Due to the fact that diabetes is most frequently met in people over 65, there is a common delusion that it can be classified as an age-related disease. However, more than 200,000 children and adolescents in the United States currently have the same diagnosis (Hamilton, Knudsen, Vaina, Smith, & Paul, 2017). The situation is exacerbated by the rising obesity level in American children.
Until recently, children and adolescents were mostly diagnosed with type 1 diabetes, which was supposed to be juvenile. Yet, the situation has changed dramatically during the last decade. Now, due to the problem of obesity and inactivity, children also get type 2 diabetes (the incidence of which has increased by 30,5% since 2009) (Hamilton et al., 2017). This risk is typically attributed to Hispanic, African, Asian, and other minority groups.
Children with this diagnosis are likely to enter adulthood with an increased risk of developing other conditions. The major problem is connected with researchers’ inability to detect the disease at an early stage. Thus, innovative diagnostic tools are required to address the problem.
Overview of the Disease
Type 1 diabetes occurs owing to the inability of the pancreas to produce sufficient amounts of insulin and accounts for 5-10% of all cases of diabetes. Although the cause of this condition has not been identified, it is believed by many scholars that it has a genetic component. The lack of insulin prevents the transportation of sugar to cells and leads to its accumulation in the blood. Children having type 1 diabetes need lifelong injections of insulin accompanied by a healthy diet and physical activity to prevent critical levels of glucose in their blood (Craig et al., 2014).
Type 2 diabetes is diagnosed when insulin production is reduced and the hormone cannot work properly. This leads to sugar accumulation in the bloodstream (Hamilton et al., 2017). Although in most grave cases medications may be required, the condition can generally be managed through proper nutrition and exercise.
Symptoms of Diabetes in Children
Both types of diabetes have practically the same symptoms in children: fatigue, excessive urination, thirst, blurred vision, and increased hunger (some girls may also get a yeast infection). However, there are certain differences. For instance, those with type 1 diabetes typically lose weight before being diagnosed. The condition develops rapidly (usually within 2-3 weeks). Type 2 diabetes has more symptoms, including but not limited to acanthosis nigricans (dark patches of skin), insulin resistance, and polycystic ovarian syndrome. The development of the disease is much slower (Hamilton et al., 2017). This is the major reason type 2 diabetes often goes undiagnosed for a long period of time (from several months to several years).
The Importance of Early Detection
According to statistics, only 10-15% of parents are capable of detecting the major symptoms of diabetes (of both types). The importance of early detection is supported by the fact that a lengthy delay in diagnosis may turn out to be fatal for children. Such kids can develop diabetic ketoacidosis (DKA), which is one of the major causes of mortality in the case of type 1 diabetes. A significant lack of insulin leads to the inability of the body to use glucose for energy, which makes it break down fat. As a result, toxic chemicals (ketones) are produced, making the body acidic, and leading to the appearance of DKA. Another factor increasing the importance of early detection is a rapid progression of the disease at an early age, which is fraught with eye and kidney complications, high cholesterol levels, and elevated blood pressure (Craig et al., 2014).
The Role of Nurses
Nurses play a crucial role in educating both children and their parents on early detection and treatment methods. That is why they must remain updated on the most relevant diagnostic tools to be able to make a recommendation. Each separate case must be approached on an individual basis. In order to choose an appropriate method of education, the nurse must take into consideration a number of factors, which include: the child’s age, family support, social background, IQ level, and current awareness of the issue (Wong et al., 2017). The major purpose of education for children is to make them independent in managing their condition as their age allows. As for parents, they must be informed about diet options, physical activity requirements, and diagnostic methods.
Innovative Diagnostic Tool
The KRONUS Zinc Transporter 8 Autoantibody ELISA assay is a new diagnostic tool that makes it possible to distinguish between the types of diabetes. This is done through the detection of ZnT8 antibodies (the insulin secretory granule zinc transporters, produced by the SLC30A8 gene) in the patient’s bloodstream. Since these antibodies are present exclusively in those who suffer from type 1 diabetes, the test increases the accuracy of type 1 diabetes diagnosis in children. It was proven in the course of clinical studies that it managed to detect the condition in 65% of cases. The number of errors did not increase by 2% (Gomes et al., 2017). It is crucial to integrate this test into practice since it will decrease the number of children with a wrong diagnosis. This measure can be supported by care and educational institutions (kindergartens and schools) and be made a part of a required medical examination.
Craig, M. E., Jefferies, C., Dabelea, D., Balde, N., Seth, A., & Donaghue, K. C. (2014). Definition, epidemiology, and classification of diabetes in children and adolescents. Pediatr Diabetes, 15(20), 4-17.
Gomes, K. F. B., Semzezem, C., Batista, R., Fukui, R. T., Santos, A. S., Correia, M. R.,… da Silva, M. E. R. (2017). Importance of Zinc Transporter 8 Autoantibody in the diagnosis of type 1 diabetes in Latin Americans. Scientific Reports, 7. Web.
Hamilton, H., Knudsen, G., Vaina, C. L., Smith, M., & Paul, S. P. (2017). Children and young people with diabetes: Recognition and management. British Journal of Nursing, 26(6), 340-347.
Wong, F. K. Y., Lau, A. T. Y., Ng, R., Wong, E. W. Y., Wong, S. M., Kan, E. C. Y.,… Bryant‐Lukosius, D. (2017). An exploratory study on exemplary practice of nurse consultants. Journal of Nursing Scholarship, 49(5), 548-556.
Dover City Tourism And Marketing Management
Importance of Segmentation, Targeting, and Positioning
Segmentation, targeting, positioning, also known as STP, is an important concept of marketing. This concept implies dividing customers into groups with distinct characteristics, targeting the most lucrative segments, and creating unique value propositions for those chosen segments (Gengler & Mulvey 2017). Organizations must find a way to cater to the needs of diverse populations; otherwise, their attempts at boosting the revenues will be futile. Herein lies the importance of segmentation, targeting, and positioning. (Gengler & Mulvey 2017). The purpose of this report is to determine a strategy for marketing management for Dover from the perspective of the Dover District Council.
Segmentation is critical to meeting the requirements of a culturally diverse area (Bruwer & Li 2017). Although the process implies certain challenges, such as the need to explore the cultural background and unique characteristics of a target demographic, it helps ensure perfect customer experience and create a very deep understanding of a customer’s persona. Therefore, segmentation can be seen as one of the essential components of building a competitive business environment. The proposed way of viewing segmentation, however, is rather difficult to perform in a highly diverse environment. Therefore, a segmentation process will always involve a certain degree of generalization, which implies that an organization may fail to attract a part of the target audience.
Targeting, in turn, implies developing a set of strategies that will help appeal to the type of buyers that are viewed as the primary audience (Chang, Yu & Lu 2015). Identified with the help of the segmentation process, these customers require a unique marketing approach to accept a particular service as worthy of their time and money (Brennan & Parker 2014). The choice of a targeting strategy is especially important in the context of the global economy, where competition levels are extraordinarily high. On the one hand, targeting allows catering to the needs of a particular segment, which contributes to a rise in customer satisfaction levels. On the other hand, it restricts a company’s ability to attract other types of clients.
Finally, one must acknowledge the importance of positioning as one of the pillars for building a strong brand image and entering a particular market. The creation of a brand that will appeal to the target demographic is a challenging task that requires designing a product with a unique advantage (Gengler & Mulvey 2017; Davcik & Sharma 2015). However, after a unique brand concept is created and marketed to a specific audience, a firm is likely to attain impressive success, depending on the number of its resources and the quality of staff’s performance.
Segmentation, Targeting and Positioning Strategy for Tourists (Dover District Council Perspective)
At present, tourism holds the highest potential for Dover from an economic perspective (Dover District Council n.d.). According to a recent report, tourist cars made 13.44% (2,456,817 out of 18,270,422) of Dover port traffic (‘Dover Coastal Community Team economic plan 2017-2021’ 2017). The current growth trend roughly amounts to a total of 2.9% (‘Dover Coastal Community Team economic plan 2017-2021’ 2017). Therefore, it is reasonable to build the platform for the economic resurgence of Dover in the local tourism industry, which currently accounts for 15% of the British economy (‘Britain’s visitor economy facts’ 2017). However, significant changes must be made in order to create a comfortable setting for tourists. For instance, the Dover City Council will have to handle the problem of coastal erosion, which has been a significant problem in Dover (Dover District Council n.d.). In addition, pollution issues and the associated environmental concerns need to be addressed. Finally, the lack of hotels and qualified staff for meeting tourists’ needs should be listed among the key concerns. The specified issue affects the attractiveness of the city, thus causing people to avoid the city as a tourist site.
Currently, there are several ways of characterizing Dover tourists. The first and most important, classifying the target population based on their age is necessary. There are young people who look for adventure, middle-aged people who want to spend quality time with their families, or older people who are looking for a relaxed holiday (‘Markets & segments’ 2017). But what they all have in common is a love for historical places, sightseeing, and recreational activities. Therefore, it is necessary to create an environment in which the identified types of tourists will feel comfortable. To help them relieve stress, one will have to produce the services that meet their idea of comfort and at the same time have an affordable price. Since the average income of the identified type of population is around ₤27,000, providing comparatively inexpensive services with an appropriate set of services is necessary (‘Are you better than the average man?’ 2017).
Afterward, the analysis of the demand will be required. Given the recent rapid increase in the number of Millennials, it would be appropriate for the Dover Council to consider this segment as it a prime target (Font & McCabe 2017). In order to appeal to the selected population, one will have to transfer a significant part of the tourism business to the online environment. The segment is attractive since Millennials search for unique experiences in their trips and, thus, define changes in the modern tourism industry (Lamberton & Stephen 2016). While the traditional tools for accessing available organizations and their services are not to be abandoned entirely, tourist agencies will have to consider creating several online models for marketing their products to the specified demographic (Lamberton & Stephen 2016; Font & McCabe 2017). For example, applications for booking flights and hotel rooms, keeping track of the visited sights, locating restaurants, and choosing from a wide range of activities must be designed.
The close attention to quality that defines Millennials as customers also indicates that local environmental issues must be addressed. Thus, a significant improvement in the infrastructure of the city is also an important step toward boosting the performance of the Dover tourism industry (Moghavvemi et al. 2017). Travel agencies will have to provide customers with instant access to all places that might interest the target audience, including beaches, restaurants, bars, and other entertainment areas (Liu & Chou 2016; Molina-Azorín 2015). Additionally, a massive issue concerning the maintenance of Dover beaches has emerged recently and requires the immediate attention of local authorities. Because of the erosion issue that has affected a significant part of the beach area, Dover currently does not look attractive as a resort (Dover District Council 2017). With the introduction of equipment and a management strategy that will help maintain the area safe and clean, one will improve the competitiveness levels of the resort to a considerable extent.
Given the recent rapid increase in the number of Millennials among Dover tourists, one will have to focus on creating a comfortable environment for the specified type of customers. Particularly, the presence of online tools for booking and shopping will have to be provided. For this purpose, the adoption of digital marketing along with traditional marketing tools will have to be seen as a necessity (Oliveira & Panyik 2015). The use of demographic, psychographic, and behavioral characteristics of the target population is crucial to delineating an appropriate marketing strategy. At present, the Dover District Council is facing a very difficult situation in which it has to attract both Millennials and older tourists to visit the local attractions (Xu et al. 2016). Therefore, two entirely different models of product promotion and marketing must be utilized.
The suggested mixture of cultures and lifestyles should become the brand image of the area. The specified approach toward positioning implies looking at the concept of tourism from an entirely new angle. Other tourist attractions often tend to fall into one of the extremes, i.e., either take people out of their comfort zone entirely with local exotics or barely change the setting of tourists’ home areas (Camisón & Forés 2015). Dover, however, will be able to develop a very strong competitive advantage by combining the two experiences and positioning itself as a resort that will satisfy the needs of both British customers and overseas tourists (Krajňáková, Navikaite & Navickas 2015). While the latter will be delighted to experience a seemingly incompatible combination of “Britishness” and a traditional resort, the residents of Great Britain will have a chance to enjoy the comfort of a beach resort, at the same time remaining in the comfort of their cultural environment.
The proposed strategy will help Dover build a significant competitive advantage. Since no other resort has created a similar opportunity or its tourists, people are likely to visit Dover more eagerly. However, apart from developing a singular advantage that will set it aside from the rest of tourist sites, Dover will need a seal of approval for the quality of its services. Thus, one must ensure a massive rise in the quality of services, which can become a possibility with the promotion of knowledge and skills acquisition among people working in the industry, as well as the renovation of the existing facilities. While the latter seems to be a fairly easy task, the enhancement of service quality and particularly the process of teaching staff members new skills might be rather difficult. Employees’ unwillingness to make an extra effort in their work may hamper the process of quality improvement. Thus, a combination of incentives and a change in the corporate philosophy along with the use of the transformational leadership technique will help promote a vast change across the industry (Camisón & Forés 2015). As soon as staff members realize that they are valued by their employers and that the latter is ready to invest in employees’ professional growth, a steep rise in service quality levels will be observed. As a result, Dover’s competitive advantage will comprise not only a unique environment but also an impressive quality of services for a reasonable price.
To ensure that Dover companies have enough competitiveness to withstand the pressure of the competition, one will have to redesign some of the aspects of tourist companies’ functioning. The focus on customers’ culture-specific needs must be regarded as the primary focus of Dover tourist agencies. For this reason, the principles of multicultural communication will have to be introduced into the context of the Dover tourist business.
Developing online services is central to the successful restoration of Dover’s economy. Since Millennials are currently viewed as the most lucrative audience, it is essential to build the market environment in which they will feel comfortable. For this reason, online services must be provided to improve customers’ experience, receive feedback, and introduce improvements to provided services and products. Online services must also become one of the advantages that Dover will have to offer to its clients. Even though the general idea of a tourist area with a unique combination of settings might seem to be enough to attract people, retaining it will require additional changes. Seeing that Millennials are viewed as the primary audience, it will be essential to design several applications that will help them book rooms in local hotels, identify available tourist agencies, search for nearby attractions and restaurants, etc.
Moreover, customers must be given an opportunity to leave their online reviews of Dover’s tourist attractions and services. Thus, Dover organizations operating in the tourism industry will be able to identify their weaknesses successfully and improve their services accordingly. Furthermore, channels for communicating with customers will have to be created. Thus, customers will feel valued, and their loyalty toward Dover’s organizations will rise.
As a tourist location, Dover has a very strong potential since it represents a unique combination of beautiful beaches and a traditional British environment with its comfort and coziness. Consequently, the specified feature of the resort must become its selling point and its primary advantage. As a result, Dover will be able to gain momentum in the tourism industry with its original and inimitable competitive advantage. In addition, one must keep the focus on the provision of online services and applications that will allow retaining new audiences. Particularly, Dover companies will need to attract Millennials as some of the most promising types of clients. Thus, local businesses will start to thrive, and significant economic growth will be observed.
Are you better than the average man? 2017, Web.
Brennan, L & Parker, B 2014, ’Beyond behaviour change: social marketing and social change’, Journal of Social Marketing, vol. 4, no, 3, pp. 194-197.
Bruwer, J & Li, E 2017, ‘Domain-specific market segmentation using a latent class mixture modelling approach and wine-related lifestyle (WRL) algorithm’, European Journal of Marketing, vol. 51, no. 9/10, pp. 1552-1576.
Camisón, C & Forés, B 2015, ‘Is tourism firm competitiveness driven by different internal or external specific factors? New empirical evidence from Spain’, Tourism Management, vol. 48, pp. 477-499.
Chang, YT, Yu, H & Lu, HP 2015, ‘Persuasive messages, popularity cohesion, and message diffusion in social media marketing’, Journal of Business Research, vol. 68, no. 4, pp. 777-782.
Davcik, NS & Sharma, P 2015, ‘Impact of product differentiation, marketing investments and brand equity on pricing strategies: a brand level investigation’, European Journal of Marketing, vol. 49, no. 5/6, pp. 760-781.
Dover Coastal Community Team economic plan 2017-2021 2017, Web.
Dover District Council n.d., Coastal erosion.
Dover District Council 2017, Coastal defences.
Font, X & McCabe, S 2017, ‘Sustainability and marketing in tourism: its contexts, paradoxes, approaches, challenges and potential’, Journal of Sustainable Tourism, vol. 25, no. 7, pp. 869-883.
Gengler, CE & Mulvey, MS 2017, ‘Planning pre-launch positioning: segmentation via willingness-to-pay and means-end brand differentiators’, Journal of Brand Management, vol. 24, no. 3, pp. 230-249.
Krajňáková, E, Navikaite, A & Navickas, V 2015, ‘Paradigm shift of small and medium-sized enterprises competitive advantage to management of customer satisfaction’, Engineering Economics, vol. 26, no. 3, pp. 327-332.
Lamberton, C & Stephen, AT 2016, ‘A thematic exploration of digital, social media, and mobile marketing: research evolution from 2000 to 2015 and an agenda for future inquiry’, Journal of Marketing, vol. 80, no. 6, pp. 146-172.
Liu, CHS & Chou, SF 2016, ‘Tourism strategy development and facilitation of integrative processes among brand equity, marketing and motivation’, Tourism Management, vol. 54, pp. 298-308.
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Moghavvemi, S, Ormond, M, Musa, G, Isa, CRM, Thirumoorthi, T, Mustapha, MZB & Chandy, JJC 2017, ‘Connecting with prospective medical tourists online: a cross-sectional analysis of private hospital websites promoting medical tourism in India, Malaysia and Thailand’, Tourism Management, vol. 58, pp. 154-163.
Molina-Azorín, JF, Tarí, JJ, Pereira-Moliner, J, López-Gamero, MD & Pertusa-Ortega, EM 2015, ‘The effects of quality and environmental management on competitive advantage: a mixed methods study in the hotel industry’, Tourism Management, vol. 50, pp. 41-54.
Oliveira, E & Panyik, E 2015, ‘Content, context and co-creation: digital challenges in destination branding with references to Portugal as a tourist destination’, Journal of Vacation Marketing, vol. 21, no. 1, pp. 53-74.
Xu, F, Tian, F, Buhalis, D, Weber, J & Zhang, H 2016, ‘Tourists as mobile gamers: gamification for tourism marketing’, Journal of Travel & Tourism Marketing, vol. 33, no. 8, pp. 1124-1142.
Transplantable Organs Supply And Decision Making
Organ transplantation (OT) is a means for saving lives and restoring the health of patients, and the rules of OT implementation should be based on respect for legislation and individual human rights. The decisions in favor of OT should be made inconsistency with humanitarian principles enshrined by the international community and with the consideration of ethical values and the interests of the people involved in the situation.
At the same time, according to the utilitarian principles of decision making suggested by John Stuart Mill, the compliance with ethical values provides the opportunity to create “an existence exempt as far as possible from pain, and as rich as possible in enjoyments” for all human beings (par. 12). Thus, during the ethical decision-making process, it is important to consider the concept of equal welfare for all people and the common good principle in order to conceive the best possible decision and achieve a positive and morally acceptable outcome.
Living donor or human cadaver OT can be implemented only in case other medical instruments cannot guarantee the preservation of organ recipient’s life and restoration of his health.
OT inevitably raises the ethical issues which cannot be answered with sufficient evidence and intrinsically entail intellectual and moral controversies because, either way, the invasive procedure can cause suffering to one of the parties. Moreover, it provokes multiple health risks and does not necessarily guarantee health restoration. Thus, to avoid various complications, physicians need to evaluate all potential methods of health intervention prior to the selection of OT.
According to the generalized view of benefit suggested by Jeremy Bentham, the utility of a decision or an object can be defined by its ability to produce advantages, pleasure, and happiness or prevent suffering and pain (par. 5). Therefore, in accordance with the utilitarian approach and in pursuit of suffering prevention, in case another option of medical treatment exists, it will be appropriate to choose it instead of OT.
Compliance with the principle of informed consent is the legal and ethical basis for the initiation of OT procedures. Organ removals from a living donor can be administered only in case his/her informed consent is obtained. In the case of human cadaver OT, it is important to consider the consent given by a donor’s relatives, and if it is known that a donor’s legal representatives are against organ removal, then OT from the given donor cannot be regarded as an ethical option.
Although according to the Greatest Happiness Principle, the common good can be achieved only when the pursuit to fulfill the egoistic personal needs will be reduced in order to achieve higher pleasure for the whole humanity (Mill par. 12), it is unethical to force a living person to become an organ donor. Ethically acceptable OT is grounded in the principles of volunteerism because by forcing a person’s decision, one contributes to his/her unhappiness and, in this way, goes against the utilitarian approach in ethical decision making.
Based on this, the consent for OT administration should be received from a recipient as well. A recipient must be warned about the possible health complications which can be caused by the upcoming surgery. If a recipient is underage, the consent of his/her caregivers is required. However, the principle of informed consent can be violated (with respect to a human cadaver donor or a recipient) in exceptional emergency cases when the delay in surgery administration can threaten the life of an organ recipient. At this rate, the whole responsibility for taking an action rests with a physician.
According to the principles of utilitarianism, any action and decision can be estimated only by its consequences (Mosser 14). Therefore, in their decision-making process, physicians need to evaluate the potential outcomes of action and analyze if a decision has a potential to fulfill the needs of the community and ensures the development of benefits for a vast number of people.
It is important to evaluate the potential health damages that can be caused to a recipient or a living donor by organ removal and OT. Hence, organ removal should not induce irreversible health problems in a living donor. Moreover, it is necessary to be sure that a transplantable organ carrier was not exposed to a dangerous disease that may threaten a recipient’s life. Thus, organ removal from a living or a cadaver donor can be carried out only with the consideration of both parties’ interests.
In decision making targeting the issues of transplantable organ supply, a physician plays a role of a “public benefactor” who strives to contribute to virtue development and achieve the most beneficial outcomes in each particular situation (Mill par. 23). According to Mill, although virtue can be perceived as a good in itself, it is only a means to achieve common good (par. 18). A physician who follows the ethical principles of utilitarianism thus should be considered a virtuous man contributing to the development of others’ happiness and the prevention of their suffering.
Bentham, Jeremy. “Principles of Morals and Legislation (1780).” Harvard University’s Justice with Michael Sandel, 2011.
Mill, John Stuart. “Utilitarianism. Chapter 2: What Utilitarianism Is.” BLTC, n.d.
Mosser, Kurt. Ethics and social responsibility. San Diego, CA: Bridgepoint Education, 2013. Print.