Ece 6604 Final Exam

Georgia Institute of Technology School of Electrical and Computer Engineering ECE6604 Personal & Mobile Communications Final Exam Spring 2010 Tuesday May 6, 11:30am – 2:20pm †¢ Attempt all questions. †¢ All questions are of equal value. †¢ Open book, open notes, exam. 1a) 5 marks: The LCR at the normalized threshold ? for a 2-D isotropic scattering channel can be expressed as v 2 LR = 2? fm ? e , where ?= ? and Rrms = R ?p = R Rrms E[? 2 ] is the rms envelope level. i) Find the normalized threshold level ? o at which the LCR reaches its maximum value. i) Explain why the LCR at ? decreases as ? deviates from ? o . 1b) 5 marks: Consider a cellular system with a carrier frequency of 2 GHz. Suppose that the user is in a vehicle travelling at 60 km/h. Assuming that the channel is characterized by 2D isotropic scattering, ? nd i) the LCR at the normalized level ? = ? 3 dB. ii) the AFD at the normalized level ? = ? 3 dB. 2) The power delay pro? le for a WSSUS channel i s given by ? gg (? ) = 0. 5[1 + cos(2 /T )] , 0, 0 ? ? ? T /2 otherwise a) 3 marks: Find the channel frequency correlation function. ) 4 marks: Calculate the mean delay and rms delay spread. c) 3 marks: If T = 0. 1 ms, determine whether the channel exhibits frequencyselective fading to the GSM system. 3) Cellular CDMA systems use soft hando? , where the transmissions to/from multiple base stations are combined to give a macro-diversity. Here we consider the e? ects of path loss and shadowing and ignore multipathfading. Suppose that the received signal power corresponding to the link with the ith base-station, ? pi , has the probability density function p? pi (x) = v dBm) (x ? pi (dBm) ) 1 exp ? 2 2 2 2 . where pi (dBm) = E[? pi (dBm) ] The ? pi are assumed to be statistically independent. a) 5 marks: The reverse link uses selection combining such that the best basestation is always selected. In this case, ? s p (dBm) An outage occurs if ? s p = max ? p1 (dBm) ? ? th (dBm) , . . . , ? pL (dBm) (dBm) . What is the probability of outage? b) 5 marks: The forward link uses coherent combining such that ? mr(dBm) = ? p1 p (dBm) + . . . + ? pL (dBm) Again, an outage occurs if ? mr(dBm) ? ?th (dBm) .What is the probability of p outage if p1 (dBm) = p2 (dBm) =  ·  ·  · = pL (dBm) ? 4) Consider the reception of a signal in the presence of a single co-channel interferer and neglect the e? ect of AWGN. The received signal power, C , and interference power, I , due to Rayleigh fading have the exponential distributions 1 ? x/C ? ?e C 1 ? pI (y ) = ? e? x/I I pC (x) = ? ? where C and I are the average received signal power and interference power, respectively. a) 5 marks: Assuming that C and I are independent random variables, ? d the probability density function for the carrier-to-interference ratio ? = C . I Hint: If X and Y are independent random variables, then the probability density function of U = X/Y is pU (u) = pXY (v, v/u)|v/u2 |dv . b) 5 marks: Now suppo se that the system uses 2-branch selection diversity. The branches are independent and balanced (i. e. , the distribution pU (u) is the same for each branch. What is the probability density function of ? at the output of the selective combiner? 5) Suppose that a system uses selection diversity.The branches experience independent Rayleigh fading. However, the average received bit energy-to-noise ratio on each diversity branch is di? erent, such that ?i = 2? i ? o ? i = 1, . . . , L a) 5 marks: Find the probability density function of the bit energy-to-noise ratio at s the output of the selective combiner, denoted by ? b . b) 5 marks: If DPSK modulation is used, write down an expression for the probability of bit error. Obtain a closed-form expression if possible; otherwise leave your expression in integral form.

Cardiac case studies Essay

CS 2: 15 points K.R. is a 46-year-old man admitted to the emergency department with unremitting chest discomfort. The pain started while he was shoveling snow from his walkway. He had experienced chest discomfort with activity previously, but the pain had subsided with rest and he sought no medical help. This time the pain did not subside and became increasingly severe, radiating to his left arm and lower jaw. In the emergency department, an ECG and cardiac enzymes were obtained. The cardiac monitor showed sinus tachycardia with occasional premature ventricular complexes. K.R. was treated with 2 L nasal oxygen, tissue plasminogen activator, sublingual nitroglycerin, and IV morphine sulfate. When he was pain free, he was transferred to the cardiac unit for monitoring. Discussion Questions 1.What changes in â€Å"cardiac enzymes† would be consistent with a diagnosis of MI? Troponins(I and T specific to cardiac muscle cells), elevated between 4-6 hours after the inset of an acute MI and remains elevated for 8-12 days. Myoglobin-level increase within 1-4 hours after the onset of chest pain and highly sensitive but not very specific. 2.What is the most common precipitating event for MI? In the most cases of MI plaque rupture followed by thrombus formation at the site is the precipitating event. 3.What is the rationale for using tissue plasminogen activator in the management of ACS? Tissue plasminogen activator if fibrin specific. It binds to the fibrin of fresh clots and the resulting compound converts adjacent plasminogen into plasmin creating localized thrombolysis. 4.Why are morphine and nitroglycerin used to manage ischemic chest pain? It’s a high priority to truce myocardial stimulation by the sympathetic nervous system. Morphine sulfate reduces anxiety and catecholamine secretion and it can reduces preload. And nitroglycerin decreases preload and reduces MVO2. CS 3 15 points: C.J. is a 16-year-old high school student who is in the  clinic for a sports physical prior to beginning basketball practice. He has no known significant medical history, takes no medications, and has no allergies. A review of systems reveals only that C.J. gets â€Å"winded† earlier than most boys on the team. He attributes this to needing to get in better shape. The physical exam is unremarkable except for a grade III systolic murmur heard over the entire precordium. An echocardiogram and cardiac cath reveals a ventricular septal defect (VSD) with moderate pulmonary hypertension.Discussion Questions 1.A VSD is usually an acyanotic defect. Why is this?  The blood being shunted is oxygenated blood from the left ventricle shunted to the right because pressures on the left are higher. 2.What is the mechanism and significance of pulmonary hypertension? The mechanism of pulmonary hypertension is due to increased blood volume within the pulmonary circuit form the VSD. Pressure is the product of CO and vascular resistance. From this case pressure is high secondary to increased CO and the primary pulmonary hypertension, the cause is increased pulmonary vascular resistance. Pulmonary hypertension can lead to cor pulmonale and right-sided heart failure. 3.What other disorders besides VSD can produce a systolic murmur? How can character of the murmur and pattern of radiation be used to differentiate among these etiologic factors? Systolic murmurs can be produced by mitral valve prolapse, aortic or pulmonary stenosis, and mitral or tricuspid regurgitation. Heart sounds are produced in some different areas of the heart and have different characteristics: Aortic stenosis- right second intercostal space, mid systolic, crescendo decrescendo and radiates to the neck. 4.Is it necessary to close a VSD? What are the common complications of untreated VSD? No, it is mot always imperative to close VSDs spending on patient’s age,size of defect and degree of shunt. Common complications include- pulmonary hypertension, cardiomegaly, atrial dysrhythmia and right sided heart failure. Reference Richard N. Fogoros, M.D. Heart Disease Expert. About health. WebMD Web site. Available at: http://heartdisease.about.com/od/heartattack/g/CardiacEnzymes.htm. Published September 10, 2014. Accessed October 21th 2014. Anju T. Peters, Kathryn E. Hulse, Lydia A. Fibrin Deposition in Nasal Polyps Caused by Fibrinolytic Impairment through Reduction of Tissue Plasminogen Activator Expression. American Journal of Respiratory and Critical Care Medicine 189:12, 1487-1493 Sepideh Jabbari, Hassan Ghassemian. Modeling of heart systolic murmurs based on multivariate matching pursuit for diagnosis of valvular disorders. June 21, 2011. Volume 41, Issue 9, Pages 802–811 Ventricular Septal Defects.Patient.co.uk.WebMD Web site. Available at:http://www.patient.co.uk/doctor/ventricular-septal-defects. Published Mar 31, 2014.Accessed October 21th 2014. Alyson A. Tamamoto, MD.Acyanotic Congenital Heart Disease. Case based pediatrics.WebMD Web site. Available at: http://www.hawaii.edu/medicine/pediatrics/pedtext/s07c02.html.Published July 2013. Accessed October 21th 2014.

Banking in the Present Day

When going to banks or other financial institutions, people often make deposits, withdrawals, and deals. In fact, behind it there is a very complex and interesting process. Some people think that everything is done on paper and is mailed from one place to another. This is no longer applicable. Most banking operations are currently taking place electronically. Banks, credit unions and other financial institutions currently utilize technological advances to store and process customer data, which affects customer service, data security, transactions and the way financial institutions operate . I will deposit the bank. This group includes the largest bank of the day, the so-called savings account (mainly receiving deposits and providing credit). They are the foundation of the UK banking system. They are often called retail banks. Banks in at least two countries of the Union Bank have capital of the Consortium Bank and no one has a controlling interest. With the expansion of the euro mark et, these banks will develop rapidly. They are mainly represented by specialized banks of multinational and multinational industry issues. From the date of introduction, the banking business in India has developed rapidly. Originally founded in 1770 the bank of the 18th century failed to maintain its stability, leading to the liquidation of the bank. The first bank established was still one of the famous banks, it was the National Bank of India since its inception in 1806. The Indian banking industry has not been stable for decades after its establishment, but it is still one of India's major sectors in terms of consumption and profitability. Rapid development, the dynamic evolution of Indian banking industry can be divided into three stages as follows.

Literature Assg 2 A Essay Example | Topics and Well Written Essays - 2000 words

Literature Assg 2 A - Essay Example also has attempted to show different layers of human existence and how impulsive or biased judgements, blinded by pride or prejudice can lead to catastrophe. The King, like most of the human beings, also believed in false display of affection, whereas, he ignored and disrespected genuine feeling of those who are loyal to him. Thus, Shakespeare, within scope of the play has dealt with an essential human tendency of being attracted towards exhibition or show off or false elaboration of emotions and how an individual, trapped within such falsehood, forgets to appreciate and acknowledge genuine human feelings, consequently leading to his tragedy. Thesis Statement: The two daughters of the King surely have a major role to play in deepening the tragic plight of their father kin King Lear. However, the seeds of tragic and painful ending of the King were already sowed during Lear’s desperate rejection of Cordelia’s true affection, honesty and respect for him. Thus, besides holding the elder daughters responsible for his catastrophe, it is also important to consider his false choices, which he made out of prejudiced observation, as catalysts for his tragic end. A close and critical study of the four major Shakespearean tragedies, namely, Hamlet, King Lear, Othello and Macbeth, would clearly show that in each of these dramas the dramatist has exhibited certain common themes and a specific sequential approach to evoke the sense of tragic aesthetics. Hamlet’s tragedy is caused due to his dilemmatic nature and the existential crisis that he suffers from, in case of King Lear, the kingly pride, a stubborn sense of supremacy and overdependence to others, in this case on children, to decide the course of his life, have resulted in his fall. Finally, his realization regarding the wrong choices he made evoked in him a philosophical self that helps him to look deep in reality, keeping aside his trivial pride. Othello cannot escape his tragic plight due to the conjoint

Literature Review - Forms of Business Essay Example | Topics and Well Written Essays - 1750 words

Literature Review - Forms of Business - Essay Example Because of this, an accountant must understand the different forms of business so they are able to provide the best information for the particular business. There are many different types of business structures. These include sole proprietorships, partnerships, and limited liability companies. In order for an accountant to do well with business, he or she needs to understand how each of these business structures work. Relationship of the Topic to Future Career Goals I have chosen this topic because accountants are needed all over the world. Many organizations provide many services for profit. Of course, accountants are also needed in the non-profit sector so the prospects for careers are endless. Many companies have gone bankrupt because they did not do well with their money. For example, companies like Enron, Qwest, and others had problems because they did not handle their financial affairs well. Because of this, an accountant can specialize in many different areas. An individual co uld decide to become a financial accountant, a managerial accountant or a cost accountant (Peavler, 2013). The field of accounting seems very open and it seems more dependent on an individual’s decision as to which aspect of the field they choose as a career. I wanted to investigate the different business structures and focus on the advantages and disadvantages of each one. Accounting is a basic principle of economics and can be viewed on different levels. For example, a company will use accounting, but an individual may also use an accountant to take care of everyday needs. Many people use accounting for calculating their taxes, making decisions, and understanding their stocks and bonds. This literature review will continue to develop the differences between the business structures and provide an understanding of the main characteristics and the advantages and disadvantages of each of these structures. Sole Proprietorship A sole proprietorship is generally the organizational structure that someone takes who is just beginning a start-up company. This allows the individual to have a business name and use their own social security number or register with a business number. A sole proprietorship allows an individual to operate as a business and to take all the profits. One person runs the business and therefore is responsible for any losses or debts that the business incurs. Advantages of a Sole Proprietorship The literature review provides a variety of ways that a sole proprietorship has its advantages and relates to accounting. Amato (2013) states that sole proprietorships need to do succession planning although they are the only ones running the business. Amato states that sole proprietors must understand that there is a need for them to name someone who will take over the business when they want to leave it, if they are not selling it. Hendrix (2012) states that a sole proprietorship is the easiest form of business to start because the owner and the bu siness are the same entity. LaMance (2012) states several advantages of a sole proprietorship. The owner does not have to do separate business tax forms, sole proprietors can hire employees and they can receive tax breaks for hiring people. Also, the owner of the business is the only one responsible for making decisions in the business. Disadvantages of Sole Proprietorship LaMance (2012) states that there several disadvantages of sole proprietorsh

Business Plan Term Paper Example | Topics and Well Written Essays - 2500 words - 3

Business Plan - Term Paper Example The salad bar would be offering over 50 ingredients for salad and a choice of more than 18 dressing to go with them. The customers would be allowed to choose every ingredient of the product. Apart from this beverages and toast would be also available. It would be better to opt for Salad Bar then simple restaurants because there are many competitors in the restaurant segment, whereas good salad bars are few. Moreover, customers have been more health conscious nowadays and are opting for healthy food in times of hungry. So salad bar would be their obvious choice. Mission Statement and Objectives. The mission statement of Salad Station would be â€Å"To Offer Healthy, Tasty and Quick Serve Salad to Customers at Reasonable Price.† In order to attain this mission, the salad bar would have to fulfill certain objectives, such as offer absolutely fresh ingredients, and tasty dressings, the price should be competitive, the customer service and ambience should be effective, and excellent. The location chosen for the business is mainly London Ontario. The salad bar would be opened in a plaza building in Masonville area, which is on the north of London Ontario. The site expenses would be including the rental, and maintenance fees. Since the salad bar would be one of its kinds in London Ontario area, so the potential of attracting customers would be immense. Apart from this, the competitors are also few for example, Subway, so through proper planning and well-integrated strategy customers can be acquired and Salad Station can acquire market share efficiently. Salad Station would be offering tailor made products, and it would also offer a fixed menu, with each item having an amusing name so as to brand them among customers. It would be operating under the company name of Salad Station Inc. In order to develop a strategic framework for the business, the ingredients of product and

'Team-work forces employees to internalise managerial controls' Essay

'Team-work forces employees to internalise managerial controls'. Critically analyse this statement - Essay Example A synonym often used for management control is internal control.† (Havens, 1) The manager is the one that is normally in charge of this work. As he monitors the activities, he is able to make changes or corrections wherever he sees it necessary. This work of control helps the company know how well they are performing in connection with the goals of the company. Control helps the organization to adjust to the change of environment, reduce the build-up of error, cope with the complexities of the organization, and lastly to reduce the costs. In order for control to be successful, certain steps have to be followed. Standards have to be established, performance of the workers should then be measured, then a comparison between performance and standards should be done, and lastly, the manager should determine if there is need for modification of behaviour. The scope of the control involves a variety of areas. There is the control over the organizational policies; most companies will t estify that this is done through their policy manuals. Then there is control over the organization or the company, and this is done through the chart or manual of the company. Then there is control over the employees, this is because the basic definition of management is getting the work done through the people that are working for the company. There is also control over the income or salaries of the employees; this is done through the personnel department. There is also control over the costs, this work is done through the cost accountant, it is this individual who sets the cost for the materials and labour, and he does this by comparing it with the standard costs. There is also control over methods; this is done by holding a periodical inspection of the work of each department. Then there is control over capital spending, this is done through grading different projects and determining where the capital should be spent. There is also control over the production, it is in this area that effort is exerted to make simple and explain the line of products. There is also control over research and since this work is technical in its essence, no direct control is given to it. There is also control over external relations; this work is done through the public relations department. And lastly, there is overall control, this is done through a master plan, all the departments are obliged to participate in this overall procedure. As the years have gone by, management control strategies have also improved. â€Å"Organizations often use standardized documents to ensure complete and consistent information is gathered. Documents include titles and dates to detect different versions of the document. Computers have revolutionized administrative controls through use of integrated management information systems, project management software, human resource information systems, office automation software, etc. Organizations typically require a wide range of reports, e.g., financia l reports, status reports, project reports, etc. to monitor what's being done, by when and how.† (Mcnamara, 1) This and many other technological improvements that have come due to the growth of technology have helped modify and make better the management control system. And hence, it has proven to be a very effective and reliable system, one that is able to ensure that all the goals of the organization are met in a short period of time. Unlike the previous years where the progress of organizational goals was very slow. This

Evaluation of an Argument Essay Example | Topics and Well Written Essays - 1000 words - 1

Evaluation of an Argument - Essay Example The essay "Evaluation of an Argument" evaluates the validity, degree of soundness, and truth of the premises of the following argument: some sound arguments are valid, some valid arguments are arguments with false premises, some arguments with false premises are arguments with mood and figure OAO-2. According to Hyde, a syllogism refers to a deductive argument comprising of a minor premise, major premise, and a conclusion. The first syllogism for the above argument, which we have established to be a sprite can be deduced as: some arguments with mood and figure OAO-2 are not sound, some valid arguments are not sound, some arguments with false premises are not sound, no arguments with false premises are valid. In the general sense, the conventional logic expression of this argument: some T is not Q, some F is not Q, T is not F. The second syllogism for the original argument can be deductively interpreted within the context of the sortie to imply that: no arguments with false premises a re valid, some arguments underpinned with false premises are not sound, all arguments with mood and figure OAO-2 are generally not sound. Therefore, in the second syllogism, the conclusion of the original argument being evaluated has been transformed into a portion of the second syllogism. Moreover, the changed premise of the original automatically became an intermediate conclusion for the second syllogism. The example shows the unique character in which sorites tend to change the premise.

International Marketing Mix Essay Example | Topics and Well Written Essays - 2000 words

International Marketing Mix - Essay Example In case of the consumer base enjoyed by the company, there is a sharp segmentation in terms of the target group. The basic target group of the company includes people in the upper income group starting from the age of 30 and above. Further, the people who have retired and are in the age group of 50 and above, serve as a major source of profitability. Another important source of income for the product is the Internet. Therefore, the important element in the application of the entry point strategy for Tutbury’s is to recognise the age and income groups that predominantly define the demographics in India, before going on to carry out segmentation and reach suitability in terms of the marketing mix. In this case, the entry point strategy may be used as a preliminary process that will help develop the marketing mix. This entry point strategy has been defined throughout the paper in the various elements of the marketing mix so as to find a suitable base for segmentation and subseque nt brand positioning.Entry Point StrategyIn terms of the suitable model to be used for the development of a relevant marketing plan and strategy, we have made use of the International Market Entry Mode Strategy for this company. This strategy is ideal for those companies that wish to diversify geographically. (Walter et al, 1988) This strategy along with others that have to do with market segmentation and brand positioning for maximum customer satisfaction will be used in order to evolve a strategy that is best suited for the purpose.... This is the reason for choosing India as the country where a suitable marketing mix for a brand like Tutbury's will be suggested. Also, in this regard, the paper will carry out a discussion of Tutubury's current marketing and segmentation strategy in order to arrive on the aspects where the entry mode strategy can be introduced and defined to suit the consumer preference in India. About Tutbury's: Born and marketed during the 1920s to the 1960s, Tutbury's was named Thomas, Webb and Corbett to start with until it was known by its present name in 1984, owing to the spot of it factory which was in a 15th century village named Tutbury. 2006 saw a strategic move on Tutbury's part where its factory chose to be based at Stroke - on - Trent, instead of Tutbury's. The branding of Tutubry's has been largely based on norms that revolve around exclusivity and a certain amount of mystery with the nitty gritties of the company. The basic finding that this paper will work on is that Tutbury's has c apitalised on the lifestyles of a certain section of people so as to form a brand identity of its won. As far as the actual product is concerned, it is imperative to identify where its unique features lie. In this regard, Tutbury's is a product that works on the highest quality of glass which is produced primarily from a high standard of full lead crystal. This crystal has a crystal element that can be estimated at over 30%. In case of the consumer base enjoyed by the company, there is a sharp segmentation in terms of the target group. The basic target group of the company includes people in the upper income group starting from the age of 30 and above. Further, the people who have retired and are in the age group of 50 and above, serve as a major source of

Philosophy Essay Example | Topics and Well Written Essays - 1250 words - 5

Philosophy - Essay Example But in reality what is a person, it is one subject on which many theologians, philosopher and psychiatrist pondered over a long period of time. Since we are discussing about an intangible identity, one cannot establish the truth, even when one is definite about its true nature. We could say that person is an identity, with certain capabilities and abilities to perform sanely at a given situation or circumstances. Some people are reluctant to accept a mentally defective human being as a person due to their deficiencies in intellectual power. According to (Dennett,14)â€Å"For instance, infant human beings, mentally defective human beings, and human beings declared insane by licensed psychiatrists are denied personhood, or at any rate crucial elements of personhood† Now just because a human being have a defective mental system, he should not be losing his right to be called as a person. So are we a person just because we possess a well defined intellectual workability. It really seems absurd, for a human being with a soul and mind to be disregarded just because he cannot work rationally and logically .Then it would make also sense to call these mentally defective and immature people as animal. As we know animals does not have rational thinking, and same is the case with infants and mentally ill people. So why is it that we do not address these mentally immature and insane people as animals? Here we can explain that being a person is more about the genetic structure we possess. Otherwise the mentally ill person or animals are not guided by intellect a d they act abnormal in our view. We can understand here that the genetic make up or the body structure and his surviving pattern make him a person. People say that we are designated as a person because we have certain capabilities and abilities which we use in support with our intellect and logic. Being rational means, we act according to our reasoning or as per the guidance of our intelligence .A being can be a person and still cannot be rational, just because he is weak in his brain or working ability. But a rational being cannot exist as a non person, because to be rational he very much has to be a person. It is seen that a mentally insane person is not given the same accountability and responsibility as a normal person .He is not considered as a whole personality ,as he lacks the ability to sort out things with his intellect .So it could be understood that intelligence and rational behavior offers a human being a personhood. Another aspect to being a person is the awareness and consciousness which a person experience in his personhood. The awareness or the consciousness is what is lacking in mentally ill or infants which make them less of a person. The consciousness is the center to the self and a personality and a human being which is not connected to his consciousness can be regarded less of a person. Most of the people nowadays know that we have evolved from the species called hom osapiens. A person is a being with logic, morality and ethical behavior which is obviously lacking in a homosapiens .As per(Rosenberg, 11)â€Å" To regard some being as a person, in shorter, is to grant to that being the sort of respect and treatment due persons, to acknowledge it as having to certain ethical or having standard â€Å".We as persons are more evolved than homosapien species. For example, if we see a human raised in a forest from his childhood, we might hesitate call him a person but might address him as

Behavior Description Interview Essay Example for Free

Behavior Description Interview Essay You have invested the time of several experienced employees and a good deal of expense to interview a number of promising entry-level accountants. However, you wonder if your interviewing techniques are really helping you hire the job candidates that will be superior performers and help your organization remain profitable. Your concerns may be justified if you are using a typical interviewing strategy in which there is no standard set of questions or a strategy in which interview questions do not explicitly focus on the past behavior of the applicant. Yet, there is an alternative. Studies in human-resource management suggest that behavior description interviewing may help you identify better performers from the rest of the applicants PRINCIPLES OF THE BEHAVIOR DESCRIPTION INTERVIEW The first principle of the Behavior Description (BD) interview is interviewers standardize or structure the interview. The most important aspect of standardization is asking applicants the same or highly Similar questions. This allows all applicants to have a chance to provide information about certain job-related concerns and allows interviewers to compare similar types of information. The alternative of each interviewer asking their own questions will have your organization comparing apples and oranges when trying to make hiring decisions. Often this leads to lower quality hiring decisions. An organization may also seek to standardize the location of the interview, the individual who conducts the interview, etc. Any efforts to ensure similar treatment of applicants should be encouraged. An additional benefit of standardizing interview questions is that the interview is more defensible in court. In the past, organizations that had standardized questions won employment discrimination lawsuits more often than those without standardized questions. The second principle of BD interviewing is to explicitly focus on past behavior. BD enthusiasts believe that past behavior is the best predictor of future behavior. They also believe more recent behavior is a better predictor of future behavior than older behavior and that longstanding trends are better predictors of behavior than isolated incidents. The belief in the effectiveness of using past behavior to predict future behavior leads BD interviewers to ask certain questions. These questions use a superlative adjective (e.g. most, least, toughest, etc.) to focus the applicant on one particular incident of behavior. For example, accounting firms need staff members who are willing to address both internal and client problems. To gather relevant information about an applicant, a BD interviewer might ask the applicant to tell me about the last time a new idea of yours helped an organization or group work better. The interviewer might also be ready with follow-up questions such as how did you develop this idea, how did you convince your supervisor or client to adopt it, and how did it help the organization? The follow-up questions may be answered a s the applicant discusses a particular situation, but their presence alerts the interviewer that this information is important. In another instance, accounting professionals are often called upon to make presentations to groups such as audit committees or boards of directors. Accordingly, an interviewer might ask a job candidate to tell me about the most difficult presentation you have ever had to make to a group of five or more people. Probes might include what was the presentation about, how did you prepare for it, and was the presentation evaluated or graded? In each case, the BD approach to interviewing should yield a large amount of high quality information to the interviewer and can help the somewhat anxious applicant have a particular incident to discuss. The BD approach to interviewing can be strongly contrasted with more typical interviewing strategies. First, typical strategies suggest interviewers let candidates take the interview where they want to, go with the flow, or let the interviewee talk about any subject they desire so that you can best assess their personality. While this advice is encountered frequently, it is highly inaccurate. Studies contrasting BD interviewing to this approach show that the BD interview does a much better job of predicting job performance. In addition, studies that statistically combine the results of 10,000+ interviews from many smaller studies strongly suggest that various styles of interviews that standardize questions or other aspects of the interview work much better than the nonstandardized interview styles. Second, BD interviewing seeks to avoid making judgments of applicants personalities. Assessing personality characteristics in a 345 minute interview would be highly difficult for a psychologist. As a result, many professionals rely on well established tests to measure personalitythey are cheaper to use and much more accurate. Additionally, many personality characteristics do not have a history of predicting job success. Currently, many human resource management professionals believe intelligence and dependability do differentiate higher performers from lower performers. Extroversion, considered by many to be a positive trait for auditing personnel, also differentiates higher versus lower performers in some situations. Other traits should be viewed with caution until they clearly are shown to relate to job performance. Care should also be taken in trying to match the personality type of an applicant to the personality of the office. While it is extremely difficult to measure either of the above, it is also potentially hazardous. The solution to this problem is to avoi d using most personality traits and ask applicants about past behavior that may be similar to behavior required on the job. Finally, the BD interviewer tries to avoid hypothetical and self evaluative questions. In most cases, there is little evidence to suggest that most hypothetical questions actually distinguish between better and poorer performing individuals. This may be due to the difficulty of injecting enough reality in the situation to make it a good predictor of job success. Self-evaluative questions such as describe yourself or are you computer literate also have no history of predicting job performance. In addition, they ask the applicant to do your job for you. You should decide how competent applicants are in a particular area since you are worried about their contribution to your organization. Applicants answers are influenced to a large degree by their desire to land a job. BD interviews differ from situational interviews. Recent literature has confused the two approaches. While the BD interview focuses on past applicant behavior, the situational interview asks applicants how they would behave in future situations (extensive research is used to create real situations). The situational interview can also require different types of rating scales to be used at the end of the interview. While there are several differences between BD interviewing, situational interviewing, and typical interviews, there are also similarities. BD interviewers also believe it is important to break the ice with applicants, that they should ask for an applicants preferred name, that they should take notes, and they should close the interview in a professional manner. These guidelines are important in any style of interview. STEPS TO CONSTRUCTING A BD INTERVIEW Three steps should be used to develop a BD interview. They are illustrated in the following hypothetical example involving the hiring of entry-level accountants in a CPA . Interviewers need to analyze the job and determine the key results areas. Key results areas are the major tasks or behaviors that an entry-level accountant must be able to accomplish. Key results areas may be defined by many different strategies including a discussion among recruiters, managers, and partners. Key results areas might include: 1. Communicate with other individuals-a. In verbal and written forms with other accountants including supervisors and peers; b. In verbal and written forms with clients; 2. Diagnoses organizational problems; 3. Recommend solutions to organizational problems; and 4. Use common computer software (e.g., spreadsheet programs, data retrieval software, on-line services, or tax-preparation packages). The above behaviors or tasks should be examined to determine the knowledge, skills, and abilities (KSAs) that will enable them to be accomplished. Thus, an entry-level accountant should have: 1. Written communication skills to interact through letters and reports to clients and other accountants; 2. Verbal communication skills to communicate with clients and other accountants (not necessarily including making presentations to large groups); 3. Ability to diagnose problems in complex situations; 4. Ability to solve problems individually and in groups; 5. Ability to attend to large amounts of detail; 6. Ability to manage multiple tasks; 7. Knowledge of common software programs; The KSAs required lead to a selection plan that involves a series of BD questions. In this example it is assumed that there will be two interviews: a recruiting interview at the school and an invitation to the firms office. To evaluate the candidates KSAs the following questions and probes might be used. 1 Written communication skills a. Ask for a sample of writing from a professional or educational setting before the second interview. 2. Verbal communication skills: a. Watch for verbal communication skills throughout each interview and rate them at the end of the first and second interviews. 3. Ability to diagnose problems in complex situations: a. Tell me about the last time you recognized a problem in an organization in which you were involved. * How did you recognize the problem? * How did you study the problem? * How did you determine a solution to the problem? b. Tell me about a time in the last year in which you were gathering information from a person who was being uncoopeative. * What was the situation? * Why were they being uncooperative? * How did you feel? * How did you get the information you needed? * What was the result in this situation? 4. Ability to solve problems individually and in groups/teams: a. What was the most successful solution that you and a group of other individuals developed to a particular problem? * What was the problem? * What was your role? * What was the result of your solution? b. What is the toughest problem that you as an individual have solved in an educational or work setting? * What was the problem? * What was the result of your solution? 5. Ability to attend to large amounts of detail: a. Tell me about the last time when you had to gather large amounts of information to complete a project. *What was the project? *How did you organize the details? * What was the end result? * Did anyone assign you a grade for the project? b. Which class of yours required the most attention to detail. Please tell me how you dealt with the demands of the class. * How did it require attention to detail? * What was your strategy to deal with the detail? *What was the result? 6. Ability to manager multiple tasks: a. Tell me about how you managed your school work and extracircular activities during your busiest semester. * What made the semester so busy? * Did you have any priorities? * Where there any strategies that helped you cope? * How did the semester turn out (in terms of grades, activities, etc.)? b. Tell me about the last time you had to juggle several different responsibililties when you held a job. * What were the responsibilities? * Did you have any priorities? * Where there any strategies that helped you cope? 7. Knowledge of computer software programs: a. Please tell us about the most involved computer project that you have been involved with in school or in an organization. * What software was involved? * What was your role? * What was the result or grade? 4. Please tell us about the last time you learned a new piece of software. * What did it help you accomplish? * How did you learn it? * Did you enjoy the experience? c. Please tell us about any time that you used a spreadsheet program such as Lotus 1-2-3, Quattro Pro, or Excel. * Was individually or a group? *What did you need to accomplish? * What was the result or grade? Once the questions are developed, recruiters should organize the questions and probes into some logical order on an interview form. The form may provide reminders to greet the applicant warmly and any other reminders desired by the recruiters. It should definitely leave enough room for notes about the answer to each question. These notes can be extremely helpful when recruiters are trying to remember the remarks of each person recently interviewed. We recommend that recruiters practice with the new interviewing form. Recruiters may pair off and take turns playing the interviewer and the applicant, or they may wish to enlist a student to go through an interview. The trial interviews could be recorded on a video camera. The feedback from the video playback is often a very valuable learning experience. Lastly, an interviewer evaluation report should be designed to record ratings for each candidate. The process is relatively simple once the knowledge, skills, and abilities (KSAs) required by the job have been listed. We suggest that recruiters list all the KSAs down one side of the paper as seen in Figure 1. (Figure omitted) This will allow a systematic consideration of each applicant against job requirements. Next, recruiters should choose a rating scale. We have chosen a five-point scale anchored by very little of the KSA on one end of the scale and a great amount on the other end of the scale Scales should have from five to seven points and anchors meaningful to the recruiters. A place for notes or comments and a set of simple instructions is also recommended. Finally, there should be a place for an overall evaluation of the candidate. There are several different methods which can be used to generate an overall evaluation score. A recruiter can make an overall evaluation of the candidate on the same scale used for each KSA. Unfortunately, past research has suggested that this method is not very reliable. Another option is presented in the figure on page 77. In this case the recruiters add their ratings to form a final evaluation. This approach is relatively simple and often yields final recommendations quite similar to more complex methods. Furthermore, individual KSAs can be weighted differently. In this case, each KSA evaluation score could be multiplied by its weight. All scores would be summed to obtain an overall score For example, assume that the first four KSAs in the figure were assigned weights of .2 and the last three KSAs weights of .1. A candidate might be given a rating of 5 on the first two KSAs and ratings of 4 on the other KSAs. The candidates overall evaluation score would equal 4.8 (5 x .2 + 5 x 2+ 4 x .2 + 4 x 2 + 4 x .1+ 4 x .1+ 4 x .1). Either of the last two approaches is recommended. The authors would like to thank Paul Osting (Vice-Chairman, Human Resources, Ernst Young, New York, NY), J. Breck Boynton (Director of Human Resources, Elliot, Davis, Company, Greensville, SC) and Patricia G. Roth (Clemson University) for their comments and suggestions.

Terrorism and Intelligence Failures Essay Example for Free

Terrorism and Intelligence Failures Essay Terrorism by dictionary definition is described as the unlawful use or threatened use of force or violence by a person or an organized group against people or property with the intention of intimidating or coercing societies or governments, often for ideological or political reasons. Terrorism comes from decades of histories of deep national pride, religious disputes and what is seen as an intrusion upon Islamic holy grounds. Terrorist groups try to gain influence and power in order to affect political change on either a local or an international level. They make this possible through the publicity and fear that is generated by their violent acts. Throughout history terrorist groups have caused much devastation and damage, leaving a huge impact on the world. Terrorism is one of the leading problems in today’s society. The terrorist attack against the United States, on September 11th, 2011, clearly demonstrated the power and strength that terrorist groups possess. The causes of these acts come from the instability, oppression, poverty and political alienation that the citizens of many Islamic-Arab nations face. As a result, the people of Afghanistan and many other Arab nations have generated a deep hatred for the United States going back over a hundred years. The American government and intelligence agencies, such as the Central Intelligence Agency, now work harder than ever to prevent such horrifying acts of terrorism from re occurring, since they failed in the prevention of 9/11. â€Å"Terrorism is a complex problem: Its origins are diverse; and those who engage in it, even more so† (Reich, 1). The actions of terrorist groups, as well as terrorists as individuals, are complex. One must recognize that there is not only a single explanation for the act of terrorism. The subject is very intricate and involves a huge diversity of causes and reasons that aid in the explanation and understanding of terrorism. In the book, Origins of Terrorism, Walter Reich examines the psychologies, ideologies, theologies, and the states of mind of terrorists in an attempt to better understand the realms of terrorism. Reich does not only work with terrorism studies itself but instead works within the realms of political science, Islam, history and social psychology to gain a more well rounded understanding of terrorism. Through recognizing the knowledge of these realms, Reich and other scholar’s state this information can contribute to the understanding of the ways in which terrorists view the world and behave in it. Terrorism can be explained as an expression of political strategy. Meaning that terrorist behavior is a willing choice made by an organization for specific strategic reasons. These organizations are very radical political groups that determine that terrorism is the best course of action in accomplishing their political goals. â€Å"The practitioners of terrorism often claim that they had no choice but terrorism, and it is indeed true that terrorism often follows the failure of other methods† (Reich, 10). Failure to mobilize support from masses, lacking of utilization of military power, time constraints and unrealistic expectations cause radical political organizations to turn to terrorism. By choosing terrorism, group members and leaders, willingly accept the risks of challenging the government. The origin of terrorism is as old as humans’ willingness to affect politics through the use of violent acts. Terrorism dates back to first-century Palestine when a Jewish group fought and murdered the Romans and their collaborators who ruled over them. Terrorism went on to be classified as a modern phenomenon. In the twentieth century terrorism was associated with the Italian Red Brigades, the Irish Republican army, the Palestine Liberation Organization and Perv’s shining paths among many others. Terrorism moved away from being based on state action and moved further into a larger aspect of attack against existing political orders. The result of this was due to the growing amount of ethnic nationalism within countries. Groups with strong ethnic nationalism were forming throughout the entire world. Then in the late 1960’s international terrorism became a prominent issue. Terrorism progressed from random killings to massive plans of attacks. Hijacking and bombing had become the favored and popular methods of attack. Organized groups had specific political goals that they carried out through theatrical, symbolic acts of violence. As the twenty-first century came around terrorism started becoming very religiously motivated. Groups like Al-Qaeda, Hamas and Hezbollah come to mind as they justify their acts of violence on Islamic grounds. Terrorism was now not only being used for political reasons but for religious reasons as well. Religiously motivated terrorist groups are the most alarming terrorist threats in today’s world. The rise of Islamic radicalism and militancy began during the 1970’s in the Middle East region of the world. Islamist terrorism is based on the belief that U.S. foreign policy has killed, oppressed and harmed Muslims throughout the Middle East. This belief resulted in a tense relationship between the ‘West’ and the Arab and Muslim nations, creating a great amongst American society. Osama bin Laden was the founder of the most well known Islamic militant organizations called Al-Qaeda. His goal was to remove and end American military presence in the Middle East and Arabian Peninsula, end American support for Israel, return East Timor and Kashmir to Muslim rule and overthrow any Arab regimes that he considered corrupt and insufficiently religious. Al-Qaeda is the most innovative and dangerous terrorist group that has ever existed according the American government and all other countries that have been victims of terrorist acts. It has been known to engage in suicide attacks, kidnappings, hijackings and recruiting new members through the Internet. Al-Qaeda’s operating network consists of a multinational, stateless army, and a radical Sunni Muslim movement calling for Jihad. Jihad is an important religious duty of Muslims that involves the protection and keeping of the Islamic faith. In the book, The Age of Sacred Terror, authors Daniel Benjamin and Steven Simon provides essential insight into the thinking of bin Laden and his followers. Benjamin and Simon talks about bin Laden’s first televised interview with Peter Arnett in March 1997. During his interview he complained and stated, â€Å"the truth is that the whole Muslim world is the victim of international terrorism, engineered by America at the United Nations . We are a nation whose sacred symbols have been looted and whose wealth and resources have been plundered.† Bin Laden continued to state, â€Å"If their people do not wish to be harmed inside their very own countries, they should seek to elect governments that are truly representative of them and that can protect their interests† (Benjamin, 147). Bin Laden gave the people of America a clear warning that he is planning an attack and a war against them. Osama bin Laden issued and signed his second fatwa on February 23, 1998, as the leader of Al-Qaeda. A fatwa is a legal pronouncement in Islam, issued by a religious law specialist on a specific issue. Through the issue of bin Laden’s fatwa, he gave the USA an indictment on the Arabian Peninsula, Iraq and the Middle East. He blames America for occupying lands of Islam and intervening in Middle Eastern affairs. Bin Laden’s goal was to get rid of any Americans getting in the way of his radical Sunni movement. By issuing his second fatwa, bin Laden declared was on the West and Israel. Al-Qaeda also released a video later that year declaring war on the United States and the West as well. After bin Laden had declared war, bombings were carried out on US embassies in Kenya and Tanzania. There was also an attempted bombing of Los Angeles International Airport and then the USS Cole bombing occurred in October 2000. On September 11, 2001, Al-Qaeda attacked the United States once again. This attack not only crushed American ideologies, but also took away the feelings of security that had taken hundreds of years to build. To plan and successfully execute the September 11th attacks, Al-Qaeda terrorists worked for years within the United States using Islamic organizations to coordinate and build their networks. In the book, American Jihad, Steven Emerson tells the story of the terrorists who sought to destroy the United States from the inside. Emerson states, â€Å"Operating in our open society, with freedom of speech and assembly and with only casual oversight from the FB I, the CIA, and the Immigration and Naturalization Service, the worldwide network of militant Islamic organizations has finally been able to coordinate† (Emerson, 3). The idea that terrorists were working within the United States seemed unimaginable, but the attacks of 9/11 proved that it was possible. Bin Laden organized and set up a network of â€Å"cells† in Tucson, Arizona; Brooklyn, New York; Orlando, Florida; Dallas, Texas; Santa Clara, California; Columbia, Missouri; and Herndon, Virginia. He understood that if he recruited U.S. citizens it would help him in his terrorist efforts because they would be allowed to travel freely throughout the world. By having an American passport his followers would not be detected or questioned whether they were a part of or members of a terrorist group. Bin Laden â€Å"made efforts to recruit United States citizens†¦ in order to utilize the American citizens for travel throughout the Western world to deliver messages and engage in financial transactions for the benefit of Al-Qaeda and its affiliated groups and to help carry out operations† (Emerson, 153). Bin Laden was obviously successful in his attack on America, which demonstrated not only to Americans, but also to the rest of the world what great threat terrorism can be to humanity. The success of terrorism depends on the existence of a mass media, which will create and spread the feeling of fear throughout the world. As a result, the attacks of September 11, threw America into a full waged war against terrorism. Military efforts were sent to abroad to Afghanistan and the Bush administration increased domestic efforts in order to prevent future attacks. New ideas and reforms needed to be put in place. American citizens did not understand why the CIA, the biggest intelligence agency in the world, could not prevent such a large scaled terrorist attack from happening. â€Å"The CIA was designed to†¦ â€Å"Connect the dots.† Yet it failed to penetrate sufficiently with human intelligence agents or to fathom analytically with sufficient clarity the Al-Qaeda 9/11 conspiracy that lead to the slaughter of some 3000 individuals on U.S. soil† (Russell, 18). â€Å"The terrorists that intelligence must uncover and track are inert objects; they are living, conniving strategists. They, too, fail frequently and are sometimes caught before they can strike† (Hoge, 146). The intelligence system failed and in order to understand this failure one must understand that the strategic role of intelligence in decision making of foreign policy has been a neglected field of study. The outrage of the intelligence failure forced the Bush administration to fall to political pressure. The administration accepted the 9/11 Commission’s recommendation to the create DNI post. This post was to serve as the president’s chief intelligence advisor and oversee the entire intelligence community, including the CIA. The root cause of the failed penetration of Al-Qaeda’s 9/11 plot, by the CIA, has to do with their failure to marshal the resources that work against Al-Qaeda, which were corresponding with the threat. The CIA did provide the president with a strategic warning about the attacks but it would have been much better if they had access to the Al-Qaeda related information that the FBI had collected. The CIA has also failed to produce spies that are needed to reveal the plans and intentions of America’s enemies. The focus should be put on what can be done to improve intelligence rather than recap evidence of what the CIA did and did not do. Spending more money on intelligence agencies will not necessarily improve American security. Intelligence could be improved by the collection of more important information, the building up of human intelligence throughout the world and recruiting more and better spies. If the American government wants to protect its citizens, property, liberty and interests from attacks of terrorist groups then dramatic reforms need to happen. These reforms would hopefully give the president access to the enemy plans and tactics. â€Å"The systematic failures of American strategic intelligence and the CIA since its inception have been obscured by the political and emotional impulse to examine each and every incident of intelligence failure in isolation and not to put them together into a larger context with other intelligence failures that shared the same root causes† (Russell, 27). Nonetheless, America was in an overall agreement that changes in the American intelligence systems were necessary. The United States Department of Homeland security was created in November 2002 as a new cabinet level agency. This department was responsible for the reorganization of the U.S. federal government. Government bureaucracies dealing with military functions and security were also reorganized. In October 2001, the USA Patriot act was signed into effect reducing the restrictions on law enforcement agencies’ ability to search medical, financial, telephone, e-mail communications and other records. It also eased the restrictions on gathering foreign intelligence within the United States. The Patriot act also gave the Secretary of the Treasury more authority to closely regulate financial transactions, involving foreign persons. Immigration authorities and law enforcement could now detain and deport immigrants that were suspected of being affiliated with acts of terrorism more easily. Author Richard K. Betts suggested, â€Å"The National Security Agency (NSA), the National Imagery and Mapping Agency (NIMA), and associated organizations can increase â€Å"technical† collection – satellite and aerial reconnaissance, signals intelligence, communications monitoring – by buying more platforms, devices, and personnel to exploit them† (Hoge, 148). A Terrorist Finance Tracking Program was actually created to in order to monitor the movements of terrorists’ financial resources. However, the New York Times newspaper leaked this information, which ended th e project. The National Security Agency instead set up an electronic surveillance program that studied telecommunication use by suspected and known terrorists. All the laws and reforms that removed restrictions on governmental authority are notionally good for the overall prevention and protection against terrorism. In certain perspectives the removal of governmental restrictions is advantageous to American security. However, political interest groups have stated that because these new laws remove restrictions on governmental authority, they violate the civil liberties of the American citizens. The American Civil Liberties Union filed the first legal challenge against the Patriot Act. It claimed that the Patriot act violates the rights of the First Amendment, Fourth Amendment and the right to due process. It is a violation because the Patriot act grants the government the right to search a person’s private property without having to inform them that they are being investigated. Former Pr esident Bush stated that the Patriot Act helped convict more than two hundred suspects of being involved with acts of terrorism. On the other hand, the figures of the Justice Department show that there have been complaints of abuse of the Act from about 7000 people. The real question one must ask oneself is if the governments’ unknown investigations are worth the price of freedom and protection from terrorism. â€Å"The deaths of 3,000 people on American soil at hands of a ruthless adversary along with the CIA’s profound misreading of Iraq’s weapons of mass destruction (WMD) capabilities are the latest and greatest and in a long string of U.S. intelligence failures† (Russell, 149). The United States government has heavily concentrated on improving intelligence through bureaucratic approaches. Fighting the war on terrorism became a huge challenge for the United States. The terrorist attacks of 9/11 caused enormous devastation and damage to all the citizens of America. September 11 will never be forgotten as it has left a huge impact on the world. Al-Qaeda is a very serious threat to the United States but there will most likely be many more in the next generations to come. â€Å"The United States needs to rectify the substantial shortcomings in human intelligence collection operations if it is to deal successfully with issues of war and peace in the future† (Russell, 168). The protection of America is in the hands of the government and the intelligence agencies. Terrorism will not end on its own, therefore Americans need to be prepared for what the future has to bring. Terrorism has been around for centuries and will probably always be around. The question is how to handle it and keep it in check. There will always be extremists working against the governments in the world.

CARL ROGERS PERSON-CENTRED APPROACH

CARL ROGERS PERSON-CENTRED APPROACH Introduction Carl Rogers (1902-1987) a psychologist developed the person-centred approach theory mainly in relation to the therapist and the client and initially named it the client-centred approach. Rogers later referred to this theory as person-centred rather than patient-centred in order not to reduce the individuals autonomy and consequently lend the client to difficulties. The approach therefore is to turn individuals (clients) into subjects of their own therapy. In his theory it was noted that individuals are endowed with the power of self actualization and through their own perception of resources inherent in them, they can provide remedy for change in their difficult situations, provided a facilitating environment exists This view as expressed by Rogers implied that every person has a tendency to grow and attain a certain level of actualization. He observed that in order to allow the client (person) asses his/her own wisdom and self defeating behaviours and also engage in therapeutic move ment with the therapist, there must be a conducive climate. Three conditions were identified for this relationship to thrive favourably: Genuineness (Congruence), Empathy and Unconditional Positive Regard. GENUINENESS (Congruence) In this relationship the therapist is expected to show a real sense of genuine attitude towards the clients feelings and thoughts, be willing and ever present to assist them in whatever situation they may be. He should be transparent and discourage the attitude of being the superior in the situation. This attitude would in turn retain a high sense of confidence in the client towards realization of him/herself in therapy. Any deviation from this attitude renders the process unworkable. UNCONDITIONAL POSITIVE REGARD (Total Acceptance) According to Rogers, the therapist in this situation must show non-judgemental and total acceptance to the clients feelings and his perceptive world as a whole to enhance his process of recovery. This total acceptance of the clients attitude and perception should be devoid of whatsoever differences that might exist between them either culturally or socially. However in doing so the therapist should ensure the safety and security of the client. EMPATHETIC UNDERSTANDING In his theory, showing empathy refers to the ability of the therapist to show positive sensitivity to the clients world, his perception towards recovery and also communicate his feelings to the client. This will convey a special meaning to the client of his relationship with the therapist and consequently solidify their mutual relationship towards the expected therapeutic movement. Rogers continue to state that any deviation from these attitudes on the part of the therapist makes it difficult for the process to continue. This empathetic attitude is more exhibited by therapists who are more confident about their own identity and can cope with other persons world without any fear. PERSON-CENTREDNESS AS A CONCEPT Person-centeredness a concept in health care delivery has poor and conflicting definitions over the years and is considered one of the best ways of health care delivery in which patients are valued as individuals (Winfield et al. 1996). It has further been observed by (Slater 2006; Leplege et al 2007), that the concept of person-centredness has been described using different terms like patient-centred, client-centred, person-centred interchangeably which makes it most often unclear which consistent term to use in the description of the concept. Notwithstanding all these difficulties, Kitwood (1997) defined person-centredness as a standing or status that is bestowed upon one human being by others in the context of relationship and social being. It implies recognition, respect and trust. (p.8) Kitwood (1997) further used person-centredness to formulate ideas and ways of working which puts much emphasis on communication and building relationships in care. Brooker (2004), elaborating on person-centred approach found out that the definition of the term has such characteristics as:  · Respecting and valuing the individual as a full member of society  · Providing individualised places of care that are in line with peoples changing needs  · Understanding the perspective of the person and providing a supportive social psychology in order to help people live a life of relative well-being. Dwelling on these definitions of Kitwood and Brooker, it is evident that they are built on the works of Carl Rogers (1950), which developed person-centred approach as a way of facilitating psychological growth (Natiello 2001).In addition a critical look at Kitwoods definitions definitions showed that personhood has been considered very essential. (Dewing 2008) observed that Person-centredness is often associated with gerontological nursing and more particularly issues relating to dementia care and have personhood as a basis of promoting its practice. It is therefore relevant to explore the philosophical and theoretical underpinnings of personhood in as much as it recognised in person-centredness (Baker 2001; Ford McCormack 2000; Fares 1997). Baker (2001) declared that personhood is consistent with individuality and has three dimensions; the persons world which relates to understanding the persons needs, self relating to emotional and physical security and others which signify social and material world that considers the need for interventions and a sense of belonging and place. Similarly (Ford McCormack 2000) recognises personhood as the persons ability to rational make decision by virtue of his reflection on available needs, choices wants and desires. On the contrary this ability to make rational decisions might be difficult particularly in persons with dementia (Kitwood 1997), however choices can be offered to the person. Harre (1998, p.6) drawing on the work of Apter (1989),concludes that ; a sense of personal distinctiveness, a sense of personal continuity and a sense of personal autonomy important phenomenon that best described personhood. Elsewhere in literature, transcendence (a state beyond material or usual existence) has been referred to as an essential characteristic for description of personhood (Heron 1992 Kitwood 1990a, 1997).This goes to establish the assertion that personhood can be accessed from three type of literature- theology and spiritual, ethics and social psychology and each of these literature gives different meanings to attributes relating to personhood (Kitwood 1997, p.8). McCormack (2004) compared the definition of person-centredness by Kitwood and his own findings in an extensively reviewed literature and concludes that four concepts should be considered in describing person-centred nursing. These are: Being in Relation, Being in Social Context, Being In Place, Being With Self. Being In Relation Being in relationship emphasizes the point that, for any effective person-centred care to commence, continue and achieve success ,the nurse and the patient should be in a good interpersonal relationship and this relationship requires valuing of self, moral integrity, reflective ability, knowing self and others as derived from reflection on values and their place in the relationship. Being in relationship is also reflected in one of the seven attributes of person-centredness identified by Slaters (2006) concept analysis-evidence of a therapeutic relationship between person and health care provider. He further states that this relationship between the person and care provider must be one of mutuality, mutual trust and non-judgemental which does not take into consideration the balance of power. Being In Social Context This is the interconnectedness of persons with the social world in which individuals create meaning to themselves through being in the world. Being able to understand the social world of the person enables one to clearly identify things that are considered paramount in their lives Slater (2006). Being In Place Andrew (2003) declares that concept of place and its impact on health care delivery is poorly understood in nursing. Andrew further argued that places are not just physical but involve situated human intentions within them.(Andrew, 2003; Luckhurst Ray, 1997; Hussain Raczka, 1997) contends that attention must be paid to place in care relationships for its important role. In order for nurses to be facilitators of person-centredness, care values must be balanced with other organisational values no matter how difficult it might be, to enable the process of the concept to continue smoothly (Woods 2001). A similar idea was expressed by Johns (1995) that nurses cannot freely fulfil their moral obligation to patients without taking cognisance of organisational and professional implications. To buttress this McCormack et al (2002) asserts that whilst it is important for nurses to facilitate person-centredness, other contextual issues such as staff relationships, organisational systems, power differentials and the extent to which the organisation tolerates innovative practices and risk taking should be worth noting. Being with Self Knowing self is very central in person-centred nursing approach. This is important in that, health care providers need to identify their personal values first in order to respect the values of other patients under their care, to avoid trampling over their autonomy and cultural needs paramount to person-centredness (Downs, 1997; Ford McCormack, 2001; McCormack, 2001b; Nolan, 2000).Further, knowing self enables the nurse to make comparisons of current lifestyles and behaviours of the patient with his preferences and values of life in general as a clue to enhance care process (Meyers,1999). PERSON-CENTRED PRACTICE BASED ON AUTHENTIC CONSCIOUSNESS Based on the four concepts- Being In place, Being In relationship, Being with self, Being In social context, McCormack (2003) outlined five conceptual models in consistent with current nursing principles. These are: Authentic consciousness (McCormack 2001a, 2001b, 2003 and 2004), Positive person work (Packer 2003), the senses Framework (Nolan et al 2001), Skilled companionship (Titchen 2000, 2001 p.80) and The Burford Nursing Development unit model (Johns 1994). McCormack developed a conceptual framework for person-centredness practice based on Authentic consciousness. He identified five imperfect duties on which the framework will operationalize.further, McCormack (2003) declared that for person-centredness to operate effectively in practice, factors such as the patients value, the nurses values and the context of care environment. For the purpose of this study, imperfect duties and factors (Patients values, the nurses values, context of care environment) on which person-centred practice operationalize will be explored to highlight their effect on the concept. According to Immanuel Kants morale theory cited in (Sullivan, RJ 1990), imperfect duties are described as wide, broad and limited such that it gives room for discretion but within the rules of the organization within which one works. There is no means of offering an exhaustive and a priori account of how the duties are to be fulfilled. The five imperfect duties discussed earlier are as from (the conceptual framework of McCormack 2003):  · Informed flexibility: this is the facilitation of fdecision making based on information dissemination and the integration of new information into established perspectives and care practices.  · Mutuality: the recognition of the others values as being equally paramount in decision making.  · Transparency: making clear the intentions and motivations for action and the boundaries within which care decisions are set.  · Negotiation: patient participation through a culture of care that values the views of the patient as a legitimate basis for decision making while recognizing that being the final judge of decisions is of secondary importance.  · Sympathetic presence: this is an engagement takes into consideration the uniqueness and value of the individual by appropriately responding to cues that maximize coping resources through the recognition of important agendas in daily life. PATIENTS VALUES In person-centred practice respect for patients values are identified as being central in order to achieve an effective process of the concept (Dewing, J. 2002; William,B. Grant. 1998; McCormack 2001).It is important to develop a clear picture of what patients values about their life and how they make sense of what is happening around them. Helping the individual to have realization in care makes them to tolerate the incongruency of their illness and also helps them to plan for future, to do this, there is the need to build a baseline value history of the patient through biographical accounts and narrative story.(Meyers, D.T. 1989).The complex nature of most health care decisions couple with anxiety, fear of illness, dependency and other aggressive tendencies results in the patients decision making ability being diminished.( Buchanan Brock, 1989) Argued that if patients are left to be in total control of their health care decisions, most often than not their choice of treatment dec ision might not work effectively towards their well being as expected. They further argued that, as much as patients are expected to participate in decision making regarding their health, they should also be protected sometimes from harmful consequences of their own choices. According to Seedhouse, D. (1986) health has different meanings to different people and is also given various degrees of relevance by individuals. It therefore implies that there is no single care intervention that can be considered best for everyone. Whiles are a particular approach is applicable in one situation it may not be same in the other. In view of these, health care decisions need to adopt a negotiated approach between the patient and the practitioner (McCormack, 2001). NURSES VALUES In spite of partnership being a common phenomenon in person-centred practice where nurses are encouraged to be lenient in their presentation to patients, it is unusual for nurses to present their own views as a part of information that patients are given to help their decisions.Gadow (1980) argued that in as much as patients values should be dominant in the decision, nurses values also contribute to enhance the efficiency of the process but in a less explicit manner. Nurses expressing their values in care decisions should not really be a problem if there is partnership, since these will help the patient to have more insight into the nurses position regarding their care. CONTEXT OF PRACTICE ENVIRONMENT Despite more attention on nurses and patient values the care environment also play a significant role in the person-centred process in which there is the tendency to either promote or hinder its smooth running (McCormack et al 2002; Rycroft-Malone et al 2002).In facilitating person-centredness nurses are faced with difficulties of having to cope with the morale obligations to patients as well as organisational and professional implications (Johns, 1999).this situation has been confirmed by recent analysis f context undertaken by McCormack et al (2002). Yarling (1990) expressed a similar view to earlier researchers above that, in modern health care delivery, while nurses are expected to engage in autonomous decision making they are limited in exercising their authority. THE CONCEPT OF PERSON-CENTREDNESS IN REHABILITATION Clare et al. (2006) define rehabilitation as an individualized approach to helping people with cognitive impairments in which those affected, and their families work together with health care professionals to identify personal-relevant goals and strategies for addressing these. This definition clearly shows a connection between rehabilitation and the concept of person-centredness. Leplege et al (2007) argued that the notion of person-centredness have been used interchangeably as patient- centred ,client-centred, individual- centred, person-directed. Reasoning along this argument, implies that the term has a multidimensional use. In order to establish further the description of this terminology, Leplege and his colleagues undertook a conceptual analysis of person-centred concept in the field of rehabilitation and identified few supportive concepts that clearly elaborate on the use of the term. THE PERSONS SPECIFIC HOLISTIC PROPERTIES AND DIFFICULTIES IN EVERYDAY LIFE Person-centredness as a means of addressing the persons specific and holistic properties suggests that in dealing with individuals, their biological and psychosocial needs must be considered as paramount as opposed to classical analytic medical attention on the functionality of specific organs and related medications prescribed for relief of ailment. In their view regarding person-centredness in rehabilitation, the term seeks to address difficulties in everyday life of disabled persons in such a manner as to reflect their needs and social adjustment. Rehabilitation alone without person-centredness seems more technical and ignores other aspects of the patients life. PARTICIPATION AND EMPOWERMENT It is further argued that disabled persons be given more decisional autonomy in order to be aware of what is happening to them, the way they perceive treatment and care offered them and other variations about care available to them. Patients of disability should not be passive about interventions available to them; they should be allowed as key participants. It is however stressed that the concerns of disabled persons are not different from able persons and therefore equal attention is supposed to be given to both. RESPECTING THE PERSON BEHIND THE IMPAIRMENT Respecting the person in spite of his/her impairment or the disease reflects the notion that disabled persons be accorded the dignity and respect they deserve, because disability can be considered as part of normal life and therefore should not be treated with pity and stigmatization. Leplege et al therefore declared person-centredness as anti-reductionism which seeks to hold in high esteem views and rights of disabled persons in decision making regarding their health care. PERCEPTION OF PERSON-CENTRED NURSING ACROSS NATIONAL AND INTERNATIONAL DIVIDE The concept of person-centred care has long been associated with the nursing profession, and understood in principle as; establishing mutual trust and understanding with individuals, respecting their values and rights as a person, and developing therapeutic relationships with them and others associated with their care. The good aspect of delivering care in the philosophical context of person-centredness cannot be over emphasised, but it has been observed that translating the main concept into daily practice is always met with challenges (McCormack McCance 2006).The reasons for these inefficiencies manifest in different forms and are seldom indicative of the context in which care is delivered, coupled with constant changes that occur particularly within health and other social care sectors. Person-centredness has been in existence with health care delivery for some time now and is consistent with policy direction and reflected in many approaches to delivery of care. The concept manifests itself in policy directions across both national and international health care sectors. In the United Kingdom the concept of person-centredness is embedded in most health care policies such as The Dignity in Care Campaign (DoH, 2006) and The National Service Framework for older people (DoH 2001). Further, recent publications by the Royal College of Nursing (RCN) emphasised challenges for nurses and midwives in provision of dignified and sensitive care, in its report on health care. In Northern Ireland, the focus is on promoting person-centred standards- (respect, attitude, privacy and dignity, communication, behaviour) across health and social care sectors. It has been observed that within the health service, the drive to promote effectiveness and efficiency in performance management has not been high. As a result, patients, clients and their families receive less attention in care delivery as indicated in a range of quality and clinical indicators (DHSSPS 2007a; Nolan, 2007). Whilst the term person-centred care is rampant in the UK health and social care literature and policy documents, the underlying principles of person-centred care are similar to that of international movements that is focused on humanizing the health and social care experience. This is evident in the Skaevinge Project carried out in Denmark (Wagner L. 1994). In his action research, focus was on preventative work and also to ensure the rights of residents in care homes as citizens in society. This model again helps in putting to shape the future of residential care and the design of care homes internationally. Wagner infused into his work such principles underpinning person-centred care as autonomy, citizenship, dignity and respect, to enhance efficiency of his model. Health care policies around the world adopt these principles and use them in several policy frameworks related to social and health care sectors. In Australia for instance, person-centred care has been a solid foundation of facility accreditation in The Aged Care Standards and Accreditation Agency and the New South Wales department of nursing has its focus on enhancing practices and models of care to support person-centredness across all specialities. Developing models that enhance care and promote person-centred principles has become a vital issue in health and social care. A notable instance is the Institute for Health care Improvement (IHI) in the United States of America. Most governments in the West have initiated transformations and innovated frameworks in health and social services through most of the practices of the IHI. Majority of the plans initiated by these governments focused on person-centred care mainly through transformation systems and redesign of clinical services.

The Trial of Socrates Essay -- Papers

The Trial of Socrates The trial of Socrates is an excellent source of events during the period in which Socrates lived and died. Athens was a democratic city with much pride in their freedom. Especially their freedom of speech. Socrates was a political philosopher who did not agree with these freedoms provided by the Athenic democracy. However, it is his trial in which both the democracy of Athens and Socrates himself show their hypocrisy. It is this hypocrisy that makes the trial and death of Socrates quite ironic. Athens, the city in which Socrates resided, was a free democratic city that was governed by all citizens in a fair democracy as seen in apology. It was said to be an association of free men with no single leader or king. The town prided itself on the freedom of its citizens and, especially, its freedom of speech. Most all citizens prided themselves on these views, although they respected the views of other people because of their own freedom of speech. This was the society in which Socrates lived. Socrates was a philosopher who believed that only those who are wise should rule the people. In other words, the people are not capable of government participation because they do not have the knowledge According to this philosophy; democracy is not a capable government. Other than his time spent fighting for Athens, Socrates rarely took part in any democratic actions. He spent most of his life preaching his philosophical views Socrates had many pupils to his preaching, although he denied being a teacher of philosophy. He proved this by showing them as witnesses in the court. He boasted about many topics. He also attacked the opinions of many others. He believed that one should give specific definitions o... ...ny listeners and pupils that agreed with his philosophy. He did not make any actions against the democracy that he despised so greatly. Throughout the events of the trial, both sides were quite hypocritical, although Socrates willingly became hypocritical in order to expose the hypocrisy of the government. Throughout the trial, Socrates did not deny the accusations exactly , because he actually wanted to be convicted. We can also see this in Socrates’ dialogues with his accusers. He made them talk and answer his questions which most of them were not exactly questions. His questions were as if they were answers. These are all the proofs of what he wanted to do in the trial. Finally, as for the question â€Å"Should Socrates have been convicted†, if I were the trial’s judge, I would have decided him to be guilty although he wasn’t. I think I would have awarded him.

Changing the Drinking Age to 18 Essay -- Argumentative Persuasive Essa

Young teens all get a bad rep when it comes to drinking alcohol. Especially college students that are considered â€Å"binge drinkers†. When in reality a nation wide survey of students at 168 colleges and university’s found some interesting things about the underage corrupt youth. 93% of all students have never received a lower grade in a class because of drinking too much. 98% of all college students say that they have never gotten into trouble from an administrator from excessive drinking. While the media continually gives the under twenty one community a bad rep, in reality they are continually practicing safe drinking habits and in some cases not drinking at all. According to the National Institute on Drug Abuse by the Institute for Social Research of the University of Michigan, the proportion of non-drinkers in the U.S. just reached a record breaking all time high. The point is that college students drink less than what most people think and are in reality res ponsible drinkers. So what can be done to change the drinking law to eighteen again? These underage students continually spite the law and show that they can handle the responsibility. It is silly to overlook this and maintain a blind law such as the current drinking law. The first step into taking this law and changing it back to eighteen is to start at home and inform the children at a young age the harms and hazards of alcohol. It is not something to take lightly and it can lead to many life long problems. However I feel if this is taught at an early age and drinking is looked at as a privileged rather than a right it will be abused and rather something that will not be taking for granted. This will make drinking in small portions more commonplace and drinking in an excessive manner a rarity. Drinking would no longer be a big deal. Young children start off learning the dangers of drinking and would eventually start drinking at family events like they do in other foreign countries. These countries do this and do not have a major drinking problem in their society. By the time these children get to the age of 18 it will be legal to purchase and legally drink and it will not be a big deal because they have been taught responsible drinking from the start. This is an obvious start to fixing and changing this law, however it would be difficult to change the social and family traditions of A... ... that it is morally wrong to let eighteen year olds to drink legally. They would also argue that more and more deaths would happen due to this law being changed. When in reality if you follow these steps, teach young children at a young age to drink moderately and responsibly, add more harsher penalties to the drinking and driving laws and make defensive driving courses mandatory to graduate in high school, and to finally make a â€Å"permit† for under twenty one drinkers as a test to see exactly how it affects the society. All in all the age of eighteen is thought to be old enough to make such big decisions as getting married and joining the army to defend the country. It would at least show that this country has confidence in the eighteen year olds to be responsible with this new law and to not abuse the power. It would make a uniform â€Å"legal age†. This simplicity in itself will make checking I.D.’s less of a problem. This law needs to be changed and ev eryone knows it. This is a reasonable proposal to try something that has never been tried before and I think that the lawmakers are scared that it would work and it would just make them look foolish for not thinking of it on their own.

A New Nation of Individuals :: Literature Papers

A New Nation of Individuals Abstract As John Savage articulates, â€Å"Nothing costs enough here,† in Huxley’s Brave New World (1932) of bottled automata, where maelstroms of soma-ingesting, Malthusian orgies casually toss human life about (239). Nothing is dear when the freedom to choose disappears because individuals â€Å"don’t know what it’s like being anything else† (74). Removing choice is simply a method of brainwashing that only subdues human nature for the short-run. Consider Sigmund Freud's views of private property: In abolishing private property we deprive the human love of aggression, certainly a strong one, though certainly not the strongest; but we have in no way altered the differences in power and influence which are misused by aggressiveness, nor have we altered anything in its nature. Aggressiveness was not created by property. (Kumar 384) Aggressiveness, too, was not created by choice. This essay proposes a utopia based on individual freedom, derived from a laissez-faire economy and semi-socialist meritocracy. A New Nation of Individuals First existed the individual; then a group of individuals established government via a social contract. Thus, as Percy Bysshe Shelley writes, "(g)overnment has no rights; it is a delegation from several individuals for the purpose of securing their own. It is therefore just, only so far as it exists by their consent, useful only so far as it operates to their well-being" (qtd. in Chianese 282). Such basic democracy founded the United States of America—yet modern democracy has gone terribly awry, and power now lies in the hands of few rather than many. Ideally, "(t)he highest purpose of Nature, which is the development of all the capacities which can be achieved by mankind, is attainable only in society, and more specifically in the society with the greatest freedom," and the greatest freedom can only be obtained, as Thoreau believed, through a government that governs least (202). In order for the individual to maintain full rights and a completely separate, private sphere of self, government must be just large enough to protect man's unalienable rights, Thomas Jefferson's "life, liberty and pursuit of happiness," but not overstep its boundaries onto the slippery slope of tyranny or oppression. A utopian society should thus stem from a meritocracy that allows for maximum individuality and freedom of choice while protecting man from one another, specifically through universal education and healthcare, and a laissez-faire economy founded on a flat-rate sales tax. A New Nation of Individuals :: Literature Papers A New Nation of Individuals Abstract As John Savage articulates, â€Å"Nothing costs enough here,† in Huxley’s Brave New World (1932) of bottled automata, where maelstroms of soma-ingesting, Malthusian orgies casually toss human life about (239). Nothing is dear when the freedom to choose disappears because individuals â€Å"don’t know what it’s like being anything else† (74). Removing choice is simply a method of brainwashing that only subdues human nature for the short-run. Consider Sigmund Freud's views of private property: In abolishing private property we deprive the human love of aggression, certainly a strong one, though certainly not the strongest; but we have in no way altered the differences in power and influence which are misused by aggressiveness, nor have we altered anything in its nature. Aggressiveness was not created by property. (Kumar 384) Aggressiveness, too, was not created by choice. This essay proposes a utopia based on individual freedom, derived from a laissez-faire economy and semi-socialist meritocracy. A New Nation of Individuals First existed the individual; then a group of individuals established government via a social contract. Thus, as Percy Bysshe Shelley writes, "(g)overnment has no rights; it is a delegation from several individuals for the purpose of securing their own. It is therefore just, only so far as it exists by their consent, useful only so far as it operates to their well-being" (qtd. in Chianese 282). Such basic democracy founded the United States of America—yet modern democracy has gone terribly awry, and power now lies in the hands of few rather than many. Ideally, "(t)he highest purpose of Nature, which is the development of all the capacities which can be achieved by mankind, is attainable only in society, and more specifically in the society with the greatest freedom," and the greatest freedom can only be obtained, as Thoreau believed, through a government that governs least (202). In order for the individual to maintain full rights and a completely separate, private sphere of self, government must be just large enough to protect man's unalienable rights, Thomas Jefferson's "life, liberty and pursuit of happiness," but not overstep its boundaries onto the slippery slope of tyranny or oppression. A utopian society should thus stem from a meritocracy that allows for maximum individuality and freedom of choice while protecting man from one another, specifically through universal education and healthcare, and a laissez-faire economy founded on a flat-rate sales tax.

Newborn Exam

The government initiatives to reduce junior doctors’ hours within the NHS Plan (DH 2000) have increased the call for midwives to expand their traditional role and take on some of the tasks that in the past have mainly been carried out by junior doctors (Kings Fund 2011). Having been working within the community setting as a midwife for the past three years I was interested in extending my role in order to provide more holistic care for my caseload of clients and their babies.Holistic care for mothers, babies and their families is highly recommended within the midwifery profession and is known to provide an improved experience for women (Changing Childbirth (DOH 1993a) NMC 2012, NICE 2006). The Newborn and Infant Physical Examination (NIPE) is one element of the UK National Screening programme and is offered to all parents for their baby within 72 hours of birth and then repeated again at 6 weeks of age, usually by their GP.This role is one of the tasks that has been highlighte d where midwives can expand their role (Marshall & Raynor 2010). The trust where I work has recently introduced community clinics where parents can take their baby in order to have the newborn examination performed, therefore allowing early discharge home from the unit enabling early family bonding. With this in mind I commenced the Newborn and Infant Physical Examination course.Screening has been used within the NHS for many decades and is a process that enables the health professional to highlight healthy members of the population that could potentially have a health related problem (UK National Screening Committee 2008). The NIPE is a head to toe examination that will enable a practitioner to detect in an apparently healthy baby any abnormality that can then be referred onto the appropriate professional for further investigation.This can then improve the newborns future health by providing early intervention and prevention of further complications (DOH 2009). It particularly focu ses on the eye, heart, hips and testes in the male infant. The importance of these particular areas is of great significance to the baby’s future health. An undetected congenital cataract may lead to the child being blind in that eye. A missed heart defect may not be diagnosed until the parents present with a very unwell or even dead infant.If developmental dysplasia of the hip is not treated early enough following birth it could lead to several episodes of major surgery or even disability in the future. Bilateral undescended testes can lead to problems with future fertility. There are many issues surrounding the NIPE that are argued about within the literature Green and Oddie (2008) question whether the NIPE provides the population with and improvement to overall health or if it just gives the parents reassurance that could in the future be proved wrong, due to the NIPE being a screening tool and not a diagnostic test.Within the content of this essay I will be critically ana lysing the NIPE and some issues around this topic focusing particularly on the examination of the hips. Since being a midwife, and a mother, I have always found this part of the examination most difficult to watch someone perform as it appears to be uncomfortable for the baby. Therefore on commencing the course I have been aware of the discomfort it appears to give the newborn and also the distress this could in turn cause for the parents.I will also be looking into the issues regarding which professional is best qualified to be performing the examination and also if there are any benefits or risks as to the place that it is undertaken. When I am performing the examination I will mainly be alone in the community setting either at a children’s centre or within the home environment, so therefore it is imperative that I am aware of any limitations this may present for the baby, parents or me.As previously mentioned there is a growing trend within many obstetric units for midwive s to carry out the NIPE examination. Within the trust that I am based midwifery led clinics are held on the post natal ward and also within the community for the sole purpose of performing the newborn examination. Bloomfield et al (2003) discussed where the examination should take place and found differing opinions. The benefits of being in hospital were noted to be that medical back up was available and it was more convenient for further immediate referral process.Community examinations were thought to be more likely to enable the parents to ask questions and mention concerns due to the relaxed environment. Following the Maternity Matters report (DOH 2007) advocating that women should have a greater choice for place of birth the home birth rate has increased and is continuing to do so. It is therefore ideal for community based NIPE facilities so that women do not have to attend hospital at all following a home birth.On reflection the examinations that I have witnessed and performed unfortunately seem to have been a way to speed up the postnatal discharge procedure therefore freeing up beds within the unit and not due to providing a more continuous midwifery led experience for the parents and baby as Hutcherson (2010) found. The ideal situation would be to perform the examination on the newborn belonging to the mother you have seen through antenatal care and will be caring for post natally therefore providing continuous care for your personal caseload of clients, as discussed by Baston & Durward (2010).The patient satisfaction and overall job satisfaction in this case scenario would be high for all involved but unfortunately I feel in practice will be a rare occurrence. Eventually I believe that in our trust when there are enough trained midwives within each geographical area the possibility of a midwife performing newborn examinations on babies within the teams’ caseload is possible. This far from being the ideal scenario is the closest it will probabl y get to the holistic care sought after by myself and many other midwives.The EMREN (Evaluation of Midwife Role extension in the routine Examination of the Newborn) study carried out by Townsend et al (2004) looked into aspects of the NIPE one of them being whether a midwife was as capable as a senior house officer when carrying out the NIPE and discovered not only that this was the case but that the mothers satisfaction level may be increased if a midwife performed the NIPE and that also money may be saved by the NHS.Having observed SHO’s, appropriately trained midwives and advanced neonatal practitioners (ANP) performing the NIPE I felt that the midwives and ANP’s communicated far more effectively with both the baby and parents therefore better fulfilling the communication aspect of the competency’s indicated by the UK National Screening Committee (2008). They also provided more detailed information on parenting and public health issues during the examinations which should be an integral part of the NIPE (Baston & Durward 2010).There has been much interest recently into whether pulse oximetry should be part of the newborn screening for congenital heart defects. The UK National Screening Committee is at the present time looking into whether this should be included within the NIPE as part of the screening for congenital heart defects in the newborn. It has been recommended in recent studies and has found to increase the detection rate of congenital heart defects (Ewer et al 2011, Chang 2009). Within our trust I have seen this performed on three ewborns following their NIPE, due to nasal flaring, slight cyanosis and a raised respiratory rate, all have proved to be within the normal range. The saturation monitors are present in the units’ clinic rooms where newborn examinations are performed but the community midwives working in children’s centres or at home do not have access to a monitor. Therefore this could be cause for con cern for parents of babies that are being examined in the community. This then presents the ethical dilemma that newborns are being offered a different aspect within the NIPE depending on where it is carried out.Powell et al (2013) found that parents were happy about having the pulse oximetry screening carried out on their newborn but questions need to be asked if they would prefer to not have it done in favour of the NIPE being performed more conveniently within the community. Ewer (2012) discusses the benefits of introducing pulse oximetry monitoring but without any mention of community based NIPE, or newborns that were born in the home environment. Another concern that I have witnessed and am aware of is not having access to all the antenatal notes of the mother within a community setting.On two occasions the mother has been discharged without the appropriate paper work or has not brought it to the clinic appointment. Obviously within the unit the antenatal and labour notes are e asily accessible, within the community if the mother hasn’t the appropriate information then the parents word must be taken. Having all information relating to the antenatal and interpartum periods is an essential part of the midwives role when performing the NIPE. The practitioner must be aware of antenatal and interpartum occurrences to be able to fulfil the competence set by the UK National Screening Committee (2008).When first undertaking the NIPE’s I found the examination of the hips the hardest part of the procedure, mainly because the baby would quite often cry and struggle a little and this would cause the parents to be distressed and concerned. I also, in the past, as a midwife and mother observing this procedure felt uncomfortable. Having now done a larger amount of these examinations and reading and understanding the relevant literature find them easier to perform. Screening for developmental dysplasia of the hip is based n the fact that if not picked up in the newborn could create the need for major surgical procedures in later life also with a poorer future outcome, Dezateux & Rosendahl (2007). Developmental dysplasia of the hip used to be widely known as congenital dislocation of the hip but has been renamed since the 1990’s. The factors behind this change are that it is now recognised that the condition is not always ‘congenital’ and rarely ‘dislocated’ and more likely to be ‘displaced’, Bracken et al (2012).The definition of developmental dysplasia of the hip is very obscure as there are varying degrees and it quite often develops after birth, overall it describes a disorder where the hip joint is unstable and occasionally dislocated. The hip joint consists of the femoral head, the rounded end of the bone which sits within the cartilage of the socket joint known as the acetabulum. There are thought to be different factors as to why the hip joint becomes unstable. At around seven weeks gestation hip formation has already begun, problems can start to occur then.If the femoral head is wrongly positioned from the start it could result in the formation of a too shallow socket. During pregnancy the hip joint can be affected by external and internal forces, for example oligohydramnios, lack of foetal movement due to foetal conditions, breech presentation (Hurley 2009, McDonald & Jenkins 2008). The incidence of developmental dysplasia of the hip varies in the literature, at birth it is thought to be 1-20 in 1000 but the majority of these stabilize without any treatment within the first few weeks of life, bringing the incidence down to 1-2 in 1000 (Campion & Benson 2007).The incidence is higher in female babies, it is believed due to the female newborn being more susceptible to the maternal hormones therefore the joints are more relaxed, Hurley 2009. It is also more prevalent if a sibling or parent has had developmental dysplasia of the hip, McCarthy et al (2005) and McDo nald & Jenkins. Other factors mentioned by McDonald & Jenkins (2008) include first born infants, multiple gestation and occurring in the left hip more frequently than the right.