Radiographic Modalities in Detecting Suspected Child Abuse

Radiographic Modalities in Detecting Suspected Child Abuse The moves people make against a youngster so as to perpetrate passionate or physical mischief are, tragically, restricted uniquely by the creative mind. Youngster misuse has been officially characterized as the shaking, punching, battering, hitting, harming, singing or consuming, suffocating or suffocating a kid as well as in any case taking an interest in activities that lead to the child’s physical damage (Safeguarding Children 2006). As of the most recent quite a while, the meaning of kid misuse has likewise coordinated the inability to forestall damage to a kid (Safeguarding Children 2006). In 1946 pediatric radiologist John Caffey first used radiographic pictures in the finding of youngster misuse when cracks of the long bones were joined by subdural hematomas (Longman, Baker Boos 2003). In 1962 Kempe et al. (as refered to by Longman, Baker Boos 2003) offered the term battered youngster disorder to depict wounds found in kids steady with examples of misuse, with skeletal oddities the most widely recognized wounds found in this condition. For instance, bone breaks are seen in as much as 55% of misuse cases (Longman, Baker Boos 2003). As momentum research shows (Freeman 2005; Zimmerman Bilaniuk 1994), the radiographer is regularly the main human services supplier that kid sees who is in a situation to associate or decide the nearness with a non-mishap injury (NAI). Davis (2005) brings up the radiographer sees the kid stripped and is in a situation to see lash marks and other wounding demonstrative of youngster misuse while trying to recognize different zones of injury th rough the radiographic assessment; along these lines seeing irregular wounding or other improper real checks on the patient can help set up an example of maltreatment related to the radiologic discoveries of injury. While Silverman (1987) states that radiography can be utilized to decide both nature of injury creating power just as time of injury alert is likewise pushed as different issues that radiography traditionally is utilized to distinguish can be mistaken for youngster misuse, for example, the radiologic proof of scurvy, osteogenesus blemished, self-supported injury and childish cortical hyperostosis. Youngster misuse measurements Longerman, Baker and Boos (2003) relate stunning measurements for youngster misuse. In the only us during 2000, 1,200 youngsters were lethally harmed in scenes of kid misuse, For instance one to two kids are lethally manhandled by a parent or other guardian on a week after week premise (Safeguarding Children 2006). Norris (2001) states that as much as 27% of cases introduced as accidental wounds were in reality because of occurrences of kid misuse. Youngster misuse related fatalities among kids under 1 year old enough comprise 41 44% of detailed instances of misuse or disregard (Offiah 2003’ Longerman, Baker Boos 2003). Radiographer duties by law The law is very unequivocal with respect to the job of the radiographer in instances of suspected youngster misuse. For instance, the Children’s Act of 1989, Section 27 unequivocally requires every human services supplier to play out all assessments mentioned by other social insurance experts or lawful specialists when cases present with suspected youngster abuse or misuse (Aspinell 2006; Freeman 2005). As a subordinate to the 1989 Act, with explicit respect to human services experts, The Children Act of 2004 orders an additional duty past individual practice rules when working with a manhandled kid or suspecting abuse, and necessitates that medicinal services specialists cooperate to share data as suitable and participate so as to offer the best treatment for the youngster (Aspinell 2006; Davis 2006). Extra rules on the radiographer’s job in instances of suspected kid misuse are promptly accessible (Freeman 2005). Be that as it may, regardless of whether law or not, eventually, the radiographer has legitimate, proficient and individual obligations in identifying instances of suspected kid misuse and has many imaging methodology alternatives. Stover (1986) lets us know explicitly that radiographic assessments can help the distinguishing proof of the injury, instrument of injury, for example, shaking, bending, footing of an appendage or direct blow. Moreover and all the more critically, the radiographic assessment can recognize earlier injury and decide proof of mending forms; which are all vital in circumstances of suspected youngster misuse, abuse or risk (Stover 1986). In this way, this exposition will audit the scope of radiographic imaging methodology choices accessible when kid misuse is suspected. It is considered past the extent of this article to talk about the legitimate jobs and duties of the radiographer in instances of suspected youngster misuse and all things considered, data identifying with this will be expressly rejected past those demonstrations and rules featured previously. Additionally, it is considered past the degree to examine radiographic diagnostics comparable to imaging advancements. The rest of this paper will concentrate carefully on imaging modalities. Standard radiographic x-beam Kirks (1983) accepts that standard radiographic x-beam (SXR) imaging is proper for wounds related with skeletal breaks, pneumoperitoneum, gastric dilatation or injury to the aspiratory parenchyml, which are normal in instances of kid misuse. Specialists disclose to us that skeletal assessments are especially important in cases were non-unplanned injury (NAI) is suspected (Gutanunga, Evans Harrison 2007, Johnson 2007; Summerfield et al. 2007; Offiah 2003) and is the most grounded radiologic based pointers that youngster misuse or abuse has occurred (Diagnostic imaging 1991). Specifically, Alexander and Kleinman (1996) accept that in kids under 2 years old giving wounds steady with youngster misuse the skeletal overview is basic. Parks (2002 as refered to by Imaging suspected NAI 2002) reveals to us that in spite of the fact that the most suitable in instances of suspected NAI, the skeletal overview is one of â€Å"the most troublesome assessments to perform† given general hesitance of the little youngster to submit to the assessment, the sincerely charged situation encompassing the skeletal review demand and the incessant criticalness required. The skeletal overview normally comprises of the accompanying pictures: AP/PA chest, diagonal perspective on the ribs, sidelong skull study in a more established youngster, AP pelvis/femora, AP tibia/fibula, AP humeria, AP lower arms, DP/AP hands, Half pivotal/Townes skull projection, AP 20 degrees skull projection and horizontal aptitude projection in more youthful kids, parallel spine and DP of the feet (Parks 2002 as refered to by Imaging suspected NAI 2002). So as to limit radiation introduction to the creating tissues of little youngsters, exceptional pediatric imaging frameworks have been modernized to utilize uncommon tapes, movies and increase screens (Diagnostic imaging 1991). In youngsters more seasoned than five years old, Alexander and Kleinman (1996) disclose to us the skeletal study is essentially of no utilization when screening for wounds, yet clinical pointers should direct whether such a radiographic assessment is performed. A fresher radiographic aide to skeletal overviews is the bone scintigraphy, additionally alluded to as radionucleotide scintigraphy (Conway et al. 1993; Howard, Barron Smith 1990), supported by ebb and flow research as a corresponding method to the skeletal review as opposed to a substitution when NAI and kid misuse are suspected (Mandelstam et al., 2003). Mandelstam et al. (2003) archived the capacity to distinguish hard peculiarities that avoid customary radiographic skeletal pictures. For instance, 20% of those concentrated by Mandelstam et al. (2003) announced typical skeletal overviews; anyway wounds were apparent upon bone scintigraphy. This model confirmations the expanded affectability of the bone scintigraphy noted by Conway et al. (1993), making a bit of leeway in surveying delicate tissue wounds notwithstanding injury to bone structures. Apgar (1997) stresses SXRs can be of foremost significance for surveying potential kid misuse or abuse through the imaging of hands and f eet to evaluate for breaks. Specifically, Apgar (1997) reveals to us that bone sweeps and skeletal overviews that emphasis on a diagonal perspective on the hand or foot join to report breaks in the hands and feet through confirming recuperating at various stages just as distinguishing cracks from bowing or turning an appendage or digit as opposed to exacting a hard impact. Alexander and Kleinman (1996) accept the skeletal overview ought not be utilized as an essential demonstrative methodology, however ought to be utilized related to SXRs. By and large a GP or essential consideration doctor will demand a skeletal overview be performed when kid misuse is associated to evaluate current and age with earlier wounds. CT Scan Non-unintentional head wounds (NAHI) are the main source of death or neurological brokenness found in babies (Jaspan et al. 2003). Analysts concur CT checks are the perfect radiographic methodology to survey pediatric head injury from which to assess injury as well as family conditions that would prompt NAIH ends characteristic of kid misuse or abuse (Jaspan et al. 2003; Hymel et al. 1997; Alexander Kleinman 1996). Fell (2007) reveals to us CT is suggested over standard SXR as SXR are known to defer analysis; anyway SXR in a triage setting when CT isn't accessible when combined with understanding perception is as yet an alternative. Stover (1986) accepts that a head CT ought to be viewed as required for episodes of pediatric head injury. Lamentably, as Jaspan et al. (2003) demonstrate, there are no consistently settled upon conventions for radiographic imaging of NAHI. Moreover, Alexander and Kleinman (1996) accept that CT examines without the utilization of a MRI may disparage the d egree of injury supported, for instance, MRIs can picture subdural hematomas, which as per Alexander and Kleinman (1996) might be â€Å"the just target imaging proof o

Advantages and Disadvantages of Franchising

Points of interest and Disadvantages of Franchising Diversifying Franchising is game plan where one gathering (the franchiser) awards another gathering (the franchisee) the option to utilize exchange name just as certain business frameworks and procedures, to deliver and showcase great or administration as per certain particular. The franchisee generally pays a one-time establishment charge in addition to a level of deals revenueas sovereignty, and increases quick name perception, attempted and tried items, standard structure and decor,detailed method in running and advancing the business, preparing of representatives, and continuous assistance in advancing and overhauling of the items. The franchiser increases fast development of business and earningsat least capital-cost. Highlight of the establishment is that every purchaser embraces to satisfy the different conditions and necessities of the dealer (franchiser), identified with the creation and offer of merchandise and the arrangement of related administrations to buyers. According ly, on the planet showcase there are gatherings of organizations joined in a solitary framework under the sponsorship of a significant global enterprise. Its accomplices in the agreement the franchisor gives counsel on corporate area, chooses hardware, helps in preparing, exhortation on the board, and may likewise give money related help. This encourages the normalization and unification of items and administrations of the organizations remembered for the arrangement of diversifying gives solidarity on advertise occasions, style and structure, the nature of merchandise and enterprises sold the centralization of acquisition related reserve funds (and the extra advantage to the franchisor). Focal points of diversifying mode are following (Kotler, 2002, p. 377): Rapid development of deals showcases, the increment in deals volume and the regional extension of the business Absence of the expense of the vertically-incorporated system the executives (decrease of staff costs) A lower level of own capital speculation Lift the glory of the organization and its trademark, acknowledgment from the clients, expanded trust in the quality and scope of items a solitary organization Income from the offer of the permit and leasing land establishment and gear Profit from loaning openings franchisees and lessening the hour of turnover. Drawbacks of diversifying mode are following (Kotler, 2002, p. 377): The probability of a littler piece of the benefits from the establishment business than on their own Low notoriety of one of the establishments without appropriate quality control can influence the notoriety of the firm; Difficulty in controlling the unwavering quality of money related detailing franchisee The franchisor is setting up a potential rival despite franchisee organization Joint endeavors Joint endeavors are frequently made for access to remote markets, company’s choice to collaborate with their outside accomplice, sharing proprietorship and power over the exercis es of the organization. In world practice, there are numerous instances of notable relationship of firms and partnerships to tap new markets and increase upper hand. Making of a joint endeavor might be the favored strategy for access to outside business sectors for the accompanying reasons: 1. In the event that the organization comes up short on the money related, innovative, administrative and different assets for self-advancement in outside business sectors 2. On the off chance that the legislature doesn't admit to its market outside organizations or auxiliaries without the support of nearby capital for some political or monetary reasons; 3. At the point when the organization, for monetary reasons, collaborate with an outside organization for the joint creation, the offer of which will give the organization higher benefits because of the minimal effort of utilization of nearby assets (work, crude materials, and so forth.)

The best of English, the worst of English

The best of English, the worst of English Hello, everyone! Its been awhile. How are you? This semester Ive been running around campus, and it looks a little bit like this. You may know the feeling: head down, tiny legs running faster than you thought they could to get out of the rain/cold/slush the weather decided to bestow upon us that day. Maybe a casual face-plant, or two. Although everything seems to be a dash for the finish line, I wanted to take a moment to slow down and appreciate my major. This semester is the first semester that Ive only had one English class. Most of my time is spent working at the Admissions Office, The Daily Illini, and at a startup, but last year I was taking three English classes a semester and I absolutely  loved  it. Sure, there can be a lot of papers (and by that I mean around 30 pages per class, per semester) but English classes provide you with something that a lot of other classes dont: connection. My classes vary in size, but every discussion session is about 15 people. Thats only  15 people, with their own respective majors, interests, ideas, hobbies, and opinions. And you get to know them, I promise. We are a relatively tight-knit group. When you put 15 people into a room all semester and just tell them to talk about books, its an experience that you wont get anywhere else. I dont think that even book clubs usually achieve this level of discussion (but that may have to do with the readings not being mandatory). Either way, its something to appreciate more as I transition from my major classes to my minor classes, which are a lot of large lectures. There are so many English courses to take, with so many topics available its sometimes hard to decide. Ive taken pre-18th century, post-18th century, medieval bodies, Shakespeare, Romantic literature, American literature, heroism and national identities (a comic book class), 19th century womens writers, and slew of other courses. Ive learned that, while it is amazing to be able to read all of the books I actually want to read (that youd probably never imagine reading for course material) its whats beyond that that matters. My backpack, sometimes. English forces you to look at things differently, survey a situation from all angles, and make an argument based off of your observations. Its difficult to convey your thoughts sometimes, and get them across to a large community of peopleâ€"often how its difficult to pitch a new idea to a boardroomâ€"but it provides you with that essential skill of written communication. Granted, it can be extremely difficult to churn out a 10-page paper in a couple weeks. The frustration of starting it is what gets me the most. But being able to demonstrate your thought process,   clearly explain what you want to say in a concise manner and actually have people understand it, thats rewarding. To some in the business world, its invaluable. Overall, its easy to say that I love my major, and my classes. But its nice to take the time to sit down and think about everything Ive accomplished so far in my years at the university. Its a lot more than reading books, and with my major Im confident that I can find my fit in a number of different fields. Just remember, no matter what your major, to pursue what makes you happy. If you ever have any questions about English majors, classes, or school in general, feel free to comment below. Alexandra Class of 2019 I'm an English major in the College of Liberal Arts and Sciences. I'm also minoring in Business. May my blogs help you with your searches toward finding what you love.

Hobbes vs. Thoreau - 2591 Words

Thomas Hobbes’ book, Leviathan and Henry David Thoreau’s essay, Resistance to Civil Government could not be more opposed when it comes to looking at the social contract from a political philosophy viewpoint. On the one hand, Hobbes maintains that humanity’s utmost obligation is to submit oneself to the authority of the sovereign state. Thoreau, on the other hand, argues that under specific circumstances, it is humanity’s duty is to resist the state. This paper will argue that Hobbes does not succeed in establishing our obligation to submit to the sovereign’s authority. Instead it is Thoreau whom is correct that in certain circumstances we are obliged to resist the State. The two main issues with Hobbes’ reasoning in Leviathan regarding the†¦show more content†¦One of the first aspects of Hobbes’ work that undermines his, mostly logically-sound Leviathan, concerns the Laws of Nature. Hobbes seems to take it for granted that all the people in a single state would agree with one another to submit all of their power to one authoritative entity, on the basis that they will realize it is in the best interest of their security. As professor Ian Johnston says, â€Å"If human beings are like sheep, I dont see why they need a ruler; if human beings are like wolves, I dont see how they will tolerate a ruler.† If, as Hobbes suggests, the state of nature is anarchy, then what aspect of nature drives all people to form a commonwealth? In this respect, it appears that Hobbes contradicts himself, for he proclaims that man is brutish, violent, and only concerned with self-interest, however he is also reasonable enough to form a social contract in which his own ease and commodious living is secured. In light of the latter characteristics of man that Hobbes describes, where man is rational enough to participate in such a social contract, the necessity of submitting oneself entirely to the sovereign authority is unfo unded and too extreme. The second main issue with Leviathan concerns the power of the government. Hobbes fails to explain why people would trust an authority made up of other people, no different from themselves. If every person knows that their own inherent violence and selfishness is what necessitates

Mass Media Such As Television, Newspapers, And Internet

Mass media such as television, newspapers, and internet are the center of the public s communication and entertainment. Society relies heavily on mass media for their news, education, entertainment, and their socialization. It can inspire, persuade, and change the behavior of the audience depending on the objective. The public is often misinformed and uninformed by media outlets to control the information that reaches the public. As technology continues to grow, access to mass media continues to grow as well. Society has 24/7 access to news at all time whether it be on television, computer, cell phone and so on. The constant access also means the public has devices readily available to shine a light on things happening around them that†¦show more content†¦With the media’s ability to control the news, they play a significant role in politics. Citizens rely on mass media to keep them informed on political issues so that they can form an opinion about current events an d vote accordingly in polls. Unfortunately, according to Graber and Dunaway (2015), Like caricatures, media stories often create skewed impressions because they cannot report most stories in detail or full context. The lack of truth and details gives citizens the wrong idea of what is happening and a false impression of people represented in the stories. Therefore, the citizens remain uneducated and uninformed in regards to political issues and politicians, so they are unable to make the decisions needed to better the economy and the future. During the 2016 Presidential campaign between nominees, Hillary Clinton and Donald Trump, there was a tremendous amount of news stories spreading around the country. These stories had no evidence or facts to support their claims. Both candidates were depicted in situations that were untrue. Many false news sites published articles giving the public the impression that Hillary Clinton was heading to prison following an e-mail investigation by t he Federal Bureau of Investigation. Many fake news stories were shared about Donald Trump such as a story stating that Pope Francis endorsed him. The stories continuedShow MoreRelatedThe Effects Of Digital Media On Society s Media1714 Words   |  7 Pagesundeniable that the society is experiencing a mediated culture, where mass media have direct effects on our society. Newspapers, magazines, radios, and televisions constantly give out messages to promote products, attitudes, and ideas in an attempt to influence audiences. The effect is further enhanced when digital media, particularly the Internet, enters the competition for the limited supply of audience attention. 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With recent technological advancements, such as television and the internet, news and information can be widely shared concerning immigration. With the continual increase of news programs, Americans today are often bombarded with all sorts of pressing issues in todays society- but, how do you decide where to get information about issues such as immigration? In todays major media installments, the attentionRead MoreEvolution of Mass Communications Essay examples1151 Words   |  5 Pagesevolution of mass communications has gone through majo r developments; from etching the beginnings of an alphabet into a rock the size of a standard dinner table to letting a computer recognize words spoken into a speaker as it types away what it hears. Dating back to around 1700 B.C. when the first alphabet was said to come into existence, society has come far in different fields of communications. Nothing made as large of an impact in the world of communications as the revolution of the Internet. 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As the use of mass media continues to evolve, so will the way we interpret, view, and use them. Newspaper Magazines Mass media over the century has grown from

Use of Real Options Theory in Financial Management/Modeling Free Essays

At a previous employment environment, the president of the corporation acted on a whim, rather than, conducting a series of testing for his expansion to go into other businesses ventures. Within a few short months, the plan was abandoned for lack of profitability. As an employee, I thought of this as a failure on the owner’s part. We will write a custom essay sample on Use of Real Options Theory in Financial Management/Modeling or any similar topic only for you Order Now However, the Real Options Theory is basically, weighing the outcome for expansion or acquisition utilizing capital investments for future ventures. Consider Real Option theory as a method to remove some of the risk in capital investments. Helpful assistance and decision making can be derived using such charts as the Decision Tree. The decision can be extremely tiresome. Use of Real Options Theory in Financial Management/Modeling Long past are the days, where a company can sit idling waiting for an idea, because while waiting someone else is making the move. The benefits that an older company may experience through experience may not fit into today’s society of technological changes. However, the risk of a company that has existed over 50 years, can they lose to new companies that evolve because of revolutionary changes in the ability to change the course of history. Creating valuable service for consumers and bringing a product or service to market, must be planned to meet the expectations of stockholder profits. Consider the comparison of social networking sites, Myspace and Facebook. Both are considered to be rapidly growing and competitive to increasing in membership. However, rapidly increase the popularity of Facebook and exceeded the expectations within the social network environment. The billion dollar corporation enters the market with more appeal to younger consumer, as well as a variety of other industries. Facebook provided more appeal by allowing the markets to meet the consumer where they were located, rather than wait on the consumer to come to them. As financial managers in the corporate environment decide which project is beneficial to stock holders’, returns on investment, and which should be abandoned or expanded, risk can become a certainty in the outcome. The risk of capital investment in the attempt to take on future debts just because they have a hunch that the business will be a success. The amount of time to construct a business model would save enormous amounts of money before taking on the future project. Gathering data of the competitive market and using past financial accounting statements will be useful, however, with new projects, there will be limitations, but estimation of the percentage values can be constructed. Strategic budgeting and capital investment planning decisions to expand into the future profitability of a company can be agonizing if not properly planned by financial managers. The assets, in addition to capital and distribution, change over long periods of time according to the supply and demand of the consumer markets. The net present value (NPV) of what is available, as far as Return on Assets and the Return on Investment (ROI). Cost projection into buying new equipment, inventory over the long run rather than a short period. Capital resources and budgets are the topics as it relates to using the Real Options Theory in Financial Management Modeling. Financial managers can utilize the Real Options Theory as a series of practical solutions to foresee into the future over several years. New products and the amount of capital to invest as well as the funding needed to make an expansion or either to realize that the project would not work. Theoretically, it is very simple and that many companies would utilize this theory. However, the recap or history of business failures is not seen in the futility of business success. The numbers may not lie. All systems may say go full steam ahead with the plans for expansion; however, there is a business cycle which will prove the business model incorrect. According to Rothbard, (2005), expectation in business fluctuations all the time. There is no need for any special â€Å"cycle theory† to account for them. It is simply the results of changes in economic data and is fully explained by economic theory. Many economists, however, attribute general business depression to â€Å"weaknesses† caused by a â€Å"depression in building† or a â€Å"farm depression. † But declines in specific industries can never ignite a general depression. Shifts in data will cause increases in activity in one field, declines in another. There is nothing here to account for a general business depression — a phenomenon of the true â€Å"business cycle. † It is pointless to say, as many people do, that a farm depression will ignite a general depression, because farmers will buy less goods, the people in industries selling to farmers will buy less, etc. This ignores the fact that people producing the other goods now favored by consumers will prosper; their demands will increase. (2005, pp. 6) Both the entrepreneur and large corporations have ideas to expand into new market. The main goal is company profits, either with or without expansion. Business expansion into other industries or international territories with current business. However great the idea may seem at the Real Options application of theory will conclude how fallible an idea with be in implementation. Payback period, cash flows and internal rate of return, as well as long term debt financing are the foundation of provision for utilizing the real options theory. Major growth will not derive from duplication of products that are already in the market place, but to begin with creating superior quality and improvements. Such as Facebook found a better way for people to communicate over the internet. Before Myspace, there were such things as electronic mail. Facebook, the ability to socialize as well as form groups, and fan pages begin with meager begins on a college campus. However, did the owner plan for this growth or was it happenstance. How does the work into the corporate structure for a welding company or maybe a warehouse which manufactures auto parts? Examining the stream of information within the forums, research and development addressed. According to Ketchen et al, (2007), â€Å"entrepreneurship refers to firms’ pursuit of superior performance via simultaneous opportunity-seeking and advantage-seeking activities. Both small and large firms face impediments while pursuing strategic entrepreneurship† (2007, p. 71)In other words, rather an entrepreneur or fortune 500 company, Real Options Theory, should be the focus to starting a new business, taking on expansion or abandoning projects. The only difference will be in the amount of capital investments. Kretchen et al, continues to state, Ketchen, et al, (2007), While small firms’ opportunity-seeking skills may be strong, their limited knowledge stocks and lack of market power inhibit their ability to enact the competitive advantages necessary to an appropriate value from opportunities the firms choose to pursue. In contrast, large firms are skilled at establishing ompetitive advantages, but their heavy emphasis on the efficiency of their existing businesses often undermines their ability to continuously explore for additional opportunities. (2007, p. 371) There are many three components in which company financial manager should be interested in the expected return on assets (ROA), return on equity (ROE) and debt ratio. Finally, another method of expansion can be with the acquisition of new business that is in operation. As stated by Stefano, Reality is that buyers must have capital available to be competitive in acquisition negotiations. Accumulating capital may be as simple as retaining earnings in the agency instead of distributing those earnings, which is the equivalent of creating a war chest. The other option is to have a line of credit available from a financial institution. Banks are much more willing to offer financing for acquisitions than in years past. Today many banks are in the insurance business and got there through acquisitions. Insurers are also very supportive of the acquisition process and will uncover acquisition prospects because they like to see their successful agencies growing. Stefano, 2005) As explained by Childs et al, (Sep. , 1998), summarizes several calculation in deductive and calculated reasoning for financial managerial modeling and utilizing the Real Options Theory. They state, â€Å"consider a firm that has the opportunity to invest in two projects (a and b). Investment in each project takes place in two stages: The firm can invest in C1 R (I = a, b) to develop a project, which res olves uncertainty regarding the project’s future profitability; it can then make a further investment of K1, (i= a, b) to implement a project. 1998, p. 308). It is clearly mentions by Childs et al, the â€Å"NPV framework for making capital investment decisions has been extended to recognize the dynamic nature of investment decisions† (Childs, p. 305) According to Miller who goes into greater details of the formulation of providing computations to make a decision, it basically states if one project NPV is greater than 0, then it would be wise to invest in the project or product. Screenshot, (2005, p. 7) Summary Companies can no longer hesitate to make a business decision. However, ecisions that are not planned out utilizing capital assets can also cause undue hardship. It is no longer the large Fortune 500 companies designing the most innovative products and services, but also it can be the small entrepreneur with a grand idea. The markets no longer persuaded by familiar names, but can be mesmerized by new names such as Facebook. Methodology and theoretical planning and measurements can be experimenting with resourceful application s as Real Options Theory. By carefully measuring the logistics of one or more projects and committing or abandoning them all. How to cite Use of Real Options Theory in Financial Management/Modeling, Papers

Lord Woolf’s Reforms Essay Example Essay Example

Lord Woolf’s Reforms Essay Example Paper Lord Woolf’s Reforms Essay Introduction Essay Title: â€Å"Although settlement, rather than litigation, poses a number of problems for a civil justice system these matters have been largely resolved by Lord Woolf’s reforms. † What is civil justice system? There are several definitions for the civil justice system. Every civilized system of government requires that the state should make available to all its citizens a means for the just and peaceful settlement of disputes between them as to their respective legal rights. The means provided are courts of justice to which every citizen has a constitutional right of access. Lord Diplock in Bremer Vulkan Schiffb au and Maschinenfabrik v South India Shipping Corp. [1981] AC 909, HL, p. 976. The justification of a legal system and procedures must be one of lesser evils, that legal resolution of disputes is preferable to blood feuds, rampant crime and violence. M. Bayles, ‘Principles for legal procedure’, Law and Philosophy, 5:1 (1986), 33–57, 57. The first impulse of a rudimentary soul is to do justice by his own hand. Only at the cost of mighty historical efforts has it been possible to supplant in the human soul the idea of self-obtained justice by the idea of justice entrusted to authorities. Lord Woolf’s Reforms Essay Body Paragraphs Eduardo J. Couture, ‘The nature of the judicial process’, Tulane Law Review, 25 (1950), 1–28, 7. There have been over 60 official reports on the subject of civil processing the past. Latest published reports were Evershed Report in 1953, the report of the Winn Committee in 1968, the Cantley Working Party in 1979, the Civil Justice Review in the late 1980s and the Woolf. All those reports are focused on the same objects like how to reduce complexity, delay and the cost of civil litigation. What are the problems before reforms? This is a mere compare of the pre-Woolf and post-Woolf civil landscape without baseline statistics. As research for the Department of Consumer Affairs (DCA) on the pre-Woolf litigation landscape (pre-1999) demonstrates that: 50% – 83% of defended cases in the county courts were personal injury (PI) claims overall at least 75% of cases were within the small claims or fast track financial limit; in most courts this figure was 85% or mo re the higher the value of the claim, the more likely both sides were to have legal representation PI cases had high settlement rates and a small number of trials. Non-PI cases had a higher proportion of trials, and a much higher proportion of cases withdrawn. Debt cases were most likely to end in trial (38%) and in all of those the claimant succeeded. In 96% of all cases going to trial the claimant was successful In all types of cases 50% of awards or settlements were for? 1,000 –? 5,000, and a further 25% – 33% were for? 5,000 –? 10,000. Costs in non-PI cases were relatively modest, and in PI cases around 50% had costs of? 2,000 or less, 24% had over? 4,000. Wolf Reforms Lord Woolf’s approach to reform was to encourage the early settlement of disputes through a combination of pre-action protocols, active case management by the courts, and cost penalties for parties who unreasonably refused to attempt negotiation or consider ADR. Such evidence as ther e is indicates that the Woolf reforms are working, to the extent that pre-action protocols are promoting settlement before application is made to the court; most cases are settling earlier, and fewer cases are settling at the door of the court. In fact, most cases are now settled without a hearing. Lord Woolf, Access to Justice (Final Report, July 1996), identified a number of principles which the civil justice system should meet in order to ensure access to justice. The system should: (a) Be just in the results it delivers; (b) Be fair in the way it treats litigants; (c) Offer appropriate procedures at a reasonable cost; (d) Deal with cases with reasonable speed; (e) Be understandable to those who use it; (f) Be responsive to the needs of those who use it; g) Provide as much certainty as the nature of the particular case allows; and (h) Be effective: adequately resourced and organized. The defects Lord Woolf identified in our present system were that it is: (a) Too expensive in tha t the costs often exceed the value of the claim; (b) Too slow in bringing cases to a conclusion; (c) Too unequal: there is a lack of equality between the powerful, wealthy litigant and the under resourced litigant; (d) Too uncertain: the difficulty of forecasting what litigation will cost and how long it will last induces the fear of the unknown; (e) Incomprehensible to many litigants; f) Too fragmented in the way it is organized since there is no one with clear overall responsibility for the administration of civil justice; and (g) Too adversarial as cases are run by the parties, not by the courts and the rules of court, all too often, are ignored by the parties and not enforced by the court. The Basic Reforms of Woolf A system is needed where the courts are responsible for the management of cases. The courts should decide what procedures are suitable for each case; set realistic timetables; and ensure that the procedures and timetables are complied with. Defended cases should be a llocated to one of three tracks: (a) An expanded small claims jurisdiction with a financial limit of? 3,000; (b) A new fast track for straightforward cases up to? 10,000, with strictly limited procedures, fixed timetables (20-30 weeks to trial) and fixed costs; and (c) A new multi-track for cases above? 10,000, providing individual hands on management by judicial teams for the heaviest cases, and standard or tailor made directions where these are appropriate. Lord Woolf’s Inquiry was also asked to produce a single, simpler procedural code to apply to civil litigation in the High Court and county courts. The Final Report was accompanied by a draft of the general rules which would form the core of the new code. Pros and Cons of wolf reforms However, costs have increased, or have at least been front-loaded. In particular, in cases where mediation has been attempted and agreement has not been reached, costs are clearly higher for the parties. Litigation will be avoided wherever possible. People will be encouraged to start court proceedings to resolve disputes only as a last resort, and after using other more appropriate means when available. Litigation will be less adversarial and more co-operative. There will be an expectation of openness and co-operation between parties from the outset, supported by pre-litigation protocols on disclosure and experts. Litigation will be less complex. There will be a single set of rules applying to the High Court and the county courts. The rules will be simpler. The timescale of litigation will be shorter and more certain. All cases will progress to trial in accordance with a timetable set and monitored by the court. The cost of litigation will be more affordable, more predictable, and more proportionate to the value and complexity of individual cases. There will be fixed costs for cases on the fast track. Estimates of costs for multi-track cases will be published or approved by the court. Parties of limited financia l means will be able to conduct litigation on a more equal footing. Litigants who are not legally represented will be able to get more help from advice services and from the courts. There will be clear lines of judicial and administrative responsibility for the civil justice system. The Head of Civil Justice will have overall responsibility for the civil justice system. The structure of the courts and the deployment of judges will be designed to meet the needs of litigants. Heavier and more complex civil cases will be concentrated at trial centers which have the resources needed, including specialist judges, to ensure that the work is dealt with effectively. Judges will be deployed effectively so that they can manage litigation in accordance with the new rules and protocols. Judges will be given the training they need to manage cases. The civil justice system will be responsive to the needs of litigants. Courts will provide advice and assistance to litigants through court based o r duty advice ; assistance schemes, especially in courts with substantial levels of debt and housing work. Final conclusion It can be concluded, overall the Reforms were supported by both branches of the legal profession, judiciary and both the lay and the legal press welcomed them. Promoting settlement and avoiding litigation can be the iggest boon to litigants who otherwise when get entangled in the costly and everlasting court procedures suffer a lot. The reforms intended to focus on reduction in cost and delay, however they did not escape criticism and reduction in cost is still considered to be a debatable area. But the reforms were a step in the right direction and were deemed triumphant as they have resulted in justice being accessible to wider proportion of society especially when problem is of small nature and can be quickly and cheaply dealt with in lower courts. Wholistically, the advantages of the Reforms outshine the disadvantages. The reforms were a positive way for th e future; still a lot of work needs to be done in a few areas for making timely, inexpensive justice available to the lay man. Reduction in cost of litigation as a consequence of reforms was not fully realized but nonetheless it cannot be said that reforms had a detrimental impact on civil justice overall as timely exchange of information between the parties does promote culture of co-operation and settlement if not always and as a result of the reforms problem of delay in litigation were well catered. There was a move away from the adversarial culture and increase in out of court settlements was seen. It can be concluded that the foundation stone for a better and prosperous litigation culture has been laid, what needs to be done now is to rectify the shortcomings of the Woolf reforms and build on the so called revolutionary much needed positive reforms aiming to avoid litigation and promoting timely settlement of disputes, so that parties no longer are faced with the never ending l itigation process. Bibliography http://www. lawteacher. net/english-legal-system/lecture-notes/civil-justice-review. php Cambridge University Press: 978-0-521-11894-1 – Judging Civil Justice: Hazel Genn: Excerpt D. Gladwell, ‘Modern Litigation Culture: the first six months of the Civil Justice reforms in England and Wales’ 19 Civil Justice Quarterly, 2000 pp. 9-18 Gary Slapper and David Kelly, The English Legal System 9th edition, Routledge. Cavendish, Chapter 9(The Civil Process), pg 369. P. We will write a custom essay sample on Lord Woolf’s Reforms Essay Example specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Lord Woolf’s Reforms Essay Example specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Lord Woolf’s Reforms Essay Example specifically for you FOR ONLY $16.38 $13.9/page Hire Writer

Writing Letters in Japanese - Format and Tips

Writing Letters in Japanese - Format and Tips Today, it is possible to communicate with anyone, anywhere in the world, instantly by email. However, it doesnt mean that the need to write letters has disappeared. In fact, many people still enjoy writing letters to family and friends. They also love receiving them and thinking of them when they see the familiar handwriting. In addition, no matter how much technology progresses, Japanese New Years cards (nengajou) will most likely always be sent by mail. Most Japanese people would probably not be upset by grammatical errors or incorrect usage of keigo (honorific expressions) in a letter from a foreigner. They will be happy just to receive the letter. However, to become a better student of Japanese, it will be useful to learn basic letter-writing skills. Letter Format The format of Japanese letters is essentially fixed. A letter can be written both vertically and horizontally. The way you write is mainly personal preference, though older people tend to write vertically, especially for formal occasions. Opening Word: The opening word is written at the top of the first column.Preliminary Greetings: They are usually seasonal greetings or to inquire about the addressees health.Main Text: The main text starts in a new column, one or two spaces down from the top. The phrases like sate or tokorode are often used to start the text.Final Greetings: They are mainly wishes for the health of the addressee.Closing Word: This is written at the bottom of the next column after the final greetings. Since opening words and closing words come in pairs, make sure to use the appropriate words.Date: When you write horizontally, Arabic numbers are used to write the date. When writing vertically, use kanji characters.Writers Name.Addressees Name: Make sure to add sama or sensei (teachers, doctors, lawyers, Diet members, etc.) to the addressees name, depending on which is proper.Postscript: When you need to add a postscript, start it with tsuishin. It is not appropriate to write postscripts for a letter to superiors or a formal letter. Addressing Envelopes Needless to say, it is rude to write the addressees name incorrectly. Make sure to use the correct kanji characters.Unlike addresses in the west, which usually start with the addressees name and end with the zip or postal code, A Japanese address starts with prefecture or city and end with the house number.The postal code boxes are printed on most envelopes or postcards. Japanese postal codes have 7 digits. You will find seven red boxes. Write the postal code in the postal code box.The addressees name is in the center of the envelope. It should be slightly larger than the characters that are used in the address. Make sure to add sama or sensei to the addressees name depending on which is proper. When you write a letter to an organization, onchuu is used.The writers name and address are written at the back of the envelope, not on the front. Writing Postcards The stamp is put on the top left. Although you can write either vertically or horizontally, the front and the back should be in the same format. Sending a Letter from Overseas When you send a letter to Japan from overseas, romaji is acceptable to use when writing the address. However, if possible, it is better to write it in Japanese.

7 Stress Management Techniques for Nurses

7 Stress Management Techniques for Nurses Stress is an ever-present buzzword in pretty much every industry, but it takes on especially sharp significance for those in the medical and nursing professions. Daryn Eller at Scrubs Mag has compiled some strategies for nurses to help them manage stress without feeling overwhelmed. The consequences for losing the ability to manage stress are severe: burning out and leaving the industry, substance abuse, chronic illness, neglecting self care, or even  making fatal errors. Be proactive about advocating for yourself, beginning with these basic approaches:1. Take ControlStart by observing your daily routine objectively. What gives you energy, and what saps it? Can you structure your day or your approach to tasks to emphasize the ones that build you up, or at least balance them more effectively with the draining moments? Talk to your supervisor and your colleagues and see if you have a counterpart you might be able to trade with- this step helps rebuild your  sense of agency, which a lleviates that helpless, scrambling feeling.  2. Keep PerspectiveStress in the field of nursing is unavoidable- even if you try to stay detached, there are people’s lives at stake! So don’t bottle up your emotions at work- breathe and talk and even write through them. This strategy may even be more useful for your life outside of work; when you remember what the stakes at work are, interpersonal conflict or household issues seem lighter by comparison.  3. Lighten UpWhether you burst into song like Julie Andrews or make inappropriate jokes to alleviate the tension, it’s important to let levity in when you can. Learn from your mistakes, and then let them roll off your shoulders. Carrying around guilt or shame will not make your job easier.  4. Don’t be a Hero (when it comes to overtime)While the opportunity to double your usual wages might be appealing, it’s crucial to remember that nursing is exhausting physically and emotionally. There are le gal maximums for a reason. Don’t feel like you always have to be the one stepping up for extra shifts, and remember to compartmentalize and sign off at the end of the day or night.  5. Take BreaksMany nurses don’t take breaks- unless they’re smokers, which seems totally counterintuitive. Whether you treat yourself to a 15 minute non-smoking smoke break or just pause to close your eyes for a long slow breath between patient rooms, make sure you find moments to refresh yourself during the day. If you can manage even short workouts before or after work, even better.  6. Live in the MomentAmbition can take us to exciting places, and nostalgia is always a bittersweet mental journey. But during your daily life, make sure you know right when and where you are. Don’t be racing to the next thing or brooding on the last one- let go of past and future stress and work with what’s facing you right there in that moment.  7. Be Ready to Make ChangesIf you g et to a point where you have to constantly reach for these coping strategies and more, it may be a sign you’re in the wrong specialty, the wrong hospital, or the wrong doctor’s office. Be strategic about planning a move. Think about the kinds of places you’d really want to work, and don’t just restrict yourself to reading job postings or want ads. For other nurses, involving their families in their work- or even just bringing them to the hospital to get a sense of what their daily experience is- can help build a more supportive family dynamic.  The consistent thread in these tips is to know yourself, know what you need, and be empowered to advocate for yourself in large and small moments  when you feel like you’re overstressed. It will only help your work to have a revitalized version of you at work every day.

A CRITICAL REVIEW OF THE USE OF FACEBOOK AS A SOCIAL MEDIA TECHNIQUE Literature

A CRITICAL OF THE USE OF FACEBOOK AS A SOCIAL MEDIA TECHNIQUE TO PROMOTE SMALL AND MEDIUM SCALE BUSINESS ONLINE - Literature review Example oviding online shopping experience to its customers and over the years this mode of shopping has been very well accepted by the customers (Internet World Stats, 2012a). However the industry had also witnessed a crash of some major companies and it was realised that competing in the age of internet has become more risky and this tool has to be used very wisely so as to gain the competitive edge (Internet World Stats, 2012b). Social media is still being deemed as a transforming power of the present world. It makes marketing more innovative and intellectual. Social media network allow its users to share ideas, events, activities and interests by providing a platform to share news and information, provides different alert services like CAS and SDI, facilitates enhanced consumer knowledge by allowing product reviews, provides information about new products and services and allows businesses to come up with innovative strategies that would help the owners expand the business opportunities among a wide range of customers (Kalmath, 2013; Humphrey and Schmitz, 2002). The activity of a group of people gathering together to share knowledge, views and information by making the use of conversational media is commonly known as Social media (Weinberg, 2009; Kaplan and Haenlein, 2009). There are different forms of social media that SMEs can take advantage of, for example, social book marking, blogs, social networking websites, content writing communities, virtual worlds, micro-blogging sites, online gaming websites, news sites, online forums and many more. Web 2.0 and social media are both, means of communication that share the same features implying both are user-friendly and user-empowering and enhance knowledge sharing (Erdogmus and Cicek, 2012). A company can overcome the problems associated with the conventional methods of marketing, by way of adopting social media marketing strategies. Thus the user will be able to efficiently allocate the available resources to improve

Research Paper to included Data Analysis Plan Example | Topics and Well Written Essays - 1750 words

To included Data Analysis Plan - Research Paper Example The same document reveals that among the general public, men are more likely (60%) to come across traumatic experiences that may trigger PTSD than do females (50%). However, women are more likely to develop the condition despite their lower rate of exposure, with a likelihood of 10% compared to men’s 4% (Gradus, 2014). At the same time, research has established that veterans who took part in different operations have varying rates of PTSD prevalence. This could be the result of varying intensities of the wars, and differing levels of exposure to other traumatic experiences. The Operation Iraqi Freedom (OIF) veterans have a prevalence of between 11% and 20%; Gulf War (Desert Storm) veterans have a 12% prevalence; and 30% of Vietnam War veterans have endured PTSD in their lifetime. Taking a look at the gender dimension in prevalence of PTSD among military personnel reveals that a higher percentage of women (55%) are exposed to sexual harassment than men (38%) (U.S. Department of Veteran Affairs, 2014; Haskell et al, 2010). Needless to say, these experiences elevate female veterans’ risk of developing PTSD. With this fact in mind, it is accurate to adjudge that female veterans are more prone to PTSD than are male veterans. It is these assertions on higher prevalence of PTSD among veterans and among females in society (both in the general public and the veteran community) that this research seeks to investigate. None of the literature material consulted appears to point at the implications of longer or shorter exposure on the prevalence of PTSD among veterans. The researcher delves into this issue by seeking to establish whether those who have been in the battlefield for longer periods are equally likely to suffer PTSD as a result of accumulated traumatic experiences. As indicated, this research aims to investigate whether there

Analysis of Recruitment in the NHS

Analysis of Recruitment in the NHS CIPD Management Report Utilising E Recruitment Executive Summary This Management report will look at the Recruitment Processes with an NHS Acute Trust and identify if E recruitment can help with the difficulties experienced in the Trust. Alongside a literature review of Recruitment difficulties, Employer Branding, Traditional recruitment and E recruitment, the author has conducted a benchmarking exercise in order to establish best practice in recruitment in local NHS organisations, A Process Mapping exercise to identify current practice and identify any difficulties or hold ups in the current process and a Managers questionnaire to allow the author to identify current perceptions of the recruitment service in the organisation alongside what expectations are. Appendices. Satisfaction Survey Survey results 1.0 Introduction The Pennine Acute Hospitals NHS Trust was established in April 2002 and manages hospitals in Oldham, Rochdale, Bury and North Manchester. Serving a population of approximately 800,000, the Trust is one of the largest in the country and had an operating expenditure of over  £425 million in 2006/07. It runs services across five hospital sites: Fairfield General Hospital, Bury; North Manchester General Hospital; The Royal Oldham Hospital; Rochdale Infirmary and Birch Hill Hospital, Rochdale and employs a staff of approximately 10,000. The Trust has four divisions identified as Surgery, Medicine, Women and Childrens, and Diagnostics and Clinical Support. It also has directorates providing support to clinical services including Human Resources, Facilities, Planning, Finance, Information and Management Technology, Modernisation and Performance, Governance and Research and Development. The local economy in which the Trust is situated is strong, with a great deal of competition from local organisations for staff. There is little competition within the NHS for staff, as Pennine is ‘the only Trust in town, in each of the 4 areas. Transport links to the Trust are generally good, although access to some peripheral sites is difficult, and car parking can be a problem, especially at the Royal Oldham site. The Trust is concerned, as many Trusts in the Greater Manchester area are, that many of its nurses will retire within the next five years and it is trying to develop a programme to get people to stay on after the normal retirement age. It also attempts to recruit as many student nurses as possible, but positions for newly qualified staff have been reduced in the last few years due to reconfiguration of services and redeployment to avoid redundancy. The Trust has a lower proportion of nursing staff from ethnic backgrounds than the local population, when comparing the 2001 Census with its workforce data; but the percentage of staff as a whole from ethnic backgrounds is higher, due to the numbers of medical staff from ethnic minorities within the Trust. The Trust works hard to recruit staff from ethnic minorities/deprived backgrounds. It has an Equality and Diversity Team who work to promote diversity within the Trust, supporting proactive recruitment where there is a concentration of individuals from ethnic or disadvantaged backgrounds. There is a central HR function, with designated HR Managers for each division. Restructuring of this model has taken place in recent years. Recruitment is managed from the North Manchester General Hospital site and provides a central function. With a workforce of over 10,000 people, the average monthly cost of recruitment at Pennine Acute Hospitals NHS Trust is xxxxxx. Added to this is the length of time it takes to place a new employee in post, which is on average 60 days. This estimate is from measured from the advertised positions closing date to offering that position. Recruitment is currently a major issue in the Trust with days lost in the recruitment process costing money and reducing morale and effectiveness. At present the department is receiving a lot of pressure from the rest of the Trust and the reputation of the department is poor. This management report is being undertaken to identify recommendations that will allow the recruitment process to become more efficient and identify whether utilisation of e recruitment is a viable proposal in the Trust and whether its implementation will increase efficiency and save resources. All employers face the challenge of employing the right staff for their organisation and this often falls under a human resource arena. The recruitment and retention of healthcare professionals has been identified as a key challenge facing the NHS (NHS Plan 2002). High on the agenda at local, regional and national levels is the development of strategies and initiatives to attract suitable people to work in the professions, in order to ensure that services are responsive to patient needs. 2.0 Literature Review Recruitment is an extensive subject with many aspects making up the area. A study by Ullman (1966) cited in Breaugh Starke (2000) was one of the first to examine recruitment sources. Finding that new employees who were recruited by means of informal sources (i.e., employee referrals, direct applications) had a lower turnover rate than individuals recruited via formal sources (i.e., newspaper advertisements and employment agencies). Barber (1998) has since concluded that past research has not made a strong case for the importance of source differences. The author is interested in research into the prevalence of the sources used in traditional recruitment, which appears to be research that has not been undertaken significantly. Torrington, Hall and Taylor (2005) identified that employers in the UK recruit over 3 million people each year, in a costly and time consuming exercise to add suitable staff to their organisation. They identify a need to ‘sell jobs to potential employees in order to ensure they can generate an adequate pool of applicants. Organisations are now facing a greater challenge recruiting rather than selecting. (Ployhart 2005) Other researchers having also identified the difficulties organisations have in attracting candidates, identifying selection will only be effective and financially defensible if a sufficient amount of applicants apply to the organisation. (Taylor and Collins, 2000) However according to Barber (1998), It is important that employers do not consider the recruitment process to be completed at this point, It continues during the short listing and interviewing stages and is only deemed as complete when an offer is made. For the purposes of this literature review the author will review thoughts and research on the initial stages of recruitment, that being the attraction of employees and advertisement of vacancies in order to recruit to the organisation, this will allow the author to include the areas of employer branding and e-recruitment in the review. 2.1 Recruitment Difficulties The Audit Commission (2002) has identified that the UK labour market is highly competitive at present with the rate of unemployment at a historically low level. Employers are openly competing harder to attract and retain staff. This is made more difficult, with reports across the country, of recruitment and retention problems affecting local public services, the NHS being no exception. There have been serious concerns about shortages in staff numbers, and fewer young people being attracted to work for the public sector, meaning there is a potential ‘demographic time bomb. It has been identified that 27 per cent of the public sector workforce are now aged 50 or over. (Gulland (2001), Audit Commission (2002)) Recruitment is also expensive, in a recent survey; CIPD (2007) identified the average cost of recruiting a member of staff is  £4,333; however this increases significantly to  £7750 when organisations are also calculating the associated labour turnover. They identified that eighty four percent of organisations have reported difficulties in filling vacancies in 2006, a rise of 2 percent on the previous year. The key challenges faced by organisations in regard to recruitment have been identified from the survey as; attracting and recruiting key staff to the organisation, reducing recruitment costs, enabling the achievement of the organisations strategic goals and addressing skills shortages. CIPD strongly believes that: ‘effective recruitment is central and crucial to the successful day-to-day functioning of any organisation. stating that ‘successful recruitment depends upon finding people with the necessary skills, expertise and qualifications to deliver organisational objectives and the ability to make a positive contribution to the values and aims of the organisation. The Audit Commissions report (2002) also identified there are concerns about ‘skill shortages, not only in terms of ‘basic skill levels in the workforce, but also in key leadership, management and specialist skills that are required. Previous research from the Audit Commission (2001) has showed that, on average, a new employee will perform at only 60 per cent of their productive potential when they are first appointed, only reaching 100 per cent after being in a post for a year. This makes recruitment in these areas and adequate delivery of services even harder to manage. In their extensive report on public service recruitment, the Audit Commission identifies the way the employers can maximise their recruitment practices. They advised: Informed, quick and professional responses to job advertisement enquiries are essential for maximising applications; routine monitoring of recruitment will ensure that recruitment initiatives are driven by the bigger picture rather than just the latest concern; success in addressing diversity issues are to be achieved through efficient, effective targeted recruitment campaigns based on knowledge of the target community; and any initiative to attract a specific group of staff will benefit from being profession-led and in partnership with HR. Audit Commission (2002) Effective recruitment practices and policies are recognised as making a significant contribution to an organisations success, according to Plumbley (1990). He states it is not simply about placing suitable candidates into jobs, but also about building an adept and flexible workforce in order to meet the organisations changing and demanding needs. The first stage of recruitment and selection is to be able to attract an adequate number of appropriate candidates. Prospective employees do not select the organisation they wish to work for on the foundation of job and organisational characteristics such as location, and organisational structure alone. 2.2 Employee Brand The increased competitiveness in the recruitment market has led to organisations spending more time, effort and resources on developing their recruitment brand and expanding the range of advertising methods used, to try and attract quality applicants from as broad and diverse a pool possible. Almost seven in ten organisations describe themselves as having an employer brand according to CIPD (2007), and studies have shown that an organisations reputation and identity is vital in the fight to attract suitable talented applicants into organisations. (Lievens Highhouse, 2003; Cable Turban, 2001). Identifying that in order for the corporate brand to be more successful at attracting suitable candidates there is an importance in promoting and monitoring that brand. (Slaughter, Zickar, Highhouse, Mohr, 2004) Fombrun, (1996) agrees with this stating the reputation of an organisation has been acknowledged as one of the key factors that can affect the probability of potential applicants choosing to apply to work for it. In the same way, organisation reputation has been found to be an important influence on applicants decisions of whether they fit with an organisation and want to join it (Rynes et al., 1991). This researcher has also showed that applicants utilised information on how informative and the ‘recruiter friendliness as an indicator of how an organisation treated its employees. Fombrun (1996) expands this argument to identify that reputation is of particular concern to applicants seeking employment in knowledge-based institutions, such as universities and hospitals, because of the intangibility of the services these organisations provide. Whilst Turban et al. (1998) also found that applicants perceptions of the specific attributes of a post were influenced by their evaluation of the organisation, even if they had been interviewed and were successful. The importance in private/commercial organisations reputation in relation to the recruitment and retention of staff has been well documented in literature, for example: (Turban, 2001) and Cable and Graham (2000), Gray and Ballmer 1998)), there has however been comparatively little consideration on the impact of reputation for public sector organisations. Most people in the course of their life have a need to use the services the NHS provide, some more than others and health is an important issue, not only on a personal level, also in the political arena. The NHS is the UKs largest employer, so many of the UK population are at present working in it, with a great number more many having done so at some point in their lives. In brief, the NHS has a wide range of different stakeholders, who may feel they have a vested interest in the quality; provision of services and ultimately, the reputation. People have varied, and very personal experiences of the NHS and this could mean image and reputation are therefore difficult to manage. The Audit Commission study (2002) study showed that public sector staff thinks that ‘their image in the eyes of the public would discourage potential recruits from entering the NHS. The study analysed a wide sample of the UKs national press to see if the evidence supported this observation. Analysis of the results showed that plenty of stories are told and coverage given to the NHS is extensive. They concur that the picture of public sector work presented to the reading public is often bleak. Of the former public sector workers surveyed, 68 per cent thought that the image of their former profession would discourage people from entering that job. Only 9 per cent thought the opposite and stated that the image would instead encourage people to enter. The NHS is such a well-known organisation that carries out specific roles in society, that when considering a career in the NHS people often have an idea regarding an occupation they would like to pursue. The GTI (2006) conducted a survey to establish the major determinants that influence applicants in their choice of employer. The results show that for 22% of student nurses and doctors, the reputation of a prospective employer (often influenced by media coverage) is a key factor in determining their aspirations. They identify that ‘word of mouth can be damaging to an employers reputation. If employers get things wrong, it can really affect the way they are viewed by potential employees as over half of the survey respondents have shared their bad experiences with their peers. So for some people the images and reputation of the NHS may be crucial to their decision of whether to work for it. 2.3 Traditional Recruitment Methods Traditional recruitment methods are the way in the past, that an organisation announced a job opportunity to the marketplace, through a classified advertisement, a job fair, an external recruiter, or other media. Any candidate who happened to see the announcement would submit his or her CV, ring the company for an application form or submit a letter of interest. Lievens and Harris (2003) have stated that in the past, job searching was a more time-consuming activity. They identified ‘A candidate who wished to apply for a job would need to first locate a suitable job opportunity, which often involved searching through a newspaper or contacting acquaintances. After locating potentially suitable openings, the candidate would typically have to prepare a cover letter, produce a copy of his or her resume, and mail the package with the appropriate postage. Arboledas, Ferrero and Vidal (2001), presented some examples of recruitment methods that organisations have traditionally used. These were identified as newspaper advertisement, faxed/mailed resumes, recruitment agencies or the use of headhunters. Galanaki (2002) similarly identified all these methods and also defines them as ‘traditional recruitment methods. This idea of traditional methods can also be found quoted in numerous HR texts, which have sections dedicated to recruitment and try to identify best recruitment practices. The authors of such texts include Cole (2004), Rayner and Adam Smith, Armstrong (2007) and Mullins (2005). These texts give a useful overview of the concepts of recruitment but again the best practice and evidence of what is most effective is not present. An IDS study in 2006 reported that to maximise their chances of appointing the best candidate, many organisations have utilised a combination of online and traditional approaches. In 2004 Softworld HR and Payroll identified in a study, that 24% of respondents envisaged e-recruitment entirely replacing all traditional methods of advertising in the future, however 76% of the practitioners surveyed, see it as an additional tool to allow the widest possible range of applicants to be accessed. Traditional methods also identify the use of recruitment agencies in the way of recruiting staff. According to an IES study (2005), recruitment agencies remain confident that the growth in e-recruitment technology will not eliminate their role in the process, as many organisations lack the time and expertise to carry out these tasks. Many organisations, especially smaller ones may also lack the technology to carry out their own recruitment online. They state with the low unemployment rate that currently exists, the task of finding quality candidates will remain challenging and this may prompt organisations to continue to use agencies, in particular, for specialised, senior or difficult to fill positions A Demos report (2007) however has identified difficulties in the recruitment business. They point out that the ‘landscape has changed remarkably over the past decade. And identify the recruitment industry has been growing rapidly, and the talent war has led to an increase in outsourcing and much greater efforts being made to reach candidates through on and offline advertising. They identify that recruiters have had to embrace technology, or be left behind. In the 2007 CIPD recruitment and retention survey, it was identified for the first time in the UK; corporate websites have broken even with local newspapers advertisements as the most common method of recruiting candidates. 2.4 E-recruitment E-Recruitment is identified as ‘the use of Internet technology to make the job of recruiting staff more efficient and effective, when used together with traditional recruitment methods; the benefits derived from e-recruitment can be considerable. (E-recruitment Best Practice Guide 2007) Internet usage in recent years has seen the recruitment process transformed. Online recruitment, internet recruitment, web-based recruiting and e-recruitment are terms used to describe the use of the internet to recruit potential employees, and mediums to conduct other elements of the recruitment process. We will use the terms interchangeably in this report. According to Schreyer McCarter (1998) e-recruitment refers to â€Å"The recruitment process, including placing job advertisements, receiving resumes, and building human resource database with candidates and incumbents E-Recruitment is establishing itself as a significant part of the recruitment strategy in a range of organisations across the UK and the world. This is in addition to becoming a progressively more accepted method for job seekers in searching and applying for jobs. The traditional method of recruitment has been transformed by the appearance of the Internet. In the past few years, the Internet has dramatically changed the face of HR recruitment and the ways organisations think about the recruiting function. There is predicted to be a continued dramatic growth in recruiting and hiring via this medium in future years. (CIPD 2007) A survey by the public appointment service in Ireland in 2006, relating to e-recruitment in Irish organisations, has also identified a high level of current or intended future use of e recruitment, this being identified as an area forming an important part of the Irish recruitment strategy. It would seem that e-recruitment has been implemented in many organisations from small companies to large organisations. These organisations are already using e recruitment to advertise jobs and accept CVs on the Internet, and also to communicate with the applicants by e-mail. In the CIPD Recruitment, retention and turnover 2006 survey it was identified that eighty-four percent of respondents have made greater use of e-mail applications in the last three years. Over seven in ten organisations also said they are actively advertising jobs on their corporate websites and using online recruitment applications. Lievens and Harris (2003) have identified the following methods of using the Internet to attract candidates, acknowledging that approaches are continually changing. †¢ Company websites Advertising posts and providing information to candidates through the company website. The facility to apply online is often also provided. †¢ Job Boards Commercial general purpose recruitment portals, (e.g. Yahoo!, Monster.com) and specific industry job boards. †¢ Online Searching Recruiters searching online sources such as company websites and professional chat sites to identify candidates who may not be actively looking for a position. †¢ Relationship recruiting Using the internet to build and maintain long term relationships with passive candidates, through using internet tools to learn more about web visitors interests and experience and to e-mail regular updates about careers and their fields of interest. Kerrin and Keetley (2005) have suggested that the reasons for many organisations to introduce e recruitment have been recruitment cost reduction, speedier processes, access to a wider pool of applicants and better employer branding. In the CIPD Recruitment, retention and turnover survey 2006,  it was identified that the key drivers for e-recruitment were; reducing recruitment costs (cited by 71%), broadening the selection pool (60%) and increasing the speed of time to hire (47%). It was also noted that : ‘over a third of respondents believed it brought greater flexibility and ease for candidates, and over a quarter believed it strengthened the employer brand. This has been further supported by the IRS Employment review (2007). Reduction in costs E-Recruitment has allowed employers to make reductions in advertising costs and remove their dependency on recruitment agencies. Technology in online recruitment is not expensive and the hours saved in the pre-selection process gives HR staff more time. Administration can be significantly reduced in most organisations. This can prove to be extremely important when recruiting involves high numbers of staff or when receiving high numbers of applications. (DTI 2006, Guertal et al 2007). The IRS 2007 study identified 7 out of 10 organisations say administration is easier to perform when utilising online recruitment services and 8 out 10 identified the e- recruitment process as being substantially cheaper. Cappeli (2001) calculated that ‘it costs only about one-twentieth as much to hire someone online as to hire that same person through †¦ other traditional methods. This can again, be achieved through significantly reducing advertising costs and by reducing recruitment related administration according to Elkington (2005) An IDS HR Study in April 2006 identified how the Internet now plays a significant role in recruitment activities of employers. The report examined the use of corporate and third party recruitment websites and identified they are being used to reduce advertising costs and tap into a more diverse candidate base. They also identified that technology is streamlining the application process with the encouragement of online applications, linking into sophisticated application tracking systems and allowing organisations to measure the success of attraction methods. IDS state that over 70% of adults utilise the Internet, and employers are using this medium to attract and recruit much more frequently. They identify significant cost savings for employers and reduced time taken to fill vacancies, but are keen to point out the wariness of employees in missing out on potential candidates and feel that traditional recruitment media is set to retain and important role, particularly when recruiting locally or hard to fill jobs. This supports reservations held by IRS (2007) who identified that e recruitment was considered unsuitable for certain kinds of vacancies. Grout and Parrin, authors of the book, ‘recruiting excellence agree with the assessment by IDS. In an article for HR Director (2006), they identify that online recruitment can improve efficiency by the reduction in man hours involved in the process, and help employers reach a wider and larger audience of jobseekers. They also recognise that it can be a valuable part of a recruitment process, in addition to traditional press advertising and the use of agencies (DTI, 2005). Kerrin and Keetley (2005) however, have stated, that the full cost savings are often only realised if the whole recruitment process is carried out online, a view supported by a number of authors. (Demos 2007, IRS 2007) Reducing time-to-hire With e-recruitment the time taken to recruit can be reduced by as much as 75% and allow the recruitment of the most appropriate employees more quickly into the organisation. Time is also saved by spending a reduced amount of time tracking, communicating with and screening the applicants. Online recruitment also allows organisations to the share best practice and improves the consistency of recruitment processes across the organisation. The Public Appointments Service survey showed that a reduction in administrative workload (cited by 49% of respondents), and reduced timescales for hiring (cited by 40% of respondents), were key drivers in the decision to implementing e recruitment. Hogg (2000) stresses a shorter recruitment cycle can be gained by the speed at which several steps of the recruitment process are carried out online. Elkington (2005) supports this and has identified that the immediate posting of jobs online and the effortlessness of completing online application forms and e-mailing CVs to an organisation has made these steps much faster. Moving further into the recruitment process, the short-listing process can be accelerated by routinely aligning applications dependent on prearranged criteria (CIPD 2005). Applications can be progressed within minutes rather than weeks, saving both recruiters and job applicants time. Widening Talent Pool Internet tools that enable employers/recruiters to reach a wider pool of potential applicants and to fill positions faster with less cost to the organisation are obviously advantageous in such a competitive environment. Online advertising opens up a wider candidate pool, by providing 24/7 access to job seekers, at local, national and international locations, thus providing a better chance of finding the right candidate (CIPD 2005a). As job seekers become increasingly more web literate and the growth of broadband makes web surfing easier and cheaper (IRS 2005), the potential for e-recruitment to attract wider candidate pools is increasing. Enhancing Employer brand Increased numbers of candidates are expecting to apply directly online and they routinely make judgements about employers based on their recruitment process. To combat this employers are adopting increasingly dynamic e-recruitment solutions to allow them to distinguish themselves from others and to professionally manage the recruitment process. (Willock, 2005; Paton 2006). E-Recruitment enables an organisation to raise its profile to potential applicants and promote itself as innovative and forward looking, allow visitors to the website to leave with a positive experience. Kerrin and Kettley (2003) in their report ‘e-recruitment is it delivering identified a key factor for organisations in their adoption of e-recruitment, is the desire to increase their profile as an employer of choice amongst potential candidates and to promote their image as a progressive organisation. This is supported by 7 out of 10 organisations also agreeing that the use of online recruitment was more likely to improve reputation (IRS 2007) E-Recruitment can help to build the image of a brand. Barrow (2005) recommends that organisations build their brand identity very carefully however; warning of a need to ensure substance is beneath the clever name, logo or design, as employees once appointed will see through the facade. This is further supported by Gray and Balmers (1998) term, ‘routine interactions. They state that outsiders have a place in shaping image and reputation when they interact with organisations; communications are likely to be received with scepticism when they do not match personal experience. CIPD (2005) also demonstrated that more detailed information can be provided on the organisations website than in a newspaper advertisements and in recruitment agency literature, reinforcing the employer brand, improving the corporate image and profile whilst also giving an indication of the organisations culture The use of the Internet allows organisations to pass far more information in a much more dynamic and consistent fashion to candidates than was the case in the past (Lievens and Harris 2003). Applicants therefore have much more information at their disposal before they even decide to apply for a job than in the past. In addition, candidates can easily and quickly search for independent information about organisations from various sources, such as internet search engines and libraries. Therefore, unlike in the past, a candidate may have applied for a job based on practically no information; todays candidate may have reviewed a substantial amount of information about the organisation before choosing to apply. Disadvantages of e-recruitment The CIPD Recruitment, retention and turnover 2006 survey revealed some concerns that e-recruitment could increase the number of unsuitable applicants and that it could act as a barrier to recruiting older workers. A factor which seems to be discouraging some employers from making more use of online recruitment systems, is a concern, over the level of internet access and levels of accomplishment with technology, of their target audiences. While usage of the Internet does vary by social group there is evidence to suggest that recruiting online results in at least as diverse an applicant group as those recruited through traditional methods (McManus M.A., Ferguson M.W. 2003). Searle (2003) would dispute this however stating that participation in online recruitment is skewed towards ‘white males from higher socio-economic groups. A further concern in relation to access is the suitability of online recruitment methods for candidates with disabilitie Analysis of Recruitment in the NHS Analysis of Recruitment in the NHS CIPD Management Report Utilising E Recruitment Executive Summary This Management report will look at the Recruitment Processes with an NHS Acute Trust and identify if E recruitment can help with the difficulties experienced in the Trust. Alongside a literature review of Recruitment difficulties, Employer Branding, Traditional recruitment and E recruitment, the author has conducted a benchmarking exercise in order to establish best practice in recruitment in local NHS organisations, A Process Mapping exercise to identify current practice and identify any difficulties or hold ups in the current process and a Managers questionnaire to allow the author to identify current perceptions of the recruitment service in the organisation alongside what expectations are. Appendices. Satisfaction Survey Survey results 1.0 Introduction The Pennine Acute Hospitals NHS Trust was established in April 2002 and manages hospitals in Oldham, Rochdale, Bury and North Manchester. Serving a population of approximately 800,000, the Trust is one of the largest in the country and had an operating expenditure of over  £425 million in 2006/07. It runs services across five hospital sites: Fairfield General Hospital, Bury; North Manchester General Hospital; The Royal Oldham Hospital; Rochdale Infirmary and Birch Hill Hospital, Rochdale and employs a staff of approximately 10,000. The Trust has four divisions identified as Surgery, Medicine, Women and Childrens, and Diagnostics and Clinical Support. It also has directorates providing support to clinical services including Human Resources, Facilities, Planning, Finance, Information and Management Technology, Modernisation and Performance, Governance and Research and Development. The local economy in which the Trust is situated is strong, with a great deal of competition from local organisations for staff. There is little competition within the NHS for staff, as Pennine is ‘the only Trust in town, in each of the 4 areas. Transport links to the Trust are generally good, although access to some peripheral sites is difficult, and car parking can be a problem, especially at the Royal Oldham site. The Trust is concerned, as many Trusts in the Greater Manchester area are, that many of its nurses will retire within the next five years and it is trying to develop a programme to get people to stay on after the normal retirement age. It also attempts to recruit as many student nurses as possible, but positions for newly qualified staff have been reduced in the last few years due to reconfiguration of services and redeployment to avoid redundancy. The Trust has a lower proportion of nursing staff from ethnic backgrounds than the local population, when comparing the 2001 Census with its workforce data; but the percentage of staff as a whole from ethnic backgrounds is higher, due to the numbers of medical staff from ethnic minorities within the Trust. The Trust works hard to recruit staff from ethnic minorities/deprived backgrounds. It has an Equality and Diversity Team who work to promote diversity within the Trust, supporting proactive recruitment where there is a concentration of individuals from ethnic or disadvantaged backgrounds. There is a central HR function, with designated HR Managers for each division. Restructuring of this model has taken place in recent years. Recruitment is managed from the North Manchester General Hospital site and provides a central function. With a workforce of over 10,000 people, the average monthly cost of recruitment at Pennine Acute Hospitals NHS Trust is xxxxxx. Added to this is the length of time it takes to place a new employee in post, which is on average 60 days. This estimate is from measured from the advertised positions closing date to offering that position. Recruitment is currently a major issue in the Trust with days lost in the recruitment process costing money and reducing morale and effectiveness. At present the department is receiving a lot of pressure from the rest of the Trust and the reputation of the department is poor. This management report is being undertaken to identify recommendations that will allow the recruitment process to become more efficient and identify whether utilisation of e recruitment is a viable proposal in the Trust and whether its implementation will increase efficiency and save resources. All employers face the challenge of employing the right staff for their organisation and this often falls under a human resource arena. The recruitment and retention of healthcare professionals has been identified as a key challenge facing the NHS (NHS Plan 2002). High on the agenda at local, regional and national levels is the development of strategies and initiatives to attract suitable people to work in the professions, in order to ensure that services are responsive to patient needs. 2.0 Literature Review Recruitment is an extensive subject with many aspects making up the area. A study by Ullman (1966) cited in Breaugh Starke (2000) was one of the first to examine recruitment sources. Finding that new employees who were recruited by means of informal sources (i.e., employee referrals, direct applications) had a lower turnover rate than individuals recruited via formal sources (i.e., newspaper advertisements and employment agencies). Barber (1998) has since concluded that past research has not made a strong case for the importance of source differences. The author is interested in research into the prevalence of the sources used in traditional recruitment, which appears to be research that has not been undertaken significantly. Torrington, Hall and Taylor (2005) identified that employers in the UK recruit over 3 million people each year, in a costly and time consuming exercise to add suitable staff to their organisation. They identify a need to ‘sell jobs to potential employees in order to ensure they can generate an adequate pool of applicants. Organisations are now facing a greater challenge recruiting rather than selecting. (Ployhart 2005) Other researchers having also identified the difficulties organisations have in attracting candidates, identifying selection will only be effective and financially defensible if a sufficient amount of applicants apply to the organisation. (Taylor and Collins, 2000) However according to Barber (1998), It is important that employers do not consider the recruitment process to be completed at this point, It continues during the short listing and interviewing stages and is only deemed as complete when an offer is made. For the purposes of this literature review the author will review thoughts and research on the initial stages of recruitment, that being the attraction of employees and advertisement of vacancies in order to recruit to the organisation, this will allow the author to include the areas of employer branding and e-recruitment in the review. 2.1 Recruitment Difficulties The Audit Commission (2002) has identified that the UK labour market is highly competitive at present with the rate of unemployment at a historically low level. Employers are openly competing harder to attract and retain staff. This is made more difficult, with reports across the country, of recruitment and retention problems affecting local public services, the NHS being no exception. There have been serious concerns about shortages in staff numbers, and fewer young people being attracted to work for the public sector, meaning there is a potential ‘demographic time bomb. It has been identified that 27 per cent of the public sector workforce are now aged 50 or over. (Gulland (2001), Audit Commission (2002)) Recruitment is also expensive, in a recent survey; CIPD (2007) identified the average cost of recruiting a member of staff is  £4,333; however this increases significantly to  £7750 when organisations are also calculating the associated labour turnover. They identified that eighty four percent of organisations have reported difficulties in filling vacancies in 2006, a rise of 2 percent on the previous year. The key challenges faced by organisations in regard to recruitment have been identified from the survey as; attracting and recruiting key staff to the organisation, reducing recruitment costs, enabling the achievement of the organisations strategic goals and addressing skills shortages. CIPD strongly believes that: ‘effective recruitment is central and crucial to the successful day-to-day functioning of any organisation. stating that ‘successful recruitment depends upon finding people with the necessary skills, expertise and qualifications to deliver organisational objectives and the ability to make a positive contribution to the values and aims of the organisation. The Audit Commissions report (2002) also identified there are concerns about ‘skill shortages, not only in terms of ‘basic skill levels in the workforce, but also in key leadership, management and specialist skills that are required. Previous research from the Audit Commission (2001) has showed that, on average, a new employee will perform at only 60 per cent of their productive potential when they are first appointed, only reaching 100 per cent after being in a post for a year. This makes recruitment in these areas and adequate delivery of services even harder to manage. In their extensive report on public service recruitment, the Audit Commission identifies the way the employers can maximise their recruitment practices. They advised: Informed, quick and professional responses to job advertisement enquiries are essential for maximising applications; routine monitoring of recruitment will ensure that recruitment initiatives are driven by the bigger picture rather than just the latest concern; success in addressing diversity issues are to be achieved through efficient, effective targeted recruitment campaigns based on knowledge of the target community; and any initiative to attract a specific group of staff will benefit from being profession-led and in partnership with HR. Audit Commission (2002) Effective recruitment practices and policies are recognised as making a significant contribution to an organisations success, according to Plumbley (1990). He states it is not simply about placing suitable candidates into jobs, but also about building an adept and flexible workforce in order to meet the organisations changing and demanding needs. The first stage of recruitment and selection is to be able to attract an adequate number of appropriate candidates. Prospective employees do not select the organisation they wish to work for on the foundation of job and organisational characteristics such as location, and organisational structure alone. 2.2 Employee Brand The increased competitiveness in the recruitment market has led to organisations spending more time, effort and resources on developing their recruitment brand and expanding the range of advertising methods used, to try and attract quality applicants from as broad and diverse a pool possible. Almost seven in ten organisations describe themselves as having an employer brand according to CIPD (2007), and studies have shown that an organisations reputation and identity is vital in the fight to attract suitable talented applicants into organisations. (Lievens Highhouse, 2003; Cable Turban, 2001). Identifying that in order for the corporate brand to be more successful at attracting suitable candidates there is an importance in promoting and monitoring that brand. (Slaughter, Zickar, Highhouse, Mohr, 2004) Fombrun, (1996) agrees with this stating the reputation of an organisation has been acknowledged as one of the key factors that can affect the probability of potential applicants choosing to apply to work for it. In the same way, organisation reputation has been found to be an important influence on applicants decisions of whether they fit with an organisation and want to join it (Rynes et al., 1991). This researcher has also showed that applicants utilised information on how informative and the ‘recruiter friendliness as an indicator of how an organisation treated its employees. Fombrun (1996) expands this argument to identify that reputation is of particular concern to applicants seeking employment in knowledge-based institutions, such as universities and hospitals, because of the intangibility of the services these organisations provide. Whilst Turban et al. (1998) also found that applicants perceptions of the specific attributes of a post were influenced by their evaluation of the organisation, even if they had been interviewed and were successful. The importance in private/commercial organisations reputation in relation to the recruitment and retention of staff has been well documented in literature, for example: (Turban, 2001) and Cable and Graham (2000), Gray and Ballmer 1998)), there has however been comparatively little consideration on the impact of reputation for public sector organisations. Most people in the course of their life have a need to use the services the NHS provide, some more than others and health is an important issue, not only on a personal level, also in the political arena. The NHS is the UKs largest employer, so many of the UK population are at present working in it, with a great number more many having done so at some point in their lives. In brief, the NHS has a wide range of different stakeholders, who may feel they have a vested interest in the quality; provision of services and ultimately, the reputation. People have varied, and very personal experiences of the NHS and this could mean image and reputation are therefore difficult to manage. The Audit Commission study (2002) study showed that public sector staff thinks that ‘their image in the eyes of the public would discourage potential recruits from entering the NHS. The study analysed a wide sample of the UKs national press to see if the evidence supported this observation. Analysis of the results showed that plenty of stories are told and coverage given to the NHS is extensive. They concur that the picture of public sector work presented to the reading public is often bleak. Of the former public sector workers surveyed, 68 per cent thought that the image of their former profession would discourage people from entering that job. Only 9 per cent thought the opposite and stated that the image would instead encourage people to enter. The NHS is such a well-known organisation that carries out specific roles in society, that when considering a career in the NHS people often have an idea regarding an occupation they would like to pursue. The GTI (2006) conducted a survey to establish the major determinants that influence applicants in their choice of employer. The results show that for 22% of student nurses and doctors, the reputation of a prospective employer (often influenced by media coverage) is a key factor in determining their aspirations. They identify that ‘word of mouth can be damaging to an employers reputation. If employers get things wrong, it can really affect the way they are viewed by potential employees as over half of the survey respondents have shared their bad experiences with their peers. So for some people the images and reputation of the NHS may be crucial to their decision of whether to work for it. 2.3 Traditional Recruitment Methods Traditional recruitment methods are the way in the past, that an organisation announced a job opportunity to the marketplace, through a classified advertisement, a job fair, an external recruiter, or other media. Any candidate who happened to see the announcement would submit his or her CV, ring the company for an application form or submit a letter of interest. Lievens and Harris (2003) have stated that in the past, job searching was a more time-consuming activity. They identified ‘A candidate who wished to apply for a job would need to first locate a suitable job opportunity, which often involved searching through a newspaper or contacting acquaintances. After locating potentially suitable openings, the candidate would typically have to prepare a cover letter, produce a copy of his or her resume, and mail the package with the appropriate postage. Arboledas, Ferrero and Vidal (2001), presented some examples of recruitment methods that organisations have traditionally used. These were identified as newspaper advertisement, faxed/mailed resumes, recruitment agencies or the use of headhunters. Galanaki (2002) similarly identified all these methods and also defines them as ‘traditional recruitment methods. This idea of traditional methods can also be found quoted in numerous HR texts, which have sections dedicated to recruitment and try to identify best recruitment practices. The authors of such texts include Cole (2004), Rayner and Adam Smith, Armstrong (2007) and Mullins (2005). These texts give a useful overview of the concepts of recruitment but again the best practice and evidence of what is most effective is not present. An IDS study in 2006 reported that to maximise their chances of appointing the best candidate, many organisations have utilised a combination of online and traditional approaches. In 2004 Softworld HR and Payroll identified in a study, that 24% of respondents envisaged e-recruitment entirely replacing all traditional methods of advertising in the future, however 76% of the practitioners surveyed, see it as an additional tool to allow the widest possible range of applicants to be accessed. Traditional methods also identify the use of recruitment agencies in the way of recruiting staff. According to an IES study (2005), recruitment agencies remain confident that the growth in e-recruitment technology will not eliminate their role in the process, as many organisations lack the time and expertise to carry out these tasks. Many organisations, especially smaller ones may also lack the technology to carry out their own recruitment online. They state with the low unemployment rate that currently exists, the task of finding quality candidates will remain challenging and this may prompt organisations to continue to use agencies, in particular, for specialised, senior or difficult to fill positions A Demos report (2007) however has identified difficulties in the recruitment business. They point out that the ‘landscape has changed remarkably over the past decade. And identify the recruitment industry has been growing rapidly, and the talent war has led to an increase in outsourcing and much greater efforts being made to reach candidates through on and offline advertising. They identify that recruiters have had to embrace technology, or be left behind. In the 2007 CIPD recruitment and retention survey, it was identified for the first time in the UK; corporate websites have broken even with local newspapers advertisements as the most common method of recruiting candidates. 2.4 E-recruitment E-Recruitment is identified as ‘the use of Internet technology to make the job of recruiting staff more efficient and effective, when used together with traditional recruitment methods; the benefits derived from e-recruitment can be considerable. (E-recruitment Best Practice Guide 2007) Internet usage in recent years has seen the recruitment process transformed. Online recruitment, internet recruitment, web-based recruiting and e-recruitment are terms used to describe the use of the internet to recruit potential employees, and mediums to conduct other elements of the recruitment process. We will use the terms interchangeably in this report. According to Schreyer McCarter (1998) e-recruitment refers to â€Å"The recruitment process, including placing job advertisements, receiving resumes, and building human resource database with candidates and incumbents E-Recruitment is establishing itself as a significant part of the recruitment strategy in a range of organisations across the UK and the world. This is in addition to becoming a progressively more accepted method for job seekers in searching and applying for jobs. The traditional method of recruitment has been transformed by the appearance of the Internet. In the past few years, the Internet has dramatically changed the face of HR recruitment and the ways organisations think about the recruiting function. There is predicted to be a continued dramatic growth in recruiting and hiring via this medium in future years. (CIPD 2007) A survey by the public appointment service in Ireland in 2006, relating to e-recruitment in Irish organisations, has also identified a high level of current or intended future use of e recruitment, this being identified as an area forming an important part of the Irish recruitment strategy. It would seem that e-recruitment has been implemented in many organisations from small companies to large organisations. These organisations are already using e recruitment to advertise jobs and accept CVs on the Internet, and also to communicate with the applicants by e-mail. In the CIPD Recruitment, retention and turnover 2006 survey it was identified that eighty-four percent of respondents have made greater use of e-mail applications in the last three years. Over seven in ten organisations also said they are actively advertising jobs on their corporate websites and using online recruitment applications. Lievens and Harris (2003) have identified the following methods of using the Internet to attract candidates, acknowledging that approaches are continually changing. †¢ Company websites Advertising posts and providing information to candidates through the company website. The facility to apply online is often also provided. †¢ Job Boards Commercial general purpose recruitment portals, (e.g. Yahoo!, Monster.com) and specific industry job boards. †¢ Online Searching Recruiters searching online sources such as company websites and professional chat sites to identify candidates who may not be actively looking for a position. †¢ Relationship recruiting Using the internet to build and maintain long term relationships with passive candidates, through using internet tools to learn more about web visitors interests and experience and to e-mail regular updates about careers and their fields of interest. Kerrin and Keetley (2005) have suggested that the reasons for many organisations to introduce e recruitment have been recruitment cost reduction, speedier processes, access to a wider pool of applicants and better employer branding. In the CIPD Recruitment, retention and turnover survey 2006,  it was identified that the key drivers for e-recruitment were; reducing recruitment costs (cited by 71%), broadening the selection pool (60%) and increasing the speed of time to hire (47%). It was also noted that : ‘over a third of respondents believed it brought greater flexibility and ease for candidates, and over a quarter believed it strengthened the employer brand. This has been further supported by the IRS Employment review (2007). Reduction in costs E-Recruitment has allowed employers to make reductions in advertising costs and remove their dependency on recruitment agencies. Technology in online recruitment is not expensive and the hours saved in the pre-selection process gives HR staff more time. Administration can be significantly reduced in most organisations. This can prove to be extremely important when recruiting involves high numbers of staff or when receiving high numbers of applications. (DTI 2006, Guertal et al 2007). The IRS 2007 study identified 7 out of 10 organisations say administration is easier to perform when utilising online recruitment services and 8 out 10 identified the e- recruitment process as being substantially cheaper. Cappeli (2001) calculated that ‘it costs only about one-twentieth as much to hire someone online as to hire that same person through †¦ other traditional methods. This can again, be achieved through significantly reducing advertising costs and by reducing recruitment related administration according to Elkington (2005) An IDS HR Study in April 2006 identified how the Internet now plays a significant role in recruitment activities of employers. The report examined the use of corporate and third party recruitment websites and identified they are being used to reduce advertising costs and tap into a more diverse candidate base. They also identified that technology is streamlining the application process with the encouragement of online applications, linking into sophisticated application tracking systems and allowing organisations to measure the success of attraction methods. IDS state that over 70% of adults utilise the Internet, and employers are using this medium to attract and recruit much more frequently. They identify significant cost savings for employers and reduced time taken to fill vacancies, but are keen to point out the wariness of employees in missing out on potential candidates and feel that traditional recruitment media is set to retain and important role, particularly when recruiting locally or hard to fill jobs. This supports reservations held by IRS (2007) who identified that e recruitment was considered unsuitable for certain kinds of vacancies. Grout and Parrin, authors of the book, ‘recruiting excellence agree with the assessment by IDS. In an article for HR Director (2006), they identify that online recruitment can improve efficiency by the reduction in man hours involved in the process, and help employers reach a wider and larger audience of jobseekers. They also recognise that it can be a valuable part of a recruitment process, in addition to traditional press advertising and the use of agencies (DTI, 2005). Kerrin and Keetley (2005) however, have stated, that the full cost savings are often only realised if the whole recruitment process is carried out online, a view supported by a number of authors. (Demos 2007, IRS 2007) Reducing time-to-hire With e-recruitment the time taken to recruit can be reduced by as much as 75% and allow the recruitment of the most appropriate employees more quickly into the organisation. Time is also saved by spending a reduced amount of time tracking, communicating with and screening the applicants. Online recruitment also allows organisations to the share best practice and improves the consistency of recruitment processes across the organisation. The Public Appointments Service survey showed that a reduction in administrative workload (cited by 49% of respondents), and reduced timescales for hiring (cited by 40% of respondents), were key drivers in the decision to implementing e recruitment. Hogg (2000) stresses a shorter recruitment cycle can be gained by the speed at which several steps of the recruitment process are carried out online. Elkington (2005) supports this and has identified that the immediate posting of jobs online and the effortlessness of completing online application forms and e-mailing CVs to an organisation has made these steps much faster. Moving further into the recruitment process, the short-listing process can be accelerated by routinely aligning applications dependent on prearranged criteria (CIPD 2005). Applications can be progressed within minutes rather than weeks, saving both recruiters and job applicants time. Widening Talent Pool Internet tools that enable employers/recruiters to reach a wider pool of potential applicants and to fill positions faster with less cost to the organisation are obviously advantageous in such a competitive environment. Online advertising opens up a wider candidate pool, by providing 24/7 access to job seekers, at local, national and international locations, thus providing a better chance of finding the right candidate (CIPD 2005a). As job seekers become increasingly more web literate and the growth of broadband makes web surfing easier and cheaper (IRS 2005), the potential for e-recruitment to attract wider candidate pools is increasing. Enhancing Employer brand Increased numbers of candidates are expecting to apply directly online and they routinely make judgements about employers based on their recruitment process. To combat this employers are adopting increasingly dynamic e-recruitment solutions to allow them to distinguish themselves from others and to professionally manage the recruitment process. (Willock, 2005; Paton 2006). E-Recruitment enables an organisation to raise its profile to potential applicants and promote itself as innovative and forward looking, allow visitors to the website to leave with a positive experience. Kerrin and Kettley (2003) in their report ‘e-recruitment is it delivering identified a key factor for organisations in their adoption of e-recruitment, is the desire to increase their profile as an employer of choice amongst potential candidates and to promote their image as a progressive organisation. This is supported by 7 out of 10 organisations also agreeing that the use of online recruitment was more likely to improve reputation (IRS 2007) E-Recruitment can help to build the image of a brand. Barrow (2005) recommends that organisations build their brand identity very carefully however; warning of a need to ensure substance is beneath the clever name, logo or design, as employees once appointed will see through the facade. This is further supported by Gray and Balmers (1998) term, ‘routine interactions. They state that outsiders have a place in shaping image and reputation when they interact with organisations; communications are likely to be received with scepticism when they do not match personal experience. CIPD (2005) also demonstrated that more detailed information can be provided on the organisations website than in a newspaper advertisements and in recruitment agency literature, reinforcing the employer brand, improving the corporate image and profile whilst also giving an indication of the organisations culture The use of the Internet allows organisations to pass far more information in a much more dynamic and consistent fashion to candidates than was the case in the past (Lievens and Harris 2003). Applicants therefore have much more information at their disposal before they even decide to apply for a job than in the past. In addition, candidates can easily and quickly search for independent information about organisations from various sources, such as internet search engines and libraries. Therefore, unlike in the past, a candidate may have applied for a job based on practically no information; todays candidate may have reviewed a substantial amount of information about the organisation before choosing to apply. Disadvantages of e-recruitment The CIPD Recruitment, retention and turnover 2006 survey revealed some concerns that e-recruitment could increase the number of unsuitable applicants and that it could act as a barrier to recruiting older workers. A factor which seems to be discouraging some employers from making more use of online recruitment systems, is a concern, over the level of internet access and levels of accomplishment with technology, of their target audiences. While usage of the Internet does vary by social group there is evidence to suggest that recruiting online results in at least as diverse an applicant group as those recruited through traditional methods (McManus M.A., Ferguson M.W. 2003). Searle (2003) would dispute this however stating that participation in online recruitment is skewed towards ‘white males from higher socio-economic groups. A further concern in relation to access is the suitability of online recruitment methods for candidates with disabilitie