Friday, December 27, 2019
Although there are discrete cortexes in the brain, each with a specific purpose for integration, which have complex functions of their own, each part of the brain interacts with one another in complex ways that contribute to the integration of sensory information to the reality we are all so familiar with (Eagleman, 2015a). As explained by Doctor David Eagleman (2015a), the brain is like a city. There is no true single place that reality could be said to exist in the mind. Just as in a city, there are many different parts that make up the whole (Eagleman, 2015a). Each and every part of a city specializes in getting one thing done, like each cortex. However, rather than the success of the brain or city existing in the individual parts, reality is achieved by integrating each and every part into a single entity (Eagleman, 2015a).This means that the brain also integrates sensory information by creating interactions between the separate cortexes of the brain. An example of the way that s ensory information communication is essential, is found in the interaction between smell and taste (Herz, 2007). Most of what we perceive as taste is actually a result of activation of the olfactory cortex, the area of the brain dedicated to the sense of smell (Herz, 2007). The interaction of these two senses leads to an enhancement of the sensation of taste, altering our creation and perception of reality surrounding the way we perceive taste (Herz, 2007). Essential to the communicationShow MoreRelatedSensory Integration And Sensory Processing1746 Words Ã |Ã 7 PagesSensory integration is also known as SI or sensory processing (Sensory Processing, n.d., para 1). Sensory Integration occurs automatically, unconsciously, and almost instantaneously (An Introduction, 2014). SI is an ongoing neurological process that continuously occurs. Sensory Integration refers to the brainÃ¢â¬â¢s ability to take in, process, organize, and integrate (combine) sensory input, which is the messages/ information received from the senses (hearing, vision, taste, smell, touch, motion, etcRead MoreEssay on Sensory Perceptions882 Words Ã |Ã 4 PagesRunning head: SENSORY PERCEPTIONS 1 Critical Thinking - PHI 210 Ã¢â¬Å"Sensory PerceptionsÃ¢â¬ 9 July 2010 SENSORY PERCEPTIONS 2 Ã¢â¬Å"Sensory PerceptionsÃ¢â¬ The bodyÃ¢â¬â¢s senses are the input devices of the human computer known as the brain. These senses, touch, sight, smell, sound and taste, are only as effective as the human brain can process the information. The accuracy of these inputs can easilyRead MoreUnderstanding Sensation As A Process957 Words Ã |Ã 4 Pagessensation as a process where physical stimuli or feeling sent from sensory organs to our brain, I could relate the information of module 5 with my everyday experience. Learning the principal methods of operation of audition, vision, touch, taste and smell help me to obtain a deeper knowledge about our sensory organs and their interaction with stimuli, sensors, and our brain. Also, I gained a more valuable understanding of placebo effects and their implications in mental processes. I could appreciateRead MoreEssay about Beh 225 Brain Response of Behavior1589 Words Ã |Ã 7 PagesAppendix C Brain Response of Behavior Part I Note: Parts II and III follow below, complete all three. Run Multimedias 2.3 and 2.4 * Go to the Web site www.prenhall.com/morris. * Click text: Psychology: An Introduction (12th ed.) * Click Ã¢â¬Å"2Ã¢â¬ on the select a chapter tool bar. * Click Live!Psych on the left hand menu. * Select 2.3 and 2.4. Write a 350- to 700-word response to the following: Explain the communication process of neurons in the brain. List some commonRead MoreChapter 2 Fill In The Blank Essay887 Words Ã |Ã 4 PagesÃ¯ » ¿1.An extensive network of specialized cells that carry information to and from all parts of the body is called the nervous system. 2.The basic cell that makes up the nervous system and which receives and sends messages within that system is called a neuron. 3.The long tube-like structure that carries the neural message to other cells on the neuron is the axon. 4.On a neuron, the branch-like structures that receive messages from other neurons are the dendrites. 5. The cell body of the neuron, responsibleRead MoreThe Process of Memory Storage1562 Words Ã |Ã 6 Pageswhich information is encoded, stored, and retrieved. When the information is encoded, it will allow the information from the outside world to reach the senses as chemical and physical stimuli forms. The first stage is when the change in information so the memory can be put into an encoding process. Second stage is a storage process. In this process we get to know the details of what information and how much we have over periods of time. The last process is the retrieval of the information that weRead MoreNervous System And Reward Pathway1054 Words Ã |Ã 5 Pagescompilation of information gathered during lectures and through the web on the Nervous System and the Reward Pathway. This paper examines the structure of these systems, their discovery and the effects that drugs have on influencing these systems and how addictions are formed. Nervous System and Reward Pathway The nervous system is broken down into two parts, The Central Nervous System and the Peripheral Nervous System. Each System has its own function but works together to engage the brain and bodyRead MoreUnderstanding And Guiding Developmental Processes1731 Words Ã |Ã 7 Pagesbi-lateral can be represented as fundamental and specialized movements. Dynamic theory is different with Maturation and the information sensory processing theory. Although stages of motor development (reflex stage, rudimentary stage, fundamental stage and specialized stage) are shared with the dynamic theory and the nervous system was originally (in Maturation and information processing) the major determinant of movement patterns. However in the dynamic theory the nervous system is considered partRead MoreEvaluate two models of one cognitive process1042 Words Ã |Ã 5 Pagesexample of the information-processing approach. According to this model, memory consists of three types of memory stores: sensory stores, short-term store and long term store. Sensory stores consist of the eyes, nose, fingers, tongue, etc and the corresponding area of the brain. The sensory stores constantly receive information but most of this information receives no attention and remains in the sensory stores for a very brief period. If a personÃ¢â¬â¢s attention is focused on one of the sensory stores, thenRead MoreSensory Integration Therapy For Children754 Words Ã |Ã 4 PagesMany parents believe that they are the reason why their child acts a certain way. Researchers are unable to pin point exactly what is the cause of sensory integrated problems but are able to narrow down several possible directions such as genetic factors, premature birth, birth trauma, viruses, illnesses, drugs or alcohol during pregnancy and many more. Unable to understand their childÃ¢â¬â¢s behavior, parents have chosen to medicate their child to help them focus. These children may show signs of unacceptable
Thursday, December 19, 2019
Reflective Essay The aim of this essay is to reflect on an incident, which took place in a hospital setting during the first month of my Foundation Degree Assistant Practitioner course. It will explore the importance of communication amongst the health care professionals and how a good nursing documentation is an integral part of nursing. It will also demonstrate how reflection enabled me to make sense of and learn from this experience, as well as identify any further learning developments needed to improve my practice and achieve the level of competency needed for when I qualify as an assistant practitioner. While discussing the knowledge underpinning practice, evidence based literature will be reviewed to support my discussion and forÃ¢â¬ ¦show more contentÃ¢â¬ ¦I went out of the bay and called Helen and told her what had happened. She stated that Mrs Smith was known to have mood changes and be aggressive due to her dementia, which explained why she behaved that way. Mrs Smith suffered from Fronto-Temporal dementia, which is caused by damage to parts of the brain that help control emotional responses and behaviour. Therefore, many of the initial symptoms involve changes in emotion, personality and behaviour. NHS choices (2010). In a way, I felt better that it was nothing personal against me, however I felt angry that I was not warned by Helen, or other staff members that Mrs Smith can be aggressive. When I checked the handover sheet, dementia was written in the Colum for the medical history for Mrs Smith, but checking the previous entries in medical notes it only stated:Ã¢â¬ patient confused at timesÃ¢â¬ . According to AlzheimerÃ¢â¬â¢s society (2011), it is important that all staffs are aware of the personÃ¢â¬â¢s dementia while in hospital. Any additional information that carers and family can give is valuable as it will help staff to see and respond to the person as an individual. The nurse in charge should explain to other members of staff how the personÃ¢â¬â¢s dementia can affect their behaviour and communication. Evaluation: After finishing my duties in my bay, I checked Mrs Smith nursing assessment which stated that she is prone to behaviour change and can be aggressive. I went for my lunch break and started reflecting on whatShow MoreRelatedReflection Essay781 Words Ã |Ã 4 PagesI determined that I needed a new interest, something to keep my mind engaged and challenged. I enrolled in the Doctor of Business Administration (DBA) through the Columbia Southern University (CSU) just for fulfillment. This reflection assignment exercise proves to be the catalyst for my future college endeavors. The assignment to reflect on DBA program dreamed of taking steps towards realizing those ideas and course accomplishments right now. Due to time some course assignments, I will embrace,Read MoreSelf Reflection Essays817 Words Ã |Ã 4 PagesÃ Self-Ã Ã¢â¬ Observations Ã and Ã Self-Ã Ã¢â¬ Ã Reflections Ã Maximum Ã 1000 Ã words Ã each Ã term Ã The Ã purpose Ã of Ã these Ã three Ã reports Ã is Ã to Ã demonstrate Ã how Ã you Ã have Ã used Ã the Ã learning Ã journal Ã to Ã develop Ã your Ã self-Ã Ã¢â¬ awareness Ã from Ã term Ã to Ã term. Ã (See Ã Section Ã 11 Ã about Ã the Ã Learning Ã Journal) Ã Each Ã report Ã is Ã due Ã at Ã the Ã first Ã class Ã meeting Ã after Ã each Ã reading Ã week. Ã Guidelines: Ã The Ã Reports Ã should Ã include Ã your Ã reflections Ã about: Ã Ã Read MoreWriters Reflection Essay1463 Words Ã |Ã 6 PagesEnglish Writing Reflection. English has always been one of my favorite subjects along with writing. At a young age I remember always writing childish stories, and comic books. In second grade I even won a writers competition. Writing has always been a part of my life. I keep a journal to write important events happening in my life and I like to write poems as well. However, during my high school years writing essays became more complex. For some reason I couldnÃ¢â¬â¢t seem to fullyRead More Mirror: Reflections of Truth Essay508 Words Ã |Ã 3 Pages Ã¢â¬Å"MirrorÃ¢â¬ : Reflections of Truth In Sylvia PlathÃ¢â¬â¢s poem Ã¢â¬Å"MirrorÃ¢â¬ , the reader takes a look into the messages presented and compares them with the reflections that are cast in a mirror and images in a lake. When reading this poem, we discover that the speaker is the actual reflection that gives the interpretation of its views. The first interpretation is shown as a mirror on the wall Ã¢â¬Å"I am silver and exact. I have no preconceptions.Ã¢â¬ (1), second as the water in the lake because she states Ã¢â¬Å"Now IRead MoreReflection Within Professional Development: The Gibbs Model Essay1248 Words Ã |Ã 5 PagesReflection Within Professional Development In this essay I intend to reflect upon a clinical skill, which I have learned and become competent in practicing. I will apply the Gibbs model to the chosen skill throughout the essay to allow for critical thought. Gibbs model includes the areas of description, feelings, evaluation, analysis, conclusion and action plan. (Gibbs, 1988) The term Ã¢â¬Å"reflectionÃ¢â¬ directly refers to oneÃ¢â¬â¢s own ability for serious thought or consideration regarding eventsRead MoreFamily Reflection Essay1480 Words Ã |Ã 6 PagesThroughout the last sixteen weeks from going through this class I have learned a lot. I have learned that different there are many ways to write a paper or essay. There are many ways that the format of a paper as well. But between the two essays I have chosen are from week seven which was on hunting and why it wasnÃ¢â¬â¢t a cruel sport in my thoughts. My other essay I have chose was from week nine, that was about on holding a family together and what makes a family a whole. Hunting topic in my thoughts whereRead MorePersonal Essay : Course Reflection992 Words Ã |Ã 4 PagesCourse Reflection When my advisor asked me if I wanted to take summer school the first thing I said was, Ã¢â¬Å"Yeah, I want to take English 101.Ã¢â¬ The only problem was that it started at 8AM and I usually worked the night before, but I thought I could handle it. I enjoy writing. I actually write in my free time sometimes, so I thought English would be no problem. For me, writing is either extremely easy or extremely hard. ItÃ¢â¬â¢s easy for me when I donÃ¢â¬â¢t have restrictions from what I can write about. I canRead MoreA Writers Reflection Essay1100 Words Ã |Ã 5 Pagespositively on my introductions. This was greatly pleasing, for I have always thought them to be my weakest point. In the majority of my writing, the introductions were a result of extensive revisions. For example, the introduction of my Argumentative Essay was partially written in class, but I was not completely satisfied with it. To improve the introduction, I added several things, such as the example of the McDonaldÃ¢â ¬â¢s commercial. In truth, I believe that these introductions are overanalyzed, whereRead MoreWriting Reflection Essay905 Words Ã |Ã 4 PagesWriting a decent essay is as tedious, nerve racking, and strenuous as constructing a layer cake from scratch. First you have to decide that you are going to tackle this feat, and that can be your biggest challenge, motivation. Then you have, you must figure out what kind of cake batter you want to use. Collect all the ingredients to mesh together well, making each layer at a time. You throw all the layers together hoping that somehow they will come together to form a nifty design. But, they donÃ¢â¬â¢tRead MoreEssay on An Individuals Reflection on Academic Writing 951 Words Ã |Ã 4 Pagesdeliver information logically and scientifically. This skill needs to be refined and practiced constantly regularly. After three months of taking ESL 273, I have accumulated various experiences in writing advanced sentences and organizing academic essay s which are really necessary for me to perform well in the next English course, ESL 5, as well as other classes. As a result, I think I am well-prepared and ready for the next coming course ESL 5. During the ESL 273 course, one of my strengths
Wednesday, December 11, 2019
Question: Discuss about the Research Literacy for Health Practice. Answer: Introduction: Azidothymidine (AZT) or Zidovudine (ZDV) is an antiretroviral medication that is used for the treatment and prevention of AIDS/HIV. It helps in the treatment by reducing the viral replication that brings improvement in the blood tests and symptoms. It is also used in the prevention of transmission of HIV from the mother to the child. Although AZT slows the progression of AIDS in the patients by reducing the replication of HIV, it does not stop it completely (Kanters et al., 2016). The HIV becomes AZT-resistant with the progress of time and therefore, it is used in conjunction with the other medications of anti-HIV in the form of a combination therapy known as highly active antiretroviral therapy. The treatment of AIDS has undergone a drastic change in the past twenty years as the treatment options and knowledge has increased drastically. The combination therapy of antiretroviral medications delays the progression of AIDS but do possess substantial adverse effects and complications (A rts Hazuda, 2012). WHO has laid down guidelines for the AZT therapy for delivering comprehensive HIV care in the public health approach. The guidelines are focused on maximizing the survival of the population by standardized sequencing of the therapy delivered by simplified approaches and is supported by basic laboratory and clinical monitoring (World Health Organization, 2013). This assignment is aimed at providing recommendations for the funding of a health intervention of adopting AZT therapy for the HIV treatment for the indigenous population of Australia through critical appraisal of research articles. The tools used for the purpose are CASP tool and the Onemda Critical Appraisal Tool for critically appraising the articles. The literature search was carried out for the peer-reviewed journals and research articles on the topic of adopting AZT therapy for the treatment of HIV. The quality of the searched articles was determined by their ability to reflect on the research topic and the critical appraisal was compared with other similar articles to gain a broader knowledge on the research topic. Five academic databases were employed for the literature search that included Pubmed, EMBASE, CINAHL, PsycINFO and Cochrane Library. Only the empirical research papers that were published in English were selected for the study to recognize the international debate on the topic. The search period included for the study included recent articles from the last six years and the data collection tool for the inclusion and exclusion criteria was PRISMA tool. The search terms used for the study were Azidothymidine (AZT) therapy, HIV and indigenous population. The exclusion criteria included articles that were not within the study period, not focused on the research topic and not in English. The first article used for the literature review was Antiretroviral treatment use, co-morbidities and clinical outcomes among Aboriginal participants in the Australian HIV Observational Database (AHOD) by Templeton et al. (2015). The researchers provided a clear statement about the aims of the research and since there was a dearth of publications regarding the co-morbidities and clinical outcomes of the Indigenous Australians suffering from HIV, the authors carried out this study. The study described the use of antiretroviral medications like AZT among the HIV patients of the indigenous population of Australia and compared the outcomes with the non-indigenous participants with the consideration of the demographic factors. A prospective cohort study was carried out at 27 AHOD (Australian HIV Observation Database) sites that included sexual health clinics, general practice clinics and tertiary referral centers. The patients were selected in a non-random manner and it ruled out the chan ces of biases. Ethical approval was obtained from the human research ethics committee of Australia and the relevant review boards. Development of study procedures was done in accordance with the Helsinki Declaration. Although it did not include the ethical approval of the Aboriginal and Torres Strait Islander, the researchers had the written informed consent from the participating patients. Quantitative research design was employed for the study and it was appropriate as it gave an accurate outcome of the use of cART (combination Antiretroviral Therapy) with medications like AZT and the comparative results were appropriately derived. 3894 participants were recruited to the study by March 2013 and included 20 sites of AHOD. The Indigenous status was present for 2197 participants. This recruitment strategy was appropriate to support the aims of the research as it aimed to study the use of the cART among the indigenous and non-indigenous populations. Data collection was carried prior to and during the research study. Clinical and demographic data were collected during enrolment and the various laboratory data were collected during the study to demonstrate the efficacy of the treatment. Data collection method was appropriate enough to address the research topic during the post-cART initiation for 24 months. However, in the study, the relationship between the participants and the researcher was not adequately considered. This was practically not possible considering the huge number of participants from both the indigenous and non-indigenous communities. The data analysis was sufficiently rigorous considering the fact that descriptive statistics was employed for comparing the clinical information and patient demographics between the non-indigenous and indigenous AHOD participants. Apart from these, chi-square tests and t-tests were done for the categorical and continuous variables. This signifies the depth of the analysis carried out by the researchers for understanding the effect of the cART on both the types of participants. The statement of findings was stated in the discussion part and the clinical outcomes from the result were elaborated. Virological suppression was considered the most effective measure for the successful response to the applied cART. From the study, it was found that virological suppression was found in more than 80% of the participants who were treated with cART like AZT. This research was valuable for several reasons. This is because the study not only reflected good care engagement in care from its successfu l virological suppression, but also demonstrated the fact that there were very little or no differences in results between the indigenous and non-indigenous populations. This suggests that cART can be successfully utilized for the treatment of indigenous population of Australia suffering from HIV infections. However, the researchers have also pointed an important fact that adherence is the most important predictor that plays a crucial role in the virological suppression among the patients of HIV. Poor adherence can lead to reduce the durability of the regimen by causing drug resistance. These important findings from this study that has to be kept in consideration while designing the AZT therapy for the indigenous population in Australia. Another study was carried out by Dempsey et al. (2015) titled Improving treatment outcomes for HIV-positive Aboriginal and Torres Strait Islander people at Cairns Sexual Health using the treatment cascade as a model and reflected on the activities of the multidisciplinary team of the health professionals of the Aboriginals and the Torres Strait Islanders for improving their treatment outcomes. The study had a clear statement of the aim of the research as it targeted to implement the treatment cascade as the model for gauging the success for the improvement of the outcomes of health of the indigenous patients suffering from HIV. The researchers focused on meeting adequately the client needs regarding service engagement, initiation, followed by adherence to ART (Antiretroviral Therapy). Qualitative methodology was used for carrying out this study as the intern pharmacists of the clinic carried out an audit by carrying out interviews of the indigenous HIV patients visiting the clinic. T he interview process helped in getting clear idea of the engagement of the HIV patients with the ART like AZT or non-adherence of the patients with the therapy. The research design was appropriate to address the aim of the research since the study had limited number of cases and qualitative studies are the best possible method for providing the individual case information. The study included 25 patients from the clinic who were HIV positive and belonged to the indigenous community. The recruitment strategy was appropriate for the study as it aimed at improving the treatment outcomes of the indigenous HIV patients and recruited the patients on the basis of the fact that 22 patients received ART, 20 engaged in cure and 16 cases were undetectable. Data collection was conducted for a period of 12 months and towards the end of the study, the study population rose to 29 patients with 27 males and 2 females. Data collection from the patient interview gave essential feedback from the patients that reflected on the facilitators and barriers of the treatment, especially with the use of the ART. Therefore, it addressed the research issue significantly as it helped to identify the treatment shortfalls and provided remedies for overcoming them. However, in the study, the relationship between the researcher and the participants has been considered as it helped them to conduct the interview and collect the data. Ethical approval was obtained from the ethics committee of Cairn s Hospital and Health Services. The data analysis was sufficiently rigorous as it interpreted comparative results between the patients of the clinic and Australia wide prevalence of the factors like % engaged in care, % undetectable and % on ART. It also demonstrated the study progress over the time for the similar variables to represent the improvement in treatment outcome from the study. The statement of findings clearly stated that those patients who needed the maximum care for the treatment of HIV remained in ART for better outcomes. This makes the research valuable as it pointed out the fact that ART with AZT can be valuable in the treatment of HIV for the indigenous patients and adherence to the treatment is essential to improve the treatment outcomes. To support the findings from both these studies, there are several other articles which demonstrated similar traits. Cohen et al. (2016) carried out a study titled Antiretroviral therapy for the prevention of HIV-1 transmission where ART (with AZT) was offered to the patients who suffered from HIV-1 infection. The study assigned 1763 participants from nine countries where the couples were assigned randomly to two study groups. Statistical analysis was carried to analyze the study findings. From the recent reports, it is obvious that early initiation of the AZT therapy or ART can help to reduce the HIV-1 complications and preserve the immune function. From the study, it was found that apart from these advantages, ART helped to provide health benefits to the study participants on whom the treatment was applied. This study was important from the aspect that it gave a detailed account of the application of ART on the HIV patients on the patients of several countries of the world. ART was found to have public health benefits in the treatment of HIV. To provide momentum to the results of the study, univariate and multivariate analysis of the collected data was also carried out along with the baseline study. This in-depth analysis ensured the fact that ART can be successfully used for the treatment of HIV. Another opinion study was carried out by Laskey Siliciano (2014) A mechanistic theory to explain the efficacy of antiretroviral therapy for proposing a fundamental theory for explaining the mechanistic basis of the cART (with AZT). The study provided an in-depth knowledge of the cART and the theory of its efficacy with respect to the dose-response relationship. From the study, it has been found that the greatest obstacle is drug resistance for the treatment of HIV-1. The study have argued that the median effect model is the best fit method for the description of the dose-response relationship of the ART as the efficacy of ART gets reflected from the slope parameter . This study has been of importance for the fact that it not only provided the importance of ART in the treatment of HIV but it also focused on the resistance mutations which is of utmost importance for framing the treatment regime for HIV. Adherence to the treatment is important to prevent drug resistance with antiretroviral therapy. Broder (2010) conducted a similar study titled The development of antiretroviral therapy and its impact on the HIV-1/AIDS pandemic that is aimed at providing public health benefit with ART (with AZT). The researcher has extensively reviewed the studies since the era of the appearance of HIV-1 when it was considered untreatable. Since then, there have been significant changes in the treatment of the disease and ART is now no more limited to the resource-rich countries but also have it in the medical care of the resource poor countries. The researcher has also predicted the future of the treatment of HIV-1 with ART and has recommended that much research is required to transfer the knowledge from the laboratory to clinical practice for making the treatment more efficient without adverse effects. This article has also been important from the fact that it has focused not only on the treatment of HIV-1 but also considered the arenas of genetic diversity and viral drug resistance that are important from the perspectives of ART. Paradigm shifts has been proposed by the author against the host restriction factors and new viral targets or both of them that are essential while considering the treatment options with ART. Considering the recommendations from all the articles that have been critically analyzed, a comparative study can be conducted. Templeton et al. recommended that adherence has been one of the most important and predominant factors for the treatment of HIV-1 and poor adherence can lead to the development of drug resistance and reduce the durability of the regimen for the indigenous Australians. A similar recommendation was put forward by Dempsey et al. who further added the fact that the indigenous people who have newly diagnosed with the disease should remain in care with ART. Consecutively, the studies by Cohen et al., Laskey Siliciano and Broder had similar views on the treatment of HIV with AZT therapy and discussed the efficacy of the therapy in controlling the pandemic. The recommendations from these studies had a similar view that ART or AZT therapy is highly effective in the treatment of HIV among the indigenous population of Australia and precautions should be taken to conti nue the therapy without discontinuation. Recommendation An extensive literature search was carried out for establishing the efficacy of AZT therapy for the treatment of HIV and has been listed in Appendix 1. AZT is recommended in combination with the other anti-HIV medications for the treatment of HIV but not for curing it. It has also been found effective in the prevention of the mother to child transmission of HIV during childbirth and pregnancy (Lenzi, Wiens Pontarolo, 2015). Since monotherapy leads to the development of drug resistance, AZT should be used in combination therapy and it is absolutely safe for the fetus and the pregnant women. Arguably, it can be said that AZT has some severe adverse drug reactions like bone marrow toxicity, anemia, hepatic steatosis and lactic acidosis, it can be prevented by close monitoring of the patients if the symptoms start to appear (Creagh, 2013). Therefore, it is recommended for the government department to fund the health intervention of adopting AZT therapy for the treatment of HIV for the indigenous Australians and the health workers should take initiatives to initiate the intervention in the respective indigenous communities in Australia. References Arts, E. J., Hazuda, D. J. (2012). HIV-1 antiretroviral drug therapy.Cold Spring Harbor perspectives in medicine,2(4), a007161. Broder, S. (2010). The development of antiretroviral therapy and its impact on the HIV-1/AIDS pandemic.Antiviral research,85(1), 1-18. Cohen, M. S., Chen, Y. Q., McCauley, M., Gamble, T., Hosseinipour, M. C., Kumarasamy, N., ... Godbole, S. V. (2016). Antiretroviral therapy for the prevention of HIV-1 transmission.New England Journal of Medicine,375(9), 830-839. Creagh, T. H. (2013). We can illustrate an ambispective cohort study with our multicenter intensive postmarketing surveillance study which follows a group of patients with advanced human immunodeficiency virus (HIV) disease treated with zidovudine (RETROVIR8, AZT).] In late 1987, we began identifying every patient ever presenting with a diagnosis of HIV.Drug Epidemiology and Post-Marketing Surveillance,224, 53. Dempsey, M., Elliott, M., Gorton, C., Leamy, J., Yeganeh, S., Scott, K. (2015). Improving treatment outcomes for HIV-positive Aboriginal and Torres Strait Islander people at Cairns Sexual Health using the treatment cascade as a model.HIV Australia,13(3), 36. Kanters, S., Vitoria, M., Doherty, M., Socias, M. E., Ford, N., Forrest, J. I., ... Mills, E. J. (2016). Comparative efficacy and safety of first-line antiretroviral therapy for the treatment of HIV infection: a systematic review and network meta-analysis.The Lancet HIV. Laskey, S. B., Siliciano, R. F. (2014). A mechanistic theory to explain the efficacy of antiretroviral therapy.Nature Reviews Microbiology,12(11), 772-780. Lenzi, L., Wiens, A., Pontarolo, R. (2015). Comparison of antiretroviral schemes used in initial therapy for treatment of HIV/Aids.Acta Biomdica Brasiliensia,4(1), 67-73. Templeton, D. J., Wright, S. T., McManus, H., Lawrence, C., Russell, D. B., Law, M. G., Petoumenos, K. (2015). Antiretroviral treatment use, co-morbidities and clinical outcomes among Aboriginal participants in the Australian HIV Observational Database (AHOD).BMC infectious diseases,15(1), 1. World Health Organization. (2013). Global update on HIV treatment 2013: results, impact and opportunities.
Tuesday, December 3, 2019
Strategic Procurement Management Essay The traditional purchasing methods of procuring materials and services have evolved over the last 20 years and to-day is often referred to as Supply Chain Management. The simple definition of supply chain management is the integration of all organisations involved in supporting the customer with a quality product utilising inventory in the most effective and efficient manner. This concept is vague because it embraces a number of procedures and policies within an organisational structure and senior executives in many corporations often fail to understand the important role of the supply chain function This paper will attempt to answer the questions posed by J.R. Electronics, a Scottish electronics company established in the 1980s who feel that that a new competitive advantage must be developed to maintain the companys position as a market leader. The management of the company have identified the four key strategic procurement activities of location and liaison with world class suppliers, global sourcing, E-commerce and a lean or agile approach to procurement as key initiatives that they believe will form the basis of their ongoing advantage. In writing this paper I have assumed that J.R. Electronics are a medium sized company with limited experience in strategic procurement activities. 1. Location and liaison with world class suppliers. We will write a custom essay sample on Strategic Procurement Management specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Strategic Procurement Management specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Strategic Procurement Management specifically for you FOR ONLY $16.38 $13.9/page Hire Writer J.R. Electronics must attempt to understand what the definition of a world-class supplier is before they begin to re-engineer their current procurement processes. The common answer to this question by both buyers and suppliers is that to attain world-class status a supplier will offer outstanding performance in price, quality and delivery (Tim Minahan, 1998). Terry A. Carlson, Vice President of Purchasing for the Maytag Corporation argues, that to be considered as world-class a supplier must possess the following 3 characteristics: 1. A formal (and demonstrable) company wide effort to continually improve products and processes. 2. The ability and willingness to align, products, processes and business strategies with customers for mutual success. 3. The proven ability to be an industry leader in developing new technologies and products. Genuine world-class suppliers share a common vision of continual improvement and a commitment to continually improve both their products and their processes. Continuous improvement is a way of life from the shop floor worker to the managing director. The senior management of J.R. Electronics should not underestimate the task of identifying world-class suppliers to compliment their supply base. The process of selection will require a number of meetings to determine if the potential supplier is genuine in its quest for customer excellence and is capable of meeting all of their clearly defined expectations. J.R Electronics will need to consider the following points during the selection of a prospective world-class supplier. 1. Is the supplier committed to continuous improvement? Do they have a formal process to achieve year on year improvements? 2. Are they a technology leader within their market sector? 3. How adaptable are they and are they willing to invest in new equipment as they develop new technologies? J.R. Electronics must also recognise the need to develop the relationship through mutual trust and respect. Working with a world-class supplier should be considered a long-term partnership as opposed to a short-term arrangement. They must clearly define their expectations and measure the performance to their targets and be prepared to offer assistance when required. More importantly J.R. Electronics must be prepared to reward good performance. This can be in the form of long-term contracts and the sharing of cost savings. 2. A move from international to global sourcing To maintain a competitive advantage in the market place J.R. Electronics need to consider supply management strategies that will include long-term global supplier partnerships that extend beyond the traditional buyer-seller relationships into a multi-tiered world wide network. The term international sourcing has largely been replaced with the broader philosophy global sourcing which has been defined by (Monczka and Trent, 1991) as the integration and coordination of procurement requirements across worldwide business units, looking at common items, processes, technologies and suppliers. They also distinguish international and global sourcing by recognising that international is lack of coordination of requirements between worldwide business units. The evolution to global supply management can be broken down into three distinct stages. * Stage One: International Purchasing J.R. Electronics will focus on increasing volumes, minimising prices and managing their inventory costs. These are key characteristics of an organisation first entering the global sourcing arena. * Stage Two: Global Sourcing At this stage J.R. Electronics will place more emphasis on supplier capability, supporting production strategies and servicing customer markets. * Stage Three: Global Supply Management J.R. Electronics will optimise their supply networks through effective logistics and capacity management. Risks are minimised at this point and suppliers can be considered strategic partners. Corporations at this stage are sourcing for technology leadership. The main benefits to be gained from adopting a global sourcing strategy are as follows: 1. By adopting a global sourcing policy buyers will be able to purchase parts cheaper in other parts of the world. This is as a result of cheaper labour rates, lower overheads, lower raw material costs, higher productivity and reduced transportation costs. 2. Sourcing on a global basis will increase the number of potential suppliers to select from. Increased competition will make it easier to form reliable long-term partnerships with suppliers of potentially low cost materials. 3. Improved lead times due to increased availability of parts. 4. Technology is often more advanced and it is quite possible to obtain the latest technology from a global source. 5. The quality of parts purchased globally is often higher than those bought on the domestic market. The main problems that J.R. Electronics may encounter with global sourcing are: 1. Cultural issues that can cause problems due to differences in business etiquette and spoken language. This can lead to misunderstandings that potentially hinder and prolong the negotiation process. 2. Legal systems differ from country to country and this can lead to considerable problems. Intellectual property theft is currently a major problem in The Far East particularly in countries such as China and Taiwan. 3. Global sourcing can lead to difficulties when dealing with foreign currencies. Exchange rate fluctuations often impact the actual price paid for parts, 4. Logistics and more importantly the transportation of parts due to the availability and reliability of freight forwarders although most major international freight companies including BAX Global, Danzas and Schenker have all established local offices and hubs on a worldwide basis. Many major corporations have successfully implemented global sourcing strategies and these include: Motorola, IBM, Volkswagen and Dell. 3. E-Commerce approach to procurement. Technological advancement in the field of information technology coupled with the growth of the Internet and particularly The World Wide Web has led to many companies shifting away from paper based, people intensive purchasing processes to electronic buying methods. It is assumed that J.R. Electronics have had little or no exposure to e-commerce and are not fully aware of the potential benefits to be gained by adopting this strategy. The benefits of e-commerce do not come without a cost. There is the initial investment required to purchase the necessary hardware and software. The implementation process requires substantial resource to revise the internal business processes that will include system integration and employee training. J.R. Electronics may wish to hire an I.T. consultant who is fully conversant in the installation of a web based system to ensure that every aspect of the project is planned thoroughly in advance of the implementation. It is also critical that senior management of the company communicate these changes effectively as employees generally feel threatened with the introduction of new technology. Advantages of E-commerce * Cost reduction is achieved as efficiency improves within the purchasing function. Order processing times and costs are reduced considerably. J.R. Electronics may chose to implement an Electronic Data Interchange (EDI). This system if implemented can integrate the company to specific suppliers and automate the parts ordering process, order status reporting and invoicing through electronic transmission. * Due to the transparency of e-commerce it is possible to consider a large number of different suppliers quickly taking into account both price and lead-time. New or alternative suppliers can be found quickly. E-commerce is available 7 days per week 24 hours a day. * There a number of parts brokers who utilise the world wide web to sell various parts and services. Goodrich Aerospace based at Prestwick frequently utilise e-commerce to source suppliers and are members of the Inventory Locator Service (I.L.S.), a favoured parts search medium for aerospace companies. * Competitive bidding or E-auctions on the Internet has become very popular over the last few years. Companies that adopt this approach to procurement effectively tender their requirement on the Internet and potential suppliers bid against each other to win the business. * Communication with suppliers is improved. Utilising electronic mail (e-mail) would enable J.R. Electronics to send and receive information from the supply chain quicker, eliminating the need for time consuming letters. Potential Disadvantages of E-commerce * Costs and benefits can be hard to quantify and therefore confusion can be created within the supply chain. * Purchasing professionals must be properly trained. This takes considerable effort, time and money. J.R. Electronics may have to recruit specialist procurement personnel who are already experienced in e-commerce. * Employees and current suppliers may be resistant to change, as they are often comfortable using their more traditional methods of phoning, faxing and meetings. * International e-commerce can be difficult due to currency differences, import and export restrictions and legal implications. As J.R. Electronics begin to realise the full potential of e-commerce their supply chain will become more efficient and integrated with both their suppliers and their customers. The positive implications will soon outweigh the negatives. Adopting a more lean or agile approach to procurement. Lean and agile procurement are two different yet related aspects to supply management. The Collins English dictionary defines lean as lacking fat; thin or meagre whereas agile is described as nimble or quick. Both lean and agile approaches to supply management require high levels of product quality. Lead times must be minimised from the point that a customer order is received until it is fulfilled. Lead-time reduction in a lean process must be achieved as by definition excessive lead-times is waste and a lean process demands the elimination of all waste. Agile supply chains seek to operate to customer demand as opposed to forecasting and promote the free flow of information with its partners.