Pervasive Developmental Disorders Essay Example for Free

Pervasive Developmental Disorders Essay The pervasive developmental disorders (PDDs) represent a spectrum of difficulties in socialization, communication, and behavior. Autism is the best recognized and most frequently occurring form of a group of the PDDs. Because most of the research in areas related to communication has been done on autism, we will focus here on this particular PDD. However, we should be aware that autism is probably not the most common disorder on this spectrum. Other types of PDDs include Retts Disorder, Childhood Disintegrative Disorder, Aspergers Disorder, and Pervasive Developmental Disorder Not Otherwise Specified, or PDDNOS (Twachtman-Cullen 1998). This work will also discuss the distinctive features of Aspergers syndrome, which is believed to be genetically related to autism. Much of what can be said about certain features of autism and PDDNOS applies to other forms of non-autistic PDD. The goal of this research is to provide a framework for understanding cognitive development in children with PDDs. The study will cover criteria for early PDDs diagnosis. The best-known type of PDDs is autistic disorder (variously called autism or infantile autism). The symptoms of autistic disorder typically increase gradually through the childs second year, reach a peak between 2 and 4 years of age, and then show some improvement. Young children with greater cognitive ability who receive very early intensive intervention may show dramatic improvement at this age, whereas those who are more impaired will make more modest changes. Persons with autistic disorder exhibit major deficits in their ability to relate to others. The child with autistic disorder often appears content to dwell in a separate world, showing little empathic interest in parents or siblings. Unlike the normally developing baby, the child with autistic disorder may not raise his arms to be picked up or may stiffen in protest when his parents try to cuddle him. The childrens lack of social interest may make some of these babies seem like â€Å"easy babies† because they do not seek parental attention, and appear content to remain in their cribs, watching a mobile or staring at their hands. As they get older, such lack of demandingness is recognized for the relative indifference it actually reflects. The child with autistic disorder may not seek others for comfort when she is hurt or upset, finding little consolation in the gentle words and hugs that are so important to other children. Not only do the children not ask for comfort, they typically are quite indifferent to other peoples distress and do not seem to share their joy. A siblings tears or a parents happiness may elicit no response from the child with autistic disorder. Children with autistic disorder show little interest in the domestic imitation that most children enjoy. For example, unlike the normally developing child, the child with autistic disorder usually does not use his miniature mower to cut the grass like mommy or pretend to shave while he watches daddy. This lack of interest in imitation interferes with one of the primary channels for learning by young children: their ability to model adult behaviors and master them through role play. Social play is one of the primary activities of childhood. A few simple toys can create the backdrop for long hours of companionship. The child with autistic disorder does not know how to join this kind of play, sometimes completely ignoring other children, or perhaps standing on the sidelines, not comprehending how to become part of the group. Not surprisingly, given the range of social deficits they exhibit, children with autistic disorder are very impaired in their ability to make childhood friends. Within the communication domain, impairments are present in a number of linguistic and nonverbal areas, the most fundamental of which are pragmatics and semantics (i. . , the social usage and explicit or implicit meaning of language and gestures). Although linguistic capability varies greatly across the spectrum (from a total absence of speech to highly sophisticated and erudite language), significant impairments in pragmatics and semantics are universal among individuals with PDDs. They communicate primarily to express needs, desires, and preferences, rather than to convey sincere interest in others, or to share exp eriences, excitement, and feelings. Even among those possessing highly sophisticated and complex language, compliments, words of empathy, and expressions of joy in the good fortune of others are very rare. There is little reciprocity, mutuality, or shared purpose in discussions. In addition, speech and gestural forms of communication are poorly integrated, often resulting in awkward and uncomfortable social interactions. Implicit, subtle, and indirect communications are neither used nor perceived. Expressive communication tends to be explicit, direct, and concrete. During discussions, persons with autism often fail to prepare their speaking partners for conversational transitions, new topics, or personal associations. This can result in digressive, circumstantial, and tangential comments and discussions. It would appear as though persons with autism assume that others are implicitly aware of their experiences, viewpoints, attitudes, and thoughts. The fashion in which these deficits are manifest is influenced by age, overall cognitive level, temperament, and the presence of sensory or physical limitations. In toddlers, for example, impaired pragmatics may be manifested by significant limitations in reciprocal eye contact, responsive smiling, joint attention (mutual sharing of interests and excitement), and social imitative play. In addition, socially directed facial expressions, instrumental and emphatic gestures, and modulation of speech prosody (intonation, cadence, and rate) are rarely used to complement speech, communicate feelings and attitudes, or moderate social discourse. Among preschool children, impairments in symbolic functioning (e. g. , language) are accompanied by serious limitations in pretense (e. g. ymbolic, imaginative, creative, and interactive play). Pragmatic impairments among adolescents with Asperger’s syndrome may be manifested by one-sided, pedantic discussions, with no attempt to involve speaking partners by acknowledging and integrating their experiences, ideas, and viewpoints into conversations. Sincere attempts by others to engage in reciprocal conversations may be met with a lack of acknowledgment, annoyance, and disinterest. Comments or questions that are â€Å"snuck in† by the listener may be experienced as rude interruptions, prompting the directive, â€Å"Wait! Im not done talking yet† (Bernabei, Camaioni Levi 1998). The result is a monologue or lecture that often includes abrupt changes of topic and the introduction of unexplained personal associations. This lack of conversational reciprocity suggests that persons with AS and high-functioning autism inherently assume that the listener is implicitly aware of their own experiences, viewpoints, and intent. Because the relaying of factual and concrete information is the primary goal of â€Å"social† dialog among those with ASD, the communication of subtle attitudes, viewpoints, and emotions (particularly secondary emotions, such as embarrassment, guilt, and envy) are largely irrelevant and superfluous. Therefore, emphatic gestures, informative facial expressions, and vocal modulation lack essential meaning for them. The result is that persons with autism generally disregard nonverbal cues and fail to incorporate them into their own discussions. Because this component of social communication often conveys essential information regarding feelings, attitudes, and opinions, an inability to identify, interpret, and produce nonverbal cues can have a highly detrimental effect on social interactions and relationships. Given these impairments, it is not surprising that verbal and nonverbal aspects of communication are poorly integrated, and that subtlety and nuance are rarely conveyed. Figurative and inferential language is another area of communication that is impaired in autism, largely due to a combination of deficits in abstract and conceptual thought, social reciprocity, and appreciation of the subtleties of social communication. Persons with ASD are highly literal and concrete in their language and thought processing, typically failing to understand metaphor, irony, sarcasm, and facetiousness. As a result, comments are often misinterpreted and discussions misunderstood. In addition, in an effort to remain true to the facts, comments and questions are often presented in an overly direct, straightforward, and â€Å"brutally honest† manner, lacking appropriate tact and sensitivity (Szatmari, Jones, Fisman, Tuff, Bartolucci, Mahoney 1995). This can cause embarrassment and distress for the listener and confusion for the speaker with AS. Both may become angry and resentful; the listener, because of emotional distress and perceived mistreatment; the speaker, because of the seemingly unjustifiable overreaction and a negative attitude displayed by the listener. From the perspective of the person with AS, the listener responded in a rude and ungrateful manner to comments that were intended to be informative, useful, and corrective. The emotional distress, embarrassment, and attack on self-esteem experienced by the listener are relatively foreign to the individual with autism. Interestingly, principles, rules, and codes of behavior can be interpreted in a highly concrete and rigid manner. This can result in insensitive and hurtful comments and behavior, because exceptions to the rule, adjustments to unexpected social contingencies, and appreciation for the spirit (not simply the letter) of the law are relatively foreign to those with autism. There is little awareness that rigid adherence to unavoidably flawed rules can result in a situation that is antithetical to the underlying intent of the rule itself. One of the dinning features of autism and Asperger’s syndrome is that of rigidity and inflexibility in response to minor change and transition in the environment and daily routines. This insistence on sameness and invariance can be highly impairing, because the precipitants of these reactions often are of little social significance and do not disturb the smooth functioning of the social world. It is as though persons with autism depend on these inanimate markers of space and time because the social priorities that typically direct schedules and routines have little meaning and significance for them. Aspergers Syndrome has been associated with cognitive strength since Hans Asperger first described the disorder in the 1940s. When he wrote of children who sounded like â€Å"little professors,† Dr. Asperger (1944/1991) was describing not only their pedantic tone but also their cognitive abilities. The assumption of adequate cognitive skill was reiterated when the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) stated that individuals with Aspergers Syndrome show â€Å"no clinically significant delay in cognitive development† (Willey 2001). Aspergers syndrome (AS) was added as a new â€Å"official† diagnosis when DSMIV and ICD-10 were published. In the past, children with AS were sometimes referred to as having schizoid personality, or schizotypal personality, and PDD, NOS. It is now recognized as distinct from autism. AS differs from autism in a number of key ways: first, children with AS may not be detected as early because they may have no delays in language, or only mild delays. In fact, it is usually not until parents notice that their childs use of language is unusual, or their childs play is also unusual, that concern sets in. Unlike autism, where the vast majority of children also experience some degree of mental retardation, children (and adults) with AS are rarely mentally retarded although many have low-average intelligence. Children with AS are sometimes described as â€Å"active, but odd† not avoiding others the way autistic children often do, but relating in a more narrow way, usually centering activity around their own needs and peculiar interests. In fact, having one or more areas of narrow, encompassing interest is highly characteristic of those with AS. Parents often ask whether AS is the same thing as â€Å"high-functioning autism. Research studies have addressed this question, and the answer is â€Å"no† (Fombonne, Simmons, Ford, Meltzer Goodman 2001). One main difference is that children with AS tend to have fairly comparable verbal and nonverbal levels of intelligence, while higher functioning (that is, less cognitively impaired) autistic children tend to have nonverbal IQs that are markedly higher than their verbal IQs. Another key feature of AS is the presence of intense, preoccupying interests that generally are unusual in nature and highly restricted and narrow in scope and breadth. An impressive store of factual knowledge is accrued on relatively esoteric topics; however, this knowledge is rarely utilized for functional, socially meaningful purposes. Rather, factual knowledge is pursued for its own intrinsic value to the AS individual. In addition, children and adults with AS tend to be physically awkward, uncoordinated, and poor in judging visual-spatial perspective (often failing to maintain comfortable interpersonal space during social interactions). With regard to neuropsychological functioning, verbal abilities are generally much better developed than are nonverbal abilities (e. . , perceptualmotor, visual-spatial). In a majority of cases impairments are present in executive functions, including working memory, organization, and cognitive-set flexibility. Although children with AS are thought to show no general cognitive delay, there is actually a great deal of variability in the specific abilities of individuals. In spite of mass media suggestions that individuals with AS grow up to be scientists or software engineers, we do not yet have data to support this connection. For most children, the PDDs last a lifetime. Although early intervention for many young children with autistic disorder, Asperegers disorder, and PDDNOS has produced major developmental changes, the technology has not yet reached the point where the majority of children make the degree of change that allows them to blend imperceptibly into their peer group. As a result, although most children with PDDs benefit in important ways from treatment, many still become adults with PDDs or some significant residuals of PDDs. There are no details of what causes PDDs. There appears to be a genetic contribution to at least some kinds of autistic disorder. For example, Fragile X syndrome is a chromosomal disorder than long has been linked to mental retardation and more recently has been shown to be related to autistic disorder. This disorder gets its name from a narrowing near the end of the long arm of the X chromosome that sometimes makes the tip fragile. Fragile X syndrome shows an X-linked (sex gene-linked) recessive pattern of inheritance. As a result, this disorder typically is transmitted to boys by their mothers. Fragile X syndrome accounts for a small but significant number of boys diagnosed with autistic disorder. General support for the notion that the symptoms of autistic disorder reflect underlying physiological dysfunction comes from research showing that autistic disorder occurs more often than would be predicted by chance among children whose mothers had German measles during pregnancy, that these children experienced a higher than expected rate of problems during pregnancy or birth, and that they are at greater risk for seizures than other children. Findings such as these raise important questions about where in the brain abnormalities may occur and how these neurochemical, biochemical, or neurological factors may be linked specifically to the development of the language, social, affective, and behavioral symptoms that characterize autistic disorder and the other PDDs. The process of accurate diagnosis and classification is an essential endeavor in medicine, because it is key to ensuring validity and reliability, enabling etiological research, and identifying effective methods of treatment. Although ASDs are not medical illnesses in the classical sense, they do result from neurodevelopmental abnormalities that affect social, communicative, and behavioral functioning in fundamental ways. The autism is not a unitary condition with a single etiology, pathogenesis, clinical presentation, and treatment approach; rather, it is a group of related conditions that share many clinical features and underlying social-communicative impairments. The fundamental purpose of arriving at an accurate diagnosis is to promote meaningful research that will eventually lead to effective treatment and an ultimate cure. Accurate diagnosis also enables investigators, clinicians, educators, and parents to communicate clearly, effectively, and efficiently. Ideally, a valid and reliable diagnosis should convey a great deal of information about developmental strengths and weaknesses, short- and long-term prognosis, and treatments that are most likely to be effective. Both basic and applied research endeavors are enhanced by improvements in diagnosis and classification. During recent years, efforts have been made to identify ASD as early in life as possible, in order to begin implementing educational and treatment interventions; providing families with education, support, and community resources; and reducing the stress and anxiety families experience as a result of incorrect or misleading diagnoses. The importance of an early diagnosis is supported by findings of improved linguistic, cognitive, and adaptive functioning as a result of intensive early intervention. Studies have begun to appear in the research literature assessing the reliability and stability of autism diagnoses made during the early preschool years. Experienced clinical investigators have demonstrated that an accurate diagnosis of autism can be made in the second and third years of life. However, accuracy depends on the completion of a comprehensive, interdisciplinary assessment, one that includes the use of standardized diagnostic instruments in conjunction with clinical expertise. Nonetheless, even among experienced clinicians and investigators, false positive and false negative diagnoses are sometimes made. Investigators have begun to examine clinical variables that may be predictive of treatment response and general prognosis. For example, Handleman Harris (2001) found that preschool children with autism who exhibited low baseline levels of social avoidance experienced significantly more social and linguistic progress than did their high-avoidance counterparts following 6 months of intensive incidental teaching and pivotal response training (provided in an inclusive setting). A complementary strategy for assessing the validity of AS is to examine the pattern of associated symptomatology. In this regard, a recent study investigated emotional and behavioral disturbance (psychopathology) in 4 to 18-year-olds with HFA and AS. The Developmental Behavior Checklist (DBC), an informant-based instrument completed by parents and teachers, was used to assess psychopathology. The DBC contains the following six subscales: disruptive, self-absorbed, communication disturbance, anxiety, antisocial, and autistic relating. Children and adolescents with AS exhibited high levels of psychopathology, particularly disruptive behavior, anxiety, and problems with social relationships. The best documented approach to the treatment of people with PDDs is a form of behavior therapy called applied behavior analysis. Since the mid-1960s, when Ivar Lovaas and his colleagues demonstrated that children with autism responded to carefully planned applied behavior analytic techniques, there has been extensive research on the use of these methods to treat the PDDs, especially for autistic disorder, Aspergers disorder, and PDDNOS (Durand 1990). Three decades of research have contributed to the development of a substantial array of specific behavioral treatment techniques and of documentation to support the efficacy of these methods in treatment of PDDs. This research also has demonstrated the essential role that parents can play in the treatment of their children by providing consistency of intervention between home and school, or even in some cases as the childs primary therapist.

Challenges Hospital Management In Nepal

Challenges Hospital Management In Nepal The WHO defines health as A complete state of physical, mental and social wellbeing, not merely the absence or disorder (WHO, 1948). It means that complete state of wellbeing is health and hospitals one of the major tool for promotion of health. WHO in 2010 has addressed the role and importance of hospital management for a quality health (WHO, 2010). There is no internationally accepted clear definition for hospital. There are several types of hospitals based on the facilities, equipments and services, i.e. district hospitals, provincial hospitals, speciality hospitals and referral hospitals, teaching University hospitals and other types of health care facilities. There is no international standard defining what should be the minimum services that each hospital should provide during a health crisis. Each country has to develop a national policy and technical guidelines to deal with a health crisis. Before defining the essential services, the ministry of health has to define the essential health services that the health sector will provide to the community in order to identify what more specific services will be delivered by hospitals (WHO, 2009). Management is defined as the organization and coordination of the activities of an enterprise in accordance with certain policies and in achievement of defined objectives. Management is included as a factor of production along with machines, materials and money. Renowned guru of management Peter Drucker (19909-2005) has said that the basic task of management is two fold: marketing and innovation. Practice of modern management owes its origin to the 16th century enquiry into low efficiency and failures of certain enterprises, conducted by the English statesman Sir. Thomas Moore (1478-1535). As a discipline, management consists of the interlocking services of formulating corporate policy and organizing, planning, controlling and directing an organizations resources to achieve the policies objectives (Walden University, 2011).Hospital managenmnet.net suggests that Hospital Management provides a direct link between healthcare facilities and those supplying the services they need ( Hospit al management.net 2011) . WHO in 2009 suggests understanding by hospital management as an effective and combined management of, the following factors:- (a) Acute care for emergency patients; (b) Out Patient Department (OPD) activities; (c) Investigation (laboratory; X-ray; other diagnostic elements); (d) Referral for primary health care (PHC); specialized consultations or services; (e) Contribution to public health programmes; (f) Part of health information system (surveillance system, including a EWS Component); (g) Public information and education; and (h) Preparedness for health crisis management. Nepal is a landlocked country which is mostly covered by hills and mountains and it has a population of 25.8 million as estimated in 2006. It is in the south Asian continent, north to India and south to China. Its area is 147,181 sq. km (WHO, 2007). It has been facing several challenges to establish a functional health management system (Thapa, 2010). This proposal deals with the challenges which Nepali health system is facing at present and suggests the possible ways for its improvement. Statement of the problem Nepals health system is in transition. Nepal is an underdeveloped country where most of the geographical part (85%) is covered by mountains and hills. India is in the south and China is in the northern part of the landlocked country. The southern boarder is open where the northern part is separated by the high mountains called Himalayas. The health indicators are very poor. The health service facility is not adequate to Nepali people. So the hospitals are (Dixit, 2005). Nepals hospital bed per ten thousand populations is 4.26 (2001/02), physician per ten thousand populations is 2 and Nurses per ten thousand population is also 2 as per the data of 2004 Similarly, Total Expenditure on Health (THE) as % of Gross Domestic Product (GDP) 5.3% and Public Expenditure on Health (PHE) as % of Total Expenditure on Health (THE) is 28 while Private Expenditure on Health (PvtHE) as % of Total Expenditure on Health (THE) 72(WHO, 2007). If it is compared with the other developing countries in the sa me region i.e. south east Asian region, the level of the problem may be perceived. Maldives, a small tiny country with population 298 thousand has Total Expenditure on Health (THE) as % of Gross Domestic Product (GDP) 6.2. Maldives Public Expenditure on Health (PHE) as % of Total Expenditure on Health (THE) is 89 as compared with 28 of Nepal. Private Expenditure on Health (PvtHE) as % of Total Expenditure on Health (THE) in Maldives is 11. It shows that the state has better involvement in Maldives than in Nepal. More over, the population per hospital bed is 381, which are 26.2 hospital beds per 10000 populations. Similarly, number of populations per physician 959 and nurses per 10000 populations are 33 (WHO, 2007). It clearly shows the scenario of health development of Nepal. As part of health, curative health services have a major role in providing quality health service to the people. Until the health care provider organizations are strong, the curative health service can not be delivered to the beneficiaries properly (Edelman and Mandle 2006). Hospitals are the key component of health care delivery system and they needs to be reformed to ensure a quality health care system (McKay and Healy, 2000).Unfortunately the hospitals in Nepal have very poor in quality management and they are not able to deliver quality health services to the people (Dixit, 2005). To address the needs and requirement of the hospital, the government of Nepal ( GON), Ministry of Health and Population ( MOHP) has published The guideline on the establishment, Operation policy and standard and infrastructure for Private and Public Health Hospitals in 2004 ( MOHP,2004). But it is still lacking in the formulation of the standard for the hospitals run by the government (Dixit, 2005). However, the policy published by the MOHP tries to clarify on the basic parameters of the infrastructures required for the hospitals which may be applied for the general hospitals as well. But the document does not speak about the application in the government run hospitals (MOHP, 2004). That is why; there is a lack of clear cut guideline for the management of hospital. Nepals health sector is facing a challenge regarding the management (Dixit, 2005). As part of whole system of health in Nepal, management of the hospitals is also a sever challenge for the country. 1.2 Summary of the problem Nepal has set a target to achieve the millennium Development goals by 2015. It has to meet the target in all health indicators. Goal no 3 and 4 are c loosely related with health and as part of curative health, hospital and hospital management have crucial role in health promotion. In Nepalese context, hospital management skill and concept of hospital management is still beyond the priority of the government and the government still does not have any policy guidelines over the hospital management sector (Dixit, 2005). People skill is a key asset for the development of key management styles. Dealing the people is a professional skill in itself. Being able to see from the perspective of others is essential, and caring for their welfare is also of prime importance. There are many high-profile examples of how to develop a successful management style. Managers like Bill Gates and Warren Buffett have famously developed their own distinctive management style from which others can learn. However, the fact that the two examples are very different management styles shows that there is no single route to success (Bono and Hellers, 2009). But unfortunately, there are no clear guidelines or policy found in the government documents. The recent document on the guideline on the requirement of a hospital, government does not speak about the hospital management, its skill development and transfer for the improvement of a hospital (MOHP, 2004). Lack of professional skill in the person responsible to manage the hospitals has created a problem in hospital management. The government run or supervised hospitals still do not have positions for the hospitals. MOHP in its policy document has not mentioned anything about the hospital managers (MOHP,2004). However, the private hospitals have started hiring them which is still out of the government policy (Thapa, 2010). Nepal is an underdeveloped country where the literacy rate is only 62.7% for male and 34.9% for female as per the report of census 2001 (CBS, 2001). It means still 64.1% women are out of literacy coverage. Nepal has poor health facilities all over the country except in capital Kathmandu and other urban areas. Most of the doctors are not willing to go to the rural areas hospitals and they are often running without (qualified) doctors (Dixit, 2005). In conclusion, the poor socio-economic conditions, hard geographical conditions and lack of awareness of the people and traditional beliefs and superstitions, lack of will in the political parties and their leaders are the main burning issues for the improvement of health sector in Nepal (Chaulagain, 2004). These all are problems associated with the hospitals and ultimately with their management. The factors associated to hospital management are still not uncovered in Nepal (Thapa, 2010). So, it Purpose of the study As mentioned above, it has been obvious that Nepal is facing the problems to strengthen the management of the health sector. The documents are not found to have been lacking regarding the strategies and policies on the health management. So, the proposal aims to identify the hindering factors affecting the hospital management in Nepal. It will study the existing policies and strategies of the government of Nepal on hospital management, international principles, theories and practices on hospital management and identify the factors which are affecting the betterment for hospital management sector of Nepal. So, the purpose of the study is to identify the hindering factors of hospital management in the case of Nepal and suggest the concerning authorities about improving the hospital management system, formulating the policies and implementing them. This proposal will analyse the strength and limitations of the hospital management system in Nepal and help all the concerned to mitigate and minimize them. Main research question The study can not answer all questions that come on surface while studying about the issue. So, to narrow down the study area and sharpen the focus, the study has defined the main study questions as follows:- What are the hindering factors that effect the hospital management in Nepal? Subsidiary Questions To supplement the main research question, these questions are defined as subsidiary questions as follows:- What will be the appropriate modality or best practices of hospital management that are applied in the world by other countries and What are the factors that are hindering in the betterment in the hospital management in Nepal? What is the most influential factor to promote the hospital management in Nepal? Hypothesis Lindsen and Jong (2005) have defined hypothesis as an alternative explanation of residual switch trial costs or, more precisely, of the empirical finding that the repetition trial (RT) distribution for switch trials with a long preparation intervals can be modelled as a mixture of the RT distributions for repetition trials and for switch trials with a short preparation interval (Lindsen and Jong, 2010). In here, the hypothesis tries to establish an alternative factor that might be supposed to be the commonest hindering factor for the management of hospitals in Nepal. The hypothesis taken here is the lack of professionalization of hospital managers or the persons who are involved in the management of either government run or private or community run hospitals in Nepal is the most influential limiting factors in hospitals in Nepal. Significance of Study As mentioned above there are no special policies and practices established for hospital management in Nepal. The hospitals are managed by the medical doctors or surgeons so far (MOHP, 2004). The doctors are not entitled to diagnose the patients, treat them, run medical and surgical and public health cams campaigns in the hospitals or in the periphery of the hospitals. The Medical council is liable to assign the job responsibilities of the doctors in the case of Nepal. But it has not mentioned about the management part of the hospital and its regulation, Nepal Medical Council Act, 1964 (amended in 2001).It does not speak who is responsible for that (Nepal Medical Council, NMC, 2001). There is no one professionally responsible for the hospital management in the present context. In the country where the government policy about the medical sector does not speak about the role of hospital management, it becomes obvious that the hospital management sector is not running smoothly. No presen ce of the monitoring body to supervise and evaluate the hospital management is found in the present documents whether published by the government or private organizations. So, the studies significance is in establishing the fact what are the main barrier and other minor barriers in the hospital management of Nepal. That is why this study is has a significance value. Literature Review 2.1 Concept of Hospital Management Hospital management provides a direct link between health care facilities and those supplying the service they need. This enhances the capacity of deciding and managing hospitals and health care centres and all other health care providers and other health care industries (Hospital management.net, 2011). The discipline hospital management is found to be conceptualised from the WHO Ottawa Charter for Health Promotion in 1986. It was introduced in the name of Health Promoting Hospitals (HPH) in the beginning since hospital was regarded a mean of health promotion. So, this concept is only 25 years old and newer to other disciplines. The Ottawa Charter recognised five areas of hospital management i.e. health promoting hospital setting, health promoting workplaces, the provision of health related services, training, education and research. It has identified the hospital sector as the change agent and advocate for health promotion (WHO, 2011). From the declaration of WHO, it becomes obvious that hospital is not only a place of treating the patients, but also a place where the activities for health promotion are run, all heath services are provided, trainings are conducted, education is given and researches are carried out. It rules out the understanding of the government on hospitals. Th e Bir Hospital, which is one of the units or part of the Ministry of Health and Population and the biggest government run hospital (MOHP) of Nepal has defined Bir Hospital only as a treatment and diagnosis service centre. In this definition, the other four parts defined by the Ottawa Charter are missing. However, it adds something in its website as its activities. According to it, Bir Hospital offers training to the students through its Post Graduate programme of its Medicine School (Bir Hospital, 2008). It clearly shows that the government of Nepal has some how realised the integrated approach of the hospitals, but not mentioned in its policy or strategy. There seems a gap between the Ottawa Charter and the understanding of the Government of Nepal in terms of its concept. National Health Service (NHS) of the UK has presented a model of its Week Hospital in its journal. It says that it has developed and validated an innovative integer programming model, based on clinical resources allocation and beds utilization. According to NHS, the model aims at scheduling Week Hospital patients admission/discharge, possibly reducing the length of stay on the basis of an available timetable of clinical services. The performance of the model has been evaluated, in terms of efficiency and robustness, by considering real data coming from a Week Hospital Rheumatology Division. The experimental results have been satisfactory and demonstrate the effectiveness of the proposed approach (NHS, 2011). We can see the factors that contribute in hospital management by this example mentioned above. The hospital management has become an emerging field in India, the neighbouring of Nepal and a developing country in the south Asian sub-continent. India education in its home page of its website says that hospital management and administration has become a priority and importance for healthcare industry and providing health and hygiene care in India. The government of India is paying attention on providing healthcare in both rural and urban areas by improving the management of the hospitals. It further adds that hospitals are expected to deliver quality service 24 hours a day at a minimal cost. The urgent nature of its work and the level of efficiency that is expected have increased the need of well-formulated hospital management system throughout the world (India Education, 2011). It shows that India has seriously taken the hospital management stream to upgrade the quality of the service delivery of the hospitals in India. These literatures presented above describe the concept of h ospital management. 2.2 Benefit of Hospital Management Worlds renowned management Guru Peter Drucker developed the concept of Management by Objective (MBO) in 1954. He has defined MBO as a systematic and organised approach that allows management to focus on achievable goals and to attain the best possible results from available resources. He has further said that the strong management system of the organization increases its performance by aligning the goals and subordinate objectives through out the organization. He adds that the employee get strong input to identify their objectives and timeline for completion. He has described the benefits of management to have supporting in setting objectives, organising groups, motivating and communication, measuring performance and developing people ( Peter Drucker,1954). NHS has defined its hospitals as organizations where high qualities of health care services are delivered to the clients (NHS, 2011). So, all the theories of the organization may be applied in hospitals and the importance of the hospitals may be assumed based on the benefits of a good management system as described Drucker. So, it has become obvious that to achieve the goals of the nation, the hospital management sector should be regarded as an important discipline in the context of Nepal as well. Limitations of Hospital Management Management is not a solution, but only the means of the solution which organises the resources in a proper way. For the effective management, every surrounding factor should be appropriate. Verzuh (2001) has identified five sectors that are required for effective management. They are good agreement between service providers and clients, an effective and realistic plan, constant and effective communication, a controlled scope and upper management support (Verzuh, 2001). Hospital as an organization can not provide its best services if the factors mentioned above are not available. In Nepalese context, the hospital management can not take the hospitals in the position to achieve its goals until there is an effective service giving and taking culture, until the planning body is capable enough, until the inter and intra organizational communication is strongly developed and there is a political commitment to prove upper support toward the bottom. So, these are the limitations of the hospi tal management. Barriers of Hospital Management in Nepal Nepals literacy rate is low, the national income and per capita income is also low. The difficult geographical situation is not also favourable for rapid development in Nepal. The socio-economic development is far behind as compared with other developed and even with developing countries (Dixit, 2005). As mentioned above, financial strength, political commitment, social culture and context need to be favourable for the good management of every development sector and the hospital is not an exception. The people can not consume the facilities well if they are not aware about the facilities they have been provided with (Thapa, 2010). But hospitals are managed by the Department of Health Services under the Ministry of Health Population and the, So, for the hospital management, this context has become a barrier. Hospital management practice in different countries i.e. Nepal, USA, UK, India, Japan and Thailand Hospital management is a new discipline. In Nepal, the Pokhara University strated Hospital Management course in 2001 only. Then it has put a milestone in the way of hospital management. Then some private hospitals have started to recruit hospital managers due to its influence and the government is in the way to start thinking on the need of separate hospital management stream under the health service (NOC, 2011). In USA, the hospitals are governed by the United States Department of Health. Its history goes to 1798 from when USA has started on managed health service (USDHHS, 2001). UK established National Health Service ((NHS) in 1948 from which it has been running the hospitals. All together, 12000 doctors are working in its hospitals all over the UK (NHS, 2011). Ministry of Health and Family Welfare is responsible for hospital management in India. It has Department of Health and National Rural Health Mission for managing the hospitals (Ministry of Health and Family Welfare, India, 2011). Likewise, Ministry of Health, Labour and Welfare looks health activities in Japan. It has Health Policy Bureau under the ministry and it looks after the hospitals and it has prepared a policy to manage the hospitals properly (Ministry of Health, Labour and Welfare, 2011). In Thailand, Ministry of Public Health looks after the hospital management. Under the ministry, there is Department of Health and under th is, there are 9n divisions. They are supporting the hospitals for their management in an integrated way (Department of Health of Thailand, 2011) 2.6 Previous empirical research findings on challenges in hospital management The Hospital; of St Raphael in UK has written in its website about the challenges it suffering in terms of the management. It says that the demand is growing and the challenge is increasing. Patient satisfaction concerns, hospital management demand, smart mind and smart technologies to keep healthcare system smoothly are the challenges seen in the present context. Likewise, recruiting hospital management and their turnover are other challenges (St Raphael Hospital, 2011). In Nepal context, There are no special resources are found either in published copies or in the websites. The National Open College has written about the importance of the Hospital Management course which is like an advertorial (NOC, 2011). But it does not speak about the challenges of the hospital management. So, relevant literatures are not enough as per the topic. Discussion and Conclusion After studying the literature and analysing the present hospital management system in Nepal, the points come into mind to be discussed:- The Government of Nepal has still not considered the hospital management as a separate sector. There is a lack of Hospital management professionals. There is no proper policy addressing hospital, management issues in Nepal. Hospital management sector has not been regarded as an integrated issue so far. Public and private sector are also not actively participating for the professionalization of hospital management human resources. In conclusion, we can say that hospital management is a new discipline. The developed countries like UK have already started to think on the management issues of hospitals as a separate sector. But in Nepal, the hospital management sector is not visible separately and it has not been regarded as a separate need or requirement. The hospital has not felt the need of hospital managers to manage the hospital smoothly. Lack of awareness, culture and customs low literacy rate, low income and difficult geographical situation are the factors which are hindering the hospital management sector to grow and become strong. Methodology 3.1 Instrument The study was carried out by using systemic literature review method. The literatures were searched in the website of the Universities of UK i.e. Bournemouth. The Medical Journal of America and USA were searched. The government policies of NEPAL, India, USA, Japan, Thailand and UK were other sources. The documents were collected, materials were searched and the materials retrieved were analysed before applying them in this search. The WHO website and other journals were considered as most reliable sources. Library use was the mostly used mean for search and writing the paper. This study will apply qualitative methodology to find the hindering factors of hospital management in Nepal where face to face interviews will be arranged during this study. 4 Conclusions The hospital management is a new term which is derived from the separate words hospital and management. Hospital is a mean of healthcare delivery while management is a way to utilize the resource in an efficient way. The hospital management is not very old concept in even in the developed countries while the countries while Nepal is very far behind in the development of this sector. Lack of professionalization of the existing human resources, less availability of skilled human resources, poor socio-economic situation, low interest of government towards the hospital are the hindering factors for the development of hospital management in Nepal. These all information was collected through literature review available in the library and websites developed by the governments, universities and academic institutions. It recommends the government of Nepal to recognise the hospital management as a separate and independent discipline under the health service. It suggests the academic institutions to focus on the development of hospital management professionals in their course and curriculum. It also suggests the private sector involved in running private hospitals in Nepal to start hospital management principles in their management.

Impact Of Eastern European Immigration On United Kingdom Economics Essay

Impact Of Eastern European Immigration On United Kingdom Economics Essay Is the sentiment against immigration in the United Kingdom well-founded or is immigration used merely as a scapegoat for the economic failings of liberal democratic society? In a recent survey by Populus involving more than 5,000 respondents, two out of three white Britons thought that immigration was bad for UK, a view echoed by nearly 43% of Asians and 17% black Britons.  [1]  Recently, headlines have capitalised on the death of multiculturalism and how the whole policy on immigration has lost its allure.  [2]   Clearly, the immigration debate is a contentious one. The economic downturn is Europes central political and policy preoccupation. In such a climate, it is unsurprising that the value of economic migration has come under scrutiny. Concerns are hardly limited in the UK.  [3]  Rising immigration is also common to many industrialised countries, where the average share of immigrants in the labor force has increased from 4.3% to 7.2% between 1995 and 2005.  [4]  In the wake of the global war on terror and the economic recession, the prevalent feeling today is anti-immigrant and unfortunately, according to some rights groups, bordering on racism.  [5]  Lest we rely allow speculation and emotion to take precedence on the issue, it is best to investigate empirical evidence on the impact of immigration on the UK. Critics of immigration policy have contended that the presence of immigrants have created more negative than positive consequences for the UK economy, that the unpreceden ted rise of immigrant populations have caused downward pressure on wages, taken employment off native Britons, with immigrants going for a free-ride off UKs welfare system and the need for greater integration.  [6]  Most of these criticisms are based on speculations; empirical studies on the impact of immigration on the UK are relatively young and have mixed findings. Some studies support the contention that the immigration balloon has reduced wages for Britons  [7]  but several studies have also supported the positive contributions of immigrants in the UK economy  [8]  and whatever effects immigration may have on labour, are minimal.  [9]   One of the largest immigrant groups that have made their mark on UK society are Eastern Europeans those who were absorbed in the labour forces as a result of the accession of eight countries the Czech Republic, Estonia, Hungary, Latvia, Lithuania, Poland, Slovakia and Slovenia to the European Union.  [10]  The geographical references Eastern Europe is used interchangeably with East Central Europe, the former Soviet Union, the Balkans, or the Baltic region. In the context of immigration and in the analysis being conducted in this thesis, Eastern Europe will refer to the so-called Accession 8 countries earlier mentioned. The influx of Eastern European migrants is due to several factors. Politically, EU policy is attributed to be the most significant driver of immigration in the UK. The free flow of migrant workers from Eastern Europe was fuelled by the EU Four Freedoms codified in a 2004 Directive.  [11]  While most of EU member countries came up with immigration restrictions, UK along with Sweden and Ireland did not. Migrant labourers from the A8 countries have come and gone freely in the UK since 2004. Aside from policy drivers, economic drivers also influenced migration patterns. So-called economic push and pull factors determine the expansion and retraction of migrant labour supply in the UK. Among the push factors include increasing poverty in the countries of origin, overpopulation, and excess blue-collar labour. Countries from the former Communist bloc suffered economically and had large segments of unemployed workers in their population coupled with dwindling social services. These diffic ulties are aggravated by a consistent growth in population, low levels of education, and lack of training.  [12]   Pull factors are those arising from labour demand in receiving countries such as the UK. Particular demographic characteristics could explain the pull in migrant labour from Eastern Europe. For instance, UK has seen declining fertility rates, an ageing population, and a rising level of highly educated professionals which is increasingly wary of undesirable menial jobs.  [13]  Undesirable jobs are characterised by low wages, long hours, and lack of job security those that appeal less to native Britons and more to immigrants. Jobs that fit into this category have been growing at a steady pace. Between 1979 and 1999, jobs belonging to the ten lowest paid occupations increased by 12 percent.  [14]  A small percentage of these workers receive social benefits; 3 out of 5 of them are not eligible for maternity or paternity leave; half of them do not get raises; and more than 50 percent did not receive sick pay. Studies have shown how around 90 percent of the lowest paid jobs in the UK are taken up by migrant workers.  [15]   Aside from the economic push and pull which motivate migration for most Eastern European workers, social and political factors also significant influence these decisions. Migration is also fuelled by the desire to reunite with family or build social networks. A study shows that the important of social networks and family cohesion cannot be discounted as significant factors influencing migration decisions.  [16]  New migrants are usually those who already have family members working as migrants in the UK and the decision to move is largely due to initial family migration. A report shows that the migration of Eastern Europeans to England is mainly through word-of-mouth and family networks. Family referrals are the most common routes to obtaining employment.  [17]  The importance of family networks is often seen as a boon or a bane by receiving communities. To the migrant communities, migration facilitated through family networks serve as foundation of community solidarity and f ormation. To receiving communities, such community formations may lead to the ghettoisation of migrant communities, giving worries that migrants do not assimilate enough with the mainstream society.  [18]  This, in effect, fuels suspicion and othering of migrant workers, and laying the basis for security concerns. As far as Eastern European immigrants are concerned, the common fear is the unregulated entry of migrants and asylum seekers may lead to increasing involvement with organised crime.  [19]   The most forceful argument made by immigration critics so far is to emphasise the negative consequences of Easter European immigration on labour. Saying that the influx of cheap labour from Central and Eastern Europe causes a downward pressure on wages has been asserted as early as 2004 by economists. In 1999, a study conducted by the Department of Education and Employment came up with conclusions supporting this fear: it found that if higher levels of unskilled workers came in, native Britons would be on the losing end and that if the opposite were true and migration instead attracted highly-skilled workers, native Britons would get the long end of the stick.  [20]  In addition, recent studies have also echoed the finding that the recent immigration levels have significantly reduced wages of British workers.  [21]  The disadvantages of immigration on job security of British workers have been largely hyped in the media  [22]  despite empirical studies generally contradict ing this claim. In fact, several economic papers have found that the migration flows prior to 2000 until 2005 have shown very little evidence of a negative impact. Specific studies on the impact of Eastern Europe immigrants have also stated that the general fear associated with migrant labour does not have empirical basis.  [23]  Econometric studies have also contradicted hypotheses that the increasing number of immigrants from the A8 countries have led to rising unemployment among British workers.  [24]  What is known about the impact of Eastern European immigration is little compared to U.S. studies examining migration consequences. Nevertheless, a substantial amount of scholarly literature is present. This present work reviews scholarly material and econometric studies related to the impacts of migration from A8 countries on the outcomes of native Britons in three spheres (1) labour, (2) culture, and (3) security. This paper uses the term immigrants and immigration to refer to people originated from any of the A8 countries to stay temporarily or permanently in the UK. For the purpose of this study, the term immigrants is used as a category under which labour migrants, asylum seekers, and political refugees all fall under. Research Questions The study focused on answering the following questions: What is the historical context of Eastern European immigration to the UK? What are the current migration trends in Eastern European immigration? What is the impact of Eastern European immigration on a) labour, b) culture, and c) security? Structure of the Paper This paper is structured into four main sections. The first section includes a brief description of the historical setting of migration in Europe. Moreover, the history of migration in Britain is particularly examined. The second chapter deals with the most recent migration patterns and migration trends of Eastern Europeans to the UK. It examined the rise and fall of migration numbers and account for possible factors that led to these trends. The third section presented a brief discussion on the major policies that have affected migration trends of Eastern Europeans toward the UK. The fourth section made a thorough review of the findings of scholarly studies particularly econometric studies that have dealt with the issue of immigration impacts. First, the impact on labour is examined whether or not immigration is negatively associated to outcomes of native workers. Second, the impact of Eastern European immigration in the context of assimilation, integration, and community cohesion is discussed. Third, security concerns on the so-called irregular workers and their ties to organised crime are examined. Historical Context of East European Immigration The United Kingdom is a region where immigration and emigration co-exist, and its British citizens have always been accommodating to the migrant inflow. There has been no clear evidence as to when migrants first came into the region. However, the post-war effect was the migration of the people from the New Commonwealth which was viewed as an influx of non-white races, such as Caribbeans, Indians and those from Bangladesh. The high migration was from 1950 to 1970 slowly made the UK a significant player in the European labour market. The migration has always been considered long-term or temporary.  [25]   Immigration to the UK began to increase when the government from the EU Accession countries, also referred to as the A8, have provided a policy that allowed migration from the A8 countries to the UK. The A8 countries are the Czech Republic, Estonia, Hungary, Latvia, Lithuania, Poland, Slovakia and Slovenia. Migrants from these regions have considered economic factors as one of the main reasons to move out of their respective nations into the United Kingdom, which has a relatively attractive economic status over the past years.  [26]   Migration from Eastern Europe began during the 1900s because of the Russian communist sovereign. This era was marked by a high flow of migrants from Russian territories, all determined to escape the difficulties brought about by a communist republic. It was recorded that migration was from Eastern to Western Europe, with few people returning to their original residence.  [27]  The primary estimate of migrants conducted by the Labour government was between 5,000 to 13,000, but the actual resultant population of migrants was far more than what was expected.  [28]   One such group is the Polish. The United Kingdom opened its doors to the Polish community to help Polish soldiers and support the British labour market. In 1939, migration from Poland to its neighbouring countries was due to the Soviet brutality and deportation. Polish soldiers were forced to reside outside the borders of their country to reform, and at the end of the war, some have decided to settle in the United Kingdom and even brought with them their families. The twentieth century marked the increased flow of Eastern European migrants in different nations in Europe, and even outside Europe, particularly United States and Australia. The free movement after the war resulted in the reconfiguration of the political structure in Europe, and 2004 has been marked as the turning point for the Polish migration to the United Kingdom.  [29]   In 2004, the UK has experienced a fast inflow of migrant workers from the A8 countries, and these workers have been given the freedom to migrate and work in the UK even without any employment permit. This was a political strategy to get workers for low-paying jobs and empty slots for skilled workers.  [30]   Prior to the May 1st accession of the A8 workers, the Workers Registration Scheme [WRS] was created to modulate the access of the A8 workers to different welfare benefits and gather data that will aid in regulating the inflows and creation of policies. The WRS has mandated that A8 workers who have acquired jobs in the UK in a period of one month must register with the Home Office.  [31]   Asylum seekers have also been consistently being monitored by the UK government, Roma from the Czech Republic, Slovakia and Romania have entered the UK borders by placing themselves under the Eurostar train or by hiding themselves in enormous containers being delivered to the UK.  [32]  In the early 1980s, 150,000 asylum seekers migrate per year, sharply increased in 1992 to 850,000 and went down again to 380,000 in 1997. The sharp increase in the number of asylum seekers in 1992 was brought about by the collapse of Soviet Union and other issues related to the split of Yugoslavia.  [33]   In general, the East to West migration of Eastern Europeans was brought about by the change from communism to a socialist type of government, the removal of the restrictions to travel across the region and the re-delineation of individual rights.  [34]  Aside from the political changes, the accession of the ten new countries, including the A8 countries, to the European Union on May 2004 and expansion of the EU further increased the number of immigrants to the UK, Sweden and Ireland. The three mentioned countries are the only regions which have freely opened its labour market to the A8 migrant workers upon accession in 2004. They have been able to get jobs without restrictions and were provided the right to live like UK citizens. Moreover, these migrant workers can be joined by their dependants.  [35]   Factors affecting the Immigration of European to the UK Economic factors have been regarded as the most significant motivating factor for individuals to migrate. It is a fact that the economic status in Central and Eastern European countries have changed from the communist period. The communist period was marked by a low employment rate and low wages for the working population. This has led to an unstable economy and low per capita income during that era. These factors have led individuals to consider migrating to other regions to improve their lifestyle and economic status, and minimise the effect of being deprived economically in their own countries.  [36]   Globalisation is a significant aspect in the migration trends as the improvement and economic growth of London, as paralleled to that of New York City, has made the migrants more mobile because the transportation cost has been reduced and people have become more appreciative of the employment opportunities that are available in the region. The decrease in the cost for transportation has encouraged the movement of migrant workers into the UK and has enforced its labour market.  [37]   The high employment rate and high per capita income are the main reasons why A8 countries migrate to the UK. Improvement in the GDP and employment rates in the A8 countries may eventually result to lower migrations to the UK. Similar to situations in other countries, the individual assesses the economic state of the country and compares the benefits and disadvantages of possible migration. If there is more to gain compared to that of staying in their own countries, these individuals have greater probability to migrate.  [38]   Two general factors affecting professionals and skilled people to migrate have been shown to be correlated, namely the goal to leave and the realisation of finding what they want somewhere else. The external force which serves as the driving mechanism makes individuals think of leaving their home country. These external forces are commonly in the form of job dissatisfaction resulting from low salaries or less benefits in their work area; unemployment or underemployment and uncontrollable social and political disturbances that disrupts the economic state of the individual. The realisation of finding what these individuals want is also economic in aspect, just the same as most of the reasons why they migrate. Being able to find a better-paying job, as well as getting a more specialised exposure to the field of work are appealing to those workers who are currently unsatisfied. Several factors will then be considered in terms of the location for migration. Some of these factors are job o pportunity, liberalised immigration policies, language barriers, salary, standard and cost of living, better job experience and fulfillment, environmental factors and government policies with regards to the acceptance of family members for petition. All these factors are inter-related, but different cultures and individual perspectives also affects the decisions being made by the professionals when migration is being considered.  [39]   Based on the same survey conducted by the Home Office, the UK was chosen by only 42% of their respondents as the most probable location to migrate, aside from United States, New Zealand, Australia or Europe. The UK culture and location as well as the language in the region has also been considered as significant factors for migration. The main advantage of the UK against USA was that the UK was the first to open its gates to migrant workers, providing equal job opportunities, was then seen as a provider of a less stressful work environment and that the provided jobs were better in terms of the job satisfaction and fulfillment of the migrant workers. Factors such as the intense climate, problems in procurement of work permits and distance from loved ones have been identified to reduce migration to the UK.  [40]   Political factors that caused migration have been common to both the Central and Eastern Europe. The migration policies that have been implemented in the early 1990s have significantly affected migration flow. Some of these policies are the liberalisation for visas within countries in Europe and legal entry of the working immigrants. These policies have dramatically encouraged citizens from other European regions, as well as the non-EU migrants to try to migrate to the first world countries in Europe, including the UK. Humanitarian factors such as in the case of refugees have been considered one of the reasons for immigration. The number of refugees greatly depends on the violence in the events taking place in their respective national residence. Some of these events are Coup detat  [41]  , government crises, guerrilla warfare and civil war; among which, civil war generated the most number of refugees with an estimate of 35 refugees for every one thousand of the population. The United Nations High Commission for Refugees [UNHCR] in the Geneva Convention for Refugees has referred to a refugee as someone who can no longer return to the country that he or she normally resides in because of possible persecution. The UNHCR have identified that most of these refugees are in Third World countries.  [42]   The refugees, in the course of their nations history, have moved farther away from their home where there is economic and political conflict, as well as threats to their safety, heading to the closest neighbouring country where they seek for temporary escape. However, most refugees go back to their homes as soon as the war ends because of the difficulties that they encounter in the refugee camps. The most appealing escape from the refugee camps is to cross borders of the neighbouring countries, wherein the refugees are provided only temporary resettlement and restricted rights in the countries that they have escaped to. These temporary privileges are the refugees reasons for both the migration from and return to their respective homes.  [43]   The long process required for refugees to seek protection in neighbouring countries takes a very long time and this has also been a problem because in most cases, smuggling and illegal entry into the neighbouring regions occur.  [44]  It has been estimated that 50% of the asylum seekers have been reported to enter UK, Germany and France by smuggling operations; and these refugees needed to pay at least $4000 to be able to get smuggled through Europe.  [45]  Data gathered about the asylum seekers show the uncertainties that are being encountered by these people who really have no idea of how and where their destination will be as the route that the smuggling operations take are dependent on the tightness of the security in the regions they are about to cross.  [46]  A 13-year pooled regression study  [47]  on 20 countries showed that factors such as employment rate, number of foreign nationals and the destination countrys liberalised perspective on immigration and acce ptance of asylum seekers are the key determinants for immigration. The increased influx of working migrants and asylum seekers to the UK have led to the formation of a point-based system to properly control the movement of immigrants into the UK. This type of system aimed at giving more restrictions to those who intend to apply for legal immigration in the UK, and this system also minimises the number of possible refugees that will enter the UK illegally.  [48]  The main goal of this point system is to slow down the population of UK, with the aim of controlling the pace of immigration. Types and Number of European Immigrants in the UK Immigration in the UK has been reported to be half of the total British population growth from 1991 to 2001. Some surveys have evaluated that most of the immigrants have settled in London, and Wembley has even reached half the population in its region. Three areas have also been identified in which there was a marked rise in the number of immigrants, namely Scotland, South-West and North-East England.  [49]   The number of working migrants in the UK has increased from 30,000 in the 1990s to about 80,000 in the early 2000. The labour market of the UK varies from EU nationals to non-EU nationals, but the most of which belong to the A8 countries. Professionals from other regions with the aim of improving their economic situation in first world regions also make up the immigrant population in the UK, but 90% of the aspiring immigrants are students and asylum-seekers.  [50]  The movement of foreign workers in the UK have shown that about 20% are IT professionals and about 8% work for financial services.  [51]   In 2006, the estimated number of refugees all over the world is about 12 million. This is a 400% increase compared to the estimated number during the 1970s, and is still expected to increase further based on the trends in the past decades. Furthermore, approximately 50,000 to 500,000 asylum seekers have resettled in developed countries from 1970 to 2006 (Hatton, 2004). Polish nationalities have been considered as one of the most significant ethnic population of the migrants in the UK. Being approximated at about 540,000 migrants, the Polish community is expected to grow even more in terms of the movement of the population from their country to the UK.  [52]  However, in 2007, despite the 237,000 increase in immigrants in the UK, there was a recorded decline in the number of Polish migrant workers going into the UK. The same trend is also observed with that of Latvia.  [53]   In 2009, a decrease in migration was observed, from 160,000 to 142,000, however, the data gathered did not include the number of asylum seekers, as well as the mobility of migrants in the Northern Ireland. A 59% increase was observed in the number of people that have become UK citizens, amounting to 203,790 individuals.  [54]   The increase in the number of migrants has not been only on the asylum seekers, but almost all categories of the immigrants currently living in the UK. The influx of migrants has been associated with the improvement of the economy in terms of employment opportunities, and rise in GDP. Asylum seekers, illegal aliens and overstayers were shown to be related to economic and political issues. The entry of illegal migrants is not feasible to be empirically measured but with the strong connection between migration and economic status, the number of illegal migrants is assumed to be increasing.  [55]  

Nicolaus Copernicus :: Essays Papers

Nicolaus Copernicus The sixteenth and seventeenth centuries were known as the Scientific Revolution. During these centuries, science was starting to answer many questions about the earth. Scientists all around the world were making their assumptions on how the universe worked. Nicolaus Copernicus was a Polish astronomer that also had a theory. The Copernican Theory changed many views and had a great effect on society. Copernicus lived his life in Poland. When he was nineteen, he decided to study at the University of Cracow. At the university he was required to study grammar, rhetoric and logic, arithmetic, geometry, music and astrology or astronomy. Edward Rosen is the author of, Copernicus and the Scientific Revolution. He says, "The subjects offered during his years there are known form university records that are still preserved. The names of the professors who taught those courses are also known. But the students’ records are missing."1 The grades that he received in college are unknown. However, it is known that he did not stay long enough to earn a bachelor’s degree.2 After Copernicus left school he returned home to his uncle, Lucas Waczendrode, who was the bishop of Ermeland.3 His uncle suggested that he enter the canonry n Frauenburg. The canonry is a group of clergymen that belong to a cathedral or other church. Entering the canonry would give Copernicus a stable and secure income for the rest of his life. While he waited for an opening, his uncle sent him for training at the University of Bologna.4 While there he studied mathematics and Greek language for three and half years. He also became more familiar with astronomy. In 1501 Copernicus returned to Frauenburg where he became apart of the canonry. He left quickly and started to study in Italy at the University of Padua. There he studied law and medicine.5 After a lifetime of studying, he is said to have mastered the concepts of math, medicine, theology and astronomy.6 As Copernicus began to study astronomy more, he came to strongly disagree with the Ptolemaic system of astronomy. This system was based on the idea that the earth was fixed in the center and all the other heavenly bodies moved around it. Astronomers believed that the earth was in the center because it was heavy. Copernicus saw many problems associated with this system of astronomy. For example, sometimes the planets appeared to be going in the opposite direction and the brightness of the planets would tend to change as well.

Use of Pathos in Writings on Torture Essay example -- Who Walk Away fr

Torture is a loaded word. It conjures images in a readers' mind of any number of horrors, physical and mental. Many writers rely on this reaction and use pathos in their articles to illicit a strong response in their audience. Pathos is an emotional appeal used to gain sympathy and trust from the audience and works for people of all intellectual levels. It often casts the author or characters in a story as an Everyman, easy to identify, and therefore see eye to eye, with. In my opinion, the more an author is able to create a personal connection to torture, the stronger their argument becomes. Strong emotions create a more appealing argument for an everyday audience. Michael Levin's â€Å"The Case for Torture† uses a few moments of pathos to convince the audience of the potential benefit of torture. He poses several scenarios of terrorists planning attacks on large numbers of innocent people and then asks, â€Å"If the only way to save those lives is to subject the terrorist to the most excruciating possible pain, what grounds can there be for not doing so?† Even if you don't agree with him, he urges the reader to â€Å"face the question with an open mind.† By doing this, Levin uses pathos as well as ethos to present himself as a nice guy who's not unreasonable. Though his argument is different from Levin's, Andrew Sullivan tries a similar approach in his article, â€Å"Bush's torturers follow where the Nazis led†. The article demonstrates a clear use of pathos from the beginning. Sullivan begins with some personal information about himself, showing that is is one of the regular people. His imagery is subtle but power ful. By implying that the government's behavior is in some way akin to the Nazis, he conjures up a powerful imagine in the readers min... ...Oct. 2008 . Ortiz, Sister Dianna. "Mr. President, stop the torture!" US Catholic Magazine Online. July 2004. 26 Sept 2008 news_iv_ctrl=1341&abbr=usc_&JServSessionIdr001=anotsvvjc1.app45a> Ortiz, Sister Dianna. "Speak Truth to Power Defender – Interview with Dianna Ortiz." Speak Truth to Power. 26 Sept 2008. . 26 Sept 2008. Sullivan, Andrew. "Bush's torturers follow where the Nazis led." Times Online. 7 October 2007. 23 Sept 2008 andrew_sullivan/article2602564.ece> Porter, Henry. "America's Dirty Torture Secret." The Guardian. 10 Sept 2003. 1 Oct 2008 .

Relationship between hypothesized behavior Essay

The aim of the paper was to determine the relationship between hypothesized behavior resulting from a personality test and actual information behavior from a group-based assignment. Traditionally, information seeking behavior is subsumed under a single monolithic theoretical framework. The study seeks to address the empirical categorization of such behavior. About three voluntary groups of ten library and information science students were observed during a project assignment. The NEO-PI-R test was employed to describe and define personality traits of participants. The independent variables are gender and test results. The dependent variable is the so-called ‘differential information-seeking behavior’ (between the populations). The findings are as follows: 1) some personality traits are related to actual information-seeking behavior, 2) gender is not a good determinant of good behavior, and 3) personality traits are also related to the overall context of group activities. 2) Research Design. You want to know more about the social interaction of preschoolers in the playground. Suppose the number of preschoolers (assuming) is 30 and above, then we can conduct a statistical test. The independent variable is ‘time spent playing with other preschoolers’- X- (assuming that we expand the playing time of the children). The dependent variable is ‘personal acceptability’ – Y – (the degree in which a child receives positively other children). If we observe that an increase in X is accompanied by an increase in Y, then we can assume that the two are correlated. In short, as the amount of time spent playing with other preschoolers is increased, the degree of personal acceptability increases. 3) A correlation value of 0. 89 means that there exists a very strong positive linear relationship between the two variables. In short, the amount of time (in hours) spent in studying is positively related to exam scores. A student who spends more time studying will likely to receive high exam scores. 4) The researchers subjected ‘Albert’ to intense psychological conditions without his consent. The researchers were also indifferent to the consequences of the experiment (which turned out bad for the child). These two instances merit as ethical faults in the study. 5) Neurotransmitters are chemicals which allow the transmission of signals from one neuron to the next across synapses. Neurotransmitters, in a sense, activate receptors of the nervous system. Hormones are also signal chemicals but with different purpose. They are chemicals that transport signal from one cell to another, altering body metabolism (which neurotransmitters cannot do).

Discipleship R.E Essay

In marks gospel we learn about the nature of discipleship. A disciple is someone who learns form the word of god which comes from Jesus’ teaching. Whereas an apostle is, perhaps in a way, the next stage of discipleship, where they go out and spread the word of god to others making them disciples. They had the courage to do this because of the Holy Spirit descending upon them as tongues of fire so they could preach in every language they had to. The purpose of discipleship according to marks gospel is to heal, to spread the word of God and to teach people how to change their hearts and helping people realise the things that stop them from loving God and their neighbour as themselves; as an apostle he has achieved that in most hearts. In marks gospel the disciples have an important purpose. Jesus wanted friends to help and support him on his mission. There are a number of references from mark to support this. Mark 1:16-20 talks about when he was on his first search for loyal disciples. He said to two men in a fishing boat (Simon and His Brother Andrew) â€Å"Come, follow me† â€Å"and I will make you fishers of men.† This story teaches us that Jesus chose ordinary men (Fishermen to be Precise). Mark 3:13-19 refers to when Jesus sent the disciples out to preach and to have the strength to make others disciples. This means that Jesus wanted the disciples to go out and spread the word of god to others. Another example from mark to help us understand the purpose of discipleship is in Mark 6:7-13. This is where Jesus sends the disciples out in pairs and gives them authority over unclean spirits. He also tells them not to take anything on the journey apart from a staff! A final example is from Mark 6:30-44 this is when there is the feeding of the 5000. Where Jesus takes 5 loaves and 2 fish blesses them and asks them to hand it all to the 5000. In the end it turns out that there was enough for every single person to be fed till they are full up and they end up with 12 baskets of leftovers. Jesus chose a variety of different people to be his disciples. For example he chose four fishermen as his first four disciples! (Mark 1:16-20) he also chose a tax collector (Levi the son of Alpheus) this shows Christians today that Jesus chose ordinary people not big people that were ‘the best’! Mark is very clear about the costs and demands of discipleship. Disciples have to give up everything and show total love to God. For example in Mark 12:41-44 it shows a widow putting all she had in the Treasury and Jesus Said that she had put more in than all the Others who put in what they could spare! The demands are clear from Mark 8:34-38. Where Jesus says; â€Å"If anyone would come after me, he must deny himself and take up his cross and follow me for whoever wants to save his life will lose it, but whoever loses his life for me and for the gospel will save it. What good is it for a man to gain the whole world, yet forfeit his soul? Or what can a man give in exchange for his soul? If anyone is ashamed of me and my words in this adulterous and sinful generation, the Son of Man will be ashamed of him when he comes in his Father’s glory with the holy angels.† The general consensus of what Jesus is saying is that all who wish to follow him in the path of glory must give up everything he/she has. Further examples from Mark include 6:7-10: where Jesus tells his disciples to, â€Å"Take nothing for the journey except a staff. no bread, no bag, no money in your belts. Wear sandals but not an extra tunic. Whenever you enter a house, stay there until you leave that town.† This means that Jesus was basically saying, â€Å"Don’t think you need a lot of extra equipment for this. You are the equipment. No special appeals for funds. Keep it simple. No posh inns. Get a modest place and be content there until you leave.† Even though there are many costs and demands to discipleship, there are also a lot of rewards. Mark makes this clear in Mark 10:28-31 where Peter said to Jesus, â€Å"We have left everything to follow you!† â€Å"I tell you the truth,† Jesus replied, â€Å"no one who has left home or brothers or sisters or mother or father or children or fields for me and the gospel will fail to receive a hundred times as much in this present age (homes, brothers, sisters, mothers, children and fields and with them, persecutions) and in the age to come, eternal life. But many who are first will be last, and the last first.† This shows us the rewards of discipleship because Jesus was enhancing the fact that they would get anything and everything they want in heaven as they have left everything behind. The disciples found discipleship difficult to understand. They sometimes misunderstood what Jesus meant. For example, in Mark 2:13-17, Once again Jesus went out beside the lake. A large crowd came to him, and he began to teach them. As he walked along, he saw Levi son of Alphaeus sitting at the tax collector’s booth. â€Å"Follow me,† Jesus told him, and Levi got up and followed him. While Jesus was having dinner at Levi’s house, many tax collectors and â€Å"sinners† were eating with him and his disciples, for there were many who followed him. When the teachers of the law who were Pharisees saw him eating with the â€Å"sinners† and tax collectors, they asked his disciples: â€Å"Why does he eat with tax collectors and ‘sinners’?† On hearing this, Jesus said to them, â€Å"It is not the healthy who need a doctor, but the sick. I have not come to call the righteous, but sinners.† The disciples did not understand this because they thought that Jesus was a sinless man and there he was eating with so called sinners? What they didn’t see was that Jesus had come to earth to heal sinners and cure the lame. Not applaud the perfect and righteous. Discipleship was not something that was easy. The disciples were asked to give up a lot to show their love for God. For example, in Luke 14:33 Jesus says, â€Å"in the same way, any of you who does not give up everything he has, cannot be my disciple.† AO2 The effects that Jesus’ teaching about discipleship has on Christians today when it comes to spreading Jesus’ message are as follows. The 10 commandments! Jesus referred to these quite often. I mean yes, maybe not everyone follows the 10 commandments, but at least the people that know about them acknowledge them and respect them. Also about giving up all that we have to follow God. I don’t think many people today would give up all they had to follow God; reason being that we are all selfish. I mean, at least we know that we have to, but; at the same time, nobody in today’s world would give up their possessions. The effects that Jesus’ teaching about what type of people are chosen to be disciples has on the lives of Christians today are that you don’t have to be flash and fancy to impress Jesus or God. What they focus on is a persons faith but also lack of faith! If there was supreme lack of faith, Jesus would try and help that person to be a good Samaritan. Jesus’ teaching about the costs and demands of discipleship affects the lives of Christians today by showing that they would have to give up everything to not only be a disciple but also to gain entry into the kingdom of God! This is quite a dawning thought to some as not a lot of people would do that for God. Also to leave all of their family including wife/husband and children! I don’t think that people nowadays would be in this frame of mind unless their faith was very strong! Jesus’ teaching about the rewards of discipleship affect the lives of Christians today by indulging them with the reward of 100 times as much as what they want. And anything that they want as well! People would think that this would be worth giving up everything for! But the 1 thing that usually holds them back is that there might not be a God and what if it’s just made up? Mother Teresa was a famous Christian who dedicated her life to helping others and she was made a saint. She is a great inspiration to others and if more people were like her then the world would be a better place! AO3 The arguments that people would put down as to why Children cannot be disciples and Christians are that: Jesus chose adults There is the age of reason where a child thinks what is right and wrong With confirmation, the decisions are usually made when a child is older so that they understand. Children depend on adults; therefore, they are not in a position to make self sacrifice. Even adults struggle to understand so how can children. The arguments that people would put down as to why children can be disciples and Christians are that: They are baptised so they are part of the church Jesus welcomed children especially Jesus chose a variety of people Children are excellent and willing learners Depends upon the definition of Child Age of reason (7-8 years) They should be welcomed I believe that the true Christian view is that Children can be disciples and Christians. My reasons are that most Christians are self conscious about children so thy want to protect them. Also children have to make their own choices in life so if they want to become a disciple or Christian then nobody should stop them as it is their choice!