Financial Management of the National Health Service (NHS)

Financial Management of the National Health Service (NHS) Introduction This academic paper described a public sector in health care particularly on its financial management. The chosen public sector is the National Health Service (NHS). A description of the sources of funds and expenditures of NHS is provided. Financial decision-making, control and monitoring in public sectors are analysed within the context of this organisation. Specifically, a discussion of financial accountability and budgeting in public sector are explained. At the end of the paper, the tender process and specification for NHS England was provided and a criteria for selection was devised. The National Health Service (NHS) The National Health Service (NHS) is a publicly funded organisation that provides health care services to residents of United Kingdom. It was established in 1948 and currently provides a wide array of services including antenatal screening, treatment of chronic diseases, emergency care, transplantations, preventive care and end-of-life care (NHS, 2013). The Washington Commonwealth Fund, this organisation is the best health care system in the world in 2014 (NHS Confederation, 2014). With the exception of some prescription, optical and dental services, all health care services by NHS are free for all the 63.2 million residents of United Kingdom (NHS, 2013). Health services being provided are determined by the Secretary of State for Health (England), the Minister for Health and Community Care (Scotland), the Minister for Health and Social Services (Wales) and the Minister for Health, Social Services and Public Safety (Northern Ireland) (Harker, 2012). Funding Harker (2012) released vital information on the way the NHS gets its fund. The funds of the NHS are being given by the Department of Health and come from the taxes collected from the people. For 2012/2013, the latest published fund was  £108.9 billion (NHS, 2013). An estimated 80% of NHS funds go to the 151 existing Primary Care Trusts and the amount they receive would depend on the serviceable population and their need (Harker, 2012). In addition, the money primary care trusts are getting can be dispensed by commissioning health services from NHS, independent and voluntary sectors they deemed most needed by their local residents (Harker, 2012). For prescription charging in England, patients pay an amount of  £7.20 while Wales, Northern Ireland and Scotland charge none (Harker, 2012). The Department of Health Resource Accounts for 2010/11 estimated that  £450 million were raised from prescription charging in England. For dental treatment, on the other hand, the amount being paid by patients cost around  £17.50- £209 depending on the dental case in England,  £12 to  £177 in Wales, up to  £384 in Northern Ireland and Scotland (Harker, 2012). The amounts of funds raised were estimated to  £614.3 million in England and  £27.3 million in Wales for 2009/10 (Harker, 2012). Other sources of funds would overseas patient charging, treatment of private patients and hospital parking and telephone use fees (Harker, 2012). The funding and expenditures of the NHS per year is made known to public through the government’s annual reports. NHS Public Accountability Maybin et al (2011: 7) defined accountability as the â€Å"relationship involving answerability, an obligation to report, to give account of, actions and non-actions†. Primary care trusts who are the main recipient of most of the NHS funds and the commissioners of health services are held accountable in terms of: 1) management by the strategic health authority and the Secretary of State for Health; 2) regulation on the quality of commissioning by the Care Quality Commission; 3) scrutiny for financial management and disbursement of resources by the Audit Commission, local overview and scrutiny committees, non-executive directors of the boards and patient and public representatives of local involvement networks (Maybin et al, 2011). In the future, commissioners will likewise be held accountable by the new national NHS Commissioning Board, standing rules of the Secretary of State, Monitor, new health and well-being boards, local HealthWatch, and the National Audit Office’s consolidated annual accounts (Maybin et al, 2011). The NHS Trust are accountable to primary care trusts, Care Quality Commission, local involvement networks, Audit commission, local overview and scrutiny committees, and externally appointed non-executive directors of the boards (Maybin et al, 2011). For the NHS Foundation Trust are likewise monitored the same as that of NHS Trust with the addition of the governor and Monitor (Maybin et al, 2011). In addition, independent sector providers are held accountable only by the primary care trusts, Care Quality Commission and local involvement networks (Maybin et al, 2011). Financial Control and Monitoring Good financial control and monitoring are keys to effective financial management in the health care sector (Cichon, 1999). A formal management control system includes the following processes: 1) programming, 2) budgeting, 3) operating measurement, 4) reporting and evaluation, and 5) feedback and correction (Finkler et al, 2007). Programming involves selecting the programmes that the organisation wants to engage at in the future (Finkler et al, 2007). Control of the future programmes will ensure that adding these to current programmes can meet the mission, vision and objectives of the organisation. Next is setting the budget. The budget is used to compare the budgeted amount with the actual amounts used by the organisation in a fiscal year and would mainly tell if the organisation has met its targeted operating and financial performance (McLean, 2002). Moreover, the management must be able to produce reports of its operating finances for evaluation, feedback and correction (Finkler et al, 2011). In the NHS, the chief executive is the one responsible for the organisational finances and he/she is held answerable to the Permanent Secretary or the Chief Executive of NHS (Audit Commission, 2004). Meanwhile, the director of finance is tasked to ensure that all practises and procedures related to the organisation’s finances are sound and in place (Audit Commission, 2004). The Audit Commission (2004) explicitly suggests way to improve financial management especially in controlling and monitoring. The first step is financial planning. A financial plan should be able to project the revenue and the capital needed in a particular period of time while placing consideration on possible shifts in capital spending. NHS bodies are suggested to consider extra investments that can improve the services such as spending for technology and research. In the long run, these may lessen capital costs and provide more revenues. After the financial planning, the budget must be set and prepared to ensure proper allocation. The budget must be created consistent with the vision, mission, goals and objectives of the organisation. In NHS, a combination of zero-based budgeting and incremental budgeting are being used. In zero-budgeting, the organisation starts from none while in incremental budgeting, the budgets are carried forward and adjusted yearly. Budget reporting and mon itoring comes next wherein the budget is reported to budgetholders especially the variances so that corrective actions can be applied. Board reporting comes next wherein financial information is relayed to NHS boards so that they can take corrective actions as early as possible whenever necessary. Financial reports are also produced as part of the statutory obligation of NHS bodies. Through financial reports produced annually, the NHS is able to inform the public where their taxes for health go. Treasury management, on the other hand, ensures the sufficiency of cash through receipt and payment management, borrowings and investments, and cashflow monitoring. The Department of Health sets the amount of cash expenditures that NHS bodies are allowed to spend. The NHS also implements system for financial control to ensure public accountability. This is signified by the chief executive’s annual statement on internal control. Lastly, the NHS must ensure value for money by fostering learning, transparency and openness in using new resources. Financial Information and Decision Making Decision-making is a process of selecting course of actions from a pool of actions that may be feasible or applicable (Cleverly et al, 2010). In terms of finances, the management must be able to utilise financial information in aid of decision-making. The information must then be accurate, timely and relevant in order to arrive at an effective and high quality decisions (Cleverly et al, 2010). For example, a financial forecast of a new technology serves as the information for the NHS. Based on the forecast, the decision question now is to whether the new technology must be purchased or not. Supposing that the decision was to purchase the technology and the result was significant earnings for the NHS, then the financial information was successfully utilised to aid in making the right decision. Khan and Jain (2007) suggests that to arrive at financial decisions, the finance manage must be able to determine sources of short-term and long-term financing and their alternatives at a given point in time. In the case of the NHS for example, short-term financing could be the dental charges from patients while long-term financing would be the tax funds coming from the government. Supposing that there is a shortage of funds for the coming fiscal year, the finance manager must ask what could be a good source of readily available short-term and long-term financing at the moment to meet the first quarter needs. Tender Process and Documentation The tender process may be used by organisations which need a particular service (Oakley, 2008). The organisation is expected to release a tender specification which provides the details of the type of services they need, volume of work, locations and costs (Oakley, 2008). In the NHS, there are five stages in the tender process namely: 1) assessing sustainability; 2) submission of the pre-qualification questionnaire; 3) invitation to tender; 4) final interview and presentation; and 5) contract award (Royal College of Nursing, 2005). Assessing sustainability includes performing pre-tender checks, finding a tender notice, obtaining a copy of the tender and evaluating it, providing an expression of interest and completing subsequent forms (Royal College of Nursing, 2005). The next step would be to submit the pre-qualification questionnaire which is then decided by the Commissioner. Once the Commissioner gave a favourable decision, an invitation to tender will be issued to which a respons e would be needed for final evaluation of the Commissioner (Royal College of Nursing, 2005). A final interview will be conducted together with the Commissioner and a positive response would end with the awarding of the contract (Royal College of Nursing, 2005). Based on the NHS process, tender criteria have been devised (Morledge and Smith, 2013; Ward, 2008). The scoring will be based on organisation details (10%), workforce information (10%) , financial standing (10%), relevant experience and technical ability (15%) , health and safety (15%) , insurances (5%) , references (5%), quality assurance (15%), equal opportunity declaration (5%), and evidence of registration with the regulatory bodies (5%) (Royal College of Nursing, 2005). A corresponding score will be given which range from 0=failed to 5= very high standard. The score will be multiplied with the percentages per item to get the weighted score. The weighted score will be totaled. The total weighted score will serve as basis for ranking (Ward, 2008). Summary and Conclusion They say that the health of the people reflects the richness of a nation. Health care is a fundamental right and a public concern. Thus, a public organisation such as NHS must be able to exercise effective financial management, control and decision-making so that more citizens can be given the right quality care that they pledged to provide for free. Since most of the funding of the NHS come from the money of the people, accountability must be observed by those in-charge of handling the organisational finances. A system of check and balance through transparency in financial auditing and reports and vigilance of the public are necessary in ensuring that the people’s money are spent rightly on where it is needed the most. In public sectors, the tender process is usually applied in evaluating and selecting suitable suppliers. Before one can enter into public contracts, the tender process is usually observed as a means to determine the quality of the services being procured by the government. It also ensures that every purchase has clean documentation and has gone through a thorough process of screening. For public organisations, the tender process is usually followed since the money being allocated are in huge amounts and most of all from the people who pay their taxes.

Ronald Regan :: essays research papers

Reagan, Ronald Wilson (1911- ), 40th president of the United States (1981-1989) Ronald Reagan was born in Tampico, Illinois. In a family of 3 boys he was the youngest. His father was a traveling shoe salesman. Reagan's mother taught Reagan how to read at an early age, which heavily influenced him positively. Most of Reagan's childhood was spent in Dixon, Illinois. Reagan attended and graduated from Eureka College a small religious school around Peoria, Illinois. He majored in economics, and he was president of the student body, a player on the football team, and captain of the swimming team. He also looked toward acting, but when Reagan graduated the only available related to show business was a local radio sportscaster. In 1936 Reagan became a sportscaster for station WHO in Des Moines, Iowa. 1937 Reagan went to Hollywood and began to work as an actor he starred in more then 50 films like Knute Rockne-All American, king’s Row, and Bedtime for Bonzo. He married actress Jane Wyman and they had two children. After eight years of marriage they got divorced and Reagan remarried Nancy Davis. They had two children. Reagan's first political activities were associated with his responsibilities as a union leader. As union president, Reagan tried to remove suspected Communists from the movie industry. When the U.S. House Committee on Un-American Activities began an investigation in 1947 on the influence of Communists in the film industry, Reagan took a strong anti-Communist stand testifying before the committee. As governor or California, Reagan became one of several widely known conservative politicians who wanted to slow down government involvement in the economy and society. In 1968 Reagan’s first term as governor, he decided to run for presidency. He lost to Nixon. After completing his term as governor, Reagan decided to run for president again. This time he challenged Gerald Ford for the 1976 presidency.

Balancing the Budget

American Government Balance the Budget When it came to the budget simulator I went in there with a general idea of what I wanted to do, and the results were surprising. I was able to cut the deficit by $256 billion leaving a deficit of only $144 billion. I was not able to completely balance the budget which is disappointing but I made a significant difference. It was very difficult to make a balanced budget which I felt was fair but I’m sure many people would feel my cuts and increases were unfair or unwarranted. My biggest area for budget cuts was that of military spending, although it still makes up a large portion of the budget. I cut $208 billion from the military spending mainly because if we were to pull out from the war it would largely lower our deficit. I left the spending for military personnel unchanged because I do not deny that the military is necessary, I do however, doubt that we need all the research at the time simply because the war being fought was no relevant to us and we shouldn’t have been involved. Which brings me to the $80 billion cut from the Iraq and Afghanistan operations. I cut $105 billion from our military operations there and severely debated eliminating it completely, but we do need funding in order to bring our troops home. I eliminated our reconstruction aid there simply because with our country in such a huge problem area we need to focus on fixing our country first. On the topic of military personnel I chose to actually increase the spending towards military retirement simply because they have done a lot for our country and we need to show them support for all they have done. In retrospect I nearly eliminated the budget for foreign affairs, due to the fact that we have our own problems to fix. I completely eliminated the international development and humanitarian assistance, and international military aid budgets. My reasoning behind this is that our development is hurt in terms of economy and yes it is bad that the other countries aren’t as privileged as us but when more money is going into their development than fixing our country it is a serious problem. I won’t go into detail about every field but the last field I want to outline my reasoning behind for cutting spending in is the tax breaks for large corporations and the benefits for the richest 20% of the taxpayers. My main reason for doing this is because we need to stop placating the â€Å"rich† in our country and stop giving them so many ways to continually make obscene amounts of money which many of them will spend on frivolous things and very few give to charity. Giving the rich many tax write- offs and benefits did nothing but hurt this country. This is why I actually increased the benefits given to the bottom 60% of taxpayers by 20%. I cut all corporate tax breaks by 20% simply because the corporations are just as much at fault as the rich for hoarding the money and not returning their wealth. Moving on to the areas where I did actually increase the budget one of the bigger increases and also one of the most important was in the education department; Increasing elementary, secondary, and vocational education budget by 50% and higher education by 20%. The education department has taken severe budget cuts and it is having an adverse effect on our students who will one day bring out a leader to run this country. I would rather not elect a poorly educated person as president thus our system needs as much budget as can be spared. Another area which received a large amount of an increase was Medicare and Non-Medicare health benefits because I personally know how much trouble this industry is in. Having a pre-existing condition and a severe one at that I know how difficult it is to get health insurance and the aid which comes with it can be less than stellar. Hopefully this increase would help promote better health in the citizens of the country. Playing off the medical benefits I also increased the aid to low income families because they are a large backbone to the society. With how the economy is you have families working three jobs and still struggling to make ends meet. This is very unhealthy and actually leads to more cost needed for medical benefits because when people get sick they have to go to the hospital. It was my hope that increasing both budgets would actually balance ut. The final increase I wish to cover is also slightly more of a controversial one and it may not be a modest increase but it is still important. I increased the border security and immigration budget by 50% in hopes that it would help lower the rate of illegal immigrants coming into the country and not becoming citizens. While at first it may be viewed as a heartless thought the truth is that while we allow the immigrants who come to the country and donâ€⠄¢t get citizenship to stay we increase our own expenses. By not being citizens they themselves do not actually pay federal taxes, especially if they work under the table. However, despite not being citizens they are still eligible for our low income aid, and medical benefit programs and this is actually taking away from the citizens and taxpayers who need it. There is also the unspoken fact that without a large amount of illegal immigrants who don’t speak English we could actually cut the spending for production of many products in Spanish and other languages since those who require them wouldn’t be living in the country. While balancing the budget it occurred to me why congress would have so many problems balancing the actual budget; it is difficult to keep everyone happy while maintaining a balanced budget. My cuts were largely from the foreign affairs, the rich and corporate America. The problem is those areas in this current day and age hold a lot of influence and it runs the risk of making a whole lot of people very angry. Congress has to try its’ hardest to create a balanced budget while remaining as politically correct as it possibly can. In short balancing this budget wasn’t as hard on me as it could have been simply because I have thought about this exact topic for a long time. While my budget may not be the most politically correct budget and it may not be completely balanced it did get results, and very significant ones at that. There were probably areas which I could have not increased the budget for or areas which could have been cut a little less but I feel strongly about my decisions and I would stand by them if ever they were questioned. Balancing the Budget American Government Balance the Budget When it came to the budget simulator I went in there with a general idea of what I wanted to do, and the results were surprising. I was able to cut the deficit by $256 billion leaving a deficit of only $144 billion. I was not able to completely balance the budget which is disappointing but I made a significant difference. It was very difficult to make a balanced budget which I felt was fair but I’m sure many people would feel my cuts and increases were unfair or unwarranted. My biggest area for budget cuts was that of military spending, although it still makes up a large portion of the budget. I cut $208 billion from the military spending mainly because if we were to pull out from the war it would largely lower our deficit. I left the spending for military personnel unchanged because I do not deny that the military is necessary, I do however, doubt that we need all the research at the time simply because the war being fought was no relevant to us and we shouldn’t have been involved. Which brings me to the $80 billion cut from the Iraq and Afghanistan operations. I cut $105 billion from our military operations there and severely debated eliminating it completely, but we do need funding in order to bring our troops home. I eliminated our reconstruction aid there simply because with our country in such a huge problem area we need to focus on fixing our country first. On the topic of military personnel I chose to actually increase the spending towards military retirement simply because they have done a lot for our country and we need to show them support for all they have done. In retrospect I nearly eliminated the budget for foreign affairs, due to the fact that we have our own problems to fix. I completely eliminated the international development and humanitarian assistance, and international military aid budgets. My reasoning behind this is that our development is hurt in terms of economy and yes it is bad that the other countries aren’t as privileged as us but when more money is going into their development than fixing our country it is a serious problem. I won’t go into detail about every field but the last field I want to outline my reasoning behind for cutting spending in is the tax breaks for large corporations and the benefits for the richest 20% of the taxpayers. My main reason for doing this is because we need to stop placating the â€Å"rich† in our country and stop giving them so many ways to continually make obscene amounts of money which many of them will spend on frivolous things and very few give to charity. Giving the rich many tax write- offs and benefits did nothing but hurt this country. This is why I actually increased the benefits given to the bottom 60% of taxpayers by 20%. I cut all corporate tax breaks by 20% simply because the corporations are just as much at fault as the rich for hoarding the money and not returning their wealth. Moving on to the areas where I did actually increase the budget one of the bigger increases and also one of the most important was in the education department; Increasing elementary, secondary, and vocational education budget by 50% and higher education by 20%. The education department has taken severe budget cuts and it is having an adverse effect on our students who will one day bring out a leader to run this country. I would rather not elect a poorly educated person as president thus our system needs as much budget as can be spared. Another area which received a large amount of an increase was Medicare and Non-Medicare health benefits because I personally know how much trouble this industry is in. Having a pre-existing condition and a severe one at that I know how difficult it is to get health insurance and the aid which comes with it can be less than stellar. Hopefully this increase would help promote better health in the citizens of the country. Playing off the medical benefits I also increased the aid to low income families because they are a large backbone to the society. With how the economy is you have families working three jobs and still struggling to make ends meet. This is very unhealthy and actually leads to more cost needed for medical benefits because when people get sick they have to go to the hospital. It was my hope that increasing both budgets would actually balance ut. The final increase I wish to cover is also slightly more of a controversial one and it may not be a modest increase but it is still important. I increased the border security and immigration budget by 50% in hopes that it would help lower the rate of illegal immigrants coming into the country and not becoming citizens. While at first it may be viewed as a heartless thought the truth is that while we allow the immigrants who come to the country and donâ€⠄¢t get citizenship to stay we increase our own expenses. By not being citizens they themselves do not actually pay federal taxes, especially if they work under the table. However, despite not being citizens they are still eligible for our low income aid, and medical benefit programs and this is actually taking away from the citizens and taxpayers who need it. There is also the unspoken fact that without a large amount of illegal immigrants who don’t speak English we could actually cut the spending for production of many products in Spanish and other languages since those who require them wouldn’t be living in the country. While balancing the budget it occurred to me why congress would have so many problems balancing the actual budget; it is difficult to keep everyone happy while maintaining a balanced budget. My cuts were largely from the foreign affairs, the rich and corporate America. The problem is those areas in this current day and age hold a lot of influence and it runs the risk of making a whole lot of people very angry. Congress has to try its’ hardest to create a balanced budget while remaining as politically correct as it possibly can. In short balancing this budget wasn’t as hard on me as it could have been simply because I have thought about this exact topic for a long time. While my budget may not be the most politically correct budget and it may not be completely balanced it did get results, and very significant ones at that. There were probably areas which I could have not increased the budget for or areas which could have been cut a little less but I feel strongly about my decisions and I would stand by them if ever they were questioned.

Being a Middle Class Minority Understanding the Ku Klux Klan Labeling White Males on the Top of the Food Chain

Being a Middle Class Minority Understanding the Ku Klux Klan Labeling White Males on the Top of the Food Chain To date, issues of multiculturalism and racial diversity continue to breed unnecessary conflict in the United States, in large part due to the diverse interests and needs espoused by different ethnic and racial groups (Harvey Allerd, 2008).Advertising We will write a custom essay sample on Being a Middle Class Minority Understanding the Ku Klux Klan: Labeling White Males on the Top of the Food Chain specifically for you for only $16.05 $11/page Learn More As a matter of fact, different races have over time established contact organizations and splinter groups to spearhead and protect their interests, with a section of whites subscribing to the Ku Klux Klan (KKK) from as early as the 1900s to safeguard their interests while limiting the influence of the minority, particularly the blacks, Jews, and members of the catholic church (Ku Klux Klan, 2010). The minority black Americans, on their part, rallied behind several lobby groups such as the Black Panther or ganization, which they felt offered more hope to their cause of fighting discrimination, oppression and slavery. As it shall be demonstrated in this discussion, more still need to be done in the U.S. to level the playing ground for members of America’s middle class minority to be able to enjoy the same status and perks as their white counterparts. The KKK is the name given to a number of past and present hate group entities in the U.S. whose affirmed objective was to safeguard the rights of and enhance the interests of white Americans through the employment of aggression, terrorism, coercion, and lynching to murder and oppress African Americans, Jews and members of other minority groups (Ku Klux Klan, 2010). Although various legislations have been put in place to curb this form of white supremacist aggression, evidence is available to the fact that American class issues are largely influenced by racial connotations, with the whites likely to be seen as supreme to the blacks e ven in instances where there are no presumed differences of social status or class. The sudden recognition that the above is the case came immediately after the 2008 election of Barrack Obama, the first African American man to lead the U.S. Even though Obama was overwhelmingly elected by whites as well as blacks, concerns about his suitability and capability as the U.S. president continues to elicit sustained debate in popular media forums. Through my own analysis, I have come to discover that these concerns are not triggered by class issues or an evident lack of leadership capabilities; rather they are being triggered by the fact that Obama is a black man and some white men feel extremely uncomfortable by the fact a man of color is in charge of the White House.Advertising Looking for essay on african american? Let's see if we can help you! Get your first paper with 15% OFF Learn More A number of criticisms directed to Obama often demonstrate the â€Å"KKKâ €  reinforced understanding on the part of some whites that a black man is unable to achieve what a white man can achieve despite his level of education or class status in society. From experience, I can firmly say that in some parts of the U.S., an established black man with a doctorate-level education is still referred to as a ‘nigger,’ while a white college graduate may end up attracting more favor and respect from a society that is predominantly white. The challenges of the middle class minority, in my view, are further complicated not by the account of their divided identity as members of a minority group who have used their endowed and learnt abilities to scale the social and economic ladder, but by their reinforced persistence to celebrate the black underclass as the â€Å"purest† illustration of true African American identity or the ‘victim-focused’ black identity. This need not be the case as such an orientation only further to enhance th e false belief that American white males are on the top of everything, including good careers, social-economic status, and political muscle, not mentioning that such an orientation further enhances the KKK mentality, which is principally founded on false premises and an obvious hatred of certain racial groups perceived to be undesirable. Upon his election as the U.S. president, some sections of Americans started viewing Obama as a black African who was born in Africa and not the U.S. Such racial predispositions, according to Harvey Allerd (2008), only serve to elevate disharmony while encouraging instances of victimization regardless of class or an individual’s ability. Indeed, this orientation has led a sizeable white Americans to believe that it is difficult for a black American to achieve a middle-level class status. Americans therefore need to take pride in the diverse racial groupings as a source of strength rather than a reason to fight each other and label others as i nferior due to the skin of their color. As observed by Harvey Allerd (2008), diversity increases productivity and innovation if the performance of organizations such as Coca Cola and IBM is anything to go by. These organizations, according to the authors, promote diversity programs to source talents from a wide range of diverse ethnic and racial groups. In my view, the KKK mentality that puts much focus on the capabilities of the American white males must not be encouraged since every racial group has its own strengths and weaknesses. Whites and black Americans need to be encouraged to substitute and compliment each other’s efforts in nation building and no body should be viewed as superior or inferior to the other on status of his or her racial orientation. It is also imperative to view the U.S. middle class as a state that is brought by an individual’s capabilities and hard work rather than his or her racial orientation. Efforts aimed at implementing this paradigm s hift have already achieved enviable results, and we already have many African Americans shining in many fields, including sports, academic and research.Advertising We will write a custom essay sample on Being a Middle Class Minority Understanding the Ku Klux Klan: Labeling White Males on the Top of the Food Chain specifically for you for only $16.05 $11/page Learn More However, care must be taken to preserve our interracial relationships since they enhance our understanding of our own identity and roots. The KKK wrongfully assumed that interracial relationships have little or no value (Ku Klux Klan, 2010), but this assertion is akin to someone who throws away his or identity in the pursuit of other shallow interests. Reference List Harvey, C., Allerd, M.J. (2008). Understanding and managing diversity, 4th Ed. New York, NY: Prentice Hall Ku Klux Klan. (2010). Retrieved from https://www.tititudorancea.org/z/ku_klux_klan.htm

buy custom Fractures and Myopathy essay

buy custom Fractures and Myopathy essay A fracture may be defined as a crack or break in the bone. Fractures result from excessive pressure exalted on the bone surface or due to weakening of the bones due to a medical condition, also called osteoporosis (Cavendish, 2008). Generally, fractures can be categorized as closed or simple where the skin is still intact with the bone, or as open or compound in which there are wounds within the fracture or where it is exposed to the surrounding, thus can be easily contaminated. Fractures can be complete, where broken bones are completely separated, or incomplete (greenstick) where broken bones are not completely separated. Impacted fracture is where the bone-ends have been drawn together, avulsion fractures result when a portion of the bone is pulled off by a tendon whereas pathologic fractures result from minor injuries to bones already weakened by diseases. Fractures may lead to excessive loss of blood through bleeding, swellings and itching around the affected areas and overall body weakness. Bone fractures are characterized by extreme pain due to breaking of the periosteum, edema of soft tissues caused by bleeding from periosteal blood vessels which evokes pressure and pain, muscle spasms and swelling at the fracture site. Some people also experience paralysis or itchiness in areas below the fracture. Weakness and inability to bear weight may also indicate the presence of a bone fracure (Egol, Koval Zuckerman, 2010). Diagnosis of fractures involves assessing the history of the fracture: how, when, where and why it occurred. This is often followed by pain control and minor operations. Treatment include First Aid to prevent bleeding, covering open wounds, X-Rays of affected areas, maneuver of displaced bones, and anesthesia treatment for severe fractures, surgery and physical therapy to repair fractures. Pain relievers and muscle relaxants are also administered. People should avoid risky activities and reckless behaviors that may increase chances of accidents. One should wear protective clothes when involved in exposure activities such as construction and sports. Those with fractures should seek medical attention immediately and take more of Vitamin C and Zinc supplements to promote healing of the fractures. Myopathy Myopathy refers to a condition in which muscles of the body fail to function properly due to weaknesses in their fibers and strands. Myopathy is primarily associated with body muscles only. Other forms of myopathy may include muscle spasms and cramps (Lawrence, 2011). Myopathy is caused by muscle weakening, spasms or tetany and inflammations of the muscles. It develops due to genetics (inherited) or acquired conditions of the muuscles that may result from fatigue, body dehydration or stiffness. Vinken suggest that myopathy usually takes two forms; inherited such as nemaline, congenital and mitochondrial Myopathy, and acquired myopathy for example polymyositis and dermatomyositis (Vinken, 1992). Myopathy causes body weakness, inflammation of muscles, dysfunction of the metabolic system and muscle rigidity thereby hindering free movement. In comparison, acquired myopathy resolves quicker than inherited myopathy. They also show varied symptoms in different individuals. Myopathy is generally characterized by weakness of muscles, general body weakness and inactiveness and sometimes muscle pains. In rare cases, a person may pass out discolored urine. Treatment of myopathy starts by undergoing diagnosis testing, after which drug therapy, massage and acupuncture and yoga may follow. Physical therapy and minor surgery may be used as well. Pain management is usually essential. Full medical care may involve administration of immune-suppressive drugs that ease inflammation, for example, Trexall (Kagen, 2009). People who are experiencing muscle cramps and inflammations should seek medical attention as soon as possible. It is advisable to do regular exercises to increase muscle flexibility and blood circulation within the body, muscles and nerves. Buy custom Fractures and Myopathy essay

Marketing Strategy and Planning (Two Product Portfolio Analysis Essay

Marketing Strategy and Planning (Two Product Portfolio Analysis models) - Essay Example Increased competition fuelled by the process of globalisation, vast developments in the information and telecommunication technology as well as rapid changes in the world social and political structures have created intensely competitive markets in which today’s organisations are struggling to find a competitive foothold. Nature of today’s business is such that, organisations can no longer succeed in achieving a competitive advantage through product quality, speed of supply or production cost management. These factors have become prerequisites to stay in business and no longer offer a platform for competitive advantage. Organisations need to streamline their business strategies and explore and identify areas, which can be best exploited with the organisation’s resource base. Maximizing the effective deployment of organisational resources involve, crafting of market and product strategies that best achieve the organisational objectives. Thus, management of the pro duct portfolio becomes a key management consideration for those companies that aim to achieve sustainable competitiveness in the market place.

Rhetoric anlysis Essay Example | Topics and Well Written Essays - 250 words - 2

Rhetoric anlysis - Essay Example rb indicates that Catton’s style does not emphasize on action images, but on descriptive images that aim to illustrate the paradox of being different, and yet being alike. Another example of atypical syntax is: â€Å"Daring and resourcefulness they had too† (paragraph 15). It is a typical because the predicate â€Å"Daring and resourcefulness† was put first before the subject â€Å"they.† The unique quality of writing emphasizes descriptions of the greatness of these two generals, and how they truly captured the diverse characters of the American identity. Catton focuses more on the backgrounds of the two generals and how they served as the metaphor of their people because they are more important than statistics and dates in representing the greatness of two people uniting for a great common cause. For instance, Catton says that â€Å"Lee†¦himself was the Confederacy† (paragraph 6) and Grant was â€Å"the Westerner† (paragraph 11). By making each general stand for the people they were fighting for, Catton successfully creates a patriotic tone that can unify Confederates and Union supporters because, if their generals, the epitome of who they are and what they stand for, can set aside their differences to attain common interests, then these two groups of people can also do the same. The single sentence in paragraph 3 provides the thesis of the essay. It argues that these two generals are truly different, but they must collide in order to pave a new direction for the country. The purpose of using a single sentence is to emphasize the thesis and to set the tone of writing and attitude of the speaker toward the values and ideals that Lee and Grant represent, individually and jointly. These coordinating conjunctions give special coherence to the paragraphs because they provide the signal posts for talking about differences or similarities between the two generals and the lives they represent. They also support the patriotic, conversational tone that Catton uses, so