Seasonal Workers Essay Example for Free

Seasonal Workers Essay Seasonal work, the ideal job for young people, college students, and those in need of working urgently. We will show how some companies benefit from seasonal jobs and how individuals make these jobs an opportunity to reach their goals using this chance as a stepping stone. Different ways to reach out those in need of a job, and the trouble these seasonal jobs cause companies when not fill completely or in time for the summer demands. Review/Analysis of the Case Being able to fill positions during demanding times is crucial for all businesses regardless of their affiliations. For companies like High Sierra pools that need lifeguards and pool staff, but can’t obtain them throughout promoting the positions locally, using outside agencies is the best choice. With the policies Congress has impose over the H-2B visas that will prevent previous employees under the visa program apply again, will generate a significant problem while trying to hire employees for the season. Businesses must result to other strategies in order to accommodate their needs. Requesting volunteers from within the company to work extra hours, or add more days to their schedules could help them resolve the current issue. Other ways to fill up the empty positions would be to promote a program that will secure individuals looking for a possible permanent position; having the flexibility to hire for the season with high probabilities of keeping the job would attract more people for those positions locally. Also promising your business directly to one agency may give them the motivation to work the extra mile and bring the best seasonal workers out there. I would recommend them to create a hiring program that would brings students looking for a chance within a business, that will allow them to start at a certain position with the opportunity to apply for others within the company. This would allow them to bring in those looking for interships in business environment. Adapt the program to allow those with a business major to be selected as trainees in different positions within the company, allowing the the chance to stay as a permanent employee or even come back next year during the same time frame. This could serve as a experience stepping stone for those about to graduate and looking for a background experience for other promising jobs. Other strategies that could be use to gain more employees, would be to seek students directly. Going to campuses and providing briefings about the company, their vision, employment programs, and benefits for those young future employees facing the business world. Could promote a higher rate of employment for the company, not only throughout the seasonal time but chances of permanent and best experienced workers in a near future. By providing a good advertisement, the company can be found easier in the many search engines used now days. Making it easier for students to come across them while in the internet. High Sierra Pools, should take this strategies to consideration and give them a try, it could help them find workers faster, easier, and expend less money searching for employees instead of using an outside agency to do the work for them like the previous years. Summary and Conclusions If High Sierra Pools maintains the current employment issue without searching for other alternatives. They will eventually face a major downfall when the summer season comes around. This could hurt their business greatly, not only by not having enough employees, but the current customers may notice a change in the services provided and change their location comes next year season. Being able to adapt to the demanding load of customers and service will be a key tool for the success of their business. Make themselves reliable and flexible to future employees and candidates will maintain the flow of seasonal employees they need to succeed every year. Whether is a company or corporation being able to supply the required number of employees and provide an attractive work environment with good opportunities, will provide the business with a steady growth every season.

An Analysis of William T. Vollmann’s The Visible Spectrum Essay

The task of interpreting William T. Vollmann’s works seems as monumental for the reader as writing the story oneself. The text of â€Å"The Visible Spectrum†, in fact, does not feature any extensively challenging vocabulary or particularly thwarting subject matter; yet it would seem that in all of its â€Å"objectivity† and â€Å"transparency†, there lies no obvious, dominant or intended interpretation. The narrative is ambiguous in its â€Å"message† to an infinite degree, and thus the reader must construct its â€Å"meaning† given only scraps of discontinuous plot, description and dialogue. Vollmann’s story concentrates on the private experiences of individuals in a hospital. The commonality of the setting allows the reader to make necessary assumptions about the locale, timing and purpose of these hospital visits, also permitting the author flexibility in selecting events to comprise the plot. The universality of the hospital experience (lingering in the waiting room, a doctor’s examination, and a nurse’s questioning, for example) encourages the reader to relate to these private events in a shared, public manner. In this way, Vollmann relies upon one’s knowledge of hospital procedure to make greater comments about other institutions and society in general. Using a pseudo-scientific, case-study approach, â€Å"The Visible Spectrum† correlates the ideologies of a hospital to that of society. Vollmann’s sociological critique describes the hospital as a microcosm of the society in which it is located; although theoretically structured, efficient and beneficial to its patrons, in practice, however, the institution (and likewise, society) veils its omnipotence in the illusion of an individual’s agency and self-determination, while acting... ...aims to a final hope or refuge for humanity, but rather concludes its hospital-as-society metaphor with a semi-entropic presentation of sociological reality as counter-utopian, desolate and irreparable. WORKS CITED 1. Vollmann, William T. â€Å"The Visible Spectrum.† Postmodern American Fiction. Ed. Paula Geyh et al. New York, NY: W. W. Norton & Company, 1998. 153-161. [1] I suppose that characterization is not particularly necessary in this story, as one is able to ‘connect with’ a character given the generality of his or her experience (having blood drawn, for example). [2] On another note, a discussion of veins and blood seems necessary in Vollmann’s work. In one sub-chapter, â€Å"People without Veins† (Vollmann, 157), it appears as though the author is hinting that the vein-less individuals (who are therefore also blood-less) are inhuman, almost robotic

Deviations of Marxism

The problem of a man’s economic and political freedom has been widely discussed by specialists throughout centuries. Chomsky (1987), Bakunin (1934), Rousseau (1960), Humbold (in Botting 1973) have all questioned the issue whether a man can ever be free in the society. The theory of Marxism can be regarded as a synthesis and conclusion of classical political economy, particularly of utopian socialist authors from which Marx borrowed many ideas. â€Å"The teaching of Marx is all-powerful because it is true.It is complete and symmetrical, offering an integrated view of the world, irreconcilable with any superstition, with any reactionism, or with any defense of bourgeois oppression. † (Eastman, Marx 1959, p. xxi). The problem of freeing man from the curse of economic exploitation and political and social enslavement in Marx’s works has been discussed by Highs (2004), Kozyn (1987), Sayer (1991), Suny (1993), and Wood (1997). As the sources argue, according to the opi nion of Marx, this problem can be solved, but only after many changes take place in the society.Capitalism is destined to fail and be replaced by socialism which can put an end to contradiction between two social classes- bourgeoisie and the working class. Opposite to the system of capitalism, socialism was going to be based on the principles radically different from the principles of capitalist society, and thus end economic exploitation. According to Marx, people could become free if they were free economically, and thus the end of economic exploitation was going to determine the freedom for people.In â€Å"The Criticism of the Gotha Program† Marx devotes major attention to the analysis of ownership and the problem of workers’ estrangement of the results of their work as the major feature of exploitation: â€Å"Within the cooperative society, based upon the common ownership of the means of production, the producers do not exchange their products; †¦ the labor o f the individual becomes, no longer in a roundabout way, but directly, a component part of the total labor. † (Eastman, Marx, 1959, p. 5).According to Marx, the exploitation of workers provided on all levels of production, their estrangement from the results of work all were the reasons of the inevitable changes in the future. The fact that surplus value was obtained by the capitalist was also one of the arguments for the future change in the structure. The class of workers realized that the results of their work were taken by the capitalist even though they were the ones who actually created the value. Therefore, they were eventually destined to struggle for their economic freedom, which would also lead to their social and political freedom.The dialectics argues that contradictions are the driving force of progress. Once contradictions appear in some system, the system will need to undergo many changes and develop until the new level in which the synthesis of new qualities wi ll be finally reached. Therefore, as it was correctly noticed by Marx, the phase of capitalism could not be completely over- it would just develop until its new phase socialism and the most positive features of both systems would be present in the final synthesis of the two systems.People would reach the freedom only after the final stage of evolution, because earlier stages would still contain some features from the earlier system. Marx argues that communist society â€Å"still bears, in every respect, economic, moral and intellectual, the birthmarks of the old society from whose womb it is issuing† (Eastman, Marx, 1959, p. 5). Therefore, it is impossible to conclude that communism entirely frees people from economic exploitation and political and social enslavement. Communism is not a completely new system and has connection with the previous system of capitalism.It interacts with it in some ways but at the same time it has many new features which are beneficial for the wor king class and liberates people in many aspects of life. In â€Å"The Poverty of Philosophy† Marx argues that eventually, communism is going to give political freedom to people. â€Å"The working class will substitute, in the course of its development, for the old order of civil society, an association which will exclude classes and their antagonism, and there will no longer be political power. † (Eastman, Marx, 1959, p.2). The author also states that in the new socialistic society, all of the assets will be expropriated from the capitalists and thus they will not be able to obtain the benefits of the surplus value anymore. Therefore, economic exploitation will be finally brought to an end. Another feature of socialism is the equality of people, when they are able to work according to their abilities for themselves and the state they live in. The socialist society is not divided into classes because it regards people equal in all the ways.Marx mentioned that unfortunat ely, all of the major developments needed to happen not as the result of evolution but as the results of struggles and revolutions because they were the only ways of destruction of the old system. Marx did not deny the role of evolution in the process of freeing people but he had very radical views and thus regarded revolution as the best tool of speeding up the evolution process which was going to lead to the long-waited changes in any case. As the author stated, the final end to capitalism could be put and the new socialist society could be established only with the help of arms.A remarkable feature of Marx’s theory of capitalism development and evolution into socialism is that he does not share the opinions of utopian writers on this issue. Many utopian writers considered that social changes could be originated by the government of the country or by a class of â€Å"educated† capitalists. Marx was completely against these theories because he was confident that the f ormer capitalists and members of government were unable to bring any changes into the country’s social structure.In order to form the new society, the new principles needed to be established and those people who belonged to the rival class of the workers were unable to bring any of the mentioned changes. It is also necessary to investigate the problem of freeing man from the curse of economic exploitation and political and social enslavement in Soviet Union. As the experience of the country shows, application of Marxism theory in Soviet Union completely failed to achieve its goals.As it was mentioned by Geoffrey (1997), Grigor (1993), Khazanov (1992), Lieven (1998), Kon (1993), one of the major mistakes made in Soviet Union was connected with â€Å"Russian exceptionalism†. As Grigor (1993) states, Soviet Union applied the concept of Marxist â€Å"nationless† society in a way completely different from its original meaning. Instead of â€Å"freeing† citizen s of the country as Marxism stated, Soviet leaders oppressed all of the nations except Russians. Russia was the major center of all activities going in the country.Soviet Union was a very peculiar structure because it united a large number of nations which were very different in many ways. Some of the nations included in the country were quite close to one another (Russia, Belarus, and Ukraine), while other republics in the Soviet Union structure were very different by their cultures. For example, Eastern republics, like Azerbaijan, Tajikistan, and Turkmenistan belonged to Muslim countries, and had very different traditions from Russians, but Russian nation forced all of them to act according to the traditions of the dominant nation.This was one of the major reasons of the â€Å"empire’s† failure in the following years. â€Å"Sovietology paid far too little attention for far too long to the non-Russian peoples, to the extrapolitical social environment, and to the part icular contexts, contingencies, and conjunctures of the Soviet past. † (Grigor, 1993: 3) According to Marxists, all the nations within the Soviet Union had to be completely alike and without any differences between them. Soviet leaders took the features of the Russian nation as the basic features. Therefore, all other nations had to adapt to the new culture which was not very familiar to them.The â€Å"nationless† society in reality turned out a â€Å"Russian† society with total dominance of the Russian nation in all the ways. All the nations other than Russians were oppressed greatly. They were all considered a step lower in the society ladder due to their origin, and did not have any political freedom. Policy of the country was in many ways channeled to the development of Russia and its cities. The largest sums from the budget were assigned to the development of Russia. While Russia’s economy was booming, particularly the economy of Moscow, all other eco nomies were at a much lower level of development.Besides exceptionalism, there were many other problems with application of Marxist theory in Soviet Union. For example, Soviet leaders did their best to apply the principle according to which every person was required to contribute to the wealth of the country at his best and would get services from the state in the maximum amount. Instead, it was easy to notice that leaders of the communist party got all of the benefits from the state while working people got only the minimum. As Lieven (1998) states, the reality of Soviet Union was very far from giving any freedom to its citizens.During capitalism workers were oppressed greatly and did not have a chance to satisfy all of their needs. The situation did not change much when Soviet leaders brought communism to the country because the oppression remained the same; it just came not from capitalists but from communist leaders. Communist leaders in Vietnam also failed to implement principl es of Marxism in the country. Similar to Lenin’s Soviet Union, Ho Chi Minh’s Vietnam failed to liberate people from economic exploitation and did not give them social and political freedom. According to Anh (1995, p.126), one of the major reasons of communism’s failure in Vietnam is lack of background for it in the country. Marxism required the struggle between classes as the basis of the future revolution. In rural Vietnam, there were no antagonist classes similar to industrial Britain or Russia. The â€Å"liberation† of people in Vietnam could not be solely based on Marx’s principles due to the radical differences between the British society which Marxism based his theory on and the Vietnamese society. There was no working class in Vietnam looking for liberation from capitalist exploitation.The major figure in Vietnamese society was a peasant fighting against the exploitation by foreigners oppressors. â€Å"At the centre of Vietnamese history, s tands the peasant, tenacious and heroic defender of the land inherited from the ancestors against the foreign invaders, but recurrently rising up against the masters from within in an endless rebellion. † (Le Vietnam traditionnel. Quelques etapes historiques, 1971, p. 170). Communism in Vietnam was supposed to serve the interests of peasants in their fight against French oppressors.â€Å"The highly destructive system of economic exploitation installed by the colonial regime gave birth to new social forces, while aggravating the situation of the rural masses. † (Institute of Historical Studies, Vietnamese peasantry and rural society in the modern period, 1990, p. 35). Despite the attempts of application of Marx’s theory in Vietnam, it was destined to fail because Vietnam was eventually liberated from oppressors, and any basis for the struggle between antagonist classes disappeared.In conclusion, it is necessary to mark that in its pure version, Marxism provides an answer to the question of how to liberate people from economic, political and social oppression. Liberation of people from economic exploitation comes first and as long as it is achieved, political and social freedom can also be targeted. However, the attempts of the application of Marxism in Soviet Union and Vietnam have showed that people’s freedom cannot be achieved in real life due to fatal mistakes made by communist leaders in the application of Marxism.

Public Healthcare Policy - 692 Words

There is a confluence of factors that is related to providing adequate health care on a systemic basis within virtually any population setting. While attempting to address the health care needs of such a setting is always a challenge, this challenge becomes exacerbated by varieties in social and economic conditions, as well as those that apply to race and ethnicity. The problems that plague contemporary health care coverage in the United States are myriad and even more complicated by the fact that many of these issues are interrelated. Three of the most salient of these difficulties concern health care coverage, health inequities, and ineffective health promotion. However, prudent analysis of this topic indicates that of these three areas, the one that is most problematic is that of healthcare coverage. The logic behind this fact is fairly simple; improved health care coverage can ameliorate many of the issues that stem from ineffective health promotion and health inequities. It is a widely confirmed fact that in certain parts of the world such as Israel in which the law provides a standardized insurance package of medical services for all residents (Machnes, 2006, p. 265) there are a number of countries in which universal healthcare is a reality. In these countries, the amount of money spent on a per capita basis is oftentimes significantly less than that spent on a per capita basis is the United States. There is a distinct relationship between lack of healthcareShow MoreRelatedPublic Healthcare Policies, And Inadequate Health Awareness994 Words   |  4 PagesGrowing up a lower income community of Atlanta, Georgia allowed me to see 1st hand the perpetual cycle of absent public healthcare policies, and inadequate health awareness. My mother and aunts were results of this neglect and misguidance, consuming unhealthy diets, and sedentary lifestyles not realizing the damages they were causing to their bodies. 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They argue that the high price is very effective in limiting or completely getting done with other hospital expenses that would be incurred in the long run because the drug is effective in the curing of the disease rather than the management of symptoms over the years and, therefore, savings (CharlesRead MoreHcs 455 the Policy Process: Part I Essay1489 Words   |  6 PagesThe Policy Process: Part I Susan Kunz HCS 455 July 6, 2011 Rich Jones The Policy Process: Part I Patient access to affordable health care is an ongoing issue in the United States. The first portion of the policy process involves three different stages, the formulation stage, legislative stage, and the implementation stage. Three main stages exist in the process to transform a topic into a policy (Morone, J. A., Litman, T. J., amp; Robins, L.S., 2008). 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TheRead MoreSocial Welfare Policy Analysis For Social Workers Essay926 Words   |  4 Pages Plan to Influence Policy In order to conduct meaningful change and to be effective in influencing policy, there must be a well thought out plan in place. In the text The Policy-Based Profession: An Introduction to Social Welfare Policy Analysis for Social Workers by Popple and Leighninger (2015) they argue that â€Å"For an action strategy to be effective, it is imperative that the people taking the action have a firm grasp on the problem they are dealing with and on achievable goals. You must do yourRead MoreCritical Analysis - The Models of Public Policy Essay example1278 Words   |  6 PagesAccording to William Jenkins (1989) public policy is a set of interrelated decisions taken by a political actor or a group of actors concerning the selection of goals and the means of achieving them within a specified situation where those situations showed in public policy be within the power of those actors to achieve. In this case, public policy involves making policies that are involved in enhancing health care reforms in the Canadian situation. Policies are often as a result of a multiple decisions

Treatment Of Gestational Diabetes Mellitus - 3510 Words

Treatment of gestational diabetes mellitus, whether using insulin, oral diabetes medications, or another means, reduced maternal, fetal, and neonatal risks associated with the disease. When treating GDM, the goal is to bring the patient’s blood glucose levels down to the same levels as those of pregnant women without GDM. Current therapeutic targets are: fasting blood glucose ≠¤95 mg/dL, 1-hour postprandial 140 mg/dL, and 120 mg/dL for 2-hour postprandial blood glucose concentrations (Hernandez, et al., 2011). However, just as there is no universal agreement on screening and diagnosis strategies, there is no universal agreement on the optimal therapeutic targets in the treatment of GDM. Blood glucose concentrations during a normal pregnancy are actually lower than these targets, and in fact, rarely exceed 100 mg/dL in the absence of obesity. Hernandez, et al. (2011) recommended lowering therapeutic targets to levels more in line with normal pregnancies. They found that mean blood glucose concentrations in 255 pregnant women of normal weight without GDM were 71 mg/dL (fasting), 109 mg/dL (1-hr), and 99 mg/dL (2-hr). Given the fact that adverse outcomes are directly linked to blood glucose concentrations, it is appealing to aim for lower levels; however, this goal must be balanced with the possibility of inducing hypoglycemia in patients with treatment. IV. Available Treatments IV. A. Diet and Exercise For women with mild gestational diabetes mellitus (having bloodShow MoreRelatedThe Prevalence Of Gestational Diabetes1325 Words   |  6 PagesGestational diabetes is a glucose intolerance that develops during pregnancy. Early diagnosis and effective treatment are important because gestational diabetes can cause serious maternal and fetal complications. Diet and exercise are the first line treatment options of gestational diabetes, while insulin therapy is the first line medical treatment option. 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Essay about Project management - 2448 Words

Executive Summary This assignment critiques the initiation and execution of the Bring your own device (BYOD) Project 2013 at Robot Eyes Ltd, an electronic component manufacturer for industrial robots. The BYOD program allows sales personnel to utilize their personal smart phones, notebooks and other mobile devices to conduct wireless sales transactions. Robot Eyes Ltd. experienced significant wireless confidential data leakage through the mobile devices, for three consecutive years at the same exhibition center in Singapore. The main data encryption unit’s security software was non- responsive as a result of a software malfunction after the mobile devices were upgraded by XXX Ltd. The mobile devices were then susceptible to wireless†¦show more content†¦Failure to have a proper organizational structure by having two separate leads, Director of DPA and Director of Information Management, results in ambiguity in the upward reporting chain and a less conducive environment for definitive c ommunication and progress reporting. The organizational structure implemented can be described as a â€Å"Lightweight Matrix† (Ulrich, K.T. and Eppinger, S.D. 2000) where an issue for the project manager is described as the â€Å"Two bosses problem†. The structure that was employed was not carefully articulated for efficient project execution because there was no Responsibility Chart formulated to carefully integrate the list of tasks, designations together with milestone planning. Additionally, there was no formal specification of task details or progress reporting done with a paper trail as in the case with Taz who had a verbal briefing of his duties and was giving verbal reports at meetings. Re – designing the organizational structure with a single leader is recommended. Also, introducing official log forms that need to be filled and filed for reporting purposes. Project Scope Management Project Scope Management accounts for â€Å"all the work required, and only the work required, to complete the project successfully† (PMBoK Guide 5th Edition, pg 104). Fulfilling this Knowledge Area ensures that the project manager has an understanding of all the work or tasks the project entails. It can be further refinedShow MoreRelatedProject Management : Projects Management902 Words   |  4 PagesProject Management Project Management. What does the words Project Management mean and what are the steps to managing a great project. 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During _________formal tools and techniques were developed to help and manage large complex projects. a. 1950s b. 1980sRead MoreProject Portfolio Management : Project Management1432 Words   |  6 PagesProject Portfolio Management (PPM) is the centralized management of the processes, methods, and technologies used by project managers and project management offices (PMOs) to analyze and collectively manage current or proposed projects based on numerous key characteristics. The objectives of PPM are to determine the optimal resource mix for delivery and to schedule activities to best achieve an organization’s operational and financial goals ― while honoring constraints imposed by customers, strategicRead MoreProject Management, Project Communication, And Project Stakeholder Management797 Words   |  4 Pagesareas of project management that stood out while taking this program. Project integrated management, project communication, and project stakeholder management. A discussion on how they are executed will be presented. As more courses were taken during this project management graduate program, many of the project management concepts became clear and revealed more of the interdependencies and intricate dynamics that are required for successful project management. Stakeholder Management Project StakeholderRead MoreProject Management : Project Integration Management1236 Words   |  5 Pagesâ€Å"Direct and Manage Project Execution is the process for executing the work defined in the project management plan to achieve the project s requirements/objectives defined in the project scope statement† (comp. PMBOK3, p. 78). The Project Manager helps with the execution of the planned activities, sometimes with the assistance of a project management team for larger projects. This occurs during the execution phase of the project. Figure: Phases of a project When we are completing the work assignedRead MoreProject Management Msc. 7Pjmn009W Project Management Project.1391 Words   |  6 Pages Project Management MSc 7PJMN009W Project Management Project Author: Maria Chico Garrido Date: 06 March 2017 Version: 1.1 Project type: Academic Preferred Supervisor: Proposed Title: How does the use of formal project management methodologies in complex Home Automation projects contribute to project success? Main Deliverables/Milestones: Deliverable Date Project Mandate 09 March 2017 Project Brief: In depth literature review of formal project management methodologies and project success. BackgroundRead MoreProject Management1510 Words   |  7 PagesSystem. You are the project manager on a project to construct a flyover in the city to ease traffic congestion. Flyover construction should cause minimum disruption to the traffic until it is complete. Ensuring safety of the commuters and workers at the site is the responsibility of your company. The date of completion of the project is six months from now. This date cannot be extended because of an upcoming international summit in the city. To achieve the overall project time lines, the followingRead MoreProject Management Project And Change Management1940 Words   |  8 Pages Paper on project management in smart voice project Sohail Kamdar Project and change management Table of contents Name of the topic Page No. Abstract†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦..3 Introduction†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦4-5 View point of project management†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦5 Outlook of the project†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦5-6 Milestone inventory†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦6-7 WBS†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦7 Plan of project management†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦7-9 Cost savings plan†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Read MoreProject Management1713 Words   |  7 PagesProject Management The Project Manager has some tasks that have to be carried out, he/she is responsible for the full project. The Project Manager has to make the best use of all the resources so the project can be completed successfully. The project Manager sets the boundaries for the project, such as schedules and what is done and when it has to be completed. There are various tasks the project manager is responsible for such as: 1) Time and resource allocation and management 2) Setting upRead MoreProject Management1015 Words   |  5 Pagesor renewed interest in the field of project management? IT is growing at a rapid rate and with that growth demands people to manage this growth. People I think are more trained to be project managers and also there is new software that helps tremendously with the management part of the tasks. So demand is up, skilled workers are up, and the cost benefit is there for this renewed interest. 2. What is a project, and what are its main attributes? How is a project different from what most people do

Drug Utilization Study Of Antidepressants Health And Social Care Essay Free Essays

string(26) " were males and 87 \( 51\." There is a demand for prospective drug use surveies to adequately measure patient attention and installation indexs. Ordering wonts among head-shrinkers can be improved by making consciousness about taking drugs from the Essential Medicines List. Inclusion of a drug in the infirmary formulary requires consideration of both prescribers ‘ pick of a drug and its presence in the Essential Medicines List. We will write a custom essay sample on Drug Utilization Study Of Antidepressants Health And Social Care Essay or any similar topic only for you Order Now Prescriber instruction can besides concentrate on decrease in prescription of attendant ataractic soporifics. Prescribers should besides be encouraged to look into for patients ‘ conformity with the prescribed medicines and to enter them in the instance sheets. Such steps will advance the rational usage of medical specialties and finally, the quality of health care. The World Health Organisation ( WHO ) defines Drug use as the selling, distribution, prescription and usage of drugs in a society, with particular accent on the ensuing medical, societal and economic consequences.1 Often, drugs are non used maintaining in head their safety and efficacy.2 Rational drug prescribing is the usage of the least figure of drugs to obtain the best possible consequence in the shortest period and at a sensible cost.3 Irrational prescribing and disparity between prescription and ingestion of medical specialties may countervail the benefits demonstrated by randomized controlled tests on drug efficacy.4-7 Furthermore, optimistic outlooks of a drug, based on consequences of clinical tests may non happen when used outdoors controlled settings.8 The recent proliferation of new drugs, increasing acknowledgment of delayed inauspicious effects and concentrate on pharmacoeconomic considerations has stimulated involvement in ordering forms of physicians.5 Antidepressant prescribing forms have changed globally over the last few old ages, with conventional drugs like tricyclics and MAO inhibitors being bit by bit replaced by selective 5-hydroxytryptamines reuptake inhibitors ( SSRIS ) and fresh antidepressants. Prevalence of antidepressant use in the community is lifting in Western populations, with Iceland, Australia and Sweden holding the highest consumption.9 Therefore, our purpose was to analyze the drug use of antidepressant drugs in the psychiatric unit of a third attention infirmary in Pondicherry. Our aims were: To detect the prescribing form of antidepressants among head-shrinkers in our infirmary To measure the reason of the prescriptions To measure the prevalence of antidepressant use in the community MATERIALS AND METHODS Type of survey: Retrospective and experimental. Time period of survey: 1st January 2006 to 31st December 2006 Topographic point of survey: Psychiatric unit of a third attention infirmary in Pondicherry. Inclusion standards: 1. All patients who attended the Psychiatry outpatient ( OP ) clinic of the infirmary from 1st January 2006 to 31st December 2006. 2. All patients diagnosed with depressive or adjustment upset ( diagnosed as per International Classification of Diseases – ICD 10 standards ) 10 or any status where antidepressants are indicated. Exclusion standards: Patients who did non have antidepressant drugs. Patients go oning merely those antidepressant drugs prescribed outside the infirmary. Data aggregation: Case records of Psychiatry outpatient clinic were taken from the medical records subdivision of the infirmary. Datas were entered in a pre-designed proforma ( Fig1 ) . From the multiple prescriptions in the instance record with follow-up visits, we took all prescriptions incorporating at least one antidepressant as one prescription. Therefore, if the initial prescription was continued, it was regarded as the same prescription for the given continuance. Any dose alteration in that prescription was noted for ciphering drug ingestion. Addition of another antidepressant to or alteration of antidepressant from the bing regimen was regarded as a separate prescription. In both instances, the figure of drugs in the prescription included the added or changed antidepressant ( s ) , along with attendant medicines from the earlier prescription. However, prescriptions incorporating drugs for co-morbid conditions ( non-psychiatric ) which were non prescribed in the section of Psychiatry were excluded. Sampling frame: All patients run intoing eligibility standards as given above. Datas analysis: Datas were subjected to analysis for: Demographic inside informations ( Age and gender ) Psychiatric diagnosing Antidepressant drugs prescribed 4. Completeness of prescription, rightness of drug, dosage, frequence and continuance. 5. Rationality of prescription harmonizing to WHO ordering indexs. 6. Defined daily dose ( DDD ) of the antidepressants per 1000 dwellers per twenty-four hours ( DID ) 7. Prescribed day-to-day dosage ( PDD ) of the antidepressants 8. PDD to DDD ratio of the antidepressants Anatomical Therapeutic Chemical ( ATC ) categorization and Defined Daily Dose ( DDD ) per 1000 dwellers per twenty-four hours ( DID ) computations were used for gauging antidepressant usage in the community. Following the methodological analysis outlined by WHO,11 we calculated DID as follows: DID =Amount of antidepressant prescribed in 1 twelvemonth ( milligram ) Ten 1000 dwellers DDD ( milligram ) X 365 yearss X Population of Pondicherry and Cuddalore All patients belonged to either Pondicherry or Cuddalore territory of Tamil Nadu. So, for computation of DID, we used the population of Pondicherry every bit good as Cuddalore territory as per available statistics. Entire figure of DIDs is calculated by adding up the DIDs for single antidepressants. PDD was calculated as follows: For each prescription, there were multiple doses of the antidepressants, due to dose titrations and we took the norm of the day-to-day doses for the antidepressant as the PDD. This procedure was repeated for all the indicants of each antidepressant and the concluding value was the norm of the PDDs therefore obtained. PDD to DDD ratio was so calculated. Statistical analysis: Descriptive statistical tools were used. Ethical clearance: As it was a non-interventional survey, the institutional research commission granted waiver on the confidence that capable confidentiality would be maintained. We took the undermentioned stairss in this respect: Designation of patients by the infirmary figure merely and non by name. Case records to be accessed by research workers in the Medical records subdivision merely. Patient inside informations non to be divulged to any party other than co-authors. Proformas to be destroyed after decision of survey. Consequence Demographic inside informations: Out of 222 patients having psychoactive medical specialties during the survey period, 169 ( 76.58 % ) received one or more antidepressants. Among these 169 patients, 82 ( 48.52 % ) were males and 87 ( 51. You read "Drug Utilization Study Of Antidepressants Health And Social Care Essay" in category "Essay examples"48 % ) were females. Age distribution of patients having antidepressants is shown in Fig 2. Psychiatric diagnosings: Distribution of primary psychiatric diagnosings of patients having antidepressants is shown in Table 1. Antidepressant drugs prescribed: Entire figure of prescriptions given was 192 and a sum of 446 drugs were prescribed. Of them, 192 were antidepressant medicines of 8 types, as per ATC category. Table 2 and Fig 3 show different antidepressants prescribed. Number of antidepressant prescriptions along with their indicants is shown in Table 3. Substitutions and Adjunctive antidepressants: Change of antidepressant was required on 18 occasions. Duloxetine was substituted on 10 occasions, escitalopram on 4, mirtazapine on 3 and imipramine on 1 juncture. Addition of a 2nd antidepressant was seen on 3 occasions because of hapless response with a individual drug. Of them, duloxetine was the first antidepressant on 2 occasions and mirtazapine on 1. Attendant medicines prescribed in the section of Psychiatry: Table 4 shows attendant medicines prescribed in the section of Psychiatry. Completeness of prescription, rightness of drug, dosage, frequence and continuance: Besides patient inside informations and outpatient designation figure, prescriptions contained the patient ‘s primary diagnosing, drug ( s ) prescribed, dose signifier, dosage, frequence of disposal and continuance of intervention along with the day of the months of followup. There was no incorrect dosage, frequence and continuance of intervention ; in some instances, inappropriate drug was prescribed for a incorrect diagnosing which was corrected when primary diagnosing was revised on follow up. Table 5 shows the figure of drugs per prescription among the 192 prescriptions. More than 5 drugs were non prescribed to any patient. Rationality of prescription harmonizing to WHO ordering indexs: As per WHO Prescribing indexs, we observed: Average figure of drugs per prescription: 2.32 ( 446/192 ) Percentage of antidepressant drugs prescribed by generic name: 88.54 % ( 170/192 X 100 ) Percentage of Fixed dose combinations ( FDCs ) of antidepressants: Nothing Percentage of brushs for ordering injections of antidepressants: Nothing Percentage of antidepressant drugs prescribed from Essential Medicines List ( 16th EML of WHO ) : 1.56 % ( 3/192 X 100 ) Percentage of drugs prescribed from the National List of Essential Medicines ( NLEM, endorsed 2002 ) was 2.60 % ( 5/192 X 100 ) . Percentage of drugs prescribed from the infirmary pharmacopeia was 96.35 % ( 185/192 X 100 ) . Defined daily dose ( DDD ) of the antidepressants per 1000 dwellers per twenty-four hours ( DID ) : ATC cryptography, DDD and computation of DID are summarized in Table 6. Entire figure of DIDs of antidepressants was 0.02. Prescribed day-to-day dosage ( PDD ) of the antidepressants and PDD to DDD ratio of the antidepressants: PDD and PDD to DDD ratios are besides summarized in Table 6. Discussion Demographic inside informations: Antidepressants were prescribed more in females ( 51.48 % ) than in males ( 48.52 % ) . This is consistent with findings in other studies.12,13 This female preponderance might reflect the higher prevalence rate of psychiatric morbidity in adult females, peculiarly, depressive and anxiousness upsets and may besides be due to gender functions played by adult females in society, with more voicing of psychological jobs and seeking of professional help.13 The age distribution shows the bulk of patients, having antidepressants belonging to 21-30 old ages age group ( 36.69 % ) . In fact, 66.27 % were aged between 21 and 40 old ages. This is in contrast to the consequences of a survey of antidepressant usage in East Asia, wherein the average age of patients having antidepressant prescriptions was more than 40 years.14 In another survey in Europe, where antidepressants were the 2nd most normally prescribed psychotropic drugs, bulk of the users were between 35 and 49 old ages, with a average age greater than 40 years.13 Psychiatric diagnosings: Depressive upset was the most common psychiatric diagnosing among the population ( n=222 ) , with a prevalence of 47.75 % . It was besides the most common indicant for utilizing antidepressants ( 62.72 % ) , followed by Mixed Anxiety and Depressive upset and Schizophrenia with station schizophrenic depression among the top three diagnosings. Antidepressant drugs prescribed: Antidepressants were the most common psychotropic drugs prescribed ( 76.58 % ) . Choice of antidepressant was based on ICD diagnosing, badness of disease/disorder, co-morbidity, drug efficaciousness and considerations for patients ‘ tolerability. Most common antidepressant prescribed was the Selective Noradrenaline re-uptake inhibitor ( SNRI ) duloxetine ( 50 % ) . The newer antidepressants – duloxetine, escitalopram, Zoloft and mirtazapine accounted for the majority of prescriptions. ( 96.36 % ) , which follows the planetary tendency towards antidepressant prescribing.14-18 In many surveies, Selective 5-hydroxytryptamine re-uptake inhibitors ( SSRIs ) accounted for the majority of the prescribed antidepressants, with high ordering rates.14-17 In our survey, SSRIs – escitalopram, Zoloft and Prozac were prescribed on 57 out of 192 occasions ( 29.69 % ) . Among the SSRIs, escitalopram was the preferable drug. Again, this is in contra st to findings in the East Asian survey on antidepressant usage, wherein Prozac and Zoloft were prescribed more often than escitalopram and its usage was lower than Desyrel, mirtazapine, impramine hydrochloride and amitryptiline. However, ordering rates of tricyclic antidepressants impramine hydrochloride and amitryptiline were lower than the prevalent norms.14 Doses of antidepressants were prescribed harmonizing to badness of disease/disorder, get downing with low doses and titrated upward or downward harmonizing to clinical response and patients were kept on regular followup. Duloxetine was the most common antidepressant prescribed in Depressive upset ( 56.56 % ) , Mixed Anxiety and Depressive Disorder ( 41.38 % ) and in BPAD ( 62.50 % ) . Most common antidepressant prescribed in Schizophrenia with post-schizophrenic depression was escitalopram ( 44.44 % ) , and in OCD, Zoloft ( 80 % ) . Substitutions and Adjunctive antidepressants: Prescription of a individual antidepressant was common and occurred in 98.44 % of instances. Reasons for altering an antidepressant were hapless curative response or unbearable inauspicious effects. Duloxetine was the most normally substituted antidepressant. It was besides the most common antidepressant to which adjunctive antidepressant drug was prescribed. Attendant medicines prescribed in the section of Psychiatry: Ataractic soporifics were the most common group of drugs prescribed ( 65.10 % ) concomitantly with antidepressants, followed by major tranquilizers, temper stabilizers, trihexiphenidyl, acamprosate, propranolol and vitamin B1. Except for Vitamin B1, which was prescribed in Alcohol Dependence, and propranolol, which was prescribed for intervention of shudders, all others were psychoactive medicines. Trihexiphenidyl was prescribed to counter the extrapyramidal inauspicious effects of attendant major tranquilizers. Completeness of prescription, rightness of drug, dosage, frequence and continuance: Rational prescribing was followed as per the rules of prescription order writing.19 Sing the definitions of polypharmacy which are most normally cited, there was no polypharmacy because there was no prescribing of antidepressant medicine which did non fit diagnosing and there was no prescription with more than 5 drugs.20 68.23 % of the prescriptions ( 131 out of 192 ) had 2 drugs or less, which is recommended. However, there were instances where wrong diagnosing led to ordering of inappropriate drug ab initio ; it was rectified when primary diagnosing was revised on follow up. Clinicians ‘ pick of drug was non based chiefly on affordability for the patient, so the cheapest drug was non ever prescribed. Rationality of prescription harmonizing to WHO ordering indexs: The mean figure of drugs per prescription was more than 2, which is high. But, we had excluded all prescriptions where antidepressants were non prescribed. So, prescriptions where merely guidance was provided were non considered, in which instance the figure of prescriptions with less than 2 drugs would hold risen, thereby conveying down the mean figure of drugs per brush. Ordering by generic names was high ( 88.54 % ) and close to 100 % . There were no fixed dosage combinations ( FDCs ) or injectible readyings prescribed, which indicate rational prescribing patterns. The per centum of drugs prescribed from the 16th WHO Essential Medicines List and the National Essential Medicines List ( endorsed 2002 ) was low. However, per centum of drugs prescribed from the infirmary pharmacopeia was really high ( 96.35 % ) . This indicates the demand to convey about a balance between clinicians ‘ petitions for maintaining a dru g in the infirmary pharmacopeia and the recommendations of WHO and National Essential Medicines Lists. ATC Classification, Defined daily dose ( DDD ) and DDD of the antidepressants per 1000 dwellers per twenty-four hours ( DID ) : The anatomical curative chemical ( ATC ) categorization system divides drugs into different groups harmonizing to the organ or system on which they act and their chemical, pharmacological and curative properties.21,22 Each drug is assigned a peculiar combination of letters and Numberss. The defined day-to-day dosage ( DDD ) is the false mean care dose per twenty-four hours for a drug used for its chief indicant in adults.21 DDD was developed to get the better of expostulations against traditional units of measuring of drug ingestion and to guarantee comparison between drug use surveies carried out at different locations and different clip periods. Entire DID of the antidepressants show low ingestion, in crisp contrast to the tendency of Western European states and the USA, particularly during the last decennary, with high rates of antidepressant prescribing and consumption.9,22,23 DID for duloxetine can be interpreted as 0.0025 out of 1000 patients or 0.025 % would hold used a dosage of 60mg. Similarly, DIDs of escitalopram, mirtazapine, Zoloft, impramine hydrochloride, Desyrel, amitryptiline and Prozac can be interpreted as ingestion of their several DDDs by a population of 0.019 % , 0.004 % , 1.007 % , 0.003 % , 0.019 % , 0.12 % and 0.00007 % . Prescribed day-to-day dosage ( PDD ) of the antidepressants: The prescribed day-to-day dosage ( PDD ) is defined as the norm dosage prescribed harmonizing to a representative sample of prescriptions. It is of import to associate the PDD to the diagnosing on which the dose is based. The PDD will give the mean day-to-day sum of a drug that is really prescribed. PDD is particularly of import for drugs where the recommended dose differs from one indicant to another ( e.g. psychotropic drugs ) . When there is a significant disagreement between the PDD and the DDD, it is of import to take this into consideration when evaluating and construing drug use figures, peculiarly in footings of morbidity.24 PDD to DDD ratio of the antidepressants: Ratio of PDD to DDD is frequently used as an indicant of the adequateness of dosing. A ratio less than 1 as seen in instance of duloxetine and mirtazapine indicates under-dosing. A ratio greater than 1 was seen for Zoloft and amitryptiline. All other antidepressants showed a PDD to DDD ratio equal to 1, reflecting the adequateness of dosing in these cases.25 Restrictions of the survey: Our consequences should, nevertheless, be seen in the visible radiation of the little sample size, compared to the surveies with which they have been compared. Restrictions of the survey were the deficiency of patient attention indexs and some of the installation indexs like handiness of drugs and impact of cost on drug intervention, which increase the public-service corporation of the survey, but which can be derived prospectively merely. As with any drug use survey, existent usage or conformity with prescribed antidepressant was non possible to supervise, more so with a retrospective survey of instance records, where notes on conformity are missing. Furthermore, we could non quantify informations on comparative clinical effectivity of the antidepressants. Strengths of the survey: Strengths of the survey are the usage of a structured proforma for informations aggregation with inside informations of drug prescriptions on follow up visits, and a comprehensive application of drug use tools like ATC/DDD categorization and computation of DID and PDD/DDD ratios to measure prevalence of antidepressant usage in the community of the survey population. Documentation of longitudinal follow-up informations gives a better thought of drug ingestion than transverse sectional informations. Data on drug permutations and augmentations every bit good as attendant psychotropic medicines are besides provided. Decision: Our survey shows that depressive upset was the most common psychiatric diagnosing in the population and antidepressants were the most normally prescribed psychotropic medical specialties. There was a higher prevalence of antidepressant prescribing for adult females. Majority of antidepressants were prescribed to immature and older grownups between 21and 40 old ages. The SNRI Duloxetine, the SSRIs escitalopram and Zoloft and the untypical antidepressant mirtazapine were the most normally prescribed antidepressants, with or without other attendant psychotropic medical specialties. Most patients were treated by a individual antidepressant. However, hapless response and/or tolerability considerations made the prescribers change the antidepressant or add a 2nd antidepressant. Antidepressants were prescribed for many indicants other than depressive upset and head-shrinkers ‘ pick of drug was influenced by diagnosing, badness of disease/disorder, co-morbidity, drug efficacio usness, and considerations for patients ‘ tolerability, but non chiefly on the cost of medicine. Prescriptions were complete and polypharmacy was non seen. Favorable and unfavorable results were seen for 3 and 2 WHO ordering indexs severally. Consumption of antidepressants in the community was low. Adequate dosing was seen for all antidepressants, except for duloxetine and mirtazapine, for which under-dosing was prevailing. Recommendations: There is a demand for prospective drug use surveies to get the better of some of the restrictions of our survey. Ordering wonts among head-shrinkers can be improved farther by making consciousness about taking drugs from the Essential Medicines List and cut down prescription of ataractic soporifics. Such steps can diminish the figure of drugs per prescription and besides the cost of therapy. Prescribers should besides be encouraged to look into for patients ‘ conformity with the prescribed medicines and to enter them in the instance sheets. Such steps will advance the rational usage of medical specialties and finally, the quality of health care. How to cite Drug Utilization Study Of Antidepressants Health And Social Care Essay, Essay examples