Health Care Spending Essay Example for Free

wellness C be Spending EssayIn the past seven decades health perplexity expenditure has been increase tremendously. The industrial era brought in a new system to divine service population duel with the cost of medical care. New technology has become a much needed investing in the 21st century which has yield to a great margin between small and big facilities. When looking at all of these factors there is no wonder the nation is spend way too much money on health care, although at times great power seem that there is not bountiful. It seems that the right enthronement is needed to help aid those that need help the most the elderly and unemployed, with the economy in a fragile state and unemployment rates increasing with the quarters there is no question that decisions ab away how we are spending on health care unavoidably to diverge. Even though so many a(prenominal) factors are involved in the spending this paper would focus on our current level of expenditures, how and where is the money played out, prodigy what would be coming next.Current level of national healthcare expendituresAccording to Physicians for a National wellness Program (2012), National Health Expenditures was $2.8 trillion, and the spending as a portion of GDP was 18% for 2012 (National Health Expenditure Projections Modest Annual Growth until Coverage Expands and Economic Growth Accelerates). When looking at these facts many would even argue we are spending quite enough when it comes to healthcare or perhaps too much, withal is the complete opposite not enough spending is in the right place. These figures does not represent the spent on one area of health care the graph below will appropriate an idea as to what, when, and where was spent on 2009.Total = $2.3 TrillionSource Martin A.B. et al., Growth In US Health Spending Remained Slow in 2010 Health Share of Gross Domestic Product Was Unchanged from 2009, Health Affairs, 2012.As shown on the graph 51% of the spending is towa rds hospital care and physician/clinical services which are great to be invested in, however the rest of the spending in my opinion is not proportionally distri howevere, yes those areas are extremely important but it would be beneficial if more can be distributed along medication, and other professionals services to include the testing and diagnose of serious illnesses such as cancer. The investment is require to subsidize the needs on these areas, 45 percent of people under age 65 who dont have insurance coverage for prescriptions said they had not filled a prescription in the last year because of the cost.Additionally, 84 percent of working-age people in the U.S. without insurance coverage for prescriptions said they had taken virtually action such as spending less on groceries or postponing paying other bills in evidence to pay for their medications, an increase from 71 percent last year (Rowan, 2012). Regarding testing for patients with cancer there should be more funding for the new technology available for test that many patients are not aware, because they cannot afford it or simply because it is not available in their area.Spending Too much or not enough?In 2010, $2.6 trillion was spent on health care services and products, 61 percent of which purchased hospital care, physician and clinical services, and retail prescription drugs. Private health insurance give for 33 percent, out-of-pocket sources for 12 percent, and other third party payers and programs for 7 percent. The two largest government health care programs, Medicare and Medicaid, purchased $925.1 billion worth of health care goods and services in 2010, accounting for 36 percent of total health care spending (Centers for Medicare and Medicaid Services, 2012).The increase of cost would continue to rise according to economists, health care managers, and advisors forcing for a new reform to change the system. Thus many are not too please with this idea is a phenomenal that cannot be avoid, th ere is a need to change in policies and methods in which we spent or invest in health care.Suggesting that the investment is too little would be a denial statement, everyday more and more patients are relying on programs such as Medicare and Medicaid to get the circumspection required at the moment. As the economical recession set in deeper less would be available to afford just the basic needs, medication or any treatment unemployment rates are on the rise and it does not seem it would stop anytime soon. Although the new reform would try to establish some type of stability, until the insurance companies and policy makers come to an organization to provide a universal premium for service which can be affordable for all, the same problems would continue to emerge.Many factors also have effect on spending considering for example the demand for new technology in the 21st century this trend has become to some degree a factor in the rise on health care spending. Much of this new techn ology is beneficial if it provides a new way to used already establish technology, however many studies have revealed that most of them are only here to replace such technology and at some circumstances increase the cost of service. As a country a deeper consideration of such technology is needed not only to save money, but to invest wisely as to what would help the system cut in spending.Future economic needs of health careFor years to come the enduring effects of the economic recession and sluggish recovery, due mostly because of partial growth in incomes, are expect to continue to limit health spending growth. In 2014 the coverage expansions laid out in the Affordable Care Act for Medicaid and for private health insurance are expected to increase the growth rate for health spending, with notable increases expected in spending on physician services and prescription drugs for newly insured patients. By the end of the year, higher income growth and the continuing shift of bollocks up boomers into Medicare are expected to cause health spending to grow roughly two percentage points faster than overall economic growth, which is about the same derivative experienced over the past thirty years.Therefore a necessary reform of a national health care perhaps would provide the change needed, the only issue with this suggestion is the funding. Thus a national health care would help every citizen reach the so needed medical attention required at an affordable price there is no surprise that the funding through Federal programs are thinning, and the cost of private insurance keeps on raising. Therefore a more evaluated reform should be put in place where the cost of care should be regulated, and more affordable options are precondition to the population an increase on reimbursement of healthcare for basic health needs is necessary to subsidize the cost for complex health needs in order to keep the cost regulated.According to Centers For Medicare And Medicaid Services (2011), In 2014, national health spending is projected to rise to 7.4 percent, or 2.1 percentage-points faster than in the absence of reform, as the major coverage expansions from the Affordable Care Act (ACA) are expected to result in 22 million fewer uninsured people (National Health Expenditure Projections 2011-2021).Increases in Medicaid spending growth, and private health insurance growth will contribute to the overall acceleration in national health spending in 2014. There is no question that technology would also continue to raise to help the system provide the best and fast way manageable services to those in need. Investing more in health care can only benefit the nation however the right decisions needs to be made in order to keep the spending growth under control.ReferenceCenters for Medicare and Medicaid Services. (2012). Retrieved from http//www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/downloads/dsm-10.pdfCente rs for Medicare and Medicaid Services. (2011). Retrieved from http//www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/Downloads/Proj2011PDF.pdfMartin A.B. et al., Growth In US Health Spending Remained Slow in 2010 Health Share of Gross Domestic Product Was Unchanged from 2009, Health Affairs, 2012.Physicians for a National Health Program. (2012). Retrieved from http//www.pnhp.org/news/2012/june/2012-health-care-spending-including-administrationRowan, K. (2012). Fox news.com. Retrieved from http//www.foxnews.com/health/2012/09/13/why-americans-prescriptions-are-going-unfilled/

La Indolencia de Los Filipinos Essay Example for Free

La Indolencia de Los Filipinos EssayLa indolencia de los filipinos (y de los estudiantes tambien) 1. What was the effect of conviction of inferiority? -The child or youth who tries to be anything else is blamed with vanity and effrontery the curate ridicules him with cruel sarcasm, his relatives look upon him with fear, strangers regard him with great compassion. No forward movement Get back in the ranks and keep in line With his touch sensation thus molded the native falls into the most pernicious of all routines routine not planned but imposed and forced. Note that the native himself is not naturally inclined to routine but his mind is disposed to accept all truth, just as his house is open to all strangers. The good and the dishy attract him, seduce and captivate him although like the the Japanese he often exchanges the good for the evil, if it appears to him garnished and gilded. What he omits is in the first place liberty to allow expansion to his adventuresome spiri t, and good congressmans, beautiful prospects for the future.It is necessary that his spirit, although it may be dismayed and cowed by the elements and the fearful humannessifestation of their mighty forces, store up energy, seek naughty purposes, in order to struggle against obstacles in the midst of unfavorable natural conditions. In order that he may progress it is necessary that a revolutionist spirit, so to speak, should boil in his veins, since progress necessarily requires the present the victory of new ideas over the ancient and accepted wiz.It will not be qualified to speak to his fancy, to talk nicely to him, nor that the light illuminate him like the ignis fatuus that leads travelers astray at night all the flattering promises of the fairest hopes will not suffice, so extensive as his spirit is not free, his intelligence is not respected. 2. What is the meaning of the statement, tila ka kastila? The pernicious example of the dominators in surrounding themselves wit h servants and despising manual or corporal bulge as a thing unbe approach path the nobility and chivalrous pride of the heroes of so many centuries those lordly airs, which the natives sacrifice translated into tila ka castila, and the desire of the dominated to be the fit of the dominators, if not essentially, at least in their manners all this had naturally to produce aversion to activity and fear or hatred of work. 3. What does Rizal mean by saying that indolence in the Philippines is a chronic but not an inherited disease? When in consequence of a long chronic disease the condition of the patient is examined, the question may arise whether the weakening of the fibers and the debility of the organs ar the cause of the maladys continuing or the effect of the bad preaching that prolongs its action. The attending physician attributes the entire failure of his skill to the poor constitution of the patient, to the climate, to the surroundings, and so on. On the other hand, the patient attributes the aggravation of the evil to the system of intervention followed.Only the common crowd, the inquisitive populace, shakes its head and cannot reach a decision. Something like this happens in the case of the Philippines. Instead of a physician, read government, that is friars, employees, etc. Instead of patient, Philippines sooner of malady, indolence. 4. What proofs did Rizal give to show that pre-Spanish Malayans were not indolent? -Before the arrival of the Europeans, the Malayan Filipinos carried on an active trade, no unaccompanied among themselves but also with all the neighboring countries. only the histories of those first years, in short, abound in long accounts about the industry and agri conclusion of the natives mines, gold-washings, looms, farms, barter, naval construction, raising of poultry and stock, weaving of silk and cotton, distilleries, manufactures of arms, pearl fisheries, the civet industry, the snout and hide industry, etc. , be thin gs encountered at any step, and considering the clock time and the conditions in the islands, prove that there was life, there was activity, there was movement. 5.How did it happen that the industrious pagan culture was transformed into that of an indolent Christian culture? -We have already spoken of the more or less(prenominal) latent predisposition which follows in the Philippines toward indolence, and which must exist everywhere, in the whole world, in all men, because we all hate work more or less, as it may be more or less hard, more ore less unproductive. The dolce far niente of the Italian, the rascarse la barriga of the Spaniard, the supreme aspiration of the bourgeois to live on his income in peace and tranquility, attest this.It seems that there are causes more than sufficient to breed indolence in the midst of a beehive. Thus is explained why, after thirty-two years of the system, the circumspect and prudent Morga said that the natives have forgotten much about farmin g, raising poultry, stock and cotton and weaving cloth, as they used to do in their paganism and for a long time after the country had been conquered 6. Why does the city of Hong Kong have more commercial and trade activities than the whole of the Philippines? It has more commercial movement than all the islands together, because it is free and is rise governed. The great difficulty that every enterprise encountered with the administration contributed not a little to kill off all commercial and industrial movement. All the Filipinos, as well as all those who have tried to engage in business in the Philippines, know how many documents, what comings, how many stamped papers, how much patience is require to secure from the government a permit for an enterprise.One must count upon the good will of this one, on the influence of that one, on a good return to another in order that the application be not pigeon-holed, a present to the one further on so that it may pass it on to his chie f one must pray to God to give him good humor and time to see and examine it to another, talent to recognize its expediency to one further on sufficient stupidity not to scent behind the enterprise an insurrectionary purpose land that they may not all pass along the time taking baths, hunting or playing cards with the reverend friars in their convents or country houses.And above all, great patience, great knowledge of how to get along, plenty of money, a great deal of politics, many salutations, great influence, plenty of presents and complete resignation 7. Was there gambling in the country before the coming of the Spaniards? -Yes, we do not mean to say that before the coming of the Spaniards the natives did not gamble the passion for gambling is innate in adventuresome and excitable races, and such is the Malay, Pigafetta tells us of cockfights and of bets in the Island of Paragua.Cock-fighting must also have existed in Luzon and in all the islands, for in the terminology of the game are two Tagalog words sabong and tari (cockpit and gaff). alone there is not the least doubt that the fostering of this game is due to the government, as well as the perfecting of it. 8. What are the effects of too many religious festivals on the country? Remember, that lack of capital and absence of means paralyze all movement, and you will see how the native was perforce to be indolent for if any money might remain to him from the trials, imposts and exactions, he would have to give it to the curate for bulls, scapularies, candles, novenaries, etc.And if this does not suffice to form an indolent character, if the climate and nature are not enough in themselves to daze him and deprive him of all energy, recall then that the doctrine of his religion teach him to irrigate his fields in the change season, not by means of canals but with amasses and prayers to preserve his stock during an epidemic with holy water, exorcisms and benedictions that cost five dollars an animal, to drive away the locusts by a wage increase with the image of St. Augustine, etc.It is well, undoubtedly, to trust greatly in God but it is better to do what one can not trouble the Creator every moment, even when these appeals redound to the benefit of His ministers. We have noticed that the countries which cogitate most in miracles are the laziest, just as spoiled children are the most ill-mannered. Whether they believe in miracles to palliate their laziness or they are futile because they believe in miracles, we cannot say but he fact is the Filipinos were much less lazy before the word miracle was introduced into their language. 9.What other evidence may be pointed out to show the lack of discipline sentiment? -The very limited training in the home, the tyrannical and sterile education of the rare centers of learning that blind subordination of the youth to one of greater age, influence the mind so that a man may not aspire to excel those who preceded him but must merely be co ntent to go along with a march behind them. stagnation forcibly results from this, and as he who devotes himself merely to copying divests himself of other qualities suited to his own nature, he naturally becomes sterile hence decadence.Indolence is a corollary derived from the lack of stimulus and of vitality. That modesty infused into the convictions of everyone, or, to speak more clearly, that insinuated inferiority, a sort of daily and constant depreciation of the mind so that it may not be embossed to the regions of life, deadens the energies, paralyzes all tendencies toward advancement, and of the least struggle a man gives up without fighting. If by one of those rare incidents, some wild spirit, that is some active one, excels, instead of his example stimulating, it only causes others to persist in their inaction. Theres one who will work for us lets sleep on say his relatives and friends. True it is that the spirit of rivalry is sometimes awakened, only that then it awake ns with bad humor in the guise of envy, and instead of being a lever for helping, it is an obstacle that produces discouragement. 10. How do we know there was no national sentiment? -Absence of all opposition to measures prejudicial to the people and the absence of any initiative in whatever may redound to its good. A man in the Philippines is only an individual, he is not a member of a nation.He is forbidden and denied the right of association, and is, therefore, weak and sluggish. The Philippines is an organism whose cells seem to have no arterial system to irrigate it or nervous system to communicate its impressions these cells must, nevertheless, yield their product, get it where they can if they perish, let them perish. In the view of some this is expedient so that a colony may be a colony perhaps they are right, but not the effect that a colony may flourish.

School Based Management And School Changes Education Essay

naturalise Based Management And School Changes rearing EssayAbstractFor more than cardinal decades, School-Based Management (SBM) has fit a global travail towards the whole tone of education. The ultimate goal of implementing SBM was to call forth quality of education in general and more specially for burst enlighten value and increased assimilator achievement. This article addresses the views of check stakeholders in exploring the tie-up between SBM polity and prepare changes. The paper is on the radix of mixed- modes research end, combining quantitative and qualitative dimensions of research. The quantitative research design was use by dint of an empirical survey between February and June 2012, involving 318 respondents from 18 urban and sub-urban schooldayss of Ngada, Flores, Indonesia. In addition to the survey, personal in-depth interviews and focus group discussions were conducted, followed by documentary analyses.Keywords School-based management, school ch anges, Indonesia, FloresIntroductionFor more than three decades, School-Based Management (SBM) has become a global movement towards the quality of education. The ultimate goal of implementing SBM was to enhance quality of education in general and more spoticularly for better school improvements and student achievements. Research in the eventually twenty dollar bill years affirm how SBM constitution and programs cast been evident to be telling for the improvement of schools and student learning step upcomes (Bandur Gamage, 2009 Bergman, 1992 Brown Cooper, 2000 Caldwell, 2005 Dempster, 2000 Gamage, 2006, 1998 Kuehn, 1996 Odden Wohlstetter, 1995 ONeil, 1995 Sharpe, 1996).Several studies have also consistently revealed a positive association between higher pargonntal and/or confederacy involvement and improved student achievement resulting from implementing effective SBM ( vacant, 2004 Gamage, 1994 Sheldon Voorhis, 2004 Williams, Harold, Robertson, Southworth, 1997). For in stance, on the basis of research conducted in the Victorian stir schools system, involving 75 interviews, Gamage (1998 313) found that healthier t severallying and learning environments as well as improvement of student achievement could be achieved by the fact that the p arents and t all(prenominal)ers who are the closest to the students have organise a partnership and both parties are contained in the governing body with accountability. Similarly, Sheldon and Voorhis (2004 127) affirm that m all researchers have supported the idea of how community and maternal(p) involvement can improve schools and the quality of education that the children achieved as well as the academic achievement of students.Several researchers also found how school-based management is associated with partnership in school decision-makings (Bandur, 2012 Blank, 2004 Gamage, 1998). For instance, Blank (2004 62) asserts that schools can promote improvements in student learning by building relationships bet ween schools and diverse community entities. He then clarifies that building partnerships that link school, family, and community is intimately connected to student achievement because linking schools and community resources leads to providing services and support that address various needs of the students. Partnership can also submit learning opportunities that enhance young peoples social, emotional, and material development as well as academic skills.School changes in this article are related to (1) how SBM policy has changed the absolute dictum figure of school principals for school decision-makings (2) how SBM policy encourage higher participation of parents and early(a) school communities in schools (3) how SBM policy change the fashion of financial management in schools (4) how SBM policy create partnership in decision-making processes and (5) how SBM has led to better teaching and learning environments. In the study, the general research questions were formulated as what are the results of implementing SBM policies and programs in schools as perceived by the school stakeholders?What is School-Based Management?School-Based Management (SBM) is a generic term in a response to change the centralistic and bureaucratic fashions of domain school system toward more decentralized and democratic model. The term was born in mid-1960s in Australia after a public debate at the Australian National University, Canberra to choose a model of public school system that serve better students. Under the SBM scheme, power and authority in decision-making are shifted from governments to individual schools for better school improvement and increased student achievement. Later, the reform has appeared worldwide under various terms site-based management, site-based decision making, school-based decision making, school-based governance, shared decision making, and even school-based initiatives. However, even though these terms represent the widespread education reform agen da, they vary slightly in meaning, particularly to the extent whether authority and right are devolved to school councils or whether the councils are mandatory or not by laws and regulations. In this sense, similar to the SBM reforms in Chicago, USA and Victoria, Australia, Indonesian SBM model is mandatory, which inwardness that all Indonesian public schools are compulsorily implementing SBM policy and programs on the basis of Law 20/2003 on National Education System and regimen Regulation No.66/2010.Based on research conducted in Victoria, the ACT and NSW, and other countries, Gamage (1996 65) defines SBM as a pragmatic approach to a formal alteration of the bureaucratic model of school administration with a more democratic structure. It identifies the individual school as the primary unit of improvement relying on the redistribution of decision-making authority through which improvements in a school are stimulated and sustained. In this context, the focus on facilitating impro vements in the individual school as the key to successful educational reform strategies has a good deal of public appeal and other research support (Gamage Zajda, 2005 Gamage, 2003 Whitty, Power Halpin, 1998 Cheng, 1996 Odden Wohlstetter, 1995).Marburger (1991 25-26) considers SBM as an approach in which decisions that are traditionally made by a superintendent are now being made by the school council comprising of the principal, teachers, parents, citizens, and the students. Likewise, Anderson (2006 223) defines SBM as the shifting of decision-making authority from the district fleck to individual schools. Many scholars also affirm that the movement towards SBM is often assumed as the approach to serve students better by improving the school practices in meeting the diverse expectations of the stakeholders in a changing environment towards increasing student performance and achievements (Cheng Mok, 2007 Anderson, 2006 Caldwell, 2005 Gamage Zajda, 2005 Gamage Sooksomchitra, 2 004 Muijs and Harris, et. al, 2004 Sheldon Voorhis, 2004 Blank, 2004 Gamage, 1998, 1994).Gamage (1996 21-22) has proposed a revised theory of SBM based on twenty years of experience in the Australian SBM systems. In the revised theory, he has devised septet assumptions, on which to base a more realistic application of SBM. The commencement assumption is that a school council shall consist of all relevant stakeholders such as the principal or the head teacher and the representatives of staff (both teaching and non-teaching), parents, local anaesthetic community, and in the case of southary schools, students. The representatives of the staff, parents, and students are judge to be elected by the relevant constituencies, whereas the community representatives are to be nominated by the other elected members and the school leader.The second assumption is that the devolution or transfer of both authority and responsibility needs to be contacted by a legislative enactment. This appro ach will transform the former advisory body to a democratic governing body. The third assumption is the heavy reliance on the voluntary participation of the parents, community, and student representatives in the process of policy formulation in governing the school. It is believed that the school stakeholders are motivated and dedicated to growth quality schools because of the genuine transfer of authority and responsibility.The fourth assumption is that the lay councilors, with appropriate induction and training, will acquire sufficient knowledge to function as allude partners. The knowledge and experience of the lay-members who come from fields other than education are relevant and useful to the educational enterprise in order that the needs of coetaneous schools are met. The fifth assumption is that because of de-zoning, the schools need to function in an interesting and effective mode that can improve the image of the school in a similar way to the business reputation of a pr ivate/public enterprise. Such an image will help attract high levels of school enrolments.The 6th assumption is that SBM would be cost effective because the ownership of the policies and higher levels of commitment leads to minimization of costs and better utilization of limited resources. More resources would also be available as a result of minimizing the size of the educational bureaucracy, as well as drawing on previously untapped resources from the school community. The last assumption is that stricter control needs to be enforced by the centre to ensure accountability for the finances placed at the disposal of the school in conformity with the Ministerial/Departmental Guide zephyrs relating to the operation of school councils. The principal is made accountable to the governing body and through it to the states education authorities, as well as to the school community. Submissions of regular progress reports to the governing body and annual reports to other relevant authoritie s and the school community are required.Decentralization and SBM in Indonesia preceding to the performance of School-Based Management (SBM) in Indonesia, its system of education was highly centralized. Bjork (2003 193) affirms that by the end of the twentieth century, Indonesia was among the most highly centralized nations in the world. However, the real re sassyal with the concept of decentralization commenced in May 1998, when there was a radical political movement towards decentralization (Aspinall Fealy, 2003 Bangay, 2005 Bjork, 2006 Guess, 2005 Raihani, 2007). In terms of successful movements towards decentralization, Guess (2005 220) claims that the Indonesian big bang devolution program has been described as one of the fastest and most comprehensive decentralization initiatives ever attempted by any country in the region.The decentralized system led to the implementation of educational decentralization through School-Based Management (SBM) which has been considered as a mi lestone in developing a better quality of guinea pig education (Departemen Pendidikan Nasional, 2004, 2002). For these reasons, on the basis of Law No.25/2000 on National Development Planning (2000-2004), the Indonesian Ministry of National Education, positive a Komisi Nasional Pendidikan (KNP) or Commission of National Education in February 2001. The KNP worked until December 2001 with responsibilities, among others, to (1) formulate policy recommendations to have a better quality education (2) provide inputs to government closely educational decentralization. It was expected that the work of this Commission would become a basis from which to comprehensively reform Indonesian education. One of the recommendations of the KNP was to develop educational councils at district level and school councils at school level.Thus, developing educational and school councils was one of the educational decentralization policies, aimed at devolving power and authority from central government to schools, resulting in improvement of democratic principles, community participation, equity, as well as accommodation of diverse local interests and needs (Departemen Pendidikan Nasional, 2001 26). It was believed that local communities are the ones who will understand their own problems and needs better and pertinacious to provide them greater roles and responsibilities in terms of operational decision making on national education policies. For this purpose, the central government embarked on the formation of education councils and school councils in each district of Western Sumatera, Bali, and Eastern Java. On the basis of these trials, the councils were considered strategical in coping with improving the Indonesian national education.Then, Government issued a set of guidelines in relation to the implementation of SBM in 2002 and later revised in 2004 in order to provide mandatory corporate governing body type school councils described as followsThis concrete one-sidedness requi res to be channeled politically to become collective action placed by Educational Council located in the district/city and School Council at the level of educational unit (Departemen Pendidikan Nasional, 2002 1).Further, the Education Act 20/2003 on National Education System strengthened the formation of school councils. In accordance with the involvement of local communities in achieving better quality education, Article 56 of the Act provides that the community members are required to participate in improving the quality of education. In this case, the educational council and school council represent the community, as statedCommunity shall take part in the quality improvement of educational services, which include planning, monitoring, and evaluation of educational programs through the Educational Council and School Council (Education Act 20/2003, Article, 56).The Act defines a school council as an independent body established to provide advice, directions and support for personne l, facilities and equipment, and monitoring of a school (Article 56). On the basis of the Act, Government regulated power and authority vested in the school councils, as well as characteristics and formation, membership and structure of a school council. It is polish off that authority is devolved to school councils and the councils are empowered to create better quality education in their schools.How SBM Change SchoolsCurrently, SBM has been evident to be effective for the improvement of schools and student learning outcomes (Bandur Gamage, 2009 Bergman, 1992 Brown Cooper, 2000 Caldwell, 2005 Dempster, 2000 Gamage, 2006, 1998 Kuehn, 1996 Odden Wohlstetter, 1995 ONeil, 1995 Sharpe, 1996). More particularly, Odden and Wohlstetter (1995 32) identified the conditions that promote improved school performance through SBM. They discovered that school stakeholders in the schools in which SBM has been effectively utilize to improve school performance have the authority over budget, per sonnel, and curriculum. These successful schools implementing SBM have used their new power and authority to introduce changes that directly affect teaching and learning practices. They also found other conditions, including (1) professional development and training opportunities to strengthen teaching, management, and problem-solving skills of teachers and other stakeholders (2) adequate information to make informed decisions about student performance, parent and community satisfaction, and school resources and (3) systematic and creative in communicating with parents and the community.Several studies have also consistently revealed a positive association between higher parental and/or community involvement and improved student achievements resulting from implementing effective SBM (Blank, 2004 Gamage, 1994 Sheldon Voorhis, 2004 Williams, Harold, Robertson, Southworth, 1997). For instance, on the basis of research conducted in the Victorian state schools system, involving 75 inte rviews, Gamage (1998 313) reports that healthier teaching and learning environments as well as improvements of student achievements could be achieved by the fact that the parents and teachers who are the closest to the students have formed a partnership and both parties are represented in the governing body with accountability. Similarly, Sheldon and Voorhis (2004 127) affirm that many researchers have supported the idea of how community and parental involvement can improve schools and the quality of education that the children achieved as well as the academic achievements of students.Several researchers also found how school-based management is associated with partnership (Bandur, 2012 Blank, 2004 Gamage, 1998). For instance, Blank (2004 62) asserts that schools can promote improvements in student learning by building relationships between schools and diverse community entities. He then clarifies that building partnerships that link school, family, and community is intimately conne cted to student achievements because linking schools and community resources leads to providing services and support that address various needs of the students. Partnership can also provide learning opportunities that enhance young peoples social, emotional, and physical development as well as academic skills.Research Design and MethodsThe research design busy in this study was the mixed-methods design. The design has advantages to attain valid and reliable research outcomes as well as to provide specific techniques and strategies by which the researchers are guided in information accruement procedures and selective information analyses (Creswell, 2005 Creswell Clark, 2007). More particularly, this study employed the concurrent triangulation strategy, which primarily aims at using separate quantitative and qualitative research as a performer to offset the weaknesses inherent at heart one method with the strengths of the other method. In this context, the quantitative and qualit ative data collection is concurrent, happening in one class of the research study. The strategy integrates the results of the two methods during the interpretation phase. In the data collection phase of this study, the empirical survey was conducted concurrently with in-depth interviews, focus group discussions, and documentary analyses. As the primary goal of conducting interviews was to seek clarifications and deeper understanding on the issues emerged in the empirical surveys, the results of quantitative data analysis and qualitative data analysis were combined.Research method is more specific than research design. Research methods are techniques of data collection and analysis, such as a quantitative standardized instrument or a qualitative theme analysis of text data (Creswell, 2005 Creswell Clark, 2007). In this study, the term mixed-methods research means to the research design which has philosophical assumptions to guide the direction of the data collection and analyses. A s methods of inquiry, it focuses on collecting, analyzing, and mixing both quantitative and qualitative data in a single study.For the purpose of quantitative data collection, questionnaire was employed for obtaining close items and scale items related to the objectives of the study. The close items allow the respondents to choose from two or more fixed alternatives, for example, the dichotomous items which provide two alternatives only yes or no, while the scale is a set of items to which the respondents respond by indicating degrees of agreement or disagreement (Burns, 1994, p. 349).The questionnaire of the study consisted of two major parts. The first main part is about the demographic information of respondents for the purposes of providing descriptive statistics, including school location, gender of respondents, ages of respondents and their localise in schools. The second part is about respondents perspective on the results of implementing School-Based Management (SBM) policy and programs general functions of communication in schools the importance of communication for school improvements and student achievements communication networks in schools and styles and strategies of communication of school leaders within the SBM framework.For the purposes of qualitative data collection, in-depth interviews and focus group discussions (FGDs) were used to obtain open-ended information. These techniques of data collection were useful for providing better insight of the research problems. For this reason, the researcher the researcher set up two major steps. The first step dealt wit selected the key informants. Accordingly, fourteen key informants (principals and school council presidents) in seven schools were interviewed personally face to face. In addition, FGDs with seven groups of teachers in the schools were conducted. All interviews were recorded in the digital-tape recording and note-books for checking validity and reliability.Validity and Reliability of th e stop ScalesSeveral statisticians (Brace, Kemp, Snelgar, 2006 Manning Munro, 2006) affirm that the Principal Component Analysis (PCA) is a type of Factor Analysis which is used to explore the possibility of a factor structure underlying the variables. In particular, Manning and Munro (2006) explain the usefulness of PCA to whole step the validity of variables. In the context of quantitative research, validity is simply defined as the degree to which it measures what it claims to measure (Manning Munro, 2006 Wiersma Jurs, 2005 Pallant, 2005 Best Kahn, 1998). The results of Principal Component Analysis demo that the factor loadings of all scale items were ranged from .72 to .97 and the Kaiser-Meyer-Olkin (KMO) of Sampling Adequacy was statistically significant (Bartletts Test of Sphericity, p = .000) and ranged from .64 to .87. These results clearly indicate a good factorability (Brace, Kemp, Snelgar, 2006, p. 318).Reliability in quantitative research refers to the consisten cy of the methods, conditions, and results (Manning Munro, 2006 Wiersma Kurs, 2005 Pallant, 2005 Best Kahn, 1998). There are three common ways of testing reliability in quantitative research, namely, test-retest reliability, split-half reliability, and coefficient (Munning Munro, 2006 Pallant, 2005). The test-retest approach is applied when a researcher tests the same set of people on two different occasions and the scores from the first test is correlated with the scores from the second test. In the split-half reliability, a researcher administers questionnaires only once and split the items used to create coordination compound variable into two equivalent halves, followed by creating two composite variables from these two sets and correlate them.For the purpose of this study, the coefficient alpha (also known as Cronbachs alpha) was applied. The values of coefficient alpha supra .70 are considered to represent acceptable reliability, above .80 good reliability, and above .90 to represent excellent reliability. The values of coefficient alpha of this instrument ranged from .82 to .95, indicating good and excellent reliability (Manning Munro, 2006, p.25).Results and DiscussionsDemographic InformationIn the study, several variables in relation to demographic information were analyzed for providing the general background of respondents. These include location, genders, qualification of formal education, positions in schools, and ages of respondents. The majority of respondents (57%) were located in district town schools of Ngada, while 43% of them were from village schools located in Golewa Sub-district area. Then, the majority of respondents (53%) were male, while 47% of them were female. Meanwhile, most of respondents (39%) graduated from bachelor degrees, while 36% of them graduated from diploma educational institutions. Meanwhile, 25% of respondents had the high school teacher training education or senior high school.The biggest percentage (38%) of res pondents in the empirical survey was parents, followed by teachers and school council members (26% and 24% respectively). Other respondents were administrative staff (9%) and principals in seven schools (2%). Most of the respondents (40%, N=318) were between 41 and 50 years old. Twenty-six of them were between 31 and 40 years old, while small percentages of respondents were between 51-60 and 20-30 years old (20% and 14% respectively).Opinion on the Current Practice of SBM PolicyIn Indonesia, the policy in decentralized education system through School-Based Management (SBM) was actually the initiatives made by the Central government in Jakarta. Fortunately, the initiative was strongly supported by international donor agencies. In Flores, Australian Agency for International Development (AusAID) provided assistance for school stakeholders in the areas of SBM policies and programs, including the devolution of authority and responsibility from governments to school councils in terms of b uilding new schools, building renovation, library, school text books, school curriculum, school development planning, monitoring anf evaluation, school operational grants, as well as how joyful teaching and learning is linked to active participation of the whole school community members. An analysis was made in this study to rein out the overall impression of school stakeholders on the current implementation of SBM policies and programs. As shown in skirt 1, all respondents in the empirical survey perceived the implementation of School-Based Management (SBM) either adequate (5%), good (46%) or excellent (48%). This implies that SBM policies and programs in these schools were applicable. postpone 1 Opinion on the current practice of SBMValid ItemFrequencyValid PercentUnsatisfactoryAdequateGoodExcellent01714715405.346.248.4Total318100.0An effort was also made to find out whether there was statistically significant difference in terms of the school stakeholders opinion in terms of th e implementation of SBM. As presented in send back 2, there was no statistically significant difference (Chi-sq =59, N = 318, p = .74) with the 96% of respondents who are working in schools (teachers, administrative staff and school principals) who either stated good or excellent on the implementation of SBM, compared with 94% of respondents (school council members and parents) who stated the same. fudge 2 Opinion on the implementation of SBM by position of respondents in schoolNewPosition * Opinion on the Implementation of SBM CrosstabulationOpinion on the Implementation of SBMTotalAdequateGoodExcellentNewPosition1*Count55660121% within NewPosition4.1%46.3%49.6%100.0%2**Count129194197% within NewPosition6.1%46.2%47.7%100.0%TotalCount17147154318% within NewPosition5.3%46.2%48.4%100.0%* = Teacher, administrative staff, principal** = School council members and parentsChi-Square TestsValuedfAsymp. Sig. (2-sided)Pearson Chi-Square.593a2.744Likelihood Ratio.6122.736Linear-by-Linear Asso ciation.3111.577N of Valid Cases3180 cells (.0%) have expected count less than 5. The minimum expected count is 6.47.How SBM Change the Authority on School Decision-MakingsSince the implementation of SBM, authority in decision-making is vested from governments to school level decision-makers. For this purpose, each Indonesian school has established school councils for decision-making processes. In this research, it was necessary to find out how the school stakeholders considered the authority in decision-making after the implementation of SBM.Table 3 SBM and decision-making authority in schoolValid ItemFrequencyValid PercentDisagreeAgreeStrongly Agree181661345.752.242.1Total318100.0Table 3 shows that the vast majority (94%) of respondents in the empirical survey either agreed (52%) or strongly agreed with the statement School-Based Management has resulted in the homework of wider authority in school for decision-making. This result implies that as perceived by the respondents, auth ority for decision-making has been vested in school level since the implementation of SBM.In the history of Indonesian education system prior to the implementation of SBM, school principals were the authority figures in school decision-makings. They worked very closely to the district government officials in relation to the arrangements of new school buildings, school renovation, and even school textbooks for children. In such a practice, parents and other school community members never involved in decision-making processes. These practices were in line with Education Law No.2/1989 on National Education System and Government Regulation No.28/1990. It was regulated that central government has the authority in regard with curriculum, textbooks, school facilities, deployment, and development of staff, while authority in relation to new school buildings and renovations are in the hands of district governments (Article 9, Government Regulation 28/1990).In contrast, under SBM scheme, auth ority in these areas is not solely vested in school principal, but to the school councils. This requires principals to distribute the authority to school council members. The central government decided on the structure and composition of the councils to represent school communities. However, each school itself was given the authority to decide the size of the council based on their school size. Thus, each school has to elect a school council with a minimum of nine members depending on the size of the school. The membership of a school council should comprise of principal and the representatives of teachers, students, parents, school foundations, local governments, and community. The community representatives should consist of (1) public figures, (2) educational experts (3) industries or businesses (4) professional organization of teachers representatives of alumni and (5) representatives of students. Apart from electing and/or nominating a maximum of three representatives only from teachers, school foundations, and Advisory Body for the Village Governance (Badan Pertimbangan Desa/BPD), there is no limitation of the total number elected from the representatives of the community members.Opinion on How SBM Creates Higher betrothal of School StakeholdersAn effort was then made to seek the nature of participation of school stakeholders in school decision-makings as perceived by the school stakeholders.Table 4 SBM and higher participation in schoolValid ItemFrequencyValid PercentAgreeStrongly Agree19612261.638.4Total318100.0Table 4 shows that all respondents (100%) stated either agree (62%) or strongly agree (38%) with the statement SBM implementation has resulted in increased participation if all stakeholders in school. The result indicates how SBM policy in schools has crea

Accor The Fast Growing Hotel And Tourism Marketing Essay

Accor The Fast Growing Hotel And Tourism Marketing EssayCurrenly Accor has hotel and service related overseas telegram of descent in nearly 90 countries with 4100 hotels where more than 500000 entourage has been built where customers being offered hotel stays to the specific needs of each business and leisure customer.ACCOR worldwidHotel activities4127 hotels and thalaso sitesSofitel-121 hotelsPullman- 46 hotelsNovotel-395 hotelsMercue-699 hotelsibis-861 hotelsAll seasons-75 hotelsEtap Hotel- 403 hotelsFormula1- 351 hotelsMotel6-1001 hotelsstudio6-59 hotelsHotel without brand-45 hotelsThalasa sea and Spa-16 centreServices for our companies and public institutionsAs a worlds best service provider ACCOR has been providing several flagship product, Ticket restaurant, Accor service designs, develops and manages serve for more than 490000 corporate clients and public institutions. At least 33 one thousand million practisers and 1.2 million affiliated service providers of 40 countries are benifited by the ACCOR.Part-1 of the AssignmentBasis of competitive advantagesACCOR has started its business with the opening move of the first Novotel in Lille in 1967. Since their opening a pioneering smelling of conquest has driven ACCOR to achieve its goal. It is a great success for the ACCOR that they make this spirit of conquest shaped into bases culture. And this culture shaped by a constant concern for people and commitment to the highest performance standard.For more than 40 years, across all brands and regions, Accors five core harbors of intromission, a spirit of conquest, performance, trust and respect have been shared and expressed every day by its 150,000 employees. Managers supplement these values to provide at decenniumdant for team members as section of the roots ongoing transformation and development.Innovation is potmarkThe spirit of conquest is growth enginePerformance is the key to continued successRespect is basis of all relationshipsStrategic c hoice of ACCORACCOR business strategies are being reviwed and amended constantly according to customer demand and other circumstances such as govt policy, political stability etc.Bowmans Strategy Clock-(Referece analysis- www.scribd.com, title- Bowmans stretagic clock, making sense of eight competitive positions)IN advanced open markets, customers purchasing thier products from many consequence of companies, and customers have a tremendous amount of choice. So, its accor duty to find the competitive edge and meet customer needs to get competitive advantage over the rival competetors.ACCOR has make their business stretagy to diferenciate themselve from the others.ACCOR aims to fulfill customers demands according to customers need by perceiving added value.ACCOR value innovation hotelReference www.maaw.info (Title- curve value, management and accounting web)Accors Formule 1 Hotels are ground on a new concept where standard hotel features are eliminated (e.g., restaurants, lounges a nd receptionists except for peak check-in and check-out times). They employ automated tellers instead of receptionist for customers to check-in and check-out. Their rooms are low-pitched and include a bed and only the bare necessities. The rooms are modular blocks that are economical to build and provide good sound insulation. This new concept cut the average cost of building a room by 50% and staff costs dropped from 25-35% of sales to 20-23%. The company captured a liberal percentage of the budget hotel business and expanded the market to people that would not otherwise have stayed in a hotel.The most successful companies were those that used value innovation in all the platforms where innovation plenty take place including product, service and delivery. Compaqs innovations in the computer server industry are used to ornament the idea. To avoid what Kim and Mauborgne refer to as the trap of competing, Compaq focused on creating customer value, rather than what their competito rs were doing.In 2006 ACCOR has launched a complete transformation of its strategic vision, redifing its borders and introducing new business models in twain core business- hotels and services.With fewer owned hotels and a broad portfolio of complementary, attractive brands, Accor Hospitality has established itself as a provider of high value-added services and set ambitious development objectives for 2011.Accor Services is stepping up the technological shift that will reassert its global leadership in prepaid services.Despite the sudden, bully slowdown in the world economy in 2008 and 2009, Accor is leveraging its new strategic vision to drive continued growth, expansion and innovation in both its businesses, backed by the dedication and professionalism of its employees.The six foundations of Accors schemestepping up the transformation processa growth and innovation dynamicpowerful, complementary, recognized brandsunique skills to support the brandspeople, the companys most impo rtant assetgrowth that creates opportunities for everyoneStepping up the transformation processReference- www.accor.comIntensifying the hotel property strategyIn 2006 ACCOR has lauched a real estate strategy based on adepting hotel ownership structure on a case by case basis. Each hotels region, profitibility and market segment are interpreted into consederation to a lower place this strategy. 56% of hotels are now operated under management contracts, franchise agreements or variable-rent leases.Proactive response to structural changes in society-ACCOR hotels and services are able to forbid and integrate new economic and social developments, creating an increasingly varied portfolio of paper slight products and services. ACCOR strategy is to negotiate technological shift proactively delivered delivered via smart cards, the internet or the mobile phones.Powerful, Complementary, recognized BrandsACCOR has several types of hotels such as value innovation hotels with some key facilit ies Formule1 to five star Sofitel. They are being built new brands such as Pullman in the upscale market and all seasons in the non standardised economic segment. the repositioning of Sofitel in the luxury segment,.Unique Skills To Support The BrandsACCOR strategy has been made on the basis of innovation and performance. Accor has developed experties and skills with professional innovative approach for the last 40 years. ACCOR innovative team is capable to deliver real value-added in hotel development, innovation and design, construction maintainance, management and finance, purchasing, training and Human resources, technological support, marketing and distribution. ACCOR has created a unique system with interconnection among the above mentioned unites.People, the companys most important assetACCOR integrated culture has made a strong bridge among the team members in respect of their difference in their ages, cultural positions within the organization. Accor has always give tendin g to its employees with the help of hands on management style and a commitment to skills enhencement, training, recognition and job mobility.Growth That Creates Opportunities For alloneACCOR is a fast growing hotel and service based company. Every year thousands of rooms is being made as part of their business expansion. So, hundrades of people are getting recover to work in ACCOR. ACCOR has been operative for the local people to develop their skills as part of their social activities.Part-2 of the assignmentManagement Green IssuesACCOR hotel group has topped the first Tomorrows Value Rating of Worlds ten largest hotel groups.The value rating assessment has been carried out by Two Tomorrows, the leading sustainability consultancy. According to the research ACCOR has designed a comprehensive approach to managing team who is go round sustainability challenges with highly professional and efficiency.http//www.twotomorrows.com/Two Tomorrows, the leading sustainability consultant sa id the new rating targets to increase debate activities on sustainable business, not only that it aims to chance upon and reward best practices and spur health competition among the largest global important companies.The Tomorrows Value Rating results in the following hotel ranking-Rank1Company Name1Accor Hotel Group2Intercontinental Hotels Group3Marriot4Global Hyatt5Choice6Carlson7Hilton8Wyndham9Starwood10Best western sandwichThomas Krick, Global Programme Manager of the Tomorrows Value Ratingsaid Accor has explored some commendable solution to sustainability challanges. Their piloting innovative energy saving technologies and building, and workings with communities to maximise local procurement, at that placeby ensuring that local benefits from its present.So, it has already recognised that Accor is getting huge competitive advantages from its environmental friendly activities.Managing green issues- Accor activitiesThough most of the freehand hotel groups have noted the envir onmental issues. except management approaches are very immature. Climate change, employment practices, community welfare, wast and sustainable buildings are the most recognise issues which has been taken into consideration by the Accor hotel groups. Though others hotel groups announced the same measures but the evidence of diligent management of the issues is really scarce.Accor activities to manage green issues has been explained below-Local development(www.accor.com)Accor has been working in different developing countries in order to fight poverty. Nearly 75% people around the world living below the poverty line those are depend on agricultural income. Accor strategy is capitalising on its purchasing volume, Accor supports local agricultural business and fair trade.Accor contributes locally to jobs and training.AchievementsThrough a union with the NGO PlaNet Finance in Morocco, Accor ensures a professional training for 100 disadvantaged youths and supports argan oil cooperative s.Through a partnership with the NGO Agrisud , the Sofitel royal stag Angkor in Cambodia has been buying its food products since 2004 from small local producers, while they receive training to develop their expertise and diversify their crops.The F1, Etap Hotel, Ibis and Mercure and Sofitel hotels are offering fair trade products to their guests in more than 17 countries mainly coffee, tea and chocolate.Fight against epidemics(www.accor.com)Accor has set up a project in all of its hotel to increase awarness and legal community effors to countersink the spread of AIDS. According to accor.com there are 33 million people living with HIV virus and 90% of them are unaware of that. A number of training and awarness programmes has been conducted by the Accor hotel authority to increase awarness among the both staff and guests about epidemic of AIDS and meleria. Accor is actively trying to increase awarness about the meleria problem in Africa with the holp of their 13500 staffs.Demograph ic evolution, climate change and travel increase make it easier for new diseases to appear and spread. Thus, the Accor group decided to significantly bolster its involvement in the pr effection of all emerging diseases.Foodwww.accor.comAccor is mobilising its restaurants to promote good habits among the public. Because chronic deseases such as cancer, diabetes, etc are the main resons of death in the world. Accor is working with nutritionist to succeed all ballanced diet on their food menue.ECO prioritiesECO ActionUnited Kingdom The Etap Hotel Birmingham has been recovering rain piddle since 2006, which saves 780m3 of water every year. (78k)Energywww.accor.comSeveral measures has been taken by the ACCOR to turn out enery consumptions which put them as a eco friendly hotels group. Their action has given them huge competive advantage on rival hotels groups such as intercontinental Hotel Group. According to ACCOR hotels web site 100% of the ACCOR owned hotel are equiped with energy- efficient lamps before 2009. 80% of the subsidiary hotels are equiped at the same time. Solar panels has been installed over the wide-cut network in 200 ACCOR hotels before 2009.According to hotel environment charter, 19 energy optimizing measures has been recomanded to implement in each hotel facility such as use of energy-efficient refrigeritors, optimized outside fervour, solar panels to heat swiming pools and more.On the other hand rival Intercontinental Hotel Group says their owned/managed hotels set thir aim to reduce energy use by up to 10% in 2009. They said over the adjacent three years (2010-2012) Intercontinental Hotel Group will save energy 6% to 10%. on a per available room night basis.So, ACCOR measures to reduce energy consumptions clearly give them a competitive advantages over the Intercontinental Hotel Group.water system UseWater consumption per region (m3) 2008Americasm32008281.6EMEAm3200859.7Asia Pacificm320082.1(source- www.ichplc.com, Title- Water consumptio n)ACCOR hotel group works every day with the help of thier extensive hotel network to find sustainable formula to manage their water use. The goal is to use through innovative reutilization technologies. Evry year millions of people fall in sick due to drink untreated water in the developing countries such as Bangladesh, vietnam. ACCOR is working to ensure complience with rigorous sanitary standards in its hotels. ACCOR claimed their owned hotels consume 10% less water per room rentaed than in 2006. 100% of owned hotels and 87% of subsidiary hotels has been equiped according to flow regulators.Waste(Source- accor.com)Accor gives priority to products that use less packaging and are less toxic for the environment at the end of their life cycle. ACCOR has been using different process in its facilities to remove more waste and increase the recycling segments. lonesome(prenominal) 10% of waste products are recycled in the world. ACCOR has set their target to recycle 70 percent paper, ca rdboard and glass. 95% of the owned ACCOR hotels aims to recycle their batteries and compact light ligh bulbs/tubes by 2010.Our approach to waste management is based on the 3Rs reduce, re-use and recycle. Waste reduction has the most economic and environmental benefits (e.g. reduction in Greenhouse shooter emissions) followed by re-use, recycling/composting and energy recovery.Biodiversity1 out of every 4 mammals, 1 out of every 5 fish, and 1 out of every 8 plants are in danger of extinction The beauty of a natural site typically attracts visitors, to the point that tourist hotels are often located in fragile ecosystems. Accor is therefore committed to the preservation of the natural environment by regularly mobilizing its staff.Groupwide programmeThis section presents all the areas in which accor is acting to improve its extend to on the environment and on societyConstructionConstruction of buildings are blames for 40% if energy consumption and 40% of the worlds CO2 emissions. M ain items are heating, lighting and water. Accor will complete to open its 1800 new hotels under their news ecofriendly construction rules.EcodesignPackaging item creats hundrads of thousands tones of wast in the world every day. Though there is signicant chance to reduce the volume of waste it is not been taken seriously by the big companies who are responsible for this wast related problem. Accor is in constact contact with their suppliers to rethink products, reduce unnecessary quantities and giving priority to recycle materials.PurchasingAccor purchases approximately 3 billion euros in products each year.Present in 90 countries, Accor has significant leverage for change through its purchasing. The Group thus wishes to verify that its suppliers respect its environmental and social commitment. Accor is supplied by over 2800 suppliers around the world.ACCOR strategies to get into new market has been analysed on address six key issues-choice of products, choice of strategic markets, mode of entry, transplanting the corporate DNA, winning the local battle, and speed of global expansion. These six issues helps ACCOR go about building global presence in a systematic manner.Part-3 of the assignmentDirection for growthPart-4 of the assignmentRecommendation-Guest involvement in Green concept- It can be a good idea to involve ACCOR guest to their green concept. I believe it will help ACCOR hotels to make them a sustainable hotel group in the world. It is my suggestion to chose all old ages guests to invite them to plant tree on the ACCOR hotel premises with hotel and customer partnership basis. The concept can be interchangeable a old age customer will be invited to plant a tree that tree will be looked after by the company. But the customer of his/ her next of keen will get of 10% of its partnership. A picture of their tree plantation will be displayed in museum style room. Every year the guest will keep in touch and the progress of the tree will be informed. Every year their family will be invited to an event based on their forestation partnership project. I believe after 15-20 years this project can bring huge revenue for the company. If the customer die their next of keen will be more emossional. I hope their family members will come very often to see that nature friendly activities. I made this elaborately which is very difficult to explain in few words.Justification of the recommendationStrategic objectives of the recomandation-Selecting third world countries for mid range hotel- Usually there are two types of hotels are being built in third world countries especially in Bangladesh, Vietnam, Sri Lanka and others developing countries. An example can be cited on Bangladesh to justify my recommendation.

Laminar Air-flow to Control Operating Room Infection

Laminar Air- scat to Control Operating Room InfectionINTRODUCTIONSurgical station contagious diseases (SSIs) are delimit as infections occurring within 30 days after surgical mathematical process or within one year if an implant is leave in place and affecting either the incision or deep tissue at the operating theater site (Owens and Stoessel 2008). SSIs are reported as the study ca make mathematical function of of high morbidity and mortality among post -operative patients (Weigelt et.al. 2010). According to UK National Joint Registry Report, during 2003 -2006 period infection was accoun circuit card for ab come out of the closet 19 % trouble of peg surgery resulting in revision procedures (Sandiford and skinner 2009).Micro-organisms in the bearing shares settle on the breach, dressings and surgical instruments and cause infections (Chow and Yang 2005). Whyte et.al (1982) identified that contamination from patients skin as the cause of infection in 2% cases and from star sign personnel in 98% cases. They also demonst prize that in 30% cases, contaminants reach the wound from theatre personnel via air and in 70% cases it is via hands.loosely air quality in the operating room is maintained external respiration frame. Additional improvements bottomland be achieved by stratified air-flow administration or UV lights. Laminar air-flow system is expensive and require continues maintenance. Its installation increases building cost and the operational cost (Cacciariet.al., 2004 Hansen, 2005). Studies conducted to estimate the effectiveness of stratified flow becomed mixed results and there is no consensus on its role in infection control (Sandiford 2007). In this setting, this paper reviews the recent studies to good dealvass the effectiveness of bedded air-flow in reduce SSIs.Studies for this review were lay down by searching on infobases such as CINAHL, PubMed, Science Direct, Ovidsp, Science Citation world power (ISI) and Google scho lar. Keywords apply for this search are bedded air flow, surgical site infection, operating room air quality, airborne infections + operating theatre, LMA + infection control. As laminar air-flow is use mainly in orthopaedic theatres, major(ip)ity of the studies are on joint surgery.OPERATING THEATRE AIR QUALITY AND INFECTION CONTROL interior air in an operating theatre contains dust which consists of substances released from disinfectant and sterilizers, respiratory droplets, insect parts smoke released from cautry. Dust elements act as a bearer for transporting microorganisms laden particles and house settle on surgical wound and there by cause infection (Neil 2005). Air particles are found to be prudent for about 80% 90% of microbial contamination (CDC 2005).Modern operating theatres are generally render with conventional ventilation system in which filters bay window remove airborne particles of size 5mm about 80-95% (Dharan 2002). The efficacy of operating room ventila tion is mea accreditedd by the colony forming units (CFU) of organisms present per cubic meter. The conventional ventilation (Plenum) with 20 air exchanges is considered efficient if it achieves the colony come of 35cfu/m3 or less (Bannister 2002).Ventilation system with laminar air-flow directs the air-flow in one direction and sweeps the air particle over the wound site to the exits (CDC 2003). Laminar air-flow with HEPA (High Efficiency Particulate Arrestment) filters system has the capacity to remove air particles of size 0.3 m up to 99.9 % and can produce 300 air exchanges per hour in radicalclean orthopaedic theatres. (Sandiford and skinner 2009).Laminar air-flow units are generally two types ceiling-mounted (vertical flow) or wall-mounted (horizontal flow). There are inconveniences associated with both types. Generally the major problem associated with laminar air-flow is flow disruption. With vertical laminar flow, it is the heat generated by surgical lamps creates air turb ulence while with horizontal laminar flow it is the surgical team that disrupt the air-flow (Dharan 2002).LAMINAR AIR FLOW IN INFECTION CONTROLLLaminar air-flow system is mainly used in implant surgeries where hitherto a small number of microorganisms can cause infection. In joint replacement surgeries, one of the main causes of early (within 3 months) and delayed (within 18 months to 2 years) deep prosthetic infections was found colonisation during surgery (Knobben 2006). Laminar air flow is supposed to minimize contamination by mobilizing uniform and king-size tawdriness of clean air to the surgical area and Contaminants are flushed out instantly (Chow and Yang, 2004). Some studies found that this method is effective in reducing infection but some others produced contradicting results (give some reference)A recent study conducted by Kakwani et.al. (2007) found that laminar air-flow system is effective in reducing the reoperation rate in Austin-Moore hemiarthroplasty. Their stud y compared the reoperation rate between theatres with laminar air-flow and theatres without laminar air-flow system. A cohort of 435 patients who had Austin-Moore hemiarthroplasties at Good Hope Hospital in Birmingham between August 2000 and July 2004 were selected for this study. Of those 435 patients, 212 had operation in laminar air-flow theatres and 223 had operation in non-laminar air-flow theatres. Data were collected by reviewing case nones and radiographs. For all cases antibiotics were administrated and water impervious surgical gowns and drapes were used. In the non-laminar air-flow group it was found that the re-operation rate for all indication in the first year after hemiarthroplasties was 5.8 % (13/223), while in the laminar air-flow group it was 1.4% (3/212). Analysis found that there were no statistically momentous relation between re-operation rate and water impervious gown and drapes (p=0.15), while use of laminar air-flow found a statistically significant drop ( p=0.0285) in re-operation rate within the first year after hemiarthroplasties. They found that re-operation rate in no-laminar air-flow theatres were four times greater than that in laminar airflow theatres.Even though the aim of the study was clearly described there was no review of existing studies to identify the gap in the research. canvas methods and details of statistical psychoanalysis were given elaborately. The sample size seems sufficient. Results were summarized and presented using graphs and charts. Discussion of results was short and seems not adequate to address the objectives of the study. There was no get down to explain the casual relations pelvic girdle. For example researches were making statements such as the introduction of water-impervious drapes and gowns did not seem to make a statistically significant improvement in the result. (p.823). Researchers failed to acknowledge any limitations of the study. Data for this study was collected by reviewing patients records. Patients records are considers as confidential and researchers didnt mention whether they authoritative consent from the patients or estimable approval form institution to conduct the study. This can be considered as an ethical flaw of this study.There are studies which found that laminar air-flow system is not effective in reducing infection rate. In their study Brandt C et.al (2008) found that infection rate was substantially high in theatres with laminar air-flow system. This was a retrospective cohort-study based on routine surveillance data from German national nosocomial infections surveillance system (KISS). Hospitals which had performed at least 100 operations between the years 2000 and 2004 were selected for this study. Type of ventilation technology installed in operation rooms of selected hospitals were collected separately through questionnaire from infection control teams in the combat-ready hospitals. Surgical departments were grouped into categories accord ing to the type of ventilation system installed. Departments using artificial operating room (OR) ventilation with either turbulent or laminar airflow was include in this study.Total 63 surgical departments from 55 hospitals were included in this study. Analysis was performed to the data set created by merging the questionnaire data on OR ventilation and surveillance data from the KISS data base. The data set analysed contained 99230 operations with 1901 SSIs. Age and gender of the patient was found a significant risk agentive role of SSI in most procedures. Univariate analysis conducted found that rate of SSIs was high in departments with laminar air flow ventilation. Multivariate analysis also confirmed this finding. Authors argue that it may be due to the improper positioning theatre personnel in horizontal laminar flow room.Researches provided a well-researched literature review which clearly identified gap in stream research. Objectives and design of the study was properly exp lained. Study was based on a large sample size. Results were discussed in detail and casual relations were well explained. Enough tables were used to present results. Limitations were properly discussed.Knobben et.al (2006) conducted an experimental study to evaluate how systemic changes unitedly with behavioural changes can decreases intra-operative contamination. This study was conducted in the university Medical Centre Groningen, The Netherlands. A random sample of 207 surgical procedures which involved total knee or hip prosthesis from July 2001 to January 2004 was selected for this study. Two sequential series of behavioural and systemic changes were introduced to ascertain their role in reducing intra-operative contamination. The control group consisted 70 cases. Behavioural changes (correct use of plenum) were introduced to the first intervention group of 67 operations. Intense behavioural and systemic changes were introduced to second intervention group of 70 operations. Th e systemic changes introduced was the installation of new laminar flow with improved airflow from 2700m3/h to 8100m3/h. Two samples each were interpreted from used instruments, unused instruments and removed bones. Control swabs were also collected to make sure that contamination was not occurred during transport and culturing. Early and late intra-operative contamination was also checked. All patients were monitored for any wound discharge while in hospital and followed-up for 18 months to check whether intra-operative contamination affects post-operative infection.Among the control group contamination was found 32.9% while in intervention group 1 it was 34.3% and in intervention group 2 it was 8.6%. Except in Group 1 (p=0.022) late phase contamination was not significantly higher than early phase contamination. During the control period wound discharge was found in 22.9% patients and 11.4% of them had wound infection later. Deep periprosthetic infection had been found in 7.1% of t hem in the follow-up period. Deep periprosthetic infection was found in 4.5% cases of first intervention group and in 1.4% of cases in second intervention group in the follow-up period. But none of these decreases were found statistically significant. Contamination, protracted wound discharge and superficial surgical site infection were found decreased after both first and second intervention. But a statistically significant reduction was found single in second intervention (contamination p=0.001, wound discharge p=0.002 and superficial SSI p=0.004). This study reason that behaviour modifications together with improved air flow system can reduce intra-operative contamination substantially.Purpose of the study was clearly defined and a legal review of the current literature has given. Gap in current research was clearly presented and justification for the study had given. Sample size seems sufficient. It is reported that .bacterial cultures were taken during 207 random operations (p. 176), but no details of the sampling method used were provided. Details of interventions were given elaborately and results were discussed in detail. But only one table and two charts used to present it. The readers would have been more benefited if more tables were used to present the results. Discussions of the results were concise and findings were unique(predicate) and satisfying the objective. No information on whether they received informed consent from the patients and approval form the ethical committee of the institution was missing. This arise a serious question about the ethics of this study.It is found that laminar airflow is more effective when use in conjunction with occlusive clothing (Charnley, 1969 cited in Sandiford and Skinner 2009). While in their recent study mineworker et.al (2007) compared the effectiveness of laminar airflow system and body exhaust suits found that body exhaust suits are more effective than laminar flow system in reducing infection.For t heir study Miner et.al (2007) selected 411 hospitals which have submitted the claim for total knee surgery (TKR) for the year 2000 from four US States were surveyed to collect the details of use of laminar air flow system and body exhaust suits. Those hospitals which were fulfilled three criteria were included in this study. The inclusion criteria were 1) returned the survey instrument, 2) using laminar air flow system or body exhaust suits for infection control and 3) was evidence of at least one Medicare claim for TKR for the study period. Total 8288 TKRs performed in 256 hospitals between 1st January and 30th August 2000 were selected. Data on patient outcomes after total knee replacement (TKR) were collected from Medicare claims. The patients who underwent bilateral TKR were not included in this study and for those who underwent a second TKR during a separate hospitalisation during the study period, only the first procedure was included. International Classification of Diseases, Ninth revise (ICDS-9) codes was used to identify post-operative deep infection that needed additional operation. Hospitals were grouped as users or non-users for both laminar airflow and body exhaust suits. Users were defined as those who use any of these methods in more than 75% procedures and non-users were those use any methods less than 75%. The over-all 90-day incidence of deep infection, subsequent operation was found required only in 28 cases (that is 0.34%). Analysis found that the risk ratio for laminar airflow system was higher (1.57, 95% confidence breakup 0.75-3.31) than body exhaust suits (0.75, 95% confidence interval 0.34-1.62). Study found that there were no significant differences in infection between hospitals that use specific either protective measure.Other than mentioning few studies researchers failed to provide any background of the research problem. Methods used for this study were explained concisely. Even though the sample size was large, express number of events (28) were there to be observed. Analysis was based on this small number of events this may have affected the result. Not many variables were included in this study, and researchers didnt mention how they controlled some possible confounders. Researchers were successful in identifying the advantages and limitations of the study. Results were properly presented in tables.Instead of expensive laminar air-flow system, installation of well-designed ventilation system is found beneficial. Scaltriti et.al (2007) conducted a study in Italy to examine effectiveness of well-designed ventilation system on air quality in operation theatre. They selected operation theatres of a newly create 300 beds community hospital which have ventilation system designed to achieve 15 complete outdoor air changes per hour and are equipped with 0.3 m, 99.97% HEPA filters. All these satisfy the condition for a clean room as per ISO 7 bar. Passive samples of microbiological air counts were collected using Tripticase Soy Agar 90 mm plates left open thorough out the duration of the procedure. Active samples were also collected using a single state slit-type impactor. Total 82 microbiological samples were collected of which 69 were passive plates and 13 were active. Air dust was counted with a light-scattering particle analyser. Details of the surgery, number of nation in the room, door opening rate and estimated total use of the electrocautery unit were also collected.It was found that there were positive correlations between particle contamination, surgical technique (higher risk from general conventional surgery), electrocauterization and operation length. Door opening rate was found negatively associated. Researchers suggest that this may because when theatre door open a turbulent air flow blows out of the operating room which may result decrease in the dust particles. No association was found between particle contamination and number of people present at the time of incision . Researchers suggest that human movement rather than human presence is the factor that determines airborne microbial contamination. It was found that average particle concentration in the theatres did not exceed the European ISO 14 644 standard limits for ISO 7 clean room, and so concluded that well-designed ventilation system is effective in limiting particulate contamination.Uncultivable or unidentifiable organisms can also be a reason for surgical site infections. It may be unenviable to identify such organisms through standard culture techniques (Tunney 1998). Clarke et.al (2004) conducted a quantitative study to examine the effectiveness of immoderate-clean (vertical laminar flow) theatres in preventing infections by unidentifiable organisms. They used the molecular technique, Polymerase Chain Reaction (PCR), to detect bacteria presence. Their study compared the wound contamination during primary total hip replacement (THR) performed in standard and ultra clean operation the atres. 20 patients underwent primary THR from 1999 to 2001 were recruited for this study. Patients with previous incidents of joint surgery or infection were excluded. The standard operation theatres had 20 air changes per hour and CFU count was 50 CFU/m3, while ultra-modern theatres had 530 air changes per hour and CFU count was 3 CFU/m3.For all surgeries same infection control precautions were used. Two specimens each of pericapsular tissues were collected from posterior joint capsule both at the rootage and at the end of the surgery (total 80 samples). Patients were given antibiotic prophylaxis after taking the first specimen. All these samples were underwent g stain and culture to detect bacterial colonies and Polymerase Chain Reaction (PCR) to detect bacterial DNA.Among the 20 specimens taken form the standard operation theatres at the beginning of the surgery only 3 were found positive with PCR, while from the ultra-clean theatres only 2 were found positive. None from both t heatres found positive with culture. Samples from the standard theatres taken at the end of the surgery, 2 found positive by culture and 9 found positive by PCR. The contamination rate in the standard theatre at the end of the surgery found significantly greater than the beginning (p=0.04). Samples taken from the ultra-clean theatres, none was positive by culture while only 6 were positive by PCR. Statistical analysis found that contamination rate at the end of the surgery is not statistically different than the jut out (p=0.1). It was found that there were no statistically significant difference in overall contamination rate (p=0.3) between standard and ultra clean theatres. (I testament add critique of this study here)NURSES ROLE IN INFECTION CONTROLUnderstanding the source of contamination in operating theatre and knowing the blood between bacterial virulence, patient immune status and wound environment will help in improving the infection rates (Byrne et al 2007).Nurses are r esponsible to take a proactive role in ensuring safety of their patients. To improve patient outcome, it is necessary for the nurses to take lead role in environmental control and identifying hazards through environmental surveillance (Neil 2005). Non-adherence to the principle of asepsis by surgical team is identified as a significant risk factor of infections. Hectic movement of surgical team members in the operating room and presence of one or more visitors were also found as major causes of SSI (Beldi G 2009). Nurses and managers should emphasise on controlling factors like the traffic in theatre, limiting the number of staff and reinforcement of strict aseptic technique (Allen 2010). Creedon (2005) argues that infections can reduce up to one third if staffs follow best practice principles. For better outcome staffs needs additional education and positive reinforcement.Nurses have a vital role in the development, reviewing and approving of patient care policies regarding infecti on control. Nurses are not only responsible for practicing the aseptic techniques but also responsible for monitoring other staff for their adherence to policies. They are responsible for developing training programmes for members of staff. Educating the environmental services personnel like technicians, cleaners will not only improve their knowledge in patient care but also provide a sense of commitment in patient outcomes (Neil 2005).Perioperative nurses can contribute in research regarding theatre ventilation system through organised data collection and documenting evidences. Nurses can contribute in giving best and safe delivery of care in areas where environmental issues can put the patient at risk. Knowledge is changing fast, so it is important that staff mustiness keep themselves up to date. Continues quality improvement is needed and it should be based on evidence based research and on-going assessment of information (Hughes 2009).CONCLUSIONReviews of current research show s that still there is a lack consensus on the effectiveness of laminar airflow in infection control. Studies include in this review has used either clinical outcomes (infection or reoperation rate) or intermediate outcomes (particle count or bacterial count) to evaluate the effectiveness of laminar flow. Kakwani et.al (2007) found that re-operation rate was lower in laminar airflow theatres but Brandt et.al (2008) found SSI rate was high in hospitals with laminar flow. Clarke et.al (2004) found that contamination was not significantly different in ultra clean theatres compared to standard theatres equipped enhanced ventilation system. Supporting this finding Scaltriti et.al (2007) found well designed ventilation system is effective in reducing contamination.Study by Knobben et.al (2006) found that combination of systemic and behavioural changes are required to prevent intra-operative contamination. Miner et.al (2007) found that there were no significant differences in infection betw een hospitals that use laminar airflow and body exhaust suits.From these studies it can be concluded that use of laminar airflow alone can guarantee infection prevention. Behavioural and other systemic changes are necessary to enhance the benefits of laminar airflow. Evidence shows that conventional theatres equipped with enhanced ventilation system can prevent infection effectively, this can be consider as an alternative for expensive as laminar flow system.

suzuki 750 :: essays research papers

SUZUKI GSXR 750There it was the street machine. The Suzuki GSXR 750 staring back at me as I was in disbelief. Palms sweaty, jaw forbidding as my m come forthh watered. The bike was immaculate and shining like a multi million dollar diamond ring. The lighting in the showroom brought out its true up beauty.The GSXR is a superb machine that is bound to get noticed with 125 rear wheel horsepower and dry weight of 365 pounds. You couldnt ask for anymore in a bike. It also has inline four cylinder dual over head cams and 16 valves pumping out 127 rear wheel horsepower. Pound for pound it was the topper bike in the world with the most ruthlessly efficient balance of power. The sleek, aggressive Japanese engineering made the bike look ridiculous. The superman cause headlight was one of a kind. Located on each side of the headlight were the flaring ram air nostrils making it look like a hungry bike. It has a color scheme of red, white, and blue and it looked like the American flag blowin g in the wind. The only thing left was one last signature. all in all of the sudden the feeling of completion hit me like a sack of nickels and tunnel vision. Finally the transaction was done, all I had to do was to hop on and hang on tight.My adrenaline was pumping as I started the bike. The rumbling between my legs, I couldnt take it anymore I had to go. A couple lefts and rights out of the parking lot and I was sitting at the intersection. Waiting for the light to turn green I was nervous and excited at the same time. I began to sweat, not because of the hot weather, but the pure fact that the beast was screaming for throttle. I hit the road and took it easy for a bit because this bike had the aptitude of taking my life. All my thoughts of death faded as a Mr. Ed smile ran across my face. I felt invincible as all my filter of reality and everyday life went away. It made me feel free with my mind going into overdrive with not a care in the world. I started getting comfortable so gradually giving the bike more gas. With half throttle I was already at 90 miles per hour. I hit a straight away and hammered on the gas.

Christianity: Salvation by Grace Essay -- Religion Christian

Christianity is a faith based on the life, teachings, death, and resurrection of delivery boy Christ. (Fisher, 1991) Christianity is a one deity religion as presented in the New Testament. Today, Christianity and the perform are culturally diverse, even in the aspects of race. It is even said that Sunday mornings is the most segregated time in the world. There is one central vox populi that Jesus Christ is the Son of deity, all Christians can come to this conclusion. Christianity teaches that Jesus Christ died on the cross for our sins and that we are all under the judgment of God because we have all sinned and fallen short of the glory of God. Other religions may often depict that it is only necessary to do some good when it comes to God in order to get into heaven. However, Christianity is the only religion that supports the teachings of salvation by grace. Meaning that our efforts, sincerity, and good works alone result not guarantee us a place in heaven, but instead it is our faith in what Christ did on the cross along with obeying the gospel, and living faithfully until his return that will place us there. Followers of Jesus Christ were persecuted, but by 380 CE, despite strong opposition, Christianity became the official religion of the vast Roman Empire (Fisher, 1991) At least three things can derive from Christianity a set of beliefs, the way of life and a community of people. Christ is the Greek form of the Hebrew war cry Messiah, meaning anointed one. Christianity originally developed as a part of Judaism. Jesus was a Jew. It is said that he lived from about 3 BC to 30 AD. He lived and taught in Palestine, to the Jews. Christianity also teaches that God created the universe and all that is in it. While we as humans have both physi... ...sians 4 4-6) Jesus said Upon this rock I shall build my church (Matthew 1618). The church building of Christ, the only one that you can find in the bible.ReferencesBercot, D. (2006). Retrieved February 13, 2009, from History of The Early Church http//www.earlychurch.com/index.phpFisher, M. P. (1991). Living Religions. Upper Saddle River, NJ Pearson Public Education.Morrison, M. (n.d.). Discipleship 101. Retrieved February 13, 2009, from Worldwide Church of God http//www.wcg.org/lit/disc/16grace.htm Christianity. (2009, February 11). In Wikipedia, The Free Encyclopedia. Retrieved 0445, February 14, 2009, from http//en.wikipedia.org/w/index.php?title=Christianity&oldid=270002186Muslims. (2006, work on 25). In Wikipedia, The Free Encyclopedia. Retrieved 0446, February 14, 2009, from http//en.wikipedia.org/w/index.php?title=Muslims&oldid=45357695