Strategic Direction And Global Security Essay - 1618 Words

The general capabilities required by the Joint Force in 2025 will be a global surveillance and strike (GSS) network, increased naval and air investments and ensuring cyber technology outpaces adversaries. Based on the current U.S. strategic direction and global security environment these capabilities are necessary. Satellites and cyber technology will be part of the design of the GSS system. The U.S. military will be able to strike quickly and remain engaged for increased periods while additional forces move to the area of concern using the GSS system. Increased Navy and Air investments in submarines, ships, aircraft, unmanned aerial vehicles (UAV’s) and unmanned underwater vehicles (UUV’s) is critical. The Navy and Air Force allows us to project power to areas of the world far from our base of operations. Air power also enables us to provide support for ground forces while providing deterrence and denial of enemy forces. Cyber investments and security are critical beca use cyber technology will increasingly be the engine that runs our future military and allows us to attack adversary’s cyber networks and infrastructure. The U.S. Army will see a reduction in tactical armor units while the U.S. Marine Corps remains at the current level of equipment and personnel. After each capability are associated Risk. The GSS network will be a vital piece for rebalancing the force in 2025. It is a network tracking and control system designed to help deploy and control unmannedShow MoreRelatedStrategic Direction And Global Security Environment1648 Words   |  7 Pagesto U.S. national interests. The services must invest in systems that maintain strategic deterrence, infrastructure that supports power projection and operational concepts that advance wide spectrum operations in order to support diplomacy and national security. This essay will begin with providing a brief synopsis of the strategic documents, which form the guidance used to analyze and develop Joint Force 2025 strategic capabilities. A discussion of Joint Force 2025 general capability requirementsRead MoreStrategic Challenges And The Global Security Environment873 Words   |  4 Pagescurrent strategic challenges and the global security environment. This paper proposes that the Joint Force of 2025 must focus on its competitive advantages and it must curtail ineffective and expensive programs to preserve its ground forces capability to provide deterrence and defeat capabilities critical to our National Strategic Objectives. To support this position, this paper first articulates the emerging threats to U.S. National Interests and compares them to the key strategic direction of publishedRead MoreThe Problem Of Total Joint Force1604 Words   |  7 Pagesinclude hybrid and near peer competitors trying to tip the balance in the global security e nvironment. In addition, as the Department of Defense (DOD) learned from past wars while its resources reduce, the total JF 2025 must adapt and become more agile in countering these emerging threats. The DOD has provided the strategic and military guidance along with associated posturing statements for the complementary capabilities of strategic adaptability and agility that will enable the rebalancing of the totalRead MoreStrategic Challenges And The Global Security Environment819 Words   |  4 Pages(JF25) considering the current strategic challenges and the global security environment. This paper proposes that the JF25 focus on its competitive advantages and curtail ineffective and expensive programs to preserve its ground forces’ capability to provide deterrence and defeat capabilities critical to our National Strategic Objectives. To support this position, this paper articulates the emerging threats to U.S. National Interests and highlights the key strategic direction of published Department ofRead MoreManagement Of Information Systems ( Mis )1431 Words   |  6 Pagescertain goal. In order to manage the systems, strategic direction is critical in tracing the strategic goals of any organization. Careful crafting of investments in the global IT offers Microsoft an opportune to have increased control as well enhanced coordination. In addition, this has enabled the organization to have access to global markets. On the other hand, it presents challenges to the management in engineering the global systems. Introduction Global business impacts in a significant way on managementRead MoreNational Strategic Guidance And The Global Security Environment1605 Words   |  7 PagesGeneral Dempsey articulated the United States military is the premier global military with a decisive military advantage but dominance just doesn’t happen necessitating the United States military to maintain the decisive edge. Dempsey’s statement is the catalyst for the premise of Joint Force 2025 in which the United States military embarks upon a transition and rebalance to address a wide continuum of emerging threats to our nation’s national interests in the foreseeable future. Dempsey correctlyRead MoreThe Department Of Defense ( Dod )1538 Words   |  7 Pages2020 necessary to adjust the force based on current strategic direction and fiscal constraints is a smaller, efficient, adaptable and integrated joint force. The 2014 Quadrennial Defense Review (QDR) emphasizes US military forces will evolve and re main modern, capable, and ready while accepting some increased risk through force reductions. Rebalancing will require innovative approaches and solutions to protect the homeland, build global security, project power, and win decisively with a leaner forceRead MoreGlobal Intelligence Case Study1071 Words   |  5 PagesThe emerging global power recognizes the imperative and the most efficient way to corner the AI industry growth is by investing in education and cultivating talent – which is an ever growing problem for the United States. Technology giants within the United States are continually hammering the issue of immigration reform and its impact on recruiting technology geniuses. Google CEO predicts that China will reach AI parity with the United States within in the next five years. And, he warned that AmericaRead MoreU.s. Joint Forces And The Strategic Direction1677 Words   |  7 PagesThe United States will only be able to rebalance the Joint Force in 2025 if ade quate resources are available. Even with adequate funding, combatant commanders will experience considerable challenges operating in the global security environment. The current strategic direction has prompted a shift of military resources to the Asia-Pacific. This trend will continue. Additionally, globalization, cyber-attacks and advances in technology will further challenge the Joint Forces in the next ten years .Read MoreCountering Global Threats On U.s. National Interests Essay1390 Words   |  6 Pagesthe current U.S. Joint Force strategic capabilities. This rebalancing requires a widening of our current engineering and technological capabilities as relates to our adversaries capabilities while simultaneously enhancing our land force deterrent capability in order to project U.S. power worldwide. This paper will discuss pressing future challenges, and how Joint Force 2025 must prepare for them. Based on our current strategic direction and today’s global security environment, discussion will

The Effect of Knowledge Management

Question: Discuss about the The Effect of Knowledge Management . Answer: Introduction Presently, with the increase of the public awareness regarding the importance of health insurance, the demand for the health insurance services has increased. The customer base in the health insurance companies is growing. The scenario is same also in Australia. As per the current statistics, the annual growth rate of the Australian health insurance sector is 6.4% and the revenue in the last financial year was $24 billion (Miller and Hayward 2017). The reports on the health insurance sector have disclosed that the health insurance companies are coming with new schemes to insure the health of the people in a better way (Keleher 2016). Due to the demand in the health insurance services and introduction of new schemes, the health insurance companies in Australia require maintaining huge number of data related to customers preferences, customers personal data and other information. This research proposal will particularly focus on the area of knowledge management and its impact on the service quality of the health insurance firms in Australia. During this research proposal it will be clear that how the main research study will be proceed. In order to conduct the study in more concise manner, the concentration will be made on a particular private health insurance company Medibank, Australia. Medibank is one of the most popular private health insurance service providing companies in Australia. The company is currently covering 29.1% of the market in Australia. The aim of the study will be identifying and analyzing the effect of knowledge management practices on service delivery quality in private health insurance firms. As per the current scenario, many people in Australia have complained that they are not getting proper service from the health insurance companies within the required time. This type of problem may be occurring due to the improper knowledge management system in the companies. However, the companies have not mentioned anything about the problems in their knowledge management systems (Pradhan et al. 2016). Therefore, the main problem area that the study will face is identifying the loopholes in the current knowledge management techniques that are affecting the service quality of the health insurance firms in Australia. Literature review Identifying the concept of knowledge management and its benefits According to Rundi (2016), knowledge management is a systematic procedure through which the business organizations manage their information and other knowledge resources. In the other words, Wang and Wang (2016) has described knowledge management as the process of managing the data and information that includes three basic activities capturing the information, distributing the information to different users and effectively using the information by the users within the company. Inkinen and Inkinen (2016) noted that the concept of knowledge management came to existence in 1990. The main reason behind introducing such concept was to organize and manage the information of the companies in an effective manner. At this current scenario, most of the business organizations especially the large organizations have implemented the knowledge management systems within their operational systems. Wang and Yang (2016) mentioned that the organizations implement the knowledge management system so tha t they can enjoy the benefits of it. The benefits of knowledge management are mentioned below: Better decision making The use of proper knowledge management system helps the business organizations taking better decision within less time. In the process of knowledge management, the information and data are kept in a systematic procedure and at the same time, the knowledge management system keeps only the useful data (Hughes and Gosney 2016). Therefore, while taking any decision, management can easily access the information and they do not need extra time for extracting the useful part from the entire information and data set. Hence, the decision making process become easy and effective. Improve the service quality The knowledge management system in a business organization especially the service providing organization helps providing better services to the customers. In the knowledge management system, the companies can keep the information of the customers in a systematic manner (Tseng 2016). Due to that, when the customers ask for the services related to their previous transactions, the companies can easily provide the required service. For example, if in a telecommunication service providing company, a customer asks for the calling details or recharge related details, then through the knowledge management system, the company can easily provide the information to the customer (Obeidat et al. 2016). Reducing time and cost The use of knowledge management system can reduce the use of time and cost in the organizations. If the organizations maintain their information and data through knowledge management system, then they do not require providing extra time and effort to identify the relevant data and information (Obeidat et al. 2016). No manual handling is required. Hence, the time and cost get reduced. Avoiding the risk of losing the data and information The knowledge management system maintain the data and information in a technical way. No manual data and information management is required in this system. Hence, the risk of losing the important data and information can be avoided easily (Jennex, Smolnik and Croasdell 2016). Identifying the limitations in knowledge management system Knowledge management is very useful tool in todays business scenario. However, this useful tool also has some limitations, due to which the business organizations face different challenges while using the knowledge management system. The limitations of knowledge management system are as follows: The knowledge management system in a company is not able to provide any clue about the future performance or outcome of the company (Al-Busaidi and Olfman 2017). Due to this, the usability of the knowledge management system is limited. There is a risk of data and information loses due to the problem of the system failure. The knowledge management systems in the companies are based on the technology (Tseng 2016). Therefore, sometimes, due to the technological failure, the knowledge management systems of the companies do not work properly and the data and information may be lost due to that. If this happens, the company may face huge problem. Knowledge management system is based on advanced technology. This means, the companies must appoint knowledgeable and skilled personnel for operating the knowledge management system. If any time, the responsible person is absent in the organization, then he whole system suffers (Inkinen and Inkinen 2016). Moreover, the employees, who do not have enough experience of using knowledge management system, also face difficulties for using the system. Implementing the knowledge management system within the company requires investing high amount of money at the initial phase. At the same time, the maintenance of knowledge management also requires much investment (Jennex, Smolnik and Croasdell 2016). Therefore, for the small and medium size companies, it is not at all possible to enjoy the knowledge management system. Analyzing the relationship between the knowledge management system and performance of the company The above discussion and analysis has clearly shown that knowledge management system of a company has several benefits, but the system is not flawless. However, Obeidat et al. (2016) mentioned that the good quality knowledge management system positively influence the performance standard of the companies. Jennex, Smolnik and Croasdell (2016) on the other hand commented that the knowledge management system in a company has direct impact on four different elements or aspects of the company and these are process, people, performance and products. Implementation of proper knowledge management system enhances the process effectiveness and efficiency. The organization requires less time for processing the input to desired output. For example, in the large banks like, National Australia Bank, the entire system depends on the knowledge management (Nationalaustraliabank.com 2017). Due to this system, the management of National Australia Bank can take right decision within minimum time. This means, due to the knowledge management system, the entire process within the organization becomes smoother. At the same time, as the works in the company is done within a minimum timeframe, the cost of the company is also reduced. This means, the performance of the company is improved. The implementation of the knowledge management system also improves the quality of the people within the company. The employees can improve their learning through this system. Along with that, the advanced knowledge management system makes the employees more flexible and gives job satisfactions to them (Al-Busaidi and Olfman 2017). Hence, the performance standard of each employees as well as entire organization is improved. However, in this context, Wang and Yang (2016) argued that the employees of the organization can be flexible if they know the how to use the system, otherwise, it may occur high cost to the company. Rundi (2016) noted that the implementation of the knowledge management system can improve the service or product quality of the business. If the example of National Australia Bank is considered, then it can be said, as the organization runs its business through the knowledge management system, the employees of the bank has the access of the customers data and information at all time. Therefore, if a customer asks for any service at any time, the employees can provide that. This means, the service quality becomes improved. However, Obeidat et al. (2016) argued that is any data is lost due to the system failure and then knowledge management system can negatively affect the service quality of the company. On the contrary, Tseng (2016) stated that the system failure canbe avoided through proper maintenance. Moreover, as the process, people and service or products are improved, the performance of the company automatically improves. Research questions The questions based on which the research will be carried on are as under: Why the knowledge management system is important at present business context? How knowledge management system helped Medibank improving its service quality? What are the major challenges faced by Medibank due to the use of knowledge management? How the companies can improve their knowledge management system further? Hypotheses H0: The knowledge management system has no positive relationship with the service quality of the organization. H1: The knowledge management system has direct positive relationship with the service quality of the organization. Research methodology This research will be based on a specific methodology that will include specific philosophy, approach and design of the research. The philosophy, approach and design are the bases of a research project. While conducting this particular research, it will be necessary selecting the specific philosophy, approach and design from the available group of philosophy, approach and design. Among all of the three research philosophies that are positivism, realism and interpretivism, the study will prefer to choose positivism. The positivism philosophy will help the research analyzing the data following the quantitative data analysis method (Baskerville and Wood-Harper 2016). The approach of the research will be the deductive approach, which will help completing the study successfully within minimum possible time (Wright et al. 2016). At the same time, the deductive approach is very effective for conducting the study by setting the research hypotheses in the beginning. The design of the research will be based on the descriptive research design, which is effective for conducting the detailed analysis during the study (Stanek, Babkin and Zubov 2016). This detailed analysis can be done based on available literature and theories. Project plan Activities Week 1 Week 2 Week 3 Week 4 Week 5 Week 6 Week 7 Week 8 Week 9 Week 10 Week 11 Week 12 Week 13 Week 14 Selecting the topic of the research Setting aim, questions and hypotheses of the research Reviewing the existing literature Selection of the methodology for the research Initiating the primary data collection Conducting the analysis of the primary data Identifying the results of the analysis Deriving the conclusion of the study Providing appropriate recommendations Final draft preparation Table 1: Gantt chart (Source: Created by author) Research process Every research project must have a systematic flow, so that the aim can be achieved successfully within the required time (Robson and McCartan 2016). The process of this particular research will start with the topic selection and along with that setting the aim, questions and hypotheses of the study. The second step of the study will be literature review. In this stage, the research will gather the information from the previous literature. The third step will be the selection of proper methodology. In this step, the philosophy, approach and design of the research will be selected. At the same time, the data collection and analysis methods will be also decided. The next step will be data collection and analysis. In this step, the research will gather the primary data from the relevant sources and will analyze those through valid data analysis techniques. After that the research will derive the conclusion by identifying to what extent the findings of the research have provided answers to the questions and lastly, the recommendations will be provided. Data collection and analysis methods Data collection is one of the essential parts of a research. The success of a research highly depends on the quality of the data that it collects. This particular research will collect primary and secondary data, so that the study can be done accurately. The primary data will be collected by conducting survey as well as interviews. The sample for the survey will be selected from the employees of Medibank. The sample will be gathered by using the probability sampling method. The sample size is expected to be 90 for the survey of the study. On the other side, the sample for the interview will be selected from the managers of Medibank. The expected sample for the interview is 4 managers. The sample will be selected by following the non-probability sampling method. The required secondary data will be gathered from the journals, articles and different websites. After gathering the data, the research will require analyzing those collected data through proper data analysis methods. The data collected through survey will be analyzed by using the quantitative data analysis method. This particular method will help analyzing the huge quantity of survey data very easily through mathematical analysis method (Gray and Malins 2016). On the other side, the data collected by the interview, will be analyzed using the qualitative method of data analysis. This method will help analyzing the data in detailed manner (Carter et al. 2016). Expected outcomes This research will aim to identify and analyze the impact of knowledge management on the service delivery of the health insurance firms. It is expected that the study will be able to identify how the knowledge management is used by the current health insurance companies in Australia. At the same time, it is also expected that the study will focus on the challenges of the knowledge management system in a particular health insurance company like, Medibank. After identifying the challenges, the study will be able to identify how these challenges are negatively impacting the service quality of the company. Moreover, the study is expected to analyze the overall efficiency of the knowledge management system in respect to the health insurance company in Australia. Conclusion This proposal has identified that knowledge management system is very useful at the current business context. The use of knowledge management may improve the performance standard of the business organizations. At the same time, the knowledge management system also improves the efficiency of the employees. However, this system has also some limitations for which the performance quality of the companies may be negatively affected. Reference list: Al-Busaidi, K.A. and Olfman, L., 2017. Knowledge Sharing Through Inter-organizational Knowledge Sharing Systems.VINE Journal of Information and Knowledge Management Systems,47(1). Baskerville, R.L. and Wood-Harper, A.T., 2016. A critical perspective on action research as a method for information systems research. InEnacting Research Methods in Information Systems: Volume 2(pp. 169-190). Springer International Publishing. Carter, E., Temming, L., Akin, J., Fowler, S., Macones, G., Colditz, G. and Tuuli, M., 2016. Centering Healthcare Quantitative Research.The CenteringPregnancy Model: The Power of Group Health Care,61(5), p.275. Gray, C. and Malins, J., 2016.Visualizing research: A guide to the research process in art and design. Routledge. Hughes, C. and Gosney, M.W., 2016. Human Resource Development as a Knowledge Management System: The Importance of Bridging the Scholar-Practitioner Gap. InBridging the Scholar-Practitioner Gap in Human Resources Development(pp. 1-19). IGI Global. Inkinen, H. and Inkinen, H., 2016. Review of empirical research on knowledge management practices and firm performance.Journal of knowledge management,20(2), pp.230-257. Jennex, M.E., Smolnik, S. and Croasdell, D., 2016, January. The search for knowledge management success. InSystem Sciences (HICSS), 2016 49th Hawaii International Conference on(pp. 4202-4211). IEEE. Keleher, H., 2016. The private health sector and private health insurance.Understanding the Australian Health Care System, p.35. Miller, P. and Hayward, D., 2017. Social policy generosityat a time of fiscal austerity: The strange case of Australias National Disability Insurance Scheme.Critical Social Policy,37(1), pp.128-147. Nationalaustraliabank.com. 2017. National Australia Bank - International Branches. [online] Available at: https://www.nationalaustraliabank.com [Accessed 7 Feb. 2017]. Obeidat, B.Y., Hashem, L., Alansari, I., Tarhini, A. and Al-Salti, Z., 2016. The effect of knowledge management uses on total quality management practices: A theoretical perspective.Journal of Management and strategy,7(4), p.18. Obeidat, B.Y., Obeidat, B.Y., Al-Suradi, M.M., Al-Suradi, M.M., Masadeh, R.E., Masadeh, R.E., Tarhini, A. and Tarhini, A., 2016. The impact of knowledge management on innovation: An empirical study on Jordanian consultancy firms.Management Research Review,39(10), pp.1214-1238. Pradhan, R.P., Arvin, B.M., Norman, N.R., Nair, M. and Hall, J.H., 2016. Insurance penetration and economic growth nexus: cross-country evidence from ASEAN.Research in International Business and Finance,36, pp.447-458. Robson, C. and McCartan, K., 2016.Real world research. John Wiley Sons. Rundi, A., 2016. Knowledge Management System.The Innovation Tools Handbook, Volume 1: Organizational and Operational Tools, Methods, and Techniques that Every Innovator Must Know, p.207. Stanek, J., Babkin, E. and Zubov, M., 2016. A new approach to configurable primary data collection.Computer Methods and Programs in Biomedicine,133, pp.169-181. Tseng, S.M., 2016. Knowledge management capability, customer relationship management, and service quality.Journal of Enterprise Information Management,29(2), pp.202-221. Wang, M.H. and Yang, T.Y., 2016. Investigating the success of knowledge management: An empirical study of small-and medium-sized enterprises.Asia Pacific Management Review,21(2), pp.79-91. Wang, Y.M. and Wang, Y.C., 2016. Determinants of firms' knowledge management system implementation: An empirical study.Computers in Human Behavior,64, pp.829-842. Wright, A.L., Wahoush, O., Ballantyne, M., Gabel, C. and Jack, S.M., 2016. Qualitative Health Research Involving Indigenous Peoples: Culturally Appropriate Data Collection Methods.The Qualitative Report,21(12), pp.2230-2245.

American Revoution essays

American Revoution essays At the time that the Stamp act was repealed, the Declaratory Act was introduced to the colonists. The Act stated that Parliament had complete and total authority over the colonies. It said that Parliament had the power to make laws to govern the colonies, to tax them, and rule the colonies the same way as England. When the colonists found out about the Act, they were outraged. The sugar act was the first act after the French Indian war, which was in place to gain money back after the heavy costs of the French Indian war. Unlike other Acts hence forth the sugar act was strictly enforced. Even though England had obtain new land the American colonist were not able to settle in these new spaces because the British thought that there were too many natural resources. They British did not want the Americas to become to rich. Parliament levied a tax on legal and commercial documents as well as printed material such as newspapers and pamphlets, all of which had to carry a special stamp. If your document did not have the special stamp you could be fined or jailed. The money collected went directly to England. The British government still needed money from the colonist. Because the colonists were upset of the stamp act, they sent Benjamin Franklin to plead their case. He told Parliament that the colonists opposed it because it was an internal but would accept external tax. The British then placed a tax on lead, glass, paper, paint, and tea. This enraged colonist, so intern they did Advertised that British Red coats unlawfully attacked and killed innocent Americans. This only added to the hatred to the British who were being taunted for months this was know as The Boston Massacre. ...

Facts of the Pre-Historic Predator Hyaenodon

Facts of the Pre-Historic Predator Hyaenodon Name: Hyaenodon (Greek for hyena tooth); pronounced hi-YAY-no-don Habitat: Plains of North America, Eurasia, and Africa Historical Epoch: Late Eocene-Early Miocene (40-20 million years ago) Size and Weight: Varies by species; about one to five feet long and five to 100 pounds Diet: Meat Distinguishing Characteristics: Slender legs; large head; long, narrow, tooth-studded snout About Hyaenodon The unusually long persistence of Hyaenodon in the fossil recordvarious specimens of this prehistoric carnivore have been found in sediments dating from 40 million to 20 million years ago, all the way from the Eocene to the early Miocene epochscan be explained by the fact that this genus comprised a large number of species, which ranged widely in size and enjoyed a nearly worldwide distribution. The largest species of Hyaenodon, H. gigas, was about the size of a wolf, and probably led a predatory wolf-like lifestyle (supplemented with hyena-like scavenging of dead carcasses), while the smallest species, the appropriately named H. microdon, was only about the size of a house cat. You might assume that Hyaenodon was directly ancestral to modern wolves and hyenas, but youd be wrong: the hyena tooth was a prime example of a creodont, a family of carnivorous mammals that arose about 10 million years after the dinosaurs went extinct and went extinct themselves about 20 million years ago, leaving no direct descendants (one of the biggest creodonts was the amusingly named Sarkastodon). The fact that Hyaenodon, with its four slender legs and narrow snout, so closely resembled modern meat-eaters can be chalked up to convergent evolution, the tendency for creatures in similar ecosystems to develop similar appearances and lifestyles. (However, bear in mind that this creodont didnt much resemble modern hyenas, except for the shape of some of its teeth!) Part of what made Hyaenodon such a formidable predator was its almost comically oversized jaws, which had to be supported by extra layers of musculature near the top of this creodonts neck. Like roughly contemporary bone-crushing dogs (to which it was only distantly related), Hyaenodon would likely snap the neck of its prey with a single bite, and then use the slicing teeth in the back of its jaws to grind down the carcass into smaller (and easier to handle) mouthfuls of flesh. (Hyaenodon was also equipped with an extra-long palate, which allowed this mammal to continue breathing comfortably as it dug into its meal.) What Happened to Hyaenodon? What could have edged Hyaenodon out of the spotlight, after millions of years of dominance? Thebone-crushing dogs referenced above are possible culprits: these megafauna mammals (typified by Amphicyon, the bear dog) were every bit as lethal, bite-wise, as Hyaenodon, but they were also better adapted for hunting scurrying herbivores across the wide plains of the later Cenozoic Era. One can imagine a pack of hungry Amphicyons denying a Hyaeonodon its recently killed prey, thus leading, over thousands and millions of years, to the eventual extinction of this otherwise well-adapted predator.

Business Law - Questions Assignment Example | Topics and Well Written Essays - 750 words

Business Law - Questions - Assignment Example When an offer is made to the offeree, he can either accept or put down the offer made to him, if he accepts the offer, this means that the second element of the contract recognized as acceptance have been completed. If a contract has to be recognized as valid, it should contain the third element recognized as consideration. Consideration is the term assigned to a promise or a factor on which bargaining takes place, consideration is offered by the offerror and whether to accept the consideration or reject it or bargain on it is entirely in the hands of the offeree. Another important element of a contract is intention; the people involved in creation of a legal contract should have the intention of creating a legal contract and not just an agreement that has not been legally created. The last element of a contract is the certainty of the contract, this means that the contract should be concise and clear in nature so it can be enforced. Increase in the use of internet to conduct transac tion between the sellers and the buyers gave way for the creation of a distance contract. A distance contract is referred to a contract in which the buyer and the seller or the parties involved in the contract have never physically been in each other’s presence since the start of the contract till the end of the contract. For examples: a distance contract is created when parties are involved in selling and purchasing of goods and services over the internet through different means such as email, telephone calls and faxes. In this kind of contract, the seller or merchandiser is required to provide any information to the purchaser that might influence his purchasing decision, once the to be purchaser has accepted the information, the seller is required to provide the same details in written form, the merchandise has to be delivered to the purchaser within thirty days and if the purchaser wants he can cancel the contract with seven days of the date of delivery. For example, in Th ornton v. Shoe Parking case, the customer experienced injury in the parking area because of negligence caused by the defendant, the customer received the ticket of car parking after he had installed his money in the ticket machine, the terms and conditions that applied to the car parking area were stated on the ticket and the customer was not informed about the terms before he purchased the ticket, thus, the term of no exclusion of liability in case of personal injuries caused due to negligence was rejected as according to the distance contract, all information is to be provided before the purchase decision is made (Beale, 1990, p.337). Expressed terms refer to those stipulations and circumstances that are mentioned in the contact at the most specific level and are accepted by the parties involved in the creation of that particular contract, these terms can be in verbal, as well as written, form. For example, in the case of Bannerman V White, the purchaser had entered a contract wit h the seller on the terms that the hops he was purchasing were to be used to prepare beer and should not be treated with sulphur, the seller had assured him that they were not treated with sulphur, but they were actually treated with sulphur when the purchaser received them, thus, the seller was in breach of contract as the contract clearly stated that hops

Employing Strategy in a Competitive Environment Essay - 1

Employing Strategy in a Competitive Environment - Essay Example Campaigns for efficiency of national transport systems advocate for mass public means of transport as a preferred way of reducing losses and costs, posing a major threat to private transport services (Cooper, Mundy, & Nelson 2010). Unforeseen eventualities in the infrastructure and national and global economy continue to pose a threat to the transport since antiquity. Complex innovations across the infrastructure needs imply that a compromise calls for a great deal of investment to rectify the challenge. The level of damage that the multi-billion dollar industry suffers during eventualities is irreparable in the modern day, exposing the customers and the company to serious losses. As an illustration, the recent trends of extreme weather are serious challenges to the maintenance of the integrity of transport infrastructure such as roads, so the reliance on such transport services becomes risky in this era of efficient business practices (McSherry, 2002). In addition, the volatility of the global economy and the uncertainties it brings to corporate strategy options exposes the York Trans Rove to unpredictable market threats. Service and fleet portfolio at York Trans Rove elevates the company as a daring participant in the New York market, where many players would not find it easy to enter. Having entered the market as a small scale player and navigating through the competitive space with its current portfolio – these actions demonstrate resilience and conviction to market participation (Loh, 1997). In terms of this internal belief for undisputed possibilities, the company has established a strong foundation to challenge such giant players as Enterprise Rent-A-Car Corporation. The concept of operating as a small company focused only on growth prospects as opposed to a huge company considering downgrading operations under a particular pressure presents York Trans Rove with a

Effect of Bicarbonate Supplement on Kidney Function

Effect of Bicarbonate Supplement on Kidney Function Bicarbonate Supplementation Slows Progression of CKD and Improves Nutritional Status Ione de Brito-Ashurst, Mira Varagunam, Martin J. Raftery, and Muhammad M. Yaqoob  Lay Abstract Chronic kidney disease (CKD) is the long-term damage of the kidney. Symptoms only start presenting when the disease is progressing towards the advanced stages. It is a disease of the elderly population, and with the UK’s ageing population, cases are likely to increase in the near future. Metabolic acidosis (MA) is a common complication of CKD and treating this has been thought to slow down the decline in kidney function. Bicarbonate supplementation has previously been used as an experimental treatment on rat models to correct the MA but results have been inconclusive. There is also a lack of long-term trials investigating the effect on humans. The results showed bicarbonate supplementation was beneficial to kidney function and nutritional status of patients, while causing minimal side effects. More clinical trials need to be performed to consolidate these findings and to look at alternative treatment regimens before being implemented into clinical practice. Background Information and Rationale for Carrying Out the Work Chronic kidney disease (CKD) is the long-term decline in kidney function. It is defined as kidney damage resulting in a GFR ≠¤ 60 mL/min/1.73m2 for more than 3 months, or kidney damage for more than 3 months with evidence of structural or functional abnormalities, with GFR not necessarily reduced (1). In advanced stages it can lead to metabolic acidosis (MA) due to a decreased tubular bicarbonate secretion, which has been known to cause protein catabolism and increased insulin resistance (2), and impaired ammonium excretion (3). The lesser stages of CKD are quite common in communities but ESRD is quite rare in populations. CKD is a disease of the elderly with around 30-40% of the population > 75 years having CKD at stages 3-5 (1). It is usually asymptomatic until the later stages of the disease and during ESDR, the only possible life supporting treatments are transplantation or dialysis (4). Obesity is associated with an increased risk of CKD by over 2.5 times (5). With obesity, type 2 diabetes and hypertension all on the rise (6-8) , there is likely to be a boom in the number of CKD cases within the next couple of decades. There is clearly a need to address this future burden on the healthcare system. Correction of MA in dialysis patients has shown to slow down protein degradation in a small number of short term clinical trials (9, 10). Studies on rat models have shown inconsistent evidence where MA has been shown to slow down progression of renal failure (11). Due to the short term nature of these studies, there has been inadequate evidence on the impact of renal function. There have been very few studies investigating the correction of MA in CKD in humans and also the lack of long term studies of the effect on pre-dialysis patients, which were the main motives for carrying out this study. Approaches to the Question and Key Results The research question raised was whether bicarbonate supplementation to patients with MA in CKD could slow its progression and improve nutritional status. A single-centre, open-label, randomised, parallel-group study was carried out to investigate this question. The inclusion and exclusion criteria were stated explicitly. 134 eligible patients were randomly assigned to either routine standard care or oral sodium bicarbonate tablets 600mg TID which was increased as necessary to maintain bicarbonate ≠¥ 23mmol/L. The treatment assignment procedure was done by an external statistician and involved block stratification, then randomisation carried out within each stratum of men, women, diabetics and non-diabetics. This method helped to balance each of the patients’ covariates and ensured adequate concealment. As a result, 67 patients were assigned to the control group and 67 patients to the treatment group. To reach a power of 90% which would allow an absolute difference of 30% to be detected, 63 patients in each group would have to be studied, but to allow for non-compliance, this was increased to 67. Calculation of statistical power ensured a large enough sample size. The 2 groups had similar baseline characteristics (Table 1) and ap art from the bicarbonate supplementation, they were both treated equally. Patients were followed up every 2 months for 2 years for the primary outcome measurements while nutritional assessments were carried out at 0, 6, 12, 18 and 24 months by a single dietician. All patients were able to be analysed with none of the patients being lost to follow up or discontinuing the intervention, however 5 withdrew before receiving the treatment. Intention to treat analysis was performed. The investigators, statisticians and the single dietician were blinded to the initial group assignment as they were directly involved in assessing the outcomes, but since the trial was open-label, it suggests that patients and external clinicians were not. The outcomes were focused on the research question and were measured in a standard way. The primary outcomes were the decline in renal function, the number of patients with rapid progression of renal failure, and the development of ESRD that required dialysis. After 12 months, the rate in decline of CrCl was lower in the treatment group at 1.88 ml/min per 1.73 m2 (95% [CI] 0.39 to 4.15 ml/min per 1.73 m2) than the control group at 5.93 ml/min per 1.73 m2 (95% confidence interval [CI] 4.19 to 7.76 ml/min per 1.73 m2) (P Secondary outcomes were measurements of changes in normalized protein nitrogen appearance (nPNA), dietary protein intake (DPI), serum albumin and mid-arm muscle circumference (MAMC) to identify the nutritional status of patients. Results showed an increase in DPI (P Likely Impact of Research Outcome The fact that there was both a slowdown of the decline in kidney function and a reduction in the number of patients progressing to ESRD is clinically beneficial. However, the confidence interval for the treatment group is quite large (0.39 to 4.15 ml/min per 1.73 m2) and the upper limit is close to overlapping with the confidence interval of the control group at the lower limit (4.19 to 7.76 ml/min per 1.73 m2) for the rate in decline of CrCl. Statistically, the treatment may only offer a marginal improvement over the control, but the bicarbonate supplementation clearly does offer some benefit to stage 4 CKD patients. There are also significant nutritional benefits to CKD patients. Poor nutrition leads to protein energy wasting (PEW) and a low serum albumin which increase morbidity and mortality in dialysis patients (12), but this can be easily reduced with bicarbonate supplementation. The patients studied in this trial are not 100% representative of the population. This trial had to exclude 30 out of 184 potential subjects due to eligibility criteria. The exclusion criteria included morbid obesity, congestive heart failure, chronic sepsis, malignant diseases, cognitive impairment or uncontrolled hypertension so findings will not apply to patients that fall into these categories, however the findings will be important for the majority of patients with CKD. The trial was only a single centre study on patients at the Royal London Hospital in the East End of London. The demographic in this area of London is likely to vary from demographics in other parts of London and the UK. I think all the outcomes of interest to the patient were considered before the trial. Side effects of worsening hypertension and oedema that required an increase in therapy and loop diuretics respectively were minimal (Table 3). Blood pressures rose and oedema worsened more in the treatment group but these were not statistically significant (P=0.17 and P=0.5). The single main issue was that 6.5% of subjects experienced a bad taste taking the tablet of the sodium bicarbonate, which was then switched to a powder form. In the long term I think this trial will form the basis of a future change in clinical practice. The change will not be immediate as this is the first RCT on pre-ESRD patients with MA and more clinical trials need to be carried out in this area, with a subsequent systematic review and meta-analysis. Overall, the bicarbonate supplementation does offer an advantage over standard treatment, and the fact that bicarbonate itself is simple and very cheap to source and produce with minimal side effects also works in its favour. Future Work and Conclusion There are some changes I would make to the trial. The confidence interval for the treatment group is quite large (0.39 to 4.15 ml/min per 1.73 m2) and the upper limit is close to overlapping with the confidence interval of the control group at the lower limit (4.19 to 7.76 ml/min per 1.73 m2) for the rate in decline of CrCl. So statistically, the treatment may only offer a marginal improvement over the control. In order to achieve a more precise CI, a larger sample size could be used, and a multi-centre trial could be conducted so that the findings can be applied to a wider population. I think the accuracy of the outcomes would also benefit from the use of a placebo and double-blinding. This study focused only on patients in stage 4 CKD. While these patients are likely to experience MA, it may also be beneficial to study the effect on patients in stage 3 CKD. Patients especially in stage 3b CKD (GFR 30-44 mL/min) are at risk of slipping into the stage 4 category and bicarbonate supplementation has potential to act as a preventative treatment. The serum bicarbonate level in the treatment group was maintained at 23 mmol/L or greater. There was no upper limit for the bicarbonate level and considering that the normal range of serum bicarbonate is 22-28 mmol/L, we can see that the trial looked at the lower end of the reference range. I think a future clinical trial should look at the effect of bicarbonate supplementation on stage 4 CKD patients when serum bicarbonate is controlled within a middle range of 24-26 mmol/L and at the upper end range of 26-28 mmol/L. It is encouraging to see that there have been more RCTs investigating the positive outcomes of bicarbonate supplementation on CKD (13-15), however further investigations still need to be carried out to reach an optimal and definitive treatment plan. References 1.Barratt J, Topham PD, Harris KPG. Nephrology. Oxford: Oxford University Press; 2009. 2.Kopple JD, Kalantar-Zadeh K, Mehrotra R. Risks of chronic metabolic acidosis in patients with chronic kidney disease. Kidney Int Suppl. 2005(95):S21-7. 3.Bailey JL. Metabolic acidosis: an unrecognized cause of morbidity in the patient with chronic kidney disease. Kidney Int Suppl. 2005(96):S15-23. 4.Smart NA, Dieberg G, Ladhani M, Titus T. Early referral to specialist nephrology services for preventing the progression to endà ¢Ã¢â€š ¬Ã‚ stage kidney disease. 2009. 5.MacLaughlin HL, Hall WL, Sanders TA, Macdougall IC. Risk for chronic kidney disease increases with obesity: Health Survey for England 2010. Public Health Nutr2010. p. 1-6. 6.Klahr S, Morrissey J. Progression of chronic renal disease. Am J Kidney Dis. 2003;41(3 Suppl 1):S3-7. 7.Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract. 2010;87(1):4-14. 8.Guh DP, Zhang W, Bansback N, Amarsi Z, Birmingham CL, Anis AH. The incidence of co-morbidities related to obesity and overweight: A systematic review and meta-analysis. BMC Public Health. 2009;9(1):88. 9.Graham KA, Reaich D, Channon SM, Downie S, Goodship TH. Correction of acidosis in hemodialysis decreases whole-body protein degradation. J Am Soc Nephrol. 1997;8(4):632-7. 10.Williams AJ, Dittmer ID, McArley A, Clarke J. High bicarbonate dialysate in haemodialysis patients: effects on acidosis and nutritional status. Nephrol Dial Transplant. 1997;12(12):2633-7. 11.Jara A, Felsenfeld AJ, Bover J, Kleeman CR. Chronic metabolic acidosis in azotemic rats on a high-phosphate diet halts the progression of renal disease. Kidney Int. 2000;58(3):1023-32. 12.Lowrie EG, Lew NL. Death risk in hemodialysis patients: the predictive value of commonly measured variables and an evaluation of death rate differences between facilities. Am J Kidney Dis. 1990;15(5):458-82. 13.Kovesdy CP. Metabolic acidosis and kidney disease: does bicarbonate therapy slow the progression of CKD? 2012. 14.Abramowitz MK, Melamed ML, Bauer C, Raff AC, Hostetter TH. Effects of oral sodium bicarbonate in patients with CKD. Clin J Am Soc Nephrol. 2013;8(5):714-20. 15.Gaggl M, Cejka D, Plischke M, Heinze G, Fraunschiel M, Schmidt A, et al. Effect of oral sodium bicarbonate supplementation on progression of chronic kidney disease in patients with chronic metabolic acidosis: study protocol for a randomized controlled trial (SoBic-Study). Trials. 2013;14:196.