Research Paper Review

Objectives of Research

The primary objective of the research is to explore the present-day management strategies of municipal solid waste collection. In particular, the research focuses on beverage container collection issues based on the case study of Lagos. The research aims to investigate the ratio between disposal of beverage drinks and recycling processes of beverage containers (Mobolaji, 2017). In addition, the study pursues an objective to compare waste collection statistics in developed and developing countries.

Research Questions

The present study aims to respond to the following questions:

  1. How is it possible to define reverse logistics in regard to the waste generated by beverage containers?
  2. How do consumers impact reverse logistics?
  3. In what way do government policies impact reverse logistics in Lagos?
  4. How is reverse logistics impacted by government campaigns or public awareness efforts?
  5. Methodology

The present study relies on a number of case studies including Lagos, and Helsinki. The primary data was collected from a questionnaire survey, while secondary data was retrieved from academic journals, websites of companies, articles, regulations, government publications, as well as EU directives.

  1. Analysis

The data retrieved from the Lagos-based survey of consumers was analyzed using a demographic composition. In addition, a waste management-themed documentary was also incorporated in the analysis. The empirical data was analyzed with the help of IBM SPSS software alongside descriptive statistical methods.

  1. Results

Research findings show that the government plays a pivotal role in reverse logistics. To ensure effectiveness in reverse logistics, there should be used a collaborative process involving multiple supply chain stakeholders. Consumers, in turn, should also recognize their responsibility for waste management. The author concludes that a lot of work needs to be accomplished so that material suppliers accept their new role in the context of waste management in Lagos.

References

Mobolaji. D. (2017). The Reverse Logistics of Beverage Containers. (A case study of Lagos,

Nigeria): A thesis in Economics and Business Administration (master’s thesis). Alto University School of Business, Helsinki, Finland

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Failure to treat Patients in Timely Manner

Failure to treat Patients in Timely Manner

            To protect the safety and privacy rights of patients, several federal and state legislations are sanctioned. Federal and state legislations have specifically instructed health care organizations to ensure the legal rights of patients. The paper discusses the legal provisions, endorsed by federal and state governments, the patients have access to in order to secure their rights.

Official Titles of Federal and State Laws

Two specific federal and state statutes to ensure patients’ legal rights are the Health Insurance Portability and Accountability Act (HIPAA) and the Confidentiality of Medical Information Act (CMIA) respectively. Both these guarantee patient’s legal rights to be promoted by healthcare organizations.

Health Care Organization’s Obligations to meet Patients’ Legal Rights

The HIPAA maintains the privacy, confidentiality, and security of patient health information. The Act provides patients’ authorization regarding the disclosure of their protected information; their right to obtain copies of their personal medical information including presenting revisions in the event of their disagreement with the information in medical records (Kattan, 2009). It also requires strict privacy of patients’ medical records, the violation of which is subject to legal proceedings. The HIPAA encouraged the establishment of the NIST/URAC/ WEDi Healthcare Security Workgroup, which aim at facilitating communication and harmony concerning the best practices to consolidate information security healthcare as well as to advocate the implementation of uniform approach to security practices and assessments (Sharma, 2005). The HIPPA Privacy and Security Rule, enforced by the Office for Civil Rights (OCR) cover the enquiry and resolution of patient privacy complaints and investigation of violations of protected health information (PHI) (Hersh & Hoyt, 2018). In short, the HIPAA not only upholds portability of health information but also codifies fulfilment of patient rights.

California’s (CMIA) grants patients special civil and criminal protection against the disclosure of medical information. It incorporates pharmaceutical companies and obliges that they maintain strict confidentiality of patients’ medical records and also that they seek special permission to reveal medical information (Roach, Hoban, Broccolo & Roth, 2006). The Act necessitates employers obtaining medical information to make certain in preserving the confidentiality of information and undertake efforts against leakage of information. As Saviano (2008) noted that the CMIA protects patient privacy and confidentiality by regulating the uses and disclosures of various types of medical information. The CMIA is one of the landmark privacy laws that restricts use and revelation of mental health records. A healthcare provider or healthcare organization that violates the CMIA would have to face penalties.

Consequences for Non-Compliance of HIPAA and CMIA

Healthcare organizations should be on guard by initiating proactive measures to prevent privacy and security issues. They should realize the consequences of not implementing adequate privacy and security programs and non-compliance with regulatory obligations. The legal and regulatory provisions entail specific penalties and fines for the breach of the Acts.

Legal Obligation of HIPAA and associated Consequence and Real Life Case in Violation of Act  

            The central goal of HIPAA is to ensure legal safeguards against the unacceptable use and disclosure of personal medical information that covers all medical records and recognized health information in digital, written or oral formats.  The legal provision insists on creating appropriate accommodations to concretize patient privacy and adopt reasonable protections to prevent outflow of information.  All patient information is confidential and the healthcare organization should shield protected health information of individuals.

 HIPAA requires strict privacy of patients’ medical records, the violation of which is subject to legal proceedings.  The consequence for violation of this legal requirement involves civil monetary penalties for non-compliance, capped at $25,000per person per year for each provision violated and imposing of criminal penalties for specific wrongful disclosures “up to $50,000 and one year in prison for intentional disclosures and up to $250,000 and ten years in prison for disclosure with intent to sell the data” (Marcella & Stucki, 2003, p. 310).

A real-life case scenario that exemplifies the non-compliance of the legal provision of HIPPA is the case of Anonymous v. Chino Valley Medical Center, Sir Bernardino County, California Superior Court (1997). In this case, a 35-year old disabled inpatient was administered a blood test for human immunodeficiency virus (HIV) (Lippincott, 2004). The patient asked the physician not to disclose the reports of the test to anyone except him. However, one nurse and one physician disclosed the test results to the patient’s sister. The nurse denied the disclosure of information and no actions were taken against the doctor. A trail court imposed a $5,000 statutory civil penalty against the medical center (Lippincott, 2004).

Legal obligation of CMIA and associated consequence and real Life case in violation of act.

The CMIA forbids the healthcare provider from publicizing medical information without obtaining a written authorization, specifically regarding the patient’s participation in outpatient treatment with a psychotherapist.

Non-compliance with the legal provision to obtain patient authorization or failure to maintain security of information contributes to significant penalties. Solove and Schwartz (2014) pointed out that harmless divulging of medical information could lead to nominal damages up to $1,000. The CMIA provision also confers fines and civil penalties.

In 2014, Stanford Hospitals & Clinics along with two of its vendors were involved in litigation settling a CMIA class action lawsuit for $4.1 million (Solove & Schwartz, 2014). One of the two vendors leaked out the creation of a graphic regarding 20,000 patients and the other business associate posted the information on a public website for a year until it was detected by a Stanford patient (Solove & Schwartz, 2014). After two years of litigation Stanford settled the dispute with its vendors paying $3.3 million.

Conclusion

Protecting patient’s medical information is of paramount importance for the healthcare organizations failing which they not only face penalties but also risk their repute at stake. The federal and state legal statues have played leading roles in assuring the sanctity and inviolability of medical information. The HIPAA and CMIA legislation have potentially preserved patients’ health records by shielding its inappropriate disclosure through stringent legal provisions. Healthcare organizations should be cautious to protect patient’s protected medical records.

References

Hersh, W. R., & Hoyt, R. E. (2018). Health Informatics: Practical Guide Seventh Edition. Lulu. com.

Kattan, M. W. (2009). Encyclopedia of medical decision making (Vol. 1). Sage.

Lippincott, W. (2004). Wilkins. 2004. Complete guide to documentation.

Marcella Jr, A. J., & Stucki, C. (2003). Privacy handbook: guidelines, exposures, policy implementation, and international issues. John Wiley & Sons.

Roach, W. H., Hoban, R. G., Broccolo, B. M., & Roth, A. B. (2006). Medical records and the law. Jones & Bartlett Learning.

Saviano, E. (2008). Maintenance and disclosure of mental health records in the primary care clinic setting.

Solove, D. J., & Schwartz, P. (2014). Information privacy law. Wolters Kluwer Law & Business.

Sharma, S. K. (2005). Creating knowledge-based healthcare organizations. IGI Global.

Phase 2 Startup Analysis

Founders

Eco cycle is a business focused on promoting sustainable environment. The business will engage in the production hybrid bikes which are manually and electronically driven. The main drive of the Eco cycle is reducing the prolonged environmental pollution resulting from the emissions by engines propelled by fossil fuels. Notably, the success of Eco cycle largely depends on the contributions of the founders. Indeed, the initiators should be competent enough in a manner that guarantees the attainment of the set goals. The business is composed of an all-rounded team whereby the contributions of each team member counts. Basically, Eco cycle company possess the input of the following members; hacker, hipster, and hustler. Indeed, their inputs in the success of the business are paramount. To start with, the hacker is responsible for empowering scalable and sustainable growth of the business of the electronic and manual charge bikes. Indeed, Eco cycle requires the programming skills which help in ensuring that the business keeps up with the technological advancements. The gap will be filled by my friend Tim who has the requisite skills that guarantee technological competitiveness.

The ability the Eco cycle company to make sales through an efficient marketing team also guarantees success. Without any doubt, the marketing department is responsible for creating awareness about the existence of the hybrid bikes. Moreover, the marketers should explain the benefits accruing its use of manual and electronic bikes potential customers. The functions are achieved through advertising. It is the role of the hustler to provide marketing skills. My cousin Reen has pursued a marketing course in a recognized university hence placing her in a better position of filling the gap. Reen is currently, in her internship program in Macdonald company. undeniably, the internship equips her with important competencies which will be applied in the business. Unfortunately, Eco cycle company lacks the input of a hipster which is crucial for its success. However, the business intends to outsource the inputs of a hipster who plays a role in ensuring that the business keeps up with the trends in terms of fashion as well as the requirements of the customers. This aids in warranting that Eco cycle maintains a competitive advantage over the rivals in the market. Notably, there are many outsourcing sites whereby the business will seek to hire the services of the missing competencies. The hired employees are expected to deliver the skills hence assuring the business its success. The person filling the gap of ab hipster will be hired on a contractual basis. Besides, the Eco cycle intends to issue satisfactory remunerations in order to motivate the employees. Most importantly, a happy worker is always motivated due to reasonable wages as well as a conducive working environment which guarantee increased production of bikes. The composition of Eco cycle team guarantees the successful startup of the business. This means that the available capital, resources, and skills will be optimally utilized in order to meet the business goals and objectives. Notably, the input of the outsourced expertise is considered as an asset to the business.

Advisors

The roles of advisors to Eco cycle company should not be underestimated. Indeed, they play an integral role in promoting its success. They include interacting with the management during meetings and conferences in order to guide them on the faulty areas deserving to be remedied. Ideally, the advisors monitor the progress of the business in order to check whether it is in line with the plans. In the event of a deviation from the plan, they issue corrective actions. Advisors seek to understand the customers’ needs through obtaining their feedback and opinions. Indeed, they work closely with the hustler; marketing department in order to deliver the best to the clients. The argument proves the role of advisors in improving sales and profitability in the long run. Advisors also offer guidance and recommendations the business on the strategies and techniques to be adopted in order to improve efficiency in the operations Eco cycle. The role is important in ensuring that the business uses modern techniques which guarantee it a competitive advantage. The advisors should interact with the different stakeholders; workers, customers, business owners in order to understand their need and complaints. Additionally, they also advise them accordingly so that they can act in a manner that contributes to the success of the business. The advisors should clearly understand the requirements as well as the operations of the business.  Moreover, they should be competent in order to place them in a better position to offer advisory that leads to the actualization of the goals and objectives of the business. Advisors should understand the trends of the business to ensure that the advice accordingly (Gooderha 2006). Despite the fact that the services of business advisors are relatively expensive, it is worth hiring them since the benefits to the success of Eco cycle surpass the demerits.

The business intends to hire one skilled business advisor. Jeff has been in the business field for the past nine years. The duration an involvement in the business sector owes him the continued experience hence positioning him in a better position to offer advisory to Eco cycle. Jeff has also managed to start a business consultative firm which offers business advisory at a fee. The firm has gained a lot of popularity over the recent past due to its contributions to the success of numerous businesses.

Partners

Business partnerships are common business activities that have gained a lot of popularity in the recent past. It happens when a business decides to join efforts with another one. There are numerous advantages to accruing Eco cycle partnering with other businesses. They include pulling of capital together. Partners are a better position to combine their financial resources together in order to fund the business (Warhurst, 2005). The move helps in reducing the financial burden such as insufficient funds to cater for various activities. Additionally, it guarantees continuity of the production process. another advantage of a partnership is a combination of expertise. The fact that individuals are talented and skilled differently explain why the combination of different skills through partnership places the business in a better position to perform well than a sole proprietorship (Aviv, 2007). The move helps in reducing the cost of operations of Eco cycle in that the expenses of hiring an employee who will provide the crucial skills are eliminated. Undeniably, partners help in cutting the cost significantly. Partners help in sharing ideas which aid in coming up with innovative strategies focused on improving the growth of the business. The interaction further helps in problem-solving as the partners can come up with a noble decision aimed at solving the problem at hand.

It is worth noting that, businesses should keenly choose the partners. The success and failure of a business are determined by the choice of business partners. As thus, before Eco cycle partners with another business it is important to understand its goals and objectives. Moreover, the business should consider evaluating the past of the business partner.  The analysis helps in determining the history of the partner in terms of business operations (Warhurst, 2005). Basically, potential business partners should have a good reputation as the business is guaranteed improved efficiency. It is advisable that businesses should choose partners who have engaged in business operations similar or close to the line of business to their increased familiarity with the business activities.

 

 

The major business partners targeted by Eco cycle include

  • M & T banks. It’s a financial institution offering financial support to small businesses. The banks also offer financial advisory services depending on the nature of the business. M & T banks access the credit worthiness of the business through conducting credit checks of the initiators. Besides, it also conducts a feasibility study of the business to determine whether the business idea is profitable. In the event Eco cycle is promising in terms of profits as well as diversification, it accommodates the partnerships which help in dealing with the financial issues.
  • The West Coach InfoTech is another potential partner. The firm specializes in offering marketing services to businesses. In other words, it advertises on behalf of their clients. The firm also offers partnership opportunities to viable businesses which have the opportunity of growth. Undeniably, it is a potential target of Eco cycle which offers crucial services to business. The fact that advertisements play a crucial role in improving sales explains the need for the partnership with the company. Indeed, when Eco cycle partners with the firm guarantees intensive marketing of the products to the internal and overseas markets.
  • Eco cycle is primarily concerned with the production of hybrid bikes which are environmentally friendly. Therefore, it is important to partner with a firm focused on environmental conservation. The main target, in this case, is Action Group on Erosion Technology and Concentration (ETC Group). Notably, it is a non-governmental organization which has been in the frontline in promoting the protection of the environment. Partnering with the organizations helps the Eco cycle to acquire recognition in its efforts of manufacturing hybrid bikes. Indeed, the organization is expected to offer full support to the business through promotion of sales by advertising as well as educating the public on the benefits accruing the electronic and manual. The hybrid bikes are environmentally friendly in that they reduce pollutions as well as enhancing body fitness.
  • Texas instrument is yet another potential partner in the business. The company engages in the recycle of plastics. Indeed, it reduces pollution in the environment as well as creating employment opportunities. The facts that the line of recycled plastics and metals can be used an input in the business explains the need to partner with Texas instrument. Indeed, the idea that both businesses are focused on reducing pollution on the environment further explains why it is a potential partner. Eco cycle is likely to benefit from the activities of the Texas instrument company.

 

Outsourcing

Outsourcing is another crucial aspect of a business.  The provision of the input and services in different localities is known as outsourcing. The term has gained popularity in the recent past as it is continually being embraced by organizations. Notably, numerous benefits are accruing the process of outsourcing. It entails seeking the services of a third-party to offer goods and services to the business.  The business wishes to outsource labor input from different skilled individuals in order to guarantee an efficient workforce (Kremic, Icmeli Tukel, & Rom 2006). The activity is outsourced labor. It has been a common practice over the recent past especially in the corporate world. It entails hiring other external parties to the organizations mandated to perform production functions by offering services that were initially offered by the in-house team. The move is practiced with the prime aim of cutting down the production cost. Outsourcing of labor is a common practice in cases where the existing employees are incompetent.

The business will also outsource assets whose cost of purchasing is higher than the cost of hiring. In other words, if it is relatively cheaper to outsource various services in contrast to hiring. In cases where training the existing employees is expensive as compared to outsourcing organizations, the business will opt to outsource the workforce. The practice of outsourcing accrues various benefits which include firstly, it allows the business to concentrate on the prime goals hence sparing them from the diversion of efforts and resources to the outsourced areas (Kremic, Icmeli & Rom, 2006). Focusing on the core goals of the organization. The growth of business might compromise the achievement of the organization’s objectives. As thus, engaging third parties to foresee the normal running of the activities serves better since the management can comfortably concentrate on the prime goals. In this case, the ultimate role of the business is the manufacture of bikes. As thus, other services such as security and cleaning services which do not have a direct connection with the operations of the business will be outsourced. The move enables the business to focus on its core activities. Secondly, Swiftness and expertise. In scenarios of outsourcing, the human resource department focuses on individuals with the requisite expertise to perfectly handle the tasks. The fact that outsourcing applies when the available skills are insufficient in delivering the appropriate or desired quality and quality prompts the business to hire individuals with the requisite skills to proficiently deliver the services hence improving the quality of production. Lastly, the business benefits from reduces costs and time wastage on operations such as recruiting expenses.

The business wishes to outsource the following services

  • Information and technology services from INTELLECTSOFT company that specializes in software development. (https://www.intellectsoft.net/?utm_source=TheManifest&utm_medium=referral)
  • Applied minds offer research and development services. It is an American company that has specialized in offering services to different forms at a fee. The services aid in promoting innovations in the industry leading to the production of outputs capable of competing with other brands in the industry.

(https://www.ranker.com/review/applied-minds/481515?ref=node_name&pos=2&a=0&ltype=n&l=108602&g=2)

  • The business intends to outsource business processes purposed to hire various services from other businesses in order to improve the speed of manufacturing. The services will be sourced from EXL Solutions limited. It focuses on ensuring that businesses acquire improve customers experience hence leading to improved levels of satisfaction. The company also ensures on-time delivery contributing to improved profitability due to increase customer loyalty.

(https://www.exlservice.com/)

  • The business will also benefit from contract manufacturing which entails the use of another label or and designs from another company. The move is aimed at improving sales as the use of an already established brand name attracts customers. The business will outsource the services from Talan products inc.

(https://talanproducts.com/)

  • The business will also outsource the services of security companies. The move enables the business to focus on core business activities. The services will be outsourced from G4S company which is one of the leading companies in terms of security services.

(https://www.g4s.com/)

 

 

 

References

Kremic, T., Icmeli Tukel, O., & Rom, W. O. (2006). Outsourcing decision support: a survey of benefits, risks, and decision factors. Supply Chain Management: an international journal, 11(6), 467-482.

Warhurst, A. (2005). Future roles of business in society: the expanding boundaries of corporate responsibility and a compelling case for partnership. Futures, 37(2-3), 151-168.

Gooderham, P. N., Tobiassen, A., Døving, E., & Nordhaug, O. (2004). Accountants as sources of business advice for small firms. International small business journal, 22(1), 5-22.

Aviv, Y. (2007). On the benefits of collaborative forecasting partnerships between retailers and manufacturers. Management Science, 53(5), 777-794.

 

 

 

 

 

 

 

 

Developing a start up

 

 

Question 1

Problem

The main issue that drives the introduction of the EcoCycle is the phenomenon of climate change. Various scientists concur that the climate is changing unfavorably (Koch et al., 2013). As the carbon emissions from driving, flying and factories tear at the ozone layer, the climate is getting catastrophically different to the extent that it is causing natural disasters and destroying ecosystems. Fortunately, people are getting more conscious of this reality, and they are adopting a more environmentally sustainable way of life, according to the findings of Sheth, Sethia & Srinivas (2011). Consequently, they might welcome a sustainable mobility solution such as the EcoCycle.

The second problem is that of obesity. National obesity rates are rising exponentially (Wright & Arone, 2012). This seems to be an epidemic that not only has to do with diet but also inactivity but also changes in lifestyles that make activity difficult. Some people are too busy with their work lives to be active. Moreover, the life of convenience is also contributing to this problem. People can now drive everywhere or take an alternative means of transit which similarly do not exercise their bodies. Moreover, with the emergence of ecommerce, the same people have given up one more opportunity to be active.

Back-up sources

Climate change

Scholarly scientists have been warning of the detriments of climate change for decades, but the effects are becoming more evident in the 21st century (Mazo, 2010). Besides the rising temperatures that are melting the glaciers, climate change is disrupting entire ecosystems and changing weather patterns on which millions of people depend. There is therefore a human cost to climate change. Fortunately, there are means through which to reduce this impact. Scientists estimate that the latest that the reversal of climate change damage is possible, is the year 2050 (Abas et al., 2010).

Obesity

Regarding obesity, scholars claim that this is a problem in the US that is costing the tax payers millions per year (Cecchini et al, 2010; Wadden & Bray, 2018). To that effect therefore, this a problem that must be solved expediently and solving it could actually generate extensive cost savings for the tax payers and save lives. According to studies, just three weekly hours of activity could ward off obesity (McCullough & Hardin, 2013). With the EcoCycle, people will be able to pursue more activity by using transportation which gives them some exercise while they simultaneously progress through their day. This could reduce the impact that a busy schedule has on exercise intentions.

Urgency

The problem is indeed urgent and is a priority for most of the target customers. The scientists who have been cited prior, claim that at most, we have until 2050 to fix the problems with the climate, and the alternative is that the damage becomes permanent after then. A period of 30 years is quite urgent because this time is half a generation. Noteworthy, people are beginning to commit to fixing the problem as shown in the varied environmental protection initiatives around the world. Businesses are similarly being induced to be more sustainable, by the consumption patterns which reward sustainability (Sheth, Sethia & Srinivas, 2011).

Underserved

The problem of climate change is not as underserved as that of obesity, as illustrated by the previous paragraph. However, the issue of obesity is underserved because there are hardly any practical solutions which aim at solving the issue of obesity. However, there is no single solution which addressed both problems. If a person would like to be active and the same time conserve the environment, then they have to actually come up with a series of personal decisions. With the EcoCycle, the clients can derive both health benefits and environmental conservation from one value proposition.

Unworkable

Yes, this solution fixes an issue for which there are real, measurable consequences for inaction. By failing to act, then the environment will irrevocably be doomed in a matter of 30 years. From that point on, the only remaining thing to do, will be to count down towards the total destruction of the planet. Noteworthy, carbon emissions can be measured, so the use of the EcoCycle can provide demonstrable relief for the environment. Likewise, EcoCycle could solve the issue of obesity that is killing millions of people every year. From an individual perspective, committing to a change in lifestyle has measurable impacts such as weight loss.

Unavoidable

Fixing the problem has so far been quite avoidable. There are no rules whatsoever that require individuals and companies to engage in behavior that promotes environmental sustainability. Even in countries where such possible measures were introduced, they were later withdrawn. For example, Australia withdrew its carbon tax which was meant to entice companies to reduce their pollution. Second, there is no regulatory mandate to reduce the levels of obesity. Even in schools, children are not required by law to have healthy meals and therefore, it is entirely up to the individuals to take the initiative to find the appropriate solutions on their own.

Conspicuous

The problem is indeed conspicuous because there are a number of statistics which attest to the presence and impact of both issues on society. In the case of climate change, there are records which show that there is a consistent decline in environmental wellbeing as a result of global warming. For example, the Antarctica is getting warmer and snow bears are losing their habitats. Likewise, sea levels are rising and eliminating human habitats in some islands. It is therefore very obvious that global warming is having an adverse impact on the world. Obesity statistics are also readily available and they illustrate how much of a problem that the issue has become.

Critical

Yes, the problem is critical. As severally mentioned prior, climate change is edging towards irreversibility in a time frame that is as short as 30 years. Climate change is already causing so much damage in the form of destroying ecosystems and causing catastrophes which have severally led to the massive loss of lives. Likewise, obesity was upgraded to an epidemic by the centers for disease control and is becoming one of the leading cause of death in the US (Moreno, Pigeot & Ahrens, 2011). Both of these issues need to be solved expediently, and therefore introducing a product like the EcoCycle which addresses both of these issues at the same time is very important.

Question 2

Determination of the target customers

The target customers shall be segmented with both demographic segmentation and psychographic segmentation. The demographic identities of these customers are discussed below:

The target customers are millennial consumers between the ages of 18 and 28 years of age. The choice of this customer age group is based on various factors as discussed below:

According to Eastman et al. (2014), these are the customers who are the most environmentally conscious. Moreover, they not only hold the philosophy of environmental friendliness but they manifest this belief in their consumption decisions. Considering that they are very environmentally-conscious, these customers might be more receptive to the value proposition of a no-emission bike like the EcoCycle.

Moreover, these are the customers who earn their own income and therefore have agency over their purchasing decisions. By the age of 18 years, most people will be financially independent and therefore, this financial independence enables them to choose which items they spend their money on, and which ones not to. Targeting a younger segment would therefore not have been as financially feasible to EcoCycle.

Additionally, during the younger ages, these people are unlikely to have families yet. Since the EcoCycle only carries two people, targeting it at the age groups which have families could cause it to be unsuccessful.

Likewise, targeting the EcoCycle at the aforementioned age group will focus on people who still have the energy to ride a bike. The older generations might not have the necessary energy with which to use the Eco Cycle. It would therefore be counterproductive to target them with it.

Furthermore, the EcoCycle is cost-efficient and the age group which might find this value proposition worthy, is that of people who have not yet achieved total financial stability and comfort. Some of them are paying off student loans and others have just left their homes, so the savings in transportation are important for them.

Wants

What do the customers want from the product?

The customers need the product in order to exercise their commitment to saving the environment, while at the same time, making their bodies much healthier.

Benefits

The product is targeted at those customers who would like to contribute to environmental conservation by committing to a lifestyle that reduces the carbon footprints of these individuals. With the EcoCycle, these customers will be able to reduce their carbon footprint extensively.

The second benefit from the product is that the customers will be able to exercise their bodies while at the same times meeting their transportation requirements. Studies show that people struggle to find the time to squeeze exercise into their schedules. Resultantly, they are faced with choosing between their schedules and being active. With the EcoCycle’s property of both electric and manual operations, the users will find the time to work out while at the same time proceeding with their schedules. For example, riding the EcoCycle to work will have met both transportation and fitness needs.

Furthermore, the EcoCycle saves its users a great deal of money. These people do not have to buy fuel or recharge in which case they would be charged. With the EcoCycle, these people could just pedal energy into their bicycles so that they do not have to invest in fuel. Moreover, even the initial price of the EcoCycle will be lower than that of competing products, at a price of approximately $1,000.

Financial feasibility of the EcoCycle

Noteworthy, according to Yale (2018), 71.19% of these people care for the environment extensively. Considering these statistics, there is evidently sufficient demand for a product such as the EcoCycle. However, it is important to remember that the EcoCycle is a new product which requires people to pedal for their power. It is therefore necessary to explore whether the novelty of the product will be adversely affected by the culture of the market.

From this perspective, it is important to explore the extent to which the US culture is adaptive to change. This can be done using Hofstede’s cultural dimensions with the specific dimension of uncertainty avoidance. If the score of uncertainty avoidance is high, then the members of a culture are quite resistant to change. In this case, the US scores 46% (Hofstede Insights, n.d.) so the chances are that only 54 % of the 71.19% who care about the environment, are likely to adopt a new technology such as the EcoCycle. However, considering that there might still be millions of people who are likely to purchase the EcoCycle, the product can earn cost savings through economies of scale. Resultantly, the EcoCycle will be profitable.

Question 3

What is unique about the solution?

What is unique about the EcoCycle is the fact that it does not rely on external sources for mobility. The other sustainable options in the market rely on external sources of power such as solar and electricity. For example, the Daymak brand relies on hydro power for electric energy. On the other hand, there are models which do not utilize the pedaling power of the users. They use the conventional type of mobility which is pedaling. Relying on an external source but sustainable, may be seasonal so that if the bike depends on solar, it might be difficult to use the aforementioned bike in winter. Moreover, the bikes that use external sources of power, also lack the capacity to offer the individual a reward for their exercise, so that when they choose to pedal, then the pedaling power is wasted. In the case of the EcoCycle, the bike benefits the user by turning their exercise into energy so that it is not wasted, thereby giving them two incentives which are energy creation and exercise. Conceivably, the property of manual pedaling which turns this energy into electricity, has a clear competitive advantage over both types of bikes.

Gains to the customer

One of the gains to the customer, is that they get to perform exercise. According to the statistics from Cancer (2018), the rates of obesity in the United States rose by nearly 6% in eight years, so the country is in need of exercise. However, the market that we are targeting, might also struggle to find means through which to exercise, because of barriers such as a busy schedule. With the EcoCycle, these people can get their workout in, while at the same time performing the tasks that they are supposed to be performing. Rather than going to the gym and then to work, the individuals could cycle to work and this would save them time while improving their health.

The second benefit is that the customers get to preserve the environment on which they rely. The bike enables them to minimize their carbon footprint and therefore contribute to a healthier earth because they will not be polluting the environment.

Third, the EcoCycle will save its users money, because they will not have to engage in fuel purchases. All the energy that the bike uses will be free since it comes from the peddling power of the users.

Pains for the customers

The customers will have to sacrifice some of their speed when they are using the bike. Conceivably, peddling is much slower than taking the train or driving a car. Consequently, if the user is in a hurry, then they would be at a disadvantage if they were using the bike.

Second, the user would face the problem of generating fuel. If they do not peddle, then they will not have fuel. This design therefore limits the electric capacity of the bike, considering that it must be peddled as frequently as its electric component is used. If the owner is sick or has not used the bike in a long time, then there is a chance that they won’t be able to use the electric component of the bike and it will have been turned into an ordinary bike.

Additionally, the bike has issues with capacity and it cannot be used for all types of mobility and tasks. It can only carry two people, namely the rider and one passenger. For individuals with families therefore, the bike is at a disadvantage of space. The same applies to situations where the owner has various things to transport.

Question 4

Competitors of the company

There are various types of competitors for the EcoCycle. First, there is competition from the other types of bikes such as the pedal bikes and the electric bikes. Second, there is competition from the substitutes such as cars and motorbikes. As discussed below:

There are the manufacturers of electric bikes, and the producers of pedal bikes.

The producers of pedal bikes are not much of a threat though because the EcoCycle has a similar value proposition as these bikes. However, they still have some strengths and weaknesses nonetheless. The pedal bikes have the same features as the EcoCycle too, with the exception that when the user pedals, there is nowhere to store their power. They therefore have only one operating mode, which is pedaling and this reduces the value proposition of the pedaling bikes to the prospective users.

Conversely, the manufacturers of electric and solar bikes present some substantial competition. These companies produce bikes which operate on the power of hydroelectricity. These bikes will therefore use lithium ion batteries and are rechargeable with the use of electricity. Noteworthy though, the companies which are producing these brands with properties that are similar to the EcoCycle’s such as the electric features. However, their main difference is that they get their power from electricity while the EcoCycle gets its power from the peddling capacity of the users. Conceivably, having the convenience of a rechargeable bike might be more appealing than having a bike that must derive energy from peddling, since there are times that the user might not be in a position to peddle. These bikes also come in different frame sizes in order to cater to the broader tastes and preferences of the market. They have big, medium and sometimes small sizes.

Competitors’ target

The pedal bikes

The pedal bikes are targeting younger children who have not reached the age of driving so that they are likely to rely on unregulated means of transportation, such as bikes. They also target users who travel short distances in less populated areas where public transportation provides few economies of scale. In these places, the town and city amenities might be small enough to navigate on a bike. Furthermore, producers of the pedal bikes also target the hobbyists who still prefer to travel with bicycles or those who collect them for sentimental purposes.

Electric bicycle producers

Most of the producers of the electric bicycles on the market are producing mountain bikes. These mountain bikes are therefore targeted at people who engage in outdoor sports. To that effect therefore, these bikes seek to attract a customer who is adventurous, and an electric bike might be the only design through which they can get the relevant force for their adventures. Conceivably therefore, they are targeting adults within the age groups of between 18 and 45 who are also extremely adventurous. Since these are bikes which are meant for adventure and have extreme strengths, they would not be targeted at children or older consumers. Furthermore, they are targeting the high income earners because these bikes are quite expensive, and they range from $1500 to $10,000.

Strengths and weaknesses

Strengths

Pedal bikes

The main strength of the peddle bikes is that these bikes are environmentally friendly. According to Sheth, Sethia & Srinivas (2011), the 21st century consumer prefers brands that are environmentally friendly and socially responsible. To that effect therefore, these bikes have an advantage there.

Second, these bikes offer exercise to the users because they depend on the energy of the peddler for movement. As the US tried to address its problems with obesity, then demand for brands which promote activity, keeps rising. This is therefore an advantage for them.

Electric bikes

The electric bikes have the advantage of being speedier than the pedal bikes. Since the owner does not exclusively depend on their body energy for mobility, the business has greater chances of moving faster. With this property, the electric bikes can be used more often, for more mainstream travel needs than the case would be for the bikes that are exclusively dependent on pedaling.

Weaknesses

Pedal bikes

The main weaknesses of the pedaling bikes is the fact that the pedaling bikes will have a speed limit. They cannot satisfy the mainstream travel needs of the mainstream users because they are much slower. This limits the distance in which they can practically be used.

Second, these bikes have little storage capacity. They can barely be used to carry a sizeable number of groceries. Additionally, they cannot be used for family transportation and this means that more bikes have to be produced to accommodate a large number of users.

Electric bikes

The main weaknesses of the electric bikes are that they are extremely expensive. In comparison to the lowest price of approximately $300 for a pedal bike, the electric bikes cost between $1200 and $9,000. This is closed to the price of a small bike one can instead purchase an actual motor bike or even a used car since both would give them a lot more speed, and a car would give them better storage than the motorbike.

The electric bikes also rely on external rather than internal fuel so their maintenance can be relatively more expensive.

Minimum feasible features

    This new technology-based product is hybrid between a pedal bike and an electric bike. The bike is called EcoCycle. The bike will be sleek and lightweight to imitate the bodily features of the other bikes currently in the market, so that the users do not have a very steep learning curve.  It shall possess features that enable the bike to switch between the pedaling mode and the electronic mode. This idea owes its origin from technology that is currently available in other products such as the crank flashlight, so it is not a novel idea. The Ecocycle would utilize the same technology to create and store energy for the electronic aspect of the bike by peddling. This energy would then be stored for consumption later. The consumers could turn the bike into the electronic operating mode to use the stored energy by flipping the electric switch. After this, the user would could to twist the handles to raise the acceleration rate of the bike. This is instrumental when the user requires more speed such as during the times when they are in a hurry. Noteworthy, the energy will be stored in a battery that shall be stored under the passenger seat. It will be able to hold approximately 12,000 mAH of power, but the consumers will have the choice to attach more than one battery to the bike.

Why EcoCycle is highly valuable and rare among the competing brands

The competing brands do not have a bike with the same value proposition as EcoCycle. In fact, the competitors typically have brands that only peddle or hybrids that peddle and also use electric power. None of the competitors have a brand which creates and stores energy as someone peddles and this is one of the main differentiating features of the EcoCycle. Consequently, the unique feature of the EcoCycle might be its source of competitive advantage from the perspective that it does not rely on any external sources for energy needs. To be realistic though, this is also the main sources of competitive disadvantage for the brand, since it can easily be relegated to something that the customers use during their free time or when they are not in such a hurry. The additional attraction of the brand, is that it cheaper to purchase and to maintain, yet it is both manual and electric. Consequently, the users of the bike can make extensive savings on energy costs.

 

 

 

References

Abas, N., Kalair, A. R., Khan, N., Haider, A., Saleem, Z., & Saleem, M. S. (2018). Natural and synthetic refrigerants, global warming: A review. Renewable and Sustainable Energy Reviews90, 557-569.

Cancer. (2018, April 6). Obesity Rates Continue to Rise Among Adults in the US. Available from https://www.cancer.org/latest-news/obesity-rates-continue-to-rise-among-adults-in-the-us.html

Cecchini, M., Sassi, F., Lauer, J. A., Lee, Y. Y., Guajardo-Barron, V., & Chisholm, D. (2010). Tackling of unhealthy diets, physical inactivity, and obesity: health effects and cost-effectiveness. The Lancet376(9754), 1775-1784.

Eastman, J. K., Iyer, R., Liao-Troth, S., Williams, D. F., & Griffin, M. (2014). The role of involvement on millennials’ mobile technology behaviors: The moderating impact of status consumption, innovation, and opinion leadership. Journal of Marketing Theory and Practice22(4), 455-470.

Hofstede Insights. (n.d.). United States. Available from https://www.hofstede-insights.com/country/the-usa/

Koch, M., Bowes, G., Ross, C., & Zhang, X. H. (2013). Climate change and ocean acidification effects on seagrasses and marine macroalgae. Global change biology19(1), 103-132.

Mazo, J. (2010). Climate conflict: how global warming threatens security and what to do about it. New York, NY: Routledge.

McCullough, M. B., & Hardin, J. A. (Eds.). (2013). Reconstructing obesity: the meaning of measures and the measure of meanings. New York, NY: Berghahn Books.

Moreno, L. A., Pigeot, I., & Ahrens, W. (2011). Epidemiology of obesity in children and adolescents. New York: Springer.

Sheth, J. N., Sethia, N. K., & Srinivas, S. (2011). Mindful consumption: a customer-centric approach to sustainability. Journal of the Academy of Marketing Science39(1), 21-39.

Wadden, T. A., & Bray, G. A. (Eds.). (2018). Handbook of obesity treatment. London: Guilford Publications.

Yale. (2018). Environmental Protection Index. Available from https://epi.envirocenter.yale.edu/epi-topline

 

Fall Prevention in Elderly Patients on an Inpatient Psychiatric Unit

Prevention of fall in elderly is an issue of concern because fall has a significant burden on the health care services. Fall in elderly is associated with physical injury which contributes to prolonged period of hospitalization and increased cost of treatment. As much as fall in elderly people occur in the community, a high incidence has been reported in the hospitalized adults (Merom et al., 2016). The situation of fall in the elderly is aggravated by the cognitive impairment (Sharma et al., 2018). It is indeed acknowledged by Williams et al. (2015) that the risk of falling in the hospitalized elderly suffering from mental illness is higher than those elderly people who do not suffer from cognitive impairment.  The occurrence of fall in the elderly patients in the psychiatry unit often goes unwitnessed as well as unreported (Sharma et al., 2018). Therefore, the need for close monitoring of the elderly patients in the psychiatry unit is paramount as one of the fall prevention strategies.

            Fall in the elderly patients in the psychiatry unit can be due to either intrinsic or extrinsic factors. Intrinsic factors include fall history, fear of falling, dementia, poor vision, gait problems, poor coordination as in the case of depression, and the use of drugs for  the treatment of mental illnesses (Wynaden, Tohotoa, Heslop, & Al Omari, 2016). Most of the drugs used for the management of mental illness such as the antipsychotics, anticonvulsants, antidepressants, and serotonin selective reuptake inhibitors are associated with dizziness, fainting episodes, and weakness of the muscles which interferes with an individual’s balance as well as mobility (Zhao & Kim, 2015). The extrinsic factors that predisposes the older adult in the psychiatry unit to fall include walk ways that are obstructed, poor lighting, floor as well as walk ways which are slippery, and lack of proper use of the assistive devises (Wynaden et al., 2016). Effective fall prevention strategies target the alleviation of the intrinsic and the extrinsic factors contributing to fall.

            In the psychiatry unit, fall is the greatest safety issue of concern. In the psychiatry unit, the incidence of fall is four times higher than the general inpatients setting of a hospital (Zhao & Kim, 2015). The estimated rate of fall in the psychiatry unit ranges from 13 to 25 per 1000 inpatient days (Wynaden et al., 2016). The main safety goal is to not only reduce the fall incidence but also reduce the harm emanating from the occurrences of fall (McMinn, Booth, Grist, & O’Brien, 2016). Even though several strategies have been implemented to alleviate the problem of inpatient fall in the psychiatry unit, the fall incidence remains high (Abraham, 2016). Therefore, the main purpose of this review of literature is to provide evidence based strategies that will help reduce the occurrence of fall among the elderly in the psychiatry unit.

Existing Knowledge, Research, and/or Views to a Process

            Fall in the elderly are frequently reported in the psychiatry unit. In the United Kingdom, the annual incidence of fall in the elderly in the psychiatry unit is about 36,000 cases (Abraham, 2016). Similar findings of annual incidence of about 36,000 falls per year have also been reported in countries such as Australia and United States (Du, Wolf, & Knopf, 2017). The elderly in the psychiatry unit are at increased risk of falling in comparison to other hospital inpatient settings because of conditions such as impaired mental status which is caused by dementia, episodes of depression, mania, as well as anxiety disorders (Williams et al., 2015). This situation of increased prevalence of fall is further aggravated by the psychotic drugs as well as the electroconvulsive therapy (Johnell et al., 2017).

            The holistic wellbeing of the elderly patient is impaired in the event that a fall incidence occur. Following a fall, the physical as well as the mental wellbeing of a patient is impaired (Mentis et al., 2017) and this may lead to an increased stay in the psychiatry unit which as a detriment effect on the cost of the treatment regimen. Tricco et al. (2017) is in agreement with Mentis et al. (2017) by affirming that fall in the elderly in the mental health unit has led to rehabilitation with some of the patients being discharged to a long term health care facility. Möhler, Nürnberger, Abraham, Köpke, and Meyer (2016) add that globally, the cost that has been linked with the management of fall in the elderly is increasing and that the greatest cost is due to management of fall in the elderly with mental illness. Strategies of fall prevention in the elderly the psychiatry unit is being directed at alleviating the common causes of fall.

            Most of the studies on fall prevention in the elderly have focused on dementia and ineffective cognition (Sharma et al., 2018). A fall risk assessment tool is used to screen the elderly prior to admission for the risk of dementia, and impaired mental wellbeing so that the fall prevention strategies are directed towards the identified risk factors (Wynaden et al., 2016). Other research studies have placed an emphasis on Alzheimer as it is a common condition among the elderly and the key manifestations are loss of memory and confusion (Zhao & Kim, 2015) and therefore the older adult is at an increased risk of falls. The fall prevention in elderly admitted at the psychiatry unit has also an emphasis on the number of medications that a patient is taking. A patient who is taking more than three drugs for treating the mental illness is at an increased risk of falling (Williams et al., 2015). The more the number of drugs a person is taking the higher the chances of drug interactions which further contributes to falls (Johnell et al., 2017).

            The probability of a fall is influenced by the mental illness of a patient. An elderly suffering from depression is likely to fall in comparison to another patient with mental illness who is not depressed (Harwood et al., 2018). Besides, the fall incidence among the elderly is common when an individual is either walking or moving from a chair to a bed and vice versa (Möhler, Nürnberger, Abraham, Köpke, & Meyer, 2016). In the psychiatry unit, the occurrence of fall is high because patients are encouraged to participate in psychotherapy activities such as exercises and occupational therapy (Jensen & Padilla, 2017). In light of the foregoing, the occurrence of fall is higher in the elderly in the psychiatry unit.

            The fall prevention strategies in the elderly in the psychiatry unit need to be addressed in a perspective that is multifaceted. From the moment an elderly is admitted in the psychiatry unit, the risk of fall should be established even though such an individual has never fallen before (Abraham, 2016). Situations such as the use of psychotic drugs, the state of confusion, the motivation to ambulate, and the increased age, makes the elderly vulnerable to falls (Merom et al., 2016). Vigilant monitoring of the elderly in the psychiatry unit by the health care providers has been found effective one of the fall prevention strategy (McMinn, Booth, Grist, & O’Brien, 2016). Sharma et al. (2018) add that the fall risk assessment should be a continuous process since the condition of the elderly in the psychiatry unit keeps on changing in response to the treatment regimen.

Design Process/Method

            A systematic review of the previously published literature was the methodology utilized. The databases used were Ebscohost, Medline, and google scholar. These databases were selected based on the fact that they have numerous peer reviewed articles in the medical and the nursing fields. The key words used for the search originated from the title of the study and they included fall, prevention, intervention, older adults, elderly, patients, inpatient, psychiatry unit, mental health facility, and setting. The key words were used to retrieve the most relevant articles for use in the systematic review.

The Boolean operator words that were used in the search included AND and OR. AND was used for joining words that were of different meaning. An example of a search using the AND includes Fall AND prevention AND elderly AND psychiatry unit. On the other hand, OR was used for joining synonyms. An example of search using the OR incudes Fall AND prevention AND elderly OR older adults. The use of Boolean operator helped to retrieve many relevant articles and thus the researcher had a variety of peer reviewed articles to choose the best that effectively addressed the issue under investigations.

            The search was limited to articles published in English since majority of the people can understand English and that the literature review is to be conducted in English. The year of publication was also limited to the last five years since these articles contained updated information. The inclusion criteria was randomized control trials, meta-analysis of randomized control trials, and cohort studies because these articles have a high level of evidence and thus the findings are valid and reliable and can be used for evidence based practice. The other inclusion criteria was research studies which focused on the fall prevention in the elderly who are suffering from mental illnesses such as the dementia, Alzheimer, depression, as well as psychosis. These studies were included because the problem under investigation is fall in the elderly in the psychiatry setting and thus the need for these patients to be suffering from mental illnesses. Although the major area of interest was the psychiatry setting, there were few studies and as a result researches conducted in other areas so long as the setting was inpatient and the focus was on elderly with mental illness was included in the review of literature. The primary outcome of interest was fall in the elderly as a single incidence or several fall occurrences. The secondary outcome of interest was the fall prevention strategies that were effective in reducing the number of fall in the elderly.

            The data extraction process involved a team of three reviewers. The inclusion of the reviewers was to help reduce the likelihood of researcher’s bias. The three reviewers worked independently and evaluated the titles as well as the abstracts of the study before selecting the studies to be used for the review of literature. The selected studies were put together and evaluated for similarities. The research studies were listed and those that were selected by the three or two reviewers were used for the review of literature.

The selected studies were critically appraised to establish whether they had methodological rigor. This means that the methodology utilized by each of the study was cautiously reviewed by the three reviewers. Studies with a high methodological rigor are credible and can thus be used for the review of literature. The research studies with the highest score in the review of methodologies were selected for the systematic review of literature. The content of the selected studies were assessed. Studies with similar interventions were grouped together for further analysis.

Analysis

The analysis of the selected literature revealed that there are several interventions for preventing fall in the elderly in the psychiatry unit with a variation depending on the diagnosis of the patient and the inpatient setting. Some of the fall interventions strategies that were found significant include exercises, increased physical activities, fall risk assessment, modification of the environment, training of the health care providers, increased supervision, and health education to the patients (Tricco et al., 2017). The aforementioned findings on fall reduction varied with some researches showing a statistically significant decrease in the number of fall while on the other hand other results displayed a clinically significant decrease in fall occurrences (Harwood et al., 2018). The variation in findings could be due to the choice of methodology but since the selected studies had methodological rigor, the presented results have been adopted for evidence based practice. Most of these studies had a focus on cognitive impairment, depression, as well as dementia while the other aspects of mental illness such as the schizophrenia did not form part of the study population (Burton et al., 2015). In addition, the study setting of most of the reviewed studies were the residential homes though the participants were elderly with mental illness. A difference in the area of research greatly interferes with the generalization of the findings.

A comparison can be drawn between the findings of the systematic review and the other previously published researches. It is indeed acknowledged that a fall prevention intervention should be multifactorial for it to be effective (Tricco et al., 2017). Among the elderly suffering from impaired cognition and depression, exercises have been found to have a statistically significant effect on the reduction of inpatient fall incidences (Jensen & Padilla, 2017). Those elderly suffering from dementia benefited from alterations in the social environment such as training the health care providers on the techniques of reducing agitation among these patients through activities such as the aromatherapy. Besides, enhancing the psychosocial care has been proved effective in reducing the falls episodes among the elderly with dementia (Harwood et al., 2018). Psychosocial care means that the nurse focuses on enhancing the psychological as well as the social wellbeing of the patient.

A review of the medication that the patient is taking has also been effective in reducing the falls prevalence among the elderly (Johnell et al., 2017). It is indeed evident that the strongest risk factor for fall in the elderly with mental illness is the use of psychotropic medication as well as polypharmacy (Du, Wolf, & Knopf, 2017). In order to reduce the fall episodes, there is need for either reducing the number of drugs that the patient is taking or withdraw the medications that have side effects such as confusion and drowsiness (Johnell et al., 2017). A confused person is likely to be disoriented to place and thus increased likelihood of fall while a drowsy person has a gait problem and can easily fall.

Other interventions that have been found effective in falls prevention include balance training, assessment of vision, and a continuous review of the drugs that the patient is taking (Merom et al., 2016). Balance training helps improve the gait. Vision assessment will help develop strategies that enhance vision such as increased lighting. A review of drugs will help stop or supplement drugs with drowsy effects. Besides, the health care providers working at the psychiatry unit need to be empowered with information on fall risk assessment and the prevention strategies that have been found effective (Jensen & Padilla, 2017).

Conclusion

            There are very few studies conducted in the psychiatry setting although the occurrence of fall in the elderly in the psychiatry unit is high. The evidence that have been presented for application to practice is not specific to a particular strategy but a number of multifactorial interventions. In addition, the available evidence for fall prevention has not focused on a variety of mental illness especially the psychotic disorders such as the schizophrenia. This means that it is difficult to implement the aforementioned interventions among patients with psychotic disorders.  A clear guideline has not been provided on the specific strategies that have been found useful in the reduction of fall in the elderly with mental illness. The recommended techniques for fall prevention have just been outlined and they include interventions such as muscular strength as well as balance training for the patients, environmental modification, assessment of vision, review of the medications, close monitoring of the patients, training of the health care providers on fall risk assessment and prevention strategies, and psychosocial care.

            Minimal evidence on the different fall prevention strategies in the elderly admitted in psychiatry unit exist. There is need for more research studies that focus on a specific falls prevention strategies as this will help provide credible findings for use in evidence based practice. The health care providers working with the elderly with mental illness need to access the available evidence and apply it in the clinical setting. This is imperative because a health care provider could be aware of the fall prevention strategies but is not knowledgeable on the specific strategy to apply to a particular patient, and thus the need for creating awareness among staff.

            It is worth noting that the psychiatry unit is a unique environment that has safety issues of concern for the mentally ill patients. In the absence of a clear evidence, the nurses may continue assessing and preventing fall among the elderly but the fall incidences keep on either increasing or remaining constant. There is need for more future researches to provide evidence for the fall prevention interventions which are specific to a particular group of psychiatry patients. Therefore, this systematic review of literature does not only add knowledge on the fall prevention strategies but also provide a basis for future research to help in comprehending the specific elements in the presented fall prevention strategies which are suitable for the elderly in the psychiatry unit.

Limitations and Implications

            The major limitations is that the reviewed studies had methodological issues which does not only interfere with the generalization of the finings but also the validity and reliability of the evidence. The major methodological issues was the setting of the selected studies. As much as the participants were the elderly with mental illness, the study setting was not a psychiatry unit and such findings can therefore not be generalized to a psychiatry setting which has a different structure and layout. The other methodological issue was that some of the findings were statistically significant while others were clinically significant yet the both findings were incorporated into the systematic review of literature, and this reduces the credibility of the provided evidence. The final limitation was that very few studies were found addressing the issue of fall in the elderly in the psychiatry unit due to the attributes of the elderly that limits the inclusion into research. For instance, an older adult is likely to be confused or experience memory loss and thus cannot be included in the research because a participant need to provide an informed consent before taking part in a research study.

            The major implication for clinical practice is that this systematic review has provided a variety of fall prevention interventions focusing on participants with different attributes and thus the application of the provided evidence to practice is compromised. Since several fall prevention strategies are captured in a single research study, the comparison process becomes difficult and thus the only chance available is for the health care providers to adopt all the propose interventions. The other implication for practice is that the elderly and especially those suffering from mental illness do not only present with signs and symptoms of the diseases but also with changes associated with old age which may further increase the susceptibility to fall. For instance, as a person ages, the muscles become weak, gait problem is experience, and the likelihood of suffering from chronic diseases such as hypertension is high. In order to reduce the risk of harm associated with fall in the elderly in the psychiatry unit, there is need for incorporating the changes associated with old age in the fall prevention strategies.

References

Abraham, S. (2016). Looking for a psychiatric fall risk assessment tool. Annals of Psychiatry and Mental Health, 4(2), 1061–1064.

Burton, E., Cavalheri, V., Adams, R., Oakley Browne, C., Bovery-Spencer, P., Fenton, A. M., … Hill, K. D. (2015). Effectiveness of exercise programs to reduce falls in older people with dementia living in the community: a systematic review and meta-analysis. Clinical Interventions in Aging, 10, 421–434. https://doi.org/10.2147/CIA.S71691

Du, Y., Wolf, I.-K., & Knopf, H. (2017). Association of psychotropic drug use with falls among older adults in Germany. Results of the German Health Interview and Examination Survey for Adults 2008-2011 (DEGS1). PLOS ONE, 12(8), e0182432. https://doi.org/10.1371/journal.pone.0182432

Harwood, R. H., van der Wardt, V., Goldberg, S. E., Kearney, F., Logan, P., Hood-Moore, V., … Orrell, M. (2018). A development study and randomised feasibility trial of a tailored intervention to improve activity and reduce falls in older adults with mild cognitive impairment and mild dementia. Pilot and Feasibility Studies, 4(1), 49. https://doi.org/10.1186/s40814-018-0239-y

Jensen, L., & Padilla, R. (2017). Effectiveness of Environment-Based Interventions That Address Behavior, Perception, and Falls in People With Alzheimer’s Disease and Related Major Neurocognitive Disorders: A Systematic Review. American Journal of Occupational Therapy, 71(5), 7105180030p1-7105180030p10. https://doi.org/10.5014/ajot.2017.027409

Johnell, K., Bergman, G. J., Fastbom, J., Danielsson, B., Borg, N., & Salmi, P. (2017). Psychotropic drugs and the risk of fall injuries, hospitalisations and mortality among older adults. International Journal of Geriatric Psychiatry, 32(4), 414–420. https://doi.org/10.1002/gps.4483

McMinn, B., Booth, A., Grist, E., & O’Brien, A. (2016). Falls and fall injury in mental health inpatient units for older people. Australian Nursing and Midwifery Journal, 24(5), 26.

Mentis, M., Gouva, M., Antoniadou, E., Mpourdoulis, K., Kesoudidou, I., Marneras, C., & Panagiotopoulos, E. (2017). Psychological and physical problems in elderly people with problems of falls. European Psychiatry, 41, S659–S660.

Merom, D., Mathieu, E., Cerin, E., Morton, R. L., Simpson, J. M., Rissel, C., … Cumming, R. G. (2016). Social Dancing and Incidence of Falls in Older Adults: A Cluster Randomised Controlled Trial. PLOS Medicine, 13(8), e1002112. https://doi.org/10.1371/journal.pmed.1002112

Möhler, R., Nürnberger, C., Abraham, J., Köpke, S., & Meyer, G. (2016). Interventions for preventing and reducing the use of physical restraints of older people in general hospital settings. Cochrane Database of Systematic Reviews, (12). https://doi.org/10.1002/14651858.CD012476

Sharma, S., Mueller, C., Stewart, R., Veronese, N., Vancampfort, D., Koyanagi, A., … Stubbs, B. (2018). Predictors of Falls and Fractures Leading to Hospitalization in People With Dementia: A Representative Cohort Study. Journal of the American Medical Directors Association, 19(7), 607–612. https://doi.org/10.1016/j.jamda.2018.03.009

Tricco, A. C., Thomas, S. M., Veroniki, A. A., Hamid, J. S., Cogo, E., Strifler, L., … Straus, S. E. (2017). Comparisons of Interventions for Preventing Falls in Older Adults: A Systematic Review and Meta-analysis. JAMA, 318(17), 1687–1699. https://doi.org/10.1001/jama.2017.15006

Williams, L. J., Pasco, J. A., Stuart, A. L., Jacka, F. N., Brennan, S. L., Dobbins, A. G., … Berk, M. (2015). Psychiatric disorders, psychotropic medication use and falls among women: an observational study. BMC Psychiatry, 15(1), 75. https://doi.org/10.1186/s12888-015-0439-4

Wynaden, D., Tohotoa, J., Heslop, K., & Al Omari, O. (2016). Recognising falls risk in older adult mental health patients and acknowledging the difference from the general older adult population. Collegian, 23(1), 97–102. https://doi.org/10.1016/j.colegn.2014.12.002

Zhao, Y. L., & Kim, H. (2015). Older Adult Inpatient Falls in Acute Care Hospitals: Intrinsic, Extrinsic, and Environmental Factors. Journal of Gerontological Nursing, 41(7), 29–43. https://doi.org/10.3928/00989134-20150616-05

 

Master in Project Management

Scholarship Application Form

 

 

You may be eligible for a part-scholarship towards the tuition fees for our undergraduate and postgraduate programmes. Scholarship applications are assessed on a merit basis and will take into consideration previous qualifications and level of work experience. To be considered for a scholarship, please complete the form below:

 

STUDENT INFORMATION

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PERSONAL STATEMENT

Please write a statement (300 — 500 words) in support of your scholarship application. Include details of previous qualifications, work experience, why you want to study a UoEO course and how a scholarship could help you.

 

My name is …………..and I am applying for the scholarship in Masters in Project Management. I graduated from Qatar University where I studied Industrial and Systems Engineering. During my course time in Qatar University, I took up a course in Project Management and is the basis of my passion to pursue a more advanced course.   Currently, I am applying for a job and I feel that being awarded the opportunity to study in the University of Essex will be an incredible opportunity that will help me attain my dream and vision as I wait for employment. The scholarship will contribute to furthering my knowledge and experience in the fascinating field of project management. Also, attaining the masters’ qualification will add on to my education level and increase my chances of securing employment. In addition, the scholarship will be of great help to me because of the 10% discount it offers on the total school fees.

During my study time in my previous university, I consistently indicated the passion to seize every opportunity that presents to better my education and add on to my knowledge and skills. I have a strong desire to learn and be a professional in matters concerning Project Management. The scholarship is one such opportunity as it offers me the very best ground for me to place my full focus and attention on the main objective which is to excel in masters in Project Management. I always consider an exemplary performance as a reward to my professors and the noble people who have agreed to my request and granted me the scholarship award. If given the opportunity, I will strive to be a great ambassador for the University of Essex throughout my future career.

I would like to thank you for taking the time to evaluate my application and I look forward to meeting you in Essex soon.

 

MSC PROJECT MANAGEMENT

Let me begin by formally thanking you for this opportunity to join your prestigious institution and pursue the 2-year online MSc Project Management course. It represents the next milestone in my journey to becoming a project manager. So far, I have completed my undergraduate degree in industrial and system engineering as well as a course in project manager to ensure I can fulfil different positions in the industry. In fact, I currently qualify as a project engineer. Ideally, I would have preferred to attend the course on University of Essex campus grounds but find myself unable to do so under the current circumstances. In order to relocate to the UK, I need to be accompanied by a family member. At the moment, no family member is in a position to relocate with me for the two-year duration of the course. In addition, I am currently actively searching for employment in Doha thus making it impossible to relocate once I secure a job. Due to these issues and minor setbacks, I believe the online version of this course is most appropriate for me towards realizing my dream of establishing a lifelong career in project management with the hope of running and international project management organization for non-profit organizations later in life.

            I am particularly interested in completing this course because of the added advantage it would have in launching my career as a project manager in Doha. As a wealthy middle-eastern city, it is rich with career and business opportunities through participation in the myriad undergoing projects conducted in both the public and private sectors. I believe this course offers the best opportunity for me to acquire the academic knowledge and skills I need to be an effective project manager while allowing me the means to apply the knowledge and skills to gain experience at the same time. I intend to immerse myself in my studies to have thorough understanding of every facet of project management to be an effective and reputable project manager with the academic qualifications to do so once I complete this course and my doctorate in the near future. I am keen on learning effective project management techniques and methods to help guide visions better. I am also interested in learning effective financial decision making skills and other skills required in the profession.

Despite the inherent pressure, I shall excel in both spheres because of my stellar history of presenting impeccable work in a timely manner throughout my undergraduate studies. I intend to exercise the same measure of resilience and dedication to my academic work to ensure I complete this course to acquire the necessary academic qualifications to pursue a doctoral degree soon after. During my undergraduate studies, I learned the basics of project management and some of the skills required to be a successful project manager.  My dream is to become an authority in project management by developing innovative solutions.