Use at least three (3) quality references Note: Wikipedia and other related websites do not qualify as academic resources.
Your assignment must follow these formatting requirements:
Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA or school-specific format. Check with your professor for any additional instructions.
Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length.
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The critique of an epidemiologic study involves an assessment of the methods of data collection (which includes the type of study design), the analysis of the data and the interpretation of the data. For this application you are to read the following case control research article. After reading the article, complete the Case Control Template is below
•Lamontagne, F., Garant, M., Carvalho, J., Lanthier, L., Smieja, M., & Pilon, D. (2008). Pneumococcal vaccination and risk of myocardial infarction. Canadian Medical Association Journal, 179(8), 773-777.
Use the Academic Search Premier database, and search using the article’s Accession Number: 34526279
Case-Control Study
Submitted By (make sure your name and date are included here):
Article Citation in APA format:
Research Question:
Health Outcome of Interest:
Exposure(s) of Interest:
Diagnostic Criteria for Cases:
Case Ascertainment (include whether this was a single site or multi-site study):
Number of Cases (include information, if available, about the number who participated and the number who refused; indicate whether any information was provided about those who refused to participate):
Control Population (type/number/selection):
Type(s)/Method(s) of Data Collection (e.g. questionnaire, medical records, whether or not there was any procedure for validating some or the data):
Type of Data Analysis:
Results/Main Findings of Study:
Assessment of Bias (selection/information):
Assessment of Confounders:
Comments:
SAMPLE ANSWER
Case-Control Study
Article Citation in APA format: Lamontagne, F., Garant, M., Carvalho, J., Lanthier, L., Smieja, M., & Pilon, D. (2008). Pneumococcal Vaccination and Risk of Myocardial Infarction. Canadian Medical Association Journal, 179(8), 773-777.
Research Question/Hypothesis: in this article, the research question for the case study is not stated. However, the hypothesis is specified. The hypothesis was that: pneumococcal vaccination will be able to protect patients from myocardial infarction.
Health Outcome of Interest: patients being free from myocardial infarction
Exposure(s) of Interest: the authors regarded patients to have had the exposure to pneumococcal polysaccharide vaccine if these patients had been given this vaccine within the ten years prior to the index date, as documented in the Logivac database. Exposure was stratified by the interval between vaccination and index data (Lamontagne et al., 2008).
Diagnostic Criteria for Cases: patients who took part are those who were considered to be at high risk of having myocardial infarction, and had been admitted at the health care organization between 1/1/1997 and 12/31/2003. The risk for myocardial infarction is defined as the presence of diabetes; hypertension; or dyslipidemia in women aged over 50 years and in men aged over 45 years (Lamontagne et al., 2008; Lachaine, Rinfret & Merikle, 2006).
Case Ascertainment (include whether this was a single site or multi-site study): this was a single site study given that the authors carried out a case-control study of patients at risk of myocardial infarction, and these patients had been admitted at only one healthcare organization, which was a tertiary care hospital in Quebec, Canada.
Number of Cases (include information, if available, about the number who participated and the number who refused; indicate whether any information was provided about those who refused to participate):
There were 999 cases. The cases, according to the authors, were less likely compared to controls to have been vaccinated. The cases were matched according to sex, age, as well as year of hospitalization. For cases, the authors considered the admittance date for myocardial infarction to be the date of index (Lamontagne et al., 2008). No information is provided about the participants who refused to participate.
Control Population (type/number/selection): there were 3,996 controls in this study who were matched according to sex, age, as well as year of hospital admission. Controls were defined as patients who had 1 or more of the described risk factors as stated in the medical record, and had not been earlier diagnosed with atherosclerotic disease, and who never experienced a new myocardial infarction all through the study period. The authors only included those patients who had been admitted to the surgical departments of the hospital. For the controls, the authors considered the admission date into one of the departments as the index date. Four controls were matched to every case basing on sex; index, within 12 months; and age, within 24 months (Lamontagne et al., 2008).
Type(s)/Method(s) of Data Collection (e.g. questionnaire, medical records, whether or not there was any procedure for validating some or the data):
Data was collected through the use of medical records. Two sources of data collection were used. The first one was the research-purpose database of the hospital. This database, besides demographic data, comprised, for every hospital administration from the year 1996, complete information on all secondary and primary diagnoses, which were coded appropriate to the International Classification of Diseases, version 9. Logivac database was also utilized; a database that is maintained by the government and records all pneumococcal vaccination that have been administered in Quebec (Grayston, Kronmal & Jackson, 2005; Hansson, 2005).
Type of Data Analysis: The authors performed statistical analysis in which they estimated exposure to the pneumococcal polysaccharide vaccine at 20 percent. The authors utilized conditional logistic regression in estimating adjusted OR and 95 percent CI for new myocardial infarctions in relation to receiving of the pneumococcal polysaccharide vaccine. They performed both multivariable and univariable analyses and several covariables were incorporated. For all analyses, the authors matched controls and cases by index date, sex and age (Lamontagne et al., 2008).
Results/Main Findings of Study: Compared to controls, cases had a less likelihood of having been vaccinated – 95 percent confidence level 0.40-0.70, adjusted odds ration 0.53. The putative protective role of the pneumococcal polysaccharide vaccine was not noticed for patients who had been administered with the vaccine up to 12 months prior to the myocardial infarction. On the contrary, if vaccination had been administered 24 months or more prior to the hospital admission, then the association was stronger (Lamontagne et al., 2008).
Assessment of Bias (selection/information): At 3,999, the number of controls who were selected to take part in the study was considerably high compared to the cases, who were just 999.
Assessment of Confounders: After several modifying and confounding variables were considered, the findings showed that the chances of having received a vaccination within the group who had experienced myocardial infarction was roughly ½ that within the control group. In this study, there might have been residual confounding. It is of note that other cardiovascular risk factors including medication use, tobacco use, obesity, and lifestyle factors for instance exercise and diet could not be included in the model given that these traits are not documented within the research database (Lamontagne et al., 2008).
Comments: the study is of major importance since it demonstrates that there is an effect of pneumococcal vaccination in decreasing the incidents of new myocardial infarction. Nonetheless, the population of this study was restricted to only one hospital comprising largely Caucasian males. As such, future study should incorporate participants from other demographics and from multiple sites.
References
Grayston, J. T., Kronmal, R. A., & Jackson, L. A. (2005). Azithromycin for the Secondary Prevention of Coronary Events. N Engl J Med 2005;352:1637-45.
Hansson, G. K. (2005). Inflammation, atherosclerosis, and coronary artery disease. N Engl J Med, 352:1685-95
Lachaine, J., Rinfret, S., & Merikle, E. P. (2006). Persistence and Adherence to Cholesterol Lowering Agents: Evidence from Régie de l’assurance maladie du Québec data. Am Heart J 2006;152:164-9.
Role of p-values and confidence intervals within epidemiological research
Order Instructions:
Week 6
Epidemiologists control for variables such as confounding and random error by carefully developing research studies. Although there are not guarantees to eliminate or reduce all possible errors, it is important to minimize their effects.
For this Discussion, review your readings from this week. Then addressing the following:
•
• Identify the role of p-values and confidence intervals within epidemiological research and provide examples of how these are used to interpret research findings.
•
• Discuss the effect sample size has on p-values and confidence intervals and how this affects interpretation of statistical results.
SAMPLE ANSWER
Role of p-values and confidence intervals
Confidence intervals and p-values are reported in almost every epidemiological research and are used in interpreting statistical analysis results. These measures are used by medical investigators and researchers to answer such questions as: “are the results significant?” or “is the hypothesis accepted?” Epidemiological researchers do not have to worry about testing the significance of results when carrying out statistical researches because they can depend on the p-value and the confidence interval. The p-value is the probability of a value that is similarly extreme or even more extreme as the one in the study if the hypothesis is true. Confidence interval on the other hand can be defined as is an array of values within which there is reasonable confidence that the parameter of the population lies. The reporting of confidence intervals and p-values basically follows that testing of hypothesis or significance, (Bland & Peacock, 2012).
For instance, when testing a hypothesis using the p-value, the particular cutoff or level of significance (conventionally 0.05) is used to test whether values are significant or not; those less are significant, while those above are not. For instance in the study of differences in low birth weight prevalence between singletons and multiple pregnancies, the p value can be used to “endorse” the hypothesis that there is a difference. For the confidence interval, consider a test for difference in mean sugar reduction between a standard hypoglycemic and a new drug. The null hypothesis in this case should state that there is no difference in the blood sugar reduction mean; that can be accepted or rejected, (Gardner& Altman, 2013).
P-values and confidence intervals tend to decrease in size with an increase in sample size unless the null hypothesis is true. As the sample size increases, for the case of the p-value, there is an increased certainty on where the proportion mean might be, and hence large samples are more consistent with smaller ranges of possible population values. For the confidence interval, a larger sample size means a decreased error margin. The effect this has on interpretation of results is that larger samples report small marginal errors and the certainty of finding the true population parameter increases, hence the certainty of the results increases too, (Houle, 2007).
References
Bland M, Peacock J. (2012). Interpreting statistics with confidence. The Obstetrician and Gynaecologist;4:176–180
Gardner MJ, Altman DG. (2013). Confidence intervals rather than P-values: estimation rather than hypothesis testing. Br Med J. 292:746–750
When conducting research, your design and methods are developed around what you are trying to find or assess. Different research methods are used to answer and address different types of questions. In epidemiology, there are multiple forms of research studies and as a public health official, it is important for you to understand when it is best to use these different types of research.
For this discussion, review the different types of epidemiology study designs listed in Table 6-1 on page 141.
Then address the following:
•Pick three epidemiological study designs to discuss. Summarize their main characteristics and discuss at least one strength and one limitation of each study design you select.
•Discuss which measure of association is most appropriate for each of the three study designs you’ve selected and why
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For this application you are to read the following cohort study article. After reading the article, complete the Cohort Study Template is below.
•Beelen, R., Hoek, G., Van Den Brandt, P., Goldbohm, R., Fischer, P., Schouten, L., et al. (2008). Long-term effects of traffic-related air pollution on mortality in a Dutch cohort (NLCS-AIR Study). Environmental Health Perspectives, 116(2), 196-202.
Use the Academic Search Premier database, and search using the article’s Accession Number: 31169911
Cohort Study
Submitted By (make sure your name and date are included here):
Article Citation in APA format:
Research Question:
Health Outcome of Interest:
Exposure(s) of Interest:
Type of Study (please indicate whether this is a prospective (concurrent) or retrospective (non-concurrent) or ambidirectional study:
Type, Frequency and Duration of Follow-Up (indicate something about loss to follow-up and any efforts that were made to minimize loss to follow-up and include information on the characteristics of those who were lost to follow-up and comment on why this is important):
Type of Data Analysis (include measure of association used):
Results/Main Findings of Study:
Assessment of Bias (selection and information):
Assessment of Confounders:
Comments:
SAMPLE ANSWER
Cohort Studies
Article Citation: Beelen, R., Hoek, G., Van Den Brandt, P., Goldbohm, R., Fischer, P., Schouten, L., et al. (2008). Long-term effects of traffic-related air pollution on mortality in a Dutch cohort (NLCS-AIR Study). Environmental Health Perspectives, 116(2), 196-202.
Research Question: what is the association between mortality and continuing exposure to traffic-related air pollution?
Health Outcome of Interest: decreased respiratory mortality by reducing exposure to ambient air pollution
Exposure(s) of Interest: long-term exposure to traffic-related air pollution. In essence, exposure to sulfur dioxide (SO2), nitrogen dioxide (NO2), black smoke (BS), particulate matter (PM) in addition to a variety of exposure variables to traffic comprised the exposures of interest in the study which were estimated at the home address (Beelen et al., 2008).
Type of Study: this is a prospective cohort study. In essence, a prospective cohort study is understood as a study in which the effects of a given variable are plotted over time, and the research study becomes a continuing and long-term process (Gehring et al., 2006). This cohort study is prospective given that it fits the definition of prospective; it was initiated in the year 1986, and the authors assessed mortality between 1/1/1987 and 31/12/1996, meaning that it was an ongoing process.
Description/Ascertainment of Cohort: the Netherlands Cohort Study on Diet and Cancer was started with enrolling 120,852 subjects that consisted of 62,573 women and 58,279 men aged between 55 years to 69 years, who lived in 204 municipalities all through the nation (Beelen et al., 2008).
Data Collection at Baseline: Baseline questionnaire was used to collect data. At baseline, every subject filled out an 11-page questionnaire on nutritional habits, as well as other factors for cancer. For every subject, data obtained from one page of the questionnaire were entered at baseline – with information pertaining to smoking status, sex, and age.
Type, Frequency and Duration of Follow-Up: After recruitment of the subjects, all of them were followed up for cancer incidence by record linkage to registries of cancer. The authors assessed mortality between January 1st 1987 and December 31st 1996, meaning that the participants were actually followed from the year 1987 to the year 1996; a period of 10 years. The authors have not stated anything about loss of follow-up as well as any efforts that were made to reduce loss to follow-up. The authors estimated exposure to nitrogen dioxide, particulate matter, black smoke and other traffic-related air pollutants at the home address of the subjects.
Type of Data Analysis: the authors analyzed the effects of air pollution for overall concentrations, and a mixture of background concentrations and traffic variables for the purpose of identifying effects of living close to busy highways separately. They calculated relative risks for concentrations and traffic variable dissimilarities between the 95th and 5th percentiles of the distributions (Beelen et al., 2008). The authors performed Cox analyses in the entire cohort with the use of Cox proportional hazards models. They computed person-years for every subject from baseline until end of follow-up or death. The authors adjusted for smoking, sex, age, as well as area-level. Cox-Poisson random effects survival software was used in incorporating spatial clustering at the neighborhood and/or municipal scale in the entire cohort analyses (Beelen et al., 2008).
Results/Main Findings of Study: the intensity of traffic on the closest road was independently linked to mortality. Relative risks at 95 percent CI for a 10-µg/m3 rise in the concentrations of black smoke – difference between 95th and 5th percentile – were 1.05 for natural cause, 1.03 for lung cancer, 1.22 for respiratory, 1.04 for cardiovascular, and 1.04 for mortality besides lung cancer, respiratory, or cardiovascular. The results were the same for PM2.5 and NO2, but there was no association for SO2 and mortality
Assessment of Bias: The authors selected subjects who were living near busy roads in 204 municipalities across the Netherlands. Those who lived far from busy highways were not chosen.
Assessment of Confounders: analysis in the case-cohort sample illustrated little distinction between the effect estimates adjusted for every confounder and adjusted for only the narrow set of confounders that were available in the entire cohort. The effect estimates were not sensitive to dissimilar models of confounders for both the case cohort and full cohort analyses.
Comments: The study is of major importance in contributing to the evidence that continuing and lasting exposure to traffic-related air pollution is linked to increased mortality. This is because traffic-related air pollution in addition to other traffic exposure variables were found to have an association with mortality in the cohort
Gehring, U., Heinrich, J., Kramer, U., Grote, V., Hochadel, M., Sugiri, D. (2006). Long-term Exposure to Ambient Air Pollution and Cardiopulmonary Mortality in Women. Epidemiology. 17:545–651.
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1. To achieve a complete valence shell, how many electrons must an atom of strontium gain or lose?
A. lose 2 B. lose 1 C. gain 1 D. gain 2
2. Which of these pairs will form ionic bonds?
A. N and C B. Na and Cs C. K and Cl D. S and Cl
3. Which of the following groups of atoms would you expect to have similar chemical properties?
A. Mg & Na B. B & C C. O & S D. Cu & O
4. What is the most stable ion formed by chlorine?
A. Cl2 B. Cl+ C. Cl— D. Cl2—
5. A pure substance
A. has a definite constant composition and properties that are invariant and unique.
B. can be separated into distinct parts by physical separation techniques.
C. is another name for a homogeneous mixture.
6. Covalent bonds are formed when
A. an atom gives up an electron
B. atoms become ionized
C. atoms share electrons
D. metals bond to nonmetals
7. How many valence electrons does a neutral calcium atom have?
A. 0 B. 2 C. 8 D. 18
8. What types of substance normally forms anions?
A. halogens B. nonmetals C. metals D. noble gases
9. Which of the following correctly represents 2 molecules of water?
A. H4O2 B. (H2O)2 C. 2 H2 + 2 O D. 2 H2O
10. Which of the following is the correct symbol for an iron ion with a charge of plus 3?
A. Fe3+ B. Fe (III) C. Fe(III) D. 3+
Fe
11. The total number of atoms in one formula unit of (CH3CH2)2NH is
a. 6. b. 14. c. 16. d. 20.
12. Which of the following describes the difference between Na+ and Na?
A. Na is a neutral atom and Na+ is an ion with 1 more electron than Na.
B. Na is a neutral atom and Na+ is an ion with 1 less electron than Na.
C. Na and Na+ are two different isotopes of the same atom.
D. Na is a neutral atom and Na+ is an ion with 1 more proton than Na.
13. Which of the following IS NOT a stable ion?
A. Li+ B. Na2– C. Al+3 D. Zn2+
14. Which of the following is the dihydrogen phospate ion?
A. H2PO4
— B. 2 HPO4
— C. H2PO4
3— D. H2PO3
15. Which of these pairs will form covalent bonds?
A. Na and Li B. Na and Ca C. O and F D. Na and F
16. The electron configuration of Na+ is the same as the electron configuration of?
A. Na B. Ne C. F D. Mg
17. Which of the following is the chloride ion?
A. Cl2
2+ B. Cl2
2— C. Cl2
— D. Cl—
18. Which of the following is true about helium?
A. helium generally forms ionic bonds with metals
B. helium generally does not form bonds with other atoms
C. helium generally forms covalent bonds with non-metals
D. helium is a polyatomic ion
19. Which of the following is the correct way to represent the oxide ion?
A. O2— B. —2
O C. O— D. O2
4—
20. Which of these IS NOT a stable ion?
A. Mg+ B. Li+ C. Br– D. S2—
SAMPLE ANSWER
Chemistry Questions
Question 1
lose 2
Question 2
K and Cl
Question 3
O & S
Question 4
Cl—
Question 5
has a definite constant composition and properties that are invariant and unique.
Question 6
atoms share electrons
Question 7
2
Question 8
halogens
Question 9
2 H2O
Question 10
Fe3+
Question 11
16
Question 12
Na is a neutral atom and Na+ is an ion with 1 less electron than Na.
Question 13
Na2–
Question 14
H2PO4—
Question 15
O and F
Question 16
Ne
Question 17
Cl—
Question 18
helium generally does not form bonds with other atoms
a) What two inventions/technologies established during the Civil War increased “efficiency and productivity”?
b) A third of population boom from 1870 to 1900 was caused by what?
c) The government encouraged industrial growth with tariffs [taxes on foreign imports], land grants to railroads and what?
d) By 1913 the US produced what percentage of the world’s entire industrial output?
e) The railroad industry established the four time zones but how did railroads effect shopping/marketing/consumer business? (Hint: it’s part of the “Sears” story)
f) Who was Cornelius Vanderbilt?
g) What was Rockefeller’s industry and how did he create his empire?
h) Consumer prices dropped, which raised standards of living, but now there was more job…what? (starts with s) And what else that hurt the poor most?
i) About how many people died on the job per year on average in this age?
j) What was the first national union?
k) The membership of this union shrank over time because it had become unfortunately associated with what?
l) Who was Samuel L Gompers?
m) Social Darwinism argued the poor should be poor because…why?
n) This was the time when people started to argue that wealth inequality was the opposite of…what?
1) What was “manifest destiny” and how was it applied to the western frontier?
2) Who/what were “robber barons”/”captains of industry”? Give a couple of examples.
3) Who was Andrew Carnegie?
3) What is Social Darwinism?
4) What was Nativism?
5) What is a monopoly and trust?
6) Describe “vertical” and “horizontal” integration.
7) Share/describe an example of labor strife/strike during the Gilded Age, for example a picket or protest or strike. (For example, read about the railroad strike in your texts.)
8) What’s the difference between the Knights of Labor and the American Federation of Labor?
9) What were “political machines” in big cities?
10) What did Bryan mean by a “cross of gold”? What was his political argument?
SAMPLE ANSWER
“Industrial Economy” After the Civil War
a) What two inventions/technologies established during the Civil War increased “efficiency and productivity”? Financial system improvement that affected the national currency leading to improvement/ boost of telegram that improved communication of and construction of transcontinental Railway
b) A third of population boom from 1870 to 1900 was caused by what? Immigration
c) The government encouraged industrial growth with tariffs [taxes on foreign imports], land grants to railroads and what? Putting Native Americans on reservation
d) By 1913 the US produced what percentage of the world’s entire industrial output? One third of industrial output.
e) The railroad industry established the four time zones but how did railroads effect shopping/marketing/consumer business? (Hint: it’s part of the “Sears” story) Allowed shipment of jewelry and watches and other construction materials.
f) Who was Cornelius Vanderbilt? Owners of the company/captain of the industries
g) What was Rockefeller’s industry and how did he create his empire? He started as a clerk of Cleveland merchant and became the richest man in the world. Controlled 90 percent of the US oil industry
h) Consumer prices dropped, which raised standards of living, but now there was more job…what? (starts with s) And what else that hurt the poor most? Security, booms and busts on the economy
i) About how many people died on the job per year on average in this age? 35,000j) What was the first national union? Knights of labor
k) The membership of this union shrank over time because it had become unfortunately associated with what? Haymarket riot in 1886
l) Who was Samuel L Gompers? American federation of labor leader that focused on bread and butter issues such as pay for the workers
m) Social Darwinism argued the poor should be poor because…why? Inherent evolutionary flaws, which enabled tycoons to sleep at night. The reason was that the tycoons owned the means of production and were a monopoly
n) This was the time when people started to argue that wealth inequality was the opposite of…what? Success and failure, wealth and poverty
1) What was “manifest destiny” and how was it applied to the western frontier? Manifest destiny was a term used to express the belief of the Anglo Saxon Americans to expand their civilization and institutions across the North American. It was applied to the western frontier to exemplify the unity of the Americans in its purpose and mission to expand its territories.
2) Who/what were “robber barons”/”captains of industry”? Give a couple of examples. Robber barons were the people that owned industries and means of production in US. They included Cornelius Andrew, Vanderbilt ‘Re Me too’ Carnegie (Mellon), and Leland “I named my University son” Stanford
3) Who was Andrew Carnegie? He was one of the rich men, owners of the company also capital of the industry
3) What is Social Darwinism? It meant that the theory of survival of fitness should be applied to people and corporationss of people. Big companies were fitter because there was nothing to fear of monopoly. Poor people were poor because of evolutionary flaws 4) What was Nativism? Refers to policies or beliefs that protected or favored the interests of the native population at the expense of immigrants
5) What is a monopoly and trust? Monopoly is a situation where, larger industries dominate the market killing smaller companies leading to exploitation due to lack of competition. Trust, on the other hand, are entities established for purposes of investment.6) Describe “vertical” and “horizontal” integration. Vertical integration is where the company owns its supply chain while horizontal integration is where a company acquires production output of other companies in the same industry
7) Share/describe an example of labor strife/strike during the Gilded Age, for example a picket or protest or strike. (For example, read about the railroad strike in your texts.) An example of such strikes was the Great Strike that occurred in the 1877. The strike arose because of the pressures of economic depression. The powerful and big corporations such as railroad reduced the wages of their workers something that resulted to the strike. The strike affected many cities such as Chicago, St. Louis, West Virginia, Martinsburg and Pittsburgh that was highly affected. At least 20 people died and 29 were wounded.
8) What’s the difference between the Knights of Labor and the American Federation of Labor? Knights of labor was the first inclusive movement to be formed as it admitted unskilled workers, women, and children and were damaged in Haymarket 1886. While on the other hand, American Federation of Labor was formed mainly to agitate for pay issues, worker and safety. The movement workers were mostly iron and steel workers. AFL was formal federation as opposed to Knights Labor that was secretive.
9) What were “political machines” in big cities? Corporations (group of organized politicians) that sponsored elective leaders to get avenues to engage in corrupt deals through government contracts.
10) What did Bryan mean by a “cross of gold”? What was his political argument? He meant the suffering of the citizens due to challenges in the currency system. His political argument was that the government was not doing its best to stabilize the economy to ensure that farmers, industrial workers, and miners lead bett
This paper is continuation of 111486 and also 111516 so its critical that the writer reference back to all this other papers to be able to complete this paper. The writer will have to clearly discuss each points in the questions following closely the instructions in the questions. The writer must clearly respond to each point using them as subheadings.
Marketing Audit
Identify an individual in your chosen organization to be interviewed who has knowledge of the questions below and use the responses for the purposes of this week’s assignment or use information gathered through last week’s interview if the person gave information patterning to the questions below. She or he should be an individual who understands the organization’s strategic use of marketing activities to achieve competitive advantage in the marketplace and is willing to meet with you to discuss these initiatives. Complete the marketing function and strategy audit from information gathered in your interview.
Marketing Function and Strategy Audit
each of the following main areas needs to be addressed as a part of this audit; the questions listed are only guidelines to help you gather the essential information to assist in your analysis. It is important to cover each particular topic, but in a way that is most meaningful for the organization that you have selected.
When the questions result in a simple affirmative or negative answer, please elaborate on how you reached your conclusion.
Marketing Function Audit
1. Products
• What are the company’s product line objectives?
• What areas of product and brand strategy need improvement?
2. Price
• What are the company’s pricing objectives, policies, strategies, and procedures?
3. Distribution
• What are the company’s distribution objectives and strategies?
• Is there adequate market coverage and service?
4. Integrated Marketing
Communications
• What are the organization’s advertising objectives?
• Are the advertising media well chosen?
• Is there effective and sufficient use of sales promotion tools such as samples, coupons, displays, and sales contests?
• How is the company using direct, online, and database marketing?
Strategy Audit
1. Business Mission
• Is the business mission clearly stated in market-oriented terms?
• Is it feasible?
2. Marketing Objectives and Goals
• Are the company and marketing objectives and goals stated clearly enough to guide marketing planning and performance measurement?
• Are the marketing objectives appropriate, given the company’s competitive position, resources, and opportunities?
3. Strategy
• Has the management articulated a clear marketing strategy for achieving its marketing objectives?
• Has the company developed an effective positioning and marketing mix for each target segment?
Write a summary (3 minimum pages) of your findings and analysis in the marketing function and strategy audit. Use each numbered item as a heading for your paper. You should also review the scholarly literature so that you are able to include a description of the significance of the marketing audit in your completed Paper. You may also wish to review the scholarly literature to help you gain insights into any of the major issues you identify for your selected organization.
Resources
Course Text
• Marketing Management
o Chapter 6, “Analyzing Consumer Markets”
This chapter focuses on ways to analyze a consumer market and identify factors that influence customer decision-making.
o Chapter 7, “Analyzing Business Markets”
This chapter compares and contrasts business and consumer markets and then elaborates on the different needs that must be taken into consideration for business markets.
Chapter 8, “Identifying Market Segments and Targets”
This chapter describes specific market segments, the different levels of the segments, and the various characteristics that may be analyzed, such as geographical, demographical, and behavioral within a particular consumer group.
Article
• Prahalad, C., & Ramaswamy, V. (2004). Co-creation experiences: The next practice in value creation. Journal of Interactive Marketing, 18(3), 5–14. Retrieved from Business Source Premier database.
Beverland, M., Napoli, J., & Yakimova, R. (2007). Branding the business marketing offer: Exploring brand attributes in business markets. Journal of Business & Industrial Marketing, 22(6), 394–399. doi:10.1108/08858620710780154
The authors of this article describe a framework they have developed for creating a strong brand identity.
• Fugate, D. (2007). Neuromarketing: A layman’s look at neuroscience and its potential application to marketing practice. Journal of Consumer Marketing, 24(7), 385–394. doi:10.1108/07363760710834807
This article describes a new science, that of neuromarketing, which involves trying to determine what is actually occurring in the brain while an individual is making decisions about purchasing a product.
Szmigin, I., Canning, L., & Reppel, A. (2005). Online community: Enhancing the relationship marketing concept through customer bonding. International Journal of Service Industry Management, 16(5), 480–497. doi:10.1108/09564230510625778
In this paper, the authors describe service value, technical infrastructure, and interactivity as the elements that assist in creating customer bonding in online communities.
SAMPLE ANSWER
Introduction
Nike, Inc is one of the multinational enterprises in the United States of America that designs and also manufactures sports apparels, foot wares, equipments among other accessories. Its major production subsidiary is Converse Inc, a company that specializes in designing and distribution of casual apparels, foot ware, and other personal sports outfits. Hurley International Company, specialiases in designing, marketing and distribution of sports ware and equipment for the youth.
Marketing Function Audit
1. Products
Nike’s product line objective is based on performance oriented strategy that seeks to manufacture foot ware’s and sports apparels that can endure the rigorous training and competition pressures to achieve top most performance for their clients. For clients who purchase the products for casual use, Nike Inc aims at providing the best apparels and foot wares that is based on extensive research on personal performance and comfort.
Nike Inc product and brand overall strategy is mostly based on sports performance where a major of its revenues are derived from. But the overall casual market for its products is far larger than the sports market. More product branding and strategy should be focused on the casual market to achieve higher sales on the emerging market.
2. Price
Nike’s pricing objective are based on the competitive market that also aims at providing the best sporting and casual foot ware and apparel in the market. Nike products are priced slightly higher above its competitors due to its products higher quality and endurance aspects of its products. Its pricing policy is based on value for the price offered but occasional its marketing strategists conducts assessments on the overall market reaction to its prices in various parts of the world using different sampling procedures especially in the US which provides almost 45% of its total revenues.
Distribution
Nike’s Converse Inc specializes in designing and distribution of casual apparels, foot ware, and other personal sports outfits for the general public and sportsmen while Hurley International Company, specialiases in designing, marketing and distribution of sports ware and equipment for the youth, colleges and other sports events for teenagers. Besides the wholesale customers, Nike also sells directly to customers through the Direct Consumer Operations. Nike has a global presence in most of the countries worldwide and its marketing strategy is very effective and adequate. (Beverland, Napoli & Yakimova, 2007) Its product is available to most of its consumers globally besides the normal orders that can be placed under the Direct Consumer operations. (Hauser, 2007)
Integrated Marketing
Nike has won the Emmy Award for best commercial on two occasions in the years 2000 and 2002. (Nike Annual Report, 2003)Its advertising objective is to create a trademark that is associated with excellence performance in the track and field for athletes and other sportsmen and women and also for casual use.
The advertising media for Nike is well chosen and effective. The decision to use sports celebrities to market and promote its products and also to demonstrate the performance of their technology and design is proving to be the best decision. Nike Inc signed in the NBA player Mike Jordan, in the year 1984, and its revenues increased dramatically hence the introduction of the Jordan brand name in one of its foot ware products. (Beverland, Napoli & Yakimova, 2007)Nike adopted the internet and email marketing management technologies since its inception in the early 2000 and it’s currently using the broadcast and narrowcast satellite communication technologies to drive its multimedia marketing campaigns. (Schibrowsky, Peltier & Nill, 2007; Szmigin, Canning & Reppel, 2005)
Strategy Audit
1. Business mission
Nike business mission is clearly stated in market oriented terms and represented wholly by its trademark in all its designs. (Nike Annual Report, 2013) In the year 2010, the value of its brand alone was estimated to be worth more than $10.7 billion. Nike’s brand name is very feasible and it actually leads its sales. Its trademark represents all its mission strategies and accomplishments.
Marketing Objectives and Goals
Nike’s marketing objectives and its goals are well stated, adequately enough to plan its marketing and performance operations to facilitate global expansion and achieve highest returns. Nike’s athletic foot wares for example, are aimed at providing specific athletic use and they have been designed with the same purpose in mind. (Prahalad & Ramaswamy, 2004)
The company’s objective is appropriate given its competitive nature and huge resources and opportunities available. These can be confirmed from its huge revenues that are derived from its sales revenues and the popularity of its products. In the year 2012, Nike posted more than $24.1 billion dollars in its total revenues.
Strategy
The management of Nike Inc has a clear strategy of achieving its marketing objectives. The US forms its target segment with an estimated 45% of its entire revenues coming from the US alone; its major strategies are tailored for the American market. Product positioning refers to the development and marketing of the company’s products brand as the true and real images of the company’s major product. (Kotler & Keller, 2012)To form an impressive strategy, Nike has chosen a communication strategy that is unique and competitive to the nature of its products. The use of sports celebrities as its promotion strategy has created an effective marketing strategy. (Nike, 2014) Most of its customers view the Nike brand as an epitome of success something which influences its pricing policy. (O D’Esopo & Almquist, 2007).It’s a process known as brand equity and it occurs where the company’s loyal customers are even more willing to pay much more to obtain their choice of product mostly because of its positioning in the market.
References
Beverland, M., Napoli, J. & Yakimova, R. (2007) Branding the business marketing offer: Exploring brand attributes in business markets. Journal of Business & Industrial Marketing, 22(6), 394–399. Doi: 10.1108/08858620710780154
Hauser, W. (2007) Marketing analytics: The evolution of marketing research in the twenty-first century, direct Marketing, 1(1), 38–54. Doi: 10.1108/17505930710734125
Kotler, P. & Keller, K. (2012) Marketing management, Upper Saddle River, New Jersey: Pearson Prentice Hall.
Lee, N. & Broderick, A. (2007) The past, present, and future of observational research in marketing. Qualitative Market Research, 10(2), 121–129. Doi: 10.1108/13522750710740790
O D’Esopo, M., & Almquist, E. (2007). An approach to mastering the marketing mix. Business Strategy Series, 8(2), 122–131. Retrieved from Proquest Central database.
Prahalad, C. & Ramaswamy, V. (2004) Co-creation experiences: The next practice in value creation. Journal of Interactive Marketing, 18(3), 5–14. Retrieved from Business Source Premier Data base.
Schibrowsky, J., Peltier, J., & Nill, A. (2007). The state of Internet marketing research: A review of the literature and future research directions. European Journal of Marketing, 41(7/8), 722–733. Doi: 10.1108/03090560710752366
Szmigin, I., Canning, L. & Reppel, A. (2005) online community: Enhancing the relationship marketing concept through customer bonding. International Journal of Service Industry Management, 16(5), 480–497. Doi: 10.1108/09564230510625778
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Write and essay about Road sharing between bicyclists and motorists, advantages and inconvenient. It should be elaborate using proper grammatical terms.
SAMPLE ANSWER
Advantages and Inconvenience of Road Sharing
Different countries and states have different laws pertaining to how cyclists and motorists should share roads to ensure safety. Both the cyclists as well as motorists have a right to use the roads to move from point A to B. This discussion investigates on the advantages and inconveniences of road sharing between the motorists and cyclists.
A number of advantages exist when bicyclists and motorists share the same road. One of them is that it helps to improve the level of maturity of the drivers and bicyclists as drivers and riders become more careful. The level of responsible driving is improved because drivers are required to drive safely putting into consideration the lives of riders (Commute Orlando.com. 2014). Therefore, a sense of responsibility tends to improve. Another advantage is that the cyclists get to enjoy their rights especially those that ride as a hobby as well those that use bicycles as means of their transport. The level of pollution as a result of emissions from motorists reduce to some levels promoting a healthy environment.
On the other hand, sharing road between cyclists and motorists has a number of inconveniences. One of the inconveniences is increased conflict between the drivers and riders. It becomes a challenge for many riders and drivers specially when turning, and crossing roads and during traffic jams (Commute Orlando.com. 2014). The rate of accidents are likely to increase as most of the times drivers disregard motorists. Some drivers have a mentality that cyclists are not supposed to use roads and this contributes to injuries and accidents. Furthermore, sharing of road between the motorists and bicyclists increase instances of traffic jams especially in urban centers. The motorists in such instances may end up spending more time on roads, which affects their productivity.
In conclusion, even though bicyclists and motorists are required to share roads, both must respect each other. The advantage of road sharing is that it improves the level of carefulness, which may help to reduce accidents as everyone becomes responsible. However, sharing roads causes inconveniences such as delays and increases risks of injuries and accidents
Defenses to Malpractice and Risk Management Techniques
Defenses to Malpractice and Risk Management Techniques
Order Instructions:
Look at this case and respond to the 3 main points raise in the question, it is critical that the writer detail out the respond to the question clearly using credible sources and past case laws to support your stand on the case.
Take the malpractice case below and discuss the defenses that may be raised in that case. Discuss how the incident could have been prevented. What risk management techniques could have been used?
Case Study : Malpractice Action Brought by Yolanda Pinnelas
People Involved in Case:
Yolanda Pinnelas-patient
Betty DePalma, RN, MS-nursing supervisor
Elizabeth Adelman, RN, recovery room nurse
William Brady, M.D., plastic surgeon
Mary Jones, RN-IV insertion
Carol Price, LPN
Jeffery Chambers, RN-staff nurse
Patricia Peters, PharmD-pharmacy
Diana Smith, RN
Susan Post, JD-Risk Manager
Amy Green-Quality Assurance
Michael Parks, RN, MS, CNS-Education coordinator
SAFE-INFUSE-pump
Brand X infusion pump
Caring Memorial Hospital
Facts:
The patient, Yolanda Pinellas is a 21-year-old female admitted to Caring Memorial Hospital for chemotherapy. Caring Memorial is a hospital in Upstate New York. Yolanda was a student at Ithaca College and studying to be a music conductor.
Yolanda was diagnosed with anal cancer and was to receive Mitomycin for her chemotherapy. Mary Jones, RN inserted the IV on the day shift around 1300, and the patient, Yolanda, was to have Mitomycin administered through the IV. An infusion machine was used for the delivery. The Mitomycin was hung by Jeffrey Chambers, RN and he was assigned to Yolanda. The unit had several very sick patients and was short staffed. Jeffery had worked a double shift the day before and had to double back to cover the evening shift. He was able to go home between shift and had about 6 hours of sleep before returning. The pharmacy was late in delivering the drug so it was not hung until the evening shift. Patricia Peters, PharmD brought the chemotherapy to the unit.
On the evening shift, Carol Price, LPN heard the infusion pump beep several times. She had ignored it as she thought someone else was caring for the patient. Diana Smith, RN was also working the shift and had heard the pump beep several times. She mentioned it to Jeffery. She did not go into the room until about forty-five minutes later. The patient testified that a nurse Updated: June 2014 MN506- Unit 9 Page 3 of 5
came in and pressed some buttons and the pump stopped beeping. She was groggy and not sure who the nurse was or what was done.
Diana Smith responded to the patient’s call bell and found the IV had dislodged for the patient’s vein. There was no evidence that the Mitomycin had gone into the patient’s tissue. Diana immediately stopped the IV, notified the physician, and provided care to the hand. The documentation in the medical record indicates that there was an infiltration to the IV.
The hospital was testing a new IV Infusion pump called SAFE-INFUSE. The supervisory nurse was Betty DePalma, RN. Betty took the pump off the unit. No one made note of the pump’s serial number as there were 6 in the hospital being used. There was also another brand of pumps being used in the hospital. It was called Brand X infusion pump. Betty did not note the name of the pump or serial number. The pump was not isolated or sent to maintenance and eventually the hospital decided not to use SAFE-INFUSE so the loaners were sent back to the company.
Betty and Dr. William Brady are the only ones that carry malpractice insurance. The hospital also has malpractice insurance.
Two weeks after the event, the patient developed necrosis of the hand and required multiple surgical procedures, skin grafting, and reconstruction. She had permanent loss of function and deformity in her third, fourth, and fifth fingers. The Claimant is alleging that, because of this, she is no longer able to perform as a conductor, for which she was studying.
During the procedure for the skin grafting, the plastic surgeon, Dr. William Brady, used a dermatome that resulted in uneven harvesting of tissue and further scarring in the patient’s thigh area where the skin was harvested.
The Risk Manger is Susan Post, J.D. who works in collaboration with the Quality Assurance director Amy Green. Amy had noted when doing chart reviews over the last three months prior to this incident that there were issues of short staffing and that many nurses were working double shifts, evenings and nights then coming back and working the evening shift. She was in the process of collecting data from the different units on this observation. She also noted a pattern of using float nurses to several units. Prior to this incident the clinical nurse specialist, Michael Parks, RN, MS, CNS, was consulting with Susan Post and Amy Green about the status of staff education on this unit and what types of resources and training was needed.
Resources
Anselmi, K. K. (2012). Nurses’ personal liability vs. employers’ vicarious liability. MEDSURG Nursing, 21(1), 45–48.
Essentials of Nursing Law and Ethics
Chapter 5: “Defenses to Negligence or Malpractice”
Chapter 6: “Prevention of Malpractice”
Chapter 7: “Nurses as Witnesses”
Chapter 8: “Professional Liability Insurance”
Chapter 9: “Accepting or Refusing an Assignment/Patient Abandonment”
Chapter 10: “Delegation to Unlicensed Assisted Personnel”
SAMPLE ANSWER
Defenses to Malpractice and Risk Management Techniques
Introduction
It is the mandate of every medical practitioner to take care of the clients entrusted under his care. The doctor should not harm the patients, and neither should they make the existing illness worse. This case involves Yolanda Pinellas a 21 year old cancer patient entrusted under the care of Jeffrey Chambers. The client was admitted at Caring Memorial Hospital for chemotherapy but suffered massive injuries after being left unattended for over forty minutes. Despite the fact that she rung the bell, the medical staff in charge did not hurry to assuage her pain. Medical malpractice occurs when the treatment administered by the physician leads to further injury to the client (Infusion Nurses Society, 2010). Notably, there was an infiltration to the IV and as a result Yolanda suffered necrosis of the hand requiring her to go through multiple surgical procedures, skin grafting, and reconstruction. During the skin grafting process, the surgeon, Dr. William Brady, used a dermatome resulting to uneven harvesting of tissue, further scarring the patient’s thigh area where the skin was harvested.
The Defenses In This Case
While medical practitioners together with the other health care providers are not required to be perfect they have the duty to act responsibly and use reasonable care in their medical profession (Wickham, 2006). In the case of Yolanda VS Caring Memorial Hospital, Diana Smith, working during the shift heard the pump beep several times. She immediately alerted Jeffrey who was entrusted to take care of the client. Jeffrey did not take swift action as required, Diana went to the room after 40 minutes and discovered that IV had dislodged for the patient’s vein. She cross-checked and found that there was no evidence that the Mitomycin had gone into the patient’s tissue. Later it was discovered that indeed Mitomycin had gone to her tissue leading to massive injuries.
In Diana’s case, the practitioners were not apathetic, Diana responded to the patient’s bell. She took the right precautions by immediately stopping the IV, notifying the physician, and providing the necessary care to the hand. The major cause of the harm caused to Yolanda was not as a result of negligence. The Risk Manager Susan Post had noted over the last three months prior to the incidence that there were challenges of short staffing. Moreover, the nurses were working double shifts like Jeffery and this could compromise on their performance. Often the hospital assigned float nurses to several units (Sauerland, 2007). The hospital was in the process of implementing a training program to bolster the staff performance. In this case the damages that Yolanda occurred can be blamed on multiple acts of negligence, the burden of proof lies with the plaintiff to proof that more likely than not, the injuries she incurred were as a result of a particular negligent act.
How The Incident Could Have Been Avoided
This incident could be avoided by foremost ensuring that the ward in which Yolanda was admitted was sufficiently staffed because there were critically ill patients admitted in that ward. Infiltration which caused the leaking of the IV fluid could have been avoided if only one practitioner was assigned to conduct the operation. The staff who inserted the IV was not the one who administered the drug through the infusion machine. The practitioner should have applied a splint for stability and to prevent dislodging the IV infusion machine (Infusion Nurses Society, 2010).The hospital should have ensured that only qualified, chemotherapy-certified nurses trained in venipuncture are allowed to allowed administer vesicants. When Diana Smith heard the first bell from the client she should have respondent aptly knowing that the ward comprised of critically ill patients.
Management techniques That Could Have Been Used
During the administration of IV fluid the practitioner should have chosen a large vein with good blood flow for the placement of infusion machine. This would have minimized chances of infiltration (Ener, 2004). The venipuncture site must have been monitored closely to make sure that there was no infiltration, pain or discomfort.
References
Ener R., A. (2004). Extravasation of systemic hemato-oncological therapies. Ann Oncol. June;15(6):55-62.
Infusion Nurses Society (2010). Infusion Nursing. [3rd edition] 2010
Sauerland C,. A.(2007). Vesicant extravasation part I: Mechanisms, pathogenesis, and nursing care to reduce risk. Oncol Nurs Forum. 2007 Nov 27;33(6):114-41.
Schrijvers DL. Extravasation: a dreaded complication of chemotherapy. Ann Oncol. 2003;14 Suppl 3:iii26-30.
Wickham, R.(2006). Vesicant extravasation part II: Evidence-based management and continuing controversies. Oncol Nursing Forum. November 27;33(6):1143-50.
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