Causes, Symptoms, Transmission, and Complications
Tuberculosis (TB) is an infectious disease that is caused by a rod-shaped bacterium. The bacterium is referred to as Mycobacterium tuberculosis. TB occurs in different forms, the type responsible for most infections is the pulmonary TB. According to CDC (2014), it is responsible for approximately 85% of the infections. In addition, the signs and symptoms of pulmonary TB may occur before the diagnoses of the other types of TB. The main symptoms include recurring fever, persistent cough that may last for weeks, hemoptysis, chest pain, fatigue and loss of weight (Oliveira et al., 2012). TB is normally spread through the air. This implies that the Mycobacterium tuberculosis particles are transmitted by airborne. The particles are called nuclei, and their measurement ranges from 1-5 microns in diameter (CDC 2014). Oliveira (2012) states that “the droplets nuclei are generated and passed to the air when a person suffering from pulmonary TB sneezes, coughs, shouts, and or sings” (p. 2148). The participles can stay in the air for some hours (Oliveira, 2012). Thus, people exposed to the conditions are likely to be infected.
The effects of the TB infections differ depending on the person and the level of exposure. As a result, some people may not develop complications. However, other people may have mild to severe complications, which may lead the damage of vital body organs such as lungs. Other complications include cardiac tamponade, meningitis, and malfunction of kidney and liver.
The overall objective of the treatment of tuberculosis is to alleviate the suffering it causes to the infected person and to reduce the transmission of the Mycobacterium tuberculosis to other people. The treatment benefits the individual and the community. In addition, the treatment should include the clinical and social issues. The treatment of TB is influenced by different factors. One of the main factors is the type of TB and secondly is the sensitivity of Mycobacterium tuberculosis. Treatment is pharmacological, and it entails the use of different regimes. CDC (2012) recommends four regimes. The selection of the schedules is based on the type of TB and the overall health status of the patient.
Incidence, Prevalence, and Mortality
In the United States, the incidence rate in 2014 was 2.96%. The incidence rate varied depending on different categories of people. For example, the incidence rate for foreign-born persons was 13 times greater than for US-born citizens. The total number of people who died of TB was 555 in 2013. The prevalence of TB in the US varies depending on ethnic orientation. Among the whites, it is 0.6 cases per 100, 000 persons (CDC, 2014).
Determinants of Heath
The determinants of health include the social, personal, environmental, and economic factors that influence health status (Hargreaves et al., 2011). The interrelationships among the factors determine the health of an individual or population. According to Hargreaves et al. (2011), the determinants fall under broad categories of social, health services, individual behavior, policy making, and biological and genetic factors. The social determinants directly linked to the environment in which people or population live, work and age. The social and physical environment determinants influence the health outcome. For example, people in overcrowded areas are likely to have a higher prevalence of TB compared with people with better living conditions.
Health determinants relate to the access of health services. Hargreaves et al. (2011) pointed that limited access or lack of access to health services influences the health of an individual. For example, people who lack funds to go for regular medical checkups may not engage in preventive care. In relation to TB, the lack of health services results in delays in receiving the right care and hence the spread of Mycobacterium tuberculosis. Individual behaviors also influence the health outcome. According to Hargreaves et al. (2011), individual behavior plays an important role in the preventive care. For instance, cautious behavior and regular screening for TB is required especially for the HIV-positive patients and people leaving in regions with high prevalence of TB.
Biological and genetic factors relate to how a disease affects specific population more than the others. This is normally due to inherent biological traits that make a person or population more susceptible. Examples of the biological and genetic factors include age, sex, and HIV status. In relation to TB, HIV-positive patients are exposed to increased risk of being infected with TB.
There are different models of disease causation. One of the models is the epidemiologic model, which is composed of the agent, host, and environment. This implies that disease results from the interaction of the three factors. For a disease to be passed from the agent to the host, there must be a shift in balance in the three components. In relation to TB, the agent is the Mycobacterium tuberculosis, the host is the individual while the environment is the medium of transmission such as the air. The Mycobacterium tuberculosis exists only in humans. In order the bacterium to cause infection, it has to be in sufficient amounts in which the host passes it to the environment. If the host has high opportunities for exposure such as susceptibility due to social and environmental factors, the balance will favor infection. On the other hand, the environment represents the extrinsic factors that provide the opportunity for exposure. For example, a crowded environment, poor socioeconomic standards and lack of health services will lead to the infection.
Role of the Community Health Nurse
The community nurse plays a critical role in the prevention and treatment of TB. The nurses can be involved in the screening of populations in order to identify the patients, who need to be examined, i.e. identification of cases. The nurses should also develop a communication system in which the identified patients are referred to the right health facilities to start the treatment. In addition, the community nurses should compile data on the prevalence and incidence rates in the areas of their work. According to Oblitas et al. (2010), analysis of the data helps in determining the communities that are more susceptible. This data can be used in the policy formulation and the design of the intervention programs. According to CDC (2012) TB develops resistance to drugs if the right treatment schedule is not followed. This has a great implication for the patient, the community, and the government. It leads to multidrug resistance (MDR) TB, which is difficult and expensive to treat. Thus, the nurse should do follow-ups in order to ensure that patients are using drugs as advised.
National Agency that Addresses TB
In the United States, CDC plays a great role in the prevention and resolving the TB. CDC is involved in research and monitoring the trends of TB. For example, CDC developed a strategic plan to eliminate TB in the US in 1989 and outlined the actions necessary to achieve the goal. However, factors such as HIV, MDR-TB and increased immigration of people from countries where TB was common hindered the elimination.
CDC. (2012). Principles of epidemiology in public health practice: An Introduction to applied epidemiology and biostatistics. Web.
CDC. (2014). Fact sheet: Trends in tuberculosis, 2014. Web.
Hargreaves, J., Boccia, D., Evans, C., Adato, M., Petticrew, M., & Porter, J. (2011). The social determinants of tuberculosis: From evidence to action. American Journal of Public Health, 101(4), 654-662.
Oblitas, F., Loncharich, N., Salazar, M., David, H., Silva, I., & Velásquez, D. (2011). Nursing s role in tuberculosis control: a discussion from the perspective of equity. Revista Latino-Americana Enfermagem, 18(1), 130-138.
Oliveira, I., Jesus, G., Pinto, P., Balderrama, P., Cury, M., & Vendramini, S. (2012). Tuberculosis control: Evaluation of the nursing team on the framework of health services. Journal of Nursing, 6(9), 2145-2153.
The Book “Everyday Use” By Alice Walker
Most people would likely agree that preserving one’s cultural heritage is a meaningful and worthy pursuit. However, people also tend to disagree on what is the best way to proceed with it. Maintaining African American cultural legacy features prominently as a theme in Alice Walker’s “Everyday Use.” The author uses the first-person perspective and names to create a sense of distance between the conflicting characters and ultimately highlight which approach to preserving one’s heritage is better.
The feature that defines “Everyday Use” as a literary piece is, first and foremost, the first-person perspective the author chooses to use. The audience sees the events of the short story through Mama’s eyes, an aging African American woman who is both the protagonist and the narrator. This perspective impacts how the reader sees the other two principal characters of the story, namely, Mama’s daughters – Dee and Maggie. When Maggie first enters the story, Mama compares her to “a dog run over by some careless person rich enough to own a car,” using a simile designed to invoke empathy and compassion (Walker 1). Yet when thinking about Dee, the older and better-educated daughter, Mama remembers how she disturbed her and Maggie with “knowledge [they] didn’t necessarily need to know” (Walker 2). A seemingly positive trait – being knowledgeable and willing to share this knowledge with family members – becomes something negative in Mama’s eyes due to being associated with Dee. Thus, the author employs the first-person perspective to emphasize the protagonist’s perception of her two daughters and paint an unflattering picture of Dee while eliciting sympathy for Maggie.
Apart from the perspective, Walker also uses names to create distance between Mama and Dee. When the older daughter arrives, she quickly announces that her name is not Dee anymore, but Wangero Leewanika Kemanjo, as she does not want to be named after her oppressors (Walker 3). In truth, Mama named Dee not after some abstract oppressor, but after a long line of her relative going all the way “beyond the Civil War” (Walker 2). By refusing to use her old name, given to her after her ancestors, Dee quite literally renounces her heritage. Notably enough, in the very next sentence, Mama is already thinking about Dee as Wangero (Walker 3). The distance between Dee and her mother is already significant enough so that Mama would accept the new symbolical act of separation immediately, and the author’s choice of names stresses this fact.
The story culminates in a conflict between Mama and Dee regarding the fate of the hand-sewn quilts that have been in the family from the times of the Civil War. Dee wants to take them to the city and put on a display in a museum to preserve them. Mama, on the other hand, decides to stand up to her daughter and insists that Maggie should have the quilts, as she was promised. The thought that Maggie could be “backward enough to put them to everyday use” and wear them down mortifies Dee (Walker 5). To this, Mama replies: “She can always make some more… Maggie knows how to quilt” (Walker 6). While Dee thinks about preserving her African American heritage by displaying in a museum, as an artifact of a dead civilization, Maggie lives in this heritage and not merely preserves, but reproduces it.
As one can see, “Everyday Use” employs different devices to make a statement on preserving African American cultural legacies. The first-person perspective enlists the audience to the narrator’s side, and the latter is clearly predisposed to her younger daughter Maggie over the older Dee. The use of names also contributes to creating a distance between Dee and Mama and portraying the former as the one who disregards her legacy. As a result, when the story reaches its culmination, the reader is already prepared to side with Mama and Maggie against Dee and agree that the best way of preserving cultural heritage is not sealing it away in a museum but putting it to the titular everyday use.
Walker, Alice. “Everyday Use.” Aiken County Public School District, 2020. Web.
McDonald’s Managing Financial Principles & Techniques
Executive Summary McDonald’s plan to extend its operations to the UAE is a good move. The company should establish the best pricing method to use as well as come up with an appropriate budget for the anticipated expansion. The report recommends that McDonald’s should price its products/services below the competition in order to survive the stiff competition that is present in the restaurant industry. McDonald’s sales budget is approximately $ 2000000. This figure represents a variance of 5.7% that the researcher considers immaterial considering the huge budget that is associated with the anticipated expansion. In order for McDonald’s to operate within its budget, it should opt to expand to the UAE through a merger as it is the most economical as well as effective strategy the expansion.
McDonald’s has greatly expanded since its foundation in 1948. McDonald’s is the leading chain of restaurants worldwide. McDonald’s offers fast food such as hamburgers, fries and meat pie, as well as chips. The success of the McDonald’s can be associated with its strategic pricing method that has ensured that it provides its products/services at affordable prices to its targeted markets. The mission of McDonald’s is to illustrate customers’ favorite places to eat. McDonald’s is committed to five basic features that entail people, place, promotion, products, and prices. McDonald’s uses different pricing for different market segments.
For example, a McDonald’s restaurant that is located on a roadside or shopping mall in an exclusive neighborhood offers its menu at a higher price than a McDonald’s restaurant that is not located in an elite area. McDonald’s segments its customers by location. This strategy of pricing is a very effective method of availing the same product at different prices in various market segments. In addition, McDonald’s has developed pricing policies tailored for prices increases, as well as for economic downturns.
McDonald’s differentiates its prices by introducing cheaper menu such as cheeseburgers, chicken burgers as well as drinks that cost $ 1, which target low-income families. Because of the recent economic recession that has existed since 2008, McDonald’s was able to realize profits and particularly in 2010, from the profits generated from the sale of Dollar Menu sales (Ghosh & Sidana 2012).
Many new business ventures fail for lacking adequate knowledge about strategic pricing methods. There are some important marketplace factors to consider when determining prices for new products and services, including the market segment, distribution costs, as well as level of competition. In order for business owners to succeed in selling goods and services, they should stay abreast of the factors that affect prices and respond swiftly. There are three important factors in pricing. Price alone is very insignificant when the context of operating costs is not considered. One essential consideration in pricing is labor cost.
Labor cost is the money for paying for work done. Other essential considerations include material costs as well as overhead costs. Overhead costs are expenses that cannot be termed as either material or labor costs. They include expenses such as advertisements. Overhead costs are variable or fixed. Another important factor to consider when pricing is the costs of goods sold. Cost of goods sold entails the overall business costs for producing the products a company sells or the overall costs for purchasing products for sale. Delivery, as well as freight charges, are inclusive (Brodsky 2000).
All methods of costing consider the three aforementioned factors in order to avoid offering products and services at a loss. McDonald’s may opt to price its products above the competition. This process entails setting the prices of its products and services above the prices being offered by competing firms. This pricing strategy will enable McDonald’s to realize higher profits. However, the big challenge that will accompany this option is whether consumers will be willing to pay for the higher prices, and mostly at this moment when people are regaining from the aftermath of the recent economic downturn.
Because of the high competition present in the restaurant industry, McDonald’s should consider pricing its products/services below the competition. Through this pricing strategy, McDonald’s will be in a better position to compete healthily with other international fast-food restaurants such as King Fisher. This pricing strategy will entail setting the prices for its products and services at a price below that of substitute products from its competitors.
In order for a business to be in a position to price their products/services below the competition, they should be in a position to save their costs per unit. One method McDonald’s can be able to adopt this pricing strategy is by keeping its operating costs down. This is because pricing below the competition reflects small profit margins. However, because of economies of scale, companies are able to generate reasonable profits. In order for McDonald’s to enjoy good profits, it should put a tight regulation on its inventory. In addition, it should maintain its rental as well as labor expenses down. Furthermore, McDonald’s should consider looking for economical foodstuffs suppliers (Ghosh & Sidana 2012).
McDonald’s should, in addition, review its pricing model according. Whereas it is important for it to price its products and services below the competition, it should consider adjusting its prices above the competitions in instances of economic booming in order to enable it to enhance its profit realization to facilitate its subsequent expansions as well as enhance the shareholders’ wealth (Lucey 2002).
Organizations that are able to succeed in their missions are those that are able to accurately project their future performances in order to lay appropriate foundations in advance. McDonald’s can opt to use either qualitative or quantitative techniques to forecast its future price changes accordingly. The use of qualitative methods entails gathering data from primary as well as secondary sources and attempting to predict the demand level in the future. The qualitative method of forecasting is mainly used to generate future prices of commodities and services through the use of creativity methods.
This strategy is mainly employed by a few people who are experts and highly knowledgeable about the demand trends. The quantitative method is another strategy that is highly employed to project future prices of goods and services. Quantitative methods are well known for analyzing future developments of numerical data. Econometrics, as well as quantitative techniques, explicitly employ simple models to generate future prices of goods and services by inputting the current and pasts demand in services and products. The trend projection method is a very effective quantitative method that can be used to project McDonald’s future prices of goods and services.
The method entails determining the trend depending on past consumption and projecting future consumption by extrapolating this trend. For example, the future price of a commodity can be gotten from the relationship Yt= a+ b t, where Yt represents demand for year t, a, and b represent constants. The use of quantitative methods to forecast future prices for McDonald’s products and services is better than qualitative methods. This is because quantitative methods enable the manipulation of data consistently and reproductively. This makes it more possible to compare data as well as study rates of changes than when qualitative methods such as data mapping are used (Lucey 2002).
McDonald’s aspires to extend its operations to the United Arab Emirates (UAE). The decision to expand to the UAE lies in its expansion strategy meant to tap into the UAE booming market. There are various methods that McDonald’s can use to source the capital required for the expansion. McDonald’s can opt to use the money it generates from its sales to finance the expansion strategy instead of sharing it as dividends among its shareholders. This source of funds is very important, as there are no interests that will that accompany the money invested. However, McDonald’s restaurants have not performed quite well of late.
Owing to the fact that this is the period that the world economy is recovering from the aftermath of the recent economic downturn. Therefore, McDonald’s restaurants are not generating considerable revenue that it is enough to put into place a significant investment to attract the potential UAE market (Ronald 2008). Another alternative that McDonald’s can opt to consider in order to fund its project is approaching a financial institution and seeking a loan. This method will be appropriate as it will enable the company to get enough funds to finance the project. However, this strategy also has some shortcomings.
One of the shortcomings associated with borrowing money from a financial institution is the high interests that accompany the loan. Apart from paying the principle that the company will be awarded to finance the project, McDonald’s will be required to pay an extra on top of interest. However, the greatest challenge that is associated with borrowing funds from financial institutions is that if McDonald’s fails to raise the amount of money borrowed as agreed, the financial institution may sell the assets that McDonald’s has given as collateral in order to recover its money. In order for McDonald’s to be able to raise the money required to finance its project, it can also consider a merger or an acquisition.
These processes will require McDonald’s to a partnership with other traders that are doing similar businesses in order to raise the required capital required to carry out the expansion. Similarly, McDonald’s can opt to sell some of its shares in order to raise the required money for expansion. Selling of the shares, as well as the use of mergers, are the best options that McDonald’s should consider using to raise the amount of money required for it to extend its operations to UAE. These processes are appropriate because they do not have additional costs that are associated with them.
McDonald’s will require a mastery budget for the expansion project. A mastery budget is considered a summary of an organization’s plans that set sales targets, production, distribution as well as financing activities. It consists of the budget income statement, cash budget, and budget balance sheet. It usually encompasses future management plans, as well as the strategies for achieving the plans. The budget selected for McDonald’s is important, as it will indicate where McDonald’s aspires to be as well as what it requires to do in order to be there. The mastery budget will also be important as it will allow McDonald’s to genuinely project future cash flows that will enable it to get certain types of financing (Davidson 2009).
|Other Budget References
|Less cost of goods sold
|Sales budget, Ending finished goods inventory budget
|Less selling and administrative expenses
|Selling and administrative expense budget
|Net operating income
|Less interest expense
The Variance = (Sales Budget –actual budget)/ Actual budget. The variance = ($2,000,000- 1891800)/ 1891800 X 100 = 5.7% McDonald’s has a sales budget of $2,000,000; however its actual expenditure is 1891800. Considering the huge capitals that accompany the expansion strategy, an overrun of 5.7% is immaterial for McDonald’s anticipated expansion. The 5.7% overrun may have been caused by fewer administrative costs that were associated with the expansion since expansion through the merger will result in the company recording increased performance and efficiency in human capital in its new venture as the employees of the existing company are conversant with the environment (Saren & Brownlie1983).
Multinational corporations that are vulnerable to unpredictable events use flexible budgeting to mitigate the effects. This is because flexible budgeting has an overrun, which is readily available for swiftly mitigating the market demand. However, static budgeting does not respond to changing business conditions and is mainly appropriate for businesses that are not greatly affected by unpredictable events. McDonald’s operates with flexible budgeting because of the various unpredictable factors that affect its operations. The presence of a budget variance is essential in helping the restaurant respond to the market demand swiftly.
In conclusion, the decision for McDonald’s to extend its operation to UAE is superb. However, the company should require coming up with an appropriate strategy it will use to price its products. The researcher recommends the company adopt the pricing strategy that entails pricing its products/services below the competition in order to enable it to compete healthily with other international and local brands. The company sales budget is $ 2000000, which represents an overrun of 5.7%, which it considers insignificant, considering the huge budget associated with the investment. The researcher also recommends the company use a merger for its expansion as it is the most economical as well as strategic expansion approach.
List of References
Brodsky, N 2000, Street Smarts: Raising Prices, Prentice Hall, New York.
Davidson, I 2009, Budgetary Control in Modern Organization: The role and impact of management style, corporate culture and management policies, Prentice Hall, New York.
Ghosh, R & Sidana, D 2012, McDonald’s Customer Acquisition and Retention. Web.
Ronald H 2008, Managerial Accounting, McGraw-Hill-Irwin.
Saren, M & Brownlie, D 1983, A review of technology forecasting techniques and their application. Cambridge University Press, Cambridge.