Sunday, February 16, 2020

Ethical Issues on Abortion Term Paper Example | Topics and Well Written Essays - 1500 words

Ethical Issues on Abortion - Term Paper Example Catholics are seen as being at the forefront in trying to raise objections to abortion since they are pro-life crusaders’. The ethical issues on abortion not only affect centred on religion and politics but also on the clinical profession (Clark and Rakestraw1995, P. 26-29). This is because it impacts on the work performance of clinicians in making decisions as to whether to carry out the abortion on the patient or not. The purpose of this paper is to discuss the ethical issue regarding abortion. It will how to discuss how best the ethics of abortion can be responded to both socially and politically. The paper will conclude by identifying what practical lifestyle actions I might take to limit my Abortion in America became legal in every state after the 1973 Supreme Court’s ruling in a case of Roe v. Wade (Hinman 2009, p. 6-8). It is reported that prior to this landmark ruling, the legality of abortion was decided by each state. During this period, abortion was illegal in 20 states but illegal in 30 states. The Supreme Court ruling in Roe V. Wade established that â€Å"the right of personal privacy includes the abortion decision, but that right is not unqualified and must be considered against important state interests in regulation† (Hinman 2009, p5). This decision indeed did not go well with the pro-life crusaders mainly drawn from religious leaders in the US that saw the ruling to undermine the sanctity of life, which is against the biblical teaching. Since the time of this ruling, several cases of abortion have been reported in many states according to Center for Disease Control and Alan Guttmacher Institute Statistics precipitating ethical questions. For in stance, data collected by the Center for Disease Control (CDC) in 2000 reveals that more than 1.31 million abortions occurred. This figure was, however, a reduction in comparison with the 1996 statistics in which 1.36 abortion cases were reported.  Ã‚  

Russian Marketplace Essay Example | Topics and Well Written Essays - 1750 words

Russian Marketplace - Essay Example The positive side to the bakery/coffee market is it is a growing market in Russia. For an American keen on establishing bakery/coffee outlet in Russia, the difficulties may not be more than what you may encounter in any other growing economy. The distribution system in Russia does not appear to be well-organized and there are queues to make most purchases. The trend is changing with budding entrepreneurs coming up with marketing skills that, given the political nod, could easily upset the lethargic traditional system (Smilor, Ray; 2002). There are encouraging signs for anyone in America considering an entry into the bakery/coffee market in Russia. There is enormous potential for growth in this market. The annual per capita consumption of coffee in Russia is 500 gm as compared to 12 kg in neighbouring Scandinavian countries (Nestl to start coffee processing in Russia, 2004). Statistics are not available for bakery items which comprise large range of products comprising cakes, bread, biscuits, and other savouries. However, there is the eagerness to taste new assortment of baked items. There are also trade fairs and exhibitions for bakery items. So it should not be difficult for American entrepreneurs to participate in these fairs and exhibitions and glean information for starting bakery outlets in cities like Moscow and St. Petersburg to begin with (Event Profile, 2010) This does not mean that starting a bakery in Russia is a cakewalk. There are going to be difficulties and obstacles in the form of competition as well as other unknown problems. The iron curtain may not exist any longer. However, Russia is still going through teething problems and the transition to a free market is experiencing a pull between traditional radicals and budding entrepreneurs (Smilor, Ray; 2002). You got to stick to the budding entrepreneurs. While on the subject of bakeries, it is pertinent to make mention of Fazer's successful operations in Russia. "Fazer is one of Russia's leading bakery companies. During the past three years, Fazer's bakery operations in Russia have grown at an average rate of ca 40 per cent annually, and today they constitute 14 per cent of the Group's turnover. Fazer has during the past ten years invested ca 130 M in its operations in Russia and the Group's four bakeries in Russia employ 3 500 people. Fazer is a leading contract catering company in the Nordic and the Baltic countries, offering customers delicious food and tailor-made service solutions. The company operates in the Nordic countries, Estonia, Latvia and Russia." (Fazer's

Sunday, February 2, 2020

Organizational Diagnosis of Palm Essay Example | Topics and Well Written Essays - 1250 words

Organizational Diagnosis of Palm - Essay Example The name 7S describes the seven elements of an approach to organizational design and review all starting with the letter S: strategy, structure, systems, staff, skills, style and shared values (Daniell, 2004). The strengths of the 7S model rest upon the variables included in it, which are generally deemed important for any organization; and that the inter-relationship between the elements is considered in the model. However, its weakness lies in the absence of an external environment and variables relating to performance (Burke & Litwin, 2009). It should not, therefore, come as a surprise that the 7s model has been singled out as the culprit in many unsuccessful bids at strategizing in the higher level (Daniell, 2004). Congruence Model The Congruence Model was formulated by Nadler and Tushman in 1977 based on their assumption that an organization is as open system. As such, an organization is affected by its environment in the same way, although not in the same extent that the organi zation molds its environment. As explained by Nadler and Tushman, it is not enough that inputs, outputs and components are listed and described. The Congruence Model depicts the organization as a dynamic entity and uses the term fit to measure the equivalence between two pairs of inputs, particularly between the elements of the transformation process (Burke, 2011). The main issues against the congruence model include: the equal weight given to each of the organizational dimension, which does not approximate the reality that in different organizations, one or more of the dimensions are ‘weightier’ than the others; and the fact that no recommendations were given to aid in determining whether or not congruence is in place. Burke-Litwin Model The Burke-Litwin Model operates on the belief that organizational change is brought about primarily by environmental factors. Various organizational factors are viewed as a collection of interdependent components which all operate on a common environment. The interdependencies present in the organization such as mission, strategies, leadership, and culture help effect organizational transformation and drive improvements in individual and organizational performance (Noolan, 2006). Six-Box Model Weisbord called his framework the six-box model to represent the six interacting variables, namely: purpose, structure, relationships, rewards, helpful mechanisms and leadership. Preziosi (1972) added a seventh box into the six-box organisational model when he prepared the diagnostic questionnaire to provide inputs on readiness for change among the members of organisation. The six-box model offers a method of examining the structure of an organisation and how the organisation functions in order to determine how a planned change effort can happen within such organisation (Shapiro, 2011). Ironically, Burke (2011) maintained that the strength of the six-box model also contributed to its weakness. Particularly, Burke (2011) not ed that the simplicity offered by the six boxes in understanding organizations suffers from the pitfall of complications arising from the six boxes under-representing the other variables involved in the diagnosis of an organization. However, its other strenghts are significant: the prominent position of leadership stresses its coordinating function, and its usefulness for fast and simple diagnostic

Comparison & Contrast Between Two Online Holiday Companies Essay

Comparison & Contrast Between Two Online Holiday Companies - Essay Example This report stresses that is essentially targeting the middle class families who look forward to travelling but have a very limited budget for the same., on the other hand, has a different approach and a different feel to the website. The moment we get into the website, it gives a rich appeal and talks about luxury destinations, which clearly implicates their target market. targets the upper class by offering luxury holidays packages with premium pricing which is not affordable by the average middle class families. This paper makes a conclusion that they are still successful with their physical promotion and presence and attract many customers who are looking for relaxations by travelling to some exotic locations., on the other hand, is successful in their own way by doing significant online promotions and launching their exclusive application on facebook with the help of Betapond. They have successfully established themselves as low cost solution for travelers worldwide. Sticking to their current market and trying to capitalize on their target customers would help them to continuously be successful in their respective areas. The author of the report approves that since customer feedback is quite essential for the process, there is a rating prompt after every chat to enable the visitor comment on the level of service. This is very important for quality assurance purposes. It is also interesting to note that the company’ website is able to provide online booking and qu ote services. As a result, one does not have to visit Kuoni’s offices to be able to book for his or her preferred destination.

Saturday, January 25, 2020

UK Social Enterprises for Sustainability

UK Social Enterprises for Sustainability Abstract Social enterprise is a dynamic and sustainable business model of choice which is able to bring social, economic and environmental benefits to the UK. It operates across all sectors of the economy, serving individuals in the private, public and third sectors. Through out this research will identify the increase levels of understanding of the role and value of Social Enterprise, given that a lack of understanding of the role and value of social enterprises was cited as a major barrier to the acceleration of the use of the business model. I will further state that social enterprises compete in the marketplace like any other business, but they use their business skills to achieve social aims. The purpose of this research will identify the key barriers faced by Social Enterprise and explore how these barriers have/could potentially be overcome to achieve sustainability. There is also a need to recognise that some social enterprise activity will need an element of finance through public fu nds, particularly because they are operating in areas of market failure or a non-commercial market such as providing services to vulnerable people, including supported employment in many cases. This paper is intended to create an environment which will lead to opportunities for social enterprise to grow successfully in the future. Chapter 1: Introduction A brief overview of social enterprise is introduced in the first chapter. Then, the purpose of the study will be next discussed which will end with a specific research question. In the end of this chapter the contribution of this research and limitation of the study are also presented. 1.1 A Brief Overview of Social Enterprise Social enterprises are organisations that supply goods and services as part of the social economy sector; this group constitutes a collection of organisations that exist between the traditionally private and public sectors and has a stronger relationship with the Community and Non-profit sector. This sector has a key role to play in achieving many of its goals, including overcoming social injustice and exclusion Todays completive business world defining social enterprise is a challenging task, according to OECD (1999, p.10) â€Å"there is no universal, commonly accepted definition of Social Enterprise.† However, the OECD (1999, p.10) has defined social enterprise as: â€Å"any private activity conducted in the public interest, organised with an entrepreneurial strategy but whose main purpose is not the maximisation of profit but the accomplishment of certain economic and social goals, and which has a capacity of bringing innovative solutions to the problems of social exclusion and unemployment†. Social enterprises are becoming a recognised part of the local and national economy in the UK, and the organisations operating in this sector are aware that becoming sustainable businesses is the path to independence both financially and in mission. However, social enterprises, in common with many small businesses, find growth difficult, and this could impact negatively on their sustainability. These should be supported and encouraged to grow both as a sector and as individual organizations so as to become more sustainable organizations. 1.2 Purpose of the Study My paper has been developed to explore how the term social enterprise has acquired meaning in England and to illustrate how practitioners, policymakers and academics influence each other in the development of new sustainable ideas, given that a lack of understanding of the role and significance of social enterprises was cited as a major barrier to the acceleration of the use of this business model. These challenges come in many forms. Some are the same as those affecting any other business including access to business support and finance, a lack of affordable premises and finding skilled staff. However, social enterprises also face one huge barrier that seriously affects their ability to assume a position within the market. That barrier is a lack of understanding of how social enterprises work and of their potential value. This lack of understanding exists across the public, private and voluntary and community sectors. The confusion and conflict about what the model could or should be for results all too often in misrepresentation and exaggeration of its potential, fragmentation in the provision of support and real and perceived barriers to accessing contracts and mainstream funding opportunities. So my dissertation will identify the key barriers faced by Social Enterprise and explore how these barriers have/could potentially be overcome in order to achieve sustainability. It examines critical incidents that have shaped the meaning of social enterprise in England and reflects on these incidents to draw conclusions about the future sustainable development of social enterprise practice. Through out this paper I will also examine the potential conditions for the growth of social enterprise through a set of outline scenarios. The aim is to inform both policy-making and the wider debate about social enterprise: what its potential might be and how that potential can be realised in different settings. So my research question is: To explore how the social enterprise is potential for sustainability in the UK. 1.3 Limitations of the Study: During conducting the research I came across certain limitations and among them the foremost one is time constrain. The interviewed person could not provide all necessary information due to lack of time. The research timeline also reveals that time constrain was actually a barrier as there was plenty to find about this research topic. A huge portion of the report is based on primary data collected through interviews which is very lengthy process. The key point here is that social enterprise cannot be identified solely by legal form or pre-set categories. Social enterprises can often see themselves as belonging to more than one category, leading to problems of double counting. For example, a social enterprise may be a charity registered with the Charities Commission or an ‘exempt charity which is also an Industrial and Provident Society. There is also much variation in the categories which have been used in studies to date, making aggregation and comparison very difficult. 1.4 Structure of the Report: This research is divided into five chapters: the first chapter is an introduction with purpose and limitation of the study. In the second chapter, literature based review of definitions of social enterprise, roots of social enterprise, discussion relevant to the sustainability of social enterprise, the nature of their contribution and their sponsors and sources of funding. The third summarises the background information of social enterprise in the UK and the fourth and fifth chapter contain the methodology and the summary of the main findings of the study with implications for policy. Chapter 2: Literature Review This chapter will give an overview of literature and models that are related to the research problem presented in the previous chapter. This chapter will introduce the roots and concepts of social enterprise in order to give a clear idea about the research area. 2.1 Roots of social enterprise Scott specified (Market, Schmarket : Building the Post-Capitalist Society,2006, p50) â€Å"The roots of social enterprises and community enterprise overall can be found in the mutual, self help and co-operative sector which goes back, in the UK, at least to the Fenwick Weavers in Ayrshire 1769 and Dr William King of Brighton in the 1820s (Trimingham, 2007), with earlier antecedents.† Within the development of this movement there has always been an important strand which has focused on the local community-based nature of these organisations and also on the economic development of poorer communities including the need to maintain paid work. For example between the two world wars, local community activists such as Harry Cowley campaigned for housing and work for returning service people and support for small local businesses. He organised marches to demand public works ‘job creation programmes from the local council for unemployed people with some success. 2.3 General Discussion on Social Enterprise Social Enterprises combine the need to be successful businesses with social aims. This is a competitive business, owned and trading for a social purpose. They seek to succeed as businesses by establishing a market share and making a profit and emphasise the long-term benefits for employees, consumers and the community. Bob Doherty and John Thompson mentioned in the journal ‘The diverse world of social enterprise stories (p.362) that social enterprises are organizations which are seeking business solutions to social crisis. These are needed to be differentiated from other socially-oriented organizations. These also need to take initiatives that can promote to communities but which are not wanting or seeking to be â€Å"businesses†. In this esteem these latter organizations remain dependent on endowments and donations rather than build up true paying customers. According to DTI report A Progress Report on Social Enterprise: A Strategy for Success (2003, p.6), social enterprise is such a business which reinvests its surpluses in the business or in the community rather than increases profit for shareholders or owners. Peter Drucker argues that social entrepreneurs â€Å"change the performance capacity of society† (Gendron, 1996, p. 37) while Henton et al. (1997: p.1) speak of ‘civic entrepreneurs as â€Å"a new generation of leaders who forge new, powerfully productive linkages at the intersection of business, government, education and community† . Ali B. Somers (Shaping the balanced scorecard for use in UK social enterprises, p.46) stated â€Å"Social enterprise emphasise creating social and/or environmental value at all stages of their production process, as an intrinsic part of their identity†. Figure:1 describes the production process of social enterprise. Inputs Production Process Outputs: Goods and Services Labour Employee/ Client Raw Materials: from Environmental Sources Can Include: Democratic Governance or training for employee/ client Base Goods and services sold to market: Economic Profit, Social Profit and Environmental Profit Economic Profit flows back to Social Enterprise and Ethical Investors Social and Environmental profit flow to Community Indicates environmental and social motives affect production Figure: 1 Production of Social Enterprise Source: Somers, A.B., 2005. Shaping the balanced scorecard for use in UK social enterprises. Social Enterprise Journal, 1(1), p.46 2.4 Discussion Relevant to the Sustainability of Social Enterprise There has been an unprecedented wave of growth in Social Entrepreneurship globally over the last ten years (Bornstein 2004, pp.3-6). For Example, as part of the 2004 Global Entrepreneurship Monitor (GEM) report a survey was conducted of social entrepreneurship activity in the UK; these data suggested that new ‘social start-ups are emerging at a faster ate than more conventional, commercial ventures (Harding and Cowling, 2004, p.5) There are three sides to sustainability in business activity: environment, economy and community. When aiming for sustainable practice all three factors must be given equal consideration from a local through to a global level. Environment Ensuring that business engages in the proper and careful use of finite resources and the management of waste so as to minimize the negative and maximize the positive impact of human activity. Economy Ensuring that business is financially viable, engages in good employment practice and is of benefit to the economy as a whole. Community Ensuring that business is overall of benefit to communities, their culture heritage and does not endanger them. Figure2: Sustainable Social Enterprise Schulyer (1998: p.3) describes social entrepreneurs as â€Å"individuals who have a vision for social change and who have the financial resources to support their ideas.who exhibit all the skills of successful business people as well as a powerful desire for social change† Greater flexibility in the use of public resources to respond to innovative community proposals, and venture investments from foundations and the private sector could be used to stimulate innovation in areas thought to be too risky for government as the sole investor. As Catford (1998, p. 96) argues that â€Å"social entrepreneurswill only flourish if they are supported by the right environment, which will be created largely by governments together with the private sector†. Social Enterprise seeks surplus generation in order to achieve financial sustainability. The need to financial sustainability is fundamental to social enterprises. Emphasizing financial sustainability in addition to profit distribution becomes a way to account for all activities the organization engages in, including advocacy and in support of bono work. Sacrificing one cause and effect chain for another can have significant implications for both the quality of work and social enterprises financial sustainability. Profit Distribution (Increase Income) Increase Revenue Use Resource Efficiently Trading Revenue Non Trading Revenue Manage Cost Track Advocacy Financial: Promote Sustainability of organization Social: Increase value to target community Whilst many may rely on combination of grant and trading income, ultimately, if an organisation is not financially sustainable, it cannot deliver its social and environmental impact. Fig3. shows how the profit of social organisation is distributed to the organization itself and community. Figure: 3 Financial Sustainability Source: Somers, A.B., 2005. Shaping the balanced scorecard for use in UK social enterprises. Social Enterprise Journal, 1(1), p.50 2.5 Policy Reform and Good Governance DTI report A Progress Report onSocial Enterprise: A Strategy for Success (2003, p.6) describes the three key goals for government as creating an enabling environment, making social enterprises better businesses and establishing the value of social enterprise. The danger in not supporting social entrepreneurship is obvious to Reis (1999: p. 4) who calls for systematic intervention to accelerate and improve philanthropic efforts. Without this he argues that substantial numbers of potential donors and social entrepreneurs could be â€Å"discouraged, turned-off, and lost from philanthropy and social change work†. So, in recent years, the boundaries between the private sectors (in term of market thinking and managerial practices) have impacted the public and voluntary sectors and started to blur traditional distinctions between them (Bull, 2006, 2007). The emergence of radical business alternatives with a strong social orientation, democratic organisation, and positive attitude to profitable trading has led to formal recognition and academic scrutiny (Seanor, Bull and Ridley-Duff, 2007). Brown, H and Murphy, E (2003: p.57) mentioned on Bank of England report that â€Å"Social enterprises, like all businesses, need access to a range of financial products appropriate to their activity and stage of development† An HM Treasury report on Enterpriseand Social Exclusion (1999, p 108) came to the conclusion, arguing that social enterprise was â€Å"less understood and rarely promoted in a consistent way by the existing infrastructure for business support†. Thompson et al. (2000: p. 328) describe â€Å"people who realize where there is an opportunity to satisfy some unmet need that the state welfare system will not or cannot meet, and who gather together the necessary resources (generally people, often volunteers, money and premises) and use these to ‘make a difference†. It is more useful to consider and develop social enterprise capabilities rather than skills and capacity building. The fact that social enterprises need to combine commercial objectives with social mission as well as internal governance, means that a â€Å"capabilities approach† is more comprehensive. This is a useful way of recognising factors additional to individual skills that inter-play to determine the effectiveness and impact of a specific enterprise. It also moves away from limited considerations of a key person or group within the organisation, and their specific skills, towards a more holistic view of what the organisation is capable of doing, irrespective of the location of particular skills. Laville and Nyssens (2001: p 325) argue that while the origins of social enterprises are based in reciprocity and thus form part of the third system, their strength is based in their ability to tap into all three economic principles and systems. They are different from private enterprise in that their goal is not the maximization of profit to benefit owners, although they do develop market activities and generate profits. They are also different from the public sector in that they are independent from direct control by public authorities. But they benefit to a greater or lesser extent from public subsidy. Thus they mobilize market relations to sell services or goods, and can use redistributive relations by utilizing government funding to finance their services. Their long-term sustainability depends on their ability to ‘continuously hybridise the three poles of the economy so as to serve the project. Their complementary use of monetary and non-monetary relations guarantees auto nomy of service based on their connections within communities and economic viability. This view of social enterprises offers an insight into their complexity in terms of the roles they must juggle and of the many forms from cooperatives, community enterprises, social firms, fair-trade companies and more that they take. Dees (1998: p.4) identifies five criteria that social entrepreneurs possess: adopting a mission to create and sustain social value; recognizing and relentlessly pursuing new opportunities to serve that mission; engaging in a process of continuous innovation, adaptation and learning; acting boldly without being limited by resources currently in hand; and exhibiting a heightened sense of accountability to the constituencies served and to the outcomes created. Catford (1998, p.97) who articulates the issues and one possible solution most eloquently: â€Å"Traditional welfare-state approaches are in decline globally, and in response new ways of creating healthy and sustainable communities are required. This challenges our social, economic and political systems to respond with new, creative and effective environments that support and reward change. From the evidence available, current examples of social entrepreneurship offer exciting new ways of realizing the potential of individuals and communitiesinto the 21st century†. The Progress Report on Social Enterprise: A Strategy for Success(2003, p.68) concludes that there is little hard evidence to demonstrate the impact and added value of social enterprise. The report points out that one of the reasons for the lack of statistical evidence is that social enterprises create a range of social and environmental impacts, beyond their financial return (the ‘double or the ‘triple bottom line) that are hard to measure (even by the social enterprises themselves). Limited information on their social and environmental, as well as financial, impact also means that policy makers, business support providers and finance providers find it difficult to assess the value of targeting social enterprises or of including them in their activities. 2.6 Concluding Remarks Academic writing about modern social entrepreneurship skills is relatively limited, compared to mainstream business or charities. The concept of ‘social enterprise has been rapidly emerging in the private, public and non-profit sectors over the last few years. Currently, the non-profit sector is facing increasing demands for improved effectiveness and sustainability in light of diminishing funding from traditional sources and increased competition for these scarce resources. At the same time, the increasing concentration of wealth in the private sector is promoting calls for increased corporate social responsibility and more proactive responses to complex social problems, while governments at all levels are struggling with multiple demands on public funds. Chapter 3: Background Information of Social Enterprise This chapter will give the idea about the social enterprise types and size in the UK along with the impact, barriers and sources of fund in this organizations. Social Enterprise in the UK The UK government has been at the front position of enabling and encouraging the increase of social enterprises as part of both welfare services delivery and community regeneration at the policy level. The impacts and influence of public, private, and citizen are empirically proven and exhibit that these conventional sectors of society are playing a part in re-evaluating the value creation opportunities offered by market (or quasi-market) mechanisms. [Brief overview of types] According to the UK policy-making community, social enterprises play a vital role in the creation of economic and social value. It has been claimed that, there were some 15,000 social enterprises in the UK SBS(2005, pp.1-2), accounting for around 1.2% of all employing enterprises in the UK. These social enterprises generate around  £18 billion in annual turnover and employ over 775,000 people (475,000 paid employees and 300,000 volunteer staff). Governments Survey and existing data for the social enterprise sector estimated that there are at least 55,000 social enterprises in the UK, with a combined turnover of  £27billion per year which is raised to over  £800 million from the preceding year. This corresponds to 2% of the UKs GDP . The number of registered charities rose from around 120,000 in 1995 to more than 164,000 in 2005, and there are also hundreds of thousands of small community groups. According to Government estimates, social enterprises account for 5% of all businesses with employees and contribute approximately  £8.4billion to GDP (HM Treasury and Cabinet Office, 2006, p.29), around 0.7% of the total economy. The data obtained from the cabinet office website in social sector showed that in the year 2003/04, 56% of third sector organisations reported an increase in activity in the previous year, and 67% of them expected activity to grow in the next three years. Positive aspects of social enterprise: Social enterprise is a varied activity and can include a range of organisations working on different scales and at different levels of trading. Some work at community level, while others work nationally. They can work in public services or commercial markets. They often work in the most disadvantaged areas and work with the most disadvantaged groups. Some organisations work only as a social enterprise while in other organisations social enterprise is often a part of their activity. This most commonly applies in a voluntary organisation or a housing association. According to Bob Doherty and John Thompson (The diverse world of social enterprise stories, p.362) the common characteristics for a Social Enterprise are: They have a social rationale and yields and surpluses are not shared out to shareholders. Reinvested profit can be used to provide training and development opportunities for staff. They use assets and capital to generate community benefit. They pursue this with (at least in part) trade in a market place. Members or employees can also take part in decision making. The enterprise is responsible to both its members and a wider society. Citizenship participation and volunteering are encouraged within the local community The social enterprise model could create new forms of entrepreneurship and employment within a community The model is ideally placed to meet new needs within a community, if supported sufficiently at start up Social Enterprises can offer goods and services to poor and disenfranchised communities The potential of a profits and revenue stream could liberate organisations from the tyranny of fundraising and grant applications Organisations could flourish effectively and creatively under this model There is either a double or triple-bottom line concept. The assumption is that the most effective social enterprises exhibit healthy financial and social returns rather than high profits in one and lower profits in the other. Social enterprise makes an important contribution to the social, economic and environmental development of Scotland. This can be summarised as follows. Fig 4: Beneficiaries of Social Enterprise Source: Social enterprise is extremely varied but, importantly, it works in a number of key priority areas for the UK economy- these include: employment and training; childcare; health; adult care services; recycling; renewable energy; transport; financial inclusion; community regeneration; and rural development. In particular, social enterprise contributes to regenerating our most deprived communities in both urban and rural areas. It often works with the people who have least opportunity in our society, including those outside the labour market, and so it has a major role to play in developing employability and supported employment and ensuring equal opportunities to those people. Social enterprise can add value to many of its activities by focusing on social, economic and environmental benefits, importantly linking these aims in a positive way, which in other business models may sometimes cause conflict. Social enterprise can offer goods and services to its customers in a flexible and innovative way. It can focus on their needs to deliver better public services. Often this is in areas where the market has failed areas where the private sector does not want to go. Social enterprise can make sure resources give value for money where a public-sector contract is needed for the activity. This includes working with very marginalised groups, where the enterprise activity helps reduce the amount of public funding needed. Through encouraging social entrepreneurship in communities, levels of public subsidy and grant dependency can be reduced. Barriers of social enterprise â€Å"†¦often have boards of directors or trustees who come from a voluntary sector rather than a business background. This can lead to a lack of business focus and prevent social enterprise from truly reaching their potential (DTI 2002, p.62) Several challenges remain before the full potential of the third sector can be realised. First, the Government must carry through its commitment to provide a constructive partnership with the sector and resist the temptation to treat it as one of the instruments for the marketisation of the Welfare State. Amicus, a trade union with workers in the public, private and third sectors, is concerned that an expansion of the third sector will be a ‘stepping stone to the privitisation of the public sector (Maskell quoted in Little, 2007, p.31). Second, the majority of third sector organisations are small and under-capitalised and they are constrained in the growth aspirations by limited access to capital (Bank of England, 2003; SQW, 2007). Insufficient capital can lead to either under-investment, or a re-orientation towards market objectives in order to obtain finance, and the consequent re-prioritisation of economic over social and environmental outcomes. To enable third sector organisations to maintain the balance between economic, social and environmental outcomes, the Government must ensure that a pragmatic and realistic assessment of the financial costs of service delivery is incorporated into their policies and strategies (HM Treasury, 2006).Third, a curse of successful activities in the third sector is that they themselves are prone to being privatised and consequently turned into capitalist ventures that adopt orthodox business practices, as has been the case with the demutualisation of the Building Society movement in the UK. According to UK Government and various literatures review shows that there are mainly four significant barriers to accessing appropriate business support and finance for social enterprises throughout the region. 1. Cultural barriers between those setting up social enterprises and mainstream business advisors. 2. Lack of clarity about where to access business support at the local level, largely due to the huge diversity of routes into starting up social enterprises. 3. Limited numbers of accredited technical specialists in key business advice areas where social enterprises require specialist support, for example on legal structure, potential investors or taxation. 4. Limited sources of affordable equity and loan finance of all sizes. All of these barriers inhibit the use of available business support by social enterprise. Many of the issues are cultural, but there are also skills issues, with mainstream business advice agencies not being adequately equipped to address more technical aspects of social enterprise business development. Specialists do exist within the region but many of them are funded through short-term grant finance. This enables the free provision of services but a lack of long-term sustainability for the advice services themselves. To grow and develop social enterprise in UK, we must tackle a range of challenges and issues which have been highlighted by the research and consultation carried out to develop this strategy. Tackling these challenges, which are summarised into five key areas in this chapter, will be a major part of this strategy: Use of the social enterprise business model. Business opportunities. Finance and investment. Business support for social enterprise. Raising the profile and demonstrating value. Sources of Finance The key factor in an enterprises development is access to appropriate sources of finance. Social enterprises are more likely than SMEs to have been rejected for finance, although the majority of those rejected by one lender appear subsequently to be successful with another. In addition, a large minority of social enterprises perceive access to external finance as a major barrier to expansion, including some of those that have successfully accessed finance in the past. While there is no one, clear reason to account for the higher rejection rates among social enterprises than SMEs, this report explores possible contributory factors, which

Intravenous Fluid Therapy During Anaesthesia

Intravenous Fluid Therapy During Anaesthesia INTRAVENOUS FLUID THERAPY DURING ANESTHESIA Water, Electrolytes, Glucose requirement, Disposition The intravascular compartment consists of blood cells, colloids, and solutes. Each one of them plays a specific role in the homeostasis. In the perioperative period there are losses and shifts of ECF between compartments. Injury, surgery, endocrine pathology contribute to those shifts and ultimately influence outcome. It is generally accepted that the total body water of a 70kg adult patient is approximately 60-70% of the weight and approximately two-thirds of it is intracellular. The focus of this chapter is the intravascular volume which consists of extracellular volume, plasma, and intracellular volume attributable to erythrocytes, leukocytes, platelets. The plasma, constituting approximately 3 L, consists of inorganic ions, albumin and small molecules. The inorganic ions are found on both sides of the cellular membranes and their concentration is maintained due to an energy consuming process. The Na+/K+ ATP-dependent pump maintains a higher N+ and Cl concentration in the extracellular space while K+ concentration is higher intracellularly. The albumin and other larger molecules are kept in the intravascular compartment by the endothelium cells due to their size. Smaller molecules, however, can cross freely this barrier. The endothelium cells and thus the barrier they provide can be disrupted by injury, surgery, or inflammatory processes. The result Is a disruption of homeostasis with significant deleterious effects on the body. Additionally, disease states can cause disruption of the inorganic ion homeostasis and leading to fluids shifts between compartments leading to edema, poor perfusion, lactate buildup, poor excretion of harmfu l metabolites and causing additional injury. Starlings Equation underscores the important forces (hydrostatic and oncotic) affecting fluid distribution between capillary and interstitial space: Jv = Kf [(Pc Pi) à Ã‚ ­ (Ï€c Ï€i)] Jv net filtration or net fluid movement Kf filtration coefficient Pc and Pi the hydrostatic pressures in the capillaries and interstitial space respectively à Ã‚ ¬ reflection coefficient Ï€c and Ï€i capillary and interstitial oncotic pressure The natural driving force and thus fluid movement is from capillary to interstitial space, where the excess fluid is cleared by the lymphatics. Diseases and trauma, whether due to surgery or otherwise induced and leading to inflammation and release of toxic substrates, disrupts the balance and the function of the endothelium and reducing the reflection coefficient. The increased permeability can lead to changes in the interstitial fluid composition which changes the oncotic pressure difference leading to further extravasation of fluid and resulting in tissue edema. This edema compromises local perfusion and accumulation of toxic byproducts causing a vicious cycle and ultimately death. The osmotic pressure is due to semipermeable membranes. Solutes which freely traverse a membrane dont build an osmotic pressure gradient across the membrane. Glucose is present in the intracellular fluid and serves to provide energy substrate. It is regulated through insulin and maintained at a level between 70 and 90 mmol/L in healthy adults. Increase in the glucose concentration can change the osmotic pressure across the endothelium and cause fluid shifts leading to Our goal as anesthesiologist is to maintain the intravascular compartment and assure adequate delivery of oxygen and nutrients to the organs while maintain good clearance of metabolic byproducts. The following classification of the perioperatively used fluids is ubiquitous: crystalloids and colloids. Crystalloids with ionic solution and osmolality close to that of plasma are deemed balanced solutions. The glucose is used to provide energy substrate and used in hypoglycemic patients or in combination with insulin. Once the glucose is metabolized, the reminder of the free water can be easily distributed along all compartments. Colloids consist of dissolved large molecular substances. They are generally described by their molecular weight or MWw. This property contributes to the oncotic pressure created intravascularly with intact endothelium and glycocalyx. Naturally occurring colloids encompass albumin, immunoglobulins, fresh frozen plasma, and plasma protein fraction. Semisynthetic ones are: gelatins, dextrans, and hydroxyethyl starches (HES). Semisynthetic and naturally occurring colloids have raised the concern of viral and prion transmission, particularly those from bovine origin. While most of the colloids have variable size of molecules, human albumin is more uniform. Gelatins are bovine collagen derivatives. Some preparations can contain Ca or other inorganic ions and those need to be taken into consideration. Dextrans are biosynthesized sucrose derivatives. They are best described by their molecular weight, i.e. Dextran 40 has a molecular size of 40,000 Daltons (Da) and Dextran 70 70,000 Da. Their clearance is highly dependent on their molecular size with smaller molecules freely filtered through the renal glomerulum and larger sizes are metabolized by the reticular endothelial system first and then excreted through the gut. Hetastarches are derivatives of amylopectine. They are divided into high-molecular weight, medium molecular weight and low molecular weight. They can be dissolved into normal saline or balanced solution. All semisynthetic colloids are known to exert an effect on kidneys and coagulation. Thus, there is a maximum dose recommended by the manufacturers. FluidRequirementsandFluidDeficitCalculations Normal Salinevs.LactatedRingersvs. Plasmalytevs.D5W

Friday, January 17, 2020

Thinking Like a Nurse

As in every profession, in nursing too, there are a number of details that every each of nurses should have and be aware of, because of the high expectancy by patients and colleagues in both within and outside of professional domains. Professionalism refers to the key points that everyone should follow and behaves the best in order to protect its dignity and respective in a competent manner. Then it becomes even more important when it comes to public health care matter. There are many reasons for that; first of all, Nursing. In this profession, it is expected from nurses to maintain the public trust and confidence. Nurses have the full trust from patient and their family. Every patient should be treated the same way as if they are in the need of best care and it is expected from nurses to maintain the practise area in a safe and in an environment that a nurse can practise safely at all times. Secondly, a nurse should create and protect a relationship between themselves and the patient. Nurses should give extra attention to protect them from any kind of harm if they are more vulnerable than the others or if they are with handicaps. Another point to be aware of is â€Å"Nurses recognise their professional position and do not accept gifts or benefits that could be viewed as a means of securing the nurses’ influence or favour. † (Australian Nursing and Midwifery Council: 2008) Nurses should keep the relationship professional and should not keep it if it gets out of ethics and standards. Furthermore, if there is an unethical or unlawful conduct noticed within the clinic or outside of the clinic, a nurse should not overlook it or should not leave it unnoticed. The action should be reported to an authorized person or corporation to put the behaviour in a fair process. Also, nurses are responsible of treatment for people in need and to motivate the patients processing in recovery. Nurses help to prevent the illness or injuries by educating patients and help to raise the quality of health in the country. They treat the patient, help them to benefit in the best way from service provided and approach them and their families with a good sense. To sum up, the best way for any public health service to work constantly, sufficient, reachable and at the best quality is, doctors, nurses, and the other health workers should work together as a team. Nurses are indispensable and the most important ring of the chain.