Awareness, extent and nature of Business Continuity amongst managers Essay

Awareness, extent and nature of Business Continuity amongst managers - Essay Example This review examines one such document that has used statistical data inaccurately to bolster its claims. In the present document by the Chartered Management Institute (2002), responses of participants over three sets of similar data are reviewed and compared to try and understand trends that exist in some areas of business management. The survey results have been based on a response rate of just over 13%, with no observation about the representativeness of the responses collected. When the response rate is so low, it is difficult to establish the representativeness of the report (Burns,  Burns and Burns, 2008). This can pose a challenge, since it is quite likely that the responses received may be skewed to favour a certain type of respondent and may thus not be representative of the entire business community at all (Downing and  Clark, 2010). This makes many of the conclusions drawn by the report suspect. A second glaring issue that comes across instantly is that while the survey makes claims about changes in the trends observed from 1999 till 2002, no tests have been reported that test the actual significance of these changes (Burns,  Burns and Burns, 2008). For some of the categories reviewed, there are changes as small as a couple of percentages across the three surveys reported. From the data used, it is difficult to verify whether these changes have occurred due to an actual change is the experiences of respondents or whether the observed changes are due to sampling error (Guilford and Fruchter, 1973). Thus, it is quite likely that some of the variations in responses could be due to natural fluctuation and may not be true chances in trends at all. In some parts of the report, only a part of the trends observed have been used to define the nature of changes. Although the report claims to be studying changes as they occur from 1999 till 2002, when discussing some of the fear of threats and the extent of business plans

How does John Steinbeck portray racism in Of Mice And Men Essay Example for Free

How does John Steinbeck portray racism in Of Mice And Men Essay From the 17th Century, when the first settlers arrived, immigrants dreamed of a better life in America. People went there to escape from discrimination or poverty, and to make a new life for themselves or their families. They dreamed of making their fortunes in the goldfields. For many the dream became a nightmare. The horrors of slavery, of the American Civil War, the growth of towns with slums as bad as those in Europe, and the corruption of the American political system led to many shattered hopes. For the American society as a whole the dream ended with the Wall Street crash of 1929. This was the start of the Great Depression that would affect the whole world during the 1930s. However the dream survived in the hope of individuals. Thousands made their way west to California to escape from their farmlands in the mid-West. George and Lennie dreamt of there little house and a couple of acres. However, between 1929 39 there was a general world destine in trade and prosperity. A great deal of money had been spent on the First World War, and countries found themselves in debt. Lots of American lost their jobs. They joined bands of wandering farmers, looking for work. The farm owners of California found that they could pay very low wages, and expect men to work for long hours, as the demand for work was so great. The men were only needed for short periods at a time, for harvesting and so they had to travel around for work. On October 24, 1929, the stock market crashed. Prices began to decline early in the day, triggering a selling panic in the New York Stock Exchange (NYSE). This caused the loss of jobs of various workers, black or white. It was very hard for the workers to find a job elsewhere in any other farms, just like George and lennie. These kinds of workers were called itinerant workers. The coming months saw no recovery. The racism, which Martin Luther King talks about in his famous I had a dream speech, states that white men think they have got power over black people. That all men are created equally, and no one differs from each other. The black people have to give up their seats if a white person comes on to the bus and there is no space left. Also black people were not allowed to shop in the same place as white people. And black people had to send their children to a different school to the white people. This is an example of segregation and isolation. Crooks demands isolation because he is black and wants to live alone. He is also called names nigger . He is proberly one of the most disliked people in the story because of the colour of hes skin. But still people say crooks the nigger is a really nice fellow at the same time. I think they just call him that because at that time they could say or do anything to a nigger and still get away with it. The white boys did not want to sleep in the same room as a black man. I just totally disagree with this because you should not judge a perosn by the colout of the skin. Also crooks himself does not want to sleep with them because of the way the white boys have treated him. Crooks him self is a stable buck which is a very low classed job even at that time. The white boys call crooks crooks because as a stable buck he waz kicked on the back by a horse and he is now got a crooked back. Also the white lads have made crooks fight on christmas day with smitty just so he can sit down and have a drink with the white boys on christmas day. I think that is not acceptable because crooks is already hurt hes back from the accident with the horse and on top of that he had to have a fight with smitty with that injury when smitty was perfectly fine. All they did do was that they tyied hes hands behind hes back so he could not punch crooks but can only kick him. This first starts when crooks privacy is invaded by lennie. When lennie enters crooks room without no permission from crooks to cum into the room. Crooks is not very happy when lennie enters the room and says you got no right to come in my room. This heres my room. Nobody got no rights in here but me! Crooks says all of this because he is not really happy with lennies presents in the room. As lennie stays longer and longer he starts to find out that lennie is dumb and crooks thinks to him self that he has got the upper hand on lennie. Crooks for the first time has got power over someone and thats a white man. Then lennie gets up and says to crooks why are you not liked on the ranch and crooks replys by saying its just because Im BLACK! Crooks means by this quote that the white men on the ranch do not like him. And also crooks has got nobody to talk to because crooks is the only nigger on the ranch. Then lennie quickly changes the subject and starts talking about the dream him and George have got. But all crooks thinks is hes crazy . He thinks this because he thinks that lennie doesnt know what he is talking about. Crooks taunts lennie thaat George is not going to come back. And crooks also says he might even get hurt. After crooks has said that crooks face lightened up with pleasure in his torture. After crooks has said lennie quickly gets to hes feet and says nothing is going to happen to come George he si going to come back safe. Crooks is really frightened when lennis sayss that and crooks moves further up hes bed and rests hes hands on hes knees. The reason for crooks out burst like that is because all crooks is trying to do is trying to make someone feel like how crooks is feeling by telling lennie when the other boys on the ranch play horse shoe he has to stay in hes room and read a book when he would rather be playing horse shoe with the other workers on the ranch. Crooks is trying say just because i am black they dont let me play horseshoe. Crooks is trying to gain sympthy from lennie but lennie does not really understand what crooks is trying to say to him. So lennie doesnt really f eel sorry for him because he doesnt know what going on. So lennie cant really feel sorry for crooks because he is lost him self in other words. The workers on the ranch describe crooks as a nigger one second and the other second they be saying he is a very nice fella . I think my self that crooks is a very good person and stays quiet throught the book but it is just because of the colour of hes skin he is treated like dirt. Even thought crooks is proberly the most educated person on the farm. Crooks has got a dictionary which is described as battered and ripped and hes also got some tatered magazines. Also crooks has got some reading books, which are described, as dirty . And all of these things go on a special shelf over hes bunk. When crooks read these books he feels proud and really important because at this time not much people could read or write. And on top of all that hes a nigger . When we first meet crooks I thought he waz a nasty man because of hes posture and hes colour of hes skin. But looks can be dece-ving because he turned out to be a very well educated person and also soft hearted. It was very unusal for a black man to read or write in these in these times even so most of the white men could not read or write. I really feel sorry for crooks because he is alll alone and must feel really isolated at times or most of the time. And he has got no company at all and he aint even got no one to talk to at all because hes black. If you ask me I think that is really unacceptable because no one should be left alone for that reason. He aint got no friends to say hello too all because of the colour of hes skin. The white boys always pick him on. And even thought it aint hes fault most of the things are blamed on him. Also when the boss is feeling really mad he takes it all out on crooks and crooks just gets shouted at for no reason at all. Crooks on the hireachy he is right at the bottom and hes got no power at all. Even thought he has been one of the people who has been working there the longest and he has been loyal to boss. Curleys wife, the attention seeker always flirts with other prople on the ranch because her husband is always at the cathouse or out and about. And is never at home to care about her. Curleys wife is one of the most powerful people in the hireachy because she is married to the boses son. She tries to have some comfort with other people. This is because her husband takes no notice of her apart from the sex. She is used for an object of sex. When crooks reailses that his chances of being in the dream looked very slim and he crawled back defeated because he cant say anything to Curleys wife at all because she has got all the power. She can get him hung from a tree so easy, she can jus say that he waz flirting with me and thats it he would get hung. If that was a white person being prosequted they would give him a trial and would be taken to court but just because he is black they would just get him hung without any proof he did it or not. Going back to the initial question, I think that john Steinbeck doesnt throw the thought of racism in our face. He just hints of the idea and makes do the rest of the thinking. This is proved whenthe worker calls him a nigger and also a nice fella. We had do some thinking to find out that the word nigger is used so much that the workers dont even think of what the word means.

Online Technologies: Opportunities for Charities

Online Technologies: Opportunities for Charities Information Technology and developments in non profit organisations:  How online technologies offer new opportunities for growth to the charity organisations Table of Contents (Jump to) Chapter 1 Introduction 1.1 Introduction 1.2 Aims and Objectives 1.3 Overview Chapter 2 Literature Review 2.1 Introduction 2.2 Charities Chapter 1 Introduction 1.1 Introduction As Sergeant and Jay (2004, p.2) have commented, the concept of charity and their mission of raising funds to help the poor and needy has been around for centuries. However, both the numbers and complexities of charity organisations have multiplied significantly over recent decades. Sargeant and Tofallis (2000) confirmed reports from the NCVO that in the UK as of 1998, the number of NGO’s exceeded half a million, of which 40% could be designated as Charity based organisations., This group was then reported to have a collective estimated turnover of approaching  £20 billion. Both of these statistics will have grown dramatically over the past decade. The main mission of charities is to deliver practical and constructive assistance to those in need; providing information on issues such as health problems and disability or promoting the message for fairer laws. These missions can be related to human activity, preservation of the natural world environment and its wildlife or seeking justice for those that are oppressed. However, currently charities have to face up to a number of obstacles in effectively performing the task for which they have been set up, most of which arise in two particular areas. Firstly, with the increasing growth of needy causes, there is a rise in the number of charitable organisations emerging to address these issues, increasing the competition for funds proportionately. Secondly, there is little doubt from the level of research that has been undertaken, that the charity giver is becoming increasingly discerning about the impact of their donations. This concerns centres around the desire to ensure that the gi ft has the maximum impact. Therefore, it is important to the donor that the minimum amount of that gift is used for the charity’s internal administrative purposes. Despite the fact that the â€Å"mission† of a charity has in the past often been deemed more important than â€Å"economic intentions† (Hussey and Perrin 2003, p.200), the current climate within this sector is requiring them to become more efficient if they wish to sustain the objectives of their cause. This means that thy have to look for ways in which they can improve the effectiveness and the efficiency of their operations. In this regard, although somewhat belatedly when compared with the move by commercial corporations, the charity sector is increasingly studying the benefits of using information technology processes as a means of achieving the efficiencies that are required. However, as Hackler and Saxton (2007), although some charities are incorporating information within their organisations, the extent, areas of the business covered and effectiveness of these developments has not yet been perfected in a significant number of cases. In fact, in some it is considered that with some charities it can be reducing efficiency. Indeed the research conducted by Sargeant and Tofallis (2000) concluded that â€Å"the performance of many charities would appear to fall well short of the efficient frontier with no immediately obvious explanation forthcoming for why this might be so.† Indeed, they could also find no pattern to the causes of these failures either. It is the issue of information technology in particular its effective and efficient use in charity organisations that inspired this research project. Of specific interest is the intention to assess the impact that this technology has upon the duel targets of increasing financial efficiency and improving the delivery of the main services and missions of the charity. 1.2 Aims and Objectives As stated previously, the aim of this research is to identify the ways in which information technologies can be used to improve the efficiencies of charity operations. In this regard it is intended to focus the research upon the usage of IT in the online environment. Thus the research question or hypothesis that has been set for this study is as follows: â€Å"Online information technology processes can offer charities opportunities for growth and expansion in terms of the revenue and message and mission generating areas of their operations.† To assist with the achievement of this goal the research will use the following framework of objectives: Growth and maximisation of revenue It is intended to determine the extent to which a charity can make use of the IT opportunities available using the Internet to grow its revenue base and the methods by which this can be achieved. Cost reduction and efficiency Using the same premise as that included within the previous objective it is also the intention of this paper to address the issue of the appropriate IT methods that can be employed for increasing the efficiency of the charity organisation in terms of cost control and reduction where appropriate. Mission and programmes Bearing in mind the unique purpose of the charity format, which is that it has a mission to serve a specific cause, the research will also be ensure that, in addition to the financial objectives outlined above, the information processes examined are compatible with the enhancing of the message that charities need to communicate. This will be applied to both the potential and recipient of their services. The research itself will use a mixture of data to address the research question. This will include reference to the extensive range of financial statements which are available from individual charity websites or the Charities Commission (2008) online resources, although only a sample of these reports will be utilised. To address the issues and concerns of the individual charities more directly, individual interviews will be conducted with a number of representatives from this sector. 1.3 Overview The management and presentation of the research paper has followed a logical format. Chapter two presents a review of existing literature that is available and that relates to the issues being addressed by the researcher. This includes publications and comments by academics, professional observers and other interested stakeholders. Following this critical review, in chapter three it is intended to concentrate upon the methodology that has been applied to this project. It will provide an overview of the available methods and the reasons for the method that has been adopted in this instance. Chapter four provides the in-depth results of the research findings, both that which has been gathered from primary and secondary resources and these will be analysed and discussed in more detail in chapter five. Finally, the research project will reach a conclusion in chapter six and, where considered feasible and appropriate, the researcher’s recommendations will be presented and explained . Included at the end of this study, although separated from the main body of the study, will be additional information. This will include a biography of the various resources that have been referred to or used to assist with the development of the project. In addition, in attached appendices, information that is considered of further value in understanding the issues raised and the examinations undertaken, including the transcripts of interviews, have also been included. Chapter 2 Literature Review 2.1  Introduction To assess the issues of the charity use of online information technology, it is important to perform a critical review the existing literature that is available relating to various elements. In this case that will include providing a brief understanding of the charity environment. In addition, it will include a review of the information technology processes and their advantages as well as the areas where charities have been found to have deficiencies either in the usage of these technologies or the extent to which they have availed themselves of the technology itself. The chapter has been sectioned in a manner that appropriately addresses these areas. 2.2  Charities As many academics have observed, in comparison with commercial organisations, the charity is a complex organisation, not least because of its structure and mode of operations (Wenham et al 2004, Hussey and Perrin 2003 and James 1983). There are even different to the other types of non-profit organisations referred to by Hackler and Saxton (2007), such as those that are often form for regulating the decisions and objectives of various parts of nation and international political policies. An example of these would be the various organisations that have been set up in the UK to deal with the reduction of carbon emissions such as The Carbon Trust. The differences attributable to the charity organisation can be observed in many areas of the operation. For a start one of the main intentions that is needed for the organisation to qualify as a charity is for it to have a non-profit making objective (Hurray and Perrin 2003). Secondly, its mission that in the corporate sense would be classed as strategic objective is directed to the service of the external stakeholder or user (Hussey and Perrin 2003). In other words, where the purpose of the commercial organisation is to achieve financial success that will enable it to return additional value to the shareholders and potential investor, the charity’s financial aim is to utilise its funds specifically for the benefit of those whose demands and needs it is intending to address. Often, because of the break-even requirement, the charity will take on projects that are of no immediate benefit, but will have the effect of helping them to subsidise other, more highly valued activities (James 1983, p.351). Another difference in organisational processes is that the charity revenues generating activities relies heavily upon the volunteer donor (Wenham et al 2004), therefore making it difficult to predict. In addition, this places constraints upon administrative expenditure in areas such as computers and other modern equipment (Sargeanr and Jay 2004). Furthermore, because of the purpose of the charity and the need to concentrate its expenditure upon projects that are determined within its mission statement, together with the fact that funds may be limited, many charities are heavily reliant upon the efforts of voluntary employees. Many of these employees might have limited knowledge of the operational processes that are required for an efficient organisation, which can be a disadvantage (Galaskiewicz et al 2006, p.338). This is especially true if there is a sizable organisation to manage. Irrespective of these differences, to remain true to its mission statement and stated aims, every charity still has to create a strategy that allows it to address three specific operational procedures. These are the maximisation of incoming funds, minimising administrative costs to ensure the recipients of its objectives, in terms of projects and services, receive the maximum benefit and effective marketing, which is designed to attract donors and service users (Wenham et al 2004). Therefore, it is important for the charity to be organised in terms of its mission, which means having the right strategies in place (Hussey and Perrin 2003, p.215 and 218) and assessing their appropriateness. As Hackler and Saxton (2007) acknowledge, it is in these areas that the use of information technology can be considered. All charities have to be registered with the Charities Commission (2008) irrespective of their size. An integral part if this registration is the need to provide regular financial statements which Holistic Nurse Prescribing: A Case Study Holistic Nurse Prescribing: A Case Study Introduction 1 the patient and their presenting symptoms. Mr Pickles presents an interesting, complex and therapeutically challenging problem. In essence he is a gentleman with multisystem pathology who presents with an almost incidental finding which he was clearly reluctant to discuss. It is a common finding amongst experienced healthcare professionals that in any consultation it is the last 30 seconds which is the most important. As the patient stands up to go, there is the just while Im here moment when they can bring up an issue that really troubles them and may not be the real presented reason for the consultation. In this essay we shall discuss the various aspects of this situation and the measures we can take to try to help him. (Parker and Lawton 2003) 2.a holistic assessment of the pt, including any relevant medical social and psychological issues. If we start with the initial presenting symptom under discussion the impotence it is easier to work backwards from that to discuss the possible pathophysiology that can be relevant. Impotence is said to occur whenever the male fails to get an erection when it is required. This, in itself is neither unusual nor necessarily pathological. It becomes a significant symptom when the male repeatedly fails to get an erection that is sufficient for intercourse. It is quite possible to get full spontaneous erections and yet still be impotent. This is one of the major diagnostic features that distinguishes the psychogenic impotence from the purely physical. (Ackerman MD, Carey MP. 1995) There are a number of obvious physical causes of erectile dysfunction that are relevant to Mr Pickles (see on), but equally there are a number of possible psychogenic causes that may be either primary factors or possibly secondary contributory factors in the aetiology of his problems. The fact that he has recently undergone major cardiac surgery is a very relevant factor. Patients will frequently suffer from a major change in body perception when they have come to a close realisation of their own mortality. If we add to this the fact that, as the major breadwinner in the family, it is likely that Mr Pickles would have felt a major blow to his self-esteem when he was made redundant from a responsible high esteem job and forced to become a taxi driver with long working hours. This is quite apart from the anxiety and fatigue that such a job would engender.(Beck J. 1995) It is possible that the medication that Mr Pickles is taking may have a bearing on his erectile dysfunction as the male erection is dependent on the hydrostatic pressure of the blood for its maintenance. Any medication that reduces the average blood pressure, will effectively reduce the capacity to acquire and maintain an erection. In addition to this the adrenergic beta-blocker group will also selectively block the sympathetic pathways that are vital to the neurovascular control of the mechanisms of erection. Pathophysiology of diabetes and impotence Both of these topics are huge subjects, so in this essay we will restrict out considerations to those aspects which are relevant to Mr Pickles and his problems. We know that Diabetes Mellitus affects about 2% of the UK population with a specifically higher incidence in both the Asian and Afro-Caribbean communities(Nathan 1998). There is also a marked genetic component in the development of Diabetes Mellitus. Mr Pickles has Type II diabetes mellitus which is associated with a number of factors including a high BMI and increasing age. At 56 yrs. old he is currently at the peak incidence age for Type II diabetes mellitus (Gregg et al. 2003). Diabetes Mellitus is known to be associated with a number of complications. The prevalence and incidence of the complications, in general, tends to increase with the length of time that the patient has been diabetic. There is also an independent variable for complications that is directly proportional to the degree of control (as measured by the HbA1 levels). In general terms, the better the control the lower the incidence of complications (Kissebah et al. 1999) As far as Mr Pickles is concerned, there are two major complications of Type II diabetes mellitus that are directly linked with impotence and they are cardio-(macro)vascular disease and neuropathy. (Wagner et al. 1998) We can deduce that Mr Pickles has macrovascular disease by virtue of the fact that he his recovering from a CABG. And this may well be a very relevant factor in his erectile dysfunction but also there is the question of neuropathy which typically occurs in about 2.4% of the general population, but this figure rises to above 8% in the diabetic patient over the age of 60 yrs. ( Hughes 2002) Impotence tends to occur, in varying degrees, in about 10-15% of men under 40 yrs. Its incidence increases with age to the extent that 40% of men at the age of 40 yrs report a degree of impotence and this prevalence rises to 70% at the age of 70 yrs. (Gregoire 1999). If we add to this basic clinical picture the fact that there are other factors such as hypertension, smoking, cardiac neurosis, loss of self-confidence, depression and iatrogenic causes (medication etc.) all of which may well be relevant to Mr Pickles, then it can be seen that there are a plethora of potential causes of his erectile dysfunction. (Barnes, DE. 2004) Both of the first two causes (hypertension and smoking) are independent risk factors for impotence, quite apart for the fact that they are also risk factors for the development of the macrovascular complications of Diabetes Mellitus (Bowering 2001) Mr Pickles diabetic state has been recently well controlled (HbA1 of 6.5%). This is important as the incidence of development of diabetic complications is reduced by between 34-76% (depending on the particular study) for every 10% reduction in the average HbA1 reading. (Bowering 2001). In addition to all of these considerations, atherosclerosis is also a major complication of Type II diabetes mellitus, which, presumably is relevant to Mr Pickles because of his CABG, and this may be a major factor in the development of his erectile dysfunction. Management plan 3.a plan/strategy based on critical understanding of physiological and pharmaceutical issues. Any management plan must firstly be based on an accurate diagnosis. At this point in time we do not have this luxury. As we have discussed, there are anyone of a huge number of possibilities in the aetiology of Mr Pickles erectile dysfunction problem. When confronted with a problem such as this, any experienced healthcare professional may reasonably chose to manage the problem by making a rational judgement of the probabilities of any one particular cause being relevant. Implicit in such a management strategy is the fact that there are some causes that my be correctable (iatrogenic, psychological, and life style related) and there are some that may not (macrovascular damage, neuropathy and atherosclerosis). It is reasonable, in such circumstances, to discuss the situation openly with Mr Pickles and discuss with him the various treatment options. Patient empowerment and education is a vital strategy to adopt in circumstances such as this as Mr Pickles is far more likely to comply and respond if he understands the rationale behind the treatment plan.(Howe and Anderson 2003) We would suggest that an appropriate strategy would be to initially tackle the situation on two fronts. The psychological aspects of the erectile dysfunction are probably best discussed with an experienced psychologist or councillor who has expertise in this particular area. This is important because there is a considerable skill in eliciting the relevant factors from the patient. Many patients are reticent about talking openly about their imitate sexual details and there has to be a careful build up of trust and empathy on both sides. Factors such as good eye contact and a non-judgemental body stance are essential on the part of the healthcare professional if the optimal result is to be obtained Not only can the issues that are relevant be explored, but also any one of a number of psychological treatment techniques can be employed. This is a matter of considerable clinical judgement and skill and therefore probably best done by an experienced healthcare professional in that area. The pharmaceutical area can also be addressed as Atenolol is clearly not the best anti hypertensive to use as, not only will it reduce the blood pressure (which it clearly is important to do) but it also produces a counter productive beta-blockade which will not help the erectile dysfunction problem. The difficulty is that, after the CABG, Atenolol does have a degree of action on the suppression of ectopic electrophysiological foci in the myocardium which is a recognised complication of the procedure. It also is thought to have a cardioprotective effect post-myocardial infarction. It is probably a good idea to change his anti-hypertensive medication, but in the circumstances, it is probably better to seek the advice of the surgical team who performed the CABG. before making the transition. The question of Viagra has been raised by Mr Pickles. This is not as straight forward as it might initially appear. Viagra has been shown to work well in these circumstances. It has the downside that it allows sexual intercourse which is associated with increased peaks of blood pressure. As Mr Pickles is still in the postoperative recovery phase (16 weeks) it would again be sensible to consult with the surgical team as to their advice on the issue. The other problem with Viagra is that if it transpires that the long term aetiology is actually psychological rather than purely physical, then the prescription of Viagra will often breed a feeling of psychological dependence which may firstly be both inappropriate and unnecessary and secondly, very hard to break. It is probably therefore inappropriate to consider such options at this stage in the management. 4.legal and professional accountability should be discussed. The legal and professional issues are largely covered in the making of a management plan. In any area of professional competence, the best defence against criticism or censure, is the fact that a healthcare professional works from a rational evidence-based plan. It is for this reason that we have set out the rational and reasoning for the plan that we have chosen to adopt. It is actually quite permissible (legally) for a healthcare professional to be wrong on any given issue, as long as they have come to a reasoned and rational decision based on the facts that were placed before them. And behaved in a way that the majority of their professional colleagues believe is reasonable in the circumstances. It is, of course, central to these considerations, that all actions are carefully and fully recorded in the patients notes Prescribing decisions 5.a critical discussion of influences on prescribing decisions. The area of prescribing for Mr Pickles is clearly important. To some extent, we have covered the reasoning behind the change of prescription earlier in this essay. There is a common misconception amongst many members of the public (and indeed many of the less experienced healthcare professionals) that the solution to every problem comes in the form of tablets on a prescription. The whole area of patient empowerment and education is often filled with issues of lifestyle change, healthy living, self care and positive thinking which can frequently be more effective that simply giving the patient a prescription. (Boule NG et al. 2001) In the context of the NHS, it is a common observation that sometimes a prescription is given because it is the most expedient short-term measure in a given situation, (Dawes RM et al. 1974), however, time invested in an explanation to a patient as to why other measures might be equally as important is rarely time wasted., (Corrigan B. 1974) Future management 6.consider your future prescribing activity based on experience gained from this case study. In any professional area of activity, the author likes to use the mechanism of reflective practice to allow a critical assessment of a past course of action to modify future actions when faced with a similar situation. (Gibbs, G 1988) On careful reflection of this case, I believe that I may have acted rather rashly in stopping the Atenolol as a first choice. On reflection, I believe that the Atenolol did need to be changed for any one of a number of other anti-hypertensive agents but I feel that, in retrospect, I would have been wiser to take advice from the surgical team before I made that decision. Further reflection and discussion with other healthcare professionals (Marks-Moran Rose 1996), suggested that another appropriate course of action would have been to stop the antihypertensive medication altogether for a short period. This is on the grounds that his hypertension was not severe and was hitherto well controlled. If the erectile dysfunction was simply a reflection of the fact that the medication was holding his blood pressure down to a level where erection could not easily occur, a few days off the medication may allow a transient increase in his blood pressure to the point that erection could occur. As long as one was careful to monitor his blood pressure to ensure that it did not rise too far, I have been advised that this would represent a reasonable therapeutic trial to establish whether the underlying causes were mainly physical or physiological.(Wagner G et al 1998). On the face of it, this does seem reasonable but I believe that I would have to take further advice before I was fully comfortable with that decision. It follows from what has already been discussed, that I also feel that I may have been too quick to consider the pharmacological interventions before making a complete holistic assessment of the patient. There are clearly a number of lifestyle adjustments that may be relevant here such as weight loss and increasing exercise and looking for a new focus in life (to minimise any element of depression) which would be comparatively easy to achieve with appropriate empowerment and education of the patient. (Funnell R et al 2004) All in all, this is not a straight forward case. There are many elements which require careful and considered assessment. I believe that it is one of those cases that helps to point out that although there is a huge emphasis to be placed on modern scientific understanding and application of medical principles, there is also a very large element of human understanding and caring that is so very important to the successful management of patients such as Mr Pickles (Waterlow J. 1998) References Ackerman MD, Carey MP. 1995 Psychologys role in the assessment of erectile dysfunction: historical precedents, current knowledge and methods. J Consult Clin Psychol 1995; 63: 862-87 Barnes, Darryl E. 2004 Action Plan for Diabetes Copyright 2004 ISBN: 0736054596 Pub. Human Kinetics Illinois USA Beck J. 1995 Hypoactive sexual desire disorder: an overview. J Consult Clin Psychol 1995; 63: 915-927. Boule NG, Haddad E, Kenny GP, et al. 2001 Effects of exercise on glycemic control and body mass in type 2 diabetes mellitus: a meta-analysis of controlled clinical trials. JAMA 2001;286:1218-27 Bowering (2001) Diabetic foot ulcers. Pathophysiology, assessment, and therapy. Can Fam Physician. 2001 May;47:1007-16. Dawes RM, Corrigan B. 1974 Linear models in decision making. Psychol Bull 1974;81:95-106. Funnell, and Robert M. Anderson, (2004) Empowerment and Self-Management of Diabetes Clinical Diabetes 22:123-127, 2004 Gibbs, G (1988) Learning by doing: A guide to Teaching and Learning methods EMU Oxford Brookes University, Oxford. 1988 Gregg, R. B. Gerzoff, C. J. Caspersen, D. F. Williamson, and K. M. V. Narayan (2003) Relationship of Walking to Mortality Among US Adults With Diabetes Archives of Internal Medicine, June 23, 2003; 163(12): 1440 1447. Gregoire 1999 ABC of sexual health: Assessing and managing male sexual problems BMJ, January 30, 1999; 318(7179): 315 317. Howe and Anderson 2003 Involving patients in medical education BMJ, Aug 2003; 327: 326 328. Hughes RAC. 2002 Regular review: Peripheral neuropathy BMJ, Feb 2002; 324: 466 469. Kissebah AH, Freedman DS, Peiris AN. 1999 Health risks of obesity. Med Clin North Am 1999; 73: 111-138 Marks-Moran Rose 1996 Reconstructing Nursing: Beyond Art and Science London: Balliere Tindall October, 1996 Nathan D. (1998) Some answers, more controversy, from UKPDS. Lancet 1998; 352: 832-833. Parker and Lawton 2003 Psychological contribution to the understanding of adverse events in health care Qual. Saf. Health Care, Dec 2003; 12: 453 457. Wagner G, Seanz de Tejada I. 1998 Update on male erectile dysfunction. BMJ 1998; 316: 678-682 Waterlow J. (1998) Prevention is better than cure. Nurs Times 1988; 84: 69-70 Appendix

Affirmative Action in California: Has It Outlived Its Purpose? Essay

Affirmative Action In California: Has It Outlived Its Purpose? INTRODUCTION In the past, most California public agencies believed that affirmative action was an effective tool in the fight to correct discrimination. The main intent of affirmative action was to protect women, minorities and handicap individuals from discrimination (Hill, 1998,1). Affirmative action has been used in areas such as public employment, education and contracts. But today, some public agencies are questioning the meaning of affirmative action. The opponents of affirmative action believe that it encourages preferential hiring practices and reverse discrimination. They have also taken a strong stance towards the elimination of affirmative action through the California Civil Rights Initiative – Proposition 209 (http://www.ca.gov.). The supporters of affirmative action, however, still maintain that it is needed to prevent artificial barriers in the treatment of workers and hiring and admission practices (http://www.co.la.ca.us.). Even though Proposition 209 was passed by Californ ia voters, this has not discouraged professional organizations such as Americans United for Affirmative Action (http://www.auaa.org) and the American Association for Affirmative Action (http://www.affirmativeaction.org) who are still committed to educating the public on the importance of affirmative action. The concept of affirmative action has always been and continues to be a very controversial topic. This paper will focus on the positive and negative viewpoints of affirmative action as well as the future of its existence. AFFIRMATIVE ACTION: ORIGIN AND MEANING. The existence of discriminatory behavior against minorities was the leading force in the creation of the ... ...ve action, it has not stopped professional organizations such as the AUAA and the AAAA from informing the public about the past success and importance of affirmative action. It is not clear whether affirmative action will continue to be a part of the fight against discrimination in the United States. It is clear however, that affirmative action will continue to be highly debated issue for many more years. Bibliography Larson, Richard and McDonald, Laughlin (1980). "The Rights of Racial Minorities" Affirmative action. Avon Books: 82-89. Goldman, Alan (1977). (Affirmative action." In Marshall Cohen, ed., Equality and preferential treatment. Princeton, New Jersey: Princeton University Press, 192-209. Hill, John (1998). "County of Los Angeles position on the California Civil Rights Initiative" Memo to the Los Angeles Board of Supervisors, 1-5.

Marginal Costing

What is Marginal Costing? What are its features? What are the basic assumptions made by Marginal Costing? Marginal Costing is ascertainment of the marginal cost which varies directly with the volume of production by differentiating between fixed costs and variable costs and finally ascertaining its effect on profit. The basic assumptions made by marginal costing are following: – Total variable cost is directly proportion to the level of activity. However, variable cost per unit remains constant at all the levels of activities. – Per unit selling price remains constant at all levels of activities. All the items produced by the organisation are sold off. Features of Marginal costing: – It is a method of recoding costs and reporting profits. – It involves ascertaining marginal costs which is the difference of fixed cost and variable cost. – The operating costs are differentiated into fixed costs and variable costs. Semi variable costs are also divided in the individual components of fixed cost and variable cost. – Fixed costs which remain constant regardless of the volume of production do not find place in the product cost determination and inventory valuation. Fixed costs are treated as period charge and are written off to the profit and loss account in the period incurred. – Only variable costs are taken into consideration while computing the product cost. – Prices of products are based on variable cost only. – Marginal contribution decides the profitability of the products. What are the limitations of Marginal Costing? The limitations of Marginal Costing: – The classification of total costs into fixed and variable cost is difficult. – In this technique fixed costs are totally eliminated for the valuation of inventory of finished and semi-finished goods.Such elimination affects the profitability adversely. – In marginal costing historical data is used while management decisions a re related to future events. – It does not provide any standard for the evaluation of performance. – Selling price fixed on the basis of marginal cost will be useful only for short period of time. – Assessment of profitability on the marginal cost base can be used only in the short period of time. What is Cost Volume-Profit relationship? Cost Volume-Profit (CVP) relationship is an analysis which studies the relationships between the following factors and its impact on the amount of profits. Selling price per unit and total sales amount †¢ Total cost which may be in any form i. e. fixed cost or Variable cost. -Volume of sales In simple words, CVP is a management accounting tool that expresses relationship among total sales, total cost and profit. Cost Volume-Profit relationship is one of the important techniques of cost and management accounting. It is a powerful tool which furnishes the complete picture of the profit structure and helps in planning of profi ts. It can also answer what if type of questions by telling the volume required to produce.This concept is relevant in all decision making areas, particularly in the short run. Explain P/V ratio and Contribution. P/V Ratio: P/V Ratio (Profit Volume Ratio) is the ratio of contribution to sales which indicates the contribution earned with respect to one rupee of sales. It also measures the rate of change of profit due to change in volume of sales. Its fundamental property is that if per unit sales price and variable cost are constant then P/V Ratio will be constant at all the levels of activities. A change in fixed cost does not affect P/V Ratio. It is calculated as under: Contribution * 100) / Sales (Change in profits * 100) / (Change in sales) A high P/V Ratio indicates that a slight increase in sales without increase in fixed costs will result in higher profits. A low P/V ratio which indicates low profitability can be improved by increasing selling price, reducing marginal costs or selling products having high P/V ratio. Contribution: It is the difference between sales revenue and variable cost (also known as variable cost). Variable cost is the important cost in deciding profitability as fixed costs are ignored by marginal costing. It can be expressed in two ways: Sales Revenue – Variable Cost †¢ Fixed Cost + Profit The situation generating higher contribution is treated as a profitable situation. Explain Break Even Point. How does BEP help in making business decision? Break Even Point (BEP) is a volume of sales where there is neither loss nor profit. That means contribution is enough to cover the fixed costs. Thus, we can say that Contribution = Fixed Cost Any contribution generated after BEP will directly result into profits as the fixed costs are fully covered now. BEP can be computed in two ways: In terms of Quantity- Fixed Costs / Contribution per unitIn terms of Amount- (Fixed Costs) / (P/V Ratio) BEP (Break Even Point) is the situation whe re there is neither loss nor profit. At this stage, the contribution is enough to cover the fixed costs i. e contribution is equal to fixed cost. Contribution generated after the break even point will result in profits for the organisation. Profit maximization is the motive of every organisation. Thus, every organisation use BEP as a base to take various decisions in regard to its sales volume and tries to increase it so that total fixed costs can be covered as early as possible and more profits can be earned.Explain Margin of Safety. Margin of Safety is the amount of sales which generates profit. In other words, sales beyond Break Even Point are known as Margin of Safety. It is calculated as the difference between total sales and the break even sales. It can be expressed in monetary terms or number of units. It can be expressed as below: Margin of Safety = Sales – Break Even Sales = Sales – {(Fixed Cost) / (P/V Ratio)} = ((Sales * (P/V) Ratio) – Fixed Cost) / ( P/V) Ratio = (Contribution – Fixed Cost) / (P/V) Ratio = Profit / (P/V) RatioThe size of margin of safety is an extremely important guide to the financial strength of a business. If margin of safety is large, which indicates that BEP is much below the actual sales, that means business is in a sound condition and reduction in sales will not affect the profit of the business. On the other hand, if margin of safety is low, any loss of sales may be a serious matter. Thus, efforts need to be made to reduce fixed costs, variable costs or increasing the selling price or sales volume to improve contribution and overall P/V Ratio.

Studies Show Black Women Are Healthier at a Higher Weight Than White Women

Studies Show Black Women Are Healthier at a Higher Weight Than White Women Studies reveal that African American women can weigh significantly more than white women and still be healthy. By examining two standards of measurement - BMI (body mass index) and WC (waist circumference) - researchers found that while white women with a BMI of 30 or more and a WC of 36 inches or more were at greater risk for diabetes, high blood pressure and high cholesterol, black women with those same numbers were considered medically healthy. African American womens risk factors did not increase until they reached a BMI of 33 or more and a WC of 38 inches or more. Typically, health experts consider adults with a BMI of 25-29.9 to be overweight and those with a BMI of 30 or greater to be obese. Peter Katzmarzyks Studies The study, published in the January 6, 2011 research journal Obesity and authored by Peter Katzmarzyk and others at the Pennington Biomedical Research Center in Baton Rouge, Louisiana, only examined white and African American women. No similar racial difference between black men and white men were studied. Katmzarzyk theorizes that the weight gap between white and black women may have to do with how body fat is distributed differently throughout the body. What many call belly fat is primarily recognized as being a significantly greater health risk than fat in the hips and thighs. Dr. Samuel Dagogo-Jacks Findings Katzmarzyks findings echo a 2009 study by Dr. Samuel Dagogo-Jack  of the University of Tennessee Health Science Center in Memphis. Funded by the National Institutes of Health and the American Diabetes Association, Dagogo-Jacks research revealed that whites had more body fat than blacks, which led him to theorize that muscle mass may be higher in African-Americans. Existing BMI and WC guidelines are derived from studies of predominantly white and European populations and do not take into account physiological differences due to ethnicity and race. Because of this, Dagogo-Jack believes that his findings argue for a review of the existing cutoffs for healthy BMI and waist circumference among African-Americans. Sources: Kohl, Simi. Use of BMI and waist circumference as surrogates of body fat differs by ethnicity. Obesity Vol. 15 No. 11 at Academia.edu. November 2007Norton, Amy. Healthy waist may be a bit bigger for black women. Reuters Health at Reuters.com. 25 January 2011. Richardson, Carolyn and Mary Hartley, RD. Study Shows Black Women Can Be Healthy At Higher Weights. caloriecount.about.com. 31 March 2011.Scott, Jennifer R. Abdominal Obesity. weightloss.about.com. 11 August 2008.The Endocrine Society. Widely Used Body Fat Measurements Overestimate Fatness In African-Americans, Study Finds. ScienceDaily.com. 22 June 2009.