The Treatment of Acute Exacerbation of COPD Research Paper - 1

The Treatment of Acute Exacerbation of COPD - Research Paper Example However, Sahn (2012) conducted research that showed the pre-hospital administration of hydrocortisone may improve. This could possibly be a result of evidence-based practice (EBP) and the purpose of this paper is to present the results of research into the topic.   EBP is relevant in practice mainly because it is informed by recently researched data that has been approved by professionals and the industry. According to Moyer (2008), managing acute exacerbation of COPD is a common practice that demands the critical search for evidence in the healthcare setting. In agreement with this opinion, Gregory and Mursell (2010) emphasize that medical practitioners should formulate relevant questions about the treatment of acute exacerbation of COPD. Based on this, this essay will search and answer the question â€Å"would the outcome of patients with acute exacerbation of COPD be improved by the pre-hospital administration of hydrocortisone in the UK?† Specifically applied to this question, the PICO model defines not only the problem but also the population at which the population is targeted. This was significant in the shaping of the literature search because it narrowed down the scope to a more defined area with specific expected outcomes. Yoder-Wise (2007) points out that it is critical in detailing the interventions and risk factors that must be considered by paramedics in their proc edure. This is as opposed to stereotyping the management of acute exacerbation of COPD to a particular long-used procedure (Goldacre, 2013).  Ã‚  

Business Risk in an Uncertain Global Economy Essay - 1

Business Risk in an Uncertain Global Economy - Essay Example The primary risks related to the global volatility are the interest rate risk, currency risk, country risk. All the three are related to each other and have a cascading effect over each other (Skipper & Kwon, 2007, pp. 20-23). Interest rate risks are related to the magnitude and probability of the unanticipated changes in the interest rates that exert an influence over the cost of various sources of capital in a specific currency denomination of an economy and others related economies and the demand for the products. The effects are considered in measuring the exposure of the overall interest rate changes. Currency risk has been related to the magnitude and probability of the uncertain changes taking place in the exchange rate and the inflation rates that is n the value of the foreign and domestic money. On the other hand the country risks refer to the enormity and probability of the changes in the country’s productivity development. Country risks are primarily related to the aggregate demand influencing the scale of production which in turn is affected by the political risk and global economical risks. The country risk exerts an influence over the business related risk and decision making policies of each business operating within the country premises. A firm competitive risk basically refers to the enormity and probability of the uncertain changes in the business specific conditions in addition to the industry specific and demand condition affected by the interest rate, currency rate and country risks (Oxelheim & Wihlborg, 2008, pp. 20-25). Instances can be derived from the global turbulence situation which Bank of England faced during 2013 and how they dealt with such situation. As per the governor of the Bank Of England, â€Å"Over two years now we have seen the situation in the euro area get worse and the problem being pushed down the road† (BBC News Business, June 2012). From the statement it can be assured that individuals in the business o rganizations, the firm itself and the government primarily deal with such uncertainties arising out of the volatile economy by executing certain risk management processes. Financial Management Theories, communication and initiatives: Financial management theories are related to the financial risks. Financial risks generate from the individual’s or the firm’s possession or usage of the financial instruments. The financial risk can evolve through various sources such as interest rates, issuance of stocks, credit extensions, and transaction of foreign currencies and also through various usages of derivatives. So it assures that the business incorporate the defaulter risk within its operations. Any firm when extend the credit to their customers suffers from the financial risk that someone will default. So as the individual also sustains the financial risk while borrowing money from the business enterprises like bank for fulfillment of their personal needs of like buying ho use, cars, making investments etc. Financial risks are primarily external towards the business and the individual and therefore are less subjected to the direct control of the same. On the other hand, they involve a careful and specific selection of the financial instruments (Pixley, 2004, pp. 1- 17). The financial management theories related to the financial risks can be divided into financial market risks, operational risks and the strategic risks. The

Conflicting Views of the California High School Exit Exam Essay

Conflicting Views of the California High School Exit Exam - Essay Example First, what is the minimum education children should have to graduate Are there a set of standards which have to be met, and a certain level of proficiency achieved Secondly, what does a high school diploma symbolize If it is meant to suggest that a person has attended high school, than by all means drop the exam. However, if it is meant to suggest that this student has an education, and has learned and met minimum levels of ability, then the exam should stand. Otherwise the degree is devalued for all those who truly earned it. Finally, can California make a clear case for discrimination, and prove that the exam is not fair to underserved children If so, then the results can not be validated. If they can prove that all children (while possibly not evenly served) have had enough opportunity to pass the exam, then the results should be upheld. By reviewing a brief history of the exam, and looking at both sides of the argument, it is clear that the exam should remain valid, and those 47 ,000 students should not be awarded their diplomas. The California High School Exit Exam is a new and fairly untested program. Originally slated to count towards graduation for the class of 2004, the schools held off until 2006, after state wide improvements were made to the schools. The exam tests for proficiency in eighth grade level math, and tenth grade level English. A student must get a fifty-five percent or higher to pass, and has six chances to pass the test. All over California people are arguing about the California High School Exit Exam. They claim that it is unfair, and that it expects too much of the students. Randy Dong, a California journalist suggests that it is not in the interest of education that these children are being tested, but rather in the interest of social promotion. He says "we are throwing algebraic and geometric problems at students who cannot even perform basic arithmetic" (Dong 2006). However, the exam only tests through eighth grade math and tenth grade reading (Washburn 2006). These children have twelve or more years of education, yet they can not pass proficiencies below their own level of academia. While Dong is in the minority, arguing about content, his view is important. In reviewing what is at stake, it is important to ask how low United States citizens are willing to set the bar in education. What should be a minimum level or proficiency to have a diploma Where Dong argues that algebra is too high a stan dard for students graduating from high school, others argue that the standards set by the test are two low. In an editorial from the Press-Enterprise, it questions "Freedman decreed that requiring students in low-performing schools to answer correctly just 55 percent of the questions in eighth-grade math and 60 percent of the questions in 10th-grade English - even after six tries - is an arbitrary violation of the state constitution." For students whose education has respectively passed four and two years beyond those levels, those minimums seem low, not high. With six tries, and tutoring available, no child should be able to fail that test, and if they do, then why should they be allowed a diploma Judge Freedman ruled that denying students the diploma would negatively impact their self-esteem, but what about the devaluation of the

Germany's Holocaust Memorial Essay Example | Topics and Well Written Essays - 250 words

Germany's Holocaust Memorial - Essay Example Then there are those who argue that the site is not Jewish enough, since it lacks obvious Jewish religious symbols (Eisenman, 2006). An advantage for having the information center within the site is to harmonize, the concept of the memorial site with individual documentation concerning the Holocaust victims and their families. Hence, visitors do not just get to express their somberness, but they get to learn more about these victims and understand how typical they were through their biographical details. Furthermore, the information center assists in the broader documentation and education of universal concerns of genocide. The downsize of the information center is that, it can be perceived as presenting a new thought of memory, discrete from nostalgia, more of a public relation gimmick. The US does not have a permanent national memorial for victims of slavery, and the genocide of American Native Indians. Currently, the proposed museum for slavery has stalled entirely, while the native Indians have the national museum of American Indians at the national mall (National Mall,

Menatl Illness Essay Example | Topics and Well Written Essays - 500 words

Menatl Illness - Essay Example For clarification purposes, OCD is a mental disorder which is not similar with having an Obsessive Compulsive Personality Disorder. OCD is characterized by intrusive thoughts such as believing that a devil or another being could possibly harm them or their loved ones. Such thoughts results into behavior that seems paranoid such as being overly protective of people close to them. On the other hand, OCD personality disorder is more concerned with rules, standards, guidelines which makes a person a â€Å"perfectionist†. OCD is a mental disorder with two different but related components. These are intrusive thoughts, the â€Å"obsessive† part of the disorder, and repetitive behaviors, the â€Å"compulsive† part of the disorder (Rachman,2003, p.21). Aardema ( 2007) characterized OCD as ego-dystonic which meant that the individual’s elf-concept is not compatible with the disorder ( p.187). On the contrary, OCD personality disorder is ego-syntonic which is define d by Dorland’s Medical dictionary as â€Å" aspects of a persons thoughts, impulses, attitudes, and behavior that are felt to be acceptable and consistent with the self-conception.† All mental disorders can lead to serious consequences for the individuals who are affected by it. Perhaps among the mental illness known to man, OCD subjects the patients to casual and daily ridicule . There are countless jokes – on everything from sit-coms to sportscasts – about people washing their hands a la Lady Macbeth in an obsessive way. People make continual references to being obsessive or compulsive about one thing or another all the time in a way that to someone who actually struggles with OCD can feel slighting and incredibly dismissive. Those who have this condition, far from finding it a joke, can in fact find it crippling and are often deeply ashamed of their thoughts and behaviors As aforementioned, the disorders have both compulsive and

A Tale of Two Cities Essay Example for Free

A Tale of Two Cities Essay Throughout well-known stories, authors tend to develop memorable characters in order to enhance the plot; although they may not always be portrayed in the most considerate manner. In Charles Dickens’ novel A Tale of Two Cities, he also uses such characters. First, Lucie’s role of over dramatic damsel in distress. Second, Miss Pross’ participation as the over protective mother figure. And third, Mme. Defarge as the bloodthirsty crazed villain. Through these characters, Dickens portrays women in the three most stereotypical demeanors: weak and fragile, a worrisome mother and a psychotic wife. Throughout the novel, Lucie is a feeble girl who cannot stand up to the hardships of life. â€Å"Perfectly still and silent, and not even fallen back in her chair, she sat under his hand, utterly insensible; with her eyes fixed upon him and with that last expression looking as if it were carved or branded in to her forehead† (Dickens 25). This is Lucie’s reaction to the news from Mr. Lorry that her father, presumed to be dead, has been found alive after spending eighteen years in the Bastille. Instead of a normal reaction of tears and joy, she is simply so stunned that she cannot even move; her expression of shock and fear is frozen upon her face. She reacts very similarly when she goes to meet  her father for the first time. Dickens writes, â€Å"Mr. Lorry got his arm securely round the daughter’s waist, and held that she was sinking†¦ ‘I am afraid of it’ she answered, shuddering. ‘Of it? What?’ ‘I mean of him. Of my father’ † (36). Of course it would be intimidating for her to meet her father for the first time in her life but she is on the verge of fainting a second time just from thinking about her father. She also does not even see him as human referring to him as â€Å"it†, not even wanting to approach her father. Finally, when her husband is taken away to prison, again she displays weakness, â€Å"As he went out at the prisoners’ door, she turned laid her head lovingly on her father’s breast, tried to speak to him and fell at his feet† (324). Yes it horrible to have her husband sentenced to death and is taken away to prison. But, she has a 6 year old daughter, she cannot give in to self-pity and weakness, it is the time for her to be strong not only for herself but for her daughter as well. It is important for her to see her mother strong and able to be there for her, but when she faints, her hope falls alongside her mother’s body. It seems Lucie has never had to really fight or be strong for anything in her life before. She acts like she always needs to rely upon someone else; she is very dependant upon others. Miss Pross’ role in the novel, although not very large, was nonetheless very important, especially for Lucie. Miss Pross was the mother figure in Lucie’s life, always caring for her and always nurturing her. When Lucie faints at the mention of her father, it is Miss Pross who is the first to her side: â€Å" ‘Why, look at you all!’ bawled this figure, addressing the inn servants. ‘Why don’t you go and fetch things, instead of standing there staring at me?†¦if you don’t bring smelling salts, cold water, and vinegar, quick, I  will’ † (26). She quickly takes charge of the situation and gives out orders in the same urgency as if it was her own daughter. It is also always Lucie for whom she is most concerned about: â€Å" ‘O me, O me! All is lost!’ cried she, wringing her hands. ‘What is to be told to Ladybird? He doesn’t know me, and is making shoes!’ † (187). Dr. Manette has a relapse and is no longer coherent. Miss Pross’ first concern is not restoring Dr. Manette back to health, but what the impact of seeing her father like this will do to Lucie. Finally, Miss Pross demonstrates her love for Lucie because she is willing to lay down her life for Lucie: â€Å" ‘I am a Briton,’ said Miss Pross, ‘I am desperate. I don’t care an English twopence for myself. I know that the longer I keep you here, the greater hope there is for my ladybird’ † (356). This demonstrates Miss Pross’ love for Lucie, risking her life in the hope that her sacrifice will keep Lucie safe. Miss Pross means well and is always looking out for Lucie and would do anything for her. However at times her actions are a bit eccentric. Finally, there is Mme Defarge, a very angry and vengeful woman. Mme Defarge takes it upon herself to make a register of all the nobility whom she proclaims as enemies to the revolution: â€Å" ‘Knitted in her own stiches and her own symbols, it will always be as plain to her as the sun. Confide in Madame Defarge. It would be easier for the weakest poltroon that lives, to erase himself from existence, than to erase one letter of his name of crimes from the knitted register of Madame Defarge’ † (166). This is M. Defarge explaining his wife’s register to others of the revolution, and saying that any who make it onto the register; will meet certain death. Not only does she register all  nobility in her knitting, but Mme Defarge also makes a point to remember the faces of anyone who is an enemy to the revolution: â€Å" ‘His appearance; is it known?’ ‘Age, about forty years; height, about five feet nine; black hair; complexion dark; generally, rather handsome visage; eyes dark, face thin, long and sallow; nose aquiline, but not straight, having a peculiar inclination towards the left cheek’†¦Ã¢â‚¬ËœIt is a portrait!’ said madame, laughing. ‘He shall be registered to-morrow’ † (171). Just from this short description, Mme Defarge already has a mental image of this man and even commits it to her memory. Finally, once she decides to kill someone, she will stop at nothing to kill them: â€Å" ‘I have been in the streets from the first, nothing has stopped me, I will tear you to pieces, but I will have you from that door’ † (356). This is Mme Defarge when she is confronting Miss Pross, telling her that she has been fighting in the streets for the revolution since day one, and nothing will keep her from killing Lucie as well. Mme Defarge’s rage and thirst for blood did greatly help the revolution. However, it became something that ultimately consumed her and turned her in to what she set out to destroy in the first place. It is through these characters that Dickens portrays women very unjustly. Lucie as delicate and flimsy, not being able to handle life’s hardships. Miss Pross as the overprotective mother, sometimes taking her job to the extreme. Mme Defarge as the crazed wife, always full of anger and violence. Even though women display these qualities from time to time, is it really fair to say that these traits define their whole character.

History of International Human Resource Management

History of International Human Resource Management Up until the 1960s, even firms operating internationally maintained organizational structures with centralised technical and managerial resources, manufacturing ability, and the access to and control of the capital (Doz Prahalad 1981). As exports increased, it was seen as more attractive to establish sales subsidiaries in other countries, often staffing them with skilled personnel from the home country. These expatriates had the necessary product knowledge, and could even initiate local manufacture, but also had a perceived primary loyalty to the home company and country culture. Unfortunately, this was also an era of convergence thinking (usually towards the dominant U.S. culture), with sometimes lamentably littleattention being given to national sensitivities and cultural beliefs and behaviours With the developing internationalisation of many firms in the late 1960s and early 1970s, companies established overseas plants and entered joint ventures with foreign affiliates. Firms sought commercial success through moving closer to their customers by employing more host-country nationals. In some situations, they aimed at being perceived more as local rather than foreign, for various reasons. In the 1990s, not only has the practice of IHRM become more sophisticated, but research into its policy and practice has become established. It has a developing body of research and practice which is regularly considered at dedicated conferences, and published in general management as well as HRM journals. Increasingly, international HRM is being taught in university faculties of business management courses, and management MBA graduates, as well as graduates in HRM, are now more frequently aware of the issues involved, and the functions of HRM in an international context. International human resource management What an HR manager does in a multinational corporation varies from firm to firm. It also depends on whether the manager is located in a global corporations headquarters or onsite in a foreign subsidiary. What is IHRM? Actually, it is not easy to provide a precise definition of international human resource management (IHRM) because the mission of an HR manger in a multinational corporation (MNC) varies on a large scale. Generally speaking, IHRM is the effective utilization of human resources in a corporation in an international environment. The term IHRM in most studies has traditionally focused on the area of expatriation (Brewster and Harris, 1999) Broadly defined, international human resource management (IHRM) is the process of procuring, allocating, and effectively utilising human resources in a multinational corporation. If the MNC is simply exporting its products, with only a few small offices in foreign locations, then the task of the international HR manager is relatively simple. However, in global firms human resource managers must achieve two somewhat conflicting strategic objectives. First, they must integrate human resource policies and practices across a number of subsidiaries in different countries so that overall corporate objectives can be achieved. At the same time, the approach to HRM must be sufficiently flexible to allow for significant differences in the type of HR policies and practices that are most effective in different business and cultural settings. This problem of balancing integration (control and coordination from HQ) and differentiation (flexibility in policies and practices at the local subsidiary level) have long been acknowledged as common dilemmas facing HR and other functional managers in global corporations. Although some argue that IHRM is not unlike HRM in a domestic setting, others point out that there  are significant differences. Specifically compared with domestic HRM, IHRM (I) encompasses more functions, (2) has more heterogeneous functions, (3) involves constantly changing perspectives, (4) requires more involvement in employees personal lives, (5) is influenced by more external sources, and (6) involves a greater level of risk than typical domestic HRM. When compared with domestic human resource management, IHRM requires a much broader perspective on even the most common HR activities. This is particularly so for HR managers operating from a MNCs headquarters (HQ). The number and variety of IHRM activities are daunting. International HR managers must deal with issues as varied as international taxation; international relocation and orientation; various other administrative services for expatriates; selecting, training and appraising local and international employees; and managing relations with host governments in a number of countries around the world. Even when dealing with one particular HR function area such as compensation, the international HR manager is faced with a great variety of national and international pay issues. For example, while dealing with pay issues, the HQ-based HR manager must coordinate pay systems in different countries with different currencies that may change in relative value to one another over time. An American expatriate in Tokyo who receives a salary of $100,000 may suddenly find the buying power of that salary dramatically diminished if the Japanese yen strengthens in value relative to the US dollar. A US dollar purchased 248 yen in 1985, but less than 110 yen in 2000. In the case of fringe benefits provided to host company employees, some interesting complications might arise. For instance, it is common in the United States to provide health insurance benefits to employees and the employees family, which usually means spouse and children. In some countries however, the term family may include a more extended group of relatives-multiple spouses, aunts, uncles, grandparents, nephews, and nieces. How does the firms benefit plan deal with these different definitions of family? A final aspect of the broader scope of IHRM is that the HQ-based manager deals with employee groups that have different cultural backgrounds. The HQ manager must coordinate policies and procedures to manage expatriates from the firms home country (parent country nationals, PNCs), host-country nationals (HCNs), as well as third country nationals (TCNs, e.g. a French manager working for an American MNC in the firms Nigerian subsidiary) in subsidiaries around the world. Although such issues are important for the HQ-based manager, they are also relevant to the HR manager located in a subsidiary. This manager must develop HR systems that are not only acceptable to the host country but also compatible with company-wide systems being developed by his or her HQ-based counterpart. These policies and practices must effectively balance the needs and desires of local employees, PCNs and TCNs. It is at the subsidiary level that the increased involvement of IHRM in the personal lives of employees becomes particularly apparent. It is not unusual for subsidiary HR managers to be involved in arranging housing, healthcare, transportation, education, and recreation activities for expatriate and local staff. IHRM activities are also influenced by a greater number of external forces than are domestic HR activities. The HQ-based manager may have to set equal employment opportunity (EEO) policies that meet the legal requirements of both the home country and a number of host countries. Because of the visibility that foreign firms tend to have in host countries (especially in developing countries), subsidiary HR managers may have to deal with ministers, other political figures, and a great variety of social and economic interest groups than would normally be encountered in a purely domestic HRM. Excerpt from Human Resource Management by Cynthia D Fisher, Lyle F Schoenfeldt, James B Shaw. Published by Biztantra