Case study on management of information systems for Top Shop

Case study on management of information systems for Top Shop Introduction This report is about the implications of MIS, and its influence on Top Shop business. It is written from the perspective of a management consultant who is to hand it over to a client company.Advertising We will write a custom essay sample on Case study on management of information systems for Top Shop specifically for you for only $16.05 $11/page Learn More The report will cover a wide range of topics some of which include organizational hierarchy, input, process and output, Hardware and software for the information system, process of decision-making, use of the management information system in strategic planning and E-commerce among others. The data for topic areas will be gathered from the secondary sources mainly books, journals, internet sources and as indicated in the references list. Organizational hierarchy Top Shop is a multinational organization with more than 20 outlets all over the world. It has its head office in London. Top shop spe cializes in women’s products such as clothes, bags and shoes. In terms of operation, it is partly owned by the Arcadia group (Barclay 2010). Top Shop management style is based on a hierarchical order, from the Managing Director Sir Phillip Green who is based in London. The MD is the overall authority in the company and operates with mandate from the Board of Directors. His role is to manage the company. Management entails â€Å"planning, organizing, staffing, directing, coordinating, motivating and controlling different activities of the company† (KK Enterprises 1993, p.12). In this regard, the managing director has been given the mandate of developing and expanding the long-term business strategies and plans of an organization. This also includes the process of making sure that the objectives of the Board are implemented. Although, the Managing Director is based in London, his role is to control the management system of the organization throughout the world from the h eadquarters. Mooney and Reiley explain that the MD is responsible for coordinating heads of functions or departments in the company (Mooney and Reiley, 2001).Advertising Looking for essay on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More Additionally, the management consists of Senior Managers in different sections of the company who are charged with the responsibility of leading and supervising various sections or departments such as human resource management, Finance, ICT, Finance and Logistics. The department heads are charged with the responsibility of making short-term decisions. The management level involves the middle managers who direct the products or services to the end user. Their main function is to implement the decisions and directives given by the senior managers or departmental heads and put them into practice. The end users who carry out all the work follow the middle and line manager. Largely, the management executes its duties through supervision, communication, leadership and motivation (KK Enterprises, 1993). Functions of Organization The functions of an organization are dealing with how various structures and aims operate, how the pools of human resources are utilised and how different departments or functions operate together. This is true for Top Shop Company that has many functions operating together. Top Shop is a chain of retail shop that mainly manufactures and supplies women’s designer clothes, accessories and shoes (Top Shop, 2012). It is a specialty in providing the latest designer fashions for women. Most of its collections are available through the catalogue. As an organization, Top Shop was invented in 1964 in the city called Sheffield, UK, by Peter Robinson. It has many franchisees and outlets all over the world. Its production of various products has brought lots of success to this organization. It also operates through mergers by coming into coo peration with other likeminded departmental stores in the US, the UK, Australia, and many others (Top Shop, 2012). Schonberg (1990) argues the successful organizations are those that have learnt to link their business functions with the demands of their customers.Advertising We will write a custom essay sample on Case study on management of information systems for Top Shop specifically for you for only $16.05 $11/page Learn More This is something that Top Shop has successfully implemented. It also has large departmental stores in London, New York and Liverpool, which serve as the mother of all stores. These flagship stores are equipped with facilities like hair salons, tailoring services, nail bars, sandwich bars and sweet shops. The first area of Top Shop’s business function is the research and development that continually invests designs and produces new products on regular basis in line with customer demands. The second major business function is selling the products and continuous production of financial services. Top Shop continues to engage in vigorous marketing in a bid to market its brands. The company knows the demands of its customers and continually updates its products. More importantly, the sales department has learnt to work in close relationship with the marketing and production departments to meet its market targets. The third most important part is the personnel department that deals with the recruitment, retention and development of the huge human resource department. The staffs are entail the management, sales representatives, production staffs and those at the public relations office. There is a well maintained staff record and a proper channel for dealing with staff grievances and relationships (Butel et al, 1997). The third important business function is its marketing department that continually invents new marketing methods to meet the customer demands. This department works very closely with the Research and Department to produce new. In terms of advertisement, this company has placed an important value in advertisements, which involve celebrity figures. The involvement of the high-class celebrity figures and supermodels like Kate Moss, Stella Vine, Christopher Kane and Celia Birthwell positively influence the company (Barclay, 2010). According to Barclays, these flagship stores have totally changed the shape and operations of Top Shop. This company has a habit of mixing and matching the fashion demands of their clients by providing designer products (Barclays, 2010). Barclays asserts that the key factor in Top Shops success has been its concept of shopping as entertainment.Advertising Looking for essay on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More The company has been creating unique design labels since 2001 to attract the attentions of the catwalk shows. It also supports young talents and sponsors graduation exhibitions popular with young people. Its involvement with young people has been hugely popular as it portrays itself as creators of young fashion gurus (Barclays, 2012) The fourth and perhaps the most important aspect of its business function is the IT department, which currently operates through the SALMON system. SALMON connects processes and transmits information across its large computer networks. It is used to transmit both raw and processed information to other departments. However, the members of the staff have been trained to handle the data carefully with confidentiality. Input, process and output The company deals with huge volume of works, therefore, managing its information system is an uphill task. It has to deal with the huge volume of producing, supplying, and marketing its services and products. As such , the company needs to come up with well-coordinated and programmed information systems across its internal organization structures. A massive company with volumes of work needs to develop proper information system that has the ability to maintain the objectives and strategic plans of the organization (Schonberg, 2009). The Salmon Information system seeks to coordinate functions of this company from the management, manufacturers, to suppliers. Products have been bar coded to keep track of the products in the shop and the stores. However, since this information system is complicated, it requires proper coordination and management. In most cases, computer experts employed to deal with such roles include computer support personnel, system analysts, computers operators, data base manager, computer programmer, information systems manager, technicians, and information systems manager. According to Schonberg, managers must come up with strategic plans to address and handle the huge technol ogical complexities behind the information systems. Hardware and software for the information system In order for the Information System to operate effectively, it has to incorporate other components like hardware and software equipment. Largely, both the hardware and software serve huge purpose of communication as well as collecting, processing, storing and retrieving of information from one network to another. An effective information system usually consists of three main scopes, which include the management, organization and technology. Concerning this case study, Top Shop is the organization, while the Technology is the information and computing system and the management ranges from the Managing Director to the supervisor on the shop floor. The computer system, which consists of the processor and its internal components must be regularly serviced and managed. This is because they grow old. There comes a time when such system age and need to be upgraded, repaired, and serviced. T he hardware disk includes video cards, in the like manner there is also the software part of the system makes the hardware to operate (Stair Reynolds, 2010). These systems need to be updated regularly. Some of the software include the anti-virus software to protect the company’s system from cyber criminals, fraudsters, and hackers. The security software protects the computing systems against loss, theft and destruction of data and provides back up for information in the event of accidental loss of information, breakage, or destruction. These software are always being updated (Stair Reynolds, 2010). A company like Top Shop must continually update its software systems in order to remain secure. In addition, as an enterprise it has well developed servers that run at high speed with the website being regularly updated and maintained (Top shop, 2012). Updating the information is something that is highly recommended by the experts. The manager may, from time to time, want to incl ude a piece of information on the website or convey a message across the organization. The information system is fast and efficient to be used in all managerial decisions (Stair Reynolds, 2010). Why use the information system? The emergence of the computers has revolutionized the world, human thinking, human relations, manufacturing and managerial operations. Most companies and organizations have today incorporated the MIS into their management program. MIS has become an effective method of translating information from one source to another, which makes it easier for managers to make appropriate decisions in their planning, controlling, and directing operations on a daily basis (Takahara Liu, 2006). For instance, Top Shop being a massive organization, the management has incorporated the Salmon information system as part of its management program. Since we live in the world of information, knowledge has become an important factor in managing firms and many companies like Top Shop h ave incorporated Information systems to achieve the competitive edge. Those companies that have fully implemented this system have obtained the competitive advantaged above the others in the market. Largely, the management needs to find out the relevant information that is appropriate for them and use it in their management programs. Moreover, almost all organizations need to incorporate the information system in their management structures. Furthermore, it has been discovered that information systems always assist the management make better informed decisions and judgments (Takahara Liu, 2006). Information system has become an important weapon for production and making strategic management decisions. It can also be used to empower staff enhancing the workers to make effective contributions to the development of the company’s overall goals (Stair Reynolds, 2010). For instance, Top Shop includes the information system to market its products locally and internationally. Proce ss of decision-making A Manager is someone who has been charged with the responsibility of making decisions that include short and long-term strategies. The decision making process often includes passing of information from one person to another, and managers use the information to make key decisions. Decision-making is a process that incorporates the production of choice or giving an opinion. Making a decision is not an isolated activity but incorporates an interaction with the environment and other factors. It may incorporate both rational and irrational process, based on facts or fictions. In every decision making process, there must be data to be processed. According to Sanders Ebrary (1999) in the corporate world, decision-making process incorporates identifying problems and assessing the outcomes. Largely, decision-making process also incorporates an element of problem analysis to find out the causes and effects of the problem to be solved. The problem analysis depends or rel ies on facts to come up with the right decisions (Saunders Ebery, 1999). Decision is then processed by analyzing and evaluating the information given. According to Fisher Ellis (1990), there are four main stages of decision-making process especially in a small group. These stages include the orientation phase that is about knowing each other in a group, and then followed by conflict characterized by misunderstandings and disputes between members in the group. The third stage is what is referred to as emergence phase, which is associated with the group giving their opinions, while the final stage is known as reinforcement; this is when a member of the group makes a decision and then justifies their decisions. Describe how the information system helps in decision-making The information system has become a vital tool for decision-making by gathering information from one source to another and the distributing it to others. Using information system, the management gathers the informati on needs, processes, stores and transmits it to relevant people. Sharing of the information can be either vertical or horizontally, to perform specific tasks within the business environment (Daft, 2011). The decision making process is about data management and maintenance of information that have been stored in either hard or soft disks to complex certain tasks. Management information system has become an effective tool for offering the information that can be used to make valuable decisions. Managers would initially use the data available to them to process information needed to make key decisions (Kallman Reinharth, 1984). Use of the management information system in strategic planning In addition, the management information system can be used for strategic planning within the business scenario especially in the case of Top Shop. The information that has been stored in the system can be retrieved, processed, and distributed between systems. Through the MIS, the management is able to control the flow of information from one point to another. Apart from strategic planning, the management information system becomes an important tool for ensuring that suitable information is protected and transmitted between suitable or relevant persons. The management would often use the information systems to process quality, reliable and well-planned information for strategic planning. Strategic planning is highly needed to compete in the highly competitive markets (Cassidy, 2006). E-commerce and its effects on business, e.g. EFT, B2B, and B2C communication As an introduction, e-commerce basically refers to electronic commerce, which normally entails conducting business transactions online. It is, thus, evident that there should be internet accessibility in order for e-commerce to take place. There are various types of e-commerce which the Top Shop management can make use of so as to increase its market base, as well as, increase the service delivery to the present customers or clients and suppliers. In the event that the Top Shop management realizes that a greater percentage of its suppliers along with customers are techno perceptive and more than ready to indulge in such transactions, then it will be appropriate to initiate them. E-commerce encompasses various business activities such as the transfer of funds electronically, online marketing, electronic data management just to mention a few. With regard to the nature of business being undertaken by the Top Shop enterprises, it will be more appropriate for them to indulge in online marketing, as well as transfer of funds electronically. Using B2B e-commerce, which is simply the business-to-business e-commerce, Top Shop will be able to make business deals with its suppliers without meeting them physically. Moreover, through e-marketing, the enterprise will be able to reach a wider market base without the need of establishing regional outlets. With the advancement being made technologically, majority of individuals are more interested in shopping online and do not like the physical shopping because it consumes most of their time. In that regard, Top Shop will definitely cut down its operational costs by indulging in e-commerce because the number of shop-attendants will be reduced significantly. However, the management will have to ensure that it has put in place vibrant secure measures to protect its clients from various frauds conducted through cybercrime (Laudon Traver, 2010). Benefits and drawbacks of the information system There are various benefits, as well as setbacks, which are associated with implementing an information system within a business enterprise. Top Shop management will enjoy various benefits such as having easy access to customers’ information along with being able to establish the customers’ preference by analyzing the data, which is already available within the information system. In that regard, it is evident that the information system will as sist the management in formulating strategies aimed at increasing its competitive edge within the market segment. In addition, information systems assist the management in the allocation of duties to its staff. It is easier to detect any staff member who has not been assigned any duty by accessing the information system. Besides, because there is information centralization through the information system, any queries brought up by clients are resolved in a timely manner without having to make consultations with the other staff members. On the other side, there are various setbacks associated with information system. The information systems entirely depend on the computer applications. In the first place, in the event that a hacker attacks it, the stored information may be interfered with. Secondly, the computers can in some occasions breakdown completely leading to loss of vital data. Lastly, in order to establish a vibrant information system, it is vital to seek the services of an I nformation Technology specialists thereby leading to additional costs (Ward, 2006). Conclusion In the advent of information and computing technology, almost every major international company has embraced the Management Information System (MIS). The Top Shop is an international retail company that produces designer clothes, shoes and bags for women. This firm has come from humble beginning from small shop to an international high street chain with many outlets in over 20 countries world. Its headquarters are situated in London under the leadership of the Managing Director, Phillip Green. The company has embraced MIS through the version of Salmon, which allows the managers make decisions, strategically plan, and implement changes. Top Shop has been successful in the recent past because of its brand and vigorous marketing strategies and plans. These include E-commerce and incorporation of celebrity figures to appeal to the younger generations. However, the information tends to have the biggest drawbacks being the external threats propagated by cyber criminals and hackers who may infiltrate into the system and steal people’s identity and information. It is in this regard that the information systems are continually being upgraded and repaired. Reference List Barclay, L. 2010, The unauthorized guide to doing business the Philip Green way: 10 secrets of the billionaire retail magnate. Chichester: Capstone. Butel, L., Curtis, T., McIntyre, J., Pearce, J., Rainbow, S., Smith, D., Swales, C., and Open Learning Foundation. 1997, Business functions: An active learning approach. Oxford: Blackwell Publishers. Cassidy, A. 2006, A practical guide to information systems strategic planning. Boca Raton: Auerbach Publications. Daft, R. 2011, Understanding management. Mason: Cengage Learning. Fisher, B. A., Ellis, D. G. 1990, Small group decision making: Communication and the group process. New York: McGraw-Hill. Kallman, E., Reinharth, L. 1984, Information systems for p lanning and decision making. New York: Van Nostrand Reinhold. KK Enterprises. 1993, Business management. North Melbourne: KK Foundation. Laudon, K., Traver, C. 2010, E-commerce: Business, technology, society. Upper Saddle River, N.J: Prentice Hall. Mooney, J., Reiley, A. 2001, Onward industry!: the principles of organization and their  significance to modern industry. Bristol: Thoemmes Press. Sanders, R., Ebrary, Inc. 1999, The executive decision making process: Identifying problems and assessing outcomes. Westport, Conn: Quorum. Schonberg, R. 1990, Building a chain of customers: linking business functions to create the world-class company. New York: Free Press. Stair, R., Reynolds, G. 2010, Principles of information systems: a managerial approach. Australia: Course Technology Cengage Learning. Takahara, Y., Liu, Y. 2006, Foundations and applications of MIS a model theory approach. New York: Springer. TOP SHOP. 2012, Top Shop Category Display, https://www.topshop.com/

Hedda Gabbler Quotes

'Hedda Gabbler' Quotes Herink Ibsen is one of Norways greatest playwrights. Hes referred to as the father of realism  which is the theatrical practice of making shows seem more life everyday life. Ibsen had a great talent for portraying the drama inherent in seemingly everyday lives. Many of his plays dealt with issues of morality which made them quite scandalous  at the time they were written. Ibsen was nominated for the Nobel Prize in Literature three years in a row.   Feminism in Ibsens Plays Ibsen is probably best known for him feminist play  A Dolls House  but feminist themes occur in much of his work. At the time female characters were generally written as side characters of little importance. When they did play major roles they rarely dealt with the difficulties of being a woman in a society that allowed them very few opportunities or choices. Hedda Gabler is one of Ibsens more  memorable heroines for that reason. The play is a brilliant portrayal of female neurosis. Heddas choices in the play  dont seem to make sense until one considers how little control she has over her own life. Hedda is desperate to have power over something, even if it is another persons life. Even the title of the show can be given a feminist  interpretation. Heddas last name in the show is  Tesman, but by naming the show after Heddas maiden name it implies she is more her own woman than the other characters realize.   Summary of Hedda Gabler   Hedda Tesman and her husband George have returned from a long honeymoon. In their new home, Hedda finds herself bored with her options and company. Upon their arrival, George realizes his academic rival  Eilert as begun working on a manuscript again. George doesnt realize that his wife and former rivals are former lovers. The manuscript could put Georges future position in jeopardy and would secure Eilerts future. After a night out, George finds Eilerts manuscript which hes lost while drinking. Hedda rather than tell Eilert that the manuscript has been found convinces him to kill himself. After learning his suicide was not the clean death she imagined she takes her own life. Quotes From Hedda Gabler These impulses come over me all of a sudden, and I just cant resist them. - Hedda, Act 2Our common lust for life. - Là ¶vborg, Act 2Oh courage...oh yes! If only one had that...Then life might be livable, in spite of everything. - Hedda, Act 2But hell come...With vine leaves in his hair. Flushed and confident. - Hedda, Act 2Everything I touch seems destined to turn into something mean and farcical. - Hedda, Act 4But, good God! People dont do such things. - Hedda, Act 4

The Neighbourhood 2002 Essay Example | Topics and Well Written Essays - 1250 words

The Neighbourhood 2002 - Essay Example In selecting suitable areas, their research work included personal knowledge, maps, census, and data that indicated depravity in different areas. In order to understand the potential boundaries of different areas they went on a tour and studied the neighborhood for their public space, shopping facilities and so on, in order to understand the nature of the areas that facilitated interaction between people as well as the areas of disorder. They chose two affluent neighborhoods on the fringe of the city- the boundaries of the Edinburgh neighborhood had low- rise housing flats and semi- detached private dwellings. In the case of Glasgow, playing fields acted as a sort of â€Å"buffer zone that separated the neighborhoods. Five key sections took part in the interviews – secondary school teachers, community police, councilors, youth group representatives and community councilors. These interviews were designed in such a way in order to study the social connections between the different neighborhoods. Baumgartner used the term â€Å"champions† to describe the outside agencies that took part in the interview and wondered if they would be of any use.In the affluent areas, crime and disorder such as property crime, environmental degradation and disturbances involving young people seemed to be the main concerns. On the other hand, serious crime and disorder in the deprived areas seemed to run rampant. Community spirit was perceived to be greater in the affluent neighborhoods than the deprived areas where there was less trust in their neighbors.The neighborly interaction was limited as residents would help in an emergency, but would prefer to keep to themselves otherwise.Findings revealed the va rying perceptions of the neighborhood by its residents. Whilst there are pockets of disturbances our findings reflect that perception of crime partially involves people reacting differently to similar phenomena (Hope, 1998). The people of the deprived areas feel that they are more exposed to serious crime and this, in turn, reflects the nature of community relationship enjoyed by their respective residents.

Violence on Television Increases Violence in Children Essay

Violence on Television Increases Violence in Children - Essay Example All these shootings and other violence by children and teenagers have opened a public debate concerning various issues. Some blamed the easy availability of weapons for the shootings while some focused on the problems of bullying and peer abuse in American High schools as the reason behind this violence. However, there were some researchers who looked beyond the obvious and pinpointed the media behind the increase in violence. In this paper, we shall debate on the controversial issue that violence on television increases the violence in children and teenagers and stand by it. According to a research, children in America watch four hours of television daily on an average which implies that television has a powerful influence in developing value systems and shaping behavior. But sadly, most of the programs broadcasted on television are violent nowadays. From the daytime talk shows, most of which are portrayed by unashamed emotional, psychosomatic, and corporeal exploitation by jury gue sts towards each other, to the prime time shows and the WCW (World Champion Wrestling), all these programs proliferate excessive violence and aggressiveness. Most of these programs are watched by a growing number of young children and adolescents who view them along with their parents. As the matter of fact, violence forms the key constituent of the Network news too, as most of it is plagued with explicit renderings of murders, traffic mishaps, kidnappings, international war scenes, and the like. The story is the same everywhere; the good people slaughter the bad people, most often with an arsenal of weapons that has become a humdrum possession for today's T.V. characters (American Academy of Child and Adolescent Psychiatry [AACAP] n.pag.). This starts the debate that whether these television programs really affect our children or not. Various studies done to evaluate the impact of T.V. violence on children and teenagers have revealed that children are affected in different ways by these shows. They may become immune or dumb to the horror of violence, or gradually accept violence as the means to sort out problems, or try to imitate the violence shown on television, and identify with certain characters, victims and/or victimizers. Children who become violent watching such T.V. programs will show a range of behaviors including explosive temper tantrums, threats, bullying, aggressiveness, armed assault, and harm to animals and peer groups. In fact, a research done by psychologists L. Rowell Huesmann, Leonard Eron and others also revealed those children who watch long hours of brutal programs during elementary school level tend to show higher level of aggressive behavior when they become teens. They further found that eight years old children, who watch too much of television, are mostly the ones who get prosecuted for criminal behavior as adults (American Psychological Association [APA] n.pag.). Additionally, many children who are overexposed to violence, and spe cially, to pragmatic violence start judging the society as one which is, by and large, hazardous and perilous. This misjudgment makes them fearful towards life as they start considering themselves future victims of violence (AACAP n.pag.). However, researcher David Buckingham stated that â€Å"one may well discover that children who are violent watch a lot of television violence, but this does not prove that violent television causes real-life violence†

Management And Treatment And Psychosocial Aspects Of Pneumonia Biology Essay

Management And Treatment And Psychosocial Aspects Of Pneumonia Biology Essay This essay will explore the pathophysiology, management and treatment, and psychosocial aspects of pneumonia in an adult patient. Information has been obtained by the means of history taking, examination, and analysing the patients medical records to form a case study in which the sections mentioned will be considered in relation to the case study. Section A Case History VD is a 68 year old female who was admitted into the acute medical unit (AMU) on 29/1/11 following complaints of generally feeling unwell and chest pain. She had a history of feeling unwell since 25/1/11 coupled with chest pain. This pain was a sharp pain under her right breast which was intermittent and radiated around her chest to her back. The pain was worse on inspiration or when coughing, and was relieved by over-the-counter analgesia. She also felt sweaty, pyrexic (39.7  °C), had rigors and aches over her body, however she was not short of breath. She also had symptoms of a non productive dry cough, poor appetite and vomiting once in AMU (watery and colourless). She previously had no episodes of nausea and vomiting, no palpitations or headaches, no urinary symptoms and normal bowel movements. She has not had any recent contact with anyone who had similar symptoms. In her past medical history she was diagnosed with Sjà ¶grens syndrome and systemic sclerosis last year; both systemic autoimmune diseases. She was on two courses of antibiotics last year for associated pleuritic chest pain. Her family history consisted of her father having ischaemic heart disease (IHD) and her mother dying from lung cancer, although she was a heavy smoker. She currently lives with her husband at home and her occupation is as a shop assistant; this indicates that the infection she has is most likely to be community acquired. She has been a lifelong non-smoker and she does not drink alcohol. She was on no regular medication prior to being admitted, but is now on 1000mg of paracetamol four times a day (QDS) and 500mg of amoxicillin three times a day (TDS). She has no allergies. On examination in a respiratory ward, VD was apyrexial with a blood pressure reading of 95/65, a heart rate of 95 beats per minute and a respiratory rate of 18 breaths per minute. Oxygen saturations (SATS) were 96% in air and she was speaking in full sentences, whilst looking generally comfortable at rest. Her hands seemed dry and scaly on inspection but there were no abnormalities on her face. On palpation of her chest, there was equal chest expansion and no tracheal deviation. There were also no enlargement of cervical or supraclavicular nodes. On percussion, there were dull sounds that could be heard on both right and left lung bases. On ausculatation, coarse crackles could also be heard in the right and left lung bases. There were no abnormal heart sounds heard and her capillary refill time (CRT) was less than 3 seconds. Her abdomen was soft and non tender, and normal bowel sounds were heard. There was normal tone, power and reflexes in all 4 limbs and her Glasgow Coma Scale (GCS ) score was 15/15. Her arterial blood gas values were as follows: pH 7.43, pCO2 5.49, pO2 10.1, HCO3- 26.8, basal excess of 2.8 and glucose of 5.6; these values indicated that she was not in respiratory failure. She was also found to have a raised C reactive protein (CRP) of 210, with a high neutophil count of 10.1. Her chest x-ray film revealed consolidation in her right lung base and no pneumothorax. The impression from the x-ray was that it was right lower lobar pneumonia (Figure 1 is an example of what VDs x-ray would have looked like). 1 No blood cultures were recorded in her notes as it was assumed that due to the neutrophilia the likely source was bacterial. After being initially treated with intravenous (IV) antibiotics in hospital, her symptoms were relieved, no crackles could be heard and her chest was clearing up on 1/2/11. She was then discharged in the afternoon on 2/2/11 given the instructions to continue with her course of oral amoxicillin. Section B Pathophysiology Introduction Pneumonia can be described as an inflammation to the lungs distal airways, particularly the alveoli, usually with a bacterial infection being the origin. 2 3 It clinically presents as an acute illness which can include fever, cough and purulent sputum, although the latter was not present in VD. Pneumonias can be classified by the site of the consolidation (anatomically), or by the aetiology of the disease (see Table 1). 2 3 VD was suspected to have lobar pneumonia after looking at her chest x-ray. The majority of lobar pneumonias are due to Streptococcus pneumonia and can affect a large part, or a whole lobe of the lung. 3 Lobar Pneumonia There are four stages to the pathology of lobar pneumonia, which is a classic example of acute inflammation; these are: congestion, red hepatisation, grey hepatisation and resolution. 3 Congestion is the first stage and lasts for approximately 24 hours. This is represented by protein-rich exudates leaking into the alveolar spaces and also causing venous congestion consequently causing the lung to become oedematous, heavier and redder in colour. 3 The next stage is red hepatisation which has a duration of a few days. Large numbers of polymorphs (neutrophils and basophils) accumulate in the alveolar spaces along with some lymphocytes and macrophages. 3 Many erythrocytes are extravasated from the distended capillaries into the lung tissue, along with the overlying pleura being covered with fibrinous exudates. 3 The lung is now solid and airless, resembling a fresh liver. Figure 1 supports the latter statement by showing a solid consolidation in the right lower lobe. When the lung become s grey and solid, this is grey hepatisation. This also lasts a few days and represents further accumulation of fibrin coupled with the destruction of leukocytes and erythrocytes. 3 The final stage is resolution, whereby the lung reverts to its normal condition. 4 This happens at approximately 8-10 days in cases which are untreated and is when the cells and fibrin in the alveoli undergo fatty degeneration. 3 4 This causes the exudates to be converted into an emulsion, producing a yellow pus-like appearance. 4 The exudates are now in a condition where they can be reabsorbed, whilst preserving the underlying alveolar wall structure. 3 4 The lungs would be softer but remain solid, and this would be confirmed on an x-ray by consolidation of the lungs. Co-morbidities VDs history also mentioned having a background history of Sjà ¶grens syndrome and systemic sclerosis; both systemic autoimmune diseases. Sjà ¶grens syndrome is an inflammatory disease that predominantly affects the exocrine glands with an association to HLA-B8/DR3, which usually causes dryness in the eyes and mouth. 2 5 However it can also cause extra glandular problems such as: Raynauds phenomenon, arthritis and lung inflammation, causing degradation of the lining of the bronchioles and alveoli consequently causing lung infections. 2 5 6 Systemic sclerosis, also known as systemic scleroderma, is a multi-system autoimmune disease in which the cause is unknown. 2 It mainly causes tightness and hardening of the skin (such as VDs hands) but other systems can also be affected, such as the lungs. 2 There is some destruction to the lungs in patients with scleroderma which can lead to right heart failure due to pulmonary hypertension. 7 Other complications that involve the lungs include pulmonary haemorrhage, pneumothorax and pneumonia. 7 Summary VD had come in with an acute infection and was diagnosed with pneumonia. Her right lower lobe was consolidated meaning that she has had it for a few days as protein exudates have leaked into the alveolar spaces and becoming fibrinous, showing up as solid on the chest x-ray, with her CRP (a marker of inflammation) also being raised. VDs medical history last year stated that she had suffered from two previous chest infections that required antibiotics for her to recover. This could possibly be due to the autoimmune diseases aforementioned that she had recently been diagnosed with, causing her to be more predisposed to contracting infections, especially in her respiratory tract. She is currently not on immunosuppressant drugs, but if she were to be for her autoimmune conditions it would then be detrimental to her immune system. This would leave her still being prone to acquiring infections, leaving her in quite a predicament. Section C Treatment and Management VD was on 1000mg of oral paracetamol QDS and 500mg of oral amoxicillin three TDS by the time she was moved to the respiratory ward. The main actions of these drugs were to improve her feverish symptoms and pain whilst also attempting to clear up her infection. Paracetamol Paracetamol (also known as acetaminophen in the USA) is one of the most widely used non-narcotic, analgesic and antipyretic over-the-counter drugs in the world. 8-11 It has properties resembling those of nonsteroidal anti-inflammatory drugs (NSAIDs) such as its analgesic and antipyrexic actions, which can be traced back to the inhibition of the central nervous systems prostaglandin (PG) synthesis. 8 9 It also shares some anti-inflammatory properties, however it does not produce the platelet or gastric side effects that the other NSAIDs do, thus causing argument as to whether it should even be classified as an NSAID at all. 8 It is commonly given orally and is metabolised in the liver, with a half life of approximately 2-4 hours, hence why VD was given it QDS to avoid toxic doses. Mechanism of Action It is considered that the main mechanism of paracetamol is the inhibition of the enzyme cyclooxygenase (COX), COX-2 in particular as studies have shown that it is highly selective towards it. Due to its high selectivity towards COX-2, its inhibition towards pro-clotting thromboxanes is limited. 9 It is said that paracetamol works centrally and is a weak inhibitor of PG synthesis in intact cells, if the concentrations of arachidonic acid available are low enough, through the inhibition of COX-1 and COX-2. 12 This concept was based on research that discovered that PG production in the brain was more sensitive to inhibition from paracetamol by tenfold compared to the spleen. 9 The COX enzymes are responsible for the metabolism of prostaglandin H2 from arachidonic acid. 9 This is an unstable molecule that can form many pro-inflammatory compounds; COX is highly active when oxidised. 9 12 The oxidised form of the COX enzyme is reduced by paracetamol, stopping it from creating pro-inflammat ory compounds. This lowers the amount of PGE2 in the central nervous system, therefore decreasing the set-point of the thermoregulatory centre in the hypothalamus. 9 Exactly how the mechanism of the inhibition of the COX enzymes is still in discussion. Due to the differences of activity between NSAIDs and paracetamol, it is thought that there may be another variant of the COX enzyme that paracetamol interacts with, COX-3 a splice variant of the COX-1 enzyme; however this is just a hypothesis and has yet to be proven. 8 9 12 Side Effects When paracetamol is given at therapeutic doses adverse effects are uncommonly seen, although allergic skin reactions are sometimes observed. 8 Fatal hepatotoxicity can be potentially caused by toxic doses of paracetamol (10-15 grams). 8 Initial symptoms are nausea and vomiting, followed by liver damage after 24-48 hours. 8 13 This happens when the enzymes in the liver, cytochrome P450, catalysing the normal conjugation reactions become saturated, and consequently causes the drug to be metabolised instead by mixed function oxidases. 8 A toxic metabolite, N-acetyl-p-benzoquinoneimine, is formed and inactivated by conjugation with glutathione. 8 13 However when glutathione levels are depleted, the toxic metabolite accumulates and reacts with nucleophilic constituents in the cell, causing necrosis in the liver and kidney tubules. 8 Contraindications Paracetamol is generally well tolerated by the liver when polypharmacy is involved. However, evidence has shown that chronic alcoholics are more susceptible to paracetamol hepatotoxicity, even at therapeutic levels. 13 Chronic alcohol ingestion induces hepatic microsomal enzymes (CYP2E1) by twofold and can increase paracetamol hepatotoxicity, due to increased amounts of the toxic metabolite. 13 Amoxicillin Amoxicillin is a moderate to broad spectrum, ÃŽÂ ²-lactam antibiotic that is commonly used to treat infections that are caused by susceptible bacteria, pneumonia being one of them. 8 14 A derivative of penicillin, this semi synthetic ÃŽÂ ²-lactam antibiotic is created by adding different side chains to the penicillin nucleus, causing it to become broad-spectrum. 8 It is sometimes combined with clavulanic acid in treatment to form co-amoxiclav, which is more effective in treatment nowadays due to the increase in antibiotic resistance; microorganisms are now developing a resistance to penicillins by secreting ÃŽÂ ²-lactamases and the addition of clavulanic acid inhibits this enzyme. 8 Pharmokinetic Aspects The routes of administration are quite vast: when given orally, amoxicillin is absorbed to a different degree compared to other penicillins as it depends on their stability in acid and their adsorption to foodstuffs in the gut. 8 It can also be administered through intramuscular or intravenous injections; however intrathecal administration is generally avoided as it can cause convulsions. 8 Elimination of amoxicillin is rapid and mainly due to the kindneys, with 90% being through tubular secretion. This however may be advantageous as the inhibition to cell wall synthesis is intermittent rather than continuous, and exposure to the drug is reduced. 8 Mechanism of Action Î’-lactam antibiotics inhibit the synthesis of the bacterial cell wall peptidoglycan leading to lysis of the bacterium; this peptidoglycan is crucial for the structural integrity of the cell wall in bacteria, particularly organisms that are Gram-positive. 8 In the synthesis of a peptidoglycan, the final stage is transpeptidation which involves transpeptidases known as penicillin binding proteins (PDPs). Î’-lactam antibiotics attach to these PDPs on bacteria and inhibit the transpeptidases that cross-link the peptide chains attached to the backbone of the peptidoglycan. 8 15 16 The ÃŽÂ ²-lactam antibiotics are closely related to D-alanyl, the terminal amino acid of the peptidoglycan layer. 15 16 The similarity between these two structures allows for the antibiotic and the amino acid to promote their binding to the PDP. 15 The binding of the ÃŽÂ ²-lactam nucleus to the residue of the PDP is irreversible, and it is this irreversible binding of the PDP that disr upts the final transpeptidation of the peptidoglycan layer and consequently inhibits bacterial cell wall synthesis. 8 15 16 The inhibition of transpeptidation due to the ÃŽÂ ²-lactams causes an accumulation of peptidoglycan precursors, which initiates autolytic enzymes to lyse the excess peptidoglycan. 8 Under normal circumstances, the peptidoglycan precursors inhibit the autolytic enzymes; however the ÃŽÂ ²-lactams inactivate this and halt the process. 8 Unwanted Effects Penicillins are mainly free from toxic effects. The main side effects are hypersensitivity reactions caused by by-products of the breakdown of penicillin, which combine with the host protein and become antigenic. 8 Skin rashes and fever are common but much more serious is acute anaphylactic shock which can be fatal in some cases. 8 When administered orally, penicillins, particularly broad-spectrum types such as amoxicillin, can disturb the bacterial flora in the gut; this can be associated with gastrointestinal (GI) disturbances. 8 Summary VD had no complications and responded well to the treatment that she was given. It was suspected that she had community acquired pneumonia and that the treatment would be a broad-spectrum antibiotic to fight the infection. Paracetamol was also prescribed to alleviate her symptoms. As paracetamol and amoxicillin work on different receptors, there were no contraindications to her treatment. She was given medication intravenously, but once she moves onto oral amoxicillin, she must be aware of GI side effects that may occur. Section D Psychosocial Aspects and Public Health Psychosocial Aspects Although initially there may not be many psychosocial aspects to pneumonia, VD could be suffering indirectly from it. A sufferer of Sjà ¶grens syndrome, VD is susceptible to fatigue which can be physically and mentally exhausting. This can lead to depression, emotional stress and general lethargy. As VD is susceptible to getting infections such as pneumonia due to Sjà ¶grens syndrome, it can also further impact on her psychologically whilst dealing with those infections as her quality of life may be significantly reduced. 17 It is important that a patient with Sjà ¶grens syndrome can address these issues to a health professional if they are ever in distress as psychosocial factors may lead to non-compliance in their treatment. Epidemiology There have been many population studies that have been investigating the annual incidence rate of community acquired pneumonia (CAP). In adults, this can vary from, 2.6-13.4 per 1000 inhabitants, with somewhat higher figures in males and at the extreme ages of life. 18 19 Rates of hospitalization range between 22-51%, with annual mortality rates between 0.1-0.7 per 1000 patients. 20 In approximately 50% of patients with CAP, a pathogen of cause was determined. Streptococcus pneumoniae is found in 20-75% of the cases followed by Mycoplasma pneumoniae at 1-18%, Chlamydia pneumoniae at 4-19% and other viruses from 2-15%.20 C. pneumoniae, however, has arisen as a noteworthy pulmonary pathogen in adult pneumonia patients requiring hospitalization. 20 Cost-effectiveness of Patient Care On average there are roughly 4.5 million visits annually to outpatient clinics, emergency departments and physicians offices due to CAP. 21 However, there has been very little in terms of studies gathering national data on the costs of CAP treatment. One study showed that there was, a total cost of $4.8 billion for treating patients aged à ¢Ã¢â‚¬ °Ã‚ ¥65 years and $3.6 billion for treating patients aged Conclusion VD was an elderly woman who was admitted into hospital complaining of acute chest pain and fever for the last few days. After taking a detailed history and examination from her, and with confirmation from a chest X-ray she was diagnosed with right lower lobe community acquired pneumonia. Due to the high neutrophil count in her alveolar spaces, the causative pathogen was most likely to be bacterial and so VD was promptly treated with intravenous amoxicillin, a broad spectrum ÃŽÂ ²-lactam antibiotic that works by inhibiting peptidoglycan synthesis in bacterial cell walls. Paracetamol was also prescribed to alleviate her feverish and chest pain symptoms by inhibiting COX enzymes and PG synthesis in the CNS. Having been diagnosed with chronic autoimmune diseases that can lead to increased susceptibility to chest infections, this can lead to psychological issues such as depression. Recurrent admissions will also be costly to the NHS; if alternative treatments that can allow patients to be treated in an outpatient setting are possible, then there could be significant reductions in cost, particularly for patients over 65.

Revolutionary road Essay

Revolutionary Road was a profound movie. This film portrays the malaise that had lied behind the American Dream during the mid-1950s. During that era, the image of the nuclear family living in suburbia where the man is the bread-winner and the woman as the domesticated housewife was considered as the dominant idea constructed by a patriarchal society. This film tracks the unraveling of April and Frank Wheeler, a couple who had unwantedly settled with two children living in suburbia unable to get themselves out of the empty and meaningless life they have. April had thought she and Frank were different than everyone else around them that had fallen victim to conformity. She thought they were deserving of a more exciting life and so convinces Frank to move to Paris rather than being stuck as a chance to escape from being a lonely unfulfilling housewife. But as soon as April realizes she is pregnant for the third time, plans to move Paris had to be abandoned which then really sends April over the edge. Both Frank and April are individuals in their own right, the suffering and inflicting suffering eventually leads to a tragic end to April’s life through a self-induced abortion. As well gender stereotypes, gender discrimination, androcentrism are well indicated within this film and era which will be further discussed. This film expresses the suffering of how many domesticated women had felt in the era of the 1950s. It reveals the sickness of a culture that tends to shut down a woman’s feelings in the self-serving illusion that a nice home with a yard, committed stay at home mom and a bread-winning husband were the answer for a happy and fulfilling life. Evidence of female discrimination were depicted when April is shown to take out the garbage and realizes all the trash is perfectly lined up along with one and another along the streets and during the scene where Frank is shown to be standing in the train having a breath of fresh air while having a cigarette (Orawan, 2010). These two scenes basically show the difference in the amount of freedom and choices that a man and woman had, where married women are shown to be confined to their home with their household and childrearing duties, meanwhile the man gets the freedom and choice of going about whatever they like outside their home (Orawan, 2010.). In another scene showcasing the gender discrimination that was placed on women was the topic on abortion. Besides being a high-risk mortality procedure, it was also illegal during the 50s as a way  to prevent women’s autonomy and restrict them to their traditional child-bearing role (Gordon, 1990). As such this was portrayed when April attempts to take abortion into her own hands as a desperate attempt to get her life back in hopes to take control of her life and so to be free to pursue to her dreams (Orawan, 2010). April had no rights over the choice to reproduce due to the standards set by society which had led to her taking the abortion into her own hands (Tas, 2010). It is evident that society at the time had preceded the belief about women’s duty to be subservient to their man and become a baby producing machines plus the ambivalence felt towards women that had led to discrimination of women (Matlin, 2012, p. 39) The movie clearly presents androcentrism in one particular scene for me, when Frank makes his way to work and all the people around him were men with very few that were women. This just shows the freedom and normalcy of men being able to work and be able to be out during the day. The very few women depicted to be working or on the city streets are only women that were unmarried. To me, this showed that women still had their individual identity until they became married where the women adopts the identity of her husband to become his supportive and obedient wife. Another issue is that even though unmarried women were able to obtain work, but because women were also considered as second class human due to androcentrism they were limited in options as well. Unmarried women were discriminated from higher employment positions with the choices of only low-levels jobs such as administrative or secretarial jobs (Tas, 2014). As it is suggested by Matlin (2012), there are negative attitudes to wards women’s competence especially from men of traditional views; as such women during the 50s were seen only capable of dull, mind-numbing jobs. Gender stereotypes were particularly evident when the Wheelers had told their friends, Miley and Shep Campbells, that they were moving to Paris and that April would take on the bread-winning role making Frank a dependent. In reaction to the news, Shep had thought their plan was immature imposing the stereotypical idea again that married women should not be working and that the man should be the one bringing home the money to support the family; this was the norm. This is clearly evidence of benevolent sexism as it shows  the assumption that women should not be held with so much work responsibility and should be taken care of by the man (Matlin, 2012, p. 58). When Shep asked Miley to confirm his opinion about the Wheeler’s being immature, she hesitantly agreed and begins to cries. This scene was of huge significance as this reveals the suffering that Miley feels as a housewife and by her husband’s comment she realizes that her life is hopeless in that she will remain i n her current position for the rest of her life. I can see that Miley is just a bit jealous of the Wheelers for making the move to Paris, she desperately wants out but is afraid to tell Shep what she feels inside. The consequences of internalizing gender stereotypes are represented in the same scene where Miley does not reveal her real thoughts and so allows her husband to further oppress her. Miley is influenced by the gender stereotypes that is presented in society and assumes the role of a subservient housewife. Miley did not say anything to act or rebel against her husband as she is afraid to appear to be a disobedient wife and accepts her husband’s comments about the Wheelers, revealing the fact that she has given up on her own principle. Additionally, Miley cries to let out her emotional frustration in that she then realizes the hopeless and empty life that she holds and inability to express her feeling shows her acceptance of her role in life; this in some way I feel is abusive to oneself psychologically and physically. Revolutionary Road is definitely a blast from the past taking on a Feminist approach to revealing all the negative effects of women living in suburbia during the 1950s. Due to androcentrism being the main idea of society, many negative attitudes and beliefs about women were expressed in this revealing the gender stereotypes and discriminations that were experienced. The character April Wheeler had revealed the sufferings of living a life with no choices bounded by her house, husband and children. With the women’s movement of the 1970s much of the negative attitudes and discrimination towards women have decreased in North America (Silverstein, 2008). However, I believe the idea of the nuclear family, the American Dream is still seen as for many, such as my family, is still the ideal way of life. References Gordan, L. (1990). Woman’s Body. Woman’s Right. Retrieved from http://www.feminist.com/resources/ourbodies/abortion.html Matlin, M. W. (2012). The Psychology of Women. (7th Edition). Belmont, CA: Wadsworth, Cencage Learning. Orawan, C. (2010, March 9). Revolutionary Road: Feminist Liberation in Post-War Suburban Prison. Retrieved from http://blog.nationmultimedia.com/print.php?id=8050 Silverstein, M. (2008, December 26). Feminism & Revolutionary Road. Retrieved from http://www.huffingtonpost.com/melissa-silverstein/feminism-revolutionary- ro_b_153604.html Tas. (2010, April 14). Was ‘Revolutionary Road’ about Feminism? Retrieved from http://metrac.wordpress.com/2010/04/14/was-revolutionary-road-about-feminism/

Breaking Away From Society A Doll’s House by Henrik Ibsen...

Modern interpretations of â€Å"A Doll’s House† and â€Å"Trifles† portray that these dramas are solely works of feminism, when in fact they address a more important issue of the time: marriage ideals. During this time, marriages were nothing but a masquerade. Husbands and wives hid behind their commitment, and were overly focused on the appearances and opinions of society. Society played a key role in the formation of the attitudes and opinions of marriage in the late 1800’s and early 1900’s. â€Å"A Doll’s House† by Ibsen was written in 1879 and focuses on the problems within the traditional marriage of the time. â€Å"Trifles† was written several years later in 1916 by Susan Glaspell and was also a story that brought the issues with marriage ideals to the†¦show more content†¦Their marriage is strained mostly because of Torvald’s inability to see the wrong in society. Torvald treats Nora as if she were a young child. He patronizes her by calling her nicknames such as, â€Å"Little Miss Sweet Tooth†, â€Å"little pigheaded miss†, and â€Å"my little featherbrain†. (Ibsen 1602, 1599, 1625). While some may argue that Torvald’s patronizing and demeaning attitude is the sole cause of the deterioration of their marriage, the real reason behind the fall out is a collection of much deeper issues. From early on in the story we can tell that there are more problems with their marriage than Nora leads on. When Nora sees her old friend Mrs. Linde, she acts as if her life is going perfectly as planned. Nora brags about her husband exclaiming, â€Å"Just imagine, my husband’s been appointed manager of the bank!† (Ibsen 2604). Nora only reveals the positive parts of her marriage and keeps her hardships and struggles locked away. Later on in the story it becomes very apparent that in the late 1800’s, secrecy was a key part of matrimony. Nora went to extr eme lengths to keep secrets from not only her husband, but from herself; she acted completely oblivious to the demeaning attitude that Torvald emitted towards her. The couple also faced problems with honesty. Nora felt that she could not trust Torvald; hence why she kept the forged signature a secret from him. Torvald, himself, also was not completely honestShow MoreRelatedRebellion Against Society in Ibsens A Dolls House Essay677 Words   |  3 PagesRebellion Against Society in A Dolls House      Ã‚  Ã‚  An underlying theme in A Dolls House, by Henrik Ibsen, is the rebellion against social expectations to follow what one believes in their heart. This theme is demonstrated as several of the plays characters break away from the social norms of their time and act on their own beliefs. 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