some alternative approaches theory, social interactionism, and call for methodological pluralism, International Journal of Medical Informatics, Vol. 64 39-56. 19 Management Information Systems in Process-oriented Healthcare Organisations Kaplan R. S. , Norton D. P. , (1996), Translating strategy into action the Balanced Scorecard, Boston, Harvard Business School Press.Luce BR. Elixhauser (1990), A. Standards for Socioeconomic Evaluation of Healthcare Services. Berling Heidelberg Germany Springer-Verlag. Maij E. , Toussaint P. J. , Ka lshoven M. , Poerschke M. , Zwetsloot-Schonk J. H. M. , Use cases and DEMO aligning functional features of ICT-infrastructure to business processes, International Journal of Medical Informatics, Vol. 65 179-191. Orlikowski W. J. , (1993), CASE Tools as Organizational Change Investigating Incremental and Radical Changes in Systems Development, Management Information Systems Quarterly, Vol. 7 309-340. Patel V. L. , Kaufman D. R. , Arocha J. F. , manoeuvre through the murky waters of a scientific conflict situated and symbolical models of clinical cognition, Artificial Intelligence in Medicine, Vol 7 413-438. Prop. 1999/2000149, Nationell handlingsplan for utveckling av halso- och sjukvarden, Sveriges Riksdag, Stockholm, 1999. Senge, P. M. , (1990), The Fifth tally The art and practice of the learning organisation, New York, Bantam Doubleday Dell Publishing Group Inc. Sommerville I. Sawyer P. , (1997), Requirement Engineering A good practice guide, Chichester, John Wiley & Sons Ltd. Stake, R. E. , (2000), lawsuit study, In Denzin N. K. , Lincoln Y. S. , (eds), Handbook of Qualitative Research second edition, Thousand Oaks, Sage Publication. Stead W. W. , Lorenzi N. M. , (1999), Health Informatics Linking enthronement to Value, Journal of the American Medical Informatics Association, Vol. 6 341-348. Strauss. A. , Corbin J. , (1990), Basics of Qualitative Research Techniques and