Monday, September 30, 2019
Discuss the Use of an Assessment Tool When Caring for a Child and Their Family
Commentary 1: Discuss the use of an assessment tool when caring for a child and their family In the following commentary I am going to reflect upon what I have learned about conducting the new born baby assessment regularly carried out on the neonatal unit. To write about the new born baby assessment it is important to understand what assessments are, why assessments are important and how this particular assessment is an essential part of nursing. ââ¬Å"Assessment forms the first part of any nursing activity and is the first step in the nursing process.Without a comprehensive assessment of the child and familyââ¬â¢s needs, care cannot be planned, delivered or evaluated effectively. â⬠(Great Ormond Street Hospital 2012). Examination of a new born infant allows nurses to assess and monitor a new born babyââ¬â¢s condition and promptly identify any abnormalities in order to treat and give appropriate care as early as possible. It is an important part of overall care contribu ting to the babyââ¬â¢s wellbeing and survival (NNF Teaching Aids: Newborn Care 2010).Over the time I have spent so far on the neonatal unit I have learned about the physical assessment of new born babies and observed the trained staff carrying out these assessments day to day. The assessment of a new born infant involves the checking of several aspects of the babyââ¬â¢s anatomy; the Brain (the control centre for all organs), the Heart (pumps the 80mls of blood around the babyââ¬â¢s body), the Lungs (provides o2 for the bodyââ¬â¢s organs and muscles), and the Kidneys and Liver (filters toxins out the body to be excreted). These vital organs are the key to the babyââ¬â¢s survival in life.To begin to asses these organs is by examining the skin as this is the easiest organ to view and the examination is non-invasive so therefore should not distress the baby. The skin can be a key indicator of if something is wrong. The nurses and I looked at the colouring, the texture, th e nails, and looked closely for any presence of rashes. The skin regulates body temperature (Ross and Wilson 2010) therefore monitoring a babyââ¬â¢s temperature is an important part of caring for a baby. The skin is also the babyââ¬â¢s first stage of protection from infection forming a barrier between its self the outside environment.The head is another important indicator of what is going on within the baby. We examined the fontanel as this can swell or sink to show signs of dehydration or Hydrocephalus. A dry mouth can also be an indication of Dehydration. During birth the babyââ¬â¢s head can change shape due to the sutures in the skull (as seen in the diagram, Nucleusinc 2010) therefore it was important for us as nurses to check the sutures and the overall shape of the head and look for any bruising or swelling caused by trauma to the skull during birth.It was important to observe and record the babyââ¬â¢s activity eg Agitated, Alert, Active as this will forms the bas eline for further assessments of the baby and could help identify any neurological abnormalities. The next stage of the physical examination was the eyes. A discolouration of the whites of the eyes could be an early indication of Jaundice and be a warning to start treatment. Staring or bloodshot eyes could indicate a raised intracranial pressure or raised a blood pressure.Pre-term babies are often on o2 therefore checking the lung function, the patency of the airway and the o2 delivery method is important in order to maintain o2 saturations above 95%. Having conducted the physical assessment of the baby the digestive system needed to be assessed. This was done by a physical examination of the abdomen and by looking at the method of feeding (Breast, Bottle, NG Tube, OG Tube, JJ Tube, or PEG) and the amount of milk to be administered (amount per day: ml/kg/day times babyââ¬â¢s weight divided by the number of feeds to give in 24 hours).The Neonatal Unitââ¬â¢s policy is for the pr eterm baby is to start them on 60ml/kg/day +30ml per day up to 150ml and for the term baby to give 40ml/kg/day + 20ml per day up to 150ml. After this the doctors take over calculating feed volumes. These feeds are then recorded on a feeding chart and totaled at the end of every 24 hour period to monitor fluid intake. The initial assessment of a new born infant is a complicated process but is vital in providing the best possible care for the baby.The initial assessment acts as a baseline for further care to be compared with. Without an assessment important information and signs may be missed with awful consequences. Although I have observed and assisted with the assessment process I do not yet feel comfortable performing this assessment on my own as I feel I have a lot more to learn so as I donââ¬â¢t miss something or disregard any of my findings as insignificant. References: Boston Children's Hospital (n. d. Assessments for newborn babies. [online] Available at: http://www. child renshospital. org/az/Site600/mainpageS600P1. html [Accessed: 22/07/2012]. | Healthy Babies (1997) Guide for Newborn Physical Assessment, Anticipatory Guidance and Health Teaching. Vermont: Maternal and Child Health Home Visiting Nursing Standards and Competencies. | Macqueen, S. et al. (2012) The Great Ormond Street Hospital Manual of Children's Nursing Practices. Chichester: Blackwell Publishing Ltd, p. 2. NNF Teaching Aids: Newborn Care (2010) Examination of a newborn baby. [online] Available at: http://www. newbornwhocc. org/pdf/teaching-aids/2010/Examinationofanewbornbaby-ENC6. pdf [Accessed: 22/07/2012]. | Nucleusinc (2010) Skull sutures in infants and fetuses. [online] Available at: http://www. nucleusinc. com [Accessed: 22/07/2012]. | Waugh, A. and Grant, A. (2010) Ross and Wilson Anatomy and Physiology in Health and Illness. 11th ed. Churchill Livingstone, p. 354-358. | Discuss the Use of an Assessment Tool When Caring for a Child and Their Family Commentary 1: Discuss the use of an assessment tool when caring for a child and their family In the following commentary I am going to reflect upon what I have learned about conducting the new born baby assessment regularly carried out on the neonatal unit. To write about the new born baby assessment it is important to understand what assessments are, why assessments are important and how this particular assessment is an essential part of nursing. ââ¬Å"Assessment forms the first part of any nursing activity and is the first step in the nursing process.Without a comprehensive assessment of the child and familyââ¬â¢s needs, care cannot be planned, delivered or evaluated effectively. â⬠(Great Ormond Street Hospital 2012). Examination of a new born infant allows nurses to assess and monitor a new born babyââ¬â¢s condition and promptly identify any abnormalities in order to treat and give appropriate care as early as possible. It is an important part of overall care contribu ting to the babyââ¬â¢s wellbeing and survival (NNF Teaching Aids: Newborn Care 2010).Over the time I have spent so far on the neonatal unit I have learned about the physical assessment of new born babies and observed the trained staff carrying out these assessments day to day. The assessment of a new born infant involves the checking of several aspects of the babyââ¬â¢s anatomy; the Brain (the control centre for all organs), the Heart (pumps the 80mls of blood around the babyââ¬â¢s body), the Lungs (provides o2 for the bodyââ¬â¢s organs and muscles), and the Kidneys and Liver (filters toxins out the body to be excreted). These vital organs are the key to the babyââ¬â¢s survival in life.To begin to asses these organs is by examining the skin as this is the easiest organ to view and the examination is non-invasive so therefore should not distress the baby. The skin can be a key indicator of if something is wrong. The nurses and I looked at the colouring, the texture, th e nails, and looked closely for any presence of rashes. The skin regulates body temperature (Ross and Wilson 2010) therefore monitoring a babyââ¬â¢s temperature is an important part of caring for a baby. The skin is also the babyââ¬â¢s first stage of protection from infection forming a barrier between its self the outside environment.The head is another important indicator of what is going on within the baby. We examined the fontanel as this can swell or sink to show signs of dehydration or Hydrocephalus. A dry mouth can also be an indication of Dehydration. During birth the babyââ¬â¢s head can change shape due to the sutures in the skull (as seen in the diagram, Nucleusinc 2010) therefore it was important for us as nurses to check the sutures and the overall shape of the head and look for any bruising or swelling caused by trauma to the skull during birth.It was important to observe and record the babyââ¬â¢s activity eg Agitated, Alert, Active as this will forms the bas eline for further assessments of the baby and could help identify any neurological abnormalities. The next stage of the physical examination was the eyes. A discolouration of the whites of the eyes could be an early indication of Jaundice and be a warning to start treatment. Staring or bloodshot eyes could indicate a raised intracranial pressure or raised a blood pressure.Pre-term babies are often on o2 therefore checking the lung function, the patency of the airway and the o2 delivery method is important in order to maintain o2 saturations above 95%. Having conducted the physical assessment of the baby the digestive system needed to be assessed. This was done by a physical examination of the abdomen and by looking at the method of feeding (Breast, Bottle, NG Tube, OG Tube, JJ Tube, or PEG) and the amount of milk to be administered (amount per day: ml/kg/day times babyââ¬â¢s weight divided by the number of feeds to give in 24 hours).The Neonatal Unitââ¬â¢s policy is for the pr eterm baby is to start them on 60ml/kg/day +30ml per day up to 150ml and for the term baby to give 40ml/kg/day + 20ml per day up to 150ml. After this the doctors take over calculating feed volumes. These feeds are then recorded on a feeding chart and totaled at the end of every 24 hour period to monitor fluid intake. The initial assessment of a new born infant is a complicated process but is vital in providing the best possible care for the baby.The initial assessment acts as a baseline for further care to be compared with. Without an assessment important information and signs may be missed with awful consequences. Although I have observed and assisted with the assessment process I do not yet feel comfortable performing this assessment on my own as I feel I have a lot more to learn so as I donââ¬â¢t miss something or disregard any of my findings as insignificant. References: Boston Children's Hospital (n. d. Assessments for newborn babies. [online] Available at: http://www. child renshospital. org/az/Site600/mainpageS600P1. html [Accessed: 22/07/2012]. | Healthy Babies (1997) Guide for Newborn Physical Assessment, Anticipatory Guidance and Health Teaching. Vermont: Maternal and Child Health Home Visiting Nursing Standards and Competencies. | Macqueen, S. et al. (2012) The Great Ormond Street Hospital Manual of Children's Nursing Practices. Chichester: Blackwell Publishing Ltd, p. 2. NNF Teaching Aids: Newborn Care (2010) Examination of a newborn baby. [online] Available at: http://www. newbornwhocc. org/pdf/teaching-aids/2010/Examinationofanewbornbaby-ENC6. pdf [Accessed: 22/07/2012]. | Nucleusinc (2010) Skull sutures in infants and fetuses. [online] Available at: http://www. nucleusinc. com [Accessed: 22/07/2012]. | Waugh, A. and Grant, A. (2010) Ross and Wilson Anatomy and Physiology in Health and Illness. 11th ed. Churchill Livingstone, p. 354-358. |
Sunday, September 29, 2019
Mergers and acquisitions continue to be made when so many fail Essay
Critically evaluate why so many mergers and acquisitions continue to be made when so many fail. The phenomenon of mergers and acquisitions (M&Aââ¬â¢s) triggers an array of opinions and viewpoints. Often it is a strategy that is seen as a perfect way of achieving growth. It is by no means an organic or natural route to success, but has tended to be a quick and easy way of increasing an organisations size and power. However although there has been ââ¬Ëwavesââ¬â¢ of popularity and success since its introduction in the 1960ââ¬â¢s it has also suffered criticism due to the amount of failures it has accounted for. Despite the strong suggestion that this strategy has been the architect for many an organisations downfall there still remains a propensity in the current business environment for managers to adopt it. Throughout this essay I am going to examine some of the areas that explain M&Aââ¬â¢s volatility and attempt to discover why managers are persevering with the strategy when it is seemingly flawed. Over the last few decades it has become increasing apparent that the effect of mergers and acquisitions is not as beneficial as once thought. When the growth strategy was pioneered in the middle part of the nineteen hundreds it was looked upon as a way of creating an empire across different sectors and countries. Many experienced managers were sucked into the strategy, only having eyes for the apparent synergistical and positive affects of M&Aââ¬â¢s. Although over the following years there has been many success stories concerning M&Aââ¬â¢s, when the big picture is examined it displays a more ugly side of the phenomenon. Hodge (1998) discovered that ââ¬Ëin the go-go ââ¬â¢80s, 37% of mergers outperformed the average shareholder return in that period; in the first half of the ââ¬â¢90s, that figure rose to 54%ââ¬â¢. Despite the encouraging increase during the early ââ¬â¢90s there remains a disturbing reality that ââ¬Ëbarely one-half of the m&a deals of recent years delivered shareholder value that outperformed even the relevant industry average, much less provided an adequate return on investmentââ¬â¢. Added to this he also highlighted that ââ¬Ëonly a paltry 25% of deals valued at 30% or more of the acquirerââ¬â¢s annual revenues could be counted as successââ¬â¢. These statistics represent the flaws that exist within the strategy of M&Aââ¬â¢s and clash with the positive theory that ââ¬Ëanalysts and investors expect the merged enterprises to be greater than the sum of its partsââ¬â¢ (Doitte and Smith 1998). Coopers and Lybrand (1993) along with many other writers have studied and expanded on some of the key factors that limit that usefulness of M&Aââ¬â¢s. Target management attitudes and cultural differences ââ¬Ëheads the list of impediments to the successful melding of two organisationsââ¬â¢ (Davenport 1998). This is appropriate not only in the case of cross-border mergers (Daimler Benz-Chrysler) where there many obvious points of concern such as language and communication, but also within the collaboration of firms based in the same country and even industry. Management often have their own ââ¬Ëway of workingââ¬â¢ that suits both themselves and their employees, which may be generated through national or corporate culture. This is generally characterised by unique and individual working practices amongst different firms nation and worldwide. Therefore when a merger or acquisition takes place the result is the combining of two sets of cultures in an attempt to work together. In most cases the merge looks both safe and profitable in theory, however management frequently underestimate the power of culture. For example when Mellon Bank and the Boston Co merged in 1993 they failed to consider how ââ¬Ëcultural conflict could drain the combined company of its most important acquired asset of the talents of Boston Co.ââ¬â¢s money-management wizards. Offended by Mellonââ¬â¢s cost-conscious management style, a key executive left the organisation. Within the next three months, he had taken 30 of his co-workers with him, along with $3.5 billion assets and many of the firmââ¬â¢s clientsââ¬â¢ (Davenport 1998). I think this example emphasizes the risk associated with M&Aââ¬â¢s due to their inevitable degree of unpredictability. For this reason alone it is hard to imagine a full proof argument advocating their use in modern business. Another factor that makes M&Aââ¬â¢s a high-risk strategy is the fact that management often have limited knowledge of the industry they are entering. This is obviously the case when two firms from unrelated backgrounds merge (conglomerate integration). In this case management are unaware of the way the industry works and are restricted to simply understanding the bare bones of the business. ââ¬ËDifferences in traditions, expectations, buying and specification practices, packaging, logistics, labelling, and legal customs and issues can have a surprisingly profound impact on the post-acquisition viability of a target companyââ¬â¢ (Price and Sloane 1998). These differences along with more obvious changes such as product, market and customers make life awkward for management. In most industries it takes time to develop and form bonds with suppliers, customers and even local communities. These types of bonds are usually a result of personal relationships and even friendships that have grown through dealings and negotiations over a long period. M&Aââ¬â¢s break up many of these ties across the industry and leave new management with the task to start fresh alliances. In many cases the change is not well received and an organisation that essentially is unchanged in terms of its core activities can fail. The art of creating a post-acquisition integration plan is also extremely important, but is difficult to master. ââ¬ËUnfortunately, for many companies, it is this phase that the deal fails because the parties focus too much on the financial aspect of the merger or acquisition without adequately addressing the people components that must be considered to forge two organizations into one cohesive entityââ¬â¢ (Doitte and Smith 1998). Employees are often neglected through the process of M&Aââ¬â¢s and even if attention is given to them there is generally a lack of meaningful consultation. Although it is an area that is very tricky to get right from a managerial perspective it is vital if the strategy is to succeed. ââ¬ËIf managers of each company shut themselves off from their employees, employees will feel adrift. Employeesââ¬â¢ resulting low morale and lack of direction will lead to high personnel turnoverââ¬â¢ (Heitner 1998). This is simply another factor, which makes the strategy of M&Aââ¬â¢s so difficult to implement and along with the previously mentioned problematic areas explains why their success rate is only around 50%. However despite the fact that many investment bankers and journalists believe the difference between their success and failure is ââ¬Ëa coin toss at bestââ¬â¢ (Davenport 1998) organisations continue to utilise them. A major reason behind M&Aââ¬â¢s continued use is the amount of advantages an organisation can potentially gain by undergoing a successful merger or acquisition. Although there are many risks and pitfalls involved when the strategy is undertaken management clearly believe the prospective benefits outweigh these possible drawbacks. In modern business globalisation has in many cases become a necessity rather than a luxury. Firms are now desperate to expand into foreign countries in order for them to compete in uninhabited lucrative markets and increase their competitive advantage. If global markets are entered successfully it gives organisations the chance to exploit resources, synergies and opportunities. However there is also a sense that in the global marketplace ââ¬Ëbigger is betterââ¬â¢ (Doitte and Smith 1998) and firms have to be of a certain size to be able to compete. In order to break into global markets organisations need to grow and often quickly so ground is not lost on competitors. In this situation M&Aââ¬â¢s are the most attractive option for managers. They represent a ââ¬Ëleapââ¬â¢ approach whereby firms can experience this desired growth rapidly. Managers are aware that it is the growth strategy that carries the highest risk, but often feel they have little choice. The modern busin ess world demands innovation and expansion and if companies stand still they will simply get left behind. Firms often use M&Aââ¬â¢s as a way of diversifying. A well-executed diversification strategy can widen an organisations product portfolio and therefore spread an organisations risk. This means entering different markets in order to reduce dependence upon current products and customers. Selling a range of different products to various groups of consumers will mean that if any one product fails, sales of the other products should keep the business healthy. As a result firms in this situation are less susceptible in market downturns and recessions. It is unlikely that a slump occurs in two diverse markets, but even in a case of a recession, where there are generally negative affects across the board, the organisation with added critical mass is in a better position to weather the crisis. The simplest way for management to achieve this diversification is to merge or takeover another company. It saves time and money being spent developing new products for markets in which the firm may have no expertise. Richard Branson and Virgin has been a major exponent of this over the last decade. His brand now covers air travel, music and even soft drinks! This is a perfect example how M&Aââ¬â¢s can produce multi-million pound empires extremely quickly. However many organisations can become influenced by such stories and attempt to mirror the success without fully understanding whether itââ¬â¢s the right move in their own business situation. Market power is also a reason firms adopt M&Aââ¬â¢s. This is usually generated when two competitors in the same market merge in what is called horizontal integration. The potential benefits for the purchaser are extremely attractive and hard to ignore. There is huge scope for cost cutting by eliminating duplication of sales force, distribution and marketing overheads and by improved capacity utilisation. There is also the opportunity for major economies of scale and increased prices due to the reduction in competition. Coca-Cola achieved this type of acquisition when taking over Orangina, a distinctive product with very strong distribution in France. Here Coca-Cola identified Oranginaââ¬â¢s customer base as one that they struggled to attract and decided for them to increase their market power they needed to acquire the brand. However, this is by no means the correct move for all firms. The merge between car manufacturers Daimler Benz and Chrysler has been ridden with problems since its launch in 1998. Sometimes a merge in this way creates twice the size, but double the problems. Similar to the idea of joining forces with a competitor to gain market power, management can undertake a merger or acquisition to ââ¬Ëblockââ¬â¢ competitors in doing so. This tactic usually comes in the form of a vertical integration where one firm takes over or merges with another at a different stage in the production process, but within the same industry. An example of this is brewery Whitbreadââ¬â¢s purchase of restaurant chain Beefeater. This type of M&A does not only guarantee outlets for your products or develop closer links with suppliers, it can also go some way to freezing out the threat of competitors. However it is not wise for management to undertake a merge with the sole intention to damage competitors. It is important, first and foremost, that the strategy has synergistical affects for them the acquirer as otherwise it may struggle. As I have highlighted there are undoubted gains offered by successful M&Aââ¬â¢s. These attractive advantages can often persuade managers, sometimes wrongly, to implement a mergers or acquisitions of their own. The hope is that their organisation can in practice reap the rewards that the theory says is possible. The reality is that many fail because the strategy is mismatch with other objectives and inappropriate in their current position. Despite managements good intentions their judgement has been clouded by the large potential gains M&Aââ¬â¢s can offer. However it is not always the case that management adopt the strategy strictly because of the apparent advantages it can for their firm. There is a school of thought that justifiably believes that top management frequently have ulterior motives when adopting M&Aââ¬â¢s. The belief is that decisions made concerning them are not necessarily in the main interests of the organisation, but more centred on what is best for them as individuals. As a result managers may proceed with poor value acquisitions in order to meet personal goals or even objectives they think ââ¬Ëshouldââ¬â¢ be met. The ââ¬â¢empire-building syndromeââ¬â¢ is a main contributor here. As an organisation grows it becomes a more important player in its industry. Naturally as the size and power of the firm increases as does the importance of its management and with this comes higher remuneration and social status. Also ââ¬Ëexecutive compensation may increase as a result of an increase in firm size, even when there is no corresponding increase in shareholdersââ¬â¢ wealthââ¬â¢ (Jenson 1986). It is clear that a merger or acquisition strategy can work well for top management regardless of its overall success for the firm. In the same way management can be influenced by prospective financial and prestige rewards, they may also be interested in satisfying their self-fulfilment goals. In low growth markets management can feel they are not exhausting their full energy and talents. In order for them to experience this type of self or job fulfilment they may choose to grow their firm via a merger or acquisition. This may present the perfect challenge for management, but not necessarily ideal challenge for their organisation. Finally job security is also an important managerial motive. A merger or acquisition can diverse risk and minimise the costs of financial distress and that of bankruptcy. This added stability helps prevent an organisation becoming an acquisition target themselves. Although the decision might not be in the best interests of the firm and shareholders, management solidify their own position. Along with the other negative managerial motives they represent a clear reason why M&Aââ¬â¢s continue to be used in the light of so many failures. In conclusion I feel the topic of M&Aââ¬â¢s and the reasons behind their sustained use in business is now much clearer. It is initially very difficult to fathom any organisation adopting a strategy that only has a success rate of around 50%. Dominant factors such culture and management inexperience seem to make any merger or acquisition an uphill struggle. However when the topic is examined closer the reasons behind these decisions are more obvious. In the modern business environment businesses are constantly looking to better themselves and stay one-step ahead of competition. It is wrong to claim that as a result organisations are forced into strategies that stimulate rapid growth, but there is a definite feeling that factors such as globalisation and increased market power are the best route to success. As these are two hallmarks of the M&A phenomenon it is no real surprise that management frequently decide that it might be their best strategy regardless of their poor success rate. It is this risk taking mentality, that has become a characteristic of 21st century management, allied with the more cynical decision making habits some managers have adopted has kept the use of M&Aââ¬â¢s high. Added to the fact that in the right context M&Aââ¬â¢s can be an efficient and highly profitable growth strategy it is easy to see how they have had and will continue to have a great use in business regardless of their failures. Bibliography Textbooks Glanville & Belton (1998) ââ¬ËM&Aââ¬â¢s are transforming the Worldââ¬â¢ Ivey Business Journal, Autumn; Customer text-section 2, topic 11. Kieran et al (1994) ââ¬ËPlanning the deals that generate value and gain advantageââ¬â¢, Mergers and Acquisitions, March-April; Custom text, topic 12. Journals Doitte S & Smith G (1998). ââ¬ËThe morning after (avoiding mistakes in acquisitions and mergers)ââ¬â¢. Winter v63 i2 p32(8). Davenport, T (1998). ââ¬ËThe Integration Challenge (managing corporate mergersââ¬â¢ Management Review. Heitner M (1998). ââ¬ËThe thorny business of merging rival firmsââ¬â¢, Mergers and Acquisitions. Hodge, K (1998), ââ¬ËThe art of the post deal (outcomes of mergers)ââ¬â¢. Management Review. Price, A & Sloane, J (1998). ââ¬ËGlobal Designs: Tough Challenges for Acquirersââ¬â¢. Mergers and Acquisitions.. Whipple J & Frankel R (2000), ââ¬ËStrategic Alliance Success Factorsââ¬â¢. The Journal of Supply Chain Management.
Friday, September 27, 2019
Cause and effect on hunter-gatherer Essay Example | Topics and Well Written Essays - 2000 words
Cause and effect on hunter-gatherer - Essay Example Proto-science can be alternatively called as the pre-science period but it had nonetheless contributed a lot to the development of established scientific methods. Simple observations of the workings of nature ensured survival of primitive peoples. It could include things like when animals will gather, where these animals drink and the various shrubs, berries and fruits of trees that are edible or poisonous (Hassler & Wilcox, 2008, p. 8). It can be described that life back then was very precarious that depended mostly on Nature on how Man manages to adapt himself to Nature. Seasons and weather patterns likewise have to be predicted with a certain degree of accuracy in order for men to prepare themselves. This paper tries to examine how these primitive societies managed to survive from the rigors and challenges of Nature from which we are descended. It is quite interesting to note that due to this preoccupation with adjusting to Nature, men had learned almost by instinct on how to interpret the world to ensure survival. It had become second nature (pardon the pun) in which men at those times behaved resulting into an in-built bias that served as a very survival mechanism by relating the cause to its effect. This is the discussion in this paper. The hunter-gatherer societies existed before man learned to develop agriculture. Due to the very nature of being entirely dependent on the vagaries of Nature, man has no choice but to become nomadic whenever and wherever there is plentiful food supply and where it is relatively safe for him to obtain such food supplies. Because of manââ¬â¢s innate capacity to learn and learn quickly, observation of Nature alone is not sufficient for him to survive. To be able to make sense of the observed patterns in Nature, man has to construct a model. This model is then used to resolve the ambiguities often seen in Nature. As a result of this tendency to avoid ambiguity, our brainââ¬â¢s circuits are predisposed to
Bringing Back Traditional Toys in the Technological Age Essay
Bringing Back Traditional Toys in the Technological Age - Essay Example As the study discusses in preschools where learning areas divide the classrooms, children gravitate to those areas where more possibilities in play are foreseen.Ã Usually, these are in the Make-believe area, filled with housekeeping toys like kitchen furniture, telephones, tea sets, cooking sets, tool sets, doctor kits, and the like which encourages creative imaginings.Ã From this research it is clear that one of the most popular areas in the classroom frequented by children is the Block Area where children spend time building their own constructions with wooden block pieces of many sizes and shapes.Ã During block play, children seem to get lost in their own imaginative world as they plan, design and build the structure one block at a time, carefully choosing the right block to stack on a particular place. This paper will thoroughly discuss the value of block play in the early childhood education setting.Ã Despite the widespread availability of new educational tools and te chnology, the traditional blocks developed nearly a century ago by Caroline Pratt, remain one of the most enduring mediums for early childhood education and even in the primary grades.Ã Unit blocks are those small hardwood blocks filled with potential for creative play.Ã These blocks are designed in a 1:2:4 size proportion emphasizing the size relationship among the different blocks.Ã Aside from rectangular and square-shaped blocks, there are cylinders, archs, half-circles, ramps, and many more shapes in the set.
Thursday, September 26, 2019
Setting the Stage for Strategic Compensation and Bases for Pay Assignment
Setting the Stage for Strategic Compensation and Bases for Pay - Assignment Example The present study focuses on the setting of the stage for strategic compensation and bases for pay in organizations, by answering five questions in association. Question 1: Describe the three main goals of compensation departments. Solution: The primary stakeholders for an organizationââ¬â¢s compensation packages include the employees, the management or the executives, and the government. Thus the three main goals of the compensation departments in an organization are associated with satisfaction and gain advantages from these three above mentioned sources (Compensationââ¬â¢s Role in Human Resource Strategy, 22). The first and most important goal that the compensation departments have reflects on keeping the employees of the organization satisfied such that they perform efficiently and with sincere concerns working towards the achievement of the organizational goals. Secondly the concern of the department is associated with the management and executive teams since these individ uals are the experts of the organizations and need to be retained for future endeavors. ... Thus the three primary goals of the compensation department could be learnt from the above section of the study. Question 2: Describe the contextual influence that you believe will pose the greatest challenge and the contextual influence that will pose the least challenge to companiesââ¬â¢ competitiveness and explain why. Solution: A companyââ¬â¢s competitiveness and the level of competitive advantage that it gains over its competitors depend significantly on the performance of the employees of the organization. However, with the changing world of businesses and the market trends that determine the level of competition, the compensation systems have also significantly altered and modified. This in other words reflects the influences of the contextual factors in association with the competitiveness of an organization. The most important factor that seems to influence the compensation program is the determination of the wage rates for the employees. High wage rates on one hand in creases the cost of the company and thus the prices of the goods reflecting on decreasing financial performances for the company; on the other hand, it guarantees the gain of competent workforce. Thus this factor poses the greatest challenge for an organization. The factor that poses least challenges in the present times include the determination of wages according to the geography or industry, since now the satisfaction of the employees influence more depending on the needs of the organization. Thus strategic compensation system has become significantly necessary in the planning for wages within organizations (Kim, 2-5). Question 3: Describe when subjective performance evaluations might be better (or more feasible) than objective
Wednesday, September 25, 2019
Lin-chi and Ten-Foot-Square-Hut Essay Example | Topics and Well Written Essays - 1500 words
Lin-chi and Ten-Foot-Square-Hut - Essay Example The power of action lies in a manââ¬â¢s hand, but his decisions to imply that power is much more powerful than the energy itself. A man capable of extreme stroke, when empowers the desire and maintains to be amid, a man of word and action; becomes a true man. The aim of life is not to wait and watch throughout but to take action when it is needed without hesitation or second thoughts. Doubts can blur the path of destiny so can the temptation of desire. Thus, true man comes with a light and he has a vision which is visible and can be shared by his fellow men. A powerful mind can hold a powerful body, which in turn influences power and control over him and others. Inspiring sayings of Leader of Zen Master, Lin- chi concluded complex laws of life and success; in an easy approach. The core of Buddhism is based on the philosophy of sensibility, down to earth behavior, practical approach of action in life and spirituality. The temptation felt by five senses of a human enable him to expe rience the state of materialism. The uncountable desires and the appeal of the objective achievement pushes a man into a state of rush for life long. The rigorous journey of Narvana also ends up by rewarding the traveler with experience and patience. Therefore, the control on uncountable desires puts one to ease and struggle for more is stopped by him. This control over temptation makes him the most powerful among others. The relevance of right and wrong is within oneself, thus there is no need to look for the directions elsewhere. Hence, a true man has the potential to evaluate and assess the right path and can ascertain it for others without getting influenced by them. The ancestors of Buddha never looked towards others for the answers they completely depended upon. Lin-chi the master of martial arts depicted action in equilibrium and the tone of voice adjacent to the action. Thus, the action of a leader is not without a reason, if he shouts the message is to convey the note of re adiness, as a leader never attacks his rival in the state of ignorance. Every action, shout, beat, knock, kick and jump is balanced in its true essence. Thus, the pattern needs to be learnt and practiced to predict the move of rivals. The clearly of action portray the feature of true man, who can decide the action himself according to the environment. True man is calm and free from any sort of constrains; therefore, his actions have coherence and objectivity in them. Acceptance is the key lesson which a master taught his students to live life gracefully with low expectations. According to the theory of ââ¬Å"The wayâ⬠aimlessness or going nowhere is nothing that should be despised just like today. When you donââ¬â¢t strive for materialistic benefits, they come after you eventually because fate has decided that you will face both glories and blessings in your life. No matter what you do, you cannot get more than your destined or decided share. Acting ordinary is the part of the bargain. Act like the crowd and be contended and confident in the state you are in, which will lead you to your destiny. The same theory can be taken in terms of being true to one self. When people try to be something else to gain benefits, they not only deceive people, but also themselves. Their true nature is even hidden by themselves, which destroys their veracity and uprightness. To be the one you are and not what you desire to be that should be the actual way of living. According to Lin-Chi, a personââ¬â¢s mind should be free from doubts to become a man of true virtues.
Tuesday, September 24, 2019
Savior Siblings Essay Example | Topics and Well Written Essays - 1750 words
Savior Siblings - Essay Example This may involve: pursuing parenthood through adoption and foregoing conceiving children who have blood ties, applying a collaborative reproductive procedure e.g. surrogacy or donation of an egg, embryo or sperm with a parent who is free of the genetic illness being the child's genetic parent, following conception women may undertake pre natal diagnosis i.e. PND though the procedure involved has an inherent risk and also raises a challenge in the decision as to whether to terminate the a pregnancy of a fetus which is affected. PND is recognized and a number of women have continually ended pregnancies in their effort to conceive a child with no genetic illness under debate. PGD/embryo screening has the merit that it informs a woman whether her baby is affected or not with the genetic problem In question or under test during her initial stages of her pregnancy; this enables the said woman to make an informed decision as to whether to terminate or continue with the pregnancy. As such, owing to the ethical, psychological and physical reasons, PGD option is more preferred to PND/fetal screening. The initial PGD application was reported in 1989 and so far it is applied as detect quite a big number of a genetic conditions e.g. determining embryo's sex ( this have medical relevance for sex-related conditions such as hemophilia and Duchene's muscular dystrophy), identification of the single gene conditions such as spinal muscular atrophy, thalassaemia and cystic fibrosis. Human Leucocytes Antigen tissue typing together with PGD may make it certain the fact that an embryo is not affected by a severe genetic condition/s and also guarantee that the said child possibly will be a tissue-matched donor for an existing affected sibling requiring stem cell transplant. The embryo is not prone to extra risk as the equivalent biopsy carried out for PGD may be applied to check for tissue typing. Donating cord blood stem cell is not invasive, thus postnatal intervention concerning the "savior sibling" is not possible, and hence, no physical harm risk is incurred. I agree with the authority's decision of rejecting the request by the Whitaker family on the basis that it was not right to create a human life with the express intent of saving another life. There are various ethical arguments in opposition to the notion of 'saviour siblings' i.e. wrongful instrumentalization of the child, welfare of the child and slippery slope. Wrongful Instrumentalization of the Child Wrongful instrumentalization of the child is founded on the grounds that any child should be sought for his/her own sake. The concept of wrongful instrumentalization holds both the notion of choosing the character of a child and conceiving him or her so as to provide the ends of another child. The 'savior siblings' idea renders its application as a tool even though for superior ends. In case of conceivement of a savior sibling, he/she should be taken care of as a human being with his/her personal rights. It can not be accepted where the single reason for conceiving a child as a "savior sibling" is to make available a supply of stem cells that will be utilized to take care of a child on hand ( Immanuel kant pp) Welfare of the Child Welfare of the child
Monday, September 23, 2019
Fudations of busesiness computing Essay Example | Topics and Well Written Essays - 3750 words
Fudations of busesiness computing - Essay Example I have read the CQU policy on plagiarism and understand its implication. I can produce a hard copy of this assignment within 24 hours if requested." A knowledge worker is someone who works for a living at the jobs of producing or utilizing knowledge. Today we are able to define knowledge workers as contributors in the knowledge economy (Jonathan, 2005). The knowledge economy proposes a financial situation where information and its management are the product and the activity. In the context of todays business world, without a knowledge worker, an immense deal of the business world would come to a standstill. Knowledge workers are occasionally known as information workers, and some times people argue that information workers carry out additional tedious responsibilities than knowledge workers. Knowledge Workers are capable to carry out several activities that are ambiguous in their gain to an outsider, however are really important to the overall success of a company and business. They have the capacity to make use of the most excellent sources to achieve the information they required, which are together correct and modern. After t hat, with the data readily available they excel at pulling out the main information, understanding it, and then manipulating it to offer the organization and its business the maximum benefit possible (Jonathan, 2005). For instance, a knowledge worker can be somebody who works at some of the jobs of acquiring, programming, analyzing, organizing, storing, distributing, marketing, searching, planning, or else contributing to the makeover and business of information and those who effort at utilizing the knowledge so produced. In this question I will discuss the difference among the `information technology and `information system. Information system occasionally refers to an organization of persons, data records and activities that process the information and data in an association, and it comprises the
Sunday, September 22, 2019
The poem Half caste Essay Example for Free
The poem Half caste Essay The poem half caste has one reference of rhyme in it glow, shadow, tomorrow this rhyming makes the poem seem like a well planned argument rather than a rant. This gives the effect that he is reasoning with someone in an argument (his audience). The rhythm in the poem nothings changed, starts off with a very slow rhythm to it, it sues mono-syllabic words small round hard stones click this creates a slow harsh bitter mood. During the 2nd stanza the pace speeds up, he begins to use repetition and my hands, and my skin, and and this repetition of the word and shows his anger rising, consequently causing the poems pace to quicken dramatically. Once again the rhythm changes, this change occurs in the 4th stanza no sign says it, but we know where we belong the rhythm is slower meaning that he is sad. The rhythm in the poem half caste is very constant, it has a steady rhythm to it mainly because the poem is very humorous and harsh all through the poem yu mean when Picasso mixed red and green, is a half caste canvas The poet in the poem half caste uses many references to imagery, imagery means when you can see what the poet is trying to describe yu mean when light an shadow mix in de sky is a half caste weather this compares having parents of different colours to a natural image of the sky mixing. Nothings changed also uses imagery. Name flaring like a flag this simile shows the proud and insulting dominance of the white mans inn. The white mans inn is posh it is admirable it is up-market but still it squats , it does not blend in with its surroundings, this new inn, with posh food contrasts sharply with the black peoples inn, with plastic tables and no tissues but to wipe your hands on your worn out jeans. The flag of the white mans inn seems to be taunting the man. The poets use language to explore their feelings about racism in many interesting and imaginative ways. In half caste the poet repetition of the words explain yuself this gives a conversational and yet aggressive tone. The poet also uses Creole explain yuself, by the poet using Creole it shows he is comfortable with both sides of his background. In the poem nothings changed the poet uses alliteration and one syllable words to tell his poem. Cuffs, cans, crunch by using mono-syllabic words the poem seems sad, but it also makes it seem snappy and hard hitting. Afrika also uses onomatopoeias click, crunch. Onomatopoeias are words that sound like the sound they make. Both of the poems are expressing their hate for racism they have told it in two different perspectives one from each poet. Tatamkhula afrika has a more aggressive view of racism, he despises it. On the other hand john agard has a more conversational attitude to racism he debates about it and is able to laugh the idea of racism off. John agards poem interested me the most, because I was interested to hear about his ideas on racism (half caste). In conclusion I agree with both poets about their view on racism, racism is for the small minded and it should be stopped.
Saturday, September 21, 2019
The European Convention on Human Rights and its effect on the UK Judiciary Essay Example for Free
The European Convention on Human Rights and its effect on the UK Judiciary Essay The UK legislation incorporated the provisions of the ECHR or European Convention on Human Rights, with the enactment of the 1998 HRA or Human Rights Act. This measure imposed a grave responsibility on the English judiciary, with which it was in the least experienced. Every individual in the UK has certain rights and this new legislation compels the courts to decide whether any of these rights have been trampled upon by the different measures adopted by the UK government . In the process of this exercise, the judiciary has to scrutinize even the legislative actions of Parliament, and it has to analyze the effect of the acts of the state on individuals or groups. As such, the national courts, while conducting judicial reviews, had concentrated on whether the acts and rulings of government institutions and officials had been within the boundaries prescribed by the extant legislation. In this endeavour, the UK courts had, in general, ignored such transgressions by the Parliament . The enlargement of the scope of their rulings had proved to be quite a daunting task for the judiciary. In addition, section 6 of the Human Rights Act, requires the courts to conform to the rights provided by the ECHR. Any incompatibility with these rights requires the specific sanction of Parliament. Consequently, the courts have to conduct inquiries that are protective in nature and not prosecutorial . The Human Rights Act is efficiently implemented in the UK and it cannot be replaced by a separate Bill of Rights. The UK courts have greater flexibility in pronouncing verdicts and this was enabled by the HRA. The HRA also enabled the UK courts to function along the lines of the ECtHR. The decisions of the UK courts, in the context of human rights, will undoubtedly have an important influence on the jurisprudence of the ECtHR. Thus, the UK is now enjoying the full advantage of the margin of appreciation provided by the Strasbourg court . The provisions of the ECHR have been integrated with the British law through the Human Rights Act. Under section 4 of the HRA, the House of Lords and the Court of Appeal can derogate from the ECHR by declaring incompatibility with the ECHR. However, national courts are not permitted to declare statutes as incompatible with the ECHR. In the event if any national court declaring a statute as being in conflict with the ECHR; or in the event the ECtHR specifying that certain statutes are in conflict with the ECHR, the government can rescind or amend such conflicting statutes, under the provisions of sections 10 and 11. Section 12 of the HRA requires both the Houses of Parliament to pass a resolution, which seeks to implement such remedial orders of the government, which seeks to amend or to repeal a conflicting statute. However, in cases of urgency, a minister can do so and subsequently, seek the necessary approval . In addition, there are other requirements to be fulfilled. First, under section 3, the government must adopt a procedure to interpret the provisions of the HRA and the procedure it adopts must not conflict with the ECHR. Second, the HRA imposes on the public authorities a new legal obligation under which they must not act in a manner that is incompatible with the ECHR. Section 6 of the HRA states that this duty may not apply if a statute specifically requires them to act in such manner. As such, the HRA provides substantial grounds to oppose constitutional principles and the bill of rights . The current situation is that the development of legislation has fallen to the lot of the judges. This is an unprecedented development. The UK judges have to interpret and implement the Human Rights Act, in accordance with the Commission on Human Rights and the jurisprudence of the court; however, this jurisprudence is not binding upon them. Consequently, they enjoy a significant amount of leeway in modifying the tenets of the ECHR to suit the circumstances obtaining in the UK. This makes the courts susceptible to the criticism that they have injected their own values into the legal system . In addition, the ever increasing importance of the judiciary will bring considerable attention to bear on their competence, structure and character. Despite the seeming vividity of the incorporation of the ECHR into the legislation of the UK; the effectiveness of this measure, to a significant extent, is dependent on the stance adopted by the judiciary, in this regard . As such, the European Union is very much seized with the task of engendering human rights, as is evident from its action of specifying a new charter of rights to be implemented on its schedule. This new charter is certain to prove much more effective than the Human Rights Act. This is due to the fact that the UK judiciary would have to uphold the rights bestowed by it, even at the cost of directly overriding the existing legislation . In the United Kingdom the citizens have fundamental rights. These fundamental rights are enforced within certain limitations and are subject to other legislation. The operation of the fundamental rights is usually seen in the context of their negative implications. For example, the right to freedom of speech is respected to the extent to which it does not contravene other legislation. Thus, fundamental rights are enforced only when they do not attract any legal provisions . The UK courts interpret the provisions of section 6(3) (b) of the Act in a restricted and limited manner. This narrow interpretation by the courts results in non inclusion of a majority of government branches in the definition of Public Authority. This ultimately results in the improper implementation of the rights provided by the ECHR in the UK. The courts are taking the institutional position of regulatory bodies in determining whether they are public authorities, under the scope of section 6(3) (b) of the Human Rights Act. In cases of infringement of human rights, the UK courts deal with them by adopting a proportionality test in an effort to arrive at a balanced ruling. This concept is at variance to the narrow interpretation that was being accorded in the past. The UK courts employ a broader and more balanced approach, in order to have greater flexibility in making decisions, in accordance with the precepts European Court of Human Rights. This wider application of the Human Rights Act by the UK Courts is aimed at ensuring the human rights and personal interests of the general public . The United Kingdom has no written constitution. Legal experts consider that in the absence of a written constitution, it is very difficult for the executive or legislature to operate independently. The royal prerogative and parliamentary sovereignty are the basic concepts that shape the UKââ¬â¢s legal order. In WEBB v OUTRIM , Lord Halsbury had stated that an Act of Parliament should be an Act of Parliament and none can go beyond that concept . The HRA integrated the ECHR into the laws of the UK. This enabled the ECtHR to decide human rights cases, of the UK. The UK has to comply with the decisions of the ECtHR. In this manner, the ECtHR gradually assumed control over the British judiciary. It criticised the new Prevention of Terrorism Act 2005, because it infringed the human rights of British citizens who are also citizens of Europe. It pointed out that almost every aspect of the governmentââ¬â¢s attempt to curb terrorism on British soil was a violation of human rights . The United Kingdom had been a signatory to the ECHR and complied with the Convention. The British courts are directly enforcing the provisions of the ECHR. The HRA had successfully integrated the British law with the ECHR. The domestic courts in the UK are efficiently making use of the ECHR as an interpretative instrument in cases of legislative uncertainty. Individuals whose basic rights have been infringed can take the UK government to the ECtHR by filing a suit before it . This right of individuals can only be used after all domestic legal remedies have proved futile in redressing the wrong done to an individual. Therefore, bringing an appeal before the ECtHR entails a costly and elaborate procedure. However, this situation has been rendered much simpler at present. If a domestic court finds an act to be conflicting with the provisions of ECHR, then that court can directly award relief or remedy to the victim. It may award damages to the extent that it finds appropriate . Such a remedial action may include the award of compensation for damages ensuing from a breach of the ECHR rights. The court may allow the dispute to be relied on in other proceedings. The extensive powers bestowed upon the courts by the ECHR, has generated considerable constitutional objections. . The liberalization of the process of the interpretive method, which is a vital component of the HRA, poses a much greater danger to a democracy, in comparison to the predicted deference of Parliament towards assertions of incompatibility. Apparently, it looks as if there is greater validity for the right of Parliament to decide upon the law to be implemented in the UK, rather than the present interpretive procedure. Nevertheless this right of Parliament is susceptible to the current interpretive methodology . At its worst, the Parliament can enact a piece of legislation at its will and pleasure, and the national courts can rescind it on the grounds that it is not in accordance with the ECHR. The right of Parliament to make laws and the right of the judiciary to interpret them are equally and firmly ensconced. There is near unanimity of agreement regarding the view that it is the prerogative of the courts to interpret the law. This is due to the understanding that it comprises a component of the process of adjudication, which is considered to be its exclusive domain . The upshot is that Parliament cannot discard judicial interpretation of statute. In addition, it cannot express misgivings about the interpretive methods adopted by the judiciary. The reason is that such acts violate the constitution, in addition to being difficult to justify politically. Thus, judicial prerogative is invulnerable to the demands of democracy. In this manner there is the very real danger that the judiciary could make an inroad into legislative authority. This would render the HRA a very potent instrument for stifling or curbing elected governments, and could possible generates a number of doubts regarding its democratic qualities . The ECtHR assumed a secondary place in protecting human rights in Europe, and left the primary task or the active role to the member statesââ¬â¢ legal systems. It had reduced its role to a subsidiary position, with respect to the national judiciary. From the perspective of the Convention it did so for two reasons. First, the ECHR had remained as the minimum standard for basic human rights. By assuming this position, it would be easier for the Member States to attach themselves to it without discontent and to easily comply with the minimum standards of human rights protection . The ECHR had aspired to become the first step in the ladder of protection of human rights, and it pre empted any descent below this conceptual ladder. Secondly, it aspired to distance itself from dealing with cases, in which the member states could possibly breach these minimum standards. It is practically impossible for it to deal with each and every case of violation of human rights. Therefore it did not aspire to be a threshold for every claim concerning human rights . This step forced the member states to shoulder the major responsibility for protecting human rights in their states. Article 13 ECHR requires the Member States to be under an obligation to protect the human rights of their citizens. Moreover, the appellants are under an obligation to approach all national legal avenues before invoking the ECtHR. They can approach it only when all other domestic possibilities have been exhausted. This is the prerequisite for the claims to be admitted before the ECtHR . Accordingly, the State courts are required to deal with human rights violation cases, to the extent that the stateââ¬â¢s constitution permits them. If they find that there is a conflict between the stateââ¬â¢s legislation and the obligations of the Convention, then and only then, the national courts should refer the claims to the ECtHR. In other words, national courts are required to possess knowledge about the provisions of the ECHR and the jurisprudence of ECHRââ¬â¢s institutions. In a similar manner, whenever the Convention imposes certain duties on them, the national courts are required to enforce them. In addition, if the Convention permitted some discretion in these duties, the national courts would have to determine the extent of the applicability of such discretion . The United Kingdom is a signatory to the European Convention on Human Rights. However, it had not integrated the principles of the ECHR into its domestic law until the implementation of the Human Rights Act 1998. The European Court of Human Rights had established that the Convention had not imposed any obligation on the parties to accord a direct effect of the Convention rules. However, it was an implied obligation on the part of the members to incorporate the provisions of the ECHR . Unconstitutionality was a concept which was alien to the English courts. However, over the centuries, the judiciary evolved as an important branch in the British constitution; which enabled the Law Lords to declare Acts of Parliament as unconstitutional. Furthermore, the European Court of Human Rights can also rescind some Acts of Parliament, which are in conflict with the ECHR. Despite these developments, the British judiciary had maintained its role as impartial and capable of providing balanced judgements. At that point of time, the Human Rights Act 1998 was enacted, which further influenced the British judiciary, albeit in a positive manner . The ECHR provided the maximum powers to the courts, like, judicial review and the repealment of offending legislation enacted by Parliament. The traditional concept of Parliamentary Sovereignty is slowly vanishing due to the decisions of the courts, which have been empowered by the ECHR. Therefore, it can be concluded that the adoption of the ECHR has significantly modified the role of the judiciary in the UK.
Friday, September 20, 2019
Financial Performance Of Selected Commercial Banks In Uganda Finance Essay
Financial Performance Of Selected Commercial Banks In Uganda Finance Essay Persistent poor financial performance in commercial banks in Uganda yet stakeholders continuously alleged that corporate governance of these banks was doubtful, provoked the writing of this paper. Disclosure and trust, which constitute the integral parts of corporate governance, provide pressure for improved financial performance (Mark2000). This paper aims at establishing the relationship between the core principles of corporate governance and financial performance in commercial banks of Uganda. Findings indicate that Corporate Governance predicts 34.5 % of the variance in the general financial performance of Commercial banks in Uganda. However the significant contributors to financial performance include openness and reliability. Openness and Reliability are measures of trust. On the other hand credit risk as a measure of disclosure has a negative relationship with financial performance. It is obvious that trust has a significant impact on financial performance; given that transpar ency and disclosure boosts the trustworthiness of commercial banks. Banks both local and international should enforce full disclosure practices and transparency practices thereby enhancing trust in order to survive in the competitive financial landscape. Introduction The International financial landscape is changing rapidly; economies and financial systems are undergoing traumatic years. Globalization and technology have continuing speed, financial arenas are becoming more open, new products and services are being invented and marketed and regulators everywhere are scrambling to assess the changes and master the turbulence. An international wave of mergers and acquisitions has swept the banking industry as boundaries between financial sectors and products have blurred dramatically. In this brave new world, one fact remains unchanged. The need for countries to have sound resilient banking systems and strong banks with good Corporate Governance then will use competition to strengthen and upgrade their institutions that will survive in an increasingly open environment (Kaheeru, 2001). According to James Wolfensohn former World Bank Group President, Corporate governance is about promoting corporate fairness, transparency and accountability (Financial Times, 1999). Governance is a requisite for survival and a gauge of how predictable the system for doing business in any country is. In developing countries, the importance of governance is to strengthen the foundation of society and chip into the global economy. International standards and guidelines on corporate governance have been established by many multilateral organizations including the OECD and the Basle Committee in the effort to ensure improved legal; institutional and regulatory framework for enhancing corporate governance in institutions such as banks and financial markets (Kibirango, 2002). Specifically, the World Bank has proposed guidelines for good corporate governance in the financial sector, because of the critical role of the sector as the main vehicle for robust economic growth and effective transmission of monetary policy In Uganda, the factors responsible for poor corporate performance especially in banks emanate from lack of transparency, accountability and poor ethical conduct (Kibirango, 1999). Commercial banks failures have been linked to self-inflicted causes resulting from bank owners; ICB(International Credit Bank), GBL(Greenland Bank), and Coop Bank were afflicted with the one-man management syndrome of corporate governance exemplified by Thomas Kato (ICB), Sulaiman Kiggundu (GBL) and USAID (Co-op Bank). There was no separation between senior management and the board of directors in ICB or GBL and that management took little account of depositors interests. The board of ICB consisted of 4 members of the Kato family including a six -year- old child GBL had two boards of directors but neither had a say in the running of the bank for instance ICBs audit report cited connected or insider lending to a tune of UShs. 4 billion In the case of GBL the July 1998 Bank of Uganda (BOU) Audit Report stated that as per30th June 1998, Insider lending stood at Ushs.22, 722 million representing 47 percent of customer deposits and accounting for 5 5 percent of the total loan portfolio yet the maximum amount the bank could lend according to FIS 1993 was Ushs.975 million only. The report also cited that in most cases credit was extended on sole instructions of then Managing Director without any or minimal documentation (BOU, 1999). At the time of removing the Managing director in December 1998, the bank was more illiquid than what the financial statements were showing. Greenland Bank had tried to cover up the shortfall through kiting cheques between them selves and Uganda Commercial Bank and this involved instruments worth about Ushs. 4 billion. At the time of handing over, Kigundu admitted having made huge investments (UShs. 37bn off-Balance Sheet) mostly in related companies without disclosing these in books of the bank. In addition, he had secretly solicited for substantial deposits UShs. 20 billion which were kept off the financial Statements of the bank (BOU, 19, 1999). The B.O.U. closure of the above mentioned banks was intended to awaken the owners, directors and managers of the other commercial banks to institute sound corporate governance principles and foster better financial performance. It is worth highlighting that, insufficient financial disclosure evidenced by high level of off-balance sheet items, lack of transparency resulting from gross mismanagement and dubious accounting actions as observed in cases of ICB, GBL (Yunusu, 2001) and TransAfrica Bank Ltd (B.O.U., 2002) are detrimental to interests of banks stakeholders especially the depositors. The banks capital, asset and earnings values are affected and as a result the financial performance is questionable. This may be due to poor corporate governance. Amazingly, even after the intervention by Bank of Uganda through the closure of at least three commercial Banks in 1999, a number of Commercial Banks in Uganda have continued to register poor financial Performance, for instance, National Bank of Commerce in 2001/2002 reported a loss of 729,000,000/= and the banks liabilities swelled to 5bn/= in year 2002 from Ug. Shs 2.3bn in 2001.Citibanks profits fell from Ug. Shs. 4.1bn. in year 2001 to 2.3bn/= in year 2002 (Aggrey, 2003), Similarly, the Balance sheet position of Stanbic Bank (U) ltd. for year 2001 declined by 14.24 per cent compared with a growth of 19.19 per cent in 2000. Loans and advances, which comprised 32.95 percent of total assets declined by 24.42 percent, and the efficiency ratio deteriorated from 31.65 percent to 35.07 percent (Stanbic Bank Uganda, 2001). The overall aim of this paper is to investigate the link between, financial performance and the Core pillars of corporate governance; transparency, disclosure and trust in commercial banks in Uganda, within International and local Commercial Banks with headquarters in Kampala District, Stanbic Bank, Cairo Bank, Orient Bank and CERUDE Bank were the key focus in this paper. In order to achieve this aim bank annual reports formed a major source of financial data used to gauge financial performance. Financial performance was measured using CAEL Model which was later correlated with corporate governance variable. An Overview of the Key Variables To understand corporate governance and financial performance variables in relation to commercial banks, the major corporate governance pillars i.e. financial transparency, disclosure and trust are dissected. Financial performance especially relating to commercial banks is also reviewed based on the performance dimensions comprising capital adequacy, asset quality, earnings and liquidity. The significance of stakeholders in commercial banks is also highlighted. These are compressed in a conceptual framework Revenue Authority and Bank of Uganda, the expectation of government is that, information from these enterprises should not be biased and misleading. Management has to take into account the stakeholders expectations when they set a strategic direction but this can only be attained through sound corporate governance. Corporate Governance Corporate governance is about building credibility, ensuring transparency and accountability as well as maintaining an effective channel of information disclosure that would foster good corporate performance. It is also about how to build trust and sustain confidence among the various interest groups that make up an organisation. Indeed the outcome of a survey by Mckinsey in collaboration with the World Bank in June 2000 attested to the strong link between corporate governance and stakeholder confidence(Mark, 2000). Given that a study has already been carried out on the extent to which board composition affects team processes (orientation communication feedbacks, coordination, leadership and monitoring), board effectiveness and performance of the selected financial institutions in Uganda (Rosette, 2002), the researcher picked three basic tenets of Corporate Governance; Transparency, Disclosure and Trust in relation to commercial bank financial performance in Uganda, these tenets fall under the accounting field. The constructs/tenets are reviewed in the following sections. Transparency Transparency is integral to corporate governance, higher transparency reduces the information asymmetry between a and bondholders), mitigating the agency problem in corporate governance (Sandeep et al, firms management and financial stakeholders (equity2002). In Uganda lack of transparency is attributed to the closures of commercial banks (Yunusu, 2001). Bank Transparency The concept of Bank transparency is broad in scope it refers to the quality and quantity of public information on a banks risk profile and to the timing of its disclosure, including the banks past and current decisions and actions as well as its plans for the future. The transparency of the banking sector as a whole also includes public information on bank regulations and on safety net operations of the central bank (Enoch et al, 1997 and Rosengren, 1998). Weak transparency makes banks asset risks opaque. Stock market participants including professional analysists such as Moodys encounter difficulties in measuring banks credit worthiness and risk exposures (Poon, Firth, and Fung, 1999, Morgan 1999, and Jordan, Peek, Rosengren, (2000)). Ball (2001) argues that timely incorporation of economic losses in the published financial statements (that is, conservatism) increases the effectiveness of corporate governance, compensation systems, and debt agreements in motivating and monitoring managers. For instance, improved governance can manifest in a reduction of the private benefits that managers can extract from the company or in a reduction of the legal and auditing costs that shareholders must bear to prevent managerial opportunism Governance research in accounting exploits the role of accounting information as a source of credible information variables that support the existence of enforceable contracts, such as compensation contracts with payoffs to managers contingent on realized measures of performance, the monitoring of managers by boards of directors and outside investors and regulators, and the exercise of investor rights granted by existing securities laws. There are a number of issues to consider in this regard. First, the existence of a strong financial accounting regime is likely a precondition for the existence of a vibrant stock market and in its absence the notions of equity-based pay and diffuse ownership of firms become moot (Ball (2001) and Black (2000)) Institutional Variables Used to Measure Corporate transparency comprises. Financial accounting disclosures of major stakeholders, Timeliness of disclosures, Information dissemination and completeness of information. Robert Abbie (2001) concur with BPS especially on institutional transparency, they outline the transparency dimensions as; Completeness of financial information, Release of information, Timeliness, and Means of dissemination. Disclosure Given the recent corporate scandals (US Based; Enron, WorldComà ¢Ã¢â ¬Ã ¦ (Heidi and Marleen (2003) and Uganda Based; Greenland Bank Ltd, ICB(Japheth (2001)) restoring public trust is at the top of the agenda of todays business leaders. Greater information provision (disclosure) on the companys capital and control structures can be an important means to achieve this goal. High quality and relevant information is crucial for exercise of governance powers. Full Disclosure seeks to avoid financial statements fraud(Beasley, 1996; Beasley et al, 2000). Prior studies have concentrated on disclosure of items such as management earnings forecasts (Johnson et al, 2001; Lev and Penman1990) or interim earnings (Leftwich and Zimmerman 1981), or have examined a very general disclosure index of financial and/or non financial items (Chow and Wong Borren, 1987). The CIFAR Index (i.e. a disclosure index created by the Center for Intentional Financial Analysis and Research (CIFAR) rates annual reports on the inclusion or omission of about 90 (rather traditional and mandatory financial) items from the following categories; general information, income statements, balance sheet, funds flow statement, accounting standards, stock data and special items (Laporta et al, 1998). Dangers of Voluntary Disclosure The most common arguments against voluntary disclosure from a managerial perspective are fear of giving away sensitive information to competitors and procurement of extra costs for collecting and disclosing the information (Eccles and Mavrinac (1995), Healy and Palepu (1993), Reich and Cylinder (1997).However, it is worth noting that as competition continues to bite, the basket of secret information tends to reduce. Financial Disclosure Financial disclosure, which is a key component of the newly proposed Basel Capital Accord, is reviewed in the following paragraphs. In April 2003, the Basel Committee on Banking Supervision (BCBS, 2003a), headquartered at the Bank for International Settlements in Switzerland, released the new Basel Capital Accord, which replaced the1988 Capital Accord with an attempt to set regulatory capital requirements that are comparable across countries. The purpose of pillar three is to complement the other pillars by presenting an enhanced set of public disclosure requirements focusing on capital adequacy. This pillar is examined in more detail than the first 2 pillars given that disclosure represents one of the key variables in the scope of this study. Details of Pillar Three Pillar Three addresses the issue of improving market discipline through effective public disclosure. Specifically, it presents a set of disclosure requirements that should improve market participants ability to assess banks capital structures, exposures, management processes, and, hence, their overall capital adequacy. The proposed disclosure requirements consist of qualitative and quantitative information in three general areas: corporate structure, capital structure and adequacy, and management. Corporate structure refers to how a banking group is organized; for example, what is the top corporate entity of the group and how are its subsidiaries consolidated for accounting and regulatory purposes. Capital structure corresponds to how much capital is held and in what forms, such as common stock. The disclosure requirements for capital adequacy focus on a summary discussion of the banks approach to assessing its current and future capital adequacy. The Concept of Trust Trust means many things. Everyone knows intuitively what it is to trust; yet articulating a precise definition is not a simple matter (Wayne Megan 2002). Trust is difficult to define because it is so complex, in fact, Hosmer (1995) has observed. There appears to be widespread agreement on the importance of trust in human conduct, but unfortunately there also appears to be an equally widespread lack of agreement on a suitable definition of the construct. Trust is a multifaceted construct, which may have different bases and phases depending on the context; it is also a dynamic construct that can change over the course of a relationship (Wayne and Megan, 2002). Facets of trust There are at least five facets of trust that can be gleaned from the literature on trust (Hoy Tschannen-Moran, 1998; Tschannen-Moran Hoy 2001). Benevolence, reliability competence, honesty and openness are all elements of trust (Wayne Megan 2002). Benevolence perhaps the most common facet of trust is a sense of benevolence confidence that ones well being or something one cares about will be protected and not harmed by the trusted party (Baier, 1986; Butter Cantecell, 1984; Cummings Bramily, 1996; Deutch, 1958 Frost, Stimpson Maughan, 1978; Ganbetta, 1988; Hosner, 1995; Hoy Kupersmith 1985; Mishra 1996). Reliability at its most basic level trust has to do with predictability that is, consistency of behaviour and knowing what to expect from others (Butter Cantrell, 1984; Hosmer1995). In and of itself, however, predictability is insufficient for trust. We can expect a person to be invariably late, consistently malicious, inauthentic, or dishonest when our well-being is diminished or damaged in a predictable way, expectations may be met, but the sense in which we trust the other person or group is weak. Competence: Good intentions are not always enough when a person is dependent on another but some level of skill is involved in fulfilling an expectation an individual who means well may nonetheless not be trusted (Baier 1986; Butter Cantrell, 1984; Mishra, 1996). Competence is the ability to perform as expected and according to standards appropriate to task at hand, many organisational tasks rely on competence. Honesty: Honesty is the persons character, integrity and authenticity Rotte r (1967) defined trust as the expectancy that the word, promise, verbal or written statement of another individual or group can be relied upon. Statements are truthful when they confirm to what really happened from that perspective and when commitments made about future actions are kept. A correspondence between a persons statements and deeds demonstrates integrity. Openness: Openness is the extent to which relevant information is shared; it is process by which individuals make themselves vulnerable to others. The information shared may be strictly about organisational matters or it may be personal information, but it is a giving of oneself (Butter Cantrell, 1984, Mishra, 1996) such openness signals reciprocal trust a confidence that neither the information nor the individual will be exploited and recipients can feel the same confidence in return. Individuals who are unwilling to extend trust through openness end up isolated (Kramer, Brewer Hanna, 1996). In Uganda, as in many oth er countries, there is a rooted distrust in most of the public sector Shleifer, and Vishny, (1993) this may also be the case for the private sector in which the commercial banks fall. Macro-Economic Variable Macro-economic variables through factors such as inflation and changes in interest rates may either enhance or distress commercial banks financial performance. Cordella levy Yeyati (1998a) point out that if the shocks of the economy are wide and banks cannot control their asset portfolio risks, then full transparency of banks risk positions may destabilize the banking system. A countrys macro economic environment may also affect transparency levels therefore it becomes difficult to relate to financial performance of commercial Banks. Consider Uganda where the economy is shaped by a number of straining factors like unemployment, 38% of entire population under the poverty line. Such factors have a serious impact on the behaviour of potential account holders or even those who operate accounts. This means that even if there is proper transparency, full disclosure and trust in the banking industry, the above challenges may negatively affect financial performance in Uganda. In this paper, these together with other social, political and technological factors are assumed invariable. Relationship of Transparency, Disclosure, Trust and Financial Performance Transparency, disclosure and trust, which constitute the integral part of corporate governance, can provide pressure for improved financial performance. Financial performance, present and prospective is a benchmark for investment. The Mckinsey Quarterly surveys suggest that institutional investors will pay as much as 28% more for the shares of well governed companies in emerging markets (Mark, 2000). According to the corporate governance survey 2002, carried out by the Kuala Lumpur stock exchange and accounting firm Price Water House Coopers (PWC), the majority of investors in Malaysia are prepared to pay 20% premium for companies with superior corporate governance practices. Financial Performance and financial institutions Financial soundness is a situation where depositors funds are safe in a stable banking system. The financial soundness of a financial institution may be strong or unsatisfactory varying from one bank to another (BOU, 2002). External factors such as deregulation; lack of information among bank customers; homogeneity of the bank business, connections among banks do cause bank failure. Some useful measures of financial performance which is the alternative term as financial soundness are coined into what is referred to as CAMEL. The acronym CAMEL refers to the five components of a banks condition that are assessed: Capital adequacy, Asset quality, Management, Earnings, and Liquidity. A sixth component, a banks Sensitivity to market risk, was added in 1997; hence the acronym was changed to CAMELS. (Note that the bulk of the academic literature is based on pre -1997 data and is thus based on CAMEL ratings.) Ratings are assigned for each component in addition to the overall rating of a bank s financial condition (Jose, 1999). The ratings are assigned on a scale from 1 to 5. Capital Adequacy: This ultimately determines how well financial institutions can cope with shocks to their balance sheets. The bank monitors the adequacy of its capital using ratios established by The Bank for International Settlements. Capital adequacy in commercial banks is measured in relation to the relative risk weights assigned to the different category of assets held both on and off the balance sheet items (Bank of Uganda, 2002). Asset Quality: The solvency of financial institutions typically is at risk when their assets become impaired, so it is important to monitor indicators of the quality of their assets in terms of overexposure to specific risks trends in non- performing loans, and the health and profitability of bank borrowers especially the corporate sector. Credit risk is inherent in lending, which is the major banking business. It arises when a borrower defaults on the loan repayment agreement. A financial institution whose borrowers default on their repayments may face cash flow problems, which eventually affect its liquidity position. Ultimately, this negatively impacts on the profitability and capital through extra specific provisions for bad debts (Bank of Uganda, 2002). Earnings: The continued viability of a bank depends on its ability to earn an adequate return on its assets and capital. Good earnings performance enables a bank to fund its expansion, remain competitive in the market and replenish and /or increase its capital(Bank of Uganda, 2002). A number of authors have agued that, banks that must survive need: Higher Return on Assets (ROA)., better return on net worth/Equity (ROE), sound capital base i.e. the Capital Adequacy Ratio (CAR), adoption of corporate governance ensuring transparency to stakeholders that is equity holders, regulators and the public. Liquidity: Initially solvent financial institutions may be driven toward closure by poor manage ment of short-term liquidity. Indicators should cover funding sources and capture large maturity mismatches. An unmatched position potentially enhances profitability but also increases the risk of losses (The Ugandan Banker, June 2001). The M represents Management, given that this paper is hinged on financial performance, the management component in not considered in the measure. Generally, literature on corporate governance comprises attributes such as financial transparency, disclosure and trust among others and it is revealed that financial transparency and disclosure enhance trust between the stakeholders and organisations like commercial banks. Capital Adequacy, Earnings and Liquidity are the key dimensions of measuring financial performance in Commercial Banks. In summary, this literature forms an underpinning for the establishment of the association between corporate governance and financial performance. Methodology This study was conducted as a cross sectional and correlational investigation. Given that the key focus was to investigate the relationship between Corporate governance and financial performance. The managers of commercial banks in Uganda may be ensuing the arguments of Eccles Mavrinac (1995), Healy Palepu (1995), and Reich Cylinder (1997) whose studies make a note that voluntary disclosure of information for instance on Total capital bases Tier 1 2 capital, and preference shares may directly give away sensitive information to competitors and the disclosure process itself may lead to extra bank operating costs. Analysis Level of Trust in Commercial Banks On average the Commercial banks are not open to their clients on matters concerning the banks the majority indicated that manages do not tell them what is really going on in the bank; over 62 % were not sure and affirmed this statement. The lack of openness in these commercial banks may raise distrust as noted by Beatty Cantrell (1984), and Mishra (1996) who note that openness signals reciprocal trust a confidence that neither the information nor the individual will be exploited and recipients can feel the same confidence. Many authors conclude that reliability implies a sense of confidence. From URA, it was shown that the commercial banks are open to URA officials about what is going on in the bank (62.5%), it was also found out indicated that the commercial banks are competent in doing their work. The majority of URA officials also indicated that commercial banks are honest to URA and it is also indicated that commercial banks are reliable to URA , Overall analysis from the findings institutes a piece of evidence that URA trusts commercial banks activities. Level of Financial Performance in Commercial Banks As noted earlier, financial performance was considered the dependent variable in this paper, before correlating it with governance variables its magnitude within the commercial banks was ascertained. Secondary data especially from respective commercial banks annual-reports (from 2000 to 2003) were used to extract the summary of the banks financial performance Based on Capital Adequacy, Asset Quality, Earnings and Liquidity as recommended by BOU for measuring Financial Performance (BOU 2002). Capital adequacy, which is measured by CK/RWAs ratio(Core Capital / Risk Weighted Assets), in most banks was above the central banks, required level of 12%. Asset Quality, which was measured by NPA/ Total advances and Specific Provisions, also indicated that most banks were above the FIS (1993) requirement of 25%. Earnings, which are measured by ROE and ROA ratios, indicated that some banks earnings performance was below zero for instance Bank R. Some other banks indicated a steady movement upwards especially on their ROA Ratios. Liquidity which is measured by Liquidity Assets/Total Deposits and Total Advances/Total Deposits ratios, indicated that in the overall commercial banks were highly liquid over the trend 2000 to 2003,for instance for bank Z the Liquidity Assets/Total Deposits ratios were 119%, 140%, 112 % and 129% respectively, this implied a weakness in the financial performance of commercial banks. Relationship between Corporate Governance and Financial Performance in Commercial Banks. It was disclosed that all the dimensions of financial transparency, Disclosure and trust had positive relationships with most of the financial performance dimensions in commercial banks in Uganda. For instance capital adequacy, earnings, assets quality highly showed positive correlations with openness competence honestly and kindness. This is also in agreement with the McKinsey quarterly Survey Mark (2000) and the Corporate Governance Survey (2000) by the Kuala Lumpar Stock Exchange and accounting firm PWC that noted that there is a link between corporate governance and financial Performance due to the investors willingness to inject more funds in a wellgoverned firm. The extent to which corporate governance influences Financial Performance Regression analysis was used to find the influence of the independent variable Corporate Governance (financial transparency, disclosure and trust) on the dependent variables financial performance (capital adequacy, asset quality, earnings and li quidity). An analysis of Variance was produced reflecting the variables corporate Governance and financial performance. Results indicated that Corporate Governance (Transparency, Trust and Disclosure) predicts 34.5 % of the variance in the general financial performance of Commercial banks in Uganda. The significant contributors to financial performance were openness and reliability. Openness and Reliability all these are measures of trust. On the other hand, credit risk as a measure of disclosure had negative relationship with financial performance, this is in harmony with extant finance literature which highlights that, it is probable that when risky lending increases the payback declines. This in turn negatively affects commercial banks earnings. Conclusion and Recommendations Disclosure whose strongest dimension was ascertained as Credit Risk in this paper is in agreement with the New Basel Capital Accord (2003) and Lopez (2001). On the side of Trust; reliability, openness and honesty came out to be the strongest dimensions to gauge trust in commercial Banks this is in conformity with the study undertaken by Butter Cantrell (1984); and Wayne Megan (2002).Whereas completeness came out as the significant dimension when measuring financial transparency. Recommendations based on the above finds include: Given that the corporate governance can influence over 34% of the financial performance of banks, commercial banks need to adopt and strengthen the corporate governance principles especially on dimensions of timeliness in delivering the financial reports to Bank of Uganda and presenting the details of Loan Advances This means that issues regarding transparency where timeliness and completeness fall should not be underestimated by such banks. After the Commer cial Banks have established mechanisms to enforce proper governance practices such as financial disclosure and transparency. They will automatically build a bond of trust with their numerous stakeholders including customers, society, and government among others. Some of these stakeholders especially customers will in turn invest their funds in these banks. For instance, they buy shares when the respective commercial bank is listed both on the local capital market like Uganda Stock Exchange (USE) or on international Capital Markets like The New York Stock Exchange (NYSE) or any other capital market. Commercial Banks operating in Uganda, like any form of business organisation, in todays dynamic financial landscape should focus on proper Governance Practices and Principles not only to boost and enhance their financial performances but as path to gaining a better publ
Thursday, September 19, 2019
Nonprofit and For-Profit Hospitals Essay -- Health Care, Long Term Car
Describe the differences between nonprofit and for-profit hospitals. William & Torres provided a table to reflect hospitals ownership, and noted that some hospitals, while owned by one type of entity, may be operating under a contract by another entity, such as a hospital management company (Williams & Torrens, page 185). Some of the largest groups of hospitals in the nation are nonprofit community hospitals (Williams & Torrens, page 185). Nonprofit entities, including hospitals, function under special provisions of corporation law in each state, and under federal and state tax provisions that recognize their community service function (Williams & Torrens, page 185). The nation has approximately 1 million nonprofit entities of various sorts and hospitals have long been a traditional service provider in the nonprofit sector (Williams & Torrens, page 185). Nonprofit entities are generally exempt from most taxes at the federal, state, and local levels including income and property taxes (Williams & Torrens, page 185). These facilities are govern ed by a community based board that has ultimate authority for running these entities. Sponsorship for a nonprofit can come from various organizations, unlike other hospitals with traditional religious sponsorship (Williams & Torrens, page 185). A small percentage of the nationââ¬â¢s hospitals are operated by for-profit businesses (Williams & Torrens, page 186). For-profit hospitals have owners and issue stock to those owners to reflect their equity position (Williams & Torrens, page 185). For-profit hospitals are not just accountable to the community but must also provide a return on investment to the shareholders; they expect to generate a profit to pay a return to the equity inves... ... pays for 47 percent of all nursing facility care, and residents and their families pay for one-third. (Williams & Torrens, page 205). As for as the hospital, Medicare and private insurance are the primary payers from hospital services, with individuals paying relatively little from their pockets (Williams & Torrens, page 205). Critique the current state of long-term care policy in the U.S. After reviewing the current state of the long-term care policy from the United States, it appears to be slowly moving toward extinction. Public policy is not likely to provide any over- arching continuity for long-term care in the near future (Williams & Torrens, page 218). I agree with the idea of Americans engaging in personal planning. Personal planning will assure individual that if he or she needs long-term care it will be available.
Wednesday, September 18, 2019
Frank Mccourt Angelas Ashes Essay -- essays research papers
Bednarz-Caraballo Sylwia Essay 6 - ââ¬Å"This is lifeâ⬠¦Ã¢â¬ Reading ââ¬Å"Angelaââ¬â¢s Ashesâ⬠was very emotional. One would not believe how people lived in Ireland some years ago. And Iââ¬â¢m sure that wasnââ¬â¢t the only place in the world where people were struggling like that. Frank Mc Court, the oldest child who tried to take care of his brothers the best way he knew, tells the story. He didnââ¬â¢t have an easy life. This poor child tried to do anything for him and his siblings to survive. Looking at people I know and comparing their life to Mc Courtââ¬â¢s lives, well I think that most of them wouldnââ¬â¢t even know what to do, how to do it, to survive. My main point: how is it that some people have everything they need to live and others have nothing and still find a way to make things work, not on a high level, but still. How is it possible that Frank McCourt and his brothers survived? In my eyes they went through a lot. How anyone would be able to do it now? I canââ¬â¢t see that happening. I donââ¬â¢t know if I could. Although, Iââ¬â¢m sure that there are people living this way. The McCourt family moved from New York to Ireland to look for a better way of living, to forget about their dead children, to try to have a regular life. Well, it didnââ¬â¢t work out. The father of the family was to caught up with drinking, instead of giving the money for the needs of the family, which would be just simple - food. When the father left to England to look for a job and never sent any money to his starving family Frank felt ob... Frank Mccourt "Angelas Ashes" Essay -- essays research papers Bednarz-Caraballo Sylwia Essay 6 - ââ¬Å"This is lifeâ⬠¦Ã¢â¬ Reading ââ¬Å"Angelaââ¬â¢s Ashesâ⬠was very emotional. One would not believe how people lived in Ireland some years ago. And Iââ¬â¢m sure that wasnââ¬â¢t the only place in the world where people were struggling like that. Frank Mc Court, the oldest child who tried to take care of his brothers the best way he knew, tells the story. He didnââ¬â¢t have an easy life. This poor child tried to do anything for him and his siblings to survive. Looking at people I know and comparing their life to Mc Courtââ¬â¢s lives, well I think that most of them wouldnââ¬â¢t even know what to do, how to do it, to survive. My main point: how is it that some people have everything they need to live and others have nothing and still find a way to make things work, not on a high level, but still. How is it possible that Frank McCourt and his brothers survived? In my eyes they went through a lot. How anyone would be able to do it now? I canââ¬â¢t see that happening. I donââ¬â¢t know if I could. Although, Iââ¬â¢m sure that there are people living this way. The McCourt family moved from New York to Ireland to look for a better way of living, to forget about their dead children, to try to have a regular life. Well, it didnââ¬â¢t work out. The father of the family was to caught up with drinking, instead of giving the money for the needs of the family, which would be just simple - food. When the father left to England to look for a job and never sent any money to his starving family Frank felt ob...
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