Telenursing Essay Example | Topics and Well Written Essays - 1000 words

Telenursing - Essay Example ogy used to define the technology used to deliver nursing care and conduct the nursing practise with the use of electronic media (Fairchild et al, 2007). Emphasising this particular terminology, the essay gives an overview on telenursing, along with a brief discussion of its advantages and disadvantages. Telenursing is gaining popularity in the recent times, as it has proved beneficial to cut down costs for healthcare organisations when providing nursing facilities. It also eases the availability of proper healthcare facilities even in sparse areas. The consensus proves that the number of ill population is increasing, which is again increasing the need of telenursing today. The telecommunication technology combined with the education to provide nursing care has helped telehealth nurses largely to serve patients located distantly (American Telemedicine Association, 2011). With due significance, the International Council of Nurses (ICN) has extensively researched on the fact that the crisis of nurses all over the world is huge and the predicted proportion of nurses are so low that this number would have an adverse effect on the health system of the world. This gap could only be fulfilled with the use of tele-nurses (Jordanova & Lievens, 2008). With the advent of the new era of technology, societal structure has changed dramatically exhibiting a huge difference between the preferences, lifestyle choices and working structures of people. Health has always been the foremost priority in human life, but due to the lack of timing, it has been observed that people has been compromising their health to work. This is where telenursing comes as a saviour. Telenursing helps people to avail nursing facilities with the flexibility of time (College of Registered Nurses, 2008). The foremost advantage telenursing can be discussed as the facility it provides for rapid response to the disease. The patients who need to be immediately taken care of are the best sector where

Adaptive Optics Overview

Adaptive Optics Overview Adaptive Optics Adaptive optics is a technological development used for optical system performance improvement. It works by reducing the effect of wavefront distortions. Light from a distant celestial object gets distorted as it passes through earths atmosphere, thus a telescope located on earths surface cannot form accurate images. It would take a telescope placed above Earths surface, such as the Hubble Space telescope, to acquire accurate images or a telescope able to measure the effect and attempt to correct it. Instruments using adaptive optics have been created for this exact purpose to eliminate the incoming distortion in light under the effect of our ever-moving atmosphere. Through adaptive optics, optical systems are able to adapt in order to compensate for the effects imposed by the medium in between an object and its image. This is considered the most revolutionary technical development in the field of Astronomy ever since 1609, when Galileo first used an astronomical telescope. A graphical example of this effect is presented below: Figure 1 When uniform waves of starlight enter Earths atmosphere they get distorted due to the variations in temperature in atmospheric cells. This causes the light to travel slightly faster in less dense and warm air, resulting in a non-uniform refraction. An adaptive optical system works by measuring the distortion of an incoming wave of light and correcting its deformation through deformation of a mirror. These optic systems function at high frequencies of around 1000 Hz, which is too fast to allow deformation of a primary mirror so a secondary mirror is used, along with other optical elements placed in the light path. The main use of adaptive optical systems is in astronomical telescopes and laser communication systems. It has other uses as well, such as microscopy and retinal imaging systems, but the primary progress has been developed in telescope technology. To better understand the way adaptive optics work, think of starlight as waves. When these waves reach Earths atmosphere, they are entirely flat, but the turbulence causes them to change shape. The telescope receiving a misshaped wave will return a blurry image. If a telescope with adaptive optics is used, the distorted waves would then reflect off of a deformable mirror which is equipped with hundreds of actuators on its back. These actuators detect the shape of the incoming wave and change the mirrors shape to match that of the wave. The result of this process is an almost entirely accurate image of a flat wave just as it was before entering Earths atmosphere. See figure 2. Figure 2 The system performs wave front sensing and wave front reconstruction, with input from adaptive mirrors. Wavefront Sensing (WFS) WFS provides a signal that is used to estimate the wave front shape. It involves an optical device that is phase- sensitive, along with a highly efficient, low noise detector for photons. The achromatic wave front means that the sensors usually operate within the visible spectrum where the CCD chips and photo diodes have a high quantum efficiency and are virtually noise free. There are mainly three types of WFS that operate in the broadband spectrum with varying sensitivity and dynamic range. They are the curvature WFS, the Shack-Hartmann WFS, and the Pyramid WFS. The Shack-Hartmann WFS is based on producing numerous spots corresponding to the local wavefront through the use of lenslets located across the aperture. The average wavefront slope over the subaperture is determined by observing the position of these spots. The Pyramid WFS is very similar to the Shack-Hartmann WFS when the pyramid is modulated. When the prism is hit on either side by an aberrated ray, it only appears in one pupil. Thus the slope is measured through the distribution of pupil images. The curvature WFS measures intensity distributions in two different planes, corresponding to the wavefronts curvature. The most advantageous part of the curvature WFS is the ease of use. In terms of sensitivity at high spatial frequencies, the curvature WFS performs better than the Shack-Hartmann but has low performance when it comes to low special frequency. Wavefront Reconstruction This helps to calculate a suitable correction vector (consisting of voltages sent to the DM from slopes measured at the WFS) to reconstruct the wavefront. In a closed loop, the WFS operates linearly, therfore the reconstruction of the wavefront can be described as: Dv = s + n Where n is the measurement noise usually assumed to be Gaussian and uncorrelated, D is matrix for the interaction between the wavefront sensing and the deformable mirror These vector matrix calculations are computing intensive, especially because they have to be carried out in microseconds regime. Linear-quadratic-Gaussian (LQG) or Kalman filter can be used to predict the systems state which would be an improvement of wavefront reconstruction and control. Using such a setup, telescope vibrations can be introduced in the state vector and corrected. The only drawback would be the computational complexity which may be overcome by keeping the use of the scheme to a minimum only applying it to certain modes. Deformable Mirrors (DM) The atmosphere distorts the incoming light. The induced optical path differences are corrected by the DM. The mirror surface can be deformed by the movement of many small actuators present beneath the optical surface. The resolution of this deformation depends on the number of actuators, their separation, operation speed, and response time. There are thousands of actuators present in the DM system for large ( There are three primary technologies used to produce adaptive optics deformable mirrors: deformable secondary mirrors (DSM), piezo deformable mirrors and micro-optical-electrical-mechanical systems (MOEMS ). DSM provides adaptive optics correction while keeping up and high transmission and low thermal emissivity. The position of the actuators is handled by an internal control loop. They are normally separated by a few cm and attached to an optical shell. Piezo DMs have a spacing of actuators of several millimeters. Their response time is over a hundred microseconds. Piezo DMs usually require to be controlled by 8 Davies Kasper, an adaptive optics system to provide stable wavefront quality because they do not have local position control. MOEMS use electro-static actuation. They are much smaller than other DMs due to their interactuator spacings of a few hundred microns. Their response time is almost instantaneous, however they require a very large number of actuators, which is currently a technological challenge. Throughout the development of the telescope which started 400 years ago with a small, manual device that later on evolved into a sophisticated, computerized instrument, two parameters have been vital: the diameter of the telescope and the angular resolution. Since the perfect telescope would have the resolution directly proportional to the inverse of the telescopes diameter, the ideal would be to convert incoming wavefronts into a perfectly spherical wavefront, only restricted by the diffraction limit. Adaptive optics were first envisioned by Horace W. Babcock in 1953,[6] but only entered common usage in 1990s, following computer technology development which made it a practical technique. This system was first applied to flood-illumination retinal imaging for the purpose of producing images of single cones in the human eye, in conjunction with scanning laser ophthalmoscopy to produce the first images of retinal microvasculature and associated blood flow and retinal pigment epithelium cells in addition to single cones. In 1995, Lawrence Livermore installed a laser guide star on the 3-meter Shane telescope at the University of Californias Lick Observatory, which later became the first major astronomical telescope consisting of full adaptive optics. There has been massive development in adaptive optics in the field of astronomy following these memorable points in history. However, given that in practice there are still too many errors distorting the wavefront, both due to atmosphere and telescope system, even adaptive optics have limitations. The primary challenges of adaptive optics are: the ability to create an optical system mechanically capable of correcting incoming waves of light and computers ability to keep up with the speed required by the atmosphere. For the first impediment, the telescopes at Mount Wilson Observatory, for example, use two mirrors working together a tip-tilt mirror which provides the correction of incoming light and a second deformable mirror which aims to shape after the distorted wave of light, making it reflect its actual shape as if outside Earths atmosphere. Both the distorted and undistorted images must be known by the system in order to determine the shape of the deformable mirror. There are several methods that can be used for determining the final shape of a point source at the Earths surface. The adaptive optics system at Mount Wilson uses a star near the telescopes target as the source of the distorted wavefront. That is, it looks at a star as seen through the telescope close to the object under study and determines how it has been distorted from its expected appearance. This technique is advantageous because no extra equipment is needed, the light from the source passes through the entire atmosphere and it is located in proximity to the object studied. The downside is that it requires the object being observed to be close to a relatively bright star. Because the isoplanatic patch for the atmosphere is so small, only a small part of the sky could be close enough to a bright star to be observed. There have been attempts to overcome this limitation by using lasers to excite sodium atoms producing an artificial star instead of a guide star. The technique involves projecting a laser beam into the sky close to the object of interest. As long as the lasers light is bright enough, there is no need for a guide stars light. The second challenge is caused by the ever-changing distortions. The deformable mirror must modify quickly to keep up with the incoming light. Since this part of the process must be handled through the use of computers, it requires that the systems be fast enough to analyse the incoming wave of light and transmit the appropriate commands to the mirror many times per second. Thus if the turbulence in the atmosphere is increased, the system will have to worker harder in order to achieve accurate results. Since the first astronomical adaptive optics systems were brought into common use in the early 1990s, a vast number of technical developments have been achieved, numerous ingenious techniques have been created, and it has now come to a point where it is inconceivable to even consider building a large telescope without adaptive optics. Sadly, many of the complex concepts today still exist only on paper or demonstrated on small scale only. Even though many of these innovations have arisen after 2000s, recent years have been mostly dedicated to developing the technology for practical, large scale use of these systems. It seems adaptive optics are fully developed on a theoretical level, but the practical progress is still lacking. It is expected that in the years to come the main areas to be explored and developed will be high-density deformable mirrors with thousands of actuators, high-power sodium lasers and powerful real-time computers with processors exceeding 109 to 1010 operations per second, along with, possibly, fast and low-noise near-IR detectors, since optical detectors with sub-electron read-noise and very high quantum efficiency are already close to perfection. Many recent astronomical discoveries are directly attributed to the new optical observation developments. With the help of Very Large Telescopes, the role of adaptive optics is very important. With this capability, their huge light-gathering along with the ability to resolve small details, has the potential to bring major progress in ground-based astronomy in the new decade. Further in the future, giant optical telescopes such as E-ELT, will rely on advanced adaptive optics systems for virtually all their observations.

Romeo and Juliet by William Shakespeare :: Free Essay Writer

Romeo and Juliet by William Shakespeare "Violent delights have violent ends" Romeo and Juliet, two young people from Verona, come from two families in conflict. They meet at a ball and fall in love and only to find out their roots and families. They realise their stubborn families would not approve and plan on how they can be together. As we see in the play the friars words "violent delights have violent ends", has a very significant meaning to the story where things that are started violently have often have violent ends. At the beginning of the play the scene opens with the Montages and the Capulets fighting in the market place of Verona. Already from the first scene we know that there will be more violence and possibly a tragic end. Here the friar's premonition is already coming true before he has even said it. The prince suddenly appears and says, "thrice has my city been disturbed by your fighting". He vows that if they disturb again the culprits would be put to death. The climate in Verona is very hot and dry this often sparks fights and people's tempers become fiery. The main characters in the play are Romeo and Juliet who are in love and the play is centred on them. Mercutio is a Montague; he is a lighthearted man and a joker. Benvolio is also a Montague; he is a ver peaceful and sensible man. Tybalt is very aggressive and passionate. Romeo and Juliet meet at a masked ball hosted by the Capulet family. Romeo goes because he thinks that Roselyn the girl he admires will be there. When Romeo arrives there he puts his mask on so they do not recognise him, as he is the Capulets enemy. Romeo begins to dance and he spots Juliet she also spots him. They gaze at each other's eyes and begin to dance. It could be said that fate is already at work here. Juliet's nurse calls for her and here is where they both find out each there's identity. They are both devastated.

Ideal Student

With scholarship, one may subdue savants in court; Brave in spirit, one may fight courageous battles; Born a king, one might rule over an Empire; One may even land on the moon; But of what use are all these achievements, If one is not able to control the mind and the senses, And uphold eternal human values? My Teachers, Fellow Students, Boys and Girls! The world badly needs today ideal students with exemplary character instead of wealth and prosperity. The progress of the nation depends on such students alone. It is such sacred practices alone that have protected ideal students through the ages.My Teachers, Fellow Students, Boys and Girls! Unfortunately, Islamic values declined in the course of time among us. Today’s student has completely forgotten all about our Islamic culture and human values. We need to find them in our self and must spread in our society. We always speak truth and follow the path of honesty and justice. This is the most important factor to become an ideal student. Fellow Students, Boys and Girls! True Knowledge is another barometer against which we can measure in an Ideal Student.Knowledgeable students always respect by the society and admire by the world. His knowledge always makes pride to his parents, family and school. Fellow Students, Boys and Girls! We are the future citizens of this country. We all could become ideal students for the glory of our nation. It can be revived only if we become the torchbearers because falsehood, injustice, bad conduct, and evil are widespread in our country. We need to fight against them getting excellent knowledge and taking an active role to spread joy and happiness among our society. Thank You and God bless you all†¦!

Criticisms of IMF

â€Å"The fund believes it is fulfilling the tasks assigned to it: promoting global stability, helping developing countries in transition achieve not only stability but also growth. † â€Å"I believe, however, that it has failed in its mission, that the failures are not just accidental but the consequences of how it has understood its mission. † This is what Stiglitz states in his book, and is also his platform on how he feels about the International Monetary Fund. He believes that the IMF has a narrow view stating that â€Å"what the financial community views as good for the global economy is good for the global economy and should be done†.Stiglitz criticizes that the IMF has done great damage to the countries wherein they prescribe economic policies that must be followed in order to qualify for an IMF loan, or for loans from banks and other private-sector lenders that look to the IMF to indicate whether a borrower is creditworthy. Stiglitz argues that the Inter national Monetary Fund and its officials have ignored the ramifications of having incomplete information, inadequate markets, and unworkable situations, all of which are particularly present characteristics of newly developing countries.Stiglitz states that the International Monetary Fund called for policies that conform to logical textbook economics, however, they do not make sense to the country that the policies are going towards to provide relief. â€Å"Stiglitz seeks to show that the consequences of these misguided policies have been disastrous, not just according to abstract statistical measures but in real human suffering, in the countries that have followed the. † (Stiglitz, 2003).The most traditional and perhaps best-known IMF policy recommendation is for a country to cut government spending or raise taxes. Either one of these actions, or both would be used to balance a country’s budget and eliminate the need for government borrowing. Most people believe that a lot of government spending is wasteful anyway. Stiglitz accuses the IMF for reverting to Herbert Hoover's economics in imposing these policies on countries during deep recessions.The deficit, at this time, is mostly the result of a stimulated decline in revenues. Stiglitz argues that cuts in spending or tax hikes only make the downturn worse. He also emphasizes the social cost of cutting back on various kinds of government programs, such as eliminating food subsidies for the poor, which Indonesia did at the IMF's request in 1998, only to be engulfed by food riots. Another standard IMF recommendation is high interest rates, which make deposits and other assets denominated in the currency more attractive to hold.Most countries go to the IMF because they find themselves having trouble maintaining the exchange value of their currencies. Stiglitz argues that the high interest rates imposed on many countries by the IMF have made their economic downward spirals even worse. Countries are intended to battle inflation that was not a serious problem to begin with. â€Å"Stiglitz repeatedly claims that the IMF's policies stem not from economic analysis and observation but from ideology—specifically, an ideological commitment to free markets and a concomitant antipathy to government.† In part, Stiglitz complaint is that the International Monetary Fund did not understand or even try to understand, his and other economists' theoretical work depicting that markets that are pretty much unregulated do not necessarily deliver positive results when information or market structures are incomplete (Stiglitz, 2003). A country that currently has loans from the International Monetary Fund is the country of Venezuela. Venezuela first negotiated an economic program with the International Monetary Fund in the year of 1989. In the mid 1970s, oil prices soared and seemed unstoppable.Venezuela is a country very rich in oil, so at this time, they accumulated a lot of money fr om oil revenues, but also from loans from international banks. The government then used this money to expand state-owned industries, however, the government ended up supporting the least efficient enterprises, which came to rely on government credits and direct subsidies. Government investments were fruitless from 1974 – 1989. As government expenses continued to increase, the gross domestic product grew very little as a ratio of the government expenditures.The excess amount of money supply, created by government spending, raised the price index by a factor of 15, interest rates 3. 7 times and the devaluation of the national currency by a factor of 10, all happening during the same period. In addition to all of this, Venezuela’s foreign debt increased to a record level of $33 billion and their payments could not be honored. Venezuela undertook negotiations with the IMF when they were under all of this pressure from the decreasing oil prices and the rapidly rising intere st rates on their immense foreign debt.They had tried to borrow money to finance some of their debt; however, the international markets had been apprehensive for Venezuela had refused to work with the IMF. Venezuela had first turned to American banks for proposed financing because it did not want to agree with an economic program with the International Monetary Fund. The International Monetary Fund cleared a loan of about $453 million to the country of Venezuela. Officials declared the loan as a first installment of what is expected to be a credit package that may total as much as $4.6 billion from the international agency to support Venezuela’s economic reform program over the next three years. They believe that Venezuela’s economic adjustment program should â€Å"encourage a substantial reflow of private capital† to the South American country. The planned economic reforms were aimed at freeing and unifying Venezuela’s foreign exchange rates, deregulatin g interest rates and opening the country’s economy to foreign trade by removing quotas and tariffs. The austerity program is the price that Venezuela had to pay for the aid in financing from the IMF.Domestic interest rates were allowed to rise substantially and the government had cut several important subsidies as part of a proposed economic program with the IMF. Since Venezuela agreed on an economic program with the IMF, commercial bankers seem a lot more ready to compromise with them. The IMF reform program included many policies. As a result â€Å"The per capita gross domestic product fell almost 8% from 1989 to 1993; the inflation index rose almost 10 fold; the outstanding foreign debt increased by $5 billion and the banking crisis that burst out in 1994 erased 10% of the GNP and $6 billion of the country’s international reserves.† What the Venezuelan government basically did was sign an agreement that led to a transfer of money from private sectors to the à ¢â‚¬Å"pockets of the wasteful government†. The government attempted to balance its accounts through its citizens, by increasing the taxes and increasing the interest rates. Little attention was given to increasing the productive capacity of the nation, but was all focused on the fiscal demands of the state. In recent years, Venezuela's economy has gone from bad to worse. Its deterioration corresponded with the implementation of policies recommended by the International Monetary Fund.Venezuela has gone through two IMF aid packages beginning in 1989. Since the implementation of the most recent package in 1996, Venezuela’s interest rates have more than doubled to 68 percent annually. The national currency, the Bolivar, has been devalued by 94 percent, accumulated inflation has reached 218 percent and production output has stalled. Capital flight has exhausted more than $2 billion from Venezuela’s international reserves, which are much lower now, than they were befor e the International Monetary Fund package was signed.The fiscal deficit has been declared unmanageable and Venezuela’s stock market is down more than 50 percent. This downward spiral was the result of the tax increases, devaluation, few privatizations and public service rate hikes in the 1996 IMF package. The repeated devaluations have increased costs to the private sector and ignited inflation. The IMF also allowed the government to delay reforms of ineffectual state hospitals and public schools. In the case of the country of Venezuela, Stiglitz’s criticisms of the IMF do apply.The IMF’s policies do not take into account the economic and social circumstances that currently exist in the country where it is applied to. As per usual, the International Monetary Fund used its traditional methods on Venezuela. Increase taxes, and have higher interest rates. The positive effects of any loan obtained from the IMF or other financial institutes are useless because of the collection of interest and the rising interest rates. For developing countries such as Venezuela, the benefits from an agreement with the IMF cannot be seen for the large burden of clearing away their large foreign debt blocks their view.The IMF did not take into consideration the social implications that would be caused when such harsh adjustment measures are put into operation. The poor are always the most affected. Their frustration was seen in Venezuela, as outbreaks of violence. The Venezuelan currency kept being devalued constantly therefore workers had to pay more for their essential needs, as their wages began to decline. The unemployment rate would then rise and that is why it is no surprise to why the people of Venezuela turned to violence. When bitterness and despair take hold, sometimes violence may be the only way to be heard.It becomes imperative in times like this to have concrete negotiations on a debt plan to achieve a substantial reduction in debt and in interest payments. While losing many of its systemic functions, the Fund’s operations during the 1980s became dominated by dealing with the debt difficulties faced by a relatively small group of highly indebted developing countries. All the Fund’s lending was to developing countries, and the majority of it was to the highly indebted countries, even though the majority of programmes remained with low-income countries.The Fund frequently became depicted as a development agency offering concessional assistance to developing countries. Even some of its staff bemoaned what they saw as the loss of its monetary characteristics and consequently much of its financial reputation (Finch, 1988). The least subtle criticisms of this type tended to use the phrase ‘development agency’ almost as a term of abuse. What the Fund was doing was perceived as being bad in and of itself. The more subtle criticism was that the Fund had largely been pushed by political pressure into lowering its own financial standards.The criticism here was not so much that development assistance is inappropriate, but rather that the IMF is an inappropriate institution through which to give it. This argument sees it as important to retain the revolving character of Fund resources, as well as the Fund’s short-term monetary perspective—features, so it is claimed, that will be lost if the Fund is forced to lend over the long term on the basis of unviable programmes and unachievable targets. The plea has been strongly articulated to ‘let the IMF be the IMF’ (Finch, 1988).An extension of this argument is that unsuccessful programmes will damage the reputation and credibility of the Fund and adversely affect its catalytic role. The claim that financial standards have been sacrificed is intimately related to the debt crisis. In essence, it is that the governments of countries where the private banks are located, and in particular the United States, encouraged the F und to lend to the highly indebted countries in order to reduce the probability of default. In the early years of the debt crisis, the argument could be made that such action was sustaining the stability of the international banking system.But as the banks themselves adjusted to the crisis by reducing their exposure, strengthening their capital adequacy, provisioning, and expanding other lines of business, this systemic argument for lending by the IMF disappeared. Even critics who approach the issue from a rather different angle, having more in common with the ‘traditional’ criticisms of Fund conditionality, have concluded that the main beneficiaries of Fund lending to highly indebted developing countries during the 1980s were the international banks.Simply put, the claim is that it was positive net transfers from the Fund that financed negative net transfers with the banks. This is a claim that is at least superficially consistent with the evidence at aggregate level, but it is not an interpretation that finds ready acceptance—publicly at least—inside the Fund, where the accusation that it had bailed out the banks has been, often staunchly, rejected. Yet the criticism that the Fund failed in its dealings with the highly indebted countries during the 1980s has more dimensions to it than this.First, there is the argument that, along with others, the Fund misinterpreted the very nature of the debt crisis by treating it either as a liquidity crisis or as one of short-term internal adjustment rather than as a more deep-seated problem of structural adjustment which required important supply-side responses as well as the appropriate management of demand. This meant that the Fund opted to support new financing which assisted countries in meeting their outstanding debt-servicing obligations but which did little to restore medium-term viability to their balance of payments.The nature of the programmes supported by the Fund has, in relation to this, been criticized for an overemphasis on devaluation resulting from a desire to strengthen the tradable sector of the economy and thereby to facilitate debt servicing, and an over-ambitious attempt to achieve stabilization and liberalization simultaneously. A long-standing worry associated with the use of devaluation is that a shift in the nominal exchange rate will fail to alter the real exchange rate because of the inflation it generates.Devaluation is seen as destroying the ‘nominal anchor’, or to use the older jargon ‘reserve discipline’, that a fixed exchange rate provides. Is this not a particular worry in highly indebted countries where the inflation record is frequently very poor and where the reputation of governments as inflation fighters is often weak? Just as the counter-inflationary merits of fixed exchange rates were being acknowledged and accentuated in the context of the European Monetary System, were they not being neglected by the IMF ?Critics of the Fund’s approach to conditionality within the highly indebted countries have argued that, whereas devaluation may certainly be appropriate in some circumstances it may be inappropriate where the fiscal deficit is under control and where the income redistributive effects, particularly in terms of lowering the urban real wage, spark off political unrest and measures to restore real wages. In these circumstances, the price of non-tradeables may also rise, with the result that the relative price effect of devaluation on the internal terms of trade is lost.The dangers of a vicious circle, whereby inflation leads to devaluation which then leads to further inflation, have long been acknowledged in Latin American economies where there is a legacy of rapid inflation and a low degree of money illusion. Indeed, in the context of forward-looking models of economic policy which emphasise the importance of the government’s reputation, the vicious circle can take on an additional twist.Here the use of devaluation damages a government’s anti-inflation credentials; private agents anticipate devaluation and mark up prices ahead of it; the inflation thereby caused itself forces the government to devalue. Expectations become self-fulfilling and generate their own internal dynamics. The Fund has also been seen as being over-ambitious. Its stabilisation and liberalisation objectives have been interpreted as paying inadequate regard to the potential inconsistencies that may exist between them.Within developing countries, in particular, revenue from tariffs may be an important element in total government income. Tariff reduction can therefore exert a significant adverse impact on the fiscal balance unless this source of revenue is replenished by other tax changes. Evidence suggesting a falling rate of success in achieving programme targets is cited as supporting the claim that Fund-supported programmes in highly indebted countries have been unreali stic.In the case of intermediate targets, relating, for example, to aspects of credit creation, such a record reflects an increasing problem of non-compliance. Countries have often simply not complied with strategic elements in Fund-supported programmes. Some authors have again sought to explain this phenomenon in terms of the specifics of the debt problems with which highly indebted countries have been faced, the argument being that Fund-supported programmes have offered little domestic rate of return. The principal beneficiaries have instead been private foreign creditors.The distribution of the costs and benefits of the programmes has established a set of incentives that is antagonistic towards a high degree of compliance. The debt overhang has had the effect of weakening Fund conditionality through acting as a tax on necessary reforms, with one implication being that it has become increasingly difficult to muster the necessary domestic political support for such reforms (Sachs, 1989; Krugman, 1988). In this context it is claimed that debt relief is needed to create the necessary incentive structure to adjust.The Fund has been criticised for failing to recognise this. Indeed, its policy of ‘assured financing’, whereby IMF support was predicated on countries continuing to meet their outstanding obligations to the banks, has been interpreted as systemically discouraging the provision of debt relief by the banks and thereby impeding the resolution of the debt crisis. At the beginning of the crisis the Fund had some success in encouraging new commercial money inflows by making these a precondition of its support, but this insistence faltered as the banks’ reluctance to lend became more pronounced.Moreover, it is argued that the Fund’s inappropriate approach to the debt problem was reflected by its apparent neglect of the distinction between new financing and debt reduction—a distinction which was being accentuated in the academ ic literature as the 1980s progressed (Krugman, 1988). Critics suggested that this neglect again showed the Fund as being primarily concerned with cash flow rather than medium and longer-term problems.Yet, even in a short-run context, the different expectational responses to new money and debt reduction can cause different effects, with new money leading to further indebtedness and therefore the prospects of additional domestic fiscal and monetary problems. Statements emanating from the Fund about its own perception of its role in the debt crisis tended to side-step these analytical issues and stick with broader organizational ones, which emphasized its strategic importance as an ‘honest broker’ or catalyst (Nowzad, 1999).The Fund described its objective as that of normalising creditor-debtor relations and restoring country access to sustainable flows and spontaneous lending. The means to this end were to be vigorous and sustained adjustment efforts by the debtors, and a co-operative concerted approach involving creditors, the Paris Club, commercial banks and the export credit agencies. While recognising that progress had been uneven and vulnerable, by the mid-1980s the Fund was interpreting its overall record on the debt problem as ‘encouraging’ (Nowzad, 1999).At the same time, however, critics were assessing that, ‘the IMF’s recent record in the debtor countries is one of failure’ (Sachs, 1989a). Such disagreement persists because there is no universally accepted set of criteria by which the Fund may be judged. Apart from anything else, there is always the basic problem of the counterfactual: what would have happened if the Fund had done things differently?Accepting this difficulty, a superficial review of the empirical evidence suggests that the Fund’s record in terms of dealing with the debt problem of the 1980s was, at best, mixed. Certainly it managed to help avoid a major systemic international financ ial failure and this was no small achievement. But, by other criteria, no substantial or sustained degree of success can be claimed. By the end of the decade, creditor-debtor relations had not been normalised, and access to spontaneous lending had not been restored.Indeed, the creditworthiness of the highly indebted countries, as represented by the secondary market price of their debt, had continued to fall; net transfers to highly indebted countries were still significantly negative; a concerted and co-operative approach to the debt problem had not emerged; most debt indicators failed to show any notable or sustained improvement; and macroeconomic performance in the highly indebted countries was poor and often deteriorating, with forward-looking indicators such as the investment ratio and import volume suggesting bleak prospects for the 1990s.Even IMF-specific indicators were discouraging, with declining programme compliance, rising arrears and the increasing use of waivers. Episod ic successes existed but the overall picture was not reassuring. During a decade in which open economy macroeconomics became more sophisticated, the accusation was increasingly made that the model underpinning the Fund’s operations had failed to be modified and that it was out of date and inappropriate. Research of an excellent academic standard conducted within the Fund’s own Research Department was, according to this view, no longer having a significant operational impact.Indeed, and again at a superficial level, the empirical evidence seemed to suggest that the conventional caricature of a Fund-supported programme involving a combination of exchange rate devaluation and the deflation of aggregate demand through credit control was more accurate during the 1980s than it had been before (Edwards, 1989). At the same time as Fund-supported programmes were being criticised for lacking intellectual sophistication, evidence as to their adverse social and human implications was also being more systematically collected and coherently presented (Cornia et al., 1997; Demery and Addison, 1997).Increasing infant mortality and morbidity, malnutrition and falling life expectancy were now being attributed, at least in part, to IMF-backed programmes. And the design of programmes which emphasised reduced government expenditure rather than increased tax revenue was being seen not only as endangering important welfare schemes in developing countries, but also as reflecting the dominant current politico-economic paradigm within the developed countries, where the role of the state was under stark review.This in turn highlighted another area—the sequencing of reform—in which the Fund came in for criticism. Merely designing an appropriate programme of policies was now seen as inadequate; more consideration needed to be given to the order and inter-temporal distribution of elements of an adjustment programme, particularly as even research conducted within the Fund itself was beginning to suggest that Fund-supported programmes could have a negative effect on output, at least in the short run (Khan et al., 1996; Vines, 1990).Earlier models, which formed the basis for financial programming within the Fund, most notoriously the Polak model, had basically assumed away such an effect by making output exogenous. Yet even the more outspoken critics of the Fund’s handling of the debt crisis suggest that its approach changed towards the end of the 1980s, particularly after Michel Camdessus took over as Managing Director in 1987.This change of approach found expression in terms of a softening attitude towards debt relief, a change in the treatment of arrears, with the Fund becoming prepared to make loans while countries were in arrears with the banks, and an increasing concern for the effects of Fund-supported programmes on income distribution and the related recognition that income distributive effects might be important in determining the political, and therefore practical, feasibility of programmes.Although criticisms still remained, for example that the Fund placed too much reliance on voluntary forms of debt reduction which, given the associated free rider problems, should instead be treated as a public good, they became slightly more muted. If the Fund was still not coming up with right answers, at least, according to some critics, it seemed to be asking more relevant questions. Moreover, some of the broader criticisms relating to the input of the Research Department were suspended awaiting the impact of the appointment of a new Managing Director.On top of this there appeared to be a growing acceptance that macroeconomic stability was a necessary precondition for sustained economic development, and this took some of the sting out of the old debate about IMF conditionality. At the beginning of the 1990s private capital began to return to some of the lightly indebted countries, to the extent that some commenta tors claimed that the Latin American debt crisis was over. This was not the case in Africa, and it is unclear as to how significant the Fund’s input was in generating capital inflows. References Cornia, G. A. , Jolly, R. and Stewart, F. (eds) (1997)Adjustment with a Human Face: Protecting the Vulnerable and Promoting Growth, Oxford: Oxford University Press. Demery, Lionel and Addison, Tony. 1997. The Alleviation of Poverty Under Structural Adjustment, Washington, DC: World Bank. Edwards, S. 1989. ‘The International Monetary Fund and the Developing Countries: A Critical Evaluation’, Carnegie Rochester Conference Series on Public Policy 31. Finch, David C. 1988. ‘Let the IMF be the IMF’, International Economy, January/February. Krugman, Paul. 1988. ‘Financing versus Forgiving a Debt Overhang’. Journal of Development Economics 29.Khan, Mohsin, Montiel, Peter and Ul Haque, Nadeem (1996) ‘Adjustment with Growth: Relating the Analytical Approaches of the World Bank and the IMF’, World Bank Discussion Paper, Washington, DC: World Bank. Nowzad, B. (1999) ‘The Debt Problem and the IMF’s Perspective’, in Graham Bird (ed. ), Third World Debt: The Search for a Solution, London: Edward Elgar. Sachs, Jeffrey D. 1989a. ‘Strengthening IMF Programmes in Highly Indebted Countries’, in C. Gwin and R. Feinberg (eds).The International Monetary Fund in a Multipolar World: Pulling Together, US-Third World Policy Perspectives No. 13, Washington, DC: Overseas Development Council. Sachs, Jeffrey D. 1989b. ‘Conditionality, Debt Relief, and the Developing Country Debt Crisis’, in Jeffrey D. Sachs (ed. ), Developing Country Debt and Economic Performance, Vol. 1. International Financial System, Chicago, IL: University of Chicago Press. Stiglitz, Joseph E. 2003. Globalization and its Discontents. New York: Norton. Vines, David. 1990. ‘Growth Oriented Adjustment Programmes; A Recons ideration’, London: Centre for Economic Policy Research Discussion Paper No. 406, March.