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Thursday, October 17, 2019
D3 H1N1 Essay Example | Topics and Well Written Essays - 250 words
D3 H1N1 - Essay Example Isolating within the embroyonated eggs reduces the possibility of contaminating the virus strain. The now hybrid virus is tested to determine its effectiveness, safety and establish whether it stimulates appropriate antigen response in the body. The entire production process of influenza vaccine takes about six to nine weeks (Gerdil, 2003). New influenza vaccines are produced every year because the virus undergoes constant genetic mutation that changes the hemagglutinin and neuraminidase surface glycoprotein of the pathogen (Gerdil, 2003). The mutation undermines effectiveness of the influenza vaccines. When a healthy person is vaccinated with the influenza vaccine, the body immune system responds by producing relevant antigens to fight and destroy the influenza virus. Therefore, when influenza pandemic occurs, the immune system of the vaccinated persons is capable of fighting the infection easily. Though the vaccinated individuals could become infected, the symptoms and the effect s of influenza are less severe compared to individuals who are not vaccinated. This limits transmission of the highly virulent influenza virus to other persons who are exposed to the infected person. Influenza is an airborne disease that is mainly transmitted when a person inhales droplets that are released when an infected person coughs or/and sneezes (Carrat, et al, 2008). Vaccinating people helps in preventing the spread of diseases and reduces the severity of ailments in the community. Failure to vaccinate people against influenza and other diseases could cause outbreaks that affect economy, social interactions and the environment negatively. When people are infected with a particular disease, the productivity of the country is lowered because of lengthy bed rests, incapacitation and deaths, which reduce the number of people capable of working. Disease outbreaks undermine social activities such as sports, travelling
Wednesday, October 16, 2019
Operatons management Essay Example | Topics and Well Written Essays - 2000 words
Operatons management - Essay Example Moreover, the advancement of the information technology is another important add-on for logistic management. With the used of the advance IT system, operators can track the flow of materials from the point of purchasing inputs for productions to the point finished products are sold in the retail stores. This gives enough data for logistics managers to make a wise decision for the overall business operations. Lastly, the principles and value chain are also discussed. The principles of logistic management give pointers for managers to help them gauge the correctness and effectiveness of their decision making. Transport and logistics, according to the report written by Shepherd, is a sector in which global value chain (GVCs) play a vital role in connecting countries. It is also responsible for spreading technologies. It also promotes best practice with all the countries in the world. Major shipping, freight forwarding, express delivery firms are just a few of the notable firms involved with this sector. Not only big and notable firms – transport and logistics also partners with local operators. It does not focus on first world countries alone as it extends hands to low income countries or commonly known as the third world countries to help boost their flow of goods, information and other valuable resources. In addition to its vital role as a global value chains, this sector also helps improve the trade performance of many countries around the world. For example, in order for manufacturing and agricultural industries to deliver their produce or goods to consumers quickly and reliably, they need the help of the transport and logistics sectors. A banana plantation industry depends on transports and logistics sectors to ship tons of harvested bananas to different countries. Without a cost-effective model of delivering these
Tuesday, October 15, 2019
Smallpox Article Example | Topics and Well Written Essays - 500 words
Smallpox - Article Example There was some opposition regarding terms posted for getting vaccination. Certain difficulties were encountered during the process of eradication. WHO faced serious financial difficulties and it lacked constant support from its various offices within its framework. The above bottle necks were overcome in 1970's with the help of various governments and development agencies. U.S joined hands with countries like Russia and the WHO framework to make eradication a success. The decade of 1970 played a major role in helping the eradication of small pox by conducting expanded Programme on Immunization. The smallpox eradication was then certified based on intense verification performed in the countries by a group of scientists who confirmed it in December 1979 and was acknowledged by WHO's Health Assembly in 1980. 1980 witnessed the fulfillment of the goal which was considered impossible. This was the greatest achievement of global public health in the 20th century. After the 1980's, people were free from the deadly virus. But it did not last for a longer time. WHO announced multiple deadlines in 1993, 1995 and 1999 to eradicate the remaining virus stocks. But they failed to accomplish the task in the expected deadline. In 2002 U.S saw a sudden outbreak of small pox.
Monday, October 14, 2019
Politics and Global Warming Essay Example for Free
Politics and Global Warming Essay Introduction            Every day we go about our own business. Many of us never take the time to look around and see how we are affecting our earth’s atmosphere.  Everywhere you look today you are bound to see some factory or machinery polluting our air. Just think how many times you have seen those large semi trucks or big fossil fuel factories emitting thick dark smoke into the atmosphere. We need to come to reality and realize that all that polluting we have been doing over the last half-century is finally catching up to us. It is very easy to detect through scientific research that our earth’s climate is changing, Time magazine reports in its 2004 issue that the earth’s average temperature is increasing at a steady rate. Yes, we all have heard the term â€Å"global warming†, however many people don’t know in depth what global warming is, or how our actions will affect our earth if we don’t respond to the issue. If we can educate ourselves on what global warming is and how it will affect us in the near and far future, we can then begin to change our old habits of polluting and create new habits and goals to living in a much healthier and cleaner environment. The purpose of this study is to know what global warming is and what the government is doing to resolve the issue as well as what else can be done in short term and long term. Background What is global warming?            Global Warming is an issue that concerns almost everybody worldwide: it is the primary cause for the erratic and sometimes devastating weather that is experienced around the world. Global warming is causing the rise in sea level which in turn causes the flooding of coastal areas and areas with low elevation. Global Warming and doomsday            Will global warming spell doom for our world? Scientists believe this to be so. â€Å"Much depends on what actions we take now and in the coming years.†Meteorologist Jagadish Shukla of the University of Maryland found out that deforestation would cause rainfall in the Amazon River to decline by more than 26 percent from the current 2.5 m. to about 1.8 m. a year (Bellamy, 2000).            At the same time, the burning of fossil fuels, particularly coal and oil, produces sulfur dioxide and nitrogen oxides which are hazardous to the atmosphere. Findings show that a single smokestack may produce as much as 500 tons of sulfur dioxide a day. When these gases combine with oxygen and moisture, sulfuric acid and nitric acid is formed. The rain will carry the acids to the ground (acid rain) which may cause the depletion of calcium and magnesium in the soil, elements needed by plants for the formation of chlorophyll and wood, or it may cause the release of aluminum in the soil, which are poisonous and can kill the roots of trees (Carwardine, 2000). Discussion            During the earliest times, the life-styles of our ancestors were very simple. The air they breathed was clean. The streams were clear and free of harmful organisms. They used natural fertilizers for their agricultural crops. The surroundings were free of household throwaways.            Today, there has been a tremendous growth in science and technology. Such advances have brought about changes in terms of new products, improved equipment, and more effective methodologies. Unfortunately, this same technology which made life easier for us produced wastes which are now affecting the quality of our surrounding air, water, and land. Factories and motor vehicles send tons of pollutants into our air. Excessive air pollution poses a danger to our health and environment. It can likewise cause stunted growth and even death to our plants. Out streams are polluted by discharges from industrial plants that use chemicals. Garbage and sink wastes are carelessly thrown in our surroundings. Synthetic fertilizers and insecticides pollute our land and farm products (Johnston, 2000).            At the same time, the burning of fossil fuels, particularly coal and oil, produces sulfur dioxide and nitrogen oxides which are hazardous to the atmosphere. Findings show that a single smokestack may produce as much as 500 tons of sulfur dioxide a day. When these gases combine with oxygen and moisture, sulfuric acid and nitric acid are formed (Jenner, 1999). The rain will carry the acids to the ground (acid rain) which may cause the depletion of calcium and magnesium in the soil, elements needed by plants for the formation of chlorophyll and wood, or it may cause the release of aluminum in the soil, which are poisonous and can kill the roots of trees.            Nitrous oxide or laughing gas is a colorless gas with a sweet taste and odor that is used as an anesthetic in minor surgery that H2O is responsible for about 6 percent of the human contributes to greenhouse warming. Methane or cow gas, on the other hand, makes up about 18 percent of human contributions to greenhouse effect. Cattle, sheep, goats, and other cud-chewing animals give off methane, in burps and flatulence as they digest (Cairncross, 2002).            CFCs are estimated to account for 14 percent of global warming. Experts said that what is happening right now is not a matter of adding a few degrees to the average temperature of a community. A rise of this magnitude may cause life, for without the environment, creatures on earth cannot survive            Are we all aware of the extent of the damages brought about by modernization? Have we contributed to such environmental dilemma? What have we done to minimize such danger to our lives?            How can we take care of our environment? We must undertake measures to preserve our resources and minimize utilization of energy before it’s too late. Our fight against pollution is an initial step toward conserving our environmental resources and energy. We must all join hands for this common goal.            Furthermore, of all issues affecting humanity, climate change is the most pervasive and truly global, posing a very real and serious threat to our environment. Climate change is the alteration of the pattern of global climate that may be due to human activity that alters the composition of the atmosphere.            If present day emissions of greenhouse gases continue, it is estimated that the rate of increase in global mean temperatures will reach about 0.3o C per decade. This will mean a likely increase of 1o C above the present level by the year 2025, and 3o C before the end of the next century. Resolution            a.) Recycling and Reuse of Solid Wastes            Solid wastes are now viewed as a potential resource which must be recovered and reused whenever possible. Since disposal forest resources are rapidly being depleted, recycling solid wastes offer a solution to both.            Consider the element phosphorus. Mined from phosphate ores, it is manufactured into fertilizers. It enters the plant tissues and we obtain it when we eat plant as vegetable. This is later excreted and joins the sewage system. The sewage system sludge can be used directly as fertilizer or soil conditioner.            Used bottles can be used over and over again. Durable plastic containers can be saved for more household uses. Tires can be recapped and used again. Old clothing materials are used as kitchen towels and bags (see Environment Matters: Industrys Guide to the Issues, the Challenges and the Solutions, 1999).            If the materials cannot be used over several times, then they can be shredded and converted into a new form. Old newspapers are repulped into new paper. Broken glasses are ground and manufactured into new ones. Tires are processed to raw rubber. Protein leftovers are manufactured into animal feeds.            b.) Conserving our Forests            Every now and then we receive alarming news about our forests being denuded. Big logging concessionaires indiscriminately cut down trees without undertaking reforestation measures. Without trees, the soil is loosened and rapid erosion occurs. As a result fertile topsoil is washed away, which makes growth of other forms of vegetation almost impossible. We suffer great loss of timber, wildlife, and other forest products. But the greatest danger is the occurrence of floods and global warming that cause losses of food, properties, and lives (Davidson, 1999). III. Conclusion            In conclusion,            of all issues affecting humanity, climate change is the most pervasive and truly global, posing a very real and serious threat to our environment. Climate change is the alteration of the pattern of global climate that may be due to human activity that alters the composition of the atmosphere.            I can personally say that as a young individual, I should do something about it before it is too late and must not only depend on our government. Global warming may affect my health, if not resolved, and may take my life at risk if nature starts to avenge of what people doing. I need to recycle and reuse my solid wastes and encourage everyone to conserve our forests by not cutting down trees without undertaking reforestation measures. In addition, burning of fuel must be avoided because it can contribute to the possibility of having a global warming.
Sunday, October 13, 2019
Client Based Care Case Study: Elderly with Diabetes
Client Based Care Case Study: Elderly with Diabetes 215479 Client Based Care Study Introduction In this essay, the author will explore the care of a single patient, encountered in clinical practice, examining the impact on quality of care, and on the health and wellbeing of the individual, of key aspects of care. Case studies allow nurses to reflect on practice, examine critical elements of case and of clinical decisions made and actions taken, and to examine areas of care in more detail. This essay will explore the care of one patient, who shall be called Molly, an older, community dwelling adult with Type 2 diabetes, who was admitted to a medical admissions ward having been found unconscious at her home by neighbours. The essay will examine the aspects of her care that relate to the management of her condition, the assessment and management of her social, care and personal needs, and the planning of her future care and support needs. Reference will be made to governmental guidelines and policies, and to interprofessional working as a fundamental component of meeting patient needs in this case. Discussion Diabetes is a chronic disease which is known to impact significantly on the health, wellbeing and prosperity of individuals, of families, and of society as a whole[1]. More than 1.4 million in the UK are affected by diabetes[2]. Because of the great impact that this disease has on public health and on the use of NHS and social care resources and services, the Department of Health has published a National Service Framework for diabetes, which not only sets standards for management and diagnosis of the disease, but outlines best practice in the light of the latest available evidence on the condition[3]. There are two types of diabetes, Type 1 and Type 2, both of which are signified by a persistent high level of circulating blood glucose, due to a lack of insulin or a significantly impaired response to insulin, or to a combination of both factors[4]. Type 1 diabetes is due to the insulin-producing cells in the pancreas, called the Beta Cells, located in the Islets of Langerhans, failing to produce insulin, because the body’s own immune system has destroyed them[5]. Type 2 diabetes is usually caused by a reduced amount of insulin production by these cells, and by a degree of insulin resistance within the body, wherein the body’s metabolic responses to insulin are not as sensitive[6]. Type 2 Diabetes is the condition which Molly, the patient in this case study, has been affected by. Molly is a 66 year old woman who has had Type 2 diabetes for 17 years. She is treated by twice daily insulin, and, living independently still in her own home, she is visited once weekly by a district nurse to monitor her glycaemic control and check her insulin stocks and her general wellbeing. Molly has a BMI of 35, and also has a history of hypertension which is controlled by medication. She has her blood pressure checked weekly as well. Molly lives alone, never having married, and has no children. She has an active social life, attending a local book group, taking part in a local history and re-enactment society, and volunteering at a community library. She is known by the district nurses to be competent in administering her own insulin and measuring her own blood sugar, but she does not always adhere to her regimen and her recommended diet, because it can interfere with her social life. Molly was found unconscious by one of her neighbours at 9 pm, and the ambulance was called. Paramedics attending were told of her history by her neighbour, who waited with her, and suspected either Diabetic Ketoacidosis or hypoglycaemia. Diabetic ketoacidosis is a condition which can be life-threatening, and is usually due to a lack of insulin, which means that the cells of the body are unable to use glucose for energy, and so instead convert fat reserves to energy, which can produce ketone bodies which can adversely affect brain function[7],[8]. Hypoglycaemia can be caused by an overdose of insulin, or inadequate carbohydrate intake in a person who is taking insulin, or by the patient taking too much exercise, thus using up glucose, or by a combination of these Paramedics found her blood sugar to be 1.1 mmols, and administered glucagon to reverse the hypoglycaemia. She recovered consciousness quickly once her blood sugar improved, but was also given facial oxygen, and had full observations taken. Molly remained confused after insulin administration. She was taken to the medical admissions unit for a full assessment and, if necessary, in-patient admission and review of her diabetes. According to emergency care principles for the diabetic patient, the priorities are to save the patient’s life, alleviate their symptoms, prevent long-term complications of the disease and their current risk factors, and then to implement care that will help to reduce risk factors for their health, such as hypertension obesity, smoking, and hyperlipidemia, along with providing ongoing education and support for self-management of their condition[9]. In Molly’s case, the team evaluated her condition, because although the initial diagnosis was hypoglycaemia, suggested by her self-reported history of missing meals that day and being very busy, the differential diagnosis was diabetic ketoacidosis, which can be precipitated by physical or biological stress, including changes in endocrine function or other diseases, such as myocardial infarction[10]. Molly is pale as well, a finding suggestive of hypoglycaemia, along with her elevated blood pressure and dilated pupils[11]. As Molly was conscious, her Glasgow Coma Score was 13, and she had responded well to glucagon, according to established diabetic protocols, she needed to be stabilised and undergo a range of investigations to determine any other disease or factors precipitating her condition[12]. Blood pressure, temperature, pulse and respiration rate were monitored recorded via continuous telemetry, and an ECG was carried out, which ruled out myocardial infarction. Molly had blood sent for Full Blood Count, Liver Function Tests, Urea and Electrolytes and Glucose, as well as insulin levels, prothrombin time, clotting factors[13]. Prothrombin Time and Clotting Factors may also be tested, due to the risk of disseminated intravascular coagulation. Bloods were also sent to test HbA1c; Fructosamine; Urinary albumin excretion; Creatinine / urea; Proteinurea; and Plasma lipid profile[14]. Urine was dipped with reagent strips to test for glucose, protein (suggestive of kidney problems) and ketones. Because of her presentation, Molly was put on a continuous IV infusion of insulin, titrated hourly using a syringe driver against blood glucose, with an infusion of 5% glucose running in a different IV port. IV fluid therapy, and fluid balance, were also monitored closely[15]. Diabetes can cause kidney damage and impaired urinary function, so monitoring kidney function was an important part of care[16]. Once Molly was stabilised, ongoing care related to supporting her health and wellbeing, and minimising complications of her diabetes, became an important part of care. Diabetes is a significant public health issue, because it is not only associated with the ‘social’ disease of obesity, but also because as a disorder it is associated with a number of serious health implications[17]. These complications include macrovascular complications, including atherosclerosis and cardiovascular disease[18], [19], [20]; diabetic retinopathy and sight loss due to vascular damage which weakens the walls of the blood vessels in the eyes, causing microaneurysms and leakage of protein into the retina, vascular damage and scar tissue [21], peripheral neuropathy, peripheral vascular disease and gastrointestinal dysfunction, gomerular damage, and kidney failure[22]. The impact of this disease on public health relates to the fact that many people of working age are diabetic, and because the co ndition is chronic as well as serious, with acute exacerbations and so many complications, it presents a serious drain on health and social care resources. Therefore, it is imperative that individuals with diabetes are identified as early as possible, and are educated and supported in good self-management, and provided with ongoing care to maintain good glycaemic control[23]. Molly’s status as an older adult is also a public health issue, because older adults constitute the largest patient group in the UK, and the ones which consume the biggest proportion of healthcare services[24]. However, it was also important to avoid stereotyping Molly as an older person, and making assumptions about her needs and her health. Although she was obese and hypertensive, and had Type 2 diabetes, she was very active and had a very important social life, and was usually independent and self-caring. It was important to consider the social support that she had, and to ensure that she was aware of any services or support she might be able to access if she felt it necessary. However, some members of the multidisciplinary team, in particular, some of the medical staff, did appear to act in a way that suggested they were stereotyping Molly based on these factors (age, weight, health) and were discussing her case without really making clear reference to her as a whole perso n. This leads on to the need to evaluate the multidisciplinary input in Molly’s case, and the quality of the interprofessional working that took place, which is discussed below. As can be seen from the list above, diabetes can affect the individual and the body in complex ways, and so requires an holistic approach to care[25]. Care should also be based on evidence based, collaboratively agreed care pathways[26], as suggested by the NSF for diabetes[27]. Molly may need a comprehensive review of her management and her lifestyle, the patterns of care and the ongoing monitoring of her condition[28]. The National Institute for Clinical Excellence recommends a patient-centred approach to ongoing patient education and management, and also suggests a number of options for patients who might require different forms of insulin administration, such as continuous sub-cutaneous insulin[29], [30]. This, however, was not suitable for Molly, because it is usually for people with Type 1 diabetes. Health promotion and education is an important part of Molly’s care at this point, which is related to the fact that her current hospital admission is due to mismanagement of her condition herself. It was important to determine what factors about her lifestyle and behaviours had led to the lapse and the serious hypoglycaemia. Ongoing care, health promotion and education involved multi-professional collaboration and integration of care into a complex, detailed care plan. The aim was to provide Molly with the information, support and guidance that would allow her to view her diabetes management as a means of achieving a better quality of life, rather than viewing her diabetes as something which interfered with her quality of life. It was also important to view Molly in terms of supporting her to continue with her normal social activities. Research shows that making changes in lifestyle, and providing good, effective health education, helps to contribute to reducing rates of diab etic complications[31]. However, the kind of health education and support used is important, because different approaches have different levels of effectiveness. Some research examines the differences between health education that tries to persuade patients to be compliant with regimes and activities designed by health professionals, approaches which are usually generic, and health education that is client-centred[32]. Client centred approaches are usually more effective, as they are individualised. Research shows very clearly that patients with diabetes need to understand their disease fully, and be supported and empowered to make the lifestyle and behavioural changes that will enhance their wellbeing whilst enabling them to control their condition[33]. In this case, a diabetic nurse specialist was involved with Molly’s case, and a plan for health education and support drawn up, with clear guidelines and a tailored plan for managing her social life around her diabetes. Diabetes UK recommends a struc tured, tailored education programme for people with the condition[34]. Interprofessional and multidisciplinary working is a fundamental component of care for a patient with diabetes like Molly[35]. This means that diabetic patients should experience seamless care, addressing all needs, with access to all the professionals necessary to support her care[36]. Specialist involvement, including diabetic nurse specialists, was a feature of this care, and helped with a client centred focus[37]. The literature suggests that it is important for a lead professional to take charge[38], but in Molly’s case, her lead nurse was not present for the majority of her inpatient stay, and there was a lack of effective coordination of the complex number of professionals involved. In relation to multidisciplinary, interprofessional working Molly was referred to ophthalmic services for a check-up, to ensure that there was no diabetic retinopathy or glaucoma. She was referred to a dietician to support her in managing her dietary intake. She was also referred to a social worker. Diabetic specialist doctors were involved, and a report was sent to the diabetic nurse at her local surgery, as well as to her GP. Molly ended up staying in hospital, however, on a medical ward, for two weeks, even though her condition was stabilised rapidly, and she experienced no further complications. In this case, interprofessional working was not effective, because although the said referrals were made, or were recorded to have been made, Molly was not seen by the dietician or a social worker for over a week, and only when she began to threaten to take a discharge against medical advice did the dietician and social worker arrive and get involved. The doctors in charge of Mollyâ€℠¢s case however appeared to make judgements about plans for discharge and ongoing care without involving the nursing team and without considering some aspects of her social situation and Molly’s own preferences and wishes. It is apparent, from this case, that while Molly’s immediate medical needs were met, the interprofessional working element of her ongoing care failed in some way. There are a complex range of professionals and support workers who provide healthcare[39]. Because of this complexity, interprofessional education has become part of healthcare education programmes[40]. Interprofessional working is supposed to help with the provision of true patient-centred care, and the highest quality of care[41]. However, experience in this case, and some of the literature, cites ongoing problems with interprofessional working in a number of contexts. Some of this is to do with the professional boundaries and hegemonies which persist in healthcare professions, which continue to be defended rigorously by each profession[42]. Some literature shows that elitism, professional isolationism and professional defensiveness can have negative effects on health professionals themselves as well as on the qual ity of care delivery[43]. Yet there is ample government guidance, particularly from the Department of Health, which aims to improve service provision, and the NSF for Older People[44], identifies the most important elements of care and service provision which must be improved upon. Standard 2 of the NSF, ‘Person-Centred Care’, requires that health and care services are designed around the needs of the older patient (and their carers)[45]. However, this kind of needs-based care then demands . â€Å"an integrated approach to service provision†¦ regardless of professional or organisational boundaries, [which is] delivered by clinical governance, underpinned by professional self regulation and lifelong learning†.†[46] In Molly’s case, the fundamental role of the nurse in providing leadership and coordination for her care was not acknowledged or supported. Some researchers suggest that this can be due to medical hegemony[47]. Current approaches to offsetting such ingrained hierarchical thinking are very much focused on initial education of healthcare professionals, overcoming historical professional boundaries[48], [49], [50]. The research shows that there is a difference between multiprofessional working, which does not transcend the traditional hierarchies and boundaries , and inter-professional working, which is built on the desire to share care, support each other, and value each others’ expertise[51]. Government drivers continue to underpin strategies for better, ‘joined up working.’[52],[53]. The failures which occurred in Molly’s care were clearly linked to poor communication between the healthcare professionals, a lack of joined up working, and a lack of recognition, perhaps, of the importance of the social aspects of Molly’s case, and the health-education aspects, based on her individual needs. On reflection, the author believes that had there been better, collaborative working, then none of these needs would have been overlooked and they would have been dealt with more speedily. But another aspect of her care that could be improved upon was related to her own involvement in her case. Molly was not fully involved in her case discussions and in the medical decisions made about her care. While this can be a product of the medical hegemony mentioned before[54], it constitutes a serious oversight and is not in line with governmental guidance[55]. Research shows that the patient voice is the most important one in terms of collaborative care planning and manage ment[56]. Conclusion This case study has identified the case of Molly (a pseudonym), an older patient with Type 2 diabetes who received good quality clinical care in meeting her acute care needs and managing her medical condition and its potential consequences, but for whom interprofessional working failed in relation to ongoing care and multi-discinplinary involvement. Diabetes is a significant public health issue, and a range of governmental guidance and research evidence informs care for patients with the condition. The public health issues surround the serious morbidity and mortality associated with diabetes, and the fact that good management and glycaemic control can minimise these complications. In this case, the patient’s needs were prioritised medically, but interprofessional communication broke down. While the appropriate referrals were made, proper joined up working did not take place. Similarly, Molly was not fully involved in her case, and should have been. 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Nursing Standard 17 (6) 33-35. Kesby, S.G. (2002) Nursing care and collaborative practice Journal of Clinical Nursing 11 357-366. Krentz, A. (Ed). (2004) Emergencies in Diabetes : Diagnosis, Management and Prevention. USA: John Wiley Sons. Masterson, A. (2002) Cross-boundary working: a macro-political analysis of the impact on professional roles. Journal of Clinical Nursing 11 331-339. NICE (2003) Guidance on the use of patient-education models for diabetes www.nice.org.uk accessed 6-1-09. OBrien, S.V. Hardy, K.J. (2003) Developing and implementing diabetes care pathways. Journal of Diabetes Nursing. 7 (2) 53-6 OBrien, S., Michaels, S., Marsh, J. Hardy, K.(2004) The impact of an inpatient diabetes care pathway. Journal of Diabetes Nursing. 8(7) 253-6. O’Neill, A.E. Miranda, D. (2006) The right tools can help critical care nurses save more lives. Critical Care Nursing Quarterly 29 (4) 275-281. Pollard, K.C., Miers, M.E. Gilchrist, M. (2004) Collaborative learning for collaborative working? Initial findings from a longitudinal study of health and social care students. Health and Social Care in the Community 12 (4) 346-358. Pollom, R.K. Pollom, R.D. (2004) Utilization of a multidisciplinary team for inpatient diabetes care. Critical Care Nursing Quarterly 27 (2) 185-188. Price, B. (2006) Exploring person-centred care. Nursing Standard 20 (50) 49-56. Reinauer, H. (2002) Laboratory Diagnosis and Monitoring of Diabetes Mellitus. Geneva: World Health Organization. Robinson, F. (2006) Community programmes promote healthier living. Practice Nurse. 10 32 (8) 11, 13. Scott, A (2006) Leadership in diabetes nursing: Where is it? Journal of Diabetes Nursing 10(9) 324 Skinner, T.C., Cradocl, S., Arundel, F. Graham, W. (2003) Four theories and a philosophy: self-management education for individuals newly diagnosed with Type 2 diabetes. Diabetes Spectrum 16 (2) 75-80. Snow, T. (2006) A breath of fresh care in diabetes Nursing Standard 20 (37) 14-15. Soedmah-Muthu, S.S., Fuller, J.H., Mulner, H.E. et al (2006) High risk of cardiovascular disease in patients with type 1 Diabetes in the UK. Diabetes Care 20 (4) 798-804. Stanley, D., Reed, J. Brown, S. (1999) Older people, care management and interprofessional practice. Journal of Interprofessional Care 13 (3) 229-237. Suman, S. Lockington, T. (2003) Generic care pathways for acute geriatric care and rehabilitation as a tool for care management, discharge planning and continuous clinical audit. Journal of Integrated Care Pathways 7 (2) 75-79. Turina, M., Christ-Crain, M. Polk, H.C. (2006) Diabetes and Hyperglycaemia: strict glycaemic control. Critical Care Medicine 34 (9) 291-300. Watkins, P.J. (2003) ABC of Diabetes (Fifth edition). London: BMJ Publishing Group. 1 Footnotes [1] Department of Health (2002) [2] Hilton, L. Digner, M. (2006) p 89. [3] Department of Health (2002). [4] Department of Health (2002). [5] Watkins, P.J. (2003). [6] Watkins (ibid) [7] DoH (ibid) [8] Hankin, L.(2005) p 67. [9] Watkins (ibid). [10] Turina, M., Christ-Crain, M. Polk, H.C. (2006) p 291. [11] Guthrie, R.A. Guthrie, D.W. (2004) p 113. [12] Edge, J.A., Swift, P.G.F., Anderson, W. Turner, B. (2005) p 10005. [13] Hankin (ibid) [14] Reinauer, H. (2002) [15] Guthrie (ibid) [16] Guthrie (ibid) [17] DoH (2002); Department of Health, (2001). [18] Guthrie (ibid) [19] Bloomgarden, Z.T. (2006) [20] Soedmah-Muthu, S.S., Fuller, J.H., Mulner, H.E. et al (2006) [21] Guthrie (ibid) [22] DoH (2002). [23] DoH (2002) [24] Department of Health, (2001) [25] Collis, S. (2005) [26] Pollom, R.K. Pollom, R.D. (2004) [27] OBrien, S.V. Hardy, K.J. (2003) [28] Snow, T. (2006) [29] NICE (2003) [30] Diabetes UK (2006) [31] Anthony, S., Odgers, T. Kelly, W. (2004) [32] Skinner, T.C., Cradocl, S., Arundel, F. Graham, W. (2003) [33] Antony (ibid) [34] Diabetes UK (2006) [35] DoH (2002) [36] Keene, J., Swift, L., Bailey, S. Janacek, G. (2001) [37] Keen, H. (2005) [38] Scott, A (2006) [39] Masterson, A. (2002) [40] Pollard, K.C., Miers, M.E. Gilchrist, M. (2004) [41] Kenny, G. (2002) [42] Colyer, H.M. (2004) [43] Price (ibid)
Saturday, October 12, 2019
The Class-Size Amendment Must be Repealed in Florida! :: Argumentative Persuasive Argument Essays
The Class-Size Amendment Must be Repealed in Florida! The latest amendment to the Florida constitution reduces the average class size in schools around the state. Although many people believe that smaller class size will help students learn by giving them more time individually with their teacher, studies prove that class size has little or no effect on student achievement. The class-size amendment is a waste of non-existent money, and in the long run, it will only hurt Florida’s economy and the education program. On November 5, 2002, voters approved the reduction of class sizes around the state, much to the dismay of the governor and well-informed citizens everywhere. Governor Bush previously had warned that the revision to the constitution would cost $27.5 billion over eight years and would force the state to raise taxes and cut services. Unfortunately, naà ¯ve supporters of class size reduction chose to go ahead with the modification of the constitution for emotional reasons, having no actual evidence demonstrating benefit from smaller classes. Much evidence exists, however, to demonstrate why this amendment should not have been passed. In 1986, the Tennessee legislature commissioned the Tennessee Class Size Experiment to determine if class size made a difference in achievement for disadvantaged students. After studying 79 different schools in 42 school districts for 4 years, the researchers found that class size only had an effect on students in kindergarten through 3rd grade, and that effect was minute. The impact was only on reading, not math, and smaller classes did not help disadvantaged students. A 2002 study of New York City schools showed that smaller schools, not smaller classes, had an effect on student success. From these and other studies, Florida should have learned that paying $27.5 billion to count the number of children in a class is a waste of money. Instead,
Friday, October 11, 2019
Ethics in Modern Marketing
Ethics in Modern Marketing Abstract: The success of every marketing company depends upon their involvement towards their customers. The modern marketing concept mainly stresses the importance of developing a good relationship by every marketing company with its customers to enhance their business and to withstand in the competition. During the last two decades, marketing professionals were increasing their awareness of customer/ client relationships; society has become much more aware of ethical issues.As competition increases, the marketers are involved in some unethical activities to compete and attract the customers. But the customers are more aware and they have more options for every product. They are giving high importance for quality rather than cost. Unethical practices will create a bad opinion over the product and the marketer and in turn it will result in vanishing of that business. Keywords: Modern marketing, customers, ethical issues, competition, customer relationship. Introduction:Marketing can be defined as an activity or process that involves â€Å"creating, communicating and providing value delivery to the clients and the relationship with them in advantage of the organization and its shareholders†. From this definition apparent role in society of those involved in marketing activities are: to be responsible for carrying out actions to persuade consumers in different markets segments, that, for a price, to benefit from products and services that meet their needs and fulfill their expectations and desires.Considering that the marketing aims at determining and influencing the purchasing behavior and that competition in modern economy is more intense and unscrupulous, an important issue that arises is that workers in marketing, as well as professional category may be tempted to behave unethical to achieve their objectives. Marketers today face big challenges as they try to make their marketing messages heard. Practitioner estimates suggest that consumers are exposed daily to thousands of marketing communications.This proliferation of marketing communications not only has created unprecedented levels of perceived disorder; it also has led to heightened contempt for corporations by many consumers who actively seek to avoid marketing communications from any source. Modern marketing concept: An academic called Grnroos defined marketing as â€Å"to establish, maintain and enhance relationships with customers and other partners, at a profit, so that the objectives of parties involved are met. This is achieved by mutual exchange and fulfillment of promises. †By engaging with their customers marketing professionals are able to secure report business.Loyalty schemes are a device for building that loyalty within the retail and customer service sectors. Marketing professionals talk in terms of fulfillment, meaning fulfillment of their relationship with the customer. During the last two decades, while marketing professio nals were increasing their awareness of customer/ client relationships, society has become much more aware of ethical issues. Ethical issues are concerned with making appropriate responses to social situations. Failure to make the correct social response can expose a business to reputational issues, the unwelcome attention of political activists and legal sanctions.A modern business that is interested in developing long term relationships with their customers and other stakeholders has to take an interest in ethics. Ethical problems raised in modern marketing Not a few times, marketers are usually blamed for launching and promoting on the market, the low quality products to compete in certain segments of the market price. Also the complaints relate to a significant increase in the price (to preserve brand image, or to save profits encumbered by high costs of advertising campaigns). thus depriving clients with smaller financial possibilities of access to some products and services. A lso, marketing responsibility for handling consumer raises an important ethical problem, namely, if marketing and those working in the field can create needs and cause consumers to buy things that are really has no need. Another responsibility of marketing in direction of ethics is influencing the value system and the promotion of non-values. Products advertised are not always perfect, and the ads are not designed with original concept and do not reveal the reality of the product.Ethical issues in marketing are an important consideration for a modern business. First consider marketing, our understanding of what is required of a marketing professional has changed over the last decade. It used to be adequate to discuss product, promotion and price. A modern marketing professional is also expected to develop his/her relationship with the customer or client. TOP 5 ETHICS ISSUES IN MARKETING Every business relies on marketing to attract customers and to sell products or services. The pro blem is that marketing can sometimes promote products or services in unethical ways.What can businesses do to follow ethical standards in their marketing strategies? What are the top 5 ethical issues in marketing? 1. HONESTY The news of corporate scandals seems to be a daily occurrence. Consumers have lost trust in the integrity in many corporations because of the unethical and sometimes illegal behavior that seems to be embraced in the organizational culture of the corporation. Companies need to realize that company reputation is part of the honesty factor. People seek alternatives when they know a business engages in unethical practices.The claims of â€Å"sweat shop†assembly lines has forced more than one company to change its supply chain policies simply because of the damage to brand that resulted from unethical behavior. Another important facet of honesty is an accurate representation of the product. People want to know they are receiving the quality of product that wa s presented to them through marketing. Promises made should be promises honored. A return policy is a necessary component in fostering honesty in marketing. 2. FAIRNESS Fairness is the need to balance the interests of the company with the needs of the customers.That is, companies want to sell more products in order to increase profits. Fairness is conveyed in recognizing that customers want to feel they are engaging in a transaction that will result in them receiving something of value. Value is associated with the product and with the quality of customer service. Fairness is the company treating the customer in a business to consumer transaction the same way it would want to be treated in a business to business transaction. The long term benefit of fairness is customer loyalty. 3. RESPECT Customers want to know they are respected by the company.Respect means the company sees the value of stakeholders. Groups are not subjected to stereotypes and tolerance is demonstrated for the int erests and values of others. Respect means that feedback from stakeholders is welcomed and heard. The long term benefit of respect is the company positive association with company that should foster company and brand loyalty. 4. SOCIAL RESPONSIBILTIY Social responsibility is the recognition that a company must do no harm to individuals and the community. Companies incur a trust that they will operate in such a manner as to protect the welfare of the customer.Dangerous products or lapses in safety can quickly erode confidence and trust in a company. Companies have a responsibility to â€Å"give back†to the community. Part of this marketing strategy is to convey the idea that the company is a neighbor. The company cares about the quality of life of its â€Å"neighbors†in the community at large. One way to do this is by responding to the interests of non-customer stakeholders such as through supporting local education, sponsoring environmental awareness projects, and as sisting in community enrichment efforts. . TRANSPARENCY Transparency means the marketing strategy conveys honesty about the operations of the business. A company is practicing transparency when it admits to and corrects operational problems or areas of stakeholder concern. Transparency in marketing means the company is honest about a product’s limitations. The recall policy of the automobile industry is a great example of transparency. Car companies issue recall notices to acknowledge design or mechanical flaws in automobiles.Granted, failure to do so would bring down the wrath of the federal government as this would constitute a violation of national safety standards. When voluntary, the practice of recognizes weaknesses and then seeking to correct the problem conveys the company recognizes its commitment to the customer. The long term benefit is trust. CONCLUSION Marketing includes the promotion of a company rather than the promotion of a product or service. The above point ed five issues work together to create the marketing image of the company. Unethical behavior will destroy the reputation, the name and fame and ethical image of a company.
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