Practices in Project Management Essay

Abstract The St. Dismas Medical Center (SDMC) Assisted Living Facility (ALF) Project was authorized to create a new service line to counteract a decline of inpatient activity. The project objectives are to build 100 light- and heavy-assist units in a standalone residential facility with a sheltered connection to SDMC by late-July 2001 and within an $11 million budget. The particular deliverables, constraints, assumptions, exclusions, and work breakdown structure are outlined in the Project Scope Statement. Brainstorming and scenario analysis will be used in the risk strategy, while cost-benefit analysis will be the primary tool in project quality management. A project work list and milestone schedule illustrates the critical path for the 102-week construction phase. And, the $10 million budget is detailed by activity and quarter to reconcile the multiple cost perspectives of team members. Project monitoring will primarily use earned value metrics along with the Gantt chart and budget. Data will be analyzed and reported weekly to the team, and significant deviations from the plan are subject to the control strategy; milestone status reporting and meeting with the Board of Trustees and submission of change requests to get the plan back on track. The plan will conduct a formal closeout process to include an audit, closeout meetings, a final report, closeout meetings, and record archival. Project Purpose and Justification Over the past few months, there has been a steady decline of the inpatient population at St. Dismas Medical Center (SDMC) due to the increased usage of seatbelts and bicycle/motorcycle helmets. A planning retreat was held to  identify business opportunities and a solution was proposed to build an assisted living facility on the St. Dismas campus. The purpose of the project is to plan and implement Assisted Living Facility (ALF) as authorized by the Board of Trustees in May 1999. The project is being completed in order to create a new service line to take advantage of the opportunity presented by the shortage of medically-focused and highly specialized facilities available throughout the country and a growing geriatric population. We project that the ALF, the for-profit subsidiary of SDMC, will bring in a net income between $9,000 and $12,000 per unit and a net cash flow of about $1,500,000 annually. Both outpatient referrals and inpatient population are expected to increase. Furthermore, we hope that the project will have an added benefit of strengthening the organizational focus on reimbursable preventive and wellness programs for healthier aging community. Project Requirements The ALF Project Steering Committee has identified several actions and processes that need to be met, including: facility design and construction; operational needs for food services, housekeeping, and staffing; development of operational policy and procedures; creation of an operating budget; creation of payroll and accounting systems; characterization and set up of telecommunications and information system needs; preliminary marketing plans, with community and staff communications plans; development of medical assessment tools for incoming residents; designation of clinical services offerings; development of an organizational structure; identification of government regulations and industry standards. Primary Project Objectives The primary project objectives of the ALF Project are as follows: The cost objective is to fall in between $8.5 to $11 million for the construction of the facility. The time objective was to complete construction and open by July 2000, but was later revised to a duration of two years, with completion by late July 2001. The scope objectives are to build a standalone residential facility with a sheltered connection to SDMC that can access the  cafeteria and hospital services, containing 100 units that accommodate up to 150 single and couple residents with 15 to 30 â€Å"heavy-assisted† units and the remaining units â€Å"light-assisted†. Assumptions and Constraints The following is assumed: Project funds will be released in a timely manner. Project team members and resources will be available as needed. Contractors will have the skills and experience needed to complete the project. The constraints are as follows: The construction cannot begin until after the November 1999 city elections. The facility needs to open by late July 2001. Operational and administrative policies, procedures, and systems need to be created and regulations and standards need identification. High-Level Risks As with all projects, there is a risk of running over budget, over schedule, and/or falling short on scope. There are several high-level risks for the ALF project. One particular area of concern was the short seven-month time period for the complex construction project, but that has been extended about another year. Further, the organizational complexity is high with the number of people involved across many functions and the decision-making body being the Board of Trustees. This complexity may lead to delays in decision-making. The project is also much larger than SDMC has handled in the past with only one team member having construction experience. The operational and administrative regulations and standards for construction and healthcare industries will be complex and have not yet been identified. Construction projects have a strong potential to impact the local ecology which will add a risk factor to the project. Further, weather poses a high-level risk to the project and may negatively impact the schedule by delaying supply deliveries and construction work. Major Project Milestones Major project milestones include: 1. Facility design and construction 2. Identification of operational needs 3. Project and operating budget development 4. Creation of payroll and accounting systems 5. Define telecommunications needs and system setup 6. Define information systems and system setup 7. Creation of a preliminary marketing plan and communications package 8. Organize major ground breaking event 9. Clinical Services 10. Design of assessment tool for incoming residents 11. Identification of demands for clinical services 12. Development of facility’s management structure 13. Identification of governmental regulations and industry standards Preliminary Budget Estimate The preliminary budget estimate for the completed project is between $8.5 and $11 million, which includes the land purchase, facility construction, facility furnishings, and construction of the sheltered connection from the assisted living facility to the Medical Center. Key Stakeholders Illustrated below is the key stakeholder analysis matrix, which demonstrates the key stakeholders, their levels of power and interest, and an engagement plan. The matrix is followed by a communications chart that outlines stakeholders, their responsibilities, and their communication needs. The project scope is to build a standalone residential facility for the purpose of providing assisted living services to up to 150 single and couple residents. The product will also include a sheltered connective structure that provides access to St. Dismas Medical Center’s cafeteria and hospital services. The facility will contain 100 residential units with 15 – 30of those units that accommodate residents that need heavy assistance and the remaining units categorized as â€Å"light-assisted†. The cost to construct the facility should fall within $8.5 to $11 million range. Acceptance of the project requires that construction may not begin until after city elections in November 1999 and the facility must open to the public by late July 2001. Project Constraints The construction cannot begin until after the November 1999 city elections. The facility needs to open by late July 2001. Operational and administrative policies, procedures, and systems need to be created and regulations and standards need identification. The budget cap is $11 million. Project Assumptions There are several assumptions that may also impact the implementation of the project if they prove to be false (Project Management Institute, 2013): Project funds will be released in a timely manner. Project team members and resources will be available as needed. Contractors will have the skills and experience needed to complete the project. Project Deliverables facility design and construction; operational needs for food services, housekeeping, and staffing; development of operational policy and procedures; creation of an operating budget; creation of payroll and accounting systems; characterization and set up of telecommunications and information system needs; preliminary marketing plans, with community and staff communications plans; development of medical assessment tools for incoming residents; designation of clinical services offerings; development of an organizational structure; identification of government regulations and industry standards. Project Exclusions Items that are not included in the scope include: design and construction of a parking lot or garage design, construction, and furnishings of patient entertainment and activity areas design, construction, and furnishings of exercise and fitness areas design and development of landscaping, walking paths, and gardening areas design, construction, and furnishings of private visiting areas design, construction, and furnishings of salon and barber services area design, construction, and furnishings of dining area Project Risk and Quality Management Strategy Project Risk Strategy The project team has held a brainstorming session with a group of consultants in several relevant areas of expertise to identify an exhaustive list of risks by questioning what could go wrong with tasks. The scenario analysis method has also been utilized to identify, analyze, and prioritize risks from high-to-low impact. This method entails utilizing critical thinking skills to realize events that may likely impact the project (Mantel, Meredith, Shafer, & Sutton, 2011). Additionally, the work breakdown structure (WBS) and project profile were scrutinized to further identify highly probable risks as suggested by Mantel et al. (2011). The following highly probable risks have been identified: Bad weather Inadequate staffing Inadequate budget Project management team inexperience Regulatory and industry requirements Cost estimation errors Complex organizational structure and decision-making process Broad set of stakeholders that have yet to weigh in on the project Environmental impact from construction Project communication and coordination issues Inadequate deliverables (e.g. parking garage) Inadequate time schedule The strategy for handling risks is to develop a risk response plan as advised by Mantel et al. (2011). The risk response plan will include contingency plans to handle events that do happen, with more than one contingency plan and supporting logic charts developed for high-impact risk. Furthermore, risk identification and response planning will be ongoing through the project duration. Project Quality Management Strategy The ALF project quality management strategy is to follow the Project Management Institute (PMI) (2013) guidelines: identify quality requirements, document compliance levels of quality requirements, perform quality assurance auditing, and control quality by taking action to address poor quality measurements. Inevitably changes will have to be made to manage events or unsatisfactory quality results. The ALF Project change management strategy is to include provisions in the original contract to accommodate change as suggested by Mantel et al. (2011). An integrated change control process will be created and implemented, as advised by PMI (2013) to reduce project risks through holistic analysis of proposed changes. This process will outline how change requests will be reviewed, approved or denied, and how those changes will impact other aspects of the project (policies, documents, plans, etc.) (Project Management Institute, 2013). Two tools that will be used to manage quality are: cost-benefit analysis, which compares the cost of the proposed change to the expected benefit. cause-and-effect diagrams which utilizes the question  Ã¢â‚¬Å"why† to discover the root cause of a problem in order to correct it. Cost-benefit analysis will be useful in presenting problems and their possible changes to the decision-making body in order for them to fully assess their options and identify the solution that best suits their requirements. The cause-and-effect diagram will be beneficial in recognizing the true problem that needs to be addressed. Finding a solution for the root cause will help the team avoid unnecessary costs, time, efforts, and rework in addressing the wrong issues. Construction Phase Milestone Schedule Below is the work list and milestone schedule for the construction phase of the St. Dismas Assisted Living Facility project. The critical path (B-C-D-E-F-G-H-I-K-L-O-P-S-T) is illustrated in green on the milestone schedule. The project is scheduled to be completed in 102 weeks, just shy of two years. The assumptions for this schedule are the following: The milestone schedule will be approved by the Board of Trustees. The project will begin in August 1999 after action plans are submitted. Project funds will be released in a timely manner. Project team members and resources will be available as needed. Contractors will have the skills and experience needed to complete the project. Project Budget Below are the summary-level budget and detailed budget for the St. Dismas ALF Project. The assumption from examining the provided cost information chart is that the Chief Operating Officer and the Construction Project Manager provided the estimates for the facility design and construction activities of the ALF project, and upper management dictated the administrative and contingency budgets, and both did so honestly. Bottom-up budgeting utilizes the work breakdown structure in a way that cost estimates of each activity are completed by the team members responsible for carrying out those tasks, while top-down budgeting produces estimates based on the judgments and experiences of top managers (Mantel et al., 2011). The combination use in this project of top-down and bottom-up budgeting is ideal, according to Mantel et al. (2011). The advantage of top-down budgeting is that it generally has a high degree of accuracy, although it can include considerable miscalculations for low-level act ivities; bottom-up budgeting is opposite in that it provides accuracy for low-level activities and the possibility of considerable miscalculations for high-cost activities (Mantel et al., 2011). The detailed budget is also divided by task and expected quarter of expenditure to address the multiple perspectives of cost between the project manager (PM), the accountant, and the controller. Mantel et al. (2011) point out that the PM is concerned with commitments made against the budget, accountants track costs as they are incurred, and controllers are responsible for the organization’s cash flow. Dividing costs by activity and quarter allow all three parties to understand their relationship to the project. In this budget, the bulk of the detail outlines only one deliverable from the project’s scope statement and work breakdown structure—facility design and construction. The other deliverables are clumped into the central and direct administrative costs categories. Although the budget may sufficiently cover the costs of the labor that needs to go into the other deliverables (identifying needs and regulations, and developing plans, systems, and budgets), it may insufficiently cover the costs for other aspects of some of the deliverables, such as setting up  telecommunications and information systems, and organizing a major ground-breaking event. Furthermore, consideration should be given to the fact that project exclusions from the Project Scope Statement, such as design and construction of a parking area and activity and entertainment areas, are not factored into this budget. The current budget totals $10,000,000, which is still $1,000,000 under the original estimated budget and leaves some room to add deliverables if necessary. Project Summary Budget Project Monitor and Control Strategy The ALF Project monitor and control strategy is as follows. The project team will continuously monitor schedule progress via the Gantt chart and monitor budget progress via the detailed budget. Monitoring these will give the team a comparison of the time period against the actual plan. However, the team will utilize earned value (EV) metrics to not only compare the current situation with the plan, but also consider the actual progress at the point of evaluation (Mantel at al., 2011). The data from these control tools will be collected and analyzed weekly and reported to the team on a weekly basis as stated in the communication chart. The project management team will assess if any deviations from the plan are significant enough to employ control measures. If the project management team feels that intervention is  necessary, data (including the project milestone status report), assessments, and suggestions will be communicated with the Board of Trustees, and change requests will be s ubmitted with the aim to reduce the differences between the plan and the actual circumstances. Earned value metrics is the ALF Project preferred monitoring tool for the purposes of monitoring and controlling. Earned value metrics allow the team to compare the plan with the actual progress at any given point in the project, to see how efficiently our schedule and costs are being maintained, and providing an estimate of cost if the project is continued at the current rate (Mantel et al., 2011). Utilizing a go/no-go control, such as the milestone status report, allows us to compare the project output (using milestones as checkpoints) to the existing standard, assess what are needs are in terms of physical assets, human resources, and/or finances for particular tasks, and employ the necessary steps to meet those needs in order to get the project schedule, budget, and/or scope aligned with the plan (Mantel et al., 2011). Project Closeout The ALF Project will conduct a formal project closeout primarily to â€Å"help the organization improve its project management skills on future project† (Mantel et al., 2011, p. 273). The formal project closeout will allow SDMC to understand project mistakes, accomplishments, performance, and project team and management efficiencies and deficiencies, and document these in the organizational knowledge base. Furthermore, a formal close out deals with all those involved in the project in a way that has positive impact on morale and trust. The organization and the project managers show they are reliable when they finish what they start, communicate to each department that it is time to finalize their project activities, and deal with project staff and their reassignments in a tactful manner. The project closeout will follow the suggestion of Mantel et al. (2011). After the project manager ensures that all project work is complete, the project must go through the project acceptance phase. Acceptance needs to be gained from the Board of Trustees, and project management team, and officially recorded. A detailed audit will be performed to assess the progress and performance of the project’s plan through examination of â€Å"its methodology and procedures, its records, properties, inventories, budgets, expenditures, progress, and so  on† (Mantel et al., 2011, p. 275). Audit findings as well as the complete project history will be written in a final report. The final report will include the project failures, successes, and lessons learned. The final report will also document the project activities and management techniques, the location of the organization’s assets, and recommendations for improvement. The final report will be distributed to stakeholders upon completion. Closeout meetings with contractors and department heads (financial, legal, purchasing, organizational, facility, etc.) will be head to notify them of project termination, provide direction to clear the project activities in which they are responsible, and address final issues. A closeout meeting with project personnel will be conducted to address reassignments and stress, and provide closure. Finally, the project books will be closed, organizational assets will be updated, and records will be archived. References Mantel, S., Meredith, J., Shafer, S., & Sutton, M. (2011). Project Management in Practice (4th ed). Hoboken: John Wiley & Sons. Project Management Institute. (2013). A Guide to the Project Management Body of Knowledge (PMBOK ® guide) (5th ed). Newtown Square: PMI Publications.

Nursing and American Nurses Association Essay

Describe the definition of nursing as put forward by the American Nurses Association. How does it address the metaparadigm theories of nursing? According to the American Nurses Association (ANA), the definition of nursing is â€Å"the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations.† Metaparadigm theories of nursing consists of theories that describe the four interrelated concepts, which are persons, environment, health and illness, and nursing. Persons are the recipients of nursing care and include individuals, families, and communities. Environment refers to the surroundings of the client, internal factors affecting the client, and the setting where nursing care is delivered. Health and illness describe the client’s state of well-being. Nursing refers to the actions taken when providing care to a patient. ANA’s definition of nursing has included three of the four concepts that make up the metaparadigm theories of nursing. Its definition strongly emphasizes the concept of nursing. It listed many functions that nurses perform such as: protecting, promoting, optimization of health and physical abilities, preventing illness and injury, alleviating suffering, and advocating for patients (ANA website, n.d.). All these nursing actions are related to the care of health and illness, which is the second concept of the metapardigm theories of nursing. The ANA’s definition of nursing describes in more detail the concept of health and illness in terms of health, abilities, illness, and injury. These physical conditions affect the state of well-being and may lead to one’s own suffering and negative responses (ANA website n.d.). Persons is the third concept. According to the ANA definition of nursing, persons include: individuals, families, communities, and populations that receive nursing care. The fourth concept is environment. It is directly related to the other three concepts mentioned above. The environment is the surroundings or the settings in which nursing care is delivered and includes the in the hospital, home, theater, etc†¦

Ability to learn is affected by the classroom environment

The schoolroom environment is the ambiance and scene of the room that pupils learn within. It includes a broad scope of educational constructs that include both the physical and psychological environment. These constructs consist of both societal context and instructional constituents related to teacher features and schoolroom scene ( Konza, Grainger & A ; Bradshaw, 2001 ) . â€Å" The physical environment of a schoolroom explains a batch about the outlooks of a instructor towards their pupils † ( Konza, Grainger & A ; Bradshaw, 2001 ) . Before a pupil begins larning efficaciously they must be provided with a safe, positive and supportive learning civilization. In return will cut down struggle and enhance acquisition capablenesss. A pupil ‘s instruction is affected by the undermentioned constructs of the schoolroom environment: pick of coloring material, type of lighting, noise degree, room temperature, category size and ornament. A classrooms pick of coloring material impacts extremely on pupils larning. Certain colorss used on the walls of the schoolroom create both good and bad tempers ; impacting pupil larning. Mood is a pertinent facet of larning within a schoolroom. A pupil who is in a good temper and environment by others in a good temper will seek to larn and take in more from their lessons. Where as a pupil who is in a bad temper and surrounded by others in a bad temper will be loath to larn and seek distraction. Konza, Grainger & A ; Bradshaw ‘s, ( 2001 ) research proves the colors orange, yellow, green, and light blue used in schoolrooms create a cheerful, sociable environment with minimum ill will and annoyance. In return allow for pupils to increase the consumption of information and apprehension for larning. Opposed to the dull, white, brown and black colorss used in a schoolroom that creates a non- stimulating nor productive environment. Hence colour itself is a critical portion in promoti ng comfy and effectual acquisition. Consequently the pick of coloring material when utilizing in a schoolroom puting demands to be addressed as it impacts extremely on a pupil ‘s temper and in return affects their learning abilities. Sound is another construct that impacts on a pupil larning. On a day-to-day footing the schoolroom encounters many sums and different types of noise and can run from: schoolroom treatments, background noise, conversations and music. Nevertheless Marsh ( 2008 ) states that â€Å" sounds are all around us, nevertheless when sounds are unwanted they are redeemed as noise † . In order to larn pupils are subjected to conversations throughout their twenty-four hours, if non by the instructor, but themselves and other equals. The degree of variable noise will change depending on scenes such as the difference between libraries to art categories. Every schoolroom has background noise such as fans, airing, treatments and conversations which is step in dBs as BNL ( Background noise degrees ) . Marsh ( 2008 ) . A instructor can pass on clearly in a quiet voice when the BNL rises to 35dB, supplying a safe and comfy ambiance. A normal voice will transport good over a BNL of 40dB where larni ng takes its extremum as information and instructions can be delivered and heard clearly. Opposed to anything over 45dB or 50 dubnium where a instructor or pupil must talk really aloud which in return can do distraction, annoyance, emphasis and weariness ( Marsh, 2008 ) . Due to the fortunes of being subjected to a assortment of different degrees of noise within a schoolroom, pupils can change between efficient acquisition and aside. This clearly outlines the importance of noise degree in the schoolroom and its effects on instruction. There is much research grounds based on the effects of category size that is redeemed to be contradictory, whether it impacts on pupils accomplishments or non. However there are many survey ‘s that do place the significance of category size and its impact on pupil larning. Such as, Larkin, ( 2004 ) who states â€Å" that by cut downing category size, particularly for the younger kids, will hold a positive consequence on pupil accomplishment † . In making so will construct better instructor pupil relationships which will break their attitude towards larning and better their instruction. The province authorities had taken action to cut down category sizes for illustration New South Wales had aimed to hold category sizes changing from 20 to 24 pupils in the first three old ages of schooling for all province schools by 2007.Marsh ( 2008 ) . The pupils within these schoolrooms will hold the chance to derive more of the instructor ‘s clip, attending and instruction. Leti ng for more one- on- one instruction to take topographic point in the schoolroom and clip and attending for inquiries and replies that will heighten pupil cognition and better their instruction. Rather than, the pupils being subjected to big category size where the instructor struggles to run into the demands of all his or her pupils. In return go forthing the pupils troubled, unconfident and discerning towards their instructor, schooling and in peculiar instruction itself. Based on the synthesis of Course, Minus, & A ; Passing. ( 2008 ) that little categories in the early classs generate better environments for pupils and these are greater the longer the pupils are exposed to the smaller categories. Due to the consequence of pupil accomplishment displayed in the authorities ‘s actions to make smaller category sizes, it is now more of precedence within schools to move on the information and work towards smaller categories as it is turn outing to be successful. Based on authori ties consequences and theoreticians, the success of the passage to smaller categories is sketching the significance category size has on pupil acquisition. When measuring the schoolroom environment, temperature is a critical construct as it can impact pupil ‘s behavior and in return their ability to take on cognition. Marsh ( 2008 ) states that â€Å" Common sense would bespeak that there is a reasonably limited temperature scope in which school pupils might be expected to work at their best † . She explains that high temperatures can do some pupils to be cranky and uncomfortable and in utmost instances both unenrgetic and nauseating. Equally good as cold temperatures that may convey out aggression and negative behavior in some pupils within the schoolroom. The temperature of a schoolroom can be altered through the usage and execution of osculating ceiling fans, oil and gas fired warmers and air-conditioning. Marsh ( 2008 ) . It is the duty of the instructor to be cognizant of the possibilities of temperature emphasis if excessively high or low temperatures prevail and adjust their activities consequently. Temperature is a critical facet on the schoolroom environment. It can change how a pupil feels and in return their attitude to school and instruction. Therefore temperature has considerable impact on a pupil ‘s ability to larn comfortably and expeditiously. A pupil ‘s ability to larn is extremely affected by the constructs of the schoolroom environment. Students go to school to be educated and this instruction can be manipulated by many factors that exist within the schoolroom. Therefore changeless alteration and appraisal of schoolrooms is needed to guarantee that there is an addition of sufficient and effectual acquisition taking topographic point without distraction and hurt. By researching and admiting that the schoolroom environment has many constructs to it such as pick of coloring material, degree of noise, category size and temperature that all impact on how a pupil learns and their ability to larn. The school and instructors can work together to make a comfy acquisition environment to accommodate the acquisition demands of pupils.

Illicit Drug Usage and the Law in Canada Essay Example | Topics and Well Written Essays - 1250 words

Illicit Drug Usage and the Law in Canada - Essay Example This has prompted the Canadian government to join the United Nations and other like-minded countries in the war against drugs. Canada has instituted various legislations aimed at curbing this cropping vice. For instance, the Canadian government has established new prohibitionist drug laws with very harsh penalties. The social, economic and political effects that substance abuse has had on the entire Canadian society are self-evident. For instance, a substantial number of Canadians who succumb due to drug-related complications has soared. Direct health care costs have also increased to large extents. Besides, substance abuse cost Canadians billions of dollars annually. Furthermore, there is low productivity in Canada due to morbidity that has adversely affected the Canadian economy. According to Montigny (2011), drug- related crimes are the order of the day in Canada in that crime rate has tremendously heightened. Consequently, crime and law enforcement costs have been on the rise due to increases in use of illicit drugs. This has invoked the Canadian government to tighten up its belt in the fight against illicit drug and substance abuse. A number of Acts aimed at controlling these drugs have been instituted. A legal foundation for drug legislation in Canada was laid in the early twentieth century. This was precisely in 1908 when the Opium Act instituted the initial drug restrictions. The act also created prohibition toward various other medicines and restrictions on tobacco and alcohol usage. Later in 1911, the Opium and Drug Act of 1911 was enacted establishing further restrictions on cocaine and opiates (Roach, 2008). In the year 1923, the Act incorporated restrictions towards cannabis usage. These developments led to the ultimate enactment of the Opium and Narcotic Act 1929, which became a crux in the Canadian drug policy. This act was backed up by various international drug legislations instituted by specified conventions. They include the Single Convention on Narcotic Drugs of 1961 as well as the Convention on Psychotropic Substances of 1971(Whitaker, 1970). The fight on illegal drug usage in Canada took a new dimension in the year 1969 when the Le Dain led Commission was mandated to look into the Non-medical use of drugs in Canada. The commission established that the number of Canadians convicted with life imprisonment and other personal barriers annually due to illegal drug possession and usage was on tremendous rise. More so, they discovered that the police used excessive force against drug offenders (Moore, 2007). Owing to these discoveries, there was need for gradual withdrawal from criminal sanctions against those found in possession and use of illegal drugs as well as less coercive alternatives to the application of criminal law on drug offenders. This witnessed the implementation of the Canada Drug Strategy of 1987 that was aimed at addressing the identified problems. A decade later, the Controlled Drugs and Substances Act of 1997 was enacted. This Act was specifically meant to address the Canadian drug situation disregarding what was transpiring in other countries around the world. This Act was soundly prohibitionist since it barred any activities related to illegal drugs. As such, the most outstanding federal statute dealing with illegal drugs in Canada is the Controlled Drugs and Substance Act of 1997 (CDSA). This statute is charged with the

Workplace issues or disaster management Essay Example | Topics and Well Written Essays - 500 words

Workplace issues or disaster management - Essay Example d a theoretical framework discussion issues that related retention and bullying, as well as the reported organizational culture that was deemed contributory to exacerbation of the issue by being indifferent or not addressing these concerns. Steven (2002) confirmed that the workplace issue of intimidation or bullying has pervaded the nursing profession for a considerable length of time: â€Å"bullying behavior has occurred within the nursing profession across a variety of institutional settings, including nursing faculties and professional bodies, for at least seventy-five years† (Stevens, 2002, p. 190). The author was reported to be part of the investigation team. The nurses who were victims of intimidated reported cases of supervisors who â€Å"regularly yelled at the nurse in front of other staff and patients, withheld information she needed to perform her duties, and excluded her from meetings and social functions. Others were given the â€Å"silent treatment† (talk ing to them through third parties, talking about them as if they were not present). Continual criticism of a person’s work, personal appearance, and voice was another type of behavior reported by nurses in the survey† (Stevens, 2002, p. 190). Through the initiation of management, the intimidation and bullying were appropriately addressed, which eventually resulted in lower turnover. Financial Impact on the Organization: The workplace issues on intimidation or bullying have financial impact on the organization in terms of the high turnover rates where were evident. Due to the need to frequently recruit new nurses to replace those who resigned due to intimidation or bullying, the hospital spends more in terms of high acquisition and training costs. These costs take a toll in terms of minimizing the organization’s profits. Personnel Impact: There are significant impacts in terms of personnel through exhibiting lower morale, low job satisfaction, and low productivity as a result of intimidation or

Program Analysis-Enterting the workforce at a later age Essay

Program Analysis-Enterting the workforce at a later age - Essay Example The issue is important because it ensures that all employees remain lively and with elevated spirits. Studies have confirmed that boredom in the workplace reduces employee productivity. People at a later age also continually lose taste and interest in life (Gregory, 2001). They have many depressing life experiences, have families with needs, and think about their life after retirement. These factors may significantly impact on their performance in the workplace if they are not properly looked into. They want an environment full of joy and comfort, especially joy that leads to mental comfort. The later is best attained through entertainment activities. Entertainment affects new workers, single and working couples in a number of ways. It allows the workers to have some joyous space away from the stressing circumstances of daily life. Through entertainment, new workers acclimatize better to the workplace environment by learning to socialize easily with the other employees (Gregory, 2001). The socialization factor is enhanced by the elevated moods of the employees that enable them to talk openly, share ideas and experiences of life. The workplace becomes another home with entertainment and leisure joints over and above the busy schedule. Working couples at a later age may also lack entertainment and fun in their homes. Most of their children are married, working, or studying. This creates an environment of boredom in their homes. Entertainment in the workplace makes them prefer and enjoy being at the workplace. The more they extend their stay at the workplace, the more their productivity increases. They develop a passion and preferen ce for the workplace that makes them good performers. The best workplace program for dealing with entertainment of aged workforce is by initiation of an entertainment joint at the workplace. After the busy

Medical equipment lifecycle ( Medical Equipment & Technology Services Essay - 1

Medical equipment lifecycle ( Medical Equipment & Technology Services Management) - Essay Example The technology life cycle of a medical component initiates in the design and acquisition phase, by means of the acceptance process. The technology life cycle of the medical component extends through its application in the clinical environment . Subsequently, it reaches the obsolescence phase where it is replaced and discarded after reaching its maximum life utility. The acquisition, approval and obsolescence of a medical technology occurs only once in its useful life (Chan, 2003, p. 13). The optimal application of technology incorporates a number of occupations and can occur over a variety of instances. This optimal application of medical technology can be deconstructed into two sub cycles. These sub cycles are the acquisition and application sub cycle. The acquisition sub cycle consists of the following events: Technology evaluation- Technology evaluation is a classification of policy study which reviews the short term and long term outcomes which are societal, ethical, legal and economic. These aspects constitute the comprehensive evaluation of the technology (Banta, 2009, p. 8). The gold criteria for clinical research assessment of novel medical technology is historically recognized as the Randomized Control Trial (RCT) (NHTSA, n.d.). A primary tenet of technology evaluation is â€Å"buying smart, not cheap†(University of Boston Massachusetts, 2010, p 9). In the technology evaluation, the following details are delineated: Guiding adaptation and application in medical equipment technology goes hand in hand. The important factor in being successful is carrying out a comprehensive and thorough planning procedure (NSBA, n.d.). Efficient technology designs are directed towards applications, instead of technology. The technology should be based on inputs and not results (See, n.d.). A new medical technology equipment system

Equity and Trust Essay Example | Topics and Well Written Essays - 2500 words

Equity and Trust - Essay Example However area of conflict had arisen in the proper disposition of these gifts. A detailed description of Neil’s will and the circumstances related to each of the term stated in the will may prove to be helpful in resolving the conflict. Neil’s will states the following terms : -> 30,000 to be given to the â€Å"Supporters of Elfed Hospital† as a gift -> 60,000 to be gifted to the â€Å"Friends of Thomas Hospital† and -> 400,000 to be used to provide benefits to the inhabitants of Elfed and special privilege to be given to the employees of Neil & Co Ltd and their families. Discussing each of the terms in details would give a clear view of the scenario and will also be helpful in advising the executors of Neil on the probable terms of the declarations made. -> 30,000 to be gifted the â€Å"Supporters of Elfed Hospital† A view on the history behind the relationship between Neil and Elfed Hospital reveals that the main factory of Neil & Co Ltd. is situat ed in the village of Elfed. There is every possibility that considering this fact Neil had included this term in his will, for gifting 30,000 to the â€Å"supporters† of Elfed hospital. Though he mentioned the term â€Å"supporters† and as such there is no legal declaration or discrimination for this particular term, it could be well assumed that the main intention behind mentioning this in the will is to provide welfare in terms of monetary benefits to the Elfed hospital and not in particular to any supporters or volunteers or anyone specific as such.

Art Deco Essay Example | Topics and Well Written Essays - 1000 words

Art Deco - Essay Example In its initial stages, it highlighted faith in technological and social progress, luxury, exuberance, and glamour. The term Art Deco became popular in 1966, in a French exhibition, in 1925. In this event, the term helped to differentiate French art works of the Belle Epoque from art works of the time. In addition, it describes a number of crafts developed in the Entre Deux Guerres period, and also developed by the Bauhaus. Nonetheless, since it started in France, there is a claim that it should be utilized to works associated with the French and those made in nations with direct influence from France. The Art Deco period has lasted from 1925 during an event to exhibit novel concepts in applied arts. Its inspiration largely came from ancient art from all over the globe. In the 1920s, inexpensive means of travel allowed direct contact to several, societies, communities, and cultures. In addition, there was a common interest in archeology because of excavations in areas, for example, th e tomb of Tutankhamun and at Pompeii, Troy. Designers and artists incorporated Machine age elements with decorations from ancient Greece, Oceanic, Egypt, Asia, Mesopotamia, Rome, and Mesoamerica. Also, Futurism, Constructivism, Modernism, Functionalism, and Cubism contributed to its development. The sculptor, the cubists and other art workers worked together to decorate a Studio House in 1927, with a number of them designing the staircase, others the fountain, others the Cubist rug, and others the fireplace mantel. Art Deco also highlights geometric forms, for example, sunburst, spheres, chevrons, polygons, zigzags, trapezoids, and rectangles motifs. There is an organization of the components in symmetrical designs. There is also utilization of modern materials, for example, plastics, aluminum, chrome, stainless steel, and Bakelite. In addition, there is also the use of lacquer and stained glass inlays. Its colors also appear to be high-contrast and vivid. Moreover, it was a popular international style that influenced a large field of design. It was also largely utilized in consumer goods, for example, clocks, automobiles, jewelry, furniture, textiles and electronic goods, for example, jukeboxes, radios, and telephones (Bayer 14). Additionally, Art Deco influenced cinema, architecture, graphic arts, interior design, fashion, and industrial design. Amusement parks, public works projects, movie palaces, and ocean liners also employed Art Deco during the 1930s. Nevertheless, the negative effects caused by World War II made Art Deco decrease in reputation. A renaissance of attention started in the 1960s. Moreover, there has been the development of a style associated with Art Deco referred to as Streamline. This style started in the beginning of 1930. Streamline got its inspiration from contemporary principles of aerodynamics to decrease air friction at soaring swiftness. Manufacturers used the elements to buildings, cars, gas pumps, trains, refrigerators, and ship s. The Chrysler Airflow of 1933 was one of the first vehicles manufactured from this

Eco 365 Supply and Demand Essay Example for Free

Eco 365 Supply and Demand Essay The supply and demand simulation shows different aspects of economic structures. Although mostly focused on microeconomics, the simulation does show a small role of macroeconomics. The principles of microeconomics would apply to drop in rent prices to increase the supply being demanded. Another microeconomic principle shown in the simulation is the rise in demand when the cost of rent is lowered. Macroeconomics principles came into play when the rise in demand for apartment was a direct product of the establishment of a new company in town. Same principles of microeconomics apply to an excess supply created by a price ceiling enforced by the government. Supply and Demand Shifts A shift in the demand curve was created when the new company brought an increase in population to Atlantis. A greater amount of people created a greater demand for the apartments. Equilibrium is reached in the demand shift by raising the price of rent to decrease demand. A supply shift was created when 400 apartments were converted into condominiums, which in turn caused a drop in supply. The equilibrium would be fixed by raising the cost to lower the demand because of a decrease in supply. Real World Application With the nutritional corporations expanding and health awareness on the rise prices of nutritional supplements are rising to meet the demand. Especially in local areas, there aren’t too many health and wellness shops that offer the best available supplements or expert advice, therefore the few local shops in town can raise the prices of their products because of high demand and low supply. Microeconomics: Supply/Demand Shifts A sudden increase in population can cause a demand shift which would either cause you to increase or decrease price reach equilibrium and maximize revenue. Supply shifts are caused by eliminating or adding supply to an economy to meet the choices of the population. Macroeconomics: Supply/Demand Shifts An increase in wages from neighboring business may cause a demand shift. This would cause a company to make changes to their prices to try to reach another target or meet the needs of the current target. A shift in supply because of macroeconomics can be caused by price ceilings or floors that would lead to a surplus or shortage of supply. Pricing Strategy Price elasticity of demand will always change the pricing strategy of a company so that they can maximize revenue, not demand. If a company figures they have low demand for their products they may lower the price so that more people become interested and vise-versa. The price elasticity is the equal to the percent change of quantity demand times the percent change in price. Price elasticity is used to figure the change in demand after a change in price (Colander, 2010). PEoD = (% Change in Quantity Demanded)/(% Change in Price) When the price of causes a change in the demand the formula will recognize that change and give you an indication of delicate that products demand is to a change in price. The higher the result equals higher sensitivity to price change (Moffatt, 2013). References Colander, D. C. (2010). Economics (8th ed.). New York, NY: McGraw-Hill. Moffatt, M. (2013). Price Elasticity of Demand. Retrieved from http://economics.about.com/cs/micfrohelp/a/priceelasticity.htm

Roma People And The European Union Politics Essay

Roma People And The European Union Politics Essay The term Roma refers to a variety of groups of people who describe themselves as Roma, Gypsies, Travellers, Manouches, Ashkali, Sinti, as well as other titles. For the purpose of this paper, we will use of the term Roma to describe the group in question. This is in no way intended to downplay the great diversity within the many different Romani groups and related communities, and it is not intended to promote stereotypes. Our basic question is what is the status of the Roma people today, within the context of the European Union? For millennia, the Roma have been an integral part of European civilisation. Today, with an estimated population of 10-12 million people, Roma are the biggest ethnic minority in Europe; Roma communities are present in all 27 EU Member States. And in contemporary times, most Roma are EU citizens. An issues is that their situation is characterised by persistent discrimination and social exclusion. Thus, Roma are very exposed to the risks of poverty, unemployment, stereotypes and social prejudice. Its vital to understand that the Roma population is heterogeneous. Following the elimination of traditional labor activities and of nomadic lifestyles in some Member States, urban migration, but also migration from Eastern Europe to the western EU states, there have been a lot of changes affecting the Roma people. However, there is a very big gap between the living conditions (in the fields of health, education, labor and housing) of the Roma and the majority population. And a concentrated effort toward EUs integrated policy towards the Roma is needed, preferably a multidisciplinary one, dealing with the problem from multiple angles, not just from an economic of sociological point of view, and also one whose results have to be quantifiable, state-wide but also centrally. This is our hypothesis. Legal Framework in the EU The European Union has established a strong legal anti-discrimination framework; the most important documents on the issue consist of Article 13 of the Treaty establishing the European Community, Council Directive 2000/43/EC on Racial Equality and the Council Directive 2000/78/EC, that establishes a general framework for equal treatment in employment and occupation. The European Union also has a strong legal framework dealing with Roma discrimination, that is based, among others, on article 13 of the Treaty of the European Community, the Directive 2000/43/EC on racial equality and the Directive 2000/78/EC concerning the prohibition of discrimination in employment and vocational training. Its important to note however that it is the duty of the Member States to translate these Directives into their own national legislations.   The European Commissions mandate also includes stimulating the use of EU Structural Funds by EU Member States for supporting Roma inclusion.  This process is supported by the EURoma network, composed of representatives from 12 Member States,  whose goal is to promote the use of Structural Funds in order to enhance the effectiveness of policies targeting the Roma and to promote their social inclusion.   Roma people in Romania According to official data, Roma population in Romania included, according to the 2002 census, 535,250 people, of which 325,000 people (60%) lived in rural areas. Roma population is, numerically speaking, the second ethnic minority group in Romania, after the Hungarians. However, these census numbers might or might not reflect reality, for there are probably more Roma who havent been accounted for because they refused to participate in the census or might have avoided stating their nationality. According to a study by the National Agency for Roma, the socio-economic situation of Roma ethnicity remains still quite difficult: Roma score on a high level of poverty. Roma communities are affected by various problems: high levels of unemployment (28%), low income, low educational and vocational training (with visible effects in the labor market participation), improper living conditions and limited access to public services. Many Roma are working as day laborers, thus without having a stable source of income. According to OSI (Open Society Institute) research conducted in 2007, 4.9 percent of Roma people in Romania lacked a birth certificate. Among nonà ¢Ã¢â€š ¬Ã¢â‚¬ËœRoma citizens, less than 1 percent lacked a birth certificate. Similarly, surveys in 2007 and 2008 indicated that between 1.9 and 6 percent of Roma lacked identity cards, compared to 1.5 percent of nonà ¢Ã¢â€š ¬Ã¢â‚¬ËœRoma. The lack of identity documents leads to exclusion from participating in elections, receiving social benefits, accessing health insurance, securing property documents, and participating in the labor market. Another survey, conducted by the ICCV (Institutul de Cercetare a Calitatii Vietii), points out that the proportion of illiterates among Roma is disturbing: more than one third of the Roma (38.6%) are functionally illiterate, 19% of men and 27% of mature women only attended one school year. 18% of Roma children aged between 7 and 16 years have never been to school. Among the conclusions of the study are the following: Roma population categorically refuse to be a part of the education system. The problem is that the Roma population lives, usually in secluded and / or notorious neighborhoods, and schools located in these areas, where Roma children might study, have inferior learning conditions. NGOs and the media report that discrimination by teachers and other students against Romani students served as an additional disincentive for Romani children to complete their studies. However, other Roma are largely or fully integrated into society. Scholarships in schools and universities were created for Roma by the state creating positive discrimination whose impact on improving integration in Romania remains to be seen. On the downside again, in schools where students are predominantly Roma, repeater rates reach 11.3%, almost three times higher than the national average. Because of the low quality level of the school, almost 20% of Roma students enrolled in the fourth grade are functionally illiterate, according to the ICCV. The EU, Romania included, has launched a program entitled Decade of Roma Inclusion to combat this and other problems. Roma situation differs from country to country, but integration problems remain in developed countries. A report by the European Roma Rights Center (ERRC) emphasizes that, in 2005, the Roma in France for example, counting around 500,000 individuals are the target of dramatic levels of discrimination. The report notes that civil, political, social and economic community are frequently violated and concluded that the authorities fail integration of minorities in the Hexagon (France). The most important communities of Roma live in Central and Eastern Europe, but, similariy to Romanias case (where the official 2002 census claims numbers of 535,000, while a EU report dating from 2004 says there are 1.8 million Roma) their number varies between official censuses and unofficial estimates: Czech Republic has between 11,000- 200,000 Roma, Slovakia, between 95,000- 550,000, Hungary, between 200,000- 600,000, and European reports on this minority are often negative. In each of the three of the EU countries mentioned above, unemployment among Roma reaches 75% -80%; when they have access to education, most often the children study in special schools and the wider community is a victim of racial prejudice coming from the majority population, according to Amnesty International. EU Strategy for Roma integration The European Commission has set up a programme to tackle the main difficulties involved in the integration of Roma people. There are EU funds available to help, and countries are encouraged to make greater use of them on a national level. To this effect, one important tool is the European Social Fund, which currently stands at around 12 billion Euros and amounts to 10% of the EUs budget. The purpose of the fund is to provide support for projects that seek to improve social cohesion in the Union. The second European Roma summit, was being held at the beginning of April 2010- on the International Roma Day, and was set-up as a forum to discuss the Commissions new strategy and to renew commitments. Representatives of EU institutions, EU countries and civil society organisations, including Roma groups, have participated in the conference and also present were World Bank Director Theodore Ahlers and the investment banker and philanthropist George Soros. The direct involvement of Roma organisations and representatives was a key feature of the event. The agenda included the implementation of rules against discrimination and racism by member countries of EU. Concerning this, the Commission had taken legal action against 24 EU countries which have not fulfilled their obligations in this respect and for 12 of these cases, the proceedings are ongoing. The focus shifted in the EU in 2009 from an analysis of the problems to an exploration of how existing instruments could be made more effective and how the situation of the Roma could be addressed more explicitly across a broad range of policies, including employment, social inclusion, health, education, housing, youth and culture. But the enforcement and development of specific EU legislation in the areas of non-discrimination, freedom of movement and anti-racism has continued. The European Platform for Roma inclusion- composed of key players in Roma inclusion from EU institutions, international organisations, Member States governments and civil society, was launched in April 2009 to exchange good practice and experience and to stimulate cooperation among its participants, with a clearly stated objective: to increase the coherence and effectiveness of the parallel policy processes at national, European and international level with a view to creating synergies. Most Member States report a stronger focus on internal coordination and on involving the Roma communities. Some Member States have begun to use the opportunities of complex programming and combined cohesion policy instruments. Among the findings of the forum, it seems that Member States want to mainstream Roma issues and to use mutual learning in order to explore how to improve their current initiatives on desegregation and on access in the areas of education, employment and basic social services. Another new effort of The European Commission deals with the implementation of a pilot project on Roma inclusion (5 million Euros for 2010-2012), initiated by the European Parliament, addressing early childhood education, self-employment through micro-credit, and public awareness particularly in countries with high Roma populations. The pilot project will also explore methods for data collection and counterfactual evaluation to assess the impact of the interventions in these three fields. Specific problems concerning the workforce As a fact, working age Roma lack sufficient human capital. Apart from barriers such as labor market discrimination still affecting them, the vast majority of working age Roma lacks the necessary qualifications to participate effectively in the labor market. The next figures will portray the cases of 3 member states, Bulgaria, the Czech Republic and Romania, and also a non EU state, Serbia, in order to get a grasp of how serious the educational problems are among various European Roma communities. Note: Data included in figures 1, 2 ,3 and 4 comes from the World Bank. This is seen dramatically in Figure 1, which shows the proportion of working-age Roma that have completed at least some secondary education or more. Only 1 in 5 Roma of working age in the Czech Republic and as few as 1 in 8 in Bulgaria, Romania and Serbia are equipped with these necessary education skill levels. Working age members of the majority populations in these countries are 4 to 6 times more likely to have these educational qualifications. Figure 3 shows the average monthly net income that employed Roma earn compared to that of the majority population. Employed Roma earn 31% less in Bulgaria, 48% less in Serbia, 55% less in Romania, and 58% less in the Czech Republic. Specific problems concerning demographics and education The health situation of the Roma conditions their life expectancy and their demographics are different from the european average. The European Roma population is significantly younger than the overall population (an average of 25.1 years old in seven Member States, compared to 40.24 years in the whole EU; 62.38 percent of the Roma population is under 29 years old, compared to 34.98 percent in the EU-27). There is no official information on the average life expectancy of Roma, but this is expected to be significantly lower than the overall EU population (which is around 63 years old in Romania) The child dependency index is 57.77 compared to 23.33 in the EU, while the elderly dependency index reaches 4.11, much lower than the EU of 24.93. There is also a gradual decline in birth rates among Roma, however, the replacement index (reflecting the number of people with ages between 15 and 39 for every 100 people aged 40 to 64) remains significantly higher among Roma (231) than for the overall population (101). As we have seen from the figures above, Roma citizens in some Member States influence the demographic pyramid in a specific manner. Educational systems are selective and, despite efforts by Member States to overcome segregation, a great deal of the systems that have been ostensibly designed to combat segregation are often used in practice to increase disparities between social groups and disadvantage the poor profoundly, especially in the case of Roma. There is a constant need of specific educational policies to address Roma families and also policies that encourage active participation. Although the proportion of young Roma enrolled in education and higher education systems has largely increased in some Member States, their level of qualification is still below the EU average. However, in the absence of formal qualifications, the position of Roma in the labor market can be improved by creating a system of recognition of practical skills. Indeed, Figure 6 shows that among Roma who completed secondary education the average earnings are much higher than the average earnings among Roma who completed primary education: 83% higher in Bulgaria, 110% higher in the Czech Republic, 144% higher in Romania, and 52% higher in Serbia. Romanias efforts aimed towards the Roma through structural funds Surprisingly, there is a great deal of implication concerning this matter with the local, Romanian authorities, and a lot o projects concerning Roma and their social integration are on their way. Most projects are co-funded by the European Structural Funds, are managed centrally and focus primarily on education (including early childcare), vocational and professional training, labour market insertion and social inclusion. According to the information provided by the Romanian Managing Authority, a total of 11 projects are being or will be implemented multiregionally or statewide with an aggregate budget of 37,819,853 Euros and are planned to benefit 61,634 Roma men and women. Most projects are short-to-medium-term (2-3 years). We can note that 6 major projects (employment and early education) are directly managed by the National Roma Agency. Our hope it that perhaps these efforts will actually wield some quantifiable results. Figure 5 source: EURoma report- Roma and the Structural Funds There are currently several integrated projects that rank as highly important. First, a transnational pilot project, Together on the labour market, is managed by the National Roma Agency is being implemented in 8 cities, in partnership with the Fundacià ³n Secretariado Gitano from Spain as transnational partner during the period 2008-2010. In the following period, 2010-2013, the project aims to be expanded nationwide. At a cost of 4,908,749 Euros for a period of two years, the project has ambitious aims: to benefit 6,670 Roma women and men through personalised support for labour insertion, vocational training adapted to the demand of the Romanian labour market. With a budget of 4,770,000 Euros, another employment activation project, Strategic steps for improving access to education for Roma children, presents ambitious outcomes and outputs: to increase the qualification on the labour market of 2,000 persons, including 1,000 Roma, the development of social economy structures, the increase of job opportunities addressed to vulnerable groups, the establishment of 8 Regional Centres to supporting social economy structures, the creation of 8 Regional Partnerships, and the development of 80 social economy projects. Within the education field, the All in kindergarten, all in the first grade. Integrated programmes for increasing the access to education and the educational level of the children within under-privileged communities, mainly Roma, during 2008-2009 project, is managed by the central government with a budget of 5,000,000 Euros. Although no data is yet available on its results, it had some ambitious and specific targets. The general objective of the project is to prevent and correct early school leaving for children aged 5 to 8 within 420 disadvantaged communities (a high proportion of them being Roma children). It seeks to increase access to pre-school and school education for 8,000 children within disadvantaged communities, mainly Roma, trough participation in Summer kindergarten and School after school educational programmes. Its potential outputs are ambitious: A 75% decrease in school dropout rate for pupils in the first grade belonging to the 420 disadvantaged communities; 6,000 Ro ma children benefiting from the school-after-school programme and 10,000 Roma parents receiving counseling regarding child education. Three other projects target pre-school education. Two are managed respectively by the Amare Rromentza Roma Centre and the National Agency for the Roma, with more than 4,000 combined beneficiaries. The third, titled Strategic steps for improving access to education for Roma children is managed by Romani CRISS and will have as a general objective the reduction of early school leaving risk among Roma pupils. With a budget of 4,872,060 Euros, it will develop desegregation plans within 90 schools from 4 regions of the country -North-West, Centre, South-East and Bucharest-Ilfov over three years, including intercultural training for 150 teaching staff and awareness-raising initiatives regarding the benefits of education to 20,000 planned Roma beneficiaries. Finally, an integrated project, Education of Roma children- the way to a guaranteed employment, is being managed by the National Roma Agency and implemented for three years (no exact dates provided). It aims to increase of the educational level of the Roma children from rural and urban areas nationwide and the development of human resources. With a budget of 4,943,831 Euros and targeting 4,800 beneficiaries (50% women), it could help to find ways to articulate education and employment policies through effective local implementation of equal opportunity and desegregation measures, and if it demonstrates long-term sustainability. Economic costs of Roma Exclusion: As expected, the fact that Roma people sit on the margins of society leads to some macroeconomic consequences. These consequences have been thoroughly analized and documented in a recent, 2010 report by The World Bank. Note that some of the issues presented in the report have surfaced in the previous chapters of this paper. A summary of the findings is presented in the following table: Figure x: The economic costs of Roma Exclusion The vast majority of working-age Roma lack sufficient education to participate successfully in the labor market. As a result, European countries are losing hundreds of millions of Euros annually in productivity and in fiscal contributions to the governments. Lower bound estimates of annual productivity losses range from 367 million Euro in the Czech Republic, 526 million Euro in Bulgaria, to 887 million Euro in Romania. Lower bound annual fiscal losses range from 202 million Euro in Romania, 233 million Euro in the Czech Republic, and 370 million Euros in Bulgaria. Toward inclusive growth: bridging the education gap is also the economically smart choice to make Better educated Roma can expect much higher earnings. Compared to Roma with primary education, Roma who complete secondary education can expect to earn 83% more in Bulgaria, 110% more in the Czech Republic, 144% more in Romania. The annual fiscal gains from bridging the employment gap are much higher than the total cost of investing in public education for all Roma children; by a factor of 7.7 for Bulgaria, 7.4 times for the Czech Republic, 2.4 times in Romania. The share of Roma among the working-age populations will rise as majority populations in Eastern and Central Europe are aging rapidly. Equal labor participation among the Roma is essential to shoulder the nationally rising costs of pensions, health and other costs of aging. source: The economic costs of Roma exclusion, World Bank Report, April 2010. Conclusions We consider that Roma are mostly discriminated because of a certain lack of education, but also because they are sometimes perceived as social outcasts. And this is sometimes a matter of choice, even tradition, which makes this a very tough area to cover and improve. Education is a milestone to consider, and perhaps the key to solving a lot of Roma related problems. We have seen that there are trumendeos efforts on a local but also European level, which we believe is a positive sign. The use of structural funds could be a very powerful tool when used properly. While targeting Roma education might lead us to certain cultural barries, we have to do our best to understand these limitations and figure out a way to please both parties. There are a lot of opportunities and advantages what will come with a better integration of the Roma people, and some steps have been taken into this direction, both socially and economically. However, there is one problem that should be noted. The issue of results, and more specifically, how do we make the efforts quantifiable? We see a lot of projects through structural funds in Romania, but we should also bear in mind their specific results and goals. The centralisation of these results should be a priority, otherwise they risk getting by unnoticed. Have the goals been achieved? They the programmes succesful, but just how much? How can they be improved so they reach the broader audience rather than smaller groups? Bibliografie www.euractiv.ro www.ecursuri.ro 3. www.ec.europa.eu Home http://www.romadecade.org/ http://www.anr.gov.ro http://worldbank.org/

Macro Environment Influences Of The Airline Industry Tourism Essay

Macro Environment Influences Of The Airline Industry Tourism Essay In terms of the case, it suggests that the environment of airline companies is not very stable, especially the increasing price of fuel which is the key driver of change. From Ryanair profit statement (Exhibit 1a) it shows the fuel and oil cost has increased by â‚ ¬200 million from 2005 to 2006. The increase in fuel costs is 74 percent. The impact to the airlines companies is obvious and the budget airlines may face the trouble more so than normal airlines. Moreover, airline companies also have to concentrate on some other issues. For example, according to the case, they are facing the risks from terrorist attacks which are difficult to predict. It is not difficult to find the changeability, however it is complex to the airline environment. Some factors, such as legal action and customer demand, also have influence on them. Some of these such as the price of fuel and oil can be predicted, while some of them cannot. Stage 2 Audit environmental influences The Pestel Analysis is employed to identify macro-environment influences of the airline industry. Political: Government wants to strengthen the economy and, consequently, will support local airlines by setting rules, such as preferential rights. Every government however, will probably do so. Therefore theres no obvious advantage between competitions. The political issues have a wide range of effect, so they are not the key points that budget airlines are facing. Economic: This is identified as the most crucial factor to airline companies, especially to budget airlines. The influences refer to the macro-economic factors such as the national growth rates and the exchange rates. As budget airlines, they will pay more attention to the operation costs such as fuel cost. It became a big issue for budget airlines because of the increasing cost of fuel. That may reduce the advantages and the companies will be less competitive than before. On the other hand, the recession will lead more people to choose budget airlines. Social: With the development of Asian countries in particular China, there are more and more people deciding to study or travel in Europe. In recent years, the lifestyle of local people has also changed. They tend to travel abroad to enjoy their lives. Most of these people are not wealthy such as student. The budget airlines therefore, will be their best choice to reduce the travel costs. Technological: The innovation of technology helps the airline companies reduce costs and carry out tasks more effectively. The new type of aircraft can help to reduce the burning of fuel; and new technology can also make the security check more efficient and accurate. Environmental: European countries pay more attention on environmental issues, especially greenhouse gases from carbon emissions. Moreover in terms of the case, airline companies have to pay the environmental taxes for the contributions they make to global warming. In particular, it is bad news for budget airlines. Costs will increase and the companies want to maintain good brand image in the consumers perception. Furthermore, noise pollution and energy consumption cannot be ignored under such conditions. Legal: Some legal actions such as preferential airport rights are directed against the specific airlines. As budget airlines, which have higher competitive power, they should pay more attention to the legal forces to prevent loss. On the contrary, they can also take the initiative over illegal aid to rivals. Stage 3 Determine industry specific factors (this stage will be analysed in Question 2) Stage 4 Identify competitive position (this stage will be analysed in Question 3) Stage 5 Identify key opportunities and threats There are many potential opportunities for the airline companies. For instance, the recession may lead to more people choosing the budget airline rather than the expensive ones; new technology which helps to reduce the usage of fuel; government set the tax at a lower percentage. On the other hand, the increasing cost of fuel may be the most significant issue most budget airlines face. Whats more, the compensation to passengers, terrorism and security, and customers satisfactions will all have potential negative impacts on the airline. In order to achieve lower costs, budget airlines will have to reduce costs from many departments and operations. Thats why lots of customers are not satisfied with the budget airlines except for the price. Question 2 Prepare a Porter Five Forces analysis of the budget airline industry. Express Ryanairs perspective of these forces. The threat of entry There are high barriers to enter the budget airline industry. i) High investment requirements. Economies of scale are important in the airline industry. It is difficult for new entrants to match others existing competitors. In addition to this, the operational experiences cannot be acquired in such short space of time. ii) Expected retaliation. Retaliation will take place when new entrants appear for budget airlines, it will probably be in the form of a price war due to costs of entry being very high for them. iii) Legislation or Government action. Government wont let new entrants enter the market if the industry is saturated. With regards to Ryanair in the budget airline industry, there will not be large impacts to existing budget airlines if new entrants appeared. Budget airlines always focus on the costs and price, so does Ryanair. According to the case, Ryanair was the first budget airline in Europe and now its ticket prices are much lower than the other rivals. Therefore it will be impossible for new entrants to set a low price to win the market. The threat of substitutes Before discussing the threats, some comparative data is showed below. Round Trip by Ryanair Flight: London Stansted Milan Going Out Regular Fare Adult 8.99 GBP Tue, 2 Dec 08 Flight FR 4184 8:15 Depart 11:15 Arrive Coming Back Regular Fare Adult 12.99 GBP Sun, 8 Dec 08 Flight FR 4185 6:45 Depart 7:50 Arrive (Source: Ryanair.com) One way by Rail Europe: London (ST Pancras) Milan Standard Class Adult 227 GBP Tue, 2 Dec 08 8:40 Depart 21:20 Arrive (Source: Raileurope.co.uk) Most of the travellers will prefer the short journey, in addition to the cheaper way to travel. From the tables it is obvious that taking a plane from Ryanair is much cheaper than taking the train in a similar situation. Although some airlines may be expensive, budget airlines such as Ryanair will usually be the best choice. The impact of substitutes, therefore, has less impact on the budget airlines. The power of buyers Buyers of airlines tickets can sometimes be the travel agency.  In other cases, Ryanair caters to ultimate consumers. Majority of the buyers are not concentrated buyers and they come from all over the countries. Individuals can select the budget airlines according to their preference, because the switching costs are low and the differentiation of such service is weak. It is extremely expensive for people to own an aircraft. When there is a choice of budget airlines to use, with low prices. So there is a low buyer competition threat. Like Ryanair, with less concentrated buyers and buyers competition threat, the power of buyers is low. The power of suppliers The high power of suppliers may be one of the most significant threats among the budget airline industry. The increasing price of fuel, which leads to a high cost for airlines, is a basic issue they are facing. As we know, fuel industry is now concentrated in the hands of few producers. Therefore, in this situation it is difficult to cut the price for this essential material. In addition to this, it is useless to change fuel suppliers when the global price is growing. Moreover there are no practical substitutes. Ryanair is facing this problem with other budget airlines. Furthermore Ryanair sells all the ticket directly through the website. Thus there is no intermediary. Competitive rivalry Rivalry is influenced by these four competitive forces and each of them may have different levels of impact on the competitive rivalry. In this market, every airline provides the same services which are poorly differentiated. Low differentiation and switching costs in this industry, therefore, cause the price competition. Ryanair, which has the first mover advantages, still holds the dominant position. Although many of the competitors were losing money or even have been taken over, Ryanair remains steady in incremental growth. For industry growth rate, this industry is in the maturity situation of life cycle, which means the growth is low. Price war is therefore playing a crucial role throughout the competition. Question 3 Evaluate Ryanairs particular strengths and weaknesses and explain, with reasons, what Ryanair must do to retain a sustainable competitive advantage. As the first-mover of budget airline industry, Ryanair still holds the dominant lowest-cost position. This is also the one of the strengths it has. Whats more, Ryanair was announced being the most profitable airline in the world according to the case. The revenue is still increasing, despite the price of fuel did not stop growing in recent years. The brand image of Ryanair is also one of its strengths. Customers are attracted by the lower price. Its traffic is the highest among the competitors (see Exhibit 2) and it is still increasing due to the enlargement of the company. On the other hand, there are still some weaknesses of this budget airline leader. In terms of the case, Ryanair win the market mostly depends on the costs. However, the costs of its major raw materials are increasing rapidly these years. This will be a serious issue. Further, minimize costs largely will cause the lack of service and training quality and so on. The Skytrax star rating (See Exhibit 2) indicates Ryanair is below the average level. Besides, competitors contribute big influence to Ryanair. For example, Easyjet which is a young upstart of the European budget airline industry grows quickly with a large number of market shares. It is obvious Ryanair makes success base on its price advantage, and how to sustain this advantage become very crucial issue in recent situation. Keep first mover advantages. Long history with experiences, well-known brand image and economy of scale, these are the unique resources of first mover advantages. It is difficult for competitors to get these resources at a similar level. Therefore, in order to prevent the competitors from copying the same strategy as cost reduction, Ryanair must make good use of these unique resources and try to dominate the market. Technology. Purchase and introduce the latest technological support. Although the fixed costs will be high, they can help the airline carry out tasks more efficiently and effectively such a new security check machine. Moreover it can also help to reduce the variable costs. For example, according to the case, new type aircraft produced 50 percent less emissions, 45 percent less fuel burn and 45 percent lower noise emissions per seat. They help Ryanair reduce the fuel cost with a lower pollution to environment. Unique cost structure. A cost structure which aims to minimize the costs must be set up. In particular to fuel cost, the fluctuations are subject to unpredictable and volatile world events according to the case. It is important for Ryanair hedge the risks before the price goes up suddenly. On the other hand, choosing the secondary and regional airport destinations is a good way of the structure. Moreover, the internet is used to reduce distribution costs. Service quality / Customers satisfaction. Customers will normally associate low price with low service benefits. Ryanair was voted the worlds least favourite airline due to its bad service such as unfriendly staff and poor legroom. However it still won a great number of customer base on the price. Thus if some competitors cut down the ticket price to a low level, Ryanair will get into a big trouble due to the similar prices but lower service quality. Therefore it must not only focus on the price but also the service. In order to gain competitive power, for example, brand loyalty can be one of the aspects. Government / legal actions. Ryanair should take care of the government and legal actions and moreover, can take the initiative over illegal aid to rivals. These may prevent the unnecessary loss. In summary, Ryanair, as the cost leader in budget airline industry should not only focus on the costs but also lots of other issues. Although it is developing rapidly and successfully, the future is unknown. The uncertain environment is changing all the time, thus Ryanair should always follow it and make the long-term plans in order to retain a sustainable competitive advantage. Grasp the opportunities, and it will has a bright future. Word:2123

Heart Of Darkness :: essays research papers

The Transformation of Marlow - Conrad’s Explication of Europe’s Colonial Practice in Africa In “Heart of Darkness'; Conrad introduces his protagonist Marlow, his journey through the African Congo and the “enlightenment'; of his soul. With the skilled use of symbols and Marlow’s experience he depicts the European colonialism in Africa, practice Conrad witnessed himself. Through Marlow’s observations he explicates the naiveness of the Europeans and the hypocritical purpose of their travelling into the “dark'; continent. Marlow’s experience in Africa starts with the desire for travel and great journeys to conquer the “blank spaces'; on the map and the naive believe that the mission of the Europeans is to civilize the natives. Marlow’s aunt believes that this voyage is a mission to “wean those ignorant millions from their horrid ways.'; (Conrad, 16). In reality everywhere they went they colonized the land, used the natural resources, and left ruins behind them. Marlow says, “They grabbed what they could get for the sake of what was to be got. It was just robbery with violence, aggravated murder on a great scale, and men going at it blind - as is very proper for those who tackle a darkness. The conquest of the earth, which mostly means the taking it away from those who have different complexion or slightly flatter noses than ourselves...'; (Conrad, 10). With the unfolding of his journey Marlow starts his “enlightenment.'; We can observe his evolution from “everyday European'; to someone who realizes his own naiveness and begins to see the surrounding reality. This is the moment when he witnesses the shelling of the continent, “In the empty immensity of earth, sky, and water, there she was,incomprehensible, firing into a continent. Pop, would go one of the six-inch guns: a small flame would dart and vanish, a little white smoke would disappear, a tiny projectile would give a feeble screech - and nothing happened. Nothing could happen. There was a touch of insanity in the proceeding, a sense of lugubrious drollery in the sight;'; (Conrad, 17). Marlow is watching this occurrence, what to his fellow Europeans appear to be a fierce battle, in his eyes is a senseless destruction. He sees them firing “tiny projectiles'; producing a “pop,'; which symbolically represents the falsity of the European mentality. With that passage Conrad starts Marlow’s realization, and from this point on he begins his separation from the typical Europeans that surround him.

Is Abortion Murder? Essay examples -- essays research papers

Many people believe that morals or ethics should not have any persuasion at all in our laws. Do you believe that slavery is immoral? Is the issue of slavery a moral position? Is the legislation on that moral position appropriate? Then what you have most likely said is that it is appropriate to legislate moral issues that you are in favor of. Should slavery be enforced purely as a moral issue? This is an important point because many people say that we should not force a particular morality on the issue of abortion. Slavery was brought up because it involves human rights, as abortion does also. The question is whether an unborn child is a human being that has the same inalienable rights that a black human being has. This stems the question, â€Å"Is abortion murder?† If so then there has been a legal genocide going on in the United States since 1973 with over 40 million victims. â€Å"Life, biologically speaking, begins at fertilization. We all begin with the same raw materials: an egg and a sperm. We are fully human when these gametes unite at fertilization, as nothing else is added to us- only nourishment and time to grow.† (Earll, 2003) According to Carrie that means that we are human at the moment of conception. At this controversial point is where Carrie with the pro-lifers and the pro-abortionists butt heads. Pro-abortionists like Henry Morgentaler say that, â€Å"I believe that an early embryo may be called a potential human being. But remember that every woman has the potential to create twenty-five human beings in her lifetime. The idea that any woman who becomes pregnant as a result of non-procreative sexual intercourse must continue with her pregnancy does not take into consideration the fact that there is a tremendous discrepancy between the enormous potential of human fertility and the real-life ability of women and couples to provide al l that is necessary to bring up children properly.† (Morgentaler, 1996) This summarizes most pro-abortionists views that abortion is not about the child but about the mother and what she wants. Others do not see an unborn child as being a human being. Stephen Currie agrees with this when he wrote â€Å"It is a mistake, however, to see this as evidence that the smallest fertilized egg is somehow already a person. Perhaps "life" does begin at conception in some way, but fully human life does not.† (Currie, 2000) This shows t... ...torials that promoted abortion were unimpressive and seemed written out of anger and never mentioned what most girls who have had an abortion felt like after the fact. I found the pro-life editorials very hopeful and full with a sense of love for the innocent children. Unlike the pro-abortion editorials they took slanderous stab at those who oppose them which helped me to respect what they were saying more. People like Hank Hanegraaff are showing others who are not educated about unborn children that, â€Å"They deserve protection, not capital punishment.† We now have a president that also believes in the sanctity of life and has shown it by proclaiming Sunday, January 18, 2004, as National Sanctity of Human Life Day. References Earll, C. (2003) The Sanctity of Human Life. Retrieved February 10, 2005 from http://www.family.org/cforum/pdfs/fosi/bioethics/sanctity_of_human_life.pdf Morgentaler, H. The Moral Case for Abortion. Free Inquiry, Free Inquiry, Summer 1996 Currie, S. Abortion. Opposing Viewpoints Digests ® Series. Greenhaven Press, 2000 Hanegraaff, H. Practical Apologetics, Annihilating, Abortion Arguments. Retrieved February 11, 2005 from http://www.equip.org/free/DA375.pdf

Symbolism in a Seperate Peace

â€Å"A Separate Peace† Throughout the novel, many settings reveal characters and events that had great importance in the book. The tree, the Assembly Room and the White Marble Staircase revealed Finny’s accident, and how the characters reacted. At the tree, Phineas is shaken from the tree and into the Devon River. Finny breaks his leg, creating the climax of the novel and a while after, Brinker hosts a trial to discover the truth about what really happened at the tree in the Assembly Room. During the trial Gene is revealed as a coward.He begins to make up lies to show that he didn’t push Finny out of the tree. He eventually starts to proclaim that he was standing at the bottom of the tree when Finny fell. When Brinker and the other young boy who had been questioning him came closer and closer to the truth, he began to come off very defensive to the audience; arguing with what they were accusing him of. As Brinker went on and on about what may or may not have hap pened, Phineas will not listen, and this portrays his character as very naive.For example, Phineas seems to be blindsided by the friendship he and Gene share, and believes that Gene truly was at the bottom of the tree, and also that he just simply lost his balance. Further into the trial, Leper Lepellier is called into the Assembly Room and clarifies what really happened the day at the tree. The truth was, Gene was standing on the limb right next to Finny and jounced the limb, causing the fall. Hearing this news, Finny is completely dumbfounded. He leaves during the trial very quietly and when Gene calls out to him, he responds, â€Å"Never mind.I don’t care. † This concluded the trial. The Marble Staircase is also a very significant setting in the novel. After the trial, Finny stumbles down the marble stairs, re-breaking his leg, Finny soon after dies from bone marrow entering his blood streams. This setting and the event that took place here impact Gene immensely. â €Å"Then these separate sounds collided into the general tumult of his body falling clumsily down the while marble stairs. † Gene says this as he is listening to his ‘best pal’ fall to his death. Fifteen years later, Gene revisits Devon School.Gene’s first visit was the Marble Staircase, where he reminisces about his best friend. Many settings John Knowles incorporated in the novel also reveal Finny, Gene and many of the other boys’ personalities. For example, one setting that was very substantial during the novel was the Playing Fields. At the Playing Fields Finny invented a gamer called Blitzball. Many of the boys enjoyed playing Blitzball (instead of the instructed game of Badminton) because Finny made the rules as the game progressed, showing his leadership as well as athletic side.During the game, Finny created a rule that there will be no teams, showing that he wants everyone to be included. John Knowles portrays Gene as a follower within the game of Blitzball. For example, Gene does exactly what Finny tells him to, when he tells him to. Additionally, Leper Lepellier’s character is also shown within the game. At one point, Gene throws the ball to Leper, he says â€Å"Leper looked up in anguish, shrank away from the ball and voiced his first thought, a typical one, â€Å"I don’t want it! This scene shows through Lepers tone and actions that he is very shy and lonely, hence his given nick-name of ‘Leper’. In chapter three Finny and Gene take a trip to the beach. When Finny convinces Gene to go to the beach to go to the beach with him, it reveals that Gene is willing to do everything in his power to earn Finny’s approval; even if it means failing the math test he should be studying for he would attend the next morning. While being at the beach the boys do activities such as swimming in the ocean and drinking in the bar.This represents the main theme of the novel, â€Å"A Separate Peace,à ¢â‚¬  which is the reason this setting has such great importance. At the end of the night Finny tells Gene that he is his best pal. When Gene doesn’t say the same, it reveals that Gene may not truly feel the same. Another example of a setting that reveals the characters and events is the tree. Many important events take place at the tree. For example, one night Gene and Finny take a walk to the tree and climb it together. They then decide to form the Super Suicide Society of the Summer Session.Finny, again showing his leadership, made the rule that he and the other new members of the society would meet every night, creating something fun for the boys; creating peace. Also at the tree, Gene shows a huge betrayal when he causes Finny’s fall, and also the climax of the novel. This happened because of Gene’s extreme jealousy of Phineas. The settings John Knowles includes throughout the book help the reader understand the characters and events that happened further in depth. The settings also show the main theme of the book; creating a separate peace for the boys of the summer of 1942.

IOM Finished Paper Essay

a) Discuss the work of the Robert Wood Johnson Foundation Committee Initiative on the Future of Nursing and the Institute of Medicine research that led to the IOM report, â€Å"Future of Nursing: Leading Change, Advancing Health.† b) Identify the importance of the IOM â€Å"Future of Nursing† report related to nursing practice, nursing education and nursing workforce development. c) What is the role of state-based action coalitions and how do they advance goals of the Future of Nursing: Campaign for Action? Summarize (2) initiatives spearheaded by your state’s Action Coalition. In what ways do these initiatives advance the nursing profession? What barriers to advancement currently exist in your state? How can nursing advocates in your state overcome these barriers? Robert Wood Johnson; a remarkable man. He is a man that changes the face of healthcare even after he is no longer on this earth. Robert Johnson, a pilot, writer, sailor, and activist, to name a few was devoted to his small family business to what is known now and Johnson & Johnson. He took a particular interest in hospitals and noticed hospital administrators needed specialized training and was a pioneer in the first school that provided that education. He also was an advocate for the patients that he saw get lost in the maze of healthcare. Being such an advocate for education and having such a humble heart for the needy, when he died he left the majority of his money to the Robert Wood Johnson Foundation. This Foundation continues to help the poor, and uneducated. However, this foundation is also the advocate for so much evidence-based recommendations for leading change and advancing heath in our health care society today. â€Å"In 2008, the Robert Wood Johnson Foundation (RWJF) and the Institute of Medicine (IOM) launched a two-year initiative to respond to the need to assess and transform the nursing profession† (IOM). The IOM formed a committee on the RWJF Initiative to develop a report that would â€Å"Make recommendations for an action-oriented blueprint for the future of nursing† (IOM). This was created due to the fact nurses have so many barriers to overcome to be able to provide optimal patient care (IOM). A path needs to be pave to be able to overcome these barriers, and this  initiative is jus t the tool to help start paving the way of the IOM report that will lead change in the future of nursing. There are several important aspects to the IOM report relating to the future of change in nursing. One of those is in the way nurses practice. One of the recommendations is to remove the scope of practice barriers (IOM thick one). This would require action on the congress and state level. From the Congress, they would need to â€Å"Expand the Medicare program to include coverage of advanced practice RN’s† (IOM thick one). They would also need to authorize advanced practice RN’s to perform assessments for admission into home health or long term care facilities (IOM thick one). These are just a couple of examples. On the state level, they would need to â€Å"reform scope of practice regulations to conform to the National Council of State Boards of Nursing Model Nursing Practice Act and Model Nursing Administratiive Rules† (IOM thick one). They also need to revise the way advanced practice nurses are reimbursed and make it easier for them to be paid for their services as long as they are within their scope of practice within their state (IOM thick one). This recommendation also expands to the Office of Personnel Management to require insurers to include coverage of services provided from a Nurse Practitioner. This would allow patients so see a nurse practionor if desired or needed to avoid long waits to be seen by a doctor as those are becoming short handed as well. Another aspect to the IOM report that came from the RWJF is looking at nursing education. There are several recommendations that came to light in this area. First is the recommendation to establish nurse residency programs. Getting all entities such as the state boards of nursing, the Secretary of Health and Human Services, Heath care organizations, services administration and Centers for Medicare and Medicaid Services and philanthropic organizations all involved in developing and funding continuing education for nurses. These programs will not only expand competency but also vastly improve patient outcomes (IOM thick one). Education recommendations continue with increasing the proportions of nurses with BSN degrees to eighty percent by the year 2020 and doubling the number of nurses with a doctorate by the year 2020 as well. The pathway to help make this happen would be to help the academic nurse leaders to help pave the way for employers to help with funding, initiatives to continue such as raises and promotions, and to monitor progress (IOM thick one). Another aspect to the IOM report that came from the RWJF is looking at nursing education. The recommendation to â€Å"Expand opportunities for nurses to lead and diffuse collaborative improvement efforts† (IOM thick one) was made. This recommendation would lead to nurses being able to collaborate more with physicians in a leadership role conducting research and helping to redesign the healthcare system.