Understanding assessment of children’s learning

March 20, 2017

Understanding assessment of children’s learning










To be retained by parents/guardian only

Understanding assessment of children’s learning

Assessment-Year 3

We would like to inform you that the school is planning to start an assessment for the learning of year 3 pupils. The learning assessment will be conducted by the class teacher with the help of the school administration and you as a parent.

Assessment of the children’s learning is voluntary. Deciding that your child should not be assessed will not affect his or her current class performance. Before you make a decision on whether your child will be assessed, it is good for you to have an understanding of the importance of assessing children’s learning and what will be your role in the assessment. Please take sufficient time to go through this information and if you wish you discuss it with other people. Ask the school assistant principal using the contacts below if you want more information or there is something you clarity.

What is the purpose of the learning assessment?

Assessment is one of the integral parts of teaching and child’s learning. It is a tool that will be used to collect evidence about the achievements of the children. Being aware of what is assessed and how learning will be assessed will help the teacher, students, and parents/guardians to gain a deeper understanding of what should be valued and where to focus the attention.

Assessment will be used for several purposes, but the main purpose will be to support the learning of the students ((Gardner, 2012).

Currently, there are 30 students in the class (18 boys and 12 girls) with a different range of abilities and in order to ensure that they all obtain excellent performance, the school has decided to implement an assessment program. Assessment will enable the class teacher to find out what each child understands, how each child thinks, what each child is able to do, and what is their interests and dispositions. This information will help you and the class teacher builds understanding of your child as competent and capable learner in order to support his or her further development and learning (Stiggins, Arter, Chappuis, Chappuis & Educational Testing Service, 2006. The teacher will use information collected from the assessment to give feedbacks to students and their parents about their improvements. Assessment feedbacks will also provide enjoyable and challenging learning environment and experiences to the students, choose the most appropriate support for each child, and make sound plans for the next steps (Gardner, 2012).

How will assessment information collected

The class teacher will use different methods of collecting information about each child’s progress in their development and learning. The class teacher will decide which method is best depending on the student being assessed, and the aspects of development and learning being focused on. In choosing the assessment method, the class teacher will be mindful in the background, culture, language, interests, abilities, and areas that need extra support. For instance, the class linguistically and culturally diverse with over 15 different languages. The school will ensure that the chosen assessment method is compatible with each child’s language and culture. There are also 2 girls and 1 boy in the class from an indigenous background. The method chosen for these three students will be mindful in their background. There is also a child in the class with moderate hearing loss and the school will ensure that he is assessed using a method that cares for this disability. There are also two children in the class that need learning support and the teacher only receives four SLSO hours each day. The assessment methods used will also help the children improve their technology usage in the classroom since the school has an interactive smart board. The Internet will be used sometimes to help children develop their learning.

Methods of assessment

Assessment will be done formally and informally. There are five methods of assessment that will be used:

1. Diagnostic- This type of assessment used to provide intervention opportunity and feedback. It helps a teacher determine the strengths, skills, weaknesses, and knowledge before issuing instructions (Killen, 2005). An example of this method is “The Unit Pretest” whereby prior to starting to teach a particular unit, a teacher creates an assessment to find out what children understand about the topic.

2. Formative- Teachers use this method to improve the learning of the students. It is a collection of methods used by teachers to carry out an in-process assessment of the learning needs and the progress of a child during a unit or a lesson.an example of formative assessment is the observation that helps a teacher know what each student does and what they do not understand.

3. Summative- This method is used to assess the learning of the students after completion of each unit or lesson by comparing their performance with some standards (Killen, 2005). An example of a summative assessment is standardized exams such as SATs.

4. Formal- This is an assessment method that has some information that supports the conclusions that teachers make from test results (Killen, 2005). A good example of this type of assessment is standardized tests.

5. Informal- Unlike formal, informal assessments do not have supporting data but they are performance and content driven. An example of the informal assessment is grading, a method used by teachers to assign a value to the work of a student (Marzano & Association for Supervision and Curriculum Development, 2006).

Possible benefits

The assessment is intended to improve the performance of all students in the class.

How to get further information

If there is something to need clarification, contact the assistant principal via the school telephone number on 020 766 388.

Thank for spending your time to read this information sheet.


As far as education or learning is concerned, assessment or evaluation of students on what they have been learning is a central factor. According to my point of view it makes no sense for students to go through a course and finally fail to be evaluated. Assessment is the only way used by educators to know whether they have been teaching the right content or not. However, bearing in mind that the ability of students vary the educators came up with the above methods of assessment covering all types of students. This is to show that every child is able to access education no matter their mental ability and their physical composition. This was aimed to bring equality to all children and to wipe out discrimination. This great job by educators is worth appreciation because all students can go through learning and assessment.



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Gardner, J. (2012). Assessment and learning. Los Angeles [i.e. Thousand Oaks, Calif.: SAGE Publications.

Killen, R. (2005). Programming and assessment for quality teaching and learning. Southbank, Vic: Thomson Learning.

Marzano, R. J., & Association for Supervision and Curriculum Development. (2006). Classroom assessment & grading that work. Alexandria, VA: Association for Supervision and Curriculum Development.

Stiggins, R. J., Arter, J. A., Chappuis, J., Chappuis, S., & Educational Testing Service. (2006). Classroom assessment for student learning: Doing it right — using it well. Princeton, NJ: Educational Testing Service.

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Understanding assessment of children’s learning.

March 20, 2017

Understanding assessment of children’s learning










To be retained by parents/guardian only

Understanding assessment of children’s learning

Assessment-Year 3

We would like to inform you that the school is planning to start an assessment for the learning of year 3 pupils. The learning assessment will be conducted by the class teacher with the help of the school administration and you as a parent.

Assessment of the children’s learning is a very vital tool that helps teachers and parents monitor the progress of children in school. Deciding that your child should not be assessed will not affect his or her current class performance. Before you make a decision on whether your child will be assessed, it is good for you to have an understanding of the importance of assessing children’s learning and what will be your role in the assessment. Please take sufficient time to go through this information and if you wish you discuss it with other people. Ask the school assistant principal using the contacts below if you want more information or there is something you clarity.

What is the purpose of the learning assessment?

Assessment is one of the integral parts of teaching and child’s learning. It is a tool that will be used to collect evidence about the achievements of the children. Being aware of what is assessed and how learning will be assessed will help the teacher, students, and parents/guardians to gain a deeper understanding of what should be valued and where to focus the attention.

Assessment will be used for several purposes, but the main purpose will be to support the learning of the students (NSW Education Standards Authority, 2012).

Currently, there are 30 students in the class (18 boys and 12 girls) with a different range of abilities and in order to ensure that they all obtain excellent performance, the school has decided to implement an assessment program. Assessment will enable the class teacher to find out what each child understands, how each child thinks, what each child is able to do, and what is their interests and dispositions. This information will help you and the class teacher builds understanding of your child as competent and capable learner in order to support his or her further development and learning (NSW Education Standards Authority, 2012). The teacher will use information collected from the assessment to give feedbacks to students and their parents about their improvements. Assessment feedbacks will also provide enjoyable and challenging learning environment and experiences to the students, choose the most appropriate support for each child, and make sound plans for the next steps (Australian Federation, 2017).

How will assessment information collected

The class teacher will use different methods of collecting information about each child’s progress in their development and learning. The class teacher will decide which method is best depending on the student being assessed, and the aspects of development and learning being focused on. In choosing the assessment method, the class teacher will be mindful in the background, culture, language, interests, abilities, and areas that need extra support (UNSW Australia, 2015). For instance, the class linguistically and culturally diverse with over 15 different languages. The school will ensure that the chosen assessment method is compatible with each child’s language and culture. There are also 2 girls and 1 boy in the class from an indigenous background. The method chosen for these three students will be mindful in their background. There is also a child in the class with moderate hearing loss and the school will ensure that he is assessed using a method that cares for this disability. There are also two children in the class that need learning support and the teacher only receives four SLSO hours each day. The assessment methods used will also help the children improve their technology usage in the classroom since the school has an interactive smart board. The Internet will be used sometimes to help children develop their learning.

Methods of assessment

Assessment will be done formally and informally. There are five methods of assessment that will be used:

1. Diagnostic- This type of assessment used to provide intervention opportunity and feedback. It helps a teacher determine the strengths, skills, weaknesses, and knowledge before issuing instructions (Australian Federation, 2017). An example of this method is “The Unit Pretest” whereby prior to starting to teach a particular unit, a teacher creates an assessment to find out what children understand about the topic.

2. Formative- Teachers use this method to improve the learning of the students. It is a collection of methods used by teachers to carry out an in-process assessment of the learning needs and the progress of a child during a unit or a lesson.an example of formative assessment is the observation that helps a teacher know what each student does and what they do not understand (Australian Federation, 2017).

3. Summative- This method is used to assess the learning of the students after completion of each unit or lesson by comparing their performance with some standards (Australian Federation, 2017). An example of a summative assessment is standardized exams such as SATs.

4. Formal- This is an assessment method that has some information that supports the conclusions that teachers make from test results (Australian Federation, 2017). A good example of this type of assessment is standardized tests.

5. Informal- Unlike formal, informal assessments do not have supporting data but they are performance and content driven. An example of the informal assessment is grading, a method used by teachers to assign a value to the work of a student (Australian Federation, 2017).

When and how feedback is provided to children and parent/care givers

Written assessment feedback reports will be sent home at the end of each term. Parents/caregivers will be sent a summative report of each term’s/year’s results based on your child’s understanding, skills, and knowledge that will be measured against the country’s education performance standards, social and personal development. Additionally, class newsletters, displays and learning presentations, and meetings with parents and students need arise, and display of class programs and achievements of students are ways that will be used provide feedback to parents/cares about the student’s learning progress. Teacher-parent discussions will be conducted after each end term exam. At this time parents will be invited to meet the class teacher to discuss about their children’s developments in order to identify the child’s strengths and the areas that need reinforcement and make plans for his or her progress.

How to get further information

If there is something to need clarification, contact the assistant principal via the school telephone number on 020 766 388.

Thank for spending your time to read this information sheet.


As far as education or learning is concerned, assessment or evaluation of students on what they have been learning is a central factor. According to my point of view it makes no sense for students to go through a course and finally fail to be evaluated. Assessment is the only way used by educators to monitor the progress of all students in class. According to NSW Education Standards Authority (2012), assessment helps teachers, students, and parents/guardians to gain a deeper understanding of what should be valued and where to focus the attention. This is because it helps teachers to learn more about each student’s thinking, understand, and abilities in class (NSW Education Standards Authority, 2012).

The mode in which assessment information is collected is a very determining factor. According to NSW Education Standards Authority (2012), the method used to collect assessment information should be focused on evaluating the depth and breadth of learning based on the interests, cultural backgrounds, linguistics, abilities, and needs of the students. The method that will used in the classroom assessment will care for all these considerations. Providing assessment feedbacks to the students and parents/caregivers is an integral part of learning assessment that helps all students understand all class subjects and provides them and their parents/cares with a clear platform on how to make effective improvements. Spiller (2009) argued that, providing students and parents with assessment feedback is consistently and strongly related to improved achievement than other assessment behavior.



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Spiller, D. (2009). Assessment: Feedback to promote student learning. Manuscript submitted for publication, The University of Waikato, The University of Waikato, Hamilton, New Zealand.

NSW Education Standards Authority (2012). Kindergarten – Year 6 assessment strategies. From: https://syllabus.bostes.nsw.edu.au/support-materials/k-6-assessment-strategies/

Australian Federation, (2017). Assessment modes and practices. From: https://federation.edu.au/staff/learning-and-teaching/curriculum/assessment/assessment-modes-and-practices

UNSW Australia (2015).Assessment Toolkit: Giving Assessment Feedback. From: https://teaching.unsw.edu.au/printpdf/537



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Effect of enzyme concentration on the initial rate of an enzyme-controlled reaction

March 13, 2017


Enzymes are types of proteins necessary for catalyzing chemical reactions in the body. Enzymes are synthesis just as ribosomes do other proteins synthesis in the cell.  Enzymes are substrate specific and therefore react with specific substrates to enhance the rate of chemical reactions in cells (Karbach, Veit, & Ewe, 2009). Chemical reactions would otherwise be slower in the cells were it not for the action of enzymes and thus inhibiting basic human functions like breathing and digestion.

Trypsin is an enzyme that acts on proteins; it is secreted in the inactive form of trypsinogen from the pancreas into the small intestines. It acts on protein substrates resulting in the formation of amino acids and peptides (Hughes, Cohen, Arvan, & Seamonds, 2009).  Trypsin just as any other enzyme is pH specific and therefore requires specific levels of alkalinity and acidity for optimum action.

In the context of this experiment, the main objective was to determine how enzyme concentration changes the effectiveness of trypsin enzyme.

Health and safety

1% to 5% of Trypsin solution is an irritant and should be handled with care. If the solution splashes on the skin, it should be washed using plenty water as quick as possible. Eye protection should also be worn by all students in the laboratory to ensure their eyes are safe from the solution. In any case, the solution gets in any students eye; it should be reported immediately to the laboratory instructor (Poupon, Poupon, Grosdemouge, & Erlinger, 2009). Extra caution also needs to be taken when handling the enzyme’s solution; the enzyme may be kept in a refrigerator, but students should ensure that the experiment is completed within one session as the activity of protease enzymes decline with time.

Silver halides are low hazard materials and therefore can be used without considering extra caution, it should, however, be noted that old-fashioned photographic film is used for this experiment as the modern films do not use gelatin coatings (Zhang & Vardhanabhuti, 2014).


Trypsin (an example of protease) acts on milk protein (casein), the action results in breaking down of the milk from the opaque white colour into a clear solution (Poupon, Poupon, Grosdemouge, & Erlinger, 2009). The reaction can, therefore, be monitored by a colorimeter or a spectrometer as the clear solution allows for easy monitoring. The reaction apparatus can be arranged as shown in fig 1.0.

Fig 1.0: Apparatus for monitoring the rate of reaction.




1% trypsin solution was taken and diluted using distilled water into various test solutions of 0.2%, 0.4%, 0.6% and 0.8% respectively. The solutions were made up to 10 cm3 in boiling tubes and each of the boiling tubes containing solutions labeled using a lab maker. The resultant solutions were recorded in the laboratory notebook. 2 cm3 of trypsin, and 2 cm3 of water were added to the cuvette and used to set the absorbance of the calorimeter/spectrophotometer to zero. A suitable filter/wavelength for analysis of a blue solution was determined from the BIOL4A graph. 2 cm3 of milk powder solution was measured and added to a second cuvette. To the milk solution, 2 cm3 of trypsin solution was added and the solution quickly mixed and placed on the calorimeter/spectrophotometer and the stopwatch started.

The value of absorbance was measured immediately and subsequently at 15 seconds intervals until there was little change in the absorbance. The results were recorded in the table of results and used for further analysis. The procedure was repeated using new cuvettes with different concentration of trypsin from 1% to 0.2% and the results recorded in the table of results.


Trypsin Concentration /% Absorbance
0 15 30 45 60 75 90 105
1 0 3.5 5.5 6 7.8 8.8 9.4 9.7
0.8 0 2.7 4.5 5.8 6.8 7.5 8.2 8.7
0.6 0 1.7 3 4 5 5.8 6.5 7
0.4 0 1 1.7 2.5 3 3.8 4 4.5
0.2 0 0.5 1 1 1.7 2 2 2.3
0 0 0 0 0 0 0 0 0


Fig 2.0: A plot of Absorbance Versus Time

Fig 3.0: A plot of initial rate of reaction versus enzyme concentration.

For a comparison of the rates of reaction of the five sets of reaction, the rates at the beginning of the reaction were determined. This is because once the reaction begins, there is a variation of substrate concentration as there is a conversion of the substrate to the product at different rates. The differences in reaction rates captured from the beginning are therefore important indicators of difference in enzyme reactions caused by the difference in the concentrations of the enzymes (Hughes, Cohen, Arvan, & Seamonds, 2009). The initial rate of enzyme reaction was calculated from the slope of the curves of the five different reactions at 30 seconds from the beginning of the reaction. An ideal case should, however, be as close to zero as possible which is not practical to implement. A second graph was then drawn with the initial rate of reaction plotted against the concentration of the enzyme in the reaction.

Fig 4.0: Absorbance Versus the wavelength

A plot of absorbance versus wavelength results in an absorption spectrum of a sample under investigation. It is useful in the identification of unknown samples because samples have unique characteristic absorption spectra.  The spectra shown in fig 4.0 was used for this experiment, the enzyme peaked at an approximate wavelgth of 600 nm.


Trypsin concentration was the independent variable in the experiment while the rate of reaction (absorbance) was the dependent variable in this experiment. A rapid reaction occurs between the milk substrate and the enzyme resulting in the quick depletion of the milk and thus formation of a clear solution. At the beginning of the experiment, controlled variables such as substrate concentrations are normally the same at all levels for the independent variable thus making it easier for comparisons to be done. Absorbance values for the experiment may be higher than the actual values due to the presence of systematic errors. Other factors that may affect the rate of an enzyme-catalyzed reaction include the pH (Karbach, Veit, & Ewe, 2009). A change in pH of the reaction results in changes shape and size of the active site of the enzyme thus resulting in a variation in the rate of enzymatically catalyzed reactions. Enzymes thus work best at their optimum pH values.

From the graph, it is clear that a linear relationship exists between the initial rate of reaction and enzyme concentration that is the reaction rate is directly proportional to the concentration of the enzyme. This is because doubling or increasing the number of enzymes in a reaction increases the active sites available for slotting in of the substrate (Poupon, Poupon, Grosdemouge, & Erlinger, 2009). It should, however, be noted that the increase of enzyme concentration can be inhabited by the unavailability of the substrates.

Other factors that may inhibit the rate of enzyme catalyzed reactions include; the concentration of the substrate, the pH, temperature among other factors. An increase in substrate concentration also results in an increase in the rate of enzyme catalyzed reaction; this is, however, subject to the concentration of the enzyme and other factors. Temperature is also a vital component for optimum functioning of the enzymes (Zhang & Vardhanabhuti, 2014). Enzymes work best at specific temperatures, an increase in temperature beyond these temperatures denatures the enzymes and thus result in reduced rates of enzyme controlled reactions. A decrease in temperature below the specified temperature for enzyme operation results in inactivation of enzymes and thus slow enzyme reactions.

Enzymes work in specific pH values beyond which they are damaged. For example protease in the stomachs work under acidic environments and are damaged in alkaline conditions.


Enzymes are proteins and are useful in chemical reactions in the body as they lower the activation energies of reactions thus catalyzing the reactions. All chemical reactions in the body including anabolic and catabolic reactions are enzyme controlled. Enzymes are site specific and therefore are unique in structure and shape thus binds only to specific sites of the substrate resulting in the formation of an enzyme-substrate complex. Substrates reshape the size and shapes of binding thus resulting in perfect binding of the substrates and the enzymes.

Factors that affect the size and shape of the active site such as higher temperatures than the enzymes optimum temperature, high and low pH values, the presence of non-competitive inhibitor reduces the enzymes ability of binding with the enzyme and thus its activity (Poupon, Poupon, Grosdemouge, & Erlinger, 2009). The rate of reaction of en enzyme-catalyzed reaction may also be reduced by the presence of competitive inhibitors that reduces the likelihood of the substrates to bind thus reducing the rate of reaction.

Trypsin is an example of protease and thus acts on proteins to form peptides and polypeptides. Trypsin being a protein it works under specific conditions of temperature, pH, and concentrations of body fluids.  In this experiment, the effects of trypsin concentration on the rate of enzyme catalyzed reactions were examined, and the results analyzed as shown in the discussion section above (Karbach, Veit, & Ewe, 2009). Trypsin concentration affects the rate of digestion of proteins that is an increase in trypsin results in an increase in the initial rate of enzyme catalyzed reactions. It is, however, wise noting that the rate of reaction of an enzyme-catalyzed reaction is inhibited by other factors such as the concentration of the substrates.

The main objective of the experiment was achieved as the initial rate of reaction of the enzyme was compared to the concentration of the enzyme (Hughes, Cohen, Arvan, & Seamonds, 2009). A linear relationship was observed which is true for the initial.




Hughes, W., Cohen, S., Arvan, D., & Seamonds, B. (2009). The Effect of the Alkaline Tide on Serum-Ionized Calcium Concentration in Man. Digestion15(3), 175-181. http://dx.doi.org/10.1159/000198001

Karbach, U., Veit, J., & Ewe, K. (2009). Postprandial Cholylglycine Serum Concentration and Extent of Heal Inflammation or Resection in Crohn’s Disease. Digestion34(3), 202-206. http://dx.doi.org/10.1159/000199330

Poupon, R., Poupon, R., Grosdemouge, M., & Erlinger, S. (2009). Effect of Portacaval Shunt on Serum Bile Acid Concentration in Patients with Cirrhosis. Digestion16(1-2), 138-145. http://dx.doi.org/10.1159/000198064

Zhang, S. & Vardhanabhuti, B. (2014). Effect of initial protein concentration and pH on in vitro gastric digestion of heated whey proteins. Food Chemistry145, 473-480. http://dx.doi.org/10.1016/j.foodchem.2013.08.076


Ventilator-Associated Pneumonia

March 13, 2017











Ventilator-Associated Pneumonia


Institutional Affiliations










Table of Contents

Introduction. 3

Definition of Ventilator Associated Pneumonia (VAP). 3

The Disadvantages and Effects of Ventilator Associated Pneumonia (VAP). 3

Etiology: Causes of the Disease. 4

Causes of Ventilator Associated Pneumonia (VAP). 4

Signs and Symptoms of VAP. 6

Diagnosis of VAP. 7

Radiologic Diagnosis. 9

Clinical Method. 10

Microbiologic Diagnosis. 11

Pathophysiology: As a Result of the Disease or Abnormality. 12

Review of the Pathogenesis of ICU-Related VAP. 12

Review of the Epidemiology of VAP; Focusing on Modifiable Risk Factors. 14

Treatments: Specific Respiratory Treatments. 17

Evidence-Based VAP Prevention Strategies, CDC Guidelines and VAP Prevention Bundles. 17

Surveillance for Ventilator-Associated Events (VAE) and VAP, and the Rationale for the VAE/VAP Surveillance Definition Algorithm.. 19

Prognosis: Progress or Outcome of the Disease. 20

Conclusion. 21

References. 22





Ventilator-Associated Pneumonia


Definition of Ventilator Associated Pneumonia (VAP)

Pneumonia is a respiratory disease that affects the lungs and can be contagious based on the causes. The disease can either be viral or bacterial in nature. However, most studies have concentrated on the bacterial causes considering that the viral causes have not been fully conclusive. According to the Association of for Professionals in Infection Control and Epidemiology, APIC (2009), Pneumonia accounts for between 11 and 15 percent of all hospital acquired infections in the United States. It also accounts for 24 percent of all the infections acquired from the coronary unit and 27 percent for the ones resulting from medial intensive care unit (ICU). One therapy used in the treatment of Pneumonia is the Mechanical ventilations (MV). However, the therapy is not without medical complications and one of them is the Ventilator-associated Pneumonia (VAP). Ventilator-associated pneumonia is understood as a type of pneumonic complications mostly occurring after 48 hours following a tracheotomy or endotracheal intubation on a patient (Kalanuria, Zai, & Mirski, 2014). In this paper, the discussion will revolve around the VAP including its aetiology, pathophysiology, treatment/prevention, and prognosis.

The Disadvantages and Effects of Ventilator Associated Pneumonia (VAP)

Just like many other medical-related complications, VAP has wide reaching effects, which doubles as disadvantages and they include the following. Patients and families have to foot huge medical and hospitalization bills incurred in the medication and during the hospitalization of the patients (Cason et al., 2007 as cited in O’Keefe-McCarthy, Santiago, & Lau, 2008). Besides the family members, countries suffer from huge economic burdens and especially through the subsidization of the hospital services and medication as well as in the provision of the health insurance covers among the citizens. Also, the patients put under MVs have relatively long stay at the hospital. The situation exacerbates after the patients acquire the VAP since the hospital stay is further stretched. Finally, this medical complication leads to increased mortality and morbidity rates (Klompas et al., 2014).

Etiology: Causes of the Disease

Causes of Ventilator Associated Pneumonia (VAP)

According to some of the previous studies, the occurrence of the ventilator-associated pneumonia can kick off either early or late after a patient is put under the mechanical ventilation process (O’Keefe-McCarthy, Santiago & Lau, 2008). According to Pruitt and Jacobs 2006 (as cited in O’Keefe-McCarthy, Santiago & Lau, 2008), the early-onset VAP develops between 48 and 96 hrs after the intubation. The most common microorganisms associated with the early-onset VAP includes; Moraxell catarrhalis, and Haemophilus influenza. On the other hand, the late VAP will occur more than 5 days after the mechanical ventilation has been performed on the patient.  The common bacteria associated with this category of VAP include; Kebsiella pneumoniae, enterobacter, and Staphylococcus aureus among others (O’Keefe-McCarthy, Santiago, & Lau, 2008). From the above, it is clear that Ventilator-associated pneumonia is classified into two categories, which largely depend on the type of bacteria accessing the lower part of the aero-digestive tract.

It is important to note from the onset, though, that Ventilator-associated pneumonia is a sub-classification of Health acquired pneumonia (APIC, 2009). However, this is only in the instant where a patient has been admitted in the hospital during the mechanical ventilation process. Like many other diseases, the development of VAP is partially contributed to by the presence of a wide range of risk factors. The body should be in a position to fight against diseases though its natural immunity. However, the introduction of foreign objects into the body goes against this principle. VAP arises from mechanical ventilation and, according to O’Keefe-McCarthy, Santiago and Lau (2008); this therapeutic procedure impedes the body and leads to compromised natural immunity of the body to fight against the respiratory infections. In other words, the aspect of introducing a new endotracheal tube deviate the effective cough reflexes, which are very pertinent in protecting the airway against any invasive pathogens. In this case, the endotracheal tube has been considered a major risk factor in the sense that it violates the natural disease resistance mechanisms (Kalanuria, Zai, & Mirski, 2014). It negatively affects the; larynx, glottis, and the cough reflex, which are critical in the respiratory system.

Some studies are in the support of the above findings. According to a panel of experts from the American Thoraic Society (as cited in Sedwick, Lance-Smith, Reeder, & Nardi, 2012), the introduction and positioning of an endotracheal tube increases the chances of the ventilator-associated Pneuomonia complications from 6 to 20 fold among the patients who have been put under the mechanical ventilation therapy. For VAP to occur, however, the microorganisms must have access to the normal sterile lower part aero-digestive tract (Sedwick, Lance-Smith, Reeder & Nardi, 2012). Sedwick, Lance-Smith, Reeder and Nardi (2012), continues to state that most of the seriously ill patients have depressed levels of consciousness and their weakened gag reflex puts them at a relatively higher risk of the microorganisms having quick access to their lower part of the aero-digestive tract.  Although some studies have argued that the development of VAP can be attributed to viral and fungi causes, there are no scientific conclusions. Hence, there some studies are still in progress to ascertain this argument (Deem & Treggari, 2010). In that case, and based on the above discussion, most of VAP cases have been attributed to the bacteria causes. Although, the complication can be either early or late onset, the causes are mainly bacterial-related. The former is caused by antibiotic sensitive bacteria while the latter is mainly as a result of antibiotic resistant pathogens. According to Deem and Treggiari (2010), for the development of the VAP to take place, two processes must take place; bacterial colonisation of the respiratory tract and the aspiration of the contaminated secretions of the lower airway.

Signs and Symptoms of VAP

VAP is a type of pneumonia and hence, from a broader perspective, some the signs and symptoms may be similar to those of patients suffering from pneumonia. However, most of the patients suffering from the ventilator-associated pneumonia will mainly experience the following signs and symptoms. An important point to note is that the signs may present themselves instantly or may develop gradually. Firstly, the patients are highly likely to experience fever, which implies increased body temperatures beyond the normal body temperature range.

Secondly, there is the presence of chills among the VAP patients. This is a situation where the patients experiences extreme cold and subsequent shivering. Chills are largely evident at the onset of an infection and are as result of rapid changes in muscle contraction and relaxation. Pneumonia is as a result of the pulmonary infection, the reasons as to why most of the patients are likely to experience the chills. Although, a chill may present itself as an individual symptom among the patients, there is strong correlation between chills and fever. In this case, PAV tend to experience both of these two symptoms.

Thirdly, some of the patients may also experience a cough as well as the production of the purulent sputum. A cough partly develops as a result of accumulated foreign irritants and mucus build-up in the trachea. As such, it can be regarded as a common reflex action, whose aim is to clear up the above mentioned accumulations and build ups. On the other hand, sputum production refers to the aspect of coughing out the material that is produced in the respiratory tract.

Fourthly, a shortness of breath is another major symptom among the VAP patients. In fact, shortness of breath has largely been associated with lung and heart diseases and VAP is a complication affecting the respiratory system. This is linked to the above-mentioned symptom, which is as a result of mucus build up and the presence of foreign elements in the trachea that eventually, implicate the normal breathing of the patients.

Fifthly, it is not uncommon for the VAP patients to experience thick mucus. As demonstrated in the previous sections, VAP majorly affects the respiratory tract. The mucus membrane is aligned on the trachea implying that most of the mucus processes take place in the aero-digestive tract. As previously demonstrated, the mechanical ventilation and intubation take place in the respiratory tract. Therefore, the development of VAP, which mainly affects the respiratory tract, will have an impact on the mucus formation and excretion processes.

Finally, some of the patients suffering from VAP complication may experience chest pain symptoms. The primary cause of the chest pain is associated with heart’s muscle problems when the muscle is unable to access enough blood, rich in oxygen. From the preceding sections, it is apparent that the patients of VAP will experience decreased oxygenation. Eventually, the blood will be oxygen deficient (Hypoxemia), thereby triggering the problem of chest pain. Furthermore, lung-related problems have been linked to the causes of chest pain and, hence VAP is not an exceptional.

Diagnosis of VAP

To this present day, there is no standard diagnostic criterion that has been recommended for VAP and, hence the diagnostic approach to use is still elusive. In fact, some studies have argued that the detection of nosocomial pneumonia, especially VAP, is very difficult to diagnose (Tablan et al., 2003). The traditional methods that have largely been used in the diagnosis criteria of the VAP include; the combined existence of the development of the purulent sputum, coughing, and existence of fever. The cultures of the sputum and some clinical criteria are sensitive for bacterial pathogens. However, some studies have imputed the ability of the above to diagnose VAP, as they are not specific. The culture of the blood has also not been considered effective in testing the presence of VAP (Tablan, 2003).

However, according to Tablan et al., (2003), some methods of diagnosing pneumonia, which extends to VAP, were proposed back in the year 1992 by a group of investigators. These were considered the standard diagnosis methods for detecting this medical complication. The methods incorporated the aspect of carrying out the bronchoscopic techniques on the patient (Tablan et al., 2003). However, with time more researches have been conducted and have established that using bronchoscopic methods can lead to more complications considering that they are invasive in nature.

According to the Infectious Diseases Society of America (AIDS) and the American Thoracic Society (ATS), the diagnosis of VAP can be made possible through the extraction of some samples from the lower aero-digestive tract, which can then be used for culture and microbiology. According to AIDS and ATS, the samples can be either qualitative or quantitative.

Additionally, based on the guidelines proposed by the Infectious Society of American and the American Thoracic society, the tracheal aspirates can be used for the negative predictive value (Kalanuria, Zai, & Mirski, 2014). Johnson et al., (as cited in Kalanuria, Zai, & Mirski, 2014), offered the description of the clinical diagnosis for VAP as described below. According to authors the psychological, microbiological, clinical, and radiographic evidence are taken into account by the clinical pulmonary infection score (CPIS), which let a numerical value to help predict the existence of the ventilator-associated pneumonia (Munro & Ruggiero, 2014). The score range is between 0 and 12, and the score value of more than 6 indicates a strong correlation with the incidence of ventilator-associated pneumonia. However, despite the existence and application of the CPIS, there are debates revolving around its diagnostic validity (Kalanuria, Zai, & Mirski, 2014). The inter-observer variability in CPIS remains significant regardless of its straightforward computation.

Radiologic Diagnosis

This denotes the aspect of using medical imaging in the detection, such as the X-rays of the chest in the diagnosis process. Previous studies have imputed the possibility of the normal chest radiograph in the diagnosis of the presence of VAP (Munro & Ruggiero, 2014). Some of these studies have argued that the asymmetric pulmonary infiltrates that are consistent with the ventilator-associated pneumonia can result from among other causes such as drug reaction, chemical penumonitis, and pulmonary embolism among others. The total radiographic specificity of a pulmonary opacity consistent with pneumonia stands at between 27 and 35 percent. However, medical researchers are convinced that the high specificity degrees present in some of the radiograph findings can be very critical and effective in the diagnosis of the pneumonia, especially in the case where it is present. Although the radiographic diagnosis criterion has been considered to have specificity percentage of 96, radiographic abnormalities are common (Munro & Ruggiero, 2014).

Clinical Method

The clinical criteria for the diagnosis of the Ventilator-associated pneumonia require the mandatory use of the portable chest radiograph. However, the use of this approach is considered to present specificity and sensitivity challenges. Studies have, additionally, cited low-quality of the films, obtained from the chest X-rays as presenting another compromise to diagnosing the presence of VAP.  What is evident is that the clinical criterion in the diagnosis of VAP has limited diagnostic accuracy. The development of purulent tracheobronchial secretions, leukoytosis, and chest radiograph predicate the presence of suspected Ventilated-associated pneumonia (Kalanuria, Zai, & Mirski, 2014). However, the clinical diagnosis criterion for pneumonia has been limited in the diagnosis of the Ventilator Associated Pneumonia relative to its appropriateness in the diagnosis of community acquired pneumonia. Previous studies have stated that; more diagnostic symptoms have to be used in the combination of the above mentioned three. They further establish that the elimination of one of the above-mentioned clinical variables will reduce the sensitivity and the use of a single variable declines it further. Further, such studies have argued that symptoms such as fever, leukoytosis, and tachycardia, which are common symptoms of VAP, do not qualify as the final specific diagnostic criteria considering that they are present in other medical conditions (Munro & Ruggiero, 2014). Additionally, patients receiving mechanical ventilations are likely to exhibit purulent tracheal bronchial secretions, which in such a case are not caused by the presence of pneumonia. The sensitivity of VAP among the above discussed cluster of patients is more challenging for those patients suffering from Acute Respiratory Disease Sydrome (ARDS) (Center for Disease Control and Prevention, 2014). According to the clinical VAP diagnosis approach, the diagnosis of the nosocomial tracheobronchotis is only validated if there is the presence of leukocytosis, fever, and purulent sptum that has a positive sputum culture. However, in such a case scenario, there has to be the absence of any new lung infliltrate. Nosocomial tracheobronchial has largely been associated with the longer ICU stay and extended time on the ventilator for the patients undergoing the mechanical ventilation. In the case of the clinical criteria diagnosis criterion, the CPIS is largely recommended as compared to the direct therapy. Although it is sensitive, the chest radiography is typically nonspecific. On the other hand, the clinical diagnosis criterion has been used alongside other features in the diagnosis of the ventilator-associated pneumonia. To this point, CPIS has been considered helpful in the diagnosis of VAP. Unfortunately, it has moderate performance and a considerably high degree of inter-observer variability, which compromises its reliability in VAP diagnosis.

Microbiologic Diagnosis

The microbiologic diagnosis criterion has been considered the most appropriate approach in the diagnosis of ventilator-associated pneumonia. This method makes use of invasive techniques, which require the aspect of obtaining samples such as B-PSB, NB-BAL, and B-BAL. The samples are later on evaluated through the use of Gram stain, which uses quantitative cultures (Marti & Ewig, 2011). Based on previous findings, there can also be the use of less invasive suctioning of the trachea (Marti & Ewig, 2011). This way, there is the yielding of valuable ETAs that are later accessed by the bacterial culture and Gram stain, either semi-quantitatively or quantitatively. Gram stain has been considered reliable in the sense that it provides rapid information on the quality of the specificity as well as the number and morphology of the infecting pathogens. The presence of any offending bacteria is made possible by the morphology of that particular bacterium. Also, the presence of a myriad of squamous epithelial cells indicates the presence of oral contamination of the particular specimen (Kalanuria, Zai, & Mirski, 2014). The infections leading to the emergence of the ventilator-associated pneumonia are suspected in the case where the Gram stain is contaminated or colonized by relatively too many bacteria and polymorphonuclear cells (Marti & Ewig, 2011).

However, there is a strong negative predictive value for the presence of VAP in the case where Gram stain of the ETA or sputum has no inflammatory cells and there is non-existence of bacteria. This is primarily because, the fever detected as being the cause of the VAP may have been as a result of another medical conditions. The invasive techniques, B-PSB (10^3 cfu/ml), NB-BAL (10^4 cfu/ml), and B-BAL (10^4 cfu/ml) have presented the standardization criteria in the diagnosis of VAP (Kalanuria, Zai, & Mirski, 2014). Any quantitative cultures, with values ranking below the above stipulated thresholds, imply a colonization or contamination by other exceptions. Most of the laboratory tests make use of the semi-quantitative techniques and there is no single quantitative technique that can be used in the diagnosis of an infection. Most of the laboratory tests make use of the threshold of > (greater or equal to) 10^5 cfu/ml. Any growth of pathogens below the pre-stated threshold is mostly associated with colonization (Kalanuria, Zai, & Mirski, 2014).

Pathophysiology: As a Result of the Disease or Abnormality

Review of the Pathogenesis of ICU-Related VAP

Previous studies have established that the interplay between risk factors and the presence of the endotracheal tube largely contribute to the development of the Ventilator associated pneumonia (Kalanuria, Zai, & Mirski, 2014). As demonstrated in the preceding sections, the onset and development of the ventilator-associated pneumonia is triggered by the invasion of the lung parenchyma and the lower sections of aero-digestive tract by microorganisms. The pathogenesis of VAP, whether nosocomial or ICU acquired, is highly characterized by the invasion and colonization of the oral cavity by aero-digestive pathogens that access the lower sections of the respiratory tract. Most of the patients admitted in the intensive care units often suffer from critical medical conditions and their overall bodies’ natural immunity, to fight against any potential infections, is compromised. One of the factors that have been attributed to the eruption of pneumonia is the inability of the host patient’s inability to fight against any invading microbial pathogens. The reduced state of the immune system has been linked with the interplay of a myriad of multilevel factors.

Ventilator- associated pneumonia accounts for approximately 30 percent of the all the ICU-related infections. VAP has the probability of increasing the hospital stay among the affected patients and may also negatively affect the overall outcome (Klompas, 2014). According to Deem and Treggiari (2010), an argument can be made that relative to the ventilator, the endotracheal tube predisposes the high susceptibility to VAP among the ICU patients. The positioning and regular maintenance of the tube through the glottis increases the chances of developing the VAP (Hess, et al., 2003).

According to Kalanuria, Zai, and Mirski, (2014), bacteria can access the lower respiratory tract in four major ways. Firstly, they can do this by impairing the mucociliary clearance of secretions and the placement of the endotracheal tube has been found to increase this risk considering that it depresses the epiglottic reflexes and also prevents the mucociliary clearance of secretions (Kalanuria, Zai, & Mirski, 2014).  In such cases, the bacteria will travel around the cuff or through the tube in small quantities. What follows is the embolization of the bacteria into the lungs after every other breath.  Secondly, the bacteria can pool and trickle secretions around the cuff, through the micro-aspirations of secretions. Most of the aspirations, among the patient subjects, happen during the night. Risk factors are higher among the hospitalized and ICU patients and especially the ones who have undergone the mechanical ventilation process (Hess, 2003). This is mostly among the patients who have an underlying disease as well as the patients who have been put under sedative drugs, which are common in the Intensive care units. Studies have established that most cases of micro aspirations are linked to high volume-low pressure inflated ETT cuffs (Huff, 2003).  Thirdly, the access can be accelerated during the instances when the intubation is being performed. Aspiration and oropharyngeal secretions are bound to occur during the intubation process (Deem & Treggiari, 2010). Finally, the bacteria access can be triggered by the development of a biofilm lumen in the tube. According to Deem and Treggiari (2010), there is a strong concordance between tracheal-suction samples, obtained from VAP patients, and the biofilm. Further, the study establishes that the biofilm creates a good environment for the proliferation of the bacteria while at the same time acting as a resistant to antibiotics. Eventually, the increase of the bacteria in the aero-digestive tract leads to its colonization. Consequently, the excess secretions, presence of aspirated oesophageal as well as the pools and leaks have relatively high potential of infiltrating the lungs, thereby, causing the Pneumonia and, in this case, the Ventilator Associated Pneumonia (Kalanuria, Zai, & Mirski, 2014).

Review of the Epidemiology of VAP; Focusing on Modifiable Risk Factors

According to O’Keefe-McCarthy, Santiago and Lau (2010), the risk factors linked to the ventilator-associated pneumonia include the ones that can increase the possible aspiration and oral secretions as well as those that impair a patient’s defence system.  Additionally, according to Ablan et al., (2003), the potential risk factors associated with the nosocomial bacteria related pneumonia have been researched in several studies. According to these authors, the risk factors can be categorized into four major groups despite the fact that the populations that were used in the studies varied slightly. These risk factors include the following; firstly, the factors that promotes the colonization of the oropharynx by microorganisms. Secondly, other risk factors include the conditions that favour the aspirations into the reflux or the aero-digestive tract from the gastrointestinal tract. Thirdly, the conditions that require the prolonged dependence on the mechanical ventilatory support and which have potential exposure to respiratory devices that are contaminated or are in constant contact with colonized hands, especially in the case of the healthcare personnel. In this line, there should be more education on ventilator-associated pneumonia (AARC, 2003). Finally, there is a cluster of other factors such as extreme underlying conditions, malnutrition, and the ones that are age-related (Ablan et al., 2003). The risk factors can be either modifiable or non-modifiable. The modifiable risk factors are the ones that can be prevented and are amenable to change since they are within human control, for instance physical inactivity and discharge from the ICU. On the other hand, the non-modifiable risk factors are the ones that are beyond human control and there is nothing that can be done to alter or reduce them, for instance age and sex.

As regards VAP, the modifiable risk factors include the following discussed.  One of the risk factors associated with the ventilator-associated pneumonia is the issue of colonized hands among the healthcare personnel. The issue of “unclean” hands is not uncommon as a lead risk factor to nosocomial and ICU acquired infections. The use of combined interventions is appropriate in the prevention of VAP. For instance, there is a need to use enough staffing, alcohol-based hand sterilizations, and education-based infection-control interventions so as to reduce the VAP incidence levels (APIC, 2009).

Secondly, increased aspiration of microorganisms, which are rich in colonizing flora bacteria, into the lower parts of the aero-digestive tract promote the incidence of VAP. Through the use of subglottic secretions, there is a high probability of reducing the incidence of Ventilator associated pneumonia.

Thirdly, the incidence of VAP is triggered by the bacteria formation during the intubation process and is also largely dependent on the longevity of the mechanical ventilator in the body. The ventilators should be avoided at all costs (Klompas, 2014). There could also be the use of alternative strategies and application of non-invasive methods, Non-invasive positive pressure ventilation, so as to reduce the incidence of the disease.

Fourthly, some studies have cited the formation of the biofilm as one the risk factors that increases the incindence of VAP (Klompas, 2014). The bacterial biofilm is formed on the inner side of the endotracheal tube. Eventually, the accumulation of these bacteria results in resistance to antibiotics. Additionally, they lead to the humoral and cellular defenses and have been attributed to increased recurrence rates of infections. Some of the bacteria that have been linked to the formation of the biofilm include among others the pseudomonas (Klompas, 2014). What follows is the mechanical dislodge of the bacteria through the bronchoscope, airway, and the suction catheters in the trachea. Eventually, this increases the incidence rate of VAP. This incidence rate can be corrected by making use of antimicrobial agents in coating all the intravascular catheters such as in the case with the intubation and mechanical ventilation performed in the respiratory tract. Consequently, this will help mitigate a large number of infections that are device-associated.

Finally, the presence of the Oropharyngeal colonization has linked to VAP incidence. This is caused by the p. Aeruginosa and entric gram-negative bacteria. The Oropharyngeal colonization is positively correlated with the time of admission as well as the length of stay in the ICU (Wunderink & Rello, 2011). In this case, the intonation of the Oropharyngeal colonization can be achieved through the optimal use of the appropriate chlorhexidine therapy and antibiotics.

Treatments: Specific Respiratory Treatments

Evidence-Based VAP Prevention Strategies, CDC Guidelines and VAP Prevention Bundles

A number of strategies have been proposed as mechanisms to helping prevent the incidence of VAP. Most of the VAP prevention strategies focus on the contamination of equipment used, the colonization of the respiratory tract, and aspiration (APIC, 2009). According to Kalanuria, Zai and Mirski (2014), there are five VAP bundles that can be used in the mitigation and improvement of the VAP outcome. Firstly, there is the need to have a daily sedation assessment as well as spontaneous breathing tests, accompanied with possible and effective extubation. Secondly, there is a need to have a deep venous thrombosis prophylaxis. Thirdly, there is a need to avoid the supine head positioning by ensuring the appropriate head elevation. Fourthly, there is a need to use chlorhexidine as a daily oral care (Health Protection Scotland, 2012). Finally, the healthcare personnel should consider the concept of stress ulcer prophylaxis (Sedwick, Lance-Smith, Reeder, & Nardi, 2012). According to O’Keefe-McCarthy, Santiago and Lau (2008), the collective implementation of all the VAP bundles achieves better outcome as compared to the individual application. Eventually, this reduces the incidence of VAP. In connection to the above, there is a need to adopt the following prevention strategies if success is to be achieved.

The first prevention to use is extubation. From the above-discussed risk factors, it is clear that one potential to the increased incidence rates is the time span of the endotracheal tube (APIC, 2009). This is also captured in the five “VAP Bundles”. In this connection, therefore, there is a need to perform daily tests on patients’ weaning to mitigate the higher chances of VAP incidence (O’Keefe-McCarthy, Santiago & Lau, 2009). The second prevention strategy can be obtained from the “VAP Bundles”, which require the proper position of a patient’s head. There is a need to ensure a semirecumbent head positioning for the ventilated patients (APIC, 2009; Deem & Treggiari, 2010). The third highly ranked prevention strategy is to ensure minimized or zero instrumentation of the aero-digestive tract. In other words, the healthcare personnel should try as much to avoid the use of endotrachea tube, which eventually increases the rates of bacteria colonization (APIC, 2009; Deem & Treggiari, 2010). In this connection, APIC 2009, cites the issue of hand hygiene as being a contributor risk factor to VAP incidence. The fourth prevention strategy is the decontamination of the f the oropharynx with topical chlorhexi-dine, which has been cited by APIC, (2009) as well as Deem and Treggiari (2010). This concept is also captured in the VAP bundles. The fifth prevention strategy can be adopted from the article by Deem and Treggiari (2010), who proposes the use of modified designs of the endotracheal tube so as to reduce the issue of biofilm formations. The sixth VAP prevention strategy stems from VAP bundles and has been stressed by Dickinson and Zalewski (2016), and regards the use of antiseptic agents such as chlorhexidine in the daily mouth care. Other proposed prevention approaches include mobility and nutrition, which pertain to reduced time length of bed rest and enteral feeding respectively (APIC, 2009).

Surveillance for Ventilator-Associated Events (VAE) and VAP, and the Rationale for the VAE/VAP Surveillance Definition Algorithm

Due to the challenges experienced in the accurate diagnosis of VAP, the National Healthcare Safety Network (NHSN) came up with new surveillance approach, VAE that includes VAP. VAE is an acronym to Ventilator-Associated-Events. According to the Center for Disease Control and Prevention (2014), VAEs constitutes the combination of objective criteria, which are commonly referred to as the 3-tiers. These include; “deterioration in respiratory status after a period of stability or improvement on the ventilator, evidence of infection or inflammation, and laboratory evidence of respiratory infection” (Center for Disease Control and Prevention, 2014, p. 18).

The surveillance definition algorithm of VAE, as proposed by the NHSN, has a definition rationale that utilizes the following five steps. The first step focuses on the Ventilator-Associated Events (VAE) Surveillance Algorithm. It concentrates on the patient stability improvement while in the ventilator, oxygenation, temperature variations, antimicrobial agents, purulent respiratory secretions, and positive cultures. The second stage revolves around issues on the Ventilator-Associated Condition (VAC). It focuses on the baseline improvement of a patient stability on the ventilator. This should be “defined by more than or equal to 2 calendar days of stable daily decreasing minimums*FiO2 or PEEP values” (Center for Disease Control and Prevention, 2014, p. 18). Different indicators of worsening oxygenation must also be assessed on a daily basis. In the third step, the focus is on the Infection-related Ventilator-Associated Complications (IVAC), which requires the patient to have met the VAC criteria.  Worsening oxygenation criteria, temperature variations, and antimicrobial agents must be taken into consideration during this stage. The fourth step focuses on the Possible Ventilator-Associated Pneumonia (VAP), which necessitates the client to meet both the VAC and IVAC criteria. Additionally, factors relating to worsening oxygenation and purulent respiratory must be taken into account. Alternatively, positive cultures can be used in the place of the purulent respiratory. The final step relates to the Probable Ventilator-Associated Pneumonia (VAP) and requires the patient to have met the VAC and IVAC criteria. Additionally, there has to be the assessment of the worsening oxygenation criteria as well as one of a host of other factors such as the positive fleural fluid culture; positive lung histopathology; positive diagnostic test for aero digestive tract secretions; or positive culture of, lung tissue and protected specimen brush among others.

As opposed to the traditionally used VAP diagnostic approaches, which lack accuracy, the new VAE surveillance algorithm definition is able to address the diagnosis issues. The suspected patient is put under the five different stages that take into account all the possible criteria used in the diagnosis process.

Prognosis: Progress or Outcome of the Disease

Previous studies have demonstrated that VAP has continued to be major medical complication increasing the morbidity and mortality rates among the critically ill patients (Stevens, 2014). Major developments are being made regarding this disease including coming up with appropriate diagnostic methods such as the one adopted by the NHSN, VAE/VAP surveillance definition. Eventually, this implies that treatment will be offered on evidence-based diagnosis that goes beyond the traditional and inaccurate VAP diagnosis such the clinical, radiology, and microbiologic approaches. Besides the increased mortality rates, there are high costs incurred among the VAP patients to cover for the mechanical ventilation and intubation. Additionally, the patients are likely to suffer from lung-induced injuries as well discomfort especially in cases where there is delayed removal of the mechanical ventilator. Fourthly, there could be medical negligence during the mechanical ventilation and intubation process and this may lead to ventilatory muscle fatigue. Finally, there is likelihood of extended length of hospital and ICU stay among the patients suffering from ventilator-associated pneumonia (Stevens, 2014).


Conclusively, the above discussion has established that ventilator-associated pneumonia accounts for a large number of mortality and morbidity rates in the United States.  Early onset VAP is acquired within the first 48-96 hours after mechanical ventilation or intubation. On the other hand, late onset VAP sets in several days after the mechanical ventilation or intubation. This medical complication has several negative implications, which doubles as disadvantages. The primary cause of VAP is mechanical ventilation and intubation. Traditionally, there has been no accurate diagnosis for VAP and the medical fraternity has relied on the radiology, clinical, and microbiological criteria. There are four different mechanisms through which the development of the ICU acquired VAP can occur. However, there are some modifiable risk factors that can help mitigate the incidence of VAP, if properly controlled. These are the risk factors that are within the control of the patients and the healthcare providers. Eventually, these risk factors have some connection with some of the VAP prevention strategies that can be used in the mitigation or total elimination of the disease’s incidence. The lack of reliable and accurate VAP diagnosis criteria has necessitated the development of a new diagnosis approach, ventilator-associated events (VAE). The new criterion follows a surveillance definition algorithm that incorporates five steps and three tiers. The adoption of the new diagnosis criterion helps incorporates different VAP-related symptoms, thereby ensuring diagnosis specificity.   Huge costs, injuries on the respiratory tract, increased mortality rates, and elongated hospital stays are some of the outcomes of VAP.


AARC. (2003). Care of the ventilator circuit and its relation to ventilator-associated pneumonia. AARC Evidence-Based Clinical Practice Guidelines, 48(9), 869-879.

APIC. (2009). Guide to the elimination of ventilator-associated pneumonia. K Street, NW: APIC.

Center for Disease Control and Prevention. (2014). Ventilator-Associated-Event. Device Associted Module, 10, 1-46.

Deem, S & Treggiari, M. M. (2010). New endotracheal tubes designed to prevent ventilator  associated pneumonia : Do they make a difference?. Respiratory Care, 55(8), 1046-1055.

Dickinson, S & Zalewski, C. A. (2016). Oral care during mechanical ventilation-critical for VAP prevention. Society of Critical Care Medicine, 1-4.         

Health Protection Scotland (2012). What are the key prevention and control recommendations to inform a minimising ventilator associated pneumonia (VAP) quality improvement tool?, National Services Scotland, 1-12.

Hess, D. R., Kallstrom, T. J., Mottram, C. D., Myers, R., Sorenson, H. M., & Vines, D. L. (2003). AARC evidence-based clinical practice guidelines: Care of the ventilator circuit and its relation-associated pneumonia. Respiratory Care, 48(9), 869-879.

Kalanuria, A. A., Zai, W., & Mirski, M. (2014). Ventilator-associated pneumonia in ICU. Critical Care, 1-8.

Klompas, et al. (2014). Strategies to prevent ventilation-associated pneumonia in acute care hosptials: 2014 update. Infection Control and Hospital Epidemiology, 35(8), 1-23.

Marti, A. T., & Ewig, S. (2011). Nosocomial and ventilator-associated pneumonia. Sheffield: European Respiratory Society.

Munro, N & Ruggiero, M. (2014). Ventilator associated pneumonia bundle. American Association of Critical-Care Nurses, 25(2), 163-175.

O’Keefe-McCarthy, S., Santiago C., & Lau, G. (2008). Ventilator-associated pneumonia bundled strategies: An evidence-based practice. World Views on Evidence-Based Nursing, 5(4), 193-204.

Tablan, O. C., Anderson, L. J., Besser, R. Bridges, C., & Hajjeh, R. (2003). Recommendations of CDC and the healthcare infection control practices advisory Committee. Guidelines to Preventing Healthcare Associated Pneumonia, 1-179.

Sedwick, M. B., Lance-Smith, M., Reeder, S. J., & Nardi, J. (2012). Using evidence-based practice to prevent ventilator-associated pneumonia. Critical Care Nurse, 32(4), 41-51.

Stevens, J. P., Silva, G., Gillis, J., Novack, V., Talmor, D., Klompas, M., & Howell, M. D. (2014). Automated surveillance for ventilator-associated pneumonia. CHEST, 146(6), 1612-1618.

Wunderink, R. G., & Rello, J. (2001). Ventilator-Associated Pneumonia. Boston, MA: Springer US.




Reflective writing

March 10, 2017

Financial management in library environment

Academic libraries in the United States have operated on inadequate budgets especially for the last ten years. Acquisition and maintenance of new technology, storage of electronic information, high cost of library materials and facilities has caused a strain on library financial management. Financial management models vary from one library to another depending on the nature of the institution (Rader, 2000). It could be public or private. The libraries are also operated under different budgetary regulations. Libraries are characterised with a wide range of costs to cater for. The currency of library materials keeps changing with time. For instance research studies recommend that source materials should be dated within the past few years. This consequently means that the libraries have to be restocked regularly with the most current materials ranging from electronic sources to shelve books.

Research shows that libraries in the US have not realised growth in the past three decades due to the impact of the inflation cost that has been associated with library materials. The libraries’ financial managers have been forced to cut on the budget by cutting on the operating expenses. The basic library budget covers material costs and personnel expenses only. A small proportion of the budget is allocated to maintenance of the building structures, library equipment and technology. In order to stay at par with the currency of the library materials, their financial managers resort to fundraising. Many libraries in the United States have fundraised to support library operations. Many University libraries have a development program through which fundraising can be made. Universities that provide doctorate grants are more likely to resort to fundraising for their libraries. However, even the smaller institutions that do not provide doctorates programs and grants are quickly pursuing fundraising opportunities (Rader, 2000).

Accounting for Librarians- Evidence Based Practice

The article,”Evidence based library and information practice”,  states that it is not necessary to review evidence-based practice when one is writing for the Evidence based library and information practice. Some researchers insist that it is obvious for librarians who deal with medical information to use the paradigm of evidence based practice in their profession (Brophy, 2007). I agree with this argument because the medical sector is one of the most dynamic fields .This means that the professionals in that field have to keep up dated with the trending factors .Medical professionals have to be guided by evidence-based practice in their decision making for diagnosis and treatment (Holt, 2002). Evidence-based librarianship aims at enhancing library practice (Brophy, 2007). This is made possible when librarians use the best evidence available at their disposal together with the pragmatic perspective that is acquired from librarianship experience. Evidence-based librarianship allows librarians to use the most rigorous forms of evidence in decision making. The strength of the article is revealed in its acknowledgement of the importance of using more rigorous evidence. However, the article emphasizes on medical evidence .Don’t other fields need to be associated with complete and rigorous evidence?


Marketing & Strategic Engagement with End Users

In the world of information, end users have to know about the most current information. They also need to be aware of the procedures that are appropriate for handling new information as it comes in. Librarians are required to handle advanced information technology, altered organisation cultures and staying updated with virtual counterparts. They have to devise new ways of attending to end users. Librarians need to be aware of the cultural similarities and disparities in the clients (Reeves & Tillmanns, 2012). This ensures that they learn new knowledge, skills and techniques on a regular basis. Currently, the knowledge and skills that people acquire are bound to change with time. Knowledge that is acquired today may be replaced with another the next minute or tomorrow. Acquisition of information entails a continuous cycle in which end users change from a position of uncertainty to certainty (Watson-Boone, 2000). Information professionals have to continue learning in order to keep up with newer trends. This is true for Librarianship because the librarians are required to provide access to accurate meaning of information to the end users.

New librarians have to practice the theories they learn and apply the acquired skills and knowledge in order to establish their trustworthiness to the end users of the information they deliver. With time, they are able to transform their experiences into knowledge, attitudes skills, values, beliefs and attitudes. The professionals in the information field are able to add empirical knowledge to practice hence they are able to market themselves to end users and engage with them (Watson-Boone, 2000).












Brophy, P. (2007). Narrative based practice. Evidence based library and information          practice, 2(1), 149-158.

Eldredge, J. (2006). Evidence-based librarianship: the EBL process. Library hi tech, 24(3),            341-354.

Holt, G. (2002). God–and the devil–are in the details. The Bottom Line, 15(4).

Rader, H. B. (2000). Fundraising in academic libraries: the United States experience. The Bottom             Line, 13(2), 93-99.

Reeves, M., Love, C., & Tillmanns, P. (2012). Your strategy needs a strategy. Harvard     Business Review, 90(9), 76-83.

Watson-Boone, R. (2000). Academic librarians as practitioner-researchers. The Journal of academic librarianship, 26(2), 85-93.











Trust and Trustees (Unmarried Partners and Property Ownership)

March 10, 2017

How Edward Could Claim the Extra £250,000


It is a common phenomenon to find couples living together living together for an indefinite period of time before they can marry. Some of these couples will end up not marrying even after the long time they have spent living together. However, our main concern is about property ownership and division when these couples separate or fail to marry. It should be understood that despite the time duration taken by these couples while leaving together, the law still treats every individual as a separate individuals when matters of property arises (News, 2013). This therefore means that these people lack guaranteed rights and responsibilities when their relationship comes to an end. It is therefore advisable that people be extra keen when buying property either jointly or on their own while in relationships to avoid problems when it comes to claiming and sharing such properties incase their relationship ends.

The following is an outline on what Edward (a client having problems on sharing of property after they broke up his spouse) could do while observing some set rules and regulations while making a claim on proceedings of property sold by his spouse. Edward’s case is that type where both spouses contributed towards acquisition of the property but only one of them is the owner. The situation further gets complicated when Lucy marries another person and they proceed to purchase some property which they jointly register it in their names. At the same time, Lucy is experiencing some financial problems which she informs Edward when he claims for more cash from the proceeds.

Edward has the right to claim a share in the proceeds obtained from selling the house despite the fact that he is not a joint owner of the property. This is following the fact that Edward contributed in one away or the other during the bringing up of that house. We learn that him being a self-employed builder he had to sacrifice his time from the beginning of 2012 to the end of 2013 while constructing the house. He additionally pent £200,000 of his savings for all costs incurred during the construction period. After this he continues contributing equally to all household expenses.

The general rule on property division demands that property in ownership of one spouse, in a cohabiting relationship, is not subject to division with the other spouse incase the two part ways. This is basing on the fact that cohabiting couples are treated as separate individuals. The individual whose name this property was registered retains full ownership of the property. However, an allowance s provided when the other partner may have contributed financially like paying for mortgages, renovations or took part in its purchase. In this case any formal or informal agreements between these two partners on how the property was to be shared are used. If, in any case, these agreements show that the property was intended to be owned jointly, then it is the mandate of these spouses to make arrangements on how they will share their property. The other partner could be forced to pay the amount the other partner contributed towards the purchase or maintenance of the property. For Edwards’s case, Lucy observes these by paying him back his £200,000 plus an additional £50,000 for as compensation for resources lost during the construction period. This does not go well with Edward who feels that he should have received half of all the cash obtained from selling the property, something I agree on basing on some reasons (Unmarried Couples Rights, 2016).

The law of equity is one way of claiming fairness in division of property pertaining unmarried spouses when they terminate their relationship. Through the law of equity, a spouse is offered various special exceptions to rules concerning property sharing cohabiting couples with one spouse in ownership of the property. All these exceptions are derived from unjust enrichment which is a claim filed by one of the spouses claiming unfair division of property after their break up. It is through this unjust enrichment that the other spouse could demand for additional compensation or equal sharing of property previously owned by the other spouse. However, there are several things to be observed before claiming an unjust enrichment against another spouse (Neyers, McInnes, & Pitel, 2004).

There are various things to be observed when claiming an unjust enrichment against your spouse. For one to make a successful unjust enrichment claim against the other spouse, they should be able to show three of the following to a court of law. One, the spouse should show a gain obtained by the other spouse from the property or proceeds of the property. Secondly, he or she should also be able to show a loss or losses incurred by him or her on the property. They should also be able to show that both clients contributed in one way or the other towards the property. And lastly they should be in a position to justify that there is no legal reason for the other spouse to enjoy gains from the property or losses pertaining to the property. After ensuring that the other spouse’s circumstances meet the above mentioned condition, he or she can then comfortably claim an unjust enrichment against their spouse (Bits of Law, 2015).

Proving unjust enrichment claim against could at times be difficulty when there is proven agreement or universal partnership between the partners concerning ownership of the property. Like in the case of Edward, Lucy and Edward had not entered into entered into any form of agreement concerning property division and ownership. During registration of their house, Lucy comfortably registers it in her name with no restrictions. However, Edward is still entitled to claim the extra £250,000 from proceeds obtained after Lucy sold the house. This could be achieved basing on the following reasons (Neyers et al., 2004).

To start with, Lucy and Edward are like married couples given the fact that they had stayed together for more than two years. This is evidenced by the fact that they had been staying earlier own together before they developed the idea about getting a home, which then took two years. Therefore, basing on Family Law Act of British common law, these two individuals were like married couples and share legal rights just like other married couples. Among these rights include; the right to 50% share of property, debts, and even inheritance of a spouse’s property. It should however be understood that property acquired before they started having a relationship are not subject to this unless the other spouse contributed in ways of skill, finances or any other way (News, 2013).

Basing on the provisions of the family law act, Edward is entitled to a fifty percent share of proceeds of sale of their property. It is therefore a rightful thing for him to demand an extra £250,000 in addition to the earlier amount. The property in question was also obtained when the two were in a relationship. This is in full support of Edward’s claim on the fifty percent share in the house despite the fact that it was registered in the name of Lucy. Furthermore both the two individuals contributed in equal amounts towards the house. Lucy was responsible for purchasing land on which the house was house was set up while Edward was responsible for its construction, each spent £200,000.

The common law also offers Edward the chance to claim damages suffered after the sale of the house. For instance, Edward used his savings in the construction of the house. He also quit his job for two good years, which was an agreement between the two, in order to foresee the building of their house. However, when it comes to selling this property, Lucy fails to consult him, goes on to sell the building and does the unimaginable by giving Edward a quarter of the proceeds from the sale of the building. Compensation of £50, 000 is not sufficient for compensations for time lost and profit during the two years Edward did not report to work (Papworth, 2013).

A court of law could make various orders depending on claims of spouses presented before them. Taking Edward’s case as an example, the court could order compensation of losses accrued during the time of construction resulting from the sale of property. This would mean that Edward might get the extra £250,000 he is demanding for depending on agreements or conditions the two had. The court could also do the unimaginable by demanding that Lucy builds Edward a new and similar house on land similar to that on which the two had constructed their building. This however, would be the hardest to be achieved given the fact that Lucy is currently experiencing financial constraints.

Injunctions could another option offered by the court of law. However, Edward will have to meet several requirements before injunctions to stop operations pertaining to the sale of the house. With these injunctions, Lucy would be barred from completing or engaging in activities related to the sale of the house, finalizing buying of her new house, and even clearing her debts using proceeds from the sale of the house. For Edward to succeed in obtaining an injunction against Lucy, he should be able to justify to the court that his claim is a serious question to be tried. More so he should prove that compensation offered by his spouse is not adequate to cover all the losses suffered (Anderson, 2013). He should therefore insist and with evidence that during the two years he was out of work he lost a lot of money that is not close to the £50,000 offered by Lucy as his compensation.

There are several types of injunctions that could be considered by a court of law during the hearing of Edward’s case. One such injunction would be search orders, which basically is an interim but mandatory injunction aimed at preserving evidence from destruction by the defendant. This type of an injunction is exercised without notice and could be used to stop any transactions while holding evidence for the case before Edward arrives from China. The other type of injunction that could be applied is the freezing injunction. This is also applied without notice with the main aim being to stop the defendant from getting rid of money or assets before judgment is made (Freezing orders, 2016). For Edward’s case, this could be a boost given the fact that Lucy is married at the moment and could be tempted to transfer the remaining cash to his husbands account in order to deny or claim spending it on all expenses incurred by her businesses.

The law holds that property owned by one spouse is subject to division if it was acquired by spouses who had constructive trust. Constructive trust could include common intentions for benefit from the property, direct contributions to the property, indirect contributions, and conduct developed in the course of their stay. In this scenario Edward is only required to express the constructive interest behind his claim. One way of justifying this would include providing evidence on receipts, invoices and any transactions done during the construction of their house. The other would support offered during the process of buying the piece of land and registration in the name of Lucy. Lastly the claim on constructive trust may be developed on the fact that the two agreed to build a home for themselves and continued contributing on household requirements in equal capacities, a proof for they both shared common intentions for benefit from the property (Unmarried Couples Rights, 2016).

Liability of strangers is crucial when it comes to matters of property ownership and breach of trust. The same could also be used by Edward in his pursue for an additional pay from proceeds obtained on the sale of the house. As we know, Jamie is a stranger in this case and takes part in buying a house with Lucy from funds obtained from the sale of the other house. Through the law, there are two grounds on which strangers could be held liable for their actions with trustees. Such grounds include; involving themselves in deals with property from breach of contract or having an involvement with dishonest assistance in association with a breach of trust. In this case, Jamie could qualify for liability on grounds of his involvement with property breach of trust. (Hudson, 2007).

I this case, Jamie should be held liable for involvement in the purchase of their new home. Bearing in mind that Edward had not been consulted about on the sale of their previous home Jamie still allows Lucy to go ahead and purchase a new home. It makes the matters worse by having this property registered in joint ownership of Jamie and Lucy, something that was not the case during Edward’s time. It therefore means that Edward has been bared out of the new property acquired by Lucy from money obtained from the sale of their previous house. The fact that Jamie has knowledge of the breach of trust between Lucy and Edward qualifies him to be personally liable for the loss of property or trust between the two (Bits of law, 2015). Jamie might therefore take part in refunding Edward basing on this claim.

Jamie is an opportunist who like other opportunists would not allow golden chances to pass them. He quickly seizes the opportunity when it presents itself that Lucy was willing to sell their previous house and buy a new one. He avoids questioning about Edward (the person responsible for building the house) on whether he could claim extra cash when offered the £250,000. What Jamie did was convenience Lucy and has the new house registered in both their names despite the fact that he did not contribute even a coin. Ironically, Edward who contributed equally with Lucy in the older house was never involved in the ownership of the property. Basing on this, Lucy and Jamie owe Edward.

Trustees are endowed with the responsibility of protecting all property entrusted to their care and distributing all benefits obtained from such properties. Trustees are not expected to use the trust property for their sole benefit or any other person who is not a beneficiary. They are also not expected to fail to take action when breach of trust is being committed by another person among other things. A trustee may therefore be held liable in the case where the trustee goes against their expectations, neglect their duties or walk away with the property without consent of the other (Hudson, 2007). The same case applies to Lucy who is left in the ownership of a house when Edward leaves for China.

Lucy should be held liable for breach of trust following her acts of neglecting her duties and going against her expectations. Breach of trust is observed when Lucy sells their house without the consent of Edward and yet they both contributed equally towards the house and have been in a relationship for more than two years. She also goes ahead to use the proceeds obtained for her sole gains. She uses some of the cash obtained for paying losses and expenses of her business (a significant amount of about £225,000 payment to her bank). While referring to the duties of a trustee it is against the law for a trustee to walk away with property without informing the other party or using it for self-gains (Hudson, 2007).

Including Jamie as a co-owner of the newly acquired house is against duties and expectations of a trustee. Any trustee is not expected to use trust property for the benefit of other people who are not beneficiaries to the property. Jamie is a stranger in this case, but he might have convinced Lucy towards the purchase of the new building worse enough registering it in their names. Sixty percent of proceeds from the sale of the house (£600,000) are used in the purchase of the new house. By doing so, Lucy goes against the law on the duties of and expectations of a trustee. She should therefore be held liable for breach of trust between her and Edward and be responsible for losses encountered by Edward (Hudson, 2007).

Any person occupying a fiduciary position is expected to act in good faith always. They are therefore not expected to generate profit or benefits for his or her self or a third person without the consent of their informed principal. Failure to observe this may land this individual into liabilities of fiduciaries which are similar to those of trustees. The individual my then be held accountable of all actions committed and any resulting impacts to the other part. If there may be losses suffered by the other part from such actions, he or she may be asked to compensate them (Hudson, 2007).

Lucy fails to meet expectations of a person holding fiduciary position. She puts her self-interest before everything during the sale of their house. As observed in early scenarios she does not involve Edward during the sale of their house and her inclusion of Jamie, a second party, when purchasing the other house. Her actions of using some of the proceeds obtained to pay some of her company’s losses and liabilities are also against the fiduciary duties (Hudson, 2007).


It is apparent that Edward is right to claim an additional £250,000 payment from Lucy of the proceeds basing on some if not all considerations aforementioned above. We learn that Lucy during the sale of her older home and purchase of the new one violated some rules and regulations regarding property ownership and sharing. She failed to observe some critical steps like informing Edward before selling their property, one of the contributors of breach of trust between them. Her ignorance on rules governing property ownership among cohabiting couples that have stayed for more than two years together could also have contributed significantly. This might have been the reason as to why she offers Edward a quarter of the proceeds rather than half as stipulated by the Common Law of British Columbia.

From my point of view, Edward is entitled to an extra £250,000 to complete the fifty percent right in division of property by married couples. The same rule applies to couples who have stayed more than two years together even when not married. All is required of him is filing a claim to demand for this. He could also claim unjust enrichment against Lucy for her acts that resulted into unfair division of their property. Through his lawyer, Edward might claim compensation from Lucy on the basis of breach of trust between him and Lucy through fiduciary and trustee liabilities. Liabilities to strangers (which he would use against Jamie) could also offer an upper hand in Edward’s claim.

Division of Family Home in England and Wales for Unmarried Cohabiting Couples

A man and woman living together in a stable sexual relationship but not yet married are often referred to as c law cohabiting spouses. These spouses as we know have limited laws protecting them in terms of property ownership, liabilities, and rights. However, when it comes to England and Wales these spouses are viewed in a different perspective. In England and Wales these spouses are protected by the common law of British Columbia and hence their name common law spouses. This rule stipulates that couples who live together for at least two years also have same legal rights like those who are married. Thanks to the efforts that resulted from uncertainties on what really qualified marriage (Fairbairn, 2016).

Unmarried couples in England and Wales still lack protection from the court when break ups occur. Despite the fact that a court of law takes into account the circumstances and history of their relationship in ensuring fair division of assets, everyone still has the right to maintain all their acquired property. Courts still find difficulties in determining on proper division of properties in the cases where there are no clear circumstances. All in all, solutions on division of property are reached basing on some provisions in the law.

The general rule on property ownership holds that property registered by one spouse is not subject to sharing or division in case the two separate. However, this rule does not apply in all circumstances pertaining to their marriage. For instance, if by any case, there were agreements between the two spouses on division of property. The same rule does not apply to property acquired by both spouses but registered one spouse’s name (Unmarried Couples Rights, 2016).

The family law act holds differently when it comes to property ownership by cohabiting spouses with at least two years in their relationship. Through provisions of the family law act these spouses are given same legal rights as married spouses. Among these rights is the 50/50 division of property in case they break up. Therefore, a house or household property acquired during their relationship might end up being divided in equal amounts between them. However, this rule does not apply to scenarios where property was acquired one spouse before they entered into a relationship (Papworth, 2013).

A spouse has no legal rights to claim shares in property they found their other spouse already in possession even if they may contribute to it in one way or the other. Take for instance, a lady move into a house owned by a man, even if she may contribute to paying mortgages or paid in other form. Such ways may include staying back at home to look after children or paying for household expenses. This is owing to the fact that there is no law or provision regarding rights for personal maintenance even she might have offered financial support for over  five years during their relationship. However, they could enter into an agreement or the other spouse in ownership of the property voluntary agrees to share with the other (Unmarried Couples Rights, 2016).

Cohabiting spouses in joint ownership of family home have a fifty percent legal right claim according to English law. Despite the fact that one of the couples might have contributed more than the other, both couples are entitled to 50:50 share of the property. However, there are provisions for spouses who had entered into a legal agreement on how they were going to share their property. In this case, spouse with the highest contribution might be entitled to more than half ownership of the property. A spouse may also challenge against the 50:50 share rule, something that might not be that easy or very much expensive (Papworth, 2013).

Division of Family Home in the Republic of Ireland following Civil Partnership Certain Rights and Obligations Act 2010

The law in Ireland is clear on the differences between a family home and that of a shared home. According to the civil partnership and certain rights and obligations act 2010 a shared home is any dwelling or place of stay that civil partners stay. A family home on the other hand refers to a place of residence to a married couple. Ordinarily most family homes are registered in the name of both spouses. This has been achieved owing to the fact that it is among the conditions of mortgage used to when buying homes. For the few homes owned by one spouse, there are no restrictions or payment of stamp duty or registration fees during the process. The same applies to shared homes that are in the sole name of one spouse (Family and shared homes, 2016).

The Family Home Protection Act of 1976 offers protection for family homes owned by married couples through amendments made by the Family Law Act of 1995. Shared homes are also offered protection just like the case in family homes. This protection denies a spouse the ability to sell, mortgage or lease their family home without the consent of the other. It is there possible for a spouse or a civil partner to apply for court orders to restrict the other partner from using their family or shared home for self-gains (Fairbairn, 2016).

On separation of spouses, whether they were married or civil partners, there is need for agreements on who will be left to occupy the home. In case the two fail to agree the court could intervene to help with a property adjustment order. in this order the court will spell out the right person to live in their home and the given time they may live there. The court will also outline the person with ownership rights and how much each partner owns with regard to their house. In most cases the spouse living with children would be given the home to leave in as opposed to the other (Family and shared homes, 2016).



Fairbairn, C. (2016). “Common law marriage” and cohabitation (Rep. No. 03372). House of Commons Library.

Hudson, A. (2007). Liability for dishonest assistance in a breach of fiduciary duty. Journal of International Trust and Corporate Planning, 14(1), 23.

News, C. (2013). Common-law couples as good as married in B.C. Retrieved December 31, 2016, from http://www.cbc.ca/news/canada/british-columbia/common-law-couples-as-good-as-married-in-b-c-1.1413551

Neyers, J. W., McInnes, M., & Pitel, S. G. (2004). Understanding unjust enrichment. Hart Publishing.

Papworth, J. (2013, March 09). Why a cohabitation agreement is essential for non-married couples. Retrieved December 31, 2016, from https://www.theguardian.com/money/2013/mar/09/cohabitation-agreement-essential-non-married-couples

Anderson, M. (2013, May 05). Damages are not an adequate remedy: go directly to injunction. Retrieved December 31, 2016, from https://ipdraughts.wordpress.com/2013/05/04/damages-are-not-an-adequate-remedy-go-directly-to-injunction/

Family and shared homes. (2016, February 8). Retrieved December 31, 2016, from http://www.citizensinformation.ie/en/birth_family_relationships/separation_and_divorce/family_home.html

Unmarried Couples Rights. (2016). Retrieved December 29, 2016, from http://www.sheppersonssolicitors.com/unmarried-couples-rights.html

Bits of law. (2015, August 13). Retrieved December 31, 2016, from http://www.bitsoflaw.org/trusts/management/revision-note/degree/proprietary-personal-remedies-against-third-partie

Freezing orders: a quick guide. (2016). Retrieved December 31, 2016, from http://uk.practicallaw.com/6-205-5417

Internationalization of JBS

March 7, 2017



Table of Contents

1.0 Introduction. 3

1.1 Background of the Case. 4

1.1.1 Key Patterns and Trends in International Business Activity. 5

2.0 Internationalization Strategies. 6

2.1 Identification of Current Internationalization Pattern. 7

2.2 Theories of Internationalization. 8

2.2.1 Sequential Theory (Uppsala Model) 9

2.3 Assessment of the Current Internationalization Strategies. 10

2.3.1 Joint venture. 11

3.1 Recommended Future strategic direction. 12

3.1.1 Proposed Strategy. 12

3.1.2 Porter Generic Strategy. 12

3.1.3 Ghemawat’s Strategic Choices. 13

Bibliography. 14


1.0 Introduction

This is a report based on J.B.S, S.A, a Multinational Company headquartered in Brazil. It presents a theoretical analysis of the process of internationalization by the Brazilian multinational over the years. It will identify and critically evaluate the strategies used by the company to internationalize. In the first section, the report will give an introduction of the company and what it entails as a ‘Story’. It will then identify some of the key patterns and trends in international business activity that the company is engaged in.

In the second section of this report, a critical analysis of internationalization strategies that the company is engaged in will then be given followed by the identification of the current internationalization pattern. The report will then look into the theories of internationalization based on the pattern already identified and then give a critical assessment of the current internationalization strategies of the company. This will finally be followed by a critical appraisal of the success of the current strategy used by the company in addressing the external influences on international business.

In the third section, the report will give recommendations for future strategic direction for the company to attain competitive advantage. This will mainly be based on the analysis and engagement of models with a proposition of the most suitable and relevant internationalization strategy that would give it competitive advantage. Using the Porter Generic Strategy, the report will classify the proposed strategy and then it will look at Ghemawat’s Strategic choices of adaptation, aggregation and arbitrage.

1.1 Background of the Case

Brazilian food Company, JBS, is the largest (by sales) meat processing and producer of meat in the world with engagements in the production of chicken, beef and pork and the sale of by-products from the processing of the meats (JBS S.A. 2016). The main headquarters is in Sao Paulo. The company was founded in Anapolis, Goias in 1953 and over the years has expanded to 150 industrial plants all over the world. It has expanded to establish itself in five continents with facilities of production in Australia, Italy, Argentina, Brazil, Uruguay, United States, China, Mexico, Russia, among others (Torres, 2011). With the responsibility of over 120,000 employees, the company has become significant in participating in the economy of countries it is present in (JBS 2012).

Initially, JBS was established by rancher Jose Baptista Sobrinho as a slaughtering business in 1953 killing just five animals per day, with the founder’s initials making up the company’s name (The Economist 2011). The business began to expand when Brasilia, Brazil’s capital was established bringing in a new market within the reach of the ranch. During the late 1960s, it expanded into various slaughterhouses and grew in the 1980s to incorporate the whole of Brazil and purchase of other companies of meat processing (JBS S.A. 2011). In 2007, JBS became a company held by the public, receiving a major investment from the Brazilian Development Bank (Blankfield 2011).

In the years that subsequently followed, the growth of the company in the beef sector has substantially grown to make the company the world’s largest through the acquisition of various food companies and stores in brazil and around the world. This includes the acquisition of the U.S. Company Swift & Company, the third largest U.S. pork and beef processor in 2007 for US $225 million and renamed it JBS USA (Barreto 2007). JBS, S.A, leads in slaughter capacity in the world with 51.4 thousand head daily and continued focus on processing, operations of production, and export plants both at the national and international levels. The meat giant has an annual sale of around US $45 billion, incorporating various international markets (Paul 2016).

1.1.1 Key Patterns and Trends in International Business Activity

A year after its creation in 2005, JBS began internationalizing through the acquisition of Swift Amour in Argentina. With a mutual border being shared and being the second largest processing region of land mass in Latin America, Argentina became the most appealing market. According to the report by the Brazilian Beef Export Industries Association, the beef exports of Brazil surged in 2006 to 27% from $3.13 billion in 2005 to reach $1.39 billion in 2007 (Barreto 2007). This was due to the business ventures of JBS. With the acquisition of Swift and Company in 2007, JBS began a fast rising global business. The new acquisition gave JBS the opportunity of entering into the pork market with the feature of an impressive performance to make it the third largest processor and producer in the United States of this type of meat. The company’s portfolio expanded to include the worldwide use rights of the Swift brand. In 2008, Smithfield Foods’, a beef business was also acquired and renamed JBS Packerland.

Earlier on, as the global financial crisis hit the sector, many of the main companies exited giving JBS the opportunity of buying some of the plants and in 1999, as the market stabilized; the company put all its focus on its operations in the foreign markets, greatly strengthening its internationalization. Furthermore, as the consumer market expanded, the operations of the company also expanded due to the attractive market providing high margin gains. However, as per the company analysis, the market now has the tendency of decreasing due to the more difficult task of selling to consumers who are more responsible and conscious, seeking for green products and only buying products from companies offering products according to the animal health standards.

There were reports in August 2010 that it was the consideration by JBS to sell some of the eight slaughterhouses in Argentina that it owned due to the export restrictions and scarcity of livestock. By 2011, JBS tried to bid for control of a meat business, Sara Lee Corporation, though it still struggled ending up unsuccessful. Having the takeover of Sara Lee, JBS would have consolidated its power as a global integrated producer of meat to rival its competitors. In 2015, JBS paid US $1.5 billion for Moy Park, a poultry company in Northern Ireland and recently filed with the Securities and Exchange Commission (SEC) in New York for documents outlining its plans of effectively moving its parent company to Ireland (Lewis 2016).

2.0 Internationalization Strategies

As a company, JBS has gone through an internationalization process like other companies. For most of the beef industry companies in Brazil, there is poor consolidation or tendency of being family oriented with reservations for local consumption (The Economist 2009). However, JBS went outside the box with a shopping spree of companies. Its main success factor has been its understanding of the goal it has and its mentality of expansion.

When using internationalization strategies, the multinational companies need to have an understanding that they are more than just a business sector since they also engage in the political factor (Fosgren 2008). The company needs to have a perfect and clear understanding of the environment and legitimacy has to be established for each subsidiary. This entails the society’s perception of the company as successful, respectful and honest.  Hymer (1976) noted that it is significant to have an understanding of the border differences meaning different cultural values and legal systems that should be adapted to by the companies.  In 2008, JBS had a case where 100 Muslim workers were fired and complained that they were not granted a break by the company for the Ramadan prayer hours causing a lawsuit against JBS (Candela, 2007). Therefore, it becomes important to understand the values and norms of others and ensure they are respected and followed so that legitimacy can be maintained.

2.1 Identification of Current Internationalization Pattern

In 2010, JBS posted an increase of almost 60% in year-over-year revenues, partly driven by its business acquisitions, ranking it as the third largest company in Brazil by revenue. JBS, under Joesley Batista undertook an aggressive strategy of international expansion leading to acquisitions and alliances in Australia, Argentina, the US and Europe. By late 2010, JBS got into a joint venture of 50/50 with Jack Link’s Beef Jerky, a top maker of US meat snack brand. Simultaneously, Jack Link’s made a purchase of a beef jerky manufacturing plant  from JBS with an agreement made to supply raw meat for processing, packaging and distribution to Jack Link’s.

There have been significant acquisitions also made by JBS like the taking over of Swift in 2005 and Pilgrim’s Pride in 2009. In 2007, JBS purchased Swift in the US in order to establish its operations in other regions of the world allowing the company to have more effective dealings with the currency fluctuations and have better management of sanitary restrictions and other barriers of trade (Bell & Ross, 2008). It also purchased 50% of one of the largest beef products producers in the European market, Inalca, an absolute leader in the beef industry of Italy. This led to operations expanding to Europe, Africa and Russia. This was a representation of a strategic alliance costing 225 million euros, creating important synergies between the selling channels and products. It also led to the introduction of products by JBS to key markets throughout Western Europe and brought Inalca-JBS into close contact with the main beef suppliers of the world. This was an important initial step represented by the acquisition for the future growth of JBS in the market of Europe (JBS 2008).

2.2 Theories of Internationalization

The internationalization process of JBS clearly shows that it follows the establishment chain of the Uppsala model (Johanson & Vanhle 1977) where it first did exportation through agents in Brazil to a point where it could acquire 21 plants in Brazil and five plants in Argentina meaning a capacity of slaughter of around 22,000 head of cattle compared to 1970 with 500 cattle (Torres 2011). This is then followed by setting up of sales subsidiaries along the facilities of production internationally.

With economic theories explaining the process of internationalization through the aggregation level of macroeconomics, firms and industries, the theories of international operations give explanations of the variety of plants located internationally. Porter (1986) noted that the internationalization process has been studied from the competitiveness perspective. The internationalization decisions made by companies like JBS can be driven by a variety of motives especially on internalization of the production activities in terms of market transactions and ownership. JBS has proven to use indirect exporting methods. In this method, a company does not have an international activity by itself, operating through intermediaries in the foreign market for physical distribution of services and goods. JBS utilized the sequential theory in its internationalization strategy.

2.2.1 Sequential Theory (Uppsala Model)

The Uppsala model is a theory explaining how companies intensify gradually in their activities in foreign markets. In this model, the company is able to gain experience from the domestic market before moving into the foreign markets. They also start foreign operations from geographically or culturally close countries and gradually move to more distant ones. The Uppsala model is based on sequential theory. It was developed by Swedish researchers Johanson and Vahlne (1977) and Johanson and Wiedersheim-Paul (1975) as a more independent model of explaining the sequential steps in the direction of increasing foreign dedication. The Uppsala Model of Internationalization distinguishes various steps of getting into an international market that cannot be independently viewed by the situation of the company, the market knowledge and the market itself. The model involves four steps (Hollensen 2007);

Step 1: Sporadic export (export activities are irregular)

Step 2: Export mode (export through independent representation)

Step 3: Establishing a foreign sales subsidiary

Step 4: Foreign manufacturing/ production

The proposition of the model is that foreign sales start with export orders occasionally given and followed by regular exports. Through the observation of the Swedish researchers, it is indicated that companies usually begin their expansion in a psychic nearby market. Through this, there is enhanced knowledge of the market and more resource control where gradually, more experience is gained and better resources acquired for expansion to the more distant markets.  JBS began by acquiring the Argentinian company Swift Amour in 2006, internationalizing through the acquisition. With a mutual border being shared and being the second largest processing region of land mass in Latin America, Argentina became the most appealing market.

In the subsequent years that followed, it acquired Swift in the US to make it the third largest beef processor in the US after Tyson Foods and Cargill Meat solutions, with holdings in Europe, Australia and the US in addition to Argentina and Brazil. JBS also acquired Tasman Group, an Australian Company in 2008 to consolidate its leadership in the meat industry of the world. Through the acquisitions, JBS represented the investment plan for constructing a sustainable platform for production, slaughter, and commercialization of meat in Australia and US. The model’s core explanation is that market knowledge increase leads to an increase in market commitment.

2.3 Assessment of the Current Internationalization Strategies

Through its international acquisitions, JBS has purchased various other companies and gained consumers in the foreign markets. This illustrates a form of internationalization that creates competitive advantage for the company. JBS also used the Foreign Direct Investment (FDI) where a company physically invests in other countries. Through this method, it was able to gain the greater control level over its information and technology propriety.

The production structure of JBS is embedded in the worldwide consumer markets with the installation of plants in the four leading beef producing nations in the world; Brazil, the United States, Argentina and Australia, to serve 110 countries through exportation. An announcement on September 16, 2009 by JBS indicated that it had made another acquisition of one of three market leaders in Brazil, Grupo Bertin, consolidating its world position as the largest producer of beef. The transaction was assisted by the banks Santander Brasil and JP Morgan Chase. 64% of Pilgrim’s Pride was also acquired on the same day for a US $800 million bid, establishing the position of JBS in the industry of chicken production. However, JBS currently owns 75.3% of the company.

2.3.1 Joint venture

De Propris (2009) noted that a company can utilize various ways to FDI through the acquisition of an existing company, merging and establishing a foreign operation or creating equity joint ventures. JBS chose the use of joint ventures by creating a new identity where both the initiating partners actively take roles in making decisions and formulating strategies.  The joint ventures make companies gain economics of scope and scale in value by adding activities globally. The company is able to secure access to the technology of its partner and accumulated the learning process effectively used for future competition in the industry.

With the JBS, the internationalization process was generally natural as it was a joint venture with the meat processor Bertin. The realization of the company was that the exchange rate was the main factor associated with the price of sale of beef internationally. For instance, while a kilo of steak in Brazil is sold by US $20, the foreign market sales reach US $20, making the international sales more profitable than in the market domestically. The exports by JBS almost entirely go to Russia in its industrialized production. The joint venture formed between JBS and Bertin was a partnership to enable control of all the operations of Bertin by JBS. The two companies gained and strengthened their market position in the world. The international joint venture that was established as a partnership sought synergies between the companies and explored the best skills of each entity and thus created more competitiveness in the external market.

3.1 Recommended Future strategic direction

3.1.1 Proposed Strategy

Based on the analysis and engagement of models, JBS can utilize a proposed internationalization strategy that would be most relevant to attain competitive advantage. By focusing on mergers and acquisitions of competitors that are less efficient and on the global markets, the best strategy would be that of global consolidation.

3.1.2 Porter Generic Strategy

Porter (1985) proposed the Generic Strategy which can be utilized by JBS. The relative position of a company within its industry determines whether the profitability of the company is below or above the average of the industry. When the average profitability in the long term is above average, then it gains sustainable competitive advantage two basic types of competitive advantage can be possessed by a company; differentiation or low cost. These two, in combination with the activity scope for which the company seeks to achieve, leads to three generic strategies in the achievement  of above average performance in the industry; differentiation, cost leadership and focus.

The cost leadership strategy can also be utilized to set out to become a low cost producer in the industry. Depending on the industry structure, the low cost production can find and exploit sources of cost advantage. The focus strategy can also be used by selecting segments of cost advantage to exploit the differences in cost behavior.  Using the differentiation strategy, JBS can seek to be unique in the meat industry along dimensions that buyers widely value by selecting the attributes of many buyers. This will be efficiently done through the generic strategy of global consolidation. In this way, the domestic markets would be large and fast growing. This strategy will enable excellence in production and design to meet the needs of consumers for the company.

3.1.3 Ghemawat’s Strategic Choices

Ghemawat’s AAA framework will be adequately used by JBS to gain competitive advantage. The framework gives three generic approaches of value creation globally; adaptation, aggregation and arbitrage.  Adaptation seeks to increase the market share and revenues in tailoring the components of the business model for the company suiting the preferences and requirements of the locals. Arbitrage exploits economic differences between the markets by locating various parts of the supply chain while aggregation focuses on the achievement of economies of scope and scale through the creation of efficiencies by typically involving the standardization of a significant portion of value grouping and proposition. JBS can utilize focus to reduce the need of adapting, innovation to improve on the existing adaptation, design to reduce the cost of adaptation and externalization to reduce the burden of adaptation. Using the vertical focus strategy, JBS will limit its direct involvement to specific supply chain steps while outsourcing others. It will be able to sell its products globally from different countries and earn from the price differences. While globally expanding, JBS can have an emergence of a new scale from the offered acquisitions offering competitive advantage but only if the individual resources and operations work in coordination with each other. This will be a form of aggregation.






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Organisational Behaviour

March 7, 2017



The article is trying to bring the issue of technology. In modern life, companies have advanced regarding technology and are using any device to make sure that their staffs are up to date with the current and advanced technology, (Fitzsimmons, and Fitzsimmons, 2013). According to the article, it is seen that some employees are using smartphones to perform organizational duties during off hours or at home with their families. It shows that any given person can use technology to work from any geographical location and meets the organizational objectives, (Commoner, B., 2014)

Also, the article is trying to bring in the limelight the issue of communication. Since workers are working from their homes, it means that they are doing various things in a contemporary way. For example, when an employee uses a smartphone during off hours, it implies that he or she is only concentrating on the phone or multitasking, (Knapp, Vangelisti, and Caughlin, 2014). But according to the article, it is witnessed that there is the likelihood of the family conflict of interest. Considering the issue of conflict of interest, it can be said that, workers only pay attention to the work issue and forget their families, (Abreu, 2014). Furthermore, for a person to work on a smartphone, it means that he or she must make communication with the organizational staffs for the work to be delivered, (Broadbent, 2013).

Also, the article is speculating the issue of performance. It’s the duty of every person to provide to their families and work respectively. Therefore, when an employee is working at home for the purpose of meeting the organizational goals, he or she is doing do so to meet the demands of the organization and family at large, (Petchsawang, and Duchon, 2012). It brings the issue of a relationship between working for an organization and meeting family needs. If the employee meets the objectives of the company, in return he or she will get a pay which will be used to cater for the family. Catering for the household means the person is performing the family roles.

Overview of the article

The article is trying to portray the challenge of time management. It can be seen that most of the employees are using smartphones at their homes to do companies work. Although it is necessary for the benefit of providing for their families, it might be of great significance if they could have used that particular time at home with their families. It could have avoided the conflict of interest that emerges from its either work or family.

Methods of collecting data

According to the article, quantitative method of collecting data was used, (Bernard and Bernard, 2012). It means that most of the methods that were employed were questionnaires, observations, interview to mention but a few, (Creswell, 2013). The article shows that the sample size was seventy employees and the data point ranged from 265 to 280.

Main content of the article

The article is focusing mostly on the issue of communication. Without communication, it’s hard to make things running either at home or work. It means that it will be complicated to realize the needs of the family and at the same time achieving the demands of the firm, (Eisenberg, Goodall Jr, and Trethewey, 2013). To avoid the issue of communication, it is essential to employ the time management skills. Time management helps an individual no do the right thing at the right time, (Forster, 2014). For example, if the employees did not perform the organizational activities at home or during the off hours with their families, the issues of conflicts could not exist. However, since their primary aim was to meet the needs of the organization and family, they had to juggle between the two. Since family issues are directly proportional to the job issues, the employees have to go family forego and perform the job-related tasks.

In the end, both the organization and family will benefit since the employee will have met the organizational goal and satisfy the demands of the family. Contrary to this, he or she would be a victim of social problems. Although he or she met the needs of the family, there emerged a conflict because there is no time meant for the family, (MAY, ELECTED, RECEIVE, and LOAN, 2014). The battle challenge at home will give birth to stress, (Levine, and Scotch, 2013).When an employee is stressed, he or she may fail to work efficiently and more. It means that he or she is not performing excellently at the organizational level and since family and job are directly associated to one another, the family will suffer too on the issue of performance.

Implication of the main content

Technology has its advantages and disadvantages. Using advanced technology means that any person can work from anywhere and what matters is for the employees to meet the target of the company. Doing so means that the employee will have to be concentrated on what they are doing with the technology for the benefit of the result. However, they forget about their social life. To keep up with social life means that every person must enhance the nature of communication. Communication helps solve conflicts, assist in meeting many requirements and many more things. Failing to communicate especially to your family will bring the challenge or the problem of conflict, and since a person is juggling between the two, it becomes challenging to forego the work related issue since without work it is hard to meet the family demands.

The result of the conflict is stress. The employee will have stress because they feel that they are doing so much at work to cater for their families. They feel neglected at home and the overwhelming under stress. Even if the rate of employee’s performance was increasing at an increasing rate, with pressure, the employee reaches a point of diminishing rate of return, (Wang et al. 2014).  At this stage, the employee rate of performance is decreasing at an increasing rate. The parties that are affected by the employee’s stress will be the organization and the family, (Henry, and Stephens, 2013).


Working for the purpose meeting the family needs is of importance, but employees should take into consideration the aspect of time management. Time management will help them to do the right thing at the right time, (Glover, Ronning, and Reynolds, 2013).It will help avoid the issue of conflict at their homes and the production of stress. With efficient time management skills, the employee will be able to give ample time to his or her family and also be able to office work at work excellently, (Goetsch, and Davis, 2014). The end product of it all is that the employee will meet the organizational goals and since family and labor are directly proportional to each other, he or she will be able and will to perform the duties of the family.




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Knapp, M.L., Vangelisti, A.L. and Caughlin, J.P., 2014. Interpersonal Communication & Human Relationships. Pearson Higher Ed.

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MAY, I.N.C., ELECTED, C., RECEIVE, O. and LOAN, A.C., 2014. Conflict of interest. Newsletter.

Petchsawang, P. and Duchon, D., 2012. Workplace spirituality, meditation, and work performance. Journal of management, spirituality & religion, 9(2), pp.189-208.

Wang, P.S., Beck, A.L., Berglund, P., McKenas, D.K., Pronk, N.P., Simon, G.E. and Kessler, R.C., 2014. Effects of major depression on moment-in-time work performance. American Journal of Psychiatry.





March 3, 2017

Efficient market hypothesis traces its origin back in 1960s by its founders Paul A.Samuelson and Eugene F. Fama who provided perspectives regarding the stock prices of financial securities that the market prices provide all the information that is available. Samuelson came up with the notion that if all market player’s information and expectations are put into consideration then there will be an informational efficient market (Brown, 2012). This would mean that price fluctuations must be unforecastable if they are properly anticipated. On the other hand Fama empirical analysis of efficient markets contributed to the deep focus on test concerning both single factor and multi factor linear asset pricing models, events study and empirical regularities and anomalies in stock, bond, currency and commodity markets. His argument was based on providing a way forward in distinction between technical analysis that involves the use of geometric patterns in price movements and volume charts to predict future price movements of a security and fundamental analysis that sought to determine a security’s fail value with the help of accounting and economic data (Brown, 2012). These concepts proved very helpful in ensuring that significant profits were generated due to the use of statistical properties of stock prices this was characterized by random walk hypothesis. However to develop these methodological and empirical research Fama used digital computes in finance especially in the mathematical formulations.
An efficient market was characterized by competition and a large group of investors aimed at getting huge returns from investment in the market securities by using prediction mechanisms with each potential investor searching for the relevant information that enabled real prices at every point in time represent very good estimates of intrinsic values (Burton, and Shah, 2017).   In addition he went ahead and expounded more on his theory efficient markets and categorized them into distinct levels of strong efficiency, semi-strong and weak efficiency. The three levels were based on the extent of the availability of information whereby for a strong market the prices depict information available to those who form the market or where the investment managers acquire as much information they can get by paying for it. In addition a semi-strong market involves the easily accessible information concerning the public in connection with stock splits and announcements by media sources and other reports (Brown, 2012). The behavior as a results of these announcements are then tested with the help of capital asset pricing model   A weak efficient market however requires any available information which is mirrored by price to be obtained especially one relating to the past and it requires random walk hypothesis. Based on past knowledge of price changes a weak form efficiency tests raises concern that the investor may consistently obtain returns that are of higher level than the normal ones. However the strong market efficiency proved irrational and could not be relied upon due to the fact that the corporate managers had the opportunity to acquire non-public information that they used for their advantage. In addition through payment for privileged information by market makers they were exposed to profit opportunity that served as an open door to their best interests at hand. Those who did not have the means to acquire the public information were left vulnerable and faced high uncertainty on their investments (Guerrien, and Gun, 2011)
Despite the accolades given the efficient market hypothesis, some authors have argued that some inefficiency may exist in the market from time to time. The perfection of market efficiency would render the gathering of information unhelpful since profit is not being reflected. In addition such inefficiencies would mean that investors are willing to dig deeper into their pockets in search of information and trading. This is expected to be reflected in the numerous profit opportunities as a result of those few individuals who pretend to have information to trade but they only get the economic rents. This would mean that an investor my find himself having information concerning market inefficiency and would require a higher return.  However some tests may imply efficiency or inefficiency depending the trend in the price fluctuations and the pattern depicted. It goes without saying that market efficiency cannot be fully denied except a situation where an individual is certain that the right model has been chosen for that market in case of normal returns. It requires therefore appropriate bench marking for market efficiency. It is argued that for abnormal return the information gathering and processing is deemed to be expensive. In addition a joint test of inefficiency and the model that indicates the normal returns in an efficient market is important and termed as of greater impact and relevance forecasting of future returns from past returns.

In modern times the theory of efficient market hypothesis has been widely used by investors due to its consistent dominance in the market and the constant positive feedback on its reliability due to the successive price changes.
The technical analysis date back in the 20th centuries where the behavioral and psychological elements were premised on principle. That information available is relevant in stock market in price changes which move in in trends to enable prediction during trade and also historical patterns in the past stock price changes that replicates over and over again throughout.
Recent technical analysts have adopted majorly the charting and indicator methods in ensuring that past data on price changes is captured for trading decisions. The use of judgmental skills are applied in interpretation of these patterns in charting and in indicator method adopts the mathematical algorithms in analyzing past and present price changes and the use of technical trading rules was fundamental in the trading decisions (Muhammad, and Rahman, 2010).  The bar charts are suitable in representing individual securities with their indication in price changes and the patterns associated with them such as head and shoulder patterns and triangle patters.

Arguably technical analysis rests on the some basis assumption that forces of demand and supply cause the changes in trend, despite the minimal fluctuations in the market the price of security change for a longer period of time and they do so in trends and the interactions of the demand and supply determines the market value caused by both rational and irrational factors and with the use of charting mechanism the shifts in demand and supply can be predicted on time (Burton, and Shah, 2017).
Theorists have provided different perspectives on the trends especially Charles Dow in his theory providing three classification of trends. He examines the primary trends, secondary movements and tertiary moves and suggests the use of line charts to illustrate these types. In addition Elliot wave theory identifies the different cycles that a market moves and is divided into impulse waves and corrective waves.
There are other technical analysis techniques that involve the use of behavior of market participants .such systems analyze the strength market decline or advances in, short sales levels and small investors with small funds and they are well known as contrary opinion theories.
Most importantly is note that with the aid of the above techniques the demand and supply is determined and also information is made available as far as selection of appropriate securities to purchase or sold are concerned (Borges, &Maria, 2010). The assumption that slowly occurring shifts can be detected and this validates the new information that is observed in the security prices. This has amassed wealth to some individuals for being smart enough to apply the techniques in useful timing decisions with the help of fundamental tools on securities to be purchased

Analysts have demonstrated how technical rules have contributed to high returns over a long duration especially in 1970s and 1980s. There has been persistence in the sophisticated and complex rules that have lately been used since 1990s to generate profits associated with the trading (Yalçın, 2010).

A controversial notion was put forward by some new economics discarded the use of information available of stocks that spreads widely pertaining the individual stocks and stock markets. They claimed that in order to earn excess risk the determination of stock prices relied heavily upon predictable future stock prices in the event of past stock price patters .using behavioral and psychological elements (Borges, &Maria, 2010).
The forecasting power of pattern charts evaluated by head and shoulders patterns sought to determine how the stock prices varied with the fluctuating currencies to statistically predict profits suing floating rates in an efficient market. The research sought to combine the technical analysis and efficient market hypothesis in evaluating statistical significant profits. The researchers first identified the head and shoulder patterns and by using the available information to identify the resulting profit values. The last step was to use technical analysis in head and shoulder patters to assess the predictive power of some currencies over others.   The technical analysis was directed to solving the market inefficiencies by using algorithms of comparisons of major currencies and the dollar (Burton, and Shah, 2017). The randomness of price movements and fluctuations in an efficient market is contributed by the informational efficiency. Research has shown that the more an efficient market is the more the randomness and unpredictability. This therefore is very resourceful to market participants since they are able to generate statistically significant profits from this informational efficiency. The self-interest therefore leads to many potential investors adopting the concept that matriangles are followed by price in their trading to reduce on costs due to accurate available information at their disposal which is very advantageous in the stock markets.
In conclusion it is probably seasonable to acknowledge that the adaptation speed of markets continued reduction in profit opportunities deviates with the standard notion of market efficiency (Holton, 2015). The paradigm of the adaptive market hypothesis allows future developments of models. The establishment of profits earned rather than risks incurred is very important especially in devising market inefficiency in the profitability of technical analysis.
The interaction of the technical analysis and market efficiency is envisaged on the emphasis that the decision rules will move from standard rational paradigm including the focus on learning and evolutionary mechanisms that will address financial markets especially in currency market research (Burton, and Shah, 2017).

Bloomberg- screenshot


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March 1, 2017

Describe the organization and the change to which it is responding.

The South Australian Tourism Commission was established by the South Australian government with an aim of improving the tourism sector. The bill to form the South Australian Tourism Commission was introduced and passed by the minister for Tourism in 1933, Hon. Mike Rann. The organization is committed to facilitating the state’s growth in the tourism sector. In addition, it contains six business units who are answerable to the Chief Executive Officer. It is governed by the Board of Directors who are directly controlled by the Minister of Tourism. The strategic plans of the organization involve deciding on the strategic alignment and direction of the government as a whole and to fulfill the objectives of the tourism industry (Hall, et al. 2015). The South Australian Tourism Commission, just like every other organization in the public sector of the government, has been through and is currently going through a sequence of organizational changes. The changes are brought about by the public sector reform policy. The changes which occur at the federal and state level exhibit the need for a Public Service that is able to withstand change and create continuity in all organization sin the public sector. The introduction of a South Australian Tourism Plan 2009-2014 was a major change that took place in the South Australian Tourism Commission. Before implanting the recent plan, the organization saw it necessary to implement change. The tourism plan 2009-2014 had objectives which included: creating external perspectives and great industry accountability. The minister also agreed to the tourism plan on the condition that it would achieve a set target of $6.3 billion in the tourism expenditure.



Describe the organization and the change to which it is responding.

The South Australian Tourism Commission wanted to know how employees viewed the change of the tourism plan. Therefore, more than 200 employees were required to complete an online survey plan. The online survey revealed that 31% believed that it would lead to good outcomes and 29% believed that the plan could partially achieve the objectives of the organization (Hayes, 2014). The establishment of a public service that can sustain change and promote continuity can only be created through reforms in the Australian Public Service Commission. However, until the Australian Public Service is reformed, employees are required to adjust and respond to the changing expectations and needs of the government. Change in practice and management philosophy in the South Australian Tourism Commission has occurred since 1999 by six internal reviews. The 2004 internal review which was the seventh was initiated by an internal team which identified that the management was disproportionately hierarchical and centralized. The internal team believed that there would be better service provision if responsibility and authority would be given to officials who were directly responsible for better service provision.

Evaluate the strategies the organization used in its change plan and determine the level of success the organization experienced with the strategies.

Changes in the South Australian Tourism Commission were not welcomed as expected. Employees strongly opposed the changes as they knew it would be difficult for them to adjust quickly to the changes. Although they strongly opposed change, they knew they did not have any other option other than to quickly adapt to the changes as required by the government. The changes that occurred in the organization led to reduced staff members. Most employees decided to resign when they felt that they could not cope with the organizational changes (Benn & Griffiths, 2014). The changes also gave managers more power and control over finances and staff. It went on to clearly outline the responsibilities of managers to avoid confusion which usually led to time wastage. The change insisted on good performance and responsiveness to the community and parliament. The achievement of change initiatives depends on the understanding of the changes by the employees. Regardless of how minor the change is, it will always be opposed. Therefore, leaders who initiate change in the South Australian Tourism Commission should be knowledgeable on the implications of change. The change initiators are required to have a vision of the change when the decision is made. Therefore, to facilitate total acceptance, change initiators are advised to enlighten employees on the need and vision for the current changes. In addition, change initiators can merge the wants of the employees and the organization with the aim of diluting strong opposition from employees.

Determine the effect the change had on stakeholders, and to what degree stakeholders have resisted. Assess how well stakeholder resistance was addressed.

Shareholders of the South Australian Tourism Commission partially agreed to the changes, especially after they saw that the minister of tourism set a target for the tourism expenditure. Most of the shareholders who resisted felt that the organization could not quickly respond to change. Shareholders are also part of the organization’s administration, therefore, it was important to get them to agree to the changes for the company to function smoothly. If there was no way to quickly deal with the resistance from stakeholders, the company was bound to fail or struggle with operations due to the the withdrawal of some shareholders. Therefore, shareholders were called in for a few meetings to clearly expound on the importance of the South Australian Tourism Plan 2009-2014. Shareholders who attended the meetings had a difficult time understanding the importance of change in an organization which was not performing poorly. The change initiators claimed that it was important to implement changes in the organization as the world was also undergoing changes and they had to cope up with them as they are a tourism organization. Finally, the shareholders were made to understand the importance of the South Australian Tourism Plan 2009-2014 and were in favor of it. Change initiators claimed that they had trouble convincing shareholders on the importance of change although they finally managed to convince them.

Evaluate the overall implications the change had on interdepartmental collaboration.

Implementation of changes had an impact on the organization as a whole. The Interdepartmental collaboration was poor in the beginning because they were not used to reporting and working with some departments. Some departments were used to working independently but after the implementation of change, they had to work together. Almost every department was used to reporting to the Chief Executive but after the changes took place, they had to report to a manager who would in turn report to the Chief Executive Officer. Initially, interdepartmental collaboration was poor and the organization experienced rough operations but as time passed, people adjusted to change and the organization was back on track.

In your opinion, how well did the leaders of the organization respond and prepare for the change? What worked and what did not work with the strategies they implemented?

The leaders and change initiators of the South Australian Tourism Commission prepared their employees for change in the best way possible. They first ensured that the change to be implemented was in the best interest of the organization. The organization’s administration then took a step of informing their employees of the desired change. They ensured that after they implemented the South Australian Tourism Plan 2009-2014, they had their employees and stakeholders on board and working towards adjusting to change. Although the change could have led to a reduction of employees because they felt that the change was too much to take in, they tried to keep their organization together (Cummings & Worley, 2014).

What modifications would you suggest the leaders of the organization make in order to better address the change dynamics? What additional strategies would you recommend to assist the organization through this change?

The changes that were implemented in the South Australian Tourism Commission, the tourism plan being one of them, gave the leaders more power. The leaders were bestowed with more power which could have a positive and negative impact on the organizations (Bridges & Bridges, 2017). People who envied more power could destroy the organization by mistreating the employees. In order to avoid negative effects due to power, leaders should have the organization’s best interest at heart. Leaders should frequently visit other departments to ensure they are coping with change in the right way. They should also ask the employees of any challenges they are experiencing while adjusting to change. It assists employees to feel free with their leaders and report to them in the case of any challenges. Leaders should be a reflection of the change in the organization. They should show their employees that they have the vision of change with them to promote the organization’s smooth running. Leaders should also be ready to deal with employees who are not up to speed with change. They should be placed in departments that require quick adjustment to facilitate their quick adjustment to change. The South Australian Tourism Commission is up to speed and has responded positively to change. The organization has tirelessly worked towards absorbing change and working towards the vision.





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