Help writing a narrative essay
Research Paper Topics In Optometry
Tuesday, August 25, 2020
Model Train Building :: essays research papers
The universe of Model Train Building has developed incredibly with the guide of PCs and innovation to improve the fun of building. Innovation has for some time been a piece of Model Train working with the including of lights, chimes, and whistles to catch your advantage and creative mind. Be that as it may, with the most recent age of building comes the convergence of innovation and the PC. The PC brings along another variety of developers who plan track format, purchase parts on the Internet, get refreshed news, and talk with other lover. The most remarkable distinction that PCs have brought to the universe of Model Train building is in programming. Presently available there are various bundles of programming that empower specialist in the ââ¬Å"challengeâ⬠of genuine yard procedure for a littler scope. These projects permit the individual to move stacks among stations and monitor your incomes. They permit reproductions of operational switches between tracks, different train activity, coupling/uncoupling of railcars. In any case, the best advantage that they bring is permitting the individual to structure a design utilizing an electronic format and guaranteeing that all estimations in the format will work before a solitary bit of track is laid. A significant number of these product programs even play off on the promotion of utilizing a PC for plan in their name, with names of CyberTrack, The Right Track Software, and Design Your Own Railroad, who couldn't have any desire to get associated with there use. This product integrates with numerous different parts of building that empower the utilization of the Internet in this diversion. A significant number of these projects permit the specialist a ââ¬Å"realistic railyardâ⬠activity complete with sights, sounds and even arranged accidents. With the occasion of an accident you are continually going to require new parts for fix or possibly you simply need to overhaul or grow you track framework. This acquires the comfort of the utilization of the Internet in item requesting. With not many stores in dissipated regions it might be troublesome or costly for some specialist to get to these areas for the parts that they need. The Internet brings this store directly into their home with online inventories and parts stores. One standard over the counter list, The Atlas Catalog, gives an electronic form, The Atlas Online Catalog, for web clients to arrange parts on a protected online inventory. Considerably increasingly significant for certain individuals are the Online Magazines that give up to the moment news breaking data.
Saturday, August 22, 2020
Supply Chain Management at Dell Computers
As per Klapper et al, gracefully chain the board is the coordinated arrangement of capacities that look to guarantee that the results of an association arrive at a client in an auspicious way. In this way, the jobs of the gracefully chain chief at Dell PCs are to guarantee that the client is happy with the item dispersion used by the company.Advertising We will compose a custom paper test on Supply Chain Management at Dell Computers explicitly for you for just $16.05 $11/page Learn More The primary jobs of a flexibly fasten supervisor are to guarantee the powerful determination and the executives of providers and to direct effective transportation of items from the creation area through capacity, however capacity, lastly to the purchaser (Chomilier, Samii, and Wassenhove). Accordingly, at Dell, the duties of the flexibly anchor administrator are to guarantee that there is compelling correspondence between the client, the provider, and maker of the last item. This job prompts a popula rity for flexibly chain administrators by firms, for example, Dell in light of the fact that the gracefully chain directors guarantee that the companyââ¬â¢s items are effectively circulated to different purchasers in the market (Kale, 2004). These supervisors are additionally sought after in light of the fact that the organization needs to convey its items to various populaces, and to do this, viable correspondence in the gracefully chain is required. SWOT Analysis Strengths From the Case StudyonDell Computers, it is obvious that the organization is the biggest PC creator on the planet, so promoting the PCs is streamlined in light of the fact that they have a set brand name. Another quality from the customerââ¬â¢s viewpoint is the utilization of specially crafts to make PCs; a few clients will arrange uniquely designed PCs from the organization in this manner expanding their image reliability. The shipment methodology utilized by the organization is a viable strategy that guar antees that the PCs arrive at the client with negligible postponements, which builds the showcasing capability of the organization. Shortcomings The principle shortcoming with the showcasing capability of Dell PCs is that they have a powerless relationship with retailers since the organization lean towards promoting its own items. This implies the organization doesn't infiltrate the market viably, and the retailers don't showcase the organization items. The other advertising shortcoming of the organization is the way that they don't have exceptional innovations to offer the market, so new items don't build the market capability of the organization. The issue of managing a lot of providers from various nations implies that the organization faces numerous potential issues when their items are reviewed from the market (Cohen and Rousell, 2004). Openings The principle opportunity that the organization has in the market is the chance to enhance the brand made by the author; it presents a n opportunity for the organization to grow its market capacities to districts outside the present areas. The other advertising opportunity originate from the anticipated development to new markets like China and India, which are anticipated in the circumstance investigation to develop in the following three to five years (Clay, 2006). Dangers The primary danger to the advertising capability of Dell PCs is the expanding number of famous brand names in the market, which builds the serious factor and diminishes piece of the overall industry. Since Dell is an organization that is centered around worldwide business, changes in world monetary standards can influence the benefit potential and advertising abilities of the organization. Creating solid relations among retailers and contending organizations that decrease the dissemination ability of the organization, additionally influence the advertising capability of the organization. References Case Study: Dell. Can The Icon of The Logistic s Industry Survive in India?à Chomilier, B., and Samii, R., and Wassenhove, L., The Central Role of Supply Chain Management at IFRC, [Online] Available at: https://www.fmreview.org/. Cohen, S., and Rousell, J., 2004, Strategic Supply Chain Management. New York: McGraw Hill. Kale, S., n.d., Global Competitiveness: Role of Supply Chain Management, [Online] Available at:â http://dspace.iimk.ac.in/bitstream/handle/2259/507/503-511+.pdf;jsessionid=22A58EB0104D0855E5F5AD128979AB25?sequence=1 .Advertising Looking for paper on business financial aspects? How about we check whether we can support you! Get your first paper with 15% OFF Learn More Klapper, L., and Hamblin, N., and Hutchison, L., and Novak, L., and Vivar, J., 2000, Supply Chain Management: A Recommended Performance Measurement Scorecard. London: Logistics Management Institute. This paper on Supply Chain Management at Dell Computers was composed and put together by client Omari Diaz to help you with your own investigations. You are allowed to utilize it for research and reference purposes so as to compose your own paper; nonetheless, you should refer to it in like manner. You can give your paper here.
Saturday, August 8, 2020
Prosecutorial Misconduct and Law to Them
Prosecutorial Misconduct and Law to Them Prosecutorial Misconduct Mar 26, 2018 in Law Influence and Authority of Prosecutors Modern-day prosecutorial teams and the police have considerable influence and authority in almost all criminal and civil cases right from the start of investigations to sentencing of any criminal defendant after a conviction (Rosenfeld, 2005). From the prosecutor, this enormous levels of influence and authority comes from discretion the criminal justice system has vested in them to make a decision on whether to conduct an investigation, whether to file charges, when to file those charges and, most controversially, whether to provide a plea bargain or offer leniency. Considering the present sentencing regime for federal cases, prosecutors have the primary control of a case and not the trial judges. In the criminal justice system, it is agreeable that prosecutors have more power than any other actors.
Saturday, May 23, 2020
Importance of Self-Image in the Loman Family - 1483 Words
Published in 1949, Arthur Millerââ¬â¢s Death of Salesman is a post Second World War American drama that highlights the plight of isolation and desolation experienced by the common man, as symbolized by Willy. The play deals with the society, lifeââ¬â¢s absurdity, various internal and external conflicts, death and above all, the tragedy of existence. It is located in the industrial society of the twentieth century where the pressure to succeed and the financial difficulties seem insurmountable. The play depicts America as the land of opportunity as well as a place where the society has acquired a new set of values that threatens to destroy those who cannot abide by new changes. This paper discusses the importance of self-image in the Lomanâ⬠¦show more contentâ⬠¦The best characterization of Linda is in these words: ââ¬Å"Linda, as the eternal wife and mother, the fixed point of affection both given and received, the woman who suffers and endures, is in many ways, the ear th mother who embodies the plays ultimate moral value, love. But in the beautiful, ironic complexity of her creation, she is also Willys and their sons destroyer. In her love Linda has accepted Willys Greatness and his dream, but while in her admiration for Willy her love is powerful and moving, in her admiration for his dreams, it is lethal. She encourages Willys dream, yet she will not let him leave her for the New Continent, the only realm where the dream can be fulfilled. She wants to reconcile father and son, but she attempts this in the context of Willys false values. She cannot allow her sons to achieve that selfhood that involves denial of these valuesâ⬠(Gordon 312). Furthermore, the Loman family lives in a society where the monetary status of residents determines their value. It is a consumer-based materialistic society which measures the worth of people on the basis of wealth owner. Clearly, being a part of this society and finding himself a complete ââ¬Ëfailureââ¬â¢, Willyââ¬â¢s sense of self image suffers drastically, which worsen when he sees his sons doing nothing about their life. Willy tries to, in fact, he knows that he wants to live in this society but at the same time, his idealism makes him imagine aShow MoreRelatedAnalysis Of Death Of A Salesman By Arthur Miller1235 Words à |à 5 Pagestheir accountability, it often leads to inner battles with hypocrisy. This self-deception involves a lot of confusion regarding the nature of ones beliefs, ideals, and principles. Such situations can lead to two very different, yet life changing conclusions, self-realization or misconception of reality. Death of a Salesman, a tragic play b y Arthur Miller, explores the effects of such deception through the character Willy Loman and the consequences of his decisions. It does so by addressing the mentalRead MoreAnalysis of Arthur Millers Death of a Salesman1581 Words à |à 6 Pagesï » ¿Arthur Millers play Death of a Salesman was a hit nearly from its debut, and its importance to American literature and theater has not diminished in the over half a century since its first performance in 1949. However, the specific areas of the play that have most intrigued critics have changed over time, as different historical, social, and literary concerns lead critics to come up with different interpretations. By analyzing three different critical responses to Death of a Salesman, it will beRead MoreArthur Millerà ´s Death of A Salesman: A Commentary1170 Words à |à 5 Pages Arthur Miller Born on October 17, 1915 in Harlem, New York. Arthur Miller was raised in a moderately household until his family lost almost everything in the Wall Street Crash of 1929. They moved from the upper east side in Manhattan to Gravesend, Brooklyn. After graduating from high school, Miller worked little jobs so that he can save up money to attend the University of Michigan. Arthur Miller took courses with playwrightRead MoreConsequences Of A Superficial Dream : Will Loman1076 Words à |à 5 PagesSuperficial Dream: Will Loman Various numbers and symbols throughout Death of a Salesman, by Arthur Miller, highlight an important equation worth noticing that prove Willy Lomanââ¬â¢s frame on life. Success is equal to money; money is greater than life; success and money lead to fame and name brands, which lead to ultimate happiness. A man, more living than dead in his own dream fails to interpret the importance of life any other way. Because of his failed outlook, he believes his self worth is better offRead More Reality and Illusion in Arthur Millerââ¬â¢s Death of a Salesman Essay1088 Words à |à 5 PagesReality and Illusion in Arthur Millerââ¬â¢s Death of a Salesman In Arthur Millerââ¬â¢s play, Death of a Salesman, a major theme and source of conflict is the Loman familyââ¬â¢s inability to distinguish between reality and illusion.à This is particularly evident in the father, Willy Loman.à Willy has created a fantasy world of himself and his family.à In this world, he and his sons are men of greatness that ââ¬Å"have what it takesâ⬠to make it in the business environment.à In reality, none of them can achieveRead More Tragic Heroes in Arthur Millers Death of a Salesman and Henrik Ibsens A Dolls House1709 Words à |à 7 Pagesfor example, Arthur Millers Death of Salesman and Henrik Ibsens A Dolls House. Death of Salesman shows the downfall of the modern tragic hero, Willy Loman, a middle class working man. Nora, in A Dolls House displays that characteristics of a tragic hero, in that she shows potential for greatness, but is stifled by her society. Willy Loman in Death of a Salesman and Nora in A Dolls House are two perfec t examples that illustrate a tragic hero. In Tragedy and the Common Man, ArthurRead More Illusion Verses Reality in Death of a Salesman by Arthur Miller 972 Words à |à 4 PagesIllusion Verses Reality in Death of a Salesman by Arthur Millerà à à à à à à Death of A Salesman, by Arthur Miller, is a play that tells the story of a traveling salesman, Willy Loman, who encounters frustration and failure as he reflects on and experiences his own life. Willys quest for the American Dream leads to his failure because throughout his life, he pursues the illusion of the American Dream and not the reality of it. His mindset on perfection, his obsession with success, and his constantRead MoreEssay on The Failure of the American Dream in Death of a Salesman1480 Words à |à 6 Pagesknown as a land of opportunity. Out of that thinking comes the American Dream, the idea that anyone can ultimately achieve success, even if he or she began with nothing.à In The Death of a Salesman, Arthur Miller uses the characterization of Willy Loman to represent the failure of his ideal of the American Dream.à Willyââ¬â¢s quest for the American Dream leads to his failure because throughout his life he pursues the illusion of the American Dream and not the reality of it. His mindset on perfection, obsessionRead MoreArthur Miller s Death Of A Salesman1159 Words à |à 5 Pagesform their identities. People go through life trying to recognize their character traits, the act of which leads them to their identities, but over time can lose the identities they have through society, through a marriage, or through oneââ¬â¢s own self. Willy Loman, a delusional salesman, in Arthur Millerââ¬â¢s Death of a Salesman; Minnie Wright, an unhappy and lonely housewife, in Susan Glaspellââ¬â¢s Trifles; and Oedipus, a king with excessive pride and determination, in Sophoclesââ¬â¢ Oedipus the King illustrateRead More A Psychological Reading of Death of A Salesman Essay3503 Words à |à 15 Pagesbring his family into grace.à à Miller does, however, also uses this play to express underlying themes and ideas.à Reading Death of a Salesman from the starting point of a Marxist results in the perception that miller uses his play as a means to demonstrate the effects of a changing capitalist society. à On the other hand, a psychological reading of Death of a Salesman allows the play to be seen as one mans flight from shame and his own weakened self image.à The Marxist
Tuesday, May 12, 2020
Oprah Winfrey Influence on American History - Free Essay Example
Sample details Pages: 3 Words: 978 Downloads: 1 Date added: 2019/10/30 Category People Essay Level High school Tags: Oprah Winfrey Essay Did you like this example? Heroes are often described as a person who is admired by their courage, achievements, and noble acts. There are various people today who are still looked up to as a hero. People who are recognized as a hero have made some impact on the world to be seen as a hero. Donââ¬â¢t waste time! Our writers will create an original "Oprah Winfrey: Influence on American History" essay for you Create order A person like Oprah Winfrey made an impact, so she would be labeled as a hero today. Oprah Winfrey is an American hero who helped stand up for her beliefs and for injustice against child molestation. Without Oprah, America and the world would not see how much of an impact someones voice can make and how powerful one individual can be. On January 29, 1954, in Kosciusko, Mississippi a hero was born. Oprahs childhood was challenging, but she still fought through those early battles in life. In Oprahs early life, her parents were poor teenagers, who worked as a housekeeper and a barber (Rowley 2). In her youth, Oprah was repeatedly molested by other visitors who came while her mother was out at her job, and gave birth to a son who later died at a very young age (Goodman 1). Besides the troubled times Oprah faced in her adolescence, she loved education. Oprah was taught to read by her grandmother at a young age, and had a great interest in reading. Reading was one of the most positive things from her childhood. Oprah went to Tennessee State University and studied communications. She first wanted to be famous and break her silence after she did not receive her undergraduate degree in school, and later became the first black female news anchor is what started the spark in her (Rowley 2). It takes hard work to become a hero, so Oprah had to face various acts to accomplish her battle of being a victim to victory. Oprah first started getting recognized by being a co-host for her first show, People Are Talking, and served as an anchor while being a news reporter. She got noticed and was asked to host a Chicago talk show for half an hour, and less than a year later, Oprah turned AM Chicago into a hit show. Oprah later extended the show to an hour and renamed the show, The Oprah Winfrey Show (Dillion 2-3). While she was on the show, Oprah would share her beliefs and her past, tell about how she broke her silence, and how that made such an impact on her life today. Oprah would also feature in movies that would influence her life as a hero today. Some of the movies that Oprah was featured in was, The Color Purple, Native Son, and Selma. The movie, The Color Purple, that Oprah played a major role in, impacted her majorly. Oprah said while playing this part in that movie, tha t she felt compassion for the person that she played (Dillion 2). She had to face other struggles, for example how she did not make it in her education, so she had to fight harder than most people (Rowley 2). Oprah has also started many charities and organizations that helped influenced her to break her silence and her education struggles such as, The Oprah Winfrey Foundation and Oprah Winfrey Leadership Academy for Girls. She advocates and helps out with womens rights and education rights (Dillion 2). Becoming a hero does not just happen overnight. Like Oprah, it took time and effort to become the hero she is for todays society. Oprah Winfrey is still alive and well today. Today, she is still in book clubs, working foundations, and still giving scholarships. She is still seen and viewed as a hero today, and is featured in many advertisements, commercials, and television shows today (Cash 1). Oprah has also received various awards for her heroic acts. For example, Oprah has won medals and awards like the, Presidential Medal of Freedom, International Emmy Founders Award, and TCA Lifetime Achievement Award (Cash 1). She is still looked upon today also because of the organizations she helps out with today. She is still helping education organizations for young girls (Dillion 2). The legacy Oprah has left for the world today is by her strong voice and what she has fought for is how she is viewed on today. Her impact on people has helped out in various ways, and she is still being active in her heroic acts today. Heroes today, are viewed as influential and inspirational to society. There are numerous people still looked upon as heroes today. A hero looked upon todays world is Oprah Winfrey. Oprah Winfrey has made a vast impact on people, America, and the world today. An American hero, like Oprah, has stood up for various rights and justices from her beliefs. When Oprah was in her youth, she was molested, and has broke her silence over the years. Heroes do not just appear, they all have a start. Oprah, in her earlier life had obstacles that she had to go through in her journey. Oprah began her early works in hosting in shows, being featured on talk shows, and was viewed on news cast as well. The recognition she received from being on television helped her be acknowledged. She then spoke about her past and confessed what had happened to her. Oprah stood out to numerous people for speaking out against what she had struggled with. Many people today look up to Oprah Winfrey because of her strength and courage to fight the battle that she had been facing. She has many heroic traits like her noble act to stand up to her battle and her strength to say what her big obstacle was in her life that was weighing her down. The world without Oprah would not be complete, because one would not understand how much of an impact she applies to todays society. Her heroism has touched many lives by her courage and the voice she has.
Wednesday, May 6, 2020
Desistance Free Essays
string(46) " were victims of their own lack of insight\)\." Criminology Criminal Justice à © 2006 SAGE Publications (London, Thousand Oaks New Delhi) and the British Society of Criminology. www. sagepublications. We will write a custom essay sample on Desistance or any similar topic only for you Order Now com ISSN 1748ââ¬â8958; Vol: 6(1): 39ââ¬â62 DOI: 10. 1177/1748895806060666 A desistance paradigm for offender management FERGUS McNEILL Universities of Glasgow and Strathclyde, UK Abstract In an in? uential article published in the British Journal of Social Work in 1979, Anthony Bottoms and Bill McWilliams proposed the adoption of a ââ¬Ënon-treatment paradigmââ¬â¢ for probation practice. Their argument rested on a careful and considered analysis not only of empirical evidence about the ineffectiveness of rehabilitative treatment but also of theoretical, moral and philosophical questions about such interventions. By 1994, emerging evidence about the potential effectiveness of some intervention programmes was suf? cient to lead Peter Raynor and Maurice Vanstone to suggest signi? cant revisions to the ââ¬Ënon-treatment paradigmââ¬â¢. In this article, it is argued that a different but equally relevant form of empirical evidenceââ¬âthat derived from desistance studiesââ¬âsuggests a need to re-evaluate these earlier paradigms for probation practice. This reevaluation is also required by the way that such studies enable us to understand and theorize both desistance itself and the role that penal professionals might play in supporting it. Ultimately, these empirical and theoretical insights drive us back to the complex interfaces between technical and moral questions that preoccupied Bottoms and McWilliams and that should feature more prominently in contemporary debates about the futures of ââ¬Ëoffender managementââ¬â¢ and of our penal systems. Key Words desistance â⬠¢ effectiveness â⬠¢ ethics â⬠¢ offender management â⬠¢ nontreatment paradigm â⬠¢ probation 39 40 Criminology Criminal Justice 6(1) Introduction Critical analysts of the history of ideas in the probation service have charted the various reconstructions of probation practice that have accompanied changes in penal theories, policies and sensibilities. Most famously, McWilliams (1983, 1985, 1986, 1987) described the transformations of probation from a missionary endeavour that aimed to save souls, to a professionalized endeavour that aimed to ââ¬Ëcureââ¬â¢ offending through rehabilitative treatment, to a pragmatic endeavour that aimed to provide alternatives to custody and practical help for offenders (see also Vanstone, 2004). More recent commentators have suggested later transformations of probation practice related ? rst to its recasting, in England and Wales, as ââ¬Ëpunishment in the communityââ¬â¢ and then to its increasing focus on risk management and public protection (Robinson and McNeill, 2004). In each of these eras of probation history, practitioners, academics and other commentators have sought to articulate new paradigms for probation practice. Though much of the debate about the merits of these paradigms has focused on empirical questions about the ef? acy of different approaches to the treatment and management of offenders, probation paradigms also re? ect, implicitly or explicitly, developments both in the philosophy and in the sociology of punishment. The origins of this article are similar in that the initial impetus for the development of a desistance paradigm for ââ¬Ëoffender managementââ¬â¢1 emerged from reviews of desistance research (McNeill, 2003) and, more speci? cally, from the ? ndings of some particularly important recent studies (Burnett, 1992; Rex, 1999; Maruna, 2001; Farrall, 2002). However, closer examination of some aspects of the desistance research also suggests a normative case for a new paradigm; indeed, some of the empirical evidence seems to make a necessity out of certain ââ¬Ëpractice virtuesââ¬â¢. That these virtues are arguably in decline as a result of the fore-fronting of risk and public protection in contemporary criminal justice serves to make the development of the case for a desistance paradigm both timely and necessary. To that end, the structure of this article is as follows. It begins with summaries of two important paradigms for probation practiceââ¬âthe ââ¬Ënontreatment paradigmââ¬â¢ (Bottoms and McWilliams, 1979) and the ââ¬Ërevised paradigmââ¬â¢ (Raynor and Vanstone, 1994). The article then proceeds with an analysis of the emerging theoretical and empirical case for a desistance paradigm. This section draws not only on the ? ndings of desistance studies but also on recent studies of the effectiveness of different approaches to securing ââ¬Ëpersonal changeââ¬â¢ in general and on recent developments in the ââ¬Ëwhat worksââ¬â¢ literature in particular. The ethical case for a desistance paradigm is then advanced not only in the light of the empirical evidence about the practical necessity of certain modes of ethical practice, but also in the light of developments in the philosophy of punishment, most notably the ideas associated with the work of the ââ¬Ënew rehabilitationistsââ¬â¢ (Lewis, 2005) and with Anthony Duffââ¬â¢s ââ¬Ëpenal communicationsââ¬â¢ theory (Duff, McNeillââ¬âA desistance paradigm for offender management 2001, 2003). In the concluding discussion, I try to sketch out some of the parameters of a desistance paradigm, though this is intended more as an attempt to stimulate debate about its development rather than to de? ne categorically its features. 41 Changing paradigms for probation practice Writing at the end of the 1970s, Bottoms and McWilliams declared the need for a new paradigm for probation practice, a paradigm that ââ¬Ëis theoretically rigorous, which takes very seriously the limitations of the treatment model; but which seeks to redirect the probation serviceââ¬â¢s traditional aims and values in the new penal and social contextââ¬â¢ (1979: 167). Bottoms and McWilliams proposed their paradigm against the backdrop of a prevailing view that treatment had been discredited both empirically and ethically. Though they did not review the empirical case in any great detail, they refer to several studies (Lipton et al. , 1975; Brody, 1976; Greenberg, 1976) as establishing the broad conclusion that ââ¬Ëdramatic reformative results are hard to discover and are usually absentââ¬â¢ (Bottoms and McWilliams, 1979: 160). They also stressed the theoretical inadequacies of the treatment model, noting several ? aws in the analogy between probation interventions and medical treatment; ? st, crime is voluntary whereas most diseases are not; second, crime is not pathological in any straightforward sense; and third, individual treatment models neglect the social causes of crime. Worse still, neglect of these ? aws produced ethical problems; they argued that over-con? dence in the prospects for effecting change through treatment had permitted its advocates both to coerce offenders into interventions (because the treatment provider was an expert who knew best) and to ignore offendersââ¬â¢ views of their own situations (because offenders were victims of their own lack of insight). You read "Desistance" in category "Essay examples" Perhaps most insidiously of all, within this ideology coerced treatment could be justi? ed in offendersââ¬â¢ own best interests. Bottoms and McWilliams also discerned an important ââ¬Ëimplicit con? ict between the determinism implied in diagnosis and treatment and the frequently stressed casework principle of client selfdeterminationââ¬â¢ (1979: 166). How can offenders be simultaneously the objects on whom psychological, physical and social forces operate (as the term diagnosis implies) and the authors of their own futures (as the principle of self-determination requires)? Bottoms and McWilliamsââ¬â¢ hope was that by exposing the weaknesses of the treatment paradigm, they would allow for a renaissance of the probation serviceââ¬â¢s traditional core values of hope and respect for persons. They suggested that the four primary aims of the service ââ¬Ëare and have been: 1 2 3 4 The provision of appropriate help for offenders The statutory supervision of offenders Diverting appropriate offenders from custodial sentences The reduction of crimeââ¬â¢ (1979: 168). 42 Criminology Criminal Justice 6(1) It is their discussion of the ? rst and second of these objectives that is most relevant to the discussion here. However, it is worth noting ? rst that, for Bottoms and McWilliams, the problem with the treatment model was that it assumed that the fourth objective must be achieved through the pursuit of the ? rst three; an assumption that they suggested could not be sustained empirically. 2 With regard to the provision of help as opposed to treatment, Bottoms and McWilliams rejected the ââ¬Ëobjecti? cationââ¬â¢ of offenders implied in the ââ¬Ëcasework relationshipââ¬â¢, wherein the offender becomes an object to be treated, cured or managed in and through social policy and professional practice. One consequence of this objecti? ation, they suggested, is that the formulation of treatment plans rests with the expert; the approach is essentially ââ¬Ëof? cer-centredââ¬â¢. Bottoms and McWilliams (1979: 173) suggested, by way of contrast, that in the non-treatment paradigm: (a) Treatment (b) Diagnosis (c) Clientââ¬â¢s Dependent Need as the basis for social work action becomes becom es becomes Help Shared Assessment Collaboratively De? ned Task as the basis for social work action In this formulation, ââ¬Ëhelpââ¬â¢ includes but is not limited to material help; probation may continue to address emotional or psychological dif? ulties, but this is no longer its raison dââ¬â¢etre. Critically, the test of any proposed intervention technique is that it must help the client. Bottoms and McWilliams (1979: 174) explicitly disavowed any claim that the help model would be bene? cial in the reduction of crime. 3 Having reconceived of probation practice as help rather than treatment, Bottoms and McWilliamsââ¬â¢ discussion of probationââ¬â¢s second aim, the statutory supervision of offenders, explored the implicit tensions between help and surveillance. Accepting that probation of? cers are ââ¬Ëlaw enforcementââ¬â¢ agents as well as helpers, they drew on an article by Raynor (1978) that argued for a crucial distinction between coercion and constraint; ââ¬Ëchoice under constraint is morally acceptable; manipulative coercion is notââ¬â¢ (Bottoms and McWilliams, 1979: 177). Following Raynor, they suggested that making this distinction meaningful required probation of? cers actively to seek, within the constraints of the probation order, to maximize the area of choice for the offender. Their paradigm therefore invoked a distinction between the compulsory requirements imposed by the court (with the offenderââ¬â¢s constrained consent) and the substantive content of the helping process. In the latter connection, the ââ¬Ëclientââ¬â¢ should be free to choose to accept or reject help without fear of further sanctions. Put another way, the authority for supervision derives from the court but the authority for help resides in the offender. For Bottoms and McWilliams this required that the (then) legal requirement of consent by defendants to probation and community ervice should be taken much more seriously; indeed, they suggested that so as to avoid compulsory help McNeillââ¬âA desistance paradigm for offender management arising from a probation recommendation, defendantsââ¬â¢ consent to such recommendations should be required. Where consent was absent, no such recommendation should be made. Fifteen years later, Peter Raynor and Maurice Vanstone (1994) argu ed that the non-treatment paradigmââ¬âa paradigm that they clearly regarded as being well worthy of the in? uence that it had exercised in the intervening yearsââ¬âwas none the less in need of revision. The resurgence of optimism about the potential effectiveness of some forms of ââ¬Ëtreatmentââ¬â¢ led Raynor and Vanstone to argue that the foundations of the non-treatment paradigm, ââ¬Ëbuilt as they were out of a mixture of doubt and scepticism about the crime-reducing potential of rehabilitation, have produced cracks in the structureââ¬â¢ (1994: 396): By uncoupling ââ¬Ëhelping offendersââ¬â¢ from ââ¬Ëcrime reductionââ¬â¢, the paradigm is prevented from exploring whether work with individuals on their thinking, behaviour and attitudes has any relevance to crime reduction. Current knowledge of research into effectiveness necessitates, therefore, a rede? ing of the concept of appropriate help in a way that retains the principle of collaboration, and the stress on client needs, but which incorporates informed practice focused on in? uencing and helping individuals to stop offending . . . This should not detract from the need to address the social and economic co ntext of crime. (Raynor and Vanstone, 1994: 398) 43 It is clear that Raynor and Vanstone (1994) were not advocating a return to a treatment paradigm; rather, in their discussion of intervention ââ¬Ëprogrammesââ¬â¢, they explicitly rejected Bottoms and McWilliamsââ¬â¢ dichotomization of treatment and help. More speci? cally, Raynor and Vanstone questioned the assumption that critiques of psychodynamic approaches as ââ¬Ëinvolving disguised coercion, denial of clientsââ¬â¢ views, the objecti? cation of people, and a demonstrable lack of effectiveness when applied to offendersââ¬â¢ (1994: 399) could be equally applied to all forms of treatment. This false assumption, they argued, led Bottoms and McWilliams to ââ¬Ëignore other possible bases for intervention outside the ââ¬Å"medical modelâ⬠and encouraged the reader to identify all attempts to in? uence offenders as ethically objectionable treatmentââ¬â¢ (Raynor and Vanstone, 1994: 400). A further crucial problem with the ââ¬Ënon-treatment paradigmââ¬â¢ rested in its neglect of victims. The arguments of left realist criminologists (Young, 1988) persuaded Raynor and Vanstone (1994) that the traditional probation value of ââ¬Ërespect for personsââ¬â¢ had to include the actual and potential victims of crime. This in turn implied that the extent to which client (that is, offender) choice could be respected and unconditional help could be offered had some necessary limitations; essentially, probation had to accept an obligation to work to reduce the harms caused by crime, as well as the ills that provoke it. Thus: Compensatory help and empowerment of offenders are a proper response to situations where individuals have had few opportunities to avoid crime, but 44 Criminology Criminal Justice 6(1) their purpose is not simply to widen offendersââ¬â¢ choices: it includes doing so in a manner consistent with a wider goal of crime reduction. Such a goal is not simply in the interests of the powerful: although criminal justice in an unequal society re? ects and is distorted by its inequalities, the least powerful suffer some of the most common kinds of crime and are most in need of protection from it. This includes, of course, many offenders who are themselves victims of crime . . . ) (Raynor and Vanstone, 1994: 401) Raynor and Vanstone (1994: 402) concluded by adapting Bottoms and McWilliamsââ¬â¢ (1979) schematic summary of their paradigm: (a) Help becomes Help consistent with a commitment to the reduction of harm Explicit dialogue and negotiation offering opportunities for informed con sent to involvement in a process of change Collaboratively de? ned task relevant to criminogenic needs, and potentially effective in meeting them b) Shared assessment becomes (c) Collaboratively de? ned task becomes In terms of both organizational change and practice development, the 10 years that followed the publication of Raynor and Vanstoneââ¬â¢s (1994) article have been even more tumultuous than the years between the publication of the non-treatment paradigm and its revision. It is beyond the scope of this article to give an account of these changes (see Nellis, 1999; Raynor and Vanstone, 2002; Mair, 2004; Robinson and McNeill, 2004). Indeed, since the purpose of this article is to consider how the practice of offender management should be reconstructed in the light of the desistance research, there is some merit in ignoring how it has been reconstructed for more political and pragmatic reasons. That said, two particular developments require comment. The ? rst relates to changes in formulations of the purposes of probation since the publication of the earlier paradigms. Without entering into the ongoing debates about the recasting of probationââ¬â¢s purposes south of the border (see Robinson and McNeill, 2004; Worrall and Hoy, 2005), it is suf? cient to state that, in contrast to the four aims outlined by Bottoms and McWilliamsââ¬âaims which were still uncontested by Raynor and Vanstone in 1994ââ¬âthe new National Offender Management Service, incorporating prisons and probation, exists to manage offenders and in so doing to provide a service to the ââ¬Ëlaw-abidingââ¬â¢ public. Its objectives are to punish offenders and to reduce re-offending (Blunkett, 2004: 10). The second development concerns the application of a particular approach to developing effective probation practice in England and Wales in McNeillââ¬âA desistance paradigm for offender management the form of the ââ¬Ëwhat worksââ¬â¢ initiative (McNeill, 2001, 2004a). In effect, this initiative involves the imposition from the centre of an implicit ââ¬Ëwhat worksââ¬â¢ paradigm for probation practice. Once again the debates about the characteristics, implications and ? aws of this paradigm are complex (see Mair, 2004). Perhaps he easiest way to summarize the paradigm however, is to suggest a further revision to Raynor and Vanstoneââ¬â¢s (1994) adaptation of Bottoms and McWilliamsââ¬â¢ (1979) schematic summary: (a) Help consistent with a commitment to the reduction of harm (b) Explicit dialogue and negotiation offering opportunities for informed consent to involvement in a process of change (c) Collaboratively de? ned task relevant to criminogenic needs, and potent ially effective in meeting them becomes Intervention required to reduce reoffending and protect the public Professional assessment of risk and need governed by the application of structured assessment instruments 5 becomes becomes Compulsory engagement in structured programmes and case management processes to address criminogenic needs ââ¬â as required elements of legal orders imposed irrespective of consent Theoretical and empirical arguments for a desistance paradigm4 A fundamental but perhaps inevitable problem with the non-treatment paradigm, the revised paradigm and the ââ¬Ëwhat worksââ¬â¢ paradigm is that they begin in the wrong place; that is, they begin by thinking about how practice (whether ââ¬Ëtreatmentââ¬â¢, ââ¬Ëhelpââ¬â¢ or ââ¬Ëprogrammesââ¬â¢) should be constructed without ? rst thinking about how change should be understood. For Bottoms and McWilliams (1979) this omission makes some sense, since their premise was that the prospects for practice securing individual change were bleak. However, for Raynor and Vanstone (1994) and for the prevailing ââ¬Ëwhat worksââ¬â¢ paradigm, the problem is more serious; given their reasonable optimism about the prospects for individual rehabilitation, the absence of a well-developed theory of how rehabilitation occurs is more problematic. 5 Understanding desistance The change process involved in the rehabilitation of offenders is desistance from offending. The muted impact that desistance research has had on policy and practice hitherto is both surprising and problematic because 46 Criminology Criminal Justice 6(1) knowledge about processes of desistance is clearly critical to our understandings of how and why ex-offenders come to change their behaviours. Indeed, building an understanding of the human processes and social contexts in and through which desistance occurs is a necessary precursor to developing practice paradigms; put another way, constructions of practice should be embedded in understandings of desistance. The implications of such embedding are signi? cant and far-reaching. Maruna et al. (2004) draw a parallel with a related shift in the ? eld of addictions away from the notion of treatment and towards the idea of recovery, quoting an in? uential essay by William White (2000): Treatment was birthed as an adjunct to recovery, but, as treatment grew in size and status, it de? ned recovery as an adjunct of itself. The original perspective needs to be recaptured. Treatment institutions need to once again become servants of the larger recovery process and the community in which that recovery is nested and sustained . . (White, 2000, cited in Maruna et al. , 2004: 9) Although the language of recovery may be inappropriate in relation to offenders, given both that it implies a medical model and that it suggests a prior state of well-being that may never have existed for many, the analogy is telling none the less. Put simply, the implication is that offender management services need to think of themselves less as providers of correctional treatment (that belongs to the expert) and more as supporters of desistance processes (that belong to the desister). In some respects, this shift in perspective, by re-emphasizing the offenderââ¬â¢s viewpoint, might re-invigorate the non-treatment paradigmââ¬â¢s rejection of the objecti? cation of the ââ¬Ëclientââ¬â¢ and of the elevation of the ââ¬Ëtherapistââ¬â¢. However, it does so not by rejecting ââ¬Ëtreatmentââ¬â¢ per se, but by seeing professional intervention as being, in some sense, subservient to a wider process that belongs to the desister. Before proceeding further, more needs to be said about how processes of desistance should be understood and theorized. Maruna (2001) identi? es three broad theoretical perspectives in the desistance literature: maturational reform, social bonds theory and narrative theory. Maturational reform (or ââ¬Ëontogenicââ¬â¢) theories have the longest history and are based on the established links between age and certain criminal behaviours, particularly street crime. Social bonds (or ââ¬Ësociogenicââ¬â¢) theories suggest that ties to family, employment or educational programmes in early adulthood explain changes in criminal behaviour across the life course. Where these ties exist, they create a stake in conformity, a reason to ââ¬Ëgo straightââ¬â¢. Where they are absent, people who offend have less to lose from continuing to offend. Narrative theories have emerged from more qualitative research which stresses the signi? cance of subjective changes in the personââ¬â¢s sense of self and identity, re? ected in changing motivations, greater concern for others and more consideration of the future. Bringing these perspectives together, Farrall stresses the signi? cance of the McNeillââ¬âA desistance paradigm for offender management relationships between ââ¬Ëobjectiveââ¬â¢ changes in the offenderââ¬â¢s life and his or her ââ¬Ësubjectiveââ¬â¢ assessment of the value or signi? cance of these changes: . . . the desistance literature has pointed to a range of factors associated with the ending of active involvement in offending. Most of these factors are related to acquiring ââ¬Ësomethingââ¬â¢ (most commonly employment, a life partner or a family) which the desister values in some way and which initiates a reevaluation of his or her own life . . (Farrall, 2002: 11) 47 Thus, desistance resides somewhere in the interfaces between developing personal maturity, changing social bonds associated with certain life transitions, and the individual subjective narrative constructions which offenders build around these key events and changes. It is not just the events and changes that matter; it is what these events and changes mean to the people involved. Clearly this understanding implies that desistance itself is not an event (like being cured of a disease) but a process. Desistance is necessarily about ceasing offending and then refraining from further offending over an extended period (for more detailed discussions see Maruna, 2001; Farrall, 2002; Maruna and Farrall, 2004). Maruna and Farrall (2004) suggest that it is helpful to distinguish primary desistance (the achievement of an offence-free period) from secondary desistance (an underlying change in self-identity wherein the ex-offender labels him or herself as such). Although Bottoms et al. 2004) have raised some doubts about the value of this distinction on the grounds that it may exaggerate the importance of cognitive changes which need not always accompany desistance, it does seem likely that where offender managers are dealing with (formerly) persistent offenders, the distinction may be useful; indeed, in those kinds of cases their role might be constructed as prompting, supporting and sustaining secondary desistance wherever this is possible. Moreover, further empirical support for the notion of secondary desistance (and its usefulness) might be found in Burnettââ¬â¢s (1992) study of efforts to desist among 130 adult property offenders released from custody. Burnett noted that while eight out of ten, when interviewed pre-release, wanted to ââ¬Ëgo straightââ¬â¢; six out of ten subsequently reported re-offending post-release. For many, the intention to be law-abiding was provisional in the sense that it did not represent a con? dent prediction; only one in four reported that they would de? itely be able to desist. Importantly, Burnett discovered that those who were most con? dent and optimistic about desisting had greatest success in doing so. For the others, the ââ¬Ëprovisional nature of intentions re? ected social dif? culties and personal problems that the men facedââ¬â¢ (Burnett, 2000: 14). That this implies the need for intentions to desist to be grounded in changes of identity is perhaps supported by Bu rnettââ¬â¢s ? ndings about different types of desisters. She discerned three 48 Criminology Criminal Justice 6(1) categories: ââ¬Ënon-startersââ¬â¢ who adamantly denied that they were ââ¬Ëreal criminalsââ¬â¢ and, in fact, had fewer previous convictions than the others; ââ¬Ëavoidersââ¬â¢, for whom keeping out of prison was the key issue; and ââ¬Ëconvertsââ¬â¢ who appeared to have decided that the costs of crime outweighed the bene? ts. Indeed, the converts were: the most resolute and certain among the desisters. They had found new interests that were all-preoccupying and overturned their value system: a partner, a child, a good job, a new vocation. These were attainments that they were not prepared to jeopardize or which over-rode any interest in or need for property crime. (Burnett, 2000: 14) Although Burnett notes that, for most of the men involved in her study, processes of desistance were characterized by ambivalence and vacillation, the over-turning of value systems and all pre-occupying new interests that characterized the ââ¬Ëconvertsââ¬â¢ seem to imply the kind of identity changes invoked in the notion of secondary desistance. Marunaââ¬â¢s (2001) study offers a particularly important contribution to understanding secondary desistance by exploring the subjective dimensions of change. Maruna compared the narrative ââ¬Ëscriptsââ¬â¢ of 20 persisters and 30 desisters who shared similar criminogenic traits and backgrounds and who lived in similarly criminogenic environments. In the ââ¬Ëcondemnation scriptââ¬â¢ that emerged from the persisters, ââ¬ËThe condemned person is the narrator (although he or she reserves plenty of blame for society as well). Active offenders . . . argely saw their life scripts as having been written for them a long time agoââ¬â¢ (Maruna, 2001: 75). By contrast, the accounts of the desisters revealed a different narrative: The redemption script begins by establishing the goodness and conventionality of the narratorââ¬âa victim of society who gets involved with crime and drugs to achieve some sort of power over otherwise bleak circumstances. This deviance eventuall y becomes its own trap, however, as the narrator becomes ensnared in the vicious cycle of crime and imprisonment. Yet, with the help of some outside force, someone who ââ¬Ëbelieved inââ¬â¢ the ex-offender, the narrator is able to accomplish what he or she was ââ¬Ëalways meant to doââ¬â¢. Newly empowered, he or she now seeks to ââ¬Ëgive something backââ¬â¢ to society as a display of gratitude. (Maruna, 2001: 87) The desisters and the persisters shared the same sense of fatalism in their accounts of the development of their criminal careers; however, Maruna reads the minimization of responsibility implied by this fatalism as evidence of the conventionality of their values and aspirations and of their need to believe in the essential goodness of the ââ¬Ëreal meââ¬â¢. Moreover, in their accounts of achieving change there is evidence that desisters have to ââ¬Ëdiscoverââ¬â¢ agency in order to resist and overcome the criminogenic structural pressures that play upon them. This discovery of agency seems to McNeillââ¬âA desistance paradigm for offender management relate to the role of signi? cant others in envisioning an alternative identity and an alternative future for the offender even through periods when they cannot see these possibilities for themselves. Typically later in the process of change, involvement in ââ¬Ëgenerative activitiesââ¬â¢ (which usually make a contribution to the well-being of others) plays a part in testifying to the desister that an alternative ââ¬Ëagenticââ¬â¢ identity is being or has been forged. Intriguingly, the process of discovering agency, on one level at least, sheds interesting light on the apparent theoretical inconsistency that Bottoms and McWilliams (1979) inferred from the treatment paradigm; that is, an inconsistency between its deterministic analysis of the causes of criminality and its focus on self-determination in the treatment process. Arguably what Maruna (2001) has revealed is the role of re? exivity in both revealing and producing shifts in the dynamic relationships between agency and structure (see also Farrall and Bowling, 1999). Supporting desistance The implications for practice of this developing evidence base have begun to be explored in a small number of research studies that have focused on the role that probation may play in supporting desistance (for example Rex, 1999; Farrall, 2002; McCulloch, 2005). In one study of ââ¬Ëassisted desistanceââ¬â¢, Rex (1999) explored the experiences of 60 probationers. She found that those who attributed changes in their behaviour to probation supervision described it as active and participatory. Probationersââ¬â¢ commitments to desist appeared to be generated by the personal and professional commitment shown by their probation of? cers, whose reasonableness, fairness and encouragement seemed to engender a sense of personal loyalty and accountability. Probationers interpreted advice about their behaviours and underlying problems as evidence of concern for them as people, and ââ¬Ëwere motivated by what they saw as a display of interest in their wellbeingââ¬â¢ (Rex, 1999: 375). Such evidence resonates with other arguments about the pivotal role that relationships play in effective interventions (Barry, 2000; Burnett, 2004; Burnett and McNeill, 2005; McNeill et al. , 2005). If secondary desistance (for those involved in persistent offending at least) requires a narrative reconstruction of identity, then it seems obvious why the relational aspects of practice are so signi? cant. Who would risk engaging in such a precarious and threatening venture without the reassurance of sustained and compassionate support from a trusted source? However, workers and working relationships are neither the only nor the most important resources in promoting desistance. Related studies of young people in trouble suggest that their own resources and social networks are often better at resolving their dif? culties than professional staff (Hill, 1999). The potential of social networks is highlighted by ââ¬Ëresilience perspectivesââ¬â¢, which, in contrast with approaches that dwell on risks and/or needs, consider the ââ¬Ëprotective factors and processesââ¬â¢ involved in positive adaptation in spite of adversity. In terms of practice with young 49 50 Criminology Criminal Justice 6(1) people, such perspectives entail an emphasis on the recognition, exploitation and development of their competences, resources, skills and assets (Schoon and Bynner, 2003). In similar vein, but in relation to re-entry of ex-prisoners to society, Maruna and LeBel (2003) have made a convincing case for the development of strengths-based (rather than needs-based or risk-based) narratives and approaches. Drawing on both psychological and criminological evidence, they argue that such approaches would be likely both to enhance compliance with parole conditions and to encourage exprisoners to achieve ââ¬Ëearned redemptionââ¬â¢ (Bazemore, 1999) by focusing on the positive contributions through which they might make good to their communities. Thus promoting desistance also means striving to develop the offenderââ¬â¢s strengthsââ¬âat both an individual and a social network levelââ¬âin order to build and sustain the momentum for change. In looking towards these personal and social contexts of desistance, the most recent and perhaps most wide-scale study of probation and desistance is particularly pertinent to the development of a desistance paradigm. Farrall (2002) explored the progress or lack of progress towards desistance achieved by a group of 199 probationers. Though over half of the sample evidenced progress towards desistance, Farrall found that desistance could be attributed to speci? c interventions by the probation of? cer in only a few cases, although help with ? ding work and mending damaged family relationships appeared particularly important. Desistance seemed to relate more clearly to the probationersââ¬â¢ motivations and to the social and personal contexts in which various obstacles to desistance were addressed. Farrall (2002) goes on to argue that interventions must pay greater heed to the community, social and personal contexts in which they are situated (see also McCulloch, 2005). After all, â â¬Ësocial circumstances and relationships with others are both the object of the intervention and the medium through which . . . change can be achievedââ¬â¢ (Farrall, 2002: 212, emphases added). Necessarily, this requires that interventions be focused not solely on the individual person and his or her perceived ââ¬Ëde? citsââ¬â¢. As Farrall (2002) notes, the problem with such interventions is that while they can build human capital, for example, in terms of enhanced cognitive skills or improved employability, they cannot generate the social capital that resides in the relationships through which we achieve participation and inclusion in society. 6 Vitally, it is social capital that is necessary to encourage desistance. It is not enough to build capacities for change where change depends on opportunities to exercise capacities: ââ¬Ë. . the process of desistance is one that is produced through an interplay between individual choices, and a range of wider social forces, institutional and societal practices which are beyond the control of the individualââ¬â¢ (Farrall and Bowling, 1999: 261). Barryââ¬â¢s (2004) recent study provides another key reference point for exploring how themes of capital, agency, identity and transition play out speci? cally for younger people desisting from offending. Through in-depth interviews with 20 young women and 20 young men, Barry explored why they started and stopped offending and what in? enced or inhibited them McNeillââ¬âA desistance paradigm for offender management in that behaviour as they grew older. The young people revealed that their decisions about offending and desisting were related to their need to feel included in their social world, through friendships in childhood and through wider commitments in adulthood. The resolve displayed by the young people in desisting from offending seemed remarkable to Barry, particularly given that they were from disadvantaged backgrounds and were limited in their access to mainstream pportunities (employment, housing and social status) both because of their age and because of their social class. Barry recognizes crucially that: Because of their transitional s ituation, many young people lack the status and opportunities of full citizens and thus have limited capacity for social recognition in terms of durable and legitimate means of both accumulating and expending capital through taking on responsibility and generativity . . . Accumulation of capital requires, to a certain extent, both responsibilities and access to opportunities; however, children and young people rarely have such opportunities because of their status as ââ¬Ëliminal entitiesââ¬â¢ (Turner, 1969), not least those from a working class background. (2004: 328ââ¬â9) 51 It is interesting to note that similar messages about the signi? cance both of the relational and of the social contexts of desistance have emerged recently from ââ¬Ëtreatmentââ¬â¢ research itself. Ten years on from McGuire and Priestleyââ¬â¢s (1995) original statement of ââ¬Ëwhat worksââ¬â¢, these neglected aspects of practice have re-emerged in revisions to and re? nements of the principles of effective practice. One authoritative recent review, for example, highlights the increasing attention that is being paid to the need for staff to use interpersonal skills, to exercise some discretion in their interventions, to take diversity among participants into account and to look at how the broader service context can best support effective practice (Raynor, 2004: 201). Raynor notes that neglect of these factors may account for some of the dif? culties experienced in England and Wales, for example, in translating the successes of demonstration projects to general practice. He suggests that the preoccupation with group programmes arises from their more standardized application, which, in turn, allows for more systematic evaluation than the complex and varied nature of individual practice. However, this pre-occupation (with programmes), ironically perhaps, is undermined by the literature on treatment effectiveness in psychotherapy and counselling; arguably the parent discipline of ââ¬Ëwhat worksââ¬â¢. Here, the evidence suggests that the most crucial variables of all in determining treatment outcomesââ¬âchance factors, external factors and ââ¬Ëclientââ¬â¢ factorsââ¬â relate to the personal and social contexts of interventions rather than to their contents (Asay and Lambert, 1999). Moreover, in terms of those variables which the therapist can in? uence, it is a recurring ? nding that no method of intervention is any more effective than the rest, and, instead, that there are common aspects of each intervention that are responsible for bringing about change (see Hubble et al. , 1999; Bozarth, 2000). These 52 Criminology Criminal Justice 6(1) ââ¬Ëcore conditionsââ¬â¢ for effectivenessââ¬âempathy and genuineness; the establishment of a working alliance; and using person-centred, collaborative and ââ¬Ëclient-drivenââ¬â¢ approachesââ¬âare perhaps familiar to probation staff, but not from earlier reviews of ââ¬Ëwhat works? ââ¬â¢. 7 With regard to the probation paradigms reviewed earlier, these ? ndings are particularly signi? cant because, despite the disciplinary location and positivist approaches of these studies, the forms of treatment that they commend seem to be some way removed from those criticized by Bottoms and McWilliams (1979). Indeed, the notion of therapeutic or working alliance implies, as Bottoms and McWilliams (1979) advocated, that the worker and client share agreement on overall goals, agreement on the tasks that will lead to achievement of these goals and a bond of mutual respect and trust (Bordin, 1979). This seems explicitly to preclude the kind of attitudes and practices that Bottoms and McWilliams (1979) associated with treatment and that arguably characterize the prevailing ââ¬Ëwhat worksââ¬â¢ paradigm (McNeill, 2004b). Ethical arguments for a desistance paradigm Leaving aside these emerging empirical ? ndings and theoretical issues, desistance research has some clear ethical implications for the practice of offender management. The ? rst of these implications is perhaps already obvious. Rexââ¬â¢s (1999) research, reviewed in the context both of Marunaââ¬â¢s (2001) account of narrative reconstruction and of the evidence from psychotherapy research about the critical signi? cance of certain core conditions for treatment, points to the importance of developing penal practices that express certain practical virtues. Virtue-based approaches to ethics have experienced something of a resurgence in recent years (Pence, 1991), suggesting a shift in moral thinking from the question ââ¬Ëwhat ought I to do? ââ¬â¢ to the question ââ¬Ëwhat sort of person should I be? ââ¬â¢ In this context, one of the merits of desistance research is that by asking offenders about their experiences both of attempting desistance and of supervision, progress is made towards answering the question that a would-be ââ¬Ëvirtuousââ¬â¢ offender manager might ask: What sort of practitioner should I be? The virtues featured in responses from desisters might include optimism, hopefulness, patience, persistence, fairness, respectfulness, trustworthiness, loyalty, wisdom, compassion, ? exibility and sensitivity (to difference), for example. The practical import of the expression of these virtues is suggested by recent discussions of the enforcement of community penalties, which have emerged particularly (but not exclusively) where community penalties have been recast as ââ¬Ëpunishment in the communityââ¬â¢. This recasting of purpose has increased the need for effective enforcement in order that courts regard community penalties as credible disposals. Though the language of ââ¬Ëenforcementââ¬â¢ implies an emphasis on ensuring the meaningfulness and inevitability of sanctions in the event of non-compliance, Bottoms (2001) has argued convincingly that attempts to encourage or require compliance in McNeillââ¬âA desistance paradigm for offender management the criminal justice system must creatively mix habitual mechanisms, constraint-based mechanisms, instrumental mechanisms and normative mechanisms (related to beliefs, attachments and perceptions of legitimacy). What seems clear from the desistance research is that, through the establishment of effective relationships, the workerââ¬â¢s role in supporting compliance is likely to be particularly crucial to the development of these normative mechanisms. It is only within relationships that model the kinds of virtues described above that the formal authority conferred on the worker by the court is likely to be rendered legitimate in the mind of the offender. Just as perceptions of legitimacy play a key role in encouraging compliance with prison regimes (Sparks et al. 1996), so in the community legitimacy is likely to be a crucial factor both in preventing breach by persuading offenders to comply with the order and, perhaps, in preventing recidivism by persuading offenders to comply with the law. This notion of moral persuasion (and modelling) as a role for offender managers resonates with some aspects of Anthony Duffââ¬â¢s penal communications theory (Duff, 2001, 2003). Duff (2003) has arg ued that probation can and should be considered a mode of punishment; indeed he argues that it could be the model punishment. However, the notion of punishment that he advances is not ââ¬Ëmerely punitiveââ¬â¢; that is, it is not concerned simply with the in? iction of pain as a form of retribution. Rather it is a form of ââ¬Ëconstructive punishmentââ¬â¢ that in? icts pain only in so far as this is an inevitable (and intended) consequence of ââ¬Ëbringing offenders to face up to the effects and implications of their crimes, to rehabilitate them and to secure . . . reparation and reconciliationââ¬â¢ (Duff, 2003: 181). The pains involved are akin to the unavoidable pains of repentance. For Duff, this implies a role for probation staff as mediators between offenders, victims and the wider community. Though developing the connections between Duffââ¬â¢s theory and desistance research is beyond the scope of this article, Marunaââ¬â¢s (2001) study underlines the signi? cance for desisters of the ââ¬Ëredemptionââ¬â¢ that is often achieved through engagement in ââ¬Ëgenerative activitiesââ¬â¢ which help to make sense of a damaged past by using it to protect the future interests of others. It seems signi? ant that this ââ¬Ëbuying backââ¬â¢ is productive rather than destructive; that is, the right to be rehabilitated is not the product of experiencing the pains of ââ¬Ëmerely punitiveââ¬â¢ punishment, rather it is the result of evidencing repentance and change by ââ¬Ëmaking goodââ¬â¢. In working to support the reconstruction of identity involved in desistance, this seems to underline the relevance of the redemptive opportunities that both c ommunity penalties and restorative justice approaches might offer. No less obvious, by contrast, are the futility and counter-productiveness of penal measures that label, that exclude and that segregate and co-locate offenders as offenders. Such measures seem designed to con? rm and cement ââ¬Ëcondemnation scriptsââ¬â¢ and thus to frustrate desistance. However, as well as highlighting the importance of encouraging and supporting offenders in the painful process of making good, the desistance 53 54 Criminology Criminal Justice 6(1) research at least hints at the reciprocal need for society to make good to offenders. Just as both Bottoms and McWilliams (1979) and Raynor and Vanstone (1994) recognized the moral implications of accepting the role that social inequalities and injustices play in provoking offending behaviour, so Duff (2003) argues that the existence of social injustice creates moral problems for the punishing polity. The response must be ââ¬Ëa genuine and visible attempt to remedy the injustices and exclusion that they [that is, some offenders] have sufferedââ¬â¢ (Duff, 2003: 194). Duff suggests that this implies that: the probation of? cer . . . ill now have to help the offender negotiate his relationship with the polity against which he has offended, but by whom he has been treated unjustly and disrespectfully: she must speak for the polity to the offender in terms that are censorious but also apologeticââ¬âterms that seek both to bring him to recognise the wrong he has done and to express an apologetic recognition of the injustice he has suffered: and she must speak to t he polity for the offender, explaining what is due to him as well as what is due for him. (2003: 194, emphasis added) Thus the help and practical support advocated in the non-treatment paradigm can now be re-legitimated both empirically, in terms of the need to build social capital in supporting desistance, and normatively (even within a punishment discourse) as a prerequisite for making punishment both intelligible and just for offenders. Recognition of interactions between, on the one hand, exclusion and inequalities and, on the other, crime and justice, also lies behind some of the arguments for rehabilitative approaches to punishment. Such arguments tend to lead to rights-based rather than utilitarian versions of rehabilitation. For McWilliams and Pease (1990), rights-based rehabilitation serves a moral purpose on behalf of society in limiting punishment and preventing exclusion by working to re-establish the rights and the social standing of the offender. By contrast, Garland (1997) describes how, in late-modern penality, a more instrumental version of rehabilitation has emerged in which the offender need not (perhaps cannot) be respected as an end in himself or herself; he or she has become the means to another end. He or she is not, in a sense, the subject of the court order, but its object. In this version, rehabilitation is not an over-riding purpose, it is a subordinate means. It is offence-centred rather than offender-centred; it targets criminogenic need rather than social need. The problem with this version of rehabilitation, however, is that it runs all the same moral risks that led Bottoms and McWilliams (1979) to reject treatment; it permits, in theory at least, all of the same injustices, violations of human rights and disproportionate intrusions that concerned, for example, the American Friends Services Committee in 1971, and led ultimately to the emergence of ââ¬Ëjust desertsââ¬â¢ (von Hirsch, 1976; Home Of? e, 1990). Indeed, in England and Wales, the current situation is worse in one respect: McNeillââ¬âA desistance paradigm for offender management the removal of the need for offendersââ¬â¢ consent to the imposition of community penalties (under the Crime (Sentences) Act 1997), which made some sense in the context of the move towards seeing prob ation as a proportionate punishment, means that offenders can now be compelled to undertake ââ¬Ëtreatmentââ¬â¢ in the form of accredited programmes. In a recent article, Lewis (2005) has drawn on the work of the ââ¬Ënew rehabilitationistsââ¬â¢ (Cullen and Gilbert, 1982; Rotman, 1990) to revive the case for a rights-based approach to rehabilitation; meaning one which is concerned with the reintegration of offenders into society as ââ¬Ëuseful human beingsââ¬â¢. According to Lewis, the principles of the new rehabilitationists include commitment to, ? rst, the stateââ¬â¢s duty to undertake rehabilitative work (for similar reasons to those outlined above); second, somehow setting limits on the intrusions of rehabilitation in terms of proportionality; third, maximizing voluntarism in the process; and, ? ally, using prison only as a measure of last resort because of its negative and damaging effects. In exploring the extent to which these principles are articulated and applied in current penal policy, she reaches the conclusion that ââ¬Ëcurrent rehabilitative efforts are window-dressing on an overly punitive ââ¬Å"man agerialistâ⬠systemââ¬â¢ (Lewis, 2005: 119), though she retains some hope that practitioner-led initiatives at the local level might allow some prospect that these principles could be applied. The value of the desistance research may be that just as the evidence about ââ¬Ënothing worksââ¬â¢ allowed Bottoms and McWilliams (1979) to make a theoretical and empirical case for more ethical practice, and the evidence that ââ¬Ësomething worksââ¬â¢ enabled Raynor and Vanstone (1994) to revise that case, so the evidence from desistance studies, when combined with these constructive developments in the philosophy of punishment, might do a similar job in a different and arguably more destructive penal climate. 55 Conclusions: a desistance paradigm This article has sought to follow the example offered by Bottoms and McWilliams (1979) and Raynor and Vanstone (1994) by trying to build both empirical and ethical cases for the development of a new paradigm for probation practice. In summary, I have suggested that desistance is the process that offender management exists to promote and support; that approaches to intervention should be embedded in understandings of desistance; and, that it is important to explore the connections between structure, agency, re? exivity and identity in desistance processes. Moreover, desistance-supporting interventions need to respect and foster agency and re? xivity; they need to be based on legitimate and respectful relationships; they need to focus on social capital (opportunities) as well as human capital (motivations and capacities); and they need to exploit strengths as well as addressing needs and risks. I have also suggested that desistance research highlights the relevance of certain ââ¬Ëpr actice virtuesââ¬â¢; that it requires a focus 56 Criminology Criminal Justice 6(1) on the role of legitimacy in supporting normative mechanisms of compliance; that it is consonant in many respects with communicative approaches to punishment which cast probation of? ers (or offender managers) as mediators between offenders, victims and communities; and that it suggests a rights-based approach to rehabilitation which entails both that the offender makes good to society and that, where injustice has been suffered by the offender, society makes good to the offender. Like the authors of the earlier paradigms, I do not intend here to offer a detailed account of precisely how a desistance paradigm might operate in practice (for some initial suggestions see McNeill, 2003). That task is one that could be more fruitfully undertaken by those working in the ? ld, preferably in association with offenders themselves. However, in an attempt to suggest some direction for such development, Table 1 summarizes the contrasts between the constructions of practice implied by the nontreatment, revised, ââ¬Ëwhat worksââ¬â¢ and desistance paradigms. Unlike the earlier paradigms, the desistance paradigm forefronts processes of change rather than modes of intervention. Practice under the desistance paradigm would certainly accommodate intervention to meet needs, reduce risks and (especially) to develop and exploit strengths, but Table 1. Probation practice in four paradigms The non-treatment paradigm Treatment becomes help The revised paradigm Help consistent with a commitment to the reduction of harm A ââ¬Ëwhat worksââ¬â¢ paradigm Intervention required to reduce re-offending and protect the public A desistance paradigm Help in navigating towards desistance to reduce harm and make good to offenders and victims8 Explicit dialogue and negotiation assessing risks, needs, strengths and resources and offering opportunities to make good Collaboratively de? ed tasks which tackle risks, needs and obstacles to desistance by using and developing the offenderââ¬â¢s human and social capital Diagnoses becomes shared assessment Explicit dialogue and negotiation offering opportunities for consensual change ââ¬ËProfessionalââ¬â¢ assessment of risk and need governed by structured assessment instruments Clientââ¬â¢s dependent need as the basis for action becomes collaboratively de? ned task as the basis for action Co llaboratively de? ed task relevant to criminogenic needs and potentially effective in meeting them Compulsory engagement in structured programmes and case management processes as required elements of legal orders imposed irrespective of consent McNeillââ¬âA desistance paradigm for offender management whatever these forms might be they would be subordinated to a more broadly conceived role in working out, on an individual basis, how the desistance process might best be prompted and supported. This would require the worker to act as an advocate providing a conduit to social capital as well as a ââ¬Ëtreatmentââ¬â¢ provider building human capital. Moreover, rather than being about the technical management of programmes and the disciplinary management of orders, as the current term ââ¬Ëoffender managerââ¬â¢ unhelpfully implies, the forms of engagement required by the paradigm would re-instate and place a high premium on collaboration and involvement in the process of co-designing interventions. Critically, such interventions would not be concerned solely with the prevention of further offending; they would be equally concerned with constructively addressing the harms caused by crime by encouraging offenders to make good through restorative processes and community service (in the broadest sense). But, as a morally and practically necessary corollary, they would be no less preoccupied with making good to offenders by enabling them to achieve inclusion and participation in society (and with it the progressive and positive reframing of their identities required to sustain desistance). Perhaps the most obvious problem that might be confronted by anyone seeking to envision further or even enact this paradigm, is that the communities on which its ultimate success would depend may lack the resources and the will to engage in supporting desistance, preferring to remain merely ââ¬Ëpunishing communitiesââ¬â¢ (Worrall and Hoy, 2005). This is, of course, an issue for any form of ââ¬Ëoffender managementââ¬â¢ or reintegration. However, rather than letting it become an excuse for dismissing the paradigm, it should drive us to a recognition of the need for offender management agencies to re-engage with community education and community involvement and to seek ways and means, at the local level and at the national level, to challenge populist punitiveness (Bottoms, 1995) and to offer more progressive alternatives. 57 Notes I am very grateful to Steve Farrall and Richard Sparks for their hospitality in hosting the seminars through which this article was developed and to all of the contributors to the seminars both for their helpful and encouraging comments on earlier versions and for the stimulation that their papers provided. I am also grateful to Monica Barry, Mike Nellis and Gwen Robinson for comments on the draft version of this article. Though I have grave reservations about the term ââ¬Ëoffender managementââ¬â¢ (relating to its obvious inference that the offender is a problem to be managed rather than person to be assisted and that the task is technical rather than moral), I use it here, not just because of its contemporary relevance, but also because it refers both to community disposals and postprison resettlement. 8 Criminology Criminal Justice 6(1) 2 Owing to their pessimism about the prospects for treatment delivering their fourth aim (the reduction of crime), Bottoms and McWilliams tu rned their attention to other crime reduction strategies and in particular to crime prevention. Their argument in this connection was essentially that because ââ¬Ëcrime is predominantly social . . . ny serious crime reduction strategy must be of a socially (rather than an individually) based characterââ¬â¢ (Bottoms and McWilliams, 1979: 188). 3 That said, they allowed that: ââ¬Ëthere is, ironically, at least a tiny shred of research evidence to suggest that, after all, help may be more crime-reducing than treatmentââ¬â¢ (Bottoms and McWilliams, 1979: 174). To support this claim they referred to two studies that presaged later desistance research; the ? st suggested that although intensive casework treatment had no apparent impact, changes in the post-institutional social situations of offenders (for example, getting married or securing a job) were associated with reductions in recidivism (Bottoms and McClintock, 1973); the second suggested that treatment did demonstrate lower reconviction rates where the ââ¬Ëtreatmentââ¬â¢ involved primarily practical help which was given only if and when offenders asked for it (Bernsten and Christiansen, 1965). 4 This section of the article draws heavily on McNeill et al. (2005). 5 It may be that this gap in theory s in part the product of the incremental and quasi-experimental character of ââ¬Ëwhat worksââ¬â¢ research; indeed it might even be said that the ââ¬Ëwhat worksââ¬â¢ philosophy is anti-theoretical in that it is more preoccupied with identifying and replicating successes than in explaining and understanding them (Farrall, 2002). 6 Signi? cantly, Boeck et al. ââ¬â¢s (2004) emerging ? ndings suggest that bridging social capital in particular (which facilitates social mobility) seems to be limited among those young people in their study involved in offending, leaving them ill-equipped to navigate risk successfully. That said, some recent studies have begun to explore the contribution of particular practice skills to effectiveness. Raynor refers in particular to a recent article by Dowden and Andrews (2004) based on a meta-analysis examining the contribution of certain key staff skills (which they term ââ¬Ëcore correctional practicesââ¬â¢ or CCPs) to the effectiveness of interventions with offenders. 8 It is with some unease that I have merely mentioned but not developed arguments about the importance of making good to (and for) victims in this article. I am therefore grateful to Mike Nellis for highlighting the contingent relationships between offenders making good and making amends to victims. There is little empirical evidence that desistance requires making amends or making good to particular victims, although there are of course independent and compelling reasons why this matters in its own right. As Nellis suggests (personal communication, 18 August 2005), the case for making amends requires separate justi? cation. He further suggests that from the point of view of interventions with offenders, it may be important not so much as an enabling factor in desistance as a signifying factor. Drawing on this distinction, my own view is that although making amends is neither necessary nor suf? cient for desistance to occur, it may be useful none the less in consigning the past to the past (for victims and offenders) and thus in entrenching redemption scripts (for offenders). McNeillââ¬âA desistance paradigm for offender management References American Friends Services Committee (1971) Struggle for Justice. New York: Hill Wang. Asay, T. P. and M. J. Lambert (1999) ââ¬ËThe Empirical Case for the Common Factors in Therapy: Quantitative Findingsââ¬â¢, in M. A. Hubble, B. L. Duncan and S. D. Miller (eds) The Heart and Soul of Change: What Works in Therapy, pp. 33ââ¬â56. Washington, DC: American Psychological Association. Barry, Monica (2000) ââ¬ËThe Mentor/Monitor Debate in Criminal Justice: What Works for Offendersââ¬â¢, British Journal of Social Work 30(5): 575ââ¬â95. Barry, M. A. (2004) ââ¬ËUnderstanding Youth Offending: In Search of ââ¬Å"Social Recognitionâ⬠ââ¬â¢, PhD dissertation, University of Stirling, Stirling. Bazemore, Gordon (1999) ââ¬ËAfter Shaming, Whither Reintegration: Restorative Justice and Relational Rehabilitationââ¬â¢, in G. Bazemore and L. Walgrave (eds) Restorative Juvenile Justice: Repairing the Harm of Youth Crime, pp. 55ââ¬â94. Monsey, NY: Criminal Justice Press. Bernsten, K. and K. O. Christiansen (1965) ââ¬ËA Resocialisation Experiment with Short-Term Offendersââ¬â¢, in K. O. Christiansen (ed. ) Scandinavian Studies in Criminology, vol. 1. London: Tavistock. Blunkett, David (2004) Reducing Crimeââ¬â Changing Lives: The Governmentââ¬â¢s Plans for Transforming the Management of Offenders. London: Home Of? ce. Boeck, Thilo, Jennie Fleming and Hazel Kemshall (2004) ââ¬ËYoung People, Social Capital and the Negotiation of Riskââ¬â¢, paper presented at the European Society of Criminology Annual Conference, Amsterdam, August. Bordin, E. (1979) ââ¬ËThe Generalizability of the Psychoanalytic Concept of the Working Allianceââ¬â¢, Psychotherapy 16: 252ââ¬â60. Bottoms, Anthony (1995) ââ¬ËThe Philosophy and Politics of Punishment and Sentencingââ¬â¢, in C. Clarkson and R. Morgan (eds) The Politics of Sentencing Reform, pp. 17ââ¬â49. Oxford: Oxford University Press. Bottoms, Anthony (2001) ââ¬ËCompliance and Community Penaltiesââ¬â¢, in A. Bottoms, L. Gelsthorpe an How to cite Desistance, Essay examples
Friday, May 1, 2020
Data Needs and Gaps
Questions: Closed-ended questions What is your gender? How long or how many years are you related with this organization? From which age group do you belong? Have you ever met a near miss in health care facility provision? How many times you have met a near miss in healthcare? Have you reported your near misses or errors? Is lack of knowledge factor contributing to the near misses? Do you think immediate reporting is important? Have you ever met a severe consequence of patient after a near miss in health care? Should there be a person to blame if near miss is reported?Open-ended Questions What is your age, gender and tenure of experience in health care settings? Do you have experience of near misses in health care settings? If yes, give a brief description. What is your point of view regarding reporting of near misses in health care settings? Have you ever gone through a situation when an unreported near miss led to serious health issue? How did you handle the situation? What factors in the he alth care settings of nursing are contributing to these kinds of behavior of not reporting? Do you know how important the reporting or documentation for these phenomenon are? From personal viewpoint, what are the specific needs for reducing these kinds of mistakes in health care settings? Can you suggest a reporting system or quality control check point which can help to reduce medical errors and influence reporting near misses? o you think incorporation of reporting system will enhance patient outcomes? Answers: Data Needs and Gaps Introduction The topic of the needs assessment study includes educating the importance of near misses or errors in a healthcare facility. The study has considered Registered nurses (RN) and Licensed practical nurses (LPN) as the target population for the study. This section of the study will focus on analyzing the gaps in data existing within the selected organization i.e. Baxter International, which might hinder the overall conductance of the study. Identification of the Gaps There are certain key gaps that is prevalent within the operations of Baxter International. One of the major gap relevant to data include the gap between the nurses and the patients and the health care unit (Strub, 2010). Errors mainly deem to occur in healthcare unit when there is a gap between assessment approaches of the nurses in context to the health issues of the patients. Another vital gap that has been identified in this context include lack of identification of the health issues of the patients in advance. In order to deal with or eliminate the near misses and error, RN should have the consensus to identify the health issues of the patients well in advance to deal with the same positively without any error (Crane et. al. 2015). There has been a lack of proper training for the RN within the selected health care units which is also can be seen as a potential issues of data gap. Furthermore, the management of the healthcare unit also lacks in terms of management of the informa tion relating to errors and near misses for using the same as future references to eliminate the issues (Baxter, 2016). There has been a large number of preventable error that has been highlighted as a part of new policy of the healthcare authorities. As per the analysis conducted within the selected healthcare unit i.e. Baxter International, there has also been a lack of monitoring from the management of the organization towards dealing with the problems of near misses and errors (Wolf Hughes, 2010). Proper monitoring of the approach of the nurses and healthcare professionals is vital as per the new policies of Medicare system to deal with the errors within the healthcare workplace. Owing this particular inability of the management of Baxter International, it becomes quite challenging for the unit to eliminate the preventable errors from the workplace (Manaq, 2011). As per the norms of Medicare system the preventable errors and close miss should not be ignored and hence Baxter Int ernational should also move positively in this regard. Identification of the Solutions There are certain solutions that can be developed in order to deal with the data gaps identified in the above section of the study. Notably, proper data management would one of the key attribute of managing errors and near misses within the healthcare workplace. When the management of the companies are able to record such incidents of errors and near misses, it would help in improving the same with proper training and development of the RNs. In this context, proper training and development can be regarded as a potential approach or solution at large. Another vital solution to deal with the identified issues include reediness of the nurses in their practices. This can be promoted through effective orientation program within the workplace of the selected healthcare organization (Pharmacol, 2009). The solutions that can be regarded as efficient in this context will include proper monitoring of the approaches of the RNs and Licensed practical nurses (LPN). Nursing practices for the RNs a nd LPNs will need to be able to get proper training for dealing with the errors and near misses involved with their work approach within the workplace. Teamwork will also be one of the solution that can be considered by the nurses within the operations of Baxter International. Teamwork can ensure that the nurses are able to work efficiently while dealing with the health issues of patients and work as a group to eliminate the all the unwanted errors. In this regard, the management of the healthcare organization needs to place close supervision upon the activities of the nurses while dealing with the patient. Hence, it can be seen that these solutions might work effectively towards eliminating the errors and close misses within the workplace (Pharmacol, 2009). Conclusion From the overall analysis, it can be concluded that eliminating close misses and errors within the workplace of healthcare organization can further work towards enhancing the prospect of patient care. This can also help in enhancing the operational quality of the healthcare organization. In this regard, both need gaps and the subsequent solutions relevant to the operations of Baxter International has been considered in this study. References Baxter. (2016). Sustainability. Retrieved from https://www.baxter.com/corporate-responsibility/sustainability/overview.page? Crane, S. et. al. (2015). Reporting and Using Near-miss Events to Improve Patient Safety in Diverse Primary Care Practices: A Collaborative Approach to Learning from Our Mistakes. Journal of the American Board of Family Medicine, 28 (4): 452-460. doi: 10.3122/jabfm.2015.04.140050. Manaq, J. N. (2011). Nurses' perceptions of medication errors and their contributing factors in South Korea. Blackwell Publishing Ltd, 19 (3):346-53. doi: 10.1111/j.1365-2834.2011.01249.x. Pharmacol, J. C. (2009). Medication errors: Emerging solutions. British Pharmacological Society, 67 (6): 589-591, doi: 10.1111/j.1365-2125.2009.03420.x. Strub, W. (2010). Near Miss Reporting: An Educational Program. Retrieved from https://fisherpub.sjfc.edu/cgi/viewcontent.cgi?article=1013context=nursing_etd_masters Wolf, Z. R. Hughes, R. G. (2010). Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK2652/
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