Enhancing Medication Adherence Through Technology-Assisted Therapy Drug Monitoring

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1. Introduction
Now there are so many emerging technologies that can help therapy, and one of them is a mobile app. A mobile app has very broad access and is suitable for use in reminder and monitoring systems. It can be an alternative to the reminder systems that have been tried using short message service. This mobile app can provide added value in a reminder system because it can have a direct connection to monitoring. Furthermore, this app might facilitate more patients with a variety of features, for example, a simple reminder with a calendar display, education using video, and a chat with medical personnel.
Enhancing adherence to medication can be done in many ways. The previous meta-analysis showed that adherence could improve significantly using reminding systems. The reminder systems themselves can be tailored to the patient’s problem, for example, reminders for patients who are forgetful or education for patients who do not take the meds due to their beliefs. Although reminding systems have proved to be effective at improving adherence, there was not one patient who did not go back to non-adherence. Patients stop taking their meds because they feel no benefit or the meds cause adverse effects. To detect this, a monitoring system is needed. The monitoring can detect whether a patient is still taking their meds and what the outcome of the meds is. This information can be used as feedback to the patient because the patient is still not aware that what they are feeling now is the result of discontinuation of meds. Detection of the outcome of meds is used as a consideration for doctors whether to adjust or change the therapy that has been done. Taking it a step further, the result of monitoring can also be used as evidence for research on the meds. Although so promising, there was not one study that reported using monitoring systems for meds. This drug monitoring can be a bridge to the continuation of the use of reminding systems.
Adherence to medication is so essential that without it, it can cause serious health problems, even death. There are so many clinical studies that have observed the problem of low adherence to medication and have tried to explain it. One of the studies showed that non-adherence to meds reaches 4% – 23% in developed countries, 2% – 59% in developing countries, and 1% – 50% in developed countries. Another study reviewed adherence to meds in long-term therapy in more detail and concluded that most of the patients stopped taking their meds when the meds showed no benefit for them or when the meds caused adverse effects. Low adherence to medication happens not only in developing countries but also in developed countries with different kinds of health problems and meds. This leads to the necessity of finding any method to improve adherence to medication.
1.1. Background
Improved adherence to medication could save many lives and reduce health care costs. Reasons given for poor adherence are varied. They include patient beliefs about their illness and medication (e.g. what it is, its cause, expected duration and perceived severity), characteristics of the treatment regimen (e.g. complexity, duration and side effects) and also importantly, characteristics of the patient. This is a substantial task for the healthcare professional to identify and try to change in order to improve adherence. High rates of poor adherence led to recommendations to assess patient adherence on each visit. However, patients have been shown to overestimate their adherence and many physicians do not accurately assess their patient’s adherence [4]. A study of orthopaedic outpatients found a 40% discrepancy between physician and patient reports of recommended treatment regimens [5]. A more accurate and convenient method of monitoring patient adherence is needed.
The World Health Organisation recognises that improving adherence to medication is crucial to improving health outcomes. Patients with chronic conditions often do not adhere to their medication regimens. A review of 569 studies examining adherence to long-term medication regimens found that on average 24% of doses were not taken; adherence was 75%; and half of the patients stopped their medication within a year [2]. Poor adherence is a major cause of increased morbidity and mortality as well as a reduced quality of life. A study of 96,000 hypertensive patients found that a 20% decrease in adherence was associated with a 14% increase in the risk of death or MI [3]. It is estimated that increasing adherence to medication regimens would have a greater impact on the health of the population than any improvement in specific medical treatments.
1.2. Purpose
The purpose of this essay is to examine the effect of enhanced therapy and drug monitoring on medication adherence. It will also discuss the use of technology in aiding medication adherence. The focus is on the improvements in adherence resulting from the use of a combined intervention of a modified directly observed therapy (MDOT) monitoring system in conjunction with home-based video in asthmatic children and their caregivers. This intervention has not been discussed in prior studies and the early evidence of its efficacy is encouraging. Asthma is chosen as the model disease because of its prevalence, high rate of hospitalization, and necessity for preventative therapy. With the high usage of inhaled corticosteroids and their known side effects, adherence must make adherence a primary concern in the care of pediatric asthma. This essay will use this ongoing study as a reference in the relationship between adherence and clinical outcome. The evidence from other studies on the effects of adherence on clinical outcome will be cited to show the importance of adherence in the care of chronic illness. Technology has been widely used to monitor adherence, and this essay will examine its effect in comparison to traditional methods of adherence monitoring. This essay will also explore possible future advances in medical adherence and how they may affect clinical outcomes in chronic illness.
1.3. Scope
The scope of this essay is to determine if medication adherence among adults 18-64 years of age with a diagnosis of schizophrenia can be increased through the use of technology-assisted therapy drug monitoring and to identify barriers to use of the technology. Medications to treat chronic conditions have often proven to be effective; however, only if taken as prescribed. Among individuals with schizophrenia, nonadherence to antipsychotic medications can range from 40-89% and tends to be highest during the first few months after initial prescription. Nonadherence with antipsychotic regimens can result in a higher risk of relapse, rehospitalization, and suicide-related events and is also associated with higher total costs of care. Types of adherence measurement in the research included: pill count, self-report, clinician rating, monitoring of appointments, and biochemical measures. The most often used approach to measure medication adherence is a patient self report which tends to overestimate adherence levels. Due to limitations of research designs and cultural differences in validity of adherence measures, it is suggested that multiple measures should be used in adherence research. An interactive Voice Response System was found to be effective in specifically identifying nonadherent individuals and inquiring about their reasons for nonadherence. However, this method does not assess actual medication taking, relies on a landline telephone, and is no longer commonly used. Currently the most effective way to monitor medication adherence is using electronic methods. Assessment of electronic monitoring adherence interventions found a significant but small effect in improving adherence when compared to control groups (OR=1.50, 95% CI 1.19-1.90). Due to the findings of this meta-analysis, our research question, was there a change in adherence to antipsychotic medications among adults with schizophrenia after the use of technology-assisted therapy drug monitoring, is relevant in the determination of more effective methods for improving medication adherence.
2. Importance of Medication Adherence
2.1. Impact on Patient Outcomes
2.2. Economic Implications
2.3. Challenges in Medication Adherence
3. Technology-Assisted Therapy
3.1. Definition and Overview
3.2. Types of Technology-Assisted Therapy
3.2.1. Mobile Applications
3.2.2. Smart Pill Dispensers
3.2.3. Electronic Monitoring Devices
4. Drug Monitoring in Medication Adherence
4.1. Role of Drug Monitoring
4.2. Methods of Drug Monitoring
4.2.1. Urine Drug Testing
4.2.2. Blood Testing
4.2.3. Saliva Testing
5. Benefits of Technology-Assisted Drug Monitoring
5.1. Real-Time Data Collection
5.2. Improved Accuracy and Compliance
5.3. Enhanced Patient Engagement
6. Challenges and Limitations
6.1. Privacy and Security Concerns
6.2. Technological Barriers
6.3. Patient Acceptance and Adoption
7. Case Studies
7.1. Case Study 1: Implementation of Mobile Applications
7.2. Case Study 2: Smart Pill Dispenser Pilot Program
7.3. Case Study 3: Electronic Monitoring Device in Clinical Trials
8. Future Directions and Innovations
8.1. Artificial Intelligence in Medication Adherence
8.2. Wearable Technology for Drug Monitoring
8.3. Integration with Electronic Health Records

Ethical and Legal Challenges in the Collection, Management, and Use of Information and Technologies

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Questions
1)  From your perspective what are the major ethical and legal challenges and risks for abuse that we must keep top of mind in the collection, management, and use of information and technologies overall—and in the public arena specifically? 
2)  Suggest guidelines to help prevent unethical uses of data in general and especially in the public sector.

Answer
1. Ethical Challenges
The rapid development of information technology has led to situations of increased uncertainty and the definition on how existing rights apply to new technologies. This has led to a consideration of an information society framework for the protection of the individual in regards to privacy, data security, accountability, and the right to access on the occasion of the widespread collection and identification of personal information.
Privacy is a right that individuals and groups can have control over the extent, timing and circumstances of sharing themselves with others. The freedom from unreasonable and unwarranted intrusion into our private lives is now recognized as a fundamental human right. Data security is the right of individuals and organizations to be assured that their data and the systems processing it are secure and not accessible to third parties. Measures used to ensure data security include confidentiality (limiting access to information), integrity (maintenance of accuracy and consistency of data over its life), authenticity, and privacy.
Concerns about ethical implications of information and technology are spread out within this field, but the main concerns are concentrated around issues regarding individual rights, fairness, accountability, and the impact on society. What information should a person or an organization have the right to keep to themselves? What data about others should they be required to share? What is an equitable distribution of resources and access? How can the rights and interests of various individuals and stakeholder groups be safeguarded? And just who is being well served by information technology?
1.1. Privacy concerns
Privacy is the ability of an individual or group to seclude themselves or information about themselves and thereby reveal information selectively. The essay’s focus on privacy centers on the increasing move by governments and business organizations to use computers to store data about individuals. The computer has led to a growing move towards the use of personal data as computers are very effective record keepers. Using the Internet, vast amounts of personal data can be retrieved and even more personal data can be gleaned, often without the knowledge of the person concerned. This often results in the inference of information about an individual who would prefer to remain anonymous. The storing and accessing of personal data can result in damaging disclosures about an individual. There are numerous ways in which privacy stands to be eroded in the information age. For instance, electronic surveillance using powerful surveillance technologies has great potential for invasions of privacy. Data matching is a technique used to compare two sets of data, such as the list of names on a payroll and the list of names receiving welfare benefits, in order to determine if there is any correlation between the two. If data is stored on an individual in both these sets of data, it is highly likely that there will be a disclosure of personal information in such a scenario. Though data matching can be a useful tool, it can threaten privacy and in some cases can lead to discrimination. National ID cards can also have a dramatic impact on privacy with centralized databases to store personal information. An ID card often becomes a requirement to access services and without it, an individual may be denied access to services to prevent the use of someone else’s card. This may create a situation of ID apartheid for the disadvantaged who are less likely to retain possession of a card. With technology constantly advancing, there are now ID cards being developed with biometric information such as facial details and fingerprints. These details, which are unique to each individual, bring about new privacy issues. High-quality photographic and digital imaging technologies allow for the covert and high-quality capture of someone else’s biometric details, and if this information is ever captured and stored about a person who is unaware, there has been a serious privacy violation.
1.2. Data security risks
Data is a representation of the world. In some cases it is used to model complex systems or to assist in decision making. For example, climate data is used to model future climate states. Market trends are used to make financial predictions. In these cases it is often difficult to verify the data thoroughly and in general, there are many different possible uses of data. Often individual interpretations of data may vary from the actual context or intent of the data. In the case of climate models, it may be impossible to foresee whether or not an interpretation of model output is correct given that climate states are inherently unpredictable and the model itself could contain errors. High impact decisions can be made on uncertain data that can lead to the perpetuation of errors and biases. This is known as methodological bias. In other cases, the data itself may carry biases or other undesirable assumptions. An example would be the use of race as an identifier in medical decision making. Failing to account for social constructs of race and genetic variation can lead to incorrect inferences from the data and ultimately, race may become a deciding factor in choices of treatment. These cases show a variety of ways in which data and its use can lead to biased outcomes. Often the bias is unintended and is usually a result of the neglect of ethical considerations in the early stages of information system design. Owing to this, bias is an issue that overlaps with many other ethical challenges of information and technology.
Another ethical challenge involves data security. In a digital society, the collection, flow, and processing of information is done electronically. This may result in theft, unauthorized access, loss of information, and the like [23]. The security and integrity of data is essential to any information system. For example, electronic health records are becoming a standard feature of medical practices; the information in these records must remain confidential and available only to those with authorized access. Despite this, electronic health records are subject to hacking and other forms of information loss. Data breaches can result in severe consequences for affected individuals and organizations. Loss of personal information can result in identity theft or in severe cases, it may pose as a threat to personal and public safety. The loss of financial information can have harmful effects on an organization’s clients and result in an organization’s loss of revenue. Steps must be taken to ensure that the privacy and integrity of data is maintained. This means that information systems must be resistant to various forms of threat, quick to recover from data loss, and must provide fail-safes for information in transit. Making systems “highly secure” in this context is easier said than done and is not always cost effective or convenient. This is a risk-benefit issue that will be a recurring theme in dealing with ethical challenges of information and technology.
1.3. Unintended bias in algorithms
Mentions about solving the problem of bias in algorithms through ethical behavior might seem naive in the light of quick movements in the nature of production and use of algorithms. Efforts to increase ethical behavior in algorithm design may not solve the more fundamental problem of how to specify what we want, to a system, without having undesirable effects in the real world. This is a problem that is only going to get more acute. As the parts of our lives that we hand over to data analysis increase, the systems being used are going to come to be seen as controlling the opportunities open to people. A famous example, from the early days of web advertising, is that of an optician who discovered that his ads were not being shown to people in high income neighborhoods, because the analysis of who would be willing to spend money on glasses had incorrectly identified the target group. At the time all this meant was that the optician got low rates for ad space, but in general such behavior can have damaging effects and can be hard to identify, especially as it might not be clear to human decision makers what the system is doing. An improperly specified algorithm for sorting CVs according to quality destroyed prospects for minority job applicants in the US by generalizing from the fact that some of the worst CVs were from minority graduates. In other cases, a system can potentiate existing social biases by affecting decisions that are based on its predictions, as is feared in criminal sentencing if judges start to use the output of risk assessment algorithms.
1.4. Potential for discrimination
The development of data science technology for the supporting of decision making, automatically conducted by sophisticated learning software called algorithm, should bring benefits to individuals. In addition, with the employment of data science in numerous fields now will give assessment and decision for individual’s better than hiring explicit human that may involve personal feeling of the assessor. Despite that, algorithm may yield certain decisions that are merely based on sensitive attributes, not because of the relevance with a person’s ability, skill, or other legitimate reasons. Machine learning algorithm is designed to learn from data and optimize an objective function to find a correct answer, thus the relation between an input (data regarding an individual) into an output (assessment or decision) sometimes it’s difficult to be detected and it’s called as indirect discrimination. This is a new problem in comparison to the pre-data science discrimination such as in employment opportunity, housing, provision of goods or services, and education, thus far legislation in United States, Canada and European Union do not directly proscribe indirect discrimination. Simulation study by Mitchell and Brynjolfsson (2019) reveals that altering the vocabulary in job ad postings can influence the click rates of majority group and minority group of race, where the part of minority group can be less interested in the job advertisement. This is an utilization of artificial intelligence to assess potential employees, with machine learning algorithm learning from the ad postings to the behavioral data of potential employees, it’s very likely the algorithm will replicate the ad employer’s message to the assessment result on minority group in hope to find individuals possessed the attributes shown in active ad respondents, which in reality it’s a mind conditioning in order to get job at a disadvantages price. This may eventually cause litigation to the employer if the ad respondents succeed to prove the causation of an adverse action. Another example is a case of race and ethnicity prediction using facial recognition. Although this research aims to help minority group in preventing discrimination and improving health care and social services quality, a tool that simply based on prediction without prevention to avoid creating biased results still has controversial ethical issues. High rate of predictive error can cause classification into the wrong group, and it’s not impossible the researcher release this tool first to the small number of people without noticing the tool’s effectiveness to the actual benefit. Nevertheless, it’s a decline proposal from a vendor who develops a data science system to equalize the prediction error rate with a prevailing rate. This means the system only works to a case with a crime prevalence at certain race, but this raises the question does minority group will forever have a burden for crime prevalence indication and is it true that it will benefit them.
1.5. Lack of transparency in data practices
Whether the data is being shared or analyzed, there is often a lack of clarity or oversight of the data handling and processing chain. Ultimately, many organizations want to keep their data practices undisclosed to gain a competitive advantage, or in some cases, to prevent the implementation of effective public scrutiny or consumer resistance. But often the practice is ambiguous even to those directly involved. Data is a valuable asset and its value is increased when it is shared, however data sharing practices can result in a loss of control over data once it has been released. For example, in the NHS IT outsourcing deals of the early 2000s, it was identified that the contract specifics had been unclear and this had allowed for widespread data sharing and commingling between companies and healthcare organizations, showing that even in a highly regulated industry, lack of clarity in data practices can result in a concession of data control. This loss of control can compromise the individual’s privacy and rights regarding the data in question. Often it is unclear what the data will be used for and whether there is potential for a change of data ownership that might result in future usage that is unrelated to the initial instance of data collection. In contrast to this, some instances of lack of transparency are less a result of unclear intentions and more to do with insufficient technological development in methods for data tracking and monitoring. With the increase in complexity of data storage structures and the rise of distributed systems, it is not always easy for an organization to map the journey of its own data and ensure that it does not lose oversight of its location and usage. While this benefits the data in question as it essentially becomes ‘lost’, this can be a disadvantage for the organization or individual who owns the data, as they may be unaware of any breaches of data protection legislations and their data rights.
2. Legal Challenges
2.1. Compliance with data protection laws
2.2. Intellectual property rights
2.3. Jurisdictional issues
2.4. Liability for data breaches
2.5. Legal implications of data misuse
3. Risks for Abuse in the Public Arena
3.1. Manipulation of public opinion
3.2. Surveillance and invasion of privacy
3.3. Targeted advertising and marketing
3.4. Exploitation of personal information
3.5. Cyberbullying and online harassment
4. Guidelines for Preventing Unethical Uses of Data
4.1. Clear data governance policies
4.2. Informed consent and opt-out options
4.3. Regular data audits and risk assessments
4.4. Ethical training and awareness programs
4.5. Collaboration with regulatory bodies
5. Guidelines for Preventing Unethical Uses of Data in the Public Sector
5.1. Transparent data collection and use practices
5.2. Strict adherence to data protection laws
5.3. Independent oversight and accountability mechanisms
5.4. Safeguards against data breaches and leaks
5.5. Public engagement and participation in decision-making processes

Evaluation Plan for HIT System Implementations

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question
To prepare:
Review the case study you chose for your evaluation plan. Consider what viewpoint and research goal you would use to guide your evaluation plan. Although many potential research goals or viewpoints could be selected for your case study, you are only required to choose one goal and one viewpoint.
Research three published evaluations that have been conducted on HIT system implementations similar to the case study you selected.
Answer
1. Introduction
This evaluation plan provides all the details that will show the need and importance of health information technology system in the health industry. This plan will guide the implementation process and support the information system to provide a good service in managing the patient records. This plan will guide the user through the system step by step to achieve the maximum potential of managing patient records by using health information technology. This plan will evaluate the user and system interaction. This exam is going to make sure the health information technology system would be capable of supporting the target users, which are physicians. This exam will also evaluate the data that he wants input and output. This method is related to a before and after study using the same user applying cross-over implementation. Data for system evaluation is subjective and objective to evaluate the ease of use, usefulness, user intention, productivity, and quality of work life expectancy influences on the technology, task, and external variables, perceived mismatches, and completion success. This evaluation would determine the efficiency and effectiveness of managing patient records using health information technology system (Hammill, Ning, Scott; 2000).
1.1 Purpose of the Evaluation Plan
The findings from this evaluation will be used to improve the new EHR system and to prevent any potentially harmful effects with future system changes at this institution or at other healthcare organizations.
The overall goal of the evaluation process is to identify any positive or negative effects associated with the new EHR system and to make recommendations that will enhance its effects on quality and safety. More specifically, we will use a combination of qualitative and quantitative methods to: – Assess the effects of the new system on various measures of healthcare quality and safety – Identify important or unintended changes in work processes by those who use the system – Pinpoint system design and implementation issues that are associated with either positive or negative outcomes – Enhance the understanding of how and why the new system was effective in certain areas and detrimental in others.
The purpose of the evaluation plan is intended to outline the rationale for evaluating the HIT system implementation at a large academic medical center on the east coast. The primary goal of this project is to implement a comprehensive inpatient electronic health record system to replace existing paper and electronic documentation. As with the implementation of any new system, it is important to carefully evaluate the process to ensure that the goals of the organization are being met and to identify any unexpected consequences associated with the new system. This project will use a comprehensive evaluation strategy to assess the impact of the new system on healthcare quality and patient safety. This plan is intended to guide the evaluation process and to ensure that the findings are effectively translated into practice. Given that this is a 5-7 year project with a system that is continually evolving, this evaluation plan will focus primarily on the initial implementation of the inpatient EHR system and has flexibility to adjust the evaluation focus in subsequent years.
1.2 Scope of the Evaluation Plan
Using the AHRQ framework for the National Resource Center of Health Information Technology as a guide, this plan will detail the impact of health information technology (HIT) on a microsystem level. Each process that is being implemented or evaluated will be given an overall assessment to determine a qualitative and quantitative result. This will give an overall assessment to determine if the process is an improvement compared to the previous method. The various permutations can be seen in a fishbone diagram built around the central idea that HIT will improve patient safety and quality at the facility. A time series analysis of specific indicators such as mortality rates, medication errors, turnaround time, and nursing sensitive indicators will be used to provide an overall impact in the microsystem.
The scope of this evaluation plan is to detail various processes that are being implemented in patient information management and assess the utilization of the health information exchange. This evaluation plan will take an in-depth look at the before and after results of a new medication administration system, specifically bar coding. The plan will then shift its focus to assessing the overall impact on the healthcare facility.
1.3 Background of the Case Study
Baylor’s implementation of the Epic Systems HIT took place in several stages from 2003 to 2008. EHR was first activated at pilot sites, then installed at all of the primary care clinics and associated ambulatory practices. These ambulatory systems were integrated with the in-patient EHR at two hospital sites. During this time period, several natural experiments occurred that provide an ideal environment for empirical evaluations of HIT: 1) a new EHR system was installed at one of the two hospital affiliates that had previously been sharing the same system as the other hospital (non-randomized comparative system); 2) within the same hospital, there was a temporary and non-randomized cessation of electronic lab ordering and results retrieval due to catastrophic IT failure; 3) electronic prescribing (e-prescribe) was federally mandated to be phased in between 2007 and 2009 which provided additional bonus payments and penalties for Medicare and Medicaid services.
2. Research Goal and Viewpoint Selection
2.1 Selection of a Research Goal
2.2 Selection of a Viewpoint
3. Published Evaluations on HIT System Implementations
3.1 Evaluation 1: [Title]
3.2 Evaluation 2: [Title]
3.3 Evaluation 3: [Title]
4. Comparison of Published Evaluations with the Case Study
4.1 Similarities in Evaluation Approaches
4.2 Differences in Evaluation Methodologies
5. Development of Evaluation Plan
5.1 Defining Evaluation Objectives
5.2 Identifying Evaluation Metrics
5.3 Determining Data Collection Methods
5.4 Establishing Evaluation Timeline
6. Implementation of Evaluation Plan
6.1 Recruitment of Participants
6.2 Data Collection Procedures
6.3 Data Analysis Techniques
7. Results and Findings
7.1 Presentation of Evaluation Results
7.2 Interpretation of Findings
8. Recommendations and Action Plan
8.1 Proposed Recommendations
8.2 Action Plan for Implementation
9. Conclusion
10. References

Factors to Consider When Starting up a Domestic Aviation Operation

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Question
factors to consider when starting up a domestic aviation operation
answer
1. Introduction
When starting up a domestic aviation operation/public transportation service, it is essential to consider all the factors that will affect the operation, whether large or small. This document focuses on the factors the typical air carrier should consider. It is common for one to only think about the certification process and rules and regulations that must be followed to start an air carrier, but these are not the only factors that need to be well understood. Factors concerning the markets to be served, the need for the service, the competitive environment, the economics of the new operation, and the type of operation to be conducted must all be considered. This document is designed to help the new operator understand all these factors and how they will affect the certification process and the operation in general. This document is not a standalone guide to certification or Part 135 operations. It’s simply a detailed explanation for what must be considered along the way. Because the certification process is so involved, many times the operator will lose sight of the operation in an effort to meet FAA requirements. This explains why the author chose to write this document with regards to factors an operator must consider in lieu of the certification process itself. Factors concerning the FAA requirements will sometimes be invoked to better understand how they will affect the given factor, but a detailed explanation on the FAA rules and regulations concerning a specific subject is outside the scope of this document.
1.1. Purpose of the Document
This document is intended for people contemplating starting up an aviation concern. This is a wide ranging audience and the document will not cover every eventuality. A person starting up an operation in a single building at a non-towered airport flying one aircraft needs a far less complex operation than a regional operator flying into a dozen cities. However, this document should provide a framework from which a project plan tailored to the specific operation can be constructed.
This document has been assembled in order to illustrate at a high level the process of starting up a new aviation concern. It is aimed at individuals who want to know what is involved in aviation operations but who do not necessarily have a background in aviation. This document addresses not only the aviation specific issues but also will touch on general business and project management principles.
1.2. Scope of the Document
The document is quite detailed and some aspects may not be relevant to all readers. It is structured in a manner that it can be readily determined what information is relevant and what can be overlooked. The document is broken down into specific aircraft operation phases, being pre-start up, start-up, setting up the initial operation, expansion of operation, and winding down an operation. Each phase identifies key objectives and possible issues that can occur. Readers can determine if the information is relevant to them based on the phases of their operation and how far they plan to take the aircraft operation. This is particularly relevant to operators working for AOCs where various job position changes can mean involvement in different phases of aircraft operation. Although it is recommended that all information is read at least once!
While it is obvious that an aviation operation needs an aircraft to fly, the first stage of planning could be the deciding factor as to why an operation is successful or not. Ambitious aviation operations have failed to get off the ground because of poor planning, a lack of clear objectives, no identified target market, insufficient resource analysis, and so it continues. Though it is preferable to enter the aviation industry with a business already established, these decisions are no less important for an individual purchasing an aircraft for private use. This document aims to cater for aviation operations looking to move into the aviation industry through to the established small aviation enterprise. The intention is to provide guidance on all the various phases of aircraft operation, identifying possible pitfalls and providing solutions.
1.3. Background Information
With an understanding of the costs, commitment, and competition involved, and armed with the right resources and information, starting an airline can be a viable and rewarding venture.
An SIA study has shown that it is very difficult to change a customer’s existing loyalty to an established carrier. This illustrates the high level of competition and threat of substitute products in the industry. Failing to consider some of these aspects can lead to a new airline’s quick demise. New airlines tend to do best where they can meet a demand that is not being fully satisfied by existing services. A market analysis will help to reveal this and will allow a new airline to evaluate where and how it can be competitive.
The aviation industry is known for having a few dominant players. This is due to the effectiveness of mergers and acquisitions. Even some of the smaller airlines are actually subsidiaries of the larger ones. This suggests that competition in the industry is fierce and likely to be directed towards a new entrant. New airlines often fail to fully understand direct and indirect competition. It is also important for these new airlines to understand the needs and limitations of their prospective customers. These are varied and are usually based upon cost, frequency, journey time, comfort, and access.
An aviation company operates aircraft to transport passengers and/or goods. This is the primary source of income for the airline. As one of the most complex and costly industries, it is to be expected that the number of airlines that start up and fail is relatively high. It is necessary to consider the idea of establishing an airline very carefully and to be aware of the numerous costs and potential pitfalls that may be encountered.
2. Legal and Regulatory Factors
2.1. Compliance with Aviation Regulations
2.2. Licensing and Permits
2.3. Insurance Requirements
3. Financial Considerations
3.1. Startup Costs
3.2. Funding Sources
3.3. Revenue Generation
4. Market Analysis
4.1. Target Market Identification
4.2. Competitor Analysis
4.3. Demand Forecasting
5. Operational Factors
5.1. Fleet Selection and Acquisition
5.2. Staffing and Training Requirements
5.3. Maintenance and Safety Procedures
6. Infrastructure and Facilities
6.1. Airport Selection and Negotiations
6.2. Hangar or Terminal Facilities
6.3. Ground Support Equipment
7. Marketing and Branding
7.1. Brand Identity Development
7.2. Advertising and Promotional Strategies
7.3. Customer Relationship Management
8. Technology and Systems
8.1. Aviation Management Software
8.2. Reservation and Ticketing Systems
8.3. Communication and Navigation Equipment
9. Risk Management
9.1. Safety and Security Measures
9.2. Emergency Response Planning
9.3. Contingency Plans
10. Conclusion
10.1. Summary of Key Considerations
10.2. Next Steps

Goals of Drug Therapy for Hypertension and Antihypertensive Treatment

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Question
Describe the goals of drug therapy for hypertension and the different antihypertensive treatment. 
Describe types of arrhythmias and their treatment
Discuss Atrial Fibrillation
Discuss types of anemia, causes, symptoms, and treatment options

Answer
Goals of Drug Therapy for Hypertension and Antihypertensive Treatment Types of Arrhythmias and Their Treatment Atrial Fibrillation Types of Anemia, Causes, Symptoms, and Treatment Options
1. Goals of Drug Therapy for Hypertension
Lowering blood pressure with drug therapy in a patient with hypertension is unequivocally beneficial. For every 10 mmHg reduction in mean systolic blood pressure, there is a 40% reduction in the rate of fatal stroke and a 15% reduction in the rate of coronary heart disease and other vascular diseases. These are the findings from a meta-analysis of over 60 hypertension trials. The benefits of reducing diastolic pressure are very similar to those of reducing systolic pressure, and in relative terms, the effects of antihypertensive drug treatment are similar in the elderly and the middle-aged. Available data do not show a clear threshold below which lower blood pressure no longer has benefit, so it is best to achieve the greatest reduction possible, especially considering the variety of antihypertensive agents currently available.
Drug therapy for hypertension has as its primary goal the achievement of a blood pressure level that reduces the risk of adverse cardiovascular events and target organ damage. The delay in progression of hypertension to a level that requires polypharmacy to control or the prevention of established hypertension from getting worse are additional important goals. So the ultimate objective in hypertensive patients is control. Control of blood pressure from an elevated level to a lower level is the major determinant of reduced morbidity and mortality. The specific goals of drug therapy occur within the broader framework of lowering blood pressure, reducing cardiovascular risk, and preventing target organ damage.
1.1. Lowering Blood Pressure
Objective is to perusing this issue is to lower the blood pressure to solve the problem of hypertension. Hypertension is cured by reducing elevated blood pressure, preventing its associated cardiovascular complications, and decreasing resultant morbidity and mortality. To achieve it is to resolve the problem of hypertension. Situation where patients easily get back to their primary condition before treatment due to they stop consume medicine. This condition will not with immediate result, but requires persistent changes of lifestyle and pharmacological treatment for years. Lifestyle modification include weight reduction, high regular aerobic exercise, alcohol reduction, sodium intake reduction, and maintain diet based on DASH (Diet Approach to Stop Hypertension). But this modification has limitations, because it will show the result if done in massive level and takes a long time, so it will not compatible if combined with drug therapy. Pharmacological treatment will base on administration of antihypertensive drugs with various classes, started from the cheapest one, effective, and safe with minimal side effects for long term use. So it tailored to what patients need and can be monitored. Given the J-shaped association between diastolic blood pressure and cardiovascular and renal disease, and fixed small risks of antihypertensive drug treatment, drug therapy is recommended for all patients with stage 1 hypertension and higher. For patients with prehypertension and diabetes, the decision to use drug therapy depends on an assessment of total cardiovascular risk, with drug therapy recommended for high risk patients. This recommendation applies not only to the elderly, but also to older adults with isolated systolic hypertension. Role of antihypertensive drug is to lower the blood pressure, but current evidence also supported the different classes of antihypertensive drug to prevent cardiovascular complication which independent from its blood pressure lowering effect. This unique effect is very favorable for hypertensive patients.
1.2. Reducing Cardiovascular Risk
That’s why risk reduction can be seen as simplifying hypertension-related goals. High blood pressure is oftentimes associated with diabetes and dyslipidemia, and addressing these conditions can have a two-fold benefit. Nevertheless, it is important to remember that if these are not severe and there are no obvious associated target organ damages, it may be more appropriate to change lifestyle and monitor the patient while treating the blood pressure. Nevertheless, if judged to be severe or at high risk of progressing, then drug treatment would be associated with improved prognosis.
Cardiovascular risk is greatly increased when a person has high blood pressure. However, in most cases, it is more efficient to treat the blood pressure itself rather than trying to separately treat the cardiovascular risk. In some cases, the risk may need treating independently, and the best way of identifying these patients is understanding which other risk factors are present and whether these are reversible and can be influenced by drug treatment.
1.3. Preventing Target Organ Damage
Preventing target organ damage: Hypertension, if not controlled, can lead to a number of complications as a result of target organ damage. Organ damage can occur because of ischemia. This is the inadequate supply of blood and oxygen to a particular organ. Ischemia as a result of hypertension is caused by arteriolosclerosis and it can lead to left ventricular hypertrophy, myocardial infarction, heart failure, aneurysm or peripheral arterial disease. Hypertension can cause damage to the heart in a number of ways. It is a major risk factor for diseases of the arteries and the most common cause of aneurysm. High blood pressure can also lead to left ventricular hypertrophy, in which the muscle of the left ventricle is thickened, which can cause heart failure, and also a heart attack. Hypertension is a major contributor to chronic kidney disease. It can cause damage to the small blood vessels in the kidneys and lead to glomerular sclerosis. This is the hardening of the glomerulus, which is the site in the kidney where the blood is filtered. It can ultimately lead to end-stage renal failure. High blood pressure is the most important risk factor for stroke. It can lead to impaired brain function and a major risk factor for dementia. High blood pressure has shown to be an important risk factor in the pathogenesis of retinopathy and macular degeneration. Preventing target organ damage means treating or even reversing the harmful changes that have occurred in the major organs of the body. It is the most important goal in treating patients with hypertension. In a number of the clinical trials, it has been the prevention of target organ damage in which have been the primary end-point. This is because the prognosis and quality of life for patients with diseases due to target organ damage can be very poor and anything that can prevent this would be a great achievement. An example of this is in the Systolic Hypertension in the Elderly Program (SHEP) trial, in which older patients were treated with chlorthalidone to try and prevent stroke. This was found to be successful and the risk of stroke was reduced by 36% in non-diabetic patients and 51% in diabetic patients.
2. Antihypertensive Treatment
2.1. Lifestyle Modifications
2.1.1. Dietary Changes
2.1.2. Regular Exercise
2.1.3. Weight Loss
2.2. Medications
2.2.1. Diuretics
2.2.2. Beta Blockers
2.2.3. Calcium Channel Blockers
2.2.4. Angiotensin-Converting Enzyme (ACE) Inhibitors
2.2.5. Angiotensin II Receptor Blockers (ARBs)
2.2.6. Renin Inhibitors
2.2.7. Alpha Blockers
2.2.8. Central Agonists
2.2.9. Vasodilators
2.2.10. Combination Therapy
1. Types of Arrhythmias
1.1. Atrial Fibrillation
1.2. Ventricular Tachycardia
1.3. Atrial Flutter
1.4. Supraventricular Tachycardia
1.5. Bradycardia
2. Treatment of Arrhythmias
2.1. Medications
2.1.1. Antiarrhythmic Drugs
2.1.2. Beta Blockers
2.1.3. Calcium Channel Blockers
2.1.4. Digoxin
2.2. Electrical Cardioversion
2.3. Catheter Ablation
2.4. Implantable Devices
2.4.1. Pacemakers
2.4.2. Implantable Cardioverter-Defibrillators (ICDs)
2.4.3. Cardiac Resynchronization Therapy (CRT)
2.5. Surgical Interventions
1. Introduction to Atrial Fibrillation
2. Causes and Risk Factors
3. Signs and Symptoms
4. Diagnosis of Atrial Fibrillation
5. Treatment Options
5.1. Rate Control
5.2. Rhythm Control
5.3. Anticoagulation Therapy
5.3.1. Warfarin
5.3.2. Direct Oral Anticoagulants (DOACs)
5.4. Catheter Ablation
5.5. Surgical Procedures
5.5.1. Maze Procedure
5.5.2. Pulmonary Vein Isolation
5.6. Lifestyle Modifications
5.7. Follow-up and Monitoring
1. Introduction to Anemia
2. Types of Anemia
2.1. Iron-Deficiency Anemia
2.2. Vitamin B12 Deficiency Anemia
2.3. Folate Deficiency Anemia
2.4. Hemolytic Anemia
2.5. Aplastic Anemia
3. Causes of Anemia
3.1. Nutritional Deficiencies
3.2. Chronic Diseases
3.3. Genetic Disorders
3.4. Bone Marrow Disorders
4. Symptoms of Anemia
4.1. Fatigue
4.2. Weakness
4.3. Shortness of Breath
4.4. Pale Skin
5. Treatment Options for Anemia
5.1. Iron Supplements
5.2. Vitamin B12 Injections
5.3. Folic Acid Supplements
5.4. Blood Transfusion
5.5. Bone Marrow Transplantation

Grievances and Dispute Resolution in the Workplace

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Question
The National Labor Relations Act (NLRA) of 1935 was established to help protect the rights of employees and employers, encourage collective bargaining, and discourage harmful labor and management practices. It also created the National Labor Relations Board (NLRB). When employees work at a unionized company, the union negotiates for wages, hours, and other workplace factors. However, if an employee or group of employees finds that their company is not following parts of the collective bargaining agreement, they can file a grievance. In your assignment, please answer the following questions:
Based upon your experience or recent research, what are some examples of grievances?
If you had to report a grievance to the NLRB, what steps would you take?
Using recent examples, what are the differences between mediation and arbitration?
If you were a human resources (HR) professional, what strategies would you recommend the company take to create a work climate where disputes could be resolved and grievances are a last resort?

Answer
1. Introduction
The purpose of this essay is to explore the management of disputes and grievances in the workplace. Disputes and grievances are a common aspect of employment and can arise for a variety of reasons. They can have an extremely damaging effect on both the individual and company level, causing an increase in absenteeism, a drop in productivity, and a rapid staff turnover. They can also be a source of stress and anxiety, with both physical and psychological effects. Research suggests that managers spend a considerable amount of time dealing with dissatisfied employees, with as much as 25-40% of supervisory time being used to address employee grievances. In light of these effects and the high costs associated with employee dissatisfaction, it is evident that grievance and dispute resolution is a matter worth addressing. An effective dispute management system can lead to a reduction in the number of disputes that arise, and if they do arise, it can channel the negative energy usually fostered in the dispute to a more constructive outlet.
2. Examples of Grievances
2.1. Wage Disputes
2.2. Discrimination Complaints
2.3. Unsafe Working Conditions
2.4. Violation of Employment Contracts
3. Reporting a Grievance to the NLRB
3.1. Gathering Evidence
3.2. Filing the Grievance
3.3. NLRB Investigation Process
3.4. Resolving the Grievance
4. Mediation vs. Arbitration
4.1. Definition and Purpose
4.2. Mediation Process
4.3. Arbitration Process
4.4. Recent Examples of Mediation and Arbitration Cases
5. Strategies for Creating a Positive Work Climate
5.1. Effective Communication Channels
5.2. Conflict Resolution Training
5.3. Employee Feedback Mechanisms
5.4. Fair and Transparent Policies
5.5. Encouraging Collaboration and Teamwork
5.6. Leadership Support and Involvement
5.7. Continuous Improvement Initiatives

Comparing Walmart Financial Statements under IFRS and GAAP

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Question
Prior to beginning work on this discussion forum, read Topic 6 International Accounting Standards in Appendix A in the course textbook, Using Financial Accounting. Next, review the Walmart Case Study.
Compare and contrast the differences in the Walmart financial statements if the company were to use International Financial Reporting Standards (IFRS) rather than Generally Accepted Accounting Principles (GAAP). Be sure to discuss specific accounting differences between the two.
Debate the pros and cons this would create for Walmart. Be sure to be specific and support any opinions.
Describe any legal or ethical challenges this convergence may create using the country you selected in prior courses.

Answer
1. Introduction
Globalisation is happening in the world, and the movement toward IFRS might seem like a natural evolution of U.S. accounting standards. However, IFRS is more principle-based while U.S. GAAP and has developed rules over time. IFRS is also more detailed and precise than IAS. The movement of IFRS might sound good for the global economy, but people do not like changes. It is evident that the U.S. will resist IFRS convergence until it has seen that the development of IFRS is successful and will benefit the U.S. economy. Until full convergence, there will be a long period where both standards are used domestically and internationally (Mala, 2010). This issue is important because Walmart operates globally, and will also affect accounting students, since most accounting students study U.S. GAAP and IFRS is not a main course yet.
Walmart is a US public multinational corporation, which operates a chain of discount department stores and warehouse stores. Walmart was incorporated in 1969 and trades publicly on the New York Stock Exchange. Walmart is the second largest public corporation according to the Fortune Global 500 list in 2013, the world’s largest give store retailer with over 2 million employees worldwide, and is the biggest private employer in the world. Walmart is a family-owned business and is the biggest grocery retailer in the United States. It has stores in more than 50 countries under 69 different banner names (Farfan, 2012).
1.1. Background information
After the accounting scandals in the early 2000s, the International Accounting Standards Board and the Financial Accounting Standards Board have attempted to work towards a unified set of accounting standards between the IAS/IFRS and the US GAAP. It is believed that one set of accounting standards will provide a greater degree of transparency of a company’s position. Throughout this paper, the accounting policies of Walmart are reviewed and the effects of the IFRS convergence on these are highlighted. I’ll also take a look at their financial statements taking note of any defined effects through changes in accounting policy or errors with relation to the Restatements provided. Walmart has faced continual issues over the years in regards to producing reliable financial statements. Between misrepresented amounts to errors in classes of inventory, Walmart has undergone several restatements of their financial statements communicated the need for a change in accounting policies to better represent them accurately. It has taken Walmart several restatements to understand the effect of changes in inventory levels. With the mistakes made it is clear that another guideline and/or standard would have helped Walmart in understanding and representing the effects of changes in inventory with relation to LIFO liquidations. This can be clearly seen with the changes in inventory levels from 2009 to 2010. By moving their operation towards Canada from the US, Walmart showed a drastic reduction in levels of inventory by over $1 billion. This had no effect on cost of sales when represented, when in actuality it must have been assumed that all inventory under previous acquisition cost was sold in Canada.
1.2. Purpose of the comparison
The purpose of this comparison is to assess the financial statements under IFRS and U.S. GAAP to determine whether there are economic consequences from reporting to investors, creditors, or other stakeholders. A high quality financial reporting system can build a basis for a capital market in a country and attract international capital to flow into that country, which in turn has a significant impact on the economic growth in that country. A major development in the world of financial reporting is the convergence of IFRS and U.S. GAAP. In 2001, the IASB and FASB agreed to work together, in mutual respect and in the best interest of investors and others, as a way to bring the two sets of standards closer. In February 2006, the IASB and FASB set forth a plan for convergence where projects would be undertaken but a revised standard in order for IFRS and U.S. GAAP to align, and potentially result in elimination of difference between the two standards for particular issues. This plan included many phases and continual assessment and monitoring from both boards. Although this was the case, in 2012, the SEC made an announcement that it would no longer provide a statement that indicates whether or not IFRS would be incorporated into U.S. capital markets. This was due to a number of reasons that include separate discussions on future reporting standards for US domestic issuers and the oversight and infrastructure funding of IFRS. A decision has yet to be made, however, the standard setting environment continues to evolve along with potential global acceptance of IFRS. For these reasons, Walmart was chosen as a company to compare financial statements. With many countries still having their own, in some cases unique set of accounting standards, companies engaging in international business or investments are faced with having to convert their financial statements into various standards. This can be an extremely complex process, inhibiting comparison of financial statements and in some cases misinterpretation due to language barriers and lack of understanding of a particular standard. As of the company’s 2011 annual report, Walmart has retail outlets in 15 different countries, each faced with a separate local standard and the potential for varying global acceptance of IFRS. It would be in these companies’ best interests to follow the developments in the standards environment and prepare for the potential adoption of IFRS. For this reason, these comparisons may, in fact, provide an understanding of what future changes may affect the way in which Walmart reports its financial position and performance.
2. Overview of International Financial Reporting Standards (IFRS)
2.1. Explanation of IFRS
2.2. Key principles of IFRS
3. Overview of Generally Accepted Accounting Principles (GAAP)
3.1. Explanation of GAAP
3.2. Key principles of GAAP
4. Comparison of Walmart Financial Statements under IFRS and GAAP
4.1. Income statement differences
4.1.1. Revenue recognition
4.1.2. Expense recognition
4.2. Balance sheet differences
4.2.1. Valuation of assets and liabilities
4.2.2. Treatment of intangible assets
4.3. Cash flow statement differences
4.3.1. Classification of cash flows
4.3.2. Treatment of interest and dividends
5. Pros of Walmart adopting IFRS
5.1. Enhanced comparability with global companies
5.2. Simplified financial reporting for multinational operations
5.3. Access to international capital markets
6. Cons of Walmart adopting IFRS
6.1. Costs of transitioning to IFRS
6.2. Potential loss of industry-specific guidance
6.3. Increased complexity in financial reporting
7. Legal challenges of convergence in the selected country
7.1. Impact on local laws and regulations
7.2. Compliance with international standards
7.3. Potential conflicts between IFRS and local laws

Concert Report: Instrument Era Genre Artists Composers and Personal Reflections

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Question
Write a 15 to 20-sentence report for the concert, focusing on the instrument, era, genre, artists, composers, and personal reflections.
Classic Rock:

Concert Details:
   – Instrument: Identify the primary instrument(s) featured in the concert.
   – Era: Determine the historical era or period the music represents.
   – Genre: Categorize the music into a specific genre (e.g., baroque, classical, jazz, pop, rock).
   – Artists: Note the names of performers, bands, or orchestras involved.
   – Composers: Identify the composers of the pieces performed.
Personal Reflections (20 sentences):
   – Initial Impressions: Describe your expectations before attending the concert.
   – Instrumental Mastery: Reflect on the technical skill of the performers and their mastery of the chosen instruments.
   – Emotional Impact: Discuss how the music made you feel emotionally. Did it evoke specific emotions or memories?
   – Historical Context: Explore any historical or cultural context relevant to the era or genre of the concert.
   – Favorite Moments: Highlight specific moments or pieces that stood out to you.

Answer
1. Instrument
The bassoon is one of the most unique and amusing looking instruments because of its long and thin shape. It may be played multiple ways, either being held horizontally or vertically, but there is no difference in sound or technique. It is a two-part instrument and is made of heavy wood. It’s probably the heaviest of all woodwind instruments. The bassoon is played with a double reed, so it is similar to the oboe but much more difficult to control. The double reed refers to two reeds tied together to form the instrument. This is supposedly a reference to a time when the bassoon was crafted from a single piece of wood and the player had to use their own double reed to make music. It has a wide range of sound and is used to play many different kinds of styles of music. Due to its complexity and difficulty, it has a very low chance of being played by a non-professional or a beginner musician. The instrument’s cost is average for an instrument, but it is still very expensive due to the maintenance of replacing and ordering reeds or any other replacement parts.
1.1. Key features of the instrument
The marimba is played with wooden, rubber, or yarn-wrapped mallets. The performer strikes the wooden keys, creating a bright, metallic sound that fades quickly. Other keyboard instruments (piano, celesta, harpsichord) share some similarities with the marimba, but none of these instruments’ mechanisms and materials produces the characteristically warm and percussive attack and sustain of the marimba. Keyboard percussion instruments are now more isolated in this category of sound generation. This idea is important to understand because it links the marimba to other keyboard percussion instruments, providing a future basis for marimba concerti and ensemble pieces. The marimba would not evolve into the exciting solo and ensemble instrument that it now is had its design and sound production not kept it largely isolated from the family of keyboard instruments.
1.2. Historical significance of the instrument
The historical significance of the harpsichord is mainly due to it being the main keyboard instrument in the Baroque period. It has been said that the sound of the harpsichord is the sound of the Baroque era. It evolved over a period of 150 years in response to changes in musical style and to the musical needs of composers. By the end of the Renaissance, the harpsichord had attained the shape in which it was to persist for about 200 years. Both France and Italy have played a large role in the history of the harpsichord. It is widely accepted that in the 15th century, the harpsichord had spread to many countries in Europe. Reaching a peak during the 17th century, especially in France, the harpsichord developed in terms of visual design, mechanical action, and sound quality. In France, two schools of construction exist: the Ruckers school and the Blanchet school. The Ruckers school produced intricate instruments featuring paintings or intricate inlay materials. However, such instruments may not play well from a musical perspective. Despite this intricacy, many Ruckers harpsichords were later converted into the plainer Blanchet design, demonstrating a musical emphasis during the later part of this period. In Italy, the harpsichord underwent mainly mechanical improvements. The most significant of the Italian builders were the Grimaldis, who developed an action which made it quick to play in contrast with the heavier sound of the French instrument. The harpsichord did not develop with the same success in England and Germany, both countries preferring the Clavichord and the Virginals. The harpsichord eventually became outdated in the late 18th century, being succeeded by the piano, although it has had a modern revival with interest in historically informed performance.
1.3. Notable performers of the instrument
Notable performers of the piano: It is far too difficult to encapsulate all of the world’s most famous pianists within one small list, given the monumental influence of the instrument. Many of the greatest composers themselves were pianists, so we have excluded them based on principal instrument to the composer’s title, i.e. F. Liszt would not be included as a pianist. We are left with no shortage of names no less. The Russian School of pianists has long been heralded as one of the most influential in history. From the incomparable audiences in artistry such as Sofronitsky and Richter, to the legendary teaching lineage from Goldenweiser to Neuhaus and Zak, pianists of Russian pedigree have wielded formidable prominence for close to a century. It is difficult to speak of great pianists without venerating Claudio Arrau, whose concert career spanned over eighty years. His recording of Beethoven’s ‘Hammerklavier’ sonata is still considered one of the most distinguished ever captured. Other notable pianists relevant to particular aspects of Beethoven interpretation include D’Albert, notable for his role in the Austro-German tradition and Schnabel whose recordings are seen as essential in appreciating the composer.
2. Era
2.1. Overview of the era
2.2. Key characteristics of the era’s music
2.3. Influential composers of the era
3. Genre
3.1. Definition and characteristics of the genre
3.2. Evolution of the genre over time
3.3. Notable works within the genre
4. Artists
4.1. Biographies of the performing artists
4.2. Previous notable performances by the artists
4.3. Awards and recognition received by the artists
5. Composers
5.1. Background information on the composers
5.2. Major works composed by the composers
5.3. Influence of the composers on the music industry
6. Personal Reflections
6.1. Overall impression of the concert
6.2. Emotional impact of the music performed
6.3. Memorable moments or performances during the concert

Conservation of Natural Resources and Sustainable Practices

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question
The human population depends on various natural resources, plants, and other members of the animal kingdom for our survival and lifestyles. Take a day in your life at home and at work and think of items or ways you could reduce or do away with. In what ways does the reduction promote resource depletion? As a nurse, how would you advocate for mitigating unrestricted consumption and its effects on the human population and health? (USLOs 5.1, 5.2)
OR
Take any two finite/non-renewable resources and discuss ways to conserve them or promote their sustainable use. How do the effects of resource depletion intersect with socioeconomic status, gender, race/ethnicity, and health outcomes? Explain. Next, in what ways can nurses encourage sustainability in their personal and professional settings? (USLOs 5.1, 5.2, 5.3, 5.4)
Answer
1. Introduction
With increasing globalization of the economy and competitive industrial growth, the pattern of consumption, production, and marketing has become complex. Global consumption of natural resources has increased rapidly because of population growth, urbanization, and changed lifestyles. Industrialized countries have employed technological and institutional means to exploit resources to meet the growing consumption demand. This has put severe stress on the availability of resources. Developing countries are also following suit in consuming the resources. Sooner or later, if this consumption trend continues, it will lead to economic degradation and cause a high cost for future generations. This calls for an urgent need to conserve natural resources. Now the question arises: what do we mean by resource conservation? Why is it needed? What will be the impact of unrestricted consumption of resources? What are the ways to conserve resources and sustain development? This study is an attempt to answer such questions.
All the activities of man are directly or indirectly interwoven with the natural resources of Earth. All the industries based on agricultural raw materials, minerals, fuels, etc. are products of natural resources. In fact, life itself is a gift of nature – vegetables, animals, water, and the atmosphere. Man is the most precious resource, utilizing all the natural resources for life. The development of human civilization has been closely linked with the availability of natural resources. Now, these resources have been overutilized to feed the large human population. According to some estimates, 85% of resources have been consumed in the last 100 years.
1.1 Importance of Natural Resources
Importance of natural resources. Natural resources are those things that are in the environment and obtained from it. They are the gift of nature and make the life of humans very comfortable and easy. They are an essential part of our lives. They are the things which are limited in nature. Natural resources have been classified into various types. The most common classifications are: – Biotic and abiotic. – Renewable and non-renewable. Renewable natural resources are those which can be generated again and are virtually unlimited. The major types of such resources are air, water, soil, and forests. On the other hand, non-renewable resources are those which are available in a limited quantity and can be exhausted. Such resources include coal, oil, natural gases, and minerals. The word resource is a vast term. It is essentially a functional concept; it only has meaning in human reflection upon human needs for inputs to maintain or increase the functioning of their life. It is hard to overestimate the importance of human resources. It is a necessity for life and no substitute for it will exist. Without resources, human life would be a very short and squalid affair, in no way approximating its current meaning. The issue which society must consider is not whether to use resources; this is its inevitable act in pursuit of survival and betterment. Rather, it is how to use them.
1.2 Impact of Unrestricted Consumption
Presently, about 80% of the raw material and 90% of its uses come from natural resources, and only 1% has been closed into biological cycles (Narayanan, 2005). Natural resources are being used so much: land, water, air, wildlife, nonrenewable resources, and human capacities and needs to meet development goals and objectives. Unrestricted consumption of natural resources will have a negative impact on the environment. If land is an important natural resource for economic development in third world countries, this will occur at the expense of the land itself and its health, especially when there is no proper land use planning and controls. Conversion of forest land to agriculture land is a controlled way for economic development, but it will affect the fertility of the soil. Not to forget rampant deforestation, which is mainly for its timber being exported or for land cleared up for commercial plantations or conversion to rural land with no regulations. All of this would decrease the quality and quantity of forest resources.
2. Ways to Conserve Natural Resources
2.1 Reduce, Reuse, and Recycle
2.2 Energy Conservation
2.3 Water Conservation
2.4 Sustainable Agriculture
2.5 Forest Conservation
3. Intersection of Resource Depletion and Socioeconomic Status
3.1 Disparities in Access to Resources
3.2 Environmental Justice Issues
3.3 Impact on Economic Development
4. Intersection of Resource Depletion and Gender
4.1 Gendered Impacts of Resource Depletion
4.2 Gender Equality and Sustainable Practices
4.3 Women’s Role in Conservation Efforts
5. Intersection of Resource Depletion and Race/Ethnicity
5.1 Disproportionate Effects on Minority Communities
5.2 Environmental Racism
5.3 Promoting Environmental Equity
6. Intersection of Resource Depletion and Health Outcomes
6.1 Health Impacts of Resource Depletion
6.2 Vulnerable Populations and Health Disparities
6.3 Promoting Health through Sustainable Practices
7. Nurses’ Role in Encouraging Sustainability
7.1 Education and Advocacy
7.2 Incorporating Sustainability in Healthcare Practices
7.3 Promoting Sustainable Lifestyles

Addressing Workplace Mental Health Issues, Including Employee Depression

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1. Introduction
In order for American businesses to be successful in a global economy, they must have a productive workforce. What happens when this workforce is suffering from a debilitating illness, such as mental illness? Is a productive workforce able to suffer from such an illness? This is a question that I often ask myself, and one that I will explore in this essay. In exploring this question, I will be drawing on evidence from an academic study done in New Zealand, in which sleep and mental health among a workforce were correlated (Clarke et al., 2006). The importance that this essay has is evident in the following quote: “Studies have demonstrated that the indirect costs associated with diminished productivity of symptomatic employees, absence from work, and reduced work efficiency on the job exceed the direct medical costs and represent a significant portion of the overall cost of depressive illness to employers” (Lerner et al., 1999).
1.1. Importance of Workplace Mental Health
A clearly communicated role within the organisation. Employees who do not know what is expected of them can become stressed and anxious. Providing employees with clear direction and identity can reduce these feelings, and can be achieved through effective management and regular discussion and review of employee roles.
A positive work environment that values and supports employees. This can involve identifying and utilising employee skills, providing ongoing development and training, and giving employees a level of autonomy in their role. Doing so can increase employee satisfaction and pride, which in turn enhances mental well-being.
Employers can create an organisational culture that enhances the well-being of its employees in a number of ways, many of which have a positive impact on the mental health of employees. The Centre for Workplace Mental Health (2017) identified the following protective factors that can reduce the risk of mental health problems occurring in employees.
Good mental health is fundamental for functioning well in everyday life, and is as important in the workplace as it is in our personal lives. As a result, the way in which a person’s mental health is handled by their manager and the culture of their workplace has a direct impact on that person’s productivity, morale, and well-being. One of the best ways to understand the importance of mental health in the workplace is to look at what employers can do to support the well-being of their employees.
1.2. Prevalence of Employee Depression
Mental health problems are one of the main causes of overall disease burden worldwide. Depression is cited as the third leading contributor to the global burden of diseases. A recent study of 24,000 employees in Europe found the average reported prevalence of depression to be 17.2% (range 2.8-28.4%). Depression has also been shown to have a higher prevalence among part-time workers compared to full-time employees. In another European study, depression was found to account for 50% of all absences from work and 37% of all work incapacity. The WHO has estimated that by the year 2020, depression will be the second leading cause of disability throughout the world. These figures and trends clearly indicate that depression is a highly prevalent disorder which will have an increasing impact on organizations throughout the world. Depression is a major cause of presenteeism (being at work, but not fully functioning) and employee turnover, which are both very costly for employers. It has been estimated that the economic burden of depression is 1% of the EU’s GDP, which equates to 200 billion euros. The impact of the recent COVID-19 pandemic is likely to further increase the prevalence of depression in the workplace. The pandemic has been associated with a large volume of job losses, financial strain, social isolation, and health anxiety due to increased risk and exposure to the virus. Recent data from the UK has shown that the prevalence of depression has doubled from 10% to 20% before and after the pandemic. Given the large impact and stigma of the mental health effects of COVID-19, it is likely these rates of depression will be further increased as the pandemic progresses.
2. Understanding Employee Depression
2.1. Definition and Symptoms of Depression
2.2. Causes and Risk Factors
2.3. Impact on Employee Performance
3. Creating a Supportive Work Environment
3.1. Promoting Open Communication
3.2. Encouraging Work-Life Balance
3.3. Providing Mental Health Resources
4. Training Managers and Supervisors
4.1. Recognizing Signs of Depression
4.2. Responding to Employee Disclosures
4.3. Offering Support and Accommodations
5. Implementing Mental Health Policies and Programs
5.1. Developing a Mental Health Policy
5.2. Offering Employee Assistance Programs
5.3. Providing Mental Health Training
6. Reducing Stigma and Promoting Awareness
6.1. Educating Employees about Mental Health
6.2. Challenging Stereotypes and Myths
6.3. Sharing Success Stories and Resources
7. Supporting Return-to-Work Programs
7.1. Facilitating Gradual Return-to-Work Plans
7.2. Providing Workplace Accommodations
7.3. Ensuring Continued Support and Follow-up
8. Monitoring and Evaluating Mental Health Initiatives
8.1. Collecting Data on Employee Well-being
8.2. Assessing the Effectiveness of Programs
8.3. Making Adjustments and Improvements
9. Collaborating with Mental Health Professionals
9.1. Partnering with External Resources
9.2. Consulting Mental Health Experts
9.3. Seeking Professional Guidance
10. Conclusion