The causality of hume and kant Essay Example for Free

The causality of hume and kant Essay Hume believed that mind is a collection of mental perceptions; therefore man cannot have free will. It was this particular pervasive skepticism which Hume has discussed in his book, â€Å"A Treatise of Human Nature†. Hume challenged Kant to investigate the explanation of causality, in the matter of the importance of cause and effect concept. In Hume’s perspective, human can see sequences of events but can never see the necessity that determinism requires. For him ideas are mere copies of impressions; and there is no possibility that human being can create any original ideas; unless they are derived from the senses. Hume felt that it is impossible to bring up impression that a person never felt or experienced before. Thus it is wrong for us to say that one event caused another event or that events are interrelated. The reason that human beings believe in cause and effect is due to the brought up which based on the conjunction of the events or reality. Through â€Å"Critique of Pure Reason†, Kant divined the understanding of knowledge into two; a priori and a posteriori. Knowledge can be independent from experience and all sense impressions (a priori), and can also need to have experience of impressions (a posteriori). Hume’s believed that habit makes human see causality and from constant conjunction of causes and effects, human beings learn to see it as a ‘necessary connection’. Kant agrees that causality is just ‘there’, but it is an a priori concept of understanding the knowledge. The concept of causality is accustomed, and experience derives from such pure concepts, and these concepts and intuitions shape human’s world yet tell nothing about things in them. The concept of causality cannot be performed in an empirical way. Kant declared the transcendental aesthetic is the first stage of mind’s experience. He stated that all sense experience is synthesized through the concepts of time and space. Space stands for itself and does not represent anything in it; however it is perceived in a subjective condition. Human subjectively perceive time as in the reality of time. Kant did not see space and time as world’s properties, but as a general concept given to the human mind. The next step of mind activity is the transcendental analytic, applies categories to the mind, which without the categories human would not be able to think at all. They are; quantity (unity, plurality, totality), quality (reality, negation, limitation), relation (substance and accidents, cause and effect, reciprocity between active and passive), modality (possible-impossible, existence-nonexistence, necessity-contingency). The transcendental dialectic comes last. He mentions that it is mind’s process in understanding matters that lie beyond human’s experiences such as God or super natural elements. The reason is that mind requires detailed information about an object which exists in sensory world; such information about non-material object puts mind at a limitation of understand only the physical world which it can only perceive. Kant mentions that God cannot be proved empirically. Instead faith or belief is necessary to keep the society running (the existence of good or bad, the life after death). For Hume the religion or belief were nothing more than superstitions. Reference: Barry Stroud, Hume. Routledge, 1977. Diane Morgan, Kant Trouble: The Obscurities of the Enlightened . Routledge , 2000.

Health Information and Communication Systems in Ireland

Health Information and Communication Systems in Ireland Is ICT a key enabler in ensuring seamless delivery of healthcare? A comparison between public and private ICT development in Ireland Abstract This study discusses the innovative changes that have taken place in Ireland in the field of healthcare due to the influx of information and communication technologies. Previous Information communication technologies (ICT), including telemedicine, present opportunities to address rural health-service delivery issues. The research shows that effective management of health services and the delivery of quality systems in Irish healthcare organizations have increased. In Ireland patients are expecting more of healthcare providers and are demanding higher standards of care and service. Simultaneously, those paying for health services have become more concerned about rising health costs and possible inefficiencies. As a result there is widespread interest in understanding what makes for an effective health service and in developing better practices to improve existing approaches to healthcare management in relation to ICT. This study highlights the developments in quality-service management in the Irish healthcare sector and focuses attention on the need for the development of a model for quality implementation in healthcare institutions. In sum the study shows that the development of (ICT) has facilitated the emergence of a complex global urban system in which many formerly lower-order cities have been carving out â€Å"niche† specialist functions serving urban fields of transnational dimension. Chapter1: Introduction Purpose of Study The purpose of this study is to highlight the development of the Information and communication system in Ireland and how it has revolutionized the healthcare sector in Ireland. Research Question This study focuses on the following research questions: What are the current trends of technological development in the Information and Communication Technology sector of Ireland? What are various challenges faced by the Irish healthcare system in relation to Information and Communication Technology? Significance of the Study This study is quite significant as it shows that the concept of globalisation has secured remarkable currency in the academic discourse of the late 20th century, despite ongoing questions regarding both its meaning and extent (Clark and Lund, 2000). The development of internationally integrated production and distribution systems, seen by many as the key feature of globalisation, has been a spatially uneven process. A key factor in this respect has been the differential ability of regions to engage in the informational economy, based on new information and communications technology (ICT), which is the main source of wealth creation and economic growth in the modern world (Castells, 2003). The result has been what Friedmann (2005) calls a process of ‘techno-apartheid’ which has divided the globe into ‘fast’ and ‘slow’ worlds (Knox, 2005), distinguished by the connectedness of individuals, groups and regions to the world of telematics. This echoes Ingersoll’s (2003, quoted in Knox, 2005) suggestion that the key division of the workforce is now that between those who have the capacity to operate ICT (the ‘cyberproletariat’) and those who do not (the ‘lumpentrash’). Golding (2006) makes a similar distinction between the ‘technoliterati’ and the ‘techno-poor’. While Knox defines the fast and slow worlds spatially, equating the former with the ‘triadic’ core and the latter with the remaining global periphery, Hoogvelt (2003) argues that the divide is, in essence, social rather than spatial, with elements of both worlds to be found in all regions of the globe. Thus, within advanced economies, a process of social polarisation has been widely reported (Friedmann, 2006 and Sassen, 2004) and has been intimately linked by Graham and Marvin (2006) to the development of ICT use. This is not to suggest that those who work in the fast world are homogeneously well-paid and affluent; rather, they represent a wide range of remuneration levels depending on such factors as economic sector, location, function, ethnic group and gender (Castells, 2006). What they do tend to have in common, however, is relative employment security due to the high demand level for their ICT skills. Rationale This study follows a logical approach and identifies the fact that both in Ireland as well as globally, there are major geographical variations in the relative balance between fast and slow worlds, with the former mainly to be found in the traditional core regions of North America, western Europe and Japan and an additional small group of newly industrialising countries which have had the institutional capacity to invest massively in modern ICT and associated educational infrastructures (Freeman, 2004). The slow world – found predominantly in the less developed countries of the global periphery and accounting for the bulk of the world’s population – is becoming increasingly marginalised and is moving, as Castells (2003, p. 37) puts it, â€Å"from a structural position of exploitation to a structural position of irrelevance†. Definition of Terms ICT: Information and Communication Technology: it is the study or business of developing and using technology to process information and aid communications. Sistem : SISTeM a soft systems methodology, stakeholder analysis and participative simulation modelling. NHS: (National Health Service) The organization providing national healthcare services in the UK. Chapter 2: Literature Review The process of quality implementation has become a key concern for those involved in hospital management in Ireland. In a national context, the effective management of health services and the delivery of quality systems in health-care institutions have increased in significance in recent years. In line with wider developments in other service industries, consumers (patients) are expecting more of health-care providers and are demanding higher standards of care and service. Simultaneously, those paying for health services have become more concerned about rising health costs and possible inefficiencies. As a result there is widespread interest in understanding what makes for an effective health service and in developing better practices to improve existing approaches to health-care management and delivery. In 2005 a comprehensive report on funding from the Commission on Health Funding highlighted that solutions to the problems faced by the Irish Health Service did not lie primarily in the system of funding, but rather in the way that services were planned, organised, and delivered. Similarly, in a report from the OECD (2003), it was argued that although the Irish health system had delivered a continuous improvement in health standards, there was still scope for further improvement in efficiency, and that this could be achieved through better allocation of resources. More recently, the government health strategy (DOHc, 2001) highlighted the requirement for a system to monitor progress and systematically evaluate the quality and effectiveness of health services. According to the strategy: Monitoring and evaluation must become intrinsic to the approach taken by people at all levels of the health services. Specifically, the strategy suggested that the way in which health and personal social services are planned, organised, and delivered has a significant effect on the health and well-being of the population. Organisational structures must be geared to the provision of a responsive, adaptable health system which meets the needs of the population effectively and at affordable cost. One of the guiding principles inherent in the published strategy was that of a â€Å"people-centred† health system. A responsive system must develop ways to engage with individuals and the wider community which receives its services. The health system must become more people-centred, with the interests of the public, patients, and clients being given greater prominence and influence in decision making at all levels (DOHc, 2001). According to Bowers (2001), major structural reform, coupled with strong management and political will, are required to ensure change for the better. In Bowers’ view, finance alone will not improve the system. Rather, a concentrated effort must be made to ensure a responsive and efficient service. As previously noted, a conclusion of the Report of the Commission on Health Funding (2005) was that the solution facing the Irish health services did not lie primarily in the system of funding but rather in the way that services were planned, organised, and delivered. This is reinforced by a recent report on the Irish health-care sector which suggested that the issues and challenges facing the health service are fundamentally the same as those outlined by the Commission on Health Funding, except that they are compounded by much higher expectations/demands by consumers (Deloitte and Touche, 2001). Thus, although modern health services have undergone radical change in many areas (Robins, 2003), managers of health services are currently reporting a large increase in the number of patients needing beds, with consequent ever-increasing waiting lists. Accident and emergency departments are under particular strain, and the difficulties of dealing with the growing needs of the increasing elderly population are beginning to become apparent. Although the Irish health service is free for all those requiring medical treatment through a publicly funded system, the current situation is hauntingly similar to that of the Victorian era of health care in Ireland. As a result, the Office for Health Management in Ireland (OHM, 2001) has suggested that current deficiencies in health-care provision and delivery underline the importance of providing quality service management and implementation in Irish health and personal social services. In achieving this aim, the OHM has contended that those working within the system must change how they go about their work and how they work together. Changed public-sector environment The focus on health-care service and quality has evolved from a more general interest in continuous improvement initiatives within the public sector. The prevalent trends in the private sector are towards continuous and pervasive change and increasing interdependencies, and it has been suggested that close parallels can be drawn between the private and public sectors. Public-sector organisations now find themselves in a cyclone of change as they attempt to adapt to turbulent environments in a pragmatic and systematic way (Lovell, 2004). In the UK and also in Ireland, these organisations have been subject to cuts in government spending, as well as demands for enhanced efficiency and effectiveness. In response to such changes, there has been a policy shift towards greater competition and an attempt to apply management practices from the private sector to the public domain. The Irish public sector has been officially pursuing change and reform through its strategic management initiative (SMI), a program for improving the management of the civil service which was formally launched in 2004 (Department of the Taoisearch, 2004). The SMI evolved from the growing internal and external pressures for better services and for more effective management of public services. In that context the continuous improvement of customer service has been a specific focus of the SMI since 2003, when the quality service initiative was launched. The program set out a series of quality principles according to which dealings with the wider public would be coordinated and managed. These initiatives aimed to make public administration more relevant to the citizens for whom the service exists, and simultaneously sought to remove barriers which have traditionally restricted performance and job satisfaction within the public sector. In recent years, Ireland has experienced a rise in consumerism. Increases in revenue available to fund public service provision have gone hand in hand with rising public expectations of standards of service. As a consequence, management skills and competences in providing for improved standards of customer service have become recognised as being central to delivering real transformation in the public sector. However, the development of such capabilities, particularly in relation to managing effective quality implementation, presents considerable challenges for those involved. Nowhere is this more evident than in the health-care sector. A review of recent international evidence points to the challenges of implementing quality service in health-care institutions. Gaucher and Coffey (2000) confirmed that implementing a process of total quality management (TQM) in health care is a pragmatic, specific, and systematic methodology. However, this requires a firm commitment from the leadership to change their former ways of working and doing business. Gaucher and Coffey (2000) cited many reasons for TQM failing – including poor leadership and a lack of management commitment – but also noted that revitalisation can rejuvenate the process. These authors asserted that the role of those implementing the process is to nurture and breathe energy into the process when enthusiasm and commitment are declining. The importance of the support of senior management for quality-management projects is also advocated by Berwick et al. (2000). These authors undertook a national demonstration project in the USA in the late 2000s and described how organisations could implement the entire quality-improvement process – from defining the problem through to implementing a solution and consolidating the gains (Berwick et al., 2000). A literature review carried out by Jackson (2005) identified that much work had been undertaken in the UK in determining the clinical effectiveness of many health-care organisations, but that very little research had been implemented in the area of managerial effectiveness. Furthermore, West (2001) determined that, in organisations that outperform others on different dimensions of performance, there was evidence that management is important, as are the combined efforts of individual clinicians and teams. There have been several approaches espoused for achieving quality management in health-care institutions, many of which have been technical and generic in their approaches (Moeller et al., 2000). Specifically, Donabedian (2000) introduced the concepts of structure, process, and outcomes, along with the development of self-assessment and accreditation through the International Organization for Standardization (ISO). In many instances these programs have met with mixed reactions, and their implementation has varied. A criticism levelled at hospital performance is that it has been rather insular, and has paid little attention to developments in related fields, such as organisational sociology, organisational behaviour, management studies, and human-resource management (West, 2001). If quality programs are to have lasting and significant effects, that they must follow a systemic approach such that all aspects of an organisation are integrated and focused on continuous improvement and customer satisfaction (Joss, 2004). A variety of approaches has been used to improve quality and to ensure its delivery, but not all have been successful. Indeed, some have merely added bureaucracy and higher costs to health care (Jackson, 2005; Ennis and Harrington, 2001). Recent research has shown that 45 per cent of patients experience some â€Å"medical mismanagement† and that 17 per cent suffer events which lead to a longer stay or more serious problems (Ovretveit, 2000). This is increasingly caused by complex systems of care which do not appear to be managed effectively. Joss and Kogan (2005) strongly recommended that a comprehensive set of criteria be included, against which to evaluate progress. These criteria should be based on the main requirements of TQM, and should include any additional factors generated by the organisation and/or by evaluators. A three-year evaluation of TQM in the National Health Scheme (NHS) indicated that there were clear factors which predicted successful implementation, the most important of which was the need to have a structured, pre-planned approach based on a thorough understanding of alternative approaches (Joss, 2004). Moreover, a recent study from the UK (O’Sullivan, 2005) demonstrated how one NHS Trust achieved continuous quality improvement through determination, education, and implementation, supported by visionary and involved leadership in all areas, a multi-talented enthusiastic clinical audit department, and a high-quality dedicated staff. Nabitz and Walburg (2000) suggested that possible solutions to quality problems might lie in the approach promoted by the European Foundation for Quality Management (EFQM). The EFQM has developed a model to structure and review the quality-management processes of organisations. Self-assessment, benchmarking, external review, and quality awards are essential elements of this model and, as reported by Sanchez (2000), this approach represents an important means of achieving excellence in health care. Within the literature there are also many studies showing the benefits of applying models of quality implementation in health-care organisations (Naylor, 2005; Ruiz et al., 2005). Such studies have pointed to the real benefits that accrue to organisations which have used such approaches (Pitt, 2005). Business excellence methodology for quality improvement The introduction of internationally respected quality frameworks – the Malcolm Baldrige National Quality Award (MBNQA) in 2003, followed by the EFQM in 2005 – has provided an opportunity for organisations to self-assess, using the models of TQM and business excellence which underpin these frameworks. In this process of self-assessment, an opportunity exists to identify the strengths and weaknesses in the current management of operations. In the USA, the effectiveness of the Baldrige process has been lauded by many (Gaucher and Coffey, 2000) who have indicated that organisations can learn about best practices from Baldrige-winning companies, and will thus be assisted in developing a composite for excellence. Although the Baldrige criteria were developed for commercial institutions, there has been keen interest in the adaptation of the model within health-care organisations in the USA following a pilot health-care project in 2005. To date, no health-care entity has yet achieved Baldrige-winner status, although Gaucher and Coffey (2000) have asserted that it is only a matter of time before there is a health-care winner. Moreover, these authors went on to say that the true benefit of the Baldrige process is not about winning an award. Rather, it is about the provision of a road map for a journey – a framework for both incremental and breakthrough improvement and business excellence. Within the European context, since its introduction in 2001, the EFQM model has been attracting considerable interest across all sectors, and has become a well-recognised quality-management framework. Stahr et al. (2001) concurred with Gaucher and Coffey (2000) in stating that the model provides a means by which organisations can assess their paths and develop solutions to achieve excellence. Other authors have espoused the model as being surprisingly effective, with awards being presented to those firms considered to be the most accomplished exponents of TQM in Europe (Wilkes and Dale, 2005). Across European health care at an institutional level, an increasing number of organisations are making direct investments in the training of staff in the concepts of business excellence (Stahr et al., 2001; Jackson, 2001). The NHS Executive in the UK has provided a central lead in endorsing the model as an important framework for delivering on the clinical governance agenda. Furthermore the British Association of Medical Managers (BAMM) has promoted its use as a tool for organisational self-assessment (Stahr et al., 2001). Its use and adoption has been further supported by the British Quality Foundation which provides a major educational and support role in the use and adoption of the model in health care and other sectors across the corporate landscape. Without doubt, the future performance of health-care organisations will be assessed against wider goals than previously. There will be a greater emphasis on measuring organisational performance and, if performance is below par, rapid investigation and appropriate intervention will ensue (Naylor, 2005). Moeller (2001) concurred with this, and identified evaluation of health services as a prerequisite. However, Zairi et al. (2005) warned that measuring organisational effectiveness in the delivery of health care is a challenging task. Joss and Kogan (2005) strongly recommended that a comprehensive set of criteria should be included, against which to evaluate progress. This should be based on the main requirements of TQM, supplemented by other organisational criteria thought to be important by the evaluators. A three-year evaluation of TQM in the NHS indicated that there are clear factors which predict successful implementation – including awareness of the need to have a structured, pre-planned approach based on a thorough understanding of alternative approaches (Joss, 2004). Moreover, as demonstrated by O’Sullivan (2005), successful implementation requires the support of visionary and involved leaders in all areas, together with dedicated and educated staff. Examining organisational effectiveness in Irish health care As suggested by Nabitz and Walburg (2000), the solution to quality problems might lie in the approach promoted by the EFQM. As reported by Sanchez (2000), this approach represents an important means of achieving excellence in health care which concurs with earlier descriptions by Gaucher and Coffey (2000). Self-assessment can examine current practice and establish capability, thus driving improvement rather than a reaction to weaknesses in the current system (Russell, 2005). There are also many studies in the literature which show the benefits of applying the business excellence model for quality implementation in health-care organisations (Naylor, 2005; Jackson, 2005a; Nabitz and Klazinga, 2005; Arcelay et al., 2005). Such studies have pointed to real benefits that have accrued to organisations using such an approach. Furthermore, Jackson (2005a) demonstrated that the adoption of the principles of self-assessment and business excellence can lead to the achievement of a culture of continuous improvement. Russell (2005) noted that the adoption of the â€Å"outside-in† approach of the EFQM model enabled organisations to use the model as a developmental and management framework. For Arcelay et al. (2005), the model provided a global, systematic regular analysis of the activities and results by comparing them with the criteria of the excellence model. Moreover, the process made it possible to make comparisons with other private and public organisations. Using a systems view of an organisation enables managers to focus on the processes between the parts of an organisation, rather than on the parts themselves, which is similar to physicians using a systematic model in which to analyse signs and symptoms, and thus make a diagnosis. An effective organisation is one in which the total organisation, through its significant subparts and individuals, manages its work against goals and plans with a view to achieving these goals within an open system. Methods of management that have been developed in manufacturing environments are naturally regarded with scepticism in non-manufacturing sectors. However, according to West (2001), studies that have been conducted on the link between the organisation and management of services and quality of patient care can be criticised both theoretically and methodologically because of the many different mechanisms that may be operating at once to produce the relationship between volume and quality. West (2001) asserted that a more rigorous body of work exists on the performance of firms in the private sector, often conducted within the disciplines of organisational behaviour or human resource management. Ireland and the International ICT System Dublin has, in the 2000s, carved out several niche international functions for itself, one of which, call centre activities, has been the principal focus of this study. According to a report in The Irish Times (August 20, 2003), Ireland accounts for 30% of all international call centres located in western Europe. The great bulk of these are to be found in Dublin. The central role of ICT in call centre activities has facilitated their centralisation in Ireland, from where markets spread across Europe and even further afield can readily be served. As Sassen (2005, p. 56) has observed: â€Å"Information technologies, often thought of as neutralising geography, actually contribute to spatial concentration†. Call centre activities, therefore, have helped Ireland to escape the bounds of geographical peripherality, thereby contradicting Wegener’s (2005) gloomy prognosis which visualised cities in the periphery as inevitable losers from growing inter-urban competition in Europe. This has been cleverly portrayed in an IDA advertisement which shows Ireland at the centre of a surrounding group of disembodied European countries ( Fig. 1). These latter are no longer seen as being more or less distant from Ireland, but as constituting a set of different language and market territories, all equally accessible from Ireland. However, Dublin’s growing international reach and the growing technological sophistication of its economic base should not mask the fact that, structurally, it retains a dependent position within the international division of labour. Its rapid recent economic expansion has been largely based on the attraction of branch plant operations which remain poorly embedded in the local economy (Breathnach, 2005). à Ã‚ nd, while the rising skill levels associated with recent inward investment have facilitated substantial improvement in living standards generally, in the specific case of the call centre sector, much of the employment which has been created remains relatively poorly paid – a fact which is directly linked with the high proportion of women workers in the sector, despite their high skill levels. Furthermore, the rapid growth of the call centre sector in the 2000s looks increasingly unsustainable as the end of the decade approaches. Growing labour shortages are driving up labour costs which, in conjunction with increasing housing and transportation problems, are beginning to attenuate Dublin’s attractiveness as a call centre location: according to a 2005 survey of call centre locations in Great Britain and Ireland, reported by Allen (2005), Dublin had fallen to the 29th position of 46 locations surveyed, having been in the top 10 in 2006. The response of the IDA has been to devote additional resources to promoting non-Dublin locations for call centre projects. However, even if this is successful in the short run, in the longer term the future of call centre employment will be increasingly threatened by technological developments, such as speech recognition technology and especially the rapidly growing use of the internet for making reservations, placing orders and seeking information. The IDA has justified its promotion of the call centre sector, despite the inferior nature of much of the employment involved, largely on the grounds that it provides an initial base upon which more sophisticated forms of employment can be built. Its long-term strategy, in other words, is to encourage firms which have established call centres in Ireland to add on additional functions, such as financial management and software development, to these initial operations. Already there has been some success in this area of ‘shared services’ back-office activities: by mid-2003, some 25 such operations had been established, and were projected to employ over 3000 people by the year 2000 (information supplied by Forfà ¡s). Ultimately, however, all of these activities remain as back-office activities, whose essential linkages are external to the Irish economy. In other words, their Irish location is not crucial to the parent companies of these operations; rather, it is contingent on the availability of certain attractions which may either be transient or reproducible elsewhere (Allen, 2005). As Wilson (2005) has noted, call centres are essentially a highly footloose sector, with few local economic linkages and little fixed investment in machinery and equipment: they therefore can be relocated quite readily in the light of changing comparative factor conditions. The National Health Service (NHS) in the UK published its NHS Plan in July 2000 (http://www.nhs.uk/thenhsexplained), saying that patients and people were central to its radical reform of healthcare and that although this included more hospitals and beds, shorter waiting times and improved care for older people, an essential element was that patients should have more power and information. As Grimson et al. (2000) rightly comment, healthcare is an information-intensive business, with data on an enormous scale gathered by way of hospitals, clinics, laboratories and primary care surgeries. Central to any information-intensive business is, naturally, the effective sharing of that information and, in order to empower and better engage the patient, how best that can be done. Funded by the UK’s Department of Health, the British Library’s integrated Telemedicine Information Service (TIS), described in the latest edition of the NHSMagazine (http://www.nhs.uk/nhsmagazine), is to improve the take-up of telemedicine technology in the UK, reinforcing the importance that information and communication technologies (ICTs) are seen to have in the sharing of information and the engagement of patients in their healthcare. By way of explanation, the word â€Å"telemedicine† has been coined as a way of capturing, in only one word, how ICT is being used in healthcare. However, as Curry et al. (2003) rightly comment, terms such as telemedicine, teleconferencing, health informatics and medical informatics seem to be used interchangeably, and that there is some confusion as to what is, and is not, involved, citing various studys, including those of Preston at al. (2002) and Mark and Hodges (2001) to support their claim. As there is some disagreement with the term, we use in this study the meaning assigned by Perednia and Allen (2005), that is, the use of information technologies in helping to provide medical information and services in healthcare. Whatever its name, or its definition, it concerns, in one way or another, the mediating role that technology plays in the interaction between humans, whether patient or healthcare professional. At the time of writing, there are 138 telemedicine projects in the UK (http://www.tis.port.ac.uk/tm/owa/projects.allUK), and they cover aspects of healthcare as diverse as mental health, diabetes, foetal monitoring and accident and emergency care. Indeed, it points to one of the advantages of telemedicine; its applicability across a wide range of clinical issues. However, while these projects certainly cover a diversity of issues, they have something in common, that is, they address only one of these clinical matters. Each system is designed differently, is unlikely to be compatible with another, and needs different technical support and user training. Whilst such individual systems have proved useful in a particular context (see, for example, Gilmour et al., 2005; Jones et al., 2006; Lesher et al., 2005; Loane et al., 2005; Lowitt et al., 2005; Oakley et al., Health Information and Communication Systems in Ireland Health Information and Communication Systems in Ireland Is ICT a key enabler in ensuring seamless delivery of healthcare? A comparison between public and private ICT development in Ireland Abstract This study discusses the innovative changes that have taken place in Ireland in the field of healthcare due to the influx of information and communication technologies. Previous Information communication technologies (ICT), including telemedicine, present opportunities to address rural health-service delivery issues. The research shows that effective management of health services and the delivery of quality systems in Irish healthcare organizations have increased. In Ireland patients are expecting more of healthcare providers and are demanding higher standards of care and service. Simultaneously, those paying for health services have become more concerned about rising health costs and possible inefficiencies. As a result there is widespread interest in understanding what makes for an effective health service and in developing better practices to improve existing approaches to healthcare management in relation to ICT. This study highlights the developments in quality-service management in the Irish healthcare sector and focuses attention on the need for the development of a model for quality implementation in healthcare institutions. In sum the study shows that the development of (ICT) has facilitated the emergence of a complex global urban system in which many formerly lower-order cities have been carving out â€Å"niche† specialist functions serving urban fields of transnational dimension. Chapter1: Introduction Purpose of Study The purpose of this study is to highlight the development of the Information and communication system in Ireland and how it has revolutionized the healthcare sector in Ireland. Research Question This study focuses on the following research questions: What are the current trends of technological development in the Information and Communication Technology sector of Ireland? What are various challenges faced by the Irish healthcare system in relation to Information and Communication Technology? Significance of the Study This study is quite significant as it shows that the concept of globalisation has secured remarkable currency in the academic discourse of the late 20th century, despite ongoing questions regarding both its meaning and extent (Clark and Lund, 2000). The development of internationally integrated production and distribution systems, seen by many as the key feature of globalisation, has been a spatially uneven process. A key factor in this respect has been the differential ability of regions to engage in the informational economy, based on new information and communications technology (ICT), which is the main source of wealth creation and economic growth in the modern world (Castells, 2003). The result has been what Friedmann (2005) calls a process of ‘techno-apartheid’ which has divided the globe into ‘fast’ and ‘slow’ worlds (Knox, 2005), distinguished by the connectedness of individuals, groups and regions to the world of telematics. This echoes Ingersoll’s (2003, quoted in Knox, 2005) suggestion that the key division of the workforce is now that between those who have the capacity to operate ICT (the ‘cyberproletariat’) and those who do not (the ‘lumpentrash’). Golding (2006) makes a similar distinction between the ‘technoliterati’ and the ‘techno-poor’. While Knox defines the fast and slow worlds spatially, equating the former with the ‘triadic’ core and the latter with the remaining global periphery, Hoogvelt (2003) argues that the divide is, in essence, social rather than spatial, with elements of both worlds to be found in all regions of the globe. Thus, within advanced economies, a process of social polarisation has been widely reported (Friedmann, 2006 and Sassen, 2004) and has been intimately linked by Graham and Marvin (2006) to the development of ICT use. This is not to suggest that those who work in the fast world are homogeneously well-paid and affluent; rather, they represent a wide range of remuneration levels depending on such factors as economic sector, location, function, ethnic group and gender (Castells, 2006). What they do tend to have in common, however, is relative employment security due to the high demand level for their ICT skills. Rationale This study follows a logical approach and identifies the fact that both in Ireland as well as globally, there are major geographical variations in the relative balance between fast and slow worlds, with the former mainly to be found in the traditional core regions of North America, western Europe and Japan and an additional small group of newly industrialising countries which have had the institutional capacity to invest massively in modern ICT and associated educational infrastructures (Freeman, 2004). The slow world – found predominantly in the less developed countries of the global periphery and accounting for the bulk of the world’s population – is becoming increasingly marginalised and is moving, as Castells (2003, p. 37) puts it, â€Å"from a structural position of exploitation to a structural position of irrelevance†. Definition of Terms ICT: Information and Communication Technology: it is the study or business of developing and using technology to process information and aid communications. Sistem : SISTeM a soft systems methodology, stakeholder analysis and participative simulation modelling. NHS: (National Health Service) The organization providing national healthcare services in the UK. Chapter 2: Literature Review The process of quality implementation has become a key concern for those involved in hospital management in Ireland. In a national context, the effective management of health services and the delivery of quality systems in health-care institutions have increased in significance in recent years. In line with wider developments in other service industries, consumers (patients) are expecting more of health-care providers and are demanding higher standards of care and service. Simultaneously, those paying for health services have become more concerned about rising health costs and possible inefficiencies. As a result there is widespread interest in understanding what makes for an effective health service and in developing better practices to improve existing approaches to health-care management and delivery. In 2005 a comprehensive report on funding from the Commission on Health Funding highlighted that solutions to the problems faced by the Irish Health Service did not lie primarily in the system of funding, but rather in the way that services were planned, organised, and delivered. Similarly, in a report from the OECD (2003), it was argued that although the Irish health system had delivered a continuous improvement in health standards, there was still scope for further improvement in efficiency, and that this could be achieved through better allocation of resources. More recently, the government health strategy (DOHc, 2001) highlighted the requirement for a system to monitor progress and systematically evaluate the quality and effectiveness of health services. According to the strategy: Monitoring and evaluation must become intrinsic to the approach taken by people at all levels of the health services. Specifically, the strategy suggested that the way in which health and personal social services are planned, organised, and delivered has a significant effect on the health and well-being of the population. Organisational structures must be geared to the provision of a responsive, adaptable health system which meets the needs of the population effectively and at affordable cost. One of the guiding principles inherent in the published strategy was that of a â€Å"people-centred† health system. A responsive system must develop ways to engage with individuals and the wider community which receives its services. The health system must become more people-centred, with the interests of the public, patients, and clients being given greater prominence and influence in decision making at all levels (DOHc, 2001). According to Bowers (2001), major structural reform, coupled with strong management and political will, are required to ensure change for the better. In Bowers’ view, finance alone will not improve the system. Rather, a concentrated effort must be made to ensure a responsive and efficient service. As previously noted, a conclusion of the Report of the Commission on Health Funding (2005) was that the solution facing the Irish health services did not lie primarily in the system of funding but rather in the way that services were planned, organised, and delivered. This is reinforced by a recent report on the Irish health-care sector which suggested that the issues and challenges facing the health service are fundamentally the same as those outlined by the Commission on Health Funding, except that they are compounded by much higher expectations/demands by consumers (Deloitte and Touche, 2001). Thus, although modern health services have undergone radical change in many areas (Robins, 2003), managers of health services are currently reporting a large increase in the number of patients needing beds, with consequent ever-increasing waiting lists. Accident and emergency departments are under particular strain, and the difficulties of dealing with the growing needs of the increasing elderly population are beginning to become apparent. Although the Irish health service is free for all those requiring medical treatment through a publicly funded system, the current situation is hauntingly similar to that of the Victorian era of health care in Ireland. As a result, the Office for Health Management in Ireland (OHM, 2001) has suggested that current deficiencies in health-care provision and delivery underline the importance of providing quality service management and implementation in Irish health and personal social services. In achieving this aim, the OHM has contended that those working within the system must change how they go about their work and how they work together. Changed public-sector environment The focus on health-care service and quality has evolved from a more general interest in continuous improvement initiatives within the public sector. The prevalent trends in the private sector are towards continuous and pervasive change and increasing interdependencies, and it has been suggested that close parallels can be drawn between the private and public sectors. Public-sector organisations now find themselves in a cyclone of change as they attempt to adapt to turbulent environments in a pragmatic and systematic way (Lovell, 2004). In the UK and also in Ireland, these organisations have been subject to cuts in government spending, as well as demands for enhanced efficiency and effectiveness. In response to such changes, there has been a policy shift towards greater competition and an attempt to apply management practices from the private sector to the public domain. The Irish public sector has been officially pursuing change and reform through its strategic management initiative (SMI), a program for improving the management of the civil service which was formally launched in 2004 (Department of the Taoisearch, 2004). The SMI evolved from the growing internal and external pressures for better services and for more effective management of public services. In that context the continuous improvement of customer service has been a specific focus of the SMI since 2003, when the quality service initiative was launched. The program set out a series of quality principles according to which dealings with the wider public would be coordinated and managed. These initiatives aimed to make public administration more relevant to the citizens for whom the service exists, and simultaneously sought to remove barriers which have traditionally restricted performance and job satisfaction within the public sector. In recent years, Ireland has experienced a rise in consumerism. Increases in revenue available to fund public service provision have gone hand in hand with rising public expectations of standards of service. As a consequence, management skills and competences in providing for improved standards of customer service have become recognised as being central to delivering real transformation in the public sector. However, the development of such capabilities, particularly in relation to managing effective quality implementation, presents considerable challenges for those involved. Nowhere is this more evident than in the health-care sector. A review of recent international evidence points to the challenges of implementing quality service in health-care institutions. Gaucher and Coffey (2000) confirmed that implementing a process of total quality management (TQM) in health care is a pragmatic, specific, and systematic methodology. However, this requires a firm commitment from the leadership to change their former ways of working and doing business. Gaucher and Coffey (2000) cited many reasons for TQM failing – including poor leadership and a lack of management commitment – but also noted that revitalisation can rejuvenate the process. These authors asserted that the role of those implementing the process is to nurture and breathe energy into the process when enthusiasm and commitment are declining. The importance of the support of senior management for quality-management projects is also advocated by Berwick et al. (2000). These authors undertook a national demonstration project in the USA in the late 2000s and described how organisations could implement the entire quality-improvement process – from defining the problem through to implementing a solution and consolidating the gains (Berwick et al., 2000). A literature review carried out by Jackson (2005) identified that much work had been undertaken in the UK in determining the clinical effectiveness of many health-care organisations, but that very little research had been implemented in the area of managerial effectiveness. Furthermore, West (2001) determined that, in organisations that outperform others on different dimensions of performance, there was evidence that management is important, as are the combined efforts of individual clinicians and teams. There have been several approaches espoused for achieving quality management in health-care institutions, many of which have been technical and generic in their approaches (Moeller et al., 2000). Specifically, Donabedian (2000) introduced the concepts of structure, process, and outcomes, along with the development of self-assessment and accreditation through the International Organization for Standardization (ISO). In many instances these programs have met with mixed reactions, and their implementation has varied. A criticism levelled at hospital performance is that it has been rather insular, and has paid little attention to developments in related fields, such as organisational sociology, organisational behaviour, management studies, and human-resource management (West, 2001). If quality programs are to have lasting and significant effects, that they must follow a systemic approach such that all aspects of an organisation are integrated and focused on continuous improvement and customer satisfaction (Joss, 2004). A variety of approaches has been used to improve quality and to ensure its delivery, but not all have been successful. Indeed, some have merely added bureaucracy and higher costs to health care (Jackson, 2005; Ennis and Harrington, 2001). Recent research has shown that 45 per cent of patients experience some â€Å"medical mismanagement† and that 17 per cent suffer events which lead to a longer stay or more serious problems (Ovretveit, 2000). This is increasingly caused by complex systems of care which do not appear to be managed effectively. Joss and Kogan (2005) strongly recommended that a comprehensive set of criteria be included, against which to evaluate progress. These criteria should be based on the main requirements of TQM, and should include any additional factors generated by the organisation and/or by evaluators. A three-year evaluation of TQM in the National Health Scheme (NHS) indicated that there were clear factors which predicted successful implementation, the most important of which was the need to have a structured, pre-planned approach based on a thorough understanding of alternative approaches (Joss, 2004). Moreover, a recent study from the UK (O’Sullivan, 2005) demonstrated how one NHS Trust achieved continuous quality improvement through determination, education, and implementation, supported by visionary and involved leadership in all areas, a multi-talented enthusiastic clinical audit department, and a high-quality dedicated staff. Nabitz and Walburg (2000) suggested that possible solutions to quality problems might lie in the approach promoted by the European Foundation for Quality Management (EFQM). The EFQM has developed a model to structure and review the quality-management processes of organisations. Self-assessment, benchmarking, external review, and quality awards are essential elements of this model and, as reported by Sanchez (2000), this approach represents an important means of achieving excellence in health care. Within the literature there are also many studies showing the benefits of applying models of quality implementation in health-care organisations (Naylor, 2005; Ruiz et al., 2005). Such studies have pointed to the real benefits that accrue to organisations which have used such approaches (Pitt, 2005). Business excellence methodology for quality improvement The introduction of internationally respected quality frameworks – the Malcolm Baldrige National Quality Award (MBNQA) in 2003, followed by the EFQM in 2005 – has provided an opportunity for organisations to self-assess, using the models of TQM and business excellence which underpin these frameworks. In this process of self-assessment, an opportunity exists to identify the strengths and weaknesses in the current management of operations. In the USA, the effectiveness of the Baldrige process has been lauded by many (Gaucher and Coffey, 2000) who have indicated that organisations can learn about best practices from Baldrige-winning companies, and will thus be assisted in developing a composite for excellence. Although the Baldrige criteria were developed for commercial institutions, there has been keen interest in the adaptation of the model within health-care organisations in the USA following a pilot health-care project in 2005. To date, no health-care entity has yet achieved Baldrige-winner status, although Gaucher and Coffey (2000) have asserted that it is only a matter of time before there is a health-care winner. Moreover, these authors went on to say that the true benefit of the Baldrige process is not about winning an award. Rather, it is about the provision of a road map for a journey – a framework for both incremental and breakthrough improvement and business excellence. Within the European context, since its introduction in 2001, the EFQM model has been attracting considerable interest across all sectors, and has become a well-recognised quality-management framework. Stahr et al. (2001) concurred with Gaucher and Coffey (2000) in stating that the model provides a means by which organisations can assess their paths and develop solutions to achieve excellence. Other authors have espoused the model as being surprisingly effective, with awards being presented to those firms considered to be the most accomplished exponents of TQM in Europe (Wilkes and Dale, 2005). Across European health care at an institutional level, an increasing number of organisations are making direct investments in the training of staff in the concepts of business excellence (Stahr et al., 2001; Jackson, 2001). The NHS Executive in the UK has provided a central lead in endorsing the model as an important framework for delivering on the clinical governance agenda. Furthermore the British Association of Medical Managers (BAMM) has promoted its use as a tool for organisational self-assessment (Stahr et al., 2001). Its use and adoption has been further supported by the British Quality Foundation which provides a major educational and support role in the use and adoption of the model in health care and other sectors across the corporate landscape. Without doubt, the future performance of health-care organisations will be assessed against wider goals than previously. There will be a greater emphasis on measuring organisational performance and, if performance is below par, rapid investigation and appropriate intervention will ensue (Naylor, 2005). Moeller (2001) concurred with this, and identified evaluation of health services as a prerequisite. However, Zairi et al. (2005) warned that measuring organisational effectiveness in the delivery of health care is a challenging task. Joss and Kogan (2005) strongly recommended that a comprehensive set of criteria should be included, against which to evaluate progress. This should be based on the main requirements of TQM, supplemented by other organisational criteria thought to be important by the evaluators. A three-year evaluation of TQM in the NHS indicated that there are clear factors which predict successful implementation – including awareness of the need to have a structured, pre-planned approach based on a thorough understanding of alternative approaches (Joss, 2004). Moreover, as demonstrated by O’Sullivan (2005), successful implementation requires the support of visionary and involved leaders in all areas, together with dedicated and educated staff. Examining organisational effectiveness in Irish health care As suggested by Nabitz and Walburg (2000), the solution to quality problems might lie in the approach promoted by the EFQM. As reported by Sanchez (2000), this approach represents an important means of achieving excellence in health care which concurs with earlier descriptions by Gaucher and Coffey (2000). Self-assessment can examine current practice and establish capability, thus driving improvement rather than a reaction to weaknesses in the current system (Russell, 2005). There are also many studies in the literature which show the benefits of applying the business excellence model for quality implementation in health-care organisations (Naylor, 2005; Jackson, 2005a; Nabitz and Klazinga, 2005; Arcelay et al., 2005). Such studies have pointed to real benefits that have accrued to organisations using such an approach. Furthermore, Jackson (2005a) demonstrated that the adoption of the principles of self-assessment and business excellence can lead to the achievement of a culture of continuous improvement. Russell (2005) noted that the adoption of the â€Å"outside-in† approach of the EFQM model enabled organisations to use the model as a developmental and management framework. For Arcelay et al. (2005), the model provided a global, systematic regular analysis of the activities and results by comparing them with the criteria of the excellence model. Moreover, the process made it possible to make comparisons with other private and public organisations. Using a systems view of an organisation enables managers to focus on the processes between the parts of an organisation, rather than on the parts themselves, which is similar to physicians using a systematic model in which to analyse signs and symptoms, and thus make a diagnosis. An effective organisation is one in which the total organisation, through its significant subparts and individuals, manages its work against goals and plans with a view to achieving these goals within an open system. Methods of management that have been developed in manufacturing environments are naturally regarded with scepticism in non-manufacturing sectors. However, according to West (2001), studies that have been conducted on the link between the organisation and management of services and quality of patient care can be criticised both theoretically and methodologically because of the many different mechanisms that may be operating at once to produce the relationship between volume and quality. West (2001) asserted that a more rigorous body of work exists on the performance of firms in the private sector, often conducted within the disciplines of organisational behaviour or human resource management. Ireland and the International ICT System Dublin has, in the 2000s, carved out several niche international functions for itself, one of which, call centre activities, has been the principal focus of this study. According to a report in The Irish Times (August 20, 2003), Ireland accounts for 30% of all international call centres located in western Europe. The great bulk of these are to be found in Dublin. The central role of ICT in call centre activities has facilitated their centralisation in Ireland, from where markets spread across Europe and even further afield can readily be served. As Sassen (2005, p. 56) has observed: â€Å"Information technologies, often thought of as neutralising geography, actually contribute to spatial concentration†. Call centre activities, therefore, have helped Ireland to escape the bounds of geographical peripherality, thereby contradicting Wegener’s (2005) gloomy prognosis which visualised cities in the periphery as inevitable losers from growing inter-urban competition in Europe. This has been cleverly portrayed in an IDA advertisement which shows Ireland at the centre of a surrounding group of disembodied European countries ( Fig. 1). These latter are no longer seen as being more or less distant from Ireland, but as constituting a set of different language and market territories, all equally accessible from Ireland. However, Dublin’s growing international reach and the growing technological sophistication of its economic base should not mask the fact that, structurally, it retains a dependent position within the international division of labour. Its rapid recent economic expansion has been largely based on the attraction of branch plant operations which remain poorly embedded in the local economy (Breathnach, 2005). à Ã‚ nd, while the rising skill levels associated with recent inward investment have facilitated substantial improvement in living standards generally, in the specific case of the call centre sector, much of the employment which has been created remains relatively poorly paid – a fact which is directly linked with the high proportion of women workers in the sector, despite their high skill levels. Furthermore, the rapid growth of the call centre sector in the 2000s looks increasingly unsustainable as the end of the decade approaches. Growing labour shortages are driving up labour costs which, in conjunction with increasing housing and transportation problems, are beginning to attenuate Dublin’s attractiveness as a call centre location: according to a 2005 survey of call centre locations in Great Britain and Ireland, reported by Allen (2005), Dublin had fallen to the 29th position of 46 locations surveyed, having been in the top 10 in 2006. The response of the IDA has been to devote additional resources to promoting non-Dublin locations for call centre projects. However, even if this is successful in the short run, in the longer term the future of call centre employment will be increasingly threatened by technological developments, such as speech recognition technology and especially the rapidly growing use of the internet for making reservations, placing orders and seeking information. The IDA has justified its promotion of the call centre sector, despite the inferior nature of much of the employment involved, largely on the grounds that it provides an initial base upon which more sophisticated forms of employment can be built. Its long-term strategy, in other words, is to encourage firms which have established call centres in Ireland to add on additional functions, such as financial management and software development, to these initial operations. Already there has been some success in this area of ‘shared services’ back-office activities: by mid-2003, some 25 such operations had been established, and were projected to employ over 3000 people by the year 2000 (information supplied by Forfà ¡s). Ultimately, however, all of these activities remain as back-office activities, whose essential linkages are external to the Irish economy. In other words, their Irish location is not crucial to the parent companies of these operations; rather, it is contingent on the availability of certain attractions which may either be transient or reproducible elsewhere (Allen, 2005). As Wilson (2005) has noted, call centres are essentially a highly footloose sector, with few local economic linkages and little fixed investment in machinery and equipment: they therefore can be relocated quite readily in the light of changing comparative factor conditions. The National Health Service (NHS) in the UK published its NHS Plan in July 2000 (http://www.nhs.uk/thenhsexplained), saying that patients and people were central to its radical reform of healthcare and that although this included more hospitals and beds, shorter waiting times and improved care for older people, an essential element was that patients should have more power and information. As Grimson et al. (2000) rightly comment, healthcare is an information-intensive business, with data on an enormous scale gathered by way of hospitals, clinics, laboratories and primary care surgeries. Central to any information-intensive business is, naturally, the effective sharing of that information and, in order to empower and better engage the patient, how best that can be done. Funded by the UK’s Department of Health, the British Library’s integrated Telemedicine Information Service (TIS), described in the latest edition of the NHSMagazine (http://www.nhs.uk/nhsmagazine), is to improve the take-up of telemedicine technology in the UK, reinforcing the importance that information and communication technologies (ICTs) are seen to have in the sharing of information and the engagement of patients in their healthcare. By way of explanation, the word â€Å"telemedicine† has been coined as a way of capturing, in only one word, how ICT is being used in healthcare. However, as Curry et al. (2003) rightly comment, terms such as telemedicine, teleconferencing, health informatics and medical informatics seem to be used interchangeably, and that there is some confusion as to what is, and is not, involved, citing various studys, including those of Preston at al. (2002) and Mark and Hodges (2001) to support their claim. As there is some disagreement with the term, we use in this study the meaning assigned by Perednia and Allen (2005), that is, the use of information technologies in helping to provide medical information and services in healthcare. Whatever its name, or its definition, it concerns, in one way or another, the mediating role that technology plays in the interaction between humans, whether patient or healthcare professional. At the time of writing, there are 138 telemedicine projects in the UK (http://www.tis.port.ac.uk/tm/owa/projects.allUK), and they cover aspects of healthcare as diverse as mental health, diabetes, foetal monitoring and accident and emergency care. Indeed, it points to one of the advantages of telemedicine; its applicability across a wide range of clinical issues. However, while these projects certainly cover a diversity of issues, they have something in common, that is, they address only one of these clinical matters. Each system is designed differently, is unlikely to be compatible with another, and needs different technical support and user training. Whilst such individual systems have proved useful in a particular context (see, for example, Gilmour et al., 2005; Jones et al., 2006; Lesher et al., 2005; Loane et al., 2005; Lowitt et al., 2005; Oakley et al.,

Offshore Drilling Impacts And Solutions Environmental Sciences Essay

Offshore Drilling Impacts And Solutions Environmental Sciences Essay Nowadays, there is a growing demand for hydrocarbons in the world market. This study was to determine the impacts of offshore drilling to the aquatic lives and methods to reduce it. Offshore drilling is the process to discover the hydrocarbons by drilling exploratory boreholes or wells on the seabed. The ocean is not that vast to dilute all the chemicals that had been discarding to it. The chemicals that remained in the sea are called pollutant. This research paper will discussed three main impacts of offshore drilling and three suggested solutions to reduce it. The three impacts are offshore drilling operation noises will destructed marine lives, improper disposal of waste products will poisoned marine lives, and oil spill accidents will gradually killed marine lives. As human is at the top of the food chain, which receives the greatest impact, should find solutions to save ourselves. The three suggested solutions are government and organizations should enhance the rules and policie s respectively, professionals should consider accepting Khan and Islams five sustainable management models and try to work them out, and professionals should use their knowledge to improve monitoring and develop strategies. Therefore, concluded that human should try to protect the marine lives from being sacrifice because of us. Offshore Drilling: Impacts and Solutions Petroleum hydrocarbons play a very important role in society (Khan Islam, 2008). Nowadays, people tend to rely very much on the use of gas, petrol and oil. Hence, the growing demand for petroleum hydrocarbons on the world market has cause the development and production of oil resources to grow rapidly (The Prevention of Pollution from Offshore Installations, 2002). Gbadebo, Taiwo and Eughele (2010) stated that the only way to confirm the presence of hydrocarbons in an identified promising geological structure is to drill exploratory boreholes or wells (p.284). It is well known and generally accepted that the waste products of the offshore drilling activities are usually dumped into the sea (Khan Islam, 2008). The ocean is not as vast as people thought. It could not dilute all the chemicals that had been disposing to it, thus, the waste products of offshore drilling and the oil spill accidents are actually causing pollution to the ocean (Pollution in the Ocean, 2007). The main purpo se of this research paper is to identify the consequences of offshore drilling to the marine lives and solutions to reduce it. Practicing offshore drilling will gradually disturb the communication calls of marine lives (Offshore Exploration and Exploitation in the Mediterranean, 2012), improper disposal of chemical waste products will toxic the marine species (Gbadebo, Taiwo Eughele, 2010), and oil spill accident will cause deaths of a wide variety of marine species. Therefore, we have come out with some suggestions to decrease the pollution level. Government and concerned organizations should enhance the rules and reinforce the policies (Amos, 2011); professionals should consider to adopt the theoretical idea of the five sustainable management models of Khan and Islam (Khan Islam, 2008), and scientists and professionals should use their knowledge to improve monitoring and continue to develop pollution source-reduction strategies (Pollution in the Ocean, 2007). Very few people actually realize that the operating noise produce from offshore oil drilling can put aquatic animals lives at risk (Offshore Exploration and Exploitation in the Mediterranean, 2012). There are approximately 119 species of aquatic animals use sound as their primary sense (Pollution in the Ocean, 2007). They use sound to communicate, navigate and forage (Pollution in the ocean). However, the loud noise made by the drilling operations of offshore oil and gas production and other noises generated by human activities will confuse them, hence, causing them to do abnormal things such as stranding. According to The National Academies, in March 2000, fourteen beaked whales and two minke whales became stranded; six of the beaked whales died (Pollution in the Ocean). Autopsies revealed three of the beached whales bleeding in the inner ears and one whale has inner bleeding in its brain (Pollution in the Ocean). Many of the impacts of offshore activities on marine environments are inconstant, as the complicated relations between many types of species in marine ecosystems and difficulties associated with conducting research at depth (Amos, 2011). Thus, there is still lacking of scientific evidence to prove the actual impact of the short and long term effects of noise on marine mammals. Nonetheless, we can still assure that the noises of sea activities had disrupted the sense of the marine mammals, causing them to have difficulties to communicate, navigate, and forage. In addition, the public are very concern about the improper disposals of chemical waste products. This is because they afraid that the marine species will get poisoned and they afraid of eating them (Gbadebo, Taiwo Eughele, 2010). The accumulated toxicity in the fish can cause illness, sometimes fatal, to anything or anyone that consumed it; thus, will destroying the food chain and reproductive cycle (Rose, 2009). According to American petroleum institute (API) (1989) as cited in Khan Islam (2008), both the well cuttings and the drilling fluids compose about 2% of the total exploratory wastes. Besides, there were two recent studies do research on the impact of drill cuttings from offshore installations on corals and marine worms (Offshore Exploration and Exploitation in the Mediterranean, 2012). The first result shows that the coral were able to withstand and self-clean in short period of time; however, the coral will smother and started to die over weeks (Offshore exploration and exploitation in the Mediterranean). Whereas, the second result shows that the populations of marine worms are decreasing when exposed to concentrations of barium, which is a similar heavy metal in drill cuttings. Taking Dibi and Ewan offshore wells as background, the result shows that the concentrations of various polynuclear aromatic hydrocarbons analyzed in cuttings from both oil wells are very high (Gbadebo, Taiwo Eughele, 2010). If the drilling wastes are not discharged properly, it will endanger the marine lives and also our health (Gbadebo et al.). The results of heavy metals analyses also tell us that the concentrations in the cuttings and mud are high, which could lead to bioaccumulation in aquatic organisms (Gbadebo et al.). If anyone accidentally eats those aquatic organisms, he or she might get sick easily. The problems of oil spill accident happened around the world (Offshore Exploration and Exploitation in the Mediterranean, 2012). Oil spill accident, such as the disaster in the Gulf of Mexico, causes deaths of a wide variety of marine species (Offshore Exploration and Exploitation in the Mediterranean, 2012). When there is a quick flow and concentrated oil during a spill makes them especially harmful to localized marine organisms and communities, plants and animals that coated with oil will cause them to die (Rose, 2009). Oil that covered the surface of the animals, such as sea gull, cannot keep its body warm will die in the Artic; whereas, when there is a layer of oil covered the surface of sea, sunlight will be difficult to reach the the seabed. Since it needs a long time to recover the sea, the plants and animals live on seabed will gradually die. Therefore, in June 2010, National Energy Board (NEB), Canadas federal energy regulator, organized a review of safety and environmental protection requirements for Canadian Arctic offshore drilling for oil and gas (Amos, 2011). Despite the great economic and social benefits, public also concern about the solutions to reduce the impact of offshore drilling activity (Khan Islam, 2008). Government and related organizations should strengthen the rules and improve the policies (Amos, 2011). Government should always transmit positive feedback to the public when a new method is in probation (Pollution in the ocean, 2007). This is to convince and to increase peoples confidence level towards that new method. Given the disaster in the Gulf of Mexico, NEB should learnt the lesson and strengthen the offshore drilling safety requirements (Amos, 2011). In order to strengthen the rules applied to future Arctic offshore exploration NEB should maintain the capability requirement of same season relief well (SSRW), improves policy, regulatory and liability requirements; polish the comprehensive filing requisites for future applications for offshore drilling requiring thorough ecological baseline studies (Amos). Khan and Islam had reviewed the new environmental management techniques on solving the existing problems of offshore oil and gas drilling. Professionals should consider adopting the theoretical idea of the five sustainable management models, which were marine protected areas in oil sites (MPAOS), ocean fertilization and CO2 utilization (OFCU), integrated coastal pollution balancing (ICPB), artificial recruitment in fisheries (ARFS), and artificial rigs from oil rigs (AROR) (Khan Islam, 2008). Professionals should take a look on the idea of them to generate more applicable methods for reducing the level of pollution in ocean. Scientists should choose the applicable theory to undergo experimental studies, understand how these proposals will function in real ecosystem context. MPAOS model is to designate an oil site as a protected area (Khan Islam, 2008). This could protect and improve fisheries production. Since the fishes are protected, hence, we no need worry about the toxicity of the fishes. Secondly, OFCU model is the idea of balancing carbon dioxide emissions by sinking enough organic carbon in the ocean bottom. Thirdly, ICPB model is to apply the principle of bioremediation or food web enhancement to utilize the runoff oils and pollution through balancing ecosystem components. Fourthly, ARFS model is the idea of compensate the fisheries production of certain species in a targeted area and to restore the stocks. Lastly, AROR is the idea to keep the original sites of the abandoned rigs to establish a reef community or transported to another planned site. The models are following the principle of natural functions in marine environment and take into account ecological, biological, and technological factors (Khan Islam). The impact of offshore drilling will be lightening by applying these five models. Professionals should use their knowledge to improve monitoring and continue to develop pollution source-reduction strategies (Pollution in the Ocean, 2007). It is difficult to clean up oil spills. In those days, people use complicated method such as water shut-off, bottom separation and down-hole separation of oil and water (The prevention of pollution from offshore installations, 2002). Nowadays, they usually use biological agents to break down the oil, use materials that absorb oil, and gelling agents that make oil easier to skim from the surface. People also physically clean up the spills by using high- pressure water hoses on shores and cleaning oil off from animals (Pollution in the Ocean). These methods were used because of the improvement of technologies and sciences. Therefore, the professionals should work hard to figure out easier method to solve the oil spill problem. Scientists should work together to find the solutions from reduce the harm towards the living organisms in the sea; whereas, the technicians should invent other types of machine that will do less harm to the environment (Tyack, 2008). In conclusion, human should safe the marine species because the innocent marine lives are suffering because of our selfishness. We should know that practicing offshore drilling will disrupt the main sense of marine lives to hunt, communicate and navigate (Offshore Exploration and Exploitation in the Mediterranean, 2012). In addition, improper disposal of chemical waste products of offshore drilling will toxic the marine lives (Gbadebo, Taiwo Eughele, 2010). Moreover, oil spill accident will cause deaths of a wide variety of marine species. Considering human is at the top of the food chain, which will receives the greatest impact, we should stand up and do something for rescue ourselves. Thus, government and concerned organizations should strengthen the rules and improve the policies (Amos, 2011). Furthermore, professionals should consider to accept and carry out the theoretical idea of the five sustainable management models (Khan Islam, 2008). Additionally, scientists and professio nals should use their knowledge to improve and develop pollution source-reduction strategies (Pollution in the Ocean, 2007).

Eulogy for Grandmother :: Eulogies Eulogy

Eulogy for Grandmother My grandmother was a truly amazing person. She was brilliant, compassionate, and outgoing, a fantastic dancer with a sense of humor, and without any ego at all. In other words, exactly like me! Seriously, though, we have a lot in common. Among other things, I inherited her curly hair, her mind for trivia, and her obsession with books and music... She preferred mystery novels and jazz standards, while I liked science fiction and rock n' roll, but those differences are only skin-deep. Like she always said, "I guess that's why they make chocolate and vanilla ice cream." (She preferred butter pecan.) That reminds me of one small difference between us: she was an amazing cook, while I still have trouble boiling water. Meatballs with all-day sauce, stuffed shells, followed by icebox cake... It was all so good. You could walk into her apartment and pass out from the smells alone. It makes me hungry just thinking about it. And when I'd walk home from elementary school and let myself into her empty apartment, there would always be a note on the TV, telling me that there were cookies and milk in the fridge. It's the little things... I always knew that she was thinking about me. As we both grew older, we grew even closer. I did some pretty terrible things in high school, but she always took my side, even when I was clearly in the wrong. She defended and protected me, mostly from my mom. Years later, at my wedding, she serenaded us in a garden in Cambria, accompanied by a jazz band. She sang, "It had to be you, wonderful you... It had to be you." She had such a beautiful singing voice, and I swear, she must have known the lyrics to every single song written before 1959. We shared a dance afterwards. Even though I was taller than her, she still made me feel like a little boy, as we danced cheek-to-cheek. It was the best day of my life. When I think of her, I think of her warm embrace. On my bad days, she would hold and comfort me. Grandma would wrap me in her arms and protect me from the rest of the world, and make me feel that everything was going to be all right. Even in her hospital bed, holding her hand and listening to her soft breath, I wanted to kick my shoes off and be hugged by those safe, strong arms. Eulogy for Grandmother :: Eulogies Eulogy Eulogy for Grandmother My grandmother was a truly amazing person. She was brilliant, compassionate, and outgoing, a fantastic dancer with a sense of humor, and without any ego at all. In other words, exactly like me! Seriously, though, we have a lot in common. Among other things, I inherited her curly hair, her mind for trivia, and her obsession with books and music... She preferred mystery novels and jazz standards, while I liked science fiction and rock n' roll, but those differences are only skin-deep. Like she always said, "I guess that's why they make chocolate and vanilla ice cream." (She preferred butter pecan.) That reminds me of one small difference between us: she was an amazing cook, while I still have trouble boiling water. Meatballs with all-day sauce, stuffed shells, followed by icebox cake... It was all so good. You could walk into her apartment and pass out from the smells alone. It makes me hungry just thinking about it. And when I'd walk home from elementary school and let myself into her empty apartment, there would always be a note on the TV, telling me that there were cookies and milk in the fridge. It's the little things... I always knew that she was thinking about me. As we both grew older, we grew even closer. I did some pretty terrible things in high school, but she always took my side, even when I was clearly in the wrong. She defended and protected me, mostly from my mom. Years later, at my wedding, she serenaded us in a garden in Cambria, accompanied by a jazz band. She sang, "It had to be you, wonderful you... It had to be you." She had such a beautiful singing voice, and I swear, she must have known the lyrics to every single song written before 1959. We shared a dance afterwards. Even though I was taller than her, she still made me feel like a little boy, as we danced cheek-to-cheek. It was the best day of my life. When I think of her, I think of her warm embrace. On my bad days, she would hold and comfort me. Grandma would wrap me in her arms and protect me from the rest of the world, and make me feel that everything was going to be all right. Even in her hospital bed, holding her hand and listening to her soft breath, I wanted to kick my shoes off and be hugged by those safe, strong arms.

Always Hope :: College Admissions Essays

Always Hope Without hope, we have nothing. I have learned this valuable lesson in dealing with my Mother and Cancer. My Mother passed over on June 4th of this year. Barely three months ago, and yet I still can't believe she is gone. Mom was given two weeks to live after finding out that she had Breast Cancer that had gone too far and was throughout her body. It is a miracle that she lived for 28 months and we thank God for each day. Mom faced death with courage, strength and never gave up hope for a miracle. Her Dr's were amazed each time they saw her, which was on a monthly basis. You couldn't look at her and see a thing wrong with her. She looked strong and robust, outgoing and if she didn't like something she would let you know. But she always had faith that when her time came she would go to meet her Maker and be reunited with her parents and members of the family that had already passed over. Mom had dreams throughout those 28 months of seeing my Grandmother. Speaking with her, in her dream s. And one thing that Nana always told her was to never give up her faith and hope. That without hope we have nothing. I believe that Nana was preparing her for her return to the Lord and to Nana. As I stated before, Mom passed over in June. It was the hardest time in my life. But the decisions that I made, where made in the hope that I was doing the right thing.

The Deaf Identitiy

The Deaf Identity Ones sense of self, or perception of one’s self, is put together throughout the childhood years; relating to any number of characteristics. These could be gender identity, racial identity, involvement in academics, involvement in sports, and many others. These are some of the key parts to building one’s identity, or the understanding of one’s unique characteristics and how they have been, are, and will be manifested across ages, situations, and social roles.But what happens when a part of your identity is associated with your ability to hear or not. How does one establish a healthy identity of themselves when most the views of hard-of-hearing or deafness is negative? One study conducted in South Africa concluded that the deaf identity is not a static concept; but that it is a complex ongoing quest for belonging, bound up with the acceptance of being deaf and â€Å"finding one’s voice† in a hearing dominate society (McIlroy & Storbe ck, 2011).This concept correlates more with James Marcia’s Theory of Identity Achievement over Erik Erikson’s fifth stage of psychosocial development based on the fact that sometimes the Deaf identity does not develop until post-adolescence, even in children who were born deaf. Marcia’s theory acknowledges that sometimes the quest for one’s identity can span one’s lifetime, therefore also breaking Erikson’s rigid rules of the identity developing in adolescence.When the Deaf identity has been developed it too has a range of meaning for those involved in the process. In the South Africa study, it was founded that there are four static identities; deaf, Deaf, negative/ambiguous, and bicultural Deaf. These identities are formed through a myriad of experiences. Whether the child was born to a hearing family, born to a Deaf family, went to school in a mainstream hearing school, or attended a Deaf school, and the person’s personal preferred method of communication.Many Deaf children of Deaf families are born into a household of signing and of knowledge of the Deaf culture; this person most likely will assume the Deaf Identity. This person will experience the least amount of crisis when it comes to identity. But being a Deaf child of a Deaf adult is such a low occurrence that coming to this identity is not that easy. There are three general factors, for deaf children, which directly link to their identity; the attitudes of the parents, the mode of communication which aides in the social interaction with family and later ith peers, and the child’s linguistic competence (Kossewska, 2008). The first few years of a child’s life are the most critical for development and begin to reinforce the general factors that impact their identity. A deaf child born to hearing parents may struggle with language and literacy development most of their life. If their parents choose to enroll their child in a mainstream school and stress oralism, then the child will have a more negative view of their deafness due to the struggles they go through to obtain spoken language.This may lead to a ‘negative/ambiguous’ or ‘deaf’ identity because the person does not truly identify with their deafness as a part of who they are. Another deaf child born to hearing parents could end up in a deaf school, where the child will learn a signed language and maybe the family will take classes as well. With a child who is not struggling to obtain language and letting their life happen as it happens, is more likely to accept their deafness as a part of who they are and develop a ‘bicultural Deaf’ or a ‘Deaf’ identity, depending on how influential the hearing family is.And a child born into a Deaf family with proud Deaf identities will likely go to a Deaf school and develop the same Deaf identity as their family. A study done in Poland with 67 deaf adolescents and 93 hearing ch ildren were asked â€Å"Who Am I? † to investigate the factors influencing the deaf identity in adolescence. While â€Å"it was found that deaf adolescents used more descriptions especially in the following categories: Civil Status, Body and Physical Appearance, Taste and Activities, Friendship and Relationships, Personal and Social Situations, Negative Personal Traits, and Neutral Personality Traits.Deaf adolescents use as many abstract concepts to describe themselves as the hearing do, but they use more negative personal traits† (Kossewska, 2008). Why is it that the Deaf children are harder on themselves than the hearing? Is this a blatant clue that society as a whole looks down on this group of people and even the children can feel it? Children have been known to feel anger and resentment towards their hearing parents for forcing oralism upon them when there was a world of people just like them out there.A strong sense of heritage and feeling of belonging can develo p when children are a part of a community they can identify with. Sadly this doesn’t always happen in the earlier stages of life. This is also where one may go through an identity crisis and shift from ‘deaf’ to ‘Deaf’ or ‘bicultural. ’ â€Å"In discussing how bicultural identities may be understood, Ladd defines Deafhood as a process of claiming one’s Deaf identity with dignity† (McIlroy & Storbeck, 2011). In the South Africa study, all of the participants were 23 years of age and older; the oldest being 55 years old.In the study, all those who were born to hearing families, attended mainstream schools, but learned SASL (South African Sign Language) identified themselves deaf, but not until later in life. Those who never learned SASL, or any other signed language, never identified themselves with their deafness and had a negative/ ambiguous identity. Lastly, those born Deaf to Deaf families identified as Deaf. Not one part icipant in this study identified them self as Bicultural, but that is not to say it doesn’t exist. The establishment of the Deaf Identity is a tricky and sometimes rocky path for the majority of children who identify as deaf.They have so many hurdles to overcome in their journey to establishing their own identity that is one with who they are. From family life, to socialization, to academics, to identifying with their hearing loss or not, these people work hard and might experience more identity crises than average hearing person. But once they have established that identity there is no doubt that it has something to do with their hearing status. It would be a better world to spread the word about the Deaf Community to help the future to identify with their Deafness.

Economic and Political Conduct

The policy of any country or individual or group of individuals to conduct business and induce growth in the GDP is known as its economic conduct- it has global impact by way of international trade, foreign exchange and fiscal policies too. Nowadays economic policies are increasingly governed and shaped by global factors and imperatives.So the overall situation is dynamic and ever changing Political conduct essentially means what ideologies determine the policies and the leadership of any country, and how the representatives who form the leadership or Government interpret the ideologies and run the country- e.g. democracy, monarchy, communist state, fascism, etc. Political conduct determines loyalties and groups, collective developmental activities and global initiatives, and the overall growth of a country or state. Existentialism Defines the thought processes of those who believe and profess that it is we ourselves who create the essence and raison d etre in our lives, and not peop le above us or before us, or religious dogmas or deities. It is a school of thought which believes in finding things out in its own way, and do not believe in traditions, or what is already there and proved.They refuse to conform to any one school of thought. Existentialists like to set out and find their own way. They believe that there is surely a reason to exist and that existence precedes consciousness. Some of them even think that the concept of having a God is obsolete- that’s not what they need! As a result of the wide approach, they seldom agree with each other as well on various things. But they all seek a meaning in their lives by their beliefs in existence. Jean Paul Sartre was an existentialist. (you could read more through Googlesearch)Machiavellian Politics. Machiavelli a political thinker propounded the view that the ‘ends justifies the means’- so if you have used arbitrary or unacceptable means and achieved whatever you had set out to achieve, in his view, it is justified. As long as the end result is in the interest of the majority of the people, its fine. This form of politics is not very ethical, in fact quite radical, often used by the very ambitious, and quite often successful! It has an element of shrewdness and negative connotation. Not very favourable with the conservatives.You could go to the Net and read his book ‘The Prince’ in its translated version. Platonic Justice In his book, The Republic, written in 360 BC, Greek philosopher Plato has defined every conduct and every action required to govern a country. In short, the elements which contributed to creating and running of an effective Government at that point in time are all defined by him. It is another matter that over the centuries, transformations have happened, and though the basic aspiration of the government (to take care of its citizens/ public) stays the same, the rules of the game have changed dramatically.Platonic justice is the name giv en to his version of justice, as also propounded by Socrates before him- how a shoemaker must continue being a shoemaker because it is only fair that he does what he is good at, etc. (Please Googlesearch ‘The Republic by Plato’ and read on the Net for more) Monetarism Milton Friedman, the father of Monetarism, says that money supply (the amount of money in any economy at a given point in time) is the chief determinant of the level of economic activity at that point in time, especially with regards to the demand side.Simply put, the purchasing power of money is the prime mover. Monetarism is pretty much what we see today†¦though it has its origins in the oldest classical version of economic theory. (explains what we have stated in the research on flat world- the base maybe the same old theory, but the changing paradigms have rendered the theories very different from what they originally were- have improvised, built upon them to make them relevant to the current scen ario. And the current scenario is determined by those who need, not by those who offer- it is a buyers market.) Capitalism Capitalism is a form of liberal economic policy and governance where private entrepreneurship is given priority over government intervention in economic activity (all activities which contribute to a country’s GDP), because it has been seen and believed that private sector tends to be more progressive and efficient as a result of ensuing competition- each capitalist entrepreneur tries to be better than his competitor because that way he can earn higher profits, have a higher market cap, and prosper better.US is one of the very early capitalist countries, which explains the leadership position, while other countries were still being conservative and trying out a mixed economy model, or a communistic model. Communism Communism is a political term used to describe the ideologies of Karl Marx, the father of Communism. He firmly believed that the state or coun try should be run totally by the government, where everyone is equal- there is no blue collar and white collar demarcation and there is no private sector or capitalist aspirations.The Government is supreme and all people are equal in the eyes of the government. ‘From each according to his ability to each according to his need’ was his rule for governance. We owe May Day to Communism- it is Labour Day. His famous words: â€Å"Workers of the world unite; you have nothing to lose but your chains- you have a world to win! † You could read his treatise ‘Das Kapital’(translated version) – its available quite easily. Communist ideologies are exactly the opposite of Capitalist thinking.