The Violence Of Teen Pregnancy - 2500 Words

The media plays a huge role in an adolescent’s choice to participate in drinking, drugs, and smoking. The media spends on average twenty-five billion dollars per year on advertising tobacco, alcohol among other things; this advertising is at the fingertips of America’s adolescent’s. All of these media in contradictory to the â€Å"just say no† policy that parents try to enforce, all adolescents see is yes. Adolescents view approximately one thousand to two thousand alcohol and tobacco advertisements in a year. The odds of being exposed to an advertisement for drinking or smoking are far more likely than an advertisement for safety and good choices. What sort of values is reality TV sending to the children? I wonder what the glorification of teen pregnancy does to the minds of our youth. This holds true for smoking, drinking, or whatever else the media decides to portray on television. It does not have to be just substance abuse it could in general be t he bachelor. The issue is that while the media does have campaigns for anti substance abuse you always see the portrayal of death and destruction. This has a minimal effect in that while most people will focus on the death factor it will only be for a short amount of time. That is for most people. On the other hand commercials with alcohol or smoking portray a glamorous life of fun and happiness. Generally speaking these are the memories that people will focus on. Another example is those commercials that make us laughShow MoreRelated The Causes of Teen Pregnancy, Violence, and Drug Abuse Essay1075 Words   |  5 PagesThe Causes of Teen Pregnancy, Violence, and Drug Abuse The headlines proclaimed the controversial news: race, poverty, and single-parents were NOT the irrevocable harbingers of drug abuse, teen pregnancy, and violence. 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Lately, these shows are stirring a debate if they are trying to support or avoid teen pregnancy. And this topic is important to the public, because it relates to the young community’s future. Young girls and boys can watch these shows and

Davenport Blues Essay - 1104 Words

Gabrielle Bacarella Professor James History of Jazz Davenport Blues Meter: 4/4 Introduction (4 bars) 0:00 Band (2 bars) → Cornet Solo (1 bar) → Clarinet Solo (1 bar) **Solo break at Bar 3** Verse (16 bars) 0:06 Band (8 bars) 0:18 Band (8 bars) Chorus 1 (32 bars) 0:31 A Cornet Solo (8 bars) 0:43 B Cornet Solo (8 bars) **Solo break at Bar 7** 0:55 A Cornet Solo (8 bars) 1:08 C Cornet Solo (8 bars) **Solo breaks at Bars 1 and 3 (stop time)** Verse (16 bars) 1:21 Band (8 bars) 1:34 Band (8 bars) Chorus 2 (32 bars) 1:47 A Cornet Solo (2 bars) → Clarinet Solo (2 bars) → Cornet Solo (2 bars) → Clarinet Solo (2 bars) 2:00 B Band (6 bars) → Trombone Solo (2 bars) **Solo†¦show more content†¦The rhythm section consists of the piano by Paul Mertz, drums by Tommy Gargano, and banjo by Howdy Quicksell. Throughout the piece, the cornet, which is accompanied by the clarinet, plays the main tune as the trombone and piano keep the tempo like a bass. The piano plays the chords as the trombone plays consistent quarter notes which helps the whole ensemble keep time. The â€Å"Davenport Blues† introduction begins sounding somewhat homophonic. It sounded homophonic because the cornet and clarinet begin by playing the same melody but at different pitches. The melody in the intro sounds a little broken up and unorganized. But then we begin to hear the verses becoming somewhat reminiscent of the New Orleans style, which is known for its collective improvisation and polyphony. Polyphony is clearly heard in the three different melodies played simultaneously by the cornet, clarinet, and trombone in the â€Å"Davenport Blues† verses. The instruments in the â€Å"Davenport Blues† generally have the same interactions that a New Orleans ensemble would have. The cornet, for instance, plays the melody while the clarinet plays a countermelody drawn from the underlying chord progression. 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Simulation And Result Of Scalar Control Engineering Essay Free Essays

string(47) " compared subsequently on with vector control\." 6.0 Introduction This chapter focuses on scalar control in three stage initiation motor public presentation, trying to happen the intrinsic advantages and disadvantages of the method. An probe is conducted, via instance survey, into the public presentation of initiation motor thrust using the scalar control method. We will write a custom essay sample on Simulation And Result Of Scalar Control Engineering Essay or any similar topic only for you Order Now As package bundle, Matlab Simulink has been used and the simulation consequences are presented to turn out the dynamic behaviour of this type of control method. 6.1 Matlab and simulink. In the simulation of initiation machines utilizing Matlab and Simulink are first-class for numerical computation and informations visual image ; control applied scientists use them extensively for analysis design are many different tool chests available which extend the basic map of Matlab into different application countries ; for illustration, the Matlab tool chests, â€Å" control system † â€Å" model prognostic control † and â€Å" Robust control † supply methods for computing machine -aided control system design. The simulation bundle allows a broad scope of different constellations and theoretical accounts to be investigated quickly. The Simulink Matlab application is adopted because of its intrinsic integrating of vectorized system representation in block diagram signifier. Therefore, in this bundle, the package is used as an analytical for the graphical portraiture of the clip developments of signals combined with the simple realisation of the functionality of control and power electronic excitements. 6.2 The initiation motor theoretical account The initiation motor theoretical account has to be taken into consideration, It is of import because it is related to the control of the initiation motor. The initiation motor is used because it has perfected of features of theoretically and by experimentation. It is driven in a figure of different mentions frame, so the purpose of the theoretical account is frequently expressed in an arbitrary two-axis go arounding mention frame. This makes it easy to command ; the interior decorator can mend the mention frame to a peculiar motor measure and adjust the theoretical account consequently. All electrical parts of the machine, the variables and parametric quantities, are viewed from the stator. This is all indicated by the major marks in the machine equations given below. All rotor and stator measures are in the arbitrary two-axis rotor mention frame ( dq frame ) . The inferiors used are defined as follows: vitamin D: A vitamin D axis measure Q: A A Q axis measure R: A A rotor measure s: A stator measure cubic decimeter: A A escape induction m: A common induction iˆ? Electrical System ( 6.1 ) ( 6.2 ) ( 6.3 ) ( 6.4 ) Where, ( 6.5 ) ( 6.6 ) ( 6.7 ) ( 8.8 ) ( 9.9 ) ( 6.10 ) ( 6.11 ) iˆ? Mechanical System ( 6.12 ) ( 6.13 ) Asynchronous machine parametric quantities in the rotor mention frame are defined as follows: Rs, Lls stator opposition and escape induction R’r, L’lr Rotor opposition and escape induction Lumen Common induction Ls, L’r entire stator and rotor inductions Vqs, intelligence quotient Q axis stator electromotive force and current V’qr, i’qr Q axis rotor electromotive force and current Vds, Idahos vitamin D axis stator electromotive force and current V’dr, i’dr vitamin D axis rotor electromotive force and current stator Q and vitamin D axis fluxes rotor Q and vitamin D axis fluxes angular speed of the rotor P figure of pole braces electrical angular speed ( Wr * P ) Tellurium electromagnetic torsion Thulium shaft mechanical torsion rotor angular place Joule combined rotor and burden inactiveness Hydrogen combined rotor and burden inactiveness invariable F combined rotor and burden syrupy clash Table ( 6.1 ) -rotor mention frame definitions Where the inferior s corresponds to stator, r corresponds to rotor, d corresponds to direct axis, q corresponds to quadrature axis and L corresponds to leakage. Te represents torsion, while P is the figure of poles. The tantamount circuit is shown above. 6.3 Reference frame. The mention frame is used to change over input electromotive force ( abc mention frame ) to the dq mention frame and besides used for change overing the end product currents dq mention frame to ( abc mention frame ) . A pick has to be made between the following mention frame transmutations: Synchronous. Stationary ( Clarke or ii transmutation ) . Rotor ( park transmutation ) . The pick of the mention frame wave forms affects all dq variables. It besides affects the velocity of the simulation and, in some instances, the truth of the consequences. The undermentioned guidelines are suggested: If the stator electromotive forces are non balanced or non connected and the rotor electromotive forces are balanced ( or 0 ) a stationary mention frame can be used. If the rotor electromotive forces are non balanced or non connected and the stator electromotive forces ; are balanced rotor mention frame can be used. If all the electromotive forces are connexions and balanced the stationary or synchronal mention frame can be used. The undermentioned relationships explain the rudiment to dq mention frame transmutations which apply to the initiation machine block ‘s input electromotive forces. ( 6.14 ) I n the old equations, I? is the angular place of the mention frame, while i = i? ± – i? ±r, and the difference between the place of the mention frame and the place ( electrical ) of the rotor. Because the machines twists are connected in a three-wire Y constellation. There is no sequence ( 0 ) constituent. It besides justifies the usage of two input electromotive force lines to the line in the signifier alternatively of three electromotive force lines to impersonal. The relationships that follow depict the dq-to rudiment mention frame transmutations applied to Asynchronous machine stage currents. ( 6.15 ) ( 6.16 ) ( 6.17 ) ( 6.18 ) In the tabular array below are shown values represented by andi . In each mention frame ( vitamin E is the location of the synchronously revolving mention frame. Mention Frame Rotor R 0 Stationary 0 -r Synchronous vitamin E e – R Table ( 6.2 ) , value of and in each mention frame. ( Reference Matlab ) 6.4 Induction Motor Drives with Scalar Control One manner of understanding scalar control method is by utilizing instances survey with Matlab simulation. This portion of this chapter will concentrate and discus how this method performs. The simulation consequences will be analysed and compared subsequently on with vector control. You read "Simulation And Result Of Scalar Control Engineering Essay" in category "Essay examples" 6.4.1 Case survey The circuit shown below as the instance survey, an unfastened cringle scalar control method with PWM inverter is used to feed the stator through the control electromotive force supply. This inverter uses sinusoidal pulse-width transition ; hence, the base of frequence of the moving ridge ‘s frequence is set at 60 Hz and the triangular bearer wave ‘s frequence is set at 1980Hz. This corresponds to a frequence transition factor medium frequency of 33 ( 60 *33 = 1980 Hz ) . A three-phase initiation motor is connected to a changeless burden of nominal value 11.9Nm.In this circuit, a three stage initiation motor is built. Blocks of the machines and power electronic Matlab libraries have been used and besides in this circuit all the parametric quantities are the same circuit of vector control because the research worker wished to do a comparing between this circuit diagram of scalar control and vector control. Furthermore, the machine is used it has the same parametric quantiti es of vector control and scalar control. Figure ( 6.2 ) unfastened cringle simulink block diagram theoretical account 6.4.2 Construction of Electrical Model Induction Machine. Figure ( 6.3 ) shows block diagram the abc transmutation to dq of the initiation machine Figure ( 6.4 ) shows implement distinct trspezoidal integrating of machine equations in rotor, stationary or synchronal mention frame. Figure ( 6.5 ) shows block diagram of the dq transmutation to abc of the initiation machine 6.4.3 Simulation parametric quantities: Choosing the ode23tb incorporating algorithm, set the comparative tolerance to 1e-3, the absolute tolerance and maximal measure size to car and the stop clip to 4s. So the scalar method simulation was carried out utilizing the motor parametric quantities as shown in the tabular array below. The tabular array shows the simulation parametric quantities for constellation of the circuit Fig ( 6.2 ) Start clip 0 Integrator type 0d23 Stop clip 4s Relative tolerance 1e-3 Relative tolerance car Maximal measure size car Initial measure size car Table ( 6.3 ) the simulation parametric quantities in the simulation parametric quantities instance survey. Power, electromotive force and frequence [ pn ( VA ) Vn ( Vrms ) , fn ( Hz ) ] [ 50*746, 460,60 ] Stator opposition and induction [ Rs ( ohm ) L1s ( H ) ] : [ 0.087 0.8e-3 ] Rotor opposition and induction [ Rr, ( ohm ) Llr, ( H ) ] : [ 0.228 0.8e-3 ] Common induction Lm ( H ) : [ 34.7e-3 ] : Inertia, clash factor and pole braces [ J ( Kg.m 2 ) F ( N.m.s ) p0 ] : [ 1.662 0.12 ] Initial conditions [ 1,0,0,0,0,0,0,0 ] Table ( 6.4 ) Asynchronous motor parametric quantities 6.4.4 Simulation consequences: The thrust started from deadlock by stipulating 0 for all initial conditions of province variables in the Powergui interface. In this instance, the mention velocity was stepped from 120 to160 rad / s at t= 1 s and thrust variables velocity, torsion and current observed. Transeunt responses to get down the initiation motor thrust are shown below ; the first figure shows motor steady province torsion and velocity. Figure ( 6.6 ) the motor started and reached its steady province velocity of 120 rad/s ( 1800rpm ) at 1s ; at get downing, the magnitude of the 60 Hz current reached approximately 180 A, its peak current ( 127 rms ) , = = 127 Arms. Therefore, there was a high initiation motor get downing current, as was expected, because the motor has high power, whereas its steady province value was ( 20A ) and the Irms value about ( 14,14 rms ) . Besides, strong oscillations of the electromagnetic torsion at get downing were observed. On the torsion in steady province observation noisy signal with a average value of 11.9 Nm. In the three motor currents there was observed all the harmonics [ multiples of the 1980 Hz exchanging frequence ] which were filtered by the stator induction, so that the 60 Hz constituents were dominant. Sing the curves of the three stage initiation motor ( squirrel Cage ) , on get downing the motor without burden, the motor get downing currents, torsion and velocity can be observed on the range. At the terminal of simulation clip at ( 4s ) . , when the motor was reached steady province that is the torsion and velocity are changeless, So, Te – TL = 0, it was observed that the stator and rotor currents were rather ( noisy ) and the torsion and velocity had truly changeless value because the motor was non yet loaded so that is why the motor was on steady province. Figure ( 6.6 ) Simulation of the initiation motor without burden 6.4.5 Get downing with burden. In the following simulation end product different simulations were used to happen out the result when the velocity is set-up at steady province at a certain clip. In this figure ( 6.7 ) , the rotor velocity started increasing from 0 to 120 rad/s, after this, the lessening velocity for short clip between 2 2nd and 2.5 second, so velocity decreased until steady province ( 100 rad/s ) , for the falling value of the velocity is 20 rad/s. Suddenly, alteration in the magnitude of the stator current resulted in transient before the torsion reached the steady province and besides alteration in the linkage of the rotor flux. The research worker could detect the motor currents were high and largely noisy get downing current and besides that the torsion starts additions from 2 seconds to 2.5 seconds and to increase until changeless value was reached ; at the same clip as cut downing velocity, the current, nevertheless, was increased because the relationship between torsion and velocity are reci procally related. Finally and clearly either the dynamic torsion control is really hapless and besides it has jobs with the transeunt response of the torsion or it is really hapless and can non be controlled by the torsion in the transient province. Figure ( 6.7 ) measure up torque response at 11.9N.m The undermentioned simulation of torsion 50N.m applied at least two seconds and a changeless velocity of 120 rad / s to see how this theoretical account of scalar controls responded to these alterations. This simulation shows the end product velocity started increasing from 0 to 120 rad / s, than at 2 seconds the velocity will be reduced to 90 rad / s, so that the torsion is applied to two seconds, so get down to cut down velocity ( a little ) at the same clip, torsion is increased until making a changeless value. The starting currents were high, up to 1.5 seconds, and so reduced until the steady province was reached at the same clip the torsion applied. Internist provinces torque and current were noisy and did non discontinue. However, the dynamic behavior of scalar control was non perfect, so in this it instance affected the public presentation of the initiation motor. Scalar control should be used at low velocity and variable velocity, for illustration as fans or pumps. Figure ( 6.8 ) simulation of the initiation motor thrust with step-up torsion Figure ( 6.9 ) shows simulation end product difference simulation status was used to happen out the result when the velocity is step up at the steady province at certain clip. At the one second the velocity starts to increase and the torsion besides increased but for short clip so the torsion starts to decreased until reached changeless value, besides this clip the velocity invariable. This means altering the velocity with the scalar control under the steady province status will be sensible. Figure ( 6.9 ) simulation of the initiation motor thrust with step-up velocity The dynamic public presentation of thrust ( public presentation relation to the velocity control mention alteration and burden torsion ) as Fig ( 6.10 ) can be studied by using two alterations in operating conditions of the thrust ; a measure alteration in velocity mention and measure alteration of the burden torsion. The torsion 50Nm was applied for 2 seconds and velocity of measure 140rad / s for 1 2nd, to see how these model scalar controls would react to these alterations. In this instance, it was observed the velocity dropped aggressively to one second, shortly, and so went up to 140 rad / s to 3.5 seconds. The electromagnetic torsion of the initiation motor was foremost variable in 0.6 seconds. After the torsion is little bead of one second when the rate was applied the torsion continuously went up to 90Nm in 3.5 seconds. In this instance, the increased velocity and torque addition were non the same as earlier. The chief job of current and torsion in 1 second is if the torsion all of a sudden drops and the current addition is more than the starting current, In this instance, the value of the burden and velocity control should be increased. Figure ( 6.10 ) simulation of the initiation motor thrust with step-up velocity and torsion. Figure ( 6.11 ) simulation of the initiation motor thrust with step-up velocity and torsion. 6.5 Scalar control dissection The electromotive force applied to the motor must alter with frequence. The control method is really simple and easy to implement. Improves inactive public presentation of control system, but its transient capableness is non satisfactory. Accurate place control is non possible. Open cringle scalar control will be able to provide speed fluctuation ; it is non able to supply reliable control under transeunt conditions. Therefore, the scalar control is suited merely if the motor operates in steady province without velocity ordinance. Scalar control is used chiefly in applications where changeless torsion is required. Scalar control ever has hapless kineticss. Scalar control methods are used merely the magnitude and frequence ( V/Hz ) . How to cite Simulation And Result Of Scalar Control Engineering Essay, Essay examples

The Danger in Trifles Essay Example For Students

The Danger in Trifles Essay Susan Glaspells Trifles is a play about a real life murder case that uses symbolism to help bring it to a close. It is easy to see that Mr. and Mrs. Wright live in a society that is cut off from the outside world and also strongly separated by gender. Three of the key symbols in Glaspells play are a simple bird cage, a quilt, and isolationism. Anna Uong of Virginia Tech and Karen Shelton of JSRCC share these same ideas on symbolism. These three symbols are the main clues that help the reader decide who killed Mr. Wright. The bird cage that was found is one of the most profound symbols in the story. Mrs. Hale describes Minnie as, kind of like a bird herself, real sweet and pretty but kind of timid and fluttery(841). The bird and Minnie are similar because they are both caged in. When Mrs. Hale and Mrs. Peters find the broken birdcage, they think nothing of it until they discover the bird. He was found wrapped in a cloth inside of a small box, with his neck wrung. Mrs. Wright wrapped the dead bird in a silk cloth and placed it inside a fancy box; this symbolises her cherishing of her past life.(Uong, 1) When John strangles the life out of Minnies bird, he also strangles the life out of Minnie. The broken birdcage that was found represents Minnies liberation from John. Just like the bird, Minnie has now freed herself from John by killing him. The second symbol that ties the story together is the quilt, which was symbolic of Minnies life. The quilt that Minnie was working on at the time of her husbands death is almost perfect, except for the most recently sewn block. It is said to be All over the place as if she didnt know what she was about, states Mrs. Hale(840). This is another clue into how enraged and flustered Minnie was. Minnies last straw was when John killed her bird. When the bird died, so did Minnies personality. After that murder, Minnie was enraged, confused, and didnt know what to do. Mrs. Hale wondered if she was goin to quilt it or knot it(840). By quilting the blanket, she would have chosen to endure the pain that John was putting her through, but by knotting the quilt she chose to eliminate it. Just as a knot represents a finishing or a completion of a project, it also was an end to John. The weaving of the quilt also symbolises the building up of the marriage and then the end of it. The quilt started out as a beautiful piece of art and was brought to a close by a couple of sloppy stitches and knots(Uong). Just like the Wrights marriage, the quilt was beautiful until the end where everything was simply a mess. Isolationism also plays a very important role in the story. The Wrights farmhouse is located in a hallow, in the woods. This sets her in a secluded place away from most civilisation. The Wrights didnt even have a phone in their house to be able to call anyone. Mr. Hale came to talk to Mr. Wright about a phone a few times but, he put me off, saying folks talked too much anyway(Glaspell, p.835). This is an example of how Mr. Wright did not want him or his wife to have regular contact with anyone in town, which is another part of John sheltering Minnie and not letting her live her life. This is why Minnies bird was so important to her. It was the only normality to the outside world she had, and Mr. Wright had taken that away from her(Shelton). When John finally killed the bird, he also killed a part of Minnie. .u4becee2c13aef97c491f5ae3b5961e93 , .u4becee2c13aef97c491f5ae3b5961e93 .postImageUrl , .u4becee2c13aef97c491f5ae3b5961e93 .centered-text-area { min-height: 80px; position: relative; } .u4becee2c13aef97c491f5ae3b5961e93 , .u4becee2c13aef97c491f5ae3b5961e93:hover , .u4becee2c13aef97c491f5ae3b5961e93:visited , .u4becee2c13aef97c491f5ae3b5961e93:active { border:0!important; } .u4becee2c13aef97c491f5ae3b5961e93 .clearfix:after { content: ""; display: table; clear: both; } .u4becee2c13aef97c491f5ae3b5961e93 { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .u4becee2c13aef97c491f5ae3b5961e93:active , .u4becee2c13aef97c491f5ae3b5961e93:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .u4becee2c13aef97c491f5ae3b5961e93 .centered-text-area { width: 100%; position: relative ; } .u4becee2c13aef97c491f5ae3b5961e93 .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .u4becee2c13aef97c491f5ae3b5961e93 .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .u4becee2c13aef97c491f5ae3b5961e93 .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .u4becee2c13aef97c491f5ae3b5961e93:hover .ctaButton { background-color: #34495E!important; } .u4becee2c13aef97c491f5ae3b5961e93 .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .u4becee2c13aef97c491f5ae3b5961e93 .u4becee2c13aef97c491f5ae3b5961e93-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .u4becee2c13aef97c491f5ae3b5961e93:after { content: ""; display: block; clear: both; } READ: National Crisis Essay Symbolism plays a big role in Susan Glaspells Trifles. Symbolism is what helps the reader decipher who killed Mr. Wright. Glaspell uses a dead bird with its cage, a quilt, and isolationism to create a motive in the mind of the reader. The bird symbolised Minnie herself and how she was suppressed and literally murdered. The quilt symbolised Minnies life and her choices about her husband; and finally the isolationism of Minnie gives her a good motive and reason to want to be free from her husband. Glaspells use of symbolism gets the reader involved in the play and requires the reader to piece together this puzzle of a murder. This .

Les Brown-You Deserve Essay Example

Les Brown-You Deserve Paper I’m going to start off by saying I’m a huge fan of Mr Brown. I believe he is a great motivator with a dynamic personality. Years ago, Mr Brown was the keynote speaker at one of my family reunions. His speech, although tailored to family, was mainly about the power we have as individuals to achieve personal greatness. I’m not the only one who left that reunion feeling better about myself and my family as awhole. When we watched the speech in class, I was pleasantly surprised. I’ve heard of the You Deserve seminar but had never heard it myself, so I was excited to be able to watch it in class. I was not disappointed at all. This speech basically talked about the fact that we deserve greatness and how we can achieve it. Mr Brown talks about how we are in fact our own worst enemies when it comes to achieving our goals. There is nothing anyone can say to or about you, positive or negative, that will change who you are unless you let it. As a young man who grew up misdiagnosed as educably mentally retarded and held back in school not once but twice, I’m sure Les Brown wasn’t the most confident student. But, while everyone else had given up on him, Mr Brown met a man who let him know that the label given to him didn’t define him. With that knowledge, Mr Brown has become a success who uses his successes to create success in others. The speech reached me in ways that may not have reached others. I find that I am always my worst enemy when it comes to reaching my goals. It’s not a lack of confidence but a penchant of making excuses and not going all the way in trying to achieve my goals. It’s almost like become afraid of my actual potential. We will write a custom essay sample on Les Brown-You Deserve specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Les Brown-You Deserve specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Les Brown-You Deserve specifically for you FOR ONLY $16.38 $13.9/page Hire Writer After watching this seminar, I now see that as long as I remain in this mindset, I’m never going to be all the way happy. I don’t like having that â€Å"what if† feeling, and unless I do something about it, that’s the way stuff is going to be. I will once again say that Mr Brown is a magnificent motivator, but the truth of the matter is once you see this program, and apply what you’ve learned, your life will change by leaps and bounds. But, you have to actually put in the work to do so. Otherwise, you could have the knowledge and do nothing about it. What a waste that would be.

Enzymes Lab Report Essay Example

Enzymes Lab Report Essay Example Enzymes Lab Report Paper Enzymes Lab Report Paper The size, the smell, the color? Most of us WOUld have to say that if they grabbed an apple that had a bruised body, they would return that apple to the pile in search for that perfect skinned apple. This is why studying catechist oxides is so important! Lets take a look at population numbers and why catechist oxides is so important with the increasing number of people living on Earth. In 2010, the global population was estimated to be around 6. 9 billion people (1). From 2008 to the end of 2011, the number of hungry families in Washington grew from about 88,000 to 163,000 In 2011, 15. Percent of Washington households reported some level of food insecurity, which means they regularly struggle to get enough food for their families, according to the USDA. (2). With an increase like that in the amount of people struggling to feed themselves, how do we think its going to be when the expected population growth on Earth jumps to 9. 6 billion in 2050 (1)? This is why studying catechist oxides is so important. According to a UK news article back on September 19, 2013, Up to two-fifths of a crop of fruit or vegetables can be wasted because its ugly Produce grown in the UK that does not meet detailer standards on size or shape or is blemished is often used for animal feed or simply ploughed back into the ground even though it is edible, with as much as 40% of a crop rejected. (3). Up to 40%! With people going hungry all over the world, if we were able to figure out how to reverse catechist oxides or even halt it for a period, we would be able to have those fruits and vegetables out longer with purchasers willing to buy them because they still hold their pretty appearance. Before I get into more about the actual experiments done in the lab, let me explain in a little more detail about enzymes. Enzymes speed up chemical reactions and those chemical reactions then either consume or change the enzyme itself. Enzymes structures are three-dimensional that are built up by at least one or more peptide bonds that form what is known as an active site. The active site is where the substrate (catechist in this experiment) will go and attach. Many things such as changes in temperature and changes in pH can affect the structure of the active site which will affect the rate of reaction of how the enzyme contributes. Please see below for the chemical reaction done by catechist oxides: (4) This reaction is what causes the fruits and vegetables to brown or looked bruised. In the middle you see where the catechist oxides (remember: it is the enzyme so that means it speeds up the reaction) comes into play. Catechist oxides are found in the cytoplasm of the fruits and vegetables. When catechist oxides is exposed to oxygen, it turns the fruits and vegetables brown. Remember how above I stated that many things can change the structure of the active site, such as pH? Well as it would have it, all enzymes are affected by changes in PH. Not only can it change the shape of the structure of the enzyme, UT it can also change the shape or charges of the substrate as well. That can make it so the substrate is unable to bind to the active site making it unable to go through catalysis. So they work in whats called the lock and kef manner with the substrate. When the optimum pH level of an enzyme is met, it allows it to lock with the substrate to form the catalyst. The optimum pH is where the enzyme is the most active. But just because one enzyme is most active at a certain point, doesnt mean that other enzymes are the same. In fact, the optimum pH can differ greatly from enzyme to enzyme. Please look to the left for what optimum pH will look like on a graph (5). As you can see, at the highest point of the bell curve is where the optimum pH of that enzyme is. The optimal pH allows the reaction between the enzyme and substrate to continue on. My hypothesis for this lab, Exercise C: Effect of pH on the Action of Catechist Oxides: The rate of the catechist oxides activity levels will be altered by the change in pH levels. I believe this is so because as stated above, pH has a great effect on the structure and function of the enzyme itself. The rate of absorption will tell me whether my hypothesis is correct or not. My null hypothesis for this lab, Exercise C: Effect of pH on the Action of Catechist Oxides: The rate of the catechist oxides activity will not change due to the different pH levels. Rather it will stay the same throughout. Methods: was in a group of four people: Kari Serial, Kelsey Heinz and Deborah Thermal. For our Lab 4 Enzyme activities, we were going to be using potato juice (enzyme) and catechist to resemble the natural acting potato and catecholamine reaction. We followed Exercises A B as instructed in the Lab Manual for Lab 4 Enzymes. When it came to Exercise C, we were assigned pH. In order for us to be able o get all the information down, we split up the tasks for this exercise. Deborah and myself were the readers and recorders of the absorbency rates. We used a blank tube to get the absorbency level at 0 on the spectrophotometer at 0 seconds to get the experiment off correctly. Kelsey was the person who would take the test tube in and out of the spectrophotometer on Saris instruction as she was the one doing the 10 second timing. When Kelsey pulled the test tube out that held our pH, she inverted the tube twice before sticking it back into the spectrophotometer. We did this process for a total of 120 seconds and recorded the readings. Results: Table: Absorbency vs Time- Enzyme Activity Thursdays Lab Class Time (sec) pH pH pH pH (replicate) pH pH 0. 01 10 I . 420 0. 206 0. 694 -0. 070 0. 380 20 1. 750 0. 356 0. 820 -0. 033 0. 500 0. 644 30 2. 050 0. 430 0. 880 -0. 001 0. 538 0. 656 40 2. 340 0. 486 0. 940 0. 013 0. 586 0. 642 50 2. 660 0. 550 0. 960 0. 031 0. 614 0. 628 60 2. 940 0. 616 1. 000 0. 050 0. 648 0. 20 70 3. 150 0. 680 1 . 030 0. 074 0. 676 80 3. 400 0. 718 1. 070 0. 133 0. 700 0. 606 90 3. 700 1. 025 1. 110 0. 148 0. 728 0. 596 100 3. 900 1 . 090 1. 140 0. 151 0. 772 110 4. 100 1. 160 1. 180 0. 176 0. 792 0. 578 120 4. 200 1. 250 1. 210 0. 194 . 800 0. 570 color (after 120 seconds) deep rust deep rusty brown rusty brown orange rusty pink-brown The table above not only shows my groups pH level reco rdings, but also the rest of the groups recording as well. On the bottom of the table you will see the color of which those groups determined the contents in their test tubes to look like. While the amount of contents, absorbency readings and timing are all quantitative observations, the color inside the tube was a qualitative observation. All pH levels increased in absorbency except for phi. Because most of the pHs absorbency increased with time, that shows that the reaction teen the enzyme and the substrate are continuing and moving forward. Graph: Absorbency vs Time- Enzyme Activity- Thursdays Lab Class: In this graph above, you can visually see the dramatic increase in absorbency in pH while pH (replicate) has the lowest level of absorbency. Also take not though, while you cannot see it very well on this graph, phi has an absorbency that started out strong, but decreased as time went on. In order for us to determine the reaction rate, we needed to look at the information collected from the experiment that is listed on the first table of this report. I also created operate tables for each pH level for my own guidance. In the mathematical equation, you use y=mix+b. In this experiment, b is equal to O, so really you have y=mix. In order to find the slope or rather the reaction rate, we needed to do the rise/run=m which meant we needed to find the change in y and the change in x. The equation at this point would be ye-ye/xx-xx. Because yell and XSL are both O, you simply had to do ye/xx. In a simpler explanation, you take the 10 second absorbency and divide it by 10. That is how the rate of reaction numbers above came to be. This table includes all the pH data collected. For a view of what this looks like on a graph, please see below. Please take note that due to my excel, I was not able to make it a curve table as it should have been. Rather it is a table with strict points. You can see just the same the high points and low points that you would see if it was a bell curve table. Graph: Reaction Rate vs PH with all pH data: This graph shows that the absorbency level throughout the pHs goes down the higher the pH, meaning the lower the acidity. Though the information presented is all over the board which to me is telling me that most likely, there were errors n the experiment. I will discuss those further in the discussions and conclusions part of this report. There are a couple of outliers that I believe could be taken out in order for the data to be more correct. For those, I would choose to take out pH and pH (replicate). The reason for pH, even though it was the pH that my group was assigned to, it was significantly higher than the rest showing it to be one of the biggest outliers. I then am going to take out pH (replicate) because first, it is a negative number, and second, it is the second largest outlier. Updated Table: Reaction Rate vs H- Excluding pH pH (replicate)- Thursdays Lab Class pH Rate of Reaction 0. 0206 0. 0694 0. 038 PHI 0. 065 An updated graph for the table above is below: This shows a more linear graph with taking out those outliers. This changes the findings though as well from saying absorbency is decreased with a higher pH to the absorbency is increased with the higher PH. Discussion and Conclusion: The absorbency for all by phi increased as time passed; Though there wasnt a direct trend as to the higher the pH level the more it was absorbed or visa versus. In my hypothesis I stated that I believed that the rate of catechist oxides activity will change with the different pH levels. The findings supported my hypothesis because it showed that there was a significant change throughout the pH levels. The higher acidic pHs, such as pH and pH, ended up having the greatest absorbency, though pH was close behind. Phi actually had an absorbency that decreased as times passed. pH absorbency rate was significantly higher than the rest of the class which leads me to believe that we did something incorrect or that something went wrong in our results. While I thought we took special care when putting the contents into the tube and made ere that everything was working correctly, still many things could have gone wrong. We could have had air bubbles or a dirty cavetti that would not let the light to penetrate through, there could have been measuring errors, missed timings, cross contamination of solutions, or even the spectrophotometer could have been set incorrectly or it could have been drifting causing the incorrect information. So like I said, many things could have gone wrong. It seemed that a lot of the information from the other groups was also incorrect. It didnt show an optimum curve at all with the pHs which is the first indicator. So from there .NET ahead and took out the two largest outliers which was pH and pH (replicate) to try and get more of that curve and a more accurate finding. While it came closer to linear and more of a curve, I still believe that the findings in the class with the groups were mostly incorrect. So I would suggest that this experiment be repeated to get better and more accurate results. Because I excluded pH and pH (replicate) from my findings, I would have to say that pH was the most effective. It is more in the safe range for the pHs and is less acidic than pH and pH, which could mean that it allows for easier absorption.

Collective Security Systems during and after the Cold War Essay

Collective Security Systems during and after the Cold War - Essay Example The theory of collective security intended to keep security and maintain peace through a sovereign international organization. In this assignment, I will discuss collective security during and after the old War. Since United Nations was a key organization in dealing with collective security, the organization will be emphasized in an attempt to discuss collective security. Discussion After the League of Nations became incapable of providing collective security to the states, it disintegrated; this led to the development of United Nations. According to the United Nations Charter, the United Nations was to provide peace and deal with security matters, but had to rely on the leadership of Russia and the United States since they were the two super powers. However, although the leadership of security and peace matters rested on the superpowers, the emergence of Cold War and its consequences, in terms of bloc politics, blocked the United Nations from performing its principal goal of providi ng collective security (Kupchan 1991, p. 123). In the hostile condition of the Cold War, the United Nations could not perform its role to implement the provisions of the Charter in most cases related to international peace and security. Although the Cold War barred the United Nations from performing its function satisfactorily, especially in security and peace matters, it successfully pursued its Charter goals in other areas like decolonization, which aided in achieving collective security. After the end of the Second World War, winners of the war saw the need of finding a World organization, which could deal with issues relating to maintenance of peace and security. On this bid, the United Nations became established with an aim of correcting the deficiencies of League of Nations. The principal intention of the superpowers while establishing the United Nations Charter entailed finding a remedy to chief weaknesses of the League of Nations; these included the absence of collective sec urity system for the upholding of international peace. During the Cold War period, the United Nations played a significant role in fighting for collective security among states. After the start of the Cold War in 1947 up to 1960, formation of a collective security was a massive failure. The chief reason for failure of having a collective security system during this period arose from tensions of the Cold War. The idea, which was put during the formation of the United Nations, provided that the two principal powers had to direct the Security Council in formulating the collective security system. However, there emerged mistrust between the two principal powers, which led to divided ideologies of providing a collective security. This division between the two superpowers became vast since the United States used the United Nations to contain Russia (Thakur 2006, p. 109). Under these circumstances, it was remarkably difficult for the United Nations to establish the proposed machinery for m aintaining international peace and security. Since West and East did not trust each other in undertaking military operations on behalf of the United Nations, the activities of the Security Council became limited to a capacity that it could not establish the collective security system. This became evident during the Korean War and the Suez Canal Crisis. During these two conflicts, the Superpowers were still divided and the UN was not capable of providing collective sec

Discretion Granted to National Courts in Relation to the EU Legal Essay

Discretion Granted to National Courts in Relation to the EU Legal Order - Essay Example The body that was named as the European Court of Justice (ECJ) that enables the national courts to refer to it. The preliminary reference procedure has been essential in designing the fundamental principles of the national legal system, the unity of the member countries, and the development and maintenance of the national laws. In Article 234, the Court has the powers to give preliminary rulings in a request from the national courts. The preliminary rulings might be about the interpretation of the Treaty, the legality and the interpretation of the actions of the member countries and the European Central Bank. The national courts have therefore a vital role to play in the administration and how the community law is implemented. However, the European Union Treaty does not precisely define â€Å"the national court or tribunal†. Nevertheless, it is vital to know that the national laws of the member states do not depend upon the definition of the tribunal or national courts by the European Court of Justice. The Court has the role to define the national laws of a given community. ... Moreover, different cases shall be looked upon in the preliminary ruling procedure (Arnull, 1989). The Right and Obligation to Refer Cases The case of Vaasen- Gobbel came up with the decision to define the national court in order to find a way to refer to the ECJ. The case was held by stating that any body making a reference to the European Court of Justice must satisfy a number of criteria: It first need to be established by law, must have a permanent existence, it must be in a position to practice a lasting jurisdiction, must work under the rules of the Community law and its procedures and should apply the rule of law. The Court therefore had to extend the stated criteria to apply to the national courts so that they would be independent (Komarek, 2005). Several other cases including the De Coster Case, enabled the college which previously had the powers concerning the local tax proceedings and never operated on its own nor made its own decisions regarding the process later satisfie d the criteria to operate as an independent body. The De Coster and CLIFIT cases demonstrate the national courts that have the powers to give judgment in relation to article 234 of the European Court of Justice (Komarek, 2007). Even though the case regarding the definition of the court or tribunal that satisfies the previously defined criteria for an independent body is at times inconsistent and therefore provides a room for some critics to disagree on which bodies are to refer cases to the ECJ. However, in order to solve this problem of disagreements, the European Court is coming up with the preliminary reference procedure that would be used by all judicial bodies while they might be dealing with cases involving the Community law (Maher, 1994). On the facts of the case, the De Coster and

John Updike A&P Essay Example | Topics and Well Written Essays - 1250 words

John Updike A&P - Essay Example Within the play the role of Sammy has been on the sidelines of being a conformist. Inevitable to state here that this nineteen-year-old cashier at A&P does not believe in playing around with his point of view and focuses on what is the right thing. More than that, he is proud to say what he sees and then judge in the light of the same which definitely distinguishes him from the rest of the lot in our society. (Saldivar, 1997) He is a non-conformist to start with and he is one that is not really appreciated by the society norms and customs that are so very religiously followed in the present times. The writer has made Sammy the main character in the play whereby he has written of him from the first person’s perspective. This essentially has made his character look a bit highlighted and one that could be seen as the main one during the course of the whole saga. Add to that, the tone with which the writer has penned down the same has been certainly set by Sammy’s rigid and stern attitude which can be rightly remarked as being nonchalant as well as frank as Sammy does clear the air when a question is raised on his calling the things as he sees them and quite rightly so he comes out as clean as a whistle. His wits are a mode of cynicism and this is an added facet when one speaks highly of the frank and vivid attitude related with the young man. (Lewis, 2003) Add to that, he has turned out to be pretty crude at times during the story which meshes along quite nicely with his attitude and ways that he has so very easily been showing. Another aspect that gives evidence t o his non-conformist ways and attitude is that he loves to be taken as an adult by all and sundry and would really mind if someone, out of the blue, starts calling him like a kid as he is of the perception that he possesses wisdom par with no one and his thoughts and feelings have a deep embedded meaning that is not easily comprehensible by people of his age, let alone the ones

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.,