Cross Curricullum Essay Example | Topics and Well Written Essays - 3000 words

Cross Curricullum - Essay Example The process of learning is as important as the content learned (Newby 2005). Professor Colin J. Marsh (2004) suggests that any definition of curriculum gives insight about its main characteristics and emphases. One of his definitions notes the significance of ‘permanent’ subjects such as grammar, mathematics, reading, logic and literature of the Western world which represent necessary knowledge. This has been known as the â€Å"knowledge-based curriculum†. This model of curriculum has been implemented in most schools. An example of this could be the National Curriculum in the UK which has specific content subjects with specific goals for student achievement. It is essential to remember that subjects and syllabi need to be adjusted to fit current culture and the society. One of the most traditional and most commonly used models is â€Å"content or syllabus-based†. Blenkin et al (1992) suggest that curriculum is delineated into subjects and delivered through a bulk of knowledge-content. Education, he states, is the route where these can be transferred to students using efficient teaching and learning methods. This type of curriculum emphasizes students attending schools to learn subject-specific facts. It also helps to use this model in assessment process where students, according to their gained qualification can be grouped in to high and low achievers. Furthermore, it dictates what route a student will be able to take. Students with high grades traditionally would be expected to progress to universities where less successful students would be advised to take a non academic route (i e. study a vocational programme or gain employment elsewhere). It is interesting to note that most of the employers are not as interested in a depth of ones’ subject knowledge but more on practical skills such as problem solving, analysing, evaluating, self-reflection and self discipline which are directly related to work (Ross, 2000). However, this does not discount the fact that subject-based curriculum will always have a place in education. The Review of the national primary curriculum of UK prioritizes the development of: A strong, coherent curriculum which has flexibility to personalise teaching and learning is crucial to driving up standards further. It is central to the ambitions we have set out in the Children’s Plan and to delivering the outcomes of the Every Child Matters agenda. (Rose, 2009, p. 27). The key outcomes of Every Child Matters agenda are the following: being healthy, staying safe, enjoying and achieving, making a positive contribution and economic well-being (HM Treasury, 2003).In addition, the Rose review likewise recommends that the curriculum must provide all pupils with a broad and balanced entitlement to learning which encourages creativity and inspires in them a commitment to learning that will last a lifetime. (Rose, 2009, p. 27) Currently, the Association of Teachers and Lecturers, (ATL, 20 06) proposes that changes in the National Curriculum should start with the pupil in mind – his needs and interests and should be designed in terms of the skills and attitudes educators would want pupils to pursue and develop. Emphasis of the curriculum mu

Customer Care In Ghanaian Hospitals Dissertation - 2

Customer Care In Ghanaian Hospitals - Dissertation Example Quantitatively, patients of the hospital were given the questionnaire to respond to. The questionnaire contained questions that bordered on several areas of customer care services and practices including the environment of the hospitals, the hospital premises, the staff of the hospitals, and the facilities available at the hospitals. Qualitatively, staff and other stakeholders of the hospitals were engaged in an interview where they gave a professional perspective on the issue of customer care at the university hospitals in Ghana. On a generalized view, the results that were gathered have shown that there is a high level of customer satisfaction at the university hospitals in Ghana. This line of the result was agreed by both patients and staff. However, some core areas of customer satisfaction where it was expected that there would be a balance between practice and what is currently accepted as best practice were found to be lacking. Example of this has to do with the use of informat ion technology in reaching out to customers and creating a virtual healthcare system. Based on the findings, it has been recommended on the need for the university hospitals to ensure that the customer service practice they render become those that will match current needs of the globalized health sector. It would be noted that for the greater part of the discussion that was performed, the researcher looked at the results that were produced from the questionnaire distributed to patients of the hospital on their views and perspective on customer care practiced within the university hospitals in Ghana. In this section of the discussion, the researcher takes a look at the qualitative results that were produced from staff and other stakeholders of the hospital through an interview that was conducted among these stakeholders.

Report On Bed Capacity Planning In Hospitals

Report On Bed Capacity Planning In Hospitals Nowadays, the number of medical treatment and medicines increases which allows a spectacular growth of the health care sector. Despite this development, the sector suffers from inefficient management and ineffective planning [15]. Managing patients, nurses and physicians is a difficult problem that needs to be solved. Hospital bed planning is a central problem that affects hospital capacity, health care quality and also management of nurses and physicians. During the last decades, hospitals are a non profit organization where the demand is not a primary concern for the manager of these hospitals. Today, many private hospitals are acting with a primary objective to satisfy the demand and to provide outstanding services to compete with other private hospitals [10]. The hospital is not just a medical care unit but also is providing hotel and transportation services. To insure competiveness of hospitals we need to improve the quality of services and to satisfy as much as we can the deman d. Therefore, hospitals need to look for their supply chain and how to manage it. In this report, we focus on the supply chain management of hospitals in Dubai. Dubais health services are internationally recognized and due to their high standard and their modern facilities equipment, are comparable to other developed countries. The location of hospitals in Dubai is strategic to ensure accessibility for patients. There are approximately 20 clinics and hospitals distributed across the Emirate. The ratio of clinics/hospitals to patients is 1:78,000. One of the more impressive practices of medical professionals in Dubai is the post-clinic, private medical call. These are considered as part of their responsibilities. Medical attention is provided, regardless of residency or nationality. In general, Dubai aims to improve the over-all wellbeing of its people. Its strategy is to provide patient-specific care. The most popular medical services provided by healthcare providers in Dubai include immunizations and vaccinations, psychiatric treatments, medical fitness examinati ons, community services (such as marriage and family counseling), adult and infant yoga therapy, rehabilitation, and education on health and nutrition. We focus on this report on Rashid private hospital in Dubai, UAE. We mainly present a multiple objective stochastic programming for the bed capacity planning taking into account the quality of the service and the stochastic demand in that hospital. In the next chapter, we present a general overview of the hospital supply chain in general before we present in chapter 3 some of the Rashid hospital operations. In chapter 4, we focus on hospital bed capacity planning in order to introduce to the multiple objective stochastic program that we are going to propose for Rashid hospital bed capacity planning. The obtained model is transformed in chapter 6 into its certainty equivalent and solved in chapter 7 using data from Rashid hospital. Chapter 2 Hospital supply chain 2.1. Introduction Health is defined as à ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬Ãƒâ€¦Ã¢â‚¬Å"a state of complete physical, mental and social well beingà ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬Ã‚ . The health care sector is an important sector as regards to the welfare of people. Health services require the synchronization of various resources, such as Human resources, medicines and medical equipment. In any organization, a supply chain must be designed in accordance with its mission. The mission of all hospitals includes the maximization of the level of patient care. The size of a hospital, geographical location, diversification, and the various specializations all affect the nature of care provided in a hospital and, therefore, the goals of its supply chain. The hospital chain may have some of the following goals [7]: To secure the availability of product , To Reduce the storage space and to maximize the patient care, To reduce time and cost of handling the medical team (nurse, pharmacist, physician) Minimize the stocks of inventory The main functions of hospital supply chain are defined as follows [7]: To allocate the main resources (technical platforms, beds, physicians, nurses ) and their location in the hospital. To plan for extra resource needed (medical staff, medical equipment), and to schedule the care activities. To organize transportation of patients and equipment. Generally, the hospital supply chain may be split into two parts (see Figure1): the external chain and the internal chain [14]. Fig 1: Hospital supply chain [15] 2.2. The external supply chain The external chain begins with companies specialized in the creation of the raw material (patent, drug, machinery, etc). The raw material can be materialized (machine, drug, etc.) or immaterialized (know how to cure). The manufacturer may itself be the creator or a company that works in relationship with him. In this case, the company is responsible for the duplication (making molecules on a large scale and add excipients or drug) for the test and for the control. Once the product is ready to be used and receives the necessary certifications, the role of the distributor is to place the product on the market. The market is generally formed by a central purchasing (WHO, national distributors, NGOs, etc) or individual (hospital, pharmacy, etc). Each health facility may maintain direct relations with manufacturers so that products pass through certain distributors. 2.3. The internal supply chain The health establishment is the last link in a supply chain consisting of manufacturers and distributors from various industries (medical supplies, pharmaceuticals, food, laundry, maintenance, etc). The supply chain within the hospital is complex. The size of the hospital, the geographical location, the diversification, various specializations, the high cost and perishable goods, all affect its supply chain. The first characteristic of the appropriate health care supply chain is its diversity in distribution channels. Inside the hospital, the hospital product is made up of items at low prices or high-prices and durable and perishable goods that are consumed in large or small quantities. A health institution is composed of five main activities that manage different types of flows to offer many services or products to patients. These activities are defined as follows: Intralogistics activities which are the fact that the hospital acquire, receives and distribute different supplies used in the service. The demand management that is the planning and the coordination between the different necessary resources. Operations and services given to the patient within the hospital from admission to discharge. External logistic represented by the medical follow-up for the patient. Services to the patient which are all auxiliary activities that are not linked to medical activities offered to the patient (gift shop, religious programs, etc). The supply chain within the hospital can therefore be presented as follows: 2.4. Conclusion The hospital supply chain must be developed for a specific product based on its unit cost, demand variability and the physical size. We can say that integration of the supply chain in the health care sector requires the synchronization of internal and external supply chains to each individual service. A good supply chain management within a hospital is necessary and must be performed efficiently Chapter 3 Operations in Rashid hospital 3.1. Introduction Rashid Hospital is a 454-bed general medical/surgical hospital in Dubai, the United Arab Emirates, and is a part of the Dubai Government Dubai Health Authority. Rashid Hospital is considered in Dubai as one of the first medical facilities for trauma, emergency, ambulatory care and critical care which provide a high-quality of services to all patients within the community. The Rashid hospital provides also leadership in the training and education of health care professionals. In the emergency, Rashid Hospital is considered as one of the most reputable and prominent medical centers in the Gulf region. It receives the majority of complicated case other hospitals are destined to Rashid hospital which coordinates also closely with the Dubai Civil Defense and Police for the training of emergency medical staff inside the airports In Rashid hospital, two types of admissions are used: the outpatient admission and the admission through emergency department 3.2. Outpatient registration This type of admission or registration is present in all hospitals and it can be defined as follows: An outpatient admission is presented when a patient is admitted to the hospital, surgical center or ambulatory center for a surgical or nonsurgical operation, therapeutic procedure or diagnostic procedure, that does not require an overnight hospital stay. The preparation for outpatient admission varies with each procedure [20]. In Rashid hospital, the responsible physician, the treating physician and the admitting physician are responsible of the admission procedure of the outpatient. The registration of the outpatient is done after the patient gets a discharge from the emergency department or the inpatient unit. This must is done by the physician who gives the patient an outpatient appointment for follow up with the required specialty. After that the patient will be transferred to the required specialty. The next step is the direct admission which must be done during the same day. The admitting physician/clinic nurse informs the case manager and the admission office that the patient requires admission, and then the admission of the concerned patient is linked with the availability of a bed. Next, the account department or the admission office informs the patient about charges for treatment as per the hospital payment policy. The clinic nurse will inform the patient about the admission conditions and about provisional diagnosis. But if the hospital cant find an available bed, the treating physician will give to the patient another appointment or ask for a transfer of the patient to another healthcare unit (if the case is urgent). In Rashid hospital, urgent case admission is directed to the emergency department. The admission in this department is different from the outpatient admission. In the next section, we are going to overview admissions procedures in the emergency department. 3.3. Admission through the emergency department This type of admission is different from the outpatient admission because patient must access directly to health due to the urgency of his/her case of illness. It can be defined as housing the patient in the hospital to provide special interventional procedure(s) or definitive treatment. We can distinguish three types of patients in this admission. First, the unstable patients who will suffer irreversible damage or loss of life if not admitted immediately. Second, the stable patients who are the patients that requires urgent treatment or interventional procedures(s) that cannot be accomplished on an outpatient basis. Third, patients are not suffering loss life or serious damage if not admitted [21]. In the emergency department, the emergency physician has to observe and to investigate to know if the patient needs admission and to refer the patient to the on call physician. The emergency physician and on call physician will decide about the required screening and diagnostic tests after examining/before admitting the patient. The emergency department must inform the case management about the admission, provisional diagnosis and level of care needed and check for the availability of bed. If there is no available bed in the selected department, the case manager can admit the patient temporarily in another department where bed is available (with adequate equipment). But if there are no available beds throughout the hospital, the case manager has to refer patient to another hospital. The patient flow in Rashid hospital can be presented as the following figure [10]: Bed flow in hospital 3.4. Rashid hospital departments At Rashid Hospital it exists many specialized medical and paramedical departments all equipped to receive all kinds of patients and also patients from neighboring hospitals. The existing specialities in this hospital are: Psychiatry Cardiology Gastroenterology General surgery Hematology Infectious disease Respiratory Neurosurgery Traumatologie Geriatric 3.5. Conclusion Rashid Hospital aims to provide an outstanding service to all outpatients and patients that are admitted through the emergency department. This aim cannot be achieved if the hospital has not the adequate capacity in terms of hospital bed and human resources (physicians and nurses). At the same time the hospital must run in profit to ensure the future of its activity. In this study we will try to answer this important question of hospital capacity planning in order to determine both the level of beds and the number of resources that Rashid hospital needs to satisfy the random demand. Chapter 4 Hospital capacity planning 4.1. Introduction The capacity is defined as the quantity of service that the health care institution must provide to satisfy patients need. Capacity management is related to the control of the impact of demand variability on the management of the health care institution. It concerns the good coordination of resources through the management of medical equipments, human resources and bed occupancy. Hospital capacity has long been an indicator of the importance of the hospital structure and for budget allocation [18]. The capacity planning is a component of the internal hospital supply chain. This planning is usually used to help hospitals, to do well their objectives which are: Trying to avoid an underestimating of the number of beds, planning for the future maintain a good service quality, optimize resource use, satisfy the requirements of internal and external security. 4.2. Bed capacity management In hospitals, capacity planning usually focuses on the total capacity of beds, the capacity of the surgical system, the allocation of beds for different services, equipment capacity, the ability of auxiliary services, and the number of staff and their competence [11]. Before we plan capacity in a hospital, the following issues must be clarified [1]: The length of the planning horizon (operational, tactical and strategic) The level of the provided care (primary, secondary) The type of care (provided to inpatient and / or outpatient) The quality, cost and types of available resources (physicians, nurses, technicians, rooms, beds, medical equipments and all what constitute an input for health) The hospital capacity depends not only on the number of beds, but also how these beds are used. The hospital capacity can be influenced by several factors: The geographic distribution of patients: each locality has its own hospital. The type of resources currently in use: a patient who wants to have a particular diagnosis by the nearest hospital must visit the hospital where it exist the necessary equipment. availability of nurses, physicians, and support equipment in the hospital Hospital bed management may affect cost, quality and accessibility of care. The daily management of beds is closely related to the management of the hospital. To properly determine the capacity of beds, we need to track the activities of hospital patients (admission, assignment, stay and leave) [12]. The essential role of the hospital bed manager is to ensure balance between supply and demand for hospital beds. Bed management has a long-term component, which is the choice of the overall number of beds as well as sharing among different departments, and a short-term component for the daily bed allocation to patients. We conclude that hospital beds are important measure to determine the hospital capacity. The bed management does not only affect the overall capacity but it also impacts on cost, quality and accessibility of care [8]. 4.3. Models for hospital bed capacity management Many models were elaborated to determine the optimal number of beds inside a hospital. The simple and the most used models to evaluate the adequate capacity of a hospital department are based on the following index: N = (length of stay * number of patient)/number of days = number of patient per day / number of days The transfer between departments and the randomness of some of the index parameters are not considered in the above model. To overcome this shortness in the index model more elaborate stochastic models can be used. These models can be used for the short term (daily problem), the long term (monthly problem) or even for the case of a disaster. The Queuing models are short term models that are usually related to the operational level of the hospital capacity planning. These models characterize the relationship between the number of beds, the average occupancy levels and the number of patients transferred from one department to another based on the arrival time of patients, the nature of patients transferred from one unit to another and the period of use of each type of bed by the patients. [13]. The simulation models have the ability to consider the results of a decision on an item without carrying out the experiment on the actual item [9, 19]. They represent an artificial reproduction of what will happen when random parameters change their values. Sally C. Brailsford [16] proposed a simulation model to plan for the capacity of an intensive care in hospital using software called SIMUL8. Nowadays, the health sector, an increasingly privatized sector, seeks to find an effective planning of his resources for the long term. Taking into account the benefit t and also the quality of offered service. The medical ethics and money profit are two conflicting criteria. Multiple objective programming is a model that can deal with several criteria. Chu and Chu [6] proposed a goal programming model for hospital beds allocation in Hong Kong. The model takes into account the constraints of location, the demand constraint and constraints related to manpower. Black and Carter modeled the problem of allocating physicians to hospital department using a linear goal programming model [3]. The model focuses on the number of cases handled by a physician taking into account that the hospital must be able to generate enough revenue to cover fixed costs and variable production. 4.4. Conclusion The models developed for the hospital bed capacity planning problem are mostly categorized as stochastic models. These models are suitable for short and medium term. In this study, we are more concerned with the long term. This is way we focus on multiple objective programming models to plan for the bed capacity in Rashid hospital. Chapter 5 The model In this document, we follow Ben Abdelaziz and Masmoudi model to determine the optimal bed capacity in Rashid hospital [2]. The model was first developed for bed capacity planning in all public Tunisian hospital to evaluate of missing beds. 5.1. Notations l: specialty in a hospital department, . We have two kinds of specialties. Those called primary health specialties for which we cannot transfer the patient to another hospital and secondary healthcare specialties that in case of no hospital bed available can be transferred to another hospital. : A subset of primary healthcare specialties that can be served by the same hospital bed (for which we are using the same equipment), . : A subset of secondary healthcare specialties that can be served by the same hospital bed, . : the set of specialties that may be served by the same type of nurses , : the set of specialties that may be served by the same type of physician , 5.2. The parameters : Existing beds in specialty in the hospital, . : the number of beds that can be added in the specialty in the hospital, . : ratio of nurses per bed, i.e. the number of nurses needed to serve one patient in the specialty l, . : ratio of physicians per bed: The number of physicians needed to serve one patient in the specialty l, . : the stochastic yearly demand for the specialty in the hospital where express the random demand. 5.3. Decision variables : number of beds in the specialty in the hospital. 5.4. Constraints of the model Maximum and minimum number of beds in the hospital The demand for the set of specialties in the hospital must be satisfied The demand for the set of specialties must be satisfied otherwise transferred to another hospital (1) where express the number of vacant beds in the set of specialties and the number of missing beds in the set of specialties . 5.5. Objective functions The first objective function is to minimize the cost of adding and managing new beds where is the daily cost of creating and managing an additional bed of the specialty in the hospital during the period of investment. The stochastic constraint (1) is related to the satisfaction of the demand in secondary health care specialties. This transfer generates an additional cost (transfer cost). We have to use a recourse approach to get certainty equivalent constraint. In a recourse approach a penalty in the objective function is generated when the solution does not satisfy the random constraint. Here the penalty is the transfer cost. The expected transfer cost is where is the expected transfer cost. The third group of objective functions is to minimize the number of nurses in the groups of specialities in the hospital The fourth group of objective functions is to minimize the number of physicians in the groups of specialities in the hospital 5.6. The final model The final model is expressed as the following multiple objective stochastic program 5.7. Conclusion To solve the above multiple objective program, we need to transform it into an equivalent mathematical program. This transformation must be done following the problem hypotheses. In the next chapter, we will review these hypotheses and we will provide a suitable transformation of the program (P) into its certainty equivalent program. Chapter 6 The certainty equivalent program 6.1. Introduction The program (P) is a stochastic program as it presents two stochastic constraints (P.5) and (P.6) and a multiple objective program as it has several objective functions to minimize. To solve a multiple objective stochastic program, we need to transform it into its certainty equivalent program, under predefined approaches. In the next sections and using a chance constrained approach for the constraint (P.5), a discretization technique for the constraint (P.6) and a goal programming approach to deal with the two objective functions (P.3), and (P.4), we are going to build such a certainty equivalent program to the program (P). 6.2. Chance constrained approach The chance constrained approach transforms the random constraint into a deterministic constraint by considering as feasible solution those satisfying the uncertain constraints with a predefined level of probability [4]. Therefore, under a chance constrained approach, the following stochastic linear constraint where , and are random variables, will be transformed into the following deterministic constraint where is fixed level of probability. It means that a feasible solution must satisfy the uncertain constraints for all scenarios with a probability of occurrence higher than . The constraint (P.5) expresses the satisfaction of the demand on primary health care specialties (the demand on these specialties cannot be transferred to another hospital). It is difficult and not justified to satisfy the demand for all scenarios and especially scenarios with a small probability of occurrence. In the following, we propose a chance constrained approach to deal with the constraint (P.5). Therefore, the demand on the primary health care specialties Ar must be satisfied with a given fixed probability level as follows (3) The constraint (3) is a chance constraint. Using the model hypotheses, the random daily demands are normally distributed with a mean of and standard deviation of . Note that, Then, we can rewrite the chance constraint (3) as follows 6.3. Discretization approach We must satisfy almost surely the constraint (P.6). In stochastic programming, the normal distribution is approximated by a discrete distribution and then the constraint (P.6) can be rewritten as follows: The total recourse cost and the monthly transfer cost for secondary health care specialities are transformed using the discretization of the normal distribution of demands as follows: 6.4. Goal programming approach Charnes and Cooper [5] are the first to introduce the goal programming approach which is essentially used to transform multiple objective linear program into a linear program. This transformation consists on these steps: First, to fix a target values for some or all objectives (called also goals) Second, to transform the objective functions to constraints and third minimizing the difference between objective functions value and these goals. Using a goal programming approach, the following objective functions can be transformed to constraints as follows where and are the negative and the positive difference, respectively, between the fixed goals and the achievement , and the new objective function to optimize is expressed as follows where and are weights of the negative and the positive deviation, respectively. The objective functions (P.3) and (P.4) minimize the number of nurses and physicians in each hospital. As the actual number of nurses and physicians can not be reduced, a goal programming approach is used to deal with objectives (P.3) and (P.4) where goals must be equal to the number of nurses and physicians already working in hospitals. Let us denote by and the number of nurses and physicians, respectively, who already work on the specialty in the hospital. We denote by and the goals for the objective functions (P.3) and (P.4), respectively, and are expressed as follows where is the number of nurses in shortage in the group of specialties in the hospital, is the number of nurses in excess in the group of specialties in the hospital, is the number of physicians in shortage in the group of specialties in the hospital and is the number of physicians in excess in the group of in the hospital. From these goal constraints the additional cost that gives monthly salary of new nurses and physicians is as follows: where is the nurse salary per month in the group of specialty in the hospital and is the physician salary per month in the group of specialty in the hospital. The monthly salary of nurses and physicians who work in hospitals is fixed. Now, as all objective functions represent yearly expenses, we propose to combine all cost objectives which are the yearly transfer cost, the yearly cost of creating and managing new beds and the yearly salary of new nurses and new physicians, into a single objective function expressed as follows: 6.5. The certainty equivalent Finally, under a chance constrained approach and a goal programming approach, the certainty equivalent program to the multiple objective stochastic program (P) is expressed as follows: (CE) 6.6. Conclusion The chance constrained and the goal programming approaches are used to generate the certainty equivalent program. Their use is motivated by the problem hypotheses. In the next chapter, we are going to test the model using real data from Rashid hospital. Chapter 7 The experimental study In this chapter, we discuss the results obtained by the previously presented model for hospital bed capacity planning using data from Rashid hospital. The data was obtained from the administration of the hospital and is related to a recent period (2009-2011). The quality of results here is highly linked to the quality of the input data. We are going in the following to report some of the data given to us as well as the model output. 7.1. Model parameters From the Rashid hospital we collected data related to the following parameters: Number of patients / specialty New admissions/ day Discharges / day Stay of every patient Number of Physicians / specialty Number of physicians / team Number of teams / specialty Number of hours worked by each physician Number of patients assigned to each team / day Number of nurses / specialty Number of beds / specialty A description of the system of operation of each specialty. In this document we cannot disclose the information that was given to us. We refer the reader to the manuals that the hospital published yearly and that are related to his yearly activity. 7.2. Lingo 12.0 To solve the linear programming (CE), we used the commercial software Lingo 12.0. Recently Lingo was ranked by INFORMS (www.informs.org) as one of the most valuable package for linear and nonlinear mathematical programming problems. For the mixed integer linear program (CE), Lingo uses a modified Branch and Bound algorithm [17]. 7.3. Hospital beds The Rashid hospital must have 467 beds in the total. It means that 15 supplementary beds must be added to the hospital. The number of optimal beds in each speciality is presented in the following table: Specialty Current number of beds Optimal PSYCHIATRY 46 46 CARDIOLOGY 74 74 GASTRO 9 9 GEN.SURGERY 84 84 HEMATOLOGY 4 4 IDU 23 23 RESPIRATORY 22 22 NEUROSURGERY 39 44 TRAUMA 104 114 GERIATRIC 47 47 TOTAL 452 467 Table 1: number of optimal beds Only two specialities require additional beds. These specialities are the Neurosurgery where 5 beds must be added and the trauma speciality which requires 10 additional beds. This difference between the optimal number of beds and the current beds is also represented with the following histogram: 7.4. Nurses The Rashid hospital needs to hire 3 additional nurses to the hospital to cover the demand. The optimal number of nurses per specialty is represented in the following table: Spec. Current number of Nurses Optimal PSYCHIATRY 12 14 CAR

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†¢ Breastfeeding: A natural way of using birth control, and is free, and requires no prescription. Breastfeeding is safe, simple, and convenient. Does not need any medical supervision. Breastfeeding can be effective for six months after delivery only if a woman does not substitute other foods for breast milk, feeds her baby at least every four hours during the day and every six hours at night, and has not had her period since the delivery of her baby. (Planned Parenthood 2014) The woman should also have her partner wear a condom, or use a female condom to reduce the risk of infection. †¢ Male Condom: A type of birth control where the man puts on a latex or non latex plastic on his penis before having sex with a woman. The male condom can reduce the risk of pregnancy and STDs. Using a condom is safe, effective, and very affordable to get. Condoms are about $1 each, but are sometimes available for free, at medical clinics. (Planned Parenthood 2014) As a nurse, we would need to keep in mind to tell the male to make sure that they handle condoms properly. Keep in mind that certain types of lubricants can damage a latex condom. (Planned Parenthood 2014)Use only water-based lubricants, such as K-Y jelly. Instruct the male to read and understand the instructions and check the expiration date before using a condom. Teach the male patient to apply the condom onto the penis and should first be hard. When applying a condom on, instruct the male to pull back the foreskin, unless circumcised, before rolling on the condom. Place the rolled condom over the tip of the hard penis and leave a half-inch space at the tip to collect semen and then pinch the air out of the tip with one hand while placing it on the penis.(Planned Parenthood 2014) †¢ Spe... ...re provider who will let them know what to do and what not to do after their abortion. Inform the patient that they may have a wide range of feelings after an abortion. (Planned Parenthood 2014)Most women ultimately feel relief. Some women feel anger, regret, guilt, or sadness for a little while. Sudden shifts in hormones may make these feelings stronger. Serious, long-term emotional problems after abortion are about as uncommon as they are after giving birth. (Planned Parenthood 2014)The woman may be more likely to have emotional problems after abortion for certain reasons which are, having a history of emotional problems before your abortion, having important people in your life who aren't supportive of your decision to have an abortion, or having to terminate a wanted pregnancy because your health or the health of your fetus is in danger.(Planned Parenthood 2014)

Increased Prices of Necessary Goods and Inflation Affecting the Poor Working Class People

Research Paper Increased prices of necessary goods and Inflation affecting the poor working class people. Submitted By Minhazur Rahman Course: ENG -105 Abstract Global food price has shot up in the last years that have been succeeded by an extraordinary global economic down-turn; Rich, mid and poor economies are affected largely in terms of erosion of growth, shrunk investment and lessening of job creation. The global food crises and the economic recession in the major economies have created a complex scenario whereby food price may not stabilize creating erosion of income of the common mass and making investment more costly.This is presenting tremendous challenge to countries like Bangladesh which is plunged further in economic deprivation and stagnation. The bad impacts of high prices on food stuff is devastating the on the poor producers, wage laborers and consumers in our country. These people are surviving very harshly in these dire situations and are having many difficulties li ving their lives. This paper is the outcome of a research conducted to analyze the impact of price hike over lower working class people.The Research consists of the Introduction containing Background of the Research, Areas of the Research, Hypothesis, Methodology, Data Analysis, Findings, and Recommendations. The purpose of the research was to identify what are their actual problems these people are facing because of price hikes and high inflation. TABLE OF CONTENT 1. Introduction†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 4| 2. Background†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 5| 3. Areas of research†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢ € ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 6| 4. Hypothesis†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ †¦ 6| 5. Methodology†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 7| 6.Review of literature†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 8| 7. Key terms†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 8| 8. Limitations†¦Ã ¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 9| 9. Primary data presentation and analysis†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 10| 10. Recommendation†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 24| 11. Conclusion†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 25| 12. Reference†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. . †¦ 26 13. Appendix†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. †¦Ã¢â‚¬ ¦ 27| Introduction Since early 2007, Bangladesh has been experiencing a rising rate of inflation particularly in food grain at the backdrop of global hike of food grain prices.The rising inflation has become a major threat to people from all segments of the society. This higher inflationary trend does not bode well with respect to the socio-economic progress, particularly, on the poor and vulnerable groups. Rapidly higher food inflation has made it difficult for the low income households to carry on with their daily basic expenditures. According to the World Bank, four million people have been pushed below the poverty line due to abnormal rise in food price.Another statistics of the World Bank shows that between January 2010 and March 2011, the gross income of the poor decreased by 46. 7 percent mainly due to surge of food items, pushing 3 million households below the poverty line. Even the bumper boro harvest could not save the people from the grip of high inflation. On the other hand, the adverse impact of inflation has created a stumbling block to macroeconomic stability and curtailed the pace of economic growth, which is necessary to poverty reduction and meeting other development challenges and goals.This research shows what problems the low earning people in our country are facing right now because of the inflation and the increasing food prices. This also shows that what are the foods they are likely to consume and the prices trend of those foods over a period of years. This shows that how much the price of necessary foods has gone up rapidly. 1. 1Background Bangladesh is a very populated country and most of the people of our country are below the poverty line so we have lots of people with very little income or with no income at all.This sets a problem for the government to maintain food prices so that those people can feed themselves. This is one of the biggest challenges each government of our country has to accomplish but sadly none of them were ever able to defeat it, not only that the prices of everything is going up as there is a global crisis going on. Global crisis is also increasing our inflation rate and because of that the food prices of our country is going up and up. Also the amount of food needed to feed the country is increasing thus slots of food have to be bought from outside the country such as India, Vietnam, Ukraine etc.Because of this our imports are getting higher than export thus we have a bad GDP than most of the countries in Asia. It is obvious nowadays that the price of everything ranging from essential daily commodities to transportation, educational, medical and other expenses are increasing. According to the study, as a consequence of the price hike, the majority (97. 7 perce nt) of people of Dhaka metropolitan city and other parts of the country are facing deep trouble in coping with the situation. In Dhaka city 43. percent of the people think that because of price increase almost everything, they are encountering economic hardship. To help people to overcome this economic crisis Government should come forward and take steps against this price hike. The low earning people are therefore having problems leading a normal life; they are facing tremendous hardships such as they have to buy food that is very low in quality thus they are getting less amount of nutrition, they cannot afford any kind of fruits for themselves or their family even if they can they are not so good.Also they are not able to buy good clothes for themselves or their family and not only these they can’t afford education for their children as they already have so little income that they can hardly feed the whole family. So they are being stripped from all sorts of happiness a nor mal human being can have and when asked they say that it is a curse to be born poor as there is very little help from them. 1. 2 AREAS OF RESEARCH In this section, I will discuss about the areas of research that I have studied.For working on it comfortably and getting my intended and expected result, I have prepared several questions, which helped me a lot for working on my survey. The whole questionnaires was based on the people with low income and there problems. From this questions I found out that people with low income are having difficulties leading there life and hardships they are facing to overcome this problems. This inflation and high prices of foods are forcing them to survive with a very little amount of food and commodities they require.While doing this research my overall analysis was correct that the people with low income are living in terrible conditions. My respondents were local people from where I live that is in Mohammadpur, here different levels of people live from poor to rich it easy to find any category of people you like. So it was not hard for me to go through this interview, my primary focus was on the Rickshaw Pullers, Garments Workers, CNG & Taxi Drivers & Security Guards with a variable age difference with a range of 15 to 50.As most of them were illiterate I had to translate each and every query for them and so were the results of the questionnaires. I interviewed a total of 40 eligible people that fit into my profile and gathered the other required information to complete this research. 1. 3 Hypothesis Majority of the people of our country is this low earning people so high inflation and increases food prices is making their life hard to live. 1. 4 Methodology Primary Source: – Through Questionnaire – Interviews with general people Survey respondents: 40 people- targeted segment is general low income earning people with ages between 15 to 50Secondary Source: – Websites – Newspaper archive in web – Articles and other reports At the beginning I searched the web for relevant resources and took some ideas for my research and later with that knowledge I developed the questionnaires and conducted the interviews and later started compiling the primary and the secondary data to complete this research paper. 1. 5 Review of Literature My secondary data includes online article and journals, government report on inflation also some independent research conducted by various NGO’s. This research is based on the primary data that I collected using the ideas of those secondary researches.As is this topic is a very vast one and it changes form area to area but the base of the facts remains the same but more sample would have been better to make it a good quality research paper. For the research I used data from the Bangladesh Bureau of Statistics, Bangladesh Bank, and World Bank. From here I used the information about the prices of the foods and other necessary goods. For research I used different journals such as the journal written by Shamsu Uddin Shakib in the European Journal of Business and Management regarding the high inflation of Bangladesh and it causes an affects.Also for the research I used one article Iqbal Ahmed on regarding the Inflationary Trend in Bangladesh and Impact on High Food Commodity Prices. Here the writer has shown how the inflation is affecting all the people of Bangladesh this paper is done with the help of a sponsor from a NGO as it is a national level paper. 1. 6 Key terms Inflation: Inflation is a rise in the general level of prices of goods and services in an economy over a period of time. Commodity: A commodity is the generic term for any marketable item produced to satisfy wants or needs.GDP: Gross Domestic Product is the market value of all officially recognized final goods and services produced within a country in a given period. 1. 7 LIMITATION While preparing this research paper I had faced a number of problems. Some of these had very little effect on the paper while other ones caused my research to be limited. The first limitation is I could not do my survey to the whole population for my primary research. I did my primary survey on my area and most of the people did not want to answer the questions. Besides, I had difficulty finding necessary information in the internet related with my topic.The secondary sources were very limited. Lastly because of being inexperience I might have not been able to organize all the materials properly. 2 Primary data presentation and analysis For my primary research, I collected data from 30 male and 10 female respondents, aged between15-50 years. I conduct this survey within the married and unmarried people who have similar social positions. The â€Å"Data Analysis† section is an explanation of data gathered from the primary research. My respondents were: PART: A (Questionnaires) Q1. What is your highest Qualification?When I asked this question I k new that I was going to get this kind of result with 20 people who are illiterate, 14 people who passed class – 5, 4 people who passed class – 8, and 1 person SSC and 1 person HSC graduate but still they are earning very low level income. Q2. Want kind of Job do you do? Well it was my choice actually, to get a more accurate result I interviewed 14 rickshaw puller, 10 garments worker, 6 drivers, and 10 security guards. Q3. Are you married of not? This question was conducted in order to know the number of family member they have. Q4. What is number of total family members that live in your household?Here we can see that 13 people has a family of 4 people, but there is 16 people who has 5 people family, and 9 people who has 6 family members and 2 people with a family of 8 or more people. So here we can see a total of 202 people who are depended on maybe one or sometimes 2 bread winners for the family. PART B Q1. What is your total family income? This shows that there is 2 1 people who are earning less than 4000 Tk, 11 people who are earning less than 6000 Tk, 5 people are earning less than 8000 Tk and just a lucky few among this group of people is earning 8000Tk or more.This shows that how low amount of salary they are getting but still they are doing a very hard work compared to middle class people. This shows that how bad the state of our countries low earning people. Q2. What is your total family expense? When asked this question many of them were not sure how much to say but after a while they gave me the answers which shows that 23 of the people spend less than 3000 Tk, 10 people 5000 Tk, 6 people 7000 Tk and only one person spends 7000 Tk.When asked why they do not spend all of the money they say that most of the time they do have to spend it all but they sometimes are able to save some money for some other extra use. Q3. How many hours of work do you do each day? As we can see from the above chart that most of the people have to work more than the usual amount of work that should be done by a normal person, because as they have every little knowledge they are required to do multiple jobs sometimes overtimes as a result they tend to work more than the natural working hour which is 8 hours.Q4. What is the total amount of money you spend on food? This chart shows that these people are spending most of their salary on food, 15 people is spending 1500tk as they have a pretty low income, 13 people spends 3000tk, 7 people spends 4000tk, and only 2 people spends 5000tk. Here it clearly shows that as these people has low income so they are forced to spend less on food and they are spending the most amount of money on the food. # The relationship between the number of family members and the amount of money they spend on food.This graph clearly shows that as the number of family members increases the amount of money spent in buying food increases thus making a clear assumption that more number of people will require more food and m ore money is therefore required to feed a large family, which increases more difficulty of the bread winners and they have to work more hours as shown in previous charts. So one way to reduce this spending can be done by giving birth to less number of kids as a result there will be less amount of mouths to feed also the population will get lower Q5.What food items do you consume and how much of it? This chart shows the average percentage of food items they consume in order to survive. A total of 40 percent of food out of 100 percentages is rice as rice is the most common staple food of our country. Than the potato it is because it is cheap and it provides lots of energy and therefore it is eaten a lot, then the other staple foods that the people consume. The food items that they consume are of very low quality and that’s why they are available at a cheaper rate. Q6. What are the other areas that you spend your money other than food?This chart shows that after they buy their f ood the rest of money rather getting the opportunity of saving it, it is required in other places such as the rent, medicine and doctors, clothing and education. These are the general areas that they spend next to the food. Rent is the highest among all of this because the living cost in Dhaka city is increasing rapidly and to make sure that there is a roof above their head they are sometimes willing to pay the rent before they go and buy the food. Even in the slums the rent is getting higher rapidly so much of the income goes into paying the rent after food expenses.Doctors & Medicines Usually this entire people receive a very low class treatment. All of them have to go to the cheap government hospital which has a very well reputation in providing the worst kind of treatments. Also they cannot afford good medications as a result they become sicker and are more prone to catch diseases. If the government made some efforts to at least improve the quality of the hospitals and provi de good generic medications at a cheaper rate than they would be able to save some money. ClothingThe people that I researched on are low income people no naturally they have a very low budget for clothing. Most of the times the clothes they wear are given by the people to them as charity or the wear 2nd hand clothes or clothes which are of very poor quality. Education Education is the most important requirement for a nation to grow but most of the people I interviewed are illiterate or just primary graduate. Also most of the children of these people do not go to school as they have to pay the fees so they don’t want to waste their money school. Some of the children go o school but they dropout early to help earn money for the family. The ones that remain they hardly pass the PSC, JSC or SSC exams and starts working. Inflation and Food prices trend of the last 4 years This graph shows the general inflation that is the inflation of everything all over the country and the infla tion of the food price over a period of 4 years. It shows that during 2008 and 2009 the general inflation increased 1. 5% more and food price inflation to 2. 8%, this shows that the problem of inflation is not recent but we all were suffering since 2008.But in 2010 there was a small hike in general inflation and the food price inflation reduced but in 2011 due to some social and political turmoil the food price inflation during shot up more than 2. 8% as a result the price of food increased drastically. This graph shows the price of some common food that everyone consumes but the quality of the products are of low grade as this research is about the low income earning people so is the price of this products but still this is high enough for these people.As we can see that during the year 2008 there was a price hike in both rice and atta this was because of the global financial crisis, because the amount of rice that is produced in our country is not enough so we import most of our r ice from Vietnam and Ukraine and due to the global recession Bangladesh also suffered the impact of recession as result our exports decreased but our imports increased as the population has also increased.Than in later years it stabilized but in 2011 it again hiked because of some political unrest in our country and also there was a breakdown of relationship with the neighboring countries as a result we took a huge hit. But for potato it was not a problem because we produce a lot of potatoes enough to the poor people of our country. 3 Recommendation It is obvious nowadays that the price of everything ranging from essential daily commodities to transportation, educational, medical and other expenses are increasing.To help people to overcome this economic crisis people from all walks of life should come forward and take necessary steps against this price hikes. Following steps should be taken Quick action: 1) To control price of commodity deposit rate and lending rate of Banks should control. 2) Provide more importance to agriculture sector. 3) Control Business syndicate as well as stockiest who create artificial crises in market. 4) Provide micro credit facility by government. The interest rate of that disbursement should not more than 6%. ) Import duties of fundamental goods have to deduct. 6) Consider corporate tax rate. 7) Established government regulated mega shop. 8) Tax rate of medical instrument & medicine should minimum. Long run Action: 1) To remove unemployment problem seek different sources of sector. 2) Utilize our natural gas directly by government. 3) Growth rate of population control. 4) Indifferent monetary policy provides both public & private sector. 5) Overall control of malpractice. 6) Reduction of corruption. Conclusion High inflation is not good for any country it holds a nation back.This inflation does not only harms the low income people but also everyone in the country, this affects everyone this decreases the living standards o f people. As I have shown high inflation limits the low income people they all live a very hard life, they buy very less amount of food as they have to pay the rent to live under a roof they constantly need medications as their living conditions are very bad and if they have enough money left they try to buy some new clothes or send their kids to school but many of them are not lucky enough. Most of their income is only enough for just rent and food.Because they already have low income and this high inflation is causing the prices of food and other commodities to increase rapidly as shown earlier, so they have no other choice but to live a very hard life. References 1. Shakib. S. U. ,( 2012) European Journal of Business and Management ISSN 2222-1905 (Paper) ISSN 2222-2839 (Online) Vol 4, No. 3, http://www. iiste. org 2. Ahmed, I. (February 2008) Inflation and the Poor in Bangladesh, Policy Analysis Unit, Bangladesh Bank, pdf http://www. bdprices. org/article/jan_11/meu_jan_2011. pdf 3. Ahmed, I. (n. ) Inflationary Trend in Bangladesh and Impact on High Food Commodity Prices. pdf. http://www. bdprices. org/journal/jun_10/meu_jun_2010. pdf 4. Bangladesh Economic Update, (2011). http://www. unnayan. org/reports/meu/june_11/meu_jun_2011. pdf. 5. Consumer Price Indexes, (April 2011). http://www. bbs. gov. bd/home. aspx 6. Engendering Development: Through Gender Equality in Rights, Resources and Voice, A co publication of the World Bank and Oxford University Press. 2002 7. Bangladesh Bureau of Statistics. (2011) Inflation & Price trends http://www. bbs. gov. bd/home. aspx Appendix

The external influence for Lufthansa airline

The external influence for Lufthansa airline was the gulf war which realized a decline of traveling passengers.   With the increased number of flights the they had to com up with a strategy to enable them to survive in the market. To do this the company started by redeveloping workshops tat would see change management instilled in the managers and the whole company as a whole. This therefore enabled the workers to be sensitized for the need for a radical change. This initial crisis management meeting was the starting point for the recovery team.The other step towards change was when the company decided to move from being publicly owned to privatization and the need to embrace restructuring that could see to it that there is an increase of cost and revenue transparency as well as market proximity and thus reducing the disintegration in decision process. There was a need for the company to focus on their external relationship. This was a result of experiencing overcapacity. Therefore there was the need to change their strategy of growth through internal strength to an alternative strategy of growth through partnership.   In the end of the 20th century the strategy of the airlines changed from competition between airlines to competition between networks.   Ã‚  So there was need to strengthen integration and alliance strategies.Change is inevitable in the endeavor of a company or an organization to remain relevant in its business. Change comes along with its advantages and disadvantages. For instance due to technological change some of the employees might be found redundant and therefore be retrenched. Also change might require some expertise manpower and therefore leading the company to hire skilled labor. It is therefore the responsibility of the managers to manage all manners of changes in the organization that matters, hence determining the success of the organization (Elsevier, 2005).At Lufthansa Airways the managers have been trained to counter change s trategically. They are sensitized such that they consistently redesign the company to fit the change in line with a new product. This is seen when the company takes on a new route.   The company makes the staffs to readjust frequently to the changing trends in business. For instance, the sometimes considers readjusting its payment mode to counter the fluctuation of the US dollar currency which the company is currently using.   Though this redesigning has not yet been approved, it shows that the company is ready to seal the loss it is encountering through this fluctuation.In the endeavor to manage the changing trends in the marketing field the company consistently comes up with new marketing strategies. The example provided earlier of the company contemplating of changing their trade currency due to fluctuation and its unpredictability shows that the company is proactive since the management foresees problems in the market which has already had an impact in terms of their revenue . For instance if the management decides to change the denomination of trade, they have to consider the pros and cons of the move before finally settling for the decision. The company is currently researching on the issue and this shows that indeed the management is sensitive on the issues thus manifesting a sound managementThe management of Lufthansa Airways handles change by prioritizing the change they have to take. In doing so, the management informs all the staff through written forms and meeting about the change. Of course, some of the staffs tend to resist change but the move is pacified by the management by ensuring the staffs that apparently resists change are informed about the need for change at the particular time. The staffs are taken through training and are shown the relevance of the change to particular individual and the importance of the change in reflection to the company’s goals.For instance when a new office is established on a new route, the staffs that are to be affected are put on a training session so that they are enlightened on the need for the expansion, how they will benefit individually and how they will be resourceful to the company. In essence the employees’ attitude is taken care of and the employees get motivated to take the responsibility they are given.This also tackles the issue of resistance to change since the employees are made to be part of decision making in the change process. Thus the company successfully manages change by ensuring that its vision is articulated. In addition the management ensures that they establish core values on which the workers will consistently work on (Handy, 1993). Thus in the process of managing change the management also succeeds in enabling the workers focus on quality services by encouraging them to participate, and pump a sense of ownership into them and shared accountability.The company’s Information Technology is wanting and this is affecting their communication. L ack of a thorough networked computer within the company’s premises makes it difficult for information to be relayed from one point to another. I T is indispensable in any business at this point and time in the contemporary world. The company has to invest in this technology and use it to do most of its transactions thus doing most of the business. It has to develop a website that will enable them to market their products globally.This problem of inadequate Information Technology has been deliberately caused by lack of prioritizing it as important. This in turn costs the company extra costs by keeping many employees who could have otherwise have been done away with. Therefore the main challenge in implementing this issue is that the current employees have a negative attitude towards the introduction of the new technology.The company should endeavor to improve the quality of their service. Partially their importation and distribution process is thwarted by the insufficient tech nology. They ought to employ the right employees in terms of the qualification too. This will make them to be more professional in their operations and thus increasing their productivity.In the endeavor to improve the quality of the company’s services the company ought to employ more employees and probably establish a synchronized customer care department. In this breath the company has to ensure that each department within their operation has defined roles and thus whenever a client asks for a query he/she is directed to the right department. This will make work easier for each person in the organization and thus leaving the client who is paramount in this organization pleased with their work. This also creates a win-win situation between the company’s management and other employees.The company can improve in minimizing the cost they incur by introduction of a synchronized technology and ensuring that information flows within the hierarchies of the company. Most of th e losses the company incurs as a result of poor communication between the company and its chain of distribution. This poor communication results to lose of customers’ due to dissatisfaction of their services. The company should not fear to hire competent people because they might be expensive in their charges and salaries, but they (competent people) are bound to work and bring results.The company should also ensure that its employees are trained and sensitized about time management. In so doing the company will save a lot in terms of the backlog of the work not attended to due to poor time management. The company will also have to solve the problem of perennial absenteeism among its employees. Time management is crucial in any organization that deals with supply and distribution of commodities since and if it is not taken into consideration, it might lead to loses as a result of cancelled orders due to late delivery and sometimes cancellation of the services. The challenge t hat might come along with implementation of strategies to manage time is that some employees might feel that their freedom is curtailed and feel that they are monitored around which might reflect negatively in their attitude and eventually their performance.The organization can resolve resistance by taking into account the needs, attitudes, and beliefs of the individuals involved as well as forces of the organization (Greenbury, 1999). The company should come up with a strategy that will ensure individuals are personally benefiting from the change so that they can be willing to participate in the change process. Positive and strong pressures for change can be established by creating shared perceptions by the group members of the need for change, thus making the pressure come form within the unit.The company can also reduce amount of opposition to change when those people who are to be changed and those who are to exert influence for a change have a strong sense of belonging to the s ame group.   There is a receptiveness for change from within to be easily acceptable than that that emanate from outside (Armstrong, 2002) it is therefore wise for the company to initiate change from within. Sometimes it is indispensable for change to come from outside, for instance technological change has to be borrowed from outside and at this time it is the duty of the company to enlighten their employees on the benefits of this kind of change. The company should at this point train their employee. This will make them to be positive in their attitude towards the change and thus work towards the success of the implementation of change.In addition the company must ensure that all relevant people in the group share the information relating to the need for change. They should plan for change and be ready to face the consequences of change. There is also the need of all the managers at all levels to deliberately open communication channels for the success of the process of change.à ‚   Also for the success of a change process the company has to specify the progress criteria against which improvement will be measured. This will reduce the possibility of conflict among the members of the organization thus reduction of resistance to change.List of ReferencesArmstrong, M. (2002) How to Become Even a Better Manager. London: Kogan PageBarbara S. (2006) Change management. NY Person EducationElsevier, B. (2005) Positive Working Relationships. London: Kogan PageGreenbury, J. (1999) Organizational Behavior. New Jersey: Prentice HallReferencesHandy, C (1993) Understanding Organizations. Berkshire: PenguinMullins, L (2000) Management and Organizational Behavior. Berkshire: PenguinRollin, D (1988) Organizational Behavior and Analysis. New York: Wiley