Inventories and Cost of Goods Sold Essay Example

Essays on Inventories and Cost of Goods Sold Essay The paper "Inventories and Cost of Goods Sold" is a great example of an essay on finance and accounting. Students face difficulty in understanding the difference between the physical flow of inventory and the cost flow assumption because the cash flow does not consider taxes in its computations unlike the physical flow of inventory (Greenberg Wilner, 2011). This arises because taxes are not permanently reduced, but deferred. It implies that the reduced amount will still be remitted to the tax authorities after the decrease in the cost of inventory. It is also apparent that the deferred tax owed by an organization is beneficial during inflationary periods since it reduces net income. Another reason that causes confusion between the physical flow of inventory and the cost flow is the earnings in which costs are charged off against current revenues (Greenberg Wilner, 2011). This takes place during inflationary periods when prices of goods are high and the company tends to reduce its c osts by hiking charges. It is also evident that the cost flow assumption is different from the physical flow of the products because a firm can turn around inventory through the sale of its oldest units first and then run the overheads using LIFO or weighted average (Greenberg Wilner, 2011). This suggests that firms normally switch cost flow assumption from FIFO to LIFO during inflation. As a result, spreading the current higher overhead costs into the cost of goods sold (COGS) on the income statement and tax return reveals a positive net income and less payable returns. In this regard, the disparity evident between the physical flow of inventory and the cost flow assumption relates to the taxes and net income that a firm attains to achieve when prices are higher in the market (Greenberg Wilner, 2011).

Service Quality and Customer Satisfaction Free Samples for Students

Question: Discuss about the Service Quality and Customer satisfaction in branded hotels in kiev. Answer: Introduction The main purpose of this research is to evaluate the effect of service quality in the branded hotel in kvei. This part of research proposal will provide a systematic direction to conduct the research study. The research methodology chapter will incorporate the philosophy, approach, strategy, data collection method and sample selection. Those will be the essential to get effective information and data to solve the problem of the research study. Research Objectives To explore differences on customers service quality perceptions among branded hotels in kiev. To evaluate the impact of different service quality standard on the customer satisfaction in branded hotels in kiev. To evaluate the challenges faced by the branded hotel during the implementation of service quality standard in kiev. To recommend `different ways to overcome the challenges encountered in the implementation of service quality standards in kiev. To propose strategies to increase customer loyalty Literature Review The importance of service quality and customer satisfaction in the hospitality sector Understanding the consumer is an effective factor for the success in the hospitality industry. According to the Chen and Chen (2010), the service quality and customer satisfaction are more important in the luxury properties, where the guest expects the high-quality service. In addition to this, service quality, customer satisfaction and positive customer experience play a very important role in the organization success because it will become a reason for the customer that they wish to return to the hotels and stay longer. Moreover, customers also recommend the establishment to others. Hence, operators of the hotel must take care on the quality of the service that has been encountered by the guest. In the present context, when most of the hotels deliver similar facilities than the survival of the branded hotels depends on the quality of service offers by the hotels to the customers. In contrast to this, Ryu et al (2012) stated that difference within the culture gives an impact on the customer belief related to the quality of service and customer satisfaction. Along with this, customer mostly focuses on the luxury but somehow the customers also concentrated on the space, time and freedom that should also describe the perception of the customers. Moreover, Ryu and Han (2010) described that pricing is an indicator of the luxury service. At the same time, the business customers were given more focused on the pricing as compare to the luxury. As the high price service also leads to an expectation for the good quality services, large rooms, pleasant atmosphere, and good location in the branded hotels. Service quality refers to the degree of difference between the expectation of customers and the service that are actually perceptions of performance. It also refers to the particular service comparing that performs with the customer's general expectation from the service consumed by the customers. Service Quality As per the view of Siddiqi (2011) that there are mainly three types of services quality offers by the hotel i.e. service experience, physical product, and food and beverage service quality. In addition to this, the stressed the improving the service quality in lights on the branded hotel of the whole world to motivation required that support brand image. The personality traits of the front-line employees of the hotels should correlate with the customer perception and the hotel managers are also train their personal for the ensure delivery of politeness, friendly and respectful services. Nam et al (2011) support the view of Siddiqi (2011) that quality of service is an important factor that determines the behavioral intention and customers satisfaction. As per the views of Rahmana et al (2014), SERVQUAL model is used to identify the difference between customers perception and customer expectations. It is an approach in service quality that will manage the business process in the context to ensure the service quality as well as full satisfaction level of the customers. The SERVQUAL model has used a service quality framework that has been developed by the Zeithaml which aim to measure the scale of service quality in the service sectors. Along with this, Ali and Raza (2017) supports the views of Rahmana et al (2014) that SERVQUAL model has been measured with the help of 10 aspects i.e. access, competence, courtesy, credibility, communication, responsiveness, tangibles, security, credibility and understanding the customers. It is helpful to measure the gap between the customer expectation and customer experience. This model is used within the service industries that helps to understand the perception of the service needs of the customer s and also provide measurement related to the service quality. According to the Ajam et al (2014) SERVQUAL model is applied on the internally basis in the service industries to know the perception of the customers and the overall objectives of this model are to achieve the improvement in service. SERVQUAL model provides information related to the perception of customers for service and the level of performance that has been perceived by the customers. With the help of this model, hotels will able to estimate the information related to the comments and suggestions of the customers. Along with this, it also able to take information related to the impression from employees with due respect to the expectation and satisfaction level of the customers. On the other hand, there is very less evidence by which the customer can access the quality in order of expectation and perception gap. In favor to this, Peprah and Atarah (2014) states that SERVQUAL model can enable the organization to access the service quality in order to the perspective of the customers. It also helps for the comparison within competitors in order to the common aspect of service. Through this, it will able to access the perception and expectations of the internal customers and also an organization can track the perception and expectation level of the customers over the time period. Further to this, the quality of service is the difference between the expectation level of service and performance level of the service. In contrast to this, Xie and Heung (2012) stated that poor quality of service by the hospitality lead to the dissatisfaction level of the customers. There are some factors that are responsible for maintaining the quality service and gap i.e. reliability, tangibility, assurance, empathy, and responsiveness. All the dimensions of the service quality affect the satisfaction level of the customers. Along with this, evaluation level of service quality and customer satisfaction affects the measure of the success of business at thebottom level. The branded hotel in the Kievremains competitive in thecontext of customer satisfaction and the hospitality industry search many investors who are willing to meet all requirements of the customers. In support to this, Clemes et al (2011) stated that service quality pays a very powerful attention to increase in profit and market share that will help to meet the overall expectation of the customer. It becomes a strategic factor that will help to differentiate the service quality from the other competitors. The service quality of branded hotels does not only increase the customer satisfaction but also it also contributes to the market share and returns on investment. On the other hand, quality of service is an essential tool for the success of the organization in the competitive environment, which also influences the decision-making process of the organization. It will help to improve the relationship between the customers and the company. Moreover, Ooi et al (2011) described that h hospitality industry is facing theproblem of increased competition and environment pressure that will result in the globalization, economic situation and technological advancement. The branded hotels a re focusing on understanding the needs and demand of the customers and also set out the strategies that are responsible for the success of the organization. In oppose to this, mistake to make the provision related to the quality of service increase the level of cost by which reputation of the organization will suffer. Customer Satisfaction Customer satisfaction means to deliver goods and services that will create a specific level of the perceived value towards the customers to remain positively engaged with the hotel industry. The highly satisfied customer means the customers that their actual performance is more than the level of expected performance. The level of high service quality and customer satisfaction is known as the fundamental factor that will help to improve the overall performance of the hotel as well as the tourism industry. According to the Jahanshahi et al (2011), the managers of hotel industry consider the business that can make the high profit by satisfying the customers. At the same time, the satisfied customer did not provide the guarantee that they will avail the service again. In the hotel industry, the success of the hotels depends on the customer satisfaction so the companies always striving to receive a high level of customer satisfaction by providing service quality. As per the views of a scholar, there is 10 useful requirements to evaluate the quality of service i.e. reliability, responsiveness, credibility, tangibility, security, communication, understanding the customers, and competence. Customer Satisfaction and Customer Loyalty In favor to this, Han et al (2011) stated that all operators of the hotels are continuously trying to increase the quality of service as the satisfied customers will lead to the overall success and customer loyalty. The customer loyalty has two magnitudes such as behavioral and attitudinal. The high-quality service of the customer will lead to the positive and higher repurchase behavior of the customers. Along with this, brand image is basically referred that what comes in the mind of the customers from the direct experience of the service that the customers have from the organization. Customer satisfaction is to be an indicator of the future income and profit of the overall company. In addition to this, the quality of service in the hospitality sector is the great indicators for the satisfaction that will help the company to catch in the competitive era. The service quality of the firms is realized at the time when the quality of product maintains the competitive edge. The relations hip between the service quality and loyalty of customers refers to the positive feeling that will result to receive the higher expectation level of the organization. The satisfaction level of the customers is an important factor to create and reinforce the long-term relationship and customer loyalty between the customers and service providers. Moreover, the satisfaction level of the customer is directly related to the customer loyalty. Branding and Service Quality According to the Kassim and Asiah Abdullah (2010) that to overcome the challenges encountered in the implementation of service quality standards, the branded hotel should motivate the employees that will help to do their work well. Along with this, the hotel should solve the problem of the overconfidence within the employees and provide them the accurate knowledge that will help them to attract more and more customers. In addition to this, management should ensure the employee those have direct contact with the guest. The company should provide proper induction by which they understand the values and culture that will help to increase the customer satisfaction and maintain the quality standard. Research philosophy Research philosophy will provide an appropriate direction to the researcher to conduct the research and it will be associated with the belief based on the ontological and epistemological. With the help of research philosophy, the researcher will easily develop an understanding related to the topic and issue. Mainly, there is three research philosophy i.e. realism, interpretivism, and positivism that will helpful to provide knowledge in the research issue (Collins, 2010). The positivism is used to focus on the social phenomena that influence the individual who gives real outcomes related to the research issue. On the other hand, interpretivism philosophy is used to assure the subjective nature of the research topic and suitable for the qualitative approach. In this research, the researcher will use the interpretivism philosophy by which the researcher will investigate the customer feedback on the service quality that is useful for the hotel operator to increase the quality of service (Creswell, 2013). Research Approach The research approach will helpful the researcher to determine the effective that will useful to accomplish the objective of the research study. Along with this, there are two types of research approach i.e. inductive approach and deductive approach. Inductive approach is useful for the development of new theories (Levy and Lemeshow, 2013). On the other hand, the deductive approach focuses on the existing theories testing that is also known as the top-bottom approach. The topic of the research study is subjective in nature that will motivate the researcher to use the inductive approach in the study. Along with this, with the interpretivism, philosophy inductive approach will suitable because this research is mainly based on the views and thoughts. The deductive approach will not in the research study by the researcher because it is relevant to the positivism philosophy and perception, attitude and beliefs of customers and employees of hotels are not measurable (Robson and McCartan, 2016). The researcher will use an inductive approach that will help to create a new theory in order to see the impact of service quality of branded hotel on the customer satisfaction in kevi. Research Strategy The research strategy is an effective aspect of the research methodology that will evaluate the ways of the data collection that are used to solve the research issue. There are various types of research strategies such as experimental, survey, case study and many more. With the help of research strategy, the researcher can enhance the consistency of the research that will helpful to solve the problem and to achieve the overall research objective (Pickard, 2012). In this research, the researcher will collect all information with the help of case study and survey method. Along with this, the researcher will collect views and thoughts of the existing customers and staff of the hotels with the help of survey method. With the help of survey method, information will be collected on the effective basis and discrimination will reduce in the research study. Data collection method In the research methodology, data collection is a very important part. The researcher will collect the useful and appropriate data that will helpful to solve the research issue and achieve the objectives of the research study. Mainly, there is two types of data collection method i.e. primary data collection method and secondary data collection method. The primary data will collect with the help of various sources i.e. survey, questionnaire and observation method and the data that will be collected with the help of primary data collection method will be new data (Creswel and Clark, 2011). The researcher will also collect the data with the use of secondary data collection method. The secondary data will be collected with the help of annual reports, journals, government reports and many more. The secondary data collection method is less expensive as compare to the primary data collection method (Crowther and Lancaster, 2012). The researcher will also use the primary data to increase the worth of the research study and it will be collected with the help of a questionnaire. In this research, the researcher will use particular 4 hotels and will collect the data with the help of on- site survey by distributing the questionnaire. The researcher will collect the data by distributing hard copy in the hotel and also by using E-Survey by using e-mail service. Along with this, the on-site survey is more realistic for the researcher to collect the information related to service quality and customer satisfaction in the hotels. The researcher will talk to the employees of the hotel because the researcher will also want to take information from the employee about the customer satisfaction and service quality. The researcher will select 5 managers from each hotel and take the information with the help of interview method. On the other hand, in this research, the data collection method will be helpful to analysis the issue with the help of past and present existence of the data that will maximize the significance of the research study. The quality of data will need to maintain before, after and during the data collection process. Sample Selection Sampling is the process of the selection of the participants within the defined population that helps to collect desire information and data to solve the research problem. The appropriate sampling method helps the researcher to identify proper observation among the target population. There are two sample selection method i.e. probability sampling method and non-probability sampling method, which is used by the researcher to target the population to collect the data. In addition to this, probability sampling method known as the method that will give equal chance to the research participants and reduce the biases. At the same time, non-probability sampling not provides an equal chance to all participants in the target population. The researcher will target 60 participants from each hotel and 300 participants onsite from online. Gantt chart Grant chart is a presentation of the project schedule that will show start date and end date of the service elements. It is also known as the bar chart. The no of weeks and timescale that can be taken for the completion of research can be described as below- Name of Activity Number of Weeks 1 2 3 4 5 6 7 8 9 10 Research topic selection Design aims and objectives of the research Secondary information collection Designing questionnaire target population and sampling Selection survey Analysis of findings final draft Submission of report From the above discussion, it can be identified that the research will take the time of 10 weeks. On the other hand, some activities take more time as compare to rest activities. Ethics The research study will have to be organized in an ethical manner by the researcher that will help to increase the reliability of all research outcomes. The researcher should use the right of privacy and the researcher will use all information and data as per their own view. The researcher should effectively manage all issue that will arise in the research study (Murchison, 2010). The main issue in this research will arise related to the confidentially, rules and guidelines, misuse of the information, utilization of authentic sources and many more. Along with this, the handle of ethical issues will protect the researcher against the legal implication of the research study. In addition to this, the research study of the researcher will become damage if the researcher has any doubt related to the integrity and objectivity (Smith, 2015). Hence, it will be the responsibility of the researcher to maintain all the issues in an effective manner. For the fabrication of data, ethical consideration will play a very important role in the research study. The ethical behavior of the researcher will be very effective because it will encourage the researcher to maintain accountability, respect and trusty environment. Expected outcomes The research proposal will enlarge the understanding and effectiveness of the service quality and customer satisfaction in the branded hotels in kiev. The research will facilities the in depth understanding of the service quality standard that will affect the customer satisfaction in luxury hotels. In addition to this, the research will also specify the challenges faced by the hotel towards maintaining the service quality standard and also provide a recommendation to overcome the challenges in the branded hotels in kiev (Mallinson et al., 2013). The research will explore the various outcomes that will attain by the hotel operators after maintaining the service quality standard in branded hotels. Moreover, the aim and objective of the research will receive with the help of gathering data, analysis, and findings. The research proposal will be significant for the hotel operators as well as the readers that will helpful to retain the knowledge related to service quality standard in the b randed hotels. References Chen, C.F. and Chen, F.S. (2010) Experience quality, perceived value, satisfaction and behavioral intentions for heritage tourists, Tourism management, 31(1), pp. 29-35. Clemes, M.D., Gan, C. and Ren, M. (2011) Synthesizing the effects of service quality, value, and customer satisfaction on behavioral intentions in the motel industry: An empirical analysis, Journal of Hospitality Tourism Research, 35(4), pp. 530-568. Collins, H. (2010) Creative Research: The Theory and Practice of Research for the Creative Industries. US: AVA Publishing. Creswell, J.W. and Clark, V. P. (2011) Designing and Conducting Mixed Methods Research. London: SAGE. Creswell, W.J. (2013) Research Design: Qualitative, Quantitative, and Mixed Methods Approaches. US: SAGE Publications. Crowther, D. and Lancaster, G. (2012) Research Methods. UK: Routledge. Han, H., Kim, W. and Hyun, S.S. (2011) Switching intention model development: Role of service performances, customer satisfaction, and switching barriers in the hotel industry, International Journal of Hospitality Management, 30(3), pp. 619-629. Jahanshahi, A.A., Gashti, M.A.H., Mirdamadi, S.A., Nawaser, K. and Khaksar, S.M.S., (2011) Study the effects of customer service and product quality on customer satisfaction and loyalty, International Journal of Humanities and Social Science, 1(7), pp. 253-260. Kassim, N. and Asiah Abdullah, N. (2010) The effect of perceived service quality dimensions on customer satisfaction, trust, and loyalty in e-commerce settings: A cross cultural analysis, Asia Pacific Journal of Marketing and Logistics, 22(3), pp. 351-371. Levy, S.P., and Lemeshow, S. (2011) Sampling of Populations: Methods and Applications. US: Wiley. Mallinson, C., Childs, B., and Herk, G.V. (2013) Data Collection in Sociolinguistics: Methods and Applications. UK: Routledge. Marshall, C., and Rossman, G.B. (2010) Designing Qualitative Research. London: SAGE. Murchison, J. (2010) Ethnography Essentials: Designing, Conducting, and Presenting Your Research. USA: John Wiley Sons. Nam, J., Ekinci, Y. and Whyatt, G. (2011) Brand equity, brand loyalty and consumer satisfaction, Annals of Tourism Research, 38(3), pp. 1009-1030. Ooi, K.B., Lin, B., Tan, B.I. and Yee-Loong Chong, A. (2011) Are TQM practices supporting customer satisfaction and service quality?, Journal of Services Marketing, 25(6), pp. 410-419. Pickard, A. (2012) Research methods in information. UK: Facet publishing. Robson, C. and McCartan, K. (2016) Real world research. USA: John Wiley Sons. Ryu, K. and Han, H. (2010) Influence of the quality of food, service, and physical environment on customer satisfaction and behavioral intention in quick-casual restaurants: Moderating role of perceived price, Journal of Hospitality Tourism Research, 34(3), pp. 310-329. Ryu, K., Lee, H.R. and Gon Kim, W. (2012) The influence of the quality of the physical environment, food, and service on restaurant image, customer perceived value, customer satisfaction, and behavioral intentions, International Journal of Contemporary Hospitality Management, 24(2), pp. 200-223. Siddiqi, K.O. (2011) Interrelations between service quality attributes, customer satisfaction and customer loyalty in the retail banking sector in Bangladesh, International Journal of Business and Management, 6(3), p. 12. Smith, J.A. (2015) Qualitative psychology: A practical guide to research methods. London: Sage. Xie, D. and Heung, V.C. (2012) The effects of brand relationship quality on responses to service failure of hotel consumers, International Journal of Hospitality Management, 31(3), pp. 735-744. Rahmana, A., Kamil, M., Soemantri, E. and Olim, A. (2014) Integration of SERVQUAL and Kano model into QFD to improve quality of simulationbased training on project management, International Journal of Basic and Applied Science, 2(3), pp. 59-72. Ali, M. and Raza, S.A. (2017) Service quality perception and customer satisfaction in Islamic banks of Pakistan: the modified SERVQUAL model, Total Quality Management Business Excellence, 28(5-6), pp. 559-577. Ajam, M., Sadeghifar, J., Anjomshoa, M., Mahmoudi, S., Honarvar, H. and Mousavi, S.M., (2014) Assessing quality of healthcare service by the SERVQUAL model: A case study of a field hospital, Journal Mil Med, 15(4), pp. 273-279. Peprah, A.A. and Atarah, B.A. (2014) Assessing Patients Satisfaction using SERVQUAL Model: A Case of Sunyani Regional Hospital, Ghana, International Journal of Business and Social Research, 4(2), pp. 133-143.

Neighborhood Watch Essays - Community Development, Local Government

Neighborhood Watch The Neighborhood Watch: One of the most effective crime prevention tools being utilized today is the Neighborhood Watch. The Neighborhood Watch was designed to help strengthen the relationships between neighbors and in the process build community wide crime prevention. Law enforcement officials have for years relied on the community to assist in apprehending criminals after the crime has been committed. With a Neighborhood Watch, this assistance is proactive instead of reactive, meaning that the watch can stop the crime before it occurs. A Neighborhood Watch can be formed around any geographical unit: a block, apartment, public housing complex or neighborhood. A watch group serves as an extra set of eyes and ears for reporting crime and helping neighbors. The effectiveness of a Neighborhood Watch is depends on its members. The Neighborhood Watch serves as a springboard for efforts that address community concerns such as recreation for youth, child care, and affordable housing. A Neighborhood Watch can easily be set up, first contact your neighbors, then then contact your local law enforcement agency and check about setting up a Neighborhood Watch meeting. In order for a group to be certified as a neighborhood watch, most agencies require a minimum of two initial meetings. After the two initial meetings, it is up to each neighborhood to elect a captain for the Neighborhood Watch. Once this is done, the captain will receive signs that will announce to would be criminals that the neighborhood is on the watch. (National Crime Prevention) There are some tips that are important to keep in mind, which help the Neighborhood watch succeed. First, organize regular meetings that focus on current issues such as drug abuse, crime in schools, recreational activities for young people, and neighborhood problems. Second organize community patrols to walk around streets or apartment complexes and report suspicious activity to police. People in cars with cellular phones or CB radios can also patrol. Also, adopt a park or street in the neighborhood. Pick up litter, repair broken equipment, paint over graffiti, to make the neighborhood look nicer. If your

010 Ethos and Audience Professor Ramos Blog

010 Ethos and Audience Ethos Quick Write Ethos Ethos is about values. In rhetoric we connect ethos to  character, credibility, and trustworthiness.  At their core, these concepts have to do with values. We tend to believe and trust those individuals who exemplify the values we cherish, who live the sort of life that we would want to live.  Ethos Handout from University of Maryland Ethos is inferred, NOT possessed. Five strategies for persuading through character. Personal info Sources Identification with Audience Point of View Balanced Presentation 5 Ways to Persuade with Character (Ethos) | How to Craft an Argument Presidential Hats Trump in Cowboy Hat Obama in Cowboy Hat Bush in Cowboy Hat Using Rhetoric Notes Ethos Research Unbiased Pathos Emotional Storytelling So What? Logos Logical History Facts Statistics Evidence Authority/Pros Background Include the Conversation What argument is she making? How does she build Ethos? How does she use pathos? How does she use logos? Understanding Audience Audience is quite possibly the most important thing to consider when writing an argument. You need to appeal to them, understand their problems, values, and beliefs, in order to convince them of your point of view. Who your audience is should influence  how  you present your argument. Who your audience is should influence  how  you present yourself. Who is your audience? Determine what is important to your audience. What do they really care about? What do they value? Are your reasons in line with those values? Argumentative Essay Arguing a Solution to a Problem Position. Take a clear position on an arguable topic. Reasons. Develop main reasons, keeping audience in mind. Evidence. Support all reasons with strong research. Opposition. Acknowledge the opposing argument and take it out. Agree or Disagree with a Reading from our Textbook Summarize the article and argument. Agree or Disagree but add something. Incorporate research to argue your position. Take a Position on a Controversial Topic Present the controversial topic. Give pro arguments. Give con arguments. Take a position. Integrate research to argue your position.

Analysis Of The Medical Marketplace Health And Social Care Essay

Although my brother was a comparatively healthy babe, he suffered from terrible asthma onslaughts. At the clip, the interventions of asthma onslaughts were unwritten bronchodilators because inhalators were non readily available to be purchased in Nigeria. The customary process for antagonizing reoccurring asthma onslaughts was for one to see their physician, who would order one an unwritten bronchodilator that one could so buy from their local pharmaceutics. So my female parent took my brother to our local baby doctor who examined him and prescribed the unwritten bronchodilator, aminophylline. ( Harmonizing to the NIH, aminophylline is used to forestall and handle wheezing, shortness of breath, and trouble external respiration caused by asthma, chronic bronchitis, emphysema, and other lung diseases. It relaxes and opens air transitions in the lungs, doing it easier to take a breath ) . She so went to our local pharmaceutics to buy the aminophylline with the trade name name Franol. As a pediatrician-in-training, my Dad vehemently agreed with this determination and was the primary force in forcing the visit to the physician. He remembered that there were non many other merchandises on the Nigerian market that would be effectual. My female parent gave him one pill instantly and took him place to rest. Weeks subsequently my ma, a physician-in-training herself, was reading a local medical diary when she came to an article about forgery Franol. The article stated that there was imitative Franol on the market that was being distributed to all the pharmaceuticss in the state. Could I hold given my boy bogus medicine † , my female parent idea. This was in fact the instance. Even though the Franol had the exact same pill signifier and was the exact same medicine that had been successful in so many other instances, the Franol she had given to her boy was forgery. She was devastated: â€Å" I merely could n’t believe it † . Unfortunately, this was non her lone experience with imitative medicine ; anti-malarial forgeries were besides common in Nigeria. This occurred in the late eightiess as was mentioned before. One would hold expected that things have gotten much better. Unfortunately, non much had changed when my pa visited earlier this twelvemonth. In fact, as my male parent provinces, some facets have become even more inferior: â€Å" some things are worse as doctors now openly divert patients to their private clinics, something that was barely seen during my clip at that place † . So the basic inquiry that most would inquire is: why has at that place been so small alteration in the efficaciousness of the medical market place? Why can the Nigerian medical market place non germinate to go like that of the United States or others that are smartly regulated? The inquiry is more sophisticated answer than one would anticipate In fact, these inquiries can merely be answered by analysing another inquiry and the cardinal issue of my treatment: how and why does the efficaciousness of the Nigerian medical market place differ from the American system? To be clear, when I mention medical market place, I am specifically mentioning to the buying, merchandising, and efficaciousness of pharmaceuticals and equipment as they are distributed and wheedled in the community to ordain good wellness. Before I delve more profoundly into the issue, it is necessary to set the treatment into context with a elaborate description of Nigeria ( in contrast with the U.S. ) including critical statistics and wellness attention systems, among other things. With a late counted population of more than 144 million people, Nigeria is the most thickly settled state in Africa. Compare this to somewhat more than 300 million in the United States. Located in West Africa, it is somewhat more than twice the size of California and boundary lines the Gulf of Guinea, between Benin and Cameroon. Life anticipation is 44 old ages and 45 per centum of the population is under 15 old ages of age ( Chankova et al. , 1 ) , while life anticipation in the U.S. is about 70 old ages of age. The under-five mortality rate per 1,000 unrecorded births is 201 while the maternal mortality rate is estimate at 800 per 100,000 unrecorded births ( 1 ) . Among the major subscribers to the disease load of the state are malaria, TB, and HIV/AIDS. There are great disparities in wellness position and equity of wellness attention among different population groups in Nigeria. For illustration â€Å" the under-five mortality rate in rural countries is estimated at 243 per 1,000 unrecorded births, compared to 153 per 1,000 in urban countries. While 59 per centum of adult females in urban countries deliver with a physician, nurse, or mid married woman, merely 26 per centum of adult females in rural countries do so † ( 1 ) . Harmonizing to the World Health Organization, the entire outgo on wellness in Nigeria as per centum of GDP is equal to 4.1, about four times less than that of the United State at 15.5 per centum. The national wellness attention policies, schemes, and guidelines have been mostly related to turn to the wellness jobs related to malaria, TB, and HIV/AIDS. â€Å" A five-year strategic program for RBM was developed with chief aims to cut down the morbidity and mortality of malaria by 25 per centum by the terminal of 2005, peculiarly among pregnant adult females ; and to cut down malaria instance human death by 10 per centum in pregnant adult females and kids by the terminal of 2005 † ( 2 ) . However, these attempts have mostly been uneffective because of corruptness and inefficiency. The wellness service proviso in Nigeria includes a broad scope of suppliers in both the populace and private sector, such as public installations, every bit good as community based and religions based organisations. Nigeria is a federation with three grades of authorities: federal, province, and local. Responsibility for wellness service to the populace is based on this organisation. Each degree has a primary function in this wellness duty, which is non unlike that of the U.S. The first degree of attention is local. Facilities at this degree organize the entry point of the community into the wellness attention system. â€Å" They include wellness centres and clinics, dispensaries, and wellness stations, supplying general preventative, healing, and pre-referral attention. Primary installations are typically staffed by nurses, community wellness officers, community wellness extension workers, and environmental wellness officers. Local Government Areas are mandated by the fundamental law to finance and manage primary wellness attention † ( 2 ) . The following degree is province, including secondary attention installations. Secondary attention installations include â€Å" general infirmaries, supplying general medical and research lab services, every bit good as specialized wellness services, such as surgery, paediatricss, OBs and gynaecology. General infirmaries are typically staffed by doctors, nurses, accoucheuses, research lab and pharmaceutics spe cializers, and community wellness officers. Secondary degree installations serve as referral points for primary wellness attention installations. Each territory or zone is expected to hold at least one secondary degree wellness installation † ( 2 ) . The largest degree of attention is federal or third. The third degree installations form the highest degree of wellness attention in the state and include specializer and instruction infirmaries and federal medical centres. They treat patients referred from the primary and secondary degree and have particular expertness and â€Å" fully fledged technological capacity that enables them to function as referral centres and resource centres for cognition coevals and diffusion. Each province has at least one third installation. Primary and secondary degree of attention is besides provided by the mostly unregulated private wellness sector, which includes a broad scope of suppliers such as physician patterns, clinics, and infirmaries â €  ( 2 ) . Outside of the modern wellness attention system, faith-based organisations support clinics and infirmaries and traditional herb doctors are another often used beginning of attention. Nigeria has one of the largest stocks of human resources for wellness in Africa comparable merely to Egypt and South Africa. There are about 35,000 physicians and 210,000 nurses registered in the state, which translates into 28 physicians and 170 nurses per 100,000 in the population. ( 3 ) . However, this figure is still dwarfed by the United States. In comparing, the U.S has 218 physicians and 958 nurses per 100,000. In add-on, there is a really limited ( about non-existent ) local capacity for research and development of advanced pharmaceutical drugs to be put in to the medical market place. This means that the local fabrication capacity is merely geared towards a little category of common generic merchandises that are comparatively easy to fabricate. Even so, much of that capacity is for secondary packaging instead than for existent fabrication. Harmonizing to my male parent: â€Å" capacity use is merely approximately 40 % due to hapless basic substructure such as electric power coevals † . Imagine what that excess 40 per centum could make. In footings of the medical market place, a prescription is non needed to purchase antibiotics and most common medicines in Nigeria. Prescriptions are merely needed for controlled substances like opiods or benzodiazepines. Peoples can acquire ill and walk into a pharmaceutics inquiring for a peculiar sort of antibiotic. An immediate return of antibiotics is non possible without a prescription in the U.S. As good, Nigeria relies to a great extent on importing of finished pharmaceutical merchandises to run into national drug demands. Therefore, the pharmaceutical supply concatenation is really helter-skelter and until late was really ill regulated. Even so, the current regulative system has really limited capacity, particularly with the widespread corruptness and unequal enforcement of Torahs and ordinances, some of which are long disused. Unlike in the US, go oning instruction is non emphasized. Health attention suppliers frequently are non held decently accountable for their determina tions on attention, mostly because the patients are by and large uninformed and unempowered to be spouses in their attention. Added to all of the above is the fact that there is widespread superstitious notion, ignorance, and poorness. Many people still believe an unwellness to be a expletive visited on them by wicked/evil people or the spirit of their ascendants. There are still deep rooted beliefs in enchantresss. As a consequence, people foremost consult mediums, churches, mosques, traditional medical specialty men/women, and untrained drug shop attenders for intervention of common complaints. Others self-medicate. Often, the people use the infirmary or trained physician ‘s office as a last resort when their conditions are in advanced phases or worse, terminal. Let me besides add that in infirmaries and exigency suites, drugs and other supplies are frequently non-existent. In fact, my pa recounted sing a kids ‘s exigency room 6 old ages back: â€Å" I remember sing a kids ‘s exigency room in 2004 when we visited merely to see a kid with diabetic coma whose parents were told to travel to a pharmaceutics shop in town to purchase their ain insulin, syringe, needle, extract set, and extract, among other supplies needed. As if that was non bad plenty, subsequently he was told by the physicians in the exigency room that the insulin he bought was forgery and that it will non cut down the girl ‘s blood sugar. He now had to travel looking for a echt insulin injection † . An incident like this is can ne’er go on in the United States. If this were to go on in the U.S. and be reported by the imperativeness, there would instantly be an probe into the infirmary ‘s method, people would be arrested and caputs would tur n over. But in Nigeria, no one even water chickweeds. Subsequently my male parent recounted some more of his experiences with the medical market place in Nigeria: â€Å" In 2005, I was in another infirmary to see the caput of the infirmary who used to be my co-worker in the section of paediatricss of a teaching infirmary in another metropolis. While chew the fating with him, his caput of surgery came into his office to inform him that they can non make any surgery that twenty-four hours because they have run out of all surgical kits but one, which they are reserving for a desperate exigency † . One must maintain in head that these two incidents occurred in the really best and largest infirmaries in those two several metropoliss. Imagine a sawbones in New York City non being able to execute life-saving surgery because he has merely one surgical kit left to utilize. What tumult would such a thing cause! These two incidents and the aforesaid issues are among the many factors that foster the counterfeiting of drugs and have led to th eir overpowering presence in the Nigerian medical market place. In an interview with my ma, she stated, â€Å" they say that 60-70 % of pharmaceuticals in the market topographic point of Nigeria were imitative † . However, in my interview of my male parent he refuted that statistic: â€Å" of pharmaceutical merchandises in the market, approximately 20 % are estimated to be imitative † . So which statistic is accurate? Well, merely the fact that there is some difference as to the sum of forgeries on the market suggests that there is an innate job with the information that is distributed to the population. My parents are highly educated compared to the mean Nigerian, yet there still seems to be some dissension. â€Å" Everyone involved in contending the illegal trade admit how hard it is to quantify the job and hence step its success † . As stated by Abiodun Raufu of the World Health Organization, the forgery market thrives on ignorance among the people: â€Å" In 2001, most Nigerian consumers were unmindful to the danger of f orgery drugs. ‘Fake drug traders used to boom chiefly because of a deficiency of consciousness ‘ [ stated Dora Akunyil ] . Warnings were broadcast on wireless and telecasting to do the public aware of the dangers and to promote people to describe leery drugs. Newspapers on a regular basis published lists on forgery drugs. Last twelvemonth, fake drugs deserving about two billion naira ( US $ 16 million! ) were voluntarily handed over by forgers or seized after tip-offs from the populace † . Progression is being made but his deficiency of consciousness will finally forestall the cognition of caution from spreading through the population. How does this contrast with the U.S. ? Surprisingly, there is a turning job of forgery drugs in the U.S. every bit good because of the turning disposition of upper category society to seek â€Å" non-traditional † medicine imported from different states. Harmonizing to the National Center for Complementary and Alternative Medi cine: ‘more than one-third ( about 36 % ) of U.S grownups use complementary and alternate medical specialty and that figure is on the rise † . Let ‘s travel back to the about tragic narrative of my older brother and his terrible asthma onslaughts. Although the consequence was about tragic, my ma did what she was supposed to make. She gave her boy medicine that she expected to assist alleviate his symptoms. So whose mistake was it? Depending on who you ask the reply will change, most patients will fault the physician because he was the 1 who wrote the prescription. Others will fault the druggist because he was the 1 who bottled the medicine as if it was the exact same medicine. Still others will fault themselves for giving their kid medicine that hurt them. To this twenty-four hours, my ma blames herself for what occurred and remains cautious when she gives her kids medicine. Even so, indicating the finger is non of import in this state of affairs. More of import than who is to fault is analysing whether the state of affairs is still salvageable. At some point in every issue or treatment, there is a point of no return, where any solution becomes inaccessible. Could the medical market place in Nigeria have already been packed to the top with so many forgery drugs that it will be impossible to blush them all out, or at least to the degree of tolerability? Still, some argue that an chance exists for betterment in the Nigerian pharmaceutical sector and the full wellness attention system. There was a recent U.S. wellness attention reform jurisprudence passed in March 2010. While the jurisprudence ( Patient Protection and Affordable Care Act [ PPACA ] ) remains controversial, the jurisprudence expanded coverage to the antecedently uninsured and those with preexisting medical conditions, provided single authorizations so that those who are healthy can purchase insurance coverage thereby avoiding an unduly big bad pool that the insurance companies may be left with, and developed the program for the constitution of Patient Centered Outcome Research Institute ( PCORI ) to measure comparative effectivity of attention, among many other commissariats ( Kruger ) . Many Nigerian physicians, particularly those in the U.S. have discussed the possibility of suggesting statute law that has elements of this American statute law. There is talk that such a proviso may come up on the national treatment in the following 10 old ages. Besides, Nigeria has been at the head of planetary attempts to contend forgery drugs since Dora Akunyili took over the National Agency for Food and Drug Administration and Control ( NAFDAC ) in 2001 ( Raufu ) . â€Å" Before Akunyili took over, staff abused their place to extort money from honest makers at the same clip as taking payoff from forgers in return for entree to the Nigerian medical specialties market. Akunyili fired the most corrupt of her officers. To promote honestness among her staying 3000 staff and to hike morale, she offered inducements such as preparation abroad, improved installations and a better working environment † . Nevertheless, no affair how promising this sounds, the obliteration of such jobs as counterfeiting is non even remotely close. The solution to these jobs ( which besides reflects what is go oning within the full society ) rests with leading. As my male parent pr ovinces: â€Å" Nigerian leaders and elites non merely steal public money instead than utilize such money to for the greater good of the people, they and their households fly abroad for their wellness attention and their kids ‘s instruction. So they lack the will or involvement to do things better for the generalization of the population † . Furthermore, nil in the medical market place will alter because leading will ne’er basically change for the greater good of the people of Nigeria. The point of no return has been reached. Analysis Of The Medical Marketplace Health And Social Care Essay Although my brother was a comparatively healthy babe, he suffered from terrible asthma onslaughts. At the clip, the interventions of asthma onslaughts were unwritten bronchodilators because inhalators were non readily available to be purchased in Nigeria. The customary process for antagonizing reoccurring asthma onslaughts was for one to see their physician, who would order one an unwritten bronchodilator that one could so buy from their local pharmaceutics. So my female parent took my brother to our local baby doctor who examined him and prescribed the unwritten bronchodilator, aminophylline. ( Harmonizing to the NIH, aminophylline is used to forestall and handle wheezing, shortness of breath, and trouble external respiration caused by asthma, chronic bronchitis, emphysema, and other lung diseases. It relaxes and opens air transitions in the lungs, doing it easier to take a breath ) . She so went to our local pharmaceutics to buy the aminophylline with the trade name name Franol. As a pediatrician-in-training, my Dad vehemently agreed with this determination and was the primary force in forcing the visit to the physician. He remembered that there were non many other merchandises on the Nigerian market that would be effectual. My female parent gave him one pill instantly and took him place to rest. Weeks subsequently my ma, a physician-in-training herself, was reading a local medical diary when she came to an article about forgery Franol. The article stated that there was imitative Franol on the market that was being distributed to all the pharmaceuticss in the state. Could I hold given my boy bogus medicine † , my female parent idea. This was in fact the instance. Even though the Franol had the exact same pill signifier and was the exact same medicine that had been successful in so many other instances, the Franol she had given to her boy was forgery. She was devastated: â€Å" I merely could n’t believe it † . Unfortunately, this was non her lone experience with imitative medicine ; anti-malarial forgeries were besides common in Nigeria. This occurred in the late eightiess as was mentioned before. One would hold expected that things have gotten much better. Unfortunately, non much had changed when my pa visited earlier this twelvemonth. In fact, as my male parent provinces, some facets have become even more inferior: â€Å" some things are worse as doctors now openly divert patients to their private clinics, something that was barely seen during my clip at that place † . So the basic inquiry that most would inquire is: why has at that place been so small alteration in the efficaciousness of the medical market place? Why can the Nigerian medical market place non germinate to go like that of the United States or others that are smartly regulated? The inquiry is more sophisticated answer than one would anticipate In fact, these inquiries can merely be answered by analysing another inquiry and the cardinal issue of my treatment: how and why does the efficaciousness of the Nigerian medical market place differ from the American system? To be clear, when I mention medical market place, I am specifically mentioning to the buying, merchandising, and efficaciousness of pharmaceuticals and equipment as they are distributed and wheedled in the community to ordain good wellness. Before I delve more profoundly into the issue, it is necessary to set the treatment into context with a elaborate description of Nigeria ( in contrast with the U.S. ) including critical statistics and wellness attention systems, among other things. With a late counted population of more than 144 million people, Nigeria is the most thickly settled state in Africa. Compare this to somewhat more than 300 million in the United States. Located in West Africa, it is somewhat more than twice the size of California and boundary lines the Gulf of Guinea, between Benin and Cameroon. Life anticipation is 44 old ages and 45 per centum of the population is under 15 old ages of age ( Chankova et al. , 1 ) , while life anticipation in the U.S. is about 70 old ages of age. The under-five mortality rate per 1,000 unrecorded births is 201 while the maternal mortality rate is estimate at 800 per 100,000 unrecorded births ( 1 ) . Among the major subscribers to the disease load of the state are malaria, TB, and HIV/AIDS. There are great disparities in wellness position and equity of wellness attention among different population groups in Nigeria. For illustration â€Å" the under-five mortality rate in rural countries is estimated at 243 per 1,000 unrecorded births, compared to 153 per 1,000 in urban countries. While 59 per centum of adult females in urban countries deliver with a physician, nurse, or mid married woman, merely 26 per centum of adult females in rural countries do so † ( 1 ) . Harmonizing to the World Health Organization, the entire outgo on wellness in Nigeria as per centum of GDP is equal to 4.1, about four times less than that of the United State at 15.5 per centum. The national wellness attention policies, schemes, and guidelines have been mostly related to turn to the wellness jobs related to malaria, TB, and HIV/AIDS. â€Å" A five-year strategic program for RBM was developed with chief aims to cut down the morbidity and mortality of malaria by 25 per centum by the terminal of 2005, peculiarly among pregnant adult females ; and to cut down malaria instance human death by 10 per centum in pregnant adult females and kids by the terminal of 2005 † ( 2 ) . However, these attempts have mostly been uneffective because of corruptness and inefficiency. The wellness service proviso in Nigeria includes a broad scope of suppliers in both the populace and private sector, such as public installations, every bit good as community based and religions based organisations. Nigeria is a federation with three grades of authorities: federal, province, and local. Responsibility for wellness service to the populace is based on this organisation. Each degree has a primary function in this wellness duty, which is non unlike that of the U.S. The first degree of attention is local. Facilities at this degree organize the entry point of the community into the wellness attention system. â€Å" They include wellness centres and clinics, dispensaries, and wellness stations, supplying general preventative, healing, and pre-referral attention. Primary installations are typically staffed by nurses, community wellness officers, community wellness extension workers, and environmental wellness officers. Local Government Areas are mandated by the fundamental law to finance and manage primary wellness attention † ( 2 ) . The following degree is province, including secondary attention installations. Secondary attention installations include â€Å" general infirmaries, supplying general medical and research lab services, every bit good as specialized wellness services, such as surgery, paediatricss, OBs and gynaecology. General infirmaries are typically staffed by doctors, nurses, accoucheuses, research lab and pharmaceutics spe cializers, and community wellness officers. Secondary degree installations serve as referral points for primary wellness attention installations. Each territory or zone is expected to hold at least one secondary degree wellness installation † ( 2 ) . The largest degree of attention is federal or third. The third degree installations form the highest degree of wellness attention in the state and include specializer and instruction infirmaries and federal medical centres. They treat patients referred from the primary and secondary degree and have particular expertness and â€Å" fully fledged technological capacity that enables them to function as referral centres and resource centres for cognition coevals and diffusion. Each province has at least one third installation. Primary and secondary degree of attention is besides provided by the mostly unregulated private wellness sector, which includes a broad scope of suppliers such as physician patterns, clinics, and infirmaries â €  ( 2 ) . Outside of the modern wellness attention system, faith-based organisations support clinics and infirmaries and traditional herb doctors are another often used beginning of attention. Nigeria has one of the largest stocks of human resources for wellness in Africa comparable merely to Egypt and South Africa. There are about 35,000 physicians and 210,000 nurses registered in the state, which translates into 28 physicians and 170 nurses per 100,000 in the population. ( 3 ) . However, this figure is still dwarfed by the United States. In comparing, the U.S has 218 physicians and 958 nurses per 100,000. In add-on, there is a really limited ( about non-existent ) local capacity for research and development of advanced pharmaceutical drugs to be put in to the medical market place. This means that the local fabrication capacity is merely geared towards a little category of common generic merchandises that are comparatively easy to fabricate. Even so, much of that capacity is for secondary packaging instead than for existent fabrication. Harmonizing to my male parent: â€Å" capacity use is merely approximately 40 % due to hapless basic substructure such as electric power coevals † . Imagine what that excess 40 per centum could make. In footings of the medical market place, a prescription is non needed to purchase antibiotics and most common medicines in Nigeria. Prescriptions are merely needed for controlled substances like opiods or benzodiazepines. Peoples can acquire ill and walk into a pharmaceutics inquiring for a peculiar sort of antibiotic. An immediate return of antibiotics is non possible without a prescription in the U.S. As good, Nigeria relies to a great extent on importing of finished pharmaceutical merchandises to run into national drug demands. Therefore, the pharmaceutical supply concatenation is really helter-skelter and until late was really ill regulated. Even so, the current regulative system has really limited capacity, particularly with the widespread corruptness and unequal enforcement of Torahs and ordinances, some of which are long disused. Unlike in the US, go oning instruction is non emphasized. Health attention suppliers frequently are non held decently accountable for their determina tions on attention, mostly because the patients are by and large uninformed and unempowered to be spouses in their attention. Added to all of the above is the fact that there is widespread superstitious notion, ignorance, and poorness. Many people still believe an unwellness to be a expletive visited on them by wicked/evil people or the spirit of their ascendants. There are still deep rooted beliefs in enchantresss. As a consequence, people foremost consult mediums, churches, mosques, traditional medical specialty men/women, and untrained drug shop attenders for intervention of common complaints. Others self-medicate. Often, the people use the infirmary or trained physician ‘s office as a last resort when their conditions are in advanced phases or worse, terminal. Let me besides add that in infirmaries and exigency suites, drugs and other supplies are frequently non-existent. In fact, my pa recounted sing a kids ‘s exigency room 6 old ages back: â€Å" I remember sing a kids ‘s exigency room in 2004 when we visited merely to see a kid with diabetic coma whose parents were told to travel to a pharmaceutics shop in town to purchase their ain insulin, syringe, needle, extract set, and extract, among other supplies needed. As if that was non bad plenty, subsequently he was told by the physicians in the exigency room that the insulin he bought was forgery and that it will non cut down the girl ‘s blood sugar. He now had to travel looking for a echt insulin injection † . An incident like this is can ne’er go on in the United States. If this were to go on in the U.S. and be reported by the imperativeness, there would instantly be an probe into the infirmary ‘s method, people would be arrested and caputs would tur n over. But in Nigeria, no one even water chickweeds. Subsequently my male parent recounted some more of his experiences with the medical market place in Nigeria: â€Å" In 2005, I was in another infirmary to see the caput of the infirmary who used to be my co-worker in the section of paediatricss of a teaching infirmary in another metropolis. While chew the fating with him, his caput of surgery came into his office to inform him that they can non make any surgery that twenty-four hours because they have run out of all surgical kits but one, which they are reserving for a desperate exigency † . One must maintain in head that these two incidents occurred in the really best and largest infirmaries in those two several metropoliss. Imagine a sawbones in New York City non being able to execute life-saving surgery because he has merely one surgical kit left to utilize. What tumult would such a thing cause! These two incidents and the aforesaid issues are among the many factors that foster the counterfeiting of drugs and have led to th eir overpowering presence in the Nigerian medical market place. In an interview with my ma, she stated, â€Å" they say that 60-70 % of pharmaceuticals in the market topographic point of Nigeria were imitative † . However, in my interview of my male parent he refuted that statistic: â€Å" of pharmaceutical merchandises in the market, approximately 20 % are estimated to be imitative † . So which statistic is accurate? Well, merely the fact that there is some difference as to the sum of forgeries on the market suggests that there is an innate job with the information that is distributed to the population. My parents are highly educated compared to the mean Nigerian, yet there still seems to be some dissension. â€Å" Everyone involved in contending the illegal trade admit how hard it is to quantify the job and hence step its success † . As stated by Abiodun Raufu of the World Health Organization, the forgery market thrives on ignorance among the people: â€Å" In 2001, most Nigerian consumers were unmindful to the danger of f orgery drugs. ‘Fake drug traders used to boom chiefly because of a deficiency of consciousness ‘ [ stated Dora Akunyil ] . Warnings were broadcast on wireless and telecasting to do the public aware of the dangers and to promote people to describe leery drugs. Newspapers on a regular basis published lists on forgery drugs. Last twelvemonth, fake drugs deserving about two billion naira ( US $ 16 million! ) were voluntarily handed over by forgers or seized after tip-offs from the populace † . Progression is being made but his deficiency of consciousness will finally forestall the cognition of caution from spreading through the population. How does this contrast with the U.S. ? Surprisingly, there is a turning job of forgery drugs in the U.S. every bit good because of the turning disposition of upper category society to seek â€Å" non-traditional † medicine imported from different states. Harmonizing to the National Center for Complementary and Alternative Medi cine: ‘more than one-third ( about 36 % ) of U.S grownups use complementary and alternate medical specialty and that figure is on the rise † . Let ‘s travel back to the about tragic narrative of my older brother and his terrible asthma onslaughts. Although the consequence was about tragic, my ma did what she was supposed to make. She gave her boy medicine that she expected to assist alleviate his symptoms. So whose mistake was it? Depending on who you ask the reply will change, most patients will fault the physician because he was the 1 who wrote the prescription. Others will fault the druggist because he was the 1 who bottled the medicine as if it was the exact same medicine. Still others will fault themselves for giving their kid medicine that hurt them. To this twenty-four hours, my ma blames herself for what occurred and remains cautious when she gives her kids medicine. Even so, indicating the finger is non of import in this state of affairs. More of import than who is to fault is analysing whether the state of affairs is still salvageable. At some point in every issue or treatment, there is a point of no return, where any solution becomes inaccessible. Could the medical market place in Nigeria have already been packed to the top with so many forgery drugs that it will be impossible to blush them all out, or at least to the degree of tolerability? Still, some argue that an chance exists for betterment in the Nigerian pharmaceutical sector and the full wellness attention system. There was a recent U.S. wellness attention reform jurisprudence passed in March 2010. While the jurisprudence ( Patient Protection and Affordable Care Act [ PPACA ] ) remains controversial, the jurisprudence expanded coverage to the antecedently uninsured and those with preexisting medical conditions, provided single authorizations so that those who are healthy can purchase insurance coverage thereby avoiding an unduly big bad pool that the insurance companies may be left with, and developed the program for the constitution of Patient Centered Outcome Research Institute ( PCORI ) to measure comparative effectivity of attention, among many other commissariats ( Kruger ) . Many Nigerian physicians, particularly those in the U.S. have discussed the possibility of suggesting statute law that has elements of this American statute law. There is talk that such a proviso may come up on the national treatment in the following 10 old ages. Besides, Nigeria has been at the head of planetary attempts to contend forgery drugs since Dora Akunyili took over the National Agency for Food and Drug Administration and Control ( NAFDAC ) in 2001 ( Raufu ) . â€Å" Before Akunyili took over, staff abused their place to extort money from honest makers at the same clip as taking payoff from forgers in return for entree to the Nigerian medical specialties market. Akunyili fired the most corrupt of her officers. To promote honestness among her staying 3000 staff and to hike morale, she offered inducements such as preparation abroad, improved installations and a better working environment † . Nevertheless, no affair how promising this sounds, the obliteration of such jobs as counterfeiting is non even remotely close. The solution to these jobs ( which besides reflects what is go oning within the full society ) rests with leading. As my male parent pr ovinces: â€Å" Nigerian leaders and elites non merely steal public money instead than utilize such money to for the greater good of the people, they and their households fly abroad for their wellness attention and their kids ‘s instruction. So they lack the will or involvement to do things better for the generalization of the population † . Furthermore, nil in the medical market place will alter because leading will ne’er basically change for the greater good of the people of Nigeria. The point of no return has been reached.

The Use of Military Special Forces in CIA Paramilitary Operations Research Paper

The Use of Military Special Forces in CIA Paramilitary Operations - Research Paper Example Some of these military activities are in public knowledge while others remain classified. There is speculation that covert paramilitary operations will end up being the responsibility of unacknowledged distinct operation units within the USSOCOM. One of the fundamental concerns by the American people is the dichotomy of operations by the central intelligence agency and the military. This is fueled by the fact that military personnel can get involved in central intelligence agency operations1. At the same time, the central intelligence personnel can serve in the military. There is similarity in training and military operations means that it is never clear whether the central intelligence agency activities are alienated from the military activities. The nature of secrecy in the CIA operations means the Special Forces in the United States of America military can hold joint operations with CIA. The role of Special Forces in paramilitary activities is unknown to the public. Therefore, it becomes hard to tell whether a given activity is being conducted by the central intelligence agency or the particular forces of United States. For instance, paramilitary operations in Yemen require presidential authorization. Besides, the intelli gence committees have to be notified. There is a growing concern on whether the same requirement applies to secret military operations. In case of a joint operation of the central intelligence agency operations paramilitary officers and Special Forces, it is not clear on whose authorizes. There is a need to known to what extent Special Forces can get involved in paramilitary activities and operations. There is a perception that the personnel involved in United States covert operations are contractors. This poses a significant threat to the security of United States due to access of classified information2. According to Brennan, the

Why did I become a Christian Essay Example | Topics and Well Written Essays - 500 words

Why did I become a Christian - Essay Example Islamic doctrinal message is not typically delivered and spread as Christianity is with God’s Word for the Muslim culture appears exclusive for the followers of Muhammad who are disposed to reconcile materialism and spirituality under the context of political setting. Becoming a Christian is entirely and remarkably different as I experience living by faith through Christ and having a personal relationship with God. I particularly appreciate the fact that in Christianity, the values of love and compassion are magnified rather than the rigidity of moral order and punishment for sins, believing that God’s unconditional love is a kind that is sincere, patient, and does not keep record of wrongs (Cor. 13:4 – 5). According to the Holy Scripture, it was through Father God’s plan of salvation that Jesus Christ be given biological birth by an ordinary pure woman after which the gospel declares ‘a word became flesh’ to live among men that the prophecy in the Old Testament of the Bible may be fulfilled. To me, this is something that entails more than a significant event in the history of redemption for it reflects the heart of God by virtue of humility that despite His divine nature, He reaches out to sinful men by allowing His holiness to touch the earth’s ground and take no other form higher than that of us when Jesus was born to live in utter simplicity and thereafter carry out his ministry apart from worldly wealth and power. Basically, Jesus embodies his teachings and I am quite fascinated to discover how consistent this truth holds as stated via Luke 14:11 -- â€Å"For everyone who exalts himself will be humbled, and he who humbles himself will be exalted.† Gaining deeper understanding of God’s Word all the more settles my conviction toward Christianity wherein besides knowledge of the Scripture, I learn to refine my ways by wisdom in meditative prayer and