Turnaround Strategy free essay sample

The two broad turnaround strategies that may be followed by Public and Private companies are Strategic and Operating. Strategic turnarounds can be branched into activities that comprises of a change in business strategy for competing in the same business and those that involve for entering a new business or businesses. Operating strategies does not involve altering the business level strategies and usually focuses on increasing revenues, decreasing cost, decreasing assets or a combination effort. Our research work mainly focuses on existing corporates that applies Strategic turnaround strategies to reverse a major decline in their performance. Repositioning Strategy Repositioning is an entrepreneurial strategy that puts its emphasis on growth and innovation. This strategy answers the declining situation in an organization by devising out a new definition of the mission and its core activities. The organization can choose to stay and become more dominant in the existing market or by diversifying itself into new markets and products. We will write a custom essay sample on Turnaround Strategy or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page In some of the cases the management may think that the current resource capabilities of a company can achieve a greater competitive advantage, if applied to a new market segment by successfully integrating and making a fit between the capabilities of the firm and the external environment. The repositioning strategy acknowledges the notion of diversification and provides an opportunity for a firm to leverage on it existing resources such as financial and technical capabilities to come up with related or unrelated products. However, the success of this strategy is highly dependent on the management to effectively select the right portfolio mix. Nike was successful in pursuing related diversification when it decided to launch beach styled sport clothing (Hurley) as a business line. The impact of this entrepreneurial strategy applied in the private sector has been researched in 11 empirical studies. Out of 11, only two of these find that the repositioning strategy has no impact on the financial recovery . From the remaining 9 studies, 7 of them has clear evidence that repositioning has a positive impact on the firms performance. Focusing on the Core Activities This turnaround relates to a particular niche or a focus strategy (Porter,1980,pp. 38–40). This strategy doesn’t involve a complete redefinition of the business but it tries to bring in a strategic change for refocusing on a particular product/market mix. Sometimes this strategy is chosen when a firm loses its focus by adding new product lines or customers while still trying to compete with its historical product/market mix. A classic extension failure exa mple would be Coca-Cola launching â€Å"New Coke† in 1985. [33] Although it was initially accepted, a backlash against â€Å"New Coke† soon emerged among consumers. Not only did Coca-Cola not succeed in developing a new brand but sales of the original flavour also decreased. Coca-Cola had to make considerable efforts to regain customers who had turned to Pepsi by focusing on its core brand. Outsourcing Outsourcing is a strategy that addresses an organization’s position within the value chain it operates. It shares some similarity with the focus strategy as this process calls for focusing on the activities where the firm is more profitable and to outsource the remainder activities to the third parties who can perform them more efficiently. Traditionally, outsourcing strategy has been applied more to the finance and Information system departments. In 2008 Chrysler made news in which it announced that several hundred technology workers would lose their jobs as it was moving with plans to outsource their IT department. The rationale behind this step was to improve the effectiveness and efficiency of the company while making it more flexible to the environmental changes. The Management Process One of the widely researched and generalized Turnaround strategy is the replacement of the current Top Management Team of the business suffering from declining performance. Alot of turnaround experts sees that replacing the CEO is one the most important ingredient for recovering a business. The rationale behind this is that the top management has a certain set of beliefs about running a business, many of which must be wrong for the current decline in performance to arise. Previous researchers who have studied the turnaround strategies have also asserted that the turnaround efforts are begun with the top management being replaced mainly due to thefact that the new management brings in a new understanding of the factors affecting a firm’s performance, enabling productive change to occur. However, regardless of the evidence provided above, not all of the turnaround strategies require a change in their top management. Some of them can be successfully accomplished through the incumbent management. The decision whether to change the current management or not are dependent on a number of factors, e. g. the causes of decline (Some decline may occur becau se of unmanageable external factors), the industrial differences as well as the firm resource situation.

EDF about europe essays

EDF about europe essays French issue about Europe : EDF (French national electricity company) needs to be privatised? EDF is a french public company which provides electricity in the entire France. It has a monopolistic position, and as a consequence, it has a huge turnover. This turnover allows investments everywhere. Furthermore, as EDF is a public company, it can borrow money from banks with the Government as guarantee. The possibility of getting loans which are supported by the State is a huge advantage. The company can find money easily to invest and to protect its monopolistic situation. As a matter of fact, EDF has a great advantage on its European competitors, which are private companies. The European community ask to the French government to change this situation by selling EDF to private investors. But at this time, this privatisation is not debating on the political scene. The subject was avoided during the presidential election of May 2002 because it is a French dilemma. Indeed, our country wants to keep this system in order to have a good repartition of the electrical network, particularly in the rural area. People are afraid that different private networks will break the good access to electricity in the areas which account just few inhabitants. Indeed, this kind of areas are not profitable places to provide an electrical service. On the other hand, the opening of this market will create competition, which could imply a diminution of the prices for the consumers... As a conclusion, we think that this French and European issue shows how complex and difficult the harmonisation of the Economies and Business laws in the EC is. ...

Music Critical Analysis Essay Example | Topics and Well Written Essays - 250 words - 1

Music Critical Analysis - Essay Example Additionally, as the massacre begins to unfold, the original score tends to utilize homophony as the percussion is boosted. It comes as no surprise since the percussion was and is considered a sign of military parades and hence military strength. On the other hand, the adapted score continues as an oratorio as the musical score tries feebly to support on screen actions during the massacre. Another distinctive feat in the original score is the use of dissonance to introduce multiple new elements such as strings with the original percussion. The musical score’s rhythm and melody are pressed upon further in order to relate the music to the developing climax. However, the adapted musical score is far more flat since the rhythm fails to accrue various beats in order to augment the development of the entire piece. In a similar manner, the original score features a number of differentiated tones before it relegates itself to the end as the entire composition begins to signify an ending. However, the adapted musical score continues unabated in a single composition to the very end providing a trite homophony that fails to highlight the start, climax or end of the visual

H&M KEY ISSUE Research Paper Example | Topics and Well Written Essays - 1000 words

H&M KEY ISSUE - Research Paper Example This is because maintaining this balance in the present truly competitive times translates into gaining a competitive edge over rival companies. Every successful company has its share of problems, but success is sustained only after finding answers to those problems. H&M is no different in the sense that the organization gets its fair share of problems related to fast growth. H&M’s rate of success and growth is considered dazzling in nature. Research proves that stores like Hennes and Mauritz (H&M) â€Å"have grown to become the largest apparel retailers in the world† (Caro & Mart ´Ã„ ±nez-de-Alb ´eniz, 2014). Fast growth has helped H&M strike a chord with a broad range of consumers from diverse backgrounds. However on the other hand, this has also been a real source of tension for the company from a management perspective. H&M is known globally as a fast fashion giant due to fast growth which is a good thing, but also this has brought the brand’s social resp onsibility under increased scrutiny (Caro & Mart ´Ã„ ±nez-de-Alb ´eniz, 2014). Fast growth also lays emphasis on accelerating the production phase. Growing fast in a safe manner without speeding up the production phase is impossible. This is why H&M has also encountered challenges in the area of getting products reach different stores in different parts of the world as soon as possible. Making delivery in a short time is important to deliver real value to customers. But, ensuring such a thing when there are so many international stores to look after can be understandably daunting. This is why H&M began to invest more wisely in the department of operational agility (Caro & Mart ´Ã„ ±nez-de-Alb ´eniz, 2014). Operational agility helps to ensure quick response or QR which was missing in the way H&M operated. In the absence of QR, there are increased pressures on suppliers which readily damages â€Å"overall retailer and supply chain

Characteristics of Business Leadership Research Paper

Characteristics of Business Leadership - Research Paper Example It is after this that Steve struggle with the board for directors and left for NEXT Company which is, a computer plat-form development firm that specializes in higher education and business markets. Apple Computer Company was invented and established by Steven Jobs and Wozniak who formed it in his won garage since there was a challenge in raising more funds for its expansion compelling the company to look for more funds and resources for its expansion. Another challenge was insufficient competent personnel, and in this case, the Apple Two companies began looking for an experienced and a competent executive who could help them manage its expansion (Linzmayer, 2004). Therefore, the success and the growth of Apple Company at that time were met severely by insufficiency of both human and financial capital. As a consequent, Steven Jobs encountered a personality challenge of indiscipline and temperament which adversely affected the relationship between him, his workers and the general soci al environment within the company which incapacitated him on the daily running of the business. This led to a decline in the output of the company resulting to a slump in 1980s. Leadership Styles Used By Steve Jobs Steven Jobs throughout his life depicted an autocratic leadership style which realized especially because of him not making any assumptions and down to earth leader. Moreover, based on his leadership and managerial style, he was not boisterous and thus, he understood clearly the need for strong personal relations (Arnold, 2012). Steve Jobs were also identified as a transformational leader due to the fact that he is passionate and enthusiastic about his work. He is also known for creating visions and injects energy and motivation into his stream to ensure effective management. Apple Company developed a competitive culture especially at the work place, and this was as a result of jobs competency. Jobs control extended as far as the structure and design of the company bus an d necessities such as food served at the cafeteria. Within the company, Steven Jobs practiced and encouraged the concept of strictness that resulted into greater accountability into the entire organization. This was carried out through the frequent meetings especially on Mondays with various executives to set the main objectives for the week (Beahm, 2011). Similarly, to put this in place, the executives formed some agenda and at the same time the meetings also reviewed each and every product that was under development. This therefore, led to high out put in terms of quality and competence among the employees in the organization. Employees were recruited into the firm as specialists and were assigned duties based on their specific abilities and strengths, and this also helped in making feel motivated as they enjoyed whatever they were doing in the organization (Young & Simon, 2005). As a result of honesty accountability and transparency, the organization started to enjoy the global m arket. Steve jobs was also strict and encouraged competent work among his employees hence this created an environment for competent work, producing quality products that sell easily in the global market encouraging Jobs to exert all his control over every aspect of the business. As a Consequent, Steve jobs encouraged a working culture whereby there was a devoted employer-employee relationship and rapport in areas such as communication between the management and the employees, problem

Reimbursement Issues For Nurse Practitioner Health And Social Care Essay

Reimbursement Issues For Nurse Practitioner Health And Social Care Essay The Balanced Budget Act of 1997 was unquestionably a frontward step for advanced practice nurses (APNs).   Payment is remarkably allowed for all settings as long as no other provider fee or other facility fee was being paid in relationship to the assistance supplied by the APN.   The various constraints on settings for services provided by the advanced practice nurse were totally removed from the guidelines (Bardach, 2006). The regulations for reimbursement of APN services typically changes based on the category of setting. Within the office setting, the permissible reimbursement to nurse practitioners is only 85% of that of a physician. This same reimbursement is acceptable only if billed straight under the nurses name and provider number (Fishman, 2002). The decrease in conversion factor for Medicare for reimbursement has affected rural clinics. This paper will discuss some pressing issues regarding reimbursement for nurse practitioners. I. Crucial Areas for Reimbursement that Nursing Practitioners Should Know 1. An advance practice nurse (APN) should be responsible and aware of the reimbursement process. APN must have read the participation contracts involved. They must determine the following: Does the plan credentials the APN and assigned a provider number. What are the claim submission requirements?   It could be direct billing or billing which is conducted by a supervising physician. And what are the time frames for submission. Can appeal mechanisms for claims denial be conducted? What are the covered services? Is it reimbursement methodology capitation or fee for service, etc? 2. An APN must familiarize documentation requirements in order to support the Certified Performance Technologist or CPT. Last 2001, the Office of Inspector General had conducted reviews on nurse practitioner, clinical nurse specialist and assistants of physicians. This is to comply with the Health Care Financing Administration or HCFA rules and regulations. (Cooper, 2000) II. Understanding the Reimbursement Procedure In order to better understand the underlying reimbursement issues in nursing practitioner, we must first have a clear grasp on the reimbursement process itself. In 1965, two methods, the Medicare and Medicaid of Social Security Act were amended by the Congress. These two will be discussed thoroughly in the next sections of the paper. With the first method, Medicaid, 100% of the physician rate is reimbursed. This will only apply if the incident to criteria are met. The phrase incident to refers to the services provided by nursing practitioners where a physician is actually present, or available for consultation. In order to verify the presence of the attending physician, the patients contact, appointment schedule or a documentation of the medical records can be used. The local Medicare will give the nursing practitioner a unique identification number (UPIN) for his or her bills. For a direct reimbursement, a practitioner must undergo an application process conducted by the payer. With the second method, Medicare, the nursing practitioner receives 80% of the fee that is set by the practice. Or they also have the chance to receive 85% of the Medicare physician fee schedule. One disadvantage of this method is that it reimburses the lowest charge possible. Citing an example, a practitioners bill for his or her services is $120 and Medicare only allows $100, the practitioner will only reimburse $85, which is 85% of the Medicare allowable. (Rapsilver, 2000) II. General Issues There are various notable issues connected to the reimbursement for services provided by the APNs. They are expected to take possession and responsibility of the procedure on the reimbursement. The APNs should first begin with comprehending their involvement contracts with health care plans to ascertain the following items (Fishman, 2002): if the said health care plan will give credit to the nurse practitioner involved and will consequently assign a provider number, if there are any appeals procedures for denials of claims, if it is possible to review the comparison of fee for service versus the plans reimbursement methodology capitation, etc., if claims such as billing under the administering physicians name or direct billing ask for requirements to be submitted within a specific timeframe; and, if all specific services are covered On the secondary topic, nurse practitioners should become familiar with various requirements when it comes to documentation to sustain appropriate CPT coding. APNs should refer themselves to the HCFA rules and the Federal register for guidelines (Bardach, 2006).   The nurse practitioner should actively participate on internal audit of documentation to find out if their documentations support the CPT code billed. APNs should responsibly scrutinize an illustration of their assortments against their monthly charges. This guarantees that reimbursements are properly made according to contract and that no charges are being denied. (Kansas Nurse, 2008). III. Medicaid Reimbursement Process Issue The lack of consistent progress in the Medicaid hospital reimbursement processes has left the nurse practitioners confused and disappointed over the past few years. Progress towards simplifying the Medicaid reimbursement process has been slowed by the absence of relevant policies in hospital reimbursement, memberships, and the level of access for the members (Fishman, 2002). The lack of priority and actions from the leaders of healthcare to implement the policies for the Medicaid hospital reimbursement processes resulted to the decline in the productivity of the program and posed major setbacks for nurses. With the necessary improvements not being achieved, the government is left with nothing to use in integrating the needed reforms in the Medicaid hospital reimbursement processes. Suspended reforms for Medicaid hospital reimbursement processes reveal incoordination among various health departments which significantly affected Medicaid members. The adverse effects of the current economic crisis put local governments in a state of uncertainty whether to pursue plans of implementing the new Medicaid hospital reimbursement processes to handle the health needs of their residents (Farley, 2000). Over the past few years, the local governments have been limited with their actions to completely adopt the new Medicaid hospital reimbursement processes. In New York alone, residents that are not yet affiliated with Medicaid have reached a number of almost 4 million. New York, however, is still way ahead in terms of progress as compared to other states in America. Still, according to Bardach (2006), the majority of New York residents are completely dependent to the Medicaid program because: (1) Medicaid assists them in the access of health benefits; (2) Medicaid assists them by means of health insurance. Yet these Medicaid policies also led to New Yorks health issues due to the lack of coordination by the leaders. IV. Medicare Reimbursement Process Issue Many advanced practice nurses inaccurately presuppose that receiving an APN license eliminates all obstructions to getting reimbursements for all their services by the insurance companies.   The primary goal obviously is to achieve direct reimbursement, which basically means being able to bill in the APNs exact name and not that of the or under the physician.   This is because being billed under a doctors name austerely propagates the invisibility of the nurse practitioners (Fishman, 2002).    To accomplish this goal of straightforward reimbursement, advanced practice nurses have to be empanelled by a reimburse-er or have to get a provider status.   The methodology for Medicare had primarily implicated achieving a PIN or a Provider Identification Number, which has now transformed into the new NPI or the National Provider Identifier (NPI).   Ã‚   In reality, as an example, Medicare already was issuing PINs to advanced practice nurses in Illinois two years before the APN regulations for practice were written.   Comparatively, Medicaid in Illinois was also agreeable to directly reimburse advanced practice nurses even before Medicare (Bardach, 2006). The frequent misconception of many advanced practice nurses about Medicare is that if a contributor gets a Medicare number, he or she will be reimbursed mechanically by every other insurance corporation, including PPOs and HMOs.   That is very wrong since insurance companies create or develop their own precise policies.   It can then be said that what one company permits, another one might not (Fishman, 2002).    V. Private Insurance In the United States, there are many private insurance plans that exists. Due to this, the guidelines for advance practice nurses are highly variable. There are times that the plans include the nurse provider in the preferred provider network. But there are also times that the nurse provider is considered outside the preferred provider network. So in general, less coverage is then afforded for the services rendered by nurses. These phenomenal places burden on those who have minimal resources. The number of networks that seeks to include practitioners among their credential providers is increasing. When discussing about the reimbursement issues, the fact that advance practice nurses always receives less payment that physicians arises. Advance practice nurses have been taught how to provide high quality care which is equal to the care provided by physicians. Because of this, they should be paid an equitable fee for the services they have rendered. Efforts are now exerted in order to fix these inequities. (Lundy) VI. Why APNs Do Not Receive Equal Reimbursement The Medicare Payment Advisory Commission or MedPAC examined the payments differencials between the clinicians and physicians. Why does this two groups do not get equal reimbursements? The MedPAC conjured that there is actually no analytical foundation that can support this. So in order to answer this question, the Commission investigated if these two groups, physicians and non-physician providers produces the same products or different products. According to the Commission, the Medicare must set the service payment equal to the cost incurred in efficiently rendering the service. Whenever the physicians and clinicians have provided the same service, then the payment for the low cost provider must be applied for all service providers. In many cases, there are many distinguishable differences between the services rendered by physicians and clinicians. Citing an example, according to reimbursement data, clinicians who are not physicians demonstrates a less complex evaluation and management services than physicians. Other specializations and surgical services are not included in the scope of practice of certain clinicians. Adjustments and changes for these types of billing codes include differences in resource costs. Since the nature of billing codes is imprecise, the Center for Medicare and Medicaid Services were not able to distinguish the different categories of clinician who provide similar services. They have this assumption that physicians are much prepared to diagnose and treat patients that have severe illnesses. But, contrary to this, anecdotal reports stated that other clinician sometimes spend more times in checking and treating patients with severe illnesses or who are in critical conditions, which made the physicians to care for a greater number of patients with lower acuity. Whenever a physician and other clinician bill for the same service, it is very difficult to tell of the physician saw a more complex patient. Due to these uncertainties in comparing their services, the Commission is reluctant in altering the payment differential. And certain policies even on the same company might be allowed in one state but not in another state.   As point of the matter, if one company has three product lines such as HMO, fee-for-service or indemnity, and PPO, then it may also have three dissimilar guiding principles for nurse practitioners (Bardach, 2006).    Consecutively, to ultimately become a credentialed contributor for each insurance plan that patients are secured with, a nurse practitioner must then submit an application for provider category with each and every insurance company, including Medicare and Medicaid. From that discussion, every provider must be familiar with some fundamentals about Medicare. First and foremost, there is Medicare Part A, which actually covers skilled nursing home, hospital, and home health charges; and then there is Medicare Part B, which then envelops most outpatient services, the care patients in particular obtain from doctors offices (Fishman, 2002). When it comes to the incident to billing, the Commission decided to consider that services rendered by clinicians who are not physicians but billed as incident to must be paid 100% of the physician fee schedule. The Commission have stated that the incident care fee is predicated upon the care or service provided by the team, with the non-physician giving the direct patient care services and the physician taking responsibility to the over-all welfare of the patient. They concluded that the team approach to care provides value which warrants payment at the full rate. (Edmunds, 2002) V. Conclusion Reimbursement issues have become challenge to nursing practitioners. Among the critical areas that NP should know are the following: the reimbursement process, contracts and the documents required. They are expected to take possession and responsibility of the procedure on the reimbursement. The APNs should first begin with comprehending their involvement contracts with health care plans. Secondly, nurse practitioners should become familiar with various requirements when it comes to documentation to sustain appropriate CPT coding. APNs should responsibly scrutinize an illustration of their assortments against their monthly charges. VI. Preparing for Future APN Reimbursement Being part of the healthcare system, Advance Practice Nurses (APNs) continue to search for greater quality, effectiveness and effeciency in delivering care. Many organizations and institutions like Center for Medicare and Medicaid Services (CMS) are taking the lead in identifying and validating indicators of high quality health care aiming to streamline delivery of care and to reduce convulated health care costs. à ¢Ã¢â€š ¬Ã‚ ¢ Composite Measures a reimbursement coding category that is currently being validated to deliver quality measures which can lead to desired patient results for chosen chronic diseases or conditions. (Kennerly, 2007) Establishing these new standards are based on the assumptions that by using them will cause a consistent high quality of outcome for the majority of patients and there will a great decrease in health care cost. The CMS is currently focusing on reforming quality reimbursement sytems which can save money while rewarding those care providers for their quality performance. à ¢Ã¢â€š ¬Ã‚ ¢ Pay-for-Performance led to determining the importance of implementing a common set of clinical standards for medical care. This means a providers performance and reimbursement is now and in the future will depend on and be judge against a national standard for care rather that past provider;s performances. (Kennerly, 2007)

Lysergic Acid Diethylamide Essay -- Drugs Sixties Health Essays

Lysergic Acid Diethylamide The late sixties were a time filled with sex, drugs, and rock and roll. A huge part of American culture at the time was focused around these three things. Musicians possessed a tremendous amount of social influence, and like wise, society put a lot of emphasis on the lives and attitudes of musicians. Of the rock groups from this time period, the Beatles were by far the most influential. The British rock group was probably the most catalytic band in rock and roll history. Although they came together in the shadow of the Beatles, another band of that era was Jefferson Airplane. Jefferson Airplane was deemed the first of the San Francisco psychedelic rock groups. Jefferson Airplane was always considered to be a psychedelic rock group, but it was not until later in their existence that the Beatles fell into this category as well. Both groups earned this title for their creative style of rock as well as for their experimentation with drugs. Each of these groups wrote songs that alluded to drug use at one time or another. Two of the most criticized songs from these bands are Lucy in the Sky with Diamonds by the Beatles, and White Rabbit by Jefferson Airplane. White Rabbit is a song latent with drug references. The connection with drugs in Lucy in the Sky with Diamonds is not as clear. Although John Lennon claims that he had no intention of making references to LSD in his song, the abstract lyrics and metaphoric language invite drug connotation. Lucy in the Sky with Diamonds and White Rabbit mirror each other in their association with LSD and their allusions to Alice in Wonderland, but looking into these songs more deeply it is obvious that both artists were writing about escape; escaping reality. Lyserg... ...ame out of the late 1960's. Both songs were criticized for their relationships to drug use and possible influence on impressionable youths. It was the media, the fans, and the critics that Jefferson Airplane and the Beatles were trying to escape from. It was through their music, Alice in Wonderland, and a drug called LSD that they were able to do so. Works Cited "The Beatles Ultimate Experience Database: Songwriting and Recording Sgt. Pepper's Lonely Hearts Club Band." (Online) Available http://www.geocities.com/SunsetStrip/Frontrow/4853/dba08sgt.html, 25 September 2000. "KidsHeath." (Online) Available http://kidshealth.org/kid/grow/know_drugs_lsd_prt.htm, 26 September 2000. Larrea, J.J. "Fifty Years Later, LSD Gains New Popularity in High Schools." (Online) Available http://www.lycaeum.org/drugs/tryptamines/lysergic/lsd_use_up.html, 27 September 2000.

The Prevalence Of Diabetes Health And Social Care Essay

Diabetess Mellitus is considered to be a major public wellness job worldwide. Its planetary prevalence has been estimated by World Health Organization WHO to be more than 135 million. The projection for the twelvemonth 2025 estimates a 120 % addition in figure of instances throughout the universe ( Al-Lawati & A ; Mohammed 2000 ) and besides estimates a 150 % addition in the East Mediterranean Region ( EMR ) ( Al-Lawati et Al. 2002 ) . In EMR, the diabetes prevalence rate for grownups is 7.7 % but this figure rises to between 12 % and 20 % for older age groups in urban communities and in Gulf States ( EMRO 2005 ) . The prevalence is higher in developed states than developing states. However, more addition will be in the underdeveloped universe in the coming 30 old ages ( King et al. 1998 ) . This is clearly coercing the developing states to take active stairss towards commanding diabetes. Diabetess is a chief cause of morbidity and mortality globally. It was estimated that the extra planetary mortality attributable to diabetes in the twelvemonth 2000 to be 2.9 million decease. The diabetes is likely to be the 5th taking cause of decease ( Roglic et al. 2005 ) . This is true for Sultanate of Oman and the magnitude of the job is continuously increasing. I will research diabetes in Oman in a elaborate manner. I will be analysing the load of diabetes and the factors maintaining its prevalence high. I will besides foreground the steps that have been adopted to get the better of this job. At the terminal I will discourse the restraints and place the countries necessitating more attending in order to beef up the control of diabetes in Oman.The state:Sultanate of Oman occupies the southeasterly corner of the Arabian Peninsula. It is bounded by the Gulf of Oman, Arabian Sea, Yemen, Saudi Arabia and the United Arab Emirates. Its entire country is 309,500 square kilometers. The capital is Muscat. Oman comprises a costal field of 1700 kilometer length and an interior part of hills and desert. The population is 2.5 million harmonizing to 2003 nose count ( MONE 2005 ) . The population is preponderantly Arab, with Pakistani, Indian, and Zanzibari minorities. Around 51 % of the Omani population is under 15 old ages old. Omanis remain a big bulk ( 74 % ) in their state unlike some of the Gulf States, which are dominated by foreign workers ( Hejleh 2005 ) . Oman is administratively divided into 5 parts and 3 governorates with 59 Wilayates ( territory ) ( MOH 2003 ) . Ministry of Health is responsible for presenting wellness service in Oman. The wellness attention is provided free of cost for the Omani population all Omani but fee is applied for non-Omani population ( MONE 2004 ) .Burden of the disease:It is indispensable to discourse the prevalence of diabetes and the its complications in order to hold a general thought about the magnitude of the job in OmanPreva lence of diabetes:Diabetess prevalence is quickly increasing in Oman over last few old ages. The first national diabetes study, which was conducted in 1991, showed that the prevalence of diabetes in topics 20 old ages old and above is 8.3 % ( Al-Lawati et al. 2002 ) . It besides showed the impaired glucose tolerance trial prevalence was 10 % and impaired fasting glucose prevalence was 5.7 % ( DGP 2003 ) . Both figures were alarmingly high figures that necessities immediate control enterprises ( Asfour et al. 1995 ) . 10 old ages subsequently, the 2nd national study showed that the prevalence of diabetes was 11.6 % and that of impaired fasting glucose was 6.1 % ( Al-Lawati et al. 2002 ) . This is clearly demoing that the load of the disease has about increased by one tierce over a decennary. The prevalence of diabetes was higher among work forces. In 2000, it was 11.8 % and 11.3 % in work forces and adult females severally ( Al-Lawati et al. 2002 ) . The diabetic instances diagnosed in Oman are chiefly of type II. This type constitutes about 95 % and type I constitutes merely 5 % ( DGP 2004 ) . The prevalence is summarised in table one. Year Type of sample Diabetess prevalence IFG prevalence 1991 Fasting blood sample 8.3 % 5.7 % 2000 Fasting blood sample 11.6 % 6.1 % Table 1: Prevalence of Diabetes and IFG in Oman in topics 20 old ages old and above harmonizing to national wellness studies in 1991 & A ; 2000.Prevalence of diabetic complications:The load of the disease can besides be measured by the prevalence of its complications. Many of diabetic complications do be in Oman in higher rates. Some of these are:Diabetic oculus diseases:The diabetic retinopathy prevalence in Oman is 14.39 % and it is the commonest cause of sightlessness in people age 30-69years ( Khandekar et al. 2003 ) . It was besides shown the rate of glaucoma among diabetic patient was 8.87 % ( Khandekar & A ; Zutshi 2004 ) . In both complications, the diabetic patients are at higher hazard. It could be easy drawn from these two surveies that a particular attention must be given to diabetic patients to cut down the ocular disablements.Diabetic pes diseases:It has been found that the diabetes is responsible for 51.8 % of all amputations reported in Oman ( DGP 2004 ) . Foot compli cations are one of the most serious and dearly-won complications of diabetes. It is an pressing issue that need more attending.Cardiovascular diseases:It was shown in 2004 that most of diabetic Omani patients died as a consequence of cardiovascular complications ( MOH 2005 ) . This is due to the fact that hazard factors for the development of macro-vascular diseases are often found in diabetic patients ( DGHA 2003 ) .Nephritic failures:It was shown that 33 % of nephritic failure instances diagnosed in Oman are due to diabetes ( MOH 2005 ) .Factors behind diabetes in Oman:Such high prevalence of diabetes is perfectly maintained by many implicit in factors. The chief factors are summarized in table two. No. Factor 1 Dietary form 2 Physical inaction 3 Corpulent or fleshy 4 Other behavioral hazard factors ( e.g. smoke ) 5 Akin matrimony 6 Familial susceptibleness Table 2: Underlying factors behind diabetes Oman has rapid socioeconomic developments that are associated with urbanization consequence. This consequence is really clear particularly in Muscat and secondly in Batinah part. This is due to the fact that more than 56 % of the population life in those two parts which represent merely 15 % of the entire country ( MONE 2005 ) . The urbanization consequence is manifested in rapid life manners alterations such as alterations in dietetic form ( High fat/ high salt/ Calorie dense diet ) and decreased physical activity ( DGHA 2003 ) . There was a pronounced displacement from simple traditional life styles to more westernized life manners. The physical inaction is high and its prevalence is 22.5 and 3.1 in males and females severally ( DGP 2004 ) . The rapid addition in auto ownership has led to further lessening in physical activity. Fleshiness and corpulence are closely associated with diabetes. It has been shown in 2001, 47.4 % of diabetic patients either corpulent or fleshy ( Al-Lawat i et al. 2002 ) . In 2000, the age adjusted prevalence of fleshiness reached 16.7 % in work forces, compared to 10.5 % in 1991. In adult females the prevalence was 23.8 % in 2000 compared to 25.1 % in 1991.Both corpulence and fleshiness has markedly increased among Omani work forces during the past decennary, while a worsening tendency was seen among Omani adult females. The worsening tendency among females could be explained by increasing educational degree, worsening birthrate rates and improved consciousness of self image ( Al-Lawati & A ; Jousilahti 2004 ) . However, the prevalence is still high for both sexes and need more attending through establishing effectual nutritionary plans and promotional life manner alteration plans ( Al-Riyami & A ; Afifi 2003 ) . In add-on, smoke is closely associated with many non-communicable diseases and it is common in Oman. Recent studies for the prevalence of behavioral hazard factors among big Omanis have revealed a high prevalence of smoke ( 23 % male smoke and 1.5 % among females ) ( Al-Lawati & A ; Hill 2001 ) . Another factor underlying the higher prevalence is akin matrimony between Omani. Arranged matrimonies are normally seen between first or 2nd degree relations. This will increase the familial heritage of diabetes ( Al-Haddad Y 2003 ) . A familial susceptibleness may besides explicate why diabetes has become an â€Å" epidemic † . In comparing to Caucasian and European populations with similar grades of fleshiness and glucose tolerance, Arabs are more insulin-resistant than Europeans. This feature, which is a strong forecaster of diabetes, seems to be genetically determined in these populations ( Al-Mahroos 2003 ) . Equally long as the above mentioned factors exist, the diabetic prevalence will be high. So it sounds logic controlling of these factors will cut down diabetic prevalence.Diabetess is a existent wellness challenge in Oman:From the above, it is clear that the diabetic load has increased signif icantly and at the same clip its underlying or lending factors do be strongly. This puts Oman ‘s wellness attention system at cross roads as it is witnessing an epidemiological passage from catching diseases to non-communicable diseases ( DGP 2003 ) . This should be accompanied by a passage displacement in the system from commanding infective and childhood unwellness to face challenges of the twenty-first century in battling chronic unwellness such as diabetes, high blood pressure and fleshiness. One of the challenges is incorporating and bettering the quality of wellness attention provided to diabetic people. Presently, a significant proportion of the Ministry of Health budget is spent on direction of diabetes and its complications ( DGHA 2003 ) . The passage from catching disease to non-communicable diseases is manifested clearly in morbidity and mortality indexs. It is shown in figure one there is a raising tendency in the per centum of non-communicable diseases part to the entire out patient section ( OPD ) visits. It increased from 42.5 % in 1996 to make 53.2 % in 2004. On the other manus, there is a worsening tendency for catching diseases part ( DGP 2004 ) . Figure 1: Catching and non-communicable diseases part to the OPD morbidity in 1996 & A ; 2004. Inpatient morbidity of non-communicable diseases had besides increased in comparing with catching diseases over the last nine old ages as shown in figure two. They contributed approximately 36.1 % and 39.6 % of entire discharge instances in 1996 and 2004 severally. Figure 2: Catching and non-communicable diseases part to the inpatient morbidity in 1996 & A ; 2004. Out of these non catching diseases, diabetes is considered to be the 2nd prima cause of inpatient morbidity in male and female in the age group 45 old ages and supra after ischaemic bosom disease ( MOH 2005 ) . The load is good demonstrated by the fact that diabetes mellitus is entirely responsible for about 9 % of all grownup infirmary admittances and 12 % of the grownup infirmary bed tenancy rate ( Asfour et al. 1991 ) . Inpatient morbidity for diabetes has raised steadily from 1528 instances in 1986 to 3695 instances in the twelvemonth 2000 as shown in figure three ( Al-Lawati et al. 2002 ) . Figure 3: Number of diabetic instances registered in 1986 & A ; 2000. Distribution of new diabetic patients harmonizing to the age groups is shown in figure four. It is shown in that about tierce of the diabetic instances are diagnosed at the 40-49 old ages group and a high proportion even after the age of 50 old ages ( MOH 2005 ) . This indicates somehow that there is hold in the diagnosing. This could be due either unavailable services or patients non be given to seek intervention early. Figure 4: Distribution of new diabetic patients harmonizing to the age groups.Diabetess care in Oman:Ministry of Health has ensured the wellness attention to be readily accessible to all. It is free of charge and delivered through more than 156 wellness establishments ( MOH 2003 ) .Diabetic attention is ensured and provided through National Diabetes Prevention and Control plan. The 6th five twelvemonth program ( 2001-2005 ) has identified diabetes as a major precedence ( DGP 2003 ) .National Diabetes Prevention and Control Program and its accomplishments:This plan was initiated in 1991 and is managed by the section of non-communicable disease surveillance and control represented by diabetes bar and control subdivision. The caput of this subdivision is the national plan director. The plan is responsible for developing constabularies and implementing schemes for diabetes control ( Al-Lawati et al. 2002 ) . It aims to supply diabetic attention in all wellness degrees: primary, secondary and third in close coaction with each other to guarantee an effectual referral system. Its aims are ( DGHA 2003 ) : Prevent the disease susceptible persons and communities. Early sensing of persons at high hazard. Keeping a better quality of life for diabetic patient and cut down the long term complications and therefore cut down its morbidity and mortality. Provide suited and quality wellness instruction to diabetic patient ‘s relations and the community. The aims are crisp and comprehensive. They are directed foremost towards the bar of the disease and secondly to early sensing through testing plans. In instance these failed to be fulfilled, an of import aim is to keep a better life quality to the patient. Many accomplishments took topographic point over the last 14 old ages Such as ( EMRO 2005 ) : The diabetic control plan was integrated in primary wellness attention in 1995 ( MOH 2003 ) . So that all basic services required for diabetic patients are available at the primary wellness attention establishments through the constitution of mini diabetic clinic. This has optimized the direction of diabetes at the primary wellness attention degree ( Al-Lawati et al. 2002 ) . A good advancement in rating of national diabetes registry in which all diabetic patients are registered. Registers are maintained on a regular basis in which all patient inside informations are mentioned. This registry was initiated foremost in 2000 ( DGHA 2003 ) . It is a good mechanism for follow up within the catchment country of wellness establishment. Annual preparation workshops for the staff ( Doctors/ nurses ) . This is of great value in updating the cognition and experiences of the old staff and introduces the new staff to the plan. These workshops could besides be used to work out challenges confronting the regional plan. They are conducted at territory and provincial degrees. Constitution of a policy for oculus attention for all new diabetic patients. There was a existent demand for such policy as the diabetic oculus diseases are increasing in Oman. The plan director at the cardinal degree is responsible for organizing the activities between different degrees. A squad at the primary wellness attention degree provides the diabetic attention. Antidiabetic drugs and insulin are being made available free of charges to all Omani ( Al-Lawati et al. 2002 ) . This squad consists of doctor, nurse, dietician / diet technician and wellness pedagogue as shown in figure five ( DGHA 2003 ) . The diabetes squad at the primary wellness attention Health Educator Dietician / Diet technician Nurse Doctor Take basic measurings Maintain patient records. Provide list of defaulters. Provide Diabetic attention Maintain diabetic register Train other members Inform and educate patient on basic and exigency state of affairss. Health instruction follow up. Provide dietetic advice. Advice patient how to cover with hypoglycemia. Figure 5: The construction of the squad members and their chief duties. The construction of the squad is good defined with clearly demarcated functions and duties which are designed to undertake the most pressing issues required in the diabetic attention. The squad is supervised by a regional diabetologist at the secondary wellness attention degree. There are nine regional diabetologists in Oman ; one in each part. In add-on, the regional diabetologist should develop the primary wellness attention doctors on the basic direction of diabetes and this may include regular visits to primary wellness attention establishments in his/her part.Prevention of diabetes in Oman:Ministry of Health has adopted many bar schemes. The bar is considered as precedence and it is achieved through three degrees ( DGHA 2003 ) :Primary bar:This is done through commanding the implicit in causes and hazard factors. It aims at increasing consciousness about diabetes by mass instruction candidacy, telecasting and wireless. The diabetic squad at the primary wellness attention degree conducts most of the wellness instruction activities.Secondary bar:This aims at early sensing of instances. It includes screening individuals at high hazard for diabetes and its complications every three old ages. The people at hazard are corpulent ( Body mass index & gt ; 30 Kg/m ) , first grade with diabetes mellitus, history of gestational diabetes mellitus, high blood pressure and dyslipedemia.Third bar:This includes proper direction and any action taken to forestall complications. The schemes for third bar involve testing for early complication phases, rigorous metabolic control, instruction and effectual intervention.Constraints to a better diabetic attention:Although there are a batch of good accomplishments of the diabetic attention, many restraints confronting the better attention such as:Need for a National diabetic Centre:There is no national diabetic Centre in Oman. All complicated instances end up in the medical wards in the third infirmaries. This is particularly of ad ded importance as the load of disease is increasing. It is an pressing issue to set up a diabetic Centre in which all the diabetic instances will be evaluated and managed by following the same guidelines. The diabetic Centre should be besides responsible for carry oning preparation workshops and besides bring forthing studies and surveies.Inadequate installations for direction of diabetic pes:As the figure of diabetic instances addition, figure of diabetic pes instances besides increases. So far no organic structure is specialized in diabetic pes attention in the Sultanate and the intercession or direction is still non effectual. Merely one workshop was conducted in this respect in December 2004 but it was merely an introductory workshop and the participants were merely staff nurses and no physicians ( IDF 2004 ) . There is a existent demand for more expertness and extremely specialised techniques in diabetic pes attention. This will finally better the patient quality of life.How ca n the diabetic attention be improved further in Oman?This inquiry can be answered merely by analyzing the precedence work countries. This analysis finally will take to many future schemes that can be used efficaciously in bettering the diabetic attention. The top of import schemes are:Prevention of diabetes through life manner alteration:The most effectual manner of bettering the diabetic attention is by forestalling the disease. This is the first measure and can be carried out by sing bar of diabetes through life manner alteration as a precedence. It is logic as the type II being the most common type of diabetes and it is chiefly due to life manner alterations and besides its prevalence increasing twelvemonth after twelvemonth. Empowering the community to take control over their ain wellness could carry through this. As a consequence, wellness life manner alterations can be implemented at community degree in the signifier of healthy life manner undertakings. Through these undertaki ngs the wellness of people can be promoted by authorising them and affecting them in planning and taking determinations about different ways of accomplishing a better life manner. One such scheme is guaranting the active engagement of community leaders particularly on the international diabetes twenty-four hours, which is on the 14th of November every twelvemonth. An illustration of this was conducted in Oman in what is called Nizwa Healthy Life Style undertaking. However, this is still a new construct and more attempts should be done in this country. An illustration of a factor that needs more attending from the bar point of position is fleshiness. It appears to be the most of import individual mark variable to command if the incidence of diabetes is to be reduced. Although impermanent decreases in weight can be achieved by dietetic restraint, long-run control of fleshiness appears to depend on keeping higher energy outgo is the most of import. In Oman, most businesss are sedentary, walking and cycling are the two signifiers of activity through which energy outgo can most easy be increased. However, cycling is non at present culturally acceptable. This highlights the trouble of change by reversaling the inauspicious effects of lifestyle alterations. Alternatively, physical activity could be increased by regular engagement in exercising preparation plans, but long-run engagement in such plans would necessitate high degrees of motive ( Al-Mahroos 2003 ) .Early on and effectual showing plans:A 2nd measure towards a better attention is the executions of early and effectual showing plans. These plans should be regular and available in all different wellness establishments. Specific standards should be set up for the showing. The showing could be taken up one measure in front by sing the community and test the people in their places. This is important because a comprehensive population-based programme is the most cost-efficient attack to incorporate this emerging diabetic epidemic ( EMRO 2005 ) . An illustration of this could be the organisation of diabetic run in the community. This will pick the instances instantly taking to early sensing and direction.Combined diabetic clinic:Another measure is of class the better direction. The ultimate jail of the direction is to forestall the complications. At the same clip the direction of diabetic complications require many different fortes viz. diabetologist, physician, nephrologists and gynecologist. Keeping these issues in head, a better direction requires a multidisci plinary attack. This can be achieved by combined diabetic clinic in which diabetoligist and another specializer harmonizing to the status or the complications see the patient at the same time. These will better the attention by guaranting the understanding of the concerned physicians about the intervention program.Diabetic pes attention:Another issue of bettering the diabetic wellness attention is through the betterment of diabetic pes attention. The importance of this issue comes from the fact that the diabetes is responsible of 51.8 % of all amputations reported in Oman as mentioned above. The diabetes subject for 2005 is diabetes and pes attention. It will be a cost effectual attack because the diabetic pes is a important economic job, peculiarly if amputation consequences in drawn-out hospitalization, rehabilitation, and an increased demand for place attention and societal services ( IDF 2005 ) . The purpose is to cut down by half the figure of foot amputations caused by diabete s in the state ( IDF 2004 ) . This can be achieved through a attention scheme that combines: bar ; the multi-disciplinary intervention of pes ulcers ; appropriate organisation ; close monitoring, and the instruction of people with diabetes and health care professionals, it is possible to cut down amputation rates by between 49 % and 85 ( IDF 2005 ) .Coordination between MOH plans:Last, there should be coordination between different MOH plans in order to guarantee that all diabetic bar is good covered. These include nutritionary plan, antismoking plan and plan to advance physical activities.Pressing issues to be raised up:It is of import to implement effectual diabetes surveillance system in Oman. It could be used as an earlier anticipation of the epidemic nature of diabetes and its features. It is besides a necessary first measure toward its bar and control, which is now recognized as an pressing precedence ( King et al. 1998 ) . Furthermore, it is indispensable to set up a quality confidence system. Such system will take to uninterrupted rating which is important to the success of national diabetes control plan. It should concentrate on both procedure steps and result steps ( EMRO 2005 ) . Rehabilitation of diabetic patients is indispensable and a precedence. It is a cost effectual attack. This is because many persons with diabetes may develop disenabling complications with high associated costs ( DGHA 2003 ) .Decision:Oman is undergoing demographic and socio-economic alterations, which favours an addition in the load of diabetes presenting a hard challenge. The diabetic control plan is good in topographic point and bar activities are traveling on in all different degrees. However, there is a existent demand for set uping quality confidence mechanisms in topographic point for the plan. As portion of this it is besides necessary to set up a Centre of excellence at the third degree which could supply the needful advanced diabetic attention and besides map to sets criterions in the attention of diabetics. It is besides required to concentrate every bit good augment attempts for better bar in order to minimise the underlying modifiable hazard factors. Ultimately, these ste ps could cut down the diabetic prevalence or at least command it at this degree.

Guilty Discussion Game for English Learners

Guilty Discussion Game for English Learners Guilty is a fun classroom game which encourages students to communicate using past tenses. The game can be played by all levels and can be monitored for varying degrees of accuracy. The game gets students interested in detail which helps to refine students questioning abilities. Guilty can be used as an integrated game during lessons focusing on past forms, or just to have fun while communicating. Aim: Communicating with Past Forms Activity: Question and Answer Game Level: All Levels Outline Start by describing a crime which happened last night. Each student pair will be interrogated by the rest of the class and will create alibis to prove they are innocent.Have students get into pairs.Have the students develop their alibis for where they were when the crime was committed. Encourage them to go into as much detail as possible when discussing their alibis.Go around the classroom getting an alibi statement from each group (e.g. We were away for a weekend trip to the countryside).Write the individual alibis on the board.Once each group has developed their alibis, ask them to write down 3 questions about the other alibis on the board.To begin the game, ask one student from the beginning pair to leave the room. The other students ask the first student the questions.Ask the other student to return to the classroom and have the students ask the same questions. Take note of how many differences there were in the students responses.Repeat the same with each student pair.The guilty pair is the pair with the most discrepancies in their story. For more information on teaching past tenses, here are some how-to guides: How to Teach Past SimpleHow to Teach Past ContinuousHow to Teach Past Perfect ContinuousBack to lessons resource page

Apartheid in South Africa 3 Essay Example

Apartheid in South Africa 3 Essay Example Apartheid in South Africa 3 Essay Apartheid in South Africa 3 Essay Apartheid in South Africa How would you feel if when you came to school, you had to sit in a specific area based on, let’s say the colour of your hair. This would mean that who you associate with would be based on these characteristic. My topic is very vast as it is spanned over 46 years so today I’m going to touch on the side that follows the way the blacks were forced to live and how they were seen as lesser human beings. To put it simply it was due to a long history of settler rule as well as Dutch and British colonialism. The essential thinking behind apartheid was that although South Africa was a unitary nation, it was comprised of four racial groups. This sparked internal resistance to which the government responded with detention without trial and torture. Whites in their own eyes were seen as sophisticated and therefore entitled to rule South Africa. So to begin at the beginning, during the lead up to the 1948 elections the national party began to campaign their ideas on Apartheid and began to pass legislation on their laws shortly after to coming onto power. Classifying individuals began by segregating everyone into black, white coloured or Indian. Those in the coloured group included those of Bantu and European descent. Officials would perform tests to determine which group someone belonged to and often members of the same family ended up in different groups. The East Asian population was the hardest to classify because the just didn’t seem to fit into any group. The descendants of the chinese who came to Johannesburg in the late 19th century were classified as Indian and hence, non-white. In contrast, immigrants of Japan and South Korea were considered honorary whites and were given the title â€Å"worthy oriental gentlemen† and given the same privileges as whites. In South Africa under apartheid, the blacks were stripped of their citizenships and became one one 10 homelands. The natives were discriminated against and legislation stated where and how they should live, work, educate and mingle. In 1949 mixed marriages were prohibited between racial groups. Then in 1953 the separate amenities act was passed which ultimately created separate ospitals, beaches, buses, schools and universities. Signs outlined things clearly with wording such as â€Å"whites only† which applied to nearly everything, even park benches. The government then tightened existing laws forcing South Africans to carry identity cards stipulating their racial group, which prevented the migration of blacks into white South Africa. Blacks were prohibited from living in or visiting white to wns without a permit. The Travelling without a pass meant that a person was subject to arrest. Blacks were not allowed to buy liquor, only a specific type of beer. In 1952 a program of action was launched. By defying laws, a black organisation aimed for mass arrests which the government would be unable to cope with. At one stage Nelson Mandela lead a crowd of 50 men down the streets of a white town. After that, across the country black people disregarded racial laws by doing things such as walking through white only entries. By the end of the campaign the government had made 8,000 arrests and was forced to relax its apartheid laws but eventually came back stronger than ever. The suppression of communism act arose and Mandela was one of 20 tried under the law and received 9 month imprisonment and 2 years suspended sentence. A large amount of white South Africans supported the apartheid laws but it is important to remember that between the 1970’s and 1980’s around 20% of voters were opposed. Violence persisted right through to the 1994 elections People had to cast two votes, one for a national government and another for a provincial government. As part of the new government structure each province was given a degree of political power. This meant that not all decisions were made by the National Government. The government of national unity was established and the cabinet was made up of 12 ANC reps, 6 from the national party and 3 from another. Nelson Mandela became the first democratically elected president. Since then the 27th of April is celebrated as a public holiday known as freedom day. www. un. org/av/photo/subjects/apartheid. htm http://en. wikipedia. org/wiki/Apartheid www-cs-students. stanford. edu/~cale/cs201/apartheid. hist. html

Final Project-The Story Essay Example | Topics and Well Written Essays - 2500 words

Final Project-The Story - Essay Example Such policies should also define stakeholders who will be held accountable on the progress, success or failure of the initiative. Inevitably, policy makers, physicians, nurses, nursing bodies, educators, patients, insurance firms and state authorities must collaborate to bring diabetes under control. The most effective control measure would be the prevention of the occurrence of new cases, while at the same time controlling and managing the condition among those already living with it (Davies, Dixon & Currie, 2001). The role of educators, therefore, becomes a key emphasis of the policy making procedure. This becomes a key issue because a 20 year old patient representing a diagnosis was interviewed for the project and confirmed not having been sufficiently informed on the necessity of a healthy lifestyle in the prevention and treatment of diabetes. This, in turn, means that the role of diabetes educators is not sufficiently felt in society, creating a knowledge gap. This issue is link ed to nursing because nurses have the abstract information on patient care and can contribute significantly towards formulating policies that will effectively curb the growing numbers of diabetic cases. Being the ones closest to patients in terms of provision of care, they are in a better position to know what advice needs to be given in the prevention and control the problem. Therefore, their role is significant in promoting the initiative through providing evidence-based and up-to-date facts about education and care in diabetes (Davies, Dixon & Currie, 2001). This essay will discuss the problem, the policy and political procedures and provide a concluding solution. Policy Analysis The subject of diabetes has faced numerous policy challenges. The American Association of Diabetes Educators (AADE) pointed out that at some time, when citizens were diagnosed with diabetes, access to life insurance available in their states became unaffordable and even sometimes unavailable (Oliver & Mo ssialos, 2012). The reason was that federal law permitted life insurance firms to operate on policies that rated or charged a premium basing on the health status of applicants. Essentially, such plans allowed the insurance companies to deny an applicant the sought cover depending on their health status. Even so, patients requiring access to diabetes educators require a physician’s referral in order to receive the services (Peeples & Austin, 2007). This poses another policy challenge in the management of diabetes. Some physicians may not be giving the referrals as a measure to safeguard their revenue sources, and even if they did, the number of available educators is not sufficient to handle them. On the other hand, without a physician’s referral, the services of an educator are not among the covered benefits of insurance. According to the American Diabetes Association (ADA), diabetes at any stage needs round-the-clock management to alleviate long term complications ass ociated with hyperglycemia and hypoglycemia. Within the learning environment, levels of blood sugar not within the target range will interfere with the learning ability of a student. Non-diabetic students must be taught healthy lifestyles to avoid it, while the diabetic ones should have the ability to check and respond to blood glucose levels accordingly. Although some may handle the routine independently, others, due to developmental level or

Geothermal Energy Essay Example | Topics and Well Written Essays - 2500 words

Geothermal Energy - Essay Example Unlike the conventional method of burning fuels to produce the heat required, optimizing earth's energy from deep within the ground is by nature sustainable and would not take additional chemical process to be transformed to a useful form. Moreover, geothermal energy is never likely to contribute to greenhouse effect as fossil fuels are and once put up, the power plant would be self-sustaining or not necessitating external energies aside from the power it yields. Roughly 33,000 feet beneath the earth's surface lies heat that contains about fifty thousand times more energy compared to the combined presence of natural gas and oil currently processed by men. This inevitably fluid heat experiences high temperatures in various zones where layers upon layers of molten rock commonly known as 'magma' are continuously formed as a consequence of naturally occurring radioactive elements that undergo intense decomposition on a subatomic level for several years. Because magma is less dense than t he rocks surrounding it, it rises to the surface. Sometimes magma escapes through cracks in the Earth's crust, erupting out of volcanoes as part of lava. But most of the time magma stays beneath the surface, heating surrounding rocks and the water that has become trapped within those rocks. Sometimes that water escapes through cracks in the Earth to form pools of hot water (hot springs) or bursts of hot water and steam (geysers). The rest of the heated water remains in pools under the Earth's surface, called geothermal reservoirs. By the Earth’s crust shifting and allowing water to mix into natural hot-spots water is superheated and then vented through holes in the Earth’s surface with tremendous power. The superheated water generated at these locations can naturally reach temperatures of up to 200Â °C (430Â °F). Earth's core is nearly 6000Â °C - hot enough to melt a rock. Even a few kilometers down, the temperature can be over 250 Â °C given that the Earth's crust is thin. Temperature generally rises a degree Celsius for every 30 - 50 meters you go down, but this alters with respect to location. Among the hotspots from which geothermal energy may be obtained are certain states of America as Oregon, California, Alaska, and Nevada which possesses a significant number of volcanoes comprising the Pacific Rim or the Pacific 'Ring of Fire'. Hotspots are typically close to fault lines or young volcanoes were the Earth’s crust is thin enough to allow internal heat to escape and be accessed by as little drilling is possible. It may be a surprising fact to discover that besides these seismically active regions, any other location on earth ranging from a depth of 10 to a few hundred feet through the crust is capable of heating objects even at lower degrees. The capacity to generate electricity by extracting heat out of these places would of course depend on the quantity of drawn heat which can be converted to electrical energy. Landrello, in Ita ly is the first to own a geothermal power station, followed by Wairekei in New Zealand and a few others were built in Iceland, Japan, Indonesia,