Cross Cultural Managers

Sample details Pages: 17 Words: 5222 Downloads: 2 Date added: 2017/06/26 Category Statistics Essay Did you like this example? Cross Cultural Awareness Task 1 Don’t waste time! Our writers will create an original "Cross Cultural Managers | Management Dissertations" essay for you Create order The FIVE most important competencies for managing internationally in my country, Hong Kong, for these three American managers of TDS are: Interpersonal Skills If this is not the most important skill of all, it is the crucial one. This skill helps the expatriate managers to establish relationships, coordinate with others, satisfying the needs for friendship and intimacy when they are abroad. It also helps in building trust and form relationships with the people around them. The expatriate managers are often experiencing uncertainties and getting stressed when dealing things with work and personal life in a new environment. So with good interpersonal skills will be able to reduce the stress coming from every angle. Referring to a recent book (Schneider Barsoux, 2003, 190-1), the primary selection of many companies for the expatriate managers in practice is their track records on reaching their targets or getting their jobs done. Companies also would like to send those that are eager to climb further on their career ladders or those with technical or conceptual abilities instead of those with interpersonal skills abroad. These expatriates are often too focused on their personal agenda to make things happen and ignore the pressure that are given to the local staffs which would create tension at work. Moreover, feelings of mistrust and resentment of the local staffs towards the head office will also be exacerbated. Therefore, interpersonal skills should be taken into account when the American managers are being chosen to manage in a foreign country like Hong Kong. Motivation to live abroad It is a key factor for the expatriate managers and their families to adapt into the local culture successfully (Schneider Barsoux, 2003, 192). Basically they should have real interests in the country they will live in, in order to have the curiosity to get to know it better and experience it well. It is the desire that makes them easier to understand the culture with ease. Patience and respect Different countries have different cultures so it is necessary that the international managers have the patience and respect when dealing with the new culture. It takes time to cope and learn the differences between the culture at home and the culture of the new place so the international managers should be patient (Schneider Barsoux, 2003, 193). They also need to have respect for the local of how the things happen in some ways when dealing with different circumstances in any aspects. Cultural empathy This is a not skill that can be easily acquired because it is deeply rooted in someones character to have the mentality of empathy for others with cultural differences (Schneider Barsoux, 2003, 193). It is required in order to respect the local staffs by the international managers to be a good listener to focus on what they have to say. Being non-judgmental is also important for those managers to be able to understand others points of views. The psychological development of a human being allows narcissism to be evolved to a point that interfere the capacity for empathy (Kets de Vries, M. and Mead, C. 1992). Managers that are narcissistic usually are self- centred and think that others are paltry or just the extensions of their own. They make the values of others hard to be recognized, let alone appreciate, because they see others as objects or tools for them to get what they want in order to achieve their goals and they also think of others as the mirrors to reflect their own glory. This type of managers would use all their efforts to prove their worth instead of considering the needs and the existing values of the other staffs. Flexibility, tolerance for uncertainty and ambiguity These managers also need to have the flexibility, tolerance for uncertainty and ambiguity. Changing circumstances that are unexpected makes the managers face with thread of uncertainty and ambiguity because the reactions and the behaviors of the local staffs may be unpredictable. Managers are intended to reinforce greater controls and restrict on the information flow when they face this kind of tread especially during an international assignment (Schneider Barsoux, 2003, 192-3). It often results in a stereotypical response and not well adapted to the situation on hands. Although it is difficult for the managers that are usually awarded by being in charged and staying on top of things, expatriates need to go with the flow and let go of control. Everyone doesnt always need to go by the book because actions are often taken base on insufficient, unreliable or/ and conflicting information. Task 2 Controlling model and Adapting model are the names and characteristics of two specific models of strategy related to cultural assumptions and approaches in adapting to external environment as discussed in the literature. The differences between controlling and adapting approaches are described below: Controlling model is based on active search that is focused and systematic. The planning system of the controlling approach is formalized and centralized using expert consultants to assist in devising strategy. The information being used by the controlling method is objective, quantitative and impersonal also interpreting information relies on formal models and methods like strategic forecasting with scenario planning. The people involve in this model are those from the top management or the experts of the particular area. The decisions for the controlling approach would be made by the top management and pass down to be implemented. The strategic goals and action plans are clearly defined, articulated and it would be explicitly measured and rewarded in this controlling method. As it assumes that the environment is known to reduce environmental uncertainty. This approach is usually sequential and short term (Schneider Barsoux, 2003, 124). Adapting model is broad, sporadic, decentralized and mostly based on monitoring. It is the opposite from the controlling model, informal and decentralized. The adapting approach is personal, subjective and qualitative; the information would be interpreted by some informal methods with discussions and debate. It would have the employees involved from all across the ranks. The decisions for the adapting approach would be made by the front lines staffs, neither the people from top management nor the experts. The strategic goals tend to emerge and action plans are broad, implicit and vaguely monitored. Also it assumes that the environment cannot be readily known or controlled. This approach is long term and simultaneous (Schneider Barsoux, 2003, 124). The model of adapting approach is more appropriate in this situation with TDS because TDS is new to town and not quite familiar with the culture and environment in Hong Kong. Also the environment cannot be controlled or readily known, it would be wise to have the responsibilities to be diffused throughout the organization to make all the staffs from different ranks to get involved. Strategic direction tends to emerge when different people come with different perspective on the business point of view. The implementation should be locally determined to keep it within this strategic frame. Strategy can be refined on an ongoing basis and the adjustments can be made to any unexpected circumstances. TDS should be flexible in order to deal with any sort of unforeseen events or sudden change in any situation. A broad scan is needed in case of any subtle change in the environment and also accountability should be assigned to the collective too because everyone is involved to contribute to make things happen. Task 3 The Five methods of discovery that I would recommend to the three American managers transferring into my country, Hong Kong, are: Architecture and design According to a recent book (Schneider Barsoux, 2003, 24-6) the most obvious artifact is the architecture and design of the building when you enter the organization. In the United States, most of the office design would be opened space with partitioned off by half walls with each individual cubicles personalized by personal interested items such as photos, plants or aphorisms. By not being able to see each other directly allows a sense of privacy to be established. Also opened doors are usually signaled as accessible and available while closed doors are indicated as a sign of privacy desire in the United States. To the contrary, Japanese prefer to have some of the walls knocked off so informal communication would not be inhibited. On the other hand, Germans experience difficulty to work in an open-plan office due they feel it is lack of privacy. Although Hong Kong has a majority of 95 percent Chinese people according to a website (The American Chamber of Commerce in Hong Kong, 2008), and was also a British colony for over 150 years, the main business partner of its own is still the United States as shown by the figures provided from the Business Expectation Statistics Section, Census and Statistics Department, (2007a) (2007b). Therefore, most of the office design in Hong Kong is followed to the same style as those in the United States. Greeting rituals In the United States, the greeting rituals are tended to be paid less attention according to a recent book (Schneider Barsoux, 2003, 26-7). But for the other countries, the protocol is taken quite seriously. There are different forms of way in greetings such as showing respect by exchanging and inspecting business cards in Japan, greeting individual by name, shaking hands and making eye contact by French. The degree of body contact expected in greeting creates a fair amount of confusion in another part of the rituals too. In the United States, people might greet others with a hug even when the acquaintanceship is ordinary. In some countries like France, kissing hello and goodbye are common while people from countries like Hong Kong might feel uncomfortable and uneasy about it. According to a website (The Economist Newspaper Limited, 2008), handshaking followed by an immediate swapping of business cards is the most common form of greeting in Hong Kong. Dress Codes It is another cultural artifact varies from the degree of formality. Schneider Barsoux (2003, 29) pointed out that Anglo and Asian managers do not want to get too much attention or stand out by the way they dress while the Latin managers really care about their personal style. Moreover, corporate dress seems to be color coded in some countries. For example in the United Kingdom, some women are advised not to wear suits and dresses in bright color to work such as red and some bankers of a Dutch bank even avoid to wear suits in brown. It also signals task orientation. In the United States, rolled up shirt sleeves is considered as a signal of hard working while in France means relaxing on the job. Not to mention that some US companies have designated days to encourage people to appear in casual clothes at work such as Fridays. According to a website (World Business Culture, 2008), dress codes differ base on the size of company and industry sector in Hong Kong. Men mostly wear dark suits, shirts and ties while women wear conservative suits and dresses. Trousers and causal wear are tended to be worn only on informal occasions or designated days. Written versus verbal contracts In different parts of the world people have different definitions toward the sealed business agreements as mentioned in a recent book (Schneider Barsoux, 2003, 30). In some places, ones word means more than a legal document while others need to put down all the details on a paper in black and white. Problems would appear when the contracts are expected by the head office to be signed, sealed and delivered from a place where ones reputation and honor are way more valuable than some legal documents. Figures from Schneider Barsoux (2003, 30) for the estimated numbers of lawyers per capita of some countries like United States, United Kingdom, Germany, France and Japan reflect the differences on expectations. American managers will bring it to the legal department to retrieve whenever a business deal has been fell through while some other countries would sort things out through the relationship. Since Hong Kong is a Common Law Jurisdiction like most of the United Kingdom, Ireland and the United States (Wikimedia Foundation, Inc. 2008a), people most likely to expect to have a written contract over a business deal. Criteria for success It depends on the importance of stakeholders whether it is the benefit of the shareholders, the customers or the employees. Beliefs and values differ when there are different stakeholders; there are different criteria for success. Schneider Barsoux (2003, 31) claimed that American companies only exist for the benefit of the shareholders. This might be disagreed in Japan or even shock the Japanese as they believe customers have the divine rights. Some countries in Europe such as Germany or Sweden believe that the employees have the divine rights instead. Although all these factors are crucial to the business success, you still need to have a closer look to the cultural preferences in different countries like Hong Kong. Task 4 In my opinion, the key functions for managing people and human resource management are recruitment and selection, compensation and rewards, employee relations, and career development. Recruitment and selection This can be the most challenging and important function for managing people and human resource management. It is because finding the right people for the right job is essential. It is often a challenge as well especially when the nature of the local labor market or the available human resources is not familiar. The company needs to understand how to access the local labor pool in order to get the equivalent people to work for the company. So finding those candidates who have the abilities and requirements to finish the task and get the job done is also hard and essential, not to mention to get those who seem to likely match with the existing corporate culture. Moreover, the standard profile of one country might be very different from another in terms of representation and the differences in education systems also play a part to make the selection difficult in selecting which person fits the profile for the job (Schneider Barsoux, 2003, 151). Compensation and rewards The cultural differences play a role when it comes to determine the terms of reward and who gets it. Different cultures have different type of value in relations to the reward and vary to the extent in the belief that reward should be collective or individual. Pay for performance is assumed to be based on contribution or equity instead of the belonging to the group or equality (Eretz and Early, 1993). In the contractual view of employment, the notions of equity, you get what you deserve, are embedded while the notions of equality, you deserve what you get, correspond to the social view (Pennings, 1993). According to Susan Barsoux (2003, 165), the current trend of linking salary payment to working performances is especially suspect to be cultural related. It has been discovered that in some countries like France, it would be shocked for the French executives to have clearly stated quantifiable objective relating increased performances to increased bonus. It is because the French executives found that discussion about money and finance is such a turned off. It also provoked outcries when the merit pay was attempted to be introduced in Japan. It created uproar as the Japanese executives were scared that it would ruin the harmony of the group and might also encourage short term thinking especially when the employees only focus on the performance in order to get the bonus. On the other hand, the dominant influence in American managerial thinking is the principle of equity that each one should be rewarded based on the solely contribution by that particular person. Nowadays in the view towards team management that demands group cooperation instead of competition among individuals finds the merit-based pay in the United States demotivating (Susan Barsoux, 2003, 167). The preference between financial or non financial incentives is also related to the culture. The motivating potential of money, status, vacation time is also affected and changed across countries. Swedish would prefer to have some time off rather than a bonus because they are more concerned with the quality of life and monetary rewards are less motivating while giving time off might seem to have not much point in Japan when most of the employees only take half of their holiday entitlement (Susan Barsoux, 2003, 167). So the internationally operated companies should learn to appreciate the different values and evaluate the potential impact as well because the remuneration package is a very strong indicator of the culture and the behavior expected and also can be used in order to encourage cooperation or competition, risk taking or conservatism, and information sharing or information hoarding. The remuneration package is also a very important signal when it comes to aspiring recruits. When the company wants to attract local elite, it can choose to align itself with the local norms or the alien one when the preference of the company changes to attract the less mainstream or adventurous or those that are frustrated with the local practices and looking to be rewarded for their efforts and success (Susan Barsoux, 2003, 168). Employee relations It is important to have a good relations and mutual understanding between the management and the staffs of the company. Any staff grievances of the company should be dealt with and well listened to in order to promote a harmony environment. An open dialogue is needed to be promoted between the management and the unions of the company to eliminate any conflicts or fictions that may occur between the staffs and the management specially when there is a new implementation of company policies. Also the employees political standing should be respected and well listened to especially when it is toward the company policy and issues. Good employee relations help increasing the engagement of the employees to the company so as their commitment and involvement as well. It also helps with the staff retention which is necessary for a company setting up in a new country like TDS (CIPD, 2008). Career development National culture has an impact on career development and the natures of the managerial tasks on what management should do or be are depended on assumptions of being versus doing. The determinants for success varies across cultures when some places have it based on achieving results like the United States while in the United Kingdom having good interpersonal skills and personal connections are the keys for success at the career front. Favored career paths also differ culturally and it is bound up with cultural assumptions regarding the importance of the individual versus loyalty to the company, doing versus being, and tolerance for uncertainty. So a multinational company should make sure that the perceptions of what it takes to get to the top and the patterns of career development would include people with different skills, abilities, knowledge and perspectives (Susan Barsoux, 2003, 168 -70). With the references to managing people and HRM, I feel the four department managers, two from the United States and two from Hong Kong, should focus on during their first three months is selection because it is vital to get the right people for the right job in any organization (Schneider Barsoux, 2003, 151). Local talent may have different types of abilities, skills, knowledge and strength owing to the national values differences placed on the education so it is also a challenge to get the right people who fit the requirement for the particular job and also fit with the company culture. The managers should consider the differences in attitude towards the hiring practices in Hong Kong and also the cultural differences will influence on how to recruit as well. So getting access to the local labor pool to get the people that match with the job criteria is important too. Therefore, selection should be focused by four department managers for the first three months to get the right people in place and help them to adjust and fit into a new culture and way of life in order to make the launch of TDS in Hong Kong a success. The trade unions in the United Kingdom has a culture as a collective bargaining tool with management while the one in the United States has more of a hire and fire culture. In Hong Kong, there are four trade unions and the largest one among them is the Hong Kong Federation of Trade Unions and their main slogans are patriotism, solidarity, right, welfare and participation (Wikimedia Foundation, Inc. 2008b). Although the unions in Hong Kong are focused on the rights and welfares of the workers as much as those in the United Kingdom and the United States but they are still at the stage of establishing as the largest unions in Hong Kong was founded in 1948 while those in United Kingdom have been existed for over 100 years like the General Federation of Trade Unions (UK) (Wikimedia Foundation, Inc. 2008c) and so as those in the United States like the American Federation of Labor and Congress of Industrial Organizations was founded in 1886 (Wikimedia Foundation, Inc. 2008d). Since the United States is the biggest trade business partners of Hong Kong, most of the companies would contain the culture of the United States to remain individual. Task 5 The benefits of creating and working within the context of a multicultural team are given the larger complexity and speed of change in the international business environment. It seems obvious that bringing people together from different cultures enhance the quality of decisions taken. These multinational cultures contribute a greater range of perspectives and options with even more successful marketing strategies and ideas to attract different types of customers. It can also provide a different or new way of looking at the old or existing problems and help to promote the chances for greater innovation and creativity with the cultural differences as well (Schneider Barsoux, 2003, 218). Combining people from different cultural backgrounds also benefits the organization integration and learning so as the managerial development. It improves lateral networks for the communication and information flow. Also when bringing the people with the different cultural backgrounds together, it can be a solution to help minimize the risk of uniformity and pressures for conformity which can appear in the company when there are too many like minded people working at the same company together at the same time (Janis, 1971). Also teams that are composed by members with different profiles are far more effective than teams that are made by the best and the brightest performers or with the members who are having the similar profiles. Teams that have included a mixture of members with profiles of different areas performed better as they have the balance of roles. Different cultures have different assumptions toward the business issues and also have different ideas about the reasons of teams. So that to share information and discuss about any problem at work with people from different cultural background would often generate greater results in a dynamic way. Furthermore to the benefit of the combination with people from different cultures background would enhance the productivity for the organization. The challenges of creating and working within the context of a multicultural team are that bringing people together from different cultures is given more ambiguity and uncertainty in decision making. Also it would be much more complex in the organization from the procession to implementation due to the cultural differences in assumptions. People with different cultural backgrounds work together might create interpersonal conflict and communication problems at work. Also it would create greater potential for frustration and dissatisfactions that might lead to higher turnover of team members within the group (Schneider Barsoux, 2003, 231). The choice of language using within the multicultural team might also creates friction and misunderstanding especially when the native language for the three American managers is English while the native language for the local managers is Chinese, there is a huge scope for misunderstandings that could hamper the cohesion and effectiveness of the team no matter how fluent the local managers could speak in English (I-change, 2008). According to the personal upbringing and values, technical background and training, and also the national backgrounds can distort and filter the messages in many layers of meaning within a multicultural team that can lead to further misunderstanding and frustrations. Barriers would also be created for the multicultural team due to the direct versus indirect communication; trouble with accents and fluency; differing attitudes toward hierarchy and authority and so as the conflicting norms for decision making (Brett, Behfar Kern, 2006). Direct versus indirect communication is that in western cultures, the communication is typically direct and explicit. The listener does not need to know much about the speaker in order to interpret the context because the context of the meaning of the conversation is on the surface while the meaning of the conversation is embedded in the way the message is presented in many other cultures. Although the language of international business is English, the trouble with accents and fluency may lead to deep frustration and misunderstanding because of nonnative speakers accents, problems with translation or usage and lack of fluency would also influence the perceptions of status and competence. A challenge inherent in multicultural team with differing attitudes toward hierarchy and authority is that by design, teams have a rather flat structure. But team members from some cultures that people are treated differently according to their status in an organization probably are uncomfortable on flat teams. If they defer to higher status team members then their behavior will be seen as appropriate when most of the team members are came from a hierarchical culture; but they may damage their stature and credibility and even face humiliation if most of the team members are came from an egalitarian culture. Cultures differ enormously when it comes to decision making due to the conflicting norms for decision making particularly on how much analysis is required beforehand and how quickly the decisions should be made. American managers like to make decisions very quickly and with little analysis relatively when compared to the managers from other countries that may also be the challenge too. Task 6 Management Approach The four profiles are Village Market Well oiled machine Family or tribe Pyramid of people Ethical considerations: Managers and companies need to access how different spheres of cultural influence contribute to ethnical behavior. Ethical considerations could include such things as harsh capitalism which could include laying off workers, breakdown of psychological contract, corruption, codes of conduct, and the Sullivan Principles. Common rationalizations in explaining unethical behavior can be: It is not really illegal or immoral It serves the best interest of the individual or company It is safe because it will never be found out or publicized The activity helps the company and therefore it will be condoned and protected References: Brett J., Behfar K. Kern M.C. (2006) Harvard Business Review[online]. Available from:https://web.gsm.uci.edu/~kbehfar/Behfar-HBR%202006.pdf [Accessed 27 July 2008] Business Expectation Statistics Section, Census and Statistics Department. (2007a). Hong Kong Statistics Statistical Tables [online]. The Government of the Hong Kong Special Administrative Region. Available from: https://www.censtatd.gov.hk/hong_kong_statistics/statistical_tables/index.jsp?htmlTableID=133excelID=134chartID=tableID=133ID=subjectID=5 [Accessed 29 June 2008] Business Expectation Statistics Section, Census and Statistics Department. (2007b). Hong Kong Statistics Statistical Tables [online]. The Government of the Hong Kong Special Administrative Region. Available from: https://www.censtatd.gov.hk/hong_kong_statistics/statistical_tables/index.jsp?htmlTableID=134excelID=chartID=tableID=134ID=subjectID=5 CIPD. (2008) Employee Relations: an overview [online]. Available from: https://www.cipd.co.uk/subjects/empreltns/general/emprelsovr.htm [Accessed 13 July 2008] Eretz, M. and Early, P.C. (1993) Culture, Self-identity, and Work, New York: Oxford University Press. I-Change. (2008) Multicultural teamwork Communication[online]. Available from: (https://www.i-change.biz/multiculturalteamworkcommunication.php [Accessed 27 July 2008] Janis, I.L. (1971) Victims of Groupthink, Boston, MA: Houghton Mifflin. Kets de Vries, M. and Mead, C. (1992) Development of the global leader, in V. Pucik, N. Ticy and C.Barnett (eds) Globalizing Management, New York: John Wiley, pp.194-205 Pennings, J.M. (1993) Executive reward systems: A cross national comparison,, Journal of Management Studies, 30(2), pp.261-80, p.264. Schneider, S.C. and Barsoux, J.L. (2003), Managing Across Cultures 2nd edition, pp.24-6, Prentice Hall. Schneider, S.C. and Barsoux, J.L. (2003), Managing Across Cultures 2nd edition, pp.26-7, Prentice Hall. Schneider, S.C. and Barsoux, J.L. (2003), Managing Across Cultures 2nd edition, p.29, Prentice Hall. Schneider, S.C. and Barsoux, J.L. (2003), Managing Across Cultures 2nd edition, p.30, Prentice Hall. Schneider, S.C. and Barsoux, J.L. (2003), Managing Across Cultures 2nd edition, p.31, Prentice Hall. Schneider, S.C. and Barsoux, J.L. (2003), Managing Across Cultures 2nd edition, p.124, Prentice Hall. Schneider, S.C. and Barsoux, J.L. (2003), Managing Across Cultures 2nd edition, p.151, Prentice Hall. Schneider, S.C. and Barsoux, J.L. (2003), Managing Across Cultures 2nd edition, p.165, Prentice Hall. Schneider, S.C. and Barsoux, J.L. (2003), Managing Across Cultures 2nd edition, p.167, Prentice Hall. Schneider, S.C. and Barsoux, J.L. (2003), Managing Across Cultures 2nd edition, p.168, Prentice Hall. Schneider, S.C. and Barsoux, J.L. (2003), Managing Across Cultures 2nd edition, pp.168-70, Prentice Hall. Schneider, S.C. and Barsoux, J.L. (2003), Managing Across Cultures 2nd edition, pp.190-1, Prentice Hall. Schneider, S.C. and Barsoux, J.L. (2003), Managing Across Cultures 2nd edition, p.192, Prentice Hall. Schneider, S.C. and Barsoux, J.L. (2003), Managing Across Cultures 2nd edition, pp.192-3, Prentice Hall. Schneider, S.C. and Barsoux, J.L. (2003), Managing Across Cultures 2nd edition, p.193, Prentice Hall. Schneider, S.C. and Barsoux, J.L. (2003), Managing Across Cultures 2nd edition, p.218, Prentice Hall. Schneider, S.C. and Barsoux, J.L. (2003), Managing Across Cultures 2nd edition, p.231, Prentice Hall. The American Chamber of Commerce in Hong Kong. (2008). Living in Hong Kong [online]. Available from: https://www.amcham.org.hk/hongkong/lhk/lhk2008/CH01-p06-Ppl_Customs.pdf [Accessed 28 June 2008] The Economist Newspaper Limited. (2008). Cities Guide Hong Kong [online]. Available from: https://www.economist.com/cities/displayobject.cfm?obj_id=10316488 [Accessed 28 June 2008] Wikimedia Foundation, Inc. (2008a) Legal System of the World [online]. Available from: https://en.wikipedia.org/wiki/Legal_systems_of_the_world#Common_lawWorld [Accessed 29 June 2008] Wikimedia Foundation, Inc. (2008b) List of trade unions [online]. Available from: https://en.wikipedia.org/wiki/List_of_trade_unions [Accessed 13 July 2008] Wikimedia Foundation, Inc. (2008c) General Federation of Trade Unions (UK) [online]. Available from: https://en.wikipedia.org/wiki/General_Federation_of_Trade_Unions_%28UK%29 [Accessed 13 July 2008] Wikimedia Foundation, Inc. (2008d) AFL-CLO [online]. Available from: https://en.wikipedia.org/wiki/AFL-CIO [Accessed 13 July 2008] World Business Culture. (2008). Hong Kong Dress Code [online]. Available from: https://www.worldbusinessculture.com/Hong-Kong-Business-Dress-Style.html [Accessed 29 June 2008] Bibliography: CIA. (2008) The World Factbook Hong Kong [online]. Available from: https://www.cia.gov/library/publications/the-world-factbook/print/hk.html [Accessed 28 June 2008]. Hmieleski, K. (2006). Research: Empowering leadership style doesnt work in start-up companies [online]. TCU The Neely School of Business. Available from: https://www.neeley.tcu.edu/default.asp?nodeid=1361 [Accessed 5 July 2008] The New York Times. (1997) The New York Times: Hong Kong [online]. 1997. Available from: https://www.nytimes.com/specials/hongkong/ [Accessed 28June 2008]

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It was found that 23%, N=814Read MoreKidney Cancer Essay2558 Words   |  11 PagesPathophysiology: Your kidneys are two bean-shaped organs, each about the size of your fist. Theyre located behind your abdominal organs, one on each side of your spine. Like other major organs in the body, the kidneys can sometimes develop cancer. Your kidneys are part of the urinary system, which removes waste and excess fluid and electrolytes from your blood, controls the production of red blood cells, and regulates your blood pressure. Inside each kidney are more than a million small filteringRead MoreTransformation Related Protein 53 : A Tumor Suppressor Gene1300 Words   |  6 PagesTransformation-Related Protein 53, also known as TP53, is a tumor suppressor gene. It is named after its molecular mass. The gene was discovered by Arnold Levine, David Lane, and William Old in 1979 and was voted molecule of the year by science magazine in 1993. 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United States Bill of Rights and American Sporting Tradition Free Essays

Gun Control Gun control would not help crime or murder rates because instead it disarms the law abiding citizens, therefore putting them at a disadvantage in defending there selves against criminals. The second amendment states that citizens have the right to bear arms. Guns have also been an American sporting tradition for years, and have saved many lives from rapist, murders and innocent civilians from the hands of criminals. We will write a custom essay sample on United States Bill of Rights and American Sporting Tradition or any similar topic only for you Order Now The second amendment is part of the constitution and is something that should never be taken away, and can’t be taken away. The amendment says that â€Å"A well-regulated Militia, being necessary to the security of a free state, the right of the people to keep and bear Arms, shall not be infringed. † The first 10 amendments to our Constitution protect our most basic rights from being stripped away by an overly zealous government, including rights that all Americans hold dear. The United States Bill of Rights plays a central role in American law and government, and remains a fundamental symbol of the freedoms and culture of the nation. One of the original fourteen copies of the U. S. Bill of Rights is on public display at the National Archives in Washington, D. C. This amendment and right give us the citizens a chance to defend ourselves from danger from not only criminals but also a foreign attack. A shooting sport is a competitive sport involving tests of proficiency (accuracy and speed) using various types of guns such as firearms and air guns. Hunting is also a shooting sport, and indeed shooting live pigeons was an Olympic event only once, in 1900. The shooting sports are categorized by the type of firearm, target and distances at which targets are shot at. Shooting sports have been a part of the Games since Baron Pierre de Coubertin brought us the first modern Olympiad in 1896. It was one of the first nine events held at the first Olympic Games along with track and field, Cycling, Fencing, Gymnastics, Swimming, Tennis, Weightlifting, and Wrestling. Guns have been a huge part of American history since the Olympics started in 1896. Guns have been used for many years not only to defend our country but also defend ourselves in the event of being attacked by a criminal. If the availability of guns is the major reason for the murder of people, why isn’t it that when the rate of gun sales go up the murder rate doesn’t go up as well? The answer is simple guns don’t kill people, people kill people. Imagine if the 10,000+ victims had guns of their own. That statistic could have shockingly stayed the same, just with different victims: the criminals. Americans tend to believe that guns are easily obtained, when in reality federals laws already passed make it impossible for criminals to legally obtain a weapon. Gun sales have gone through the roof since president Obama took office yet in terms of violent crime, the United States is safer today than it was 20 years ago. Violent crimes will continue to exist with or without stricter gun control. Guns will always be obtained by criminals if they want to get their hands on one, and making stricter gun control laws will only make civilians defenseless against these criminals. Taking the right to bear arms away will not save lives it will only cause more violence and since criminals don’t follow the laws in the first place more laws would only hinder law abiding people not the criminals; they will still get any type of gun they want because the all mighty dollar is king. Even if we outlawed all guns criminals would still have them smuggled into the country just like drugs. The only thing that would accomplish would be law abiding people would be defenseless and the criminals would rule. How to cite United States Bill of Rights and American Sporting Tradition, Papers

Ethics and Mental Health for Mental Disorder- myassignmenthelp

Question: Discuss about theEthics and Mental Health for Mental Disorder. Answer: Introduction Deinstitutionalizing began in the1960s when the people diagnosed with a developmental disability or mental disorder were placed in communities with mental health services rather than psychiatric hospitals [20,21,24]. Leon Eisenberg a renowned psychiatrist has said that deinstitutionalization has been beneficial for the mentally ill. This can be supported by a recent study done by Steven P. Segal,M.S.W., Ph.D.,Stephania L. Hayes,M.A., O.T.R.,Lachlan Rimes,B.A. under the title The Utility of Outpatient Commitment 2. Mortality risk and protecting Health, Safety, and Quality of life. In this study, Steven P. Segal along with his colleagues assessed the outpatient communities in Australia. They found out that there was a notable low mortality risk and the quality of life was enhanced in the case of the mentally ill in comparison to the psychiatric hospitals. As through this government policy, the mentally ill were able to move out of the insane asylums run by the government and were able to live in community health care centers. So according to the definition of deinstitutionalization, it is not the reduction of the hospital censuses but it is the extension of the alternate services beyond a hospital setting. Although the closing of the psychiatric hospitals is the main part of this process it is only a part of the process. It is not all that deinstitutionalization stands for. Therefore this statement Since the closure of mental institutions, the community has been over-run with dangerous people who do not get the care they need. Like it or not, they need to be kept separately from the rest of the community for everybodys good is neither completely false nor it is completely true in nature. Deinstitutionalization has had three components firstly it is the release of the mentally ill from psychiatric hospitals to communities with alternative facilities, secondly ensuring that new admissions are not made to these alternative facilities and thirdly provision of the car e that these noninstitutionalized mentally ill need in these communities. Through these components, we can see that the last one is the most important. The altered life circumstances for these mentally ill will need new changes and configurations in the health services that they need. Therefore the statement made by the member of the parliament shows how he is fearful that our community is over-run by the mentally ill. But what it is pointing out clearly is that these mentally ill are not getting the care they deserve in these alternate services. It is showing how the government has failed to provide the care that these people need in a community care setting. [11] Body Throughout the world, the process of deinstitutionalization has been given mixed reviews. In order to understand deinstitutionalization, we need to see what scientific and societal changes led to this process [17].Firstly the scientific discoveries of many psychiatric drugs helped to treat the mentally ill. Secondly, which is quietly debatable even now, the society understood that the mentally ill do not need to be locked but should be treated for their illness. Thirdly federal funding with programs like Medicare and Medicaid were sourced for community health centers for the mentally ill rather than psychiatric hospitals. It must be understood that the first and the second component of deinstitutionalization which are release of the mentally ill from psychiatric hospitals to communities with alternative facilities, secondly it is ensuring that new admissions are not made to these alternative facilities did rapidly proceeded than the third component which is provision of the care that these noninstitutionalized mentally ill need in these communities. The President of the American Psychiatric Association Dr. John A. Talbott who states how the psychiatrists that were involved in the formation of the policies related to deinstitutionalization, oversold the certainty of the community treatment which at present is hurting the credibility of this process. The widespread scientific discoveries in the 50s and 60s including penicillin to treat psychosis led to the leaders in being prodded to take action in believing that mental illness is far more prevalent in the society than it was first thought. This is completely true that mental illness is prevalent in our society in far more numbers than it was believed earlier. But the degree and symptoms of each mental illness vary greatly. While depression and anxiety are also termed as mental illness PTSD or Post Traumatic stress disorder is also a form of mental illness that may have violent episodes. The growing political and economic liability that the legislators were facing due to the taxes being used to support the mental institutions was a final push for deinstitutionalization. The extravagant claims that were made by the psychiatrists for the community health care centers for the mentally ill, only added to the urgency to create it. The scientific professional community has had made a mistake of being overly optimistic and the political community was all about saving money. The statement Tranquilizers became Panacea for the mentally ill is quite apt for this change. The rationale to pursue deinstitutionalization had elements of pragmatism and idealism that reflect the concern for the wellbeing of the mentally challenged and ill. Many assumptions were made for the community based mental health care as for how this will be more humane than the psychiatric hospital care. This has proved to be quite true as studies such as The Utility of Outpatient Commitment 2. Mortality risk and protecting Health, Safety, and Quality of life conducted by Steven P. Segal,M.S.W., Ph.D.,Stephania L. Hayes,M.A., O.T.R.,Lachlan Rimes,B.A show [18]. But these assumptions had to be empirically tested as they cannot be realized until the severally mentally ill are included in the data pool. How will we realize whether they are being given the adequate and mandatory resources that are needed to implement these services? Secondly, it was assumed that the community-based health care centers will prove to be cost-effective in comparison to the psychiatric hospitals. Now has b een seen that there are numerous hidden costs associated with these community-based health centers that were firstly ignored. It is crucial that not all of the psychiatric hospitals are closed as it is important to acknowledge that these alternative services require a structural overhaul to ensure that they are providing comprehensive and intensive care in a setting that is not like a psychiatric hospital. When the three components of deinstitutionalization are concurrently implemented it can result in being beneficial for the mentally ill. As the quality of care for these people is improved substantially and they experience a greater satisfaction in their everyday life. They obtain a certain normality in their life even after suffering from these illnesses. They are able to live independently to a certain degree and are numerous times are employed in the society thus making them productive to the society. But these positive developments cannot be applied to all mentally ill individ uals. The severely mentally ill these new long-term community dwellings could be extremely challenging to sustain on their own. Numerous individuals will get easy access to drugs and alcohol which can make the conditions worse for their recovery and symptoms. There are concerns about the severely mentally ill who would have access to the community and society after living for many years in the psychiatric hospitals. Lets take the example of people who suffer from bipolar disorder, major depression, schizophrenia and schizophrenia disorder. These people have been in hospitals for long and are passive to a point where they are used to following orders. In a community setting these people have sufficient structure and support to tend and cater to their needs. They have their sanctuary.[22] It is not always that these mentally ill people are rehabilitated peacefully in the community. That is where the problem arises and the statement like these Since the closure of mental institutions, the community has been over-run with dangerous people who do not get the care they need. Like it or not, they need to be kept separately from the rest of the community for everybodys good is made [4,6]. Many of these individuals pose new challenges to the clinicians and planners as they suffer from side effects of psychoactive drugs such as denial, and fear of tardive dyskinesia [14]. In a state of denial, a mental patient is skeptical about his or her treatment. Mentally ill are also admitted to the criminal justice system but due to deinstitutionalization number of these people are in the society. So when these circumstances along with a shortage of resources are mixed it results in shunting of the mentally ill. The society already has a low tolerance for the mentally ill as we have see n cases where even minor offence by mentally ill have resulted in arrest and incarceration. Many of these offence are often the results of manifestations of their illness. Through deinstitutionalization, we have developed a heightened awareness for the mentally ill. We want to be more humane and understanding towards them. Mental illness varies in a great degree and so is their ability to handle unpredictability and stress. Therefore the kind of programs that would help them varies according to their needs. These needs could range from either living alone, needing psychiatric interventions, would be better in living in a residential setting or less invasive care. Whether they would be able to work also depend on the degree of their illness. [19] The service planners have grouped the mentally ill as a one, asking a single question What should be done for the mentally ill?. The focus is on individual need and rehabilitation or should we rephrase this question as what should be done for this person who is suffering from a mental illness?. It is crucial to understand that some of the mentally ill need the hospital care and deinstitutionalization is not a replacement for the care some need. Deinstitutionalization was introduced to eliminate the countertherapeutic practices that were being followed in the psychiatric hospitals but we do not need to eliminate these hospitals altogether. Unfortunately, the initial planning and implementation of these community centers were based on the assumption that we would no longer need any extensive resources for these mentally ill who need inpatient care. But experience has clearly shown that severely mentally ill need the hospital care for long periods of time and sometimes it could last the ir lifetime. The number of patients admitted to these hospitals precisely depends on the alternative services given in these facilities. So if these facilities have an array of integrated community based services and excellent infrastructure to support it tradeoffs are possible. Where the patients that are recovering well from their symptoms can be shifted to these facilities from the hospitals. For the success of deinstitutionalization we need to know that hospitals and these alternative services have to go hand in hand. Mental health professionals have an ethical obligation to respond to the stigma and discrimination that the mentally ill face in our society [16]. If a member of the parliament will make statements like these the people would feel that mentally ill are dangerous for the society and should be locked. This mistreatment for the mentally ill strips them of the expectation and hope they need to recover from their illness [13]. In this essay, we have studied how deinstitutionalization is helping the mentally ill by giving them a better quality of life and giving them a certain degree of independence. Some are even working and adding as a productive member of the society. We even learned how all mentally ill cannot be grouped as one group. Therefore it is necessary that the mental health professionals educate the people and community about this. They need to educate people that a mentally ill person has equal rights for getting treated and to be treated with respect in the society. In a rep ort by the NIMHE or the National Institute of Mental Health in England, it was stated that recovery for the mentally ill depends on many factors. Factors such as family support, community involvement, minimization of the stigma associated with their illness, clinical care, any meaningful activity or work and peer support. Many of these factors are community-based. These interventions need the support of the community. Counselors and educators are needed in the community to minimize the discrimination that the mentally ill face [3]. Approaches to the assertive community treatment where a team of multidisciplinary professionals work in a community setting for the recovery of a severely mentally ill (SMI) are needed [7]. Through these approaches and models, we can ensure that the mentally ill will be treated fairly in the community and would have lower chances of going homeless or be involved in a crime. Other models such as peer support model and supportive employment model are also f ound effective in many studies. These models are also helpful as the cost of providing care for a mentally ill decreases if he or she has recovered well enough to work. The health workers working in these community settings need specific training to work with SMI population. The movement of care from a hospital setting to a community settings needs specific training that these individuals should go through and ensure that the community around them supports the recovery process of a SMI. [10] Many of the mental health professionals are obliged to learn about the cultural aspect of the care a SMI needs. The services have to be culturally relevant. These services should be planned according to both the rural and urban community settings. This is not only needed because of the variations in the community settings in these areas but also on the fact that the social support varies in these areas. Mental health professionals should aim to involved an SMI in their recovery process [23]. Each and every individual has a set of values and goals it is necessary that a health professionals realize this and be informed about these individuals personal goals. The phrase Ask the Patient works well here. Consulting their family and friends is an extension for this care. Conclusion Mental health issues are often co-occurring with chronic physical problems. Therefore it Is needed that mental health care is integrated into community and primary based care. Through this essay, we have learned that community mental health is more therapeutic and humane than a hospital setting. But its full potential can only be realized when certain preconditions and factors are met. Due to these unmet factors, people fear the mentally ill. Which in turn encourages them to make statements like the one the member of the parliament made. That statement highlighted the fact that there are shortcomings in the care for the mentally ill in community settings on the part of the government and planners. There is too little knowledge in the community about the SMI. There are disjunctions in the following of the three factors or components of deinstitutionalization that are depopulation from the hospitals, diverting new admissions in the alternative services and development of the community- based services. We need to realize that the central problem is not locking the severe mentally ill in psychiatric wards but the central problem is provided adequate treatment and care to these individuals in a community-based setting. With the help of the psychosocial treatments and antipsychotic drugs, we can treat these individuals in an open community setting like apartments, halfway houses and care homes [8]. Nevertheless we do need to realize that there are a minority of some severely and chronically mentally ill persons that need the structured care of a psychiatric hospital. These people have to have a twenty-four hour specialized structured care and therefore we cannot eliminate mental health institutions from our society. We must aim for a continuity of support and care in the community [9]. Where the continuity of care is most important and these individuals need to be tended to in early years of deinstitutionalization. This is also the time where they can be monitored and seen whether they are fitting in the community setting or not. The lack of funding in training the health professionals have led to the failure of denationalization to a great level. Therefore additional funding along with educating the society about the mentally ill will help in achieving the success we need with deinstitutionalization. We have to highlight the plight of these victimized and isolated percentage of our population. They need the support and care of the community that can give them a life of satisfaction [2]. They should not be fear as dangerous and should not be subjected to harassment and stigma. When the mentally ill are unsupported only then they are at high risk to others and first and foremost to themselves. They should not be given a choice to trade the isolation they face in a hospital ward to the life of isolation they would face in an apartment or care house. References Bedaso A, Yeneabat T, Yohannis Z, Bedasso K, Feyera F. Community Attitude and Associated Factors towards People with Mental Illness among Residents of Worabe Town, Silte Zone, Southern Nations Nationalities and Peoples Region, Ethiopia. PLOS ONE. 2016;11(3):e0149429. doi: 10.1371/journal.pone.0149429. Cleary M, Jackson D, Hungerford C. Mental Health Nursing in Australia: Resilience as a Means of Sustaining the Specialty. Issues in Mental Health Nursing. 2013;35(1):33-40. doi: 10.3109/01612840.2013.836261. Chow W, Priebe S. Understanding psychiatric institutionalization: a conceptual review. BMC Psychiatry. 2013;13(1). doi: 10.1186/1471-244X-13-169. Fuller Torrey E. Deinstitutionalization and the rise of violence. CNS Spectrums. 2015;20(03):207-214. doi: 10.1017/S1092852914000753. Jose A. Attitude of the Adults towards Mentally Ill. International Journal of Psychiatric Nursing. 2016;2(2):1. doi: 10.1016/j.apnu.2016.09.003 Kunitoh N. From hospital to the community: The influence of deinstitutionalization on discharged long-stay psychiatric patients. Psychiatry and Clinical Neurosciences. 2013;67(6):384-396. doi: 10.1111/pcn.12071. Lee C, Liem S, Leung J, Young V, Wu K, Wong Kenny K et al. From deinstitutionalization to recovery-oriented assertive community treatment in Hong Kong: What we have achieved. Psychiatry Research. 2015;228(3):243-250. doi: 10.1016/j.psychres. Marginean R, Marginean O. P.The psychosocial rehabilitation of people with severe mental illness: a study of the impact of an assertive community treatment program. European Neuropsychopharmacology. 2013;23:S491. McCall R. Review: The consequences of early institutionalization: can institutions be improved? - should they?. Child and Adolescent Mental Health. 2013;18(4):56. doi: 10.1111/camh.12025. Mezzina R. Community Mental Health Care in Trieste and Beyond. The Journal of Nervous and Mental Disease. 2014;202(6):440-445. doi: 10.1097/NMD.0000000000000142. Moxham L. Where you live and who you live with matters: Housing and mental health. Journal of Prevention Intervention in the Community. 2016;44(4):247-257. DOI:10.1080/10852352.2016.1197720 Pescosolido B. The Public Stigma of Mental Illness. Journal of Health and Social Behavior. 2013;54(1):1-21. doi: 10.1177/0022146512471197. Reed N, Josephsson S, Alsaker S. Community mental health work: Negotiating support of users' recovery. International Journal of Mental Health Nursing. 2017;1(1):98. doi: 10.1111/inm.12368 Reta Y, Tesfaye M, Girma E, Dehning S, Adorjan K. Public Stigma against People with Mental Illness in Jimma Town, Southwest Ethiopia. PLOS ONE. 2016;11(11):e0163103. doi: 10.1371/journal.pone.0163103. Santos J, Barros S, Santos I. Stigma. Global Qualitative Nursing Research. 2016;3(1):233339361667044. doi: 10.1177/2333393616670442. Schnyder N, Panczak R, Groth N, Schultze-Lutter F. Association between mental health-related stigma and active help-seeking: systematic review and meta-analysis. The British Journal of Psychiatry. 2017;210(4):261-268. doi: 10.1192/bjp.bp.116.189464. Shen G, Snowden L. Institutionalization of deinstitutionalization: a cross-national analysis of mental health system reform. International Journal of Mental Health Systems. 2014;8(1):47. 10.1186/1752-4458-8-47 Segal S, Hayes S, Rimes L. The Utility of Outpatient Commitment: II. Mortality Risk and Protecting Health, Safety, and Quality of Life. Psychiatric Services. 2017;:appi.ps.2016001. 10.1176/appi.ps.201600164 Spaulding W, Sullivan M. Treatment of Cognition in the Schizophrenia Spectrum: The Context of Psychiatric Rehabilitation. Schizophrenia Bulletin. 2016;42(suppl 1):S53-S61. doi: 10.1093/schbul/sbv163. Taylor Salisbury T, Killaspy H, King M. The relationship between deinstitutionalization and quality of care in longer-term psychiatric and social care facilities in Europe: A cross-sectional study. European Psychiatry. 2017;42:95-102. doi: 10.1016/j.eurpsy.2016.11.011 Taylor Salisbury T, Killaspy H, King M. An international comparison of the deinstitutionalisation of mental health care: Development and findings of the Mental Health Services Deinstitutionalisation Measure (MENDit). BMC Psychiatry. 2016;16(1). doi: 10.1186/s12888-016-0762-4. Thoits P. Im Not Mentally Ill. Journal of Health and Social Behavior. 2016;57(2):135-151. doi: 10.1177/0022146516641164. Winters S, Magalhaes L, Kinsella E. Interprofessional collaboration in mental health crisis response systems: a scoping review. Disability and Rehabilitation. 2015;37(23):2212-2224. doi: 10.3109/09638288.2014 Yohanna D.Deinstitutionalization of People with Mental Illness: Causes and Consequences. Virtual Mentor. 2013;15(10):886-891. doi: 10.1001/virtualmentor.2013.15.10.mhst1-1310