Enterprise Resource Planning Essay

Enterprise Resource Planning is a term that describes a system of business management in which all facets of a business are integrated. These include sales, manufacturing, planning and marketing . EPR is about integrating all these different aspects of business in one software. Software develops of ERP software include the Carter Group (who originally came up with the term), Peoplesoft, Oracle and SAP. There have been several attempts of ERP implementation that have been unsuccessful. Most of these failures happened in 1999, in an attempt to manage Y2K issues. This suggests that companies at the time may have been compelled to implement ERP due to pressing needs. The success of company’s that adopted ERP later shows that these late adopters have benefited from mistakes made by other companies. Current research indicates most recent implementations to be successful Failure of ERP projects occurs at varying degrees. When a project is not fully utilized it can be considered to have failed. Forrester Research in April 2001 reported that about 6 percent of 500 companies that they had surveyed found their ERP systems to be work effectively. Another 79 percent found their ERP systems to be ineffective or somewhat effective. The complexity of implementing ERP projects has been cited as a common and major for ERP implementation failure. The process requires commitment from all divisions of the company to be successful. It consumes a lot of time and is difficult as well as expensive to implement. The tight integration characteristic of the project means that without commitment from all workers and a change in the way of doing business means that it cannot work. ERP projects have been known to cost upwards of $500 million for very large companies and to take years to be fully complete. This happens without a guarantee of the eventual outcome Hershey Food’s SAPAG’s R/3 implementation illustrates this point best. The company incurred expenses of about $113 million and took thirty months on their ERP project. Upon completion in July 1999 the company had large problems of ensuring orders were pushed through the system. The result of this was delays in shipping and loss of customers due to orders that were incomplete. Some of the reasons given for this failure include the haste in which it was done. The ERP project if it had gone according to schedule would have taken 4 years rather than the short 30 months it took. Additionally, the company was at the same time implementing two other packages a logistics and customer relations package. This only made things more complex and harder for employees to learn. The time at which Hershey Food ‘went live’ with the ERP project happened to be the busiest time of their year, Halloween. Consequently the delays that resulted cost the company dearly leading to a $ 151 million fall in profits compared to the year before Most managers try to work around the complexities of the process rather than take the time, money and effort to go through the complex configuring process to ensure the ERP system fits with a company’s specificities. Using process templates is a short cut to make implementation faster and leads to generalization. This in the end has an effect of limiting performance and lowering competitive advantage. Speeding up the process often means that critical testing and adequate training of the users will be compromised. Inadequate training and education of employees is a common problem because training needs are almost always, underestimated. The crucial nature of ERP training cannot be overemphasized. Employees have to learn new software interfaces and processes in the business end. All this affect the whole project and the company. Outside consultant issues are another feature of most ERP failures. Sometimes the consultants hired may be in experienced or overstaffed leading to an increase in operating costs for the ERP project. Where more than one consultancy firm is used conflict almost always ensues. A forestry products manufacturer based in Atlanta used four consultancy firms at various stages of implementing its SAP project. The CIO reported that the consultants were in constant conflict over the best approach to the project. Control of the project seemed to be the main issue rather than forming a partnership with the manufacturer for the project’s success. The company finally shelved the project. FoxMeyer, a $5 million drug company contracted two vendors for its SAP R/3 project. The warehouse automation was bought from Pinnacle while Anderson had the job of integrating and implementing the Delta III project and the SAPR/3. The ERP project drove FoxMeyer Drugs to bankruptcy. Though there were other reasons for their failure but the use of two consultancy firms contributed a lot to an already complex situation. Incompetence of consultants in implementing the ERP project is common. Peoplesoft and Deloitte & Touche were sued by W. L. Gore following ERP failure after the system they had installed went live and resulted in many problems. Gore alleged that Deloitte & Touche were unqualified since when the system went live, the company had to depend on the customer service hotline following system problems. The company had to find other consultants to correct the damage caused causing hundreds of thousands of dollars in losses. Deloitte & Touche paid referral fees to Peoplesoft, this lead Peoplesoft to recommend them despite the fact they had no expertise for implementation of the software. FoxMeyer had a similar problem with the CLO reporting that the company was more like training ground for inexperienced consultants. When software is over customized, a problem is usually created. McFarlane of Western management consultants claims that modification of software results in trouble. He suggests modifying business processes instead. When software is modified, upgrading and testing become a problem increasing the chances of failure of the subject. Many businesses find it easier to purchase software rather than identify weaknesses in business process and improve them. It is best for the business process to fit the software and where there is absence of fit or appropriateness, the business process should be modified. The commander of Military Sealift Command decided to reduce risk of ERP implementation by finding a package that closely mirrored the business practices of MSC so as to avoid software modification. In only about 11 areas did the software fail to match and even then, the commander changed the MSC processes so that they would fit the Oracle ERP software they were using. Application of technology as a solution to problems of business processes is another reason for failure of ERP. Many ERP initiatives are system driven; these have a higher probability of failure compared to those that are business driven. Most companies consider ERP implementation as a competency by itself that could serve as a fix to a problem. This should not be the case since technology is a vehicle by which competency can be obtained rather than a competency by itself. This was FoxMeyer’s mistake. By adopting ERP early the company took up software that was designed for manufacturing companies rather than distribution companies. With this major underlying problem there is no way the ERP project could have been a success. The software could not handle processing demands leading to FoxMeyer’s bankruptcy. Corporate culture also has great influence as far as the failure of ERP implementation is concerned. When top management is not seen to be backing up the project it is not very well recognized. In addition most ERP projects are rejected by employees who fear that their jobs will be lost. Failure to realize the benefits of the projects leads to a resistance to change. Management has a role in this because if they were to communicate effectively to the employees, there would be increased ownership of the project. To foster buy-in and ownership, employee involvement should be as high as possible otherwise employees will back out or refuse to be cooperative leading to failure of the project. FoxMeyer had such a problem, most employees felt that their jobs were threatened by the ERP project and some of them even trashed the interfaces set up while others simply did not participate in training leading to delays in orders and general mismanagement of the whole distribution process. The aforementioned forestry manufacturing produces did not put into consideration the effect of ERP implementation on its Vice Presidents. The Vice presidents of the 12 divisions in the company would have lost their autonomy to a more centralized and integrated system. When the VPs realized the effect of the company’s long-term strategies they balked leading to scraping off of the subject. Testing of the ERP project requires time and effort. Whenever a red flag is raised, the system should be checked. Miscalculation of how much time and effort will be required leads to failure of the project. It is better to exceed the timeline rather than compress the time required for completion of the project and end up with system that is flawed. Sticking to a schedule despite the problems that have been identified will cause problems later. This is evident from the troubles experienced by Whirlpool following its SAP system implementation. The company went live in spite of the fact that problems had been identified in the testing phase. The decision not to change their schedule led to shipping delays with appliances in warehouses for upwards of six-weeks past their correct delivery time. Meritor experienced a similar problem. Believing they had adequate training, they began to roll out the ERP system in phases beginning with a manufacturing plant in Wales. It took another 30 days with more staff to ensure that manufacturing would not be delayed. To prevent a problem like that from occurring in the future, the Vice President added another two weeks to ERP deployment timeline. Though this requires extra time and consequently more expenses an attitude more like this is necessary for the ERP rollout to be a success. The mainframe at Cleveland State University could not handle the application by Peoplesoft necessitating a change to a Unix System. The problems created by this failure of infrastructure lasted for a year following the first rollout of the ERP project. Bio Rad Laboratories had a problem along the same line. The implementation of their ERP system led to WAN becoming very slow as a result of conflict between ERP and email traffic. Email alone was using up the greater percentage of the bandwidth available between locations. This had the effect of important data in the ERP system distribution and financial modules being left to languish at some sites. This caused stalling of orders and slowed product shipment. From the two examples cited above it is evident ERP failure can result from poor infrastructure. Infrastructure appraisal is therefore necessary to ensure that it can support implementation of an ERP system. If this is done early the infrastructure can be modified early to suit the desired ERP system. This will lead to reduction in costs due to problems or failure of initial rollout of the ERP system. The intellectual capital of the company as far as the ERP system is a significant factor that contributes to failure of ERP systems. Often when the project is complete and within months after the exodus of the consultants most companies are left in trouble. This is because most companies do not have their own person(s) who are capable of dealing with problems in the ERP system. This was the case in FoxMeyer where upon the departure of the consultant firm staff, the company was left without people who could manage the ERP system effectively. This brain drain effect happened to a semiconductor manufacturer in Silicon Valley. The manufacturer lost about 70-80 percent of the projects core-team in about three months following ‘go live’ after most members of the core-project team had left. This loss meant that there was no one familiar with the project to address issues concerning the system that came up. User expectations may also cause ERP systems to fail when users expect that the return on investment will be unrealistically high. Usually, the costs of planning, consultation, training and testing as well as data conversion, replacement staffing, documentation and the drop in learning performance are all factors that will reduce the benefits anticipated from an ERP system. Other expectations like expecting a really short time of implementation of the system will lead to failure. For instance if a company is late in finding a consultancy firm, and still unwilling to change it’s ‘go live date’ the company risks failure as the consultancy that agree to work with the company will do so in a short time ending up with a less than perfect system. The consulting company may fail to meet user expectations leading to shelving of the project. Sometimes when there are executives from other organization who have recently joined the company, they may be tempted to impose ideas from a previous organization that has already implemented ERP systems. This creates a problem because each organization has its own unique processes and often what is applicable for the ERP system of one company is not wholly transferable to another company. User expectations should be as realistic as possible and reflect an understanding of the business processes and the vision of the company. To avoid poor management of using expectations it is necessary to provide the clear expectations of what can be achieved. Failure to understand and prioritize user expectations will lead to problems and the best way to solve this is to ensure documentation of these expectations as well as validating deliverables of the projects to the expectations of the users. A desire to cut costs also contributes to a lot of ERP failure. The major problem with this is it creates more problems which result in more time and mistakes that have to be corrected making the date of completion further and the costs higher. Ill-advised cost cutting which attempts to avoid conversion costs, for example going live at a multi-plant simultaneously may lead to failure. This may cause all plants to shutdown if a false start-up occurs. Trying to make the schedule as short as possible so as to save expenses leads to overrunning both the schedule and budget. Return on Investments should be a last consideration when the company’s information system is being upgraded. An attitude like this will help in avoidance of cost cutting as far as ERP projects are concerned. This will ensure success of the organizations ERP implementation. Inexperienced project managers may cause ERP implementation to fail. When the core-team project members has no one from the company’s IT team or other members of the user community it becomes difficult to continually monitor the progress of the project. A southeastern electronics manufacturer due to poor management by inexperienced personnel almost closed a plant because they were unable to accept deliveries. To ensure the success of ERP projects, it is important to first redefine the measure of success. Success is currently measured by whether a project is finished on time within the budget. The ability for the system to be fully utilized is not considered. Measures for performance ought to be developed and undergo standardization so that companies have a better and clearer understanding of benefits of ERP implementation as well as the basic rules to avoid failure.

Ethics for the Real World

ETHICS FOR THE REAL WORLD Creating a personal code to guide decisions in work and life RONALD A. HOWARD & CLINTON D. KORVER Hanle Ying Special Topics in Accounting March. 16, 2011 Introduction Within the development of human culture, ethics has been more and more emphasized in human beings. Ethics is not only requested in the work place, but also it should be requested in individuals. Ethics is an extremely helpful in human daily life. For the work place, ethics can help people to trust each other, allow people to know clearly what they can do or not do, and assist their efforts with each other to create a true market in the world.For the individuals, ethics can help to correct people’s attitude about life and to help them build a positive outlook. However, no matter whether in the work place or in an individual’s life, ethics can create a personal code to help people to make the right decision. Reading ETHICS FOR THE REAL WORLD-creating a personal code to guide decisio ns in work and life not only can help us know what ethics is and how we can draft a personal code to help us make the right decision, but it also lets us know how we can use ethics to transform our life and work.It’s really a good book on ethics and very practical for human beings. This book represents the different thinking of ethics and provides a personal code for people who working; individuals can use the code of ethics to examine their own ethical problems so they can make the right decisions during work. In the real world, there are many behaviors that look ethical, but are not. Conversely, some behaviors look unethical, but are ethical. Since we cannot always discriminate what is really ethical, we sometimes have a dilemma in making a decision.However, the description in this book, expressed by the authors help us to know what ethics is and he helps us to build an ethical framework and draft a personal code in our mind. We can use the ethical framework and the persona l code to help us make the right decision. The authors also demonstrate that people can use three steps to help them to clarify the ethical issue, evaluate the consequence of the behavior, and in the end, make the right decision. Moreover, ethics not only can help people make the right decision, but it also can help people to transform the work and life.Author Biography The names of the authors are Ronald A. Howard and Clinton D. Korver. â€Å"Ronald A. Howard is one of the founders of DEF, who is the academic director of the Strategic Decision and Risk Management certificate program at Stanford University. He supervises teaching and research in the Decision Analysis Program of the Department of Management Science and Engineering and he also is the director of the department’s Decision and Ethics Center. Moreover, Mr. , Howard is a professor in the Stanford Graduate School of Business.His experience covers many fields in decision analysis project, from investment planning to research strategy, and from hurricane seeding to nuclear waste isolation† (2011). Furthermore, â€Å"Mr. Howard has been a consultant to several companies and was a founding director and chairman of Strategic Decision Group† (2011). Clinton D. Korver not only is the co-author of Ethics for the Real World, but also â€Å"he is a partner and co-founder at Ulu Ventures, a Silicon Valley venture capital firm investing in early-stage information technology companies.He is also a Kauffman Fellow, co-founder and co-president of Stanford Angels & Entrepreneurs, and a venture partner at Crescendo Ventures† (2008). Moreover, â€Å"Mr. Korver is the founder and CEO of DecisionStreet, which provides Web-based tools to help consumers make information life decisions about health, wealth, housing, and family affairs† (2008). Mr. Howard and Mr. Korver wrote Ethics for the Real World-creating a personal code to guide decisions in work and life in 2008.In order to create t he habit of highly ethical behavior, Howard and Korver help us to know what ethics is and how we can discriminate ethical issues in our daily lives. In addition, they help us to use ethics to make the best decision in every situation. Summary of Book It’s a good book on ethics, and the authors use a practical approach to talk about what ethics is. The purpose of the authors in this book is not to stimulate people to get high ethics in their mind. Contrarily, they want people to know and study ethics through the tiny little things around us. People do some things or make some decision unethically because they think he decision seems unimportant; however, they still want others to respect and trust them. They even want to continue live in a harmonious environment. But their actions and thoughts are reversed. As a result, this is one of the reasons why people sink into the ethical dilemma. The book provided many theories to help people to understand and study ethics, such as som e behavior seems ethical for one, but he still has to confirm if it’s ethical for another; one could look analyze another’s ethical behavior when one sinks into the ethical dilemma; and one could set up an ethical code to help him to correct his ethical problems.But the one of reason why people do the unethical things are they often misunderstand the meaning of ethical, legal, and moral. Someone considered poor ethical as poor moral. Also the legal behavior is considered ethical, and illegal behavior is considered unethical. Actually, there is a total difference between ethical, legal, and moral. Something could be legal, but it’s unethical, such as lie, using profanity to someone. Something could be illegal, but it might be ethical, such as killing terrorists. Therefore, the most important issue for people when knowing ethics is to be able to discriminate the meaning of ethical, legal, and moral.This topic was expounded clearly in the beginning of the book. Thi s book combined four parts: Introduction, seven chapters, an epilogue, and two appendices. Furthermore, the authors combined these four parts very logically, especially in the seven chapters. The authors provided the almost ethical at first, and give a roughly ethical frame in people’s mind, through know and study the ethics to create the personal code. And then use the personal code to do the ethical behavior or make the ethical decision. In the end, the authors demonstrate that the ethics can help people transform their work and life.This sequence is coincidence with people’s thinking and easier to be understood by people. The Introduction not only reflects the rough content of the rest of the book, but it also includes a short summary of each chapter, the engineering approach, and the clarification of the difference between ethical, legal, and moral. Moreover, it also includes the experience of both authors. This introduction is very helpful for people to know what the book is and how to use this book. In addition, the introduction also talks about the skill of making the right decision, it is a weakness we often have because we have little education in this area.The seven chapters can be divided into four parts: the first three chapters, the fourth chapter, the fifth chapter, and the last two chapters. The first three chapters represent what ethics is and the problem of setting up an ethical bottom line. Actually, ethics is not very strange for each person; everyone has a rough framework about ethics, but most of us don’t know the real meaning of ethics. Everyone wants to be an ethical person, and most people have an ethical bottom line to contrast their ethical behavior. This bottom line is very important for each person.But people always sink into the ethical trouble because the ethical bottom line. Certainly, someone utilize this bottom line and the loopholes in the law to build a gray area, doing something between right and wrong. Everybody knows that to tell a lie is unethical behavior, but some use white lies to prevent crime or war; why not? I think most of us would rather to tell this lie. Therefore, there are no fixed rules for people to study ethics. People should learn and analyze the ethics of other’s ethical behavior and set an own ethical bottom line to do the right things or decisions.The fourth chapter is based on the first three chapters. After people know what ethics is and set up an ethical bottom line to distinguish what they can do or not do, they should create their own ethical code to complete their ethical framework. The main purpose of the fourth chapter is to show people how to draft someone’s own ethical code. The fifth chapter talks about how some people to do nothing when facing unethical issues. Although people can make the ethical code by themselves, it does not mean they will be ethical all the time. In this situation, people have to re-clarify the ethical issue and t ry to create alternatives.Moreover, in order to ensure the feasibility of their alternatives, people have to evaluate the alternatives and then re-make the ethical decision. The last two chapters stated how people use their personal ethical codes to transform their personal life and work life. Having a good ethical code is very important to our daily lives. It not only helps us to distinguish what we can do or not do, but also it can make us face life and work peacefully. This has the most positive effect on our daily lives. The book is composed by the skill of ethical thinking and the ethical decision making.The main purpose in the Epilogue stated how people developed the habit by this skill. However, the habit is developed through constant practice, and the practice is directed by thoughts. Therefore, having good ethical thinking skills not only can help people to make the ethical decision, but also can help develop the right habit in their life. The Appendix A is the flow chart o f ethical decision making process which not only helps us know better what ethics is, but also we can use this flow chart to compare our ethical frame to correct and complete our weakness in ethics.The Appendix B talks about the three people’s ethical code that has totally different backgrounds. And the Appendix B let us know no matter what background people have, as long as they are willing to understand and study ethics, they can possess the ethical code. Personal Reflection and Conclusion I always ask myself what does ethics mean? What kind of action belongs to ethical or unethical? Is any behavior within laws ethical issue? However, we have to face ethical decisions in our daily lives, and we always sink into the ethical dilemma because of these decisions.For example, we will make some excuses to avoid trouble, and we will use some white lies to make others feel more acceptable. We always ignore ethics in some trivial things, and ethics becomes strangers around us. This b ook has very helpful to me. I know that I am not a real ethical man. For example, I used fake excuses to explain my absences; or a bad grade to my parents, as well as use profanity to someone. Now all these behaviors seem wrong. In the past time, I always use different excuses to avoid responsibility when I got into some troubles, and put all the blame upon someone or something else.Now I think carefully; avoiding responsibility is unethical behavior. Individual development and social development should not lack communication and responsibility. If everyone is not sincere and they choose to avoid responsibility when faced the trouble, the individual and social development cannot be achieved, not mention to creating a real life environment. Therefore, building a good personal code is very important to everyone. We are always bothered by the issue that seems ethical, but indeed it’s not.Different people have different values, so they have different ethical lines. Some consider that the white lie is moral; someone may consider that the rational avoidance tax also is moral. People always abandon their principle to do some things which they consider are ethical, but indeed they are not. Thus, people slowly lose their moral bottom line because of these tiny little issues, and then, make them into the gray areas to do something that seems legal, but indeed it’s unethical. If everyone stays in the gray area, nobody will be honest with each other anymore.Therefore, in order to correct our values and life attitude, we should build a personal code which cannot be broken by any excuses. Before doing anything or making any decision, we should consider own personal code and use it to restrain our behaviors, which give us no excuse to do anything that violates ethics. The authors Ronald A. Howard and Clinton D. Korver together created Ethics for the Real World-creating a personal code to guide decisions in work and life, they clearly define what ethics is and u se bright black and white contrast to make us know better the meaning of ethics.Moreover, because of the sufficient experience, the essence of this book is easier to be accepted and studied and has a profound meaning in our daily work and life. The reason why I choose this book is I am always bothered by the ethics bottom line in the daily work and life. Sometimes ignore ethics because of the tiny little things. As a result, I slowly lose my ethics bottom line. Now think carefully; this is a wrong behavior and life attitude. This book opened my eyes; it teaches me that not only everyone should have their own ethical code and personal code, but also we should build our principle to do everything.No matter when we do anything or make decisions, we should base them on this personal code. Let our life be surrounded by ethics. Reference Clinton D. Korver, Bloomberg Businessweek, 2008, Retrieved from: http://www. businessweek. com/bios/Clinton_D. _Korver. htm Clinton D. â€Å"Clint† Korver’89 2001, Grinnell College, 2008, Retrieve from: http://www. grinnell. edu/offices/president/trustee/memberintro/korver Ronald A. Howard, Decision Education Foundation, 2011, Retrieve from: http://www. decisioneducation. org/about-DEF/board-of-directors/ronald-howard

An Analysis of the Culture of an Organization Essay

An Analysis of the Culture of an Organization - Essay Example An organization is a social unit of people that is structured and managed to meet a need or to pursue collective goals. All organizations have a management structure that determines relationships between different activities and the members and assigns roles and responsibilities to actualize different tasks. Since time immemorial, human beings had to organize the activities that were paramount to their survival. According to Hatch (4), as  organizations evolve and become more dynamic, coping systems and methods of how to manage change continue to be refined. Medecins Sans Frontieres (MSF, or Doctors Without Borders) is a renowned, independent international non-governmental organization that responds to emergency humanitarian situations by delivering emergency aid to people afflicted by natural or man made catastrophes, armed conflict, epidemics, and healthcare exclusion.This organization combines medical, charitable, witnessing or (temoignage) and advocacy in a unique way. Since it s inception in 1971, MSF has grown from a small, charismatic lobby group into a large institution comprising of 19 sections, and 25,000 staff members, 20 presidents, 20 directors, and more than 200 board members. It operates in not less than 77 countries, with 365 projects. Culture The term culture encompasses the primary values, attitudes and regulations that make a society what it is. A community’s customs, the self-image of its people and the attributes that distinguish it from other societies are its culture. Culture is strongly personal and mirrors the meanings that are naturally linked to situations, and the solutions, that resolve common problems. Schein (1985) argues that culture includes the fundamental assumptions that any given group of individuals have formulated or gained while learning to deal with its issues of exterior or internal adjustment and can be considered suitable enough to be imparted to new members as the acceptable way to perceive and react to these problems. Since an organization comprises of people from different backgrounds and exists in an environment, certain behaviors emerge consequently forming the culture of that organization. At the same time, an organization can define or create its own culture based on its circumstances and endeavors. Furthermore, people enter organizations from the surrounding community and bring their culture with them. It is still possible for organizations to have cultures of their own, as they possess the paradoxical quality of being both ‘part’ of and ‘apart’ from society. They are embedded in the wider societal context but they are also communities of their own with distinct rules and values. MSF includes a work force recruited from all over the world that blend well to breed a unique culture. The fact that MSF offers its assistance worldwide, it encounters people with a wide range of cultures causing it to align itself with different cultures to enable it integrate and achieve its purpose. At the same time, MSF is not alone in the field of international non-governmental organizations. Despite this background, MSF is envied for its ability to remain steadfastly independent. Organizational Culture Schein (1992) defines the culture of a group or organization as a model of shared basic statements the group acquires as it works out its dilemma of external adaptation and internal integration, which has worked well enough to be adapted and entrenched as the blueprint and accepted mode of socialization within an

Research report on Australian financial services industry Essay

Research report on Australian financial services industry - Essay Example The economic recession spiralled by the subprime crisis has called upon business organizations particularly banks and other financial institutions to ensure better risk management practices. It also calls for financial institutions to increase the level of compliance. These calls for a collective effort on the part of bankers, central bankers as well as policy makers to formulate policies that seek to ensure financial health and stability of these crucial institutions of the economy. The present study would analyse the financial institutions in Australia with regards to their structure and legal framework. Special emphasis would be given to the banking sector in the report that would also analyse the challenges faced by the Australian banks. Structure of Australian Financial Institutions The Australian financial services industry is divided into a total of nine distinct sectors which includes deposit based financial institutions like banks and other credit agencies, non deposit based financial firms, the central bank, asset investing firms like stock trading companies, pension and superannuation fund management companies, auxiliary firms like stock brokers, mortgage securities firms, life insurance, general insurance and finally the insurance broking companies. The financial sector contributes about 18 billion Australian dollars to the nation’s economy which equals almost 8 percent of the total GDP of the nation. The nation has a total of 30000 financial institutions which also provide employment opportunities to a significant share of the population of the nation that is being pegged at 700000 individuals which includes approximately 6.4 percent of the total workforce in Australia (IBSA, 2010, p.4, 6). Figure 1: Assets of the Financial Institutions in Australia (Source: Austrade, 2009, p.13) The figure above shows the total assets of the financial institutions in Australia as of the year 2009. According to the statistics shown in the figure the total as sets of the financial institutions of the nation was 4431 billion Australian dollars. The compounded annual growth rate is being pegged at 11.8 percent starting from the year 1994. The financial institutions in Australia have also expanded their reach to across all the major and developing markets across the globe (Austrade, 2009, p.13). In terms of investment based funding assets the current value of the total assets in the nation is 541 billion AUD which is the fourth largest in the world. The figure is expected to grow to about 1979 billion AUD by the year 2015 (Austrade, 2009, p.16). Banking Industry in Australia As per the latest information from the Australian Reserve bank there are about 58 banks in the nation that includes 7 major banks, 7 local banks, 9 foreign banks incorporated in Australia and 35 foreign banks. The total cash and liquid assets including notes, deposits and coins apart from other liquid assets amounted to 3 percent of the total assets of residents in Aust ralia. Trading and investment based securities accounted for 9.3 percent and 6 percent respectively. The loans and advances segment including all forms of loans extended to the retail as well as corporate houses in the nation amount to 62.2 percent. Other

How the environment plays a role in learning Research Paper - 1

How the environment plays a role in learning - Research Paper Example e student enters the advance stage in learning, the use of computer-based learning and living environment has to be incorporated in the school curriculum in order to maximize the learning experience of the students. Parents are responsible in the learning capacity of a child. This is a widely acceptable fact since majority of the child’s learning foundation is developed at home. As a child grows older, external influences would start to affect the child’s learning. The child starts to attend school wherein the teaching responsibility is transferred to the teachers. Each day, the students’ learning can take place in several ways. Specifically the use of classroom learning environment includes the process of learning from a professor within a classroom setting, the application of time driven events, the concept of hands on learning, and the interaction between two or more students will be thoroughly discussed. The use of Web-based or computer learning environment includes online classes, internet research activities, online library, and the use of discussion boards whereas learning from living environment includes interaction within the community setting, family and friends, and within the work place. In line with the importance of effective learning in terms of improving the students’ ability to learn new things each day, a literature review will be conducted in order to discuss the advantages and disadvantages of adopting the classroom learning environment, Web-based or computer based learning environment, and living environment. Teaching is considered as both a science and an art of employing strategies, schemes, and different tactics to enhance the learning and development of the students. Since teachers are the front-liners in proving a quality education for each the students, teachers must be able to implement strategies based on theories that are effective in moulding the mental development of the child. According to Barbara McCombs, â€Å"almost

Changing Values in the New Economy Essay Example | Topics and Well Written Essays - 2000 words

Changing Values in the New Economy - Essay Example Thus globalization of business and the revolution in information technology are the cornerstones of the new economy that has come into existence. The changing circumstances and thought processes in the business environment under the New Economy are undermining the old order and are forcing business to restructure. The emergence of the new economy has also brought changes in the outlook of the investors in that the there has been an increased expectation of return on the capital invested. Investors in the new economy prefer to work on a faster payback of their investments as against their counterparts in the old economy who were satisfied with a nominal and consistent return on their investments and safety of the investments as the deciding factor for any investment decisions. With this background this report analyses the radical changes brought about by the new economy in the outlook of the investors including the institutional investors. Stephen B. Shepard (1997) states that the New Economy has emerged because of the interaction of two broad trends namely the globalization of business and the revolution in information technology. In the New Economy "capitalism is spreading around the world--if not full-blown capitalism, at least the introduction of market forces, freer trade, and widespread deregulation." It boosts productivity, reduces cost, cuts inventories and facilitates electronic commerce. The digital technology is creating new companies and new industries before our eyes. Paper on New Economy from PPI (2000) defines the new economy as knowledge and idea based economy where the key to higher standards of living and job creation is the extent to which innovative ideas and technologies are embedded in services, products and manufacturing processes. The new economy is one where risk, uncertainty and constant changes are the rule rather than the exception. In the new economy there is a transformation process constantly going on which replaces the hierarchical organizations by network learning organizations. It may be interesting to note that almost eleven new companies are created every week in Silicon Valley and one of them went public every five days when the new economic development process started. The new economy has also seen a widespread change in the methods of conclusion of trade transactions, changes in the purchasing methods of consumers and novel methods of meeting the customer needs by innovative approaches in delivering the products ordered over the internet. E Commerce took its root and developed over a short period in the new economy, although initial hiccups were present. The classic example in this type of business is the success of Amazon.com. Thus new business activities using the new technology, media, telecommunication facilities, e commerce and Web portals became inseparable parts of the new economy. 3.0 Outcome of the New Economy: The new economy with the advent of globalization and the rapid development of information technology has resulted in an all round development of various economic sectors. These developments attributable to the modern digital technologies had been a reason for excitement and elation at the end of the last decade. The reported developments were mainly concerned with: the emergence of a knowledge based sector whose huge market and broader

Compare and Contrast Dependency Theory and Neoliberalism Essay

Compare and Contrast Dependency Theory and Neoliberalism - Essay Example This discussion stresses that the dependency theory  refers to the model explaining the notion of flow of resources. According to this theory, resources flow from the boundary or the periphery of the undeveloped and poor countries to the center of the economically stable or the wealthy states enriching the developed countries at the expense of the weak states. Whereas the dependency theory originates from third world countries to explain the fate they suffer in the hands of the developed countries, Smith describes the neoliberalists as people from the economically stable nations concerned with the modern political economy. Neoliberalism refers to the modern political, the economic theory that favors free trade. Hays and David describe neoliberalism to favors the privatization of public organization with minimum government intervention in the commercial business. It is seen to advocates for a decrease in public expenditure on social services, On the other hand, is from the third wor ld countries, the dependency theory assumptions are based on these nations. They hold that countries that are more developed should play a part in improvising those countries that lie below in development. Their assumptions, therefore, focus on the capitalist approaches to break the development of these countries. Besides this theory hold a view of underdevelopment rather as a process as compared is to a stage. For these countries, under development forms a process to reach a full developmental goal or a full potential. Finally, the theorist holds that significant influence to the third world countries is by financial aid and subsidiaries. However, they not that foreign aid is never free rather it has some attached strings. This foreign aid most of the time form a debt trap for the developing countries.

Role of leadership when merging companies Essay Example | Topics and Well Written Essays - 500 words

Role of leadership when merging companies - Essay Example This teamwork between companies is essential to enhance the potential success of the merging. Basically, every organization has a culture, an interconnected value system, shared by the majority of the organization’s members. Organizational culture also involves and is influenced by the trend of effective internal reactions to adjust to external problems and threats (Keyton, 2005). Since the culture is an outcome of previous achievements, it will oppose change such as that brought about by merger or acquisition. Hence, the role of leadership is to facilitate the transition of organizational culture during the process of merging (Hunt, 2009). The auto industry has been historically known for its horizontal formations (Badrtalei & Bates, 2007). The future merging of American automaker Chrysler and Italian automaker Fiat will be discussed in this essay. The possible success or failure of this merging will be discussed in terms of the management perspective and organizational cultu re differences between the two totally distinct automakers. Organizational Challenges to the Chrysler-Fiat Merge It is obvious that American and Italian cultures are starkly dissimilar. The collective bargaining process of Chrysler and Fiat is different.

Progymnasmata Essay Example | Topics and Well Written Essays - 500 words - 2

Progymnasmata - Essay Example The Miller, his son, and their Ass Is an example of fable in which an old man and his son are approaching the city with their ass. On their way, they meet three groups of people in different occasions and each seems to be surprised by their way of journey (Aesop 76-9). Their first encounter with a group of women who are surprised at the old man his son walking when they can ride the donkey. These women’s sentiments convince the old man to mount his son on the ass. Just before they can go far, another group of old men come by them and express their disappointment at the boy riding the ass while the old man should be the one to rest his limbs. At this point, the old man brings the son down and mounts the ass. A few minutes later they meet with a group of women and children who criticizes the old man for being uncaring to the young boy by riding alone on the ass. This makes the old man call the lad up and both ride on the ass. They have not gone far and another citizen wonders ho w two people can oppress an ass while they should carry it and the old man abides by tying the ass and carrying it with the help of the son. This free drama attracts a crowd who begins to make noise and the donkey breaks off into the water. The old man has lost his donkey for listening to various people. A critical analysis of this fable presents various moral lessons. The society has various characters that hold diverse opinion on different circumstances. Considering the experience of the old man, it can be noted that listening to people may be misleading in various cases (Aesop 56-7). The different groups the old man met on his way are symbolic of different alternative ideas that come into people mind. The moral lesson that can be learnt in this case is emphatic to the need for independent decision making. The fable is relevant into contemporary time where people are advised to make informed and personal decision

How to write a Definition Essay Essay Example for Free

How to write a Definition Essay Essay A definition essay is an essay concentrated on the explanation of the meaning of a definite term. The term may be analyzed from the position of one and only meaning and also from the position of subjectivity of the person defining the term. This classification divides the words into two groups: †¢material terms – a table, a door, a printer. †¢spiritual terms – friendship, love, honor, pride. How to write a definition essay? Read more:  How to write an outline for a cause and effect essay A good definition essay is required to have a strong thesis statement in which the point of view of the author on a certain term is revealed. Ordinarily, the term is given the general basic definition implying that the dictionary definitions must be only a start for the author’s unique definition of the term. In order to make a definition essay professionally it is necessary to find a definition of the term that corresponds to the opinion of the author. The definition is always given in own words and specifies what meaning of the term is to be analyzed. Definition essay Outline Three Tips for an effective definition essay †¢The readers should be told the defined term. †¢The presented information should be basic and clear. †¢It is necessary to use a wide range of examples to make sure the reader understand the point of view of the author. Three gold rules for writing a good definition essay †¢Ã¢â‚¬Å"When† and â€Å"where should not be used in a good definition. A noun is defined through a noun, a verb through a verb, ect. †¢The definition should never copy the dictionary definition but is supposed to be unique reflection of the author’s opinion. †¢The best way to explain the definition is to use simple language. DEFINITION ESSAY CONTINUED †¦ Structure: definition essay format The basic structure of a definitions essay consists of the thesis statement, examples to reveal the term from the necessary side and the author’s final restatement. †¢Definition is presented †¢It is analyzed by: function structure analysis †¢The meanings which are not considered by the author are specified. †¢The definition is supported with various examples. †¢The structure of the essay language must be appealing to the reader. CAUSE AND EFFECT ESSAY How to write a Cause and Effect Essay: format, structure, outline, examples, topics This type of essay is concentrated on the ability of the writer to connect the reasons the things happen and the consequences they might have. In other words it is the connection between the causes of events and the effects this cause have on any analyzed aspect. A cause and effect essay is designed to organize the discussion of the ideas of a certain topic (its causes and results). Writing a cause and effect essay In order to write a professional cause and effect essay it is necessary to understand the term casual chain or domino effect. A cause chain or a domino effect –is a chain formed of a cause producing a situation and this situation producing another situation and so on. Each situation may have various causes and effects. Nevertheless, it is suggested for students to analyze no more than three causes or effects of any situation devoting a separate paragraph for each point. Cause and effect essay structure As the situation analyzed in the cause and effect essay may have different background there are three structures that may be applied. Each situation requires only on of the three structure variants. 1 variant Multiple causes  ® one effect †¢Thesis statement (mentions the general effect of the situation mentioning three causes that lead to such an effect) Ex. Child violence is caused by lack of parental attention, parental abuse and parental immaturity. †¢First cause (a more detailed look on lack of parental attention with two minor supports) †¢Second cause (a more detailed look on parental abuse using two minor supports) †¢Third cause (a more detailed look on parental immaturity with the help of two minor supports) 2 variant One cause ® multiple effects CAUSE AND EFFECT ESSAY CONTINUED †¦ †¢Thesis statement (mentions that one factor leads to a variety of consequences). Ex. Watching violent films has a great impact on the child’s psychological and physiological condition. †¢First group of effects (psychological effects) †¢Second group of effects (physiological effects) 3 variant Causal chain (Domino effect) †¢Thesis statement (mentions the first and the last parts of the chain) Ex. Thinking about art leads to poor results in foreign language class. †¢First domino (thinking about art  ®forgot to take the medicine) †¢Second domino (without the medicine could not get enough sleep) †¢Thirst domino (being tired could not learn the home work for the foreign language class) †¢Last domino (being not ready for class gained a poor mark). COMPARE AND CONTRAST: Compare and Contrast Essay How to write a Compare and Contrast Essay: format, structure, outline, examples, topics Writing a compare and contrast essay This type of essay is basically a composition, which is concentrated on two points. The compare and contrast essay reveals the differences and the similarities of these two points, things, situations, etc. The main task of any writer is to find as many similarities and a difference, as it is possible. How to write a compare and contrast essay? In order to write a professional compare and contrast essay it is necessary to remember that it is vital to identify the points of comparison. This is a major requirement because without this proper identification the essay will not have a correct logical form. To make a detailed compare and contrast essay the first step is to point out the key aspects and do a research on the topic including articles and books. Compare and contrast essay structure The compare and contrast essay has a rather simple structure but nevertheless it is important to specify its contents: Introduction (Introduction is used to choose what will be compared and contrasted and to identify the major lines of comparison. The introduction must be very bright as it is supposed to catch the attention of the reader and make the rest of the essay appealing to the reader. One of the main secrets of any successful compare and contrast essay introduction is adding a surprising fact or an anecdote on the topic of discussion). Body a.Each of the compared points has to be presented in a separate paragraph or if it is necessary in two paragraphs. b. When all the compared points are revealed to the reader the writer is suggested to put analyze them one more time together in order to put in one solid comprehension of the essay. The paragraphs must be connected with each other with very strong topic sentences. The reader is not supposed to face any difficulties understanding the reason the material is organized the way it is. In other words the reader is expected to understand the reason the writer is analyzing these given aspects. COMPARE AND CONTRAST CONTINUED †¦ c.The body should be critically read, as each topic sentence has to clearly summarize the main point of the paragraph. d.For better result the body should be analyzed from the perspective of an independent analytic, so it should be read a day after it was written or by another trusted person for review. Conclusion (Conclusion is used to summarize the key similarities and differences of the two analyzed things. Word for word restatements should be avoided. The reader is not supposed to feel any doubt in the compare and contrast essay perspective on the topic). ARGUMENTATIVE ESSAY: How to write an Argumentative Essay: Outline, Structure, Format, Examples, Topics How to write an argumentative essay? The leading tone in an argumentative essay is the position of proving that the presented point of view is the correct one and possesses more truthful arguments than any other opinions. The author through proper reasoning, inducting and making conclusions, must prove the assertions or the theories of the argumentative essay. If the author fails to apply the reasons and conclusions to the topic of the essay such essay is considered to be an unsubstantiated opinion. Argument essay writing requires the ability of the author to show that he makes conclusions according to definite facts and not on his personal assumptions only. The idea that a theory created on a base of some sort of argument answers the question â€Å"how to write an argumentative essay†. So in reality it is the best argument essay. Argumentative essay Format Any argumentative essay needs to be written according to the following form: 1.It must begin with a clear statement and reveal the significance of the presented opinion in terms of the analyzed phenomenon. 2.In order to make the argumentative essay professional a wide range of information concerning the phenomenon should be reviewed. 3.As the reader is to â€Å"agree† with the data listed in the essay must be as reliable as possible. Structure of the argumentative essay A good argumentative essay has several paragraphs that should be concentrated on different aspects of the essay 1.Introduction (The reader is introduced to the analyzed phenomenon and the opinion is revealed through a strong thesis statement). 2.Previous attempts to solve the argument ( Are provided from literature). 3.The consequences of the problem (its negative or positive impact). 4.Repercussion of the argument in case it is not finally solved(supported with sources). 5.Connecting the argument with the provided facts. ARGUMENTATIVE ESSAY CONTINUED †¦ 6.Summary (a conclusion including main ideas and the thesis restatement). Argumentative essay outline structure A good argumentative essay has several paragraphs that should be concentrated on different aspects of the essay 1.Introduction (The reader is introduced to the analyzed phenomenon and the opinion is revealed through a strong thesis statement). 2.Previous attempts to solve the argument ( Are provided from literature). 3.The consequences of the problem (its negative or positive impact). 4.Repercussion of the argument in case it is not finally solved(supported with sources). 5.Connecting the argument with the provided facts. 6.Summary (a conclusion including main ideas and the thesis restatement). DIVIDE AND CLASSIFY ESSAY: Classification Essay How to write a Classification Essay: format, structure, outline, examples, topics Writing a classification essay This type of essay is a very specific one as it deals with the Classification of organizing the logical connections in it. The author of a classification essay is supposed to organize or sort the arguments of the essay in categories. An important thing to mention is that the categories are to fully resemble the essence of the essay’s topic. How to write a Classification essay In order to write a professional classification essay three advices should be kept in mind. First of all the organized categories are expected to fully reveal the theme of the essay and therefore must be very useful in terms of the classification Classification. In spite of the amount of the separated categories each of them must follow one logical principle. And also each of the presented categories is to provide examples. Classification essay Outline This rubric is a condensed treatment of the Classification essay writing, this Outline is just a description of the main facts and rules about how to write this type of essay. One should practice as much as possible to become good in writing a Classification essay. Classification essay structure The structure of a classification essay is built around the construction of the categories. 1.Introduction (The basic part pf the introduction is the thesis statement. The strength of the thesis statement depends on how well it reveals the topic and its classification. It is to justify the specific categories chosen for this classification). The thesis statement has a very determined logical structure: theme ® its classification ® chosen categories (the number of categories is suggested to be limited to three in order not to blur the classification). For instance: Exchange students can face three benefits: education, experience and cultural exchange. DIVISION – CLASSIFICATION ESSAY CONTINUED †¦ 1.Body †¢First category (The less important category). †¢Second category †¢Third category (The most important one and requires brighter examples). In a good classification essay each category must follow one organizing principle. The categories can be organized on the basis of forming different groups of arguments) . 1.Conclusion The conclusion is the summary of the analyzed categories and the restatement of the thesis statement. Classification essay format This type of essay like all others could be formated in MLA, Chicago/Turabian, APA, AMA. That depends on your essay topic, subject area and the assignment requeirements. Please be consistent following the one style of format of all the essay elements: Title, headings, paragraphs Text pages, Fonts, Indents, Justifications, Spacing, Page numbers, Emphasis, Footnotes, reference list etc.

Developing An Evidence Based Study Into Postoperative Pain

Developing An Evidence Based Study Into Postoperative Pain In spite of recent advances in pain management, postoperative pain still remains a major clinical problem (Gilmartin and Wright, 2007; Manias et al., 2005; Singer et al., 2010) with about 69% of patients experiencing moderate to severe pain after surgery (Apfelbaum et al., 2003). Postoperative pain, although expected is an undesirable experience after surgery (Good, 1995; Rosenquist and Rosenberg, 2003). When left untreated or inadequately managed, it can negatively affect an individuals physical, psychological and social well being (Vaughn, Wichowski and Bosworth, 2007). Thus, it generates additional responsibilities for the healthcare provider (Wilmore and Kehlet, 2001) as well as creating economic difficulties for ones family, society and the nation at large (Vaughn et al., 2007). Pharmacological interventions have been used as the mainstay in the management of postoperative pain (Dolin, 2002). However, these interventions are not without undesirable effects such as nausea, vomiting, dizziness, drowsiness and allergic reactions (Koch et al., 1998). Analgesic techniques for perioperative pain relief are therefore, being challenged by an ever-increasing demand for complementary and holistic therapies (McCaffrey and Locsin, 2002). Thus, several non-drug techniques can be used as adjuncts in managing postoperative pain (Good et al., 2005). The use of music as a nonpharmacological technique has prompted various research studies in the area of postoperative pain management (Ikonomidou et al., 2004). Resultantly, several studies have been published on this issue; hitherto, these have produced contradictory findings (Anderson et al., 2005; Good et al., 2001, 2002, 2005; Heiser et al., 1997; Heitz et al., 1992; Ikonomidou et al., 2004; Nilsson et al., 2001, 2003; Taylor et al., 1998). In an attempt to find solutions to the efficiency of music as a pain management intervention, an increasing number of systematic reviews (Cepeda et al., 2006; Dunn, 2004; Engwall and Duppils, 2009; Evans, 2002; Nilsson, 2008) have been published during the past years. Nonetheless, the conclusions from these studies may be questionable for various reasons such as poor methodological quality of included studies, limited search strategies, inclusion of studies from only developed countries and being outdated. With the evolvement of recent studies (Allred, Boyers and Sole, 2009; Cooke et al., 2010; Ebneshahidi and Mohseni, 2008; Good and Ahn, 2008; Hook, Sonwathana and Petpichetchian, 2008; Sen et al., 2009) which continuously report conflicting findings and the flaws identified in previous reviews, this issue needs to be addressed in a more rigorous manner. The aim of this dissertation is to ascertain the efficacy of music as a postoperative pain management intervention by systematically reviewing the available literature. With the aid of the evidence from already existing literature, this dissertation will commence with the rationale for the proposed systematic review and justification of the review question. In the subsequent chapter, the systematic review methodology will be explored together with the justification for the main decisions of the review. Following this, the results of the proposed review will be presented in the next section. This will be followed by discussions and conclusions on the review. Finally, I will reflect on the learning achieved through the systematic review process and the implications of the study findings for clinical practice, research and education. Literature Review A review of the literature identifies the trends, strengths and limitations of the methodological approaches of a study (Dunn, 2004). Thus, it provides an orientation to the known and unknown aspects of a subject area (Blaxter et al., 1996; Parahoo, 1997; Polit et al., 2001) and directs future studies (Stevens, 1993). In this section, the rationale and justification of the review question will be provided following the background information and literature on the use of music in managing postoperative pain. Epidemiology of Postoperative Pain It has been estimated that more than 73 million surgeries are per ­formed every year in the United States (Apfelbaum et al., 2003). Apparently, the tissue damage and trauma caused during surgery results in acute postoperative pain which may vary in intensity from mild to excruciating pain (Hutchison, 2007). Recent studies indicate that effective pain management remains elusive for a significant proportion of surgical patients (Dolin, Cashman and Bland, 2002; Svensson, Sjostrom and Haljamae, 2000; Werner et al., 2002). Many of them continue to experience unrelieved postoperative pain (Backstrom and Rawal, 2008) despite years of research into pain and its management (Botti, Bucknall and Manias, 2004; Hutchison, 2007). This may be partly due to the insufficient training received by healthcare professionals on pain management (American Medical Association, 2010). In addition, many patients have accepted the notion that acute postoperative pain is to be expected during hospitalisation. Thus, the resultant effect is the widespread poor management of postoperative pain (Warfield and Kahn, 1995). The ineffective management of postoperative pain has been highlighted in the literature (Abbott et al., 1992; Bostrom et al 1997; Donovan et al. 1987). A survey conducted by Oates et al. (1994) revealed that 34% of the 206 patients experienced moderate to severe pain postoperatively. Conclusions from the National Health and Medical Research Councils (1999) report also depicted that about 75% of patients experienced moderate to severe postoperative pain. An inquiry made by Watt-Watson and colleagues also showed that 51% of 225 postoperative patients following cardiac surgery reported of severe pain (Watt-Watson et al., 2000). Moreover, a random national study conducted by Apfelbaum and co-workers illustrated that out of the 80% of patients who reported of postoperative pain, 86% of them were experiencing moderate to severe pain (Apfelbaum et al., 2003). All these continuous reports of moderate to severe postoperative pain draw attention to the inadequacies in pain management (McCaffer y Ferrell, 1997). This is because patients often underestimate their pain due to their high expectations regarding postoperative pain experience (Hutchison, 2007). Some clinicians and patients also have misconceptions about the use of opioid analgesics which contribute to the inadequate postoperative pain management (McCaffery and Ferrell, 1991). Other factors also include the type of surgery (Rai, 1993), patients gender, age, preoperative pain and psychological factors (Bisgaard et al., 2001; Edwards et al., 2004; Granot and Ferber, 2005). Potentially, technical difficulties with intravenous (I.V.) access lines and patient-controlled analgesia (PCA) devices also serve as contributory factors (Wickstrom, Nordberg and Johansson, 2005). Pharmacokinetic and pharmaco ­dynamic factors may also affect postoperative analgesia (). *A meta-analysis comparing the incidence of pain following three analgesic techniques: I.M. analgesia, PCA, and epidural anal ­gesia after surgery was conducted by Dolin et al. (2002). Data stratification based on the drug administration route revealed that the pro ­portion of patients with moderate-to-severe postoperative pain was highest in I.M. opioid administration group while this was lowest in the epidural opioid group. In recent times, pain management is gaining increasing attention among healthcare providers and professional bodies (Hutchison, 2007). Thus, January 1, 2001 was declared during a United States congress as the commencement of a decade of pain control and research (American Academy of Pain Medicine, 2010). Furthermore, the Ameri ­can Pain Society (APS) presently urges clinicians to consider pain as the fifth vital sign (Loeser, 2003). This initiative has stimulated more interest and attention to the management of pain. As a consequence of that, several professional and regulatory bodies have recently produced guidelines for managing postoperative pain (American Society of Anaesthesiologists, 2004; American Pain Society, 2003; European As ­sociation of Urology, 2003; Veterans Health Administration and Department of Defense, 2002; Joint Commis ­sion on Accreditation of Healthcare Organisations, 2001). Definition of Postoperative Pain The concept of pain has been a subject for discussion since antiquity. A universally accepted definition of pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage described in terms of such damage (IASP, 1979: 250). This definition emphasises on the subjective nature of the pain experience which can be influenced by multiple factors (IASP, 2003). As a result of this, McCaffery (1983: 14) defines pain as whatever the experiencing person says it is, existing whenever she says it does. Postoperative pain is thus, defined as an acute form of pain which is experienced after surgery (Fine and Portenoy, 2007). Impact of Inadequate Postoperative Pain Relief Unrelieved postoperative pain can be detrimental to the physiological, psychological and sociological health of patients (Reyes-Gibby, 2002; Strassels, 2000; Vaughn et al., 2007). These negative consequences are derived from various body systems such as the cardiovascular, respiratory, gastrointestinal, renal, neuroendocrine and the autonomic nervous systems (Duggleby and Lander, 2004; Tulay, 2010). Physically, longer periods of unrelieved postoperative pain can result in physiologic alterations which include the stimulation of the pituitary-adrenal system (Yeager et al., 1987), sympathetic nervous system (Pasero, Paice and McCaffery, 1999) and restricted mobility (Yeager et al., 1987; Murray, 1990) which may result in cardiovascular, gastrointestinal and renal changes (Puntillo and Weiss, 1994; McCaffery and Pasero, 1999). All these changes in a postoperative may serve as a risk factor for the development of adverse effects such as deep vein thrombosis, pul ­monary embolism, pneu ­monia (APMGP, 1992), coronary ischaemia, myocardial infarction (APMGP, 1992; Jacox et al., 1994; Puntillo and Weiss, 1994; Staats, 1998; McCaffery and Pasero, 1999), reduced immunity (Ikonomidou et al., 2004), poor wound healing (Shang and Gan, 2003) and chronic pain. Psychologically, unrelieved postoperative pain may result in stress, anxiety, depression and demoralisa ­tion (Murray, 1990). In addition, the undertreatment of postoperative pain has potential negative consequences for health systems (Hutchison, 2007). This includes extended periods of hospitalisation (Heiser et al, 1997; Miaskowski, 1993), readmissions (Ikonomidou et al., 2004) and patient dissatisfaction (Shang, 2003). As a result of this, additional responsibilities are placed on the healthcare provider which may lead to staff exhaustion and its resultant sick leaves (Wilmore and Kehlet, 2001). Subsequently, these may increase the overall costs of hospitalisation and place health systems at a disadvantaged position, especially in todays competi ­tive healthcare environment (Henry, 1995). Ultimately, these negative consequences have a enormous impact on the patients family, society and the nation at large (Vaughn et al., 2007). Pain Management The importance of addressing the complex issues of pain management cannot be overemphasized (Botti, Bucknall and Manias, 2004). Apart from reducing unnecessary suffering, effective pain control improves patient outcomes (Wasylak et al., 1990; Watwill, 1989; Sydow, 1989) and enhances their quality of life (Goudas, 2001; Reyes-Gibby, Aday and Cleeland, 2002; Rogers et al., 2000a; Rogers et al., 2000b; Strassels, Cynn and Carr, 2000). It is generally accepted that needless suffering from pain in any patient is unethical (Sà ¶derhamn and Idwall, 2003) and illustrates a betrayal of the healthcare professionals commitment to serve humanity (Ikonomidou et al., 2004). This is because patients are entitled to good quality care (Rawal, 1999; Idwall, 2004). Important goals for postoperative pain management are therefore to promote comfort, quicken recovery and avoid complications (Ready and Edwards, 1992). Pharmacological interventions have been used as the mainstay in managing postoperative pain (Dolin, 2002). Nevertheless, these interventions are not without unwanted adverse effects such as nausea, vomiting, dizziness, drowsiness, and allergic reactions (Koch et al., 1998). Thus, nonpharmacological methods have been used as adjuncts in the treatment of postoperative pain (Ready and Edwards, 1992). *Combining pharmacologic and nonpharmacologic methods of pain provides effective pain relief for the patient (McCaffery, 1990). Thus, the nurse may make a significant contribution to postoperative pain management by offering the patient various non-drug techniques that can be used concurrently with analgesics (McCaffery, 1990; McCaffery and Beebe, 1989). Nonpharmacologic interventions have been known to be valuable, simple and inexpensive adjuvants to analgesic techniques (Hyman et al., 1989). As a result, several non-drug techniques can also be used as adjuncts in managing postoperative pain (Good et al., 2005). Specifically, the use of music as a nonpharmacological technique has prompted various research studies in this area (Ikonomidou et al., 2004), leading to the publication of numerous studies (Anderson et al., 2005; Good et al., 2001, 2002, 2005; Heiser et al., 1997; Heitz et al., 1992; Nilsson et al., 2001, 2003; Taylor et al., 1998) and reviews (Cepeda et al., 2006; Dunn, 2004; Engwall and Duppils, 2009; Evans, 2002; Nilsson, 2008). History of Music Therapy Music, as a remedy for sickness is a prehistoric concept (Todres, 2006) that has been used to influence human health (Bunt, 1994; Nilsson, 2003; White 2000). It is the art of listening to sounds that usually have rhythm, pitch (Funk and Wagnall, 1998), melody and harmony (Steckler, 1998). Throughout history, music has been used as an alternative therapy to promote the wellbeing of patients (Guzzetta 1988). Thus, music therapy can be defined as the act of using musical sounds to support the physical, psychological and social needs of an individual during illness or disability (Aluede, 2006; Munro and Mount, 1978). Its main goal is to promote comfort by serving as a diversionary measure from an unpleasant occurrence (Nwokenna, 2006). Archaelogical findings reveal that the sick primitive man used music as a way of pacifying the gods (Henry 1995). Also, the Egyptians of 1500 BC used music to enhance their fruitfulness while the Greeks and Romans strove for human body and soul integration using music (Buckwalter, Hartsock and Gaffney, 1985). Thus, Apollo, the Greek god of mythology, was considered as the giver of medicine and music (Todres, 2006). There is anecdotal evidence from contemporary writings that music was used by Hippocrates to promote wellbeing (Storr, 1994). The sixth century Greek philosopher, Pythagoras, who is considered as the founder of music therapy and geometry, believed that music greatly influenced human health (Olson 1998). As a result, he often prescribed music and diet to reinstate and sustain the integration human body and soul (Bunt, 2001; White 2001). Also, it was demonstrated by the Renaissance movement group that different types of music affected digestion, blood pressure, respiratory and heart rates (Cook, 1986). In a nameless article that appeared in the Columbian Magazine in 1789, a case was made for the use of musical experiences to influence and regulate emotional conditions (White 2000). Subsequently, a book entitled the influence of music on health and life, which describes the use of music in healing, was written by Chomat in 1846 (Biley, 2000). From a nursing perspective, music has been used to promote patients health and well-being (Chlan, 2002). In the early 1800s, Florence Nightingale noticed the power of music as a vital part of the healing process for injured Crimean soldiers (Nightingale, 1992). After observing different types of music, she remarked that wind instruments with continuous sound or air created a positive effect on patients while those that lacked continuous harmony produced negative effects (Nightingale 1992, McCaffrey and Locsin 2002). Nightingale believed that, it was the nurses responsibility to control the environment for healing to take place (Nilsson, 2003; White, 2001; McCaffrey and Locsin, 2002; Nightingale, 1992). After the invention of the phonograph in the late 1800s, recorded music was used in hospitals to promote sleep and relieve perioperative anxiety (Taylor, 1981). An extensive account of this occurred when healthcare professionals concurrently used music with analgesia and anaesthesia (ibid). In 1914, music was used for the first time in the intraoperative environment to distract patients from the horror of surgery (Kane, 1914: p.1829). Afterwards, the National Association for Music in Hospitals was established in 1926 by a nurse named, Isa Maud Ilsen (Ilsen, 1926). After identifying rhythm as the basic therapeutic element, she advocated for the implementation of specific musical prescriptions (Ilsen 1926). An extensive study on music was made by Hunter, in 1892, after playing a piano in the Helensburg Hospital, Scotland. He noticed that there was a reduction in the patients report of pain and temperature following musical exposure (Hunter, 1892). An observation made by Coring (1899) and Tarchanoff (1903) also revealed that different types of music had an effect on the patients heart rate, respiration and bodily secretions (Light et al 1949). Also, a group of surgeons in 1949 studied the use of music together with psychosomatic factors. They discovered that music had a calming effect on those patients who were anxious and unresponsive to routine medication (ibid). With the advent of the technological advancements of the twentieth century, the link between health and music declined (Heitz, Symreng and Scamman, 1992). However, there has been an upsurge interest in music therapy due to its prominence in pain management (McCaffery, 1979) Thus, it is considered as a vital aspect of the nursing discipline (Paterson and Zderad, 1988). The Analgesic Properties of Music The mechanism by which music affects pain responses appears to be as varied as the research paradigms (Pricket and Standley, 1994). Music has been shown to affect the physical, emotional, cognitive and social aspects of the pain experience (Todres, 2006). *Thus, the question is: how does music exert its analgesic properties? In the search for answers to this query, various theories and hypotheses have been proposed (Gagner-Tjellesen et al., 2001). The auditory stimulation of music produces a biological effect on human behaviour by engaging specific brain functions (Thaut 1990). The effect of music is perceived in the right hemisphere of the brain (Thaut 1990, Lià ©geois-Chauvel et al., 1998, Myskaja and Lindbaeck, 2000), whereas a greater portion of interpretation occurs in the left hemisphere (Thaut 1990, Myskaja and Lindbaeck, 2000). Music stimuli serve as a distraction (Good et al., 2000; McCaffery and Good, 2000) and cause the prefrontal cortex to be conditioned to the music, which is more pleasant, (Nilsson, 2008), familiar, relaxing (Mok and Wong, 2003) and preferred (Siegele, 1974; McCaffery, 1992; Mok and Wong, 2003). Patients can thus, focus their awareness from the noxious input unto the music (Fernandes and Turk, 1989; Good et al., 1999; Willis, 1985) to aid relaxation (Beck, 1991; White, 2000; White, 2001; Thorgaard, 2005). Although patients are often in a transitional zone between consciousness and sleep during the perioperative period, the sense of hearing still persists amidst the impairment of other senses (Nilsson, 2003). As a result, music may be of immense benefit to this population. The inhibition of the afferent noxious impulses causes the activation of *endogenous opiates, descending nerve impulses, and neuropeptides in the in the central nervous system (Andy, 1983; Yezierski et al., 1983). Subsequently, excitatory neurotransmitters such as substance P, prostaglandins, bradykinins are inhibited leading to reduced muscle and mental tension (Good, 1995; OCallaghan, 1996; Taylor et al., 1998). On the contrary, it has also been demonstrated that music, which is inappropriately used, can aggravate pain sensation and thus can increasing pain perception and experience (OCallaghan, 1996). The Ghanaian Context Despite the fact that 3.5% of the worlds surgical operations are performed in developing countries (Weiser, Regenbogen, Thompson et al., 2008), the management of postoperative pain is poor in Ghana (Clegg-Lamptey and Hodasi, 2005; Murthy, Antwi-Kusi, Jabir et al., 2010). This may be due to factors such as inadequate knowledge, negative attitudes (Hall-Lord and Larsson, 2006), discrepancies between healthcare professionals and patients assessment of postoperative pain and the lack of relatively efficient analgesic techniques such as PCAs and epidural analgesia (Murthy et al., 2010). Moreover, the use of non-invasive, safe and cheap nonpharmacological interventions such as music is also underutilised. Music plays a vital role in the life of an African; however, the origin of music therapy in African societies remains a puzzle due to the lack of indigenous written records (Aluede, 2006). Although, many Ghanaians love music (FGMSA, 2010), music therapy in Ghana is currently at its embryonic stage (Kofie, 2004). Music, as the *stock-in-trade of traditional healers is used in the Ghanaian society. It accompanies their set of dances until they reach the semi-conscious state whereby they begin their communication with ancestral spirits. During this enterprise, music stimulates their ecstasy and they are being offered concoctions that may be used in healing the sick (Kofie, 2004). Music is also an effective form of therapy for patients who believe their ailments is a form of misdemeanour towards others and for that manner receiving punishment from the ancestral spirits (ibid). Rationale for the Proposed Review The use of music as a postoperative pain intervention has prompted various research studies (Ikonomidou et al., 2004), leading to the publication of numerous articles (Anderson et al., 2005; Good et al., 2001, 2002, 2005; Heiser et al., 1997; Heitz et al., 1992; Ikonomidou et al., 2004; Nilsson et al., 2001, 2003; Taylor et al., 1998). Nevertheless, these studies have reported mixed/ contradictory/ conflicting findings. While some show improved pain relief (Anderson et al., 2005; Good, 1999; Good et al., 2001; Good et al., 2002; Good et al., 2005; Heitz et al., 1992; Laurion and Fetzer, 2003; Masuda, Miyamoto, and Shimizu, 2005; McCraty et al., 1998; Mullooly et al., 1988; Nilsson et al., 2001; Nilsson et al., 2003), others showed no difference in pain management among study participants (Blankfield et al., 1995; Good, 1995; Heiser et al., 1997; Ikonomidou et al., 2004; Taylor et al., 1998). The approaches used in these studies have mainly been experimental, however, most of them lac k strict control with various outcome measures ranging from psychological (pain, anxiety), physical (sleep) to physiological parameters (heart rate, respiratiory rate, blood pressure). In an attempt to find solutions to the efficiency of music as a pain management intervention, an increasing number of systematic reviews (Cepeda et al., 2006; Dunn, 2004; Engwall and Duppils, 2009; Evans, 2002; Nilsson, 2008) have been published during the past years. Nonetheless, the conclusions from these studies may not be fully supported for various reasons such as poor methodological quality of included studies, limited search strategies, inclusion of studies from only developed countries and being outdated. Evans (2002) conducted a systematic review on the efficacy of music as an intervention for hospitalised patients. This review included postoperative pain as well as pain occurring after certain procedures. Of the four eligible studies, three of them found no difference in pain scores and analgesic consumption (Blankfield et al., 1995; Good, 1995; Taylor et al., 1998) while the remaining study (Koch et al., 1998) reported a reduction in analgesic consumption among the music intervention group. On this basis, he concluded that music may be an effective diversion in treating pain. This assumption may be obstructive due to limited evidence as at that time and its resultant myopic inference. A systematic review conducted on the efficiency of music in reducing postoperative pain (Dunn, 2004) was also inconclusive due to the poor methodological quality of the included studies. Moreover, it was also restricted to developed countries such as the United Kingdom and the United States of America. For this reason, such findings may not be applicable to other developing countries such as Ghana, where the clinical settings and management may be different. Cepeda et al. (2006) systematically reviewed the literature on the use of music for relieving pain. This review included all types of pain ranging from acute, procedural, cancer and chronic pain. It was concluded that music listening reduces pain and analgesic consumption, but the magnitude of these effects is small and thus, had vague clinical significance. Based on this premise, it was recommended that music should not be used as a first line management option for pain. Although the conclusions are quiet reasonable, this review is outdated (Kaveh et al., 2007) due to the publication of new studies that specifically report on the use of music in patients experiencing postoperative pain. Another systematic review (Nilsson, 2008) was also conducted on the efficacy of music in relieving postoperative pain and other parameters such as anxiety and stress. This review limited the inclusion criteria to studies conducted between 1995 and 2007. The review concluded that: approximately half of the reviewed randomised controlled trials favoured the pain reducing effects of music while the rest were not in support of this. In the light of this, the author recommended some additional studies to be conducted in this area [ibid]. A recently published article in 2009 concluded that music can be used as an adjuvant for pain relief (Engwall and Duppils, 2009). This conclusion may not be fully supported considering the fact that the review included other non-randomised controlled trials (which are subject to biases). Moreover, the review included the combined use of music with other nonpharmacological interventions (such as jaw relaxation, therapeutic suggestion, guided imagery and so on) which creates difficulties in determining whether the outcomes is solely due to music or the other interventions. The review also used few databases (Blackwell Synergy, CINAHL, PubMed and Elsevier/ Science Direct) and restricted the review to studies conducted between 1998 and 2007. Considering the publication of new randomised controlled trials that have reported conflicting findings (Allred, Boyers and Sole, 2009; Cooke et al., 2010; Ebneshahidi and Mohseni, 2008; Good and Ahn, 2008; Hook, Sonwathana and Petpichetchian, 2008; Sen et al., 2009) and the limitations identified in previous reviews, an updated version of a systematic review conducted on this topic will be of immense benefit. My review, therefore intends to include randomised controlled trials irrespective of the location, and will include only music as the nonpharmacological pain intervention. I will also expand my search strategy to include other databases and will not limit it to any year range since music is not an intervention that becomes outmoded with time and largely depends on an individuals preferences. Summary In this section the background information and literature on the use of music in relieving postoperative pain has been provided. Moreover, the rationale for the systematic has been thoroughly explained as well as the justification for the review question. Chapter Two Methodology Once a research question has been shaped, it is useful to think about its type, as this will have an effect on what kind of research would provide us with the greatest quality evidence. The review question concentrates on music as a postoperative epain management intervention for patients after all kinds of surgery. In providing the best evidence of effectiveness of an intervention, a systematic review is considered the most suitable way. This is because it summarises or draw conclusions from primary research on a specific subject, therefore increasing the number of subjects and enhancing the power to detect an intervention effect (Dickson, 2003). This chapter will discuss the systematic review approach and evaluate its role in evidence-based practice. It then outlines the strengths and limitations of systematic reviews. Following this, a description of the procedural steps is given. Finally, the method used to conduct this review is discussed. l Definition of Systematic Reviews Types of Systematic Reviews Systematic Reviews Process The Role of Systematic Reviews in Evidence-based Practice In an era of evidence-based nursing, care providers need to base their clinical decisions on the preferences of patients, their clinical expertise, as well as the current best available research evidence relevant for practice (Beaven and McHugh, 2003; Mulhall, 1998; Sackett and Rosenberg, 1995). Implications from the ever expanding volumes of healthcare literature (Beaven and McHugh, 2003) means that, it is impossible for a clinician to access, let alone understand, the primary evidence that informs practice (Glasziou, Irwig and Colditz, 2001; Handoll et al., 2008). As a result of this, useful research studies and valuable findings are concealed and abandoned as a whole (Beaven and McHugh, 2003). Systematic reviews of primary studies are therefore an essential aspect of evidence-based healthcare for practitioners who want to keep up to date with evidence in making informed clinical decisions (Lipp, 2005; Glasziou et al., 2001; Handoll et al., 2008; Schlosser/ FOCUS, 2010). Commencing with a well-defined research question, such reviews utilise explicit methods to systematically identify, select, critically appraise, extract, analyse and synthesise data from relevant studies on a particular topic (Handoll et al., 2008; Petticrew and Roberts, 2006; Wright et al., 2007; Sackett et al., 2000). This process helps to minimise bias (Cook, Mulrow and Haynes, 1997), eliminate poorly conducted studies, confers power to the results that may not be given to individual studies (Lipp, 2005) and thus provide practitioners with reliable, valid and condensed evidence (Glasziou et al., 2001) in a considerably shorter period of time (Mulrow, Langhorne, and Grimshaw, 1997). Systematic reviews may involve the use of statistical methods (meta-analysis) (Handoll et al., 2008) in estimating the precision of treatment effects (Egger, Smith and ORourke, 2001). Unlike traditional narrative reviews, systematic reviews allow for a more objective appraisal of the evidence and may thus contribute to resolving uncertainty when original research, and reviews disagree (Egger et al., 2001). By using an efficient scientific technique, systematic reviews also can counteract the need for further research studies and stimulate the timelier implementation of findings into practice (Lipp, 2005). They can also inform the research agenda by identifying gaps in the evidence and generating research questions that will shape future research (Eagly and Wood, 1994; Handoll et al., 2008; Lipp, 2005).