The Epidemiology Of Tuberculosis Health And Social Care Essay

The intent of this paper is to inform and educate the reader of the mechanisms that make up the respiratory disease called TB. This paper addresses the history, the survey of the disease, and how it affects the wellness of the human population and its environmental public assistance. This survey ‘s purpose is to analyze and see the epidemiology three, symptoms, diagnostic trial, isolation, intervention, Koch ‘s Postulates, probe, surveillance, and obliteration associated with this respiratory infective disease. The Epidemiology of Tuberculosis Tuberculosis ( TB ) is a extremely contagious disease that if non treated, can be fatal. This infection is known for originating in the lungs, nevertheless it has the possible to impact any and all of the organic structure. The tubercle B or Mycobacterium TB is the bacterial micro-organism the causes TB ( Schiffman, 2010 ) . Scientist have traced TB every bit far as 2400 BC in spinal fragments of Egyptian mas and 750 BC in castanetss found in South American ( Medical News, 2010 ) . Throughout the old ages of find of this disease, there have been many names associated with Terbium: white pestilence, ingestion, awful disease, and the male monarch ‘s immorality. The nineteenth century, the generation of the industrial revolution conflicted with a deathly eruption of TB that killed one out of every seven persons infected with the bacterial infection in Europe. Finally this contagious unwellness spread to the United States as the big metropoliss became overpopulated ( Endreszi, 2009 ) . Present twenty-four hours, worldwide, there is more than 2 billion infected with TB. In 2007, there was â€Å" 1.77 million † TB related deceases ( World Health Organization [ WHO ] , 2009 ) . Our society has so many possible countries of increased hazard for the development of TB. The Center for Disease Control ( CDC ) reports that in 2009 there were â€Å" 11,540 TB ( TB ) instances reported in the United States † which is a lessening of 4.2 % in 2008 ( Center for Disease Control, 2010 ) . Hazard of continuance of TB involve HIV unwellnesss, in-migration of individuals from countries with high incidence of TB, and the transmittal of TB in high hazard environments, such as homeless shelters, infirmaries, and correctional installations. These same environments are now describing multi-drug immune TB ( MDR TB ) and extensively drug immune TB ( XDR-TB ) with an addition in decease rates. MDR TB histories for â€Å" 5 % † of the reported TB instances, † 27 sta tes † make up â€Å" 85 % of all MDR TB instances, † ( WHO, 2009 ) and 58 states have been confirmed to hold XDR-TB ( WHO, 2010 ) . The purpose of this survey is to analyze the epidemiology of TB, Koch ‘s posits, surveillance, control, and obliteration steps related to TB. Epidemiology Triad The â€Å" epidemiological three † is a tool that consists of an agent, host, and an environment used to explicate the spread of disease throughout a community, to place points of intercession to forestall transmittal, and to steer epidemiologic probes ( McMurray, 2007 ) . The agent in this survey is Mycobacterium TB ; an acid fast aerophilic rod that reproduces easy and is hypersensative to heat and ultraviolet visible radiation. TB chiefly effects the respiratory system, nevertheless, it can besides consequence the pericardium, lymph nodes, menges, kidneys, bowels, castanetss, articulations, and generative variety meats ( The Merk Manual, 2010 ) . Tuberculosis, a taking worldwide infective disease slayer, killed 1.7 million in 2009. However, â€Å" the TB decease rate has fallen by 35 % since 1990 † ( WHO, 2010 ) . The transmittal of the Mycobacterium TB is spread from individual to individual by airborne droplets with vehicles being coughing, sneeze, and speaking. The smaller the droplet, the longer it can linger in the air after the septic individual has left the country, leting incease probablity of inspiration by another individual. Passing Terbium from a household member or colleague is more likely than a alien in a shop or on the street ( Reichler, Reves, and Bur, 2002 ) . Mycobacterium TB ( infective disease agent ) is readily spreaded to susceptible worlds ( host ) through respiratory exposure in communal scenes or public assemblages ( environment ) . Persons with impaired unsusceptibilities, such as with diabetes mellitus, malignant neoplastic disease, corticosteroid therapy, and HIV/AIDs are at greatest hazard for geting the bacteria infection. In 2008, some Harvard Epimiology pupils conducted an analysis of 13 separate surveies in respects to diabetic patients and the possible elevat ed hazard for TB. Their analysis found that it is prevelant to concentrate on diabetics as high hazard with possible lessening in TB if diabetes can be controlled ( Jeon and Murray, 2008 ) . Although, peoples with healthy immune systems are susceptible if exposed for a long period of clip, for illustration health care workers. Healthcare staff are continuously exposed to illness in infirmary and extended life installations, which places these professionals at hazard for TB. Early sensing and intervention of the active septic individual is the key to bar of transmittal of TB in the health care puting ( Smeltzer, Bare, & A ; Hinkle, 2007 ) . External factors such as the environment can act upon the affects of the being. There are many environments factors that induce the susceptibleness of the organic structure for TB, such as: ethnic/racial minority, impoverished, homeless, overcrowded lodging, prison systems, and immigrants. The denisity of the bacteria in the air besides dictates t he possible hazard for aqcuiring TB ( Smeltzer, Bare, & A ; Hinkle, 2007 ) . Symptoms Latent TB refers to an person that has been exposed to the bacteria and can transport the being in the lungs without any symptoms of TB. This individual can hold a positive tegument trial, a normal thorax X ray, and a negative phlegm vilification. This person will non experience sick. A individual with active Terbium can hold any, all, or none of the undermentioned symptoms: feeling tired all the clip, weight loss, loss of appetency, chronic cough, febrility, haemoptysis, and or dark workout suits. This individual will hold amphoric breath sounds, the thorax may exhibit obtuseness on percussion, and increased tactile fremitus with cracklings can be aucultated after coughing. These persons frequently feel sick and can easy distribute TB to others. The skin trial on this individual will be positive, and they may hold an unnatural thorax X ray and or a positive phlegm vilification ( Center for Disease Control [ CDC ] , 2010 ) . Diagnostic Trial Several diagnostic surveies are available to be performed to find if Mycobacterium TB is present. First, the Mantoux tegument is performed by shooting 0.1ml of PPD agent subdermally doing a wale to guarantee an accurate reading. Errythema and tangible wale. 5mm is considered a positive reading. Of class, a positive skin trial does non ever intend the individual has active TB and the individual could hold been exposed in the yesteryear. Once a individual trials positive with the Mantoux trial, he or she should obtain other methods to find possible exposure. A new trial, Quantiferon TB gold blood trial is now being used in many infirmaries. This trial is reportedly for valid than the skin trial. A sputum sample is collected after a positive tegument trial to execute an acid-fast B ( AFB ) for civilization. This civilization will find if Mycoacterium is present in the giver of the sample. The 3rd survey requires a chest X ray to be completed. The X ray will be viewed for hempen multitud es and possible lesions or redness related to infection the the upper lobes. A medical rating for TB must include a complete history, chest X ray, and physical scrutiny ( Steadman ‘s Medical Dictionary, 2006 ) . Patients that are likely extended attention installation occupants much have these trials performed prior to arrangement. Anytime a patient has an active instance, that patient must be contained and specific intervention initiated to forestall an eruption of the disease. Isolation A confirmed TB or a susptected verification of the disease warrents isolation of the person to forestall farther transmittal to others. The following are several control methods to diminish the hazard of taint. The first is an inititiation of AFB safeguards instantly for all patients with confirmed or suspected of active TB and who may be infective. AFB suites are a individual private room with particular airing systems. Ultraviolet lamps or other methods may be used to supplement airing. The 2nd step is to put up a personal protective equipment ( PPE ) station outside the room. This station provides N95 disposable peculiar inhalators that each individual necessitating to come in room is required to wear prior to capture into room. These mask require a FIT trial to guarantee right size is used for each individual. The 3rd step, is isolation safeguards should be continued until there is a lessening in the beings on a phlegm vilification or clinical grounds of reduced infection. Fourth step, if any grounds of medicine opposition maintain AFB safeguards ongoing until there is a negative phlegm vilification. Particular safeguards should besides be initiated when bring oning a cough for smear sample ( Smeltzer, Bare, & A ; Hinkle, 2007 ) . Treatment Originating intervention without hold is the lone manner TB can be cured. Specialized intervention is based on whether TB is an active disease or merely an infections. Person who has been infected but does non hold the disease may necessitate preventative therapy merely. This preventative therapy is designed to kill the sources that have the possible to do injury. Preventive therapy is normally a prescription for a day-to-day dosage of INH, which is an cheap TB medicine. This preventative therapy last for nine months, with periodic medical examinations to guarantee the medicine is being taken right. Active Terbium instances require intervention with effectual drugs, such as: INH, Rifadin, pyrazinamide, and ethambutol ( WHO, 2009 ) . The intervention regiman entales an initial two month intervention stage followed by a continuance stage. The continuance stage is suggested to last four months for the bulk of patients but can be extended to seven for a sum of nine months. All TB medicin es should be taken together alternatively of divided doses ( Center for Disease Control, 2003 ) . Taking the medicines right is really of import due to if taken falsely patient can go ill and the TB will be more hard to bring around as it becomes drug immune. Multi-drug immune TB ( MDR TB ) is highly unsafe as the bacterium becomes immune to the medicine used to handle the TB, which makes the intervention uneffective. MDR TB is by and large due to the being going restistant to the INH or Rifadin, which are the two most of import anti-TB medicines. Directly oserved therapy ( DOT ) is utilised to guarantee that the patients adhere to the therapy set up for them. DOT is active when a designated individual watches the patient swallow each dosage of medicine. This is a recommend pattern for all patients due to unable to find who will be compliant and who will non ( WHO, 2008 ) . Koch ‘s Postulates â€Å" In 1890, the German doctor and bacteriologist, Robert Koch, released his famed standards for judgment † if a specific bacterium is the existent cause for a specific disease ( Medicine Internet, 2010 ) . Dr. Koch, over one hundred old ages ago, developed the unequivocal association of Mycobacterium TB and the existent TB disease. The cognition of the extended make up of the bacterium, their actions to the organic structure, their life rhythms, and their transmittal from individual to individual has been studied and observed by scientist over the last century. The tubercolusis bacterium was used by Koch in explicating â€Å" Koch ‘s posits, † the systematic series of stairss proved a specific being was so the cause of the specific disease ( Guyer, neodymium ) . Koch ‘s posits are as follows: The bacterium must be present in every instance of the disease. The bacterium must be isolated from the host with the disease and grown in pure civilization. The specific disease must be reproduced when a pure civilization of the bacterium is inoculated into a healthy susceptible host. The bacterium must be recovered from the by experimentation septic host. In order to happen â€Å" fulfillment † of Koch ‘s posits it is still a demand for tie ining an infective agent with a disease ( Medicine Internet, 2010 ) . Probe Every province is required to describe active TB instances and suspected instances to the wellness section by the clinician, infection control nurses, or by the pharmaceuticss when the TB medicines are dispensed. Labs are besides required to describe all positive TB vilifications and civilizations. Early coverage is critical to the control of TB and provides the clinicians entree to the resources of the wellness section for aid in instance direction and contact probe. Health sections routinely conduct contact probes for all instances of active pneumonic TB to place secondary instances of active TB and latent TB infection. This action will eleminate a TB epidemic by originating therapy as needed during these probes. Probes are categorized by the sum of exposure to TB the individual obtained. Health section staff notify exposed contacts so that the contact is scheduled for a PPD. A follow up trial is recommend three months from the initial trial or last exposure. All positive contacts are provided a thorax xray, every bit good as immature kids and immunocompromised contacts to find whether they have active TB ( Reichler, Reves, and Bur, 2002 ) . Surveillance Public wellness surveillance â€Å" is the on-going, systematic aggregation, analysis, reading, and airing of wellness informations † ( CDC, 2010 ) . As for any surveillance system, it is a tool for sweetening. This type of tool is to guarantee timely sensing of the exposure to TB. Nurses, by and large the first contact with the wellness attention system, may happen themselves tracking and alarming the proper governments and originating disease containment plans. The constructs of epidemiology, early sensing, and surveillance should be considered ( Veenema & A ; Toke, 2006 ) . World Health Organization 2008 guidelines to cut down TB transmittal: Everyday surveillance of reported instances and supervising results of interventions should be a first line of measuring epidemiology and control. All plans should be strong in the public presentation of the systems used for describing TB instances so the information reflects accurately the true incidence of TB and its tendencies. The rating procedure should be supported by appropriate operational research surveies. The analysis of disaggregated surveillance informations should be encouraged so as to pull out the maximal information of the TB epidemic and the impact of control steps. Appropriate computing machine package should be developed and implemented to better modus operandi recording and coverage. Execution of these specific guidelines prevents a TB eruption from happening. Trailing of septic persons requires uninterrupted supervising through clinics and other health care installations. Factors of import to supervising include the individual ‘s age, the country they reside, and other factors to enter and describe to community. Eradication In 2006, the World Health Organization ( WHO ) launched the new Stop TB Strategy, a planetary program to halt TB. More than 22 million patients have been treated under direct observation therapy-based services, since the initial launch. Over 500 groups and organisations have come together to accomplish this end. The scheme consists of programs to cut down TB prevalence by 50 per centum when compared to 1990 and entire obliteration by 2050 ( World Health Organization, 2006 ) . In the chase to eliminate TB, there are six constituents of the stop TB schemes implemented by the World Health Organization. These are the lineations listed below: Pursue high quality DOTS enlargement and sweetening. Address TB/HIV MDR/XDR- TB and other challenges. Contribute to wellness systems stregthening. Prosecute all health care suppliers. Empower people with T B and community. Enable and promote research. Presently, TB is non a campaigner for obliteration attempts: obliteration is defined as the accomplishment of a position whereby no farther instances of a disease occur anyplace and command steps are unneeded. Equally long as the epdicemic of untreated HIV infection exist and until a concerned attempt is made to command TB in all states, TB will increase despite optimum application of presently available TB control engineerings ( Mississippi Department of Health, 2010 ) . Decision Since 1953, when the first national study came out, TB instances have been on a diminution. â€Å" In entire, 13,779 Terbium instances were reported in the United States in 2006. This represents a 3.1 % diminution in the rate since 2005 † ( Center for Disease Control, 2007 ) . The TB infection rate for foreign born people was 9.5 times greater than U.S. born people. Screening foreign born individuals as they enter in the U.S. will let the individual to profit from curative and preventive steps and greatly cut down the hazard of distributing the infection to others. These steps will include identifying and wholly handling all individuals who have active TB, contact probe to measure all individuals in contact with TB patient to find TB infection or disease for appropriate intervention, and testing the populations at high hazard for TB to turn up individuals infected with TB to supply complete therapy in bar of the investion from come oning to active, infective disease ( Centers for Disease Control, 2010 ) . The CDC indicates that suppliers need developing so they will â€Å" believe TB † in the first topographic point and go more familiar with the advantages of join forcesing with the wellness section. Public wellness staff should happen more effectual schemes to guarantee that suppliers are current and remain current with new guidelines for the diagnosing and intervention of TB ( American Journal of Infection Control [ AJIC ] , 2007 ) .

Organizational Change

Organizational Change Plan-Part One The use of mobile technology for health care professionals, including personal digital assistants (PDAs) has increased exponentially in both clinical practice and nursing education (Farrell & Rose, 2008). Some evidence exists that the use of a PDA in health care settings may improve decision-making, reduce the numbers of medical errors, and enhance learning for both students and professionals (Nilsson, 2008); for these reasons, the Learning Technology Committee (LTC) at Sinclair Community College (SCC) explored the benefits of nursing students using the PDA at the bedside in the clinical setting.The committee proposed a change, Project PDA, to implement the use of PDA among novice nursing students and faculty. The following paragraphs will focus on the assessment and plan of the Project PDA; and examine the rationale for the change, barriers to change, influences on change, application of a theoretical model and resources available to support t he change initiative. Rationale for Change Healthcare is a dynamic and evolving field of knowledge. Nursing students are trying to learn and implement this large amount of information at a rapid pace.Nursing students are generally unsure of their skills, feel insecure about their knowledge level, and lack self-confidence (Fisher & Koren, 2007). Many advantages have been seen with the use of the PDA, such as time savings, reduction of errors, and ease of use (Miller, Shaw-Kokot, Arnold, Boggin, Crowell, Allegri, Blue, & Berrier, 2005). Through the use of the PDA, it is thought, the nursing student will have reduced stress, fear, and improved self-confidence (Martin, 2007). Students will benefit from gaining immediate access to resources at the point of care, become more efficient, and spend more time focusing on patient care.PDAs will provide a bridge for students to apply theoretical learning to practice and foster the development of critical reasoning skills and professiona l autonomy. Nurse educators will need to develop creatively new, innovative models of teaching to keep up with changing society and technological advances in nursing practice (Jeffries, 2005). Adopting this new technological process will ensure SCC is keeping up with the trends of technology in nursing education. Organizational and Individual Barriers to Change Organizational change is a complicated process and is likely to be met with resistance.According to Borkowski (2005), resistance may originate from two sources: organizational barriers and individual barriers. These barriers threaten to impede change success. In an effort to avoid change failure, management must identify and understand potential barriers to change. Organizational barriers are typically beyond the control of management and may be perceived as insurmountable, which in the early stages of change can prove to be futile (Borkowski, 2005). Two potential organizational barriers to implementing Project PDA are cultur al complacency; and the lack of financial and technology resources.The first barrier was cultural complacency. Spector (2010) suggests that organizational culture may enable and create barriers to change. The nursing department has functioned like a well oiled machine as result of shared values and beliefs among faculty and students; subsequently creating a complacent atmosphere. Management must change the culture of the nursing department to engage faculty and students; and promote behaviors in line with the proposed change. The second barrier was the lack of financial and technology resources.The college was in the midst of a new levy campaign and there were no current funds allocated in the nursing department budget for technology improvements including the purchase of equipment. The college does not own PDAs for the students or faculty to use. No process was in place for technical support if students were to experience challenges with the device. The individual barriers identifi ed included lack of motivation, staff support, and computer competency. Faculty and students may lack motivation if they perceive the change will disrupt the status quo, or the preference for the current situation (Borkowski, 2005).The lack of support and acceptance of the new technology by other clinical staff and faculty is one of the key challenges of implementing new technology into educational programs (Farrell & Rose, 2008). Some students and faculty are computer literate, but many are less familiar and lack experience with computer systems. As a result, it will take time for students, faculty, and clinical staff to become comfortable with using the PDA. Factors of Influence The college’s readiness to change could lead to success or failure.The change itself is not the reason, but the organization’s culture of environment and the employees respect, trust, and attitude toward the management implementing the change (Krause, 2008). The attitudes of faculty and s tudents may directly affect how responsive and committed they will be to the change process. The factors of influence within any organization may originate or draw in part on the quality of leadership (Krause, 2008). The leaders must implement strategies to communicate the value of the change, establish a coalition, and empower all participants to become change agents.Theoretical Model Kurt Lewin’s change theory was the theoretical framework selected for analyzing the change process involved in adopting the use of PDAs in the clinical setting as planned in Project PDA. Lewin’s change theory identified three stages in the change process-unfreeze, move, and refreeze. To unfreeze leaders must create a sense of disequilibrium to motivate change. A pre-pilot survey completed by the LTC revealed students and faculty believed time management was the priority challenge for students in the clinical setting.PDA use is expected to improve time management skills. In stage two, cha nge is implemented. Students and faculty will be required to use the PDA during clinical for access required textbooks and other resources. The final stage, refreeze, the change is cemented into the organization’s culture (Spector, 2010). The LTC will evaluate the change process, communicate progress, maintain support structures, reinforce required behaviors and encourage continued commitment to sustain the change. Internal and External ResourcesBorkowski (2005) noted managers must be certain adequate resources are available to implement change and ensure organizational goals are met. The nursing department at SCC is fortunate to have access to internal and external resources needed to support efforts to implement Project PDA. A strong organizational structure facilitates collaboration within the department. Webinars will be used for faculty and student development. The nursing department secured grant funding to purchase 16 i-Touch devices for faculty. Students will use fina ncial aid to purchase the PDA and software undle. E-book resources will be made available through contracted publishing vendors. Learning and troubleshooting tutorials will be included with the software as well as the Sinclair Help Desk will be available for technical support. Information technology has integrated in the health care delivery systems to include the use of personal digital assistants (PDA) and other computer devices (Fisher & Koren, 2007). Teaching institutions are being challenged to keep up with the trends in technology and meet demands for use of hand held devices.In response to this challenge, SCC proposed to implement Project PDA. Students and faculty will begin using PDAs in the clinical setting. The use of these devices will provide real-time access to important resources enabling medical personnel and students to manage point of care activities more efficiently (Lee, 2006). As a result, students will be less stressed, more confident, and more competent hea lth care providers. Change may be complicated by organizational or individual barriers.The specific barriers were identified as cultural complacency, lack of financial and technology resources, employee motivation, staff support, and computer competency. Organizational change in the nursing department at SCC could be influenced by the nursing department’s readiness for change; and the attitudes of faculty, students, and clinical staff toward the change. The Kurt Lewin change theory was applied to Project PDA examining the three stages of the change process. Leaders at SCC have access to internal and external resources necessary to implement the proposed change.The presence of a solid organizational structure, access to grant funding, technology resource vendors, and on-site technical support will facilitate the success and sustainability of Project PDA. Organizational Change Organizational Change Plan-Part One The use of mobile technology for health care professionals, including personal digital assistants (PDAs) has increased exponentially in both clinical practice and nursing education (Farrell & Rose, 2008). Some evidence exists that the use of a PDA in health care settings may improve decision-making, reduce the numbers of medical errors, and enhance learning for both students and professionals (Nilsson, 2008); for these reasons, the Learning Technology Committee (LTC) at Sinclair Community College (SCC) explored the benefits of nursing students using the PDA at the bedside in the clinical setting.The committee proposed a change, Project PDA, to implement the use of PDA among novice nursing students and faculty. The following paragraphs will focus on the assessment and plan of the Project PDA; and examine the rationale for the change, barriers to change, influences on change, application of a theoretical model and resources available to support t he change initiative. Rationale for Change Healthcare is a dynamic and evolving field of knowledge. Nursing students are trying to learn and implement this large amount of information at a rapid pace.Nursing students are generally unsure of their skills, feel insecure about their knowledge level, and lack self-confidence (Fisher & Koren, 2007). Many advantages have been seen with the use of the PDA, such as time savings, reduction of errors, and ease of use (Miller, Shaw-Kokot, Arnold, Boggin, Crowell, Allegri, Blue, & Berrier, 2005). Through the use of the PDA, it is thought, the nursing student will have reduced stress, fear, and improved self-confidence (Martin, 2007). Students will benefit from gaining immediate access to resources at the point of care, become more efficient, and spend more time focusing on patient care.PDAs will provide a bridge for students to apply theoretical learning to practice and foster the development of critical reasoning skills and professiona l autonomy. Nurse educators will need to develop creatively new, innovative models of teaching to keep up with changing society and technological advances in nursing practice (Jeffries, 2005). Adopting this new technological process will ensure SCC is keeping up with the trends of technology in nursing education. Organizational and Individual Barriers to Change Organizational change is a complicated process and is likely to be met with resistance.According to Borkowski (2005), resistance may originate from two sources: organizational barriers and individual barriers. These barriers threaten to impede change success. In an effort to avoid change failure, management must identify and understand potential barriers to change. Organizational barriers are typically beyond the control of management and may be perceived as insurmountable, which in the early stages of change can prove to be futile (Borkowski, 2005). Two potential organizational barriers to implementing Project PDA are cultur al complacency; and the lack of financial and technology resources.The first barrier was cultural complacency. Spector (2010) suggests that organizational culture may enable and create barriers to change. The nursing department has functioned like a well oiled machine as result of shared values and beliefs among faculty and students; subsequently creating a complacent atmosphere. Management must change the culture of the nursing department to engage faculty and students; and promote behaviors in line with the proposed change. The second barrier was the lack of financial and technology resources.The college was in the midst of a new levy campaign and there were no current funds allocated in the nursing department budget for technology improvements including the purchase of equipment. The college does not own PDAs for the students or faculty to use. No process was in place for technical support if students were to experience challenges with the device. The individual barriers identifi ed included lack of motivation, staff support, and computer competency. Faculty and students may lack motivation if they perceive the change will disrupt the status quo, or the preference for the current situation (Borkowski, 2005).The lack of support and acceptance of the new technology by other clinical staff and faculty is one of the key challenges of implementing new technology into educational programs (Farrell & Rose, 2008). Some students and faculty are computer literate, but many are less familiar and lack experience with computer systems. As a result, it will take time for students, faculty, and clinical staff to become comfortable with using the PDA. Factors of Influence The college’s readiness to change could lead to success or failure.The change itself is not the reason, but the organization’s culture of environment and the employees respect, trust, and attitude toward the management implementing the change (Krause, 2008). The attitudes of faculty and s tudents may directly affect how responsive and committed they will be to the change process. The factors of influence within any organization may originate or draw in part on the quality of leadership (Krause, 2008). The leaders must implement strategies to communicate the value of the change, establish a coalition, and empower all participants to become change agents.Theoretical Model Kurt Lewin’s change theory was the theoretical framework selected for analyzing the change process involved in adopting the use of PDAs in the clinical setting as planned in Project PDA. Lewin’s change theory identified three stages in the change process-unfreeze, move, and refreeze. To unfreeze leaders must create a sense of disequilibrium to motivate change. A pre-pilot survey completed by the LTC revealed students and faculty believed time management was the priority challenge for students in the clinical setting.PDA use is expected to improve time management skills. In stage two, cha nge is implemented. Students and faculty will be required to use the PDA during clinical for access required textbooks and other resources. The final stage, refreeze, the change is cemented into the organization’s culture (Spector, 2010). The LTC will evaluate the change process, communicate progress, maintain support structures, reinforce required behaviors and encourage continued commitment to sustain the change. Internal and External ResourcesBorkowski (2005) noted managers must be certain adequate resources are available to implement change and ensure organizational goals are met. The nursing department at SCC is fortunate to have access to internal and external resources needed to support efforts to implement Project PDA. A strong organizational structure facilitates collaboration within the department. Webinars will be used for faculty and student development. The nursing department secured grant funding to purchase 16 i-Touch devices for faculty. Students will use fina ncial aid to purchase the PDA and software undle. E-book resources will be made available through contracted publishing vendors. Learning and troubleshooting tutorials will be included with the software as well as the Sinclair Help Desk will be available for technical support. Information technology has integrated in the health care delivery systems to include the use of personal digital assistants (PDA) and other computer devices (Fisher & Koren, 2007). Teaching institutions are being challenged to keep up with the trends in technology and meet demands for use of hand held devices.In response to this challenge, SCC proposed to implement Project PDA. Students and faculty will begin using PDAs in the clinical setting. The use of these devices will provide real-time access to important resources enabling medical personnel and students to manage point of care activities more efficiently (Lee, 2006). As a result, students will be less stressed, more confident, and more competent hea lth care providers. Change may be complicated by organizational or individual barriers.The specific barriers were identified as cultural complacency, lack of financial and technology resources, employee motivation, staff support, and computer competency. Organizational change in the nursing department at SCC could be influenced by the nursing department’s readiness for change; and the attitudes of faculty, students, and clinical staff toward the change. The Kurt Lewin change theory was applied to Project PDA examining the three stages of the change process. Leaders at SCC have access to internal and external resources necessary to implement the proposed change.The presence of a solid organizational structure, access to grant funding, technology resource vendors, and on-site technical support will facilitate the success and sustainability of Project PDA. Organizational Change Organizational Change Plan-Part One The use of mobile technology for health care professionals, including personal digital assistants (PDAs) has increased exponentially in both clinical practice and nursing education (Farrell & Rose, 2008). Some evidence exists that the use of a PDA in health care settings may improve decision-making, reduce the numbers of medical errors, and enhance learning for both students and professionals (Nilsson, 2008); for these reasons, the Learning Technology Committee (LTC) at Sinclair Community College (SCC) explored the benefits of nursing students using the PDA at the bedside in the clinical setting.The committee proposed a change, Project PDA, to implement the use of PDA among novice nursing students and faculty. The following paragraphs will focus on the assessment and plan of the Project PDA; and examine the rationale for the change, barriers to change, influences on change, application of a theoretical model and resources available to support t he change initiative. Rationale for Change Healthcare is a dynamic and evolving field of knowledge. Nursing students are trying to learn and implement this large amount of information at a rapid pace.Nursing students are generally unsure of their skills, feel insecure about their knowledge level, and lack self-confidence (Fisher & Koren, 2007). Many advantages have been seen with the use of the PDA, such as time savings, reduction of errors, and ease of use (Miller, Shaw-Kokot, Arnold, Boggin, Crowell, Allegri, Blue, & Berrier, 2005). Through the use of the PDA, it is thought, the nursing student will have reduced stress, fear, and improved self-confidence (Martin, 2007). Students will benefit from gaining immediate access to resources at the point of care, become more efficient, and spend more time focusing on patient care.PDAs will provide a bridge for students to apply theoretical learning to practice and foster the development of critical reasoning skills and professiona l autonomy. Nurse educators will need to develop creatively new, innovative models of teaching to keep up with changing society and technological advances in nursing practice (Jeffries, 2005). Adopting this new technological process will ensure SCC is keeping up with the trends of technology in nursing education. Organizational and Individual Barriers to Change Organizational change is a complicated process and is likely to be met with resistance.According to Borkowski (2005), resistance may originate from two sources: organizational barriers and individual barriers. These barriers threaten to impede change success. In an effort to avoid change failure, management must identify and understand potential barriers to change. Organizational barriers are typically beyond the control of management and may be perceived as insurmountable, which in the early stages of change can prove to be futile (Borkowski, 2005). Two potential organizational barriers to implementing Project PDA are cultur al complacency; and the lack of financial and technology resources.The first barrier was cultural complacency. Spector (2010) suggests that organizational culture may enable and create barriers to change. The nursing department has functioned like a well oiled machine as result of shared values and beliefs among faculty and students; subsequently creating a complacent atmosphere. Management must change the culture of the nursing department to engage faculty and students; and promote behaviors in line with the proposed change. The second barrier was the lack of financial and technology resources.The college was in the midst of a new levy campaign and there were no current funds allocated in the nursing department budget for technology improvements including the purchase of equipment. The college does not own PDAs for the students or faculty to use. No process was in place for technical support if students were to experience challenges with the device. The individual barriers identifi ed included lack of motivation, staff support, and computer competency. Faculty and students may lack motivation if they perceive the change will disrupt the status quo, or the preference for the current situation (Borkowski, 2005).The lack of support and acceptance of the new technology by other clinical staff and faculty is one of the key challenges of implementing new technology into educational programs (Farrell & Rose, 2008). Some students and faculty are computer literate, but many are less familiar and lack experience with computer systems. As a result, it will take time for students, faculty, and clinical staff to become comfortable with using the PDA. Factors of Influence The college’s readiness to change could lead to success or failure.The change itself is not the reason, but the organization’s culture of environment and the employees respect, trust, and attitude toward the management implementing the change (Krause, 2008). The attitudes of faculty and s tudents may directly affect how responsive and committed they will be to the change process. The factors of influence within any organization may originate or draw in part on the quality of leadership (Krause, 2008). The leaders must implement strategies to communicate the value of the change, establish a coalition, and empower all participants to become change agents.Theoretical Model Kurt Lewin’s change theory was the theoretical framework selected for analyzing the change process involved in adopting the use of PDAs in the clinical setting as planned in Project PDA. Lewin’s change theory identified three stages in the change process-unfreeze, move, and refreeze. To unfreeze leaders must create a sense of disequilibrium to motivate change. A pre-pilot survey completed by the LTC revealed students and faculty believed time management was the priority challenge for students in the clinical setting.PDA use is expected to improve time management skills. In stage two, cha nge is implemented. Students and faculty will be required to use the PDA during clinical for access required textbooks and other resources. The final stage, refreeze, the change is cemented into the organization’s culture (Spector, 2010). The LTC will evaluate the change process, communicate progress, maintain support structures, reinforce required behaviors and encourage continued commitment to sustain the change. Internal and External ResourcesBorkowski (2005) noted managers must be certain adequate resources are available to implement change and ensure organizational goals are met. The nursing department at SCC is fortunate to have access to internal and external resources needed to support efforts to implement Project PDA. A strong organizational structure facilitates collaboration within the department. Webinars will be used for faculty and student development. The nursing department secured grant funding to purchase 16 i-Touch devices for faculty. Students will use fina ncial aid to purchase the PDA and software undle. E-book resources will be made available through contracted publishing vendors. Learning and troubleshooting tutorials will be included with the software as well as the Sinclair Help Desk will be available for technical support. Information technology has integrated in the health care delivery systems to include the use of personal digital assistants (PDA) and other computer devices (Fisher & Koren, 2007). Teaching institutions are being challenged to keep up with the trends in technology and meet demands for use of hand held devices.In response to this challenge, SCC proposed to implement Project PDA. Students and faculty will begin using PDAs in the clinical setting. The use of these devices will provide real-time access to important resources enabling medical personnel and students to manage point of care activities more efficiently (Lee, 2006). As a result, students will be less stressed, more confident, and more competent hea lth care providers. Change may be complicated by organizational or individual barriers.The specific barriers were identified as cultural complacency, lack of financial and technology resources, employee motivation, staff support, and computer competency. Organizational change in the nursing department at SCC could be influenced by the nursing department’s readiness for change; and the attitudes of faculty, students, and clinical staff toward the change. The Kurt Lewin change theory was applied to Project PDA examining the three stages of the change process. Leaders at SCC have access to internal and external resources necessary to implement the proposed change.The presence of a solid organizational structure, access to grant funding, technology resource vendors, and on-site technical support will facilitate the success and sustainability of Project PDA.

Immigration in America Research Paper Example | Topics and Well Written Essays - 1000 words

Immigration in America - Research Paper Example Among these, over 90,000 are nonimmigrant business people, students, workers and tourists, who get in to the nation through airports and border crossings. Approximately 3,000 of them are immigrants or expatriates, who would become permanent dwellers of the U.S. through special invitation. Moreover, over 1,000 of the immigrants are illegal aliens; typically, Mexicans, who dodge border controls, enter the United States, and inhabit. Several factors motivate these immigrants including religious, political, and economic factors. For the initial immigrants, Spaniards needed Christian converts in Florida and the southwest; the Puritans in Massachusetts wanted to institute a society limited to members of their faith while German sectarians wanted religious liberty in Pennsylvania (Martin & Midgley, 2003). Cynical perceptions of outsiders as belonging to a different race, ethnicity, economic status, religion, or political attachment have significantly interfered with America's interest for n ewcomers. Since the eighteenth century, the inborn Americans have raised various issues concerning the influx of immigrants in to the country. These issues include concerns regarding pressure on public services, job contest, and an apparent incapability of the U.S. to take in cultural foreigners easily (Ogletree, 2000). Several studies on the public opinion concerning immigrants in the 1960’s indicate that many of Americans proposed for the reduction of both authorized and unauthorized immigration. On the other hand, public opinion surveys carried out at the close of the 18th century indicate that the public were more lenient toward immigration. This is because there were low rates of unemployment and the economy was growing (Martin & Midgley, 2003). Immigration policies in America After the World War I, many Americans became more patriotic and demanded for the removal of foreign blood from their country. Consequently, this resulted in the development of various acts and poli cies aimed at regulating immigration in to America. For instance, this anti-immigrant climate prompted for the enactment of Immigration Acts of 1921 and 1924. These resultant acts instituted quota methods intended to decrease considerably the number of southern and eastern Europeans and to block all Asians. During this time, there was widespread perception that these foreigners were polluting the American culture. This perception carried a lot of weight in congressional discussions, as did the argument that strangers were the carriers of fundamental ideologies (Vecoli, 1996). For the nation’s first 100 years, the United States assisted immigration, welcoming aliens who could help to inhabit a huge nation. However, from the 1880s onwards, the United States started to block particular categories of immigrants. This comprised low-skilled contract workers, Chinese and prostitutes. Consequently, this led to the development of the phase of qualitative limitations on immigration. Ac cording to the United States laws and policies, immigrants are nationals of foreign countries given visas that permit them to live and work permanently in the United States

Australian Health I ssue Essay Example | Topics and Well Written Essays - 2750 words

Australian Health I ssue - Essay Example Despite this fact, however, problems in workforce shortages threaten to compromise the delivery of adequate health care in the country. The mounting problems in this sector have recently sought to be addressed by the National Health Reform Agreement arrived at by the Council of Australian Governments (COAG) in April 2010, the latest in a series of health care reforms pursued in the country over the decades. The agreement guarantees provision by the Commonwealth of no less than $16.3 billion in additional growth funding to the States and Territories, within the period 2014 to 2020 (AHMC, 2011). The principal directions are provided by the eight streams identified in the COAG agreement, and this paper shall treat on the sixth stream concerning the health care workforce. While this discussion on the health care providers is relevant across disciplines, the focal point shall be on the nursing profession, inasmuch as nurses and midwives comprise 55% of the entire health workforce in Austr alia (Bryce, 2009). The Sixth Stream – Workforce The best-laid plans, though well-funded and sufficiently provided with the necessary logistics, could not hope to attain success if the available manpower pool is inadequate or lacking in the necessary skills. Workforce shortages have plagued the Australian health care system in the last decade, for which reason the development of a skilled and adequate workforce has been specified as the Stream 6 in the Health Care Reform plan presented by the COAG agreement. The stated stream purpose is â€Å"to improve Australians’ access to health and aged care services by expanding the health care workforce and providing health professionals with the skills and training opportunities necessary to delivery Australia’s future care benefits† (NHHN, 2010, p. 40). According to the Agreement, substantial resources are to be provided by the Commonwealth in the realisation of the objective of this Stream. In the plan, the Comm onwealth has committed to invest over the next four years a total sum of $1.2 billion, for the purpose of providing training to general practitioners and specialists; for supporting nurses working in the areas of general practice, care for the aged, and those working in rural areas; and for providing assistance and support to other professionals in allied fields rendering service in rural communities (NHHN, 2010). In the plan, the Commonwealth commits to fund 60% of costs of staff training in public hospitals, for which the following targets have been articulated (NHHN, 2010, p. 42): 1. Delivery of 5,500 new general practitioners (GPs) throughout the coming decade, amounting to a total of $345 million for the first four years; the target calls for 1,375 additional GPs who are either practicing or in training as of 2013; 2. Designation of 975 places annually as training ground for future physicians in their postgraduate training period, to experience how it feels to have a possible c areer in general practice; this requires $150 million as of 2012; 3. Provision of 680 additional specialist doctors spread throughout the coming ten years, for which an estimated $145 million shall be provided for the first four years; 4. Creation of a comprehensive and integrated package of programs in order to provide greater support to health profession

Analyze federalism Research Paper Example | Topics and Well Written Essays - 1250 words

Analyze federalism - Research Paper Example Federalism has the quality of holding local pride, ethnicities and supremacy, while letting the central government to manage common issues. In the United States, ‘federal government’ is generally assumed to bring up entirely the national government in Washington1. Federalism With Respect To Execution and Administration of Policy One of the most compound subdivisions of federalism analysis is that of political economic federalism. It includes federal bodies’ monetary situations and their political background. Incorporation with the global economy, impacts the cost-benefit analysis of federalism. The advantage of federalism is that it slices out variety within a nation, so that citizens can choose a place to move on which meets their requirements for policies such as taxation and consumer goods among others. Incorporation with global economy can raise expenses of regionalization if significant governments are permitted to use the status of the central government2. T he federalist system in the USA enjoys shared power between federal, state and local governments and involves a requirement for cooperation, harmonization, and interaction. In the American federalism system, the local governments possess most of the discretions and responsibilities for emergency and disaster management where federal organizations are envisioned to deliver monetary support and resources. State governments act as intercessor by enabling the operations of federal policies regarding emergency and disaster management at the local level3. Role Of Three Branches Of Federal Government The constitution comprises of a system which separates the authority where three branches of federal government can scrutinize and balance the role of each other. The three branches of federal government are ‘Executive branch’, ‘Legislative branch’ and ‘Judicial branch’4. Executive Branch: Executive branch comprises of the President, Vice President, and o ther Cabinet Officials such as State Secretary, Treasury Secretary, Defense Secretary and Labor Secretary among others. These officials are appointed by President and together they make up the executive branch. The role of executive branch is to implement the commandments4. Legislative Branch: The legislative branch comprises of the ‘Senate’ and ‘House of Representatives’. The most important role of legislative branch is to make the rules, regulations and laws. It is the duty of legislative branch to decide the policies and how the federal money can be used for the benefits of the country4. Judicial Branch: The judicial branch comprises of the Supreme Court as well as other courts. The judicial branch clarifies the implication of constitution and commandments that are issued by legislative branch. The role of judicial branch is to interpret the regulations and punish the criminals and the lawbreakers4. Interaction And Intersection Of Three Branches With Sta te Governments People interact regularly with the state governments. State governments comprise of police divisions, libraries, education and issuing licenses among others. Each state government has its own written structure and those are far more elegant compared to the federal equivalents. According to the 10th amendment of American constitution, each and every authority reserved for state government is not allowed to the federal government5. Executive Branch:

Roles and responsibilities of community health Essay

Roles and responsibilities of community health - Essay Example Employers should therefore pay people enough money so that the issue of money is off the table. . Autonym involves one being allowed to do something in their own way as long as they produce good results. The urge for better understanding of skills motivates a person to work harder. Extra ordinary conditions are often brought about by having a purpose to achieve a certain goal and hence making people have purpose for something is much more important than monetary motivation. Ken Robinson argues that the current system of education has failed in creating creativity among the students. He indicates that academic inflation is being caused by people not giving value to whatever they study which he terms as ‘shifting beneath or feet. Schools have turned into institutes of constructing hypothetical careers rather than skills that one can measure. He observes that in the recent days people are studying various careers but fail to apply them in life and become completely different people. Ken believes that children have innovative capacity and talents that are squandered ruthlessly by schools. The education system has focused on more on science and humanities leaving behind art that is a subject that exercises the child’s creativity. According to me his hypothesis is very true, and most of our talents fade away with time. While in primary school I was an excellent in painting but when as my level of education goes higher, attention has shifted to science and thus my little talent has faded away. No teacher has motivated me on making a career out of painting and even my parents focus more on me having a different career rather than in my talent. Digitization of the world has led to changes in the academic sector some of which include softcopy notes and virtual schooling. One can attend classes at the comfort of their homes that are convenient to many people. Virtual schooling gives people a

Is PTSD linked to criminal behavior Research Paper

Is PTSD linked to criminal behavior - Research Paper Example In chapter 8 it discusses in detail the possibility of a correlation between psychological disorders like PTSD and criminal behavior. It also furnishes very relevant and useful statistics pertaining to mentally ill offenders in state and federal prisons. It presents the conclusions from many studies regarding the prevalence of mental illness amongst criminals. It is a very informative source which facilitates important insight regarding the research question from a practical, statistical and academic perspective. Chapter 7 in this book is exclusively about childhood post traumatic stress disorder and criminal behavior. It delves on the ramifications of exposure to stressful and catastrophic events on children. The book summarizes various scientific studies that link childhood trauma to juvenile delinquency, drug abuse and criminal behavior. The approach of this book towards the question under consideration is very scientific and analytical. Chapter 7 also gives a detailed historical overview of the study of childhood stress and trauma and its relation to criminal behavior. Overall, it is a reliable scientific source that will make immense contribution to the research question. It is an elaborate and detailed, peer reviewed article that offers a literature review of the prior studies focused on the association between PTSD and criminal behavior in the offenders serving sentences in state and federal prisons. This article makes an immense contribution to the selected research question in the sense that it is a compilation of the approaches and views of the previous researchers associated with the issue of PTSD and criminal behavior. This is an immensely useful source as it examines the linkage between PTSD and violent behavior. The conclusions of this article are extremely reliable as it studies the association between violent behavior

Edwin Henry Landseers work Waiting Essay Example | Topics and Well Written Essays - 500 words

Edwin Henry Landseers work Waiting - Essay Example The essay "Edwin Henry Landseer’s work Waiting" discovers the painting "Waiting", created by Edwin Landseer. Because all artists tend to capture the images and scenes that mean the most to them, whether they intend to or not, they also manage to provide their audience with clues as to the ideals of their era. As a result, artistic efforts often provide useful tools for the study and understanding of complicated concepts in a variety of fields. In cases in which the artists choose to provide visual images in which the forms and figures are recognizable, future generations are able to get a sense of how these people lived by examining shifts in depictions, deliberate misrepresentation and so forth that provide clues as to the underlying social structures. These ideas can be found in Sir Edwin Henry Landseer’s work, such as in his oil on canvas painting â€Å"Waiting† This painting appears to represent an inner courtyard to an estate. An arched wooden door stands aj ar at the back of the painting revealing blue sky and green fields, but there is a stonework wall surrounding the picture space and the ground is covered with bare ground and more stonework. A cement stairway curves up along the left-hand side of the painting just revealing the bottom edge of another wooden door at the top of the steps. The second-floor banister for these steps is covered with a red rug on which perch several birds. The main characters of the image, though, are a dazzlingly white horse, a small black dog and a much larger black.

How History of Freight Trains reflect OPERATIONS MANAGEMENT Research Paper

How History of Freight Trains reflect OPERATIONS MANAGEMENT - Research Paper Example The purpose of writing this paper is to analyze how the history of freight trains in America reflects on the subjects of operation management. In order to understand the subject, I will analyze the train freight process. First we have the order perspective and train perspective. The order perspective involves receiving orders, booking trains for the particular orders and receiving containers and invoice. The train perspective involves finding the desired train depending on the cargo that needs to be transported. In the paper, I will show how the strategic operations of the freight railway systems have made the industry competitive and profitable. I will also discuss how specialized freight scheduling system is used to streamline the operations, control the cost and to respond to changes in demand in the railway industry. It is important to note that most of the transformations in the freight train industry occurred during the industrial revolution. The trains from the different parts of the world arrive at the bailey train yard where they are sorted and reassigned to ensure they arrive at the desired destination. Everything that is produced in the United States is transported through the railway system. All the train activity in the railway yard is monitored from the computer screens of the command centre. In the command centre scheduling takes place where the movement of the trains is coordinated to ensure efficient operation of the train yard. By utilizing the latest computer control software, the command centre monitors all the traffic in the yard. Scheduling ensures the times the freight trains spend in the yard to be minimized by ensuring that traffic is controlled and sorted out in the shortest time possible (Aalam, 2014). The trains are then sorted in the classification yard where the incoming trains are reassigned to their intended

The Application of Cognitive Learning Theory in Learning How to Read Essay

The Application of Cognitive Learning Theory in Learning How to Read and Use Maps - Essay Example The objective of the essay is to examine the potentials of one of the learning theories aforementioned, the cognitive learning theory, in identifying and explaining the components and mechanisms of learning a particular task. For this essay, learning how to read and use a map will be explored by applying the cognitivist approach. Primarily, the essay will provide a brief overview of the task of learning how to read and use a map and its importance in the discipline of geography. Afterward, the types of knowledge required to acquire or learn the particular skill will be discussed, and then the cognitive learning theory, as it applies to the learning task of reading and using a map, will be examined. Specifically, Piaget’s and the neo-Vygotskian’s theories will be employed in explaining the chosen learning task. And lastly, the essay will conclude the discussion by identifying the strengths and weaknesses of the cognitive learning theory, relative to other learning theori es, in explaining the task of learning how to read and use a map. The discipline of geography explores the relationship between human beings and the earth and particularly takes into account the environment, location, and space. In studying locations and geographical subjects, geographers illustrate and identify the mechanisms and structures they observe in their physical environment. Hence study of spatial structures and the acquisition of locational knowledge shape distinguishing and core components of the field, with various kinds of maps being an essential tool in this practice (Palmer & Birch, 2004).

Beta Blocker in Case of Heart Failure Essay Example for Free

Beta Blocker in Case of Heart Failure Essay Introduction : Beta-blockers, also known as beta antagonists, beta-adrenergic blocking agents, or beta-adrenergic antagonists, are drugs that are prescribed to treat several different types of conditions, including hypertension (high blood pressure), angina, some abnormal heart rhythms, heart attack (myocardial infarction), anxiety, migraine, glaucoma, and overactive thyroid symptoms. Beta-blockers block the action of the sympathetic nervous system of the heart, thus reducing stress on the heart. The sympathetic nervous system activates the fight or flight response. It is part of the autonomic nervous system. Beta-blockers block beta-adrenergic substances, such as apinephrine (adrenaline) in the autonomic nervous system (involuntary nervous system). They slow down the heart beat, decrease the force of the contractions of the heart muscles, and reduce blood vessel contraction in the heart, brain, as well as the rest of the body. Generic Names:| Carvedilol / Metoprolol / Atenolol / Bisprolol / Propranolol / Timolol| Brand Names:| Coreg / Lopressor, Toprol XL / Tenormin / Zebeta / Inderal / Blocadren| How it is given:| Oral (tablet or capsule), intravenous (IV)| Indications : Doctors may prescribe beta-blockers for patients with tachycardias (rapid heart rates). They help patients with angina by lowering the amount of oxygen the heart muscles require. Angina pectoris occurs when the heart requires more oxygen than it is getting. Beta-blockers can help hypertensive patients because their effects on blood vessels lower blood pressure. Patients with hereditary tremors as well as those who suffer from migraines may benefit from taking beta-blockers. In other words, beta-blockers are known as beta- adrenoreceptor blocking agents and are used to treat: Commonly * Angina * Heart failure * High blood pressure (hypertension) * Irregular heart beat (atrial fibrillation) * Myocardial infarction (heart attack) Â  less commonly * Prevention of migraine * Thyrotoxicosis (overactive thyroid) * Anxiety * Tremor * Glaucoma (as eye drops) - The first clinically useful beta adrenergic receptor antagonist was called Propranolol. It was invented by Sir James W. Black (born 1924), a Scottish doctor and pharmacologist. Sir James also synthesized Cimetidine (for the treatment of heartburn and peptic ulcers) and was awarded the Nobel Prize for Medicine in 1988. Propranolol revolutionized the medical management of angina pectoris it is considered as one of the major contributions to clinical medicine and pharmacology of the 20th century. Mechanism of work : The use of beta blockers in heart failure is primarily associated with the medication’s effect on heart rate. The medication, by way of the sympathetic nervous system, decreases the patient’s heart rate, preventing the heart from having to work harder because of the condition. This effect was not considered desirable for heart failure patients when the medication was first studied, however. A lowered heart rate has the risk of worsening heart failure symptoms, but as research continued, beta blockers proved to have benefits that outweighed this risk. The exact etiology of the case of heart failure is of importance when a doctor is deciding whether to use beta blockers. A case that is present because of impaired ventricular filling, in contrast to a case caused by impaired ventricular emptying, seems to respond better to beta blockers in heart failure. In addition to their sympathetic action on heart muscle, beta blockers in heart failure influence the kidney’s renin/angiotensin system. Beta blocking medications cause the secretion of the hormone, renin, to decrease. As renin decreases, a cascade of events transpires that decrease the heart’s demand for oxygen. The cascade lowers extracellular fluid volume and increases the blood’s ability to hold and carry oxygen to body tissues. Beta blocker treatment can be supplemented, and is supplemented in most cases, with diuretics and angiotensin-converting enzyme (ACE) inhibitors that enhance this effect. Patients who have significant dyspnea — shortness of breath — while they remain at rest are among those who may not be candidates for treatment with beta blockers. Having severe dyspnea can increase the risks that are associated with beta blocker treatment. Some patients are considered hemodynamically unstable if their blood does not carry oxygen well, even under normal circumstances; these patients may not be good candidates for treatment either. Heart problems for a patient with heart problems beta-blockers can reduce the workload for the heart; so that it does not have to work so hard to supply all parts of the body with oxygen-rich blood. For people with angina, heart failure, or after a heart attack, reducing the hearts workload is crucial. Drugs Used in case of Heart Failure : * Propranolol * Metoprolol tartrate (Lopressor) and metoprolol succinate (Toprol XL)| * | * Carvedilol (Coreg)| * | * Bucindolol (Bextra)| * | * Bisoprolol (Zebeta)| * | Side Effects : The most common side effects are: * Cold feet * Cold hands * Diarrhea * Fatigue * Nausea * Very slow heartbeat The following less common side effects are also possible: * Sleeping difficulties and disturbances * Bad dreams (nightmares) * Erectile dysfunction (male inability to achieve or sustain an erection during sex) References : Myo clinic www.Hearthealthywomen.com http://www.wisegeek.com

Effect of Enzyme Catalase on Hydrogen Peroxide

Effect of Enzyme Catalase on Hydrogen Peroxide Introduction In this experiment, I am going to determine the effect of different concentration of enzyme catalase on the rate of reaction of decomposition of hydrogen peroxide. Normally, hydrogen peroxide is produced naturally in human or plant cell. Hydrogen peroxide is the by-product of respiration. As an oxidizer, it will decompose to form oxygen and water. The chemical equation for the decomposition of hydrogen peroxide is 2 H2O2 → 2 H2O + O2. The reaction is speeded up by the presence of enzyme, namely catalase which is used in this experiment. This mechanism is important in living organisms cells and body system particularly in human. This is because the corrosive characteristic of hydrogen peroxide may damage the wall of liver where it is largely produced during cellular respiration process. When it is present in high concentration, it is an aggressive and powerful oxidizer, whereby it is unstable and also hazardous as it will corrode many substances including human skin. Therefore, concentration of hydrogen peroxide in the cell should be constantly regulated. When hydrogen peroxide is used for the purpose of experiment, this highly corrosive material should be kept in a container made up of non-reactive material such as glass. However, at low concentration, hydrogen peroxide can be used as disinfectant and antiseptic for medicinal uses. In this context, catalase, a teramer of four polypeptide chains is made up of over 500 amino acids long. It is also categorised as globular protein in which the polypeptide chain is highly folded into a compact spherical shape. There is also active site available to bind to the hydrogen peroxide substrate to form enzyme-substrate complex. It is further adapted with four porphyrin heme groups to react with hydrogen peroxide. Besides, the enzyme catalase is known to be one of the enzymes that possess a high turnover number. Its turnover number can be up to 600 000 whereby one molecule of enzyme catalase can catalyse the decomposition of 600 000 molecules of hydrogen peroxide to oxygen and water at body temperature. This reaction is known as catabolic reaction as the hydrogen peroxide molecule is broken down into oxygen and water which are comparatively smaller. Sometimes, catalase also uses hydrogen peroxide to oxidise toxins including Phenols, Formic Acid, Formaldehyde and Alcohols. I n this experiment, potato is chosen to be tested due to the presence of catalase in it. However, other organisms such as fungi or yeast can be used as well as they are producers of enzyme catalase. Enzyme is used to speed up the rate of reaction by lowering the activation energy of a reaction. Activation energy or free energy of activation, is the initial investment of energy for starting a reaction the energy required to contort the reactant molecules so the bond can break for a reaction to occur. Enzyme functions as biological catalyst in many chemical reactions that occur inside our body. For example, saliva secretes enzyme amylase which catalyses the hydrolysis of carbohydrates in the mouth. Not only does enzyme play an important role in maintaining efficient function of body system, it is largely used in industrial field as well to speed up the production rate. For example, protease is commonly used in biological detergent for domestic washing and rennin is used in manufacture of cheese. For an enzyme to carry out its function effectively, active site should present on the surface of the polypeptide chain. An active site is a groove or pocket formed by the folding pattern of the protein. This active site has particular chemical composition and electrical charges on the amino acids, which make up the specificity of the enzyme, in which it allows only certain substances to bind to it. When the substrates bind to the active site, here the working mechanism of enzyme starts. The binding of the substrate to the active site bring the substrates closer and thus aids in bond formation in anabolic reaction. In catabolic reaction, the active site may distort the shape of substrate to break its bond. When the products are formed, the substances no longer fit into the specific shape of the enzyme and will leave the active site of the enzyme. The enzyme is free to bind to another substrate and catalyse another reaction. The enzyme is not altered at the end of reaction. As enzyme contains specific shape and charge on its active site, its activity is easily affected by the changes in the surrounding conditions. Generally, different pH, temperature, concentration of substrate or concentration of enzyme has a large impact on its efficiency in carrying out its function. Whenever the changes in surrounding such as change in pH or temperature alter the bonding between the R group of the amino acids in the polypeptide chain which form the active site, the shape of active site will change and thus the substrate will no longer bind to the site. At this point, the enzyme is said to be denatured. On the other side, when the temperature or pH is optimum for the reaction, the rate of reaction is the highest. Although the optimum pH and temperature may vary from one another, optimum temperature for most enzymes functioning in human body system is often 37 Â °C. However, the presence of inhibitors or cofactors may alter the enzyme activity as well. In this experi ment, the effect of enzyme concentration is chosen to be investigated on the rate of reaction catalysed by enzyme catalase. An increase in enzyme concentration will increase the active site available and thus increase the rate of reaction until it reaches maximum velocity when all active sites of the enzyme molecules are engaged. Problem Statement: Do different concentrations of enzyme affect the rate of reaction? Objectives: To investigate the effect of different concentrations of catalase on the rate of reaction to catalyse the decomposition reaction of hydrogen peroxide To determine the presence of catalase on the rate of reaction of hydrogen peroxide. To develop effective experimental skills throughout the experiment Aim: To determine the effect of different concentrations of enzyme on the enzyme activity Hypothesis: The higher the concentration of enzyme, the higher the rate of reaction until a maximum velocity is reached. Techniques: Use a water displacement technique to determine the volume of oxygen gas evolved Calculate the rate of reaction by using the gradient of the graph Materials: Freshly mashed or blended potato, 3.0 % hydrogen peroxide solution, buffer solution (pH 6.5), distilled water Apparatus: Boiling tubes, graduated tubes, 500 ml beaker, weighing balance, spatula, delivery tube, stop watch, measuring cylinder, dropper, rubber bung, weighing dish Variables: Variable How the variable is determined 1. Manipulated Concentration of catalase By using different mass of blended potato at 1g, 2g, 3g and 4g. Different masses of blended potato indicate the difference in concentration of catalase in its content. 2. Responding The volume of oxygen gas released By recording down the reading on the graduated tubes at 30 seconds interval. 3. Constant pH Volume and Concentration of hydrogen peroxide By using buffer solutions at pH 6.8 throughout the experiments By using the same volume and concentration of hydrogen peroxide, which is 2.5cm3of 3.0 % hydrogen peroxide throughout the experiment Procedure: 1 g of the freshly prepared or blended potato is transferred into a boiling tube. 5 cm3 of buffer solution is added into the tube and it is swirled to mix the substrate. A graduated tube is filled with water to the brim. It is placed carefully into a beaker of water. One end of the delivery tube is placed into the graduated tube with the other end with rubber bung ready to fix with boiling tube. 2.5 cm3 of hydrogen peroxide solution is measured and it is added into the boiling tube containing the potato and buffer solution. The tube is immediately closed with a rubber bung connected to the delivery tube. A stopwatch is started by one member of the pairs in conducting this experiment. The volume of gas released is measured for every 30 seconds for 5 minutes or until the gas evolution stops. The experiment is repeated using 2g, 3g and 4g of freshly blended potato. The results obtained are recorded in a table. Graphs for volume of gas released against time is plotted for each concentration or amount of enzyme used. The initial rate of reaction for each concentrations of enzyme used are worked out. Discussion: Based on the above experiment, the effect of different concentrations of enzyme on the rate of reaction is successfully determined. Five graphs are plotted based on the results obtained in the experiment to show the data in a clearer way and provides a better mean for analysing. The results show that the rate of reaction is increased by an increase in enzyme concentration. In this experiment, potato is used as source of catalyse. The first four graphs showing oxygen gas evolved against time are drawn based on respective mass of blended potato used. The initial rate of reaction is measured from each graph by obtaining the gradient of the graph. A predicted line is drawn on each graph. Generally, the longer the time taken, the higher the volume of oxygen gas evolved. In the beginning, all graphs show an rapid increase , the speed is the slow down as some of the substrates are converted to products. For the substrate at 1 and 2 g of bended potato used, the maximum volume of oxygen gas e volved has reached within 300 seconds and a plateau is obtained. This is because the reaction has completed for all substrates. Theoretically, the maximum volume of oxygen gas released should takes a shorter time as compared to 1g and 2 g of potato as more active site are offered. However, In the 3 and 4 g of blended potato which react, the maximum volume of oxygen is unable to be obtained within 300 seconds. This is probably due to some errors conducted throughout the experiment, particularly due to the vigorous and rapid reaction and in the process of changing the graduated tube. The errors will be discussed later. The initial rate is taken because the rate of reaction is rapid as the collision between the substrate and enzyme is the highest. The rate of reaction may not be reliable to be compared between data if readings are taken in the middle of the experiment because some reactions have reached the maximum rate. The initial rate of reaction for hydrogen peroxide with 1g, 2g, 3 g and 4g of blended potatoes are 0.0611, 0.2895, 0.6579 and 0.7000 cm3/ s respectively. The initial rate of reactions for all the experiments are then compiled into the fifth graph. This shows a clearer picture on the effect of concentration of substrate on the rate of reaction. Initially, there is an increase in the rate of reaction when the mass of blended potato increases. This is because the increase in the concentration of enzyme offers more active site for the binding of substrate. Then, the slope of increasing line becomes less steep with further increase in concentration of enzyme. This is because the active site has been occupied by the substrates or it is said to be saturated whereby the increase in substrate has no further effect on the rate of reaction. Theoretically, the graph should reach a maximum velocity where the plateau occurs in the graph. However, in this experiment, the plateau is not shown because most probably the concentration of enzyme is not high enough to bind to all the 3.0 % of hydrogen peroxide substrate. However, throughout the experiment some errors might occur in which the real values may not be obtained. Firstly, there is a high tendency for the reading obtained from water displacement method to be inaccurate especially when the volume of oxygen gas evolved are too much that the first graduated tube is fully filled with oxygen gas and when the delivery tube has to be transferred to the next prior-prepared graduated tube. The delivery tube transferring process may consume some time particularly if a rubber delivery tube is used instead of a glass delivery tube. This will cause some of the oxygen gas to escape into the water during the process. Next, parallax error may occur as well when the reading is taken from the graduated tube on the volume of oxygen gas evolved. This is because oxygen gas is a colourless gas, in which its level is not so clearly seen on the calibration of the graduated tube. To minimise the errors, the experiment is repeated twice and the mean reading is obtai ned. To further increase the accuracy of the results, a piece of white paper can be placed behind the graduated tube to make the reading easier. Next, the possible error is greater if the experiment is carried out individually. This is due to the human limited ability to record the reading and at the same time watch over the time. Inaccuracy may arise. In this case, a pair work is preferred in this experiment as one of the members times and the other one record the readings obtained. Next, when the mashed potato is poured into the boiling tube from the weighing dish, some potato may be left in the weighing dish. To minimise this error, a few drops of distilled water can be used to rinse the weighing dish to ensure there is no residue left. Consequently, there are a few precautions that ought to be taken to increase the accuracy of the results obtained. For each experiment, the potato used must be freshly mashed or blended. If the potato is prepared in a container, the lid of the container should be kept closed after the desired mass of blended potato is scooped out for each and every experiment. The preparation of blended potato in a beaker which is exposed to the air should be prevented because oxidation will occur and this may affect the activity of enzyme catalase in it. Changes in surrounding such as temperature may also induce changes in the enzyme. A blended potato is used instead of discs of potato so that it will react easier. Its viscosity should be reduced so that it is easier to use. Next, hydrogen peroxide has to be stored in an opaque container as it breaks down quickly when exposed to light. The lid of the container that contains hydrogen peroxide solution should be kept closed after each desired sample i s taken out using a dropper as the oxygen in the surrounding air may oxidise its content and causes the results to be inaccurate. A buffer solution is used to ensure the pH is kept constant throughout the experiment. The buffer solution of citric acid sodium phosphate solution which has a pH of 6.8 is used because this is the optimum pH for the enzyme catalase. Furthermore, a water bath is preferable as the surrounding temperature may change throughout the experiment. In addition, as the rubber bung of the delivery tube should be of the same size as the boiling tube to ensure all the opening of the boiling tube containing enzyme and substrate is fit tightly, it should be pushed and twisted with care. It should also be checked from time to time to ensure there is no leakage of product in gaseous form to the surrounding. Besides, the other open end of delivery tube should be placed in water all the time for the bubble of gas to form and rise to its surface. The presence of air bubbles ensure that the rubber bung is still in contact with the boiling tube unless the substrate and enzyme has completely reacted. To fix the graduated tube in place, a retort stand and clamp can be used. Besides, the boiling tube containing reactants and enzyme ought to be swirled throughout the experiment to ensure the substrate and enzyme react. This may increase the rate of collision between the reactants and enzymes and thus fasten the time taken for the reaction to complete. Throughout the experiment, some safety measures should be abided by. As the substrate used in this experiment which is hydrogen peroxide is highly corrosive, rubber glove should be used to protect the skin. After the hydrogen peroxide is used, it should be disposed off and not to be returned to stock bottles as any contaminants may result in decomposition and explosion may occur. The blended potatoes have to be handled carefully as well as it will irritate some peoples skin. A lab coat should be put on. The glass wares and the delivery tube used should be handled carefully as they are fragile. Conclusion: The hypothesis is accepted. The presence of enzyme increases the rate of reaction of hydrogen peroxide. When the concentration of enzyme increases, the rate of reaction increases until a maximum velocity is reached. Limitations: The species of potato Different species of potato may contain various concentration sof catalase The age of potato An older potato may have lower concentration of catalase The freshness of potato The concentration of catalase may vary in different potatoes which are stored in different ways before experiment. Storage at high temperature may cause the enzyme to denature Part of potato used Different parts on the potato may have different amount of catalase. Further Work: The effect of temperature on the enzyme activity The effect of different concentrations of substrate on the enzyme activity The effect of pH on the enzyme activity The effect of concentrations of enzyme on activity of other type of enzyme such as amylase on starch The effect on the rate of reaction of hydrogen peroxide by using different concentration of fungi as the source of catalase

Purchase decision of apartments in metropolitan India

Purchase decision of apartments in metropolitan India Factors affecting the purchase decision of apartments in metropolitan India Abstract Purpose The purpose of this paper is to provide an insight into the motivation behind Indian buyers when looking to purchase an apartment. The factors driving demand preferences for apartments are not well established and are difficult to measure, and often builders may not have an insight into what buyers are looking for. Design/methodology/approach The research in this paper is based on telephonic interviews and internet based survey with recent purchasers, who bought a home in the past 1 year and prospective purchasers looking to buy an apartment in the coming one year. They belonged to number of locations across all metropolitan cities of India Delhi, Mumbai, Bangalore, Kolkata and Chennai. The data were analysed using factor analysis to identify the criteria in an apartment that buyers value the most. This research was done across all ages and irrespective of their intention of why they bought or if this was their first purchase. Further, Cluster analyses was used to determine clusters and one way Anova was used to determine the factors that hold different value to different clusters of people. Discriminant Analysis was used to determine any difference in behaviour of first time purchasers with others. Findings The findings in this paper revealed that issues signifying â€Å"affluence† accounted for approximately 27 percent of the choice of housing by Indian buyers to purchase apartments in metropolitan India. Also, Cluster Analysis revealed that demographically different set of buyers differ significantly in their attitude towards â€Å"Financial† factors. Discriminant analysis revealed that first time buyers give significantly more importance to â€Å"Financial† factors like â€Å"House price†, â€Å"Income† where they give much lesser importance to â€Å"Builder reputation† and â€Å"Status of neighbourhood†. Research limitations/implications The research in this paper is aimed specifically at Indians living in metropolitan cities only which may be very different from the rest of India. The majority of the respondents belong to Delhi, which may also bias the results. The majority of the data has been collected from an online survey which may reduce the validity of the findings. Practical implications If due consideration is given to the factors that buyers are most concerned about, builders of new apartment housing would be better equipped to meet this demand and maximise their profits. Builders will also be able to target buyers better by knowing the difference in preference of first time buyers to others. Originality/value This paper provides an invaluable insight into Indians concept of a suitable apartment in metropolitans. While important decision factors were determined for the entire population, further analysis was done to determine difference in issues felt important to first time buyers. Also, the most important factors were determined for different demographic clusters. Thus in this way, the transaction of purchasing an apartment was analyzed from several points of view. Keywords Consumer behaviour, Purchase, Apartment, India Paper type Research paper INTRODUCTION The Real Estate sector is important to the Indian economy. In terms of employment generation, it is second only to the agricultural sector. The housing sector contributes nearly 5% to Indias GDP. It is expected to rise to 6 per cent in the next five years. Property markets in India are recovering faster than those in the US and the UK. The sector is expected to attract around US$ 12.11 billion of investments in the next five years. Residential space comprises almost 80% of the real estate developed in the country. There is a shortage of 22.4 million dwelling units according to the Tenth Five Year Plan. 80 to 90 million housing units will have to be constructed over the next 10 to 15 years to rectify this, with the majority of them for the middle- and lower-income groups. It is for this reason that residential properties in India, particularly in Mumbai and Delhi, are viewed as very good investments as per a study by PricewaterhouseCoopers (PwC) and Urban Land Institute, a global non-profit education and research institute. In the 2009-10 budget, a tax holiday on profits was granted to developers of affordable housing (units of 1,000-1,500 sq ft). This exemption was instituted for projects that started from 2007-08 onwards with a deadline of completion of March 1, 2012. US$ 207 million was also allocated to grant a 1% interest subsidy on home loans up to US$ 20,691 with the caveat that the cost of the home should not be more than US$ 41,382. This was expected to further help the housing sector. An apartment is a residential unit that forms a division of a building. It can be either owned or rented. Some people own their apartments together where each owns a part of the corporation which owns the flat. In condominiums, dwellers own the individual apartments and share the public environment. Living in apartments is gaining popularity in India. 217 townships across India are in the building plans for the Sahara Group. Their allure lies in the convenience that they offer in terms of safety and security and maintenance of utilities like electricity and water. A central maintenance system obviates the need for hiring outside help for minor problems like leaking taps or electric short circuits. Stand-alone homes also require incurring additional costs like buying/leasing land, licensing, duties, etc. Apartments enable maximization of space utilization and reduce demand on public resources. People are also able to avail of additional amenities like gymnasiums, swimming pools, etc. at affordable prices. There is a gap in the literature, however, with regard to the value drivers that dictate purchase decisions of residential property in the country. Similar studies exist for other countries but were found wanting in the Indian context, especially when it comes to apartments. Through this paper, we aim to do the very same, i.e. establish which factors dictate purchase decision and to what extent. We will also correlate these preferences with the demographic profiles and characteristics of our respondents and hence arrive at a greater and much deeper understanding of these issues. We see immense utility for our paper, especially for builders and property dealers who can use our findings in structuring their own business activities. RESEARCH BACKGROUND AND HYPOTHESIS Even though consumer behaviour is generally assumed to be an important part of real estate valuation, buyer preferences are generally not considered during the valuation process. It is basically reduced to the confirmation of a bid price which may or may not be met by the buyer. Efforts are being made to address this fault and many papers have been written on the analysis of motivations of residential property purchasers, attempting to explain them using models such as bounded rationality and hedonic pricing. Hedonic Pricing, or Hedonic Demand Theory as it is also known, decomposes the item of interest into constituents and evaluates the importance of each of them and their contribution to the overall valuation. These factors can be both internal characteristics of the good or service and external factors. In the case of real estate valuation, internal characteristics include layout, structure, etc of the property while status of neighbourhood, proximity to schools, etc are the exter nal factors. Factor Analysis enables us to do just that. It is a statistical method that reduces the number of variables by grouping two or more of them into unknown or hidden variables known as factors. Further analysis is then conducted by looking at the variation among these factors and evaluating their relative performance. These factors are taken to be linear combinations of the original variables plus error terms (Richard L. Gorsuch, 1983). â€Å"Factor analysis seeks to do precisely what humans have been engaged in doing throughout history that is to make order of the apparent chaos of the environment† (Child, 1990). It has great use in evaluating consumer behaviour. Charles Spearman is credited with its invention. He used it in the formulation of the ‘g Theory as part of his research on human intelligence (Williams, Zimmerman, Zumbo Ross, 2003). Over the years it has found uses in fields as diverse as psychometrics, marketing, physical sciences and economics. It can be used to segment consumers on the basis of what benefits they want from the product/service (Minhas Jacobs, 1996). It has evolved as a technique over the years, with many researchers working on fine-tuning and improving the analytical process. Bai Ng (2002) developed an econometric theory for factor models of large dimensions. It focused on the determination of the number of factors that should be included in the model. The basic premise of the authors was that a large number of variables can be modeled by a small number of reference variables. Marketing strategies based on customer preferences and behaviour often make use of this technique during the market research phase (Ali, Kapoor Moorthy, 2010) and while devising and changing the marketing mix (Ivy, 2008). Factor Analysis has also been used in ground water management to relate spatial distribution of various chemical parameters to different sources (Love, Hallbauer, Amos Hranova, 2004). The facility of segmentation that factor analysis offers has been extended to the real estate sector and all studies thereof. Regression analyses are subject to aggregation biases and segmented market models yield better results. This segmentation is done using factor analysis Watkins, 1999). Property researchers have also dedicated a lot of attention to researching the preferences of property buyers and identifying the drivers of property value. A study in Melbourne, Australia (Reid Mills, 2004) analyzed the purchase decisions of first time buyers and tried to determine the most influential attributes that affect the purchase decision using factor analysis. The research findings of the paper indicated that financial issues explain about 30% of the variance in the purchase decisions of first time house-owners. This related to timing, the choice of housing, and the decision to buy new housing. Apart from that the choice of housing is dependent on Site Specific factors (Location) and the decision to buy new housing is dependent on Lifecycle factors, such as family formation, marital status or the size of the existing house. Another study determined that brand, beauty and utility play a defining role in property value (Roulac, 2007). The findings of the paper explain why certain properties command premium prices, relative to other properties. It came to the conclusion that for value determination of high priced properties the overall perception of the brand is the most important factor followed by utility and beauty. Brand names are also very important especially in metropolitan markets as they add to the appeal, distinctiveness of the property. Another way to attract buyers attention is through the mix of neighborhood amenities offered (Benefield, 2009). Neighborhood amenities like tennis courts, clubhouses, golf courses, swimming pool, play park and boating facilities significantly impact property values. Xu (2008) used a hedonic pricing model to study the hous ing market of Shenzhen, China. He operated under the assumption that buyers consider property specifics and location attributes separately when they buy a home. The findings suggest that the marginal prices of attributes are not constant. Instead, they vary with the household profile and location. Cluster analysis involves the grouping of similar objects into distinct, mutually exclusive subsets known as clusters. The objective is to group either the data units or the variables into clusters such that the elements within a cluster have a high degree of natural association among themselves while the clusters remain relatively distinct from one another. Mulvey and Crowder (1979) presented and tested an effective optimization algorithm for clustering homogenous data. Punj and Stewart (1983) reviewed the applications of cluster analysis to marketing problems. They presented alternative methods of cluster analysis to evaluate their performance characteristics. They also discussed the issues and problems related to use and validation of cluster analysis methods. Ketchen and Shook (1996) chronicled the application of cluster analysis in strategic management research. They analyzed 45 published strategy studies and offered suggestions for improving the application of cluster analysis in future inquiries. They believed that cluster analysis is a useful tool but the technique must be applied prudently in order to ensure the validity of the insights it provides. Since Marketing researchers were introduced to discriminant analysis half a century ago, it has become a widely used analytical tool since they are frequently concerned with the nature and strength of the relationship between group memberships. It is especially useful in profiling characteristics of groups that are the most dominant in terms of discrimination. Morrison (1969) explained how discriminant analysis should be conducted using canned applications and how the effect of independent variables should be determined. However, care must be taken when applying discriminant analysis. The potential for bias in discriminant analysis has long been realized in marketing literature. Frank, Massy and Morrison (1965) showed that sample estimates of predictive power in n-way discriminant analysis are likely to be subject to an upward bias. This bias happens because the discriminant analysis technique tends to fit the sample data in ways that are systematically better than would be expected by chance. Crask and Perreault (1977) looked at the validation problems in small-sample discriminant analysis. Various research papers have studied the features that are evaluated while purchasing a home, how these features factor in terms of pricing the residences and how the home owners rate the various scales on importance. Such studies, however, were found lacking in the Indian context. This paper aims to understand the value drivers of apartments in Indian metros using factor analysis. The initial variables that we have considered are as follows Ø House Price This refers to the price/rent that is being charged for the apartment. The real estate market is often segmented using this variable. Ø Availability of Gymnasium, Swimming Pool and other sports facilities Many apartment complexes and housing societies offer recreational facilities to the residents to service their lifestyle needs. Ø Traffic This variable refers to the density of vehicular movement in the location in which the apartment is located. Ø Size of Individual Rooms The size of the rooms within the apartment is also an important factor. Some buyers prefer big, airy rooms while others might want smaller rooms. Ø Proximity to City This refers to the location of the apartment relative to the city boundaries, i.e. whether it is within the city proper or on the outskirts. Ø Ability to obtain Loans This variable stands for the ease with which the buyers can get loans, either through the builder or on their own. Ø Parking Space The availability of parking space is considered important by some consumers. Ø Exterior Look of the Apartment This refers to the faà §ade of the apartment, i.e. whether its attractiveness is a strong enough motivation. Ø Household Income The total income of the household often dictates the purchase decision of families. Ø Perceived Safety of Locality This is a big concern for some customers, especially single women and old people and may significantly influence the purchase decision. Ø Branded Building Components Some consumers may value an apartment more if it has branded fittings, furnishings, etc. Ø View from the apartment This can be an important variable for some customers. Ø Preference for Ground Floor This variable refers to the customers preference for the ground floor relative to other floors. Ø Water Supply This variable means to measure how important it is for the consumers that there is continuous, guaranteed and good quality water supply. Ø Structure This refers to the layout of the apartment whether it is a 2BHK or 3BHK, etc. Ø Status of Neighbourhood For some consumers, the reputation and social standing of the locality that they live is very important. Ø Proximity to Shops and Parks This seeks to measure whether proximity to these places is an important criterion for buyers or not. Ø Interior Design This refers to interior features of the apartment like flooring, lighting, balcony, etc. Ø Availability of Domestic Help This can be important consideration, especially for working couples. Ø Proximity to Schools and Offices This seeks to ask how important such proximity is to the buyer. Ø Builder Reputation Many buyers are heavily influenced by the brand name and reputation of the builder. Ø Monthly Living Costs Certain average monthly expenditure is incurred as living expenses. We seek to gauge the relative value of this variable. Ø Proximity to Public Transport, Major Roads, etc This refers to the accessibility of the apartment with regard to public transport and roads. Ø Power Backup Full power backup in case of power outages is frequently advertised by builders. Whether this actually influences buying behavior needs to be examined. Ø Proximity to friends/relatives homes This can be a big variable that dictates consumers in their decision-making process. Methods Sample The questionnaire was sent to people residing in Indian metropolitan cities. Out of the 172 responses received, 13 were rejected since the respondents had not purchased a property in a metropolitan city. Another 13 were rejected because either the respondents had not purchased the apartment in the last one year or were undecided as to when to purchase the property. Finally out of all the respondents 146 (84.9%) were identified. Measures The 25 variables were measured by a Likert scale with responses ranging from 1 (Very Low Importance) to 5 (Very High Importance). Analysis This study uses four tests to analyze the factors involved in purchase of an apartment. The first test conducted is the factor analysis which is used to club the variables in order to determine the purchase criteria of apartments. Thus, in this analysis the broad set of variables will be constricted to determine the smaller set of factors that can explain what home owners look for when purchasing an apartment. After this, a cluster analysis was conducted to determine the various clusters (groups) that exist within the demographic population. On the above said factor analysis and cluster analysis, a one way ANOVA was conducted in order to determine the order of preferences of each factors amongst such clusters. Finally, a discriminant analysis was conducted to identify factors that best differentiate the first time purchasers with others. Results The first test conducted was the factor analysis. Under this test, we followed the Principal Component Analysis method on the 25 variables to combine the correlated variables into factors. The KMO value calculated is 0.799 is above the suggested value of 0.5 which indicates that it is good idea to proceed with Factor Analysis. On the basis of the computations as represented in the Rotated Component Matrix (Table 1), the following factors were received: Affluence, Financial, location, lifestyle, Site-Specific. The variables were classified into a factor if their loading for the respective factor was greater than 0.4. Also, two other unnamed factors were received which remained so due to the fact that no factor can be formed between two variables. We have followed the Kaiser criterion (1960) of retaining only those factors that are greater than one. The initial research on 25 variables was reduced as the variables on domestic help, floor and proximity to friends/relatives was removed a fter the factor analysis was done. Domestic help was removed because it loaded on three factors (Financial, Location and Lifestyle) equally. Preference of Ground Floor was removed from the analysis as it showed a positive loading and negative loading on each of two factors which means that while some considered ground floor to be in consideration other considered the penthouse to be better. Proximity to friends/relatives was removed as it was the only variable in factor 6 (unnamed) and thus no factor can be made by one variable. The results of the Factor Analysis are as under: Rotated Component Matrix Variable Name Affluence Financial Location Lifestyle Site-Specific Unnamed Unnamed Factor 1 Factor 2 Factor 3 Factor 4 Factor 5 Factor 6 Factor 7 Traffic 0.768 Gym/Pool/Sports Facility 0.755 View from Apartment 0.721 Builder Reputation 0.644 Parking Space 0.568 Status 0.513 Monthly Cost of Living 0.764 Household Income 0.735 Availability of Loan 0.691 Availability of Domestic Help 0.498 0.414 0.435 Proximity to Schools/Office 0.778 Proximity to Transport 0.607 Proximity to City 0.575 0.424 -0.401 Proximity to Shops/Parks 0.546 Interior Design 0.768 Branded Components 0.712 Power Backup 0.594 Structure 0.741 Size 0.580 0.598 Safety 0.549 Preference of Ground Floor -0.415 0.423 Proximity to Friends/Relatives 0.845 Water Supply 0.410 0.652 House Price 0.405 0.508 Exterior Look 0.426 0.405 -0.464 Extraction Method: Principal Component Analysis. Rotation Method: Varimax with Kaiser Normalization. Rotation converged in 21 iterations. Table 1 Factor Loadings- Purchase of an Apartment Table 2 Factor Analysis Factor No. Factor Name Eigen Values Total Variance (%) Cumulative Variance (%) 1 Affluence 6.826 27.306 27.306 2 Financial 2.9 11.600 38.906 3 Location 1.835 7.342 46.248 4 Lifestyle 1.504 6.016 52.264 5 Site-Specific 1.447 5.788 58.052 6 1.129 4.516 62.568 7 1.059 4.236 66.804 The second test that was conducted was the Cluster analysis and has done to segment the respondents on demographic variables of Age, Gender, City and Number of members in the family. Squared Euclidean distance and average linkage hierarchical clustering method was used. At fusion coefficient value of 1.0, two distinct clusters were evident. On conducting a One way ANOVA to compare means with the demographic variables we observe that the two clusters are differ on the mean age with a significance of 0%. The first cluster consists of a younger population with an average age of 37 approximately and the s