Impact Of Air Pollution In China - Free Essay Example

Sample details Pages: 4 Words: 1334 Downloads: 1 Date added: 2019/04/15 Category Ecology Essay Level High school Tags: Air Pollution Essay Pollution Essay Did you like this example? Ever since Deng Xiaopings Reform and Opening Up policy, which emphasized on rapid industrialization and decentralization, China experienced an economic miracle, ranking 2nd in GDP in the world and lifting millions out of poverty. However, this GDP-above-all rationale which radically improved Chinas economy has dealt a huge blow to the environment. For instance, the heavy exploitation of land and natural resources, as well as the reliance on fossil fuels for electricity generation are one of the few sources contributing to Chinas environmental destruction. Don’t waste time! Our writers will create an original "Impact Of Air Pollution In China" essay for you Create order Since the scope of environmental pollution is too large for practical concerns, I shall only be evaluating the impact of air pollution on Chinas development in this essay, as air pollution is one of the most dangerous and controversial type of pollution occurring nowadays in China. Owing to the combustion of coal and malpractices of the heavy industry, air pollution has been ever worsening in China ever since the Reform and Opening Up, however it seems to have worsened drastically for the past decade. For example, smog, a weather phenomenon involving a dense layer of dust suspended in air (mainly PM2.5 and SO2), is bringing disastrous effects to many eastern cities in China, and the problem was brought to light when even the capital, Beijing, succumbed to the heavy smog. According to lecture readings, a mere 22/522 cities in China have good air quality with 55 having seriously unacceptable air quality . Air pollution problem in China has caused various negative impacts to health, economic development and social development. Firstly, in terms of health implications, severe air pollution has led to deterioration in general health and thus an increased burden on Chinas public health system. In fact, air pollution has caused 1.58 million deaths in China in 2016 alone , coming second in the world after India. Air pollution is now the 4th most common cause of death in the world, with 6.1 million deaths in 2016 attributed to air pollution, since it causes serious illnesses like cancer, respiratory and cardiovascular diseases. Polluted air contains substances such as sulphur dioxide and PM 2.5 suspended particulates, accumulate in the respiratory tract or enter the bloodstream, either as an irritant inducing heart and lung diseases, or even as a carcinogen to induce cancer, resulting in death or affecting child development due to prolonged exposure. Air pollution has also cast doubts on Chinas public health system. According to the World Bank, the health expenditure resulted from air pollution accounted for 2% of Chinas GDP, mainly because of increased usage of emergency visits in acute cardiopulmonary conditions, which is on the rise partly due to air pollution (as well as lifestyle factors such as smoking, obesity, etc) . This expenditure is projected to rise as more and more people gradually become sick, forcing the government to allocate more resources into public healthcare. Should China fail to reduce pollution and prevent air pollution-associated illnesses, a huge sum would have to be paid to address public health problems in curing the population. From the viewpoint of economics, the Reform and Opening Up brought benefits to both the urban and rural communities. Ironically, it has brought drawbacks to both by sacrificing the environment in favor of rapid economic growth. Firstly, in urban cities, the worsening air pollution has led to a reduction in foreign interest in investing in China and incentive to set up branches in China, as well as unwillingness of overseas staff, especially experts and senior executive staff, to come to China for work. With persistent smog, the poor living standards (as aforementioned the possible adverse health effects of smog) and work environment has deterred businesses to set up branches in China. For example, in a survey conducted by the American Chamber of Commerce, which covered various businesses in eastern and northern part of China, Almost one-third of the companies said they had no plans to expand investments in China in the coming year (2016), up from 27 percent last year and 16 percent in 2013, and more than half of the respondents said pollution made it more difficult to recruit senior executives to work in China, raising concerns over air quality turning away expertise, professionals and executives away from working in China . Secondly, tourism is also affected by air pollution. In the past decade, China has begun developing its tourism industry. As a result, tourism related profits, including retail, service and hotel industries, begins to contribute more and more to Chinas total GDP. However, with the severe smog, foreigners will be deterred from visiting China, partly because of health issues, and partly because of the diminished attractiveness of natural scenic spots, which used to be a main feature of Chinas tourism, thus undoubtedly reducing Chinas income from tourism. In fact, 6 out of 8 Chinese cities including Beijing which made it into the Top 100 City Destination Rankings by Euromonitor International, experienced a drop in tourist arrival from 2012 to 2013, which correlated with the notorious reports of heavy smog during the time. With more traditional and social media from both China and beyond such as documentaries and news, China is more often put under the international spotlight than before , and the actual air pollution problem can be easily depicted and shown to foreign tourists, hence lowering their desire to come to China fearing for their health, not only leading to a reduced number of tourists but also a significant decrease in national income from tourism and related industries. Thirdly, agriculture in China is also affected by air pollution. Being one of the largest agricultural economies in the world, China has a history of ? »Ã‚ «Ã¢â‚¬ ¹Ã¢â‚¬ ¹, or to establish the country by agriculture, and currently produces 1/5 of the worlds grain and 1/2 of worlds vegetables . However, air pollution affects farming in two ways. Firstly, air pollutants like sulphur dioxide or ozone directly contaminate water sources or soil, thus affecting the crops. Secondly, the presence of suspended particulates blocks out sunlight, resulting in lowered photosynthesis rates and hence yield less crops. For example, Hunan, being a major province of rice production, is suffering from decreased crop yield these years . The severe air pollution also affects the farmers health and thus productivity, as they often work outdoors, inhaling a lot of pollutants over time, and thus prone to the aforementioned health risks. As we can see, despite economic gains from the Reform and Opening Up, the economy in both urban and rural areas are suffering from air pollution, which suggests the scope and severity of air pollution on Chinas economic growth. In the social aspects, air pollution has stirred civil unrest and general dissatisfaction towards the alleged industries and government responsible for air pollution. This originates from the inability of the civil society or media to observe or regulate malpractices, due to the lack of transparency and participation of civil society or media in Chinas government policies and industries, especially in the past. Over the years, a lot of mistrust is built up in the population, some of which resorting to unorthodox or illegal methods to voice their opinions towards malpractice. For example, a complaint of bad odor and leakage from a chemical factory in Fujian has escalated into riots and violent clashes with the factory staff and the police who were sent for a c rackdown, of which many were arrested, and several staff were badly beaten . Had there been effective, legal measures for locals to complain, and officials to address this problem, violence could have been avoided. In conclusion, air pollution has dealt severe blows to Chinas urban and rural economy, citizen health, and social stability. Chinas environmental protection minister, Zhou ShengXian, admitted that Environmental quality is not satisfactory and environmental protection work is arduous, on the Peoples Daily. The government must act swiftly to enforce strict environmental regulations; the industries ought to establish better corporate social responsibility to reduce their malpractices; and the civil society ought to voice out concerns more in order to pressurize the local government or industry. It is only through combined efforts and decisiveness of the Chinese Government, which is still a massive influence in Chinas policy-making and development, can air pollution be alleviated.

How Did Steinbeck Influence Of Mice And Men - 912 Words

Steinbeck’s influence in of Mice and Men Steinbeck’s personal views on people he perceived as less than him shaped of Mice and Men. He had created a story that was in direct correlation with the people that he encountered in his everyday life. Steinbeck developed characters off his own biased opinions of those people. He falls into place within his own story without ever mentioning his own name. Overall Steinbeck based the story off his personal views. Steinbeck’s parents, John Ernst Steinbeck and Olive Hamilton, had both imprinted their own perspectives on him. His father was a county treasurer and his mother was a school teacher (Commire 176). He had received his economic views from his father. Due to his success and wealth, he†¦show more content†¦They talk as if they were born and raised on a farm, and never given the opportunity to be properly educated, much like the people Steinbeck was involved with. The characters in of Mice and Men can be compa red to real people from Steinbeck’s life. During Steinbeck’s days of being a ranch hand, he was surrounded by workers that represent George and Lennie. â€Å"Two migrant ranch hands, George and the mentally challenged Lennie, and their simple yet ultimately thwarted dream of owning their own land.† (â€Å"John Steinbeck†). All their lives they had jumped from job to job because of Lennie’s disability. They had experienced several difficulties due to Lennie’s inability to control himself, so their dream of a farm full of rabbits and other animals had seemed to be nothing more than a dream. Other people within the story had also been in direct relation to those of his personal life. Curley’s wife had been depicted as a harlot. This specific character could have been put into place due to Steinbeck’s several failed marriages. Steinbeck had been married to Carol Henning from 1930 to 1943, Gwyn Conger from 1943 to 1949, and then set tled down with Elaine Scott in 1950 (Commire 176). Curley’s wife was referred to as a â€Å"tart† or â€Å"jailbait†, she was tempting the men in a way that no man can resist. She was doing all of this out of pure revenge, Curley left her alone on the farm all the time because he was a very busyShow MoreRelatedInfluence Of Writer s Life And Times1416 Words   |  6 PagesAssignment #1: Influence of Writer’s Life and Times No other period in American history did the civilian population suffer the most financially than in the 1930s. The unemployment level rose to an all-time high, and inflation made it nearly impossible for the common man to afford basic luxuries. It was in this era that John Steinbeck wrote a short story based off of migrant laborers set in his hometown of Salinas. 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Steinbeck later introduces Curley,Read MoreThe Portrayal of Society in Of Mice and Men and The Outsider Essay1430 Words   |  6 Pages World literature; self taught language Hungarian: After reading the two books for my world literature, of mice and men and the outsider I decided I will compare the two books on the topic choice; portrayal of society in the literature studied. This includes points such as: Meursault and Lenny not being accepted in society for who they are because they are different then others; another point would be there is a lot of violence within societies. The rest will be presented further on in my essayRead MoreAnalysis Of The Sphinx And Of Mice And Men 1493 Words   |  6 Pagesthe city the Sphinx was guarding. In many ways, the Sphinx is analogous to the American Dream where many people are devoured by it while a small quantity ever â€Å"solve the riddle† and achieve their American Dream. 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Downsizing Essay Research Paper 1 IntroductionDownsizing is free essay sample

Downsizing Essay, Research Paper 1. Introduction Retrenchment is the procedure of # 8220 ; cut downing employment to better efficiency, productiveness, and fight # 8221 ; ( Schwind et al. , p 538 ) . There has been a surprisingly big sum of downsizing. Between 1984 and 1994 # 8220 ; entire employment of Fortune 500 companies fell by 3 million people # 8221 ; ( Anthony et al, p 655 ) . This paper will concentrate on how to pull off retrenchment and will affect analysing the retrenchment procedure in phases. First is the pre-downsizing phase. This is where an organisation analyzes the issues involved in downsizing their company. Second, there is the planning phase where by the organisation plans the retrenchment procedure that will be taken. The 3rd stage is the procedure of execution and the 4th phase being pull offing the subsisters. It is really of import that human resources be greatly involved during the complete retrenchment procedure. The ground for this is that downsizing is a really hard state of affairs for all parties involved and the procedure should be managed decently and finely. There are many different grounds why organisations feel that retrenchment is the lone option with certain keys that will take to a successful retrenchment. 2. Keies to a Successful Retrenchment Procedure As already stated, downsizing in most instances is a really delicate state of affairs. Schwind notes # 8220 ; the mean size of downsizing scopes from 14 to 20 per centum of the work force # 8221 ; . This is a really important sum of people therefore the retrenchment procedure should be handled really carefully. The six cardinal rules to maintain in head for a successful retrenchment procedure are ( Schwind et Al, p539 ) : 1. Retrenchment should be initiated from the top but requires hands-on engagement from all employees. 2. Work force decrease must be selective in application and long-run in accent. 3. There is a demand to pay particular attending both to those who lose their occupations and to the subsisters who remain with the organisation. 4. It is critical that decision-makers identify exactly where redundancies, extra costs, and inefficiencies exist and attack those specific countries. 5. Downsizing should ensue in the formation of little semi-autonomous organisations within the broader organisation. 6. Downsizing must be a proactive scheme focused on increasing public presentation. The keys outlined above are merely a guideline and other cardinal factors should besides be considered for a successful retrenchment procedure. Communicating the organisations plan to downsize and why it must make so to the work force early is good pattern. This will give the employees that are being dismissed an chance to fix for their hereafters and less of a feeling of uncertainness with their state of affairs. It will besides give the staying employees more regard for the company and give them more occupation security since they feel that the company will be honest with them with regard to company concern. Another factor that is of import to see during the retrenchment procedure is that with a reduced workforce the staying employees will necessitate to pick up the slack. In downsizing state of affairss the company should be cognizant of this fact and inquire the staying employees how they feel their occupations could be made easier in order to manage the increased work load. 3. Reasons or Advantages of Downsizing The chief ground why an organisation chooses to downsize is that a company may wish to reconstitute their organisation. Theoretically reconstituting an organisation is a agency of increasing productiveness and the efficiency of the company. Cuting the figure of employees within an organisation is the easiest and quickest manner to cutting costs. Another advantage to retrenchment is that certain places or people that are unproductive are released. An addition in international competition is another ground organisations choose to downsize. Some companies feel that in order to vie in their several industries globally that retrenchment is the solution. 4. Disadvantages of Downsizing There are both advantages and disadvantages of an organisation downsizing its figure of employees. One of chief disadvantages of retrenchment is the affect that downsizing has on the staying employees. After a major organisational retrenchment there is a lessening in morale and a sense of insecurity amongst the staying employees. The lessening in morale is non merely felt by the co-workers of the released employees but by everyone within the company at all degrees. The people that were in charge of the existent fire might experience guilty which might convey on depression. A lessening in employee trueness and a feeling of bitterness towards the company are besides a consequence of retrenchment. The consequences of which may ensue in lower productivenesss and higher turnover rates. In some instances the quality of green goods being green goodss can besides diminish as a consequence of employee attitudes. As celebrated above retrenchment is # 8220 ; theoretically # 8221 ; supposed to increase productiveness. The ground why it is merely theoretical is that there are different surveies to back up both the addition and lessening in productivenesss as a consequence of retrenchment. Surveies show that: ? # 8216 ; fewer than tierce of downsized houses received expected net income increases # 8217 ; ( Duran et al ) . ? # 8216 ; 38 % of surveyed companies that downsized reported no alteration in worker productiveness ; 34 % reported increased worker productiveness ; and 22 % reported reduced worker productiveness # 8217 ; , ( Filoposki, p. 71 ) . As can be seen from the above statistics downsizing is non ever the best solution. 5. Stairss in the Downsizing Procedure If retrenchment is inevitable, doing certain that certain downsizing stairss are implemented successfully and swimmingly can cut down the negative affects of downsizing. There are four chief processing in downsizing procedure: analysis, planning, execution, and pull offing the subsisters. These stairss make it as easy a passage as possible for all parties involved. This procedure should be implemented with a big sum of counsel from the human resource section. 5.1 Analysis The first measure in the procedure of downsizing for the human resource section is the pre-downsizing phase. This measure must be done before the determination of retrenchment is made by the organisation. This phase analyses the effects and affects that the determination of retrenchment may ensue in. The factors that are considered are the costs to the company, both direct and indirect, the stakeholders # 8217 ; demands, the employees, and how retrenchment would impact the organisation as a whole. The organisation should merely see downsizing as a long-run solution, non merely a speedy hole for the organisation. 5.2 Planning The following measure in the retrenchment procedure is be aftering phase. For the successful execution of a retrenchment procedure careful and complete planning by the human resource section and direction should be done. This procedure should get down long before the formal proclamation. If the determination of retrenchment is made in the pre-downsizing analysis phase the following measure in the procedure is to take the best manner to downsize. Two possible methods of downsizing are attrition and budget film editing. Attrition is when a company reduces its work force by non replacing employees that leave on a voluntary footing. This is a really slow procedure and therefore is non normally used as a retrenchment method. Budget film editing is the most popular type of downsizing. As specified earlier retrenchment of employees is the easiest and most widely used signifier of budget film editing. A company is able to cut down its work force while increasing, or at least non diminishing, productiveness by increasing the mechanization within the organisation, taking certain places, or increasing the work load of other employees. Another portion of planning is the determination of when to downsize and which employees should be released. The places that are less proficient should be released before the extremely proficient places since they are more hard to make full. The timing of the proclamation and the act of retrenchment is really of import. Timing should be balanced between company public assistance and employee public assistance. In deepness planning is needed if retrenchment is to be successful. The last measure in the planning phase is to make up ones mind upon the inside informations of the passage. Some of the options open to the employer are to offer: rupture wage, outplacements, and occupation guidance. These will be looked at further in the pull offing the subsisters phase. 5.3 Execution The 3rd measure involved with the retrenchment procedure is its effectual execution. The morale and productiveness of employees staying after downsizing can be a direct affect of how the retrenchment procedure is implemented. Therefore, this is the most delicate of the retrenchment processes. Therefore, it is of import for all parties involved to be considered, including directors, the employees being laid off, and the staying employees. One of the first stairss in that demand to be done is the preparation of directors and supervisors. This is done before the proclamation and is really of import in the execution stage. The supervisors need to understand that they will hold a big communicating function when the proclamation is made, and peculiarly afterwards. Employees tend to swear their direct supervisor more than anyone else in the organisation, so the supervisors need to hold the communicating and diplomatic accomplishments necessary to cover efficaciously with the inquiries that may originate. Directors and supervisors besides have to get the accomplishments to get by with stating employees they are discharged. This can be really nerve-racking and hard for most people. To pr oviding supervisors with effectual communicating accomplishments, they will hold to be given considerable information about the company’s retrenchment and future programs, so they are able to accurately and convincingly reply, employee concerns. The execution must be good planned, good organized, and good communicated. Employees should be notified in progress that there will be a retrenchment, and the existent proclamation should take topographic point on the specific twenty-four hours promised. The statement should be carefully prepared and announced to all employees at the same time. Senior directors should do the proclamation. They should be unfastened and honest about the grounds for retrenchment, explicating the concern principle behind the determination, supplying every bit much information as they can to employees, and be prepared to reply employees # 8217 ; inquiries. Senior directors must besides pass on the company # 8217 ; s vision for the hereafter. This gives the subsisters more trust in direction # 8217 ; s ability to do the company successful. Besides the senior directors should be prepared to listen to employees who need to vent their emotions right after the proclamation. The information provided should i nclude what the alterations mean, and how employees, including those non discharged, will be affected. Newsletters and meetings can be utile tools to supply information to employees. After the initial proclamation, each director or supervisor should run into with each employee in their section separately, either to inform them that they have been discharged, or to give them information on what specific alterations will be happening that will straight impact them. Communication is the key to an affectional and smooth execution procedure and should be done before rumors begin, which can do a lessening in morale and fuel bitterness. Rumours frequently consequences in over-exaggerations, which may take to insecurities amongst the work force. The existent breaks may be less lay waste toing than what the rumor express, but if there is non adequate unfastened and honest communicating, rumor may play a important function, adversely impacting morale. Even after the proclamation communicating plays a major function in the procedure. As such, companies to promote communicating through the usage of inquiry bead off boxes. Discharged employees should be treated reasonably, shown concern, given generous rupture and benefits bundles, and given aid with happening other employment, non merely to protect the repute of the organisation, but besides to guarantee that the subsisters will experience more positively about the retrenchment. Fairness is an of import factor when an organisation is in a retrenchment state of affairs. Perceived unfairness may be inevitable, but with first-class communicating, and rational grounds given to employees misinterpretations and bitterness should diminish. Employee engagement during the execution stage may assist better subsisters # 8217 ; morale and motive after the retrenchment. For illustration, employees can be involved in redesigning work, reconstituting occupations, and bettering internal procedures to make greater efficiency. Employee engagement helps subsisters experience more in control of their hereafter. This engagement may diminish some of the negative feelings that the subsister may hold, therefore productiveness should be maintained or increased as a consequence. 5.4 Pull offing the Survivors The last measure in the retrenchment procedure is the managing of the lasting employees. This measure is really of import to maintaining the morale of the staying employees. Even if the execution of the retrenchment has been done efficaciously, the company and staying employees will still hold many issues to decide. A figure of critical issues need to be addressed if these employees are to go optimally productive subscribers to the freshly downsized organisation. They are: subsisters # 8217 ; feelings of heartache, opposition to alter, fright, loss of assurance, motive, trust, committedness, self esteem, employee trueness every bit good as issues originating out of the increased work load, such as new accomplishment demands, and diminishing systems support. Many employees resist alteration even when their employment position is non threatened. When that menace is present it is non at all surprising to happen even more opposition than might be otherwise expected. The cause of this may be associated with fright. The fright is that downsizing, one time begun, will go an on-going procedure and though you may hold survived this unit of ammunition, there is bound to be another unit of ammunition and you may non be so lucky the 2nd clip around. Once the outlook of unafraid employment has been violated, fear creeps into each employee # 8217 ; s consciousness and continues to eat away at assurance, motive, trust, committedness, and self-esteem. These feelings may be intensified if the work load of an person is increased as a consequence of downsizing. Now the employee may be required to work longer hours compounded by the complication of executing work that requires the acquisition of new cognition, the mastering of new accomplishments and the constitution of new relationships. These demands are farther menaces to the assurance of many employees, who fear that if they fail in these new undertakings their occupation is at even greater hazard. Employee trueness may be a concern during the post-downsizing phase. In add-on to the increased work loads and new accomplishments needed, chances for promotion and growing are frequently diminished. These factors may take to an employee seeking for better chances elsewhere. A deficiency of trueness is one of the earliest consequences of retrenchment. An organisation can assist cut down some of the feelings that the subsisters may hold by guaranting the followers ( Mishra A. , Umiker, and Mishra K. ) : ? Employees have equal chance for personal growth/development. ? Make sure that survivors experience enhanced occupation assortment and liberty. ? There is sensible chance for promotion/advancement. ? Peoples receive appropriate acknowledgment for excellence in their work. ? Employees are given the chance to accept extra duty. ? Peoples are valued for their creativeness and thoughts. Both directors and the human resources section are responsible for helping employee accommodation to the alterations caused by downsizing. The human resources direction is responsible, possibly more than of all time before, for the development of bing staff within the organisation. Employees who survive a retrenchment frequently feel dying and betrayed. HR can assist these employees by supplying emotional support, function elucidation and calling direction aid. Employee aid plans may be one method used to help with supplying emotional support to subsisters. Directors besides have an of import function in covering with subsisters. Keeping an # 8220 ; unfastened door policy # 8221 ; is one manner to promote communicating within the section, which may assist some of the employees to cover with and show their ideas about the state of affairs around them. 6. Decision Retrenchment is a really hard pick that a company makes and affects a great trade of people in the procedure. The determination should be carefully analyzed before the existent determination is made in order to do the procedure easier on all parties involved. Six cardinal things to maintain in head along with four general downsizing stairss should be followed in order for a successful retrenchment passage. The four chief stairss are: analysis, planning, execution, and pull offing the subsisters. Following these stairss will cut down the negative affects that downsizing consequences from such as decreased trueness, productiveness, morale, and misgiving in the company. Making the downsizing passage every bit easy as possible for all parties involved is the duty of both direction and human resources. Stairss should be taken to ease the affects of downsizing on employees, discharged employees, and besides direction. The chief key to a successful organisational retrenchment procedure is g ood communicating. Bibliography 7. Mentions ? Anthony, William. , Pamela Perrewe, Michele Kacmar. Human Resource Management: A Strategic Approach Third Edition. Montreal: The Dryden Press Harcourt Brace College Publishers, 1999. ? Cascio, W.F. 1993. # 8216 ; Downsizing: What do we cognize? What have we learned? # 8217 ; . Academy of Management Executive, 7 ( 1 ) , p. 96. ? Duran, Catherine A. , Vinitia E Mathews, . # 8220 ; Some retrenchment attacks more effectual than others. # 8221 ; Health Care Strategic Management, Volume 17 Issue 9, 1999. ? Filoposki, D. , November 1993, Volume 72, Issue 11, # 8216 ; Downsizing International Relations and Security Network # 8217 ; t ever rightsizing. # 8217 ; Personnel Journal, p. 71. ? Hendricks, Charles. , The Rightsizing Redress: How Directors can React to the Downsizing Dilemma. Homewood: Society for Human Resource Management and Business One Irwin, 1992. ? Mishra, Aneil K. , Gretchen M Spreitzer. , # 8220 ; Explaining how subsisters respond to retrenchment: The function of trust, authorization, justness, and work redesign. # 8221 ; Academy of Management. Volume 23 Issue 3, 1998. ? Mishra, Karen E. , Gretchen M Spreitzer ; Aneil K Mishra. , # 8220 ; Continuing employee morale during downsizing. # 8221 ; Sloan Management Review. Volume 39 Issue 2, 1998. ? Schwind, Hermann. , Hari Das, and Terry Wager. Canadian Human Resource Management: A Strategic Approach Fifth Edition. Toronto: McGraw-Hill Ryerson Limited, 1999. ? Tomasko, R. Downsizing: Reshaping the Corporation for the Future # 8217 ; . New York: American Management Association, 1990. ? Umiker, William. , # 8220 ; The necessities of compassionate downsizing. # 8221 ; The Health Care Manager. Volume 17 Issue 4, 1999. 31b