Abortion And Murder :: essays research papers fc

Premature birth And Murder On January 22, 1973, the U.S. Preeminent Court, in two separate choices, Roe v. Swim and Doe v. Bolton, announced that Congress and the states needed to receive an arrangement on fetus removal. From that point forward, premature birth has been one of the most questionable issues in our nation today. Each time the subject of fetus removal is raised, a similar inquiry consistently comes up: should individuals reserve the option to end an unborn youngster? The appropriate response is no. No individual ought to reserve the privilege to end an unborn kid which has not yet gotten the opportunity to live, regardless of what the explanation is. Premature birth is the end of an alive, unborn youngster, which can encounter torment through the procedure of a fetus removal. There is no compelling reason to have a fetus removal when these youngsters could be set up for appropriation as opposed to being Æ'â ±aborted.æ'â ° Abortion is the end of alive, unborn kids. By what method can an individ ual choose exactly when an unborn hatchling turns into an individual with established rights. Numerous individuals differ when an embryo turns into a genuine individual, yet in all actuality a baby turns into an individual at the hour of origination. An article entitled Æ'Â ±Pro-lofe and ace decision? Yesæ'â ° says that, Æ'Â ±From the snapshot of origination, the hatchling is enriched with all the hereditary data that will empower its advancement into a full human personæ'â ° (Church 108). Innovation has progressed especially in the previous twenty years and now with the guide of clinical innovation and the study of fetology, specialists can demonstrate that a hatchling is a genuine individual as ahead of schedule as thirteen weeks of development (Meyer 62-64). These realities just assistance to demonstrate that an embryo is a genuine individual, who merits the opportunity to be conceived. In opposition to conviction, an embryo can really feel torment. The perception of prem ature births on ultrasound have been upsetting. So upsetting, that numerous premature birth specialists who have seen the strategy, decline to take an interest in premature births once more (Meyer 62-64). An article entitled Æ'Â ±Fetal positions: Making Abortion rareæ'â ° reports that, Æ'Â ±Bernard Nathanson, a previous chief of the National Abortion Rights Action League, who performed a large number of premature births, revoked the training in the mid 1980's subsequent to watching the clear misery of an embryo exposed to a pull tip abortionæ'â ° (Meyer 62-64). Present day nervous system science bolsters the case that the baby can encounter torment, not simply reflex. Reflexive responses invigorate just the spinal segment, yet the more mind boggling responses that animate torment happen in the minuscule segment of the cerebrum called the thalamus. Premature birth And Murder :: papers explore papers fc Premature birth And Murder On January 22, 1973, the U.S. Preeminent Court, in two separate choices, Roe v. Swim and Doe v. Bolton, announced that Congress and the states needed to embrace an arrangement on premature birth. From that point forward, premature birth has been one of the most disputable issues in our nation today. Each time the subject of fetus removal is raised, a similar inquiry consistently comes up: should individuals reserve the option to end an unborn kid? The appropriate response is no. No individual ought to reserve the option to end an unborn kid which has not yet gotten the opportunity to live, regardless of what the explanation is. Fetus removal is the end of an alive, unborn youngster, which can encounter torment through the procedure of a premature birth. There is no compelling reason to have a fetus removal when these kids could be set up for reception as opposed to being Æ'â ±aborted.æ'â ° Abortion is the end of alive, unborn youngsters. By what means can an individual choose exa ctly when an unborn baby turns into an individual with sacred rights. Numerous individuals differ when a baby turns into a real individual, yet in all actuality an embryo turns into an individual at the hour of origination. An article entitled Æ'Â ±Pro-lofe and star decision? Yesæ'â ° says that, Æ'Â ±From the snapshot of origination, the embryo is enriched with all the hereditary data that will empower its improvement into a full human personæ'â ° (Church 108). Innovation has progressed especially in the previous twenty years and now with the guide of clinical innovation and the study of fetology, specialists can demonstrate that an embryo is a real individual as ahead of schedule as thirteen weeks of development (Meyer 62-64). These realities just assistance to demonstrate that a hatchling is a real individual, who merits the opportunity to be conceived. In spite of conviction, an embryo can really feel torment. The perception of premature births on ultrasound have been ups etting. So upsetting, that numerous premature birth specialists who have seen the system, decline to take an interest in premature births once more (Meyer 62-64). An article entitled Æ'Â ±Fetal positions: Making Abortion rareæ'â ° reports that, Æ'Â ±Bernard Nathanson, a previous executive of the National Abortion Rights Action League, who performed a large number of premature births, denied the training in the mid 1980's in the wake of watching the evident desolation of a baby exposed to an attractions tip abortionæ'â ° (Meyer 62-64). Current nervous system science bolsters the case that the baby can encounter torment, not simply reflex. Reflexive responses animate just the spinal segment, yet the more mind boggling responses that invigorate torment happen in the small segment of the cerebrum called the thalamus.

The Devil in the Shape of a Woman

The Devil in the Shape of a Woman via Carol Karlsen (1987) insightfully centers consideration upon the female as witch in pilgrim New England, along these lines permitting a conversation of more extensive subjects with respect to the job and position of ladies in Puritan culture. Karlsen's work, which has been generally welcomed, centers around the situation of charged witches as to a great extent females set in shaky social and financial positions, frequently on the grounds that they remained to acquire, had acquired, or lost a legacy in property.Karlsen withdraws from the possibility that ladies blamed for black magic were rambunctious hobos, a delineation â€Å"tantamount to accusing the victim† (Nissenbaum) and rather focuses to these â€Å"inheriting women† as being socially defenseless in a male centric culture. Karlsen's work isn't just of verifiable criticalness to the Salem flare-up of 1692. Indeed, â€Å"that year remains something of an anomaly† (Nisse nbaum) as 33% of the charged witches at that point were male contrasted with short of what one-fifth of allegations made in any case in pioneer New England.Instead, Karlsen's investigation takes â€Å"women emphatically back to middle of everyone's attention, finding them in a rich man centric lattice that coordinates it with class and family. † (Nissenbaum). One analyst noticed that inside this specific situation, Karlsen offers critical experiences. The first is a glance at the â€Å"ambivalent evaluation of ladies inside New England's way of life. † (Gildrie). Karlsen finds a situation set apart by its time and spot in which ladies exemplified the â€Å"Puritan perfect of ladies as highminded helpmeets† (Boyer).In an odd duality, ladies were both the new stewards of God's otherworldly administration on earth, while compliant to a Medieval, sexist sex job which to a great extent set their destiny on account of men. Besides, Karlsen centers consideration around the informers and finds that they were occupied with a â€Å"fierce negotiation†¦ about the authenticity of female discontent, disdain, and outrage. † (Karlsen; see Gildrie). Allegations of black magic were regularly an outlet where this exchange bubbled over into viciousness, as men abused female neighbors who undermined a set up, yet unsafe, social order.The essential theory on which a great part of the book rests is that black magic allegations were frequently made against ladies who compromised the organized exchange of land from father to child †a procedure, best case scenario laden with strain and tension and best case scenario set apart by the move of scant, important properties starting with one family then onto the next by method of an interceding lady in a man centric legacy framework. The had young ladies assumed a double job in this â€Å"symbolic social drama† in which they defied the social job to which they had been fated during childbirth by all the while submitting in that job by opposing the â€Å"witch. In the case of nothing else, Karlsen's ongoing work demonstrates that there is despite everything space for considerable examination and grant encompassing black magic, sexual orientation, and different issues in provincial New England. One pundit composes, â€Å"Karlsen's examination is provocative, wide-going, available, and honest. † (Lindholt). Another, that the book's â€Å"descriptions and examinations remain all alone as significant commitments as far as anyone is concerned of witch legend and the uncertain status of ladies in early New England. † (Gildrie).Paul Boyer and Stephen Nissenbaum, whose Salem Possessed set the standard for social narratives of the episode in Salem, find that Karlsen's work is one of â€Å"formidable scholarly power† and â€Å"a significant commitment to the investigation of New England black magic. † It puts the focal job of ladies as witches under the ma gnifying instrument and â€Å"for the first run through as the subject of foundational analysis† a significant 300 years after the occasions happened. Karlsen's work is required perusing for the understudy, researcher, or general peruser looking to comprehend and decipher the wide image of pioneer black magic in New England.

Negotiation Strategies and Theories free essay sample

A large portion of us imagine dealings as a type of contention where the result is ordinarily one victor and one washout (or winning and losing party/gathering). Since the two gatherings participating in dealings have something to accomplish, individuals will in general enter exchanges stressing result or potentially process objectives (Katz-Navon and Goldschmidt, 2009). Contrasts in status, force, and sexual orientation all assume profoundly critical jobs (in many cases subliminally or incidentally) and will be examined additionally broke down in this paper. As to some degree a disclaimer, the terms â€Å"individuals†, â€Å"groups†, or â€Å"parties† are frequently utilized conversely with no respect to the conditions on what number of individuals or elements are engaged with the arrangement speculations to be talked about. Exchange hypothesis is an interdisciplinary field that has been created by financial specialists, sociologists, and analysts, and offers solutions for compelling arranging (Arvanitis and Karampatzos, 2011). Reflectively I would hypothesize that like individual’s arrangement system or style is a lot of like some other character quality in that it is inborn, and minimal subject to change over the long haul. We will compose a custom article test on Arrangement Strategies and Theories or on the other hand any comparable subject explicitly for you Don't WasteYour Time Recruit WRITER Just 13.90/page In any case, in particular, I have no psychological reservations to presume that exchange aptitudes and speculations can be learned and polished to expand ones capacities and inalienable characteristics. People whose essential spotlight is fixated on result based objectives, in light of their restricted readiness or capacity to widen the view of their exchange procedure, would mostly focus on the conclusive outcomes of the arrangement (Katz-Navon and Goldschmidt, 2009). I accept this procedure has a gigantic measure of utility when you need to subliminally lead the contradicting gathering to accept this is your essential exchange system. In any case, I accept this clandestine methodology to be viable just in the event that one enters the arrangement with the most force. At the point when people have more force than the contradicted, they are less reliant on their resistance and all the more effectively and prone to have the option to fulfill their own needs and wants (Malhotra and Gino, 2011). This personal responsibility based methodology can frequently raise moral clash in the event that one party’s objective contradicts the other, especially along the grounds of sexual orientation or socially based convictions or inclinations. There are a few procedures where gatherings entering dealings off guard can use in endeavor to move the force and bearing of an arrangement which will be talked about further in this paper. Counter to the result based system recently examined, parties who are all the more unequivocally process-situated will be able to plan and send all the more similarly flexible procedures that lead to an effective goals of the arrangement (Katz-Navon and Goldschmidt, 2009). I accept that a lion's share of individuals would discover this procedure definitely more productive than the result based methodology. In the field of brain research, most of research has been centered around this dynamic point of view establishing an organized procedure between levelheaded gatherings (Arvanitis and Karampatzos, 2011). Despite the arrangement procedure utilized, its technicians can be investigated dependent on cognizant and subliminal trades of data (and endeavors to approve claims). Hindrances ENCOUNTERED Negotiating people depend on comprehensions during the arrangement procedure. Commonly, these comprehensions are incorrect ones (I. e.heuristics, generalizations, and different inclinations) and essentially influence exchange results. Generalizations commutate a fixed disposition toward a social gathering which are brought to the cutting edge of commitment during arrangement meetings. Obstructions experienced frequently lead to a fixed-pie predisposition (Dweck and Leggett, 1988), restricting the extent of what each gathering will have the option to pick up or accomplish from the arrangement. Lame ntably, a significant number of these discernments are profoundly established in social clashes, bringing about comprehensions reflecting as character qualities and individual convictions. For example, in Afghanistan we are progressing in the direction of the unification and fortifying of the Afghan government, yet most of its populace are relate to one of various inborn substances who have no feeling of nationality or solidarity with other innate elements. The less gatherings comprehend about the restrictions of bartering range and suitable measures for understanding, the greater equivocalness there is in the exchange circumstance (Bowles, Babcock, and McGinn, 2009). Lacking data by not directing appropriate research on the different parties(as well as their own) cutoff points and requirements creates vulnerabilities about what is feasible in the exchange. Likewise, saw imbalances in status and force between arranging parties are brought into the main part of things when societies impact (more-so maybe than sex based issues to be talked about later). Approaches TO EXPAND THE PIE Both sides must enter dealings accepting that a success win situation is conceivable. One of the principal detours to growing the pie is entering the arrangement obstinate that there is just one issue or issue that is up for conversation. A comparative situation constraining pie-growing abilities is the method of reasoning that the attention is on splitting the pie front as opposed to expanding the pie before isolating it. These situations quite often bring about a success lose type situation. A characteristic counter to this situation is to carry extra issues into the exchange. Underneath the surface, it is in every case genuinely likely extra issues do exist which can be deliberately and painstakingly brought to the table. Bringing others or gatherings into dealings may likewise extend the size of the bartering pie by including extra knowledge or haggling power. Also, this assists with staying away from one explanation dealings bomb by unbundling issues, or keeping away from contention over a solitary issue. Gatherings ought to set themselves up for dealings by saddling and planning approaches to use their capacity, thusly expanding their positive thinking and view of control during the arrangement (Malhotra and Gino, 2011). The individuals who enter dealings concentrated on their absence of intensity (saw or genuine) will be progressively centered around expanding their capacity over the span of the exchange rather than being centered around increasingly valuable, all encompassing techniques that are bound to bring about a success win situation. Arbitrators ought to participate in communications by communicating interest and worry with the perspectives of the restricting party. This assists with guaranteeing that restricting gatherings are almost certain and ready to take part in future arrangements and will be progressively open. In the interim, gatherings should flag their ability to share data about their own advantages also. This makes a conspicuous Catch 22 because of desires that the two gatherings be imminent and responsive, yet as in numerous if life’s fragile circumstances, uncovering an excess of too early can put a gathering off guard. Detours to growing the pie may inadvertently be set up when individuals or gatherings accept that their advantages are non-debatable or excessively independent or far off from that of the restricting party, when in actuality, they are most certainly not. This is known as â€Å"false conflict† or â€Å"illusory struggle. † In request to bypass this unavoidable disappointment, parties must abstain from making untimely concessions with respect to the next gathering. Like the measures contained in bogus clash, â€Å"fixed-pie perception† is where the different party’s interests are conversely identified with one’s own. At the end of the day, not exclusively are they excessively far off or independent, however they are seen as being legitimately interestingly with the present gatherings sees. Inventive METHODS TO CREATE ALTERNATIVES One of the most remarkable approaches to guide exchanges towards a progressively positive course (principally when the other party is being uncooperative) is by means of a procedure of making various proposals of equal worth all the while. This creates options by differentiating the proposal to stay away from consecutive declination of offers, frequently bringing about a â€Å"lose-lose† situation. Talk, as characterized by Aristotle, is the workforce of finding the potential methods for influence regarding any subject whatever (Arvanitis and Karampatzos, 2011). This can fill in as an integral asset for changing the structure and progess of arrangements and help to reveal a portion of the basic standards in the restricting parties’ exchange structure. Aristotle proceeds to contend that: â€Å"That which is enticing is influential concerning somebody, and is powerful and persuading either without a moment's delay and in and without anyone else, or on the grounds that it gives off an impression of being demonstrated by recommendations that are persuading. Talk won't think about what appears to be plausible in every individual case, for example to Socrates or Hippias, however that which appears to be likely to either class of persons† (Arvanitis and Karampatzos, 2011). Mediators may even hotel to the utilization of feigning (or level out lying) so as to achieve their central goal. In a circumstance where one gathering has a (genuine, not saw) burden, they can render a forceful passionate impact by feigning. For example, they may endeavor to â€Å"throw-off† their more grounded resistance by astonishing them with a bogus proclamation that they have gotten a superior offer or have as of late discovered progressively perfect intends to achieve their own closures. At the point when first rate, feigning can reverse the situation on the impression of intensity throughout an arrangement. In any case, the feigning moderators need to have solid choices accessible, just as regard the need to not over-feign or feign too soon so they don't emanate a feeling of edginess because of their ailing in status and force. Contrasts IN S

Langston Hughes Poems Analysis Essay

Langston Hughes reason for these arrangements of sonnets was to diagram the present condition for African Americans around then, and furthermore to show his wants and present the perfect conditions for African Americans. The following are a few of his sonnets that has symbology and reflects and shows his wants and goals. As I would see it, Dream Variations shows Hughes want for African Americans to have the option to appreciate the delights of life as white individuals did. At the point when he says â€Å"to spin and to move till the white day is done† he is talking about having the option to be free, moving and â€Å"flinging your arms† is decisive of opportunity and an open articulation of opportunity. At that point have the option to rest around evening time and have a feeling of true serenity, realizing that African Americans have similar open doors that White Americans experienced. In Hughes’s sonnet Prayer Meeting, he shows a feeling of expectation and yearning for development in African Americans lives and needed African Americans to be liberated from persecution. â€Å"Glory! Thank heaven! The dawn’s a-comin† shows that opportunity from abuse is not too far off and that African Americans should celebrate. The setting of this sonnet in religion additionally shows a feeling of expectation since religion is regularly looked for after to accomplish a feeling of expectation. In Song of the Revolution, this sonnet utilizes the symbology of the American Revolution as another call for opportunity from mistreatment, anyway this is opportunity from the persecution of White America. â€Å"Marching like fire over the world, weaving from the earth its splendid red banner† utilizes fire as an image for expectation and fearlessness and the utilization of a red pennant as conviction and faithfulness. In the third refrain, which states â€Å"Breaking the obligation of the darker races, breaking the chains that have held for quite a long time, breaking the hindrances isolating the individuals, crushing the divine forces of dread and tears† This verse fills in as an invitation to battle for African Americans. This refrain is less representative and mysterious than the others. â€Å"smashing the lords of dread and tears† is the opportunity from rulers and the foundation which has wronged and mistreated them. He needs a solidarity of the races and an opportunity and absence of abuse. In Let America Be America Again, hughes is utilizing America’s calling as an encouraging sign to the world to exhibits his optimal for America to really be free and not just as an adage. This is clear in the primary verse, which states â€Å"Let America be America once more, Let it be the fantasy in used to be, let it be the pioneer on the plain, looking for a home where he himself is free. † The bracket between the refrains is what is significant, in light of the fact that it shows Hughes’s genuine assessment of America around then, which was he doesn’t put stock in America, and to him was never an encouraging sign or a place that is known for freedom. He accepts that America is overbearing, harsh, and biased to him and his kin. In the last verse he additionally utilizes divisions of class and different races that are abused as fortification for his assessments of America. In the third verse which states, â€Å"O, let my property be where Liberty is delegated with no bogus energetic wreath, yet opportunity is genuine, and life is free, Equality is noticeable all around we breath. † It’s showing Hughes’s want for America to truly be as it’s imagined and not just as it is depicted (according to Hughes); equity ought to be as predominant and accessible as air.

5 Simple Strategies for Taking Better Notes at Work

5 Simple Strategies for Taking Better Notes at Work Have you ever failed to remember a great idea you’d had and thought, “If only I’d written it down”? It’s not a good feeling. Virgin Group founder,  Richard Branson, wrote, “If you don’t write your ideas down, they could leave your head before you even leave the room.” Capturing your ideas is just one of the many benefits of effectively taking notes at work. Better note taking can also help you learn new concepts, organize your thoughts, encourage your creativity, help you share important information with others and so much more. Having great notes can reduce stress levels, keep you on task and make you more productive. To get great notes, you just need to find the right note-taking strategy. Key Strategies for Taking Notes Different situations call for different kinds of note taking. You probably wouldn’t choose to make a detailed outline to capture a brainstorming session, or handwrite notes that you need to share with five other people via email after a meeting. We’ll walk through five different scenarios and how you can tailor your note-taking strategy to meet your professional goals. 1. Team meetings The best team meetings result in a clear, shared understanding by everyone involved and actionable items. When taking notes in team meetings or collaborative environments, you should focus on: Facts: (Example: Jenna is the creative lead on this project) Issues: (Example: There is too much work to get done by the deadline.) Decisions: (Example: We will break this project up into smaller, more manageable chunks.) Action plans: (Example: The project manager and creative lead will determine how to break this project up, then the project manager will schedule a meeting to discuss how to distribute that work.) Questions and answers: Take note of questions team members bring up during the meeting and the answers that are given. Your browser is not able to display frames. Please visit Weekly Strategy Meeting on MindMeister. For maximum efficiency, use a note-taking tool that allows you to easily capture and share notes (like Google Docs or Evernote) or try turning notes into tasks and to-do lists. Mind maps can also be used for meeting management. An online mind mapping tool like MindMeister can help you take meeting minutes and then create and assign tasks within the mind map, in real-time. To use the above free mind map, simply click on the Copy and edit map button in the bottom-right corner of the map. If you already have a MindMeister account, the map will be copied to your account automatically, so you can then edit or embellish the topics to make the map suitable for your team meeting. Dont have an account yet? You can sign up for free now. 2. One-on-one meetings Sometimes you want to take notes in one-on-one meetings â€" maybe you’re having coffee with your mentor or heading into a performance review. These are more intimate learning environments where you’re engaged in discussion but still want to capture what you hear. Taking notes in these situations is a balance. You want to record information without putting a laptop-shaped wall between you and the other person. And too much focus on your notes could make you seem distracted or inattentive. Prioritize that personal connection by ditching your laptop as a note-taking device and opt for a small, unobtrusive notebook. Tomasz Tunguz, a venture capitalist with Redpoint and former Google Employee, writes that when he worked at Google, “I carried a laptop to every meeting I went to. I typed notes, jotted down action items, and distributed the minutes of almost each one of my meetings.” When he started working at Redpoint, “outside the rainbow bubble of the Googleplex very few people take notes on laptops during meetings. It’s just impolite. People wonder if you’re typing emails (which I often was).” Sometimes a personal connection is more important than recording every single word. Don’t worry, though, you can still capture what was said: immediately after the meeting is over, write down everything you talked about while it’s still fresh in your mind. Efficient  meetings with mind maps Sign up for MindMeister Sign up for MindMeister 3. Brainstorming sessions Brainstorming sessions can be a flurry of activity with ideas flying. When your team brainstorms, you need to be able to record a lot of information quickly, capture unusual concepts and combine, refine and build on those ideas. You need the freedom to be able to record whatever comes up, be they words, sketches, diagrams, photos or other visual elements. Mind maps are great for brainstorming because they let you capture notes in a flexible format that doesn’t limit you to a linear flow of words. You can use good old fashioned paper or a whiteboard, but an online mind mapping tool allows you to share mind maps with the team or save maps so you can come back to them later. They also offer an endless amount of space, so your map can be as big as it needs to be. 4. Interviews Interviews can take lots of forms. Maybe you’re talking to candidates for a new position you’re hiring or interviewing an expert for a blog post. Perhaps you’re conducting interviews as part of user research. In these situations, look to journalistic methods of taking notes for tips. “Write down all the questions you have beforehand,” suggests Roy Peter Clark, senior scholar at the Poynter Institute. “At the end of the interview, scan your questions to see if there’s anything you didn’t cover. Now’s the time to ask.” Clark also says you should record the interview but not rely on the recorder completely. “Even if you have a chance to record an interview, back it up with notes in your notebook,” he says. “You never know when technology will fail you.” Taking notes on what you observe in addition to what’s said will also help. “Divide your note-taking areas into two sections,” writes journalist M.T. Wroblewski. “Devote the first and bigger section to the interviewee’s answers and the second, smaller section to your observations and impressions. In this second area, you might write, ‘Seemed most enthusiastic about this job’ or ‘Avoided eye contact at this point; seemed nervous.’” 5. Educational settings If you’re taking notes to learn â€" at conferences, workshops or professional development events, for example â€" academic note-taking styles can help you record information so that you actually absorb and remember it. First, you might opt for pen paper to help you process ideas. According to one UCLA study, even when you use your laptop solely for note-taking (and not browsing social media or getting distracted by email notifications) processing still might be more shallow than it would be with handwritten notes. You can draw from several academic note-taking systems, like outlining or charting, but the Cornell Method is most applicable to professional situations. This method has you divide your paper into one small column on the left and a larger column on the right. During the event, try taking notes in the larger, right-hand column. When the event is over, review your notes, and for every significant piece of information, write a “cue” in the left margin. The cue can be a single word or short phrase that summarizes the information. This method helps you condense your notes so they’re easy to remember and talk about later, which is especially great for sharing what you learned from a conference when you get back to the office. Taking the right notes means you have all the information you need to do your best work. Next time you prepare to take notes, think about your goals and your environment and tailor your note-taking strategy based on those things. Never again will you think, “If only I’d written that down.” Do you have a favorite strategy or tool for taking notes? Wed love to hear about it in the comments below! Take more effective notes with mind maps

Kids Products Description Girls Vista Boarder Jacket - 550 Words

Kids Products Description: Girls Vista Boarder Jacket (Essay Sample) Content: 1 7-G720083 Girls Vista Boarder JacketKeep her warm in style this winter in our Girls Vista Boarder Jacket! Our brightly colored signature Radiance fabric exterior is both wind and water resistant, so whether shes hitting the slopes or just playing outside, youll never have to worry that shes staying warm and dry. The added snow skirt, Velcro adjustable cuffs and storm placket all help to stop any snow or wind from sneaking through, while the butter pile lined collar, poly fill quilted lining and removable faux fur trimmed hood keep her toasty. Two front faux-flap pockets, zipper close chest pocket and elastic waist detailing round out the fabulous features of this jacket!Details:100% PolyesterMachine WashableWind resistantWater resistantQuilted poly fill interior liningTwo front flap-look pocketsChest zipper close pocketFaux fur trimmed detachable hoodVelcro adjustable wrist cuffsChin guard to protect from irritation from zipperVelcro and zip front closureStorm plack etButter pile lined inner collarSnow skirtElastic detail at waist 2 39-G720481 Girls Snowstar Boarder JacketLet her express herself this winter with the peace of mind shell be toasty warm in our Girls Snowstar Boarder Jacket. The Radiance dobby fabric is durable, wind and water resistant with a quilted poly fill interior lining, so she can play nonstop. The dual Velcro and zipper front closure with inner storm placket help block the wind, while a snow skirt and detachable faux fur trimmed hood fend off any snow. Dual entry pockets give room for her hands, with a zipper close pouch to hold her more valuable belongings. In addition to all these features, the fun and colorful digital dash print will have her feeling and looking her best!Details:100% PolyesterMachine WashableWind resistantWater resistantQuilted poly fill interior liningTwo dual entry pocketsFaux fur trimmed detachable hoodVelcro adjustable wrist cuffsChin guard to protect from irritation from zipperVelcro and zip front closureStorm placketButter pile lined inner collarSnow skirtElastic waist detail at back 3 77-G7131 Girls Butter PileOur soft double-sided butter pile fleece jacket works well as a lightweight jacket for outdoor activities or a cute extra layer for cozy days inside. The lofty butter pile helps retain warmth, but is breathable so she wont overheat no matter how much she plays. When it starts to get chilly, pull up the attached hood, with a chin guard to prevent irritation from the zipper, and use the two front pockets to warm her hands. The quilted woven overlay at the shoulders adds a sporty touch to show off her adventurous spirit.Details:100% PolyesterMachine washableSoft and breathable double sided butter pile fleeceChin guard to prevent irritation from zipperTwo front pocketsAttached hoodQuilted woven overlay 4 276-H7112 Boys Windbreaker]Let him show off his daring style while staying warm and dry in our Boys NAME Jacket. The digi-camo print outer fabric is both wind and water resistant and is constructed with a comfortable brushed fleece lining, so he is unstoppable in any weather. Just pull up the ...

Jean Piaget s Theory On Child Development - 2312 Words

Jean Piaget has introduced theories on child development from 1896-1980. He is the the most cited and most influential on cognitive development. Piaget is the foundation of current child developmental in psychology. His inspiration came from observing children’s as he even used his own. His development of the cognitive deployment focused on mental process, remembering, believing and reasoning. To help explain his theory, Piaget’s came up with Stage-bound cognitive development. â€Å"Stage-bound is the development progresses through a series of stages as a result of assimilating (using the environment for already-learned activities)and accommodating (changing behaviors—and mental structure—in the face of environmental demands)† (Lefrancois, G. R. 2012). Piaget’s stage theory makes up four components, Sensorimotor, Preoperational, Concrete operations, and Formal operations. With these components a teacher or educator can designs its class r oom and better understand the deployment a child goes through. Once the knowledge of the theories is understood the teacher can teach the child the correct development that they are in. It’s important to know the characteristics of the development a child is going trough because all different age group have their own development stages. Piaget’s theory has four stages the first stage in Piaget’s theory is the sensorimotor development. This stage is from the age’s birth to 2 years old. In this stage is where the child has really no sense ofShow MoreRelatedVygotsky And Vygotsky : Early Childhood Development1683 Words   |  7 PagesRezzonico Piaget vs Vygotsky Early Childhood Development Lev Vygotsky and Jean Piaget are known in the educational world. Vygotsky and Piaget were developmental psychologists who had many of the same views and beliefs, but at the same time had opposing views. According to Jean Piaget â€Å"cognitive development was a repetitive reorganization of mental processes that derived from biological maturation in addition to environmental experiences’’ (McLeod, S. A. (2015). The child is able toRead MoreInfluential Theorist And Child Development : Who Are Capable Of Inventing New Things? Essay1214 Words   |  5 Pages Chevannes 1 Mrs. Slinger HPC 3OR September 17th, 2016 Influential Theorists In Child Development: Intellect, Jean Piaget (1896-1980) The goal of education is not to increase the amount of knowledge, but to create the possibilities for a child to invent and discover, to create men who are capable of inventing new things. Jean Piaget is an influential theorist in child intellect development. Piaget insights society on the importance of not learning, but thinking, his thoughts/studiesRead MoreJean Piaget s Theories Of Cognitive Development1360 Words   |  6 Pages Jean Piaget was a Swiss psychologist. 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Instead of continuing the Freud s work with psychoanalysis, as many psychologists and philosophers did at the time, Piaget stayed â€Å"closer to his teacher Pierre Janet s psychology† (Vidal)Read MoreVygotsky And Vygotsky Theories Of Learning1257 Words   |  6 PagesTheories of learning In this essay, I will compare and contrast jean Piaget and lev Vygotsky theories of learning. First, I will discuss Piaget followed by Vygotsky then I will compare and contrast both theorists. Jean Piaget was a Swiss developmental psychologist and philosopher, he is known for his contribution to a theory of cognitive development. Piaget became interested in the reasons why children gave the wrong answers to questions that required logical thinking. He believed that these incorrectRead MoreJean Piaget s Theory And Theory1673 Words   |  7 PagesWhat is a theory? A theory is an organized set of ideas that is designed to explain development. 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Piaget’s theory encompasses development throughRead MorePiaget s Theory On Stages Of Developmental Psychology1180 Words   |  5 Pages Piaget Today Rebecca Biddle English 101 Mrs. Rufino 17 December 2015 Rebecca Biddle Mrs. Rufino English 101 9 December, 2015 Piaget Today â€Å"Child development does not mean developing your child into the person you think they should be, but helping them develop into the best person they are meant to be.† ― Toni Sorenson Jean Piaget was a leader in the field of developmental psychology, the study of how people grow. Instead of continuing the Freud s work with psychoanalysis, as manyRead Morejean piaget1284 Words   |  6 Pagesï » ¿Jean Piaget Jean Piaget (1896 - 1980) was employed at the Binet Institute in the 1920s, where his job was to develop French versions of questions on English intelligence tests. He became intrigued with the reasons children gave for their wrong answers on the questions that required logical thinking. He believed that these incorrect answers revealed important differences between the thinking of adults and children. Piaget (1936) was the first psychologist to make a systematic study of cognitiveRead MoreEducational Methods Influenced By Jean Piaget And Lev Vygotsky800 Words   |  4 Pagesresearch of Jean Piaget and Lev Vygotsky. Both of these men provided influential theories, which had a significant impact on evaluating children’s learning styles and abilities. After years of research and observation, Piaget determined that intellectual development is the result of the interaction of individual and environmental factors. He felt that as a child develops and always interacts with the world around him, knowledge was established. Through his observations of his children, Piaget developed

The Great Depression and Hebert Hoover - 559 Words

Following an era of economical prosperity, the Great Depression, otherwise known as the ugliest sister of the 1900’s family, which lasted an entire decade from 1929 to 1939, began on a fateful day with the New York Stock Exchange abruptly crashed and was unable to recover quickly. This occurrence, of course, had an unforgivable effect on the economy, leading to one of the most memorable and significant eras in American history. Not only affecting the economy domestically, internationally trading was burdened by the limp leg that was the United States. Socially, people were struggling to regain their balance after a main income source –agriculture- was swept away by the Dust Bowl, only worsening the drawn out effects of the initial Wall Street crash. Politically, the US faced severe turmoil with presidency of Herbert Hoover due to a lack of action to prevent economic decay and promote domestic and foreign recovery. Needless to say, after one presidential term, Franklin D . Roosevelt was elected into office and soon passed the New Deal, a highlight in his presidential career. However, due to the previous president, there were several critics about the nature and efficacy of such a policy. The Great Depression was a time of discussion and criticism of political policy and the nature and efficacy of said policy in dominating the backfire of grand economical proportions within the United States alone. The presidency of Herbert Hoover only lasted for one term from 1929 to 1933Show MoreRelatedEssay about The Great Depression in America1156 Words   |  5 Pagesfar fetched, but the Crash of 1929 made this a reality. The crash of 1929 established the beginning of Americas most memorible era; the great depression. According to the London Penny Press, following the week of Black Thursday, one could go to New York and see speculators hurling themselves from windows because they had lost everything in the crash. (The Great Crash 1929-Galbraith) Many people had everything they could ever dream of before the crash occured, but after the crash they found themselvesRead More How Steinbeck Creates Two Contrasting Characters In Beginning Of Mice and Men954 Words   |  4 PagesDuring the presidential reign of Hebert Hoover in the early 1930s, America was hit with a severe economic slowdown which was notoriously known as The Great Depression. During this time of crisis, an estimated sixteen million people were left unemployed and many others were left homeless. Even though it was expected that many industries in the United States would be significantly affected as a result of the crash, it was Agriculture that was destroyed. Many landowners were desperate to employ workersRead MoreTyranny Of The Minority By Benjamin Bishin2074 Words   |  9 PagesDemand Model. This model asserts that elected representatives respond to the demands of their constituents (Bishin, 5). Additionally, candidates try to appeal to active groups for the purpose of being reelected. Active interest groups can have a great impact on the political process overall; which is why Bishin’s model for his theory mainly focuses on its power to do so. â€Å"The people have power when they care intensely† (Bishin, 158). In 1962, for example, the United States legislated an embargo

The Correlation Between Income And Happiness - 1477 Words

A number of publications have presented their analysis on the impact of income on happiness. The results provided in these papers acknowledged that there is a connection between the two. Yet, other factors considered in their studies also say otherwise. Likewise, I wanted to see what these studies have concluded for myself and do my own analysis on the issue. Using data from the 2010-2014 World Values Survey (Wave 6), along with a cross tabulation analysis and Chi-Square Test, I tested the hypothesis that as an individual’s income increases, then their happiness also increases. My crosstabs confirmed this notion, but the previous reports also showed that certain elements can affect income and happiness. INTRODUCTION The correlation between income and happiness has produced numerous studies among the academic community. Prior to delving into the (complicated) discussion of the relationship between income and one’s happiness, I would like to highlight previous studies and findings available on the subject in question. To begin, it has long been assumed that income and happiness are linked. The paper written by Christopher Boyce, Gordon Brown and Simon Moore in 2010 briefly acknowledges this notion, while also providing viable explanations as to why income and happiness are not linked. For instance, according to conventional economics, money can buy happiness for it can be traded for commodities that will increase an individual’s utilityShow MoreRelatedIncome Discrepancy as a Driving Factor for Divorce Essay1175 Words   |  5 Pagescultural values. This paper is going to explore how a difference in income can cause dissatisfaction and eventually, loss of love in a heterosexual marriage in American society. 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The decreasingRead MoreSubjective Well-Being Essay1316 Words   |  6 Pagesto Freud’s conclusion based on decades of experimentation and theoretical work in the field of psychotherapy, humans cannot be happy because a satisfaction of needs creates only a momentary phase of happiness which expires after some time. Therefore, the focus of life should not be obtaining happiness, and people should focus on avoiding suffering instead (Bullock, n.d.). However, several paradigms about well-being exist, and individual cognitive patterns and paradigms define the emotional responsesRead MoreMoney and Happiness1647 Words   |  7 Pages Running head: MONEY AND HAPPINESS Does An Increase In Wealth Make People, And Countries, Happier? Bishop s University Term paper March 11, 2014 PSY 246B: Social Psychology II Professor Standing Abstract In this paper, the relationship between happiness and money was examined. Does money buy happiness? Three studies were examined in depth to provide an answer to this question. This paper found that people believed that they would be happier if they were richer. It was also found thatRead MoreWealth Envy in Richard Cory, by Edwin Arlington Robinson Essay1408 Words   |  6 Pages Is it possible Richard had the reverse in his mind when he ended his life? Money appears to be a key that unlocks happiness to people on the lower end of the financial spectrum. If that were the case, then those who are well-to-do should be measurably happier. Studies give conflicting evidence as to a possible link between wealth and happiness, but for those with lower incomes it is there. While the issues plaguing the affluent are different, they struggle to be satisfied as well. HumansRead MoreIs Relative Income Rather Than The Income Itself?1719 Words   |  7 Pagesrelative income rather than the income itself. He found that, â€Å"when people are asked to choose between a real income of, say, $75,000 a year in a world where the average income is $37,500 and a real income of $100,000 a year in a world where the average income is $150,000, a majority typically chooses the former†. (Lee) This is caused by humans need to feel superior above others around them. This is one of the main determinants in ranking the level of happiness for people in middle to upper-classRead MoreMath Teachers : Social Emotional Development927 Words   |  4 Pages The R Square statistic in Figure 2.1 is 6.0 percent. A 6 percent R Square means that the two independent variables income inequality and household income account for 6.0 percent variation in consensus among math teachers that the social and emotional development of students is as important as their acquisiti on of knowledge in math classes. A P-value of 1.39E-12 indicates that the probability of the null hypothesis being true is false. 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Plenty of philosophers and social anthropologists have been seeking to answer it but they still can not suggest an obvious solution because various factors affect happiness and these are interacting with each other, thus, these points are not analyzed easily. However, even though analyzing happinessRead MoreHappiness Is A Personal And Multi Dimensional Notion2176 Words   |  9 PagesHappiness is usually expressed as â€Å"the point to which an individual assesses the total worth of his or her existence as a whole positively† (Veenhoven, 1993), and regularly, considered on an ordinal scale of answers to biased questions. Most experimental findings consume various kinds of self-reported ideals on happiness or particular well-being dignified from various scaling methods. Happiness is a personal and multi-dimensional notion – every distinct person depicts it in a diverse way, it is

Positive and Negative Possession in the Television Series...

Possession is defined by many religions as the act by an outside force, either demonic or spiritual in nature, which takes physical control of an individuals body or an object. According to many religions and beliefs, humans, animals, places and objects alike are all susceptible to these supernatural forces. Possession can be ended in two different ways: through an exorcism as seen by the Catholic Church, or using an anti-possession symbol seen in voodoo, witchcraft, hoodoo, and shamanism. Possession is also seen, mainly in Christian beliefs as being unwanted, however there are other religions that allow and attract spirits for possession to take place such as spiritual healing mediums in Brazil (Greenfield). Anthropologists have†¦show more content†¦Janice Boddy is an anthropologist who did research regarding the beliefs of a small village of people in the Northern Sudan. She found that their central belief revolved around a supernatural spirit called a Djinn, which is bet ter known as a Zar Spirit in this village. This predominantly affects women who have fertility or marriage problems. This spirit is invisible with no physical form or barrier, and possesses the woman by hovering over her head or being somewhat close to her. In this legend there is a specific type of â€Å"Djin n† that one would usually refer to as harmful or playful. According to lore, this Zar Spirit is playful and there is no way to remove the possession by exorcism, but rather to accommodate the spirit by allowing it to play and indulge. This form of possession is what many anthropologists call a positive possession that results in healing an illness or condition. This results in what Boddy calls a cultural healing (Boddy 368-85), which is the result of making the womans possession public which lessens the negative stigma associated with being possessed because it is seen as something beyond her control. In the series Supernatural, the episodes depict a more negative aspec t of possession rather than aShow MoreRelatedEssay on The Harry Potter Controversy2662 Words   |  11 PagesThe Harry Potter Controversy The wildly popular Harry Potter book series by J. K. Rowling has caused controversy for many families over the past five years. These novels according to some critics are harmless, adventurous, childrens tales. Others choose to portray them as stories that inspire children to become involved in the occult and serious witchcraft. The Harry Potter novels chronicle the life of a young wizard whose wizard parents were killed by the evil Lord Voldermort. On his eleventhRead MoreEveryday Nightmare: the Rhetoric of Social Horror in the Nightmare on Elm Street Series6614 Words   |  27 PagesTHE RHETORIC OF SOCIAL HORROR IN THE Nightmare on Elm Street SERIES The Nightmare on Elm Street movie series has enjoyed six successful theatrical releases since 1984, and a seventh installment was released in time for Halloween in 1994. It and other successful horror movie series, such as Friday the 13th and Halloween, are frequently analyzed from Freudian psychological perspectives and characterized as allegories of the psychological dynamic underlying the return of the repressed. Although theRead MoreTheology of the Body32011 Words   |  129 Pagesthe gift and the collapse of innocence. 4) The woman was â€Å"given† to man in the mystery of creation and received by him as a gift in the full truth of her person and inspires the reciprocal gift and acceptance. Real masculinity comes through the â€Å"possession of self† thanks to which he is capable both of giving himself and of receiving the other’s gift. 5) JP II is considering the time before the Fall from the aspect of human subjectivity, not the method of objectivization proper to metaphysics ofRead MoreStephen P. Robbins Timothy A. Judge (2011) Organizational Behaviour 15th Edition New Jersey: Prentice Hall393164 Words   |  1573 PagesDiversity 18 †¢ Improving Customer Service 18 †¢ Improving People Skills 19 †¢ Stimulating Innovation and Change 20 †¢ Coping with â€Å"Temporariness† 20 †¢ Working in Networked Organizations 20 †¢ Helping Employees Balance Work–Life Conflicts 21 †¢ Creating a Positive Work Environment 22 †¢ Improving Ethical Behavior 22 Coming Attractions: Developing an OB Model 23 An Overview 23 †¢ Inputs 24 †¢ Processes 25 †¢ Outcomes 25 Summary and Implications for Managers 30 S A L Self-Assessment Library How Much DoRead MoreSAT Top 30 Essay Evidence18536 Words   |  75 Pagesafter graduating he was a journalist for the Kansas City Star. Here he learned (from the newspaper’s style guide) the basic style that would become his trademark: â€Å"Use short sentences. Use short first paragraphs. Use vigorous English. Be positive, not negative.† When World War I arrived, Hemingway enlisted as an ambulance driver and was stationed at the Italian Front, where he witnessed horrific scenes of violence and destruction. During the war, Hemingway was badly wounded by mortar fire; despiteRead MoreDeveloping Management Skills404131 Words   |  1617 PagesBuilding Relationships by Communicating Supportively Gaining Power and Influence 279 Motivating Others 323 Managing Conflict 373 PART III GROUP SKILLS 438 8 Empowering and Delegating 439 9 Building Effective Teams and Teamwork 489 10 Leading Positive Change 533 PART IV SPECIFIC COMMUNICATION SKILLS 590 591 Supplement A Making Oral and Written Presentations Supplement B Conducting Interviews 619 Supplement C Conducting Meetings 651 Appendix I Glossary 673 Appendix II References 683 NameRead MoreLogical Reasoning189930 Words   |  760 Pages..................................................................... 539 Designing a Scientific Test ............................................................................................................ 539 Retaining Hypotheses Despite Negative Test Results .............................................................. 540 Three Conditions for a Well-Designed Test ............................................................................... 543 Deducing Predictions for Testing ....Read MoreOrganisational Theory230255 Words   |  922 Pagesdogma, superstition, prejudice and so on. It is interesting to note that the television series The X Files, which was about the paranormal and supernatural, actually used a rather objectivist epistemological stance in all its opening sequences – ‘the truth is out there’. The problem for one of the key protagonists in the series, Agent Scully, seemed to be getting the necessary evidence to convince her that the supernatural actually existed. At first sight, epistemological objectivism seems eminently

Is Music a Good Tool for Health Free Essays

In the article â€Å"Is Music a Good Tool for Health† by Elizabeth Scott, M. S. , she states that music has a powerful energy and affects our body and mind. We will write a custom essay sample on Is Music a Good Tool for Health or any similar topic only for you Order Now And music therapy is a benefit to patients. I agree with the author’s opinion. Research shows that our body will be affected when we are listening to music. Our breathing and heart rate will slow down. This means music can help us reduce stress and depression. After we calm down, we can begin to solve the problem. When I have a trouble, I always lose my head and I have no idea how to deal with it. Then I sit down, and listening to music. After I calm down, I can think about the problem and figure out the way to solve it. Music therapy is a growing field of health care. Many hospitals have already begun to use music to help patients. According to the article, â€Å"Hospitals are beginning to use music therapy to help with pain management, depression, to promote movement, to calm patients, to ease muscle tension, and other benefits. † As we can see, music is not only for relaxed, but also health. Many people like to listen to music when they are nerves and depression. Most people will feel better after they listen to music. Some people will ask how music can affect our body and mind. There is other research that shows brainwaves can be synchronized by music with a strong beat. Different speed beats have different effects in our brain. According to the article, â€Å"Faster beats bring sharper concentration and more alert thinking. Slower beats promote a calm, meditative state. † I think this is the reason why music can affect our body and we feel better after we listen to music. Music is a benefit to us, and music therapy will be growing in popularity. How to cite Is Music a Good Tool for Health, Papers

Dealing with Complaints free essay sample

You know I have just moved to a new region and noticed the advertisement near by my house. I would like to know about your internet services. Sure. first of all I want to know for what do you need the internet? For work? For communication? or may be for online games? well, I think mostly for communication with my relatives abroad. -Ok, then how often do you use internet? -every day. I have choose some variants for you. What kind of tariff do you prefer? limited or unlimited? unlimited, I think. so there are 23$ and 17$ variants. Â  a days ago I have bought a new coat and didnt noticed that there is a big hole inside! oh, we are really sorry for it. ou can choose from several options: to refund, to replace or to repair it. -I think replacement is what I want. -wait me a minute. Ill be back soon. We will write a custom essay sample on Dealing with Complaints or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Here it is. thank you. -we apologies again for this defect How can I help you? I would like to choose a mobile phone for present for my wife. -Well I can offer you this models. Women like it most of all. -Very good. My wife like to make a photos, so I need good camera within the phone. -ok, this models have a 16 megapixels camera. But I would recommend you this phone. It has wi-fi and 3g functions, big sized screen. Moreover this screen can react on nails! thats what I need. What is the price for it? -oh, lucky you! Right now we have sale on all phones of this series. It costs only 640$!!! -great. Can you say some words about the guarantees? Of cause, it has a guarantee on 2 years. With opportunity to refund or replace it if something will go wrong. I forgot to said that it is available in 5 colors: black, white, pink, yellow and blue.

Skipton is located Essay Example

Skipton is located Essay Skipton is located just off the A65 20 miles away from the north west of Bradford. It is at the southern base of the Yorkshire Dales located on the river Elbeck which is a tributary of the river Aire. The word Skipton comes from the Saxon word for sheep hence the reason why it started off as a trading center for sheep and wool. Since then Skipton has grown a lot because it was of great importance in the industrial revolution due to the fact that the Leeds and Liverpool canal was used for trading. Skipton still remains a very historic town with many cobbled streets, a canal and a castle. The population is 16000 people approximately.Chapter 1 (traffic survey)Aim: To discover how the traffic in Skipton varies from time to time and from place to place.Hypothesis 1: The by-pass will have a greater proportion of commercial traffic than the road through the center of Skipton.Method: We were doing the first traffic survey on the Skipton by-pass the A65. We started the survey at 09:45am and f inished at 09:55am the survey lasted 10 minutes. We surveyed how many vehicles traveled to the north and south of Skipton. We recorded the results by sitting in a pair of two in the coach one of us collected the data of the vehicles traveling north whilst the other collected the data of the vehicles traveling south. At times we found it difficult because many vehicles were passing together in large amounts, for our data we wanted to see how many vehicles traveled north and south in an hour as we didnt have the time to collect data for an hour we multiplied the grand total of the vehicles traveling north and south by six.Results:Type of vehiclesVehicles moving northTotal amount of vehicles moving northVehicles moving southTotal amount of vehicles moving southCar40403535Van1151136Lorries6571046Buses057046Motor Bikes057046Caravans057046Bikes057046Other057046The chart and graph shows the total amount of vehicles that travel to the north and south of Skipton, and it also shows the types of vehicles and their amount, which traveled on the same road.Type of vehiclesVehicles moving northTotal amount of vehicles moving northTotal amount of vehicles moving north hourlyVehicles moving southTotal amount of vehicles moving southTotal amount of vehicles moving south hourlyCar40402403535210Van1151306136216Lorries6573421046276Buses057342046276Motor Bikes057342046276Caravans057342046276Bikes057342046276Other057342046276In this graph and chart u have multiplied the total amount of vehicles and the types of vehicles as shown on page 3 by six to show the hourly rate of traffic.Type of vehiclesVehicles moving into SkiptonTotal number of vehicles moving into SkiptonVehicles moving out of SkiptonTotal number of vehicles moving out of SkiptonCar65654545Van11761156Lorries177460Buses077565Motor Bike077065Caravan178065Bike078065Pedestrians791573398The above chart and graph show the number of vehicles and pedestrians in and out of Skipton.Type of vehicles/pedestriansVehicles/pedestrians moving into SkiptonTotal number of vehicles/ pedestriansTotal number of vehicles/pedestrians hourlyVehicles/pedestrians moving out of SkiptonTotal number of vehicles/pedestriansTotal number of vehicles/pedestrians hourlyCar65653904545270Van11764561156336Lorries177462460360Buses077462565390Motor Bike077462065390Caravan178468065390Bike078468065390Pedestrians791579423398588In this graph and chart I have multiplied the total amount of vehicles and pedestrians as shown on page 5 by six to show the hourly rate of traffic going in and out of Skipton in the morning.Conclusion: My hypothesis was incorrect as there was more traffic in the city center of Skipton rather than the by-pass (A65) of Skipton.My results disprove my hypothesis strongly because there was a lot more proportion of traffic in the city center of Skipton.I think the surveys were not done for long enough because if you want to collect data for a survey you need to collect that data for hours not 10 minutes but we figured out a solution to come up with the data of surveying for an hour by multiplying the total number of vehicles and pedestrians by 6.The results would have been different on a non market day because we visited Skipton on a market day and the Central business district/high street of Skipton was crowded with people and most of them people were crowding around the market whereas on a non-market day there wouldnt have been as many vehicles and pedestrians because there would be a less variety of shops and stalls to shop at.Hypothesis 2:In the morning the traffic will be going into Skipton and in the afternoon most of the traffic will be leaving Skipton.Method: I did my morning survey on Swadford Street that is at the bottom of the high street. We also did another survey in Swadford Street that was in the afternoon, which started at 12:35pm to 12:45pm that lasted for 10 minutes we also multiplied the total of this survey by 6 to make an hourly total. The traffic was going in and out of Skipton and was done in the exact same way as the first survey on Swadford Street.

Sample Visual Arts MFA Essay - The Essay Written By Your Student

Sample Visual Arts MFA Essay - The Essay Written By Your StudentWriting a MFA Essay sample is one of the most important parts in a student's education. This essay is what will get the student noticed as an educator or professional. Students will do well to take a careful look at their choices and find one that will best suit their educational needs.The main goal of this essay is to have the student identify what skills he or she has that make them an ideal candidate for the job and how these skills can be applied to the field. The student should know what experience is required and what skills are needed to succeed in the profession. There are different aspects to this essay.For example, if the essay focuses on one of the requirements for the career such as being a great artist, the student might want to highlight this skill. The student might also want to have the student examine the advantages and disadvantages of art work in general. It is also important for the student to underst and the concept of learning to be, their perception of their abilities and the rewards of doing so.A sample visual arts MFA essay can contain drawings, paintings, sculptures, and other images from the different disciplines. The student might want to use their own artistic talent to draw or paint the images. It can include teaching the student to create their own unique pieces of art. Some MFA students choose to illustrate their own masterpieces with oil paintings and acrylics.Students will need to create a portfolio with a list of their skills and talents from visual arts to music. This allows the student to highlight and support each of their different areas of expertise. When they put their work together, they might want to look at it and decide if it's what they are looking for. If it is, they will then need to illustrate the image using a drawing.It is important for students to write a sample visual arts MFA essay because this is where they will be going into the work world. The y will need to showcase the strengths and weaknesses of each of their artistic areas. Most students will do this in the first two years of study.The essay will likely last anywhere from 30 minutes to one hour depending on the type of program they are enrolled in and the number of students who they will be sharing this with. To ensure that the student does not forget important points in this section, make sure that they include the date and time that the essay was written.

Young Goodman Brown Essays - Abrahamic Mythology, Satan, Free Essays

Young Goodman Brown Essays - Abrahamic Mythology, Satan, Free Essays Young Goodman Brown "Young Goodman Brown", by Nathaniel Hawthorne, is a story that is thick with allegory. "Young Goodman Brown" is a moral story which is told through the perversion of a religious leader. In "Young Goodman Brown", Goodman Brown is a Puritan minister who lets his excessive pride in himself interfere with his relations with the community after he meets with the devil, and causes him to live the life of an exile in his own community. "Young Goodman Brown" begins when Faith, Brown's wife, asks him not to go on an "errand". Goodman Brown says to his "love and (my) Faith" that "this one night I must tarry away from thee." When he says his "love" and his "Faith", he is talking to his wife, but he is also talking to his "faith" to God. He is venturing into the woods to meet with the Devil, and by doing so, he leaves his unquestionable faith in God with his wife. He resolves that he will "cling to her skirts and follow her to Heaven." This is an example of the excessive pride because he feels that he can sin and meet with the Devil because of this promise that he made to himself. There is a tremendous irony to this promise because when Goodman Brown comes back at dawn; he can no longer look at his wife with the same faith he had before. When Goodman Brown finally meets with the Devil, he declares that the reason he was late was because "Faith kept me back awhile." This statement has a double meaning because his wife physically prevented him from being on time for his meeting with the devil, but his faith to God psychologically delayed his meeting with the devil. The Devil had with him a staff that "bore the likeness of a great black snake". The staff which looked like a snake is a reference to the snake in the story of Adam and Eve. The snake led Adam and Eve to their destruction by leading them to the Tree of Knowledge. The Adam and Eve story is similar to Goodman Brown in that they are both seeking unfathomable amounts of knowledge. Once Adam and Eve ate from the Tree of Knowledge they were expelled from their paradise. The Devil's staff eventually leads Goodman Brown to the Devil's ceremony which destroys Goodman Brown's faith in his fellow man, therefore expelling him from his utopia. Goodman Brown almost immediately declares that he kept his meeting with the Devil and no longer wishes to continue on his errand with the Devil. He says that he comes from a "race of honest men and good Christians" and that his father had never gone on this errand and nor will he. The Devil is quick to point out however that he was with his father and grandfather when they were flogging a woman or burning an Indian village, respectively. These acts are ironic in that they were bad deeds done in the name of good, and it shows that he does not come from "good Christians." When Goodman Brown's first excuse not to carry on with the errand proves to be unconvincing, he says he can't go because of his wife, "Faith". And because of her, he can not carry out the errand any further. At this point the Devil agrees with him and tells him to turn back to prevent that "Faith should come to any harm" like the old woman in front of them on the path. Ironically, Goodman Brown's faith is harmed because the woman on the path is the woman who "taught him his catechism in youth, and was still his moral and spiritual adviser." The Devil and the woman talk and afterward, Brown continues to walk on with the Devil in the disbelief of what he had just witnessed. Ironically, he blames the woman for consorting with the Devil but his own pride stops him from realizing that his faults are the same as the woman's. Brown again decides that he will no longer to continue on his errand and rationalizes that just because his teacher was not going to heaven, why should he "quit my dear Faith, and go after her".

Requisitos y medidas foto visa EE.UU. y cómo subirla

Requisitos y medidas foto visa EE.UU. y cà ³mo subirla Las fotos para las visas no inmigrantes, visas de inmigrantes y para participar en el sorteo de la loterà ­a de visas de diversidad de EE.UU. deben cumplir requisitos sobre cà ³mo debe lucir en ellas el fotografiado y medidas. Adems, en los casos en los que es necesario subir la foto al formulario de solicitud del visado, la imagen debe cumplir con los parmetros de peso, dimensiones y formato. Antes de seguir con este artà ­culo cabe destacar que no todos los solicitantes de visa para Estados Unidos necesitan sacar una foto y subirla al formulario de solicitud de la misma o llevarla en formato papel al consulado el dà ­a de la entrevista. Y es que en los casos de solicitarla en un consulado con Centro de Apoyo como CAS o ACS como sucede, por ejemplo, al solicitar la visa de turista en Argentina, Mà ©xico o Repà ºblica Dominicana, las fotos se toman en dichos centros junto con otros datos biomà ©tricos como las huellas digitales. Por lo tanto, toda la informacià ³n de este artà ­culo solamente aplica en los casos en los que las fotos no deban ser tomadas en un Centro de Apoyo. En el mismo se explican los requisitos de foto y fotografiado, tamaà ±o, peso y formato de las fotos digitales, cà ³mo saber si cumplen con los parmetros, cà ³mo modificarlos si fuera necesario y cà ³mo subir con à ©xito la foto al formulario de solicitud de la visa. Finalmente, cules son las caracterà ­sticas de las fotos en papel. Requisitos de las fotos para las visas americanas Las imgenes deben cumplir los siguientes requisitos: en color, con fondo blanco o blanco roto (off-white). La persona fotografiada, que es la que solicita la visa, debe mirar de frente a la cmara y asegurarse de que la cabeza sale centrada en la fotografà ­a y completa, desde el pelo hasta la barbilla, que debe alcanzar unas medidas de entre una pulgada y 1 3/8 pulgadas (entre 25 y 35 mm). Ambos ojos deben salir abiertos y la altura de los ojos caer entre 1 1/8 y 1 3/8 pulgadas del fondo de la fotografà ­a ( entre 28 y 35 mm). Para asegurarse de que se cumplen las especificaciones es recomendable familiarizarse con ejemplos que cumplen estos requisitos. No puede vestirse ningà ºn tipo de uniforme, salvo el religioso como por ejemplo en el caso de sacerdotes y monjas. Tampoco se deben llevar gorros, sombreros, velos o cualquier otra prenda u objeto que dificulte la vista del pelo, salvo que su utilizacià ³n està © justificada por motivos religiosos. Si habitualmente se utilizan audà ­fonos no es necesario quitarlos para sacar la foto si se tiene la precaucià ³n de evitar que se produzcan reflejos en los cristales. Sin embargo, en la actualidad si se usa espejuelos o lentes es necesario quitarlos, salvo cuando no sea posible hacerlo por razones mà ©dicas. En ningà ºn caso la oficina consular aceptar como vlidas fotos de mala calidad o que son el producto de haber escaneado la foto de un I.D., como por ejemplo una licencia de manejar. Tampoco son vlidas aquà ©llas en las que la persona sale de cuerpo completo. Dà ³nde tomar las fotos para la visa americana Si se est en Estados Unidos, en cualquier negocio de fotografà ­a que saquen fotos para el pasaporte americano. Lo mismo puede decirse de otros paà ­ses. En este caso es imprescindible hablar con el fotà ³grafo y especificarle los requisitos de fondo blanco, tamaà ±o, mirada al frente, etc. Incluso, si reà ºnen los requisitos, es posible hacerlo con un telà ©fono mà ³vil o una webcam. En estos casos, asegurarse de cumplir todas las directrices mencionadas y que la foto tiene calidad suficiente. Si la foto debe subirse al formulario de solicitud de la visa y no est ya digitalizada puede escanearse con una resolucià ³n de 300 pixeles por pulgada (12 pixeles por milà ­metro). Se puede enviar por correo electrà ³nico para descargarla en la computadora en la que se va a realizar el trmite de solicitud de la visa. Medidas, peso y formato de las fotos digitales para la visa americana. En los casos en los que la foto debe subirse al formulario de solicitud de la visa aparece la expresià ³n Photo Upload en dicha planilla. En estos casos, la imagen debe tener las siguientes caracterà ­sticas Tener una dimensià ³n mà ­nima de 600 x 600 pixeles (ancho x largo)En color de 24 bits por pixelSà ³lo se admite el formato JPEG.Y el tamaà ±o del archivo ha de ser de 240 kb o menor. Si es necesario, puede comprimirse con una proporcià ³n de 20 a 1 o menor. Se puede verificar si la foto cumple con esos parmetros colocando el cursor sobre ella y clickando con el botà ³n derecho del ratà ³n. Se abre la ventana de propiedades y, en la etiqueta de General puede verificarse el tamaà ±o en KB. En la etiqueta de Detalle puede comprobarse el alto y ancho de la imagen. Si no cumpliese con los requisitos seà ±alados anteriormente, es posible cambiarlos utilizando un programa. Para hacerlo, si se tiene una computadora con el sistema operativo Windows colocar el cursor sobre la imagen, hacer click con el ratà ³n derecho y en Abrir con elegir Paint. Checar la Barra de Estatus y asà ­ es posible ver la informacià ³n de la foto en la parte inferior de la misma. A continuacià ³n, para ajustar la foto a los parmetros necesarios clickar en el icono de Seleccionar para cambiar el alto y ancho de la foto. Una vez que en la barra de estatus se obtienen los nà ºmeros que se buscan clickar en Guardar y elegir como formato JPEG y a continuacià ³n en Guardar como, dale un nombre y guardar. Si se tiene una computadora Mac puede utilizarse Paintbrush. En todos los casos pueden utilizarse otros programas informticos de manipulacià ³n de fotografà ­a. Cà ³mo subir la foto al formulario de solicitud de la visa Cuando se est llenando el formulario de solicitud de visa el momento para subir la foto es cuando se llega a Upload Image. Se debe clickar en ese botà ³n. A continuacià ³n aparecen las directrices ya mencionadas sobre peso, dimensiones y formato. Si alguno de los parmetros no es el exigido se va a obtener un mensaje de error y, si es el formato el equivocado, un mensaje de Only JPEG Images. La solucià ³n es modificar los parmetros como se explicà ³ en el apartado anterior. Una vez que se est seguro de que todo est correcto clickar a Browse y elegir la foto. Dar a OK y aparecer la foto. En ese momento se pueden ver dos botones: Upload Again y Confirm. Clickar en este à ºltimo y dar a OK y asà ­ se sube realmente la foto al formulario y ya se puede continuar con la aplicacià ³n. Fotos 5x5 para la visa americana En algunos consulados o para algunos tipos de visas el requisito es llevar una o dos fotos a la entrevista. En este caso deben cumplir con los requisitos de fondo blanco o blanco roto, no espejuelos, mirar de frente, etc. explicados con anterioridad. Adems, la foto debe: Estar impresa en papel de buena calidadTamaà ±o de 5x5, es decir, 5 cm de ancho por 5 cm de largo, o lo que es lo mismo: 2 pulgadas por 2 pulgadas (51 x 51 mm).Si se pide ms de una foto, todas deben ser idà ©nticas. Adems, si la foto se subià ³ digitalmente siguiendo los puntos que seà ±alaba el formulario de solicitud de la visa es prudente llevar una foto de estas caracterà ­sticas tambià ©n el dà ­a de la entrevista. Para re-asegurarse de que la foto est clara y no ha habido ningà ºn problema con el sistema. Puntos Clave: fotos para visa americana Las visas no inmigrante, las de inmigrante y la loterà ­a de visas de diversidad requieren una fotografà ­a o ms del solicitante. Dependiendo del tipo de visa y/o consulado, el solicitante puede tener que presentarse a un Centro de Atencià ³n donde le tomarn las huellas digitales y la foto antes de la entrevista en el consulado.Por el contrario, si debe subirla digitalmente al formulario de solicitud de la visa o presentarla en papel en el consulado, los requisitos son los siguientes:Requisitos de la foto: en color, fondo blanco o blanco roto. El fotografiado debe mirar a la cmara, con los ojos abiertos y sin gafas ni sombreros o gorras. La excepcià ³n son los velos religiosos, por ejemplo, los de las monjas.Parmetros digitales: formato JPGE, mximo 240kb y medidas de 600 pixeles de ancho por 600 pixeles de largo. Programas como Paint y Paintbrush permiten modificar los parmetros de las foto para ajustarlos a estos requisitos.Foto en papel: debe ser de buena calidad y tener un tam aà ±o de 5 cm de ancho por 5 cm de largo. Si deben presentarse dos fotos, ambas sern iguales.Dà ³nde sacar las fotos: pueden tomarse en cualquier fotà ³grafo que saque fotos para pasaporte, especificando las caracterà ­sticas que debe tener la foto. Posteriormente, si debe subirse digitalmente para subirla al formulario de solicitud de la visa, puede escanearse empleando una resolucià ³n de 300 pixeles por pulgada. Este es un artà ­culo informativo. No es asesorà ­a legal de ningà ºn tipo.

Gradcom Ltd Organization Behavior Research Paper

Gradcom Ltd Organization Behavior - Research Paper Example This paper highlights that  some of the external influences resulting from the management can be manipulated to be benefit the company. It is however the duty of the management to find out how. The better the managers understand their employees, the better the relationship and the better the performance per employee. This analysis is going to be based on the factor stated above in relation to my current company-Gradcom. It is renowned for its mobile phones and computer consultancy services in Kenya and the whole of East Africa. It has been in this business for more than ten years now.  This study outlines that communication is the key to success of every organization. It is through communication that information is passed from the floor managers to the apex C.E.Os for decision making in bureaucratic organizations. A failure at any level guarantees total failure since decisions will be made based on a distorted information or insufficient data. Communication at Gradcom can be desc ribed as a mix of formal and informal with the former being strictly for communications that requires keeping records. Grapevine define the communication among the employees with majority of the information passed on informally from person to person. This culture by the prevailing environment that discourages authoritarian ruling of the juniors and less hierarchical ranks within the organization.  Most of the formal communications involve written memos, outgoing and incoming letters as well as any other official documentations where records are a necessity.

Corporate Cultures and Their Impact on Recruitment and Retention Essay

Corporate Cultures and Their Impact on Recruitment and Retention - Essay Example The study suggests that global companies are realizing the importance and need to invest in the human ‘capital’. They can no longer take people for granted and sit back. Global economy is expanding, business opportunities growing but the available workforce steadily reducing. A culturally strong organization succeeds in attracting and retaining the top talent and can expect to climb the ladder of success. By the close of the twentieth century, business houses came to accept that people, not cash, buildings, or equipments differentiate one company from another. Corporate culture is moving into the limelight and proving to be an untapped asset for employees and businesses alike. Researches have shown that at the time of economic turndown the companies having strong and adaptive cultures are better able to handle the financial crisis than those with weak and poorly defined cultures. The right combination of people and culture can mean the difference between the financial su ccess and failure. As technology advances corporate culture will assume an even bigger role especially in the IT sector as competition increases. Organizations today recognize the need to attract the right brains to thrive in the competitive market and retain the employees. The norms of an organization are transmitted from generation to generation and are responsible for its financial success, which is the ultimate goal of any business organization. Understanding and assessing the company culture at every stage is vital.

George Bernard Shaw and His Short Story About the Cremation of The Narr

George Bernard Shaw and His Short Story About the Cremation of The Narrator's Mother   Ã‚  Ã‚  Ã‚  Ã‚  In a written exerpt from a letter about the cremation of his mother, George Bernard Shaw recalls her â€Å"passage† with humor and understanding. The dark humor associated with the horrid details of disposing of his mother's physical body are eventually reconciled with an understanding that her spirit lives on. He imagines how she would find humor in the bizarre event of her own cremation. The quality of humor unites Shaw and his mother in a bond that transcends the event of death and helps Shaw understand that her spirit will never die. The reader is also released from the horror of facing the mechanics of the cremation process when â€Å"Mama's† own comments lead us to understand that her personality and spirit will live on.   Ã‚  Ã‚  Ã‚  Ã‚  Shaw's diction is effective in conveying his mood and dramatizing the process of cremation. The traditional words of a burial service â€Å"ashes to ashes, dust to dust† are not altered for the cremation, the interior chamber â€Å"looked cool, clean, and sunny† as by a graveside, and the coffin was presented â€Å"feet first† as in a ground burial. In selecting aspects of a traditional burial service, Shaw's mood is revealed as ambivalent toward cremation by imposing recalled fragments of ground burial for contrast. Strangely fascinated, he begins to wonder exactly what happens when one is cremated. This mood of awe is dramatized a... George Bernard Shaw and His Short Story About the Cremation of The Narr George Bernard Shaw and His Short Story About the Cremation of The Narrator's Mother   Ã‚  Ã‚  Ã‚  Ã‚  In a written exerpt from a letter about the cremation of his mother, George Bernard Shaw recalls her â€Å"passage† with humor and understanding. The dark humor associated with the horrid details of disposing of his mother's physical body are eventually reconciled with an understanding that her spirit lives on. He imagines how she would find humor in the bizarre event of her own cremation. The quality of humor unites Shaw and his mother in a bond that transcends the event of death and helps Shaw understand that her spirit will never die. The reader is also released from the horror of facing the mechanics of the cremation process when â€Å"Mama's† own comments lead us to understand that her personality and spirit will live on.   Ã‚  Ã‚  Ã‚  Ã‚  Shaw's diction is effective in conveying his mood and dramatizing the process of cremation. The traditional words of a burial service â€Å"ashes to ashes, dust to dust† are not altered for the cremation, the interior chamber â€Å"looked cool, clean, and sunny† as by a graveside, and the coffin was presented â€Å"feet first† as in a ground burial. In selecting aspects of a traditional burial service, Shaw's mood is revealed as ambivalent toward cremation by imposing recalled fragments of ground burial for contrast. Strangely fascinated, he begins to wonder exactly what happens when one is cremated. This mood of awe is dramatized a...

Management Information Systems in Process-Oriented Healthcare Organisations

Linkoping Studies in Science and Technology Thesis No. 1015 Management Information Systems in Process-oriented Healthcare Organisations by Anna Andersson Submitted to the School of Engineering at Linkoping University in partial fulfilment of the requirements for the degree of Licentiate of Philosophy Department of Computer and Information Science Linkopings universitet SE-581 83 Linkoping, Sweden Linkoping 2003 Management Information Systems in Process-oriented Healthcare Organisations by Anna Andersson Maj 2003 ISBN 91-7373-654-6 Linkopings Studies in Science and Technology Thesis No. 015 ISSN 0280-7971 LiU-Tek-Lic-2003:14 ABSTRACT The aim of this thesis work was to develop a management information system model for process-oriented healthcare organisations. The study explores two questions: â€Å"What kinds of requirements do healthcare managers place on information systems? † and â€Å"How can the work and information systems of healthcare managers and care providers be inc orporated into process-oriented healthcare organisations? † The background to the study was the process orientation of Swedish healthcare organisations. The study was conducted at the paediatric clinic of a county hospital in southern Sweden. Organisational process was defined as â€Å"a sequence of work procedures that jointly constitute complete healthcare services†, while a functional unit was the organisational venue responsible for a certain set of work activities. A qualitative research method, based on a developmental circle, was used. The data was collected from archives, interviews, observations, diaries and focus groups. The material was subsequently analysed in order to categorise, model and develop small-scale theories about information systems. The study suggested that computer-based management information systems in processoriented healthcare organisations should: (1) support medical work; (2) integrate clinical and administrative tools; (3) facilitate the ability of the organisation to measure inputs and outcomes. The research effort concluded that various healthcare managers need the same type of primary data, though presented in different ways. Professional evelopers and researchers have paid little attention to the manner in which integrated administrative, financial and clinical systems should be configured in order to ensure optimal support for process-oriented healthcare organisations. Thus, it is important to identify the multiple roles that information plays in such an organisation. Department of Computer and Information Science Linkopings universitet SE-581 83 Linkoping, Sweden Co n te n ts 1. Introduction †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 1 1. . 1. 2. Organisational and work process models in medical informatics †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 2 Aims of the study†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 3 2. Research methods†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 4 2. 1. The setting of the case study†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 4 2. 2. The data collection†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 6 2. 2. 1. Archival data †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 6 2. 2. 2. Interviewing †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 6 2. 2. 3. Diary method †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 6 2. 2. 4. Observation†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 7 2. 2. 5. Focus groups †¦Ã¢ € ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 7 2. . 6. Feedback loops †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 8 2. 3. Analyses†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 8 2. 4. Modelling†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 9 3. Results†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 9 3. 1. 3. 2. 3. 3. The requirements of healthcare managers for an HIS†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. Interpretation of organisational and work processes in relation to HIS†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 10 A management information system model for process-oriented healthcare†¦. 12 4. Discussion †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 14 5. Conclusions †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã ¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 15 6. Future work †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 15 7. References †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 7 Management Information Systems in Process-oriented Healthcare Organisations 1. Introduction Swedish healthcare organisations are required by law to maintain a holistic view of their processes (Prop. 1999/2000:149). Thus, such organisations need to have an overview of the entire scope of health service delivery. As a result, system thinking is vital (Senge, 1990). An organisation must be able to collect data from its operational processes and furnish health service management with data concerning the way in which th ey have utilised their resources (Kaplan & Norton, 1996). As a response to this imperative, many healthcare providers have begun to introduce process-oriented structures recently. There are a number of theories about how to design such structures. One theory is based on Business Process Reengineering (BPR), the purpose of which is to identify and redesign organisational processes (Davenport, 1993). Another approach is to analyse a healthcare organisation as a Complex Adaptive System (CAS), an interdisciplinary method that focuses on the self-organisation of systems and patterns, as well as the way in which outcomes emerge. The purpose of a CAS analysis is to resolve issues associated with adaptable systems (Zimmerman, Lindberg & Plsek, 2001). Regardless of whether a BPR or CAS approach is employed, process-oriented organisational structures face difficulties stemming from the fact that healthcare organisations operate on multiple levels, including county councils, hospital management, clinical management, and care providers, each with its own information requirements (Andersson, Vimarlund & Timpka, 2002). Each level struggles to survive under difficult economic constraints, limited growth and the constant threat of regulation (Luce & Elixhauser, 1990). Healthcare organisations need an integrated structure in order to quickly disseminate information among managers and care providers (Van de Velde, 2000). The first challenge is to structure information systems such that they support the workflow in a healthcare environment (Strauss et al. , 1985). Thus, it is not surprising that healthcare managers are increasingly seeking help from health information systems (HIS). Their objective is to minimise the overall costs of healthcare delivery, to improve the quality of their services (Greenes & Lorenzi 1998; Clayton & van Mullingen, 1996) and to correlate costs with resources consumed (Stead & Lorenzi, 1999). One option for gathering data in an 1 Management Information Systems in Process-oriented Healthcare Organisations HIS is to use censors and other devices that continuously furnish the healthcare organisation with data about its finances, quality, competence and level of satisfaction. However, before an HIS can be designed, both managers and developers need to be familiar with work routines, information requirements, and other key parameters at the clinical level, given that medical information is linked to the environment in which it is generated (Berg & Goorman, 1999). Thus, the organisation must outline its information requirements and work procedures. The HIS that ultimately emerges will be embedded in the organisation’s processes and must satisfy the care provider’s information needs (Berg, 1999). To sum up, in order to design an HIS in process-oriented healthcare organisations, attention must be paid to issues such as patient focus, cost effectiveness, service quality, adaptability to the constraints of the organisation, and integrated use of information at both the hospital and clinic level (Ovretveit, 1992; Flarey, 1995). Moreover, a holistic overview based on system thinking is vital, including the gathering of data from multiple sources in order to correlate costs with the utilisation of resources. The challenge is to define models that can support the design of an HIS. 1. 1. 1. Organisational and work process models in medical informatics The main purpose of reengineering was to focus on the processes rather than the functions or an organisation (Hammer, 1990). Further organisational enhancement could be achieved with quality methods such as Total Quality Management (TQM), which included process-oriented models. Another approach is to modify the business culture such that it becomes a learning organisation (Senge, 1990). In the financial area, Balanced Scorecard has been used to translate mission and strategy statements into operational objectives and measurement variables (Kaplan & Norton, 1996). When it comes to medical informatics, attempts have been made to design various kinds of organisational models, such as socio-technical modelling (Berg et al. ,1998). The rationale for introducing these models is to gain a greater understanding of the ways in which an HIS will affect the allocation and content of work tasks. Changes in work activities require modification of information management (Berg, 2001). The validity of a technology rests not only on the fulfilment of functional specifications, but also on the interaction of the technical system with its 2 Management Information Systems in Process-oriented Healthcare Organisations organisational environment (Brender, 1998). The resulting conclusion that has been drawn today is that social, organisational, cultural and contextual issues should be taken into consideration at an early stage of the development process (Kaplan, 2001). Moreover, approaches such as cultural-historical activity theory have been used to perform contextual analyses of clinical cognition and activity. Culturalhistorical activity theory argues that studying the present healthcare setting is insufficient – a researcher must also become acquainted with the history of the setting, given that clinical cognition is embedded in broader institutional structures and longstanding evolution (Engestrom, 1995). One method was to highlight patient data on the presumption that the objective of any healthcare organisation is to improve the health of individuals (Engestrom, 1999). Other researchers argue for a framework that allows for a constant interplay of different models, theories and perspectives (Maij et al. , 2002). The advantages of integrated frameworks are that methods and models can be optimised during the development process, while methods with specific weaknesses can be reinforced by others (Timpka, 1995). Finally, there are approaches for exploring the ways in which healthcare providers tend to reason in clinical contexts – such as situated action, an emerging perspective for studying human cognition and behaviour in order to design intelligent systems (Patel, Kaufman & Arocha, 1995). Such models address the clinical tasks that are to be performed within specific guidelines and define criteria for selecting appropriate options when there is a set of potentials (Wang et al. , 2002). 1. 2. Aims of the study The aim of this thesis is to develop a management information system model for process-oriented healthcare organisations, based on two questions: â€Å"What kinds of requirements do healthcare managers place on information systems? † and â€Å"How can the work and information systems of healthcare managers and care providers be incorporated into process-oriented healthcare organisations? The work is based on a circular process, during which models are developed by collecting and categorising data, as well as by designing small-scale theories about information systems. Organisational process is defined as â€Å"a sequence of work procedures that jointly constitute complete healthcare services†. A work 3 Management Information Systems in Process-orie nted Healthcare Organisations activity is defined as a set of work procedures that are closely related by virtue of their purpose and means of performance. A functional unit is the organisational venue responsible for a certain set of work activities. Healthcare Information Systems (HIS), Management Information Systems (MIS) and Information and Communication Technology (ICT) all define computer-based information systems. 2. Research methods A qualitative research strategy, based on an idiographic case study, was employed. Qualitative research, which has evolved within several disciplines, consists of a set of interpretive practices. It does not accord priority to any single methodology for data collection and analysis, nor does it have a theory or paradigm that is distinctly its own (Denzin & Lincoln, 1998). Qualitative research is best suited for understanding the processes inherent to a situation, along with the beliefs and perceptions of the people involved. Nevertheless, qualitative researchers can make their findings more widely applicable (Firestone, 1993). Furthermore, a case study is both a process of inquiry and the product of that inquiry (Stake, 2000). The researcher needs a wide array of information about the case in order to provide an in-depth assessment (Creswell, 1998). A primary distinction is between single-case and multiple–case designs of such studies (Yin, 1994). A case study whose primary mode of research is hermeneutic is idiographic in a natural setting – its main type of data is qualitative and its fundamental level of analysis is holistic (Fishman 1999). Interpretive studies are well served by a considerable degree of openness to field data, along with willingness to re-examine initial assumptions and theories. The result is an iterative process of data collection and analysis during which initial theories are expanded upon, revised or abandoned altogether (Walsham, 1995). 2. 1. The setting of the case study The setting of the study was a paediatric clinic at a county hospital in Sweden. In 1996, the county council adopted a wide-ranging quality program based on TQM and a Plan-Do-Check-Act (PDCA) cycle. In 2000, the county council started using Balanced Scorecard to measure the healthcare organisation’s outcomes. At the time of the study, the county’s development and change program for 4 Management Information Systems in Process-oriented Healthcare Organisations organisational quality was based on a CAS strategy. Furthermore, a processoriented healthcare information system was being designed. With some 30 clinics and 3,200 employees, the hospital had identified its main organisational objectives as the delivery of emergency and specialist healthcare, as well as county-wide rehabilitation and habilitation services. The purpose of habilitation is to enable someone with a congenital impairment, whereas rehabilitation focuses on recovering lost ability. Above and beyond the responsibilities of healthcare managers in accordance with the functional structure, all clinics at the hospital (including paediatrics) had developed work processes for specific groups of patients. These Patient Need Group Processes (PNGPs) centred on the healthcare needs of individual patients. The main objective of the PNGPs was to cultivate and maintain a high level of knowledge about medical care at the paediatric clinic. The scope of the processes varied considerably. However, a PNGP unit always comprised at least a doctor, nurse and secretary. If necessary, several clinics, hospitals and county councils could collaborate on the same process. In order to improve nursing care, development teams, staffed by practitioners interested in development work, were set up. Specific development areas included palliative care and the use of technical equipment. The teams produced documents concerning their specific areas that could prove of value for their co-workers. New work routines were developed for nursing care and for activities that are indirectly related to the patient care process, such as meal delivery, ordering medication and play therapy. The teams had contact people at each ward who were prepared to step in whenever nursing care problems arose. The team members normally attended meetings during their free time – or overlapping time when two shifts were on duty simultaneously. The paediatric clinic also cooperated with maternity wards and a total of 13 Child Health Centres (CHCs) throughout the county. The clinic was part of a network of specialist clinics in southern Sweden that focused on the exchange of knowledge and experience. At the time of the study, the paediatric clinic employed 12 senior physicians, 21 physicians, 91 nurses, 77 paediatric nurses (specialist nurse’s aides) and 13 secretaries. The management team consisted of six senior physicians, seven nurses and one secretary from the clinic. During the period of the study, the paediatric clinic supplied approximately 16,000 bed-days to inpatients, performed 5,000 scheduled surgical interventions and handled 5 Management Information Systems in Process-oriented Healthcare Organisations 6,000 emergency room visits by children. The paediatric clinic comprised one surgical unit and three wards, each with a physician responsible for medical matters and a nurse as manager. The ward for neonatal patients had eight beds for intensive care and ten for prenatal care. The ward for contagious patients had 16 isolation rooms for newborn babies and contagious children. The institutional care ward for children older than a year had 18 beds. The clinic used 15 PNGPs. 2. 2. The data collection The collection of data was conducted throughout documents, archives, interviews, observations, diaries, focus groups and feedback loops. 2. 2. 1. Archival data Archival data was used to place the research into context before, during and after the studies at the clinical site (Drury, 2002). An obvious danger posed by fixed data is that it can easily become outdated unbeknownst to the researcher. In these studies, archival data was related to: 1) annual reports by the clinic; 2) the county council’s quality pronouncements; 3) the government’s bill for the healthcare organisation; 4) the physical and mental health survey of hospital employees; 5) reports concerning the county council’s development plans for an HIS. 2. 2. 2. Interviewing A common interviewing technique is to meet face to face (Fontana & Frey, 1998). The interview may be structured, semi-structured or unstructured. The scope of an interview can range from five minutes to the lifetime of the subject (Fontana & Frey, 2000). This study involved semi-structured interviews with four doctors and four nurses. A series of open-ended questions addressed daily work routines and communication patterns. 2. 2. 3. Diary method The holistic perspective of this approach identifies connections among the individual, societal and organisational levels. One of the techniques that have evolved is the diary method, which proceeds from subjective assessments of time utilisation. The various steps require a practitioner to enter time, activity, Management Information Systems in Process-oriented Healthcare Organisations location, the names of co-workers with whom they interact and other comments during a specified period (Ellegard, Nordell & Westermark, 1999). In this study, a ward nurse kept a diary during one workweek. She entered the nature of her work tasks, the times that she performed them and the names of the co -workers with whom she interacted. 2. 2. 4. Observation Observation involves gathering impressions of the surrounding world. Qualitative observational research is fundamentally naturalistic (Adler & Adler, 1998). There is â€Å"descriptive observation†, in which the researcher assumes that he or she knows nothing about what is going on and takes nothing for granted. He or she employs â€Å"focused observation†, ignoring that which is defined as irrelevant. Finally there is â€Å"selective observation†, the most systematic approach, during which the researcher concentrates on the attributes of various activities (Angrosino & Mays de Perez, 2000). This type of observation requires a notebook, a storage location for the data that is collected during the process (Ely, 1993). The researcher observes and interacts with care providers at the paediatric wards before and after their rounds. Alongside the observations, the clinical staffs were interviewed again about what they were doing, why they were doing it, what they hoped to gain from an HIS and what benefits they expected. Field notes were entered into a log during the observation study. 2. 2. 5. Focus groups A focus group’s planning process should begin as soon as it is set up. The process includes the following steps: establish research objectives, appoint a moderator, develop moderator guidelines and draw up procedures. The moderator plays an important role during the group session. He or she conducts the interviews. It is important that the moderator not be the same person that put together the moderator guidelines and questions. In this study, a focus group session was held with seven nurses and three paediatric nurses, all of whom were women selected by a ward nurse. The participants had various duties at the paediatric clinic, where they had been employed for anywhere from 9? to 32 years. Five nurses were ward managers and two also managed development teams. They all had experience at each ward, as well as the paediatric surgery. The researcher had furnished the group moderator with 7 Management Information Systems in Process-oriented Healthcare Organisations guidelines and questions (Greenbaum, 1993). The questions were based on the clinic’s profile of itself: administrative activities, care provision and development work. Questions also dealt with work activities and the exchange of information with other units. Some questions focused in on a patient’s relations with the care providers, as well as the time and place for the performance of care activities. The entire focus group session was videotaped and transcribed. . 2. 6. Feedback loops Feedback loops throughout the research project permitted the generation of reports for evaluating data collection. A total of four reports were sent to the practitioners as a result of the case study. In addition, four seminars were held with the practitioners, the purpose of which was to discuss the research findings. The practitioners discussed and critiqu ed the results. 2. 3. Analyses There was no theory at the beginning as to how the material should be analysed. The first step was to break down healthcare management into the hospital, clinical and care process levels. Statements from the various management levels were interpreted on the basis of information requirement, i. e. main objectives, system functions, expected benefits and risks to be avoided. The second step was the analysis of three main work activities, each with three work procedures, at the clinic level. The third step involved the design of a management information system model. All empirical data was categorised. Various themes were identified and classified. After the categories had been cross-compared and clustered, abstract new categories were defined (Strauss & Corbin, 1990). The final analysis started with a category-by-category comparison, which enabled the identification of core categories that were sent to the paediatric clinic as a preliminary report for comment and critique (Glaser, 1978). Finally, the categories were modified in response to the comments. The focus was to come up with a context-based, process-oriented description and explanation of the phenomena (Orlikowski, 1993). The categories were incorporated into two small-scale theories. The first theory interpreted the information requirements of three management levels. The second theory interpreted the work processes employed by institutional care. 8 Management Information Systems in Process-oriented Healthcare Organisations 2. 4. Modelling In order to conduct the final analysis, the two small-scale theories were applied to the modelling of a management information system. Various possible approaches included data modelling (Connolly, Begg & Strachan, 1996), function modelling and object-oriented modelling (Booch, Rumbaugh & Jacobson, 1999). To handle such approaches, various modelling languages have been developed, including the object-oriented Unified Modelling Language (UML) (Fowler & Kendall 1999). The symbols and notations of the various languages can be difficult for the uninitiated to grasp (Sommerville & Sawyer, 2000). Furthermore, the notation and logic for modelling a system must work in tandem with the people involved in the development process. Thus, it is useful to visualise the information flow by means of a modelling approach, using notation and logic that have been established by consensus. As a result, the management information system models were designed in dialog with the practitioners in the case study. The notation was taken from Eriksson & Penker’s (2000) business processes but modified on the basis of the discussions. 3. Results The results are presented in accordance with the three sub-analyses. The first sub-analysis focused on the requirements of healthcare managers for an HIS. The second sub-analysis focused on interpreting organisational and work processes in relation to the HIS. The third sub-analysis focused on designing a management information system model for process-oriented healthcare. 3. 1. The requirements1 of healthcare managers for an HIS Hospital management expressed its intention to use an HIS to empower patients while maintaining control of resource utilisation. Thus, the planned HIS was expected to encourage a greater overall awareness of cost effectiveness with respect to the services provided by various units of the hospital. The biggest risk noted was that of a mismatch between the system and the existing organisational culture, in which it was easy to identify and reward employees who handled 1 Requirements and demands are used as synonym in this chapter and in article 1. 9 Management Information Systems in Process-oriented Healthcare Organisations mergencies. As a result, some of the staff appeared to resist a new way of transmitting information throughout the various levels of the organisation. The goals of the functional units (i. e. clinic management) focused on patients and the introduction of leadership based on co-determination. While management accepted patient empowerment and cost effectiveness as the their main objectives, they thought it was important that employees be allowed to make their own organisational decisions. Management wanted to see a new approach to measuring the activities of their organisational unit. In order to achieve these goals, they sought a way to define the data that is essential to making a reliable estimate. In managing the healthcare process, the objectives of an HIS centred on developing and maintaining specific clinical competence by enhancing support for decision-making and co-operation on the part of care providers. While all the process managers agreed that sharing information and knowledge was important to improving the decision-making process, they were unaware of resource competition issues. However, the withholding of information was not always intentional. Due to limited resources and full schedules, process managers were often unable to share their knowledge with other employees. 3. 2. Interpretation of organisational and work processes in relation to HIS Work activities included: (1) co-ordination of information exchange management; (2) care, including documentation of the care provided and the practice that had evolved at the clinic; (3) supply, including patient assistance and psychosocial support. The work procedures of the various activities were often related to and dependent on each other. Co-ordination activities were oriented toward management of the wards and the clinic. The activities focused on co-ordinating various types of information in order to support the care effort. External co-ordination is related to the exchange of information between the paediatric clinic and other care units. This coordination continued after the patients had been discharged from the clinic. Thus, the coordination of external resources and inter-organisational collaboration was important to the management of the clinic. Patient co-ordination started before a patient was admitted to institutional care. There were two 10 Management Information Systems in Process-oriented Healthcare Organisations easons for such approaches. First, the amount of time that patients stayed at the wards proved expensive for the healthcare organisation. Thus, such approaches saved money. Second, these approaches enhanced the relationship between care providers and caretakers, assuming that patients and their families were kept well informed. Internal co-ordination was related to management and planning activities at the clinic and the wards. Such activities were linked to external and patient co-ordination, given that providers needed to cooperate with other units and patients in order to manage ward care. Care activities were underpinned by what had been agreed upon during the coordination of work activities and the information that was to be used by various co-ordination procedures. Care provision involved medical and nursing care performed by physicians, nurses and paediatric nurses. Care activities were broken down among the various professions. But care was regarded as teamwork from the point of view of the patients. Thus, the work tasks of the various professions cumulatively became what are referred to as the outcome of care provision. Practice development took in both medical and nursing care issues. The knowledge and information cultivated was incorporated into the ordinary work routines of the paediatric clinic. Care documentation activities were linked to care work and development efforts. Documentation provides protection for both care providers and patients. Care documentation served as a means of communication among care providers. Supply activities were indirectly related to care activities. Among employees who performed supply activities were nurses, paediatric nurses, kitchen staff, cleaning staff, play therapists and teachers. Material provision furnished care activities with pharmaceuticals, equipment and materials. Based on the resources that material provision furnished to care activities on a daily basis, estimates were prepared concerning the resources the activities would require over time. Bandages, diapers, syringes, etc. were also a part of material provision. Material provision also included equipment and supplies for play and school activities, such as games, videotapes and textbooks, as well as kitchen and cleaning supplies. Psychosocial support activities called for an information system that could offer emotional support, such as administrative tasks associated with permitting patients to have their own personal phones. Thus, psychosocial support depended on the ability of patient co-ordination efforts to proceed smoothly, assuming that both patients and their families could be kept well 11 Management Information Systems in Process-oriented Healthcare Organisations informed. The main purpose of Patient assistance, which included both material provision and psychosocial activities, was to assist care activities. Such activities were related to supporting the physical and mental well-being of patients while undergoing medical and nursing care. 3. 3. A management information system model for process-oriented healthcare The county council formally required that hospital management monitor and report on service production with regard to quality and cost. As a result, hospital management needed data about resource utilisation and healthcare quality from the hospital organisation, along with information systems that could support methods such as Total Quality Management (TQM) and Balanced Scorecard. To monitor costs and quality, hospital management needed data from the functional units after determining what needed to be collected. The focus of process management was developing and maintaining a high level of quality in the medical and nursing care processes. The process unit was responsible for documentation and quality control operations. Process management needed directives from the functional management unit about both data collection templates and quality for medical and nursing care. Process management generated information about medical and nursing quality data for functional unit management. Best practice guidelines and decision support protocols for clinical practitioners were involved in the clinical process. The HIS application required by process management was a service quality control system that could extract data from and support decision making for medical and nursing care. Functional unit management comprised managers at both the clinic and ward levels. Clinic management organised the monitoring of the clinic’s resources, while ward managers co-coordinated the exchange of information at the wards. Functional unit management requested information about resource allocation specifications and templates for expenditure reports, as well as for patient satisfaction and staff work satisfaction data, from hospital management. Functional unit management needed data concerning the perceptions of patients and staff with regard to the services provided by the unit. Management was also looking for a way to relate its expenditures to resources utilised. In other words, its primary needs were in the areas of data collection, storage and access tools. 12 Management Information Systems in Process-oriented Healthcare Organisations Thus, functional unit management required data from clinical activities, but not at an individual or contextual level. The systems it was seeking were to supply data for use at a composite level, including the volume of financial and human resources that specified care activities necessitated. To monitor service delivery, management units in process-oriented healthcare organisations need data in three distinct areas: (1) medical and nursing care, (2) patient flows and (3) the utilisation of human and material resources. Although the management units may have access to a common data warehouse, requirements for data analysis and presentation vary considerably. Similarly, data collected from the healthcare organisation during daily work routines can be shared, but the primary data must be converted into a format that is usable by healthcare managers. The data that is collected should ideally be located where it can be made available to ordinary healthcare activities. For instance, networked devices can be used to monitor pharmaceutical use. Intelligent devices can also be connected to equipment in order to track their use, and material storage and use (diapers, sheets, etc. ) can be traced by bar-code systems. Furthermore, patients and healthcare staff can be registered with smart cards as they come and go. However, computerised patient records (CPRs) are the most logical central resource for data collection in the clinical setting. The data that is documented in the records can be used to monitor the clinical activities that have been performed. CPRs can also furnish data about work activities at the healthcare organisation. Such data is of little value as long as it is limited to individual patients. What is useful is to analyse cumulative data, such as the number of radiology examinations that have been conducted on leukaemia patients. The purpose of the data warehouse is to store what has been collected from various sources. The application and its interface are the parts of the HIS with which healthcare managers interact and with which users most readily identify. Thus, the application must help healthcare managers use information and must supply the right information to the right healthcare managers. Moreover, the application must support the specific analysis methods, tools and data formats required by current organisational analysis procedures, such as Balanced Scorecard and quality assurance methods. 13 Management Information Systems in Process-oriented Healthcare Organisations 4. Discussion The aim of this thesis was to develop a management information system model for process-oriented healthcare organisations. The research effort employed qualitative methods such as archival data analyses, interviews, observations, diary analyses and focus group analyses. Constant feedback loops among the participants in an idiographic case study helped establish a balanced interpretation. Meanwhile, categorising and modelling formed the pattern of interpretation for the management information system model. The main findings of the study are that an HIS in a process-oriented organisation must support the medical work, integrate clinical and administrative tools, and furnish information that allows for the measurement of organisational inputs and outcomes. As a result, it is important to identify the multiple roles that information plays in a process-oriented healthcare organisation. Most of the organisational development methods that healthcare currently takes advantage of, such as reengineering and quality management, include process definitions. However, the interaction between various groups of processes has seldom been analysed. Several recent organisational methods, such as Balanced Scorecard (Kaplan & Norton, 1996), address the problem of relating costs to resources. The areas in which information systems are expected to enhance care delivery range from access to medical knowledge bases, patient and clinician communication, and the minimisation of medical errors. Nevertheless, little attention has been paid to how integrated administrative, financial and clinical systems should be configured in order to support process-oriented healthcare organisations in an optimal manner. Internal co-ordination is informed by and dependent on documentation of care activities, particularly by monitoring the way in which human resources are harnessed to take care of patients. Furthermore, such co-ordination relies on information about the utilisation of material resources, i. e. durable equipment and disposables. Thus, internal coordination must obtain information from care activities in order to synchronise the work of the clinic, as well as to track costs associated with care and supply activities. The various processes monitor costs and allocate resources, relating them to the kinds of care activities that have been provided. 4 Management Information Systems in Process-oriented Healthcare Organisations The third sub-analysis discovered that the various management levels in process-oriented healthcare organisations need the same type of primary data, though in differing formats. An HIS for healthcare management in a processoriented healthcare setting can adhere to its structure and practice activities. Moreover, CPRs and other tools can be used to directly collect management data where and when the activities take place. But the data is useful only if healthcare management has the opportunity to examine it with its own analysis tools. For instance, while computerised ordering systems are regarded as important, the fit between organisational and information system models is not identified as a success factor. Clearly, there is a need for systems that optimise clinical workflow, as well as those that support the maintenance of equipment and supplies. However, systems provide optimal organisational value only if they support an integrated organisational model and business plan. 5. Conclusions This thesis points out that healthcare managers at different levels in an organisation all need the same primary data. The differences among the various management levels all concern the ways in which they compile the data that they need for their work. One problem when developing management information systems for healthcare organisations has been a lack of interest in integrating administrative, financial and clinical systems. In process-oriented healthcare organisations, integration is essential to obtaining the full benefits of such a structure. System thinking must also pervade the development of healthcare management information systems. As a result, the multiple roles played by information in process-oriented healthcare organisations must be identified. 6. Future work Identifying the multiple roles played by information in a process-oriented healthcare setting requires additional research about the process of designing an HIS. In the complex environment that healthcare organisations represent, various practitioners are required to pinpoint data sources and information 15 Management Information Systems in Process-oriented Healthcare Organisations requirements, as well as to advocate for the process of change in the organisational and information structure. Healthcare managers have differing preferences when it comes to information requirements, organisational processes and work activities. Thus, the development process relies on tools that can incorporate those divergent needs into system thinking. As a result, primary data is refined into information differently at the various levels of a processoriented healthcare organisation. More research is required concerning information system models and their notation. Though various groups (system analysts, designers, programmers and healthcare managers) can employ models and modelling activities during a development process, their objectives differ. Healthcare managers need to visualise their work environment and organisational processes, system analysts are interested in developing information systems in collaboration with designers, and programmers are looking for coding specifications. They may share a vision in terms of designing a healthcare information system, but their perspectives vary. Thus, the modelling effort should be based on at least two dimensions: (1) furnishing models with notations and objectives oriented towards specific groups; (2) ensuring that the models visualise the same system but address varying interpretations. Arguments based on the cognitive and practice perspective have identified prototyping as a fruitful approach to the development process (Houde &Hill, 1997). Prototyping is often used when the design calls for a high degree of involvement on the part of practitioners and end-users (Bodker & Gronb? k, 1991). Modelling, on the other hand, is linked to an organisational perspective and is frequently employed by system analysis methods. Thus, there is an opportunity to combine these two perspectives during the development process. Modelling is useful as part of a design theory with a high degree of practitioner involvement alongside of system analysts, designers and programmers. 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