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How VITAMIN D Deficiency Affects the immune response in HIV patients
ABSTRACT
Vitamin D deficiency is a common issue in patients diagnosed with chronic conditions including Human Immunodeficiency Virus (HIV) infection. Research estimates that vitamin D deficiency in HIV infected people range between 12-100% (Lake & Adams, 2011). Generally, vitamin D deficiency is associated with various risk factors including age, race, overweight, geographical location and exposure to some antiretroviral therapy medication.
However, there is little research on the role of vitamin D in human immune system. This systematic review explores in depth analysis of on the factors associated with vitamin D deficiency. The paper also explores the role of vitamin D on the immune system (both adaptive and innate immune system).
However Ginde, Liu and Camargo(2009) believes, Vitamin D deficiency and supplementation in patients diagnosed with HIV is not well understood. The rationale of this dissertation is to provide to review current information on the role of vitamin D on HIV patient’s immune system. The aim of this literature review is to understand the impact of Vitamin D in HIV patients.
The key words that were used during literature search were structured the dissertation topic which was to find the impact of vitamin D on HIV patients. This included; Vitamin D, HIV, Vitamin D deficiency, Vitamin D role in innate immune system, Vitamin D in adaptive immune system, ; disease progression, pathogenesis of HIV, CD4, CD4+ T cells, CD$ count, Vitamin D supplementation, CD4 percent, role of Vitamin D,25(OH)D and the immune system, and factors that influence Vitamin D levels in HIV patients
Current strategies to help manage HIV
Regardless of the fact of progress in antiretroviral treatment (ART) in the last 10 years, HIV diagnosis is still very high. Recent studies stress on the importance of nutrition in HIV patients, especially the Vitamin D. Most of HIV patients are diagnosed with vitamin D deficiency. The deficiency has been shown to affect the immune cells (B cells and T cells) because the immunologic cells may not metabolize the active part of the vitamin D which is D3. There are many factors that contribute to vitamin D deficiency such as skin colour and diet. These limitations will be discussed in more detail in chapter 2.
Sun (2010) suggests, vitamin D has an impact in anti-inflammation and anti-infection which has newly founded and important movement for calcitriol receptor . Salahuddin (2013) suggests that vitamin D increases protective immune responses to Mycobacterium tuberculosis (TB) by reducing Interferon-gamma (IFN-g) and suppressing diseases linked with inflammation in the host. This study suggests, increased vitamin D dosage helped TB patients and enhanced their host immune response compared to deficient vitamin D levels. This suggests vitamin D can be used to treat TB. Vitamin D deficiency causes patients to be more susceptible to autoimmune conditions such as tuberculosis (Norman & Henry 2006; Aranow, 2016).
Vitamin D deficiency in HIV populations
The published rate of associated with Vitamin D deficiency/ insufficiency in HIV infected people range between 12% and 100% posted by Lake & Adams(2011). Generally Lake & Adams, (2011) suggest the rates of low 25 (OH)D in HIV patients is high and is associated with traditional risk factors such as age, race, overweight, seasonality, overweight and exposure to ART Research by Aranow (2011), suggests that the impact of Vitamin D status on health status of human being played a significant role.
Therefore, Ginde, Liu and Camargo(2009) believe the African community in Europe, UK, and USA are likely to be affected by the geographical location, such that their current vitamin D intake is low due to restriction due to high melanin content in their skin. In addition, the USA Black ethnic group is associated with vitamin D deficiency because they need longer exposure to produce the same level of vitamin D as the white ethnic people do.
For instance, in USA, the average 25(OH) D concentrations are low for blacks is 17.4 ng/ml as compared to 21.9 ng/ml d 28.3 ng/ml in fair skin tones respectively. Therefore Prietl et al(2013) suggests , HIV patients with darker skin pigment in these regions are likely to report Vitamin D deficiency These studies suggests that in the future, skin pigmentation is an effective strategy to identify people who are at risk of vitamin deficiency, especially among the HIV infected population so as to reduce further HIV related issues.
In some specific ART sessions and agents are associated with Vitamin D deficiency. Some studies have indicated that non-nucleoside reverse transcriptase inhibitor (NNRTI) is associated with 25OHD deficiency.
Giusti, Penco, & Pioli (2011), suggest that the protective function of Vitamin D against disease progression and mortality in HIV patients can be explained by its role in immune response. Djukic et al., (2017) suggest 1, 25 (OH) 2D is active in all organ systems and plays an important role in human immune system. Especially, 1, 25 (OH) 2 D reduces T cell activation and genes associated in cell differentiation and ability to spread.
Furthermore Djukic et al., (2017) believes it reduces the amount of pro-inflammatory cytokines such as Tumor Necrosis factor (TNF – α),Interlukin 2 and 12 (IL2, IL-12) and Interferons (IFN –γ) triggers the T cells to response to TH1 and TH2 responses; these responses also play an important function in controlling the immune cells and antimicrobial defense including monocyte chemotaxis and their differentiation into macrophages, releasing nitric oxide by macrophages and production of ß defensin 4 and cathelocidin and anti-microbial peptides that stops virus from copying. Due to these antimicrobial and anti-inflammatory functions, it has been suggested that Vitamin D deficiency has a great role in immune anti-inflammatory (Giusti, Penco, & Pioli, 2011).
Effects of vitamin D on immune response
Bailey et al., (2010) suggest that Vitamin D triggers the immune system. The results suggest that Vitamin D plays a major role in boosting the immune system. Many studies including Rathish(2012), have looked at human T cells in the lab to study the complex process of Vitamin D in innate and the adaptive immune system, and how the different cells fights infection. These findings are supported by the discovery of people with vitamin D deficiency tend to be more likely to have infections and that supplementation of vitamin D may boosts immunity. This chapter explores the role of vitamin D in innate and adaptive immune response.
The studies provided suggest that Vitamin D deficiency allegedly had an effect on immune cells and the reaction quickly destroys CD4 count and furthers the disease. Evidence from Langfordet,al,(2007) does provide that low CD4 is associated with low vitamin D in HIV paitents knowing that, CD4 count are low compared to intracellular pathogens .
Moreover Sun (2010) suggests, enough vitamin D can help increase that natural immune system, fight pathogens, regulate infected CD4 cells and other immune cells. Vitamin D can reduce the progression of HIV progression through CD4 response, recognizing cytokines secretions.
References
Diamond, T., Levy, S., Smith, A. and Day, P. (2000). Vitamin D deficiency is common in muslim women living in a Sydney urban community. Bone, 27(4), p.27.
Djukic, M., Onken, M. L., Schütze, S., Redlich, S., Götz, A., Hanisch, U. K., … & Bollheimer, C. (2014). Vitamin D deficiency reduces the immune response, phagocytosis rate, and intracellular killing rate of microglial cells. Infection and immunity, 82(6), 2585-2594.
Giusti, A., Penco, G., & Pioli, G. (2011). Vitamin D deficiency in HIV-infected patients: a systematic review. Nutr Dietary Suppl, 3, 101-111.
Holick, M.F. (2007). Vitamin D deficiency. New England Journal ofMedicine, 357, 266–281.
Holick, M. (2007). Vitamin D Deficiency. New England Journal of Medicine, 357(3), pp.266-281.Prietl, B., Treiber, G., Pieber,
The Impact of Electronic Health Record (EHR) Systems on Healthcare Delivery in Australian Hospitals
Abstract
Variations in healthcare needs of today’s population compel modern healthcare organizations to change the manner in which they deliver healthcare. A good number of contemporary healthcare organizations have taken advantage of advancements in information technologies, and they increasingly integrate electronic health record (EHR) systems into healthcare delivery.
The current study aims at finding the impact of electronic health record systems on healthcare delivery in Australian healthcare organizations. The study will utilize a theoretical research approach that involves a review of records of selected companies in order to obtain relevant data. Findings obtained from this study will be used to advise modern healthcare organizations on some of the reasons why they should either adopt or avoid implementation of electronic health record systems.
The Impact of Electronic Health Record (EHR) Systems on Healthcare Delivery in Australian Hospitals
1.0 INTRODUCTION
With the rapid rate of advancements in information communication technologies, contemporary healthcare organizations have integrated electronic health record system into healthcare delivery to match healthcare needs of the current population (Zeng, 2016). An electronic health record (EHR) system is a computerized version of a patient’s health data, including past medical history, laboratory reports, vital symptoms, demographics, medications, and progress notes, that can be shared among healthcare practitioners within a healthcare organization (Bowman, 2013).
According to Gao, Sorwar, and Croll (2013), Australian healthcare industry began to consider electronic health record systems in 2000. Since then, many hospitals in the country have made an effort to develop and implement electronic health record systems. As opposed to the traditional paper records system, it is anticipated that electronic health record systems will enhance the quality of care, minimize medical errors, improve patient satisfaction, and reduce healthcare costs in Australian healthcare organizations (Gao, Sorwar, and Croll, 2013).
This proposal will direct a study on the impact of electronic health record systems on healthcare delivery in Australian hospitals. It provides a detailed analysis of existing body of literature on the study topic. Additionally, the paper outlines the procedures and processes that will be followed to gather data to answer the research question. It also highlights the relevance of the study approach as well as the implications of study findings.
1.1 Problem Identification
Traditionally, hospitals used to rely on paper records to keep important medical information of patients. Although clinicians used well-organized templates to document their patient’s health data, retrieving this information was sometimes difficult due to illegible handwriting. Furthermore, the handwritten information could not be shared among healthcare providers through computer systems.
Paper records were also easy to destroy, thereby resulting in loss of patient’s data. Advancements in information technology systems allow contemporary healthcare organizations to store patients’ medical data electronically to allow easy sharing and analysis. The number of hospitals which are implementing electronic health record systems is on the rise in today’s society due to the anticipated benefits of this new technological advancement.
In order to help Australian hospitals to evaluate the financial feasibility of implementing electronic health record systems, it is important to investigate and reveal the nature of impact that an electronic health record system has on healthcare delivery.
1.2 Significance of the Problem
An electronic health record system makes it much easier to track and retrieve patient data as compared to paper reviews. Availability of these systems in hospitals makes patient information available to authorized healthcare practitioners who may need it within the organization. For this reason, healthcare organizations that use electronic health record systems are highly likely to have a form of healthcare delivery that is different from those organizations that use paper records (Bowman, 2013).
1.3 Research Question
Have electronic health record systems improved healthcare delivery in Australian Hospitals?
1.4 Hypotheses
Alternate Hypothesis (H1): Electronic health record systems have improved healthcare delivery in Australian hospitals
Null Hypothesis (HO): Electronic health record systems have not improved healthcare delivery in Australian hospitals
1.5 Variables
Independent variable; an electronic health record system
Dependent variables; health care quality, medical errors, and patient safety
2.0 LITERATURE REVIEW
A number of studies have been performed with the aim of finding out the benefits of electronic health record systems as far as their influence on clinical outcomes is concerned. The main clinical outcomes that have been the center of focus in a large percentage of these studies are patient safety, healthcare quality, and medical errors (Menachemi and Collum, 2011). Healthcare quality is achieved when the healthcare provider delivers the right type of care, in the right manner, at the right time, and to the right patient, with the aim of having the best results possible.
In order to maximize patient safety, healthcare providers must avoid injuries for their clients and ensure that services offered are able to generate the intended help (Gao, Sorwar and Croll, 2013). As Gao, Sorwar and Croll (2013) explain, medical errors are minimized during care delivery when data is entered accurately and when there is clarity of medical records. According to Menachemi and Collum (2011), electronic health record systems generally minimize medical errors, improve health care quality, and enhance patient safety.
In a survey conducted across Australian health organizations in 2015, Australian Digital Health Agency revealed that electronic health records have got numerous benefits for healthcare providers which translate into improved healthcare delivery for patients. According to the Australian Digital Health Agency (2015), electronic health record systems enable healthcare providers to spend more time with their patients as they do not have to waste time looking for clinical information.
This gives patients an opportunity to share their important health information with health care providers thereby contributing to improved health care quality. Furthermore, healthcare providers in Australian health organizations which have implemented electronic health record systems are able to closely monitor their patients’ progress, including those with chronic health problems, while at the same time offering them necessary medical support. This helps patients to have a comprehensive understanding of their health problems (Australian Digital Health Agency, 2015).
Australia is one of the industrialized countries which support the integration of electronic health record systems into healthcare delivery. The version of electronic health record system which majorly operates in Australia is the Personality Controlled Electronic Health Record (PCEHR) system (Gao, Sorwar and Croll, 2013). The Australian public has demonstrated support for PCEHR system due to a number of benefits they have experienced since its adoption.
For instance, with PCEHR systems, patients can now have immediate access to their health information, easily track their prescriptions and medications, as well as make necessary changes to their health records. Basically, PCEHR system has helped Australian healthcare organizations to keep accurate patients’ health records, deliver the right care at the right time, and to maximize patient safety (Gao, Sorwar and Croll, 2013).
Several researchers agree that electronic medical systems are associated with reductions in medical errors in healthcare organizations because they improve the accuracy with which patients’ health data is maintained (Menachemi and Collum, 2011). In a study conducted by Bates, Leap, and Cullen (1998), an electronic health record system reduces medical errors in healthcare settings by approximately 50 percent.
In a similar study, Bowman (2013) found out that computerization of patients’ health data results into an error rate reduction of approximately 10 percent. These findings indicate that clarity and accuracy of medical records are greatly enhanced with the use of electronic health record systems in healthcare organizations.
Although electronic health record systems generate numerous benefits, healthcare organizations serious negative consequences by adopting the technology due to inappropriate design choice and careless use (Bowman, 2013). For instance, poor design choice of an electronic health record system will increase medical errors instead of reducing them. Additionally, poor use of the system may interfere with the integrity of data thereby endangering patient safety and decreasing the quality of care (Zeng, 2016).
In most instances, these are unintended consequences which may make an organization to face lawsuits and pay huge legal fines. As health information technology becomes increasingly involved in the delivery of care, healthcare organizations must be prepared to manage HIT-related risks which may damage their reputations if no appropriate actions are taken. The most appropriate ways through which such risks can be avoided are; choosing appropriate electronic health record system design, and ensuring proper use of the system (Sitting and Singh, 2011).
3.0 METHODOLOGY
The study will involve a detailed analysis of the impact of electronic health record systems on healthcare delivery in Australian hospitals. The first step of the study approach will involve selecting Australian health organizations which have already adopted electronic health record system. A list of this category of hospitals will be obtained from the Australian Public Health Database. Top 30 largest hospitals which have adopted the EHR systems will be used in the study.
The Chief Executive Officers of the selected organizations will be contacted via email in order to obtain an appointment to visit their organizations. The chosen healthcare organizations will be visited physically in order to obtain consent from them and to request usage of their health records for purposes of the study. During the visit, the Chief Executive Officers will be informed about the purpose of the study, the study objectives, how research findings will be used, benefits of taking part in the study, as well as the risks involved. Only those organizations that will agree with the provided terms will be used in the study.
Under the permission of Chief Executive Officers, health records and annual reports of the selected organizations will be reviewed. Changes in a number of factors will be recorded from when the selected companies used paper-based records to the period following adoption of the electronic health record systems.
Specific items which will be extracted from the health records include changes in; patients’ waiting time, the manner in which care is delivered, clarity of medical records, the accuracy of patients’ data, recovery period, readmission rates, and death rates. Similar data will be collected across all healthcare organizations which will have agreed to take part in the study. The collected data will be analyzed using Statistical Packages for Social Sciences (SPSS) software.
4.0 DISCUSSION
4.1 Relevance of the study approach
The proposed methodology is highly appropriate for this study because it will help in gathering data that will best answer the research question. A list of Australian healthcare organizations which have adopted electronic health record systems is found in country’s Public Health Database. The rationale behind selecting top 30 largest organizations in the list is the large volume of relevant data that these organizations can provide.
In addition, it is important to obtain consent from the Chief Executive Officers of the selected organizations due to high privacy concerns associated with the release of important health records. The Chief Executive Officers of the chosen health care organizations must be convinced that their health records will be used solely for purposes of research before they can allow anybody to access them.
The effectiveness of healthcare delivery in hospitals are best measured in terms of major clinical variables namely; quality of care, medical errors, and patient safety (Gao, Sorwar and Croll, 2013). The type of data collected during health records’ review can easily tell the degree of health care quality, medical errors, and patient safety in the selected hospitals. For instance, data related to changes in patients’ waiting time and the manner in which care is delivered will help the researcher to understand the quality of care in the selected organizations.
Data related to changes in clarity of medical records and accuracy of patients’ data will tell more about medical errors, while data related to changes in the recovery period, readmission rates, and death rates will inform the researcher more about patient safety in the selected hospitals. By analyzing the collected data using SPSS software, the researcher will be able to see the impact of electronic health record systems on healthcare delivery in Australian hospitals. This research approach will help the researcher to easily answer the research question.
4.2 Limitations of Methodology
The main limitation of the methodology is reviewing health records of only 30 hospitals. By limiting the data collection process to only top 30 hospitals which have already adopted electronic health record systems, the researcher may leave out other small hospitals which might have successfully adopted HER systems, and which may have better information than the organizations used.
The other limitation of the methodology is over-reliance on secondary data which is available in company records and annual reports. Conducting actual research would produce more accurate data because the validity of information available in company records might be questionable.
4.3 How the study findings may lead to further research
The proposed study focuses on how clinical factors may be impacted by the adoption of an electronic health record system. For instance, in the study, the researcher intends to evaluate how electronic health record system will impact health care quality, medical errors, and patient safety in Australian hospitals. Findings obtained from this study can guide further research on the impact of electric health record systems on organizational factors such as healthcare cost.
5.0 CONCLUSION
The number of Australian hospitals which are adopting electronic health record systems is on the rise. Australian healthcare organizations which are implementing electronic health record systems anticipate that the new technology will help them to improve the quality of care, minimize medical errors, improve patient satisfaction, and reduce healthcare costs.
Prior to spending a lot of money in the implementation of electronic health record systems, Australian healthcare organizations should be aware of the financial feasibility of implementing those systems. Making a decision of whether the approach is financially possible requires a comprehensive knowledge of the nature of impact that EHR systems will have on the quality of care, medical errors, and patient safety.
The proposed study intends to investigate whether electronic health records systems have improved healthcare delivery in Australian hospitals, by focusing on three variable; quality of care, medical errors, and patient safety. A comprehensive analysis of available literature has been conducted to show previous studies on the topic.
In addition, a methodology that will help to answer the research question has been identified. Findings obtained from this study will be used to advise modern healthcare organizations on some of the reasons why they should either adopt or avoid implementation of electronic health record systems.
Bates, D., Leap, L. & Cullen, D. (1998). Effect of computerized physician order entry and a team intervention on prevention of serious medication errors. JAMA, 280(15):1311-1316.
Bowman, S. (2013). Impact of electronic health record systems on information integrity: Quality and safety implications. Perspectives in Health Information Management, 10(Fall):1c.
Gao, J. X., Sorwar, G. & Croll, P. (2013). Implementation of E-health record systems in Australia. The International Journal Technology Management Review, 3(2):92-104.
Menachemi, N. & Collum, T. H. (2011). Benefits and drawbacks of electronic health record systems. Risk Management and Healthcare Quality, 4: 47-55. Doi:10.2147/RMHP.S12985
Sitting, D. F. & Singh, H. (2011). Defining health information technology-related errors. Archives of Internal Medicine, 171:1281.
Zeng, X. (2016). The impacts of electronic health record implementation on the health care workforce. North Carolina Medical Journal,77(2):112-114. Doi:10.18043/ncm.77.2.112
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MacArthur, John and The Master’s Seminary Faculty, Pastoral Ministry. Nashville, TN: Thomas Nelson, Inc, 2005.
Summary
The book is centered on a running theme of character that is above reproach as a pastor in the call to lead the church. Two broad views are expounded on and broken down into four perspectives from which he gives a more detailed discourse. Integrity and leadership are two themes which are interlinked and which of necessity cannot be divorced from each other. Integrity must be above reproach (1 Timothy 3: 2, ESV), implying deadness to self and not moral perfection .He says “anything else is an abomination to God and spells doom for the life of the church”.[1]
Leadership is elevated to giving moral direction and also providing spiritual protection as a shepherd. The pastor has the responsibility to invigorate the church by inspiration and motivation with himself as the role model. Alex D Montoya writes: “It is not enough to be at the front of the pack; the leader must do also inspire the pack and do it with a willing and enthusiastic attitude.”[2]
The above themes are the foundational themes on which the perspectives are expounded. Biblical, Preparatory, Personal and Pastoral perspectives are discussed and the way they affect leadership in the church. In the preparatory perspective, sexual morality is emphasized as being a cornerstone in benchmarking the character of a pastor.
The ability of a pastor to effectively govern his household is given prominence in Personal perspectives, as failure to do so would affect the ministry negatively The importance of living by example off the pulpit is highlighted in Pastoral perspectives. Practical Christianity by the pastor brings a good image to the church.[3]
Critique
I agree with the author’s position of leadership and humility which is a trait frowned upon in the American society today. He emphasizes the need to lead by serving with humility as Christ taught the church. This is lacking in todays so called “mega churches” where pastors are taken as small “gods”.
Sexual sin which is damaging to the image of the church is another point in which I concur with him. This sin has made many churches to diminish in congregational membership as well as retiring once promising clergy who fell into sin. Impurity of the sexual nature is not only limited to sex, but also watching pornography and “sexting” which all sins are. Public integrity is equally important to private integrity, as one is interlinked with the other. Pastors need to embrace and practice both of them.
Two points of divergence are on the radical position taken on sexual purity before ministry and children who may reject the truth. The author states that there must be no sexual immorality even before one got saved. Then where is mercy and grace applicable, since all have sinned and fallen short of the glory of God? (Romans 3:23, ESV).The essence of Christianity is based on a fallen humanity which needed a savior.
The call into ministry is followed by a process of justification and perfection. (Romans 8:29, ESV) Impure sexual thoughts would disqualify all pastors if an honest survey was to be undertaken to gauge purity before ministry.
Another point I differ with the author is if children of a pastor reject the truth, then he is disqualified from serving as a pastor. Many good men would fall short of this bar, yet the same children can reform and embrace Christ down the line. The family is the smallest unit of the wider church and differences in opinion between a pastor and his children will be expected. Rejection of the truth could be as result of rebellion against authority as a teenager, but later accepts Christ with maturity and introspection.
Evaluation
MacArthur and his team have contributed to academic discourse which is both practical and pastoral. This book has value in reading by both the church congregants and pastors, but can also be used in Bible Colleges and Seminary in their course work. His book adds value in the preparatory perspective of leadership training with concise and academically and reasoning.
The book is not a long and boring academic presentation of facts and figures, but it challenges the reader to take action. Its approach enriches the academic literature on leadership with a strong emphasis on integrity. His work carries the hallmark of excellence academically, since the author is both a pastor and a tutor in a Seminary and his work-life balance can be practically interrogated.
Many scholars base their work on theory, majoring on the academic treatise only, having value only inside the classroom and nothing else.5This author has balanced academic quality with practical significance.
Bibliography
DISSERTATION NOTICES. The Journal of Applied Christian Leadership, 8(2), (2014).110-115. Retrieved from https://search.prquest.com/docview/1754574556?accountid=45049 MacArthur, John and The Master’s Seminary Faculty, Pastoral Ministry. Nashville, TN: Thomas Nelson, Inc, 2005.
[1] MacArthur, John and The Master’s Seminary Faculty, Pastoral Ministry. How to Shepherd Biblically. Thomas
One of the guidelines of the Institutional Review Board (IRB) pertains research expounds about red flags of research that require Research Ethics Consultation. This guideline can affect the research process and the research approval process mainly because if a researcher wants to conduct research and collect data about sensitive topics or vulnerable population he/she is required to obtain ethics guidance that should be incorporated into research planning.
Examples of vulnerable populations that have been stipulated by the Institutional Review Board include the following; minors, that is individuals who are below 17 years, prisoners, mentally impaired or disabled persons, and undocumented immigrants, residents in nursing homes, patients of the research or adult students of the researcher (Chew-Graham, 2016).
Vulnerable populations can affect the research population because one should evaluate the degree to which it is appropriate to include the vulnerable populations in the research or if it is necessary to carry out research using information from individuals who do not have decision-making capacity such as the mentally disabled individuals as required by the research approval process guidelines.
Information from some of these individuals should also not be disclosed to the public; this, therefore, poses a challenge to the researcher when it comes to the presentation of the research findings. Chew-Graham (2016) reports that when dealing with vulnerable groups, it is advisable for one to consider any possible adverse impact that inclusion of the participants such as minors may have in later stages.
The Walden IRB also offers direction on the use of Archival researchers (Beyer et al., 2016). Mostly private or public records are used to provide IRB approval before data is analyzed. The IRB protects the data of the stakeholders. Therefore, when doing research one will ensure that he/she does not use an organization’s data without permission. If so, then the report should indicate the source of the data to avoid plagiarism issues with can prompt stakeholders to press charges against the researcher.
References
Beyer, T., Tiehen, J., Mahato, M., Ferrari, L., & Ramakrishnan, S. (2014). Institutional Review Board.
In the case of Talia, several questions ought to get researched on because of the massive effects a victim of rape undergoes. However, the author has critically analyzed and chose the following two questions as the most appropriate in providing a reliable solution for this persistent and growing menace. The questions include:
Why is it suitable for a victim of rape to open up to someone they trust about the condition?
How has the enacted laws and rules affected the issue of rape cases?
The first question is vital in the sense that it explores the reasons for the victim of abuse to report the case instantly. Talia Johnston failed to report her case to anyone for about three weeks a condition that left her with painful scars she wouldn’t bear. This question, therefore, would help the researcher to seek for new and appropriate reasons for the victim to share the occurrence.
It would lead to the enhancement of new knowledge in the field of art. Through informing a person about the case of rape, then greater and efficient interventions will transpire (Lisak & Miller, 2002). Besides, the process of healing of the victim would become faster, and hence there would be social change. The question will as well open a good way for more research to erupt.
Also, the question “How has the enactment and implementation of rules and laws impacted the issue of rape cases?” is very crucial. In essence, Talia went through a traumatic condition because of sexual abuse by an unfamiliar person. The question would lead to the exploration of the impacts that lack of law application can result in dire effects altogether as detailed by Lisak (2006).
This would add a lot of knowledge for social work. Besides, a critical analysis of how these rules have affected the number of rape cases need to be carried out. There would as well be a positive impact on the social change of the approach taken concerning rape cases. Answering the question would assist greatly in more research to get done about sexual assault.
The author has selected the resources by applicability, the content in the articles and the recentness year of publication of the articles. The content of the two articles would aid in answering the above questions critically.
Major facts, in this case, include Dell’s strategies involving direct sales, product customization and stakeholder engagement and the changing competitive environment. These are strategies that have worked for Dell in its quest to provide customers with the highest quality products. A focus on direct sales has ensured that Dell can reach its clients and meet their needs better.
Engaging suppliers as important stakeholders of the organization have enhanced Dell’s manufacturing strategy of mass customization by ensuring that supplies are made just-in-time and with short lead times. Dell utilizes focused mass customization where a limited number of common platforms are manufactured and then customized to meet customer needs. This has created more demand because customers demand unique products. Despite the success in strategy, downward price pressure, competition and a weakening market position challenge the company’s survival.
Major problem
Dell faces a weakening market position, perpetrated by the intense competition in the marketplace, combined with downward price pressure.
Possible Solutions
Dell has various options that it can consider in increasing its market share and absorbing downward pressure as follows.
New products: Diversification can be a viable option for Dell and may involve developing more advanced computers and laptops to meet competitors such as Apple. It could also invest in new products such as smartphones whose demand is currently high in the market. This has the advantage of attracting a larger market share but may be expensive to implement (Hans-Ruediger, 2014).
Cost-cutting measures: To increase profitability and counter falling prices, Dell can revise costs in its production system by reducing wastage, streamlining processes and automation. The advantage of this strategy is that it increases returns through reducing the company’s production costs. However, it may impact on process quality when important aspects are eliminated or downsized. Ethical issues may also arise from some steps such as employee layoffs and automation which creates unemployment (Ciravegna, Fitzgerald & Kundu, 2013)
Increased Marketing: Dell could increase its market position through increased advertising of its products. This will ensure that more customers are aware of their products and capabilities, thus improving the market (Kotler & Armstrong, 2015). This has the advantage of increasing product visibility and increasing market share. On the other hand, it may be very costly to implement.
Invest in more advanced research and development: Technology is changing rapidly, and to benefit from the growing market, companies must provide clients with unique products that meet their needs. This calls for investment in research and development to promote the development of advanced products (Ciravegna, Fitzgerald & Kundu, 2013). While new products will increase the company’s market position, research and development are very costly, especially where customer demands keep changing.
Choice and Rationale
New product development is chosen as the best choice of strategy for Dell to pursue. This is because the current customer is increasingly demanding more sophisticated technology and companies that take the opportunity to satisfy this demand will capture a large market share.
Dell should invest in more advanced computers to serve different customer needs. I did not choose cost cutting as the best strategy because Dell has already implemented cost cutting measures before including the laying down of staff. The company may not be ready for more cuts as it would impact its performance. Increased marketing and research and development would come automatically if Dell chooses the new product strategy.
To succeed in new product development, Dell would need to invest in research and development to ensure the production of sophisticated products, which would later be followed by marketing to promote sales (Kotler & Armstrong, 2015).
Implementation
New product development will be achieved using the following plan.
New Product Development Implementation Plan
Objectives
Develop ten new computer models in the next yearIntroduce a smartphone range with ten new models in the next two years
Strategies and procedures
Appoint a marketing research team to explore the market on new technology trends and demandsFund the research and development unit to conduct research on new technologies Train the team on new technologies and aspects of the smartphone marketDevelop new products based on the research and development team’s recommendations
Timelines
July 2017 – July 2019
Person(s) responsible
Chief Executive OfficerResearch and Development ManagerInformation Technology Manager
Budget
$ 130,000,000
References
Ciravegna, L, Fitzgerald, R. & Kundu, S. K. (2013). Operating in Emerging Markets. A GuideTo Management and Strategy in the New International Economy. Pearson: FT Press.
Hans-Ruediger, K. (2014). Handbook of Research on Managing and Influencing ConsumerBehavior. Hershey, PA: IGI Global
Question 1: Fundamental reasons for Dell’s success
Some of the most fundamental reasons for Dell’s success include direct sales, focus on partnerships and product customization. By focusing on selling direct to the customer, Dell had an opportunity to interact with its clients and thus understand their needs better. Building effective relationships with suppliers and linking them to production systems ensured that Dell could implement its production strategy, which included the just-in-time supply of components to save time and warehouse costs. Product customization played a role in increasing demand by providing products that met customer expectations (Hans-Ruediger, 2014). Mass customization was also effective I saving costs.
Question 2: Maintaining competitive advantage and viability of business model
As customers’ needs continue to change amidst increasing competition, Dell should invest in research and development and leverage the social media strategy to maintain its competitive advantage. Research and development will ensure that the company can come up with innovative products to meet the needs of its customers (Ciravegna, Fitzgerald & Kundu, 2013).
Social media is the novel platform that contemporary organization must maximize on to reach existing and potential customers, given the advancement in technology and potential to reach customers across the globe. As part of the organization’s strategy that involves direct customer sales, Dell could reach more customers to increase its sales while engaging them directly to get feedback about its products.
Question 3: Will Dell formula work elsewhere?
The Dell formula is highly successful and can be replicated elsewhere. Customization is a growing trend, informed by customer demand to have products that meet their unique needs. By adopting customization, companies could gain a higher market share. It is notable that creating good relationships with customers and stakeholders can yield great outcomes through better quality products and efficiency.
However, the just-in-time formula and direct sales may not work for all companies. Businesses that thrive on mass production, for example, require regular supplies and warehousing is necessary to meet demand. Direct sales may not work for most consumer products because there need to be middlemen to connect geographical boundaries and enhance availability in locations nearer to the customer. Direct sales would also be costly for the organization (Kotler & Armstrong, 2015).
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The protestant reformation movement was started as a way to repudiate some of the long-held beliefs that had been propagated by the Catholic Church. The growing sentiments against the tight control the papacy had over religious expression contributed to the eventual schism between the reformers and the Catholic Church. The Protestant Reformation had two critical components: Lutheran and English Reformation.
Luther is acknowledged as the father of reformation that led to the birth of the Protestant church while the Church of England is credited with leading the way in the later reformation. One of the early reformers who profoundly influenced Reformation was John Calvin.
Calvin was pivotal in moving forward the reform agenda but was also vilified by his detractors for some of his teachings such as predestination, weak personality, false spirituality and his participation in the Servetus execution. The following critical review is based on the literary work by Bernard Cottret, Calvin, A Biography: A Biography (2003).
Background History
John Calvin or Jean Cauvin according to French pronunciation was born on July 10th 1509 in France in Noyon Picardy and died at a relatively young age of 55 years in the year 1564. Calvin was born into a family of parents who came from the middle class, with his father being employed in the service of the local bishop[1]. The employment of his father affected his initial decision to send him to further his studies as a priest but later changed his mind and decided to enroll Calvin for training as a lawyer.
According to Cottret[2], Calvin was trained as a lawyer in Orleans and Bourges in the law schools that operated there. While studying, Calvin was profoundly impacted by the emerging ideas of Erasmus which centered on RenaissanceHumanism[3]. Renaissance Humanism aimed to reform the status quo of the church and society, and this laid the foundation for Calvin’s involvement later in the Reformation movement.
The Renaissance Humanism that emphasized salvation by grace and not good works inspired Calvin to undertake studies in Latin, Greek and Hebrew languages which were the primary languages of discourse in Christian antiquity. His studies eventually led him to write his first discourse on clemency based on the commentaries of Seneca in 1532. Bouwsma[4]
Posits that the growing lack of tolerance in Paris to the reform movement forced Calvin to relocate to Basel where his conversion grew stronger as he engaged in intensive studying of the scriptures and theology. This time that was spent in Basel resulted in the first writings of what would later constitute his masterwork publications- the Institutes. This paper in the Institute gave him prominence within the Protestant movement and led leaders of the movement to seek him out as an authority in the movement.
In 1536, Calvin was invited to extend his stay in Geneva where he was temporarily staying, to strengthen the Protestant movement in the town[5]. He later came back to Geneva in 1541 and contributed to the change of leadership of the town under his ordinances. The town efficiently was run under the concepts postulated by Calvin which included the enforcement of morality laws and the abolition of abortion.
Calvin instituted leadership and laws that were meant to make the town to be aligned to the laws of God. The measures initiated by Calvin were humanist in nature including setting up an Academy to train for positions of leadership that were secular based on humanist principles. He is criticized for this period of his life for leaning more on principles that espoused humanist beliefs rather than doctrinal teachings by his detractors.
Calvin was instrumental in making sure that there was continuity in the reformation movement by giving refuge to protestant refugees fleeing religious persecution. The refugees came from as far as England while others came from France. One such refugee who went back to change his country positively was John Knox from England who found refuge in Geneva under the control of Calvin. Many refugees who sought protection in Geneva were drawn to Calvin and to his teachings on reformation which they took back home with them[6].
The school of theology he founded in Geneva was outstanding in offering training for the refugees who went back home after receiving theological training. According to Treasure[7] Calvin was involved in sending back home to France more than 100 Reformed missionaries, and this was critical in strengthening the Reformed Church in the early years of the Reformation.
Criticism
Personality- Calvin was a man whom many considered cold and impersonal when compared to Luther who was considered warm and approachable. His perspectives in life were considered as abstract rather than ideas that were practical for everyday Christian living. This writing was more his solace that portrayed him as a person who lived in his world, cut off from the ordinary laity.
His introvert character could have been caused by feelings of inadequacy about salvation, and these inner deficiencies made him a man of letters. His character of being cold and aloof could also have been contributed to his early upbringing in a class that was relatively privileged and cut off from the common people. The writings were only beneficial to a few within the circles of the Protestant movement much in the same as most liturgical readings in the Catholic Church.
The character of the man Calvin is seen today in Calvinists who today come across as being unemotional, cold and emphasize the ability to control oneself and the environment. This characterization of Calvinists has been an impediment to believers who may embrace the tenets of his philosophy but are put off by the practicality of the ideal Calvinist characterization.
The Institutes- The institutes that were written by Calvin is largely made up of logical and reasoned arguments which are designed to appeal to the academic mind. The writings are more of the personal beliefs of Calvin and which have played a significant role as the central theology of Calvinism. They point to God yet at the same time over emphasize on the frailties of man such as reprobation and depravity. The writings come across as being narrow regarding hermeneutics with the negative portrayal of humanity[8].
Calvin in his writings takes on a prescriptive view of discipleship that is based on instilling fear rather than love. His humanist beliefs are seen to exert influence in his writings where he posits that the middle order of human life is a utility. This emphasis on utility and practicality in Christianity is influenced by his conviction and early influences from Renaissance Humanism. Thus his writings are a strange mix of theology infused with thoughts from the school of humanism.
Calvin rejects some of the sacramental claims of the Catholic Church and retains two sacraments of baptism and the Lord’s Supper in his writings. The point of departure between Calvin and the Catholic Church seem to be superficial as he claims that sacraments are dependent on the faith of the recipient and not on the form of ritual for its sake. This is repudiated in his acceptance of infant baptism which negates the principle of faith by the recipient of the sacrament[9].
His approach to the Lord’s Supper is closer to the consubstantiation position of Luther while rejecting the transubstantiation position of the Catholic Church. His position on the sacrament of the Lord’s Table is thus theologically correct while his position on child baptism is faulty in the same measure.This, therefore, shows his selective rejection of some beliefs of the Catholic Church while holding on to others which question his sincerity as a reformer.
Theology– One of the major criticisms about Calvin is in the theology that he espoused on predestination. According to Perry[10]Calvin posits that certain people were predestined by God to be the “elect” from the foundations of the world. This carries the implications that those who were not predestined were already condemned from the foundations of eternity and therefore no amount of preaching and evangelism can save them.
This presumption by Calvin states that people will be saved and serve God because God chose them and therefore man has no choice in salvation. This is the foundation of Calvinism that is represented by the acronym TULIP. This stands for Total- total inability of man to be good. U- Unconditional election of man. L-limited atonement meaning Christ paid for the few elect.
An i-irresistible meaning man has no choice. P-perseverance meaning that one is always saved if chosen to be among the elect few.The theology of Calvin is therefore unsound due to the shortcomings that are in contrast to the scriptures.
His theology negates the tenets of evangelism since God has already chosen the select fewhe predestined[11]. It negates prayer for family, friends and the sick. It implicitly implies that God is complicit in creating sin. The assumption that man is incapable of being good implies that man cannot be truly remorseful or to repent truly. If man cannot be truly good, he cannot be faulted for acts which are considered sin.
The eternal condemnation of the non-elect portrays God as an unjust God by the concept of double-predestination[12]. John 10:11 states that Christ died for all and not a few elect while James 5:19-20 warns against going back to the sinful ways of the world. This is contrary to Calvinist theology that once a person is saved, they will stay saved.
Protestant Work Ethic– Calvin is credited as being one of the founders of the philosophy known as the Protestant Work Ethic. This philosophy postulates that work is a path to salvation or deliverance. This was from the earliest theology that was developing from the Protestant church, influenced by teaching of Lither on work as a calling or beruft. Calvin expounded on this early thoughts based on his Calvinist ideology that the elect should work daily to perfect their calling with regards to righteousness.
His time spent in Geneva contributed in shaping his thoughts on the work ethic from a Protestant view. While at Geneva, Calvin espoused teachings that work was more beneficial to God than the individual and thus disdained accumulation of wealth. The role of work was to serve God and his work (evangelism) and to serve one’s, neighbor. This is a false premise according to the scripture as seen in 3 John 1:2 which openly shows that it is the will of God for Christians to prosper.
The philosophical teachings of Calvin based on his ideology of Calvinism was contrary to the belief that self-improvement was a viable attainment of work.[13]This is based on his humanist philosophy rather than Scripture which declares that we are expected to be fruitful and to grow ( 2 Peter 1: 8, Genesis 1:22).[14]The humanist philosophical ideals of Calvin which he institutionalized in literature distort the foundational constructs that are scriptural.
The Calvinist ideals that founded the false premise of the Protestant work ethic have a wrong foundation from that man was doomed to work after his fall. Work is not necessary to expiate humankind before a merciful God rather it is an extension of the divinity of God in his creation. This is because God is a worker having created the world in six days and rested on the seventh day ( Genesis 2:2)[15]
Prosperity comes with diligence and self-improvement which leads to the creation of wealth as seen from the scriptures in Proverbs (12:14, 27: 18-27).[16] Work for its sake as the center of moral life and as a measure of virtue and worth is less of scripture and more of Calvinist philosophy. The encouragement of labor as way to edify the Church laid the foundation for Capitalism as part of the Protestant work ethic. Capitalism brought sweeping beneficial changes to the society but also resulted in great inequalities in equal measure.
Spirituality- Calvin posits two metaphors for the Christian life that are found to be wanting from practical application in everyday Christian living. The first metaphor he posits is to compare the life of a Christian to that of a soldier who is called to live a life of rigorous discipline. The Christian soldier is called to bear arms in war against his wickedness in the flesh while learning from the punishments that are visited upon the wicked.
This can be traced to his stay at Geneva where he controlled the town and enforced his strict interpretations of morality according to scripture. The citizens of Geneva who resented his teachings were punished for their intransigence including hangings so that others could learn from such example[17]. The belief that other people suffer so that the elect can learn from their sufferings is false spirituality with no Biblical foundation.
The belief that the misfortune of other people especially the non-elect helps to purge the wickedness of the elect lacks merit in the scriptures. It, therefore, offers a hollow sense of spirituality to the believer. The suffering of the non-elect could be because of demonic oppression, sin or even for God to be glorified according to John 11:4 (NKJV)[18]. Thus the simplification of suffering of the non-elect to their shortcomings which draws the wrath of God is faulty.
The approach is taken to the Christian life as a perpetual conflict negates the rest that was promised to the body of Christ. The finished work of the cross is not complete without works in the flesh. The Christian is expected to suffer as part of the atonement each pays for sin. The suffering of the elect can thus be seen as a manifestation of inward sin that is not confessed that has drawn the ire of God, and thus the elect is punished with affliction.
Another metaphor Calvin draws is to compare the Christian walk with a journey that strenuously progresses in holiness. The journey in holiness involves progressive sanctification in on a daily basis. This presumption by Calvin is faulty from Scripture and offers a Christianity that becomes strenuous by human endeavor and effort. The scriptures declare that we receive the righteousness of God according to Romans 3:22 which are imputed to be by faith (NKJV).
We cannot increase in righteousness but we can increase daily in faith: “For in it the righteousness of God is revealed from faith to faith; as it is written, ‘The just shall by faith’” (NKJV Romans 1:17)[19]. The pursuit of progressive holiness and sanctification by Calvinists according to Calvin becomes their single-minded goal in their journey of Christianity. The pursuit of the superior virtues may sound spiritual but has no scriptural foundation and therefore sets the Calvinist adherent on a journey of false spirituality.
Apologist– In the tradition of the founding fathers of the Reformation who were apologists, Calvin comes across as a weak apologist. Calvin in his Institutes posits that faith is always reasonable even though it may appear at times as being reasonable. This is contrary to the leanings of other apologists like Luther who steadfastly faith is unchanging and central to understanding the workings of God in human affairs.
This is seen when Calvin wrote an epistle dedicated to King Francis who was purging the early reform movement in Paris. The dedicatory epistle sounds more like a letter of apology from an individual who seems to be undergoing internal struggles as to his beliefs. This epistle questions his true allegiance to the Reformation movement as it introduces some skepticism as regards his core theology.
This epistle can be interpreted as the surest sign that Calvin was still willing to make a rapprochement with the Catholic Church and thus not a true reformer. It could also be due to his belief that rulers and authorities could be instrumental in propagating the reform movement.[20]
Michael Servetus– The role that Calvin played in the execution of Michael Servetus helped put a blemish on his beliefs which were compared to the Catholic Church from which he had broken way from. Servetus was of the same age as Calvin and equally learned in theology but was considered a heretic by both Catholics and Protestants[21].
While fleeing from certain death from Roman Catholic authorities; he entered by chance into a church where Calvin was preaching. Calvin ordered his arrest, and he was subsequently charged with heresy and blasphemy. This arrest of a non-citizen of Geneva has raised questions as to the legality of his arrest and subsequent execution by burning at the stake[22].
The Protestant Council that tried him condemned him to death at a time when Calvin was in charge of the city of Geneva. Calvin is accused of not being forthright for his role in the execution of Servetus especially for a movement that was based on reform.
The execution by the Protestant church under a leading reformer such as Calvin was no different from the practices that had estranged the movement from the Catholic Church. Burning at the stake was the common form of execution for heretics, some of whom were innocent. The expected reforms within this movement included the forms of punishment that were to be meted on heretics such as imprisonment.
The decision to follow in the traditional Catholic forms of punishment was blight on the record of the early reformers under the leadership of Calvin. The practice of burning at stake had been misused by the Catholic Church, and this execution of Servetus negatively impacted the gains that were being made by the Protestant Church[23]. Most reformers of this period rejected the verdict that was reached by the council under the leadership of Calvin as being anti-reformist.
Missionary Work– The perspective taken by Calvin on evangelism and missionary work is faulty and is a product of his humanistic philosophy combined with theology. Calvin believed that Christian rulers and magistrates could play a major role in spreading Christianity. This is seen from his belief that the ascension to the throne by Queen Elizabeth in 1558 could help propagate Christianity[24].
The lack of demarcation between Church and the State could also have been influenced from his time as the chief authority in the town of Geneva where he sought to join the Church and the civic authority. This is also seen from his correspondence with Jeanne d’Albret who was a woman from the French nobility to support the reformation in France[25].
His approach to missionary work was more from a theological perspective rather than from a practical approach. He believed more in sending literature to the mission fields rather than personally engaging on the ground. His academic approach to evangelism could partly have been influenced by his doctrinal beliefs in predestination.
Assessment
John Calvin played an important role within the reformation movement that led to the growth of a strong and vibrant Protestant Church as it stands today[26]. His scholarly approach to interpreting Scripture made him write several Bible commentaries on the New and Old Testament. He is credited as being the founder of the Presbyterian system of church leadership which is widely used today by most churches.
The structure he founded on church government has remained largely unchanged to this day. The theological principles he posited laid the foundation of Calvinism and the modern day Calvinist Church. His influences can be seen in the Reformations that were impacted by his works in churches in Scotland, France, and Germany. His works also affected the Baptist Church tremendously as well as the churches that were planted in North America.
The influence of Calvin was not only limited to the church but also contributed to the aspects of Western civilization such as capitalism and Puritanism. His writings contributed to the development of the concept of the Protestant work ethic and capitalism. His writings on theology also contributed to the corporate body knowledge within Christianity[27].
His influence on leading reformers of his time impacted the reformation with his focus on his peculiar form of evangelism by writing letters. His writings and focus on distributing the Bible as well as his writings helped to propagate the gospel across Europe and the rest of the world. His thoughts on morality and ethics have contributed to the development of the philosophy of Humanism as well as Utilitarianism.
Despite his divergent views from some leading reformers such as Martin Luther, Calvin made significant contributions as an apologist for Reformation as well as a Bible expositor of his generation. He lived a life that was predestined to make an impact that is still felt in this generation.
Conclusion
The life of John Calvin was a life that was lived to the dedication of reforming the body of Christ. The pursuit of education in his formative years was instrumental in shaping his mental astuteness that would be pivotal in his theological studies. The early proponents of Renaissance Humanism inspired him on the journey to a deeper study of the scriptures and led him to begin his writings. The works of Calvin have both positive and negative aspects that are attached to them.
Critics of Calvin majorly criticize him on his theological perspectives on predestination. Some other shortcomings can be found in his beliefs on infant baptism. His detractors fault his participation in the execution of Michael Servetus. His personality is equally faulted as being a cold and unapproachable person. Despite the many negative aspects of his life and writings, Calvin is still acknowledged today as one of the most influential thinkers in the history of the church and therefore a church Statesman.
Cottret, B. Calvin, A Biography: A Biography. London: Continuum International Pub. Group.(2003).
Gordon, B. John Calvin’s Institutes of the Christian Religion: A biography. Princeton, NJ: Princeton University.(2016).
Goroncy, J. John Calvin: Servant of the Word. In Rae M., Matheson P., & Knowles B. (Eds.), Calvin The Man and the Legacy. ATF (Australia). (2013). (pp. 13-40). Retrieved from http://www.jstor.org/stable/j.ctt163t9d3.5
John. New King James Version. Bible Society. (2012).
Kim, S. Calvin’s Doctrine of Predestination. In Deus provide bit: Calvin, Schleiermacher, and Barth on the Providence of God. Augsburg Fortress. (2014). (pp. 25-86). Retrieved from http://www.jstor.org/stable/j.ctt9m0v8x.7
McKee, E. A Week in the Life of John Calvin. In Rae M., Matheson P., & Knowles B. (Eds.), Calvin The Man and the Legacy. ATF (Australia). (2013).(pp. 61-78). Retrieved from http://www.jstor.org/stable/j.ctt163t9d3.7
Treasure, G. Calvin: THE WAY, THE TRUTH, AND THE LIFE. In The Huguenots. Yale University Press.(2013). (pp. 75-83). Retrieved from http://www.jstor.org/stable/j.ctt5vm0ht.14
[8]Cottret, B. Calvin, A Biography: A Biography. London: Continuum International Pub. Group.(2003). Pg. 320.
[9]Goroncy, J. John Calvin: Servant of the Word. In Rae M., Matheson P., & Knowles B. (Eds.), Calvin The Man and the Legacy. ATF (Australia). (2013). (pp. 25). Retrieved from http://www.jstor.org/stable/j.ctt163t9d3.5
[11]Kim, S. Calvin’s Doctrine of Predestination. In Deus provide bit: Calvin, Schleiermacher, and Barth on the Providence of God. (2014). (pp. 62). Augsburg Fortress. Retrieved from http://www.jstor.org/stable/j.ctt9m0v8x.7
[13] Smith, Virgil O., and Yvonne S. Smith. “Bias, History, and the Protestant Work Ethic.” Journal of Management History 17, no. 3 (2011): 282-98, https://search.proquest.com/docview/875621956?accountid=45049.
[14] 2Peter 1:8 New King James Version, Bible Society, 2012, Genesis 1:22 New King James Version, Bible Society, 2012.
[15] Genesis 2:2 New King James Version, Bible Society, 2012.
[16] Proverbs 12:14 New King James Version, Bible Society, Proverbs 27:18-27 New King James Version, Bible Society, 2012.
[17]Cottret, B. Calvin, A Biography: A Biography. London: Continuum International Pub. Group.(2003). Pg. 220.
[18]John. New King James Version. Bible Society. (2012).
[19]Romans. New King James Version. Bible Society.(2012).
[27]McKee, E. A Week in the Life of John Calvin. In Rae M., Matheson P., & Knowles B. (Eds.), Calvin The Man and the Legacy. ATF (Australia). (2013). (pp. 70). Retrieved from http://www.jstor.org/stable/j.ctt163t9d3.7
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Nursing is a field that has been changing rapidly over the years and along with its good transition is the coming up of various nursing theories (Cowen, 2014). These theories are what the advanced nursing practitioners keep in mind d use as a guide to either give them a sense of direction during work or help them understand and grasp most valuable lessons of nursing. Science based nursing theories specifically have been a backbone of clinical care.
Self-efficacy is a theory by Alberta Bandura that came about from the socio-cognitive approach (Maddux, 2013). This theory acclaims that there exist three aspects that affect self-efficacy, these are the environment, habits as well as personal factors. Schwarzer, (2014) states that self-efficacy theory is exceedingly important for advanced nursing practitioners in that, the goal of all healthcare providers is for people to manage their health (self-efficacy) particularly those patients with chronic illnesses such as diabetes, asthma or hypertension. T
his in a way goes in line with what Bandura concluded in his theory that motivation, performance, and feelings of frustration associated with repeated failures impact an individual’s perception of health.
Another important theory is the tidal model theory by Phil Barker, which emphasizes on helping people to reclaim the personal story of mental distress by recovering their voice. Barker here gives a philosophical approach to the discovery of mental health (Alligood, 2014). For nurses to start using this model in the engagement process, some requirements need to be agreed upon such as change is unavoidable, the patient, in the end, understands what it is best for him or her, and recovery is possible (Monteiro et al., 2015).
For this reason, the tidal model theory is useful for any nursing practitioner since it helps people recover from mental illness. Kurt Lewin born in 1890 came up with the change theory (Burnes, 2017). This theory has three main concepts: Main thrusts, controlling strengths and harmony. What makes or course change to occur are the main thrusts, they bring about the change since they push a patient to in the desired direction.
Controlling strengths are those that hinder the patient since they push the patient in the opposite direction (Monteiro et al., 2015). Harmony is a condition where the main thrust forces equal the controlling strengths forces, and thus no change occurs. This theory inspires nurses to push patients in the desired direction by all possible means.
Finally, The Helvie Energy theory addresses the notion of energy. In this theory, the person might be seen as an energy field influencing and being influenced by all other energy fields in the synthetic, physical, organic situations (Alligood, 2014). It has been noted here that the mentioned science-based nursing theories help advanced nursing practitioners positively in performing their work.
Nursing theories Question 2
To become a doctorate-prepared nurse, one needs to have enough clinical nursing experience and good memory of several nursing theories at hand (Hunt, 2013). It is critical to know what other scholars who are in the nursing field have done so as to avoid replication. Studying the several nursing theories can assist one to also come up with their science-based nursing theories.
Nursing everywhere has been committed to a rigorous scientific need that provides a significant set of knowledge to advance nursing practice (Blais, 2015). Many science-based theories have been documented over the past decade. Any Ph.D. in the nursing field is built upon doctoral programs including research methods, nursing theory, policy, and economics. Science-based nursing theories over time have aided many people in getting their doctoral degrees.
Madeleine Leininger came up with the Transcultural Nursing Theory, which emphasizes that nurses work on as per the patient’s social choices (Rav, 2016). It begins with the nurse assessing the patient while considering the patient’s cultural background after which a nursing care plan is also given according to the logical cultural assessment. In this theory, it is the responsibility of nurses to comprehend the part of the culture in a patient’s well-being.
Leininger used three nursing activities to accomplish culturally loving care for the patient, which are: Cultural maintenance, cultural negotiation, and social care patterning (Mallela, 2015). Madeleine is now a registered nurse with several degrees such as Doctor of Philosophy, Doctor of Human Sciences and Doctor of Science. She also is a certified transcultural nurse. All these achievements of Madeleine could not have come about if it were not for her coming up with the nursing mentioned above theory.
The Humanistic nursing theory by Paterson and Zderad integrates both humanity and existentialism to nursing theory. Butts & Rich, (2013) elaborate that humanism tries to understand people from the contexts of their experiences while existentialism, then again, is the acceptance that pondering begins with the acting, feeling and living person. In this theory, the nurse assists and cares for the patient. Any nurse applying for a doctorate needs to have such good values so as to achieve the doctorate.
All things considered, any nurse in practice slowly realizes that the work they do, the care they provide is all based on their theory of what is right for their area of nursing. Their philosophies for their jobs, work ethics, treatment of patients, and their behavior all fall in the realms of some nursing theorists whom they learned in school.
References
Alligood, M. R. (2014). Nursing theorists and their work. Elsevier Health Sciences.
Blais, K. (2015). Professional nursing practice: Concepts and perspectives. Pearson.
Burnes, B. (2017). Kurt Lewin: 1890–1947: The Practical Theorist. The Palgrave Handbook of Organizational Change Thinkers, 1-15.
Cowen, P. S., & Moorhead, S. (2014). Current issues in nursing. Elsevier Health Sciences.
Hunt, E. C., Sproat, S. B., & Kitzmiller, R. R. (2013). The nursing informatics implementation guide. Springer Science & Business Media.
Maddux, J. E. (Ed.). (2013). Self-efficacy, adaptation, and adjustment: Theory, research, and application. Springer Science & Business Media.
Mallela, R. G. (2015). TRANSCULTURAL NURSING THEORY. NARAYANA NURSING JOURNAL, 4(1), 43-46.
Monteiro, A. R. M., Martins, M. G. Q., Lobô, S. A., de Freitas, P. C. A., Barros, K. M., & de Fátima Tavares, S. (2015). Systematization of nursing care to children and adolescents in psychological distress. Revista de Pesquisa: Cuidado é Fundamental Online, 7(4), 3185-3196.
Question 1: various viewpoints and findings observed during literature review
The social cognitive process is critical especially when an individual is navigating complex social interactions. The way people perceive or interpret other people’s actions is important. However, most people diagnosed with atypical mental disorders such as autism lack appropriate social cognitive skills.
It has been postulated that people diagnosed with ASD are biased in visual cognition such as body language or facial assessment. This is a challenge among the adolescents because they are in a stage characterized by consolidation of their social self, their identity and understanding their roles in the social world (Loukas et al., 2015).
From the literature review, I identified two contrasting viewpoints about social cognition development in adolescence diagnosed with ASD; theory of mind (ToM) and adolescent’s sensitivity to social rejection (Leekam, 2016). According to the concept of sensitivity to social rejection, the studies stated that the developmental mismatch occurs due to poor regulation of the adolescent’s emotions and accounts for the poor social cognition skills in adolescents diagnosed with ASD.
On the other hand, ToM argues that individuals are trained to understand other people’s minds, thoughts, intentions and beliefs based on the principles they were taught at the age of 4, and that their social cognition is mainly influenced by their caregivers or parents (Leekam, 2016).
These two viewpoints have been integrated into the literature review and will be used during analysis to determine whether adolescent’s social cognition is determined by the affective theory of mind, sensitivity to social rejection or both. This is because adolescence stage is marked with increased social and emotional sophistication; therefore, the underlying themes that influence social cognition skills should be explored to empower adolescents diagnosed with ASD well-being and behavioral outcomes (Loukas et al., 2015).
Question 2: Thought processes when developing research question
A good research question should be relevant and manageable. Therefore, the research question was developed from issues of intellectual interest raised in practice and literature. The aspects that I find most interesting in this field are children growth and development. From the literature, it is evident that parenting skills greatly influence the children behaviors (Loukas et al., 2015). In this context, the adolescent stage is marked by distinct changes in their relationship with family, peers and the society. It is a stage when they should be taught on ways to assert autonomous control over their emotions, actions, and decisions.
During this stage, it has been argued that the brain undergoes remodeling process. Whereas substantial research has been conducted on social cognition in autistic children, there is little attention in researching parent’s role in ASD adolescent’s social cognition, and whether support training of the parents and caregivers reinforce positive social cognition skills in ASD adolescents (Leekam, 2016). From this analysis, the knowledge gap was evident which led to the formulation of the research questions;
Does parallel complementary training for parents make them be well informed about their children social and intellectual development? Does it empower them with new viewpoints that help to improve social cognition in their children (autistic adolescents)?
Question 3: Developing research methodology
After developing the research questions, I evaluated six evidence-based studies to analyze the research method appropriate to this discipline critically. From these articles, I found out that it is important to establish appropriate study sample because excessive sample or too small study sample lack the statistical power that shows the significant effect. The literature review as the primary source that informed by choice and application of the mixed research method. This research method has a clear connection with the research problem as it provides a complete and comprehensive understanding of the research question (Leekam, 2016).
Moreover, the data collection process is through interviews and questionnaire which are an appropriate approach that facilitates the researcher to develop better and more contexts that have greater construct validity (Loukas et al., 2015). From the literature review, I also learned that the most commonly used data analysis method include chi-square, t-test, and ANOVA, which I have integrated into the proposal’s research methodology. Also, it is important to ensure that the data gathered is accurate. One advantage of mixed research method is that it facilitates triangulation (assessing the same phenomenon using several means of research methods) thereby enhancing the study validity and reliability (Loukas et al., 2015).
Question 4: Innovative part of this research proposal
It is evident that children’s social and cognitive skills development is influenced by their parenting style. Responsive parenting has been explored using various research frameworks such as socio-cultural and attachment; and have been found to have a strong foundation is children’s social and emotional skills (Loukas et al., 2015). In combination with the environment, these aspects shape the child’s social cognition needs including the various range of support required for the child’s learning process. It is these supports that enable the children to be actively engaged in problem-solving, self-regulation and execution of social cognitive skills (Walsh, Creighton, & Rutherford, 2016).
However, the social and emotional stability of parents with children diagnosed with ASD is small. Therefore, their parenting responsiveness is poor and negatively impacts on the child’s social cognition function. The benefits of SCTI-A training is well documented. The study proposes that integrating a parallel complementary training for the parents and caregivers will promote mutual engagement and reciprocate the parent-child interaction. That inturn enables the adolescent to become more active and to develop a trust and bond between the parents and to internalize the trust such that they can generalize the learned behavior to new social cognitive functions/ experiences (Leekam, 2016).
References
Loukas, K. M., Raymond, L., Perron, A. R., McHarg, L. A., & LaCroix Doe, T. C. (2015). Occupational transformation: Parental influence and social cognition of young adults with autism. Work, 50(3), 457-463.
Leekam, S. (2016). Social cognitive impairment and autism: what are we trying to explain?. Phil. Trans. R. Soc. B, 371(1686), 20150082.
