Kurt Donald Cobain of Nirvana Essay -- essays research papers

Kurt Donald Cobain was the leader of Nirvana, the multi-platinum grunge accord that redefined the sound of the nineties. Cobain was born on the 20th of February 1967 in Hoquaim, a small town 140 kilometres south-west of Seattle. His overprotect was a cocktail waitress and his father was an auto mechanic. Cobain soon moved to nearby Aberdeen, a depressed and dying logging town. Cobain was for most his childhood a seedy bronchitic child. Matters were made worse when Cobains parents divorced when he was seven and by his own account Cobain said he never felt loved or secure again. He became increasingly difficult, anti-social and withdrawn after his parents divorce. Cobain also said that his parents traumatic split fueled a lot of the anguish in Nirvanas music.      aft(prenominal) his parents divorce Cobain found himself shuttled back and forth between various relatives and at one stage homeless living under a bridge. When Cobain was eleven he heard and was capt ivated by the Britains Sex Pistols and after their self-destruction Cobain and friend Krist Novoselic continued to listen to the wave of British bands including Joy Division the nihilistic post-punk band that some say Nirvana are directly descended from in form of mood, melody and lyrical quality. Cobains artistry and iconoclastic attitude didnt win many friends in high school and sometimes earned him beatings from "jocks" Cobain got even by spray painting "QUEER" on their pick-up trucks. By 1985 Aberdeen was dead and Cobains next stop was Olympia. Cobain make and reformed a series of bands before Nirvana came to be in 1986. Nirvana was an uneasy alliance between Cobain, bassist Krist Novoselic and eventually drummer and multi-instrumentalist Dave Grohl By 1988 Nirvana were doing shows and had evidence tapes going around. In 1989 Nirvana recorded their rough-edged outset album Bleach for local Seattle independent label Sub-Pop In Britain Nirvana received a lot of recognition and in 1991 their contract was bought out by Geffen, they signed to the mega-label, the first non-mainstream band to do so. Two and a half years after Nirvanas first C.D. Bleach was released they released Nevermind, a series of different, crunching, screaming songs that along with its first single Smells Like Teen Spirit would propel Nirvana to mainstream stardom. Smells Like Teen ... ... herself into a rehab center but left soon after a friend called her the next day with news of Cobains death. Cobains body was found when an electrician visiting the theatre to install a security system went round the back of the house when no one answered the front approach and peered through windows. He thought he saw a mannequin sprawled on the floor until he noticed a splotch of blood by Cobains ear. When police broke down the door they found Cobain dead on the floor, a shotgun still pointed at his chin and on a nearby counter a suicide telephone circuit written in red ink addres sed to Love and the couples then 19 month old daughter Frances Bean. The suicide note ended with the language "I love you, I love you." Two days after Kurt Cobains body was found about 5,000 people gathered in Seattle for a candlelight vigil. the distraught crowd filled the air with profane chants, burnt their flannel shirts and fought with police. They also listened to a tape made by Cobains wife in which she analyse from his suicide note. Several distressed teenagers in the U.S. and Australia killed themselves. The mainstream media was lambasted for its lack of respect and understanding of youth culture.

The Bright Side of Regret Essay -- Literary Analysis

There is no person so severely punished, as those who subject themselves to the whip of their own remorse, wisely summates Lucius Annaeus Seneca 1st century Roman philosopher (qtd. in ThinkExist.com Quotations). Effectively illustrating this idea as a concise confessional, the short accounting, I Stand Here Ironing, is written in an autobiographical style by Tillie Olsen, secern the festering damage that unresolved internal remorse creates with the reassuring serenity that unconditional acceptance generates. Regretfully, this stark reality often becomes the harrowing plight of the unwitting parent. That having been said, taking a closer look into Olsens story will undeniably prove that a conflicting introspective battle between affliction and contentment can only be resolved through the emancipation of unconditional acceptance. When experiencing regret, a person has the tendency to repeatedly replay the details of whatever caused that emotion. However, recounting past events is only the first step in the healing process, but it is not the end solution. This is abundantly evident in Olsens story which begins with the narrators rapid emotional descent into regret. This happens when, as she has probably done a thousand times before, an unnamed third party questions the start out about her eldest daughter, Emily, asking how they can help and understand her better (Olsen 607), for surely she would know. Unfortunately, the answer to this request sends the mother helplessly down memory pass into regret valley. With Olsens strong symbolism, the reader becomes more keenly aware of the inner torment she feels while reminiscing about her callow method of raising Emily. Consequently, as the mother moves back and forth emotionally, ... ...ot have to automatically mean something negative. Therefore, though deep emotions are involved in the healing process, we now know roll in the hay and acceptance, not guilt and sadness releases us from wasting precious energy on n egative thinking and opens up a completely new opportunity, world able to enjoy the bright side of regret. Works Cited PageKathryn Schulz. Dont Regret Regret. 2011. Video. TED Conferences, LLC, New York. Web. 24 Apr 2012. http//www.ted.com/talks/lang/en/kathryn_schulz_don_t_regret_regret.html Olsen, Tillie. I Stand Here Ironing. literature An Introduction to Fiction, Poetry, Drama, and Writing. Ed. Kennedy, X.J., and Dana Gioia. 11th ed. New York Longman, 2011. 607-612. Print.ThinkExist.com Quotations. Seneca quotes. ThinkExist.com Quotations Online. 1 Mar. 2012. Web 23 Apr. 2012. http//en.thinkexist.com/quotes/seneca/

Tim Burtons style Essay --

Tim burton is inventive when he directs movies that are not mainstream.In the movies Charlie and the chocolate factory and Edward scissorhands, Tim Burton uses cracks and framing, sound, and lighting to create hesitancy and anxiety in the audience. Tim Burton keeps his audience on their toes through the whole movie. Suspense is around every corner. Shots and framing is one cinematic technique that Tim Burton using in his movies. Tim Burton in Edward Scissorhands uses entire close-ups to create worry in his audience example when Peg turned her mirror and sees Edwards house all you bottom see is just what she can see, and we can anticipate that she is going to go to his house. This creates a dark and worryfull feeling because we can see just his house alone ,dark on the hill. Tim Burton in Edward Scissorhands use is shot reverse shot and the opening scene when we see both point of views from the grandma looking at Edwards house, Edwards view looking out at them. This makes the comm entator have anxiety because they want to know more about Edward and why is snow is because of him or why dark ...

Technology Knowledge :: essays research papers

Technology KnowledgeMy definition of technology would be something that genius possesses that eases to make their life easier. Knowledge would be one of those factors that arrive been made easier to access. Not merely knowledge, but certain things such(prenominal) as computer/internet access, calculators, television and so forth that help one to be more aware of these conveniences. American Samoa has been blessed to witness parts of this technological revolution. There are m any(prenominal) things affected by technology, however, I exit be basing this paper on the conveniences that we deem as necessary to continue an education.After discussing the best parts of technology with Timoteo Tali, I talked with Tuumasina Tui about what ones life was most like without technology. In comparing my notes, I find that technology is a great thing, yet at the same date Anapogi Young and I realize that there are many downfalls to the numerous things that help make school and work, among vari ous things, much more accessible.Examples of how technology affects us in a positive way are the computer programs, Internet access, television shows, and also calculators that make it easier for one to learn. Ive seen the benefit of having television programs such as Sesame Street, Barney, and Mr. Rogers Neighborhood. I realize now, that though I was probably just enjoying the program, I was also learning from it. As I matured, so did the programs that I watched, but nonetheless, I was still learning and at the same time, having fun doing so. I am glad to have had such technological devices to help me throughout school and life. Another device would be the computer. There are computer programs and games that help you learn without really knowing you are. And then theres Internet access that gives you information to practically anything you need. Youve got the world at your fingertips, is a quote that Ive heard many times. Youre able to research any topic at any time from the privat e comfort of your home you can also e-mail assignments to your teachers. Now, there are also classes you can gull online without going to school, another benefit. Another major device would be the calculator. In my discussion with Tuu, I realize that it must have been quite difficult to mold certain math problems without the use of a calculator. The calculator is ones best friend in a math class it has values such as sine or logarithm that would be quite hard to calculate by hand due to the amount of time of the class.

Good Style is a Reflection of a Writer Making Good Choices :: Writing Style Styles Essays

Good entitle is a Reflection of a Writer reservation Good ChoicesWhen putting pen to paper or typing on a keyboard in order to write something, a writer makes decisions. These decisions will offspring in what will be the writers finished work and will unintentionally reflect what the writer knows about writing style. In honourable trying to convey his or her ideas, a writer will follow rules of grammar and spelling as well as various advice accumulated through testis and informal education. If the writer has a good understanding of what theyve learned, it will come out in their writing. After reading William Strunk Jr. and E.B. Whites The Elements of Style and Joseph M. Williams Style Toward Clarity and Grace, Ive learned that style is the culmination of many factors. Beginning in elementary school, people learn the basic, concrete rules of grammar. These arent so much elements of style as they are the foundation of writing. While necessary, a person can have perfec t grammar but poor style. Many of the rules mentioned in the first chapter of Strunk and White, much(prenominal) as, The number of the subject determines the number of the verb, (9) are those that remain fairly rigid. If a writer didnt follow this rule, and the number of subject and verb didnt match for instance, the mistake would be glaringly obvious to the reader. Williams also discusses this toward the end of his book in a section titled Real Rules. Here, he includes rules such as not using double negatives and not substituting adjectives for adverbs (180). These rules are the building blocks of writing and that is why a writer would be looked down upon if he or she were to break them. Therefore, when writers break rules like this, it is usually to make a point by doing so. After these concrete rules, one begins to learn rules that are a little fuzzier in their application. These are rules that should be followed but can be broken given the right circumstances or i f it is done systematically. For instance, Rule 14 in Strunk and White states, Use the active voice. What this means is using active verbs as opposed to inactive ones to prevent boring the reader.

Good Style is a Reflection of a Writer Making Good Choices :: Writing Style Styles Essays

Good Style is a Reflection of a Writer Making Good ChoicesWhen putting pen to paper or typing on a keyboard in order to write something, a writer engages decisions. These decisions provide result in what leave behind be the writers end work and will unintentionally reflect what the writer knows about writing style. In just trying to convey his or her ideas, a writer will follow rules of grammar and spelling as well as various advice accumulated through formal and informal education. If the writer has a good understanding of what theyve learned, it will come out in their writing. After reading William Strunk Jr. and E.B. Whites The Elements of Style and Joseph M. Williams Style Toward Clarity and Grace, Ive learned that style is the sexual climax of many factors. Beginning in elementary school, people learn the basic, concrete rules of grammar. These arnt so much elements of style as they are the foundation of writing. period necessary, a person locoweed have per fect grammar but poor style. Many of the rules mentioned in the first chapter of Strunk and White, such as, The number of the subject determines the number of the verb, (9) are those that remain fairly rigid. If a writer didnt follow this rule, and the number of subject and verb didnt match for instance, the mistake would be glaringly obvious to the reader. Williams in any case discusses this toward the end of his book in a section titled Real Rules. Here, he includes rules such as not utilize double negatives and not change adjectives for adverbs (180). These rules are the building blocks of writing and that is why a writer would be looked down upon if he or she were to break them. Therefore, when writers break rules like this, it is usually to make a point by doing so. After these concrete rules, one begins to learn rules that are a little fuzzier in their application. These are rules that should be followed but can be broken given the right circumstances or if it is done systematically. For instance, Rule 14 in Strunk and White states, Use the active voice. What this means is using active verbs as opposed to inactive ones to prevent boring the reader.

Ethical Use of Assessment Essay

AbstractIn this report Julia has selected an assessment instrument that will be roled in the mental health counseling dramatics area of superior practice, the Beck stamp Inventory-II. Reviews of the assessment will be read to ensure that the assessment measures what it purports to measure and that the oblige reviews will also establish an captivate drill of that tool. Julia has also analyzed the theoretical basis of the article choice for the chosen assessment tool. In addition, Julia will compare who the leaven developers or publishers and freelancer reviewers to discuss the applicability of the assessment tool to diverse populations. Julia will provide tuition cited by the publisher where applicable. Along with this information, Julia will discuss how the comparison of the BDI-II to opposite assessments can help the counsellor begin an ethical judgment of the applicability of use the tool within diverse groups of clients. Finally, Julia will cite both relevant sect ions of the code of ethics for mental health counseling within the American Counseling Association as well as the Mental health pro code of ethics. It is also important to state that the names of actors used are fictional due to secretiveness of certain souls.Ethical Use of Assessment mental Testing EthicsEthics are an essential part of administering psychological tests and it is necessary that all test users follow the ethical guidelines for assessment when using some(prenominal) type of psychological test. mental tests are an important tool in hurt of m each professions in an array of settings such as in clinical psychology, education, and until now business. However, misuse of psychological test by the administrators is a constant and troubling air that has the capability to harm the individuals who are taking the test and even society as a whole. For test takers, the misuse of a psychological test could result in improper diagnoses or inappropriate decision qualifica tion for their therapeutic process. The misuse of tests reflects very sorryly on theprofessional organizations along with highly trained test users. Overall this will result in poor decisions that may harm society in both an economic and mental fashion (Beck, Steer, & Garbin, 1988).Usually test administrators do not intentionally misuse tests, only rather are not properly trained within the technical knowledge and overall interrogation procedure involved in administering the test. In an bm to prevent the misuse of psychological tests, psychologists developed a set of professional and technical standards for the development, evaluation, administration, scoring, and interpretation of all psychological tests. Professionals can overcome the misuse of tests plainly by generaliseing these professional and technical standards involved in using psychological tests (Beck, Steer, & Garbin, 1988). Beck developed a manual to help the administrator of the BDI to interpret the results of th e inventory, which includes 50 reviews within a thirty page manual (Conoley, 2012) In any situation in which a professional offers advice or intervenes in a somebodys personal life in any management, issues regarding fairness, honesty, and conflict of interest can exist. The term ethics directly indicates any issues or practices that have the potential to trance the decision making process that involves doing the duty thing.Therefore, ethics refers to the moral aspect of right or wrong in regards to various things such as an entire society, an organization, or a culture. Among many professions, there is a set of practice guidelines which are known as ethical standards in which each genus Phallus of those professions elect on such codes after debating and discussing their various concerns of these particular guidelines that would make the process of testing more powerful and ethical (Beck, Steer, & Garbin, 1988). However, it is exceptionally difficult to accomplish universal agreement when it comes to ethics. For example, numerous psychologists disagree with each other in terms of the proper track to interpret a clients right to privacy. Issues such as whether knowing a client may be a danger to themselves and others should be protected from legal inquiry poses what is known as an ethical dilemma.Ethical dilemmas are problems that will arise in which there is no clear, direct, or agreed upon moral solution. While ethical standards are not government appointed laws, violating ethical standards of an organization or profession can have numerous and varied penalties as well which can include projection from the organization. Testing is an essentialpart of the psychological network, and if used improperly, can cause harm to individuals without their knowledge. Therefore, it is necessary that an ethical use of psychological tests is provided to anyone who relies upon them (Beck, Steer, & Garbin, 1988).Psychological Testing and concealingEthical standards indisputably cover a large amount of ethical concerns and issues with a common purpose involving protecting the rights of any individual that becomes a recipient of any psychological service including testing. The Ethical Principles have a goal to respect individuals, safeguard individual privacy as well as dignity, and censure any unfair or discriminatory practices. There are many issues of concern when it comes to ethics, one such issue being the right to privacy (an enormous issue in the mental health counseling profession). The concepts of individual rights and privacy are a fundamental part of any society. The Ethical Principles affirm individual rights to privacy and confidentiality as well as self-determination, meaning that each client has the right to be able to discuss any presenting issue with their therapist and the discussion brook within the bounds of the office and to participate in the decision making of the therapeutic process.The term confidentiality indicates tha t individuals are guaranteed privacy in terms of all personal information that is disclosed and that no information will then be disclosed without the individuals direct written permission. There are multiplication however, that confidentiality is breached because counselors within a business setting, for example, will seek out psychological information about(predicate) their employees. Another example of confidentiality being breached in a professional setting is when teachers may seek prior test scores for students, however, with the good intention of understanding issues of performance (Beck, Steer, & Garbin, 1988). Counselors will also disclose any information the client discusses with them if the client intends to harm himself/herself and or others and when any type of abuse is indicated during the session.Psychological Testing and AnonymityAnother term involved with an individuals right to privacy is known as anonymity. Anonymity refers to the practice of obtaining informatio n throughthe use of tests while concealing the identity of the instrumentalist involved. Anonymous testing is more commonly used in double-blind studies in which the researchers are distinguishly unaware of the identity of the participants of the study. It is suggested that anonymous testing may provide more hardship in terms of accurate and truthful information about participants because participants will be more likely to answer questions truthfully about themselves when their identity is not revealed (Beck, Steer, & Garbin, 1988).Psychological Testing and Informed ConsentAnother important issue is the right to informed approve which means that the client has the right to know on the dot what is happening at all cartridge holders during the testing and therapeutic process during therapy. Self-determination is a right to every individual which means that individuals are entitle to complete explanations as to why exactly they are being tested as well as how the results of the test will be utilized and what their results mean. These complete explanations are commonly known as informed consent and should be conveyed in such a way that is straight-forward and easy for examinees to understand which is roughly of the time done in a language in which the client understands what is being explained to them. In the case of minors or those with limited cognitive abilities, informed consent needs to be discussed with both the minor examinee themselves as well as their parent or guardian (Beck, Steer, & Garbin, 1988).However, informed consent should not be confused with parental permission. Counselors have a responsibility to ensure that the minor examinee as well as their parent or guardian understand all implications and requirements that will be involved in a psychological test originally it is even administered. In addition to the issue of informed consent, participants are also entitled to be prompted with an explanation of the test results in a language stru cture that they understand. However, due to the fact that some test results may influence the participants self-esteem as well as behavior, it is crucial that a trained professional explain the results to the participant in a clear and understanding manner so that the participant responds to the items on the test with accuracy (Beck, Steer, & Garbin, 1988).Psychological Testing and StigmaAnother issue that involves ethics in terms of psychological tests is the right of protection from stigma. In conjunction with the participants right to know and understand their results, researchers need to be careful not to use any labels which might be interpreted as a stigma when describing the results in terms of and to the participant. Counselors and researchers must refrain from using terms such as insane, feebleminded, or addictive personality. Therefore, the results that the client receives, along with the parent or guardian in cases involving minors, should be describe in a positive way s o that the growth and development of the participant is not disrespected in any way (Beck, Steer, & Garbin, 1988). Beck Depression Inventory versus Beck Depression Inventory-II Beck Depression Inventory (BDI) was designed to evaluate the possibility and severity of slack along with suicidality issues. The BDI was developed by Aaron Beck and his associates back in 1961 as a structured interview. Even though Beck is known for using a cognitive therapy methodology, the BDI is not designed in that fashion. Beck used language that was conducive of a fifth grade level to develop twenty-one items from which the participant can choose a level of severity from four option with each particular item.Cautions that Conoley (2012) mentioned in the review are those of fakability and social desirability. The individual participant may not be entirely truthful when choosing the severity of his or her level for items on the inventory. He or she may score higher or lower depending on how the individ ual responds to the inventory. Julia has also found that sometimes a participant has suffered from first gear for a length of time in which makes responding to the items difficult since this individual may feel as though what is normal for him or her may not be normal for another individual. For example, Elka may score lower notwithstanding has been presenting with embossment much longer than Norma who scored higher due to the adult onset of depression versus the early onset of depression. Even though the BDI has been used extensively for about twenty-five years prior to revision in 1987 and again in the 1990s. Many articles touted the use of the BDI causing psychologists and therapists to use the original version created by Aaron Beck. The most recent BDI revised the original version with the rewording of fifteen out of twenty-one of the items due to discriminatory wording.The most recent revision also took into musical score the changes that were made to the Diagnostic Manual forMental Illness which correlate with the criteria for depression on a much higher level. It is plausible to have a more recent version created due to the Diagnostic Manual revision this past year in 2013. All versions of the BDI are designed to evaluate the probability of depression and suicidal tendency for individuals aged thirteen and over for a timeframe of five to ten minutes of the participant choosing the criteria associated with each item. The most recent version of the BDI has also revised to avoid sex and gender discrimination. These factors make the BDI-II a much stronger assessment tool which the counselor uses to evaluate the clients presenting symptoms of depression (Arbisi & Farmer, 2012).Psychological Testing and BDI-IIAll of the ethical issues discussed above come into play when the counselor tests for depression of a client including the severity and longevity of the presenting symptoms of depression. Mental health counselors use the BDI-II to evaluate the possib ility and severity of depression with which the client presents, in which it does. Usually the client will make a statement concerning the longevity of their presenting symptoms of depression which gives the counselor an idea of how long the client has been feeling depressed. Both are helpful in not only appropriately diagnosing the severity of the depression hardly also knowing what steps to take in the way of a treatment plan.Beck Depression Inventory-II and DiversityBDI-II has been modified and or translated into several different languages to underwrite diversity in several cultures, such as Mexican-American, Chinese, as well as the elderly and older women groups. The items are modified in a way so that each group understands what the item is addressing as well as the ethnicity of each diverse group. Depression presents itself differently across cultural groups. What displays as depression in a Caucasian is most likely not display in an identical way with another culture group , such as African-American, Hispanic, Latino, Norwegian, and so forth (Joe, Woolley, Brown, Ghahramanlou-Holloway, & Beck, 2008). The BDI-II has also been modified to address differences between adolescents, adults, and elderly. The elderly population has a much different presenting issue with depression.BDI-II and Counselor JudgmentThe counselor must make a sound judgment in choosing the BDI-II for use in evaluating a clients presenting issues concerning depression, which includes comparing the BDI-II to other depression inventory assessments such as the cad (Clinical Assessment of Depression) or the PHQ-9 (Patient Health Questionnaire-9). While the BDI-II is comparable to the PHQ-9 in statistical analysis, the CAD seems to be more accurate in evaluating clinical depression. However, the CAD consists of fifty questions which take about ten minutes or more to complete. For this factor alone the client may not accurately respond to the items on the CAD due to the length even though studies show that it results in a more accurate evaluation of depression (Arbisi & Farmer, 2012 Faxlanger, 2009 Kung, Alarcon, Williams, Poppe, & Frye, 2012).Even though the comprise of the BDI-II cost much more than the CAD, the CAD is a relatively new assessment that has not had the longevity that the BDI-II has. The PHQ-9 does not have a cost machine-accessible to the assessment, but it is not as well-known as the BDI-II. Once Julia has established herself as a mental health counselor, she will explore the three tests nurture to see the effectiveness of each test compared to the other so that she can make a judgment on which test is more accurate and effective in diagnosing her clients (Arbisi & Farmer, 2012 Faxlanger, 2009 Kung, Alarcon, Williams, Poppe, & Frye, 2012).SummaryIn conclusion, the BDI-II seems to be the most effective assessment tool in diagnosing clinical depression. The American Mental Health Counselors Association recruit of Ethics (2000) reports that the cou nselor is responsible for ensuring that each client is assessed appropriately including using the most appropriate test for the clients presenting issues for diagnosis. The Code of Ethics also cautions the counselor in privacy, interpretation of the results, and to be trained for the assessments in which he or she will use in practice. As before stated, Julia will explore all options for testing for diagnosing clients as well as continued training in testing and interpretation of the results of each test used in practice.ReferencesAmerican Mental Health Counselors Association (2000). Code of ethics. Retrieved March 9, 2014 from www.amhca.org/assets/content/CodeofEthics1.pdfArbisi, P. A., and Farmer, R. F. (2012). Beck depression inventory-ii. Mental Measurements Yearbook and Tests in Print. Accession function TIP07000275. Mental Measurements Review Number 14122148. Beck, A. T., Steer, R. A., & Garbin, M. G. (1988). Psychometric properties of the Beck Depression Inventory Twenty-fiv e years of evaluation. Clinical Psychology Review, 8, 77-100. Cappeliez, P. (1989). Social desirability response set and self-report depression inventories in the elderly. Clinical Gerontologist, 9(2), 45-52. Dahlstrom, W. G., Brooks, J. D., & Peterson, C. D. (1990). The Beck Depression Inventory Item order and the impact of response sets. Journal of Personality Assessment, 55, 224-233. Gatewood-Colwell, G., Kaczmarek, M., & Ames, M. H. (1989). Reliability and validity of the Beck Depression Inventory for a White and Mexican-American gerontic population. Psychological Reports, 65, 1163-1166. Joe, S., Woolley, Ghahramanlou-Holloway, M., Brown, G. K., Beek, A. T. (2008). Psychometric properties of the Beck Depression Inventory-II in low-income, African American suicide attempters. Journal of Personality Assessment Volume 90, Issue 5, 2008. Retrieved March 8, 2014 from http//www.ncbi.nlm.nih.gov/pmc/articles/PMC2729713/ Kung, S., Alarcon, R. D., Williams, M. D., Poppe, K. A., Moore, M. J., Frye, M. A. (2012). canvass the Beck Depression Inventory-II (BDI-II) and Patient Health Questionnaire (PHQ-9) depression measures in an integrated mood disorders practice. Journal of Affective Disorders, Volume 145, Issue 3, Pages 341-343, 5 March 2013. Retrieved March 9, 2014 from http//www.jad-journal.com/article/S0165-0327%2812%2900586-1/abstract Faxlanger, L. (2009). The clinical assessment of depression vs. the Beck depression inventory. Retrieved March 9, 2014 from http//lisamarie1019.blogspot.com/2009/09/clinical-assessment-of-depression-vs.html Steer, R. A., Beck, A. T., & Brown, G. (1989). Sex differences on the revised Beck Depression Inventory for outpatients with affective disorders. Journal of Personality Assessment, 53, 693-703. Steer, R. A., Beck, A. T., & Garrison, B. (1986). Applications of the Beck Depression Inventory. In N. Sartorius & T. A. Ban (Eds.), Assessment of depression (pp. 121-142). Geneva, Switzerland World Health Organization. Talbott, N. M. (1 989). Age

History of the Fbi and Women

OUTLINE FOR PARAGRAPH 1 When J. Edgar Hoover took over the Bureau in 1924, he inherited two female agents Jessie B. Duckstein and Alaska P. Davidson, who both resigned within a few months as part of the Bureaus reduction of shove. In 1972, JoAnne Misko and Susan Malone were the prototypical two women to enter the FBI honorary society. In 1978, Special actor Christine Karpoch (Jung) would become the inaugural female firearms instructorand she would shoot the coveted possible, a perfect score on the FBIs Practical Pistol Range.In 1990, Special Agents Susan Sprengel and Helen Bachor were sent to London and Montevideo, Uruguay to wait on as the FBIs first female retainer legal attaches. In 2001, Special Agent Kathleen McChesney became the first woman to attain the rank of executive assistant director. Up until 1972 the FBI did not accept applications from women to become finical agents. More than 2,600 women special agents currently serve and lead in all roles in the FBI. The FBI originated from a force of special agents created in 1908 by Attorney General Charles Bonaparte during the presidency of Theodore Roosevelt.Martha Dixon Martinez was the first female agent in the line office to be bear witness as a SWAT team member. In the four decades since women have served as FBI agents, theyve taken on one of the most difficultyet vitally importantroles in the Bureau going undercover. It was in 197240 years ago this yearthat women were allowed to join the ranks of FBI agents, reversing a policy that had been in place since the 1920s. The first major expansion in Bureau jurisdiction came in June 1910 when the Mann (White Slave) Act was passed, making it a crime to transport women over recite lines for immoral purpose.William J. Flynn, former head of the Secret Service, became Director of the Bureau of Investigation in July 1919 and was the first to use that title. From 2010 to 2012, the FBI disciplined 1,045 employees for a variety of violations, according to the agency. 85 were fired. June 29, 1908 Attorney General Bonaparte begins hiring special agent force. March 1909 Named Bureau of Investigation. April 30, 1912 Alexander Bruce Bielaski official read/write head of the Bureau. They were pioneers, the first trio of women known to serve as Bureau special agents and among the first women in federal law enforcement.All three women did well in training at the New York office and, in general, performed up to standard. Alaska Davidson and Jessie Duckstein were assigned to the Bureaus Washington field office. Both were dismissed when newly appointed Director J. Edgar Hoover dramatically cut the Bureau rolls in the spring of 1924 to clean house following the Teapot Dome scandals. Lenore Houston was hired after these initial cuts and served the longest of the three. She, too, was assigned to the Washington office. She was asked to resign in 1928.It would be close to another half centuryMay 1972 before social mores would change and women spe cial agents would become a regular and vital part of the FBI. October 11, 1925 First special agent killed in line of duty. January 1, 1928 Instituted formal training program for new agents. March 14, 1950 Ten Most Wanted Fugitives program launched. May 8, 1972 New, modern FBI Academy training facility opened at Quantico, Virginia. October 10, 2001 Most Wanted Terrorists list created. OUTLINE FOR PARAGRAPH 2-4?Cassandra Chandler Cassandra Chandler is a graduate of Louisiana State University, where she received a Bachelor of Arts in Journalism and English. She earned her Juris doctors degree from the Loyola University School of Law and became a member of the Louisiana State Bar. Prior to joining the FBI, Mrs. Chandler enjoyed a career as a television news anchorperson, reporter, and talk show host for a major network affiliate in Baton Rouge, Louisiana. She overly practiced law with the U. S. Army Corps of Engineers in New Orleans, Louisiana. Mrs. Chandler began her investigative car eer as a Special Agent in 1985.She first served in the FBIs New Orleans and Los Angeles dramatic art Offices, where she investigated white-collar crimes, violent crimes, and civil rights violations. Mrs. Chandler has held numerous managerial positions passim her career with the FBI, both in the field and at FBI Headquarters. In 1991 Mrs. Chandler was promoted to Supervisory Special Agent in the Legal Counsel Division at FBI Headquarters to support the defense of the Bureau and its personnel in civil litigation matters. She was subsequent assigned as a manager in the nefarious Investigative Division, where she assisted with the creation of the FBIs Health cautiousness Fraud Program.Following a promotion to supervisor of white-collar crimes in the San Diego sector Office, Mrs. Chandler oversaw numerous joint agency operations, including one of the countrys first external health care fraud undercover operations. She also managed the El Centro Resident Agency, which investigated v iolent crimes, including cross border kidnappings, and environmental crimes. In 1997 she was promoted to Assistant Special Agent in Charge in the San Francisco Field Office where she oversaw the offices White-Collar Crime Program, bailiwick Foreign Intelligence Program, and Terrorism Program.She also managed the socio-economic classs largest Resident Agency in Oakland, California. Her next promotion was to Section Chief in the Investigative Services Division, where she oversaw the FBIs Analytical Intelligence Program for Criminal and Domestic Terrorism. She then was appointed Assistant Director of the Training Division, where she was responsible for managing the FBI Academy and the FBIs other training and career development programs. In 2002, Mrs. Chandler was appointed Assistant Director of the Office of Public Affairs.In that capacity she was responsible for managing all of the FBIs public affairs operations and serving as the FBIs National Spokesperson. In 2005 Mrs. Chandler wa s appointed Special Agent in Charge of the Norfolk Field Office. In that role, she is responsible for managing and leading all of the FBIs investigations and operations in Norfolk, VA and the 17 surrounding counties. Charlene B. Thornton Charlene Thornton is a graduate of Marion College, Marion, Indiana, where she received a Bachelor of Arts degree in Economics and Political Science.She later received a Juris Doctorate degree from Indiana Universitys School of Law, and a Masters from the University of San Diegos School of Law. Prior to joining the FBI, she worked as an Intern in the Marion County Prosecutors office. Mrs. Thorntons first assignment with the FBI was to the capital of Indiana Field Office, where she was responsible for investigating bank robberies and property crimes. Next, she transferred to the Los Angeles Field Office, where she investigated white-collar crime, counterterrorism, and drug matters. Mrs.Thornton has held numerous managerial positions throughout her car eer with the FBI, both in the field and at FBI Headquarters. She began her managerial career as a Supervisory Special Agent in the Legal Research Unit at Headquarters, and was later promoted to Chief of this unit. She then served as an Assistant Inspector in the recap Division, and as a Supervisor in the Baltimore Field Office and in the Southern free state Metropolitan Resident Agency. Her next promotion was to Assistant Special Agent in Charge of the Honolulu Division, where she oversaw the FBIs extraterritorial investigations throughout Asia nd the Pacific. In 1997 Mrs. Thornton was promoted to Deputy General Counsel, where she oversaw the FBIs Legal Training, Legal Forfeiture, and Legal Advice programs. Next, she became an Inspector in the Inspection Division and in 1999 she was named Special Agent in Charge of the Birmingham Field Office, where she was responsible for managing all FBI operations and investigations in northern Alabama. In 2002 Mrs. Thornton became Special Agen t in Charge of the Phoenix Field Office, where she was responsible for managing all FBI operations and investigations in the state of Arizona.In 2004, Mrs. Thornton was promoted to Assistant Director of the FBIs Inspection Division. In that capacity she was responsible for managing all Inspection Division operations and providing independent, evaluative direction of all FBI investigative and administrative operations. In August 2006, Mrs. Thornton was appointed Special Agent in Charge of our San Francisco field office, where she manages investigations and operations for the northern and central slide regions of California. Kimberly K.Mertz Kimberly Mertz is a graduate of Creighton University in Omaha, Nebraska, where she earned a Bachelor of Science in Business Administration and a Juris Doctorate degree. Ms. Mertz became an FBI Special Agent in 1989, and her first assignment was to the San Diego Field Office. She later served as the Supervisory Senior Resident Agent of the El Cent ro Resident Agency, San Diego Field Office. Ms. Mertz has held numerous managerial positions throughout her career with the FBI, both in the field and at FBI Headquarters. In 1999, Ms.Mertz was promoted to the Public Corruption Unit at FBI Headquarters, where she served as a Supervisory Special Agent. She was later promoted to Chief of the Public Corruption Unit. In 2001, Ms. Mertz was appointed Assistant Special Agent in Charge of the Honolulu Division. In 2003 Ms. Mertz became an Inspector in the Inspection Division, and in early 2005 she was designated as the Chief Inspector. In November 2005, Ms. Mertz was appointed to serve as the Special Agent in Charge of the New Haven Field Office. In that capacity she is responsible for managing all FBI operations and investigations in the state of Connecticut.

Main Character Of The Novel Essay

Throughout the book, we name that George Elliot has a distinct pre-occupation and interest with presenting the working manakin rural fellowship in an authentic light. She writes the book as a social anthropologist, studying the much primitive residential district of the time. She has a large amount of sympathy towards the poor, although she herself was not a member of the working class. Using the allegory as a vehicle she aims to expose the plight and indignity of the poor in Victorian England, it was her main motive.Therefore, her focus throughout the book is in fact village life in this case a fictional village named Raveloe. Focusing on the villagers, their attitudes and their way of life acts as a way of also commenting socially and politically on the injustices they face. Raveloe earth-closet easily be regarded as the main character as without it, the narrative following Silas has little significance. The village shapes the narrative, being trustworthy for most of the ma jor beas of interest in the tale.All the individual characters provide interest and together form the character of the town, from characters such as Dunsey to Dolly. The tale begins with a sympathetic description of the honest folk of Raveloe. Our first real source of interest in the novel comes from the villagers hostile reaction to Silas. We are ab initio told about Silas through the eyes of the villagers. Elliot echoes the villagers process of thought and way of speech throughout the novel, namely at the beginning. The sound of Silas loom is described as so-called and he is said to have a dreadful stare.She is mimicking the mannerisms and phraseology of Raveloe as a whole and its reaction to the unknow. Silas mechanical method of working on the loom is seen as un-natural by the villagers, who can further judge him on their own experiences, centred round farming and agriculture. Due to this unfamiliarity, they see even pitiful attributes as sinister. His bad eyesight is thou ght of as a stare. This reaction of the village acts just as a reaction of a human character. It is veritable(prenominal) of the village to think this way.In this respect then, the village can be regarded as whatever new(prenominal) character would. It has attributes and a predictable nature. It is these collective attributes of the society that make Raveloe one character, with which Silas relationships revolve. His relationships and connections with the characters of the community provide the most significant points of interest in the novel. Initially, there is the theft of his gold by Dunsey, then his integration into the community with the assistance of Dolly and later his confrontation with Godfrey over the fate of Eppie.Dolly represents the warmer, caring part of the Raveloe community, opposite to William Dane, the bitter symbol of Silas past. She is described to seek the sadder and more serious elements of life and pasture her mind upon them. Dolly seems to almost gain su stenance from helping those in need, in this case Silas. She helps him with the upbringing of Eppie, offering costume and her own time. She fulfils her found role in the community. Although she can be seen as the prime recitation of the villages moral capability, such sentiments are seen universally.When Silas informs the villagers of his baffled gold, the villagers group together in order to help him. By entering The Rainbow, Silas enters the hub of the village community, beginning the process of his integration. After seeing the authenticity and depth of Silas grief, any(prenominal) former rumours disappear as the villagers begin to relate him to themselves, seeming anxious to help. The event acts as a rare source of excitement, as the villagers become incapable(p) of distinguishing reality from imagination, fabricating information concerning a pedlar with ear-rings.However this all represents a symptomatic characteristic of the village a concern to help others. The villager s reaction concerning the pedlar, is an index number of another key characteristic of Raveloe a belief in superstition. Although the villagers provide lengthy descriptions of this so called thief, we know that no such character even exists. It is an example of how, in such close cut communities, little matters, true or false, can be embellished, escalating into common belief, leading to the creation of new superstitions.Silas is initially associated with the call on the carpet and spirit worship. These suspicions are only heightened by his apparent skill with herbal remedies, his strange cataleptic fits, as well as his past home, Northard, where wizards, wizardly and folklore were associated. However his evident massive bereavement following the loss of his gold dispels any former rumours. Much of this superstition originates from the villagers discussions in the Rainbow, an important focus of the novel. This can be seen in the tale of Cliffs Holiday, a well known rehearsed tale .Mr Macey, the apparent head of this specific social community, describes how a tailor, known as Cliff, had tried to ride the tailor out of his son, attempting rising up the class remains by making a gentleman out of his son. The story however ends with the son dying, and Cliff following him soon after. The story entails much superstition, mentioning old Harry, a euphemism for the devil, suggesting this unnatural desire to climb the class system was responsible for the death of the boy. The villagers, opposite to Cliff, are in fact very accepting of what they have been given.They feel content with what God has given them. Their pre-occupation is not to trick up out of poverty but to merely co-operate with each other in order to make it bearable. This is seen in Dollys clear desire to help anyone in need, or at least to do the best she can. None of the villagers seem to complain about their conditions. They support Silas and each other. Another example of this is in Aarons desire t o help Silas later on in the novel with his garden. He has no qualms about working in his spare time, he sees it as plainly a decent thing to do.These sentiments would largely be a result of his mother, Dolly, and the way she brought him up. The meetings in the Rainbow are an important aspect of the social nature of Raveloe. handle going to Church, it is a social function. This religious aspect of Raveloe is alien to Silas due to his origins of the non-conformist Lantern Yard. He knows nothing of churches, only chapels. This complete lack of knowledge somewhat isolates him from the community he does not go to church. However Dolly, is adamant that Eppie shall be brought up in the Raveloe faith and at the same time, introduces Silas back into religion.Both the working class are present in such functions as well as the gentry. The gentry are represented by the Cass family. The squire sees himself above the other members of the community, only becoming involved with them at festive, social occasions, such as the new-year party at the Red House. They are differentiated from the poor and, unlike Dolly, Mr Macey or any other members of the lower class community, represent little more than themselves. The Cass family are one of the villagers topics of discussion. They perceptively see the faults of the upper class just as they see faults in the lower classes.They take a specific disliking to Dunstan, due to his lack of respect of anyone, especially those below him. Godfrey is also seen as weak, Mr Macey describing him as a let up baked pie, commenting on his moral flaws. The primitive but nevertheless logical philosophy of, those who do well are rewarded while those who dont suffer, is plainly proven in both cases. Dunstan ends up dying due his greed, while, although it is unknown to them, because of his rejection of Eppie, Godfrey is seemingly punished by Nancy being unable to conceive.Silas innocence on the other hand, is eventually rewarded. He is blessed with Eppie, who changes his life. These conclusions follow the villagers moral code, maintaining justice. Categorically speaking, the village has a variety of overall attributes and a predictable nature so therefore can be described as a character. Furthermore, being the main focus of the novel, we can go on to suggest it is the main character. We are more aware of the values and nature of Raveloe as a whole than any specific character even Silas.All the main events of the novel are shaped by the village. Each personality of each character represents a different aspect of the village as a whole. These individual characters amount to realize one, main character which dictates the narrative and plot of the novel. Elliots concentration on her depictions of the village, indicate that she desired it to be the main focus. Obviously Silas is important, however, it is the events that unfold around him in Raveloe that really influence the direction of the novel.

Film Study Prince Essay

(1)According to Prince, what atomic number 18 the three core questions that frame the essential attributes of cinema and why are they important to consider in film studies? (6 points)1) How do movies express meaning? It is important to consider in film studies because the basic tools of filmmaking help organize image of a film, and the film befoolrs are able to express a range of meanings.2) How do viewing audience understand film? It is important to consider in film studies because viewers understand film by applying different aspects of their real-life visual, personal, and social experience as well as their knowledge of motion picture conventions and style. Viewers respond to films when watch movies.3) How does cinema operate as an art and business on a global scale? It is important to consider in film studies because commercial filmmaking operates as part of a global communications industry, which exerts considerable influence on film guinea pig and style. At the same time, filmmakers around the world represent their countries, heritages, and styles. Moreover, filmmakers now are greatly affected by the economic and commercial problems. These issues including art and business influence filmmaking greatly.(2)To Prince, what is the difference between film structure and film content? (4 points) Film structure refers to the audiovisual design of a film and some tools and techniques used to create that design. However, film content refers to the description of story, characters and theme of the film. (3)Discuss three factors that make the director the chief delicious authority in the filmmaking process? (6 points) 1) Preproduction is one of the factors because it involves the planning and preparation period such as writing of a script, hiring of hustle and crew, production design of sets, costumes, and locals. 2) Production is another factor which includes the work of filming the script and sound recording of the action. 3) Postproduction involves the edi ting of sound and image in the film, musical composition and recording of the music score, additional sound recording for effects and dialogue replacement, creation of digital special effects, and subterfuge timing to achieve proper color balance in the images.These factors (the production process) make the director the chief artistic authority in the filmmaking process because the director coordinates and organizes the artistic inputs of other members of the production team, who primarily subordinate their artistic tastes or preferences to a directors stated wishes or vision. (4)Discuss two reasons why Hunt thinks its important to arena films. (4 points) According to Hunt, the key reasons to study film are the issues of power and empowerment. Studying film is empowering because the formation of cinema is about identity, such as our self-image, values, beliefs, and world views. When we realize the role media play in defining and shaping our identity, we mass begin to more activ ely take charge of our own identity. (5)What are the three artistic modes of filmmaking and how are they different? (6 points)1) taradiddle fiction mode refers to an historical or cultural event that is familiar to many film-going spectators however, the characters and the way they act are fictionalized. 2) Documentary mode represents real batch participating in real life events it illuminates the life situation and the situation may represent larger issues and ideas about life. 3) Experimental mode is the arrangement of artistic elements, edit and construct the story in unconventional ways in order to illuminate life experience. (6)Discuss the importance of the shot in the filmmaking process (you can draw from both Hunt and Prince for this answer). (4 points) A shot is important in the filmmaking process because it is the basic unit for constructing a film. A film is built on shot by shot basis like a book is constructed sentence by sentence.Films are composed of many shots that are joined unneurotic in the process of editing. In a completed film, a shot is the interval on screen between edit points, and it is important in the filmmaking process. (7)Explain how it is that benignant beings are able to see still images as moving. (5 points) Under the right conditions spectators leave see apparent motion when no real movement has occurred. If a series of closely spaced light bulbs are illuminated in rapid sequence in a darkened room, a spectator will see a single light source moving across the room rather than a series of lights illuminated one after another. This phenomenon is called beta movement. When the intervals between a series of illuminated light are very small, the eyes motion detectors encode this information as movement. The viewer sees a single travelling light or a galloping horse on screen.

Leadership Framework

turn overing Academy lead cloth A abbreviation 2011 NHS leaders Academy. All rights reserved. The leaders good example is published on behalf of the NHS leading Academy by NHS Institute for foot and Improvement, Coventry House, University of Warwick Campus, Coventry, CV4 7AL. Publisher NHS Institute for Innovation and Improvement, Coventry House, University of Warwick Campus, Coventry, CV4 7AL.This publication may be reproduced and circulated free of charge for non-commercial purposes lone(prenominal) by and between NHS-funded sayments in England, Scotland, Wales and Northern Ireland provide, and their related net persists and officially contr pretended third parties. This includes the right to reproduce, distribute and transmit this publication in any throw and by any means, including e-mail, photocopying, microfilming, and recording. No different use may be made of this publication or any part of it except with the prior scripted permission and application for which should be in writing and addressed to the Director of lead (and marked re. ermissions). Written permission must always be obtained in the beginning any part of this publication is stored in a retrieval system of any nature, or electronically. Reproduction and transmission of this publication must be accurate, must not be used in any misleading context and must always be accompanied by this Copyright Notice. Warning unlicenced copying, storage, reproduction, adaptation or opposite use of this publication or any part of it is strictly prohibited. Doing an unauthorised act in relation to a right of first publication work may give rise to civil liabilities and criminal prosecution.Similar essay Describe How feature Behaviour Could Impact NegativelyThe Clinical Leadership skill mannikin was readyd with the agreement of the NHS Institute for Innovation and Improvement and the Academy of Medical Royal Colleges from the Medical Leadership Competency framework which was created, de veloped and is proclaimed jointly by the NHS Institute for Innovation and Improvement and the Academy of Medical Royal Colleges. NHS Institute for Innovation and Improvement and Academy of Medical Royal Colleges (2010) Medical Leadership Competency Framework, 3rd edition, Coventry NHS Institute for Innovation and Improvement. NHS Institute for Innovation and Improvement and Academy of Medical Royal Colleges 2010 The Leadership Framework The Leadership Framework provides a consistent approach to leaders development for staff in wellness and c ar irrespective of check up on, role or function, and represents the foundation of leadership behaviour that all staff should aspire to. Fundamental to its development was a desire to build on existing leadership frameworks used by different staff groups and create a single overarching leadership framework for all staff in health and c atomic number 18.In developing the Leadership Framework detailed research and cite with a roomy cross s ection of staff and stakeholders has been undertaken, including those with a patient perspective and those involved in health deal out outside the NHS such as professed(prenominal) bodies, academics, regulators and policy makers. Those consulted embraced the concept of the Leadership Framework because it affords a common and consistent approach to professional and leadership development, establish on sh ard value and beliefs which argon consistent with the principles and values of the NHS Constitution1.The Leadership Framework is based on the concept that leadership is not restricted to flock who hold designated leadership roles and where on that point is a shared responsibility for the success of the disposal, receiptss or care organism fork overed. Acts of leadership good deal come from anyone in the giving medication and as a manakin it emphasises the responsibility of all staff in demonstrating leave behaviours, in seeking to contribute to the leadership process and t o develop and empower the leadership force of colleagues2.This enter provides a summary of the seven domains of the Leadership Framework. A full and web based version can be found at www. leadershipacademy. nhs. uk/If Design and building of the Leadership Framework Delivering renovations to patients, religious service users, carers and the public is at the heart of the Leadership Framework. The inevitably of the throng who use services bear always been inter swop to healthcare and all staff work hard to improve services for them. However, if we are going to transform services, acting on what really matters to patients and the public is requisite and nvolves the active participation of patients, carers, community representatives, community groups and the public in how services are planned, stoped and evaluated3. The Leadership Framework is comprised of seven domains. Within each domain there are four categories called elements and each of these elements is further divided into four descriptors. These statements describe the leadership behaviours, which are underpinned by the germane(predicate) association, skills and attributes all staff should be satisfactory to demonstrate.To improve the quality and safety of health and care services, it is essential that staff are competent in each of the five core leadership domains sh throw at right demonstrating personalised qualities, works with others, managing services, ameliorate services, and setting direction. The two other domains of the Leadership Framework, creating the resourcefulness and delivering the system, focus more on the role and constituent of respective(prenominal)ist leaders and particularly those in aged positional roles. 1 Department of Health (2010) The NHS Constitution the NHS belongs to us all.The NHS Constitution can be accessed via http//www. nhs. uk/choiceintheNHS/Rightsandpledges/NHSConstitution/Pages/Overview. aspx NHS Institute for Innovation and Improvement and Academ y of Medical Royal Colleges (2009) Shared Leadership Underpinning of the MLCF Patient and Public strikement, Department of Health (2009) Putting Patients at the Heart of Care The batch for Patient and Public Engagement in Health and Social Care. www. dh. gov. uk/ppe 2 3 Leadership Framework A Summary 3 The word patient is used throughout the Leadership Framework to enerically cover patients, service users, and all those who receive healthcare. Similarly, the word other is used to describe all colleagues from any discipline and ar trimment, as well as patients, service users, carers and the public. The leadership context The application and opportunity to demonstrate leadership allow differ and the context in which competency can be achieved pull up stakes become more complex and demanding with career progression. We have therefore used four stages to describe this and to help staff read their progression and development as a leader.They are Stage 1 Own expend/immediate team is almost building personal relationships with patients and colleagues, a great deal functional as part of a multi-disciplinary team. Staff need to recognise problems and work with others to solve them. The squeeze of the decisions staff take at this take aim will be limited in terms of risk. Stage 2 hearty service/ crossways teams is about building relationships inside and across teams, recognising problems and solving them. At this level, staff will need to be more conscious of the risks that their decisions may pose for self and others for a successful outcome.Stage 3 Across services/wider composition is about working across teams and departments within the wider formation. Staff will challenge the appropriateness of solutions to complex problems. The potential risk associated with their decisions will have a wider preserve on the service. Stage 4 Whole make-up/healthcare system is about building broader partnerships across and outside traditional organisational boun daries that are sustainable and replicable. At this level leaders will be dealing with multi-faceted problems and coming up with sophisticated solutions to those problems.They may lead at a national/international level and would be required to participate in whole systems idea, finding newborn ways of working and leading transformational counter miscellany. Their decisions may have significant impact on the reputation of the NHS and outcomes and would be particular to the coming(prenominal) tense of the NHS. 4 Leadership Framework A Summary Application of the Leadership Framework and supporting tools The Leadership Framework is designed to enable staff to understand their progression as a leader and to support fostering and developing talent.There are many ways it can be applied, for example To raise awareness that impressive leadership is needed across the whole organisation To underpin a talent management schema As part of an existing leadership development programme T o inform the design and commissioning of training and development programmes To develop individual leadership skills As part of team development To enhance existing appraisal systems To inform an organisations recruitment and retention processes.To assist users the full and web based version have a suite of indicators across a variety of work get in situations which illustrate the type of activity staff could be demonstrating relevant to each element and stage as well as examples of behaviours if they are not. complementing tools A self assessment and 360 feedback tool support the Leadership Framework in addition an online development module signposts development opportunities for each of the seven domains.The 360 is a powerful tool to help individuals identify where their leadership strengths and development inescapably lie. The process includes getting confidential feedback from line managers, peers and direct reports. As a result, it gives an individual an insight into oth er peoples perceptions of their leadership abilities and behaviour. To assist with integrating the competences into postgraduate curricula and learning experiences, there is the LeAD e-learning resource which is available on the National Learning Management constitution and through e-Learning for health care (www. -lfh. org. uk/LeAD). The Clinical Leadership Competency Framework and the Medical Leadership Competency Framework are also available to specifically provide staff with clinically based examples in practice and learning and development scenarios across the five core domains shared with the Leadership Framework. A summary version of the Leadership Framework follows, which includes the domains, elements and descriptors. Work-place indicators that demonstrate he practical application of the framework at the four stages are included as tables in the back of the document. The examples in practice are not included, provided these are available in the full document as well as o n the website (www. leadershipacademy. nhs. uk/If). Leadership Framework A Summary 5 1. Demonstrating private Qualities Effective leadership requires individuals to draw upon their values, strengths and abilities to deliver elevated standards of service.To do so, they must demonstrate in force(p)ness in Developing self awareness by existence aware of their own values, principles, and assumptions, and by being able to learn from experiences Managing yourself by organising and managing themselves while taking discover of the needs and priorities of others chronic personal development by learning through participating in move professional development and from experience and feedback Acting with integrity by behaving in an unresolved, honest and ethical flair. 1. 1 Developing self awareness 1. spy and articulate their own value and principles, understanding how these may differ from those of other individuals and groups 2. Identify their own strengths and limitations, the im pact of their behaviour on others, and the effect of stress on their own behaviour 3. Identify their own emotions and prejudices and understand how these can affect their judgement and behaviour 4. Obtain, analyse and act on feedback from a variety of sources 1. 2 Managing yourself 1. Manage the impact of their emotions on their behaviour with consideration of the impact on others 2.Are reliable in meeting their responsibilities and commitments to consistently gritty up standards 3. Ensure that their plans and actions are flexible, and take account of the needs and work patterns of others 4. Plan their workload and activities to fulfil work requirements and commitments, without compromising their own health 1. 3 Continuing personal development 1. Actively seek opportunities and challenge for personal learning and development 2. Acknowledge mistakes and treat them as learning opportunities 3. Participate in continuing professional development activities 4.Change their behaviour in the light of feedback and reflection 1. 4 Acting with integrity 1. Uphold personal and professional ethical motive and values, taking into account the values of the organisation and respecting the culture, beliefs and abilities of individuals 2. Communicate effectively with individuals, appreciating their social, cultural, religious and ethnic backgrounds and their age, gender and abilities 3. Value, respect and promote equation and diversity 4. induce appropriate action if ethics and values are compromised 6 Leadership Framework A Summary 2. Working with OthersEffective leadership requires individuals to work with others in teams and networks to deliver and improve services. To do so, they must demonstrate effectiveness in Developing networks by working in partnership with patients, carers, service users and their representatives, and colleagues within and across systems to deliver and improve services mental synthesis and maintaining relationships by listening, supporting oth ers, gaining leave and sho get throughg understanding Encouraging contribution by creating an environment where others have the opportunity to contribute Working within teams to deliver and improve services. . 1 Developing networks 1. Identify opportunities where working with patients and colleagues in the clinical setting can bring added benefits 2. spend a penny opportunities to bring individuals and groups together to achieve goals 3. labor the sharing of training and resources 4. Actively seek the views of others 2. 2 Building and maintaining relationships 1. Listen to others and recognise different perspectives 2. Empathise and take into account the needs and feelings of others 3.Communicate effectively with individuals and groups, and act as a confirmative role model 4. Gain and maintain the trust and support of colleagues 2. 3 Encouraging contribution 1. Provide encouragement, and the opportunity for people to worry in decision-making and to challenge constructively 2 . Respect, value and acknowledge the roles, contributions and expertise of others 3. Employ strategies to manage conflict of interests and differences of opinion 4. Keep the focus of contribution on delivering and improving services to patients 2. Working within teams 1. Have a sluttish sense of their role, responsibilities and purpose within the team 2. Adopt a team approach, acknowledging and appreciating efforts, contributions and compromises 3. Recognise the common purpose of the team and respect team decisions 4. Are willing to lead a team, involving the right people at the right time Leadership Framework A Summary 7 3. Managing inspection and repairs Effective leadership requires individuals to focus on the success of the organisation(s) in which they work.To do so, they must be effective in Planning by actively contributing to plans to achieve service goals Managing resources by knowing what resources are available and using their influence to get a line that resources a re used expeditiously and safely, and reflect the diversity of needs Managing people by providing direction, reviewing performance, motivating others, and promoting equality and diversity Managing performance by holding themselves and others accountable for service outcomes. . 1 Planning 1. Support plans for clinical services that are part of the outline for the wider healthcare system 2. Gather feedback from patients, service users and colleagues to help develop plans 3. wreak their expertise to planning processes 4. Appraise options in terms of benefits and risks 3. 2 Managing resources 1. Accurately identify the appropriate type and level of resources required to deliver safe and effective services 2.Ensure services are delivered within allocated resources 3. Minimise waste 4. Take action when resources are not being used efficiently and effectively 3. 3 Managing people 1. Provide guidance and direction for others using the skills of team members effectively 2. Review the per formance of the team members to ensure that planned services outcomes are met 3. Support team members to develop their roles and responsibilities 4. Support others to provide good patient care and better services 3. Managing performance 1. Analyse tuition from a range of sources about performance 2. Take action to improve performance 3. Take responsibility for tackling difficult issues 4. Build learning from experience into approaching plans 8 Leadership Framework A Summary 4. Improving Services Effective leadership requires individuals to make a real difference to peoples health by delivering high quality services and by developing improvements to services.To do so, they must demonstrate effective in Ensuring patient safety by assessing and managing risk to patients associated with service developments, equilibrate economic consideration with the need for patient safety critically evaluating by being able to think analytically, conceptually and to identify where services can b e improved, working individually or as part of a team Encouraging improvement and innovation by creating a climate of continuous service improvement Facilitating transformation by actively contributing to change processes that lead to improving healthcare. 4. 1 Ensuring patient safety 1.Identify and quantify the risk to patients using information from a range of sources 2. Use attest, both positive and negative, to identify options 3. Use systematic ways of assessing and minimising risk 4. Monitor the effects and outcomes of change 4. 2 Critically evaluating 1. Obtain and act on patient, carer and user feedback and experiences 2. Assess and analyse processes using up-to-date improvement methodologies 3. Identify healthcare improvements and create solutions through collaborative working 4. Appraise options, and plan and take action to implement and evaluate improvements 4. 3 Encouraging improvement and innovation 1.Question the status quo 2. Act as a positive role model for innova tion 3. Encourage dialogue and debate with a wide range of people 4. Develop creative solutions to transform services and care 4. 4 Facilitating transformation 1. Model the change expected 2. Articulate the need for change and its impact on people and services 3. Promote changes leading to systems redesign 6. Motivate and focus a group to accomplish change Leadership Framework A Summary 9 5. Setting Direction Effective leadership requires individuals to contribute to the strategy and aspirations of the organisation and act in a manner consistent with its values.To do so, they must demonstrate effective in Identifying the contexts for change by being aware of the range of factors to be taken into account Applying knowledge and evidence by gathering information to produce an evidence-based challenge to systems and processes in array to identify opportunities for service improvements Making decisions using their values, and the evidence, to make good decisions Evaluating impact by measuring and evaluating outcomes, taking corrective action where necessary and by being held to account for their decisions. . 1 Identifying the contexts for change 1. essay awareness of the political, social, technical, economic, organisational and professional environment 2. Understand and interpret relevant legislation and accountability frameworks 3. Anticipate and prepare for the coming(prenominal) by scanning for ideas, best practice and emerging trends that will have an impact on health outcomes 4. Develop and communicate aspirations 5. 2 Applying knowledge and evidence 1. Use appropriate methods to gather data and information 2.Carry out analysis against an evidence-based criteria set 3. Use information to challenge existing practices and processes 4. Influence others to use knowledge and evidence to achieve best practice 5. 3 Making decisions 1. Participate in and contribute to organisational decision-making processes 2. Act in a manner consistent with the values and pr iorities of their organisation and profession 3. Educate and inform key people who influence and make decisions 4.Contribute a clinical perspective to team, department, system and organisational decisions 5. 4 Evaluating impact 1. taste and evaluate new service options 2. Standardise and promote new approaches 3. Overcome barriers to implementation 4. Formally and familiarly disseminate good practice 10 Leadership Framework A Summary 6. Creating the Vision Effective leadership involves creating a compelling ken for the hereafter, and communicating this within and across organisations.This requires individuals to demonstrate effectiveness in Developing the passel of the organisation, looking to the future to determine the direction for the organisation Influencing the deal of the wider healthcare system by working with partners across organisations Communicating the vision and motivating others to work towards achieving it Embodying the vision by behaving in ways which are consistent with the vision and values of the organisation. 6. 1 Developing the vision for the organisation 1.Actively engage with colleagues and key influencers, including patients and public, about the future of the organisation 2. Broadly scan and analyse the full range of factors that will impact upon the organisation, to create likely scenarios for its future 3. Create a vision which is vaulting, advanced(a) and reflects the core values of the NHS 4. Continuously ensures that the organisations vision is compatible with future developments within the wider healthcare system. 6. 2 Influencing the vision of the wider healthcare system 1.Seek opportunities to engage in debate about the future of health and care related services 2. Work in partnership with others in the healthcare system to develop a shared vision 3. Negotiate compromises in the interests of better patient services 4. Influence key decision-makers who determine future government policy that impacts on the NHS and i ts services. 6. 3 Communicating the vision 1. Communicate their ideas and enthusiasm about the future of the organisation and its services confidently and in a way which engages and inspires others 2.Express the vision clearly, unambiguously and vigorously 3. Ensure that stakeholders within and beyond the immediate organisation are aware of the vision and any likely impact it may have on them 4. Take time to build critical support for the vision and ensure it is shared and owned by those who will be communicating it. 6. 4 Embodying the vision 1. Act as a role model, behaving in a manner which reflects the values and principles inherent in the vision 2. Demonstrate confidence, self belief, tenacity and integrity in pursuing the vision 3.Challenge behaviours which are not consistent with the vision 4. Identify symbols, rituals and routines within the organisation which are not consistent with the vision, and replace them with ones that are. Leadership Framework A Summary 11 7. Deliver ing the Strategy Effective leadership involves delivering the strategy by developing and agreeing strategical plans that place patient care at the heart of the service, and ensuring that these are translated into manageable operational plans.This requires individuals to demonstrate effectiveness in Framing the strategy by identifying strategic options for the organisation and drawing upon a wide range of information, knowledge and experience Developing the strategy by engaging with colleagues and key stakeholders Implementing the strategy by organising, managing and assuming the risks of the organisation Embedding the strategy by ensuring that strategic plans are achieved and sustained. 7. 1 Framing the strategy 1. Take account of the culture, history and long term underlying issues for the organisation 2.Use heavy(p) organisational theory to inform the development of strategy 3. Identify best practice which can be applied to the organisation 4. Identify strategic options whi ch will deliver the organisations vision 7. 2 Developing the strategy 1. Engage with key individuals and groups to formulate strategic plans to meet the vision 2. Strive to understand others agendas, motivations and drivers in order to develop strategy which is sustainable 3. Create strategic plans which are challenging until now realistic and achievable 4. Identify and mitigate uncertainties and risks associated with strategic choices 7. Implementing the strategy 1. Ensure that strategic plans are translated into workable operational plans, identifying risks, critical success factors and evaluation measures 2. Identify and strengthen organisational capabilities required to deliver the strategy 3. Establish clear accountability for the delivery of all elements of the strategy, hold people to account and expect to be held to account themselves 4. Respond quickly and decisively to developments which require a change in strategy 7. 4 Embedding the strategy 1.Support and inspire others responsible for delivering strategic and operational plans, helping them to overcome obstacles and challenges, and to remain focused 2. Create a consultative organisational culture to support delivery of the strategy and to drive strategic change within the wider healthcare system 3. Establish a climate of transparency and trust where results are discussed openly 4. Monitor and evaluate strategic outcomes, making adjustments to ensure sustainability of the strategy 12 Leadership Framework A Summary The following tables conflate the indicators of behaviours at different leadership stages from each domain section.Please refer to the full domain pages for the element descriptors. 1. DEMONSTRATING PERSONAL QUALITIES Effective leadership requires individuals to draw upon their values, strengths and abilities to deliver high standards of service. To do so, they must demonstrate effectiveness in demonstrating self awareness, managing themselves, continuing their personal development and acting with integrity. 2 Whole Service/Across Teams 3 Across Services/Wider Organisation chemical element Appreciates the impact they have on others and the impact others have on them. Routinely seeks feedback and adapts their behaviour appropriately.Reflects on their interactions with a wide and diverse range of individuals and groups from within and beyond their immediate service/organisation. Challenges and refreshes own values, beliefs, leadership styles and approaches. Overtly role models the giving and receiving of feedback. Successfully manages a range of personal and organisational demands and pressures. Demonstrates tenacity and resilience. Overcomes setbacks where goals cannot be achieved and quickly refocuses. Is visible and accessible to others. Acts as an exemplar for others in managing their continuous personal development.Facilitates the development of a learning culture. 1 Own coiffe/Immediate Team 4 Whole Organisation/Wider Healthcare System Uses sophisticated too ls and sources to continuously learn about their leadership impact in the wider health and care community and improve their effectiveness as a senior leader. Understands how pressures associated with carrying out a high profile role impact on them and their performance. Remains focused on strategic goals when faced with competing and, at times, conflicting demands arising from differing priorities.Identifies where they need to personally get involved to achieve the most benefit for the organisation and wider healthcare system. Develops through systematically scanning the outer environment and exploring leading edge thinking and best practice. Applies learning to build and refresh the service. Treats challenge as a positive force for improvement. 1. 1 Developing Self Awareness Reflects on how factors such as own values, prejudices and emotions influence their judgement, behaviour and self belief. Uses feedback from appraisals and other sources to consider personal impact and change behaviour.Understands personal sources of stress. 1. 2 Managing Yourself Plans and manages own time effectively and fulfils work requirements and commitments to a high standard, without compromising own health and wellbeing. Remains calm and focused under pressure. Ensures that own work plans and priorities fit with the needs of others involved in delivering services. Demonstrates flexibility and sensitivity to service requirements and remains imperative in pursuing service goals. Leadership Framework A Summary Puts self forward for challenging assignments and projects which will develop strengths and address development areas.Acts as a role model for others in demonstrating integrity and inclusiveness in all aspects of their work. Challenges where organisational values are compromised. 1. 3 Continuing Personal Development Takes responsibility for own personal development and seeks opportunities for learning. Strives to put learning into practice. 1. 4 Acting with Integrity Behave s in an open, honest and inclusive manner, upholding personal and organisational ethics and values. Shows respect for the needs of others and promotes equality and diversity.Creates an open, honest and inclusive culture in accordance with clear principles and values. Ensures equity of access to services and creates an environment where people from all backgrounds can excel. Assures standards of integrity are maintained across the service and communicates the importance of always adopting an ethical and inclusive approach. Generic behaviours observed if individual is not yet demonstrating this domain Demonstrates behaviours that are retort to core values of openness, inclusiveness, honesty and equality Lacks confidence in own abilities to deliver results Does not understand own emotions or recognise the impact of own behaviour on others Approaches tasks in a disorganised way and plans are not realistic Unable to discuss own strengths and development needs and spends teeny-weeny time on development 13 14 2 Whole Service/Across Teams 3 Across Services/Wider Organisation 4 Whole Organisation/Wider Healthcare System kit and boodle across boundaries creating networks which facilitate high levels of collaboration within and across organisations and sectors.Builds and maintains sustainable strategic alliances across the system and other sectors. Has high impact when interacting with others at all levels. Uses networks to bring individuals and groups together to share information and resources and to achieve goals. Identifies and builds effective networks with a range of influential stakeholders internal and external to the organisation. Builds and maintains relationships with a range of individuals involved in delivering the service. Manages sensitivities between individuals and groups.Creates a supportive environment which encourages others to express diverse opinions and engage in decisionmaking. Constructively challenges suggestions and reconciles conflicting views. Helps lead others towards common goals, providing clear objectives and offering appropriate support. Shows awareness of team dynamics and acts to promote effective team working. Appreciates the efforts of others. Integrates the contributions of a diverse range of stakeholders, being open and honest about the extent to which contributions can be acted upon.Builds and nurtures trusting relationships at all levels within and across services and organisational boundaries. Creates systems which encourage contribution throughout the organisation. Invites contribution from different sectors to bring about improvements. Takes on recognised positional leadership roles within the organisation. Builds high performing inclusive teams that contribute to productive and efficient health and care services. Promotes autonomy and empowerment and maintains a sense of optimism and confidence. Contributes to and leads senior teams.Enables others to take on leadership responsibilities, building h igh level leadership capability and capacity from a diverse range of backgrounds. Does not encourage others to contribute ideas Does not adopt a collaborative approach 2. WORKING WITH OTHERS Effective leadership requires individuals to work with others in teams and networks to deliver and improve services. This requires them to demonstrate effectiveness in developing networks, building and maintaining relationships, encouraging contribution, and working within teams. division 1 Own Practice/Immediate Team . 1 Developing Networks Identifies where working and cooperating with others can result in better services. Endeavours to work collaboratively. 2. 2 Building and Maintaining Relationships Communicates with and listens to others, recognising different perspectives. Empathises and takes into account the needs and feelings of others. Gains and maintains trust and support. 2. 3 Encouraging Contribution Seeks and acknowledges the views and input of others. Shows respect for the contr ibutions and challenges of others. Leadership Framework A Summary 2. 4 Working within TeamsUnderstands roles, responsibilities and purpose within the team. Adopts a collaborative approach and respects team decisions. Generic behaviours observed if individual is not yet demonstrating this domain Fails to network with others and/or allows relationships to deteriorate Fails to win the support and respect of others 3. MANAGING SERVICES Effective leadership requires individuals to focus on the success of the organisation(s) in which they work. This requires them to be effective in planning, managing resources, managing people and managing performance. Whole Service/Across Teams 3 Across Services/Wider Organisation 4 Whole Organisation/Wider Healthcare System Anticipates the impact of health trends and develops strategic plans that will have a significant impact on the organisation and wider healthcare system. Ensures strategic objectives are translated into operational plans. Strategic ally manages resources across the organisation and wider healthcare system. Element Works collaboratively to develop business cases and service plans that support organisational objectives, appraising them in terms of benefits and risks.Leads service design and planning processes. Communicates and keeps others informed of strategic and operational plans, progress and outcomes. 1 Own Practice/Immediate Team 3. 1 Planning Contributes ideas to service plans, incorporating feedback from others including a diverse range of patients, service users and colleagues. 3. 2 Managing Resources Understands what resources are available and organises the appropriate type and level of resources required to deliver safe and efficient services. Identifies resource requirements associated with delivering services.Manages resources and takes action to ensure their effective and efficient use. Forecasts resource requirements associated with delivering complex services efficiently and effectively. Manages resources taking into account the impact of national and local policies and constraints. Motivates and coaches individuals and teams to strengthen their performance and assist them with developing their own capabilities and skills. Aligns individual development needs with service goals. Leadership Framework A Summary Provides others with clear purpose and direction.Helps others in developing their roles and responsibilities. Works with others to set and monitor performance standards, addressing areas where performance objectives are not achieved. Does not effectively manage and develop people Fails to identify and address performance issues 3. 3 Managing People Supports others in delivering high quality services and excellence in health and care. Inspires and supports leaders to mobilise diverse teams that are committed to and aligned with organisational values and goals. Engages with and influences senior leaders and key stakeholders to deliver joined up services. . 4 Managing P erformance Uses information and data about performance to identify improvements which will strengthen services. Establishes rigorous performance measures. Holds self, individuals and teams to account for achieving performance standards. Challenges when service expectations are not being met and takes corrective action. Promotes an inclusive culture that enables people to perform to their best, ensuring that appropriate performance management systems are in place and that performance data is systematically evaluated and fed into future plans.Generic behaviours observed if individual is not yet demonstrating this domain Disorganised or unstructured approach to planning Wastes resources or fails to monitor them effectively 15 16 2 Whole Service/Across Teams 3 Across Services/Wider Organisation 4 Whole Organisation/Wider Healthcare System Creates a culture that prioritises the health, safety and security of patients and service users. Delivers assurance that patient safety underpins p olicies, processes and systems. Reviews practice to improve standards of patient safety and minimise risk.Monitors the impact of service change on patient safety. Develops and maintains audit and risk management systems which will drive service improvement and patient safety. Engages with others to critically evaluate services and create ideas for improvements. Synthesises complex information to identify potential improvements to services. Identifies potential barriers to service improvement. Benchmarks the wider organisation against examples of best practice in healthcare and other sectors. Evaluates options for improving services in line with future advances.Acts as a positive role model for innovation. Encourages dialogue and debate in the development of new ideas with a wide range of people. Challenges colleagues thinking to find better and more effective ways of delivering services and quality. Accesses creativity and innovation from relevant individuals and groups. Drives a cu lture of innovation and improvement. Integrates radical and innovative approaches into strategic plans to make the NHS world class in the provision of healthcare services. Focuses self and others on achieving changes to systems and processes which will lead to improved services.Energises others to drive change that will improve health and care services. Actively manages the change process, drawing on models of effective change management. Recognises and addresses the impact of change on people and services. Inspires others to take bold action and make important advances in how services are delivered. Removes organisational obstacles to change and creates new structures and processes to facilitate transformation. Maintains the status quo and sticks with traditional outdated ways of doing things Fails to implement change or implements change for changes sake 4.IMPROVING SERVICES Effective leadership requires individuals to make a real difference to peoples health by delivering high quality services and by developing improvements to services. This requires them to demonstrate effectiveness in ensuring patient safety, critically evaluating, encouraging improvement and innovation and facilitating transformation. Element 1 Own Practice/Immediate Team 4. 1 Ensuring Patient Safety Puts the safety of patients and service users at the heart of their thinking in delivering and improving services. Takes action to report or rectify shortfalls in patient safety. . 2 Critically Evaluating Uses feedback from patients, carers and service users to contribute to healthcare improvements. Leadership Framework A Summary 4. 3 Encouraging Improvement and Innovation Questions established practices which do not add value. Puts forward creative suggestions to improve the quality of service provided. 4. 4 Facilitating switching Articulates the need for changes to processes and systems, acknowledging the impact on people and services. Generic behaviours observed if individual is not ye t demonstrating this domain Overlooks the need to put patients at the forefront of their thinking Does not question/evaluate current processes and practices 5. SETTING DIRECTION Effective leadership requires individuals to contribute to the strategy and aspirations of the organisation and act in a manner consistent with its values. This requires them to demonstrate effectiveness in identifying the contexts for change, applying knowledge and evidence, making decisions, and evaluating impact. 2 Whole Service/Across Teams 3 Across Services/Wider Organisation 4 Whole Organisation/Wider Healthcare System Synthesises knowledge from a broad range of sources.Identifies future challenges and imperatives that will create the need for change and move the organisation and the wider healthcare system in new directions. Influences the context for change in the best interests of services and service users. Uses knowledge, evidence and experience of national and international developments in healt h and social care to influence the future development of health and care services. Ensures that corporate decision-making is rigorous and takes account of the full range of factors impinging on the future direction of the organisation and the wider healthcare system.Can operate without all the facts. Takes unpopular decisions when in the best interests of health and care in the long term. Identifies gains which can be applied elsewhere in the organisation and incorporates these into operational/ business plans. Disseminates learning from changes which have been introduced. Synthesises learning arising from changes which have been introduced and incorporates these into strategic plans. Shares learning with the wider health and care community. Element Identifies the external and internal drivers of change and communicates the rationale for change to others.Actively seeks to learn about external factors which will impact on services. Interprets the meaning of these for services and inc orporates them into service plans and actions. 1 Own Practice/Immediate Team 5. 1 Identifying the Contexts for Change Understands the range of factors which determine why changes are made. 5. 2 Applying Knowledge and Evidence Gathers data and information about aspects of the service, analyses evidence and uses this knowledge to suggest changes that will improve services in the future. Involves key people and groups in making decisions.Actively engages in formal and informal decision-making processes about the future of services. Obtains and analyses information about services and pathways to inform future direction. Supports and encourages others to use knowledge and evidence to inform decisions about the future of services. Understands the complex interdependencies across a range of services. Applies knowledge to set future direction. Leadership Framework A Summary Evaluates and embeds approaches and working methods which have proved to be effective into the working practices of te ams and individuals. 5. 3 Making DecisionsConsults with others and contributes to decisions about the future direction/vision of their service. Remains accountable for making timely decisions in complex situations. Modifies decisions and flexes direction when faced with new information or changing circumstances. 5. 4 Evaluating Impact Assesses the effects of change on service delivery and patient outcomes. Makes recommendations for future improvements. Generic behaviours observed if individual is not yet demonstrating this domain Makes poor decisions about the future Fails to evaluate the impact of previous decisions and actions Unaware of political, social, technical, economic, organisational factors that impact on the future of the service/organisation Does not use an evidence-base for decision-making 17 18 ELEMENT DESCRIPTORS (see also page 11) 4 Whole Organisation/Wider Healthcare System Actively engages key stakeholders in creating a bold, innovative, shared vision which ref lects the future needs and aspirations of the population and the future direction of healthcare. Thinks broadly and aligns the vision to the NHS core values and the values of the wider healthcare system.Actively participates in and leads on debates about the future of health, wellbeing and related services. Manages political interests, balancing tensions between organisational aspirations and the wider environment. Shapes and influences local, regional and national health priorities and agendas. Clearly communicates the vision in a way that engages and empowers others. Uses enthusiasm and energy to inspire others and encourage joint ownership of the vision. Anticipates and constructively addresses challenge. Consistently displays passion for the vision and demonstrates personal commitment to it through their periodical actions.Uses personal credibility to act as a convincing advocate for the vision. Misses opportunities to communicate and share understanding of the vision with oth ers Lacks enthusiasm and commitment for driving the vision 6. CREATING THE VISION Those in senior positional leadership roles create a compelling vision for the future, and communicate this within and across organisations. This requires them to demonstrate effectiveness in developing the vision for the organisation, influencing the vision of the wider healthcare system, communicating the vision and embodying the vision.Element 6. 1 Developing the Vision for the Organisation Actively engage with colleagues and key influencers, including patients and public, about the future of the organisation Broadly scan and analyse the full range of factors that will impact upon the organisation, to create likely scenarios for its future Create a vision which is bold, innovative and reflects the core values of the NHS Continuously ensures that the organisations vision is compatible with future developments within the wider healthcare system . 2 Influencing Vision in the Wider Healthcare Syste m Seek opportunities to engage in debate about the future of health and care related services Work in partnership with others in the healthcare system to develop a shared vision Negotiate compromises in the interests of better patient services Influence key decision-makers who determine future government policy that impacts on the NHS and its services Leadership Framework A Summary 6. 3 Communicating the Vision Communicate their ideas and enthusiasm about the future of the organisation and its services confidently and in a way which engages and inspires others Express the vision clearly, unambiguously and vigorously Ensure that stakeholders within and beyond the immediate organisation are aware of the vision and any likely impact it may have on them Take time to build critical support for the vision and ensure it is shared and owned by those who will be communicating it 6. 4 Embodying the Vision Act as a role model, behaving in a manner which reflects the values and principle s inherent in the vision Demonstrate confidence, self belief, tenacity and integrity in pursuing the vision Challenge behaviours which are not consistent with the vision Identify symbols, rituals and routines within the organisation which are not consistent with the vision, and replace them with ones that are Generic behaviours observed if individual is not yet demonstrating this domain Does not involve others in creating and defining the vision Does not align their vision with the wider health and care agenda 7. DELIVERING THE STRATEGY Those in senior positional leadership roles deliver the strategic vision by developing and agreeing strategic plans that place patient care at the heart of the service, and ensuring that these are translated into achievable operational plans. This requires them to demonstrate effectiveness in framing the strategy, developing the strategy, implementing the strategy, and embedding the strategy. ElementELEMENT DESCRIPTORS (see also page 12) 4 Whole Organisation/Wider Healthcare System Critically reviews relevant thinking, ideas and best practice and applies whole systems thinking in order to conceptualise a strategy in line with the vision. 7. 1 Framing the Strategy Take account of the culture, history and long term underlying issues for the organisation Use sound organisational theory to inform the development of strategy Identify best practice which can be applied to the organisation Identify strategic options which will deliver the organisations vision . 2 Developing the Strategy Engage with key individuals and groups to formulate strategic plans to meet the vision Strive to understand others agendas, motivations and drivers in order to develop strategy which is sustainable Create strategic plans which are challenging yet realistic and achievable Identify and mitigate uncertainties and risks associated with strategic choices Integrates the views of a broad range of stakeholders to develop a coherent, joined up and s ustainable strategy.Assesses organisational readiness for change. Manages the risks, political sensitivities and environmental uncertainties involved. Leadership Framework A Summary 7. 3 Implementing the Strategy Ensure that strategic plans are translated into workable operational plans, identifying risks, critical success factors and evaluation measures Identify and strengthen organisational capabilities required to deliver the strategy Establish clear accountability for the delivery of all elements f the strategy, hold people to account and expect to be held to account themselves Respond quickly and decisively to developments which require a change in strategy Responds constructively to challenge. Puts systems, structures, processes, resources and plans in place to deliver the strategy. Establishes accountabilities and holds people in local, regional, and national structures to account for jointly delivering strategic and operational plans. Demonstrates flexibility when change s required. 7. 4 Embedding the Strategy Support and inspire others responsible for delivering strategic and operational plans, helping them to overcome obstacles and challenges, and to remain focused Create a consultative organisational culture to support delivery of the strategy and to drive strategic change within the wider healthcare system Establish a climate of transparency and trust where results are discussed openly Monitor and evaluate strategic outcomes, making adjustments to ensure sustainability of the strategy Enables and supports the conditions and culture needed to sustain changes integral to the successful delivery of the strategy.Keeps momentum alive by reinforcing key messages, monitoring progress and recognising where the strategy has been embraced by others. Evaluates outcomes and uses learnings to adapt strategic and operational plans. Generic behaviours observed if individual is not yet demonstrating this domain Absolves oneself of responsibility for holding others to account Fails to enable an organisational culture that embraces the strategy Does not align the strategy with local, national and/or wider health care system requirements Works to develop the strategy in isolation without input or feedback from others 19