Self-Fulfilling Prophecy The Choices MacBeth Made That...

A self-fulfilling prophecy is a statement that alters one’s actions and evokes a behavior from a person/character which makes the originally false statement come true (Wisegeek). For example, one might say, â€Å"Today is going to be a great day!† Which will alter a persons actions in a way that will actually make this prediction come true. William Shakespeare’s, The Tragedy of Macbeth, uses self-fulfilling prophecy in a subtle yet foreshadowing way to prepare and unfurl the thoughts and actions of his characters. This tragedy, written in the early 1600’s, was composed mainly to appeal new interests around London. It is a depiction of a noble, along with his wife, who brutally slaughters a King and his kinsman so that he may be the King†¦show more content†¦He realizes that if he want to start his own dynasty, then he will have to have control of all the variables. Then Macbeth began to think, â€Å"For Banquo’s issues have I filed my min d;/ For them the gracious Duncan I have murdered† (Shakespeare 85). He realizes that he has set himself up to fail. He is cleared a path to the crown for Banquo’s kin. Macbeth goes on to state, â€Å"He chid the sisters/ When first they put the name of king upon me† (Shakespeare 85). This give the readers the thought that Banquo is jealous of the king. Macbeth, not wanting to risk his crown, calls for some outside murderers. As I stated earlier, Macbeth knew he must get rid of Banquo and his sons. He succeeds in having Banquo killed, but Banquo’s son, Fleance (the one person Macbeth needed to kill), escapes. Going in a change of direction, here are some points of self-fulfilling prophecy with Lady Macbeth. After killing Duncan Lord Macbeth was guilt ridden, he was stricken with regret. Lady Macbeth told him just to forget it ever happened, â€Å"Using those thoughts which should have died/ With them they think on? Things without all remedy/ Should be with out regard. What’s done is done† (Shakespeare 93). She also said to him, â€Å"You face, my thane, is as a book where men/ May read strange matters, To beguile the time/ Look like the time. Bear welcome in your eye,/ Your hand, your tongue. Look like th’ innocent/ flower,† (ShakespeareShow MoreRelatedThe Tragedy Of Macbeth By William Shakespeare1205 Words   |  5 PagesThe play of Macbeth is a tragedy which led to his demise. Macbeth was an honorable solider whose life became one of a traitor and a coward. The conflict of light and darkness within Macbeth began after he receives a prophecy from three witches that one day he will become King. This prediction without a doubt consumes him with ambition and greed. In order to fulfill the three witches prophecy Macbeth is led down his treacherous path by his wife, Lady Macbeth who urges him to murder King Duncan and

Organisational Change Change Management

Question: In todays highly volatile, unpredictable and ever flexible business environment, organisations can only take an emergent approach to change.Discuss the validity of this statement. Answer: In ever changing business environment, organisations are adopting emergent approaches to deal with those. Modern business environment never stands still and hence, keep changing. People running businesses might have already experienced various kinds of changes related to economy, consumer purchasing decisions, political changes and supply chain changes (Kotter, 2011). However, outside of this myriad of negatives coming by the change cycles are businesses that are flourishing and growing year by year. Businesses that are successful in long run adopt business models that provide them with an opportunity to adapt to the changes in the demands of the market. This essay aims at examining organisational changes and the issues firms usually face while coping up with frequent changes. The essay will analyse the statement, In todays highly volatile, unpredictable and ever flexible business environment, organisations can only take an emergent approach to change. In present scenario, all types of organisations, from small to large are engaged in the process of change. There are changes to processes, products, services, consumer needs, locations, success drivers. These changes can be difficult to cope with but once organisation adopts a dynamic business model, it is able to adapt to frequent changes effectively (Kotter, 2011). As a preparedness measure, businesses nowadays, tend to adopt business models or management plans to adapt to changes. Change Management models adopted by companies include change planning, stakeholder management, understanding the impact of change, determining ways to cope with change and competency management. By definition, change management refers to the process of renewing the theories, approaches, structure and capabilities of an organisation in order to provide customers with something innovative every time and also adapting to changes effectively. Since changes are inevitable and necessary at the operational and strategic level of the organisation so there is no doubt about its importance and management. Often, it is argued that successful change management is crucial for every organisation if it intends to survive in the long run (Levin, 2012). Organisations that dont implement change management in their system are likely to fail in the long run. But theories and approaches related to change management available with the experts are contradictory. It is believed that change management is becoming a required skill in every manager (Filicetti, 2007). There are different theories and approaches used by managers today to manage change effectively. In earlier times, managers believed that organisations with maximum changes couldnt sustain in competitive environment and meet customer preferences. They thought other way round i.e. the organisations with stability and employees with a set routine can only achieve success (Filicetti, 2007). But with evolving world and business scenario, changes have become necessary for a business to sustain. One of the widely accepted approaches for change management is Emergent Approach. To cope up with the continuous changing market curves an organisation has to follow some Business models that further help it to adapt with the changes and keep an organisation stable and ever-growing (Filicetti, 2007). By definition, a business model refers to the rationale of how a firm develops, delivers and captures value throughout the changing times (Filicetti, 2007). Amongst various Business Models that are followed by the business organisations in order to deal with the staggering changes in the market, the Emergent Approach seems to be a convincing way in the present day world of business. Emergent strategy is the view that strategy emerges over time as intentions collide with and accommodate a changing reality. Emergent strategy is a set of actions, or behaviour, consistent over time, a realized pattern that was not expressly intended in the original planning of strategy. As per emergent strategy, it is implied that a firm gets to learn what is put into practice. Emergent strategies are implemented by allocating resources (Bhasin, 2012). Henry Mintzberg believes that in modern marketplace, allocation of resources is usually unknown and keeps changing. As a result, these emergent strategies enable organisations to adapt to changes in most effective ways. It goes in the opposite direction to the previous traditional approach adopted by most organisations-The Deliberate Approach. The Emergent approach deals with strategies changing with respect to the requirement of the hour. It describes the process of strategy-making as consequential effect of the need to cope with the imperfections of the real world model which is subject to changes every second hour. This approach sees strategic management as an after effect of the trials and errors from the activities and experiences of the management. It identifies the following roles as pertinent to strategy leaders being successful in strategic management and coping up with changes: Planner, Communicator, analyst and Catalyst as well (Levin, 2012). Compared with other approaches, critiques of emergent approach are also significant. Foremost, emergent approach is a coherent change and also criticised for its emphasis on the political dimension of change. It is also limited to organisational changes to which emergent approach is applied and secondly, how it should be applied. Further, there is no assurance that organisa tional leaning will suit with the crisis or not. Some of the change management approaches that can be adopted by organisations are: Education and Communication Approach: It is believed that lack of communication and information usually doesnt let the organisations to cope up with frequent changes. Upfront education and effective communication can help employees up-to-date with market trends and hence, they get prepared to face the changes effectively (Marshak, 2005). This, ultimately, helps in reducing different rumours about any concerns in the organisation. Deliberate Approach: Under Deliberate approach, management team specifies the action the firm will be taking to accomplish its goals. Deliberate approach is also sometime referred to as top-down approach. It involves some form of planning and choices are dependent on the estimation of what might happen in future (Raineri, 2011). This type of approach is generally weak due to two reasons; one it is difficult to predict future due to rapid changes taking place in business environment. Second, these kind of strategies usually fail when developing new products. Umbrella Approach: This type of approach has a clear definition of strategic goals and general strategic decisions that are made by higher management. In this, detail of how goals are to be accomplished is yet to be decided. Managers then use a process of iteration and consensus building that enables senior management to develop the strategy. In other words, senior management decided the detail of how goals should be accomplished (Conner, 2012). These are the some of the approaches that help organisations to adapt to changes effectively. Nevertheless, of all the business Models coping with changes the Emergent Approach is in the upswing and provides better solutions towards the constantly changing market environments. From the economy to the needs of the market, things are constantly in motion. A business needs to go with this flow and use it to its advantage. Rigidity is not the answer when you are looking for if you seek constant growth. From technology to market dynamics, the present scenario is often nothing like what it was 10 years ago. So it can never be expected that things remain unchanged 10 years from now (NeÄ ask, Klmek, Mal and Mlnkov, 2012). Even if the core product stays the same, which is next to impossible given the intense competition in every market, there will be still the need to upgrade the technologies, train workforce, create new markets and seek more streams of revenue. All this comes under the ambit of change and is necessary for survival. While a growing number of business leaders are starting to realize the importance of changing and adapting, the problem lies in the fact that the organizations they sit atop are inherently resistant to change (Filicetti, 2007). This is often the case with multinational corporations that have been doing things a certain way for a long time now. The inertia makes it very hard to mobilize these organizations. So while the head of the business wants certain things done, the organization itself finds it unable to meet these demands. Hence, change management is a major job requirement for large organizations. Businesses that recognize what a massive challenge changing can be utilized the services of experts to ensure a smooth and seamless transition (Levin, 2012). Whether this change is in terms of operation model, or you are upgrading the technological backbone of your organization, preparing your workforce for this change is a crucial element. Training may be required to ensure that your employees are able to cope up with the changes. At times, you may even need to bring in a new workforce to manage your needs while your current workforce undergoes training (Kotter, 2011). A change management expert will be able to guide you through this process and provide you with the detailed requirements. One of the reasons start-up companies gains so much success and traction is because they are structured to deal with all kinds of changes. The roles of employees are flexible and a lean model ensures that everyone understands the need to change. In effect, start-ups have a work culture that is conducive to change (Anderson, 2001). This same environment needs to be created in any organization. Only when management have a work culture that does not hinder change, employees efforts produce tangible results. Hence, organisations must learn to embrace change, and encourage everyone to do the same (Levin, 2012). In nutshell, it will be right to say that in todays highly volatile, unpredictable and ever flexible business environment, organisations can only take an emergent approach to change. References Anderson, D. (2001). Beyond Change Management: Advanced Strategies for Todays Transformational Leaders. San Francisco: Jossey-Bass/Pfeiffer. Barber, M., Donnelly, K., Rizvi, S., and Summers, L. (2013). An avalanche is coming: Higher education and the revolution ahead. Bhasin, S. (2012). An appropriate change strategy for lean success.Management Decision,50(3), 439-458. Bordia, P., Restubog, S. L. D., Jimmieson, N. L., and Irmer, B. E. (2011). Haunted by the past: Effects of poor change management history on employee attitudes and turnover.Group and Organization Management, 1059601110392990. By, R. T., Burnes, B., and Oswick, C. (2011). Change management: The road ahead.Journal of Change Management,11(1), 1-6. Cameron, E., and Green, M. (2012).Making sense of change management: a complete guide to the models tools and techniques of organizational change. Kogan Page Publishers. Conner, D. (2012). "The Real Story of the Burning Platform". Filicetti, J. (2007). "Project Management Dictionary". PM Hut. Accessed 25 Feb, 2015. Gerth, C. (2013). Introduction. InBusiness Process Models. Change Management(pp. 1-12). Springer Berlin Heidelberg. Goetsch, D. L., and Davis, S. B. (2014).Quality management for organizational excellence. pearson. Haslam, S. A., van Knippenberg, D., Platow, M. J., and Ellemers, N. (Eds.). (2014).Social identity at work: Developing theory for organizational practice. Psychology Press. Huczynski, A., and Buchanan, D. A. (2013).Organizational behaviour. Pearson. Keppel, G., and Wardellà ¢Ã¢â€š ¬Ã‚ Johnson, G. W. (2012). Refugia: keys to climate change management.Global Change Biology,18(8), 2389-2391. Kotter, J. (2011). "Change Management vs. Change Leadership -- What's the Difference?". Forbes online. Accessed 25 Feb, 2015. Levin, G. (2012). "Embrace and Exploit Change as a Program Manager: Guidelines for Success". Project Management Institute. Accessed 25 Feb, 2015. Marshak, J. (2005). "Contemporary Challenges to the Philosophy and Practice of Organization Development". In Bradford, David L.; Burke, W. Warner. Reinventing Organization Development: New Approaches to Change in Organizations. pp. 1942. Mehanna, H., Olaleye, O., and Licitra, L. (2012). Oropharyngeal canceris it time to change management according to human papilloma virus status?.Current opinion in otolaryngology and head and neck surgery,20(2), 120-124. Merrell, P., and Watson, T. (2012). Effective change management: The simple truth.Management Services,56(2), 20-23. NeÄ ask, M., Klmek, J., Mal, J., and Mlnkov, I. (2012). Evolution and change management of XML-based systems.Journal of Systems and Software,85(3), 683-707. Phillips, R. (2012). "Enhancing the effectiveness of organizational change management". Human Resource Management 22 (12): 18399. Raineri, A. B. (2011). Change management practices: Impact on perceived change results.Journal of business research,64(3), 266-272.

Designing an Editorial Calendar You Can Actually Stick With †Part 1 - The Writers For Hire

DESIGNING AN EDITORIAL CALENDAR YOU CAN ACTUALLY STICK WITH – PART 1 Are you new to content creation? Having trouble keeping tabs on projects with multiple deadlines and lots of moving parts? Still looking for a good way to organize all your projects? Designing an easy-to-use, effective editorial calendar is the key to creating consistent, successful content for yourself, your business, or your clients. It might also be the key to keeping your sanity in the process! What is an Editorial Calendar and Why Do You Need One? An editorial calendar establishes what projects need to be completed, outlines the workflow or tasks of each project, and helps you track the progress of those projects. Editorial calendars have been used in the publishing industry for years to help magazine and book editors stay on top of their projects and deadlines. When you or your clients have an online presence and social media platform, an editorial calendar can help you create, publish, and track ongoing content. Getting Started: The Main Parts of an Editorial Calendar An editorial calendar can be as detailed as you need it to be. Some editors and project managers prefer to focus on the big-picture stuff like topics and deadlines. Others track projects down to the tiniest details, keeping tabs on things like keywords, audience profiles, click-through rates, social media shares, and more. Regardless of the level of detail and what format or program you use, there are seven key parts to an effective editorial calendar: The name of the project to be completed.The type of project, whether a social media post, blog, magazine article, book, etc. The purpose of the project (inform, announce, get sales, get leads, entertain).Tasks involved in the project and who is responsible for those tasksWhere the content will be used, sent, or published.Deadlines for both project completion and publishing.Estimated time for each project and each project task. Once you have the basic parts of your editorial calendar, you can expand on them as needed. The idea is to create the best calendar for you, one that is fluid so you can grow it as your content needs and projects grow. Need inspiration? You can click here to see some examples. Creating and Using an Effective Editorial Calendar The most effective editorial calendars clearly organize the tasks and timing of multiple projects in one easy-to-use tool. It also tracks the flow of each individual project to see progress and completion of the work at hand. Use these eight time-tested strategies for getting your editorial calendar right from the start: 1. Use one calendar for all content projects. No matter how many or what types of projects you are trying to manage, or if you have multiple people involved, use only one editorial calendar to track it. Keeping everything in one easy-to see calendar means you’re less likely to miss a deadline or overextend yourself or your staff. Using one editorial calendar also makes it easier to update and revise as needed. 2. Identify outside influences that may impact your calendar. If you’re submitting content to an outside publication, you’ll make sure that your editorial calendar aligns with theirs. Depending on your company’s industry or area of expertise, your editorial calendar may be affected by current events, conferences and tradeshows, sales goals, product launches, and more. Make sure to identify these potential sources of conflict and adjust your schedule accordingly. If you’re submitting content to an outside publication, you’ll make sure that your editorial calendar aligns with theirs. Depending on your company’s industry or area of expertise, your editorial calendar may be affected by current events, conferences and tradeshows, sales goals, product launches, and more. Make sure to identify these potential sources of conflict and adjust your schedule accordingly. 3. Plan your work, work your plan. An editorial calendar should show your content plan as a whole, with an emphasis on when it needs to be done and who is in charge of doing it. From there, break down each project further, showing every task involved from start to finish. This will help you allow enough time to complete the work involved with each task. In most cases, each individual project’s tasks will include things like: creating the topic idea, assigning the content piece, research, interviews, outline, draft, editing, photos, links and credits, approval of writing, proofing, and publishing. 4. Plan for the unexpected. If you can, keep blocks of unscheduled time to add projects in or move them around as needed. The calendar should be a clear working plan but one that also allows for changes you may need to make in your projects and workflow. 5. Add key information. Add to your calendar as you become more comfortable and consistent with using it. In addition to including basic information you can start to add more details like keywords, audience, number of social media shares, click-through rates, original publishing dates, how often the content was published and where, and spin-off ideas from the original content. 6. Decide how far ahead to plan. Some content plans encompass a whole year while some may only go six months out. Ultimately, you decide what is appropriate for your goals. Going too far out in advance, however, can be overwhelming, especially if this is your first time using a content plan. Smaller timespans may be easier to stick to at first. 7. Develop a system. Whether you use a spreadsheet, a calendar program, or good, old-fashioned paper planner, it’s important that you have a way to easily identify the different elements of each project. Create multiple tabs or areas on the single calendar based on the type of project, timing, or person assigned to the task. Use color to identify projects, assigned people, timing, or tasks. Create notifiers or alarms so tasks don’t go missed. Flag or highlight important notes that your team can see. 8. Share and protect. Make sure that your calendar is available to everyone on your team at all times – and that everyone is aware of important updates and changes. Of course, there are risks to allowing everyone to access and update the calendar. It’s a good idea to take some steps to safeguard against accidental deletions or changes. Spreadsheets and other programs will allow for certain fields to be locked and still give others access and updating abilities. Allow for others to update their progress and make notes on the calendar but protect all the main fields such as headers, categories, critical projects, and firm deadlines. The Next Step: Now that you know how to create an effective editorial calendar that meets your needs, check out part two of this series to learn about the common pitfalls you should avoid when designing your calendar. You’ll also learn about some of the tools available to help you create this critical document for your content plan.

Types of Mobile Operating System (Os) and Its Pros Cons Essays

Types of Mobile Operating System (Os) and Its Pros Cons Essays Types of Mobile Operating System (Os) and Its Pros Cons Paper Types of Mobile Operating System (Os) and Its Pros Cons Paper in 2005. The unveiling of the Android distribution in 2007 was announced with the founding of the Open Handset Alliance, a consortium of 86 hardware, software, and telecommunication companies devoted to advancing open standards for mobile devices. Google releases the Android code as open-source, under the Apache License. The Android Open Source Project (AOSP) is tasked with the maintenance and further development of Android. Among the advantage of using this operating system is Multitasking. Android phones can run many applications, it means you can browse, Facebook and as well as listening to the song. Besides, Android make ease of notification, any SMS, Email, or even the latest articles from an RSS Reader, there will always be a notification on the Home Screen Android phone, do not miss the LED indicator is blinking, so you will not miss a single SMS, Email or even Miscalls. Easy access to thousands of applications via the Google Android App Market. Through Googles Android App Market you can download applications for free. There are many thousands of applications and games that are ready for you to download on Android phones. On the other hand the disadvantages of using this operating system is Application in the Android phones can indeed be obtained easily and for free, but the consequences in each of these applications, will always be ads on display, either the top or bottom of the application. Besides, since Google Android is an open source platform driving all Android phones, it could significantly increase the risk of hacking these devices. If this happens, then locking mobiles as a security measure will be a mockery. The second mobile operating system is iOS. OS (formerly iPhone OS) is Apple Inc. s mobile operating system. Originally developed for the iPhone, it has since been extended to support other Apple Inc. devices such as the iPod Touch, iPad, and Apple TV. Apple does not license iOS for installation on non-Apple hardware. As of October 4, 2011, Apples App Store contained more than 500,000 iOS applications, which have collectively been downloaded more than 18 billion times. It had a 26% share of the smart phone operating system units sold in the last quarter of 2010, behind both Googles Android. And Nokias Symbian. In May 2010 in the USA, it accounted for 59% of mobile web data consumption (including use on both the iPod Touch and the iPad). The user interface of iOS is based on the concept of direct manipulation, using multi-touch gestures. Interface control elements consist of sliders, switches, and buttons. The response to user input is immediate and provides a fluid interface. Interaction with the OS includes gestures such as swipe, tap, pinch, and reverse pinch, all of which have specific definitions within the context of the iOS operating system and its multi-touch interface. Internal accelerometers are used by some applications to respond to shaking the device (one common result is the undo command) or rotating it in three dimensions (one common result is switching from portrait to landscape mode). The advantages of using this operating system is iOS 4. 0 version can run multiple applications simultaneously and is in no way inferior to other similar operating systems  . Users can schedule an application to be run in the background. When the system detects update or notice, it will appear in the current interface. But due to technical reasons, only iPhone 4,  iPhone  3GS and above can enjoy the service. Besides that, Folder settings are the first time appearing in iOS. The result is very obvious when starting to use. The home page layout becomes well-organized. It is convenient to find the folders for the software come down in the appropriate folders. The disadvantage of using iOS is Unlock way is complicated. Apple don’t modify the operate of lock screen to iPhone, perhaps in order to maintain the consistency of user habits. However, you may miss the next important voice mail, phone, short message. Next is there is no real features upgrade for iPod Frankly speaking, the new operating systems home page has much improvement to the older. But the iPod itself does not get the nature improvement. It is lack of adjustable graphic equalizer, and better support to create playlists. Last but not least is Blackberry OS BlackBerry OS is a proprietary mobile operating system, developed by Research in Motion for its BlackBerry line of smart phone handheld devices. The operating system provides multitasking and supports specialized input devices that have been adopted by RIM for use in its handhelds, particularly the track wheel, trackball, and most recently, the track pad and touch screen. The advantages of using this operating system is compared to other brands, Blackberry mobiles allow users to use the device for two days at a stretch on a single charge. Thus proving its power efficient features of the Blackberry OS. Next is the mobile platform of this brand is extremely secure, thus making it the favourite for businessmen. The push email experience is excellent amongst others. It provides easy accessibility from the moment you get to the main screen together with strong attachment support. The disadvantage of using this mobile OS is Blackberry App World does not come with a wide selection of apps. On top of that, premium programs are quite expensive. Furthermore, the browser is much slower compared to Web Kit based browser on other branded phones like iPhones and Android. When it comes to QWERTY devices, the browser comes with small type. In a nutshell, by choosing the right mobile operating system for your phone, hopefully it will fulfil your needs. Thank You.

Mbuti Culture Research Paper Example | Topics and Well Written Essays - 2000 words

Mbuti Culture - Research Paper Example The Mbuti tribe is dependent on the forest for all the aspects of their life including getting their food, clothes, materials for hunting, item of play, musical instrument etc. In the recent times the tribesmen have come in contact with the agricultural people living the peripheries of the forest. However hunting remains their primary source of subsistence. Even in their trade with the agricultural people they exchange the meat they get from the forest in exchange for farm products (Tanno, n.d. pp. 1-51). The forest and hunting activities influenced the culture, social structures, gender relations and the beliefs and values of the Mbuti tribe associated with the Molimo ritual of the tribe. Social Organization The difference in the strategy for procuring the subsistence has attracted the interest of the anthropologist and ethnographers. Along with the difference in the hunting technique some difference in the social structure has also been observed with reference to the number of memb ers in the community. The inhabitants of the southwestern region, the net hunters live in a comparatively large camp consisting to seven to thirty families together. There method of hunting and distribution of the hunt are also of communal type. The women beat the under bush to drive the animals to the net which are looked after by the men. According to famous pygmy researcher Turnbull, this method of hunting requires a number of families to cooperate with each other in order to procure their subsistence. On the contrast the archers live in small groups of three to five. Individual members hunt with the help of arches and bows. The different operations of arching are tracking and ambushing which requires less number of men than net hunting. Several reasons have been cited for this difference in hunting pattern and consequent social structure based on region. According to Turnbull, this has occurred due to the historical distribution of the forest. The southwestern parts of the count ries have been subjected to encroachment for agriculture, mining, plantations, tourist centers etc. As a result the inhabitable land and the land for hunting and gathering have been reduced. On the other hand the population of the tribe has increased over the years. As a result the tribe was forced to increase their utilization of the reduced amount of available land. Moreover due to the Law of Diminishing Return the tribesmen had to undertake more work individually in order to maintain similar level of consumption. Another interesting feature that has been pointed out by the scholars is that the pygmy tribe has a low exposure to the technological advancement. Therefore they are unable to increase the utilization of the plot of land with the help of technology. To compensate for that, the tribesmen are required to increase the coordination and cooperation among themselves to maintain similar level of consumption. (Abruzzi, 1979) Renowned anthropologist, Harako suggests another alter native theory. According to him the original mode of hunting of the Mbuti tribe was archery. But some time in history a part of the tribe came in touch with the Bantu speaking tribes. In course of their interaction and exchange the Mbuti tribe learnt to use the net as a tool for hunting. This theory gives an explanation for the division of hunting methods

My walk with ecology Essay Example | Topics and Well Written Essays - 750 words

My walk with ecology - Essay Example My favorite form of outdoor activity is walking. I live in the urban city of concrete jungles with skyscrapers blocking out the sunlight. I miss the beauty of natural scenery. I have seen how man has destroyed his natural environment and upset the ecology of nature and man. Industrialization brought along deforestation to make way for human habitats and agriculture. The increased burning of fossil fuels increased the release of greenhouse gasses and the sum total effect has led to global warming. My thesis is that Man needs to reconnect with nature to help preserve ecology. The simplest and most direct way of reconnecting to nature is by walking through the rural countryside. It is one of the best ways of observing nature and appreciating the great diversity of life forms and the ecology. I believe that when Man comes to self-realization on his close relationship with nature, he will value it and refrain from participating in activities that would harm the balance of our ecology. I c hoose walking on foot to go sight seeing and explore nature because any other artificial mode of transport would burn fossil fuels and harm the environment with the emission of toxic waste gasses. When I walk at my own leisurely pace, I get to observe nature at work, play and rest. I think walking is the best way to get close to nature. Fenton recommended walking as a cheap and easy way to maintain health, effect weight loss and stay fit. We can kill two birds with one stone by taking up walking for health reasons as well as to observe nature. Fenton said that; 'Walking is not only better for your spirit, mood, and body, it's better for your whole community. Trust walking.' (Fenton 5). Walking does wonder for you while conserving the ecology. Walking is a cheap form of exercise. You just need a pair of comfortable walking shoes and thick socks to cushion your feet against blisters. The writer Werner recommended carrying a backpack for your basic essentials like a map, compass, a quart of water for every miles of walk, tissue and toilet paper, refuse / trash bag, raincoat / poncho, protective clothing against the cold and wet, energy snack foods and cell phone. (Werner 4). These are for a day walk. If you are walking at night, you need additional equipment like a flashlight with extra batteries, flares, insect repellant, and maybe a walking stick. If you are a photography and nature enthusiast, bring your camera and binoculars. If you are creatively inclined, bring along a notebook or sketch pad. The beauty of nature might inspire you to write or draw something. It is safer to prepare for emergencies in the event of being caught up in some unfavorable weather. A beginner should start walking during the day and on familiar terrain. One should take caution and plan a walk with a realistic distance as a goal in mind. I would keep in mind to let the people around me know my intentions just in case if I don't make it back in time, they would know to send out a search party for me! Walkers often choose routes to cut across natural terrain. I like the opportunity to breathe in fresh air, unpolluted by traffic. Sometimes, I see the traffic along the established paths and it is ugly traffic. Litter left behind by humans is detrimental. The wild animals do not know better than to ingest litter and this poses a health risk to them. Human food is not suitable for animals. Non-degradable refuse like plastic is an eyesore and dangerous when innocent animals ingest them. I would not have known about the effects of litter if I had not come across piles of them in my walks. They spoil the natural beauty of the landscape. This brings up the use of the trash bag in my backpack. Every walker should be responsible for keeping their own trash out of the natural environment. Waste items should be deposited in the trash bag and carried out of the natural

Satisfaction Rates Among Outpatients of Hospital

Satisfaction Rates Among Outpatients of Hospital Assessment of satisfaction among outpatient department (OPD) patients visiting tertiary level government hospital ABSTRACT Background Selection of an appropriate health care and measurement of its quality is very complex and elusive yet the tools of its measurement have been improving. It is easier to evaluate the patient’s satisfaction towards the service than to evaluate the quality of medical services that they receive. (1) Therefore, a research on patient satisfaction can be an important tool to measure of health system performance and improve the quality of services. (2,3). Satisfaction manifests itself in the distribution, access and utilization of health services. Objective: The main objective of this study is to measure the satisfaction of OPD (Outpatient Department) patients in tertiary care public health facility namely Guru Gobind Singh govt. Hospital, Jamnagar, Gujarat. Materials and Methods: Data were collected from a pre-tested pre-structured questionnaire from 322 patients who gave the verbal consent at the end of their O.P.D visit at tertiary health facility, Guru Gobind Singh Government Hospital, Jamnagar for days from to. The items in the questionnaire referred to particulars of the patients such as age, gender, education, occupation, income, family type etc.; perception of patients towards doctor , paramedical staff, basic amenities and quality of care. The responses were expressed in proportions. The data was tabulated on Microsoft Excel sheet and analyzed using EPI info. Results –Although majority of patients were satisfied with the availability of medicines; availability of information on illness, treatment and prevention; doctor’s patience, compassion and dedication but most of the patients were not satisfied with the behaviour of hospital personnel ;delay in reception of investigation reports ;unhygienic toilets and improper cleanliness of hospital; and lack of availability of drinking water . INTRODUCTION Quality care is the most important dimension of public health and it has emerged as an internationally important aspect in the health care services provision. This quality of care can be measured in terms of structure, process and outcome. Structure refers to the basic infrastructure and facility, process refers to the way the care is delivered and outcome refers to the end result. (4) While measuring health outcome and quality of patient care services, patient’s satisfaction is considered to be important component. Patients’ perceptions about health care systems and his satisfaction seem to have been largely ignored by health care managers in developing countries (12). The outcome of any disease is influenced not only by the appropriate diagnostic and treatment services but also the receipt of satisfactory care from service providers. A satisfied patient is more likely to develop a deeper and longer lasting relationship with their medical provider, leading to improve compliance, continuity of care and ultimately better health outcome. But it is difficult to measure the satisfaction and gauze responsiveness of health systems as not only the clinical but also the non-clinical outcomes of care do influence the patients’ satisfaction ,(5)such as: Quality of clinical services provided, availability of medicine, behavior of doctors and other health staff, cost of services, hospital infrastructure, physical comfort, emotional support, and respect for patient preferences.(6) Mismatch between patient expectation and the service received is related to decreased satisfaction.(7) Therefore, assessing patient perspectives gives them a voice, which can make public health services more responsive to people’s needs and expectations.(8,9) In the recent past, studies on patient satisfaction gained popularity and usefulness as it provides the chance to health care providers and mangers to improve the services in the public health facilities. Patients’ feedback is necessary to identify problems that need to be resolved in improving the health services. Even if they still do not use this information systematically to improve care delivery and services, this type of feedback triggers a real interest that can lead to a change in their culture and in their perception of patients. (10) OPD is the window to any health system and OPD care indicates the quality care of hospital reà ¯Ã‚ ¬Ã¢â‚¬Å¡ected by patient’s perception in terms of satisfaction to the services they are provided.(11)This study was therefore undertaken at OPDs of tertiary level health facility in Jamnagar to measure patient satisfaction. The main objective of this paper is to know the desired level of services as perceived by the patients about various components of out-door patient department (OPD) services. In this study, the OPD is defined as the hospital’s department where patients received diagnoses and/or treatment but did not stay overnight. MATERIALS AND METHODS Study design: Institution based cross-sectional study. Study population: The present study was conducted among the patients attending the outpatient department (OPD) of Guru Gobind Singh government hospital, Jamnagar. Period of study: The period of survey was days from to. Sampling frame: The sampling frame consisted of the outpatient department (OPD) of Guru Gobind Singh government hospital, Jamnagar. . Sample size: fifty percent of the OPD patients. Sampling technique: random sampling technique. The sampling population was interviewed from the most frequented OPDs (Medicine, General surgery, Obstetrics and Gynecology, Paediatrics, Orthopedics, Otorhinolaryngology, Ophthalmology, Skin, Tuberculosis and Chest diseases) according to probability proportion to size based on the past years OPD attendance. Inclusion criteria: A new or referred patient attending the OPD of the respective health care facility who gave verbal consent, Exclusion criteria: Patients working in the health care facility and patients admitted (indoor patients) and follow-up patients attending the OPD of the respective health care facility, who didn’t gave verbal consent or gave incomplete information, were excluded from the study. Selection of patient: The patients attending the OPD of the respective health care facility were selected for the interview by systematic random sampling. Depending upon the previous attendance of the particular department and the time taken to complete the interview, a random number was chosen and every nth patient was selected for the interview. This process was continued till the required sample size was completed. Tools of data collection: Permission to conduct the study was taken from the superintendents of the concerned health care facility. All the patients were interviewed after they had consulted the doctor. Informed verbal consent was taken from all the participating patients before the start of the interview after telling them about the objective of the study and the approximate time that will be involved in the completion of the interview. The prescribing doctor was largely kept unaware of the procedure, except in unavoidable circumstances, to avoid the bias in their behaviour with the patient. A pre-tested pre-structured questionnaire was used to record information taking the key elements of socio-demographic characteristics and perception of the patients regarding quality of services available at the outpatient health care facility. Analysis Data was tabulated on Microsoft Excel sheet and analyzed using the software Epi Info version 6. OBSERVATIONS AND RESULTS:- Table 1-socio-demographic profile of the patients:- Among all the subjects interviewed during the data collection, 322 were included in the statistical analysis and the remaining were not included, because of incomplete information. A majority (56.21%) of the responders were male. The mean ages of the responders were years .About 40% of the responders were illiterate. About half (56%) belonged to a joint family. Nearly half of the study subjects belonged to the lower socioeconomic status category as per the Kuppuswamy classification. TABLE 2-PATIENTS’ PERCEPTION OF THE QUALITY OF SERVICES AVAILABLE (n =322) The results regarding each question are shown in Table 2. Most of the respondents were satisfied with the availability of medicines, also they were able to get the medicines easily. Most of the respondents agreed that complete information was provided to them on the illness, treatment, and the methods to avoid illness. Almost half (48%) of the patients were not satisfied with the politeness of the hospital personnel. More than half (61%) of the patients stated that hospital personnel were not helpful. 59 % patients said that the doctor did not give them adequate time while 60% of the patients said that the doctor has given enough time to listen completely to their complains. 57% of the patients were satisfied that the doctor has checked carefully and was readily answering their questions. Almost 50% of the patients were told that the doctor gave them adequate time and didn’t rushed. 42% patients couldn’t easily locate the place of investigation. 55% of the patients didn’t receive their reports in time. 57% of the patients were not satisfied with the cleanliness of the hospital. 69% of the patients were not satisfied with the toilet conditions. 59% of the patients stated that drinking water wasn’t available in the hospital. TABLE – 3: QUALITY OF CARE Overall 66.45% respondents termed the hospital services as satisfactory, 62.11% were satisfied with the treatment given, but 52.48% stated that the services provided were not worth the money spent, and 40.99% replied that they would not like to visit the facility again in future. [Table 3]. DISCUSSION In our current study, patients were satisfied with the ease of availability of the required medicines while in a study done by Sivalenka (13) medicine supply was an area of concern. Most of patients were satisfied with the information provided to them about illness, its treatment and prevention. Patients were not very satisfied with the behaviour of the hospital personnel .lack of monitoring of staff, due to very high patient load, could be the reason for this. It was observed during the study that the ultimate satisfaction of the patient is their rapport with the doctor. A patient forgets the pain he faces to reach the doctor if the doctor sees him with patience and compassion. In our study, most of the patients were satisfied with the behaviour of the doctor, which was similar to the result of study by Kumar et al (14). More than half of the patients were not satisfied due to the delay in reporting time of the investigations thereby increasing their waiting time which is similar to other studies (17-18). Some of the responder cited inability to locate the departments as a constraint. Lack of proper sign boards leads to difficulty in locating the departments. A good number of patients were not satisfied with the cleanliness of the hospital. Also most of them were not satisfied with the condition of the toilets. As compared with private sector, government hospitals lack in general cleanliness and hygienic toilets, thereby leading to severe patient aversion and dissatisfaction, which needs to be improved .similar findings have been observed in some other studies (13-16) As observed in our study, Overall level of satisfaction of patients towards government tertiary care health facility is low, although patients appeared to be satisfied with the doctors, which seems to be a strong reason of their still existing faith in the tertiary care government hospital. Thus we need to improve the rest of the factors so as to keep up to the expectations of the patients ,thereby try to fulfill the basic need of patient- which is readily available ,easily accessible, and satisfactory health services for all. CONCLUSIONS Efforts should be made to reduce the patient load at the tertiary level facilities so that doctors and other staff can give more attention and time to the patients. 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