Pay for Performance and Unionization

Pay for Performance (230 words)
There is a trend in moving towards pay-for-performance as
the preferred mechanism for compensation (rather than through seniority,
skills, knowledge, etc). Discuss the challenges with implementing a
pay for performance system in the public sector (especially since it
is more challenging to determine productivity and performance with
public programs such as welfare, crime, student performance, etc).

Unionization (230 words)
Nearly 40% of public sector employees are members of a bargaining unit
or union (versus approximately 8% for the private sector). Evaluate
and discuss the impact unionization has on public sector productivity,
both the advantages and disadvantages

Pay for Performance and Unionization

The pay-for-performance system has been a successful means of increasing productivity within the private sector for a long time. Instead of using knowledge, the level of education and the skills, that one has in order to evaluate his or her performance, organizations have long since migrated to the use of general merit to rate the effectiveness of an employee. Employees that are considered best in their performance are given financial incentives. This is after meeting the quantifiable goals that are predetermined during the delegation of duties (Bregn, 2015). Introducing this system into the public sector becomes a source of more challenges because it is not commonly used.

Using pay as an inventive to reward employees does not necessary work for every employee. This means that not everyone is entirely works smart in order to get the reward of money. There are those employees that derive motivation through being praised, recognition as well as accessing opportunities of handling assignments that are better (Bregn, 2015). The other looming danger that is caused by the implementation of the pay-for-performance system is the lack of adequate funds for sustaining the program. The budget for public sector organizations is usually fixed and therefore, employees are rated using their seniority and grade levels. It has been noted that there is a constant conflict between the rate and the ones being evaluated. This results in employees lack of confidence in the  performance evaluation techniques that are employed (Bregn, 2015). The existence of these conflicts is the source of bias and compromises the implementation of pay-for performance system in the public sector.  


Bregn, K. (2015). Pay for performance in the public sector: the challenge of fairness. International Journal of Behavioural Accounting and Finance5(2), 122.


The unionization of workplaces has become a subject of debate in the recent past especially in the public sector. This prompts employees to make informed decisions in a bid to weigh the advantages and disadvantages of joining unions. Primarily unions are significant groups that help in the oversighting the rights and needs of employees. They act as watchdogs for the proper treatment of employees by the employers and if they violate their rights, they will help their clients to sue their bosses. Unionized employees are said to earn higher wages as compared to those that are not unionized (Pontusson, 2013).

With this trend evident in the public sector, it spells doom for the productivity in the public sector. Increased pay for the public sector employees means that the government organizations has to spend more on remuneration and few funds on the exploitation resources and provision of facilities necessary for effective operation of these organizations. Additionally, allowing employees to join unions has been one of the nightmares in the public sector. Employees have been noted to be spending much time in handling cases that deal with pay rise and poor treatment at their workplaces. This means that the lost time is essential for accomplishing the different goals and tasks that increase productivity. In this case, the public sector faces a big decrease in productivity (Pontusson, 2013). On the other hand, union members are legible to present their lamentations about their work environment. Therefore, the managers in public sector can access information about the possible ways to improve the environment of their employees so that they can give their best in terms of productivity.


Pontusson, J. (2013). Unionization, Inequality and Redistribution. British Journal Of Industrial Relations51(4), 797-825.

Internet Small Computer System Interface (iSCSI)

A fictional company called Craft Digital is among the best software developers in South Africa with a workforce totaling 130 staff members. Out of the 130 staff members, 80 are on permanent employment while the rest are in temporary employment. Managing such a firm requires dedicated and instinctive individuals who spearhead innovation in the company. The company that began in the late 1990s has a clientele database comprising of financial institutions and has developed over 200 software packages implemented by a majority of financial institutions in South Africa. On an economic scale, the company tops its competitors in the region with an average annual financial gain of over $300,000 after all deductions inclusive of salaries and allowances. Recently the company ventured into the mobile applications development niche due to the advancement in technology. Additionally, its clientele has shifted to mobile banking thereby forcing the company to adopt the recent innovation.

As a technological company, the company relies heavily on the Internet and advanced software systems to ensure its clientele and products are well equipped and online 98% of the time. The firm makes use of Microsoft servers to conduct its internal processes such as communication, data storage, application hosting, and so forth. The company has opted to adopt iSCSI (Internet Small Computer System Interface) to enhance its network connectivity. iSCSI operates on top of the TCP (Transport Control Protocol) allowing SCSI (Small Computer System Interface) commands to be sent end-to-end over the Internet, LANs (Local Area Networks), and WANs (Wide Area Networks) (Chadalapaka, Satran, Meth, & Black, 2014). Moreover, iSCSI is one of the popular SAN (Storage Area Network) protocols due to its ease of use and management. The adoption of iSCSI has numerous advantages to the company that boosts its economic growth and productivity (Chawla, Narayanan, & Iyer, 2015). In the next section, I will look into the business and financial impacts of Internet Small Computer System Interface (iSCSI) at Craft Digital.

Business Impacts

Reduction in Server Administration Staffing Expenses

Virtualization requires less personnel to manage and maintain it (Chaudhry, Malibiradar, Mathur, Chugh, & Harfoush, 2013, December). Implementing iSCSI at Craft Digital will assist in the reduction of the server administration staff members thereby reducing the costs the company incurs when remunerating the personnel. Additionally, those removed from the server administration staff can be assigned to various positions within the firm thereby increasing the productivity and profit of the business.

Reduction in Numbers of Existing Servers

iSCSI is more of a virtualization technology and requires less hardware to operate efficiently. When Craft Digital implements the technology, there will be no need for additional servers in the organization and those in excess will either be sold off or stored for future use. Reducing the number of operational servers in the firm reduces several expenses such as power consumption costs thereby affecting the business positively.

Avoidance of Server Replenishment Costs

iSCSI uses the current servers in the firm, therefore, avoiding server replenishment costs. Replenishment is the movement of inventory from the reserve locations to primary locations. At the reserve location, inventory is stored while when at the primary location inventory is shipped or picked. Replenishment ensures there is no inventory overstocking which may affect a business negatively.

Reducing Power and Cooling Required

iSCSI requires few servers in operation to perform its tasks. Unlike before, Craft Digital saves on power usage and the cooling expenses at the firm. The few the servers the lesser the power and cooling is required. A reduction in power and cooling has a positive impact on the business since there is a reduction in expenses, which translates to increased profit margins.

Financial Impacts

Reduced Costs of Operation

Implementing iSCSI at Craft Digital reduces the costs of operation greatly by increasing the manageability and storage utilization. Easing manageability enables the firm to focus on other vital areas of interest the company has, therefore, increasing the returns and profit margins. In the past, the allocation of numerous funds was to data storage and management of the systems at the firm and additional workforce. The trend led the company to financial losses that threatened its existence due to the rising competition from rival firms that had implemented iSCSI in their operations. Internet Small Computer System Interface has positive impacts on the financial status of a company when correctly implemented.

Eradication of Training Costs

Unlike other implementations such as Fibre Channel, iSCSI does not require advanced skills to implement. In the past, the company allocated numerous funds to training the staff members whenever a new technology came into existence. However, with the implementation of iSCSI, there is no need for the training session since the technology requires a familiarity with TCP/IP technology to implement. The personnel at the firm are conversant with TCP/IP technology hence installing, configuring, and managing the internal network will not require additional knowledge. The eradication of training costs are beneficial to the financial position of the firm since funds will be channeled to other areas requiring advancement or training thereby the technology is economical in nature.

Reduced Acquisition Costs

Since the company relied on the traditional TCP/IP technology, there will be no need of acquiring novel equipment to enhance the implementation of iSCSI technology. iSCSI uses the same network storage equipment from different vendors amalgamating them to form a system that works together seamlessly. Additionally, the technology offers advanced, better, and simple network storage solutions, which reduce the need for additional storage devices (Dey, Chakraborty, Naskar, & Misra, 2012, October). The technology works using the same gadgets the LAN was using in the company thereby lowering hardware acquisition and initial costs the company will incur. I would recommend organizations adopt iSCSI instead of the Fibre Channel since it is cheaper, better, and easy to implement, configure, and maintain.


Chadalapaka, M., Satran, J., Meth, K., & Black, D. (2014). Internet Small Computer System Interface (iSCSI) Protocol (Consolidated) (No. RFC 7143).

Chaudhry, M., Malibiradar, P., Mathur, V., Chugh, R., & Harfoush, K. (2013, December). Performance analysis of iSCSI with data center bridging suite of protocols. In 2013 High Capacity Optical Networks and Emerging/Enabling Technologies (pp. 179-183). IEEE.

Chawla, G., Narayanan, R., & Iyer, S. T. (2015). U.S. Patent No. 8,972,616. Washington, DC: U.S. Patent and Trademark Office.

Dey, S., Chakraborty, A., Naskar, S., & Misra, P. (2012, October). Smart city surveillance: Leveraging benefits of cloud data stores. In Local Computer Networks Workshops (LCN Workshops), 2012 IEEE 37th Conference on (pp. 868-876). IEEE.

Walmart’s Expansion Strategy in Africa


One of the largest retail businesses is Walmart Inc. With the constant growth and development observed in this corporation, it is of no surprise to note that the company does engage in regular expansions of its outlets. This has successfully been done in countries such as China and Canada. The involvement of this Company in these ventures has helped it to launch a platform for interacting with many customers around the globe. The secret behind its exemplary performance in attracting customers on a large scale is the implementation of the `Every Day Low Policy’ policy (Kenny, 2014). The Company also largely depends on the customer-centered strategy of allowing customers to return items that they purchased and found out that the products had some defects.

In order to come up with a strategy that would help evaluate the demand of its products in Africa, the Company decided to start by extending its services to South Africa. This is one of the best-performing countries in terms of socioeconomic growth and development. Going by the report that many of the African countries have shown reasonably good economic growth over the years, Wal-Mart Inc has developed a strategic plan of fully venturing into this market.

Wal-Mart plans to officially enter into the African market due to the increased levels of consumption that have been recorded in this continent.  Therefore, the plan would commence with acquiring giant retail in South Africa under the name of Massmart. However, it is expected that the company would face many challenges that lie in the cultural and infrastructural aspects (Kenny, 2014). Since the securities and legal framework for handling business risks are weak in the continent, it is projected that the company will experience this as one of the major challenges as well. The entry into the African market will also see the company experience uncertainties in consumer fluctuation.

Walmart Company’s Actions

With the existing mutuality between the company and local cultures; employing the locals of the countries that the Company operates in, Wal-Mart Inc has learned its lessons despite the failures. Finally, the company has decided to invest in the African continent. The company decided to enter the African market by taking over Massmart Holdings Ltd of South Africa by purchasing $2.4 billion of its shares. This would amount to a 51% stake of Massmart being given to Wal-Mart (Kenny, 2014). Through the deal signed with the South African giant retail outlet, it would be possibly an easy task to access the sub-Saharan Africa market as well. This is in connection to the fact that Massmart has 288 stores which are situated in 14 countries in the sub-Sahara.  In this strategic plan, Wal-Mart has promised to make sure that within a span of two years, there is no employee is fired regardless of the financial status of the company. In order to increase the sales and expand the customer loyalty base, the company has resorted to low prices, efficient operations, hiring of local managers, and making use of technical expertise that the local people possess.

Specific Global Strategies

In this plan, it is observed that Wal-Mart opting to enter into the difficult to predict the African market through Massmart was the best strategy. This is advantageous because, Massmart has enough knowledge of the African market (Kenny, 2014). The shared sourcing of the two companies, additionally, would help the company to flourish and seek amicable solutions t the challenges that they might face in the market. The company has already established supply for its products and therefore, supply chain management would be easily be maintained. Despite the challenges that are projected to be a hindrance to the company’s operations, the sub-Saharan countries would be huge scope for business expansion. These strategies are globally accepted and used by other international companies in order to expand their market and competitive advantage (Chang, 2012).

The use of local expertise in each of the countries that they will invest in will be one of the applauded global strategic plans of garnering support from the local customers as well as developing a liking (Chang, 2012). As outlined in business, this amounts to corporate social responsibility and with this in place, more jobs will be available for the unemployed. When a corporation blends with the local communities in order to better their lives by offering low prices for their goods and services and creating job opportunities, the customer base for the company in question grows and keeps the business going (Brea-Solís, Casadesus-Masanell, & Grifell-Tatjé, 2014). This strategy has been employed by Walmart for its entire time of operation. Therefore, it has worked before and would work with the unexploited African market.

The company’s initiatives are not new and have been tested before; despite the challenges that they have faced in the past, it is evident that gradually, the growth of consumption of Walmart’s products in Africa will progressive (Brea-Solís, Casadesus-Masanell, & Grifell-Tatjé, 2014). In comparison to other nations that the company has ventured into such as china, Canada, and Mexico, it is pretty clear that the successes surpass the failures. It is expected that a similar scenario will be noted in the African continent. It would be advisable for the company to ensure that there is no rush to the plan that they have laid down. At this point, one step should be taken at a time by studying the market knowledge, the culture and the connections that they can create in order to make a strong foundation (Hise & Barcan, 2011). The mistakes that the company made in its expansion plan in Germany, Japan and Korea should be a source of learning and making the right decisions about the African market.


Brea-Solís, H., Casadesus-Masanell, R., & Grifell-Tatjé, E. (2014). Business Model Evaluation: Quantifying Walmart’s Sources of Advantage. Strategic Entrepreneurship Journal9(1), 12-33.

Chang, B. (2012). Strategies of Post-entry Foreign Expansion: Speed-up or Slow-down?. IBR5(8).

Hise, R. & Barcan, D. (2011). Vinchel Contemplates Market Expansion Strategies. Journal Of Business Case Studies (JBCS)4(1), 1.

Kenny, B. (2014). Walmart in South Africa: Precarious Labor and Retail Expansion. International Labor And Working-Class History86, 173-177.

Workplace Diversity

  • What are strategies that companies have implemented or should consider implementing to effectively address the challenges and opportunities of workplace diversity?
  • Refer to a best practices model of at least one organization in any industry that has successfully implemented an innovative diversity program, which can be modified and replicated on some level

Workplace Diversity

Diversity at the workplace encompasses the different aspects envisioned in the workforce (Gotsis & Kortezi, 2015). Some of the aspects include age, gender, race, and ethnicity. Businesses require strategies to handle the diversity in the workplace thus improving and increasing the production and profits respectively. In the paper, I will answer two questions pertaining to the strategies companies implement or should implement to address the opportunities and challenges resulting from workplace diversity, and an example of a practice that other businesses can replicate and modify to implement innovative diversity programs. Addressing the problems arising from workplace diversity should be a priority for modern-day firms or companies due to the increasing levels of globalization.

Several strategies that companies should implement or are already implementing to address the opportunities and challenges arising from workplace diversity include the Utilization of diversity training; Fostering attitudes of openness; Promotion of diversity in managerial positions; Warding off change resistances using inclusion; and Launching customizable workforce satisfaction surveys that provide comprehensive reporting (Lambert, 2016). The mentioned strategies are just a few of the numerous applicable strategies that companies apply to handle workplace diversity. The utilization of diversity training helps businesses in shaping their diversity policies thus ensuring each employee understands workplace diversity. Fostering attitudes of openness in the companies helps in promoting employee openness to opinions and ideas thereby creating an environment where each employee feels valued by the business. The promotion of diversity in managerial positions creates an environment where the benefits and visibility of workplace diversity are evident thereby creating a sense in the employees that no particular aspects arising from diversity are at play during enrollment or application. Warding off change resistances using inclusion ensures each employee is involved in the formulation and execution of diversity initiatives thus eradicating the sense of alienation at the workplace. Launching customizable workforce satisfaction surveys that provide comprehensive reporting ensures that companies have realistic statistics before the implementation and design of successful diversity in the policies applicable to the workplace.

The Coca-Cola Company implements a diversity program that is replicable or modifiable at some level by other businesses; the diversity program of the company entails fairness and inclusion in all the business’ aspects (“Global Diversity Mission,” 2015). Coca-Cola further considers diversity as a concept encompassing all business operations and not just the practices and policies. Involving all the stakeholders in the assessment of workplace diversity makes it easier for the company to determine the obstacles and challenges present thus aiding in the redesigning or elimination of some of the existing policies concerning diversity. Additionally, the company can reassess the applicable policies and strategies to determine its success in the industry due to the implementation plans adopted. Coca-Cola is a global business operating in regions harboring diverse populations, and its adoption of diversity programs ensures it remains a leader in its niche of operation. Other firms can replicate or modify the diversity program used by Coca-Cola to eradicate cases of workplace diversity.

Conclusively, one of the key forces leading to the rise of workplace diversity is globalization; many companies are hiring employees from different backgrounds, genders, ethnicity, races, and ages. A business’ primary goal is to realize maximum revenues and promote employee satisfaction at the workplace. Coca-Cola is one business that has successfully implemented workplace diversity programs that other firms can replicate or modify to suit their needs. Most companies implement various strategies such as the utilization of diversity training, fostering attitudes of openness, promotion of diversity in managerial positions, warding off change resistances using inclusion, and launching customizable workforce satisfaction surveys that provide comprehensive reporting.


Global Diversity Mission. (2015). The Coca-Cola Company. Retrieved 27 October 2016, from

Gotsis, G., & Kortezi, Z. (2015). Workplace Diversity: A Resource or a Source of Conflict?. In Critical studies in diversity management literature (pp. 1-12). Springer Netherlands.

Lambert, J. (2016). Cultural Diversity as a Mechanism for Innovation: Workplace Diversity and the Absorptive Capacity Framework. Journal of Organizational Culture, Communication and Conflict20(1), 68.


  1. What Is Entrepreneur Ship? What is the relevant importance of entrepreneurship to the American economy?
  2. What are the advantages and disadvantages of entrepreneurship?
  3. Discuss the advantages and disadvantages of Entrepreneurship?
  4. What factors should you look for in buying a used business?


Entrepreneurship entails the risks taken in a bid to develop, organize as well as engage in management activities of a business enterprise with the expectation that it will thrive in the constantly evolving competitive global market. The American economy is supported entirely by small and medium-sized businesses. An approximate of 70% of the whole employment opportunities that exist in America are created by the small and medium-sized businesses (Che Xu. 2011). These businesses are entrepreneurial adventures of that innovative and investors have launched with the aim of creating job opportunities and earning a living. Therefore, the new innovative products that are quality and are sold at low prices help people save and become productive and wealthy in the American economy.

Advantages of Entrepreneurship

Entrepreneurship offers the owner of the business venture a control over the entire business and its operations. In this case, the owner has control over the activities that he or he can engage in, especially those that are inclined to the individual’s skills and strengths. People love to work on tasks that they enjoy and since the expertise and skills of these entrepreneurs are in what they find enjoyable, they are always excited to discover more opportunities on a daily basis (Che Xu. 2011). Since entrepreneurs can work o the tasks that they enjoy, it is worth noting that their schedules are flexible. This flexibility means that they have freedom of working when they want, wherever as well as however they want it to be done.

Disadvantages of Entrepreneurship

Administration tasks are entrusted in the hands of an individual which proves to be a burden to them because of the paperwork that takes up the energy and time of the entrepreneur. The administrations of tasks are driven at ensuring that small businesses stay in the competition (Che Xu. 2011). Similarly, to sustain its competitive advantage, the business needs to have a unique product that is different from its competitors in the market place. In entrepreneurship, it is common to note that entrepreneurs that there is no regular paycheck. Sometimes the business slows down and puts one’s personal income at a risk.

When setting out to buy a business enterprise that already exists in the market place it is necessary to consider the following factors:

  1. the reason the owner is selling the business
  2. an analysis of the business on sale
  3. the operational adjustments that need to be made
  4. The name of the business that is on sale


Che Xu. (2011). An analysis on advantages and disadvantages of C2C E-commerce in entrepreneurship. 2011 2nd International Conference on Artificial Intelligence, Management Science and Electronic Commerce (AIMSEC). doi:10.1109/aimsec.2011.6009848

Google Corporation’s Situational Analysis

Student’s Name


Instructor’s name


Google Corporation’s Situational Analysis

Google Company has been one of the strongest companies that have been in operation for long. It is characterized by a continued high growth rate in the past five years. The Company operates worldwide in a market that has strong competition. Using the SWOT analysis tool, it is evident that the Corporation has a strong foundation.


Google Inc. enjoys a high power of substitutes with no switching costs incurred. Additionally, the company does not give power to the suppliers. In this way, it proves that the company has control over the production, the supply of products, and the pricing (Durica & Svabova, 2015). In order to maintain the customer base in the market place, Google Inc. offers moderate power to its customers. This is to ensure that the customers dedicate themselves to purchasing from the company. It also indicates that they have a share in enjoying the control of market prices of its products as well as the quality.


Despite of the existing big range of strengths that give it dominance in the corporate world of technology, some weaknesses are evident and they pose challenges to the corporation. Primarily, the corporation is dependent on the internet (Durica & Svabova, 2015). The company has to wait for improved network coverage in order to expand its services to developing countries. This presents a challenge to the business in comparison to other competitors such as Apple that has in the establishment of physical presence in the same countries.


Based on technological changes, the company can engage in the tapping of the existing mobile users in order to offer them products that are mobile user friendly. Additionally, Google is well-positioned in a bid to offer fiber coverage and expand it to many countries. In this way, the overall revenue will increase greatly.


Despite the lucrative opportunities that are promising, some significant threats have been observed in the operations of Google Company. Over the years, more companies have come up and presented tough competition to Google (Durica & Svabova, 2015). Such companies include Apple and Yahoo. The existence of these companies means that they produce products that are similar to Google’s and thus imitation of products weakens its competitive advantage in the market.

The tentative target market of Google Inc. is each individual that has access to the internet. With the large potential market of an estimated a billion-plus customers. This means that its marketing objectives should be based on tapping customer potentiality.


Durica, M. & Svabova, L. (2015). Improvement of Company Marketing Strategy Based on Google Search Results Analysis. Procedia Economics And Finance, 26, 454-460.

Risk Management

Factors that affect foreign exchange risk

Risk presents a basis for opportunity. It is the likelihood that losses will result from certain events e.g. market price fluctuations. To any economy, these risks pose a great threat. The following are factors that influence foreign exchange risks;

  1. Interest rates – A country with higher interest rates compared to its neighbors offers lenders an opportunity to make more returns when they invest in the country. Investors attracted by high-interest rates, they purchase the currency of the country leading to a higher exchange rate for the country.
  2. Commodity price – In most instances, currency values are inversely associated with commodities. Since investors use it as a safe haven in case of a falling currency value, exchange rates can be affected by patterns in the hard asset, e.g. oil prices (Horcher, K, A., 2011).
  3. Inflation rates – Currency exchange rates are influenced by market inflation. A country having a low rate of inflation compared to other experiences an increase in its currency value. Consequently, an increase in the price of its goods and services will be at a slower rate. On the other hand, the country with higher inflation experiences currency depression and higher interest rates.
  4. Government debt – this is national or public debt that a central government owns. Having government debt makes a country less likely to acquire foreign capital thus experience inflation (Horcher, K, A., 2011). If the market anticipates that a country has government debt foreign investors will sell their bonds in the open market. This leads to a decline in its exchange rate value.

The theories of interest rate determination

There are several theories that analyze the determination and nature of interest rate. The main theories include;

Marginal Productivity Theory – states that the capital’s marginal productivity determines the interest rate. Payment of interest is done due to the productive nature of capital that’s also equal to its marginal product. The function of capital is crucial since more volume is produced with it than without. A higher productivity of capital translates to higher interest and vis a vis. However, since every product is jointly produced from every factor, the marginal product of capital is impossible to determine separately.

The Loanable Funds Theory – states that the interest rate of the market is influenced by factors that control demand for and supply of loanable funds. The demand for loanable funds shows the inverse relationship between the interest rate and the number of loanable funds demanded.An increase in the demand for these funds leads to a decrease in interest rate. Government demand for the loanable funds is interest-elastic; the quantity of demanded loanable funds are not affected by the interest rate (Lutz, F. A. 1968). As interest rate increases so do loanable funds supply.

The Keynesian Theory – In this theory, the main determinant of total employment and output levels is the degree of total spending. A higher level of total spending translates to more output by businesses thus more people employed. In a simple economy lacking foreign trade and government sector, output and employment levels would be determined by investment spending and consumption levels (Lutz, F. A. 1968). According to this theory, there’s a positive relationship between consumption spending and disposable income; higher-income earned means more spending.

Determine an appropriate level of risk tolerance

Risk tolerance refers to the level of variability which an investor is ready to tolerate within investment returns. It is significant to determine the business’ and personal risk tolerance level since there are various forms of investments around thus how does the investor determine their tolerable levels. An appropriate risk tolerance level should consider;

Time horizon – prior to investing the time available to have the money in investment should be determined. Provided longer time horizons, the investors are able to recover potential losses and thus in theory tolerable of larger risks (Investopedia Staff, n.d). For instance, if the investor has $26,000 to purchase a beach house in 10 years, this can be invested in higher-risk stocks instead. Why? The reason being they have more time to recover their losses if any and less likely of being compelled to sell out early from their positions.

Bankroll – Investors should determine the amount of cash they can afford to lose. This is a realistic investment tactic since investing what one stands to lose or tolerate being tied up over certain time periods they will stand pressures of selling off due to panic or issues of liquidity in the market. The more money an investor has, the more risk they can take (Investopedia Staff, n.d).

The three main sources of financial risk

They are;

  1. Exposure of a business or organization to fluctuations in prices in the market like commodity prices, exchange rates, and interest rates.
  2. Financial risks which arise as a result of transaction dealings and actions of other businesses or organizations like competitors, vendors, clients/ customers and counterparties within derivatives of transactions (Horcher, A. K. 2011)
  3. Financial risks emanating from internally within the organization e.g. organizational failures specifically from their systems, individuals, and processes (Horcher, A. K. 2011).

 Three broad alternatives for managing risk

They are;

  1. Do nothing and actively, or passively by default, accept all risks.
  2. Hedge a portion of exposures by determining which exposures can and should be hedged.
  3. Hedge all exposures possible (Horcher, A. K. 2011)


Horcher, A. K. (2011) Essentials of Financial Risk Management, John Wiley and Sons Inc. USA

Horcher, K, A., (2011) Essentials of Financial Risk Management. Wiley Publishers.

Investopedia Staff (n.d). Determining Risk And The Risk Pyramid. Investopedia. Retrieved from

Lutz, F. A. (1968) The Theory of Interest. 2nd Edition. A Division of Transaction Publishers. USA&London

Statement of Research Gaps or Unanswered Questions


WRTG 391: Final Project


The research that was conducted was titled “Is Biometrics worth for investment” taking considerations of various applications of Biometric Technologies from the past decades and into the new millennium and the present time. This research also went further to analysed research conducted on the biometrics technology that are likely and the effect any future advances which might have on the world. The angle of the research was particularly vantaged upon how feasible investing into this technology in terms of profitability and effectiveness basing this next to other traditional methods in the field of providing security systems. However, the research highlighted many important reasons for overlooking traditional methods for biometrics technology, this technological advances have failed to address how this security system standardization that is very little information regarding how the technology would accommodate over the course of a long duration of time regarding its performances due to deterioration and user fluctuating characteristics due to aging, poor lighting among others.

Gaps Highlighted by the Research

This research on whether biometrics was worth to be invested in bringing up the question of whether this technology would still have the accuracy and effectiveness regarding its operation to provide reliable security over a long period of time as a result of various factors on both the users and the technology itself. While conducting a background check on population levels which could be serviced by the security systems, i noticed the human population would continue to increase with more people changing physical appearances and behavior. Very little information was provided on the accountability of this technology to address how aging, injury and/or illness that alter appearances and expressions would be accounted for long periods of time. Also, the technology involves advanced equipment however little information was provided on how the technology could be standardized in cases of adverse environmental or orientational factors such as poor lighting, poor image resolutions and even user training among others that can affect future identifications.

Areas for Further Research on this Issue.

Due to the confidentiality nature that biometrics provides to its users worldwide, more research could be done on how the biometrics system could have integrated networking that would link up with cloud computing to provide a wide variety of back end data cross-referenced across various user IDs. This would provide an up to date individual records as the user change in physical or behavioral characteristics. I believe on the questions of the biometrics technology for its accountability to be standardized, more information on updated equipment needs to be conducted to curb questions such as poor resolutions and sweaty fingers and palms when taking fingerprints among others.


Changes in the world must be accommodated by the biometrics technology in order for it to maintain its accuracy in providing systems security to users and organizations. Gaps in the biometrics technology like its standardization along the period of time requires more research in case further individuals and companies will invest in it. Further research however also needs to be done regarding the biometrics databases in updating their information towards accurate authentications and/or identifications.

Roles and Functions of a Professional Nurse

Nursing encompasses collaborative and a great deal of autonomous care of people across all groups, ages, communities, and families, whether well or sick and in every type of setting. In a day nursing involves the prevention of illness through the promotion of health, caring for the disabled, ill and dying individuals. Apart from these, the nurses operate around a wide variety of specialties working as a part of a larger team of individually to plan, assess, evaluate and implement care. To see this accomplished, a nurse has several roles/ functions that he or she performs, usually simultaneously and depending on the needs of the patient. I believe a nurse is a manager of care, collaborating with other healthcare workers, they ensure cohesive patient care. He/ She coordinate and direct care for non-professionals and professionals alike to ensure the patient’s objectives are met. They prioritize and manage multiple patient care at the same time. They are also in charge of continuity beginning from the entry of a patient in the hospital until they are discharged, which may include supervising their homecare needs.

With this in mind, as a nurse, I acknowledge that efficient communication techniques would assist in improving the healthcare environment as a communicator since the healing process can be inhibited by barriers to effective communication. This is a key component towards continuity of care program since it requires good communication with patients, their families as well as the team of healthcare members. I believe decision making through critical thinking skills in setting goals, making decisions and influencing patient outcomes are critical in assessing my patients, recognizing their problem, planning and executing an intervention and finally evaluation their outcomes.  Since I would be juggling multiple responsibilities, critical judgment, plus the capacity to distinguish the best need for the patient would provide the best way forward for my patients and success in providing health care.

Weekly Matinee




  1. Identify a character in the film that presented both their public and the private self (1-2 paragraphs).

A critical assessment regarding the film provides that Mark Zuckerberg is the main character who presented private as well as public self within the movie. Ideally, it is heeded that he is primarily concerned and focused on personal interests and the way he can be ahead of his friends and peers (Fincher & Sorkin, 2010). As such, in relation to his private life, Mark Zuckerberg has a limited social circle and does not create strong and friendly associations with friends. Nonetheless, publically he creates an impression that he is actually concerned about facilitating and communicating friendships as well as associations across the world. It is evident that he even has the intention of creating the largest social network
2. Identify a scene in the film that offered a good example of perception and emotion (1-2 paragraphs).

A scene within the film which provided a good example regarding emotion and perception is at the time Eduardo Saverin moves to the headquarters of Mark and finds out that he is no longer identified as one of the founders regarding Facebook. In addition, he observes that the shares regarding other people are intact while his shares have been significantly abated from 34% to just 0.03% (Fincher & Sorkin, 2010).  As such, he experiences an array of emotions. It is observed that he immediately goes into the office of Mark and begins to shriek at Mark. This indicates the emotion he has regarding disbelief and anger. After some time, it is observed that he experiences emotions pertaining to hopelessness, disbelief, and denial.
3. Identify a scene in the film where the language was key to your understanding of the situation (1 paragraph).
The scene in which Erica is breading up with Mark Zuckerberg represents the instance in which language was critical in the comprehension regarding the situation. While the two are seated in the bar having normal dialogue, it is evident that Mark insists it is important to join the Best Ivy League university (Crossley et al., 2015). He states that Erica ought to be supportive as pertains to this specific matter because by joining this university it would be possible for Erica to meet and interact with new people. As such, Erica becomes offended and affected by this specific statement due to the actuality that it indicates that Mark has ego. In turn, this makes Erica to say that they are not going to date anymore.

4. Identify a character in the film that effectively used nonverbal communication (1 paragraph).

It is evident that Mark Zuckerberg is the main character within the film that has deployed non-verbal communication a number of times within the film. The main example is noted within the final scene regarding the film (Crossley et al., 2015). In this case, it is heeded that Mark Zuckerberg makes a search pertaining to Erica Albright over Facebook. During the initial stages, it is observed that he is worried on whether or not he ought to add Erica and at the end he sends a friend request. Notably, during these moments it is evident that the perceptions as well as emotions are perceived through body language, facial expressions, and his eyes.
5. Identify a scene in the film that negatively portrayed gender or cultural (or both!) in relationships (2 paragraphs).

The negative portrayal regarding culture within associations is observed in the case where girls and boys are seated and are engaging in activities associated with hacking. It is observed that each time they fruitfully hack, they become joyous and happy (Fincher & Sorkin, 2010).The aspect regarding hacking is regarded as being morally unacceptable among cultures.  At the same time, it is observed undertaking activities that are against the legislation is culturally unacceptable since it engenders unrest among individuals.

Most associations have the potentiality regarding suffering due to the actuality that cultural values are not embraced (Fincher & Sorkin, 2010). Nevertheless, within this specific scene, the portrayal regarding gender and culture within associations is depicted as something that is not appropriate. Typically, no individual ought to be happy while hurting others. Within this specific scene, this is considered as significant attainment which is supported and embraced by most youths.

 6. Identify a scene in the film that positively portrayed conflict management (2 paragraphs).

The scene in which Eduardo identifies that Mark has altered his partnership as well as the name of Eduardo has been taken away from the co-founder provides significant information concerning conflict (Fincher & Sorkin, 2010). Despite the actuality that this is an intense scenario, it is observed that Mark behaves in a stubborn manner and this engenders Eduardo’s anger. As part of conflict management, it is observed that Eduardo does not act in any manner to hurt Mark.

Eduardo deployed a positive approach in managing through the involvement concerning the court and jury. Although he would have done significant harm, it is heeded that Mark he had significant patience (Fincher & Sorkin, 2010). On the same note, he did not use his own efforts to deal with the matters at hand.  The ideology that the court ruling took considerable time did not matter much to Eduardo since he remained patient throughout the process.
7. What lessons, if any, did each of the characters learn? What lessons in life do you think teach people to be more accepting of others differences? (2 paragraphs)

The entire film provides that the character regarding Mark Zuckerberg is based on stubbornness and selfishness (Fincher & Sorkin, 2010). Right from the beginning concerning the film, it is evident that in each association with other people, he is observed to be associating in a manner that he has ego. Mark Zuckerberg is seen to be arrogant and sarcastic in most of scenes within the movie. Ideally, stubbornness and arrogance makes him to lead a lonely life.

The scenes provide lessons that each time an individual fails to accept the differences of other people results to hatred and arguments (Fincher & Sorkin, 2010). Markedly, an individual that demonstrates this personality cannot have true friends. This is attributed to the actuality that the arguments and hatred can minimize associations as well as friendships.


Crossley, N., Bellotti, E., Edwards, G., Everett, M., Koskinen, J., & Tranmer, M. (2015). Social network analysis for ego-nets (2nd ed.). New York: Cengage.

Fincher, D., & Sorkin, A. (2019). The Social Network [DVD].

Health Services Financing



Health Services Financing

Healthcare financing and its impact on the healthcare delivery system

In its broad sense, healthcare financing refers to the application of various mechanisms through which individuals can pay for their healthcare. As well, healthcare financing may be defined as the range of concepts of insuring, paying and financing that permit the mobilization and the allocation of funds to diverse population groups in order to pay for healthcare. As such, the impact of financing on a healthcare delivery system is to influence the access to healthcare services among the people. As well, it influences the expenditure and the supply factors on a healthcare delivery system (Paolucci, 2011).

How the United States can decrease Healthcare cost

For a long time, the total cost of healthcare in the United States has been rising. A significant part of this problem has been the use of increasingly costly drugs. In the view of this, one way that the United States may decrease healthcare cost is by making prescription drugs affordable and available so that consumers can easily afford them. Ideally, regulating drug prices would be a great policy change for the nation in the sense that it would enhance social equity, promote economic development and support public health.

General concepts of insurance

Insurance refers to a contract in which an insured enters into a contract with an insurer whereby the insured agrees to pay a premium in return for protection against the occurrence of an event that may lead to loss that has been covered by the policy. The general concepts of insurance are as follows; the insured and the insured must give clear information about the terms of the contract, the contract must carry some financial gain, the insurer must restore the insured to his or her previous position prior to the occurrence of an insured event, and the insurer must not profit from the contract if the risky event occurs.

Scenario: The advice you would give to your coworker about choosing an insurance plan

Having an insurance cover guarantees an insured against financial loss in case an event for which the cover is taken occurs. As such, I would begin by advising the employed coworker to choose the plan that takes into account her immediate family needs. In this case, she ought to the plan that provides cover for her daughter’s autistic condition. She should choose the plan that covers the routine health needs, the medication and counseling needed for her daughter. As well, she should consider the plan that provides cover for long-term care and other specialized care privileges for her daughter.

Pay-for-performance and its objectives

Pay-for-performance is a value-based pay strategy in which the evaluations of organizational and individual performance carry a significant effect on the pay increases that are awarded to each worker. Some of the main objectives of the pay-for-performance pay strategy are as follows; the strategy helps a company to not only recruit but also retain the best workers, it engages employees to ensure organizational success, rewards creative employees, and enhances the objectives, goals and the values of an organization (Roussel, Swansburg & Swansburg, 2015).

Provisions made by the U.S. federal government for providing health care to military personnel and to veterans

Over the years, the demand for military medical care has been increasing causing the federal government to take various initiatives in order to provide healthcare to not only the military personnel but also to the veterans of the U.S. armed forces. As such, the federal government established the Tricare program, which is a health insurance program designed for the healthcare needs of the military personnel and their dependents, survivors and former spouses, and it entails three plans as follows; the Tricare Prime plan that provides a health maintenance organization option, the Tricare for Life plan that provides a Medicare supplement option for eligible retirees and the Tricare Select plan that is the preferred provider option (Mendez, 2018).

Relationship between uncompensated care and cost shifting and the reason providers have limited ability to shift costs

Uncompensated care refers to the amount of care that healthcare providers often write off as a result of providing care to patients that are not able to pay for healthcare services. As such, healthcare providers may prefer to shift costs, that is, increase the amount they charge the patients that are able to pay for healthcare or accept lower profit margins for providing healthcare services (Wilensky, 1984). Therefore, the relationship that exists between uncompensated care and cost shifting is the fact that the former focuses on writing off the amount of care that is given to patients that are unable to pay, while the latter is a strategy of compensating or minimizing the extent of losses arising from the write off. Currently, providers have limited ability to shift costs since potential reimbursements and capitation have eaten away the profit margins that are derived from cost shifting thereby making it difficult for them to continuously provide uncompensated care through cost shifting.


Mendez, H. B. (2018). Medical Care: Frequently Asked Questions (CRS Report No. R45399). Retrieved from Congressional Research Service website:

Paolucci, F. (2011). Health Care Financing and Insurance Options for Design (10th ed.). Berlin, Germany: Springer-Verlag.

Roussel, L., Swansburg, R. C., & Swansburg, R. J. (2015). Management and Leadership for Nurse Administrators (4th ed.). Sadbury, MA: Jones & Bartlett Learning.

Wilensky, G. R. (1984). Solving Uncompensated Hospital Care: Targeting the Indigent and the Uninsured. Health Affairs, 3(4), 50–62. doi: 10.1377/hlthaff.3.4.50

Negative Effects of Social Media

Social media is one of the pieces of technology that are actively shaping this world. As a part of the internet, social media creates more excellent avenues through which people can interact all over the world. The adverse effects of social media are; however, not unknown, and young people are the center. Sadly, the youth use social media to levels that, if not restricted or monitored, could result in severe repercussions for their overall wellbeing. As a young person myself, I got to learn this lesson from experience, allowing me to understand the reach of the effects of this technology. This approach to learning, despite being useful, is not a likable experience, and neither is it one that a person can easily forget. I learned, however, that the self I present to the public through my social media accounts is not me, but a pretty, happy version of me.

In most cases, no one usually wishes to see the pain and sadness of their friends, which forces people to hide this side of themselves away, including me. We protect this side of ourselves and save it for real interactions, for our families, partners, and friends. Social media interactions, on the other hand, are reduced to likes or hearts, which fails to capture the emotional component of human social life truly. For this reason, I believe people use these platforms to fulfill other agendas apart from seeking interactions. It is because they feel that everything that occurs online has no consequences; people are willing to cross the set thresholds of safety to get what they want. Therefore, being extra cautious when engaging with others online can be highly beneficial.

My personal experience with social media centers around Facebook depression, which many people believe not to be a real issue. However, Blease argues that this form of depression occurs when young users see wall posts, photos, and status updates that harm their popularity (4). The psychological impact of social media sites on young people with low self-esteem or those with other problems is even more significant. Many arguments against Facebook depression agree on the point that social media is an instrument, meaning that it is not possible for it to cause a medical illness by itself. In my case, the experience involved Facebook postings that undermined my social relations with my peers in school. It created an emotional disturbance by making me feel inferior to my Facebook counterparts. In my opinion, this issue resulted from my desire to fit in and be accepted by my colleagues. When some of the people I thought were my friends posted humiliating information about me, it affected my self-esteem and confidence to face others. In school, I was well known among the students, mainly due to my proactive participation in school events. I considered the act by my friends a significant betrayal since they very well understood the effects of their actions. It was sometimes impossible for me to have a meal or even study in peace after the event, which only added to my list of troubles and causes of restlessness.This Facebook encounter left me anxious and unwilling to interact with others, at least not face-to-face. I retreated to an isolated world that would have eventually led to my self-destruction. Appel et al. assert that social media can contribute to the occurrence in three ways, namely comparison with others, affecting self-worth and bullying (45). I suffered from countless experiences of bullying at the time, as there are students who used the opportunity to vent their feelings of oppression by social media platforms. Just like me, others have been subject to these humiliation attacks and would seek similar opportunities to hurt others emotionally. They achieve this by creating rumors and narratives designed to harm a person’s social status, which negatively affected my self-esteem and self-worth.

Kingsnorth assert that most people throughout history could scarcely comprehend the purpose attached to the staring on the glowing screen and paper marks. It is observed that the notion which they had that they would aid anyone in understanding complexity regarding lived actuality would have appeared illogical as it is the still the case among many people. The author also emphasizes that the technology regarding writing has made them to forget the way in which they ought to handle abstraction (Kingsnorth). There is also the tendency concerning confusing some words with the actuality and reality they are meant to convey. Ideally, this can be related to my Facebook experience. The social media sites represent what humanity has the potentiality of accomplishing, which provides explanations concerning what humanity can attain.  As a result of this, the social media sites are considerably gaining emplacement, in not only the business circles but also in the social circles. While Facebook is becoming an integral channel as pertains to communication, it is observed that the way in which people present themselves and their perceptions regarding others on the site start to bear considerable consequences within the actual world.

The importance regarding the way in which other people regard you can be seen in the article “Silence and the Notion of the Commons”. In his narrative, Franklin asserts that the current technological patterns have made individuals to move towards a reduction in various spaces which encompass the mindscape, the landscape, as well as the soundscape. He provides that silence ought to prevail within the mindscape, the landscape, and the soundscape (Franklin, p.3). This creates the room for the unprogrammed and unplanable which is the primary strength related to silence. As well, silence is considered as the core regarding sanity both collectively and individually. The aspect regarding silence has been replaced with common availability. Franklin provides that through the deployment regarding technology, societies are currently at a position in which something which was initially normal has now become precious and rare. A critical evaluation regarding this specific perspective indicates that it has a significance application to my experience. This is based on the actuality that the perceptions which other people bored towards me were the primary cause regarding the state that I was in (Franklin, p.4). It is heeded that with the silence that comes with the utilization regarding technology and social media, my attention shift has shifted from others due to the fact that I have the tendency of focusing attending to my own concerns. Although this specific silence can be regarded as being abnormal to other people, I observe that it has the effect of expediting the activities that I normally do and engenders both sanity and peacefulness. This is a clear indication that despite the actuality that social media enhances silence which can result to a negative impact to other people.   

The third season of the series titled “Black Mirror,” an episode known as “Nosedive,” will perhaps provide a basis for understanding the problems I faced much more elaborately. In this particular episode, written by Mike Schur and Rashida Jones, an imaginative world where social media channels are the frameworks used in running economic systems is presented. After each interaction an individual has with another, the participants rate each other based on a scale of 1 to 5. Getting a score of 4 or higher meant that a person was in an excellent social position, while those under 4 had to face the consequences both socially and economically. Achieving social mobility upward in this world meant that an individual had to pretend and hide his or her real self from others. The episode’s heroine, Lacie, begins at 4.2, which is a decent number but just not sufficient to get her the life she desires. She embarks on a mission to reach a 4.5 rating in record time to achieve this goal. The journey, however, is more gruesome than she initially thought since the episode climaxes with Lacie choosing to let out all her frustrations. Lacie came to realize that getting the social ratings she desired was only possible by sacrificing her true self and replace it with an image that others would like. Plastic smiles and pretending were the order of the day if anyone were to move upward socially. Even when Lacie was alone in the bathroom, she would often practice how she would laugh before a mirror, evidencing the fact that Lacie always wore a mask whenever she interacted with others. Her true self became so foreign to her to the extent that the idea of expressing and projecting that true self was not only unnatural to Lacie but barely even an option.

The narrative presented in the “Nosedive” episode demonstrates the potential impact of social media platforms on the world, though at the extreme end. As things stand today, the problem is still manageable by reducing the significance given to these platforms. People should understand that despite the promise of this technology, it is not wise to let it replace real interactions, or we might bear the consequences. Perhaps, it is time that the public became sensitized to the potential adverse effects of social media and implemented strategies to mitigate them.  

Works Cited

Appel, Helmut et al. “The Interplay Between Facebook Use, Social Comparison, Envy, And Depression”. Current Opinion in Psychology, vol 9, 2016, pp. 44-49. Elsevier BV, doi:10.1016/j.copsyc.2015.10.006.

Blease, C. R. “Too Many ‘Friends,’ Too Few ‘Likes’? Evolutionary Psychology And ‘Facebook Depression’”. Review of General Psychology, vol 19, no. 1, 2015, pp. 1-13. SAGE Publications, doi:10.1037/gpr0000030.

Didion, Joan. “At the Dam”. 1970, pp. 1-2., Accessed 9 Oct 2019.

Franklin, Ursula. “Silence and the Notion of the Commons”. 1994, p. 4., Accessed 16 Oct 2019.

Kingsnorth, Paul. “The Language of the Master – Emergence Magazine”. Emergence Magazine, 2015, Accessed 16 Oct 2019.

“The Jetman”. pp. 71-3., Accessed 9 Oct 2019.

Profession Value

                                                            Profession Value



Essay 1 – Professional Practice

It is patently clear that standardized nursing language is an approach that is deployed in documentation. Ideally, standardized nursing language ought to be clearly defined in such a way that nursing care is disseminated and communicated in an accurate manner among the health care providers as well as nurses (Ackley & Ladwig, 2019). The deployment concerning standardized nursing language is important in ensuring that the generally comprehended terms are employed throughout the nursing profession. The aim regarding this paper is to create a standardized care map pertaining to two NANDA nursing diagnosis by using deploying ANA recognized data element set as well as recognized terminologies. The North American Nursing Diagnosis Association (NANDA) is an organization that was developed in order to enhance the creation, refinement, as well as dissemination and deployment of standardized nursing assessment terminology through the provision regarding evidence-oriented diagnoses (Ackley & Ladwig, 2019).  Health awareness is important in the management and prevention regarding various health problems. As such, the two main diagnoses that will be considered in this scenario encompass sedentary lifestyle as well as readiness for enhanced health literacy.

The NANDA Nursing Diagnoses, Definition and Classification

The two NANDA nursing diagnoses that are being evaluated in this scenario encompass the sedentary lifestyle as well as readiness for enhanced health literacy (Fernandes Peixoto, 2018). A critical assessment regarding the diagnosis concerning the sedentary lifestyle indicates that it is classified under the health awareness category. Sedentary lifestyle is connoted as a lifestyle that is characterized by physical deconditioning, preference pertaining to physical activity is low, and the mean daily physical activity is seen to be less than the standard for age and gender. The diagnosis concerning readiness for enhanced health literacy is also categorized under the class of health awareness. Notably, readiness for enhanced health literacy is defined as the pattern regarding deploying and establishing a set of competencies and skills to find, understand, assess, and utilize health information as well as concepts in order to maintain and promote health and reduce health risks (Fernandes Peixoto, 2018). It is observed that the aspect of readiness for augmented health literacy is defined by the desire to improve the ability to write, read, and interpret numbers pertaining to health needs. At the same time, the readiness for augmented health literacy is demonstrated through the desire to augment communication with among healthcare providers. The zeal to improve social support as pertains to healthcare is another important feature associated with the diagnosis regarding readiness for augmented health literacy.

Data Element Sets from the ANA that are important for the care map and their relationship with personal nursing practice

The most important data element set and terminology which is critical in this care map relates to the Nursing Interventions Classification (NIC) (Fernandes Peixoto, 2018).  A close assessment concerning this dataset indicates that primarily encompasses the interventions that ought to be given to the clients that demonstrate these two diagnoses. The main intervention that ought to be provided to a client that presents a diagnosis with sedentary lifestyle relates to providing the client with explanation regarding the importance of physical activities and its significance in the well-being and body functioning. The paucity regarding resources can cause hindrance to the engagement in activity and as such, it is essential that the client is asked about the core barriers to their engagement to planned activity or exercise (Ackley & Ladwig, 2019).  Another important intervention that ought to be administered to a client that leads a sedentary lifestyle entails starting an activity by using warm-up exercises as well as ending the activity with exercises which cool down. This particular intervention will prevent the client from getting injuries while exercising.  At the same time, it is important that the vital signs are evaluated prior to the commencement of the exercise. It is noted that this will offer baseline data as well as give information about whether or not the convalescent is physically active and ready to carry out activities.

The Nursing Interventions Classification (NIC has provided various interventions that can employed in managing the readiness for enhanced health literacy. These interventions have been categorized into three categories which include health education, health literacy improvement, and health system license (Ackley & Ladwig, 2019). The readiness for enhanced health literacy can be managed by first identifying the degree regarding health literacy by using a standard tool. Various instruments have been recommended in order to examine people’s health-oriented reading comprehension. Therefore, it is important that a standard instrument is employed in identifying the degree of health literacy. As well, the NIC recommends that it is important to ascertain the various facets that influence health literacy which include education, ethnicity, age, and cognitive function. The implementation regarding health literacy standard precautions is also important in ensuring readiness for enhanced health literacy.


This specific paper sought to evaluate the nursing diagnosis regarding sedentary lifestyle and the readiness for enhanced health literacy. Based on the interventions provided, it is observed that the client will have increased knowledge and awareness about the benefits and importance regarding physical activities. Besides, the interventions geared towards the management concerning sedentary lifestyle promise to enable the patient to ascertain the necessary safety concerns, self-monitoring tactics, and precautions needed while undertaking   physical activity. Finally, the outcomes associated with interventions given for readiness for enhanced health literacy include deploying information sources and seeking more information from healthcare professionals.

Essay 2 – Professional Roles and Organizations

            Professional nurses have various roles to play within the healthcare environment today. Ideally, each of these professional roles has a significant influence on the patient, the healthcare, and the family at large (Luanaigh, 2017). As members of the nursing profession, it is observed that these nurses can choose to be active in at least one professional organization. The purpose of this paper is to evaluate three professional roles which nurses can perform and the impact regarding each specific role on the convalescent, the healthcare, and the family. As well, the paper will examine the two professional organizations that nurses can be members in and how being part of these institutions would enhance the profession.

The primary professional responsibility regarding nurses relates to the provision concerning patient care. In this regard, a nurse is the caregiver for convalescents as well as aids in the management concerning physical needs, prevention of diseases, and treatment of health conditions (Masters, 2018). In order to achieve this, a nurse has the obligation regarding observing and monitoring the convalescent, and recording appropriate information to assist in decision-making pertaining to treatment. It is observed that throughout the process regarding the provision of treatment, the nurses examines the patient’s progress and acts based on the interests as well as values of the patient. In addition, these nurses have the responsibility regarding providing holistic care to convalescents, which entails the developmental, psychosocial, spiritual, and cultural needs concerning the individuals (Luanaigh, 2017). By providing holistic patient care, it is heeded that the health outcomes and quality of life of patients have the potentiality of significantly improving. As well, the improvement regarding the quality of life and health outcomes of patients implies that patient admissions and healthcare costs can remarkably reduce.   

The second professional obligation that a nurse has encompasses patient advocacy. In this case, the nurse has the responsibility regarding advocating the best interests and values of the patients and enhancing the dignity of the convalescents throughout care and treatment (Masters, 2018). Patient advocacy can encompass making suggestions pertaining to the plan of treatment and collaborating with other healthcare providers. It is also heeded that patient advocacy also involves the convalescent’s family as well as support framework, that ought be incorporated within patient’s care given that it is carried out in a positive manner (Luanaigh, 2017). Notably, in this way, it is observed that patient advocacy engenders the integrity of the patients and makes family members to be actively involved in the care process. 

Another important role that nurses have encompasses providing patient support and patient education (Masters, 2018). Nurses have the obligation of ensuring that convalescents are at a position of understanding their health, diseases, medications, as well as therapies. Typically, this is crucial when convalescents are being discharged from the healthcare facility. Through the instructions that they receive from the nurses regarding self-management of their conditions, it is observed that convalescents are able to manage certain health conditions independently.

                The two professional organizations that nurses can be members in encompass the American Nurses Association (ANA) and the International Council of Nurses (ICN) (Luanaigh, 2017). By belonging to ANA, it is noted that a nurse has accessibility to research and at the same time, they can advance their education in nursing. The ICN is a professional federation that constitutes of at least 130 international institutions. The ICN provides continuing education and instruction to nurses. A nurse belonging to this professional organization has the benefit of providing quality care, developing appropriate international practices, as well as teaching changes to the healthcare industry.

In conclusion, it is evident that nurses have an array of roles to perform within the healthcare industry such as, patient support and education, patient advocacy, and provision of patient care.  These professional roles have a considerable impact on the healthcare, the family, and the patient. Through the provision of holistic patient care and enhancement of patient support and education, it is observed that the quality regarding life and health outcomes can significantly improve. Finally, belonging to professional organizations such as, the American Nurses Association (ANA) and the International Council of Nurses (ICN) enables nurses to advance in their education. 

Essay 3-Profession Standards

It is patently clear that nurses ought to act in an appropriate manner in order to minimize unethical and unsafe practice concerns. Ideally, it is heeded that there are various resources that exist to address aspects associated with ethical practices and nursing practice. Delegation and discharge practices are some of the responsibilities that are carried out by nurses but this exhibit variation based on the state. According to the to California’s Nurse Practice Act, delegation is connoted as having the right to person, right to circumstance, right to supervision, right to task, and the right to communication.  On the other hand, the Idaho State’s Nurse Practice Act defines delegation as the transfer regarding responsibility of a nurse to another member in the nursing staff while maintaining the outcome. The regarding this particular paper is to evaluate the discharge practices as well as nursing delegation based on the California’s Nurse Practice Act.  These discharge practices as well as nursing delegation will then be compared with those regarding the Idaho State’s Nurse Practice Act.

Delegation based on California’s Nurse Practice Act

Delegation is regarded as a complex protocol within professional practice that requires sophisticated and comprehensive clinical judgment as well as final accountability pertaining to convalescent care (Kaplan, 2015). Notably, the complexity and variability regarding the situation of each convalescent necessitates RN examination in order to ascertain the tasks that are appropriate to nursing assistant, LPN, and other personnel to perform. As well, within the delegation protocol, it is observed that nurses have the obligation regarding matching the competencies of the staff with the requirements that the convalescent or family have. A critical assessment regarding the aspect of within California’s Nurse Practice Act provides that registered nurses cannot delegate the direction regarding care or the scope concerning practice to a licensed vocational nurse (Kaplan, 2015). At the same time, it is evident that registered cannot delegate the responsibilities that are contained in the CCR 1443.5 unless they are given the chance to do so by the licensed vocational nurse (LVN) degree or scope concerning practice. Therefore, this provides implications that a registered nurse cannot delegate responsibilities that pertaining to the assessment regarding patient during each shift.  At the same time, it is noted that registered nurse cannot delegate the responsibility pertaining to the diagnosis of a patient to a (LVN) based on the provisions contained in the Competent Performance California Code of Regulations.  Registered nurses within California are limited and restricted from assigning the nursing obligations that are meant for them to the unlicensed assistive personnel (UAP). As well, a registered nurse cannot give the UAP the opportunity regarding performing tasks even under immediate clinical supervision regarding a RN given that they require significant technical competencies and scientific knowledge (Kaplan, 2015). Markedly, these obligations encompass administration concerning medication, provision regarding intravenous therapy, invasive protocols, and parental feeding. On the same note, functions such as, the evaluation regarding the condition of the patient and the provision regarding education to convalescents pertaining to their health conditions cannot be assigned.

Delegation based on the Idaho State’s Nurse Practice Act

Delegation by registered nurses within Idaho State is quite different from that of California and this is highly pegged on the scope regarding practice.  According to the Idaho State’s Nurse Practice Act, it is noted that nursing care responsibilities that are delegated to the assistant personnel ought to be provided in writing within the practice setting (“Idaho Nurse Practice Act;” 2014). A registered nurse within the Idaho can delegate a UAP in assisting with medication. However, this can be only achieved through the supervision as well as direction given by a licensed nurse. In this case, assistance pertaining to medication can encompass crushing a tablet, providing medication through the deployment regarding a pre-mixed nebulizer, and instilling nose, ear, or eye drops. Nevertheless, specialized assignments such as providing injections are not included in the delegation process since they necessitate that the UAP has to be trained first. 

Scenario Analysis

Based on the assessment regarding the delegation regarding tasks by registered nurses, it is observed that a nurse within California cannot delegate IV removal as well as discharge to a nursing assistant.  This is attributed to the actuality that these activities require specialized knowledge.  A critical evaluation regarding the provisions provided by  the Idaho State’s Nurse Practice Act indicates that a registered nurse can delegate this duty to a nursing assistant but they ought to supervise them while do this (“Idaho Nurse Practice Act;” 2014). However, this can be only achieved through the supervision as well as direction given by a licensed nurse.


In conclusion, it is evident that each state has regulations pertaining to nursing delegation. Ideally, the aspect regarding delegation is primarily impacted by the scope regarding practice. The evaluation regarding the Idaho State’s Nurse Practice Act indicated that its provisions pertaining to delegation are quite relaxed. However, nursing delegation within California is quite strict. It is observed that registered nurses are only allowed to delegate responsibilities that do not require significant competence and knowledge.

Essay 4


It is evident that the baccalaureate education encompasses the development concerning professional values as well as value-oriented behavior. Ideally, through my own life experiences, I have come to comprehend that the nursing career has various meanings. My personal nursing journey began when I was attending to one of my siblings that had been admitted in the intensive care unit. During this period, I was at a position of understanding that nursing is all concerned about enhancing wellness. The aim regarding this paper is to examine the nursing career in the context of my personal journey as a nurse.  As well, the factors that have motivated to remain within the nursing profession will be evaluated in this paper. The parallelism and association between my nursing practice and the American Nurses Association (ANA) Code of Ethics will be assessed within this paper.

Drawing on your own life stories and experiences, what does a nursing career meant to you?

 The three-month period in which I spent in the intensive care unit attending to my brother enabled me to garner significant information and knowledge pertaining to nursing.  In the first place, I realized that the nursing career implies augmenting wellness. The actuality that the nurses that were involved in the process regarding caring were constantly available to ensure that my brother has taken his medication based on the prescription enabled me to deduce that the nursing career is primarily focused on bringing wellness (Porter, 2014). At the same time, I observed that the nursing career is a noble profession which provides nurses with the opportunity regarding providing selfless care to convalescents. In this regard, I observed that nurses within this profession had the obligation concerning providing care to convalescents even during the darkest hours of the night. Notably, I noted within the nursing profession nurses had the responsibility regarding comprehending the emotional state associated with disease and the way in which it interconnects with patient’s health.

 How does your nursing practice parallel the ANA (2015) Code of Ethics? List 4 specific examples from the Code of Ethics.

A critical evaluation regarding my nursing practice indicates that it is linked with the ANA (2015) Code of Ethics (Porter, 2014). While providing care to patients, I have always demonstrated respect as well as compassion to the patients that I interact with. As well, I ensure that I maintain healthy associations and relationships with patients in order to augment patient outcomes. It is observed that this nursing practice is in line within the provision by the ANA (2015) Code of Ethics that a nurse needs to practice with respect and compassion for significant worth, dignity, and distinct attributes concerning each individual (Porter, 2014). The ANA (2015) Code of Ethics provides that the primary commitment regarding a nurse is to the convalescent, whether a family, individual, population, or community. Observably, throughout the nursing process, I have always been committed to the patient. In this regard, I usually take the initiative concerning evaluating the primary needs regarding the patient and ensuring that I develop appropriate strategies to meet them.

 In addition, the specification by the ANA (2015) Code of Ethics states that a nurse advocates, promotes, as well as protects the rights, the safety, and the health regarding the patient. Ideally, when providing convalescent care, I have always taken the initiative regarding protecting confidentiality and privacy of the patients (Catalano, 2014). When carrying out research that encompasses human participants, I ensure that that they are also protected. In order to enhance patient care, I make decisions as well as take actions which are in consistency with the responsibility regarding health promotion. As such, this is in consistent with the provision that the nurse exhibits accountability, authority, and responsibility pertaining to nursing practice and engages in decision-making in order to provide optimum patient care.

What motivates you to remain in the nursing profession? Give an example through a personal story and what you learned that motivates you as a registered nurse.

There are various facets that have engendered me to remain within the nursing profession. The first factor that has been making to stay within this profession is that nursing is noble career that allows nurses to selflessly provide care. At the time that my brother was receiving care in the intensive care unit, I observed that most of the nurses demonstrated dedication in ensuring that he would return to his normal state. During this period, I had feared that my brother would not recover now that his condition was critical. However, through the efforts, motivation, and initiatives of nurses as well as other healthcare providers, my brother completely recovered. This made me to conclude that nursing is a noble profession which ensures that various lives can be saved (Catalano, 2014). As such, this influenced me to join and remain in the nursing profession.  The actuality that nursing provides various opportunities for improvement and advancement motivated me to stay within this profession. In this case, I noted that remaining within the nursing profession would aid me in advancing into management and leadership.

Develop 3 short-term and 3 long-term goals that emphasize your unique strengths
In order to augment my nursing profession it would set various short-term and long-term goals. The short-term goals that will guide me in improving my nursing profession encompass:

Three Short-Term Goals

  1. To learn more about the provision regarding patient care within a period of three months.
  2. To enhance my understanding regarding the nursing professional within duration of six months.
  3. To engage in nursing research activities that are aimed at augmenting evidence-based practice in the future 

Three Long-Term Goals

On the other hand, the long-term objectives that will guide my profession concerning nursing encompass:

  1. To work in an organization that has a internship program after five years.
  2. To become a nurse specialist within the field concerning cardiac nursing in the next seven years.  
  3. To obtain certification through the American Nurses Credentialing Center within the next eight years. 
  4. To get an advanced degree in order to be an advanced practice registered nurse in the next six years.

The way in which a BSN degree impact your short-term and long-term goals

Undertaking a BSN degree has a considerable impact on both the long-term and short-term objectives mentioned above. In the first place, the BSN degree will aid in the garnering of knowledge pertaining to the nursing profession as well as ways of augmenting patient care in the future. In addition, the BSN degree will provide the basis regarding gaining competencies that are crucial in providing care within the healthcare facility that I will be working for in the future. Finally, the BSN degree will form the basis of undertaking future courses related to nursing.  


In conclusion, it is observed that that the baccalaureate education encompasses the development concerning professional values as well as value-oriented behavior. Based on my own life experiences, I have come to comprehend that the nursing career has various meanings.  I understand the nursing career is typically focused on the enhancement regarding patient wellness and quality of life.

Essay 5

Nurses Roles in Health Promotion

The ICN position statement chosen is the nursing role in health care services. The specific area of focus is the health of migrants, refugees, and displaced persons (MRDPs). It is heeded that  nurses have to ensure that everyone around the world have good health. They do this by advising on the prevention of disease and treating people who are already affected. One group that always suffer a lot is the migrants, refugees, and displaced persons (International Council of Nurses, nd). As such, nurses have to give special care to them. The reason why this group is vulnerable is that they are always oppressed, do not get the right foods, and live in poor houses. This is due to poverty, war, and other natural calamities that necessitate them to migrate or leave their homelands. The group always experiences discrimination, violence, detention, human tracking, and malnutrition. This is what is making them be at the heart of nurses’ roles in health care provision.

Goals of the plan

This plan aims at achieving several goals. The way in which drugs and medication can be made accessible to the migrants, refugees and displaced persons is one of core objectives associated with this project. Secondly, this project evaluates the way in which the ambulance can reach these vulnerable groups to ensure that they get the health care they need on a timely basis. How drugs can be made affordable, being that the group lives in poverty.  How the medication can be made to be culturally sensitive to all. The nurses must look at a way to ensure that they cater to the cultural needs of every person in this group. Another goal is how best nurses can ensure that they maintain confidentiality in handling the personal information of the patients from this group. How best the nurses can ensure that there are long term health care providers to the group. Lastly, nurses must assess ways on how they can strengthen public awareness of health vulnerabilities among the MRDPs.

Objectives (what need to be done to accomplish the goals)

For these goals to be achieved, the nurses and the government have roles to play. First, nurses have to ensure that they get the necessary training that will ensure that they maintain a code of ethics while handling this group. Secondly, they have to know how best they can do to ensure that they cater to the cultural differences of the patients. This group consists of people from different cultural backgrounds, and handling them must be based on the culture they come from. On the side of the government, access to health care should be made a right of all people in a given area regardless of citizenship, race, age, or cultural background. Again, the government should ensure that the drugs are made affordable to all, especially people who come from this vulnerable group. Generally, there should be no discrimination when it comes to offering medication to people. This will ensure that MRDPs are not left out in the provision of medical care.

Resources required for this project

To complete this project, I would need experts in various fields. One, I would need nurses or medical professionals who will help in giving multiple suggestions on how to improve this group. Two, I would need people who are fighting for the rights of the vulnerable groups. Such people include lawyers or people who are specialized in the rights of various groups of individuals. Financially, I would need around $ 10 000 to cater to the traveling expenses and booking the different individuals for the interview session. Lastly, I would need help from the government with a right authorizing the project of assessing how best the vulnerable group can be helped. This is to ensure that the research is done under the law and that all the processes remain legal. Also, abiding by the law can make the government accept the project and use it to improve the issues addressed.


I would require one month ensuring that all the activities are accomplished. In the first week, I will look for various ways on how to get the finance needed for the project. In the second week, I will be organizing multiple activities and arranging on how to meet the experts required. In the third week, there will be traveling to numerous refugee camps to ensure that I get to know what is affecting them. In the last week of the month, I will be meeting with various experts to discuss the logistics and how the problem can be addressed. This week will also be used for compiling the different results obtained from the experts. All the activities dealing with researching on the various issues should end within the stipulated time. In case there is some issues that have not been addressed, I will make up for them in the following month.

The method that will be used to share the project

To ensure that the issue addressed reaches various people, I will use an online method to share the problems. First, I will open a Facebook account that will enable people to join and have to know more about how the issue can be solved. Also, I will share the information through the twitter account. The reason for choosing the social media site is because many people are nowadays connected to social media accounts. To the specific group like the government, I will open a website where the information will be posted for relevant authorities to access. With all these strategies in place, the data will reach all the intended persons.


I have learned that most of the people who come from the MRDPs group have a lot of problems. They are oppressed and discriminated against, making them not have good health care provision (International Council of Nurses, nd). The nurses have a more significant role to play to ensure that the health care of this group is catered for. One way the nurses can do this is by ensuring that they uphold the code of ethics to ensure that they remain focused on providing healthcare to all without discrimination. Also, they will ensure that the maintain professionalism in their line of duty. Even though the government also has a role to play in ensuring that this group gets health care services, the major part is played by nurses. Nurses should lead the way in strengthening the public awareness of the health vulnerability and healthcare-related issue to this group. They should train this group on means that they can use to prevent diseases and live a healthy lifestyle.  Through this, the provision of healthcare will be accessed to all.


Ackley, B., & Ladwig, G. (2019). Nursing Diagnosis Handbook – E-Book (2nd ed.). New York: Elsevier Health Sciences.

Fernandes Peixoto, I. (2018). Self-mutilation nursing diagnosis concept of analysis of the NANDA-I taxonomy. Nursing & Care Open Access Journal5(4). doi: 10.15406/ncoaj.2018.05.00158

Catalano, J. (2014). Contemporary professional nursing (3rd ed.). Philadelphia: F.A. Davis Co.

Idaho Nurse Practice Act;. (2014). Retrieved 3 November 2019, from

International Council of Nurses (nd). Position statements. ICN. Retrieved from

International Council of Nurses (nd).Health of migrants, refugees and displaced persons. International Council of Nurses. Retrieved from

Kaplan, L. (2015). California’s Nurse Practice Act. The Nurse Practitioner40(5), 8. doi: 10.1097/01.npr.0000461956.53786.5b

Luanaigh, P. (2017). Nurses and Nursing: The Person and the Profession (2nd ed.). Cengage: Routledge.

Masters, K. (2018). Role development in professional nursing practice (2nd ed.). Cengage: Jones & Bartlett Learning.

Porter, R. (2014). The American Nurses Association Code of Ethics. Journal Of The Dermatology Nurses’ Association5(1), 31-34. doi: 10.1097/jdn.0b013e31827d9eaa


Researching Depression



What is depression, and how is it related to sadness?

Depression is connoted as a serious and common medical disease that negatively impacts the way one feels, acts, as well as thinks. It is observed that depression has a significant association with sadness due to the actuality that depression causes one to feel sad as well as interest as pertains to the activities initially enjoyed (Abraham & Kneisl, 2016). The actuality that depression engenders physical and emotional problems also considerably contributes to sadness and reduces the potentiality regarding an individual to operate effectively.    

What are the causes of depression?

Despite the actuality that the exact cause regarding depression is not known, it is observed that there are various factors that are associated with its development (Abraham & Kneisl, 2016). Ideally, depression arises due to the combination of current events as well as personal factors. In regards to the personal facets, it is observed that family history has a significant impact on the development concerning depression. Abraham and Kneisl (2016) assert that depression has the potentiality of running within families and as such as some individuals are have a more genetic risk. Personality is another aspect of the personal factors which has an impact on the development concerning depression. In relation to this, it is evident that some individuals are vulnerable to depression due to their personality more especially if they exhibit low-self esteem and are self-critical. Critical medical conditions are associated with considerable worry and stress which can in turn influence depression more especially while managing chronic pain.
What are the common symptoms of depression?

Depression is associated with various symptoms which exhibit variations based on the degree of severity. One of the symptoms that characterize depression encompasses the lack of pleasure and interest in activities which one initially enjoyed (Duggal, 2016). The manifestation concerning a depressed mood is another symptom that a person with depression is likely to demonstrate. Thoughts regarding death and difficulty in concentration as well as decision-making are other symptoms that are associated with depression. At the same time, people that have depression are likely to exhibit symptoms such as, feeling worthless and having sleeping problems (Duggal, 2016). Variations in appetite and the loss regarding energy are other signs and symptoms observed in individuals that have depression.
What therapies exist to treat depression?
Depression is a mental disorder that can be treated. Ideally, there are three main facets associated with the management concerning depression which encompasses drug treatment, psychotherapy, and support (Duggal, 2016). In relation to drug treatment, it is observed that there are various medications that can be utilized in treating depression which encompasses tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), and selective serotonin and norepinephrine reuptake inhibitors (SSNRIs) (Duggal, 2016). Psychotherapies are also regarded as the first-line treatment option for mild scenarios regarding depression. However, in severe and moderate cases, it is observed that they can be employed alongside other treatments.

What are the most constructive and destructive ways of communicating with a depressed person?

One constructive approach of communicating with a depressed individual is to assess them to determine what would be influencing their depression (Duggal, 2016). As well, it is important to make them comprehend that a psychotherapist is there to aid them in solving their needs.  Nonetheless, compelling an individual to talk regarding their concerns is regarded as a destructive approach to communication.


Abraham, I., & Kneisl, C. (2016). Depression (3rd ed.). Philadelphia, PA: W.B. Saunders.

Duggal, H. (2016). The complete guide to self-management of depression (3rd ed.). Cengage: New York.

The Cost and Extent of Terrorism in the U.S

Student’s Name

Institutional Affiliation


The analyses of the consequences and costs of any conflict are centered on either interstate or civil conflicts. However, the 9/11 terrorist attack has shown to intensify the interest concerning the costs of terrorism, a form of conflict and violence that is directed to civilians or noncombat who are generally not associated with a political object of the perpetrators. Though terrorism in the U.S may be perceived as a particular tactic applied in both external and internal conflicts, its costs have been separately studied. Direct costs of terrorism are those that have immediate losses related to the attack, including lost wages/layoffs, sustained injuries, destroyed goods, and reduced commerce. While most of the losses due to terrorism cause significant property damage and casualties, the indirect costs cause the highest cost. They are the subsequent terrorism losses, including higher insurances, increased compensation to victims and states affected, security costs, and expenses on counterterrorism. This essay explores the cost and extent of terrorism in the U.S.

The extent of terrorism in the U.S

The U.S has, for seventeen years, been at war in Afghanistan and fifteen years in Iraq. Subsequently, U.S has also far longer been active in Somalia, whereby it has spread operations in dealing with extremist and terrorist threats in a broad continuum of conflicts in South Asia, North Africa, sub-Saharan regions, and South East of Asia. In event after event, the U.S has shifted beyond counterterrorism to counterinsurgency as well as from momentary and small force of antiterrorism to constant military presence. According to Cordesman (2018), the line between counterinsurgency and counterterrorism has continuously shown to be so blurred that no significant difference can be depicted. Based on the fact that the database for terrorism events only date back in 1968, every study pattern regarding terrorism ought to commence in 1968 as well (Sandler, 2014). Reports assert that terrorism escalated from 1968 to around the mid-1980s, with almost 500 cases every year (Sandler, 2014). As Sandler (2014) highlights, the incidents fell from about 100 to 200 events every year since the mid-1990s, except for 1995 and 2001. The most comprehensive terrorist incident database, the Global Terrorism Database (GTD), was founded in the U.S and still maintained in the country. 

Combining this with the fact that U.S media extensively covers terrorist incidents than any other event, dated back in the 1970s, is a clear depiction that the country has the complete leading record of terrorism in recent decades (LaFree, 2010). The annual death toll resulting from terrorism in the U.S since 1970 showed a downward trend until the year 2001, where it raised to four times higher with approximately 3000 fatalities in the September 11 attack (LaFree, 2012). In recent history, the September 11 attack that hit New York stood out as the largest fatal terrorist case worldwide. LaFree and Dugan (2007) assert that, based on these fatalities, terrorism has been perceived to have been relatively higher in the 1970s, comparably slight in the following decades except for 1995 and 2001. Reports have brought out that for the past five years, U.S has had a small though a constantupsurgein terrorist fatalities. In most of the years, terrorism caused at most 50 casualtiesevery year, and in some of the years, no fatality occurred (LaFree and Dugan, 2007). With the 2001 attack exemption, terrorism accounts for less than 0.01% of the fatalities experiences every year in the U.S since 1970 as compared to 120 fatalities caused by road accidents every day in the country (Filigrana Villegas, 2019). Nevertheless, the costs of terrorism are still felt in the U.S.

Direct costs

Loss on human capital and economic output

The direct costs of terrorism are the loss of capital, both human and non-human. According to Tavor (2011), the estimated loss of capital (human and non-human) in the U.S range between $25 and $60 billion, which the physical resourcesamounts to 0.2% of the country’s economy and 0.06% of the U.S valuableresources or assets. The U.S has suffered a loss of its economic output due to terrorism. For instance, Navarro & Spencer (2001) found out that the country experienced a loss of $47 billion in its economic output and a loss of $1.7 trillion of its stock marketcapital. Nevertheless, the short-term impact on economic behavior uncertainties tends to vary based on the adept offsetting responses. 

Losses on industries 

Terrorism impacts specific industries and regions in the U.S that have been proved to be a substantial cost. Particularly, sectors like tourism, transport (airline and shipping, postal services, insurance industries, as well as any other related activities like lodging. For instance, exemplifying the September 11 terrorist attack, the Bureau of Labor Statistics found out that it caused job layoffs as well as separations. Data has shown that a minimum of 125,000 employees was laid off for not less than 30 days due to the attack (Keith, 2004). Keith (2004) explained that the figure underestimated the full extent of layoffs related to terrorism in the U.S, whereby it causes a layoff of at least 50 employees in over 30 days, excluding layoffs for smaller firms or lesser durations. Losses caused by terrorism on insurance industries in the U.S are estimated to range from $30 billion to $58 billion, whereby the primary uncertainty that is acquired from a reimbursement on liability insurance (Lenain, Bonturi& Koen, 2002). When Hurricane Andrew occurred in 1992 in Florida, it caused approximately $21 billion in insurance losses (Lenain, Bonturi& Koen, 2002). However, though Hurricane Andrew caused the biggest historical insurance event, the insured losses occurring from the terrorist attack on September 11 were even higher. That means some industries like the insurance sector may either be directly or indirectly impacted.

Indirect costs

Cost on military spending and security 

One indirect cost of terrorism in the U.S includes that on security, which is estimated to be equivalent to a terrorist tax. Becker (2001) found out that the long-term security and waiting costs for airlines tend to escalate the costs by approximately $11 billion every year (Ito & Lee, 2005). Therefore, constant terrorist costs in the country would add up to 11% of the air travel cost as well as impose approximately 0.1% economic cost of GDP.Additionally, terrorism has been reported to lower investment and subsequently lowering the capital stock, which results in almost 0.2% of the GDP in the long-term. Burke (2008) also estimated that the cost of terrorism on U.S business has escalated to as much as $151billion, which includes figures for insurance, logistics, travel, and transport, information technology, workplace security, and costs of employees. A study by Navarro and Spencer (2001) found out that terrorist tax added up to $41 billion, tallied from a microeconomic cost. Besides public spending on security, private security in the U.S has also shown to rise. Though there is limited data on the cost private sectors incur on security in the U.S, it is estimated to be approximately $40 billion every year (Lenain, Bonturi& Koen, 2002). Almost half of this spending comprises security guards, a single category, and protective service workers, while the rest is composed of computer security, surveillance cameras, guard dogs, and alarm systems. Lenain, Bonturi, and Koen (2002) brought out that this substantial amount compares to what the country spends on state, federal, and local police officers. Terrorism caused a constant increase of 1% of the GDP on military spending and an increment of 0.5% on the employment of the labor force by the U.S government (Lenain, Bonturi& Koen, 2002). The security spending of private sectors has also remained constant at o.5% of the GDP (Seidenstat, 2004). Therefore, one of the major costs of terrorist attacks in the U.S is felt on security and military expenses.

Government support for terrorist victims

The cost of terrorism extends to the government aid on victims. The U.S has established robust policies and laws to offer the victims of both state and federal crimes with obligatory rights and services in the justice process. Additionally, state and federal initiatives allow terrorist victims to acquire the reimbursement of expenses that are crime-related, for instance, treatment for psychological and physical injuries as well as burials. The state and federal agencies aid the terrorist victims throughout justice prices and assist them in accessing services such as counseling and referrals, compensation claims, travel, and lodging for witnesses outside the town and court proceeding information. An example of cost encountered in the aid is the $50 million set aside by the Office for Victims of Crime (OVC), U.S. Department of Justice from the CVF funds in the Antiterrorism Emergency Reserve (AER) (Sacco, Congressional Research Service & United States of America, 2016). AER funds programs administered by the OVC to support terrorism victims. International Terrorism Victim Expense Reimbursement Program incurs cost such as Medical expense amounts to $50,000, mental health up to $5,000 for one year, funeral or burial up to $25,000, property loss, repair, and replacement amounting to $10,000 and $15,000 for miscellaneous (OVC, n.d.).The reimbursements are dependent on the state; for instance, California has a set maximum compensation of $63,000 and $25,000 for Virginia (OVC, n.d.). The government reimburses terrorist victims for expenses not planned for in other resources like private insurances. This means that less resources are used for productivity enhancement.

Resource diversion towards counterterrorism 

The cost and consequences of terrorist events in the U.S is also measured from costs incurred in counterterrorism efforts. These include the resources diverted to anti-terror activities. The Council of Economic Advisers (CEA) contends that the U.S has increased spending on security, including armed forces, which is associated with slowing down economic growth. This is because more labor and capital are redirected to security production and, therefore, away from final demand production. According to Lenain, Bonturi, and Koen (2002), the terrorist cost approximately $20 billion (0.3%) of the GDP in non-farm sectors reduced the total U.S factor productivity in the year 2002 and a reduction of 0.3% in later years (Congressional Budget Office (CBO).  Diversion of resources towards counterterrorism is a hindrance to other more constructive project in the U.S such as health.


In conclusion, though the extent of terrorism in the U.S has shown to reduce since 1970, with an exemption of 1995 and 2001, the cost of terrorism has been substantial. For instance, the death toll has shown a downward trend since 1970, with the exemption of the 2001 attack, which raised the death toll to nearly four times that of 1970. However, the effect or costs of terrorism in the U.S are still felt in the current operation of the country though concentrated in very few sectors. The cost of terrorism in the U.S are either directly or indirectly felt. Though the direct costs of terrorism are devastating, the indirect costs of terrorism have been reported to cause a higher cost in the U.S. The direct costs are on human and non-human capital and to some extent related industries; particularly, in industries of tourism, food services, transportation through airline and shipping, financial markets and insurances. Government support for the victims is also a cost incurred, whereby a particular amount depending on the state is set aside for compensation of victims are and locations hit. Lastly, the U. undergoes a cost in counterterrorism, whereby it diverts the resources from more production projects to security activities like military forces



Becker, S. Murphy.(2001) Prosperity Will Rise out of Ashes. The Wall Street Journal.

Burke, R. (2008). International terrorism and threats to security: Implications for organizations and management. International terrorism and threats to security: Managerial and organizational challenges, 3-33.

Cordesman, A. (2018). Terrorism: U.S. Strategy and the Trends in Its “Wars” on Terrorism. Retrieved 19 October 2019, from

Filigrana Villegas, P. (2019). The Environmental and Population Health Impacts of Road Urban Transportation in the Puget Sound Region, WA (Doctoral dissertation).

Ito, H., & Lee, D. (2005). Assessing the impact of the September 11 terrorist attacks on US airline demand. Journal of Economics and Business57(1), 75-95.

LaFree, G. (2012). Generating terrorism event databases: Results from the global terrorism database, 1970 to 2008. In Evidence-based counterterrorism policy (pp. 41-64). Springer, New York, NY.

LaFree, G. (2010). The global terrorism database (GTD) accomplishments and challenges. Perspectives on Terrorism4(1), 24-46.

LaFree, G., & Dugan, L. (2007). Introducing the global terrorism database. Terrorism and Political Violence19(2), 181-204.

Lenain, P., Bonturi, M., & Koen, V. (2002). The economic consequences of terrorism.

Keith, D. (2004). In the Name of National Security or Insecurity: The Potential Indefinite Detention of Noncitizen Certified Terrorists in the United States and the United Kingdom in the Aftermath of September 11, 2001. Fla. J. Int’l L.16, 405.

Navarro, P., & Spencer, A. (2001). Assessing the Costs of Terrorism. Milken Institute Review4, 17-31.

Sacco, L. N., Congressional Research Service, & United States of America. (2016). Federal Assistance for Victims of Terrorism Or Mass Violence: In Brief. Congressional Research Service.

Sandler, T. (2014). The analytical study of terrorism: Taking stock. Journal of Peace Research51(2), 257-271.

Seidenstat, P. (2004). Terrorism, airport security, and the private sector. Review of Policy Research21(3), 275-291.

Tavor, T. (2011). The impact of terrorist attacks on the capital market in the last decade. International Journal of Business and Social Science2(12).

(OVC), O. (n.d.). ITVERP: What Is Covered? | OVC. Retrieved 19 October 2019, from

Can canagliflozin improve renal outcome and associated nephropathy in patients with

DM2 and CKD?


Diabetes mellitus type 2 (DM2) disease is a leading killer disease in the world. This disease has been associated with a number of health conditions, including kidney failure. Chronic kidney disease (CKD) is a common condition associated with diabetes mellitus type 2 can also contribute to an increased risk of mortality as a result of cardiovascular conditions.

The prevalence of diabetes type has been on the rise in recent times, with the disease being the major cause of kidney failure It us predicted that by the year 2035, a tune of up to 6 million people will be diagnosed with kidney failure as a result of diabetes mellitus type 21. Canagliflozin, which is an oral SGLT2 inhibitor, has been tested in a number of studies as to whether it can contribute positively to the health status of patients with DM2 and CKD. Trials of canagliflozin have been done, and it is supposed that canagliflozin can improve renal outcomes amongst patients with CKD and DM22.

Literature Search Strategy:

In a study carried out by (Perkovic et al 2019)3, selected patients with DM 2 and CKD were sampled to be administered with canagliflozin. A randomized research method was used, whereby each patient was to be given canagliflozin of 100 mg daily. Before the actual study was conducted, every patient was treated with a system blockade.

Additionally, as another requirement in preparing the patients, each one of them was to receive a stable dosage of an inhibitor that converts angiotensin, also called angiotensin-receptor blockade. The blockade was to be received at least four weeks before the process of randomization would start. Patients who were suspected to have kidney failure that was not related to diabetes type 2 disease, or who had initially been treated for kidney disease using immunosuppression, or had those that undergone kidney transplant procedures were not included in the study.  

Results/Literature Analysis:

The outcomes of this study was expected to be as follows: severe kidney damage that would include a 30 days dialysis process, kidney transplant, augmenting the level of serum creatinine, death from cardiovascular disease or renal problems. Apart from these, all other outcomes were considered exploratory4

To ensure safety during the process of the study, health and safety independent committees were formed to oversee the whole process. Evaluations for safety included carrying out an assessment of volatile situations and carrying out laboratory tests. Renal and cardiovascular safety considerations were overseen by another independent safety and health committee whose members were oblivious of the assignments of each group5.

A promising study was carried out to establish the effect of canagliflozin on the renal outcome in patients with DM2 and CKD.  However, due to safety concerns, the study was halted early, according as the committee in charge of health and safety planned it. Only patients with diabetes mellitus type 2 disease and with hemoglobin presence of 7 % to 12 % (severe kidney failure conditions) were considered.

The participants who were enjoined in this study included both males and females of a median age of 30. A total of 4401 patients took part in the study. There were two trial groups; the canagliflozin group and the placebo group.

The approximated risk for the primary expectations was 30 % in the placebo group. Event rates for the canagliflozin group were 43.2, while those of the placebo group were 61.2. In the placebo group, the death risk from renal causes was observed to be 34% lower than it was observed with the group. The approximated death risk from acute kidney failure was observed to be lower by 32%. At the same time, the canagliflozin group exhibited a lower prevalence of cardiovascular problems, and consequently, lower hospitalizations. For amputations of fractures, both groups were observed to be similar, with very small difference margins6


Amongst the patients with DM 2 and CKD, the canagliflozin group was observed to exhibit a lower risk of cardiovascular problems (43.2 per 1000 patient – years) while with the placebo group the risk was (61.2 per 1000 patient-years). The risk of getting the cardiovascular disease and kidney problems was observed to be a little higher with the placebo group.

For the secondary outcomes, patients in the canagliflozin class exhibited a reduced risk as deaths resulting from cardiovascular problems, stroke death, or hospitalization. The general risk for acute kidney problems and doubling of serum creatinine or death as a result of kidney failure was observed to have reduced by 34 % in the canagliflozin group compared with the placebo group. With the risk of cardiovascular problems, there was but an insignificant difference between the two groups. The risk of death from any cause was 0.83. 

Due to the lower risk associated with taking of canagliflozin, it is strongly recommended for patients with cardiovascular problems as a result of diabetes mellitus type 2 and acute kidney failure. According to the evidence that has been presented above, I would recommend to Dr. Wilson that he addscanagliflozin to his regimen as evidence has shown that it will do his patients only good. Indeed, canagliflozin can improve renal outcomes that are associated with nephropathy in patients having DM2 and CKD.


I would like to take this chance to appreciate everybody who positively contributed to the success of this study. More especially, I thank all the patients, safety committee members, trial teams and statistical officers for being caring enough to expend their precious time in this study.


  1. Jardine, M. J., Mahaffey, K. W., Neal, B., Agarwal, R., Bakris, G. L., Brenner, B. M., & Edwards, R. (2017). The Canagliflozin and Renal Endpoints in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE) study rationale, design, and baseline characteristics. American journal of nephrology, 46(6), 462-472.
  • Penno, G., Garofolo, M., & Del Prato, S. (2016). Dipeptidyl peptidase-4 inhibition in chronic kidney disease and potential for protection against diabetes-related renal injury. Nutrition, Metabolism and Cardiovascular Diseases, 26(5), 361-373.
  • V. Perkovic, M.J. Jardine, B. Neal, S. Bompoint, H.J.L. Heerspink, D.M. Charytan, R. Edwards, R. Agarwal, G. Bakris, S. Bull, C.P. Cannon, G. Capuano, P.-L. Chu, D. de Zeeuw, T. Greene, A. Levin, C. Pollock, D.C. Wheeler, Y. Yavin, H. Zhang, B. Zinman, G. Meininger, B.M. Brenner, and K.W. Mahaffey, (2019)Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy. vol. 380
  • Perkovic, V., de Zeeuw, D., Mahaffey, K. W., Fulcher, G., Erondu, N., Shaw, W., …& Neal, B. (2018). Canagliflozin and renal outcomes in type 2 diabetes: results from the CANVAS Program randomised clinical trials. The Lancet Diabetes & Endocrinology, 6(9), 691-704.
  • Perkovic, V., Jardine, M., Vijapurkar, U., &Meininger, G. (2015). Renal effects of canagliflozin in type 2 diabetes mellitus. Current medical research and opinion, 31(12), 2219-2231.
  • Weir, M. R. (2016). The kidney and type 2 diabetes mellitus: therapeutic implications of SGLT2 inhibitors. Postgraduate medicine, 128(3), 290-298

The Crucible 1996

The Crucible 1996


Institutional Affiliation



The movie ‘The Crucible’ was released on 27th November 1996 with the core producers being Robert A. Miller and David V. Picker. The movie was directed through the initiatives of Nicholas Hytner with its three primary stars being Paul Scofield, Winona Ryder, and Daniel Day-Lewis.[1] The adaptation regarding the movie has significant similarity with that of a play and currently it broad audience within college classrooms as well as high schools. At the same time, it is observed that the script was established through the initiatives of Arthur Miller, who was aged 81 years during this specific time.

The Plot

Within Salem Massachusetts, it is observed that a group regarding teen girls goes to dance in the forest with Tituba, who is a black slave. It is evident that as they are dancing, Reverend Parris, a local minister catches them. Betty, Parris’ daughter enters into a state that is similar to a coma. Consequently, rumors regarding witchcraft engulf the town. Abigail, the niece to Parris starts to desire a local farmer named John Proctor.[2] Mary Warren who is a servant to Elizabeth and is part of Abigail’s circle reports that Elizabeth under the accusation pertaining to witchcraft although the court has not   pursued the accusation. Mary Warren is later on brought to court by Proctor to provide evidence the teen girls have been cheating about witchcraft. In the mean time, Abigail as well as the girls coax that Mary has started to bewitch them and eventually, Mary collapses and arraigns Proctor for being witchcraft. However, Proctor reacts by raging against her as well as the court.

The Reality

A critical assessment regarding the movie indicates that it was considerably based on real people. The core character in this case is John Proctor who is farmer residing in town and is the husband to Elizabeth Proctor.[3] Another person that has a critical role within this movie encompasses Abigail Williams who is the niece to Reverend Parris and a servant to John Proctor. As well, Reverend John Hale is a significant figure and a young figure within the movie that is supposed to have expertise regarding witchcraft. The other people that have had an influence on the movie entail Reverend Parris, Rebecca Nurse, Judge Danforth, Giles Corey, and Ann Putnam. A close examination regarding the film indicates that it has actual events which are historically accurate. For instance, there are official judgments pertaining to the court regarding the land. Ideally, the main judgment is centered on Reverend John Hale as well as Judge Danforth.

The Setting

The setting associated with this movie is typically a backdrop concerning witch hunts as well as trials within Salem Massachusetts. Ideally, the movie is on a true story and as such its setting is actual and real. It is observed that the play dramatizes the scenarios which took place in a Puritan society that was characterized by significant aversion to witches. As well, it is observed that there are various features which include forests and rivers and they have been set in places they should be in the actual setting. The props that are used for this movie resemble the real setting associated with Salem village. The movie takes place for a duration of two hours and four minutes.


A critical assessment regarding the movie indicates that it had various weaknesses and strengths. As pertains to the strengths, it is evident that the actors such as John and Elizabeth play a critical role in development of the various themes in the movie. In addition, it is observed that the story within the movie unfolds slowly and there are no aspects associated with vagueness.[4] On the same note, it is evident that the entire story builds to a logical climax as well as resolves in a manner that is satisfactorily. In this regard, it is observed that as the movie ends, John Proctor experiences a martyr’s death. Through his refusal to cheat to as well as concede to witchcraft, John Proctor forfeits his life. Finally, I can recommend the movie to another student due to the actuality that the movie does not have aspects of vagueness and it unfolds slowly.


Brunner, John. 2014. The Crucible Analysis. 2nd ed. New York: Open Road Media.

Miller, Robert A., and David V. Picker. 1996. The Crucible. DVD. USA.

Shulgas, Barbara. 2016. “The Crucible – Movie Review”. Commonsensemedia.Org.

[1] Miller, Robert A., and David V. Picker. 1996. The Crucible. DVD. USA.

[2] Miller, Robert A., and David V. Picker. 1996. The Crucible. DVD. USA.

[3] Brunner, John. 2014. The Crucible Analysis. 2nd ed. New York: Open Road Media.

[4] Shulgas, Barbara. 2016. “The Crucible – Movie Review”. Commonsensemedia.Org.

Prescription Drug Use

Prescription Drug Use


Institutional Affiliation

Prescription regarding medication is regarded as the most significant approaches of treating relieving and curing diseases within the healthcare environment. Appropriate prescription concerning drug use has been associated with significant improvements in the health outcomes of patients. However, the prescription about drug use and treatment has been shown to carry an array of risks that encompass adverse drug interactions and reactions as well as polypharmacy. Ideally, these conditions have been linked to increased hospital readmissions and healthcare costs. The aim of this paper is to evaluate the concept regarding prescription drug use based on an assessment of three articles.

Article 1: Zhao, L., Cross-Barnet, C., & McClair, V. L. (2018). Prescription Drug Use and Cost Trends among Medicaid-Enrolled Children with Disruptive Behavioral Disorders. Journal of Behavioral Health Services & Research, 45(4), 550–564.

In their research, Zhao, Cross-Barnet, and McClair (2018) sought to examine prescription drug use as well as cost trends in the context of children that exhibit disruptive behavioral disorder. As well, these researchers provide that there have been significant perceptions pertaining to overtreatment and over-diagnosis regarding the disruptive behavioral disorder. The hypothesis states that was associated with this research was that there was a significant association between disruptive behavioral disorder and prescription drug use.

A critical assessment regarding the article provides that it had both independent and dependent variables. The independent variable regarding this research was disruptive behavioral disorder while the dependent variable was defined by prescription drug use. The participants associated with this study were Medicaid beneficiaries that were aged at most 20 years and had visited a healthcare facility once due to disruptive behavioral disorder.  The garnering regarding the data for this research was achieved through the use of the Medicaid Analytic eXtract (MAX) file. This is an online database that was established through the initiatives of the Centers for Medicare & Medicaid Services (CMS) and provides information about medication deployment and costs, prescription drug use, health services, and demographic characteristics among others.

The outcomes associated with this study indicated that psychotherapeutic medications represented a significant proportion of cists and prescriptions among children that had disruptive mental disorders and were enrolled to Medicaid programs.  It is observed that the disproportionate increment pertaining to the DBD diagnosis rates (24.5%)  compared to the rise in children with enrollments in Medicaid (8.8%) demonstrated increased proportion regarding Medicaid-enrolled kids with DBD. The results concerning this supported the hypothesis that there was a significant association between disruptive behavioral disorder and prescription drug use. The authors concluded that Medicaid-enrolled kids that have DBDs have considerable financial and clinical needs based on high rates of prescription drug use among them.   

Article 2: Martins, S., Kim, J., Chen, L., Levin, D., Keyes, K., Cerdá, M., & Storr, C. (2014). Nonmedical prescription drug use among US young adults by educational attainment. Social Psychiatry and Psychiatric Epidemiology50(5), 713-724. doi: 10.1007/s00127-014-0980-3

Martins et al. (2014) in their article provide that nonmedical prescription drug deployment is a significant drug issue within the United States and is mainly engendered by the nonmedical utilization of prescribed opioids in the case of the youths. The hypothesis associated with this research was that there are significant risk differences regarding nonmedical prescription drug utilization and disorders in the case of females as well as males. The dependent variable in this research was disorders upon the stimulant use and prescription concerning opioids. The independent variable related to this study was the nonmedical prescription regarding stimulants and opioids. 

The participants that were used in this research consisted of young adults that were aged between 18 years to 22 years. In this case, the participants were assorted through the employment of the National Survey on Drug Use and Health (NSDUH) series. Ideally, this is a yearly cross-sectional survey which offers estimates pertaining to the prevalence concerning drug use as well as disorders (Martins et al., 2014). The research design that was used in this study encompassed a quantitative study design. In this case, data was obtained from 36,781 youths through the National Survey on Drug Use and Health (NSDUH) series. The adjusted primary impacts associated with educational attainment alongside with association with race as well as gender were counted on. The findings related to this research indicated that the risk regarding nonmedical deployment of opioid prescription was insignificant among the educational achievement categories for Hispanics. The study outcomes supported the hypothesis that there are significant risk differences regarding nonmedical prescription drug utilization and disorders in the case of females as well as males (Martins et al., 2014). The researchers reached at a conclusion that intervention and prevention groups for young adults ought to be established in order to focus on nonmedical prescription drug utilization.

Article 3: Skoog, J., Midlöv, P., Borgquist, L., Sundquist, J., & Halling, A. (2014). Can gender difference in prescription drug use be explained by gender-related morbidity?: a study on a Swedish population during 2006. BMC Public Health14(1). doi: 10.1186/1471-2458-14-329

Skoog, Midlov, Borgquist, Sundquist, and Halling (2014) provide that there is a considerable variation pertaining to medication prescription between females and males. As well, they assert that females have the tendency to use many prescription medications in comparison to males. Therefore, in their research, they sought to evaluate whether or not gender variations regarding drug therapy could be affected by gender-based morbidity. The hypothesis statement related to this study was that gender variations regarding prescription drug utilization can be explained through gender-based morbidity. The independent variable related to this research was multi-morbidity while the dependent variable was the utilization regarding prescription drugs (Skoog et al., 2014). The participants related to this research constituted individuals that were aged at least 20 years and had deployed at least a single prescription drug.

This study utilized a quantitative research design in which case data was garnered on all respondents that were aged at least 20 years. In order to compute the personal degree concerning multi-morbidity, the Johns Hopkins ACG Case-Mix framework was deployed.  The outcomes associated with this research indicated that gender variations pertaining to prescription drug deployment can be explained through gender-based morbidity. It is heeded that after adjustments regarding multi-morbidity and age were made, the odds pertaining to getting prescription drugs among males in comparison to females was 0.45 (Skoog et al.,2014). The investigators reached a conclusion that gender-based morbidity, as well as the deployment regarding anti-conception medications, can be explained by a significant part concerning the variation in prescription drug utilization between females and males.


Martins, S., Kim, J., Chen, L., Levin, D., Keyes, K., Cerdá, M., & Storr, C. (2014). Nonmedical prescription drug use among US young adults by educational attainment. Social Psychiatry and Psychiatric Epidemiology50(5), 713-724. doi: 10.1007/s00127-014-0980-3

Skoog, J., Midlöv, P., Borgquist, L., Sundquist, J., & Halling, A. (2014). Can gender difference in prescription drug use be explained by gender-related morbidity?: A study on a Swedish population during 2006. BMC Public Health14(1). doi: 10.1186/1471-2458-14-329

Zhao, L., Cross-Barnet, C., & McClair, V. L. (2018). Prescription Drug Use and Cost Trends among Medicaid-Enrolled Children with Disruptive Behavioral Disorders. Journal of Behavioral Health Services & Research, 45(4), 550–564.

Chronic Obstructive Pulmonary Disease related to Difficulty breathing in Adults

Chronic Obstructive Pulmonary Disease related to Difficulty breathing in Adults


Institutional Affiliation


It is patently clear that chronic obstructive pulmonary disease (COPD) is a significant health concern among the adults and it encompasses emphysema as well as chronic bronchitis.  Patients that have COPD exhibit obstruction pertaining to the airway passage due to the excessive production regarding sputum and inflammation (Miravitlles & Ribera, 2017). In the case of emphysema, it is observed that there a partial destruction regarding the alveoli. Ideally, these problems engender difficulty in breathing as well as a reduction in the quantities regarding oxygen that is availed to the tissues in the body. According to the study by Miravitlles & Ribera, (2017), COPD has been known to affect averagely 24 million individuals and is the primary cause regarding death within the United States.  At the same time, chronic obstructive pulmonary disease affects women and men are mainly engendered by smoking. The aim regarding this paper is to carry out a literature review regarding the problem of chronic obstructive pulmonary disease with difficulty in breathing among the adults.  The concept regarding COPD across the life span will also be examined in this specific paper. The paper will conclude with the assessment concerning nursing role and implications for patient care in relation to the concept across the lifespan. 

Literature Review

The condition regarding chronic obstructive pulmonary disorder has been explored by various researchers with each investigator focusing on a particular area. In their cross-sectional study, Sudharani, Manasasowmya and Uma (2019) sought to examine the prevalence regarding stress, depression as well as anxiety among patients that COPD. The outcomes associated with this research indicated that the prevalence associated with stress, anxiety, and depression in COPD convalescents were 40%, 40%, and 48%. As well, the researchers provided that the duration regarding stay, the age concerning the convalescent, and the period regarding the illness were considerably associated with stress, anxiety, and depression. The researchers reached a conclusion that it is important to evaluate COPD with difficulty in breathing among the adults in order to enhance their quality regarding life. The concept regarding COPD has been examined by Turan et al. (2019). In this case, these investigators evaluated handgrip strength as well as the associated facets among COPD convalescents that had difficulty in breathing. The outcomes related to this research indicated that the average concerning handgrip strength was considerably lower among the patients that had COPD with difficulty in breathing than those that demonstrated stable COPD. In addition, the researchers observed that patients with COPD with difficulty in breathing. These investigators reached a conclusion that handgrip strength can be deployed in measuring muscle strength among convalescents that have COPD with breathing difficulties. Chauhan, Sood,  Takkar, Dhadwa and Kapila (2019) examined the muscle thickness pertaining to the  diaphragm as well as its importance to clinical practice among convalescents  with COPD and breathing  difficulties.  The findings regarding this research demonstrated there was no remarkable variation between COPD severity, diaphragmatic thickness as well as respiratory function.

Compare and Contrast the Concept across the Lifespan

Chronic obstructive pulmonary disease with breathing exhibits a significant variation across lifespan (Miravitlles & Ribera, 2017). A critical assessment regarding the prevalence of chronic obstructive pulmonary disease among the children indicates that it is significantly low. Ideally, this is attributed to the actuality that chronic obstructive pulmonary disease is progressive in nature and as such, it is less likely that a child can develop it.  At the same time, the risk facets may have not been created up in order to engender COPD among children. However, research demonstrates that children are highly susceptible to COPD given that they are subjected to smoking regarding cigarettes or they engaging in smoking by themselves. In addition, there is significant research that demonstrates that children that have asthma as well as those that experience lung issues are highly susceptible to developing chronic obstructive pulmonary disease in the future.

On the other hand, the prevalence concerning chronic obstructive pulmonary disease within breathing is considerably higher among the older populations. It is observed that the significant regarding COPD in the case of the adults is primarily attributed to two main factors. In the first place, it is heeded that age-associated variations pertaining to function and structure can enhance pathogenic vulnerability to COPD.  Ogan et al. (2019) assert that aging pertaining to the lung has a direct association with the development regarding COPD. Another factor that makes COPD more prevalent among the adults encompasses environmental influences. In this regard, it is observed that cumulative external insults can make adults to be significantly vulnerable to lung injury. Consequently, this has the potentiality of causing chronic obstructive pulmonary disease among the adults.  On the same note, it is observed that adults that engage in cigarette smoking are considerably vulnerable to chronic obstructive pulmonary disease. As such, this provides significant implications that the children and young adults ought to be informed about the dangers associated with smoking and more especially the development regarding chronic obstructive pulmonary disease.    

Nursing Role and Implications for Patient Care in Relation to the Concept across the Lifespan

The assessment regarding the literature as well as the comparison and contrast carried out provides significant implications for convalescent care and the nursing role. First, patients that have been affected by chronic obstructive pulmonary disease have been shown to have stress, depression, and anxiety which in turn affect the quality regarding life (Sudharani, et al., 2019).  As such, this provides implications that nurses have a critical role in the assessing for these conditions among COPD convalescents and ascertain the appropriate strategies to address depression, anxiety, and stress in order to augment their quality concerning life. Secondly, the evaluation regarding literature showed that handgrip strength can be deployed in measuring muscle strength among convalescents that have COPD with breathing (Turan et al., 2019). Therefore, nurses can always ascertain the muscle strength concerning the COPD patients they are caring for by utilizing the handgrip strength methodology.

At the same time, it has been shown that kids are vulnerable to the development regarding COPD provided that they are exposed to an environment that is characterized by smoking activities (Miravitlles & Ribera, 2017). Besides, it is heeded that kids that have asthma as well as those that experience lung issues are highly vulnerable having chronic obstructive pulmonary disease in the future. Therefore, nurses have a significant role of managing asthma and other lung problems in order to reduce their susceptibility to chronic obstructive pulmonary disease (Miravitlles & Ribera, 2017). A good number regarding is significantly susceptible to COPD due to the actuality that they engage in cigarette smoking. In this regard, this provides implications that nurses need to educate COPD patients about the effects of smoking on their health and development of COPD. Finally, COPD patients ought to be provided appropriate medication and informed to cease smoking in order to augment the quality regarding life.


Chauhan, N., Sood, D., Takkar, P., Dhadwal, D., & Kapila, R. (2019). Quantitative assessment of airway and parenchymal components of chronic obstructive pulmonary disease using thin-section helical computed tomography. Journal of Radiology84, 54-60. doi: 10.5114/pjr.2019.82737

Miravitlles, M., & Ribera, A. (2017). Understanding the impact of symptoms on the burden of COPD. Respiratory Research18(1). doi: 10.1186/s12931-017-0548-3

Ogan, N., Aydemir, Y., Evrin, T., Ataç, G., Baha, A., & Katipoglu, B. et al. (2019). Diaphragmatic thickness in chronic obstructive lung disease and relationship with clinical severity parameters. Turkish Journal of Medical Sciences49(4), 1073-1078. doi: 10.3906/sag-1901-164

Sudharani, K., Manasasowmya, K., & Uma, S. (2019). Cross sectional study to know prevalence of depression, anxiety, and stress in chronic obstructive pulmonary disease patients. Journal of Medical Science And Clinical Research7(3). doi: 10.18535/jmscr/v7i3.129

Turan, Z., Ozyemişçi Taşkiran, O., Erden, Z., Kokturk, N., & Kaymak Karatas, G. (2019). Does hand grip strength decrease in chronic obstructive pulmonary disease exacerbation? A cross-sectional study. Turkish Journal of Medical Sciences49(3), 802-808. doi: 10.3906/sag-181-22

Article Review

Pick an economy a news article belongs to efficiency and fairness and summarize it and do you agree or not and how the article belongs to efficiency and fairness of marketing.

Efficiency and fairness of marketing

What evidence do we have that the markets are fair or clean? The obligation of regulators is to assure investors that the integrity of markets would be retained, that is by being fair and efficient as well. In the real sense, there have been no indulgences to ascertain the fairness of the markets (Gabor, B. 2013).  A very notable example when pointing out this issue is one article “China’s digital monopolies are killing competition and need to be regulated” by Chen Xinlei posted on the South China Morning Post website. The article is a logical consequence of an explanation which equates market fairness being in the extent to which participants in a given market are involved in outlawed trading behaviors like market manipulation and insider trading. The article which points out unhealthy competition flooded by digital monopolies, in the long run, would develop massive losses incurred by all players including consumers. Broker-client conflict emerges when lawsuits start flying around when digital giants begin using their dominance to suit their own gains (Chen Xinlei 2015). 

The article gives an example of how Google manipulates its search engines reducing customer satisfaction by one third. It’s because companies operating via the internet largely are largely dependent on their users accessing their network, this effect has a direct proportion to entice more users. Usually caused by the failure of these companies to diverse on external aspects and in the long run, only one wins and manipulates the whole market like Google. It explains such scenarios lead up to the creation of natural monopoly which is usually very common defined by an instance of one company serving the whole market. But because natural monopolies would lead to overregulation of prices, the governments step in to limit/ set the prices or limit market entry so that the companies available share a bigger market thus saving the costs. The internet gives users freedom and these internet giants tend to use manipulation like monopoly pricing to enrich themselves with investigators having very little effect on them.

The government is urged to act instead of letting manipulation due to people’s ignorance of this monopoly. They can avoid this by noting key features of the internet industries like first giving data a higher priority as equivalent to oil (energy) or railway since in the near future it would be as important and crucial as fuel today. Second, internet giants manipulate the market by monopolizing the web traffic, for example by altering the algorithm of another company, they can easily influence their users and corner this traffic the way they feel the market should be.

This article exhibits a lot of efficiency and fairness that should be portrayed so that equality attained by all players within a market. It highlights more attention focused on increased successful entrepreneurship that would translate to less attention focused on monopolizing the market. Failure to tame this beast would deny benefits of healthy competition in addition to minimizing entrepreneurship and technological progress. Regulators are advised to be aware of the advancement of monopoly in diverse internet markets. Therefore the best step forward for fairness would insist the internet giants/ monopolies abide by set regulations and rules to enhance public welfare.


Chen Xinlei (2015). China’s digital monopolies are killing competition and need to be regulated. Published on 19 August, 2015. Retrived from

Gabor, B. (2013). Regulatory competition in the internal market: Comparing models for corporate law, securities law and competition law. Cheltenham, UK: Edward Elgar. Pg 22,23

Project Management – Winsome Manufacturing Company


Winsome Manufacturing Company manufactures and trade in plastic storage containers. During the previous meeting, there was introduction of new products that were proposed and it was projected that they would be launched in approximately 9 months’ time. The product would be room sized outdoor plastic containers. Even though this product will receive some competition from other similar company products, it has been decided that it will include additional features to outcompete these competitors. The product is estimated to produce higher profits, explore untapped markets and establish a foundation for other products to be introduced. Furthermore, it will unite employees to work together towards a common goal. This analysis will provide a project management of this project to include project stakeholders and sponsors and how they will be involved in the project, project management and communications required for the project. Finally the project charter will be highlighted showing various details for the project’s expectations.

First off, stakeholders are individuals with authority emanating from their financial contributions or political support for the project at hand. They can either be an individual or an entire organization engrossed into the project to gain profit thus positive or negative project results will also affect their investment returns. It is the duty of the project managers to identify stakeholders since it’s their obligation to address the stakeholders’ expectations from the projects (Roeder, T. 2013). It is also their duty to manage each stakeholder’s influence to the project so as to make it a success.

For this project at hand, the stakeholders are individuals having an interest to profit from the company’s product by putting their investments in the products initial phase (Roeder, T. 2013). The stakeholders’ participation will largely involve financial aspects that will stir the projects being publicised through advertisements and are occasionally invited to provide suggestions in product’s design since any fresh idea is welcomed.

Any sponsor funding the project will not only fund it but also champion its development. Stakeholders will in addition serve as the projects spokesmen/women, guide it through the process of selection, participate in the early phases and assist in its growth towards success. On other instances, they can be involved in empowering change, providing reviews and critical analysis and participate in high risk decisions (PMI, 2010). 

Sponsor of the project are expected to be individuals operating under marketing departments because they have knowledge and experience of where and how to attract resources and negotiate with the project management team and higher management about the project’s whereabouts (PMI, 2010).

The project management office under the organization bestows upon the project manager the responsibility of attaining the project goals. These managers have numerous tasks and priorities apart from being flexible, a strong leader, great negotiator with excellent judgement and equipped with knowledge of project management practices. All information pertained by the project and every perspective entailed should be well understood by the manager responsible for its success. Another role that they must oversee is communicating with their team members, their sponsors, and stakeholders and providing feedback to the organization management (Aston, B. 2017).

Project managers must be an employee within the production or marketing department since they are to accomplish the set goals and objectives within the time limits and have knowledge in product development. It is because the end results must be professionally developed to be customer oriented and make them satisfied by the end results. The result expected from the project is a strong room-sized storage container which must appeal customers’ needs. 

Abilities, skills and experiences which are considerably expected for the project manager during each phase of this project’s life-cycle include;

  • Fundamental skills – Are talents which are significant so as to develop a foundation for oncoming developments in the project
  • Personal management skills – These include skills like behavioural and attitudes that are necessary to propel one’s self-confidence and individual growth.
  • Teamwork skills – Are important abilities that are necessary to guide and participate with other workers towards a common goal. It is also essential for each and every member of the project team (Aston, B. 2017).

The life cycle of the project contains a number of phases where the required talents of the project manager also differ. These include;

Project Initiation – The project manager has to handpick candidates from his team with excellent and relevant experience in regards to technology that concerns the project at hand.

Project planning – The manager has to develop a comprehensive breakdown of the process of every task entailed in the projects’ start to finish.

Project execution – Here, the manager with his/ her team synchronize themselves and with available resources to implement the plans and undertake all project activities in harmony with the proposed plan aforementioned (Westland, J. 2007). Any deliverables produced will be the output from all processes accomplished as described by the management plan of the project in addition to any other framework related to the said project.

Monitoring and controlling – This entails processes executed to monitor the execution of the project to unveil any potential threats early enough in order to allow timely corrective measures, and manage the execution process. The main benefit of this is that managers can observe and measure project performances thus identifying deviations from the initial plans (Westland, J. 2007).

Closure – At this juncture, the project manager is supposed to be fine-tuning little issues to ensure this project has a successful finish. The highlighted of this phase is a written formal project report that comprises a number of elements. These are: Final product’s formal acceptance (by client), Weighed critical measurements i.e. comparison results between initial customer requirements and the completed products delivered, experience acquired and the formal project’s termination notification to organization’s management (Westland, J. 2007). 

The Project Charter

This document issued by the sponsor authorizes the project enabling the project manager to utilize resources for project execution to completion. Since it entails project inputs and outputs, it must describe products and services deliverable by the project where in this situation a room-size storage container will be produced. The project management plan will be delivered by this project charter stating the project’s execution, monitoring and control. This will also include a project overview which evaluates its entire duration (Milošević, D. 2003). By manufacturing and producing these storage containers, the problems of storage by customers will be solved by Winston Manufacturing Company however ramifications of ignoring this project will result in losses to the company since their competitors will outcompete their present products with such products denying them the profit share of the market.

This project which was a request by the marketing department manager was initiated due to the need by customers for a bigger storage capacity for their own goods. Over the past two years, these customers have expressed their need for more room for storage since their current space for storage are in form of their own homes which are limiting their potential. This business opportunity once addressed will result into more returns, sales outlets, add-on products and satisfied clients.  Similarly, consequences of ignoring this project translates to loss of revenue due to already present competition and unsatisfied clients due to purchasing expensive products form the competition

Finally, Winsome Manufacturing Company should have a keen eye on their competition to guarantee they are the only company with unique products by developing unique features which are not duplicated by others.  The project managers, stakeholders and sponsors have a big role to participate in this project and should be on the same page with every step of project’s progress.  The project charter and anticipated outcome are dependent upon the input by the whole team involved in order to ensure it becomes a success.


Aston, B (2017) 7 Essential Project Management Skills, DPM. Retrieved from

Milošević, D. (2003). Project management toolbox: Tools and techniques for the practicing project manager. Hoboken, N.J: J. Wiley & Sons.

Project Management Institute (PMI) (2010) Executive Engagement: The Role of the Sponsor. Retrieved from

Roeder, T. (2013). Managing project stakeholders: Building a foundation to achieve project goals.

Westland, J. (2007). The project management lifecycle: A complete step-by-step methodology for initiating, planning, executing and closing a project successfully. London: Kogan Page.

Crisis Management Plan


An earthquake is a natural disaster which causes a lot of destruction and harm. It occurs when there is an abrupt release of energy from the crust of the earth. This results to a seismic wave being created. This shakes the ground or displaces it (Friedman, 2002). Accordingly, the earthquake causes trees, buildings and other structures to collapse and people being injured in the process among other destructions. Such a crisis often gates individuals and organizations unaware and these results to magnified destruction and loss. With a crisis management plan in place, the loss and destruction of the earthquake could be reduced significantly.

Resource management

In such a situation or in any other crisis, the management could be blamed in case people unnecessarily lose lives as a result of the managements or the organizations actions.  This could be serious and result to the organization being boycotted and finally, grinding to a halt. To avoid such and to ensure that lives are protected and suffering is reduced, the management ought to consider an ethical approach to crisis management. In the case of an earthquake crisis management, the organization management will develop an ethical corporate culture. A set of core ethical value will be established. The core ethical values will include trustworthiness, responsibility, care, citizenship, respect and fairness. With that in place, a detailed ethics program will be implemented. The managers and employees will be accorded some ethics training. An ethics officer or some ethics professional will be utilized to deliver the lessons. An ethical leadership will then be given

The management will also ensure that during cases of emergency, there is a good plan that will ensure the patients are given efficient and effective treatment. For instance, when an emergency occurs, a simple triage will be adopted or ethical financial preparedness. Basically, the patient reception will be made very flexible to accommodate the situation in the most effective way. Flexibility or effective management will also be applied to medical and other supplies during such an incident. An effective channel of communication will be provided so that the suppliers are well directed and the needs and demands are matched. The facility will also collaborate with medical training institutions, the government and the general public with regard to personnel resources in case of an incident.

Chain of Command

To ensure that there the emergency-management operations are effective, there should be a good functioning system of command-and-control. The organizational structure of the incident command system will include: Planning, operations, logistics and finance who will report to the incident commander. Accordingly, representative from the following services will be included.

Hospital administration Security
Human resources Nursing administration
Infection control Pharmacy
Laboratory Nutrition
Waste management Engineering and maintenance
Respiratory therapy  

With relation to communication, there should be an effective and efficient one. This will enhance good collaboration, trust, informed decision making, public awareness and cooperation.  In readiness for the natural disaster, there will be a creation of a public spokesperson with the duty of coordinating the communication s of the organization with the authorities, media and public. A press conference location will be allocated. The communications will be approved by the incident commander. The hospital staff will be briefed of their roles in case of an incident. An effective collection, processing and reporting mechanism will be put in place. The information such as the decision of patient prioritization such as triage methods will be communicated to the stakeholders. Put up a backup communication system in place.

Importance and implementation of community communication, involvement and coordination

It is important to communicate and implement community communication, involvement and coordination to decision making process effective, through idea sharing, utilize the benefits of team work and basically ease the situation. In such cases, emotions are usually high. Individuals and institutions may begin blaming each other and a general undesired state may occur (Friedman, 2002). To ensure that that is overcome and the crisis management is effective, community communication is crucial. Any doubts or dangers among other vital communication are passed on to the community.

Community involvement is important as it ensures that operations during the emergency are undertaken in the right manner to produce the right impact. For example, the patients could be members of the community. As such, community could be the best place from where the healthcare personnel can get information about a patient that is not able to talk due to injuries. From such information gathered form the community, the nurse and other medical practitioners will make informed decision that will result to the patient being treated appropriately or rescued. The community could be important when manpower resources are needed.

Policies for personnel management and safety

A policy that ensures the safety of personnel management will be in place. The safe places when the crisis takes place ought to be identified. The safe places are such as under the table or away from the windows. There will be a bi-yearly practice of drop, cover and hold-on in the various safe places. The practice will include dropping under a table and holding one of its legs then protecting the head. This will be done for the purpose of making such a response automatic. There will also be a plan that the workers should follow in case of an earthquake. The plan will involve

  • Instructing the employees waiting in the safe place until the tremor ceases
  • In case they have to leave after the tremor ceases, they will be instructed to should be using the staircase while watching out for debris.
  • For those who will be outside, it would be safe to remain outside
  • looking out for fires

The workers will be informed of the plan and earthquakes often discussed with them. First aid training will be done .Basically; the policy will be in alignment with the federal emergency management agency with regards to people/property protection in cases of emergency (, n.d.).

Steps for supply chain management

  • When disaster occurs, the needs and resources should be recognized  with the help of rapid damage assessment
  • In case of external assistance, request should be made basing on the resources that are not available within the zone. Consideration should be in place for the required shipment time, and planning for the other needs that will not be met.
  • The management should then get prepared for the reception of large amounts of donation from all over


Friedman, M. (2002). Everyday crisis management: How to think like an emergency physician. Naperville, Ill: First Decision Press., (n.d.).Occupational Safety and Health Administration: Earthquake preparedness and response. United States Department of Labor. Retrieved 12/6/2017 from

Healthcare Medical Record Policies

Health Care Medical Record Policies

Course name and code




Health Care Medical Record Policies Part I

The Healthcare environment is an indispensable requirement for every human life. The medical technology deals with procedures and instrumentation which are designed for the principle purpose providing the public with quality health care. Therefore, the medical record plays as a powerful tool which enables the treating physician to keep track of the medical history of their patients and recognize patterns or problems which might assist in determining the course of healthcare provided (Sharpe, C. C. 1999).

The purpose for the medical records therefore is to describe the constituents of the electronic and paper medical record in order to provide support to the patient’s diagnosis while justifying treatment, care and other services provided.  The medical record has to be maintained for each and every patient served by the healthcare facility, where with varying automation levels, some records could be maintained in paper format while others electronically. It is crucial that every medical facility has in place a formalized for maintaining their records since all the records have to be organized systematically and readily accessible.


Every medical record entry, inclusive of electronic and handwritten/ paper records, must be completed, timed, dated and legitimate/ legible also authenticated by the individual in charge for evaluating and providing the offered services in consistency to policies and procedures of the hospital/ medical facility.

The Content of the Medical Record

The medical record content which contains electronic and written documentations should be able to allow the physician/ professional account for major source of information and support for their medical decision making.

  • The medical record contains patient demographic information such as: name, date of birth, their address, sex, their legal status, ethnicity and race, communication and language needs, and any representative legally authorized.
  • The medical record contains patient’s clinical information like; purposes for treatment, their original condition and/or diagnosis and diagnosis established in their course of treatment, medication prescribed/ ordered, any allergies or undesirable drug reaction to medication or food, medication administered and prescribed when patient is discharged and treatment goals among other clinical information.
  • In order to provide treatment and care, the medical record contains; any documentation on communication with the patient (e.g. mail, phone calls), advance directives, information generated by patient, informed consent prior permission.

A key constituent of the maintenance of medical records is handling of corrections, amendments and any deletions. Any individual documenting the medical records has to have authority or be credentialed to document following the policies defined by the facility. The individuals should have competence and be trained in the facility’s essential practices and legal standards of documentation.

  • Entries must be made immediately in the event of a confirmed observation. It’s crucial for timely input of patients’ medical records and each entry inclusive of day, month year and time associated with it.
  • It is thus illegal and unethical to pre- or back-date any entry. Dating should be done for the accurate time and date of inputting the entry.
  • Each entry has to be linked to the residence in practice, providing their name and medical record number, and authenticated by the medical author, that is, it should not be edited and signed by any other individual other than the author.

When making corrections to a paper medical record, accepted principles are accomplished through the use of one like strike through to allow future reference of the original content. It’s important that the author of this alteration dates and signs his/her revision. Electronic health records medical records on the other hand require more consideration. Records originated from electronic records with corrections or amendments have to specifically make out any delays, corrections or amendment while also providing a dependable means for vividly recognizing the original content, including the authorship and date for every modification on the records.

Health Care Medical Record Policies Part II

Ownership of the medical record

The medical records (electronic or paper documents) are to be possessed/owned by its author (practitioner or physician) and not by the patients. Alternatively, the medical record’s information belongs to the patient and therefore should be accessible by the patient or their legal representative upon their request (Heller, M. E., et al 2009). Although the practitioner or physician still has the overall say to avoid any access to specific pieces of information, particularly information which contain likelihood of causing substantial harm to either the patient or any other person. 

A patient has a legal right to seek court protection in case of wrongful use of the physician’s discretion having their own initiative for challenging the physician to denial of access. The original medical records cannot be removed from the medical facility, except when authorized by a court order or when required by law. Therefore, the medical personnel and other professionals in the healthcare facility are accountable for documenting the medical records within the proper and mandatory time frame in their support of patient care.

Policies/procedures for the release of records

Physicians and practitioners have constantly encountered immense complexities whenever they want to release medical records in response to Health Insurance Portability and Accountability Act (HIPPA) of 1996. So as to uphold confidentiality of patients and conform to government regulations, the following procedure and policies will ensure that confidential medical records’ are transferred according to all essential guidelines when released.

Health Care Medical Records will only be released upon the patient’s written request. This request has to be followed in accordance to Uniform Health Care Information Act 70.02 RCW (Washington (State). 1970). The Medical Healthcare facility shall only release records which were generated the facility’s practitioners/ physicians and preserved within the facility. Records from other facilities will not be released.

The requirements to be met for valid authorization in order for medical records release are; Written document signed and dated by the patient, which exclusively recognizes the patient, healthcare provider (practitioner/ physician) making this disclosure and exclusively provides information to be released. The document provides name, contact information, and affiliated institute of the individual/ entity who would be the recipient of this information. Before processing the request, the patient’s Identification has to be verified by the information provided in order to verify the appropriateness of information appealed for release. The request is then completed if its content meets the facility’s requirements. If not the application is returned to the requestor together with a description explaining need for more information needed.

Ways to maintain confidentiality

 In harmony to the Confidentiality of Medical Information Act (CMIA) (California Civil Code Sections 56-56.37, n.d.) and Information Practice Act attending to security and privacy of medical information the confidentiality of medical information in the facility shall be reserved. The following controls and principles should be executed in every location of the medical records within the healthcare facility.

  • Only the individuals having authorization/permission by the director shall have access to the information.
  • The service provider must date and sign the information recorded like consent to service, diagnose, and treat and any follow up prior to storage of the information.
  • The medical information records shall be put in a locked room or files while the electronic records protected by passwords when not in use.
  • Each of the medical facility shall be reviewed yearly on their record management practices to guarantee filing, storage and utility of the medical records in a conduct which provides standard confidentiality.
  • Back-up of the medical records electronic data shall be reserved in a secure off-site locality.


California Civil Code Sections 56-56.37(n.d.) Confidentiality of Medical Information Act (CMIA). Retrieved from

Heller, M. E., & Veach, L. M. (2009). Clinical medical assisting: A professional, field smart approach to the workplace. Clifton Park, N.Y: Delmar Learning.

Sharpe, C. C. (1999). Medical records review and analysis. Westport, Conn: Auburn House.

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Washington (State). (1970). Washington appellate reports. Olympia, WA: Court of Appeals. Retrieved from

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MMHA 6600

Self-Assessment and Effective Leadership

Self-assessments are valuable tools that enable leaders to learn more about themselves, including how temperament and unique preferences influence their interactions with others. There are a variety of assessments available to promote self-reflection. For this Assignment, you are required to complete the DiSC Classic 2.0, but you are also encouraged to take or review additional assessments (e.g., Myers-Briggs, Keirsey Temperament Sorter, a 360-degree evaluation) on your own. As you engage in this learning process, it is important to remember that everyone—regardless of temperament type—experiences challenges and opportunities with leadership.

To prepare for this Assignment:

  • Reflect on specific instances in which a leader has had a powerful impact on you. These leadership examples may be ones that you consider unsuccessful, as well as those you consider successful; they may be from the health care industry, as well as from other fields. Consider the behaviors that you observed and how they relate to leadership characteristics and styles as well as values.
  • Complete the DiSC self-assessment and review your results. Be sure to save a copy of your results for future reference. Note: To access the DiSC Assessment, go the go the MyWalden main Menu, located on the top left and then go to Academic Resources > Explore All Resources.
  • Consider how the leadership examples you have identified and the statements in your DiSC profile relate to one another. What insights does this give you with regard to the following:
    • How you, personally, evaluate leadership effectiveness
    • Your own leadership strengths and preferences
    • Potential challenges or areas in which you need to strengthen your leadership skills and competencies

The Assignment

In a 2- to 3-page paper, address the following:

  • Provide two or more leadership examples that are personally meaningful.
  • Evaluate your leadership strengths and preferences, as well as potential challenges and areas for development. Be sure to refer to specifics of your DiSC profile, as well as insights from the Learning Resources.

Note: The paper should be 2–3 pages, not including the title and reference pages. Your Assignment must be written in standard edited English. Be sure to support your work with specific citations from this week’s Learning Resources and at least three additional scholarly sources. See the rubric for additional requirements related to research and scholarly writing.