Managing Budgets and Financial Plans Essay Example | Topics and Well Written Essays - 1250 words

Managing Budgets and Financial Plans - Essay Example II. Objectives that are important to Kitchens2Go: Ultimately, it appears that the Manager is concerned with the profitability and long term prosperity of the firm, so all of the objectives that are important to the Manager should be important internally as well. III. Measuring the Objectives: The objectives can be measured by the use of Statement of Financial Performance, cash flow analyses, analysis of cost of goods sold, expense analysis, etc. All of these will show how much revenue is being generated as well as how much the firm is spending. Ultimately, the Statement of Financial Performance shows whether or not a profit is being generated, and exactly how much profit, or the lack thereof. IV. Integration of the Objectives: These objectives could be integrated into budget and reporting systems by performing a given analysis as it relates to a specific department, as well as an overall analysis of the entire operation. It appears that the Bank Manager would like copies of Kitchens2Go's financial statements every year in order to monitor expenses, revenue, and profit or loss, so that a clear picture of the health of the firm can be examined. The most useful calculations that the bank can be doing on these statements are calculations of the cost of the goods sold, value of inventory on hand, labor

The integumentary Research Paper Example | Topics and Well Written Essays - 1000 words

The integumentary - Research Paper Example She is also forgetting to wash her hands after toileting. Her skin has become very dry, pale and thin, tearing easily even when she simply scratches an itch. Q 1. Identify a specific cell from the integumentary system (1 cell only for each), involved in a) protection – SQUAMOUS CELL of the skin appears thin and flat; this is very important in protecting the entire body against damage brought about by cuts, bumps, spills of acids and bases, and damage due to ultraviolet radiation (Marieb, 2008). b) sensation – CUTANEOUS SENSORY RECEPTOR is another cell which can appear as specialized neurons, dendritic nerve endings, or specialized epithelial cell connected with sensory nerve endings; this is particularly responsible for the sensation of skin (Seeley, 2008). c) secretion – CUBOIDAL CELLS of sebaceous gland exit as single layer with polygon-shaped cells; it appears square-like in structure with a central round nucleus found in most glands of the human body (Tortora & Derrickson, 2007). Describe how each of these cells is designed for the function it carries out. Squamous cells are designed to be flat and thin to easily cover the outer part of the skin and facilitate the process of diffusion of substances effectively and more rapidly, in or out of the cells. Cutaneous skin receptors on the other hand, appear elongated, mesh-like and inter-networking with one another; this type of design is intended for fast conduct and transmission of impulses or electrical conductivity. Lastly, the cuboidal cells have box-like feature which is designed to permit fluid-holding capacity; allowing cells to secrete substances.. Q2. How does skin structure and function change with age and lifestyle factors? Make reference to the case study and the cells and functions you have discussed in Question 1. Skin, the largest organ and the most visible in the body, also undergoes aging process that shows multiple clinical manifestations and concerns. Organ aging and failu re, become evident if and when the skin is affected. Skin deterioration is the outward evidence of faltering physiology. Although in the healthy aged population, expected changes occur, and sometimes lead to problems. Most of the skin changes that are linked with aging are caused by intrinsic aging rather than lifestyle factor or photo damage (Shekar, Luciano, Duffy and Martin, 2005; p. 125-1119).Cellular damage due to intrinsic factors are not fully understood, however, the stress of free radicals derived from reactive oxygen species that resulted from oxidative metabolism may lead to mutation of DNA, oxidation of proteins due to oxidation of membrane lipids, reduced function, and resulting in the abnormal trans-membrane impulse transmission and reduced transport efficiency. The moment repair is incomplete, damage over time can result to to abnormal structure and function.(Tortora & Derrickson, 2007). The ultraviolet exposure will also speed up chronological skin changes, and as ag e increase the impact of photo aging heightens (Seeley, 2008). Q3. Florence has expressed discomfort with hot weather. Explain how her skin changes may be contributing to this? Normally, occupation, lifestyle, and health associated decisions frequently determine the appearance of skin. Smoking, weight loss, lack of exercise, inadequate nutrition, stress and lack of sleep, exposure to cold weather, are common contributors to unhealthy skin. For elderly people, there are major changes in the structures

Discussion for online Healthcare HRM Essay Example | Topics and Well Written Essays - 250 words

Discussion for online Healthcare HRM - Essay Example Human resource in the healthcare setting interacts with a group of people who are highly sensitive to the environment around them due to their respective health complications. On the same note, all the stakeholders in the health care setting work towards promoting patient welfare, and so should the attitude and perception exhibited in this setting. In this respect, the realized performance outcomes rely on the basis of interaction between healthcare practitioners and the patients, thus making attitude and perception direct influential variables on performance. The integration of attitude and perception into an evaluation process should account for the links and relations between the human resource and all the other parties present in the healthcare setting, especially the patients. While this would be a positive move, the legal aspect of the matter could be highly bureaucratic, thereby slowing down the integration process and challenging the basis of operation of the evaluation system. On the same note, the likelihood of discrimination issues against human resource arising could be relatively high (Flynn, Mathis, Jackson & Langan, 2007). Moreover, the need to set measurement variables for the purpose of undertaking the evaluation becomes

Religion in Africa Essay Example | Topics and Well Written Essays - 2500 words

Religion in Africa - Essay Example African independent churches formed as a result of the political, social, and economic conditions that were prevalent in Africa at the time. Independent churches were formed as a way of protesting against colonial rule and how Africans, despite being considered equal to Europeans as Christians, were treated as lesser human beings. In most circumstances, Africans resented that they were forced to abandon their own ways and communities by the colonial governments through the influence of Christianity, so that these governments could continue to dominate every aspect of their lives (Mosala, 1985). They felt that Christianity was an extension of colonialism and this made it difficult for them to accept a European led church as part of their lives. These circumstances sowed the seeds of dissention among them as well as the need to remove themselves from the authority of European-led missions and to create churches of their own. As political movements against colonial rule, independent churches took an active part in rejecting the European way of life and chose instead to look back towards the African way of life where they be lieved that they were better off (Machoko, 2013). Their rejection of European ways ensured that they gained followers who felt the same way and this allowed these churches to thrive as they created a new niche for themselves within the Christian community. These movements had charismatic leaders who ensured that they took the first steps towards breaking away from their mother churches and form churches that were truly independent from ones of western origin through the integration of African practices. Independent churches came into being as a place of refuge for those Africans who did not have enough authority or economic means to protect themselves within their societies (Oduro 2006). These churches were highly attractive to the poor, oppressed and outcasts in their communities for whom

BP Stakeholder and Reputation Management Research Paper

BP Stakeholder and Reputation Management - Research Paper Example Stakeholder management helps a business to achieve the desired goals more efficiently by maintaining the investors’ satisfaction levels. It also enables the organizations to retain the existing investors and recruit new ones in an ethical and responsible manner. Stakeholder management forms an important part of business through which an organization can develop its goodwill. Every sound organization needs to satisfy the stakeholders in order to sustain in the business (Carroll and Buchholtz, 2014). Reputation management involves activities that a business must perform in an attempt to create or upkeep goodwill in the eyes of the public (Argenti and Druckenmiller, 2004). It involves identification of the individuals’ expectations from a business and taking necessary steps to ensure that the general consensus is in parity with the organizational goals. This term was originally used to denote public relations that are necessary for a company in order to sustain in the market. The disaster turned out to be an issue of search result over the web, following the advancement made in social media, computing, and internet. There are various ethical forms of reputation management such as responding to the customer complaints, restraining sites from displaying incorrect information and utilization of the online feedback to influence the process of product development (Argenti and Druckenmiller, 2004). BP is a multinational oil and gas company that is headquartered in London. It is the fifth largest company in terms of revenue and ranks sixth in terms of production. BP operates in nearly 80 countries.  Therefore, considering the recommendations mentioned, BP can derive greater benefits as well as regain the lost status in the oil and gas industry. Implementation of the suggestions provided can considerably help other oil and gas companies, such as PBGC, to rebuild lost integrity and reputation.

Context and History of Conflict Paper Essay Example for Free

Context and History of Conflict Paper Essay This essay will discuss the issues between two people, Robert and Denise Patton, along with how these issues affect their two children. To enable an understanding of the problem a summary of the nature and history of the conflict has been given. In addition, a look at the interaction of interests, goals, and the power of each party allows an understanding of each person’s position and role in the conflict as well as personal attempts at resolution of the problem. In working to resolve this conflict there will be strategies discussed which, if Robert and Denise are willing to apply, could help them resolve the conflicts that they are facing in their marriage. Summary of the Nature and History of the Conflict The Patton Family case study has different types of conflict inside it. The summary of the conflict starting with the family dynamic gives a look of what is happening with the family from an outsider looking inward. To an outsider the family is in shambles; they fight regularly, and it seems that the parents have concern about one child only. In the beginning, the parents were happy; they both were on a path that looked successful. They both were in college and had great jobs after college. Once they started a family things changed for the couple. The mother wanted to be a part of the children’s lives more, so she quit her job and found another that worked with her schedule. The parents fought frequently about the youngest child and how to parent him. Since the parents were not getting along for a while the husband finally had enough. He decided to leave the house and tell his wife he wants a divorce. The husband and wife blame each other for the failed marriage, and the youngest child blames himself for his father’s leaving. â€Å"Without an apology or other form of resolution, the trust on both sides is compromised, and may not know what to expect from this person in the future† (Scott, 2011 p. 2). When the father left he never sat down with his children or wife to explain why it had come to this. The father finally had enough with his wife, but he did not explain his reasoning. Context of Conflict The context of the conflict is that two parents have separated after a long marriage resulting from arising conflicts in the marriage. The couple has two children; one who is almost an adult, and the other is a young child who seems to have trouble with his energy at home and at school. The conflict started to occur more frequently and more harshly as their second child started having problems in school. One parent, the mother, believes that there is something wrong with him and that he requires special attention with him all the time. A child with these kinds of behaviors would become costly and would require significant attention. The other parent believes that his son is just spoiled and requires normal attention and discipline. He further believes that these luxuries have left his son vulnerable with a lack of awareness for his surroundings. Whether or not the parents are splitting, they were a team trying to provide for their two children. â€Å"When managing conflicts, collectivist cultures place more emphasis on the avoidance and accommodation of conflicts because collectivists value harmony, security, and conformity† (Hong, 2008). Interactions of Interests, Goals, and Power The interests, goals, and power of both parents are that they cannot stand each other and need space in to function. One believes that he does not receive enough attention from his family and wife, and that they show no gratitude for his hard work. He has been working for many years and has primarily been the sole wage-earner in the family. The wife feels that her family does not appreciate her. She feels that she has lost her active role in the environment of her oldest child and husband. Her focus has been her young son who has been having these troubles at school and home. This amount of pressure has shut her out of everyone’s world except her son, who does not know what is going between the two split parents. According to the text the â€Å"conflict above may be substituting for intimacy and connection, or it may serve as a launching pad for problem solving† (Hocker Wilmot, 2011). Attempts Made at Conflict Resolution There are competing family goals regarding Arnie (Wilmot Hocker, 2011). Robert believes lack of discipline is the cause and wants Arnie to be held accountable whereas Denise believes there is a neurological basis and believes Arnie should be tested and treated according to his perceived needs. Though both parents have expressed ideas for dealing with the problem they have not agreed on a method, nor given significant consideration to the other’s opinion in this matter. The conflict has evolved and in the process a couple of resolution tactics have been used. Early in the conflict, aggression and competition were used, with each attempting to use power of position as a tool to win the battle. Rob made the money and determined it would not be used for mental health treatment; Denise was primary care-giver and as such was responsible for seeing that Arnie’s needs were met. Screaming matches to coerce the other into submission failed and eventually gave way to avoidance (Wilmot Hocker, 2011). Withdrawal from the conflict equated to withdrawal from the relationship as the couple slept apart and ceased communication (Wilmot Hocker, 2011). The interactions that did take place were interpreted based upon past events, setting the paradigm for what each could expect from the other, likely feeding into rather than helping to resolve the conflict (Coltri, 2010). Robert’s final act of avoidance was for self-protection; he moved out to protect himself from further emotional harm (Wilmot Hocker, 2011). Personal Initial Reactions or Strategies for Resolving this Conflict Personal Initial Reaction The initial reaction to the conflict between Robert and Denise is that they should agree to mediation as a mean of solving their disagreement. Denise relies on Robert for complete financial support for their family. The problem here is Denise does not want to work because of their son’s neurological condition. Robert believes differently about Denise not wanting to work and feels that Denise is using Arnie’s condition as an excuse. Robert and Denise seek legal consultation, after Robert leaves the home. Strategy for Resolving this Conflict Legal consultation has it advantage but mediation would be better in this situation. Most lawyers discuss with clients if they should choose mediation based on their situations. Mediation would give the couple the opportunity to explain their side of the situation in privacy. Attorneys are contacted for legal advice but mediation is for solving issues and helping the couple to make the right decision. An attorney represents only the client who has retained his or her service and not for solving the problems. A mediator has a neutral part and only help in resolving the issues. Mediation taken place in courts is not private and the judge makes decision on the case. In the case of Robert and Denise, mediation would allow them to decide the outcome. The best thing for Robert and Denise is to have a mediator presence to help settle property, child support, and custody issues. According to Divorceinfo (2013) â€Å"The mediator remains neutral between the husband and the wife. That means the mediator cant give advice to either party, and also cant act as a lawyer for either party.† Conclusion Robert and Denise Patton seek legal consultation as a mean of finding ways of settling their conflicts. Legal consultation provides the couple with advice on the best avenue to take in solving their problems. Once the two meet with their lawyer, the couple is told if they should have a mediator there with his or her lawyer. Mediators do not represent either of the couple, only the individuals’ lawyers do.

Ascites Is A Special Case In The Medical Geriatric Ward Nursing Essay

Ascites Is A Special Case In The Medical Geriatric Ward Nursing Essay Background I think ascites is a special case in this Medical Geriatric ward, because I saw this only one case of ascites in this four weeks practicum. And it is my first time that care patient with ascites. Therefore, I interest and choose this case for studying the nursing care of ascites. In this total patient care study, I will talk about the information and relevant clinical data about this case, the pathophysiology of ascites, the nursing assessment, care plan within patient hospitalize period 20-21/09/2010, plan for future management, and what I learn from this case. Case presentation Patient X is 72-year-old male. He lives in old age home, chair bound for activities of daily living. He is dependent Comprehensive Social Security Assistance, exsmoker and exdrinker. He was admission to Accident Emergency at 20/09/2010. He complained that increased abdominal distension for 2 days, poor appetite, shortness of breath. Physcial condition: conscious, SaO2 95% under room air, afebrile, chest clear, no ankle edema. His primary diagnosis is cirrhosis and gross ascites. He has chronic renal impairment, diabetes mellitus, alcoholic cirrhosis of liver, and chronic ascites. Last time admitted from 05-07/09/2010 for ascites, therapeutic abdominal tap was done and 1.3L ascites fluid was removed. Ascites is an accumulation of extracellular fluid in the peritoneal cavity abnormally. It is the most common major complication of portal hypertension following liver cirrhosis. Blocking the blood flow through the liver sinusoids to hepatic veins and vena cava lead to increased pressure in the portal venous system. It results in plasma leaks out directly from the liver capsule and the congested portal vein into the peritoneal cavity. In addition, hepatocellular damage reduces the livers ability to synthesize normal amounts of albumin, which may deteriorate by leakage of protein in ascites. The evidence of hypoalbuminemia shows in the blood test that the albumin was 24g/L, which is a low level. Adlosterone cannot activate by liver to stimulate the kidneys to retain sodium and water due to hepatocellular damage. Thus, sodium and water are still retention, and the volume of peritoneal cavity fluid grows continue. In this case, the medical management can be performed to patient X should be paracentesis or abdominal tap. This procedure involves using a thin needle to pull ascites fluid from the abdomen (George Longstreth, 2009). Large-volume paracentensis repeated done in combination with Albumin administered intravenously, which can avoid a sudden drop in blood flow in the arteries and to replace each liter of removed ascitic fluid. The physician prescribed IV administration of Albumin 40g after tapping and 30g. 10500ml milk like in color of ascites fluid was removed. If ascites is recurrent, therapeutic abdominal tap may need to be done every two weeks or more frequently, and need to remove up to 10 liters ascites fluid (Cirrhosis Ascites). Ascitic fluid analysis also done before for provides a sample of fluid for analysis, which help for determine the underlying cause of the ascites. No malignant cell was found. An abdominal x-ray and ultrasonography study was done to comfier the presence of ascites. It may locate fluid in the peritoneal cavity. The result did not show dilated bowel. A low sodium and protein diet with restriction of fluids 1L per day. Edema in the form of ascites brings about shallow breathing and impaired gas exchange, as a result of respiratory compromise. We need to Promote and maintain an effective breathing pattern, Arterial blood gas analysis and pulse oximetry monitor every four hours were ordered. Potassium- sparing diuretic Frusemide tablet 40mg twice a day was prescribed. Nursing assessment In abdominal assessment, inspect for skin integrity (pigmentation, lesions, scars, veins, and umbilicus, etc), contour (flat, rounded, etc), distension, respiratory movement, visible peristalsis, and pulsations. Then to auscultation of the abdomen, warmed the stethoscope and the hands, light pressure act on the stethoscope is sufficient to detect bowel sounds and bruits. Then perform percussion of the abdomen; abdominal percussion is aimed at detecting fluid in the ascites, gaseous distension, and masses within the abdomen. Percuss lightly on abdomen according to auscultation site at each abdominal guardant. The sound will be dull if the ascites is presence. Measure the abdominal girth circumference. Assess the amount of distress leaded by the ascites that ask the patient whether the fluid is interfering with sleeping, eating, and breathing (Head-To-Toe Assessment (R. Abdomen), 2008). Nursing diagnosis Excess fluid volume and deficient fluid volume related to fluid shifts secondary to portal hypertension, hypoalbuminemia. It is a combination of volume problem for patient with ascites. The expected outcomes of this care plan are that a normal balance of fluid in the peritoneal cavity will be maintained as evidenced by normal serum albumin levels, without of hypovolemia, decreased abdominal girth, and normal blood pressure measurement. Electrolyte or acid- base are balance. For nursing intervention, monitor the intake and output of patient daily, and record the IO chart. Output should be equal to or exceed intake. Strictly restrict the patients fluid intake. If possible, administer medication with meals, so mealtime fluids can be used for taking medications. Assess the patients dietary intake and habits that may lead to fluid retention. Limit high sodium intake, because it can lead to increased water retention. Administer albumin and diuretics as physician prescribed. Aspirin and nonsteroidal anti-inflammatory drugs may inhibit prostaglandin synthesis and impair sodium excretion by the kidney. Thus, it needs to avoid administering them. Weight the client and measure the patients abdominal girth daily. Closely monitor the patient after paracentesis procedure. To ensure the client has tolerated the procedure well, check the vital signs frequently. Check the dressing carefully to ensure that there are no losing excessive amounts of fluid. Use a pouch to co llect leaking fluid if necessary. Ineffective breathing pattern related to increased intra-abdominal pressure on the diaphragm. The expected outcomes of this care plan are that the patient express relief of feelings of faulty breathing pattern as a result of no shortness of breath and the presence of normal respiratory excursion. Patient has a normal respiratory rate, compared with baseline. (Lynda juall carpenito-moyet) For nursing intervention, position the client in a high-Fowler position with an arm supported with pillows. It can facilitate breathing and relieves the pressure acting on diaphragm. Monitor the clients respiratory status (crackles and increased respirations) for the development of atelectasis or pneumonia to identifies fluid in lungs. Encourage the patient to deep breathe and cough. Use an incentive spirometer to maintain and monitor the respiratory function. If the cough does not loosen to expectorate reparatory secretion, patient can receive ultrasound treatment For improving gas exchange, administer oxygen and blood products as ordered. Teach the patient some breathing techniques, such as pursed-lip breathing to overcome poor breathing patterns (Lynda juall carpenito-moyet). To evaluation the outcome, treatments of ascites enable the client to breath with minimal difficulty. Imbalanced nutrition: less than body requirements related to increased pressure on stomach and intestines, feeling of fullness, poor appetite. The expected outcomes of this care plan are that patient X has appetite and he can keep or increase body weight to an ideal weight and consume sufficient nutrients. Identify deficiencies in daily intake. For nursing intervention, measure the body weight daily to monitors the weight gain or loss. Monitor hemoglobin, hematocrit, albumin, total protein values for monitoring the intake of nutrients, presence of anemia, and colloidal osmotic pressure. Offer and encourage oral hygiene before meals, because poor oral hygiene may cause bad odor and taste, which can reduce appetite. Encourage the patient to rest before meals due to fatigue may decrease appetite and ability to eat. (Lynda juall carpenito-moyet) Provide small, frequent meals for patient instead of few large ones, because even distribution of intake can help to prevent feeling full and ensures enough nutritional intake. Determine food preferences and selected low or no protein and low salt (no more than 1500 mg/day of sodium). If possible, encourage the patients relative to bring permitted foods from home. Prevent constipation to reduce abdominal pressure and fullness. Administer Lactulose liquid 20mal three times a day as physi cian ordered. Plan for management after discharge, patient x should back to the old age home and have follow up by community geriatric assessment service. Recommend short the follow up clinically admission if symptomatic ascites occur. Refer PCU home care nurse for visiting and symptom assessment, and admission clinically for symptom management. Learning points After this total patient care study, I have learnt that more understand the cause and care of ascites. And know that to provide a holistic care not only physical nursing care, but also we need to care the patient mental, social, finical condition, and discharge planning Make sure patient can have a complete care after discharge. Word count: 1452 Black, J. M. Hawks, J. H. (2009). Medical-Surgical nursing: Clinical management for positive outcomes. Missouri: Saunders. George F. Longstreth MD http://www.healthline.com/adamcontent/ascites#ixzz11s5PVSzi Head-To-Toe Assessment (R. Abdomen) (Head-To-Toe Assessment (R. Abdomen), 2008) (Cirrhosis Ascites). http://www.healthcentral.com/ency/408/guides/000075_11.html