Discussion Board Post Response Essay Example | Topics and Well Written Essays - 250 words - 6

Discussion Board Post Response - Essay Example e analysis making out why there are variations in a budget and subsequently creating strategies to address the problem (Laureate Education Inc, 2012). The fact that analyzing the budget reflects the internal financial situation or performance denotes how variations can be identified. Catherine Schneider, your writing also clearly explains the value of variance analysis in decision making. I concur that variance analysis enhances accountability (Zelman, McCue and Glick, 2009) as it is similarly the case in my organization. Analyzing the budget will help identify departments where variations are occurring and the department manager is answerable for any mismanagement of funds. This drives the departmental managers into making more effective pronouncements in terms of staffing and supportive action plans such as trainings to improve employees skills and abilities. This clearly shows that variance analysis determines how managers make decisions. In other words, it forces managers to make more effective decisions. I also agree that variance analysis may reveal the need to expand the budget and give data and information to support the claim. This means that decisions to expand a budget is dependent on budget

Cybersecurity Personal Statement Example | Topics and Well Written Essays - 500 words

Cybersecurity - Personal Statement Example My academic objectives can be divided into two sections, long term and short term objectives. My general objective at the moment is the acquirement of additional knowledge that would serve me in my career operations. Taking cyber security classes would increase my basis of knowledge in IT and related subjects thus allowing me to not only expand my area of expertise, but improve on the existing ones as well. The overall objective mentioned above can be seen as the leading long term objective in my academic path. I am aware that this would require my whole concentration on the achievement of these objectives in order to progress in this particular aim. I believe that my previous experiences, however, will serve me in successfully achieving this endeavor. My previous studies in India concerning web programming languages enabled me to develop a steady and applicable approach to new academic challenges in my life. This was because apart from the study of the various languages (which inclu ded PHP, MySQL and asp.net), I also enrolled for an online course on DB analyzing on www.coursera.com. This was at the same time as my web language courses that helped develop my personal organization and prioritization skills. My research interests lie in the world of E-commerce, and my main career plan is growing the business that I established with two other partners after my studies. This company offers web solutions for any company with (or in need of) an online platform. This business will be able to achieve this growth through the additional expertise I will gain from the cyber security classes. About my qualifications, I have a number of past achievements that I believe puts me in the driver’s seat for additional success should I continue to apply myself. As a student, my graduation project was able to win first place in Salman bin Abdulaziz University in the

Wound care Essay Example | Topics and Well Written Essays - 1000 words

Wound care - Essay Example It is the hope of this author that such a unit of analysis will be beneficial in not only providing the reader with a more informed understanding of how this process normally takes place within the medical sphere; but also with regard to furthering best practices within the medical community and spreading awareness of common techniques and practices. One of the most overlooked aspects of wound care is with respect to the fact that many medical professionals focus too much attention on identifying the type of wound and follow a rather limited procedure in terms of how the wound should be addressed. For instance, a wound sustained as the result of a fall could easily have foreign objects embedded beneath the skin or other tissues of the body. Similarly, a persistent bedsore is not likely to have embedded material that could potentially cause issues with respect to treating in healing the wound at a later date. Yet, as a function of simplicity, many medical professionals are oftentimes tempted to treat all wounds in the same manner. This is not only a shortsighted approach, it does not benefit the ultimate health and Outlook of the individual patient in question. This necessarily brings the analysis to the first and most salient point that should be discussed. Essentially, the role of identifying the wound, asking salient questions , and gathering relevant information is the first and most important process that any medical professional should engage in prior to attempting to dress the wound (Chen et al., 2013). As illustrated previously, a fall or similar wound that could have introduced foreign particles beneath the skin or tissue requires an alternative approach as compared to a wound that was sustained without direct trauma being applied to the individual. Likewise, with a wound sustained as a result of a fall or

Relationship Between Crude Oil And Natural Gas Prices Essay

Relationship Between Crude Oil And Natural Gas Prices - Essay Example Observing the pattern of crude oil and natural gas prices generally supports the economic theory and leads to the belief that both commodities do share a relationship. However, over the past few years, a decoupling of natural gas prices from crude oil prices has been observed (refer to graph 1.1 in appendix). This has led concerns over the strength of the relationship between crude and natural gas prices. Economic factors link crude oil and natural gas prices through supply and demand. There has been a strong conviction regarding the one-way relationship between the prices of crude oil and natural gas, whereby changes in crude figures influence natural gas prices and any changes in natural gas prices have no impact on crude. This is due to the relative size of each market. Prices of crude are determined on the world market whereas natural gas valuation takes place in regionally segmented markets. As a result, any adverse event or condition is unlikely to affect the global price of oil (Villar, Joutz) This paper attempts to signify the economic and statistical relationship between crude oil and natural gas prices. The period under review is from 1985 to 2005. ... Overview of Natural Gas Industry The structure of the natural gas industry has changed dramatically over the last 15 years. In the past, the structure of this industry was simple, with limited flexibility and few options for gas delivery. Exploration and production companies explored and drilled for natural gas, selling the product to transportation pipelines. These pipelines transported the natural gas, selling it to local distribution utilities, who in turn sold the product to its customers. Pricing at the exploration, production and transportation level was federally regulated whereas state regulation monitored the price at which local distribution companies sold natural gas to customers (naturalgas.org). Prior to deregulation, the structure of the natural gas industry was very straightforward, however, it suffered from shortages in the 1970s and surpluses in the 1980s. Since deregulation, the industry is much more open to competition and choice. Prices are no longer regulated and are determined by the demand-supply forces. One of the notable differences in the revised structure of the natural gas industry is the existence of natural gas marketers. They serve to facilitate the movement of natural gas from the producers to the end users. Marketers may either own the natural gas being transferred, or simply act as facilitators for the transportation. Source : NGSA The diagram above shows the pathway of natural gas from producer to end user in a regulated environment. The diagram below shows the pathway in a deregulated environment where marketers exist and can sell directly to end users. Source : NGSA Price of natural gas is simply a function of demand and supply. When demand for gas rises,

Unnatural Causes Movie Review Example | Topics and Well Written Essays - 250 words

Unnatural Causes - Movie Review Example Social class and racism are not natural causes for sickness and hence the title of the film ‘unnatural causes’. The film is similar with other media that I have seen, read, and heard on the issues of health disparities and how it relates to one’s social class in that people in the lower social class are prone to disempowerment. Their economic status is low due to lack of the necessary resources and opportunities and hence they tend to get sick more often and their life expectancy is low. The people in this class are subject to chronic stress and cannot have access to better medical care services. They tend to get sick more often and hence live shorter lives. Exposure to chronic stress of race in a lifetime often leads to delivery of premature babies thus affecting health and life expectancy (California Newsreel, 2008). The film confirmed biases I had in regards to being poor rich, that wealthy people lead better, longer and healthy lives as compared to the poor (Haitkin, 2008). The question that surfaced for me during the film that I would like to know more about is how the health status of the low social class can improve. With America having the highest gross national product in the world, how can the poor have access to medical care and training on health issues? The statement that best describes what I learnt from the film is that health inequalities are not natural. This is because, health disparities that are because of racial and class inequities arise from the decisions the society makes (California Newsreel, 2008). As a future nurse, I propose that the society or the government should try to ensure that everyone gains access to health care regardless of their wealth in order to live longer and healthier

Microsoft- tablet PC Essay Example for Free

Microsoft- tablet PC Essay 1)Who should Microsoft have targeted at the launch of the Tablet PC why? Before discussing who Microsoft should have targeted, we have to look at the strengths and weaknesses of the product. The success of any strategy depends on being able leverage the most of the strengths and rely less on the weaknesses. The strengths of Microsoft were its brand, distribution channel, existing enterprise user base and large resources. The risks involved those related to new product development, price and changing user behavior. The exhibit tells us that the large and medium business accounted for the most portable PCs in terms of volume and revenue. Due to the enterprise refresh cycles, a third of the PCs are replaced every year. Now let’s take a look at the options Microsoft had as target initial customers. They could target first time PC buyers, enterprise IT managers, students, early tech adopters or existing Windows customers. Looking at the strengths and weaknesses listed above it is easy to eliminate a few of the choices provided. Microsoft should have targeted the enterprise user base. Enterprise devices are much less sensitive to price as regular customers and have a higher willingness to pay. Thus the high price tag might not have been a difficult barrier if the product delivered value. They demand compatibility with existing enterprise frameworks. Given Microsoft’s dominance in enterprise software, they could easily ensure that the tablet PC has software that was compatible with Microsoft’s existing enterprise software. The iPad was very geared towards the consumer segment. Thus there was a niche in the enterprise tablet space that Microsoft should have exploited. This would have also helped in terms of narrowing down the focus on a few key applications, distributors and use cases. Taking a leaf out of Blackberry’s book they could have made enterprise security as one of their key differentiators especially given the wide adoption of outlook email in the enterprise. 2) What are the pros cons of Microsoft’s strategy vs. Apple’s (Microsoft being dependent on hardware manufacturers to market the Tablet PC, vs. Apple’s control of both the hardware and software?) This is essentially a question on the merits and demerits of a horizontal strategy vs a vertical strategy. The Microsoft strategy is a horizontal strategy. It involves creating a product that can deliver value up and down the value chain by allowing manufacturers innovate above and below it. This strategy can scale quickly and demands fewer resources from an individual firm to create an ecosystem. This also allows for wide range of innovations from a variety of players along the value chain. It is also a case of imperfect competition given that at each level of the value chain different levels of competition exist that promote greater product differentiation on multiple levels. The demerits of this strategy is lack of focus and control. Since the product is extensible and involves many players, there is always a risk of not being able to control what the end product looks like and the features it should prioritize on.The vertical strategy by Apple allows for control on the experience, and look and feel of the product. This enables Apple to focus and do a few things really well and better position the brand. By vertically integrating, Apple is also able to extract multiple premiums at different levels of the value chain. This can lead to higher profit margins. However, the downside of this strategy is that it cannot scale quickly, requires high upfront fixed costs and doesn’t offer the wide breath of product differentiation or features.

Culture of Silence: Talking About Death and Terminal Illness

Culture of Silence: Talking About Death and Terminal Illness In the past, it may have been acceptable for doctors not to tell a patient they had cancer. There was a culture of silence around talking about death and terminal illness (Heyse-Moore 2009). In On Death and Dying (Kubler-Ross 1973) Kubler-Ross said it was often the wife or husband who was told the diagnosis and then had the burden of whether to tell the painful truth. However, the development of the Hospice movement and Palliative Care in the past 30 years has made it the duty of health care professionals to inform patients of their diagnosis. Now, there are General Medical Council guidelines (2006) that make it an ethical duty for the doctor to inform the patient of the diagnosis (Heyse-Moore 2009). Parkes (Parkes Markus 1998) discusses the importance of breaking bad news effectively and sensitively. Parkes sees this as an element in preparing for loss. He is specifically discussing how to care for the terminal patient, so this may be a limitation (Parkes Markus 1998).He describes how the doctor should arrange and meet with patient. It is notable he does not provide exceptions and does not discuss involving family or speaking to a spouse first. Parkes provides practical guidance possibly gained from clinical experience. He advises finding a homely area where everyone can be comfortable. This can be a place where everyone can sit and not be disturbed. The decor should be the opposite of clinical if possible. He discusses giving as much information as the patient can cope with, and suggests bite sized chunks of information (Parkes Markus 1998, p. 8). He suggests inviting questions from the patient and using this to guide how to prevent information. The difficulty in talking about dying is where the patient becomes distressed and anxious, they may not take in what has been said, and may not fully understand the diagnosis or terminal nature (Parkes Markus 1998). If the dying person has a thinking coping style then the doctor can begin to help him/her focus on the feelings involved and expressing them; and vice versa for the person with a feelings coping style where the focus might be on the problem solving (Parkes 1996b). In Bereavement: Studies of grief in adult life (Parkes 1996a) discusses the tendency for the family to conceal the truth from the dying person. He is clear that the patient should be told of the terminal illness. According to Hinton (1967) (see Parkes 1996a), dying people tend to know and value the chance to talk about their terminal illness. There is some evidence that older people contemplate the end of their life and possibly want to talk to others about it. In a small study of 20 older residents in care homes in the UK, only 2 residents did not wish to discuss dying and death and neither objected to being asked (MacKinlay 2006). Further, Parkes sees giving bad news as a process. It is the beginning of an anxious and stressful period. The doctor should take the time and with empathy help the patient to adjust to the psychological transition of terminal illness (Parkes 1996a). In Speaking of Dying (Heyse-Moore 2009) Heyse-Moore discusses how it is possible to move the focus from the patient to the family if they are included in this initial discussion. Also it is possible for hidden or concealed barriers between family members to come to light while breaking bad news. She also writes of bad news as the beginning of a process that becomes part of the dying persons life. She advises being honest with the patient, including saying I dont know. There is an emphasis on balancing giving information and supporting the patient with his/her feelings and reaction to the news. The point is also made that an older generation of patients can react passively as they are used to doing as the doctor tells them. There has been some research in communicating with the dying that agrees with Parkes. In a study in USA involving 137 individuals in 20 focus groups of patients, family members and health care professionals, there were some common themes identified around effective communication. The best communicators were suggested as being honest and using understandable language. Qualities elicited were being willing to talk about dying; being sensitive in giving the news; listening to the patient; encouraging questioning; being sensitive to when patient will discuss dying (Wenrich et al. 2001). Information is necessary to cope and adjust in life in general. If the doctor fails to give correct information or even perhaps mislead the patient, this can cause confusion and distress as the patient may feel betrayed. The lie if told may not be consistent across teams and even silence can give information and be distressful to patients. This can undermine the trust implicit in modern health care (Parkes 1996b). Parkes is speaking of the doctor as the professional who will break the bad news. This has probably been the sole duty and responsibility of the doctor in health care traditionally. Nurses and other professionals would face sanctions if they accidently gave information about the diagnosis. However, with the development of the multi disciplinary team; and professional roles for other health care workers it is possible for other members of the team including nurses to be involved in the meeting to discuss a terminal diagnosis (Heyse-Moore 2009). Parkes however, conceives of the doctor as the agent of change for the patient. He argues that the medical profession should acquire the skills and knowledge to help the process of dealing with loss and with bereavement. He does not argue for a speciality role but instead argues that General Practitioners are ideally placed to facilitate this change process as they tend to build up a relationship with the patient over time and know the person well (Parkes Markus 1998). For Parkes the process that begins with breaking the bad news is not just about an ethical imperative to inform patients of their diagnosis. He believes that grief both for the dying person and the spouse and family involves grief work that is difficult and painful. For Parkes, breaking the bad news although this can be painful, allows the dying person and family to begin to prepare for loss (Parkes Weiss 1983). He argues that anticipatory grief is less severe than grief due to unexpected death (Parkes Weiss 1983). This preparation can allow spouses to come closer together before death; and there is possibility of working through some grief prior to death (Parkes 1998) (Schaefer Moos 2001). Kubler-Ross echoes this with her concept of unfinished business. She states that the dying person can share how she works through her grief and that this may allow the family to begin the process of grieving before death (Kubler-Ross 1973). Walter when examining the concept of unfinished business discusses the need to sort things out before death and if not attended to then this can lead to torment for the bereaved spouse and family (Walter 1999). Death means a fundamental change to the persons world. Distress and anxiety can result due to the difficulty in making sense of this seismic shock (Parkes 1997). A theoretical concept of Parkes is Psychosocial Transitions which he applies to losses in the broadest sense. He talks of a life changing event and an upheaval in the psychological internal world or assumptive world. Parkes view is that the dying and death of a loved one involves changes in meanings and relationships, status and roles and values which is why it can be so traumatic (Parkes 1993). Parkes had done some research in one of his interview studies in Boston where he compared how two groups of bereaved spouses reacted depending on how much warning they had of impending death. In one group there was less than 2 weeks of notice and in the other there was over 2 weeks and even up to over a years knowledge of terminal illness. Parkes found that the long forewarning group fared better and more effectively in dealing with grief and this was consistent over significant period of bereavement (Parkes Weiss 1983). Stroebe and Stroebe (Stroebe Stroebe 1987) agree with this idea that forewarning can help deal with anticipatory grief and help spouses to share and resolve difficulties. Parkes does not advise any exceptions to breaking the bad news. His approach is based on the universality of bereavement and the experience of loss. This may be a limitation for his work, if research suggests that grief and the process of bereavement is not universal to the human condition. Parkes, although he acknowledges concepts of pathological grief and mental illness, sees the process of loss as part of the human condition (Parkes Markus 1998). However, Heyse-Moore (Heyse-Moore 2009) provides a list of those who should not be given the bad news of a terminal diagnosis. Any patient who clearly states he doesnt want to know his diagnosis or treatment options. The only caution here might be that often the dying person could change his or her mind and be ready to talk and discuss at some future point. Implicit in this example is the idea that the patient is autonomous and capable of making an effective decision regarding their healthcare and indeed their life. Secondly, there is demented person whose loss of memory means she has forgotten what you told her half an hour later (Heyse-Moore 2009, p. 78). Thirdly, is the confused patient who cannot understand and fourthly, the psychotic patient who are liable to incorporate the information you give them into their paranoid delusions (Heyse-Moore 2009, p. 78). The second example is the crux of the dilemma when dealing with Mr Brown in the incident in this essay. Together with the third and fourth examples about confusion and psychosis, the issue here is whether the patient has the capacity to make an informed decision about their treatment and ultimately, their life. Heyse-Moore argues that there should be a full discussion with the family and the multi disciplinary team with the aim of arriving at a consensus on how to proceed (Heyse-Moore 2009). This should also be done within the relevant health legislation framework, for example, in Scotland the Adults with Incapacity (Scotland) Act 2000 (Griffith 2006). One example to illustrate this is sharing information with children. A study of a series of interviews with 20 social workers about their work with a total of 53 children of dying parents, revealed some guidelines in avoiding euphemisms with children and updating children regularly and giving information in bite sized chunks (Fearnley 2010, p. 453). However, one finding was that often the younger children were not given as much information and were not perceived by parents as understanding as much (Fearnley 2010). A second example is with people with learning disability where withholding information about a dying relative can still be common. Read discusses several barriers to breaking bad news: such as lack of understanding about learning disability; some of sensory, behavioural and cognitive impairments of specific learning disabilities; and also, a continuing paternalistic attitude towards people with learning disability. This means treating people with learning disability as less than adult (Read 1998). With dementia patients there is evidence that patients with Alzheimers are not told their diagnosis. Family members can be ambivalent towards disclosing diagnosis to their loved ones. However, in a study 69% of people experiencing memory problems stated they would like to know if further diagnosed with Alzheimers (Elson 2006). A systematic review suggested that disclosure of diagnosis with dementia is under researched. Euphemistic terms such as memory problems and confusion can be used. Clinicians reported difficulties in disclosing diagnosis to both patients and carers (Bamford et al. 2004). On one level it is understandable that patients who perhaps lack capacity are not given full information about their own health or of those in their family or even details about death of loved ones. However, what is left if information is withheld but deception? In a study of 112 staff working (in North East England) with dementia sufferers in care settings, 106 admitted to some form of lying to residents; 90% to ease distress; 75% to ease care givers distress and 60% to promote treatment compliance. Staff recognised both benefits and problems in using lies to help manage care (James et al. 2006). In a further article, Wood-Mitchell et al (Wood-Mitchell et al. 2006) state that the most common reason given for a lie is when the dementing resident wants to see a deceased relative. Wood- Mitchell et al argue for a realistic stage response to such situations starting with sensitively imparting the truth; then trying meet the need by an alternative means; then trying distraction to some other activity; and finally using some form of a therapeutic lie. One of the problems care giving staff recognises in lying is inconsistency amongst the staff team and Wood-Mitchell et al argue that care planning should be considered to ensure consistency and also when lie should not be told. A debate on the ethics of lying to dementing patients ensued in the Journal of Dementia Care in 2007, involving 6 separate articles for a variety of responses. Walker (Walker 2007) argues that although lying to patients will happen but cannot be justified. She suggests finding alternate ways of interacting with patients using a Validation approach. She advocates being silence if the truth is judged too painful to give, though she emphasises staying with the person. The aim is to try and connect with the patient and workout the symbolic or hidden meaning. Wood-Mitchell et al (Wood-Mitchell et al. 2007) then discuss the range of lies from outright lies down to not telling someone or not correcting them and so being deceptive. They argue against Walkers Validation or symbolic meaning approach: describing dealing with dementia as problem solving where the sufferer has to sort cues out and find the correct behaviour. They argue that communication should be conceived of directly; else in the search for hidden meanings the nurse may ignore a basic need like going to the toilet. Pool (Pool 2007) says the focus should be on emotions and feelings rather than factual information. She advocates using Rogerian principle of Congruence with person centred care for dementia sufferers and therefore cannot agree with Wood-Mitchell et al as this is fundamentally dishonest. While Muller-Hergl (Muller-Hergl 2007) describes care giving as being about integrity; and that suffering cannot justify lying or treating someone unethically. Fowler and Sherratt (Fowler Sherratt 2007) does little but raise some further questions and acknowledge this in their article. Bender (Bender 2007) makes a good case that the context is most important here. She argues that ethical absolutes are not useful for poorly paid and trained care staff. Bender advocates a realistic approach that accepts that in everyday life lies are tolerated and accepted and can even be valued to protect and care for someone. She suggests there is value in understanding a persons life story and biography to aid communication and understanding. She also raises the question of new approaches to loss and bereavement around ideas of continuing bonds instead of accepting loss and moving on. Finally, she states the value of strong caring and therapeutic relationship that can withstand, if necessary the lie.