Enteral Feeding After Gastric Intestinal Resection

Enteral Feeding After Gastric Intestinal Resection Optimum nutrition has always been a major target of post: operative care. Ileus is a common phenomenon after abdominal surgery, therefore early oral feeding is avoided and nasogastric decompression is being used. Conventionally, post abdominal surgery, the passage of flatus, or bowel movement was the clinical evidence of starting an oral diet. The end of post operative ileus based to be taken by the passage of flatus usually occurred within 5 days. The many studies have proved that the routine use of a nasogastric tube after abdominal Surgery and colorectal surgery may not be necessary. studies were undertaken to evaluate /whether different abdominal surgeries could benefit from early feeding. Early feeding improves the outcome of the patients with trauma and Burns although few studies have examined its use after gastro intestinal anastomosis. In case of laparoscopic colectomy patients have been fed routinely on day 2 after operation and that is being safely tolerated by the majority of patients. There are many evidences which indicate that immediate feeding after operation is actually feasible and safe whether post laparoscopic or post laparotomy , including gastro intestinal surgery. It has been proved by many studies that early enteral feeding in surgical patients improves nutrition and immunity and ultimately reducing septic complications and over all morbidity when compared with parenteral nutrition. A study conducted that compared an early regular diet to conventional post operative dietary management to determine G1 complications and mortality after major G1 anastomosis. The aim of this study was to assess the safety and tolerability outcomes of early oral feeding after elective gastro intestinal anastomosis. Patients and Methods Between July 2006 and December 2009, after the study was approved by ethical review committee, patients were offered participation and informed consent taken. Patients with chronic liver disease or those with metastasis and patients with histories of acute obstruction, perforation and intra abdominal infection were excluded. Patients were subject to a thorough history, physical examination and investigations. The patients were then randomized into two groups. Randomization done using sealed envelopes. Group 1 (Early feeding); 30 patients were offered simply a liquid diet within 6 hours of arrival on the ward. If 1 liter was being tolerated they were free for free liquid on the second day and then regular diet on the third day. (Tolerance is being indicated by an absence of vomiting or abdominal distension). Group 2 (Regular feeding) 30 patients were managed conventionally (that is nothing by mouth until the resolution of ileus, then a fluid diet, followed by regular diet. All patients underwent general anesthesia no nasogastric tube was inserted in any patients during surgery in patients in group 1 and a nasogastric tube was inserted in all patients during surgery and continued till the resolution of ileus in group 2. The patients were monitored for vomiting, abdominal distension length of ileus, tolerance of regular diet, length of hospitalization and complications. If there were two episodes of vomiting in the absence of bowel sounds or passage of flatus in the absence of any bowel movement, insertion of nasogastric tube was implemented.Also those who suffered from abdominal distension, emesis and succussion splash of stomach were diagnosed with acute dilatation of stomach, subjected to G I decompression. If there was anastomosis failure, treatment ensued such as antibiotics, nutritional support, ileostomy or colostomy. Patients with normal post operative course were discharged when they could tolerate a regular diet. Demographics were age and sex, medical and surgical histories of the patients and indications for anastomosis were noted. Different patients had different types of anastomosis were randomly allocated to group 1 irrespective of anastomotic type to eliminate bias. Table 1. Indications group 1 group 2 Tuberculous 5 5 Stricture at Ileum Closure of 20 20 Ileostomy Colorectal surgery 5 5 The main outcome was to evaluate post operative complications that included wound infection, leakage of anastomosis, obstruction, mesenteric emboli, upper G1 bleeding, wound dehiscence, prolonged ileus, and mortality. Ileus was defined as hypoactive bowel sounds, abdominal distension and no passage of flatus or bowel movement with or without nausea or vomiting after the first post operative day 3. Statistical analysis of data done by SPSS version 10. For continuous variables, descriptive statistics were calculated and were reported as mean +SD. Categorical variables were described using frequency distribution. The student T-test for paired samples was used to detect difference in the mean of continuous variables and the chi-square test was used in cases with low expected frequencies (a P value

Passionate Learning :: Philosophy Psychology Education Essays

Passionate Learning To lack [self-respect] is to be locked within oneself, paradoxically incapable of either love or indifference.....It is the phenomenon sometimes called 'alienation from self.' In it's advanced stage, we no longer answer the telephone, because someone might want something; that we could say no without drowning in self-reproach is an idea alien to this game. -Joan Didion, "On Self-Respect" Last Spring, as part of a senior project, I took Tai Chi classes and researched how meditation is used in mind/body medicine. I read several books by doctors who use meditation as a form of healing, in stress-reduction clinics and as treatment for people suffering from severe pain and panic disorders. One doctor in particular, Dr. Jon Kabat-Zinn teaches a method he calls mindfulness, in which he has his patients meditate in order to achieve total mind/body awareness. Zinn instructs patients to focus on their pain and to become aware of it. This often helps them realize that they can live with their pain. No pain is too extreme, he says, in the same way that no emotion is a wrong emotion. Awareness is the only absolute, and the only thing that allows people to live in the moment. Not live for the moment, but live in the moment. I left that project feeling extremely aware and extremely at peace. After three years of struggling to find answers, happiness, and a sense of purpose, I began to appreciate my present state of mind. I began to revel in the struggle, confusion, and push of not knowing. And as I approached graduation, my high school experience suddenly made sense to me. I understood life as a system of games. High school was simply one of them. I came to realize that playing games was both understandable and necessary as long as we are aware that we are playing them. I realized that a major struggle throughout high school had been my struggle to resist playing its game. I spent my three years at boarding school governed by my passions rather than playing by the rules of the institution. And in refusing to play by its rules, I made it increasingly more difficult for me to function within its realm. By rules, I do not mean the actual do's and don't's, but rather, I am referring to the prompts the school sets up in order to fulfill its goals as an academic institution.

Rational Theory

This paper introduces Rational System Perspectives in relations to four promin ent schools of organization theory; which are Taylor’s scientific management, Fayol’s general principles of management, Weber’s theory of bureaucracy and Simon’s discussion on administrative behavior. Rational System Perspectives There are two key elements characterizing rational systems: 1) Goal Specificity Specific goals support rational behavior in organizations by providing guideli nes on structural design, which leads to specify what tasks are to be performe d and how resources are to be allocated. ) Formalization Formalization is an attempt to make behavior more predictable by standardizing and regulating. Formalization provides stable expectation, which is a precond ition to rationality. Selected schools The author related rational system perspectives to four schools of organizatio nal theories. Taylor’s Scientific Management (1911) Taylor Scientifically analyzed t asks performed by individual workers and disco vered the best procedure that would produce the maximum output with the minimu m input of resources.His attempts (to rationalize labor at level of the indiv idual worker )led to changes in the entire structure of work arrangement. Ther efore, efficiency improved. His four principles includes: 1) Develop a science for each element of an individual’s work. 2) Scientifically select and train workers. 3) Heartily cooperate with workers to ensure that each work is done as plan. 4) Divide work and responsibilities between management and workers. Taylor also proposed the use of incentive system based on performance as a mot ivation tool.Arguments: 1) Workers resisted time-study procedures that attempt to standardize every as pect of their performance. 2) Workers rejected incentive system requiring them to perform continuously at a peak level of efficiency. Fayol’s Administrative Theory (1916) Fayol emphasized management functions by proposing broad administrative principles as guidelines to achieve rationalization of organizational activiti es. Fayol’s and other supporters believed in two main types of management activi ties. ) Coordination includes any elements related to collaborations of individuals such as scalar chain, unity of command, span of control and exception princip le. 2) Specialization involves various activities distributed among positions abou t how such positions can most effectively be grouped into work units. For exam ple, departmentalization, line-staff principle. Arguments: Herbert Simon was one of the main opponents of this theory. He commenced that so-called principles are truthful, but not realistic. Thus, they are inapplica ble (details will be discussed).Weber’s Theory of Bureaucracy (1922) Weber developed a theory of authority structures and describes organizational activity on the basis of authority relations. By building the structure, task responsibilities and de cision-making authorities would be clearly defined. He proposed that rational-legal authority (the authority a person possesses be cause of his/her position in an organization, not because of wealth, social st atus or individual’s admirable character) provides the value to develop the u niversal authority structure called â€Å"bureaucracy†.Weber’s ideal bureaucracy principles includes: 1) Division of labor. Jobs are broken down into simple, routine, and well-defi ned tasks. 2) Authority hierarchy. Positions are organized in a hierarchy, each lower one being controlled and supervised by a higher one. 3) Formal selection. Members are selected on the basis of technical qualificat ions (training, education of formal examination). 4) Formal rules and regulations. Managers must depend on formal rules to ensur e uniformity. 5) Impersonality. There is no personal preference of employees. ) Career orientation. Managers do not own the units they manage. They work fo r sa lary and pursue their careers. Arguments There are self-contradictions in Weber’s principles. 1) Management based on discipline: individuals obey the rules and orders becau se they regard the rules and orders as methods to fulfill organizational goals . Therefore, obedience is a mean to an end. 2) Management based on bureaucracy: individuals obey the rules because rules a re considered as commands, setting aside their judgements. Thus, obedience is an end itself.Simon’s Theory of Administrative Behavior (1958) Simon proposed a more realistic view related to rational system perspectives b y pointing out the boundaries (limits and constraints) on how rational manager s can be in making decisions. He introduced the term â€Å"bounded rationality†. Rather than pursuing all alternatives to identify the best solution that would maximize returns, managers will choose the solution that appears to solve the problem, even though they realized the chosen solution is not th e best one, d ue to time/cost constraints and other limitations.Furthermore, Simon clarified the process by which goal specificity and formali zation contribute to rational behavior in organization. Goal specificity: He introduced â€Å"means-ends chains† which establish a hierar chy of goals. According to organizational level, each level of activity is con sidered as an end relative to the levels below it and as a mean relative to th e level above it. Formalization: Simon believed formalized structure supports rational decision making in the sense that formalization simplifies a border of responsibilities among participants and provides participants with guidelines to handle them.Conceptual Framework (means) (ends) Formalization Goal Specificity Input Output Rational System Conclusion 1. Rationality in this paper can be viewed in two senses as follows: 1. 1) Technical or Functional rationality which can be attained through a serie s of actions (means) which lead to predeterm ined goals (ends) with maximum eff iciency. In short, Technical or Functional rationality emphasizes instrumental means-ends efficiency. Taylor’s and Fayol’s theories are related to rationa lity in this sense. 1. ) Formal rationality which can be derived through imposing rules an regulations to organization. Weber defined bureaucracy as rational in this sen se. 2. Level of Analysis 1. 1) Social psychological level. Taylor and Simon focus on individual participants as they perform tasks or make decision. 1. 2) Structural level. Fayol and Weber attempt to analyze the characteristics of organizational structures. Direction for my further research According to the paper above, I would like to examine which ideas of the above theories are still applicable to current information technology era.Furtherm ore, adding to my personal interest in strategic management, I would like to a nalyze how classical theories influence managers on strategic decision-making. Please see the su mmarized table in the next page. Table: Summarize and compare four organization theories. Taylor Fayol Weber Simon Year introduced 1911 1916 1922 1958 Means l Scientifically analyzed tasks performed by individual workers. l Concer ned with management at the shop levels l Generated broad administration princi ples. l Focused on activities of all managers l Described organizational activi ty on the basis of authority relations. Proposed rational-legal authority as a value to develop bureaucracy. l Proposed â€Å"bounded rationality† individuals have limits (boundaries) on how rational they can be. l Introduced means-ends chains. Ends Max. efficiency by using one best way. Max. efficiencyby using management expertise Max. efficiency by using bureaucratic structure Choose a fairly goo d solution, not optimal one. Assumptions Technical & Functional Rationality Technical & Functional Rational ity Formal Rationality Bounded rationalityLevel of Analysis Social Psychological Structura l Structural SocialPsychologic al Arguments 1) Workers resistedTime-study procedures, attempting to standardize every aspect of performance. 2) Workers rejected incentive system, requiring th em to perform continuously at a peak of efficiency. 1) So-called principles ar e truthful, but not realistic. 2) Simon: Due to limitations & constraints, the se principles are not thoroughly applicable. Self-contradictions 1) Based on d iscipline: Obedience is a mean to an end. 2) Based on bureaucracy: Obedience is an end itself.

America’s New Free Trade Agreement Essay Example

America’s New Free Trade Agreement Essay Example America’s New Free Trade Agreement Essay America’s New Free Trade Agreement Essay The North American Free Trade Agreement (NAFTA), implemented in the year 1994, is meant to remove barriers to trade between the United States, Canada, and Mexico. An important component of this free trade agreement is the member countries’ concern for environmental as well as labor issues, which must be worked on and agreed upon by the member countries. Yet another significant component of NAFTA is that of conflict resolution between the member nations. For this, the free trade agreement outlines procedures (Topulos).Since the time that it was first implemented, NAFTA has proved to be a positive experience for all member countries. In Mexico after NAFTA, poverty rates were reduced, and the real income increased, despite the economic crisis that the country went through during 1994-1995. Experts believe that the free trade agreement has the potential to reduce the poverty of Mexico even further. Trade among member nations has already increased tremendously. Goods produced in the United States, Canada or Mexico, are now distributed simultaneously in all three member countries. Moreover, the Mexican factories that process imported raw materials into finished goods for export have seen a dramatic increase in their income. Trade in other sectors of the Mexican economy has also increased. In the area of agriculture, Mexico has witnessed a steady increase in exports every year since the inception of NAFTA (North American Free Trade Agreeme nt). Undoubtedly, NAFTA is expected to benefit Mexico also in the future, just as the benefits of the agreement are being realized more fully today by the United States and Canada. The latter are expected to still increase their benefits of NAFTA with Mexico’s economic development.Given the benefits of NAFTA to the economies of the member countries, and the faith of the United States that it should have firm economic relationships with its neighbors – in December 2003, the United States, El Salvador, Guatemala, Honduras, and Nicaragua completed their negotiations on the newest free trade agreement in the region: the Central American Free Trade Agreement or CAFTA (Promoting Trade With Central America And The Dominican Republic). The United States and Costa Rica agreed on the latter’s participation in the new free trade agreement in January 2004. Two months later, the United States concluded negotiations also with the Dominican Republic to integrate the latter int o the CAFTA. This changed the name of CAFTA to DR-CAFTA, or the Dominican Republic-Central America Free Trade Agreement (Costa Rica).The goal of DR-CAFTA was the establishment of a free trade zone, which would be similar to the NAFTA. Thus, the DR-CAFTA removes tarrifs on approximately 80 percent of the U.S. exports to the other member countries (Dominican Republic-Central America Free Trade Agreement). By so doing, the new free trade agreement makes it especially beneficial for member countries that are economically weak to buy high quality U.S. products and thereby raise their standards of living. What is more, the agreement allows for easy access of goods from member countries into the United States market. Once again, the economically weak member countries are bound to benefit substantially through the new agreement, seeing that they may now have the gigantic U.S. market to sell their products to (Runyon).Other provisions of the DR-CAFTA include: (1) a promise made by the govern ments of all member countries that foreign investment is guaranteed in their respective nations; (2) a gradual removal of all barriers to trade that were initially meant to protect domestic production; (3) no duties on the import of agricultural goods; (4) subsidies on all agricultural goods, except sugar, must be eliminated; (5) intellectual property rights must be maintained; (6) a gradual removal of protectionist barriers in all sectors; (7) national monopolies must be dismantled so as to allow foreign investments to compete equally with the domestic organizations; (8) transnational companies would be given the right to resolve conflicts in private international courts; (9) the environment must be respected, and environmental laws abided by; (10) the major labor standards of the International Labor Organization must be enforced in all member countries; and (11) government corruption must be reduced and eventually eliminated in all member countries, especially the economically wea k ones where corruption is rampant (Dominican Republic).The United States’ economy would benefit by selling tariff-free goods to the member countries of the DR-CAFTA. The DR-CAFTA states would be able to purchase more U.S. goods than before, seeing as the tariffs would have been lifted. It is worthy of note, however, that the combined GDP of the DR-CAFTA states is only 0.5 percent of the GDP of the United States. The quantity of U.S. goods that the DR-CAFTA states would be able to purchase would be limited but naturally. Still, the benefits that these states achieve in the long run through the DR-CAFTA are expected to be greater than the benefits that the United States would be able to realize. This is because the DR-CAFTA states are all economically weaker than the U.S. Thus, positive changes manifested in the economically weak states would appear to be much greater in extent (Runyon).Although the effects of the new free trade agreement between the United States, Dominican R epublic, and five Central American countries, have not been documented as yet, it is believed that once the DR-CAFTA has been fully implemented, the United States would be able to increase its exports to the member countries by approximately 15 percent. U.S. imports are similarly expected to increase by around 12 percent, while the effect on the aggregate output as well as employment in the United States is expected to be little. Hornbeck states: These estimates are in line with expectations made prior to the negotiations that the marginal effects of the DR-CAFTA would be small, but positive for the U.S. economy as a whole, given the DR-CAFTA countries had small and already largely open economies.Once again, the overall benefits of DR-CAFTA would be more clearly visible in the DR-CAFTA states in the long run, just as the case of Mexico and NAFTA reveals greater interest in the benefits of NAFTA to Mexico. Just as NAFTA reduced poverty rates in Mexico, increased trade in the DR-CAFTA nations is expected to reduce poverty rates in these nations. However, it may take a while before the full benefits of DR-CAFTA are realized in these nations. Molly Runyon explains why the full range of benefits of DR-CAFTA would not be immediately visible in the economically weak nations: 1. Costa Rica. Retrieved from ustr.gov/assets/Document_Library/Reports_Publications/2004/2004_National_Trade_Estimate/2004_NTE_Report/asset_upload_file462_4745.pdf. (7 April 2007).2. Dominican Republic-Central America Free Trade Agreement. Wikipedia (2007). Retrieved from http://en.wikipedia.org/. (7 April 2007).3. Hornbeck, J. F. The Dominican Republic-Central America-United States Free Trade Agreement (DR-CAFTA). Congressional Research Service (2005, July 6). Retrieved from http://price.house.gov/UploadedFiles/CAFTA%207.6.05.pdf. (7 April 2007).4. North American Free Trade Agreement. Wikipedia (2007). Retrieved from http://en.wikipedia.org/wiki/North_American_Free_Trade_Agreement. (7 April 2007 ).5. Promoting Trade With Central America And The Dominican Republic. The White House. Retrieved from whitehouse.gov/index.html. (7 April 2007).6. Runyon, Molly. Free Trade in Weak States: The Case of DR-CAFTA in Nicaragua. Retrieved from http://fletcher.tufts.edu/research/2006/Runyon.pdf. (7 April 2007).7. Topulos, Katherine. NAFTA. Duke University School of Law (2007). Retrieved from law.duke.edu/lib/researchguides/pdf/nafta.pdf. (7 April 2007).

The 1st Punic War

The 1st Punic War One of the problems with writing ancient history is that much of the data  just isnt available any longer. The evidence for early Roman history is notoriously problematic. Roman historians developed extensive narratives, preserved most fully for us in two histories written in the late ï ¬ rst century bc, by Livy and by Dionysius of Halicarnassus (the latter in Greek, and fully extant only for the period down to 443 bc). However, Roman historical writing only began in the late third century bc, and it is clear that the early accounts were greatly elaborated by later writers. For the period of the kings, most of what we are told is legend or imaginative reconstruction.Warfare and the Army in Early Rome,- A Companion to the Roman Army Eyewitnesses are in particularly short supply. Even second-hand accounts can be hard to come by, so its significant that in their A History of Rome, historians M. Cary and H.H. Scullard say that unlike earlier periods of Rome, the history of the period of the First Punic War comes from annalists who had contact with actual eye-witnesses. Rome and Carthage fought the Punic Wars during the span of years from 264 to 146 B.C. With both sides well-matched, the first two wars dragged on and on; eventual victory went, not to the winner of a decisive battle, but to the side with the greatest stamina. The Third Punic War was something else entirely. Carthage and Rome In 509 B.C. Carthage and Rome signed a friendship treaty. In 306, by which time the Romans had conquered almost the entire Italian peninsula, the two powers reciprocally recognized a Roman sphere of influence over Italy and a Carthaginian one over Sicily. But Italy was determined to secure dominance over all of Magna Graecia (the areas settled by Greeks in and around Italy), even if it meant interfering with the dominance of Carthage in Sicily. The First Punic Wars Begin Turmoil in Messana, Sicily, provided the opportunity the Romans were looking for. Mamertine mercenaries controlled Messana, so when Hiero, tyrant of Syracuse, attacked the Mamertines, the Mamertines asked the Phoenicians for help. They obliged and sent in a Carthaginian garrison. Then, having second thoughts about the Carthaginian military presence, the Mamertines turned to the Romans for help. The Romans sent in an expeditionary force, small, but sufficient to send the Phoenician garrison back to Carthage. Carthage responded by sending in a larger force, to which the Romans responded with a full consular army. In 262 B.C. Rome won many small victories, giving it control over almost the entire island. But the Romans needed control of the sea for final victory and Carthage was a naval power. The First Punic War  Concludes With both sides balanced, the war between Rome and Carthage continued for 20 more years until the war-weary Phoenicians just gave up in 241. According to J.F. Lazenby, author of The First Punic War, To Rome, wars ended when the Republic dictated its terms to a defeated enemy; to Carthage, wars ended with a negotiated settlement. At the end of the First Punic War, Rome won a new province, Sicily, and began to look further. (This made the Romans empire builders.) Carthage, on the other hand, had to compensate Rome for its heavy losses. Although the tribute was steep, it didnt keep Carthage from continuing as a world-class trading power. Source Frank Smitha The Rise of Rome

Capital Budgeting Problems Article Example | Topics and Well Written Essays - 2500 words

Capital Budgeting Problems - Article Example Rather than that it is easier to the investment. This is due to the difficulty the future organization face in calculating the future benefits; most organizations normally do not undertake new investments. These judgements can be undertaken if the assets are quantifiable. The benefits attached to the intangibles can only be judged by the educated senior executive of the organizations and investments in such projects can be made on the basis of the beliefs of the organizations heads. The investments in these projects should be formally budgeted on the other hand it is strongly recommended to undertake periodic reviews of the outcomes and benefits attached to these projects. With investment in value delivering projects it is also important to invest in organizational skills and system since they affect the value. Activity Based costing system is used to achieve the organisation's objectives by supporting decision-makers inside the enterprise. Internal decision-makers are employed by the enterprise. These internal decision-makers create and use internal accounting information in order to undertake cost cutting and enhance the business profits (Meigs, Williams, Haka & Bettner, 1999). The development of effective management accounting systems although has played an important part in dealing with the problems discussed above but also it has given rise to the problems of downsizing and cost cutting. There are several factors, which were identified to have influence on the structure of these systems. These include differentiation degree of integration (internal & external) and the configuration of the organisations. Some researchers reveal contextual relationship between the above mentioned factors the management accounting system and information systems. (Daft and Mac intosh 1978; Khandwaila, 1972) Although many theories have been put forward in order to find out the efficient allocation of resources of the organizations but each of them has different drawbacks attached to them. Open theories: Open theories address all the social, psychological and structural factors. According to the open theories organisations are the organisms which take inputs from the environment and give outputs. Open systems undertake the analysis of all the different disciplines and levels. The open theories address all the aspects such as political social and technological extending its scope from other theories, which are confined only at studying the economic consequences. Cybernetics: covers the techniques applications. The cybernetics theories contend goal oriented behaviour and emphasise the change of role of individuals according to the situation. The main drawback of the theory is that it doesn't provide a universal solution and fails to provide specified guidelines for the individuals about their behaviour in different scenarios. (Aney, 1980) Social

Impact of Rewards on Employee Motivation and Organisational Dissertation

Impact of Rewards on Employee Motivation and Organisational Performance - Dissertation Example This research will begin with the statement that majority of the studies on the links between reward, motivation and performance are conducted in Western organizational context, so additional studies in Middle Eastern settings are needed to determine differences and similarities across cultures.   There is also a gap in literature regarding the connection between Saudisation policies and private-firm human resource practices. This dissertation aims to identify the drivers of motivation for Saudi nationals in Banque Saudi Fransi (BSF), to assess the impacts of various financial and non-financial rewards on sustaining high motivational levels within varied categories of employees such as workers,   to understand the contribution of employees’ motivational levels on individual and organizational performance, and to examine if incentive preferences differ by duration of employment, age, educational attainment, gender, job type, and social class. The research used survey resear ch design and weighted average charts to analyze results. Findings showed that financial incentives significantly drive performance and motivation more than non-financial incentives, but non-financial incentives are still important to motivation. Saudi culture, duration of employment, job type and social class greatly affected motivation differences than other factors too, while future studies should consider how sector and organizational culture interact with national culture to shape motivation and performance.... Saudi culture, duration of employment, job type and social class greatly affected motivation differences than other factors too, while future studies should consider how sector and organisational culture interact with national culture to shape motivation and performance. Implications for Saudisation of workforce and recommendations to BSF and the government are provided. ACKNOWLEDGEMENT First of all, I want to thank God for His blessings in my life. I dedicate this paper to our Creator who makes all things possible. Next, I thank my mother for her enduring support and my late father for being my running inspiration and for his guidance. I want to show appreciation to my supervisor for his help, support, and patientguidance. He has provided invaluable knowledge and assistance that enabled me to complete this dissertation. Finally, I would also like to express gratitude to the management and employees of Banque Saudi Fransi (BSF). They have opened both their doors and minds by particip ating in this research and they deserve heartfelt thanks. Table of Contents Impact of Financial and Non-financial Rewards on Employee Motivation and Organisational Performance of Saudi Nationals in i Banque Saudi Fransi (BSF) i DECLARATION 1 CERTIFICATION STATEMENT 2 ABSTRACT 2 ACKNOWLEDGEMENT 3 Table of Contents 4 LIST OF ILLUSTRATIONS AND TABLES 8 CHAPTER 1: INTRODUCTION 9 1.1 Saudisation and HR in the Middle East 9 1.2 Motivation and Performance 11 1.3 Incentives, Motivation, and Performance 11 1.3.1 Financial incentives and performance 12 1.3.2 Non-financial incentives and performance 13 1.4 Problem Statement 13 1.4.1 Banque Saudi Fransi (BSF) 13 1.5 Research questions, aims, and objectives 14 1.6 Summary 15 CHAPTER 2: LITERATURE