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Physical Activity among the Adolescents

Physical Activity among the Adolescents
Physical Activity among the Adolescents
Barriers to physical activity among the adolescents (Age 13-18 Years) in rural and urban areas of Deptford

Abstract

Objectives: Physical activity among the adolescents is associated with psychological, social and physical benefits. Moreover, research indicates that physical activeness observed in adulthood originates from childhood.  Physical inactivity is associated with obesity and diabetes type 2 (Craggs et al., 2011). This study is developed to explore physical activity barriers in a representative sample of adolescent in Deptford, London Borough of Lewisham.

Design: The study is conducted in rural and urban areas of Deptford in London Borough of Lewisham. The study design is mixed research design. The quantitative part will consist of 159 randomly selected adolescents, whereas the qualitative part will consist of semi-structured interviews with the participants and focus group discussions.

Outcomes: The study findings will identify the physical activity barriers among the adolescents, and the strategies to overcome them.

Conclusion: Increase of public knowledge on importance of physical activity is crucial as it helps the society to understand the health benefits of adopting active lifestyles. The study findings help in understanding physical activity determinants among the adolescents (13-18 years).

Title:  Barriers to physical activity among the adolescents (Age 13-18 Years) in rural and urban areas of Deptford

Background

 Physical activity is associated with psychosocial and physical benefits for everyone including children and young adults.  Physical inactivity correlates with increase of lifestyle diseases such as diabetes type 1 and obesity among the adolescents.  The current levels of physical activity in the UK are low (Rothon et al., 2010). For instance, in England, only 66% of males and 56% of females meet the recommended physical activeness.  In Scots, only 62% of the population is physically active. These findings may not be realistic as most of the studies conducted are self-reporting, which indicates that the reporting could be a little bit biased but it portrays the exact picture on levels of physical activeness among the UK (Department of Health, 2011).

Research indicates that physically active lifestyle originates from childhood. Therefore, childhood health promotion is an effective strategy in obesity prevention (Craggs et al., 2011). In the UK, several community based programs and school based programs have been developed to increase physical activeness knowledge and health benefits in the population. However, increasing health activity information in the community does not automatically translate to increase in physical activeness among the adolescents. Therefore, this paper explores the determinants of exercise among the adolescent. The findings gathered will help to design effective interventions that will increase adolescent’s physical activeness across the ethnic groups (Rothon et al. 2010).

Study Problem / Purpose

            High levels of physical activeness in young lives are associated with normal skeletal development, increased wellbeing, good-metabolic, and cardiovascular system. However, physical activeness in the UK is a huge public health concern, and is shown to decline in adolescence (Craggs et al., 2011). There are a number of factors that influence physical activity including biological, environmental, psychological and social factors. In depth interviews on physical activity among the youth have also been explored, where socioeconomic status, gender and societal (peer and parents) have been correlated with physical activity or inactiveness among the adolescents (Craggs et al., 2011).

 However, these study findings correlates mainly to cross-sectional differences and therefore are limited to formulation of hypothesis concerning the potential mediators and factors. Therefore, this study explores factors that hinder physical activity by examining the potential barriers of physical activity among the youth. The purpose of this paper is to strengthen the evidence base in order to inform the process of designing effective interventions (Oliveira, 2013).

Relevance / Study Rationale

Physical inactiveness is associated with wide range of health complications such as cardiovascular disease, type-2 diabetes, obesity and psychosocial disorders such as low self esteem, depression, and eating disorders. Childhood obesity is a growing threat to the UK’s public health (Oliveira, 2013). In UK, 3 out of every 10 children between age 2 and 15 are obese or overweight, and 1 in six children in the same group is obese.

Research estimates that these lifestyle diseases reduce life expectancy of the adolescents, and account for 1-3% total health expenditures. Psychiatric morbidity in adolescents is a major issue in the USA. The median prevalence of mental health in adolescents in UK is 10%.  Most population based cohort investigations as randomized controlled trials associated with depressive symptoms in adolescents (Craggs et al., 2011).

Physical inactivity is the leading cause of mortality in developed countries, and it accounts for 22-23% of cardiovascular diseases, 17% colon cancer, 13% strokes, 15% diabetes and 11% breast cancer incidences. In Scotland, physical inactivity contributes to 2,500 deaths per year and consumes approximately £94 million of NHS health budget. Other non-aggregating non-healthcare costs such as low productivity leads to additional costs of £8.2 billion per annum, with additional £2.5 billion for addressing obesity and its related complication (Department of Health, 2011).

  Lewisham borough of London is has the highest rate of childhood obesity. Statistics indicates that about 25% of Lewisham are below 20 years. The population is diverse, with 69% of school children are from minority ethnic background, with 37% of them living in poverty. The National Child Measurement Program (NCMP) reveals that prevalence of childhood obesity in this borough is higher than England average.

This is an indicator that adolescents residing in this borough are not physically active. Therefore, understanding barriers to physical activity in adolescents (representative sample) will help address the challenges, and in designing of effective strategies that promote physical activity among the vulnerable population group (Department of Health, 2011).

Brief Literature Review

 Physical activeness among children and adolescents plays an important role. In current society, technology such as computers and social media has reduced the desire for young adults to play or be involved with any physical activity. Adolescent and children physical activeness decrease with age, with the decline is lower in boys and girls. The barriers associated with physical activities should be addressed with enthusiastic support and enthusiastic (Oliveira, 2013).

 Sedentary lifestyle is identified as a high risk factor for cardiovascular and obesity. The prevalence rate of obesity and overweight in adolescents is a major public health concern. Physical activity is a habit acquired through influence friends, family, coaches, teachers and environment. Young people who are not exposed in environments that build their confidence in their physical abilities tend to adopt sedentary life. Research indicates that movement activities such as jumping, running, throwing serve as great building blocks for children  physical activity. Therefore, children who lack avenues to develop these skills at young age are not likely to become physically activity in the future (Kelishadi et al. 2010).

 Physical activity is essential for children healthy development. Research indicates that physical activities have beneficial effects on children body composition, blood sugar, cholesterol, and muscular strength. Physical activity is also associated with better academic performance and general well being. Instilling positive behaviors in children and adolescents makes them to carry over these behaviors into adulthood.  Age and sex are the most demographic factors associated with physical activity in adolescence. Boys tend to be more active as compared to girls. Research indicates an inverse association between age and physical activity. Patient level of education and socioeconomic factors also determines the adolescent’s level of participation in physical activity. Age is inversely associated with physical activeness in adolescents. This indicates that as adolescents get older, their level of physical activity declines (Heitzler, 2010).

 Psychiatric morbidity in adolescents is a major issue to public health. In a study that reviewed psychiatric disorders in children and adolescents indicated that the median prevalence to mental health condition is about 12%. In UK, a comprehensive study of mental disorders among children and adolescents was reported at 10% and 4% emotional disorders such as depression and anxiety. The emotional disorders were observed in adolescents than in children. If no effective treatment is put in place, the children and adolescents are at risk of having poor academic results, isolation, substance abuse and suicidal thoughts. 

There is increase in literature that associates physical activity with reduction in emotional disorders on adults, but there is limited research on its effectiveness in adolescents (Rothon et al. 2010). The increased frequency of mental illness in adolescents and its associated long-term complications makes it important area to research on, particularly on protective factors. More research is required in order to explore further on the relationship between physical activity and reduction of mental disorders among children and adolescents because there is limited evidence of this issue from longitudinal studies (Rothon et al., 2010).

There are four key hypotheses of psychosocial explanations that explain the association of physical activity with reduction of emotional disorders. The first hypothesis posits that the ‘time-out’ provided by physical activity enhances mood. This theory has been supported by experiments that indicated that physical activity was more efficient in improving people’s mood during the relaxation period. The second explanation indicated that ‘mastery’ of the  physical activity task such as learning of new tasks  gives a person a sense of pride for  a new achievement, which leads to improved mood(Gomes et al., 2016).

The third explanation suggests that the indirect effect of physical activity is that it provides opportunities for social interaction which also improves mood. The interaction during the exercise classes, team sports as well as social support that comes with it improves mental health. Lastly, physical activity relates with improved self efficacy and self esteem. People who engage in physical activity programs have the potential to modify their body shape and improve their self image which improves mental well being (Rothon et al. 2010).

Maternal education is inversely correlated with high trend of physical inactiveness. Research indicates that family house hold income is associated with vigorous and moderate physical activity.  There is some positive association between presence of recreational facilities in the neighborhood and extent of children physical activity. The proximity of playgrounds and parks was positively associated with physical activity.  There is positive association between safety of neighborhoods and physical activity among the adolescents. Other determinants include weather and presence of sidewalks as well as bike lanes (Oliveira, 2013).

 Understanding physical activity barriers in developed countries is important when developing of effective strategy. In most literature, lack of moral support from families and peers and lack of psychological support is one of the main barriers to physical activeness among the adolescents. Most parents believes in children’s education achievement  which makes them place it as a priority and limits the availability of safe and easy access for the adolescents, inhibiting them an active health lifestyles. Children from families with high socioeconomic status have low level of physical activity.

This is an indicator that the successful parents put priority to studying and achieving of good grades. This is attributable to insufficient knowledge on importance of integrating physical activity in their routine lives. Therefore, increasing community knowledge on importance of physical activity, and ways it boosts children learning activity and school performance will make them adopt physical activeness as their lifestyle (Dunton et al., 2009; Gomes et al., 2016).

 With increase in technical advancement, it has made peoples life to be easy and convenience and increasingly less active. However, individual person may have their own reason for living a sedentary life. The most common reasons for not exercising is lack of time to exercise, low self motivation, lack of interest and enjoyment of exercise, boredom, low confidence and ability to become physically active, fear of having injuries, low self efficacy, inability to set personal goals, poor self management skills, low support and encouragement. However, the major personal barrier to engaging in physical activity includes energy, time and motivation issues (Gomes et al., 2016).

A study conducted in 2013 aimed at identifying the external and internal barrier to physical activity as well as exercise among middle aged women and geriatric population indicated that their major challenge is lack of time and inadequate physical facilities. Other issues identified were cost, transportation and safety issues. The environment and its neighborhood influence children level of physical activity.

There are many factors that affect people in the society including availability of cycling trails, walking paths as well as recreational facilities. Factors such as transport availability, crime and pollution will discourage people from becoming physically active. The social environment also plays an integral role in influencing physical activeness among the adolescents (Ding et al., 2011).

Research Objectives / Research Question / Hypotheses

There is growing body of research focusing on association between physical activity and psychological as well as physical performance among the adolescents. To better understand these correlations, this study will examine the barriers to physical activity among this age group in order to develop scientific literature that can be used by the healthcare providers to design targeted interventions (Craggs et al., 2011).

The study theorizes that socioeconomic and social cognitive factors are the key determinants of physical activity among adolescents in rural and urban areas of Deptford, Lewisham borough of London. Therefore, the study’s hypothesis statement is as follows; In adolescents, socioeconomic and social cognitive factors, as compared demographics factors determine the level of physical activeness among the adolescents. The research question is – What are the barriers of physical activity among adolescents (13-18 years) residing in rural and urban areas of Deptford, Lewisham borough of London.

 Study Methods

Study Design:  The study designed used in this study is mixed research method. The research design is chosen so as to explore a phenomenon, describe it and report the findings. In this type of research design, combination of qualitative and quantitative research methods will be used to give a reasonable basis for developing evidence based strategy (Abbott and McKinney, 2013).

The study data will be collected from epidemiological study of adolescents from three schools in Deptford. The study participants will be recruited from three Local Education Authority (LEA) boroughs in Lewisham. Further funding will be obtained from the relevant authority to facilitate study follow up.

Subjects / Participants: There will be 159 participants aged (13-18 years) from comprehensive education facilities in Lewisham borough or London. The sample size is determined by size calculation sample.

Inclusion / exclusion criteria: The study participants must be 13-18 years of age. The participant should be from any ethnic group and socioeconomic status. The study will exclude participants with history of any disease, cannot communicate in English and are above 18 years of age.

Sampling: The study sample will be selected as guided by simple random sampling. This sampling method will help ensure that there is equal probability to select adolescents (age 13-18 years) when creating the study sample size. This sampling method is chosen because it will help reduce potential human errors when creating study sample.

This implies that the sample size used will be a highly representative of population being studied. This in turn will help the students make statistical inferences from the findings of the sample to the entire population.

Recruitment: Information about the study will be given to school representatives a week before school visit. The information will also be emailed to adolescent’s parents. Parents are allowed to opt out their child. The adolescents who will not be opted out will be randomly selected according to the study inclusion and exclusion criteria. The recruited participants will be invited in study rooms of respective schools, where they will be briefed about the study.

They will be issued with a written consent that must be signed by the student and their parents. Students were informed that they could withdraw from the study at their wish, and they could decline to answer questions that they did not like or were uncomfortable answering them.

Intervention details: The research team will administer the classrooms questionnaire that will be answered in 40-50 minutes. Three types of questionnaires will be used in this study. The first questionnaire is one that evaluates on students social cognitive factors, one that evaluate socio-demographic variables such as gender, age, family income and education and one that examines the level of physical activeness and environmental factors.  To analyze the participant’s experiences and perceptions, grounded theory approach will be utilized. 

This will consist of a total of 7 focus group discussions and 5 in-depth interviews to explore the students’ perception on physical activity and barrier to adopting physical active lifestyles. The focus group discussions and interviews will be done using semi-structured open-ended questions which will provide an opportunity for the respondents to explain in detail their perceptions and opinions about barriers to physical activity. The discussions will be audio taped and supplemented with short hand notes. The data collected from audiotapes will be transcribed and analyzed accordingly.

Variables / Data Collection:  The questionnaires are designed to collect data variables such as subjective norms, attitudes, self efficacy, and behavioral control regarding physical attitudes. The information gathered will help the researcher formulate adolescents’ perception of physical activity and associated barriers. The questionnaire will be evaluated with 5- point Likert-type scale where 1 indicates Highly Disagree and 5 highly agree. For the qualitative study, the variables that will be collected by the focus group discussion include perceived barriers to physical activity (Abbott and McKinney, 2013).

Data analysis: For qualitative part of the study, the data collection will be done simultaneously with data analysis as guided by grounded theory approach. Therefore, data obtained from focus group talks and interviews will be analyzed manually and guided by constant comparative analysis. Analytical tools will be used to ask questions and for comparative analysis so as to identify emerging themes and concepts.

For quantitative study, the dependent variables include the level of physical activity (Vigorous, Moderate, and Low). The independent variables are socio-demographic factors such as ethnic background, age, gender, social cognitive factors, parent’s level of education, and socioeconomic variables. For these data, statistical analysis will be done using SPSS windows software (SPSS Inc., Chicago, IL, USA; Version 15.0). The statistical tests that will be conducted include Chi-square, analysis of variance (ANOVA), Spearman correlation, and logistic regression analysis. The significance level is set at p<0.05.

 Ethical Considerations

The initiative aims at identifying barriers of physical activeness among adolescents residing in urban and rural areas of Deptford.  This implies that before implementing the project, the researcher is expected to obtain approval and support from Institution review boards. In this case, the board committee will be briefed about the proposed project and its implication to public health.

This effective communication will help clear doubts held by the members. The informed consent will be used in order to ensure that the participants are well briefed about the study findings, and to ensure that they are not coerced or forced to participate in the proposed study (Bowling, 2014). 

The participants used in this study are below 18 years, under the governing law, these people are still under their parents care. Therefore, written informed consent will be obtained from parents of each participants and oral assent will be required from each of the participants. Confidentiality is a major issue when dealing with the adolescents.  Most of them will not open up unless you ensure them that their opinions will be protected.

To maintain confidentiality, the institutions names and names of the participants will be not mentioned, instead, each of the institution will be given a code, and the participants will be issued with numbers anonymously (Abbott and McKinney, 2013).

Other considerations

Limitations

The most common potential barriers in community based projects is inadequate knowledge, skills, poor attitudes towards evidence based projects, economic restrictions as well as so organizational influences (Dunton et al., 2009; Gomes et al., 2016). Lack of knowledge is a potential limitation as it results to inadequate understanding on how the evidence gathered promotes community’s well being.

This might make adolescents parents refuse to give consents. This is correlated to attitudinal barriers and weak beliefs, which are very difficult to control than knowledge barrier. The socio-organizational limitation includes little or no support from the managements and disagreements as well as conflicts among the involved stakeholders (Offredy and Vickers, 2013). 

To overcome these barriers, effective strategies will be applied. This includes parent education about physical activity and its impacts on adolescent’s psychological and physical wellbeing. Parent education will be reinforced using pamphlets. In regards to economic crisis, the researcher will explore sources of funds through various agencies and charity acts. To remove attitudinal barriers and weak beliefs will be done through regular meeting to discuss the pros and cons of proposed interventions.

Effective communication is the key solutions to all research limitations. The weekly meeting and focus group discussion with the relevant stakeholders will enhance collaborative and supportive relationship. Research findings show that team oriented approaches enhances strong communication and promotes strong interaction between involved stakeholders (Bowling, 2014). 

Budget

The project implementation will take approximately eight months. Effective implementation of the exercise will require planning. Part of the planning includes establishing preliminary budget which recognize the following areas (See Appendix 2). The annual cost for principle investigator is about £16000 for the eight months. The principle investigator assistant responsibilities will be to train the stakeholders about the project and assisting in data collection activities. The training cost of the participants and their parents will cost about £3000. The printing cost is estimated to be about £4000. Therefore, the total implementation cost is expected to be £28000.

Plans for Dissemination

            The project will be implemented in six phases. The first phase is that of seeking approval from the Institutional Review Board (IRB) and head of department. IRB will review the safety and feasibility of the study in promoting public’s health. After approval, the second phase will involve planning and designing of the project. This involves strategies that outline project implementation process, funding and sourcing for resources (Tracy, 2012). The third and the fourth phase will involve carrying out of the proposed project.

This include recruitment process, screening the participants using the inclusion and exclusion criteria, signing of informed consent, carrying out individual interviews and focus group discussions and assessing participants cognitive, socio-demographic and socioeconomic factors. The five phases is the data collection and data analysis phase. The sixth phase will involve compiling the study findings, and making a comparative analysis with the existing literature so as to establish the evidence base (Abbott and McKinney, 2013).

REFERENCES

Abbott, M. L., and McKinney, J. (2013)Understanding and Applying Research Design.  Hoboken Wiley (Ebook available)

Bowling, A. (2014). Research methods in health: investigating health and health services. McGraw-Hill Education (UK).

Craggs, C., Corder, K., van Sluijs, E. M. F., & Griffin, S. J. (2011). Determinants of Change in Physical Activity in Children and Adolescents: A Systematic Review. American Journal of Preventive Medicine, 40(6), 645–658. http://doi.org/10.1016/j.amepre.2011.02.025

Department of Health (2011). Start Active, Stay Active: A report on physical activity for health from the four home countries’ Chief Medical Officers. Retrieved from https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/216370/dh_128210.pdf

Ding,D., Sallis, J.F., Kerr, J., Lee, S., and Rosenberg, D.E. (2011). Neighborhood environment and physical activity among the youth a review. American Journal of Prev medicine; 41 (4): 442-455 doi: 10.1016/j.amepre.2011.06.036.

Dunton, G. F., Kaplan, J., Wolch, J., Jerrett, M., & Reynolds, K. D. (2009). Physical Environmental Correlates of Childhood Obesity: A Systematic Review. Obesity Reviews : An Official Journal of the International Association for the Study of Obesity, 10(4), 10.1111/j.1467–789X.2009.00572.x. http://doi.org/10.1111/j.1467-789X.2009.00572.x

Gomes, C.S., Matozinhos, F.P., Mendes, L.L, Pessoa, M.C., Velasquez-Melednez, G. (2016). Physical and social environment are associated to leisure time physical activity in adults of a  Brazillian City: A crossectional study. PLoS One 11(2) doi: 10.1371/journal.pone.0150017

 Heitzler, C. D., Lytle, L. A., Erickson, D. J., Barr-Anderson, D., Sirard, J. R., & Story, M. (2010). Evaluating a Model of Youth Physical Activity. American Journal of Health Behavior, 34(5), 593–606.

Health profiles. (2010).  Healthy Schools London- Lewisham Child Health profile.  Retrieved from www.healthprofiles.info

Kelishadi, R., Ghatrehsamani, S., Hosseini, M., Mirmoghtadaee, P., Mansouri, S., & Poursafa, P. (2010). Barriers to Physical Activity in a Population-based Sample of Children and Adolescents in Isfahan, Iran. International Journal of Preventive Medicine, 1(2), 131–137.

Offredy, M., & Vickers, P. (2013). Developing a healthcare research proposal: An interactive student guide. John Wiley & Sons.

Rothon, C., Edwards, P., Bhui, K., Viner, R. M., Taylor, S., & Stansfeld, S. A. (2010). Physical activity and depressive symptoms in adolescents: a prospective study. BMC Medicine, 8, 32. http://doi.org/10.1186/1741-7015-8-32

Tracy Ross (2012) A Survival Guide For Health Research Methods Maidenhead. McGraw-Hill Education.

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The Benefits of TCP Protocol

The Benefits of TCP Protocol
The Benefits of TCP Protocol

TCP Protocol

The benefits of TCP Protocol include: control of flow the rate of data exchange, segment size, network control and flow control. On the other hand, the benefits of UDP Protocol include its time sensitivity and ability of its servers towards answering small queries from a large pool of clients (McKeen & Smith, 2014). The differences between TCP and UDP include:  TCP is more reliable than UDP; TCP transmissions are ordered in a sequence whereas messages sent through UDP may not be in a sequence; and finally TCP connection is heavyweight while that of UDP is lightweight (McNurlin, 2009).

TCP Protocol is used in remote surgery because of its preferred in a procedure that requires error correction facilities at network interface level. UDP Protocol is the choice for online gaming and online shopping, which are time sensitive applications for online gaming and the servers are requiring the ability of answering small queries from a large pool of clients for online shopping (O’Brien, 2013).

Basic Data Transfer: The TCP is able to transfer a continuous stream of octets in each direction between its users by packaging some number of octets intosegments for transmission through the internet system. In general, the TCPs decide when to block and forward data at their own convenience.

Reliability: The TCP must recover from data that is damaged, lost, duplicated, or delivered out of order by the internet communication system. This is achieved by assigning a sequence number to each octet transmitted, and requiring a positive acknowledgment (ACK) from the receiving TCP.

The Transmission Control Protocol (TCP) is intended for use as a highly reliable host-to-host protocol between hosts in packet-switched computer communication networks, and in interconnected systems of such networks.

Precedence and Security: The users of TCP may indicate the security and precedence of their communication. Provision is made for default values to be used when these features are not needed.

References

Matthews, H. S. & Williams, E. (2012). Telework Adoption and Energy Use in Building and Transport Sectors in the United States and Japan. Journal of Infrastructural Systems, 11(1), 21-30. doi:10.1061/(ASCE)1076-0342(2005)11:1(21)

McKeen, J. D. & Smith, H. A. (2014). Making IT Happen: Critical Issues in IT Management, Wiley Series in Information Systems. New York, NY: Prentice Hall.

McNurlin, B. (2009). Information Systems Management in Practice (8th ed.). New York, NY: Prentice Hall.

O’Brien, J. (2013). Management Information Systems: Managing Information Technology in the Internetworked Enterprise. Boston, MA: Irwin McGraw-Hill. ISBN 0-07-112373-3

Sardeshmukh, S. R., Sharma, D., & Golden, T. (2012). Impact of Telework on exhaustion and job engagement: A job demands and resources model. New Technology, Work and Employment, 27(3), 193-207. doi:10.1111/j.1468-005X.2012.00284.x

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Treatment Plan: Case Study

Treatment Plan
Treatment Plan

TREATMENT PLAN

CLINICIAN NAME: LEAH                       CLIENT NAME: GINA S.

Diagnosis (es):
DSM 5 Code Diagnostic Classification
309.81 (F43.10) Posttraumatic stress disorder (PSTD)
Medications: Prazosin and sertiline
Supports/Strengths: Prazosin would be appropriate for this patient because it has been shown to reduce insomnia and nightmares. Sertiline is also necessary since it is an anti-depressant hence will help in management of anxiety and depression. This agent also aids in improving the patient’s concentration and sleeping problems.
Presenting Problems: Leah presents with flashbacks and nightmares to an extent that she fear sleeping alone. She has disturbing thoughts, dreams as well as feelings related to the terror attack that occur at her school. Moreover, Leah develops distressing and repetitive images of the attack. The event has made it difficult for her to concentrate in class or even remember what was taught in previous classes.
Treatment Recommendations:  a) Psychotherapy is the primary treatment for patients suffering from PSTD. Leah should therefore be subjected to exposure therapy, a form of psychotherapy, which helps a patient to safely face what they find frightening so that she can learn to cope with the negative thoughts that she has. This technique uses virtual reality programs that would help Leah to re-enter the setting similar to that of the attack. Cognitive therapy should also be used to help Leah change her ways of thinking.

b) Medications such as diazepam an anxiolytic agent or sertraline an anti-depressant can be used to manage Leah’s symptoms.

Desired Goals of Tx: The psychotherapy treatment will help Leah learn ways of coping with the symptoms of the attack that she witnessed. They drugs can help in relieving symptoms of fear, depression, and anxiety that Leah is going through.  This will in turn improve Leah’s sleeping problems and concentration in class. Additionally, Leah is expected to start socializing with her classmates just like she used to.
Frequency of Tx: Treatment should be initiated immediately and maintained and the patient is stable enough. The initial dose of sertiline should be 10mg once daily and increased to 20 mg after one week. Adjustments should be made weekly based on patient presentation.  However, the patient should be monitored since administered agents, that is, sertraline and diazepam are associated with severe side effects.

Project Length of Treatment: Approximately 2- 3months
Supportive Background Documentation for Diagnoses and Meds:

PSTD is the primary diagnosis in the case study presented. This is because the disorder occurs as a result traumatic events such as traffic collisions, sexual assault, or terror attacks. Patients suffering from PSTD present with nightmares, flashbacks as well as distressing and repetitive images (Williams et al., 2013). These findings are consistent to those presented in the case study, hence proving that the Leah has PSTD.

TREATMENT GOALS/INTERVENTIONS
CLINICIAN NAME:     LEAH                   CLIENT NAME: GINA S.
Long Term Goals:

– Exercise proper sleeping patterns

– Patient should demonstrate proper control and relaxation techniques
Short Term Goals:

– Patient should manage her feelings and fear.

– Improved social interaction

-Improved concentration


TREATMENT GOALS/PROBLEMS, STRENGTHS, BARRIERS, PERSON RESPONSIBLE


Goal #1: Leah should demonstrate control and relaxation techniques
OBJECTIVES: Distinguish between present and memory. She should also recognize environmental triggers and react to them appropriately.
INTERVENTIONS: Evaluate the patient’s symptoms, encourage her to identify terrors, use de-escalation techniques in her management, and use virtual programs to boost Leah’s courage.
Target Date: December 20th, 2016 |Review Date: |Completed ?yes, ?no | New Target Date: |Review Date: |Completed ?yes, ?no
TREATMENT GOALS/PROBLEMS STRENGTHS BARRIERS PERSON RESPONSIBLE
Goal #2: Improved social interaction
OBJECTIVES: Patient will interact effectively with her peers. Her concentration in class should also improve. Leah should also use proper skills when initiating and maintaining an interaction.
INTERVENTIONS: Enquire which symptoms she experiences when she starts feeling anxious. Leah should be trained on how to briefly remove herself when she feels agitated and engage in exercises that relief anxiety such as deep breathing. This will aid in improving her sense of control in public.

Target Date: January 7th, 2017 |Review Date: |Completed ?yes, ?no | New Target Date: |Review Date: |Completed ?yes, ?no

Signature of Client/Date Signature of Therapist/Date

Reference

Williams, A. M., Richardson, G., & Galovski, T. E. (2013). Posttraumatic Stress Disorder. Anxiety Disorders: A Guide for Integrating Psychopharmacology and Psychotherapy, 176.

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Unethical behaviors in the Workplace: Case Study

Unethical behaviors in the Workplace
Unethical behaviors in the Workplace

Unethical behaviors in the Workplace

Human Resources and Staffing Crisis at Blumberg’s Nursing Home

            Ethics goes a long way in ensuring the organization achieves good public relations and good image as a means of acquiring public confidence. In the case of Blumberg Nursing Home, the actions of three employees were detrimental to its reputation and government regulations, requiring a change of tact by the administration in approaching future crises. It is requisite to formulate an effective way of replacing the erring staff, while setting policies and incorporating residents and staff views in the future running of the nursing home.

Staffing needs

            There is an immediate need for a Director of Nursing, dietician, and a receptionist at Blumberg Nursing Home. A DON is important since she manages nursing activities, controls patient care, makes nursing policies and institutes short-term and long-term future nursing plans that ensure that the hospital meets stringent government standards (Bisk, 2016).

The DON also does financial and nursing budget needs, involves the hospital management in nursing care, evaluates nursing activities to ensure it is patient-centered, meets regularly with other members of the executive, and communicates with them regarding the nursing department. The hospital dietician also does several important tasks in the hospital such as teaching patients about nutrition, addressing patients’ healthcare needs, partially gets involved as a multidisciplinary team, and coordinates dietary changes among the patient.

            Additionally, the medical receptionist is important for coordinating patient arrival and plan for care, gives patients information concerning their problems, organizes clerical and administrative activities and keeps inventory of office and medical equipments (Hicks, 2016). The receptionist also answers phone calls, registers new patients’ and coordinates their next treatment plan by notifying other members of the medical team.

Therefore, the DON, dietitian and the receptionist all are important for the general welfare of the hospital. However, due to the large administrative responsibility of the DON, the hospital should fill this position first. The nursing care is a very important part of hospital activities and requires a leader to coordinate all its activities effectively, including hiring a receptionist and dietitian, important in nursing care.

            In addition, the receptionist should come second to aid the nursing staff in coordinating the activities of receiving patients and informing them of their treatment requirements. Since the receptionist helps in keeping office records and inventory of all the required equipments for administrative work in the hospital, it is imperative to have this staff member (Hicks, 2016). On the other hand, the hospital can outsource a temporary self-employed dietitian to coordinate dietary needs of the patients. Most dieticians have their own clinics and can always schedule hospital visits, as the plan of acquiring a permanent dietician is underway.

Policies for addressing unethical behaviors in the workplace

            Unethical behaviors in the work place can be detrimental to the overall running of the organization and can really hurt the organizations reputation. Each employee in the organization acts as an agent of the company, and whatever they do may be beneficial of disadvantageous to other employees. To avert future crisis and staff misdemeanor, a good policy ought to be in place. The first step is to have a robust human resource manager, either internal or hired externally, to provide trainings, procedures, and policies for tackling ethical issues (Goldfield, 2015).

Having a robust human resource manager is requisite for effective reporting of unethical behavior, and for company to have and maintain proper policies. The task of the HR manager shall involve communicating to employees the organization’s expectations and making clear to them how their bad demeanors can affect the entire organization.

            An effective way of combating unethical behavior is creation of codes of ethics. The codes of ethics aids in communicating the organization’s values, and establishing means of creating boundaries for what is appropriate (Goldfield, 2015). These codes of ethics are simple and succinct, contained in the mission statement, value statement, and employee handbooks. The codes of ethics for Blumberg hospital shall have a protocol where employees can report unethical behaviors to the human resource manager or a senior manager far removed from the role.

This aids in bringing seriousness to the issue and creating trust in employees (Goldfield, 2015). A dedicated anonymous hotline is also useful in reporting such cases. Additionally, the protocol shall ensure no victimization to any employee who reports such cases. The policy shall also entail empowering the employees through training, yearly bonuses and public acknowledgement, in order to ensure the code becomes effective (Goldfield, 2015). The hospital shall have to review the code on a yearly basis y having the employees read and sign over a form, to encourage adherence to the standards.

            The organization can have punishment procedures for unethical employees who may not adhere to ethical standards. These may include demotions, suspension, denying leaves, or firing them, but as a last resort whenever warnings and summons do not work (Mack, 2016). The organization can also fight ethical misdemeanors through protection of whistleblowers, rewarding ethical employees, and having a dedicated panel or person who shall offer unbiased approach to enforcing ethical standards in the organization.

Leadership roles

            The aftermath of an unethical crisis within a business offers an opportunity for the administrator of the organization to exercise decisions that aid in boosting staff morale and that of the residents. According to Lisa Quast (2011), the administrator of an organization ought to lead by example. By incorporating good ethics in one’s behaviors makes the employees avoid unethical situations at work.

The administrator can constantly echo the need to act ethically within the organization, by encouraging employees to follow the codes of ethics every time. Quast (2011) adds that reinforcing ethical behavior and punishing unethical behaviors aids in warning employees, and coercing them towards adhering to code of ethics.

            The administrator can further show good leadership skills by listening to the unethical employees’ explanation of their action. Having good listening skills helps in getting valuable feedback from the erring employee. This can also provide an opportunity to remind and enforce codes of ethics to an employee who may err because of being overconfident (Quast, 2011). The administrator can also bring back confidence among his juniors by showing calmness and confidence that makes other employees increase in morale.

The confidence shows that the decision taken was appropriate and the administrator is in charge. The administrator can also use his character and competence as part of good leadership skills to encourage the employees and inspire them (Trevino & Brown, 2004). Instead of punishing erroneous employees, the administrator can re-inspire confidence in them by reminding them of their value to the organization, and its expectation of them. The unethical employees have new challenges to spur their recovery and show support to them.

            The administrator of Blumberg hospital can show management skills by exercising his authority effectively. The administrator can demonstrate his integrity by ensuring adherence to the codes of ethics by all employees (Quast, 2011). A high integrity leadership communicates straightforwardness to the employees. The administration should be consistent in rewarding ethical employees and punishing the unethical ones, but at the same time taking time to encourage employees adhere to codes of conduct (Kurucz & Wheeler, 2013).

However, despite the need to warn and lead unethical employees into recovery, it is imperative that the employees understand the severity of their actions. In the case of Blumberg hospital, a drunk DON, who also happens to be a senior member of the executive, sends a wrong leadership message to the entire nursing fraternity. This communicates to the other nurses that they too can behave unethically without undergoing any punishment. A drunken receptionist can give wrong information to patients and may talk inappropriately to the hospital clientele.

            According to Goldfield (2015), it is imperative to inculcate good communication framework within the organization to ensure employees grow satisfactory with the management decision. The administrator can do this by often calling for meetings to highlight to the employees the recent happenings, the reasons for taking such decisions, and the expectation of the management to the employees in assisting to averting a future crisis.

This helps to communicate the urgency, and the dire need of the employees to maintain high work standards and ethics for the benefit of the organization. Additionally, Trevino and Brown (2004) suggests that the administration can train and encourage the lower leadership levels who interact with the employees on a higher levels, to show high levels of integrity and support for other employees. By maintaining a culture of professionalism and high work standards, the hospital can avoid future crises occurring from employees acting unethically.

How to use the Quality Indicator Survey

            The Quality Indicator Survey is a computer-generated survey meant for assessment of long-term care to ensure nursing homes licensed by the Medicare and Medicaid meet the federal guidelines (Lin & Kramer, 2013). The survey entails two processes meant to assess certain regulations within nursing homes to ensure they follow the federal laid standards. Factors such as deficiencies, current complaints, and adherence to standards can undergo review to assess the suitability of a nursing home to its intended purpose.

The surveyors does this, while at the same time ensuring the federal set guidelines are followed to the later. The first stage of the survey involves interviewing residents, reviewing clinical records and observing the residents (Lin & Kramer, 2013). The data gathered goes into a computer system, which analyses it using special software and gives a feedback. The second stage of the survey entails using investigative tools to do an in-depth analysis and systematic review of the causes of certain discrepancies and the completion of essential and non-essential tasks.

            According to Lin and Kramer (2013), the QIS can help a hospital to gather information concerning the perception of the residents towards it and their expectations in terms of the type and quality of services offered. Therefore, the administration of the Blumberg hospital can use the QIS survey to learn of the perception, requirements and recommendations that the residents deems imperative for the efficient running of the institution.

The actions of the DON, the dietitian and the receptionist might be an opportunity for the hospital administration, to check whether the breaching of the hospital codes of conduct has been persistent, and whether some of the employees have offered poor services. The employee staff can take the survey to echo to the administration their recommendations and desired mode of treatment in case of future crises. It is vital to ensure training of the codes of ethics to the employees during its implementation.

Conclusion

            The Blumberg nursing home staff crisis is solvable by hiring a new Director of Nursing as a more urgent plan, so that the DON can assist in hiring the best receptionist and dietitian who are instrumental in the activities of the nursing care. The hospital administrator requires good leadership and management skills such as listening, integrity, and understanding the employees. Good procedures should exist to ensure unethical behaviors undergo punishment, while at the same time rewarding those acting well. The Quality Indicator survey is useful for the hospital administrator to assess and implement changes that shall ensure future adherence to the hospital’s codes of ethics.

References

Bisk. (2016). RN Management Careers for Master’s Degree Graduates: Nurse Director. Retrieved from: http://www.jacksonvilleu.com/resources/career/director-of-nursing-salary-job-description/. (Accessed December 5, 2016).

Goldfield, B. (2015). A Proactive Approach to Addressing Unethical Behavior in the Workplace. (Updated 20 January 2015). Retrieved from: https://www.entrepreneur.com/article/241924. (Accessed 5 December 2016).

Hicks,J. (2016). Medical Office Receptionist: Job Duties and Requirements for a Medical Office Receptionist. (Updated 20 November 2016). Retrieved from: http://medicaloffice.about.com/od/jobdescriptions/p/Medical-receptionist.html. (Accessed 5 December 2016).

Kurucz, E. C., Colbert, B. A., & Wheeler, D. (2013). Reconstructing value: Leadership skills for a sustainable world. University of Toronto Press.

Lin, M. K., & Kramer, A. M. (2013). The quality indicator survey: background, implementation, and widespread change. Journal of aging & social policy, 25(1), 10-29.

Mack, S. (2016). How to Enforce Ethical Behavior in the Workplace. Retrieved from: http://smallbusiness.chron.com/enforce-ethical-behavior-workplace-20234.html. (Accessed 5 December 2016).

Quast, L. (2011). How To Prevent Poor Ethical Decision-Making. (Updated 19 December 2011). Retrieved from: http://www.forbes.com/sites/lisaquast/2011/12/19/how-to-prevent-poor-ethical-decision-making/#1daa9bc7544a. (Accessed 5 December 2016).

Treviño, L. K., & Brown, M. E. (2005). The role of leaders in influencing unethical behavior in the workplace. Managing organizational deviance, 69-87.

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Ethical Dilemma in Advanced Nursing Practice

Ethical Dilemma
Ethical Dilemma

Ethical Dilemma in Advanced Nursing Practice

Physicians may be confronted with an ethical dilemma where they must decide whether or not provide treatment for themselves, family members, or others close to them(CPSO, 2016). Whereas it may be the physician’s best intentions to provide treatment in this context, there is a growing body of literature indicating that personal or close relationships have the potential of compromising the emotional and clinical objectivity of the physician. This paper examines the process of using ethical principles in decision-making and meeting the Nursing Practice Core Ethics Competencies.

The first step in approaching ethical decision-making is to state the ethical dilemma. It is important for the physician to identify the components of the situation presenting a potential ethical dilemma. In the case scenario, Mrs. ABC’s mother should have first identified the ethical dilemma presented by her undertaking to treat Mrs. ABC. The physician should be able to identify the issue objectively without the influence of subjective perceptions, values or attitudes specific to the issue.

Upon identification of the ethical dilemma, the physician needs to connect ethical theory to the dilemma in practice. Beauchamp and Childress’s ethical theory is often regarded as one of the basic foundations for discussions of this nature. This theory is grounded in four major principles: justice, beneficence, non-maleficence, and autonomy. Justice involves appropriate, equitable, and fair treatment of patients.

Beneficence supports the use of positive steps for benefitting others, which involves the balancing of benefit, risk and costs. Non-maleficence encompasses the intent not to inflict harm. Lastly, autonomy is a principle which requires a professional or client to have the capacity to self-determination in his/her engagement in decision-making (Nagy, 2015).

Exploring an ethical dilemma requires a physician to examine the issue and see the manner in which each of the principles relate to it. In some cases, this examination alone clarifies the issue enough that the resolution of the dilemma becomes obvious to the physician (Forester-Miller & Davis, 1995).

References

CPSO. (2016). Physician Treatment of Self, Family Members, or Others Close to Them. Retrieved from: http://www.cpso.on.ca/policies-publications/policy/treating-self-and-family-members

Forester-Miller, H., & Davis, T. E. (1995). A practitioner’s guide to ethical decision making. Alexandria, VA: American Counseling Association. Nagy, T. F. (2015). Approaches to ethical decision making. Journal of the Academy of Nutrition and Dietetics. Retrieved from: http://www.eatrightpro.org/~/media/eatrightpro%20files/career/code%20of%20ethics/approaches-to-ethical-decision-making.ashx

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Mental healthcare Decentralization

Mental healthcare Decentralization
Mental healthcare Decentralization

Mental healthcare Decentralization

Improving mental health efficiency by using of community health workers to decentralize health care services

Overview of healthcare industry, markets and competition

Recent changes in the UK in National mental Healthcare Services (NHS) have introduced new complexities into the accountability arrangements of the healthcare facilities. The current mental health systems are best described as command and control system. The mental budgets as well as policy are strategically set centrally by the Department of Health (DoH) and the government is administered locally by the NHS organization but accountability lies with the DOH.

The situation is more complex than the explanation of the ‘command and control.’  The balances between the central government and the local government have led to fluctuating autonomy and misallocation of resources (Normand, 2011).

 The UK mental healthcare system relies on highly centralized and costly expertise to delivery healthcare services. This type of system relies in intuitive medicine, and is best suited for healthcare issues that are complex and episodic. In addition, this type of healthcare system is associated with mismatch for chronic diseases, preventive measures and wellness care; which results into additional barriers and disparities especially among the underrepresented population. 

It is time for the National Health System (NHS) to depart from a one-size-fits all model and develop channels that will enable better delivery of services that can serve the dynamic needs of the population (Clayton, 2009).

 This study proposes that decentralizing mental healthcare services will aid in lowering cost of care, broaden accessibility and maintain as well as improve quality of care. For instance, the physician specialist will have the capacity to work in outpatient, the nurse practitioner will effectively provide care in retail clinics, and lay community health promoters or workers will improve health education, thereby reducing health complications associated with disease progression.

For example, the system will improve diabetic self management at patient’s residents.  This measure is in line with Institute of Medicine (IOM’s) health disparity vision of confronting ethnic and racial disparities using strategies that improve care delivery and or implement preventive measures and to enhance risk reduction (Black & Gruen, 2005).

Perceived problems in current healthcare systems

The fundamental issue that is believed to affect mental healthcare activities includes quality of care, safety issues, access to healthcare, cost of care, and delivery of services. These issues arise because of the problems that affect healthcare systems which include misallocations of national health resources, allocative inefficiency, and increased inequalities. Most of the health facilities get less proportion of healthcare budgets. An example of healthcare system that suffers from misallocation of resources is the mental healthcare system, which suffers due to misallocation of resources within the sector (Goodwin, Gruen, & Iles, 2006).

 In my facility, funding is done on low cost effective-interventions such as non-essential prevention strategies. For instance, People diagnosed with substance use along with mental health (commonly referred to as dual diagnosis) is associated with many health demands, yet they suffer too much to access quality healthcare services. These patients have complex needs and often experience multiple adversities in their lives including deprivation, childhood abuse, poverty and loss of support from their family members.

These persons are also associated with multiple needs such as homelessness and unemployment that makes them become prone of exploitation. This increases their risk of poor physical health, self harm, suicide and perpetrating violence. Dual diagnosis is unpopular in the UK, partly because the society is entrenched perceptions of substance abuse where most people believe that is a lifestyle choice instead of a health issue that needs urgent care and treatment (Normand, 2011).

 Dual diagnosis is one of the issue facing mental health and substance abuse. In the past one and half decades has lead to development of specific initiatives but all of them have had no improvement. The same changes have been implemented since the 90s. Today, mental health services today still exclude people if the problem is not perceived as substance related disorders. The misallocation of resources is associated with inefficient delivery of care as most of the healthcare resources are wasted (Kirk and Glendinning, 1998).

For example, it is inefficient to give patient a brand name over drugs cheaper generic ones that have same efficacy. The misallocation of resources also results to underutilization of resources which also affects the productivity efficiency. In current type of healthcare system often leads to indiscretions such as specialists handling numerous uncomplicated cases at high cost, cases that primary care centers could handle with ease (Normand, 2011).

 The aforementioned factors have lead to increase on cost of care without matching consumer’s health benefit. In addition, the existing weak monitoring system enables leakages of public subsidies to private sectors and medical covers which are already financially stable. This results to increased health disparities where poor and under-privileged in the society lack care affordability (World Health Organization, 2000).

These affected populations unfortunately are the majority, and often receives low quality of care. One of the best strategies is to train the staff in mental health facility in order to equip them with skills that will help make dual diagnosis by improving their knowledge and skills but have not managed to change the society’s perception and values.

Therefore, the two great challenges in this aspect of mental health a) to increase awareness on dual diagnosis in order to change attitudes people’s attitudes on mental health and b) to provide effective services to people diagnosed with dual diagnosis, especially in this unprecedented mental health crisis (Normand, 2011).

 Change in mental healthcare systems

 Change in the healthcare system is intended to improve the performance by adjusting the way services are delivered and relocating or roles and responsibilities for specific healthcare services and the processes of delivering care to the population including financing, implementation process, monitoring as well as regulation.  There are various drivers of change in the current health care system including the expected shift in political, social and economic factors that will come with new governing system. In addition, the increase in technological advancement should be enhanced to not only improve quality of care, but also the accessibility (Normand, 2011).

The key drivers for the proposed change within the mental healthcare system in NHS includes changes in population growth, demographic characteristics due to immigration, technological advancement, health’s infrastructure conditions, and increased patient level of acuity.  Change in ideologies refers to the modifications of frameworks used by the public health services to deliver care. For instance, new labor in 1997 removed department of health monopoly which created more opportunities for private sector and voluntary services that helped better healthcare system to some extent, at higher cost of care.

Similar changes have been observed with the coalition government in 2009 which removed government agents and gave more roles to local authorities and the private providers, which led to increase misallocation of resources. Therefore, decentralizing delivery of healthcare services using community workers will create freedom for providers to innovate strategic services that meet the specific demands for patient needs (Pickard and Glendinning, 2002).

 In addition, the current infrastructure conditions are too old and are not adaptable to provision of modern care for dual diagnosis. The current healthcare infrastructure demerits include high cost of care, reduced staff retention and inconsistencies in delivery of care. Therefore, vertical integration of decentralized health care in this community is aimed at addressing these challenges by reconfiguring healthcare services to suit the specific community demands.

For instance, technological advancement has made it easy to access patient information and also increased portability of patient’s health information and education of appropriate optional treatment. It is time to tap on the innovative techniques to increase efficiency in delivery of mental healthcare system and manage delivery of care in a way that maximizes population health benefits (Duguid & Pawson, 1998).

 Changes in population growth and the demographic factors is also another driving force for decentralization of mental healthcare services by the NHS. The increase in population has put pressure on the current healthcare system as it has led to dilapidation of healthcare facility caused by congestion due to population growth, which has led into high demands building of bigger healthcare facilities that will accommodate the patients. 

In addition, the gentrification of the low socioeconomic households by the middle class has led to inconsistence in delivery of services. The increased patient level of acuity and knowledge on quality issues is pushing the healthcare providers to improve delivery of care in order to meet their expectations (Clayton, 2009).

Recommendation

Change refers to any alteration of healthcare services with the aim of improving its quality. Changes in healthcare system are wide and ranges from revolutionary technology to refining of health workers responsibilities. There are three types of change namely originates, borrowed and adapted. Borrowed changes are easy and cheap to implement. However, these types of changes are often not appropriate to meet the local needs as no community is similar to another, which implies that one size fits to all may not apply (Goodwin, Gruen, & Iles, 2006).  

The proposed change is adapted change, which mainly implies that the strategies are borrowed from elsewhere and gets modified to fit the community needs. However, factors such as situational circumstances, management approach, wrong adaptation, and changes in political as well as economic environments determines if the change process will be effective or not.

Originated changes would be more effective as it involves more creativity than the adapted changes, but their implementation process is expensive as it requires an organizational climate that promotes innovation and creativity.  The proposed change is a technical change as it modifies the ways in which normal activities are carried out by altering the organization and program structures (Clayton, 2009).

 Decentralization is kind of change that involves dispersal of administrative, political and financial functions. It involves a process of shifting authority, power and responsibility from national to local government levels of the healthcare systems. The main advantages for vertical integration of decentralization in mental healthcare system includes technical benefits such as improving delivery of healthcare services, leading to better health outcomes. In addition, this method eradicates challenges associated with bureaucracy and monopoly that hinders effective delivery of healthcare services to the needy service users (Atun, 2007).

 Political benefits associated with decentralization of healthcare services are that it extends democratic control of healthcare services to the needy individuals at community level. This may also increase opportunity for the citizens and services users to participate in decision making processes. This is effective strategy as it helps the government to identify the specific community needs.

Decentralization process also helps in minimizing financial burden associated with public procurement processes by transferring risks from a central point and distributing them to lower and private sector. This helps promote innovativeness and competition, which further improves the service user’s outcome (Bossert, 1998).

In this context, decentralization is the recommended as an approach of improving administrative activities that will help deliver healthcare services. This is also done for the purposes of achieving effective service delivery. In addition, decentralization helps improve local participation as well as autonomy in healthcare services. This acts as a means of redistributing power when it is effectively done, thereby reducing health disparities associated with tribal and regional tensions. 

Decentralization is also invoked as a means of increasing cost efficiency in mental health care systems, which is attained by giving the local units better and greater control over the available resources as well as healthcare revenues. In turn, this approach sharpens NHS accountability in healthcare services and operations. The approach helps to covertly offload financial burden from resource poor governments to local service providers (Saltman et al., 2007).

Conclusion

The Mental healthcare system relies upon on highly centralized and costly. The optimal for mental healthcare system is based on intuitive medicine, and is best suited for complex and episodic mental health complication. This increases additional barriers to healthcare care disparities and the minority groups.  It is important for the NHS mental health care system to depart from the one size fits all paradigms and to establish better channels that will ensure that healthcare delivery is improved to meet the growing dynamic needs for the underprivileged service users.

 The potential impacts of decentralization intervention are that it creates opportunities that improve the prevention strategies. The balance between the primary and tertiary preventive measures regarding saving. The strategy will also increase access to healthcare services by ensuring that the downstream expenses are balanced. In addition, the approach will help replace the costly unnecessary services with less expensive and quality ones.

References

Atun, R. (2007). Privatisation as decentralization strategy, Chapter 14, 247-266. In Saltman, R. B., Bankauskaite, V., & Vrangbaek, K. Decentralization in Healthcare. European Observatory on Health Systems and Policies Series. McGraw Hill, Open University Press. Maidenhead, Berkshire, England.

Bossert, T. (1998). Analysing the decentralization of health systems in developing countries: decision-space, innovation and performance. Social Science & Medicine. 47(10), 1513 – 27.

Black, N., & Gruen, R. (2005). Understanding Health Services. Open University Press, Berkshire, England

Clayton, M. (2009). The Management Models Pocketbook. Management Pocketbooks

Duguid, S. & Pawson, R. (1998). Education, change and transformation: The prison experience. Evaluation Review. 22(4), 470-95

Goodwin, N., Gruen, R., & Iles, V. (2006). Managing Health Services: Understanding Public Health. Open University Press, Berkshire, England

Kirk, S and Glendinning, C. (1998). Trends in community care and patient participation: implications for the roles of informal carers and community nurses in the United Kingdom. Journal of Advanced Nursing 28:370-81

Normand, C. (2011). The healthcare system in Ireland: Controlling growth in expenditure and making best use of resources. Chapter 3 (pp 57-74). In Callan, T. (editor). Budget Perspectives 2012. Economic & Social Research Institute (ESRI) Research Series 22, Dublin.

Pickard, S and Glendinning, C. (2002). Comparing and contrasting the role of family carers and nurses in the domestic health care of frail older people. Health and Social Care in the Community 10: 144-50

Saltman, R. B., Bankauskaite, V., and Vrangbaek, K. (2007). Decentralization in Healthcare. European Observatory on Health Systems and Policies Series. McGraw Hill: Open University Press.

World Health Organization (2000). The World Health Report 2000. Health Systems: Improving Performance, WHO, Geneva.

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Low calorie Products: Investment Decision Case Study

low calorie
Low calorie Products

Low Calorie Products

Investment Decision Case Study

A low calorie or healthy option microwavable food is a fresh concept which has gained a lot of interest among consumers. A majority of consumers are evaluating the food products provided in the market and consideration is given to the healthiest diet. Thus, introduction of microwavable products made up of low calorie has gain a high market due to consumer’s health concerns. To cater for the needs of the market, managers must formulate methods that will increase the product’s market share and profitability while increasing value to consumers.

As such, the intention of this paper is to outline a plan for managers in anticipation of rising prices, examine the major effects the government have on production and employment, determine whether government regulations are fair in the food industry, examine the major complexities under expansion via capital projects, and lastly suggest how a company could create convergence between the interests of stock holders and managers. The Company aims to keep the prices of its products as inelastic as possible.

Low calorie dietary is the new form of healthy foods and it has gained a lot of popularity among the consumers. In schools, homes, and restaurants, the concept of healthy feeding is not new. With the emergence of many chronic diseases, people desire to live healthy lives and lifestyles, thus the need for low calorie diets as will be produced and sold by Lean.

The purpose of this paper is to assess the main impacts the government has on production and employment, if government policies and laws facilitate fairness, determine the complications of expansion, and finally, offer recommendation on the merger of a company’s stakeholders and the management. For sustainable growth and profitability, the firm seeks to have the prices of its products as inelastic as it possibly can (Sullivan and Sheffiran 2013).  

It therefore means that the strategy used for pricing should have no effect on the way consumers recognize and purchase the commodities. In general, the type of demand occurs only for products that are essential for the normal living of consumers. However, the situation is not the same for food products that are microwavable. Elasticity of demand for low calorie products highly depends on the offered price, availability of substitutes, expenditure on promotions, income level of consumers, and prevailing economic conditions.

Considering the demand function and elasticity, low calorie products are favorable in a monopolistically dominated market. In a monopolistic competitive market, buyers and sellers are usually few. Therefore, if one company raises its prices, consumers shifts to another brand. As thus, firms in this market increase demand for their products through differentiation.

ThProfit (NP) = Total revenue (TR) Total Cost (TC)

According to the FOC of profit maximization,

=Marginal Revenue  =Marginal Cost = 0      

So Marginal Revenue = Marginal Cost

By applying the elasticity of 1.9, it was stipulated that demand for low calorie microwavable processed products is low. Since the company purposes to keep the prices of the products inelastic, it will strategize on differentiation to obtain a competitive advantage in the market. Differentiation is important since consumers will be able to pick the product from other substitutes hence increasing the sales. More so, it is proved that when product differentiation is noticeable to competitors, a firm’s market power and leadership increases. As such, it is advisable for the firm to strategize on product differentiation to increase the rate of returns.

Globally, the government usually has the mandate of regulating the market to protect consumers and the firms. However, whether markets are regulated or unregulated they are always influenced by the forces of demand and supply. As such, government regulation is critical for stability. For instance, the government handles externalities through provision of public utilities such as roads, contracts enforcements, and supply of currency (Wall and Griffin 2013). All theses aspects are better done by the government compared to private firms whose main aim is profit making.

A lot of discussion has been made on determination of the activities that the government is limited. Though regulations are important, extreme policies and laws are adverse to the growth of an economy. An ideal economic climate is only possible when government regulations are in accordance with the prevailing market conditions. The main reasons that the government involves itself in a market are enactment of policies and rules to facilitate exchange between buyers and sellers, and enforcement of the policies.

In the area of employment government sets rules for employers to follow when selecting, recruiting, and compensation. No employee should be paid below the set minimum wage rate, they are to be treated humanely and allowed to interact and work freely without fear of intimidation. Labor unions and other industrial agencies set regulations for firms follow failure to which employees have the right of suing the firm.

The government also limits production through the taxation rates, production costs, and prices for raw materials (Frank 2013). When terms are favorable, firms are able to produce to full capacity but when there is over production, the government sets higher terms to stabilize the market. As such, the effects the government will have on the company are limitation of production capacity and selling prices, employment, and eventually profitability since regulations are costly to the firm.

It is the mandate of the government to ensure the market is stable and at equilibrium for benefit of all stakeholders (MIT 2012). For instance, without intervention, big mergers and monopolistic conditions would be possible leading to excessive exploitation of the consumers. Thus, the government gets involved by limiting mergers and monopoly situations. It is fair for the government to get involved in the low calorie microwavable commodities to control prices, limit entrants and exit for fair market competition, and avoid emergence of monopolistic powers that would made the firm irrelevant.

When many unregulated firms are in the market, price wars would lead to consistent low prices causing the prices to be unstable. More so, unregulated market causes poor quality goods to be introduced as firms seek to minimize production costs for profits.

Thus, the major reasons for government involved are to control prices, ensure that the market is stable for protection of local firms, and protect consumers from exploitation. For microwavable foods, firms have to correctly label the contents of the products and they should be processed in certain measures to avoid provision of unhealthy contents.  Moreover, regulations also assist in protection of the environment where firms are supposed to observe efficient waste management practices, as well as reduce usage of production methods that release poisonous gasses in the environment.

An example of government involvement is the control of industries in China which have the tendency of producing smog that forcing people to wear masks to avoid getting contaminated. These goods are exported to US and other countries and the government has set measures to control the packaging of the products, their distribution and usage. Additionally, the government enforces policies to regulate the banking and finance industry by setting minimum interest rates so that consumers are not exploited and for banks to remain in business.

Some capital projects that the firm could undertake are mergers or acquisitions for expansion purposes. The reason for the projects is to increase market share, share operational risks, and increase market leadership and profitability (Harris et al. 2014). However, these projects bring complexities such as collusion between the shareholders and management. Managers tend to get additional capital from the reserves or by requesting shareholders to top up using their savings.

Shareholders may not be willing to use their reserves or contribute extra capital due to uncertainty of the venture. To avoid the complexity, managers should undertake projects that have high chances of generating returns in the short run by carrying out comprehensive evaluation of the project. For instance, managers should acquire a brand that is already dominating in the market to avoid experiencing losses.

Convergence between managers and shareholders is created through a firm’s strategic decision making process and through the use of financial statements. Whereas the shareholders own the company, they have limited control over the decision making process and the actions of management. On the other hand, managers are responsible for controlling the affairs of the firm.

Managers seek for higher income and allowances irrespective of a firm’s performance while shareholders are usually interested in higher profits for increased dividends. As such, shareholders seek for firm’s growth through mergers. However, mergers may compromise manager’s job security and control leading to divergence between the interests of shareholders and managers.

Therefore, strategic decision making should be done such that managers get allowances and salaries depending on the generate profits. If profits are high, their salaries are high and vice versa. As a result, managers will become productive so as to get high profits and allowances and in the process, the interests of shareholders will be met and both parties will be satisfied. Therefore, convergence of shareholders and managers lead to higher profits since managers become preoccupied in generating high revenues so that they pay is high and when the revenues are high, dividends are also high.  

Instances that bring convergence of the interests of managers and shareholders include: managers being employed on contractual terms such that their contracts are renewable if they perform as required, and application of commission terms whereby managers are paid depending on the income generated at a certain period.

It therefore shows that the government should get involved in microwavable food market to ensure products are of high quality, control monopoly activities, and stabilize the market. For better returns, managers and shareholders should have a common vision and the needs of each party considered. The firm is likely to excel and attain market leadership through product differentiation since demand is inelastic, ensure all the needs of stakeholders are met, and follow government conditions as they relate to production and employment.

References

Frank, R. (2013). Microeconomics and Behavior, (7th ed.). New York, NY: McGraw-Hill.

McGuigan, B. P., Moyer, R. C., &Harris, F. H. (2014).Managerial economics: Applications, strategies and tactics, (13th ed.). Stamford, CT: CengageLearning.

Mit. (2012). Government Regulations in the Market. University of Cambridge.

Sullivan, A. &Sheffrin, S. M. (2013). Economics: Principles in Action. Upper Saddle River, NJ: Pearson Prentice Hall.

Wall, S. & Griffiths, A. (2012).Economics for Business and Management.New York, NY: Financial Times Prentice Hall. 

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Employability Skills Research Paper

Employability Skills
Employability Skills

Employability Skills

Introduction

Effective career readiness for college students requires the acquisition of excellent skills in terms of academic knowledge, technical experience and a collection of set competencies, referred to as employability skills (US Department of Education 2016). Employability skills can be defined as work competencies, which can drive success across all levels of employment in the labor market.

The skills include the ability to assess personal responsibilities and evaluate your performance, ability to improve interpersonally, ability to understand the dynamics of work relationships, and the ability to develop effective strategies for solving work related problems. However, the question is about how one can acquire or develop effective employability skills. The objective of this paper is to discuss the most efficient strategies for developing employability skills.

1.1 How to determine own responsibility

As a Practice Educator in Gold View Hospital, my duties are planning objectives, and monitoring team performance. In addition, I am tasked with the role of coordinating various departments, organizing meetings, and providing an enabling environment for employees to work better. Generally, my duty is to enhance performance objective.

How to enhance performance objective

Performance objective can be enhanced by improving one’s capabilities such as communication skills, problem-solving skills, work and team management skills et cetera.

Effective Communication skills: As a practice educator, my strategy to effective communication involves good listening skills, use of verbal and non-verbal messages. In addition, I should be able to relate well with issues and know when to speak.                                

Problem solving techniques: The best approach of solving problems includes: problem definition, problem analysis, developing options for solving the problem, selecting the most suitable option, implementing the option, evaluating the outcome, and learning from the problem.

Decision making skills: Before making a decision, it is important to learn and develop your decision within the work requirements. This often calls for embracing intuition approach by applying experience and personal values. Furthermore, the process should encourage reasoning and comprehensiveness of ideas without attaching emotional aspects to decision.                                

Organizing work: The best approach to handling any given assignment is by writing down every detail needed as well as any related information that you think might be useful to you. Develop a time schedule to ensure that all tasks are prioritized and accomplished within the set timeframe. Consult your friends, tutor, or anyone who might provide important information regarding your assignment.

Embrace leadership skills: Observe good relationship with coreworkers and the institution at large. Make use of negotiation, influence, and persuasion techniques in the case of divergent views.

Team management skills: This is equally an important aspect of increasing performance objective. The skills include effective communication, establishing team virtues, effective decision-making approach, and developing suitable conflict resolution techniques.

Work Ethics: Virtues such as credibility, honesty, industriousness and respect for others are also important factors to developing performance objective.                                                            

However, the above-highlighted skills are to some extent  too general to bring out an efficient objective performance. Therefore, they can be effective or not depending on a person’s nature and state of mind. However, the efficiency of this skills can be enhanced by addressing several factors considered to be obstacles to their effectiveness.

For instance, to promote aspects of effective communication skills, one should develop effective stress management skills (Robinson, Segal &Smith 2016).  Stress and emotions can lead to misinterpretation of other people or project. According to Robinson, Segal &Smith (2016), to deal with stress while communicating one is required to:

  • Take a moment of calm before you decide whether to continue the conversation or postpone it.
  • Carry out stress managing activities such as taking some deep breaths, relaxing and clenching muscles, and recalling a sensory image, which is soothing and rich in your memory.
  • Using humor in the conversation to ease tension and release emotions
  • Be able to appreciate the concerns of others even though may not appear so big to you

On the other hand, problem-solving techniques can be made better by applying the psychological theory of problem-solving such as the Herzberg’s Motivation-Hygiene Theory (Cooper 2014). Team management, building, and work ethics can be enhanced by introducing motivation and morale boosting factors.

According to Herzberg’s Motivation-Hygiene Theory, it is believed a happy and motivated person is more productive as compared to an unsatisfied person. Some requirements such as incentives and rewards to recognize people’s efforts will motivate them to be more committed to their work.

1.2 How to monitor and evaluate performance objective

Mind Tools (2016) outlines that the best approach to monitoring and evaluating performance objective is by embracing the SMART technique, which is an acronym for:

S- Specific

M- Measurable

A-Acceptable

R- Relevant

T-time bound        

Specific: This describes a project or work regarding what should be done, how it should be done, and the project outcomes in the most observable manner.

Measurable: It describes the objectives of the project in terms of quantitative and qualitative measures, frequency, project costs, and timeframes among others. This is to ensure that the project meets the expectations.

Acceptable/achievable: The aspect of ‘achieving’ involves ensuring that the team is in a position to carry out the assignment, and has the necessary experience and technical skills. In addition, it evaluates whether the objective can be attained within the given timeframes, opportunities, and resources.

Relevant: The techniques applied in carrying out the assignment should be relevant to the objectives and the implementation plan.

Time-bound: This determines the way of achieving the objectives within the set timeframe. It evaluates the progress of the project at specific time intervals. More often than not, timeframes are put in place to create a sense of urgency to help the team to complete the work on time.

1.3 Recommendation

Dubinsky, Jennings & Brans (2010) states that to improve the performance quality in work environment, the following recommendations should be implemented:

Adoption of performance appraisal techniques: Appraisal techniques such as 360-degree performance appraisal should be adopted to help keep employees on track towards their assignments. It involves the process of gathering feedback on individual performance from a variety of sources. It includes self-appraisal, management, appraisal, subordinate appraisal, and peer appraisal.

Self-appraisal enables employees to evaluate their performance, strengths and weaknesses, and achievements. Management appraisal involves the rating of employees’ performance by the senior management. Subordinate appraisal involves the evaluation of employees’ communication and motivating skills, their ability to deliver desirable results, and their leadership qualities.

Salary increments and bonus: This is a motivational approach of getting employees committed to their work. It improves the relationship between the employees and management.

Promoting strengths and minimizing weaknesses: This can be done through a S.W.O.T analysis. It helps to explore new efforts or problem-solving techniques. In addition, it helps in identifying threats, which is a mechanism of minimizing weaknesses.

Developing training programs: Regular training will help to improve the skills of team members.

Rating responsibilities: This includes introducing different ranks and carrying out paired comparison. The aim is to motivate the employees to put in more efforts in order to attain a higher rank.

1.4 Quality improvement through motivational techniques

Motivational theories- Abrahams Maslow’s Need Hierarchy Theory

Hierarchy of need theory is essential in understanding motivational factors, human management, training programs, and employee development.  Maslow’s theory helps in creating a working environment, which encourages self-actualization (McLeod.  2014). The hierarchy is summarized below;

Fig 1: The Maslow’s Hierarchy of Needs theory.Source: studyob.com

Motivational approaches

Developing a conductive work environment

This includes motivating employees by providing necessary tools and means of performing duties. In addition, management should encourage teamwork, sharing ideas and amicable problem-solving.

Setting Goals

Management should help the junior officers to establish and develop professional goals and objectives. The goals should be idealistic and attainable to prevent people from getting disillusioned.

Giving Incentives

Incentives motivate employees and make them appreciate the nature of their work. They include financial incentives such as cash prizes and rewards as well as non-financial incentives, which include vacation days, or choice of working offices and parking spots.

Achievement recognition

Employees’ achievements should be celebrated through issuing of awards such as employee-of-the-year awards. Achievements should be appreciated by issuing certificates of exemplary performance. Team accomplishment should be celebrated as well.

Sharing Profits

Motivate the team by providing bonus resulting from the accrued profits. This encourages a sense of ownership and pride.

2.1 Developing solutions to work-related problems in a health care environment

Hicks (2016) recommended the following steps of developing a suitable solution to work-related problems: identifying and defining the problem and appreciating the problem as an opportunity, and using a checklist to identify particular aspects of the problem. In addition, explore the root cause(s) of the problem -analyze the root facts of the problem to find out the most relevant information regarding the problem.

Develop options for solving the problem- create several options for problem-solving by being mindful and inclusive of other people’s ideas. Moreover, decide on the most suitable approach- evaluate options and decide on the most appropriate approach to statutory requirements. Implement the technique- follow the project management guidelines while keeping in mind the consequences of the outcome. Finally, evaluate the outcome and learn- evaluate the effectiveness of the solution and recommend which areas are in need of improvements

To effectively apply the above steps, one should develop and employ the following interpersonal skills:

  • Personal effectiveness- one should embrace leadership qualities such as being impartial, mindful of other people’s  ideas, nonjudgmental, influential et cetera
  • Team player- it is crucial in identifying unique characteristics of an individual. It is significant in choosing the kind of approach of handling work related problems.
  • Uses of negotiation skills- this involves engaging parties in a negotiation process. Dialogue should be embraced to reach an agreement. This is a win- win outcome for all parties.
  • Assertiveness – it involves being confident, aggressive and assured that you can effectively manage the problem.

2.2 Effective communication in a health care environment

Verbal and non-verbal communication-Verbal communication can be enhanced through the use of effective communication skills such listening skills, assertiveness, mindfulness, and responsiveness. Non-verbal communication involves the use of electronic means such as e-mails and the use written messages in a professional manner to convey the message (Robinson, Segal & Smith 2016). Using body language -It includes, posture, maintaining eye contact, body gestures, tonal variation, and facial expression to enhance effective means of conveying important messages.

Sending and receiving formal and non-formal feedback from colleagues- this will serve as a reminder to keep the team updated on the activities to be done. Use of ICT as an effective medium of communication – ICT is the most effective way of passing information to a large group of people within the shortest time possible. In a Hospital setting, use of informatics facilitates sharing data, ideas, and conveying important messages within the working environment.

 Organizing regular team meetings-Regular meetings provide a medium to discuss the emerging issues, evaluate work progress, and foster the unity of the team.

2.3 Employing Time management strategies

Prioritizing workload- prepare a working schedule of accomplishing duties. Apply the working schedule in a systematic manner.

Setting up work objectives- set up clear objectives to guide the team from straying away from the real issue. It creates a sense of focus by allowing team members to work towards the set goals; thus, reduce time wastage.

Developing appointment schedule- appointment schedules help reduce interference during working hours. Working in a steady as opposed to an erratic manner is essential.

Setting time for learning enables one to improve working skills; thus, improving the quality of work as well as reducing time as a result of uncertainties (Mind Tools, 2016). A reliable estimate of the project creates a sense of urgency and assists in keeping the team focused on accomplishing the assigned duties.

3.1 Working together through team and team building activities

Assigning specific roles to every team member- working together is an inclusive process requiring the active participation of every member.

Mixing skills and styles- this is the best opportunity to explore new skills and styles of developing quality work. In this case, members have an opportunity to showcase their skills.

Identifying roles for the team- team roles and objectives are emphasized to keep members focused.

Stages of team development such as loyalty, dedication, identity, common practices, and health assessment- these stages are essential in reminding members of the best protocol to follow in developing career skills;

  • Action planning- include time schedules for every activity
  • Monitoring and feedback- it involves team progress evaluation and results analysis
  • Exchanging constructive feedback- members give their views on how the process has been conducted

Successful teamwork calls for the development of leadership skills, which includes setting direction, setting the pace and standards, being influential, practicing effective communication, being a motivator, innovative, reliable and consistent. In a healthcare environment, effective leadership involves provision and justification of objectives and contribution; motivating teams and team members to exhibit exemplary commitment; and pay attention to developing quality system performance (Cooper2014).

Based on health-care, an effective leadership recommends:

  • Providing and justifying clear  aim and benefits
  • Motivating teams and individuals to work effectively
  • Concentrating on enhancing performance of the system

3.2 Team dynamics in Children wards

  • Communication barrier–   children are unable to express themselves. Embrace good listening skills to understand explanations by parents
  • Informal and formal setting- the children ward consists of both professionals and civilians. Interpersonal skills are encouraged to meet the objective
  • Objectives of teams and groups like long-term purposes/strategies
  • Problem-solving and temporary projects
  • Flexibility- must be willing to assist whenever called upon. Children need a lot of care which requires one to be flexible to handle them

3.3 Alternative ways of accomplishing tasks in a health care environment

According to Borrill, West & Dawson (1998), tasks in a healthcare environment can be accomplished by;

  • Setting clear objectives , active participation by individual team members, highlighting on quality patient service through innovation
  • Develop stress management techniques for team members
  • Embracing quality meetings,  effective integration and communication processes to develop improved service of patient care
  • Adopt clear leadership skills to enhance the relationship with patients
  • Observe work ethics

Good leadership skills include setting the course, standards, inspiring, innovative, response, open communication, trustworthy, and reliable (Messum, Wilkes & Jackson 2011).

4.1 Evaluate the tools and methods of developing solution to problem

According to Hicks (2016), the general problem-solving techniques include the following

  • Identity and define the problem- appreciate the problem as an opportunity. Use a checklist to identify particular aspects of the problem
  • Explore the root cause(s) of the problem-analyze, the root facts of the problem, to find out the most relevant information regarding the problem.
  • Develop options for solving the problem- create several options forproblem-solving by being mindful and inclusive of other people’s ideas
  • Decide on the most suitable approach- evaluate options and decide on the most appropriate approach to the statutory provisions
  • Implement the technique- follow the project management guidelines while keeping in mind the consequences of the outcome
  • Evaluate the outcome and learn- evaluate the effectiveness of the solution and recommend on which areas need improvements

4.2 Problem solving techniques apply to different scenarios.

Consider the following settings:

Scenario 1

A member of the team is involved in an accident and that causes him to take some time off for several months. How would the team react initially and how would they handle it as the months go by? As a team leader, I will take the responsibility of informing the team members about one of us getting involved in a road accident. I will organize a compassionate pay visit and encourage all members to participate. During the visit, I will find out doctor’s recommendations involving the anticipated date of recovery and communicate to the team on the expected date of return to work.

I will reassign some of his/ her responsibilities to a relevant group member. At first, the team members will feel remorseful and easily accept taking up of his/her responsibilities. However, as time goes by, the member assigned the duties might start feeling overburdened by the workload.  Therefore, I shall design makeshift roles to ensure that his or her responsibilities are shared out to several team members. For the duties that need his /her personal presence, I will reschedule until further notice. Upon recovery, I will lead the team to welcome back our member.

4.3 The potential impact of the problem on the business of Gold view hospital on the implementation of the strategy

The problem wills definitely affecting the quality of service provided. The interim team members will not be able to deliver the most desirable results for lack of enough experience in that particular work. Similarly, some services which require his/her physical presence will not be provided. Furthermore, the members selected to step in will have increased workload as well as less focus on their designated duties. I can say that the solution was partially solved and therefore recommend that we have more members of staff within one docket such that in the absence of one member, team operations are not affected.

Conclusion

Based on the issues outlined in the paper, it is evident that employability skills depend on determining an individual’s responsibility and ways of enhancing performance to meet the objectives.  To this effect, performance objective must be monitored in line with the SMART model, motivational methods such profit sharing and bonus et cetera.

In terms of developing solutions to work-based issues in health care setting, it is necessary to  define and identify the problem; establish the main causes of the problem; choose the appropriate alternative; implement the alternative; and assess the results. In the long run, communication can only be effective through the use of not only verbal and non-verbal techniques, but also through good listening, assertive, mindful and responsive skills.

References

Borrill. C, West, M & Dawson, J 1998. The Effectiveness of Health Care Teams in the National Health Service http://homepages.inf.ed.ac.uk/jeanc/DOH-final-report.pdf

Cooper, B. 2014, Psychological Theories To Help You Communicate Better With Anyone. Available from:https://blog.bufferapp.com/3-psychological-theories-communication-insigh, [24th May 2016].

Dubinsky, I. Jennings, K &. Brans, B. 2010.  360-Degree Physician Performance Assessments for quality improvement Healthcare Quarterly Vol.13 No.2 2010 71

Hicks, T 2016, Seven Steps for Effective Problem Solving in the Workplace. Available from: http://www.mediate.com/articles/thicks.cfm, [24th May 2016].

 McLeod, S. 2014, Maslow’s Hierarchy of Needs. Simply Psychology. Available from http://www.simplypsychology.org/maslow.html, [24th May 2016].

Mind Tools 2016, Effective Scheduling Planning to Make the Best Use of Your Time. Available from: https://www.mindtools.com/pages/article/newHTE_07.html, [24th May 2016].

Messum, D., Wilkes, L. & Jackson, D.E., 2011. Employability skills: Essential requirements in health manager vacancy advertisements. Verified OK.

Mind Tools 2016, Golden Rules of Goal setting. Available from https://www.mindtools.com/pages/article/newHTE_90.htm, [24th May 2016].

Robinson, L., Segal, J., & Smith, M 2016, Effective Communication, Help Way Guide. Available from http://www.helpguide.org/articles/relationships/effective-communication.htm., [24th May 2016].

The U.S Department of Education 2016, College- and Career-Ready Standards. Available from <http://www.ed.gov/k-12reforms/standards>, [24th May 2016].

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Social and Health care for the Elderly

Social and Health care for the Elderly
Social and Health care for the Elderly

Social and Health care for the Elderly

Introduction

This essay revolves around the case review associated with elderly abuse in health and social care. Elderly abuse has been on the high increase in the recent past largely because the government has failed to perform its obligations. This paper sets out to put certain issues into perspective so as to enable a friendly environment to the elderly to the elderly persons in the community.

Task 1.1 Description of how information could reach the public

The content based on the case study analysed in this paper ought to reach the public sphere at all costs. To begin with, there is a need for a well-structured response mechanism to facilitate the disclosure of all manner of abuses to the concerned authorities (Seale, 2003). Again, the abused persons should not be afraid of the outcomes of disclosing the wrongs meted against them.

There has been a culture where wrongs meted out by one party are perpetuated because the injured party is ignorant of the right channels that would help them seek help or talk about them to get the required public attention. In our contemporary world, for instance, help relating to electronic shopping, fast foods among other associated aspects is widely available.                              

Nonetheless, no one pays much attention to  the elderly. Moreover, available channels of communication have been outrun with time, an aspect that makes it intricate to communicate.  This backdrop calls for an appropriate review of the situation by the regulators. However, because the government may not be able to do everything for everyone, people ought to take initiatives when it comes to reporting the issues to the relevant authorities. In the UK, for instance, the modifications to the components of Southern Cross have culminated to several mistakes (Hara, 2011).                                                                                                            

The Southern Cross has been relentless to providing new information concerning the projected new operators for a momentous proportion of its residential and nursing homes in England.  Nonetheless, owing to poor management and communication methods, there is a scenario of chaos right now (Johnston & Andy, 2013). The authorities and the law enforcers should work closely with those respective houses. On the other hand, the locals should help the authorities as much as they can to ensure these cases are reported promptly.

Task 1.2 Analysis of different media techniques such as media, leaflets, newspapers used for communicating information associated with elderly care.

Media plays an integral role when it comes to disseminating societal issues. However, information linked to elderly care never reaches the public because of the failure of the media to report about it. Nevertheless, the media house should not be subjected to blames or held responsible for not covering some issues, or for simply reporting issues that the public is interested to hear. Contemporary media for instance, reports more about the popular trends regardless of whether or not they have any relevance to the public (Hickey, 2014).

During prime time, media goes out to report sensational news too. In this respect, the perception of the media attitude should be altered (Davies, 2005). Moreover, information associated with elderly issues should be disseminated without any repression or omission. With the advents of social media, it becomes easier to disclose social ills rather fast. There is a need to put into use social media.

Task 1.3 influence of divergent ways on people’s attitudes, thoughts, and behaviors

Much as  people’s attitudes and behaviors are diverse, it is easier to influence them through different channels. For instance, type of media, presentation layout, content, logical visual basics, and sound influence people’s attitudes and behaviors. And because the people’s attitudes can be altered through visualization and sounds, it becomes effective per se. In due course, enhancing people’s understanding about particular issues through graphical representations will certainly enhance their attitudes and behavior. 

Task 2.1 Influence of media on the attitudes and behaviour of people

The media has many functions and the key one is informing the public about current events. In the healthcare sector, the media informs the public about current issues related to health and social care including an outbreak of illnesses, new medicines, treatment techniques and so forth. The increased demand for data has contributed to advancement in periodicals, newspapers, television programs that address health, and social care. Discussions on current events associated with health and social care is done to inform public.

Such debates involve professionals from different fields of health and social care to influence perception of the public (Willby, 2008). For instance, in the US there was a discussion on a department in Novartis that paid a large sum of money to physicians following a prescription manufactured by the company. This scenario will affect public behaviors and attitude towards the products of these firms.

The media can be used as a watchdog of political structure to influence people’s attitude and behaviour. This way the media creates awareness about political structures, by releasing important political opinions, and conditions associated with health and social care. Therefore, a person is empowered to access information about the government, rights and assists them in formulating decisions in health and social care (Davies, 2005).

Moreover, the media is in charge of educating people on health and social care, as it is able to reach many. For instance, the media can educate the public about risks associated with smoking. This can be carried out through health education programs through social media platforms. Again, the media can be used as a platform for announcing events related to health and social care including risks of certain drugs, and epidemics.

Health and social care institutions can also utilize the media to market services to the larger public. However, they should ensure that the ads are convincing and also attractive to help people make informed decisions (Kelly et al. 2005). The objective of any ad is to attract the attention of people; the more attractive the ad is the higher the ability to influence their attitudes and behaviors.

Task 2.2 Evaluating the Reliability and Validity Of Media Content

It’s vital for people to assess validity as well as the reliability of information prior to considering it factual. The public can ascertain this by evaluating the source of information, the issuance of the data and the manner in which it is released and presented. There are different sources of data, for example, government websites, and advocacy groups, political, and religious institutions. The public must understand the agenda behind any information or basically to create awareness. For instance, information released by the Ministry of Health (MoH) on a given policy issue is reliable in comparison to that provided by lobby groups (Hopson, 2013).

Presently, UK is campaigning for quality health and social care by incorporating the elderly people. This campaign is organized by the government, making it valid and reliable as it values the interests of its population. Conversely, in the United States, there is Obama care, which purposes to modify insurance sector to cater for the healthcare needs of low-income earners. The bill was widely debated; some opposed it while other supported it. However, the media plays an important role of presenting facts and views about the bill (Hopson, 2013). By and large, the public must get information from reliable sources like government sites and publications.

Task 3.1 Contemporary Issue

Compared to previous years, Britain population is healthier than ever. Nonetheless, regardless of the improving health of the population, minorities’ health is increasing at a remarkable low rate in comparison to the general population. In the attempt to address the issues, it has been challenging, particularly, for healthcare providers as well as policy makers. It is evident that causes of inequalities are determined based on social factors (Hara, 2011).

Employment industry and education structures plan access to job opportunities based on the society. Moreover, inequalities are influenced by sexuality, gender, and racial background. Experts have demonstrated that addressing unequal allocation of the variable of health is vital in terms of improving Britain’s health sector. Facts on the mortality rates of immigrants demonstrate the presence of heterogeneity across minorities.

Task 3.2 Monitoring different perspectives

In the UK, ethnic groups comprise of about eight percent or 4.6 million individuals of the entire population. Previous studies have shown that racial communities have a low quality of health in comparison to white Caucasians in conditions like heart diseases, mental health, and stroke among others (Hickey, 2014). In the past years, healthcare inequalities of various ethnicities are common in various healthcare institutions across the UK. The UK government in the past decade provided data on the healthcare gaps across the nation and also certain areas that the gap was increasing (Davies, 2005).

The inequalities start at birth, for example, children born in poor households are in danger of being born premature and developing chronic illness in adulthood. This leads to the cycle of inequalities. As such, the government has initiated a number of measures with the objective of investigating aspects of healthcare inequalities while reducing it among racial communities. Some of the initiatives are; Health Challenge England; Spearhead Primary Care Trusts; Race for Care and so forth. Much as initiatives were introduced to not only improve, but also minimise healthcare gaps. Some have been successful, while others were have failed in addressing inequalities in healthcare.

Task3.3 Significance of results to health and social care

Previous studies on health and social care documented in a number of journals have been the basis upon which health experts use to practice while improving service delivery. These studies are crucial when it comes to creating awareness about challenges in health and social care and presents a general understanding of handling such challenges. For example, many intellectuals have investigated about the significance of training of healthcare experts on ethnicity and cultural diversity of UK’s populace (Davies, 2005). This a suitable step because it helps health care experts to be conscious of the expectations of racial communities, including beliefs, practices, and social conditions.

Furthermore, findings are used publicly as the foundation for informing them about new events in health and social care industry such that the they are aware of the healthcare gaps across health care institutions across the UK. Data from government published on their sites about health care gaps is helpful since it informs the public on current issues on health and social care. In addition, advocacy groups publish information about social and health care on their sites and other channels to create public awareness.

Task 3.4 Factors influencing development of various perspectives

A number of factors are attributed to the development of various perspectives over a given time frame, for instance, ignorance about the health care requirements racial minorities. Regardless, of the enhanced outcomes conducted through ethnic diversity initiatives, three is a lack of provisions for health care experts across the UK apart from in psychiatry.

Therefore, it is important for health education to integrate principle that purpose to achieve the objectives of improving health for the entire population, and identification of special health requirements, belief and communication challenges of racial groups (Anon, 2013). Many health professionals state that changing lifestyles in inner cities have contributed to increasing the number of ethnic minorities. In fact,

Asians people in the UK has increased considerably, hence, it is crucial to find a remedy to these issues. Other elements that influence the growth of various perspectives include economic constraints, availability of adequate information, and changing roles of corporates in managing hospitals. These factors were evident in the past and they have greatly influenced the perception of people. As such, this is a field that planners and policy makers should take into account when making decisions (Anon. 2013).

Task4.1: The extent of local attitudes reflect those found at a national level

Recently, NHS has been under pressure to review measures aimed at reducing health inequalities. On one hand, reports indicate that NHS is not effective in terms of minimizing health inequalities, on the other, the gap is increasing considerably. The reports call upon the government to concentrate on issues at different health institutions while highlighting the main cause of such inequalities.

Social and economic issues are main causes of changes in behaviour and attitude in local and national levels are not adequately emphasized (Morris, Carrell & McDonald, 2016). There is the need for education and training programs on social causes of illnesses while encouraging health specialists to advocate for patients. The media has played its role of reporting health gaps as well as changing racial minorities face in the UK.

While the released data can be deceptive, its necessary for the government to provide information so as to ascertain accurate facts on health inequalities reach the public. Furthermore, the government must use various modes of media to release the information including television, radios, websites among others (Hara, 2011). Again, the government must inform the public on necessary measures to address health inequalities, for instance, integrating progress records on initiatives they have implemented.                                                                                                                

With respect to local level, there is a wide range of beliefs and practices that greatly influence health status. The majority of people in local areas do not want to change the manner in which they take medication, they still believe in their practices. This is an aspect that contributes to spreading of diseases. At the local level, social care facilities are regarded as ineffective and simply a place for caring for elderly individuals.

Subsequently, local attitudes lead to many national issues. If individuals are not able to reduce the spread of endemic, it is reflected at the national level, which leads to remarkable risks to economic, health and physical issues. Therefore, to reduce while ensuring the country’s population is health, everyone should be involved.

Task 4.2 Evaluation of validity of public attitudes and behaviors

Healthcare is a field that entails creating awareness about health related issues (Willby, 2008). This also entails wide areas  associated with social, spiritual, intellectual, physical, and environmental health.  This is the basis upon which people learn to conduct themselves in a way that is appropriate to the promotion of health. In many instances, media post news without taking into account the element of empathy.

The variation in public attitude and behaviour can be as a result of the gap in income. The public’s response to social platforms in the promotion of health is positive. As a matter of fact, social platforms are commonly employed to influence individuals’ behaviour towards health. Social promoters use several marketing strategies including placing information in clinics, community outreach, and promotion. Therefore, based on the case study the information will significantly influence public attitude as well as behaviors. In addition, releasing information on elderly abuse in the public will demonstrate the increased health gaps of this group.

In turn, this will contribute to the formation of groups that aims to create awareness about elderly abuse. The groups can also organize peaceful protests to get the government to enact laws that prohibit abuse of elderly. The groups can also educate elderly people about their rights and how to increase their wellbeing. Releasing such data contributes to contemporary thinking in terms of health and social care, which makes the government be effective in the provision of services to all.

Task 4.3 Effects of contemporary thinking

Contemporary thinking in the delivery of health and social care can result in many consequences. For instance, it helps in educating the public about what  the government is doing and ways of addressing a given social and health event. Nonetheless, the public should be cautious regarding the sources of the information. Moreover, the public must ensure the information is not only valid, but also reliable (Willby, 2008).

This is because the released data impacts on the public’s attitude, behaviour, and thoughts.  Caution should then be considered prior to release. Contemporary thinking involves the utilization of informatics in health and social care, which is imperative in obtaining good outcomes including; management of care setting; team collaboration; and negotiation.

Conclusion

In the end, this paper determined to highlight not just an overview and insight on global health issues, but also the role played by the media to inform the wider society. Accordingly, the public has a pertinent role to play as well. While almost everyone has an obligation towards reporting, individual attitudes and the motive behind reporting is of a great importance .

The national health issues tend to play out in the global sphere. Hence globally major issues tend to happen to owe to the attitudes of local peoples. Again the relevant authorities should take a lead to create public awareness, in healthcare related issues and determine the veracity of publications. While it is vital to champion the notion that the young should always be educated through media, they should always take limited interest in media publications. It is imperative for the public to assess the consistency and legitimacy of media content before they can think of consuming it. 

This starts with evaluating not just the information source, but also who is dispensing the information and how the content is disseminated. Some of these sources may include the political class, religious agenda, government sources and lobby groups among others. The public ought to analyse whether or not the information presented is aimed at playing with the public emotions or simply reporting plain facts.

References

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