The Bill of Rights Essay Example for Free

The Bill of Rights Essay The Bill of Rights practically became part of American constitution with the endorsement of the first ten amendments to the Constitution. When constitution was formally framed it contained Bill of rights in the form of charter of rights and liberties. But it was felt there were many things left to allow government to operate with full force. The name Bill of Rights was at once applied to these ten amendments, but in a truly national sense it was a misnomer. The restraints contained in them were imposed solely upon the federal government: the states were untouched by these prohibitory mandates. That seemed of little moment at the time, since most of the states had their own bills of rights and citizens of those states had varying degrees of double protection. Bill of Rights A new national responsibility had to be assumed, and one aspect of it was the expansion of the existing Bill of Rights to make its provisions effective against violation by the states as well as by the national government. Half a century later another amendment, the Nineteenth, wiped out a remaining inequality by extending the right of suffrage to women, and in 1964 the Twenty-Fourth Amendment struck down the poll tax as a device to restrict the right to vote. Thus, by subsequent growth as well as by antecedent beginnings, the identification of the first ten amendments as the American Bill of Rights became grossly inadequate. The American Bill of Rights as it exists today has to be brought together from all its sources, a compendium derived from the original Constitution, the first ten amendments and the subsequent amendments. Design and harmony emerge. In the entire worlds history there is nothing to compare with the pledges of human rights and freedom that have been worked into our charter of government at the great moments of national history. The swift ratification of the anti-poll-tax amendment, and the awakening of Congress revealed by passage of the Civil Rights Act of 1964, provided the first evidence of a relinking of freedom with justice in American public opinion. But the continuing assaults on the Supreme Court, for decisions deserving the highest praise, produced no general uprising in defense of the liberties implanted in the Constitution in the period of its adoption. Apathy due to ignorance, interacting with ignorance due to apathy, continued to be the outstanding feature of the popular reaction. On July 4, 1951, the Madison, Wisconsin, Capital-Times sent out two reporters to ask people encountered at random to sign a petition saying that they believed in the Declaration of Independence. Fear has to be combined with ignorance to produce such a state of mind, which allows active play to an equal ignorance inflamed by passion. Far fewer than half of the American people have the remotest idea of what their personal and political rights embrace. Still less do they know their neighbors rights. People will answer yes, when asked if they believe in a certain form of liberty guaranteed by the Constitution. What, then, is the Bill of Rights? Other reference works, histories and libertarian books consulted by him disclosed no adequate compilation of constitutional rights, liberties, privileges and immunities. Hamiltons argument was not wholly flawless, when he disparaged the impotent shoulds and ought tos of existing state declarations of rights. But there was a basic rightness in his assertion that such ethical aphorisms did less to secure recognition of popular rights than the Preamble to the Federal Constitution, whose wording he capitalized and italicized: Constitutional guarantees of liberty have been enormously enlarged. But the fundamental protection remains what it was in the beginningthe action of the People in ordaining and establishing the Constitution. In other words, the first and foremost element in the American Bill of Rights is the fact that we have a written Constitution, enforceable as it stands, and unchangeable by ordinary acts of legislation. Conclusion For the real significance of that fact, compare the American Bill of Rights with Englands great document, Magna Carta, of which its leading analyst, McKechnie, wrote: The great weakness of the Charter lay in this, that no adequate sanction was attached to it, in order to ensure the enforcement of its provisions. There could be no adequate sanction, because the Charter was not a constitution enforceable against king and parliament. Edward I repeated the restoring operation in 1297. Again and again, as century followed century, the Commons and Lords affirmed and English kings acknowledged that Magna Carta was the law of the land. Thirty-two times, wrote Sir Edward Coke in his Second Institute, the Charter had been enacted into law. Also, it is only fair to point out that between 1950 and 1960, certain written guarantees of the American Bill of Rights went in and out of the United States Constitution with an ease and frequency that made some Englishmen and Americans gasp, due chiefly to changes in the personnel of the Supreme Court. In England, all acts of Parliament are the validly enforceable law of the country, binding on the courts. A British law may play havoc with the British Constitution, and it is still a valid law. The great need of the present day is to cast off fear of freedom, and recapture the courage and vision of those who first erected the standard of American liberty. pity checks in government employment, extending far beyond the legitimate needs connected with national defense. Stalin robbed the Soviet treasury if he paid Chambers twenty rubles for them. WORKS CITED Kramer, Daniel C. The Price of Rights: The Courts, Government Largesse, and Fundamental Liberties. New York: Peter Lang, 2004. Martin, Rex. A System of Rights. Oxford: Clarendon Press, 1997. Van Kley, Dale, ed. The French Idea of Freedom: The Old Regime and the Declaration of Rights of 1789. Stanford, CA: Stanford University Press, 1994. Wood, James E. , ed. The First Freedom: Religion the Bill of Rights. Waco, TX: J. M.

Crohns Disease And Modulen IBD

Crohns Disease And Modulen IBD Crohns disease and Modulen IBD Crohns disease is a chronic disease associated with inflammations of the digestive tract. However, most often the lower part of the intestine (the ileum) is affected. Crohns disease is characterized by periods of remission and exacerbations. Currently, there is no remedy for Crohns disease; inducing and maintaining remission of disease activity, addressing complications and correcting malnutrition are the most predominant objectives of treatment. Nestles Modulen IBD is especially composed for patients with Crohns disease. Modulen IBD is a casein-based formula that is rich in transforming growth factor-beta (TGF-B2). This nutritionally complete polymeric formula can be given either by the nasogastric route or orally as the sole source of nutrition or as a supplement. According to Nestle, Modulen IBD is suitable for patients over five years of age and can be reconstituted to a variety of caloric densities. Evaluation of Modulen IBD based on evidence in literature Both corticosteroids as enteral nutrition (EN) are used in the treatment of Crohns disease. However, the effectiveness of EN compared to the use of conventional steroids is controversial. Both the effectiveness of exclusive EN therapy as primary therapy to induce remission in Crohns disease as well as the efficacy of EN for the maintenance of remission in Crohns disease are recently evaluated. In a Cochrane meta-analysis of six trails including 192 patients in the EN group and 160 patients in the steroid group, it was concluded that EN can induce remission of active Crohns disease. However, this effect was found to be inferior to steroids. These findings are in line with past meta-analyses. In contrary, it is indicated that the effectiveness of EN diverges between adults and children; two pediatric trials (of which one was an abstract) with a total of 58 patients and a previous meta-analysis with 147 children demonstrated that EN equals the efficacy of steroids in the induction of remission in pediatric Crohns disease. Moreover, no dissimilarities in the effectiveness of elemental nutrition and non-elemental nutrition can be found based on 10 trials including 344 patients. A recent review of Akobeng and Thomas (2007) showed that supplementary EN can be effective for maintenance of remission in Crohns disease. Data is based on two recent randomized clinical trials, however, sample sizes were too small to provide statistical power. Recommendations It is strongly indicated that steroids are more effective in inducing remission in Crohns disease compared to EN. Additionally, compliance might be less for exclusive nutritional intervention compared to the use of steroids; several studies demonstrated a higher withdrawal rate in patients that were treated with EN compared to patients receiving steroids. Nonetheless, the use of steroids as a first line treatment in children should be carefully considered for several reasons. First, it is shown that EN in children is equally effective as steroids in the induction of remission. Moreover, the use of steroids is often associated with side effects in children such as impaired growth and bone mineral density [1; 3]; the use of EN is regarded as safe. A long-term randomized pediatric trial of 37 patients demonstrated that withdrawal rates were comparable in the group of children receiving EN as well as in the group receiving steroid treatment; withdrawal rates in the EN group were even inf erior to those observed in adult studies. Accordingly, it is recommended to use EN to induce clinical remission in the growing child suffering from Crohns disease. Additionally, adults can be treated with EN as an alternative for conventional steroid use if they suffer from intolerances to steroids or if they (strongly) denote to prefer the use of EN above steroids. Since it is suggested that elemental and non-elemental diets are equally effective, it is advisable to treat patients with a polymeric diet such as Modulen IBD since polymeric diets have a higher palatability and compliance is expected to be improved. Although the current evidence suggests that supplementary EN may be effective for maintenance of remission in Crohns disease, evidence is not indisputable and it is indicated that more research is needed to confirm these findings. Furthermore, studies should be performed to elucidate the daily amount of EN required to maintain clinical remission in Crohns disease patients as well as the cost-effectiveness of supplementation as the impact on the quality of life for the patient. Moreover, the compliance of supplementation is expected to be low since the end-point for patients is unclear. In conclusion, EN is advisable in children during a remission to avoid steroid side-effects such as an impaired growth and development. In special cases, Modulen IBD can be prescribed to adults. For the time being, Modulen IBD supplementation for the maintenance of remission is not advised. The additional benefits for mucosal healing, growth, nutritional status and quality of life strengthens the argument for considering its use as primary therapy. Kosten, Compliance. polymeric nutrition is more palatable than elemental nutrition; polymeric diets are less expensive and more palatable than elemental diets, and therefore it would seem reasonable to suggest that there is no place for the elemental diet. Improvement quality of life? Improvement nutritional status? Module ibd is a naturally complete powdered feed, designed to meet the specific nutritional needs of people with Crohns disease. It is free from gluten, lactose and is suitable for vegetarians. EN by means of a polymeric diet can be given via the nasogastric or per oral route. Module IBD is designed for patients with Crohns disease, can be used as the sole source iof nutrition or as an oral supplement. The specific polymeric diet selected was a highly palatable, casein-based formula rich in TGF-B2 (transforming growth factor) which can be taken by mouth. Crohns disease is a chronic inflammatory disease of the intestines. Crohns disease frequently occurs in the lower part of the small intestine (the ileum), however, it can affect any part of the digestive tract, from the mouth tot the anus. Crohns disease is a cgronic relapsing consition with a high morbidity. There is no cure for Crohns disease. Treatment is aomed at inducing and maintaining remission of disease activity, correcting malnutrition, addressing complications, and thereby improving the quality of life of patients. The relative merits of corticosteroids and enteral nutrition in the treatment of Crohns disease remains an area of controversy. There was a cumulative withdrawal rate of 26% in those receiving enteral nutrition compared to zero in the steroid group. .. there was a 39% withdrawal rate in the enteral group compared to only 9% in the steroid group. In the pediatric study, the majority took the feed orally, but if they failed adequate oral consumption, NG feeds were administered (in 23.5% of subjects). The withdrawal rates were similar in both the neteral nutrition (10.5%) as in the steroid arm (11.1%). The mild active subjects were allowed to take the feeds orally, while those with moderate to severe disease received the diet nasogastrically. Although polymeric diets are more palatable, failure can occur if inadequate oral administration occurs, and the nasogastric route should then be used to optimize compliance and effectiveness. Although exclusion of a normal diet/and or the nasogastric route of administration mey be viewed as barriers to enteral nutritional therapy, even young children can learn to insert the tube for overnight feeds. may suggest that the benefits of enteral nutrition differ between adults and children. Although the majority of data suggests that patients treated with corticosteroids more often achieve clinical remission, it is well established that corticosteroids fail to induce mucosal healing. Studies demonstrate a substantial higher drop-out rate for continuing enteral nutritional theraphy, whether given orally or by overnight nasogastric intubation. Enteral nutrition has important growth and developmental benefits and continues to be a recommended therapy for children with Crohns disease. The sample sizes of both included studies were small and the studies lacked statistical power. It is therefore difficult to draw any definite conclusions from these data. Future studies should be well-powered and should also investigate the amount of enteral nutritional supplements that will produce optimal benefits. These studies should also assess cost-effectiveness and the impact of supplementation on patientsquality of life. The optimal daily amount of enteral nutrition that needs to be consumed is unknown. In individual cases, EN can be provided to adults: steroid intolerance, patient refusal of steroids or undernourished individuals. Treatment can take 4-8 weeks, depending on the patients characteristics.

The Relationship Between Social Class and Educational Achievement Essay

The Relationship Between Social Class and Educational Achievement Many sociologists have tried to explore the link between social class and educational achievement, measuring the effects of one element upon the other. In order to maintain a definite correlation between the two, there are a number of views, explanations, social statistics and perspectives which must be taken into account. The initial idea would be to define the key terms which are associated with how "social class" affects "educational achievement." "Social class" is the identity of people, according to the work they do and the community in which they live in."Educational achievement" is the tendency for some groups to do better or worse in terms of educational success. Research reveals that the higher the social class, the higher the levels of educational achievement are likely to be. The children of parents in higher social classes are more likely to stay on in post compulsory education, more likely to achieve examination passes when at school, and more likely to gain university entrance. These features painted a true picture of British education in the twentieth century and can be argued to follow this trend today. However, whether there has been any reduction in the inequalities is more debatable, but some research suggests that these inequalities are as great as ever, despite the overall improvements within the education system. Many researchers argue that IQ tests are biased in favour of the middle class, since members of this group largely construct them. If it is accepted that social classes and other groups have distinctive subcultures and that this affe... ... to reject school and school values (such as academic success). This has its roots outside of school in the nature of the fathers and elder brothers' in manual work. They look up to these figures and see school as "sissy", un-masculine, unlike the "real" masculine work that their fathers, brothers etc do. Overall, in conclusion there can be no definite correlation identified between "social class" and "educational achievement" in that there is much research into this and many sociologists suggest their own theories, and have yet not decided whether there is a link or not. However, there does seem to be correlation of some kind as sociologists either favour it or not. It can be still said that the main relationship between these factors is the higher the social class; the more likely the pupil is going to succeed.

Alzheimer’s Disease Essay -- Alzheimers Disease Essays

Alzheimer’s disease is a neurodegenerative disorder, meaning it attacks the neurons within the brain. Neurons are the areas of the brain that allow for chemical messages, or neurotransmitters, to be transmitted. These neurons are necessary for connections with other nerve cells, and without them, the neuronS ultimately die. Alzheimer’s is a form of, and the most common cause of, dementia, or loss of intellectual capacity and personality. ("Dementia.") Alzheimer’s disease, or AD, is not a normal part of aging, although risk of developing the illness increases with age. The onset behavior of the disease normally doesn’t appear until age sixty and older. Though symptoms that appear before age sixty have occurred, it is less common and tends to run in families; these early onset also tend to progress more rapidly. (â€Å"Alzheimer’s Disease†) AD is one of the top ten most leading causes of death in America. In fact, estimates say that as many as 5.1 million people in the U.S. may have Alzheimer’s; that number steadily increasing with the growing elderly population. (â€Å"About Alzheimer’s†) In the last forty years, AD has become a prevalent topic amongst the medical and non-medical communities affecting lives and families; giving us motive for further our understanding of the brain. Alzheimer’s disease has been known since the turn of the century but was not a prevalent concern until the 1970s. In 1907, Alois Alzheimer, a German physician, documented a case of a fifty-one-year-old woman who was suffering from severe cognitive disabilities. She exhibited difficulties in areas such as memory, language, and social interactions. (Reger 1) After death, Alzheimer performed a brain autopsy using silver staining techniques. This allowed him to ... ...int. â€Å"Dementia.† Dictionary.com Unabridged. Random House, Inc. 02 May. 2015. Reger, Beth. "Alzheimer's Disease: A Brief History and Avenues for Current Research." Journal of Young Investigators: Undergraduate, Peer-Reviewed Science Journal 6.2 (2002): 1-3. Web. 29 Apr. 2015. Robinson, Lawrence, Joanna Saisan, and Jeanne Segal. "Alzheimer’s Disease: Signs, Symptoms, and Stages of Alzheimer’s." Helpguide.org: Expert, Ad-free Articles Help Empower You with Knowledge, Support & Hope. HelpGuide, Mar. 2011. Web. 29 Apr. 2015. "Studies Demonstrate Link Among Alzheimer's Disease, Down Syndrome and Atherosclerosis." ScienceDaily, 15 Jan. 2010. Web. 3 May 2015. Wattamwar, Pandurang, and P. Mathuranath. â€Å"An Overview of Biomarkers in Alzheimer’s Disease.† Annals of Indian Academy of Neurology 13.6 (2010): 116. ProQuest Research Library. Web. 12 April 2015.

Schizophrenia Essay -- Schizophrenia Essays

  Ã‚  Ã‚  Ã‚  Ã‚  During the 1950s, mentally disordered people who were harmful to society and themselves could be treated with medications and were able to return safely to their communities. During the 1980s, the cost of health care increased more than any other cost in our national economy. As a result, strategic planning has been made to reduce costs. â€Å"The political decision made to deinstitutionalize chronic mental patients started with the appearance of phenothiazine medications. Dramatically reducing the instability influenced by psychosis, these medications were of great significance to many individuals with serious mental disorders. At both the state and federal levels, legislators looked at the high cost of long-term psychiatric hospitalization. Social scientists guaranteed them that community-based care would be in the best interests of all concerned: the mentally ill and the general, tax-paying public (Barry 13).† It was believed that a social breakdown syndrome would develop in chronically mentally ill persons who were institutionalized. The characteristics of this syndrome were submission to authority, withdrawal, lack of initiative, and excessive dependence on the institution.   Ã‚  Ã‚  Ã‚  Ã‚  While deinstitutionalization was kindhearted in its primary logic, the actual execution of the concept has been greatly undermined by the lack of good community alternatives. At this time a large amount of the individuals using community mental health treatment services are the homeless. Nearly half of the homeless are chronically mental ill. These individuals are often separated from their families and all alone on the dangerous street. These homeless schizophrenics stay away from social structures such as community health treatment centers. Since they start a new life of independence they often stop taking their medications, become psychotic and out of place, and begin to live on the street. Since the schizophrenics are deinstitutionalized they are thrown into a whole new world of independence. Since their brain functions different than the usual human being they can't cope with the problems of life. The schizophrenics drive themselves crazy wanting to kill themselves and others in order to escape from this perplexing world.   Ã‚  Ã‚  Ã‚  Ã‚  Schizophrenia is the most common psychoses i... ...around because states are closing their mental institutes for financial reasons. Even though the cost of mental institutes are high, the schizophrenics are better off being kept in them because they could cause a huge uproar on the streets. Without the mental institutes the schizophrenics will get worse because they are unable to live independently. Many schizophrenics might even be harmful to society because their brain is out of control. The paranoid schizophrenics could go on a rampage and try to kill everyone in sight because they think that everyone is out to hurt them. This could be the future of our world if we don't take time to treat these schizophrenics who desperately need it no matter what the cost. Works Cited Barry, Patricia D. Mental Health and Mental Illness. Philadelphia: J. B. Lippincott,   Ã‚  Ã‚  Ã‚  Ã‚  1994. Coon, Dennis. Introduction to Psychology. New York: West Publishing Company, 1995 McCuen, Gary E. Treating the Mentally Disabled. Hudson, Wisconsin: Gary E.   Ã‚  Ã‚  Ã‚  Ã‚  McCuen, 1988. Varcarolis, Elizabeth M. Psychiatric Mental Health Nursing. Philadelphia: W. B.   Ã‚  Ã‚  Ã‚  Ã‚  Saunders, 1990.

Private Sector Approaches Essay

Since the advent of new public management reforms, private sector managerial approaches are fast gaining attention in various public sectors. This is due to the belief that on-going global economic constraints and fiscal crises are demanding for more organisational effectiveness with minimal cost, and private sector practices are believed to be more efficient than its public sector counterpart. It is within this context that human resource management practices are being transferred into the public sector for better performance. However, several literatures have debated the numerous differences between the public and private sector and often concluded that effectiveness of privately transferred human resource practices into the public sector are likely to be strained (Rainey et. al., 1976). One argument is that public sector goals as opposed to its private counterpart, are unclear and intangible and therefore, outcome becomes difficult to measure towards performance. Moreover it is also argued that public sector workers are inherently motivated and as such cannot be monetarily motivated towards performance. Also, managers in the public sectors are often argued to have limited autonomy posed by politicians leading to a strain on the performance process. And finally, the constant financial deficit in the public sector has also been argued to limit its performance and reward systems. The case of the NHS as a public sector in the UK will be used to answer the above question. It will first start with a brief description of the NHS, and then provide an overview of what human resource management means and what its practices are. The effects of these practices (performance management, appraisals, and rewards) would then be reviewed in specific NHS examples in relation to the contrasting public environmental differences. Overall, due to the overwhelming literature demonstrating the ineffectiveness of HRM practices in the NHS or rather the inability of HRM and supporting studies empirically demonstrating the link between HRM practices and performance, this essay holds the opinion that the private sector practices of HRM should not be directly transferred into the public sector or at least should be cautiously transferred in its adaptation into the public sector. THE NHS The UK NHS was created for a comprehensive (quality), universal (equity) and free health delivery at its point of use. The search for effective delivery of services in the UK NHS prompted the NHS marketisation via the 1990 NHS and community care act. Markets divided the purchasing power from the providing power of health services thereby making Trusts (self-governing hospital) accountable for their performances. Perhaps, this division occurred because the effective management of human resources out of many other organisational assets was widely viewed as a better tool to address financial crises via organisational performance improvement (Huselid, 1995). HUMAN RESOURCE MANAGEMENT Due to the rapid rise of considerable interest in Human resource management over the last decade, there has been varying definition ascribed to its definition. This essay agrees with the Harvard definition in which Human resource management is viewed to encompass all managerial decisions that influences the relationship between the human resources of an organisation (it’s employees) and the organisation itself (Beer et. al., 1985, p. 1). Though, its practices have been grouped into various models, it is beyond the scope of this essay to discuss them. However, the general concept of its practices can be understood as the use of various strategies which includes amongst many others, performance management, appraisals and reward to effectively manage employee attitudes towards the organisation’s goal and performance (Armstrong, 2002, p. 3). PERFORMANCE MANAGEMENT Performance management and appraisal as described by Bratton and Gold (2007, p. 274) is a process used to assess a team or individual’s abilities towards performance development and improvement. This process involves setting a goal towards an outcome, monitoring and evaluating via performance indicators, and rewards as well as penalties as the case may be. However, in the public sector, arguments have ensued that performance management often contradicts the blue print of public services or is rather strategically used by politicians to assert some form of control over the sectors and not to perform its intended purpose. Performance indicators albeit is fast becoming popular both in the public and private sectors, has a measurability often argued to be complex in the public sector as opposed to the private sector where only monetary values and profits are measured. Even though, the ultimate goal of this HR tool is to drive performance either in the private or public sector, the role of targets in the public sector is often debated as many studies have demonstrated their obscurity by questioning whether ratings or indicators can actually measure performance accurately. However, over the last decades, some studies have agreed that HRM tools have to a certain extent a drive on organisational performance both in the public and private sectors (Carter and Robinson, 2000, Boxall, 2003). In the NHS, the labour government has initiated performance management via the NHS STAR RATING as a tool to drive performance and accountability. A balanced score card which consist of both financial and non-financial measures of HRM measures is used as a multidimensional goal and target in assessing hospital performances. That is, the NHS star rating evaluates hospital performance across dimensions like patient satisfaction, clinical output, waiting times and deliver ing capacity of hospitals (Healthcare Commission , 2004). Hospitals are ascribed ratings of zero, one, two or three stars based on their performances in the score calculation. As a result, higher star rating hospitals acquire greater autonomy whilst managers in lower star rating hospitals are been threatened of their dismissal (Givan, 2005). Some researchers have tried to demonstrate its efficacy, however, other researchers have demonstrated that the associated indicators, targets, star ratings, rewards and punishment are unfair and unreal in the public sector and consequently destroy the blue print of NHS which is fairness, equity, quality and universality. Givan (2005, p. 636) argues that the supposed intention of the NHS star ratings to improve performance and to increase public awareness to quality of delivered health services is only rhetorical. She argues that, in practice, HR performance indicators have not been generated from fair, accurate and transparent data, and as such; the indicators have not fulfilled their primary goals as m any HR directors have expressed their lack of confidence in the quality of data used towards the ratings. She further notes that the public has used the rating as an opportunity to criticise hospitals instead of understanding and appropriately accessing the facilities. The ratings therefore affected how patients patronize hospitals. It was noticed that more patients patronize the highly rated hospitals whilst, the poorly rated ones were less visited with subsequent difficulty on how to restore their image. Another point, Givan (2005) highlighted, is the negative effect the media plays in the association of the public sector performance and the effect of HRM performance measurement. She explained how the NHS publication of hospital ratings has led to the demoralisation of hospital staffs resulting in poorer performance. She argues that the media took advantage of these publications by constantly publicising the negative aspect of health service delivery even though according to her the best rated hospitals are not necessarily the best performing as items measured are sometimes intangible and those not measured becomes insignificant. Bevan (2006) has also highlighted how HRM practices have led to the loss of one of NHS blue print, which is the quality of services provided to patients. He argued that, due to the fact that rewards and punishment have been perceived to be unfair as a result of unfair indicators and ratings, pretence and gaming has ensued amongst practitioners because measurement and ratings are perceived to be presently more weighted than quality of services being rendered. As a result, practitioners have devised means of being measured well as opposed to the focus on quality of service given. Indeed, waiting times have reduced just for hospital recurrences to increase. Moreover, the measurement of service quality within the NHS has been highlighted and argued to represent a form of professional distrust from the government and seen as a breach of professional idealism where a nurse or a doctor can be expected to perform maximally without supervision (Morgan & Potter, 1995). In the same vein, public service employees have been argued to have public service ethos where staffs perform maximally without strict supervision or even any form of incentives (Public Administration Select Committee, 2002). Indeed, to some extent, these researchers have believed that performance management via NHS star rating is a political gimmick for politicians to shift blames of underperformances on professionals who work in the public sector or at least to control the public sector which still perhaps, point to the fact that the public sector is different from the private sector within politicians’ control devices. This is also in line with the notion of Propper and Wilson (2003) who have noted that performance management and NPM are strategic methods used by politicians to assert control over the public and not for its intended purpose for performance improvement as in the private sector. However, although the NHS star rating and the balanced score card have met some form of resistance from professionals and hospitals in the public sector, Aidemark & Funck (2009) have been able to positively demonstrate their effect on practitioners and NHS services. In their study, they explained how competition for efficiency ensued amongst practitioners towards becoming best performing hospital and consequently seen to improve availability of health care services. The balanced score card which consist of most practices from HRM was able to help practitioners work more efficiently by helping them compare more numbers of patient parameters in one unit. For example, comparing patient need, treatment and feedback simultaneously facilitated cost efficiency and reducing waiting times. PERFORMANCE APPRAISAL Moving away from the view of government and NHS institutions, and looking at performance appraisals within organisations, that is, between organisational leaders and employees, HRM practices seem also not to be applauded. The argument is that due to the measurement of intangible goals within the public sector, many of the performance appraisals conducted by senior managers or supervisors would result into a low quality appraisal. Within this context, low quality appraisals are faults generated during performance management processes, which often lead to wrong evaluation/judgments of appraisal either from employee or supervisory perspectives. This notion follows Murphy and Cleveland (1995)’s argument that public sector performance appraisal is a complex process because services are unquantifiable and would most likely result into bias and subjective judgment by the management supervisor. They noticed that these biases often result from the way a supervisor perceives and judges the outcome of the management process. Moreover, the judgment of any managerial appraisal in the public sector can be influenced by so many factors such as emotion, government policy, structures or even the appearance of the person appraised. Treadway et al. (2007, pp. 48-55) further emphasised on the progressive increase in appraisal bias and subjectivity within the public sector. The argument is that supervisors are often noticed to exhibit negative attitudes towards appraisal processes, perhaps due to the reason that they feel uncomfortable giving negative feedbacks to staffs. Therefore, in the public sector, they conduct this process more for the purpose of accountability or just for the reason to be seen conducting it. In the NHS, various studies have been carried out to determine the effectiveness of appraisal systems. It appears that many have not supported their effectiveness. In the study of personnel functions within the NHS by Guest and Peccei (1992), the effectiveness of performance appraisal was ranked 14th out of 17 personnel practices in view. Wilson and Cole (1990) have blamed the lack of sustainability of appraisal system within the NHS to the highly and complex politicized nature of health care. Redman et al. (2000), in their study on the effectiveness of appraisal within an NHS hospital also concluded that the process has not been proven to be fair and effective, perhaps due to lack of time, resources and results ambiguity that makes the process difficult within the health system. REWARD The effectiveness of HRM reward systems in the public sector is another practice that is keenly contested. Bratton and Gold (2007, p. 358) define reward as, the financial and non-financial payment given to an employee by an organization for a successful work done. It is often in form of promotion, recognition, benefits or pay. This new approach of rewarding public sector employees seems more flexible as opposed to the old reward system in which rewards automatically comes after years of service or hierarchy. This new approach may be argued to motivate employees towards work performance since employees are not promoted or rewarded if they do not perform well at work. However, some researchers have viewed this approach to be unethical within the public sector since it goes against the public service ethos of equity, equality and fairness. Some also have demonstrated the paradox and tensions between the pay methods. That is, where an employee perceives the method to be dissatisfactory even though it may be fair, it may cause more harm than good. Some even argue whether public sector staffs that are often seen to be intrinsically motivated are extrinsically motivated. Extrinsic reward within this context is a pay, benefit or promotion rewarded from an equivalently rendered service whilst intrinsic reward is the satisfaction derived psychologically from doing a job without an equivalent pay. Crewson (1997), in his empirical study carried out on public employee to determine to what extent pay incentives will affect motivation to work found out that the majority of staffs were not motivated to do more than how they have often been used to perform. Some were even noticed to demonstrate a demotivation. In fact, the overall notion is that rewards have not been actually effective within the public sector, perhaps, due to the complex and unquantifiable service rendered in public sector, which are often difficult to measure as opposed to the private sector where financial outcome is the basis for performance measurement. The quality and outcome framework of the NHS is an example of an institution that provides financial incentives to its employees (clinical team). It awards points to levels of targeted achievements of care processes and indicators of clinical outcomes. Rewards are directly linked to the number of points achieved. Though Doran et al. (2008) noticed that the framework achieved some changes in employee behaviour and concluded that the process was costly. Campbell et al. (2009), also questioned the relationship between some of its performance targets and the health improvement of its population and concluded that the setting of standard for one aspect of health care have reduced health performance elsewhere. The overall notion is that even though incentives may have seemed to be beneficial, its costly nature within the NHS may not be able to justify its implementation and subsequently its sustainability may not be guaranteed. CONCLUSION The effectiveness of private practices including Human resource management practices in the public sector is still unclear; yet, these practices are continuously utilised in the public sector. Perhaps, this is due to the wide belief that private sector tools are better than its public counterpart in resolving the on-going financial and fiscal deficit. Tools used by the human resource management are performance management, appraisal and rewards. The NHS is no exception to public sectors that greatly depends on these human resource management tools presently in the UK. The NHS having its blue print in fairness, equity and quality has been widely criticised to lose its originality after the initiation of new public management and human resource management. To drive performance within the NHS, the government adopted the NHS star rating which paved the way for various studies to be carried out on its fairness and effectiveness. Many researchers as discussed above have demonstrated the process to be unfair and highly politicized especially whilst questioning the indicators and targets used during this process. Appraisals have also not been applauded by many studies as it is seen to lead to a low quality appraisal via supervisory subjectivity and bias. It has also been viewed as contradictory to public service ethos and has led to distrust between employees with subsequent underperformance of staffs. Rewards in the quality and outcome framework of the NHS have also not been perceived to be effective and where it is, it was described to be costly and lack sustainability within the public sector or at least in the NHS. Overall, this essay holds the opinion that the success in transferring private human resource management practices into the public sector is yet unclear at least in the NHS. 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Literary Analysis Battle Royal by Ralph Ellison

The society is mainly composed of different individuals with their own unique sense of personality, idealism and characteristics. Each of these factors symbolizes the critically means of becoming an individual significantly apart from the group of humanity as an existent being. In relation to this concept that the aspect of socio-cultural identity is established wherein different individuals bind themselves together through developing their cultural identity and anthropological affinity into groups. Thus, the cultural and race identity factor became a part of the social development of the people. As each cultural and race background was developed unique to the social group that harbors an affinity to this factor, society developed a disparity barrier surrounding each socio-cultural groups based on their anthropological development and historical relationship with the general community. The historical development of each social group indeed played a significant factor in the present identity of that particular division. These differences in the cultural factor and historical background breed in one of the most alarming ethical issue in the present global community, the issue of discrimination. Discrimination is mainly the oppressive social view towards a certain socio-cultural division. This problem is mainly a threat to the ideal vision of social equality across the general human community. The negative problem of discrimination hinders the unification of the people because of the inferior views and opinion of the dominant social community towards a particular division regarding them as an inferior social breed.   For the American society, this oppressive social issue became a significant problem for their people particularly the Negroes. The historical development of American society breeds an oppressive segregation view based mainly on the factors of race and color. This negative issue has resulted to great detrimental perspective towards the established inferior class in this social perception namely the Blacks. As their historical background denotes them as once slave to the white people, the latter continuously perceived the former as such even after the liberation. This means that freedom did not prevail over the social impact of the historical stature of the Black society. Thus, the freedom of the Blacks from the issue of slavery did not entitled them to gain an equal stand in the American society where they still have been discriminated as the inferior race to be ruled over by the Whites. This concept of discrimination is particularly the main theme of the short literary story written by Ralph Ellison entitled â€Å"Battle Royal†. This story was a clear depiction of the detrimental effects that the concept of discrimination posts on development of the lives of the Black people. This literary story focuses on the issue of the struggles of a boy to get a proper education over the obstacles that the issue of discrimination posts on his path to reach his goal. Analysis of the Elements in the Story The story of â€Å"Battle Royal† is mainly centralized on the struggle of a particular boy over the discriminative views of the general society towards his racial background. It is emphasized on the story that eventhough he displayed a series of potential and capability to become intellectually triumphant, he was still held back by the factor of his personal background. This concept is presented in the story through a series of encounters and elements symbolizing a significant issue to the struggles of the character over the oppression and the discrimination he must endure to realize his dream. The story takes place mainly through one particular character who narrates the story, as he perceives it. This boy was clearly depicted as an individual who has a potential to excel on his academic affairs as he once displayed through becoming on top of his class. This character was shown to be on his path towards achieving his dream of becoming a properly educated individual and become successful on a socio-economic perspective. Indeed, this boy has an ideal view and perspective towards his life cultivating his passion to undermine the obstacles he must endure. His awareness towards the adverse issue of discrimination comes from the dying words of his grandfather who displayed a significant passion of remorse on his final moments. He expressed his views of betraying his kind for the sole reward of gaining the favor of their social counterparts who he used to view as the superior ones. He denounced that he has betrayed his people to become a member of the society he once adored though they only rejected him on the end. Thus, he confessed that he sacrificed his racial identity to gain the image of something, which is clearly not him. He shared these opinions to his family on his dying moments as a legacy of advice for them not to follow what he claims as his mistakes. These dying words of his grandfather took a significant toll on the views and social perception of the narrator. At first he has not yet clearly realize the effects of racial discrimination and the obstacles they posts on the path of his dreams. He continuously pounded on the words of his grandfather searching an applicable reality into such concepts while his family members shrugged off these words from his mentality. Then the moment came, when the boy was given a chance to stand before an audience of elite and highly viewed white people to display his intellectual abilities and gain support for his struggle towards gaining proper education. One of his first obstacles was to endure the event of the â€Å"Battle Royal†. The Battle Royal is mainly an event where a group of black boys fights and brawls against each other to gain the dominant position in their group. Symbolically, this event is rooted on the similarly experiences during the period of the African American’s slavery. Battle Royal is particularly where African Americans fight against each other to gain money, prominence, social position among their society though the winner is still segregated from their racial counterparts. This is an approach of the White slave masters to prevent unity among the African American thus delimiting their capacity to fight for their freedom through a unified spirit. As history always tells, people can make significant changes through having a unified hearts and spirit. Indeed, battle royal fosters only infighting and hatred inside the racial community of the African American to delimit their capacity ideal capacities thus, rendering them further as slaves to their counterparts. In this event, the narrator witnessed the negative impact of the segregation issue from the horrified and scared eyes of his fellow African Americans. He saw their kind as a weak and helpless group in front of the prominent and elite white community. He became part of this group and continued struggling in the event, as he perceived it as part of the challenges in his path towards the attainment of his desired education. He was brutally beaten by one of the boys sustaining physical damages on the bout yet, he remained strong and ideal on his conviction. The payment portion afterwards was more oppressive and humiliating than the previous brawl wherein the boys must compete against each other for money while sustaining significant electrocution for the entertainment of their audience. The narrator pit against his group in this process as he waits for the moment of his stand before this elite and prominent audience. He sustained and endured the physical electrocution of his body and personal dignity regarding them again as part of his struggles until finally he was called and recognized to give his speech His speech was the one he delivered on his graduation where he ended top of his class. His prominent society applauded this accomplishment. However, the moment, which the narrator long aspired for, became his personal testament of the oppressive views towards his racial identity. The audience clearly displayed disinterested and unenthusiastic presence during the delivery regardless of the ideal values that the speech depicts. The narrator was only able to grasp strongly the attention of his audience at the point when he unintentionally highlighted the concept of social equality. The audience immediately dissuaded this concept form the narrator as a mere illusion, which the later succumbed into. Finally, he was rewarded with a gift symbolizing the recognition of his intellectual triumph and potentials. He was rewarded with the strong tool for the realization and accomplishment of his aspiration for a proper education, which he viewed as a payment for his struggles. Indeed, the narrator was satisfied. The story ended with the symbolical encounter of the narrator with his grandfather, which is highlighted as the narrator’s chance to answer back the argument given by the later of his deathbed. The narrator proudly displayed his accomplishment of gaining his ticket for his desired education however, this was reprimanded by the laughter of his grandfather. In this part of the story that the author’s accomplishment was regarded as an illusion perpetuated by the white society to hide the racial segregation and discrimination in the general society which the narrator falls victim into. Indeed, the symbol of the grandfather’s character questioned the integrity of the accomplishment of the narrator and the motives behind the said triumph. This reaction implied the fact that the author must not be drowned with the illusion of him being honored by the white people through their material gifts as they were mere cover for the oppressive and discriminative opinion they still hold towards him as an African American. Conclusion In general, the story entitled â€Å"Battle Royal† depicts a series of contradiction presented through the views and perception of the narrator. In the story, the boy endured several challenges of social and racial relevance to gain his ticket for achieving the education he desires with. Based from the personal opinion of the author, he perceives this education as his ticket towards alleviating him and his family through life and society With this ambition, he strongly hold on to this dream enabling him to endure the certain obstacles presented in this path including the discriminative and oppressive views towards his race. Indeed, one of the most significant issues presented in the story as the primary to the dreams and aspirations of the narrator is the oppressive segregation that the society has for his race. Indeed, because of his racial background, he was viewed as an inferior individual regardless of his previous intellectual accomplishment and the abilities he possessed. Though the society represented by the narrator’s audience in the story realizes this potential, their appreciation displayed through the scholarship award is still influenced by the segregation concept in their society. This idea is presented through the events needed prior to the award, the reaction of the audience to the mere mention of the word social equality, and the title presented in the scholarship in particular. In addition, the oppressive and humiliating nature of the event he must first participate with to gain an audience with the prominent and elite individuals of their society also manifests as a significant challenge on his path. Indeed, events and social views such as the â€Å"Battle Royal† which are all rooted on the concept of racial discrimination and segregation become part of the challenges and hindrances that the author must endure to achieve a decent education and a successful individual as an African American in their society. As what his grandfather has expressed in his dying moments, to become successfully greater than their social counterparts, an African American must live in the territory of the white people and endure their oppressive perception, from it, shrugged off the hindrances and rise far greater than the oppressive dominant race.