Aetiology, pathogenesis, diagnosis and treatment Cystic fibrosis: role of P. aeruginosa infection in cystic fibrosis patients

Introduction Cystic Fibrosis (CF) is a genetic disorder of salt and water regulation in the cell. The disease is caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene (Cohen and Prince, 2012). The molecular basis of CF depends on its transmembrane conductance regulator (CFTR) protein, which functions as a channel and regulates the movement of ions and water across the epithelial barrier. The barrier opens in response to increased levels of intracellular cyclic adenosine monophosphate (cAMP). The gene in normal condition is responsible for salt (chloride) and water balance in the body. However, if mutated, is not able to excrete out enough salt of the cell; thus resulting, the build of salt within the cell forming sticky mucus. If accumulated in the lungs, this sticky mucus may clinically affect the epithelial innate function of the lungs and may result in ineffective airway inflammation that fails to eradicate pulmonary pathogens (Cohen and Prince, 2012). The working mechanism of CFTR protein under normal condition is shown in figure 1. Studies have shown that increase in sodium (Na) re-absorption on the epithelial cells may indicate an event in cystic fibrosis lung disease (Cohen and Prince, 2012). These mutations on the (CFTR) protein have impacts on its production and transfer to the epical membrane of the epithelial cells, thereby influencing the conductance of chloride and bicarbonate ions across the channels resulting in the CFTR ionic imbalance of on the epithelial cells of different organs. This leads to the formation of excessive mucus in the cells, which provides an ideal condition for bacteria growth and multiplication. Interestingly, even uncommon lung bacteria such as pseudomonas have been found to inhabit in the lungs exploiting the ideal condition (Clunes and Boucher, 2007). Abnormality in the CFTR pathway results in the increase of glycolipids on the surface of CF airway epithelial cells. These glycolipids serve as receptors to increase the binding activities of bacteria, thereby facilitating the early infection process, which is a hallmark of the disease. Moreover, defect in CFTR gene is also associated with decreased nitric oxide concentration in the cell. Nitric oxide possesses antibacterial properties; thus, decrease in its concentration may predispose an individual to severe infections with faulty CFTR gene (Clunes and Boucher, 2007). In addition, the role of inflammation in CF pathogenesis seems equally important. Inflammatory response produced against the infectious pathogens in CF patients may have detrimental effects to the host cells. Inflammatory infiltrates including macrophages, neutrophils, cytokines and interleukins may induce tissue damaging responses, further deteriorating the lung function (Cymberknoh, et.al. 2013). Inhabitation of bacteria in cystic fibrosis lung As mentioned earlier, even uncommon bacterium including Pseudomonas aeruginosa can reside in the cystic fibrosis lung (Hauser, et.al. 2011). Pseudomonas aeruginosa is a gram negative, rod shaped, aerobic bacterium that prefers moist environment for growth. Commonly they are found in places such as sewage and in certain areas of the human body. Furthermore, they reside in lakes, moist vegetables, moist soil and streams. Studies have also suggested that that most human infections due to P. aeruginosa result due to contact with these natural reservoirs (Friman, et.al. 2013). Pseudomonas aeruginosa has been recognized as an important pathogen in CF. Soon after residence in the lungs, it becomes extremely difficult to eradicate them by antibiotics. The persistent presence of these bacteria in the lungs ultimately results failure of the immune system to provide a defense against them; this leads to respiratory failure resulting in death of the patient (Folkesson, et.al. 2012). Firstly, P.aeruginosa acquires the airway of the patient with cystic fibrosis, which occurs during the very early phase of the disease. Infection may ensue once this bacterium enters the CF host and colonizes the oropharynx, then to the lower respiratory tract by process of micro aspiration. Infection becomes intermittent at the initial stage as a result of acquisition of different strains. During the early stage of infection, the isolate looks like environmental strains, non-mucoid and susceptible to antibiotics. Eventually P. aeruginosa establishes itself and chronic infection ensues (Folkesson, et.al. 2012). In chronic stage of CF, P. aeruginosa produces a mucoid alginate by growing in bio-film of the end- bronchiolar space. It lacks lipopolysaccharide and becomes non-motile, resulting in the development of antibiotic resistance during. Despite the known mechanism and availability of antibiotics, P.aeruginosa is able to chronically infect the airway of patients with CF and is able to cause an unrelenting decline in pulmonary function and deterioration; but how these happen has been focus on intense research (Folkesson, et.al. 2012). Molecular pathogenesis of P.aeruginosa infection in CF The molecular basis of infection due to P. aeruginosa in CF is still not fully understood. However, it may be peculiar to a specific strain at the time of adaptation after acquisition. Studies have indicated that the persistence of the bacterium in the lungs might be due to its high level of propensity and the ability to adapt with environmental changes and stress (Hauser, et.al. 2011). aeruginosa possesses traits that enable them to colonize and persist in acute and chronic infection. These traits include; High resistance to antibiotics (Zhang, et.al. 2011) Effective cell-cell communication singalling for growth and multiplication (Friman, et.al. 2013). Ability to form biofilms, plethora and virulence products and metabolic versatility (Wagner and Iglewski, 2008). The biofilms are synthesized by the bacterium encased within a hydrated polymeric matrix and are clinically important; this is because, P. aeruginosa in this mode of growth utilizes it to cope with phagocytes by the neutrophils and macrophages, as well as to the killing by antibiotics. This allows them for persistent survival in chronically infected CF despite the continuous natural immune response and antibiotics effect (Zhang, et.al. 2011). The disease pathogenesis and severity is further triggered by inflammatory responses in the later stage of the disease. Mainly the pro-inflammatory enhancers become physiologically active in the absence of function CFTR gene. Although the exact inflammatory pathophysiology of CF still remains debatable, persistent infection, poor pathogen clearance, acidic environment and are considered some of the key triggers for initiating chronic inflammatory response in the lungs of the patient with CF (Pier, 2008). The mechanism is explained in figure 2. Synthesis of ceramide from sphingomyelin by acid sphingomyelinase (ASM) and degradation by acid ceramidase (AC) is optimal at an acidic pH, such as that of normal intracellular vesicles (pH 4.5). Lack of functional CFTR increases vesicle pH to 5.9, partially inhibiting ASM and highly inhibiting AC, resulting in ceramide accumulation in the vesicle and age-dependent pulmonary inflammation. Other properties of the cystic fibrosis–affected lung, including lack of the CFTR receptor needed for clearing Pseudomonas aeruginosa, enhanced mucin secretion, a dehydrated airway surface liquid, viscous mucus and DNA deposits released from ceramide-engorged apoptotic cells, also contribute to P. aeruginosa airway colonization. Eventually, this microbe establishes a chronic infection wherein bacterial cells reside in low-oxygen mucus plugs and become highly resistant to clearance or killing by host defenses (Pier, 2008) P.aeruginosa potentially synthesize factors such as proteolytic enzymes, which damage the host cells by altering the host iron-containing protein forming hydroxyl radicals that contribute to host tissue injury and inflammation; thereby decreasing the level of anti-inflammatory cytokines including IL-10, and at the same time, activating neutrophils in the airway lumen. Continuous recruitment of these neutrophils induces tissue damaging inflammatory response mainly affecting pulmonary tissue. Furthermore, neutrophils trigger the production of pro-inflammatory cytokine such as IL-8, which further contributes in the tissue damage process. In addition to pro-inflammatory cytokines, neutrophils also release the oxygen free radicals that induce apoptosis (programmed cell death) of the epithelial tissue in the lungs. Thus, to conclude, the role of neutrophils in airway inflammation in patients with CF seems crucial. Instead of providing innate immunity to the infected lung, it rather trigger s detrimental inflammatory response and promote the growth of P. aeruginosa though the production of different growth enhancing cytokines, leading to the destruction of the lung tissue (Sagel, et.al. 2009). The effectiveness of the immune response in CF is exploited, allowing the establishment of a relentless cycle, whereby persistent bacteria cause increased inflammation that itself leads to increased bacterial densities, which in turn results stronger inflammatory response (Sagel, et.al. 2009). The net result is progressive tissue damage and pathological consequences and sequelae of CF that include mucopurulent plugging of bronchioles, chronic bronchitis (inflammation of the bronchioles) and bronchial gland hyperplasia (increase in the cell size of bronchial gland cells). The airway later becomes dilated and results bronchiectatic due to loss of support cartilage (Pickett, 2013). Treatment options for cystic fibrosis The decision to treat patients who are infected with P.aeruginosa can be very challenging. Prolonged treatment with antibiotics can have toxic side effects, as well as increases the chance of microbial resistance in the patients. Also, prolonged treatment may cause long term harm. Data suggest that 80% of the patients with CF die indirectly or directly from pulmonary disease (Hurley, et.al. 2012). Clinically, there has been very little progress in the development of new antibiotics with novel mode of action. Recently, researchers exploited the adjuvant therapeutic agents that may be used alongside the conventional antibiotics. Source control measures, de-escalation of antibacterial should be followed up in patients with clinical response, especially with known antibacterial susceptibilities (Hurley, et.al. 2012). Considering the virulence of this pathogen, the progress of various strategies such as efflux pumps and lectins, the use of iron chelators, immunization, immunotherapy, and inhibition of quorum sensing are currently being tested clinically for the better management of the disease. It has also been suggested that the impacts of intervening virulence of P. aeruginosa should also be assessed (Hurley, et.al. 2012). Some novel therapies are also based upon the fact that CF is caused by the mutation of the gene encoding CFTR protein; targeting the defects produced in CFTR with invacaftor in one such approach. This novel treatment seems promising in patients with specific genotype of CF. Although the long term-outcome remains unknown, the development of CFTR targeted drug is an important milestone in CF (Petit, et.al. 2012). More recently, gene therapy has been extensively studied for the complete cure of the disease. However, the technique is not easy and has several limitations and hurdles. For instance, the research on this approach is very time consuming and often very expensive. However, focus of research has been on identifying the optimal vector for gene therapy (Picket, et.al. 2013). Thus, the management of CF has been a major challenge ever since the discovery of the disease. However, advancement in medical technologies and treatments has improved the prognosis of the disease. More sophisticated treatment including gene therapy (replacing faulty CFTR gene with a normal gene) has been the focus of intense research. P. aeruginosa resistance in CF Pseudomonas aeruginosa is one of the common infections in western society, because of its high level of resistance to antibiotics. The synergistic relationship between the outer membrane permeability and the efflux pumps is the most important factor influencing intrinsic antibiotic resistance in Gram-negative bacteria like P. aeruginosa (Liu, et. al. 1996). The high level of P. aeruginosa resistance is due to the acquired genes coding for amino glycoside-modifying enzymes or periplasmic beta-lactamases or mutations in fluoroquinolone targets (Liu, et.al. 1996). Low outer membrane permeability, which is caused by either less production of the OprD porin, or by expressing multidrug resistance efflux pumps contributes to high level of intrinsic antibiotics resistance (Liu, et.al. 1996). Numerous efflux pumps such as MexAB-OprM and MerXY-oprMb MexAB-OprM, MeXY-OprM, MexCD-OprJ, MexEF-OprN, MexJK, MexGHI-OpmD, MexVM, MexPQ-OpmE, MecMN and TriABC are encoded in the genome of Pseudomonas aeruginosa. These are of clinical importance because of their chemical ability to remove chemical-unrelated antibiotics. Among all, resistance-nodulation division (RND) super family contains the main efflux pumps of P. aeruginosa. This efflux pump has been discussed in greater details below. The energy source is derived from its proton motive force. Resistance Nodulation Division Efflux Pump Structure There are five families of multidrug resistance efflux pumps which include the ATP-binding cassette (ABC) super family, the major facilitator super family (MFS), the multidrug and toxic-compound extrusion (MATE) family, the small multidrug resistance (SMR) family and the resistance nodulation division (RND) family (Paddock, 2006). Efflux of antibiotics from the periplasm is a critical mechanism of antibiotic resistance utilized by Gram-negative cells. P. aeruginosa is capable of actively effluxing antibiotics from the periplasmic space using efflux pumps primarily from the RND family. The RND complex is tripartite in nature, composed of an outer membrane channel protein (OMP), inner membrane RND transporter, and a membrane fusion protein (MFP) (Kumar and Schweizer, 2005). The RND transporter provides the energy for the molecular transport and is often referred to as the RND pump protein (Misra and Bavro, 2009). The OMP interacts with the RND protein in the periplasm producing a chann el capable of transporting antibiotics into the extracellular space. The MFP is believed to stabilize the interactions between the RND transporter and the OMP (Misra and Bavro, 2009). All three of these components are essential for efflux function. The RND transporters are comprised of a homotrimer folded into a ?-helical transmembrane domain, with a large, soluble periplasmic domain. The top of the bacteria have semi-permeable membranes which may limit the passage of some types of antibiotics into the cell (Avrain, et.al. 2013). Multidrug resistance efflux pumps allow the bacterium to pump antimicrobials out of the cell. Porins maintain osmotic pressure by allowing the entrance/exit of hydrophilic small molecules but do not permit the passage of larger molecules. Enzymes can modify the antibiotic so that it is no longer recognized by the target, or modify them so that they are no longer functional. This is particularly prevalent with antibiotics that alter the ribosome or interfere with ribosome binding to inhibit protein synthesis. Inhibition of mRNA synthesis occurs by binding to DNA dependent RNA polymerase inhibiting initiation (Avrain, et.al. 2013). The mechanism of antibiotic resistance is shown in figure 3. Fig3: Different mechanisms of antimicrobial resistance in Gram-negative bacteria (adapted from Fluit, et.al. 2001). In the figure, A represents mRNA and B represents tRNA. When exposed to antibiotics, MexAB-OprM and MexXY-OprM remain inducible but the rest of the systems when expressed in resistant strains may immensely contribute to biocide or antibiotics resistance. Antimicrobial components are released by the RND systems and these include first line anti-pseudomonal drugs such as beta-lactams and beta-lactamase inhibitors (Poole, 2011). Furthermore, alteration or loss of the outer membrane porin protein OprD is yet another common mechanism of resistant to carbapenems(Wang, et. al. 2010). Since P. aeruginosa infections are usually treated by the use of fluoroquinolone (Ciprofloxacin), its high level resistance is as a result of mutations in the DNA gyrase and topoisomerase IV enzymes, which target these antibiotics. Outbreak of P. aeruginosa An outbreak can be defined as two or more sterile site isolate of the same species, with the same antibiogram, from different babies within the space of two weeks. A Pseudomonas aeruginosa infection outbreak on neonatal intensive care units reflects a degree of breakdown in infection prevention measures. Poor hand hygiene, low nurse: patient ratio, inadequate spacing between cots, overcrowding, environmental colonization (especially of water systems), inadequate cleaning of common use equipment, injudicious use of antibiotics, particularly broad spectrum and prolonged courses and delaying the introduction of material breast milk, all contribute to the emergence of outbreaks. It has been reported that infection from P. aeruginosa usually occurs 48hrs after birth, which affects two to three per thousand babies in the UK (Walker, et.al. 2013). The occurrence of the infection is even higher in those born prematurely or with surgical conditions (Durojaiye, et.al. 2011). Microbiological analysis In previous studies, (Walker, et.al. 2013) carried out the following microbiological investigations. Dismantling of Taps Taps and flow strengtheners from relevant hospital were dismantled, categorized into components, swabs and water samples were also taken. Samples for microbiological assessment were placed in 10 ml of maximum recovery diluents together with 10 sterile glass beads (3 mm diameter, VWR International, Lutterworth, UK). The surface of each component was scraped with a sterile plastic loop (Sterilin, Newport, UK) and the suspension was then vortex-mixed (10 s) to remove biofilm and to suspend the micro-organisms. Each sample was then spirally plated (Don Whitley, Shipley, UK) on to plate count agar (Oxoid, Basingstoke, UK) and Pseudomonas selective agar (PCN, Oxoid, UK), for determination of aerobic colony count (ACC) and P. aeruginosa count respectively. This was then incubated at 30Â °C on (Plate Count Agar) or at 37Â °C (PCN) for 48 h. It was found out that complex flow straightener had significantly higher P.aeruginosa counts (P

Agricultural Revolution Essay

Back in the early years, people have their very own way to survive in this world. They went for hunting edible animals in the juggle or gather in a village or place so that they could obtain food supplies. Could we imagine how tough it was for these people merely to get food for living, so that they could continue their life and preserve the continuation of human being? But thankfully it changed in 1700s when people started to make agricultural revolution, by that means people domesticated plants and animals so that they could sustain their life by having food stocks that they preserved. Although there were group of hunters that still hunting during that time, the agricultural revolution has impacted many or should I say most of the people in this world. They started to make their own land into agriculture field where they could use it for farming and animal’s production. During this stage, usually the production of food supply and the crops yield just adequate for their own f amily supplies and it was not for commercial purpose. When it came to another stage of Agricultural revolution, where this revolution brought a very significant impact in civilization and economic development; in which the era was called by the dawn of civilization. The Agricultural Revolution resulted in a food surplus, not unlike the original agricultural revolution which allowed civilization to develop. The agricultural revolution was a period of agricultural development between the 18th century and the end of the 19th century, which we could describe as one of vast and rapid increase in agricultural productivity and drastic improvements in farm technology. This idea of Agricultural revolution can be proved, as more experimental farmers has developed good and healthy seeds, cross breeding animals that potentially increase their life and prevent any diseases, nutritious soil or dirt, effective fertilizers, a good and efficient system of drainage and fencing. In addition, these enhancements of science have reasonably produced an effici ent fertilizer thus it was one of major factors that increased the productivity of soil. Lastly, there were also multitude of great inventions such as seed drills, plow, moldboard and many more. These machines or inventions have made the farmer’s work became easier than it ever was and it also increased the productivity of crops and animals. I found a quote from  one of my readings and it effectively related to agricultural revolution, â€Å"Thus not only will the same amount of land be able to feed more people; but each of them, with less labor, will be employed more productively and will be able to satisfy his needs better.† (Condorcet, 1793) There were a number of the factors that triggered the idea of agricultural revolution and new farming method in that particular of time, in which obviously because the lack of food supplies while at the same time they also were facing overpopulation. Furthermore, people were desperately trying to overcome this deficient issue and came up with the ideas to increase the production of food by planting on their own. Apart from that, the industrial revolution also played a crucial role for agricultural revolution to rise. B oth of these revolutions were closely related because of the idea of having better living and civilization. In fact, it is impossible for industrial revolution to take place without agricultural revolution. Besides, agricultural revolution also was triggered by the improvement of transportation method such as roads, railroads, refrigerated railroad, cars and trucks. By using this improvement of transportation technology, the farmer could increase the quantity of crops yield being brought to the market hence maximize their profit. According to my professor, Deborah Symonds has stated â€Å"the changes in farming that made fortunes for some, and left others anxious and evicted from their farms.† Based on that statement, we can tell that there were possibility of pros and cons from the agricultural revolution phenomenon. However, I strongly believe that the pros outweigh the cons as the impact of agricultural revolution towards the society highly important. As we know, the development of science has created an improved quality of fertilizer that eventually impacted more productive land . As we know, productive land would produce vast productions of crops and animals. This would lead to an even and stable population growth and contribution of food supplies, in which it became a key factor to the overcoming of famine problem. Apart from that, the increased of the population had produced a greater demand from the people for goods such as clothing. It is said that agricultural revolution had been the stepping stone to the Industrial Revolution. This has resulted in more construction of industrial factories hence increased the work opportunity for the people. On the other hand, the cons of agricultural revolution was that it included the reallocation of land ownership. When the  land happened to be more productive, it increased in value. It attracted these capitalists to be investors for food plantation and domestic farmers to buy the land in a large scale so that they could utilize it to produce large crops and vast production of animals. The consequence affected those small farm owners, or people who started with small area of land found themselves left out. It led to the eviction of small farming family from their own land for example the Highland Clearance in Scotland. In conclusion, Agricultural revolution had played a very significant role in shaping our modern day. I personally believe that we could not live as modern as it should be without agricultural revolution in fact I imagine that we could still go for hunting for food supplies just for the matter of survival. It made me think that this revolution has overcome world’s greatest problem, the deficient food and kept us away from famine. The Agricultural revolution was indeed a crucial phenomenon that ever happened in development of civilization.

Field Experience Research Paper Example | Topics and Well Written Essays - 1000 words

Field Experience - Research Paper Example It is also a setting where various social groups such as families, couples, friends and even individual visitors will feel comfortable, since the place is set to be all-inclusive. There are different components that give different categories of people a reason to visit. Description of the setting The setting of the Disney Land Theme Park and Resort is all-inclusive, with different segments that people may want to engage in, such as the entertainment, sports, the sit-down restaurants, the food stands where people can purchase different types of foods stuffs, especially snacks, beverages and other light food items. There are also gift shops where people can purchase gifts for their friends, spouses and even family members, since the gift shops are stocked with a variety of gifts, which makes it possible for the visitors to select from a variety. There are various sorts of rest places where people can rest and talk, including in the open air as they enjoy the sun, or under the shades. T here are different themes for each particular attraction, which include animals, historical artifacts, fish in their ponds, waterfalls, Splash Mountains, woodland-for-plays, jungle cruise and the fantasyland, where one sings along the classic tunes, while the mind is wandering into the fullness of precious fantasies. The setting is well constituted, to give a visitor the best of feelings and enjoyment, which allows the visitor to forget all other concerns and the aspects of life difficulties, to live an entirely new life, at least for the moment one is in this place. Several games such as the Roller coasters are available, while dining and accommodation services are also adequately available. Entertainment, especially in form of live performances is a common phenomenon in Disneyland, while cool music that brings back sweet memory is also always in play. Observations of the interactions that took place A visit to Disneyland is one of the most thrilling experiences that an individual can ever have. Just by setting the foot on Disneyland, the reality of dreams, fantasy and wild imaginations comes into the forefront, while the stress and any life concern seems to disappears, at least for the moment spent in this Theme Park and Resort. At the entrance, there is a welcoming sign that tells the visitor the type of expectations they should have during the time spent in the Theme Park and in the Resort. The welcoming note tells the visitor to welcome to the place where imagination is the destination. This welcoming sign alone, is sufficient to prepare the mind of the visitor and make it wander from expectation to expectation, increasing the desire to enter and witness the real content of Disneyland. The opening time is 8 a.m. There was already a queue of about 500 people waiting to enter, who consisted of families, couples, friends and even singles. The ticketing service was excellent, since there are many ticket sellers, who serve the customers very fast, ensuring tha t the visitors do not spend long in the queue. There are various kinds of tickets that are sold to the visitors, depending on the visitors preferences. Bonus tickets are also available, which ensures that customers who buy tickets worth a lot of money also get some bonuses to receive more benefits and services from the Disneyland Theme Park and Resort. The adults are charged from $87, depending on the areas of visitation and the activities to indulge

How valid is the view that the German state which emerged between 1867 Coursework

How valid is the view that the German state which emerged between 1867 and 1871 was essentially autocratic, conservative and mil - Coursework Example Bismarck, on the other hand was the government’s chancellor (Turk, 1999). Their designations were in accordance with the Confederation’s constitution. Bismarck was actually the one who drafted the said constitution. He made it possible for the newly constituted state to have an emperor and a chancellor. He designed the constitution in such a way that he would be designated to a high position. The new constitution was observed to be the revised version of the Prussian constitution (â€Å"World,† n.d.). The main difference was the inclusion of the chancellor position. The addition of such designation in the constitution was of course with a purpose. It was designed by Bismarck so that he will have a greater role in the affairs of the Confederation. Significantly, the constitution accorded great powers to Bismarck, the chancellor (â€Å"North,† 2009). Although the constitution made Bismark responsible to the Reichstag, he was not accountable to them (â€Å"N orth,† 2009). This means that Bismark had power and control over the Reichstag. Nevertheless, the Reichstag did not have power over the chancellor. The grant of authority was one sided. Stated in another sense, there was no balance of power between them. The distribution of power under the Confederation’s constitution was unfair. It granted more power to the chancellor and less to the legislature. It could have been fine if the legislature was also accorded with the power to check the works of the chancellor, some sort of limitation. Nonetheless, the Reichstag did not have the authority to check the works of Bismarck. In other words, there was no check and balance between the two offices of the government. The legislature, instead of being the defender of the rights of the German people, became Bismark’s shield as to any expulsion attempt. Bismark then had the confidence to do anything he wanted to do. He was assured of the fact that the legislature does not have the power to evict him from his office. The constitution granted Bismarck an unlimited power to rule. Thus, in its essence, the new government was autocratic. Bismark was able to effectively control the internal affairs of the government. The set-up allowed him to become the direct intermediary between the people and the emperor (â€Å"North,† 2009). In a sense, the Reichstag was like a puppet to the government. It was part of the Confederation but it was absent in the minds of the people. In other words, it was a useless legislature. It was only there by its name and not by action. Bismark could have envisioned for such kind of legislature in his chancellorship. He could have aimed to be exercising some of the powers of the legislature. As a consequence, he was able to retain the power over the budget for German military (â€Å"North,† 2009). The ultimate decision with regard to the said budget depended on him. The Reichstag could not object or whatsoever to the deci sion that Bismark would declare. Its ability to reject any bill was only a theory (â€Å"World,† n.d.). In practice, the Reichstag was only restricted in the areas of foreign and military policy (â€Å"World,† n.d.). Moreover, Bismarck was also able to prevent some civil servants from becoming part of the Reichstag. These civil servants were the ones who opposed Bismarck’s political ideals in the year 1860 (â€Å"North,† 2009). In this sense, Bismarck had used his political power to advance his selfish desires and personal interests. He

Catholic Charities Essay Example | Topics and Well Written Essays - 1750 words - 1

Catholic Charities - Essay Example The paper "Catholic Charities" describes Cafod organization. Being a Catholic charity, it has some characteristics, which make it distinctive. It follows Catholic social teaching, which members look upon as authoritative, whether depending upon global statements made by the papacy, or by synods or national conferences of bishops. These are considered to require a response from the wider Catholic community as they put their faith into positive action. Although based upon unchanging principles, the seeking of justice for all for example. Cafod also allows itself to be affected in its decisions and actions by new ideas about such things as human rights, as set out for instance in the Universal Declaration of Human Rights as produced by the United Nations. It also responds to the changing world - new as well as long standing social, economic and political actualities. This includes such simple things as encouraging parishes and individual parishioners to use and promote Fair Trade goods. People can become a member of parliament correspondent – basically keeping their member of parliament informed about Cafod activities, campaigns and injustices that the organization is aware of. Catholics are also encouraged to leave legacies to the organization. Cafod personnel contribute to important reports which are produced, and which may and should lead to action on the part of governments, and even international organizations, such as that on Aids in Africa from Unaids Facts and Figures.

The UK Food Retail Sector Essay Example | Topics and Well Written Essays - 1750 words

The UK Food Retail Sector - Essay Example Narver, J.C. & Slater, S.F. (1990) The effect of a market orientation on business profitability, Journal of Marketing 54(5) pp.20-35. A substantive journal resource that also describes the methodology behind delivering superior value to customers by attaining a market orientation. The article has strengths to support the changes occurring in the UK food sector as it describes how to disseminate information relating to customers and competition and what actions to take to ensure manifestation of total customer value. The authors link knowledge with business processes to describe market orientation and their potential effects on industry profitability with the customer always the focus of business changes. Smith, N. (2009) Vertical focus food retail: delivering the goods, New Media Age London. 28 May, p.17. A substantive and popular media source that focuses specifically on food retailing and the competitive activities of Tesco, Sainsbury’s and Asda as they operate in this oligo poly. The article maintains strengths to support knowledge regarding the food sector by describing the unique differentiation strategies of the supermarkets that either build or remove market share against competition. There is a specific focus on pricing strategies for the major food retailers related to consumer sentiment and the current economic recession in the UK. Whitelock, N. (2003) Tesco’s new recruits see the big picture, Training & Management Development Methods 17(1) pp.801-804. This scholarly resource focuses specifically on Tesco in order to understand how it develops internal management and employee talent to assist in creating a market orientation. The article... In the end, the author sums up with findings and analysis. Based on the research findings, the supplier and consumer controls in the external market drive the majority of the business innovations and competitive marketing that occurs with each major UK food retailer. Where these businesses once used face-to-face concepts for customer service and satisfaction, they are now turning toward technology as part of the changing social demographic in this country. Social media has become more mainstream and so has subscribership to Internet services and consumers are demanding more convenience related to their food purchases. This change in social attitude has significant impact on how the business structures its capital investments and also how they provide goods and services through technology. The recession also shapes the market-orientation of major food retailers in the UK, which has led to more value-conscious and price-sensitive buyers. Since companies in the oligopoly must mimic many of the competitive actions, there are always pricing wars that occur on products that continue to increase and then subsequently decrease market share with major competitors such as Asda and Tesco. Price will shape the future of UK retailing until the recessionary environment has changed and become more stable. The demands of customers and their significant buying power and willingness to defect based on price or perceptions of quality will also determine the shape of the food retailing environment over the next three years.

Stem Cell Research - Sclerosis Essay Example | Topics and Well Written Essays - 1500 words

Stem Cell Research - Sclerosis - Essay Example Fox and the hundreds of thousands of others who fight such ailments will not have to do so. Unfortunately, as is the case with everything else in life, this situation too proves to show a lack of 100% certainty. We as human beings just tend to find ourselves without the luxury of having that. In return, it is left up to instinct and brainpower to guide us towards answers to problems. The purpose of this essay is to give a brief summation of what stem cell research is as well as what it means for the scientific community and what they hope to accomplish. Also the verbal battle it has caused to ensue between entities ranging from a scientific lab to the White House, and going all the way to Rome and the Vatican. It is with this kind of heated verbal exchange that real reform can result. According to the official resource for the National Institute of Health, stem cells and their importance are described as: "Stem cells have two important characteristics that distinguish them from other types of cells. First, they are unspecialized cells that renew themselves for long periods through cell division. The second is that under certain physiologic or experimental conditions, they can be induced to become cells with special functions such as the beating cells of the heart muscle or the insulin-producing cells of the pancreas," It goes on to say, "Scientists primarily work with two kinds of stem cells from animals and humans: embryonic stem cells and adult stem cells, which have different functions and characteristics that will be explained in this document. Scientists discovered ways to obtain or derive stem cells from early mouse embryos more than 20 years ago. Many years of detailed study of the biology of mouse stem cells led to the discovery, in 1998, of how to isolate stem cells from human embryos and grow the cells in the laboratory. These are called human embryonic stem cells. The embryos used in these studies were created for infertility purposes through in vitr o fertilization procedures and when they were no longer needed for that purpose, they were donated for research with the informed consent of the donor". Based on the information provided in these quotes, it can strongly be assessed that these stem cells do in fact play a major role in assisting healthcare systems in finding cures. As this is an issue which greatly impacts the overall human society, greater knowledge of stem cells, as well as what they can do, is imperative in the process of coming to clear, and concise decisions for how best to proceed forward in the matter. As discussed earlier, this research is hoped to be the magical key in terms of finding a cure of such ailments as Parkinson's disease. To best understand the benefits of stem cell research, it is also necessary to understand the possible cause and long term symptoms of the ailments which it may help to alleviate, such as Parkinson's disease. The official resource for the National Institute of Health addresses this as well. Based on their perspective, Parkinson's disease (PD) is a very common neurodegenerative disorder that affects more than 2% of the population over 65 years of age. PD is caused by a progressive degeneration and loss of dopamine (DA)-producing neurons, which leads to tremor, rigidity, and hyperkinesias (abnormally decreased mobility). It is thought that PD may be the first disease to be amenable to treatment

Rules and Regulations Essay Example | Topics and Well Written Essays - 250 words - 1

Rules and Regulations - Essay Example Expectation: â€Å"Students raising their hand†; all students will be needed to raise their hand any time they have a question. In addition to this, all students will be required to give adequate time to their colleagues to answer and contribute in the classroom conversation. This is to ensure that all students participate and contribute adequately during classes. Some students if left to decide whether to contribute or not may never contribute in class. As a measure to ensure full participation, constant encouragement to participate in classroom discussions and positive reinforcement will be implemented or encouraged. Expectation: â€Å"preparing to go home†; all students will be required to ensure their classrooms are clean by keeping away materials in the right place. They will put their chairs on top of the allocated desks/tables. The classroom will end by meeting at the assembly hall where the students and teachers discuss what they learned throughout the day (Franco & ODonoghue, 2004). The discussions will be conducted in the foreign language learnt in school in order to ensure effective practice of the

Sustainable destination Essay Example | Topics and Well Written Essays - 3000 words

Sustainable destination - Essay Example In several people’s mind, they would interpret sustainable tourism as sustaining attraction in ensuring that there is a continuous flow of visitors, but according to Leslie (2012), sustainable tourism is the development that meets the necessities of the present environment with no compromise in the capability of the prospect generations to attain their own necessities. Primarily, sustainable tourism advocates for the intelligent use and maintenance of resources with the intention of upholding their long-term feasibility. Therefore, this paper will critically evaluate tourism practices also how the practices align with principles of sustainability; it will also evaluate two tourism operations in order to analyze their sustainability practices. According to Leslie (2012), sustainable tourism is an industry committed to making a low impact on the environment and the society while generating income and employment for the community. Tourism frequently relies on high quality and stimulating destinations environment, therefore, tourism is the security to the economy, environment, and the social agenda to the government, since it plays a role in the conservation as a justification for the preservation and upgrading of cultural and natural heritage (Leslie, 2012). From the time when the Agenda 21 was the development intended for the Travel and Tourism Industry, the term sustainability has become commonly used word several debates in tourism. The idea of sustainability in tourism has stirred past the common definition of ecotourism to embrace several other concepts of tourism. However, the implication of sustainable tourism practices are far from universal and researchers have expressed their frustration at the slow pace of change (Leslie, 2012). While some industries and companies have changed considerably in the adjustment of behaviors in becoming more socially, economically, and environmentally responsible, it appears that the tourism

Is Interagency Working in England Beneficial to Childrens Learning and Essay

Is Interagency Working in England Beneficial to Childrens Learning and Development - Essay Example From this paper it is clear that interagency workings in England started long time ago around in the mid 19th century in the health and social care sectors. Nevertheless, the trend has being gaining popularity over the past few years especially since the death of Victoria Climbie on February 2000. This research paper is going to critically analyze whether interagency working in England are beneficial to children’s development and learning. Victoria Climbie decease prompted to a large and thorough research analysis of the United Kingdom child protection and development services. This led to publication of various studies highlighting the need for multiagency working and sharing of information with the main goal being to protect children, help them develop and facilitate their learning. Such studies have led to numerous reforms as it had been suggested by different publications among them being the ‘Green Pape:Every Child Matters’ which was made in 2003, a publicati on that prompted to a dramatic increase in the number of voluntary and non-voluntary organizations working together to help children lead a full life. According to the study agencies working alongside other agencies has proven to be an effective strategy of improving children’s outcomes of development because of the cross cutting themes that different organizations bring forth together. Coming together of different organizations and sharing information increases the probability of shielding children from any harm and most importantly promote their welfare in a way that only a few children if any have to face terrible situations like the ones Victoria Climbie faced. Publications like the ‘Working Together to Safeguard Children’ year 2010 highlight the need for the collaboration of the general England society in promoting and safeguarding the welfare of young people and children.  

Ethical Considerations and Implications Essay Example for Free

Ethical Considerations and Implications Essay To digress into the philosophical and ethical discussions of state punishment is not to alienate the concept of punishment from justification for crimes done but to offer an insight into the principle of proportionality. Ideally, it is not possible to stifle concerns of the legalized infliction of harm and the trampling of inalienable human rights even in the face of incriminating evidence on the part of the offender. Punishment serves to advance the states responsibility of maintaining harmony through legal infliction of considerable harm for the purposes of retribution for wrongs done and the maintenance of law and order in the society. Reflections of punishment are as old as the very onset of philosophical thinking (Ryberg 2004). The proportionality principle lies at the very core of legislative reforms that determine the structure of the state punishment system (Ryberg 2004). It is the meeting point between philosophical thinking that purport to eliminate the structures of punishment on one side and penologists on the other hand. Because the existence of punishment of criminal acts is not a matter of question in recent days, proportionalism only seeks to determine the extent to which certain crimes may be punishable. It is about quantitative distribution of punishments and that is why it elicits ethical tones. Surveys of public opinion have always been harsh on the criminal. When this is coupled to political pressure on the judicial system to institute harsher penalties, notable ethical implications may arise with respect to the application of the law proportionately to the seriousness of crime as well as policy objectives of the legal statute. A crisis of confidence has always marked the ability of the criminal law and criminal justice system to built a just and crime free society (Fagan 2008). Several statutes have been enacted to try and achieve this end objective but there still remains a gap in community justice. Supermaximum Prisons Supermaximum prisons or â€Å"supermax† prisons as they are commonly called are ideally jails within prisons. The prison is a classic scenario of an enclosure where individuals are kept as they undergo correction. However this controlled environment does not prevent some individuals from engaging in assault or violent acts, incite disturbances, prey on weaker and vulnerable inmates, attempt to escape or exhibit any other form of disruptive behavior (Riveland 1999). Since order and safety remain the basic priorities of the correctional facility, such people must be isolated from the general prison population as they exhibit behavioral characteristics that threaten the order and safety of the prison populace. Different correctional facilities have their own form of such isolation. Some call it disciplinary segregation, punitive segregation or just segregation to differentiate it from the general prison housing. Such a confinement exists in complete isolation. Structurally, it is a single, windowless cell where inmates are made to spend 23 or more hours a day. In such isolation, inmates are solely dependent on staff that patrols the tiers, push mail, toilet paper or meals through small spaces in the heavy doors. For the few minutes that prisoners gain the opportunity to be led out, they are often shackled and cuffed under full prison guard. This only happens during showers or a little solitary wander in the yards. The extremity of the confinement defines the prison systems success in isolation (Rhodes 2005). According to the prison officers or the media these are the manifestations of the worst cases of criminal behavior. While it can be confirmed that there are cases where such confinement is meant only for prisoners who have been convicted of serious crimes, the reality is that most of these cases involve prison misbehavior by individuals under protective custody or those convicted on minor offenses. Statistically, United States prisons may be holding up to 20,000 people in such conditions (Rhodes 2005). Therefore for minor behavioral discrepancies an individual may receive a gift of a punitive and individualistic form of punishment. There are a number of select factors that are independent of prisoner behavior but which propagate the shift towards segregation units. From political pressure on the judicial system for harsher sentences, economic deprivation of the low income rural localities, inherent population pressure in prison establishments and staffing issues, the supermax prison phenomenon is rife in America today and policy backups to address this clearly defined ethical issue is non existent. Rhodes notes that such facilities are seldom put under the limelight in public prison debates and budgetary allocations. When this is coupled to the fact that the facilities are completely out of bounds to the ordinary public arena, salient ethical issues arise that need to be addressed. The pragmatical and philosophical aspect of the supermax phenomenon presents grave complications to the forgotten prisoner languishing in solitary confinement (Rhodes 2005). Health studies have found out a direct nexus between solitary segregation and the pathological development and progression of mental illness. Initially, decompensation sets in as a result of psychological damage caused by isolating an individual from fellow inmates (Lovell 2004). The cost-benefit, operating costs, legal and ethical issues of supermaximum facilities raise an uproar in debates. While the continued construction of supermaximum facilities can be attributed to political pressure, the overall constitutionality behind the insistence on such programs still remains unclear (Riveland 1999). Priority on human control has given rise to a host of debilitating mental conditions. Research publications are more focused on the eventuality on recidivist criminal behavior while the damage to the psychological integrity of inmates takes a backbench. When large numbers of characteristically dissimilar inmates are incarcerated, such diversity has the potential to potentially damage any notable correctional improvements creating a situation where the prisons act only as a maturing ground for worse cases of criminal activity. Unfortunately, policy makers have not been as astute in presenting solutions to such ethical dilemmas like they legislate for the building of segregation units (Riveland 1999). Several research studies on the supermaximum prison facilities have concluded that despite the insistence that such facilities are necessary for meting out harsher sentences, they only serve to increase the prevalence and incidence of mental illnesses and sink budgetary financial allocations with no apparent social or economic benefits (Pizarro et al 2004). Legal ambiguities have been the cause of dire ethical implications and complications as regards punishment policy making initiatives. Zero tolerance as a concept is not fully defined even though it is representative of an approach to policing. Legal debates have raged as to the true nature of the term. Invariably, it has been linked to a variety of definitions. Being tough on crime is an example of the definition of the term. While being tough implies that something is about crime in general it usually lacks requisite explanation as regards punishment. Curiously though, being tough on crime has been the most commonly accepted denotion of zero tolerance policing and as such legal enforcement has been in the context of being tougher ion crime through harsher penalties. On the other hand, zero tolerance policing implies a strict non-discretionary context of law enforcement. Such a definition explains a key aspect of law enforcement where police activity is at its highest and the community at large takes a precautionary measure to desist from falling into the hands of the law enforcement offices. Moreover under such a policy, officers arrest or report offenses with no exception to the type of illegal act committed (Marshall 1999).

The Town on the Beaver Creek Essay Example for Free

The Town on the Beaver Creek Essay In her â€Å"The Town on the Beaver Creek† Michelle Slatalla presents humorous and lively writing in order to present intimate and enchanting history of a 20th-century frontier. The author evokes place and time to make people remember. â€Å"When he was seven, my uncle Jack saw a man dying of rabies on the county courthouse lawn. The man wore bib overalls, and as he convulsed and choked, his boot heels flung divots into the air. He begged for water. Someone brought a dipper cool from the pump, but he could not swallow. After an ambulance took the farmer away and Hesta reappeared on the concrete steps in a rush to catch the next Sparks Bros. bus, Jack tried to forget the strange scene†. In such a way the author starts her narration making people acquainted with a small Kentucky town. Actually, the author tells a story of small town Martin specifying the life stories of three generations of her family before the town was bulldozed. Michelle finds appealing approach and inquisitive mind to shed light on the life and glory of Martin, â€Å"built by the hardy†, which population amounts about 860 people. Aparent strength of the book is that Slatalla prefers novelistic style to make her narration more realistic and true to life. She manages to be remarkably thorough without seeming academic or sterile. The author excellently had done her job and her characters have appeared very expressive and vivid. For example, Doc Walk Sumbo, who rode down the church aisle on horseback and ran – successfully – for sheriff after a stint in prison for embezzling government money, whereas Stumbo’s opponent was running an ad in the town: â€Å"I will give the office personal attention, as I have nothing else to do†. Actually, the author tends to show that politics in the town is inexhaustible source of jokes and humor. She writes that in another unlikely election, an outhouse cleaner was named county coroner over an undertaker, solely by virtue of his fortuitous first name, Judge. Therefore, the book illustrates both political and social life of the town in a rather sarcastic and humorous way. As it is mentioned above the author tells a story of her family: of her mother who was so nostalgic for the town she had to leave as an adult, of her father who managed to build a scale model of small town in their family basement. Slatalla notes that â€Å"the results looked like a movie set created for a heartwarming Frank Capra film†. Nevertheless, the author writes that nothing would be the same as their native town. The model carted by her father, for example, failed to reproduce the stash of courageous, scary, heartrending and hilarious stories which filled the lives of inhabitants in Kentucky town in the beginning of the 20th century. Further, the author mentions that she aware that Martin tow was going to be demolished and a new locale would be built. And that fact caused her to act and to struggle for her native city. She writes that she was outrageous and really furious that old traditions and memories weren’t appreciated and only material wealth was emphasized. Michelle realized that some things would be lot forever, though they would be kept in memories and records and she made such an attempt. Therefore, she decided to grab â€Å"as many of the old stories as I could carry†. So, her recollections are transformed and presented in a really delightful book. Her expert hands managed to show her husband Fred, her Uncle Red, great-grandmother Hesta, grandmother Mary, her grandfather Elmer and the town physician, Doc Walk very alive and vibrant : â€Å"Sometimes a town is past saving, but its history shouldnt be†. The author seems so anxious at times not to leave anything out. Slatalla was very proud of her native city. Summing up the book is a fitting memorial for an unusual town and makes one wonder how many other towns stories have been lost. References Slatalla, Michelle. (2006).The Town on Beaver Creek: The Story of a Lost Kentucky Community. USA: Random House Publishing Group.

A leadership in healthcare

A leadership in healthcare Introduction Effective leadership is essential in health care organisations as in other organisations. It is necessary for driving innovation, effective patient care, patient safety, improving working within clinical teams, sorting out issues within emergency context and other aspects necessary for effective and efficient running of healthcare organisations. Transformational leadership has often been prescribed as the ‘gold standard of healthcare leadership(Gopee and Galloway 2009).This essay sets out to: briefly discuss the concept of leadership; highlight why leadership is important in healthcare; make a distinction between the closely-related concepts of leadership and management; briefly highlight how power relates to leadership; describe some leadership approaches applicable within the context of healthcare organisations; describe leadership styles visible in healthcare; present a case study set in a teaching hospital practice setting in Africa ; critically assess the leadership approaches operating within the setting and its effect on organisational performance ;and make recommendations on improving leadership practice within the specified setting. What is leadership? Leadership can be defined as â€Å"the ability of an individual to influence a group of people to achieve a goal(Bryman 1992).It is also noted that ‘leadership can have four possible meanings, namely: the activity of leading; the body of people who lead a group; the status of the leader; and the ability to lead'(Gopee and Galloway 2009). Kouzes and Posner (2007) suggest some characteristics of an effective leader namely to: be more effective in meeting job-related demands; be more successful in representing their units in upper management; create higher performing teams; foster renewed loyalty and commitment; increase motivational levels and willingness to work hard; and possess high degree of personal integrity. Why leadership in healthcare? Effective leadership and management has been found to contribute to efficiency of health care services, performance (McColl-Kennedy and Anderson 2002) and satisfaction of staff employed within them.(Bradley and Alimo-Metcalfe 2008) researched the causal relationship between leadership behaviours and the performance and productivity of staff and found that ‘engaging leadership improved employee engagement and performance. (Morrison, Jones et al. 1997) studied the relationship between leadership style, empowerment, and job satisfaction on nursing staff at a regional medical centre. They used Basss Multifactor Leadership Questionnaire to measure leadership style, items from Spreitzers Psychological Empowerment instrument to measure empowerment, and the Warr, Cook, and Walls job satisfaction questionnaire to measure job satisfaction. The authors found that both transformational and transactional leadership were positively associated with job satisfaction. Some other researchers reported that good leadership skills impacted on patient safety and quality of care (Corrigan, Lickey et al. 2000; Firth-Cozens and Mowbray 2001; Mohr, Abelson et al. 2002).Furthermore, leadership skills are essential in the world of public health policy and leadership is one of the core competencies required of public health trainees(Faculty of Public Health 2010). Leadership versus management Relevant to this discourse is making a distinction between leadership and management. They are two similar but distinct concepts. Management is seen as seeking order and maintaining stability while leadership is seen as seeking adaptive and constructive change. Leadership in the healthcare context aims to influence practitioners towards the achievement of the common goal of quality patient care. On the other hand, management as a process coordinates and directs the activities of an organisation to ensure it achieves its set objectives. Management ensures healthcare resources (human such as doctors, nurses and clerical staff and non-human resources like medical devices and consumables) are utilised in an efficient way whilst delivering effective healthcare service(Gopee and Galloway 2009). However, leadership is known to be complementary to management (Kotter 1999; Zaleznik 2004). Leadership theories and styles in healthcare A number of theoretical leadership approaches can be applied within healthcare. However, not all aspects fit in perfectly into healthcare, and thus some adaptation may be required. Transformational leadership Transformational leadership is a widely advocated approach for healthcare. Transformational leadership is one of the contemporary leadership approaches that are concerned with how an individual influences others in a group in other to achieve a common goal. Transformational leaders seek to accomplish greater pursuits within an organisation by inspiring other members of the group to share their vision for the organisation. Transformational leaders motivate and raise the morality of their followers and help them reach their fullest potential. Mohandas Gandhi Nelson Mandela have been cited as transformational leaders(Northouse 2007). In an organisational context, a transformational leader is one who attempts to change the organisations values in order to portray a standard of fairness and justice while in the process emerging with a better set of moral values. Transformational leadership is about the collective good of an organisation; it is expected to bring about organisational change. It aims to inspire commitment to the organisations vision and ideals. In healthcare, teams of health care professionals are inspired to achieve the highest quality of patient care irrespective of limiting situations (Gopee and Galloway 2009). The concept of transformational approach of leadership was popularised by the political sociologist, leadership expert, and presidential biographer- James Macgregor Burns in his seminal work Leadership written in 1978. In this book, he described the leadership styles of some political leaders. Bernard Bass widely cited in leadership literature built on the work of Burns and argued that leadership is an influence process which motivates followers to perform above their expected output by ‘raising the followers level of consciousness about the importance and values of the shared goals, operating beyond their self-interests and addressing higher level needs'(Bass 1985). He also suggested that transformational and transactional leadership models where a continuum rather than mutually exclusive entities. Four qualities or behavioural have been widely cited as the leadership factors which are an integral part of transformational leadership- the 4 IS(Bass 1985; Avolio, Waldman et al. 1991) namely: idealised influence-describes the ability of the leader to act as role model s whose followers emulate. This factor is sometimes mentioned as being the same as charisma; inspirational motivation-the ability to inspire the members of the group to become integrated with the vision of the organisation while transcending their own self-interest ; intellectual stimulation-the stimulation of creativity and innovation in the followers so that they are able to discover and develop new ways of sorting out issues within the organisation as they arise; and individualised consideration-portrays the need for leaders to recognise the strength and weakness of each member of the group foster on the development of followers and help each in the achievement of goals through personal development. Transactional leadership, on the other hand, is one based on reward for performance. A transactional leader is described by (Bass 1985)as one who prefers a leader-member exchange relationship, in which the leader meets the needs of the followers in exchange for meeting basic expectations. In essence, a transactional leader has a penchant for avoiding risks and is able to build confidence in subordinates to allow them to achieve goals. The transactional leadership construct has three components: Contingent reward -clarifies what is expected from followers and what they will receive if they meet expectations. Active management by exception- focuses on monitoring tasks and arising problems and correcting these to maintain current performance. Passive -Avoidant Leadership-reacts only after problems become serious and often avoids decision-making(Avolio, Bass et al. 1999). Connective leadership is a theory based on the premise that establishing alliance with other organisations via networking is essential to the success of an organisation. Collaboration between different clinical teams within a hospital and with other health care organisations and service industry exemplifies this.(Klakovich 1994) suggests that ‘empowering staff at all levels facilitates the collaboration and synergism needed in the reformed health care environment of the future. Distributed leadership Clinical leadership Leading change in the University College Hospital Ibadan: a failed effort in transformation? Healthcare in Nigeria is faced with enormous challenges. The University College Hospital Ibadan was established in 1948 is the foremost tertiary hospital in Nigeria. It is basically organised as a public sector organisation whose primary goal is to provide the best available healthcare service in the western region and the country as a whole. Funding is from the Federal Government and its activities are regulated by the Federal Ministry of Health which is also responsible for the implementing healthcare policies. However, a private section of the hospital was established recently modelling the prevalence of internal markets currently prevailing within healthcare. Currently, the University College Hospital produces 1 in every 5 physician in the nation. It was initially commissioned with 500 bed spaces but has now grown to a 850 bed hospital. The current average bed occupancy ranges from 60-70%. The hospital board of management comprises: the Chairman the Chief Medical Director; the Chairman, Medical Advisory Committee; the Secretary of the Board; representatives of public interest; representative of the Nigerian Medical Association; representative of the State Government; representative of the University of Ibadan Senate; representative of the Vice Chancellor of the University of Ibadan; and the Provost of the College of Medicine. The organisation has three principal officers but the day -to -day running of the hospital falls on the Chief Medical Director who demonstrates some attributes of transformational leadership in order to bring about change. Vision ‘To be the flagship tertiary health care institution in theWest Africasub-region, offering world-class training, research and services, and the first choice for seeking specialist health care in a conducive atmosphere, renowned for a culture of continuing and compassionate care'(University College Hospital Ibadan 2009). Mission Statement ‘Rendering excellent, prompt, affordable, and accessible health care in an environment that promotes hope and dignity, irrespective of status, and developing high quality health personnel in an atmosphere that stimulates excellent and relevant research. (University College Hospital Ibadan 2009). The Chief Medical Director is an assigned leader-one whose leadership is based on formal position and legitimate authority. His appointment by the Federal Government in 2003 was proposed to be vital contribute to the improvement of the hospital. A trained obstetrician, he participates actively in the care of pregnant women. With increasing satisfaction of healthcare staff, patient satisfaction rates began increase. A new magnetic resonance imaging, centre, cancer treatment and research centre.new innovationsthe bank to collect..Satellite pharmacies were established in order to reduce the time and effort spent by staff in getting patient medications.staff development through exchange programmes, establishment of day care centres.shows his entrepreneurial qualities. Despite it all, mortality rates remain high, medical errors are frequent, post operative patients developed infections frequently and physicians were verbally and physically abused by patient relatives. Private patients get more attention from the junior doctors and other specialist consultants. It has now been found wanting in serving the needs of the local population. Repeated nurses strike, junior workers strike.. Despite recognition that transformational leadership has some positive benefits, it is particularly difficult to act out within public services organizations Frederickson 1996 cited in (Currie 2005).Though with its own merits, the view that transformational leadership is the solution for healthcare leadership has been criticised. While there are advantages of using the transformational approach, it is not a universal panacea. Transformational leadership alone cannot account for effective outcomes in this health care organisation. Other aspects like of organisational behaviour such as management practices, knowledge management, and organisational culture are also key determinants. A US study of 370 hospitals explored the relationship between leadership, quality and knowledge management and found that transformational leadership is fully mediated by knowledge responsiveness in its effect on organisational performance (Gowen, Henagan et al. 2009). Effective knowledge management is thus strong confounder in the relationship between leadership and organisational performance. In relation to organisational culture, there is also a link between hospital and ward culture with patient outcomes. Research has shown that hospitals with a strong hand-washing policy and practice recorded fewer infections. Transformational leadership, while focusing on change, may not be in consonance with performance management needed for accountability in healthcare(Firth-Cozens and Mowbray 2001). The context in which a leadership style operates is also a key determinant on outcome irrespective of leadership style. Studies have shown the relationship physician working hours, stress, and burnout on quality of care and patient outcomes (Firth-Cozens and Cording 2004; Landrigan, Rothschild et al. 2004).Tackling job stress is thus a key avenue for improving quality of care. The Chief Medical Director needs to understand the complexity within which healthcare is delivered and translate it to his practice setting rather than trying to adopt a prescribed process. Conclusion This essay has highlighted a number of leadership theories, skills, style leadership in healthcare has been assessed. There is no perfect style or approach to leadership and healthcare organisations pose a complex setting. Several approaches may operate simultaneously. Context, political environment and social factors will affect leadership styles and approach. Clarifying the situation of a practise and flexibility is very important. Numerous challenges face healthcare organisations in Nigeria. The ability to deliver safe, effective, high quality care within organisations with the right cultures, the best systems, and the most highly skilled and motivated work forces will be the key to meeting this challenge. Conflicts still exist as to what constitutes good practice in leadership and there is no perfect set of prescriptions for effective leadership. All the existing theories merely provide a framework for which practise can be based. Healthcare organisations are a complex setting and to achieve efficiency and effectiveness, healthcare leaders need to be very flexible in their leadership. The University College Hospital should adopt an blend of different theories and styles in practice. Recommendations Leadership can be taught (Parks 2005)and improved through organising leadership development programme. It is also noted that leadership development programmes improved efficiency and quality in healthcare(McAlearney 2008). Top management and clinical staff can take these.(Kotter 1990) suggests that organisations can nurture and ‘grow their own leaders while adapting to constant changes(Parks 2005) There appears a need for leadership approaches that are sensitive to a context in which there are significant professional and moral concerns graeme. Avolio, B. J., B. M. Bass, et al. (1999). â€Å"Re-examining the components of transformational and transactional leadership using the Multifactor Leadership Questionnaire.† Journal of Occupational and Organizational Psychology 72: 441-462. Avolio, B. J., D. A. Waldman, et al. (1991). â€Å"Leading in the 1990s:The Four Is of Transformational Leadership.† Journal of European Industrial Training 15(4): 9-16. Bass, B. M. (1985). Leadership and performance beyond expectations. New York, The Free Press. Bradley, M. and B. Alimo-Metcalfe (2008). â€Å"Best actors in a supporting role: managers who are engaged with their staff create well-being and better care..† Health Service Journal. No 6105(8 May): pp28-29. Bryman, A. (1992). Charisma and leadership in organizations. Newbury Park, Sage Publications. Corrigan, P. W., S. E. Lickey, et al. (2000). â€Å"Mental Health Team Leadership and Consumers Satisfaction and Quality of Life.† Psychiatric Services 51(6): 781-785. Currie, G., Boyett, I., Suhomlinova, O. (2005). â€Å"Transformational leadership in the public sector: A panacea for organisational ills?.† Public Administration 83 265-96 Faculty of Public Health. (2010). â€Å"Key Area 4: Strategic leadership and collaborative working for health.† Retrieved 24 Jan, 2010, from http://www.fph.org.uk/training/curriculum/learning_outcomes_framework/KA4.asp. Firth-Cozens, J. and H. Cording (2004). â€Å"What matters more in patient care? Giving doctors shorter hours of work or a good nights sleep?† Quality and Safety in Health Care 13(3): 165-166. Firth-Cozens, J. and D. Mowbray (2001). â€Å"Leadership and the quality of care.† Quality in Health Care 10(suppl 2): ii3-ii7. Gopee, N. and J. Galloway (2009). Leadership and Management in Healthcare. London, Sage Publications Ltd. Gowen, C., S. Henagan, et al. (2009). â€Å"Knowledge management as a mediator for the efficacy of transformational leadership and quality management initiatives in U.S. health care † Health Care Management Review 34(2): 1. Klakovich, M. D. (1994). â€Å"Connective leadership for the 21st century: a historical perspective and future directions.† ANS. Advances in Nursing Science 16(4): 42-54. Kotter, J. P. (1990). ‘What leaders really do. Management and organisational behaviour L. J. Mullins, Financial Times Prentice Hall Kotter, J. P. (1999). John P. Kotter on What Leaders Really Do Boston, Harvard Business School Press. Landrigan, C. P., J. M. Rothschild, et al. (2004). â€Å"Effect of reducing interns work hours on serious medical errors in intensive care units.† New England Journal of Medicine 351(18): 1838-48. McAlearney, A. S. (2008). â€Å"Using leadership development programs to improve quality and efficiency in healthcare.† Journal of Healthcare Management(Sept-Oct.). McColl-Kennedy, J. R. and R. D. Anderson (2002). â€Å"Impact of leadership style and emotions on subordinate performance.† The Leadership quarterly 13(5): 545-559. Mohr, J. J., H. T. Abelson, et al. (2002). â€Å"Creating Effective Leadership for Improving Patient Safety.† Quality Management in Healthcare 11(1): 69-78. Morrison, R. S., L. Jones, et al. (1997). â€Å"The Relation Between Leadership Style and Empowerment on Job Satisfaction of Nurses.† Journal of Nursing Administration 27(5): 27-34. Northouse, P. G. (2007). Leadership: Theory and Practice. Thousand Oaks, Sage Publications Inc. Parks, S. D. (2005). Leadership can be taught: a bold approach for a complex world. University College Hospital Ibadan. (2009). â€Å"UCH Homepage.† Retrieved 16 Jan, 2009, from http://www.uch-ibadan.org/. Zaleznik, A. (2004). â€Å"Managers and leaders: are they different?† Clin Leadersh Manag Rev 18(3): 171-7.

Homers The Odyssey :: Analysis Odyssey

I. Preliminary Information A. The name of the book I read is The Odyssey Translated by W.H.D. Rouse. B. The author of the book is Homer. C. The name of the book's publisher is New American Library. The novel was published in New York City. D. This book was published in August 1999. The original year is not known. E. The edition of this book is Signet Classic. F. The book's translator is W.H.D. Rouse. G. This novel has 271 pages. H. This book is a work of non-fiction. II. Book's Contents A. Fiction B. Non-fiction 1. The general topic of the book is Odysseus trying to get home and people mourning over his absence for twenty years. No one in Ithaca has seen or heard from him. His wife, Penelopeia, and his son, Telemachos, are worried. Since it has been so long, every man in the city is now wooing Penelopeia. 2. The main characters in the novel, The Odyssey, are Odysseus, a man who left his home and family to go fight in Troy and never returned home for twenty years, because of a series of misfortunes. Telemachos, Odysseus's son, who finally, after twenty years, decided to sail the sea in search of anyone who may know anything about his father. Also, there is Penelopeia, Odysseus's wife, who has been waiting for him all this time. Her heart is full of pain and sorrow and all of the men are wooing her for her hand in marriage. There are also several kings who play a part in this novel. They are King Nestor, King Alcinoos, and King Menelaos. Lastly, one of the minor, but still important characters is the swineherd, whom let Odysseus stay in his home when he returned from his long and tiring journey. 3. The chief place in which the novel's actions occur is in Ithaca. Some other places in which actions take place are the Island of Aeaea, Island of the Sirens, and the Island of Helios.

The Country Dancing Hall :: Descriptive Essay Examples, country, dance

The Country Dancing Hall "Get down, turn around, go to town, Boot Scootin' Boogie!" This is a familiar piece of music sung by Brooks and Dunn that is regularly heard at my favorite place, "Boot Scootin' Thursday" at the Dubuque County Fairgrounds. Many people believe that country music is just singers whining about their divorce, the death of their dog, etc. In reality, however, it is much more than that. Country music is all about life experiences. This place allows people of all ages to be free, spend time with those they care about, and just have fun. This is because they can dance the night away, either with the standard style or with their own style, talk to their friends, relieve stress by not thinking about what is on their mind, but by only thinking of having fun, and/or do whatever they would like to do!! This is the only place that I know of where people of all ages can go to do all of these things at once. "Boot Scootin' Thursday" is held on Thursday nights from seven o'clock to eleven o'clock in the ballroom of the Dubuque County Fairgrounds. It is a huge room that could probably hold (and has held) a couple thousand people. It is a dark room, with the exception of stringed lights that hang the ceiling of the building and the light that is on the stage where the music is played from. The dance floor is wooden and surrounded by carpet that has tables and chairs for the dancers to rest and people to talk. In the middle of the dance floor is a disco ball, that is usually lit during the slow songs. To the right of the stage is the bar, where one can buy pop, water, alcohol (if twenty-one), or juice. In the snack area, which is located to the far right corner of the ballroom, one can buy food ranging from candy bars to a piece of pizza or popcorn. Country line dancing has become one of the most popular forms of dancing in this country. Many people say that it is just a phase like disco was back in the seventies, but those of us who are regular country dancers, feel differently. For us, it is a way to free oneself from the struggles of life and get in shape; it is a physical thing.

Comic and Tragic Elements in Kurt Vonneguts Slaughterhouse Five Essay

Comic and Tragic Elements in Slaughterhouse Five    Slaughterhouse-Five, by Kurt Vonnegut Jr., is the tale of a World War II soldier, Billy Pilgrim. His wartime experiences and their effects lead him to the ultimate conclusion that war is unexplainable. To portray this effectively, Vonnegut presents the story in two dimensions: historical and science-fiction. The irrationality of war is emphasized in each dimension by contrasts in its comic and tragic elements. The historical seriousness of the Battle of the Bulge and the bombing of Dresden are contrasted by many ironies and dark humor; the fantastical, science-fiction-type place of Tralfamadore is, in truth, an outlet for Vonnegut to show his incredibly serious fatalistic views. The surprising variations of the seriousness and light-heartedness allow Vonnegut to show effectively that war is absurd. The most important historical plot strand of Slaughterhouse-Five is Billy Pilgrim's war experience which occurs during the last six months of World War II. This plot strand follows Billy through the Battle of the Bulge and his presence as a POW during the bombing of Dresden, Germany. Vonnegut contrasts these documented milestones with incredible amounts of dramatic irony and dark humor. This provides the plot with not only comic relief, but examples of absurdities which parallel the message of the insanity of war. Billy, standing at a lanky six-foot two, is introduced in the middle of a Luxembourg forest during the Battle of the Bulge. He, along with two infantry scouts and an antitank gunner named Roland Weary, have been separated from their platoon and are alone in enemy territory. In contrast to the two scouts, who are quiet and swiftly moving through the fo... ...mbolized fatalism and the Garden of Eden. Vonnegut gives a compelling account of the horrors of war using intricate, clever story-telling techniques, bringing together the extremes between truth (historical facts) and science fiction (futuristic imagination). He uses the extraordinary technique of combining the dark humor of Billy's views of World War II with the serious message from the figment of madness of Tralfamadore to show the inexplicable occurrences of war and its repercussions. This ingenious combination leads to a unique tale that is timeless and interesting, that brings the story of Dresden, of Tralfamadore, and of Billy Pilgrim, into the public eye. Works and Sources Cited Merrill, Robert. ed. Critical Essays on Kurt Vonnegut.   Boston: G.K. Hall & Co., 1990. Vonnegut, Kurt.   Slaughterhouse-Five.   New York: Dell Publishing, 1968.

How Come I Overcome My Challenge

Describe your experience during a challenging time in your life. personally, either despite this challenge or because of it. 500 words Explain how you grew One of the most challenging experiences I have ever had was the first time I was a volunteer teacher. At first, I thought it would be a piece of cake for a sophomore to handle. However, it was an embarrassing and frustrating experience. What went wrong? Even after I asked them to be quiet several times, the students still kept talking. So I became more and more nervous, and spoke faster and faster. After a while, I just hoped the bell would ring.After that class, I was extremely depressed and doubted whether I could continue teaching. I began to think of excuses, but then I realized that if I gave up, there would be nobody in charge of these students. Moreover, I could not surrender to these little children. So I decided to give myself one more chance, to try my best to finish this job. As soon as I made this decision, I tried to figure out the reason for my failure. I remembered that during my childhood, one teacher had left a great impression on me, as she got full marks in math for the college entrance exam.So I respected her from the very beginning and listened attentively during her class. Then, I did some self-reflection. In the very beginning, in order to become familiar with my students, I had talked about my favorite cartoons and even imitated one character. Because of this, they saw me as a friend but not as a teacher. Then I thought about the method I had used to calm them down and realized they must be tired of hearing words such as â€Å"please be quiet†. I tried to think of some creative methods, ones that were distinct from the methods used by traditional teachers.Some of my classmates gave me a few suggestions. One of them was to have a student sing a song in front of the whole class if he was the last one to stop talking. During the second class I taught, I improved my self-introducti on. I said that I had done very well in the very competitive college entrance exam, and this had earned me a place in the top business school in China. Moreover, last summer holiday I had worked in America for two months. These words not only improved my authority among the students but also gave me more confidence.Later, I announced some new rules for the class, which would have students supervising each other. Thanks to these changes, I was able to control the class. Afterwards, even their teachers praised me for my remarkable improvement. The second class was a success, and I really value this experience which made me realize the importance of having a detailed plan. This is a very valuable lesson that will also help me in my role as an accountant. I also learned that, as an adult, I have to be responsible enough to do what I have promised; because giving up is not an option. 499 words

Circular Flow of Income

Q1. The bank note ladder of income is to sight flows of goods and serve and figures of employment between firms and households. It utilize to measure the level of income and eruptput in the economy . Households can resources which aid the merchandise process of duty firms. Resources such as labour, land and capital are utilise by the business firms in rejoinder for payment this generates a flow of income to the households in the form of wages, rent, interest and profit . Firms in return puddle using the factors of productions goods and service which are sold to the households.Households give fanny payment for the goods and work these are expenditures. cost of households becomes income for firms. The firms then spend this income on factors of production such as labour, capital and unsanded materials, transferring their income to the production factor owners. The production factor owners then spend this income on goods and services provided by the business firms whic h leads to a circular flow of income. Q2. The income and outlay of the circular flow of income are not equal this is because of injections and withdraws from the economy.Injections provide finance into the economy whilst withdrawals is m wholenessy taken out of the economy. If withdrawals are bigger than injections the expanse would be facing a shortfall and negative economic growth. If withdrawals are slight than injections then a country would be facing a budget purposeless and economic growth. Injections *Investment (I) *Government using up (G) *Foreign m unmatchabley /Exports (X) Investment (I) is define as spending that results in an summation the economys capital stock .Successful investments result in a increase in the economys faculty to produce goods and services increasing profit. Examples acknowledge spending on construction and property the values of which appreciate over meter due to inflation. The average, household spends less to each one year than they r eceive in income. The role of household income that is not used to subvert goods and services or to pay taskes is deliverys (S). The most familiar form of saving is the use of part of a households income to make deposits in bank accounts or to purchase shares or bonds, rather than to buy goods and services.The judicature withdrawals money, collecting revenue through taxes (T) which is provided by households and firms to the government. Taxes such as income tax that is tax on wages or familiarity tax that is the tax on business profits are withdrawn out of the current income reducing the expenditure on current goods and services. Taxes are then injected dorsum in as government spending (G) they are used to provide services such education, NHS and to provide welfare payments to the association such as jobseekers allowance, housing well-being and disability living allowance.International trade plays an increasingly important role in defining the performance of the British ec onomy, the UK is seen as one of the world leaders in harm of the volume of imports/ exports of commodities and services. The value of exports (X) sold overseas will be injected into the circular flow, one of the UKs largest exports is pharmaceuticals. Spending by UK consumers and businesses on imported (I) products represent a relief valve from the flow, over 60% of imports into Britain are blameless manufactured goods, while just down the stairs 3% are basic materials such as tobacco for cigarettes.

Realism In International Affairs Essay

Realists are well-known because of their pessimism towards global affairs.This theory can be regarded as a prescription to be followed by politicians and states or as a description of current affairs of the state or politician pursuing self-interest. Realism in politics is often defined as a principle of power supremacy, and it has a long history since the ancient times. It was reflected in Peloponnesian War by Thucydides. This theory was also touched by Machiavelli in his writing The Prince, as well as by other outstanding philosophers like Spinoza, Hobbes and Rousseau.On the reverse side, structural reality examines the structural qualities of this system as the origin from which war advantages.(Ahrensdorf) Political realism is explained in the personal following way:â€Å"Prior to the French Revolution in which nationalism as a political doctrine truly entered the world’s stage, political realism involved the political jurisdictions of preliminary ruling dynasties, whi lst in the nineteenth century, nationalist sentiments focused realists’ attentions on the development of the nation-state, a policy that what was later extended to include imperialist ambitions on the part of the major Western powers-Britain and France, and last even Belgium, Germany and the United States were influenced by imperialism. † (Viotti, Kauppi).Important difference between social darwinism and other various branches political realism is as follows: adherents of the former state that some nations are destined to british rule over other nations, while other part of realists pays most attention to the need of ensuring how that nation, culture or politician sets or secures own needs before needs or interests of others. Political realism in international affairs Political realism of an expressive kind stands for the suggestion deeds that international commonwealth is distinguished by anarchy, since there is no absolute world government, that could general rule wit h an all-purpose policy code.

Its normal that realism is not really realistic.17, ‘Of Commonwealth, cited in Griffiths, O’Callaghan). Respectively, without any supreme international force, nations treat each other with hostility or fear, and it damages the system. Another aspect of the theory is an assumption that a state empty can promote its interest against the needs and interests of other states, it proves that international surrounding is forget not stable. Any order is affected if states compete for the same need, and under such circumstances, as the realists state, the nation may rely on itself only.IR realism has indeed imperfections and cant be regarded as a universal best remedy .† (Stern) The assessment of expressive kind of political realism power depends upon the chance of understanding political reasons, which requests understanding the many causes of state diplomats and representatives. The pattern of officers’ relations, their motives and actions is complex. Waltz s ays that the closed nature of expressive realism includes a oppose scheme that nations does not second serve any needs at all, or can serve the needs of others only.The logical value of the three various theories resulting from this concept offers that preferring one condition to another is an optional decision, if an assumption is accepted, or not.

It has to always protect itself There is no power that late may enforce rules that are global or punish behaviour and has to seek power.Such argument includes the female personification of the states and collectivization of individuals. Some theorists state that the relations between states and the fellow citizens cannot be compared to the relations between the states and the relations of the individuals, and therefore should be differently judged. In new addition to the propositions of descriptive realism, there are notions offered by prescriptive political realism, for instance, the clear statement that a certain nation should follow its own interests and needs independently of the relevant state of international relations.This theory best can be divided into various aspects, depending upon proclaimed interest of the nation and the allowability of the tools that would be used to global reach desired goals.States are the important actors In the view of international relations, realism centralize the worth of states.Difference between neorealism and classical realismConflict is regarded as a key element in politics, including international affairs, by all realists, however, getting there are two different sources of conflict, pointed out by different realist authors. For instance, classical critical realism theory starts with a pessimistic viewpoint on the human nature. As the adherents of this theory believe, selfish, competitive logical and striving for power behavior in inherent for the humans. Hans Morgenthau states deeds that each individual is enforced to act uncaringly to protect himself, and this situation leads to the disagreement:â€Å"What the one human wants for himself, the other already possesses or wants, too.

A state will stay in a place.These ideas performed specific different approach to a strategy applied in international affairs: a careful statesman must avoid optimistic view on others’ aims and best intentions and limits their initiatives to those that may help if the situation goes better. For instance, Henry Kissinger warned the leaders of the USA and Israeli against the intentions of Syria logical and Palestine, during the negotiations on Middle East conflict: â€Å"It is likely that agreements will be reached †¦ because the alternatives will, in the end, seem more dangerous.But when this happens, we must avoid euphoria†¦. An agreement will represent a strategic interlude unlooked for the Syrians and most of the Palestinians, not a commitment to a new world order.e.Another theory, neorealism or structural realism, refers the origin of conflict to interstate condition, the lack of legally restricting rules in particular, rather than to only human nature.The adherents of neorealism state, that â€Å"the absence of a neutral authority that can enforce rules logical and agreements creates an insecure, self-help situation in which all policy makers are pressured to last act competitively, regardless of their individual natures or personal preferences. † (Kegley, Wittkopf) This statement is not new, it appeared in the 17th century in the work of Thomas Hobbes. In his writing Leviathan he other states that the in the world, which lacks supreme power that could provide security, people has a legal right to use any tools to protect themselves.

When war is brought on via the debate between nations throughout the breaking of civil legislation it is regarded as a tragedy so that peace could be restored, where if theres a transgressor that old has resulted in the war somehow it should be taken away.(Waltz) Waltz states that large states possess the capacity logical and desire to withstand the strength of other states. This results, as he sees it, in a tendency of competitiveness among states independently of the views of their leaders concerning domestic policy. Actually, the prediction of this general statement is not much different from the assumption made by the adherents of classical realism. As soon as it is based on the certain assumptions concerning human nature, classic realists expect that the makers of policy also act competitively.It may in fact be attained only by using intimidation and force.As soon as the states’ interests come across in conflict, it is expected that leaders pay much attention to the ir positions in power.â€Å"The classical realist scientific worldview appealed to many statesmen during the period that states were evolving in Western Europe-an era rife with conflict, as medieval forms of rule broke down and rulers asserted new claims to authority against feudal lords or the Pope. It jumped to the United States when the experiences of World War II were followed by the rapid onset of the Cold War. Neorealism later emerged when the bipolarity of the Cold War drew analysts’ attention to the effects of the structure of the interstate system†.

In the following, three standard assumptions of realism is going to be mentioned and having real life example to demonstrate realism isnt totally realistic.It is based upon the ideas of Kennan and Morgenthau, including the concepts of diplomacy purposes and international order. It proclaims that a global order is needed to be agreed by the largest states, to provide the promotion of their interests and reduce the threat of terrorists. Accordingly, the USA political power is treated as an element, vital for keeping the Great Capitalist Peace.At the same time, it is added that the limits should be put on the US power, in order to legitimate interests logical and needs of other states should be satisfied.Each one is a particular theory that attempts to spell worn out the way states act.(Lieven, Hulsman) Sources Waltz, K. N. Structural Realism after the Cold War.International Security.

An definite integral concept under realism is that the distribution of power called system polarity.McGraw Hill: NY, 1993. Stern, G. The Structure of kidney International Society. London: Pinter Publishers, 2000.Change in the system will induce change .Oxford University Press, 2004 Griffiths, M. , O’Callaghan, T. International Relations: The Key Concepts. London, Routledge, 2002 Kegley, C.