Saturday, August 31, 2019

Commercial item transport and distribution Essay

There has been a gradual change in the mode of packaging for last years.For instance, earlier fruits and vegetables were used to be transported in wooden boxes but today cardboard crates are used .This is mainly to reduce the cost. Obviously,a cardboard crate would cost less than wooden crate. Moreover,using cardboard crates is more eco friendly than cutting trees and making wooden boxes and supporting an environmental cause helps firms improve their goodwill and eventually their sales. Similarly,selling of milk,first in glass bottles,then in packets, then tetra packs and vending machines is all to reduce costs or improve their goodwill by innovating the mode of packaging. Tetra pack keeps the milk safe for months and is made of paper and can be recycled. Plastic packets incur lesser costs and vending machines in itself have no packaging cost. So,companies use new and unique mode of packaging to ,one,reduce their costs,two,to promote the product. Packaging refers to the container or wrapper that holds a product or group of products. Most commercial packaging serves two basic functions: protecting the product from damage during shipping, and promoting the product to the ultimate consumer. Some common types of packaging include shipping cartons, containers for industrial goods, and bags, boxes, cans, and other holders for consumer products. Packaging is of great importance to both sellers and buyers of products. It can prevent spoiling, breakage, tampering, or theft; enhance convenience in use or storage; and make products easier to identify. A significant improvement in packaging can even create a â€Å"new† product by expanding the ways in which it can be used, and thus its potential markets. For example, a soup that is packaged in a microwavable bowl might suddenly increase its sales to working people. Prior to World War II, packaging was used primarily to surround and protect products during storage, transportation, and distribution. Some packages were designed with aesthetic appeal and even for ease-of-use by the end consumer, but package design was typically left to technicians. After World War II, however, companies became more interested in marketing and promotion as a means of enticing customers to purchase their products. As a result, more manufacturers began to view packaging as an integral element of overall business marketing strategies to lure buyers. This increased attention to packaging coincided with socioeconomic changes taking place around the world. As consumers became better educated and more affluent, their expectations of products—and their reliance on them—increased as well. Consequently, consumers began to rely much more heavily on manufactured goods and processed food items. New technologies related to production, distribution, and preservatives led to a massive proliferation in the number and type of products and brands available in industrialized nations. Thus, packaging became a vital means of differentiating items and informing inundated consumers. The importance of consumer packaging was elevated in the United States during the late 1970s and 1980s. Rapid post-war economic expansion and market growth waned during that period, forcing companies to focus increasingly on luring consumers to their product or brand at the expense of the competition. Package design became a marketing science. And, as a new corporate cost-consciousness developed in response to increased competition, companies began to alter packaging techniques as a way to cut production, storage, and distribution expenses. Furthermore, marketers began to view packaging as a tool to exploit existing product lines by adding new items and to pump new life into maturing products. Today, good package design is regarded as an essential part of successful business practice. Since many potential customers first notice a new product after it has arrived on the shelves of a store, it is vital that the packaging provide consumers with the information they need and motivate them to make a purchase. But packaging decisions involve a number of tradeoffs. While making a product visible and distinctive may be the top priority, for example, businesses must also comply with a variety of laws regarding product labeling and safety. Protecting products during transport is important, but businesses also need to keep their shipping costs as low as possible. study mode material : Disadvantages of wooden crates- Deterioration * After wooden pallets are used several times, the wood begins to wear. It splinters, cracks and even breaks under the pressure of continued use. The deterioration is natural and occurs eventually, even if the wood is treated to repel moisture and to strengthen it. This disadvantage leads to replacement much sooner than with plastic pallets. Infestation * Wooden pallets are more susceptible to infestation by termites, ants and other insects that make their home inside the wood. Pallets stored outdoors are more likely to succumb to infestation than the ones kept within a warehouse. The insects burrow into the wood, eating away at it and thus weakening what should be a support structure.. Cleanliness * In addition to germs, wooden pallets are collectors of dirt and debris. Cleaning them becomes more and more difficult over time as the pallets age. They must be heat-treated to get rid of the contamination and washed to be rid of dirt and debris. However, the heat accelerates deterioration, and the water, if improperly dried, can feed mold spores that thrive on wood and harm the vegetables and fruits inside it. Advantages of cardboard crates- Protects Items * As packaging, cardboard protects vegetables being shipped or moved. Corrugated cardboard often has multiple pieces of cardboard placed on top of each other to cushion soft vegetables. Cheap Material * Cardboard is cheap to produce, and is usually made from recycled materials and doesn’t cost much money if purchased wholesale. Other packaging materials are made from plastic, wood or metal, all expensive materials that are often heavier then cardboard, which adds†¦ [continues] Read full essay

Friday, August 30, 2019

Wgu Kot 2

Medicare, the Uninsured, and International Healthcare Review Western Governors University Medicare, the Uninsured, and International Healthcare Review Healthcare and healthcare reform are hot topics of debate in today's society. As the population grows and life expectancy increases, the nation faces many challenges in providing healthcare benefits to the people. â€Å"According to the report, titled Income, Poverty and Health Insurance Coverage in the United States: 2010, 49. 9 million Americans or 16. 3 percent of the total US population had no health insurance in 2010.That percentage represents a slight increase on 2009’s figures, when 49 million citizens or 16. 1 percent of the population was uninsured† (Gamser, 2011). Unless there is a turnaround in their economic downfall, unemployment rate, and healthcare reform these numbers will most likely continue to increase. This paper will discuss some of these issues and how they impact two different families. The paper wi ll look at Mrs. Zwick, a 77-year-old female who was hospitalized for five days following a minor stroke and is then transferred to the skilled nursing facility for rehabilitation.Her rehabilitation is delayed 10 days into her stay due to a hospital acquired urinary tract infection. Discussion will include coverage for her medical care using Medicare Part A, Part B and Part D. Discussion will also include how the hospital acquired infection is not reimbursed by Medicare. Finally the paper will discuss how Mr. Davis, a gentleman with chronic sickle cell anemia and loses his job position due to his illness, will have the option to continue insurance coverage by way of the Consolidated Omnibus Budget Reconciliation Act (COBRA).Discussion will include two challenges that state or local government face when providing care for the uninsured with long-term or chronic illnesses. Elaboration on one of the challenges will be further described. Due to his frustrations with loss of his employmen t, healthcare coverage, and his chronic sickle cell anemia, Mr. Davis verbalizes he wish he lived in another country. Through investigation of healthcare in Great Britain, Japan, Germany, and Switzerland this paper will discuss which of these countries would best benefit Mr. Davis if you ere to become a citizen there. Mrs. Zwick was hospitalized for five days following a mild stroke, and then transferred to a skilled nursing facility for rehabilitation with projected discharge in 21 days. However it is discovered that she developed a hospital acquired urinary tract infection 10 days into her rehabilitation requires IV antibiotics to treat. The infection leads per week and unable to continue her rehabilitation until the urinary tract infection is cleared. As a result, instead of 21 days in rehabilitation she has to stay 40 days.When discharged she was giving a prescription for several medications and a walker. Her daughter inquires about the bills from other is insured with Medicare Part A, Part B and Part D and asks the nurse if she can explain the benefits to her. Medicare Part A, which is also known as hospital insurance, is usually provided free since Medicare taxes are paid into the program while working. â€Å"Part A is hospital insurance that helps cover inpatient care in hospitals, skilled nursing facility, hospice, and home health care† (Medicare. gov, n. d. ). Cherry and Jacob (2011, p. 28) states that Medicare is a federal health insurance plan for Americans 65 and older and certain disabled people. The client must be eligible for Social Security or Railroad retirement. The nurse would explain that Medicare Part A will cover the cost of the hospital stay as well as the skilled nursing and rehabilitation stay. Medicare Part B she explains is considered to be the medical insurance. This will cover services such as physician services, services and supplies that are needed to diagnose and treat her medical condition and would also cover certain pr eventative services such as flu vaccines (Medicare. ov, n. d. ). This would cover the rehabilitation services that her mother has received while in the rehabilitation center as well as the walker that was prescribed by the physician at the time of discharge. Medicare Part D is the prescription drug plan. There are various options under this portion of Medicare and depending on the one that your mother has chosen would base the amount of coverage that she would receive for prescription medications. This does not necessarily cover the full cost of the prescription medications; there are deductibles and copayments that must be met. The hospital acquired rinary tract infection that Mrs. Zwick developed during her hospital stay is not covered by Medicare. Research of an article in Medical News Today states: â€Å"Starting in 2009, Medicare, the US government's health insurance program for elderly and disabled Americans, will not cover the costs of â€Å"preventable† conditions, m istakes and infections resulting from a hospital stay. So for instance, if you are on Medicare and you pick up a hospital acquired infection while you are being treated for something that is covered by Medicare, the extra cost of treating the hospital acquired infection will no longer be paid for by Medicare.Instead, the bill will be picked up by the hospital itself since the rules don't allow the hospital to charge it to you† (Paddock, 2007). Healthcare acquired infections (HAI) not only contribute to exorbitant amounts of financial burden on the healthcare system but also attribute to staggering numbers of patient deaths. â€Å"Healthcare acquired infections (HAIs) are infections that patients contract while receiving treatment for medical and surgical conditions. The U. S. Centers for Disease Control and Prevention (CDC) estimates that HAIs contracted in U. S. ospitals account for approximately two million infections, 99,000 deaths, and an estimated $4. 5 billion in excess costs annually† (Centers for Disease Control and Prevention, 2009) More recent results show a very minuscule decline in these types of infections. It is but a mere scratch at the surface of the deeply rooted problem within our healthcare systems. There are ethical implications as well in treating Mrs. Zwick’s healthcare acquired infection. As healthcare providers, there is a duty to do no harm. Ethically we must do the right thing as an advocate for patient safety.To attain these standards the healthcare provider must diligently be cognizant of infection control measures and ways to improve current practice. Examples include strict hand hygiene, aseptic technique, and current best practice as defined by evidenced based medicine. The continuous monitoring and surveillance of all healthcare acquired infections looking for trends. Perhaps it is a specific hospital unit or employee. These identifiers will assist through education and competency in the correction and preven tion of future occurrences.Healthcare as a whole also has an ethical obligation to make known to the patient, patient families and the community these HAI’s when discovered. This paper will now focus on Mr. Davis who was terminated by his employer for extended absences due to hospitalizations from chronic sickle cell anemia. Even though Mr. Davis is unemployed his employer must offer him the opportunity to continue his healthcare benefit under the Consolidated Omnibus Budget Reconciliation Act (COBRA).COBRA requires employers with more than 20 employees to provide the employee and his family the opportunity to continue medical benefits for up to 18 months. This includes voluntary or involuntary job loss, decreased work hours, changing jobs, and various life changing events. The employee may be responsible for paying the entire premium to continue this healthcare coverage. COBRA can also impose fines of up to $110 per day to employers that fail to offer continued healthcare be nefits to the separated employee. (U. S. Department of Labor, n. d. ) Should Mr.Davis remain unemployed beyond the 18 month limit imposed by COBRA, state and local government are usually called upon to provide assistance. There are options available but often times these require months or even years to get assistance and quite frequently require the assistance of an attorney to receive benefits. Medicaid is probably the most widely known and the recommended source of state medical assistance. The Medicaid program is a federal and state grant program that used primarily for the disabled, low income families with dependent children, and people who are confined in nursing homes with low income levels.The state is responsible for setting the guidelines of eligibility for this program. Once Medicaid is approved for an individual, the coverage can be retroactive for up to three months from the time it was approved. Indigent and underinsured medical care must be funded by state and local g overnment. This challenge is usually met through taxation. Each municipality and sometimes healthcare district must budget to provide care for its citizens through state and local tax. Depending on the economic region this can present a huge challenge.For example, areas of Florida where migrant farmers are present may have to budget more for healthcare than a wealthier district such as West Palm Beach. So in reality, all working citizens pay for the indigent healthcare in their particular municipality. In Texas such budgeting and care is known as the Indigent Health Care and Treatment Act passed in 1985. This act spells out what basic services must be allowed for the indigent in each county. If more care is provided then it is the local governments’ responsibility to pay for it.Other state and local programs may include State Children's Health Insurance Program (SCHIP) which is also a state and national government run program designed for families that don't meet the minimum requirements for Medicaid due to income even though the income is still modestly below poverty level. Local and state governments may also provide other benefits such as free clinics, public health, Meals on Wheels, subsidized housing, discounted transportation services, food stamps, and free or discounted childcare for working parents.Local consumers have even pitched in by providing either free or drastically reduced prescription medications that are commonly prescribed to provide assistance during these tough economic times. Mr. Davis had mentioned in his frustration that at times he wished he lived in another country. His hope would be that healthcare would be more accessible to him. This paper will look at the healthcare system of four different countries Great Britain, Japan, Germany, and Switzerland. After a brief review of the healthcare systems in these countries this paper will focus on one country's health care system that would benefit Mr.Davis the most. Discussion of th is country's healthcare system will examine areas such as medication coverage, pre-existing conditions coverage, requirements if necessary for healthcare specialist evaluation and the access for retired people, children, and the unemployed. The healthcare system in Great Britain is considered to be socialized medicine. Basically what this means is that the citizens of Great Britain pay taxes for health care and in return the government-run National Health Service (NHS) provides and pays those funds to healthcare providers.There are no fees when a patient sees a physician since most physicians and nurses are government employees. In order to see a specialist patients must first visit there general practitioner for a referral. Physician visits are free; however there are fees for prescription medications. â€Å"Young people and the elderly are exempt from all drug co-pays† (Public Broadcast System, n. d. ). A major problem with this healthcare system according to Tanner (2008 p . 4) is the extremely long waits for healthcare and depending upon the patient's severity of illness, a procedure such as an open heart surgery for someone deemed too ill or too old by the government may be denied treatment. Switzerland has long been considered to have one of the best healthcare systems in the world. However it is not without its drawbacks. The overall cost for healthcare and Switzerland is second only to the United States. Even still is far less than what the United States spends on healthcare. All residents residing in Switzerland are required to purchase basic healthcare insurance with them three months of residency.Swiss law requires all citizens to purchase a basic package of health insurance, an individual mandate. The term basic benefits package is somewhat misleading since the required benefits are quite extensive, including inpatient and outpatient care, care for the elderly and the physically and mentally handicapped, long-term nursing home care, diagnosti c tests, prescription drugs, and complementary and alternative therapies. (Tanner, 2008 p. 25) The Swiss government does provide assistance for those that are low income and can't afford to pay the healthcare premiums.It is expected that citizens pay no more than 10% of their income on healthcare premiums. Referrals to specialists are not required by the primary care physician. There are no exclusions for pre-existing conditions. Private rooms in the hospital and dental insurance require a supplemental policy and are not covered in the basic plan. Healthcare in Germany is based primarily on two types of insurances, public and private insurance. Anyone earning a salary in Germany must have public health insurance. This public health insurance covers not only the employee of German citizenship but all nonworking dependents as well.There is no added cost for pre-existing conditions. Pregnant women are provided public health insurance for free. The premium for the insurance is around 5% of the person’s total income. Referrals are not required to see a specialist but higher co-pay may be charged. If a person opts out of the public health insurance for private insurance he cannot go back later to the public health insurance, even if income drops below the level required for private insurance (Underwood, 2009). The unemployed people are covered through a social fund which pays the physicians fee.This paper will now discuss the healthcare system in Japan. The Japan healthcare system would probably be the most beneficial for Mr. Davis of the four countries that we have researched. There are two types of healthcare insurance in Japan, National Health Insurance and Employees’ Health Insurance. Anyone who cannot afford healthcare insurance is provided with public assistance. The premium for the Employees’ Health Insurance is usually split between the employer and the employee; although there are some companies that will pay more. â€Å"Everyone in Ja pan is covered by insurance for medical and dental care and drugs.Insurers do not compete, and they all cover the same services and drugs for the same price† (Arnquist, 2009). The government decides on the fee schedule. Insurance premiums are not held or inflated for pre-existing conditions. Premiums are based on taxable income for the National Health Insurance. This insurance is for the self-employed, retirees and students. â€Å"The financial resources for unemployment benefits are covered by insurance premiums paid by employees and employers (they equally bear the amount equivalent to 0. 8% of workers' wages) and by the National Treasury† (The Ministry of Foreign Affairs of Japan, 2011).Healthcare is free for all children under the age of six. So as a result Mr. Davis would be well covered under Japan's healthcare system. Mr. Davis will have coverage for his medications, he would be able to see any specialist of his choice although a premium might be added without ha ving a referral, and there is no denial or rate increase for pre-existing conditions and the healthcare system provides for children, the unemployed and retired persons. In summation, this paper has discussed Medicaid Part A, B, and D. There is discussion on how COBRA would help Mr. Davis continue his insurance while he's out of work.There has been discussion of at least two challenges that both local and state government would face in providing care for Mr. Davis. And then finally there is some discussion of healthcare in Great Britain, Germany, Switzerland, and of course Japan which is the system that was chosen for Mr. Davis. While researching this paper it is discovered that healthcare reform is needed not only in the United States of America but throughout the entire world as well. The hope is that one day everyone will be afforded some type of healthcare coverage. References Arnquist, S. (2009, August 25). Health care abroad: Japan.Retrieved from http://www. prescriptions. blo gs. nytimes. com/2009/08/25/health-care-abroad-japan/ Centers for Disease Control and Prevention (2009, December 31). Healthcare acquired infection and prevention plan. Retrieved from http://www. cdc. gov/HAI/pdfs/stateplans/or. pdf Cherry, B. , & Jacob, S. R. (2011). Contemporary Nursing issues, trends, & management (5th ed. ). St. Louis, MO: Elsevier Mosby. Gamser, M. (2011, September 16). US Census Shows Little Change in Number of Uninsured Americans. Retrieved from http://www. globalsurance. com/blog/us-census-shows-little-change-in-number-of-uninsured-americans-420520. tml Medicare. gov (n. d. ). Medicare Benefits. Retrieved from http://www. medicare. gov/navagation/medicare-basics/medicare-benefits/part-a. aspx? AspxAutoDetectCookieSupport=1 Paddock, C. (2007, August 20). Medicare will not pay for hospital mistakes and infections, new rules. Retrieved from http://www. medicalnewstoday. com/articles/80074. php Public Broadcast System (n. d. ). Sick around the world. Retrieved f rom http://www. pbs. org/wgbh/pages/frontline/sickaroundtheworld/countries/ Tanner, M. (2008, March 18). The grass is not always greener: a look at national health care systems around the world.Retrieved from http://www. scribd. com/doc/13673626/–the–grass–is–not-always–greener–a–look–at–national–health–care-systems–around–the–world–Cato–policy–analysis–no–613– The Ministry of Foreign Affairs of Japan (2011). Second periodic report by the government of Japan under articles 16 and 17 of the international covenant on economic, social and cultural rights. Retrieved from http://www. mofa. go. jp/policy/human/econo_rep2/article9. html U. S. Department of Labor (n. d. ). Health plans & benefits, continuation of health coverage-COBRA. Retrieved from http://www. dol. gov/dol/topic/health-plans/cobra. htm Underwood, A. (2009,

Elections and Democracy

Elections have widely been accepted as major tool for expressing the will of the people about the political government in a democratic state. It can be said that elections are a form of direct democracy as well as a democratic highway to a representative government .The concept of democracy, electoral systems and political parties is cardinal to the modern state but at the same time difficult to define. This assignment will attempt to explain these concepts and amplify the significance of electoral systems as a key pre requisite for democracy.Elections and Democracy Commenting on the concept of democracy, Makinda held that democracy can be seen as: â€Å"†¦ a way of government firmly rooted in the belief that people in a society should be free to determine their own political, social, economic and cultural systems.†1 From the aforegoing, it can be said that the concept of democracy is used to describe a political system designed to widen the participation of ordinary citi zens in government, the powers of which are clearly defined and limited. The building pillars of any democratic political systems remain without any doubt, elections which are seen as the most critical and visible means through which all citizens can peacefully choose or remove their leaders,2 In other words, elections are the principal instruments that compel or encourage policy makers to pay attention to the electorate (citizens)3 It follows that in a democratic dispensation elections require the existence of a system that allows citizens to make a political decision by voting for competing candidates fielded by various political parties holding divergent views and providing different alternatives .In this case, political opposition is held to be legal, legitimate and somewhat necessary because there will be no real test of the competence of the ruling party without the opposition in elections. It is generally agreed among political scientists that one of the key elements of a hea lthy democracy is the existence of an enduring opposition that critically checks the day to day activities of the ruling party.4 The opposition parties point out defects in the ruling parties’ public policies and make alternative proposals hoping that the voters will entrust them with power in four ,five or six years’ time. The opposition takes on the role of essentially being a government in waiting.5 It can be said that in any  political system the litmus test for democracy will be by default ,the peaceful changeover of the reins of governmental power with the opposition winning elections and constituting a government with the ruling party quietly accepting the result and not responding with violence and intimidation .A notable case is that of Zimbabwe, where the ruling party accepted its defeat in the first round of the elections of March 2008 with trepidation and almost immediately resorting to absurd retribution .6 It is with this in mind that the electoral syst em of any state takes centre stage .whether it allow the general populance to exercise their choice during elections or the system favours those currently in power. Electoral SystemsAt its 51st session in June 2002, the Venice Commission for Democracy through Law adopted a number of standards which define the democratic running of elections. These were summarised in a CODE OF GOOD PRACTICE IN ELECTORAL MATTERS (Guidelines and Explanatory Report).7 These European standards were formulated in two groups; the first group, Principles of Europe’s Electoral Heritage, includes five basic principles which are universal suffrage, equal suffrage, secret vote and direct elections .The European commission further adds the characteristic ‘periodical elections’ to the five principles.8. The second group is conditions for implementing the principals mentioned in the first group .These include: respect for fundamental rights, high regulatory level and stability of objective elec toral law ,procedural guarantees containing organization of elections by an independent body, observers at elections and an effective system of appeal . Based on the principles mentioned and the absolutely necessary conditions for implementing these principles, the Commission made the following very bold conclusion: â€Å"†¦ Electoral System. Within the respect of the above mentioned principles, any electoral system may be chosen.9. It is very clear that elections and the functions performed thereby are vital and hence require systemizing and institutionalizing. This is achieved through the electoral system. The electoral system thus consists of the legal rules, techniques and framework whereby voters express their political will by casting votes for the purpose of constituting the representative government bodies in a state. Therefore a balanced election system which contains and implements the principles of universal, equal and direct suffrage with secret voting is a mandato ry  technique of establishing and maintaining a democratic state. The electoral system is thus a critical factor in that it puts into motion the principles of Election Law as a branch of the effective objective law of the state.In applying any type of electoral system to a state, the following factors have to be analysed and answered: I. The legal and technological aspect: Finding the formula and legal techniques which will ensure those who are governed are best represented in the public authority institutions, in the process assimilating them into â€Å"those who govern†. The question would therefore be how to achieve proportionality of the votes cast and the mandates they are converted into having at the same time a stable government? II. The political aspect: How to have the election system reflect accurately the separate exercise of power in the state and promote citizen’s interest at the same time?The heart of democracy in a state depends on the implementation o f an electoral system because the will of the sovereign people designates through election of legitimate representatives who in turn are responsible before the people and supervise the Executive and the Judiciary and are responsible before the electorate in periodical and definitive elections.Types of Electoral Systems Electoral systems are by no means uniform and identical and the selection of one type or a combination of electoral system depends on a number of important variables. The legal theory10 ascertains that the general indicators of the election system are in two categories; the first category includes those factors which concern the election organization, implementation and procedures of the elections; these include the constituencies, the qualification of candidates and methods of voting.The second category provides for the rules related to the counting of the votes and the distribution of mandates that is, the valuation of given votes. When considering the different ele ctoral systems practiced in different countries, this paper will mainly concentrate on the second category (on the distribution of mandates) because this the defining factor of the electoral system and according to Professor Drumeva, it runs in two stages: The first stage is the distribution of mandates between the constituencies that is  implemented before the voting, in most cases, is a subject of legislation.The second stage is the distribution of mandates between the participating political parties/ and independent candidates if it is foreseen, the second stage is the decisive one.11 Electoral systems are broadly grouped into major categories with their own variations: the plurality system, the majority system and the proportional representation system.Plurality System Also known as the first-past-the-post or winner-takes-all system originated in Medieval England and has a centuries old history. This system is based on territorially demarcated single member constituencies, wit h the candidate or party getting the greater number of votes winning in only one round even if the proportion of votes does not constitute a majority.12The electoral system currently used in Zambia is modeled on the plurality system. Articles 63(2)13 and 77(1)14 of the Constitution of Zambia15confirm that the Parliamentary elections and based on direct adult franchise, first past the post constituency elections.The President of Zambia is equally elected by plurality through universal adult suffrage as provided for under Article 34(8)16 of the Constitution. The major advantage of the plurality system is that of personal choice. This seems to be so because votes cast for individual candidates or personalities. A notable relationship between electors and the elected is since established. Another positive for the first-past-the-post system is that it is very simple and easy to understand. In a first past the post system, elections turn into a decision of who will be the ruling party and who will be in opposition.In addition, the plurality system is considered to be less costly than other more complex systems. The first past the post formula which is practiced in Zambia, as a decisive principle of the plurality system has a concentrating and integrating on the electorate and the society in general. This effect is regarded as both a big plus and big minus. Proponents of the plurality system, point out that it ensures a working parliament and a stable, in most cases, single party government. While this may seem to be convenient, the advantages of the plurality system are offset by the most important disadvantage which critics call non-representativeness. This is because all votes cast for the losing candidate are lost and remain unrepresented.Murithi cites the system as constituting both a structural inadequacy and an obstacle to democracy in Africa’s highly ethnicised politics as the votes cast for losers are considered wasted in the sense that they do not se rve as effective instruments for expressing voters’ will.17 This assertion holds true for Zambia, where there are ten provinces and seven major tribes among over seventy ethnicities countrywide. Besa18 seems to allude to this assertion and criticizes the first past the post system as a means of electing a president by advancing the argument that in the Zambian scenario where Bemba speaking people account for over 45% of the population, he observed that if the plurality system is maintained, in the near future, all presidents in Zambia will be elected from that particular region. This will undoubtedly lead to tribal tension as the other ethnicities will feel left-out of the country’s leadership.Furthermore, opponents of the first-past-the post system regard the so called integrating effect of the system as a defect which encourages extremities in the electorate’s behavior, either through voter apathy and political interference or violent contests with unforeseeab le results. Critics of this system19 have proposed supplementary votes and proportional representation to be adopted in Zambia as a means of enhancing democracy by the increasing the participation of smaller parties in the legislature.The Majority System The majority system is a modification of the plurality system that ensures that a candidate only wins if he or she receives an absolute majority of the votes cast in the election that is one more than fifty percent of the votes cast.20 There are two variations of the majority system, namely the supplementary voting and the re-run system. In the re-run system, if none of the candidates contesting the initial votes attains more than 50% of the votes cast, the electorate are given an opportunity to choose between the top two candidates through a second round of voting known as the ‘re-run’.Where a candidate manages 50 % plus one vote or more in the first round, a second round of voting will not be required. The supplementa ry voting system is much similar to a re-run because it also operates on the basis of elimination.21 In this scenario, the top two contenders would share the  second preferences of the remaining candidates. The candidate that emerges with most votes after the allocation of preference votes have been allocated is declared the winner.Examples of countries which use the majority system in presidential elections are France, Liberia and Zimbabwe. In the last election held in France, in February 2012, a total of ten presidential candidates contested the first round of polling with none of them reaching the 50% plus one required to claim an outright victory, the top two contenders, namely Francois hollande and the incumbent Nicolas Sarkozy contested the re-run. Hollande managed to garner 51,62% of the second round vote compared to Nicolas Sarkozy’s 48,38% to be declared President of France.The undeniable advantage of the majority system, is that unlike the plural system, it places power on a candidate who can garner support from the majority and not one elected on ethnic lines. This system effectively eliminates questions of legitimacy which is a major criticism of the plurality system. Proponents of the system like Besa, contend that the majority system operates in accordance with the tenets of democracy, where the majority rules.Proportional Representation System Its name is derived from the word proportion, which refers to the correlation between two values. This system treats the entire state as one constituency or provides for multimember constituencies. The purpose of this system is to ensure that all political parties are guaranteed a place in the legislatures. The system attempts to relate the allocation of seats as closely as possible to the distribution of votes. Under the proportional representation system, there are two variables namely the single transferrable vote and the party list system. The single transferrable vote emphasizes the personal rather than the territorial principle and provides for a candidate to obtain a quota of votes which is approximately the number of votes equal to the total votes cast divided by the number of seats to be filled.This system is applied in the United States of America for the Presidential election where a winning candidate is supposed to garner a certain number of electoral college votes to be declared the winner. With the party list system, it is practically impossible for one political party  to dominate the legislature because even the smaller parties participating in elections are allowed, through their representatives in the legislature to express their views. In addition, proportional representation is economical in that, in the case of an early vacating of mandate, the seat is taken by the next candidate on the list. In an event that the candidate list is exhausted, the seat remains vacant until the next general election. In this way, no efforts or expenses are incurred to con duct by-elections as is the case with a plurality system.However, the proportional representation system under the party list system does not concern itself with majority rule but only concerns itself with issues of participation of political parties in the process of governance, thus its widespread use in countries with two legislative chambers like the United States of America and its limited use in countries with a single legislative chamber. Besa observes that the party list system is not ideal for elections to the legislature of a country with a single chamber, but rather, proposes the establishment of a second chamber in the legislature for the system to be implemented in Zambia.We can therefore conclude that there is no electoral system which is totally good from every angle. Each system has its own advantages and drawbacks, which vary in magnitude on what function fulfilled by the electoral system is put to the fore. Some writers have propagated the use of a combination of e lectoral systems so as to advance democracy. Mulenga Besa, in his book, Constitution, Governance and Democracy suggests that for democracy to thrive in Zambia, a combination of the fifty percent plus one majority and the proportional representation system under the party list formula should be employed.For this to work he suggests a Fifty percent plus one system to elect the president and proportional representation to be used to elect members of the Legislature in a two chamber system. The discussion presented in this assignment made no pretence of comprehensiveness and the suppositions that that re affirm the idea that substantial democracy demands more than just the conducting of elections without choice or caricature of elections.For democracy to flourish, it requires the careful selection of the fairest and most efficient electoral system which should mainly ensure  the systematic and regular conduct of elections, the non-discriminatory allocation of votes and broadest possib le representation of all political parties. It also requires the sustainability of de-ethnicised political parties which are diligently involved in mobilizing popular support thereby linking the demands of all citizens in forming either a reasonably institutionalized government or convincingly effective opposition.

Thursday, August 29, 2019

Research, define, and discuss what strategic philanthropy is and why Essay

Research, define, and discuss what strategic philanthropy is and why it is beneficial to organizations, as well as give one example - Essay Example It is also a creative planning process that does not just entail volunteerism and generalized charity giving, it is instead a system that requires monitoring, tracking, and strategic assessment to determine whether a philanthropy effort can be qualified a success (Putnam 2008). What does this mean? Take for example the business REDF, which is a company provider that offers technical assistance in order to help community members achieve workforce development. REDF goes a step beyond just general philanthropy: the organization has developed a total management tracking system to determine whether its workforce programs have made long-term differences in the lives of those who sought the technical support services (Brest, 2010). This is the main difference between strategic and general philanthropy, it seeks the long-term benefits either to the organization or to society as a means of building a more positive future and knowing whether the effort is worth the investment or the cost. Strategic philanthropy is beneficial to the organization because it can give consumers, business leaders, or general community citizens a more positive view about the responsibility and values of a company. Some individuals in society believe that businesses should share their wealth and expertise with others less fortunate, and strategic philanthropy efforts can influence their purchasing decision-making behavior toward the firm. A positive consumer or social attitude about a business can help the organization achieve more long-term profitability or gain better contracts with like-minded business leaders in many different industries. It can, in some instances, even improve relationships with government members who are already responsible for securing the welfare of their constituents, thus allowing for political endorsements in favor of the organization. It should be said, then, that strategic philanthropy is a vital component

Wednesday, August 28, 2019

Six blind men & Elephant Assignment Example | Topics and Well Written Essays - 250 words

Six blind men & Elephant - Assignment Example It also enables categorization of all the complex information into four simple perspectives: financial, customer, internal and innovation and learning perspective which enables minimization of information overload which is a common thing in modern business. A balanced score card tracks and indicates all the results which have been attained pointing to the high and short scores. This therefore enables the managers put strategies in place rather than exercising control and in the end the success is high and employees and customers are satisfied and happy. With a balanced score card, management of the modern business becomes easier and takes shorter time. The customers, employees and manufacturers are all satisfied by how the balanced score card makes business relations easier than before. Lastly, the financial tracking as well as operations management which have previously proved to be challenging to monitor are simplified and monitored simultaneously ensuring nothing goes wrong (Kaplan and Norton,

Tuesday, August 27, 2019

The Significance of Lyrics in a Song Essay Example | Topics and Well Written Essays - 750 words

The Significance of Lyrics in a Song - Essay Example The significance of words in a song is very well known. Indeed words are the building blocks of the songs. Any song writer will know the relevance of the words for its composition. It is the words that cause a stir in the minds of the song composer and as a result of this kind of effect; the song takes its birth. The song writer often uses special techniques so as to blend the words, to make the song quite unique and at the same time inspire the listeners. Indeed this could be considered as the real history behind the production of the songs. It is through this process by which the great song composers have been able to produce the greatest songs, ever known in the history of mankind. The power of the words is so much that, it can make the mind of the composer as well as the listener to get motivated and boosted up and take oneself to an elevated magical platform, where the inner meaning of the words can be visualized and realized. For this reason they are extremely choosy about the words and feel that a song’s whole power lies in it. ... Thus based on the song written the music is composed in such a way that, the tune fits very well with the words or lyrics and gives a unique experience to the listener. (www.scribd.com ) This technique is most commonly used in the case of popular song creation and very well seen in the case of the national anthem, where the tunes and the melody composed is made to fit with the text that is being written. It is always seen that in a majority of cases the music composers are not expert song writers due to which, they rely heavily on the lyrics and the poems written by others. This has been the common practice among the music composers down the ages and belonging to different nationalities. Almost in all the countries like England, Germany and America this system has been practiced. Examples are Franz Schubert who had been a very well known German music composer, very well relied on the poetry of many famous German poets like Heinrich Heine and many others. Aaron Copland the American mu sic composer was very much attracted to the poetry, that was written by Emily Dickinson and almost all the major musical works were based on the verses of this poet. (www.poets.org ) Thus history has been filled with several such cases which very well prove that, the greatest music composers the world over have been very much inspired by the verses of poetry written by the great poets. They get inspiration from them and tune their music based on the settings and text of the poems. It has been seen that in the modern day, it is not only the traditional music composers who tune their songs based on the poetry works but also the various rock bands and pop bands also compose the music, taking direct inspiration from the poetic

Monday, August 26, 2019

Logic and thought Essay Example | Topics and Well Written Essays - 250 words - 1

Logic and thought - Essay Example This paper contains analysis for each sub-argument and suggests how these arguments could be strengthened. The first argument is based on the claim that, until the eighteenth century, diagnoses and prescriptions of astrology were considered more reliable and efficacious than those of the medical practitioners. The arguer simply asserts their argument without citing any original sources to prove that astrology is more trustworthy than the medical profession. These original sources could include official documents or ancient artifacts; however, the arguer does not provide anything to back up their argument and thus we must dismiss it on this reason alone. For example, in Korea over 1000 years ago, rulers from the Koryo dynasty used astrology as political reference and this was an accepted practice at that time. If the arguer had provided these kinds of documents, then their argument would have been stronger and would have been taken more seriously.

Sunday, August 25, 2019

Digital media has changed the ways ideas, information, and arguments Essay

Digital media has changed the ways ideas, information, and arguments in society are communicated both locally and globally - Essay Example This revolution has changed the people’s lifestyles and actions are manipulated by the information that they can access. The availability of information due to digital technology has brought along positive and negative impacts on the new society referred to as the network society. This paper features out the various ways in which digital media has impacted on the society’s way of thinking and reasoning, and how this has changed their course of actions. In the Dark Age, an age where information was a scarce resource, the behavior of the people was so much influenced by their community traditions and social-cultural norms. Information was common only on the elite people and the society highly depended on such while working out their decisions. The elite community would misuse this privilege of having information to manipulate the reasoning of the people to make decisions that would favor their individual goals. This was common in the political arena where politicians woul d influence the voting process to suit their political ambitions during the campaign period. Deprived of the power of information the people were likely to arrive at immature conclusion and consequently uninformed decisions (Silverstone, 2005). The evolution of information technology has phased out this era and information can no longer be hoarded among the few elite in the society. Today, dense media networks are available and accessible to all humanity in the entire world, and its power cannot be ignored (Risi, 2013). The evolution of telecommunication devices and numerous service providers have brought about a whole new experience for the community with information from the global view available to the majority of the people. With television people can access live information, and with digital mobile phone communication takes place in real time across the boundaries. According to Silverstone (2005), the evolution of the digital technology has brought a new different morphology of the society, and the digital trends will have more influence on the society that it had ever been imagined. The proliferation of the internet has completely changed the world into a global village by closing in the distance that existed between different national boundaries. The emergence of video conferencing technology today people can communicate and hold conferences from their remote locations without any problem (Risi, 2013). The internet resource has become an answer for multinational corporations and international business can now be conducted at ease. The numerous social networks in the internet have formed new platforms where people can communicate, share and pass information, exchange ideas and influence the peoples thinking process, and hence their decision making practice (Silverstone, 2005). One of the areas where digital media have been used to influence the decision making process of individuals is in the political field. Today, political agendas can be propagated ac ross the world at a click of a mouse and it only takes few minutes before the entire world responds to an issue. This has had a great impact on the political campaigns since the factors of time, cost and distance have been put behind by the evolution of technology. On the other hand the people have vast information which they can use as a ground to make more informed and wise decisions. For instance, Cambodian politics general

Saturday, August 24, 2019

Analysis of the the Canadian International Development Agency Research Paper

Analysis of the the Canadian International Development Agency - Research Paper Example The International Cooperation Ministry of the Federal government, which is currently headquartered in Gatineau, Quebec, oversees the activities of CIDA. Its major objectives are social development including child protection and basic education, economic health of developing countries, sustainability of the environment, and striving for good governance, democracy, and respect of human rights by governments in developing countries. The Agency concentrates most of its bilateral aid in a select group of countries including Haiti and Indonesia. However, this concentration is not inclusive of programs offered by such multilateral bodies like UNDP and UNICEF. It does not also include assistance in fast intervention measures for natural disasters, conflict, and crisis, which are offered all over the world by the Agency’s strong hand of help (Bruneau, 2008). CIDA has made real progress in obtaining results in the arena of international development via collaboration with international, Canadian, and local partners. These results are inclusive of a drop in poverty levels from 1.3 billion in 1990 to 980 million in 2004 (Bruneau, 2008). Other accomplishments are the enrollment of more children in developing countries to primary schools, decline in child mortality, and achievement of Millennium Development Goal by developing countries like Ghana. 2. Organizational Design According to the information systems at the agency, CIDA has 2336 positions, which are, classified (Irwin, 2008). The branch in Africa is the biggest of all the branches with three hundred and eighty five positions in total. It is followed by the Asian branch, which has two hundred and twenty eight positions. After which the branch in the Americas follows with its one hundred and ninety three positions, and finally the branches in the Maghreb, Middle East, and Europe with its one hundred and fifty two positions. The policy branch, which consists of two hundred and thirteen positions, is the Agencyâ₠¬â„¢s largest corporate branch. Two hundred and three positions strong branch then follows it for Canadian Partnership, and then the branch for multilateral programs, which is one hundred and nineteen strong and finally the thirty-eight strong Canada corps. With regard to the branches dealing with a corporate service, the branch of HR and corporate services is the most staffed with three hundred and thirty nine positions. It is then followed in a distant second by the information technology and management branch with one hundred and ninety six positions, then by the branch dealing with communication with one hundred and forty four positions and finally by the Knowledge management and performance branch with its forty one positions. The remainders of the positions, which come up to eighty-five, are inclusive of the offices of the Senior Vice President, Executive Vice President, and President (Irwin, 2008). The distribution of the4 Agency’s positions is as follows. Of the two t housand three hundred and thirty six agencies classified positions, eight hundred and twenty three job positions are clumped against one of twenty-three generic descriptions of work at the agency. Administrative and Program services 1563 Social and economic science services 171 Purchasing, commerce, and audit 113 Executive group 108

Friday, August 23, 2019

Human Resource Plan Essay Example | Topics and Well Written Essays - 1500 words

Human Resource Plan - Essay Example The shares of the company are traded in the New York stock exchange, and that of Hong Kong. These shares are also traded in London, and Shanghai. Sinopec Group is believed to be the fifth largest company in the world, and this is in relation to the revenues the company manages to get (Wu, 26). In a survey conducted in 2007 by Forbes magazine, Sinopec Group was ranked as the best company in China. This is when the company was compared with some 500 companies operating in China. This company is also the largest oil refiner in the continent of Asia, and for purposes of improving its refinery capabilities; Sinopec acquired Shengli Petroleum in 2006 (Wu, 27). This company had oil filed as its main asset. This was beneficial to Sinopec because it could get some sources of crude oil for refinery purposes. The products and services of Sinopec includes gas and oil exploration, marketing, refinery, sales and production of petrochemical products, chemical fertilizers and fibers. Other services include transportation and storage of crude oil, petrochemicals, refined oil products, and other petro-related chemical products (Wu, 29). Sinopec Company is a very large organization, and on this basis, it needs an elaborate human resource plan. This human resource plan can guide the company into recruiting the best human resource personnel for the various positions it has to offer (Herholdt, 19). It is important to denote that without a human resource plan, chances are high that the organization will not be able to meet its objectives and mission. This is because chances are high that the organization may recruit human resource personnel who are not skillful enough for the various positions that are offered by the organization (Kanbur, 27). On this note, the objective of the human resource plan is to guide the management on how to recruit talented and highly qualified personnel for the various positions it has. To provide a

Thursday, August 22, 2019

Bartleby the Scrivener Essay Example | Topics and Well Written Essays - 500 words

Bartleby the Scrivener - Essay Example The symbolism of the food had important meaning in the story. Bartleby was not attracted to food, which could symbolize greed. This was subtly shown in the story by the author when he named the two other scrivener after food ( Ginger Nut and Turkey ). I was struck by the details of the scenes and puzzled at first about Bartleby. Later on, I realized that the lawyer who seemed like a decent person also used food to bargain with Bartleby. The lawyer was thinking that for a few morsels of food, he could have a peaceful conscience, thereby revealing the materialistic attitude of the lawyer. As for Bartleby’s attitude to refuse doing his job by politely saying â€Å" I prefer not to† , the issue is not all about laziness or being obstinate. It was Bartleby’s philosophy towards life that forebodes something in his past that could have made him a beaten down man .Maybe the drudgery has gotten to him and broken his spirit causing him to have passive resistance to almost everything in his life. This is what makes the story enigmatic. In the second half of the story, the lawyer is trying to remove Bartleby because he feels that Bartleby is negatively affecting his business. He is just sulking in one corner of the office the whole day. Later, the lawyer moved his office and the new tenant at the old place kicks Bartleby out. Bartleby just hangs around the hallways of the building like a specter – after all, where would he go? After some time, the lawyer finds out that Bartleby was arrested and jailed for this behavior .Later the lawyer visits him in jail but Bartleby is not interested in his concern. The second time the lawyer visited him, he has died in the yard. He died in jail because he â€Å"would prefer not to† eat. I felt the story had come to a sad conclusion until the lawyer informs us that Bartleby once worked at the Dead letter office. Bartleby found his existence meaningless after coming from there, burning letters sent to

Strategic Management Essay Example for Free

Strategic Management Essay Introduction For a company to succeed in its businesses, strategic management must be its main agenda. Managing multinational companies can be a hectic job and can end up in disarray if not well structured. Strategic management is based on a company’s top brass of management. The top management of the company is always at the center of decision making process on behalf the real owners of the company. This set up is in charge of mobilizing resources and structuring the company to match the external business environments. Formulating policies, planning and setting of objectives is the management’s concerns. Strategic management also deals with the achievement of the company’s vision through fast tracking the mission, programs and projects. In strategic management, there is a deliberate effort by the management to strike a scorecard that is balanced through evaluating the general performance of the business and the steps toward the achievement of the business’ set objective. Strategy in any business or company is in line with the expectations of all the stake holders of the business and must be based on the stakeholders’ objectives. Most multinational companies that have managed to be main players in the global business market have history of effective strategic management measures and settings. Such companies include the Coca-Cola Company, the Toyota Company, and the Hyundai Company among other multinational companies. Strategic management is the backbone of a successful multinational company or global business. Witcher Chau (2010) Background study For any company or business to be competitive in the market, there must be a high level and a well coordinated strategy management which is the fundamental aspect of tactics and goal setting. Strategic management is always vital in offering the direction to the business and its ultimate success. In business administration, strategic management and strategic consistency between the business and its environment needs to be struck. In various companies, strategic management is always undertaken by a management team which is mostly comprised of a Board of Directors among other stakeholders. Amason (2010) Different companies employ different strategic management approaches in trying to stay competitive in the business environment. The management boards in different companies apply different processes of evaluation and controlling the businesses and the various industries that are involved with the company. This is the case in two leading automobile companies, the Toyota and Hyundai companies. In assessing their competitors’ strategies, the two companies use various strategy management processes. Despite executing different strategic management forms, both companies consider basic factors in strategically managing their businesses. Such include the size of the organization and the need to adapt to the changes of the business environment. In order to achieve the objectives of any company, there are various aspects and concepts that need to be explored. A strategic management which is more structured may be employed in consideration to the size of the company, operations, requirements and the views of the stakeholders. Strategic management plays a very important role in shaping the way a business is run or the success and achievements of a company. Nevertheless, strategic management is always tied to the goals, vision, mission and the objectives of the company. In managing a company, the management board or team do work towards the views and expectations of the owners of the company or business. Hitt, Ireland Hoskisson (2009) Toyota Motor Corporation The Toyota Motor Corporation is based at Toyota at Aichi in Japan. The multinational company is an automaker with a large employee base of over 400000 employees with the largest manufacturing capacity of automobiles and specifically the famous vehicle brand ‘Toyota’. It terms of world revenue, the Toyota Company sits at the eleventh position and had manufactured an estimated 200 million vehicles in July 2012. Founded in 1937 as a family company by Kiichiro Toyoda, the company has been keen to strategically manage its businesses. The Toyota Company has had a choice of leadership that has embraced the benchmark of quality, perfect practices and corporate responsibility in the wake of stiff competition and technological advancement in the global market. Borowski (2010). The strategies of the company have been deeply rooted in principles that have continued to improve the respect for people, their strategy framework as been gearing towards waste cutting, positive attitude building and maximum utilization of the inherent talents of the workers. The Toyota Company has managed to create an impression of social responsibility in the global market. The company has exploited a number of strategies with a view of being the best company in terms of product quality and service provision vis-a-vis matching growing customers’ needs and technological advancement. The management board of the Toyota Company has been vigil to clinch any opportunity in developing and growing the company’s worth, a strategy that has gone a notch higher to see the company explore options of developing hybrid cars among other market strategies. The underlying strategy of the Toyota Company is rooted in rewarding merit and identifying faults in an attempt to perfect the product and service delivery. Through this basic strategy, the Toyota Company has managed to propel its influence and achieve an extensive customer base. Magee (2008). Strategy and management The success of the Toyota Company is attributed to its strategic management formula that has made them to remain competitive in the automobile market while maintaining the quality and efficiency of their products. The philosophy of management at Toyota Company has continued to evolve over a long period of time. This management philosophy has been built on the original value of the company which was centered on ‘Lean manufacturing and the concept of production in time. These two concepts have been vital in the development and growth of the company. The Toyota Company strives to produce designs of cars that are exclusively ideal and perfect. In its lean manufacturing policy, the company aims at achieving a customer ideal production which will eventually cumulate to customer satisfaction. In this quest, the Toyota Company has been producing different models of cars in order to meet the demands, taste and different preferences of its customers. Hino (2006). This has enabled the company to remain competitive and to have a wider market area. The business strategies and managerial values have been collectively convened into a single structure referred to as the ‘Toyota Way’. a. The ‘Toyota Way† The ‘Toyota Way’ was one of the strategies that the Toyota Company adopted in order to help them stay ahead in the automobile industry. It is a set of values guidelines of conducts that all the employees at Toyota are expected to embrace. The strategy had two main pillars; Continuous improvement and Respect for People. Liker Jeffrey (2011). All the conduct guidelines and values of the Toyota Company are summarized into major principles of embracing challenge, striving to improve their services and products, respect to customers, teamwork and a ‘go and see’ slogan. This is a strategy that the company has employed to ensure that the employees not deviate from the main objectives of the company thus enhancing success in business thus working as a driving force towards an achievement. Liker (2003). The strategy has also aided the formation of identity and has kept the spirit of quality and service which has helped the company to be outstanding among other automobile manufacturers. Alongside the Toyota Way are four other components that complement the strategy. These components include management decisions that are based on long term deliberations and a comprehensive problem solving process. Further, the aspect of focusing on the development of the people has added a lot of value to the organization. Consequently, the Toyota Company has embraced the art of organizational learning through solving the root problems continuously in the organization. Ono (1988) b. Worldwide establishment The Toyota Company has used a world presence strategy that has made them be a common household name in terms of automobile development. Through intensive marketing and strategic management, the company has expanded tremendously thus establishing factories in a majority areas in the world that deal with assembling and manufacturing of different types of vehicles. The Company has set branch factories in countries like South Africa, Turkey, Japan, India, The United States of America, Brazil, France, the United Kingdom, and Columbia and has recently established factories in Thailand, Mexico, Malaysia, Argentina, Pakistan, Vietnam, Russia, Egypt and Mexico. In this manner, the company has been able to meet the rising demand for automobiles and have provides a large variety of automobiles thus giving the customers the large variety to choose from. This is a strategy that has ensured that the products of Toyota Company are accessed by most people around the globe. The strategy of worldwide establishment does make a company to be widely known and become easier to be identified with. c. Electric technology Strategic management is all about exploring the possible options that can assist a company to be elevated above its competitors. This means that every implemented strategy needs to be suitable to effectively achieve the mission, feasible to ensure that it is applicable and that the strategy is accepted by the stakeholders. The management team at Toyota Company has explored the application of electric technology which is feasible, acceptable and suitable. In this respect, the Toyota Company has gone a long way in releasing hybrid electric vehicles into the automobile market. It has been the first company to introduce and sell hybrid electric vehicles, thus shaping the face of the automobile industry. In 1997, the company introduced the Toyota Prius and started producing vehicles that were smaller but maintaining the luxurious touch. Such cars like Lexus and Camry were received into the automobile industry with excitement, a sign of an effective strategic management implementation. Anderson Judy Anderson (2010). In 2012 October, the Toyota Prius became the hybrid car that was best sold in the whole world and this earned the Toyota Company about 2. 8 million units. This high sale was replicated in most parts of the world. Later in 2012 October, the company was the first to manufacture a passenger car that was hybrid and a motor vehicle hybrid that was one plug in model. This model was availed to around 80 regions and countries worldwide. The company has an aim of achieving the launch of a 20 hybrid vehicles models at the end the year 2015. Hyundai Motor Company. The Hyundai Motor Company has been a main player in the motor industry just like the Toyota Company. It is a multinational automotive company with it’s headquartering in South Korea in Seoul. Founded in 1967, Hyundai is ranked the forth in terms of automobile manufacturing having sold about 3. 6 million vehicles in the year 2010. Hyundai is the largest automobile company that is integrated with an employee base of around 75000 people working in the factories worldwide. Hyundai Company has applied strategic management in its success story. The company has set up 6 development and research centers across the world. The company has also an established center in California for designing automobiles specifically for the markets in the United States of America. Hyundai Company has applied various forms of strategy to remain equally competitive. The Hyundai Company has been able to establish a system of quality management which has gone forth to help the company achieve the status of a major player in automobile industries and machineries globally. In this sense, the company has realized a top class service provider status. Lansbury, Chung , Sok Suh, Kwon Ho Kwon (2007) a. Product development. Hyundai has strived to improve the quality levels of their products through application of unique procedures. The company has applied pilot production vis-a-vis researching by center engineers in an aim to meet the desired levels of production. The pilot production is a strategy that Hyundai Company used to avoid problems during the production of automobiles in mass. Through the large pilot plants, Hyundai Company is able to ensure there is quality in the production of its models. The company is also striving towards achieving a perfect product quality in order to be at the helm of profit making. Henry (2008) b. Outsourcing Outsourcing has been part of Hyundai’s strategy to maintain the quality of products they offer. This is a strategy that amalgamates various parts manufacturers who manufacture specific automobile parts before the parts are assembled by Hyundai to form complete automobiles. This strategy contravenes the Toyota policy whereby the manufacturing of the automobiles is done wholesomely by the company. The Hyundai Company outsources companies which make parts. The outsourced parts are sub-assembled into some modules which are further assembled into final automobiles. This strategic management aspect has made the Hyundai Motors Company to save a lot in terms of profits. Through outsourcing, the company has been able to shift its concentration more on marketing and product development and not to worry about the production of parts. This aspect of the Hyundai production model has been advantageous to the company as it accumulates more resources and channels them towards marketing and improving on its products. c. Advanced philosophy and Quality innovations strategies The achievements made by the Hyundai Motors have been as a result of quality innovations. The company, through strategic management organs, has weathered the challenges of hostile and competitive business environment through application of innovation. There has been an increase in customer satisfaction which has proved that the Hyundai Company has the ability to marshal massive shares in the market. As a result of aggressive and intensive innovations, Hyundai has come up with vehicles which meet the customers’ demands, wishes and comfort. This has been in line with the achievement of the company’s objective of meeting customer satisfaction and bringing ultimate elegance, enjoyment and creating confidence in its customers. The style and luxury that is aimed at by the Hyundai Company is thereby achieved. This strategy has ensured that Hyundai Company stands out in terms of class and design, making its products popular among people worldwide. Despite the growing fierce competition in the automobiles industry, Hyundai Company has managed to stay at the top in terms of quality and market base as a result of its management philosophy which is advanced. Its strategy has ensured that there is a clear cut for the future of the Company not leaving the customers behind. Hyundai’s philosophy has seen an increased favor among the customers due to its striving to make products of good quality and its main goal of laying emphasis on the satisfaction and efficiency of its products to the customers. Hyundai has continued to be a global brand name in automobiles. This has been boosted by the fact that the company has been creating an impression of fairness and transparency in terms of the acceptable and expected business ethics. d. Expansion of production Hyundai Company has employed the strategy of market expansion as a way to ensure it achieves its main objectives. It has increased the shares of its export in the market internationally and domestically. During the economic recession in the year 2009, Hyundai still managed to export 1. 3 million vehicles amidst a production capacity of 1. 6 million units. This strategy ensured that the company stayed at the top of automobile manufacturing and assembly industries when other players were diversely affected by the recession. Its marketing strategy and management strategy strength is further exhibited in the company’s success in increasing its market shares in the United States of America. This has gone a long way in improving on the quality of the company’s products. Hyundai has also extended its competitiveness in engaging in overseas businesses since the late 1990s. It has established its products in Alabama, Montgomery among other areas. In North America, Hyundai’s plant was ranked second in the level of productivity. e. Electric vehicles Just like the Toyota Company, the Hyundai Motor Company has embraced the use of electricity in the manufacture of vehicles. The company has introduced a hybrid electric automobile to match the increasing technological advancement. In 2008 November, the company introduced the first electric car which was facilitated by the technology of lithium polymer battery. In applying the electricity technology, Hyundai Company aimed at achieving sophistication, style and class in order to remain as competitive as possible. Chris, Masrur, Gao (2011). The strategy of applying electricity technology has ensured that the company has been at par with the other automobile producers to ensure that it does not lose its grip on the top spot in the global business. Society of Automotive Engineers (2000). Conclusion. Strategic management has been the center of interest for both the Toyota and Hyundai automobiles companies. Both have gone out of their way to establish global markets and have embraced the use of electricity in automobile development. Toyota Company manufactures its own vehicles from scratch while the Hyundai Company opts to outsource for parts manufacturers in order to reduce the costs incurred. The role of strategic management is evident in the two automobiles companies as both do have a team or a board of managers that is always tasked with the responsibility of formulating policies to help the company grow to transcendent heights. The board reviewing possible strategies in the companies does work towards actualizing the aims and objectives of the companies. The owners’ wishes can never be ignored in the strategic management process. References Allen C. Amason (2010). Strategic Management: From Theory to Practice. NY: Taylor Francis. Anthony Henry (2008). Understanding Strategic Management. NY. Oxford University Press. Arkadi Borowski (2010). Report on the Toyota Company. UK: GRIN Verlag. Barry J. Witcher, Vinh Sum Chau (2010). Strategic Management: Principles and Practice. UK: Cengage Learning EMEA. Chris Mi, M. Abul Masrur, David Wenzhong Gao (2011). Hybrid Electric Vehicles: Principles and Applications with Practical Perspectives. UK: John Wiley and Sons. Curtis Darrel Anderson, Judy Anderson (2010). Electric and Hybrid Cars: A History. UK: McFarland. David Magee (2008). How Toyota Became #1: Leadership Lessons from the Worlds Greatest Car Company. UK: Penguin Group. Jeffrey Liker (2003). The Toyota Way: 14 Management Principles from the Worlds Greatest Manufacturer. McGraw Hill Professional. Liker, Jeffrey (2011). The Toyota Way: Management Principles and Field book (eBook). NY: McGraw-Hill Professional. Michael A. Hitt, R. Duane Ireland, Robert E. Hoskisson (2009). Strategic Management: Competitiveness and Globalization: Cases. Canada: Cengage Learning. Russell D. Lansbury, Chung-sok So, Chung-Sok Suh, Sung-ho Kwon, Seung-Ho Kwon (2007). The Global Korean Motor Industry: The Hyundai Motor Companys Global Strategy. Seoul. Taylor Francis Satoshi Hino. (2006). Inside the Mind of Toyota: Management Principles for Enduring Growth. Productivity Press. Society of Automotive Engineers (2000). Hybrid electric vehicles. Society of Automotive Engineers. Nov 1. Taiichi Ono (1988). Toyota Production System: Beyond Large-Scale Production. Tokyo: Productivity Press.

Wednesday, August 21, 2019

Stakeholders In The Tourism Industry

Stakeholders In The Tourism Industry It always cross mind of stakeholders in the tourism industry of why people buy package trips to be on holiday or business trip they take, why visitors choose one particular destination instead of another. For the stakeholders, it is a challenge to learn and understand pre-requisite factors visitors take into consideration in choosing a destination. Holloway (1998) said that relatively little is known about tourist motivation and although numerous statistics are gathered which reveal a great deal about who goes where, the reasons for these choices are little understood. These literature reviews highlights the different theories of stakeholders and the use of Network Analysis (NA) to study the link between different destination stakeholders. Stakeholder theory is a management theory which argues that the interests of all stakeholders are of intrinsic value (Donaldson and Preston, 1995).Literatures also enlightens the different theories of motivation combine with the different authors motivational factors to explain why people travel. The pull and push motivation factors are the theories that are the most acceptable (Yoon Uysal 2005; you et al., 2000). The concept behind this theory is that people travel because they are pushed and pulled to travel by certain forces (Uysal Jurowski,1994). Uysal Jurowski, 1994 stated the push factor are socio-psychological needs related to intrinsic motivators while pull factors relates to the attractiveness and specific features of the destinations. ). LINK BETWEEN STAKEHOLDERS AND NETWORK A tourism destination may be considered as a cluster of interrelated stakeholders embedded in a social network (Scott at al., 2008a).Such a network of stakeholders interacts, jointly meeting visitor needs and producing the experience that the travellers consume. A stakeholder is any group or individual who can affect or is affected by the achievement of the organizations objectives according to Freeman, (1984, p.46). Palmer, 1996; Tyler and Dinan 2001; Pforr, 2002; developed networks as an important conduit for managing public-private relationships and understanding structures of tourism governance. Interaction of stakeholders is multifaceted. Governance is a concept used to direct the stakeholders. It refers to relationships between multiple stakeholders and how they interact with one another. It involves how stakeholders determine implement and evaluate the rules for their interaction (Beritelli et al., 2007). The Network Analysis is an applicable method used to study the link between tourism destination stakeholders while differentiating between the public and private sector. An individual firms performance depends on the behavior of others that it is directly and indirectly connected to according to Freeman (1984). The NA studies the links between tourism destination stakeholders, while distinguishing between private and public sectors.NA show in preferential order with which stakeholder they want to be in touch first. TOURISM MOTIVATION The question that is still asks by many authors and stakeholders are the factors that encourage tourism to travel, that is, motivation. Motivation refers to hat directs the behavior of the individual towards goals. It is defined as the psychological process that gives behavior purpose and direction( Kreithner,1995). According to S.P.Robbins (1997), motivation is the process by which activities are started directed and sustained to fulfill both physical and psychological needs. Whenever an individual try to satisfy a need it is classified as motivation, need is an objective interest. Robbins (1997) explained the motivation process as follows. C:UsersNathaliePictures3-8cb9d53c1c.jpg (Source: S.P. Robbins (1997), Organization Behavior: Concepts, Controversies, Applications, 7th Ed. The diagram demonstrates the willingness for individual to employ high levels of effort to reach organizational goals in order to satisfy some individual needs or self- individual needs. As shown above, unsatisfied need always lead an individual to be anxious. This state of mind is converted into tension making an individual to wish something. These wishes or drives provoke a search behavior. As from the search behavior, individual discover wants that if satisfied will lead to a reduction in tension. So, when an individual is on pressure, they alleviate this stress by making effort. The greater the stress the higher will be the effort made. This effort leads towards achieving goals set, leading to satisfaction of needs. According to the understanding of Luthan (1995), this process lies in the meaning of and relationship between needs, drives and incentives. The following section deal with the different factors stating why visitors want to visit a destination and why they choose one particular destination instead of another. To better understand the, the concepts of push and pull factors are developed. THE PUSH FACTOR A TRAVEL MOTIVATOR Travel motivations is one of the useful approaches in understanding travel needs and tourists behaviours (Crompton, 1979; Yoon Uysal, 2005).After the study done by Jang and Wu(2006), they stated that there are significant differences among travellers from different countries in terms of the level of importance attached to the push and pull factors. Starting with the push factor,it described how people are pushed to make a travel decision by internal forces (example,to have holiday, to rest or relaxà ¢Ã¢â€š ¬Ã‚ ¦) according to Uysal Hagan. Push factors are socio-psychological needs, which are related to intrinsic motivators. The Maslows (1943) hierarchy of needs is the most influential model used and its application to tourism research. All human needs can be arranged in a hierarchy of five categories according to Maslow (1970) as shown in the figure below. C:UsersNathaliePictures450px-Maslows_Hierarchy_of_Needs_svg.png According to Maslow, the human need follow these steps in an ascending manner. The most basic need is the physiological one which satisfied the basic needs of individual. Once the basic need is fulfilled, human upgrade their needs and look forward for the next level to be satisfied. However, there are cases where individuals want to satisfy a higher level though the lower level is not accomplished. Pearce (1982) suggests that travel motivation has the properties of an approach-avoidance paradigm. He developed the Travel Career Ladder (TCL) in accordance with the Maslows hierarchy of needs as a conceptual framework. The aim of the TCL is to show how peoples needs change as experience increase. Pearce classified the TCL into five steps starting with the lowest; Relaxation Stimulation Relationship Self-esteem and development Fulfillment TLC proposes that people progress upwards through motivational levels with accumulated travel experiences (Lee and Pearce, 2002). The TLC demonstrates how individual start their travel career at a low level, that is, Relaxation. As individuals become more experienced travelers, they advance for higher goals until they reach high level of fulfillment. E:070360103001.png It is recognized that the push factors contribute in the study of tourism behavior and understand a wide variety of needs that can be influential motivator to tourist behavior. Cohen (1972, 1979a, 1979b) contended that what tourists want is not merely to satisfy their psychological needs but authenticity of the destination. So, the other factor which could motivate people to travel must be taken into consideration. The following section will focus on the external motivator. THE PULL FACTOR The pull factor focus on another aspect of tourism behavior. Pull factors are external and related to the attractiveness and specific features of the destination (Uysal Jurowski, 1994). They are the general features of tourism regions that people recognize as touristically agreeable and attractive, such as culture, traditions and heritage, nature, amusement among others (Peters, 1969).After the study on travel motivators of Yuan Mc Donald, Jang Wu (2006), Mohammad Mat Som (2010), Jang Wu (2006) asserted that common pull factors found in most studies were natural and historical environments, safety, cost, ease of access, and facilities. A destinations attractiveness pulled individuals in their travel decision. Dann (1981) asserted that it is comprehensible that researchers focus attention on the pull factors of tourist behavior, since they symbolize the specific attractions of the destination, which tempt once the decision has been made. Dann(1981) also claimed that the pull factors of the resort such as sunshine, relaxed tempo and friendly natives , both respond to and strengthen push factor motivation. DIRECT RELATIONSHIP BETWEEN TH E PUSH AND PULL FACTOR Peoples motivation to travel has been discussed on a multidisciplinary basis since the aftermath of the Second WorldWar, when mass tourism began to thrive. It is not only a matter of explaining, from a psychological perspective, why some people travel and others do not (Crompton, 1979; Dann, 1977; Plog, 1974). Plogs (1974) With travel personality, P. L. Pearces With (1988) travel career ladder (TCL),and Cohens With (1972) concept of strangeness-familiarity, try to show the possible factors that drives people to travel. Plog use the travel personality to model to study why do some people do no travel. He based himself on psychological impetus. Push-Pull framework a motivational paradigm Moreover, Plog (2001) use the Travel Personality model to study why some people do not travel. Plog (1974) concluded that nontravelers are indeed nonadventuresome and proposed the notion of travel personality in this sense; dependable, near dependable, mid-centric, near venturer, and venturer types. In his model, emphasis is laid on psychological impetus. Cohen (1972, 1979a, 1979b, 1984), from a sociological perspective, set his model in a broader social context, arguing that tourism is essentially a social phenomenon. Tourists therefore should be analyzed by underscoring their relationships with both business establishments such as tour operators and the destination (Cohen, 1972). Highlighting social relationships in the tourism system remains the most remarkable distinction of Cohens (1972) model, which is represented by the concept of strangeness-familiarity. This concept is constructed by breaking down Boorstins (1964) holistic image of the tourist into more specific and empirically identifiable types,namely, the organized mass tourist, individual mass tourist, explorer, and 122 Yong Chen, Barry Mak, and Bob McKercher drifter (Cohen, 1972). As Plog, Pearce and Cohen focus in the same field of study, they all use their model to represents an integrated motivation framework. The aim behind is to show the possible linkages among the three models. Diagrams + Explanations (It is taken for granted in this framework that the destination represents the pull factors of tourist motivation, whereas characteristics of individual tourists represent the push factors (Crompton, 1979). However, at a destination such as in a city with a complex of economic, cultural, and historical attractions and heritages, tourist behavior may demonstrate a pattern other than those indicated by, for example, the distance decaying effect from the origin to the destination.)

Tuesday, August 20, 2019

Treating diabetic foot ulcers

Treating diabetic foot ulcers The aspect of professional practice I choose related to my role as an adult nurse was diabetic foot ulcers. I choose this topic because it is often seen and treated by nurses and so understanding the treatments available and the effect living with diabetic foot ulcers has on individuals in very important. The first article I am going to discuss and evaluate is the ‘short report: the effect of topical phenytoin in healing diabetic foot ulcers: a randomised control trial’. This was located from the Diabetes UK website. This article explores how the use of a topical treatment for treating diabetic foot ulcers may be more conducive for the healing process as it contradicts the need for medical intervention as well as minimising patient caused to the individual. This study concludes that there were no changes in the diabetic foot ulcers being assessed between the two trail groups. This implies that the study doesn’t support the use of phenytoin in the treatment of diabetic foot ulcers. In relation to the hierarchy of evidence, this article falls under randomized controlled trials, which is the second from the top on the hierarchy. The National Institute for Clinical Excellence (NICE) defines a randomized control study as ‘A study in which a number of similar people are randomly assigned to two (or more) groups to test a specific drug or treatment. One group (the experimental group) receives the treatment being tested; the other (the comparison orcontrol group) receives an alternative treatment, a dummy treatment (placebo) or no treatment at all. The groups are followed up to see how effective theexperimental treatmentwas. Outcomesare measured at specific times and any difference in response between the groups is assessed statistically. This method is also used to reducebias.’ (NICE 2013). According to the British Medical Journal (BMJ), randomised controlled trails are the most thorough and precise technique of assessing if the participant is reacting p ositively to the treatment they have been administered. This also contributes towards managing the monetary value of the study and its effectiveness. The BMJ states that this method of evidence can come with some ethical issues one being, ‘exposing patients to intervention believed to be inferior to current treatment.’ (1998). They also express that although not all studies conducted by this means may be unethical, the validity of using this method may be unreliable, one of the main reason for this is due to the struggle to get the population to sign up to be a participant in the trail. In a case study directed by Wootton R. (2000), it can be argued that although treatment offered in RCTs may be inferior to current treatment, it can work for the benefit of the participant and when it does the results are more desirable than what was seen from current treatment. The second article I am going to discuss and evaluate is ‘debridement of diabetic foot ulcers’. This article was located in the Cochrane library. This article studies the debridement of foot ulcers and what impact it has on healing the diabetic foot ulcer. It also explores the use of dressings on the wound and what dressings apart from the standard gauze had a positive impact on the healing process. The findings of this study showed that the dressing that was being trailed had a positive impact on healing DFU and in an increased time compared to the standard gauze. From this article it Is clear that debridement as well as the other dressing which was trailed has a profound effect on the healing of DFU’s which may have a direct impact on the variations of dressings nurses have to treat diabetic patients. In accordance to the hierarchy of evidence, this article is a systematic review which comes at the very top of the hierarchy. The Cochrane Collaboration agree syst ematic reviews are the most reliable if they are carried out correctly because ‘Researchers conducting systematic reviews use explicit methods aimed at minimizing bias, in order to produce more reliable findings that can be used to inform decision making.’ (2013). This definition has been demonstarted in the article which has been chosen as they have managed to keep to the strict methods used to eliminate bias. One of them being randomised controlled trails. This type of trial ensures that all participants are randomly put in control groups where they would receive a placebo or the actual drug. This trail is strictly confidential as only those people conducting the study not assisting know which group is receiving what drug. All results obtained from the trail are ‘assessed by rigorous comparison of rates of disease, death, recovery, or other appropriate outcome in the study and control groups.’ (The Centre For Evidence Based Medicine. 2013). Leibovici L an d Reeves D also hold systematic review in high esteem describing it as a ‘powerful tool deployed in the pursuit of evidence based practice.’ (2005). They argue that systematic reviews do not just focus on the drug or treatment in question but highlight questions which are important to patients from the point of view that the patients well -being is the primary outcome of the study. Whereas in some clinical trails the primary outcome would reflect the need to save resources or to attempt to claim that certain treatments have an advantage which isn’t always the case. Despite systematic reviews appearing to cover all areas, some researchers have conflicting views on the expenses involved to run a study using individual patient data (IPD). According to Stern and Simmes (1997) IPD is much more expensive and time consuming than other research methods. However it is argued that due to the advancement of technology obtaining patient data is not as time consuming or expensive than in the 90’s. The final article I am going to discuss and evaluate is â€Å"Whatever I do is a lost cause.’ The emotional and behavioural experiences of individuals who are ulcer free living with the threat of developing further diabetic foot ulcers’. I obtained this article from the online Wiley Library. The article is relevant to my discipline as nurses treat many patients who currently have or have had diabetic foot ulcers in the past. This article gives and in depth picture of the fears of those who have had successful treatment for their DFU but are afraid of them returning. This article homes in on the feelings of the patients and how different aspects of DFU and the possible consequences affect their lives and how they approach the condition. However it doesn’t acknowledge how beneficial the treatments they received were. And the effects it had on them emotionally and physically if any. This article is qualitative study which according to the hierarchy comes at the bottom under the heading expert opinion. The Office of National Statistics use Ritchie and Lewis (2003) definition of qualitative study which is, ‘a naturalistic, interpretative approach concerned with understanding the meanings which people attach to actions, decisions, beliefs, values and the like within their social world, and understanding the mental mapping process that respondents use to make sense of and interpret the world around them’. The National office for statistics continues on the say that qualitative research offers an extended understanding of the subject and information related to it. Moreover it explains reasons for certain findings, evaluate how effective the study was and how it would aid their research. According to Ewe Flick the need for qualitative research has increased in the last few decades due to the rapid changes of society. He refers to it as a means to keep up to date with the current situations. Although qualitative research has been a fundamental study for the past couple decades, there are many defects in this method. Becker and Geer (1960) highlighted the fact that although the interviewer and participant speak the same language, there may be some discrepancies with the interpretation, which in effect may leave the interviewer without information he needs/ wanted. According to Beaker and Geer another reason it may be difficult for the participant to open up about certain issues which are bought up. This again may be another factor which prevents the researcher getting all the information they need. There also positives to this research method. Qualitative research is also known as going out on the field because the researcher has to find the participants and in some ca ses has to meet in an environment that suits them. The advantage of this is that if a participant who is being interviewed about a sensitive subject is in the comfort of their own home then they may feel more able to talk about the issues raised as Crabtree and Miller (1991) suggested. References Leibovici L Reeves D. (2005) Systematic reviews and meta- analysis. Journal of antimicrobial chemotherapy. Page 803. Volume 56. The Cochrane Library. (2013) http://www.thecochranelibrary.com/view/0/AboutCochraneSystematicReviews.html Last accessed 12th January 2014 Sage Publications (2002) http://ehp.sagepub.com/content/25/1/76.full.pdf+html Last accessed 11th Janurary 2014 Flick U. (2009). Introduction to Qualitative Research. 4th edition. London. Sage Publications Office for National Statistics- http://www.ons.gov.uk/ons/guide-method/method-quality/general-methodology/data-collection-methodology/what-is-qualitative-research-/index.html last accessed 12th January 2014 National Institute for Health and Care Excellence (2011) http://www.nice.org.uk/website/glossary/glossary.jsp?alpha=R Last accessed 12th January 2014 British Medical Journal (1998) http://www.bmj.com/content/316/7126/201 Last accessed 12th January 2014 British medical Journal (2000) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC27370/ Last accessed 12th January 2014