History of Nursing Homes Essay

Today, there are approximately 16,100 nursing homes in the U. S. with approximately 1. 5 million residents (www. cdc. gov). However historically, the sick, disabled, and aged were cared for at home by family members. Changes in technology and social changes have created a shift in how we care for our elderly and disabled, and there is evolution in geriatric care that continues today (Morris, 1995). Nurses have had a huge role in revolutionizing the care for our elderly and for creating what is the modern nursing home. Caring for the old age, or geriatric nursing, is often not viewed as being as prestigious as other specialties in nursing. Despite the growing elderly population and the fact that 46% of all Registered Nurses will be providing direct care to the elderly, the majority of nursing students still do not receive any specialized content in geriatric nursing (Ebersole & Touhy, 2006). Later on, we will discuss the development of geriatric nursing as a specialty and as it relates to the history of long-term care. In the sixteenth century, we began to see institutions developed to care for a variety of people in need. This did not just include the elderly or disabled, but any dependent poor, sick, orphaned children, widows, insane, and even minor criminals. These institutions could be considered a predecessor to the nursing homes that eventually followed (Morris, 1995). Poor laws in Europe gave rise to these institutions referred to as workhouses, almshouses, or poorhouses. They provided very minimal nursing care, and the care was often provided by â€Å"pauper nurses† who were not trained and usually inmates themselves, often alcoholics. Agnes Jones, a Nightingale trained nurse visited a Liverpool Infirmary in 1864 and reported â€Å"deplorable† conditions. She was forced to dismiss 35 pauper nurses for drunkenness and stated that bed clothes had not been washed for months (Ebersole & Touhy, 2006). These poorhouses were common in the United States as well and often had the same deplorable conditions. Carolyn Bartlett Crane, the Chairman of Charity Organization Department of Women’s Civic Improvement League of Kalamazoo, MI attempted to address these problems first with the Michigan State Nurses’ Association in 1906 and again with the Nurses’ Associated Alumni of the United States in 1907 with pleas for nursing care in these almshouses. In her 1907 paper, â€Å"Almshouse Nursing: the Human Need; the Professional Opportunity†, she described the county almshouse as a â€Å"hospital with the hospital part left out. † She went on to talk about how the specialization of institutions for certain groups, such as asylums and orphanages, left the elderly and infirm to be the majority of those left with no other options besides the poorhouses (as cited in Ebersole & Touhy, 2006 p. 8). Little progress was made. In 1912, the American Nurses’ Association Board of Directors appointed an Almshouse Committee to oversee housing in these institutions. Progress continued to be slow. From 1910 to 1920 focus was taken away from elder care due to the war (Ebersole& Touhy, 2006). An article published in the American Journal of Nursing in 1930 by Munson, R. N. discussed the conditions in the almshouses and lack of quality nursing care. She states, â€Å"Modern nursing in England and in this country was started with the purpose of ‘cleaning up’ just such conditions in hospitals as are still found in almshouses. † She proposed that these small almshouses be consolidated into larger facilities that are better managed (1930). Morris describes the factors that have led to the need for the care that nursing homes provide today. They describe an area of healthcare when a person is not acutely ill and in need of hospital care, but is perhaps chronically ill and cannot return independently to live in his or her home. This â€Å"middle† is ever changing and is affected by two factors: technology and social change. As we discussed earlier, care for the elderly and infirm had largely been done by individual families. Poorhouses and almshouses arose to meet the need for anyone who did not have family to care for them or means to care for themselves. The need increased in the U. S. as the immigrant population rose and there was a shift from extended to nuclear families. A child born in 1900 had a life expectancy of only forty-seven years old. As medical technology, for example, infection control, rapidly developed, the population of elderly people increased. With the rise in aged population, there was an increase in chronic disabilities associated with age (1995). In the nineteenth and twentieth centuries, living standards increased. The poorhouses began to become a thing of the past as there was a movement to specialize care for certain groups. For example: asylums for mentally ill, TB sanatoriums, veterans’ hospitals, and orphanages. There was homecare provided by public health nurses, but many refused to care for the chronically ill (Morris, 1995). As mentioned earlier, the elderly and infirm were among the last left in the poorhouses. Thanks to the efforts of many, including many nurses, there was a push to provide better care and bring trained nurses into these almshouses. By 1940, increased expectations for care and the Social Security Act led to the rise of the modern nursing home. The Social Security Act provided a means for elderly who could no longer work and widows to have financial means to pay for care. Entrepreneurs quickly took advantage and homes for the elderly were often as much for profit as for care. By the 1960s, scandals and patient neglect led to increased regulation and public control over expansion (Morris, 1995). Medicare and Medicaid provided more money for care of the elderly and also further increased government control. Rapid increases in technology and new treatments led to a further rise in the aged and vulnerable population and increasing costs. Nursing homes became linked to local hospitals and doctor referrals. Some homes specialized their services to include services for cognitive impairment or active rehabilitation. Government reimbursement and regulation became more complicated. Nursing homes became less â€Å"homes† and more medical facilities. They operated with a limited nursing staff and very little physician presence. It continues today that nursing homes face contradictory pressures to accept sicker and more difficult patients while at the same time maintaining a â€Å"home-like† atmosphere. All this while limiting costs (Morris, 1995). As more specialized care for the elderly developed, it was apparent that the needs of the elderly were not as simple as taking the principles of nursing care and applying them to the aged. Geriatric nursing has only become recognized as a specialty within the past fifty years. However, the origins of gerontological nursing can be traced all the way back to Florence Nightingale who once was a superintendent in an institution we would call a nursing home today. The clinical study of the aged can be traced back much further to Hippocrates. A Viennese physician, Ignatiz Nascher coined the word â€Å"geriatrics† in a 1909 New York Medical Journal article. In 1935, a physician named Marjorie Warren established an elderly concentrated practice with a concentration on environment, rehabilitation and motivational methods (Ebersole & Touhy, 2006). Geriatric nursing is a unique specialty in that it was developed by nurses themselves. Other nursing specialties were first developed in medicine and then carried over to nursing. The reason for this difference is that medicine so often concentrates on curing illness and prolonging life. As Ebersole states, â€Å"Old people often have little life left and therefore are unattractive subjects. † Nurses, in contrast, have always sought to prevent illness and alleviate suffering (Ebersole & Touhy, 2006). It seems fitting that nursing, and not medicine, would give birth to this specialty and that is something that nurse’s should take pride in. However, as mentioned earlier, geriatric nursing is often considered the least prestigious of nursing concentrations. With the continued rise of the elderly population as the baby-boomer generation ages, nurses should be prepared to care for elderly in some capacity no matter which specialty they choose. It is unfortunate that nursing schools often provide little material on geriatrics as a unique population. Care for the elderly has continued to make slow, but consistent progress even in more recent years. Although we are leaps and bounds from the almshouse, there has still been serious abuse and neglect in nursing homes and cries for change in the way we house and care for our elderly. In addition to more people receiving homecare services that allow them to live at home longer, there are other movements to change the nursing home itself. William Thomas describes an alternative concept that hopes to revolutionize long-term care, the Eden Alternative. He states, â€Å"The modern American nursing home is being crushed between the intrinsic weaknesses of the institution and the rising expectations of a new generation of elders. We are witnesses to its destruction. Like the leper colony, the tuberculosis sanitarium and insane asylum, the nursing home is about to be heaved onto the ash heap of history (Thomas, 2003 p. 42). † In 1992, the Eden Alternative began as a grant project in New York. It has changed over the years, but is based on a set of principles that aim to make facilities more like homes. The focus is on treating the residents as unique individuals first and patients second. Some changes that differ from traditional nursing homes include environmental changes like carpets, plants, and allowing pets and personal items, single rooms, and family style meals. Staff at Eden facilities do not dress in scrubs and whenever possible, a child daycare is on site to increase staff satisfaction as well as bringing more life into the facility. Currently only about 2% of U. S. nursing homes have adopted this new format despite the statistics showing significant reductions in behavioral incidents, decubitus ulcers, bedfast residents, use of restraints, and staff absenteeism. There was also an increase in census (Thomas, 2003). Going a step beyond the Eden Alternative, an even more recent development has been the â€Å"Green House† with a focus on smaller being better. These homes aim to blend seamlessly into a community and house up to eight residents in what is more than a home-like atmosphere, but very much a home. The technology would still be utilized, but as in the original Eden model, it should be woven into daily life without interfering with it. So far, Green Houses have been able to meet the increasing challenges of providing state of the art care and keeping costs down while complying with state and federal regulations (Thomas, 2003). In conclusion, the nursing home and geriatric nursing have developed to meet the needs of a changing society with ever increasing medical advances and a larger than ever population of elderly. Nurses have been a huge part in the development of what has become the modern nursing home. As the geriatric nursing specialty has grown, there has also been greater understanding of the unique needs of our aging population. It is clear that despite the advances made, there is still much dissatisfaction in how we care for our elderly population and a lot of room for improvement. New alternatives are being developed and it will be fascinating to be in the field of nursing to witness the changes that are yet to come.

The Medical Elective Medical Training Health And Social Care Essay

The medical elective is an of import portion of medical preparation and calling. It can besides be an exciting chance to see wellness attention systems of different states and research countries of medical specialty that I have peculiar involvements in. My initial programs are to hold the elected arrangement abroad, ideally in two separate locations. Language is an of import factor in taking the states as I would wish to be able to pass on with the patients and physicians. Out of all the English speech production states, I think it would be an interesting experience to see a less developed state or a less developed part within a developed state. The other half of the elected I would take a developed state and comparison and contrast the two wellness systems. I want the fond regards to be chiefly clinical based as I can use the accomplishments in general medical specialty and other forte I have learnt during the two old ages of clinical preparation. I would non wholly decline the chance to blend in some clinical based research, but I am cognizant that research undertakings may take some clip to organize and may besides necessitate excess resources input, such as permission from patients and aid from other staff, from the finish infirmary and establishments. In footings of safety during travel, although I have travelled to assorted states, but I have ne'er travelled or organised travel on my ain. Safety in footings of personal properties, nutrient and drink and personal safety should be put into consideration. If possible, holding the arrangement with a friend would be ideal. As all the 4th twelvemonth King ‘s medical pupils are traveling on electives this summer, happening a spouse traveling to the same topographic points should be rather possible. Having merely came back from vacation in America, the idea of traveling back for the elective to hold a on the job experience over in the States appeared rather attractive. The US has a really different wellness attention system comparison to the UK. To see their physicians, the patients over in America would necessitate to hold private wellness insurance which can be a really dearly-won payment. It would be interesting to see how the in private funded wellness system impacting patient experience compared to the NHS in the UK. America is a large state and this makes taking the location a spot more hard. To acquire an thought about where usually make medical pupils travel for electives in America, I searched on the Elective Abstract System on Virtual Campus. USA seems to be a really popular state for King ‘s pupils to travel for electives as there is a immense list of infirmary and establishment for all fortes. The popular finishs are the major metropoliss like New York, Los Angeles, San Francisco and etc. Majority of the infirmaries do non accept international pupils for elected straight, a few smaller clinics do, but the cost is really high and they seem to be really specialized. Feedbacks from pupils are besides assorted, most are happy with their experience, but non everyone had a hands-on experience. Access to patients can be a job sometimes in some forte clinics, and most times are spent on detecting. Using to medical schools can besides be hard as a batch of American medical pupil are besides l ooking for elected arrangements and the disposal fee entirely can be $ 100 for the application entirely. After those research and farther idea, I was somewhat put off by the thought of traveling to the States. Alternatively of traveling entirely, it would be a better manner to go with a friend. Culadeeban ( Deeban ) Ratneswaran, another King ‘s 4th medical pupil was looking for a spouse for electives and I have worked with him during my abdominal rotary motion in 3rd twelvemonth. Deeban was in the procedure of organizing a research undertaking about respiratory medical specialty in Singapore which involved some informations aggregation. He needed a spouse to work with on the undertaking and we decided to make the elected arrangements together. We came across a paper written by Dr Deborah Ng and her co-workers, titled: â€Å" consciousness of smoking hazards and attitudes towards in writing wellness warning labels on coffin nail battalions: a cross-cultural survey of two populations in Singapore and Scotland † . We were believing about emulating this survey ourselves, looking into the cross-cultural differences between Singapore and London, alternatively of Scotland. We will utilize a questionnaire attack to roll up the information as oppose to interviews because we want to roll up as much informations as possible while still working on the clinical side of the arrangement during the elected period. We besides emailed Dr Ng on farther advice about her survey and she kindly contacted the caput of respiratory section she was working under in Singapore, Professor Sin Fai Lam. Professor Sin agreed to give us 4 hebdomads arrangement in Khoo Teck Puat Hospital in the respiratory section and at the same clip let us entree to patients for the research undertaking. In order to transport out this undertaking we besides require moralss blessing and this demand to be applied by a qualified physician. We were told that Professor Sin ‘s squad is instead busy and unable to perpetrate their clip for the ethical blessing. We are still committed for the clinical arrangement in Khoo Teck Puat Hospital, and at this phase we are seeking alternate ways to acquire the ethical blessing, perchance from another section or another infirmary. For the 2nd half of the elected, we did non desire to go excessively far out of the parts. This is partially to salvage cost and besides clip spent on travel. So we applied for a few posters in Kuala Lumpur in Malaysia. Hospital Kuala Lumpur kindly accepted our applications for a 4 hebdomad long posting in the general medical specialty section. This would cover a big assortment of medical specialty, and it would be good to hold a broad scope of experience after a really specialized surgical arrangement. I can besides utilize this clip to acquire more experience in fortes that we merely had limited exposure so far, for illustration, ENT, dermatology and ophthalmology. Word Count: 1004Career SectionSelf-assessmentDuring my pre-clinical surveies in Cambridge, I had really limited exposure to existent clinical pattern so I kept an unfastened head about which forte I would wish to prosecute for future calling. I exhaustively enjoyed larning anatomy in first twelvemonth of medical specialty, and peculiarly the clip spent in dissection lab. What appealed to me is that I would read about certain parts of the organic structure and the following twenty-four hours I can hold the hands-on chance to recap the cognition to visualize it in existent life. The clinical survey offered better chances in calling geographic expedition. Throughout the assorted rotary motions, I found surgery fascinating and I ‘m ever enthusiastic to go to theatre Sessionss. Although, as a medical pupil, most of the clip spent in theater is to detect the operations but I was more than lament to scour in to help when asked. I besides enjoyed the type of squad work in surgery where each person has a clearly defined and alone function in the operating theater.Career research geographic expedition and treatmentsThe Medical Specialty Training web site ( 1 ) is a good starting point for callings research as it provides information on all fortes within medical specialty. After medical school, every physician has to travel through two foundation old ages and use for forte preparations, these can be medical, surgical, psychopathology and list of run through fortes. For the surgical fortes, there are two Core Surgical Training old ages to be completed foremost. Then there is another application procedure for the 3rd twelvemonth ( CT3 ) , which is for a sub-specialty, for illustration, cardiothoracic surgery. The competition information shows that surgery is a extremely popular pick, though the competition for other fortes can be every bit ferocious. I have besides attended the Specialty Fair hosted by Royal College of Medicine. It was aimed for both medical pupils and foundation twelvemonth physicians and it had a whole scope of fortes on show. Having talked to a figure of the physicians from assorted fortes, orthopedic surgery peculiarly stood out for me. It is a surgical forte concerned with castanetss, articulations and their motion. It covers both hurt and other diseases, for illustration, congenital and degenerative. I think it can be an highly rewarding calling where I can set patients back after terrible injury or reconstruct independency by alleviating creaky articulation hurting, both can genuinely transform the patient ‘s life. Figure 1. Orthopedic surgery. From www.sussexotc.nhs.uk Having non done the rotary motion for orthopedic surgery and injury, I wanted some early gustatory sensation for the forte and the 2011 National Undergraduate Trauma Conference provided the perfect juncture. The conference gave great penetration into the calling options available in injury and orthopedic surgery. The workshops lead by experient physicians in the field besides allowed the pupil to pattern some of the skilled involved, for illustration, laparoscopy.Using your elected to research your optionsI think the elected period will be an first-class clip to research my country of involvement and callings option. For the first half of my elected in Singapore, I will be passing four hebdomads in the orthopedic section in a really modern infirmary. There are five advisers in the section, all of which are trained in the UK so they will hold a reasonably good apprehension of the degree of preparation I ‘m presently at and what would profit me the most during this poster. By thi s phase I would hold done my orthopedic surgery fond regard, and extra exposure in this field will reinforcement and hopefully farther develop the cognition and accomplishment I already have. I should besides do the most out of this chance to acquire every bit much practical experience as possible in larning the basic surgical techniques and direction of the common instances encountered in orthopedicss. For the 2nd half the elected in Kuala Lumpur, although I ‘m officially posted under general medical specialty, in world the infirmary is really flexible for the elected pupils. The adviser who is oversing me during the poster has no job with elected pupils doing usage of the clip in Hospital Kuala Lumpur to acquire a broad scope of experience.Personal contemplation on calling thoughts/decisions to day of the monthThe big calling pick medical specialty offers makes the determination really hard, particularly most fortes requires drawn-out preparation. In order to do a steadfast determination on which way to take, careful research needs to be done to do certain that I am clear in my ends, altering calling way in medical specialty and re-start preparation can be really boring. I think at this phase of developing it is really hard to hold a clear image of what I want to make. While larning about the different subjects in medical specialty can be rather different when work on them. Although it does give some penetration about what it is like to work in that field. To this day of the month, I am really inclined towards surgery for my future calling. Bing able to straight see the job, keeping the breakage or experiencing the obstruction so repairing the job utilizing your custodies is really hearty. It requires drawn-out preparation and new accomplishments are invariably acquired even after making. I ever find it exciting to scrubbing-up, operating, or largely as a medical pupil, helping in theater. There is a huge array of subspecialties on offer, from urogenital medicine to plastic surgery. Some factors will be common to all fortes, but each will hold their ain set of challenges and demands. Orthopedic surgery is the most appealing subspecialties in surgery, it can be really physical but there are many specialist tools available to cut down the demand for inordinate force. The on-call agenda is comparatively demanding as accidents can go on any clip of the twenty-four hours. In contrast with ENT surgery where more of the surgeries are elected with really small exigency work so the working hours can be rather flexible. Through the class, I am going more informed about the different calling options and have got a better thought of what kind of calling I want, though non confident plenty to do a concluding determination. At the same clip I should non go narrow minded and ignore the other countries of medical specialty, because I may yet detect other new involvements. Word Count: 1018Global Health SectionGlobal wellness is a subject in medical specialty derived from public wellness and international wellness. It has been defined as â€Å" an country for survey, research and pattern that places a precedence on bettering wellness and accomplishing equity in wellness for all people worldwide ( 2 ) † . It is a field joins the medical and societal scientific discipline subjects, including human ecology, economic sciences, epidemiology and many others. It uses wellness informations such as life anticipation and infant mortality rate to mensurate the wellness jobs present in an country. It besides emphasises on wellness issues such as HIV/AIDS and malaria that can hold a planetary economical and political impact.What is equity in wellness?Health equity among states and within a state or community is a major issue in planetary wellness. The publicity of societal and economic equity and decrease of wellness disparities has been a cardinal subject in domestic public wellness, international wellness, and planetary wellness ( 2 ) . Equity of wellness can be confused with equality of wellness. Health equity focuses on the distribution of resources and other procedures that drive a peculiar sort of inequality between more and less advantaged groups, in other words, wellness inequality that is unjust or unfair ( 3 ) . Not all wellness disparities are unjust ( 4 ) , for illustration, we would anticipate immature grownups are healthier than the aged and work forces have prostate jobs whereas adult females do n't. However, if the difference arises from immunization degree or nutritionary position, so it would do concern from an equity position ( 3 ) . More late, Braveman and Gruskin defined wellness equity as â€Å" absence of systematic disparities in wellness between different societal groups. Unfairnesss in wellness consistently put groups of people who are already socially disadvantaged ( for illustration, by virtuousness of being hapless, female, and/or members of a disfranchised racial ethnic or spiritual group ) at farther disadvantage with regard to their wellness ; wellness is indispensable to wellbeing and to get the better ofing other effects of societal disadvantage. † ( 3 )Financing of wellness attentionFinancing of wellness attention is a major factor in equity of wellness attent ion, it is the activity of raising or roll uping gross to pay for the operation of a wellness attention system ( 5 ) . The conventional classs for fiscal beginnings are revenue enhancement, societal wellness insurance, private wellness insurance and out-of-pocket payments. Depending on the wellness attention system there are many fluctuations in the funding beginnings, for illustration, societal wellness attention insurance can be implemented on a national degree or a community degree and it can either be compulsory or voluntary ( 6 ) . Equity in wellness attention funding is assessed by the grade of inequality in paying for wellness attention between families of unequal Ability To Pay ( ATP ) ( 7 ) . Policy shapers in assorted states seem to be building wellness attention financing harmonizing to ATP. The Ministry of Health ( MOH ) in Malaysia subscribes to this scheme by suggesting that the state ‘s part to the new national wellness financing strategy to be related to ATP ( 8 ) .Malayan wellness attention systemThe cardinal rule of the Malaysian wellness attention system is that the handiness to wellness attention is non to be related to ATP, peculiarly in the event of illness ( 9 ) . The Malayan wellness attention system has seen great betterment over the past old ages. During the period of 1990 to 2005, life anticipation at birth increased significantly: males from 69.0 to 71.8 old ages and females from 73.5 to 76.2 old ages ; infant mortality rate fallen from 13.5 to 5.1 per 1000 ( 8 ) . Malaysia was ranked at 49 from 191 WHO member states ( 10 ) , which assessed the overall wellness public presentation against the three aims of good wellness, reactivity and just fiscal part. Malaysia ‘s public presentation at just fiscal part is comparatively low ( 122-123 out of 191 WHO member states ) compared to the other two aims ( 10 ) . In Malaysia, the populace and private wellness services co-exist. The authorities provides public wellness services through public infirmaries and wellness clinics. Private wellness attention complement the medical services provided by the authorities and its outgrowth is driven by demand. The wellness system overall is preponderantly revenue enhancement financed. The national outgo showed that authorities subsidises 58.2 % of the support in public sector whilst the balance of 41.8 % is financed by the private sector in 2003 ( 11 ) . The support are from five chief beginnings: direct revenue enhancements, indirect revenue enhancements, Employee Provident Fund ( EPF ) and Social Security Organisation ( SOCSO ) parts, private insurance premiums and out-of-pocket payments ( 6 ) . Those financess are transferred straight or indirectly to either public or private installations. Figure 2. Households ‘ Financial Contributions to Health Care System in Malaysia. From ( 6 ) . Many parametric quantities and techniques are available in the appraisal of equity of funding in a peculiar wellness attention system. Progressivity measures the divergence from proportionality in the relationship between wellness payment and ATP ( 12 ) . A progressive system means that the persons or families with greater ATP are paying more proportionately in funding wellness attention. The Kakwani ‘s progressiveness index ( 13 ) is a widely used tool in public finance to measure equity. The value ranges from -2 in the most regressive system to +1 in the most progressive system, 0 agencies that the system is relative and wellness payments account for the same proportion of income, irrespective of the person ‘s income ( 14 ) . A research carried out by Yu et Al ( 6 ) employed information from Household Expenditure Survey ( HES ) Malaysia 1998/99 indicated that the five finance beginnings in Malaysia have produced a imperfect system which is regarded as just. Malaysia â⠂¬Ëœs Kakwani ‘s progressiveness index mark compares really favorably to other revenue enhancement financed wellness attention systems in both development and developed states ( 6 ) . This determination contradicts the WHO World Health Report 2000, in which an older informations beginning from 1980s was used compared to the 1998/99 figures used in the new study. The two different findings besides indicate betterment in the equity of fiscal part in the wellness attention system during this clip. Although the finance of wellness attention can be regarded as just in Malaysia, there are other unfairnesss. Many among the hapless fail to seek wellness service due to go and chance costs. The private travel costs incurred to seek intervention have been high and besides increased at a higher rate compared to household income ( 15 ) . The hapless besides live farther from medical installations and have to pass more to go compared to the rich ( 15 ) . From the instance of Malaysia we can see that achieve equity in wellness attention can be really hard. The state has a really just manner to finance the wellness attention system but jobs remains in the distribution of service. Besides the turning proportion of private finance beginnings will do an escape of skill medical forces from the populace sector which will make farther entree unfairnesss. Word count: 1104Final Aims and AimsExperience wellness attention systems in different states. The two states that I ‘m sing will hold rather different systems to each other and the UK. It would be interesting to see what can be learnt from each and what can we make to better our ain wellness system. Practice the clinical accomplishments acquired in the past two old ages and hopefully get some new accomplishments that can be used in the hereafter. This can be a good clip to retouch on all the clinical accomplishments which will be needed during fond regards in the 5th twelvemonth and foundation occupations. Use this chance to research calling options. More exposure in orthopedic surgery will hopefully beef up my aspiration towards surgical callings. Use the clip in Kuala Lumpur to acquire more exposure to fortes that I have n't had much exposure, for illustration, ENT and dermatology. To carry on the research undertaking, this is still pending on ethical blessing. This is an chance to pattern how to transport out clinical researches, which is a utile accomplishment to hold regardless of the forte I will be come ining. If the research is approved and everything else goes good, it can be a good opportunity to hold some work published early in the calling. Word count: 207History of Elective PlansSingaporeSince my elective is split into two halves, I shall speak about each individually. My first finish is Singapore. Officially known as the Republic of Singapore, it is a metropolis province and besides an island state. Situated off the southern tip of the Malay peninsula, separated from Malaya by the Strait of Johor. It is the universe ‘s 4th taking finance Centre and the 3rd busiest port. Figure 3. Singapore skyline at dark from www.panorami.com With a population of merely over 5 million and being one of the smallest states in the universe, its population denseness is the 3rd highest in the universe. Merely 2.9 million of its population are born locally, 43 % ( 16 ) . Singapore is a multicultural state, the 2010 nose count ( 17 ) indicates that bulk of population being cultural Chinese ( 74.1 % ) , with 13.4 % Malays, 9.2 % Indians. There are four official linguistic communications in Singapore: English, Mandarin, Tamil and Malay. English is the on the job linguistic communication and all physicians are trained in English. The largest faith is Buddhism ( 44.2 % ) , Christianity and Islam are the other chief faiths with 18.3 % and 14.7 % severally ( 17 ) . Figure 4. The Merlion, a symbol of Singapore. This fabulous animal is a capturing loanblend of a king of beasts and a fish. From www.travelerfolio.com Singapore has a cosmopolitan health care system where the authorities ensures affordability. Most care outgo ( 68.1 % ) ( 18 ) is provided by the private sector, and the remainder is from the authorities. Harmonizing to the World Health Organisation ( 18 ) , Singapore has the lowest infant mortality rate ( 3 in 1000 ) and it besides has one of the highest life anticipations at birth ( 80 old ages ) . Singapore has â€Å" one of the most successful health care systems in the universe, in footings of both efficiency in funding and the consequences achieved in community wellness results † ( 19 ) . The system uses a combination of mandatory nest eggs from salary tax write-offs, founded by the workers and employers, a means-tested authorities subsidies for those in fiscal adversity and a national insurance strategy to cover major and drawn-out unwellnesss ( 19 ) . Although really successful, this peculiar health care system is â€Å" hard to retroflex in other states † , chi efly because the comparatively little population of 5 million on a concentrated piece of land, so the planning of the health care substructure is much easier comparing to larger states ( 19 ) . There are 13 private infirmaries, 10 authorities founded infirmaries and a figure of other specializer clinics. Khoo Teck Puat Hospital ( KTPH ) is the newest public infirmary in Singapore, built to function the health care needs of more than 650,000 peopleA who live and work in the North of the city.A The infirmary was officially opened in November 2010, the entire cost of development was $ 674m ( 20 ) , $ 125m of which was donated by the late Khoo Teck Puat ‘s household, who was wealthiest adult male in Singapore. KTPH is a territory general infirmary consists of 19 wards with 550 beds, with a six-storey Specialist Outpatient Clinic block, and an eight-storey edifice lodging the private wards and a 10-storey subsidized tower ( 20 ) . KTPH is besides actively involved in medical instruction and supply clinical instruction to medical pupils from Yong Loo Lin School of Medicine at the National University of Singapore ( 20 ) . Figure 5. Khoo Teck Puat Hospital. From www.flickr.comKuala Lumpur, MalaysiaMalaysia is situated in South East Asia, separated into two parts by the South China Sea into Peninsular Malaysia and Malaysian Borneo, besides known as West and East Malaysia severally. The Peninsular Malaysia was known as Malaya, gained independency from Britain in 1975, so united with Sabah, Sarawak and Singapore to organize Malaysia in 1963. However in 1965, Singapore withdrew from the federation and formed an independent state. The entire population of Malaysia is merely over 28 million ( 21 ) , Malays and other Bumiputera groups make up 65 % of the population, Chinese 26 % , Indians 7.1 % and other cultural groups 1 % ( 22 ) . The distribution of population across the state is instead uneven with approximately 80 % life in Peninsular Malaysia ( 21 ) . There are 137 living linguistic communications spoken in Malaysia ( 23 ) . Bahasa Malaysia, a standardised from of Malay is the official linguistic communication. English was the official administrative linguistic communication before Malaysia ‘s independency and remained to be widely used, particularly in service industries and other work topographic points. So communicating should non be an issue during the elected. Islam is the largest and the official faith with 60.4 % of the population, Buddhism and Christianity are the other chief faiths with 19.2 % and 9.1 % followerss severally. Figure 6. Map of Malaysia. From www.cia.gov Kuala Lumpur is the capital and the largest metropolis in the state with a population of 8 million in the metropolitan country ( 24 ) . The name literally means â€Å" boggy estuary † in Malay It has developed from a hovel town lodging mineworkers from the nearby Sn mine in mid nineteenth century to be dominated by the tallest skyscrapers in Southeast Asia and flower with the returns of international trade and commercialism. Kuala Lumpur is a really diverse metropolis in footings of human ecology, faith and civilization with historic temples and mosques sitting aboard futuristic towers. This diverseness attracts tourers from all over the universe, and I am certain I will hold plentifulness to make and see in my free clip. Figure 7. Kuala Lumpur at dawn with Petronas Towers ruling the skyline. From kualalumpurhotels.travel Hospital Kuala Lumpur is the largest infirmary in Malaysia and one of the largest in Asia. It is situated on 150 estates of land with 83 wards and 2302 beds. It employs a immense staff of 7000 workers, including 200 advisers and specializers with 500 registrars and house officers ( 25 ) . The infirmary is situated at the Centre of the metropolis, and was built in 1870 and consisted of merely 3 wards. Since so, it has been invariably upgraded and in 1997 it has completed upgrading its Institute of Radiotherapy, Oncology and Nuclear Medicine ( 25 ) . HKL besides plays an of import function in developing wellness professionals. As it is the chief instruction infirmary for medical pupils from the National University of Malaysia the staff will be more than capable to supply a worthwhile acquisition experience and hence it is a really popular pick among elected pupils. Many fifth pupils spent their electives in HKL exhaustively enjoyed their posters. As it is a immense infirmary there are so many different sections I can see and most physicians are more than happy for you to fall in their squad for a twenty-four hours regardless the section you are posted under. Figure 8. The Thean Hou Temple is one of the largest Chinese Buddhist temples in Kuala Lumpur. Officially opened in 1989, it is dedicated to Tian Hou ( The Heavenly Mother ) . From www.flickr.com Word count: 1092Personal Safety, Health and WellbeingFor personal safety issues about the states I am about to see for the electives, I foremost checked the Foreign and Commonwealth Office web site for some general advice. For Singapore, â€Å" there is an underlying menace from terrorist act. Attacks could be indiscriminate, including in topographic points frequented by exiles and foreign travelers † ( 26 ) .This means there is a low degree of known terrorist activity. So from terrorist act concern point of position, Singapore is possibly safer than the UK. FCO besides states that violent offense is rare, but travelers should be cognizant of street offense such as bag-snatching. This sort of activity occurs more often in tourist country such as airdromes, I think I should exert same sort of cautiousness as I would in all big metropoliss. The FCO peculiarly highlighted that â€Å" the offenses of indignation of modestness ( molestation ) can ensue in a all right, gaol or bodily penalty ( the Calamus rotang cane ) . Travelers are advised to avoid any action that could be interpreted as molestation. Scams affecting false claims of molest are thought to be † ( 26 ) . This should non be a major concern as most people would exert common sense non to do any offense, though this does alarm traveler to the state that certain misbehaviors that would be dealt laxly in the UK can take to really serious penalty in Singapore. The menace of terrorist act is somewhat more serious in Malaysia, FCO listed it as a state with â€Å" general menace of terrorist act † and â€Å" some degree of known terrorist activity † ( 26 ) .The FCO besides warned against travel to the east Sabah part of the state as there â€Å" are indicants that both condemnable and terrorist groups are be aftering violent Acts of the Apostless against foreign tourers † ( 26 ) in that country. The last incidence affecting foreign subjects was in 2003 and there are no other reported incidences since. East Sabah is in east Malaysia, far from the capital metropolis Kuala Lumpur, and I have no programs to go to that portion of the state. In footings of insurance during elected period and other travels that may follow, I have ever purchased travel insurance to cover my flights to and from place during the holiday period. I have been with Insure & A ; Go for a figure of old ages, it ‘s a really dependable company and their one-year multi-trip policy is really comprehensive. The insurance bundle costs ?70 per twelvemonth, which includes cancellation, personal properties, luggage, paperss and whole scope of other screens. One of import screen I should foreground is the medical screen. As if for any ground I fall ill during the elected or the period spent going after the elected, I would be cover for the local wellness service if it ‘s needed. The wellness attention systems in Singapore is mostly in private founded so the cost it would be rather expensive, and the National University of Singapore requires all incoming elected pupils to hold medical insurance during the elected period. I have besides checked wi th the insurance company that the â€Å" medical elective † is covered as portion of the travel insurance as it can be a gray country between vacation travel and working travel. They have confirmed that the elective is covered by this policy. Professional insurance or malpractice insurance is besides required by the arrangement in Singapore. I have joined the Medical Protection Society since first twelvemonth of medical school but I have ne'er required their service. If I keep on following the counsel as I have been in the UK during the clinical surveies, professional insurance should non be of concern. I understand the medical pattern in different wellness systems and different civilization can change, patients ‘ outlook and apprehension of the function of medical pupil can besides be rather different. While working with patients, whether on ward or clinic, I should explicate my function and do certain the patients understand who I am and what I ‘m making. At any point, if I am diffident about the ethical deductions of a certain pattern, for illustration, inquiring for consent from patient for scrutiny, I should confer with a senior member of the squad and inquire for advice for the recognized criterion of pa ttern in that peculiar infirmary. Dengue febrility is known to happen in both Singapore and Malaysia ( 27 ) . There is no available inoculation or medical specialty to forestall this disease. The best step is to avoid mosquito bites by utilizing anti-mosquito sprays and picks. There is besides a hazard of malaria in Malaysia ( 27 ) , once more anti-mosquito steps should be used. In add-on, chemoprophylaxis should be used in concurrence. Chloroquine opposition is present in peninsular Malaysia, I shall take proguanil along with chloroquine. These drugs are available from most pharmaceuticss. Another major wellness concern for pupils traveling abroad for elected arrangement is the hazard of HIV exposure. The prevalence of HIV in Singapore and Malaysia are both really low. The latest figure shows that the prevalence of HIV in Malaysia is approximately 0.5 % and 0.15 % in Singapore, comparing to 0.35 % in the UK ( 28 ) . For the orthopedic surgery fond regard in Singapore, I will likely be in contact with blood while detecting or helping in theaters. Since the prevalence of HIV in Singapore is lower than this state, the hazard of exposure is really little. The fond regard in Kuala Lumpur would be based in the general medical specialty section, so the opportunities of contact with blood is minimum along with the low prevalence of HIV, the hazard of HIV exposure is once more really low. Hence, I ‘m non sing taking a post-exposure prophylaxis kit with me during the elected fond regard. One unwellness which I ‘m likely to endure from is traveler ‘s diarrhea. From experience, during about every abroad trip, I would hold traveler ‘s diarrhea at some phase. This is likely because I frequently like to seek the local nutrient and drinks and non afraid of eating unfamiliar things. To understate the hazard of holding diarrhea, of any kind, I should avoid feeding and imbibing in less reputable constitutions. As a safeguard I would besides take some loperamide tablets and anti-emetics in instance of diarrhea or more serious nutrient toxic condition. Word count: 998

All characters in the novel Essay

All characters in the novel ‘Of Mice and Men’ are either lonely, bored or in need of escaping from the soulless existence of the itinerant labour. It is based on a society of men leading empty lives, trapped in a lonely life, consisting mainly of hard physical work. There was not enough happiness, love and affection in their lives. The novel is set in California, the Southern states of America, in the 1930’s around the time of the ‘Great Depression’. The ranch is based in ‘Soledad’; which is the Spanish word for ‘Loneliness’. The bunkhouse that the men sleep and live in is a long and rectangular building. The walls are white washed and the floor unpainted. In three of the four walls are small, square windows. In the fourth one was a solid door with a wooden latch. There are eight bunks, all with a nailed apple box over them with the opening forward. This made two small shelves for the personal belongings of each ranch hand occupying the certain bunk. On these shelves were little articles, soap, razors, talcum powder, Western magazines, medicines, little vials, combs and a few neckties. There was also a black cast iron stove, and a big square table in the centre of the room, with scattered playing cards across it, and surrounding the table were boxes for the men to sit on. The bunkhouse also had lice and roaches in it! Carlson and the other ranch hands all dream of owning their own land and living and working from this, resulting in wealth and happiness. This was known as the ‘American Dream’, this is shown as an opportunity to all people no matter how rich or poor they are. There is a lot of government propaganda, informing people that if they work hard and push their ambitions to the limit, they can make this dream reality. However they all knew, no matter how hard they worked or how successful they were, it was very unlikely of this dream ever becoming reality. Their way of escaping this disappointment was to collect their fifty bucks at the end of the month and of a weekend spend all of it on women and alcohol, usually at the nearest ‘cat-house’. During the week they play cards games or horseshoes. Crooks is very lonely, this is due to the fact that he is coloured and everyone knows him as a nigger! He is treated completely differently to all the others, an outsider. He is also crippled, after a horse kicked him and severely damaged his back. In the 1930’s it was very racist in America and the coloured people weren’t allowed to speak up or were too scared to defend themselves in fear of what the white people would do to them. This is the situation Crooks is in. However he is the only coloured person at the ranch, so he has to accept all racial comments on his own. He has his own separate room, which isn’t even a room it is a shed that leans off the side of the barn wall. He is isolated from everyone else, therefore unable to socialise. On one occasion Lennie entered the barn to see his pup. He saw Crooks’ light shining and stood in the doorway of Crooks’ room. Crooks saw him and said sharply ‘†you got no right to come in my room. This here’s my room. Nobody got any right in here, but me. † He then followed with â€Å"I ain’t wanted in the bunkhouse and you ain’t wanted in my room†, â€Å"they play cards in there, but I can’t play because I’m black. They say I stink. Well, I tell you all of you stink to me. † Crooks reads to amuse himself when he has nothing better to do. This keeps his mind off of the atmosphere and situation he is surrounded by in his everyday life. Curley’s wife is perhaps one of the loneliest characters, trapped in her strict and original woman’s/wife’s role. Her daily routine only ever consists of her doing housework, such as cooking Curley’s dinner, washing Curley’s clothes, making Curley’s bed, cleaning Curley’s house, etc. If Curley catches her talking to the ranch hands he is always very annoyed by it, she is to stay in the house. She is known as ‘Curley’s wife’, no one knows her name so they cannot call her by it. One time when she enters the bunkhouse and begins to talk to the ranch hands, Crooks suggests † Maybe you better go along to your own house now. We don’t want no trouble. † It is this idea that she is ‘trouble’ that makes Curley’s wife so upset and angry. † Well, I ain’t giving you no trouble. Think I don’t like to talk to somebody ever’ once in a while? Think I like to stick in that house alla time? † Having a husband even makes her loneliness worse, because Curley is so strict about whom she socialises with and what she does. She calls him sarcastically a â€Å"Swell guy†, who † Spends all his time sayin’ what he’s gonna do to guy’s he don’t like, and he don’t like nobody. † Curley’s wife tries to escape her loneliness and sadness by dreaming of being an actress or a model. She had been offered the chance before â€Å"I tell you I could of went with shows† † An’ a guy tol’ me he could put me in pitchers†. Curley’s wife is also very good at flirting, this attracts male attention. Therefore just for a moment she is listened to and is the centre of attention, this moment matters so much to her because she is being paid attention to for once, that she makes a very bad habit of it. However the ranch hands have got used to her scheming ways and do not want to risk getting â€Å"canned† because of a â€Å"tart†. However Lennie and George are different to the other ranch hands, they may live a lonely existence, but they have each other. Other than the other ranch hands expressing their feelings about their hopes, dreams, lonely lives etc, George and Lennie are the only characters we really get to know. All other ranch hands haven’t got a family or anything to look forward to, but it is different with George and Lennie; they believe they have a future and as long as they have got each other, it doesn’t matter whether they have a family or not. These men love each other. They talk to each other and know that the other cares for them, because George looks after Lennie, and Lennie looks after George. However, George has a much greater job in looking after Lennie, than Lennie has in looking after George. Lennie is a bit of a dunce and is always forgetting things, but George has the brains. They both are physically well built, but Lennie does not realise his own strength sometimes, he is dangerously strong. Lennie is the physical side of the pair, whereas George is the mental. The fact that they have each other gives them more of a chance of success, than the other ranch hands. Lennie loves George to tell him what; one-day things will be like. Their dream is to one day buy a little house, with a ten acres, a â€Å"win’mill†, a kitchen, an orchard to grow â€Å"cherries, apples, peaches, ‘cots, nuts, and a few berries†, a section on the land to grow alfalfa that Lennie will use to feed the rabbits with, hutches and pens full with pigs, chickens, cows, goats, cats, pigeons, a dog and rabbits that Lennie could pet, a smoke house so they could kill the pigs and then smoke it, for smoked ham and bacon etc, and for them to literally â€Å"live off the fatta the lan'†. They would only work six or seven hours a day. Lennie likes to pet, smooth, soft, furry things, as a kind of comfort. Other than for George and animals, love and affection are withheld, not only from Lennie, but also for all the ranch hands. This is why they have their own individual comfort or way of escaping from the repetitive daily routine and loneliness. Candy is a dissimilar character from the other ranch hands. He is very lonely and sad. He has no hand, but a very old dog that he cares for very much. This dog is similar to Candy. They are both very old and when Carlson shoots the dog, because it smells, has no teeth, he cannot eat, is stiff with rheumatism, is nearly blind and Carlson thinks it will be better to put the dog out of his ageing misery. Candy wants people to treat him once he is canned like this. This is because he â€Å"won’t have no place to go, an’ he can’t get no more jobs†. The other ranch hands say that he can replace the dog with one of Lulu’s pups, but of course that wouldn’t be the same, never is anyone or anything the equivalent, everyone and everything is unique. Candy seems to think that when he is dead, people will say the same thing about him. When a new ranch hand comes and replaces him, he’ll be forgotten. For obvious reasons Candy is upset and hurt by this. It is as if the characteristics of his dog and the way the other men treat the dog, symbolises Candy. Candy wants to join George and Lennie in their ‘dream’. Candy has already got three hundred bucks and another fifty coming at the end of the month, when the men get paid. He explains that he â€Å"ain’t much good, but I could cook, tend the chickens, and hoe the garden some†. Then when George and Lennie get their fifty bucks each at the end of the month, they will have four hundred and fifty bucks, and although the woman wants six hundred bucks, George thinks she will accept their offer as a deposit and then George will get a job and start to collect the rest, while Candy and Lennie could work on the land as well as sell eggs etc, making more money. This is Candy’s route of escaping. Everything seems to be falling into place and their dream looks like it could become reality. This is everything a man wants and Candy is thrilled he is part of it. However much their dream looks real, it all ends when Curley’s wife tries her old tricks with Lennie. Curley’s wife enters the barn, as Lennie sits there mourning over his pup, he has just accidentally killed! George has already warned Lennie about Curley’s wife, says she is trouble, so Lennie refuses to talk to her, â€Å"George says I ain’t to have nothing to do with you- talk to you or nothing†. Curley’s wife says in a innocent voice, â€Å"All the guys got a horse-shoe tenement goin’ on†, so â€Å"Why can’t you talk to me? † She eventually persuades Lennie that it is safe to talk to her. They talk for ages and Lennie tells her how he â€Å"likes to pet nice things with my fingers, sof’ things†. She tells Lennie to â€Å"feel right here†, on her hair. Lennie was enjoying stroking her hair until she warned him not to â€Å"muss it up†. She then got angry because Lennie wasn’t listening to her. She went to pull away and Lennie clasped his fingers tightly in her hair and wouldn’t let go. She began to shout, â€Å"you let go†. Lennie began to get scared because he thought George would hear and go mad. He covered her mouth and nose to prevent her screaming, and continued to beg her to be quiet. She continued to struggle and he shook her. Suddenly â€Å"her body flopped like a fish†. She was dead! Lennie ran to the brush that George had told him to hide in when they first arrived in Soledad if he ever got into trouble. When Candy found Curley’s wife dead and told all the ranch hands, they all knew it was Lennie! Most of the men wanted to kill Lennie, but George got there first. George knew that Lennie would be scared if half a dozen men ran towards him shooting, but if George was to do it at the back of his head, just like Candy’s old dog it would be pain free. When George found him, Lennie asked for the story of their dream to be told to him and questioned George why he wasn’t mad at him, but obviously if this was George’s last moments with Lennie he didn’t want to be mad at him. As George told the story and paused every so often, Lennie would say â€Å"go on† or â€Å"Gonna do it soon† as if he knew what George was about to do and was encouraging George to get it over and done with. George finally shot Lennie. Lennie jarred forward and the settled peacefully as he lay on the sand. George just sat stiffly and silently n the bank, looking at his hand that had just pulled the trigger disgustedly. George knew it was for the best, where ever they were to go Lennie’s unrecognised strength would lead to trouble; it had already, both in Weed and Soledad. Lennie was trapped by his strength. Although, Lennie has now been released from pain by no longer being able to kill others and from not getting shot by half a dozen men cruelly, but peacefully by George. The upsetting thing is, that Lennie was so afraid of being alone and away from George, and now he was just that. It was all over!!! George is now free; he is no longer trapped by his want of freedom, of constantly looking after Lennie. I think the novel tries to give us the message that people try to lead their lives as successfully as possible, in order to result in the best possible outcome. However this is very hard to succeed. The ranch hands wanted the ‘American Dream’ to become reality, but is very unlikely and as shown does not happen. The novel gave a very positive view of the ‘American dream’, but this is erroneous and does not come true. The chances of finding true, lasting friendship and happiness are also very unlikely as it is always spoilt by misfortune, arguments, inconveniences and sometimes death, as in this case.

How the American government works Essay

In order to understand how the American government works, one must address the questions, who governs and for what purpose. However, the obvious answer may not be the correct one. Many may think that those who govern are the people or perhaps politicians. In actuality, there is no definite individual or particular group who governs. Instead governing is a process, which involves several groups (voters, candidates, parties, executive officials etc) who carry out the policies of the people by bargaining, supporting, and compromising. The purpose of those who govern is to bind society in law. The Constitution provides legitimacy for the government’s purpose, ensuring the rights of the people, as well as, protecting those who are governed from being dominated by those in power. One of the most important components of the American government is democracy. Democracy is relevant to who governs because it shows that one individual does not govern and although â€Å"the people† may elect someone, the process of getting there and the process of staying there involves other institutions that prevent too much power. Democracy involves political participation, voting, and citizen participation. Thus, one can say that every institution or individual governs in various ways and for different purposes. The American government follows Participatory democracy or representative democracy. The president is elected to serve the interests of the people. He represents the will of the majority, just as the title suggests. He is authorized to make decisions, but he alone does not have full control. In an essay concerning civil government, John Locke describes how a government functions. According to him, the only way a government can exist is when the people individually consent to the power of the government under majority rule. In order for a government to exist the people must submit to the government (if not there would be no government). The Constitution provides a similar explanation but not entirely. The Constitution creates a system of separate institutions (or branches) that share powers. The presid ent makes up the executive branch. Those eligible for voting contribute to choosing the president. The Electoral College votes also and chooses the president. The president has certain powers like being commander in chief, making treaties, etc. However, Congress and the Courts (or the legislative and judicial branches) can check his powers. Congress can refuse to pas a bill the president wants, use impeachment powers, refusing to ratify treaties, or passing laws over the president’s veto. The Courts can also check the president by declaring to be unconstitutional. Similarly the Courts can check Congress and vice versa. Each branch uses its power to help pass policies. The question of who governs is not only limited to those who fall into the category of the three branches. Several institutions of influence and monetary dominance take part in the government. Many corporations govern in their own way by funding campaigns. They use their involvement to help carry out policies that perhaps can or will benefit them. Thus, the question of who governs is vague. The Constitution focus on the 3 branches, but governing is not limited to the national government. When addressing the question to what ends or for what purpose one governs, one can say that the purpose of the government is to make decisions and laws, provide for the welfare of the people and ensure their rights. The Bill of Rights is an example of one of the purposes of the government. It states individual rights and liberties. The Constitution gives certain rights to the branches and those rights should be used for the people. Others may argue that those who govern have a special interest. It is human nature to have such instincts. However, this brings us back to the purpose of checks and balances and separation of powers. Governments govern for the majority because they represent these people (this doesn’t mean that they always serve in the best interest of the body politic). Addressing the questions is a difficult task. The answer to the question varies based on ones perspective. However the Constitution enables us to understand what institutions govern and what powers aren’t entitled to those who govern and those who are governed. Bibliography . American Government: Policies and Institutions Houghton Mifflin Company Boston 1998 Excerpts from Dahl’s Who Governs? John Locke’s Essay Concerning Civil Government

Molar Mass of Oxygen Essay

Applying the individual % of elements in Water to the molar mass Conclusion____________________________________________________________ In conclusion the experimental value of the molar mass of oxygen is. To achieve this result, we wrote the chemical reaction, compared the ratio of mole between and, find the mole produced by water using the formula, calculate the molar mass from the mol value, calculate the % of individual elements in water, and finding oxygen’s molar mass from the overall molar mass. Analysis & Evaluation ___________________________________________________ -In analysis, our results show an unreasonable result. The majority of the failure is from the volume result. From Avogrado’s law we know that. As such, because the average volume (0.051 L) was low, the mol resulting from it is also low. A small mol results in a large Mr value, or in our case the Mr of Oxygen is too high. -Another point to that is that if the experiment was assuming r.t.p, our results prove to be incorrect again. If we compared the mol, the actual mol results of andusing the ideal gas laws is different than if we calculated using normal Stoichiometry. From Stoichiometry, the actual mol of is, and if we compared it to a ratio of 2:2, the actual mol value of is also 0.138 mol. However in our experiment using the gas law, our mol result was. Again this is due to the fact of the low amount of volume recorded. -In addition to that point, from the section to: Calculate molar mass of Water using the mass of Hydrogen Peroxide , another flaw to the experiment was the amount of uncertainty in the result. From the section we apply the ‘law of conservation of mass’ stating that no mass is created or destroyed. Or in this experiment’s case, most of the mass decomposes into Oxygen gas and finally results in the volume of water displaced from the process. However as shown from the low amount of volume our group collected, this can result in two conclusions. The first conclusion is that most of the oxygen gas that eventually turns into the volume of water left is lost to the surroundings (from the test tube openings) OR the second conclusion is that our group did not wait long enough and thus lost some potential volume results. -To evaluate, the major flaw to the experiment was the value of the data collected. Part of the reason was because we used Vaseline as a tool to reduce the amount of energy (in the form of the Oxygen gas) to the surroundings. Vaseline is a good measure to do so, however a better alternative is probably to increase the number of trials, to have a more close system that may significantly reduce the uncertainties, and to maybe reduce the length of rubber tube (by reducing the length of rubber tube the amount of water left is reduced). References IB- Foundation books. Raymond Chang (pg: 87, 181, 182, 191.etc)

Discussion Questions Essay Example | Topics and Well Written Essays - 750 words

Discussion Questions - Essay Example 2006 posited that the key to leadership is ‘the discipline to prioritize and the ability to work toward a stated goal’ (p.30). Hitler was certainly able to work toward his set goal. A scenario in which this style would be best suited would be the one in which members of a community are experiencing prejudicial treatment because of the color of their skin or their ethnic background. There may be a situation where individuals from a particular community are constantly being the subject to racial attacks via the media and through face-to-face interactions. One individual can arise from the group who has the qualities of a charismatic leader. This individual can influence based on his/her charm, the majority of the community members to take a specific stand against the injustice. The charismatic leader suits this scenario because in the case of discrimination, it takes someone who would be respected and revered by all to make a difference. Not only must this individual be respected by the community in which he /she belongs but also by the community that is meting out the injustices. Change is inevitable and although people are naturally resistant to change the author of this paper believes that the following strategies as cited by Kotelnikov 2008 would be effective in dealing with dissent and resistance: An employee who refuses to change after being invited to participate in the change process and after all the above strategies have been attempted would have to be directed to another organization. This individual would only hinder rather than help the new initiatives of the organization to go forward. The length of time such an individual would remain in the organization would therefore depend on the length of time it takes to complete each of the strategies decided as best by the organization to deal with resistance to change. Musser, S.J. (1987). The determination of positive and negative charismatic leadership, Retrieved February 20, 2008 from

Analyse critically the claim that there is no caste in Sikhism. Draw Essay

Analyse critically the claim that there is no caste in Sikhism. Draw particular reference to the Valmiki and Ravidasi Communi - Essay Example On the other hand, although Guru Nanak emphasized Bhakti or devotion, it was not that of popular Hinduism to a tangible manifestation of the divine, but it was towards a formless God. Similarly, Guru Nanak rejected Hindu beliefs and practices such as the superiority of Brahmins or the Hindu priestly community, and their performance of rituals. Thus, the Sikhs began identifying themselves as a separate and distinctive religious group. Further, the early Sikhs’ requirement for an identity increased with offspring born into the Sikh faith. The Sikh Gurus denounced the practice of Hindu rituals and the prejudice of the Hindu caste system. They readily accepted into their community, the Hindus of lower caste and the â€Å"untouchables†. Thesis Statement: The purpose of this paper is to investigate the claim that there is no caste system in Sikhism. The Valmiki, Ravidasi and other communities will be examined to determine the truth of the claim. Evolution of the Sikh Religion During the first two hundred years of the evolution of the Sikh religion beginning from the mid-fifteenth century, a line of Gurus or preceptors guided the community. The Mughal empire ruling India at the turn of the seventeenth century perceived the expanding base of the Sikh community as a threat. The consequent tensions between the local administration at Lahore and the Sikhs led to the execution of Guru Arjan (1563-1606), the fifth Sikh Guru. As a result, the Sikh center was moved to the Shivalik hills in the 1630s. The tenth in line, Guru Gobind Singh (1666-1708), dissolved the position of the personal Guru, and vested the Gurus’ authority both in the Adi Granth or original book of Sikh scripture, as well as in the Panth or community (Mann 2001). An overall, uniform Sikh identity cannot be defined since the Panth has several types of Sikhs including: Punjabi Sikhs, Gora Sikhs, vegetarian/ non-vegetarian Sikhs, Mazhabi Sikhs, Khalsa Sikhs, Non-Khalsa Sikhs, Khalsa Sikhs living with Gurus, and Khalsa Sikhs with particular Sants. According to Takhar (2005: 188), â€Å"the essential core of Sikh identity must be Gurmukh oriented, the characteristics of which would be nam simran or continuously repeating the divine name, and truthful living. These would form the heart of the federal identity of the Panth as a whole, and would not emphasize the Khalsa representation. Thus, Valmikis and Ravidasis â€Å"would not fit into the federation due to their assertion of a non-Sikh identity† (Takhar 2005: 188). The Sikhs meditated on the Name (Nam) or the Truth (Sat) which denoted God’s total being. Through meditation, â€Å"the believer attained unity with God and all notions of duality disappeared as illusory† (Cole & Sambhi 1995: 7). As a result, all differentiation and distinctions based on caste or other concepts were condemned, and idol worship was opposed. Men and women of all social status were taught by Sants who wrote their devotion al poems in the vernacular. Human Gurus were not acknowledged, since God as self-communicating was their Guru. Sikhs express concern at any attempts to associate Guru Nanak with the Sants, because they fear that it would threaten the claim that the message given by God to Guru Nanak was unique. The divine revelation to Guru Nanak was that there is no Hindu and no Muslim; and only the brotherhood of man and the fatherhood of God was of significance. This reinforced Guru

The Role of Public Affairs in U.S. Military Operations Essay

The Role of Public Affairs in U.S. Military Operations - Essay Example The media has also improved the accuracy of reporting and allowed the audience to know their perspective. The benefit is especially important when there is an express need for the military to rapidly influence public opinion such as at the outset of a military action so as to mobilize immediate public support. The relationship with the media was strained during the Vietnam War but later the Department of Defense improved this relationship, which gave rise to the ‘embedded media process’. This had a positive effect on public opinion. In reality, conducting Public Affairs is a complicated task. It is a skill of the PAO to handle any kind of sensitive information and deal effectively with those who are informing and those are to be informed. The office of PA is very important in the age of real time news, and the public media has a very powerful influence and immediate effect such that army conduct can very easily have strategic consequences. This research paper begins with a brief description of the office of Public Affairs and the role of the Public Affairs Officer, and then surveys the important role of Public Affairs in US military operations focusing on how public media has had a positive influence on the US Army. However, some problems and deficiencies are also highlighted. Finally, a case study focuses on the PA and media experience in the war against Iraq. The offices of Public Affairs are important branches of the US Department of Defense that deal with the public media as well as playing a community role. They comprise of not only military officers and enlisted personnel but also civilians. The role of the main Public Affairs Officer (PAO) is to develop â€Å"a working relationship with reporters and other media representatives, maintaining a robust community relations program, keeping contact with other government agencies, and keeping†¦[its own internal members and the general public] informed on issues that may affect them† (Wikipedia,

The Liberation Of Women's Bodies In Modern China Research Paper

The Liberation Of Women's Bodies In Modern China - Research Paper Example Attitude towards foot binding varied in accordance with family status. While great families favored foot binding, lesser families often followed them in imitation (Hong 2013, p.48). The historical evidence shows that the foot binding as a custom flourished in between the 10th and the 20th centuries and many women practiced it even after it was outlawed in 1912 thinking that it would bring good suitors for their daughters. Mothers impressed upon their daughters that the mark of a woman’s attraction reside more in her character more revealed in the bind of her feet than in the face of physique with which nature had endowed her (Blake 683). A very significant thing to note that ‘Her selection in marriage was the task of her prospective mother-in-law, whose criterion for a good daughter-in-law was the discipline that the bound foot represented’ (Pruitt 22). This throws light on the fact the young women during this period were denied the right to think freely and indep endently and were under chains. Aesthetic appreciation of the small foot was the major driving force for the practice of foot binding in China; foot binding was also promoted to sustain male erotic interest and was regarded as an effective tool to maintain gender distinctions and to ethnically differentiate civilized Chinese from northern barbarians (Mackie 1996, p.1002). The proposed study is conducted on the grounds that foot binding was very common among the Chinese people for a long time and it was once regarded as a symbol of beauty. But it is evident that the foot binding caused for everlasting pain for the womenfolk and they were merely treated as a tool for sex, disregarding their individuality and potentiality as a working class.

New Paper Publishing on the Verge of Extinction Essay

New Paper Publishing on the Verge of Extinction - Essay Example In events where the newspaper is state-owned or is a mainstream medium, it is likely to be extremely centralized and as a result, requires important investment and resources. In other words, this can be heavily influenced by the government through various mechanisms and forms of control. On the contrary, the digital media is radically dissimilar in terms of its characteristics. In its implications, the new media that is; the internet can be used for both â€Å"points to mass communications as well as point to point and mass to point message distribution†. They tend to be tremendously de-centralized and require very low investment. For instance, a blogger only requires having a computer and internet connection and one is able to get the breaking news while in the house and without necessary moving out to collect the newspaper. As a result, it provides greater interactivity and public participation and is much more difficult to fall prey to control. Reflecting on the above under standing, one can deduce that critics choose the new media over the newspaper due to its benefits.In most countries, the new media which comprise of the television, the radio and the internet has gain popularity and acceptance because of the need to have free information flow. This has been given the first priority since the mainstream media that is, the newspaper is perceived to be controlled by the government. In that sense, it does not provide secretive information concerning government matters, unlike other platforms such as Twitter. The nature of the internet has made it possible for online newspaper to be in operation as it is easy to join (Mahmud, S. (2009). A case study on the country of Malaysia reveals intense changes in the media context over the past few decades. Beginning with a controlled media environment where the print media worked under an annual licensing scheme and broadcasting media were state-controlled. Malaysia

Article summary Example | Topics and Well Written Essays - 1000 words - 1

Summary - Article Example The survey listed credit rating as the second most important factor in organization’s capital structure policy decisions. The CR-CS model (credit rating –capital structure), as formulated by Kisgen illustrates that, the capital structure policy of any firm is influenced by its credit ratings (Kisgen, p1325). The model is a general description of the behavior of a subsample of firms. The appeal of the model varies systematically between firms as classified by some firm-level attributes. Those attributes are examined as follows; first, a test of the sensitivity of the active firms to the capital market participation versus inactiveness to capital market participation. Second, the sensitivity of the CR-CS model in firm’s bond ratings. Third, the effect of CR-CS motivation on firms that are active participants in the commercial paper markets as compared to the inactive firms. Last, examination of the capital structure behavior in relation to investment opportunities available (Kisgen, p1325). Reconfirming Kisgen’s findings, firms on the verge of rates change uses less debt financing margin therefore supporting the CR-CS model. However, CR-CS motivation cannot be documented to be systematically related to the attributes above. The major drawback of the model is the fact that, CR-CS model does not apply to all the rating classes. The model, as analyses indicates only holds in B-rated firms. Thus, Kisgen’s initial findings were driven by a subsample of firms with very low ratings. The usage of B-rated firms in support of the model presents a major weakness in the model. B-rated firms are associated with constant financial distresses therefore, their marginal financing behavior is influenced more by their lack of access to the debt market (Kisgen, p1331). Additionally, the model implies that, organizations on the edge of grade rating based on investment and noninvestment should be

Christian Church Art Architecture Essay Example | Topics and Well Written Essays - 750 words

Christian Church Art Architecture - Essay Example In fact, this is the building that I will attempt to effectively 'dissect' in order to ascertain to what extent it has been constructed from an amalgam of various styles as well as attempting to identify the particular styles in question. First, let us look at the details behind the design and construction of this building. The actual construction of this building began in 1851 and reached its completion some six years later. However, due to extensive damage, the building was reconstructed in the 1920s although the reconstruction remained true to the original design. The building was designed and built under the direction of Fr. John Cambiaso who was a Jesuit originating from Lyon in France. We learn that Fr. Cambiaso actually learnt the practice of architectural design during his stay in Spain and this gives us some clues behind his particular use of certain elements within the design. Because as we see from our first view of the church from the outside (fig. 1) it distinctly remind s us of those buildings that were produced under the Islamic and Moorish influences that were so predominant in the seventh and eighth centuries, especially in countries such as Persia, Egypt and Spain.(1) 2 Fig. 1 As we can see, the Moorish elements of this building are typical of how the designers let their imaginations play a little with both patterns and forms to produce designs that were almost dreamlike. However, another building that comes to mind here (especially with regards to the second level arches) is the Palace of the Doges of Venice that was built in the 14th century. It is from this that we learn that our particular church was in reality designed in a Venetian Gothic Style. It is then that we begin to notice the elements of this building that are so essential to the Gothic. In the words of the art historian Heinrich Wolfflin, we notice how in the gothic "†¦the vertical movement streams upwards without check and dissolves playfully at the top" (Wolfflin 60). We k now that the Gothic architects were particularly fond of intricate ornament and tracery and here we see examples of how, again in the words of Wolfflin, "[The Gothic] developed in the direction of ever slimmer and more pointed shapes, to a point of extreme exaggeration" (75). In fact, the Venetian Gothic Style was effectively revived during the 19th century. This revival was mainly down to the work of the British architectural critic, John Ruskin especially his book entitled The Stones of Venice (2). It was Ruskin who spoke of the lightness and soaring spaces of this style and, once inside the church, this is the first thing that strikes us. In fact, the massive height of the nave although typical of most churches in New Orleans is particularly stunning (fig 2) 3 Fig 2 The nave is lined with intricate arcading and 'triforium' windows so typically expansive enough for Gothic taste to permit huge amounts of natural light to swarm the interior. The arcading is layered on intricately de signed columns that incorporate the geometric designs so familiar within the Moorish style. There is also what is known as a Solomonic column (fig 3) that features a kind of corkscrew design. This style of column actually dates back to ancient Jerusalem and has become popularly used since because of its symbolic reference to the gates of paradise. Further adornments include chandeliers constructed of fine bronze, which again appear to be of Moorish style (fig 3). However, further

Strategic management of human resource Essay Example | Topics and Well Written Essays - 1250 words

Strategic management of human resource - Essay Example Competitive advantage in the case of employees comprises of unique talents including innovation, flexibility, high productivity, superior performance and personal customer service. These are ways employees provide critical ingredients in giving a firm an edge over its competitors in the market. HR departments can improve decision making of organisations on human capital. First HR can improve organisation’s compliance with labour law rules and regulation. HR can help improve talent management decisions with respect to how talent is selected, developed and managed. This can be done by providing unique insights about the connection between human capital and strategy and identifying key strategic success factors that facilitate attainment of organisational goals. HR should fully understand the direction an organisation is taking and should be able to provide support using competent HR tools. For organisations moving towards expansion, the HR department should create an organisation culture capable of absorbing diversified manpower with strong learning attitude as these are a necessary tool for competitiveness in the global market. For new organisations, HR strategy should focus on effective manpower acquisition and placement objectives as new organisations are inevitably driven by employee turnover both from recruitment and attrition point of view till they stabilise. The HR strategy can involve creating a more informal environment that will help build close knit teams with strong bonding between them to address attrition issues. New organisations may not be able to pay high salaries or devise reward schemes to retain manpower thus building teams with cohesive relationships will increase employee retention. Relatively stable organisations are not very vulnerable to small competition threats, and can afford to spend more time on employee development,

Ford Motor Company Analysis Report Essay Example | Topics and Well Written Essays - 3500 words

Ford Motor Company Analysis Report - Essay Example The contingency perspective has been demonstrated with the technologies that are used along with the justification of their fitness in the organisational structure. In this regard, the structural problems have also been identified and analysed. The next part of the report demonstrates the cultural aspect of the organisation assessing its goals, norms and rules and how effectively the organisational structure fits into its present culture. Lastly, the report analyses the political perspective in the company while explaining the way in which power is distributed between stakeholders and managers. The project also proposes suitable recommendations based on the analysis of the above four perspectives and identification of the challenges. The Ford Motor Company is one of the largest manufacturers of automobile products in the world. The company had initially started with manufacturing twin cylinder engines which had a potential of 20mph. Later on, the company diversified into developing o ther models. The Model-T had become particularly popular since 1909 because of its price at $850, engine size, fuel consumption and speed in the range of 40-mph. The company had confronted an economic slowdown during the Second World War, but had gradually regained its potential since then. Even amidst very stiff competition, Ford has retained the topmost position with its constant production of innovative products. The worldwide popularity of the company can be attributed to its low price, innovative styles, enhanced production and customer satisfaction (Bryant University, 2004). Analysis Bureaucratic The Ford Motor Company, which is an America based multinational automaker, is located in... This essay stresses that the company has a proper hierarchical structure in which each ones’ roles and responsibilities are clear and well defined. The rules and regulations are designed by the top management and implemented at the ground level. However, this often becomes difficult for the global organisation to incorporate. Ford is a global organisation where the business units are located at different geographic locations. This is the reason why the company has been decentralising at rapid rate. It is recommended that there should be greater decentralisation efforts from the top management. It is not easy to control the entire business from one place. Each business unit must have a specific implementation and management control. This paper makes a conclusion that the company faces problems integrating the different cultures across the different global units. As the company has globalised, the bureaucratic structure has become increasingly obsolete. In order to create a single corporate culture, it is crucial for the top management to allocate power and authority to the individual managers. They should be accountable for implementing the culture, norms and regulations in the individual business units. Maintaining a single culture from a single location would be impossible. This is where the bureaucratic structure fails. Greater decentralisation and allocation of power and authority would be the most effective method of integrating the diverse culture of the global organisation and focussing one single and common norm.

Journal of learning style Essay Example | Topics and Well Written Essays - 3000 words

Journal of learning style - Essay Example I decided to begin with a short ‘Study Skills Assessment’ questionnaire provided on-line by Columbia Basin University (Appendix 1), containing fifty-six questions; received feedback indicates that I could improve strategies used for reading as well as for concentration and memory. Thinking about this I wrote up a personal SWOT analysis in an attempt to find further evidence of my strengths and weaknesses. I found a downloadable example from Bristol Business School, belonging to the University of Western England (Appendix 2), which helped me with the questions I should ask myself. This exercise proved quite time consuming and needed much effort on my part to really think about and answer each question as fully and as honestly as I could; nevertheless I did persevere and ascertained my strengths as an outgoing, imaginative and very personable at a social level. My weaknesses include writing, especially long assignments or reports – this Journal assignment is not too difficult because it is broken into manageable sections, oral presentations and making decisions. The most useful aspect of this task was that it induced me to really think about my strengths and weaknesses, as well as any considered threats and how I intended to deal with them. Next I completed a learning approaches questionnaire (based on Approaches to Study Inventory (Tait & Entwistle 1996) and provided on-line by Bournemouth University (Appendix 3). Results indicate that I have a surface/passive approach to learning and that I tend to reproduce information and try to memorize subject matter rather than delving further or seeking to extend that information, that I keep closely to the syllabus provided by the lecturers and do not follow up interest of my own. At this point I wanted to know more, so because a discussion on learning styles is a component of this Learning Journal, I decided to spend time researching learning styles and

Assignment 1 Example | Topics and Well Written Essays - 750 words - 3

1 - Assignment Example It is the very essence and nature of human geography that informs us that the greater the distance a product or service must travel, the less likely the trip will be made. Demand must be sufficient enough to justify the time, effort, and expense. If demand for a product or service is relatively low, and there is not access to those products or services nearby, then it is likely that demand will not be met. If, however, there is a surplus of goods or materials in area that causes demand to easily be met, suppliers will look for viable transport routes to make their goods available to other markets where demand exists (Hesse 75). Finally, before we get this particular case study, it is important to understand that, no matter what the demand for a good or service may be, adequate transferability must exist. If a product is in high demand in a rural area of the world, for example, suppliers must still consider the feasibility and logistics of transporting goods there. There is the human safety to consider, plus the expense to do. If the expense involve in getting a good or service to such an area causes the demand to then weaken, it will likely be determined that the effort is simply not worth it (Zolnik 338). The issue here is whether or not sand and gravel operators in Sault Ste. Marie should begin to use their trucks to deliver their products to Southern Ontario, where prices might be higher. On the surface, businesses would always seem to desire to sell their product for the highest price possible. Spatial interaction, however, teaches us differently. Large trucks, for example, are expensive to maintain. The fuel alone makes traveling long distances cost prohibitive in many circumstances. In order for the gravel operators in Sault Ste. Marie to justify the trip down south, they must be able to account for these extra

Politics in the Caribbean and United states Intervention Essay

Politics in the Caribbean and United states Intervention - Essay Example in Caraley, 4). This egocentric approach of the US is what has prompted it time and again to get involved in the domestic matters of other nations. But the immediate reasons have been different for different regions and countries. For example, As far as the Caribbean region is concerned, it is observed that it is the â€Å"dramatic asymmetry in power† between the US and the Caribbean nations as well as the â€Å"geographic proximity† that prompted America to intervene there (Maingot and Lozano, 1). The US has been initially interested in this region so as to control â€Å"the commercial sea lanes† and also this interest was based on its policy of â€Å"dollar diplomacy† that is, â€Å"military intervention to promote and secure economic expansion† (Maingot and Lozano, 2). The importance that the US foreign policy gave to â€Å"stopping communism† was yet another reason why America often intervened in the Caribbean (Manigot and Lozano, 20). Sp ecific examples show that US annexed Puerto Rico as a full-fledged colony, established a puppet military government in the Dominican Republic, tried to overthrow many times the Cuban communist government and militarily occupied Haiti (Langley, 157). And as Caraley has observed, it can be concluded that the American foreign policy as evolved in the period of George W. Bush â€Å"is the establishment of American hegemony, primacy or empire. In the Bush doctrine, there are no universal norms or rules governing all states. On the contrary, order can be maintained only if the dominant power behaves quite differently from others†

Alien Social Scientist Essay Example | Topics and Well Written Essays - 500 words

Alien Social Scientist - Essay Example I wanted to understand why westerners spend so much time and energy on their physical grooming. What is the reason how they appear to their peers is so important for them? Therefore, in western cities like Miami which is flooded with people from a wide range of ethnicities, the residents mostly have no scarcity of basic necessities (like food) and hence have ample leisure time and money to spend towards other activities involving glamour and beauty. People in western cities like Miami try vigorously to maintain their status which often is a combination of physical appearance (even if they are obtained artificially through surgeries and waxing) and financial resources. The citizens here are motivated to keep the momentum going by looking great and acting decent. From small kids to adults, each person was willing to walk the extra mile to ensure that they attract recognition and prestige as per their respective plans (University of Alberta). I was surprised to see young people in Great er Miami so obsessed with beauty that they could spend hours in one still position without moving while applying makeup with the sole aim of the colleagues adoring their appearance. This patience is mostly observed while tattooing. Even men invest in shaving, grooming, expensive fashionable clothes, creams and cosmetic products and shoes.

Relationship-Driven Leaders Focus on People, Not Power Essay Example for Free

Relationship-Driven Leaders Focus on People, Not Power Essay My article talks about the behavioral theories, as the author discussed the new stream in leadership orientation. To be more specific, he believed that as the industry is now facing globalization and rapid change, leaders must adapt this changing landscape or risk losing high-potential employees. Younger employees prefer relationship-driven leaders and a sense of community. So in other words, they value relationships and leaders who respect their ideas and consult them on decisions. Bobbie (2010) took an example of a general counsel who successfully led a group for years before hiring a vice president to help manage a growing workload. Because this leader spent his career in the traditional model, he found it difficult to delegate work to the new vice president. The issue was not about power, but an Inability to let go and trust the new vice president to complete the work well. If the general counsel had formed a stronger personal connection with the vice president nd built trust based on that relationship, he could have empowered the vice president Instead of constraining her performance. Relationship-driven leaders are more empathetic, patient and tolerant. They approach decision-making subjectively, using personal values as a guide and examining how each option will impact others. Yet, while they are adept at listening and forging personal connections, they can sometimes appear too concerned about what others think or too weak to make tough decision. While leaders cant change their innate personalities, they can change their behavior. Adopting these best practice behaviors will enable leaders to be more effective in an increasingly diverse workplace 1. Open yourself to different viewpoints. 2. Balance empathy with strong decision-making. 3. Collaborate on issues management. 4. Champion employee development. 5. Dont mistake silence for agreement. By adopting a relationship-driven approach, leaders can earn the trust and confidence of an increasingly diverse workforce and improve long-term retention.