Implementation of Patient Centered Concepts to Improve Quality Essay

Implementation of Patient Centered Concepts to Improve Quality Outcomes and Control Cost - Essay Example The model aims at soliciting the input of patients on the support and education they need to make decisions and participate in their individual care. It is therefore an innovative approach used to healthcare planning, delivery and evaluation. The concept can be implemented in any healthcare setting. However, its implementation in the current healthcare system has a lot of potential impacts and many healthcare providers struggle with how to actualize the concept into the daily business of caring for patients and their families. Potential impact of Patient-Centered Concept on the current health system’s finances According to Lorig (2002), the concept of patient-Centered care can impact positively on the business metrics of the current health system like finances, safety, satisfaction, quality and market share. Overall, the model reduces the costs of providing patient care and it is associated with increased efficiency of care. This is mainly seen in terms of reduced number of re ferrals and reduced diagnostic tests. Increased patient participation during visits by healthcare providers reduces their anxiety and perceived need for investigations/diagnostic tests and referrals. However, there could also be a need to increase the financial resources in some hospitals and increased their levels of staffing to match with the level of staffing required to provide continuity of care. Despite these costs of education, support and other interventions, there is usually a general resource utilization leading to a positive financial result. Generally, the model is associated with improved patient satisfaction and improved health status and this has the potential of increasing the demand for services offered by the heath system (Stewart et al, 2000). This can be equated with high sales because of increased market share and the end result of this is increased profits. The model is not about technological innovations or renovations and the acquisition of new equipment. Ins tead, it is mainly about kindness, compassion, empathy and attitude all of which are completely free and their provision require the hiring of new staff. It entails a maximization of the interactions with patients at the current staffing levels present in the current health system. The exact areas of the budget that may be impacted There are two main areas of the health system budget that are impacted by patient-centered care are expenses for referrals and diagnostic tests. As noted above, increased patient participation during visits by healthcare providers reduces their anxiety and perceived need for investigations/diagnostic tests and referrals. Reduced referrals and diagnostic tests mean reduced costs per unit for the health system. For example, it is cheaper both for the family and the health system to attend to a patient at home than maintaining the same patient in hospital. Cost/benefit analysis that would be helpful in assessing this trend One of the ways to achieve a cost/b enefit analysis for assessing this trend is assessing the overall costs of managing long-term illnesses verses patient outcomes. For example, if the costs of managing such long-term diseases have reduced while at the same time, the survival rates have been increased and mortality rates reduced, then is the model is good. Impact on the structure of health systems and organizational dynamics Effective patient-centered care requires a shift of the current healt

Fashion Buying and Merchandising Essay Example | Topics and Well Written Essays - 2000 words

Fashion Buying and Merchandising - Essay Example The paper "Fashion Buying and Merchandising" discovers the Merchandising and the process of the Fashion Buying. In the fashion industry the fashion retail buyers play an important role. There are many important factors like supplier’s selection and product decision. The most important fact to be noticed is the shift of the retailers from the purely operational background to more strategic background. According to Douglas (2009) the merchandising is the fundamental factor for all of those commercial activities which have distribution attached with it. The fashion wears for the kids have become a new trend in the market. According to the Key Note Childrenswear market report (2009) the UK children’s wear market was valued at 5.29 billion pound in 2008. The primary responsibilities of the buying and merchandising team are identifying the vendor, evaluating the best vendor, negotiation, and placing the order. In the retail industry the fashion and merchandising go parallel. According to Packard et al (1983) the primary role of the buyer’s team is the proper selection of the merchandise to ensure the availability of the new stocks in the store. According to Jackson T, and Shaw D. (2006) the merchandising and the buying team should identify the main responsibilities to add some values to the shop and the main responsibilities are one: pre-selecting and editing product range, two: negotiating value for money price, three: breaking down bulk orders, four: holding stock, five: providing product support.

How Was Vietnam Sexual Bias Essay Example for Free

How Was Vietnam Sexual Bias Essay People have long suffered because of their sexual orientation, but the increasing frequency and severity of this problem only recently gained the attention of the United Nations. Human rights violations based on sexual orientation and gender identity encompasses violence, cruelty, discrimination, and other acts of hatred based on real or perceived sexual orientation or gender identity. Sexual orientation is defined as ―each person‘s capacity for profound emotional, affectional and sexual attraction to, and intimate and sexual relations with, individuals of a different gender or of the same gender or of more than one gender. Gender identity refers to ―deeply felt internal and individual experience of gender, which may or may not correspond to the sex assigned at birth, including the personal sense of the body (which may involve, if freely chosen, modification of bodily appearance or function by medical, surgical or other means) and other expressions of gender, including dress, speech and mannerisms. Violations of sexual minorities are manifested in two ways: 1) physical harm resulting from murder, kidnapping, sexual assault or other forms of violence and 2) unfair treatment, deprivation of liberty, and discrimination exercised on personal and institutional levels. The aspect of physical harm is more frequently noted by the media, but many cases go unreported and without the attention that is needed to curb their prevalence. Special rapporteurs from the UN found previously unnoted examples that show the gravity of these issues. A period of violence specifically targeting members of lesbian, gay, bi-sexual, and transgender (LGBT) groups in Honduras resulted in the brutal killings of 21 people in 2010. One of these victims was ―found dead in a ditch, her body beaten and burned, showing evidence of rape and blows to her face from stoning so severe as to render the remains virtually unrecognizable. In other parts of the world, transsexual women have been beaten in the breasts and cheekbones to intentionally burst implants and release painful toxins in their bodies. Four people were seriously attacked in Uganda and many were forced to hide when a local paper published the photos of 100 people it said were homosexuals and encouraged people to ―hang them. There‘s a cultural contribution to the prevalence of this violence, too. More than 5,000 honor killings take place each year to punish people who do not remain true to cultural expectations. An increasing number of these victims are killed because of their sexual orientation or gender identity. This is seen in the 2009 Iraq killing campaign that tortured and murdered hundreds of LGBT members on the basis of protecting society from the ―third sex. Killings also take place by victims‘ relatives to preserve their family‘s honor. Cultural myths such as homosexuality being a disease or that lesbian women‘s sexual orientation will change if they are raped by a man are also dangerous elements of this problem. Though physical violence based on sexual orientation and gender equality is a pressing issue, attention must also be given to the second aspect of this topic. Discrimination and unfair treatment based on sexual orientation date back to the religious laws of the Bible and other holy books. Napoleon temporarily established laws decriminalizing homosexuality as part of his penal code in 1791, but long-term protection did not take place until Denmark repealed its similar laws in 1933. Almost all other countries have followed Denmark‘s example since then except for those in the Middle East (save for Israel), North Africa, and the former British colonies in Africa, the Caribbean, and South Asia. These latter countries are the most common (but not exclusive) context in which LGBT members are deprived of their liberty in areas of ―judicial prosecution and trial, administrative detention, deprivation of liberty on medical grounds and arrest for the purposes of harassment, among o thers. Even countries that have repealed these laws can foster unfair treatment stemming from sexual orientation because of their inability to better protect victims. Cases of discrimination based on sexual orientation are vastly underreported, but several examples exist that illustrate its solemn presence in the life of people of all ages. According to a 2007 study, up to 40 percent of homeless youth were turned away from their homes and charitable shelters because of their sexual orientation or gender identity. LGBT students are often the targets of violence, harassment, and other forms of bullying while in high school and college. In addition to the physical harm that results, many victims struggle with emotional consequences such as depression and low self-esteem. A 2010 report on prison conditions in Greece revealed that ―detainees in a lesbian, gay and transgender section of a prison were reportedly denied access to an outside yard for two years, confined to their cells and a corridor at all times. Striving to address these forms of discrimination and unfair treatment, the Human Rights Committee (HRC) affirmed that its regard to ―equal and effective protection against discrimination on any ground such as race, color, sex, language, religion, political or other opinion, national or social origin, property, birth or other statusâ€â€" in Article 26 of the ICCPR extends to discrimination on grounds of sexual orientation. Even so, the lack of response from Honduras, Greece, and other countries in which similar atrocities occur demonstrates that nations have not fully adopted the HRC‘s concern on the issue. Without the creation and observation of standard operating procedures that guide law enforcement to handling these issue seriously and responding properly to violations that occur, these countries are unable to progress toward a greater solution. There have been several emergences of human rights violations based on sexual orientation and gender identity in recent world events. In March 2012, a gay man died after being attacked by a group of neo-Nazis at a park in Chile. The perpetrators tortured the man for an hour by carving swastikas in his body and otherwise mutilating him. His death brought renewed efforts by the UN and human rights organizations to call attention to the mistreatment of sexual minorities and the need for harsher penalties for hate crimes. Another example was seen that same month in a different arena when Muslim delegates protested legitimizing homosexuality by walking out of the first UN Human Rights Council debate on gay rights. Without these nations‘ support, the problems will persist and further metastasize. Past UN Action: The UN has made efforts to ensure that the issues of sexual orientation and gender identity are given equal attention to all other areas of human rights violations. In 2007, the International Commission of Jurists‘ discussion on the inclusion of sexual minorities in human rights protection resulted in the ―Yogyakarta Principles on the Application of International Human Rights Law in Relation to Sexual Orientation and Gender Identity. This document served as the foundation for later work by the OAS (AG/RES. 2435) and the UN‘s first resolution (A/HRC/17/L.9/Rev.1) concerning LGBT rights. The UN‘s resolution affirms that violations based on sexual orientation or gender identity are matters of human rights, and it calls for a report on related cases of violence and discrimination. The report (A/HRC/19/41) was published in November 2011 and accounts for unprecedented levels of violence and injustice shown toward sexual minorities. Most recently, th e UN reiterated its deep concern of violence based on sexual orientation and urged member nations to prioritize its reduction and elimination. Problems and Possible Solutions: Researchers fear that the majority of violations go unreported due to the shame of the victim or the apathy of the law and legal systems in some countries. Real action most often takes place when international attention is drawn by a death caused by hate crimes based on sexual orientation or gender identity. There may be no better solution for this problem than to increase international pressure on countries to curb the rate of crimes committed against LGBT members. If a sense of national pride for reducing the crime rate could be established – and a strong sense of shame if the rate remained the same or deteriorates – then a solution to this issue would be more effective and more sustainable. Questions to Consider as you Prepare: * Which should efforts for change focus on: law or education? Who should enact these changes and where would funding originate? * Is there one general solution to this problem or is it region-specific? If solutions are region-specific, how could resolutions be tailored to meet the problems of multiple regions? Who would determine what each regional problem requires to be eliminated? * How can the reporting of crimes based on sexual orientation be improved? How can international actors help without posing a risk to nations‘ sovereignty? * With many crimes occurring within prisons, how can LGBT members be better protected? Is there a way to do this without incurring significant expenses?

An Acute Upper Respiratory Infection Health And Social Care Essay

An Acute Upper Respiratory Infection Health And Social Care Essay Health is an asset and is more valuable than wealth. But, mans triumph in controlling a single disease is always associated with the emergence of a new disease. Acute upper respiratory infection is the major cause of morbidity and mortality in children throughout the world, particularly in developing countries. In developing countries, a children under 5 years of age dies every 7 seconds due to acute respiratory infection. In both the developed and developing countries 20-30 episodes of ARI occurs during the first 5 years of life in a child. About 4 Â ½ million children die due to ARI which accounts for about 30% of all deaths in children (Behara D, 1995). Lahiri and Nadkarni (2001) say that ARI accounts for 20 25% of deaths among under five and 15-30% of total deaths. In a sample survey, pneumonia ranked first in all ages. In India, 10 -15 children per 10,000 die whereas in united states one child per 10,000 die of acute upper respiratory infection. Thus, 25% of the deaths are preventable through proper immunization. Acute upper respiratory infection is the leading cause of child mortality (30%) followed by diarrhea (20%) in India. One in every 100 children in India between the age group of 0 14 years suffers from AURI (ALL INDIA SURVEY 2002). In a general hospital acute upper respiratory infection accounts for 20 40% of outpatient and 12 35% of Inpatient attendance. The vast majority of acute upper respiratory infections are caused by viruses. Most children have 3 to 8 episodes of common cold in a year. Rhinovirus accounts for up to 60% of infections. Cough occurs in 60 to 80% of children with cold. A streptococcal infection accounts for approximately 15% of bacterial pharyngitis. Acute upper respiratory infections (ARI) are one among the important causes of death in all age groups especially in children below 1 year of age. It has been estimated that 2.2 million deaths are due to Acute upper respiratory infections (ARI) throughout the world. ARI accounts for 13 -20% mortality during first year of life and in child hood in India (Registrar generals published figures). It is estimated 630,000 deaths occurred due to acute upper respiratory infection annually among pre-school age group. The magnitude of ARI morbidity and its impact on health services can be measured by the proportion of outpatient attendance due to ARI. As high as 20 40% of children brought to outpatient department and 12 -35% of children admitted to hospital have ARI. There is a need to undertake periodic surveys in various parts of the country to determine the incidence of ARI associated morbidity and mortality in children in order to plan organize and evaluate the health services. The government of India in its policy document of health for all by 2000 A.D recommends the ARI control program me to reduce infant and pre-school child mortality. (Tambe MP, Shivaram.C, Chandrashekhar.Y. Acute upper respiratory infection in children a survey I the rural community, 1999). The symptoms of acute upper respiratory tract infection include rhinitis, pharngitis/ tonsillitis often referred to as a common cold and their complications sinusitis, ear infection, laryngitis and sometimes bronchitis. Symptoms of upper respiratory tract infection are cough, sore throat, runny nose, nasal congestion, headache, low grade fever, facial pressure and sneezing. Onset of the symptoms usually begins 1 3 days after the exposure to a microbial pathogen. The duration of illness lasts for 7 -10 days. (WIKipedia, the free encyclopedia 2000). Acute respiratory infections (ARIs) also includes pneumonia, influenza, and respiratory syncytial virus (RSV), causes 4.25 million deaths every year. ARIs accounts for third largest causes of mortality in the world and the top killer in low and middle-income countries. Acute upper respiratory infection causes at least 6 percentages of the worlds disability and death. These deaths occur mainly in the worlds poorest countries, where the drives of acute upper respiratory infection, includes malnutrition, pollution, overcrowding, and tobacco use. The death due to pneumonia is 215 times higher in low-income countries 3 million to 5 million people suffer from flu every year The most common source of respiratory illness in children is Respiratory Syncitial Virus. Acute upper respiratory infection affects people infected with HIV. The main cause for 20 percent to 40 percent of all hospitalizations in childhood is due to Acute Respiratory Infection. Pneumonia causes 20 percent of all pediatric deaths around the world -1.6 million in 2008, and, 732,000 children die from malaria and 200,000 from HIV/ AIDS every year. Respiratory Syncitial Virus kills at least 66,000 children every year. (Acute respiratory infections Atlas 2010). Researchers from the universita delgi reported that bacteria in the mouth offer probiotic potential against upper respiratory tract infections. There is only a minimal understanding of internal communication between human hosts and their microbes is available,it is of an idea that probiotics are live microorganism which promote health within their host. The benefits of probiotics are predominantly explored so far in the intestinal tract; but,few studies suggest probiotics also promote wellness in the stomach, vaginal tract, skin and mouth. The leading cause of visits to the pediatrician is due to upper respiratory infection in children between the ages of 5 and 12. The main cause for upper respiratory infection is Streptococcus pyogenes and the only treatment available at present is antibiotics, where it prescription rates are running up to 90 percent. Bacteria from the mouths of healthy volunteers were isolated and identified two potential probiotic bacterial strains named Streptococcus salivarius RS1 an ST3. The recently developed oral probiotic prototype and these two strains bound to human pharyngeal cells and responsibe for antagonizing of S. Pyogenes adhesion and growth. Additionally, all these strains were sensitive to antibiotics which are used routinely for treating upper respiratory tract infection. Only about 1 percent of development funding was spent on research on Acute Respiratory Infection in 2007, than the amount spent on HIV related research. Some of the low-cost strategies are available which can be implemented immediately whereas,others require longer term efforts. The strategies mentioned are: Effective distribution of nutritional supplements, vaccination programs, Dissemination of knowledge by public awareness campaigns, Tobacco use to be reduced. Identifying efficient ways to produce vaccines and the distribution need to be strengthened. (Acute respiratory infections Atlas 2010). The supportive therapy of sore throat is gargling with lukewarm saline solution, steam in inhalation, not forcing the child to eat and giving frequent small amount of warm liquid. Tulsi or the loly basil is one of the most common herbs used in cough related remedies. It maintains the health of the throat chest and lungs. In fact, it helps to protect the entire respiratory tract. NEED FOR THE STUDY Literature highlights are increasing incidence of ARI as a major health problem for under five children and health experts advocate alternative therapies like lukewarm saline solution, steam inhalation to treat ARI rather than medication alone. A survey conducted in the rural community regarding respiratory tract infections says that the delay in receiving medical care is considered to learn important reason for the high mortality related to acute respiratory infections in the developing countries. Far distance of the hospital was the main reason for not receding treatment followed by ignorance, family problems etc. Those reasons may force the parents to seek treatment from other alternate resources. The rural medical practitioners are often not institutionally qualified and hence are frequently not able to select and use appropriate antibiotics in adequate dosage for proper duration for the treatment of acute respiratory infections, making the outcome unfavorable in many children. Sensitive use of antibiotics can decrease the adverse effects of it and also the costs spent towards it. Decreased antibiotic usage benefits the patient by reducing the rise of drug resistant bacteria, which is now concerned as a problem in the world nowadays. Health authorities are encouraging physicians to reduce the prescription of antibiotic to treat common Upper Respiratory Infection due to above reasons. (National Center for health statistics 2008) Upper respiratory tract infections (URIs) accounts significant health burden among children.An average child suffers from six to eight attacks of colds each year, where, each attack lasts for seven to nine days. While children are frequently given drugs such as antihistamines, cough suppressants and decongestants, to reduce symptoms, there is no such effectiveness by these medications among children younger than 12 years. The drugs which prescribed for respiratory tract infections are antibiotics, all these antibiotics are not providing much protection against respiratory infections which in turn becomes a sign of future asthma. This again becomes difficulty to attribute antibiotic use in case of asthma. (Anita Kozyrskyj, PhD, University of Manitoba, Winnipeg, MB 2010). When young children affected with both respiratory and non respiratory infections, the antibiotic is the one which is being prescribed frequently. (Mark J.Rosen, MD, FCCP, President, American college of chest Physicians 2010).These physicians came with the conclusion that better decisions for treatment option for respiratory infection can be made only if physicians understand clearly the relationship between asthma and antibiotic use. Tulsi has an important role to play in treating the symptoms of respiratory tract diseases. It acts regularly on phlegm hence it works as a good expectorant giving relief from wet cough. It helps to fight the cause of allergy by which our respiratory tract gets inflamed and then resolves the causative agent. It is anti-inflammatory. It promotes optimum respiratory support. It is an excellent remedy for sore throat and fever. The investigator during her clinical exposure in the community observed that 50% of the under five population is suffering from acute upper respiratory infections. The investigator observed that mothers with under five (child affected with AURI) seeking medical treatment only in case when AURI becomes severe. Mothers in this community ignoring treatment when their children affected with mild AURI and also they are unaware about home remedy for treating the symptoms of AURI. The investigator also identified that reason for seeking treatment only in the severe AURI by the mothers with under five is due to far distance of the health care facilities and also due to poor transportation facilities. And even if mothers seek medical treatment, antibiotics are being prescribed and it is not advisable as per study conducted by (National centre for health statistics 2008). So, the investigator found it is useful to a conduct a research in this community to find the effectiveness to Tulsi on upper respiratory tract infection among under five with upper respiratory infection, where this herb is commonly available and is of no cost. STATEMENT OF THE STUDY A study to assess the effectiveness of steam inhalation with Tulsi leaves on signs and symptoms and behavioral responses of children aged 6 months to 2 years with acute upper respiratory infection at home in a rural community, Coimbatore. AIM OF THE STUDY The aim of the study was to assess whether there was a reduction in the signs and symptoms of acute upper respiratory infection and changes in behavioral responses of the children who received steam inhalation compared to children who did not receive steam inhalation. SPECIFIC OBJECTIVES To assess and compare the degree of acute upper respiratory infection in experimental and control group after intervention. To assess and compare the behavioral responses of children with acute upper respiratory infection in experimental and control group after intervention. To find out the mothers views about steam inhalation with Tulsi leaves. To find out the association between the degree of acute upper respiratory infection demographic variables (Age, sex, immunization status, education of mother, total income of the family). HYPOTHESIS H1 There will be a significant difference in the degree of acute upper respiratory infection between the experimental and control group after intervention. H2 there will be a significant difference in the behavioral responses between experimental and control group after intervention. OPERATIONAL DEFINITION Effectiveness Producing the desired or intended result which is the reduction of symptoms of mild and moderate acute upper respiratory infection and duration of the infection. Steam inhalation with Tulsi 1 liter of water is boiled in a wide mounted receptacle and Tulsi leaves are added to it. The steam coming out of it is breathed by the child while mother is sitting in front of the steam holding the child with head covered. Signs Changes which are observed by the researcher with naked eyes. Symptoms Changes that are noticed by the mother and reported on asking Behavioral responses The reaction of the child in terms of activities such as smiling, walking, running, eating and playing. Acute upper respiratory tract infection (AURI) It is inflammation of the upper respiratory tract involving nose, pharynx and tonsils and manifesting signs and symptoms like runny nose, sneezing, tearing eyes, itching of the nose, pink and shiny nasal mucosa, red and swollen throat, cough, fever and fatigue. Based on the signs and symptoms, AURI is classified as mild moderate and severe AURI. In mild AURI. The symptoms are runny nose, sneezing, tearing eyes, itching of the nose, pink and shiny nasal mucosa, and presence of crusts on the nose and fever. In moderate ARUI, the symptoms are red swollen throat, cough along with the symptoms of mild AURI. In severe AURI, the symptoms are inflamed and enlarged tonsils, pus within the fold of the tonsils, pain during swallowing and pain in the symptoms of mild and moderate AURI. ASSUMPTIONS Acute upper respiratory infections are very common among under five children in urban and rural community. Mothers follow certain home remedies like application of Vicks and Camphor over chest, over head and nose and administration of milk with turmeric and pepper and sugar. Caring children with respiratory infection home in the community is influenced by personal and socio-cultural factors. Children with acute upper respiratory infection mostly treated at home with home remedies which varies from one community to another DELIMITATION The study is delimited to children aged 6months to 2 years The study is delimited to children suffering from mild to moderate acute upper respiratory infections. SCOPE OF THE STUDY The degree of AURI, duration of infection and behavioral response are assessed in AURI children before and after intervention. If there is a significant reduction in the degree, duration and changes in the behavioral responses of experimental group of sample, then it is the clear indication effectiveness of steam inhalation with Tulsi leaves. Teaching steam inhalation is very simple and it can be practiced very easily. If the mothers are able to administer the steam inhalation with Tulsi for their infected children without any difficulties, and if this intervention is acceptable it is clearly indicate the utility value of Tulsi leaves for acute upper respiratory tract infection children. The findings will be beneficial to health practices to motivate mothers with AURI infected children and to promote health life. Conceptual framework A conceptual model can be defined as a set of concepts and those assumptions that integrate them into a meaningful configuration (Fewett, 1980). The development of a concept model is a fundamental process required before conducting actual research. The frame work influence each state of research process. The conceptual framework in nursing research can help to provide a clear concise idea of knowledge in the area. Conceptual framework for this study nursing process model based on Dorothy E.Johnsons Behavioral system theory (1980). According to Johnson, nursing views the individual as a set of interconnected or inter-dependent parts functioning as a integrated whole. Johnson identified seven subsystems. The subsystems are affiliation, aggressive, dependency, eliminative, ingestive, restorative, and sexual. The subsystems carry out special function for the system as a whole. Disturbance in any of the subsystem usually affects the other. The steps of the nursing process in incorporated with the Dorothy Johnsons Behavioral system model. Nursing process is a deliberate activity where the proactive of nursing is performed in a systematic order. Dorothy Johnsons presents a three step nursing process, the steps are entitled nursing diagnosis which parallel the assessment and diagnosis phase, the second step nursing goal equal to the implementation and third step is evaluation. This study focused on children and the dependency system which is one among the subsystems which result in approval, attention, recognition, and physical assistance. ASSESSMENT Assessment is the process of collecting data regarding each subsystem. In this study, the assessment was done in the dependency subsystem. Data on demographic profile (age, sex, immunization status, education of the mother, income of the family) was collected. The children were examined for signs and symptoms of acute upper respiratory infection and behavior responses of the children were collected by interviewing the childrens mother. DIAGNOSIS Through assessment from the subsystem problems are identified and diagnosis is made and it provides basis for nursing intervention. In this study the data collected through observation and interview using interview schedule and observation checklist was analyzed the diagnosis is made on acute upper respiratory infection and categorized into mild, moderate and no infection. NURSING GOALS (PLANNING) After diagnosis is made the goal is to maintain or restore the persons behavioral system balance and stability through planning interventions. In this study, the goal was to reduce the degree acute upper respiratory infection and to restore the high level of activity (behavioral responses). In this study the planning occurs when the children and a nurse identify activities and bring about dependency system equilibrium. INTERVENTION Nursing activity as an external regulatory force assists the equilibrium. Based on the diagnosis, nursing actions and intervention can be planned in terms of teaching, external control or providing responses needed by the client. In this study, the nursing activity was the administration of steam inhalation therapy with Tulsi leaves the children in the experimental group for a period of time brings about change in the degree of acute upper respiratory infection. EVALUATION Evaluation refers to checking the subsystems identified as problematic for balance and overall system stability. In this study, the investigator compared the degree of acute upper respiratory infection of the experimental group children with the control group by using criteria and evaluated the effectiveness of the intervention by observing the signs and symptoms of infection and the report given by mothers of the children. Figure 1 Highlights the conceptual framework on modified nursing process based on Dorothy Johnsons Behavioral system model.

Strategic Management at Honda Essay -- Business Management Studies

Strategic Management at Honda 1. Firstly what is strategic management? It is the process of specifying an organization’s objectives, developing policies and plans to achieve these objectives, and allocating resources so as to implement the plans. Strategic management is usually performed by the highest level of managers in the company. A company’s strategy must be realistic enough for it to achieve it; hence it must make sure it has the right resources to be able to cope with the strategy. An example of an overall business strategy may be to put the organization in a position where it can carry out its mission. Now to see how the definition of strategic management conforms to what’s been written about how Honda grew and developed its markets in the US. Firstly in the BCG account of how Honda grew into the US markets it quotes â€Å"the success of the Japanese manufactures originated with the growth of their domestic market during the 1950s.† To think strategically there are three big questions that need to be answered that are, where are we now? Where do we want to go? How will we get there? I believe the first question of thinking strategically is now answered, â€Å"where are we now† Honda must of seen that they have been successful in their own domestic market and are ready to go into other markets so at this point they must have been thinking where do they want to go next hence the second strategic question. Another quote from the BCG report, â€Å"†¦.the basic philosophy of the Japanese manufactures is the high volumes per model provide the potential for high productivity as a result of using capital intensive and highly automated techniques.† This now I believe has answered the third question of thinking strategically, â€Å"how will we get there.† Honda knew from the success of their own domestic market the key to their success was gaining economies of scale as the cost of producing motorbikes declined with the level of output. So this would be their way of entering the US markets as they also knew their competitors would have a scale economy disadvantage in technology and manufacturing. If we look at the second account of how Honda grew and developed its markets in the US we can see other ways of how its conforms with strategic management. Pascal’s version is based on interviews with the Japanese executives. They say they had no ... ...aving a formalised approach to strategy and implementations there are some disadvantages. Having a formalised strategy can mean a lot of time and thought need to be put into forming a good strategy which might mean a huge drawback in cost savings whereas this time and thought could be implemented elsewhere in the business. A formalised approach to strategy development can also mean a slow response when there is a change in the market. Developing a strategy and implementing as said before takes a long time and a lot of thought which in business means money so when there is a change in the market the strategy may not be relevant to the new situation which could consequently mean further cost occurring such as forming new strategies and responding to the new market situation. A situation like this can be learnt from Honda when they thought their larger bikes would sell as Americans liked bigger things and also they thought the Buddha like handlebar would assist in sales of these larger bikes, but when this was not the case and they learnt it was the smaller bikes (50cc) the consumers wanted they had to quickly change their main strategy and follow on with a new one.

The Injustice of Female Genital Mutilation :: essays research papers fc

The horror of female genital mutilation is a global issue, and it is also one surprising foreign to Americans although an estimated ten thousand girls in the United States are currently at risk of this operation (Sarkis par. 1). This is a cultural practice that is both unethical and incredibly detrimental to its victims besides obviously being in direct violation of basic human rights. In order to attain a broader view of this issue the following will be examined: basic information about this practice, organizations fighting it, current news pertaining to it, recent academic articles evaluating it, and the question of how it can be stopped. FGM has recently been receiving growing media attention due to the controversy surrounding it, but the newfound attention is also in hopes that widespread awareness will bring about change. Female genital mutilation, or FGM when abbreviated, is also known as female circumcision, but this practice is far more drastic than male circumcision and is actually more comparable to a surgery in males where the entire penis is removed (Sarkis par. 4). FGM is classified into three different categories based on the extent of the procedure, but it usually entails the removal or the clitoris and/or the adjacent labia. The third degree of FGM is so severe that the female must be cut open to engage in sexual intercourse from that point on (Sarkis par. 5). This surgery is commonly performed in unsanitary conditions with unclean sharp tools like razor blades, kitchen knives, scissors, and pieces of glass (Sarkis par. 6). Female children usually undergo this procedure at three years of age (Sarkis par. 10). Sarkis also states, â€Å"Besides the obvious initial pains of the operations, FGM has long-term physiological, sexual, and psychological effects† (par. 7). It is done for a number of reasons ranging from the prevention of marital infidelity to using it as a cultural rite of passage, but more numerous than the reasons behind it are the countries that partake in it. FGM is most common in Middle Eastern countries and throughout Africa (Sarkis par. 2). FGM is by no means a one-dimensional problem or something that can be recovered from. It is, most significantly, a life-altering procedure. One of the major groups fighting FGM is The Female Genital Mutilation Education and Networking Project. It focuses primarily on the â€Å"knowledge is power† aspect, meaning that it concentrates more on educating the population of FGM in an effort to bring reform instead of direct actions.

Destin Brass Products Co. Case Study

Destin Brass Products Co. has been established and grown to bring forth valves ( 24 % of the company gross ) , pumps ( 55 % of the company gross ) , and flow accountants ( 21 % of the company gross ) . This paper will exemplify the recommended solutions for the direction of the company that are seeking to measure the competitory tendencies of the market for the mentioned merchandises, and seeking to get down new schemes to cover with these tendencies. Finance and accounting, as mentioned by Ambler ( 2008 ) are the necessities and footing to the short and long being of any type of companies. The high fight of market requires that all types of concerns have a comprehensive apprehension to the costs and net incomes in much item in order to ease determination doing procedure. In Destin Brass instance, the company tried to set up a high trade name name for bring forthing the valves, but subsequently as an enlargement to the concern, the company included two new merchandise lines which are the pumps and the flow accountants maintaining in head the similarities of productions and the handiness of the productions capacity. Destin Brass did non hold a distinguished rival in the valves market because of the high quality of the valves produced, but there is a monolithic competition in the pump and flow accountants market. This paper will capture a clip of the company concern where there is a high competition on the pumps ‘ monetary values and the solution of increasing the monetary values of the flow accountants did non alter the market. The direction is in demand to reconsider its fiscal scheme in order to face competition.The fiscal analysisAfter measuring the current fiscal state of affairs of Destin Brass, The analysis hereby will join forces to reply the direction inquiries, and illustrations of the below solutions had been used by concern and it proved to hold an influence of determination devising procedure sing the company scheme. The solutions are as follow s:Merchandise costs as per the ABC informationFrom the given information in the instance survey, there is a connexion between the merchandises costs and the costs incurred by the activities related to the productions of each merchandise line. The reply to this issue is to fix cost estimations for the three merchandises by using the necessities of the activity based costing, table 1 shows that the ABC costs of the valves is 37.8, the pumps is 48.82, and the flow accountants is $ 100.63. The ABC method attempts to link the indirect costs to the merchandises, and accordingly handle them as direct costs. Based on the instance analyze fiscal information, the computations in table 1 have been prepared by utilizing the followers: Making a cost pool for the machine depreciation and care cost, and apportion the merchandises based on machine hours. Making a cost pool for having and material handling costs by ciphering the figure of minutess consumed for every merchandise. Making a cost pool for technology costs by ciphering how much technology is consumed by each merchandise.Comparing the ABC with the criterion and the revised unit costsIn this comparing, it will look the cost of each merchandise under the three types of bing computation methods and the ground why they are different. Table 2 shows the comparing. The three bing methods dainty direct costs which are run labour and stuff, in the same manner. Furthermore, fiscal experts support the thought that direct costs is non the existent job as this can be tracked to the merchandise, but the issue is that bing computations gets complicated when seeking to apportion the operating expenses ( Indirect costs ) . The allotment of operating expenses is where the differences in costs come under the three bing methods. In the criterion cost accounting there is no attempt made to track the operating expense costs to the merchandises. It is believed that indirect costs can non be related with the merchandises that ‘s why they are summarised and so allocated to the merchandises based on the given allotment factor ( cost driver ) . In Destin Brass instance, the operating expenses which include the receiving and stuffs managing, packing and transportation, and depreciation and care for $ 680.000 per month, are allocated based on the tally labour dollars. Consequently, every merchandise is allocated a per centum of the operating expenses in the same ratio that the merchandise consume of labor ( valves 0.5 tally hours per unit, pumps 0.5 tally per unit, and flow accountants 0.4 run per unit ) . See table 3 for inside informations. The revised cost accounting makes portion of the indirect costs as direct. The stuff and handling costs are treated in a separate manner, but non the best cost driver had been chosen ( direct stuff dollars ) , as it would be seen in the ABC. Furthermore, setup labor is assigned straight based on the apparatus hours for which information is available. The staying operating expenses are allocated on the footing of machine hours. As mentioned by Peggy Alford, this gives an thought why rivals are cutting monetary values on pumps. It is now clear that costs of the pumps is overstated utilizing the criterion bing method while the costs of the valves are unostentatious. But, bing can be improved particularly that the flow accountants ‘ monetary value is non truly explained that they are cheaper to bring forth than it was calculated by the criterion bing method. The ABC method paths every bit much as possible of the indirect disbursals of the merchandises and services. So any disbursal incurred of a merchandise is straight charged to that peculiar merchandise instead than distributing the disbursal over all the merchandises. When disbursals incurred of a figure of merchandises, they are gathered and allocated based on a proper cost driver. In this manner, the allotment will be done in proportion to the existent costs ingestion by all the merchandises. Table 1 had shown the ABC costs computations for the three merchandises. Now, we can see that flow accountants have been subsidised by pumps and selling them for $ 97.07 is loss devising ( be $ 100.63 ) instead than at 42 % gross border. But, subsidizing flow accountants had made pumps less profitable while selling monetary value of $ 81.26 corresponds to 43.37 % gross border. The costs of the valves are the same under both the criterion and the ABC methods.Strategic deductions of the fiscal an alysisHarmonizing to Bhimani et La ( 2008 ) , extremely competition concern environment requires a comprehensive costs understanding, and a proper costing scheme is indispensable to ease determination doing. In Destin Brass instance, the direction is confronting a determination whether to travel on in the pumps market in malice of the monetary values autumn and decreasing net income borders or to cut this concern line and dressed ore merely on the valves and the flow accountant ‘s merchandises which are profitable. But, doing a determination following the standard costing method would hold caused black effects for the company as it would cut the profitable merchandise and concentrate on merchandises that are selling at a loss. Destin Brass is an ideal illustration of how critical is to hold an accurate bing method to follow to supply strategic determination devising. But, in malice of the importance of the fiscal and accounting information that the bing method will supply, the direction vision should be supported by the information non merely dictated by the accounting information.The following month consequencesIn the clip where cost accounting does non count for the cost allotment to find the costs of the merchandises, it does non impact the bottom line. Here, presuming that the measures of the productions and the gross revenues, stock list, selling monetary values stay the same, and the monetary values of stuff, labor, managing remains the same. The net net income would be the same as the net net income of the last month. The bottom line will be affected in instance the consequences demoing in the ABC method are considered and the merchandising monetary values are adjusted.DecisionThe costing methods used to place the strengths and failing of the concern public presentation helps direction to make up one's mind whether operations require any betterments. This indicates that the inaccurate costing allotment can take to either over or under pricing. Con sequently, this will forestall the direction from taking the company to do higher net income, retain clients or take the company to wrong strategic determinations.