Staff Retention in Nursing

Staff Retention in Nursing Arlena Davis, Stephanee Thurman STAFF RETENTION IN NURSING Introduction Staff retention is one of the strategies nurse administrators employs in preventing high rates of nurse turnover. Currently, the rate of nurse turnover is quite high, and this problem is more common in nurses at the entry level. The high rate of nurse turnover is one the major contributors of the shortage of nurses experienced throughout the country (Brunetto, 2012). Apart from prevention of nurse turnover, retention of nurses has a lot of benefits accrued to it. The strategy is useful in keeping nurses in a particular organization, and this helps to retain the skills and knowledge accrued in the process of serving at the organization. Other benefits associated with nurse retention include a reduced number of new nurses or â€Å"rookies,† thus reducing cost of training, fewer terminations that lead to reduced termination cost and increased productivity. However, the retention of nurses also comes along with increased cost. Some of the nurse retention costs include salary incre ases, rewards, bonus programs, ongoing â€Å"education and promotion,† among others (Ley, 2007). Therefore, as a nurse manager, it is essential to devise ways of dealing with challenges that arise as a result of nurse retention. Possessing the knowledge on nurse retention is vital for career development as a nurse manager. Hence, this paper provides an analysis of research articles regarding the issue of nurse retention. Staff Retention in Nursing Part A: Summary of Each Study Article 1: Retention Priorities for the Intergenerational Nurse Workforce by Wieck et al., 2010 The researchers in this particular study focused on the retention priorities for nurses belonging to different generations. The purpose of the study was â€Å"to conduct an assessment on the environment, job satisfaction, and desired traits of managers in a bid to improve nurse retention† (Wieck et al., 2010). As mentioned earlier, nurses’ retention is important in any organization since it helps reduce the problem of nurses’ shortages that is felt across the whole country. Work environment, job satisfaction, and qualities portrayed by nurse managers have direct impacts on nurse retention. As part of the methodology, this study was purely quantitative and entailed collection of data from 1,773 nurses from 22 hospitals. The survey was conducted online and included aspects such as â€Å"nurse manager desired traits, safety perceptions, nursing work index and job satisfaction† (Wieck et al., 2010). The findings of this research indicate that the satisfaction with work environment were high among all the participants. The satisfaction was highest where there existed nurse-physician relationship, and lowest where there was nurse control of practice, and younger nurses were less satisfied compared to nurses aged over 40 years. 40% of nurses involved in the sample expressed safety concerns. Additionally, 61% of all the participants indicated that they were planning to leave their jobs within the next ten years (Wieck et al., 2010). In order to halt the alarming findings contained in this research, the researchers assert that health organizations should create model managers since the characteristics of the manager are among the major factors influencing nurse retention. Hence, it important for nurse managers to possess qualities that promote a good working relationship with the nursing staff. The nurse managers should empower the staff nurse councils, which are very useful in advancing the grievances raised by nurses, hence improving job satisfaction. The other recommendations are revamping of the incentives, stabilizing staffing, and focusing on their safety during service delivery (Wieck et al., 2010). Article 2: Study on Nurse Retention by Brunetto The study aimed at improving the rates of nurse retention by focusing on the factors that make nurses stick into their professions (Brunetto, 2012). The study took three years, and it sought to determine nurses’ satisfaction levels concerning the relationship with supervisors, ability to solve problems during service delivery, and communication structures (Brunetto, 2012). The findings of the study show that nurses leave their jobs due to lack of autonomy. 20% of the nurses involved in the study felt that they did not possess the relevant skills to solve the problems they were facing, thereby forced to consult from their superior. This practice leads to erosion of the autonomy in nursing. Other findings indicate that younger nurses are faced with the greatest challenges of retention. Another factor that contributes to nurses leaving their job is random changes in the hospital management that complicate the work relationships between the nurses and supervisors. Well-organized structures in the hospital have the potential to reduce the number of nurses leaving their jobs (Brunetto, 2012). The insights contained in this study can be very beneficial if they are applied in a hospital. First of all, increasing the autonomy of nurses can help lower nurses turnover and retain more nurses in the hospital. In the cases where nurses lack autonomy due to lack of knowledge on how to deal with certain situations can undergo further in training to increase their knowledge (Brunetto, 2012). The supervisors should create proper working relationships with nurses. Good relations between the nurses and their supervisors will help reduce the rate of nurse turnover. Article 3: â€Å"Keeping Nurses on the Job: Retention is part of the Answer to the Nursing Shortage† (New York University, 2009). The purpose of this study was to â€Å"establish the factors that can help keep new nurses from leaving their jobs† (New York University, 2009). The topic of study was important because nurses turnover not only results in a shortage of nursing staff in the hospital, but also results increased hospital budget as the hospitals tries to cater for turnover costs (New York University, 2009). This study was funded by the Robert Wood Foundation, and it incorporated a sample size of 1,933 newly licensed nurses that were sampled from various hospitals across 34 states in the USA† (New York University, 2009). The results of the study showed that nurses stayed on their jobs based on factors that included perceptions of the working conditions, job opportunities available, personal characteristics and specific workplace attributes. According to the researchers, nurse retention can be useful in cutting the costs of running the hospitals. Nurse retention is also useful in improving patients’ outcomes since it increases the staff stability. Whenever the nurses are satisfied with their jobs, bear the organizational commitment, possess autonomy, and have opportunities for promotion, such nurses have minimal chances of leaving their job (New York University, 2009). The knowledge contained in this research article is applicable in addressing problems with nurses’ retention. Health organizations should try to create equal chances for promotion for the nurses. Some nurses should not feel sidelined for promotions whereas others are favored. As the results of the study show, the hospitals can reduce high workload for nurses in a bid to increase job satisfaction. Increasing job satisfaction can result in the high rate of nurses’ retention. The nurse managers should provide supervisory support in the efforts to increase the organizational commitment among younger nurses. Nurse Managers should also avoid some practices such as mandatory overtime since they lead to reduced organizational commitment (New York University, 2009). Article 4: â€Å"Effective Strategies for Nurse Retention in Acute Hospitals; A mixed Method Study† by Koen et al., 2013 Nurse retention is one of the best strategies in countering the problem nurse shortage within the organization. Therefore, â€Å"the purpose of this study was to examine the impact of nurse education, nurse staffing and nursing practice environment on the nurse reported intention to leave the hospital† (Koen et al., 2013). The study also sought to â€Å"provide best practices in the nursing care that can lead to a sound practice environment and thereby improving nurse retention rates† (Koen et al., 2013). The study involved 3186 bedside nurses drawn from 56 Belgian acute hospitals. The results show that 29.5% of the participants were planning to leave the hospital. â€Å"Two factors, namely, nurse work environment and patient-to-nurse ratio were among the leading reasons for the intentions of nurses to leave† (Koen et al., 2013). Further results indicate, â€Å"high performing hospitals with high rates of nurse retention had a participative management style, structured education programs, and career opportunities for nurses† (Koen et al., 2013). However, the study contains several limitations. The RN4CAST nurse survey conducted did not cover all the components. Important elements like magnetic force 11 were locked out of the study. The qualitative data was collected from six Flemish hospitals and thus it hard to make generalizations of the findings. Therefore, the knowledge contained in this research article is applicable in addressing problems with nurses’ retention, and this can be achieved by mentoring nurses and addressing their dissatisfactions in a timely manner (Koen et al., 2013). Article 5: â€Å"Exploring the Key Predictors of Retention in Emergency Nurses† by Sawatzky Enns, 2012 The objective of this study was specifically â€Å"to explore and describe the influencing and intermediary factors that predict the retention of nurses working in the emergency departments† (Sawatzky, Enns, 2012). The researchers employed cross-sectional survey designed in the collection of the data (Sawatzky Enns, 2012). The results indicate, â€Å"Engagement emerged as the most convincing predictor for intermediary factors† (Sawatzky Enns, 2012).The intermediary factors use in this case included job satisfaction, fatigue, and burnout. An inverse relationship was evident between â€Å"engagement and influencing factors such as nursing management, collaboration with nurses, available resources, and shift work† (Sawatzky Enns, 2012).There are limitations contained in this work. The purposive sampling method used can elicit biased findings. The other limitation is that the despite the fact that framework used in the research was â€Å"based on scientific evidence,† it had not been tested (Sawatzky Enns, 2012). In addition, since the subjects used in the study were drawn from the nurses operating in the emergency departments, the findings of the study cannot be applied in the entire nursing population. According to the findings of this study, engagement is a key factor in retainin g nurses working in the emergency departments. Hence, nurse managers should work on factors that increase engagements. Some of these factors include engaging the nursing management in providing guidance, collaboration with physicians, and shift work. Article 6: â€Å"The Mediating Role of Organizational Subcultures in Health Care Organizations† by Lok et al., 2011 The objective of this study was â€Å"to investigate the mediating role of the organizational subculture between job satisfaction, organizational commitment and leadership culture in health care organizations† (Lok et al., 2011). The study used nurses drawn from 26 wards in indifferent hospitals (Lok et al., 2011). The results obtained â€Å"shows that in the innovative ward, subculture was found to bear greater impact on nurses’ commitment and retention. In the bureaucratic ward, â€Å"subculture had a significant negative direct relationship with commitment† (Lok et al., 2011). On the supportive ward, â€Å"subculture had small but positive indirect relationship with job commitment, and this was achieved through job satisfaction† (Lok et al., 2011). Some limitations contained in this research calls for further research. In the first instance, this research is only applicable in Australia due to differences in culture across the different countries of the world. Another limitation is that the study was conducted in a hospital in which nurses spend long periods in the ward. Hence, in organizations where nurses move more frequently, they may not have adequate time to form subcultures that influence commitment (Lok et al., 2011). The findings of this research can be applied in healthcare organizations by creating an environment that promotes commitment. Servant leadership is critical in increasing the level of commitment among the employees. Hence, the nurse managers should embrace a transformative style of leadership in order to boost the level of commitment among the nurse Article 7: â€Å"Which Organizational Culture Moves Towards Organizational Excellency† by Gogheri et al., 2013. The overall objective of this study was to evaluate â€Å"the relationship of types of culture and the execution of organizational excellencies based on the EFQM model in government organizations† (Gogheri et al., 2013). 311 questionnaires were used to collect the data contained in this study (Gogheri et al., 2013). According to the descriptive data collected by the researchers, culture is a major determiner of the organization’s boundaries (Gogheri et al., 2013). Culture creates a stable and sustainable social system. The result findings found out that the majority of the respondents viewed culture as a label that is capable of connecting components of the organization through proper standards. The findings found it essential for nurse managers to understand culture issues in groups and the organization at large. However, the study was faced with several limitations. One of the limitations was lack of cooperation from personnel and organizations during the process of collecting. There were also some previous studies conducted on â€Å"the relationship between organizational culture and organizational excellence performance† that made the findings no original (Najmi Hosseini, 2006). According to the findings of this study, organizational culture is important in any organization since it affects goals and strategies set by the organization. Organizational culture can be a strength or weakness in the organization. Since nursing managers have an essential role of developing organizational culture, they should ensure they develop positive organizational culture that will impact the organization positively (Najmi Hosseini, 2006). Part B. Critique and Overall Summary The above articles address the issue of nurse retention in health organizations. The information contained in this articles can be successfully applied in addressing problems associated with retention of nurses in health care organizations. In the first article, the knowledge can be applied in health organizations by creating model nurse leaders and empowering the nursing councils. In the second article, the application of the insight collected can be done through increasing the autonomy of nurses, and this strategy can help lower nurses’ turnover rate and eventually retain more nurses in hospitals. The supervisors should also create good relationships with the employees. Nurse Managers can apply the findings of the third article by providing supervisory support to nurses during service delivery in the efforts to increase the organizational commitment among younger nurses (New York University, 2009). Nurse Managers should also avoid some practices such as mandatory overtime since they lead to reduced organizational commitment, and thus increased turnover. In the fourth article, the knowledge obtained can be applied by creating a more participative work environment where nurses collaborate freely with the management (Koen et al., 2013). Nurse Managers can apply the knowledge on the fifth article in healthcare organizations by working on factors that increase engagements. Some of these factors include nursing management, collaboration with physicians, shift work and resources (Sawatzky, Enns, 2012). The findings of the sixth and seventh research article can be applied in health care organizations by creating an environment that promotes commitment and as well as cultural sensitive work environment (Manojlovich, 2006). In summary, all the summarized articles are very credible, and they provide evidence-based practices that can be applied by nursing managers to avert the increasing problems associated with retention of nurses. Apart from the interventions identified in the articles, nursing managers can also address problems of retention among nurses by addressing shortages of nurses, adopting top-notch recruitment and retention policies, effective planning and use of the available nursing resources, and providing incentives that motivate nurses. Therefore, all the strategies identified in the articles when implemented effectively can increase nurses’ job satisfaction thus reducing problems of retention (Ley, 2007). Conclusion Nursing retention is an effective measure in curbing the problem of nurses’ shortages in heath care organizations. For nurse managers, understanding the mechanisms of retaining nurses is essential for the purposes of career development. This research paper has provided five articles addressing the issue of nurse retention, and two articles addressing organizational culture and it influence on retention. In regard to nurse retention, the style of leadership adopted by nurse administrator has direct impacts on the nurse retention. Hence, nurse administrators should create an environment that promotes commitment. In regard to organizational culture, leaders are largely responsible for developing an organizational culture and it important for nurse managers to use their positions to develop a positive culture that promote retention of nurses. References Brunetto, Y.( 2012). Study on Nurse Retention. The Journal of Nursing Scholarship, 34, 28-38. Duffield, C. M., Roche, M. A., Blay, N., Stasa, H. (2011). Nursing unit managers, staff retention and the work environment.Journal of clinical nursing,20(1à ¢Ã¢â€š ¬Ã‚ 2), 23-33. Gogheri, A. S., Nawaser, K., Vesal, S. M., Jahanshahi, A. A., Kazi, R. (2013). Which organizational culture moves towards organizational excellency. Asian Social Science, 9(11), 221-236. Koen, V., et al. (2013). Effective strategies for nurse retention in acute hospitals: A mixed method study. International Journal of Nursing Studies. 50(2):185–194 Ley, L. (2007). ‘Shortage of Nurses.’ Journal of medical practice. 3(1), 23-43. Lok, P., Jo, R., Westwood, B. (2011). The mediating role of organizational subcultures in health care organizations, Journal of Health Organization and Management, 25(5): pp.506 – 525. Manojlovich, M. (2006). Enhancing nurses job satisfaction through improvements in the practice environment and effective nurse physician communication. Journal of Nursing Administration, 36(5), 229-230 Najmi, M., Hosseini, S. (2006). EFQM Excellence Model, From Idea to Execution. Ronas (6th ed.). Tehran, Iran. New York University. (20130). Keeping Nurses on the Job: Retention Is Part Of The Answer To The Nursing Shortage. ScienceDaily. Retrieved August 29, 2014 from www.sciencedaily.com/releases/2009/03/090330154802.htm Sawatzky, V. Enns, C.(2012). Exploring the key predictors of retention in emergency nurses. Journal of Nursing Management., 20(5); 696-707. Wieck, K., et al. (2010). Retention priorities for the intergenerational nurse workforce. Nursing Forum, 45(1), 7-17.

Greek History Essay -- Greece Historic Historical Essays

Greek History Works Cited Missing Relatively little is known about the nature of life in Greece during the Neolithic and Early Helladic periods. Since there are no written records from these periods in Greek history, it is only possible to learn about the cultures that existed during this time by studying the remains of their settlements. The sites of Sesklo, Dimini, and Lerna are all good examples of the types of settlements that existed on mainland Greece from the Middle Neolithic period to the Early Helladic. Although they don’t give us a complete picture, these sites help us understand what life was like on the Greek mainland before the arrival of the people that are known today as the Greeks. During the Neolithic period the most advanced area of Greece was Thessaly. This area in northern Greece was the place where both Sesklo and Dimini were established. During the Helladic period the area of greatest advancement shifted to the south. This period is best represented by Lerna. Sesklo was first occupied in the Early Neolithic period but didn’t reach its peak until the Middle Neolithic. It was built on a low mound that had an area of about 100m by 45m. A large, two-room megaron which opened on to a paved courtyard was built at the center of the mound (www.perseus.tufts.edu/cgi-bin/siteindex?entry=sesklo). Near the megaron were various other smaller buildings packed closely together. One building stands out from the others, because it appears to have served a special purpose. That building is the two room building now identified as a potter’s workshop. The inhabitants of Sesklo surrounded the whole area on top of the mound with what appears to have been a single one meter thick wall. It’s uncertain whether thi... ...peaks in the development of the Greek mainland from the Neolithic to Helladic period. Each settlement represents a fairly significant advancement over its predecessor and shows how Greek settlements progressed over the years. These settlements also provide many clues about the nature of mainland Greek culture during this period of time. Even though we have no written records, by examining the architecture and artifacts of these cultures we are able to determine how their communities were organized. We are also able to determine the nature of their relationships with other settlements by examining their fortification systems. Although many things about early civilizations in Greece remain a mystery, we have learned much from these sites and continue to study them in hopes of gaining a more complete picture of what life was like for the early inhabitants of Greece.

Promotion and Retention of Women in Mathematics :: Mathematical Careers Education Essays

Promotion and Retention of Women in Mathematics How do we interest and retain more women in the field of mathematics? "Women now make up nearly half the undergraduate math majors in the U.S. (1993 Annual Survey of the American Mathematical Society and the Mathematical association of America); yet in graduate math programs, only about one-quarter of the American students are women" (Adhikari & Nolan, 1997, p. 17). For women who choose SME (Science, Mathematics, Engineering) majors, persistence rates in the major are significantly lower than that of male peers. (Seymour, 1995, p. 438) I am interested in the topic because I am a female who experienced pursuing undergraduate and graduate mathematics degrees. I want to know what I can do to help motivate other women in mathematics. While reading the literature, I became aware of subtle personal experiences that paralleled common experiences of women pursuing mathematics majors. Whereas I had informally considered my attempts at fair, consistent treatment for all students to be po sitively related to motivating women (and other minorities) in mathematics, upon reading the literature a strong case is made for additional support to different groups. Although I will focus the majority of the paper on college experiences that influence women in SME majors, literature also points to the influence of pre-college coursework. â€Å"Maple and Stage (1991) found that students who took more science and math courses in high school were significantly more likely to choose science and math majors in college† (Trusty, 2002). Farmer, Wardrop, Anderson, and Risinger (1995) found taking elective science courses in high school had a moderate direct effect on persistence for women in science-related careers, but taking elective math courses did not. (p. 163) Although in this research taking elective math courses was not found to effect persistence of women in science-related careers, I contend that math courses are still critical as they are prerequisites for science electives of chemistry and physics. The National Science Foundation has reported, â€Å"young women have lower interest in math courses and take fewer advanced math courses† (Farmer, Wardrop, Anderson and Risinger, 1995, p. 157). In addition, Seymour and Hewitt (1997) found the effects of inadequate high school preparation to be the most common contributor to early decisions to switch from SME (science, mathematics, engineering) majors to non-SME majors (p. 79). Seymour (1995) also points out that studies have noted â€Å"the subtle deterrents to active participation in mathematics and science which bear upon precollege girls† (p.

Macroeconomics: Should the Minimum Wage Increase? Essay

Minimum wage is the lowest wage permitted by law or by a special agreement that can be applied for an employee or put simply, the lowest amount of pay that an employee can make. Governments set a minimum wage on businesses in hope for reduced poverty and increases in the standard of living. Minimum wages are beneficial up to a line, when minimum wage is too high, it makes businesses make crucial decisions and must save money by firing workers, reducing output, and increasing prices on products. Over the years, the federal minimum wage has increased and has been beneficial up to the minimum wage increase in July 24, 2009 from $6.55 to $7.25. After the increase, the unemployment rate has soared and businesses fired worker and increased their prices. For this reason, it would be beneficial to the economy if the minimum wage is reduced back to $6.55 because it will decrease the unemployment rate, increase GDP, and help youth and unskilled workers in the job industry. The Great Depression was a devastating time for the United States with families having no income, there was no economic growth, and the poverty rate was at an all time high. To aid with the matter, President Roosevelt attempted to impose a federal minimum wage but was struck down by the Supreme Court. The Court continued to refuse to have a federal minimum wage over and over again. It was until chose a presidential nominee, and made a platform that supported minimum wages by the party’s presidential nominee, Alf Landon. After this, the Court decided to allow a minimum wage. Over the years, the government has increased the minimum wage from 25 cents in 1938 to $7.25 in 2009. The current debate in Congress now is that President Obama wants to raise the minimum wage to $9.50 which is going to be a bad idea for the economy, decreasing the minimum wage will benefit the economy for reasons that will be stated now. Human labor is very important to businesses even though technology is rapidly improving but if the minimum wage increases, the cost of human labor increases, so to deal with this, businesses must decrease output, increases prices, and ultimately fire employees. So if the minimum wage increases, the unemployment will also ultimately increase. Evidence of this occurring is seen through a recent minimum wage increase from $6.55 to $7.25. When the minimum wage increased from 2008 to 2009, the unemployment rate almost doubled. In 2008, the unemployment rate was 5.5% and in 2009, it increased to 11.2%. Decreasing the minimum wage will reverse this because human labor is cheaper, therefore businesses can increase output, lower prices, and hire more employees. This rapid increase unemployment rate is undesirable because of the huge economic cost for GDP. The economic cost is determined using Okun’s Law which is to double the unemployment rate to find the GDP gap, so the GDP gap for the year 2009 is 22.4%. Multiplying the GDP gap with the potential GDP gives the economic cost. The potential GDP in 2009 was about $13750 billion and multiplying this with the GDP gap 22.4% gives the economic cost of $3080 billion (McConnell, 2012, p. 175). The cost of this was way too high and the cost will increase much more if the minimum wage is increased, but if the m inimum wage was decreased, maybe the economic cost can be reversed. If the minimum wage can be decreased, the unemployment rate will also decrease, and GDP can increase. GDP is a monetary measure of the health of the economy. This is calculated by adding up all the expenditures made on final goods and services in the U.S or adding all the income mad in the U.S. If minimum wage is decreased, businesses and firms can increase output with more employees and lower prices. Since there are lower prices, there will be a higher demand so more goods and services can be sold thus increasing GDP making a bigger and healthier economy. For example, a man sells burgers and hires 10 people at $7.25 and minimum wage goes up to $9.50, the cost of ingredients goes up. The labor that is used in bringing the beef to market is paid with minimum wage. If those wages go up the cost of producing the beef will go up, ultimately driving up the price of beef. The man now can’t afford the price rise on raw ingredients because it will cause him to run at a deficit. Instea d he will have to raise prices and sell less burgers or make less output. Since there is less output to be made, fewer employees are needed so employees are fired. Since there is less burgers to be sold and it is at higher prices, not a lot of consumers will purchase the burgers and thus GDP will decrease. Decreasing the minimum wage will not just decrease unemployment and increase GDP; it will also benefit the working youth and unskilled workers as well. If the minimum wage decreases, businesses and firms can afford to hire more employees, including youth workers and unskilled workers and can train them. This gives youth and unskilled workers valuable experience which can help them with future job opportunities. If the youth and unskilled workers can at least get a job, they can work their way up the ladder and use the experience they get from the minimum wage job and use it as they rank up or pursue higher income jobs. There are many reasons for why decreasing the minimum wage would benefit the economy but there are those who oppose this view. Those who oppose this view say that decreasing the minimum wage will hurt the economy because lowering the minimum wage decreases the income of families so that they can purchase fewer goods and therefore decrease the GDP growth rate. There is another argument saying that is only fair to give an employee a â€Å"living wage† and can support at least a family of two for 40 hours a week. This is untrue because most employees that work minimum wage don’t work 40 hours a week anyway so it is already not a living wage but they don’t take the job for the short run, they do it to gain experience and can in the future work with other businesses that require past experience and will pay the employee a higher wage. As stated before, employees can work their way up the income ladder. Decreasing minimum wage is beneficial to the economy because of many reasons. It is beneficial because it reduces the unemployment rate, increases the GDP, and helps youth and unskilled workers with future job opportunities. This can be done by first refusing Obama’s plan of increasing minimum wage, and then starting a bill to reduce minimum wage. Minimum wage is needed to prevent employees getting an unfair pay but there is a limit on it, don’t raise the minimum wage too much Mr. President. References 2050., & 2000, u. f. (n.d.). Congressional Budget Office (CBO). Congressional Budget Office (CBO). Retrieved July 24, 2013, from http://www.cbo.gov/ Brownstein, R. (n.d.). A Short History of the Minimum Wage Fight – NationalJournal.com. NationalJournal.com. Retrieved July 24, 2013, from http://www.nationaljournal.com/politics/a-short-history-of-the-minimum-wage-fight-20130214 Macroeconomics, global edition (19 ed., p. 175). (2012). 9. S.l.: Mcgraw Hill Higher Educat. Shemkus, S. (n.d.). Increasing the Minimum Wage: Pros & Cons – Salary.com. Welcome to Salary.com – Salary.com. Retrieved July 24, 2013, from http://www.salary.com/increasing-the-minimum-wage-pros-cons/ U.S. Bureau of Economic Analysis (BEA). (n.d.). U.S. Bureau of Economic Analysis (BEA). Retrieved July 24, 2013, from http://www.bea.gov/index.htm U.S. Department of Labor – Wage and Hour Division (WHD) – Minimum Wage. (n.d.). United States Department of Labor. Retrieved July 24, 2013, from http://www.dol.gov/whd/minwage/coverage.htm

Advantages and Disadvantages of the HPV Vaccine in Adolescent Girls: An Ethical Essay

Human papillomaviruses (HPV) are a group of more than 40 types of viruses that infect the genital areas, throats (recurrent respiratory papillomatosis), and mouths of males and females and is the number one most common sexually transmitted disease (Center for Disease Control and Prevention [CDC], 2009). It is spread by genital contact. It is most easily spread by vaginal and anal sex, but also through oral sex and even just genital-to-genital (skin-to-skin). In 90% of people that contract HPV, their own immune system clears it up within two years, most never even developing any symptoms from it (CDC, 2009). Out of the many types of HPV types, most end up causing warts on one of the above-mentioned areas, while a certain few are known to cause cervical cancer. Lockwood-Rayermann & McIntyre (2009) state that â€Å"[t]he most common oncogenic/high-risk virus types worldwide and in the United States are Types 16, 18, 31, 45, and 52; 11% of invasive cervical cancers in the United States are caused by Types 16 and 18 (55% by Type 16 and 22% by type 18). HPV Types 31, 45, and 52 comprise another 8% of all cases.† Cervical cancer is usually not detected until it is quite advanced, which is why women should get screened for cervical cancer regularly. There is also another precaution women can take. The Food and Drug Administration approved the very first vaccine to prevent cervical cancer by the types of HPV that cause it in June of 2006 (Thomas, 2008). This vaccine, being new, and therein little is known about its long term effects, has caused ethical debates about the use of it, particularly in adolescent girls. Thomas (2008) mentions that the CDC recommended, by a unanimous vote, that girls aged 11 to 12 years old receive this new HPV vaccine. This may seem  young, but in order for the vaccine to be effective, it must be administered before a person has been exposed to HPV, which happens during sexual encounters. Since few girls are sexually active at this age, most of whom haven’t gone through puberty yet, this is an ideal age to have them be vaccinated (Thomas, 2008). Thomas (2008) also goes on to say that this vaccine has been administered to 11,000 girls around the world with no serious side effects. Their ages ranged from 9 to 26 years old. This vaccine is given by a series of three shots over the course of six months and it’s important that they get all three to be effective, since little is known about the effectiveness of people who only receive one or two (2008). But is it ethical for a girl as young as nine years old to be receiving such an invasive procedure in order to avoid a sexually transmitted disease? After all, what nine year old is even thinking about sex and STDs? That is why this issue is one that is left for the parents to decide, and opinions are unsurprisingly mixed. One of the main arguments against vaccinating young girls with the HPV vaccine is cost. Thomas (2008) lists the total cost of this vaccine, for all three shots, as around three hundred dollars, relatively inexpensive considering the detrimental consequences of contracting one of the types that are known to cause cancer. There is another issue to take into consideration, though, when accounting for the price of this vaccination; the effects for protection are only estimated to be four or five years (2008). If a young girl were to be vaccinated at nine years old, and again at ages twelve, sixteen, and twenty, you are looking at close to one thousand dollars in total. How are parents with poor health insurance coverage or none at all supposed to protect their daughters for this virus that can cause cervical cancer? A parent can also anticipate losing a day’s pay to take their child to the doctor’s office or the clinic on three different occasions to receive all three shots. Because of the cost, and the limited duration of effectiveness, a lot of women decide not to get vaccinated and not to vaccinate their daughters, hoping that a better, longer lasting, and less expensive alternative will â€Å"arrive on the pharmaceutical market† at some point in the near future (2008). Another popular argument against HPV vaccination is that some parents view it as a green light for their daughters to behave promiscuously (Thomas, 2008). Much like condom distribution at high schools, there are those that view HPV vaccination as another way to promote, and cause a rise in irresponsible sexual behavior (2008). Thomas (2008) goes on to describe a conservative political group called the Traditional Values Coalition and how they have publicly denounced the HPV vaccine and claim that genital warts, cervical cancer, etc. are not a national health concern, and â€Å"that HPV can be prevented through abstinence and marital fidelity.† This group attributes â€Å"monetary gain† by pharmaceutical companies as a motive for the mandate for HPV vaccination. Like most every ethical or moral dilemma going on in this country, this issue rests in the parents’ religious and personal beliefs. Studies have shown that despite abstinence programs, teenagers still engage in sex, proving that something as insignificant as a vaccine is not going to encourage kids to have sex—they are having it anyway. Thomas (2008) cited a study that showed that 90% of teens are using condoms when they engage in sexual intercourse, but condoms alone cannot protect you from HPV, making the vaccine all that more important for young girls to receive. If a parents cannot set aside their religious and personal beliefs long enough to acknowledge that this vaccine has the potential to save their daughter’s life, then they may require a lot more than just education. Each year 6.2 million new cases of HPV come about and currently, 20 million people in this country are infected with HPV. The vaccine that is available has the potential to save 70% of the people it would otherwise infect from cervical cancer in young women (Thomas, 2008). â€Å"In 2008, an estimated 11,070 women in the United States will be diagnosed with cervical cancer, and 3, 870 women will die from the disease† (Lockwood-Raverrmann &McIntyre, 2009). Lockwood-Raverrmann & McIntyre (2009) go on to explain that the prevalence of HPV in peaks in women in their early twenties, and also go on to say that even younger women, i.e. teenagers, are more susceptible to the virus. They describe one possible explanation for this is because in younger women, it â€Å"could be the changing histology of the cervix following the commencement of puberty.† They go to say that â€Å"during this period of time, large populations of cells are undergoing maturation and are more  suscep tible to the development of an HPV infection† (2009). With all of this statistical data, it is confusing to think that some little girl’s parent’s are prepared to deprive her of a vaccine that could potentially save her life should the opportunity arise and she chooses to have sex. Again, said girl wouldn’t even have to have vaginal intercourse to contract Type 16 HPV, which would years later cause cervical cancer in which she could quite realistically die from. It is a frustrating and infuriating thought—that this girl could die because of her parent’s ignorance and/or their undyin

Justus Case

Just Us! Case Just Us! is a corporation that imports, roasts and sells primarily organic coffee from fair traded certified coffee producers. Their vision is: â€Å"to be a leading Fair Trade business that builds on quality, professionalism and innovation for the benefit of all our stake holders. Since its inception, Just Us! had experienced healthy growth in the maritime provinces of Canada, mainly supported by its corporate values: social and environmental responsibility, sustainability, ethical practices in all the areas of the business and in all stakeholders, and product differentiation.They even opened a fair trade museum to help educate the public on the social impact and benefits of fair trade. Once roasted and packed, the coffee and other products are shipped to retail outlets, supermarket chains, health food stores, coffee shops and churches. A substantial portion of Just Us! revenues came from wholesaling to large retail stores such as supermarket chains. Their coffee is a lso offered in the Just Us cafes, which were meant to be a place where customers could enjoy a cup of premium fair trade coffee and gather information about fair trade. The locations were not standardized as a typical chain.A major competitor in the retail organic fair trade coffee market is Kicking Horse which also offers products that are certified organic and fair traded. Its main channels are: coffee shops, gourmet food stores, grocery chains and restaurants. The growth of fair trade product sales had prompted several major food brands to offer fair trade products, such as: Kraft Foods, Procter & Gamble and Nestle. Also, in Canada, large super market chains such as Loblaws were offering also fair traded private labeled products which was concerning for Just Us, since supermarkets is one of its most important channels.In the coffee shop area, there was a lot of competition since some independent coffee shops and well-known chains (Ex. Starbucks) were trying to tap into the  "fair trade trend†. Due to the original management team lack of marketing experience a new Marketing Director was hired and part of the initial issues she found was that Just Us! did not spend much on advertising. 2009 had been set at $20,000. There was a massive growth opportunity in the fair trade market in Canada but the economy was on recession, therefore, the expansion needed to be planned carefully.The marketing director had several specific questions to answer to help develop a marketing plan to bolster the growth of Just Us! First off, how was Just Us! going to target new buyers given the current competition and what segment would those buyers belong to? College students were clearly a growing customer base and Just Us! already had a strong presence in three college universities. Therefore, marketing should be directed at the young, educated demographic that are willing to pay a premium for products.Furthermore, the majority of their sales are business to business and their marketing needs to emphasize the benefits of fair trade to the end user. The case stated that the internet was a great tool for increasing awareness of fair trade products, along with initiatives that enhance word of mouth (p. 3). In order to reach new customers they should consider expanding their internet marketing, such as using search engine optimization/ search engine marketing. They can also utilize co-op advertising with other organizations that emphasize fair trade, organic, and environmentally friendly practices.The fair trade museum should also be utilized to educate potential customers and will be discussed in more detail below. All Just Us! advertising needs to emphasize the story behind the products in order to educate new customers. Educating customers on the benefits of fair trade is the key to growth and will set Just Us! apart from competitors with brand recognition. In order for Just Us! to enhance the cafe’s performance they need to improve the custom er experience and become customers’ first choice of â€Å"place outside the home to enjoy coffee. Surveys and focus groups should be used to find out what customers like to do in their cafes as well as what customers like about the competitors cafes (Starbucks and Trident) and incorporate those into Just Us! ’ cafes. Additionally, the current Just Us! cafes are stand-alone destination shops. Just Us! should open up new stores in large commercial shopping centers in densely populated cities with multiple Universities. This would allow Just Us to still market to the young educated demographic that have long customer lifetime values that they have had success with and reach new customers via foot traffic in the shopping center.By keeping the overall educational theme about fair trade and brand awareness the same across all of the cafes should be able to convert new customers into loyal customers. Another questions the Marketing Director had to consider was how Just Us! c an expand their loyal customer base? This could be achieved through improving the customer experience mentioned above. However, offering opportunities for the customers to get involved would create a concept of community among their customers and which could develop into a core competency and set them apart from their competitors. Just Us! ould achieve this by having guest speakers or workshops on fair trade in the stores or even get involved with community organizations to help educate people about fair trade. Customers could sign up to receive emails for upcoming events, new products, new services, and new social initiatives. These actions would all help expand their loyal customer base. The Marketing Director also needed to make several changes to the marketing program in order to benefit the cafes. The marketing budget should be increased to reflect the company sales and growth potentials. A larger budget will allow Just Us! o compete with similar fair trade coffee companies suc h as Java Factory and threatening new mainstream entrants such as Starbucks who can capture the market share quickly. The existing market media plan (Case exhibit 8) should be updated to focus on product differentiation and increase channel diversity. Just Us! should advertise in multiple newspapers, magazines, and outdoor locations to increase customer reach. Furthermore, Just Us! should promote more direct communication to events around colleges and young professionals emphasizing their fair trade and environment responsibility concept in order to foster community involvement.A major customer segment for Just Us is students and young professionals who are mostly tech-savvy. Therefore, internet should be a main advertising vehicle to reach mass marketing. Just Us should use internet marketing tools including emerging social media (e. g. Facebook, Tweeter, blogs), mobile advertisement (e. g. Groupon), search engine marketing, and co-op advertising on sites offering similar fair trad e concepts. Finally, the Marketing Director needs to utilize the fair trade Museum as a way to spread awareness as well as promote brand awareness just like they should in the new locations but take it one step further.Just Us! could hold free concerts or guest speakers at the museum to attract potential new customers. They could also charge for the concert and allow free admission if you bring a reciept from a recent purchase at the Grand Pre store. Just Us! could sponsor a local race or work with local University fundraisers in the community. Once again, Just Us! needs to be involved with the community to educate people about fair trade and get their customers involved to create a sense of community that can lead to new customers and extend the lifetime customer value of existing customers.

Inequalities in Health

Inequalities in health have many factors but these can be argued against as to whether they are the actual cause. Social class is a factor, along with region, age, gender, ethnicity etc. Measuring the impact of social class is difficult because social classes have changed over the years, eg) working class living conditions have changed, and there is a delay in the onset of diseases, eg) Asbestos related illness. (NICE 2009) However the Black Reports (1980) finding was that the death rate for men in the lower social classes was twice that for men in the higher social classes, and the gap between the two was increasing not reducing.It also showed that some people in the lower classes were experiencing worse health than in the 1950s, maybe giving evidence that the change in working class living conditions wasn’t such a contributory factor. The report showed that British rates of infant mortality were in some cases higher than those in many developing countries, which doesnâ€℠¢t point towards a class inequality. The Black Report identified four explanations of health inequalities, the artefact explanation, natural or social selection, the cultural/behavioural explanation and materialist or structural explanation.The artefact explanation stated that the relationship between class and health is artificial rather than real, arising either through the inadequate measurement of social class and health, or in the measurement of the relationship between the two. (UCEL 2003) The natural and social explanation involved the idea that health was a cause of social class position rather than a consequence, and that individuals are selected into higher classes, while the weakest go down the social scale to occupy the lowest position.The cultural/behavioural explanation defined culture as a set of specific behaviours (smoking, excessive drinking, unhealthy diet and physical inactivity) which have consequences for health. These behaviours were regarded as cultural becau se of the understanding that they are within the control of individuals. The materialist or structuralist explanation explained the role of economic and structural factors in the distribution of health and well being. Research was conducted to provide evidence for the materialist/structuralist explanation.It found a link between low birth  weight and high blood pressure in adulthood which leads to increased coronary heart disease. (UCEL 2003) The Inverse care law stated that working class people receive poorer treatment from the health service. It stated that in poorer areas, qualified doctors are less likely to set up practices so people in lower classes are less like to receive efficient healthcare, when in fact they may be the ones that need it most due to bad living conditions & housing etc. The postcode lottery refers to this suggesting postcodes in richer areas tend to have more money to spend on health care than poorer areas.  (DH 2011)The Acheson Report (1998) showed man y similarities with the Black Report. It found that there are still inequalities in different class groups, with evidence it is still growing. The report put forward several solutions including policies to reduce stress at work, improved access to health services for all classes, improve nutrition in schools, improved benefits and access to benefits for the most needy families. (DH 2011) In summary the evidence shows there are social class based health inequalities, however there are problems in measuring class and health.The issue of social change, and delay in the onset of diseases should be taken into account when looking at this inequality. Evidence shows life expectancy is lower in poorer, less developed countries. The Acheson Report is in depth, but prefers to advise how funds should be allocated and not what should be done to solve the problems. Some evidence for social class health inequality is more conclusive than others, however social class can involve status, wealth, cu lture, background and employment. There is not a simple relationship between class and ill health. Everyone will experience a number of different influences on their health.