Professional Values and Awareness Essay

In this assignment I will identify issues that affect the care provided in a home for adults with learning disabilities. Using the â€Å"case study† format I will focus on the interpersonal relationships and identify the underlying factors that influence them, then provide explanations for these by applying established theories. Churton (2000:214) describes a case study as â€Å"a detailed investigation of a single research area†¦Ã¢â‚¬ . The case study will form a unique representation of the individuals involved at the time they were observed. As a single study the outcomes may not be representative of all care homes, but it is reasonable to assume many issues may be similar. As a student I was able to observe both staff and clients in their normal routines. I was accepted as a member of the care team and took part in daily activities. This form of research is described in Giddens (1997:542) as â€Å"Participant observation†. Becker describe the role of the researcher as â€Å"someone who watches the people he is studying to see what situations they ordinarily meet and how they behave in them† (cited in Marsh I. 1996:124), however the by taking on a role within the group that justifies their presence the researcher acts as more than a passive observer and becomes a participant. As a stranger to the group my presence will have affected the behaviour of the clients and studies have shown that the presence of students affects the way that qualified staff work (Reed J & Procter S. 1993:31). My own preconceived ideas of Learning disabilities and the staff and clients previous experience of students will all have contributed to the behaviour I witnessed. On my first day at the placement I was introduced to my mentor (the deputy manager). We discussed the homes basic philosophy and the clients’ disabilities. I was introduced to the nine clients, and the staff approximately 15. During this first meeting my mentor made me feel welcome and allayed some of my fears about the placement. Unfortunately other than two brief conversations this was the only time I worked with her over the six-week placement. The staff are mostly female with only four male staff. They were of all ages and came from a mix of races and religions, some single and others married with children. All of the staff are support workers and most have NVQ level 3 or are currently studying towards it. I found all the staff very friendly and felt welcome, but I also felt a like a ‘spare part’, as the clients were encouraged to do things for themselves, very little intervention was necessary. Record keeping, giving medication and supervising the clients at the many activities they attended were the main tasks. The days soon became very predictable with set activities and â€Å"opportunities† to be achieved. The slowness of the day meant that staff talked a lot, discussing personal matters as well as how they felt about the clients and their jobs. Conversation included issues around the low regard support workers had from the general public and other health care professionals, the quantity of paper work to be completed daily and the emphasis placed on it, little support and understanding from the management, and having to attend college in there own time. My personal performance was influenced most by the lack of a mentor. Without a mentor to shadow I would try to â€Å"latch onto† a member of staff only to find that we were on different activities or were at the end of their shift. My shifts and my mentors were not together, when I asked the manager if I could swap my weekend to the same as my mentors, she told me that there was no need for me to work with my mentor at all. I was left feeling very isolated. The need for student and mentor to work together â€Å"as much as possible† to build successful relationship is highlighted in Baillià ¯Ã‚ ¿Ã‚ ½re’s Study Skills for Nurses (Maslin-Prothero1997:32). Good mentoring is a two-way process requiring willingness from both mentor and mentee to build a collaborative relationship (Ellis et al 1995:121, Ajiboye P. 2000:11). Formal mentoring is relatively new to nursing (Maslin-Prothero 1997:51), and is closely related to Project 2000 (Salvage J.1999:14). The ENB define mentors as â€Å"an appropriately qualified and experienced first-level nurse/midwife/health visitor who by example guides assists and supports the student in learning new skills, adopting new behaviour and acquiring new attitudes† (as cited in Quinn F. 1995:188). Mentorship has existed for centuries with references dating back to Greek mythology (Ellis R. et al 1995:109), and it is widely used for career development in business, where mentors are â€Å"role models, talent developers and door openers†(Tyson S. & Jackson T. 1992:121). There are several theories on how mentoring works, most emphasise the mentor as a facilitator allowing the student to experiment while ensuring the safety of the patient/clients, and providing a â€Å"developmental bridge between theory and practice† (Ellis R. et al 1995:109). Communication and interpersonal skills are the foundations on which a successful relationship is built and are therefore essential skills in a mentor (Ellis R. et al 1995:121). However the mentor themselves may be the most important factor. A mentor is a role model good or bad. Hopefully the student will witness a high standard of practice and set their own standards similarly. But when the standard is low it depends on the students’ knowledge of the theory as to whether they choose to imitate the mentor or apply their own higher standard. Bandura (cited in Ellis R. et al 1995:116) describes this process as Social Learning Theory, a three-stage process. Stage 1 Observational Learning: Imitating a good role model Stage 2 Inhibitory/Disinhibitory Effects: bad practice rejected or imitated Stage 3 Eliciting Effect: good practices learned and core knowledge improved. The break down of the mentor mentee relationship on my placement may have been for variety of reasons, poor communication, unrealistic expectations or time constraints. Supernumerary students have time to observe and reflect, but mentors may have an already busy schedule and supervising students can become just another pressure (Reed J. & Procter S. 1993:36). Students in this environment may find themselves being used as â€Å"another pair of hands† (Ajiboye P. 2000:11). Many texts cite good leadership of the manager as vital to forming an atmosphere conducive to learning (Quinn F. 1995:182). A good manager will find time to inspire staff to enthusiastically provide high quality care (Grohar-Murray 1997:125). In the philosophy of care/service values of the placement it states that â€Å"we have a well trained staff who have achieved a NVQ in care or are working towards it† (not referenced to protect confidentiality). However the staff studying the NVQ had to attend college in there own time. This caused resentment towards the management as the staff felt that the qualification was for the company’s benefit, but at their expense. Tappen (1995:69) recognises that by allocating staff time to attend lectures or college days without them incurring financial penalties the outlook is changed from just gaining a ‘paper qualification’ to ‘an opportunity’ to develop skills and increase personal knowledge. Encouraging staff to develop new skills is a great motivator. Motivation has been described as â€Å"the oil that keeps the machinery turning† (Dell T. 1988:59) and is a key element in many leader/management theories. Many motivation theories are based around the concept of fulfilling needs. Maslow (1968 cited in Hogston R. & Simpson P. 1999:295/303) devised a hierarchy with seven levels, the first level are basic physical needs such as food and water progressing up to more psychological needs of self fulfilment. Individuals climb the pyramid a step at a time motivated by fulfilment at the previous level (see appendix 1). Kafka (1986 cited in Tappen 1995:304) offers five basic factors for motivation, Economic security, Control, Recognition, Personal self-worth and Belonging. But unlike Maslow the five may be placed in any order, as one person may be motivated more by the need to belong than the need for money (see appendix 2). Self-esteem/worth and belonging are needs common to both Maslow and Kafka. If managers boost self-esteem by acknowledging good practice and recognising achievements they enhance the feeling of belonging. Without feedback staff often feel overlooked and isolated. To be constructive feedback should contain both positive and negative elements and be based on observed behaviour, given objectively it can highlight areas that need strengthening and increase motivation. Kron (1981 cited in Tappen R. 1995:420) described this â€Å"positive feed back† as a â€Å"psychological paycheque†. The need to belong affects students, when they are included in procedures, and given opportunities to express opinions and don’t feel â€Å"in the way† they become part of the team. Being accepted boosts self-esteem and motivates learning (Oliver R & Endersby C. 1994:94) Dell statement that â€Å"people work harder for recognition than for money†(Dell T. 1988:59) is supported by a study of the affect of incentives such as pay increases and shorter hours. When each incentive was implemented productivity was found to increase. When the incentives were removed and working conditions returned to normal it was expected that the productivity would fall. In fact productivity rose â€Å"to the highest levels ever†. Mayo’s conclusion was that being in the study had caused the group to bond (belong) and that the interest (recognition) showed by researchers had encouraged the workers to achieve the level they believed the researchers expected of them (Mayo E. 1933 cited in Barratt M. & Mottershead A. 1999:74). If the security of â€Å"belonging† is absent self-esteem deteriorates which can lead to an â€Å"increase in complaints and fatigue†¦and absenteeism is likely to rise†(Barratt M.& Mottershead A. 1999:73). Lack of appreciation and support are two of the ten factors cited by Tappen (1995:455) that contribute to ‘burnout’. As the â€Å"most caring and most highly committed are often the ones most prone to burnout† (Eisenstat & Felner cited in Crawford J. 1990:48) it’s frequently linked to health care. Burnout is defined as, (Kozier B et al 2000:1387). † an overwhelming feeling that can lead to physical and emotional depletion, a negative attitude and self concept, and feelings of helplessness and hopelessness† There are many methods to prevent burnout. One of these I observed, and have been guilty of my self, is the ability to suddenly become deaf. For example one client would continually ask for a ‘cup of tea’, to which staff would respond ‘you’ve just had one’ and the client would reply ‘I’ve just had one’ and walk away. But if the frequency of requests increased or they interrupted another activity staff would often pretend not to hear, they would ovoid eye contact and turn away. By ignoring the client it extended the periods between acknowledged requests. For the same reason this client was always last to receive his cup of tea when it was being made for the group. This coping mechanism ‘denial’ is one of many established ways to deal with stress (Kenworthy N. 1996:91). In denial you reject the thing that is unacceptable choosing to believe it isn’t there. Denial is very similar to ‘repression’ where although aware of the feelings you block them out, Tappen suggest that this can leave the caregiver with a â€Å"vague sense of unease† towards the client. Having denied hearing the request staff would then repress their guilt, leaving them with an uneasy feeling towards the client. This practice while not acceptable, had no long-term affects on the client as he would simply ask again a few minutes later, however if all requests where dealt with in the same way it could become harmful to the client (Tappen R. 1995:11). Another behaviour I witnessed was the reliance on PRN medication; a different client was very vocal following staff around the home asking questions about her forthcoming blood test. After a couple of failed attempts to reassure her it was decided she needed PRN to clam her down. The staff had coped by rationalising the situation. Rationalisation uses one explanation to cover up a less acceptable one i.e. their reason for giving the medication was to calm the client down. But the real reason was it would stop her bothering them with questions. (Tappen R.1995:11). Often in learning disabilities carers see a client’s failure to behave in an acceptable way or achieve targets as a personal failure (Brown H. Smith H. 1992:95). These failures or ‘client losses’ are another factor that contributes to burnout (Tappen R.1995:455). Other factors often experience by learning disabilities cares also contribute to burnout such as ‘low pay’, ‘discrimination’ and ‘inadequate advancement opportunities’. Learning disabilities are often referred to as â€Å"the Cinderella of the Cinderella services†(Parish C. 2001:13), and as such tend to attract the least skilled workers, who are given a low status even in relationship to carers in other fields (Brown H. & Smith H. 1992:93). Care is traditionally seen as â€Å"women’s work† and therefore â€Å"unskilled and unworthy† (Brown H. & Smith H. 1992:162/166). This is reflected in the fact that care staff are predominately women working part time, earning low levels of pay and having few opportunities to advance their careers (Hudson B. 2000: 88). Care work is rarely undertaken solely for financial gain; often the motives are more altruistic (Dagnan D. 1994:127). A study into staff satisfaction found that â₠¬Å"in spite of low pay† care staff â€Å"found rewards in the close nature of the caring relationship† (Hudson B. 2000:89). Recent government white papers ‘NHS and Community Care Act’ and ‘Valuing People’ aim to enhance the status of learning disabilities by reorganising the way that the service is provided (Beacock C. 2001:23), and â€Å"give those working in social care a new status which fits the work they do† (Hudson B. 2000:99). These proposals may ultimately improve the status of the service, but in the short term the changes are creating more paperwork, require new skills, and are leading to greater job insecurity. These factors are adding to an already stressful job (Hudson B. 2000:96). Studies found that the main causes of stress for care workers were â€Å"the inability to provide service users with what they needed, accountability or responsibility without power, frustration at office politics and uncertainty about the future† (Hudson B. 2000:90). ‘Powerlessness’ and ‘unresponsiveness to client needs’ added to ‘too much paper work’ are more factors that can contribute to burnout (Tappen R. 1995:456). Care staff are under a great deal of pressure, in their daily work they face all of the ten factors that contribute to burnout. This must ultimately have an affect on the way care is provided. I have no doubt that the staff at my placement are genuinely caring people who do their best to provide a high standard of care for their clients. However sometimes the quality of care I witnessed reflected the pressures they were facing. Only when the attitudes towards care work improve will its status be increased. This would in turn see a rise in pay and a decrease in the stress felt by carers, which would have the end result of improving the care received by clients. References Ajiboye P. (2000) Learning partners. No Limits. Autumn 2000 pp.11 Barratt M. Mottershead A. (1999) Understanding Industry. 5th Edition. London, Hodder & Stoughton. Beacock C. (2001) Come in from the cold. Nursing Standard. Vol.15 no.28 pp.23 Brown H. Smith H. {Editors} (1992) Normalisation: a reader for the nineties. London, Routledge. Churton M. (2000) Theory and Method. London, Macmillan Press Ltd Crawford J. (1990) Maintaining Staff Morale: the value of a staff training and support network. Mental Handicap. Vol. 18 June pp.48-52 Dagnan D. (1994) The Stresses and Rewards of Being a Carer in a Family Placement Scheme for People with Learning Disabilities. British Journal of Learning Disabilities. Vol.22 1994 pp.127-129 Dell T. (1998) How to Motivate People: a guide for managers. California, Crisp Publications Inc. Ellis R. Gates R. {Editors} (1995) Interpersonal Communication in Nursing: Theory and Practice. Kenworthy N. London, Churchill Livingstone. Grohar-Murray M, DiCroce H. (1997) Leadership and Management in Nursing. 2nd Edition. Connecticut, Appelton and Lange. Giddens A. (1997) Sociology. 3rd edition. Cambridge, Polity Press. Hudson B. Editor (2000) The Changing Role of Social Care. London, Jessica Kingsley Publishers Ltd. Hogston R, Simpson P. {Editors} (1999) Foundations of Nursing Practice. London, Macmillan Press Ltd. Kenworthy N, Snowley G. (1996) Common Foundation Studies in Nursing. 2nd Edition. Gilling C. Singapore, Churchill Livingstone. Kozier B. Erb G. Berman A. (2000) Fundamentals of Nursing: concepts, process, and practice. Burke K. 6th Edition. New Jersey. Prentice-Hall Inc. Marsh I. (1996) Making sense of society: an introduction to sociology. London, Longman. Masllin-Prothero S. (1997) Baillià ¯Ã‚ ¿Ã‚ ½re’s Study Skills for Nurses. London, Hardcourt Brace and Company Ltd. Oliver R. Endersby C. (1994) Teaching and Assessing Nurses: a handbook for preceptors. London, Baillià ¯Ã‚ ¿Ã‚ ½re and Tindall. Parish C. (2001) Take the reins. Nursing Standard.Vol.15 no.29 pp.12-13 Quinn F. (1995) The Principles and Practice of Nurse Education.3rd Edition. Cheltenham, Stanley Thornes (Pulishers) Ltd. Reed J. Procter S. (1993) Nurse Education – A reflective approach. London, Edward Arnold. Salvage J. {Editor} (1999) Nursing Times Student Pack. London, Nursing Times. Tappen R. (1995) Nursing Leadership and Management: concepts and practice. 3rd Edition. Philadelphia, F. A. Davis Company. Tyson S. Jackson T. (1992) The Essence of Organizational Behaviour. Hemel Hempstead, Prentice Hall International (UK) Ltd. Bibliography Bartlett C. Bunning K. (1997) The Importance of Communication Partnerships: A study to investigate the communicative exchanges between staff and adults with learning disabilities. British Journal of Learning Disabilities. Vol.25 (1997) pp.148-154 Brigham L. Atkinson D, (2000) Crossing Boundaries, Change and Continuity in the History of Jackson M, Rolph S, Walmsley J. Learning Disability. Plymouth, BILD Publications. Booth T. Simons K. (1990) Outward bound: Relocation and community care for people with Booth W. learning difficulties. Buckingham, Open University Press. Clegg A. (2000) Leadership: improving the quality of patient care. Nursing Standard.Vol.14 no.30 pp.43-45 Clissett P. (2001) The Effectiveness of NVQ Training. Nursing Management. Vol. 8 no. 1 pp.11-13. Clutterbuck D. (1991) Everyone needs a Mentor: fostering talent at work. 2nd Edition. London, Institute of Personnel Management. Dinsdale P. (2001) Community spirit. Nursing Standard. Vol.15 no.39 pp.14 Gray J. (2001) Inside out: Analysis of the difficulties surrounding participant observation. Nursing Standard.Vol.15 no.31 pp.51 Hattersley J, Hosking G, (1987) People with Mental Handicap: Perspectives on intellectual Morrow D, Myers M. disability. London, Faber and Faber Ltd. Hill M. {Editor} (2000) Local Authority Social Services: an introduction. Oxford, Blackwell Publishers Ltd. Kroese S. Fleming I. (1992) Staff’s Attitudes and Working Conditions in Community-Based Group Homes of People with Mental Handicaps. Mental Handicap Research. Vol. 5, no.1 pp 82-91. Moore S. (1987) Sociology Alive Cheltenham, Stanley Thornes (Publishers) Ltd. Oliver M. Barnes C. (1998) Disabled People and Social Policy: from Exclusion to Inclusion. London, Longman. Quinn E. (2001) Stressed out? RCN Magazine. Spring 2001 pp.14-15 Sarantakos S. (1998) Social Research. 2nd Edition. London, MacMillan. Wilson J. (1994) The Care Trade: a picture of health. Lancaster, Quay Pulishing Ltd.

Quantitative Easing

Evan Schrager 11/14/2011 Quantitative Easing Research Paper The term  quantitative easing  (QE) describes a process in which the Federal Reserve expands its balance sheet through purchasing back government bonds from financial institutions with electronically created funds. The government purchases, by way of account deposits, give banks the excess reserves required for them to create new money by the process of  deposit multiplication  from increased lending in the fractional reserve banking system. As the supply of medium and long-term government bonds decreases, their prices increase. This leads to a decrease in their yield; yields are often a determinant of long-term interest rates, mortgages and most business lending. Since it is easier for individuals to borrow money, consumer wealth increases, which leads to investment and consumption increases as well. Risks include the policy being more effective than intended, spurring  hyperinflation, or the risk of not being effective enough, if banks opt simply to pocket the additional cash in order to increase their capital reserves in a climate of increasing defaults in their present loan portfolio. In the quantitative easing process, the Fed goes to a network of dealers, in search of Treasury bonds. The Fed buys the bonds in a competitive bidding process between the approved bond dealers. The Fed takes a bond certificate and gives the dealers freshly printed US dollars. The transactions are done electronically, but it is still referred to as printed money. The US  Federal Reserve  held between $700 billion and $800 billion of Treasury notes on its balance sheet before the current recession. In late November 2008, the Fed started buying $600 billion in  Mortgage-backed securities. By March 2009, it held $1. 75 trillion of bank debt, MBS, and Treasury notes, and reached a peak of $2. 1 trillion in June 2010. The primary dealers can offer to sell the Fed bonds held by their clients. The newly printed money moves from the Fed, to the dealer, to the client’s brokerage account. Cash is moving directly into the real economy. The customer can buy another bond, buy stocks, use it at the grocery store, or simply keep the cash. Right now, however, cash is earning next to nothing, so investors are motivated to find alternative stores of value. They are motivated to spend or invest their cash. With an ongoing battle taking place between inflationary and deflationary forces in the economy and financial markets, it is extremely important for investors to understand how â€Å"quantitave easing† programs will impact their investments and their long term purchasing power. Since quantitative easing represents a threat to our wealth based on its potential adverse impact, this topic warrants serious attention above and beyond a boilerplate analysis. Common references to â€Å"cash sitting at banks† will give investors a poor read on what quantitative easing is and the possible ramifications for our portfolios and the economy. In order to put QE in context, I will discuss the Japanese deflationary spiral of the ‘90s. Japan suffered from stagflation throughout the 1990’s, so the Bank of Japan instituted a quantitative easing program of its own, referred to as QEP. The QEP consisted of three key elements: â€Å"(1) The BOJ changed its main operating target from the uncollateralized overnight call rate to the outstanding current account balances (CABs) held by financial institutions at the BOJ (i. e. , bank reserves), and ultimately boosted the CAB well in excess of required reserves. 2) The BOJ boosted its purchases of government bonds, including long-term JGBs, and some other assets, in order to help achieve the targeted increases in CABs. (3) The BOJ committed to maintain the QEP until the core CPI (which in Japan is defined to exclude perishables but not energy) stopped declining. † The effect of the Bank of Japan’s liquidity injections on bank lending was muted by the substitut ion of central bank liquidity for interbank liquidity. Second, despite the dampening of the stimulus from the liquidity injections due to this substitution, there was a positive and significant effect of liquidity on bank lending. This implies that quantitative easing can affect the supply of credit, particularly during periods of financial stress. However, the overall effect was fairly small, so that huge amounts of liquidity would have been needed to achieve noticeable effects. Third, weak banks benefited more from QEP than stronger banks. However, â€Å"the rapid unwinding of liquidity infusions observed at the conclusion of QEP had little impact on lending growth once bank health and confidence in the banking system had been restored. † It is possible that QEP exerted ositive effects, but that these were simply overwhelmed by the drag on total spending coming from weakness in the banking sector and balance sheet problems among households and firms. Since there are a number of ways that QEP may have stimulated spending, we can infer that the QE programs in the United States will stimulate some spending as well, but perhaps we will overestimate the effects just like Japan did years ago. When you consi der some of the world’s largest sovereign wealth funds may participate in QE, you can understand the potentially broad impact of the Fed’s actions. The largest ones control billions of dollars. With the currency risk involved when foreigners hold treasury bonds, it is not a stretch to believe that some sovereign wealth funds will be interested in selling some of their treasuries to the Fed in exchange for newly printed US dollars. They may also quickly exchange the cash for gold, silver, copper, oil or stocks to reduce their currency risk. Fears of future inflation can make cash unattractive in the eyes of investors and consumers. A big part of the Fed’s approach is to increase the expectations of future inflation since it can change the investing and buying habits of businesses and consumers. Since there are many unknowns, and many moving parts, listen with skepticism to anyone who claims to know the long term impacts of QE programs on both the financial markets and the economy. † We need to better understand the QE process, and monitor and assess the market’s reaction to details as they are released by the Fed. We must be willing to make inflationary a nd deflationary adjustments based on market internals and economic data. Adopting a â€Å"QE will work or won’t work† approach in advance would be highly speculative. Flexibility is always important in the markets, but maybe more so when it comes to the possible long term impacts of QE. This newly printed money will find its way around the globe, impacting currencies, commodities, and foreign stock markets. According to Brian P. Sack of the NYFRB, â€Å"The effect of asset purchases on the economy remains a point of ongoing debate, with some uncertainty about the channels through which such purchases operate and the magnitude of those effects†¦ In particular, by purchasing longer term securities, the Federal Reserve removes duration risk form the market, which should help reduce the term premium that investors demand for holding longer term securities. That effect should, in turn, oost other asset prices, as those investors displaced by the Fed’s purchases would likely seek to hold alternative types of securities. † â€Å"Nevertheless, balance sheet policy can still lower longer-term borrowing costs for many households and businesses, and it adds to household wealth by keeping asset prices higher than they otherwise would be. It seems highly unli kely that the economy is completely insensitive to borrowing costs and wealth, or to other changes in broad financial conditions. † Notice the references to â€Å"boosting asset prices,† and â€Å"lowering borrowing costs,† and â€Å"adding to household wealth by keeping asset prices higher. From Mr. Sack’s perspective, the Fed buys intermediate term treasuries, which drives down the yield for new investors. Mr. Sack hypothesizes that those new investors will decide to purchase other bonds, perhaps with longer maturities as they search for higher yields. As the Fed pushes demand to other areas of the bond market, longer term interest rates would fall. As new investors look at their options, they may decide to purchase other high yielding assets since the Fed’s actions have made yields on more conservative investments unattractive. Since the Fed promises to remain in the market with QE for an extended period, the risk associated with holding stocks, higher yielding bonds, commodities, precious metals and real estate are reduced. If you think in extremes, if the Fed stated that all treasuries would pay no interest for the next 5 years, investors would move into investments with more risk in search of higher yields. A good way to summarize QE is as follows: QE attempts to lower long term interest rates, keep them low for a pre-defined period of time, while pouring cash into the economy in an effort to boost consumption and investment. Like gold, US dollars have value only to the extent that they are strictly limited in supply. The government has technology that allows it to produce as many US dollars as it wishes at essentially no cost. By increasing the number of US dollars in circulation, or by threatening to do so, the US government can reduce the value of a dollar in terms of goods and services, which is the same as raising the price in dollars of those goods and services. Thus, we can conclude that, under a paper money system, a determined government can always generate higher spending and hence, positive inflation. The important takeaway is the concept, which is to print money, and devalue the purchasing power of US dollars in your wallet/bank account. Based on the government and Fed’s extreme actions during the financial crisis, it is safe to say that we have a determined government. Investors cannot underestimate how determined our government will be, in terms of â€Å"how much money are they willing to print? † and â€Å"what assets are they willing to buy? † For example, if buying T-bonds doesn’t work, what prevents them from moving to corporate bonds, stocks, residential housing, or commercial real estate? That sounds extreme, but five or six years ago, having the Fed buy treasury bonds or having the government take over AIG seemed extreme. But that happened right before our eyes. A problem around the globe is weak balance sheets from consumers to corporations to municipalities all the way up to the United States’ assets and liabilities ledger. There are two ways to address weak balance sheets. You can attack the asset side or the liability side. During recessions, bad debt is removed from the system when entities go out of business, defaulting on their debts. This is a painful part of a recession, but is necessary to allow capital to reform, which eventually leads to new investment and sustainable economic growth. The hard way to address our problems with balance sheets is to let those who deserve to fail go out of business. Unfortunately for the country’s long term outlook, the hard way, or short term pain, does not sit well with those in positions of power—especially politicians, who are always concerned about the next election. This is a huge flaw: we need to think in terms of what is best for the future of our country instead of thinking in the short term. If we need to reduce our standard of living in order to combat the national deficit, then so be it. Americans need to stop complaining about the recessionary conditions and must make sacrifices now in order to guarantee future standards of living. In order to understand all of the bailouts, government takeovers, and money printing, you basically need to think about powerful people in business and government who are simply trying to stay in power, regardless of whether or not their actions are in the best long term interest of shareholders, taxpayers, and ordinary hard working citizens. These comments do not apply to the select few in positions of power who still make decisions based upon sound principles and integrity, but most politicians do not. I’ll stay away from this topic because it is a political issue, but quite relevant so I felt it was worth mentioning. In a healthy credit market, banks lend while consumers and businesses borrow to invest and consume. Demand, based upon available credit, boosts asset prices and profits. As asset prices rise, balance sheets strengthen. With healthy balance sheets, businesses and consumers feel wealthy, and borrow more, invest more, and consume more. This is known as the wealth effect. As asset prices rise, the collateral backing the loans remains sound, allowing the banks to lend even more, and around and around we go, until credit causes the creation of too much supply. A good example is the recent overbuilding in the housing market. Then asset prices begin to fall. Now the wealth effect becomes the reverse wealth effect, as consumers, businesses, and banks begin to see their net worth deteriorate. When the Fed lowers interest rates, they attempt to spur borrowing and lending. This, in turn, can get the wealth effect back into gear, as borrowed money creates demand for goods, services, and assets. In the present day, traditional banks are reluctant to lend, and many consumers either don’t want a loan, or cannot get a loan. In this environment, the Fed, via QE, is trying to spark the wealth effect by attempting to re-inflate asset prices. QE II refers to the decision in November 2010 in which the FOMC announced the purchases of 600 billion longer-term treasury debt. A fair question to ask is, â€Å"Why did we pursue QEII? There are several reasons the government went through with another round of QE. Firstly, the Japanese experience with mild deflation and a near-zero nominal interest rate has been poor. Second, inflation in the US was close to the implicit FOMC inflation target during the first part of 2010. However, during 2010, a renewed disinflation trend developed and the recovery slowed down in the summer of ’10. These developments leav e the US at risk of a Japanese-style outcome. Was QEII effective? The financial markets effects of QEII looked the same as if the FOMC had reduced the policy rate substantially. Specifically, real interest rates declined, the dollar depreciated, and equity prices rose. These are the classic financial market effects one might observe when the Fed eases monetary policy in ordinary times (in an interest rate targeting environment). The QEII experience shows that monetary policy can be eased aggressively even when the policy rate is near zero. However, it is difficult to observe the overall effects of QE and QEII because of the lags involved. Effects on the real economy would be expected to lag by six to twelve months. Real effects are difficult to disentangle because other shocks hit the economy in the meantime. This happened, apparently, during the first half of 2011, and is a standard problem in evaluating monetary policy. Overall, QE2 has shown that the Fed can conduct an effective monetary stabilization policy even when policy rates are near zero. Now I will discuss investment strategies for inflationary and deflationary outcomes of quantitative easing. Inflationary and deflationary forces coupled with possible Fed intervention require a flexible approach to financial markets. Common sense tells us that money printing is probably not the path to long term prosperity, but I do believe QE can impact asset prices in a manner not fully understood by many individual investors as well as many financial advisors. If the Fed is successful for a period of time, I would invest in inflation friendly and weak-dollar assets such as gold, silver, copper, oil, and emerging market stocks. If the Fed fails in the long run, then a deflationary spiral may be the outcome, making cash, gold, dividend payers, conservative bonds, and CDs attractive. Middle of the road choices include utilities, consumer staples stocks, and other dividend payers. Financial markets tend to anticipate Fed announcements. We always have to be on our toes for information/news relevant to QE. If you read the writings of Ben Bernanke and more recently writings by James Bullard, you know the Federal Reserve is willing to use every tool and printing press in their arsenal in attempt to re-inflate asset prices and restore some semblance of the wealth effect. However, we must understand that the Fed faces high hurdles, in the form of mountains of global debt and fragile asset prices. So far, the U. S. has been able to get away with massive debts and unsustainable deficits for one simple reason. The U. S. dollar is still the world’s reserve currency, as it has been effectively since World War II and literally since the early 1970? s. Because all governments and banks in the world accept and hold U. S. dollars as the majority of their reserves, the United States is able to simply print more money whenever it cannot afford to pay for things that it needs. Besides this, the country can borrow money in its own currency at incredibly low interest rates that we have seen approach almost zero. US citizens personally benefit in another critical way every time that they stop to get gas. With the U. S. dollar as the international reserve currency, oil and almost all  commodities  are all priced in dollars. As a result, you see an enormous amount of inexpensive goods available. Food items and other items that use oil/gas as inputs are extremely cheap. This makes restaurants and other attractions affordable in America. The level of wealth seen in the United States is simply unprecedented, and most of this results from the benefits of the dollar as universal reserve currency. There will be dramatic consequences difficult to imagine if the dollar finally ceases to be the reserve currency of the world. Should this happen, then the value of the dollar will plummet. The immediate painful effects will be that commodities prices skyrocket. These would no longer be priced in U. S. dollars, and you would see the falling value of the dollar buy fewer and fewer commodities. Gasoline at five to ten dollars a gallon is not only possible, but highly likely. Along with higher gas prices, we could see higher prices for anything that uses oil to ship goods around the world. This means practically everything that you buy would all cost dramatically more. As prices skyrocket, your lifestyle would sustain a punishing drop overnight. This is a very scary succession of possible events. Unfortunately, this is not the only consequence that you would see of a dollar that is no longer the reserve currency of the world. Interest rates would rise dramatically. They could easily reach ten to fifteen percent. This would wreck the housing market far worse than it is today. It would also cause the stock market to crash by almost half in a number of weeks. As the costs of supplies and materials go up with the falling currency value, businesses would be forced to cut back on  employees  because of their falling sales. Unemployment could reach twenty to thirty percent or more as a result of this. As if this is not bad enough,  inflation  would be sky high along with the rising prices and disappearing jobs. It is important to remember that the only thing that has to occur for all of these terrible things to happen is for other countries to prefer to be paid in anything besides U. S. Dollars. In the event that non-United States holders of dollar-denominated assets decided to shift holdings to assets denominated in other currencies, there could be serious consequences for the US economy. The possibility of QE3 has some serious implications, although Bernanke has denied that there will be another round easing. The dollar has plunged nearly 20% against the euro over the last year and a half, a period that includes the run-up to and aftermath of the last round of quantitative easing, the Fed's $600 billion bond-buying program known as QE2. But a QE3 may not pack the same dollar-slamming punch. If there is a QE3, the dollar's fall could easily approach 10% on a trade-weighted basis against rival currencies, said David Woo, head of G-10 global rates and currencies research at Bank of America Merrill Lynch in New York. But â€Å"the market is now more skeptical of the benefits of QE for the economy,† Mr. Woo said. â€Å"It is possible that by extension this means any short-term [dollar] decline on the back of QE3 will be also more limited. † Instead of QE3, Bernanke and the Fed decided to implement â€Å"Operation Twist,† a widely expected stimulus move reviving a policy from the 1960s. The policy involves selling $400 billion in short-term Treasuries in exchange for the same amount of longer-term bonds, starting in October and ending in June 2012. While the move does not mean the Fed will pump additional money into the economy, it is designed to lower yields on long-term bonds, while keeping short-term rates little changed. The intent is to thereby push down interest rates on everything from mortgages to business loans, giving consumers and companies an additional incentive to borrow and spend money. Some reputable names believe the dollar is going to depreciate in value over the next decade or two. Bestselling authors Robert Wiedemer of â€Å"Aftershock† and David Skarica of â€Å"The Great Super Cycle† both forecasted the housing collapse, financial crisis, and stock market collapse years ahead of them happening. They are calling for a collapse of the dollar. This could lead to many unsophisticated investors to â€Å"hop on the train†, causing a swing in technical expectations. QE attempts to lower long term interest rates, keep them low for a fairly well-understood period of time, while flooding the economy with cash in an effort to boost consumption and investment. In my opinion, quantitative easing in the US was a mild success. The markets were in a state of flux and we needed to do something. QE2 was necessary because we needed to increase the scale to which the LSAPs (large scale asset purchases) affected the economy. As for QE3, I don’t believe it is in our country’s best interest, because it would show even greater weakness, leading many foreign investors to flee from the dollar. Somewhere down the line, I predict that the IMF will attempt to overtake the dollar as the world reserve currency, but it certainly won’t happen overnight. If this happens, Americans will have to downgrade their wealthy standard of living due to increased commodity prices. However, I don’t believe the US Dollar will lose its currency reserve status anytime soon, nor do I believe that QE3 will happen. My recommendation is to continue QE in small amounts, unwinding it under Bernanke’s plan from his September speech in Minneapolis. Bernanke has stated that there will be no more easing, but you never know with the â€Å"Bernanke, Obama, Geithner brain trust. † Thus, our best option is to remain flexible in our policy schemes and monitor and react to relevant news as best as we can. Ben Bernanke concludes his Minneapolis speech in an attempt to reassure us that our country will be okay. â€Å"The Federal Reserve will certainly do all that it can to help restore high rates of growth and employment in a context of price stability. † Let us hope they act with rationality and in the best interest of the long term growth and stability of our economy. If America is ever going to dig itself out of the enormous debts it has taken, we must not devalue the dollar to the point that it is phased out as the world reserve currency. Perhaps a downgrade in American’s standard of living is necessary to reduce the deficit by a significant enough margin. There is some hope for a return to prosperity and consistent growth, but Americans need to be aware of the implications of QE on their portfolios and their long term purchasing power. Works Cited 1. United States. Richmond Federal Reserve. By Thomas M. Humphrey. The Theory of Multiple Expansion of Deposits: What It Is and Whence It Came. Mar. -Apr. 1987. Web. 14 Nov. 2011. . 2. A QE1 Timeline. † Calculated Risk, 03 Oct. 2010. Web. 13 Nov. 2011. . 3. Ciovacco, Chris. â€Å"Video Series: Quantitative Easing. † Ciovacco Capital Management. Web. 14 Nov. 2011. . 4. Sack, Brian P. â€Å"Managing the Federal Reserve's Balance Sheet – Federal Reserve Bank of New York. â€Å"Federal Reserve Bank of New York, 04 Oct. 2010. Web. 13 Nov. 2011. . 5. Bowman, David, Fang Cai, Sally Davies, and Steven Kamin. Quantitative Easing and Bank Lending: Evidenc e from Japan. †Ã‚  Www. federalreserve. gov. Board of Governors of the Federal Reserve, June 2011. Web. 13 Nov. 2011. ;http://www. federalreserve. gov/pubs/ifdp/2011/1018/ifdp1018. pdf;. 6. Eichengreen, Barry. â€Å"Dollar's Reign as World's Main Reserve Currency Is Near an End. â€Å"Foreign Exchange Report. The Wall Street Journal, 02 Mar. 2011. Web. 13 Nov. 2011. 7. Herold, Thomas. â€Å"What If The U. S. Dollar Loses Reserve Currency Status? † Wealth Building Course, 14 Jan. 2011. Web. 13 Nov. 2011. ;http://www. wealthbuildingcourse. om/dollar-loses-reserve-currency-status. html;. 8. Bullard, James. â€Å"QE2: An Assessment. † Federal Reserve Bank of St. Louis, 30 June 2011. Web. 13 Nov. 2011. ;http://research. stlouisfed. org/econ/bullard/pdf/Bullard_QE_Conference_June_30_2011_Final. pdf;. 9. Wieland, Volker. â€Å"Quantitative Easing: A Rationale and Some Evidence from Japan†, in  NBER International Seminar on Macroeconomics 2009  (2010), Univ ersity of Chicago Press   http://www. nber. org/papers/w15565 10. Cronin, Brenda. â€Å"Slow-Paced Recovery Feels Like a Recession. † The Wall Street Journal, 10 Oct. 2011. Web. 13 Nov. 011. ;http://online. wsj. com/article/SB10001424052970203499704576623053674426690. html;. 11. Fontevecchia, Agustino. â€Å"Central Banks Dump Treasuries As Dollar's Reserve Currency Status Fades. † Forbes, 03 Mar. 2011. Web. 13 Nov. 2011. ;http://www. forbes. com/sites/afontevecchia/2011/03/16/central-banks-dump-treasuries-as-dollars-reserve-currency-status-fades/;. 12. Case, Karl E. , John M. Quigley, and Robert J. Shiller. Wealth Effects Revisited. Yale University, Feb. 2011. Web. 14 Nov. 2011. ;http://cowles. econ. yale. edu/P/cd/d17b/d1784. pdf;. 13. Rooney, Ben. IMF Discusses Plan to Replace Dollar as Reserve Currency. † CNNMoney, 10 Feb. 2011. Web. 13 Nov. 2011. . 14. Weisenthal, Joe. â€Å"This Is How The Dollar Could Lose Its Reserve Currency Status. † Business Insider, 15 Nov. 2010. Web. 13 Nov. 2011. . 15. Bernanke, Ben. â€Å"The U. S. Economic Outlook–September 8, 2011. † Board of Governors of the Federal Reserve System, 08 Sept. 2011. Web. 13 Nov. 2011. . 16. Hamilton, James. â€Å"5 Key Arguments Against Quantitative Easing. † Business Insider, 20 Oct. 2010. Web. 14 Nov. 2011. . 17. Johnson, Andrew J. â€Å"Sizing Up Dollar's Pain From a QE3. † The Wall Street Journal, 05 Sept. 2011. Web. 14 Nov. 2011. . 18. Censky, Annalyn. â€Å"Federal Reserve Launches Operation Twist. † CNNMoney, 21 Sept. 2011. Web. 14 Nov. 011. . ——————————————– [ 1 ]. Richmond Federal Reserve. By Thomas M. Humphrey. The Theory of Multiple Expansion of Deposits: What It Is and Whence It Came. [ 2 ]. Wieland, Volker. â€Å"Quantitative Easing: A Rationale and Some Evidence from Japan† [ 3 ]. Calculated Risk. â€Å"A Q E1 Timeline. † [ 4 ]. Videos: Quantitative Easing, Chris Ciovacco [ 5 ]. Videos: Quantitative Easing. Chris Ciovacco [ 6 ]. Bowman, â€Å"Quantitative Easing and Bank Lending: Evidence from Japan. [ 7 ]. Bowman, â€Å"Quantitative Easing and Bank Lending: Evidence from Japan. †Ã‚   [ 8 ]. Hamilton, James. â€Å"5 Key Arguments Against Quantitative Easing. † [ 9 ]. Hamilton, James. â€Å"5 Key Arguments Against Quantitative Easing. † [ 10 ]. Sack, Brian P. â€Å"Managing the Federal Reserve's Balance Sheet [ 11 ]. Wieland, Volker. â€Å"Quantitative Easing: A Rationale and Some Evidence from Japan† [ 12 ]. Wieland, Volker. â€Å"Quantitative Easing: A Rationale and Some Evidence from Japan† [ 13 ]. Cronin, Brenda. â€Å"Slow-Paced Recovery Feels Like a Recession. † [ 14 ]. Case, Karl E. , John M. Quigley, and Robert J. Shiller. Wealth Effects Revisited. [ 15 ]. Bullard, James. â€Å"QE2: An Assessment. † [ 16 ]. Bullard, James. â€Å"QE2: An Assessment. † [ 17 ]. Videos: Quantitative Easing, Chris Ciovacco [ 18 ]. Eichengreen, Barry. â€Å"Dollar's Reign as World's Main Reserve Currency Is Near an End. † [ 19 ]. Fontevecchia, Agustino. â€Å"Central Banks Dump Treasuries As Dollar's Reserve Currency Status Fades. † [ 20 ]. Eichengreen, Barry. â€Å"Dollar's Reign as World's Main Reserve Currency Is Near an End. † [ 21 ]. Weisenthal, Joe. â€Å"This Is How The Dollar Could Lose Its Reserve Currency Status. † [ 22 ]. Rooney, Ben. â€Å"IMF

Autobiographical Sketch of the Political Career Of John F. Kennedy

From my birth in 1917 I was seemingly destined for a political career. I am John Fitzgerald Kennedy, and my middle name of Fitzgerald would serve to remind the voters of Boston and Massachusetts of my maternal grandfather, Honey Fitz Fitzgerald, a beloved former mayor of Boston. During World War II I pulled all the political strings my wealthy family possessed in an effort to be sent to the fighting, for I knew that after the war I would be a more viable candidate as a combat veteran.Virtually all of my early life revolved around politics, and both my older brother and I understood we were meant for high office. My father, Joseph P. Kennedy often said that his son would be America’s first Catholic president. He would prove to be prophetic.After the war, in 1946, I conducted my first campaign for congress (jfk library n.d.), enlisting the help of my sisters, my mother and my popular grandfather, going door-to-door on crutches as I recovered from my war wounds. I was elected on my first try.My goal from the beginning was the presidency of the United States and I used my family’s money and political connections toward that end. I first had to have a national platform and I chose to seek a seat in the U.S. Senate. I was elected in 1953 and immediately began my assault on the next obstacle. In 1956 I broke a tradition of the Democratic Party by actively seeking the nomination for vice-present on the ticket headed by Adlai Stevenson (White House.gov n.d.).My brother Robert once joked that that I have been saved from that mistake by being denied the nomination, as Stevenson lost to the sitting president, Dwight Eisenhower, in a landslide. Still this honed my political skills and allowed me to build a national base for my assault on the presidential nomination in four years.In 1960 I was elected 35th president of the United States in the closest election ever conducted, narrowly beating out the sitting vice-president, Richard Nixon (ibid).On November 22 o f 1963 I made an ill-fated trip to Texas to mend some political fences within the party. I over-rode the advice of my security detail, which wanted me to ride in a limo with a bulletproof canopy. I wanted the crowd to have a better view of my wife and me as we drove past them on the narrow streets of Dallas on a beautiful sunny day.   As we were clear of the downtown canyon shots rang out and I was assassinated as my wife and a cheering crowd looked on in horror. I was the youngest man ever elected president and the youngest man to die in office.Works CitedJohn F. Kennedy Library and Museum     Biographies and Profiles: KennethP. O’Donnell   Retrieved 3-2-08 from:http://www.jfklibrary.org/Historical+Resources/Biographies+and+Profiles/Profiles/Kenneth+P.+ODonnell.htm  Ã‚  Ã‚  Ã‚  The White House  Ã‚   John Kennedy   Retrieved 3-2-08 from:http://www.whitehouse.gov/history/presidents/jk35.html  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  

Eusociality in a mammal (naked mole-rats) Research Paper

Eusociality in a mammal (naked mole-rats) - Research Paper Example Considering the three features of eusociality described above, naked mole-rats are the only eusocial mammals that we have ever known. Known taxonomically as Heterocephalus glaber, and belonging to group Rodentia of family Bathyergidae, the naked mole-rats are generally found in the hot, semiarid regions of Africa. They usually live in large colonies present underground in subterranean tunnels (Ciszek) where on average 75 mole-rats live in each colony. Only one female mole-rat reproduces by breeding with a few males of the community, while the rest of the males and females form the labor force which perform tasks like maintenance of colonies, nest building, transportation of soil, and defense. The workers keep busy in construction and provision of food. Being sterile, they do not have a direct offspring but work cooperatively together to look after the offspring of the queen. However, as Ciszek states in his research, these workers are not â€Å"obligatory sterile†, meaning tha t they are capable of reproducing but when they have to live in colonies, they are not supposed to breed. But, if they are separated from their colonies, then they are able to actively reproduce. This is the concept of inclusive fitness (Hamilton 1; Axelrod and Hamilton 1390) according to which an individual is fit for reproduction even if he/she does not have a direct offspring. This is the sharing of genes and the overall fitness is measured by also including the fitness of those who just share the genes even if they have not bred. Thus, the trouble that how the worker mole-rats are able to transmit their genes to the next generation if they are sterile, is solved through the concept of inclusive fitness according to which if the worker mole-rats share genes with their mother queen, then they are able to assist her in raising future queens thus enabling the workers to transmit their genes. This assistance is a special feature of eusociality. Hence, we see close inbreeding in these mole-rats since there is high genetic similarity (Faulkes, Abbott and Mellor). This close inbreeding eliminates the chances of out-breeding in mole-rats which increases their relatedness to the queen’s offspring. This close genetic relatedness maximizes the workers’ potential to do more work. Jarvis (571) talks about frequent workers, infrequent workers, and non-workers. Frequent workers are those who are assigned the responsibilities of digging the soil, construction, maintenance, and food provision. They make trips inside the colonies with food without taking pauses to eat themselves. Infrequent workers assist the frequent workers in work and make half the amount of effort frequent workers make. It is interesting that Jarvis found that the largest proportion of mole-rats is that of non-workers and that their roles are not clearly identified (571). He claims that the male members of these non-workers mate with the breeding female. He studied that since most of these non-workers are most of the time sleeping, thus the overall energy requirement for the colony is reduced. Their main role, he guesses, is the assistance in the brought up of the offspring. Jarvin further affirms that female mole rats of all these categories are non-breeding and will never reproduce.

College course appeal letter Assignment Example | Topics and Well Written Essays - 250 words

College course appeal letter - Assignment Example Time wastage is another reason why I feel that this course should be transferred. At the current state, I will be required to dedicate a lot of time attending classes, doing assignments and other projects required under Course 123 that I did under Course ABC. I therefore believe that redoing this course will be a duplication of efforts and I could spend the time on other course units and related activities such as academic research. In addition, the university ought to acknowledge a credential course certificate from another university and further approve the transfer of such a course for any student. Lastly, the university should allow for the transfer of this course because I not only completed it but also passed and having to repeat it will be a demoralizing experience for me. I hope you will give me the chance to have the course transferred. Thank you for considering this

DQ2 Essay Example | Topics and Well Written Essays - 750 words

DQ2 - Essay Example The payments made to the suppliers of resources are expressed and revealed (explicit) or are present but not clear (implicit). Therefore a firm incurs both implicit and explicit costs while producing products. Explicit costs of the firm are the cash expenditures or monetary payments made to the suppliers who provide materials, labor services, fuel, transportation services and other similar requirements. These monetary payments are made for using the resources owned by suppliers. Implicit costs of the firm are the opportunity costs incurred for using the firm’s self employed and self owned resources. Implicit costs are the monetary payments the self owned and self employed resources may have otherwise earned through their best alternative utilization. Economists does not use the same cost data as accountants use because economists include both implicit costs and explicit costs related to production and also include normal profit which is necessary to acquire and retain resources for a particular line of production. Economists view economic costs as the opportunity cost of resources utilized whether it is owned by the firm or others (McConnell 2005 p.155). Accountants on the other hand consider profits as the balance of revenue after deducting accounting costs (or explicit costs) only. For the economists, economic cost (explicit and implicit costs including normal profit to producer) reduced from total revenue is the economic profit (McConnell 2005 p.156). Changes in demand, supply and equilibrium occur due to fluctuations in customer income, tastes or changes in customer expectation or the changes in the price of related products. Changes in supply occur as a result of changes in the price of resources, taxes or technology. These changes can have an effect on the equilibrium of price and quantity (McConnel, Brue & Campbell 2004 p.50). Price

Leadership Development Essay Example | Topics and Well Written Essays - 250 words

Leadership Development - Essay Example Moreover, physicians constitute to twenty percent of the entire hospital board members whilst other supplementary clinicians contribute to approximately five percent. Nurses need to view themselves as fundamental decision makers who are extremely capable of influencing health results (Watts & Gordon, 2012). This process mainly entail undertaking campaign that mainly foster engagements of the well trained nurses to public policy and corresponding health care association boards mainly at the state and national levels. There ought to be leadership at each level that will mainly incorporate program for engaging staff nursing and empowering floor nurses thus advancing patient care (Watts & Gordon, 2012). The alterations ought to be tested over certain duration and implemented in case they prove to be helpful. Moreover, the program has advanced patient results encompassing eradication within falls with harms and corresponding 30-day hospital readmission rates. There is a massive chance of transforming culture of the health care when the nurses are better equipped and capable to mainly practice and enact full degree of their underlying education and

Crisis Management and Communication Research Paper

Crisis Management and Communication - Research Paper Example It is the moment of uncertainty that best describes a crisis situation. The severity of such crisis varies significantly, with less moderate to severe. The most common aspect of uncertainty pertains to the ethical and moral implications of the organization’s communication strategy during the crisis. The most common aspect of this is who is to be held responsible. Often, organizations fail to address crisis effectively because they have the tendency to engage in blame game which should ideally be the no-go area for organizations during crisis situations. The purpose of communication, or more so â€Å"strategic† communication during times like these, is to mitigate to some extent this form of uncertainty associated with the crisis. The higher the uncertainty associated with finding a solution for the crisis the greater the severity of the crisis (Stephens, Malone, & Bailey, 2005). It is often useful to classify crisis as an event caused by either external factors such as opportunities and threats as well as internal dynamics of the company including strengths and weaknesses. Crisis puts the company’s immediate survival at stake. ... Furthermore, researchers have also delineated on the steps in crisis management and communication, keeping in mind the procedural nature of a crisis situation. In the first stage, the organization gets signs and warning signals pertaining to an upcoming disaster (Stephens, Malone, & Bailey, 2005). In the next stage, organizations often engage in preparation and prevention exercises such as team-building measures as well as employing training measures to deal effectively with the crisis (Stephens, Malone, & Bailey, 2005). In the third phase, the damage is potentially â€Å"contained† or limited by several measures, the most important of which is communication, in order to avert the spillover of damage to other parts of the organization (Stephens, Malone, & Bailey, 2005). In the final phase, the organization recovers from the mishap, which is followed by essential learning in order to avoid the possibility of such a crisis in future (Stephens, Malone, & Bailey, 2005). Communicat ion during crisis situations, therefore, is fundamental to reaching the recovery phase sooner and more safely. The ultimate aim of communication during crisis situation is to frame appropriate public perceptions about the company and to maintain a favorable image of the company in the minds of stakeholders. Communication during these times also serves the purpose of informing, convincing or even motivating stakeholders towards a desired form of action. Another aim of crisis communication is to ensure that the damage is controlled and that the negative impact of the crisis on various environmental elements is minimized. Companies often use this as an opportunity to reinforce and communicate existing values, culture, vision and mission associated with the organizations to the public. As is the

Should companies routinely Google applicants or look at their Facebook Essay

Should companies routinely Google applicants or look at their Facebook pages as part of a reference check before hiring - Essay Example III. Using Google Search and Facebook, employees are able to assess applicant’s talents. IV. Counter Arguments and Responses a. Opponents argue that the practice leads to invasion of privacy. Refutation: Only employees with questionable behaviors would feel this. b. Opponents claim that the practice is that it drives away talented applicants Refutation: It appropriate when done as the last step in the assessment. V. Conclusion Use of Google and Facebook to assess applicants ensures employers hire suitable employees. Companies Should Google Applicants and Look at Their Facebook Pages as Part of a Reference Check Before Hiring Name Course Tutor’s Name Date Companies Should Google Applicants and Look at Their Facebook Pages as Part of a Reference Check Before Hiring Introduction Although most people consider social networks to be sites for their personal life, the sites are increasingly becoming important in increasing or decreasing the chances of acquiring a job. Most peo ple use social networks in informal settings and tend to share information that could be detrimental to their career life. This is because some employers are increasingly using search engines such as Google and social networking sites such as Twitter, Facebook, and YouTube to screen applicants. The kind of information that people share on the social networks depicts the kind of people they are. It is thus important that employers check on such information to discern if the prospective employees have underlying interest in the field, they have applied the job. Some employees also use social networks when they have too many applicants and want to narrow down the list. By using social networks, they are able to find reason not to hire some candidates. Additionally, the kind of information people post on social network sites can demonstrate their capability to deal with other people. This essay argues that companies should Google applicants and look at their Facebook pages as part of a reference check before hiring. The employers, particularly the human resource managers spend plenty of time dealing with employee problems. By conducting checks on the prospective employees, the employer can be able to discern the probability of an interviewee being problematic after employment. Using Google, employers are able to find out information regarding previous employment. This helps determine if the candidates present themselves professionally. Additionally this can help the employer understand the kind of a person the applicant is and their capability of coping with the company’s culture. By doing background checks using the social networks and Goggle, employees are able to detect and eliminate candidates with tainted records or a vague past. Some managers argue that they have been able to find reasons not to hire applicants by using social networks. In most cases, the managers felt that the applicant postings such as those against former employer were red flags. A dditionally, some people lie about their qualification on Facebook, which depicts their deceitfulness. This saves the company the large amount of time spent dealing with problems that such employees bring into the company (DiSilvestro, 2012). Another reason why employees should carry out background checks is to determine the capability of the candidates to

Supply Chain Management and Technology Essay Example | Topics and Well Written Essays - 2000 words

Supply Chain Management and Technology - Essay Example Today with the down fall in economy and the increase in the costs the companies are planning to have a strong and an effective supply chain in their bottom line. The reason is that the implementation of a strong supply chain at the bottom will ensure that the cost is decreased along the production line and the management is effective. However these decreases in the costs and effective management will ensure that the efficiency of the firm gets increases and the profitability and the return on the investment increases. Implementation of Enterprise resource planning in an organization works best in conjunction with a supply chain management system. ERP systems involve a multitude of business activities, including customer service and production planning that are not a part of supply chains (de Burca, Fynes, & Marshall, 2005). The success of supply chain management system lies in the hands of the technology. It can be only successful with the implementation of web- based software and through proper communication. Before the internet the supply chain could not function appropriately the reason is that the collaboration with the other firms was less efficient. The process of feed backs, updates and other important business functions used to take a lot of time. The process of transferring knowledge was all done manually which took time. Collaboration with global partners used to be a challenge for the organizations. But with the introduction of internet and new communication technologies that include email, fax etc. the communication and knowledge and information transfer issue was completely resolved. One of the biggest advantages that the technology has offered to supply chain is the ease of collaboration no matter how distant the customer, the supplier or any other organization is. This helped in developing good relationships at both ends of the supply chain which includes the customers as well as the suppliers. The companies can now also remain updated with their competitors' activities. For example a supplier of consumer goods may be linked up through internet to one of the distributors. In this way whenever the inventory goes down the order will be placed automatically. in this way, the distributor never has to worry about running out of a product and disappointing customers and the supplier doesn't have to worry about maintaining a large inventory in expectation of demand. Systems have also been made to send out multiple requests at a single time. Collaborating this way makes better use of existing resources and paves the way for a larger profit margin on all sides of the eq uation (Chow, 2006). The Importance of Technology Technology today has made both outsourcing and off shoring much easier tasks than they were initially. In a very strong supply chain and a very elaborative business it is sometimes considered good to outsource certain business functions. This helps in saving upon a lot of costs at times. Technology today like internet and some systems have made the task of outsourcing much easier. For outsourcing a task

Chinese Burial Practices Essay Example | Topics and Well Written Essays - 1250 words

Chinese Burial Practices - Essay Example An older person, according to Chinese tradition, does not show respect to someone younger so if a young child dies, no burial rites are performed since there is no one that can pay their respects. A child is buried with silence. If a young unmarried man dies, his parents cannot bring his body home or offer prayers. However, burial practices for an elderly person must strictly adhere to certain traditions. These rites which befit the deceased’s age and social status must be carried out by the family whether or not they can afford it without going into debt (â€Å"Chinese Funeral Customs†, 2003). After a person has died, their body is cleaned with a damp towel dusted with powder then dressed in simple, basic attire before being placed in the coffin. All of the other clothes of the deceased are burned. The body is not dressed in red as this is believed to transform the body into a ghost. The body is covered with a light blue cloth, the face with yellow (â€Å"Chinese Funeral Custom†, 2003). Adornments such as jewelry are not worn because â€Å"the deceased has already taken rebirth and would not be able to take anything along with him† (Suvanno, 1996). In the house of the deceased family, mirrors are temporarily removed because it is thought that if someone sees the coffin’s reflection in a mirror, this will lead to their own demise. Red paper covers any statues of gods in the house and a white cloth is placed over the front door of the house with a gong placed either to the left of the cloth if a man died or to the right for a woman (â€Å"Chinese Funer al Custom†, 2003). During the wake, the coffin is positioned on a stand in the home if the deceased passed away at home or is placed outside if the person did not die at home. The coffin remains unsealed during the wake and is positioned with the head of the body toward the home on two stools about a foot tall. Visitors are obliged to light incense to show respect for the departed and to

The Roman Catholic beliefs and teachings about the sacrament of marriage Essay Example for Free

The Roman Catholic beliefs and teachings about the sacrament of marriage Essay The bible teaches that marriage is scared and that God intended men and women to become one through marriage. Genesis 2:21-24 In the eyes of Catholics, marriage is a sacrament. A sacrament is an outward sign of an inward and spiritual grace. When Catholics marry they believe that God ratifies their union. Jesus constantly reminded us that it is through loving that we live life to the full. The more we love, the more we live and accept Gods gift of life. In the love they share in marriage, a man and woman are called to help each other to live and love. They see it as something in which God is deeply involved in and which also involves the whole community. That is why a wedding takes place in a church. Roman Catholics believe that marriage is a covenant. The words contract and covenant are very different. In a contract a person gives in order to receive, a sort of 50 50 deal. To think about marriage as a contract is not good, because if one partner does not give the 50% for one reason or another, the relationship rests on a weak basis and more likely to fail. Marriage is a partnership between two people based on mutual Trust. A covenant is a much richer way to describe marriage, it asks for 100% effort by both partners. The word covenant goes back to the Old Testament times, when God made his promises to various people, e.g. Abraham and Moses. I will be your God and you will be my people. God was faithful to his promise of love even though the Jews often turned away from him. In the New Testament Jesus blood shed for us on the cross is described as the blood of the New Covenant. Marriage as a covenant is creative and is to be open to the procreation of Children. A Christian marriage reflects God who is love. A Christian marriage helps Christians realise that the bond of love between a married couple has not only brought them closer to each other but also brought them closer to Christ. The love of God is shown in the life of Jesus who gave his life to Gods people. Roman Catholics believe that through marriage Gods love is reflected in the love that the husband and wife have for each other. Couples share in an exclusive love like that which God showed to us in the life of his son. St. Paul made the comparison of how a married couple should love each other like Christ loves his followers. Husbands love your wives, just as much as Christ loves the church and gave his life for it.(Ephesians) St. Paul also tells us what this love is like in a letter to the Corinthians Love is always kind, patient, never jealous, it is never rude. The sacrament of marriage gives us an active insight into Gods love for us and how deeply it really is. St. Johns letter shows us a further insight into this love. God is love, and anyone who lives in love lives in God, and God lives in him Roman Catholics believe marriage is a sacrament, a sign for all to see. In celebrating the sacrament of marriage the couple invite Jesus to be with them in their love and in their married life. The marriage is a sign of Gods love for his people. In the married couple we can see a reflection of Gods unconditional love, therefore marriage is a public sign of love the couple have for each other. My children, our love is not meant to be just words or mere talk, but something real and active. Love is something that is to be lived out though each other and through the eyes of god. In the service and at the time of the sacrament the couple profess their love for each other in-front of God. We promise to love each other truly, for better, for worse, for richer In the Book of Genesis we learn more about the sacrament of marriage, It is not good for the man to be alone, I will give him a help mate. That is why a man leaves his father and mother and clings to his wife, and the two of them become one body. Marriage is only made holy in the sacrament and it is a celebration shared with a community. Roman Catholics believe marriage is exclusive. To live out the sacrament of marriage to the full the couple must be prepared to love each other exclusively and their commitment of unconditional love and fidelity for the rest of their lives. Thou shall not commit adultery is the sixth commandment and adultery is a betrayal of the permanent commitment of love that a person has made. That commitment is will you love and honour each other for life. In taking this commitment it should not be broken, trust can be lost and a parent who commits adultery betrays the children of the marriage by putting at risk the stability and secure love a family should provide. Every man should have his own wife, and every woman should have her own husband. A man should fulfil the duty as a husband and a woman should fulfil her duty as a wife. (Corinthians 7:10-11) Marriage in the Christian tradition is a lifelong commitment of one partner to the other, and is based on the teaching of Jesus on the permance of marriage. Roman Catholics believe that marriage is life giving and should be open to the transmission of new life. Marriage is life giving and it involves responsible parenthood. The love exchanged in sex creative and should always be open. Every marriage should remain open to the transmission of life. Humanae Vitae. Families develop from the loving relationship of a married couple. Will you accept children lovingly from God. The love, which is shared, is not for the couple alone instead love is always creative. In Gods plan for the world the union of man and wife was designed not only for mutual happiness but so that through their love, God could continue his creative work. Christians understand that marriage is usually an invitation from God to co-operate with him in bringing new life into the world. Roman Catholics believe that marriage is permanent. Marriage in the Christian tradition is a life long commitment. In the beginning, at the time of creation God made male and female for this reason, a man will leave his mother and father and the two will become one. Jesus underlines in these words the permanence of marriage. Catholics believe a marriage between Christians can never be dissolved so although for legal reasons a catholic may get a civil divorce the church still considers them to be married and they can not remarry in the church all the days of our lives until death do us part This shows the couples commitment to each other is for life and is emphasised in their vows. Marriage is an exclusive relationship in that married people remain faithful to each other Will you love and honour each other for life In the Catholic church only annulment or death of one partner frees a person to remarry in the church. In the Church of England they teach that marriage is for life but accepts there may be circumstances where the vows cant be kept. The church prays for forgiveness and acknowledges for some divorce and remarriage. The Orthodox Church teaches wedding vows are taken with every intention of being kept but there are times this doesnt happen thus the couple should be realised from their vows. Some free churches say it is not the death of one of the spouses that end a marriage but the death of the love between the couple, so it is better to divorce than to live a lie. All denominations teach that marriage is for life; it is when things go wrong they take a different attitude. When things go wrong separation is not the only option, there is help groups such as RELATE and ACCORD who offer guidance for the couples who are finding married life difficult, these groups try to keep the marriage permanent by solving the problems that are causing the marriage to be difficult instead of avoiding the problem which can end in divorce.

Assessment of Ureteroscopy During Pregnancy

Assessment of Ureteroscopy During Pregnancy INTRODUCTION Urolithiasis during pregnancy is an infrequent condition, with an incidence of 0.026 to 0.531 percent in the medical literature (1). Renal colic is the most common presentation of urolithiasis, as well as the most common nonobstetric cause of hospitalization during pregnancy and a predetermining factor of premature labor especially if accompanied by urinary tract infection(2,3). In approximately 70 percent of the cases the stone is passed spontaneously with the use of analgesics and hydration. (4-7) In other cases the onset of infection, fever and refractory ureteral colic require a variety of endourologic actions such as stent placement treatment(8). The diagnosis of ureteral calculi in pregnant women is often difficult because of the serious risks presented by radiation exposure, especially during the first trimester. As such, the diagnosis is best based on clinical data, urinalysis and ultrasound examinations; however, ultrasound does not always provide a clear diagnostic picture, even though at times color flow Doppler ultrasound may be useful (9). Further diagnostic efforts are indicated when the patient has intractable pain or upper urinary tract infection, or if renal function is decreasing for which a more precise diagnosis aims at specific treatment. In this situation ureteroscopy was considered a useful option, since it combines the diagnostic procedure with definitive treatment(10). Because of the recent advances in the techniques and technology in the field of ureteroscopy, the new and thinner semirigid and flexible ureteroscopes have allowed easy access to the ureter without any need for dilation and with minimal manipulation. (11) Ureteroscopy can be performed successfully for ureteral calculi in pregnant women and stones can be removed with the stone basket or fragmented with ultrasonic ballistic or laser lithotriptors under sedation-analgesia (12-14). Ureteroscopy can be performed with greater care when the patient is under sedation-analgesia than if spinal or general anesthesia is used, since the patient can collaborate during the procedure. Therefore, sedation-analgesia may be preferred when ureteroscopy is performed in pregnant patients (15,16). For reasons mentioned above, we have started use of minureteroscopes for managing pregnant patients with complicated stone disease not responding to medical measures and herein we present our experience with 15 p atients. PATIENTS AND METHODS Between 2000 and 2005 we performed ureteroscopy and ureterolithotripsy on 15 pregnant patients 21 to 32 years old. All patients underwent extensive diagnostic evaluation including urinalysis, urine culture and antibiogram, complete blood picture, bleeding and coagulation times, renal and liver function tests as well as, complete abdomino-pelvic ultrasound, and an accurate obstetrical examination to evaluate the fetal condition. The women were placed on the operating table in an oblique position with the left side down when necessary to decrease the pressure of the pregnant uterus on the inferior vena cava. Sedation-analgesia with 2.5mg midazolam and 50 mg pethidine intravenously was used in the first 7 patients. In the following 8 cases 10 mg nalbuphine HCL was used in addition to midazolam. Prophylactic therapy with ampicillin/ sulbactum 1.5gm was administered before the procedure. Ureteroscopy was performed with ultrasound monitoring. The use of ionizing radiation was avoided before, during and after the procedures. Constant obstetrical monitoring was available throughout the procedures. All patients underwent ureteroscopy with thin rigid 7.0F ureteroscopes without dilation of the ureteral meatus. We used either the micro-six ACMI ureteroscope or Karl-Storz 6.9 F semirigid ureteroscope. Floppy tip guide wire 0.035 was inserted over a 6 F open tip ureteric catheter through the 22 F cystoscopy. The wire was advanced first to the collecting system where it has been fixed. In cases with difficult guide wire insertion through the cystoscope, direct ureteroscopy was then performed and a safety wire was inserted through the ureteroscope. Then the ureteroscope was advanced alongside the wire and visualization of the whole ureter was done. Once a stone is visualized a decision was made in regard to the best means of extraction. Factors, such as size, amount of speculation, degree of impaction, location within the ureter and condition of the distal ureter, were considered. Our method of choice was the use of the stone basket under direct vision. If the size of the stone preclu ded the use of the basket technique, we elected to disintegrate the stone using pneumatic intracorporeal lithotripsy. At the end of the procedure, a double pigtail ureteral stent or external ureteral catheter was placed in the ureter to avoid partial urinary obstruction and flank pain due to mucosal edema. If external stent was used, it is tied to a Foley catheter. The Foley and ureteral catheters were removed within 1 to 2 days. The operating time, hospital stay, perioperative and postoperative complications, outcome of the pregnancies and deliveries, and condition of the neonates postpartum were all recorded. All women underwent PUT and abdomino-pelvic ultrasound 6weeks after delivery. RESULTS The mean age of our patients was 25.3 years (range 21-32 years) and the mean gestation time was 28 weeks (range16-32 weeks). The main presenting symptoms and indication of surgical intervention were recurrent ureteric colic not responding to analgesics, fever, recurrent UTIs, and hematuria (table1). Urine culture was positive for ampicillin-sensitive strains of E-coli and proteus vulgaris in 3 patients. Macroscopic hematuria was found in 3 patients while microscopic hematuria was present in in 2 patients. Leukocytosis was found in 2 patients. Ultrasonography showed dilation of the renal pelvis in all cases and stones were identified in 8 cases. Upper ureteral stones were found in 3 patients while lower ureteric stones were diagnosed in 5 patients. The mean stone size diagnosed with ultrasound was 0.6cm (range from 0.5-1.2 cm). Ureteroscopy was done for all cases with the entire ureter examined without the need for ureteric orifice dilatation. Stones were extracted from the lower ureter by Dormia basket in 7 patients. Stone fragmentation with the pneumatic lithotriptor was used for stones above the iliac vessels in 6 cases and no stones have been found in 2 patients (table 2). A double pigtail ureteral catheter was inserted in 8 cases (6 patients with fragmented calculi and the 2 cases with no confirmed stone) and ensured to be in the proper position by watching its distal end in the bladder and monitoring of the upper end curling in the renal pelvis through ultrasound examination. In the 7 patients with extracted calculi, a 6 F ureteric catheter was inserted for one or two days postoperatively. Duration of the procedure ranged from 15-30 minutes and obstetric monitoring showed no signs of fetal distress or pre-term delivery. No complications encountered and convalescence was uneventful. Patients who had pain were improved remarkably and fever disappeared within the next 24 hours after the procedure. Patients were discharged home 72 days after the procedure and the external ureteric catheter was removed. Patients with double J stenting had their stent removed after labor in the two patients with negative ureteroscopic finding while patients underwent stone fragmentation had stent withdrawal after 3 weeks. All pregnancies progressed to full term delivery. Five patients had an elective Cesarean section as they had a history of previous section and no fetal abnormalities were detected. The follow up PUT and U/S performed 6 weeks postpartum revealed disappearance of renal pelvis dilatation and no calculi were found in all patients. DISCUSSION The first publications on ureteroscopic diagnosis and management of ureteral calculi during pregnancy appeared in 1988.12 The differential diagnosis of ureteral calculi versus physiological dilatation in pregnancy was rendered possible by this procedure with great assistance in management. Using ureteroscopy and stent placement, under ultrasound monitoring, was an important step forward in stone manipulation during pregnancy (12,13). It was supposed that anatomic distortions caused by the fetal presence would not allow the introduction of the rigid ureteroscope and this procedure could be of high risk to the pregnancy. However, it was proved that the natural ureteral dilation in pregnancy facilitates the introduction of the ureteroscope and the procedure could be performed easily by following the usual rules, except for the use of fluoroscopy (17). The diagnosis of ureteral calculi in pregnant women is often difficult because of the serious risks presented by radiation exposure, especially during the first trimester(9). Several investigators have highlighted the problems related to the exposure of the pregnant patients to x-rays in regard to the incidence of tumors in children who were irradiated during fetal life(9,18). Therefore, the use of x-ray for the diagnosis or management of stones during pregnancy remains controversial (19). Ultrasonography is the main diagnostic method in these cases, because besides its non-invasive nature, it does not use radiation, and is universally available (3,8). However, Ultrasound does not always provide a clear diagnostic picture, even though at times color flow Doppler ultrasound by using resistive indices may be useful (10). In our study, we avoided the use of x-ray for the diagnosis of stones during pregnancy and we depend mainly on clinical diagnosis and ultrasound examination. Renal pelvic dilatation alone or combined with calyceal dilatation was diagnosed by U/S in our patients and ureteral stones were found in 8 (61.5%) out of 13 ureteroscopically confirmed stones. Although U/S is safe under all circumstances of pregnancy, its utilization in diagnosing obstruction is of limited value owing to its sub-optimal view of the ureter and presence of hydroureteronephrosis as a physiologic concomitant of pregnancy. Hematuria, both macro and microscopic, is a frequent sign, but is not specific (4, 8, 20) while urinary tract infection is present in 20 to 45% of the cases of calculus during pregnancy (1,21-22). Among our patients, hematuria was present in 5 (33.3%) patients and asymptomatic bacteriuria was detected in 4 (26.7%) patients while pyelonephritis complicated 2 (13.3%) pregnant women. In the early protocols for stone management in pregnant patients, the double pigtail catheters were used to treat renal dilatation and in cases of failure, an ultrasound guided nephrostomy was preferred over the risks inherent with ureteroscopy (19). Stents and drains may have many disadvantages including accidental dislodgment, obstruction or bladder irritability and unpleasant symptoms (1). In addition, incrustation on double pigtail stents with resultant obstruction is frequent in pregnant women and it is advised that stents should be changed every few weeks during pregnancy. The repeated insertions of tubes and stents may have potential risks that may be comparable to the risk associated with ureteroscopy performed as a single procedure. (11-14). In the present series, we have used the 7F semirigid ureteroscope, without need of dilating the ureteral meatus in any of the cases. In fact, this procedure is simpler than it was supposed in the past. It was suggested that pregnant patients with ureteral calculus and fever should be treated with antibiotics and drainage by a double-J catheter. The advantage of this method is that it is an efficient and less invasive method. Ureteroscopy was not advised in these patients because ureteral manipulation and liquid injection under pressure in the excretory system may lead to bacteruria and dissemination of the infection (23). However, stent should be left until the end of pregnancy, which can be a predisposing factor to infections and may cause vesical discomfort in most patients. We have used ureteroscopy in 2 pregnant patients with pyelonephritis and obstructing ureteral calculi and stones were removed and double J stents were inserted for 3 weeks without complications. Those patients were given antibiotics according to culture and sensitivity test prior to the procedure and during ureteroscopy fluid pressure was kept at minimum and non-refluxing double J stents were used. A further advantage of ureteroscopy as a diagnostic and therapeutic option is that general anesthesia can be avoided during pregnancy. With the application of mini-ureteroscopes and small instruments, general anesthesia was replaced by sedation analgesia among our patients. This aspect has already been highlighted by others who reported on flexible ureteroscopy (12). In conclusion, ureteroscopy during pregnancy can be performed safely under sedation analgesia for diagnosis and removal of ureteral calculi in cases of failure of conservative management in experienced centers with the use of miniureteroscopes and without using fluoroscopy.

Macro Environment Influences Of The Airline Industry Tourism Essay

Macro Environment Influences Of The Airline Industry Tourism Essay In terms of the case, it suggests that the environment of airline companies is not very stable, especially the increasing price of fuel which is the key driver of change. From Ryanair profit statement (Exhibit 1a) it shows the fuel and oil cost has increased by â‚ ¬200 million from 2005 to 2006. The increase in fuel costs is 74 percent. The impact to the airlines companies is obvious and the budget airlines may face the trouble more so than normal airlines. Moreover, airline companies also have to concentrate on some other issues. For example, according to the case, they are facing the risks from terrorist attacks which are difficult to predict. It is not difficult to find the changeability, however it is complex to the airline environment. Some factors, such as legal action and customer demand, also have influence on them. Some of these such as the price of fuel and oil can be predicted, while some of them cannot. Stage 2 Audit environmental influences The Pestel Analysis is employed to identify macro-environment influences of the airline industry. Political: Government wants to strengthen the economy and, consequently, will support local airlines by setting rules, such as preferential rights. Every government however, will probably do so. Therefore theres no obvious advantage between competitions. The political issues have a wide range of effect, so they are not the key points that budget airlines are facing. Economic: This is identified as the most crucial factor to airline companies, especially to budget airlines. The influences refer to the macro-economic factors such as the national growth rates and the exchange rates. As budget airlines, they will pay more attention to the operation costs such as fuel cost. It became a big issue for budget airlines because of the increasing cost of fuel. That may reduce the advantages and the companies will be less competitive than before. On the other hand, the recession will lead more people to choose budget airlines. Social: With the development of Asian countries in particular China, there are more and more people deciding to study or travel in Europe. In recent years, the lifestyle of local people has also changed. They tend to travel abroad to enjoy their lives. Most of these people are not wealthy such as student. The budget airlines therefore, will be their best choice to reduce the travel costs. Technological: The innovation of technology helps the airline companies reduce costs and carry out tasks more effectively. The new type of aircraft can help to reduce the burning of fuel; and new technology can also make the security check more efficient and accurate. Environmental: European countries pay more attention on environmental issues, especially greenhouse gases from carbon emissions. Moreover in terms of the case, airline companies have to pay the environmental taxes for the contributions they make to global warming. In particular, it is bad news for budget airlines. Costs will increase and the companies want to maintain good brand image in the consumers perception. Furthermore, noise pollution and energy consumption cannot be ignored under such conditions. Legal: Some legal actions such as preferential airport rights are directed against the specific airlines. As budget airlines, which have higher competitive power, they should pay more attention to the legal forces to prevent loss. On the contrary, they can also take the initiative over illegal aid to rivals. Stage 3 Determine industry specific factors (this stage will be analysed in Question 2) Stage 4 Identify competitive position (this stage will be analysed in Question 3) Stage 5 Identify key opportunities and threats There are many potential opportunities for the airline companies. For instance, the recession may lead to more people choosing the budget airline rather than the expensive ones; new technology which helps to reduce the usage of fuel; government set the tax at a lower percentage. On the other hand, the increasing cost of fuel may be the most significant issue most budget airlines face. Whats more, the compensation to passengers, terrorism and security, and customers satisfactions will all have potential negative impacts on the airline. In order to achieve lower costs, budget airlines will have to reduce costs from many departments and operations. Thats why lots of customers are not satisfied with the budget airlines except for the price. Question 2 Prepare a Porter Five Forces analysis of the budget airline industry. Express Ryanairs perspective of these forces. The threat of entry There are high barriers to enter the budget airline industry. i) High investment requirements. Economies of scale are important in the airline industry. It is difficult for new entrants to match others existing competitors. In addition to this, the operational experiences cannot be acquired in such short space of time. ii) Expected retaliation. Retaliation will take place when new entrants appear for budget airlines, it will probably be in the form of a price war due to costs of entry being very high for them. iii) Legislation or Government action. Government wont let new entrants enter the market if the industry is saturated. With regards to Ryanair in the budget airline industry, there will not be large impacts to existing budget airlines if new entrants appeared. Budget airlines always focus on the costs and price, so does Ryanair. According to the case, Ryanair was the first budget airline in Europe and now its ticket prices are much lower than the other rivals. Therefore it will be impossible for new entrants to set a low price to win the market. The threat of substitutes Before discussing the threats, some comparative data is showed below. Round Trip by Ryanair Flight: London Stansted Milan Going Out Regular Fare Adult 8.99 GBP Tue, 2 Dec 08 Flight FR 4184 8:15 Depart 11:15 Arrive Coming Back Regular Fare Adult 12.99 GBP Sun, 8 Dec 08 Flight FR 4185 6:45 Depart 7:50 Arrive (Source: Ryanair.com) One way by Rail Europe: London (ST Pancras) Milan Standard Class Adult 227 GBP Tue, 2 Dec 08 8:40 Depart 21:20 Arrive (Source: Raileurope.co.uk) Most of the travellers will prefer the short journey, in addition to the cheaper way to travel. From the tables it is obvious that taking a plane from Ryanair is much cheaper than taking the train in a similar situation. Although some airlines may be expensive, budget airlines such as Ryanair will usually be the best choice. The impact of substitutes, therefore, has less impact on the budget airlines. The power of buyers Buyers of airlines tickets can sometimes be the travel agency.  In other cases, Ryanair caters to ultimate consumers. Majority of the buyers are not concentrated buyers and they come from all over the countries. Individuals can select the budget airlines according to their preference, because the switching costs are low and the differentiation of such service is weak. It is extremely expensive for people to own an aircraft. When there is a choice of budget airlines to use, with low prices. So there is a low buyer competition threat. Like Ryanair, with less concentrated buyers and buyers competition threat, the power of buyers is low. The power of suppliers The high power of suppliers may be one of the most significant threats among the budget airline industry. The increasing price of fuel, which leads to a high cost for airlines, is a basic issue they are facing. As we know, fuel industry is now concentrated in the hands of few producers. Therefore, in this situation it is difficult to cut the price for this essential material. In addition to this, it is useless to change fuel suppliers when the global price is growing. Moreover there are no practical substitutes. Ryanair is facing this problem with other budget airlines. Furthermore Ryanair sells all the ticket directly through the website. Thus there is no intermediary. Competitive rivalry Rivalry is influenced by these four competitive forces and each of them may have different levels of impact on the competitive rivalry. In this market, every airline provides the same services which are poorly differentiated. Low differentiation and switching costs in this industry, therefore, cause the price competition. Ryanair, which has the first mover advantages, still holds the dominant position. Although many of the competitors were losing money or even have been taken over, Ryanair remains steady in incremental growth. For industry growth rate, this industry is in the maturity situation of life cycle, which means the growth is low. Price war is therefore playing a crucial role throughout the competition. Question 3 Evaluate Ryanairs particular strengths and weaknesses and explain, with reasons, what Ryanair must do to retain a sustainable competitive advantage. As the first-mover of budget airline industry, Ryanair still holds the dominant lowest-cost position. This is also the one of the strengths it has. Whats more, Ryanair was announced being the most profitable airline in the world according to the case. The revenue is still increasing, despite the price of fuel did not stop growing in recent years. The brand image of Ryanair is also one of its strengths. Customers are attracted by the lower price. Its traffic is the highest among the competitors (see Exhibit 2) and it is still increasing due to the enlargement of the company. On the other hand, there are still some weaknesses of this budget airline leader. In terms of the case, Ryanair win the market mostly depends on the costs. However, the costs of its major raw materials are increasing rapidly these years. This will be a serious issue. Further, minimize costs largely will cause the lack of service and training quality and so on. The Skytrax star rating (See Exhibit 2) indicates Ryanair is below the average level. Besides, competitors contribute big influence to Ryanair. For example, Easyjet which is a young upstart of the European budget airline industry grows quickly with a large number of market shares. It is obvious Ryanair makes success base on its price advantage, and how to sustain this advantage become very crucial issue in recent situation. Keep first mover advantages. Long history with experiences, well-known brand image and economy of scale, these are the unique resources of first mover advantages. It is difficult for competitors to get these resources at a similar level. Therefore, in order to prevent the competitors from copying the same strategy as cost reduction, Ryanair must make good use of these unique resources and try to dominate the market. Technology. Purchase and introduce the latest technological support. Although the fixed costs will be high, they can help the airline carry out tasks more efficiently and effectively such a new security check machine. Moreover it can also help to reduce the variable costs. For example, according to the case, new type aircraft produced 50 percent less emissions, 45 percent less fuel burn and 45 percent lower noise emissions per seat. They help Ryanair reduce the fuel cost with a lower pollution to environment. Unique cost structure. A cost structure which aims to minimize the costs must be set up. In particular to fuel cost, the fluctuations are subject to unpredictable and volatile world events according to the case. It is important for Ryanair hedge the risks before the price goes up suddenly. On the other hand, choosing the secondary and regional airport destinations is a good way of the structure. Moreover, the internet is used to reduce distribution costs. Service quality / Customers satisfaction. Customers will normally associate low price with low service benefits. Ryanair was voted the worlds least favourite airline due to its bad service such as unfriendly staff and poor legroom. However it still won a great number of customer base on the price. Thus if some competitors cut down the ticket price to a low level, Ryanair will get into a big trouble due to the similar prices but lower service quality. Therefore it must not only focus on the price but also the service. In order to gain competitive power, for example, brand loyalty can be one of the aspects. Government / legal actions. Ryanair should take care of the government and legal actions and moreover, can take the initiative over illegal aid to rivals. These may prevent the unnecessary loss. In summary, Ryanair, as the cost leader in budget airline industry should not only focus on the costs but also lots of other issues. Although it is developing rapidly and successfully, the future is unknown. The uncertain environment is changing all the time, thus Ryanair should always follow it and make the long-term plans in order to retain a sustainable competitive advantage. Grasp the opportunities, and it will has a bright future. Word:2123