Causes and Effects of Overpopulation - 3400 Words

| | The Population Explosion: Causes and Consequences by Carolyn Kinder Yale-New Haven Teachers Institute (2012) Until recently, birth rates and death rates were about the same, keeping the population stable. People had many children, but a large number of them died before age five. During the Industrial Revolution, a period of history in Europe and North America where there were great advances in science and technology, the success in reducing death rates was attributable to several factors. Food Production Distribution The remarkable facts about the last 150 years has been the ability of farmers to increase food production geometrically in some places. Agricultural practices have improved in the United States in the last two†¦show more content†¦Sewage dumped into a public water supply could cause dis-ease throughout the community. With this understanding, the science of public health was born. Today, public health measures like waste treatment, water purifi-cation, vaccination, and nutritional education are well developed in MDCs And finally, with the advent of new medicines, disease was less of a problem in MDCs because medical science has invented a whole range of new medicines with which to treat everything from infections to pneumonia. In many LDCs, new drugs and medicines are simply not available. 22 Progress in medical science has, therefore, had a great effect on the population of most nations of the world. Nearly everywhere death rates have fallen. At the same time, birth rates, at least in the LDCs, have remained high. This combination of high birth rates and low death rates have led to the population explosion in many countries throughout the world. The end of the population explosion worldwide will be determined by how much countries invest in family planning efforts to lower fertility and slow down popula-tion growth. THE CONSEQUENCES OF RAPID POPULATION GROWTH Rapid human population growth has a variety of consequences. Population grows fastest in the worlds poorest countries. High fertility rates have historically been strongly correlated with poverty,Show MoreRelatedCauses And Effects Of Overpopulation1073 Words   |  5 PagesWhat are the effects of overpopulation? Overpopulation is an undesirable condition where the number of existing people on earth exceeds the carrying capacity of the earth. However, overpopulation has not always been a problem. At the dawn of agriculture, 8000 B.C., the population was approximately 5 million. 8000 years later, 1 A.D., the number of people existing on earth was between 200-300 million. That’s a growth rate under 0,05% per year. A tremendous change occurred with the industrial revolutionRead More Pet Overpopulation: Cause and Effect of Homeless Pets Essay619 Words   |  3 Pageswhen I realize I cannot adopt every homeless pet. The pet population is a increasing crisis in America. In this essay I will discuss the cause and effect of homeless pets, I will begin by explain the anatomy that contributes to pet overpopulation, then I will discuss the consequences encompassing animal breeding, then I will examine the social stance that effects pets, lastly I will conclude by suggesting solutions. First, I will begin by introducing the correlation between anatomy and the petRead MoreProblems Caused By Overpopulation Is The Rise Of A Place Populated With Excessively Large Numbers879 Words   |  4 PagesProblems Caused by Overpopulation in Cities Overpopulation is ‘The condition of a place populated with excessively large numbers’. It is considered a problem in many senses, since it causes a number of issues for various different reasons. One major issue caused by overpopulation is the rise of unemployment. This is when people actively seeking employment or just people that are able to work remain unemployed. Overpopulation causes this because the amount of jobs available would be the same as beforeRead MoreThe Effects Of Overpopulation On The Human Population1532 Words   |  7 Pageswhole. Overpopulation, the condition where an area holds more people than in which the area can properly function, is a serious issue which has many adverse effects on the well-being of a healthy human population. A growing seven billion people live on Earth and factors such as pollution, and human well being may all be affected by overpopulation, and continued growth in population will cause an even greater impact on society, individuals, and the environment. The effects of overpopulation is a multi-layeredRead MoreOverpopulation : We Must Figure It Out For Save The World Essay1645 Words   |  7 Pages Overpopulation: We Must Figure It Out to Save the World It may not be something you think about often, but human population growth is a big issue in our world today and this problem needs to be solved in the future to save our planet. Overpopulation is a condition that will be in effect if the population exceeds the carrying capacity on Earth. The carrying capacity is the peak population that can sustain human life on Earth. It is uncertain what Earth’s carrying capacity is for the human raceRead MoreThe Environmental Impact of Overpopulation Essay862 Words   |  4 Pagesto grow through the decades. The increasingly large number of people that have become apart of the world population has become a major problem. The consequences of the world being over populated has numerous effects which include: Environmental effects, depletion of natural resources, effects on the economy, food and water instability, and mass species extinction. Without a solution to the rise in human population, by the year 2020, 8 billion people will liv e on earth and by the year 2050, 9 billionRead MoreOverpopulation Is More Than Just A Crowded Planet1343 Words   |  6 Pagesas a sign of success considering the causes of a rapidly growing population include improved health care, new technology, progressive eras such as the Industrial Revolution, and an overall developing human race (Kinder). However, the current world population no longer signifies progression; it signifies regression. Today, the Earth’s human population is approaching overpopulation. Overpopulation is more than just a crowded planet. The definition of overpopulation is, â€Å"†¦too many people for the amountRead MoreThe Effects Of Human Overpopulation On The Environment1242 Words   |  5 PagesThe Effects of Human Overpopulation on the Environment â€Å"Can one apple slice feed the world?† If the world were an apple, farmland would only be one very thin slice. The growing population on this Earth has some serious questions that it needs to consider as a whole. How are we all going to eat with eight billion mouths to eat? Farmers have an interesting proposition, they need to feed a growing population with very little land. Overpopulation also has negative effects on the earth through pollutionRead MoreOverpopulation Is Not An Issue1357 Words   |  6 PagesOverpopulation is not an issue many people in developing countries face at this point in time. Put simply, overpopulation is â€Å"the condition of having a population so dense that it causes environmental deterioration, an impaired quality of life, or a population crash† (Merriam-Webster). It should not be taken lightly because it cannot be reversed in a short time period. Changes must be made gradually so that future generations do not suffer consequences that current generations have place uponRead MoreThe Problem Of Overpopulation And Overpopulation872 Words   |  4 PagesHuman overpopulation. Human population can be defined as the condition whereby, the total count of the human inhabiting a certain area exceeds the carrying capacity of the area Bongaarts, (2011). This brings out an issue of the carrying capacity of the region which alludes to the number of individuals who can inhabit a certain area for a given period. It may also be looked at as the situation whereby the available renewable resources in a certain area can satisfactorily support the current population

What Shapes My Identity - 1852 Words

What Shapes my Identity? Identity. What is identity? One will say that it is the distinct personality of an individual. Others will say that identity is the behavior of a person in response to their surrounding environment. At certain points of time, some people search for their identity in order to understand their existence in life. In regards, identity is shaped into an individual through the social trials of life that involve family, the religious beliefs by the practice of certain faiths, and through the influences of their culture. Identity is a core and unavoidable part of all our lives. Our actions shape our identity, and in turn, our identity shapes our actions. Attempting to pretend that identity doesn’t matter may make you†¦show more content†¦Culture, by definition is a shared collection of history, ideas, beliefs and customs between a group of people usually in close proximity to one another, often related to nationality or religion. Essentially, culture involves a group of peop le that you can relate to and communicate with based off a common background, culture typically involves knowledge and experience particular to a certain group that usually shares significant symbols, landmarks as well as similar practices and rituals. The concept of culture is extremely broad and abstract in nature, culture is a difficult term to define because it’s meaning varies for each individual around the world. For me, obtaining knowledge and experiencing cultural events has given me a sense of belonging and allowed me to recognize and develop my individual self-concept. Besides providing me with the means to develop my individual self concept, my culture shaped my identity because it influenced my perspective, which means it added bias towards my particular view points and the ways in which I think. What I’ve come to realize is that how I perceived an event directly affected the way I responded to it, so this viewpoint caused a characteristic pattern in respon se, which is also known as behavior, also one of the key components in defining human personality. Since a person is usually defined by their actions, and since ourShow MoreRelatedShaping Our Ego : How We Emotionally And Realistically Digest The World1090 Words   |  5 Pagesby Eckhart Tolle, has brought back many memories of my childhood and has reminded me of many things that have shaped my reality. I have seen the world, but the words I use to describe the world have made me pay attention to the parts of the world that are described. When I see the orange cat, London, a few times a week, I notice that the cat is orange, and I notice this because I was taught about colors when I was a young girl, which shapes my reality. This is important because I am better off knowingRead MoreDevelopment Of Identity And Journey1141 Words   |  5 PagesIdentity Many people believe that a journey leads to a development of identity, of who we are as a person. Along the same lines, our values and characteristics evolve over time, as we make changes throughout our lives. Therefore, the liaison that identity and journey, share is a journey of obstacles and internal and external trials. Thus, helping us grow by maturing and helps develop valuable life skills as a result, learning new experiences. This journey will help us see what makes us differentRead MoreThe Curious Incident Of The Dog807 Words   |  4 Pagesand shape our identities? We form and shape our identities by experiences, hurt, love, guilt and various other emotions as well as things we see others going through, all of these things whether they be good or bad help form and shape our identities. 2.) How do we define who we are? We define who we are by our hobbies, our interests, by our likes and dislikes, by who we talk to and who we do not talk to, by the labels we give ourselves but not by the labels we are given by others. Identity isRead MoreThe Development of Our Identities Essay1113 Words   |  5 PagesOur Identities  § Identities, as much as the perceptions of beauty, are in the eyes of the beholders. Shaped and molded by them too, we often have very little control over the construction of our identities. Paragraph 2: ids are socially constructed.  § The construction of identities is more often than not attributed to the way in which people perceive you and your personality  § Activities one participates in have their own identities and this identity is transferredRead MoreMy Culture And Identity : The Influence Of Identity1215 Words   |  5 Pagesterms with shaping my identity. Growing up my parents would always tell me to â€Å"stop acting Americanized† but this is the only way I know of whether if my culture is what is influencing me or if its my peers. â€Å"Culture, is a social practice, it is not something that individuals possess; Rather, it is a social process in which individuals participate, in the context of changing historical conditions. As a â€Å"historical reservoir†, culture is an important factor in shaping Identity† (Anonymous, 2003)Read MoreThe Impacts Of Ashima In A Gentle Memory1468 Words   |  6 Pagesone of those memories impacts who we are and who we become as a person: they shape our identities. It is important to realize that concept when we are living in a globalized world when we are interacting with people of different background. Acknowledging that fact help us find common grounds and do not pay attention to the details of our differences as much. In this paper, it is shown that past memories shape one’s identity and the reader can see that through the character of Ashima in The NamesakeRead MoreEssay A Western Identity Crisis739 Words   |  3 Pagesforced to choose an identity for ourselves at one point or another in our lives. Some choose to identify by their outer qualities, while others may identify by their inner qualities. One may identify by their looks, gender, sexuality, political views, or their beliefs. Some may have an identity that is dynamic and ever changing depending on the events faced in life, or some my identify by a single aspect throughout their whole life. Some may even struggle finding an identity due to the countlessRead MoreCycle of Socialization Essay examples982 Words   |  4 PagesThe cycle of socialization is a process through which social identities are created, and in effect, each individual repre sents and is affected by their social identity. According to the cycle of socialization, the first stop in the socialization process is outside of one’s control—one is socialized even before they are born. Our social identities are predetermined, and we are born in a world with roles, rules, and assumptions already in place. Our family and role models teach these rules and rolesRead MoreIdentity : Cultural Differences And Aspects Of Cultural Identity751 Words   |  4 PagesCultural identity is defined as, â€Å"the identity or feeling of belonging to a group. It is part of a persons self-perception and is related to nationality, ethnicity, religion, social class, generation, locality or any kind of social group.† As I read that definition, I couldn’t help but to think to myself- what is my cultural identity? How do I answer the question â€Å"what are you† or â€Å"who are you† that people ask me frequently? What makes one person differ ent from another? I feel as if humans are distinguished

Hcs 571 Free Essays

string(135) " the software system related to Electronic health record implementation with users of the selection committee before the system demos\." Capital Project HCS/571 Capital assets are generally purchased to improve quality of care, or to provide needed equipment for a new service or expansion of an existing service. The key element in capital budgeting is that the building or piece of equipment being acquired has a lifetime that extends beyond the year of purchase and it is a capital asset or long-term investment for the hospital. Capital assets are good financial investments for the organization. We will write a custom essay sample on Hcs 571 or any similar topic only for you Order Now (Finkler, Ward, Baker, 2007). The Electronic health record software system is one of the important operational priorities in the US healthcare. The change from paper-based record system to electronic record system supported by technologies and help for reducing errors and improving quality of care based on best practice. (Song, McAlearney, Lausanne, Robbins, McCullough, 2011). Research a capital purchase of software for filing patient records costing more than $5000 Health care organizations have invested heavily in computer technology. The health care organizations use computer technology and electronic health record in the actual delivery of care and to support clinical areas. The four principal uses of computers for nursing are for general information, clinical applications, research, and financial management. (Finkler, Ward, Baker, 2007). The health care organizations are in the process of major transformation, and becoming more complex. It is very important to maintain the safety of patient and to provide high quality care. (Ting, Tsang, Ip, Ho, 2011). The electronic health record system is considered as a means of technological efficiency to reduce the cost in healthcare organization. The need for EHR in healthcare organization is based on certain evidences like, It supports guideline-based care, increased patient monitoring, act as an efficient technological tool for effective communication in areas related to patient care, and improves coordination of care(Song, McAlearney, Lausanne, Robbins, McCullough, 2011). The electronic health record system act as an easy access for medical literature and it is considered as a fast access system due to the effective utilization of information technology and enhances the healthcare efficiency system. Hillestad, 2005). Employee development The computer software and electronic health record advances will continue to evolve and that computer use by staff nurses will become commonplace in most healthcare organizations. In the long run this will likely increase the quality of patient care due to more accurate and timely information, while creating at least some efficiency in the use of nursing time. This should release more nur se time for patient care. (Finkler, Ward, Baker, 2007). Computerization should work both to reduce nursing shortage and to increase nursing satisfaction. The health care organizations struggle to allocate sufficient funds for information system implementation, maintenance, and upgrade. The computerization of the nursing units has been a potential solution for nursing shortage. (Finkler, Ward, Baker, 2007). Management goals The EHR implementation and governance are related to each other and it is mainly focus on the mission, vision, and behavior related to the management. The decision and action from managers level management is very essential factor for the effective purchase of EHR. Jarvenpaa Ives, 1991). The support system in the organization related to EHR implementation helps to support and motivate the employees in difficult situation related to the technical failure of the system. (Miller Sim, 2004). The successful implementation of EMR depends upon the team and technology of the organization. Team refers to people and issues related with organization. The technology related to the choice of the software, hard ware, and desig n set up of the organization to meet the implementation process. The main components of implementation process are people, process, and technology. The main focus of the change management is people and the related objective is to change the behavior for the acceleration of change process. (McCarthy Eastman, 2010). Cost containment The software related Electronic health record implementation need to be appropriate for the needs of the organization and budget. (Swab, Ciotti, 2010) The EHR software system has many areas of market depending upon the size of the hospital bed size. The first criteria for the vendors according to the bed with 100 and small hospital The Electronic health record system cost about between $ 1 million and 2 for the electronic health record system The electronic health record software cost for the organization about medium hospital cost is much larger than the first one. It comes around three to ten million. The hospital and organization with more than average bed cost for the electronic health record system will be higher amount than the other one. The cost and amount of electronic health record system will depend upon the size of the hospital . The management has to decide about the budget for the organization. (Swab, Ciotti, 2010). The organization must evaluate its mission and goals in light of its particular strengths and weakness and in light of the demand for services and competition in the external environment. Based on that evaluation it can make a plan that will take advantage of opportunities like Electronic health record implementation according to the goals of an organization. (Finkler, Ward, Baker, 2007). The planning process explicitly address whether the implementation of new services and programs that make up the majority of operations of the organization are being retained at a steady-state level or whether they are to be contracted or expanded in scope. (Finkler, Ward, Baker, 2007). The successful implementation of EMR depends upon the team and technology of the organization. Team refers to people and issues related with organization. The technology related to the choice of the software, hard ware, and design set up of the organization to meet the implementation process. The main components of implementation process are people, process, and technology. The main focus of the change management is people and the related objective is to change the behavior for the acceleration of change process. (McCarthy Eastman, 2010). The computerization of the nursing units has been a potential solution for nursing shortage. (Finkler, Ward, Baker, 2007). Quality assurance The management of the organization need to review the costs of the software system related to Electronic health record implementation with users of the selection committee before the system demos. You read "Hcs 571" in category "Papers" The committee includes staff from clinical areas like pharmacy, radiology, laboratory, operating room, and emergency department. The committee needs to invite physician champions to participate and observe EHR system demonstrations before selecting the system. (Swab, Ciotti, 2010). The management of the organization needs to clarify the all of the costs such as travel costs, training class tuition fees, files conversion fees, and other ancillary system fees with the vendors. Another factor need to consider while implementing Electronic health record system is the costs of additional staff required to operate the EHR system. The organization need to consider adding the IT staff, Nurse informaticist, and Chief medical information officer. (Swab, Ciotti, 2010). Once the plan has been finalized and formalized, it serves as a guide for a number of years. Long- range plans are typically prepared only once every three or five years. Creating a new plan each year would only lead to constant changes in the organization’s direction. This would lead to wasted efforts, and money. The long-range budgets or strategic plans look in general terms at the entire organization over a period of years. Finkler, Ward, Baker, 2007). Program budgeting techniques are equally effective for reviewing the operations of an ongoing unit as for evaluating a new program like Electronic health record implementation. Business plans are becoming essential for the introduction of new programs. Such plans help managers complete a comprehensive examination of a proposed program. By making such a thorough review, the manager and the organization gain an in-depth understanding of the program as well as its financial implications for the organization. Finkler, Ward, Baker, 2007). Patient care, clinical research, and leadership role The Electronic health record software system support efficient and good health care. Electronic health record improve the completeness and accuracy of patient records and they improve communication among health care professionals. (Hayrinen,Saranto, Nykanen, 2008). The larger hospitals, especially academic medical centers with a high acuity case mix, may benefit from investing in Electronic health record adoption. The hospitals with high patient volumes and with complex medical problems need to adopt Electronic health record as a capital asset for the organization. (MCcullough, Casey, Moscovice, Prasad, 2010). Team refers to people and issues related with organization. The technology related to the choice of the software, hard ware, and design set up of the organization to meet the implementation process. The main components of implementation process are people, process, and technology. The main focus f the change management is people and the related objective is to change the behavior for the acceleration of change process. (McCarthy Eastman, 2010). The monitoring of EHR implementation process mainly focused on areas like project costs, project progress, schedule controls, control changes, scope of the project, quality management, and risks. (Noblin, Cortelyou, Ton, 2011). The EHR implementation is considered as a high-cost project. The management needs to consider and monitor equipment co sts including hardware and software costs. The workflow inefficiencies need to monitor and need to redesign during the implementation phase is an important step to overcome the failure. (Spector, 2010). The workflow reflects the ability of the employee to use the resources to complete the work in an effective manner to achieve better results and it also shows the efficiency of team work. (Lee, Cain, Young, Chockley, Burstin, 2005). The EHR implementation requires strong leadership and all workers need to participate to deliver their own role for the success of the implementation process. The redesigning process improves the work efficiency and job satisfaction. (Spector, 2010). The change from paper medical records to electronic medical record system improve the quality of healthcare, reduce the administrative cost, reduce medical errors, and decrease the unnecessary expenditures for the issues related to medical errors occur during paper charting. (Huryk, 2010). The electronic medical record system is considered as a means of technological efficiency to reduce the cost in healthcare organization. The need for EHR in healthcare organization is based on certain evidences like, It supports guideline-based care, increased patient monitoring, act as an efficient technological tool for effective communication in areas related to patient care, and improves coordination of care(Song, McAlearney, Lausanne, Robbins, McCullough, 2011). The electronic health record system act as an easy access for medical literature and it is considered as a fast access system due to the effective utilization of information technology and enhances the healthcare efficiency system. Hillestad, 2005). Research studies shows that the paper record system is inadequate to give all informations regarding patient to caregivers for the effective care. (Thakkar Davis, 2006) The effective use of EHR minimize the problems related to healthcare disparities, allows the involvement of patients and their families in treatment plan, and maintain adequate privacy and security. (Podgurski, 2008). Computer uses for clinic al care fall into two general areas. The first area is assement of patients. This includes computers used in laboratories to measure blood levels, in radiology for magnetic resonance imaging, and for physical assessment measures such as blood pressure. The second clinical area is storage and management of patient information. Often called the hospital information system, these computer systems store data such as patient demographics, admission, transfer, and discharge information, and documentation of nursing care provided. (Finkler, Ward, Baker, 2007). Although clinical information systems are not directly related to financial management, data produced by these systems can be used to make financial decisions. Clinical systems are used to directly link the use of services to the billing for them. Ultimately, financial management is based on the allocation of resources; clinical information systems offer the manager data about the use of resources in the organization. Clinical information systems that combine information from a variety of sources such as laboratory, radiology, dietary, and nursing are called fully integrated systems. In these systems the data are entered once and are accessible all over the organization with appropriate confidentiality precautions. These integrated systems improve the flow of information. (Finkler, Ward, Baker, 2007). The implementation of EHR in healthcare organization is influenced by human and technological factors. The implementation process depends upon many factors starting from employee attitudes and concerns to various technology. The main factors are readiness for the employee to accept the changes related to EHR implementation, resources available for the change, technical concern, availability of finance for the implementation of EHR, motivation of the employee, time, and ability of the individual to use computer for the effective implementation of EHR. (McGinn, Grenier, Duplantie, Shaw, Sicotte, Luc, Leduc, Legare, Gagnon, 2011). The managers need to take interventions to overcome the factors influencing the implementation process early in the planning stage. (Spector, 2010). The budget development in the initial phase of change process reflects the initial cost and all other related expenses of an electronic health record system. The hardware expense needs to be classified on a yearly basis. The organization need to consider the cost of upgrading the hardware and software system to maintain the efficiency of the system. The cost for the replacement of hardware and maintenance of the computer need to be considered. The Information System Success Model evaluation measures the quality and technical achievement of the system. The system quality depends on the elements like reliability, accessibility, and security of the system. (Delone, McLean, 2003). The user satisfaction level needs to be evaluated because it reflects the level of competency, skills, and experience of the users. The overall measurements include quality of care in terms of patient safety, and effectiveness of care, accessibility of care, and productivity. ( Lau, Hagens, Muttitt, 2007)The implementation process requires skilled people in areas like computer networking, informatics, administration, management, and clinical workflow. The monitoring and controlling of the proper utilization of the resource specialist will help for the cost management. (Wang, 2003). Consultant packages The consultant from outside the organization for any change process need to be assessed, monitored, and controlled as per the organizational policy and management decision. The health care organization may need assistance from outside consultants for the effective implementation of EHR and that will cause an extra cost for the implementation process and the management need to monitor the necessity of the consultant for the process. Noblin, Cortelyou, Ton, 2011). The quality assurance of the Electronic health record software system can be done by the evaluation process. The evaluation process need to focus on certain elements like care, human, educational, administrative, technical, and social aspects. (Shaw, 2002). The care aspect of evaluation consists of monitoring the quality of care, continuity, system acceptance from patients a nd other professionals. The evaluation of organizational aspects mainly focuses on examining the interconnection between different care providers in different settings. (Shaw, 2002). The educational aspects of evaluation focus on the quality of the information system for the retention of the staff, training of employees, and user satisfaction related to EHR implementation. The administrative aspect of evaluation addresses the changes related to EHR implementation and the after effect on health care services and mainly focus on areas like access to care, interactions between clients and health care workers, and changes in cost effectiveness related to new electronic system. The technical aspects of evaluation measure the technical quality, reliability, and security of the settings. The social aspects of evaluation focus on the changes in the level of social interaction after the implementation of new system. (Shaw, 2002). The other measurement strategies include evaluating the output of new system by reviewing employee satisfaction and user satisfaction. The organization need to conduct post go-live reviews after the implementation process to assessment of system. Conclusion The Electronic health record software system is one of the important operational priorities in the US health care and it should be capital assets for the organization. The health care organizations that are decided to purchase an Electronic health record system should always search for the software system with right vendors, share the costs with selection committee members, and need to think about the costs of additional staff members required to operate the software system. (Swab, Ciotti, 2010). The other measurement strategies include evaluating the output of new system by reviewing employee satisfaction and user satisfaction. The organization need to conduct post go-live reviews after the implementation process. The successful implementation requires teamwork and effective communication technique between the vendors, health care staff, management, administration, and outside consultants. The health care organization may need assistance from outside consultants for the effective implementation of EHR and that will cause an extra cost for the implementation process and the management need to monitor the necessity of the consultant for the process. (Noblin, Cortelyou, Ton, 2011). References Delone, W. H. , McLean, E. R. (2003). The DeLone and McLean Model of Information Systems Success: A Ten-Year Update. Journal of Management Information Systems,19(4), 9-30. Hayrinen,K. K. , Saranto, P. , Nykanen, P. (2008). Definition, structure, content, use, and impacts of Electronic health records: A review of the research literature. International Journal of Medical Informatics, 77(5), 291-304 Hillestad, R. (2005). Can electronic medical record systems transform healthcare? Potential health benefits , savings, and costs†. Health affairs, 2(1), 8-10. Huryk, L. (2010). Factors influencing nurses’ attitudes towards healthcare information technology. Journal of nursing management, 8(5), 606-612. Jarvenpaa, S. L. , ; Ives, B. (1991). Executive involvement and participation in the management information technology. Journal of Medical Informatics, 15(2), 205-225. Lau, F. , Hagens, S. , ; Muttitt, S. (2007). A Proposed Benefits Evaluation Framework for Health Information Systems in Canada. Electronic Healthcare, 10(1), 112-118. Lee, J. , Cain, C. , Young, S. , Chockley, N. , ; Burstin, H. (2005). The adoption gap: Health information technologyin small physician practices. Health Affairs, 24(5), 1364-1366. McCullough, J. M. , Casey, I. , Moscovice,S. , Prasad,S. (2010). The effect of health information technology on quality in US Hospitals. Health Affairs, 29(4), 647-654. McGinn, C. A. , Grenier, S. , Duplantie, J. , Shaw, N. , Sicotte, C. , Luc, M. , Leduc, Y. , Legare, F. , ; Gagnon, M. (2011). Comparison of user groups’ perspectives of barriers and facilitators to implementing electronic health records: a systematic review. BMC medicine, 9(46), 2-10. Miller, R. H. ,Sim,I. (2004). Physician’s use of electronic medical records : Barriers and solutions. Health Affairs, 23(2),116-126. Noblin, A. M. , Cortelyou, K. W. , Ton, S. (2011). Electronic Health Record Implementations- Applying the Principles of Monitoring and Controlling to Achieve Success. The Health Care Manager, 30(1), 45-50. Podgurski, S. A. (2008). Finding a cure : The case for regulation and oversight of electronic health record system†. Harvard journal of law and technology, 22(1), 107-110. Shaw, N. T. (2002). ‘CHEATS’: a generic information communication technology (ICT) evaluation framework. Comput Biol Med, 32(3), 209-220. Song, P. H. , McAlearney, A. S. , Lausanne, E. F. , Robbins, J. , McCullough, J. S. (2011). Exploring the business case for ambulatory electronic health record system adoption. Journal of healthcare management, 56(3), 169-180. Spector, B. (2010). Implementing organizational change: Theory into practice (2nd ed. ). Upper Saddle River, NJ: Prentice Hall. Swab, J. , Ciotti, V. (2010). What to consider when purchasing an EHR system. Health care Financial Management, 64(5), 38-41 Thakkar, M. , Davis, D. C. (2006). Risks, barriers, and benefits of EHR systems: A comparative study based on size of hospital. Research Journal in Health Information Management, 3(5), 10-12. Wang, S. (2003). A cost-benefit analysis of Electronic medical records in primary care. American Journal of Medicine, 114(5), 397-403. How to cite Hcs 571, Papers

Condition During Postoperat Complications †Myassignmenthelp.Com

Question: Discuss About The Condition During Postoperat Complications? Answer: Introduction Wound healing is an essential prerequisite for ensuring the speedy recovery of patients with hand surgical wounds. Considering the adverse impacts of smoking, it has been found that it exert its negative influences in exacerbating the condition during postoperative complications as well. The outcomes are strikingly different in case of the smokers as opposed to their non-smoking counterparts who pose less threat than smokers do to encounter postoperative challenges (Haskins, Amdur Vaziri, 2014). Therefore, it becomes increasingly difficult to tackle the situation for the healthcare professionals considering the extent of the symptoms exhibited by the patient. Smoking pattern data in the population of Hong Kong has highlighted on important aspects related to smoking cigarettes. The detrimental effects of smoking have not only been found to impact health status of the concerned individuals, but are also found to have certain adverse socio-economical consequences. Tobacco smoking is co nsidered particularly harmful due to the presence of toxicants such as tar, nicotine and carbon monoxide that might culminate in causation of serious illnesses like that of cancers. The carcinogenic property of these components exerts strong influences and threatening the lives of the smokers to a great extent. Statistics with respect to average daily consumption of cigarettes among daily cigarette smokers for the year 2015 showed that it is 14.8 and is highest among the individuals belonging to the age range of 50-59 years. Data suggested that this incidence rate was higher compared to the 13.8 figure as reported for the year 2012. Overall, the average incidence rate was documented to be 13.1 (Healthyhk.gov.hk, 2017). Concomitantly evidences have shown that there occurs accentuated risk of acquiring surgical site infection because of smoking alongside increased risk for postoperative complications. Recommendations for abating surgical site infection have suggested in cessation of s moking (Chp.gov.hk, 2017). Hence, deeper investigation on the issue of wound healing needs to be conducted to combat the situation and ensure quicker wound healing in the concerned target individuals. Aim and objectives of the study The study will aim to examine the impact of tobacco smoking with respect to wound healing for patients having hand surgical wound in contrast to the situation as observed in case of the non-smokers prior to undergoing hand surgery as well as in postoperative phase within the periphery of clinical setting. Significance of the study The projected study will be helpful in exploring the impact of cigarette smoking on wound healing of patients with hand surgical wound. Remedies targeted to mitigate the adverse impacts of tobacco smoking may thus be streamlined with scope of offering suitable strategies to overcome the debilitating situation and accentuate speedy recovery for the affected individuals. Healthcare professionals may be well equipped and adequately informed about the effective management of wounds for those habituated to smoking by referring to the data and recommendations in accordance with the study outcomes. Proper training may be arranged for them to facilitate optimal healthcare delivery. Literature Review Wound care in healthcare sector has garnered considerable attention until date to safeguard the health of the patients and to foster speedy recovery for them. Unlike several adverse side effects of smoking, its impact on wound healing needs to be explored vividly for better understanding the association between the two. A study conducted by Duchman et al., (2015) aimed to detect the differences pertinent to thirty days morbidity and mortality in response to primary total hip and total knee arthroplasty as per the smoking status and pack year history of smoking considering the fact that total joint arthroplasty is the most sought after orthopedic procedure in the USA. Patient identification was done by virtue of consulting the database for the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) to retrieve information about those who underwent total knee or total hip arthroplasty between 2006 and 2012. Subsequently stratification of patients was done through acknowledgement of the smoking status and pack year history of smoking. Univariate and multivariate analyses were considered for comparing the outcomes related to thirty days rate of mortality alongside wound complications as well as total complications in the concerned population. Dearth of orthopedic specific outcomes beyond 30 days from the ACS NSQIP database restricts the scope of the study in elucidating both the short term as well as long term orthopedic specific outcomes relevant to cigarette smoking. Findings of the study are suggestive of the far-reaching implications that are of significance from both clinical as well as scientific perspectives. Results obtained from the study revealed that individuals who are into the habit of smoking are predisposed to an accentuated risk of acquiring wound complications in post arthroplasty session. On the other hand, risk of total complication is evident in case of both the current as well as former smokers during period that follows total knee or total hip arthroplasty. Therefore, as part of the nursing duties, the nurses must be well trained to be able to evaluate all wound complications in an effort to ensue prompt, adequate therapeutic interventions to combat the demanding situation. Research carried out by Haskins, Amdur Vaziri, (2014) explored the independent effect of smoking on the bariatric surgical outcomes by virtue of utilizing the National Surgical Quality Improvement Plan (NSQIP) owing to the efficacy of the bariatric surgery as a feasible long-term treatment for morbid obesity. The study design comprised of identification of bariatric patients from 2005 to 2010 with respect to all types of bariatric procedures barring adjustable gastric banding. Chi square and t tests were employed for examining the univariate associations of the pretreatment variables with smoking. For the laparoscopic and open treatment groups, logistic regression was used to test for association of smoking with outcomes corrected for relevant covariates. Despite the strengths of the study, a potential limitation concerning the study refers to the ambiguity in definition of the smoker for identifying a patient as provided in the NSQIP that demarcates the patients based on their smok ing habit of cigarettes only within the year preceding surgery. Thus others forms of nicotine such as that of nicotine patch, gums upon bariatric surgery results are essentially undermined besides providing no valid information about the last puff taken by the patient or whether the concerned patient is presently a smoker or not. Therefore, in order to mitigate adverse surgical outcomes pertinent to the patient, information regarding smoking of all kinds of nicotine in addition to detection of the preoperative duration of smoking cessation need to be considered. Conclusive evidences showed that heightened incidence of postoperative morbidity for both laparoscopic as well as open bariatric surgery occurs due to smoking that appears as a modifiable preoperative risk factor. Smoking cessation has been found to exert positive influence through mitigation of the postoperative morbidity following bariatric surgery thereby necessitating the nurses interventions for directing prudent action s in accordance with patient situation. Another study conducted by Hatcher et al., (2016) assessed the tobacco use and surgical outcomes relevant to patients suffering from head and neck cancer. Use of tobacco has long been associated with the risk of harboring head and neck cancer with little focus on the postoperative outcomes as potential threat to the disease. As part of the research methodology 89 patients afflicted by head and neck cancer were recruited in before surgery condition for the study. Inclusion criteria for the study comprised of documenting self-reported tobacco use status as well as assessment of recent tobacco exposure through urinary cotinine on the day of surgery in the concerned patients. Both length of stay at the hospital in conjunction with complications were measured as outcome variables for the study. The study has been thwarted with potential limitations owing to relatively reduced incidence of specific types of complications, limited sample size and no acknowledgement of the human papilloma vi rus status of the tumor. Findings of the study confirmed the association of postoperative complications because of tobacco use status that might act to distinguish the at-risk patients. The self-reported tobacco use history was intimately associated with poorer surgical outcomes following head and neck surgery. The findings corroborated with the evidences suggesting the negative influences of tobacco in relation to clinical outcomes pertinent to head and neck cancer patients. Therefore, the implications of studies have particular significance with respect to clinical and scientific point of views. A crucial role that need to be attended by the nurses call for emphasizing the need for assessment of the improvement in surgical outcomes due to smoking cessation interventions in patients suffering from head and neck cancer alongside gaining information about the duration of cessation to procure optimal benefits. Nurses may thus act to implement risk mitigation strategies accordingly. In a study undertaken by Nsell et al., (2011) investigation was set in for gauging the impact of smoking on postoperative complications especially with respect to deep wound infections, in case of patients with operatively treated fractures. The study design was set to be a cohort study with prospective follow-up in a setting consisting of university-associated teaching hospital coupled with advanced trauma care. For the study, an overwhelming population of 906 patients who underwent operative treatment for an acute ankle fracture in course of 3 years period was detected. Patients were classified into 721 non-smokers and 185 smokers for performing the analysis. Departmental database was referred to for acquisition of relevant data, followed by review of the patients medical charts with postoperative complications as the main outcome measure. However, a major limitation in relation to the study may be identified with respect to the study design which is essentially a retrospective des pite the complications that were being registered being prospective in nature. Thus, it posed threats in verifying the background information of patient specifically with respect to smoking habits. Moreover, the complications due to smoking have not been estimated satisfactorily in course of the study because of inadequate proportion of smokers employed in the study. The results generated from the study brought to the forefront a major issue that identified cigarette smoking as a potential risk factor capable of accentuating the risks of postoperative complications in patients operated for an ankle fracture. Hence, the study results are of paramount importance concerning the clinical and nursing practice. Owing to the adverse outcomes following surgery in case of the smoker individuals, the physicians, nurses and other allied healthcare personnel must act in coalition for encouraging the patients to quit smoking while under the regime of acute treatment for harboring optimal outcome s Sweetland et al., (2013) in their study explored the incidence of venous thromboembolism with respect to smoking habits under two distinct conditions. One condition relevant to absence of surgery as well as other comprised of those during the first 12 postoperative weeks by means of a large prospective study of women residing in the United Kingdom to provide an insight on the effect of smoking in general related to the risk of venous thromboembolism apart from the postoperative period. Data were collected in course of the 6 years follow-up encompassing 1162718 women having mean age of 56 years, out of which 4630 were reported to have admitted to hospital or have encountered death due to venous thromboembolism. The novel study approach and topic of investigation act to render considerable strengths to the study thereby minimizing the chances of weaknesses associated with it. However, certain intrinsic limitations to the study that may be identified relate to restricting the study desi gn to women only for understanding the association between smoking and venous thromboembolism. Moreover, information regarding the periods of immobility during follow-up and use of postoperative anticoagulation was missing that further limited the study design. Presence of other unmeasured confounders might also threaten the research. Further conclusion has been arrived at with respect to increase in incidence of venous thromboembolism for the current smokers both in absence of surgery as well as during the follow-up in the 12 weeks following surgery. Therefore, for patients undergoing surgery it is imperative to consider smoking as a vital factor for assessment of risk due to venous thromboembolism. Hence, the results hold vital potentials to deploy suitable tobacco control strategies as effective measures of combating disease as well as premature mortality. Therefore, the nurses and physicians must collaborate among themselves to identify the patient condition for effectively miti gating the risks of venous thromboembolism. Smoking appears as a modifiable risk factor for patients undergoing surgery that can be managed properly if attended on time and requires active engagement of the healthcare personnel. Study design The study will be an exploratory one whereby necessary information will be procured from the relevant secondary data source regarding wound healing of patients with hand surgical wounds. Medical documents in liaison with the nursing assessment data will be utilized to gain a deeper probe into the issue of wound healing in case of the patients with hand surgical wounds from the concerned hospital authority (Creswell, 2013). Secondary source of data will be employed to procure information pertaining to wound healing in case of smoker patients afflicted by hand surgical wounds and admitted in hospitals to derive optimal benefits from the procedure. In this particular study, a cross sectional observational study approach will be followed to gather necessary information whereby data collected from the representative subset of the population are utilized at a specific point of time (De Vaus, 2013). No interference with the subjects will be made regarding the data collection procedure. Sampling and sample size In course of the study, purposive sampling method that is considered as a subset of non-random sampling method will be employed considering that a specific purpose will be attended to. The proposed study will utilize a number of cases aligning with the projected objectives and hence purposive sampling will be decisive in elucidating the phenomenon of interest. Objectives of the study as well as the characteristics of the population will be taken into consideration while selecting the sampling method. The type and nature of the study will play a decisive role in making a choice for the sampling method. Selection will be made consciously to include a definite population for the study due to possession of certain unique characteristics that are of significance with respect to the conduct of the study (Etikan, Musa Alkassim, 2016). Further, for the proposed study, a sample size of 200 patients will be chosen whereby documentation of data with respect to those will be kept for collection of most prudent data. Specific group of patients having hand surgical wounds and habituated to smoking will be selected for the study. Data will be accumulated for 200 respondents so that the large sample size might offer a better description being the representative of the population. Large sample size has been confirmed of better describing the population and potentially eliminates the chances of bias in data interpretation (Marshall et al., 2013). Proposed measurement tools/Questionnaire The projected study will necessarily invest in a set of preset questionnaire that will be circulated among the population of Registered Nurses (RNs) who have been appointed in the surgical unit of hospital setting in the city of Hong Kong. The RNs will be requested to share their experiences and opinions as encountered by them during their professional pursuit of dealing with smoker patients with hand surgical wounds. In research, questionnaire is generally considered as a valid instrument comprising of a series of questions by virtue of which information may be gathered from the respondents appropriately. Information collected in this manner generally helps in acquiring data in a quick fashion. Complete and accurate data that is essentially primary in nature will be obtained through questionnaire that in turn might be useful in corroborating with the secondary data that will be obtained by accessing the relevant documents from the hospital (Nardi, 2015). The responses and feedback a s received from the nurses will be helpful in interpreting the data with regards to situation in case of smoker patients having hand surgical wounds. In course of the data collection procedure, the Vancouver scar scale will be utilized to collect necessary information related to assessment of the surgical wound in the smoker as well as for the non-smoker patients. The change in the appearance of the scar will be documented by virtue of this validated tool thereby providing succinct information related to the status of the wound as observed and noted by the RN in course of routine nursing assessment. The viability of the tool has already been confirmed through empirical findings. Report has suggested that higher is the score in the Vancouver scar scale, higher is the healing time for the concerned patient (Kandamany et al. 2016). Objective scar assessment is carried out effectively through this scale. Further, it has been seen that this scale is suitable for offering vital insight in to the aspects pertaining to pliability, pigmentation, height and vascularity of the wound that are considered vital indicators of the wound healing process (Hachach?Haram et al., 2017). Hence, documentation made by the RNs in the Vancouver scar scale will offer greater insight into the issue and help in generating different themes with respect to the chosen topic. Pilot study Prior to undertaking actual data collection procedure, a preliminary study will be undertaken where a small-scale or pretest of the actual research will b done through utilization of resources such as that of the questionnaire tool. The study will be done in a way to evaluate the feasibility of the topic under investigation. In research, it is considered as a vital component of a good research design and is essentially a preparatory phase of the major research study. The feasibility of the approach that will be utilized in later hours for performing a full-fledged study on a greater scale may be indicated through conduct of this pilot study (Zainal, 2017). The extent to which the research may be translated on a greater level must be gauged through this valid measure. For the pilot study, 5-10 feedback will be sought from the RNs working in surgical wards so that wound healing issues as observed in case of smoker patients as opposed to the non-smokers prior to surgery as well as in po stoperative conditions will be better understood. Data collection procedure Data collection procedure will essentially resort to secondary data accumulation whereby data that has already been collected for research purpose are retrieved from relevant sources to inform about the situation pertinent to the topic of investigation. Organizational records regarding the patient information as obtained from the concerned hospital authority will be sought. Valid medical documents and nursing assessments about patients identified as smokers and suffered hand surgical wounds will be taken into consideration (Palinkas et al., 2015). Further, prudent information with respect to the experience and opinions of the nurses will be sought through questionnaire survey. Precautions will be taken so that requisite number of respondents feedback may be obtained. Medical data relevant to 200 patients will be obtained for including in the study for analysis. Vancouver scar scale data for these patients will be also retrieved from the nursing assessments documentations available fr om the hospital records. Data management Computer application will be used to store and manage data, whereby all the necessary and relevant documents and data will be kept in safe custody of the laptop belonging to the PI. Data will be secured with password and restrictions will be imposed regarding handling of the data. People of the research team will only be allowed to handle the data and no other unauthorized persons will be permitted to access the data (Helander, 2014). Data management will be prioritized so that improper handling or misuse of data may be prevented to certain extent. Moreover, data management will ensure prompt storage and retrieval of data in later hours whenever required. All data obtained through the hospital records will be subjected to rigorous statistical operations for deriving meaningful conclusion from the results. Statistical calculations will ensure that the data obtained are of particular significance in reality rather than being a mere theoretical representation. Students t-test will be co mputed to analyze the population parameters with respect to the two populations concerning the smokers and non-smokers. Specifically, paired t-test will be employed to compare the two population means and understand whether the differences that might have occurred in the population are of significance or have taken place due to some chance factors. The presence of significant differences between population means is indicated through this t-test (De Winter, 2013). Thus, differences in wound healing or wound management for smokers and non-smokers will be detected by incorporating t-test as part of the statistical analysis. Further, in the study Chi square test will be employed for the sake of assessing the goodness of fit between a set of observed values with respect to those expected theoretically (Schumacker Tomek, 2013). Computer based knowledge on the part of the researchers will be valuable in this context. Statistical Package for Social Sciences (SPSS) software will be used for the sake of doing all the statistical analysis of the data obtained. Ethical considerations The study will essentially follow all the legal and ethical dictums necessary to conduct the research. All the necessary guidelines will be followed so that confidentiality and authenticity of the data extracted may be maintained appropriately ((Neuman Robson, 2014). While deriving necessary information from the documents maintained by the concerned hospital authorities, precautions will be taken so that no data leakage occurs. Care will be taken so that no information regarding the patient data is shared with any third party other than the researchers and the principal investigator (PI). Further, data collection through questionnaire survey from the RNs will safeguard the data acquired by allowing the data to be kept in safe custody of the PI. Necessary approval will be sought from the concerned hospital authority to utilize the data obtained for research besides seeking permission for participation in the study for the RNs. Data will be stored safely with secured password in the l aptop of the PI so that no one other than the research team might get access to the data. It is crucial to undertake research in an appropriate fashion so that there remains no ambiguity and all the virtues related to privacy, safety, authenticity and confidentiality is well maintained (Best Kahn, 2016). Expected outcomes Smoking toxicants across several studies has lead to revelation of consistent findings that they might cause adverse health impact to various bodily tissues attributable to the interaction among the separate components that are present in cigarettes. Because of smoking, deterioration of overall health condition of the smoker has been confirmed that in turn jeopardize the wellbeing of the affected individual (Jha Peto, 2014). Pertinent studies have stated that tobacco smoking is intimately associated with impaired wound healing and aggravation of symptoms that underlie the postoperative complications thereby raising the concern that it will take longer for the smokers to heal hand surgical wounds compared to non-smokers due to smoking. Limitations of the study For the proposed study, no direct observations will be undertaken. All the necessary information will be retrieved from secondary sources. No primary data will be acknowledged in the data collection process that in turn might pose significant threats to the study outcomes. The authenticity and reliability of data may be threatened due to increased reliance on secondary data source. Dearth of appropriate primary data findings might lead to inappropriate interpretation thereby decreasing the authenticity. Lack of cooperation from the Registered Nurses in gaining their feedback on the topic that is imperative to proceed further with the study might hinder the outcomes. Funding restrictions and time constraints might further limit the progression of the study significantly. Conclusion Smoking has been unanimously presented as a potential modifiable risk factor that accentuates the risk for postoperative complications in the patients manifold compared to their non-smoker counterparts. Duration of smoking cessation prior to undergoing surgery has been considered vital to gauge the relative risk of wound healing in the concerned patients. Healthcare workforce must work in coalition appropriately to mitigate the issue so that exacerbation of symptoms may be abated to some extent. Advocacy for tobacco control strategies must be implemented rigorously so that the adversities in the form of disease onset, morbidity and premature mortality may be averted considerably. Timeframe The study will be conducted over a span of 7 months, commencing in the month of January 2018 and will end in the month of July 2018. Activity Months Jan Feb Mar April May June July Topic finalization Layout formation for research work Undertaking Literature Review Formation of Research Plan Selection of suitable research methodologies Pilot Study Data collection from secondary sources Data analysis of the collected data sets Interpretation of collected data sets Concluding the Study Designing a rough draft Submitting the Research Proposal to Ethical Committee Proposed Budget Activity Expenditure Pilot Study 5000 $ Stipend to four research scholars 40,000 $ Internet facility charges 2000 $ Paper and photocopy charges 1000 $ Other expenses 2000 $ Total 50,000 $ Reference list Best, J. W., Kahn, J. V. (2016).Research in education. Pearson Education India. Chp.gov.hk. (2017).Recommendations on Prevention of Surgical Site Infection.Chp.gov.hk. Retrieved 22 September 2017, from https://www.chp.gov.hk/files/pdf/recommendations_on_prevention_of_ssi.pdf Creswell, J. W. (2013).Research design: Qualitative, quantitative, and mixed methods approaches. Sage publications. De Vaus, D. (2013).Surveys in social research. Routledge. De Winter, J. C. (2013). Using the Student's t-test with extremely small sample sizes.Practical Assessment, Research Evaluation,18(10). Duchman, K. R., Gao, Y., Pugely, A. J., Martin, C. T., Noiseux, N. O., Callaghan, J. J. (2015). The effect of smoking on short-term complications following total hip and knee arthroplasty.JBJS,97(13), 1049-1058. Etikan, I., Musa, S. A., Alkassim, R. S. (2016). Comparison of convenience sampling and purposive sampling.American Journal of Theoretical and Applied Statistics,5(1), 1-4. Hachach?Haram, N., Bystrzonowski, N., Kanapathy, M., Smith, O., Harding, K., Mosahebi, A., Richards, T. (2017). A prospective, multicentre study on the use of epidermal grafts to optimise outpatient wound management.International wound journal,14(1), 241-249. Haskins, I. N., Amdur, R., Vaziri, K. (2014). The effect of smoking on bariatric surgical outcomes.Surgical endoscopy,28(11), 3074-3080. Hatcher, J. L., Sterba, K. R., Tooze, J. A., Day, T. A., Carpenter, M. J., Alberg, A. J., ... Weaver, K. E. (2016). Tobacco use and surgical outcomes in patients with head and neck cancer.Head neck,38(5), 700-706. Healthyhk.gov.hk. (2017).Smoking Pattern.Healthyhk.gov.hk. Retrieved 22 September 2017, from https://www.healthyhk.gov.hk/phisweb/en/health_info/behav_risk_factors/smoking_pattern/ Helander, M. G. (Ed.). (2014).Handbook of human-computer interaction. Elsevier. Jha, P., Peto, R. (2014). Global effects of smoking, of quitting, and of taxing tobacco.New England Journal of Medicine,370(1), 60-68. Kandamany, N., Kierath, J., Rea, S., Edgar, D., Finlay, V., Burrows, S., ... Wood, F. (2016). Increased Healing Time Is Associated With Higher Vancouver Scar Scale Score.Anz Journal of Surgery,86, 16. Marshall, B., Cardon, P., Poddar, A., Fontenot, R. (2013). Does sample size matter in qualitative research?: A review of qualitative interviews in IS research.Journal of Computer Information Systems,54(1), 11-22. Nardi, P. M. (2015).Doing survey research. Routledge. Nsell, H., Ottosson, C., Trnqvist, H., Lind, J., Ponzer, S. (2011). The impact of smoking on complications after operatively treated ankle fracturesa follow-up study of 906 patients.Journal of orthopaedic trauma,25(12), 748-755. Neuman, W. L., Robson, K. (2014).Basics of social research. Pearson Canada. Palinkas, L. A., Horwitz, S. M., Green, C. A., Wisdom, J. P., Duan, N., Hoagwood, K. (2015). Purposeful sampling for qualitative data collection and analysis in mixed method implementation research.Administration and Policy in Mental Health and Mental Health Services Research,42(5), 533-544. Schumacker, R., Tomek, S. (2013). Chi-square test. InUnderstanding Statistics Using R(pp. 169-175). Springer New York. Sweetland, S., Parkin, L., Balkwill, A., Green, J., Reeves, G., Beral, V. (2013). Smoking, Surgery, and Venous Thromboembolism Risk in Women: UK Cohort Study.Circulation, CIRCULATIONAHA-113. Zainal, Z. (2017). Case study as a research method.Jurnal Kemanusiaan,5(1).

The poem Beowulf was written in England sometime in the 8th century Essay Example For Students

The poem Beowulf was written in England sometime in the 8th century Essay The poem Beowulf was written in England sometime in the 8th century. It was written during a time when the society was in the process of being converted from paganism to Christianity. The Christian influences are combined with early folklore and heroic legends of Germanic tribes. Yet, the pagan elements in the epic poem Beowulf clearly overshadow the Christian elements, and it is visible in the characters superhuman personifications, their hunger for revenge, and their strong belief in fate. The main character, Beowulf, is depicted as a superhero in many of his extraordinary battles. During the battle with Grendels mother, when Beowulf realizes that Unferths sword is useless against the monsters thick skin, he grabs à ¢Ã¢â€š ¬Ã‚ ¦the best of all weapons / But so massive that no ordinary man could lift / Its carved and decorated length1558-1561. This shows the significance of Beowulfs strength, because if it were any other man, they would not be able to lift this sword and kill Grendels mother. His strength is far superior to any other human, and therefore Beowulf fits the epic and pagan quality of being head and shoulders above the rest. We will write a custom essay on The poem Beowulf was written in England sometime in the 8th century specifically for you for only $16.38 $13.9/page Order now Another instance where Beowulf demonstrates his superhero abilities, is his final battle with the dragon. Beowulf is a very old man by now and although he is, in the end, fatally wounded, he manages to deliver the final blow that kills the dragon. His lack of fear to fight the dragon by himself, is portrayed when he tells his friends to stay outside so they will not get injured. Even as an elderly person, Beowulf still has the same extraordinary courage and strength as earlier in the poem. And even with age, he has not lost the qualities that make him universally well known, and an outstanding hero. These battles are examples of epic folklore during pagan times. Another pagan element is visible in the craving for revenge by many of the Anglo-Saxons. Beowulf illustrates this wish for vengeance after Hrothgar loses one of his counselors to Grendel: Let your sorrow end! It is better for us all / To avenge our friends, not mourn them forever 1384-1385. This passage disproves the idea that Beowulf is a Christian poem, because taking an eye for an eye is not at all a Christian belief. Revenge is an idea promoted by Pagans, and was thought to be necessary to avenge to death of a friend. Another act of revenge is seen when Beowulf attempts to defeat the dragon after it wreaks havoc on the land of the Geats, causing much damage. Even though Beowulf was very old, the fame-hungry king was seeking retribution for the fury the dragon had lashed out onto his city. Beowulf is obviously very arrogant and hot-headed, and does not follow Christian ideas and beliefs. It is proven that this epic poem is a pagan work, because of the accepted seeking of revenge. One final pagan aspect of this poem, is the strong belief that everyone was in the  hands of fate, the idea that your life is predetermined. For instance, when the men of Herot are awaiting Grendels wrath, Beowulf states, Fate will unwind as it must! 455. This shows that the warriors did not worry about what would happen, because they are unable to change what is already planned for the future. Beowulfs courage is also explained in this segment, since he could not alter the future no matter what he did, he was not afraid of what would happen. Another occasion where fate takes control is when the dragon kills Beowulf. He has lived a long and meaningful life, but this tragic event proves that everyone is in the hands of fate. This also negates the belief that Beowulf is a Christian poem, because the Christian belief is that ones life is in the hands of God, and is not determined by fate. .u460bd020afd933f8bda23dab5a9efba3 , .u460bd020afd933f8bda23dab5a9efba3 .postImageUrl , .u460bd020afd933f8bda23dab5a9efba3 .centered-text-area { min-height: 80px; position: relative; } .u460bd020afd933f8bda23dab5a9efba3 , .u460bd020afd933f8bda23dab5a9efba3:hover , .u460bd020afd933f8bda23dab5a9efba3:visited , .u460bd020afd933f8bda23dab5a9efba3:active { border:0!important; } .u460bd020afd933f8bda23dab5a9efba3 .clearfix:after { content: ""; display: table; clear: both; } .u460bd020afd933f8bda23dab5a9efba3 { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .u460bd020afd933f8bda23dab5a9efba3:active , .u460bd020afd933f8bda23dab5a9efba3:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .u460bd020afd933f8bda23dab5a9efba3 .centered-text-area { width: 100%; position: relative ; } .u460bd020afd933f8bda23dab5a9efba3 .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .u460bd020afd933f8bda23dab5a9efba3 .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .u460bd020afd933f8bda23dab5a9efba3 .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .u460bd020afd933f8bda23dab5a9efba3:hover .ctaButton { background-color: #34495E!important; } .u460bd020afd933f8bda23dab5a9efba3 .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .u460bd020afd933f8bda23dab5a9efba3 .u460bd020afd933f8bda23dab5a9efba3-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .u460bd020afd933f8bda23dab5a9efba3:after { content: ""; display: block; clear: both; } READ: Environmental Poetry EssayBeowulf is clearly a pagan poem because it conveys standards that are almost the opposite of Christian beliefs. The pagan beliefs of the time are accepted and followed entirely. The very apparent aspects of this poem that make it pagan are, characters superhuman personifications, a strong belief in fate, and a longing for revenge.

Robinson Crusoe Essay

Robinson Crusoe Essay The amazing story I read was the tale of Robinson Crusoe, written by Daniel Defoe, which is the account of a man who was stranded on an uninhabited island for more than twenty years. This story was published by the English writer, Defoe, in the year 1719, about eighty years before the French Revolution. The fiction was in a relatively simple manner but was so masterfully done that it has achieved much praise. In Robinson Crusoe, there are very few characters that the author describes with much detail. The main character is Robinson Crusoe who is the son of a well-to-do middle-class father. He is very immature in the beginning because of how his emotions change like a stormy sea. He keeps jumping from wanting to become involved in law to obey his father’s wishes and sailing out to sea to show he is a rebel. Later on, his character becomes more mature while he is living on the deserted island and he shows the amount of ingenuity he has by completing his priorities to survive with very little in supplies to help him complete them. There are a few other characters in the story that have some significance to Robinson’s life like his servants Friday and Xury. He has these friend-servants at different points in the story and they help him survive in one way or another. Xury helps him escape from his Moorish slave master and stays with Robinson until they are picked by a Portuguese captain. Friday comes into Robinson’s services when Robinson saves him from cannibalistic savages that want to eat him and helps Robinson survive on the island. There are numerous characters in Robinson Crusoe but only a few of them have any real significance to the life of the main character, Robinson Crusoe, in the story. The story of Robinson Crusoe has a very straightforward and basic plot. It is about a young man disobeying his father and going out to sea to explore the world. He encounters many problems, though, but seems to overcome everything that happens to him one way or another. The largest predicament he gets into is shipwrecking on an uninhabited island in the Caribbean and having to survive there for over twenty years. In the end, though, he even overcomes that situation and eventually travels back to his home in England to settle down and have children. Other problems he encountered were being captured and enslaved, fighting bloodthirsty savages, and nullifying a mutinying ship crew. Throughout all this Robinson stayed mostly levelheaded and worked strategically to accomplish his goals. The whole story is just about Robinson encountering problems and overcoming them which is not that complex of a storyline. There are many underlying historical facts in the tale of Robinson Crusoe. Robinson’s father represents the Protestant ideal of being a hard-working individual while the savages of Brazil are considered to be the lowest form of life with their pagan practices and attitudes. Defoe also shows that during the time he was writing the book Catholics were not trusted in England because he makes Robinson suspicious of the Catholic Spaniard he saves from the savages. Christianity is shown as a form of deliverance for foreign servants that want to become free and shows that the Christian religion was seen as the best religion to believe in during the 1700s. It is also shown that the Inquisition is happening in the book because Robinson is afraid that the Spaniard will give him to the Inquisition if he lets the Spaniard take him back to Europe. There are many clues and phrases that show what was happening in the European world in the tale of Robinson Crusoe. The novel, Robinson Crusoe, was one of the greatest books I ever read in my life. Daniel Defoe captures Robinson’s own personal view, instead of the view of the masses, perfectly with Robinson’s own individual way of thinking and viewing the world around him. He shows how Robinson matures throughout the book and has a deeper understanding of life until he goes back to the corrupted European world and becomes an ignorant man looking for adventure again. The in-depth descriptions of what Robinson did to survive demonstrate that Defoe had extensive knowledge on survival tactics and enhances the story to the point of it being believable. This book is a must-read by anybody who wants to experience real English literature in all its glory. The story of Robinson Crusoe was a great book to read and was written by an amazing author from England. Even though the plot was quite simple and there were very few characters with any real significance to the story, the style of writing that the novel was done with was truly amazing and more than makes up for everything else in the story. The fiction, Robinson Crusoe, was a real English masterpiece of a novel and was done by Daniel Defoe, one of the greatest English writers of all time. You can order a custom essay, term paper, research paper, thesis or dissertation on Robinson Crusoe topics at our professional custom essay writing service which provides students with custom papers written by highly qualified academic writers. High quality and no plagiarism guarantee! Get professional essay writing help at an affordable cost.

Albert Nobbs (2011) Movie Review Example | Topics and Well Written Essays - 750 words

Albert Nobbs (2011) - Movie Review Example Albert worked as a hotel waiter for thirty years during which she exhibited extreme dedication, and was known for her introvert nature. The hotel appointed Joe Mackins for repairing of boilers, who soon went into a relationship with the flirtatious maid Helen Dawes. However, Joe proved to be a drunk and extremely dominating man. Albert then narrates her life story to Hubert Page who is a housepainter and a fellow transvestite. Albert had chosen her present life out of economic needs after she was gang raped at the age of fourteen. However, Albert refrains from revealing her true name since she considers herself as a man. Seeing that Hubert is married and has a wife, Cathleen who is a dressmaker by profession, Albert too dreams of having a life partner. Albert’s objective in life is to open a tobacco shop with her savings and for that she offered Helen to stay with her. In spite of her reluctance, Joe insists Helen to agree since he thought Albert would give her the money that he needed to leave Ireland for America with Helen. During this time, typhoid epidemic broke out in Dublin for which hotel business began to drop thus calling financial problems for Albert. Soon she learns that Cathleen has died of the epidemic. In memory of Cathleen, Albert and Hubert dress up as women wearing the clothes made by Cathleen. During a walk together, although they manage to overcome their initial uneasiness, Albert soon trips and falls which returns her to reality. They then revert to their old lives, i.e. playing the role of men. Immediately after this Albert learns that Helen is pregnant with Joe’s child. In response to Helen’s fear that Joe may abandon her and leave for America, Albert offers to marry her. Later that eveni ng, Helen and Joe get involved in a fight in which Albert intervened and physically attacked Joe. Joe, in a fit of rage, pushes Albert

Drug Trafficking in the United States Research Proposal

Drug Trafficking in the United States - Research Proposal Example Illegal immigration has proved to be the main cause of this issue. The United States of America has been facing the issue of drug trafficking for many years. In the United States, drug dealers make use of illegal immigrants for the manufacturing and exchange of drugs. The drug dealers are aware of the insecurity and fear which illegal immigrants have in their minds, and they use that fear for making immigrants work for them. The network of the drug trafficking industry has expanded, not only to the United States, but also to other parts of the world. People involved in the illegal drugs business send their representatives to other countries in order to expand their illegal activities there. However, no country voluntarily permits such individuals to migrate into their territory and continue their illegal activities. Therefore, such people use illegal methods to cross the boarders of other countries. The government of the United States needs to take effective measures to stop illegal immigration because it is one of the major contributing factors to increased drug trafficking. The purpose of this research is to reduce drug trafficking in the United States by finding ways to stop illegal immigrations. The hypothesis for the research is that limiting illegal immigrations from countries which are the homes of drug cartels can help the government restrict drug trafficking in the United States. Personal interviews with drug dealers, smugglers, drug users and victims will be conducted for the collection of data. Visits to drug users and drug dealers will also be made to gather information about the sources through which they get their narcotics. Some of the likely sources for current information on this research topic will be books, scholarly journals, and internet articles. I will collect data and statistics and organize them into charts and tables. The time required for the completion of this research is estimated

Accounting graded unit 2 Coursework Example | Topics and Well Written Essays - 3000 words

Accounting graded unit 2 - Coursework Example The goals can be significantly categorised as planning, development and evaluation. The planning process is very crucial and should be devoted moderate amount of time. The expected time frame for the planning process is approximately two weeks. The development stage require gathering of various primary information as well as secondary information for careful assessment and budget planning. A time period of three weeks can be considered thereof. Evaluation process can be conducted within a span of 10 days. The key factors are quantity of the final product the wholesaler is willing to stock, direct and indirect material required for production, manpower for operational activities and hours required for determination of total cost. Additional requirement of resources such as manpower and method of costing require more research and attention. It was determined that the company has implemented traditional as well as activity based costing for budgeting for its products. Since the new product is going for production for the first time, appropriate cost method requires significant consideration. The company is planning to make some additional investment in CNC machine and should research whether the investment is worthy. There are two research methods that can be implemented in research process, namely, primary research and secondary research. Primary research indicates towards first hand obtained data while secondary research is pursued by evaluating various readily available data such as company database, journals, books and other sources. The case study is a prominent secondary source in this paper and the other secondary sources that will be used in this regard are books and journals. The report is a multifaceted project and requires evaluation of several minor and major aspects underlying the situation. Costing

Organisational Structure Of The Ikea Company Commerce Essay

Organisational Structure Of The Ikea Company Commerce Essay Ingvar Kamprad, the founder of IKEA, as a child, started a profitable business selling matches to neighbours on his bicycle. In 1943, at just 17 using money he received as a gift from his father for doing well in school he formed IKEA which is an acronym made up of his initials and the first letters of Elmtaryd and Agunnaryd, the farm and village in Sweden where he grew up. In 1947, furniture was introduced for the first time in IKEAs product line in the form of armchairs. Local craftsmen made the furniture using wood from a nearby forest. IKEAs furniture became very popular and the line was extended to include more products. Its interesting at this point in the companies history because Kamprad was based in a very poor area of Sweden, and because of this, the people were naturally frugal and highly resourceful, in other words they had to maximise and be inventive with the limited resources available to themThe author believes that this is the setting and cornerstone for all of IKEAs subsequent success. IKEAs vision was To create a better everyday life for the many people. According to Ingvar Kamprad, the founder of Ikea; To design a desk which may cost $1,000 is easy for a furniture designer, but to design a functional and good desk which shall cost $50 can only be done by the very best. Expensive solutions to all kinds of problems are often signs of mediocrity. (Chandler, 1993: 12) Ikeas success is based on the relatively simple idea of keeping the cost between manufacturers and customers down. Costs are kept under control starting at the design level of the value-added chain. Following on from this the culture of the company emphasizes efficiency and low cost, which cannot be achieved at the expense of quality or service. Bureaucracy is fought at all levels in the organization. Kamprad believes that simplicity and common sense should characterize planning and strategic direction (Bartlett et Al, 1993: 78). Bartlett C.A. Ghoshal S. (1993) Transnational Management. Irwin Publishers Boston Massachusetts Symbolic policies, such as only flying economy class and staying at economical hotels, employing young executives and sponsoring university programs have made cost part of corporate culture and have further inspired the influx of entrepreneurship into the organization. Despite his vast wealth it is reported he used to only drive an eleven-year-old modest Volvo. By 1951, furniture sales dominated his sales inventory and he decided to specialize exclusively in low priced furniture. The author recognises here that he is playing to his market strengths and again this is a further cornerstone of his subsequent success. In the same year, the first IKEA furniture catalogue was published. IKEA opened its first furniture showroom in 1953, which allowed customers to check the quality and use the items they were buying. The author recognises that any company that is prepared to allow customers to use its products before buying them will likely ensure that the quality of the product is if anything substantially above its utility specification. People also like to handle and view a potential product before purchase, which is part of the reason, that ecommerce will always take on limited success. Today IKEA is actually a privately held company owned by Stichting INGKA Foundation, a non-profit registered in Leiden in the Netherlands that is controlled by the Kamprads three sons. The Dutch foundation is worth US$36 billion in 2006. IKEA Group with its headquarters in Denmark, is a multinational operator of a chain of stores for home furnishing and furniture. It is the worlds largest furniture retailer with a reputation for low cost, style and design. IKEAs annual home furnishing sales are 20 billion euros with more than 260 IKEA Group stores in 25 countries (Ohlsson, 2010). IKEA has about 40 distribution centres worldwide in 16 different countries, and implemented the automated Astro warehouse management system in 2005 (2005) in 15 of their Distribution Centres (DC) and Customer Distribution Centres (CDC). IKEA has approximately 1,220 suppliers from 55 different countries split more or less evenly between Europe and Asia, the top five of which are China 20%, Poland 18%, Italy 8%, Germany 6% and Sweden 5%. The company holds 3.5m stock keep units, with 10000 different product types amongst them, 10% of which are new every year. It is also a major global employer with 125000 employees in 40 different countries. Human resources The companys ethos was quite Christian in its values-their philosophy was to treat others as one would like to be treated oneself and their belief is akin to that shown by Japanese companies to their workers today that is to increase commitment and hence productivity from staff, one has to provide them with the belief of belonging to the company. For instance, all design teams enjoy complete autonomy in their work, but are expected to design new appealing products regularly. Ikeas employment philosophy is widely welcomed in the USA where historically moral amongst staff and working conditions and benefits are poor in the retail sector. This accounted for the fact that the sector had one of the highest turnover rates of all industries. Consequently, it also suffers from high human resource (HR) costs, as companies have to recruit and train replacements at frequent intervals. Definition: Management Information Systems (MIS) is the term given to the discipline focused on the integration of computer systems with the aims and objectives on an organisation. Information systems can be broadly divided into operational level for transaction processing, knowledge level for knowledge and office management, management level for decision and intelligent support and strategic level for executive support. The information systems support an information value chain for both business process-supply chain, enterprise, customer and knowledge management and management activities-planning, co-ordinating, controlling and modelling. Ultimately all the systems process data and provide feedback and for executive support for decision making planning, monitoring and implementation of strategy and the general workforce. Definition of an organisation -a stable formal structure that takes resources from the environment and processes them to produce outputs. An organisation can be said to be a formal structure with a standard operating procedure, politics and culture. Environmental factors affect their outputs -these maybe resources, government, competitors, financial, institutional culture, technology. Impact of information systems is seen in terms of a microeconomic model, transaction cost model, agency theory and behavioral theory. sociotechnical systems, redefining boundaries, recognising work flows, flattening, electronic market. Diagram Organisation Information technology mediating factors -environment culture structure standard procedures politics management decisions chance Information systems Information systems relate to the way in which Ikea is organized, its management and its technical layout. Information systems do not just consist of information technology (IT) and information transfer systems-the technical requirements should act as an adjunct to the business strategies of the enterprise rather than being a hostage to its fortune. Often business strategy requires the execution of complex processes of control and automation and the ability to quickly analyze and react to relevant data, not in an uncontrolled firefighting or reactive manner but with anticipation and forward planning based on likely demand and external changes in the business environment. Diagram showing interdependence between Business strategy, software, hardware, data management, telecommunications Organisational framework The problem is that in complex business organizations SBUs tend to design their information management needs according to their best interests rather than to the interest of the enterprise as a whole. This is termed the silo affect. To survive in an every more competitive environment, management must be strong enough to ensure that their strategy is implemented in the execution of cross-functional business processes and that information can be managed and shared across spatial, functional, geographic and segmental boundaries. Stakeholders interests e.g.are often ignored at the expense of damaging other parts of the supply chain, and the chain weakens. This maybe for several reasons, particularly because corporations are often intimidated by the thought of sharing competitive information with their suppliers. Their information security facilities often prohibits suppliers from gaining advantage by withholding from them key information e.g. manufacturing processes can benefit from effi cient production through accessing a real-time demand system. Companies therefore face a dilemma-do they share information to the extent that it allows their potential competitors access to their market information or do they with-hold information and become less competitive. In the end and on balance, a closeted attitude becomes self-defeating and exposes them to the risk of a more aggressive competitor. Ikea does not actually manufacture products, however it plays a very large design and innovative role in their production. By outsourcing manufacturing they can retain a competitive advantage -if one company fails to provide product as specified they will find another company that can and they do not suffer from set-up costs and ultimately ROI costs. One can immediately see the main problems relating to information management for IKEA. None more so than with a company whose strategy demands supply from a worldwide network and delivery to a worldwide customer base. One can easily understand that where there is a disparate group of suppliers, co-ordination between various supplier and DC is critical. A range of kitchen products e.g.may be produced by different manufacturers who have different supply times, manufacturing ability, geographical location, delivery times etc. On one hand one does not want idle inventory stock as this costs money, on the other one wants to ensure a constant supply which can meet fluctuations in demand-otherwise customers will become frustrated and will purchase elsewhere. In addition customer demand may vary between geographical location e.g. a country maybe has mainly city based stores where there would naturally be higher demand e.g. for space saving furniture which may be manufacturered in a country r ound the other side of the world. Ikea faces huge logistical problems, particularly as their ethos is to supply medium range quality product at low price. Supply planning is key to this strategy. One needs in this situation to forecast across the whole company and to organise its distribution centres into groups and hold one lot of a float of stock for a number of DCs. The capacity and geographical location of the CDCs become crucial to the companies strategic planning. Clearly a high capacity geographically distant CDC or a low capacity near CDC have redundancy issues because of the volume of product they hold and there impact on delivery time. Technology At operation level, Astro WMS (Group, 2010) is a modular WMS that IKEA adopted in 2010 and increases and improves efficiency in their distribution centre. Astro simplifies and streamlines the work process to provide total control of warehouse management with full tractability, accuracy, and on-line planning. In order to optimise capacity, handling equipment and storage spaces must be fully utilized. Astro is an automated warehouse management system that allows for ordering fulfilment automatically so reducing manual cost with automated re-ordering purchase orders being sent to suppliers when stock levels are low. Fully automatic double-aisle cranes from LTW Doppelmayr operate without any manual input as if robots have taken over the world leaving man redundant. In IKEA DC in New Jersey USA is running Astro WMS at full capacity with 175 warehouse employees. Ed Morris, Operations Manager at the site comments, We have seen that we are already back to picking 4,500 customer order lines per day and able to ship 34 trailers to the stores by the end of week one. I am confident that we will be exceeding our previous daily expectations in the very near future. Through the partnership we have built with the Consafe team, I am sure that both sides will take things away from this project and use them in the future. I really believe that this cutover was a success for both IKEA and Consafe. There will be space for 70.000 pallets in the 2 conventional modules and 100.000 pallets in the high-rack system. The warehouse capacity will be 270.000 pallets and therefore the largest IKEA Distribution Centre in the world. Taking a product to market involves many steps and information management is crucial to the products success. Ikea often designs and develops products from their inception to market. In order to do this they work from CAD drawings and have prototype machines model real products from their design drawings. But product manufacturing is more involved than just prototype production and testing. One must consider material source and process cost with the manufacturer as well as packaging development. IKEA is famous for its flat packs that were designed not just to fit into the customers car easily, but are mainly designed to maximize use of space during transport and warehousing so reducing costs storage and handling costs to a minimum. (Economist, 1994: 101). IKEA realized early on that space is often redundant during storage or transportation, yet costs money regardless of whether it is utilized or not. Hence the idea of a flat pack where storage and transport demand can be anticipated easily and utilized efficiently. In addition products have to market researched and tested and there has to be careful consideration in rollout, forecasting and financials. Neglecting one of these areas can cause immense damage to the company as a whole e.g. if a product reaches the shelf which is faulty may damage the brand of the company e.g. if the manufacturing process is too costly to set up it can place borrowing costs and liquidity capital under significant strain. The product must also be indexed, catalogued, labeled and displayed correctly. All of these represent part of the supply process, all of them require huge information analysis and appropriate information transfer. Order planning is therefore crucial to their operation and differences between expected demand and supply will affect their bottom line. In 2005 realising that these issues were becoming critical, the company decided to use an SAP based demand-planning tool solution with Manugistics and their goal was to reduce inventory levels in distribution centres by at least 10%. In its deployment the software must be able to identify critical resources such as people, equipment, storage, suppliers, finances, and be able to forecast with reasonable accuracy supply and demand fluctuations. Diagram-Forecast, stock, orders, material resource planning, requisition, quality, invoice, payment, structure of DC, CDC manufacturers. Production manager and finance officer. Management issues In modern corporate culture constant improvement has become a leading concept, and the technology has to keep up. Therefore the system needs to be flexible and adaptive, i.e. they need to be able to adapt changes in the flow. The limits of this flexibility are set at an early stage, by the choice of system and provider/supplier. As the company has such a vast range of stock there is also a tendency to be production-oriented, rather than customer focused which has made its supply chain more push than pull which naturally creates a supply-demand imbalance. The Supply Chain Council is an independent group of international supply chain industry executives and experts who developed the Supply Chain Operations Reference (SCOR) Model over a ten-year period using in-depth industry research and analysis. The models however are often based on forecasts and on theories, which are exact in them selves, but whose results maybe incorrect. The reason is that they require great quantities of data that are hard to gather and have to be estimated and calculations often have to be carried out for entire batches. One such example is the Wilson formula. The Wilson Formula The Wilson formula is a traditional method for determining production quantity where the total consumption during a period of time is known. The formula assumes that the only costs entailed are a warehousing cost per stock keeping unit and a one-time cost every time an order is placed, known as administrative re-ordering costs. The formula tries to find an optimal balance between the two costs to minimize the total cost, which is known as the economic order quantity (EOQ). In order for the Wilson formula to work, a number of conditions have to be met: Demand is constant and continuous The lead time for receiving ordered goods is constant Administrative re-ordering costs and warehousing costs are constant The order quantity does not need to be expressed as an integer The entire order quantity is delivered to the warehouse on the same occasion No shortages allowed The price/cost is independent of time requirements and ordered quantity Goods handling is ignored which is often a considerable cost e.g. the value of the article is often not proportional to the handling cost of the good. The administrative re-ordering cost is hard to determine. Price and demand also varies over time making judgement obsolete. Management by Objectives Ikea uses Opportunity Analyzer, which makes use of the Supply Chain Operations Reference (SCOR) Model. Best practices and key performance indicators are embedded in Opportunity Analyzer Management. Opportunity Analyzer recognizes important key performance indicators (KPIs) e.g. delivery performance. While MIS systems are extremely useful in generating statistical reports and data analysis they can also be of use as a Management by Objectives (MBO) tool. MBO is a management process by which managers and subordinates agree upon a series of objectives for the subordinate to attempt to achieve within a set time frame. Objectives are set using the SMART ratio: that is, objectives should be Specific, Measurable, Agreed, Realistic and Time-Specific. The success of any MBO objective depends upon the continuous tracking of progress. In tracking this performance it can be extremely useful to make use of an MIS system. Since all SMART objectives are by definition measurable they can be tracked through the generation of management reports to be analysed by decision-makers. http://www.supply-chain.org/resources/scormark/tutorial SCOR considers management processes and planning. Ikea has such a large range of products that one has to be able to benchmark supply chains against products in order to best assess the most profitable items. SCOR takes product and cross references them individually against customer sub-type then groups similar supply chain characteristics. It then applies performance matrices-those of agility, responsiveness, cost, assets and reliability and scores each group of supply chains accordingly creating a ranking of supply chains. The advantages are obvious in that the more efficient supply chains can be more heavily relied upon, to create profit, the weaker ones losing out from future reliance. However, the disadvantage is that supply chains may cut across market segments and unifying groups by supply chain efficiency rather than by market segment may destroy market uniformity. The executive team can select a relevant KPI for the particular target area. Today, companies connect into networks or chains, increasing the flow rate throughout the supply chain to satisfy an ever more demanding customer. Increased power is given over to the vendor to keep stock at the desired level. http://www.jda.com/company/display-collateral.html?did=636dcid=1 The demand supply chain software must also be able to provide key metrics in areas where demand exceeds supply and available capacity. This will improve order fill rates and network utilization and will free working capital tied to ineffective inventory. However, understanding the supply demand chain in its practical execution is not all that is required. The product, must also align with its financial evaluation in an integrated business plan. It must be able to identify any performance concerns and gaps at the lowest practical level across the strategic/business plans. The software must become a forecasting tool and be able to perform a what if scenario for management to make best estimate prediction on future capacity demands. It must be able to relate assumptions, risks and opportunities to specific hierarchy levels in the SOP plan. These are decision support systems. Like all good army strategy there must be a backup plan when all goes wrong with practical and well-worked altern atives e.g. its no good having a back up generator if its not properly serviced regularly. The information tool must also be able to track changes over time and carry out real-time review analysis of supply and highlight areas where inventory positions violate pre-defined tolerances. It must also be able to highlight critical resource constraints related to material, labor and other capacity variables. Clearly there is a position that optimizes resources, distribution, transportation, stock inventory, production and materials. http://www.allbusiness.com/company-activities-management/operations-supply/10574219-1.html Recommendations IKEA is undoubtedly a highly successful global firm. Like all firms they must ensure competitive advantage. In information transfer terms they have problems relating to the fact that their suppliers are multiple and demand can vary. It may be better for them to consider horizontal back integration and begin to act as suppliers to ensure consistant information flow-from factory to customer. They will undoubtedly sometime soon saturate their market and further market expansion may not be possible. They must look toward expansion elsewhere either by parallel related market considerations e.g. home or commercial furnishing design or by backward horizontal integration. Both would be ideal targets for integrated information design providing the company with synergistic information value and ultimately increasing their information value chain.