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Identify key obstacles/opportunities that necessitated the changes made in the event planning industry.

Identify key obstacles/opportunities that necessitated the changes made in the event planning industry..

Based on the business plan and business profile attached, describe the impact of factors of change identified as it relates to operations management.  Describe the impact of change in an industry of your choice.
 Identify key obstacles/opportunities that necessitated the changes and the nature of changes made in the related industry.
 Assess the enabling factors and the inhibiting factors that drove the change. Identify key obstacles/opportunities that necessitated the changes and the nature of changes made in the event planning industry. The assessment
should include a section on both the enabling factors and the inhibiting factors that drove or will drive the change. The force field analysis technique can be used to help
illustrate this concept [The captioned version of the video located in this document may be accessed in the following link:…. The
related article and video in the Module One resources can help you with this concept.please COMPLETE:  Describe the impact of change in the event planning industry  Identify key obstacles/opportunities that necessitated the changes and the nature of changes made in the related industry.  Assess the enabling factors and the inhibiting factors that drove the change.1-2 PagesUse original work Use APA format Use references Works cited page
Identify key obstacles/opportunities that necessitated the changes made in the event planning industry.

Concept Islamic Societies Western Societies (U.S. Justice System as an Example) Foundation of the law Islam and its principles serve as the platform for jurisprudence and legislation Democratic principles denying the dominance of any religious principles define the choice of the legal standards and practices Role of the key legal figures The mufti performs the function of an implementer of the existing Islamic regulations; The mufti plays the role of the man who implements the qiyas (legal standards) The judge serves as the person that enforces the law and ensures that all regulations are followed; The judge may play the part of a fact finder in specific cases; The jury is the body that decides whether a defendant is guilty or not. Court The Islamic court represents a rigid structure based on the Sharia principles A typical Western court represents a rigid structure based on the principles established in the state law. For instance, in the U.S. justice system, the Constitutional Law and the Amendments play an important part. Court types Civil courts (general and summary courts); Criminal courts (Hamoudi and Cammack 152) Supreme courts; Courts of appeals; District courts (Ford et al. 498) Punishment Physical punishment may ensure in specific cases; Typically, physical punishment is absent from the Western legal system; instead, either prison time or fine is used as a punishment (Rosen 166). Social justice The system of social justice is rather poorly developed’; Justice without practical application viewed as a utopian idea; Political structure affects the levels of and changes within social justice (Hamoudi and Cammack 89). The system of social justice is highly developed; High levels of social activism among western citizens are observed; Social justice affects the use of laws in court cases to a certain extent (Ford et al. 129) Political structure The social justice framework can contribute to the development of a specific type of society; The existing political structure has a direct and meaningful effect on the enactment and implementation of the legal principles and functioning of the legal system; The unity of the human race is deemed as the foundation for any decision made in the context of the legal system (Hamoudi and Cammack 699) The social justice standards are defined by the society in which they are produced, and this effect is rarely reciprocal; The existing political structure has few to none effect on the implementation and quality of the legal system within the state; The decisions made in the realm of the legal system are justified by legal standards and a system of ethical beliefs (Ford et al. 318). Criticism and the focus thereof In the Islamic justice system and especially the social justice framework, the principles of secularism are typically targeted. In the western philosophy, the ideas of Utilitarianism are deemed an ethically questionable from the perspective of the legal system; Freedom and responsibility Freedom and responsibility are defined by the principles of the Sharia; The postulates of liberty and responsibility are defined by the existing democratic principles; Rationality from the perspective of the legal system Rationality as the embodiment of the divine command that guides the decision-making in the legal system of Islam; Liberty as a psychological notion that is linked directly to the spiritual development of an individual. Rationality as a variation of common sense and a self-explanatory string of reasoning; Social liberty as the focus of the rational analysis and a foundational principle of the legal system (Ford et al. 321). Equality as the cornerstone of the contemporary justice system Equality playing the second part in the context of the Islam legal standards compared to the notion of liberty Equality regarded as a critical component of the social justice philosophy; Supporter of justice The social principles and the well-being of the general audience is regarded as the supporter of justice The Individualist ideas serve as the key supporter of justice and the relevant regulations; Social order Social order is viewed as the direct effect of the realization of justice. Social order is regarded as the implication of an individual’s decision-making and the choices made by them. List of social minimum Human instincts serve as the foundation for the implementation of the social minimum justice. The original position concerning the concept is supported. Concept of the human civilization Is interpreted as the outcome of God’s will being implemented by people; Deductive principles making the core of the understanding of how the human civilization works. Is seen as the product of individuals’ work; Inducting reasoning determining the results of the analysis of how the human civilization has been affected by the choices of specific people. Public issues Instances of civil disobedience as the focus of the public justice; The process is entirely open for everyone to observe; Civil disobedience cases being tried in court; The court sessions are only available for the jury and other members of the court to see (Ford et al. 121). Abiding the law Fidelity to the law is regarded as the intrinsic moral system of belief that defines the morality of the community; Fidelity to the law is seen as a crucial requirement for any citizen, yet the nature of the subject matter is not regarded as intrinsic to the human nature. Works Cited Ford, Lynne E., et al. American Government and Politics Today. 2017-2018 ed., Cengage Learning, 2016. Hamoudi, Haider Ala, and Mark Cammack. Islamic Law in Modern Courts. Wolters Kluwer Law
Abstract Achieving a good apical seal is crucial for ensuring successful endodontics; especially in cases that involve a wide apex (e.g. immature apices, apical resorption, and fracture involving the tooth apex). An efficient root-end material is an absolute requisite towards achieving this goal. The recent years have witnessed a decent outflow of new products for root-end applications. However, their merits, and claims of superiority over MTA, have to be ascertained via sustained research. Keywords: Apical seal, bioactive, MTA, novel root-end materials, review. Introduction The quest for an ideal material for root-end applications has produced a plethora of products that are based on different compositions and exhibit varied setting reactions. Though many of them have been proven to be effective, none of them can be described as ideal yet, thus generating scope for further development. MTA as the gold standard Since its introduction by Torabinejad in 1993, MTA has been extensively studied and used. Over the years, it has emerged as the time-tested and attested material. MTA is essentially Portland cement (Sio2, CaO, Al2O3, MgO, and Fe2O3), to which a radioopacifier (Bi2O3), and dehydrated(anhydrous) calcium sulphate have been added. MTA is biocompatible and osteogenic. It is bioactive: i.e. MTA is capable of interacting with living tissues and allows deposition of apatite crystals in the MTA-tissue interface. This material is capable of inducting hard tissue formation.1 Apart from exhibiting excellent sealing properties, it also has the capacity to set and also remain steady in the presence of moisture. Hence, a recent review has described it as ‘hydraulic silicate cement’.2 However, this material is not devoid of disadvantages. Re-entering MTA-treated teeth is difficult. High acidity and alkalinity (beyond a pH of 8.4) can unfavorably influence the surface hardness of set MTA. MTA is shown to expand uncontrollably.3 Grey MTA has been found to discolor tooth and the neighboring gingival tissues. Both grey and white MTA contain toxic substances and impurities. The material is fairly difficult to manipulate owing to its sandy consistency; though the small particle size of white MTA may aid in producing a thicker mix; hence, better workability.4 MTA exhibits low washout resistance during initial set especially when a setting accelerator is not incorporated into the MTA mixture. Its initial solubility is undesirable when used as a root-end filling material.5 In lieu of MTA’s potential drawbacks, the search for superior materials has resulted in the emergence of newer materials in the market; the majority of which, bear resemblance to MTA with minor alterations in their composition. Bioaggregate This novel water-based, hydraulic cement, consists of tricalcium silicate as its primary component. Tantalum oxide imparts radioopacity; hydroxyapatite and amorphous silicon oxide have been added to reduce the level of formation of the weak phase- calcium hydroxide.6 Purity is ensured via elimination of aluminum. Though the manufacturer states that trace amounts of naturally occurring contaminants may be detected during chemical analysis, the lack of detection of heavy metal contamination is noteworthy. The material is bioactive.7 Sayeed et al. suggested that Bioaggregate be considered as an alternative to MTA owing to the former’s better sealing ability. The authors attributed the hermetic seal associated with bioaggregate to: (1) Its nano-sized particles that exhibit excellent adhesion to the dentinal walls of the root canal, (2) Its hydrophilicity.The presence of a gel-like calcium silicate hydrate as the main component, resulted in improved strength, hardness, and sealing characteristics to the set material.8 Bioaggregate also exhibited excellent biocompatibility and induced periodontal regeneration.9 Biodentin Biodentine, marketed by Septodont is available as a powder and liquid formulation. Tricalcium silicate and dicalcium silicate form the core materials of the powder. Purity of calcium silicate is enhanced by eliminating the contaminants namely aluminates. Calcium carbonate and calcium oxide, and zirconium oxide have been added as the fillers and as the radioofacifier respectively. Liquid comprises of calcium chloride as the accelerator. Hydrosoluble polymer and water reducing agents are also present. Biodentine can be used as a root repair material but is not indicated for root amputation and hemisection. The working time is over 1 minute and the setting time ranges between 9 and 12 minutes. The final hardness of Biodentine approximates that of the dentin, thus rendering retreatment difficult if not impossible. 10 On performing cytotoxicity assay and cell growth on set materials, human gingival fibroblasts responded similarly to Biodentine and MTA extracts.11 EndoSequence Root Repair Material EndoSequence Root Repair Material (Brasseler USA) is based on bioceramic technology and is essentially composed of nanoparticles of tricalcium silicate, dicalcium silicate, calcium phosphate monobasic, amorphous silicon dioxide, and tantalum pentoxide.12 It differs from white MTA mainly in that it is aluminium free and contains calcium phosphate monobasic and tantalum pentoxide (radioopacifier).13 It is marketed as a pre-mixed formulation in two different consistencies: syringeable paste, and condensable putty. `The former has bendable tips to facilitate intra-canal material placement. 14 According to the manufacturer, the material exhibits superior handling properties owing to its pre-mixed formulations, short setting time (~2 hours), and high resistance to washout. The material is radiopaque, hydrophilic, and highly alkaline ( 12 pH), thus bactericidal. Its setting reaction is initiated by dentinal moisture. 15 Endo sequence is bioactive. 16 Hirschberg et al. compared the sealing ability of ERRM with MTA, and concluded that leakage was greater in samples restored with ERRM when compared to that of MTA-restored samples.17 In simulated root resorption defects, intracanal placement of white MTA resulted in greater and sustained release of hydroxyl ions, and thus a higher pH when compared to EndoSequence. This, the authors attributed to the quicker set of ES as compared with MTA. But, few MTA samples exhibited discoloration, while none of the ES samples did. This may be esthetically relevant.18 Top of Form Bottom of Form iRoot BP Plus These bioceramic materials are primarily composed of calcium silicate, and require the presence of moisture to set and harden. They also contain zirconium oxide, tantalum pentoxide, calcium phosphate monobasic, and filler agents They are available in three forms: (1) iRoot® BP Plus putty root canal filling andrepair material- white hydraulic premixed puttyintended to be used for root canal repair and restorative applications, (2) iRoot® BP Injectable Root Canal RepairFilling Material- white hydraulic premixed injectable paste intended to be used for root canal repair and restorative applications, and (3) iRoot® SP Injectable Root Canal Sealer- injectable white hydraulic cement paste intended to be used for permanentroot canal filling and sealing applications. 19 According to the manufacturer, these materials are insoluble, radiopaque, aluminum-free, possess excellent physical properties, and do not contract on setting.20 iRoot®BP Plus was biocompatible and did not elicit critical cytotoxic effect. However, its long-term performance was inferior as compared to White MTA.21 Another study observed that both materials i.e. iRoot BP Plus and iRoot FS exhibited negligible cytotoxicity. Under simulated clinical conditions, iRoot FS was able to completely solidify within an hour, whereas iRoot BP Plus set only after seven days.22 Ceramicrete Developed at Argonne National laboratory, Ceramicrete is essentially a chemically bonded phosphate ceramic (CBPC), which was developed to function as a binder for waste management. The material was inducted into dentistry owing to its inherent strength, biocompatibility, and bioactivity. Radioopacity is achieved by incorporation of radio opacifiers (bismuth oxide, cerium oxide). Wagh and Primus found Ceramicrete to be a strong material exhibiting lower porosity and permeability due to the formation of potassium-magnesium phosphate hexahydrate ceramic matrix phase. The decreased porosity also contributes to Ceramicrete’s superior sealing capacity.23 The use of an acid conditioner prior to application of ceramicrete may result in better adaption due to removal of smear layer, thus improving the seal. Incorporation of calcium silicate whiskers resulted in the formation of a brushite phase, which improves mechanical properties. Though, initially, the material tends to be acidic, set Ceremicrete-D is alkaline (pH of 11 after 72 hours). However, the acidic pH (2.2) of a fresh mix may exacerbate the acidic condition of an already inflamed tissue. 24 The low pH may be the reason why ceramicrete D caused initial death of primary osteoblasts and failed to support further cell growth, since low pH is shown to inhibit osteoblast activity. 25 The radioopacity of ceremicrete was substantially less (3.2mm of aluminium) than white MTA (8.5mm of aluminium). Handling properties and resistance to washout were superior. According to porter et al, Ceremicrete-D retained a weak chalk like consistency even after seven days of setting. They suggested the original formula be modified to effect increase in the strength of the material.26 Capasio Capasio (Primus Consulting, Bradenton, FL) is an experimental calcium-phospho-aluminosilicate–based cement that is mixed with a water based gel. Bismuth oxide has been added as a radiopacifier.27 When mixed, Capasio develops dough like consistency and can be rolled into a rope which enables better handling. Ceremicrete-D and Generex A also demonstrate this desirable property. Capasio displays good washout resistance, and improved physical characteristics such as setting time (9 minutes), compressive strength, and washout resistance.26 It exhibited slightly less basic pH (10.9) when compared with white MTA. 28 The radiopacity of Capasio was significantly less as compared to MTA but marginally greater than Ceremicrete-D.26 Capasio is also bioactive. It has the ability to precipitate apatite crystals on its surface. The smaller particle size of Capasio (a mean particle size of 5.3µm as compared to 10µm of MTA) may be perceived as an advantage. Materials that demonstrate the capability of penetrating dentinal tubules exhibit improved marginal adaptation, retention, and also entomb the residual bacteria. The material was shown to penetrate dentinal tubules up to a depth of 18-26 µm; much greater than that of MTA.29 Penetration of an endodontic material into the dentinal tubules results in improved marginal adaptation, increase mechanical retention, entombs residual bacteria and improved antibacterial effects owing to closer proximity of the material to the bacteria.30 Quick-set Capasio (Primus Consulting, Bradenton, FL) has been further developed and has been renamed as Quick-Set (Primus Consulting). The refinement has been performed via removal of the cationic surfactant from the liquid gel component, which was thought to affect its biocompatibility. Using murine dental papilla-derived odontoblast-like cell line (MDPC-23), Wei et al. observed that the in vitro cytotoxicity of Quick-Set was similar to that of WMTA.31 Ashraf et al. concluded that the in vitro osteogenic/dentinogenic differentiation potential of Quick-Set was favorable. 32 Generex A and B Generex A (Dentsply Tulsa Dental Specialities, Tulsa, Usa) and B are calcium-silicate-based materials with novel setting reactions. Generex A contains tricalcium silicate, dicalcium silicate, and tricalcium alumunate. Its composition is similar to that of MTA but for the fact that the powder is finer, and unique gels are used for mixing instead of water as is the case with MTA.25 Usage of the gel results in: improved handling characteristics and reduced setting time.26 Among the materials evaluated for their osteogenic potential (Generex A, Capasio, Ceramicrete, and MTA), only Generex A and MTA allowed primary osteoblast growth.25 In a study conducted by Porter et al, Generex A exhibited the shortest setting time (1.25 hrs) as compared to Capasio and Ceramicrete, which set in 2.5 hours. Generex A also emerged as the strongest among the other materials tested. 26 Endobinder Endobinder differs from MTA in that, MgO and CaO (cause undesirable expansion of the material), and Fe2O3 (causes tooth darkening) are eliminated from its composition. Al2O3 and CaCO3 are calcined at temperatures between 1315deg C and 1425d C, and are ground following which, Bismuth oxide is added to obtain radioopacity. Purity is ensured by eliminating traces of MgO, CaO, and Fe2O3.32, 33 Endobinder assisted early differentiation of a higher osteoblastic cell population in comparison to MTA. this, the authors attributed to the lower calcium hydroxide release from endobinder when compared with MTA.34 While slightly higher concentration of extracellular calcium can stimulate osteoblast cell viability, proliferation, differentiation, and function, an overload can be cytotoxic. 35 According to Oliveira et al., Endobinder exhibited better fluidity, improved handling properties, higher mechanical strength, and reduced porosity (with lower pore size) when compared with MTA.36 The material was biocompatible when tested in subcutaneous tissue of rats.37 Conclusion The past few years have witnessed the development of novel materials with a purpose of overcoming the disadvantages of MTA. Some are primarily composed of calcium silicate (Endobinder, Endosequence, Generex A and B, and iRoot BP Plus), some are primarily tricalciumsilicate-based (Bioaggregate, and Biodentine) or calcium-alumino-silicate based (Capasio and quickset), and one is a chemically bonded phosphate ceramic (Ceramicrete). The focus behind developing these materials has mainly been- improved physical and biological properties over the present gold standard i.e. MTA. While some of these novel materials have exhibited improved characteristics, more research in the form of in vivo and in vitro studies are required in this direction, in order to ascertain the same. Also, newer materials with a composition differing from that of MTA, may bring a fresh approach with regard to this application. 1
questions based on the Kohlman Evaluation of Living Skills (KELS), health and medicine homework help.

Answer the questions based on the Kohlman Evaluation of Living Skills (KELS). Select one specific mental health OT evaluation tool to critique (Kohlman Evaluation of Living Skills (KELS). Identify
the tool by name, and provide the name(s) of its author(s). Provide a
summary of the history of this tool, including how this tool was
developed, and the organization or publisher from which the tool is
currently available for occupational therapists to obtain.2. Which of the four clinical purposes can be applied to your selected mental health OT evaluation tool?
The purposes are: Descriptive, Discriminative Assessment, Predictive
assessment, and/or Evaluative Assessment. How did you determine the
clinical purpose(s) of your selected tool?3. Critique your tool by assessing it regarding the following eleven criteria:Relevance;
feasibility; utility; reliability; validity; role; setting; model of
practice; age; diagnosis; and time of day. You can review the test
manual for your selected evaluation tool for some of this information,
either in hard copy or online. Conduct a literature search for articles
in peer-reviewed journals that describe the strengths and weaknesses of
this tool in general, and in regard to a particular client population.4.
Present a hypothetical OT client for whom this tool would be
appropriate to use in the OT evaluation process. Explain your rationale
for selecting this tool for the hypothetical client. Also explain how
this tool could be used for treatment planning.5.
Remember to include an introductory paragraph describing the purpose and
content of your paper, as well as a concluding paragraph that places
your information into a “macro” perspective (e.g. in relation to mental
health OT practice, or mental health clients.)0% PLAGHigh-quality work only
questions based on the Kohlman Evaluation of Living Skills (KELS), health and medicine homework help

Medical and Research Ethics Discussion

Medical and Research Ethics Discussion.

Getting StartedOver the past three weeks, you have been learning about the qualitative and quantitative research process. You have gained insights into the different methods for conducting nursing research. Prior to any research being conducted, a potential research study is reviewed and approved by the Institutional Review Board (IRB) and/or an ethics committee at the institution where data will be collected.   Upon successful completion of this discussion, you will be able to:Explain the significance of safeguards that are in place to prevent unethical research practices.  Explain the importance of protecting research participants’ safety through understanding unethical research practices.  Apply the principles of the Nuremberg Code and The Belmont Report to past and current research studies.  ResourcesTextbook: Foundations of Nursing ResearchArticle: Lest We Forget: The Tuskegee ExperimentArticle: The Nuremberg Code: A CritiqueWebsite: U.S. Department of Health and Human Services (n.d.). Ethical Codes & Research StandardsWebsite: The Belmont Report and The Nuremberg CodePPT File: Chapter 4(Optional) Video: Miss Evers BoysFile: 7th Edition APA Style Bible CitationsBackground InformationThe Tuskegee study is a true event that occurred in 1932 in Macon County, Alabama in which African Americans were promised treatment for “bad blood.” This study was marred by numerous ethical misconducts. Events such as the Tuskegee study, the Nuremberg trials, and other unethical research practices led to the creation of The Nuremberg Code and The Belmont Report. The principles in these documents were created to protect participants from unethical research practices. InstructionsReview the rubric to make sure you understand the criteria for earning your grade.Read Chapter 4 in the textbook.  Read the article, The Nuremberg Code: A Critique.Read the article, Lest We Forget: The Tuskegee Experiment.View the Chapter 4 PowerPoint file.Visit the following website and review The Belmont Report and The Nuremberg Code. U.S. Department of Health and Human Services (n. d.). Ethical Codes & Research Standards(Optional) Watch the movie, Miss Evers’ Boys. (If it prompts you to log in to view the video, use your MyIWU Portal username – everything before “@” in your IWU email address – and your Portal password)Prepare to discuss the following Discussion Prompts:Describe three principles of the Nuremberg Code and explain how one of these principles is important to nursing research.  Describe three ethical principles from the Belmont Report and explain how one of these principles applies to informed consent, risk/benefit assessment, and/or selection of participants.  Describe the purpose of the Institutional Review Board (IRB).  What values would be threatened if these principles had not been put in place? Support your answer witha verse from the Bible. 7th Edition APA Style Bible Citations provides standards for citing and referencing scripture Instructions below and resources are attached. There’s no need to watch the movie as it is optional. The article should be enough to complete the assignment. Length should be 3-4 paragraphs minimum, APA 7th edition with references. There is another reference to be included and that a bible reference. I will include a resource of how she wants bible scripture referenced. Research and select at least two current scholarly sources to support your explanations and insights. Research and select at least two current scholarly sources to support your explanations and insights.
Medical and Research Ethics Discussion

Research and analzye the evolving relationship between business and society

online homework help Research and analzye the evolving relationship between business and society. I’m trying to study for my Business course and I need some help to understand this question.

Write a research paper that analyzes the evolving relationship between business and society. Choose at least three of the topics from the course learning objectives (listed below), and clearly identify how the topics directly impact relationships between business and society.
Topics from Course Learning Objectives:

Social responsibility
Strategic philanthropy
Government regulation
Organizational ethics
Consumer protection laws and the Six Consumer Rights
Environmental issues

The requirements below must be met for your paper to be accepted and graded:

Write between 750 – 1,250 words (approximately 3 – 5 pages) using Microsoft Word in APA style, see example below.
Use font size 12 and 1” margins.
Include cover page and reference page.
At least 80% of your paper must be original content/writing.
No more than 20% of your content/information may come from references.
Use at least three references from outside the course material, one reference must be from EBSCOhost. Text book, lectures, and other materials in the course may be used, but are not counted toward the three reference requirement.
Cite all reference material (data, dates, graphs, quotes, paraphrased words, values, etc.) in the paper and list on a reference page in APA style.

References must come from sources such as, scholarly journals found in EBSCOhost, CNN, online newspapers such as, The Wall Street Journal, government websites, etc. Sources such as, Wikis, Yahoo Answers, eHow, blogs, etc. are not acceptable for academic writing.
Basic Requirements:
Double spacing
Times New Roman 12 pt font only
All para must be at least 4 well-developed sentences, most more.
Running head:
APA Headings
Proper Sourcing (one article from your course readings; one peer-reviewed source with a doi numer; and one source of your choice but not from dictionaries, new articles, blog.
No direct quotes
Remove: great, key, like, look, you, your, we, really, basically, huge, do not begin sentences with conjunctions (It, But or Because), Eliminate According to: in order to; as well as: No Jargon.
Research and analzye the evolving relationship between business and society

Antenatal Care In Primary Health Care Centers

Share this: Facebook Twitter Reddit LinkedIn WhatsApp The antenatal period offers many opportunities to provide targeted health services. Antenatal care became associated with general health evaluation as a result of the increasing recognition of these factors as nutrition, social conditions and birth spacing influence pregnancy outcomes.(1) It is now accepted that maternity services should be centered on the woman and her needs. Each woman should be given sufficient help and information to enable her to make an informed decision about her care. In addition, the processes of empowerment and communication have become a key factor; not only between health professionals and women but also among the different health professionals providing the service. This is essential factor for effective team working to provide continuity of care.(2) In recognition of the potential of care during the antenatal period to improve a range of health outcomes for women and children, the World Summit for Children in 1990 adopted antenatal care as a specific goal, namely “Access by all pregnant women to prenatal care, trained attendants during childbirth and referral facilities for high-risk pregnancies and obstetric emergencies”. Similar aims have been voiced in other major international conferences, including the International Conference on Population and Development in 1994, the Fourth World Conference on Women in 1995, their five-year follow-up evaluations of progress, and the United Nations General Assembly Special Session on Children in 2002.(3) ISSN 1110-0834The antenatal period clearly presents opportunities for reaching pregnant women with a number of interventions that may be vital to their health and well-being and that of their infants. The aim of Antenatal Care (ANC) is to detect, prevent or manage abnormalities in early pregnancy and prepare mothers for safe deliveries.(4-6) ANC should also provide support and guidance to the woman and her partner or family, to help them in their transition to parenthood. This implies that both health care and health education are required from health services. This broad definition of ANC is endorsed by national labor laws(7) and by evidence-based clinical guideline.(8) Moreover, it introduces the needed holistic approach (biological care and concern with intellectual, emotional, social and cultural needs of women, babies and families) during pregnancy.(5) Care during pregnancy should enable a woman to make informed decisions, based on her needs, after discussing matters fully with the professionals involved. Any interventions offered in the antenatal period should be of proven effectiveness and be acceptable to the recipients. Both the individual components and the full package of ANC should conform to these criteria. Complex examinations and a variety of combination of interventions are part of modern ANC. Nevertheless, there is a huge variety of tests and medical procedures included in routine ANC worldwide.(9) Some of these interventions are based on evidence, but many of them are only based on long-held traditions. The state of the scientific evidence of risks and benefits of ANC interventions is a concern of health policy-makers. Another important concern is the level of care sufficient to delivering high-quality care for pregnant women. Most antenatal care protocols in developing countries were established along the lines of those used in developed countries, with little adjustment for local conditions.(10,11) The content of ANC for a normal pregnancy is described in three main categories: assessment (history, examination and laboratory tests), health promotion and care provision. There is inevitably some degree of repetition but it has been retained for the sake of completeness and ease of reference. World Health Organization (WHO) recommends that antenatal care for the majority of normal pregnancies should consist of four visits during pregnancy, and has outlined the key elements of the visits and their timing.(12) Use of antenatal care in developing countries rose steadily during the 1990s. Information on trends in antenatal care use over the past decade is limited to countries where more than one household survey has been carried out. At the end of 2001, a total of 49 countries had trend data.(12) Most of the antenatal care models currently in use around the world have not been subjected to rigorous scientific evaluation to determine their effectiveness. Despite a widespread desire to improve maternal care services, this lack of “hard” evidence has impeded the identification of effective interventions and thus the optimal allocation of resources. In developing countries, routinely recommended antenatal care protocols are often poorly implemented, clinical visits are irregular, and waiting time is prolonged with poor maternal satisfaction.(13) Due to global concern over safe motherhood, evaluation of ANC in PHCC in Medina; one of the holy cities in Saudi Arabia, this study was carried out. Aim The aim was to evaluate the antenatal care services given for pregnant women attending the Primary Health Care Centers, Medina city, Saudi Arabia 2009. METHODS The study was conducted during March through July 2009. The study population included pregnant women attending primary health care centers in Medina, Saudi Arabia for antenatal care. Simple random selection of seven major primary health care centers in Medina was done. The total number of the pregnant women included in the study was calculated using the following equation: n= (Z2 X p X q) / D2. A total of 394 pregnant women were included and were proportionally allocated based on attendants of each health center. A specially designed format was designed and filled by the researcher herself. Collection of data from the selected centers was done after official permission. Ethics Review Committee reviewed and approved the proposal. The survey tool was pre-tested on a random sample of 35 participants obtained from 2 centers to ensure practicability, validity and interpretation of responses. The reliability of the questionnaire was assessed using Cronbach’s alpha (0.812). The format including information on: assessment of the service (at the initial visit and return visit), health promotion and care provision. The time spent for each visit was included as well as education, work status of pregnant women, and some socio-demographic data of the physician were included (nationality, mother language , qualification and age). The centers were ordered according to the order of their visit. Each of the items of antenatal tasks was scored as following: (0) for non performed task and (1) for performed one; giving a performance score ranging as follow: 1- Assessment: a. Initial visit: i. history taking: 0-21, ii. examination: 0-12, iii. laboratory investigations: 0-11 b. Return visit: i. history taking: 0-3, ii. examination: 0-9 2- Health promotion: 0-10 3- Care provision: 0-6. The total performance score was calculated for each task at each center. Then the mean percent score was calculated. Statistical Analysis Statistical Package for Social Sciences SPSS version 10 was used. Frequencies, percentages and arithmetic mean were calculated. Chi-square test, and F- test were used. P value <0.05 was considered significant. RESULTS Description of the studied centers A total of seven centers were recruited, from them 394 pregnant women were included in the study. The most populous center was center number 4 where it was serving 35000 inhabitants (fig. 1) followed by centers 3 and 7 which were serving 28000, with significant difference between centers (p=0.000). There was only one physician per center who was carrying out antenatal care (in some centers, this physician had another tasks as examination of children in well baby clinic, etc.). Non-Saudi formed the majority of physicians where more than half (57.1%) were Egyptian, 28.7% were Pakistani and 14.2% Bangladeshi, with a mean age of 45.7±4.7 years. General characteristics of the included pregnant The minority of the included pregnant women was illiterate (0.8%) (Table I), while 41.4% got secondary education and 33.2% got university one. Only 14.0% were working. Regarding duration of pregnancy, 34.4% were in the first trimester, 36.3% in second and 29.4% in the third trimester, and 51.5% were visiting the center for the first time. The mean duration of the initial visit was 10.3±2.3 minutes (Fig. 2), while that of return visit 9.1±1.1 minutes; and there was a significant statistical difference between centers (p=0.000). Poorly covered antenatal tasks Social history and support, history of FGM, examination of general appearance, breast examination, examination for signs of physical abuse, planning for delivery and development of individualized delivery plan, smoking history and psychosocial support had lowest coverage percent (Table II). Performance scores In initial visit, history taking and investigations (Table III) had higher mean percent score (93.4 ±1.5 and 95.0±1.4 respectively) than return visit’ history taking (83.0±5.4). Meanwhile clinical examination in return visit was better performed than that of initial visit (86.1±7.7 and 75.6±11.7 respectively). All the centers had the same score for care provision (83.0±3.6). Nevertheless, health promotion had the worst score (64.9±12.7). The overall total mean percent score for antenatal care services in general was 77.1±1.1, with statistical significant difference between the studied centers (p=0.000). DISCUSSION Screening and monitoring in pregnancy are strategies used by health care providers to identify high risk pregnancies so that they can provide more targeted and appropriate treatment and follow up care and to monitor fetal well-being in both low and high risk pregnancies.(2,3) This study aimed at evaluation of the antenatal care services given to pregnant women attending PHCC in Medina City, Saudi Arabia. The study was conducted using specially designed format including 394 pregnant women attended seven PHCC in Medina City for antenatal care. Effective and appropriate ANC should be offered to all pregnant women. However, different countries offer different sets of routine ANC, which are hardly based on explicit effectiveness criteria, being mainly linked with long term tradition or other inexplicit criteria.(14) Epidemiological studies have demonstrated the benefits of ANC in reducing maternal and perinatal complications, although the exact components and timing of such ANC has been difficult to demonstrate. This uncertainty leads to the adoption of antenatal practices that are not comparable and are largely inconsistent between and within countries.(14-17) Among safe motherhood advocates, antenatal care has been down played in recent years as an intervention for reducing maternal mortality. It is not surprising that little attention has been paid to patterns and trends in antenatal care use.(17) Major barriers prevent the effectiveness of ANC in low resource settings in Medina, Saudi Arabia. Poor knowledge of the general practioners about maternal and fetal risk factors and complications that are detected in pregnancy which could prevent a large proportion of maternal and fetal morbidity and mortality, together with the language barrier between pregnant mother and health care provider, poor maternal education and nutrition and lack of strategies that improve the quality of care, all are factors behind poor performance of ANC. Physician is the crucial person in the process of ANC. Availability of one physician only who was carrying out ANC during the period of the study in the PHCC would never met the recommended time for ANC which supposed to be given for each woman to discuss her personal needs and for physician to respond appropriately especially for the first visit, when full history has to be taken and an individualized birth plan should be started. It was found that the mean duration of the initial visit 10.3 ± 2.3 minutes compared to the desired 20 minutes. Furthermore, when the appropriate number of physicians will be available, this duration will be feasible even in areas with high birth rate.(18,19) ANC performance of the studied centers correlated with age, language and qualification of the working physician. There was greater ability of younger, Arabic, qualified physicians to attain better performance scores especially for health care promotion. More than three fourths of the included pregnant women had secondary (41.4%) or university (33.2%) education. It was noticed that in developing countries as a whole, women with secondary or higher education are more likely to have ANC than women with no education.(17) Not only that, but it was also found that the educational level and work status of the attending pregnant women have been positively correlated with the ANC performance of the studied center. Nearly half (51.5%) of the studied pregnant women attended the PHCC for the first time during the first trimester. The early initiation of ANC is important to prevent and treat anemia and to identify and manage women with medical complications. Early care also allows for the development of interpersonal relationship between health care providers and pregnant women.(20,21) Health promotion of pregnant women can improve their own health and that of her child and the risks of maternal and perinatal complications can be reduced; yet, in developing countries, ANC protocols are often poorly implemented.(22-29) Although care provision should address psychosocial need of women and development of individualized delivery plan as well as their medical needs, (30-35) this study shows that aspects that were poorly implemented were psychosocial support (not done for 98.0%), planning for delivery (not done for 94.2%) and development of individualized delivery plan (not done for 99.5%). This poor implementation could be attributed to the fact that these items are not included in the maternal card that is in use in the PHCC. Also the fact that all pregnant women will be referred to maternity hospital for delivery as no delivery is allowed outside hospitals cause reluctant and neglect attitude in discussing the delivery plan. However, some items which are crucial and already present in the maternal card as general appearance (not done for 96.1%) and breast examination (not done for 91.1%) are just filled with symbols NAS which denoting no abnormal signs; even without examination. Study limitation This study carried out only for seven PHCC, and inclusion of all centers was needed which was not feasible to be performed by the researcher together with comparison of the urban and rural one. No detailed obestritic history was included. Also job satisfaction of health care providers was not fulfilled. Conclusion and Recommendations -This is the first study aimed at assessing the performance of the PHCC. We found variation between centers in their performance scores. Variation in performance scores of the studied PHCC denoting that improvement will be mandatory. -A further study using specially designed interviewing format is needed to study in depth health care providers’ characteristics, and the obstacles they face in the work place to find out suggested solutions for improvement. -Continuous medical education and training of all health care providers for ANC implemented protocol. -Ensuring satisfaction of both health care providers and receivers of ANC. -Clarifying the appropriate policy, decision-making and programmatic implications of adopting and implementing the new ANC protocols. -Perinatal audit system which aims to improve quality of care by identifying deficiencies in care. -Health promotion needs to be stressed upon especially nutritional care, rest and hygiene, and educational resources. Share this: Facebook Twitter Reddit LinkedIn WhatsApp

case study business management

case study business management. I’m studying for my Management class and need an explanation.

It is important to understand what information systems are and why they are essential for running and managing a business. It is also important to understand the different systems that support different groups or levels of management. In addition, digital technology and the Internet play a key role in executing major business processes in the enterprise. Also, it is important to understand the ethical, social, and political issues raised by information systems.
The case studies below provide you with an opportunity to critically analyze events that are taking place in real-life businesses. This helps to develop your critical thinking and research skills as you research each of these scenarios.
For this assignment, review four case studies—two from Chapter 1 and two from Chapter 2. Then, in an essay, evaluate the studies and respond to each of the questions below, using both critical thinking and theory as well as supporting documentation.
In Chapter 1, read the case study “UPS Competes Globally with Information Technology” on pages 23–24 of the textbook. Then, answer the questions below.

How does UPS use information systems technology to achieve its strategic goals of being more efficient and customer oriented?
What would happen if the automated package tracking system was not available?
Discuss how globalization has “flattened” the world.

In Chapter 2, read the case study “Data Changes How NFL Teams Play the Game and How Fans See It” on pages 52–53 of the textbook. The, address the prompts below.

Analyze how information systems are transforming business.
What types of systems does the NFL and its teams use?
What is the role that these systems play in improving both operations and decision-making?

In Chapter 3, read the case study “Smart Products—Coming Your Way” on pages 102–103 of the textbook. Then, address the prompts below.

Explain the importance of collaboration and information sharing for businesses.
Explain what a “smart” product is, and use an example.
How do smart products increase rivalry among firms?

In Chapter 4, read the case study “Are Cars Becoming Big Brother on Wheels?” on pages 121–122 of the textbook. Then, address the prompts below.

Describe how new technology trends may cause ethical dilemmas.
Discuss at least one ethical, social, and political issue raised by embedded cyber connections in cars.
Discuss how big data analytics are being applied to all of the data generated by motor vehicles.

In formatting your case analysis, do not use the question-and-answer format; instead, use an essay format with subheadings. Your APA-formatted case study must be at least four pages in length (not counting the title and reference pages).
You are required to use a minimum of three peer-reviewed, academic sources that are no more than 5 years old (one may be your textbook). All sources used, including the textbook, must be referenced; all paraphrased material must have accompanying in-text citations.
case study business management

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