The Wall Street crash was responsible for the depression of the early 1930s Essay Example for Free

The Wall Street crash was responsible for the depression of the early 1930s Essay How far do you agree with the view that the Wall Street crash was responsible for the depression of the early 1930s? The Wall Street Crash was certainly a major factor in the depression of the early 1930s, as said in source 3, setting off a devastating economic collapse. However, it was not the sole reason for the depression but only a segment. The economy was rotten well before the Crash in areas such as agriculture, industry and the banking system which had far more significant consequences. The Wall Street crash was certainly responsible, to a certain degree, for the economic downturn which brought USA to its knees through the 1930s. The frenzy of unregulated speculation which had fuelled the huge stock market bubble, with stock prices far outrunning economic growth, had burst. When panic selling began investor anxious to minimize losses sold as fast as possible. This quickened the fall in share prices. As stock values plummeted with industrial stock falling by 50 per cent between September and November 1929, business confidence evaporated. The lenders, often including large banks, which had been fuelling the boom, called in their money and the market collapsed. When people werent able to repay loans to fragile banks, which lacked sufficient reserves, bankruptcies and bank failures multiplied. However, as the accredited Historian David Reynolds states; In itself the stock market crash of October 1929 was not decisive, in any case only about 1% of the population owned securities in 1929. The importance of the stock market crash was that it showed an economic future which was uncertain. As a result millions of Americans cut back on spending and new debts which caused a massive contraction in the economy as a whole, as Aggregate demand dwindled. It is certainly clear that poor health of American agriculture, which had been suffering through the 1920s and did not share in the boom, had much more responsibility for the economic depression compared to the Stock market crash. In 1929, American farmers annual income stood at an average of $273 a year, well below the national average of $750 and their hard times as well as lack of purchasing power was an important factor. The 1920s had been a period of overproduction which had driven down the price of agricultural produce; this problem was further exacerbated by the huge amounts of imports from countries such as Argentina. As, incomes fell, farmers fell behind with mortgage repayments and loans used to invest in new equipment. This was critical as much of this business had been done with rural banks with limited capital. Which were highly vulnerable to sudden large-scale withdrawals or runs. Due to hardship on the agricultural economy which had a direct impact on the rural banks, almost 5000 collapsed between 1923 and 1930. As stated in source 3, Farmers, badly off to begin with, entered a new era of adversity. Though the adversity of farmers was an important in bringing about the banking crisis, it was only a trigger, there were much more fundamental flaws exposed by the depression. As stated in source 2, at the 1920s there were 30,000 independent banks in existence in the United States which made the banking system fragile to the extreme. Unlike Great Britain, there had not been the consolidation of small banks into a few giants which could withstand an economic storm. Combined with the lack of federal regulation; were no federal deposits insurance system existed, the allowance of banks to make purely speculative loans and hold limited capital for security against shocks was an important element of the depression, and the severity of it. Though the most important reason for the economic depression is linked to the Stock market, agriculture and the banking system; the role of the federal government. It was the failure of the Republican Administrations, who embraced a free-market laisse faire economic model, to effectively control an overheating economy which caused the catastrophic downturn seen in the 1930s. As shown by its failure to regulate the banks efficiently. Also The Federal Reserve Bank kept money tight when it should have encouraged spending to stimulate economic growth. It made it difficult to borrow by maintaining high interest rates. This forced banks to call in loans and sell assets to maintain liquidity, resulting in the price of property and shares to experience renewed falls. As stated in source 1, the United states narrow-minded economic policies of protectionism, looking to secure American industries in the domestic market, limited foreign markets that could be tapped. The best example would be the Hawley smooth tariff act which effectively chocked off international trade. This is supported by source 3, which states, by the summer of 1932 imports and exports had dropped to only a third of 1929 levels. In essence the macroeconomic policies of Hoover, the president, and the republican administration were utter failures in stimulating the components of aggregate demand needed to combat the depression. Through its monetary policy of high interest rates, when low interest rates were need to encourage borrowing and spending; or its fiscal policy of rising taxes to pay for public spending, taking away money from consumers which needed to American goods for there to be growth. In conclusion the Wall Street Crash certainly contributed to the economic depression, but as D. McCoy said, it was more a trigger-one that was a symptom of deeper and more complicated causes. He was referring to crippling state of American agriculture which left millions of Americans in poverty, the fundamental flaws of the banking system which collapsed when economic pressure was applied. However, the most important reason for the depression was the failure of the Republican government. To control an overheating economy, this now was trying to correct itself, with cataclysmic consequences for the economic welfare of the average American.

Freedom Of Speech And Expression Philosophy Essay

Freedom Of Speech And Expression Philosophy Essay Critically analyze the following statement, which is often attributed to Voltaire I disapprove of what you say, but I will defend to the death your right to say it. All humans live in societies. In these societies rules of behavior are very important in order for people to treat their fellow human beings equally. These rules of behavior are commonly called human rights. Human Rights are universal and thus apply to all people on the basis of being human regardless sex, race, nationality, sexual orientation, political opinion or any other status. As Michael Douglas said Human Rights for everyone is the necessary foundation upon which all of us may build a world where everybody may live in peace and serenity and plenty.   In this course of paper we are going to examine the right to freedom of expression which has seized particular importance. This will be achieved by discussing a famous quotation which is usually attributed to Voltaire; I may disapprove of what you say but I will fight to death for your right to say it. Through this quotation we are going to see and understand the importance of this valuable right in our societies. During our discussion we should always bear in mind that none of the fundamental freedoms, including freedom of expression, is absolute. Main Body Origin of the quotation To start with, although there are more ancient precedents, freedom of expression as it is known today has its basis from the period of Enlightenment. One of the philosophers and political thinkers of that period was Voltaire, a French thinker, who believed strongly in freedom of expression and was a significant contributor to Enlightenment movement. The well known phrase I may disapprove of what you say but I will fight to death for your right to say it is widely attributed to him but it cannot be found in his writings. This can be easily understood since the phrase was firstly appeared in The friends of Voltaire written by Evelyn Beatrice Hall. Hall claimed that this phrase was an epitome of Voltaires attitude and that she has paraphrased Voltaires words; Think for yourselves and let others enjoy the privilege to do so too, in his essay of Tolerance. International standards As indicated in the introduction, the importance of the free expression as a basic and valuable characteristic of democratic society cannot be underestimated. As a result the development of international human rights system which serves as a framework for freedom of expression is of particular interest. All major human rights treaties protect this right: article 10 of the European Convention of Human Rights, article 19 of international covenant on civil and political rights, article 13 of the American Convention on Human Rights and article 9 of the African Charter on Human and People Rights. Freedom of Expression and its importance As we have seen I am using freedom of expression instead of freedom of speech since I view the latter as an umbrella that incorporates the former. Freedom of expression is wider since it includes any form of communication that is capable of conveying meaning. For example behinds including words; it is used for pictures, images, sounds, non-verbal communication etc. As Michael Jackson said The meaning of life is contained in every single expression of life. In practice, freedom of expression serves many functions which are related to each other. First of all, a classic defense of the right to freedom of expression is the one that John Stuart Mill argued On Liberty in 1859. He stated that nobody has the monopoly of truthà ¢Ã¢â€š ¬Ã‚ ¦.Anyone has the right to express their views and opinions because truth is not a monopoly term. If people disagree with minoritys opinion should use counter arguments and not suppression. As it was stated in Bose Corporation v Consumers Union  [1]  freedom to speak ones mind is not only of individual liberty but also essential to the common quest for truth and the vitality of society as a whole. Generally in Europeans court of human rights case law, it has been made clear that freedom of expression is guaranteed not only with respect to popular and favorably receivable ideas or information, but also to those that offend shock or disturb. Furthermore, its vital role in ensuring democracy is undisputable and it has been recognized by scholars and judgments of international and national courts. For example In Handyside v UK  [2]  it was stated that freedom of expression in one of the essential foundations of a democratic society and one of the basic conditions for its progress and for the development of every man and woman. As Thomas Carlyle said Every human being has the right to hear what other human beings have spoken to him. It is one of the Rights of Men; a very cruel injustice if you deny it to a man. As it was also stated in Castells v Spain  [3]  it enables everyone to participate in political which is at the core of the concept of democratic society. Philosopher Alexander Meiklejohn argues that the concept of democracy is that of self government by the people. For such a system to work an informed electorate and free flow of information and ideas is necessary. If citizens are able to exercise their righ ts effectively, their wishes would be taken into account and also tyranny, corruption and ineptitude would be restrained. This can only be achieved through open discussion, exchange of opinions in which citizens can have the opportunity to consider and debate alternative ideas. Freedom of expression is important at all levels in society but most important for government. A government which does not know how and what people feel and think is in dangerous position. When criticisms of the government are freely voiced, government has the opportunity to respond to those comments and explain its actions. Thirdly, freedom of expression is an important aspect of an individuals self fulfillment which is a desirable objective. As we all know expression is tied up with humanity since what distinguishes us from animals is the ability that we have to communicate and express our feelings. So we can understand that all people must have the opportunity to express their views; wrong or right, in order to explore and develop their own personal identity. Otherwise we would not be able to be developed both morally and intellectually as individuals and this look like a restriction of our humanity. Summarizing all these, freedom of expression has two dimensions. It has the individual dimension of not to be prevented from manifesting ones own thinking, and the collective right to receive any information and to hear expression of anothers thought.  [4]  As we can understand protection of free expression is meaningless if it does not also extend to ideas and opinions that are generally not acceptable. When citizens are unable to talk to each other, they will increasingly talk against each other, and thus will increasingly misunderstand and mistrust each other.  [5]  As we have seen in many cases of the European court of Human Rights it was said that defense of offensive opinions is one of the demands of pluralism, tolerance and broadmindness without which we can not talk about democratic society. Tolerance is integral and a basic value in our societies. Protecting unpopular opinions is itself an act of tolerance. Also John Stuart Mill supported the idea that we must active ly work against the tyranny of majority opinion. The fact that majority holds an opinion does not necessarily makes it to be true. For example, regarding decision-making we have to consider range of ideas, and a decision is likely to be better if it does not underestimate opinions, interests and needs of minority. Liberals like Voltaire encourage open verbal and written debate, free flow of arguments, free press, art etc. Generally they support that only through open discourse we can learn from others and also encourage others to learn from us. If we not value toleration for unpopular opinions, then we reject our right to live in a tolerant society. As Nigel Warburton said commitment to free speech involves protecting the speech that you dont want to hear as well as the speech that you do. This means that is not enough to express what you want but also not prevent others from doing so. Freedom of Expression and its limits (briefly) However its importance, right of expression may be subjected to some restrictions for respect of rights of other or other values. As Judge Oliver Wendell Holmes stated free speech does not allow one to shout Fire in a crowded theatre. By this he meant that good ideas are those which survive the criticisms and are allowed for further development, in contrast with bad ideas which do not survive criticisms at all. Limitations for freedom of expression may follow the harm or the offence principle. John Stuart Mill introduced what is known as harm principle, stating that freedom of expression can be restricted in order to prevent harm to others. In contrast Joel Feinberg introduced offence principle, arguing that Mills harm principle does not provide sufficient protection against the wrongful behaviors of others. He suggested that some factors must be taken into account when applying his principle. Nowadays although the wording in article 10 paragraph 2 of the European Convention of Human Rights and article 19 paragraph 3 of international covenant on civil and political rights differs, the case law has proved that limitations to freedom of expression are relatively the same in both articles. Although both articles are important we are going just to see briefly the European test. Restrictions can only be applied if they meet the three-part test made by ECtHR  [6]  . Thus they must be prescribed by law, serve a specific legitimate aim and also be necessary in a democratic society. When assessing the restrictions we must always bear in mind the test of proportionality and also each countrys margin of appreciation. Conclusion To sum up all the above, we come to the conclusion that freedom of expression is important for the growth of our species. Our world is increasingly integrated, thus we have to be mature enough to understand that such integration comes with things that we may not want to see and with ideas, opinions and views that we may not like and may not want to hear. Based on the fact that freedom of expression is the most important ability of human beings, every person should have the right to express itself. As the Desmond Tutu maintained the more we recognize people as people, the more we are recognized as people ourselves; and vice versa: the more we degrade other people, the more we debase ourselves further and further away from being fully human. Generally as what Noam Chomsky has stated in the twentieth century If you believe in freedom of speech, you believe in freedom of speech for views you dont like. Stalin and Hitler, for example, were dictators in favor of speech for views they liked only. If youre in favor of freedom of speech, that means youre in favor of freedom of speech precisely for views you despise.  [7]  However we must know that although freedom of expression is a precious gift for people it must not exceeds its limits, thus why restrictions related to this right can be easily understood. After all the above analysis I would like to close, with the main theme of this paper I disapprove of what you say, but I will defend to the death your right to say it.

Critical Evaluation of Change Managed in Practice

Critical Evaluation of Change Managed in Practice The Government has clearly outlined the need for nurses to develop leadership skills at all levels within the workforce in order to deliver the NHS modernisation programme (DH  [1]  1998; DH 1999). The leadership role expected of community practitioners is evident in Shifting the Balance of Power (DH 2001a) and Liberating the Talents (DH 2002) with the expectation that health visitors will lead teams which will deliver family-centred public health within the communities they work (DH 2001b). The change I was to lead however was not initiated primarily to support clients, but instead to protect staff working in the community to ensure they were safe and supported in their public health work as a large proportion of the time is spent working alone. The issue of lone worker safety is particularly topical after the recent murder of a mental health support worker during a home visit (BBC News 2006). To support this proposal, Baulcomb (2003) asserts that any change management initiative should not only yield benefits for patients but also for staff and the wider organisation. The Health and Safety Executive (HSE 2005) reports that nurses and other health care workers are 2.8 times more at risk of an injury  [2]  than clerical workers and the vulnerability of health care workers increases significantly if they are working alone  [3]  (Chappell and Di Martino 2000). It was a particularly pertinent time to examine mechanisms for risk reduction as they had still not been reviewed despite a member of staff being off sick  [4]  due to an adverse incident involving lone work. As health visiting frequently requires lone work, it was clear that lone working practices needed reviewing to reduce the likelihood of a similar or more serious incident recurring. Further drivers for change were identified as a result of observations of workers in practice. I noted the following areas of concern: up-to-date whereabouts of staff not always provided (or out of date) and a lack of a reporting-in system which would identify whether staff had finished work safely for the day. I discussed these issues with the community nursing manager who wholly supported any attempts to introduce mechanisms that would improve lone worker safety. A further driver for change was the obligation to implement health and safety legislation. Due to limitations in report length, this information has been provided in Appendix One. If changes are to be implemented which lead to increased worker safety, this will have a positive (although indirect) effect on clients because if staff feel safer and more supported in their roles, they will be less likely to be off sick with stress or injuries (Mahony 2006) which would impact on the teams ability to deliver the public health agenda. As workers who contribute to the implementation of health and safety measures are known to be healthier and safer than those who do not (HSE 2005), it was felt that this would be an appropriate area for the team to examine and implement change. It was after consideration of these anteceding factors that the need for change was established and a vision created: To improve the safety of lone workers within the health visiting team. Implementing the change was a dynamic and multidimensional process with many facets too abundant to detail fully here, however pertinent examples will be selected and analysed. The following study will detail a reflective evaluation of my application of leadership and management theory to effect a change in practice. The successes and difficulties encountered will be given throughout with reference to the literature. Change management requires well-developed leadership and management skills (Marquis and Huston 2000). A combination of these skills is necessary to ensure that the job is done not only efficiently, i.e. new mechanisms are put in place and embedded into the teams practice (the management dimension) (Stewart 1996) but that it is achieved in such a way that motivates and inspires staff to change their practice- the leadership dimension (Stewart 1996). To guide the changes, a change management model was selected. Deegan et al (2004) report that such models provide a theoretical sequence, which will be instrumental in helping the change manager to choose, develop, and order activities which are required during planned change episodes. As the change was planned (as opposed to emergent), a suitable model was Lewins three-stage model of planned change (Lewin 1951)  [5]  . The use of this model in the National Health Service (NHS) is widely documented and has underpinned the successful changes in many of the research papers read  [6]  . It is also a simple model which is not overly prescriptive and so does not restrict individual practitioner creativity (Cameron and Green 2005). The three stages of planned change according to this model are: unfreezing the existing equilibrium (Unfreezing); moving to a new point (Movement) and refreezing the changes into practice so that they become embedded in practice (Refreezing). My change management project is currently part way through the Movement stage as the change has not been fully implemented or evaluated yet I continue to lead this project  [7]  . Lewin (1951) suggests that in the changes preliminary stage, factors which will drive or resist the change should be identified. This process is known as Force Field Analysis (FFA) and will identify the change enthusiasts, the potential objectors and the undecided (Turner, 2001) (see Appendix Three for the FFA carried out at this stage). Lewin (1951) asserted that change occurs as a result of a shift in the equilibrium between the opposing forces (those which resist change) and the driving forces and is thought to be more likely to occur successfully if restraining forces are removed rather than by simply increasing the driving forces. Hussey (1998) exercises a word of caution at this juncture warning that an increase in the driving forces may lead to an increase in the restraining forces, however if the driving forces outweigh the restraining forces, there is a positive climate for change (Cameron and Green 2005). After analysing the force field I could see that the driving forces o utweighed the resisting forces and so confirmed that the change was needed and realistic. Leaders motivate their staff by inspiring vision and encouraging followers to share in that vision (Bennis 1997, Davidhizar 1993) and like in Kassean Jagoos study (2005), the unfreezing stage was initiated by facilitating peoples thoughts on the current situation (Greaves 1999)- stimulating ideas for how to change the current situation  [8]  . As people can only be empowered by a vision that they understand (Sheldon and Parker 1997), it is paramount that strategies are used to foster inclusion and participation so that all team members are fully aware of the impetus for change. For change to be successful and enduring, Kouzes and Posner (1987) say that it is imperative that the leader encourages team ownership of the vision by encouraging their participation in the project. Without participation failure is likely to result due to resistance from team members. It is vital to the success of the change that it is perceived to be needed by those that will be affected by the change ( Marquis and Huston 2000) and so to raise awareness of the issue and create dissatisfaction with the current state (Lewin 1951), I introduced my ideas at a team meeting. On reflection, I can identify aspects of transformational and situational leadership in how I shared my ideas and interacted with the team. Most team members agreed that risks to lone working needed to be reduced and willingly offered their ideas (see Appendix Four). Encouraging team input and facilitating problem solving are key features of the supportive behaviours exhibited by the situational leader (Northouse 2004). Situational leadership was developed by Hersey and Blanchard (1977) and assumes the leader adapts their style according to a given situation  [9]  . This style has two main types of intervention: those which are supportive and those which are directive. The effective situational leader is one that adjusts the directive and supportive dimensions of their leadership according to the needs of their subordinates (Northouse 2004). As most team members were highly motivated in the project, freely offering suggestions and ideas, a directive role was not needed. The supportive behaviours I employed encouraged a participative approach characterised by the use of finely tuned interpersonal skills such as active listening, giving feedback and praising (Marquis and Huston 2000) which can be likened to a Skinnerian approach of positive reinforcement. In retrospect I can identify my correct use of this leadership style by looking at a later development of this model which introduced a further dimension to the leadership style: the developmental level of the participants. This is ascertained by assessing workers competence and commitment to completing the task. The member of staff that appeared to take little interest and was not able to offer ideas displayed a lower developmental level compared to other team members and hence I directed her more using the coaching behaviours advocated by Hersey and Blanchard (1977). This coaching promoted inclusion and participation by: giving encouragement, soliciting input and questioning the participant on what they thought of the proposals and the changes they would like to see. This was done to increase levels of commitment and motivation (Northouse 2004) and thus integrate that team member into the change process. On reflection this can also be identified as an example of reducing the resist ing factors to the change within the force field as by adapting to the needs of that team member, she was encouraged to take part and share ideas rather than hinder progress and potentially thwart the change. A model which places great importance on the needs, values and morals of others is transformational leadership (Northouse 2004; RCN 2005) and elements of this could be identified in my leadership. The needs of staff could be regarded as the need to stay safe, and values may be their desire to get home to their families at the end of the day. I was aware that on face value, looking at improving safety for lone workers would perhaps not appear to be an issue that would provoke much excitement, or according to Kotter (1999) light a fire. However, I articulated my vision in terms of getting people to consider the impact of what the consequences could be if we were to be a victim of an adverse incident. When discussing the impact of this with staff and getting them to consider the impact of not changing practice, of how their lives and their families lives could potentially be affected, I created motivation within the team to examine working practices. This was confirmed to me as many of the staff showed their interest by their offering of ideas to meet this challenge. By tapping into the moral dimension of a proposed change i.e. promoting the need to contribute in order to protect the safety of not just themselves but also the wider team, the transformational leader further inspires staff to change by motivating followers to transcend their own self-interest for the sake of the team and organization (Bass 1985). Once the vision had been shared and accepted by the team, several strategies were discussed that could contribute to risk reduction (Appendix Four). At this stage it was realistic to focus on a single change. A reason for this was because McIntosh (2000) highlights that many changes focus on the needs of the organisation (e.g. to provide certain services or to implement Government policy) and often overlook the needs of the employees. Applied to this case, there was an organisational need to manage risk but this had to be balanced with not overwhelming the team with too many changes at once  [10]  . At the meeting it was decided by the team members present  [11]  that the simplest intervention to implement would be to phone into the clinic base administrators when finishing their shift to notify that they had finished work for the day and were safe  [12]  . Although the proposed change would not eliminate the risk of an adverse incident occurring, it would ensure that should an incident occur, it would be identified and acted upon as swiftly as possible and thus the risk would be managed more effectively. Vroom and Yetton (1973) propose five types of considered decision-making ranging from that which may be expected of an autocratic manager i.e. a decision is made by the leader entirely alone, through to a democratic approach whereby the matter is discussed with the whole team and a consensus decision is made. When analysing my own management stance it was clear that my style had been distinctly democratic as I had sought to include everyone and promote consensus decision-making. I demonstrated sensitivity and appreciation of the pressures that others were under by ensuring that those not present at the meeting were included in the decision-making process as open consultation with key stake holders often leads to the successful introduction and adoption of change (Phair and Good 1998, cited in Deegan et al 2004). This contributed to creating a climate of a learning organisation. A learning organisation is one where all members are encouraged to increase their capacity to produce resul ts they care about (Karesh 1994) and one which promotes the exchange of information between members in order to create a knowledgeable workforce. I was determined that those who could not attend the meetings still be part of the decision making process. However there were difficulties with this as due to being in practice just two days a week meant that it was unrealistic to consult each absent worker individually and so I emailed out meeting minutes from the meeting and invited feedback  [13]  . Although the use of email to communicate ideas is one of the least popular ways to receive information, it was one of only a few methods available to me and hence justified its use. Without using this medium, communication with the team would have been compromised and could have led to some team members feeling they had been excluded from the decision-making process. Further analysis of this point reveals my own concern that all the follow up and meetings needed to be done by myself whe n perhaps this could have been delegated to someone else. With regard to situational leadership, if team members are motivated and committed to the change, the leader can assume a more passive role where they let team members take responsibility for doing the job and refrain from giving unnecessary support (Northouse 2004). This perhaps reveals Theory X management style traits (McGregor 1960) whereby the manager feels the need to keep a tight grip on staff perceiving them to need coercion to achieve tasks, deeming them to possess little capacity to explore and solve problems spontaneously without direction. This approach may convey distrust of the team (McGregor 1960) and was therefore not an ideal management style in the actual situation I was in. Rather than viewing this as a weakness however, it must be viewed as an opportunity to explore my assumptions of the team, assessing whether my assumptions had any grounding in reality or whether this style was assumed due to my inexperie nce leading and hence insecurities about the role. Reaching a consensus on the change to implement was an example of how in situational leadership, decision-making can be shared between the leader and motivated followers (Hersey and Blanchard 1977). From a management point of view, this participative approach facilitates the process of completing the task but it is also an example of how leaders empower their teams by transferring some of their power to the follower to enable them to be active participants in the decision-making process. After confirming the change intervention, the safety plan was devised (see Appendix Six). This was a contingency plan detailing the steps to take should a team member fail to report in. The team agreed that I should draw this up due to my previous experience of using one. As the manager is responsible for ensuring a task is completed on time and is done efficiently (Stewart 1996) there was no reason for this task to be delegated elsewhere as this would have taken up time and hence been an inappropria te use of resources. During the movement stage, I positively reinforced the importance of the change by acting as a role model. Role modelling is a key feature of transformational leadership whereby the leader demonstrates specific types of behaviours that they want their followers to adopt (Northouse 2004). Stewart (1996) also reports that the greatest power as a leader is the example that you set (p.25) and so I did this by ensuring that I implemented the proposed changes i.e. I always reported into base on finishing work even before the agreed implementation date. The change is currently in the latter stages of the Movement phase with implementation and evaluation still required to complete the phase  [14]  . Refreezing is the final stage of Lewins model and involves the change agent (myself) supporting staff to integrate the change into practice so that it becomes part of the status quo (Marquis and Huston 2000) ensuring that over a period of time everyones practice changes and there is no chance of reversion to former ways. A strategy for the future development of the change and to conclude the refreezing stage would be to carry out an evaluation to determine the changes effectiveness. A summative (or outcome evaluation) could be conducted to investigate: whether the intervention is effective in reaching planned goals; what happens to the participants as a result of the change and whether it is worth continuing with the change intervention (Robson 2003). The first question could be assessed by carrying out a risk assessment of the hazards faced by lone workers including strategies in place to reduce risk. The HSE (2005) detail a five-step risk assessment guide that can be carried out to assess the extent of risk post-intervention. Ideally a risk assessment should have been carried out in the unfreezing stage and thus provide a baseline to compare against. Another strategy to obtain objective data would be to keep a copy of all reporting-in records which should identify those failing to report in  [15]  . Although this appears to be a policing measure which may imply distrust for staff (typical of a Theory X manager, McGregor 1960), it may be the only way of conclusively being able to tell if people are actually putting the new change into practice. If an audit of these records revealed certain team members were not engaging in the process and were having to be chased by administrators to ascertain whether they had finished work safely, I would use responsive leadership skills incorporating effective interpersonal communication to work with these staff members to identify what the problems and issues were. It is vital that this is done as if ignored these resisting factors could impede the change and failure could result (Hussey 1998). A key goal of refreezing is supporting those involved so that the change remains in place (Marqui s and Huston 2000) and so this audit may reveal those who need further support  [16]  . The change detailed in this case study has first and foremost considered the needs of the employees (i.e. to be safe in their lone work) yet has many benefits for the wider organisation and staff: potentially decreased litigation due to decreased adverse incidences affecting staff, increased recruitment and retention due to the organisations increasing attractiveness as a supportive employer and many more. This highlights effective use of a combination of leadership skills to inspire and motivate staff coupled with the ability to function in a management capacity by directing changes necessary in order to meet the organisations requirements (Marquis and Huston 2000). Change management requires well-developed leadership and managerial skills (Marquis and Huston 2000). However as a student health visitor many of these skills were far from being well developed and rather than use and manipulate models as I went along, elements of models such as transformational and situational were recognised retrospectively. However in doing so my knowledge of the theoretical underpinning has been developed and consolidated arming me with a plethora of skills to draw on in future. Northouse (2004) states that leadership style refers to the behaviours shown by an individual who attempts to influence others. I felt this was a daunting task as in my student role I felt very much the subordinate as opposed to the leader. However, Government papers such as Making a Difference (DH 1999) stress for the need to develop leadership at all levels meaning it is not an activity reserved for the upper echelons of an organisation (Garvin 1996). I found it hard at times to reconcile the requirement to develop leadership skills with the need to embrace evidence-based practice as the two often clashed due to the fact that there is little empirical evidence of the effectiveness of many leadership models (Northouse 2004) including those I used. To further illustrate this point Wright and Doyle (2005) conclude it is impossible to say how effective transformational leadership is with any degree of certainty and it is not possible to say here that another approach would have been more effective without trying it. Northouse (2004) also criticises other models of leadership including situational leadership, and questions their validity commenting that they are under-researched and with few published research findings. I had not viewed myself as a born leader and coupled with my student status, I felt nervous embracing a leadership role. Marriner-Tomey (1996) however asserts that leadership skills can be developed over time, indicating that skills can indeed be learnt, dispelling the myth that leaders are born not made. This provides me with reassurance that with further experience of leading in practice, along with a deeper knowledge of leadership theory, I may become a more effective and inspiring leader. References Bass, B. M. (1985) Leadership and Performance Beyond Expectation. New York, Free Press. Baulcomb, J. (2003) Management of change through force field analysis. Journal of Nursing Management. 11. pp. 275-80. BBC News (2006) Man held as charity worker killed. News item [Internet], BBC. Available from: [Accessed 20th May 2006]. Bennis, W. (1994) On becoming a leader. NY, Perseus Press. Burns, J.M. (1978) Leadership. New York, Harper Row. Cameron, E. and Green, M. (2005) Making sense of change management: a complete guide to the models, tools and techniques or organisational change. London, Kogan Page. Chappell, D. and Di Martino, V. (2000) Violence at work. 2nd ed. Geneva, ILO. Davidhizar, R. (1993) Leading with charisma. Journal of Advanced Nursing. 18. pp. 675-9. Deegan, C., Watson, A., Nestor, G., Conlon, C. and Connaughton, F. (2004) Managing change initiatives in clinical areas. Nursing Management. 12 (4), pp. 24-29. Department of Health (1999) Making a Difference: strengthening the contribution of nursing, midwifery and health visiting. London, HMSO. Department of Health (2001a) Shifting the balance of power: securing delivery. London, HMSO. Department of Health (2001b) Health visitor practice development resource pack. London, DH. Department of Health (2002) Liberating the talents: helping PCTs and nurses deliver the NHS Plan. London, HMSO. Elkan, R., Kendrick, D., Hewitt, M., Robinson, JJA., Tolley, K. and Blair, M. (2000) The effectiveness of domiciliary health visiting: a systematic review of international studies and a selective review of the British literature. Health Technology Assessment. 4(13). Garvin, J. (1996) Leadership and nursing: traditional attitudes and socialisation. Nursing Management. 3 (3). pp. 20-22. Greaves, C. (1999) Patients perceptions of bedside handover. Nursing Standard. 14 (12). pp. 32-5. Health and Safety Executive (1974) The Health and Safety at Work Act. London, HMSO. Health and Safety Executive (2005) Work related violence: lone workers. [Internet], HSE. Available from: [Accessed 26th April 2006]. Hersey, P. and Blanchard, K. H. (1977) The Management of Organizational Behaviour. 3rd ed. New Jersey, Prentice Hall. Hussey, D. (1998) How to be better at managing change. London, Kogan Page. Karash, R. (1994) Learning-Org Dialog on Learning Organizations. [Internet]. Available from [Accessed 22nd May 2006] Kassean, H. and Jagoo, Z. (2005) Managing change in the nursing handover from traditional to bedside handover- a case study from Mauritius. [Internet], BMC Nursing. Available from: [Accessed on 2nd April 2006]. Kotter, J. (1999) John P. Kotter on what leaders really do. Boston, Harvard Business School. Lewin, K. (1951) Field Theory in Social Science. New York, Harper Row. Mahony, C. (2006) Risk reduction. [Internet], Nursing Times. Available from: [Accessed 14th May 2006]. Marquis, B. and Huston, C. (2000) Leadership roles and management functions in nursing: theory and application. 3rd ed. Philadelphia, Lippincott. McGregor, D. (1960) The human side of enterprise. New York, McGraw-Hill. McIntosh, N.D. (2000) Implementing clinical education for phlebotomists.Nursing Standard. 15 (1). pp. 43-6 National Audit Office (2003) A safer place to work: Improving the management of health and safety risks to staff in NHS Trusts. [Internet], NAO. Available from: [Accessed 26th April 2006.] NHS Institute for Innovation and Improvement (2005) Working with groups: improvement leaders guide. Coventry, NHS. Northouse, P.G. (2004) Leadership theory and practice. 3rd ed. London, Sage. Peters, T and Waterman, R. (1998) Re: planned change. [Internet], Shropshire and Staffordshire Workforce Development Confederation. Available from: [Accessed 15th April 2006.] RCN (2005) Transformational leadership processes. [Internet], RCN Practice Development Institute. Available from: [Accessed 1st May 2006]. Robson, C. (2003) Real world research. 2nd ed. Oxford, Blackwell. Selby York Primary Care Trust. (2004) Lone worker policy. York, SYPCT. Sheldon, L and Parker, P. (1997) Leadership and team building. Nursing Management. 4 (2). pp. 24-5 Stewart, R. (1996) Leading in the NHS: a practical guide. 2nd ed. Wiltshire, Macmillan Business. The Suzy Lamplugh Trust. (2005) Personal safety at work: guidance for all employees in the workplace, working off-site and travelling for work. UK, SLT. Turner, L. (2001) Introducing a medical emergency team. [Internet], Nursing Times 97 (40). Available from: [Accessed 14th May 2006.] Vroom, V. and Yetton, P. (1973) Leadership and decision-making. Pittsburgh, Pittsburgh Press. Wright, M and Doyle, M (2005) Classical leadership. [Internet]. Available from: [Accessed 26th April 2006]. Bibliography: Alexis, O. (2005) Managing change: cultural diversity in the NHS workforce. Nursing Management. 11 (10), pp. 28-30. Handy, C. (1999) Understanding organizations. 4th ed. London, Penguin. Home Office. (2005) Research development statistics: violence at work. [Internet], Home Office. Available from: [Accessed 26th April 2006]. Maslow, A.H. (1954) Motivation and personality. New York, Harper Row. Mayhew, C. (2003) Occupational violence: a neglected occupational safety and health issue? Policy and Practice in Health and Safety. 1 (1) pp. 31-58. NMC (2004) Standards of Proficiency for Specialist Community Public Health Nurses. London, NMC. Percival, J. (2005) Inspire the team. Nursing Standard. 19 (34), p. 71. Reporting of Injuries, Diseases and Dangerous Occurences Regulation (RIDDOR) website. [Internet]. Available from: Appendices APPENDIX ONE Health and Safety Legislation in Practice. The Lone Worker Policy (SYPCT 2006) in my practice area is heavily influenced by the Health and Safety at Work Act (HSE 1974) and the Health and Safety at Work Regulations Act (HSE 1999 cited in SYPCT 2006) which stipulate the duties of the employer  [17]  and the employee  [18]  . The more recent legislation requires employers to assess the nature and scale of any workplace risks to health and ensure there are proper control measures to reduce or eliminate risk. Although the policy encompasses the relevant legislation and raises awareness, its aims are particularly broad and apart from indicating particular training, there are few suggestions of good practice to help staff understand exactly how they can take reasonable care. It was also evident that although Lone Worker safety training was mandatory, fewer than half of the members of the team had accessed this within the l

The One Child Policy and Gender Inequality Essay -- chinese culture,e

Given the high sex ratio in recent China population report, the abnormally excessive male birth exemplifies the persistence of son preference on women’s fertility behavior. Son preference rooted in Chinese agriculture-based economy and historical feudalism, in consistence with the reliance on laborers and continuing the family line. Older people prefer to depend on their sons to get financial and physical support, while daughters are regarded as property of their husband’s family since the day of marriage. However, the wish of having multiple children, especially boys, was challenged by the strict One Child policy in 1979. The One Child policy, also known as Family Planning policy, was implemented across the country as one of fundamental national policies under the administration of Population and Family Planning Commission. Based on the purpose of lowering fertility rates to ease social pressure and improve living standard, a married couple is only allowed to have one child with some exceptions made for some ethnic minorities and rural families. The majority of citizens are classified by ethnics and occupations to fit the specific regulations of compensations and punishments to prevent them from having a second child (Li, J., & Cooney, R, S. 1993). This proposal eventually triggered a profound introspection which chronically melted patriarchal cultures. The broad topic of how government’s decisions altered social norms is discussed within five sociological studies in my essay in allusion to the impacts of One Child policy on gender inequality. Key questions Gender inequality involves ideological preference and physical loss of equal opportunities to gain. The five articles examined the indirect effort of One Child policy on... ...onal Journal of Educational Development, 5, 474-486. Li, J., & Cooney, R, S. (1993). Son preference and one child policy in china: 1979-1988. Population Research and Policy Review, 12(3), 277-296. Liu, F. (2006) Boys as only-children and girls as only-children—parental gendered expectations of the only-child in the nuclear Chinese family in present-day China, Gender and Education, 18(5), 491-505 Merli, M. G., & Smith, H. L. (2002). Has the Chinese Family Planning Policy been successful in changing fertility preferences?. Demography, 39(3), 557-572. Ming,T., & Lynne,R. (2002). The only child and educational opportunity for girls in urban China. Gender & Society, 16(1), 74-92. Zhai, F.,&Gao, Q. (2010). Center-based care in the context of one child policy in China: Do child gender and siblings matter?.Population Research and Policy Review, 29(5), 745-774.

Octopus :: essays research papers

Recently, researchers have discovered the existence of an extremely unique type of octopus. The species, known as the Indo-Malayan octopus, has the ability to alter its shape, form, and color pattern to mimic or imitate other sea creatures in order to avoid predation (2). The discovery of the mimic octopus is noteworthy because no other type of cephalopod is known to have impersonation abilities. The octopus is also not limited to one imitation. Researchers have observed up to eight different formations. The alternations occur depending upon the appetite, surrounding environment, and proximity of predators the octopus encounters (1). In analyzing the formations, behaviors, and predators of the mimic octopus, it is important to isolate the origins of this exclusive, and highly intelligent defense mechanism. Is this means of protection or evolutionary development, one that allows the cephalopod a better means of survival? Or is this the result of observed behaviors where the mimic oct opus becomes aware of the relations occurring in the environment, and successfully imitates a species based upon their ability to subsist when dealing with dangerous predators? The existence of mimic octopi is restricted to the islands of Indonesia, specifically off the coasts off Solawesi, and Bali (3). Surprisingly, the octopi have been viewed during the daylight hours, generally residing near sand tunnels, and holes (1). The octopi enjoy these mounds because they provide a significant source of food, including small worms, fish, and crustaceans. The octopus utilizes its arms to feel for prey, and then captures the food through the use of expanded webs. However, when the animal is attempting to hide itself from possible enemies, the Indo-Malayan octopus can transform itself into a variety of organisms, including fish, sea snakes, and anemones. If the octopus observes a cluster of damselfishes, it will change into a lionfish by swimming above the ocean floor, with arms extended beyond the body (2). The lionfish is known to possess poisonous spikes, which successfully deter the damselfish from preying upon the mimic octopus. Another possible transformation includes the sole fish. The octopus is able to propel itself in a similar manner by forming a leaf-shaped arm that moves it across the ocean floor effortlessly. The octopus's arms are also useful in impersonating the sea snake. Two arms are waved around to appear like a pair of snakes, while the other six are hidden from view. The octopus also changes its color and creates yellow and dark bands across the exposed arms.

Product Launch Plan -Team-Mkt 571

Altadena Computer: Product Launch Plan Team X MKT 571 Altadena Computer: Product Launch Plan Product Description Product Positioning Targeting Market Needs In 2009 approximately 870,000 full-time students were attending Canadian universities. The highest percentage increase of enrollment for undergraduates was in British Columbia (6. 4%) and the highest percentage increase of enrollment for graduate students was in Prince Edward Island (38. 1%) (AUCC. ) With so many students, Altadena Computers has a large base to target and market their special brand of customized laptops. Because of to the economic downturn the prediction in Canada reflects more people returning to college to increase their job marketability. In 2009, an increase of 4. 1% in undergraduate programs and an increase of 7. 2% in graduate programs validate the predictions. Altadena aims to provide quality merchandise that lasts longer than a few years, replacing the laptop will not be a concern for the student. Altadena employees rely on the students to guide them in designing the perfect laptop. Channel Strategy Market Potential Below is data collected by World Bank of Internet user percentages for United Kingdom and Canada. The trend of Internet use has significantly increased, doubling in the past decade. In 1990, domestic and international Internet usage was merely nonexistent and has steadily progressed past the year 2000. In 2007, Canada’s Internet usage inclined to 72. 8% while the United Kingdom ascended at 71. 7% and is steadily increasing into 2008. {draw:frame} Case # 1 – Domestic Location – Canada In 2007 Canada’s population reached 33. 0 million. Using the population data, Altadena Computers can estimate potential buyers within Canada. Internet percentages will be valuable in determining the average annual consumption and a measureable selling price of $950 per laptop. This price may be considered an expensive pecuniary; however, Altadena Computers must realistically visualize price and profits of the investment. At a selling price of $950 per laptop, customer base of 3,300,000, and an annual consumption of 10 percent of Internet users, 7. 28%, Altadena Computer’s market potential is calculated at $228,228,000. Case #2 – International Location – (United Kingdom) SWOT Analysis (Canada & England) SWOT Analysis (Canada & England) Threats and opportunities are equally justifiable. Yes, Altadena Computers may be a new player in the game but that does not determine a disqualification for Altadena Computers. This only symbolizes a significant role on behalf of Altadena Computers to orchestrate diligence and effective market strategies to compete with existing and forthcoming competition. Currently, management anticipates threats because of increasing competition, transportation costs, pecuniary regulations enforced by the government, and demographic shifts in the market. However, as there are threats, opportunities also exist. Altadena Computers does more than provide college students with cost effective, premium service laptops, Altadena Computers is providing essential tools and contributing to society’s development. Consider Canadian Internet usage in 2008. According to the Publications section of the World Fact Book, â€Å"Internet usage in 2008 was 25. 086 million users from a population of 33. 487 million residents. † Most Internet users are â€Å"educated† meaning they have at least an undergraduate degree. Therefore, it is imperative that Altadena Computers provide this service to college students because laptops are in high demand for students. Competition In a market of such magnitude, competition is expected to be fierce and strong. Dell, Hewitt Packard, Wal-Mart, MicroCenter, and Fry’s are some of the few dominant competitors in the industry. With the exception of Dell Computers, conveniences these businesses present are their ability to showcase products and provide instant gratification. Customers can assess the product and leave with their merchandise. Although instant gratification is necessary for some consumers, not all customers require their product instantly. Some would prefer to build their laptop necessities and incur offering provided by Altadena Computers. The logic here is not to dismiss the competition; for the possibility of that occurring is relatively short lived. Altadena Computers is a new and emerging business in the industry. Many lessons can be learned that can be applied that were previously encountered by the competition. Marketing Objectives and Strategy Pricing Market Communication: Canada and England Communication in marketing channels can serve as the process by which influential information is conveyed, shared decision making is encouraged, programs are created, power is put into effect and commitment and loyalty are built. Communication is the bond that holds together channels of distribution. Marketing communication builds awareness of a business, its products and the business’s position through customer interaction materials such as brochures, press releases, web sites and other forms of direct, indirect and interactive marketing. Marketing communication represents the â€Å"voice† of the brand and is one way to establish a dialogue and build relationships with consumers (Kotler & Keller, 2007, p. 279). Altadena Computer Company must have an in-depth understanding of the company’s target audience and the process of buying, selling, and communicating to customers. Marketing communications are the means by which firms attempt to inform, persuade, and remind consumers—directly or indirectly—about the products and brands they sell (Kotler & Keller, 2007, p. 279). The marketing communication mix consists of six major modes of communication (Kotler & Keller, 2007, p. 279): Sales Promotion is short-term incentives to encourage trial or purchase of a product or service. Public relations and Publicity are programs promoting or protecting company or product image. Direct marketing is the use of mail, telephone, fax, e-mail, or solicit response or dialogue from specific customers and prospects. Personal selling is face-to-face interactions with prospective purchasers for the purpose of making presentations, answering questions and procuring orders. Publicity: Canada and England Distribution Strategy: Domestic and International A distribution strategy describes how a business will generate and persuade demand for a product or service. Distribution Strategy involves shifting products for point of formation to points of utilization by the end user, in a cost-effective method. Distribution strategy will identify how a business will manage the brand. Distribution strategies come is various forms: (1) manufacturer ? consumer, (2) manufacturer? retailer? consumer, or (3) manufacturer? wholesaler? etailer? consumers. The process can involve longer channels including agents and brokers Types of Distribution Channels Canada and England Distribution Strategy The primary distribution for Altadena Computer domestic and international customer will be manufacturer to customer. The customer will have access live assistance to make orders and ask questions, through the Altadena Computer website or with a customer service representative that has the knowledge and ability to service Altadena Computer customers. Altadena Computers Distribution Strategy Altadena Computers must take advantage of the distribution opportunities. For example, gaining permission from domestic and international educational institutions to place brochures in the building were students have access to the information. Another distribution opportunity is setting up a demonstration area at domestic and international universities and colleges to provide information and a glimpse at the product to the potential customer. Customers preferring to buy online will have to fulfill orders and allow Altadena Computers to sell directly to customers. Customers can also engage in another distribution strategy with Altadena Computers specialized customer service representatives to close deals. Altadena Computers distribution program will focus on the needs of the customer. Financial Information Market Research Conclusion References Association of Universities and Colleges of Canada (2009. ) Retrieved March 7, 2010 from http://www. aucc. ca/publications/media/2009/enrolment_10_22_e. html https://www. cia. gov/library/publications/the-world-factbook/geos/ca. html https://www. cia. gov/library/publications/the-world-factbook/geos/uk. html Common Wealth (2009) United kingdom. opulation. Retrieved 3-7-2010 http://www. thecommonwealth. org/YearbookHomeInternal/139560/ Kotler, P. & Keller, K. (2007). A Framework for Marketing Management (3rd ed. ) New Jersey: Pearson-Prentice Hall. Kotler, P. and Keller, K. L. (2006) Marketing management (12th Ed. ) New Jersey: Pearson- Prentiss Hall. Statistics Canada (2009) Population and demography. Re trieved 3-7-2010 http://www41. statcan. gc. ca/2008/3867/ceb3867_000-eng. htm World Bank, World Development Indicators (2010) Internet_ users as percentage of _ population. Retrieved 3-7-2010 http://www. google. com/publicdata

Diabetes Mellitus Philippine Callcentre Staff Health And Social Care Essay

The outsourcing industry is presently a turning tendency in the Philippines supplying employment chances for many immature professionals. The Filipino outsourcing industry has grown 46 % yearly since 2004 ( Rivette, 2010 ) and is presently stand foring 21 % of the $ 7.2 billion of entire Business Process Outsourcing ( BPO ) grosss worldwide. With the addition in BPO employment chances, more and more immature Filipino professionals are using for and working as call centre agents. Approximately 400,000 Filipinos are already employed as call centre agents ( Rivette, 2010 ) and with a growing rate of 46 % yearly, it can be estimated that another 200,000 Filipinos will be fall ining this work force following twelvemonth. However, despite the economic benefits of the enlargement of BPO in the Philippines, an addition in work-related diseases in call centre companies have besides been reported. The most researched work-related disease in call centres in the Philippines is on sexually transm itted infections, peculiarly HIV-AIDS. Harmonizing to the survey done by the UP Population Institute ( 2010 ) , 20 % of male call centre agents are commercial sex workers while 14 % of them give payment in exchange for sex. The survey besides showed that 1/3 of call centre agents have had insouciant sex in the last 12 months. These statistics validate the addition in hazardous sexual behaviour among call centre agents in the Philippines. However, addition in hazardous sexual behaviour is merely a portion of the life style of most call centre agents. Other hapless lifestyle picks observed among call centre agents is their backing of fast nutrient, smoke, ingestion of intoxicant, increased caffeine consumption, reduced slumber, and diminish physical inaction. Besides hapless lifestyle picks, the nature of their work besides predisposes them to emphasize and perturbations in their sleeping form. All of these factors predispose them to wellness jobs peculiarly high blood pressure, flesh iness, and diabetes. A figure of surveies have already been conducted on the incidence of sexually transmitted diseases and name centre agents in the Philippines but there are presently no surveies yet on the incidence of other diseases among call centre agents. This survey would wish to bridge this information spread because cognition on the development of other diseases like high blood pressure and diabetes are besides every bit of import as cognition on the increased transmittal of STIs among call centre agents. A In this survey, the research workers would wish to research the association between the development of Diabetes Mellitus Type II among call centre agents in the Philippines. As mentioned above, name centre agents and their lifestyle predisposes them to developing diabetes. The research workers would wish to turn to the job of potentially developing Diabetess Mellitus because of the long-run complications of this disease on the quality of life. The research workers would desire to specifically turn to Type II Diabetes Mellitus for the basic ground that this type of Diabetes develops chiefly because of lifestyle factors. The research workers believe that cognition on the association between call centre agents and the development of Diabetes Mellitus Type II is extremely important because of the wellness deductions of this disease and its possible to be prevented.II. Significance of the StudyThe increasing tendency of call centre bureaus in the state provides occupation chances to the i ncreasing supply of alumnuss in the state. Bing employed as a call centre agent in a call centre bureau is assumed to increase the hazard of sensitivity to different disease entities because of the extremist life style alterations one undergoes. With the increasing figure of employed call centre agents, there is hence an addition in the figure of people who are at hazard of geting diseases. Few literature trades with call centre agents that discusses the acquisition of certain diseases secondary to their business. This survey aims to increase the fund of literature with respect to this. Diabetess Mellitus, Type II is a chronic and debilitating disease. Besides, as said, this is a life-long disease. Once a individual acquires this disease, he or she will everlastingly be predisposed to the co-morbidities and effects of the disease ; which in bend, will diminish one ‘s figure of productive life old ages. A Prevention is the most cost-effective attack when aiming populations. If the consequences of this survey will demo an association between being a call centre and geting Diabetes Type II, we would be able to turn to the spread in cognition with respects to the association of being an employed call centre agent and geting Diabetes Mellitus, Type II. Besides this would supply extra informations for policy shapers to turn to steps with respects to the bar of this disease.III. Scope of RestrictionsA A A A A A A A A A A The survey will merely include employees in call centres in Ortigas, Philippines. The survey will be done for a period of 5 ( ? ) old ages and will merely find if an person will develop Type II Diabetes Mellitus ( DM ) or non. The survey will non quantify the grade and badness of the disease upon diagnosing. Fasting blood glucose ( FBG ) will be used in the diagnosing of DM, as it is the most dependable and convenient trial for placing DM in symptomless persons ( Fauci et al, 2008 ) and portion of the guidelines used by the American Association of Clinical Endocrinologists ( AACE Diabetes Mellitus Clinical Practice Guidelines Task Force, 2007 ) . Persons will be counted as instances if diagnosed with Type II DM through the class of the survey. Cases will be provided with appropriate intercessions ( non-pharmacological, referral ) . A A A A A A A A A A A A A The survey will except those who have the followers at the start of the survey: Type II DM, history of Diabetes in the immediate household, organic structure mass index ( BMI ) above or below the normal value as per Asian criterion, and more than or equal to 30 old ages of age. These exclusion standards are the factors that can be controlled in choosing the persons within the population that may predispose them to be identified as instances.IV. Review of Related LiteratureName Center Industry Harmonizing to a reappraisal done by O'Maley ( 2008 ) , the Philippines has been a major participant in the outsourcing industry over the past 10 old ages. Six major factors were identified to be the grounds why the Philippines take part radically in the said industry. One is the increasing authorities support for information engineering investing despite the fickle political clime. Second is the uninterrupted pooling of college alumnuss with good English communicating accomplishments and proficiency. It was stated in the reappraisal that 75 % of the entire population in the Philippines ( harmonizing to a United Nations ‘ informations ) speak English fluently with a 94 % literacy rate which gives a comparative advantage in the industry as compared to other states. Third is high cognition about Information and Communications Technology ( ICT ) . Fourth is the easy constitution of a dependable and moderately priced telecommunication substructure. Fifth are the low costs but high quality locations of call centre bureaus. And in conclusion, 6th, the increasing tendencies of outsourcing globally. In that same article written by O'Maley, it was said that the Philippines systematically ranks among the top five Business Procedure Outsourcing ( BPO ) locations globally. This portions a five-year-compounded one-year growing rate of 38 % . The Philippine BPO system was besides coined as the major participant in the growing of the service sector in the state. The Philippines plays a major function in providing the demand for more call centre agents as an consequence of the planetary trending of outsourcing worldwide. Harmonizing to the Philippine National Statistic Office ( 2010 ) , name centre activities ranked first among all BPO activities covering about half of the entire industry with 219 ( 48 % ) call centre constitutions. A With the increasing figure of call centre bureaus, it is logical to state that there is besides an increasing demand for call centre agents to work for such industry. Call centre activities employ bulk of the workers among all BPOs. In 2008, call centre bureaus employed about 150,000 workers ( Philippine National Statistics Office, 2010 ) . There are about 400,000 Filipinos who are presently employed as call centre agents harmonizing to Rivette ( 2010 ) . Name Center Agents Harmonizing toA a policy provided by the Employment and Immigration Department of the Government of Alberta ( 2008 ) , call centre agents are the 1s who â€Å" respond to inquiries and enquiries, construct client relationships, decide client jobs and supply information about company policies, merchandises and services over the phone and via electronic communicating. † Working conditions from one call centre to another may differ. Harmonizing to that same policy, name centre agents normally work indoors but in a instead unfastened environment to diminish privateness. Further, directors are allowed to enter and supervise the conversations of an agent and his or her client. Working displacements besides differ from one bureau to another. Some bureaus provide services 24-hours a twenty-four hours, seven yearss a hebdomad. Lifestyle of Call Center Agents and Associated Health Risk Factors Because of the nature of their work, name centre agents normally live a life style that may set them at hazard for development of certain diseases. First, name centre â€Å" workers remained in a inactive sitting place 95 % of the clip † ( Rocha, 2005 ) which makes them prone to physical inaction that may take to fleshiness. Development of fleshiness is of significance because it is a hazard factor for the development of Diabetes Mellitus Type II harmonizing to the AACE Diabetes Mellitus Clinical Practice Guidelines Task Force of 2007. Second, name centre workers are exposed to a extremely nerve-racking environment. Call centre workers â€Å" identified call-time force per unit areas i.e. , holding to treat a client call within a specific figure of seconds as holding the strongest relationship to occupation emphasis † ( Di Tecco et Al, 1992 ) . Another survey identified â€Å" holding to cover with hard clients as the most important beginning of occupation emphasis in 54.0 % of call centre agents managing inbound services and 54.4 % of call centre agents managing outbound services † ( Lin et al, 2010 ) . High degrees of emphasis can take to increased hydrocortisone degrees in the organic structure which is of significance because of its effects on organic structure metamorphosis. Abnormalities in organic structure metamorphosis can take to metabolic jobs such as stress-induced fleshiness which may give rise to high blood pressure, lipemia, and hyperglycaemia ( Andrews, 2002 ) . Third, the usual diet of call centre agents is high in cholesterin and fat and low in fibre which puts them at hazard for dyslipidemia and hypercholesteremia. In a survey conducted by the UP Population Institute, they identified the usual lifestyle picks of immature professionals in Metro Manila and Metro Cebu. They studied the economic, societal and wellness position of 929 immature professionals less than 35 old ages old working at call centres and non call centres. The survey revealed that â€Å" there is a high degree of ingestion of french friess, Burgers, french friess and fried chicken † among the workers and â€Å" a few figure consume instant noodles and street nutrient on a regular basis † . It was found out that fried poulet was the most popular nutrient pick among Business Process Outsourcing ( BPO ) workers with 78 % stating that they consume it on a regular basis. French friess were the following most popular nutrient pick with 54 % stating they consume it on a regular basis, followed by french friess at 53 % and Burgers at 49 % . High caffeine consumption was besides reported in 2/3 of all immature professionals imbibing java daily. However, the survey pointed out that call centre workers drank more java than non-call centre workers. Call centre workers drank 2.3 cups of java daily while non call centre workers drank 1.7 cups daily. Tea consumption was besides reported where 1/4 of all call centre workers drank tea while merely 1/5 of non-call centre workers drank tea. The survey besides revealed that 50 % of all immature workers drink soda daily at an norm of 1.5 bottles or tins daily. The survey besides explored leisure activities of call centre agents. Based on the UP Population Institute study, 72 % of call centre agents said that their most common leisure activity is imbibing compared to partying ( 62 % ) or videoke catchs ( 59 % ) . The survey said that overall â€Å" there is a really high degree of current imbibing among workers † , 85 % for call centre agents and 87 % for non-call centre agents. Fatty nutrient and ingestion of intoxicant can increase triglyceride and cholesterin degrees which is a hazard factor for the development of diabetes ( AACE, 2007 ) . Fourth, sleep want is common among call centre agents. In the same survey, they besides found out that alternatively of the recommended 8 hours of slumber, name centre agents merely acquire 6.2 hours of sleep each twenty-four hours. Sleep want can take to metabolic perturbations and hormonal alterations doing fleshiness ( Merck ) and accordingly diabetes. Fifth, due to tire and miss of slumber, name centre agents resort to smoke to get by with emphasis. They reported that â€Å" 43 % of call centre employees smoke while merely 21 % of non call centre agents smoke † . â€Å" A call centre agent who smokes normally consumes 9 sticks a twenty-four hours on norm † . Smoking is a known hazard factor for the development of coronary artery disease taking to high blood pressure and cardiac disease. Since high blood pressure and cardiac disease are risk factors for the development of Diabetes Mellitus Type II ( AACE, 2007 ) , smoking may so predispose an person in developing diabetes. Diseases Associated with Call Center Employees An addition in the turnover, absenteeism, and occupational diseases in call centre employees resulted from deficiency of modernisation of procedures and organisational planning in call centres in Brazil ( Rocha et al, 2005 ) . A focussed group probe conducted in a call centre employed with 200 persons observed the â€Å" presence of ailments of muscular hurting, tummy achings, sleep changes and crossness † ( Westin in Rocha et Al, 2005 ) . Work-related muscular upsets were found to be extremely prevailing among the female than male call centre employees, specifically on the neck/shoulder part ( 43 % ) and on the wrists/hands part ( 39 % ) . It was observed that a combination of high demands and deficiency of work control among the female call centre employees A reflect a extremely nerve-racking occupation that predispose them to the increased hazard of holding musculoskeletal upsets ( Theorell in Rocha et Al, 2005 ) . The restrictions of the survey done by Rocha et Al ( 2005 ) are that the analyses were limited to one call centre linked to a bank, cross-sectional design, little sample size, and symptom-based diagnosing ( such as hurting, numbing, giddiness, prickling esthesis, stiffening, firing esthesis ) . In a survey done by d'Errico et Al ( 2010 ) , the presence of musculoskeletal symptoms in the same part was assessed utilizing the undermentioned inclusion standards to continue the specificity of the result, although it probably decreased its sensitiveness: a ) presence of musculoskeletal symptoms ( hurting, combustion, stiffing, numbness or prickling ) at any clip during the last 28 yearss and B ) audience to a physical and or self-medication because of the symptoms. Besides, the â€Å" presence of any disease known to be associated with musculoskeletal upsets such as high blood pressure, diabetes, systemic lupus erythematosus, urarthritis, thyroid diseases, rheumatoid arthritis ) , old hurts in the last five old ages, leisure physical activity, organic structure mass index, smoke, matrimonial position, educational degree, gender, and age category were explored as possible confounders of the association between workplace factors and musculoskeletal symptoms. † It was found i n this survey that 45 % of workers reported musculoskeletal symptoms wherein cervix ( 39 % ) symptoms were the most prevailing, followed by the shoulder ( 22 % ) , handwrist ( 10 % ) , and cubitus ( 4 % ) . Neck/shoulder symptoms were associated with â€Å" low occupation control, elevated noise, hapless desk lighting and impossibleness to tilt back while sitting. † Elbow/hand-wrist symptoms were associated with â€Å" short intervals between calls, deficient working infinite, deficiency of forearm support, occupation insecurity, and long senior status in the industry. † Other survey that reported the presence of musculoskeletal symptoms among call centre employees were done by Halford and Cohen ( 2003 ) wherein computing machine usage factors and single psychosocial factors were significantly associated with self-reporting of musculoskeletal upset symptoms. Sudhashree et Al ( 2005 ) stated in a column missive that the call centre industry in India ranked high for abrasion due to wellness grounds such as kiping upsets ( 83 % ) , voice loss ( 8.5 % ) , ear jobs ( 8.5 % ) , digestive upsets ( 14.9 % ) and oculus sight jobs ( 10.6 % ) . Burnout stress syndrome, which includes chronic weariness, insomnia, and complete change of biological beat of the organic structure are everyday cause for sickness absenteeism. Chronic degree of emphasis besides affects other systems of the organic structure such as the cardiovascular and hormone. In a survey done by Lin et Al ( 2010 ) in a bank call centre in Taiwan, name centre employees have had prevailing ailments of musculoskeletal uncomfortableness, oculus strain, gruffness, and sore pharynx. Besides, it was found that those who perceived higher occupation emphasis had significantly increased hazard of multiple wellness jobs, including oculus strain, tinnitus, gruffness, sore pharynx, chronic cough with emotionlessness, thorax stringency, cranky tummy or peptic ulcers, and musculoskeletal uncomfortableness. In the Philippines, there are no surveies about the wellness hazards and occupational diseases associated among call centre employees. However, there is a study of a rise in the figure of Filipinos infected with Human Immunodeficiency Virus ( HIV ) and includes the call centre employees ( Ruiz, 2010 ) . Diabetess Mellitus, Type II Type II Diabetes Mellitus and Epidemiology A A A A A A A A A A A Diabetes mellitus ( DM ) is a group of metabolic upsets wherein there is an addition in blood sugar ( hyperglycaemia ) ensuing from absolute or comparative lack of insulin, or both. There are many categorizations of this disease entity based on the diseased procedure that leads to hyperglycemia. In Type II DM, hyperglycaemia resulted from a scope of preponderantly insulin opposition with comparative insulin lack to a preponderantly insulin secretory defect with insulin opposition ( Fauci et al, 2008 ) . It normally occurs among the older age group ( & gt ; 30 old ages old ) but there is an increasing diagnosing in the younger group ( Tidy, 2009 ) . â€Å" Most symptoms of diabetes appear really tardily in the phase of the disease. A batch of diabetics do non hold symptoms when their blood sugars are elevated for the first clip † ( National Objectives for Health, 2005 ) . A A A A A A A A A A A There is a dramatic addition in the prevalence of Diabetes Mellitus worldwide, from ~30million instances in 1985 to 177 million in 2000. Type II DM is increasing more quickly because of â€Å" increasing fleshiness and decreased activity degrees as states become more industrialised, † as in the instance of many developing states in Asia ( Fauci et al, 2008 ) . A countrywide prevalence study in the Philippines by the Department of Health showed that four ( 4.1 % ) out of one 100 Filipinos are diabetics, and the prevalence was higher in urban ( 6.8 % ) than in rural ( 2.5 % ) countries. The World Health Organization estimates that there will be a doubling of prevalence of diabetes in Southeast Asia every five to ten old ages. Using this as premise, the prevalence of diabetes in the Philippines is about 8 to 16 per centum ( National Objectives for Health, 2005 ) . Besides, the decease rate in diabetes has risen from 4.3 per 100,000 population in 1984 to 7.1 per 100,000 population in 1993. It is of import to observe that there is underreporting of deceases due to diabetes, as shown by local surveies, because of misclassification as deceases due to cardiovascular or nephritic disease both of which are chronic complications of DM ( National Objectives for Health, 2005 ; Fauci et Al, 2008 ) . Type II Diabetes Mellitus Risk factors and Nosologies Harmonizing to the American Association of Clinical Endocrinologists ( AACE ) Medical Guidelines for Clinical Practice for the Management of Diabetes Mellitus ( AACE Diabetes Mellitus Clinical Practice Guidelines Task Force, 2007 ) , there are several hazard factors to developing prediabetes and Diabetes Mellitus. Such hazard factors are ( a ) household history of diabetes, ( B ) cardiovascular disease, ( degree Celsius ) overweight or corpulent province, ( vitamin D ) sedentary life style, ( vitamin E ) Latin american or Latino, Non-Hispanic black, Asiatic American, Native American, or Pacific Islander ethnicity, ( degree Fahrenheit ) antecedently identified impaired glucose tolerance or impaired fasting glucose, ( g ) high blood pressure, ( H ) increased degrees of triglycerides, low concentrations high-density lipoproteins cholesterin, or both, ( I ) history of gestational diabetes, ( J ) history of bringing of an baby with a birth weight & gt ; 9 lbs, ( K ) polycystic ovary syndr ome, and ( cubic decimeter ) psychiatric unwellness. To name Diabetes Mellitus, any one of the three standards is sufficient in diagnosing the patient harmonizing to the AACE. These standards are: ( a ) symptoms of diabetes such as polyuria, polydipsia, unexplained weight loss and insouciant plasma glucose concentration of greater than or equal to 200 mg/ deciliter, ( B ) fasting plasma glucose concentration of greater than or equal to 126 mg/ deciliter, and ( degree Celsius ) 2-hour postchallenge glucose concentration of greater than or equal to 200 mg/ deciliter during a 75-gram unwritten glucose tolerance trial. A Diabetess Mellitus Prevention A survey done by the Diabetes Prevention Program ( DPP ) showed that intensive alterations in life style, quantified as diet and exercising for 30min/day five times/week in persons with impaired glucose tolerance ( IGT ) delayed the development of Type II DM by 58 % . ( Harrison ‘s, 2008 ) . It was besides found out that Metformin slowed down the patterned advance or halted the development of Type II DM by 31 % compared to placebo. Peoples with a strong sensitivity to diabetes due to household history or impaired glucose tolerance or impaired fasting glucose ( IFG ) , are strongly advised to keep a normal BMI and prosecute in regular exercising. Harmonizing to the recent ADA Consensus panel, persons with IFG and IGT who are at a high hazard for patterned advance to diabetes ( age & lt ; 60 old ages, BMI & gt ; 35 kg/m2, household history of diabetes in the first-degree, elevated triglycerides, reduced HDL, high blood pressure, or A1C & gt ; 6.0 % ) could be appraised for Metformin intervention but non other medicines. Acute complications of DM The acute complications of diabetes are diabetic diabetic acidosis ( DKA ) and hyperglycemic hyperoslomar province ( HHS ) . Both upsets are associated with absolute or comparative insulin lack, volume depletion, and acid-base abnormalcies. These may take to serious complications if non quickly remedied. Diabetic Ketoacidosis The usual marks and symptoms of DKA are A sickness and emesis, hyperglycaemia, hypotension, Kussmaul respirations, fruity Oder on the patient ‘s breath, inordinate thirtst, and polyuria. DKA is characterized by hyperglycaemia, ketonemia, and metabolic acidosis that is accompanied by secondary metabolic abnormalcies. Hyperglycemic Hyperosmolar State HHS may normally be seen in an aged person with Type II DM, with symptoms of polyuria, weight loss, and lessened unwritten consumption that preceded mental confusion or coma. Physical scrutiny shows profound desiccation and hyperosmolarity with concomitat hypotension, tachycardia, and altered mental province. In contrast to DKA, HHS does non present with sickness, purging, abdominal hurting and Kussmaul marks. Chronic complications of DM The chronicity of the disease brings about systemic engagement that affects multiple organ systems. Complications may be divided into nonvascular and vascular complications. Nonvascular complications include gastroparesis, tegument alterations, and cataracts. Vascular complications can be farther subdivided into micro and macrovascular. Microvascular alterations, which result from long standing hyperglycaemia include retinopathy, neuropathy, and nephropathy. Macrovascular alterations include coronary arteria disease and peripheral arterial diseases. ( NIkki, I ‘ll direct you my bill of exchange. di ko getaway kung tama. I Ca n't make the model here. ) Figure 1.Conceptual ModelV. AimsA A A A A A A A A A A With the nature of the work and environment in a call centre industry, the survey aims to find if working in a call centre predisposes an person to the development of Type II diabetes mellitus ( DM ) . Specifically, it aims: a. A A A A A A A To find the incidence of Type II Diabetes Mellitus within the period of survey. b. A A A A A A A To find the etiologic factors associated with the development of Type II Diabetes Mellitus.VI. MentionsAACE Diabetes Mellitus Clinical Practice Guidelines Task Force ( 2007 ) . American association of clinical endocrinologists medical guidelines for clincial pattern for the direction of diabetes mellitus. Endocrine Practice. 13:3-68 Andrews, R.C. , O. Herlihy, D.E.W. Livingstone et Al. ( 2002 ) . Abnormal hydrocortisone metamorphosis and tissue sensitiveness to cortisol in patients with glucose intolerance. The Journal of Clinical Endocrinology 87 ( 12 ) : 5587-5593. Di Tecco, D. , Cwitco, G. , Arsenault, A. , Andre, M. ( 1992 ) . Operator Stress and Monitoring Practices. Appl Ergon 23, 147-53. d'Errico, A. , Caputo, P. , Falcone, U. , Fubini, L. , Gilardi, L. , Mamo, C. , Migliardi, A. , Quarta, D. , and Coffano, E. ( 2010 ) . Hazard factors for upper appendage musculoskeletal symptoms among call centre employees. Journal of Occupational Health. 52:115-124. Employment and Immigration. ( 2008 ) . Alberta Occupational Profiles: Name Centre Agent. Government of Alberta. Retrieved September 10, 2010 from A hypertext transfer protocol: //alis.alberta.ca/occinfo/Content/RequestAction.asp? aspAction=GetHTMLProfile & A ; format=html & A ; occPro_ID=71002991 Fauci, AS. , Braunwald, E. , Kasper DL. , Hauser, SL. , Longo, DL. , Jameson, JL.. , and Loscalzo, J. ( 2008 ) . Harrison ‘s Principles of Internal Medicine. 17th erectile dysfunction. A USA: The McGraw-Hill Companies, Inc. Halford, V. , and Cohen, HH. ( 2003 ) . Technology usage and psychosocial factors in the self-reporting of musculoskeletal upset symptoms in call centre workers. Journal of Safety Research. 34 ( 2 ) :167-173 Lin, YH. , Chen, CY. , HONG, WH. , and Lin YC. ( 2010 ) . Perceived occupation emphasis and wellness ailments at a bank call centre: comparing between inbound and outbound services. Industrial Health. 48:349-356 Merck Manuals Online Medical Library ( 2010 ) . Obesity. Retrieved September 11, 2010 from hypertext transfer protocol: //merck.com/mmhe/sec12/ch156/ch156a.html National Objectives for Health. ( 2005 ) . Retrieved 9 September 2010 from hypertext transfer protocol: //www2.doh.gov.ph/noh/3-2-3.pdf National Statistics Office. ( 2010 ) . 2008 Annual Survey of Philippine Businesss and INdustry: Business Process Outsourcing Activities. Manila Philippines. Retrieved September 10, 2010 A from hypertext transfer protocol: //www.census.gov.ph/data/sectordata/aspbi08_bpotx.html O'Maley, R. ( 2008 ) . Particular Report — Call Centres in the Philippines. Retrived September 10, 2010 from: www.callcentrehelper.com/special-report-in-the-philippines-2231.htm Rivette, D. ( 2010 ) . The Emerging Philippine Value Proposition. Trestle Group Consulting. Retrieved September 11, 2010 from hypertext transfer protocol: //www.bpap.org/bpap/publications/ TG_SDS_PhilippineValueProposition_March2010 % 5B1 % 5D ( 2 ) .pdf Rocha, LE. , Glina, DMR. , Marinho, MdF. , and Nakasato, D. ( 2005 ) . Hazard factors for musculoskeletal symptoms among call centre operators of a bank in Sao Paulo, Brazil. Industrial Health. 43:637-646 Ruiz, J. ( 2010 ) . HIV instances soar among Filipino yuppies, name centre workers. ABS-CBN News. Retrieved 10 September 2010 from hypertext transfer protocol: //www.abs-cbnnews.com/lifestyle/01/27/10/hiv-cases-soar-among-filipino-yuppies-call-center-workers Sudhashree, VP. , Rohith, K. and Shrinivas, K. ( 2005 ) . Issues and concerns of wellness among call centre employees. Indian Journal of Occupational and Environment Medicine. 9 ( 3 ) : 129-132 Tidy, C. ( 2009 ) . Diabetes mellitus. Filipino Medics. Retrieved 10 September 2010 from hypertext transfer protocol: //www.philippinemedics.com/diabetes-mellitus/ UP Population Institute ( 2010 ) . Lifestyle, Health Status and Behavior of Young Workers in Call Centers and Other Industries: Metro Manila and Metro Cebu. Retrieved 11 September 2010 from hypertext transfer protocol: //www.abs-cbnnews.com/lifestyle/08/05/10/call-center-workers-diet-fast- food-caffeine-and-alcohol