Thursday, December 5, 2019

Regulatory Failure in Electricity Sector †Free Samples to Students

Question: Discuss about the Regulatory Failure in Electricity Sector. Answer: Introduction The main purpose of this assignment is to analyze the financial markets of two countries and make a comparison on the same. For the purpose of this report, the two countries which have been selected are Australia and Singapore. As per Stachowiak-kudla Kudla, (2017), Financial regulations may be defined as the form of regulation which various financial institutions are subjected to certain rules and regulations which are to be followed by the bank in order to maintain the integrity of the financial system (Stachowiak-Kud?a Kud?a, 2017). Such regulations may be present upon both governmental and non-governmental institutions. In other words, the introduction of financial regulations has ensured that there is greater efficiency in the financial system and there is availability of financial products. The report in the first part of the assignment will be focusing on the aspects of literature review which is to be conducted on the basis of the two countries selected. The literature review will be concerning the regulatory financial market present in Singapore and Australia. The report will be revealing the regulatory problems which are faced by the companies and also segregates what are the different aspects of the regulatory market and who takes the major decisions (Young, 2013). The second part of the assignment will be dealing with the Regulatory capture theory which will be analyzing the regulatory markets of Singapore and Australia. In order to properly explain and relate the concepts with the two countries selected, the primary thing to understand is the meaning of capture theory and how the theory is useful (Brink, Lowe Victoravich, 2013). Lastly the report will be ending with a conclusion which will be providing the results which are related to the comparison. In the case of Australia, the IFRS standard were implemented with the primary focus to make the financial statements presentable, comparable, transparent and free from material misstatement. The standards were issued to make the accounting process a bit simple and accurate as well. The implementation of the IFRS standard were at first difficult to understand as such would be requiring proper understanding of the standard in order to carry out the treatments which were provided in the standard. This situation posed a problem for the management of the company, its shareholders and even the auditors of the company as they are used to following the old standard which the IFRS standards replaced. In addition to this, there have been other problems which are associated with the political and legal factors related to the implementation of IFRS standards. On the other hand, it can be taken as a opportunity of to develop additional skills and proper understandings of the treatments which are there in the IFRS standard (Ahmed, Neel Wang, 2013). The standard which are issued by the Singapore board which issues standard faces certain problems which are related to effective implementation of the standard. An example can be given of the FRS 115 which dealt with revenue structure. Many companies were having difficulties in implementation of the standard (Horton, Serafeim Serafeim, 2013). As per the research conducted there are a majority of companies which are having difficulty in implementation of the standard as per the regulatory frame work of the business. Regulatory Environment Australian Accounting Standard Board (AASB) is an agency of the Australian Government. The main purpose of the board is to look after the accounting process and also issues standards on the basis of which financial statements are prepared and a regulatory environment is created (Rahman, 2013). When the country adopted the accounting standard for the first time, minor adjustments were made which were related to removing certain items and adding more disclosure requirements. In the year 2007, AASB made certain kind adjustments in order to make the standard identical with the standards which were issued by IFRS. In addition to this, a new differential reporting system was introduced which stated that all accounting standards should be measured which are equivalent to IFRS standards issued. However, this reporting standard reduced the disclosures requirement of the standard. In the case of Singapore, Accounting Standard Council (ASC) is responsible for the adoption of SFRS. The group of entities for reporting the entity under the common control is considered under common control which is based under a single customer (Low et al., 2013). The main use of the regulatory framework decisions is with the government agencies which are also under single customers. The important legislations which were present in SFRS is consistent with the view of IFRS and therefore a standard is to be issued by the International Accounting Standard Board (IASB). The financial statements are on the basis of which potential investors of the company takes important decisions. The various users of the financial statements of the company are creditors, debtors, stakeholders and the public at large. Adoption of IFRS The effective date on which Australia had adopted the IFRSs standard was on 1st January 2005. The adoption of the IFRS standard by the companies which operated in Australia went about smoothly and it was especially useful to record transactions which were related with not-for- profit organization (Perera Chand, 2015). There still remains several scopes for improvements which can improve the quality of the reporting and also the cost effectiveness of the reporting framework. In addition to this as the IFRS standard is an internationally followed standard therefore the users of the financial statements in Australia will able to follow and understand financial statements of foreign companies which follow IFRS standards. In the case of Singapore, the implementation of SFRS standard which are equivalent to the standard issued by IFRS. The accounting problems and issues are looked after by Accounting Standard Council (ASC). The recognition of the importance for the ASC has affirmed that Singapore financial reporting standard registered BTs: IFRS. The IFRS convergence, ISCA has depicted audit partners from different public accounting firms. The converging exercise is required to highlight the main considerations for the entities converging with the SG-IFRS (Ramanna Sletten, 2014). The standard which are set by the boards are mandatory to follow when the companies are preparing financial statements. Regulatory Capture Theory and its Usefulness The regulated capture theory was introduced by George Stigler who won the noble prize in economics for his work. The capture theory states that the process by which agencies regulate industries comes to be dominating with the industry requiring regulation. The regulatory capture takes place when the agency is formed in order to act in the best interest of the public (Carpenter Moss, 2013). This acts in a way which can provide benefits for the common interest of the public. In simple words it can be said that regulatory capture is a form of government failure which takes place when a regulatory body which have been set up by the government to act in the public interest, engages in activities which are not in the interest of the general people. Instead the regulatory body acts on the behalf of certain political or commercial concerns of special interest groups that dominates the industry on which the regulatory body was charged of governance (Potter, Olejarski Pfister, 2014). In such cases, the interest of the business or some political groups are given more preference and their interests are considered on a priority basis instead of the interests of the general public. The government agencies which are responsible for the regulation of a particular industry when gets captured are known as captured industries. Regulatory capture takes place because individuals or groups of people who have a high stake in a company is expected to react if the government brings about certain regulations in the Industries through implementations of policies which are guided by agencies. Such groups or individual will use all its resources and power to get the policies which are most favourable for the group or individual. This has been further seen to be providing benefit to the industry it is supposed to be regulating, rather than the public. The regulatory capture theory can be pointed out as a failure on the part of the government which occurs when the regulatory agency is crea ted to act with the public interest instead of the advances from the political or the commercial concerns of special interests. The regulatory capture theory is a part of economic regulations which is picture of nowadays economic regulations which are placed by the government. The persons who are involved in a particular industry that is have significant interest in an industry are naturally to have interest in the control and regulations of the company. In addition to this, due to the interest of the public in particular industries or the activities of the industry, they have a close relationship with the agencies which are set by the government to regulate the same industry. For the effective regulation of the particular industry or activities, there should be appropriate understanding of the nature and policies of the company. The regulators who have been given responsibility for effective regulation of the industry might not act in the best interest of the public and use the adv antage to secure their own personal gains out of the authority provided to them (Nepal Jamasb, 2015). The agencies which are created for the public interest are considered to be controlled by industries on whom the captured industries were charged. The situation which occurs in the case of regulatory capture agencies and the industries on which the capture was be to be made as a gamekeeper and poacher situation. In other words, it can be said that the agencies which were appointed to work in the best interest of the company becomes the threat and works against the best interest of the company. In other words, the agency ignores the role which was given to it due to some personal interests. The theory of regulatory capture is closely linked with the branch of public choice which is often stated as the economics of regulation; and economics in the speciality are critical for the conceptualization of the government regulatory intervention. The theory of regulatory capture is associated with nature of risks which are related to the agencies itself (Magat, Krupnick Harrington, 2013). The various measures which can be given on the basis of the regulatory environment has been further able to related the different type the theories and suggest that these theories are to be protected from the outside influence as much as possible. The recent interpretations of the regulatory capture theory has been able to suggest on the mature democracies considered with the high levels of the transparency and the media which is exposed to the higher levels of corruptions. Regulatory capture is the core focus of the economics of regulation and they are of the view that the governmental regulations are implemented by the government for the overall public welfare and not for individual or groups interest this shows that regulatory capture has a risk to overall welfare of the people. The measures which can be recommended for mitigating the capturing of agencies is through increased transparency of the agencies. The transparency of the agencies will be allowing the government to keep a tr ack of the activities of the agency and also ensure that the regulatory powers which are given to the agency are not being misused by the agencies. Characteristics which suggest Regulatory Environment being Captured The analysis of the regulatory environment along with understanding what are the characteristic of a regulatory markets need to be done primarily. The first step is to identify the different types of environment which have regulatory environment. It also shows that IFRS Framework is not only helping the cost savings but also by helping in proper implementation of the financial reports. In general circumstances there have been several instances where the companies have benefitted with the implementation of the IFRS framework. These changes have been tracked when companies are seen to be controlled by the industries which were charged with the captured agencies. In several occasions the difficulties in the implementation of the NFP standards developed by the AASB has been favourable in the implementation of IFRS. An example of regulatory capture which has taken place in Australia. The taxi industry which operate in Melbourne faces such an issue. The operators are given extensive powers to collect the license taxes which are associated with the business and have an access to funds which are around half a million dollars. Such operators misuse their positions in order to extract personal gains from the power which they possess. Therefore it can be said that the capture theory is followed in the economy of Australia. The regulatory environment which were identified were able to comply with the medium sized environment which is needed to be disclosed as per the disclosure requirements of the standard. The literature review which was conducted on Singapore was able to identify the means which can be sued to provide benefits to the general public. The situation can be handled effectively if the Singapore government issues frameworks of statutory rules and regulations in order to combat the situation. The government of Singapore needs to make rapid changes in the financial regulatory environment of the country in order to facilitate fair regulatory practices in the country. Conclusion The report deals with the analysis of the regulatory markets of two countries which in this case is Australia and Singapore. After the analysis of the markets it can be said that in both markets IFRS Framework or SFRS framework has been implemented. The companies which are operating in Australia have mostly implemented the framework and the companies which are operating in Singapore will be following SFRS standards which are equivalent to the respective IFRS Standard. However, it is to be remembered that the handling and interpretation of the IFRS standard requires the people involved in the use of the method are fully aware of the bests and understand the framework for effective interpretation of the same. The problems which are there with the problems are associated with the proper understanding and proper training of the IFRS standard. The users of the financial statements which can face problems are investors, regulators, auditors as well as any interest party in the financial st atement of the company. This is also considered as a major challenge for following the requirements of gaining addition skills for application and evaluation of IFRS. There is a problem of the SFRS which is recognized due to the challenges which are faced by the business which pertains to the introducing a new revenue standard. The significant findings on the working of regulatory environment have shown the first adoption of the IFRS as Australian Accounting Standards, the AASB made some modifications to IFRSs, including removing some options and adding some disclosures. In addition to this, in Singapore the Accounting Standards council (ASC) has the statutory authority for issuing SFRS adoption. The countrys progress towards the adoption of IFRS has been identified with Australia's adoption of IFRS being effective from 1 January 2005. In the case of treatment of NFP transactions, the IFRS framework is useful which was developed by AASB. In Singapore, ASC introduced SFRS which are S ingapores equivalent of the International Financial Reporting Standard. Reference Ahmed, A. S., Neel, M., Wang, D. (2013). Does mandatory adoption of IFRS improve accounting quality? Preliminary evidence.Contemporary Accounting Research,30(4), 1344-1372. Brink, A. G., Lowe, D. J., Victoravich, L. M. (2013). The effect of evidence strength and internal rewards on intentions to report fraud in the Dodd-Frank regulatory environment.Auditing: A Journal of Practice Theory,32(3), 87-104. Carpenter, D., Moss, D. A. (Eds.). (2013).Preventing regulatory capture: Special interest influence and how to limit it. Cambridge University Press. Horton, J., Serafeim, G., Serafeim, I. (2013). Does mandatory IFRS adoption improve the information environment?.Contemporary accounting research,30(1), 388-423. Low, S. P., Liu, J. Y., Ng, S. H. M., Liu, X. (2013). Enterprise risk management and the performance of local contractors in Singapore.International Journal of Construction Management,13(2), 27-41. Magat, W., Krupnick, A. J., Harrington, W. (2013).Rules in the making: A statistical analysis of regulatory agency behavior. Routledge. Nepal, R., Jamasb, T. (2015). Caught between theory and practice: Government, market, and regulatory failure in electricity sector reforms.Economic Analysis and Policy,46, 16-24. Perera, D., Chand, P. (2015). Issues in the adoption of international financial reporting standards (IFRS) for small and medium-sized enterprises (SMES).Advances in Accounting,31(1), 165-178. Potter, M. R., Olejarski, A. M., Pfister, S. M. (2014). Capture theory and the public interest: Balancing competing values to ensure regulatory effectiveness.International Journal of Public Administration,37(10), 638-645. Rahman, A. R. (2013).The Australian Accounting Standards Review Board (RLE Accounting): The Establishment of Its Participa Ramanna, K., Sletten, E. (2014). Network effects in countries adoption of IFRS. Accounting Review, 89(4), 15171543. https://doi.org/10.2308/accr-50717 Stachowiak-Kud?a, M., Kud?a, J. (2017). Financial regulations and the diversification of funding sources in higher education institutions: selected European experiences.Studies in Higher Education,42(9), 1718-1735. Young, K. (2013). Financial industry groups' adaptation to the post?crisis regulatory environment: Changing approaches to the policy cycle.Regulation Governance,7(4), 460-480.

Thursday, November 28, 2019

Joe Willis Feeling the Heat of Tailand Essay Example

Joe Willis Feeling the Heat of Tailand Essay The three new comers believe that the rest of the group feels skeptical towards them because they might be fired too. As Willis mentions, coming from the internal audit staff, workers fear him more than trust him. Consequently, this has affected communication between him and the workers who kept essential Information for them. In addition, they think that their Inability to work at the office the four first weeks has delayed the moment when they could start building new relationship with the team. From the perspective of the three executives, these are the reasons for their difficulties to manage efficiently. However. He causes they identify as challenging their ability to build trustful relations come from their own cultural script (Thomas, D. C, 2008). It doesnt take into account cultural values and underlying assumptions behind Tall behavior (Thomas. D. C, 2008). If one would have took a Thai perspective, the root causes might have been different. In fact, this explains the diffic ulties they face and the failure of their attempt to solve the problem. 2- Three Tall cultures dimensions can help us understanding the causes for the lack of trustful relationship; feminine/masculine and diffuseness/specific cultural dimension and vertical collectivism. Based on Hypotheses cultural model, Thailand can be defined as a Feminine culture. It Is less competitive, quality of life Is rewarded and conflict and direct confrontation need to be avoid. This means that when Willis confronted its team by mentioning the poor performance of the operation It was perceived as a direct offense to individuals honor. This first bad impression has been exacerbating when they fired Moot and the daughter in law of Devalued. This decision has been perceive as they were unfaithful to the family. This can be explained by the vertical collectivist (Hypotheses,1 981 ,1998) structure of Thailand culture and its diffuseness (Trampers, 1993). The former implies that hierarchy, social status and family networks are priorities. The hierarchical structure and high power distance can be observed In the authoritative political structure of the country. The importance of loyalty toward a group also explains why relations are connected in a diffuse manner. It shouldnt be a surprise that Devalued had strong ties with the political and legal system as well as engaging Is own family in its business activity. We will write a custom essay sample on Joe Willis Feeling the Heat of Tailand specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Joe Willis Feeling the Heat of Tailand specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Joe Willis Feeling the Heat of Tailand specifically for you FOR ONLY $16.38 $13.9/page Hire Writer From there, we can make the assumption that in a country where gal structure is weak relationship becomes your economic and social safety net. So, toy 2 when Moot was Dulling Defaults snares at a enlarger price, nee was proudly making sure the network would not dissolve and that Devalued would still provide political and legal security to the company. This imply that Devalued, its family and Moot were still perceived by the team members as a part of the Fiasco Motors family and fired them was to be unfaithful to the group; proportioning honesty over loyalty. When Willis found that his lawyers were affiliated to Devalued, it should have been perceived as a gin that he was open to settle the family conflict. He was in fact showing them his importance for the company stability. Non-verbal is how high context communication society works. But now that the network is broken, the three new comers will have to prove to their employees that they can be loyal to the group, by investing in it, and that they can rebuild a communal network. 3- Willis first task is to rebuild a sense of family network that they lost. A good way to do that will be to meet the main employees families. Therefore, he will show his interest to the welfare of the group. However, considering he needs to prove its loyalty, more need to be done. It seems that the new operating system will be strict on corruption, but if it is to be establishing in an effective manner they will need to make some compromise and to show flexibility. Corruption is perceptional, and some of its form can be beneficial to the welfare of a group (Beckman, 2003). Also, compromise seems to be a better solving conflict strategy considering the feminine aspect of the culture. Consequently, they could adjust by employing family members of the employees. The idea of engaging with religious group wasnt bad, but they should invest more in the immunity to reshape a network bridging civil, political and private sphere. Communication wise, he will need to stop confronting directly his employees, and more importantly the will need to have outside meeting discussion. In a hierarchical organization employees dont show their discontent to their boss, they give their opinion informally. By being aware of non-verbal sign and engaging informal discussion he will be able to identify more of their employees needs, and avoid more mistakes because of misconceptions. Also, because Willis is very young, he might lack credibility. To balance his inherent disadvantage he might want to replace Ramsey, who has been appointed as the general manager, for a Thai older executive.

Sunday, November 24, 2019

The Rise of Oil and Electricity Price Essays - Economy, Free Essays

The Rise of Oil and Electricity Price Essays - Economy, Free Essays The Rise of Oil and Electricity Price Issues; T he government has declared that fuel price, electricity and telecommunication service rates are increased. This decision was effective since early January 2003. The policy has had good and bad effects and impacts on social situations. Argument pro; On one hand, the government policy on the increase of prices has good impacts on strengthening the national economy, avoiding smuggling and increasing the competitiveness of national economy. Firstly, the policy has strengthened the national economy. Indonesian economy has so far been much dependent on the oil price. The government has subsidized the price of commodity for domestic use. Argument contra; This is prone to crisis. In other words, the huge amount of subsidy so far has put more burden on national economy. The increase of fuel of price is due to the lift or lessening of the subsidy. Secondly, the domestic oil price is much lower than that overseas. The consequence, is that smuggling of the commodity overseas from Indonesia is a common practice, particularly by those who are adjacent to the neighboring countries like Malaysia. Thirdly, the increase of oil price has induced the competitiveness of Indonesian economy. 2. Categorize the whole sentence connector on the discussion text above! T he government has declared that fuel price, electricity and (additional information) , t elecommunication service rates are increased. This decision was effective since (time) early January 2003. The policy has had good and bad effects and impacts on social situations. On one hand (cause and effect) , the government policy on the increase of prices has good impacts on strengthening the national economy, avoiding smuggling and (additional information) , increasing the competitiveness of national economy. Firstly (furthermore or additional information) , the policy has strengthened the national economy. Indonesian economy has so far been much dependent on the oil price. The government has subsidized the price of commodity for domestic use. This is prone to crisis . In other words (contrary cause and effect) , the huge amount of subsidy so far has put more burden on national economy. The increase of fuel of price is due to the lift or lessening of the subsidy. Secondly (furthermore or additional information) , , the domestic oil price is much lower than that overseas. The consequence (emphasis) , is that smuggling of the commodity overseas from Indonesia is a common practice, particularly by those who are adjacent to the neighboring countries like Malaysia. Thirdly (furthermore or additional information) , the increase of oil price has induced the competitiveness of Indonesian economy. 3. Write a Discussion text in at least 400 words on one of the following topics Social effects of social networks on young viewers . How social media affect our children The early of the 21 st century have withnessed an explosion of internet usage. The popularity of this system give us change to keeps interconnected nonstop via media social. Obviously, with the universal acces to interactive and communicate which was offers by in ternet. It is no hard to understand why people on the world are addicted to it especially a teenager. and all of us have less attention to account of social media. there are some hidden danger the negative effect of media social . it is quite ironic that according to the Washinton press about 6% of young user of media social got hurt as a part of bullying in some of media social. Some of the kid may feel insulted or embarrassed because of hars comments or o[pinon.

Thursday, November 21, 2019

Assessing the Health Status of a Client Assignment

Assessing the Health Status of a Client - Assignment Example The assessment leads to the main problem. I introduced myself to my client and asked how I may help him. The man stated that the main reason for coming to the hospital was because lately, he was experiencing the frequent earache. In health assessment, collecting subjective and objective data is of paramount importance. These two stages form a good basis for diagnosis hence if not accurately done will lead to an improper diagnosis. Weber and Kelley (2009), simply define subjective data as the client’s perception of his health. That is, this kind of data can only be verified by the client, thus, the nurse must be equipped with effective interviewing skills. To get this, the health officer has to inquire about the client’s past health history, family history, and health and lifestyle practices. In addition, get biographical data like name and occupation; physical symptoms related to the ears and cultural practices. This is because some medical conditions like cancer may be passed down the family tree. Past health history helps in knowing how long the client has suffered from the disease or whether the complication is a new development. The client may also be engaging in a lifestyle or occupation that puts his health at risk. For instance, too much exposure to loud noise may be the cause of the hearing problems. My client is called Tom Robinson. He is an Engineer who has worked in a food processing factory for five years. He also loves music and uses earphones quite often. His office is located next to the factory’s main processor but it does not have sound proof walls. So, Tom can still hear the loud noise from his office. Nobody in the family has ever had ear problems. Tom says that he usually experiences this pain when he lies down to sleep, early in the morning and after getting off his earphones. The pain has been consistent for the last three weeks and often leads to a mild headache. Weber and Kelley (2009) say that objective data is veri fied by the examiner. This data is mainly obtained through observation, thus, the examiner must be thoroughly equipped with the four examination techniques. Objective data includes physical characteristics like skin and eye color; body functions like heartbeat and respiratory rate; measurements of blood pressure, temperature, height, and weight; mood; results of laboratory testing and X-ray findings. Objective data aids the doctor in diagnosing the main problem. Through this kind of data, the medic is able to know what is happening even in the internal organs of the client. For instance, an earache can be a pointer to a hidden problem like Tonsillitis but can only be verified after objective data is collected. My client had a temperature of forty degrees Celsius but normal heartbeat and blood pressure.  Ã‚  

Wednesday, November 20, 2019

The Ethics of Surveillance Cameras Essay Example | Topics and Well Written Essays - 2000 words

The Ethics of Surveillance Cameras - Essay Example From when you walk out of your house, in most cities, you are being watched (Parenti, 2003). This is because the cameras are now installed in major city streets, gas stations, retail shops and transport systems such as trains. The use of surveillance cameras doubled in the aftermath of the 9/11 terrorist attacks in New York City. These prompted frantic efforts, to curb terrorism, a major threat to security in this century. We are seeking to look at the ethics of surveillance cameras. Historically, the idea of watching the public by a select few, especially those who control us politically and economically can be traced to the Panoptical (Foucault, 1977). This was a kind of prison design, built in such a way that a single guard could watch the prisoners in a single gaze. This is a big way induces prisoners in a state of conscious and permanent knowledge that they are being watched. Foucault saw surveillance as productive machinery of continuous mind control, which is somehow what current surveillance cameras represent. Therefore, what we seek to argue here is that we need new ethics in the surveillance camera industry, because of the reasons below. This is because surveillance when done correctly and for the right reasons and people, then we can surrender apart of our civil liberty to privacy, for the sake of public security. Closed -circuit televisions when placed in public areas, give people a sense of security, reduce crime by up to five percent. Up to ninety percent of respondents saw no problem in having such surveillance in public areas. Surveillance done in the above manner, by the correct agencies, can be said to be ethical and legal. On the other hand, we can seek to look at the ethics of surveillance cameras, by looking at who does it and for what they will be  used to do, therefore the ethics of surveillance cameras. Ethics is defined by the BBC online, as a system of moral principles. This is what is good for the individual and society, therefore is responsible for holding the society together.  

Monday, November 18, 2019

Airport Passenger Process Mapping Coursework Example | Topics and Well Written Essays - 1500 words

Airport Passenger Process Mapping - Coursework Example Developing a comprehensive operation plans calls for the involvement of all stakeholders responsible for the running of business ventures (Magali). The Dubai airport has instituted its operation management plans to address the ever-changing intricacies as well as regulatory compliances of safety issues in the modern world. The Dubai airport handles millions of passengers all year round. For instance, in 2010, it handled close up to fifty million passengers. To manage the passengers the Dubai airport has instituted an operations management approach, which has integrated technology to manage both cargo and passengers (Dubai Airports). With numerous systems offering information, an operating system can be weighed down with information burden. Therefore, connecting and managing this data entails careful planning as well as a means of transforming the information into knowledge, which can lead to the smooth running of an airport (Rees). Security operational management With an array of ope rations platforms, all probable contributors to the general security scheme, it can fastidiously become challenging to manage security operations. The main aspect to overcome a security challenge in an airport setting like Dubai airport is in the initiation of a scalable response, which has the capacity to manage all elements of airport security from a central position. For instance, the Dubai airport consists of various terminals handling both domestic and international flight as well as cargo destined for the United Arabs Emirates and beyond (Emirates). At Dubai airport, systems that enhance airport security operations management are endless; some of the most notable include freight and baggage handling and screening, accessibility control, metal detectors, alongside video monitoring and surveillance. The security operations management of an airport has benefited a great deal from visual surveillance. Integrated visual analytics in security operations has the capacity of recognizi ng unattended passengers load, irregular behavior activities, as well as irregular passengers and vehicle flow. All these components enhance airport security rejoinders, particularity, if the number of visual streams to be monitored, is significant (Emirates). Passenger operations Dubai airport handles millions of passengers all year round. Therefore, to manage these passengers the emirate group has stepped up its operations to ensure the smooth flow of passengers in and out of Dubai. Since the majority of aircrafts traffic from Dubai airport is international, the three key passenger terminals in operation have been fitted with state-of-the-art immigration management amenities for worldwide travel (Dubai Airport Guide). The average annual passenger growth rate at Dubai airport stands at eighteen percent. This growth parameter represents a likely passenger congestion scenario at Dubai in future.

Friday, November 15, 2019

Does Palliative Care provide a peacefull death

Does Palliative Care provide a peacefull death Palliative care was traditionally considered something done just for the dying patient and patients with cancer, but times have changed. Today it is a form of care that can be administered to not just someone facing the end of life, but also to people with terminal illnesses. At the end of life many patients will receive palliative care and comfort measures which are intended to keep the patient comfortable with pain medications, turning, suctioning, oral care, etc. Comfort is something all nurses want to achieve for their patients. Comfort also means different things to different people; therefore it is difficult to gauge and deciphering concrete ways to provide comfort is not easy. In the acute care setting, researchers have focused solely on physical comfort care interventions for end of life, but research for interventions for overall holistic comfort care measures are lacking. This paper demonstrates that because comfort is the top priority for a dying patient receiving palliative care, holistic comfort measures that take care of the body as a whole should be achieved to ensure maximum comfort. The purpose of this evidence-based literature review was to explore health care providers and patients views on palliative and comfort care at end of life, examine current comfort care and palliative care practices and evaluate whether palliative and comfort care measures allow the patient to have a peaceful dying experience. Research indicated that the patients care needs to be individualized, that patients should be assessed, and personalized interventions implemented to ensure a holistic comforting dying experience. Palliative care order sets are helpful, but they are just a guideline or tool to help provide consistently good quality care. Hospice has been known for their excellent holistic comfort care for the dying patients, hospitals would benefit from learning some of their interventions and modifying them for use in the hospital. Some comfort interventions include music therapy, hand massage, utilization of visual analog scales such as the faces, and guided imagery to measure comfort. These methods are some of the ways hospitals can utilize the findings from the research into daily practice to ensure quality holistic patient comfort is achieved. Research Question Does the use of Palliative Care and comfort measures during End-of-Life provide the patient a more peaceful death experience? Relevance to Nursing Practice Research supports the need for providing holistic comfort measures using palliative care during end-of-life care. Registered nurses working in the acute care hospital setting along with Advanced practice nurses (APNs) and palliative care physicians should utilize the many other specialties such as integrative medicine to ensure holistic patient comfort. Palliative order sets are a great tool to help manage pain and anxiety levels but each patients comfort care needs to be individualized to fulfill their needs. Registered nurses need to make sure the patients comfort needs are addressed, so that the patient may have a peaceful dying experience. This Literature review advocates that holistic patient comfort during end-of-life is achieved by attending to its many physical, mental, and social states. Therefore, a nursing definition of comfort can be described as the physical and/or mental state of relief or contentment achieved as a result of holistic nursing interventions, which ensure a satisfying, peaceful, good dying experience. Review of Literature In Comfort Measures: A Qualitative Study of Nursing Home-Based End-of-Life Care, Waldrop and Kirkendall (2009) used a qualitative study method to survey employees from a 120-bed suburban, nonprofit nursing home. The researchers goals were to explore how their staff recognized a dying patient and to identify applicable standards of palliative care. The sample consisted of 42 employees, including nurses, chaplains, social workers, nursing assistants, housekeepers, and administrators. Employees in various roles were interviewed to provide multiple perspectives on the dying experience. The survey was a 30-minute interview conducted in a quiet location of the nursing home away from the nursing unit (Waldrop Kirkensall, 2009). An affiliated research assistant or investigator who has had training in conducting interviews and qualitative data analysis conducted the interviews. The interviewer asked the employees open-ended and objective questions about frequency and standards of care for dying patients and their families. All interviews were audio taped, transcribed by a professional transcriptionist, and labeled with a letter number combination (e.g., N[urse]-1). The transcripts were entered into Atlas ti software for data organization and management (Waldrop Kirkensall, 2009, p.720). The survey identified physical, behavioral, and social factors as the three main indicators of impending death. Physical indicators included altered breathing patterns (including apnea), anorexia, or increase in pain; behavioral indicators included mood changes and diminished activity level. Social indicators sometimes included withdrawal from interaction with staff or family (Waldrop Kirkendall, 2009). During the survey, the staff explained that comfort care is initiated when patients began to exhibit these signs. At this nursing home, standard order sets were not used and comfort care measures were described as being very patient-individualized and holistic. Comfort care includes an interrelationship of symptom management, family care, interpersonal relationships, and interdisciplinary cooperation in which each member of the healthcare team participates in the care of the patient, according to their scope of practice (Waldrop Kirkendall, 2009). The survey revealed that health care employees deliver comfort care in different ways. The study has several limitations including that it was conducted in only one nursing home, lacked direct physician perspectives, lacked family and resident opinions, and a possible response bias. This studys findings identified the need for more comparison studies to explore standards of care in other facilities. It also raised the questions whether or not palliative care includes comfort measures and how palliative care is defined across the healthcare settings (Waldrop Kirkendall, 2009). By further comparing nursing homes that use different models of care, comfort care standards and/or improvements can be made. This survey was conducted in a nursing home setting, but its results reflect on hospital end-of-life care. At the present time, the standard of care for dying patients in hospital settings usually consists of pre-printed order sets that are not individualized to the specific needs of the patient. This study promotes use of the holistic, individualized care approach to ensure a more satisfying and comforting dying experience. Jarabek, Cha, Ruegg, Moynihan, and McDonald, (2008) began a study within the Internal Medicine Residency Program at Mayo Clinic in Rochester, Minnesota. The researchers hypothesized that standard palliative order sets within a hospital setting would enhance physician comfort with managing 4 aspects of end-of-life care, pain, secretions, agitation, and dyspnea. A 5-question, pre-intervention web-based survey regarding physician comfort in diverse aspects of palliative care was given to 144 internal medicine resident physicians before the release of the palliative order set, which would later be used within the hospital. Each question included a 5-item Likert response scale, ranging from 1, very comfortable to 5, very uncomfortable(Jarabek et al., 2008). Three months later, an educational e-mail was sent to all house staff and faculty addressing end-of life-care along with the initiation of the order set, which consisted of physical ailment provisions. Another 3 months was spent allowi ng staff to use and or work with the order sets at which point a post-intervention survey was performed. Results of the post-intervention survey were that 88% had utilized the palliative order sets and 63% stated that they felt increasingly comfortable with palliative care (Jarabek et al., 2008). There was an overall 10% increase in resident comfort regarding the 4 aspects of palliative care with the initiation of order sets, but no change in social or communication-related comfort (Jarabek et al., 2008). One weakness of the General comfort Questionnaire (GCQ) is that each item is scored on a scale of 1 to 6 and not weighted based on importance to the patient. Some items are more significant than others in determining overall comfort level and the patients score on the GCQ as a whole may not be an adequate indicator of their overall comfort level. For example, if a patient answers 1, strongly disagree to the statement my body is relaxed right now, the patient will get 1 point for th e question, but if they score high on the rest of the GCQ, the results could show an overall high comfort level even though the patient is really uncomfortable and in pain. The GCQ is a very useful tool because it can be given to patients verbally if they are weak or lack dexterity. Because the survey addresses all aspects and levels of comfort it is a valid tool for nurses to use to make interventions to provide holistic patient care. The survey concluded that palliative order sets can increase physician comfort in providing care to patients during end-of-life, but it also revealed that the order sets do not address the psychosocial needs of the patient when providing comfort care. Although physicians find comfort in having order sets as guidelines for end-of-life care, they are only guidelines and open communication needs to be initiated between the health care team and the patient to ensure all the comfort care needs of the patient and family are met in a holistic way so that the y may have a peaceful dying experience. Teno et al., (2004) evaluated 1578 adult patients with different, chronic illnesses end of life experiences by surveying the decedents loved ones and determining whether their perspectives on quality end-of-life care were influenced by the environment where the patient spent their last 48 hours of life. A survey was devised from a conceptual model for patient-focused, family-centered medical care and the calculation of scores and psychometrics of the measures were taken from an online tool formulated by Brown University. Within 9 to 15 months from the time of death a close family member or informant whom was listed on the death certificate was surveyed and was asked about the quality of care their loved one received during their last 48 hours of life. Five different domains were used in the survey, including whether healthcare workers provided patient physical comfort and emotional support, supported collaborative decision-making with the physician, treated the patient with respect, attended to family needs, and provided coordinated care with other healthcare workers or facilities (Teno et al., 2004). Teno et al., (2004) concluded that 69% of the decedents site of death and last place to receive care was in a hospital or nursing home setting, 31% home, 36% without nursing service, 12% home nursing, and 52% home hospice. The survey showed that family perceptions of the quality of care were different according to where their loved one last received care. Families of patients who were in nursing homes or had home health had a higher rate of unmet needs for pain (Teno et al., 2004). Over half of the families in hospital or nursing home settings reported unmet emotional needs. In addition, 70% of families receiving home health care reported inadequate emotional support in comparison to 35% in families who utilized home hospice care. Patient and family respect was also a concern to families and varied in different settings. Only 68% of nursing home residents families felt they had been treated with respect and consideration compared to the 96% of families receiving hospice care (Teno et al., 2004). Survey participants felt that physical symptom management was adequately managed so it was comparably equal throughout all patient settings. Although families did not experience a difference in pain or dyspnea management in comparison to other nursing services families who used hospice services overall, 71% reported excellent care (Teno et al., 2004). The survey suggests that although patient care settings such as hospitals, home health, nursing homes all try to provide comfort care during end-of-life that it can be inadequate in meeting the emotional needs of the patient who is dying and their families. The survey supports the hypothesis that hospitals and other care settings need to start utilizing holistic comfort measures similar to the measures hospice incorporates to achieve psychosocial and emotional patient satisfaction and a comfortable dying experience. Kolcaba, Dowd, Steiner, and Mitzel (2004) identified the need for comforting interventions for patients at end of life that are simple, easy to learn and administer, and require minimal effort on behalf of the patient. Bilateral hand massage is a good intervention because it is noninvasive, easy to do, does not take long, and relies on caring/healing touch (Kolcaba et al., 2004). The purpose of their study was to determine empirically if a bilateral hand massage provided to patients near end of life twice per week for 3 weeks was associated with higher levels of comfort and less symptom distress. Thirty-one adult hospice patients from 2 hospice agencies participated in the study. Each patient was English-speaking and expected to remain alert and oriented for the duration of the trial, 13 months. Data collectors who were unknown to the patients called the homes of the patients, explained the study, and then scheduled an appointment for a research visit. Data was collected at the patients homes and at the hospice centers(Kolcaba et al., 2004). After informed consent, participants were randomly divided into the treatment group (with 16 patients) and the comparison group (with 15 patients). All participants were asked to complete a modified General Comfort Questionnaire (GCQ), tailored for end-of-life patients, once a week for 3 weeks. After completing the questionnaire each week, the treatment group then received the hand massage intervention twice a week for 3 weeks. The comparison group received the intervention once at the end of the study period. The researchers concluded that there was no significant difference between the treatment and comparison groups in regard to enhanced comfort or decreased symptom distress over time (Kolcaba et al., 2004). However, comfort did increase some in the treatment group even as the patient approached death. The study also revealed that the hand massage seemed to allow more time for therapeutic or face to face communication allowing the patients to talk about how they feel and their feelings on transitioning to death, and patients receiving the intervention reported it to be a personalized experience something they could engage in that feels good, and family members were appreciative of the care and attention their loved one was getting (Kolcaba et al., 2004). Because this intervention is easy to learn and requires minimal time for the caregiver to do and minimal effort for the patient it is an excellent intervention that can even be taught to the family. This study identifies interventions t hat can be used within the hospital setting and any other setting to enhance comfort during end-of-life. Nurses and family members can use this intervention to increase communication by using caring touch, which provide psychosocial care and therefore holistic comfort for the patient. Bakitas et al., (2009) using project ENABLE {[Educate, Nurture, Advise, Before Life Ends]} combined with a nurse-led intervention with ongoing assessment, coaching, symptom management, crisis prevention, and timely referral to palliative care and hospices hypothesize that patients newly diagnosed with advanced cancer if exposed to this intervention right away would become informed, active participants in their care, and would experience an improved quality of life, mood, and have better symptom relief. The study protocol and data and safety monitoring board plan were approved by the institutional review boards of the Norris Cotton Cancer Center and Dartmouth College in Lebanon, New Hampshire, and the Veterans Administration (VA) medical center in White River Junction, Vermont. All patient and caregiver participants signed a document confirming their informed consent.(Bakitas et al., 2009). Participants completed baseline questionnaires when they were enrolled and then completed a fol low-up one month later. Using a stratified randomization scheme patients and their caregivers were randomly assigned to the interventions or usual care group. One of 2 advanced practice nurses with palliative care experience conducted 4 structured educational problem solving sessions first one lasting 41 minutes and sessions 2 through 4 approx 30 minutes each and at least monthly telephone follow-up sessions until the participant died or the study ended (Bakitas et al., 2009) The advanced practice nurse began all contacts with an initial assessment by administering the Distress Thermometer, an 11-point rating scale recommended by the National Comprehensive Cancer Network guidelines. It identifies sources of distress in the 5 areas of practical problems physical problems, family problems, spiritual, emotional problems or religious concerns. If distress intensity was higher than 3, the advanced practice nurses then identifies the sources of distress and checks to see if the participan t would like to problem/solve to take care of their issue. The nurse then covers the assigned module for that session. The participants clinical teams are responsible for all medical decisions and inpatient care management, however the advanced practice nurse was readily available by telephone for the participants and they could also facilitate ancillary resources. The participants also were able to participate in group shared medical appointments (SMAs), which are led by certified palliative care physicians. The usual care participants were allowed to use all oncology and supportive services without restriction. Follow-up questionnaires were mailed every 3 months until the patient died or study completion in December 31, 2007. Quality of Life was measured with a 46-item tool called the Functional Assessment of Chronic Illness Therapy for Palliative Care. It measures the participants physical, social, emotional, and functional well being along with the concerns of a person whom has a life-threatening illness. Of 1222 screened, 681 were eligible and were approached and 322 were enrolled (47% participation rate). There were a total of 134 participants in the usual care group and 145 participants in the intervention group. A systematic review of specialized palliative care identified 22 trials (16 from the United States) between 1984-2007 with a median sample size of 204, half exclusively with cancer patients. There was lack of evidence due to contamination, adherence, and recruitment etc. The trial addressed these issues and contributed to the increasing evidence that palliative care may improve quality of life and mood at the end of life. In our study, intervention participants higher quality of life and lower depressed mood may be attributed to improved psychosocial and emotional well being. Mood is a determinant of the experience of quality of life and suffering despite a mounting burden of physical symptoms(Bakitas et al., 2009). However, while patients in the intervention group had improvement in these outcomes, we conservatively planned our original target trial enrollment of 400 based on a significance level of .01. Statistical inferences based on this stringent critical value would lead to the conclusion that there were no statistically significant differences between groups in quality of life or mood(Bakitas et al., 2009). A number of limitations were found in the study, first there was limited racial and ethical representation in the study, which recognizes the need for duplicate studies with more diverse populations. Second, the interviews were conducted by telephone, in-person interactions (such as those seen in another successful outpatient palliative care intervention study may have produced a more robust effect, particularly in reducing symptom intensity(Bakitas et al., 2009). In person consultation was not often feasible for the debilitated population whom usually live more than an hour away from the cancer center. More re search is needed on optimal care delivery systems for this population(Bakitas et al., 2009). The researchers concluded that compared with participants receiving usual oncology care those receiving a nurse-led, palliative care-focused interventions that takes care of the patient holistically provided at the same time with oncology care had higher scores for quality of life and mood, but did not have improvements in symptom intensity scores or reduced days in the hospital (Bakitas et al., 2009). Characteristics of Comfort Even though nursing scholars have extensively researched and described various aspects of comfort, perceptions of the characteristics of comfort vary from personal perspectives and situations. After reviewing literature and research relevant to achieving comfort, it is clear that its characteristics extend beyond its physical attributes and are indeed a state of ease, relief, and transcendence (Kolcaba Kolcaba, 1991). To achieve holistic comfort at end-of-life there needs to be patient participation to enhance comfort with the use of comforting interventions. Kolcaba et al. (2004) described a peace of mind with a reduction in undesirable dying symptoms as important indicators of comfort while researching the efficacy of hand massage in hospice patients. Nursing interventions at end-of-life should be individualized to the patient to meet their comfort needs, as comfort is vital in palliative care. Novak et al. (2001) postulated that comfort consist of holistic properties which includ e a soothing environment, social support, conflict resolution, and spiritual harmony. Waldrop et al. (2009) also proposed similar qualities he studied comfort measures in a nursing home setting and described comfort care as the combination of the integration of symptom management, family care, interpersonal relationships, and interdisciplinary cooperation. Comfort in this study was a result of holistic interventions focused on achieving enhanced patient comfort, thereby allowing a good death (Waldrop et al., 2009). Application of the Literature to Practice Findings from the literature and research support the need for providing holistic comfort measures using palliative care during end-of-life care. Registered nurses working in the acute care hospital setting along with Advanced practice nurses (APNs) and palliative care physicians should utilize the many other specialties to ensure holistic patient comfort. Palliative care nurses (PCRNs) are an excellent resource to consult for any questions regarding end-of-life care. Registered nurses need to make sure the patients comfort needs are addressed; they need to talk with the patient and their families to get a better understanding of their comfort level expectations. Palliative order sets are a wonderful tool with which to help manage physical discomfort, but Registered Nurses should assess the environmental, psychospiritual, and social comfort needs in order to create adequate interventions to help achieve enhanced holistic comfort. To achieve the physical aspect of comfort during end-of-life care pain medication can be prescribed, and to help relieve anxiety, ativan may also be given. Music is also a relaxation therapy that may also have a calming effect and can be encouraged to help bring relaxation, peaceful environment, and help the patient to forget their illness for a short time. To facilitate the psychospiritual aspect of comfort care the Registered nurse can consult a chaplain, social work, or a family therapist who can help the family and patient address the feelings of grief, fear, anxiety, and help promote resolving of family issues, which ultimately assists the patient in overcoming any negative feelings to gain closure and to achieve peace. The hospital room can be stressful, room lighting, dà ©cor, and music can be modified to help provide a more peaceful and soothing environment to relax and reflect during their last hours. The social aspect of comfort may be fulfilled by consulting social servic es to help provide support by addressing any communication issues within the family and helping the patient and their family fined courage and strength in times of need and despair. Using feedback from all the aspects of holistic comfort care is important in promoting consistent and continuous comfort during the patients dying experience. Registered nurses must determine the wishes of the patients for achieving comfort and using the many interventions the nurses should evaluate ad make adjustments accordingly. Providing holistic comfort care is an integral part of palliative medicine and it is continuously being changed to fit the needs of the patient and their families, and therefore is an excellent way to approach end-of-life care in the acute care setting of a hospital. Conclusions The research presented reveals while palliative care order sets provide a helpful guideline or tool which reassures health care providers in giving consistent good quality care, patients care needs should be assessed and individualized orders and interventions should be implemented to ensure a peaceful and comforting dying experience. Hospice care settings have been shown to provide excellent holistic care for dying patients and they have also been shown to show compassion to the family as well. The comfort interventions from these facilities can be modified for application in the hospital for use in the acute care setting. Holistic comfort care interventions include hand massage, music therapy, or the utilization of a visual analog scale the faces to measure comfort. These are some of the ways hospitals can utilize the findings from this research into daily practice to ensure quality holistic patient comfort is achieved and ultimately a peaceful death.