Improving Patient Services Intitiative & Standards in a Community Article

Improving Patient Services Intitiative & Standards in a Community Services Program - Article Example ll not only force an organization to develop and define its quality mission, but also ensure that the processes can be understood and actualized by all involved (Santiago, 1999; Hall et al, 2003). Several studies have shown intervention models that have improved the quality of health care and reduced the health care costs. One is the Total Quality Management (TQM) described as the â€Å"development of an organizational culture which is defined by, and supports, the constant attainment of customer satisfaction through an integrated system of tools, techniques and training† (Sashkin and Kiser, 1993 as mentioned in Walsh, Hughes & Maddox, 2002, p. 299). Since customer satisfaction is the goal of TQM, it should have an in-built culture of continuous improvement by focusing on an organisation’s activities on eradicating the causes of defective products and services which should never reach the customer. Blades (1995) discussed the Baxter Health Care Ltd. model for promoting quality improvement. The model involves coming up with pictorial signs to educate or remind staff of the high quality they need to render. These were initially used as slides for training and then turned to posters. It provides a framework for both analysis and education on quality issues, focusing on the elements of total quality management namely communication; commitment; customer focus and continuous improvement. Piette, Ellis, et al (2002) conducted a study with the purpose of determining the most effective quality of care using the facility’s ethical practices. In the study, constant monitoring and investigation ensure quality outcomes. A leadership council was formed, meeting monthly to discuss and communicate regarding corporate compliance and personnel programs, clinical outcomes reviews, and clinical issues. All committees and councils reported to the Board of Directors on the progress of their project. The study design utilized a clinical practice committee breakdown of the

Subsidize University Fees For Low Income Group Essay Example for Free

Subsidize University Fees For Low Income Group Essay INTRODUCTION: Globally, there is increasing demand for higher education, especially from the youth population of developing countries, as it is viewed as an important pathway for greater social mobility (Devesh, 2008). According to the World Trade Organization (WTO 2010), private returns from higher education are high for both developed and developing countries. In developing countries, the wage differential between a secondary school leaver and a university graduate is estimated to be as high as 200%. Besides the wage premium, rapidly changing technology in a globalized world is also demanding new and changing competencies that require life-long learning skills, for which mature students often have to go back to college for re-training and re-skilling. Malaysia is one of the most subsidized nations in the world. Its total subsidy of RM74 billion in 2009 is equivalent to RM12,900 per household or 4.6 per cent of GDP even higher than Indonesia (2.7 per cent) Philippines (0.2 per cent). Out of the numbers, RM 30.8 billion goes to Primary, secondary, higher education and scholarships. Higher education in Malaysia is divided into 2 sectors; public and non-public sector, there are about 20 universities and 6 university colleges (the term â€Å"university college† is used to for those tertiary level education institutions that are able to confer their own degrees but have not achieved university status). In the non-public sector there are 559 institutions of varying types including: universities and university colleges and foreign university branch campuses. The term â€Å"non-public† refers to the broad category of institutions not funded by the state. A division between private and for-profit institutions exists within this category, but is not entirely clear. Outside of these categories are polytechnics (24) and community colleges (37), which will not be dealt with this profile. The Higher Education Department within the Ministry of Education, co-ordinates and monitors the activities of public and private universities and colleges. Because of government’s large investments in higher education, issues of government involvement and university autonomy arise. Currently, students  are assigned to specific universities based on their cumulative grade point averages, faculty members are essentially civil servants with highly fixed salaries, and vice chancellors and deans are appointed by the state. Malaysian public higher education students must pay tuition and other fees and cover their living costs (though accommodations on campus are subsidized by the government). Solid financing is the backbone of a well-functioning higher education system. The decision to attend tertiary education has monetary and non-monetary variables. In Malaysia the cost of tertiary education (tuition fees) and associated living costs affect how much a cash constraint can discourage otherwise talented students from enrolling and completing higher education. Currently many kinds of subsidies exist such as government owned and operated school (public and private universities state colleges), subsidized loans, grants and scholarships. THE â€Å"PROS† TOWARDS GOVERNMENT SUBSIDY: Why does government need to intervene in the market for education? That is, doesn’t the market produce the â€Å"right† amount of education? If the market outcome is not right, what is the best way to intervene? To answer these questions, we first need to consider the basic model of education. In the economic model of education, every person in society has a certain amount of brain power, skill, knowledge, understanding, and the like. All those factors other than our â€Å"unskilled† labor allow us to produce output. We can think of all these factors as one, the composite factors which is human capital. It is very useful to think of human capital as analogous to physical capital. Durable: continues to have value over time, can decrease over time due to â€Å"depreciation† and can increase due to â€Å"investments†. Acquiring education is like making a physical investment, improves the quantity and/or quality of the human capital. The purpose is to increase productivity and that’s for sure. Hence, there are a few drawbacks if the Malaysian government didn’t subsidized university education tuition fees. Family income determines whether the student can afford the costs of the university or college. First issue related to monetary variables and non-monetary variables will lead to a drop line of a higher education access. This has made many young talents and bright students fail to enter university and are a loss to future generation. This is due to: †¢Cost benefits barrier – the barrier arises when the group decides that the cost of attending university is greater than its expected return to the education investment. †¢Cash constraints barrier – occurs when the students who have decided that the returns to education outweigh the costs still cannot put together the resources to obtain entry to universities. †¢Debt aversion barrier – arises when an individual refuses to use the funds at his or her disposal because part of the funds might be loans, which at some point will have to be repaid. †¢Parental education, race and ethnicity, gender and geographical location – all play a role in the college decision-making process. Of course there are many reasons why government should step in. Subsidy indirectly can reduce crime. Of course crime is clearly an externality in this context. The actions of others affect us and they are not negatively compensated. If we look at current situation there is an extremely strong relationship between crime and education. Well at least for three reasons: †¢Pure human capital motive – education related to income, and people with higher income have less incentive to commit crime. †¢Direct schooling effect – classes makes students smarter so realize that crime doesn’t pay at all. †¢Opportunity cost of time – students are busy at faculty so actually in other words have less time to commit crime. Escalating expenditure for public higher education has ked the government to adopt a cost-sharing system in which students and parents shoulder and increasing share of the costs. The MARA financial aid scheme was converted in January 1998 to a 100% loan scheme except for loans given out under the Excellent Student Scheme. The National Higher Education Fund Corporation (PTPTN) was established for the purpose of offering subsidized loans to help students meet the costs of enrolling a local higher education institution.  It is also designed to ensure that there would be loans available for Malays to afford both public and private higher education so that the targeted ethnic composition of enrolment in higher education is maintained. THE DEBATE TOWARDS GOVERNMENT SUBSIDY: When the government is in the business of handing out money, interest groups lobby to get it, or advocate receiving more than they are already getting. So, it is with spending on higher education. Over the long run, the funding for those areas has increased dramatically. Taxpayers should be skeptical of the current reasons for subsidizing universities further. There are few arguments are dubious for five main reasons stated below in regards with government subsidy related to university fees. It can be elaborate and debate as the following: There is no link between higher education subsidies and economic growth, and none between universities or college degrees and job creation. Malaysia has spent a much higher proportion of personal income on federal and state government to support for higher education. States with a higher proportion of university and college graduates do not necessarily grow by adding more college degrees. For now, the country is currently experiencing a rather worrying unemployment especially among young graduates. Excess of the graduates is unable to meet domestic open vacancy in any sector since most of them are experiencing the freezing phase of job vacancy. Thus its shows there are no linkage at all between higher education qualifications with job vacancies. Indirectly it could not keep the countrys economy. More subsidies equals to more waste. The number of academicians, staff, administrators and service staff at all 20 universities and 6 university colleges increased at a faster rate than full-time equivalent students over the same time period. At the same time, the compensation for the average employees increased too for sure. Colleges set tuition rates relative to supply and demand, but the government subsidies distort this process and inflate the cost. That’s why private universities such as Sunway International College and Lim Kok Wing University which receive no government funding, do a much better job at keeping down the cost of tuition. At the present time the federal government already spends billions of dollars subsidizing universities, whether it is money for Lecturer’s salaries, buildings, or the millions of dollars provided for research. The cost of classes and tuition picks up only small portion of the tab. Aside from that, there are many people who do not deserve or would not make the best of the education provided. Scholarships and government grants are available for people who have worked hard and earned the opportunity, but to hand it over to everyone for free are insane. When comparing earning power between college graduates and non-graduates, correlation is not causation, and the actual cost of universities or collage matters. Proponents of more funding for higher education almost always cite the same statistic as their main point: Overall, universities and college graduates tend to make more money in their lifetime than those without a degree. But this assumes that the degree caused the higher earnings, rather than the fact that those who complete college are already more likely to be financially successful whether they attend university or not. The common figure cited is that a college degree is worth MYR1 million over the lifetime of a worker. Besides ignoring the point above, this is a poor exercise in statistics. The number is arrived at by taking the difference between the average pay of a university and college graduate and the average pay of a non-universities and college graduate and multiplying it over a 40-year career. First, that only tells us what the average is today, not what the actual future earnings are. Second, this assumes that all universities and college degrees have the same value. For example, it assumes that a Bachelor of Arts in art history is the same as a Bachelor of Science in quantum physics. Most significantly, it ignores many important factors: taxes, the real salary data of today’s graduates, the opportunity cost of going to college (how much someone would earn during those years in school), the fact that large proportions of student’s starts school and do not finish, and, most  importantly, student loan debt. Keep in mind that government may be funding someone’s desire to paint or be involved in the arts which do not advance society enough to justify the cost. Perhaps if everyone were taking physics, biology, or computer sciences in order to contribute in a meaningful way post grad it would be a different story. Also the amount of people in college is at the highest it’s ever been. In fact a BA or BS degree is essentially required now for low level jobs and a Masters or Doctorate is needed to advance up the ladder. Ensuring that everyone has university or college schooling would not enhance the labor market – it would dilute a university degree. The assumption among many is that every career should require a higher education. This belief leads to subsidies for subjects with little practicality in the workforce and areas where a student may be better off doing an apprenticeship or working for four years than attending more school. Pushing for everyone to go to universities or college does not automatically make those students university-ready; it lowers the overall standards of higher education. This has led to a high dropout rate, more repeated classes for those in school and an explosion of marginal subjects in which many degree-holders are forced to work outside that field because of a lack of demand. In short, incentivizing degrees students do not ever use. Higher education may be the next bubble to burst. Much like the housing bubble, higher education is fueled by government subsidies, publicly-backed loans and incentives that say everyone should be doing something. Lately tuition costs have risen steeply well above inflation while colleges compete to expand into areas outside of their main purpose and taking on more debt to do so. At the same time, competition from other sectors, like online education, offer cheaper alternatives to the bread-and-butter of university academia. It is important for citizens to be educated, both to learn a job and to better be able to respond to a changing marketplace. But there is a difference between education and schooling. Spending more money to send  people to get a specific number of degrees at a specific institution is different from education. Education comes in the form of apprenticeships, trade schools and time on the job learning. And education is something you can’t force on someone else. Just putting someone in college does make force them to learn anything. Education is a personal matter, and more subsidies will only influence a persons decision to learn or not to learn at the barest of margins. Higher education can build new skills, enhance old ones and show prospective employers that students are able to put in the time to earn a degree. But the value of a degree varies — by the institution, the cost, the time and the subject. From an individual’s perspective, private universities and colleges may be worth the cost. But for a growing number, it’s not. And government subsidies, where political incentives trump market realities, only worsen that problem CONCLUSION: Education issues remain an important priority in developing countries. Because resources are limited and ensuring adequate allocation is a struggle for many countries including Malaysia itself. The delivery of educational services has become a challenge. Malaysia, like other countries in Southeast Asia, faces similar challenges in ensuring the allocation of appropriate funding for efficient and equitable educational services in order to promote access to quality education for all social groups. While Malaysia faces many challenges amid rapid global chances, we can draw on a number of strengths and unique advantages as we take purposeful policy actions to move forward. Education is not preparation for life; education is a life by itself. From the job market to tertiary education, from UPSR to A-Levels, Education in Malaysia focuses on bringing us the latest news and analysis on our nation’s best bet on the future. The future earnings of the individual typically constitute an adequate return on the gross investment in obtaining higher education. Moreover, providing  subsidy university and college education to all is a rather inefficient way to serve the interest of poor students since a large proportion of students who acquire higher education come from relatively well-off families. Raising demand for higher education and the need to produce a critical mass of highly educated and skilled workers for a knowledge economy has led to the massification of Malaysian higher education. However, escalating higher public education expenditure led the government to adopt a cost sharing system where students and parents shoulder and increasing share of the cost for acquiring a higher education.

Death of a Naturalist Analysis Essay -- essays research papers

Death of a Naturalist The poem, like Seamus Heaney’s work, is very nature minded in terms of context. However, he describes the frogs in a very evil, sinister, and menacing way. It is about a child who collects frog spawn from the dam and collects it in jars. He is innocent and unaware of the evil that lurks in the frog spawn. We can see in the poem that the boy is young, when he remembers his teacher teaching him about the frogs, and his way of calling the frogs ‘Daddy frog’ and ‘Mammy Frog’. The poem heavily appeals to the senses, which describes the more sinister parts of nature. Because when people think of nature they usually think of the more beautiful parts of it (e.g. mountains etc.) The poems appeal to senses shows how filthy and grubby nature can be describing the sight, smel...

Management function Essay

During week two the group was presented with new information that helped to teach different aspects of planning as a management function. The different types of planning include strategic, operational, and tactical planning. Strategic planning involves looking into the long term goals and plans. Tactical planning translates broad goals and strategies into specific actions to be taken within different parts of an organization. Operation planning is the specific short term procedures done at lower levels of the organization. As problems in various companies were identified by the class a SWOT analysis was something that could be used to see what weaknesses, threats, strengths, and opportunities an organization has to combat issues. This is very important to see what the organization is doing wrong or right to help strengthen and decrease weaknesses and threats. It also helps a company to find its strengths and lean on them and to look for opportunities within the company. Then there are the threats to the company that we can try and get rid of like competition. Core competencies can be discovered during this process that gives firms a competitive advantage. We discussed how organizations can remain competitive by choosing strategy options that competitors are unwilling or unable to imitate. In making sure that plans are successful managers have to make sure they implement their strategies effectively and efficiently. Learning ethics and why they are vital to the hiring process was reviewed. Business ethics are the moral principles and standards that act as a guide for how those in the business world should act. Different ethical systems include universalism, egoism, utilitarianism, relativism, and virtue ethics. Egoism is doing the right thing that is best for one person where utilitarianism is doing the right thing for the group. Relativism is a fun one that influences business because it is based on opinions and behaviors. Corporate social responsibility or CSR is an organizations obligation toward society. It was observed how ethical decision making is important in the business environment. Management has to consider all facts and how decisions will affect the organization on a short and long term basis. An example is an employee using paid work time to surf the Internet this cause’s lost wages for the company and could cause viruses to the company software by using outside company sites. In talking about ethics the topic of Greenwashing was mentioned. Greenwashing is the misleading of consumers concerning the environmental benefits of a product or service and it was discovered that several companies are guilty of this. In considering what a business needs to have customers value them brand loyalty was learned. Brand loyalty in relation to price is seen because as consumers become more loyal to certain brands they are less sensitive to the changes in price. Consumers who are loyal to a brand feel that there is not another company who is able to imitate the one they have chosen to be loyal to.

Case Study 2

Case Study 2 Springfield Express is a luxury passenger carrier in Texas. All seats are first class, and the following data are available: Number of seats per passenger train car 90 Average load factor (percentage of seats filled) 70% Average full passenger fare $ 160 Average variable cost per passenger $ 70 Fixed operating cost per month $3,150,000 Formula : Revenue = Units Sold * Unit priceContribution Margin = Revenue – All Variable Cost Contribution Margin Ratio = Contribution Margin/Selling Price Break Even Points in Units = (Total Fixed Costs + Target Profit )/Contribution Margin Break Even Points in Sales = (Total Fixed Costs + Target Profit )/Contribution Margin Ratio Margin of Safety = Revenue – Break Even Points in Sales Degree of Operating Leverage = Contribution Margin/Net Income Net Income = Revenue – Total Variable Cost – Total Fixed Cost Unit Product Cost using Absorption Cost = (Total Variable Cost + Total Fixed Cost)/# of units a. Contribu tion margin per passenger =$160 – $70 = $90Contribution margin ratio =$90/$160=56. 25% Break-even point in passengers = Fixed costs/Contribution Margin = $ 3,150,000/$90 Passengers =35,000 Break-even point in dollars = Fixed Costs/Contribution Margin Ratio = $ 3,150,000/56. 25% $ 5,600,000 b. Compute # of seats per train car (remember load factor? )= 90 * 70% = 63 Seats filled Compute # of train cars (rounded) = 35,000/63 = 556 train cars filled c. Contribution margin = $190 – $70 = $120 Break-even point in passengers = fixed costs/ contribution margin =$ 3,150,000/$120 Passengers = 26,250 BE = 90 seats *60% = 54Train cars (rounded) = 26,250/54 = 486 d. Contribution margin = $190 – $90 = $70 Break-even point in passengers = Fixed costs/Contribution Margin = $ 3,150,000/$70 Passengers =45,000 BE = 90 seats *70% = 63 Train cars (rounded) = 45,000/63 = 714 e. Contribution margin = $205 – $85 = $120 (P = Passengers) Sales205*P Variable Exp. 085*P Contribution M. 120*P Fixed Exp. 3,600,000 PretaxX Tax Exp. :X*30% Net Income Op. 750,000 750,000 = X – 0. 3X (X (1 – 0. 3) => 750,000/(1-0. 3) = X X=$ 1,071,428. 57 (Pre-Tax) $ 1,071,429= 120P – $ 3,600,000 => $ 1,071,429 + $ 3,600,000= 120P => 4,671,429/120= P P =38,928 f. Contribution margin = $120 – $70 = $50 # of discounted seats = 90*70%; 90*80% ( Difference is 10%; 90*10% = 9 Seats Contribution margin for discounted fares X #discounted seats = $50 * 9 Seats = $450 50 Train *$ 450 train cars per day * 30 days per month= $675,000 $ 675,000 (-) $ 180,000 additional fixed costs = $495,000 pretax income. g. 1. Compute Contribution margin Route 1 Route2 Overall Mix Sales160*P175*P335 *p Variable Exp. 070*P070*P140 *p Contribution M. 090*P105*P195 *P Route 1 Contribution Margin Ratio =$90/$160=56. 5% Route 2 Contribution Margin Ratio =$105/$175=60% Overall Contribution Margin Ratio =$195/$335=58. 20% Answer: Yes, it should, because the CMR is greater with the two rou tes. 2. BE = 90 * 60% = 54 Seats filled Contribution margin = $175 – $70 = $105 (P = Passengers) Sales175*P (54 Seats) Variable Exp. 070*P Contribution M. 105*P Fixed Exp. 3,150,000+250,000=3,400,000 Pretax120,000 120,000 = (105P*(54 Seats)) – 3,400,000 => 3,520,000 = 5,670P => 3,520,000/5,670 = P P=621 621/54 =12 train cars 3. Contribution margin = $175 – $70 = $105 BE = 90 seats *75% = 68Contribution margin = $175 – $70 = $105 (P = Passengers) Sales175*P (68 Seats) Variable Exp. 070*P Contribution M. 105*P Fixed Exp. 3,150,000+250,000=3,400,000 Pretax120,000 120,000 = (105P*(68 Seats)) – 3,400,000 => 3,520,000 = 7,140P => 3,520,000/7,140= P P=493 493/68 = 7 train cars 4. Springfield should consider Qualitative factors such as: (1) effect on employee morale, schedules and other internal elements; (2) relationships with and commitments to older and new suppliers; (3) effect on present and future customers; and (4) long-term future effect on profita bility and new businesses. Case Study 2 Chapter 2 Case Study Summary 1: 21-year old woman that has had type 1 diabetes for the past 8 years, was brought to the hospital in a coma. She was prescribed to take 92 units of insulin a day to maintain her sugar levels within normal limits and prevent excess sugar in her urine. Upon admission she was hypontensive, tachycardic and hyperventilating.Her labs show she is acidonic, arterial blood carbon dioxide levels were low, blood oxygen tension is normal, bicarbonate levels are really low indicating metabolic acidosis, low sodium levels, slightly high level of potassium, Chloride level is on the low end of normal, very high levels of blood urea and nitrogen, total carbon dioxide levels are really low, extremely high sugar levels and high creatinine levels. She tested positive for ketones. She recieved 8 units of regular insulin through an IV and 8 units per hour by IV infusion pump.Her blood sugar levels began to drop at about 100 mg/dL each hour. After seven hours her breathing an d pH went back to normal, following an injection of intravenous sodium bicarbonate to raise her pH and vigorous IV fluids and electrolyte replacement. 1. It seems her type 1 diabetes is uncontrolled. As her body could not use the sugar and there is not enough insulin, fat was used for fuel instead. During fat breakdown, byproducts called ketones are developed. Ketone bodies are acidic and dangerous when it build up in the body causing all her symptoms upon admission. . Yes, her pH levels became normal. Meaning her bicarbonate levels increased to compensate for the increased hydrogen proton levels in her blood. 3. When the body uses fat for energy instead of sugar, the body creates a byproduct called ketones. Since this is a byproduct, it flows through the renal system waiting to be expelled from the body. Normally, the existence of ketone bodies are detected through a urine sample. 4. The potassium results were high which can indicate some problem with her kidneys. 5.The low sodium results are based on the fact that sodiums job in the body is to keep proper acid-base equilibrium (homeostasis). Sodium has alkaline properties so if the levels are low the acid levels will be higher. 6. Diabetes can affect normal control of BP and can cause damage to the nerves supplying the blood vessels. When the blood pressure lowers the glomerular filtration rate decreases. 7. Anion gap measures of anions in the arterial blood. Anion gap equals chloride plus bicarbonate minus sodium Na-(Cl + HCO3-).The patient has a anion gap of 30. Normal levels are 7 to 16. 8. Osmolality measures the concentration of all chemical particles found in the fluid part of blood. Normal values range from 275 to 295. The patient has a osmolality of 351. 1 Summary 2: 14 year old boy that was never vaccinated against poliomyelitis got the disease late summer. He was hospitalized and needed a respirator during the severity of the illness. Once he began to recover, they took him off the respirator with no apparent effects. Days later a blood analysis revealed the following. H level is slightly acidic, carbon dioxide levels are high and indicate some respiratory acidosis, blood oxygen level is low, bicarbonate level is high, sodium levels are normal, potassium is normal, chloride level is slightly low, and total carbon dioxide levels are high. 1. It seems the patient has respiratory acidosis. Production of carbon dioxide occurs fast and the failure of proper ventilated increases the CO2 in the blood. 2. Buffers are normal compensatory mechanisms to respond to the acidosis. 3.Yes, the HCO3 (bicarbonate) test is elevated and bicarbonate is a buffer. 4. Acute respiratory acidosis is when a abrupt failure of ventilation occurs. Chronic respiratory acidosis may be secondary to many disorders. 5. Total CO2 measures the serum bicarbonate and available forms of carbon dioxide. Bicarbonate takes up about 95% of the total. They take the bicarbonate measurements by the sample of the venous bl ood and arterial blood gas analysis. 6. Chloride levels are slightly lower due to respiratory muscle weakness. Case Study 2 Chapter 2 Case Study Summary 1: 21-year old woman that has had type 1 diabetes for the past 8 years, was brought to the hospital in a coma. She was prescribed to take 92 units of insulin a day to maintain her sugar levels within normal limits and prevent excess sugar in her urine. Upon admission she was hypontensive, tachycardic and hyperventilating.Her labs show she is acidonic, arterial blood carbon dioxide levels were low, blood oxygen tension is normal, bicarbonate levels are really low indicating metabolic acidosis, low sodium levels, slightly high level of potassium, Chloride level is on the low end of normal, very high levels of blood urea and nitrogen, total carbon dioxide levels are really low, extremely high sugar levels and high creatinine levels. She tested positive for ketones. She recieved 8 units of regular insulin through an IV and 8 units per hour by IV infusion pump.Her blood sugar levels began to drop at about 100 mg/dL each hour. After seven hours her breathing an d pH went back to normal, following an injection of intravenous sodium bicarbonate to raise her pH and vigorous IV fluids and electrolyte replacement. 1. It seems her type 1 diabetes is uncontrolled. As her body could not use the sugar and there is not enough insulin, fat was used for fuel instead. During fat breakdown, byproducts called ketones are developed. Ketone bodies are acidic and dangerous when it build up in the body causing all her symptoms upon admission. . Yes, her pH levels became normal. Meaning her bicarbonate levels increased to compensate for the increased hydrogen proton levels in her blood. 3. When the body uses fat for energy instead of sugar, the body creates a byproduct called ketones. Since this is a byproduct, it flows through the renal system waiting to be expelled from the body. Normally, the existence of ketone bodies are detected through a urine sample. 4. The potassium results were high which can indicate some problem with her kidneys. 5.The low sodium results are based on the fact that sodiums job in the body is to keep proper acid-base equilibrium (homeostasis). Sodium has alkaline properties so if the levels are low the acid levels will be higher. 6. Diabetes can affect normal control of BP and can cause damage to the nerves supplying the blood vessels. When the blood pressure lowers the glomerular filtration rate decreases. 7. Anion gap measures of anions in the arterial blood. Anion gap equals chloride plus bicarbonate minus sodium Na-(Cl + HCO3-).The patient has a anion gap of 30. Normal levels are 7 to 16. 8. Osmolality measures the concentration of all chemical particles found in the fluid part of blood. Normal values range from 275 to 295. The patient has a osmolality of 351. 1 Summary 2: 14 year old boy that was never vaccinated against poliomyelitis got the disease late summer. He was hospitalized and needed a respirator during the severity of the illness. Once he began to recover, they took him off the respirator with no apparent effects. Days later a blood analysis revealed the following. H level is slightly acidic, carbon dioxide levels are high and indicate some respiratory acidosis, blood oxygen level is low, bicarbonate level is high, sodium levels are normal, potassium is normal, chloride level is slightly low, and total carbon dioxide levels are high. 1. It seems the patient has respiratory acidosis. Production of carbon dioxide occurs fast and the failure of proper ventilated increases the CO2 in the blood. 2. Buffers are normal compensatory mechanisms to respond to the acidosis. 3.Yes, the HCO3 (bicarbonate) test is elevated and bicarbonate is a buffer. 4. Acute respiratory acidosis is when a abrupt failure of ventilation occurs. Chronic respiratory acidosis may be secondary to many disorders. 5. Total CO2 measures the serum bicarbonate and available forms of carbon dioxide. Bicarbonate takes up about 95% of the total. They take the bicarbonate measurements by the sample of the venous bl ood and arterial blood gas analysis. 6. Chloride levels are slightly lower due to respiratory muscle weakness.

Sam Walton essays

Sam Walton essays There were several characteristics of Sam Walton that enabled him to be successful in his life and business dealings. Sam Walton could do anything he put his mind to. This can be witnessed in his ability to transform a small town store into a 25 billion-dollar industry at the time of his death. Walton did not want to be poor, and this helped to push him when the going got tough because he knew what the possible outcome would be. For example, when Walton first started producing more Wal-marts, he was in great debt. In fact the only way he could get out was to make more stores and continue to set lower prices than the competition. Walton grew up into a poor environment as a child, so he knew what it was like to be at the short end of the stick. Perhaps his difficult childhood gave him something to strive towards later on in his life. Walton learned several things from others as well. For instance, he learned to economize from his job at J.C. Penney. And while he was developing his f irst general store, Walton saw what the competition was doing wrong, and did the complete opposite, such as selling more quantity in order to make a bigger profit in the long run. It can probably be stated that Sam Walton would not have been as successful if his devoted wife had not been there along his side. Always there for him, Mrs. Walton was able to keep the entire family together during the hard and difficult times. While Sam was out doing the dirty work trying to make something of his business, Mrs. Walton was playing the role of mother and father back at home. Sam Walton had to create and develop his business in a very difficult environment. Competition was all around, and most people saw Waltons store as a dead-end flop when it first began. Before the founding of Wal-mart, all of the businesses were the same, trying to set prices in hopes of large gains from not so large quantities. Walton saw what was going on and took advantage of wh ...

Essay on Taxation Essay Example

Essay on Taxation Essay Example Essay on Taxation Essay Essay on Taxation Essay Consumption tax is a levy on the expenditure on goods and services rendered. This form of tax is usually indirect, and there are several types. Some of the most common forms of consumption tax include value-added tax, sales tax, excise tax and expenditure tax. 80% of the federal government revenue is from individual income tax and the payroll taxes that have been continually used to fund the insurance programs (Hyman, 2014). 11% is from corporate income tax and the remaining 9% from other sources. In2014 alone, the federal government collected revenues that totaled to $3 trillion which was equal to 17.5% of the gross domestic product (GDP). Some of the revenue that the government depends on is from the federal excise taxes which is more of a consumption tax that is levied on the goods and services purchased like gasoline and beverages. Taxation Trends State aid has been shown to have crested in the recent past considering the bulk of the government expenditure. The property tax is also another important trend that should be monitored continuously and has increased in the recent past as well. Regardless, there will be probably no significant increments on the same because it is one of the unpopular forms of government revenue. A significant reversal would, therefore, occur in the property tax long-term trends. The governments reliance on charges still continues and prospects assert that it will go on in the future. The fact that citizens are showing resistance to tax coupled with the increasing demand for foods and local services provides the best possible solution to the budget issues (Hyman, 2014). Technology has also made it easy to tax individuals hence the substantial growth in the revenue. Some of the challenges that individual governments face are eternal like people having a preference for those sources of income that are almost invisible like the sumptuary taxes (Bandyopadhyay, 2015). Also, following the trends in government revenue, particularly during the 2007 to 2009 recession, the federal government faced a lot of challenges. It also provided the opportunity to reform the financial and economic system of the states. The primary goal and priority of local governments regarding their goods and services are to create a five-year financial plan, customer service and employing a unified communications strategy. An opportunity for local governments comes in the form of co-production where professionals and citizens share the power to design, plan and deliver goods and services together. This mode of delivery allows the stakeholders to appreciate that each of the partners contributes significantly and are both vital for its success. Regardless, the local governments wi ll experience challenges still in collecting revenue from taxes because people dislike them (Bandyopadhyay, 2015). Performance budgeting is a paramount tool that can be used to improve the whole process of budgeting of the federal government. It involves the utilization of performance measures to make informed decisions. It is through this tool that governments can reduce and eliminate unnecessary expenditures using performance measures. States like Sunnyvale, CA use accounting data to allocate the budgetary resources to its citizens. Tax policy refers to the governments power to decide which tax to levy as well as the amounts. According to reports, corporate income tax rates has been shown to reduce in many countries (New corporate income tax policy, 2010). The rate at which it decreases is, however, varying throughout the countries. It is however projected to decline in many countries in 2016 than in the last two years. Reference Bandyopadhyay, S. (2015). Local government finance: challenges in revenue-raising at the Municipal Corporation of Delhi.Commonwealth Journal Of Local Governance, (16/17), 60-84. Hyman, D. N. (2014). Public finance: A contemporary application of theory to policy (11th ed.). Stamford, CT: Cengage Learning. New corporate income tax policy in corporate restructuring. (2010).China Law Practice (Euromoney Institutional Investor PLC),24(9), 53.