Much Ad About Nothing Essay Example for Free

Much Ad About Nothing Essay Write about the ways in which Shakespeare presents the relationship between Beatrice and Benedick in Much Ado About Nothing and compare it with the ways in which relationships are presented in ‘Sonnet 130’, ‘Sonnet 43’ and ‘Salome’. In Much Ado About Nothing, Shakespeare presents an interesting relationship between the characters of Beatrice and Benedick. We can compare their relationships with the poems ‘Sonnet 130’, ‘Sonnet 43’ and ‘Salome’ and the relationships presented in them. Although Shakespeare includes a conventional relationship between Hero and Claudio, he also decides to involve a different affair between Beatrice and Benedick. One of these moments where we can begin to understand their relationship is during the First Meeting. In Act 1 Scene 1, Benedick uses imagery of a bird to mock Beatrice. On line 126, Benedick says to Beatrice â€Å"Well, you are a rare parrot-teacher†. Benedick could be mocking Beatrice by suggesting that she can’t say anything original and only copies what others say, therefore relating to the imagery of a parrot. However, the word ‘rare’ shows that Benedick recognises the unique characteristics of Beatrice and that she is standing out from the crowd, consequently hinting his disguised love for her. Additionally, this quotation also relates to the context of time as women, in those days, could be punished for talking too much. Benedick could be taking advantage of the conventions of time to put Beatrice in her place in their relationship with each other. The parrot imagery can also relate to a poem called Sonnet 130. This is because, in Sonnet 130, the poe t says â€Å"I love to hear her speak, yet well i know, That music hath a far more pleasing sound;†. We can link the first phrase of Sonnet 130 with Benedicks quote of a ‘rare’ parrot-teacher. By including the word rare before the imagery of a bird, suggests that although Beatrice may talk too much, Benedick still enjoys listening to her speak hence relating to Sonnet 130 â€Å"I love to hear her speak†. As well as this, the second line of Sonnet 130 â€Å"that music hath far more a pleasing sound† links to why Benedick uses the imagery of a bird to mock Beatrice in the first place. As he includes the phrase ‘parrot-teacher’, it indicates that even though he enjoys listening to her speak, perhaps as she speaks too much, means that there are better things to  be heard. Overall, within the First Meeting of Beatrice and benedick, Shakespeare begins an interesting relationship causing the audience to be intrigued and persuaded to keep watching. Shakespeare proceeds with their relationship in Scene 1 Act 11 at the Masked Ball. Here, Benedick and Beatrice are presented as hostile towards one another as Benedick is masked, unable to reveal his identity, as Beatrice is basically insulting him while pretending that she doesn’t know who he really is. She says that Benedick will â€Å"break a comparison or two on me, which peradventure not marked, or not laughed at, strikes him into melancholy, and then there’s a partridge wing saved, for the fool will eat no supper that night.† She is making the case that benedick is so weak-minded that no one will laugh at his jokes. Then Benedick will be so upset that no one listens to his witty comparisons that he loses his appetite and is unable even to eat a partridge wing, which would be a small meal anyway. But perhaps the idea of consuming food could be changed to create a more interesting insight of Beatrice’s insult. Beatrice could also be saying that Benedick is weak but has lost his appetite not for food but for life because he is regarded so low by his friends. It could also be a reference to Benedick losing his sexual appetite. In Beatrice’s quote, she uses a powerful metaphor to insult Benedick’s manhood. This would be particularly astonishing given the context of time: women were expected to say less than men. However, in this scene Beatrice is particularly outspoken by saying something which is immensely rude; this is completely going against the conventions of time. Beatrice would also be living up to the expectation at the time as women were more sexual than men and would be prone to having affairs and ultimately cuckolding men. We could compare Benedick and Beatrice relationship throughout the Masked Ball with the poem ‘Salome’. Salome presents someone who is confessing to something that they are guilty of. One line says ‘cut out the booze and the fags and the sex.’ This indicates that the person is wanting to lose their appetite for sex whereas within Beatrice’s insult towards Benedick, it refers to a possibility of Benedick losing his sexual appetite without wanting to. Furthermore, we could link when Beatrice says ‘for the fool will eat no supper tonight’ to another quote from Salome: ‘was his head on a platter’. Perhaps when Beatrice says that Benedick will have no supper, she could really mean that he is the supper.

Ethical Principles in Healthcare

Ethical Principles in Healthcare Introduction The Department of Health (DoH) (2003) highlighted the importance for all professions currently regulated by the Health Professions Council to demonstrate competence through continuing professional development (CPD). CPD is a systematic, ongoing, structured process that encourages the development and maintenance of knowledge, skills and competency that assists us in becoming better practitioners (Chartered Society of Physiotherapy (CSP), 2003). As a result of the Health Act (1999) and for registration with the Health Professions Council (HPC), CPD is a legal requirement (HPC Standards of Proficiency, 2007) that must be completed in accordance with the (HPC) Standards of Continuing Professional Development (HPC, 2006). This essay allows for demonstration of life-long learning using evidence from clinical practice and critical evaluation to contribute to my CPD. Learning outcome 5 will be demonstrated throughout this essay. Throughout this essay the reader is directed to the appendices to support theory with evidence of practice. I considered my motivations for undertaking CPD before writing this essay and reflected upon them again on completion (Appendix 1). Demonstrate professional behaviour with an understanding of the fundamental, legal and ethical boundaries of professional practice. Beauchamp and Childress (2001) identify four ethical principles; Autonomy, Beneficence, Non-maleficence and Justice. These ethical principles can be used to morally reason whether an action or decision is right or wrong when used in conjunction with a set of guidelines (Kohlberg et al, 1983). Professional codes of conduct are developed within moral, ethical and legal frameworks to help guide and regulate practice (Hope et al, 2008). Every practitioner has clinical autonomy, therefore they are professionally and legally accountable for their actions. The following will discuss the importance of consent and duty of care for both legal and ethical reasons with regards to case 1 (Appendix 2), encounterd on practice placement 6 (PP6). Rule 9 of the HPC standards of conduct, performance and ethics (2008) states you must gain valid consent from a patient for any treatment you may perform or else you could face trial for assault, battery or negligence under civil or criminal law (Hendrick, 2002). It is a fundamental ethical priniciple that every person has a right to exercise autonomy (Article 9; Human Rights Act, 1998) and is reflected in the Core Standards of Physiotherapy Practice (CSP, 2005). Performing a procedure without gaining consent, undermines the moral priniciple of respect for patients autonomy and human dignity (Sim, 1986). However, inability for Patient X to conform to the Mental Capacity Act (2005) meant he was treated in his best intrest in adherance to section 1.5 of this act and Rule 1 of the HPC (2008) standards of conduct, performance and ethics. Assuming the medical management of Patient X, a legal and professional duty of care was established (Rule 6; HPC, 2008). As part of this duty and in accordance with standard 2 of the CSP Core Standards of Physiotherapy, all interventions were explained to patient X despite his inability to consent. Had I not treated Patient X on the basis he had swine flu, this would have been failing to do justice to him, acting outside of the Disability Discrimination Act (2005) which states everyone should have equitable access to and utilisation of services regardless of disability and also Article 14 of the Human Rights Act (1998) in that no one should be discriminated against based on their health status. The Bolam Test (1957, cited in Dimond, 1999) states if duty of care to a client is breached and subsequent harm to the patient occurs, professional standards have not been kept and therefore negligence can be assumed. Although not legally binding, the CSP rules of professional conduct effectiv ely have the same status as law and failure to comply with them means they may not only be used in disciplinary hearings but also in legal proceeding as a civil case under the tort law of negligence (Dimond, 1999; Hendrick, 2002). In summary, a sound understanding of the legal implications surrounding consent and duty of care can help avoid unwanted litigation, however they should not undermine the ethical implications. Appendix 3 demonstrates how I have learnt from this experience. Assess the needs of a range of service users and, with reference to current professional knowledge and relevant research, apply, evaluate and modified physiotherapeutic intervention A service users is anyone who utilises or is affected by a registrants service (HPC, 2008). The complex needs of a service user encompass a range of issues including social, environmental, emotional and health related, the extent of which varies from person to person. For the purpose of this essay, the physiotherapeutic management of two patients treated whilst on PP6 with differing severities of chronic obstructive pulmonary disease (COPD) exacerbations (Appendix 4) will be discussed. The National Institue for Health and Clinical Excellence (NICE) guidelines (NICE, 2004) in conjuntion with the guidelines for physiotherapy in respiratory care (British Thoracic Society (BST), 2008) advocates the use of active cycle of breathing technique (ACBT) with expiratory vibrations on the chest wall for the treatment of COPD to help aid airway clearance. Inability for patient A to comply with ACBT indicated the use of manual hyperinflation (MHI) to passively inflate the lungs and aid mucocillary transport (Ntoumenopoulos, 2005). As identified by Finer et al (1979), atelectasis is a common problem observed in mechanically ventilated patients for which MHI has been found to be beneficial in reducing it in a well controlled clinical trial by Stiller et al (1996), scoring a PEDro rating of 6/10. Absence of a cough reflex in patient A, resulted in sputum retention and the increased risk of infection indicating the use of suctioning (Pryor and Prasad, 2002) by which, copious amounts of viscous secretions were cleared. Shorten et al (1991) supports the use of saline instilation to loosen secretions prior to suctioining however, conflicting arguments by Blackwood (1999) and Kinloch (1999) question its effectiveness. Patient Bs compliance with ACBT replaced the need for MHI and suctioning. Patient A developed bilateral shoulder subluxations due to his lengthy intubation for which subluxation cuffs were applied, as suggest by Zorowitz et al (1995) with positive effect. Despite this study being on stroke patients, the results can be generalised to other patient groups as proved. The importance of mobilising patients with regards to respiratory function is highlighted by Ciesla (1996), however mobilisation of critically ill patients is restricted as they are often non-ambulatory. A high quality, randomised control trial using fifty-six participants by Mackay et al (2005), identified mobilisation as superior to other respiratory techniques, therefore Patient B was encouraged to sit out and treated using a graduated walking program. In the case of Patient B, mobilisation constitutes any change in position therefore the use of postural drainage positions and positioning into the cardiac chair setting on the bed were used (BTS, 2008). The range of problems service users present with means practitioners need to be adaptable, drawing on current evidence, professional knowledge from different fields of physiotherpy practice and experiences through CPD to deliever indiviualised patient-centred care. Appraise self management of a caseload and modify practice accordingly, demonstarating effective teamwork and communication skills Caseload management typically refers to the number of cases handled in a certain timeframe by an individual for which they have a duty of care towards (Scottish Executive, 2006). It is the management of time effectively through appropriate priority-setting, delegation, and allocation of resources to meet the service demand of its users (Curtis, 2002). Self-management of a caseload and adaptability to changing circumstances is expected of a registrant (HPC, 2008). Well developed time management skills can make a workload more manageable and improve the effectiveness of treatments and quality of time with patients. Prioritising patients to the order in which they will be seen based on their needs is encouraged by SARRAH (2010), however Nord (2002) argues whether it can be justified to prioritise those in most need if their potential benefit may not be as great as those in less need. In my experience prioritisation is dependant on a variety of factors for example, the trust where PP6 was completed, enforced protected meal times which did not run alongside staff meal times. Therefore, to prevent there being a void in the day, patients were still prioritised according to need but considertation had to be given to see patients that would be eating first and treat those that would not be during protected meal times. It is essential to consider that a therapists workload includes not only patient care, but also admistrative and research tasks in which delegation to others can be a valuable stratergy to assist with workload mangement. Curtis, (1999), identifies the need for practioners to show greater awareness of other disciplines competancies so delegation can be more effective. Feedback systems should be enforced to ensure task completion and objectives are being met (Curtis, 2002). Inter-professional collaboration refers to the process by which different disciplines work together to improve healthcare (Zwarenstein et al, 2009). Poor collaboration amongst healthcare professionals contributes to problems in quality of patient care and consequently poorer outcomes (Zwarenstein and Byrant, 1997). Liaison with members of the multi-disciplinary team (MDT) is encouraged by Shortell and Singer (2008) as practitioners are less likely to work off their own autonomy, ensuring patient safety, as demonstrated during handover in (Appendix 5). The learning objectives on PP6 to develop MDT collaboration and caseload management have been achieved as demonstrated in the feedback from my educator (Appendix 6) which identifies that improvement in self confidence will allow further development of the skills discussed. Demonstrate partnership with more junior students and/or appropriate others through the development of mentoring skills Mentoring is a process aimed at transfering knowledge, skills and psycological support from a more experienced person to a less experienced person, where the desired outcome is for both persons to achieve personal and professional growth (Anderson, 1987). An effective mentor facilitates, guides and empowers the mentee in becoming an independent learner (Coles, 1996) in which the relationships developed are based upon mutal respect, trust, confidentiality and shared beliefs and values (Lyons et al, 1990). The CSP (2005) acknowledges the importance of intergrating mentorship into CPD, in which the mentor develops a range of skills transferable to other CPD activities. This section focuses on peer mentoring as a concept, its practice and clinical application on an informal basis. Having identified the characteristics of a mentor (CSP, 2005), a SWOT analysis (Appendix 7) was completed to assist recognition of my personal learning needs. There are four stages to the mentoring life cycle (Appendix 8), in which the mentor needs to adopt and develop new skills to accommodate the mentee and guide them through the process. A qualitative study using a moderate sample size by Chan and Wai-Tong (2000) encourages the use of learning contracts (Appendix 9) to help establish rapports and facilitate autonomous learning which aids progression to stage two of the cycle. This is further supported in a recent review of the literature by Sambunjak et al (2009). Gopee (2008) recognises the importance of analysing the mentees needs. Foster-Turner (2006) states that different people approach the learning process in different ways therefore, matching the learning styles of the mentor and mentee will produce a more productive and successful relationship (Mumford, 1995; Hale, 2000). Honey and Mumford (1992) suggested people tend to have a predominant learning style and can be classified as activists, reflectors, theorists or pragmatists (Appendix 10). Boud (1999) identifies raising self-awareness as an essential tool used in lifelong leaning and through analysis of learning styles using Honey and Mumfords (1992) questionnaire, this allowed for reflection on the style of learning that would best suit the mentee to help meet their learning needs (Foster-Turner, 2006) (Appendix 11). As identified by the learning style inventory, the mentee and myself were both reflective learners, therefore we arranged sessions where we could dreflect on a clinical experience and discuss how new learning could be applied to future events. A feedback form from the mentee (Appendix 12) an a SWOT analysis (Appendix 13) demonstrates how through increased self-awareness and review of the literature, I have developed a better understanding of the mentoring process, the skills required and its application in into clinical practice. Developing others is central to current and desired practice (DoH, 2000a, 2000b, 2001, 2002) in which mentorship offers all the key attributes to the process. Preparation of an individual for this role, through self assessment, is central to its success, in which the skills developed are lifelong and can enable development into management and leadership roles later on in life. Demonstrate skills of career-long learning Lifelong learning is used synonymously with CPD and is concerned with practitioners critically reviewing their skills and knowledgebase with the ultimate goal of providing a better standard of care to all service users (French and Dowds, 2008). A recent inquest into a practitioner who did not maintain his competencies, demonstrates the possible consequences of poor CPD (Appendix 14). Appendix 15 details a range of formal and informal activities that can be undertaken to contribute towards CPD, evidence of which can be documented in a portfolio. The importance of staff development is recognised by the DoH documents (2000a, 2000b, 2001, 2002) which sets out the Governments vision of an NHS that prepares allied health professionals with the skills to take advantage of wider career opportunities and realise their potential. By using the competency based framework; The NHS Knowledge and Skills Framework (2004), physiotherapists can participate in development reviews which identify development opportunities and contribute to the fulfilment of personal development plans. References Anderson, E. (1987) Definitions of Mentoring; Unpublised Thesis, cited in; Anderson, E. Shannon, A. (1988) Towards a Conceptualisation of Mentoring; Journal of Teacher Education. 29 (1); 38-42. BBC News (2010) Patients inquest focuses on overseas locum care [online]. Available from http://news.bbc.co.uk/1/hi/health/8455971.stm [Accessed 15th February, 2010] Beauchamp, T. Childress, J. (2001) Principles of Biomedical Ethics 5th Edition. Oxford: Oxford University Press. Belbin, M. (1993) Team Roles at Work. Oxford: Butterworth Heinemann Blackwood, B. (1999) Normal Saline Instillation with endotracheal suctioning: primum non nocere (first do no harm); Journal of Advanced Nursing. 29 (4); 928-934. Boud, D. Cohen, R. Sampson, J. (1999) Peer Learning in Higher Edcation: Learning From and with Each Other. Kogna Page Limited: London. Ciesla, N. (1996) Chest Physical Therapy for Patients in the Intensive Care Unit; Physical Therapy. 76 (6); 609-625. Chan, C. Wai-Tong, C. (2000) Implementing contract learning in a clinical context: report on a study; Journal of Advanced Nursing. 31(2), 298-305. Coles, C. (1996) Approaching Professional Development; Journal of Continuing Education in the Health Professions. 16; 152-158. Curtis, K. (1999) The Physical Therapists Guide to Health Care. New Jersey; SLACK Inc. Curtis, K. (2002) Physical Therapy Professional Foundations: keys to success in school and career. New Jersey; SLACK Inc. Department of Health (2000a) The NHS Plan: a Plan for Investment, a Plan for Reform. London: The Stationary Office. Available from http://www.dh.gov.uk/en/publicationsandstatistics/ publications/publicationspolicyandguidance/dh_4002960 [Accessed 13th February 2010]. 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(2004) The Human Factor: The CRitical Importance of Effective Teamwork adn Communication in Providing Safe Care; Quality and Safety in Healthcare. 13 (1) 85-90. Lyons, W. Scroggins, D. Rule, P. (1990) The Mentor in Graduate Education; Studies in Higher Education. 15 (3); 277-285. Mackay, M. Ellis, E. Johnston, C. (2005) Randomised clinical trial of physiotherapy after open abdominal surgery in high risk patients; Australian Journal of Physiotherapy. 51 (3); 151-159. Mumford, A. (1995) Managers developing others though action learning; Industrial and Commercial Training. 27 (2); 19-27. National Institue for Health and Clinical Excellence (2004) Chronic obstructive pulmonary disease; Management of chronic obstructive pulmonary disease in adults in primary and secondary care. London: National Institue for Health and Clinical Excellence. Available from http://guidance.nice.org.uk/CG12/NiceGuidance/pdf/English [Accessed 13th February 2010]. Nord, E. 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(1999) Interdisciplinary teams in healthcare and human service settings: are they effective?; Health and Social Work. 28 (4), 228-234. Scottish Executive (2006) Allied Health Professions; Workload Measurement and Management. Edinburgh: Scottish Executive. Available from http://www.sarrahtraining.com.au/ site/index.cfm?display=144625 [Accessed 3rd February 2010]. Shortell, S. Singer, S. (2008) Improving Patient Safety by Taking Systems Seriously; The Journal of the American Medical Association. 299(4); 445-447. Shorten, C. Byrne, P. Jones, R. (1991) Infant responses to saline instilations and endotracheal suctioning; Journal of Obstetric, Gynecological and Neonatal Nursing. 20; 464-469. Sim, J (1986) Informed Consent: Ethical Implications for Physiotherapy; Physiotherapy. 72; 584-587. Stiller, K. Jenkins, S. Grant, R. et al (1996) Acute lobar atelectasis: a comparison of five chest physiotherapy regimens; Physiotherapy Theory Practice. 12: 197-209. 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(2009) Interprofessional collaboration: effects of practice-based interventions on professional practice and healthcare outcomes; Cochrane Database of Systematic Reviews. Issue 3.

UK Guidelines for Eye Screening

UK Guidelines for Eye Screening DOES THE UK CURRENTLY SCREEN THE POPULATION FOR APPROPRIATE EYE CONDITIONS? WHAT IS SCREENING? Screening is a way of identifying those individuals who are at a higher risk of developing a certain health problem; this allows them to have appropriate early treatment and information in order to prevent further deterioration. There are many different screening programmes which are offered by the NHS, for example, Screening for newborn babies, Diabetic Eye screening, Cervical Screening, Bowel Cancer Screening etc. (Nhs.uk, 2017). The screening process uses tests which can be applied to a large number of people and is an initial examination which requires further investigation and follow up. There are many different types of screening, for example, Mass screening (e.g. chest x-rays for TB), Multiple screening (e.g. annual health check), Targeted screening for those at a higher risk of developing specific diseases e.g. battery workers would be at a greater risk of developing cancer or problems with their nervous system (Anon,2017) and lastly Opportunistic screening. Opportunistic scr eening relates to identifying those at a higher risk to see whether they actually have signs of a condition as we carry out the pre-screening process/sight test, for example, we tend to check the pressures and fields of the people (maybe should write of patients over..) over the age of 40 in order to check for any signs of glaucoma, however, this cannot be classified as screening as it is opportunistic (Anon, 2017). Within this essay I will mainly be discussing Diabetic Eye Screening and Amblyopia Screening, I will be analysing how well these relate and correspond to the criteria set by the WHO guidelines for screening, how the screening programmes could be improved and what screening programmes are out in the world which could benefit us if brought within the UK. A full discussion of the classifications of diabetes or amblyopia is beyond the scope of this essay. 10 CRITERIA 1968 WHO GUIDELINES FOR SCREENING There are 10 main criteria/principles that a screening programme should meet in order to be an effective, practical and appropriate way of screening within the UK. These were brought about in 1968 by Wilson and Jungner (WHO) (Patient.info, 2017). Further down in this essay how well Diabetic Eye Screening and Amblyopia screening match the 10 criteria will be discussed, table 1.1 summarises the findings and a potential condition that we could screen for in order to enhance appropriateness of screening for eye conditions within the UK (Gp-training.net, 2017): (TABLE 1.1) 1968 WHO GUIDELINES DIABETIC EYE SCREENING AMBLYOPIA SCREENING AMD 1. The condition being screened for should be an important health problem à ¯Ã†â€™Ã‚ ¼ ? à ¯Ã†â€™Ã‚ ¼ 2. The natural history of the condition should be well understood. à ¯Ã†â€™Ã‚ ¼ à ¯Ã†â€™Ã‚ ¼ à ¯Ã†â€™Ã‚ ¼ 3. There should be a detectable early stage à ¯Ã†â€™Ã‚ ¼ à ¯Ã†â€™Ã‚ ¼ à ¯Ã†â€™Ã‚ ¼ 4. Treatment at an early stage should be of more benefit than at a later stage. à ¯Ã†â€™Ã‚ ¼ à ¯Ã†â€™Ã‚ ¼ à ¯Ã†â€™Ã‚ ¼ 5. A suitable test should be advised for the early stage. à ¯Ã†â€™Ã‚ ¼ à ¯Ã†â€™Ã‚ » ? 6. The test should be acceptable. à ¯Ã†â€™Ã‚ ¼ à ¯Ã†â€™Ã‚ » à ¯Ã†â€™Ã‚ » 7. Intervals for repeating the test should be determined. à ¯Ã†â€™Ã‚ ¼ à ¯Ã†â€™Ã‚ ¼ ? 8. Adequate health service provision should be made for the extra clinical workload resulting from screening. à ¯Ã†â€™Ã‚ ¼ à ¯Ã†â€™Ã‚ ¼ ? 9. The risks, both physical and psychological, should be less than the benefits. à ¯Ã†â€™Ã‚ ¼ à ¯Ã†â€™Ã‚ ¼ à ¯Ã†â€™Ã‚ ¼ 10. The costs should be balanced against the benefits à ¯Ã†â€™Ã‚ ¼ à ¯Ã†â€™Ã‚ ¼ à ¯Ã†â€™Ã‚ » DIABETIC EYE SCREENING It is estimated that within the UK, 4.5 million people have diabetes and around 1.1 million people have yet to be diagnosed (Anon, 2017). It is essential that we screen individuals who have diabetes as the development of Diabetic Retinopathy is one of the major complications of diabetes and early diagnosis can lead to appropriate and effective treatment (Hamid et al, 2016). This Diabetic Eye Screening (DES) is separate from a sight test and is to be carried out annually. If a woman is pregnant she will be offered additional tests as the development of gestational diabetes is common i.e. diabetes which only occurs during pregnancy, however, if the mother already has diabetes she also has a higher risk of Diabetic Retinopathy development (Nhs.uk, 2017). 1.1 Attendance at Diabetic Screenings Forster et al. (2013), evaluated whether patients who did not attend their DES were at a greater risk of sight-threatening diabetic retinopathy (STDR).   They carried out a longitudinal cohort study over 3 years (2008-2011) in which diabetic residents were invited for the screening. Forster et al found that 5.6% of the patients who did not attend in 1 year for their DES developed STDR. 2.6% patients who previously had no retinopathy at their first screen had developed STDR when they did not attend in 1 year and 5.7% of participants developed STDR when they did not attend for 2 consecutive years. With participants who previously had mild non-proliferative retinopathy at their first screen, 16.8% of these developed STDR when they did not attend for their DES in 1 year and 17% developed STDR when they did not attend for 2 years. (is this in your own words if not results should be quoted just to avoid plagerism)The results found for referable maculopathy also followed the same pat tern but the affected participants were smaller. This longitudinal study has its benefits as a large number of data can be collected however as it is over the period of 3 years, there is a risk of individuals dropping out of the study and therefore data for one year may not be comparable to the data from the next year as there would be subject differences. The findings of this study suggest that there is importance for DES and it can be deemed as an appropriate eye condition to be screened for within the UK as it does allow early detection of diabetic referable retinopathy and the greater the time between the DES the greater the risk of the development of STDR. However whether we need to screen individuals annually could be further discussed (Forster et al, 2013). 1.2 Improvements for DES Screenings To improve how we currently screen within the UK for appropriate eye conditions we could consider, increasing the time between the DES by making them biennial i.e. every 2 years. Forster et al found that participants had a 10.84 times higher chance of referable retinopathy if they had not attended their screening for 2 consecutive years, compared to those participants who were screened for every year.(I think should be kept in but change to own words if not already.) He found that for those patients who attended every 2 years had no significant increased risk of referable retinopathy compared to those who attended annually. A number of benefits can be seen from increasing the time between the screenings. Firstly this would mean that less DES would be carried out, this frees up time and space; in practices, this allows more time for regular sight tests and at the hospital, it allows more space for other important appointments. Reducing the number of DES also means that fewer professio nals would be required for these screenings; this would cut down the costs made by the NHS. Some could argue that this could lead to a cut down in the number of optometrists who specialise in the DES, however, this would allow the current professionals specialised in the DES or the ones that do carry out the training to become more skilled and have more focused knowledge on DES. Scanlon et al. (2013), found that those who were not screened promptly after being diagnosed with Type 2 diabetes had a raised rate of detection of referable diabetic retinopathy. The study didnt show whether those who were screened at a later date had a more severe form of diabetic retinopathy or whether it was anything to do with patient compliance but it did indicate that screening patients within the Quality standards set by NICE were more beneficial for the patients (Scanlon, Aldington, and Stratton, 2013). This supports that the UK does currently screen appropriately for eye conditions such as Diabetes and in a timely manner, as the earlier we screen a patient after being diagnosed with diabetes, the less of a chance for the development of severe/unnoticed diabetic retinopathy, as the development of DR is most prominent within the first two decades of developing the disease (Fong et al, 2017). In the UK, patients information once being diagnosed with diabetes is transferred via their GP to the Diabetic Eye Screening Services as soon as they are diagnosed, this allows appropriate treatment and screening for the patient immediately. We cannot solely rely on this study as it does not include any facts or figures regarding how raised the risk is for referable DR if a DES is not carried out every year. Therefore to improve screening within the UK; following Forster et al study, we could increase the time between the screenings i.e. make it biennial. The Health Improvement and Analytical Team of the Department of Health found that it would be more cost effective if the screening intervals were increased from one year to another when carrying out a cost-utility assessment for those who have low risk of development of Diabetic Retinopathy; these being defined as those who have been graded to have no background retinopathy in either eye, therefore one way of improving the screening in the UK could be by increasing the intervals between the DES (James, 2000). Currently, within the UK, Diabetic eye screening is offered to individuals who are 12 years and older. They are contacted by their local Diabetic Eye Screening service informing the patient as regards to what practices are available for them to attend for their screening i.e. a local opticians, hospital or clinic. Hamid et al. (2016) carried out a retrospective analysis of 143 patients aged between 7 and 12 in order to see whether DES should be carried out on children under the age 12. 73 of these patients were below the age of 12 and the other 70 were 12 years of age. He found that both these groups had a similar prevalence of background diabetic retinopathy (early stage of diabetic retinopathy) and none had STDR. From Hamid et al results, it can be seen that there would be no benefit to starting the DR at an earlier age as the same results are found in both groups, therefore supporting the current English protocol of starting DES at 12 years of age.   A DES test within the U K is fairly easy to carry out and requires the patient to be dilated; once the patient is dilated they are unable to drive for roughly 4-6hours in order for their pupils to return to normal.(this could be referenced from somewhere see if you can find from article or anything on how its done then reference that) This could be considered as some inconvenience to the patient as they may be required to take a day off work or prevent doing specific tasks that day however as the DES is carried out annually it is only a matter of a few hours, which could easily be rearranged or time off work can be taken. The risks of the drops are very low; a few symptoms could be experienced for example pain, discomfort, redness of the eye, blurry vision and haloes around lights which can lead to Angle Closure Glaucoma. ACG can be treated and the benefit of carrying out the DES is much greater and outweighs the risks. 1.3 DES Screening In India Currently, in India, in addition to the current Diabetic eye screening that is being carried out in practices, they are also going to be trialing (think it needs double ll m grammerly says youve spelt it the American way) Mobile DES services. This will benefit patients in several ways; firstly those who are not able to leave their homes are able to get screening and treatment readily. Furthermore, not all clinics have the appropriate equipment required in order to carry out DES, therefore, with the Mobile DES services patients are able to still get the adequate healthcare required. This is yet to be trailed therefore the success rates are unpredictable. If in the future, this helped patients get the adequate screening and healthcare required in India, then this could also be trialled within the UK in order for improving eye screening for appropriate conditions (Kalra et al, 2016). AMBLYOPIC SCREENING The common vision defects in children aged around 4-5years tend to include amblyopia, strabismus (squint) and refractive error (short or long sighted). (is this referenced from tailor et al like the next sentence, if not then needs a reference) An estimation of the prevalence of amblyopia in the UK varies between 2% and 5% (Tailor et al, 2016). Amblyopia is well understood and occurs when the nerve pathway from one eye to the brain does not develop adequately during childhood (Medlineplus.gov, 2017). Individuals are said to have an amblyopic eye when their vision is worse than 6/9 Snellen or 0.2 LogMar in the affected eye.(reference needed)   The UK National Screening Committee along with the recommendations from the Health for All Children agreed that orthoptic-led services should offer to screen for visual impairments for children aged 4-5 years (Legacyscreening.phe.org.uk, 2017). If the amblyopia is treated while the visual system is plastic i.e. still developing within the critical period (first seven to eight years of life), then this can be an effective way of restoring normal vision. Untreated amblyopia can have a negative impact on an individuals adult life; within the UK it was found that only 35% (36 out of 102) of people were able to continue their employment after losing the vision in their non-amblyopic eye (Rahi, 2002). 2.1 Testing The tests for amblyopia can include monocular visual acuity testing, plus or minus assessment of the extra-ocular muscles, colour vision testing, and binocular status (Stewart et al, 2007). The screening process can vary depending on the density of the amblyopia and age of the patient i.e. this would alter the treatment required. Patching seems to be the most common treatment for amblyopia and is seen to have improvements in vision if it is carried out adequately i.e. compliance is required. Stewart et al. (2007), researched the benefits of patching in which they found 40 children who were patched for 6 hours had an improvement in 0.21 to 0.31 log units of vision compared with another 40 children who were patched for 12 hours had a 0.24 log unit improvement. This supports the idea that patching can be carried out for fewer hours and still produce a similar enhancement in vision. However, when compliance was monitored there wasnt much of a difference between the hours, for the patient s prescribed 6 hours they tended to vary between 3.7 to 4.7 hours and the 12-hour patching children varied between 5.1 and 7.3 hours (Stewart et al, 2007). (maybe some more critical analysis of this study, I know youve got sample size and randomisation but if you can may add some more) These results suggest that Amblyopic patients can be patched for fewer hours and still have the same improvement in vision, however, compliance is necessary. Following on from this study when a randomised trial was carried out in order to see the effectiveness of Atropine and patching as a treatment of Amblyopia, it was found that visual acuity in the amblyopic eye improved for both, therefore supporting patching and atropine as adequate treatments for Amblyopia (Stewart et al, 2007). In this study equal, sample sizes were used and patients were allocated randomly, this allows the removal of subject bias and allows comparisons between the subjects and therefore more reliable results can be obtained. Furthermore, it was found that the younger the child, the less the occlusion in hours that would be required, therefore, the earlier we test the child for amblyopia the better the treatment (Stewart et al, 2007). 2.2 Problems with Patching Referring back to the 1968 guidelines in Table 1.1, patching may not be deemed as an acceptable form of treatment. When a randomised trial was carried out on 4 year old and 5 year old children it was found that they had experienced short term distress and were more upset when having to wear a patch alongside glasses than wearing glasses alone (Williams et al, 2006). Children also reported having been bullied whilst wearing a patch causing emotional problems which in turn led to long term adverse consequences. Williams et al. (2006) carried out a prospective study, in order to test their hypothesis by comparing children who had been screened preschool and required a patch and those who had not. 95% confidence limits were calculated and it was found that the risk of being bullied was the same for those who wore glasses and had been screened preschool and not. However, when comparing the preschool and school children and the rates of bullying whilst wearing the patch it was found that t here was almost a 50% reduction in the group of children who had been screened preschool (Williams et al, 2006). From these results, it can be concluded that pre-school vision screening would reduce down the bullying experienced by the children whilst wearing the patch therefore in order to improve screening within the UK we could potentially screen the children earlier to prevent the psychological stress that the child has to experience. During this study, the data was collected via an interview with the children. Childrens responses could vary depending on who was interviewing the child, the gender of the child (girls would be more(not would-they may be more likely to) likely to admit to being bullied) and other factors too(what other factors-either state them or leave it at the last point); therefore these results could not fully represent whether the child had experienced bullying and this factor should be taken into account when viewing the results. 2.3 Screening for Amblyopia within Japan Currently, outside of the UK, there are different screening processes which occur. The screening process for Amblyopia within Japan starts at the age of one and a half years old and then the children are later screened at 3 years of age by paediatricians. In The School Health Law based in Japan, the Visual Acuities of children ranging from 6 years old to 12 years old are taken by the school teachers then the children are screened by Ophthalmologists to screen for the eye diseases and amblyopia (Matsuo and Matsuo, 2005). Several studies over the years have been collected in order to compare the number of strabismus patients identified in different countries. Comparing these different studies it can be found that overall there were fewer children in Japan who developed strabismus, only 1.28% of the sample. Within the UK when a similar study was carried out it was found that 4.3% of the total number of children screened developed strabismus, this being much larger than those who develop ed it within Japan (Matsuo and Matsuo, 2005). This variation in results may suggest that the screening process in Japan is a lot more thorough compared to the UK and as children in Japan are screened for fairly early on in life, they are continuously kept an eye on, this could increase the detection of the early developments of Amblyopia and therefore appropriate treatment is also given fairly early on. (but is it screened more thoroughly in japan only because japanease children are more prone to amblyopia- is the prevalence of amblyopia higher in japan-if so then that might be why they screen earlier-find out) However, we cannot solely base the development of strabismus on the way we screen the children as there could be other factors as well. One way in which we could modify screening within the UK could be by screening children at an earlier age and more often as well; this would allow early detection of Amblyopia and therefore early appropriate treatment, reducing the number of strabismic individuals. Tailor et al. (2016) identified that a large area of controversy when discussing screening for Amblyopia is that it is currently not clear whether screening children earlier is associated with better outcomes and also whether it is more cost efficient or not, however it is widely agreed that starting screening for amblyopia at the age of 4 to 5 years old it seems to be clinically effective and also cost efficient at the moment therefore further research needs to be carried out in order to see whether we should move the screening for Amblyopia to an early stage or not (Tailor et al, 2016). IMPROVING SCREENING WITHIN THE UK AMD Within the UK to improve screening we could also screen for further conditions such as for Age-Related Macular Degeneration. AMD is an important health problem and accounts for 8.7% of all legal blindness worldwide. The development of Choroidal Neovascularisation (CNV) is the main cause of severe vision loss which leads to the development of Wet or Exudative form of AMD (Schwartz and Loewenstein, 2015). AMD development is pretty well understood by professionals and it can lead to changes in your central vision and also have an impact on the quality of an individuals life. Patients with AMD have reported more difficulties when performing tasks such as reading, leisure activities, shopping etc. (Hassell, 2006). There is currently no treatment for the dry form of AMD, whereas wet AMD is currently being treated using intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) agents which lead to an improvement in 30-40% patients visual acuity (Schwartz and Loewenstein , 2015). In Table 1.1 an extra column has been added in order to compare how well AMD screening would relate to the WHO criteria if it was to be screened for within the UK. 3.1 Techniques It has been found that the treatment of AMD at an earlier stage is of more benefit than at a later stage. Treatment of CNV within 1 month was found to have a greater gain in visual acuity than treatment which was given after this timeframe (Schwartz and Loewenstein, 2015). If AMD patients were left untreated for a year they would lose two or three lines of vision on average therefore the earlier the detection of AMD the more beneficial (Anon, 2017). The screening process could involve an Optical Coherence tomography (OCT) and a fluorescein angiography (FA) alongside clinical examinations, for example, Amsler charts, Nosefield Perimetry, Near Visual Acuity etc. In Table 1.2 these examination techniques have been presented in a table and the Pros and Cons of each technique can be seen. TABLE 1.2 (Schwartz and Loewenstein à ¯Ã‚ »Ã‚ ¿Int J Retin Vitr (2015) 1:20) 3.2 Screening Criteria If screening programs were to be carried out within the UK for AMD, we would need to consider a few factors. Firstly, at what age would we start to screen individuals for AMD and how often these screenings would take place would need to be considered(-dont need highlighted bit). AMD is most common in individuals who are over the age of 65, however, can be seen in some in their forties or fifties, not only is it affected by age but smoking, family history, UV exposure and diet can also be risk factors for the development of AMD (Rnib.org.uk, 2017). There could be a few different criteria in which individuals would qualify for the screening process of AMD, a few of these criteria could potentially be: Any individual over the age of 60 years old. Any individual over the age of 50 years old with a family history of AMD. Any individual who experiences one or more of the following symptoms: difficulty reading with spectacles, vision not as clear as previously or if experiencing straight lines becoming wavy or distorted (Rnib.org.uk, 2017). Once this screening process is carried out the recall period could vary depending on the patients health, family history, and lifestyle, this could vary from yearly up to a 5 year recall period for those that are normal; have no family history of AMD and good lifestyle. If an individual is diagnosed with Dry AMD then these screening processes would occur much more regularly in order to monitor the health of the eyes and to detect Wet AMD at an early stage. A benefit for the proposition of screening for AMD within the UK is that it would lead to more jobs and professionals to be specialised within AMD. 3.3 Time Efficient       There are a few flaws with screening for AMD. If OCT images were not clear enough patients may need to be dilated, this would mean that the patient would not be able to drive for approximately four to six hours, which could result in the patients having to take a morning/afternoon or a day off work.(maybe you can find a study where people are asked about what they dont like in dilation and it might be they dont like taking time off-then can reference that here) If all the above techniques mentioned in Table 1.2 were to be carried in the screening process for AMD, this in itself would be quite a lengthy process and would also require time to be taken off unless it was carried out on an individuals none working day. Screening for AMD would involve Fluorescein Angiography this may not be accepted by some patients as it is an invasive process and requires fluorescent dye to be injected into their bloodstream. Therefore suitable techniques would be required in which the patient would cons ent to if screening for AMD was to be carried out within the UK. Furthermore, currently within the UK, only half the adult population (48%) have heard of AMD therefore screening for AMD within the UK could be a challenge as public awareness of this disease is very limited therefore the public may be unable to recognize any symptoms or changes in their vision being related to AMD (VISION 2020, 2017). The development of CNV can be very rapid and therefore patients may remain asymptomatic or mechanisms within the brain could lead to overcome the noticeable change in their vision during the early stages of this disease, therefore, it would be difficult to screen the patient in their early stages of AMD (Rnib.org.uk, 2017). Further information should be given to individuals in which they are informed of what symptoms to look out for and also what to do in these instances. 3.4 Costs Practicality Currently within the UK if patients require a private OCT scan this can vary in price ranging from thirty-five pounds (C4 SightCare) to eighty-nine pounds (Leightons Opticians). Free OCT scans may be carried out in hospitals settings or learning institutes, for example, The University of Manchester (Gteye.net, 2017).   If we were to routinely carry out OCT scans for everyone as a technique during AMD screening then this can be very costly if funded by the NHS, in addition, if this was to be carried out privately then patients may not be willing to pay that much for the AMD screening process and therefore the success rates for screening for AMD within the UK would be less as patients wouldnt attend the screening. Furthermore, other techniques such as fluorescein angiography can be costly to be carried out for example if patients require this to be carried out privately they may end up paying up to  £103 (Anon, 2017). Another issue arising with the potential to screen for AMD would be regarding the practicality of the screening process; the equipment and machinery are fairly large and would require the practices to have adequate space in order to carry out these screenings. In addition, the equipment itself is very expensive and companies may not want to invest in such equipment if there turnover isnt worth it. In order to overcome this, we could potentially just carry out AMD screening within a hospital setting however it would still depend on the amount of space available to carry out these processes. Overall screening for AMD is quite a lengthy process and if it was to be carried out within the UK it would require a lot of work in order to make the screening process affordable and time efficient too. CONCLUSION Overall, within the UK we currently do screen for appropriate eye conditions these including Diabetic Eye Screening and Amblyopia. We could further increase this by screening for conditions such as Age-Related Macular Degeneration, as it is a very serious eye condition and early detection and treatment is beneficial. However, there are quite a few different factors which need to be considered if screening for AMD was to be carried out as mentioned above. Also, there are currently limited studies on AMD and therefore further research should focus on AMD and the benefits of continually screening the patient. Currently, as screening is being carried out for Amblyopia, this could be an eye condition that doesnt necessarily need screening for. A Cochrane review(do you need to reference which one) found that there is currently not enough evidence to determine whether the number of children with amblyopia was reduced due to the screening programs or not. The main reason for this was that de finition of Amblyopia is widely debatable and there is a lack of universally accepted definitions of amblyopia, which makes the data collected from different studies difficult to compare. However, it is much easier to leave a screening process in place rather than to remove it as a whole as further complications can arise and screening for this is somewhat beneficial.   From the discussion within this literature, it can be seen that we do currently screen for appropriate eye conditions within the UK. REFERENCES Nhs.uk. (2017). NHS screening Live Well NHS Choices. [online] Available at: http://www.nhs.uk/Livewell/Screening/Pages/screening.aspx#what-is. Anon, (2017). [online] Available at: https://www.med.uottawa.ca/sim/data/Screening_e.htm. [Accessed 5 Feb. 2017]. http://www.hsa.ie/eng/Publications_and_Forms/Publications/Chemical_and_Hazardous_Substances/Safety_with_Lead_at_Work.pdf [Accessed 9 Feb. 2017]. Patient.info. (2017). Screening Programmes in the UK. Find S

Vittore Carpaccio :: Essays Papers

Vittore Carpaccio Vittore Carpaccio was born around the year 1460 near Venice, Italy. They didn’t keep birth records then, so this date is an estimate. Vittore knew from a very young age that he wanted to be a painter when he was older. He couldn’t pay attention in school because he was always drawing or sketching on his papers. As a young man, Carpaccio was greatly influenced by two Venetian painters. These two painters were Gentile Bellini and Giovanni Bellini. Carpaccio was influenced greatly by these artists, but he also admired the work of other artists of the Venitian art period. Carpaccio used four cycles of paintings; each of these cycles was used to tell a story. However, only the first two of these cycles have become well known. Carpaccio did the first of these cycles between 1490 and 1495. This cycle consisted of nine large paintings. One of these paintings, named The Legend of Saint Ursula, is considered by most people to be his finest work. Especially original is the painting Dream of Saint Ursula. Vittore completed the second cycle of his paintings between the years 1502 and 1507. This cycle also consists of nine scenes. These scenes are mainly from the lives of Saint George and Saint Jerome. The two best known paintings of this cycle are titled Saint George Slaying the Dragon and Saint Jerome in His Study. Even tough Carpaccio was greatly influenced by other artists of his time; he still had a style that was different than everyone else. He seemed to use the colors black, red and brown more than other colors. He also put exotic animals or objects from faraway lands in many of his paintings. He also was very good with architecture and knew how to paint buildings so they looked real. Some of Vittore’s other widely known paintings include: â€Å"A Saint Reading† and â€Å"Virgin and Child.† Even though he isn’t as famous as some other artists are; Carpaccio was one of the greatest artists of the early Renaissance in Europe.

Evidence of Dissociative Identity Disorder in Fight Club Essay

In the movie Fight Club we are introduced to an average, white-collared, middle aged man who is seemingly normal at first glance. However, it is clear that the narrator suffers from insomnia, anxiety, and depression very early in the film. The narrator attempts to combat these symptoms in a number of ways, however, the only way that he has found to be effective is by attending support groups on a nightly basis. The narrator soon creates an alter ego (though we do not know he is his alter ego until the end of the film) named Tyler Durden. Durden is more attractive, has a better physique, and is overall more confident than the narrator and Durden regularly takes control of the narrator without the narrator’s knowledge to carry out tasks that the narrator does not believe he has the power to accomplish. This use of dissociation is a defense mechanism used by the narrator to remove himself from situations that may produce anxiety. The narrator has many instances in which he is not able to recollect things that happened that day or in previous days, such as having sexual relations with Marla (the narrator envisions Tyler having sexual relations with Marla, while it is him having sexual relations with Marla). However, it is difficult to reason through whether or not he is having these memory lapses due to a true dissociative identity disorder (DID) or perhaps due to physical trauma that was sustained through his fighting. Although the narrator is seen consuming an alcoholic beverage on the first day he â€Å"met† Tyler Durden, it is not evident throughout the film that these blackouts/memory lapses are due to alcohol or other substances. As the film progresses the narrator continues to have issues related to anxiety and he a... ...rrator’s lack of respect for life, however, the general lack of respect for life possibly indicated that the narrator wanted to take his own life, or that the narrator felt indestructible and did not feel that his risky behaviors would cause an untimely death. It is also unclear at the end of the film whether or not the narrator actually shot himself in the head or if this was an intrusive symptom produced by dissociations. References Brand, B., & Loewenstein, R. J. (2010). Dissociative disorders: An overview of assessment, phenomenology, and treatment. Psychiatric Times, 27(10), 62-69. Sadock, B.J., & Sadock, V.A. (2007). Kaplan and Sadock’s Synopsis of Psychiatry: Behavioral Sciences, Clinical Psychiatry (10th ed.) Lippincott Williams & Wilkins. Stahl, S. M., (2011). The Prescriber’s Guide. (4th ed.). New York, NY: Cambridge University Press.

Leadership Development in South Riding Council

Leadership Development In South Riding Council Leadership skills development is often a neglected area in local councils across the I-J. South Riding Council has sought to address this issue through establishing its own local leadership institute. The council, like all other local authorities, is facing the challenge of developing the leaders of tomorrow within a turbulent operating environment.The recruitment and retention of key staff is not easy in an area hit by a long-term decline in the local economy, following the decline In traditional and manufacturing Industries Like coal mining, ship building and steel making. The quality and performance of leadership within the council was highlighted in the findings of several external audits covering education provision and overall council performance against key indicators. These audits, conducted within a three year period in the mid asses, concluded that the council was lacking in strategic direction.At the end of the decade a simila r message was being repeated by Audit Commission inspectors during the first statutory comprehensive performance assessment (CPA). The resultant Impact on the organization cannot be overstated – staff morale plummeted and turnover increased with the loss of organizational knowledge being a major outcome. Internal staff surveys indicated that the lack of strategic leadership was felt acutely by council staff as well as being identified by external bodies.Human Resource Development in general was considered weak with staff reporting a lack of direction In career management and poor professional development provision. Deputy Chief Executive Kevin Harper commented that: our changing environment aught us out – we were reacting to uncontrollable circumstances. This highlighted a weakness generally in strategic leadership across the council. We need to retain key staff and improve our talent management programmers. We can ‘ t Just rely on staff replacement to keep the c ouncil running so we need to think about staff development and growing our own. Central to this vision was improving leadership and management skills. A new HER strategy was launched in 2009 with leadership Improvement Its key component. The strategy committed South Ruling Council to establishing an organization wide framework to develop leadership skills at political and senior managerial levels' . More recently, the council has invested time and money in shorter-term projects to enhance desired leadership skills. The latest initiative has been the creation off leadership institute. The Leadership Institute (Al) was launched in 2010 in conjunction with a local higher education provider.It ‘s focus Is on Improving management and leadership skills throughout the organization to lad succession planning. Commenting on the Al Initiative Harper said: There Is always plenty of hidden talent in a local council. People may be doing amazing things outside work, but because they are not properly engaged at work their potential is not fully realized. The Al has established a one year learning programmer based on current issues in local government leadership. The programmer includes a range of teaching and learning methods from ‘master classes' on topics such as sessions on staff engagement and organizational commitment.The programmer also involves one-to-one mentoring, group coaching and individual action learning work. The L', although a recent development, has seen promising early returns on the investment of time and money. Sickness and absence levels are falling and levels of satisfaction in leadership are rising. The clearest indication of improvement can be seen in the most recent statutory performance assessment results. The council is now rated as four-star, excellent and improving strongly in the process, rather than a fair' rating in the 2006.Harper comments: ‘The Council still has some way to go and we are not complacent but initial signs are encouraging. Leaders now feel supported ND more confident in their capacity to make decisions and staff know they are being listened to. The leadership institute will continue to help with this development. ‘ Peter Rickrack, the council's innovation manager – a rank Just below head of service level – is part of the council's leadership institute. He has seen an immediate impact on his practice and adds: ‘It is a fantastic chance for people to learn about their own leadership style and how they can develop this.No-one on the programmer is expecting promotion Just because we are on this, but we know it will help us make he most of our talents and careers. ‘ Keith Harper has overseen the Al from its inception and works closely with the council's organizational development team. The Al has cost approximately in its first year but the savings alone in staff absence reduction mean that the Al will break even financially. Harper knows however that the major challenge will be overcoming the traditional organizational culture and bringing on staff who may not easily identify themselves with a leadership role.The Al is partly aimed at unlocking hidden potential, but most of the antedates have so far come from senior positions. He said: ‘We were hoping to get people from all levels and it is something we will be looking to do more in the future†¦ We know there are a lot of talented people out there who are still not being reached. Please consider the following: 1. Outline and discuss how the South Riding Council approach to leadership development maps on to the major trends in leadership development. 2. Critically analyses the potential benefits and drawbacks of this leadership development approach for the Council.

My top 5 filipino traits Essay

1.Adept†¦Filipinos are very flexible at surging any difficulty and hardship 2. Craftsmanship†¦Filipinos are very crafty 3. Obsessive†¦Filipinos wish to improve their lives and those around them and are willing to go through great hardships and efforts, but don’t always know when to stop or how to balance it all. 4. Mimicry†¦Filipinos tend to copy or gain that which others have. In this respect, that’s why you see groups of Filipino’s in foreign countries that are so similar (like in LA every Filipino seems to have a piano at home that no one buys, or in Japan every Filipino on a military base seems to own rose wood. But if they move to a new group, then they easily wish to change and copy the new styles. Kind of like following a fad. 5. Short memories†¦No I don’t mean their dumb or something, I mean they forget the past or let go of the past easier. They don’t hold grudges quite so bad. Filipino’s are not more family oriented than in other cultures, but what makes them Filipino’s is they think they are. No offense. But many people have strong relations with their families. I lived in a home for six months and had to listen to my Brother in law tell me how family oriented they are as he yells at his father, and puts down his dead mother. I watched as just about every male member of the family had girlfriends, and the wives knew and ran those girls out of town when they got pregnant. I watched families that lived across the street visit each other once a year. I had a Filipino tell me that my daughter (half Filipino isn’t Filipino enough to live in his house with my 2nd wife for a short time). So in any respect, I’m not say they are less family oriented, but that we all have our issues with getting along, and Filipinos are no more family oriented than other cultures. This is according to the yahoo answers dot com. Well I agree with these because most of the Filipinos come from poor families and they can survive any trials becsuse they are already used to it. They are already down, so they on;y way to go is up. In the Philippines the most common thing that is talked about is the government. This is because this is the largest contributor of the poverty in the Philippines. The government system in the Philippines is very un organized and very corrupt. That’s why youre not rich if youre not in politics.