Tranexamic Acid Essay Example | Topics and Well Written Essays - 2000 words

Tranexamic Acid - Essay Example The researchers indicate that tranexamic acid is an effective antifibrinolytic agent. Tranexamic acid competes with lysine for the binding sites on the plasminogen molecules. Thus, it effectively inhibits the formation of plasmin. The binding of tranexamic acid on lysine binding sites located on plasminogen molecules is reversible. Other studies have shown that a good number of orthopedics use tranexamic acid because of its safety, efficacy and affordability. The researchers conducted a double blind study involving 40 patients who had to undergo a unilateral TNR for osteoarthritis. The study occurred in a tertiary health care facility after obtaining approval from the hospital’s ethics committee. The procedure was conducted by three experienced orthopedic surgeons. The study aimed at determining whether tranexamic acid significantly reduces post operative blood loss and the need for blood transfusion in Indian patients undergoing TKR. One half of the group was given 10mg/kg of tranexamic acid prior to the surgery. The placebo group was given normal saline without tranexamic acid. The study found out that tranexamic acid significantly reduces post operative blood loss and the need for blood transfusions in patients undergoing TKR. However, the study lacked sufficient clinical evidence and literature to support the findings. The usefulness of the study to my research is that it illustrated the significance of tranexamic acid in reducing blood loss during surgical procedures. Furthermore, same results were posted in the study carried out by Dunn and Goa. The researchers’ study methodology relied on meta-analysis of previous studies. One study reported that the need for transfusion was reduced by 60% in patients administered with aprotinin (1005). On the other hand, the study indicated that administration of tranexamic acid reduced the need for transfusion by 43% (1005). In order to validate this information, the researchers conducted a meta-analysis of previous studies. The researchers utilized literatures that have been in the journals since 1966. The researchers used Adibase to locate literatures. In addition, the researchers found references from the list of published journals resourceful. The study endeavored to explore the use of tranexamic acid in surgery and other indications in order to recommend its usefulness and effects associated with its use. The researchers revealed that tranexamic acid can be used in various hemorrhagic conditions. They reported the acid can significantly reduce post operative blood lose and the need for blood transfusion. They noted that the acid is affordable and tolerable when compared to aprotinin. In addition, the researchers found out that tranexamic acid reduces mortality and urgent surgery in patients with upper gastrointestinal hemorrhage. The acid can also be use as an alternative to surgery in menorrhagia, reduces menstrual blood loss and, has been effectively used in reducing bleeding during child birth. The research seems to have been limited to literature that could be accessed via the search engine. The researchers also concentrated on past literature in evaluating their objective.

Relations Between East and West Germany in 1969 Essay Example for Free

Relations Between East and West Germany in 1969 Essay The relationship between the two states in Germany, FRG (West) and GDR (East) has improved drastically in recent times resulting in the restructuring of Germany. Though the basis of this reunification stems from the years between 1969-1974. These years where immensely important for the two Germanys and with the change of leaders for political parties, so to did the views change. Such as the introduction of Ostpolitik. There was also the continuation of control from the mother countries that these two nations represented. The two superpowers (USA and USSR) wanted improved relations in the late 1960’s to prevent an annihilation of an international scale – there where too many weapons the stakes where too high. Many people thought that the money used to develop these weapons could be put to better use, such as improving living conditions. First it is necessary to talk about Willy Brandt, who was a German communist politician who led the German Democratic Republic as General Secretary of The Social Democratic Party of Germany (SPD) from 1971 until 1989. He had created the policy of Ostpolitik, which was aimed at improving the relations with the East. This was the first time that either one of the nations had stated any realisation of each other. They’re where many aims of Ospolitik of which its main goal was to strengthen the relations within the entire Eastern Bloc. It was to develop relations with the East and reduce the negative effects of Germany’s division. It used a policy of ‘rapprochement’ rather than a policy of strength, which was only possible due to the serious confrontation in 1962 between the USA and USSR after nuclear bases were found to have been installed in Cuba. This policy allowed both nations to be admitted into the United Nations after the signing of the Treaty of Moscow in August 1970, in which the FRG recognised the western boarders of Poland as well as stating that neither country had any territorial claims against each other. Willy Brandt was the driving force behind this offering of an ‘olive branch’ to East Germany. In March 1970, Brandt visited Willi Stoph (leader of the GDR’s Council of Ministers) in Erfurt, East German. This was the first ever meeting between senior government figures of the FRG and GDR and demonstrated that measures to develop better mutual relations were being taken seriously by both Germanys. This visit changed the views of the East German public as proven by their enthusiastic welcoming of Brandt. It gave them hope that life may improve now that they where recognised as a country. They even displayed a banner with the letter ‘Y’ on it to symbolise Willy Brandt apposed to Willi Stoph It also calmed tensions with the USA as the USSR viewed Brandt as a ‘good guy’ with whom they could do legitimate business. Although, the USA was worried that Brandt was acting of his own accord, they feared that they would lose control over the FRG and Brandt. Later that year in August he visited Moscow, the capital of Russia, which reinforced the idea of Ospolitik, it was something that Konrad Adenuer would never have done. Finally on his return journey he stopped off in Poland, which was heavily scared from the war when Germany invaded in 1939. His press stunt of stopping at a Jewish Memorial acted as a major step towards repairing relations. This could also be seen as a stepping stone for the dà ©tente of when Ospolitik did have its negative though such as, the loss of traditional support (eg. refugees) as the loss of territory in Poland caused quite an upset many calling it illegal and some went as far treason. In 1971 the GDR elected Erich Honecker as General Secretary. Erich had to respond to Brandt. He had a commitment to improve the relations. He made Western media legal in the GDR, the people could view TV and listen to radio freely – although newspapers where censored as this was the how the majority of East Germans received their news. There where significant improvements in the postal service and the telephone lines between West and East, there had been no official line linking the cities before. Finally, a new motorway was constructed from Hamburg to Berlin as part of the plan to improve its links with West Berlin. Though it helped people inside to travel around the GDR. This was again all due to the fact that the beginnings of Ospolitik and the four power agreement (an agreement that ensure what was known as a time of dà ©tente) had led to wider international recognition. Both Germanys had a applied for, and were accepted as, members of the United Nations. During the period of 1969 to 1974 over nighty countries officially recognised the GRD. They also were finally accepted by the USA. Now that both states recognised each other, in 1974 the first ever football match between the two states was held with the first round of the world cup. It ended with a 1-0 away win for the GDR. This was significant in the fact that it showed the world that communism was not necessarily a losing way. However, there where still many things wrong with the society between the two. Some parts of the relationship were still cold. Such as, the continued restriction of travel from the GDR. Travel from the GDR to West Berlin and West Germany remained tightly restricted. Despite having signed many agreements, the SED refused to comply with the human rights aspects of the 1975 Helsinki Accords, which were designed to ensure there was free travel from either country. Overall travel to the West was far more restricted from the GDR than that of Poland or Hungary. Apart from business meeting, sports matches and politicians, access to the West was made impossible to people of working age. This had to be implied or the East would have lost its whole work force to the West, at one point up to 250,000 people where leaving the country. If they didn’t prevent them their economy would have collapsed. In the 1970s, Erich Honecker rejected any aim of reuniting Germany. Instead, he focused on emphasising a policy of ‘demarcation’ to stress the differences between East and West Germany and to develop a clearer sense of the GDR’s own unique national identity. A new constitution in 1974 helped emphasise it as the true ‘German’ state and helped justify it as the only ‘anti fascist’ state that is organised on the basis of class-consciousness. The SED also promoted itself as the natural successor of Karl Marx and Engels, who, of course, were Germans. It also claimed that the FRG was too Americanised; many West German conservatives believe the same ironically. Finally, they stated that the GDR bore no responsibility for the war crimes that had been committed by Nazi Germany. Overall it is obvious that the policy of Ostpolitik was significant in that it led to a cooling of relations between East and West Germany, and between the Superpowers. It is debatable whether this alone led to the eventual reunification of Germany and its role in doing so is often overstated. Ostpolitik was in some ways limited in its impact and not supported by all. It did however mark a turning point as the FRG and GDR were prepared to recognise each other. All of this said, it is not the most significant in the development of relations- the initial events which divided Germany and the creation of a wall dividing the nation physically are far more important.

Confucius Essay -- essays research papers

Confucius became famous as a sage, or wise man, of China during the Age of Philosophers. His Five Classics have influenced the civilizations of most of eastern Asia. Confucius was born in the state of Lu when local rulers refused to pay homage to the emperor of a failing Chou dynasty. Confucius hated the disorder that ensued and looked back on a time when things like that were not even thought of. He studied the teachings of the sage’s whose teachings and influences had made China one whole nation at one time. He decided that he was the one who should restore the faith and practices of the old emperors and wise men. Since Confucius was not able to gain an official position in China, he spent most of his life teaching a core group of disciples. The main idea of Confucius’ philosophy was to provide rules and traditions for every conceivable situation in every day life. He was concerned with all the misery in the world, and he hoped that making men noble would bring about a noble world. Confucius’ ideas of being benevolent to one’s fellow man, closely following set rituals, and acting in a manner proper and befitting one’s social class became the state followed ideology during the Han dynasty.1   Ã‚  Ã‚  Ã‚  Ã‚  When studying the religion and philosophy of Confucius, one must have a clear understanding of the books he wrote. The Five Classics were from the period preceding the Warring States Period. They were brought together and edited by the members of Confucius’ original school. Once Confucianism was made China’s official philosophy, a person had to study these five books in order to gain a prized governmental position. Saying that there are only five classics is a bit of a misstatement. There are five classics and an extra book written by Confucius that is usually lumped in with the traditional Five Classics. That book is Lunyu, or The Analects. The Analects is a collection of little bits of wisdom that Confucius gave his disciples. However, the book is not a comprehensive “bible'; of Confucianism. It is a collection of quotations, anecdotes, and wisdoms. Due to this fact, Confucianism, at least according to Confucius, is open to interpretation. The Analects is still an interesting book, in that it provides a direct view of the thoughts and feelings of Confucius. T... ...e and control the world about him.   Ã‚  Ã‚  Ã‚  Ã‚  Confucius taught that when patterns on earth match those of Heaven, the spiritual beings of Heaven can be brought to earth and made to help man. All the spirits and specters of Heaven could be drawn out by earthly virtue to enact the beneficiary duties their realm imposed on them. These spirits were believed to do such things as keep rivers flowing, winds blowing and bringing rain that was needed by farmers. In turn, the farmers, following the established Confucian code of conduct, gave tithes to their overlords. This allowed the overlords to provide arts, education, and entertainment.6   Ã‚  Ã‚  Ã‚  Ã‚  Some people dispute the success of Confucianism. Technically, Confucianism failed. But only during the lifetime of its creator. During his life, Confucius only gathered a few followers. After his death, these followers passed on his teachings, wisdom, and love for rituals and the tradition survived. It survived all the way to the Han dynasty when it became the official Chinese philosophy. From then on, it was firmly established in Chinese culture and its effects and value systems can still be seen today.

A Streetcar Named Desire, by Tennessee Williams Essay -- A Streetcar Na

A Streetcar Named Desire From the beginning, the three main characters of Streetcar are in a state of tension. Williams establishes that the apartment is small and confining, the weather is hot and oppressive, and the characters have good reason to come into conflict. The South, old and new, is an important theme of the play. Blanche and her sister come from a dying world. The life and pretensions of their world are becoming a thing of memory: to drive home the point, the family mansion is called "Belle Reve," or Beautiful Dream. The old life may have been something beautiful, but it is gone forever. Yet Blanche clings to pretensions of aristocracy. She is now as poor as Stanley and Stella, but she cannot help but look down on the humble Kowalski apartment. Stanley tells her that she'll probably see him as "the unrefined type." The differences between them, however, are more complex and volatile than a matter of refinement. Desire is central to the play. Blanche is unable to come to terms with the force of her own desire. She is clearly repelled and fascinated by Stanley at the same time. And though she stayed behind and took care of the family while Stella ran off to find a new life, Blanche is both angry and jealous of Stella's choice: she seems a bit fixated on the idea of Stella sleeping with her "Polack." Stella has chosen a life built around her powerful sexual relationship with Stanley. Blanche is both repulsed by and jealous of the choice. . The play is haunted by mortality. Desire and death and loneliness are played off against each other again and again. The setting is one of decay; the dying Old South and the dying DuBois family make for a macabre and unsettling background. Blanche's first monologue is a rather graphic description of tending to the terminally ill. There is also the specter of Blanche's husband, who died when they were both very young; indeed, Blanch still refers to him as a "boy." Another symbol is the meat: Stanley enters carrying a package of bloody meat, like a hunter coming home from a day of work. Stanley is a superb specimen of primitive, unthinking, brutal man. The meat-tossing episode is seen as humorous by Eunice and the Negro Woman, who infer a sexual innuendo from the incident. Apparently, it is obvious to the neighbors that the sexual bond between Sta... ...us line is full of terrible irony. It is true that Blanche has often depended on the kindness of strangers, but all of them have abused and abandoned her. In the end, even her own sister has betrayed her. Her fragility, her inability to fend for herself, and her self- deception have brought her to madness. The representative of the new man, Stanley, is more ape than knight. But Blanche's line is earnest in that it shows her terrible loneliness. For so long, she has known only strangers; young girl in a house full of the dying, and then a woman losing her looks seeking protection from callous men. Her tragedy will for the most part be forgotten. Stella is crying, but she has nonetheless decided to stay with Stanley. She also will have to busy herself with caring for the baby. The other men have callously chosen to go on with their poker game on this day, denying Blanche the dignity of being taken away in private. The Old South dies, and the New South does not mourn her passing. Everyone is going to move on: as the play ends, Steve is already dealing a new hand. Sources:Streetcar Named Desired by Tenesse Williams Northon Anthology www.Sparknotes.com www.classicnotes.com

Managing Improvement Essay

AC 2.1: Assess an opportunity for innovation and improvement in own organisation As already discussed in Section 1, business productivity and change cannot occur without effecting people’s psychology to effect change. I initially felt that supervision would be fundamental to addressing and identify issues to allow reflection to plan a way forward to address issues, such as, performance management, productivity, effectiveness and understanding the views of the individuals to effect and improve individuals and team goals, and linking this to the business plan. This approach I felt would assist in establishing the individual’s goals to reaching and exceeding key performance indicators, such as completing assessments within timescales, as communication would be flowing in respect of planning and execution, as change can only be effectively implemented through proper planning and communication (Peter, 2006) â€Å"For supervision to be effective it needs to combine a performance management approach with a dynamic, empowering and enabling supervisory relationship. Supervision should improve the quality of practice, support the development of integrated working and ensuring continuing professional development† (pg 141, Tilmouth &Quallington, 2012). An example of this is ensuring workers understand why performance targets are in place. For example if a worker is told they have to have a assessment completed within a specific time but are given no reason for this then their motivation to complete the requested assessment does not occur. However, if you explain that delay in assessments create delays in services that are provided for children, and this could have a detrimental impact. This therefore gives reason and creditability to a worker which gives meaning and this can result in the work being completed as required and therefore  ensuring targets are met in respect of time management in line with the identified business plan, and guidance and audits in respect of Ofsted are met. Crawford 2013, would agreed with me as he believes that failure in executing change is not due to the strategy but in the way the change is delivered and executed in respect of staff psychology (2013, Building and Effective Change Management Organisation Second Edition) I realised by giving reason and understanding as to why such deadlines and expectations were in place and allowing staff members to reflect on this, putting ideas in place, such as how work load management could be addressed. This not only motivated staff but this effected a change in their views regarding their own practice, this conspired to have a positive ripple effect with regard to service delivery as a whole unit. This approach also assisted in addressing areas that Ofsted had risen especially with regard to listening and communicating with staff to effect positive change and also how we could improve the current work load management system. This saw an increase in productivity and we as a team were going over and above the expected targets in all areas in respect of services; service delivery and identifying services that would be efficient with regard to addressing concerns and putting appropriate interventions in place instead of reverting to crisis management like we had been criticised for previously. Nevertheless, issues continued to be identified with regard to achieving in all areas of the business plan for example issues around cost, consistent supervision and identifying training needs. This was due to implications in respect of policies and procedures, as there was no system in place that could â€Å"assess† workload management and also consider what was needed to monitor the success and efficiently in respect of meeting the services users needs, Ofsted and also issues such as cost, especially as overtime had significantly increased to ensure timely responses and reduce delay. This therefore was not addressing the issue with regard to productivity and effectiveness. I also sensed that delays in some respects were being created to enable staff to claim money with regard to overtime. Therefore, I was still identifying issues in respect of staff member’s psychology in respect of meeting targets as their views still appeared disjointed and addressing  this and progressing staff through change with regard to addressing work load management in respect of meeting all key performance indictor would initially be a difficult task to achieve especially in respect of meeting the business plan and Ofsted’s expectations in relation to areas such as cost, consistent supervision and guidance in respect of work load management and training need. Therefore this created an opportunity for me to develop a system to improve work load management and create systems to enable work load management to be audited to ensure it was meeting all the requirements with regard to the business plan and Ofsted. AC 2.2: Justify the improvement identified, in the context of organisation objectives As already discussed it became apparent that the workload management system needed to be developed and changed to enable staff to meet the required targets, especially as current policy and political agenda was highlighting this as a significant issue in respect of work load and work load management (Munro 2011). As this was known to be impacting on production, cost and linked to serious case reviews throughout the UK. I found within all political agenda, the local authority business plan and Ofsted, their reference to work load, considered and discussed the number of cases people had, but no consideration was given to the complexities of the cases and therefore impacting on the time and resources that would be required. I believed this was having a significant impact on moving forward and assessing issues such as productivity, staff member’s development/training and cost. Therefore, a system needed to be in place to evaluate and identify staff member’s workloads which could address and assist with the issues raised above. Furthermore within team meetings this issue was being raised by staff members. Therefore, I considered that a system was needed that looked at not only the number of cases people held but the level of complexity and this in my opinion could be a fair system than people being given a set number of cases. In order to address, assess and justify the improvements required I needed to look at a framework to assist me in how to effect the change to improve work  load management in respect of this. This was how the â€Å"point† system was born. I will discuss further within the next sections how this system was developed and the justification for the system. Within the current environment I work in today Solution Focused Approach is applied to all parts of the business, this includes problem solving, reviewing and acknowledging what is to be achieve, by analyse and identify – including what works well and what may have to be done differently to achieve and then of course making adjustments and taking a step forward to make the changes. Although this theory I felt would be useful in respect of assisting with the psychology of change and the transition through change with staff I felt I needed a theory which would assist me in pinpoint the issues and identifying quickly innovation and changes required in order to put actions in to place and put timescales around those actions. In order to monitor success and of course address areas for development Therefore, I believed that the SWOT analysis would enable me to understand the issues, review innovation and of course implement the change. This method would also assist in the justification of change or identify if change was necessary. Swot Analysis is a structured planning method used to evaluate strengths weakness opportunities and threats involved in undertaking a task or project. This enables the internal and external factor to be considered with regard to achieving an objective. Helpful Harmful Internal Origin Strengths Complexities of work would be identified and levels in respect of right members of staff completing the work would be identified. Clearer planning and time scales with regard to staff meeting targets as the  level of complexity had been identified. Identifying training needs Creating a clear guide for supervision with regard to performance management that promotes consistent supervisions as the format used would be in place throughout the local authority. Targets being incorporated into one document would be able to monitor key performance indictors Cost as this could reduce overtime as this could assist with staff not being overloaded. Weakness Staff not buying in. The points system being business and performance lead and not addressing the personal aspect in respect of the individual. This would result in limited buy in from staff and the transition of change being hindered and placing barriers with regard to change. Time in respect of managers having to review and implement the points system Assessment not being completed to an appropriate standard as focus being on time and work load. External Origin Opportunities Productivity and efficiently with regard to services users having their needs met. A more effective service Reduction in public spending Threats Cost regarding change of systems Not meeting Ofsted’s standards resulting in failure This Swot Analysis enabled me to consider and plan a framework in respect of how a pointing system could work. I developed a pointing system in respect of weekly expectations and identified points for a number of tasks that had to be undertaken throughout the week. I also consider other issues that would also need to be taken into account including staff member’s personal issues such as holidays and training as I knew they would also have to be considered and reflected within the points systems. I also realised that this tool would assist in the justification of paying overtime as if staff members were over pointed then overtime could be paid. The points I developed were reflected as the number of hours a week a member of staff works and the more complex the case the higher the points were increased. I also consider guidance that was provided from the government and Ofsted in respect of caseloads and the management of case loads to ensure the point system met all their requirements. The points plan was then put before senior management and was approved to be used under a pilot scheme to see if this had a positive change in respect of work load management, for example, productivity (consistent supervisions as a guide would be in place regarding performance management), identifying training needs and cost. AC 2.3: Use a range of techniques to generate innovative options to deliver the improvement identified Although I had used Swot Analysis in respect of planning and developing change as I knew a change needed to happen. I was still in a position in which I did not know how to go about delivering it. Where did I start? Whom did I involve? And how did you see it through? I therefore recognised that I needed a methodology to assist me in taking leadership in effecting and assess the change that I was trying to achieve.  I found there was numerous methods, tools and models, each with their own strengths and weaknesses. However, as previously discussed and identified by Hiatt and Creasey (2012), I needed a methodology that would not only engineer an approach to improving business performance but would also address the psychology to managing the human side of change. I considered Prosci Change Management Methodology Maturity Model as this focuses on the â€Å"the people side of change†. â€Å"The model reinforces the need for individuals to change and understand change by instilling: Awareness: This is recognizing the need for change. Desire: Who needs to participate in the change? Knowledge: Who has the knowledge to guide the change? Ability: Who will implement skill sets and change behaviours? Reinforcement: Who will lay the foundation for change initially and for the future?† (Hiatt & Creasy, 2012) However this focused too heavily on the individual and I needed a model that not only looked at the individual psychology to change but also engineered an approach to improving business performance, in which a leadership role could be filter though and assist in an opportunity to reflect to ensure the changes being made when beneficial for staff, meeting the business plan and also meeting the guidance set out by Ofsted. If this was incorrect then the consequences would be detrimental resulting in the local authority failing. Therefore a process was require in which the change could be constantly reviewed and adapted to ensure it was meeting all the needs initially identified. I found most methodologies that I reviewed derived from Kotter’s 8 steps to change. Kotter 1995 identified an 8-Step process for leading change. The key principle covered by each of these steps relates to establishing strong leadership, people’s response, ability and approach to change. Step 1: Establishing a Sense of Urgency Step 2: Creating the Guiding Coalition Step 3: Developing a Change Vision Step 4: Communicating the Vision for Buy-in Step 5: Empowering Broad-based Action Step 6: Generating Short-term Wins Step 7: Never Letting Up Step 8: Incorporating Changes into the Culture. Therefore this model would allow me to see where the business was at the present time and identify areas of improvement and the strengths already in place. It would assist in steering it in the right direction and put actions and goals in place to meet the short and long term objectives, not only identified in the business plan but also in respect of Ofsted, services user’s needs and staffs needs. AC 2.4: Evaluate options for generating the proposed improvement to determine feasibility and viability As previously discussed and highlighted in Section 1, a work load management scheme was in place and it had been deemed appropriate although it was raised that there was still areas that needed improvement which had been raised in the Ofsted inspection in 2013. This needed to be addressed and reviewed in order for improvements to be seen in respect of Stockton’s rating in relation to Ofsted. The areas as already discussed were in respect of supervision, timeliness of social workers responses and assessment in respect of service delivery and cost. And as discussed although there was a system in place which was deemed to be appropriate, it was evident from staff, senior management and Ofsted that this had to be developed to meet the needs of the service as it was still creating inconsistencies in the areas raised above. Therefore the system I reviewed and planned would, and was evaluated to create the outcomes we were trying to improve in the areas identified. It would be keeping in line with the business plan and the expectations of Ofsted but also with what staff members were requesting to develop a system that assisted them in the day to  day management of their workload. It appeared feasible to put this plan into place as it appeared achievable as it was in line with all the recommendations and there was already a foundation for this to be built upon with the current work load management system in place. Also the cost to the development and structure of this plan would be minimal and could hopefully see a reduction in government spending. However, I recognised there could be disruptions to the delivery and putting the plan in place with regard to the new workload system, in relation to how this was rolled out and managed with the organisation. Especially, if it was not conveyed appropriately as resistance would occur and internal and external factors already previously discussed would be impacted upon and not appropriately addressed. This would therefore create a barrier and could potentially prevent the change from occurring , therefore not addressing the issues raised by Ofsted and Ofsted potentially failing the local authority as the issues identified in the previous audit had not been addressed. Learning outcome/ Section 3: Be able to lead and manage change within a organisation, planning and implementing a project to meet, and if possible exceed, customer expectation AC 3.1: Create a change in management and improvement plan that is designed to meet and possible exceed customers and other stakeholders expectations Therefore to address the issues raised in section 2 of this assignment I used Kotter’s 8 step process, 1995, to assist me and lead the change in respect to putting the work load management â€Å"points† system in place to change how work load management was evaluated and reviewed. This is how I approached it: – In respect of Step 1: Establish a sense of urgency: As already identified for a change to happen it helps if all involved wants  the change to happen. It was already identified that this change was wanted by all, including Ofsted, senior management and ground staff. Therefore this created a sense of urgency and as already discussed these issues had been raised from supervisions, team meetings management meeting and Ofsted audit. This therefore sparked the motivation required, and although ideas had been formed people were also contributing and providing ideas to establish a way forward. As already discussed this was not about focusing and criticising individuals on what was not working but providing an honest and transparent dialogue about expectations and the impact it has on as whole in respect of Ofsted, services users and staff themselves. This created a positive vibe in respect of doing things differently in relation to work load management. Kotter 1995 suggests that for change to be successful over 75% of the work force involved has to buy into the change. This was why I worked hard within individual supervision, team meetings and management meetings to create and build a sense of urgency as I recognised appropriate preparation was required so everyone involved could move to the next step and be confident that they felt a change was required and that they would buy into this change. Step 2: Creating the Guiding Coalition I recognised that I had to stand strong as a leader and have clear conviction as to how the change would not only impact staff but would be beneficially in respect of meeting Ofsted targets and the business plan, for example, to using this as a tool to develop supervision so supervision became for consistent. I realised if I had key significant people support this vision that they could assist on the development of the change. For example the policy and procedure business manager found the ideas regarding the change regarding work load management would be beneficial and he believed it could be incorporated in to the current policies and procedures and recognised that this could have a positive effect in respect of meeting targets for Ofsted in a very innovative way. As a result of this a steering group was developed and incorporated in this group was myself, senior management, management and ground staff. Step 3: Developing a Change Vision As already discussed I provided my vision and plan which I had developed using SWOT Analysis. We used this tool as the bases to develop the idea I had initially formed. This enabled ideas to be tweaked slightly but it provided an overall vision which people could grasp and easily remember. This allowed people to see what was trying to be achieved and gave a sense of direction. From this a format, a tool regarding the points system and a points system was developed which was not only going to be used as a weekly guide for the Assessment Team but was going to be developed for all teams within the local authority but would be adapted for the needs of the individual teams. Once again bring consistency within the whole of the organisation. Step 4: Communicating the Vision for Buy-in I found that communication was key to any form of change and in the initial stages of the development, discussion were held constantly with everyone regarding how systems could be put in place to effect positive change with regard to workload management (in respect of delivery, reviewing and monitoring), and throughout the process I discussed progress and issues we were finding with everyone to prepare people for the change but also to make people part of the change. So many times i have found especially within local authorities â€Å"special meetings† are held to communicate a vision, however, in my view this does not assist with regard to preparing people and assisting people to go through that transition of change. I found talking about it at every chance assisted in people taking ownership of the change and being part of the decision making and also problem solving if issues did arise. It also helps for people to have a clear understanding and promotes a consistent structure. AC 3.2: implement the plan, monitoring progress against agreed targets Step 5: Empowering Broad-based Action When I reached this point I found the majority of the staff members were excited about the changes and were ready for it to commencement in respect of the overhaul in relation to work load management. However, I did find  there were a few people who were resisting with regard to the changes and were reluctant to see how the changes would be of benefit to them. They focused heavily on that their overtime would be reduced and they questioned how the points system would be monitor in relation to ensuring the point for the different levels of complexities were monitor and pointed correctly. I found there was justification in their concerns and realised quickly if these barriers were not addressed the feasibility and execution of the points system would fail, therefore, there had to be some consideration as to how this could be reviewed not only by management but by all including staff and Ofsted who would of course question why different levels of complexities had been pointed. I found the answer was already in place which had been highly commended by Ofsted and this was our Performance Indicator clinics. This system already reviewed on an individual/team basis the throughput of work. By adjusting this slightly we could still review the throughput of work but develop it to ensure the points and time given to different complexities of work married with the time given for work to be completed. This also would assist in the following step to see within a short period of time if the system was achieving goals which would boast motivation as people’s achievement would be highlighted immediately. The proposal of the slight changes in the performance clinic staff became empowered and became ready for the pilot scheme to commence. Staff members were feeling confident and were discussing the benefits to the system and this was already being structured into case and personal supervisions. This resulted in the pilot scheme starting. Step 6: Generating Short-term Wins As planned the system very quickly identified short term wins in respect of the distribution of work for example instead of people have 14 cases each, where one person may have 14 cases of high complexity and another may have a case load of 14 of low complexity people were feeling that cases were being evenly distributed and this was evidence by the points sheets being distributed to staff and senior management. Performance clinics were also identifying that the throughput of work was increasing as people cases were more manageable as they were being evenly distributed. It was also evidencing training needs for individuals to support them with the different  complexities of cases and in respect of cost we found that overtime reduced as people were managing to complete work in the required time. However, staff members were able to justify immediately if they required overtime, if they were over pointed and this had a positive motivating feel for all involved. As a result we developed as a team that instead of allowing assessments to go 45 days, assessment that could be completed at an early stage would be done so, and this was managed and reviewed within fortnightly case supervision, creating a consistent supervision guide. This developed a very positive attitude to work load management in which individuals were becoming accountable for monitoring and reviewing their own case load and giving them self time scales, which they were taking ownership of, with oversight from management. This had a significant change with regard to figures in respect of the turnover of assessment and when this was reviewed by the government statistics against other local authorities we were being commended for the assessment being completed in a timely manner and we did not have one assessment that went out of timescales which in this day and age is a huge achievement. To ensure assessment were still to a high level, assessment were still being quality assured by management and also being audit regularly by senior management and due to positive feedback this created a very motivated work force. Step 7: Never Letting Up Kotter 1995 argues that many change projects fail because victory is declared too early although we realised that this change was very positive and it was having a positive effects, we knew the long term goal would have to ensure that this system then assisted and filtered into all core business, for example rolling through the all the teams, ensuring a reduction in government spending and ensuring standards remained high in respect of Ofsted audit. We knew this was a bases that could be used and developed to meet the needs of all of the services but it needed to be continued to be built upon and opportunities would continue to be identified to improve the service. Therefore key to this was developing it and linking it to all core business which was initially discussed in section 2 by the business and policy and procedure management. Quick wins are therefore only the beginning of what is needed to be done to achieve long-term change, as each success provides an opportunity to build on what went right and identify what you can improve. Step 8: Incorporating Changes into the Culture. Therefore to ensure the changes stood we looked at rolling it out to all of the core business within the whole organisation. The feedback within the entire organisation from refuge collection to maintenance in respect of the points system was very positive as it was a system that was adaptable to meet every section of the local authority. In respect of senior management they had a system that clearly showed performance and identified areas of strength and weakness and what needed to be done to build on these areas, and in respect of staff they had a tool that assisted them on a day to day basis in respect of work load management. This assisted in the change becoming solid in the organisational culture and this has lead to positive support by everyone involved. This was reinforced further by the audit which I discussed in Section 1 in which Northumberland found the system that we developed was so exceptional that they believed that this would assist in the their organisation. This therefore is not only being seen in our organisation now but it is now being rolled out to other local authorities and positive feedback is being given and this continues to promote the support and the continuation of the change. Therefore when we are audited by Ofsted we hope the changes made will increase our rating as an effectively run local authority. Reference 2013, John Crawford. (Building and Effective Change Management Organisation Second Edition) [pdf] London: Crawford Consultant. Available at http://http://crawford consulting.org [Accessed 01/12/2014]. Hiatt, J.M.., & Creasey, T. J. (2012) Change Management the People Side of Change. Colorado, USA: Prosci Learning Center. Kotter, J.P. (1995): Leading Change, United States: Harvard Business School Press. Munro, E (2011) The Munro Review of Child Protection: A Child Centred System. London: The Stationary Office Limited 2006, Peters A.H. (Understanding and Managing Change) [pdf] Sydney, Australia: The Project Perfect White Paper Collection. Available at http://www.projectperfect.com.au [Accessed 7 November 2014]. Tilmouth, T., & Quallington, J. (2012) Level 5 Diploma in Leadership for Health and Social Care and Children and Young People’s Services. Oxon: Bookpoint Ltd.

Compare and contrast the funeral speeches of Brutus and Antony Essay Example

Compare and contrast the funeral speeches of Brutus and Antony Essay Example Compare and contrast the funeral speeches of Brutus and Antony Paper Compare and contrast the funeral speeches of Brutus and Antony Paper Firstly, Brutus decides to make his speech first, which is a bog mistake, because the plebians will only really remember the last speech that was made, thus making Brutus speech less effective. Brutus would usually speak in a verse language, but in his speech he spoke in prose, to try and come down to the plebians level and he thinks that they will appreciate that. However, Antony speaks as he should, in verse and the plebians respect that and expect him to speak like that, so as soon Antony starts his speech, they already like it more than Brutus. Also the first sentence of each speech is significant. Brutus starts his speech with Romans, countrymen and lovers! . This is a great start to the speech because it shows how Brutus is equal to the plebians, and the plebians like to think that they are equal to someone as great as Brutus, and therefore are on Brutus side. However, Antony starts his speech and goes one better and starts his speech by saying Friends, Romans, countrymen . The most significant word is friends, it shows how he is fond of the plebians, and that he wants to be their friends. The plebians feel surprised, and overwhelmed by this, so straight away into Antonys speech, when they were on Brutus side just minutes before, the plebians are on Antonys side. Both of them use a rhetorical question in their speech, to challenge the plebians. Brutus asks Had you rather Caesar were living, and die all slaves, than that Caesar were dead, to love all free men? He then asks that if any of them want to be slaves, then stand up. By saying this he is challenging the plebians, and making it hard for them to disagree with him. In Antonys speech he asks I thrice presented him a kingly crown, which he did thrice refuse: was this ambition? Because the plebians dont understand why a person would turn down the crown if they wanted to be king, they believe that Caesar never wanted to be king. So when Antony asks this question, it questions them whether he really was as good as they thought? He then challenges Brutus speech by saying yet Brutus says he was ambitious. This challenges whether Brutus was right in what he said, and makes the plebians think twice about whether to believe him. Brutus speech is trying to persuade the plebians to be on his side, and to make them agree with what he says, by using rhetorical questions. Antonys, however, is to make them question whether Brutus was right.. He repeats himself a lot, saying that Brutus is an honourable man. This may seem that he is praising him a lot, but actually, by repeating it, he is taking the meaning out of it. So when the plebians first here him say it, they agree with him that Brutus is honourable, but after the last time he says it (which is a lot of times) they almost get sick of him saying that and start to disagree with the fact that Brutus is honourable, and therefore turning on Brutus. Brutus tries to make the fact that Caesar is dead a good thing, whereas Antony gradually builds his speech up, and makes it seem like a tragedy. He starts this off by coming up to do his speech with the coffin next to him, instantly making the plebians feel sad. He excuses himself saying he is too emotional, and pretends to cry, and this makes the plebians want to cry, so now they dont like the fact that Caesar is dead. He then finds Caesars will in his pocket, and pretends he didnt know it was there. The plebians shout for him to read it out, but he insists not. This just makes them want it to be read out even more. The will is almost a prop for Antonys speech, making it more effective, but Brutus had no such prop, making his speech less effective. Antony then agrees to read the will, and to make it even more effective, he makes them stand around the open coffin. This is like another prop for the speech, and when the plebians see the body, it makes them more emotional and makes them hate Brutus even more. Before he reads it, he builds it up. He tells them to prepare to cry, even though some already are. He trails where the blood was, describing his death. This makes the plebians really emotional, and makes them want to kill Brutus. They all shout to kill Brutus, but Antony stops them and tells them to stay. This part of the speech is very clever by Antony, as it turns them on Brutus, and makes them love him. Overall his speech is a lot more effective than Brutus. Brutus was effective at the time, but it didnt have a cutting edge to it. The fact that Antony went last also didnt help, because now the plebians will only remember his, and forget about Brutus. A director would tell Brutus to play the role as if Brutus were very confident. This is because he thinks he has gotten away with it, and that he has won the plebians over. He also has no idea that Antony will make such a good speech after him, he thinks that it will be a speech that will praise Brutus.

WITCHCRAFT AT SALEM essays

WITCHCRAFT AT SALEM essays Chadwick Hansen's "Witchcraft at Salem" provides an interesting account of the infamous Salem Witch Trials that took place in Salem Massachusetts in 1692. Hansen provides and account of the accused persons who were tried and eventually hanged for witchcraft. Through the utilization of contemporary accounts and the trial documents, Hansen relates the usual details of the rise and fall of the terrible dealings that took place that year in Salem Village. There has been a great deal of work produced about this popular subject, with the majority of it focusing on the theories of the origins and causes of the witch craze society. Chapter one provides an introduction into the early years of witchcraft in Salem and provides the reader with a brief historical profile of witchcraft. Hensen begins by attempting to provide the reader with a useful definition of witchcraft and how it applies to Western society and the establishment of New England. Historical milestones in the evolution of witchcraft and the contributions of "learned men" such as Locke and Hobbes to that development are discussed. For example, Hensen describes how Locke recognized witchcraft in his writings and thereby recognizing an In Chapter 2 the reader is given a history of four significant witchcraft examples that occurred in 1692 in New England prior to the trials in Salem. The circumstances surrounding the cases of Anne Hibbins from Boston, Rebecca Greensmith and her husband Nathan from Hartford and Anne Cole's role in Greensmith's trial, Elizabeth Knapp from Groton, Massachusetts, and John Goodwin's four children from Boston are profiled. In each case, Hensen provides details of the "hysteria" symptoms displayed by the individuals and the outcome of their case. These examples are significant because they provide evidence to the strength of the accusation of witchcraft without any proof for a trial....