Parkinson Disease Essay Example for Free

Parkinson Disease Essay Parkinson disease is a gradually progressive degenerative disorder of the central nervous system. Parkinson disease belongs to a group of conditions called movement disorders. There are four characteristic problems caused by Parkinson disease, including tremor at rest, balance problems, stiffness, and slowness of movement. Parkinson disease occurs when areas of the brain, including an area called the substantia nigra, is slowly destroyed. The exact reason for this destruction is not completely known. In some patients, it may be due to genetic, environmental, or a combination of both causes. The end result is a deprivation in the brain of an important neurochemical, called dopamine. Dopamine helps regulate movement, and its loss leads to increased tone, rigidity, and slowness of movement. Lack of dopamine results in the symptoms associated with Parkinson disease . Approximately 50,000 Americans are diagnosed with Parkinson disease every year. 95% of those diagnosed are over 50 years old. At any given time, about 500,000 people, or 1% of those over age 50 in the US are struggling with this condition. Diagnosis of Parkinson disease is a clinical one, based on history and physical examination. There are no lab tests to definitively diagnose the condition. Your doctor will ask about your medical history and perform a thorough physical exam. A systematic neurological exam will include testing your reflexes and observing things like muscle strength throughout your body, coordination, balance, and other details of movement, including: * Muscle tone Rapid alternating movements * Gait, posture * Postural stability * Quickness and precision of movement * Observation of a tremor (during rest or activity) A mini mental status exam will be performed; questions pertaining to mood, thoughts, and behavior will be asked. Activities of daily living will be evaluated, such as dressing, cutting and eating food, swallowing, hygiene, walking, and falls. The exact cause of PD is unknown. It may have both genetic and environmental components. Some scientists think that viruses can trigger PD as well. Low levels of dopamine and norepinephrine, a substance that regulates dopamine, have been linked with PD. Abnormal proteins called Lewy bodies have also been found in the brains of people with PD. Scientists do not know what role, if any, Lewy bodies play a role in the development of PD. Certain groups of people have an increased risk of PD. Men are one and a half times more likely to get PD than women. Whites are more likely to get PD than African-Americans or Asians. PD usually appears between the ages of 50 and 60. It only occurs before the age of 40 in five to 10 percent of cases. People with a family history are more likely to develop this disorder. The four major motor problems seen in PD are: * tremor—shaking that occurs at rest * slow movements * stiffness of arms, legs, and trunk * problems with balance and tendency to fall Secondary symptoms of PD include: * blank facial expression * a tendency to get stuck when walking * small, cramped handwriting * muffled, low-volume speech * decreased blinking and swallowing * tendency to fall backwards * reduced arm swinging when walking Other, more extreme, symptoms of PD are: flaky white or yellow scales on oily parts of the skin, known as seborrheic dermatitis * sleep disturbances—including vivid dreams, talking, and movement during sleep * depression * anxiety * hallucinations * psychosis * problems with attention and memory * difficulty with visual-spatial relationships There is no specific test for PD. Diagnosis is made based on health history and a physical and neurological exam. Tests such as C AT scan or MRI may be used to rule out other conditions. Adequate rest, exercise, and a balanced diet are important. Speech therapy, occupational therapy, and physical therapy can also help to improve communication and self care. Surgical interventions are reserved for people who don’t respond to medication, therapy, and lifestyle changes. So are procedures such as deep brain stimulation (DBS). In almost all cases of PD, medication will be required to help control the various physical and mental health symptoms associated with the disease. Drugs and Medication Used to Treat Parkinson’s Disease | Medication A number of different drugs can be used to treat PD. Levodopa Levodopa is the most common treatment for PD. It helps to replenish dopamine. About 75 percent of cases respond to levodopa, but not all symptoms are improved. Levodopa is generally given with cardiodopa. This delays the conversion of levodopa to carbidopa until it gets into the brain. Dopamine Agonists Dopamine agonistscan imitate the action of dopamine in the brain. Dopamine agonists are less effective than levodopa. However, they can be useful as bridge medications when levodopa is less effective. Drugs in this class include bromocriptine, pramipexole, and ropinirole.

Managing Quality in Health Care

Managing Quality in Health Care Total quality management: a way of managing people and business processes to ensure complete customer satisfaction at every stage internally and externally (Department of Trade and Industry, DTI 2010). Although different quality experts emphasize different experts of this methodology, its major components can be summarised as follows: processes, people, management systems and performance measurement. According to Ross and Perry (1999), in addition to creating delighted customers through empowered employees, total quality management processes also lead to higher revenue and lower cost. In our Nursing home, every department is involved in implementing quality management to offer the best quality of service; we always work as a team and ensure we have offered the best quality of care that our residents need. Continuous quality improvement: is a system that seeks to improve the provision of services with an emphasis on future results (Marshall, 2003). In our nursing home, the manager ensures that every service provider receives training, implements what they have learnt and they are supervised if there is need for retraining again we are retrained this ensures that we receive updated information to offer the best quality of service. Quality standards: The Care Quality Commission for England has produced a guidance to help providers of health and adult social care to comply with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 and the Care Quality Commission (Registration) Regulations 2009 (CQC, 2010b). This guide contains the regulations and the outcomes that the CQC expects people using a service will experience if the provider complies. This forms the basis for the quality standards in care homes. There are 16 core ones range from respecting people receiving the services to safety and suitability of premises and staffing levels just to mention a few. In my care setting, we get an annual inspection from UKAF over and above inspections from CQC and have been given a star rating of three. All activities this year are geared towards a rating of four. Quality cycles: According to QCC (2010b) quality cycles represent periods within which care homes should be reviewed to determine compliance in its service provision. This may be annually. However private organisations like the United Kingdom Accreditation service also offers a quality cycle inspection called the Residential and Domiciliary care Benchmarking (RDB). The RDB annual quality cycle supports strategic planning by providing comparative feedback on a homes care provision and enables the identification of performance gaps and cost/benefit assessments to be made (UKAF, 2010). In this model we have four major aspects to be looked into namely: planning, doing, checking and acting. Quality and principles of care Legislation -these are laws and rules set by the government on how the provision of care should be for example protection of vulnerable adults. In our nursing home, every service provider should be ready to protect all residents from any form of abuse we attend mandatory trainings such as safeguarding vulnerable adults according to regulations by the CQC (2010b). Safety- in our nursing home we always do risk assessment on every service user and put measures in place like using bed rails to prevent falls by doing this we have protected residents from accidents and this ensures quality service to our residents. Independence-service users should be made in control of their lives by allowing them to do some of the things like arranging their wardrobes, making and tidying their rooms by themselves because some of the residents are very active and would like to do what they used to do before and we always encourage them to do while we supervise them and this makes them happy hence promoting the quality of service as they are satisfied. Rights- service users should continue to enjoy the same rights when in nursing homes like they used to when they were living independently. Every service user supported in nursing homes has the right to say NO, right to have a relationship and the right to have a say in their care plan. Service providers always tend to balance service users rights against their responsibilities whether both are at risk or not. 1.4) External agencies: These are bodies that regulate quality of care including: The Care Quality Commission an independent regulator for health and social care in England (CQC 2010a; 2010b). They regulate care provided by NHS, local authority, private company and voluntary organisations. Their aim is to make sure better care is provided for everyone. In our nursing home Care Quality Commission makes a minimum of three inspections annually (two announced and one unannounced) on such things as how we provide care in terms of cleanliness of the home and to service users.. It has a wide range of enforcement powers to take action on behalf of service users if services are unacceptably low. The CQC makes sure that the voices of service users are heard by asking people to share their experiences of care services. It makes sure that users views are at the heart of its reports and reviews. The CQC takes action if providers do not meet essential quality standards, or if there is reason to think that peoples basic rights or safety are at risk (CQC, 2010) through a wide range of enforcement powers, such as fines and public warnings, and can be flexible about how and when to use them. It can apply specific conditions in response to serious risks. For example, it can demand that a hospital ward or service is closed until the provider meets safety requirements or is suspended. The National Institute for Health and Clinical Excellence (NICE)- this is an independent organisation responsible for providing national guidance on promoting good health preventing and treating ill health (NICE, 2010). In our Nursing home, residents who have anxiety, panic attacks request for sedatives in order for them to sleep they are usually reassured and instead a government practitioner is consulted to review and advice them accordingly. Service providers take NICE guidelines trainings on different medical conditions for example diabetic foot (identification and care of the foot). 2.1) Quality Standards Benchmarks: According to Philip B. Crosby (1999) benchmarks are indicators of best practice including access to care environment and the culture of a home. The Benchmarks is one of the most comprehensive sets of social and environmental criteria and business performance indicators available (Daniels et al 2000). Our nursing home is accessible publically, to wheel chairs, a spacious car park and a section for activities for residents and relatives. We also have a signing in visitors book stating whom they are visiting. Code of practice for social care workers and employers for social care workers This document is developed by General Social Council and it contains agreed codes of practice for social care workers and employers of social care workers describing the standards of conduct and practice within which they should work ( GSCC, 2002). Employers use this set of code of practice to make decisions about the conduct of staff and support social care workers to meet their code of practice. Service users and members of the public use the codes to help them understand the behaviour of social workers (how they should behave towards them) and also how employers should support social care workers to do their job well. It is the responsibility of social care workers to make sure that their conduct does not fall below the standards set in the code of practice and no action or omission harms service users (NCSC, 2010). Social care workers must protect the interests of service users, maintain confidence, respect rights, promote independence, be accountable for the quality of their wor k and take responsibility for maintaining and improving their knowledge and skills. The general social council expect social care workers to meet the codes and may take actions (deregistering) if registered workers fail. 2.2) Different approaches to implementing quality Communication is a means of passing information from one person to another. In our nursing home we have different ways of communication like when doing care plans we always document what we have done for a resident so that whoever takes over knows what to do next to ensure continuity of care. Also when handing over is done during change of shifts information about residents is shared and everyone is aware of any changes in care plans in accordance to CQC guidelines (CQC, 2010). We also have staff meetings where certain information is passed on and in cases where staffs have a problem it is addressed and solutions are given out. For effective communication systems there should be a language that everyone understands. Policies and procedures These are guidelines set on how to do things often informed through regulations as outlined in various government documents (GSCC, 2002; NICE, 2010; CQC, 2010a. 2010b). In our Nursing home we have different policies and procedures for example in cases of accidents to residents we are required to fill a resident incident report and pass it on to the supervisor families, friends and relatives are informed about the accident then precautions are put into place walking frames, to avoid future occurrences of similar accidents. Infection control policy helps to prevent spread of infections within our nursing home. We always use personal protective equipment when offering personal care to residents, handling of any infectious wastes. We also use the proper technique for hand washing. There are also hand gels in each residents room, in public toilets and at the entrance of the building for sanitation purposes and all wastes like clinical and kitchen wastes are usually put in the bins ready for collection. In cases of disease outbreaks like diarrhoea and vomiting residents are isolated and managed separately and proper hand washing techniques are used to prevent further spread of the infection. Whistle blowing policy is designed to deal with issues that do not directly affect the employee and their employment but are a cause for concern in relation to the harm that may be done to other employees, residents or the wider community. Any employee who is concerned about their personal situation should raise their concern with their line supervisor or manager. This policy is for reporting issues like elderly abuse, misuse of drugs, faulty machinery that may cause accidents, illegal dumping of waste. The policy protects not only employees but the wide community. Confidentiality- all residents or service users information is private and confidential. It is not a proper practice to discuss residents information in public like their conditions and behaviours by doing that is breaching the policy and legal action should be taken. In nursing homes all information is kept safely and only accessible to relevant persons. This promotes quality of service 2.3) Quality systems ISO 9001 involves a set of procedures that cover all key processes in the business, monitoring processes to ensure they are effective, keeping adequate records and facilitating continual improvement. They have certain requirements like internal regulations, claims and procedures for residents, suggestion box and contract with uses. It also covers the importance of understanding and meeting customer requirements, communication, resource requirements, training and products, Leadership, Involvement of people, Process approach, and System approach to management and Continual improvement (Tricker and Sherring- Lucas, 2001). In our nursing home for the provision of all these elements and reporting them on day to day basis for example there is a clear procedure for residents complains. Carers, residents and relatives are informed and logged in a special complaints book and complains are followed up. When all this are put into practice, there is employee and customer satisfaction, resulting from better defined and implemented business processes. As a result of this we have motivated staffs, who understands their roles and how their work affects quality, improved product and service quality, happier customers, and improved management and operational processes, resulting in less waste (both time and materials) Business excellence is a widely used framework that helps companies to review their performance and practices in a number of areas and identify targets and actions for improvement based on principles of customer service stakeholder value and process management ( British Quality Foundation, BQF 2010). Managers develop the mission, vision and values and are role models of a culture of Excellence. Studies in Taiwan have shown that in care homes where this model is applied, managers are personally involved in ensuring the organisations management system is developed, implemented and continuously improved are involved with customers, partners and representatives of society and also motivate, support and recognise the organisations people (Cheng B, Chang, C and Sheng L. 2005). In our nursing home we use a balanced score card to keep track of activities by staff and measure consequences arising based on the British Quality Foundation model ( BQF, 2010).Service users families and relatives m easure in a scale of 1-5 where one is poor and five is excellent. We work hard in poorly rated areas to improve the quality of service. At the same time managers set a number of targets on key areas of each staff members roles which are then assessed on monthly review and awards are given to the best. This motivates other team members to work hard and best to attain the best and by doing so they provide best quality and we excel. 2.4) Trainings this refers to a learning process that involves the acquisition of knowledge, sharpening of skills and concepts (Stevens, 2004. In our nursing there are mandatory trainings offered to service providers before commencing to work like basic food hygiene, manual handling Healthy and safety is ensuring that the environment where we are working is safe for service users, other staff and others in general by our actions and omissions. It is a responsibility to all staff to ensure that the environment is safe to work on. For safety purposes in our nursing home we do not use equipment unless it has been checked and serviced. Also default equipments are labelled DO NOT USE to prevent and avoid accidents. We also have controlled cupboards where substances that are hazardous to health are stored and locked away. When there is a defect on the environment like chipped floors, loose hanging electricity wires we report to the maintenance coordinator and they are rectified immediately to avoid accidents. Again when housekeeping team are doing cleaning they always display cleaning boards and everybody is aware that cleaning is on progress or the floor is wet and they avoid using it until it is dry by doing this they minimise chances of accidents like falls 2.5) According to Marshall (2003) and Stevens (2004), external and internal barriers to delivering quality are any obstacle which prevents a given policy instrument being implemented or limits the way in which it can be implemented. They include: Resources: lack of adequate resources hinders quality of service for example inadequate or shortage of staff affects the quality of services offered and this leads to unsatisfaction of service users as they get services that are not adequate and for service providers because they are overworked. In nursing homes when there are staffs shortages they arrange cover shifts earlier by either bank staff or some agencies registered with the home. Financial barriers include budget restrictions like food supplies and other supplies like incontinent products limits the overall expenditure and this leads to inadequate provision of quality services to residents Personal Appearance: Hygiene and grooming, eating habits and attire can vary from country to country and culture to culture. For example, some people may wear attire such as a headdress as part of their custom and beliefs. To remain true to their beliefs, some workers may want to continue to wear this dress at their workplace. Employers may view this as inappropriate or unsafe. It is particularly problematic in workplaces where workers wear uniforms. Religion: In many cultures, religion dominates life in a way that is often difficult for employers to understand. For example, workers from some cultures may want to pray while at work times in accordance with their values and beliefs. There may also be religious holidays on which people of certain religions are forbidden to work. These differences need to be respected, where possible, and not ignored and they affect the quality of service. Language barriers often go hand-in hand with cultural differences, posing additional problems and misunderstandings in the workplace. When people cannot communicate properly they are frustrated when communicating with supervisors, co-workers and residents this can be dangerous because people may end up performing poorly in their work thus affecting quality of service offered. Legal and institutional barriers -these include lack of legal powers to implement a particular instrument and responsibilities which are split between agencies limiting the ability of an institution. Like the law states that students should work for twenty hours only which creates shortages at work affecting quality of services. 3.1) According to Business Dictionary.com (2010), policies are principles, rules and guidelines formulated or adopted by an organization to reach its long term goals. They are designed to influence and determine all major decisions, actions and activities take place within the boundaries set by them and procedures are specific methods employed to express policies in action in day to day operations of the organization. For example, in nursing homes the National Care Standards Commission for England, NCSC (2010) has outlined requirements that these homes must meet which in effect guide their policies and principles. These policies include, but not limited to: manual handling procedures, Risk assessment and Infection control. Manual handling These are techniques used to handle or move service users like hoisting, using belts and sliding sheets to move residents these are safe procedures for both residents and service providers as they minimise accidents to both cases and this promotes quality of service (CQC, 2010). On the other hand, they have disadvantages like time consuming when doing procedures like hoisting which requires two or three persons and also residents may not like the experiences of hoisting and thirdly it needs trainings to be carried out. Risk assessments According to healthy and safety at work act (1974) the Management of Health and Safety at Work Regulation (1999) states that it is the responsibilities of managers to do risk assessment to employers and employees. to reduce and prevent risks to them in future and they are included in their care plan so that quality of care can be improved for example residents with risks of falling have walking frames, falling mats and bed rails put in place to avoid falls but again things like bed rails have caused accidents in that residents are trapped and some sustain fractures which affect quality of service 3.2) factors that influence the achievement of quality of personal care Quality is a difficult concept to capture directly. However, resident or organisational outcomes are often used as a proxy for quality (Marshall, 2003). There is considerable debate about the relationship between quality of care and quality of life as joint, but not necessarily competing, measures of quality. A study for the Joseph Rowntree Foundation indicates that residents perceptions of nursing staff are a good indicator of quality of care (JRF, 2008).The importance of measures of social care and of homeliness epitomise the divide between health and social care provision in care homes. Factors influencing residents satisfaction with care are discussed below: Team working Heath care workers working in teams has been recognised as an improving the quality of care (Stevens, 2004; Borill et al 1999). According to Stevens, the intention is for carers to share tasks and learn from each other and possibly improve based on their experiences. This can be illustrated by the quotation below: The best and most cost-effective outcomes for patients and clients are achieved when professionals work together, learn together, engage in clinical audit of outcomes together, and generate innovation to ensure progress in practice and service. (Borill et al 1999 p.6). Stevens has for example reported from a number of surveys from UK nursing homes to suggest that there is a reduction in carer burden and significant reduction in stress when staff work in teams resulting in better coping and satisfaction. Both these studies (Stevens, 2004; Borill et al 1999) found that service users surveyed showed more satisfaction when carers and health workers worked in teams Healthy and safety at work The responsibilities of care home proprietors are subject to a range of health and safety legislation among them the Health and Safety at Work etc. Act 1974, the Management of Health and Safety at Work Regulations 1999 which require employers to assess the risks to employees and other who may be affected by their undertaking, (residents) and the control of Substances Hazardous to Health Regulations ( Care Quality Commission, 2010). These regulations have led to dramatic improvements in the safety of residents and people working in care homes according to the care quality commission. For instance, guidelines requiring minimalist manual handling has significantly reduced the numbers of health workers staying off work due to illness which has a positive effect on the level of personal care of residents ( CQC, 2010a). However, a report for the Joseph Rawtree Foundation (JRF, 2008) showed that the percentage of medication errors and adverse events in nursing homes have increased despite regular inspections by the CQC. Stevens (2004) has also reported survey results from 27 residential homes with dementia patients where 19% cases of medication errors were reported. In my care setting, clear improvements can be seen from less harm to residents when using the hoist but not many service users like to use the hoist. Some risk assessments in care homes have made it very difficult to take residents outdoors or even for activities outside the home for fear of not meeting the Health and safety requirements and this ends up reducing the quality of care. 3.3 The following recommendation can improve the quality of care in Nursing homes Training /education This means acquiring knowledge and skills or new information on how to do things according to the recommended regulations and standards ( Stevens 2004). This is a very important aspect in nursing homes all trainings as it provides ongoing trainings to update service providers and equip them with relevant and current information that enables them to provide the best quality of care that will be satisfactory to service users. In our nursing home trainings are offered and need to be implemented then supervision is done and in cases where need for retraining arises, arrangements are done and they are offered for the benefits of service users, service providers and the community at large as it reduces or minimises preventable accidents and this promotes the quality of service Review This means going through the set of targets or planned activities to see the progress whether it is improving or getting worse. This alerts and actions or precautions are put in place to make the situation improve for better quality of service ( Stevens, 2004). For example in our nursing home there are always monthly reviews of care plans of service users this includes individual or family interviews to determine whether residents are improving or need some improved care plans like in moving and handling procedures (use of hoist or belts) and then action is taken accordingly. Also for staff there is quarterly staff meetings or when need arises and previous discussed or current issues are raised and a way forward on how to carry on is agreed. There are always individual supervisions done by allocated persons and each employee identifies areas that need improvement and good performing areas by doing this there is improvement of quality of service Conclusion It has been shown that in order to improve services to users in the social care sector, it is important to follow principles, guidelines and procedures set by government, industry bodies or even individual homes. There is also need for planning, doing and checking and then reviewing to assess shortcomings in order to design improvement regimes. Similarly, it has been shown that although there is legislation and care industry standards, it will require long term commitments in developing methods, instruments and communication procedures involving all stakeholders at care or residential home level.

Energy Production Essay -- Environment, Natural Gas

In today’s society, it’s nearly impossible to open a newspaper, fire up a computer, or hold a conversation that isn’t someway related to energy. Since the beginning of the industrial revolution over a century and a half ago, nothing has been more pivotal to mankind’s rise to power as the apex species of planet earth. Had our ancestors not discovered the potential of using million year old plant and animal remains to create combustible power, the world would look very different. There is no denying that energy production is one of, if not, the most important developments in human history. After a hundred and fifty years of recklessly burning oil and coal, we find ourselves having to deal with the literal mess unforeseen by our industrious forefathers. No longer can the repercussions of our unsustainable addiction to fossil fuels be ignored nor can we defer the task of finding a solution to the next generation of humans. â€Å"Energy use and its cost are rising worldwide, most countries remain dependent on oil imports, and little progress has been made toward curbing climate change† (Deutch 2011). This inconvenient truth has left governments, environmentalists, and consumers scrambling to develop a way to provide massive amounts of energy at an affordable cost while significantly reducing our harmful carbon emissions. In a perfect world alternative, clean energy should have been pursued intensively when true magnitude of oil instability was first revealed in the 1970’s but better late than never. There are dozens, if not hundreds of oil and coal alternatives that are being considered, however, while many options look promising in theory the overwhelming majority of them such as: wind, solar, and biofuel just aren’t economically feas... ...to guide the design of the study. The initial research results from the study are expected until the end of 2012 with a goal for a report in 2014. ANH International. "About Us | ANH International." Welcome to Alliance for Natural Health International | ANH International. 03 Mar. 2011. Web. 03 Mar. 2011. . ANH-USA 1. "A Huge Fracking Mess." Welcome to the Alliance for Natural Health - USA. 23 Feb. 2011. Web. 03 Mar. 2011. . ANH-USA 2. "Campaigns." Welcome to the Alliance for Natural Health - USA. 03 Mar. 2011. Web. 03 Mar. 2011. . ANH-USA 3. "Overview." Welcome to the Alliance for Natural Health - USA. 03 Mar. 2011. Web. 03 Mar. 2011. .

Ageism and the Media Essay -- Argumentative Persuasive Topics

Ageism and the Media    Women over forty are constantly being either ignored or belittled in the media. There are countless women in their twenties and early thirties all over television and the movies. In magazines, the models tend to be much younger. Many are under twenty. Model Roxanne Daner is only 17, but her career will be over by the time she's 20. "I'm afraid to get old. I already feel old. I like to tell people that I'm 17, because 17 sounds young and they think that there is so much ahead for you. But 18, it's like there is not that much more - there's really only two more years." (Changing Face of Beauty: Illusions). According to the U.S. Census Bureau, 42% of Americans are fourty and older. In 1999, the Screen Actors Guild reported that only 1 in three roles went to performers over fourty. However, women over fourty fared worse than men of the same age. While 37% of male roles in television and film went to men fourty-years-old and over, only 24% went to women of the same age. 34% of male lead roles went to older men while only 21% went to older female leads. These depictions of older females are far from accurate when compared to the population. Now that's not to say that there's nothing out there - surly there are some additions to the re-runs of the Golden Girls - "the Bridges of Madison County," even older sex symbols like Sean Connery. But nothing commensurate with the size, wealth, and media dedication of the older population. (Starr) Of the top ten network television shows (excluding reality shows and game shows) for March 5-11, 2001; all ten portrayed men over forty while only seven portrayed women over forty. There were twenty-five males and seven females over forty. For every one female, t... ...ww.lifetimetv.com/shows/specials/changingface/illusions2.html Life Time Entertainment Services. 2000 Changing Face of Beauty: Models http://www.lifetimetv.com/shows/specials/changingface/models.html Life Time Entertainment Services. 2000 Changing Face of Beauty: Views. "Sela Ward" http://www.lifetimetv.com/shows/specials/changingface/views5b.html Life Time Entertainment Services. 2000 Changing Face of Beauty: Views. "Maricia Gillespie" http://www.lifetimetv.com/shows/specials/changingface/views.html Life Time Entertainment Services. 2000 Douglas, Susan J. Where the Girls Are: Growing Up Female with the Mass Media. New York: Random House Publishing, 1994, 278. Starr, Bernard. IT AIN'T JUST PAINT:AGING AND THE MEDIA   http://www.longevityworld.com/justpaint.html. 1997 Wolff, Naomi. The Beauty Myth. New York: Doubleday Publishing, 1991   

Offshore Banking Essay -- foreign bank, financial secrecy

Offshore banking is the action of having a bank account outside of the country of residence. Since its start, offshore banking has become a considerably lucrative business. Many of those who take part in offshore banking are looking for a secure location to place their income or seize the opportunity of having lower taxes. However, there are those who misuse the privilege of a foreign bank and use the business ventures for illegal actions rather than the original purpose of the dealings. Offshore banks seem to have an impartial acceptance of quite a few clients within the bank that create a lower standard of ethics in contrast to the ethics meant to be held—this includes those of a political position. Furthermore, this has the potential to be detrimental to the economy. Individuals that have offshore accounts control accounts through a credit card that has a unique and individual number and secret code. These would often be referred to as â€Å"identifier codes† called IBNs (International Bank Account Number)—where the account holder is identified by a sequence of characters—rather than the traditional system of recording names, as defined by National Westminster Bank. An IBN is not to be confused with an account number (though it not uncommon for an account number to be included) as it often varies between countries. Often times, a report must be filed for the purpose of obtaining this information. This system helps all of these banks provide financial secrecy which is that only you and your banker would legally be allowed to know the financial activity within your account. The financial secrecy, completely different from financial privacy, includes many regulations to maintain this asset of secrecy. For example, many banks would n... ....). Democracy Now!. Retrieved January 27, 2014, from http://www.democracynow.org/2011/4/15/offshore_banking_and_tax_havens_have Offshore banking. (2014, November 2). Wikipedia. Retrieved February 20, 2014, from http://en.wikipedia.org/wiki/Offshore_banking Purpari, M. (n.d.). How Far Offshore is Offshore Banking?. Suite101.com. Retrieved January 27, 2014, from https://suite101.com/a/how-far-offshore-is-offshore-banking-a344923 Ritchie, J. (n.d.). Connect With Us. MintLife Blog. Retrieved January 27, 2014, from https://www.mint.com/blog/trends/offshore-banking/ Warren, Z. (2013, September 23). U.S. government cracking down on offshore bank accounts through FATCA. U.S. government cracking down on offshore bank accounts through FATCA. Retrieved February 20, 2014, from http://www.insidecounsel.com/2013/09/23/us-government-cracking-down-on-offshore-bank-accou

Human resource management activities in healthcare Essay

There are many external and internal factors that might affect the health care organizations; however they are more likely to be affected by external forces that in turn affect their daily operations. Some of the factors that affect the human resource department of a healthcare organization are mentioned below. †¢ Economic factors †¢ Social and cultural changes †¢ Technological changes †¢ Legal changes HR planning and analysis Premeditated planning is a procedure that allows the health care associations to direct their future actions utilizing the resources that are accessible to them while keeping in mind the goals of the organization. There are some internal and external strength that have to be taken care of by the association and then a SWOT Analysis should be carried out. Some of the advantages of Human Resource planning are that it permits effectual use of workers and assists to replace the significant vacancies that have to be filled. Furthermore, planning suggests realistic recruitment projections, facilitates the staffing resources to be utilized more proficiently and efficiently and it also allows a improved focused investment in training and retraining, growth, career counseling and efficiency enrichment and also assists to uphold as well as to get better the level of variety. Human Resource planning is a very fundamental part of premeditated planning in addition to strategic HR planning, it assists to examine and classify the need for and accessibility of HR so that the association can meet its goals. Pynes, 2004). Projections aids in appraising the current condition and to estimate future demand and affairs by looking at the history trends of the association and is significant for the associations in a way that it assists to predict the retirement plans of the staff whereas the demand estimate helps to foresee the labor force that would be required in the future. EEO compliance EEO stands for equal employment opportunity and this expression was shaped by President Lyndon B.  Johnson when he marked Executive Order 11246 on September 24, 1965, formed to forbid federal contractors from discerning against workers on the grounds of race, sex, creed, belief, color, or nationality. Recently most managers have also added sexual compass reading to the directory of non-discrimination. The Executive Order as well required contractors to put into practice affirmative achievement plans to augment the contribution of minorities and females in the place of work. Pursuant to federal policy, affirmative achievement plans must comprise of an equivalent opportunity plan statement, an examination of the existing work force, recognition of problem areas, the establishment of objectives and schedules for mounting employment prospects, definite action-oriented plans to tackle problem areas, support for society action plans and the establishment of an internal audit and reporting structure. (EEOC, n. d. ). The reason why employment opportunity equal is important is because it is morally a right way to conduct oneself in the workplace, moreover it also helps in making the business prosper. The way that I move toward civil rights laws and employment civil rights laws, is I in fact think that they are all connected, they are all civil rights laws, anti-discrimination laws in the place of work, whether anti-discrimination on the grounds of race, sex, disability, age, creed or nationality they are all entrenched in the similar bedrock standard and i. e. , that individuals should be judged in the place of work, based upon their capability to carry out the job and not based upon the threats, myths and typecast that one may have because of their race, or gender, or disability, or age, belief or nationality. That is in fact the unifying feature of all of the regulations in which the EEOC puts into practice and imposes, I think that is really significant that is both rising out of my own personal understanding and what I feel is right; that people should be judged based upon their ability to do the job†¦ and that’s really the very simple core of what we do. And if you sort of take that notion, that principle, one step further, or take it one step, it makes business better. To the extent that you’re making employment decisions in the workplace, whether they be on the basis of hiring somebody for a job or promoting somebody for a job, or treating somebody on the job, you ground those workplace decisions in the ability of that individual to do the job, rather than on a stereotype, or a fear, or a myth, because that person is from a different race than you, or a different religion, or looks different, or is older, or doesn’t walk, or moves around or communicates in a different way from you. If you base those workplace decisions, upon the ability of that individual to do the job, you will get the most qualified person. You won’t let internal biases, or fears, or myths, or stereotypes get in the way of selecting the best qualified person. Therefore I think, it is in best interest of the business to strip away those typecasts, those threats and those myths, in order to obtain the best competent person, because then company will really be improved. The Quotations page, n. d. ). Other considerations Some of the other considerations the human resource management in the health care organizations has to take care of are staffing, development of employees, compensation, health, safety and employee and maintaining labor management relation. Staffing The HR department must ensure that a fair selection policy is being used when hiring a candidate and everyone should be given an equal opportunity. Moreover, the job should be made available for every person who has the potential to do it and for this both internal and external recruitment should be opted for. Other than this, it is also essential to provide clear job criteria for the vacancies that are being announced by the human resource department of a healthcare organization. Full supervision must be done to ensure that the right candidate has been hired after which training should be provided to him. (Shi, 2006). Development of employees Health care organizations should invest in training to augment individual performance and organizational productivity, moreover it should also focus on developing management skills/development and supervisory skills, technical skills and communication skills and provide training to the employees who are new in the organization especially the ones who are working or are hired for lower-level positions in order to augment their performance. Compensation This comprises the wages and bonuses, vacation payment, sick leave payments, recompense of the staff and insurance policies, etc. , it is HR Department that is in command to expand and to direct the benefits compensation structure for the workers that serve as an incentive to promise the staffing. Their objective does not just come to an end after staffing but they also have to work on retaining workers and make them stay on with the organization. Once the employee is hired, it is the duty of the benefits coordinator to explain the benefits and the incentives the employee can expect from the organization so that the employee is aware about it in the beginning and he does not get discouraged later onwards. Health and safety It is essential for the organization to ensure safety of employees at the workplace and the health care organizations must their employees’ health and medical benefits and the employees should be given free medical services. Employee management relation and Labor management relation It is essential for the HRM at the healthcare organization to avoid any kind of discrimination in context with the age, gender, race or religion of an employee and it is basically the duty of the HR department to take care of this so that fair treatment is given to each and every person. Moreover, the HR department must also provide the assistance of negotiation in case any issues arise between the employees working at any level in the organization in order to ensure a healthy work environment. In the same way, the HR department also has to manage the labor and have good terms with them as well. (Leat, 2001).

Discuss the ideal knowledge management environment

In today's increasing competitive environment and the new economy of brick and click enterprises, knowledge management (KM) can be considered as a business integration discipline which endeavours, ‘to improve the performance of individuals and organisations by maintaining and leveraging the present and future value of knowledge assets' (Newman, B. , ; Conrad, K. W. , 1999, p. 2). While people have criticised information and knowledge management as the same thing, knowledge management is not a new practice but rather the interpretations of knowledge management and its frameworks have incessantly changed. Successful brick and click enterprises are those which frequently management knowledge and recognises knowledge as a source and integration tool to driving the growth and sustainability of business disciplines, and hence acknowledges the high uncertainties of change ‘between the input resources and the business performance outcomes, and, the gaps between the value these enterprises create and the value demanded by changing market conditions, consumer preferences, competitive offerings, changing business models, and, industry structures' (Malhorta, Y. 2004). However, the knowledge creation process does not necessarily lead to business improvements or value creation (Chen, C. J. , ; Huang, J. W. , 2007), but more on how knowledge is handled, circulated and applied within a virtual environment, enabling knowledge flows between the individual and its organisational culture. Therefore, it is the purpose of this essay to discuss the ideal environment, in which value can only be created when knowledge is dispersed and adequately applied where needed by use of knowledge management methods; furthermore it will acknowledge that a ‘well-developed knowledge management system would stimulate the creativity of each employee by providing exactly the knowledge that employee needs to be optimally creative' (Finneran, T. Online, No Date). You can read also Portfolio Management Quizzes In the new maturing economy the management of knowledge is a critical factor for the success and competitive advantage of any organisation; as is the generating of new knowledge to fulfil organisational objectives and to achieve greater business optimisation. According to Resnick, L. M. , (2004, p. 87), as contemporary organisations evolve to a more virtual structure, they lose and gain relationships among employees, managers, customers and suppliers on an irregular basics; and without practical management, the knowledge created through these relationships will be lost. Therefore, assembling an ‘effective knowledge management will enable organisations to protect themselves from the losses experienced when employees and partners terminate their relationship with the company' (Resnick, L. M. , 2004, p. 288).Business Management Study Guide While experts have argued that information and/or knowledge management practices is not only about the administration of information, but rather entails management requirements for knowledge management systems to be integrated to all aspects of the virtual environment; a well-constructed knowledge management system will impede the production and collaboration of creativity across all organisational subunits. Finneran, T. (Online, No date) describes knowledge management in a nut shell where ‘Knowledge Management envisions getting the Right Information within the Right Context to the Right Person at the Right Time for the Right Business Purpose'. This view suggests the ideal environment in which individuals or group knowledge should be effectively communicated across all organisational divisions in ways which directly impact on business performance. Essentially, the ideal knowledge management environment will cultivate and take advantage of existing and new knowledge through the implementation and combination of KM methodologies, best practices, frameworks, and technologies that will ultimately stimulate the development of creativity and innovative ideas of human beings. In essence, the basic concept of knowledge management is about sharing knowledge to leverage existing knowledge, stimulate innovation and to achieve operational effectiveness. As KM matures many companies will start to look at KM with a more holistic approach, but ‘research shows that although many companies have begun to develop some sort of knowledge management capabilities, very few (6%) have implemented knowledge management programs on an enterprise-wide scale' (Kidwell, J. J. , Vander Linde, K. M. , ; Johnson, S. L. , 2000, p. 30). The conception on KM best practises should not primarily focus on one single type of initiative for competitive advantage, but instead centre around building on the core business capabilities and processes around knowledge sharing. For instance, knowledge sharing can be achieved through the creation of a knowledge community aimed to capture knowledge from individuals and store in teams and the organisation; taking an institutional global approach in facilitating knowledge as needed and in breaking down the cultural barriers between organisation and its customers. Finneran, T. , (Online, No Date) suggest that ‘practitioners of Knowledge Management have found that a critical success factor in the implementation of knowledge management is the creation of a cultural environment that encourages the sharing of information'. Knowledge communities can be viewed as ‘Global communities of interest' which stimulates virtual and global interactions through common categories of interest, which are not bounded and tied up to by physical and organisational impediments. Several KM best practices and trends have emerged over the last few years and are forecasted to shape the way knowledge is to be managed. It includes the materialisation of technology solutions, the union of knowledge management with e-business, movement from limited KM projects to enterprise-wide project and increasing the use of KM to enhance innovation and of tactic knowledge rather than explicit knowledge. (Kidwell, J. J. , Vander Linde, K. M. , ; Johnson, S. L. , 2000, p. 29). Generally, knowledge can be very difficult to codify and can also be very highly subjective. Two type of knowledge which is recognised in KM are explicit and tactic, and when applied productively within an organisation it can help to increase competitive advantage through innovation and knowledge sharing. Ideally, tactic knowledge would better guide actions and make better informed decisions based on the ability utilise on perception, hands-on skills, experiences, know-hows, insights and so on. Tactic knowledge is personal, difficult to formalise, communicate and transfer; ultimately it is knowledge that is embedded within people in an organisation. Seonghee, K. , (1999) suggests that KM best practices draw on tactic knowledge for creativity and ‘ensures tasks effectiveness – that the right things are being done so that work unit could attain its objectives. It also provides for a kind of creative robustness — intuition and heuristic can often tackle tough problems that would otherwise be difficult to solve'. Functionally, knowledge management frameworks offer a myriad of possibilities for organisations and help to build the integrity of knowledge dispersal and application within an organisation, providing the countless benefits in applying a KM framework which builds on the concept of knowledge management in specifics to the organisational environment, its business processes and activities. With the paradigm shift and phenomenon of the need and understanding of knowledge management over the last several years, many experts have proposed a number of approaches to KM frameworks, each of which have only addressed certain aspects of knowledge management. Holsapple, C. W. , and Joshi, K. D. , (1999, p. ) broadly classifies KM frameworks into two categories; descriptive frameworks which attempts to characterise the nature of the KM phenomena with additional sub categories including board and specific frameworks to describe the whole of the KM phenomena, and prescriptive frameworks stipulates the methodologies for performing knowledge management. For instances, the ‘Core Capabilities and Knowledge Building' framework initiated by Leonard-Barton, D. (1995), and as described in Holsapple, C. W. , and Joshi, K. D. , (1999, p. 2) paper, focuses on the profundity in the characterisation of the KM phenomenon and therefore categorising it as a board framework. This KM framework introduced by Leonard-Barton (1995), encompasses four knowledge building activities that encircle the four core capabilities, which Leonard-Barton asserts is central to a knowledge based organisation (KBO). The four knowledge building activities aimed at knowledge creation and diffusion are acknowledged in the framework as: shared and creative problem solving, implementing and integrating new methodologies and tools, experimenting and prototyping, and importing and absorbing technologies from outside of the firm's knowledge. In addition, Leonard-Barton expresses that these four knowledge building activities are influenced by the core capabilities identified in the framework as being: the physical systems such as databases, employee knowledge and skills, managerial systems such as rewards and incentives systems, and the organisational values and norms (Holsapple, C. W. , & Joshi, K. D. , 1999, p. 2). This framework is used to better understand knowledge management and its characteristics of the implication in a KBO environment. Thus, the dynamic perspective on KM frameworks does not end with knowledge as a final solution, but instead emphasises on the continuous growth, renewal, exchange and communication processes. Hence KM frameworks can offer a structure, ‘for balancing the myriad of technologies and approaches that provide value, tying them together into a seamless whole. It helps analysts and designers better address the interests of stakeholders across interrelated knowledge flows and, by doing so, better enables individuals, systems and organisations to exhibit truly intelligent behavior in multiple contexts' (Newman, B. & Conrad, K. W. , 1999, p. 2). ‘Organisations are already realising that it does no good to have robust technology solutions if the existing culture prevents knowledge sharing, and conversely that it does little good to have pockets of robust knowledge sharing without some technological means of making knowledge widely accessible' (Kidwell, J. J. , Vander Linde, K. M. , & Johnson, S. L. , 2000, p. 30). Therefore, it should not be assumed that technology is the enabler of KM, but should be perceived as a vehicle for driving the concept of ‘knowledge diffusion' in a KM environment. Nowadays, the outlook of promising technological tools for KM can help to support and improve the process of knowledge transfer. Technological tools such as, search engines, storage media, groupware, web-based platforms, portals, emails and basic collaborative tools can help to facilitate and assist individuals and groups in the creation, retention and the diffusion of knowledge. Increasingly, the use of portals is being implemented in many corporate environments for the convenient storage of meta-data, and integration of collaborative tools, emails, into one application. Kidwell, J. J. , Vander Linde, K. M. , & Johnson, S. L. , (2000, p. 30) also makes an interesting statement which suggests ‘As organizations share their lessons learned about implementing knowledge management programs, some are discovering the interdependent nature of KM capabilities. They are finding that a balanced portfolio of knowledge management initiatives yields the best results and that excelling at technology-related capabilities does not preclude excelling at people- or process-related capabilities'. Additionally, as more brick and click enterprises grow, the harder it becomes to determine what technological tools, KM methods, and best practices are to be utilised in determining the needs of individuals, groups and the organisational culture, but ‘once sound strategies based on these essential principles are articulated, the requisite technologies are chosen, and information platforms and technology architectures are built accordingly', though it may sound simple it can not always guarantee the successful deployment of a KM system (Riley, T. B. , 2003, p. 4). In a learning environment KM should not be based on a technocentric approach to creating the ideal KM environment; but instead use technology as a facilitator to simulate knowledge sharing and creativity for the development of innovation. The virtual enterprise should aspire to revolutionise itself into a knowledge-based environment which continually should aim to create, acquire and transfer knowledge to the right person when and where required. In creating the ideal KM environment there are many tools, methods, frameworks, and techniques which can be applied in stimulating the creativity of each employee. However, the assortments of KM methodologies which can be found through examples of other virtual organisations and case studies, does not necessarily lead to business improvements or value creation when applied to one's own virtual enterprise; but more on how knowledge created is disseminated and applied across the organisational culture, between individuals and teams. In summary, KM is fast becoming a chief factor for organisations in determining their competitive advantage, and without a well-developed KM system or knowledge creation process will render the organisation from succeeding.