Category: Case Analysis

Healthcare Delivery: Case Study

Healthcare Delivery
Healthcare Delivery

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.

References

Australian Digital Health Agency. (2015). Retrieved May 19, 2017, from https://www.digitalhealth.gov.au/get-started-with-digital-health/benefits

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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Rape Case Study: Formulating Research Questions

Rape
Rape

Rape Case Study

Discussion 3: Formulating Research Questions

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.

References

Lisak, D. (2006). Understanding the predatory nature of sexual violence. Boston.

Lisak, D., & Miller, P. L. (2002). Repeat rape and multiple offending among undetected rapists. Violence and Victims, Vol. 17, No. 1, 73-84.

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Dell Case Study

Dell Case Study
Dell Case Study

Case Analysis: Dell Case Study

Major facts

                        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
ObjectivesDevelop ten new computer models in the next yearIntroduce a smartphone range with ten new models in the next two years
Strategies and proceduresAppoint 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
TimelinesJuly 2017 – July 2019
Person(s) responsibleChief 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 Guide To Management and Strategy in the New International Economy. Pearson: FT Press.

Hans-Ruediger, K. (2014). Handbook of Research on Managing and Influencing Consumer Behavior. Hershey, PA: IGI Global

Kotler, P. & Armstrong, G. (2015). Principles of Marketing. Harlow, UK: Pearson Education.

Appendix

Case questions

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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Foundations of Terrorism: Case Study

Foundations of terrorism
Foundations of Terrorism

Foundations of Terrorism

Case Study of Aum Shinrikyo terrorist group

Introduction

Terrorism is founded on carefully planned structures. This paper intends to discuss terrorist organizations by developing a case study of Aum Shinrikyo terrorist group.

Origin of Aum Shinrikyo

Aum Shinrikyo refers to a doomsday cult whose origin is in Japan. The cult was formed by Shoko Asahara in the year 1984 (Ingram, 2017). Aum Shinrikyo earned international infamy after carrying out a deadly attack on Tokyo subway in the year 1995. Furthermore, in 1994 Aum Shinrikyo was also involved in a small sarin attack (Ingram, 2017). However, initially, Aum Shinrikyo conducted its activities in secret and never confessed. Shoko Asahara, the founder of Aum Shinkyo, bought a signal in Russia, which he directed to Japan and uses it in broadcasting his singing and persisting on his blamelessness (Ingram, 2017).

In 2007 Aum Shinrikyo was divided into two groups a group known as Aleph and a group called “Hikari no Wa” (Ingram, 2017). Thus, Aum Shinkyo became designated by many countries as a terrorist association. Among the countries is Japan and North Korea. For instance, in Korea, the commission in charge of examining public security made a public announcement in 2015 in the month of January that the group Aleph along with “Hikari no Wa” group is both branches of religion, which is considered as dangerous (Ingram, 2017). The commission also added that it would continue surveillance on the two groups for three subsequent years.  

As a logistical set-up, Aum Shinkyo inspired and is still inspiring acts of terrorism globally. Notably, Aleph which is one of the groups of Aum Shinrikyo is a system based on syncretism belief (Kearns, Conlon & Young, 2014). Aleph draws upon an idiosyncratic understanding of elements by Shoko Asahara regarding ancient Indian Buddhism, Tibetan Buddhism, and Hinduism. The main icon of worship was taken to be Shiva (Kearns, Conlon & Young, 2014). Aleph also incorporates millennialism ideas, which it borrows from the Bible’s Revelation book (Orsini, 2015).

Aleph also borrows from Yoga and Nostradamus writings (Kearns, Conlon & Young, 2014).  Aum Shinrikyo’s group Aleph was founded by Chizuo Matsumoto who alleged that he was seeking to reinstate original Buddhism. Thus, in the year 1992, Chizuo Matsumoto started calling himself Shoko Asahara, which became his name (Kearns, Conlon & Young, 2014).

In the same year 1992, Shoko Asahara was able to publish an introductory book where he declared himself to be “Christ.” Furthermore, in the book Shoko Asahara refers to himself as the only master who is fully enlightened and identifies with “God’s Lamb” (Kearns, Conlon & Young, 2014).

Command structure of Aum Shinrikyo

Aum Shinrikyo is known to apply precise methodologies. Furthermore, Aum Shinrikyo has a prearranged study of doctrine which is in harmony with a particular system of learning. For a follower of Aum Shinrikyo to reach another stage, it is expected that the member successfully passes a given exam (Orsini, 2015). The practice of meditation is combined with hypothetical studies.

However, Shoko Asahara emphasized to his followers that hypothetical studies cannot serve any purpose when practical experience is not achieved. Additionally, Shoko Asahara also advised members of Aum Shinrikyo never to try explaining anything if they could not mostly experience it (Orsini, 2015).

Aum Shinrikyo’s followers were grouped into two. The first group was lay practitioners. The lay practitioners are Aum Shin rik yo’s members who live together with their families (Orsini, 2015). A second group is a group of members who lived a lifestyle that is ascetic. In most cases, the second group included individuals who usually live as a group (Orsini, 2015). For any follower to earn the status of an attained member, it was an obligation for the member to meet precise conditions so as to influence senior members to recognize that the member has reached a state of higher spirituality (Orsini, 2015).

For instance, in the stage of Kundalini Yoga a member was required to give a demonstration regarding his or her ability in showing abridged oxygen consumption, modification of electromagnetic activities of the brain, and reduced rate of the heart, which was to be proven by being measured using a corresponding equipment (Richards, 2014). When a member demonstrated all the changes described above, then he or she was considered having entered a higher state referred as Samadhi (Richards, 2014). Thus, a member who has attained Samadhi state was given permission to educate other members.

The purported mission of Shoko Asahara was taking all the sins that people in the world have committed. Shoko Asahara claimed that he had the ability to transfer spiritual power to Aum Shinrikyo’s members (Richards, 2014). Additionally, Shoko Asahara claimed he would ultimately cleanse Aum Shinrikyo’s members’ sins by taking them away. Consequently, scholars view Aum Shinrikyo as an outcome from Japanese Buddhism. The view by scholars influenced how Aum Shinrikyo’s definition and view of itself. Notably, Shoko Asahara made an outline of a prophecy on doomsday that integrated the “World War III” to be prompted by the United States (Richards, 2014).

Leadership of Aum Shinrikyo

Shoko Asahara is known to be the historical leader of Aum Shinrikyo. Furthermore, Shoko Asahara was also the chief of senior operations for Aum Shinrikyo (Sageman, 2014). Shoko Asahara came from a Japanese family that was poor. After realizing a personal enlightenment in religion, Shoko Asahara formed Aum Shinrikyo, a religious cult (Sageman, 2014).

Shoko Asahara had recruited almost 10,000 followers to Aum Shinrikyo during the 1990s. Notably, Shoko Asahara dreamt of being an emperor in Japan. Thus, Shoko Asahara assumed the role of interim commander of Aum Shinrikyo (Sageman, 2014).

Shoko Asahara tried to register Aum Shinrikyo with Japan’s government based on the law of religious corporations known as “Shukyo-hojin-Ho” in 1989 (Shapiro, 2013). The registration was to include benefits such as privileges regarding taxation, rights of owning property as Aum Shinrikyo organization, along with protection from interference by the state and other external bodies (Shapiro, 2013).

Initially, the Japanese government denied permission of registration to Aum Shinrikyo citing a string of complaints raised by families with members practicing the Shukkesha (Shapiro, 2013). Shukkesha refers to a practice where members are demanded to sever all the ties they have with family and ensure they cease communication (Shapiro, 2013).

Aum Shinrikyo gave a response to the Japanese government’s rejection by holding public demonstrations, holding lawsuits, and starting legal appeals to counter the government’s decision. Consequently, in the month of August in the year 1989 Aum Shinrikyo was approved of a legal status (Zúquete, 2015).

Thus, Aum Shinrikyo started a new trend in 1989 of greeting every difficulty that comes their way with vigorous denials accompanied by lawsuits (Zúquete, 2015). Notably, in May of 1989 many parents had hired a lawyer from Yokohama known as Sakamoto Tsutsumi. However, Sakamoto uncovered claims that were faulty arguing that tests had been carried out in Kyoto University revealing that he had a unique DNA in his blood (Zúquete, 2015).

Afterward, Aum Shinrikyo started the practice of blood initiation, which was assumed to increase the spiritual power of an individual though no tests were run (Shapiro, 2013). Later, Sakamoto, his wife along with infant son disappeared. An Aum badge was found indicating that Aum Shinrikyo was involved with the disappearance, but no direct evidence was available to link the group.

Thus, Aum Shinrikyo embraced the accusations as an opportunity of getting publicity. Asahara professed the need for political action in saving the world thus, launching “Shinrito” political party which translates to “Supreme Truth Party” (Shapiro, 2013).

Motivation of Aum Shinrikyo

Aum Shinrikyo is motivated by both general reasons and particular motives. For instance, Tomomitsu Niimi attacked a VX victim at 7 am on the 12th of December in 1994 after Shoko Asahara reported of suspecting the victim of being a spy (Zúquete, 2015). The victim was murdered by being sprinkled on the neck for being a nerve agent. Aum Shinrikyo capitalizes on visions of the millennium along with predictions of the apocalypse in framing its doctrine. Consequently, Aum Shinrikyo is highly prejudiced by Nostradamus work. Notably, Nostradamus work provides a cornerstone to Aum Shinrikyo’s teachings.

Markedly, the followers of Aum Shinrikyo actively recruit students along with professionals working in the medicine field, field of science, field of computers, the engineering field, along with other areas, which are technical. Therefore, the charisma by Shoko Asahara and his messages appeared to have more appeal to a majority of people who felt estranged by the modern society, the secular society and the conformist features of the Society of Japan (Zúquete, 2015).

At the crest of Aum Shinrikyo, it is approximated to be worth over $1.5 billion. Notably, having enormous financial resources, Aum Shinrikyo is motivated to invest its capital in high-technology, laboratories for “state-of-the-art,” and funding Aum’s research. Thus, Aum Shinrikyo can circumvent restrictions, which are associated with large laboratories for corporate research.

Additionally, for Aum Shinrikyo to raise funds, they collect money from donations, followers tithe, and selling of sacred materials. Aum Shinrikyo also conducts seminars along with courses regarding the teachings of the cult where it charges all individuals who are participating in the sessions (Kearns, Conlon & Young, 2014). Furthermore, Aum Shinrikyo diversifies its enterprises through running a string of hotels in Tokyo and a firm for manufacturing computers that assembles and sells computers within Japan using parts traded in from Taiwan.

Aum Shinrikyo is also motivated by the support it gets from a Japanese mafia known as the Yakuza, who provide the group with an agreement for marketing illegal drugs manufactured by Aum Shinrikyo. Aum Shinrikyo is also motivated by cooperation given by community leaders through engaging in greenmail practice, which involves extorting money from community leaders (Kearns, Conlon & Young, 2014).

Aum Shinrikyo extorts money from community leaders through threatening them about establishing Aum Shinrikwo’s branch office or an Aum Shinrikwo’s school in the local community in question. Consequently, Aum Shinrikyo also aims at gaining leverage by engaging in extortion, acts of coercion, engaging in theft along with murder as a way of raising money for the group.

Goals of Aum Shinrikyo

The primary goal of Aum Shinrikyo is to defend the ancient faith by promoting worldwide operations that endorse theologies collected from diverse sources. Furthermore, Aum Shinrikyo also operates on a goal of collapsing dictatorship from western countries and institutions within the Middle East. According to Shoko Asahara, Aum Shinrikyo has the goal of uniting all doctrines and establishing, forcefully a desperate need of the society adhering to rules given by the original Caliphs (Kearns, Conlon & Young, 2014).

For instance, in his religious decree, Shoko Asahara talks of individuals duty globally being leading a holy life through cleaning one’s sins based on the doctrine of Aum Shinrikyo, with Shoko Asahara as the self-proclaimed “Christ”. Furthermore, in the book Shoko Asahara refers to himself as the only master who is fully enlightened and identifies with “God’s Lamb” (Kearns, Conlon & Young, 2014).

The ideology of Aum Shinrikyo is based on an idiosyncratic understanding of elements by Shoko Asahara regarding ancient Indian Buddhism, Tibetan Buddhism, and Hinduism. The main icon of worship was taken to be Shiva (Kearns, Conlon & Young, 2014). Aleph one of the groups of Aum Shinrikyo also incorporates millennialism ideas, which it borrows from the Bible’s Revelation book (Orsini, 2015).

Furthermore, Aleph also borrows from Yoga and Nostradamus writings (Kearns, Conlon & Young, 2014). The ideology is manifested by Tomomitsu Niimi’s willingness to attack and murder a VX victim at 7 am on the 12th of December in 1994 after Shoko Asahara reported of suspecting the victim of being a spy.

 Even though most doctrines disagree with almost all thoughts of Shoko Asahara, Aum Shinrikyo is rooted in earning a status (Kearns, Conlon & Young, 2014). For instance, the doctrine of Aum Shinrikyo dictates that in order for any follower to earn the status of an attained member, it is the obligation that member to meet precise conditions so as to influence senior members to recognize that the member has attained a state of higher spirituality (Orsini, 2015).

In one of the stages known as Kundalini Yoga a member was required to give a demonstration regarding his or her ability in showing abridged oxygen consumption, modification of electromagnetic activities of the brain, and reduced rate of the heart, which was to be proven by being measured using a corresponding equipment (Richards, 2014).

Threat posed by Aum Shinrikyo

Aum Shinrikyo poses a number of threats. According to an annual report by the department of state in the United States regarding global terrorism, Aum Shinrikyo is a great threat as it has evolved. Aum Shinrikyo has evolved leading to its current dispersion in the Middle East. The two groups Aleph and a group known as “Hikari no Wa”, which are operationally self-governing affiliates of Aum Shinrikyo are developing to be increasingly aggressive (Kearns, Conlon & Young, 2014).

Furthermore, the affiliates of Aum Shinrikyo in the Middle East use the instability of their regions to their advantage. Moreover, affiliates of Aum Shinrikyo tend to be financially sovereign from the central leadership of Aum Shinrikyo. Notably, affiliates of Aum Shinrikyo raise funds to run their operations from illegal activities such as extorting money from community leaders, acts of coercion, engaging in theft along with murder-kidnapping people and requesting for ransom or fraud of credit cards.

Aum Shinrikyo is also highly active in Japan according to the department of the state of the United States. Compared to all affiliates Aum Shinrikyo in Aleph is the greatest threat to the United States. The head of Aleph in Japan was appointed in 2013 to be the deputy leader of the entire system of Aum Shinrikyo globally (Finn & Momani, 2017). Furthermore, in 2013, acts of terrorism were influenced by sectarian reasons, which present a major threat.

It was also revealed that there was the resurgence in the activities conducted by Iranian security forces along with Iranian intelligence, as the two institutions were linked to primarily supporting Iran for its Assad administration in Syria. Iran also was revealed to have allies in Japan, known as “Hikari no Wa”. “Hikari no Wa” is a renowned terrorist group known for its high-level illegal activities and affiliation to Aum Shinrikyo.

Policies of combating Aum Shinrikyo

There are various policies of combating Aum Shinrikyo. Notably, Aum Shinrikyo is no longer hiding when performing its operations. At the moment Aum Shinrikyo controls its operations mainly from Japan. Thus, America is faced with a great challenge regarding its lifestyle. Aum Shinrikyo constantly fights against the United States with the aim of creating a global caliphate. Consequently, it has been globally recognized that there is need to acknowledge the terrorism problem intensity, and the magnitude required in terms of effort for combating the problem (Eid, 2014).

One of the policies of combating the problem of terrorism is having coordinated regional counterinsurgency operation. Markedly, this policy involves robust efforts of stabilization and combination of diplomatic efforts, political attempts, security endeavors, and informational attempts. The second policy is to end the brutality that averts regional cohorts from fighting Aum Shinrikyo, thus creating space or energy for Aum Shinrikyo to make recruitments and execute its operations.

The third policy is a unification of the private sector with the government in an effort of fighting Aum Shinrikyo. The fourth policy is creating strong partnerships locally as a way of ensuring the stability of governments (Eid, 2014). Notably, a majority of countries have developed less responsiveness to terrorism while others have been overpowered by terrorism through terrorists acquiring and staying on their land.

The main aim of having partnerships is to ensure that Aum Shinrikyo will not reemerge after it has been defeated. The fifth policy is analyzing the position held by key players who notably are within the majority world of Buddhism, Muslims, and Hinduism (Eid, 2014). For instance, partnering with Russia requires careful diplomatic engagement as its presence of forces within Aum Shinrikwo’s territories develops a challenge.

Conclusion

Terrorism is a global problem. For years the problem of terrorism has been shifting from one continent to another. Consequently, it has been established that terrorism is founded on carefully planned structures. Thus, this paper has discussed terrorism foundations by developing a case study of Aum Shinrikyo terrorist group. Aum Shinrikyo is known for dominating its operations within Japan along with the Middle East.

The paper above has revealed that initially, Aum Shinrikyo was a logistical set-up that aimed at defending the ancient faith by promoting worldwide operations that endorse theologies collected from diverse sources. Furthermore, it has come out clearly through the paper above that there are two separate groups of Aum Shinrikyo terrorist group. A group is known as Aleph and a group known as “Hikari no Wa”.  

However, the paper has also revealed that Aum Shinrikyo cannot be termed as an organization rather Aum Shinrikyo refers to a doomsday cult whose origin is in Japan. Furthermore, the paper has revealed that activities of Aum Shinrikyo are motivated by both general reasons and specific motives. Thus, Aum Shinrikyo tends to engage in illegal acts as a way of gaining leverage. The illegal acts include engaging in extortion, acts of coercion, engaging in theft along with murder, as a way of raising money for the group.

References

Eid, M. (2014). The Media Amid Terrorism and Counterterrorism. Terrorism And Political Violence, 26(5), 842-854. http://dx.doi.org/10.1080/09546553.2014.968025

Finn, M., & Momani, B. (2017). Building foundations for the comparative study of state and non-state terrorism. Critical Studies On Terrorism, 1-25. http://dx.doi.org/10.1080/17539153.2017.1287753.

Ingram, H. (2017). The Strategic Logic of the “Linkage-Based” Approach to Combating Militant Islamist Propaganda: Conceptual and Empirical Foundations. Terrorism And Counter-Terrorism Studies. http://dx.doi.org/10.19165/2017.1.06

Kearns, E., Conlon, B., & Young, J. (2014). Lying About Terrorism. Studies In Conflict & Terrorism, 37(5), 422-439. http://dx.doi.org/10.1080/1057610x.2014.893480

Orsini, A. (2015). Are Terrorists Courageous? Micro-Sociology of Extreme Left Terrorism. Studies In Conflict & Terrorism, 38(3), 179-198. http://dx.doi.org/10.1080/1057610x.2014.987593

Richards, A. (2014). Conceptualizing Terrorism. Studies In Conflict & Terrorism, 37(3), 213-236. http://dx.doi.org/10.1080/1057610x.2014.872023

Sageman, M. (2014). The Stagnation in Terrorism Research. Terrorism And Political Violence, 26(4), 565-580. http://dx.doi.org/10.1080/09546553.2014.895649

Shapiro, S. (2013). The Intellectual Foundations of Jewish National Terrorism: Avraham Stern and the Lehi. Terrorism And Political Violence, 25(4), 606-620. http://dx.doi.org/10.1080/09546553.2013.814502

Zúquete, J. (2015). Martin A. Miller.The Foundations of Modern Terrorism: State, Society and the Dynamics of Political Violence. Terrorism And Political Violence, 27(4), 786-788. http://dx.doi.org/10.1080/09546553.2015.1068094

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Cultural Competence Case Study

Cultural Competence Case Study
Cultural Competence Case Study

Cultural Competence Case Study

Rapid demographic changes in today’s society require health care professionals to deliver care that demonstrates respect to patients’ diverse beliefs, preferences, and values. By providing culturally responsive care, health care practitioners help to promote improved health outcome for patients and encourage sufficient use of resources by their employing organizations.

In their effort to deliver culturally sensitive care, therapists must be able to differentiate cultural differences from other related client characteristics that may have an impact on patient outcomes (Saha, Beach, and Cooper, 2008).

In the given case study, the physical therapist should take cultural, physical, cognitive, communicative, and environmental factors into consideration in working with Hernando Gonzales in a home care situation. The cultural factors that should be taken into account include age, nationality, gender, marital status, religion, ethnicity, and beliefs about health.

The therapist should understand that Mr. Gonzales is a 63-year old Mexican male who is currently a widower. Also, Mr. Gonzales goes to church regularly, and being a Catholic; he believes that God is the provider of strength. Furthermore, the therapist should consider the fact that Mr. Gonzales may want to use many herbs in the course of therapy (Saha, Beach, and Cooper, 2008).

The physical factor that the therapist should consider is that Mr. Gonzales once had a partial knee replacement and he still needs assistance with activities of daily living, despite the fact that he has made good physical recovery since he had an accident. The cognitive, communicative, and environmental factors that the therapist needs to consider include; reduced mental functioning as a result of traumatic brain injury, limited spoken English, and limited social support in Maria’s house respectively (Saha, Beach, and Cooper, 2008).

Lack of cultural competence by the therapist may make him or her to confuse cultural variations with other physical, communicative, environmental, and cognitive characteristics in this case. For instance, if the therapist is not culturally competent, he or she may think that Mr. Gonzales reactions due to influence from cognitive problems and environmental factors are as a result of cultural beliefs and values (Santisteban, Mena, and Abalo, 2012).

Furthermore, the therapist may think that Mr. Gonzales’ incapacities to speak fluent English and to carry out his physical activities normally are as a result of cultural influence. It is important to differentiate cultural differences from those related to the client’s other characteristics because positive health outcomes for the patient largely depend on the therapist’s ability to deliver culturally sensitive care (Sue, Zane, Hall, and Berger, 2009).

Cultural competence solutions

The therapist should make adjustments in both assessment and intervention based on Mr. Gonzales’ cultural, cognitive, and linguistic backgrounds. Since the therapist does not speak fluent Spanish, he or she should consider using a translator to help Mr. Gonzales to understand any information that may be presented in English during the assessment. Also, the therapist should use a cultural broker to help reduce cultural-related conflicts that may arise during the assessment (Sue et al., 2009).

Furthermore, the therapist should approach Mr. Gonzales with a lot of humility because he currently has traumatic brain injury. Again, he or she should recommend interventions that Mr. Gonzales can easily implement, bearing in mind that he has some form of physical inability and limited family support in Maria’s house (Saha, Beach, and Cooper, 2008).

The therapist can enlist the help of Mr. Gonzales’ family to facilitate therapy in two different ways. First, the therapist can advise the family on the types of social support that they should give Mr. Gonzales to promote quick recovery. Second, the therapist can help Mr. Gonzales’ family to identify the most appropriate forms of physical support that are necessary to promote positive health outcomes for him (Santisteban, Mena, and Abalo, 2012).

References

Saha, S., Beach, M. C., & Cooper, L. A. (2008). Patient centeredness, cultural competence, and health care quality. Journal of the National Medical Association, 100(11): 1275-1285.

Santisteban, D. A., Mena, M. & Abalo, C. (2012). Bridging diversity and family systems: Culturally informed and flexible family based treatment for Hispanic adolescents. Couple and Family Psychology, 2(4): 246-263. doi: 10.1037/cfp0000013

Sue, S., Zane, N., Hall, G. & Berger, L. K. (2009). The case for cultural competency in psychotherapeutic interventions. Annual Review of Psychology, 60: 525-548.

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Gerontological Nursing: Case Analysis

Gerontological Nursing: Case Analysis

Gerontological Nursing: Case Analysis

Gerontological Nursing: Identification and Description of the Interviewed Individual

            The interviewee is a male individual aged 80 years, and who currently stays with his wife and their son in the city. This client is a retired accountant who has been out of work for the past five years. Also, he is married with three children; two sons aged 25 and 36, and one daughter aged 40.  Furthermore, the patient participates in three major health promotion activities including walking regularly, limiting consumption of salt and sugary foods, and participation in community’s social support groups.

The interviewee believes that increased consumption of fruits and foods rich in sorghum and millet help people to live long. Being 80 years old, the interviewee is considered to be the oldest family member who has ever reached such age. Furthermore, the interviewee is on insulin medication to help with management of diabetes clinical problem. He visits the doctor at least twice a week for a general medical check-up and to obtain clinical guidance on how to effectively manage diabetes symptoms.

Gerontological Nursing: Identification and Description of the Cultural Implications for the Individual

            Personal values and beliefs about old age and health have a great implication to the care of the interviewee. For instance, the interviewee’s philosophy on living a long life may make it difficult for him to appreciate the fact that aging is a normal process. He believes that living long is God’s blessings while deaths that occur when people are still young are associated with curses.

Also, the interviewee has unique thoughts about people who are considered to be of old age. He feels that for a person to qualify to be of old age, lack the capacity to perform daily physical activities, be unable to maintain an upright posture, and must put on glasses to assist with vision. These cultural beliefs may impact negatively on the care of this client because the clinician will find it difficult to change the interviewee’s perceptions and replace them with new ones that can promote positive health outcomes (Shrack et al., 2016).

Additional cultural implication related to the interviewed person include; his or her beliefs regarding health and illness and his values about health status and treatment of older adults. The most appropriate way of eliminating the impact of the person’s cultural values and beliefs is through maintenance of cultural competence throughout the interview and when giving interventions.

Gerontological Nursing: Comprehensive Functional Assessment

To establish what the interviewee can accomplish as well as those that he cannot do properly at his age, a comprehensive functional assessment has been performed using four tools namely; Tinetti Balance and Gait Evaluation, Katz Index of Activities of Daily Living, Assessment of Home Safety, and The Barthel Index. The person’s movement ability has been assessed using the Tinetti Balance and Gait Evaluation.

The client’s ability to perform various activities independently has been evaluated using the Katz Index of Activities of Daily Living. The most appropriate tool that has been used to measure the safety of the patient’s environment is the Assessment of Home Safety, while that which has been used to examine whether the identified individual can accomplish some daily tasks independently is The Barthel Index.

A duly filled Tinetti Balance and Gait Evaluation, Katz Index of Activities of Daily Living, Assessment of Home Safety, and The Barthel Index tools used during the interview have been provided in the Appendix section of this paper.

Gerontological Nursing: Comparison of Age-Related Changes

There are similarities and differences between the expected age-related changes and those observed in the interviewee. Older adults are expected to present with some physiological, physical, pathological, sensory, and motor changes, which significantly affect their ability to perform their activities of daily living and to make various physiological controls. According to Shrack et al. (2016), older adults aged 65 years and above have problems with maintaining gait and balance.

Similarly, the interviewee experiences problems with maintaining gait and balance, both while he is seated and whenever he is standing. Also, Tkatch, Musich, MacLeod, Alsgaard, Hawkins, and Yeh, (2016) point out that older adults often need assistance with various activities of daily living such as dressing, cooking, washing, and toileting. Although the interviewee is 80 years old, he needs assistance only in certain activities of daily living such as rising from a chair.

However, he is still strong enough to feed alone once the food is made available for him. Older adults are at high risk of falls, and there is therefore great need to keep their home environment free from objects that may increase the possibility of falling (Phelan, Mahoney, Voit, and Stevens, 2015). Similarly, the interviewee is at a high risk of falling considering the fact he has a problem controlling balance and gait.

For this reason, his home environment is often kept free from equipment that may increase the risk of falling. Again, as it happens in older adults, the interviewee occasionally finds it difficult to control his bladder and bowel and therefore may always want people to stay around to assist.

Gerontological Nursing: Preliminary Issues Assessed from the Interview

 Four major preliminary issues have been assessed from the interview. The four issues include; age-related changes that are taking place or that have taken place in the interviewee, health promotion activities that the interviewee is currently involved, the interviewee’s cultural values over old age and living longer, as well as actions that have been taken to promote safety at the interviewee’s home environment.

As Tkatch et al. (2016) explain, nurses who are providing care to older adults must be able to understand the impacts that their age-related changes have on their abilities to perform daily activities. Using this information, these nurses must recommend relevant health promotion activities for their clients, including how they can keep their home environment safe for living. The nature of care given as well as the nature of health promotion strategies recommended will depend on the client’s cultural values and beliefs over old age and long life (Tkatch et al., 2016).

From the current assessment, the interviewer has discovered that the interviewee has undergone various physiological, physical, pathological, sensory and motor-related changes as a result of old age that greatly affect his ability to perform daily activities. Furthermore, the interviewer has found that the client engages in a few health promotion activities such as frequently walking to keep fit and consuming fruits.

Through current assessment, it has also been established that some actions have been taken to keep the interviewee’s home environment safe by eliminating objects that may increase the risk of falls. Most importantly, the interviewer has found out that the interviewee believes that God helps people to survive through old age, that the society is less concerned about assisting the aging population, and that God promotes healing and recovery.

Based on results obtained from this assessment, the interviewer understands health problems that majorly occur in older adult as well as factors that must be taken into consideration when establishing the most appropriate health promotion strategies of the elderly (Shrack et al., 2016).

Gerontological Nursing: Alterations in Health

            The interviewee has alterations in health in three major functional areas namely; physiological functions, motor functions, and physical functions. Concerning physiological functions, the interviewee is struggling to manage diabetes, which is a common chronic health problem among older adults. Due to old age, the interviewer’s body cannot control blood sugar levels as required, and hence the observed onset of diabetes (Kezerle, Shaley, and Barski, 2014).

As far as motor functions are concerned, the interviewee has a problem with bladder and bowel control, which makes him have short call accidentally and long call at any time. This problem occurs mainly because of reduced motor function, which is greatly influenced by old age (Westra, Savik, Oancea, Choromanski, Holmes, and Bliss, 2011).

Furthermore, the interviewee experiences physical problems related to balance and gait maintenance, which put him at high risk of falls. He has reported that he needs support when rising from a chair and when moving upstairs. This means that his physical movement has been limited by old age. Therefore, the nature of intervention that would be recommended for the interviewee must target physical, physiological, and motor functional areas described in this section (Tkatch et al., 2016).

Gerontological Nursing: Interventions for Identified Problems

            Interventions should be implemented based on individual health problems that the interviewee is currently suffering from. The most appropriate interventions for diabetes include nutrition counseling, exercise training, and drug adherence training. The interviewee should be guided on those foods that he should avoid keeping his blood glucose level low. Also, he should be trained on the importance of exercise in managing weight, and his family members should be guided on how to offer the right support.

Again, the interviewee should be reminded of the importance of drug adherence in reducing diabetes symptoms (Kezerle, Shaley, and Barski, 2014; & Tkatch et. al., 2016). Three different interventions can be implemented to help the interviewee to reduce risks of falls. First, the interviewee should be guided on how to perform simple exercises that will help him to improve balance and gait.

Second, his family members should be taught on strategies for reducing hazards in the interviewee’s environment to maximize safety. Third, risks of falls can be eliminated if the patient is trained in safety-related behaviors and skills (Phelan et al., 2015). The best interventions for bowel and urinary incontinence include training the interviewee on how to perform pelvic floor muscle exercise, offering nutritional counseling, and educating him on usage and side effects of anticholinergic for the bladder that is overactive.

Frequent pelvic muscle exercise will help to avoid incontinence actions of the urinary bladder and the bowel. Again, the interviewee should be taught to limit fluid intake and to avoid foods that cause bladder irritation. Furthermore, correct use and adherence to anticholinergic can help the interviewee to effectively manage bladder and bowel incontinences (Westra et al., 2011).

References

Kezerle, L., Shaley, L. & Barski, L. (2014). Treating the elderly diabetic patient: Special considerations. Diabetes, Metabolic Syndrome, and Obesity: Targets and Therapy, 7: 391-400. doi:  10.2147/DMSO.S48898

Phelan, E. A., Mahoney, J., Voit, J. C. & Stevens, J. A. (2015). Assessment and management of fall risk in primary care settings. Medical Clinics of North America, 99(2): 281-293. doi:  10.1016/j.mcna.2014.11.004

Shrack, J. A., Cooper, R.,…& Harris, T. R. (2016). Assessing daily physical activity in older adults: Unraveling the complexity of monitors, measures, and methods.  Journals of Gerontology-Series A Biological Sciences and Medical Science, 71(8): 1039-1048. 10.1093/gerona/glw026

Tkatch, R., Musich, S., MacLeod, S., Alsgaard, K., Hawkins, K. & Yeh, C. S. (2016). Population health management for older adults: Review of interventions for promoting successful aging across the health continuum. Gerontology and Geriatric Medicine, 2 (1): DOI: https://doi.org/10.1177/2333721416667877

Westra, B. L., Savik, K., Oancea, C., Choromanski, L., Holmes, J. H. & Bliss, D. (2011). Predicting improvement in urinary and bowel incontinence for home health patients using electronic health record data. Journal of Wound Ostomy & Continence Nursing, 38(1): 77-87.

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Canadian honey in the Korean market

Canadian honey
Canadian Honey

Question 1

The Korean honey market is having a challenge giving their customers quality honey. The market is flooded with poor quality honey and this does give the Korean Food a chance to penetrate the market if they focus their production on quality honey. The cost of quality honey in the market is also so high reaching a price range of $ US 100. The introduction of cheaper quality honey from the Korean Food company will increase their market share in the industry (Lee et al., 2010, p. 25).

 Moreover, the Korean’s who have visited Canada often send to their families 20 to 30 kilograms of honey when they visit (Tavares, 2014, p. 22). This is an indication of positive reception of the Canadian honey by the people in Korea. It therefore, means that entry into the market will work in favor of the Korean Food as they already have a ready market for their product.

On the unfavorable aspects, the Korean government still has a restriction on open trade policy, especially when it comes to the agricultural sector. This policy does make it hard for the company to venture into the country, despite the optimism that the Korean government is considering withdrawing the restrictions (Hayakawa et al., 2013, p. 499). Moreover, the Korean honey producers have enjoyed a monopoly in the market and may place a lot of hurdles that will make the market unfavorable for Korean foods.

Question 2

The uncertainties in the strategy arise from the fact that the company has limited experience in the export market in Korea. This does pose a huge challenge for the company as they need to conduct an intensive market research before they step into the country. This will cost them a lot of finances, considering that the maximum amount of profit that they are to make from this venture is by a margin of 20%. The Korean market is centered on their culture where most of the consumers consider honey as a medicinal rather than a food product (Sydkorea, 2017). This will pose a challenge for the company when it comes to extending their market share from the hotels to selling the products to the consumers.

Additionally, the Korean market does work on the perspectives that the company will require an intermediary to be able to penetrate the market (Yoon, 2017, p. 387).  The involvement of the middleman does pose an uncertainty on the manner to ensure that the company does achieve the objective of making a profit. The company has been working directly with the suppliers, and the changes of the operations structure to relying on the middlemen to foster their agenda will force affect the management of the company.

Lastly, despite their being hope that the Korean government will open up the agricultural market to allow imports, there is uncertainty on the resistance of the Korean honey producers (Hayakawa et al., 2014, p.499).  The Korean honey producers have a monopoly in the honey market and they, therefore, have the strength to influence the government not to open up the honey market (APHIS’ website, 2017). Moreover, they might consent the opening of the market, but place a lot of hurdles for the new entrants an aspect that will uneven the competition making the market unfavorable.

The uncertainties can be reduced by identifying a company in Korea and entering into a joint merger to enable them to penetrate the market. The merger will be a shield for them as they understand how the market operates and will provide them the needed information to venture into the market (De Mooji, 2013, p. 36).  Additionally, it will enable the company to navigate any hurdles that will be posed by the Korean honey producers in a bid to protect their influence in the market. Furthermore, the merger does reduce the cost of market research that the company will have to incur in their bid to penetrate the market.

I believe that the company has an opportunity to achieve immense success if they apply the suggested solutions in reducing the uncertainties. The company will be able to increase their margin and market share from a maximum of 20% and 60% respectively. This is an opportunity that will be effective for the company.

Question 3

Canadian honey: Marketing

In looking for ways to improve the marketing plan to make it acceptable to all the management team members, the 3 phases that form the foundation of the plan will be evaluated.  In the first phase, the distribution strategy needs to be altered to involve using the networks established by the company they decide to merge with to penetrate the hotels. The local company has been in operation in the country they, therefore, have connections in different sectors of the economy like the hotels. This will make market entry easier for the company instead of having two salespeople positioned in Seoul (Lee et al., 2015, p. 32).

Additionally, the advertising strategy in the first phase will cost the company a lot of finances. To ensure that the company saves money, the use of free samples to the hotels coupled with media advertising is sufficient. The provision of recipe booklets and carrying out person-to-person advertisement will cost the company a lot of money.

In the second phase, the company needs to focus on regulating the prices of the honey with time as they extend their control of the hotel honey market. The penetrating price strategy is used to enter the market but needs to be readjusted to ensure that the company can make more profit from this sector (De Mooji, 2013, p. 12). The minimum price is an introduction to the Korean hotel industry to the purity of the Canadian honey. Increasing the price will not alter the purchase, as they would have managed to create a customer base in the industry that is attracted to the new flavors of the honey.

Additionally, the distribution channel is effective, but the involvement of the company that they will merge with will inject efficiency in the operation. The partner comprehends the Korean honey distribution network this will, therefore, ensure that the products can reach the target customers on time.

Furthermore, the company needs to concentrate more on introducing the Canadian honey as food rather than a medicinal product. This will play a role in increasing their target market more effectively. The Korean’s already have had a negative conception of honey due to the poor quality that is present in the market. Their culture compounded with the bad honey experience has made them consider that the product can be used only as a medicinal product (Lee et al., 2010, p. 18). Emphasizing on the other uses of honey will not only revolutionize this perception but also provide them with mileage in the industry.

In the third phase, introducing different qualities of honey in the market will cast doubt on the type of honey that the customers are purchasing for medicinal purposes. It will cast a shadow on the qualities of the Canadian honey that the company is introducing in the market, hence reducing their penetration. The company needs to concentrate on high-quality honey solely to get the customers goodwill in their product (Tavares, 2014, p. 25). I will recommend the company to use the warehouse of their partner as this will save them the cost of setting up one. They can then capitalize on the sales representative of their partner to increase their market penetration in the country.

Question 4

Kevin Lee at the beginning of the case study identifies pertinent issues that are linked to the difference between their way of operations and the new marketing plan. The company has immense knowledge in importing business and limited knowledge in the exporting business. They have managed to comprehend the needs of the North Americans when it comes to the Asian foods which have enabled them to raise the business to $30 million. The exportation of the Canadian honey to Korea is a new business venture as they do not know how to navigate the Korean industry with its restrictions (Anania, 2013, p. 25).

Additionally, despite the fact that the Canadian honey is loved by Korean visitors who send it to their families, this is not a guarantee that they will penetrate the market with ease (Tavares, 2014, p. 12). On the other hand, the Asian product is loved by North America and the company has managed to create a customer base that loves their products (Shaw, 2017). The company encountered challenges but managed to establish a reputable brand. Contrariwise, the only similarity is that the company has dealt with Korea on an international business level as discussed in the essay.

References

Anania, G., 2013. Agricultural export restrictions and the WTO: What options do policy-makers have for promoting food security. Draft paper prepared for informal ICTSD policy dialogue on, 25.

APHIS’ website. (2017). Korea Product Brief: Honey. [online] Available at: http://www.aphis.usda.gov/regulations/vs/iregs/products/ [Accessed 9 Sep. 2017].

De Mooji M., 2013. Global marketing and advertising: Understanding cultural paradoxes. Sage Publications, 2013.

Hayakawa, K., Kim, H., and Lee, H. H., 2014. Determinants on utilization of the Korea-ASEAN free trade agreement: margin effect, scale effect, and ROO effect. World Trade Review, 13 (3), pp.499-515.

Lee, M.Y., Hong, I.P., Choi, Y.S., Kim, N.S., Kim, H.K., Lee, K.G. and Lee, M.L., 2010. Present status of Korean beekeeping industry. Korean Journal of Apiculture.

Lee, Y.K., Kim, S.H., Seo, M.K. and Hight, S.K., 2015. Market orientation and business performance: Evidence from franchising industry. International Journal of Hospitality Management, 44, pp.28-37.

Shaw, M. (2017). Korea Food Trading | Canadian Business Executive. [online] Canadianbusinessexecutive. Available at: http://www.canadianbusinessexecutive.com/food-drink/case-studies/korea-food-trading-expanding-asian-foods-market-a-non-traditional-audience [Accessed 9 Sep. 2017].

Sydkorea. M. (2017). Korean Business Culture. [online] Available at: http://sydkorea.um.dk/en/the-trade-council/korean-business-culture [Accessed 9 Sep. 2017].

Tavares, A., 2014. Statistical overview of the Canadian honey industry 2013. Government of Canada, Canada.

Yoon, S. J., 2017. Cultural Brokerage and Transnational Entrepreneurship: Entrepreneurs in Beijing’s Koreatown.”  Korea Observer, 48 (2), p.387

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Competitive Advantage: Case Study

Competitive advantage
Competitive advantage

The new product that is being introduced as part of Whirpool production will be marketed along the market chains that the company has used and has competitive advantage over other products in the market. The company will concentrate on marketing the product in the Western nations, followed by the Asian countries and lastly the African nations based on the sales margin of their earlier products (Chakraborty, 2017).

Customers in the industry have expressed the problem of having their refrigerator doors not tightly closing when they are shut.The company GE appliances that is one of the competitors has admitted to the existence of the problem on their website, but they have only provided a limited number of solutions (Refrigerator-Freezer Door Pops Open, 2017).

In the industry, none of the companies have come up with a long-lasting solution like the new invention. The product will provide the company with a competitive advantage in the consumer home appliances. The company does sell their products in over 170 countries, and by the first quarter of 2017, they had a market share of 34.33% (Whirlpool Corp Comparison to its competitors, market share, and competitiveness by Segment-CSIMarket, 2017).

How to Achieve a Competitive Advantage

In order to succeed in any market a company has to decide which strategy is more appropriate to use, which means identifying the sources of a potential competitive advantage such as skills or resources. Superior skills in creating a special product can represent the element that is setting the company apart from its competitors. That is easily translated into a very good quality of the products.

Reference List

Chakraborty, A. (2017). Leverage Analysis: A Study on Whirlpool LTD. Nopal Institute of Management Studies-Department of Management.

Refrigerator-Freezer Door Pops Open. (2017). Products.geappliances.com. Retrieved 15 September 2017, from http://products.geappliances.com/appliances/gea-support-search-content?contentId=16979

Whirlpool Corp Comparison to its Competitors, Market share, and Competitiveness by Segmet-CSIMarket. (2017). Csimarket.com. Retrieved 15 September 2017, from https://csimarket.com/stocks/compete-glance.php?code=WHR

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Organizations and Management in the 21st Century

Organizations and Management
Organizations and Management

To what extent is our understanding of organizations and management over the last 100 years applicable to the 21st century?

The understanding of organizations and management over the last 100 years applies to the 21st Century. The organization is a group of people who have a structured management system that directs them to pursue a common objective (Scott, and Davis, 2015, p. 45).

Notably, within that period of 100 years, many people attempted to provide relevant knowledge that could improve efficiency in organizations and management process.

In conclusion, the knowledge acquired concerning organizations and management over the last 100 years has a great impact on the 21st century.  In the past, the team was not complex like today where the firm has many department and activities.

Organizations and management Case Anlysis

The management adapted new methods to comply with new changes in a firm. Therefore, that understanding of organizations and management has helped the teams in the current century (Bohari, Hin, and Fuad, 2017, p. 56). Managers to allocate enough resources depending on the nature of goals set. Also, the use of new technological methods can help the firm to perform and compete effectively in the market.

Total Quality management is a plan that makes the management to be focused on customers and improvement of processes. SWOT analysis should be completed to provide enough knowledge concerning internal and external factors of a firm. The understanding of organizations and management should be the base of bringing change in the firm. Management needs such understanding to develop effective strategies that may improve the performance of a team.

References

Bohari, A.M., Hin, C.W. and Fuad, N., 2017. The competitiveness of halal food industry in Malaysia: A SWOT-ICT analysis. Geografia-Malaysian Journal of Society and Space, 9(1).

Ozguner, Z. and Ozguner, M., 2014. A managerial point of view on the relationship between of Maslow’s hierarchy of needs and Herzberg’s dual factor theory. International Journal of Business and Social Science, 5(7).

Sallis, E., 2014. Total quality management in education. Routledge.

Sargeant, A. and Jay, E., 2014. Fundraising management: analysis, planning and practice. Routledge.

Scott, W.R. and Davis, G.F., 2015. Organizations and organizing: Rational, natural and open systems perspectives. Routledge.

Waring, S.P., 2016. Taylorism transformed: Scientific management theory since 1945. UNC Press Books.

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