International border searches Essay Example for Free

International border searches Essay It is recognized that it is paramount to the U. S. to protect and preserve the integrity of its borders. This involves a constant balancing by the authorities between trade and commerce on one hand and terrorist activities, contraband and illegal immigrants on the other hand. By reason of this, security operations involve border searches and seizures which necessarily have implications on the Fourth Amendment (Vina, 2005). The Fourth Amendment ensures and protects the people from unreasonable searches and seizures and provides, â€Å"â€Å"The right of the people to be secure in their persons, houses, papers, and effects against unreasonable searches and seizures, shall not be violated, and no Warrants shall issue, but upon probable cause, supported by oath or affirmation, and particularly describing the place to be searched, and the persons or things to be seized† (U. S. Constitution, Fourth Amendment). The Fourth Amendment is to ensure that the powers of the federal government are not arbitrarily used against its citizens. Legally, â€Å"reasonableness† is required as one to be determined by a judge for the issuance of a search warrant. The judge is said to be independent and impartial as to determine the existence of probable cause so that the police can make the search or arrest [Katz v. U. S. , 347, 357 (1967)]. A violation of the Fourth Amendment will result in the exclusion or suppression of whatever evidence may be gathered pursuant to the exclusionary rule enunciated by the Court in the case of Mapp v. Ohio, 367 U. S. 643 (1961). There are however, exceptions established when reasonableness and warrant requirement are relaxed and therefore â€Å"probable cause is not invariably required either† (Vernonia School Dist. 47J v. Acton, 515 U. S. 646, 653 (1995). This occurs when the interests of the public require more protection than those of private interests. One of these established exceptions to the warrant and probable cause requirement is border search [Camara v. Municipal Court, 387 U. S. 523 (1967)]. Discussion Border search is defined in the case of United States v. Ramsey as â€Å"that searches made at the border, pursuant to the longstanding right of the sovereign to protect itself by stopping and examining persons and property crossing into this country, are reasonable simply by virtue of the fact that they occur at the border, should, by now, require no extended demonstration (431 U. S. 606 (1977)). This does not require a warrant, probable cause or reasonable suspicion (Onecle web site, 2005). The exception of border search is provided for under the United States Code specifically in Chapter 19, subsections 482 and 1582. This exception is premised on the duty of the state to protect its citizens, regulate trade and commerce and enforces immigration laws, thus, authorizing routine stops for searches at the border [U. S. v. Ramsey, 431 U. S. 606 (1977)]. There are two types of border search, namely routine and non-routine (Vina, 2005). In the case of U. S. v. Johnson, the Court explained that routine search include a search without any suspicion and entails very limited invasion of privacy (991 F 2d. 1287, 1291 7th Cir. 1993). This may include a dog sniff of the person, a search and inspection of belongings, luggage and car (Vina, 2005). The non-routine search includes more intrusive methods and is conducted when the authorities have suspicion that there is alimentary canal smuggling. The search may consist of â€Å"destructive searches of inanimate objects, prolonged detentions, strip searches, body cavity searches, and some x-ray examinations† (Vina, 2005). Body cavity searches include searches in cavities such as â€Å"vagina, rectum, or the use of emetics† [Vina, 2005 citing United States v. Ogberaha, 771 F. 2d 655, 657 (2d Cir. 1985) (vagina); United State v. Pino, 729 F. 2d 1357, 1358 (11 th Cir. 1984) (rectum); United States v. Briones, 423 F. 2d 742, 743 (5 th Cir. 1970) (emetics)]. The law requires that ‘reasonable suspicion’ consists in particular and specific facts which a logical person can infer from a wrong doing (U. S. v. Montoya de Hernandez (1985), 473 U. S. 531). There are also instances when border searches are allowed to extend beyond the border, in the following cases, namely: â€Å"(1) the government officials have reasonable certainty or a â€Å"high degree of probability† that a border was crossed; (2) they also have reasonable certainty that no change in the object of the search has occurred between the time of the border crossing and the search; and (3) they have â€Å"reasonable suspicion† that criminal activity was occurring† (U. S. v. Teng Yang (2002), 286 F. 3d. 940). These three requisites must exist and concur to render legal and constitutional, the extended border search by ensuring a â€Å"significant nexus with a border crossing† by the suspect (Vina, 2005). Most often the routine searches give rise to non-routine searches such as for instance where undeclared precious stones are found inside the pocket of the suspect, this resulted into reasonable suspicion thus giving rise to the conduct of non-routine search of strip searches. This yielded an envelope of narcotics (U. S. v. Flores, (1973) 477 F. 2d 608). Conclusion The U. S. government embarked on enhancing border security technologies and operations by reason of the September 11 terrorist attack. Intercepting and aborting terrorist attacks and smuggling of contraband were overstressed. Pieces of legislation are being drafted to harness further training in detection of false or falsified documents, pilot programs are launched for â€Å"surveillance technologies, biometric entry and exit data system and enhanced training of border officials (Vina, 2005). Volunteer programs were also set up to assist in observing and reporting of the movement of illegal aliens such as those launched in Arizona in 2005. This is a â€Å"citizens’ neighborhood watch’ program called the Minuteman Project. References Camara v. Municipal Court, 387 U. S. 523 (1967) Katz v. U. S. , 347, 357 (1967) Mapp v. Ohio, 367 U. S. 643 (1961). Onecle Web site 2005 â€Å" Border searches† Retrieved on October 25, 2007, from http://law. onecle. com/constitution/amendment-04/18-border-searches. html United States Code, Chapter 19, subsections 482 and 1582 U. S. Constitution, Fourth Amendment Vernonia School Dist. 47J v. Acton, 515 U. S. 646, 653 (1995). Vina, S. 2005, Protecting our perimeter:† border searches† under the Fourth amendment CRS Report for Congress. Retrieved on October 25, 2007, from http://www. fas. org/sgp/crs/homesec/RL31826. pdf. United States v. Briones, 423 F. 2d 742, 743 (5 th Cir. 1970) U. S. v. Flores, (1973) 477 F. 2d 608). U. S. v. Johnson, 991 F 2d. 1287, 1291 7th Cir. 1993). U. S. v. Montoya de Hernandez (1985), 473 U. S. 531 United States v. Ogberaha, 771 F. 2d 655, 657 (2d Cir. 1985) (vagina) United States v. Pino, 729 F. 2d 1357, 1358 (11 th Cir. 1984) (rectum); U. S. v. Ramsey, 431 U. S. 606 (1977)]. U. S. v. Teng Yang (2002), 286 F. 3d. 940.

Change Management In Healthcare Environment Policies

Change Management In Healthcare Environment Policies Question 2: Develop policies and systems for involving others in the process of change Describe how you would involve stakeholders in the introduction of this change into the healthcare organisation viz. Mercer Medical Centers. Analyze and evaluate the effectiveness of systems in promoting change in Mercer Medical Centers. (Word Count :1500 words) Question 3: Implement models for ensuring change in which risks are managed 3.1 Develop models for change that take account of risks in the context of case study 3.2 Plan the implementation of the model of change developed for Mercer Medical Centers 3.3 Evaluate the outcome of change in Mercer Medical Centers (Word Count :1500 words) Question 1: Explore the background to change affecting the healthcare organisation in the case study viz. Mercer Medical Centers Assess the background to change that faces Mercer Medical Centers. . At first change is awkward but it is something that presses us out of our comfort zone. Changing from one state to the next upsets our control over outcomes and is uncomfortable. Change changes the speed of time. Time is so slow for the reluctant, and yet it is a whirlwind for those who embrace it. Change doesnt look for a resting-place; just the next launching point. For those who dont learn from it they perceived it only as a waste, Institute of Industrial Engineers (IIE, 2010). Change management is all about people and processes that work for people. It is about how you take an organisation from Position A to Position B, in the fulfilment or implementation of a vision and a strategy and the whole art is to how to carry your people with you, so that the envisaged benefits of the vision and strategy are actually realised (Warrilow, 2010). Organisational Change Management seeks to understand the sentiments of the target population and work with them to promote efficient delivery of the change and enthusiastic support for its results (Wallace, 2007). Pressures that triggered for the need of change in Mercer Medical Centre can be seen. Competition in the market is the primary motive. The pressure has been relentless to constantly update expensive systems and equipment in order to be on the top of the business. Managed care penetration is increasing, and Mercer has bought up small private clinics as well as having its own managed care insurance plan. In order to stay competitive in the market, contracts from high technology firms such as Syntel, the company which manufactures computer chips whose function is to apply the Physician Order Entry (POE) system was sought after by Mercer Medical Centre. Plans from other competitors to implement same physician order entry (POE) system pushed Mercer to implement its system earlier than what has been planned (Ash et al, 2000). Second reason is the public relations. The latest lawsuit has a negative impact to the corporation and could damage its reputation in the market and its managed care contracts. As stated by Anderson, having a state of the art POE system will be a good promotional tool in negotiation of contracts (Ash et al, 2000). Resistance to change is normal. Lack of communication, minimal top management involvement and forced change processes are among barriers to change. Initially, the target population sees the change as a bad or threatening thing. The Project Manager should expect to encounter it and deal with it. The worst time to encounter resistance is during the cutover to the new solution. Transition is usually a busy, critical, high-risk period when the last thing you need is a lack of co-operation from the target population. A significant project will require a cascade of sponsorship, such that all affected parts of the organisation hear strong support from their leadership. If the message is delivered from the top and reinforced by the immediate management, staffs are far more likely to believe in the case for change and to act in support of the changes (Wallace, 2007). 1.2 Evaluate the strengths and weaknesses of bureaucratic health organizations Bureaucracy is a form of structure in many large scale organisations. It is based on specialisation of tasks, hierarchy of authority and decision making, systems of rules and regulations and an impersonal orientation from officials (Mullins, 2007). Bureaucracy is the division of labour applied to administration. Bureau, is a French word meaning desk, or by extension, an office; thus, Bureaucracy is rule through a desk or office, that is, a form of organization built on the preparation and dispatch of written documents. In contrast to the commonly held view of bureaucracies, they do not rule in their own right but are the means by which a monarchy, aristocracy, democracy, or other form of authority, rules (VectorStudy, 2008). Moreover, bureaucracies provide a safe haven where managers can hide from responsibility and avoid being held accountable for errors of judgement or problems they crated or failed to solve. In return, managers are able to use bureaucratic rules to stifle self-management and compel employees to follow their direction (Mullins, 2007). According to Weber, bureaucracy is a particular type of administrative structure developed through rational-legal authority. Bureaucratic structures evolved from traditional structures with the following changes In addition, the ideal bureaucracy was characterized by impersonality, efficiency and rationality. The key feature of the organization was that the authority of officials was subject to published rules and codes of practice; all rules, decisions and actions were recorded in writing. The structure of the organization is a continuous hierarchy where each level is subject to control by the level above it. Each position in the hierarchy exists in its own right and job holders have no rights to a particular position. Responsibilities within each level are clearly delineated and each level has its own sphere of competence. An appointment to an office, and the levels of authority that go with it, are based solely on the grounds of technical competence (VectorStudy, 2008). The term red tape is often used by customer to call an organisation when it has rigid policies and procedures. In addition, an organisation is described as bureaucratic when it seems to be inflexible and unresponsive to a customers individual situation. Top managers are dangerously ill-informed and insulated from what is happening on the front lines or in the field. Decisions are made based on the perceived desires of superiors, rather than concern for mission achievement. Bureaucratic management promises control and consistency, an up-focused mission promised that governmental agencies would serve the stockholders, represented by the board of directors, rather than the people within the organisation. Moreover, Bureaucracy as defined by customers and employees is an array of negative forces, attitudes or actions that are damaging to customer and employee satisfaction. It is damaging to organizational effectiveness. It weakens employee morale and commitment. It divides people within the organization against each other, and misdirects their energy into conflict or competition with each other instead of mission achievement (Visionary Publications, 2010). Compare and contrast different forms of organisational development. Organisational development (OD) can play a vital part in harnessing the collective talent of an organisation, bringing about change and improving performance. It involves taking planned steps to create an environment that will enable staff to understand and deliver organisations objectives, People Development Team (PDT), 2010. These steps include developing appropriate skills, behaviours and attitudes, culture and a style of leadership that will enable the organisation to achieve optimum performance. A clear sense of direction, strong leadership and a focus on people management issues including the management of performance and the promotion of learning, development, creativity and innovation are essential (PDT, 2010). A team building could be a group of people who improve their individual and collective performances through a process designed to bring this about. The definition needs to further state that the group of people need to have shared or common goals, which are usually the goals of the company they work for and it starts with good leadership, Team Building Online (TBO), 2010. Four stages of team building had been identified. First is the forming stage wherein people tend to be polite, cautious, trying to get organized and sense of belongingness in a group is being asked. Second is the storming stage wherein issues, irritations, and problems surface, infighting develops. Third is the norming stage wherein issues and problems are discussed openly to set new ground rules, processes and procedures to resolve them. Last is the performing stage wherein members of the organization are working together to meet the high standards of performance Some of the team building tips are valuing each member of your team, be the kind of company that a team member wants to be part of, give team members a reason to feel motivated to achieving the company goals, a strong leader committed to his or her work and make certain that there is always good communication between members and their management. While coaching is typically applied to one-on-one situations or to teams, most effective leaders are in truth coaches for their entire organisations. Coaching at its core about enabling others to succeed; toward that end coaches converse, cajole, confront and sometimes challenge individuals to do their best and then support them in that effort. Just as when you coach one on one, communications is all the more critical when coaching across an entire organisation. It can only be successful if it is based upon trust. One way you build trust is to listen to your people (Baldoni, 2005). Organisational coaching spreads the leaders message throughout the rank and file and in return it gives them ownership in the enterprise. It communicates that you care about individuals and you want them to succeed. It also gives them a voice in the process because listening to their ideas is essential. From the listening comes the learning so together leader and followers enrich a culture of sharing that builds a sense of pride as well as a more determined effort to succeed (Baldoni, 2005). A strategy is an overall approach and plan. So, strategic planning is the overall planning that facilitates the good management of a process. Strategic planning takes you outside the day-to-day activities of your organisation or project. It provides you with the big picture of what you are doing and where you are going. Strategic planning gives you clarity about what you actually want to achieve and how to go about achieving it, rather than a plan of action for day-to-day operations (Shapiro, n.d.). Word count = 1584 words Question 2: Develop policies and systems for involving others in the process of change 2.1 Describe how you would involve stakeholders in the introduction of this change into the healthcare organisation viz. Mercer Medical Centers Stakeholder is any individual, group or business with interest (a stake) in the success of an organisation. They typically concerned with an organization delivering intended results and meeting its financial objectives. A stakeholder may contribute directly or indirectly to an organizations business activities. Other than traditional business, a stakeholder may also be concerned with the outcome of a specific project, effort or activity, such as a community development project or the delivery of local health services. A stakeholder usually stands to gain or lose depending on the decisions taken or policies implemented (Investor Glossary, 2010). There are two important reasons in involving stakeholders in all phases of a project. Firstly, their involvement in a project significantly increases your chances of success by building in a self-correcting feedback loop; secondly, their involvement in a project builds confidence in a product and will greatly ease its acceptance in your target audience. Different types of stakeholders should be handled differently (Alexandrou, 2010) In approaching any businesses that require change clarity in all areas should be specified. A constant two-way communication that explains clearly the reason what and why there is a need for change. Active communications is important and demonstrate to people that you have thought the impacts of change on them, and that you are prepared to work with them to achieve their support and commitment to the change by making it work for them. Be consistent in leading the change. Constantly pay attention to the management of the tasks, activities, projects and initiatives that are delivering the capabilities into organisations that will deliver the benefits that you are seeking. Ensuring that your people have the full resources and capabilities they need to support them thro the change (Warrilow, 2010). The reason is so important is because people are stressed, tired and generally fed up with change initiatives. They need careful and detailed explanation of what are change management why the proposed change is necessary, and the direct effects on them and the benefits to them. They need help and practical support (Warrilow, 2010). There are two types of stakeholders in a company. First is the internal stakeholder that includes employees, managers and owners. Second is the external stakeholder that includes the suppliers, society, government, creditors, shareholders and customers. Mapping of stakeholders in change can be a useful tool to understand the support and opposition you will get for a planned change. Construct the map by first analyzing your stakeholders and then plotting them in the map below, writing their names in the relevant box. In doing this in a team one should write the names down of the stakeholders on Post-It Notes and stick them up on a chart on the wall. Opposition Support Stakeholder Power High Active opponents Passive opponents Fence-sitters Passive supporters Active supporters Medium Low Stakeholders all have authority, whether it is the formal power invested or it is social power of being able to persuade others to support or oppose the change. Those with higher power are likely to be your most useful supporters or most dangerous opponents thus power analysis helps you prioritize your focus on stakeholders. Some people will actively support the change, putting their necks on the line and working long hours to help it be successful. Others will work the other way, determinedly seeking to ruin your efforts (Straker, 2010). These active people are where much focus often happens. However, there is often a silent majority who are more difficult to classify. These may be in gatekeeper positions, where rather than taking positive action, they can subtly support or oppose the change by allowing things to happen or quietly blocking and hindering progress (Straker, 2010). A Stakeholder Analysis and Map is a useful and necessary process for identifying and planning the necessary communications process for a programme. It lists each of the stakeholders against their particular interest area in the programme. It also lists known or anticipated issues associated with any person or group (Warrilow, 2010). Each of these people and groups will have a specific interest area, such as financial, technical, regulatory etc so when you are identifying them it is important to recognise their specific interest areas in order to ensure that their expectations can be managed effectively. There clearly will be individuals or groups who will be worse off as a result of the programme and who are therefore potential blockers to the progress of the programme. Both the positive and negative viewpoints should be considered as part of stakeholder management (Warrilow, 2010). Moreover, the Pre Programme Review and Planning will have identified issues associated with these individuals or groups and determined potential solutions and strategies for resolving the issues. Information dissemination and two-way communications are critical for managing expectations effectively (Warrilow, 2010). 2.2 Analyze and evaluate the effectiveness of systems in promoting change in Mercer Medical Centers. A system is an organized collection of parts that are highly integrated in order to accomplish an overall goal. The system has various inputs which are processed to produce certain outputs, which together, accomplish the overall goal desired by the organization. To explain, inputs to the system include resources such as raw materials, money, technologies and people. These inputs go through a process where theyre aligned, moved along and carefully coordinated, ultimately to achieve the goals set for the system. Outputs are tangible results produced by processes in the system, such as products or services for consumers. Another kind of result is outcomes, or benefits for consumers, e.g., jobs for workers, enhanced quality of life for customers, etc. Systems can be the entire organization, or its departments, groups, processes, etc (McNamara, 2010). Decision Conferencing is a proven method of achieving more effective decisions. The process involves groups of people in a transparent decision-making process and is ideally suited to resolving complex issues fast (Catalyze Ltd, 2008). All parties involved in the decision making process are gathered together in a series of workshops where options and issues are identified and discussed. These discussions are typically aided by modelling the problem, a process that documents the discussions and allows the best value options to be identified and different scenarios to be analysed. It is a remarkably powerful communication tool, allowing the group to openly discuss their organisation, values, issues and beliefs. The results are also ideal for educating and informing people not present at the workshops (Catalyze Ltd, 2008). Systems engineering integrates all the disciplines and specialty groups into a team effort forming a structured development process that proceeds from concept to production to operation. Systems engineering considers both the business and the technical needs of all customers with the goal of providing a quality product that meets the user needs (Incose.org, n.d.). Evaluation, in the context of management activities, is carefully collecting information about something in order to make necessary decisions about it. There are a large number and wide variety of evaluations that can occur in businesses, whether for-profit or non-profit. Evaluation is closely related to performance management (whether about organizations, groups, processes or individuals), which includes identifying measures to indicate results. Evaluation often includes collecting information around these measures to conclude the extent of performance, Free Management Library (FMP), 2010. Several systems has been tried to implement in Mercer Medical Centre in order to improve its services to its user. A system called Physician has been attempted to implement two years ago and it failed in great proportions. Opposition from the medical staff was identified from the time they previewed the system. The implementation was carried out without consideration to physicians opinions. It was abandoned after two days of implementation due to technical problems. This was not a successful system because it resulted to great loss of money, the CIO nearly lost his job and the image of the information services department was severely tarnished (Ash, et al., 2000) Another system, CareReviewer was tried to be implemented but end up being unsuccessful because of its unwelcomed technology as perceived by the challenged medical staff. They thought that the system add to their workload rather than making their jobs easier. Being pushed to see more patients in less time and with less compensation, physicians see this as a cause for them to receive less salary and working for the top executives to make more money and they lost their autonomy (Ash, et al., 2000) Recently, the hospital is trying to implement a new system, the Physician Order Entry (POE). Instead of implementing the system for a longer period of time, the top management wants to implement it within nine months time. The change in the time frame was caused by competition by Mercer Medical Centre with the other health care provider around the area and public relations (Ash, et al., 2000) Reed was aware of the existing resistance to the organisation and she is willing to win back the trust of the medical staff by being available to them 24-hour and giving support by visiting them to their home personally in order to build rapport. Involving influential people and making sure that the system provides immediate benefit to the users increases the use of the POE. Fast, easy to use, being accessible anytime, consistent, accurate and reliable and a system that positively affect the patient care is the system that physicians wants. (Ash, et al., 2000). Word count = 1525 words Question 3: Implement models for ensuring change in which risks are managed 3.1 Develop models for change that take account of risks in the context of case study. There are many causes of organisational change such as economic downturns, changes in strategy, government legislation, labour market pressure, technological changes and natural evolvement. It is crucial that organisations manage this change from within and understand and plan for the effects it may have on their employees (Snaith, 2010). Introducing change to an organisation can be difficult and managers need to gain the support and commitment of their colleagues and employees to ensure that change is managed effectively and business continues as usual with as little disruption as possible. Failure to do this can result in a loss of talented employees, a loss of credibility and a loss of the organisation market position (Snaith, 2010). It is usual for organisations to encounter resistance to change. Employees may be concerned for their job, be sensitive to change, dislike the change that is taking place, or dislike the process in which it is taking place. To combat this employer need to ensure that they communicate with their employees on a continuous basis, provide any training that may be required for new roles or changes to current roles, and ensure that the reasons for the change are communicated from the offset (Snaith, 2010). When change is imposed to people they feel little ownership with their decision and it leads them to feel out of control. Some people will go through the process quickly and others slowly (RapidBi, 2008). Kotter listed reasons why change fails, these includes allowing too much complexity, failure to build substantial coalition, understanding the need for a clear vision, failure to communicate and permitting the roadblocks against the vision, not planning and getting short term wins, declaring victory too soon and not anchoring changes in corporate culture (RapidBi, 2008). There are many change management models; the most common is the Kubler Ross transition (Grief) cycle which is well grounded in academic research within clinical environments. Another model is the ADKAR model for individual management which was developed by Prosci. It describes the five required building blocks for change to be realized successfully on an individual level. The building blocks include awareness, desire, knowledge, ability and reinforcement. (RapidBi, 2008). Business process Reengineering aims to increase performance by radically re-designing the organizations structures and processes, including by starting over from the ground up (McNamara, 2010). Kaizen is a model that has incremental self-improvement that has been applied to business and management. Use only for improvement to existing processes. It is not a methodology for introducing new processes or large scale change. It works well where there is a long-term requirement. It focuses on the people aspects of improvement, requiring some discipline and acceptance of change for improvement but can be easier to implement than other business process re-engineering methodologies where more radical changes are required in the short term which can give rise to more resistance and require more robust change management skills (JISC Advance, 2009). People have different perception on change therefore it should not and cannot force on people; instead as a change manager we should encourage people to make a choice or decision. 3.2 Plan the implementation of the model of change developed for Mercer Medical Centers Business Process reengineering is a technology-oriented approach that enables radical change however requires considerable management skills. According to Davenport (1992), business process reengineering has 5 steps approach. First is to develop the business vision and process objectives. Second is to identify the business process to be redesigned. Third is to understand the existing processes. Fourth is to identify the IT levers and last is to design and build a prototype of the new process, The Executive Fast Track, (TEFT), 2010. Change is a fundamental component of continuous quality improvement. Any improvement methodology involves introducing change and measuring its impact. In health care there has been recognition of the need for system change to support the delivery of safe, quality care, Victorian Quality Council (VQC), 2006. It is not enough to provide the tools and strategies with which to improve safety and quality of health care and expect success. There is a need to be aware of what to expect when introducing change, how to engage staff and to make change sustainable. Knowledge or awareness of change processes may assist in ensuring success of a project (VQC, 2006). Successful implementation of system change is essential in the provision of safe, quality care to consumers. Implementation of improvement projects and sustaining the resulting change can be a difficult process. It has been stated all too often that quality improvement projects fail on a regular basis. The individual or the teams introducing change have a challenging task. Change management is one component of a successful project; the need for project planning and the use of quality improvement tools are also critical (VQC, 2006). People are generally the most critical resource, supporter, barrier and risk when managing change. The uncertainty of change can provoke strong emotions, with most people experiencing some sense of grief and loss as they let go of the old and move towards the new (VQC, 2006). Awareness of the range of reactions to change will help the leader of the change process respond appropriately to concerns that are expressed. Understanding why these emotions occur may assist the leader to introduce change in a manner that anticipates, acknowledges and responds to concerns (VQC, 2006). Since improvement depends on the actions of people, ultimately it comes down to winning hearts and minds. Staff will not respond well to just being told to change, nor can the project leader stand over staff to ensure compliance. To be successful, a change management process must include an effective communication strategy. All stakeholders must have opportunities to express their views and attitudes as part of the planning process. A lot of improvement is about changing mindsets. It is about having the tools, techniques and confidence to work with colleagues to try something that is different. It is about understanding the possibilities of thinking differently and aiming to make practical improvements for patients and staff (VQC, 2006). Evaluation is an important component of any change process. As part of the project planning a decision needs to be made about measures that will be used to determine if the planned change leads to an improvement (VQC, 2006). Dissemination of the evaluation is important and consideration of the audience, the method and format of communicating the feedback should be undertaken. Present the final package containing all the planning, data, outcomes and learning to staff and stakeholders. If this evaluation is shared, and the emphasis is on learning in a non-punitive environment, then it can become a benchmark (or standard) for implementing change (VQC, 2006). The key to implementing change and continuous improvement is the effective exchange of information between people and process, a combination of business and human dimensions towards a shared objective (VQC, 2006). 3.3 Evaluate the outcome of change in Mercer Medical Centres Competition and public relations are the wrong driving forces for change mentioned in the case of Mercer Medical Centre. These forces for change lead to resistance by its medical staff. In any successful change initiative 3 broad areas should be included: leadership that directly addresses the transitions and emotional dimension of those impacted by the change, and provides inspirational motivation, a change model and methodology that cover the multiple factors that must be addressed and action management that shows and assists people with the specifics of exactly what is required of them (Warrilow, 2010). Fast implementation of the POE system was pressed to Dr. Reed and she knows that the corporation is not ready for this change. They need time to implement such change and that what she does not have (Ash, et al., 2000). Mercer Medical Centre experiences almost the same environmental influences that put pressures to organisations. Two-way communication is very important thing that has been recommended by different stakeholder groups. They must come together, engage in constructive problem solving, create a common strategy, and actively take charge of the change. There can never be any general formulas for organizational success. Each organization has its own constraints and pressures however there is a large number of theories which can be used as a guide for success. Each theory has its own drawbacks and tends to be situation-specific. Managers and organizations need to treat theories with degree of skepticism. If managers can identify the theories for planning and changing organizations and they can understand it then they are in a position to identify choices and make changes (Brunes, 2004). Sometimes mangers may choose or be required by circumstances to change their organizations radically and quickly; sometimes they may choose to influence the context to promote or reduce the need for such changes. In some instances, change may take place more slowly and over a long period, as both organization and context are shaped and changed. The key factor for this is to make conscious decisions rather than rely on untested assumptions. This will require those who manage and lead organizations to question and challenge their own and other peoples assumptions. This will also require them to gather and be open to a wide variety of information. Learning should be an organization-wide and continuous process, rather than one limited to a few like-minded individuals at one point

Disadvantages Of Arv Treatment Health And Social Care Essay

Disadvantages Of Arv Treatment Health And Social Care Essay Herbs have been used extensively in hopes of improving immune response and reducing symptoms. No known herbal remedy has been shown to cure AIDS or even reduce chances of AIDS-related infections. Still, some herbs can be worth trying if used safely and in consultation with a qualified practitioner who not only understands herbs but also has experience treating AIDS and HIV infection. Immunity-boosting herbs (such as Astragalus, Echinacea, and Ginkgo) may help revive an ailing immune system, and certain herbs (such as Garlic) may help battle bacteria and viruses. Deglycyrrhizinated licorice can soothe the mouth and throat ulcers that often accompany full-blown AIDS. Unfortunately, there is no known scientific explanation yet, for how herbs have these powers in treating AIDS and the only information available about how useful herbal treatments and remedies can be, is based on the knowledge gained from people living with HIV/AIDS. This means that not all herbs and remedies have the same effect on all people. Some communities have their own knowledge of health and nutrition, based on local traditions and culture. This may complicate the administration of herbal remedies from region to region, as the fundamental factor is now depending whether the patient is willing to cross cultures in order to obtain treatment. In some extreme cases, any external medical recommendations that a patient may receive is compared with their cultural practices and the recommendations of their traditional healers. Patients will only take action if the recommendations they receive appear to make sense and provide some benefit. Ironically, some traditional beliefs and food practices may not be useful at all, judging that a herb like Garlic root should work whether the patient is of Chinese or African descent. Patients with HIV/AIDS often become frustrated with management of the disease and are willing to try anything in the hope of staying healthy and living longer. One of the greatest disadvantages is that HIV/AIDS is not a traditional illness and so far, there is no hard evidence to believe that traditional medicines or herbal remedies can treat HIV and cure AIDS. However, certain herbal medicines may help to treat many of the symptoms of opportunistic infections that are part of AIDS. While some of these medicines may be undoubtedly helpful, others may be dangerous as they may do more harm than good. This happens when the patient mixes pharmaceutical drugs and herbs resulting in contra-indications or when they take certain foods that should be otherwise avoided. The notion that herbal medicines are natural and therefore safe is as widespread as it is misleading. Some of these remedies have been associated with severe adverse effects caused by the toxicity of the herbal ingredients. Others may cause problems because of contamination or adulteration [9]. Herbs and spices should be used in moderate amounts. Exceeding these amounts may cause problems and have a toxic effect; moreover, the function of the herbs and spices will not be increased. Herbs do not replace healthy eating and should not be used in place of a healthy and balanced diet but they do retain the bodys natural pH (alkaline) and this in turn, as discussed before, forces the microzymes to stop mutating into bacteria, viruses and funguses that cause opportunistic infections. 2.1.7 Advantages of Herbal Treatment: On general note, Herbal therapies seek to boost patients immune systems, inhibit opportunistic infections, alleviate symptoms, and inhibit HIV itself. Herbal medicines are very cheap in comparison to the conventional form of medication Herbal medicine helps the body to maintain its natural pH, which is alkaline; this in turn starves and inhibits all adverse microzymes from growing or mutating. Herbal medicines can be consumed without the aid of any kind of prescription, although a herbal or medical practitioner has to be consulted prior Herbal medicines are known to be more productive in comparison to other forms of medication in curing certain conditions. Herbal medicines offer long lasting benefits in terms of overall wellness. In certain situations, Herbs are considered a possible means to minimize drug side effects. Unlike with the convectional highly active antiretroviral therapy (HAART), herbs do not need to work in combination in order to get effective results Herbs are readily available and once a patient knows which herb to use, he/she can grow their own. 2.1.8 Disadvantages of Herbal Treatment: Curing period is usually longer in comparison to conventional medication Drug-interactions can be hazardous to a patient ,if they decide to mix herbs and drugs Herbal medicines are known to be ineffective against serious ailments Herbal medicines are taken without prescription which means that in some cases, individual might be undergoing a trial and error process with their medication. Herbal medicines can cause allergic reactions in some cases Herbal medicines will not eliminate the HI virus out of the body Most governments do not approve of any kind of herbal medication. Its usually consumed upon the persons own risk, and when it comes to branded herbal supplements one cant expect any kind of quality assurance 2.2 Expert Systems and their use on the Internet 2.2.0 Expert systems An expert system is a computer program that incorporates concepts derived from experts in a field, uses the available information, heuristics and inference to suggest solutions to problems in that particular discipline or give advice. An expert system should have good decision making, this is strongly dependent on various capabilities that include the effective acquisition, storage, distribution and sophisticated use of the human experts in the field in question. The most widely used way of representing domain knowledge in expert systems is as a set of production rules which is also how humans generally infer decisions. Expert systems were made to provide knowledge and advice to a larger number of users than one user. An Expert system can be viewed as a teaching tool because it is equipped with the unique features which allow the users to ask questions on how, why and what format, expert systems also allow automation of many tasks that could not be effectively handled by human experts. In addition, an Expert system attempts to emulate how a human expert solves a problem, mostly by the manipulation of symbols instead of numbers. As a result because of the low cost per user and automation of numerous tasks ,expert system making has become very attractive and in the long run is much cheaper than getting human expert advice, its development is however relatively costly but its operation is easy and quite cheap. Maintenance is easy as well because once an expert system is developed it is simple to add new information to the knowledge base and new rules can be developed. 2.2.1 Advantages of Expert systems Availability: The expert system is always available 24 hours a day and will on no account tire Can capture scarce expertise, collected from a number of experts and integrate their opinions. Consistency: The computer does not make common futile human mistakes such as forgetting, getting drunk or strike when it is most needed. Data can be kept up-to-date. Efficiency: Expert systems have an increased output and productivity as well as decreased decision making time. Flexibility: Expert systems can operate in hazardous environments. They can also work with incomplete or uncertain information. Scalability: The system can be used at a distance over a network therefore can reach a large population. The computer can store far more information than a human expert. 2.2.2 Disadvantages of Expert systems Expertise can be hard to extract from humans Expert system users have natural cognitive limits (therefore can not perform as perfectly as a human) Experts vocabulary is often limited and highly technical Expert systems may not be able to arrive at valid conclusions and sometimes produce incorrect recommendations Knowledge is not always readily available Lack of trust by end-users Most experts have no independent means to validate their conclusions 2.3 Structure of Expert systems A typical expert system consists of: A knowledge base; this contains the specific domain knowledge that is used by an expert to derive conclusions from facts The inference engine, which is responsible for using the rules and facts to derive conclusions whether it is through forward, backward chaining or a combination of both. An explanation system, which provides information to the user about how the inference engine arrived at its conclusions A fact database, which contains the case-specific data that are to be used in a particular case to derive a conclusion and A User interface, which provides access to the inference engine, the explanation system, and the knowledge-base editor. KnowledgeBase Fact Database Expert System Shell Inference Engine Knowledge Base Editor Explanation System User Interface User Figure2.1 A basic structure of an Expert System. An Expert System can be rule-based, frame based or both. In a rule-based system, the knowledge base is a database of rules. Rule-based systems are computer systems that use rules to provide recommendations or diagnoses, or to determine a course of action in a particular situation or to solve a particular problem. Its line of reasoning or the inference engine technique can be forward chaining, backward chaining, or a combination of both and the Rete algorithm. 2.4 Inference Engine The knowledge in the knowledge base is used for reasoning and inferring conclusions. An inference rule is an abstract structure that contains a set of rules that mathematically delineates a (usually infinite) set of finite length strings over a (usually finite) alphabet. It is a two part structure using First Order Logic for knowledge representation. If then The brain of expert system is the inference engine which is generally a large number of rules and facts. The inference engine matches facts and data, which is in the fact database against the inference rules to infer conclusions which result in actions. The process of matching the new or existing facts against inference rules is called Pattern matching. Pattern matching in the inference engine can use any of the following algorithms: Linear Rete Treat Leaps Most of the rule engines under study implement and extend the Rete algorithm. Leaps is also used widely but is questionable due to poor maintenance. Rete based engines have proprietary enhancements to the Rete algorithm like RetePlus, Rete III and ReteOO. The Rete algorithm is responsible for ensuring that there is a clear distinction between rules and facts in the database. This algorithm takes the form of a network, with nodes and paths. Each path from the root node to a leaf in the tree represents the left-hand side of a rule. Each node stores details of which facts have been matched by the rules at that point in the path. In situations where new data or facts are added, it means the Rete algorithm will propagate and change data stored at the node accordingly. In this way, the system only needs to test each new fact against the rules, and only against those rules to which the new fact is relevant, instead of checking each fact against each rule. 2.4.1 Methods of Inference Engine execution There are two methods of execution for rule based expert systems, forward chaining and backward chaining. And systems that implement both are called hybrid production rule systems. 2.4.2Forward Chaining This is a data driven and thus reactionary method. When applying forward chaining, the first step is to take the facts in the fact database and see if any combination of these matches all the antecedents (conditions) of one of the rules in the rule database. When all the antecedents of a rule are matched by facts in the database, then this rule is triggered. Usually, when a rule is triggered, it is then fired, which means its conclusion is added to the facts database. 2.4.3 Backward Chaining This method is goal driven, meaning that we start with a conclusion which the engine tries to satisfy. An inference engine using backward chaining would search the inference rules until it finds one which has a then clause that matches a desired goal. If the if clause of that inference rule is not known to be true, then it is added to the list of goals. Searches for sub goal conclusions begin, in hopes that, that will help satisfy some part of the current goal. It continues this process until either the initial conclusion is proven or there are no more sub goals. 2.5 Expert system shells Expert systems can be built that contain all the useful methods without any domain specific knowledge. These systems are called skeletal systems, shells or Artificial intelligence tools. The interpreter is separated from the domain-specific knowledge and thus creating a system that could be used to construct new expert systems by adding new knowledge corresponding to the new problem domain. Examples of shells include CLIPS, eGanges, OPS5, ART, JESS, and Eclipse. 2.6 Systems currently in use 2.6.1 Expert System for HIV/AIDS information The above expert system was created under the motivation of a Microsoft sponsored project called IHISM, which aims to contribute to the digital divide by developing an HIV and AIDS public information portal accessible through mobile phones [10]. The Expert system was tailored made with reference to Botswana, according to UNAIDS estimates, HIV/AIDS has affected every segment of Botswana society and one-third of Botswanas sexually-active population between the ages of 15 and 49 (out of a total population of 1.5 million) are infected with the virus, which is the highest rate in the world [11]. The information service portal would allow the public to request for information on topics related to HIV and AIDS such as descriptions, infection, testing, counselling and support, opportunistic diseases and paediatric care etc. The portal represents this information in the form of Frequently Asked Questions (FAQ) service where the user inputs a query on any of the subjects. The system is meant to act as an online expert in HIV and AIDS information such that, some information may have to be derived through inference as opposed to simple data retrieval. The system is to accept as input a FAQ from the user and provide the most relevant answer to the question. Challenges of the system: Users may ask the questions differently in pursuit of the same answer System should be able to systematically analyse the questions and provide an appropriate answer System should be able to determine the various forms in which a typical FAQ question could be mapped to the relevant answer. Participants agreed that the expert system was not only easy to use 2.6.2 A Self-Learning Fuzzy Discrete Event System for HIV/AIDS Treatment Regimen Selection The HI virus mutates often and so a patient has to be frequently changing their medication course. And because of the strict drug adherence guidelines, it therefore becomes desirable to have a treatment- decision support system that is capable of self-learning. Basing on the fuzzy discrete event system (FDES) theory, a self-learning HIV/AIDS regimen selection system for the initial round of combination antiretroviral therapy, which is one of the most complex therapies in medicine, was developed [12]. The system consists of a treatment objectives classifier, fuzzy finite state machine models for treatment regimens, and a genetic-algorithm-based optimizer. System focuses on the four historically popular regimens with 32 associated treatment objectives involving the four most important clinical variables (potency, adherence, adverse effects, and future drug options). Advantages of the A Self-Learning Fuzzy Discrete Event System for HIV/AIDS Treatment Regimen Selection: Higher flexibility and scalability Easier knowledge upgrade for accommodating fast treatment strategy evolution with minimal system modification. Challenges of the A Self-Learning Fuzzy Discrete Event System for HIV/AIDS Treatment Regimen Selection: Patient-specific medical simulation raises several moral, ethical and policy questions that need to be answered before the methodologies can be put to widespread use. 2.6.3 A grid-based HIV expert system This system is for physicians to provide an adaptive interactive advice on treatment applied to drug resistant HI virus. Its knowledge base comprises of distributed data from infectious disease patient databases, literature on in-vitro and in-vivo pharmaceutical data, mutation databases, clinical trials, simulations and medical expert knowledge. The research uses a variety of statistical and numerical methods to identify relationships between HIV genetic sequences and antiviral resistance to investigate consistency of results. Access to and integration of data is done through existing Internet servers and emerging grid-based frameworks like Globus [13]. Advantages of the grid-based HIV expert system: Cellular automata-based simulations are used to predict the drug behaviour overtime Limitations of grid-based HIV expert system: Little data privacy. Sensitive clinical information is often kept on highly secure hospital networks 2.6.4 HIVPCES: a WWW-based HIV patient care expert system Diagnosing HIV-patients and prescribing the correct drug regimen can be a complex task whose outcome is dependent on a large number of variables. The cost of an incorrectly administered drug even for a very short time can be enormous; the HIV virus has specific drugs that can manage its growth at different levels of its life cycle. HIVPCES is a WWW-based HIV patient care expert system. It is an interactive expert system to diagnose HIV patients, and is managed centrally and accessed either as part of an intranet, or as an Internet site.781273 The user interface has been carefully designed to provide a high-level of interaction and therefore improve some of the current limitations of Web applications. The system comprises three modules: (1) A patient self-monitoring personal diary, to create a follow-up patient record; (2) A data analysis and visualisation tool; and (3) A section to allow patients to ask for advising and remote doctor support. abstract Advantages of a WWW-based HIV patient care expert system: Provides health professionals with new means for tele-monitoring and tele-caring patients. Limitations of a WWW-based HIV patient care expert system: Low system security Users anonymity features are required but hard to incorporate in this clinical domain. 2.7 Outline of proposed system In the vast world of medical expert systems there is little attention given to HIV /AIDS and when the topic does get acknowledged, little focus is put into the treatment and much more attention on the common FAQs about the virus. This system aims to center on HIV/AIDS suffering patients and offer advice on supplementary natural treatments such as herbal medicines that these patients can use. Unlike some of the current existing systems, which look at drug adherence plan, i.e. narrowing the users down to only, those on the HAART program, the proposed system can be used by patients whose CD4 count has not yet plummeted therefore allows the patient to have a informed decision on how to maintain a healthy life and have a boosted immune system. Proposed system will offer information on particular herbs, that is, the name, healing effects and the contra-indications and explanations for every herb it advises. Advantages of proposed system: Caters for both physicians and patients Caters for patients not yet on the HAART program, thus serves a wider user range Knowledge base is an integrated pool of various expert views therefore each answer supplied is about 85% System is a web based application, which is easily accessible from any computer or location with Internet access. 2.8 Conclusion The collected information above was used for the design and methodology of the proposed system. This chapter reviewed the domain in study i.e. HIV/AIDS, expert systems and a review of systems currently in existence. The following chapters of the document consist of the integration and modification of the gathered literature.

Animal Testing :: Animal Testing

Is it right to take the life of an innocent animal? Animals have been burnt, crushed, sliced, electrocuted, tortured with drugs, poisoned with toxic chemicals, and tormented in psychological testing. They do all these test just to make money or find if a chemical is safe for humans. Is this right? Lab experimentation involving animals is inhumane. Animal testing is cruel because an animal s life is just as important as a human s life, people are exploiting animals, and animal testing doesn’t t show whether or not a product is safe for humans.   Ã‚  Ã‚  Ã‚  Ã‚  In laboratories around the world, scientists test a company s product on animals. Why do these companies test their products on animals? Many scientists would argue that it s more cost-efficient to test products on animals than on humans. Others say that they experiment on animals because animals are not as important as humans, which isn’t necessarily true. Why should humans risk the death of animals for their own benefit? What makes a human s life any more valuable than any other creature s? Every creature on earth has one life to live, a common bond that all organisms share. Who is to say that one creature should have his one life taken away from him? This is different from eating another animal for survival purposes. Scientists do not need to test their products.   Ã‚  Ã‚  Ã‚  Ã‚  People are exploiting lab animals because of their inability to communicate with humans. The prominent English philosopher Jeremy Bentham, when commenting on animal testing, is quoted as having said, The question is not can they reason? nor can they talk? but can they suffer? The answer to his question is yes. Historical information from animal observations shows that animals do, in fact, suffer. Because of an animal s inability to communicate or reason, does that mean that humans have the right to decide their fate? Testing a company s product on animals doesn’t t mean that it will necessarily be safe for humans. For example, the drugs Oraflex, Selacryn, Zomax, Meritol, and Suprol have produced side effects, even death, in humans.

Key Elements:The story of an hour :: English Literature

Key Elements:The story of an hour  · Plot: Standard plot. A woman who receive the notice of her husband's death, and when she begins to felt freedom her husband appear again and she can't accept it and fall died.  · Characterization: Few characters a. Mrs. Mallard or Louise: Mallard's wife. Was afflicted with hearth trouble. b. Josephine: Mrs.Mallard's sister. She was who told Mrs.Mallard the notice about her husband death. c. Richard: Mr.Mallard's friend. He heard about the notice about his suppose death. d. Brently Mallard: Mrs.Mallard's husband. He was supposed to be dead.  · Setting: The story takes place in Louise's house.  · Theme: I think we can't live in oppression because that doesn't let us be free. We can find themes like the oppression by men, and women rights.  · Point of view: The opinion or purpose of the author is to create inside us a brainstorm, because he doesn't give a direct opinion of the story or situation.  · Diction: It is simple to the reader understanding. The author used an appropriate language for the time the story develop the plot or the action.  · Narrative techniques: He uses narration and dialogue. The author makes use of the irony and the suspense. Also he used auditory for example, the piercing cry. The story of an hour After I read, analyze and find the key elements of this short story I can wrote down a few personal reflections of this great and suspense short story. Firs of all, I like this particular short story because kept me all the way long in suspense. Also because I hate long stories, dramas and poems. I think this story mention a very important point in all marriages of all times. This point or situation is the oppression of men for women

nigeria and us women and development :: essays research papers

  Ã‚  Ã‚  Ã‚  Ã‚  Women as a group make up an enormous portion of the world’s population. Thus the development of women, the changes implemented that affect them both positively and negatively are integral in study the world. Introduction to the field of women and development can be traced back to the 1950’s post World War II., specifically the period of reconstruction. Due to focus on external issues rather than internal issues, programs like the United States Marshall Plan were created, emphasizing the need to bridge the gap between developing and developed nations. The study of women and development gives an overall perspective of women’s development in comparison to other areas. Women’s development shapes many things including our perspectives and our public policies. I will assess the contributions of the three major theoretical debates applied to the field of women and development and explain how they shaped the field.   Ã‚  Ã‚  Ã‚  Ã‚  The first and perhaps the most dominant perspective, Women in Development (WID) stresses western values and targets individuals as catalysts for social change. The origins of this perspective came about after the release of Esther Boserup’s book entitled Women’s Role in Economic Development. The theory points out that modernization had somehow bypassed women and that some segments actually destabilized the prevailing position of women. The theory argues that legal and administration modifications are needed to facilitate change and integrate women into economic systems. The most notable contribution of WID is that it drew attention to women’s questions in the arena of development theory and practice. While WID emphasizes the productive role of women, it overlooks the direct influence of race, class and culture and it minimizes the reproductive role of women entirely.   Ã‚  Ã‚  Ã‚  Ã‚  Women and Development (WAD) emerged in the 1970’s; its primary basis was critiquing the earlier theory of WID. Essentially, WAD contends that economic growth and the industrialization of the West were based upon the exploitation of nations that were subjected to colonial rule. The theory focuses on the idea that countries are core, semi-peripheral and peripheral. Power–dependency relationships are reflected in an international division of labor that encompasses each of these types. Core nations, including the major powers of Western Europe, the United States, Canada, and Japan dominate globally by virtue of their domestic and international strength. According to conventional world-system arguments, the countries in the periphery of the world-system, the least developed nations in Africa and Asia, such as Bangladesh and Rwanda are relatively weaker than the core nations and to a lesser extent, the semi-periphery nations such as Chile and Libya.

Longer School Days

American today tends to believe that our educational system is working. I truly believe for this generation of students to remain competitive with their international peers as adults, they need to start spending more time in school. I am an advocate for longer school days. In fact at 180 days of school, American children spend the least amount time in the classroom when compared to other countries. Sure there are some undeniable hurdles, but overall the core idea is simple that children need enough time to learn, to build the skills, develop the knowledge and well-roundedness required to work and thrive in the twenty-first century. Nothing considered by itself is enough to turn schools around not the most gifted teachers, most inspiring principals, newest buildings, or most up-to-date equipment. Time, on the other hand, is an imperative groundwork for new levels of student achievement and educational success. Like any precious resource, it can be wasted. Simply tacking extra time poorly spent onto the current school schedule, does not get the job done. An article from CNN. om reports that the public charter schools that belong to the well-known Knowledge Is Power Program or KIPP serving fourteen thousand overwhelmingly low-income (80 percent) African American and Latino (90 percent) students in seventeen states with concentrations in Houston, Texas decided to eliminate the lack of time as an excuse for failure. KIPP day at 7:30 a. m. and ending it at 5 p. m. , with Saturday school twice a month and at least three weeks of mandatory summer school. By every measure national, statewide, and local KIPP students not only improve themselves, they also outperform the great majority of their peers. 90 percent of KIPP Houston High School tenth graders passed the Texas statewide math exam, as compared to 49 percent of other Houston tenth graders. Nearly four-fifths of students who complete KIPP's eighth grade (the network consists mostly of middle schools) have entered college; nationally, the proportion for low-income students is less than one in five. Although I grant that longer school days do have some undeniable hurdles. For instance, loss of personal time could mean that spending more time at school would cut into the amount of time students are able to spend at home. Teacher burnout could contribute from adding hours to the school day only compound a teacher's already busy schedule. Longer school days would require more time from students and teachers, but it would not guarantee results. The budget comes in to play when keeping facilities open and requiring staff and faculty to put in longer days will cost more money. I still maintain that longer school day positive outcomes will outweigh the hurdles. My conclusion is that schools will be able to restore academic subjects that had been scaled back or even dropped due to the emphasis on core instruction and high-stakes testing in reading, writing, and math. Students are able to study crucial academic subjects such as science, history, social studies, and foreign languages. Teachers including myself will have the time to work with each other in planning how they teach their students, time that almost never exists in the current school schedule.