Wednesday, July 31, 2019

Enhancing the Quality of Education in the Philippines Essay

Enhancing the quality of basic education in the Philippines is urgent and critical. Due to that, one of the discussions of DepEd which incurred last October 2010 is to enhance the basic education program of the country in a manner that is least disruptive to the current curriculum, most affordable to government and families, and aligned with international practice through the K-12 policy. The poor quality of basic education is reflected in the low achievement scores of Filipino students. Many students who finish basic education do not possess sufficient mastery of basic competencies. One reason is that students do not get adequate instructional time or time on task. This quality of education is reflected in the inadequate preparation of high school graduates for the world of work or entrepreneurship or higher education. High school graduates also do not possess the basic competencies or emotional maturity essential for the world of work. 1 While the availability of economic opportunities contributes to this, it also illustrates the mismatch in the labor and education markets. The World Bank Philippines Skills Report in 2009 reveals, based on a survey of employers, serious gaps in critical skills of graduates such as problem-solving, initiative and creativity, and, to a lesser extent, gaps in job specific technical skills. The enhanced K-12 program, or the Department of Education’s (DepEd) proposal to overhaul the basic and secondary education curriculum by adding two more years to the system is arguably one of the most drastic and controversial programs of the Aquino administration. The program is proposed to start in school year 2012-2013 for Grade 1 and first year high school students with the target of full implementation by SY 2018-2019. According to SEAMEO Innotech 2011, which is considered as the preferred education solutions provider in Southeast Asia and also an ISO 9001: 2008 Certified, the Philippine is the last country in Asia and one of only three countries in the world with a 10-year pre-university program. The K-12 model to be implemented in the country is an educational system for basic and secondary education patterned after the United States, Canada, and some parts of Australia. The current basic education system is also an archetype of American schooling but with a 10-year cycle. DepEd reasons that it is high time to adopt a K-12 system, attributing the low achievement scores and poor quality of basic education to the present school setup. Following wide protests over the proposal, the department released its official position defending K-12. 2 â€Å"We need to add two years to our basic education, those who can afford pay up to fourteen years of schooling before university. Thus, their children are getting into the best universities and the best jobs after graduation. I want at least 12 years for our public school children to give them an even chance at succeeding. † quoted from the statement of His Excellency President Benigno S. Aquino III. K-12 has been met with criticism from youth and student groups, teachers, parents and the academic community. The DepEd, for its part, appears determined to enact the program with its proposed budget catering mostly to preparing the grounds for its eventual implementation. The DepEd argues that the K-12 program will be the solution to yearly basic education woes and the deteriorating quality of education. Critics, however, counteract that the education crisis needs to be addressed more fundamentally and adding more school years would only exacerbate the situation. With the proposed policy K-12 program, various arguments and criticisms were formulated. Different conditions generate different assumptions, which in turn create different policies. The success of any policy depends on the correctness of its policy assumptions. 3 Taking this fact into consideration, questions take place, should policy assumptions be made based on current realities? Or should policy be based on policy conditions as expected to happen, but which may not exist by the time the policy implementation was started? The below mentioned problems are just some of the queries where necessary answers are in need to be sought in order to satisfy uncertainties with regards to the implementation of this educational changes provided in K-12 Policy. PROBLEMS 1. What is the status of the country’s educational resources as to: * teaching force; * facilities and equipments; * learning materials; and * budget? ; 2. What are the provisions of the policy to the following direct entities? * family; * manpower;? and instructional apparatus**? ; 3. What is the level of preparedness of the concerned implementing stakeholders e. g. DepEd, CHED as to the execution of this educational reformation? and 4. What is the level of acceptance of the following affected stakeholders: * teaching staff; * parents; and * students? 5. What is the level of capability of the following affected stakeholders? * teaching staff; * parents; and students? OBJECTIVES The formulation of policy for the K+12 Education System requires rigorous systems analysis. Many patchworks of issues, opinions and statistical analysis have already been presented by so many sectors in so many meetings and consultations. But what is more important to see now is the entire picture, the whole tapestry of Cause-Effects and Costs-Benefits that the policy, if adopted, will create. The following are the main objectives of the K-12 policy as stated in their guiding principles4: 1. To enhance the curriculum of the Enhanced K+12 Basic Education Program as the central focus. The curriculum enhancement will be designed in line with the desired competencies and skills of a K+12 graduate. The Department of Education will constitute a body to review the current basic education curriculum and detail the implementation plan. 2. To develop tracks based on different competencies and/or student interest as an integral component of the program. Basic education program should develop tracks based on competencies to meet the country’s varied human capital requirements, and to prepare students for productive endeavor. The SHS curriculum will offer areas of specialization or electives. 3. To enhance the basic education curriculum being undertaken hand in hand with the vigorous efforts to ensure adequacy of inputs as part of the bigger basic education reform,  Expanding the education program (additional years of schooling) will be pursued mindful of the need to address the input shortages – teachers, classrooms, desks, water and sanitation, and quality textbooks. DepEd already included a provision for substantial physical requirements for 2011 budget, and is looking to introduce in subsequent years a budget that will constitute a significant increase not just in nominal terms but also in real terms. 4. To alter change in two-fold: curriculum enhancement and transition management. The intention of K+12 is not merely to add two years of schooling but more importantly, to enhance the basic education curriculum. DepEd is preparing a carefully sequenced implementation plan to ensure smooth transition with the least disruption. 5. To have an open and consultative process to be adopted in the promotion of the Enhanced K+12 Basic Education Program. In accordance with the â€Å"Tao ang Boss† principle, an open and consultative process will be adopted to ensure the successful development and implementation of the K+12 program. REVIEW OF RELATED LITERATURE. Many of us believe that in order for a person to achieve his success, he must have a good background in education and the attitude of a survivor. A great education begins with the desire to learn (Osterberg, 2004). Education is important in everybody. It gives us knowledge about the world around us, strengthens our perspective in life and helps build opinions and have points of view in everything about life. Education is really important in bringing our dreams to reality. It opens up doors to every opportunity that would give success in one’s life (Oak, 2010). In our country’s case, the Philippine government offers only 10 years in basic education (6 years for elementary and 4 for high school years), which is the lowest as compared to 12 years in many countries in the world (PCER, 1999). The poor mastery of lessons is common due to the congested curriculum and to the great number of population in public schools. High school graduates of 10-year basic education curriculum are also believed to lack basic competencies and maturity. They cannot legally enter into contracts and are not emotionally mature for entrepreneurship / employment (DepEd, 2010). According to the National Framework Plan for ICTs in Basic Education (2010), the poor performance of students across our country shown in recent national and international achievement tests, and the great number of dropouts both in elementary and secondary levels, pushes the government to add 2 more years in the basic education curriculum or also termed as the K+12 education program. The K+12 program means Kindergarten and the 12 years of elementary and secondary levels. Kindergarten refers to the 5-year old cohort that takes a standardized kinder curriculum. Elementary education refers to primary  schooling that involves six or seven years of education. Secondary education refers to high school (DepEd, 2010). According to the official gazette by the Department of Education (DepED, 2010), the model that is currently being proposed by DepEd is the K-6-4-2 Model. This model involves Kindergarten, six years of elementary education, four years of junior high school (Grades 7 to 10) and two years of senior high school (Grades 11 to 12). The two years of senior high school intend to provide time for students to consolidate acquired academic skills and competencies. By the time that the issue in K+12 program was once again brought up to public, there has been lots of comments and opinions made by those who agree and disagree about it. The pro-K+12 said that the need for enhancement of the quality of education is urgent and critical and that the congested curriculum only burdens the students by the time they pursue their tertiary level. The government also stated that by adding two more years in our curriculum would increase the GDP growth by 2%. While those who disagree said that the families would have to shell more money for transportation, food and education of their children. Many have also stated that the government does not have the money to spend for another two years in education since it does not have the money to fully support today’s ten years (Cruz, 2010). METHODOLOGY The paper presented elucidates what the K-12 policy is all about, the rationale of formulating it, the target stakeholders and beneficiaries. Further, it tackles also the current situation and the adaptation scenario as it was going to be implemented this coming school year. Various facts, criticisms and assumptions from different reliable sources were asserted in order to substantiate details needed for the best understanding. The presenters wanted to obtain information as to the queries being questioned in the above stated problems in order to have a bird’s eye view to the content and specifications of the said policy. Since the policy is soon to be implemented, the discussion presented is more on the assessment of the provisions and guidelines stipulated in the educational reform in relation to the affected stakeholders. The come up of the following options were based from the personal assessments from the presenters out from the ideas and thorough discussions gained from the varied reliable sources. Further, some contents of this part contain documentation of issues and problems base from the current news and information cited from different reliable sources. Moreover, the views and opinions of the presenters do not necessarily reflect the contents or discussion of the neither class nor stand point of the subject instructor, thus all the generated opinions are purely coming from the presenters. 1. Eradicate and impede the implementation of the policy. Constraints and limitations are highly contradicting the concerned K-12 policy, not to mention the unwillingness to embrace the pro’s and con’s brought by this. 2. Suspend the realization of the policy and reschedule for the next succeeding years. Government and direct implementing agency are not well prepared for the changes to be incurred. Further trainings and seminars, strengthening of the workforce are hereby in need as well as deep penetration to the students and parents for the better understanding and acceptance. 3. Put into practice the K-12 policy this coming school year. The country needs to improve the standard of the educational system in order to keep in line with the paces the other country is pacing. The long term outcome of the said implementation would serve as a positive outcome that will uplift the morale of the society thus bringing noticeable growth to the citizens specifically and to the country as a whole. ANALYSIS AND DISCUSSION 1st Option: Eradicate and impede the implementation of the policy. It is remarkable and inspiring to see that Philippines is now progressing economically and as such, to sustain and possibly prolong this stream, targeting the Education sector of the country is a must. But, unpreparedness, poor educational participation and development will surely yield to negative outcomes. The biggest issues the K-12 Education System must address are its requirement educational inputs and processes. If these are not given solution, the K-12 Education System policy is already ruined from the very start. In view of Sarah Katrina Maramag’s idea, â€Å"the crisis of the Philippine education system, in all levels, is stemmed not on the superficial, in this case the number of schooling years, but rather on the conditions and foundation on which it subsists. Unless the government addresses in earnest poor public spending, high costs of schooling, the predominance of a colonial curriculum, lack of transparency and accountability amid widespread corruption within the sector and the development of the country’s science and technology for domestic development, all efforts will remain on the surface and neither 10 nor 12 years would make much of difference. † To relate with the statement of President PNOY â€Å"to achieve something out of this move to K-12, we need to have a realistic set of plans† and reality check, the plan doesn’t coincide as to the current situation. Though implementing K-12 would be possible, these paradigm changes would be harder for the public system for them to cope up with the rapid changes. Why? Let us settle to the article of Junifen F. Gauuan, firstly, the budget for the education sector of the Philippines is, compared to other Newly Industrialized Countries (NICs), relatively low (for example, difference of almost 5% GDP with Malaysia and Brunei – 3. 1% GDP Philippines). Secondly, the infrastructure of the state schools are not conducive enough to admit more students (picture students taking double-shifted school time i.e. 7am-1pm + 1pm-7pm – is that good for students to not meet in a one-off-one-time schedule? OR even cram 50 students in one class? ). To correlate demand and supply, more demand = more supply. With the current shortage of teachers, as claimed by ACT (Alliance of Concerned Teachers) there is no capacity for the public system to admit more students, even more to prolong the year of study. Finally, financial constraints, millions of people in the Philippines (to be exact 23 million under the Asia-Pacific poverty line) are still living below the poverty line. Are those parents belonging to that line can really afford another 2 years extra in education? Ideally, the long term goal which can be brought by the policy is good, but reality wise, the road in reaching the target is under construction, not yet completed thus so far behind. 2nd Option: Suspend the realization of the policy and reschedule for the next succeeding years. It is the belief of some educators that the K+10 Education System failed because it lacked 2 more years of study. We can consider that as one reason. But to the idea of the presenters, the bigger reason why K+10 Education System failed is because of poor educational resources such as classrooms, lack of teachers, facilities and equipment in short budget. Now, though greater budget is allocated to the reform of the educational system in the country but unfortunately what hinders most is the present situation of the affected stakeholders such as parents, students and teachers not to mention the unavailability and lacking of the educational resources. There is a need of empowerment to the part of the teaching force since it is a great change which requires greater understanding and preparation. It can’t be denied the fact that the country has great teachers worth to be proud of, but with the change of educational pattern which they will experience, a further training and seminar is indeed a need for them to be fully equipped. Aside from that, the acceptance of pursuing the reformed educational system must have to start from them since they are considered to be the initial medium that will mediate and enlighten the process of the changes both to the students and the parents. To the part of the parents, it would be a sudden change that will greatly affect their economic standing in terms of the added financial obligations added also the uncertainties and queries about the changes wherein not all of them are aware. Further enrichment for them to have a better understanding about the policy is a must and it will surely take some time. It is a considerable way to enlighten the parents since they are the first in hand who can motivate and guide their children. To the implementing agency, the country cannot attempt a trial and error outcome out of this policy. They must have to consider this not an experimental thing to be tested and evaluated. Beforehand, all of the possible consequences and preparations to counter any of those must be well handled and planned already. An evaluation of the educational resources, a budget plan for the teaching force – a long term plan of all of these including the construction of some additional facilities and equipment must be comprehended. To the part of the presenters, they assumed that those implementing agency are not well interacted to the possible instances that may come up and the way to respond in case any unhanding occurrences will arise. As will as the parents and students, together with the current situation of the country connotes unpreparedness for the implementation of the policy. Pursuing the policy without having some intervention with the direct stakeholders and considering the factors affecting the outcome of the policy would obstruct sustainability. 3rd Option: Put into practice the K-12 policy this coming school year. The government is in to it, the policy was recommended to be implemented, government agencies relating to the educational reform took already an action and somewhat due to the media interaction the society can be said as informed about it. The vision is to uplift the educational standards of the country, the mission is to implement procedures and processes provided in the policy, regardless of all the comments and criticisms since government already spent money for it, then like it or like it very much it should be implemented. CONCLUSION AND RECOMMENDATION. Initially, the DepEd justifies the K-12 model by saying that the present short basic education program affects the human development of Filipino students. Ultimately, regardless of whichever â€Å"model†, what the youth and country direly needs is for the development and establishment of an education system that caters to the needs of the Filipino youth and the society in general. Unfortunately, data shows the current situation that the country is facing in terms of the educational system that might obstruct the implementation of the said policy. But then, the policy is soon to be implemented this coming school year. To make a recommendation as to the presented options is a mind boggling duty that the presenters could ever come up. But just to satisfy the means of having this paper the end is, the presenters chose the second option, 2nd Option: Suspend the realization of the policy and reschedule for the next succeeding years. The presenters select option two as the best option not due to the fact that the Philippines is the last country in the region to adopt a K-12 basic educations system because it is not all about the trending basis but checking in accordance to the â€Å"reality†. During the assessment done by the prestigious organization Trends in International Mathematics and Science Study (TIMSS), they conclude that the problem about the present curriculum in squeezing 12 years of basic education into just 10 is that students are overloaded with subjects which resulted to poor quality of basic education as reflected in the low achievement scores of Filipino students. International tests results like 2003 TIMSS rank the Philippines 34th out of 38 countries in HS II Math and 43rd out of 46 countries in HS II Science; for grade 4, the Philippines ranked 23rd out of 25 participating countries in both Math and Science. In 2008, even with only the science high schools participating in the Advanced Mathematics category, the Philippines was ranked lowest. This quality of education is reflected in the inadequate preparation of high school graduates for the world of work or entrepreneurship or higher education. It is not the question of teaching force because internationally we can say that the country is equipped of well trained educators capable enough for the learning needed by the students in our country. In fact, teachers in our country are highly demanded and most preferred to be hired and work in other country. But it is the matter of the educational system that we have which is designed to teach a 12-year curriculum, yet it is delivered in just 10 years. Though some criticizing it as a way only to realigned as to what is the trending educational system to must have, then why not follow it if it will sustain the development of the educational system of our country and there is nothing wrong with it. As to the question of the consequences that will be brought by the policy, surely there will be many of those and it’s a part of the changes. Better because the government exists to uplift the standard of education in the country and not just sitting down to their respective offices and waiting what will happen to the future of the students experiencing the current system. The policy exist with provisions of program to be administered for the sustainability of it, thus to relate it with economic hindrances it should be another story that is worth to be reflected and should not serve as a hindrance for the development of one system in our country (education). To reach the development wherein the citizens are wanting, admitting the fact that it couldn’t be happening simultaneously is the first step. But, out of the advantages that can be given by the policy, what is now to be considered as constraint is the time. There is a need to develop to the part of the teaching force, the facilities and the equipments the country presently have, further evaluation and thorough analysis as to the whatever outcome that can be brought by it. Implementing programs that will lead to the positive realization of the policy and usage of media is a help to penetrate the minds of the parents and making them realized the long term output that the policy can give by. In short, a more prepared country is in need for the advancement to incur in the educational system. REFERENCES PDF files: Batomalaque, Antonio. Basic Science Development Program of the Philippines for International Cooperation. University of San Carlos. ; Marinas, Bella and Ditapat, Maria. Philippines: Curriculum and Development. UNESCO International Bureau of Education International Engineering Alliance. The Washington Accord. http://www. washingtonaccord. org/Washington- Accord/FAQ. cfm (Accessed 11 September 2010) Mullis, I. V. S. , Martin, M. O. , Robitaille, D. F. , & Foy, P. (2009). Chestnut Hill, MA. Trends in International Mathematics and Science Advanced 2008. National Center for Education Statistics. Highlights from the Trends in International Mathematics and Science Study 2003. December 2004 Seamo-Innotech. Additional Years in Philippine Basic Education: Rationale and Legal Bases. Presentation to the Department of Education on 25 August 2010. Presentation notes of Dr. Isagani Cruz, 28 September 2010. Articles/ Journals: Jane Uymatiao. Why we need DepEd’s K-12 Program, Sunday, 22 January 2012. Retrived from http://www. thepoc. net/commentaries/14612-why-we-need-depeds-k-12-program. html (Accessed 15 March 2012) Joe Padre. Pros & Cons in the K+12 Basic Education Debate, October 14, 2010. Retrived from http://mlephil. wordpress. com/2010/10/14/pros-cons-of-the-k12-debate/ (Accesed 14 March 2012) Jonathan Plucker. Problems as Possibilities: Problem – based  learningforK-12education. Retrievedfrom http://findarticles. com/p/articles/mi_hb6470/is_1_22/ai_n28742235/ (Accessed 11 March 2012) Junifen F. Gauuan. K+12 Policy Framework: Pessimistic, Optimistic or Realistic? , March 26, 2011. Retrieved from http://www. aldersgate-college. com/news/high-school/k12-policy-framework-pessimistic-optimistic-or-realistic/ (Accessed 6 March 2012) K-12 Challenge to Philippine Tertiary Education. Retrieved from http://rodrigo75. wordpress. com/2011/04/19/k-12-challenge-to-philippine-tertiary-education/ (Accessed 29 March 2012). Sarah Katrina Maramag. Proposed K12 Basic Education System in the Philippines, Is the K-12 model good for the Philippine Education System? , via Philippine Online Chronicles. Retrived from http://blogwatch. tv/2011/05/proposed-k-12-basic-education-system-in-the-philippines/ (Accessed 10 March 2012) Virnads. K12 in the Philippines: A Reform or Deform. Manila Philippines, June 13, 2011. Retrieved from http://www. allvoices. com/contributed-news/9379822-k12-in-the-philippines-a-reform-or-deform (Accessed 12 March 2012).

Tuesday, July 30, 2019

Family Members Making Care Decisions Health And Social Care Essay

Every twelvemonth the United States spends more than $ 100 billion supplying attention for 1000000s of persons affected by signifiers of dementedness and for their informal caregivers.1 Assuming no alteration in the incidence of dementedness and its attention bringing, between 11 and 19 million people in the U.S. will hold dementia by the twelvemonth 2050 with projected one-year Medicare costs transcending one trillion dollars ( Family Caregiver Alliance, 2005 ) . It is estimated that 13 million to 15 million grownups in the United States have chronic conditions that impair mental map, such as Alzheimer ‘s disease, shot, Parkinson ‘s disease, and traumatic encephalon hurt. Despite the big figure of people necessitating hands-on aid, we know small about how households make determinations about in-home attention and nursing place attention. See the illustration of make up one's minding whether to put a relation in a long-run attention installation ( Family Caregiver Alliance, 2000 ) . Dementia causes a high load of enduring for patients and their households. For patients, in add-on to cognitive and functional impairment, dementedness leads to behavioural and psychological complications, increased usage of ague and long-run wellness attention services, complicated clinical direction of other comorbid conditions, and increased hazard for medical complications such as craze, falls, motor vehicle clangs, incontinency, breaks, and infections. For household health professionals, dementedness can take to higher degrees of anxiousness, depression, usage of psychotropic medicines, and chronic weariness ( Boustani, 2007, p. 631 ) . Family members attention for about 75 % of these patients at place ( Dunkin & A ; Anderson-Hanley ( 1998 ) . Given the patterned advance of this enfeebling status and engagement in attention, it is frequently the grownups household members who must do the complex determinations about attention for a mentally impaired parent as the parent progresses through the class of the dementedness. Making attention determinations for a mentally impaired older household member can ensue in emotional, physical, and fiscal hurt, which in bend create tenseness and struggle in the household ( Donelan, 2002 ) . In a qualitative survey of the experience of health professionals actively involved in puting an older grownup in a long-run attention installation upon discharge from ague attention, noted that health professionals normally described internal struggle before, during, and after doing a determination about arrangement ( Walsh, 2002 ) . Dementia is predicted to be one of the greatest world-wide disease burdens in the twenty-first century with one new instance happening every 7 seconds. Alzheimer disease ( AD ) , the commonest cause of dementedness is a progressive, degenerative disease of the encephalon is the most common signifier of mental damage ( Whitlatch, 2006 ) . Symptoms of Alzheimer ‘s disease by and large advancement in phases. Functional troubles worsen in badness and frequence over a class of eight to ten old ages, ensuing eventually in complete loss of memory, judgement, abstract idea and ability to command behaviour. At the terminal of this flight, the single becomes deaf-and-dumb person and bedridden and dies of the disease ( Sloan, 2008 ) . As the affected individual experiences a gradual loss of rational maps, judgement becomes impaired and the individual focuses on irrelevant concerns, as all ability for abstract logical thinking is lost. Recent memory is impaired, and there is a gradual loss of distant memory. The individual ‘s emotions become labile and frequently inappropriate, jumping between agitation and apathy. Speech forms are thin and insistent, and finally the individual loses the ability to hide mental jobs from household and others in their lives ( The Alzheimer ‘s Association, 2004 ) . Much of the research to day of the month about household decision-making sing attention has been dominated by premature classifications that fit ill with today ‘s complex intergenerational relationships and wellness attention environment. Since anterior research has excessively narrowed the model in which to analyze attention determinations for mentally impaired parents, it is clip to analyze the research paradigm in which we study this phenomenon. The comparative dearth of interpretative surveies in the country of determination devising for mentally impaired parents limit our apprehension of grownup offspring and their experience of doing attention determinations for this vulnerable population ( Nease, 1995 ) . The proposed research is intended to research and understand the experience of household members doing attention determinations for aged parents that have mental conditions. The information aggregation scheme is designed to be from the sources ‘ point of position and sensitive to the emerging concerns of the sources themselves. To carry through this, open-ended inquiries will be asked and carefully screened out any preconceived impressions of what the experience might be like for the participants. This enabled the research worker to understand the sources experience during the under survey. The deepness of understanding gained from this attack leads to effectual appraisal tools, comprehensive course of study for wellness attention suppliers, direct patient intercessions, and reconsideration of wellness attention policy, all of which are aimed at bettering household results. The research worker will come to grok the demands, feelings, values, beliefs the household members who ar e doing these complex determinations. The direction and analysis of informations was enhanced by usage of the package plan EZ-TEXT 3.06C which offered rapid hunt, retrieval and browse of all informations sections. Significant text phrases were coded and labeled ; transitions with similar labels were categorized and grouped into subjects. Demographic information ( age scope, instruction, work scene, figure of siblings, presence of a mentally integral parent, subject of dementedness of the receiver of the attention determination, length of clip since doing the attention determination ) was investigated to see if it informed the aims. The purposeful sample will dwell of household members who had made determinations about attention of a mentally impaired parent within the past twelvemonth. Approximately 20 sources will be recruited for this survey through Sacred Heart Home. Adults over 21 who identified themselves as holding primary duty for doing determinations about the attention of a cognitively impaired parent aged 65 or older, who could talk English, and who consented to take part were included in the survey. Since a bulk of health professionals are adult females, it is anticipated that the sample will dwell chiefly of adult females. Sacred Heart Home installation is a immense installation it is comprised of over 100 beds, caring for more than 200 aged patients yearly. Respondents were solicited on-site at the nursing centre with aid from don by personally passing out the paper petitions for engagement in the survey. An abstract of the survey and transcripts of consent signifiers will be made available to possible respondents who are willing to depict the experience of doing attention determinations for mentally impaired parents by the decision maker. The rights of participants will be assured in the account of the survey, a written consent signifier and confidentiality of single informations. Once respondents have been identified and has given permission to take part in the survey, each individual will be contacted by phone and explained the survey in a little more item. The interviews will dwell of open-ended inquiries designed to arouse specific histories of events and feelings produces informations that are closer to populate experience. Each respondent will be interviewed for about one hr at the installation site or by phone, whichever is more convenient for each single respondent. During this interview, the first inquiry will be: â€Å" I know you made a determination about attention for y our parent a short piece ago. State me about when you decided. † The 2nd inquiry will be designed to arouse an opposite emotional response from the tone of the answer to the first inquiry. For illustration, if the informat relates how disconcerting the determination was for them, so the inquiry will be asked what has reassured or comforted the respondent since doing a major determination about attention a mentally impaired parents. The 3rd inquiry will inquire about a typical twenty-four hours in the life of the respondent when some contact with or about the parent has been made. Active hearing and usage of non-directive techniques such as contemplation and restatement will advance treatment during the interviews. Since the end of this survey is to obtain a description that exactly captures the significance of the experience, this analysis is coincident with informations aggregation. Data aggregation will happen in two stages. During the first stage, the research worker will place cardinal features of the interaction while retaining informant individualism. The 2nd stage will include a thematic analysis during which the research worker underlines text phrases that stand entirely in intending. Questions asked when construing subjects will include the possible being of an implicit in procedure that household members go through when doing attention determinations for a mentally impaired parent. All important phrases will be labeled with probationary labels. These labels inform the behavior of the following interview by assisting the interviewer to research probationary togss during the following interview. This procedure is reiterative and consequences in greater specificity as more informations are collected. Data will be examined for factors that potentially affect the experience of doing the critical determinations for a parent. The direction and analysis informations will be enhanced by usage of the package plan EZ-TEXT 3.06C. This plan offers a powerful and intuitive environment for get bying with built-in complexness of undertakings and informations. Interviews, field notes, memos and determination will be collected and organized, EZ-TEXT 3.06C offers rapid hunt, retrieval and browse of all informations sections. One of import inquiry that has been studied by research workers is the impact of caregiving for dementedness sick persons versus non-dementia individuals. In a survey, which drew from more than 1500 household health professionals in the 1996 National Caregiver Study, it was found that household health professionals of relations who suffered dementedness were more likely to endure from health professional strain and mental and physical jobs than those who cared for a non-demented relation. Leisure clip and clip with other household members was reduced possibility lending to more household struggle. In addtion, dementedness health professionals experienced more complications with employment than nondementia health professionals ( Ory, Hoffman, Yee, Tennustedt & A ; Schultz, 1999 ) . In contrast, another survey of differences in caregiving effects between dementedness health professionals and nondementia â€Å" non-caregivers † , found that when taken as whole, the sample of 52 health professionals and 66 non-caregivers did non differ in health professional strain. However, when within gender differences were compared, female health professionals suffered the most strain, which resulted in wellness jobs, household struggle, and strained relationships. Both female and male dementedness health professionals had less positive mentalities and more demand for societal support than their gender specific nondementia noncaregivers ( Ekwall, 2007 ) . Although this survey was conducted in Sweden, which means the consequences must be interpreted with cautiousness for generalisation to American health professionals, the sample came from a larger survey whose population was drawn from a representative sample of health professionals and noncaregivers. This is a distingu ishable advantage in a field where there are troubles obtaining representative samples. These apparently arbitrary results for dementedness health professionals are once more demonstrated in two surveies. In a annual longitudinal survey of 188 dementedness health professionals, nonsubjective and subjective primary emphasis predicted health professionals ‘ hazard of a depressive upset from those who remained at low hazard. Objective primary emphasis consisted of behavior jobs of the dementia household member ; subjective primary emphasis was defined as function imprisonment and overload. In another survey, 43 health professionals kept diaries for 14 yearss, noticing on their caregiving activities, daily temper, and riotous behaviours of the household member. Independent raters and bunch analysis showed that there are variable degrees of hurt among dementia health professionals ( Schubert, 2008 ) . The consequences of this survey, nevertheless, appear to be complicated by methodological jobs since the writers frequently intertwine both qualitative and quantitative n omenclature. Emotional rousing appears to be an of import contextual stimulation in health professionals ‘s ability to rate their ain wellness. One hundred and sixty eight grownup offspring were studied to find how a sense of self-coherence impacts hurt in health professionals of encephalon impaired parents. Interviews utilizing mensurable graduated tables of self-coherence, emotional rousing, perceived wellness and crisis were done at the beginning and terminal of six months. Consequences showed that crisis was positively correlated with emotional rousing and negatively correlated with self-coherence and perceived wellness. Perceived wellness was reciprocally related to emotional rousing despite the presence or absence of crisis ( Dunkin & A ; Anderson-Haley, 1998 ) . The latter determination is of import since recent surveies seem to bespeak that the wellness of the health professional is a major variable in dementia patient arrangement Most standards proposed for doing determinations about degrees of attention are care receiver related symptoms such as impaired IADLs and ADLs. Caregiver features and health professional well-being, nevertheless, are stronger forecasters of arrangement determinations than attention receiving system attributes. These properties include perceived relationships with parents. Contrary to the myth of seniors in isolation, there is strong grounds that middle aged offspring and their aged parents remain close, and more than half talk by phone or in individual at least one time a hebdomad ( Deimling, 1992 ) . Womans frequently assume the function of kinkeeper and study more contact with parents than work forces do. The bulk of household health professionals are girls or daughters-in-law lovingness for an aged female parent. When divorce is taken into the equation, nevertheless, the bond between grownup offspring and parents seems to weaken. Weaker ties between kids and divorced parents raising concerns about future coevalss of aged parents. Disabled or frail divorced parents may non be able to number on personal and fiscal support from their kids ( Smerglia & A ; Deimling, 1997 ) . Making determinations with and for an older individual is seldom a straightforward procedure. Unlike single, chiseled job work outing in a inactive environment, existent life jobs are frequently equivocal, high interest mystery, which are played out by many people in unsure, dynamic environments. Family deliberations about an older member ‘s attention, although by and large on-going, are frequently influenced by an emotionally charged heath attention crisis, which may take to determinations with negative effects. Research workers who began analyzing how people made determinations in their natural environment found that rational criterions and theoretical accounts of determination devising did non take into history the context in which the determination is made or the adaptative features of the determination shaper ( Gaugler, 2003 ) . Additionally, determinations become influenced by viing, altering ends and impacted by the effects of old actions and clip stressors Given the huge array of services now available for mentally impaired older grownups, determinations about attention are less structured than taking between two options, subjected to viing single and social ends, and made in unsure, dynamic environments. These surveies might non be turn toing the issues that are being experienced by this coevals of health professionals. When grownups make these complex attention determinations for their mentally impaired parents, their worldviews and stock of cognition complicate the environment. It seems appropriate, hence, to re-examine the procedure of doing determinations about the attention of a mentally impaired parent with peculiar accent on context and household discourse. The information collected in this survey is aimed toward understand what constitutes doing a attention determination for a mental impaired parents and bettering the opportunities that an effectual determination is made that will diminish emotional and fiscal costs to househo lds and society. Potential benefits could besides include the development of experimental educational and wellness policy intercessions that improve determinations and attention for mentally impaired parents.

Monday, July 29, 2019

How has Human Civilization Advanced Because of our Knowledge of Fluid Essay

How has Human Civilization Advanced Because of our Knowledge of Fluid Mechanics - Essay Example s a diverse field in physics that have several branches such as fluid dynamics that studies effects of forces on fluid motion, fluid statics that studies fluids at rest, and fluid kinematics that studies fluids in motion. Fluid mechanics works hand in hand with hydraulics and has existed for a long time. Engineers also use fluid mechanics in aerodynamics when designing planes, ships, trains, and cars, designing mechanical systems such as engines and machines and town planning (Braben 45). Fluid mechanics has solved many problems since the ancient civilization to the modern world. In fluid mechanics, Civil engineers try to solve problems in floods by constructing better bridges and roads; they solve drainage problems by designing proper sewage systems, and design underground aquifers that supply water. The existence of fluid mechanics has contributed largely in the advancement of human civilization by affecting many areas. In the ancient civilization, many countries such as Egypt, India, China, and the Mayan people in South America used fluid mechanics in the construction of many structures. In the present day, application of fluid mechanics is seen in the construction of water reservoirs such as dams, wells, and boreholes. These serve humans in storage of water required for irrigation and drinking. Wells have existed since the ancient civilization, and they are actually used in the analysis of fluid mechanics. Other constructions include dams and boreholes (Braben 52). In the ancient civilization, human beings used pumps that dug shallow wells and boreholes. There was no technology to help dig deeper ones, and the pumps were manual and driven by hand. This caused contamination of water most of the times and people died of water borne diseases. In the present day, engineers use electrical and automated machines to drill deep wells and boreholes of up to 100 to 400 feet and this has helped a lot in solving such a problem. Unlike in the past where people went to

Sunday, July 28, 2019

Enzyme Activity Essay Example | Topics and Well Written Essays - 1000 words

Enzyme Activity - Essay Example This helps in enhancing the lively activities of the living beings. The free radical formation is an important cause in causing and increasing a disease. The enzymes that act as scavengers and remove ROS can help in preventive methods of some critical diseases. The investigations regarding the enzymes that are critical for the bacterial existence provide information about physiology of microbes. The understanding of cell metabolism, evolution of bacteria and the interactions between bacterium and host can be enhanced. With this information it is possible to explain the mechanisms that regulate the organism and to find out the proteins that are necessary of existence of the cell. According to Brendan Burns, George Mendz and Stuart Hazell in the case of CAA the resonances arising from -CH and -CH2 groups of the aspartate moiety have chemical shifts and coupling constants different from those of the amino acid aspartate. Thus, it was possible to make an unambiguous assignment of CAA.2 The investigations in other enzymes lack this type of identification in case of complex activities. Regarding the results related to the study of enzymes in H Pylori the NMR method will give good results when combined with radio active tracer analysis and spectrophotometry. The activity of the enzyme in the development of H pylori is useful in developing therapeutic drugs as it was found essential for existence and growth of H Pylori. The above activity was related to the enzyme investigation regarding the existence of disease causing bacteria. There are number of enzymes with varying activities. Some enzymes even effect the skeletal in animals (as well as in human beings). These activities are studied to solve the problems regarding the muscle problems. After the structure (skeleton) of the human body the muscle is the thing, which contributes strength and movement for it. The enzymes, which affect the fibre and the muscle, play an important role in developing methods to increase or preserve the efficiency of the muscle fibre. There are 3 types of fibres according to P. D. Gollnick, R.B. Armstrong, C.W.Saubertiv, K. Piehl, and B. Stalin (1972). These fibres are interconvertibility depends on the training given. The training proved to increase red muscle at the expense of white muscle. This means that the enzyme activity was changed due to training as the enzymes acting in the existence of red and white muscles are different. FIG. 1. Serial sections from vastus lateralis muscle stained for DPNH-diaphorase (lop) and rnyosin ATPase (boltom) from four sub- jects. A and B: untrained middle-aged subject (BA). Note relatively large fibers and light DPNH-diaphorase stain in both FT and

Saturday, July 27, 2019

Academic Integrity Seminar Assignment Example | Topics and Well Written Essays - 1000 words

Academic Integrity Seminar - Assignment Example d) From the date and source of this reading, one can conclude that some cultures or communities had shared values they wanted to preserve. They shared core values related to doing well to the benefit of the community. Such values can arise in the modern society or cultures through socialization. Socialization of the societal value begins with the family hence a child grows to know what the society expects. Greenspan is not realistic in his argument about business ethics. Exploitation of materials offers business support which makes it grow. It is not realistic for a business to buy and sell products with the same price; there has to be some differences to offer continuity of the business. Business ethics is not all about reducing exploitation to protect the beneficiaries, but it entails much more. Therefore, Greenspan is naà ¯ve in his argument. Pre-commit: People should try to make decisions before tempting situations. Pre-committing to difficult objectives can increase ones performance. Similarly, those who impose strict deadlines tend to perform better than those who don’t. Use rewards and penalties: Rewards are very vital in strengthening self-control. Many people can make short-term sacrifices for long-term gain when they have a self-imposed reward. Therefore, they will exercise self-control to get the reward in the end. On the other hand, use of penalties will discourage bad behaviors; making one develop self-control mechanism. Self-affirmation: This implies avoiding bad habits. One should reaffirm himself or herself on the core things he or she believes are better when done. It will result to self-control. Thinking about core values which are accepted will help an individual top self-control when depleted. â€Å"I would like to express my gratitude to my family members for all their support since I started schooling to this juncture. You have been supportive of my course. I am grateful

Friday, July 26, 2019

Apple and Google Article Example | Topics and Well Written Essays - 1000 words

Apple and Google - Article Example It will offer greater value to its services. The main objective of the company is to retain the customers within its ecology as its iPhone. The new Apple maps service will offer the customers with 3D images of cities and towns, known as ‘Flyovers’. It will also offer the customers with traffic updates as well as turn-by-turn navigation. The article also states that the best marketing concept that Apple uses is offering the customers with an experience which is different from that of others. It has been evident that the intended amalgamation of the feature of mobile maps app with iPhone can render Apple substantial profitability as according to a research conducted it is observed that people who use iPhone spent 35% greater amount of time on using maps than other phone users. Therefore, this marketing concept can provide Apple a major scope of market growth prospect. Apple can also get hold of the useful consumer data which was earlier received by Google. Apple can also e arn greater revenue from opportunities such as sponsored links. These factors can affect on long-term profitability of Apple by a considerable extent. The article demonstrates the fact that in this instance of launching maps application the company is product focused rather than customer focused which is closely associated to the concept of marketing myopia. Apple has also solely intended to render consumers’ such an application which can be quite value adding, thus though the concept relates to marketing myopia however not entirely. Segmentation, Targeting and Positioning Apple mobile maps will be provided as an application with iPhone itself. The purchasers of iPhone are generally high income group people who have the capability to purchase the product. The product can be used by the youth and the middle aged to old aged people. It can be used by both the male as well as the female. The high-end consumers of iPhone generally also desire use their phones to operate navigatio n facilities for their business or social networking purposes. This can enable the mobile apps to generate user activity with regard to the provided service. The product can be targeted generally to the businessmen who want to make their businesses available or traceable to the local as well as international customers. Through Apple mobile maps, customers will be easily capable of determining the exact locations of the stores that they will be looking for. The app is likely to target the app stores. The company, Apple can position its product as adding a new feature to its iPhone in order to attract a significant portion of the customers. This would help Apple to uphold competitive advantage and assist in maintaining sustainability. One of the unique features which will be inculcated in the Apple mobile maps is ‘Siri’, which is a voice-activated search tool. The company can as well position its product of mobile maps in terms of value addition with the popular product i .e. iPhone. As the application would be in-built within the iPhone, the positioning of it would not be a major concern for Apple. However, Apple needs to ensure superior quality of the maps service to draw the consumers in the long run to use the facility. Apple will entrust on outside parties for maps related information at first, the way its

Study case S Essay Example | Topics and Well Written Essays - 1000 words

Study case S - Essay Example ion Safety Administration (NHTSA) is a vital stakeholder as government agency who has the duty to see that road transports maintain high standard of transports and transport maintenance that promotes safe transportation. Basically, there are many stakeholders involved along the supply chain from manufactures to the end users as outlined above. The two pillars that have been broken by Imperial Tyres Sales are the trustworthiness and responsibility. The company has abused the trust of its customers who expected goods of high standard that would be safe to use. The notion of trustworthiness posits that when we someone is trusted, he is given a leeway by others because they do not feel the y need contract assurances that the same person will meet his obligations. It involves being honesty, integrity, reliability as well as loyalty. However, these elements of the pillar of trustworthiness have been broken as a result of low quality products that were supplied by HangZhemHai. ITS’s actions have also been against honest communication with the law and federal agency who should have been informed about the inferior quality of the tyres. They have also shown crass disregard for professional integrity by looking for their self interest at the cost of its customers’ safety. The pillar of trustworthiness has been broken by these two as their actions did not put into consideration the people’s safety. On the other hand, the pillar of responsibility has been broken by Hang Zhem Hai Rubbers by not upholding the expected standards of producing quality products that would be safe to be used by the consumers. The pillar of responsibility states that we should be accountable for our actions by always striving to pursue excellence. HZH has not been responsible in its actions for not putting enough gum stripes in its tires. HZH has been extremely indifferent to the fact that their low quality of tyres could be potentially dangerous to the safety of human life. In actual fact it

Thursday, July 25, 2019

Music Contract Negotiations and Publishing Essay

Music Contract Negotiations and Publishing - Essay Example Music publishers have diverse roles such as working on a creative entity with the songwriters in composing of new songs, enforcing as well as protecting copyrights, seeking licensees for the song, entering into arrangements with regard to licensing, and collecting as well as disbursing the income among others. Just as the songwriters, copyright laws, and collecting societies have changed, advancements in technology has changed ways in which music publishers operate. It has led to enlargement of potential sources of profit, making the industry lucrative and at the same time complex (Biederman 2007). Therefore, this essay discusses in length on the role of music publishers, the history as well as the changes in the music publishing industry, and how publishers can realize their future potential. Music publishers play an essential role in ensuring that the career of songwriters is successful. Whether or not songwriters are establishing their name or developing talents, publishers are invaluable to them since they guarantee that they are protected and their songs are not exploited. To some extent, music publishers facilitate earning prospects for songwriters and artists whose professions are not lucrative. Although most of the artists do not have ownership rights, one of the key components in the relationship between publishers and songwriters is the division as far as copyright ownership is concerned. This means that the more services the publisher offers such as licensing and being creative, the more ownership they have. Over the years, music publishers have made tremendous improvement in the music industry. They ensure successful synch licensing, demo recording and exemplary creativity. For instant, the Kobalt music Group is an independent publisher that has advanced techn ological systems that has redefined the industry. Although it does not have ownership of copyrights, it incorporates innovative elements

Wednesday, July 24, 2019

Trends in Business Leadership Essay Example | Topics and Well Written Essays - 1750 words

Trends in Business Leadership - Essay Example Changes in the work environment lead to new leadership styles whereby leaders change their styles to remain effective. Such changes include improvement in key processes, streamlining functions and restructuring for effectiveness. For an organization to sustain relevance in business, strategists must be put in place to improve the organization’s ability to read and respond to changing trends in the market environment. They should be able to identify challenges in time and respond promptly by improving structures that boost business flexibility and adaptability. Adaptability reduces rigidity of the leaders and enables them to commit to current and future changes. Therefore, they should view change as inevitable and essential part of organization success. The goal of such changes is adapt, regenerate and survive (McLean, 2006). This paper discusses five main trends in business leadership, the reasons for emerging trends and strategies to cope with these trends. Reasons for Trends in Leadership Most leaders lack competencies in strategic thinking, leading change, ability to inspire, techniques to create a vision and involve others in it. They also lack the ability to understand the organizational set up and proper functioning of systems. Most business organizations contain a large number of interacting processes and structures that are difficult to manage. This has forced many organizations to adopt strategies geared towards improving performance and attaining as well as maintaining competitive advantage. Effective leadership is the most significant of the strategies, thus most leaders are pressured by high performance expectation resulting to the emergence of new trends. Information systems in many organizations are indecipherable and complicated making the interactions between different organs of an organization difficult. Interactions in these organizations are non linear complicated implying that minute changes in leadership leads to pronounced, dispropo rtionate effects at all departments. This has led to communication trends and the need for effective leadership trends. Increased globalization has increased the urge to lead across cultures. The transformation from traditional organizational strategies has allowed room for flexibility and expansion enabling businesses to explore international markets. Most local markets are also facing stiff competition from local firms therefore creating a need for most organizations to explore international markets. Most organizations are favoring global-oriented who are able to formulate effective strategies that promote international business. Technology trends are caused by information overload, lack of interconnectedness between organization systems and business communities. Most of the new technologies also disrupt the professional practices. Organizations are thus edged towards effective leadership skills that are technologically sound to steer management towards technological advancement. The main trends in business leadership are: Focus on Human Resource Current market research indicates that most organizations consider human resource as the most eminent asset in corporate growth. Emerging trends predict that human resource will be the most

Tuesday, July 23, 2019

Questions Essay Example | Topics and Well Written Essays - 500 words - 28

Questions - Essay Example This is especially useful in approach to new products because it involves seizing new opportunities after consideration of the company strengths. An evaluation seeks to check whether the implemented projects were effectively realized as per the original strategic visions. Overall objectives of a company can never be met in solitude. It takes shared resources as well as commitment. Experts from various departments and even outside companies and consultancy groups come together to manage the decisions that are sound to operations of the company. With their diverse backgrounds, they are able to make decisions valuable to a company visions. An organization may seek market leadership through a collection of methods such as low cost products of superior quality and great innovation. However, projects are the most outward methods that the organization can use to measure achievability of the objectives. A company may be efficient internally as well as externally and this can be seen from the way objectives are effectively met. Comprehensive scope analysis is very important planning technique. This is because it specifies the contents of the work as well as the outcomes of the project. Scope analysis helps put in mind the amount of resources required and the level and amount of activities required completing a project. A comprehensive scope analysis takes into account several steps to be put to mind to make sure that the success is guaranteed. At this stage, a conceptual development is put into account to make sure that the best methods of achieving the goals of the project are the ones that are primarily used. Scope analysis also has a scope statement which seeks to put a limit to the development level of the project that is required. With consideration of six important steps, with each step serving a specific purpose, the benefits of scope analysis

Monday, July 22, 2019

International Marketing Essay Example for Free

International Marketing Essay Many researches has been conducted on flight companies that are operating and connecting all the continents, but this research is about a company that started in 1940s in an Arab country in the middle east, the company is call flight Emirates, first the company was aimed to deliver flying service in United Arab Emirates and in the region, but as soon as the company raised revenues and added new shares the company thought of going further and compete in the global market. The amazing and surprising part in this company is its ability to rapidly grow and compete perfectly in the global market not only that, it has achieved its objective in that competition as you will see in the paper. The contents of this research are four parts, in the first part we will take you through how the company started and expanded to the global market up to United State of America, vision and mission of the company in the market place. In the second part you will see how the PEST and other driving forces has effect the company operations in United States and other countries, while reaching part three the research will show how the company’s segmentation, distribution, pricing and product strategy are being perform, and we shall conclude with a comprehensive summary, analysis and present the results that we have got through out our research. The unifying them in this research is the company ability to compete in a higher competitive environment like USA not only that but resulting on generating revenue and adding value to its original capital, the company also can be count as one of the biggest flight companies in the world due to its capability and differentiation in the market place. Finally, let’s hope that our research will be a vital added value to previous researches in the same matter. PART ONE: 1.1 About flight Emirate: The beginning of Emirate flight goes back to 1959 when Sheikh Rashid Saed the government official opens the Dubai international airport and announces that Dnata company with only five staff will be in charge of ground handling services, in 1978 Mr.Manrice Flanagan was appointed by Sheikh Rashid to be the general manager of dnata company which is the operating company for flight Emirates, Mr. Flanagan later on in 1984 design how the company could possibly move to serve in air service, and with acceptance of Dubai government the company requested Pakistan international airline to lease them two aircrafts, the deals were struck to fly into Karachi, New Delhi and Bombay in India. In 1985 Sheikh Mohamed gifts two Boeing 727-2005 to the airlines, these two Boeing increased the operations where the airline was able to fly to more than twenty countries. Sheikh Ahmed later on in 1990 signed an agreement with Asian Aerospace exhibition in Singapore to add airbus A310-300s to the company. In 1992 Emirate flight become the first airline to install video system in all seats in all classes in the same year the France government allow officially the flight to operate in the country, by that time the company’s work forces become 11,000 employee. Ten years later exactly in 2011 the company managed to fly to more than 120 destinations world wide, and recorded a profit of ($1.6 billion) and bought the largest Boeing in history 50777-300ER. Flight Emirate as part of its marketing strategy has sponsored number of events and competitions e.g in 2012 the company sponsor Tennis in united state and crick’s Indian premier league. As we mentioned earlier the Dnata Company headed by smart board of directors is not an easy company and the proof is that its ability to raise the capital to $ 2 billion and the workforces from 11,000 to 62,000 employees in 2012 as it was the most profitable year for the company. The company now call the Emirate group and consist two parties Emirate and dnata company and has expanded into many business for instance, hotels, workshops and tourism and the are operating all over the world. 1.2 Flight Emirate in North and South America: Flight emirates operates in North and South America challenging Americans airlines in delivering air services it flies to Brazil, Chile, Mexico, Peru, Urguay, Canada and United States, within the United States the company operate in more than six states creating a competitive environment and adding valuing advantage to this market. The free market economy adopted by United States is a difficult market to compete in if you don’t have a competitive advantage, the flight emirate with its uniqueness and appropriate tactics has a lots of winning games as we shall discuss it later on in part three, and you will realize that the company has attracted the market using different approaches. 1.3 Flight emirates management orientation toward global business: Flight emirate as we stated earlier in our introduction started as a small company call dnata in Dubai, therefore the management structure in the early 1950 was regiocentrics but after the Dubai government increased the capital and instructed many deals the company management changed in 1960s to be geocentric orientation as the views the entire world as a potential market and strive to develop their brand and integrate in global market. The reasons why we categorize the company as a transnational company are the followings: (1) The company operates in more than 100 countries and flies all over the world. (2) The company’s work forces are more than 62,000 employee spread in six continents. (3) The company assets i.e (flights, workshops, hotels etc) are not all based in Dubai. In conclusion to this regard the emirates company management can be classified as a combined of two management structures, reogiocentric a nd geocentric because in its starts the focus was regionally but later on they progress in global scale till they adapt the geocentric orientation structure. 1.4 Flight Emirate vision and mission: Vision: The vision of flight emirate is very simple as we mentioned earlier the company started as ground services company in 1940s but after Dubai government decided to inject more capital the business increases and ambitions become more than just being a ground service company therefore in 1960s the company decided to focus broader in flight services not only in Dubai and in the region but even globally. Now the vision is to be a â€Å"leading company in flight and tourism world wide providing excellent, safe and customer satisfaction†. Mission: The mission of the company is to ensure that the flight is the choice of every traveler and to create a business competitive environment and add valuable service to the market. Differentiation, opportunities and development of a star brand in the Gulf region and all over the world is the purpose of the company’s today’s focus. PART TWO: The Business Environment: 2.1 Political, Economic, social and Technological analysis (PEST): The business environment where the company operates is an important situation that we have an obligation to express in this research, many forces drives and affect the market place of any operating company, to analyze the situation we read the political, economic, social and technology changes. Political and Economic aspects: The country where flight emirate generated from is United Arab Emirate in middle east one of the world’s largest country in oil production, the economic growth and political stability are the sign of advancement in that country. UAE currently undergoing rapid expansion in investment and private venture, the government made number of commitments to strengthen and reform its investment regulatory and make conducive environment for exports and imports. United States and UAE are strongly partners in many political alliances, economic benefits, social and cultural activities the exchange numerous of interests in regard to these issues. Politically, the relationship between the United Arab Emirates and United States has been positive and productive for more than 30 years they are a reliable allies in many military, economic, and social affairs, the United State view UAE as source of stability, tolerance, innovation and a leading figure in the Gulf region. After the US tragedy in September 11 2001 where 2,996 including hijackers killed, the US foreign policy changed a lot including the relationship with UAE based on the fact that two of the hijackers were from UAE, immediately after the attack the background security checks for an Arab visitors was very high and research shows how some harassment and hates developed against Muslim in US. In conclusion to the political environment where flight emirates operates i,e in US there is no negative impact due to the strong and smooth relationship between the two countries. Economically, the UAE is the US single largest export market in the Middle East with $1.5 billion in 20 11 most are machinery, aircraft, industrial and other valuable items, US imports from UAE in 2011 was 2.44 billion most are crude oil, aluminum and other things. The US petroleum companies played a big role in development of UAE energy sector, more than 800 US firms are operating in the UAE investing in different sectors and injecting UAE market with new jobs and opportunities of Arab youth. The research also found that the US, UAE relationship is a long term partnership and each state in US probably has its own trade relationship with UAE. Research also found that UAE is the larger operator of Boeing 777 aircraft in the world, in November 2011 Emirate flight placed an order for $ 24 billion record breaking for 50 Boeing 777-300 ERs, before that there were number of orders for purchasing Boeing from US which make the company the most consumer of this type of flights. In conclusion to economic relationship between the two countries, the flight emirates is the world’s largest operator of Boeing 777 and serves non-stop flying from Dubai, also the robust trade and investment relationship between UAE and USA is based on the political stability and diplomatic understanding. Socially, the UAE and US have a lots of social partnership in numerous of activities, UAE is an open country for visitors and legal immigrant, its population is extremely liberal and open minded society compare to the other countries in the region, UAE attracts many investors and tourist including US citizens, the US population in UAE estimated to be 4,000 people working in different sectors of production. UAE population in USA is recorded not to be affected by any violence or discrimination against any human right because US treat and protect the entire resident equally but individual harassment does exist because of personal behavior. According to researches, after September attack where two were from UAE as we stated earlier the Americans views on Islam and Arab has changeed a bit of which number of travelers to and from Arab world has decreased. Technologically, as technology refers to the application of science and research into industrial or commercial objective, it has affect societies all over the world, flight emirate in its existent relies on technology in all its operation and has benefit so much in US market on this matter, marketing customers service and other operation are possible in flight emirate because of technology and the latest news in this regard is the announcement of the company recently that it will allow all the passengers to use their cell phone in its all f light operating in US market very soon, that could not be possible if the company was not connected with USA. To conclude this topic technology has not negatively affected the operations of flight emirate in USA, it has really been a source of inspiration for the company. 2.2 The Effect of Culture and Sociology: In United States market culture as (education, religion, values, attitude etc) play a big role in business place, flight emirate with its unique study of American’s culture has found it a useful environment to operate in, US is a multi cultural community where different ethnic groups coexist without any discrimination. US market is a free economy where competition is the only factor that can push you to the top or crash you down, flight emirate adapted those diversities and without any exclusion and that is why it has been able to compete with US fight companies in the market place, as we stated earlier the only side effect on flight emirate in US market was what follows September attack when a group of terrorist from middle east and with Islam background hijack US flights and threaten US as a sovereign country, the result on that was the reduction of travelers from and to Arab countries, raising the searching system which actually targ eted travelers from Gulf countries and individual harassments by some indigenous citizens. In conclusion to culture and sociology the company does record much challenges in US market based on these aspect but the following points are what we think to be the company’s threats in US market: 1-Flight emirate generated from Arab country therefore it might be a target of terrorist and use as a cover to make insecurity in USA. 2-Services in the flight emirate are indirectly affected by Islam as the crew do welcome passengers by Quran prayers on board, this activity does not satisfy non Muslims on board. 3-Wearing of AL hijab by Arab women is not an acceptable sign by some people. 4-Citizens of UAE started to avoid traveling to USA because of long waiting visa due to background security checks. PART THREE: THE COMPANY MARKETING PLAN 3.1Marketing (country) selection and entry strategy: Flight emirate operates in more than one hundred countries and flies over six continents, the research has an interest in US market and here are the reasons why the company chosen to compete in US industry: -The airline copes and encourages free competition with other market player using a strategy known as â€Å"the open skies strategy†. -The political environment and the strong relationship between USA and UAE encouraged flight emirates to choose US as useful market to operate in. -USA is an open economy where the market competition is the art of the game, flight emirate with its quality services and competitive advantage choses to be part of it. -US dollar is the most powerful currency in the world, since the company adopted this currency to be the company main fare in its all operations than the company got it profitable to operate and expand in US market. -Flight emirate benefit mo re from long haul flying which also save fuel consumption as well as non-stop flying from Dubai to USA is profitable. -The Boeing 777 is the major aircraft used by the company hence all the accessories, parts and maintenance is cheaper and available in United States. The above reasons plus the growing business opportunities between US and UAE has increases the demand for direct flying from Dubai to United States. 3.2 Segmentation, Targeting and positioning: Flight emirate like any other flights in the airline industry has a specific strategy on targeting and positioning its self in the market place, below are the airline targets: 1-Emirate flight is one of the big airline in the world, the rapid growth of Dubai and its good relationship with other countries especially US had given a chance to the company to position it self as the major carrier between the two countries and inside the US, the company currently operates in eight states in US market targeting the following segments: 2-The demand for traveling to Dubai by tourist and business people has increased and especially in summer session where Dubai attracts more than seven million tourists. 3-Expatriates, because Dubai is a working environment and highly paid city, the demand for people to travel to and from Dubai increased hardly, many US citizens live and do business in Dubai while the also regularly visit their homes, therefore flight emirate is playing that role of targeting those group. 4-Transit passengers, before the haul long flying strategy being implemented by many companies were suffering from waiting hours, passengers from US did fly to middle east or Dubai connecting through Europe, flight emirates made it easier to dominate this segment by offering direct flight between Dubai and USA and found it very profitable. Because of demand increase within the United States, flight emirate with its quality services and golden brand attracted those groups and the company positively responded and got it much profitable. 3.3 Information and research strategy: The aim of this strategy is to keep the company growing and competitive in the market place, the information and research are the heart of any successful company, it explore opinions and attitude of customers and allow the company to predict the future result of the company’s operations. Flight emirates value information technology and research and has invested a huge of amount approximately $200 million and deployed 2,200 employees, recruited from the most qualified institutions in the world. The company’s IT department and research after ensuring solutions for the company also provide services for other business in the region as the generate revenue to the company from that services. Research found that flight emirate invest heavily in information technology and research for smooth operation and acknowledging the customers needs and demand in US market. 3.4 product strategy: Oil prices has been unstable and challenging in world’s market place for many flight companies to perform perfectly with out any conciliation or interruption, flight emirate has made it easier by signing a deal with several major oil companies to supply jet fuel to them all the time with a specific price, that deal remain unchangeable no matter what the future market may present, this fuel strategy has maintained the company profitability high among the competitors. The fight also gain a lot of profit base on product strategy through it plan of long haul flying, direct from US to Dubai because this kind of service attract big number of passengers of which the company provide cheap prices. In this strategy also the company has divided its portfolio into two, airport services and infrastructure, the airport service has to ensure the safety of passengers baggage and belonging up to the last destination, this strategy has build confident between the company and the customers. The free competition strategy that was adopted by the company enable the customers view their opinion in the services, employee training and capacity building in the company has been a successful part of the product strategy because it keeps the delivery of service in a high position. Buying new aircraft every short period is one of the promotion for product strategy and what kept the company delivering excellent services in US flight industry. 3.5 Pricing strategy: Pricing strategy is the secret of any successful company, the first thing the company does was to keep US dollar as the standard currency of exchange in the company, based on the fact that dollar is a powerful and stable currency and is convenience to all passengers regardless of their country of origin, this strategy made the company’s profit always high. The company has a sufficient strategy that enable passengers enjoy cheap pricing either in short or long haul flying, this has been a competitive advantage to the company, the company has been in the market for a short time which mean the company does not charge legacy fee in its ticket because there is no burden of pension as other companies do, the well train and qualified financial managers that the company has are playing a role of keeping the financial plan in a safe environment. The most important factor that keep flight emirate cheap and profitable is the variety of aircraft that operate in diffe rent allocation this gives the passengers the option of choosing the cheaper the can afford. All the above are supported by the fact that prices of flight are not being fixed any where because it depend on the market demand, what keep flight emirate cheap and affordable is their continuation of reading the market rightly.

Evolution of Management Essay Example for Free

Evolution of Management Essay From the Biblical times we find monarchies of the time use some form of management to lord over the great kingdoms such as the Egyptians who used hierarchy management to build the pyramids, Moses leading the Israelites through the desert to the promised land and King David when he was in charge of the kingdom of Israel. In Ancient civilizations, the Roman Empire made use of devolved government to manage the vast empires resources. This was done through governors’ who were in charge of certain areas as we see in the bible during the birth of Jesus Christ. We can find artifacts that in old cities such as Jerusalem where we find aqueducts that give us an idea of how they managed the water resources. Modernization of the world led to cities and towns that brought about the need to manage the resources in order to provide services to the people living within them. We also find management in the church and military before the industrial revolution. The Roman Catholic Church is one example that has had an impact on management as we see in the catholic hierarchy led by the pope and includes cardinals, patriarchs, and bishops. The Military has greatly influenced management through power vested in positions in the chain of command. Management continued to evolve and we find individuals in history who have made contributions to the art of management as we know it; Luka Pacioli was an Italian mathematician considered the father of accounting. He invented the double entry accounting system. Adam Smith was a political economist whose concepts on economics at the beginning of the industrial revolution contributed greatly to management today. Robert Owens, Charles Babbage, Henry Vernum Poor and Henry Robinson Towne are other individuals who were influential to management in this era. With the onset of the industrial revolution, new ways of management came into play as new generations looked to increase productivity of organizations. Classical Era Scientific Management Scientific management was pioneered by Frederick W. Taylor a mechanical engineer who sought to improve industrial efficiency. He saw the need to have management design jobs properly and provide incentives to motivate workers to achieve higher productivity. His ideology was to find the best practice, decompose the task into its constituent elements and get rid of things that do not add value. Taylor’s scientific management gave way to specialization and is considered the basis to many other management systems that came after. Taylor was supported in this new way of management by Henry Gantt who is accredited with the Gantt chart that is widely used for project management. Frank and Lillian Gilbreth were also early advocates of the scientific management system. Through the motion study, Frank sought to make the processes more efficient by reducing the motions while Lillian’s interest was on the human aspect of work. The human aspect of the scientific management principles seek to understand the workers personality and needs. Administrative Management Henri Fayol, was a French engineer and manager of the mines developed the administrative theory of management. He viewed management as an activity common to all human undertakings. He is credited to giving us the first comprehensive functions of management; 1.Planning  2.Organizing 3.Command/Direct 4.Coordinate 5.Control He urged that management was an all encompassing activity that should be taught in schools, colleges and universities. This approach proposed that management is a skill which can be acquired if its principles are understood and rejected the idea that â€Å"managers are born, not made†. Bureaucratic Management A German Sociologist, Max Weber’s approach to management was by focusing on the organizational structure. His views divided organizations into hierarchies with clear lines of authority and control, divided labor such that authority and responsibility are clearly defined and legitimized, organizational officials are appointed and not elected, organization members are selected on the basis of their technical qualification obtained through formal education and training. Organizations are to treat all employees and customers equally and not be influenced by differences. Weber’s principles on organizing can create stable, organized and systematic organizations but make it difficult for the organization to adapt to changing environments and new challenges. Neo-Classical Era Operations Management (Research) Operations management, also known as quantitative management, gives a quantitative basis for decision making. It is characterised by the search for the optimal answer to a problem by using quantitative models. It specially deals with the development of mathematical models to aid in decision making and problem solving. This theory holds that managing is a logical and rationale process, so it can be expressed in terms of mathematical models.

Sunday, July 21, 2019

Disease Process Of Herpes Zoster Health And Social Care Essay

Disease Process Of Herpes Zoster Health And Social Care Essay This paper will describe the disease process of Herpes Zoster. Herpes Zoster more commonly referred to as Shingles is an acute, unilateral, and segmental inflammation of sensory nerve roots. Herpes Zoster will be referred to as Shingles hereafter in this paper. The first section of this paper will explain the epidemiology of Shingles. This will include prevalence, mortality, and morbidity using the latest statistics available. The second section will list the predisposing factors of Shingles. Rationales for all risk factors explaining why each one predisposes the individual for that particular disease will be covered. In the third section the pathophysiology will explained. A brief description of the normal anatomy and physiological mechanism will precede the actual pathophysiology. In the fourth section all clinical manifestations will be listed. Including complaints from patients, and abnormalities found in physical exams. In the fifth section an explanation of all tests used to di agnose the disease and a description of these tests. The subsequent section will list the management of this disease from a medical stand point. This will include a description and rationale for all types of interventions such as invasive, non-invasive procedures, and pharmacological measures used to treat this disease. In the seventh section, nursing management of this condition will be explained. This will include nursing diagnoses, nursing goals, interventions (pharmacological, dietary, and patient education). The eighth and final section will describe research trends for this disorder. Including any new treatments, pharmacological, immunizations, invasive/non-invasive therapies, and, diagnostic testing, that are currently under investigation. Epidemiology Shingles is the resurgence of latent Varicella Zoster Virus (Chickenpox), so statistics from this disorder will be included. Humans are the only known reservoir for Chickenpox. Chickenpox has an attack rate of 90% in susceptible individuals. The virus is endemic in the population but becomes epidemic among susceptible individuals during late winter and early spring. Children between the ages of 5-9 are most commonly affected and account for 50% of all cases. Most other cases involve children 1-4 and 10-14. Roughly 10% of the population in the United States over age 15 is susceptible to the virus. The incubation period of chickenpox is 10 to 21 days however is more likely 14 to 17 days. Patients are contagious 48 hours prior to the formation of vesicular rash and until all vesicles have crusted. Attack rates in susceptible siblings in the same household are 70-90%. About 1 million cases of shingles occur in the United States every year. More than half of the people who develop shingle s are over 60, and nearly 50% of complications from shingles are in older adults. Shingles occurs at all ages but is more likely to affect those in the sixth decade of life. Except for immunocompromised, and AIDS patients recurrent attacks are rare. The total duration of the disease is usually 7-10 days however it may be as long as 2-4 weeks until the skin is back to normal. Predisposing Risk Factors Anyone who has recovered from chickenpox may develop shingles, including children. It is not clear what reactivates the virus. Anyone who has had chickenpox has a 10-30% lifetime risk of developing shingles. At 85 years of age, this risk increases to 50%. This increased risk may be linked to a weakening of the immune system. As people get older, their bodies become more vulnerable to many diseases. Having certain diseases such as cancer, leukemia, lymphoma, and, HIV/AIDS, can severely compromise the immune system. Also, treatments for cancer, such as chemotherapy; and other drugs such as steroids, and, medication taken to prevent rejection after an organ transplant can reduce immune function. In summary, having had chickenpox is the number one risk factor for contracting shingles. Among those that have had chickenpox advancing age is the number one risk factor. With immunosuppression being the only other risk factor for shingles. Pathophysiology Shingles is a viral disease. The initial infection with Varicella Zoster Virus causes the acute illness chickenpox, which usually occurs in young people and children. Once chickenpox has resolved, the body does not eliminate the virus. The virus lies dormant until the immune system is compromised. At which time it can cause shingles, an illness with different signs and symptoms, often years after the initial infection. The symptoms of shingles follow a series of three stages, prodromal or onset, active or erruptive, and chronic. However it is common for people not to experience all three stages. The onset phase is the most commonly experienced. During this phase, continuous or intermittent burning, tingling, itching, or various types of pain frequently precede rash by a few hours or days. While the onset phase and the presence of cutaneous nerve fibrils indicate that shingles infection is present in the sensory ganglia, a loss of sensation can also occur. The acute phase is considere d the active phase and follows the onset phase, which involves the development of the distinguishing skin lesions. Development of a rash in elderly patients may be accompanied by malaise, headache, low-grade fever, and nausea. Encephalopathy and severe pain may also go along with these symptoms. The active phase is initially characterized by erythematous papules and edema. Papules progress to vesicles in 12 to 24 hours and to pustules within one to seven days. The pustules eventually dry and fall off within 14-21 days, leaving behind erythematous lesions. The chronic phase is unlike any of the other phases and occurs mostly in the elderly. Many patients develop PHN, which is most likely to result during the chronic stage. PHN is Postherpetic Neuralgia is a chronic pain that persist after the shingles have resolved. Clinical manifestations The most common symptom of shingles is pain that can be severe and unrelenting. In the prodromal stage, which is usually 48-72 hours prior to the presence of a rash, symptoms will include: Numbness Tingling Burning Shooting pain Itching Fever Headache Chills Nausea Shingles usually begins with parasthesias, which are itching, burning, or tingling of skin on one side of the body. Patient may develop a fever, a feeling of being sick, or a headache. Within 1-2 days a rash appears on either side of the body in a band like pattern. The chest or back is typically affected by the shingles rash. The rash may also occur on the face, if it appears near the eye it can permanently affect vision .The pain of shingles can be mild to severe, and generally has a sharp, stabbing, or burning quality. Usually the pain is localized to the skin affected by the rash. It can be severe enough to affect ADLà ¢Ã¢â€š ¬Ã¢â€ž ¢s. Older adults compared to younger people generally experience more pain. Within three to four days, shingles blisters can become open sores. These sores may become infected with bacteria. If the patientà ¢Ã¢â€š ¬Ã¢â€ž ¢s immune system is not compromised the sores crust over by day 7-10. The rash generally goes away within three to four weeks. Sca rring and skin color changes may be permanent. Most people recover from shingles without any lasting problems. Postherpetic Neuralgia (PHN) is a complication of shingles. PHN is a condition in which damage to sensory nerves, causes severe neuropathic pain. This pain can be continuous or intermittent. The pain can occur without external stimuli. However it may also be caused by external stimuli, light touch, the brush of clothing, and even wind can cause extreme pain. The amount of pain from PHN greatly increases with age. PHN is defined as pain that last at least 3 months after all shingles lesions have went away.PHN is treated with: Analgesics Antidepressants Anticonvulsants Corticosteroids These medications may all be used concurrently. However they should be added to the patientà ¢Ã¢â€š ¬Ã¢â€ž ¢s regimen one at a time in case there is any adverse reaction, so that the med that caused the reaction can be promptly stopped. Diagnosis Shingles can be diagnosed in the prodromal stage, before lesions appear but this is difficult as the symptoms in this stage can mimic many other illnesses. Virology of skin scrapings once the lesions have appeared is usually the only way to achieve a proper diagnosis. This is done by isolating the Varicella Zoster Virus (Chickenpox) in tissue culture cell lines. The two tests used most are the fluorescent antibody to membrane antigen test (FAMA), immune adherence hemagglutination and enzyme-linked immunosorbent assay (ELISA). These two tests are also the most sensitive. Also contact dermatitis is pruritic and shingles is painful. If lesions of herpes simplex are not differentiated from shingles, doses of antibiotics appropriate for shingles should be used. However herpes simplex and shingles are differentiated by the staining of antibodies from vesicular fluid and identified under fluorescent light. Usually the lesions of these two disorders occur in different places. If the CNS is i nvolved, LP results show increased pressure, and protein levels. Medical Management Shingles is usually treated with prescription oral antiviral drugs to significantly reduce the healing time of the infection. Anti inflammatory drugs are used to reduce inflammation, these may be prescription or OTC. Analgesic medication is also used to lower pain level; these may also be prescription or OTC. Antivirals used to treat shingles are: Acyclovir- is administered at a dose of 800mg five times a day for 7-10 days. Famciclovir- is administered at a dose of 500mg three times a day for seven days. Valacyclovir- is administered at a dose of 1g three times a day for 5-7 days. Immunocompromised patients should be treated with IV Acyclovir at a dose of 10-12.5mg/kg q8hrs for seven days. Glucocorticoids such as prednisone administered at a dose of 60mg/d for the first 7 days, 30mg/d for day 8-14 and, 15mg/d for days 15-21. Glucocorticoid treatment should not be used unless there is concomitant antiviral therapy. Analgesics usually used for shingles include: gabapentin, amitriptyline hydrochloride, lidocane patches, codeine, aspirin, acetaminophen, and, fluphenazine hydrochloride. Topical antipruritics such as calamine lotion can be used to reduce pruritis. Nursing Management Nursing diagnoses for shingles include: Acute Pain Disturbed body image Impaired skin integrity Impaired social interaction Risk for infection Outcomes for patients with shingles include: Patient will verbalize that an acceptable level has been achieved. Patient will acknowledge a change in body image. Patient will exhibit healed lesions. Patient will demonstrate effective social interaction skills. Patient will have no further signs of infection. The following nursing interventions should be applied to patients with shingles. Apply calamine lotion as liberally as directed by physician. Apply silver sulfadiazine to soften and debride lesions that are infected. Administer pain medication as prescribed. Patients with severe pain should be referred to a pain specialist. Maintain hygiene to prevent the infection from spreading to other parts of the body. If the patient has open lesions follow contact isolation to avoid spreading the infection to immunocompromised patients. Patient should be reassured that the pain will eventually subside. Also cool wet compresses can be applied to the lesions for 20 minutes several times a day. Domeboro and Betadine soaks may be utilized to reduce crusting. The patient should be encouraged to wear loose fitting clothing to reduce irritation caused from clothing rubbing the lesions. Research Trends New research regarding shingles has been in the area of prevention. Researchers have developed a preventive vaccine, Zostavax, marketed by Merck. Zostavax is a stronger version of the vaccine given to children to prevent chickenpox. The vaccine is 50% effective and is recommended for individuals over the age of 60. Even though an individual may still get shingles after vaccination, the vaccination reduces the risk of complications of shingles. The vaccine has not been utilized by many people because shingles is not a life threatening disease and there have not been many new vaccines for adults, so many people are not aware of this vaccination. Also the vaccine is not covered by insurance so many older adults that are on fixed incomes cannot afford it. Public education about shingles and the extremely painful complications associated with it are presumed to increase the use of this groundbreaking new vaccine. In conclusion shingles is a disease that can affect people that have had chickenpox at any age. However it affects mainly the elderly population. Shingles usually presents with pain, numbness, tingling, burning, shooting pain, itching, fever, headache, chills, and, nausea. Shingles is treated with antivirals, analgesics, and antiinflammatories. Usually a person can only have shingles but there have been rare occasions of people having it more than once. From a nursing stand point relieving pain and starting antiviral therapy are the highest priority interventions. Lastly with patient education about vaccines now available to prevent shingles. The incidence of people getting shingles, or having painful complications if they do get shingles is greatly reduced.