Compare and contrast reform under Khrushchev and Gorbachev Essay

Compare and contrast reform under Khrushchev and Gorbachev - Essay Example 2009). In 1934 Khrushchev became a member of the partys central committee. He had a close link to Soviet leader Joseph Stalin, and after Stalins death in 1953 Khrushchev surfaced as the new leader. He started restructuring Stalins most atrocious extremes, and as he criticized some crimes of Stalin which was considered as a dramatic development. Khrushchev as well tried to create fresh dealings with the United States; in 1959 he visited the U.S. and met with President Eisenhower (answers.com. 2009). Khrushchev delivered his well-known secret speech in 1956 wherein he exposed the reality of a letter written by Lenin prior to his death. The letter was significant of Stalin’s misdeeds, and Khrushchev made use it as weapon to condemn Stalins rules and practices, mainly the purges that he supported. This denigration led to de-Stalinization, a course that led to reforms, for instance leniency towards government censorship of the press, transference of economic decision making, and streamlining of the cooperative farm. Concerning foreign policy, Khrushchev promoted ‘peaceful coexistence,’ and reduction of strain involving the United States and the Soviet Union. At the same time Khrushchev was condemned from the start for the recommended reforms, and his political and armed forces failure in the Cuban Missile Crisis made certain his loss of control. In addition, the majority of his reforms were not working by the early 1960s (phs.prs.k12.nj.us/ewood., N.D) The Khrushchev’s duration of rule did not limit itself to the financial system. Where as he went on to demonstrate how changing financial requirements were mirrored in the social and political ‘superstructure’. The most remarkable aspect after the Stalin period was the reduction of scare and the majority of the labour camps were out of terror and more relaxed. Essential basics of the rule of law were reinstated, as the

Procurement and supply chain management Essay Example for Free

Procurement and supply chain management Essay This Publication is concerned with the vital subject of business logistics and supply chain management, an area that can be essential to a firm’s competitive strategy and revenue generation. This management area has been described by many names, including physical distribution, materials management, transportation management, logistics, and supply chain management. Relevant business activities may include one or more of the following areas: transportation, inventory, order processing, purchasing, warehousing, materials handling, packaging, customer service standards, and production. The focus of this Publication is on the planning, organizing, and controlling of these activities key elements for successful management in any organization. Special emphasis is given to strategic planning and decision making as an important part of the management process. Managerial efforts are directed towards setting the level of the logistics activities so as to make products and services available to customers at the time and place required, and in the condition and form desired, in the most profitable and cost-effective way. Logistical activities have always been vital to organizations, and so business logistics and supply chain management represents a synthesis of many concepts, principles, and methods from the more traditional areas of marketing, production, accounting, purchasing, and transportation, as well as from the disciplines of applied mathematics, organizational behaviour, and economics. This Publication attempts to unify these elements to assist in the effective management of the supply chain. The Publication aims to present ideas, principles and techniques that are fundamental to good business logistics practice. It concentrates on important activities of management such as planning, organizing, and controlling, and also on a triangle of interrelated transportation, inventory, and location strategies, which are at the heart of good logistics planning and decision making. Contemporary trends that affect the scope and practice of business logistics and supply chain management have been integrated into the body of the text. Firstly, emphasis is placed on logistics and supply chain management in a worldwide setting to reflect the growing internationalization and globalization of business in general. Secondly, the shift towards service-oriented economies by industrialized nations is emphasized by showing how logistics concepts and principles are applicable to both service-producing tirms and product-producing ones. Thirdly, attention is given to the integrated management of supply chain activities. 1 LSCTMMOD1 Send for a FREE copy of our Prospectus book by airmail, telephone, fax or email, or via our website: Britain. International Headquarters: College House, Leoville, Jersey JE3 2DB, Britain Telefax: +44 (0)1534 485485 Email: [emailprotected] com Website: www. cambridgecollege. co. uk The Publication contains many practical and contemporary examples that show the applicability of the textual material and assist in the understanding and learning of the key points and concepts. Each Chapter in this Cambridge International College Publication on Logistics, Chain Supply Transport Management includes: †¢ An introduction section †¢ Examples and/or figures and diagrams to explain the concepts being covered †¢ A summary of concluding comments †¢ Review Questions designed to reinforce learning and contemplation of what is covered in the Chapter Advice on How to Study this Program Every individual CIC Member approaches his/her study in a different manner, and different people may have a particular study method that they find most effective for them. However, the following is a tested and proven Study Method, suggested to you as a CIC Member in order to assist in making your study and learning easier and enjoyable and to assist you to quickly master the contents of this CIC Publication on Logistics, Chain Supply Transport Management: Step 1: Set yourself a flexible study schedule, depending on the time you have available and what is best for you. For example, the target set could be to study for 1 or 2 hours a night, or for 8 or 9 hours a week, or to complete one Chapter every 2 weeks. There is no set or compulsory schedule, but simply setting a schedule or goal is often an important action in ensuring that study is undertaken successfully and within the specified timeframe. Step 2: Read the whole of the first Chapter at your normal reading pace, without trying to memorise every topic covered or fact stated, but trying to get â€Å"the feel† of what is dealt with in the Chapter as a whole. Step 3: Start reading the Chapter again from the beginning, this time reading more slowly, paragraph by paragraph and section by section. Make brief notes of any points, sentences, paragraphs or sections which you feel need your further study, consideration or thought. You may wish to keep any notes in a separate file or notebook. Try to absorb and memorise all the important topics covered. Step 4: Start reading the Chapter again from its start, this time paying particular attention to and if necessary studying more thoroughly those parts on which you earlier wrote notes for further study. It is best that you do not pass on to other parts or topics until you are certain you fully understand and remember those parts you earlier noted as requiring your special attention. Try to fix everything taught firmly in your mind. 2 LSCTMMOD1 Send for a FREE copy of our Prospectus book by airmail, telephone, fax or email, or via our website: Britain. International Headquarters: College House, Leoville, Jersey JE3 2DB, Britain Telefax: +44 (0)1534 485485 Email: [emailprotected] com Website: www. cambridgecollege. co. uk Step 5: There are self-assessment review questions at the end of the Chapter, and you are strongly advised to try to answer or think about them as best you can but do not send your answers to the College. If these questions/exercises highlight any areas that you feel you need to revise or re-read in the Chapter, then go ahead and do that before moving on to Step 6. Step 6: Once you have completed steps 1 to 5 above, move on to the next Chapter and repeat steps 1 to 5 for each subsequent Chapter. 3 LSCTMMOD1 Send for a FREE copy of our Prospectus book by airmail, telephone, fax or email, or via our website: Britain. International Headquarters: College House, Leoville, Jersey JE3 2DB, Britain Telefax: +44 (0)1534 485485 Email: [emailprotected] com Website: www. cambridgecollege. co. uk LOGISTICS, SUPPLY CHAIN TRANSPORT MANAGEMENT PROGRAM MODULE ONE BUSINESS LOGISTICS/SUPPLY CHAIN A VITAL SUBJECT (based on Chapter 1 of ‘Logistics, Supply Chain and Transport Management’ by Ronald H Ballou) Contents Introduction Business Logistics Defined The Supply Chain The Activity Mix Importance of Logistics/Supply Chain (SC) Costs Are Significant Logistics Customer Service Expectations Are Increasing Supply and Distribution Lines Are Lengthening with Greater Complexity Logistics/SC Is Important to Strategy Logistics/SC Adds Significant Customer Value Customers Increasingly Want Quick, Customized Response Logistics/SC in Non-Manufacturing Areas Service Industry Military Environment Business Logistics/SC in the Firm Objectives of Business Logistics/SC Questions and Problems Introduction As far back as history records, the goods that people wanted were not always produced where they wanted to consume them, or these goods were not accessible when people wanted to consume them. Food and other commodities were widely dispersed and were only available in abundance at certain times of the year. Early peoples had the choice of consuming goods at their immediate location or moving the goods to a preferred site and storing them for later use. However, because no well developed transportation and storage systems yet existed, the movement of goods was limited to what an individual could personally move, and storage of perishable commodities was possible for only a short time. This limited movement-storage system generally constrained people to live close to the sources of production and to consume a rather narrow range of goods. Even today, in some areas of the world consumption and production take place only within a very limited geographic region. Striking examples can still be observed in the developing nations of Asia, South America, Australia, and Africa, where some of the population live in small, self-sufficient villages, and most of the goods needed by the residents are produced or acquired in the immediate vicinity. Few goods are imported from other areas. Therefore, production efficiency and the economic standard of living are generally low. In this type of economy, a well-developed and inexpensive logistics system would encourage an exchange of goods with other producing areas of the country, or even the world. 4 LSCTMMOD1 Send for a FREE copy of our Prospectus book by airmail, telephone, fax or email, or via our website: Britain. International Headquarters: College House, Leoville, Jersey JE3 2DB, Britain Telefax: +44 (0)1534 485485 Email: [emailprotected] com Website: www. cambridgecollege. co. uk As logistics systems improved, consumption and production began to separate geographically. Regions would specialize in those commodities that could be produced most efficiently. Excess production could be shipped economically to other producing (or consuming) areas, and needed goods not produced locally were imported. This exchange process follows the principle of comparative advantage. This same principle, when applied to world markets, helps to explain the high level of international trade that takes place today. Efficient logistics systems allow world businesses to take advantage of the fact that lands, and the people who occupy them, are not equally productive. Logistics is the very essence of trade. It contributes to a higher economic standard of living for us all. To the individual firm operating in a high-level economy, good management of logistics activities is vital. Markets are often national or international in scope, whereas production may be concentrated at relatively few points. Logistics activities provide the bridge between production and market locations that are separated by time and distance. Effective management of these activities is the major concern of this Program. Business Logistic Defined Business logistics is a relatively new field of integrated management study in comparison with the traditional fields of finance, marketing, and production. As previously noted, logistics activities have been carried out by individuals for many years. Businesses also have continually engaged in movestore (transportation-inventory) activities. The newness of the field results from the concept of coordinated management of the related activities, rather than the historical practice of managing them separately, and the concept that logistics adds value to products or services that are essential to customer satisfaction and sales. Although co-ordinated logistics management has not been generally practiced until recently, the idea of co-ordinated management can be traced back to at least 1844. In the writings of Jules Dupuit, a French engineer, the idea of trading one cost for another (transportation costs for inventory costs) was evident in the selection between road and water transport: â€Å"The fact is that carriage by road being quicker, more reliable and less subject to loss or damage, it possesses advantage to which businessmen often attach a considerable value. However, it may well be that a saving induces the merchant to use a canal; he can buy warehouses and increase his floating capital in order to have a sufficient supply of goods on hand to protect himself against slowness and irregularity of the canal, and if all told the saving in transport gives him a cost advantage, he will decide in favour of the new route. † The first textbook to suggest the benefits of co-ordinated logistics management appeared around 1961, in part explaining why a generally accepted definition of business logistics is still emerging. Therefore, it is worthwhile to explore several definitions for the scope and content of the subject. A dictionary definition of the term logistics is: â€Å"The branch of military science having to do with procuring, maintaining, and transporting material, personnel, and facilities. † This definition puts logistics into a military context. To the extent that business objectives and activities differ from those of the military, this definition does not capture the essence of business logistics management. A better representation of the field may be reflected in the definition promulgated by the Council of Logistics Management (CLM), a professional organization of logistics 5 LSCTMMOD1 Send for a FREE copy of our Prospectus book by airmail, telephone, fax or email, or via our website: Britain. International Headquarters: College House, Leoville, Jersey JE3 2DB, Britain Telefax: +44 (0)1534 485485 Email: [emailprotected] com Website: www. cambridgecollege. co. uk managers, educators, and practitioners formed in 1962 for the purposes of continuing education and fostering the interchange of ideas. Its definition: â€Å"Logistics is that part of the supply chain process that plans, implements, and controls the efficient, effective flow and storage of goods, services, and related information from the point of origin to the point of consumption in order to meet customers’ requirements. † This is an excellent definition, conveying the idea that product flows are to be managed from the point where they exist as raw materials to the point where they are finally discarded. Logistics is also concerned with the flow of services as well as physical goods, an area of growing opportunity for improvement. It also suggests that logistics is a process, meaning that it includes all the activities that have an impact on making goods and services available to customers when and where they wish to acquire them. However, the definition implies that logistics is part of the supply chain process, not the entire process. So, what is the supply chain process or, more popularly, supply chain management? Supply chain management (SCM) is a term that has emerged in recent years that captures the essence of integrated logistics and even goes beyond it. Supply chain management emphasizes the logistics interactions that take place among the functions of marketing, logistics, and production within a firm and those interactions that take place between the legally separate firms within the product-flow channel. Opportunities for cost or customer service improvement are achieved through co-ordination and collaboration among the channel members where some essential supply chain activities may not be under the direct control of the logistician. Although early definitions such as physical distribution, materials management, industrial logistics and channel management all terms used to describe logistics have promoted this broad scope for logistics, there was little attempt to implement logistics beyond a company’s own enterprise boundaries, or even beyond its own internal logistics function. Now, retail firms are showing success in sharing information with suppliers, who in turn agree to maintain and manage inventories on retailers’ shelves. Channel inventories and product stockouts are lower. Manufacturing firms operating under just-in-time production scheduling build relationships with suppliers for the benefit of both companies by reducing inventories. Definitions of the supply chain and supply chain management reflecting this broader scope are: â€Å"The supply chain (SC) encompasses all activities associated with the flow and transformation of goods from the raw materials stage (extraction), through to the end user, as well as the associated information flows. Materials and information flow both up and down the supply chain. † â€Å"Supply chain management (SCM) is the integration of these activities, through improved supply chain relationships, to achieve a sustainable competitive advantage. † After careful study of the various definitions being offered, Mentzer and other writers propose the broad and rather general definition as follows: â€Å"Supply chain management is defined as the systematic, strategic coordination of the traditional business functions and the tactics across these business functions within a particular company and across businesses within the supply chain, for the purposes of improving the long-term performance of the individual companies and the supply chain as a whole. † 6 LSCTMMOD1 Send for a FREE copy of our Prospectus book by airmail, telephone, fax or email, or via our website: Britain. International Headquarters: College House, Leoville, Jersey JE3 2DB, Britain Telefax: +44 (0)1534 485485 Email: [emailprotected] The supply chain management model in Figure 1-1 viewed as a pipeline shows the scope of this definition. It is important to note that supply chain management is about the co-ordination of product flows across functions and across companies to achieve competitive advantage and profitability for the individual companies in the supply chain and the supply chain members collectively. It is difficult, in a practical way, to separate business logistics management from supply chain management. In so many respects, they promote the same mission: â€Å"To get the right goods or services to the right place, at the right time, and in the desired condition, while making the greatest contribution to the firm. † Some claim that supply chain management is just another name for integrated business logistics management (IBLM) and that the broad scope of supply chain management has been promoted over the years. Conversely, others say that logistics is a subset of SCM, where SCM considers additional issues beyond those of product flow. For example, SCM may be concerned with product pricing and manufacturing quality. Although SCM promotes viewing the supply channel with the broadest scope, the reality is that firms do not practise this ideal. Fawcett and Magan found that companies that do practise supply chain integration limit their scope to one tier upstream and one tier downstream. The focus seems to be concerned with creating seamless processes within their own companies and applying new information technologies to improve the quality of information and speed of its exchange among channel members. The boundary between the logistics and supply chain management terms is fuzzy. Even then, logistics activities are repeated once again as used products are recycled upstream in the logistics channel. A single firm generally is not able to control its entire product flow channel from raw material source to points of the final consumption, although this is an emerging opportunity. For practical purposes, the business logistics for the individual firm has a narrower scope. Usually, the maximum managerial control that can be expected is over the immediate physical supply and physical distribution channels, as shown in Figure 1-2. The physical supply channel refers to the time and space gap between a firm’s immediate material sources and its processing points. Similarly, the physical distribution channel refers to the time and space gap between the firm’s processing points and its customers. Due to the similarities in the activities between the two channels, physical supply (more commonly referred to as materials management) 8 LSCTMMOD1 Send for a FREE copy of our Prospectus book by airmail, telephone, fax or email, or via our website: Britain. International Headquarters: College House, Leoville, Jersey JE3 2DB, Britain Telefax: +44 (0)1534 485485 Email: [emailprotected] com Website: www. cambridgecollege. co. uk and physical distribution comprise those activities that are integrated into business logistics. Business logistics management is now popularly referred to as supply chain management. Others have used terms such as value nets, value stream, and lean logistics to describe a similar scope and purpose. The evolution of the management of product flows toward SCM is captured in Figure 1-3. Although it is easy to think of logistics as managing the flow of products from the points of raw material acquisition to end customers, for many firms there is a reverse logistics channel that must be managed as well. The life of a product, from a logistics viewpoint, does not end with delivery to the customer. Products become obsolete, damaged, or nonfunctioning and are returned to their source points for repair or disposition. Packaging materials may be returned to the shipper due to environmental regulations or because it makes good economic sense to reuse them. The reverse logistics channel may utilize all or a portion of the forward logistics channel or it may require a separate design. The supply chain terminates with the final disposition of a product. The reverse channel must be considered to be within the scope of logistics planning and control. The Activity Mix The activities to be managed that make up business logistics (supply chain process) vary from firm to firm, depending on a firm’s particular organizational structure, management’s honest differences of opinion about what constitutes the supply chain for its business, and the importance of individual activities to its operations. Follow along the supply chain as shown in Figure 1-2 and note the important activities that take place. Again, according to the CLM: 9 LSCTMMOD1 Send for a FREE copy of our Prospectus book by airmail, telephone, fax or email, or via our website: Britain. International Headquarters: College House, Leoville, Jersey JE3 2DB, Britain Telefax: +44 (0)1534 485485 Email: [emailprotected] com Website: www. cambridgecollege. co. uk â€Å"The components of a typical logistics system are: customer service, demand forecasting, distribution communications, inventory control, material handling, order processing, parts and service support, plant and warehouse site selection (location analysis), purchasing, packaging, return goods handling, salvage and scrap disposal, traffic and transportation, and warehousing and storage. † Figure 1-4 organizes these components, or activities, according to where they are most likely to take place in the supply channel. The list is further divided into key and support activities, along with some of the decisions associated with each activity. Customer service standards co-operate with marketing to: a. Determine customer needs and wants for logistics customer service b. Determine customer response to service c. Set customer service levels 2. Transportation a. Mode and transport service selection b. Freight consolidation c. Carrier routing d. Vehicle scheduling e. Equipment selection f. Claims processing g. Rate auditing 3. Inventory management a. Raw materials and finished goods stocking policies b. Short-term sales forecasting c. Product mix at stocking points 10 LSCTMMOD1 Send for a FREE copy of our Prospectus book by airmail, telephone, fax or email, or via our website: Britain. International Headquarters: College House, Leoville, Jersey JE3 2DB, Britain Telefax: +44 (0)1534 485485 Email: [emailprotected] com Website: www. cambridgecollege. co. uk d. Number, size, and location of stocking points e. Just-in-time, push, and pull strategies 4. Information flows and order processing a. Sales order-inventory interface procedures b. Order information transmittal methods c. Ordering rules Support Activities 1. Warehousing a. Space determination b. Stock layout and dock design c. Warehouse configuration d. Stock placement 2. Materials handling a. Equipment selection b. Equipment replacement policies c. Order-picking procedures d. Stock storage and retrieval 3. Purchasing a. Supply source selection b. Purchase timing c. Purchase quantities 4. Protective packaging designed for: a. Handling b. Storage c. Protection from loss and damage 5. Co-operate with production/operations to: a. Specify aggregate quantities b. Sequence and time production output c. Schedule supplies for production/operations 6. Information maintenance a. Information collection, storage, and manipulation b. Data analysis Control procedures Key and support activities are separated because certain activities will generally take place in every logistics channel, whereas others will take place, depending on the circumstances, within a particular firm. The key activities are on the â€Å"critical† loop within a firm’s immediate physical distribution channel, as shown in Figure 1 to 5. They contribute most to the total cost of logistics or they are essential to the effective co-ordination and completion of the logistics task. 11 LSCTMMOD1 Send for a FREE copy of our Prospectus book by airmail, telephone, fax or email, or via our website: Britain. International Headquarters: College House, Leoville, Jersey JE3 2DB, Britain Telefax: +44 (0)1534 485485 Email: [emailprotected] com Website: www. cambridgecollege. co. uk Customer service standards set the level of output and degree of readiness to which the logistics system must respond. Logistics costs increase in proportion to the level of customer service provided, such that setting the standards for service also affects the logistics costs to support that level of service. Setting very high service requirements can force logistics costs to exceedingly high levels. Transportation and inventories maintenance are the primary cost-absorbing logistics activities. Experience has shown that each will represent one-half to two-thirds of total logistics costs. Transportation adds place value to products and services, whereas inventories maintenance adds time value. Transportation is essential because no modern firm can operate without providing for the movement of its raw materials or its finished products. This importance is underscored by the financial strains placed on many firms by such disasters as a national railroad strike or independent truckers’ refusal to move goods because of rate disputes. In these circumstances, markets cannot be served, and products back up in the logistics pipeline to deteriorate or become obsolete. Inventories are also essential to logistics management because it is usually not possible or practical to provide instant production or ensure delivery times to customers. They serve as buffers between supply and demand so that needed product availability may be maintained for customers while providing flexibility for production and logistics in seeking efficient methods for manufacture and distribution of the product. Order processing is the final key activity. Its costs usually are minor compared to transportation or inventory maintenance costs. Nevertheless, order processing is an important element in the total time that it takes for a customer to receive goods or services. It is the activity triggering product movement and service delivery. Although support activities may be as critical as the key activities in any particular circumstance, they are considered here as contributing to the logistics mission. In addition, one or more of the support activities may not be a part of the logistics activity mix for every firm. For example, products such as finished automobiles or commodities such as coal, iron ore, or gravel not needing the weather and security protection of warehousing will not require the warehousing activity, even though inventories are maintained. However, warehousing and materials handling are typically conducted wherever products are temporarily halted in their movement to the marketplace. 12 LSCTMMOD1 Send for a FREE copy of our Prospectus book by airmail, telephone, fax or email, or via our website: Britain. International Headquarters: College House, Leoville, Jersey JE3 2DB, Britain Telefax: +44 (0)1534 485485 Email: [emailprotected] com Website: www. cambridgecollege. co. uk Protective packaging is a support activity of transportation and inventory maintenance as well as of warehousing and materials handling because it contributes to the efficiency with which these other activities are carried out. Purchasing and product scheduling often may be considered more a concern of production than of logistics. However, they also affect the overall logistics effort, and specifically they affect the efficiency of transportation and inventory management. Finally, information maintenance supports all other logistics activities in that it provides the needed information for planning and control. The extended supply chain refers to those members of the supply channel beyond the firm’s immediate suppliers or customers. They may be suppliers to the immediate suppliers or customers of the immediate customers and so on until raw material source points or end customers are reached. It is important to plan and control the previously noted activities and information flows if they affect the logistics customer service that can be provided and the costs of supplying this service. Management of the extended supply chain has the potential of improving logistics performance beyond that of just managing the activities within the immediate supply chain. Importance of Logistics/Supply Chain Logistics is about creating value value for customers and suppliers of the firm, and value for the firm’s stakeholders. Value in logistics is primarily expressed in terms of time and place. Products and services have no value unless they are in the possession of the customers when (time) and where (place) they wish to consume them. For example, concessions at a sports event have no value to consumers if they are not available at the time and place that the event is occurring, or if inadequate inventories don’t meet the demands of the sports fans. Good logistics management views each activity in the supply chain as contributing to the process of adding value. If little value can be added, it is questionable whether the activity should exist. However, value is added when customers are willing to pay more for a product or service than the cost to place it in their hands. To many firms throughout the world, logistics has become an increasingly important value-adding process for a number of reasons. Costs Are Significant Over the years, several studies have been conducted to determine the costs of logistics for the whole economy and for the individual firm. There are widely varying estimates of the cost levels. According to the International Monetary Fund (IMF), logistics costs average about 12 percent of the 13 LSCTMMOD1 Send for a FREE copy of our Prospectus book by airmail, telephone, fax or email, or via our website: Britain. International Headquarters: College House, Leoville, Jersey JE3 2DB, Britain Telefax: +44 (0)1534 485485 Email: [emailprotected] com Website: www. cambridgecollege. co. uk world’s gross domestic product. Robert Delaney, who has tracked logistics costs for more than two decades, estimates that logistics costs for the U. S. economy are 9. 9 percent of the U. S. gross domestic product (GDP), or $921 billion. For the firm, logistics costs have ranged from 4 percent to over 30 percent of sales. The results from a cost survey of individual firms are shown in Table 1-3. Although the results show physical distribution costs at about 8 percent of sales, this survey does not include physical supply costs. Probably another one-third may be added to this total to represent average logistics costs for the firm at about 11 percent of sales. Over the last decade, physical distribution costs have ranged between 7 percent and 9 percent of sales. There may be a trend of increasing costs for individual firms, although Wilson and Delaney show over the same period that logistics costs as a percent of U. S. GDP have declined by about 10 percent. Logistics costs, substantial for most firms, rank second only to the cost of goods sold (purchase costs) that are about 50 percent to 60 percent of sales for the average manufacturing firm. Value is added by minimizing these costs and by passing the benefits on to customers and to the firm’s shareholders. Logistics Customer Service Expectations Are Increasing The Internet, just-in-time operating procedures, and continuous replenishment of inventories have all contributed to customers expecting rapid processing of their requests, quick delivery, and a high degree of product availability. According to the Davis Survey of hundreds of companies over the last decade, world-class competitors have average order cycle times (the time between when an order is placed and when it is received) of seven to eight days and line item fill rates of 90 percent to 94 percent. LogFac summarizes world-class logistics performance for domestic companies as: Error rates of less than one per 1,000 orders shipped Logistics costs of well under 5 percent of sales Finished goods inventory turnover of 20 or more times per year Total order cycle time of five working days Transportation cost of one percent of sales revenue or less, if products sold are over $5 per 500 gms As might be expected, the average company performs below these cost and customer service benchmarks, when compared with the statistics in Tables 1-3 and 1-4. Supply and Distribution Lines Are Lengthening with Greater Complexity The trend is toward an integrated world economy. Firms are seeking, or have developed, global strategies by designing their products for a world market and producing them wherever the low-cost 14 LSCTMMOD1 Send for a FREE copy of our Prospectus book by airmail, telephone, fax or email, or via our website: Britain. International Headquarters: College House, Leoville, Jersey JE3 2DB, Britain Telefax: +44 (0)1534 485485 Email: [emailprotected] com Website: www. cambridgecollege. co. uk raw materials, components, and labor can be found (e. g. , Ford’s Focus automobile), or they simply produce locally and sell internationally. In either case, supply and distribution lines are stretched, as compared with the producer who wishes to manufacture and sell only locally. Not only has the trend occurred naturally by firms seeking to cut costs or expand markets, but it is also being encouraged by political arrangements that promote trade. Examples of the latter are the European Union, the North America Free Trade Agreement (NAFTA) between Canada, the United States, and Mexico, and the economic trade agreement among several countries of South America (MERCOSUR). Globalization and internationalization of industries everywhere will depend heavily on logistics performance and costs, as companies take more of a world view of their operations. As this happens, logistics takes on increased importance within the firm since its costs, especially transportation, become a larger part of the total cost structure. For example, if a firm seeks foreign suppliers for the raw materials that make up its final product or foreign locations to build its product, the motivation is to increase profit. Material and labor costs may be reduced, but logistics costs are likely to increase due to increased transportation and inventory costs. The â€Å"tradeoff†, as shown in Figure 1-6, may lead to higher profit by reducing materials, labour, and overhead costs at the expense of logistics costs and tariffs. â€Å"Outsourcing† adds value, but it requires careful management of logistics costs and product-flow times in the supply channel. Logistics/SC Is Important To Strategy Firms spend a great deal of time finding ways to differentiate their product offerings from those of their competitors. When management recognizes that logistics/SC affects a significant portion of a firm’s costs and that the result of decisions made about the supply chain processes yields different levels of customer service, it is in a position to use this effectively to penetrate new markets, to increase market share, and to increase profits. When a firm incurs the cost of moving the product toward the customer or making an inventory available in a timely manner, for the customer â€Å"value† has been created that was not there previously. It is value as surely as that created through the production of a quality product or through a low price. It is generally recognized that business creates four types of value in products or services. These are: form, time, place, and possession. Logistics creates two out of these four values. Manufacturing creates form value as inputs are converted to outputs, that is raw materials are transformed into finished goods. Logistics controls the time and place values in products, mainly through transportation, information flows, and inventories. Possession value is often considered the responsibility of marketing, engineering, and finance, where the value is created by helping customers acquire the product through such mechanisms as advertising (information), technical support, and terms of sale (pricing and credit availability). To the extent that SCM includes production, three out of the four values may be the responsibility of the logistics/supply chain manager. Customers Increasingly Want Quick, Customized Response Fast food retailers, automatic teller machines, overnight package delivery, and electronic mail on the Internet have led us as consumers to expect that products and services can be made available in increasingly shorter times. In addition, improved information systems and flexible manufacturing processes have led the marketplace toward mass customization. Rather than consumers having to accept the â€Å"one size fits all† philosophy in their purchases, suppliers are increasingly offering products that meet individual customer needs. Companies too have been applying the concept of quick response to their internal operations in order to meet the service requirements of their own marketing efforts. The quick response philosophy has been used to create a marketing advantage. Saks Fifth Avenue applied it, even though big profits are made through big margins and not on cost reductions that might be achieved from good logistics management. Supply chain costs may even rise, although the advantage is to more than cover these costs through increased profits. Logistics/SC in Non-manufacturing Areas It is perhaps easiest to think of logistics/SC in terms of moving and storing a physical product in a manufacturing setting. This is too narrow a view and can lead to many missed business opportunities. The logistics/SC principles and concepts learned over the years can be applied to such areas as service industries, the military, and even environment management. Service Industry The service sector of industrialized countries is large and growing. In the United States, over 70 percent of all jobs are in what the federal government classifies as the service sector. The size of this sector alone forces us to ask if logistics concepts are not equally applicable here as they are to the manufacturing sector. If they are, there is a tremendous untapped opportunity yet to be fulfilled. Many companies designated as service firms in fact produce a product. Examples include: McDonald’s Corporation (fast foods); Dow Jones Co. , Inc. (newspaper publishing); and Sears, Roebuck and Co. (merchandise retailing). These companies carry out all the typical supply chain activities of any manufacturing firm. However, for service companies such as Bank One (retail banking), Marriott Corporation (lodging) and Consolidated Edison (electric power), supply chain activities, 16 LSCTMMOD1 Send for a FREE copy of our Prospectus book by airmail, telephone, fax or email, or via our website: Britain. International Headquarters: College House, Leoville, Jersey JE3 2DB, Britain Telefax: +44 (0)1534 485485 Email: [emailprotected] com Website: www. cambridgecollege. co. uk especially those associated with physical distribution, are not as obvious. Even though many service-oriented companies may be distributing an intangible, nonphysical product, they do engage in many physical distribution activities and decisions. A hospital may want to extend emergency medical care throughout the community and must make decisions as to the locations of the centers. United Parcel Service and Federal Express must locate terminals and route pickup and delivery trucks. The East Ohio Gas Company inventories natural gas in underground wells during the off-season in the region where demand will occur. Bank One must locate and have cash inventory on hand for its ATMs. The Federal Reserve Bank must select the methods of transportation to move cancelled cheques among member banks. The Catholic Church must decide the number, location, and size of the churches needed to meet shifts in size and location of congregations, as well as to plan the inventory of its pastoral staff. Xerox’s repair service for copying equipment is also a good example of the logistics decisions encountered in a service operation. The techniques, concepts, and methods discussed throughout this Program should be as applicable to the service sector as they are to the manufacturing sector. The key, according to Theodore Levitt, may be in transforming an intangible service into a tangible product. Problems will remain in carefully identifying the costs associated with the distribution of an intangible product. Perhaps because of this, few service firms or organizations have a physical distribution manager on their staff, although they frequently do have a materials manager to handle supply matters. However, managing logistics in service industries does represent a new direction for the future development of logistics practice. Military Before businesses showed much interest in co-ordinating supply chain processes, the military was well organized to carry out logistics activities. More than a decade before business logistics’ developmental period, the military carried out what was called the most complex, best-planned logistics operation of that time-the invasion of Europe during World War II. Although the problems of the military, with its extremely high customer service requirements, were not identical with those of business, the similarities were great enough to provide a valuable experience base during the developmental years of logistics. For example, the military alone maintained inventories valued at about one-third of those held by all U. s. manufacturers. In addition to the management experience that such large-scale operations provide, the military sponsored, and continues to sponsor, research in the logistics area through such organizations as the RAND Corporation and the Office of Naval Research. With this background, the field of business logistics began to grow. Even the term logistics seems to have had its origins in the military. A recent example of military logistics on a large scale was the conflict between the United States and Iraq over Iraq’s invasion of the small country of Kuwait. This invasion has been described as the largest military logistics operation in history. The logistics support in that war is yet another illustration of what worldclass companies have always known: Good logistics can be a source of competitive advantage. Lt General William Pagonis, in charge of logistics support for Desert Storm, observed: â€Å"When the Middle East started heating up, it seemed like a good time to pull out some history books on desert warfare in this region . But there was nothing on logistics. Logistics is not a best seller. In a couple of his diaries, Rommel talked about logistics. He thought the Germans lost the battle not because they didn’t have great soldiers or equipment in fact, the German tanks outfought ours almost throughout World War II but because the British had better logistics. † 17 LSCTMMOD1 Send for a FREE copy of our Prospectus book by airmail, telephone, fax or email, or via our website: The first wave of 200,000 troops and their equipment was deployed in a month and a half, whereas troop deployment took nine months in the Vietnam conflict. In addition, the application of many good logistics concepts was evident. Take customer service, for example: â€Å"We believed that if we took care of our troops, the objectives would be accomplished no matter whatever else happened. The soldiers are our customers. It is no different than a determined, single focus on customers that many successful businesses have. Now, you take care of your soldiers not only by providing them cold sodas, and burgers, and good food: you make sure they have the ammunition on the front line, so that when they go fight the war they know they have what they need. † This meant that when 120 mm guns rather than 105 mm guns were desired on tanks, they were changed. When brown vehicles were preferred over the traditional camouflage green, they were repainted at the rate of 7,000 per month. Environment Population growth and resultant economic development have heightened our awareness of environmental issues. Whether it is recycling, packaging materials, transporting hazardous materials or refurbishing products for resale, logisticians are involved in a major way. After all, the United States alone produces more than 160 million tons of waste each year, enough for a convoy of 10-ton garbage trucks reaching halfway to the moon. In many cases, planning for logistics in an environmental setting is no different from that in manufacturing or service sectors. However, in a few cases additional complications arise, such as governmental regulations that make the logistics for a product more costly by extending the distribution channel. Business Logistics in the Firm It has been the tradition in many firms to organize around marketing and production functions. Typically, marketing means selling something and production means making something. Although few business people would agree that their organization is so simple, the fact remains that many businesses emphasize these functions while treating other activities, such as traffic, purchasing, accounting, and engineering, as support areas. Such an attitude is justified to a degree, because if a firm’s products cannot be produced and sold, little else matters. However, such a pattern is dangerously simple for many firms to follow in that it fails to recognize the importance of the activities that must take place between points and times of production or purchase and the points and times of demand. These are the logistics activities, and they affect the efficiency and effectiveness of both marketing and production. Scholars and practitioners of both marketing and production have not neglected the importance of logistics. In fact, each area considers logistics within its scope of action. For example, the following definition of marketing management includes physical distribution: â€Å"Marketing (management) is the process of planning and executing the conception, pricing, promotion, and distribution of ideas, goods, and services to create exchanges with target groups that satisfy individual and organizational objectives. † Marketing’s concern is to place its products or services in convenient distribution channels to facilitate the exchange process. The concept of production/ operations management often includes logistics activities. Now, viewing product flow activities as a process to be coordinated, product flow aspects within marketing, production, and logistics are collectively managed to achieve customer service objectives. The difference in operating objectives (maximize revenue versus minimize cost) for marketing and production/operations may lead to a fragmentation of interest in, and responsibility for, logistics activities, as well as a lack of co-ordination among logistics activities as a whole. This, in turn, may lead to lower customer service levels or higher total logistics costs than are necessary. Business logistics represents a regrouping, either by formal organizational structure or conceptually in the minds of management, of the move-store activities that historically may have been partially under the control of marketing and production/ operations. If logistics activities are looked upon as a separate area of managerial action, the relationship of logistics activities to those of marketing and production/ operations would be as is shown in Figure 1-7. Marketing would be primarily responsible for market research, promotion, sales-force management, and the product mix, which create possession value in the product. Production/ operations would be concerned with the creation of the product or service, which creates form value in the product. Key responsibilities would be quality control, production planning and scheduling, job design, capacity planning, maintenance, and work measurement and standards. Logistics would be concerned with those activities (previously defined) that give a product or service time and place value. This separation of the activities of the firm into three groupings rather than two is not always necessary or advisable to achieve the coordination of logistics activities that is sought. Marketing and production/operations, when broadly conceived and co-ordinated, can do an effective job of managing logistics activities without creating an additional organizational entity. Even if a separate functional area is created for logistics within the firm so as to achieve effective control of the firm’s immediate logistics activities, logisticians will need to view their responsibility as one of coordinating the entire supply chain process rather than being just a local logistics activity administrator. To do otherwise may miss substantial opportunities for cost reduction and logistics customer service improvement. The interface is created by the arbitrary separation of a firm’s activities into a limited number of functional areas. Managing the interface activities by one function alone can lead to sub-optimal performance for the firm by subordinating broader company goals to individual functional goals-a potential danger resulting from the departmental form of organizational structure so common in companies today. To achieve interfunctional coordination, some measurement system and incentives for cooperation among the functions involved need to be established. This is equally true of the inter-organizational co-ordination required to manage product flows across company boundaries. It is important to note, however, that establishing a third functional group is not without its disadvantages. Two functional interfaces now exist where only one between marketing and production/ operations previously existed. Some of the most difficult administrative problems arise from the interfunctional conflicts that occur when one is attempting to manage interface activities. Some of this potential conflict may be dissipated if a new organizational arrangement is created whereby production/ operations and logistics are merged into one group called supply chain. Just as managers are beginning to understand the benefits of interfunctional logistics management, inter-organizational management is being encouraged. Supply chain management proponents who view the area more broadly than some logisticians have been strongly promoting the need for collaboration among supply channel members that are outside the immediate control of a company’s  logistician, that is, members who are legally separate companies. Collaboration among the channel members that are linked through buyer-seller relationships is essential to achieving cost-service benefits unable to be realized by managers with strictly an internal view of their responsibilities. Supply chain managers consider themselves to have responsibility for the entire supply channel of the scope as illustrated in Figure 1-8. Managing in this broader environment is the new challenge for the contemporary logistician. Objectives of Business Logistics/SC Within the broader objectives of the firm, the business logistician seeks to achieve supply channel process goals that will move the firm toward its overall objectives. Specifically, the desire is to develop a logistics activity mix that will result in the highest possible return on investment over time. There are two dimensions to this goal: (1) the impact of the logistics system design on the revenue contribution, and (2) the operating cost and capital requirements of the design. Ideally, the logistician should know how much additional revenue would be generated through incremental improvements.

Elderly Patient Surgery Case Study

Elderly Patient Surgery Case Study Every nurse has the responsibility to safeguard their patients from harm and the NMC (2009a, p.14), states that it is every adults right to live in safety and be free from fear and abuse. There are a number of individuals who can be classed as a vulnerable person, these individuals can be either children or adults. A vulnerable adult is someone who is over 18 years old and meets any one of the following criteria: is receiving any form of healthcare or welfare service, needs assistance to carry out daily activities, unable to take care of him or herself and is unable to protect him or herself against harm. (DoH, 2009, Section 59)(DoH, 2000, p.8-9). Older people are generally regarded as vulnerable adults because of their general poor health and their high dependency on others to help with daily activities. In Peters case, he is not very young, is inclined to be forgetful and has mobility issues and therefore has the high probability of requiring help at home to help with his independe nce. All of these issues combined could have serious impacts on his health and safety which would mean that Peter could fit into each, if not all, of the mentioned categories and therefore he should be regarded as a vulnerable adult. The Independent Safeguarding Authority (ISA) is responsible for the vetting and barring of any individuals who may come into contact with or work with vulnerable individuals (ISA, 2009, p.3). The ISA have an Independent Barring Board who are responsible for maintaining two separate lists, one for the protection of children and the other for the protection of vulnerable adults, which contain the names of any person who has been referred to them for the harming of any vulnerable person (ISA, 2009, p.3). The harming of a vulnerable person, whether it be physical, verbal, psychological, emotional, financial or neglect, is regarded as abuse. Vulnerable adults may be abused by a wide range of people, including family members and abuse can be in the form of a single or a recurring act. As Peters daughter wants him to have the surgery the nurse will have to establish whether there is an underlying reason for this. Assessment of this situation would be essential because intimidation or coerci on, which are both forms of psychological abuse, may cause Peter to be incapable of making his own decisions (DoH, 2000, p.11). As such, if this was assessed to be abusive behaviour, it would be important to remove Peter away from his daughter as the nurse has a duty of care to ensure that her patient remains safe at all times (NMC code). Nurses have a professional responsibility to their patients, are accountable for their actions when the patient is in their care and have a duty of care to ensure that the patient receives good quality care at all times (NMC code 1.4). Every nurse must always ensure that they work within their abilities and should raise any concerns, to a senior member of staff, if they have been asked to perform any duties which they are not competent in performing and therefore may potentially cause harm to the patient (NMC, 2009b). Reasonable care must be taken to avoid acts or omissions which are likely to cause reasonably foreseeable harm to whomever a duty of care is owed (Dimond, 2008, p.40). If the nurse does not provide sufficient care to the patient and causes harm as a result, she will be held liable in the tort of negligence (Tingle crib, p.92), which is a civil wrong for the breach of duty to take reasonable care not to injure or harm a person. In order to be held liable in the tort of negligence it must first be proven that the nurse owed a duty of care to that patient, next the claimant must prove that there was a breach in this duty of care and then it must be proven that the damage being claimed for was caused by this breach of duty (Tingle). The Bolam Test is the test which is used to determine a breach of duty and is concerned with how negligence should be established (Legal aspects). It does this by testing the standard of care which should be given from a professional and comparing it to the standard of care which was actually given in the cases of the alleged negligence (). Accountability means being responsible for something or to someone (NMC, 2002, p10). According to Dimond (2008, p.5), registered nurses are held accountable to the patient, the public, their employer and their profession, and these are known as the four arenas of accountability. Where the registered nurse is accountable to the patient and the public, she is accountable to the law and accountability to her employer means she is responsible for keeping to her contract of employment and failing to do so may result in a hearing in front of the employment tribunal. Professional accountability assumes that the nurse is a member of the profession and that she has accepted the rights, status and responsibilities of the profession (foundations, p.473). The NMC (2002, p.3) suggests that professional accountability involves using knowledge, skills, experience and professional judgement in order to make decisions which are in the best interests of the patient and should be able to justify the re asons for her decisions. This implies that nurses, as professionals, are competent in their area of practice, which allows the patient to gain trust in the nurse and enables the nurse to be able to act in the patients best interest (foundations, p.473). Therefore, nurses have a duty of care to those they care for and as such, this implies that there is a right and a duty attached to professional accountability. Registered nurses must follow the guidelines within the Code of Professional Conduct and as such should be legally accountable for their work (NMC, 2009b) and will be brought in front of the Fitness to Practice Panel, and possibly removed from the register, for unprofessional behaviour that breaches the Code of Conduct (Brooker and Nicol, 2003, p.6). This is different for nursing students, as they are only accountable to their employer, in this case the university, and the law. It is not possible to hold students professionally accountable as their names have not yet been entered onto the professional register however the NMC states that students are still responsible for their actions (NMC, 2010, p.1). From this it must be said that it will be the registered nurse who is mentoring, or working with, the student that can be held accountable for the students actions or omissions as it is their responsibility to ensure that the student is working within their abilities (Brooker and Nico l, 2003, p.7). Nurses are fundamentally responsible for the promotion and restoration of health, the prevention of illness and to ease suffering for their patients (Hendrick, p.76), however nursing is not just about treating a patients illness; its about caring, teaching and supporting a patient at a time when they need it the most. This can be done if the nurse makes building a nurse-patient relationship with her patient a priority in the patients care. Communication is a necessary foundation for any nurse-patient relationship to be built appropriately and there are a number of ways in which people can communicate such as verbally, non-verbally, written or electronically. The nurse should always communicate with the patient at their level of understanding and should always avoid using medical jargon when speaking to the patient (NMC). Effective communication is not just about talking, it involves active listening too and is an essential key in building a trusting relationship with the patient. Dif ferent communication techniques could be used between the nurse and the patient which include observing, listening, silence and open-ended questions (Brooker and Nicol, 2003, p.46). Without the appropriate use of these different communication techniques the relationship will not have a base to build on and if there is no relationship, the patient will not have the trust required for them to share their feelings, anxieties or wishes. In our scenario, Peter has opened up to the nurse by telling her how he is feeling and has put his trust in her to help him make the decision as to whether or not he should have the surgery. In this situation communication is the vital key as it is important that Peter is given open, honest, accurate and unbiased information about any procedures or assessments that will be carried out and the nurse must ensure that he fully understands the benefits, risks, side effects and consequences of these procedures (). The patient should be consulted every step of the way which will enable them to remain autonomous. All healthcare professionals should have a respect for their patients autonomy and should treat their patients as individuals, with rights, rather than objects of care (Hendrick, p.95). Autonomy is the right of the person to make their own decisions and accepting their choices. One way in which a patient can exercise their autonomy is by giving consent and as such, autonomy is a requirement for consent (tingle cribb, p.143). Consent can be given in different forms such as expressed or implied. Expressed consent can be either written or verbal and this can be given by the means of a written and signed consent form or by word of mouth. Implied consent can be a simple gesture, such as holding their arm out for an injection or by arriving at the hospital for an operation. Each form of consent is as equally valid as the other however, consent is only legally valid if it is given voluntarily, based on clear and accurate information and if the patient is competent (tingle and mchale, p.100 -105). Gillan (Tingle and Cribb, 2007, p.140) defines consent as a voluntary un-coerced decision made by a sufficiently autonomous person on the basis of adequate information to accept or reject some proposed course of action that will affect the patient. This definition suggests that communication, autonomy and consent are intricately liked as effective communication is important because you must give adequate, open and honest information to the patient in order for the patient to fully understand and consider all the issues involved, which will enable the patient to be able to make an autonomous decision and ultimately be able to give consent. No other person is authorised to give consent, for any procedure or treatment, on behalf of another adult unless they are the legal power of attorney for the patient (legal aspects). Gillans definition of consent states that consent can only be given by a sufficiently autonomous person. The DoH states that healthcare professionals must not make any assumptions that a person is incapable of making their own decisions, therefore they should carry out an assessment which would assess whether the individual is mentally capable of making these decisions for themselves. Autonomous decision making is therefore based on the matter of capacity or incapacity (foundations p.500). The term capacity is used to define the individuals ability to make their own decisions about a particular matter at a particular time (Legal aspects) and, as autonomy is the basic foundation for consent, if incapacity is suspected the individual is therefore not allowed to give consent until they are deemed competent. The Mental Capacity Act 2005 states that healthcare professionals are required to assume that every person has the capacity to make their own decisions and that the healthcare professional has to prove that the individual has a lack of capacity and must then be deemed incompetent (tingle and crib, p.143). Deciding whether a person has the capacity to make informed decisions for themselves is determined using the assessment tools defined in the Mental Capacity Act and cannot be established or judged by an individuals age or appearance (The Mental Health Act section 2 and 3). There are two basic concepts that underpin the Act these are: the concept of capacity and the concept of best interests (Legal aspects). Both of these concepts link together and as such, if the patient lacks mental capacity actions can be taken or decisions can be made on their behalf and these must be made or taken in the best interests of that person. The assessment used to determine whether a patient is capable of making a treatment decision is split into two stages: the first stage is to determine whether the patient has any issues which prevent them from making a decision, and the second is to establish if this issue which prevents the patient from making a decision causes the patient any problems in communicating their decisions or wishes (Legal aspects). A person is not able to make their own decisions for themselves if they are not able to understand any of the information given to them, remember the information, utilise that information as part of the decision making process and are not able to convey or share their decision (Legal aspects). However, if the information is not given to the patient in a way that is appropriate to his circumstances such as using simple words or visual aids, they are not to be judged as unable to understand that information (legal aspects, p.139). Additionally, if the patient has a short memory span and can only retain information for a short period, they must not be classed as unable to make their own decisions, as this issue may not prevent them from being able to make the decision relevant to the treatment (legal aspects, p.139). In such instances this decision must be made whilst the information is still held within the patients memory. From this is must be said that every person should be encourag ed and enabled to make their own decisions or to participate as fully as possible in the decision-making, by being given the help and support they need to make and express a choice (NMC, 2008a). In this scenario it states that Peter has an inclination to be forgetful, because of this he must not automatically be deemed incompetent and it is vitally important that all the steps required to deem a person incompetent must be taken into account. One of the steps suggests that even though the Peter has a short memory span, it is vital to ensure that the information given is understood clearly and that the decision is made before the he forgets. This would enable Peter to give informed consent, however if he forgets this information and has not made an informed decision before his memory span lapses he must be deemed incompetent. From this we can establish that it is important to have the necessary mental capacity as it protects the individuals right to make their own decisions (legal aspects). If the individual is lacking in capacity then decisions need to be made on their behalf and these decisions that are made on behalf of someone else should be the decisions which limit the p ersons basic rights and freedoms the least (legal aspects mc). The Human Rights Act 1998 ensures that individuals rights are respected and that basic human rights such as the right to life, the right to not be discriminated against, the right to liberty, and the right to freedom from torture or degrading treatment and the right to respect for private and family life, home and correspondence are promoted (Human Rights Act 1998). These rights can be promoted by providing high standard of care and treatment, respecting a patients privacy, dignity and confidentiality and by safeguarding the patients from harm. A persons rights and freedoms are protected and promoted by the nurse when she acts as an advocate for them. Being an advocate for the patient is vitally important as it ensures that the patients choices and decisions are respected. The nurse can act as an advocate in many different situations such as, offering an alternative explanation, or asking the other professionals to give the information again in basic terms, if the nurse feels that the patient has not been given clear, honest and adequate information. (NMC). Another way for the nurse to act as an advocate is to try to adhere to the patients wishes if the patient was proved to be incompetent; if this is not possible then she must act in their best interests. As Peter has asked the nurse in this scenario to help him make the decision as to whether or not he should have the surgery, he is putting his trust in her and allowing her to become his advocate. However, until all the necessary steps have been taken to ensure whether Peter has understood what he has been told and once his mental capacity has been assessed, no other person can make this decision for him, unless he was deemed to be mentally incompetent. If he was deemed to be incompetent the decision as to whether he has the surgery or not will be made by the healthcare professionals, unless his daughter has lasting power of attorney, and will be based on his best interests. The decision that is likely to be made is that Peter will go ahead with the surgery, as this is in his best interests and will improve his quality of life. If Peter is deemed competent, then Peter should make the decision for himself and his decision will be final. If Peter decides not to go ahead with the surgery, then Peters home life would need to be assessed. Inter-professional working is required in order to care for the patient holistically. Holistic care is primarily concerned with ensuring that the patients basic needs are met (NMC, 2009a, p.9) and making sure that any observations, medications and decisions are recorded accurately (NMC, 2008b, p.6). A nurses role also includes supporting and teaching the patient and their families about the illness or about improving their lifestyle to prevent the illness from re-occurring. It is extremely important that the nurse develops a close working relationship with these other multi-disciplinary professionals, as Peter will need support when he gets home whether or not he has had the surgery. The range of other professionals which may be involved in Peters care when he gets home include social workers, occupational therapists and physiotherapists. It may be possible that Peters daughter may be pushing for Peter to have the surgery as she may be his primary carer and might be feeling stressed or overworked and if this surgery can improve his mobility, this may offer her some form of relief. If this is the case, the nurse could arrange for a carer to help them within their home and that way Peters daughter may get some relief from the work involved in his care. In this case, the nurse can act as an advocate to ensure that the decisions are not being made for him or that he is under no undue pressure or being forced to make the decision. Being an advocate for a patient implies that there should be a level of trust between the nurse and the patient and this level of trust can be built up through a therapeutic relationship. Therapeutic relationships are an intervention which is central to nursing and a nurse should have an essence of self-awareness and self-knowledge and have an awareness of the boundaries of the professional role in order to be able to establish a therapeutic relationship with their patient. Effective communication, trust, respect, genuineness, acceptance and empathy are key principles in establishing this relationship (Brooker and Nicol, 2003, p.45). When this relationship has been established the patient may feel at ease to share information and have a willingness to open up and share their feelings (Dossey and Keegan, 2008, p.370). Establishing and maintaining this nurse-patient relationship is vital to the holistic care of the patient and even though the nurse should develop a close relationship w ith the patient in order to open up communication barriers she must always keep and emotional distance from the patient and their families. It is the nurses responsibility to ensure that she never oversteps the professional boundaries throughout the care of the patient (NMC Code). In conclusion it has been established that in order for a patient to be given high quality, safe care a nurse needs to have the appropriate skills and knowledge to be able to perform the even the simplest of tasks competently. This assignment has briefly looked at the importance of a therapeutic relationship with communication being one of the vital keys, as without using it effectively it will be difficult to bond and build a professional relationship with the patient. It has also been identified that every nurse has a duty to protect their patients, that they should safeguard their patients and promote their rights and autonomy. It is vitally important that the nurse has the confidence to speak up to other professionals if she feels that the information hasnt been delivered to the patient honestly, accurately or clearly, otherwise she could be held accountable if something was to go wrong. The importance of the guidelines and codes issued by the NMC, have also been discussed, as th ey are in place to help protect, not only the patient, but also the professionals who are involved in the patients care. One of the guidelines which has been focused on, is for the nurse to make sure that the patient has given informed consent without any undue pressure and that the nurse, acting as the patients advocate, can help protect the patient. We have also looked at the importance of using assessment tools to assist in decision making process as this is used to identify whether the patient has the capacity to give consent or not. We have established that all health care professionals need to work together as a team and must communicate, not just with each other, but with the patient and his family to ensure patients needs are met and that every patient should be awarded the opportunity to live independently or be offered help and support from the necessary health care professionals to enable the patient to live as independently as possible.

Hamlet Essay -- ESSAYS

Hamlet Each major character of Shakespeare’s Hamlet has a major flaw, which destroys him or her. The King, Queen, Hamlet, Ophelia, and Polonius all have these flaws but Horatio does not. He is Shakespeare’s ideal man. Claudius’ fatal flaw is ambitiousness. Claudius kills his brother King Hamlet and then takes the throne by marrying King Hamlet’s wife: â€Å"Therefore our sometime sister, now our queen†¦have we (as ‘twere with a defeated joy, with an auspicious and a dropping eye, with mirth in funeral and with dirge in marriage, in equal scale weighing delight and dole) taken to wife†(I.ii.10-14). Claudius admits to killing the King in a confessional prayer: â€Å"O, my offense is rank, it smells to heaven; it hath the primal eldest curse upon’t, a brother’s murder†¦O, what form of prayer can serve my turn? ‘Forgive me my foul murder? That cannot be, since I am still possessed of those effects for which I did the murder: My crown, mine own ambition, and my queen. May one be pardoned and retain th’ offense?’ †(III.iii.40-43, 55-60). Another ambition of Claudius is he wants to have Hamlet murdered in England: â€Å"I like him not, nor stands it safe with us to let his madness range. Therefore prepare you. I your commission will forthwith dispatch. And he to England shall along with you†¦hazard so near ‘s as doth hourly grow out of his brows† (III.iii.1-7). The fate of the King is fatal. His deceitfulness kills him when he challenges Laertes and Hamlet to duel, he poisons the tip of Laertes sword and in a cup of wine he puts a poisonous pearl: Hamlet: The point envenomed too! Then, venom, to thy work. King: O, yet defend me, friends! I am but hurt. Hamlet: Here, thou incestuous, *murd’rous,* damnà ©d Dane, d... ...s some danger (III.iv.26-30, 38-40). Shakespeare’s ideal person is Horatio. In the beginning of the play, Horatio, when he sees the ghost decides to tell Hamlet: â€Å"So have I heard and do in part believe it†¦Break we our watch up, and by my advice let us impart what we have seen tonight unto young Hamlet†¦Ã¢â‚¬ (I.i.180-185). Horatio is ruled by reason and Hamlet recognizes and comments on this: â€Å"Give me that man that is not passion’s slave, and I will wear him in my heart’s core, ay, in my heart of heart, as I do thee†(III.ii.76-79).. Horatio does not have a fatal flaw and does not die. Shakespeare gives his main characters flaws that destroy their lives. The King, Queen, Hamlet, Ophelia, and Polonius all have flaws and die in the end, but Horatio, Shakespeare’s ideal character, does not have a fatal flaw and lives. Bibliography: Hamlet, William Shakespeare

Jamie Oliver Essay

Jamie Oliver is a chef who has made a number of television programmes for Channel 4; in most of these programmes he is cooking and instructing the audience, although he is sometimes part of documentaries about food, for example in schools. His style of speech is very different to many of his contemporaries: he uses his distinctive style to present himself as a down to earth, friendly TV chef. Oliver is the only person talking in this transcript because he is cooking and explaining his actions for the TV show.The fact that he is cooking while talking means that there are numerous pauses in the transcript, for example ayou wanna coat the bottom (3) of the pana. The three second pause indicates that he is demonstrating this action on the programme; it is important in his role as a TV chef that he doesnat just sit and talk through a recipe because viewers want to see the recipes being made and they also want to be entertained and kept interested by Oliver moving around in the kitchen.Oth er pauses suggest that, although this programme is probably scripted to some degree, Oliver is not reading from an autocue but retains an element of spontaneity to his speech. The pauses at the start of the transcript, aI got a pan (. ) er the right size pan about (. ) sort of seven inchesa, are indicators of this spontaneity, as is the non-fluent aera.Although sometimes a sign of nervousness, in this case I think the pauses help Oliver to appear normal, like his viewers, so they are more likely to attempt his recipes and, of course, buy his books. Jamie Oliveras Esturary accent and his accompanying use of London slang are also distinctive features of his talk. Words such as achivvya and asquigglea are colloquial and are not words we expect to hear on a cooking programme.We are used to words from the cooking semantic field such as awhiska, abakea, astira but Oliveras language use again makes him seem very normal, approachable and relaxed. As well as specifically accented words such as the dropping of the aha in aorriblea, Oliveras elisions agonnaa, awannaa and akindaa demonstrate his relaxed tone. As well as using these to build a successful TV persona, Oliver could be using this informal language because he is concentrating more on the actual cooking and explaining the key details of the recipe

Tlaloc the Aztec God of Rain and Fertility

Tlaloc the Aztec God of Rain and Fertility Tlaloc (Tl-lock) was the Aztec rain god and one of the most ancient and widespread deities of all Mesoamerica. Tlaloc was thought to live on the top of the mountains, especially the ones always covered by clouds; and from there he sent down revivifying rains to the people below. Rain gods are found in most Mesoamerican cultures, and the origins of Tlaloc can be traced back to Teotihuacan and the Olmec. The rain god was called Chaac by the ancient Maya, and Cocijo by the Zapotec of Oaxaca. Tlalocs Characteristics The rain god was among the most important of the Aztec deities, governing the spheres of water, fertility, and agriculture. Tlaloc oversaw crop growth, especially maize, and the regular cycle of the seasons. He ruled over the 13-day sequence in the 260-day ritual calendar beginning with the day Ce Quiauitl (One Rain). Tlalocs female consort was Chalchiuhtlicue (Jade Her Skirt) who presided over freshwater lakes and streams. Archaeologists and historians suggest that the emphasis on this well-known god was a way for the Aztec rulers to legitimize their rule over the region. For this reason, they built a shrine to Tlaloc on the top of the Great Temple of Tenochtitlan, just next to the one dedicated to Huitzilopochtli, the Aztec patron deity. A Shrine in Tenochtitlan Tlalocs shrine at the Templo Mayor represented agriculture and water; while Huitzilopochtlis shrine represented warfare, military conquest, and tribute... These are the two most important shrines within their capital city. The shrine of Tlaloc featured pillars inscribed with symbols of Tlalocs eyes and painted with a series of blue bands. The priest who was tasked with tending to the shrine was the Quetzalcoatl Tlaloc tlamacazqui, one of the most highly ranked priests in the Aztec religion. Many offerings have been found associated with this shrine, containing sacrifices of water animals and artifacts such as jade objects, which were related to water, sea, fertility, and the underworld. A Place in the Aztec Heaven Tlaloc was assisted by a group of supernatural beings called Tlaloques who supplied the earth with rain. In Aztec mythology, Tlaloc was also the governor of the Third Sun, or world, which was dominated by water. After a great flood, the Third Sun ended, and people were replaced by animals such as dogs, butterflies, and turkeys. In the Aztec religion, Tlaloc governed the fourth heaven or sky, called Tlalocan, the Place of Tlaloc. This place is described in Aztec sources as a paradise of lush vegetation and perennial spring, ruled by the god and the Tlaloques. The Tlalocan was also the afterlife destination for those who had died violently of water-related causes as well as for new-born children and women who died in childbirth. Ceremonies and Rituals The most important ceremonies dedicated to Tlaloc were called Tozoztontli and they took place at the end of the dry season, in March and April. Their purpose was to assure abundant rain during the growing season. One of the most common rites carried out during such ceremonies were sacrifices of children, whose crying was considered beneficial for obtaining rain. The tears of new-born children, being strictly connected with the Tlalocan, were pure and precious. One offering found at the Templo Mayor in Tenochtitlan included the remains of approximately 45 children sacrificed in honor of Tlaloc. These children ranged in age between two and seven years of age and were mostly but not entirely males. This was an unusual ritual deposit, and Mexican archaeologist Leonardo LÃ ³pez Lujn has suggested that the sacrifice was specifically to appease Tlaloc during the great drought that occurred during the mid-15th century C.E. Mountain Shrines Apart from the ceremonies carried out at the Aztec Templo Mayor, offerings to Tlaloc have been found in several caves and on mountain peaks. The most sacred shrine of Tlaloc was located on the top of Mount Tlaloc, an extinct volcano located east of Mexico City. Archaeologists investigating on the top of the mountain have identified the architectural remains of an Aztec temple which seem to have been aligned with the Tlaloc shrine at the Templo Mayor. This shrine is enclosed in a precinct where pilgrimages and offerings were carried out once a year by each Aztec king and his priests. Tlaloc Images The image of Tlaloc is one of the most often represented and easily recognizable in Aztec mythology, and similar to rain gods in other Mesoamerican cultures. He has large goggled eyes whose contours are made of two serpents which meet at the center of his face to form his nose. He also has large fangs hanging from his mouth and a protuberant upper lip. He is often surrounded by raindrops and by his assistants, the Tlaloques. He often holds a long scepter in his hand with a sharp tip which represents lightning and thunder. His representations are frequently found in the Aztec books known as codices, as well as in murals, sculptures, and copal incense burners. Sources Berdan FF. 2014. Aztec Archaeology and Ethnohistory. New York: Cambridge University Press.Millar M and Taube KA. 1993. The Gods and Symbols of Ancient Mexico and the Maya: An Illustrated Dictionary of Mesoamerican Religion. London: Thames and HudsonSmith ME. 2013. The Aztecs. Oxford: Wiley-Blackwell.Van Tuerenhout DR. 2005. The Aztecs. New Perspectives. Santa Barbara, CA: ABC-CLIO Inc.