How the Railway Labor Act Affected Bargaining in the Aviation Industry Essay

How the Railway Labor Act Affected Bargaining in the Aviation Industry - Essay Example (Joined Airlines CEO, 2000) In the carrier business, haggling is directed by the National Mediation Board (NMB) under the RLA. In the last 50 years the RLA, as applies to the carrier business, has brought about strikes in under 3 percent everything being equal. Regardless of this, most carrier the executives sees the procedure required by the RLA as out of date and broken (Ex-Gov. Goldschmidt, 2003) The railroad work demonstration of 1926 was the primary significant work enactment passed by the U.S. Congress. Rather than shaping standards that applied to the entire of U.S. Industry, it focused on the railroad business, at that point the most significant piece of the transportation business in U.S. (Dealing Under the Railway Labor Act). The demonstration's motivation was basically to supplant hits with bartering, assertion, and intercession as an approach to determine work debates. The demonstration likewise denied managers from constraining specialists to deal through organization commanded associations. (Aggregate Bargaining) There are two manners by which the RLA delays or takes out strikes out and out: the demonstration drags out the procedure of aggregate haggling; as the demonstration necessitates that the gatherings have been discharged by the NMB 30 days before a strike can occur, where the date of discharge is the sole attentiveness of the NMB. (Aggregate Bargaining) Second, the RLA requires compulsory arbi... (Aggregate Bargaining) Both trade guilds and bosses profited by the RLA. Laborers, who needed to have the chance to arrange themselves and to get the best possible consideration from businesses to haggle new understandings and uphold existing ones, got what they needed. So did the railroad organizations. The Congress had concluded that trade must be continued moving in light of a legitimate concern for people in general, and in this way ordered specialists, regardless of any debates, must work now and lament later. Thus managers won the option to prop business up despite progressing work questions. (Railroad Labor Act, 2005) There are a few exemptions to the work currently, lament later rule, be that as it may. Laborers are permitted to decline to work when they have a sensible conviction that the work is risky, and when work being requested is in away from of the agreement. Be that as it may, if the organization can make a sensible guarantee that the agreement legitimizes the work being mentioned, at that point the worker is required to work, and report any complaints later. (Dealing Under the Railway Labor Act) Under the RLA, the initial phase in contract dealings are immediate arrangements, which are exchanges without the intervention of the NMB. Understandings additionally don't have inborn lapse dates under the RLA-termination dates must be set inside the understanding itself. Henceforth the understanding stays enforceable, and is business as usual, until any change is settled upon by the two gatherings. (Dealing Under the Railway Labor Act) The RLA permits strikes over significant debates (or questions that worry the creation or adjustment of the aggregate dealing understanding) just if the entirety of the RLA's exchange

Compare and contrast Marxist and Functionalist accounts of religion

The two functionalists and Marxists share the normal view that religion serves to legitimize the ethics and laws inside society. Numerous functionalists just as Marxists do concur that society makes religion as a visual image of itself. Supporters are eventually not revering their religion, their loving society and all that it represents. In any case, this is the place the split in sees starts. Functionalists consider Religion to be serving towards the 4 pre-essentials of society. (To be specific: Social incorporation, shared qualities, social solidarity, and social agreement). By guaranteeing these requirements are met, religion strengthens aggregate qualities and advances solidarity. Functionalism isn't over worried about the ‘why' religion is permitted to expect this adulterated imagery, yet rather perceives it's utilization in keeping concordance and confidence in the public eye. Durkheim exhibits this in conceding that religion doesn't need to be ‘super common'. Note that human individuals and items can increase a holy status in the public arena like that of the icons of religion. For example: Princess Diana †a national image of noble cause and perhaps the last genuine ‘princess' of the British Nation in the individuals' hearts. She has become consecrated on the grounds that she speaks to a decent nature of society. From this, Durkheim trusts â€Å"Understand what hallowed things speak to and you comprehend the estimations of a society†. Here we come into the main significant distinction among functionalism and Marxism. The previous accepts that there is a positive connection among society and the person. Love society; put stock in the public arena. Marxists, be that as it may, characteristically are discontent and have an evil perspective on society for what it's worth. It is justifiable how they are against religion instilling the individuals into a worth set, maneuvering them into the aggregate inner voice that at last backings private enterprise and the possibility that individuals have the right to â€Å"have their place†. Religion has permits bolstered class frameworks and advanced disparity. In sex. In work. In power. Everything that Marxism is against. â€Å"The rich man set in his château †The poor man put at his gate† Malinowski, popular for his examination at the Trabaind islands, didn't consider religion to be a festival of society, regardless of a similar functionalist point of view as Durkheim. He did, in any case, concur that religion advances solidarity. It does as such by managing passionate pressure/life emergency (problematic occasions). Religion ventures to present services for managing different life emergency. Passing is given a burial service. Love is given marriage. In all cases at that point trust is given through the communicated confidence in interminability and individual grievers serve to solace and bolster the dispossessed, so they can become useful citizenry by and by. Risky and flighty occasions are additionally encircled in strict service. Petition is basic before a potentially unsafe encounter. These ceremonies lessen tension and increment certainty, fortifying solidarity in shared circumstances. Talcott Parsons shares this view and goes onto show how strict gadgets, for example, the 10 edicts, give the premise to numerous social standards and ethics. Religion guides conduct and aides in the definition of choice through this. At long last, Religion is hoped to answer the â€Å"ultimate questions† and offer significance to our reality. Humankind needs to feel as if there is importance in every single critical thing; which means to death and enduring, and support of presence in itself. Religion attempts to show sense in opposing situations that compromise the parity of extreme convictions. For example, a man who is benefitting through the doing of fiendishness will be rebuffed in life following death for his illegitimate increase throughout everyday life. Religion is an admonition, a supplier of equity, a supplier of direction and extreme heavenly dread on the off chance that one roams. Marx himself dismisses any thought of extraordinary part of religion. He portrays religion as the â€Å"Heart of a cutthroat world†; The merciless world being the general public formed by private enterprise. Religion is conceived out of a requirement for comfort, it does only this by padding the impact of specialist persecution. Marxists have put religion as a component of the super structure, it legitimizes the entrepreneur base just as the entire super structure. (See rich man quote page 1). Religion as an apparatus of the bourgeoisie plays a significant move in supporting specialist persecution, by indicating that all will increase equivalent award in paradise for doing the ‘right thing'. Religion has shifting degrees of severity as per financial class situation, particularly in India where the cast framework places exacting limitations and categorisations on a people place in the public arena. Equal open door is eventually squashed by brutal lessons and acknowledgment that a lower class laborer is having an awful life since overly common powers set them in that circumstance as discipline for injustice in past life. Taking everything into account, Marxist and functionalist similitudes regarding the matter beginning and end with the acknowledgment of religion as a preservationist power in the public arena. Neo Marxism accepts the thought (like functionalism) that religion can at times be valuable to society in achieving improve. For example the extreme job of Liberation Theology. (Madura). Customary Marxism is completely contradicted to the severe job of religion and would be astonished to see that extreme powers have risen with some minority strict gatherings. Functionalists, for example, Durkheim and Parsons consider religion to be being a positive and maybe basic piece of the amicable activities of society however have been censured for disregarding the useless, problematic, and disruptive parts of religion. They neglect to think about antagonistic vibe between strict gatherings inside a similar society. â€Å"It would appear that religion undermines social joining as promptly as it adds to it† (Stark and Glock).

Branding Example

Branding Example Branding â€" Essay Example > Definition of branding The definition of branding can be summarized as, “a brand is a term, sign, symbol, design or a combination of these that is intended to identify the product or a seller and to differentiate it from those of competitors” (Okonkwo 2007, 9). Branding is the process of creating an identifiable entity of the total offerings of a company which make consistent and precise promises of value, thus providing the consumers with the best experience of using those offerings. An effective brand strategy provides a business with a significant edge amidst the increasingly competitive markets. Brand is a company’s promise to its consumers. Brand suggests what expectations can the consumers assign to the products and/or services offered by the company. Brand makes the offering stand out from a range of similar offerings by the competitors. The brand is derived from what a company is, what is its mission and vision, and how it wants to be perceived by the consumers. A logo lays the foundation of a brand. The website, promotional materials, packaging, and ads of a company are all integrated in the company’s logo, so a company is able to communicate to the consumers. The brand strategy is crafted by what about, when, where, how, and to whom a company wants to communicate and convey the messages. The choice and platform of advertisements, the visual and verbal elements of communication are all essential components of the brand strategy just like the distribution channels. A company can develop a strong brand equity by adopting consistently strategic branding. Brand equity means the added value assigned to the offerings of a company which provides the company with an opportunity to charge the consumers more for the brand compared to what unbranded identical product making companies are charging. Coke vs any soda is an obvious example of this; Coca-Cola can charge customers more for its drinks without having the customers turned away because Coke has a strong brand equity whereas a generic soda might not even get half as many customers even by charging them much lesser than Coke. The added value is built in the form of emotional attachment or perceived quality. For example, Nike keeps star athletes in its ads and promotional campaigns anticipating the transfer of the customers’ emotional attachment with those star athletes to Nike’s products. This implies that it is more than just the features of Nike shoes which plays an important role in their selling out. Defining its brand for a company is more like a self-discovery business journey. Defining the brand can be time-consuming and complicated as it requires a company to clearly lay out its mission, the intended features of its products and/or services, the benefits they would generate for the consumers, the prospective or desired image of the company, and the consumers’ existing association with the company. Objectives of branding The objective of branding is to create wealth, customer loyalty, and most importantly influence in the market. The goal of branding is to encourage the consumers to purchase the offering repeatedly. Brands are robust symbolic entities with a lot of social impact which paves the way for increased loyalty on the part of the consumers. Brands are considered as communicators since they communicate the name, trademark, logo, type, communicating positioning, and contriving identity. Brands play the role of value enhancers as they are visualized to carry additional values which are linked with a company and the products and/or services it offers. Having a company branded means that the quality of its offerings is guaranteed to the consumers. Brands help build relationships between companies and the consumers. It is the objective of branding to get the offerings of a company differentiated from those of its competitors so that the product and/or service can be easily recognized by the consu mers. Another objective of branding is to launch activities of promotion. These activities may include but are not limited to personal selling, advertisement, sales promotion, and publicity. One of the primary objectives of branding is to maintain the durability and high quality of the offerings for which they are valued by the consumers. Using brand name loses all significance and weight if a company fails to maintain the quality of its offerings. Branding provides a firm with legal protection and helps the company overcome legal obstacles. Summing them up, the objectives of branding, on one hand, are directed at producing quality products and/or services, and on the other hand, they are directed at fostering the relationship between consumers and the company producing those products and/or services. The development of a brand The first and the foremost requirement of developing a brand is to have a logo that can be placed everywhere. Next comes the stage of crafting brand message. The company should write down the key messages that it wants to communicate through its brand. These brand attributes should be well known to each and every employee of the company so that all employees can display these attributes in their dealings with the customers. Branding is not limited to just one aspect of a business i. e. marketing or selling; rather branding is intrinsically related to all aspects of the business ranging from addressing the customers’ complaints, communicating with customers professionally, and doing the maximum possible to keep the customers happy and entertained. The company needs to create its own voice that would reflect its brand. This voice is incorporated in all materials’ visual imagery and written communication. The company should constantly evaluate where the brand lies on the scale wit h friendliness on one extreme and formality on the other. Ideally, a brand should lie in the middle of such a scale so that customers are dealt with in a friendly as well as a professional manner by the company’s staff. Writing a meaningful, concise, and memorable statement which contains a brand’s essence helps in the development of a tagline. The color scheme, look, feel, and logo placement should consistently be the same in all products and/or services, their marketing campaigns, and promotional platforms. How Gucci developed its brand Gucci is a famous brand for luxury accessories and fashion wear. Gucci puts in a lot of effort in its branding. Gucci’s 90th anniversary celebration was year-long and completed with the establishment of a whole “branded museum in the Palazzo della Mercanzia located in Italian city Florence’s Piazza Signoria” (Hutzler 2011). There are three separate floors in the Gucci Museo each of which is dedicated to the permanent branded exhibits that narrate the brand’s story to the visitors. There has been noticed an increase in the museum exhibits by top brands which shows that top brands feel the need to justify why they charge such high prices to the customers by telling them their history and brand’s story and worth. Branding expert Rob Frankel said, “After creating and building a brand, it’s critically important to nurture and sustain the value of the brand… This is where most brands fall down. They simply create it and hope it thrives, …But when a brand takes steps to show that it believes its own brand is worth cultivating, it makes a statement to the public” (Frankel cited in Hutzler 2011). There are three shops, one café, and several rooms for exhibition inside the Gucci Museo. With the café being located at the museum’s entrance, the tourists are enticed to meet the locals in a coffeehouse. Such meetings promote an understanding of the importance of a brand even to the ones who are very remotely aware of it. Gucci provides an example of a top brand that invests heavily in its branding, but the investment brings about far more profit in return. References: Okonkwo, U 2007, Luxury Fashion Branding: Trends, Tactics, Techniques, Palgrave Macmillan, Hutzler, K 2011, Gucci emphasizes brand value with independent museum, Luxury Daily, [Online] Available at http: //www. luxurydaily. com/gucci-celebrates-90-years-highlights-quality-with-branded-museum/ [accessed: 14 April 2015].

Assisted Suicide Should Be Legal Medical Practice

Assisted should be a legal medical practice in the United States. There is a lot of different opinions on this subject but; Is it really a question on if it’s the right thing to do? If a person is truly suffering and has no hope in getting better is it ok to end your on life; yes it is. Assisted Suicide is huge subject in our world right now, there are different types of assisted suicide but today we are going to focus on Physician-assisted suicide. Physician-assisted suicide is the act of a medical doctor who provides a patient with drugs or other means to end one’s life intentionally. Assisted suicide is a humane way that the terminally ill can end there life, to get rid of the dreaded never ending pan, to end their suffering and just†¦show more content†¦In 2006 the case went to the Supreme Court, after many appeals, which the Supreme Court upheld the law. Then in 2008 Washington became the second state to legalize assisted suicide with a sixty percent yes rate. Montana became the last state to pass the Death with Dignity Act in 2010. With three states already with the Death with Dignity Act passed and with the Supreme Court to back it. Massachusetts decided to give the Death with Dignity Act a chance. The 2012 election day, the State of Massachusetts will vote whether or not to approve the â€Å"Death with Dignity Act†, a measure that would make Massachusetts the third state in the country to approve physician assisted suicide? The state has been split politically between the medical community and politically powerful Catholic Church. The Catholic Church has made no secret to its opposition to physician assisted suicide. The right-to-die idea was before the opponents provided a lot of testimony to get lawmakers to abandon the bill and stop endorsing it. With 80,000 signatures the â€Å"Death with Dignity Act† was put on the ballot. With Massachusetts being the national health care they could play a significant role in the developing debate over physician assisted suicide throughout the country. This act was later thrown out to due to a more popular NO vote on it. Oregon and Washington both have similar laws in the Death with Dignity Act. Montana

Emmanuel College Admissions SAT Scores, Financial Aid

Tremaine Neverson Free Essays

â€Å"Success can be a dangerous drug. It definitely changes people and it can take you to another world if you allow it to. † These are famous words form popular singer, songwriter and activist Tremaine Aldon Neverson. We will write a custom essay sample on Tremaine Neverson or any similar topic only for you Order Now Born November 28, 1984, Tremaine is also known as Trey Songz. Searching for himself, he gained a love for music and began singing at the age 14. At the age of 15, he met a producer by the name of Troy Taylor, whom started his skyrocketing success as a singer. In 2003, he released his first album, and then began writing music for other artists. He has five different albums in which he considers to take his fans on five different journeys of his life. From BET to Grammy awards, Trey Songz is more than just an artist. He has used his gift of music as the launching pad to various philanthropic and entrepreneurial endeavors such as the â€Å"Angels with Heart Foundation† and the â€Å"Songz for Peace Foundation. † Through his â€Å"Angels with Heart Foundation,† Trey encourages to give back and to have a positive impact in their community through community service with local charities and random acts of kindness. Through his â€Å"Songz for Peace Foundation† he aims to curb the violence in youth. I admire Trey’s dedication to music. It is something he loves and he always pleases his fans. He is also promoting positive messages through each of his foundations. As an artist, he’s only obligated to deliver music and videos to his fans, but he does so much more for us. I am all for community service and giving back to the community, so just for that I admire him. To find someone who satisfies your taste in music and your taste in activism means a lot to me as a fan and a young adult. In closing, I would like to dedicate this special tribute to Tremaine Neverson on this very special day, Happy Birthday Trey! How to cite Tremaine Neverson, Papers

Effect of Media Violence Exposure †Free Samples to Students

Question: Discuss about the Effect of Media Violence Exposure. Answer: Introduction: The revolutionary concept of using electronic media for the purpose of marketing communication is gaining extreme popularity with different genres of business organizations, and adding the extra element of social media has contributed large to the rapid growth that this concept has gained. Despite the charming popularity statistics of this marketing idea, different organizations are still sceptical about using SOME for their marketing mix due to the perceived risks associated with this idea limiting their use. There are various risks associated with the use of social media marketing for a corporate entity given the dynamic nature if customer market, and this is what is perceived as the risky society by the most of the business management authors (Andreassen, Pallese Griffiths, 2017). The use of the new form of electronic form of media are done majorly on the marketing communication for gaining the full amount of the reputation with the organizations and adapting to the use of the so cial media is also enjoying the (SOME) for enjoying the particular form of the rapid form of growth. However, the organizations are been associated with the using of the SOME in the communication of the marketing arena (Utz Breuer, 2017). The individuals tend to explore various forms of effectiveness for the procedural controls and the processes that are done for managing these forms of risks. The results also shows that the organizations perceives the three kinds of the risks that can be avoided in the companies from the increasing the use of the SOME. Corporate organizations applied form of the practical form of the controlling the mechanisms for managing time loss of the risks (Mathews, 2016). The familiarity of the organization with SOME was found for having the strong form of impact on the resources like loos of time and for the other types of the other forms of the factors of the risks. Several researches have reviled that the role of the proactive form of the focus and the c ontrol over the procedures that are been managed for the SOME related risks are very less being anticipated. In a broader form, the social media actually refers to the phone or the application that are based on the internet for engaging themselves in the communication with the other form of people who are across space and the time. The most popular form of the social media are the Facebook and the Twitter which sufficiently serves the purpose for serving the main purpose. The other common forms are the Tumblr and the Reddit that are mostly used for blogging the applications or the websites for allowing the users for interacting with each other that can be identified as the form of social media. The defining form of all the features that the social media provides always enables the large number of the people and the potential form of the strangers for communicating with all the members who have been streamlined. In all other senses, the fact that the social media has completely taken over the interpersonal forms of relationships should not be ignored when discussing the risks associated with social media (Fikkers et al., 2013). However, the sense is very superficial. The truth is that the actual form of the interpersonal relationships that requires the present to the friend of the individuals, that requires one to be able to have a very much face to face of conversations that are been conducted with them without even distracted by competing the demands for getting the attention of the individuals. The users of the social media have also become very much incapable for the current situation. As the people are very much purged with the virtual form of world, they are never actually very present in the actual form of world for the world that the individuals are been living. Physiologically there have been episodes where the individuals are always having a distant relationship with their partners . The social media management has become a very much common form of place for having the hard time that are been live without any concerns. The websites are been intended for connecting the people that are been splitting them up (Trainor et al., 2014). It has been observed that nearly about the cases that involves the elements of the mind that are been mined from the social networking sites. Nowadays it has been a common form in the recent years that everyone around the world has created the tradition of dating in the online forum. In the recent years, it has been seen that the youth is very much comfortable for the use of the online medium for knowing people and also dating. The Tinder and the other sites are there for connecting two people to have a romantic form of relationships (Utz Breuer, 2017). On a recent survey, many individuals have noticed that they have made platonic form of friends and also professional contacts for the through these sites. However, it has also been found that one single mother have also stated that she has expanded her areas of friendship through Tinder. However, many individuals have reported that they have encountered their romantic dalliances with the help of the social networking site especially through twitter. They have also ensured that it is a good form of platform for the like the lively situation in their lives (Fikkers et al., 2013). Therefore, it is very much evident that there are the habit of using of the social media definitely has a myriad of positive form of impact on building the relationships. References Andreassen, C. S., Pallesen, S., Griffiths, M. D. (2017). The relationship between addictive use of social media, narcissism, and self-esteem: Findings from a large national survey.Addictive Behaviors,64, 287-293. Fikkers, K. M., Piotrowski, J. T., Weeda, W. D., Vossen, H. G., Valkenburg, P. M. (2013). Double dose: High family conflict enhances the effect of media violence exposure on adolescents aggression.Societies,3(3), 280-292. Hudson, S., Roth, M. S., Madden, T. J., Hudson, R. (2015). The effects of social media on emotions, brand relationship quality, and word of mouth: An empirical study of music festival attendees. Tourism Management,47, 68-76. Mathews, A. (2016). Media Bias: How Much Does it Hurt or Help the Media-Public Relationship?. Trainor, K. J., Andzulis, J. M., Rapp, A., Agnihotri, R. (2014). Social media technology usage and customer relationship performance: A capabilities-based examination of social CRM.Journal of Business Research,67(6), 1201-1208. Utz, S., Breuer, J. (2017). The Relationship Between Use of Social Network Sites, Online Social Support, and Well-Being.Journal of Media Psychology.

Genetic Essays (825 words) - Molecular Biology,

Genetic Engineering For many years, man has been advancing his race through technology. Many things through those were questionable and questionable, but none are close to a certain technology today. And that would be genetic engineering. What exactly is genetic engineering? To put it shortly, it is where scientists splice, alter, and manipulate genes of one thing to how the scientist want it, and even insert that gene into a foreign host. This technological tool is too powerful for us to handle. It is advancing faster than we can expect. Because of this fact, genetic engineering raises many moral and ethical issues while also showing signs of many dangers. This controversially technology could be looked at two ways, one religiously and the other, scientifically and economically. First, let's talk a religious point of view on genetic engineering. With the current knowledge we have today in genetic engineering, life can easily be created and manipulated to one's liking. How can one "Play God" by creating and altering life at one's will and not at all feel guilty? Haven't we learned that trying to be on a level as God is a punishable act? Such examples are ones such as the destruction of Babylon. People at that time tried to build a tower high enough to reach God, but it was destroyed, a punishment by God that warned us of what will happen if we tried to get powerful as him. People say that God gave us the knowledge to discover. If this is so, did God give us the knowledge to make the atom bomb so we could wipe out cities and vast lives in an instant? Did God give us the knowledge to make deadly biological weapons to kill each other with? And did God give us the knowledge to be so advance in warfare today that the world could be destroyed in minutes? God did not give us the knowledge to do these things or for genetic engineering. Man ignorantly chooses his own way and chooses to venture out doing things that are wrong. So who are we to decide what sex a baby should be, how it should look, and what skills it might have? These are just few of the many questions raised in a religious point of view. Next, is the scientific and economical view. One goal of genetic engineering is to make products more efficient. Things such as crops and other plants are one of the things that have been experimented on and even released into the environment. This is especially dangerous because scientists are not fully sure of what could go wrong. A genetically altered crop or plant could become dominant and take over all of the its like species and become a problem such as becoming major pests. There have been many cases where non-indigenous plants introduced into a different environment served no use and became major pest problems. But even more dangerous altered plants are genetically altered humans. The functions of all the genes are not known, only these of a very small percentage of the total genes in organisms such as humans. So why would a scientist take a risk, not knowing the full potential dangers it might cause, such as having an effect on other genes? Privacy is another major concern. What if a sing drop of a person's blood could reveal all the faults of that person? When will we wake up in a world where everyone has permanent records of what defect will come up in their lifetime and what other things they are susceptible of getting. What if insurance companies got hold of these records? Could people be refused of health insurance because of these facts? There are many examples where people have been refused of some health care because of genetic screening. Not only that, in a recent poll in Time magazine, a question was asked if a person whose genetic profile shows potential problems pay higher health-insurance rates than someone whose profile does not? Only 8 % answered yes while the majority 88% said no. Obviously even the majority of this nation does not want to be genetically profiled. One recent controversy that has come up is cloning. With some DNA of an organism, scientists are able to make and exact copy of that organism. A sheep and a monkey have already been successfully cloned, and with the current technology, humans could also be cloned. This raises the most ethical and moral issues because many questions would be raised about the clone.

The Napster Controversy essays

The Napster Controversy essays A year ago, the only people who knew the name Shawn Fanning were his friends, family, and college professors. This year, he's been written about in magazines, appeared on television, and can be recognized by his nickname, "Napster." Fanning created a program that allows users to download software that enables them to search for particular songs, and then, download them to their computers. This program, Napster, has gone under a major controversy that affects many people around the world. The Recording Industry Association of America (RIAA) has sued Napster, claiming the website and Fanning's program are assisting the theft of intellectual property. Dave Mathew from the Dave Matthews Band, referring to his bands recent Featured Music Promotion with Napster, stated, "Napster: It is the future, in my opinion. That's the way music is going to be communicated around the world. The most important thing now is to embrace it, and that was the spirit by which we did this co-promotion. Napster is the world's leading file sharing community. In terms of users, the Napster site is the fastest growing in history. Napster claims more than 50 million users (Stepp, 2001). Napster's software application enables users to trace and share media files from one convenient, easy-to-use interface. In addition, it provides media fans a forum to communicate their interests and tastes with one another via instant messaging, chat rooms, and Hot List user bookmarks. Since the beginning of Napster, album sells have increased. So, why are the music industries complaining? (Napster, 2001). Federal appeals court ruled on February 12, 2001, that the music-swapping service Napster must stop trading in copyrighted material and may be held liable for "vicarious copyright infringement." As said by the 9th U.S. Circuit Court of Appeals, Napster, must prevent users from gaining access to copyrighted content through its lists of songs archived b...

In House Payroll or Outsourcing Payroll Essay Example | Topics and Well Written Essays - 3000 words

In House Payroll or Outsourcing Payroll - Essay Example The identifying of two alternatives for pay roll administering was done and the recommendations for picking up one were done according to the needs of the management of NB enterprises. Recommendations were made keeping in view the size of the NB enterprises. The requirements for the option chosen were also mentioned with time bound plan to execute the decision taken. What is Pay roll: Payroll can be termed as a list of employees who receive regular pay from the organization. It is a system through which the employees of an organization are paid. The salary structure, schedules of tax, benefits, allowances, pay frequency and pay dates are the internal parts of the payroll structure If the system is computerized it can be understood as the process that was used by a company to process and pay the salaries of the workers and employees. 1 Identification of two alternatives for maintaining the pay rolls: The pay roll administration can be done in two different ways. First one is to have a payroll Unit in the company which administers over the payments of the employees and prepares the lists regarding the pays and advances. The other method is to outsource all the activities regarding the payments and advances of the employees to company which offers computerised pay roll administration. The outsourcing company renders the needed services as a final output, which depends on the information supplied by the company. According to Vanessa Robinson1 a resourcing adviser, the outsourcing of Pay rolls will give more time to HR personnel to concentrate more on the strategic roles that increase or enhance the performance of the organisation. Some of the advantages are listed as follows: 1. It may reduce costs, but the cost benefit must be analysed by cost effectiveness of other processes. 2. There is a chance to outsource the work to a company having higher expertise in the field of pay roll work. 3. The values of HR can be increased by decreasing the burden of pay roll from the department. The HR department can concentrate more on policy and decision making. 4. The rapid growth in organisation is capable of leaving HR department in a freezing position. This situation can be avoided by outsourcing the pay roll to a payroll bureau. The precautions that should be followed and the disadvantages in outsourcing the pay roll work. 1. The need of outsourcing must be identified accurately. The functions that are suitable for outsourcing differ from company to company. 2. The foremost thing is estimating the cost effectiveness of the outsourcing. If it is not cost effective, it is better to rethink about it. 3. Along with pay roll, some other services like tax effectiveness also must be outsourced in case of outsourcing of pay roll. 4. The level up to which the service has to be outsourced must be estimated accurately. 5. The information supplied to the company to which we outsource the work must be accurate to ensure that the output will be correct. 6. The cost of the service and the time for the services are offered for that price should also be mentioned in the pact. 7. The time allotted to the outsourcing process should be significant to avoid the negligence of staff/manager relationships. Disadvantages of outsourcing the pay roll The details of expenditure on salary and tax encumbrances will be revealed to others. The policy decisions that are taken to avoid tax restrictions on pay rolls must be conveyed to the company. Though the process

School Finance Essay Example | Topics and Well Written Essays - 1000 words

School Finance - Essay Example In fact, a 1993 circuit court of Cole County opined that "The existing school finance system does not provide an 'equal ... opportunity' for all school age children as is required by ... the Missouri Constitution" (Committee for Educational Equity v. Missouri, 1993, p. 29). As described in the decision, "various statistical measures confirm the degree and extent of these wide inequalities" (p. 13) and "All relevant standard measures of equity ... clearly and consistently indicate that Missouri funding for its public schools is highly disequalized and is getting worse" (p. 15)"(Wan Ko, 2006).This court decision instructs that the school must revise its financing policies. The court wants that school finances should be EQUALLY allocated to all children irregardless of race, religion, sex, etc. This new financing policy introduces a new hold harmless provision. Hold harmless schools clearly receive more than the normal monetary help than other schools receive. As a result, these hold ha rmless school districts give more accurate equity analysis for evaluating the state's policy impact. this study of the Missouri school finance system shows that there was an improvement in the Missouri school's finance equity under the new funding formula. However, there were times when financial help did not arrive as schedule or came only in trickles. One reason is that the monetary help had come from other sources and not from the newly approved funding schemes. Evidently, this article shows that schools need money in order to deliver high quality education to the students(Wan Ko, 2006). II. A Helping Hand: A Federal Grant Program Gives School Districts the Financial Support The Need to Develop Updated, Comprehensive Disaster Plans. The article mentions how tornadoes ravaged several towns in Missouri. The tornadoes literally scattered some elementary school buildings in the community. In Caulfied, MO, a tornado killed a seven year old girl named Elizabeth Croney. Likewise, a school in Derby, KS had to close down to allow police officers to corner and arrest an armed criminal in front the the school's premises. Many of the schools are not accustomed to confronting increasing threats from many quarters. The dangers include natural disasters, street gangs and terrorists. Many of the schools' administrators and responsible personnel underwent emergency disaster training to counter the effects of any emergency. The Department of Education's office of safe and drug -free schools spearheaded this campaign to help schools be more prepared to alleviate any emergency. In turn, the schools would be given REMS funds that would be used for the schools' disaster awareness and readiness program. The United States government has focused on school disaster preparedness programs in response to the infamous September eleven twin tower airline hijacking incidents as well as the ramming of a commandeered passenger plane onto the Pentagon. For, "If you think back to 9/11, there were a lot of lessons learned from that incident," according to Sara Strizzi, who is a program analyst for the DoE in Washington, DC. One of those lessons was the vulnerability of K-12 campuses. "We realized that within the ground zero vicinity, there were a lot of schools close by."(Bowles, 2007). Here, the government of

Non Medical Independent And Supplementary Prescribing V300 Nursing Essay

Non Medical Independent And Supplementary Prescribing V300 Nursing Essay This essay discusses the evolution of nurse prescribing in the context of legislation and political element, with the consideration of how this has changed and assisted the clinical nurse specialist role, with particularly emphasis on Heart failure. The pathophysiology of heart failure will be discussed and integrated into the relation of drug actions with particular interest into Diuretics. Alongside this; the importance of effective history taking, assessment and consultation skills to treat the patient accurately and at a high standard and quality is discussed. The decision making process and the importance of a shared approach in relation to heart failure is highlighted incorporating the importance of compliance in the maximising the treatment of heart failure. Sources of information and decision support systems that are available will be highlighted with a discussion on the importance of these in principles. Demonstration of ability to prescribe safely, rationally, cost effectively, and in consideration of the public health issues around medicine use are discussed and finally clinical governance through quality assurance and audit of prescribing practice is considered. For the purpose of the essay the following learning outcomes are discussed: Evaluate understanding and application of the relevant legislation and political context of the practice of non-medical prescribing Critically appraise sources of information/advice and decision support systems in prescribing practice and apply the principles of evidence based practice to decision making. Integrate and apply knowledge of drug actions in relation to pathophysiology of the condition being treated Demonstrate the ability to prescribe safely, rationally, cost effectively, and in consideration of the public health issues around medicines use Integrate a shared approach to decision making taking account of patients/carers wishes, values, religion or culture Evaluate effective history taking, assessment and consultation skills with patients/clients, parents and carers to inform working /differential diagnosis. Contribute to clinical governance through quality assurance and audit of prscribing practice and regular continuing professional development The controls of medicines in the UK has undergone a number of regulatory changes since the end of 1800s, climaxing in the Medicines Act (1968). Prior to 1992, doctors, veterinary surgeons and dentists were the only professions legally permitted to prescribe. This situation made the medical profession gatekeepers for medicines, certainly the case for those medicines considered more likely to cause harm or abuse such as controlled drugs i.e. morphine. Cumberledge Report (1986) identified the need for community nurses to prescribe, The Crown Report (1989) published findings of a review to determine the circumstances in which non-medical health professionals could undertake new roles with regard to prescribing, supply and administration of medicines and led to the development of protocols which we now know as Patient Group Directives (PGDs). The Crown Report (1999) recommended that legal authority to prescribe should be extended to include new groups of healthcare professionals, this also bought about the differentiation between Independent and Supplementary prescribers. This report noted that a doctor often rubber stamps a prescribing decision taken by a nurse, which is demeaning to nurses and doctors. (Cooper et al,2008) The Medicinal Products Act (1992) permitted qualified District Nurses and Health Visitors to independently prescribe, and this was only a limited number of medicines from a Community Practitioners Formulary. Over the next few years legislative changes occurred which involved, non community qualified nurses to train as prescribers, together with an increase in medications added to the Nurses Formulary. In 2003, nurses and Pharmacists were permitted to prescribe from the whole of the British National Formulary (BNF) as supplementary Prescribers, except controlled and unlicensed drugs. Controlled Drugs were prescribable by nurses and pharmacists using supplementary prescribing from 2005. During this time other allied Healthcare professionals such as physiotherapists, Radiographers, Podiatrists and optometrists were also able to become supplementary prescribers. (DOH, 2005) These rapid changes in the development of non medical prescribers in the United Kingdom were a contrast to the gradual introduction to prescribing rights in the United States of America. (Armstrong,1995). The UK now has the most extended non medical prescribing rights in the world. (Armstrong, 1995) In 2006, DOH (2006) permitted trained nurses and pharmacists to independently prescribe all medicines within their clinical competence. The most recent changes have occurred to the Misuse of Drugs Regulations (2012) which now means that appropriately qualified nurses and pharmacists will be able to prescribe controlled drugs like morphine, diamorphine and prescription strength co-codamol. Currently there are more than 50,000 Non medical prescribers in the UK, around 19,000 nurses and almost 2,000 pharmacists are qualified as Independent and/or supplementary prescribers (Carey, 2011) The changing legislation of Non medical Prescribers has changed alongside with the environment of the NHS services. This is recognised in the guide produced by NMC (2010) stating that the services delivered by the NHS become more challenging and complex as there is an ever increasing need for improved productivity without the compromising of quality. Coronary Heart disease, puts great pressure and demands on the National Health Service (NHS). Hospital admissions for Chronic heart failure have increased markedly, chronic heart failure accounts for about 5% of all medical admissions and approximately 2% of total health care expenditure. Despite improvements in medical management, under treatment for heart failure is still common. (Mcmurray et al, 2002) In 2002, The British Heart Foundation (BHF) piloted a scheme and funded with the help of Big Lottery Fund ninety two Heart failure nurses throughout the United Kingdom. The results were shown in the final report BHF (2008) showing an average reduction in heart failure admissions of 43% and an average estimated saving, per heart failure patient of  £1, 826. Increasing the role of the Non medical prescribers therefore increasing the skills and knowledge of nurses/pharmacists only enhances the vital role within the field these nurses have in todays current fight to provide the highest quality care possible. It has been shown that registered nurses are extending their roles and responsibilities to work in new ways (Furlong + smith, 2005). Crowther et al (2003), Gattis et al (1999), Paniagua (2011) Lambrinou et al (2012) and Jaarsma (2010) have all shown that Heart failure nurse specialists are optimal providers to assist physicians with Heart failure care for this complex and time-consuming patient population. The management of heart failure is complex involving both pharmacological treatments and strategies to improve patients functional status and quality of life (Palmer et al, 2003) Heart failure can be defined as an abnormality of cardiac structure or function leading to failure of the heart to deliver oxygen at a rate commensurate with the requirements of the metabolizing tissues. (ESC, 2012) Clinically patients present with typical symptoms; breathlessness, ankle swelling and fatigue. And signs; elevated JVP, pulmonary crackles and displaced apex beat. Diagnosis of heart failure relies on a detailed history and accurate physical examination (NICE, 2010). These symptoms can be related to either a reduction of cardiac ourput (fatigue) or to excess fluid retention (dysapnea, orthopnea and cardiac wheezing) fluid retention also results in peripheral oedema and occasionally an increasing abdominal girth secondary to ascites. Symptoms and signs are often non-specific and could be related to other conditions. Knowledge on the use of other diagnostic services is necessary: Echocardiography, Electrograph, Chest Xray, Blood tests all contribute to the confirmation of diagnosis. Case study One demonstrates a typical presentation of a patient presenting with first presentation of heart failure symptoms; typically compromised and in need of expert medical treatment; Pharmacological and non pharmacological therapies. This patient presented with clear signs of congestion and volume retention of which a diuretic therapy plays a central role in the treatment (Felker and Mentz, 2012) As the heart fails, there is a reduction in both blood pressure and cardiac output, in response to this the body conserves water which results in oedema. Diuretics act at different sites of the kidneys, they then eliminate sodium and water through enhanced excretion from the kidneys so are able to relieve the symptoms of fluid congestion. Different classes of diuretics work at different points within the kidney tubules. (Davies et al, 2000) Appendix two shows the diuretics available. This patient was treated with Furosemide intravenously (IV), most patients receive a loop diuretic as first line treatment for heart failure (Faris et al, 2012.) Loop diuretics are the most frequently used diuretic in treatment of Chronic heart failure despite their unproven effect on survival, their indisputable efficacy in relieving congestive symptoms makes them first line therapy for most patients. (Bruyne, 2003) Appendix three shows how loop diuretics work. As already stated first line treatment for acute decompensated heart failure is intravenous diuretic therapy either as a bolus or via continuous infusion. Despite being available for decades, few randomized trials exist to guide dosing and administration of this drug. In 2011, the Diuretic Optimization Strategies Evaluation (DOSE) trial used a prospective, randomized design to compare bolus versus continuous infusion of IV furosemide, as well as high-dose versus low-dose therapy. The study found no difference in the primary end point for continuous versus bolus infusion. High-dose diuretics were more effective than low dose without clinically important negative effects on renal function. Although no difference was found between IV and bolus dose there are benefits to both elements so clinical judgement would be made on the specific patient needs and requirements, for example, immobilization, duration of therapy requirements, haemodynamic status. The aim of using diuretics is to achie ve and maintain euvolaemia (the patients dry weight with the lowest achieveable dose. (ESC, 2012). Case study two identifies a patient whom is another example of heart failure but offers a different presentation; this accentuates the importance of a careful physical examination and valuable accurate history taking. The absent breathe sounds over the right base of lung field along with the history was an indication of pleural effusion and initiated the prescription of a radiograph chest to be performed. Absent or diminished breath sounds strongly suggest an effusion (Kalantri et al, 2007) unfortunately Congestive heart failure is the most common cause of a pleural effusion. (Enrique, 2008) Again, Pleural effusions from heart failure are managed with diuretic therapy, initially with a loop diuretic, intravenously titrated in response to clinical signs, daily weights and renal function to avoid excessive volume depletion. (Light, 2002) Non-compliance in patients with heart failure (HF) contributes to worsening HF symptoms and may lead to hospitalization. (Van der wal, 2006). Using skills that were taught during basic nursing training is imperative in conducting a beneficial and effective clinical examination, these interpersonal skills may dictate how the patient and carers perceive and acknowledge there diagnosis and may have an influence on the approach the patient has on his/her own health. Over the past 3 decades, the biopsychosocial model of health has become increasingly important in the effective practice of medicine. Central to this model is an emphasis on treating the patient as a whole person, including the biological, psychological, behavioral, and social aspects of their health (Engel, 1980). The American Heart Association (AHA) in collaboration with other professional societies has issued a new scientific statement for the management of patients with advanced heart failure. It emphasizes shared decision making and is designed to help physicians and other health professionals align medical treatment options with the wishes of the patients. Allen (2012) recognises the complexity of heart failure and complexity of the treatment options can be a barrier to shared decision making, but this only emphasizes why such a patient-centred approach should be undertaken in Advanced heart failure. Shared decision making has received particular emphasis in relation to the pre scribing of drug treatments. Traditionally, studies have identified 50% of patients with chronic conditions do not take their treatment as prescribed, with major reasons being because they do not share the doctors views, or they are worried about side effects. (REF QUOTE?) Therefore the aim is to explore these issues by adopting a shared decision making approach and reach a concordance between doctor and patients. Therefore getting patients involved in the planning and management of care, being sensitive to the individuals need, spending time figuring out what is important to them, will hopefully reduce some of the confusion and complexities concerning heart failure. Although knowledge alone does not insure compliance, patients can only comply when they possess some minimal level of knowledge about the disease and the health care regimen. (Van der wal, 2006). The National Prescribing Centre (2012) designed a competency framework which can be seen in appendix 3. One of the three domains is the consultation which highlights three areas of importance 1; Knowledge; pharmacological and pharmaceutical. 2; Options; concerning the diagnosis and management 3; Competency; involving shared decision making with parents, patients and carers. The data is clear that for the benefit of the patient and success with the treatment regimen it is vital to consider wishes of the patient/carer, ethical, cultural opinions, lifestyle of the patients. Also contributing factors which may cause non-complicance whether intentional or not for example: polypharmacy, complicated dose regimens, unpleasant side effects, and cognitive problems or physical disability preventing the patient taking the medicines. A large number of factors need to be incorporated into the thought process prior to getting to the point and writing a prescription. Surrounding issues that directly and indirectly support patient orientated prescribing Sources of information are on number of levels. In a hospital ward, for example, immediate sources of information include the British National Formulary (BNF) and ward pharmacist. The role of both is, at least in part, to assist in ensuring that, for any prescription, the correct dose and timing of administration are correct and appropriate for the indication. The BNF is widely available and accessible and can and should be used to assist in prescribing whenever there is any doubt about dose and timing. The Pharmacist provides an additional safety netting, by checking prescriptions before providing the medications. In addition, the pharmacists role includes ensuring that medications prescribed are available for administration. Further afield, but still within the hospital, local policies give guidance on what drugs are available and recommended for a particular indication. These policies may be produced by the hospital or by regional bodies, including SHA, Network PCTs, for example, local arrangement may mean that a particular statin is used for primary prevention of coronary heart disease, due to local procurement agreements or cost effectiveness analyses. Beyond the hospital setting, a number of sources provide guidance on what should actually be prescribed, or considered, for a given condition. Such sources might include national bodies, in particular National institute of clinical excellence (NICE) and specialist societies. The latter may be national and or international. For example, in the field of heart failure, NICE has given guidance on what medications should be administered and at what stage of the disease and symptoms. For all patients ACEI: should be given. There are many different ACE I. The guidelines recommend using only those which have actually been proven to be of benefit in heart failure; these [emailprotected]@@@@@@. For those who are intolerant of ACE; ARB should be used. Again, NICE recommends thoses that have shown efficacy in clinical trials, and these [emailprotected]@@@@@@. Beta-blockers are recommened but not any betablocker. Only those with proven @@@ in heart failure should be used; these are Aldosterone A ntagonists should also be used for patients with advanced heart failure (NYHA III/IV). Guidance recommends spironolactone, or eplernone if not tolerated (most usually due to gynaenomastia in men) From the above, it may be seen that the National guidance indicates which drugs from each class should be considered for each purpose. This leaves room for local policies and prescribers to decide which of the available agents is suitable for a particular individual. Pursuing the example of heart failure further, international guidelines are issued by a number of bodies. The principle of these is the European Society of Cardiology (ESC) and the American College of Cardiology (ACC) and the American Heart Association (AHA). Of these, the ESC guidelines are most applicable to the United Kingdom. Societal guidelines tend to focus more on a particular disease and the available evidence to provide best treatment, whereas NICE guidelines have greater emphasis on appraisal of cost-effectiveness, which is of greater relevance to the local health economy in the UK. Furthermore, ESC guidelines give a strength of recommendation for a particular treatment (Class I, IIa, IIb) and an indication of the level of evidence behind the recommendation. (A, B, C) Ultimately, the source of information which informs societal guidelines comes from research, in the form of clinical trials, performed on the back of pre-clinical research. Therefore, the doses of drugs which are recommended for use usually reflects the dose and frequency of a drug or used in a clinical trial which demonstrated benefit. There are therefore numerous levels of information and advice which support prescribing practice. For many conditions, these are ultimately based on evidence derived from clinical trials, in some areas these will be the gold standard RCT. However, some trials provide softer evidence, such as observations data or even anecdotal. Understanding of these various trials and guidelines is important to understanding how local guidelines and daily prescribing practice come about and are supported by evidence. The trials/guidelines all mentioned above have provided convincing evidence that clinically significant improvements can be achieved in heart failure by appropriate drug treatment. Moynihan et al (2002) recognises that the adoption of more effective and/or safer drugs, new technologies are usually more expensive, aging of the population leads to increased morbidity and drug therapy, all play a role in increasing drug expenditure. Medicines are regarded an expenditure, but can also be an investment, if they are used rationally. Rational prescribing means cost effective use of safe and effective drugs. Specialist clinics for heart failure are a tool for delivering care according to clinical guidelines and providing diagnostic treatment. They provide optimal management of the condition, education of patient and carers about the signs and symptoms of worsening disease and medication compliance. Advances in medication and technology for heart failure are vast, which again strengthens the need and importance of such clinics to enable patient treatment to change accordingly and appropriately. Studies have shown that if patients are treated by Cardiology clinicians or Heart failure specialist nurses, clinical guidelines are more likely to be followed and readmission rates are lower for these patients. (Reis et al, 1997) An example of prescribing within heart failure is an investment for the patient and the NHS is the use of Angiotensin-converting enzyme inhibitors (ACE I). These have been shown to improve symptoms, survival and slow progression of heart failure. (Luzier et al, 1998). ACE I are one of the essential therapies for all heart failure patients, if tolerated. Treatment should be maximised and in maximising the dose quite often you can reduce or stop the use of loop diuretics due to improved symptoms and clinical signs. (Hoyt et al, 2001) Therefore patients who are appropriately treated and titrated to maximal therapy therefore benefit clinically, may reduce other medicines and they can overall reduce the chances of hospital admission with decompensated heart failure which is beneficial to the patient and the NHS finances. A recent study by Dharmarajan et al (2013) covering three million hospitalizations showed that more than a third of readmissions (within 30 days of discharge) were for heart failure. Their thought was that many of these could have been preventable, with greater input from pharmacists, physicians, nurse specialists, and greater consideration to social elements; reducing readmission also reduces other risks involved in exposing patients to hospitalization. The National Heart failure Audit (2012) conducted by NICOR is an audit to monitor progress, clinical findings and patient outcomes of patients with heart failure. It is an essential audit for each NHS trust to comply and complete. ++. It provides critical information on management and outcomes which then provides data essential to drive future improvements. Conclusion: CASE STUDY ONE Description of clinical setting: Patient was an inpatient on the Cardiology ward; he was admitted the day before and had been referred to Heart failure clinical nurse specialist for review. Case history: An 84 year old retired postman was admitted from home with progressive worsening shortness of breath over the last 6 weeks. He had been to see the General Practitioner two weeks ago who treated him for a chest infection with a course of oral antibiotics (Amoxycillin). He denies any chest pain, however he complains of palpitations at times of exertion and a productive cough. Patient had not experienced any syncope, dizzy spells; only other complaint was loss of appetite and poor quality sleep. Patient has been sleeping with 4 pillows, waking regularly due to struggling for breathe and resulted to sleeping in the chair downstairs. Exercise tolerance had drastically reduced to 50 metres before having to stop due to breathlessness. On examination the patient was tachypnoeic, pulse was 95 and regular, sitting blood pressure was 110/62 standing 105/55. Weight 97kg. Oxygen Saturations on air 94%. Inspiratory crackles were clearly heard on both lung bases, no heart murmur could be auscultated and apex beat was misplaced to the anterior auxiliary line. JVP was raised +4. Pitting peripheral oedema up to thighs and a large distended abdomen, which was soft and not tender on palpation. ECG confirmed Sinus tachycardia with Q waves in antero lateral leads. Chest x-ray also confirmed cardiomegaly and interstitial oedema. Drug treatment pre admission: Aspirin 75mg once a day (OD) Blood pressure control Past medical history: Anterior lateral Myocardial infarction 7 years ago (2005) followed by Angioplasty to the right coronary artery. No further operations or admission to hospital. Blood results: Chemistry: Sodium 128mmol/l, Potassium 4.8 mmol, Urea 9 mmol/l, Creatinine 145 mmol/l, LFTs, HB and clotting was all unremarkable. Echo: severe left ventricular dysfunction, with minor tricuspid regurgitation. Social background: Patient lives with wife in a two bedroom bungalow, they are both normally well and independant. He has no allergies and takes no over the counter medications or recreational drugs in the past or present. Drug chart to date in hospital: Aspirin 75mg OD Frusemide 80 mg OD Ramipril 2.5 mg OD Discussion: Patient was fortunate enough to have had Echocardiography that morning, which offered me the definitive diagnosis. This gentleman presents with a common clinical presentation of progressive systolic dysfunction of an ischemic cause. The patient was comfortable and stable enough for a steady and methodical examination and history taking. On construction of a management plan for this patient, clearly first line treatment is diuretic therapy, T Effective dieresis and consequent adjustment of the loading conditions of the failing heart is generally regarded as essential (Raftery, 1994) This patient went on to be prescribed Intravenous Diuretics, instructions for Daily weights, Fluid balance, advice and rehabilitation for heart failure. Then longer term plan for titration of Heart failure medications to achieve maximum therapy suitable for this patient. Allen, L.A., Stevenson, L.W., Grady, K.L., Goldstein, N.E., Matlock, D.D., Arnold, R.M., Cook, N.R., Felker, G.M., Francis, G.S., Hauptman, P.J., Havranek, E.P., Krumholz, H.M., Mancini, D., Riegel, B. and Spertus, J.A., for the American Heart Association; Council on Quality of Care and Outcomes Research; Council on Cardiovascular Nursing; Council on Clinical Cardiology; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Surgery and Anesthesia, 2012. Decision making in advanced heart failure: a scientific statement from the American Heart Association. Circulation, 125(15), pp.1928-1952. Armstrong, P., McCleary, K. J. and Munchus, G., 1995. Nurse practitioners in the USA their past, present and future. Some implications for the health care management delivery system. Health Manpower Management, 21(3), pp.3-10. Avery, A.J. and Pringle, M., 2005. Extended prescribing by UK nurses and pharmacists. British Medical Journal, 331, pp.1154-1155. Bruyne, L.K., 2003. Mechanisms and management of diuretic resistance in congestive heart failure. Postgraduate Medical Journal, 79(931), pp.268-271. Carey, N. and Stenner, K., 2011. Does non-medical prescribing make a difference to patients? Nursing Times, 107(26), pp.14-16. Cooper, R., Guillaume, L., Avery, T., Anderson, C., Bissell, P., Hutchinson, M., Lynn, J., Murphy, E., Ward, P. and Ratcliffe, J., 2008. Non medical prescribing in the United Kingdom: developments and stakeholder interests. Journal of Ambulatory Care Management, 31(3), pp.244-252. Crowther, M., 2003. Optimal management of outpatients with heart failure using advanced practice nurses in a hospital-based heart failure centre. Journal of the American Academy of Nurse Practitioners, 15, pp.260-265. Davies, M.K., Gibbs, C.R. and Lip, G.Y., 2000. ABC of heart failure. Management: diuretics, ACE inhibitors and nitrates. British Medical Journal, 320(7232), pp.428-431. Department of Health and Social Security, 1986. Neighbourhood nursing a focus for care (Cumberledge report) London, HMSO. Department of Health, 1989. Report of the Advisory Group on Nurse Prescribing (Crown report) London, HMSO. Department of Health, 2000. National Service Framework for Coronary Heart Disease. London, HMSO. Department of Health, 2005. Supplementary prescribing by nurses, pharmacists, chiropodists/podiatrists, physiotherapists and radiographers within the NHS in England. A guide for implementation. London, HMSO. Department of Health, 2006. Improving patient access to medicines: A guide to implementing Nurse and Pharmacists independent prescribing within the NHS in England. London, HMSO. Dharmarajan, K., Hsieh, A.F., Lin, Z., Bueno, H., Ross, J.S., Horwitz, L.I., Barreto-Filho, J.A., Kim, N., Bernheim, S.M., Suter, L.G., Drye, E.E. and Krumholz, H.M., 2013. Diagnosis and timing of 30 day readmissions after hospitalization for heart failure, acute myocardial infarction, or pneumonia. Journal of American Medical Association, 309, pp.355-363. Diaz-Guzman, E. and Budev, M., 2008. Accuracy of the physical examination in evaluating pleural effusion. Cleveland Clinic Journal of Medicine, 75(4), pp.297-303. Faris, R.F., Flather, M., Purcell, H., Poole-Wilson, P.A. and Coats, A.J., 2012. Diuretics for heart failure. Cochrane Database of Systematic Reviews, Issue 2. Art. No.: CD003838. DOI: 10.1002/14651858.CD003838.pub3. Felker, G.M., Lee, K.L., Bull, D.A., Redfield, M.M., Stevenson, L.W., Goldsmith, S.R., LeWinter, M.M., Deswal, A., Rouleau, J.L., Ofili, E.O., Anstrom, K.J., Hernandez, A.F., McNulty, S.E., Velazquez, E.J., Kfoury, A.G., Chen, H.H., Givertz, M.M., Semigran, M.J., Bart, B.A., Mascette, A.M., Braunwald, E., OConnor, C.M., for the NHLBI Heart Failure Clinical Research Network, 2011. New England Journal of Medicine, 364(9), pp.797-805. Felker, G.M. and Mentz, R.J., 2012. Diuretics and ultrafiltration in acute decompensated Heart failure. Journal of the American College of Cardiology, 59(24), pp.2145-53. Furlong, E. and Smith, R., 2005. Advanced nursing practice. Policy, education and role development. Journal of Clinical Nursing, 14, pp.1059-1066. Gattis, W.S., Hasselbied., V., Whellan, D.J. and OConnor, C.M., 1999. Reduction in heart failure events by the addition of a clinical pharmacist to the heart failure management team. Archives of Internal Medicine, 159, pp.1939-1945. Hawkins, N.M., Petrie, M.C., Jhund, P.S., Chalmers, G.W., Dunn, F.G. and McMurray, J.J., 2009. Heart failure and chronic obstructive pulmonary disease: diagnostic pitfalls and epidemiology. European Journal of Heart Failure, 11, pp.130-139. Hoyt, R.E. and Bowling, L.S. 2001. Reducing readmission for congestive heart failure American Family Physician, 63(8), pp.1593-1598. Hunt, S.A., Baker, D.W., Chin, M.H., Cinquegrani, M.P., Feldman, A.M., Francis, G.S., Ganiats, T.G., Goldstein, S., Gregoratos, G., Jessup, M.L., Noble, R.J., Packer, M., Silver, M.A., Stevenson, L.W., Gibbons, R.J., Antman, E.M., Alpert, J.S., Faxon, D.P., Fuster, V., Gregoratos, G., Jacobs, A.K., Hiratzka, L.F., Russell, R.O. and Smith, S.C. Jr; American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1995 Guidelines for the Evaluation and Management of Heart Failure); International Society for Heart and Lung Transplantation; Heart Failure Society of America, 2001. ACC/AHA Guidelines for the evaluation and management of chronic heart failure in the adult: Executive Summary. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1995 Guidelines for the Evaluation and Management of Heart Failure): Developed in collaboration with the International S ociety for Heart and Lung Transplantation; Endorsed by the Heart Failure Society of America. Circulation, 104(24), pp.2996-3007. Jaarsma, T., 2010. Multidisciplinary approach in heart failure: evidence, experiences and challenges. Journal of Cardiac Failure, 16(9), pp.1071-9164. Kalantri, S., Joshi, R. and Lokhande, T., 2007.

Comparison Of Tones Used By Ph :: essays research papers

Two of the most well known black writers that were for the abolishnist movement in America were Frederik Douglass and Phillis Wheatley. At a time when a literate Negro would have only existed in a nightmare and when even the majority of the white women in the country were illiterate, these two authors of distinguished valor managed to write literature and recite speeches that inspired some of the most impenetrable minds to change their ways of thinking. Wheatley would move her readers with her subtle, yet powerful literature while Douglass would do the same with his powerful use of words. Phillis Wheatley was one of the more passive abolishionist writers. Because she was a slave and she was aware of her position in society as opposed to the whites, she knew that enfuriating her audience was the wisest thing to do. When criticizing slavery she chose her words very wisely. In her poem â€Å"On Being Brought from Africa to America,† for example, she does not blatantly protest about slavery and call her readers savages like Douglass would do. Instead she and realized has realized her position in serialized her position in society as a slave and In her literature she criticizes slavery through rli Although, Phillis Wheatley was an abolishnist writer, she passive than a lot of her literature didn’t always reflect. At first glance it would For a man going against a legion of non-followers, Frederik Douglass held nothing back. Wheatley, Unlike unFor an abolishnist writer, one must and Although they both took very diifrent approaches very, but also managed to get their works published. Wheatley would move the crowed inspire authors wrote poetry ab it was a forbidden for a Negros to learn how to read black to learn how to read andbeing literate being illeterate was law for blacks, and women ere being illetarate for Wheatley and Douglass wroteAt a time where it was forbidden for a Negro to learn how to read and even majority of the white women couldn’t read, Phillis and Wheatley were writing verses that were so powerful wthese two authors, managed to recite speeches and write sonnets to get to

Starbucks Internationalization in Recent Years

With the first coffee shop opened in Sydney CBD, Starbucks entered into Australian market in July of 2000 and then expanded rapidly to 85 coffee shops in the following years. However, in August of 2008, Starbucks Coffee Company Australia announced to shut down more than 60 of its 85 coffee shops and to date it has scaled down to 22 opened in Sydney, Brisbane, the Gold Coast, the Sunshine Coast and Melbourne (Starbucks 2010).This writing will focus on the analysis on the attributes of Starbucks’ products and marketing, and identify the opportunities and threats facing the Starbucks Australia. The second part of the analysis also draws attention to the changes in social economy, competitors’ move and the main trends in the hot drink market. Based on the findings, recommendations are offered, aiming to help Starbucks gain competitive advantages in Australian marketplace and long run sustainability in a larger social context.In terms of coffee products and service quality, the cafe market in Australia is extremely mature and competitive. It is understandable that consumers’ expectation towards the newly-introduced coffee brand has been exalted high, especially when they are charged with premium price (Marketing Lessons 2010). However, the exotic coffee brand does not bring specialty to the local coffee culture as expected, the consuming experience stay mediocre. Meanwhile, products do not suit Australians' coffee tastes (Marketing Lessons 2010).Starbucks’ positioning in Australian cafe market has departed from the consuming needs and patterns of the local customers. Dismantled with the uniqueness it possessed and its success in the US and other Asian countries, Starbucks Australia seems to be as ordinary as one of the numerous choices for customers in Australia (Coffee Break and review 2008), and people never genuinely felt the necessity to go to a Starbucks shop. Evidently, Starbucks overestimates its points of difference, as well as th e customer-perceived value of its services (Marketing Lessons 2010).To compete out in Australian Cafe market, Starbucks needs to find new ways of creating competitive advantage to differentiate itself from local market competitors. What could make Starbucks special? It could be the menu including items catering customers’ special needs in coffee tastes, or the store environment which makes customer feel comfortable to sit in and enjoy the time, or the excellent service offered by people. Or it could be the combination of all the specialties makes the consuming experience unique.Datamonitor (2010) points out that the core competence of Starbucks is the quality of products. However, it is far from enough, because the best coffee and best equipment in the world could only make 20 percent of success, just as Ed Charles (2007) describes that success of product and service is 80 percent due to the performance of staff, and they must be trained to perform at their best both on produ cts and service to maximize the perceived value of customer.More specifically, customers’ perceived value is related to both tangible benefits such as price, product quality, service, convenience and price, as well as intangible benefits concerning reputation, aesthetics, social and emotional needs like self-enhancement and sensory pleasure needs. Quality service performed by staff could highlight both tangible and intangible benefits of customers. The attributes of the quality service in coffee shop can be demonstrated by thinking of the best consuming experience you could ever imagine.When entering a clean, well-furnished coffee shop with attractive decoration and cozy ambience, customers are recognized by friendly employees and greeted by own names. Order is made in an attentive manner, and fulfilled accurately and timely. Coffees with appealing aroma are served at moderate temperature and they are great and unique in taste. Market players could acquire some of the attribu tes depicted in the scenario to survive in the marketplace and their service quality varies depending on the competency of the service staff.What customers need is consistent quality services, which is discovered in the report by Chen and Hu (2010) that if customers feel confident that they can have a consistent quality consumption experience each time they come, they tend to choose the same coffee shop to enjoy their coffee. And such favorable attitude towards the service they have received could evolve into customer loyalty, since the essence of customer loyalty is, as Barnes (2001) depicts, â€Å"all about how you make them feel†, vice versa.Customer loyalty may result in consistent purchasing behavior of the brand over time. Therefore, it could be concluded that the all-round quality service performed by staff with high consistency could be the competitive advantage of Starbucks, which can make it special and achieve long run sustainability in Australian market. In light of this finding, Starbucks Australia should devote more efforts to human resources management. More specifically, a series of human resource practice could be designed and implemented to strategically improve employees’ competency and working attitude.For example, staff training could help them be more competent to perform all tasks involved up to standards and with high consistency and staff motivation could boost morale and let them know what is expected of them in a quite specific way. Both staff training and motivation could increase employees’ satisfaction to the extent that they are willing to exert effort to perform the service well and taking initiative to improve the service quality. It is supported by a study that a 5 percent increase in staff satisfaction can result in 1. 3 percent increase in customer satisfaction (Kleinman 2007).By improving the service performance of each staff, which is as Kleinman (2007) defined ‘employee-centered outcome’, Starbucks could achieve higher customer satisfaction, which is ‘organization-centered outcome’, and as the customer satisfaction accumulated and boosted, Starbucks would successfully deliver its positioning as ‘best coffee with premium service’ to the Australian market. And the company’s competitive advantage lies in its human resource management which includes a combination of human resource practice to increase employees’ competency and willingness to render consistent quality service to customers.Compared with the strategies which focus on price, menu and store environment, strategies on HRM would be less susceptible to imitation, since it is intangible and tacit and it is hard for competitors to know the exact HRM practices which could be replicated Additionally, the human resource management (HRM) practices should be facilitated with other non-HRM measures. For example, particular resources related to improving the service quality should be prioritized and allocated by the management to enhance the service performance.If Starbucks managed to acquire the quality service and achieve high customer satisfaction and loyalty through its competitive advantage in human resource management, it could have stayed profitable even during tough social economic condition and keep competitors away from its marketing territory. Since 2007, customer’s consuming confidence was dramatically decreased due to the economic recession and they spent money with more discretion as a result of or threatened by unemployment, bankruptcies and degraded credit. The decreased confidence of consuming caused the curbed spending which in turn resulted in pressure on the company's margins’ (Datamonitor 2010). Such tightening of consumers’ spending has encouraged defection. McDonald's, for instance, has already made small forays into providing decent coffee, and achieved some successes (Economist 2008). To retain customer, Starbuck s need to stress on premium service quality to achieve high customer satisfaction and further differentiate its products and service from McDonald’s, so that existing customers feel attached to the unique consuming experience in Starbucks and reluctant to defect.Although McDonald’s could offer decent coffee with a reasonable price, the premium consuming experience and series of HRM practice behind the strategy will be the major barriers for McDonald’s. Like most other coffee products, Starbucks' products contain caffeine, dairy, sugar and other active compounds. It is proved by public research that excessive consumption of these ingredients may lead to variety of health hazardous. The health issues are increasingly calling for public awareness and the public are suggested by doctors and experts to choose foods with discretion and reduce the frequency or quantity of intake.Such trends of food choice will reduce the demand of Starbucks’ beverage and food pr oduct (Datamonitor 2010). Noticeably, despite the threats from the health issues against the coffee products, a report by Parker (2005) reveals that the coffee demand in Australia will keep increasing from USD268. 57 million in 2006 to USD307. 13 million in 2011. This can be partly explained by the research (Luciano et al. 2005) that people’s preference to coffee beverage is genetic in Australia, and it is different from their preference to tea which is affected by the environment.It is understandable that although people’s consuming concept is becoming increasingly health-oriented, they still maintain their coffee-drinking habit. In this sense, Starbucks could retain the coffee demand by adding more decaffeinated coffee beverages and other coffee products incorporated with healthy components. The overall increase in coffee market could be seized if Starbucks manage to tune in the market trend by adjusting their coffee product structure.According to the research by Che n and Hu (2010), one of the attributes of the coffee industry is that it is highly competitive and homogenous in terms of services and products, and the availability of alternatives to the customers can be considered as an important attribute in decision making of purchasing. Therefore, Starbucks could offer a wide range of selection of coffee products as well as other beverages like tea and juices. This proposal of strategy could be justified by the finding that Wong (2010) mentions in her report.The culture of hot drinks in Australia has been evolved towards heath, and consumers are becoming mature while choosing the beverage in better taste as well as showing their preference toward premium products in both coffee and tea categories. The estimation by Datamonitor (2010) of the overall growth in the hot drink market in the next five years is 9. 1 percent, which will increase from AUD1350 million in 2008 to AUD1473million in 2013. Noticeably, the emerging tea market will increase b y 8. 1 percent, from AUD437million in 2008 to AUD473million in 2013.To optimize the profits, Starbucks could bank upon such trend and launch new products featured in tea category. Tea product can serve its market among the health conscious Australian consumers well in the next few years, due to its healthy and medicinal benefits. There is another marketing feature draws our attention. As discovered in the research by Luciano et al. (2005), women consume more beverages than men and show a lower preference for coffee than men, but higher preference for tea, which implies that the primary driving force for tea consumption is its appeal to women.This feature drives Starbucks to develop more tea products to cater for women’s preference in taste. By adding ingredients in women’s favor and making the beverage attractive in color and design, Starbucks just launched a series of tea products (Starbucks 2010) to attract more female customers. At the same time, Starbucks has creat ively combined the tea with coffee (Starbucks 2010) to create a product with specialty, which introduces a different way of enjoying coffee and tea product and also is an effective ay to surprise and delight their customers continuously. To be successful in the competitive Australian market, it is necessary for Starbucks to focus more on the human resource management practices to achieve sustainable and competitive advantages, which make their staff more capable and motivated to perform outstanding services with high consistency, so as to restore brand specialty in the marketplace. It is also important for Starbucks to be alert to all the changes in the market, as customers’ consuming habits and preferences in taste are always changing.The product structure, according to the market trends and new marketing strategies, should be adjusted to seize the opportunity facing the company. Just as Cairns put it in the report Starbucks (2008), the company needs to put the specialty to the market and grows with its customers. The winner could even proactively guide the market trends and foster the new consuming needs of customer to boost profitability. This requires the market player to be consistent in quality service performance but active and creative in marketing changes.

Definition and Examples of the Amelioration of Words