Vulnerable Populations

Vulnerable Populations

• This learning assessment activity serves to support learners’:
• Examination of the relationship between vulnerability/social determinants of health and health disparities
• Identification of population risk and protective factors relative to health outcomes
• Prioritization of interventions for targeted population’s health based on assessment data
• Exploration of the professional nurses’ role as population health advocate
Step 1: Select a Vulnerable or Special Population
• Select a vulnerable or special population based on the ten (10) topics outlined within the lesson (see suggested resources in the table below).
• Address each of the six (6) content areas listed below in your paper. Your paper should be in paragraph form rather than answering the outlined topics.
1. Identify the vulnerable or special population selected and your state.
2. Describe the factors contributing to the vulnerability of the selected population. Discuss the vulnerable population using the epi triad-host, agent, and environment

3. Describe the significance and economic impact of the population in relation to community and population health. Cite statistics to support the significance and economic impact. Remember to cite according to APA Guidelines

4. Identify demographic and epidemiological data relevant to your population.
o Describe the characteristics in terms of demographics and epidemiological data (e.g., age, sex, marital status, economic status, employment status, race, ethnicity, household composition, health insurance coverage, access to health care, education levels, health conditions, etc.). Be sure to cite your sources appropriately.
5. Identify two (2) priority health concerns for this population and support your concerns with the literature. Cite your references in text to support your statements.

6. Discuss several evidence-based strategies nurses can implement that target the priority health concerns and the role of the nurse in improving the health outcomes for the population. You can implement using the levels of prevention-primary, secondary, and tertiary. Be thorough in your discussion.

Step 2: Research Your Population
• You will have a minimum of four (4) references for this project including your textbook, a minimum of one scholarly journal article, and minimum of one web-based source. References should be within the past 3 years. You may use the assigned reading article as one of your required journal article references.
• Use the U of A Online Libraries to locate your scholarly journal article(s).
• Review web-links related to your topic within the Project # 2 folder accessible from the Community/Population Web-Based Resources in the left-pane navigation menu.
• Review the grading rubric to guide you in the development of your paper: Project 2 Grading Rubric.(located in the back of your syllabi)
Step 3: Prepare Your Paper
• As you prepare your paper, use concepts and terms that have learned in the course. You might consider approaching the vulnerable population with host, agent, and environment. Also, look at prevalence, incidence, risk factors. Using the concepts that you have learned will add a dimension of critical thinking and synthesis to your paper.
• Remember to cite your references throughout the body of your writing to show where they influenced your writing and to support your conclusions. Note that direct quotations should be used sparingly and the paper should be written in your own words. Review your APA manual for formatting in-text and parenthetical citations and references.

EMS Safety Program

Overview of Community Assessment
A community assessment provides the basis and rationale for clinical interventions in Population/Community Health Nursing. Community Health Nurse sasses the community by using the nursing process. Nurses gather subjective and objective data, cluster the data into meaningful information, prioritize community health needs, develop Community Health Nursing Diagnoses, create interventions to address those identified needs, and evaluate the effectiveness of the intervention implemented. In order to gain a complete assessment of the community, several kinds of data are needed:
Assignment One: Windshield Survey and Interview with Two Key Members of the Community
Purpose: The purpose of this assignment is to determine and document resources that are available and have a positive input into members of your selected community. Completion of the windshield survey will provide input data into the community assessment. Make certain that you address the 16 areas for potential resources for members of your community. Note closely any disparities, lack of access, and possible community members’ lack of knowledge with the resources available.
Objectives:
• To familiarize the student with the influence of the community to members of the community.
• To assist the student with noting demographic data related to the physical appearance of the community, available resources, work sites, and people.
• To identify resources that come into the community that can support the community members
• To assist with identifying possible needs for members of the community
• To advance student’s perception of the public health nursing process of assessment, diagnosis, planning, implementation and evaluation of a community and the impact on the members of the community.
Windshield Survey: This is a first look at a community through a car’s windshield. The windshield survey is sometimes referred to as a familiarization survey because it helps establish to understand the community and the impact on community members. The windshield survey can also provide demographics about the community. The windshield survey is an initial step to a more comprehensive community assessment by raising awareness of issues for further exploration.
Observers are asked to use their senses (sight, hearing, and smell) to learn about a community as they drive, walk around, or use public transportation to get around the community. When driving through the community focus on the inputs that the community has to the members of the community. During the process, make observations about the physical and social environments and the natural and built environments in the community.
As you drive, ride, or walk through the community, pay careful attention to as many characteristics of the community as possible. Include pictures or videos as part of your survey. Make sure that you are only taking photos of people in public places. Be sensitive to the privacy of others; avoid taking pictures of people, particularly those who are vulnerable, where they could be identified.
The final submission of the windshield survey needs to be a formal written paper with complete full sentences. You can include pictures and describe the resources not just the names of the places. You can paste pictures directly into the document and upload supporting videos under the assignment link in Blackboard.
As you make observations keep in mind how available the resources are the members of the community.
Resources/Assets:

o Organizations or businesses that provide support to the community (ex: libraries, clinics, thriving local businesses)
o Family and Services: (ex: youth centers, churches, Head Start)
o Signs of Decay (Is the area well maintained or in disrepair? Is there garbage and liter in the streets and home lawns? Are there trashed/abandoned cars, places for rodents or other wildlife to hide, vacant lots?)
o Parks and Recreational Access Parks and Recreational Areas (Are there play areas for children and adults? Are they safe and maintained? Is there green space? Are there areas of opportunities for exercise?)
o Common Areas (Where do people collect for social gatherings, where do they “hang out”? Are these areas for groups or are they open to all? Are there signs posted?)
o Stores (what stores -grocery, retail, drug, etc. are in the area? How do residents travel to them? Are they locally owned or chain stores?)
o Restaurants (What options are there for eating out? How many are chain restaurants?)
o Transportation (How do most people get around the area? Is there public transportation? If so, what kind and does it appear to be used? Who uses it? What is the condition of the streets, roads, highways?)
o Service Centers (What services are available in the community – health care, social services, schools, employment offices etc.?)
o People in the Community (Who is in the area? during the day? What evidence is thereof particular “classes” of people – upper, middle, working, lower?)
o Industries and Worksites (What are the major industries located in the area? What types of occupations are evident?)
o Protective Services (Where are fire and police stations located? Is there evidence of police and fire protection in the area? Are these services in a convenient location to the family?)
o Ethnicity (What is the predominant ethnic group? Are there residents from a variety of ethnic backgrounds or is the community mostly one group? Which one? Are there stores, restaurants, churches, schools, or languages that indicate an ethnic group(s)?)
o Religion (What churches and church-run schools are in the area (denomination)? How many are there of each denomination?)
o Health and Morbidity (Is there evidence of any health problems such as drug/alcohol abuse, communicable or chronic diseases, mental illness (etc.)?)
o Politics (Is there evidence of political activity? Are there any signs that indicate a predominant political party (parties) or concern(s)?

FICTION ESSAY

FICTION ESSAY

Compares and contrasts two stories from the Fiction Unit. Before you begin writing the essay, carefully read the below guidelines for developing your paper topic and review the Fiction Essay Grading Rubric to see how your
submission will be graded. Gather all of your information, plan the direction of your essay, and organize your ideas by developing a 1-page thesis statement and outline for your essay. Format the thesis statement and the outline in a single Microsoft Word document using current MLA,
APA, or Turabian style (whichever corresponds to your degree program); check your Perrine’s Literature textbook, the Harbrace Essentials Handbook and/or the link contained in the Learn
section to ensure correct citation format is used.
Your submission must include a title page, a thesis/outline page, and the essay itself, followed by a works cited/references/bibliography page listing any primary and/or secondary texts cited in your essay.

Guidelines for Developing Your Paper Topic

The “Writing about Literature” section of your Perrine’s Literature textbook (pp. 1–54) and the
“Writing” section of Harbrace Essentials (pp. 1–12, 15–16, 18–21, 22–28) provide helpful
pointers for writing your literary essay and for academic writing in general. Be sure that you have read these sections before doing any further work for this assignment. Take particular
notice of the examples of fiction essays in the Perrine’s Literature textbook.
Choose 2 of the following short stories to compare and contrast in your essay: “The Lottery” by Shirley Jackson
“The Destructors” by Graham Greene
“The Rocking-Horse Winner” by D.H. Lawrence
“Young Goodman Brown” by Nathaniel Hawthorne
“The Prodigal Son” by St. Luke

Also, at least 1 of these elements of fiction must be the focus of your essay:
Conflict/Plot/Structure
Characterization
Setting
Theme/Authors’ Purposes

Macroeconomic environment in two countries

 

Macroeconomic environment in two countries

 

Managerial Economics

 

Case Study Assignment Brief

 

  1. Project question

 

A major multinational corporation has appointed you as an economic advisor. You are requested to compile a report regarding the macroeconomic environment in two countries where the firm operates and explain how it might affect the company’s economic activity. The suggested firm to use for this case study is ExxonMobil in the context of its operations in Guyana. However, students have the option to choose any other firm they wish.

 

  1. Project specifications

 

  1. You may choose to focus your analysis on any existing firm with international activity that can be of different types in the two countries.

 

  1. The two countries must be chosen from section C below as follows: one country from List 1 and one country from List 2.

 

  1. Your report must include:

 

  1. A brief description of the company and the product/market it operates in for both countries.

 

  1. An analysis of the market structure in which your company operates for the two countries.

 

  1. A comparative analysis of all major macroeconomic indicators (see section D below, excluding 5 and 8) for the two countries and their overall impact on firm’s economic activity.

 

  1. An analysis of the monetary and fiscal policy (instruments) for the two countries and their impact on the firm’s economic activity. You must include here an analysis of the interest rates

 

 

  1. An analysis of the foreign trade policy instruments (international trade agreements) for the two countries and their impact on firm’s economic activity. You should include here an analysis of the exchange rates 1

 

  1. Country Lists

  List 1   List 2  
     
         
  Guyana China
     
  France India
     
  United Kingdom Brazil
     
  United States Russia
     
  Japan Mexico
         

  1. Macroeconomic indicators1 to be analysed (the last available 10 years):

 

  1. GDP growth rate

  1. GDP per capita at constant prices

  1. Inflation rate (CPI)

  1. Unemployment rate (ILO measure)

  1. Interest rate (Monetary Policy Rate)2

  1. General government balances (% of GDP)

  1. Balance of Payments (% of GDP)

  1. Exchange rates (National Currency/USD OR National Currency/Euro)3

  • We recommend that you use the IMF database to collect your data for most of these macroeconomic indicators.

 

  • Data available from the relevant Central Banks websites

 

  • ibid

 

What is a case study?

A case study is a detailed story of something your company did. It includes a beginning — often discussing a conflict, an explanation of what happened next, and a resolution that explains how the company solved or improved on something. A great case study is also often filled with research and stats to back up points made about a project’s results.

Case studies are a scientific and critical exploration of a situation or a phenomenon that poses a problem and requires providing suggested solutions, recommendations and pathway to avoiding similar problems in future

The structure of a good case study just cannot be fit into a single universal pattern or copied directly from a sample case study since case studies differ in topics and writing requirements. Yet several important components cannot be skipped because they establish the valuable core and supporting elements of logical and persuasive reasoning.

The following will be the case study format that you will be using

  • Cover page
  • Content
  • Executive Summary
  • Given Case Study (The original case study must be  re-state)
  • Summary of the Case (paraphrase not exceeding 30% of the original word count of the orinal case study)
  • Introduction
  • Analysis /Issues to be solved (responding to the questions in detail using many course concepts/images/illustration as possible, and demonstrate these within the context of their application in the case)
  • Limitation in the case (identify any weakness/s in the case given)
  • Recommendations/solutions (mitigation strategy for addressing the limitations)
  • Conclusion
  • References (APA style)
  • Appendices (if applicable)

An introduction can be brief and just mention the issue to be discussed. Analysis Overview constitutes the body and takes up the majority of the paper; here you provide the context of the matter of discussion, highlight what needs to be solved and what theoretical premises can be applied for analysis from the case given. The Conclusion restates major findings and solutions but very concisely, and may also prompt the further path of exploration in the field.

Important: Make sure you support your ideas with enough justification from the case. Facts, figures, Theories, etc., MUST have source citation/s

Font: Times New Roman, 12pt, Justify

Margin: 1 inch all around

Spacing: 1.5

Referencing: APA style

Word count: Not less than 3000, not exceeding 5000. The word count must not include the following: the case study, case study summary, images, and related illustration/s)

Important: Facts must be supported with relevant referencing. No plagiarism

Case Study Evaluation

 

Evaluation Criteria Descriptors Score Score awarded
Presentation and structure Overall structure and layout of paper which includes: Cover page, table of contents, Executive Summary, Introduction, font size & spacing, grammar, correct referencing style and academic citations, appendices, tables and figures, and word limit. (Glossary where applicable). Structure should be coherent.

 

10  
Research Problem / question Clearly defined research problem or case study question; significance to the discipline in theory and practice; novelty; originality; ethical; feasibility; current, interesting, clear and unambiguous (A good research problem is one that can be attacked empirically that meet these criteria.) Where case studies are given, demonstrate analytical ability and discuss the application of various concepts. 10  
Objective of research Clearly defined and meaningful objectives, which ensures that the findings are relevant to decision makers. Objectives should be concise; should follow a logical sequence; realistic; phrased in operational terms; should use action verbs specific enough to be evaluated and measured (e.g., assess, determine, compare, verify, calculate, describe). 10  
Research methodology Purpose clearly defined, research process detailed, research design thoroughly planned, limitations frankly revealed and procedural flaws; thorough analysis for decision makers (solutions to complex problems); findings presented unambiguously; conclusions justified; systematic; logical, reliable outcome measures. very significant ability to plan, organize and execute independently a research project; coursework assignment or examination question. (a good research procedure should be described in adequate detail that another researcher can repeat the research for further advancement, keeping the continuity of what has already been attained). 25  
Quality of analysis, application of concept and originality Very significant ability to evaluate critically existing methodologies and suggest new approaches to current research approach or professional practice; very high levels of creativity, originality and independence of thought; very significant ability to evaluate literature and theory critically and make informed judgements; very significant ability to analyze data critically and demonstrate outstanding levels of accuracy, technical competence, organization and expression. 25  
Recommendation and conclusion Conclusion should be written to relate directly to the aims of the project as stated in introduction; indicate the extent to which the aims have been achieved; summarize the key findings, outcomes or information in report; acknowledge limitations and make recommendations. A good recommendation should include the steps that should be followed in future studies such as those needed to implement particular policies or actions; and any resources that would be required in the process should be well explained.  Recommendations should also aim to mitigate any limitation / weaknesses in case study within the context of the case study and appropriately formulated to alleviate the impact on the identified limitation. 20  
Total Score   100%  
Weighting of overall grade   30%  
Student Name:

Faculty:

Date:

Overall comment:    

Managerial Economics Case Study

Managerial Economics Case Study

Executive Summary

A leading manufacturer, producer, and distributor of oil, gas, and petrochemical products, ExxonMobil has established its operations in different parts of the world, including the United Kingdom and India. Conducting business in these countries necessitates adherence to the monetary, fiscal, political, and market requirements and further complying with governmental rules and policies that regulate the organization’s operations. As will be portrayed herein, ExxonMobil’s operations are characterized by different components shaping or influencing its sustainability within the nation and its surrounding neighbours. The depiction of these components will necessitate a thorough review of the monetary, fiscal, and political aspects of its economic activities. These will be coupled with an in-depth analysis and comparison of the countries in terms of their market structure, the effects of the major macroeconomic indicators, and local and foreign trade policies.

Introduction

Exxon Mobil Corporation entails an international oil and gas company based in Irving, Texas. Originated from Standard Oil, owned by John D. Rockefeller, ExxonMobil was formulated and established on November 30, 1999, through a merger between Exxon (formerly Standard Oil Company of New Jersey) and Mobil (the former Standard Oil Company of New York). The primary commodities associated with the company include Exxon, Mobil, Esso, and ExxonMobil Chemical (ExxonMobil, 2019). Throughout the years, its operations have contributed to ExxonMobil being ranked one of the leading firms globally in terms of revenue.

Most fundamentally, between 2016 and 2017, ExxonMobil ranged between first position to the sixth in terms of market capitalization and public trading. In 2016, the company was position three in the Forbes Global 2000 list, while in 2017, ExxonMobil was number ten among the companies that made the most profits, as per Fortune 500. Subsequently, in 2018, ExxonMobil position two out of the largest organizations in America, as stipulated by 500 rankings based on total revenue (ExxonMobil, 2019). These accomplishments have been characterized by company shares distributed across different local and international institutions. For instance, a large portion (55.56%) of ExxonMobil’s shares is owned by institutions such as The Vanguard Group with 8.15%, BlackRock with 6.61%, and State Street Corporation with 4.83%, as of 2019.

As one of the Big Oil companies globally, ranked 14th, ExxonMobil produced 20 billion barrels of oil equivalent (BOE) as of 2016. Besides, ExxonMobil owns 37 refineries in more than 21 nations, which constitute a cumulative refining capacity of approximately 6.3 million barrels (1,000,000 m3) daily, pushing the company to position seven among largest global refiners. Despite these accomplishments, ExxonMobil has enjoyed its fair share of criticism based on its slow response to cleaning up efforts following the 1989 Alaskan oil spill that brought immeasurable damage to the environment in the world (Chart Industries, 2020). Additionally, ExxonMobil has been associated with a long history of lobbying activities and efforts to deny climate change and objection to the global warming consensus. Thus, ExxonMobil has employed various measures in minimising the environmental impact of its global operations. Still, the company remains the target of accusations related to inadequately addressing human rights issues, American’s foreign policy influence, and its effect on the future of other countries.

Nonetheless, ExxonMobil remains the largest company not owned by the government in the energy sector that produces an average 3% of the oil and an estimated 2% of the world’s energy. (ExxonMobil, 2019) Therefore, this case’s essence entails an in-depth overview and analysis of ExxonMobil’s operations by focusing on two countries, the United Kingdom and India. The analysis will delve into the market structure in which ExxonMobil operates for and within the two countries. These elements will be followed closely by a comparative analysis and analysis of the major macroeconomic indicators between the two countries and their potential effect on the economic activities within the company. Ultimately, this case study will analyse the foreign trade policy instruments applied in both countries.

Analysis

ExxonMobil’s operations are organized into different global divisions categorised into three groups, including stand-alone and ancillary divisions such as Coals and Minerals (ExxonMobil, 2019). Today, ExxonMobil’s global operations are renowned for their popular brand names, Exxon, Esso, and Mobil. The company manufactures products that facilitate transportation in the modern world, powering cities, lubricating industries, and further providing petrochemical building blocks that foster the production of numerous consumer goods (Chart Industries, 2020).

ExxonMobil focuses on exploring oil, extracting, shipping, and wholesale operations within its upstream division. The downstream division specializes in marketing, refining, and retail operations for the company’s products. Lastly, the chemical businesses division is a merger between Exxon’s and Mobil’s chemical industries with main products that include olefins and aromatics, synthetic lubricant base stocks and additives, catalysts, and polyethylene, among others (ExxonMobil, 2019). These operations foster the identification, capturing, and evaluation of new oil and gas resources in the countries of operation. However, most of the production fields in which ExxonMobil is interested, especially in the North Sea, are operated by other companies as part of a joint venture. As a result, working in different locations around the world, ExxonMobil has, over the years, powered the economy of the neighbouring countries with significant investments in economic growth (ExxonMobil, 2019). These elements have facilitated the exemplification of the company’s commitment to supporting the communities within which it operates through education and economic empowerment, the provision of infrastructure, human capacity development, and health.

ExxonMobil’s Operations in the United Kingdom and Market Structure Analysis

Under the upstream division, ExxonMobil’s operations in the United Kingdom have involved activities such as the exploration and production of petroleum. Specifically, ExxonMobil holds or owns an average of 0.6 million acres (2,400 km2) of the land on the United Kingdom’s offshore. Across this vast property, ExxonMobil exploration activities have involved emphasis on the identification, acquisition, and evaluation of new oil and gas resources (ExxonMobil, 2019). As of 2019, ExxonMobil’s production activities entailed targeting approximately 40 production offshore oil and gas fields along the North Sea. Majority of the areas in which the company had targeted were operated by Shell U.K., boosting explorative and production operations as part of a collaborative effort (ExxonMobil, 2019). The code of practice applied in access the oil and gas infrastructure within the United Kingdom entails a voluntary agreement put in place by Oil & Gas UK in consultation with the Depart of Business, Energy, and Industrial Strategy (BEIS).

ExxonMobil’s operations in the United Kingdom have facilitated it rise in rankings as the largest oil pipeline distribution network, with approximately 700 kilometres of pipeline. Most of the United Kingdom’s refinery products are transported by pipeline to distribution terminals at Avonmouth, Birmingham, Hythe, Purfleet, and West London. The remaining products are transported by road or sea (ExxonMobil, 2019). In 2015, ExxonMobil invested £254 million in the United Kingdom North Sea, boosting its responsibility to an average of 5% of the oil and gas produced in the country. This investment and production activities further supplied the United Kingdom and other global markets with approximately 80,000 barrels of oil and approximately 441 million cubic feet of gas daily. Best known for its famous brands, Esso and Mobil, ExxonMobil remains the largest retailer in petrol across the United Kingdom. Thus, it serves around 800,000 customers daily through its retail network that comprises 1,100 Esso-branded service stations. Through its principal subsidiary in the United Kingdom, Esso, ExxonMobil is one of the largest offshore industry investors (FocusEconomics, 2021). However, investments in the North Sea are managed through 50/50 joint operations with Shell.

ExxonMobil in India and Market Structure Analysis

Incorporated and registered in May 1996, ExxonMobil has its presence in India through its upstream, downstream, and chemical businesses. Its offices are located in Bengaluru, Gurgaon, Mumbai, New Delhi, and the National Capital Region.  The upstream division focuses on providing consultancy and support services ranging from LNG business development and marketing, natural gas and support exploration and production services. On the other hand, the downstream division distributes, sells, and markets Mobil-branded lubricants and specialties (Chart Industries, 2020). Specifically, the downstream business sector has marketed fuel and lubricants in India since 1995 under the Mobil brand through operations such as importation of base oils, lubricant oil branding, packaging, and distribution and marketing. The chemical business is carried out as a service provider to other marketing agents for other ExxonMobil affiliates, facilitating imports and inland sales through distributors and directly to consumers and business analysis since 1986 (The Economic Times, 2021). For instance, in Bengaluru, ExxonMobil has a Technology Center that delivers development support. The business and the technical support centres provide various services for ExxonMobil’s operations worldwide.

ExxonMobil, operating as ExxonMobil Company India Private Limited, entails an Indian non-government firm with a private unlisted firm and a company listed by share. Specifically, ExxonMobil’s authorized capital in India stands at Rs 3500 lakhs and a 55.14429% paid-up capital (Rs 1930.05 lakhs). The last annual general meeting (AGM) for ExxonMobil Company India Private Limited was held on 29 September 2017. The company’s previous financial updates were done on 31 March 2017 as per the Ministry of Corporate Affairs (The Economic Times, 2021).

Comparative Analysis in the Major Macroeconomic Indicators

Indeed, a country’s gross domestic product (GDP) serves as a significant indicator of the national economy’s shape. In the United Kingdom, the gross domestic product (GDP) growth rate has portrayed levelling prospects in recent years after a lengthy period of the effects following the 2008 financial collapse (Monetary Policy Committee, 2020). With a constant increase in the population from 65.1 million to 66.9 million between 2015 and 2019, the nation’s GDP growth rate has significantly declined from 2.36% to 1.46% in the same period. However, projections indicate that the economy should recover this year following the potential easement of the effect of the Covid-19 pandemic and other monetary or fiscal boost. The decline in the UK’s GDP growth rate has been associated with numerous factors that include the Brexit disruption that continues to subject the nation to limitations in the access to the EU market and further indicates constraints over the growth momentum (Qiang & Kusek, 2020). The catastrophic events associated with the exit from the EU, coupled with the prolonged social distancing measures brought along the Covid-19 pandemic, have posed, and continue to pose, downside risks.

Nonetheless, the economy is expected to expand by approximately 6.0% in 2021. Following this trend, the GDP per capita at constant prices between 2015 and 2019 was USD 45 001 and USD 42 294, respectively. Though the trend portrays an increase, the rate has fluctuated exponentially, and similar patterns have been observed between 2020 and 2021 (Trading Economics, 2020).

More precisely, between 2020 and 2021, the UK’s GDP growth rate stands at an moderate rate of 1.0% from 16.1% in the third quarter. Similarly, the inflation rate, based on an annual variation of the consumer price index (CPI), in the United Kingdom was approximately 1.79% as of 2019 as compared to the previous years (See Appendix below) (FocusEconomics, 2021). Following this trend, the unemployment rate, based on the active population percentage, stood at 3.8% in 2019, a decline from 5.4% in 2015 and 4.1% in 2018. Nevertheless, the policy interest rate applied in the United Kingdom averaged at 0.75% between 2018 and 2019, while the general government’s balance (fiscal balance calculated as a percentage of the GDP) in the same period declined by 2.1% (-2.1%), indicating a steady decline between 2015 and 2019 (US Department of State, 2020). During this period, the balance of payments stood at -129.7 GBP billion in 2019, a slight increase from -139.4 GBP billion in 2018. Based on an average period (aop), the UK’s exchange rate has portrayed volatility in recent years amid political turmoil regarding Brexit and debate over when formal negotiations should be initiated with the European Union. In 2019, the exchange rate averaged 1.33 GBP per USD, a slight increase from 1.28 in 2018 (FocusEconomics, 2021).

In India, the GDP growth rate declined from 6.1% in 2018 to approximately 4.8% in 2019. This slowed growth depicted a significant reduction in consumption across the private sector, manufacturing, construction, and agriculture activity. Moreover, the stock of foreign direct investment (FDI) in India experienced a decline since 2019, mirroring a similar decline in India’s private investment (Shroff, Pandey, & Nijhawan, 2021). During this period, the substantial increase in demographics indicated that India should have generated millions of job opportunities annually. However, based on the informal economy’s large size, India’s unemployment rate rose exponentially to 5.36%, a 0.03% increase from 2018 at 5.33%. Following this pattern, the GDP per capita at constant prices in 2019 stood at USD 2,113, increasing from USD 2,023 in 2018 (FocusEconomics, 2021). During the same period, India’s inflation rate amounted to 4.76%, considering the increase in price across commonly consumed commodities.

Simultaneously, India’s monetary policy interest rate in 2019 was 4.40%, a decline from 6.25% in the previous year, while general government balances during this period were USD -57 billion. Similarly, the balance of payments in 2019 stood at USD -153.5 billion, while the exchange rates in India were 70.91 vs. USD on an average period (aop) and as a percentage of the GDP (US Department of State, 2020).

Macroeconomic Indicator in 2019 United Kingdom India
GDP Growth rate 1.46% 4.8%
GDP per capita at constant prices USD 42,294 USD 2,113
Inflation Rate (CPI) 1.79% 4.76%
Unemployment Rate 3.8% 5.36%
Interest Rate Monetary Policy rate 0.75% 4.40%
General government balances -2.1% of GDP USD -57 billion
Balance of Payments -129.7 GBP billion -153.5 USD billion
Exchange rate 1.33 GBP per USD 70.91 vs. USD on an average period (aop)

Monetary and Fiscal Policy Analysis and their Impact on ExxonMobil’s Economic Activity

ExxonMobil’s results in the economy in each country are vulnerable to various threats embedded in the global oil, gas, and petrochemical businesses. Most of these threats extend beyond the ability or control of the company and pose adverse effects to its business operations and financial condition. Specifically, the country’s economic conditions in which ExxonMobil operates may lead to undesired effects on its operations due to various factors. Among the top factors include the increase in demand for energy and petrochemicals, directly associated with expansive activities and prosperity levels (World Bank Group, 2020). However, when recessions occur or other instances characterized by negative or low economic growth tends to impact ExxonMobil’s economic activities and operations directly. Additional components that adversely impact the company’s economic conditions and activities and the country of operation include changes in the rate of population growth, civil upheaval, austerity programs put forth by the government, trade tariffs, public health or security concerns, or fluctuations in the exchange rate on the currency (Shroff, Pandey, Nijhawan, 2021). Their impact occurs due to changes in the demand for energy and petrochemicals.

Thus, these factors are coupled with other aspects that include downgrading debt within the sovereign nation, limitations to accessing debt markets following legal constraints, and restructuring of monetary, fiscal, or political systems such as the European Union.  These components impair the functionality of the financial markets and the nation, in general, (Qiang & Kusek, 2020). They collectively pose different threats to ExxonMobil, including predisposing the company to the security risks to its financial assets and that of its customers and partners in terms of their ability to fulfil their dedication to the firm. For instance, due to the Brexit movement in the United Kingdom, the policy interest rate has since 2018 stagnated at 0.75% due to the ongoing debate and the uncertainty of its monetary, fiscal, and political restructuring economy. Moreover, the outbreak of the Covid-19 pandemic has brought along unforeseen effects to the world by limiting movements, requiring social distancing measures, and locking down businesses within countries. These events have contributed to a continuous decline in the country’s inflation rate (-1.79% by 2019) and an unemployment rate at 76.6% (Trading Economics, 2020).

Similarly, the Indian market is characterized by various factors that may affect ExxonMobil’s economic activities. For instance, when the World Bank anticipates that the rate of inflation may fall below the government’s targeted level (2%), the growth of the economy tends to be slow down. At the same time, the economy faces a recession. As a result, interest rates are strategically reduced (loose monetary policy effect) (World Bank Group, 2020). Alternatively, suppose the world bank anticipates a rapid growth in the economy and inflation may exceed the government’s targeted level, its increase interest rates to regulate economic growth and further minimize pressure related to inflation, the tight monetary policy effect. In the latter case, an increase in the interest rate leads to a decline in consumer expenditure and investment, resulting in inflation. As of 2019, India’s policy interest rate stood at 4.76%, an increase from 3.4% in the previous year.

Akin to India’s case, the UK has faced similar incidents in the interest rate, leading to potential threats to ExxonMobil’s economic activities since an increase in the interest rate hinders consumer spending and investment lower inflation rate (US Department of State, 2020). The company’s performance in the economy is predisposed to adverse effects due to inflation and interest rate changes, fluctuations in the currency exchange rate, and other market condition at the local and regional levels.

Analysis of the Foreign Trade Policy Instruments and their impact on ExxonMobil’s Economic Activity

Undoubtedly, political and governmental activities can adversely affect ExxonMobil’s economic activities through limitations in the accessibility in its oil and gas resources. For instance, limiting foreign investments in the oil and gas sector lead to a significant boost in the price of the commodities, especially when national governments do not portray any need for capital from external sources (Monetary Policy Committee, 2020). Specifically, a decrease in the aggregate demand leads to the government cutting expenditure (G) and increasing taxes. The increase in taxes reduces consumer spending, and the fiscal policy’s rigidity will cause an improvement in the government budget deficit. However, when faced with situations that lead to an increase in the aggregate demand, the government tends to increase its expenditure and further cut taxes. By lowering taxes, consumer expenditure increases exponentially due to the rise in their disposable income, which, in turn, worsens the government budget deficit and the need to increasing borrowing (Qiang & Kusek, 2020).

Following the Covid-19 pandemic, the UK and India have pursued expansionary fiscal policies to stabilize and sustain operations within the country. As a result, both governments have been forced to cut VAT to boost consumer spending, translating into a significant increase in government borrowing (Trading Economics, 2020). The increased borrowing has lowered the countries’ currency value, leading to fluctuations in the currency exchange rate. For instance, by the end of 2019, the UK’s exchange rate averaged at 1.33 GBP per USD, while India was 70.91 per USD on an average period (FocusEconomics, 2021).

 

Limitations in the Case Study and Recommendations

Although much of the information is available on different sources, it is quite challenging to determine their validity and reliability. Besides, verifying the data presented in these sources is a cumbersome and time-consuming task that requires in-depth analysis and comparison of the information from the country’s or company’s website and physical records. Another limitation arises when these companies fail to voluntarily produce their data in fear that such disclosure may expose competitively sensitive commercial information, leading to violation of non-disclosure laws. To address these challenges, it would be important to seek the relevant information from the recommended sources that range from government sites, publicly released data from the company, and publications on the recent activities.

 

 

Conclusion

Despite its success in different countries, ExxonMobil, akin to other international organizations, is faced with numerous challenges characterized by monetary, fiscal, and political changes or restructuring within the country of operation. These changes bring along limitations to the local and foreign expenditure that further culminate in changes in the interest and exchange rates based on the people and businesses’ ability to spend their income on different products. Most fundamentally, government and political factors significantly affect ExxonMobil’s economic activities. They lead to adverse effects that affect operations, limit access to various commodities and services, and put laws and sanctions that prohibit the company from doing business in some countries.

References

Chart Industries. (2020, February 24). ExxonMobil, Indian oil, and chart industries pioneer virtual gas pipelines for India. GlobeNewswire News Room. https://www.globenewswire.com/news-release/2020/02/24/1989074/0/en/ExxonMobil-Indian-Oil-and-Chart-Industries-to-Pioneer-Virtual-Gas-Pipelines-for-India.html

The Economic Times. (2021, January 16). Information – Company profile: ExxonMobil Company India Private Limitedhttps://economictimes.indiatimes.com/company/exxonmobil-company-india-private-limited-/U45303MH1996PTC099555

ExxonMobil. (2019, May 9). UK operations | ExxonMobil United Kingdomhttps://www.exxonmobil.co.uk/Company/Overview/UK-operations

ExxonMobil. (2019, May 9). Operations overviewhttps://www.exxonmobil.co.uk/Company/Overview/UK-operations/Operations-overview

FocusEconomics. (2021). United Kingdom economy – GDP, inflation, CPI, and interest rate. FocusEconomics | Economic Forecasts from the World’s Leading Economists. https://www.focus-economics.com/countries/united-kingdom

FocusEconomics. (2021). India’s economy – GDP, inflation, CPI, and interest rate. FocusEconomics | Economic Forecasts from the World’s Leading Economists. https://www.focus-economics.com/countries/india

Monetary Policy Committee. (2020, August). Monetary Policy at the Bank of England. Bank of England. https://www.bankofengland.co.uk/-/media/boe/files/monetary-policy-report/2020/august/monetary-policy-report-august-2020

Press Trust of India. (n.d.). Exxon Mobil in talks to buy a stake in Indian oil, gas fields: Pradhan. Business News, Finance News, India News, BSE/NSE News, Stock Markets News, Sensex NIFTY, Latest Breaking News Headlines. https://www.business-standard.com/article/pti-stories/exxon-mobil-in-talks-to-buy-stake-in-indian-oil-gas-fields-pradhan-120120200539_1.html

Qiang, C. Z., & Kusek, P. (2020). Global Investment Competitiveness Report 2019/2020. https://doi.org/10.1596/978-1-4648-1536-2

Shroff, S. S., Pandey, R. K., & Nijhawan, V. (2021). Investing in India. Thomson Reuters. https://uk.practicallaw.thomsonreuters.com/7-596-0585?transitionType=Default&contextData=(sc.Default)&firstPage=true

Trading Economics. (2020). United Kingdom GDP growth rate | 1955-2020 data | 2021-2022 forecast | Calendar. TRADING ECONOMICS | 20 million INDICATORS FROM 196 COUNTRIES. https://tradingeconomics.com/united-kingdom/gdp-growth

US Department of State. (2020, December 4). Custom Report Excerpts: United Kingdom Bureau of Economic and Business Affairs. United States Department of State. https://www.state.gov/report/custom/9617a81391-16/

US Department of State. (2020, September 4). 2020 Investment Climate Statements: India. United States Department of State. https://www.state.gov/reports/2020-investment-climate-statements/india/

World Bank Group. (2020). Rebuilding Investor Confidence in Times of Uncertainty- Global Investment Competitiveness Report 2019/2020. 2020 International Bank for Reconstruction and Development / The World Bank.
https://openknowledge.worldbank.org/bitstream/handle/10986/33808/9781464815362.pdf?sequence=4&isAllowed=y

Appendices

Evidence-based Practices

Evidence-based Practices

Evidence-based Practices

Smoking among individuals diagnosed with schizophrenia poses serious health concerns, including smoking-related difficulties, cardiovascular complications, and premature deaths, considering their less likelihood of smoking cessation. Approximately 65 percent of schizophrenia populations engage in smoking than the general population individuals diagnosed with other psychiatric disorders (Lum, Skelton, Wynne & Bonevski, 2018). Smokers diagnosed with schizophrenia are likely to die prematurely 20 years less than the general population. Despite the efforts undertaken in promoting self-medication for outpatient schizophrenia patients, the considerable deterioration in the health of individuals points to the need for establishing the efficacy of education and awareness. As a mental health practitioner, it is critical to develop and enhance appropriate strategies to promote healthy living in creating awareness through education in enhancing smoking cessation among schizophrenia outpatients (Smith et al., 2019).

POI Significance

Mental health practitioners play a critical role in the diagnosis while promoting the adoption of behavioral therapy in reducing the vulnerability of mentally ill patients. The mental health practitioners undertake a proactive approach towards advancing pharmacological and psychological treatment for patients with diverse underlying mental health illnesses and diseases. Across the world, schizophrenic patients often indulge in tobacco smoking, necessitating mental health practitioners to evaluate, assess, and develop awareness programs to promote smoking cessation among the outpatients. The increase in the smoking patterns among schizophrenic outpatients heightens the need for promoting the cognizance among schizophrenia patients in promoting positive health outcomes. Through an individualized assessment of the patient’s risk factors, mental health practitioners promote facilitators to smoking cessation through behavioral interventions (Lum et al. 2018). While considering the diversity of factors that impact schizophrenia patients and the ease of accessing tobacco, mental health practitioners undertake to promote self-determination and independence of outpatients to reduce their risk of mortality.

Many schizophrenic outpatients are reported with diverse medical conditions, further increasing their risk of premature deaths. As a mental health nurse and practitioner, it is critical to enlighten the outpatients on the benefits of avoiding smoking in living normal healthy lives. While the structural measures will include the collaboration between the mental health practitioner and families in promoting social support, the process outcomes will involve continuous visits and determination of progress towards smoking cessation among schizophrenic patients. The implementation of change will involve the promotion of knowledge relating to the risks of smoking over a given period while encouraging self-reported adherence among the outpatients.

Besides, the initiation of vigorous programs would endeavor to inform patients on the underlying risks associated with smoking despite the underlying notion of self-medication and therapy (Gogos et al., 2019). For instance, it would be critical to promote psychosocial therapies, including motivational interviewing, interventions incorporating educational sessions within their communities, and social support for reducing the impacts of the withdrawal symptoms arising from smoking cessation. Thus, the outcome measures will determine the number of self-reported adherence among schizophrenic patients undertaking effective self-adherence directives and cases of hospital readmission due to smoking-related complications.

 

 

PICO

P:  Schizophrenic smoking adults

I:  Implementing education and awareness through education on the effectiveness of smoking cessation among adult schizophrenia patients, including educational programs and self-reporting on adherence.

C: Compared to the schizophrenic persons who continue to smoke and receive pharmacotherapy treatment and medications.

O: effectiveness, adequacy, and timeliness in preventing and detecting depression through screening of the patients, involvement of family members, and psychoeducation 

 Clinical Question: In schizophrenic smoking adults (P), is the implementation of awareness through education on the effectiveness of smoking cessation among adult schizophrenia patients in outpatient (I) more effective (O) compared to the schizophrenic persons who continue to smoke and receive pharmacotherapy treatment and medications?

Critique of Guideline/Position Statement:

The position statement ‘Exploring mental health professionals’ practice concerning smoke-free policy within a mental health trust was utilized to provide an insight on the awareness through education on the effectiveness of smoking cessation among adult schizophrenia patients in outpatient. The guideline provided an opportunity to determine how best the mental health practitioners would impact smoking cessation among schizophrenia patients. The authors provided a straightforward approach in determining evidence-based practice to reduce the prevalence of schizophrenia smokers with a focus on adult smokers. The recommendations generally focused on developing awareness among mental health practitioners to boost the positive prospects of achieving reduced rates of smoking-related conditions among schizophrenia patients (Smith, McNeill, Kock & Shahab, 2019). The clinical guideline focused on enhancing the mental health professional practice and experience in developing programs and policies as part of the mental health sensitization for workers in outpatient settings.

The study’s recommendations point to the need to improve the psychological capacity of mental health workers in promoting resilience among schizophrenia adult patients through the guideline. The recommendation enhances the clarity in the role of mental health practitioners while providing a basis for the determination of appropriate standard practices for schizophrenic adult smokers. Additionally, the guideline highlights the need to reduce the environmental and social facilitators that could improve the accessibility of cigarettes and tobacco for schizophrenia patients. While confirming the underlying ideology involving smoking in alleviating the schizophrenic patient conditions, the authors point to the negative implications of raising awareness and appropriate education among schizophrenia smokers in reducing their indulgence in alcohol consumption (Smith, McNeill, Kock & Shahab, 2019). Besides, the authors evaluate the role of mental health practitioners in the initiation and adherence to a smoke-free policy in advancing positive health outcomes among schizophrenic smokers.

Elsewhere, the authors provide credible information appertaining to their practice by involving different groups of mental health practitioners from healthcare institutions obtained from purposive sampling in validating the research findings. The thematic data analysis through the predefined codes for assessing the perception and best practices for achieving positive education and awareness in smoking policy adherence focused on developing evidence-based practice to advance mental health practice. The researchers recognized the need to undertake mental health training regarding smoking-free policies, which increased their ability to encourage commitment among schizophrenic adult individuals to cease their smoking behavior (Smith, McNeill, Kock & Shahab, 2019). In supporting the findings, the study appreciates other literature and research findings in authenticating their thematic assertions and, consequently, the recommendations. The decision to utilize the guideline was to form a basis for crediting the quality of evidence highlighted in the recommendations. Indeed, the position statement appreciates its limitations, including the failure to include varied mental health practitioners and the potential for failing to incorporate the views of different practitioners within the mental healthcare outpatient settings.

Further, the researchers draw from varied theoretical underpinnings that provide the basis for justifying the role of training the mental health nurses in providing awareness and education for schizophrenia smokers. The evidence exemplifies the need to improve the training for mental health nurses as an approach to increasing their knowledge in providing education for schizophrenia smoking patients. The clinical guideline recommendations are moderate as they affirm the role of mental health practitioners in providing education for schizophrenia patients within the outpatient settings (Smith et al., 2019). With the recognition of the diverse social and environmental factors that play a critical role in promoting smoking among schizophrenia adults, the research tends to overlook the basis for customized education to promote adherence to the smoking-free policy. In general, the article is explicit in the role of mental healthcare workers in promoting positive health outcomes among schizophrenia individuals.

 

 

Quality improvement

As a mental health practitioner, the guideline would provide an opportunity for developing educational and awareness programs critical for enhancing smoking cessation among schizophrenia adults. The recommendations enhance a critical understanding and development of effective educational materials and policy implementations to improve outpatient outcomes. Indeed, the guideline would address the bioethical principles of autonomy and beneficence throughout the education of schizophrenia smokers. According to Bester (2020), beneficence involves the role of mental health nurses and practitioners in promoting the overall good of the patients. The guideline provides a basis for developing a positive outcome for schizophrenia patients.

The recommendations provide an improved approach towards advancing positive health outcomes for schizophrenia smokers through the beneficence ethical perspective. The beneficence principle would attempt to reduce the overall harm posed by smoking, thereby focusing on managing their conditions. Additionally, the guideline would promote the bioethical principle of autonomy of the patient. The bioethical principle of autonomy highlights the need for patients to make their decisions regarding treatment outcomes (Greaney & O’Mathúna, 2017). Patients are responsible for being involved throughout the care process, heightening the need for implementing the position statement and guidelines within the mental outpatient care settings. Since the guideline will involve providing education to schizophrenia adult smokers within the outpatient settings, the position statement would offer a chance for patients to exercise control over their conditions as opposed to the inpatient setting in which they would be required to adhere to customized pharmacotherapies designed by mental healthcare practitioners and nurses.

Conclusion

The efficacy of implementing education and awareness programs for schizophrenia adult smoking individuals depends on mental health practitioners’ ability to evaluate the diverse needs of the population effectively. While considering the increasing numbers of schizophrenia smoking adults, it is critical to developing suitable standards for enhancing smoking cessation through increasing their cognizance of the underlying problems and need for self-adherence to the educational programs. The effectiveness of the results would depend on the comparison between the number of schizophrenia smokers compared to those who did not receive the intervention. The guideline shows that most schizophrenia patients would enhance improvement as the intervention would endeavor to improve their health outcomes. The customized and periodic educational programs with the assistance of mental health nurses in outpatient settings would endeavor to develop a smoking cessation approach. Besides, the guideline will improve self-adherence with the educational programs for schizophrenia patients. The guideline would endeavor to develop the capacity of the schizophrenia smoking adults to make informed decisions regarding smoking cessation. The guideline provides an evidence-based practice approach for mental health nurses and practitioners in addressing the underlying needs of schizophrenia smokers within the outpatient settings.

 

References

Bester, J. C. (2020). Beneficence, interests, and wellbeing in medicine: What it means to benefit patients. The American Journal of Bioethics20(3), 53-62.

Gogos, A., Skokou, M., Ferentinou, E., & Gourzis, P. (2019). Nicotine consumption during the prodromal phase of schizophrenia – a review of the literature. Neuropsychiatric Disease and Treatment15, 2943-2958. https://doi.org/10.2147/ndt.s210199

Greaney, A. M., & O’Mathúna, D. P. (2017). Patient autonomy in nursing and healthcare contexts. In Key concepts and issues in nursing ethics (pp. 83-99). Springer, Cham.

Lum, A., Skelton, E., Wynne, O., & Bonevski, B. (2018). A systematic review of psychosocial barriers and facilitators to smoking cessation in people living with schizophrenia. Frontiers in Psychiatry9https://doi.org/10.3389/fpsyt.2018.00565

Smith, C. A., McNeill, A., Kock, L., & Shahab, L. (2019). Exploring mental health professionals’ practice in relation to smoke-free policy within a mental health trust: A qualitative study using the COM-B model of behaviour. BMC Psychiatry19(1). https://doi.org/10.1186/s12888-019-2029-3

Smoking as a public health issue

Smoking as a public health issue

Smoking appears to be one of the public health issues among those population who has been diagnosed with schizophrenia. I currently work as a mental health nurse practitioner in an outpatient setting. My Phenomenon of Interest is to bring awareness through education on the effectiveness of smoking cessation among adult schizophrenia patients in outpatient .

Step 1: Introduction
A good introduction should be no more than 1 paragraph grabbing the reader’s attention providing insight to the POI and significance to the APN’s role. End with a strong thesis or purpose statement. Note: the thesis should be condensed to 1 brief purpose statement.
Step 2: POI Significance:
Discuss why this POI is significant to your role as an APN. How will it change practice? Why did you select this topic? What expected structural, process OR outcome measures are you hoping to see with instituting a change in practice? To see a more thorough discussion on these measures, review the following information.
AHRQ Structural, Process or Outcome Measures- (Links to an external site.)this link provides an overview of process, structural and outcome measures. Be sure to specify the type of measure you would expect with your implementation of EBP into practice. You must show understanding of the measure itself in your discussion.
Step 3 PICO :
You will include a PICO framework AND the clinical question in this section. Follow these directions as specified.
Outline the PICO framework by listing (do not write in a paragraph format) P-population or patients, I-intervention, C-comparison, and O-outcomes as it relates to your POI. Then develop the clinical question by including all parts of the PICO framework in the question. Be as specific as possible in both the PICO framework development and clinical question and avoid phrases such as: “compared to the standard practice” , or “compared to the current practice” because faculty do not know what the normal practice or standard practice is at your facility.
EXAMPLE: Be sure to include a heading for this section i.e. PICO/Clinical Question.
PICO -center this heading p. 48-49 APA book
P: children in the acute care setting that are between 3 and 18 years of age, not including non-verbal children
I: implementation of non-pharmacologic pain interventions i.e. (art therapy, music, dim lights, etc.).
C: pharmacologic interventions (Tylenol, motrin, narcotics)
O: more effective at reducing pain as measured by decreased pain ratings on approved pain scales, stable vital signs, behavior
Clinical Question: In pediatric patients aged 3 years to 18 years (P) is the implementation of non-pharmacologic pain interventions (I) more effective (O) than pharmacologic interventions (C ) in reducing pain as evidence by: decreased pain ratings, stable vital signs, behavior assessments?
Step 4 Tool Completion:
To provide an overview of the guideline OR position statement use the tool below. You will need to address each question or section of the tool as it applies to the required information; missing information may cause you to lose points. You must submit the completed tool with the assignment. Please attach the completed tool separately to the assignment area. Faculty need to see your analysis of the guideline for full credit.
Evaluation tool for Guideline OR Position statement PDF
Evaluation Tool for Guideline OR Position Statement Word Document
Step 5 Critique of Guideline/Position Statement:
Critique the guideline or position statement by discussing ALL of the following and including appropriate support from your guideline/statement selection:
(1) purpose/aim of the recommendation/postition statement-are they clear, current and relevant to your population?
(2) Recommendations or objectives of the guideline/statement
(3) Who (authors, groups, organizations) developed the guideline/position statement and what biases or funding did they receive? Did the authors, groups or organization have a valued interest in the guideline, why or why not? Remember to consider the author’s role professionally as part of your answer.
(4) Describe if they information is credible and justify your answer. What makes information credible? Is their truth in the data, interventions recommended, or studies used to support recommendations, how do you know?
(5) What levels of evidence were used to support each recommendation statement-look at the studies and resources used to develop the guideline or position statement. What levels of evidence were these resoruces/studies? Are those individual studies/resources of strong or weak on the evidence hierarchy? How do you know and does it influence the overall recommentation or guideline?
(6) Based on the level of evidence used to support the recommendation statements, is the overall quality of that evidence high/low and how does that influence your decision to implement this recommendation or practice guideline into your practice? Fully support with evidence from the literature.
Step 6 Quality Improvement:
Explain how this guideline or position statement would impact uality improvement by addressing 2 of the bioethical principles: justice, autonomy, beneficience, or nonmalficence. Students must demonstrate full understanding of each principle discussed.
Step 7 Conclusion:
Conclude the entire paper by summarizing each section. Do not repeat what you did in the paper, but summarize the findings. Never include new findings in the conclusion.
Step 8 Guideline/Position Statement Link or Attachment:
Include a direct and working link to the guideline or Position Statement. after the conclusion. Option: If you are having difficulty providing a direct link, you may provide a hard copy of the full guideline or position statement as an attachment or merged to the paper after the resources. Faculty must be able to have full and direct access to your guideline or position statement to determine if you selected and analyzed accordingly on your tool to receive full credit. See format example below:
Guideline/Position Statement Link – center this heading p. 48-49 in the APA book
https://www.guidelinecentral.com/summaries/best-evidence-statement-best-support-from-bedside-nurses-for-caregivers-of-children-newly-diagnosed-with-type-1-diabetes-mellitus/
OR use the following info.:
Guideline/Position Statement Link – center this heading p. 48-49 in the APA book
See guideline/position statement submitted with paper or merged to the paper

 

 

Evidence-based Practices
Evidence-based Practices
Smoking among individuals diagnosed with schizophrenia poses serious health concerns, including smoking-related difficulties, cardiovascular complications, and premature deaths, considering their less likelihood of smoking cessation. Approximately 65 percent of schizophrenia populations engage in smoking than the general population individuals diagnosed with other psychiatric disorders (Lum, Skelton, Wynne & Bonevski, 2018). Smokers diagnosed with schizophrenia are likely to die prematurely 20 years less than the general population. Despite the efforts undertaken in promoting self-medication for outpatient schizophrenia patients, the considerable deterioration in the health of individuals points to the need for establishing the efficacy of education and awareness. As a mental health practitioner, it is critical to develop and enhance appropriate strategies to promote healthy living in creating awareness through education in enhancing smoking cessation among schizophrenia outpatients (Smith et al., 2019).
POI Significance
Mental health practitioners play a critical role in the diagnosis while promoting the adoption of behavioral therapy in reducing the vulnerability of mentally ill patients. The mental health practitioners undertake a proactive approach towards advancing pharmacological and psychological treatment for patients with diverse underlying mental health illnesses and diseases. Across the world, schizophrenic patients often indulge in tobacco smoking, necessitating mental health practitioners to evaluate, assess, and develop awareness programs to promote smoking cessation among the outpatients. The increase in the smoking patterns among schizophrenic outpatients heightens the need for promoting the cognizance among schizophrenia patients in promoting positive health outcomes. Through an individualized assessment of the patient’s risk factors, mental health practitioners promote facilitators to smoking cessation through behavioral interventions (Lum et al. 2018). While considering the diversity of factors that impact schizophrenia patients and the ease of accessing tobacco, mental health practitioners undertake to promote self-determination and independence of outpatients to reduce their risk of mortality.
Many schizophrenic outpatients are reported with diverse medical conditions, further increasing their risk of premature deaths. As a mental health nurse and practitioner, it is critical to enlighten the outpatients on the benefits of avoiding smoking in living normal healthy lives. While the structural measures will include the collaboration between the mental health practitioner and families in promoting social support, the process outcomes will involve continuous visits and determination of progress towards smoking cessation among schizophrenic patients. The implementation of change will involve the promotion of knowledge relating to the risks of smoking over a given period while encouraging self-reported adherence among the outpatients.
Besides, the initiation of vigorous programs would endeavor to inform patients on the underlying risks associated with smoking despite the underlying notion of self-medication and therapy (Gogos et al., 2019). For instance, it would be critical to promote psychosocial therapies, including motivational interviewing, interventions incorporating educational sessions within their communities, and social support for reducing the impacts of the withdrawal symptoms arising from smoking cessation. Thus, the outcome measures will determine the number of self-reported adherence among schizophrenic patients undertaking effective self-adherence directives and cases of hospital readmission due to smoking-related complications.

PICO
P: Schizophrenic smoking adults
I: Implementing education and awareness through education on the effectiveness of smoking cessation among adult schizophrenia patients, including educational programs and self-reporting on adherence.
C: Compared to the schizophrenic persons who continue to smoke and receive pharmacotherapy treatment and medications.
O: effectiveness, adequacy, and timeliness in preventing and detecting depression through screening of the patients, involvement of family members, and psychoeducation
Clinical Question: In schizophrenic smoking adults (P), is the implementation of awareness through education on the effectiveness of smoking cessation among adult schizophrenia patients in outpatient (I) more effective (O) compared to the schizophrenic persons who continue to smoke and receive pharmacotherapy treatment and medications?
Critique of Guideline/Position Statement:
The position statement ‘Exploring mental health professionals’ practice concerning smoke-free policy within a mental health trust was utilized to provide an insight on the awareness through education on the effectiveness of smoking cessation among adult schizophrenia patients in outpatient. The guideline provided an opportunity to determine how best the mental health practitioners would impact smoking cessation among schizophrenia patients. The authors provided a straightforward approach in determining evidence-based practice to reduce the prevalence of schizophrenia smokers with a focus on adult smokers. The recommendations generally focused on developing awareness among mental health practitioners to boost the positive prospects of achieving reduced rates of smoking-related conditions among schizophrenia patients (Smith, McNeill, Kock & Shahab, 2019). The clinical guideline focused on enhancing the mental health professional practice and experience in developing programs and policies as part of the mental health sensitization for workers in outpatient settings.
The study’s recommendations point to the need to improve the psychological capacity of mental health workers in promoting resilience among schizophrenia adult patients through the guideline. The recommendation enhances the clarity in the role of mental health practitioners while providing a basis for the determination of appropriate standard practices for schizophrenic adult smokers. Additionally, the guideline highlights the need to reduce the environmental and social facilitators that could improve the accessibility of cigarettes and tobacco for schizophrenia patients. While confirming the underlying ideology involving smoking in alleviating the schizophrenic patient conditions, the authors point to the negative implications of raising awareness and appropriate education among schizophrenia smokers in reducing their indulgence in alcohol consumption (Smith, McNeill, Kock & Shahab, 2019). Besides, the authors evaluate the role of mental health practitioners in the initiation and adherence to a smoke-free policy in advancing positive health outcomes among schizophrenic smokers.
Elsewhere, the authors provide credible information appertaining to their practice by involving different groups of mental health practitioners from healthcare institutions obtained from purposive sampling in validating the research findings. The thematic data analysis through the predefined codes for assessing the perception and best practices for achieving positive education and awareness in smoking policy adherence focused on developing evidence-based practice to advance mental health practice. The researchers recognized the need to undertake mental health training regarding smoking-free policies, which increased their ability to encourage commitment among schizophrenic adult individuals to cease their smoking behavior (Smith, McNeill, Kock & Shahab, 2019). In supporting the findings, the study appreciates other literature and research findings in authenticating their thematic assertions and, consequently, the recommendations. The decision to utilize the guideline was to form a basis for crediting the quality of evidence highlighted in the recommendations. Indeed, the position statement appreciates its limitations, including the failure to include varied mental health practitioners and the potential for failing to incorporate the views of different practitioners within the mental healthcare outpatient settings.
Further, the researchers draw from varied theoretical underpinnings that provide the basis for justifying the role of training the mental health nurses in providing awareness and education for schizophrenia smokers. The evidence exemplifies the need to improve the training for mental health nurses as an approach to increasing their knowledge in providing education for schizophrenia smoking patients. The clinical guideline recommendations are moderate as they affirm the role of mental health practitioners in providing education for schizophrenia patients within the outpatient settings (Smith et al., 2019). With the recognition of the diverse social and environmental factors that play a critical role in promoting smoking among schizophrenia adults, the research tends to overlook the basis for customized education to promote adherence to the smoking-free policy. In general, the article is explicit in the role of mental healthcare workers in promoting positive health outcomes among schizophrenia individuals.

Quality improvement
As a mental health practitioner, the guideline would provide an opportunity for developing educational and awareness programs critical for enhancing smoking cessation among schizophrenia adults. The recommendations enhance a critical understanding and development of effective educational materials and policy implementations to improve outpatient outcomes. Indeed, the guideline would address the bioethical principles of autonomy and beneficence throughout the education of schizophrenia smokers. According to Bester (2020), beneficence involves the role of mental health nurses and practitioners in promoting the overall good of the patients. The guideline provides a basis for developing a positive outcome for schizophrenia patients.
The recommendations provide an improved approach towards advancing positive health outcomes for schizophrenia smokers through the beneficence ethical perspective. The beneficence principle would attempt to reduce the overall harm posed by smoking, thereby focusing on managing their conditions. Additionally, the guideline would promote the bioethical principle of autonomy of the patient. The bioethical principle of autonomy highlights the need for patients to make their decisions regarding treatment outcomes (Greaney & O’Mathúna, 2017). Patients are responsible for being involved throughout the care process, heightening the need for implementing the position statement and guidelines within the mental outpatient care settings. Since the guideline will involve providing education to schizophrenia adult smokers within the outpatient settings, the position statement would offer a chance for patients to exercise control over their conditions as opposed to the inpatient setting in which they would be required to adhere to customized pharmacotherapies designed by mental healthcare practitioners and nurses.
Conclusion
The efficacy of implementing education and awareness programs for schizophrenia adult smoking individuals depends on mental health practitioners’ ability to evaluate the diverse needs of the population effectively. While considering the increasing numbers of schizophrenia smoking adults, it is critical to developing suitable standards for enhancing smoking cessation through increasing their cognizance of the underlying problems and need for self-adherence to the educational programs. The effectiveness of the results would depend on the comparison between the number of schizophrenia smokers compared to those who did not receive the intervention. The guideline shows that most schizophrenia patients would enhance improvement as the intervention would endeavor to improve their health outcomes. The customized and periodic educational programs with the assistance of mental health nurses in outpatient settings would endeavor to develop a smoking cessation approach. Besides, the guideline will improve self-adherence with the educational programs for schizophrenia patients. The guideline would endeavor to develop the capacity of the schizophrenia smoking adults to make informed decisions regarding smoking cessation. The guideline provides an evidence-based practice approach for mental health nurses and practitioners in addressing the underlying needs of schizophrenia smokers within the outpatient settings.

References
Bester, J. C. (2020). Beneficence, interests, and wellbeing in medicine: What it means to benefit patients. The American Journal of Bioethics, 20(3), 53-62.
Gogos, A., Skokou, M., Ferentinou, E., & Gourzis, P. (2019). Nicotine consumption during the prodromal phase of schizophrenia – a review of the literature. Neuropsychiatric Disease and Treatment, 15, 2943-2958. https://doi.org/10.2147/ndt.s210199
Greaney, A. M., & O’Mathúna, D. P. (2017). Patient autonomy in nursing and healthcare contexts. In Key concepts and issues in nursing ethics (pp. 83-99). Springer, Cham.
Lum, A., Skelton, E., Wynne, O., & Bonevski, B. (2018). A systematic review of psychosocial barriers and facilitators to smoking cessation in people living with schizophrenia. Frontiers in Psychiatry, 9. https://doi.org/10.3389/fpsyt.2018.00565
Smith, C. A., McNeill, A., Kock, L., & Shahab, L. (2019). Exploring mental health professionals’ practice in relation to smoke-free policy within a mental health trust: A qualitative study using the COM-B model of behaviour. BMC Psychiatry, 19(1). https://doi.org/10.1186/s12888-019-2029-3

Professional Standards Policing

Professional Standards Policing

The Ontario Civilian Police Commission (OCPC or “Commission”) has a diverse mandate consisting primarily of hearing appeals of police disciplinary matters. Under the Police Services Act, the Commission also has the authority to accept and adjudicate a number of different appeals and applications.

Disciplinary Hearings

Under the Police Services Act, disciplinary hearings are conducted by the police services. The outcome of the hearing is decided by a hearing officer. A hearing officer is designated by the chief of police or Ontario Provincial Police Commissioner, who is also responsible for discipline. At a disciplinary hearing, the hearing officer must decide whether the allegations of misconduct have been proven on clear and convincing evidence.

OCPC Appeal Process

A respondent officer and a complainant may appeal a hearing officer’s decision to the OCPC within 30 days of receiving the decision.

The Assignment

Please visit the following website: https://www.canlii.org/en/on/oncpc/ or Google ‘OCPC’ and then click on ‘Decisions’ and follow the directions from there.

From the list of cases/decisions, pick one you find interesting from 2020 or 2019.

• Provide a synopsis of the decision and highlight the arguments being put forward
• Look up the case law referenced in the decision. Provide a summary of the case law and comment as to whether or not you think the case law is good/relevant to the decision.
• Provide your opinion – do you agree with the ruling in the appeal or not.
• 750 to 1000 words

Professional standards – Policing, Synopsis of the decision
Constable Adam Campoli was the appellant versus the Toronto Police service as the respondent, with the Independent Police Review Director as the intervener and Mr. John as the public complainant. The case had been determined by Superintendent Riyaz Hussein on the 6th December 2019, implicating Constable Campoli of one count in contravention of the Code of conduct (Campoli v. Toronto Police Service, 2020). The case is an appeal in which the appellant Adam Campoli was guilty of Discreditable Conduct contrary to the provisions of the police code of conduct through abusive words and demeaning language against John, who had lost his vehicle. In the appeal case, the appellant justifies using his language within the context in which Mr. John had reported the situation involving the location of his stolen car. Constable Campoli had acted in information regarding a gun’s potential in the vehicle’s location while also acting from information relating to John’s conduct against the police in the past. By comparing similar cases in the past involving police conduct, the intervener emphasizes the need to determine the context of Campoli’s language holistically throughout the vehicle recovery process instead of the objectification of the singular incident. Thus, the Intervener bases their decision on the Hearing Officer points out Campoli’s use of profane language and conduct to depict the police service’s role and actions negatively. While the Hearing Officer highlights the need for determining the case through an objective test of Campoli’s code of conduct, the analysis asserts the potential for a discrepancy in considering his actions within the situation. Nonetheless, the Intervener failed to take up a position on the appellant’s case given its diversity and nature (Campoli v. Toronto Police Service, 2020).

Referenced case laws
The case law references various past cases in providing a basis for the disposition and acquitting the appellant of the charges and initial verdict of guilt. First, it is apparent the parties reference the Mulville and Azaryev and York Regional Police Service, asserting the justification for determining the officer’s conduct (Campoli v. Toronto Police Service, 2020). In this case, the objective test enhances the defense for implicating the officer, Mr. P.C. Mulville, of the charges. In the second reference case involving Mulligan v. Ontario Provincial Police, the commission emphasizes the police responsibility of engaging in justifiable conduct (Campoli v. Toronto Police Service, 2020). In all the cases involving the police officers as referenced affirming their Discreditable behavior, the decision tends to implicate officers in upholding the integrity and ethical responsibility towards managing diverse situations and circumstances during their operations (Code of Conduct, 2020). The intervener further considers the case involving the Saxon vs. Amherstburg of 2011 as a significant contribution to police officers’ Discreditable Conduct. Through the case, it is evident that the primary objection needs to consider assessing the reasonable expectation of police conduct during any confrontations or engagements within their communities.
Indeed, the appeal decision fails to effectively apply the previous case references evaluating police officers’ conduct concerning their conduct. In the appeal case by Campoli, it is evident that the interpreter tends to eliminate the objective clause and test in establishing the potential harm the officer could pose to the police service. Further, the commission fails to consider the public complainant’s circumstances in asserting their decision implying the possible falsehood in their submissions’ nature (Campoli v. Toronto Police Service, 2020). While discrediting the case based on its age and failure to serve the public interest, the interpreter through the commission assumes responsibility in faulting the complainant. Thus, it becomes apparent that the decision lacks a comprehensive outlook and incorporation of diverse aspects from previously references cases and circumstantial evidence utilized by the previous hearing officer in faulting Campoli’s actions.
Opinion
The appeal decision fails to consider the situation and nature of the appellant’s necessary actions to uphold in calming down the problem. While considering the evidence provided by Campoli’s colleague on duty during the incident, it is apparent the verdict tends to fault Mr. John, having provoked the officer to engage contrary to their expected behavior. Besides, the verdict’s provisions tend to substitute the need for reasonable conduct for the officer while highlighting the victim’s violent nature on hearsay instead of reliable evidence (Code of Conduct, 2020). The intervener agrees with the appellant without highlighting the general public’s perception of who might have been present during the incidence. Concerning the Discreditable code of police conduct, the decision negates the previous verdicts and judgments favoring the appellant based on their situation compared to upholding the police values (Code of Conduct, 2020). Despite faulting the appellant, the intervener gives a justification for acquitting their actions despite the police commission and public image’s impact. As such, I’m afraid I have to disagree with the ruling based on the similarity of the case to Mulville, Mulligan, and Monaghan, which point to the considerable similarities in the police violation of the stipulated codes conduct towards the public (Campoli v. Toronto Police Service, 2020).

References
Campoli v. Toronto Police Service. (2020, February 16). Campoli v. Toronto Police Service, 2020 ONCPC 11 (CanLII). Captcha | CanLII. https://www.canlii.org/en/on/oncpc/doc/2020/2020oncpc11/2020oncpc11.html
Code of Conduct. (2020, January 29). Code of Conduct, O Reg 445/19 (CanLII). Captcha | CanLII. https://www.canlii.org/en/on/laws/regu/o-reg-445-19/latest/o-reg-445-19.html

Process of research and development in the pharmaceutical industry.  

Process of research and development in the pharmaceutical industry.

  1. Explain the costs of the process of research and development in the pharmaceutical industry.
  2. How has the requirements of Research and Development and patent protection affected the structure of the industry?
  3. To what extent might these factors affect firms in developing a vaccine for Covid-19?

Appraising Qualitative Research – Self-Assessment of Program Learning Outcomes

Self-Assessment of Program Learning Outcomes

Self-Assessment

  • Identify the role of the professional nurse within the global healthcare delivery system
  • Use inter-and-intraprofessional communication and collaboration skills to optimize patient outcomes
  • Apply quality improvement methods to implement safety initiatives and patient outcomes effectively
Student Reflections:

As a professional nurse, I have endeavored to involve in the development and implementation of global health policies focused on improving patient care. While realizing the multiplicity of health issues, it has been possible to lobby for global health prioritization as a major concern through global health diplomacy. According to Reeves et al. (2017), inter-professional collaboration focusses on achieving great team performance as part of an approach towards achieving positive global health outcomes. Besides, I have focused on improving my approach to patient care to recognize the need to advance my communication and collaboration skills in enhancing positive health outcomes. My placement has offered an opportunity to establish a culture of safety and commitment to continuous improvement as a quality improvement method aimed at enhancing patient care.

 

 

·      Describe the impact historical nursing leaders have on the practice of nursing today

·      Describe the impact historical nursing leaders have on the practice of nursing today

·      Summarize the role expectations of the professional nurse

·      Examine the ethical and legal principles guiding professional nursing practice

·      Evaluate strategies to improve nursing care through synthesizing knowledge from nursing, humanities, sciences, and the arts as a basis for a personal philosophy of professional nursing

·      Apply quality improvement methods to implement safety initiatives and patient outcomes effectively

Student Reflections:

Historic nursing leaders have set the current nursing pace in advancing patients’ rights while pursuing evidence-based standard practices to achieve appropriate nursing care. As a professional nurse, I have focused on pursuing evidence-based practice, including upholding human dignity and patient’s integrity as part of the growing need for aligning with the previous theoretical underpinnings. Additionally, I have focused on advocating for implementing ethical principles and social justice as part of the overall goal of attaining positive global health outcomes. While recognizing the global need for sharing information in the nursing field, I have focused on developing a collaborative approach and framework to knowledge translation and implementing quality improvement programs across the healthcare environments.

 

Final Thoughts (Optional):

Student Reflections: Recommendations for further development/improvement, of course, to better meet these course and program outcomes.
Indeed, the course needs to embrace historical nursing practitioners’ specific involvement who greatly impacted the current nursing practice. Through the approach, it would be possible to improve one’s alignment with the specific nursing outcomes effectively.

 

 

References

Reeves, S., Pelone, F., Harrison, R., Goldman, J., & Zwarenstein, M. (2017). Interprofessional collaboration to improve professional practice and healthcare outcomes. Cochrane Database of Systematic Reviewshttps://doi.org/10.1002/14651858.cd000072.pub3

Capstone Change Project Outcomes Handwashing intervention

Capstone Change Project Outcomes Handwashing intervention

Capstone Change Project Outcomes

Handwashing intervention provides an opportunity for improving hygiene and good practices in promoting infection control within the healthcare environments. The development of measurable objectives enhances the realization of handwashing intervention in reducing hospital-acquired infections.

First objective

Comparing the number of hospital-acquired infections before and after the intervention would provide a basis for measuring its intended outcome. According to Haverstick et al. (2017), determining the effect of handwashing intervention in hospitals on the number of infection rates is a critical indicator and an evidence-based practice to evaluating its effectiveness relating to new infections in hospitals. The assessment of hospital-acquired infections over the implementation period would form a basis for either sustaining or avoiding its adoption within healthcare institutions.

Second objective

The determination of compliance within the healthcare environment is a measurable outcome for handwashing across different hospital care departments. While considering the need to reduce the length of hospital stay, the level of compliance among the healthcare workers and patients would provide an effective correlation to the impacts of the handwashing intervention (RN et al., 2017).

 

Third objective

The third objective would focus on appraising the number of healthcare institutions reporting improved knowledge on handwashing over the period of handwashing intervention. Healthcare reporting provides a basis for realizing patient understanding of the underlying problem, focusing on implementing appropriate evidence-based guidelines for its sustainability (Watson et al., 2019). The collaborative efforts in the inclusion of healthcare workers in the program intervention provide a basis for realizing measurable outputs relating to handwashing interventions.

Fourth objective

The fourth objective would compare handwashing intervention’s impacts compared to other control measures in reducing hospital-acquired infections. Additionally, control measures to reduce healthcare infections provide a variable perspective towards adopting handwashing with the multiplicity of interventions providing a basis for comparison (Al-Ansary et al., 2020). Thus, the intervention will establish the effectiveness of handwashing intervention compared to other interventions.

References

Al-Ansary, L., Bawazeer, G., Beller, E., Clark, J., Conly, J., Del Mar, C., Dooley, E., Ferroni, E., Glasziou, P., Hoffmann, T., Jefferson, T., Thorning, S., Van Driel, M., & Jones, M. (2020). Physical interventions to interrupt or reduce the spread of respiratory viruses. Part 2 – Hand hygiene and other hygiene measures: Systematic review and meta-analysis. https://doi.org/10.1101/2020.04.14.20065250

Haverstick, S., Goodrich, C., Freeman, R., James, S., Kullar, R., & Ahrens, M. (2017). Patients’ handwashing and reducing hospital-acquired infection. Critical Care Nurse37(3), e1-e8. https://doi.org/10.4037/ccn2017694

RN, O. D., Jones, D., Martello, M., Biron, A., & Lavoie-Tremblay, M. (2017). A systematic review on the effectiveness of interventions to improve hand hygiene compliance of nurses in the hospital setting. Journal of Nursing Scholarship49(2), 143-152. https://doi.org/10.1111/jnu.12274

Watson, J., D’Mello-Guyett, L., Flynn, E., Falconer, J., Esteves-Mills, J., Prual, A., Hunter, P., Allegranzi, B., Montgomery, M., & Cumming, O. (2019). Interventions to improve water supply and quality, sanitation and handwashing facilities in healthcare facilities, and their effect on healthcare-associated infections in low-income and middle-income countries: A systematic review and supplementary scoping review. BMJ Global Health4(4), e001632. https://doi.org/10.1136/bmjgh-2019-001632