How, in your judgment, can one evaluate the ethical nature of an act Research Paper

How, in your judgment, can one evaluate the ethical nature of an act - Research Paper Example Nature of ethics has three main features that are worth examining. The first feature is that the nature of ethics is closely correlated with duties, which are generally the other side of morals and moral rights. For instance, an individual’s right to work implies that the government has a duty to ensure that jobs are available for people (Gotsis and Kortezi, 2010). Secondly, ethics gives people equality and autonomy in the pursuit of their interests. The last main feature of the nature of ethics is that it provides a basis for justification of an individual’s actions and for invocation of aid or protection of others (Gutmann and Thompson, 2006). Over the years, there has been increased concern over the need to find ways of evaluating the ethical nature of organizations including non-profit organizations, private association, or government agency. Since ethics is such an important aspect in any organization, there has been heightened need in recent years to evaluate the ethical nature of organizations in order to ensure that they derive maximum benefits from adherence to valuable ethics (Cooper, 2012). It is against this background that this paper will discuss how one can evaluate the ethical nature of a government agency: The Court Services and Offender Supervision Agency (CSOSA). It will create a format for the systematic evaluation of the agency’s ethical commitment. Nature of Ethics and Government Agencies It is commonly accepted that ethics is an essential part of operation of government agencies. Unethical behaviors can have very devastating consequences for any given government agency, while sound ethical behavior can greatly facilitate effectiveness and efficiency in the delivery of services within a particular government agency (Hayden, 2005). Acknowledgement of the importance of ethics requires commitment and establishment of an organizational ethical capacity in a structured and concerted way. Therefore, it is important that gover nment officials be competent in managing of the ethical dimensions of the government agencies. In order to produce sustainable ethical behavior, there is need to cultivate an ethical organizational culture or an ethical way of thinking and ethical behavior (Gotsis and Kortezi, 2010). The officials of the government agency need to set specific ethics objectives for their respective agencies, as well as designing and implementing a strategy that is geared towards achieving these objectives (Cooper, 2012). In addition, they need to institutionalize ethics, monitor and report on the ethical performance of all the employees of the agency. When looking at ethics in the government agency domain, ethics is a prerequisite for the improved performance and reputation of the government agency and therefore should be the foundation element in the government agency’s operations strategy (Gutmann and Thompson, 2006). Effective management of ethics in government agencies requires that there is a comprehensive evaluation of the nature of ethics in those agencies. The government officials of respective government agencies should engage in a concentrated effort of establishing mechanisms and criteria of

Health education Assignment Example | Topics and Well Written Essays - 500 words

Health education - Assignment Example The hair should be washed everyday using shampoo and rinsed well before it is dried. When bathing children, one should pay attention to all folds including the underarm, neck, ears and in between the feet. Clean clothes and shoes should be put on after taking a bath. Shoes should be polished; wiped or washed according to their make to improve their appearance and to make them last longer. Children should wear clean socks in closed shoes. This will absorb sweat and keep their feet dry and comfortable. They should brush their teeth before going to bed and after every meal to fight against tooth decay. They should learn how to brush their teeth by themselves, and it is better if they do it together with an adult. During the day, a child should fill his or her mouth with water and swish it to remove anything that is stuck in the teeth. Taking large quantities of sugary foodstuff should be avoided as it promotes tooth decay. Under clothes should be changed more often with clean, dry ones. They should well fitting and in good condition. This should be done because under clothes are worn directly next to the skin and they gather a lot of sweat and dead skin. Wearing clean under clothes prevents skin diseases such as itchy rashes and ringworms. The child also smells good and thus, he is confident to interact with adults and other children. Children should be encouraged to wash their hands with soap and clean water regularly. This should be done before and after handling or eating of food and after visiting the toilet. Children should be discouraged from inserting their hands in their mouths. |This is because, at playtime, they gather lots of dirt in their hands because of touching anything that interests them. Regular washing of hands reduces them from the risk of getting diseases like diarrhea, stomach upsets and typhoid. Both hand and toe nails should be trimmed as long nails collect lots of germs and bacteria during playtime. In

Health Inequalities In Mental Illness Health And Social Care Essay

Health Inequalities In Mental Illness Health And Social Care Essay In this assignment the author will critically analyse the health inequalities that are evident for people with a diagnosis of a severe mental illness. He will particularly focus on the inequalities that exist in relation to the prevalence, identification and management of the physical health aspects for this set of complex conditions. In the course of the assignment he will critically evaluate these health inequalities from an international, a national United Kingdom and a more local Scottish perspective. In doing so he will critically examine a selection of health promotion approaches which underpin the physical healthcare of people with severe mental illness. He will also systematically evaluate the effectiveness of some of the differing approaches which contribute to the management of these conditions and the enhancement of the health and social wellbeing of mental illness sufferers across the world. Definitions In order to analyse the health inequalities the author will first define some of the key terms that he will refer to throughout the assignment. Health was defined by the World Health Organisation (WHO) (1948) as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.Though this is a useful and accurate definition, some would consider it idealistic and non-realistic. Using the WHO definition classifies 70-95% of people as unhealthy. However Davis (2009) declared the added importance of the wider definition of health stating There is a biomedical component to health, but it exists in a setting that includes biological, personal, relational, social, and political factors Looking at health in a little more detail the determinants of health are defined by the WHO (2010) as Many factors combine together to affect the health of individuals and communities. Whether people are healthy or not, is determined by their circumstances and environment. To a large extent, factors such as where we live, the state of our environment, genetics, our income and education level, and our relationships with friends and family all have considerable impacts on health, whereas the more commonly considered factors such as access and use of health care services often have less of an impact. The determinants of health include: the social and economic environment, the physical environment, and The persons individual characteristics and behaviours. Alternatively European Union public health information system (2009) define determinants of health as Many, often interacting factors that determine a persons health or disease state. These include Socio-economic factors: education, occupation, employment, poverty and income distribution; Environment: social support, airborne particulate matter and working conditions; Health behaviours: smoking, alcohol use, drug use, food consumption, physical activity and breastfeeding; and Biological and personal factors: overweight and blood pressure. WHO (2010) declared that Health inequalities can be defined as differences in health status or in the distribution of health determinants between different population groups. For example, differences in mobility between elderly people and younger populations or differences in mortality rates between people from different social classes. It is important to distinguish between inequality in health and inequity. Some health inequalities are attributable to biological variations or free choice and others are attributable to the external environment and conditions mainly outside the control of the individuals concerned. Whereas Samuel (2000) describes health inequalities in a more simple fashion as unjust or unfair differences in health determinants or outcomes within or between defined populations. Severe Mental Illness The Rethink operational definition of severe mental illness (2008) is when people: Are diagnosed as suffering primarily from a mental illness, typically schizophrenia or a severe affective (mood) disorder. Suffer substantial disability as a result of their illness, such as inability to care for themselves independently, sustain relationships or work Are currently displaying florid symptoms or are suffering from a chronic enduring condition. Have suffered recurring crises leading to frequent hospital admissions or interventions and/or place a significant burden on their informal carers. Occasion significant risk to their own health or safety or to that of others. The Ottawa charter for health promotion WHO(1986) defines Health promotion as the process of enabling people to increase control over and improve their health They describe it as not just the responsibility of the health sector and that it goes beyond healthy lifestyles to well being. Health promotion has been defined by the World Health Organizations (2005) Bangkok Charter for Health Promotion in a Globalized World as the process of enabling people to increase control over their health and its determinants, and thereby improve their health The United Nations Convention on the Rights of Persons with Disabilities (2006) claim that persons with disabilities have the right to the enjoyment of the highest attainable standard of health without discrimination. States should take all appropriate measures to ensure access to health services with the same range, quality and standard as provided to other persons. A UK based study by the Disability Right Commission (2006) Equal treatment: Closing the gap described an analysis of 8 million health records. It confirmed that people with severe mental illness have rates of cardiovascular and diabetes problems that are 2-3 times more common than would be expected in the general public. Bowel cancer is 90% more common in males with schizophrenia and women are 42% more likely to get breast cancer. The author will now go on to explore the phenomenon where many thousands of people with severe mental illness are at high risk of dying early with physical health problems. He sees this as a significant health inequality across the world and will examine some of the health promotion activities that have been attempted to reduce this inequality. Appendix 1 gives an analysis of the search criteria and the database results that he used in order to critically examine this topic. Evidence of Health Inequalities United States of America Miller et al (2006) in a well conducted and robust clinical study in the USA examined the mortality and medical morbidity of 20,018 patients admitted to psychiatric services with a diagnosis of psychosis in Ohio between 1998 and 2002. It identified that 21 percent of cases died from heart disease and 7 percent from a cancer related disease and 3 percent from diabetes related disorders. They cited the possible causes of these problems as medication induced weight gain, poor personal hygiene, reduced physical activity, and increased prevalence of smoking, increased substance misuse and a reduced social support network. In the study they were also able to report that deaths in this client group were three times higher than expected in the general USA population (with Heart disease being the main cause) and the average age of death at 47.7 years was 32 years younger than the general population figures. They acknowledged in their report the need to better integrate the delivery of both me ntal and physical healthcare by collaborating with all stakeholders to improve the quality of life outcomes for this population. They do not however go on to explain how they would take this agenda forward. Australia These international findings are also supported by statements from the Australian National Mental Health consumer and carer forum (2010) who state that the appalling health and early mortality of people with persistent mental illness is unacceptable. These comments from a national user and carer forum are not defined from one particular study but from a body of research and audit from across Australia focussing on outcomes of a series of studies. The national voice and recommendations from a major player in Australian healthcare with a focus on the needs of the patient rather than services is as significant in the authors eyes as a single robust study. They add that these issues are having a significant impact on the persons wellbeing and is also contributing to their social exclusion. They add to the argument by stating that these causes are iatrogenic (occurring as a result of the disorder or its treatment ) They go on to add the other areas that are common in this group and that can add to the impact being poverty, neglect, discrimination, smoking, substance misuse and poor dietary habits. They add that the screening for these conditions occurs less often in patients with mental illness hence they are less likely to be treated. The Australian report adds that the life expectancy of this client group is 25 years less than the general population. An interesting fact that they add though is that their evidence suggests that the client group do not have higher than average rates of disease like cancer and heart disease but they die from the disease 2 to 3 times more often than the general public. They suggest again like the USA repo rt that this is due to patients not receiving appropriate preventative screening and treatment for these illnesses. They go on to state that psychiatrists, GPs and other prescribers of psychotropic medication have a responsibility to monitor the effects of medication on a persons physical state as well as its impact on their mental wellbeing. They go on to recommend a series of actions for the future which include State and territory governments undertake to educate all stakeholders on Physical Health Impacts of Mental Health Problems and Disorders They enable appropriate screening, assessment and physical health checks for all persons with identified mental illness, including attention to dental health The Australian Government takes leadership on these issues by requiring all identified mental health funding to be accountable for physical health maintenance All mental health programs and policy areas report on physical health screening, assessment and monitoring for all mental health consumers in receipt of services Given the nature of mental illness, service providers need to innovate and respond creatively to address the physical health impacts of mental health disorders and their treatment Doctors take responsibility, when prescribing medications for people with mental health issues, to treat them holistically and monitor their physical health changes and needs. United Kingdom Likewise in the United Kingdom Cormac (2009) in a Royal College of Psychiatrists paper cites several papers which indicate a higher incidence of physical health problems in people with severe mental illness. Phelen et al (2001) stated that people with mental disorder have a higher risk of poor health and premature mortality and a meta-analysis of 27 studies almost 10 years ago by Harris and Barraclough (1998) showed a standardised mortality ratio of at least 1.5 for this group of patients however it varied with the severity and type of disorder. Patients with schizophrenia had increased mortality ratios of almost 3-4 times that of the general public with deaths mainly caused by cardiovascular and endocrine type disorders. These findings were reported by Brown et al (2000), Osby et al (2000 and Enger et al (2004). More recent findings in the UK has been the high escalation of the risk of developing metabolic syndrome for schizophrenics which has been found to be 2-4 times higher than the general public, finding borne out in the study by Saari et al(2005) and Thakore (2005). Joukamaa et al (2006) added some additional evidence to suggest that the risk of sudden death in patients with schizophrenia increases with the addition of each different psychotropic medication that is prescribed. Likewise the Department of Health (2010) in the Our health and Wellbeing report suggest that looking beyond neighborhoods and deprivation, certain groups have poorer health and some are uniquely disadvantaged because of a combination of their circumstances. For example: People with schizophrenia: A total of 0.4% of the population experience psychosis each year. A recent UK study found that, of those living with schizophrenia in the community, men experienced 20.5 years lower life expectancy and women 16.4 years lower life expectancy than the general population. The largest single cause of this inequality is an increased rate of smoking, more than three times that of the general population. Scotland Moreover the NHS in Scotland (2008) in their report Improving the physical health and wellbeing of those experiencing mental illness again cite evidence from studies across the world that the physical health of patients with severe mental illness is compromised. They state that research in Europe and the USA has shown that mortality rates from physical illness for those with mental illness is significantly higher than the general population. Schizophrenia is generally acknowledged as a life shortening illness with sufferers dying on average 10 years earlier than the general population. Two thirds of this excess mortality is due to poor physical health. They also identified that this group are developing these illnesses at a younger age and are dying from them earlier with 5 year survival rates reduced by up to 16%. NHS Scotland (2008) also refers to the aspects of stigma and discrimination. They state that Legislation requires that all Agencies dealing with the public remove discrimination and promote equality, yet a See Me(2006) survey reports that some people with mental health problems still feel stigmatised. The Highland Users Group ( 2008) have found that when it comes to their physical health needs they can be subject to unequal access to services and can feel stigmatised and discriminated against when they try to access general health care services. They feel their physical health concerns are too often put down to their mental health problem, especially if their symptoms are medically unexplained. Frayne et al (2005) suggest that research has confirmed that they do not always receive the same medical treatments as the rest of the public and consequently their health outcomes can be worse. Additionally the Scottish Government (2008) in the equally well report highlights Mental Illness and Mental wellbeing as important factors in the argument. They state that Mental illness and mental wellbeing are specific priorities for the Task Force. People with mental illness are more likely to die earlier from suicide, or illnesses such as cardiovascular disease (CVD) and tend to have generally poorer health through conditions such as diabetes. Mental wellbeing is associated with good mental health, but is not necessarily the same as absence of mental illness. Much of the Task Forces work is based on the importance of factors such as resilience, hopefulness and optimism that create mental wellbeing and quality of life. These allow people to deal effectively with lifes problems and normal stresses, to make the most of their abilities and the opportunities available and to play a positive part in their community. People whose wellbeing is good are more likely to look after their own health. However, depression is closely associated with poor physical health, for example increasing significantly the risks of CVD. The author concludes from the overriding evidence across the world that those suffering from a severe mental illness have much poorer physical health which causes them to have a shorter life expectancy. These conditions are identified as mostly cardiovascular and metabolic type problems. There is evidence that this client group has unequal access to health services and feel stigmatised and discriminated against. Health Promotion Models and Interventions Naidoo and Wills (2000) identify 5 approaches to health promotion. Medical or preventative approaches which target the whole population and are aimed at reducing premature deaths and avoidable diseases. Behavioural Change approaches view health as the property of the individual and encourages them to adopt healthy behaviours that are regarded as key to improving health. Educational approaches are strongly linked to heath education and seek to provide knowledge, information and develop skills so that people can make informed choices about their health behaviour. Empowerment approaches are bottom up approaches which encourage communities to identify their needs, develop skills and make appropriate life changes. Social change approaches is a top down approach which targets specific groups and populations and defined by a belief that socio-economic circumstances determine health status in individuals. Its focus is usually at policy or environmental levels. The author will now explore some of the interventions used across the world within the models/approaches above. In the United Kingdom Phelan et al (2004) introduced a physical health check tool to support the monitoring and management of physical health issues with patients with severe mental illness. This would be seen in the above model as a medical or preventative approach which aims to assess need in a target population and then develop an agreed action plan with the patient on how they are going to address the defined health needs. The assessment is completed on a 12 monthly basis and is designed to supplement normal medical care and review. The results showed that 50% of clients had a diagnosed physical illness with 78.3% saying they had one or more physical symptoms. 65% of patients agreed to one or more of the actions available which included getting advice about smoking cessation, diet and starting regular exercise. The outcomes have seen an increase in the quality of the assessment and recording of the physical needs of the patients as well as a huge jump in the activities being care planned within a structured care programme approach care plan. The study compared the group with a neighbouring community mental health team and demonstrated that the use of the structured assessment and care planning tools significantly improved the quality of information recorded. The failings in the report highlight that although the staff were able to assess and plan care there was as yet no evidence that this approach had improved the health outcomes of patients and the life expectancy of them. When we relate this to the models above we identify that the medical and organisational policy approaches are easier to do and measure compared to the change behaviour that is required by the individuals concerned. The author suggests that further longer term studies are required to evaluate the long term health impact of this approach to the organisation of physical healthcare management. Likewise the Department of health (2006) in their commissioning framework document choosing health give examples of case studies which reflect some of the health promotion interventions across the UK. In one study a selection of clients from across a city were involved in a physical health consultation with a senior nurse. This assessment took place in their own home as there had been a previous reluctance to attend clinics for this purpose. Once the health issues were identified in an assessment patients were selected for inclusion in 2 healthy working groups. One focussed on healthy living and was attended by 15 patients whilst the other had a focus on physical activity, was based in the local sports centre and had an attendance rate of about 20 patients per week. A voluntary walking group was also available. There were very positive outcomes from the study which included the following 57% reduction in alcohol consumption Only a 1% DNA rate at activities 32% reduction in smoking 44%weight loss 50% increase in activity levels 95% improvement in patient self esteem Dietary improvements These significant health improvements for patients can only contribute to improving their life expectancy. The author believes that the above interventions fall into a number of the approaches to health promotion identified by Naidoo and Wills (2000) for the following reasons. Medical and preventative- These interventions are targeted at a particular sector of the population in order to prevent the formation of disease in an identified vulnerable group. The initial screening selects those that go forward for health promotion activity. This is a top down expert led approach to target interventions at a vulnerable client group reducing costs in the long term and improving outcomes. Behaviour change- information, support and improvements in access to health, social, lifestyle and sports facilities has encouraged people to make informed choices to adopt more healthy behaviours. The evidence in the outcomes has shown that people have made real improvements in their health by taking responsibility (even though in some cases it was supported initially by staff) and changing their lifestyle significantly. Health education- the specific classes and education provided by staff supported the individuals to make informed choices about their health and the behaviours that they were adopting to support it. Empowerment in this area the nurses were being seen as catalysts of change or facilitators in order to support individuals. The fact that local sports and leisure facilities was involved was evidence of a social inclusion aspect of the service where it was seen to be normal to engage with local facilities and not in specialist hospitals or clinics. Social change approaches- the targeting of this client group in a top down approach by clinicians in many ways is evidence of this approach across the uk. Likewise in the United Kingdom another approach which identifies this social change approach is the mental health component of the general practitioners contract and the quality and outcomes framework that they work to. British Medical Association (2009) states in their advice on interventions to General practitioners that Patients with serious mental health problems are at considerably increased risk of physical ill-health than the general population. It is therefore good practice for a member of the practice team to review each patients physical health on an annual basis. Health promotion and health prevention advice is particularly important for people with serious mental illness however there is good evidence that they are much less likely than other members of the general population to be offered, for example, blood pressure checks and cholesterol checks if they have concurrent coronary heart disease, and cervical screening. They feel the importance of this by identifying a number of targets in mental health two of which relate to physical health and are detailed below. MH 8. The practice can produce a register of people with schizophrenia, bipolar disorder and other psychoses MH 9. The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses with a review recorded in the preceding 15 months. In the review there should be evidence that the patient has been offered routine health promotion and prevention advice appropriate to their age, gender and health status. They also recommend that a review of physical health will therefore normally include: 1. An enquiry about smoking, alcohol and drug use 2. A blood pressure check 3. A cholesterol check where clinically indicated 4. Measurement of body mass index (BMI) 5. A check for the development of diabetes 6. Cervical screening where appropriate 7. An enquiry about cough, sputum, and wheeze. Reports on the two targets have seen achievements in the high 90% range across the country hence showing evidence of improvement in screening. This approach in primary care is commendable but there are a number of patients who still find it difficult to engage and access services. This client group require additional support to access services and NHS Quality Improvement Scotland (2007) felt it was an important enough matter to include it in their Mental Health Integrated Care Pathway standards. The GP targets which only include the offer of health assessment are enhanced further and include a recording of the completion of an assessment and actions relating to the outcome which include health promotion, communication with interested parties and evidence that action has been taken on the findings. The author agrees with NHS QIS that it was necessary to take this top down social change approach in order to bring about change which will enhance the health promotion of this complex client group. Standard 13: A general physical health assessment and management of the findings are recorded. Criteria 13a The care record shows that physical health needs are assessed at least annually using the following features: à ¢Ã¢â€š ¬Ã‚ ¢ the completion of a physical health assessment à ¢Ã¢â€š ¬Ã‚ ¢ the provision of health promotion advice, and à ¢Ã¢â€š ¬Ã‚ ¢ service users receiving medication should have side-effects and physical health assessed and managed according to the appropriate algorithm for that medication. 13b The care record shows information on the management of physical health needs, including: à ¢Ã¢â€š ¬Ã‚ ¢ information on who is responsible for the physical health assessment (primary care or specialist services) à ¢Ã¢â€š ¬Ã‚ ¢ evidence that results have been shared à ¢Ã¢â€š ¬Ã‚ ¢ evidence that results have been acted upon, and à ¢Ã¢â€š ¬Ã‚ ¢ evidence that information and/or advice on promoting a healthy lifestyle has been provided. Marder et al (2004) make a number of recommendations in their paper in the American journal of psychiatry regarding the monitoring and appropriate prescribing of antipsychotic medications. They suggest that the key is to identify the risk factors for each individual patient and tailor the prescribing according to their presentation and the potential adverse side effects of a number of the medications available. They present evidence of side effects of diabetes and cardiovascular issues and suggest that appropriate prescribing will reduce the risks or developing or exacerbating these conditions in patients with schizophrenia. This is borne out also in the NHS QIS (2007) standards above in Scotland where they recommend that service users receiving medication should have side-effects and physical health assessed and managed according to the appropriate algorithm for that medication NHS boards have been asked to develop prescribing algorithms and audit tools that will guide clinicians in assessing the physical health needs and using this information to make informed choices on the best medications for patients which have reduced risks associated with their physical health. These systems are currently under development across Scotland but can in the future only improve the outcomes in the physical health management of patients with schizophrenia. Conclusion The author in this assignment has demonstrated some of the health inequalities that are evident for people who suffer from severe mental illness from across the world. Some of the inequalities are a product of the diagnosis itself where patients often have symptoms that cause them to have reduced motivation to help themselves in many situations. Often this patient group also comes with a lower socio economic deprivation with a poor employment and education history which again provides barriers to their self management in respect to their physical health. Recent advances in the treatments available for psychoses which have physical health related side effects and the introduction of the disability human rights legislation which stipulates the requirement of equal access for all has further highlighted some of the health inequalities that exist for this complex patient group. The needs identification and health promotion interventions that the author has looked at separate themselves into key areas. This client group requires support to access to services and all of the interventions identified this need and had both support to access, structured recall systems and the facilitation of services close to patients home as their key themes. Assessment of physical health needs and the prescribing of the most appropriate psychotropic medication for their mental illness requires to be structured and coordinated in an improved fashion. Structured physical health assessments frameworks and prescribing guidelines associated with physical health symptoms appeared to be the best way of coordinating this process for this patient group. A mixture of a social change and educational approach is a model that appears to mix well with the review of mental health nursing in Scotland and across the world with mental health services now promoting a more patient inclusive and community involvement role. This allows nurses in particular to facilitate ownership of these health problems and use their teaching skills to teach patients how to change their lifestyles and effectively manage the physical health difficulties that they have. Nurses will engage with local leisure and sports facilities to make support available in a more normal rather than institutional fashion. Reflection The author in completing this assignment has been able to explore different aspects of this problem that exists in Scotland and compare the Scottish approaches with what is happening in other areas. He has found a very similar pattern of difficulties and also some similar solutions although they seem to be at different levels of implementation. He noticed the American studies focussed a lot on the prescribing issues and getting appropriate prescribing correct. He felt this was probably due to the costs and charging policies associated with the American system and possible litigation if there are side effects of prescribed medications which go on to cause disease where risks are known and identified. He felt this is becoming more apparent in the UK now but the study in America was several years ago. The approaches used were similar but there seemed to be a more coordinated approach to the assessment and monitoring of patients in the UK. The author felt that this was due to the NHS role in the coordination of care across the country where the USA has many different health economies and is focussed on a charging and insurance type policy. Recommendations Mental health nurses should continue work in a patient focussed way encouraging patients to take individual ownership of their needs and promote healthy living. The services in Scotland should coordinate themselves to ensure a physical health check is commissioned; takes place and the appropriate actions are followed through. Patients should be supported to access primary care services to enable this screening to take place. Medication algorithms should be developed and audited to ensure that prescribed medications are appropriate to the health profiles of patients and that medication for psychiatric reasons does no harm in relation to the patients physical health.

Essay --

Case Facts and Overview Cambridge Science Pharmaceuticals (CSP) is an international health care company that focuses on developing and marketing products that treat metabolic disorder and other acute and chronic medical conditions. CSP is coming up with a new product named Metabical after listening to a focus group participants that communicated their life struggles with weight loss. 65% of the adult US population is considered overweight, obese, or severely obese and that can measured by Body Mass Index (BMI) scale to understand more under which category they are. BMIs between 25 and 30 are the ones Metabical can benefit. There are over the counter non-prescription drugs for overweight category and the only FDA approved was Alli. Metabical at the time of the case would be the first prescription drug with an approval by the FDA, and clinical trials proved that participants reached their target goal by week 12. Metabical had few side effects when excess fat and calories were consumed. As a result, CSP decided to come up with a support program that included reference material, online tools and exercise plans similar to Alli the OTC drug, but was going to be more comprehensive, in order to help maintain the weight and minimize the side effects. Health care providers were enthusiastic about a drug that can help patients with their overweight struggles and maintain the weight loss. The company conducted a marketing research that shows overweight is on the rise, with 34% of US adults considered in the 25-30 BMI scale. The marketing research also shows that the highest percentage was for the age 65-74 for men, and 45-54 to women. A further research shows that 12% of the respondents said they would make an appointment and purchase the ... ...li. As for the communication strategy, sticking to heavy pull advertising and adding more money into push advertising is recommended. Furthermore, sales representatives have to be trained well on how to convince physicians and know a lot of information about Metabical before they do their visits. PR events and direct mail should also take place and be informative. My final recommendation would be not to include a celebrity, as sometimes celebrities can create a bad image especially that it is a prescription, and not just a herbal treatment. As for the timeline, it is important to create awareness for the physicians through direct mail, sales representatives visits, and seminars before the launch of the product, followed by more direct mail and DTC to the consumers. After the launch, the online contest should take place, and viral marketing should continue heavily.

Week Two Supervision Homework

Satisfied employees, however, refers to a feeling when they have completed a job or something that feels that they have done their job well. Either side of the argument will somehow make money, promotion and/or will get benefits. They're closely related that job satisfaction can be a motivation and/or they do it for the money, promotion and/or benefits but their satisfaction will come naturally. 2. Briefly discuss several specific actions that supervisors can take to improve employee motivation. No matter how big or small the company, motivating the team is really important to business.When people lose their motivation can create less productive, less of an asset to the business. Either way, employees' motivation will affect the overall success in a company. Praising them when they're doing well is probably the most common and most effective as a motivation factor. Providing opportunities for growth such as adding responsibilities or challenges. 3. Explain why many managers frequentl y raise the following questions: â€Å"Why didn't you do what I told you to do? † Managers have higher position than the employees being managed.Therefore, they have the privilege to make decisions and to say something like â€Å"Why didn't you do what I told you to do? † They are more experience and probably have the education to uphold the position. Since they are more experience and probably been there longer than the employees, they have gotten use to the methods they have been using. Some just don't have the time to change the nature in workplace, why change something that is not broken. Or maybe because some managers has a superiority complex and thinks that the way he wants something done is the best way. 4.Discuss the following statement: Meanings are in people, not in words. This can be explained in a lot of ways but I believe that Meanings is a personal preference. Just like the bible, it can be interpreted differently from other religion and culture even tho ugh the words are exactly the same. Don't assume people know what you mean when you tell them something. The meaning is something that will depend on their own experiences, what was learnt by others. People is what gives words meaning.. Hopefully that made any sense but this is how I believe it can actually interpreted.

Inflation of Singapore

Bachelor of Commerce (Bridging) Intake 17 Elements of Economics Contents Introduction3 CPI inflation4 MAS inflation5 Private road transport5 Accommodation6 Recommendation7 Conclusion8 References9 Inflation here up 5. 5% in December Introduction Last December, Singapore’s inflation, which is defined as a persistently rising price level, rose to 5. 5 per cent on a year-on-year basis. The author states that CPI inflation is due to the accommodation and private road transport higher contribution. Furthermore, the author also mention the MAS core inflation increased to 2. per cent year-on-year due to the ongoing pass-through of earlier increasing costs. The report from December’s MAS’s Recent Economic Developments in Singapore further supports the author’s article. In this discussion, it could be argued that consumer demand for housing and transport are the major factors, which Department of Statistic Singapore reported, contribute to the increment in inflation . In addressing the challenge of the governments to meet the consumer demand, the paper will mention a few discussions and a recommendation about the issue on inflation of Singapore.CPI and MAS Inflation CPI inflation CPI, or Consumer Price Index, measures the average of the prices paid by urban consumers for a â€Å"fixed† basket of consumer goods and service (Michael Parkin, 2011). In Singapore, the major contributing â€Å"fixed† baskets are Housing, Food and Transport. In total, these three factors are more than half of the entire CPI. Data extracted from the December 2011’s CPI report is using year 2009 as the base period, which is derived from a Household Expenditure Survey.As Singapore inflation rates are published monthly, the Singapore Government is preventing bad or fictional speculations of future inflation. [pic] Source: Department of Statistic Singapore, 2012 Below table showing partial data of Singapore CPI December 2011 |FOOD |2,205 | |HOUSING |2, 548 | |Accommodation |2,002 | |Fuel & utilities 357 | |Household durables |189 | |TRANSPORT |1,553 | |Private road transport |1,166 | |Public road transport |366 | |Other travel & transport |21 | |Source: Department of Statistic Singapore, 2012 |MAS inflation MAS’ core inflation is stated as a smaller amount than the CPI inflation in this article. This difference is due to MAS monitoring a core inflation measure that excludes components of â€Å"Accommodation† and â€Å"Private road transport†. Private road transport Data from Department of Statistic Singapore states that the overall inflation of transport increased 10% from last year’s December with a detailed 12. 2% increment for the sub category â€Å"Private road transport†. Singapore Government controls the number of vehicles on the island via placing a quota on COE.In mid October 2011, the Singapore Government announced that the annual growth rate will be decreased smoothly until end of 2014 as vehicles population is growing faster than the government’s vehicle growth rate (Tony Ng, 2011). With the sharp increase in COE premiums in June and July 2011 (MAS, 2012), car prices surged, therefore defining the 12. 2% increment in â€Å"Private road transport†. As COE supply is tight, private road transport costs will remain firm. Hence, contribution to the increased inflation is not entirely from private road transport, but from the other main â€Å"fixed† basket, Accommodation.Accommodation Singapore’s economy recovered fast unexpectedly, this is good news but with backlash as Singapore’s infrastructure programmes could not keep pace, causing shortage in the housing program (Prime Minister Lee Hsien Loong, 2011). Since property cooling measures were introduced by the government in year 2010, properties firms claimed that the number of deals closed have dropped by 30% compared to a year ago (PropertyWire, 2011). One of the new measures is th at home owners being required to sell off their flats first before qualifying to the higher bank loan of 80% of next purchasing flat’s value.Most sellers prefer buy first, then sell (Eugene Lim, 2011), causing them to disqualify from the higher loan and only facing with the maximum 60% loan from the banks. Now they have to produce 40% of purchasing flat value from their own cash. With such conditions, sellers are commanding higher cash premiums or cash over valuation (COV) resulting in more expensive or inflated resale flats. On the other hand, people who turn away from resale flats, with factor from the supplies of new flats that are slow in completion, are looking into rental accommodation.The other new cooling measurement the government has introduced is the Minimum Occupation Period (MOP). It is defined that flats can be only being rented out after five years, increased from the previous one to three years period. As more Singaporeans and other people in Singapore are loo king for completed dwellings, the inflation in accommodation is caused by high demand and low supply. Recommendation [pic] Supply and Demand Graph Source: Irena Asmundson, 2010. Demand and supply curves are charted as shown above.As prices rises, suppliers are willing to produce more and consumers buying less (Irena Asmendson, 2010). In addition, the demand for accommodation is high and the supply is low, Singapore accommodation’s price has inflated. To solve this increasing demand and shortage of accommodation, Singapore government has been producing more HDB apartments. From the key statistic from the Housing and Development Board, there are 43,030 apartments under construction in the fiscal year of 2010/2011, a 20. 8% increased from the previous fiscal year.A huge increase of 68. 6% apartments completed from the previous year further reinstate the government’s effort to lower the shortage of accommodation, but the total bookings for new flats are 17,419, less than h alf the number of apartments under construction. This difference can be defined as a huge number of unsold or surplus apartments as HDB in the market. If this is to be true, the huge number of unsold apartment will lower the prices, causing suppliers to produce less and consumers buying more. ConclusionSingapore CPI inflation rate in December is hugely contributed from the factor of accommodation and private road transport. In conclusion, the increased COE premiums and accommodation shortage can the detailed explanation. The Singapore government has been doing readjustment in the property market and private road transport. With introduction of new cooling measures and building of more new apartments, the government can curb or lowered the accommodation inflation rate. Inclusion with the huge surplus of unsold apartment, the accommodation inflation rate can be lowered to with the demand and supply law.Word count: 932 References Michael Parkin, 2009. Economics. 10th edition. Pearson A ddison Wesley Department of Statistic Singapore (2012, January 25). Singapore Consumer Price Index December 2011. Department of Statistic Singapore. Retrieved from http://www. singstat. gov. sg/news/news/cpidec2011. pdf [Accessed 6 February 2012] Matthew Bishop (2004, April). Economics A-Z. The Economist. Retrieved from http://www. economist. com/economics-a-to-z/i#node-21529397 [Accessed 6 February 2012] Monetary Authority of Singapore (2011, December 8).Recent Economic Developments in Singapore. Monetary Authority of Singapore. Retrieved from http://www. mas. gov. sg/resource/eco_research/eco_dev_ana/Recent_Economic_Developments. pdf [Accessed 7 February 2012] Tony Ng (2011, October 19). COE premiums hit record hit. AsiaOne Motoring. Retrieved from http://www. asiaone. com/Motoring/News/Story/A1Story20111019-305931. html [Accessed 8 February 2012] Prime Minister Lee Hsien Loong (2011, August 14). National Day Rally 2011. Prime Minister’s Office, Singapore. Retrieved from ht tp://www. pmo. gov. g/content/pmosite/mediacentre/speechesninterviews/primeminister/2011/August/Prime_Minister_Lee_Hsien_Loongs_National_Day_Rally_2011_Speech_in_English. html [Accessed 8 February 2012] Property Wire (2011, October 10). PropertyWire, Asia. Shortage or resale flats driving up prices in Singapore. Retrieved from http://www. propertywire. com/news/asia/singapore-real-estate-shortage-201110105661. html [Accessed 8 February 2012] Irena Asmundson (2010, June). Finance and Development. Back to Basic: Supply and Demand. Retieved from http://www. imf. org/external/pubs/ft/fandd/2010/06/basics. htm [Accessed 9

Presidents Who Were Secretary of State

Presidents Who Were Secretary of State A political tradition which died out in the mid-19th century was the elevation of the secretary of state to the office of president. Six 19th century presidents had previously served as the nations top diplomat. The secretary of state position was considered such a launching pad to the presidency that men who sought the highest office were widely believed to have angled to be named secretary of state.   The perceived importance of the job is brought into sharper focus when you consider that several prominent, yet unsuccessful, presidential candidates of the 19th century had also held the position. Yet the last president to have been secretary of state was James Buchanan, the ineffective president who served four years in the late 1850s as the country was coming apart over the issue of slavery.   The candidacy of Hillary Clinton in the presidential election of 2016 was noteworthy in this historical context as she would have been the first secretary of state to become president since Buchanans election 160 years earlier.   The office of secretary of state is still a very important cabinet post, of course. So its interesting that in the modern era we have not seen any secretaries of state go on to become president. In fact, cabinet positions in general have ceased to be pathways to the White House. The last president who had served in the cabinet was Herbert Hoover. He was serving as Calvin Coolidges secretary of commerce when he became the Republican nominee and was elected in 1928. Here are the presidents who served as secretary of state, as well as some prominent candidates for president who also held the position: The Presidents: Thomas Jefferson The nations first secretary of state, Jefferson held the position in the cabinet of George Washington from 1790 to 1793. Jefferson was already a revered figure for having written the Declaration of Independence and for having served as a diplomat in Paris. So its conceivable that Jefferson serving as secretary of state in the nations early years helped establish the position as the foremost post in the cabinet. James Madison Madison served as secretary of state during Jeffersons two terms in office, from 1801 to 1809. During Jeffersons administration the young nation had its fair share of international problems, including battles with the Barbary Pirates and increasing problems with the British interfering with American shipping on the high seas. Madison declared war on Britain while serving as president, a decision that was highly controversial. The resulting conflict, the War of 1812, had been rooted in Madisons time as secretary of state. James Monroe Monroe was secretary of state in Madisons administration, from 1811 to 1817. Having served during the War of 1812, Monroe was perhaps wary of further conflict. And his administration was known for making deals, such as the Adams-Onis Treaty. John Quincy Adams Adams was Monroes secretary of state from 1817 to 1825. It was actually John Adams who deserves credit for one of Americas greatest foreign policy pronouncements, the Monroe Doctrine. Though the message about involvement in the hemisphere was delivered in Monroes annual message (the predecessor of the State of the Union Address), it was Adams who had advocated for it and drafted it. Martin Van Buren Van Buren served two years as Andrew Jacksons secretary of state, from 1829 to 1831. After being secretary of state for part of Jacksons first term, he was nominated by Jackson to be the countrys ambassador to Great Britain. His appointment was voted down by the U.S. Senate, after Van Buren had already arrived in England. The senators who thwarted Van Buren as an ambassador may have done him a favor, as it made him sympathetic to the public and probably helped when he ran as president to succeed Jackson in 1836. James Buchanan Buchanan was secretary of state in the administration of James K. Polk, from 1845 to 1849. Buchanan served during an administration which was fixated on expanding the nation. Sadly, the experience did him no good a decade later, when the major problem faced by the country was the splitting of the nation over the issue of slavery. The Unsuccessful Candidates: Henry Clay Clay served as secretary of state for President Martin Van Buren from 1825 to 1829. He ran for president several times. Daniel Webster Webster served as secretary of state for William Henry Harrison and John Tyler, from 1841 to 1843. He later served as secretary of state for Millard Fillmore, from 1850 to 1852. John C. Calhoun Calhoun served as John Tylers secretary of state for one year, from 1844 to 1845.

Chemical Bond essays

Chemical Bond essays Chemical bonds form when two atoms exchange or share one or more electrons. These bonds hold the atoms together to form compounds. There are two general types of bonds- ionic and covalent bonds. Covalent bonds form when two atoms share a pair of electrons. Neither atom completely loses or gains the electrons. The electron orbit both nuclei to some extent, but the electrons spend most of the time in the space between the bonded nuclei. There are two types of covalent bond. The first one is a nonpolar covalent bond, which the molecules are symmetrical and have equal electron sharing. Nonpolar covalent bond repel from one another, and they have lower melting and boiling points. They are often smelly (aeromatic) and slippery, and dont dissolve in water (hydrophobic). However, polar covalent bond has opposite characteristics. Polar covalent bonds have unequal electron sharing. In polar covalent bond, molecules are lop-sided creating dipoles or +/-. The attractive forces (van d er waals forces) between molecules stabilize, and raise boiling and melting point. It dissolves in water (hydrophilic) and there are very high attractive forces called hydrogen bonding. Ionic bond is another type of chemical bonds. Ionic bonds form when electrons are completely removed from one atom and are completely gained by the second atom. The electrons are exchanged, and this is accompanied by the formation of two ions of opposite charge (cations and anions). The opposite charges will attract each other, and this attraction is what forms the chemical bond. These disassociate into ions as liquids or in solution. Some examples are, electric eels/rays, and nervous systems. ...

Business Project Managing And Assignments Management Essay

Business Project Managing And Assignments Management Essay Introduction Before one can tackle the question at hand, i.e. the decisions that a project manager has to make in order to create a cohesive and productive environment for his project team, one must first be familiar with the basics of project management. Project management is a wide area which has gained relatively greater importance in the last three decades. Managers began to realize that project management techniques and abilities were central to the success or failure of projects and thus a great deal of research and literature was published on the factors that affect and influence project management techniques (Maylor, 2005). Needless to say, project management is an area of study that requires a great deal of study because of the number of variables associated with it. This paper will thus start off by giving a brief overview of project management in a bid to first establish that the environment in which the project team feels motivated can in fact determine the success or fa ilure of a project and then move on to critically analyze different ways in which a project manager can improve this environment per se. Business Project Management (1)Various texts have defined a project differently, one could informally see a project as a bid to accomplish a given objective through a set of interlinked tasks using a given amount of resources. It could be something as simple as planning a wedding or a more complex task like building a new house. More formally, a project can be defined as, â€Å"A complex, non-routine, one-time effort limited by time, budget, resources, and performance specifications designed to meet customer needs (Allan 2004, p.12).† From this formal definition we can deduce some main attributes of projects such as the fact that a project has an established objective, a defined life span, has specific time, cost and performance requirements and requires across-the-organization participation. The main attributes of a project are not only ess ential for planning and implementing the project but ultimately, the success or failure of a project is judged on how well it has adhered to these essential attributes. Basically one has to see how well a project meets customer requirements and whether it has been able to do it within the time, cost and performance requirements that had been initially established. As mentioned earlier, projects can comprise large complex assignments or small tasks spanning only a few days. For practical purposes, one must also be familiar with the prevailing types of organizational structures in order to better understand the various ways in which impending projects are tackled by various organizations. The first kind can be labeled as the functional organizational structure. Different segments of the project are delegated to respective functional units of the organization and coordination is maintained through normal communication channels. Such a structure allows for flexibility, in-depth expertis e and easy post-project transition for team members. At the same time however, there is poor integration, a lack of focus and more importantly a lack of ownership for the success or failure of particular tasks. Then there is the dedicated project team structure. It is normally implemented by projectized organizations that are mainly dependent on one time projects to conduct the bulk of their business. In this system, each task or assignment is treated as a distinct project and a group of employees is put into a project team and handed the sole responsibility of completing that particular project (Burke 2003, p.89). The system is fast, simple, cohesive and allows for cross-functional integration from different departments. On the downside, it proves expensive, leads to internal strife between team members and there arises a problem of post-project transition for the employees. Thirdly, there is the matrix structure. It’s a hybrid organizational structure and seeks to combine t he best attributes of the two structures formerly discussed. Basically, there are two chains of command and project participants report simultaneously to both functional and project managers. The matrix structure achieves a greater integration of expertise and project requirements. There are three sub-types of the matrix organizational structure. In the weak-form matrix, the authority of the functional manager predominates and the project manager only has indirect authority. In the balanced form matrix, the project manager sets the overall plan and the functional manager determines how work is to be done.

Remote sensing Essay Example | Topics and Well Written Essays - 1500 words

Remote sensing - Essay Example 239) have defined the remote sensing as a field of science or art that makes use of energy reflected from the Earth that is later processed, evaluated and applied in order to assist one in retrieving information regarding the surface of Earth without physically having to be on it. Sun is the fundamental source of energy for all the creatures on earth. Sun rays falling on earth are partly reflected which are captured by the satellites for generating information. The first condition without which, the process of remote sensing can not take place, is the provision of electromagnetic energy as waves to a specific place or to a study area. Although there are many electromagnetic energy sources, yet the sun is fundamentally the best source of energy. Basically, the energy travels from a source to a target through a medium or vacuum. When it comes to the earth, the energy interacts with the atmosphere, and this interaction gets repeated when the energy is reflected from the study area to the sensor. After the electromagnetic waves have passed the atmosphere from some source, they interact with the study area. This interaction depends on the characteristics of the study area and also on the electromagnetic radiation sent to it. After the electromagnetic waves interact with the study area, part of them is absorbed and the rest is reflected back to the space. Recording and collecting the reflected electromagnetic waves requires a special type of sensor which is familiar with the reflective waves. The last step of this operation is to understand, disclose and apply the information that has been retrieved from the study area. The problem can be solved by conducting its comparison with the real information. In 1864, the British physicist Clark Maxell predicted the existence of electromagnetic waves and supposed that the magnetic and electric fields work together to produce radiant energy. In addition to that, he described the visible light to be composed of

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Global health - Assignment Example Secondly, the most vulnerable population should be protected and prioritized than the invulnerable ones. This includes the poor who have less access to medical facilities and have a difficulty in affording these services. Making these facilities available and affordable for them can be a huge step towards effective health care. Statement: The WHO report (2012) shows that over 6.6 million children under 5 years died in Africa, especially in third world countries. Increasing the medical care facilities for children can help reduce the death of the future generation. Statement: In 2008, CDC declared that the statistics of mortality at birth in Africa has gone high in developing countries and that there is need to reduce the risk of both the mother and the child of dying. The Pregnancy risk assessment program (PRAP) is an initiative that would see less annual mortality at birth. Statement: Mubi (2013) notes that Malaria claims about 0.66 million people among them children along the coastal regions of the world. This high rate of death costs the economy and should be avoided at all cost. Providing adequate medical supply within these areas would help improve the situation. Statement: Mudur (2003) notes that over 85% of India is covered by water and that this has resulted in the prevalence of waterborne diseases within this country. Hence, it is crucial to control the impact of diseases such as diarrhea and typhoid by increasing medical care in this environment. Statement: Research by Mabey and Mayaud (2004) indicates that developing countries spend over 13% of their economy budget on STD. As the number of reported cases increases every year, it would be vital to launch awareness campaigns to reduce the infection rate. Statement: In the near dry regions of the world, most communities cannot afford medical care and the death rate in these regions is very high. Providing free medical insurance will make health services free for them. Statement:

Training professionals have a leading role in innovation and change Essay - 4

Training professionals have a leading role in innovation and change - Essay Example the importance of training this important component to ensure consistent innovation that subsequently result into enhancing the organization’s competitive edge. This paper explores the role of professional training in promoting innovation and change in the current organizational setup. According to Omachonu and Einspruch (2010: 6), innovative duties require versatile people with ability to function in a wide conceptual environment. In addition, technical ability and proficient communication skills are important attributes for innovators. Unlike the previous specialists who specialized in a particular discipline, ability to multitask is a highly sought attribute in a professional in the current business environment. This implies that such a person can make valuable technical contributions and strategic decisions in diversified areas of business engagement. Therefore, promoting innovation culture in an organization does not only require recruitment of passionate innovators but also individuals with business acumen, enterprising character and negotiation skills (Resnick 2008). Recruiting a professional with these attributes requires more than just perusing resume or initiating volunteering programs in the organization. Therefore, organizations have become cognizant o f the need to incorporate training programs to promote innovation and positive change in their businesses. Various writers have investigated the role of training professionals in the current business environment in delivery of innovations. Bondarouk and Looise (2005: 163) classified the roles in context of three major human resources management issues, namely work structuring, organizing design and personnel issues. According to Bondarouk and Looise, (2005: 165) work should be structured in manner that encourages creativity and innovation. This includes changing the supervision model and creation of semi-independent teams in an organization. Work structure plays an important role in

Hrm Essay Example | Topics and Well Written Essays - 3000 words

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Monetary policy in china Coursework Example | Topics and Well Written Essays - 1500 words

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Training professionals have a leading role in innovation and change Essay - 4

Training professionals have a leading role in innovation and change - Essay Example the importance of training this important component to ensure consistent innovation that subsequently result into enhancing the organization’s competitive edge. This paper explores the role of professional training in promoting innovation and change in the current organizational setup. According to Omachonu and Einspruch (2010: 6), innovative duties require versatile people with ability to function in a wide conceptual environment. In addition, technical ability and proficient communication skills are important attributes for innovators. Unlike the previous specialists who specialized in a particular discipline, ability to multitask is a highly sought attribute in a professional in the current business environment. This implies that such a person can make valuable technical contributions and strategic decisions in diversified areas of business engagement. Therefore, promoting innovation culture in an organization does not only require recruitment of passionate innovators but also individuals with business acumen, enterprising character and negotiation skills (Resnick 2008). Recruiting a professional with these attributes requires more than just perusing resume or initiating volunteering programs in the organization. Therefore, organizations have become cognizant o f the need to incorporate training programs to promote innovation and positive change in their businesses. Various writers have investigated the role of training professionals in the current business environment in delivery of innovations. Bondarouk and Looise (2005: 163) classified the roles in context of three major human resources management issues, namely work structuring, organizing design and personnel issues. According to Bondarouk and Looise, (2005: 165) work should be structured in manner that encourages creativity and innovation. This includes changing the supervision model and creation of semi-independent teams in an organization. Work structure plays an important role in

Monetary policy in china Coursework Example | Topics and Well Written Essays - 1500 words

Monetary policy in china - Coursework Example The money market of China is considered as an indicator for funding to the financial institutions and to the smaller banks existing in the economy. The financial system plays an important role in the growth and expansion of China. The economy of china is being considered as the second largest economy of the world. The financial system of China is mainly dominated by the banking sector. The banking sector contributes more than three fifth of its credit to the private sector. The main source of the economic growth of China is from the banking sector. The financial system of China has also undergone modifications with the end of monopoly in the banking sector of the country. The banking system of China mainly constitutes two third of the financial asset of the financial system. The financial intermediaries’ plays a crucial role in the financial system of the country. The four state owned banks of China mainly dominate the market. The household savings are conducted by the financial intermediaries under the pressure of the government of China. The monetary policy of China is very complex. In order to facilitate the growth an d development in the economy, the Central bank of china has invested cash in the financial system. The interest rates this country are almost zero therefore the central bank of the country has to switch to lower funding cost. The article reflects on the economic growth of China. China is experiencing a slowdown in the economic growth and development in the recent years. The growth has decreased to more than 7% in the first quarter. China has been experiencing a slowdown in its economy since 2009. But it has gained momentum in the recent years. This situation has created more pressure on the Central bank of the country to ease its fiscal and monetary policy. The cut in the interest rate has affected the liquidity position of the economy which has

Spanish Countries Essay Essay Example for Free

Spanish Countries Essay Essay Now that we are in the 21st century the idea of a global village is fast becoming a reality, it is vital that we enlarge our worldview and reach an understanding of, and appreciation for, the cultures of the other peoples who share the planet with us. As cultural beings, we are raised with an certain way of giving order to the world around us but I also believe that we should embrace the cultures of those around the world. Known for its beauty extravagant tourist’s attractions the Caribbean island of Cuba, a communist state, is a multiracial society with a population of mostly Spanish and African origin. The island is known as the Republic of Cuba. Cuba is just ninety miles south of Key West, Florida; therefore its climate is subtropical or temperate. The climate is between 70Â °f and 81Â °. Cuba has a dry season between November to April and a wet season between May and October. Having such wonderful weather regularly makes Cuba an ideal tourist’s hot spot. Beautiful beaches and hotels also make the island a more desirable place to be. When in Cuba, there are more than enough things to do. Spain is a country on the Iberian Peninsula, and surrounded on the north by France, and Andorra on the east by the Mediterranean Sea. The capital and largest city is Madrid has a population of 3,010,492. The Spanish people are essentially a mixture of the indigenous peoples. Their population includes a mixture of ethnicities such as Roman, Mediterranean, Suevi, Vandals, and Visigoths, Teutonic people. Known for its natural beauty and people is a small country located in Central America. Located between the countries of Nicaragua and Panama, bordered by both the Pacific Ocean and Caribbean Sea is the Republic of Costa Rica. Even though it is a small country it has a very diverse landscape and a variety of weather as well. One unusual aspect of Costa Rica is that the country has no army and instead of a national hero being a general it is a young barefoot farmer. Costa Rica prides on the idea that they have gained through evolution what other countries have tried to attain through revolution.

The Main Contractors Estimators Action On Receipt Construction Essay

The Main Contractors Estimators Action On Receipt Construction Essay 1. Introduction 1.1 Structure of sub-contracting The Hong Kong Construction Industry are made up of mainly three layers though the process of tendering, which include the tendering from developers to main contractors and the sub-contracting main contractors to sub-contractors. In the report, sub-contracting will be further discussed. In the process of sub-contracting, the estimator of main contractors breaks down the whole construction work into various tasks. For instance, breaks down a building construction work into basement, substructure, bamboo scaffolding, superstructure and finishes. The estimator will then undergo tendering process and sub-contract these various works to favourable tenderers. In addition, quotation is a document plays a role in the tendering process. It is a priced document which derived from tender that main contractor released and can be regarded as a reduced size of priced Bills of Quantity that tenders submit to the main contractor. Since quotation contains monetary terms and which can result in several companies interest, it has to be kept highly confidential to avoid collusion or unequal situation to happen. 1.2 Role of cost estimator To clarify, it is to discuss the role of main contractors cost estimator in this report. First of all, the estimator is not merely one person but a team with, for example, quantity surveyor, project manager, contract manager and planning engineer. The roles of cost estimator before award of project are to estimate the cost of construction works, prepare initial budget, price the Bills of Quantity and arrange for man power, materials supply and plants for proposed project. After the award of project, the cost estimator will break down the works as described above, prepare sub-contacting schedule which stated the time to finish tendering of specific tasks and deadline of commencement of different work, and prepare the tender document with self estimated budget not enclosed. After the receipt of quotation, the cost estimator will select to sub-contract to the most suitable tenderer with equal basis. Besides, there is other role that is significant to cost estimator. They are to balance the quality and price for selection of sub-contractors, materials and plant, keep all the monetary details highly confidential even within the company and do not receipt of any kind of interest to avoid collusion which keep the tendering process undergoing in equal basis. 1.3 Sub-contracting procedure after receipt of quotation The general sub-contracting procedure can be illustrated by figure 1.3. After the preparation of the quotation documents and the sub-contractor list for open invitation of quotation, a request for quotation will be issued to the sub-contractors on the list. Interested sub-contractors will prepare their quotations and submit them by depositing to the bid box before the deadline set in the quotation documents. Upon the deadline for submission, a number of quotations would be received from different sub-contractors. The main contractors estimator is then started to assess and evaluate those quotations being received. The major actions of the estimator after receipt of quotation include checking of the quotations for their compliancy, errors and adjustments as well as selection of the preferred quotation by quality/price mechanism. A quotation report will also be prepared afterward. If the main contractor finally gets the tender from the client (i.e. the developer), performance evaluation may be conducted by the estimating team for future works. à ¥Ã…“-à §Ã¢â‚¬ °Ã¢â‚¬ ¡1.png Figure 1.3 Sub-contracting procedure after receipt of quotations 2. Checking of the quotations (with Appendix 1) Upon receipt of quotations from the sub-contractors, the date should be entered on the enquiry record. Basic information of the sub-contractors should be checked and the database is to be updated wherever necessary. To avoid any erroneous price submitted, the estimator of the main contractor then has the responsibility to read, check and verify the quotations for the following: Whether the quotations are in line with requirements set out in the enquires; Whether the costs are consistent If there are any errors; If the prices provided by the sub-contractor are reasonable How are the prices when they are compared with the market prices. 2.1 Checking of compliancy with requirements After the quotations are received from the sub-contractors, the main contractors estimator has to make an in depth examination on the quotations in order to assure that they are made in accordance with the enquires requirements and no alternative offer have been submitted. Any breakdowns of price should always be checked while the rates are being entered into a computerized estimating system to ensure they are correct. The quotations should also be checked against the terms and conditions (Fig.2.1.a) and content of the enquires (Fig.2.1.b) for any arithmetic errors, missing items, reality and consistency of rates, tender qualification, validity period of tender, and signatures properly provided. 2.1.1 Quotations from Material Suppliers The quotations for material supply should be recorded on a Materials Comparison Form (Fig.2.1.1.a) and in accordance with the enquires provided by the main contractor or the clients. The rates are entered during the pricing stage, and any divergence discovered from the provided enquires are to be recorded for later assessment. The estimator should check for the followings: The materials adopted comply with that stated in specification; The quantities of materials are sufficient to meet the required amount as stated in the enquires; The methods of delivering, unloading and handling of the materials comply with that required by the main contractor, special conditions for ordering and payment, and the suppliers with the most competitive prices should be contacted to ensure that they had noted all the relevant restrictions on delivery to site; The delivery dates meet with those required, otherwise additional enquires to maintain a full enquiry list may need to be sent; The intended on-site or off-site storage of the materials and settlement of payment; The conditions stated in the quotations is as same as the terms and conditions stated in the enquires and the quotations are not alternative offers. 2.1.2 Quotations from Plant Suppliers The quotations for plant supply should be recorded and on a Plant Quotations Register (Fig.2.1.2.a). Wherever a performance specification for the usage of the plants is given, the quotations should be checked cautiously to make sure that all the plants provided accomplish the enquires requirements. The estimator should check for the followings: The plants are sufficient to meet the needs of the construction programme; The wages for plant operators are included; The working hours of plant operators comply with the intended site working hours; The responsibilities and charges for maintenance are clearly identified. 2.1.3 Quotations from Labour-Only Sub-Contractors The quotations for labour should be recorded on a Domestic Sub-contractors Register (Fig.2.1.3.a) which is used as a form for sub-contract comparison. Any divergence from the enquires discovered should also be recorded for later assessment and unit rates pricing when selecting quotations. The estimator should check for the followings: The conditions stated in the quotations is as same as the terms and conditions stated in the enquires and the quotations are not alternative offers; The discounts comply with the enquires requirements; The payment basis of the labour; The ambiguities concerning the responsibilities for protections, storage, clearing up, unloading are resolved; The supporting information including the schedules of rates and the programme information are given. 2.2 Checking of errors and adjustments The main contractors estimator should check whether the quotations are basing on complete and accurate information. 2.2.1 Domestic Sub-contractors The main contractors estimator should ensure that all the items for a particular trade are priced properly, and should request the sub-contractors for any missing rates. The rates provided should be checked for consistency with the bill of quantities, and they should be realistic although the cost will vary depending on the quantities, location and timing. The main contractors estimator could withdraw or change an offer and report to the client if any obvious errors are detected or the tender document is found to be altered. The estimator may apply a percentage or add a lump sum to certain rates in cases where considerations are taken for the following: Work of specific builders which is not measured somewhere else is needed; Certain attendances are needed to be included in the measured rates; Specific trades requirement provided by the contractor; Margin for over-heads and profit are to be included in the measured rates so the estimator could spread the over-heads to works which seems to be under-measured. 2.2.2 Nominated Sub-contractors Nominated subcontractors are subcontractors required by the client to enter a contract for execution of work or the supply of things designated as Prime Cost of PC items. The main contractors estimator should ensure that the PC sum is included in the bill calculations and a percentage for profit is added to the PC sum wherever necessary. 2.2.2.1 General and Special Attendances The main-contractors estimator should also access the costs for general and special attendances. The costs for general attendances are normally provided in the evaluation of project over-heads for logistical requirements; while the special attendances are to be priced separately in the measured bills of quantities and the estimator may price the work if those attendances are properly described. Figure 2.2.2.1.a shows different types of attendances to be provided to the sub-contractor by the main contractor. These attendances should be priced in project over-heads and the amount required should depend on the sub-contractor. Therefore, the main contractors estimator should adjust the amount of lump sum or added percentage to different types of sub-contractors carefully. 2.3 Comparing of Prices 2.3.1 Comparing with Market Prices The main contractors estimator should compare the quotations provided by the sub-contractors with the market prices. 2.3.1.1 Variations in unit rates While comparing the prices, the estimator should also consider factors which may affect the rates of materials, plants, and labour. The rates for materials may depend on the suppliers locations, the sizes of the materials, the delivery costs, and whether alternative materials are to be adopted should also be considered. The rates for plants could be affected by the prices for erecting and dismantling, maintenance, and insurance of the plants in the construction sites. As for the rates for labour, they depend very much on whether skilled labour is available in the area or extra payment for labour with special skills are needed, the location at which jobs are to be carried out should also be taken into consideration. 2.3.2 Comparing with other quotations The main contractors estimator should carefully compare each quotation submitted by all the sub-contractors. A spreadsheet such as the Sub-contract Comparison Sheet (Fig.2.3.2.a) may be used for comparing as it facilitates listing, rates comparing as well as mathematical checking. 3. Selection of the quotation (with Appendix 2) Price3.1 General criteria Quality TimeIn most of the case (i.e. except in case of nominated sub-contractor), there is still a long-list of sub-contractors, who compliant with the requirements, remain after checking the quotations with the enquiries. In order to identify the preferred sub-contractor(s), hence, a short-listing with several criteria should be processed. The most significant factor is price, while other criteria include experience and qualifications, financial and resources standing, reputation and management system. 3.1.1 Price The quoted price in the quotation constitutes substantial effect on the decision making of the cost estimator. With a lower cost to hire a sub-contractor, the main contractor can turn out give a lower bid in the tender to the developer and therefore, increase the opportunity of getting the project. 3.1.2 Experience and qualifications An experienced and qualified sub-contractor on the type of work of the project means it can finish the work in a more effective way compares with those without (i.e. the completion time may be shortened due to its experience on the trade). In the case of specialized works such as demolition work and foundation work, experience is even more important. The cost estimator can evaluate the sub-contractors past performance with the company or refer to different Registers  [1]  and professional bodies for determination its competence on the work. 3.1.3 Financial and resources standing Financial standing of the sub-contractor is an important factor since inadequate working capital of the sub-contractor may hinder the working progress and lengthen the completion time. In addition, the cost estimator needs to ensure the sub-contractor is having sufficient resources (i.e. man power, material, plant, etc.) to deal with the work, especially in the case of supplier. By investigating into the liquidity, credibility and adequacy of resources of the sub-contractor, the cost estimator can so avoid delay of the entire construction of the project to minimize loss to the client. 3.1.4 Reputation and management system Reputation of a sub-contractor is generated when it provided quality services in the field. By investigating the past performance (i.e. workmanship, time management, worker and material quality, etc.) of the sub-contractor, the cost estimator can reasonably select sub-contractor(s) who can provide up-to-standard work. The management system should also contribute to the decision of the cost estimator, as proper management can generate synergy effect to the labour performance. 3.2 Establishment of the quality/price mechanism The major concern for the main contractors estimators to select an appropriate quotation is to have a quotation of both low price and good quality. Hence, in order to maintain a good balance between quality and price, a quality / price mechanism should be established to facilitate the process. 3.2.1 Formulation of the quality / price ratio The quality / price ratio should be formulated at the first stage. The ratio can depend on the complexity of the work, the degree of innovation and the flexibility. For instance, straightforward projects should be less complicated and less innovative. Therefore, the price factor should be given a higher weight. Thus, the quality / price ratio of 20/80 could be considered. Similar approach can be adopted for complex and repeat projects to obtain the ratio. Fig. 3.1 shows the relationship between quality and price for different kinds of projects. 3.2.2 Weighting of the quality criteria Different quality criteria should be weighted according to their importance to the project. Basically, there are four major criteria. They include the practice of the company, the project organization, the key project personnel and the project execution. Practice of the company comprises the organization structure, financial stability, quality assurance, resources, management systems, relevant experience of the company and etc. Project organization refers to the organization of the proposed project team and the authority level of team members. Key project personnel includes the qualifications, communication skills and enthusiasm of the team members and the extent they understand the project brief. Project execution refers to the programme, method and approach, as well as the management and control procedures of the project. To weight the criteria, it is suggested that the key project personnel can occupy around 30 to 40% of the total weight, 20 to 30% each for the practice of the company and the project execution, 15-25% for the project organisation. 3.2.3 Establishment of the marking (scoring) system After the quality / price ratio is formulated and the quality criteria is weighted at the first and second step, a quality threshold should be introduced to the marking system. It is the minimum marks that must be scored by the short-listed sub-contractors in the quality assessment so as to allow further consideration of the quotations. An assessment sheet can then be prepared for subsequent assessments of the quotations. In the assessment sheet, both the quality and price scores will be given and an overall score will be added. An unfilled assessment sheet is shown as Fig. 3.2. 3.3 Assessment of the quotations After returning the quotations from various sub-contractors, the main-contractors estimators can start to do the assessment on the quality and price. 3.3.1 Quality assessment Marks should be scored according to the quality criteria (i.e. practice of the company, project organization, key project personnel and project execution) and the weighting and marking system set down previously. If the scored mark of a quotation is below the targeted quality threshold, the quotation should not be further considered and should be discarded. However, if it is the situation that all the submitted quotations are below the threshold and there is a common failure of a specific criterion, then the estimators may re-assess the requirement to see if there is a need of amending it. 3.3.2 Price assessment Price assessment should be considered only if a quotation has passed the quality assessment. It is done in the way that the quotation with the lowest quoted price is considered to score 100 marks in this section. While for other quotations having a higher quoted price, their scored marks will be deducted with a proportional percentage. However, for particular quotations having an extraordinarily low price, they should be reviewed in order to ensure full compliance of the requirements. Finally, the quality and price scores should be totalled and the assessment sheet should be dated and signed for later auditing purposes. Fig. 3.3 shows an example of a completed assessment sheet. 3.3.3 Final assessment After all the qualified and assessed quotations have been obtained, their overall scores can be compared with an assessment comparison sheet. The sub-contractor with the highest overall score will eventually win the bid. Fig. 3.4 shows an example of a completed comparison sheet. It is seen that the assessments of different firms (i.e. firm A, B, C and D) have been done and the overall scores have been calculated onto the same sheet. Since firm A has got the highest overall score among the competitors, its quotation will be considered by the main contractor. 4. Quotation report A quotation report is used to summarize all the necessary information and evaluation result of the assessment, and as a reference for the cost estimator to refer to if finally sub-contractor is needed to be awarded. The quotation evaluation report should include the followings: The sub-contractor list established at the beginning A summary of the quotations received and opened The results of the checking and selection of the quotations The evaluated price of each quotation, showing any corrections, errors or adjustments The scores and rankings of the quotations, according to the assessment Recommendation to award the contract 5. Actions after tender is awarded by the developer If the main contractor finally gets the tender from the developer, there are still several actions that the main contractors estimator needs to do. Firstly, notification to the wined sub-contractor (i.e. the highest scorer in the final assessment) to ensure the selected team is still available. Once the award is made, advisement to all other discarded sub-contractors in writing should be processed. Secondly, the estimating team should evaluate the performance of both the selected sub-contractor(s) and the quality/price mechanism. Evaluation to selected sub-contractor can be by the way of inspection during work or after completion. The results may be used in selection of sub-contractor in future works as mentioned in Part 3. Besides, the evaluation of the appropriateness of the quality and price ratio and the weighting system can used to adjust the mechanism and improve its operation in future works. 6. Conclusion In conclusion, the main contractors estimators actions on receipt of quotations from their sub-contractors are first checking for their compliancy with the quotation documents, and sorting out any errors and adjustments. Secondly, the estimator needs to select the preferred sub-contractor(s) by considering their quoted price, experience, financial and resources standing, reputation, etc with the quality/price mechanism. Thirdly, a quotation report will be prepared afterward. And if the main contractor finally gets the tender from the client (i.e. the developer), performance evaluation may be conducted. The above actions and procedures conducted by the cost estimator can be further illustrated by the case study in the next part. 7. Case study The case is from the main contractor Chun Wo Constrcution and Engineering Limited, of project Tuen Mun Western Trunk Sewerage (DC/2009/11). The cost estimator proposed to sub-contract the installation works of temporary water and electricity of site offices and underwent the following procedure. In the first stage preparation of documents, the estimator prepared the description of required work. Simply, it includes the description and details of proposed installation works. They then decided the adaptation of selective tendering rather than open tendering as time was limited and selected two contractors in the sub-contractor list. They are Wing Wo and Sky. Lastly, they prepared the tender document of the work, which contains common items to all tender documents, including general conditions of contract, standard conditions of sub-contract, special condition of contract, general specification and standard methods of measurement, and specific item details such as particular specification, particular preamble, schedule of rates and drawings. Figure 7a is the tender document list of the work. After prepared the tender document, they issued request of quotation to the two contractors. In the second stage the selection of sub-contractor, the estimator received the quotations by bid box and checked with the compliance, errors, adjustment and price as described in previous section. They selected the criteria for the work as quality to price ratio, experience and reputation. After the comparison of those criteria, they recommended Wing Wo as the sub-contractor since it had better quality to price ratio and experienced. Figure 7b is the tender report for comparison. Since the score of Wing Wo was the highest, its director was invited to have further negotiation to assure all details were known and the same in two parties, and price adjustment had done at that moment. Finally, estimator prepared sub-contract for the work in which an item concerning wage payment was added, and signed with the director and project manager. Figure 7a Tender list Figure 7b Tender report