Environmental Groups Essay

Environmental Groups Tiffany Tremaine May 2, 2011 Environmental Policies 310 Instructor: David Monda Environmental Working Group known as EWG is an Environmental interest group working to protect kids from toxic chemicals in our food, water, air, and other products we use every day. The mission of the Environmental Working Group is to use the power of public information to protect public health and the environment. EWG is a 501(c) (3) non-profit organization, founded in 1993 by Ken Cook and Richard Wiles. In 2002, we founded the EWG Action Fund, a 501(c) (4) organization that advocates on Capitol Hill for health-protective and subsidy-shifting policies. EWG specializes in providing useful resources (like Skin Deep and the EWG’s Shopper’s Guide to Pesticidesâ„ ¢) to consumers while simultaneously pushing for national policy change. EWG two main goals are to protect the most vulnerable segments of the human population—children, babies, and infants in the womb—from health problems attributed to a wide array of toxic contaminants and to replace federal policies, including government subsidies that damage the environment and natural resources, with policies that invest in conservation and sustainable development. Their research brings to light unsettling facts that you have a right to know. It shames and shakes up polluters and their lobbyists. It rattles politicians and shapes policy. It persuades bureaucracies to rethink science and strengthen regulation. It provides practical information you can use to protect your family and community. And because our investigations and interactive websites tend to make news, you’ve probably heard about them. EWG primary funding is donations, grants, corporations backing, as well as interest and support from every day people. The cost is whatever the member (supporter) would like to donate. There are many different ways to donate and the donations can either be tax right offs or not. EWG gives many ways to donate, credit card or check, and their supporters can either make a one-time contribution or pay monthly. The donation helps support EWG Action Fund’s Kid-Safe Chemicals Campaign fight for organic produce, get dangerous chemicals out of your food and water, and protect your favorite national parks from mining destruction. In 2009 and 2010 EWG have accomplished Toxic chemical reform, Energy policy, Banning BPA, Highlighting cell phone radiation risks, Shedding light on secret chemicals, Pushing for more effective sunscreens, Banning phthalates, Phasing out Deca, Protecting ground water from gas-drilling chemicals, Saving the Grand Canyon, and Fighting for safer tap water. EWG motives, viewpoints, and organizational features make them successful in the public policy arena. This Environmental Working Group is successful in the public policy arena. After researching just a couple of their accomplishments are in the public arena. References Z. Smith, 2009, The Environmental Policy Paradox, 5th Edition 1993, http://www. ewg. org/

Husayn-McMahon Essay

McMahon-Hussein Correspondence refers to an exchange of letters between Sharif Husayn Ibn Ali of Mecca and Sir Henry McMahon of Britain detailing the future of the Arab world in the face of a possible annexation by the Ottoman Turks. The background to this communication can be traced to early 1914 when Sharif Husayn’s son, Amir, paid a visit to the then British Consular in Egypt, Lord Kitchener, seeking British assurance that they would offer their support incase Arabs opted to revolt against Turkey. While at first Kitchner was reluctant to make any commitment, his successor in the region, McMahon, upon sensing the dwindling British fortunes in the Middle East, made hefty promises to garner the Arabs support during the First World War. It is during this period that McMahon would initiate correspondence with Husayn. The Husayn family emerged to be an influential force in the Middle East as it lay claim to be the descendant of Muhammad and held the mantle leadership of a number of kingdoms in the region (Daly 215). The issue of McMahon-Hussein correspondence has emerged highly controversial and is held to be at the core of the crisis in the Middle East. It is regarded as an important correspondence by the Palestinians as it was seen as a commitment by the British of granting them independence. In these series of letters, Husayn had asked for Arabs independence, he outlined these areas to be the Arabian Peninsula, Palestine and Iraq amongst others. McMahon on the other hand made a commitment to ensure the independence of a number of territories which would not damage the existing cordial relations with France. Arabs in the Middle East have maintained that British had promised independence to the Palestinians; on the other hand, Britain claims that this was merely a declaration of intent that was not legally binding and cannot be used to lay claim of independence to the Palestinians (Mack 123).

Barbara Norris: Leading Change in the General Surgery Unit Essay

Barbara Norris facing many difficulties. The GSU which she lead is currently short-staffed and does not perform as she expected. Her staffs have low morale and low motivation to do their daily job. On top of that, there is a cultural issue where confrontation, blaming, and favoritism are typical in her unit. She also facing a budget problem where overtime has been eliminated due to cost cutting measure implemented on the hospital. The budget cut make it difficult to Barbara to allocate a right personnel in case of some staff take a personal or vacation leave. In many cases, she has to rely on nurses from general float pool to cover the staff on leave, but this often lead to negative effect to her staff dynamics because the substitute nurses is not familiar with the GSU. There are three broad problem Barbara has to solve: lack of collaboration and teamwork, staff conflict either within her unit or within the hospital, and lack of transparent performance appraisal procedures. All of this three issues need to be address simultaneously to ensure that the unit perform as Barbara expected. It is evident that there is conflict between junior nurses, senior nurses, and PCAS’s which lead to ineffective collaboration among them. Junior nurses feels like the don’t belong to the team and they don’t get positive feedback from senior nurses. On the other hand, senior nurses feels that many junior nurses and PCA’s are incompetent and feel overwhelmed to support them. To solve this issues, Barbara need to redefine a clear role among the nurses and make sure that the role is properly understood by all her staff. In redefining the role, she must include advice from her staff to ensure that the role definition fit within her unit. She also need to develop a transparent communication mechanism to solve any role discrepancy within her unit. To address the performance appraisal issues, Barbara needs to start creating a transparent review process. Although she still facing a budget constraint, she can utilize non-monetary approach to reward her staff. This can be in form of formal recognition in staff meeting or announcement of monthly best-staff. Although it would not directly impacted to her staff salary, it can be a great motivational tools for the junior staff to feel recognized. Barbara should also make a system where senior nurses can have a positive feedback in performance review by helping a junior nurses. Whenever possible, Barbara should persuade the hospital director to increase her unit budget.If approved, she could make a proper  adjustment to the staff salary and position based on their previous performance.

Resaearch paper Research Example | Topics and Well Written Essays - 1250 words

Resaearch - Research Paper Example This paper will analyze an important figure in three Abrahamic religions, namely Jesus Christ. The first aspect that will be used to compare and contrast the views of Christianity, Islam and Judaism is the attitude towards the nature of Jesus. It would be rather logical to begin with the point of view of Christianity as this spiritual tradition has devoted a considerable amount of attention to it, making Jesus one the key figures in its teaching. Thus, according to the Christian tradition, Jesus Christ is seen as the second Person in the Holy Trinity, which makes him God (Wuthnow 131). Indeed, the idea of Trinitarian God is rather difficult to grasp, but in the mind of true believers He is simultaneously God and Son of God which means that when Christians address their Lord they imply Jesus. The Muslim perspective on this Biblical figure is somewhat different. Just like Christians, the Muslims do acknowledge the contribution of Jesus Christ in the process of spiritual development of the humanity and believe that He enjoyed a close relationship with God. However, unlike their Christian counterparts, they do not consider him to be an incarnation of God which means that they reject His divine nature. This means that for the Muslims, Jesus Christ is a famous, respected and loved prophet who is called Isa, but nothing more (â€Å"Declaration on the Relation†). This is quite in interesting perspective as it may provide a common ground for these two religions. Finally, it may be rather important to analyze the point of view that is taken by Judaism as well. Keeping in mind that this is the only religion out of the above mentioned three that existed in the times of Jesus, it may provide an interesting perspective on His role and significance. Thus, those who adhere to the spiritual tradition of Judaism think that Jesus Christ was nothing but an ordinary Jew who claimed himself as a

Personal Statement for apply master degree Example | Topics and Well Written Essays - 500 words

For apply master degree - Personal Statement Example However, my fascination for numbers remained unchanged. I fervently wanted a job which will deal constantly with numbers. Choosing the financial field greatly satisfied my pursuit for numbers. Accountancy became my favorite subject soon as I was enthralled with its practical application in nearly every field, logic and a structured way of doing things. Every simple concept we learn in accounts will be actually used in day to day life in our career. Economics is considered to value the corporate performance in terms of financial gains a person brings to the company (Porter, 1987). To me economics is one intriguing subject which opens up the gates for a number of finance oriented careers starting from financial services to banking. Just mastering accountancy and economics will enable a person to choose from a plethora of finance oriented vocation choices. No other industry starting from medicine to engineering gives this freedom as these courses require a few years of basic training and specialization diploma as well. Graduating in accountancy and economics gives a person the basic idea about the core financial practices within a very short time. Be it stock market or basic investment, economics gives the chance understand the financial strategy of the scheme or investment better than others and accountancy helps us keep track of our finances accurately. While people from every other industry strive hard to earn money and invest it properly, financial consultants attain this skill in their profession effortlessly. Honing it properly helps them make others rich and accumulate wealth for themselves in the process. Rush Limbaugh once said economics is the most complicated simple subject. He is true. As simple as it might seem, economics and accounts combined together are used in complex matters like determining a nations financial policies. As with any critical skill in life, consistent implementation is the key to employing

People, Organisations and Management Assignment Example | Topics and Well Written Essays - 250 words

People, Organisations and Management - Assignment Example From this paper it is clear that management is the process of coordinating different function in business or organization to achieve a well-defined objective. Throughout the process of management, professional managers require ethical behavior for successful process of executing their duties. It is imperative for managers to examine their standards to ensure that they are well-founded to shape and help the company to make moral decisions. Good or great management process is an essential aspect of an organization or a business. In fact, management and leadership go hand in hand, although they are different. As per my experience, I believe that management involves working with others with the aim of achieving a common goal while leadership involves leading and influencing others to do their best. Both leadership and management play an essential role in organizations.   Ã‚  As the discussion stresses  a team is more than a group of people working together for a common goal. It must be a group of individuals that work as a single unit, working towards a mutual hallucination of achievement. Working as a team matters because it is difficult to achieve some goals individually.  A team remains necessary because each member’s work complements and supports the others’. Effective approaches to leadership and management in any sector calls for astute commitment, passion, and ideological driven mind. To achieve all the essential leadership and managerial qualities, successful techniques remain vital.

How to teach Speech to a deaf child Essay Example | Topics and Well Written Essays - 3750 words

How to teach Speech to a deaf child - Essay Example If this problem can be caught early, even in infancy then there is a high probability that speech can be taught adequately to children, if it is carried out appropriately. However, there are many non-deaf people in the world, who will come into contact with at least one deaf person in their life, who do not understand or who are not aware of what deafness really is and who will have no idea how to communicate with the deaf (Lederberg & Everhart 1998, pg. 887). In order to better understand how to interact and empathize with, support, and recognize the needs of deaf people, the kinds, causes, medical treatments, and technological advancements of deafness are major facts to know and should be a concern for many in society today. From the day children are born they require a form of communication in order to function adequately in society. A pre-speech baby will use gestures and expressions and babblings to interact with others. A toddler will participate in turn talking to satisfy a need or want (Burke & Glazer 1994, pg. 24). The more pre-schoolers participate in the world, the more they discover that language is useful. They also realize the potential of language for expressing their thoughts and feelings. From bedtime stories to a parent playing a game of "peek-a-boo", children begin to develop their language from the time they are born. There is no question then that; children are born ready to communicate. Before children begin school, they have already experienced 5-6 years of literacy experience. Research finds that the degree to which various learning experiences affect the children's literacy behaviors and development depends on external influences however (Jalongo 1992, pg. 115). These influences i nclude children's play experiences, interactions with adults and cultural and environmental influences. These factors do not vary simply because a child has a hearing disability or is totally deaf; they still play a very fluid part in how they develop their interpretation of the environment and how they gain the ability to communicate in their own way (Hendrick 1988, pg. 87). The normal, non-hearing impaired child's developing language skills is a means to an end - highly functional and meaningful. The interrelatedness of the development of language skills can be observed through watching children at play in any childcare centre, home environment or in the wider community. Children discuss ideas, work in groups, play with print and listen to each other reconstruct stories (Hendrick 1988, pg. 90). Areas within these centers are often established to encourage children to experiment with reading and writing. Many of the teachers who work in these centers have daily sharing times and whole group discussions which help extend and support the development of speaking and listening skills. Staff and parents can be observed supporting, encouraging and challenging development in all areas. Therefore, it is true that literacy develops from real life situations in which reading and writing are used to get things done. Through active engagement, children learn litera cy. An integrated approach to the teaching of language skills promotes development in all literacy areas (Jalongo 1992, pg

Why the Pros out weigh the Cons of legalizing marijuana Essay

Why the Pros out weigh the Cons of legalizing marijuana - Essay Example Herein will contain the reasons why the legalization of marijuana should take place, taxes placed on it for the purpose of debt relief and the medicinal value of the plant. It is imperative that the United States pass legislation to legalize the use of marijuana, as there are many people that use the drug for recreational reasons, and those who use it for medicinal reasons as well. According to a survey conducted by the National Survey on Drug Use and Health in 2009, 16.7 million Americans over the age of 12 had used marijuana at least one time in the month before this survey was conducted. That is roughly 5% of the population in the U.S. that were honest enough to admit to marijuana use. Given that so many people use the drug, if legalization were to take place, the taxation of it alone would critically help the United States’ debt problems. Often marijuana is labeled as a ‘gateway’ drug, meaning that it is the beginning drug for people to pursue other more dange rous drugs, like cocaine or heroin. This is a false assumption, and this report will seek to prove that as well. Marijuana has been used for centuries by varying indigenous peoples throughout Europe and Asia. It is thought to be first used as an intoxicant around 1000 B.C. in India. In China, it was used to make cloth and medicine, and considered to be in use in other parts of the world prior to 500 A.D. (National Commission of Marijuana and Drug Abuse, 2010). Among the many religions that use marijuana for religious purposes, the most commonly known are the Rastafarians. They use the drug to â€Å"enhance their consciousness of the relationship between God, Creation and the individual soul.† (Marijuana Legalization Organization, [MLO] 2006). Among other religions, the Quakers, Judeo-Christian, and Shinto use marijuana for religious reasons (MLO, 2006). Marijuana should be legalized, taxed and restricted to certain age groups for use in the United States, as the reasons for l egalization far outweigh the reasons not to legalize. Methodology In order to find out the medicinal value and the reasons for taxation of marijuana, I employed a Google search, and found a multitude of articles, journals and other written outlets both for and against legalization. Marijuana has been found to relieve pain and is a safe and effective treatment of peripheral neuropathy, which is a common occurrence in HIV/AIDS patents. Caused by nerve damage, this type of pain often cannot be effectively treated with standard narcotic pain medicines, but marijuana was shown to give these sufferers relief. It has also been shown to help those suffering from hepatitis C virus to curb the nausea associated with the traditional treatments. It is also being used for sufferers of multiple sclerosis and diabetes (Kampia, 2007). Although there are many medicinal purposes for the plant, legalization and taxation of it would be of enormous benefit to the United States Economy. The costs to the United States and taxpayers are enormous to keep marijuana illegal. There are no certain numbers available due to the variability of costs of factors. Some of those factors are: Cost of law enforcement officers Cost of prosecution and defense of offenders Cost of incarceration of convicted offenders Cost of social services and foster care for children of offenders (MLO, 2006). Given these costs, which are few in the plethora of available issues concerning keeping marijuana illegal, the costs of growing the plant and taxing it are hugely different and beneficial. According to MLO (2006) estimates, the U.S. spends anywhere from $7 to $12 billion each year on drug control programs. These do no include misdemeanor cases, but it is important to note that these numbers to not allow for the expenditures on marijuana alone, as it is all

WOMEN'S ROLE IN HISTORY FROM 1700 THROUGH PRESENT, THEIR SOCIAL CHANGE Essay

WOMEN'S ROLE IN HISTORY FROM 1700 THROUGH PRESENT, THEIR SOCIAL CHANGE TO SOCIETY - Essay Example That is, defying the traditional gender roles which are unanimously acknowledged by a patriarchal society, women have entered into male spheres and performed those male activities quite successfully. A critical analysis of the history of the changes in women’s role will necessarily reveal that these changes were, for the first time, induced during the Enlightenment Period in Europe. During that age, women were considered as mentally and physically weak. They were thought to be fit for indoor jobs such childrearing, maintaining house and hearth, cooking, washing, etc. Though women were excluded from public affairs and outdoor activities, Enlightenment scholars like Mary Wollstonecraft called for changes in the prejudiced view about women (Kreis, 2012, pars. 3). But during the early 18th century, public awareness about women’s education began to increase in the metropolitan areas of England and France. They started to participate in French Salons increasingly (Goodman, 19 94, p. 43). In public affairs, they appeared most as singers, though not professionals. But during the late 18th century, the epoch-making event, Industrial Revolution, seemed to change the whole scenario about women’s traditional role as a wife and a mother. Before the Industrial Revolution, men’s and women’s social role were highly distinctive. In a family, men were mainly considered as the breadwinner and women were dependent on their male counterparts for their bread and butter. But the Revolution, technology-based industries began to burgeon at a rapid rate, creating more opportunities for women to be involved in earning activities, as Hudson (2011) notes, â€Å"Many young people, especially young women, migrated to towns and cities in search of work as the possibilities of agricultural employment declined.† (pars. 5). During the Enlightenment period, women’s outdoor was limited to cultivation. Most the

Leadership, Power and Corporate Strategy Research Paper

Leadership, Power and Corporate Strategy - Research Paper Example In other words, organizational culture refers to the basic beliefs and aims of any organization, and how all the work and purposes of that organization will revolve around those beliefs and aims. The key to a strong organization lies in developing their organizational culture, such that it is unique to each organization, yet commonly understood by all members within the organization (Parker, 200). This basically means that every person in the organization should have a clear idea of what they are working for, what their core beliefs as a member of the organization are and what is the main purpose of the firm. It is clear however that these beliefs and strategies are not developed on their own. Any successful organization will find itself headed by a leader who has a clear vision of the purpose and future of their organization, and who does their best to instill this vision in the members of their organization (Kotter and Heskett, 192). Strong organizational culture is developed by organizational members in leadership positions, whether or not they are the founding members of that organization. The success of any organization lies in the hands of their leaders and in how successful those leaders are in developing this organizational strategy and culture. Consider for example the organizational culture and strategy of Apple Inc. Founded by Steve Jobs, Steve Wozniak and Ronald Wayne, the company initially started out as a computer technology organization, but over time developed into an organization focused more on consumer retail goods. Apple is both famous and infamous for its highly publicized organization culture, accredited highly to Steve Jobs, both in its success and its infamy. Apple Inc. enjoys a highly unique organizational culture, varied in its style from almost any of its time. The aims of the company are straightforward and simple: the company

English 1B Short Story Comparison essay Example | Topics and Well Written Essays - 1250 words

English 1B Short Story Comparison - Essay Example This paper compares and contrasts these two stories in terms of themes, point of view, and style. As stated by Tim O’Brien the story The Things they Carried portrays peace or reconciliation and not warfare or conflict yet for the combatants they have to engage in warfare before attaining peace. The setting for the story is mostly in Vietnam, and those chapters that occur in other parts of the world are thoughts about the war and the extent of its impact on the individuals that the combatants mature into. Being engaged in war for too long made the soldiers unable to cope with their ‘normal’ surroundings (O’Brien 23): They carried the soldier’s greatest fear, which was the fear of blushing. Men killed, and died, because they were embarrassed not to. It was what had brought them to the war in the first place, nothing positive, no dreams of glory or honor, just to avoid the blush of dishonor. They died so as not to die of embarrassment. The second important theme is guilt. There is an enormous level of guilt taking place in the story. For instance, both Cross and Bowker think that they should be held responsible for the death of Kiowa. Even O’Brien senses too much guilt for taking the life of an unreal person. The third central theme is truth. O’Brien emphasized that truth is revealed in numerous different ways in the story. Although not every part of the stories is real, the emotions and sentiments within them are. The last major theme is seclusion. The soldiers were secluded from the outside world, for that was there way to survive. They regarded everybody as strangers and not only the people of Vietnam but those at home too. Even at home they regarded themselves secluded, for the people around them were unable to understand or grasp the ordeals they had to endure in order to survive. One of the most obvious

Love and Soul Mate Essay Example for Free

Love and Soul Mate Essay Knowing that I would get to spend the rest of my life with my best friend is the best feeling EVER! Even after being married for years, my love still grows every day! I know I am with my soul mate and still can’t believe we have made it and have overcome so much in our life Knowing that I would get to spend the rest of my life with my best friend is the best feeling EVER! Even after being married for years, my love still grows every day! I know I am with my soul mate and still can’t believe we have made it and have overcome so much in our life njkj kj kj Knowing that I would get to spend the rest of my life with my best friend is the best feeling EVER! Even after being married for years, my love still grows every day! I know I am with my soul mate and still can’t believe we have made it and have overcome so much in our lifeKnowing that I would get to spend the rest of my life with my best friend is the best feeling EVER! Even after being married for years, my love still grows every day! I know I am with my soul mate and still can’t believe we have made it and have overcome so much in our lifeKnowing that I would get to spend the rest of my life with my best friend is the best feeling EVER! Even after being married for years, my love still grows every day! I know I am with my soul mate and still can’t believe we have made it and have overcome so much in our life Knowing that I would get to spend the rest of my life with my best friend is the best feeling EVER! Even after being married for years, my love still grows every day! I know I am with my soul mate and still can’t believe we have made it and have overcome so much in our life

The principles of Quick Response Manufacturing

The principles of Quick Response Manufacturing Abstract Quick Response Manufacturing (QRM) is a strategy which needs to applied throughout the company and whose primary goal is the reduction of lead-time in each and every operation of the company while simultaneously reducing costs and improving quality.  [1]  QRM can be defined in two contexts: (i) Externally (Customers point of view): QRM means quickly responding to customer needs by designing and producing goods customized to cater those needs. (ii) Internally, QRM stresses on reducing the lead times throughout the organization, leading to lower inventory, better quality, reduced cost, and greater responsiveness. QRM uses Manufacturing Critical-path Time (MCT) as the metric for measuring the success of QRM processes. MCT is an extension of the concept of lead-time, which is the time from the receipt of order from the customer till the product is delivered to the customer. There are 2 ways of implementing QRM: one is using large breakthrough improvements and the other is through continuous improvements. QRM was developed by Rajan Suri, a Professor at the University of Wisconsin-Madison, who is famous for his works on continuous improvement programs. He not only gave the theory but also the practical ways by which QRM could be successfully applied and integrated in the operations of the company. QRM is basically an extension of Time based Competition (TBC), which was a strategy used by Japanese firms in the 1980s. TBCs philosophy is to use speed to gain competitive advantage. QRM is more particular as it is restricted to manufacturing firms only. QRM finds its first foray in history in 1993 with the foundation of the Center for Quick Response Manufacturing at the University of Wisconsin-Madison.  [2]  In 1995, Rajan Suri published the article Slaying the Beast which put forth some bad policies which were prevalent in manufacturing companies and also offered explanations for the same. This helped QRM gain a lot of recognition and importance.1 The positive response spurred Dr. Suri to continue working on this subject and this further led to his consulting businesses in implementing QRM and successfully applying the same in many companies. Since then, the Center for QRM has helped in applying QRM in nearly 180 companies resulting in reduced lead times and increased market shares.2 QRM Principles Its not necessary to work harder, faster and longer hours to complete job earlier. One can focus on finding new ways to complete a job that takes lower time. Most of the time a job spends in a queue instead of in process and traditional approach only look to reduce processing time (touch time) and in QRM focus is on lead-time (total elapsed time) and not just processing time. Out of total lead-time 34 days only 19.5 hours is a touch time so it makes sense that we should focus on whole 34 days. But generally organizations are not designed to focus on lead-time. Mainly because organizations dont recognize the cost of waiting they mainly focus on processing time like one need to reduce batch sizes to reduce waiting time but it will increase number of setups that will increase their processing time which is mostly opposing to company goals. So, Companies need to change their accounting systems and reward systems so that benefits of reduction in lead-time can be measured and rewarded appropriately. Table 1: Examples of Organizational Waste Due to Long Lead Times Expediting of hot jobs or late orders: Requires Systems, Air Freight, People, even Top Management time à ¢Ã¢â€š ¬Ã‚ ¢ Production Meetings required to change and update priorities à ¢Ã¢â€š ¬Ã‚ ¢ Overtime costs for trying to speed up late jobs à ¢Ã¢â€š ¬Ã‚ ¢ Time spent by Sales, Planning, and other Departments to develop and update forecasts à ¢Ã¢â€š ¬Ã‚ ¢ WIP and Finished Goods holding costs, including space à ¢Ã¢â€š ¬Ã‚ ¢ Obsolescence of parts made to forecast but not used à ¢Ã¢â€š ¬Ã‚ ¢ Quality problems not detected till much later; lots of rework or scrap à ¢Ã¢â€š ¬Ã‚ ¢ Opportunity for: Order changes or even cancellations Feature and scope creep Loss of sales to competition à ¢Ã¢â€š ¬Ã‚ ¢ Sales time devoted to expediting and explaining delays to customer à ¢Ã¢â€š ¬Ã‚ ¢ Complex systems required to manage the dynamic environment There is one major problem with cost based systems that hinders QRM implementation that is functional structure of an organization. Looking the figure one can see how organizations fell into vicious circle by delaying regular jobs because of hot jobs and then again increase in hot jobs due to insertion of safety time due to delay in regular jobs. This is also called response time spiral. And so the spiral grows. QRM focus on reducing system in time like we do in service industry but this will require substantial reorganization of most of the processes. Basically, we will end up with cellular organizations in shop floor and also in offices and each cell will focus on its customers. The POLCA material control system helps coordinate production across multiple cells. Also, new operating methods such as time slicing are described, to help cells share non-cell resources. This principle is hard to digest as we believe that we should utilize capacity to its maximum possible value. Any reduction in the same would mean losing out on productive opportunities, resulting in increasing costs. However, by keeping all the machines busy at tall times does not necessarily transform into higher output or higher productivity. We frequently encounter the problems of growing queues due to the presence of a few bottleneck machines and jobs spending a lot of time waiting for resources due to mismanagement. All this ultimately results in increasing the lead time of the jobs which culminates in the increase of the organizational costs, which have been enlisted in the previous table. In the long run, these costs actually prove to be greater than the opportunity costs of not utilizing the spare capacity. Hence, the spare capacity should be considered as a strategic investment that will pay for itself many times over in increased sales, higher quality, and lower total cost s. This is again a measure which is very hard to digest. We always measure the usefulness of any process through its efficiency and utilization. However, the problem with the traditional belief is not that efficiency is not an important measure, but that most measures of efficiency result in increased lead time which ultimately harms the organization. Large batches are used in a lot of companies in a bid to reduce the setup costs. However this very measure results in increasing the lead time which can culminate in the same problems as enlisted in the previous principle. There are numerous examples to show the scope of reduction of lead time in organizations, a prominent one being the case study in Becker (2001) which showed how lead time for a line of spare parts for the oil drilling industry dropped from 40 days to 5 days using reduction of lead time as the main performance measure in a manufacturing cell. QRM says that the quantities as calculated by EOQ are not appropriate and consistent with the goal of reducing lead time as EOQ doesnt consider many costs of large lots like expediting of late orders, overtime cost for trying to speed up late jobs, WIP holding costs including space. Also quality problems are detected much later than with small lots and the amount of rework and scrap generated is also much larger. At the same time, another important point which is missed in EOQ is the lack of responsiveness which occurs when the process is carried out with large lots. Large lots and planning for the same makes it difficult for the organization to respond quickly to change in customer needs. Nor can good lot sizes for QRM be predicted by the MRP system, since it assumes fixed queue times regardless of workload. Hence, in order to reduce the lead times throughout the organization, it is important for everyone in a manufacturing firm, and especially for senior managers, to understand the dynamics of factory operations. The senior managers need to have a broad outlook and decide on the policies of manufacturing and performance measures only after fully understanding the effects of capacity utilization, efficiency measures, and lot sizing policies on lead time. Figure 3. Traditional Versus QRM Views of Capacity and Lot Sizing Source: QRM and POLCA:A Winning Combination forManufacturing Enterprises in the 21st Century Rajan Suri The differences between the traditional and QRM views can be observed from the figure given above. Traditional performance measures of utilization and efficiency encourage managers to exploit their resources to the maximum possible value. Production is considered infeasible only when the capacity utilization exceeds their maximize resource utilization, and only think about their capacity limit as a boundary between feasible and infeasible production targets. Also the perception is that larger lot sizes lead to increase in efficiency. However, QRMs focus is solely on reducing lead time, and hence the impact of utilization and lot size on the same is studied. Higher utilization leads to increase in lead time, whereas lead time first decreases and then increases with increase in lot size. It is essential to consider all such manufacturing dynamics in order to come up with a process that minimizes the lead time and thereby costs. According to QRM on-time performance is an outcome not a performance measure. Because if on time is considered as performance measure departments will quote longer lead-time to match up with on-time delivery. Again this will result in Response time spiral and results in poor performance of organization. But with QRM, organization will focus on shortening lead-time as a performance measure. In QRM its called QRM Number (measure of lead time reduction). This will eliminates Response Time Spiral and performance of organization will improve. For example see Table 2. MRP systems are of great help in managing material supply and ordering but lead-time cannot be reduced using MRP. MRP should be used on high level planning and coordination not on cell level in a cellular structure implemented by QRM, whereas POLCO can be used to manage material between cells and inside cells. POLCO basically a hybrid of push and pull systems using benefits of both. This phenomena can be again seen as entering in Response Time Spiral in which if company buys in large batches this makes supplier to have longer lead time and company to order even larger batches. Internal and external incentives like discounts motivate ordering in large batches. The results this can be verified in John Deere where implementation of QRM with suppliers reduced cost and also improved quality with shorter lead-time and batches. Not only at the supply side, the small lot concept needs to be applied at the distribution end too. Normally it is the tendency of the sales force to get higher orders by offering quantity discounts. This will again lead to the spiral of increasing lot sizes, both during the process as well as on the procurement side, ultimately leading to lowering of delivery performance. By implementing QRM, a company can reduce its costs manifold which can then be passed on to the customers. There is a need to demonstrate to the customer that the company can deliver high quality at low prices even for small lots, which would be more beneficial both to the company as well as the customer. Thus, the idea of small lots percolates throughout the organization, from top to bottom, as well as throughout the supply chain, from supplier to customer. The traditional approach might result in local quality improvements in the respective departments. However, QRM is more concerned with the overall organization than just one department. The requirement is to cut the overall lead time for manufacturing as well as office operations for which Q-ROCs are more appropriate. Such Q-ROCs result in significant reduction of lead times for jobs such as cost estimating, quoting, and order processing. Closed-loop implies that the team would be self-sufficient in dealing with all the problems related to reducing lead time. This implies cutting across functional boundaries and changing the reporting structures to ensure the success of the process. Needless to say, this team needs to be given power in order to make the decisions as reducing lead time is the primary goal of the organization. The best example would be that of Ingersoll Cutting Tool Company, in Rockford, which reduced its engineering and order processing time for customized cutters fro m 10 days to half a day after implementing QRM principles. However, QRM should not be considered as an application of Reengineering as by using principles of system dynamics in the design of Q-ROCs, providing specific engineering and management principles for manufacturing organizations, plus by changing management principles and performance measures and adopting a company-wide approach, QRM goes much deeper than Reengineering. Charging more for speedy response is sustainable only in the short-term. In the long run, it is quality which differentiates a product from its competitors, and the same purpose is served by QRM. Searching for ways of squeezing time out uncovers quality problems and wasted efforts. Changing policies and adopting measures to rectify the same results in higher quality, lower WIP, less overhead, lower operating costs, and greater sales. The QRM Approach yields even better results than Lean Manufacturing as it ignores the wastes caused by long lead times. QRM takes the goal of waste reduction to the next level, creating an even leaner enterprise that will remain a formidable competitor for years to come. As we have seen in many quality improving methodologies like Six Sigma, House of Quality the most important factor in the success of these initiatives is their acceptance by all the members of the organization; and QRM is no different. Realigning of all employees, from the shop floor to the boardroom, from desk workers to senior managers, to the QRM principles is a pre-requisite for the success of QRM, and hence training gains significance. Normally, performance measurement is tied to the cost accounting system which is an impediment to the successful implementation of QRM. Performance measurement must be aligned with the principles of QRM if the company has to benefit from the same. In a nutshell, the following points can be summarized about Quick Response Manufacturing: It requires measurement and efforts to minimize the metric, Manufacturing Critical-path Time (MCT), which is defined as the typical amount of calendar time from when a customer creates an order, through the critical-path, until the first piece of that order is delivered to the customer. This can be measured using the QRM number. Some changes in the structure of the organization are necessary to ensure the success of QRM. It basically requires the strategy of the organization to change from cost-based to entirely time-based with full emphasis on lead time minimization. Functional to Cellular:  Cellular manufacturing is a pre-requisite of QRM as the cells yield greater flexibility in manufacturing Top-down Control to Team Ownership:  QRM requires the formation of closed-loop, cross-functional teams which need to be given complete power for monitoring the processes. Specialized Workers to a Cross-trained Workforce:  Since the success of the process requires reduction in lead times across all the departments, there is a need to provide proper training to the workers so that they can perform multiple tasks and have a broader outlook. Efficiency/Utilization Goals to Lead Time Reduction:  The evaluation parameters, performance measures have to shift from the traditional accounting measures to the goal of lead time reduction. The following steps need to be implemented in the organization so that QRM is a success: 1. Creating a QRM mindset: The most important part is to make people realise the advantages of QRM over the previous measures i.e. the wastes created due to long lead time which are even ignored in Lean Manufacturing. Thereafter, a high-level QRM Steering Committee needs to be formed to oversee the QRM efforts. Also, like Six Sigma,by providing QRM training, some employees can be made QRM champions who can then be entrusted with the responsibility of the projects on a daily basis. 2. Changing of organizational structure Cross-functional planning team are formed to study feasible projects to which QRM can be applied. This would require the management to indulge in a detailed analysis of various consideration like Manufacturing Critical PathTime, product volumes, needs relating to strategy and other factors. Thereafter, QRM cells are formed and training and cross-training is provided to the operators in these cells by an implementation team which consists of members in the new cell as well as planning team members. Measurement of MCT is done to monitor lead time 3. Including of system dynamics QRM requires going through the policies on utilization and efficiency in order to determine the proper loading of the cells. It also calls for making provisions for spare capacities and reduction in the batch sizes in order to reduce the lead time. 4. Enterprisewide expansion of QRM The process would typically begin with a single project. If the project is a success, its results need to be conveyed to all the members of the organization and more projects need to be undertaken based on QRM principles. QRM should not be restricted to the organization alone but should be extended through the entire supply chain. E.g. the suppliers should also be motivated to inculcate and apply the principles of QRM which would have mutual benefits for both parties POLCA: The Material Control System for QRM POLCO is Paired-cell Overlapping Loops of Cards. To implement this system the company need to create cells of the production process focusing on subsets for similar parts and then it processes a given customer order through differing cells depending on the needs of that order. High Level MRP is used to provide high level planning and coordination of materials from external suppliers and across these internal cells. But cells are managed individually. To explain POLCO we can take an example of a shop floor shown in below figure. Assume P1 focuses on color printing and P2 on black white printing after which we have three Formatting Cells, F1, F2 and F3, which convert the printed sheets into reports with the desired pages. After formatting comes binding operation, which include punching holes and notches, cutting the sheets, and bending, A1 to A4. Finally, all orders go to the Shipping Cell S1, where the packaged plates are placed in shipping containers and then loaded onto carts. The material control system used is POLCA where High Level MRP and a cellular organization is a prerequisite. In this case all Release times are created with the help of High Level MRP. But even after authorization of POLCO work will not begin until all conditions are met. POLCO cards are used to communicate and control the material movement between cells. As Figure shows the POLCA card flows for a particular order at any organization based on initial design. This orders routing takes it from P1 to F2, then to A4 for binding, and finally to S1 to be shipped. This order will therefore proceed through the POLCA card loops with the pairs P1/F2, F2/A4 and A4/S1, as shown in the figure. If cell P1 has a job authorized that is going to F3 next, then a P1/F3 card must be available at P1 in order for it to begin that job. If a P1/F3 card is not available, that means that there is a bottleneck at F3 and working on that job will only add to the work-in-process at F3. Instead, it would be better for P1 to put its resources into a job that is needed by another cell that is not backlogged. So the cell team at P1 skips the P1/F3 job for now, and looks at the next authorized job to see if a card is available for that job, and so on. Differences from KANBAN POLCO cards only control flow between cells not within POLCA cards are not product specific but they are specific to particular pair of cells. POLCO cards are used as capacity signal whereas Kanban is used as inventory signal. As return of POLCA card from a downstream cell signals that the cell has available capacity. Benefits yielded by POLCA: POLCA helps in managing short-term fluctuations in capacity and also assists in reducing congestion on the shop floor. If a POLCA card from a downstream cell is not available, it means that that cell or some other cell further downstream is backlogged with work. Hence it does not make sense allocating further work to that particular job, without replanning of resources, as this will only increase inventory in the system since somewhere downstream there is a lack of capacity to work on this job. A better alternative would be to use this cell for some other job during the time being. POLCA cards flow in longer loops which allows the production to respond to changes in demand or differences in the complexities of jobs. The additional jobs in the loop can act as a buffer to absorb variations in demand and product mix which makes it highly suitable to meet the needs of responsiveness. On the contrary, the pull system stresses on achieving constant takt times throughout the organization, ignoring the fact that a variety of products will require different manufacturing times. Benefits of Quick Response Manufacturing Product Leadership: The main objective of QRM is to minimize lead times. By implementing QRM, a company attains many beneficial and competitive advantages. Benefits of Quick Response Manufacturing Product Leadership: QRM enables a firm to have shorter time to market. Thus a firm can reach out to customers with the latest technology while competitors play catch-up. There are two ways of looking at it. The first is that a given point of time a firms product would be superior to that of its competitor. Another point of view is that since a firm has shorter lead time it can deliver technology that is openly available to the market much earlier. Thus, the firm can skim the market due to its superior product. This can be depicted on a time line as shown below. FIRM USING QRM FIRM NOT USING QRM 2007 2009 2010 FIRM USING QRM FIRM NOT USING QRM 2007 2009 2010 Lower working capital: Lower lead times permit companies to have lower raw material and finished goods inventory. As a result the working capital requirement is decreased. This places the firm in a better strategic position to utilise their resources and capital. Better position to increase market share: The lower lead times increase the firms responsiveness to opportunities in the environment. This increased responsiveness helps the firm attract customers and increase its market share. Increased inventory turns: Since the production system is triggered by demand, smaller batches are produced, inventory decreases, and the number of inventory turns increases. Many inefficient producers have substantial amounts of capital tied up in inventory; therefore, their inventory turns are low. Reducing the cost of quality by minimising rework Cellular manufacturing places more responsibility and accountability on specific production teams. This results in specialization which inherently increases the quality of the product. It is much easier to pinpoint defects since the problems are directly traceable to certain teams or members. This has a positive impact on the quality of products. Cost Reduction: QRM aims at finding opportunities to improve the existing process. This results in lower operating costs. Using QRM, companies are able to save, in some cases, up to 25% of total operating costs by solving problems before they happen. Increasing Long Term competitiveness QRM ultimately aims at enhancing the long term competitiveness of the team. The above mentioned benefits are only the stepping stones in the right direction. The enhanced competitiveness of the firm ensures that is objective of enhancing shareholder value is fulfilled. Issues of Quick Response Manufacturing Increased reliance on suppliers QRM requires a strong relationship with ones raw material suppliers and partners. To react to demand, a manufacturing firm must closely partner with suppliers that will quickly accommodate the firms production schedule. However, if the supplier cannot provide raw materials due to problems such as quality assurance/control, equipment repair or union labour, the manufacturing firm may not be able to meet customer requirements. This could result in stock outs and backorders. Change Management It can be very difficult to implement QRM in a manufacturing environment. QRM is a business enabling philosophy that works top-down and therefore, changes the roles and responsibilities of the employees. Traditional roles, from lower levels through upper management, are drastically modified and the corporate infrastructure is typically altered. Employees can be extremely apathetic to these changes, which is a barrier that could significantly hinder the implementation process and the success of QRM. To implement QRM, companies must have representation from all functions i.e line and support functions (production, planning, purchasing, engineering, manufacturing, quality, finance and human resources) to facilitate the implementation. All functional areas need to buy-in to QRM philosophy to successfully implement such a major change in the way the firm does business. What Differentiates QRM from Lean? First and foremost is the QRM mindset: the driver for all the principles and strategies in QRM is reduction of lead time. This time-based mindset results in many operating policies that are different from traditional ones. In contrast the driver in JIT/Lean is waste reduction. Although the business press has been talking about the importance of lead time reduction, or speed, for over a decade, we find that most companies still lack the knowledge and the tools to effectively reduce their lead times. Worse still, policies are in place that are lengthening, rather than shortening, lead times. QRM devotes a substantial amount of effort in educating management and workers on why these traditional policies result in long lead times, and in showing them the QRM principles that must be put in place instead. QRM is a companywide strategy. While the original implementation of JIT/Lean at Toyota may well have encompassed the whole company, most Western implementations of JIT/Lean have focused on manufacturing and materials management. In many cases, JIT/Lean has been interpreted even more narrowly as merely implementing a pull system with kanban cards. In contrast, QRM clarifies at the outset that it is a companywide strategy with implications far beyond the shop floor, and principles for other company areas, such as, office operations, are clearly presented as part of the QRM philosophy. QRM provides rational principles and tools for lead time reduction. QRM uses an understanding of system dynamics, and exploits this understanding to define the best structures and policies that will reduce lead times. QRM begins by educating employees and giving them insight into these system dynamics. This then helps justify, to management and workers, the need for changes in policies. State-of-the-art analysis tools such as the MPX software package incorporate this analysis of system dynamics and help to derive the specific changes needed and to quantify the benefits that would be achieved. For companies making a large variety of products with variable demand, as well as for companies making highly engineered products, the JIT/Lean strategy of pull is either wasteful or breaks down altogether. For such companies, QRM provides an alternative strategy called POLCA which combines the best features of push and pull without their drawbacks. While the JIT/Lean approach tries to eliminate variability, QRM recognizes that in certain markets responding to this variability may provide competitive advantage. Instead of eliminating variability, QRM creates an effective organization structure to cope with it and serve the market. QRM does this by exploiting its understanding of system dynamics. A specific example of the difference between JIT/Lean and QRM is the issue of delivery of material or components. On-time delivery is a cornerstone of JIT/Lean is implementation. And yet QRM understands of organizational dynamics shows that promoting on-time delivery results in dysfunctional dynamics with longer lead times and higher costs. QRM provides alternative metrics based on lead time reduction that promise greater improvement in the long run. The QRM approach extends to supply management as well, and is called time-based supply management (Ericksen, 2000). Companies such as John Deere are finding that, particularly for smaller suppliers, the time based mindset and QRM principles offer an effective approach to target improvements at the suppliers operation. In addition, rapid results can be achieved, with significant improvements in supplier deliveries and quality, and reduction in supplier cost and lead time (Golden, 1999; Ericksen, 2000; Nelson, 2000). To summarize, QRM pursues the relentless reduction of lead time all QRM principles stem from this singular driving concern. Instead of management announcing dozens of programs and acronyms, QRM enables management to present one unified message to the organization, and all policies follow from this one driving strategy. Examples of implementation of Quick Response Manufacturing: Trans-Coil Inc. The Milwaukee Company is a manufacturer of equipment that supports variable-speed electric drives. Problem: Trans-Coil Inc.s process sometimes dragged longer than couple of weeks they promised to the customers. Improving its record for production time and meeting deadlines was the only way not to risk losing business. Had Trans-Coil built large numbers of components in advance, ready for shipping, it would mean spending loads of money on raw materials, production and handling, without assurances of turnover of the warehoused products. The company would be stuck then with unused, obsolete components in situations when customers made even minor changes to their specifications. Solution: Having quick-response manufacturing, companies can minimize the time it takes for products to flow via their operations. It makes companies nimble, responsive, and lower costs. For changing operations, Trans-Coil commenced with its factory. Production workers were cross-trained to learn all jobs in the plant. That was a huge change from days when employees occasionally stepped out of their work areas. Trans-Coil employees are now separated into work cells which focus on smaller order sizes which includes custom work, with teams responsible for getting products out o

The Rights Of Women In Afghanistan Sociology Essay

The Rights Of Women In Afghanistan Sociology Essay Majority of Afghanistans nationalities profess Islam as their religion. Originally Islam religion regards men more superior than women in every aspect of life. Due to civilization across the world, Islam reformed and some of its doctrines were changes in favor of women. Equality among human beings was included in Islam, regarding men and women equal in various ways. Since then Islam women acquired different rights that allow them to choose marriage partners, inherit, vote and work among other rights. In Afghanistan, women have experienced continued denial of such rights despite acceptance according to Islam doctrines (Mittra and Kunar 267). Fathers, husbands, brothers and government decrees are some of the factors that hinder women from enjoying their human rights in Afghanistan. Most of these restrictions were rampant during rule of Taliban who forced Afghan women to abandon their decent jobs such as teaching and remain indoors or when outside they ought to be in a mans escort. Since 2001, a new era began with end of Taliban reign; an improvement was recorded in regard to cultural and political position of women in Afghan. Human rights accepted under Islam law, so far are practiced in various parts of Afghan though in rural and remote areas many population regard women unequal (Zama and Sifton 25). For instance, cases of forced marriages, death threats due education matters and denial of chance to participate or enjoy public life are recordable according to research. Inequality and repressiveness of women in Afghanistan can be further be illustrated by statistics that show 75% of women are forced into marriages, 87% of women are illiterate, 33% of women experience sexual violence or physical assault, in every 30 minutes death occurs in relation to child birt h and only 30% of girls access education in Afghanistan. Literature review Introduction Afghanistan remains one of many Islamic regions where women are denied their rights and freedom. Despite acceptance by Islam Laws and governmental regulations and policies to uphold Afghan womans rights throughout in Afghanistan, many Islamic men have continued to oppress women. Most of womens rights have been upheld following intense campaigns by human rights activities from Afghan and other parts of the world (Thomsen 227). Also government efforts have helped in promoting equality by criminalizing oppression of women despite their originality and religion. Most of these changes are focused on matters that concern education, marriage and public life. In literature review section of this research, rights of Afghans woman in regard to freedom of live, dressing, education, marriage and expression will be discussed. Recommendations and conclusion will follow this discussion as part of this research work. Communication freedom Currently, Afghanistan is undergoing reconstruction after many years of war and reign of Taliban. During 1995-2001, Afghan remained under dictatorial leadership by Taliban who encouraged oppression of women and girls through out Afghan. Talibans brutality was to extent of denying women a chance to communicate with other women apart from family members. In most cases, women remained locked in their houses with small dark windows hence disallowing public intermingling. According to research, an Afghan woman could only walk to public with a company of a male counterpart who was supposed to be of the family (Osmańczyk and Mango 2708). These men act as a barrier to communication and information flow among women and men in public. Information could only be acquired from husbands, brothers and fathers who also were women oppressors according to Talibans regulations. Harsh circumstances under which afghan women lived in were not conducive for effective communication. Women associa tions that encourage information sharing in regard to social affairs are not allowed in most parts of Afghanistan. Information flow from one Woman to another is difficult in such situations hence hindering effective communication. As much as right of expression is among rights upheld by Afghan government, many women are denied such rights by men close in their lives. Womans opinion is regarded inferior and a chance to speak out is not availed to many women willing to do so. Rising of voices is made difficult due to widespread of discrimination against female gender in other major areas that contribute towards information flow. Lack of education for girl-child is a major hindrance to free flow of information. Many Afghan women can only converse in their vernacular languages due to illiteracy (Mittra and Kunar 143). Lack of access to education continues to pin many women down in decision making even those concerning their own plight. Lack of ideas coupled with fear is a key factor that makes Afghan women lag behind in raising their voices beyond their homestead. Freedom of communication by women is also prevented their lack of voting freedom. Many women are hindered fro acquiring voting cards to prevent them from taking part in political decisions. Instances of murder of electoral commissioners who tried to register women for voting processes show how far brutalism and discrimination against women has extended in Afghanistan (Thomsen 270). Such situations block womens effort to communicate their views in regard to type of governance they want. Similarly, women candidates can not be enrolled easily for similar positions to those held by men due to repression in association to voting rights. Women representatives in other parts of the world represent other women opinions therefore ensuring plight of female gender is communicated to authorities. In Afghan such chances are not provided hence continued lack of communication freedom. Additionally, lack of media freedom is another obstacle that contributes to communication problems in Afghanistan. Widespread violence coupled with political wrangles in Afghanistan prevents media efforts in steering women in fighting for their rights by speaking out loud. For instance, many journalists have been killed including and others such as Kambakhsh imprisoned for exercising their expression rights (Afkhami 179). Such situations leave women threatened and in fear of going against their male counterparts hence remain silent and oppressed. A country without freedom of expression by non-Taliban has efforts by women to communicate their views to governing bodies. Such strictness by rulers and men in the society has hindered efforts for free communication among women and men. This situation is changing as women with the support of their men, actively create awareness in regard to human equality across Afghanistan. Formation of RAWA in 1977 was an effort to eradicate violence against women and air their voices to the world. RAWA is an organization established by women and its goal is to promote Afghan women rights (Silkenat and Shulman 64). The organization major objective is to create awareness throughout Afghanistan concerning plight of girl-child and women. It also aims at reaching as many women as possible by communicating benefits of treating women with equality. Organization airs womens voices through conferences, public campaigns, internet and demonstrations. RAWA efforts have been realized over the years though right of expression by Afghan women is yet to be gained fully. Freedom of women and girls lives Since the seizure of power by the Taliban in Afghanistan, over 9 million women and girls have been denied basic human rights. This government has imposed laws against women citing religious purity while in the real sense it is persecution against women. For instance, Afghan women are not allowed to either go to school or work away from home a move which has led to closure of several schools owing to shortage of teaching staff as prior to the invasion of the Taliban about 70% of the teaching fraternity comprised of women (Afkhami 201). Devastating effects have been advanced towards widowed women who were the only source of livelihood for their families. In case women and girls want to leave their homes, then they must be escorted by a male relative. A whole body covering known as burqa must be worn. Instances of killings and beatings of the women have been witnessed due to failure of the women to be fully covered or escorted. Specific aspects of life on which Afghan women are oppresse d and to be discussed under this heading include education, marriage and dressing Education A large percentage of women in Afghanistan are illiterate due to banning of schooling for all women and successive wars in the nation had completely paralyzed the Education system. During the reign of the Taliban, community schools were opened and ran by women where girls were taught literacy skills, numeracy skills and such like subjects as Biology, English, cooking, and knitting (Zama and Sifton 27). Unfortunately instances of torture and killings of women teachers by the Taliban were witnessed. After the overthrow of the Taliban administration, substantial aid was advanced to the Karzai administration in order to restore the girl-child education. Lack of funding poses major setbacks to girl-child education with many girls opting to drop out as the facilities are not conducive. For instance, the learning facilities under unprotected structures like tents. Lack of women teachers means that majority of the girls do not attend school as their parents fail to place the care of the girls under men teachers. Since most of the girls schools were destroyed during the Taliban administration, girls and boys learn in the same facilities: a move which has caused massive criticism especially from high ranking government officials (Thomsen 184). This largely translates to discrimination and lack of freedom. Several Afghanistan women have consistently risked their lives by running clandestine schools for the women population. From 2001, Education facilities have recorded increased numbers of female students though persistent attacks by the Taliban as well as other forces present in the area continue to demean the progress achieved in the female Education sector. Cases girls dropping from schools before completing primary level education have been witnessed due to early marriages and family obligations Dressing The Afghanistan women have continually suffered turmoil especially in the type of dressing they are supposed to constantly wear. A specialty made traditional garment known as the Burqa which covers the whole body with a small grind for seeing and breathing must be worn by the women. The Burqa is extremely uncomfortable especially during hot weather (Silkenat and Shulman 58). The excessive covering may instigate illnesses such as asthma due to the discomfort of the dress as dust sticks thus enhancing dampness during breathing. The visibility of the wearer is largely limited as the size of the mesh opening does not provide adequate perceptibility. Afghanistan women claim that when they are wearing the burqa, total invisibility is exuded. It is impossible to know the kind of emotion displayed by a woman during normal conversation. Marriage In this patriarchal society, decisions are largely made by men fraternity. Women do not have the freedom to choose their marriage partners. Arranged marriages are largely advanced in this country based on economic and political reasons. Instances of girls being engaged before they are born are widespread (Zama and Sifton 54). The authority of who should marry a girl lies with the father who can opt to wed his daughter to a person who may be very old but rich. In areas badly hit by poverty, girls are sold off or exchanged for meals. Women are treated as properties as once the marriage contract is signed the girl cannot marry another man. In case she dies a suitable replacement must be offered. Violent cases have resulted when multiple betrothing is done so as to collect dowry from several men. Dowry payment is regarded as compensation for the care and upbringing of the bride. A married Afghanistan woman is controlled by the mother-in-law who makes such critical decisions on her behalf as whether to attend hospital or not and the activities to undertake (Thomsen 130). Women do not receive custody of children in case of a divorce. Though obtaining a divorce is largely difficult for women who are in abusive marriages, the divorced Afghanistan women are regarded as outcasts especially due to the Islamic beliefs and traditions. Recommendations Afghan women should fight for a chance to speak out and join others international women who are fighting against women oppression. By communicating their views to their spouses, brothers and the public will be a major start step towards their social life improvement. Freedom of expression is known as an effective tool for resistance against practices that oppress women. Lack of such freedom, means Afghan women may continue to tolerate discrimination by men under religious grounds which are used for personal political benefit. Social oppression can be overcome through speaking out in any context cultural, political or religious. Granting of women rights in education, employment , leadership and other roles in public life come as a primarily result of women expression against discrimination. Opening of communication channels in Afghanistan is a basic step in eliminating injustices that surround lives of many women and girls. Of importance is the right to vote, that has been used by many countries in defining future of women in those countries. I recommend Afghan women to retain and utilize their rights to vote intelligently as it is part of decision making. Through voting women elect leaders in support of their rights therefore acquiring access to equal opportunities similar to those awarded to men. Continued efforts by women by speaking out, eventually leads to liberation of girls and women from oppressive societal rules. Again, society starts to appreciate need to uphold plight of women and girls hence creating a balanced society that pays attention to both genders. International community should offer greater support to women organizations working with minority women at the grass roots. Awareness creations through educational programs are essential effort towards liberation of Afghan women from social, cultural, religious and political injustices in Afghanistan. International support through funding and enlightenment of few educated afghan women should be upheld as away of developing strong women leaders in Afghanistan. Conclusion In conclusion, Afghanistan is a region known for oppression of women and girls in various aspects of life. Existence of connection between Islam and governance of Afghans facilitates dehumanization among Afghan women. Most life rights and expression freedom are denied to female gender despite acceptance by Islam doctrines. Afghan constitutional rights are not upheld due lack of commitment by authorities concerned and political instabilities hence impacting on women by denying them their legal and human rights. International intervention has calmed Afghanistan human situation but majority of Afghan women and girls remain discriminated and repressed. Work-cited Afkhami, Mahnaz. Faith and freedom: womens human rights in the Muslim world. Syracuse, NY: Syracuse University Press, 1995. Mittra, Sangh and Kunar, Bachchan. Encyclopaedia of Women in South Asia: Afghanistan. New Delhi, India: Gyan Publishing House, 2004 Osmańczyk, Edmund and Mango, Anthony. Encyclopedia of the United Nations and International Agreements: T to Z. London, UK: Taylor Francis Press, 2003 Silkenat, James and Shulman, Mark. The imperial presidency and the consequences of 9/11: lawyers react to the global war on terrorism. Westport, U.S.A: Greenwood Publishing Group. 2007 Thomsen, Natasha. Womens rights. New York. U.S.A: Facts On File publisher, 2007 Zama, Coursen-Neff and Sifton, John. We want to live as humans: repression of women and girls in western Afghanistan. Washington, D.C: Human Rights Watch, 2002

The Relationship of Terrorism and Drugs Essay -- Persuasive Argumentat

The Relationship of Terrorism and Drugs Terrorism has many and varied links to the drug trade. Terrorists may use drugs for funding of their cause; may include drugs as part of their cause, as in Peru; or terrorism may be the result of the drug trade, as it is in Columbia's Extraditables and Italy's mafia. With the many linkages between the two crimes it seems that to crackdown on one you must crackdown on the other. The ties between the two are such that enforcement of one will hurt the other, to stop terrorism it would be useful to stop it's funding, purpose, and cause. Drugs are a renewable resource, it?s relatively inexpensive to grow them in fertile soil. There is an enormous profit margin in the drug trade so to those, like terrorists, who are already outside the law, the lure of easy money is strong. Many groups engage in drug trafficking. A notable example is Fuerzas Armadas Revolutionarias de Columbia (FARC) in Columbia. FARC is the military wing of the Columbian Communist Party and has been established since 1966. FARC has ?cooperated with drug interests, offering protection in exchange for money to purchase weapons and supplies? (Henderson, 61). There are other examples throughout the golden triangle and golden crescent where drugs are big business. ?Drugs have become the principle currency for the purchase of weapons? (Jamieson, 72) and this is a problem. Countries then find themselves attacked on two fronts, by both terrorists and the illicit drugs used for funding. Drugs provide funds through more than cultivation. Various grou ps aid in drug trafficking and gain funding through services, not growing, ?Tamils also find employment as couriers...as a means of financing their independence struggle in... ...organized crime is still terrorism, although it?s directed and self-serving it has political aspects and still fits most definitions. In these brief examples we gain a sense that the war on drugs and the war on terrorism overlap. These two efforts have bonds that need to be explored. In order to effectively target terrorism you also need to address the drug trade that in various instances provides funding, purpose, or reason for the terrorism. Bibliography: Henderson, Harry. Terrorism. New York: Facts on File, Inc., 2001 Jamieson, Alison. Terrorism and Drug Trafficking in the 1990s. Dartmouth: Research Institute for the Study of Conflict and Terrorism, 1994 Palmer, David Scott. ?Peru, the Drug Business and Shining Path: Between Scylla and Charbydis Journal of Interamerican Studies and World Affairs. Vol. 34, No. 3. PP 65-88

Sexism in Language Essay -- Language

Language refers to the method that humans use to communicate either through speech or written. It consists of the use of the word in a structured and conventional way. Language has been referred to as ‘our means of classifying and ordering the world; our means of manipulating reality. In structure and in its use we bring out the world into realisation and if it is inherently inaccurate, then we are misled. (Dale Spender, 1980).Language has power that allows us to make sense out of the reality we live in. Sexism is discrimination of a person based on their gender, especially on women. Sexism in language is the use of language which devalues members on one sex, almost always women, showing gender inequality. In the 1960/70’s there was a feminist campaign in Western Countries and a lot of research as conducted into gender inequality. The feminist campaign demanded that gender in equality should be eliminated from the educational system (Shi, 2001.) The existence of sexist l anguage is due to sexism in society and it is also related to social attitudes. There has been a movement amongst feminists to reduce sexual discrimination and it has led to a number of attempts to influence and change in language. Robert Hopper (2003) made a distinction between the terms ‘soft core’ and ‘hard core’ sexist language. He showed that ‘Soft core’ language was less obvious, subtle but still demeaning and patronizing to women. It was found to be more problematic because it was subtle and harder to spot. ‘Hard core’ sexism showed it to be easier to spot. Sexism in language takes many forms, though theses may be reduced to 3 types: language ignores, it defines and it deprecates women. Women and girls are hurt both physically and materially by it. Everyda... ... Language. Developmental Psychology. 20(4), 697-706. Lei, X. (2006). Sexism in Language. Journal of Language and Linguistics, 5 (1), 87-94. Mallett, R, Stangor, C, Swim, J.K. (2004). Understanding subtle sexism; Detection and Use of Sexist Language. Behavioural Science Sex Roles, 51(3/4) 117-128. Parks, J.B, Roberton, M.A. (2004). Attitudes Toward Women Mediate the Gender Effect on Attitudes Towards Sexist Language. Psychology of women Quarterly, 28(3), 233-239. Piercey, M. (2000), Sexism in the English Language. TESL Canada Journal, 17(2), 110-115. Turner-Bowker, M. (1996). Gender stereotyped descriptors in children's picture books: Does "Curious Jane" exist in the literature? Sex Roles, 35(7-8), 461-487. Ya-Lun, T. (2008). Child development (Research) Sex role (Portrayals) Children's literature (Educational aspects) Science & research, 45,(3), 310

Healthcare-associated infections (HAIs) Essay

BACKGROUND Healthcare-associated infections (HAIs) are bacterial infections acquired during a patient’s stay in a healthcare institution.   It imposes a huge burden on healthcare institutions, costing billions of dollars for additional care costs as well as a significant fraction of lost lives (Houghton, 2006).   Current estimates depict that approximately 2 million patients acquire healthcare-associated infections (HAIs) or nosocomial infections each year, of which 90,000 to 100,000 patients die (Houghton, 2006), making HAIs not only a national health problem, but a global threat as well.   Common HAIs include hematological, surgical site, dermatological, respiratory, urinary and gastrointestinal systems.   In order to control the increase in number of healthcare-associated infections, it is fundamental to identify key factors that make healthcare institutions susceptible to such outbreaks.   There is a need to evaluate the sensitivity and efficiency of healthcare institutions to healthcare-associated infections in order to prevent future outbreaks. PROBLEM STATEMENT   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   This study will investigate the sensitivity of detection and efficiency of reporting healthcare-associated infections to the hospital administration, in the context of providing measures in improving the current surveillance program in the country.   The guidelines to identification of a healthcare associated infection will be evaluated through personal interactions with healthcare workers using questionnaires which will be designed using a multiple choice approach. CONCEPTUAL/THEORETICAL FRAMEWORK   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   This study is based on the need to address the current epidemic of healthcare-associated infection that is emerging around the world.   Before an effective solution to the problem is designed, it is essential that shortcomings in the standard procedures of healthcare institutions be identified.   This may be done by determining the level of sensitivity of healthcare personnel to symptoms of healthcare-associated infections, as well as knowing what are the first set of actions to be done once an infection is confirmed within a healthcare institution.   This study may serve as the first measurement tool that addresses these aspects of the global epidemic.    RESEARCH QUESTION/HYPOTHESIS   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   This investigation aims to address the question of whether the current hospital administration is sensitive enough to detect and substantially efficient to report to healthcare institutions any incidents of healthcare-associated infections.   This will be directly evaluated using survey data collections from retrospective cases of particular health institutions as related to dates of hospital admission, confirmation of infection and treatment time.    SIGNIFICANCE OF THE STUDY   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   There is a need for an effective surveillance and control program for healthcare-associated infections that are based on current settings in a healthcare institution.   Through surveys that inquire on common practices and responses of healthcare workers, any shortcomings or avoidable gaps in the hospital system may be reformed, which in turn will alleviate the spread of infection in the healthcare institutions.   Review of medical records and interviews with attending healthcare personnel will be performed in order to determine whether there are certain discrepancies and gaps in the healthcare protocol that facilitate contamination and further spreading of infectious microbials around the healthcare institution.   This study may facilitate the identification of key factors that influence the increase in frequency of nosocomial infections in hospitals.   The results of this investigation may positively serve as a tool to healthcare workers such as nurses and laboratory technicians. STATEMENT OF THE PURPOSE (OBJECTIVES)   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   This research will determine the sensitivity and response rate of healthcare workers to healthcare-associated infections.   This proposal aims to develop a measurement tool that will determine the sensitivity for identification, efficiency of reporting and the response rate to a healthcare-association infection, with the aim of designing a cost-effective and quick way of controlling and ultimately eradicating the healthcare-related problem.       LITERATURE REVIEW   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The prevention and control of HAIs requires a comprehensive approach that addresses as many pathogens as possible (Wiseman, 2006). Urinary tract infections (UTI) associated with catheter use are the most common HAIs, with hospital-acquired pneumonia having the highest mortality rate (Houghton, 2006).   These infections are frequently problematic to treat due to the fact that the microorganisms involved have become resistant to antibiotics (Broadhead, Parra and Skelton, 2001). Recent media coverage of meticillin-resistant Staphylococcus aureus (MRSA) has increased the awareness of healthcare professionals to the threat of this particular microbe.   S. aureus infections can result in cellulitis, osteomyelitis, septic arthritis and pneumonia, and some of the systemic diseases such as food poisoning, scalded skin syndrome and toxic shock syndrome (Zaoutis, Dawid and Kim, 2002).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   MRSA and vancomycin-resistant Enterococcus (VRE) are the primary causes of nosocomial infections and are significant factors in increased morbidity and mortality rates. These microbes are currently endemic in many healthcare institutions, particularly problematic in intensive care units (ICUs) (Furuno, et al. 2005).   VRE Infections have become prevalent in U.S. hospitals over the last decade, increasing in incidence 25-fold (Ridwan et al., 2002).   Vancomycin is the antibiotic frequently used to treat infections caused by MRSA, but recent years have seen the emergence of Staphylococcus aureus infections that have high-resistance to vancomycin, which makes the future effectiveness of this drug questionable (Furuno et al., 2005). All known variants of the vancomycin-resistant Staphylococcus aureus (VRSA) isolates have possessed the vanA gene, which carries with it resistance to vancomycin.   This development is believed to have been acquired â€Å"when the MRSA isolate conjugated with a co-colonizing VRE isolate† (Furuno et al., 2005, p. 1539). This means that patients who suffer co-colonization from MRSA and VRE have an increased risk for colonization and infection by VRSA (Furuno et al., 2005). Furthermore, Zirakzadeh and Patel (2006) stated that VRE has become a major concern due, in part, to its ability to transfer vancomycin resistance to other bacteria, which includes MRSA.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Infection of susceptible patients typically occurs in environments that have a high rate of patient colonization with VRE, such as ICUs and oncology units (Zirakzadeh and Patel, 2006).   In these healthcare settings, VRE has been known to survive for extensive periods and research has also observed that VRE has the ability to contaminate virtually every surface (Zirakzadeh and Patel, 2006). Efforts to control HAIs, such as VRE, have focused on prevention, such as through hand hygiene, as the first line of defense.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Hand hygiene has been improved by using â€Å"user-friendly, alcohol-based hand cleansers, but there still remains the goal of achieving consistently high levels of compliance with their use† (Carling et al., 2005, p. 1).   Screening-based isolation practices have likewise improved transmission rates of MRSA and VRE; however, logistic issues and the cost-effectiveness of these practices are still being analyzed (Carling et al., 2005). Additionally, despite isolation practices, outbreaks and instances of environmental contamination have been documented in regards to MRSA, VRE and Clostridium difficile, which cannot be screened with any practicality (Carling et al., 2005).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The numerous obstacles that exist in regards to effective screening practices suggest that a focus on improving existing cleaning/disinfecting practices may prove to be more effective in halting the spread of HAIs (Carling et al., 2005). Studies over the last several decades have shown that there is often contamination of surfaces in and around the patient, as pathogens associated with the hospital environment have been known to survive on surfaces for weeks or even months (Carling et al., 2005). Significant rates of contamination with Clostridium difficile have been connected with symptomatic and asymptomatic patients (Carling et al., 2005).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In 2002, the CDC issued guidelines that called for hospitals to â€Å"thoroughly clean and disinfect environmental medical equipment† surfaces on a regular basis (Carling et al., 2005, p. 2). Other organizations have followed suit and stressed repeatedly the need for healthcare provides to focus on environmental cleaning and disinfecting activities, yet these guidelines have not provided directives that address precisely how healthcare providers can either evaluate   their ability to comply with professional guidelines on this topic or ensure that their procedures are effective (Carling et al., 2005).   Nevertheless, literature on the subject does offer some guidance.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Surveillance, evidence-based infection control practices and the responsible use of antibiotics have been determined to be crucial to controlling HAIs (Wiseman, 2006).   The establishment of comprehensive surveillance programs has facilitated the creation of national databases the compile cases of infection which may be useful to researchers investigating progression rates and causal factors.   Evidence-based control practices may be implemented by distributing guidelines for aseptic hospital protocols, hospital hygiene, personal protective equipment and disposal of biohazardous sharps.   A review of commonly used antibiotics in terms of proper dosage and length of treatment based on clinical evidence and best practice guidance should also be performed.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Curry and Cole (2001) reported that the medical and surgical ICUs in large inner-city teaching hospitals developed an elevated patient VRE colonization rate. A multi-faceted approach was instituted to correct this problem, which involved changing behavior by â€Å"shifting norms at multiple levels through the ICU community† (Curry and Cole, 2001, p. 13). This intervention consisted of five levels of behavioral change. These encompassed: â€Å"1. intrapersonal and individual factors; 2. interpersonal factors; 3. institutional factors; 4. community factors and 5. public factors† (Curry and Cole, 2001, p. 13).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Educational interventions were developed that addressed each level of influence and behavioral change was predicated on â€Å"modeling, observational learning and vicarious reinforcement† (Curry and Cole, 2001, p. 13). These procedures resulted in a marked decrease of â€Å"VRE surveillance cultures and positive clinical isolates† within six months and this decrease has been consistent over the next two years (Curry and Cole, 2001, p. 13).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Research has shown that the nutritional status of preoperative and perioperative patients can influence their risk for acquiring a HAI (Martindale and Cresci, 2005). This is particularly true for patients who are undergoing surgery for neoplastic disease as this can commonly result in immunosuppression (Martindale and Cresci, 2005). Inadequate nutrition, â€Å"surgical insult, anesthesia, blood transfusions, adjuvant chemotherapy/radiation/ and other metabolic changes† have been identified as contributing to suppression of the immune system (Martindale and Cresci, 2005). Furthermore, studies have also associated infection risk with glycemic control Maintaining blood glucose levels between 80 and 110 mg/dL vs. 180 and 200 mg/dL has been shown to result in fewer instances of â€Å"acute renal failure, fewer transfusions, less polyneuroopathy and decreased ICU length of stay† (Martindale and Cresci, 2005, p. S53).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Citing Ulrich and Zimring, Rollins (2004) states that getting rid of double-occupancy rooms and providing all patients with single rooms that can be adjusted to meet their specific medical needs can improve patient safety by reducing patient transfers and cutting the risk of nosocomial infections. While these researchers admit that the up-front cost of private rooms is significant, this will be offset by the savings accrued through lowers rates of infection and readmission, as well as shorter hospital stays (Rollins, 2004).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   A recent study conducted by researchers at Chicago’s Rush University Medical Center found that enforcing environmental cleaning standards on a routine basis resulted in less surface contamination with VRE, â€Å"cleaner healthcare worker hands, and a significant reduction in VRE cross-transmission in an ICU† (Cleaning campaign, 2006, p. 30). These improvement in VRE contamination continued to be experienced even when VRE-colonized patients were continually admitted and healthcare workers compliance with hand hygiene procedures were only moderate (Cleaning campaign, 2006). The strategies that the researchers implemented included that they: held in-services for housekeepers about why cleaning is important–emphasizing thorough cleaning of surfaces likely to be touched by patients or workers. increased monitoring of housekeeper performance. recruited respiratory therapists to clean ventilator control panels daily. educated nurses and other ICU staff on VRE and how they could assist housekeepers by clearing surfaces that need cleaning. conducted a hand hygiene campaign, including: mounting alcohol gel dispensers in common areas, patient rooms and every room entrance (Cleaning campaign, 2006, p. 30).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   CDC guidelines indicate that if hands are not visibly soiled, using an alcohol-based hand rub should become habitual between patient contacts. When hands are visibly soiled, use of an anti-microbial soap and water is required. If contact with C difficile or Bacillus anthracis is possible, it is recommended that the healthcare provider wash with anti-microbial soap and water, as other antiseptic agents have poor efficacy against spore-forming bacteria and the physical friction of using soap and water at least decreases the level of contamination (Houghton, 2006). Page (2005) indicates that the CDC has joined with the US Department of Health and Human Services, the National Institutes of Health (NIH and the Food and Drug Administration (FDA) to lead a task force of 10 agencies and departments, which have developed a blueprint outlining federal actions to combat this problem. This template emphasizes the efficacy of hand washing, among other points (Page, 2005).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In 2002, the CDC issued updated hand hygiene guidelines, which address new development and research on this topic, such as â€Å"alcohol-based hand rubs and alternatives to antibacterial soaps and water† (Houghton, 2006, p. 2). However, while the efficacy of hand hygiene is well accepted, it is also well known that healthcare workers â€Å"of all disciplines† frequently fail to abide by adequate hand hygiene practices (Houghton, 2006, p. 2). In fact, research has shown that adherence rates to hand hygiene guidelines are lowest in ICUs, where to the frequency of patient care contact, multiple opportunities for hand hygiene exist on a hourly basis (Houghton, 2006). According to Houghton (2006), any direct patient-care contact, which includes contact with gloves and/or contact with objects in the immediate patient vicinity, constitutes an â€Å"opportunity† for appropriate hand hygiene.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   This suggests that the proposed intervention should also include asking healthcare employees at the site of the intervention to participate in a survey that examines, first of all, how closely hand hygiene protocols are followed and, if they are not followed, why not. It may be that the activity level of ICUs is so great that the practitioners feel that they cannot take sufficient time to do adequate hand hygiene. If this is the case, alternative methods of hand hygiene to that institution’s traditional policy may need to be investigated.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Just as this study revealed factors that can be associated with non-compliance, a similar investigative effort may be called for to determine reasons why compliance may not be satisfactory for cleaning/disinfecting environmental surfaces. Again, it may be that non-compliance hinges on factors of time.   It may be, therefore, expeditious for hospitals and other healthcare organizations to look into hiring additional personnel to aid with cleaning/disinfecting tasks. It may also prove necessary, to cope with factors of time and efficiency, to train cleaning personnel to take a systematic approach to patient room cleaning that includes all â€Å"high touch† areas. As noted previously, researchers at Chicago’s Rush University Medical Center found that holding in-service training for housekeepers was an effective component of their overall strategy in lowering VRE related infections (Cleaning campaign, 2006). This process could be facilitated by a checklist approach or by periodically reevaluating rooms according to the Carling et al. (2005) methodology.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Given these detailed accounts of healthcare-associated infections in hospitals, it is of significant importance that the sensitivity and response rate of health personnel be identified in order to know if there are any discrepancies and gaps in the standard hospital protocols that foster the expansion of microbials in hospitals.   This study aims to determine the level of sensitivity and response rate of healthcare institutions to the growing epidemic of healthcare-associated infections.    SUMMARY   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   HAIs are an unnecessary tragedy, increasing morbidity and mortality figures and adding to healthcare costs. While there are ways to treat all the various HAIs, the clearest remedy for this insidious drain on healthcare resources and personnel is prevention, which begins with the simplest of acts–washing one’s hands–but also extends to considering all hospital surfaces as having the potential to harbor pathogens. This means rethinking some healthcare institutional procedures. It means habitually and routinely cleaning all surfaces, as well as everywhere and anything that is routinely touched, whether by a bare or gloved hand.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Stopping the spread of HAIs includes multiple factors, such as restrained and appropriate use of antibiotics. However, the first line of defense is cleaning/disinfecting procedures. This constitutes the â€Å"ground zero† foundational line for battling HAIs and this means that all healthcare practitioners should keep the goal of reducing the spread of HAIs foremost in their minds while going about their daily routines, washing hands between each patient contact and paying attention to other sepsis concerns. In other words, the first step in stopping HAIs is simply to keep them in the forefront of practitioner consciousness. References Broadhead, J. M., Parra, D. S., & Skelton, P. A. (2001). Emerging multiresistant organisms in the ICU: Epidemiology, risk factors, surveillance, and prevention. Critical Care Nursing Quarterly, 24(2), 20. Carling, P. C., Briggs, J., Hylander, D., & Perkins, J. (2006). An evaluation of patient area cleaning in 3 hospitals using a novel targeting methodology. American Journal of Infection Control, 34(8), 513-519. Centers for Disease Control and Prevention. (2006). Healthcare-Associated Infections (HAIs).  Ã‚   Retrieved March 17, 2007, from http://www.cdc.gov/ncidod/dhqp/healthDis.html Cleaning campaign targets VRE transmission. (2006). OR Manager, 22(7), 30. Curry, V. J., & Cole, M. (2001). Applying social and behavioral theory as a template in containing and confining VRE. Critical Care Nursing Quarterly, 24(2), 13. Furuno, J. P., Perencevich, E. N., Johnson, J. A., Wright, M.-O., McGregor, J. C., Morris Jr, J. G., et al. (2005). Methicillin-resistant Staphylococcus aureus and Vancomycin-resistant Enterococci co-colonization. Emerging Infectious Diseases, 11(10), 1539-1544. Harrison, S., & Lipley, N. (2006). Wipe It Out infection control initiative extended. Nursing Management – UK, 12(10), 4-4. Houghton, D. (2006). HAI prevention: The power is in your hands. Nursing Management, 37(5), 1-8. Johnson, A.P. Pearson, A. and Duckworth, G.   (2005):   Surveillance and epidemiology of MRSA bacteraemia in the UK.   J. Antimicrob. Chemo.   56:455–462. Lopman, B.A., Reacher, M.H., Vipond, I/.B., Hill, D., Perry, C., Halladay, T., Brown, D.W., John Edmunds, W. and Sarangi, J.   (2004):   Epidemiology and Cost of Nosocomial Gastroenteritis, Avon, England, 2002–2003.   Emerg. Infect. Dis.   10(10):1827-1834. Martindale, R. G., & Cresci, G. (2005). Preventing Infectious Complications With Nutrition Intervention. JPEN, Journal of Parenteral and Enteral Nutrition, 29(1), S53. Page, S. (2005). MRSA, VRE and CDC’s plan to combat antimicrobial resistance. Vermont Nurse Connection, 8(3), 6-7. Parienti, J. J. M. D. D. T. M., Thibon, P. M. D., Heller, R. P. P., Le Roux, Y. M. D. D., von Theobald, P. M. D. D., Bensadoun, H. M. D. D., et al. (2002). Hand-rubbing with an aqueous alcoholic aolution vs traditional surgical hand-scrubbing and 30-day surgical site infection Rates. JAMA, 288(6), 722-727. Ridwan, B., Mascini, E., Reijden, N. v. d., Verhoef, J., & Bonten, M. (2002). What action should be taken to prevent spread of vancomycin resistant enterococci in European hospitals? British Medical Journal, 324(7338), 666. Rollins, J. A. (2004). Evidence-Based Hospital Design Improves Health Care Outcomes for Patients, Families, and Staff. Pediatric Nursing, 30(4), 338. Sheff, B. (2001). Taking aim at antibiotic-resistant bacteria. Nursing, 31(11), 62. STATA 8.0. College Station (TX): STATA Corporation; 2002. Stevenson, K.B., Searle, K., Stoddard, G.J. and Samore, M.H. (2005):   Methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococci in rural communities, Western United States.   Emerg. Infect. Dis.   11(6):895-903. Tacconelli, E. Venkataraman, L., De Girolami, P.C. and D’Agata, E.M.C.   (2004):   Methicillin-resistant Staphylococcus aureus bacteraemia diagnosed at hospital admission: distinguishing between community-acquired versus healthcare-associated strains.   J. Antimicrob. Chemother. 53:474-479. Wiseman, S. (2006). Prevention and control of healthcare associated infection. Nursing Standard, 20(38), 41-45. Zaoutis, T., Dawid, S., & Kim, J. O. (2002). Multidrug-resistan organisms in general pediatrics. Pediatric Annals, 31(5), 313. Zirakzadeh, A., & Patel, R. (2006). Vancomycin-resistant enterococci: Colonization, infection, detection and treatment. Mayo Clinical Proceedings, 81(4), 529-536. METHODOLOGY   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   A retrospective non-probability cluster surveillance study will be performed on hospital records of two health institutions, Assir Central Hospital and Khamis Mushait Hospital from January 2002 to December 2006.   Such coverage will represent a larger population of similar environmental and socioeconomic settings, which may also influence the frequency of healthcare-associated infections in the area.   This type of non-probability cluster sampling will be used because it will benefit the split-level definition that will be followed, distinguishing normal hospital cases and healthcare-associated infections or outbreaks, based on the CDC’s guidelines for healthcare-associated infections.   Ethical approval from the respective ethics review committee of each hospital will be obtained before the study will be conducted. Study population.   ThÐ µ study population will includÐ µ 5,000 patiÐ µnts that have been admitted at the Assir Central Hospital and Khamis Mushait Hospital from January 2002 to December 2006.   These hospitals were chosen in order to primarily focus on collection of reliable, high-quality data based of systematic sampling.   The hospital’s administrative database will serve as the main source of information for this study.   For purposes of anonymity, patient’s names will be kept confidential and will be replaced with a case number instead.   A retrospective non-probability sampling using patiÐ µnt cases will be classified according to gender, age, diagnosis upon admission, length of stay and treatment received. The treatment category of the patients will be further characterized as surgical, respiratory, urinary, urological, obstÐ µtrical, intensive care, cardiac or trauma.   Any co-morbidities will be taken note of in every patient included in the study.   Patient records will also be reviewed to determine whether and when a healthcare-associated infection was observed after admission to the hospital or during the patient’s stay in the hospital and will be identified as the time-at-risk, or the time when the infection has been ascertained and may most probably be contagious to the patient’s immediate environment.   Among the inclusion subjects are healthcare workers such as nurses, laboratory technicians and other hospital staff members will be included in the study as population at risk.   Exclusion subjects are those patients that were not admitted into the hospital because their stay in the hospital was not recommended during their healthcare.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The database of the infection control team of each of the two hospitals will be reviewed to gather information on the study population in the hospitals.   Infection control nurses are responsible for monitoring any outbreaks in each hospital during hospital ward rounds, or are identified as the point-of-contact personnel that is alerted as soon as an HAI incident is suspected to occur in the specific ward of the hospital.   Cluster sampling will be performed when an infection does happen that fits the clinical definition of an HAI, the healthcare institution is required to report this incident to the area’s or county’s health protection agency.   The area or county health protection agency is in charge of ensuring the comprehensiveness of incident reports, monitoring data entry and conducting analyses.   The health protection agency also collects reports during months that no infections were reported to verify that no inf ections occurred at that time. Tools to be employed.   To determine whether a case patient has contracted a healthcare-associated infection, the system definitions established by the Center for Disease Control and Prevention’s National Nosocomial Infection Surveillance (NNIS) will be followed, with slight modification for usÐ µ in a rÐ µtrospÐ µctivÐ µ study.   ThÐ µ NNIS dÐ µfinitions were dÐ µvÐ µlopÐ µd according to a prospÐ µctivÐ µ approach to hospital survÐ µillancÐ µ and arÐ µ dÐ µsignÐ µd to bÐ µ quitÐ µ spÐ µcific.   BÐ µcausÐ µ clinical dÐ µcisions arÐ µ oftÐ µn not madÐ µ on thÐ µ basis of survÐ µillancÐ µ dÐ µfinitions, wÐ µ bÐ µliÐ µvÐ µ that somÐ µ casÐ µs of clinically suspÐ µctÐ µd infÐ µction would mÐ µÃ µt most but not all of thÐ µ NNIS critÐ µria and thus bÐ µ classifiÐ µd as non-HAI, Ð µspÐ µcially on a rÐ µtrospÐ µctivÐ µ chart rÐ µviÐ µw. WÐ µ designed a retrospective-based data classification scheme that follows the following criteria: patiÐ µnts who were not infÐ µctÐ µd, thosÐ µ with suspÐ µctÐ µd HAI, and thosÐ µ with confirmÐ µd HAI.   In gÐ µnÐ µral, patiÐ µnts with suspÐ µctÐ µd HAI will includÐ µ thosÐ µ who have received antimicrobial thÐ µrapy for a condition that appÐ µarÐ µd 148 h aftÐ µr hospital admission and who will mÐ µÃ µt all but onÐ µ clinical critÐ µria for a confirmed infÐ µction.   DÐ µfinitions for a confirmed HAI will bÐ µ the samÐ µ as thosÐ µ usÐ µd by thÐ µ NNIS, Ð µxcÐ µpt that rÐ µcÐ µipt of appropriatÐ µ antimicrobial thÐ µrapy will bÐ µ Ð µxcludÐ µd as a critÐ µrion for a confirmÐ µd infÐ µction. ThÐ µsÐ µ critÐ µria will bÐ µ finalizÐ µd bÐ µforÐ µ chart data abstraction bÐ µgins.   ThÐ µ Ð µconomic pÐ µrspÐ µctivÐ µ will bÐ µ usÐ µd for mÐ µasuring costs incurred by thÐ µ hospital, bÐ µcausÐ µ thÐ µ hospital administ ration will bÐ µ thÐ µ dÐ µcision makÐ µr for instituting and financing infÐ µction control programs. Data collÐ µction.   Clinical cases of healthcare-associated infection identified by the clinical laboratories of the two participating hospitals will be compiled.   Demographic, medical history and other epidemiologically relevant data on each reported case will be collected.   The microbiology laboratory of the hospital may also contribute information to the data collection.   The patient’s medical record will serve as the primary source of information for this study.   The data collected will be recorded in a standardized data collection form.   In addition, outbreak or infection summary forms that were previously completed by infection control nurses and reported to health protection agencies as a healthcare-associated infection will be collected and integrated into the study database. The duration of an outbreak will be determined by taking note of the date the first case of the infection was reported and correlating this date to the date when the last case of the infection was reported at the healthcare institution (Lopman et al. 2004).   All data will abstracted from patiÐ µnt mÐ µdical rÐ µcords of the healthcare facility.   IntÐ µrratÐ µr rÐ µliability will not bÐ µ mÐ µasurÐ µd, bÐ µcausÐ µ Ð µach abstractor will bÐ µ focusÐ µd on rÐ µcording a singlÐ µ Ð µlÐ µmÐ µnt of data for Ð µach patiÐ µnt, similar to an assÐ µmbly linÐ µ.   All data gathering will bÐ µ dirÐ µctly supÐ µrvisÐ µd by a member of the research program.   PatiÐ µnts with suspÐ µctÐ µd or confirmÐ µd HAI will bÐ µ idÐ µntifiÐ µd on thÐ µ basis of thÐ µir vital signs, laboratory and microbiology data, and clinical findings documÐ µntÐ µd in the respective physician’s progrÐ µss and consultation notÐ µs. To improve the validity of the collected data, the following approaches (Stevenson et al. 2005) will be employed:   1) a data dictionary and operations manual will be created with explicit instructions for completion of the data collection forms; 2) the data collection protocol will be discussed during conference calls along with frequent one-on-one communication; and 3) anomalous data in the data reports will be routinely searched for and corrected.   The definitions employed in this study will concentrate on the location of the patient at the time of microbiological testing for infection diagnosis, and the presence or of exposure to the healthcare environment.   The study will emphasize the time of response of any member of the healthcare institution to the definitive diagnosis of the healthcare-associated infection (Johnson et al. 2005).   Each identified HAI case will be further analyzed for its causative agent, such as MRSA or VRE.   All included in this study were HAI cases with any prior history of hospitalization, out-patient surgery, residence or care in a home/health agency with documented healthcare-associated infections in the last 6 months.   Examples would include former out-patient cases with post-operative infections.   Other coexisting factors that may be associated with healthcare-associated infections such as diabetes mellitus, immunosuppression, renal failure and other antimicrobial drug treatments, will also be included in the data collection form. The incidence rates of each type of healthcare-associated infection will be calculated for each hospital from January 2002 to December 2006.   Any patient cases that could not be ascertained to be completely reported in the medical records will not be included in the analysis.   The incidence rates will be expressed as the number of healthcare-associated infections per 10,000 patient-days or number of community cases per 10,000-person-years, based on county population (Taconelli et al. 2004). Instruments including reliability and validity.   A data collection form will be designed for use in this investigation.   Essential entry data will include case number (patient name is kept confidential), hospital name, date of admission, diagnosis upon admission, treatment regime, date of detection of healthcare-associated infection, treatment of healthcare-associated infection, date of admission of treatment of healthcare-associated infection, identification of HAI etiologic agent, resistance of HAI etiologic agent and date of patient discharge.   The healthcare institution personnel that have attended to the patient will also be noted, such as attending physician, consults, nurses, technicians and technologists.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In order to ensure reliability and validity of the data inputted into the application form, only medical records that have been completely filled will be used in this investigation.   In addition, there will be questions in the application form that will determine whether the patient has undergone any previous exposure to any hospital for outpatient or inpatient hospital or nursing facility in the last 6 months.   This is done to make sure that the source of the HAI is determined, whether it is coming from within the hospital or from another healthcare institution. Data Analysis.   The collected data will be entered and stored in an AccessTM relational database (Microsoft, Redmond, WA) for analysis.   AccessTM is a database management system that is very useful for handling and manipulation of data that are designed in the query format.   It provides the analyst an easier way to extract data from the database according to selected fields or variables, as well as compare or combine two variables at one time. Data analyses will be performed using Microsoft ExcelTM and Stata 8.0 (2002).   Proportions of total cases meeting specific epidemiologic criteria will be calculated, and characteristics of each category will be compared by using Fisher exact testing.   To compare means, the t-test will be employed, and to compare proportions, the χ2 test will be used.   All continuous data will be analyzed using linear regression.   To assess linear correlations between two variables, the Spearman rank test will be used.   Census data and ages of patients in each category will be compared using the Kruskal-Wallis equality of populations rank test.   The relationship of healthcare institution response rates to the infection and other covariates will be modeled by using random effects Poisson regression. Each hospital will be taken into account as a unit and treated as a random effect.   During thÐ µ initial phasÐ µ of data collection, dÐ µscriptivÐ µ statistics will be used to dÐ µscribÐ µ and summarizÐ µ thÐ µ data obtained in thÐ µ study.   ThÐ µ sÐ µcond phasÐ µ of analysis will focus on thÐ µ usÐ µ of multivariatÐ µ analysis to dÐ µtÐ µrminÐ µ thÐ µ rÐ µlationship bÐ µtwÐ µÃ µn variables such as length of stay and the severity of infection.   This will bÐ µ conductÐ µd through thÐ µ usÐ µ of cross tabulation of nominal data bÐ µtwÐ µÃ µn sÐ µlÐ µctÐ µd variablÐ µs in thÐ µ study.   Statistical significancÐ µ is to bÐ µ sÐ µt at an alpha lÐ µvÐ µl of 0.05; ANOVA will bÐ µ usÐ µd to Ð µxaminÐ µ thÐ µ variation among thÐ µ data. Along with it, ordinary lÐ µast-squarÐ µs (OLS) rÐ µgrÐ µssion will bÐ µ usÐ µd to tÐ µst for linÐ µar rÐ µlationships bÐ µtwÐ µÃ µn variables tested.   SuspÐ µctÐ µd HAI, confirmÐ µd HA I, and admission to ICU will bÐ µ codÐ µd as dummy variablÐ µs, with thÐ µ valuÐ µs of 1 that will bÐ µ assignÐ µd for patiÐ µnts with thÐ µ attributÐ µ and 0 for thosÐ µ without it. WhÐ µn prÐ µsÐ µnt, thÐ µsÐ µ dichotomous variablÐ µs act as intÐ µrcÐ µpt shiftÐ µrs but do not changÐ µ thÐ µ slopÐ µ of thÐ µ Ð µstimatÐ µd rÐ µgrÐ µssion linÐ µ. Limitations of the study.   Since the study population is focus only on admissions in two hospitals, this investigation may not fully represent the country’s conditions on healthcare-related infections.   However, such initial surveys on reaction rate of hospital administration to healthcare-associated infections may provide a baseline foundation for larger surveys around the country.       Ethical considerations.   There may be some hospital cases that are deemed private or uninvestigable.   These will not be included in the investigation.   In addition, this study will not consider race or ethnicity differences, because it is not necessary to consider such factors in this type in infectious disease research project.    Feasibility of the scope of this study.   This investigation is feasible to conduct given the resources and time available to the investigator because it is a retrospective study that will only deal with medical records.   Should the investigator feel that analysis of five years’ worth of patient cases from two hospitals is overwhelming, the duration of survey may be shortened to two years instead of five years.   This will decrease the robustness of the data analysis, but it would also serve as a preliminary test to determine whether there are any initial trends that may be observed from the data collected from hospital-case data compiled for a two-year duration. Summary assessment.   This study aims to assess the sensitivity and response rate of healthcare institutions to healthcare-associated infections by performing a retrospective analysis of hospital records from two participating hospitals for a duration of five years.   Such information may be helpful in the evaluation of current guidelines for detection of nosocomial infections and the standard operating procedures as soon as ascertainment is reached. Recommendation.   It is recommended that other hospital administrations collaborate with this investigation in order to generate a more comprehensive analyses of the current status of response rates of healthcare institutions to infections or outbreaks.   Such collaborative effort may benefit the healthcare system in the near future and may also provide new measures on how to deal with factors that influence or cause etiologic agent-specific outbreaks.