Business Literature Review

by admin | Mar 21, 2023 | Uncategorized

Management in Organisation Qualitative Research
Introduction
Though managing an organisation involves long-term thinking and careful consideration of the organisational dynamics, many corporations cannot handle untimely alterations of the business environment. This is because the global monetary crisis comes at an unprecedented time, thus not easy for some organisations to put their operations in order for them to cope with such financial challenges.

Despite the reality that the financial challenges have hit global business operations in one way or the other, and at different times, the horizon at which the companies operate has not been so proactive (Gustavo, Michaely & Swaminathan 2002, p. 379).

For instance, the corporate finance and agency problems have created monetary conflicts that exist between the management of the company and their stockholders, an issue that has really affected the decisions at the corporations (Gustavo, Michaely & Swaminathan 2002, p. 389).

The conflicts are relevant to corporate finance since the managers of the company, who are meant to act for the best interest of the shareholders often, fail to do so as expected of them. These managers, who act as agents of the shareholders, are meant to make decisions, which are geared towards maximizing the stockholders’ wealth. However, they fail to do so, owing to their desire to maximize their own wealth.

In essence, these agency problems are related to the corporate finance in the sense that they help in understanding and analyzing the stockholder’s equity, corporate governance, and agency costs. Contemporary studies evidence that the non-responsive nature of the management to information related to the eventual financial crisis, lead to compromised decisions about the specific monetary problems.

Literature Review
Corporate stakeholders are often faced with the conflict of interest to pursue personal goals other than the intended objectives of the company. This makes it difficult for them to formulate guidelines, which might help the company avoid the impacts of financial crisis through pre-empting the market situation and other financial environment of the company (Gustavo, Michaely & Swaminathan 2002, p. 389).

Therefore, there is need to put in place appropriate mechanisms so as to effectively deal with the potential conflicting issues in the organization. Research attributes the ignorance of the management to offer advisory opinion about looming financial crisis depicts the pursuit for personal interests, other than that of the company.

The conflict of interest among the stakeholders of the company might make the shareholders to pass a vote-of-no-confidence on some of the board members during the members’ board meetings (Gustavo, Michaely & Swaminathan 2002, p. 397). The presidents of the company are awarded bonuses due to their hard work so as to motivate them.

However, when the performance is dwindling as witnessed in the Coca-Cola Company, the stakeholders might be forced to terminate the contracts of the top management team of the corporation, if assumed that their roles would compromise the productivity in the company.

Indeed, the dividend policy of any firm can be regarded as irrelevant owing to the fact that the corporations that often pay a lot of dividends to the shareholders give little price appreciation (Gustavo, Michaely & Swaminathan 2002, p. 389).

However, but must offer the same sum of revenue returns to the investors, depending on their risk characteristics as well as the cash-flows generated from the investment ventures (Jackall 1988, p. 55). In fact, since there are lack of taxes, but, if there is any, both the capital gains as well as the dividends are often taxed under a similar rate.

Therefore, the investors ought to be indifferent to get their expected returns in both the price appreciation as well as in dividends, under such circumstances. Importantly, some assumptions must be incorporated in this argument for it to be true.

First, it must be assumed that the transaction costs are lacking, thus making it impossible to convert price appreciation into some cash (Jackall 1988, p. 58). In such cases, the entrepreneurs are disadvantaged and the company may find itself in the crisis.

Second, it has been assumed that companies, which offer a lot of dividends, are capable of issuing their stock, without both the transaction costs and the floatation costs (Jackall 1988, p. 61). As a result, this implies that the stocks are priced fairly.

Third, the management may not direct the stakeholders to take a leading role in minimizing the dilemma (Gustavo, Michaely & Swaminathan 2002, p. 389). Finally, it has been assumed that the management members of the company just pay few dividends, and do not waste the free cash-flows allocated to them so as to pursue their own personal interests and gains (Jackall 1988, p. 65).

Contrary to the former statement, dividend policy may matter in the real word owing to several imperfections that are eminent. Some of these imperfections can be attributed to conflict of interests among the stakeholders, information asymmetries, and taxes levied (Sunder & Myers 1999, p. 219). Under these circumstances, the dividend policy matters.

For instance, when the corporation’s management team members tend to waste the resources of the company, then the shareholders would prefer to have large sums of dividends, though this will eventually raise the taxes to be paid by the company (Sunder & Myers 1999, p. 219).

According to Lyandres and Zhdanov, the information and signaling content in dividend announcements can be defined as the way the dividend announcements present information to the investors/shareholders about the future prospects of the company (Lyandres & Zhdanov 2007, p. 54). The fact that the company might declare dividend is itself an indication that it is responsive to changes in the financial market.

The empirical validity of this concept can be ascertained under the fact that stock prices often increase when there is some increase announced on the dividends or when the dividends (Sunder & Myers 1999, p. 220).

On the contrary, the stock prices often fluctuate when there is decrease in the prices of dividends announced or when no dividend has been declared and may have its impacts on the financial aspects of the organization (Lyandres & Zhdanov 2007, p. 60). As a result, many investors will shy away from investing in such companies. In fact, this is caused by the dividends information content.

In situation whereby the cost of new equity capital is more than the retained earnings it would mean that the company lacked sufficient funds to compensate its shareholders (Sunder & Myers 1999, p. 220). In such a case, the firm might be forced to source for more equity funds.

However, when many new investors are brought on board the company’s ownership and control might be diluted in the process, as a result of the new investors. On the other hand, it is not a worthy venture for the company to issue new stocks so as to pay dividends in the same financial year or accounting period during, and immediately after the financial crisis (Sunder & Myers 1999, p. 221).

In addition, the performance of the stock market is not accurately predictable in the sense that it is pegged on so many factors such as history of the firm, the management of the firm, its liquidity, and credit worthiness among other factors (Sunder & Myers 1999, p. 222). Therefore, before the company declares and pays dividends to the investors, it is not likely to sell many of its stock in the market.

Therefore, the decision of a company to pay dividends using the new issue of stocks during the same year is not a rational one and could lead to more problems during financial crisis (Lyandres & Zhdanov 2007, p. 61).

The free cash flow hypothesis ascertains that the financial performance of a company is always calculated on its operating cash flow, once the capital expenditures have been subtracted (Thompson & McHugh 2002, p. 48). This helps in predicting a possible financial crisis so that the management can put in measures to reduce the affects.

Therefore, the free cash-flow is the sum of money that the company is left with after putting aside the money required for the maintenance and expansion of assets. This is important for both the company and the investors since it is able to pursue its goals as well as to enhance the shareholder value (Lyandres & Zhdanov 2007, p. 63).

In essence, the free cash flow can help in understanding the motives behind the mergers and acquisition by availing the sufficient amount of cash to carry out such business transactions (Thompson & McHugh 2002, p. 52).

This will be important for the company in the sense that it does not necessarily need to source for capital from the outsiders since there is sufficient funds for expansion. These activities are aimed at strengthening the performance of the company as well as expanding to other geographical areas, and this will help in acquiring more customers.

In addition, the cash flow hypothesis helps in understanding the leverage buy-outs since the company that does not have sufficient funds is likely to be sold out to other investor companies (Timmer 2011, p. 102). The leverage buy-outs will make the firms, which are in big debts to have sufficient funds for settling their outstanding debts.

Under the leverage buy out arrangement, the acquiring company would use collateral from the company that it is intending to purchase so as to secure loan. Though, this often comes with some interests, it is beneficial in the sense that the company is able to get cash from the secured loans so as to carry out some of its intended activities during and after the financial crisis (Timmer 2011, p. 103).

Basing the arguments on the empirical evidence, financial crisis could halt the operations in a given company, thus has to be merged with other organizations to make it viable. Therefore, once the company collapses, the acquiring group of company is likely to benefit more than the acquired group in the mergers and acquisition arrangements (Timmer 2011, p. 104).

This is because the assets of the company, including its customers and the goodwill are transferred to the acquiring company. Under many arrangements, the debts of the company are just partially settled by the acquiring firm, thus much of the profitability and gains are transferred to the firm that acquiring the other.

Indeed, debt can always be regarded as a cheaper option since the equity is more expensive than it. This is so because equity involves partnership with the shareholders who share the company’s profitability (Watson 2001, p. 224). However, in case of losses the business bears it alone since the investors are only involved in sharing the returns, which are given in the form of dividends.

These groups of the investors do not offer some technical expertise and knowledge in running the business since their work is to contribute capital to the business alone (Watson 2001, p. 225). Therefore, this can be regarded as a cost to the company.

Focusing on the debts, it is evidenced that the interest paid on the money borrowed is always periodic and has a time limit to complete the loan repayments (Watson 2001, p. 225). However, the dividends paid on the equity do not have the time limit since they are paid to the shareholders once the business is still in operation, and making profits. This compels the board of directors to declare dividends to the investors.

Bankruptcy costs play crucial roles on the firm’s capital structure and its response to financial crisis since they are the basic foundations upon which the financing policies of the firm are based (Watson 2001, p. 226). These bankruptcy costs act as the counterweight to those taxes that have been deducted on the interest payments.

Therefore, bankruptcy costs are very relevant in determining the optimal capital structure of the firm (Thompson & McHugh 2002, p. 53). The costs associated with the bankruptcy such as the reorganization costs, and tax credit losses, directly impact on the capital structure of the firm since they are borne by the failing company.

The agency cost impacts directly on the optimal debt ratio of the firm since the equity holders often have the incentives that make them to under-invest in those projects that have negative net present value (NPV), in situations whereby the leverage of the company is on the upward trend (Watson 2001, p. 227).

This happens due to the fact that the equity holders are mainly interested in the net benefits of the project, when they bear the investment costs. The rests of the cots are passed on to the bond holders.

On the other hand, the debt holders are aware of this incentive enjoyed by the equity holders of shifting the risks as well as under-investing (Thompson & McHugh 2002, p. 55). As a result of this, the debt holders price their debts accordingly as well as demanding for the higher rates of return. This agency cost problem puts much pressure on the optimal debt ratio of the firm.

The capital structure theories have several uses that facilitate the understanding of the capital structure of various companies, as outlined in the following discussion. Capital structure is the way corporation finances its own assets through combining equity, debt, or through hybrid securities (Baker & Jeffrey 2002, p. 4).

Here, the organization assets could be off-set during such an eventuality. In essence, these agency problems are related to the corporate finance in the sense that they help in understanding and analyzing the stockholder’s equity, corporate governance, and agency costs.

If external financing is a requirement, equity would imply issuing of shares bringing about external ownership inside the company (Baker & Jeffrey 2002, p. 5). This theory is made popular by Myers (1984) when he argued that equity not a preferred method of raising capital that could help the company during financial crisis and in the post crisis period.

This is because when managers who are understood to have a better knowledge of the true condition of the company than investors floats new equity, investors supposedly think that the managers are of the opinion the company is overvalued, and that the managers are taking benefit from the of this over-valuation (Baker & Jeffrey 2002, p. 7).

Consequently, the company shares might be very low after the crisis. The Study of capital structure is a significant part of a typical introduction to a finance course (Baker & Jeffrey 2002, p. 8).

The traditional approaches, which are used preempting financial crisis use inappropriate hypothesis of financial distress, and agency overheads up to when the conventional form of optimal capital structure appears (Baker & Jeffrey 2002, p. 9).

It is an organized approach which is known as the “Trade-Off” form which simply understood under the basic primary perception of optimizing worth and therefore shareholder wealth by choosing a capital organization combination which has the lowest probable cost of capital for the company. S

ometimes, managing the company before the financial crisis might be uneasy, thus creating a barrier between the previously made decisions and the actual occurrence when the financial problem finally comes (Baker & Jeffrey 2002, p. 15).

Scholarly study observes three world real phenomena difficult to explain using the agency cost and tax shield trade-off form (Myers & Majluf 1984, p. 188). These are in various industries the most profitable companies habitually do have the smallest debt ratios completely opposite what trade-off model would predict.

Huge positive and abnormal returns for a company’s stockholders are linked with leverage-increasing actions like stock repurchases and debt-for-equity interactions other leverage-decreasing events like issuing stock (Myers & Majluf 1984, p. 192).

Very few companies in America issue new stock once in a decade in the aftermath of the financial crisis. Therefore, management before and after crisis are two different aspects of the company progress (Myers & Majluf 1984, p. 194).

A company’s capital structure basically is a function brought about by its internal currency flows and the sum of positive NPV asset opportunities present (Knights & Willmott 2006, p. 14). Focused management has been cited as the appropriate way of controlling future financial crisis (Knights & Willmott 2006, p. 22).

Conclusion
In sum, the practical monetary managers will try to retain financial flexibility while making sure the long-term survival of their companies even after financial crisis. This will also help the company in planning for the possible financial problems.

The research indicates that though improved and effective administrations of the organisation, the managers have to dedicate their time to work involving long-term thinking and vigilant consideration of the company changes.

In this regard, many corporations are perceived to be unable to make alterations of the business setting so that the organization could implement most of the fiscal strategies prior to, or after a monetary crisis. This shows that only the practice of objective and focused management that such financial problems could effectively realized.

The justification was that since the global monetary crisis reaches at an untimely situation, thus not quite practical for a number of companies to realign their manufacturing and administrative processes to match the predicted financial positions and the global trends, which might be in order with their operations. Such attempts might help the companies cope with such financial challenges.

Regardless of the realism that the fiscal challenges have had gross affects on global business operations in a number of ways, and at different instances, the magnitude at which the entities operate have not been so hands-on, to deal with increasing affects of financial crises.

For instance, large business finance and organization tribulations have resulted to monetary short-fall that exist and affect the link between the management of the company, customer base and the suppliers. This situation has really compromised the choices, which the corporation could arrive at.

Finally, the stand-off could be relevant to corporate changes since the management of the entity that should make the decision in the best interest of the entire parties involved in its management often, fail to execute their duties.

Literally, these managers, who should act on behalf of the board as a watchdog of the financial alterations in the company, end up disappointing the shareholders. In fact, they are meant to make choices, which should be in favor of the shareholders. Basically, the managers fail to act appropriately, owing to their mixed interest and desire to maximize their own gain.

References
Baker, M & Jeffrey, W 2002, “Market Timing and Capital Structure”, Journal of Finance vol. 57 no.1, pp. 1–32.

Gustavo, G Michaely, R & Swaminathan, B 2002, “Are Dividend Changes a Sign of Firm Maturity?”, The Journal of Business, vol. 75, No. 3, pp. 387-424.

Jackall, R 1988, Looking up and looking around excerpt from Moral mazes: the world of corporate managers, Oxford University Press, Oxford.

Knights, D & Willmott, H 2006, Management and Leadership: Introducing Organizational Behaviour and Management, Thompson, London.

Lyandres, E & Zhdanov, A 2007, Investment Opportunities and Bankruptcy Prediction, Harcourt College Publishers, Fort Worth.

Myers, S & Majluf, S 1984, “Corporate Financing And Investment Decisions When Firms Have Information That Investors Do Not Have”, Journal of Financial Economics, vol.13, no. 2, pp. 187–221.

Sunder, L & Myers, S 1999, “Testing Static Tradeoff Against Pecking Order Models of Capital Structure”, Journal of Financial Economics, pp. 219-244.

Thompson, P & McHugh, P 2002, Work Organizations: A Critical Introduction, (3rd Ed.), Palgrave Macmillan, Basingstoke and London.

Timmer, J 2011, Understanding the Fed Model, Capital Structure, and then Some, Fort Worth, Harcourt College Publishers.

Watson, T 2001, “The Emergent Manager and Processes of Management Pre-Learning”, Management Learning, vol. 32, no. 2, pp. 221-235.

Law Literature Review

by admin | Mar 21, 2023 | Uncategorized

Research Process and Terminology: Criminal Justice Essay

Introduction

Research is one of the means for identifying if something is true or not if it applies to a certain field or category of people if it works under specific conditions. Research enables the person interested in some issues to investigate those issues explore the world and share information with others. In other words, examination of the topic can be carried out through the profound research conducted on the issue that concerns the researcher. For instance, if a researcher wants to identify the relevance of the statistical data to the analysis of population in terms of the propensity for criminal behavior, he/she should conduct research and apply the research question that bothers him/her to the actual situation. The importance of research for the identification of some issues is great due to the possibility of sharing information for optimization of further research and investigations. The educational value of research is great as well because it provides a background for further work and investigation from the scientific and educational points of view contrasted to a merely scientific approach. As claimed by Junger-Tas (2005), “there was a time in the Netherlands when all-important research was done by universities (p. 143). This means that well-planned research applied to practice can help to prove or refute a theory, claim, or assumption. At the same time, it was more appropriate to use a research to persuade someone in the correctness of ideas and the necessity of further investigations. When implemented for criminal justice, research may comprise a merely theoretical aspect as well as the practical application of ideas and concepts using surveys and statistical data and different types of research methods.

Stages of a Research

Every research process should be divided into several stages that pertain to a well-thought plan. Criminal justice as well as all other sciences and areas of their application require a research that contains relevant methods, credible sources, appropriate techniques, and literature reviewed. In other words, a scheme of the research process should be followed. As a rule, a research is divided into the following stages depending on the research question and methods: determine the issue to be investigated (a hypothesis, theory, or a question to be answered); conduct a review of relevant literature; identify the variables (define them and indicate the way the dependent variables are influenced and the independent variables). In addition, it is necessary to edit the research question/hypothesis after reviewing the literature and determining variables; select the research method; sampling methods and control of variables should be thoroughly explained as well; description of the investigation itself; analysis of results; discussion of results indicating the limitations and possible ways of improvement and optimization; determine the significance of research findings; comparison of the results with other researches in the same field; share the information received from the research. As suggested by Heffner (2004), replication of a search can be carried out by another researcher; besides, the replication of research is often considered one of the factors that add validity to the research.

The first stage of the research comprises a hypothesis to be formulated. As such, the first stage of any research process includes a problem statement or a hypothesis that would be investigated in the research itself. As suggested by Heffner (2004), the theory guess should be determined at the first stage of the research process as it shapes the entire procedure. When a question is selected, it is necessary to review relevant literary sources. A literature review is usually a second stage of the research as it enables the researcher to see what has already been done in the field and what innovative practices may be applied during the investigation. The next stage is based on the identification and analysis of variables that can affect the results. After receiving the information about the current situation concerning the issue to be investigated, the hypothesis can be edited with regard to the next stage of the research where a relevant research method should be applied.

Sampling, protocols, investigation, analysis, and discussion of results are the same for all types of research; these stages should be carried out regardless of the research method and experience of the researcher. Ethical considerations can be discussed in the introductory part of the research when the relevance and scope of research are examined or in the discussion section of the research. As Goodman & Miller (2000) state, “Ethics offers conceptual tools to evaluate and guide moral decision making. Ethical considerations apply in attempts to determine what is good or meritorious and which behaviors are desirable or correct in accordance with higher principles” (pp. 370-402). In addition, it is necessary to remember that stages can be carried out in the order relevant for a research unless the order influences validity of the outcomes. At the same time, sharing information with other stakeholders may help optimization of further attempts as well as comparison of findings with results of other related investigations.

Statistical Data

Though market research and consumer behavior are considered to be the most popular areas of application of statistical research, they can be effectively used for investigations in criminal justice. The importance of statistical thinking becomes apparent when it comes to the analysis of relevance of some terms to issues or frequency of some events. As claimed by H. G. Wells, “Statistical thinking will one day be as necessary for efficient citizenship as the ability to read and write” (as cited in Bennett, Briggs, & Triola, 2009). In this respect, statistical research when applied to criminal justice is aimed at demonstrating the data that can be received using statistics. Different types of surveys and sampling methods can be found to address any issue about the data available or unavailable.

The statistical data applied to criminal justice should be credible so that a researcher could use it for research that can further influence the way criminals are punished. For instance, if a researcher finds out that drug addicts become aggressive and predisposed to crime-committing after being imprisoned, he/she may suggest that these people should be rehabilitated instead of incarcerated. Further research should be conducted investigating the behavior of drug addicts after rehabilitation and comparison with the results of the previous approach when these individuals were imprisoned. As such, the results of a research may impact the methods applied by a correctional system to this or that person shaping the perception of this individual and his/her further life.

Research Methods

Research methods often shape the entire research and influence its validity. The importance of selecting the right research method has been actively explored by comparing the results of different investigations. As stated by Hagan (2010), people may use research methods in everyday lives though they “simply lack conceptual frameworks, scientifically acceptable tags, or sufficient knowledge of the language of research methods to defend their views in an appropriate manner” (p. 5). At the same time, it is necessary to define the research method and use tools applied in the framework of a particular method whereas different methods may be used due to the complexity of the hypothesis that involves statistics and observation. In this case, quantitative and qualitative research tools (Sanchez, 2008) may be applied to investigate the frequency of some events and the reasons for their occurrence.

A research method applied to criminal justice can be a borrowing, in terms of the tools and techniques, from other social sciences. In this respect, the process of sharing information about the research is essential for gaining knowledge and experience and applying the methods effectively used in social sciences to criminology and criminal justice. The method applied to research can alter the results and lead to the ineffective interpretation of data received before. As such, a criminologist should select a research method after determining a hypothesis, reviewing relevant literature, identifying variables, and editing the research question so that the method applied was effectively adding to the validity of the research.

Terminology

Terminology is one of the essential aspects of effective research conducted. As such, it is necessary to consider this as one of the stages of a research process because such a procedure should allow no ambiguity whereas inappropriate wording can result in inappropriate or even opposite meaning. At the same time, irrelevant terminology can make the most efficient and profound research look like a school report. In this respect, the terminology should be considered with regard to the target audience of the research. When research is designed and conducted and the results are shared between scholars with the help of scholarly articles published in respectable journals, the terminology should be appropriate whereas oversimplification may lead to the inadequate perception of the information. A career in criminal justice depends directly on the terminology used in professional cases as well as in research documentation. So, when you conduct criminal justice research, it is necessary to use proper terminology that does not allow ambiguity and leads to no misunderstandings occurring. Knowing the terms relevant to the criminal justice field can be an asset when evaluating and analyzing research studies or data because understanding the wordings properly would save time for finding out what this or that expression means.

Conclusion

To conclude, the research process is as interesting and effective as difficult and requires attention and specific knowledge. Knowing the obligatory stages of a research process would save time and make the procedure better planned and more profound. Validity of the reach can be improved by replication whereas sharing information about the research is essential due to gaining experience possible through analysis of other studies in the same area and related ones. Statistical data used during the research can influence the results of the research about its relevance and credibility. Appropriate terminology is one of the assets used in the process of conducting research related to criminal justice.

References

Bennett, J. O., Briggs, W. L., & Triola, M. F. (2009). Statistical reasoning for everyday life (3rd ed.). Boston, MA: Pearson/Addison Wesley.

Goodman, K. W., & Miller, R. A. (2000). Ethics and Health Informatics: Users, Standards, and Outcomes. In E.H. Shortliffe & L. E. Perrault (Eds.), Medical Informatics: Computer Applications in Health Care and Biomedicine (pp. 379–402). New York, NY: Springer.

Hagan, F. E. (2010). Research methods in criminal justice and criminology (8th ed.). Upper Saddle River, NJ: Prentice Hall.

Heffner, C. (2004). Research methods: Chapter one: Introduction to research. AllPsychOnline. Web.

Junger-Tas, J. (2005). The scientific integrity of applied research. European Journal on Criminal Policy and Research, 11(2), 143.

Sanchez, A. (2008). The difference between qualitative and quantitative research. Web.

Nursing Literature Review

by admin | Mar 21, 2023 | Uncategorized

Nursing Evidence Appraisal: A Systematic Review Essay
Abstract
This paper outlines the aspects of appraisal of nursing evidence. The paper uses a systematic review to outline these aspects. To effectively address the systematic review, the review has been structured into introduction, objective, research criteria and evaluation, methods of data collection, and the discussion of the findings. The main aim of this systematic review is to determine whether restraints are suitable for use on aggressive patients with dementia who are admitted to nursing homes. The systematic review on dementia and the restraints to be used will be addressed in PICO format, which will assist in determining the suitability of restraints in such situations.

Introduction
PICO components are useful in almost every clinical situation. PICO makes the practices that “involve evidence-based medicine” more efficient. The process of evidence-based medicine together with PICO involves a simple criterion. This paper describes the main components of PICO for a possible clinical condition of dementia and the best remedy for aggressive patients with dementia.

PICO
For patients with dementia in nursing homes at increased risk for falls; will restraints decrease falls as opposed to nonrestraints?

Discussion of Systematic Review for the PICO Components
Objective
The main objective of this systematic review was to collect and evaluate the information that relates to dementia and restraints by reviewing several kinds of literature.

Criteria and Search Strategy
The materials used for the review were academic journals obtained from various libraries. Even though many journals outlined the concepts of dementia and restraints, only those that were published between 2008 and 2012 were picked for the review. The journals were taken from American databases, especially the ones that specifically deal with nursing. The databases included MEDLINE, Cochrane Library, and Pubmed. After the search, the article “Placing physical restraints on older people with dementia” by Yamamoto and Aso was selected and used for the review.

Data Collection and Evaluation
The data that were used for the systematic review were exclusively obtained from the journal article. The information used in this review was scrutinized by an evaluation tool called Joanna Briggs Institute Qualitative Assessment and Review Instrument to ensure that it was valid and reliable. By using the tool and prior knowledge on the topic, the information obtained, which concerned dementia and restraints, was categorized by quality and reliability. The categories were used to construct the meta-synthesis for the review.

Synthesis of the Findings
Meta-Synthesis I: Patients with Dementia in Nursing Homes
Dementia is a condition that is caused by multiple changes in brain chemistry. Some of the changes are reversible while others are permanent. The most common symptoms of dementia include: neglecting personal safety, nutrition, and hygiene; feeling confused about time and people, and sometimes becoming lost about well-known places among others. The patients suffering from dementia lose their “psychological abilities” at different rates, which depend on the conditions in which they live.

Yamamoto and Aso (2009) in their journal article have conducted a study on patients suffering from dementia in Norwegian Nursing Homes. The study was conducted with a 12-month follow-up to ascertain the validity and reliability of the data. The main objective of the study was to investigate the natural course of neuropsychiatric symptoms in patients with dementia.

The data in this study was collected through structured interviews, which were followed by a 12-month follow-up. The patients who participated in the interview were drawn from 26 nursing homes. The information included in the review met the following criteria: it suggested the presence of neuropsychiatric symptoms and had follow-up frequencies (Yamamoto & Aso, 2009).

The study conducted by Yamamoto and Aso (2009) was effective and the data collected was valid and reliable about the objectives of the study. Out of the 1,163 participants, more than half had dementia. The study also found out that approximately 83% of the patients with dementia had neuropsychiatric symptoms. There was a persistent use of antipsychotics, psychotropic drugs, and antidepressants among patients with dementia (Yamamoto & Aso, 2009).

Meta-Synthesis II: Restraints
Although several people oppose the use of restraints on people suffering from dementia, the benefits of using them surpass the shortcomings. However, the decision to use restraints should be made by both the medical practitioners of the nursing home and the family members of the patient. There is a well-formulated policy that guides medical practices regarding the use of restraints. Restraints, as described by Yamamoto and Aso (2009) refer to the “physical materials” that are used to bar patients with dementia from movements that may hurt them or people around them (p. 193).

The main objective of the study that was conducted by Yamamoto and Aso (2009) was to investigate the coping nursing strategies used in general wards and the dilemma that the nurses face in restraining patients with dementia. The restraints are recommended in cases where the patients are perceived to be combative, aggressive and in cases where they are so confused that they can cause injury to themselves or the nursing staff. The patient’s family members who take their patients to nursing homes where they use restraints should consider the above points.

Yamamoto and Aso (2009) collected the required data directly from nurses working in general wards. There were about 272 participants in total from the general wards, where patients with dementia were taken care of. The authors used a questionnaire comprising 16 items to measure coping strategies. Any score between 1-4 points in the questionnaire would be considered as a better coping strategy. The factors that were difficult to interpret from the questionnaire were deleted to avoid obtaining unreliable information.

The contents included in the literature review were consistent and effective as they assisted to clear out the “misconceptions” that people normally have regarding the use of restraints. For instance, the results showed that restraints alone cannot keep patients safe and they are the only effective way of handling aggressive patients with dementia. The results also showed that excessive restraints can cause complications such as constipation, depression, and bone loss among others.

Meta-Synthesis III: Non Restraints
The restraining devices and techniques were used to restrict and restrain patients with dementia from movements that might lead to injuries. Therefore, the devices were meant to keep the patients from accidental injuries that were mostly caused by self-harm. The devices to an extent were used to keep the nursing staff from accidents that they could experience as a result of the aggressive patients. However, current studies such as the one conducted by Yamamoto and Aso (2009) prove that the patients are exposed to more dangers than benefits when they are restrained.

Yamamoto & Aso (2009) suggest that older people who suffer from dementia are at a higher risk of being restrained as compared to their younger counterparts. The study conducted the study proves that older patients with dementia face several psychological and physical problems when put on restraints. The study suggests that older patients should be put on non-restraining devices to avoid such problems. The method used to collect data for this study was purely a qualitative one. The data in the study was collected from other literature (Yamamoto & Aso, 2009).

Meta-Synthesis IV: Prevent Falls
Old people are generally susceptible to falls, which are worsened by psychological conditions such as dementia. Medical conditions such as cardiovascular and vision impairment may also contribute to the falls. The nurses who take care of patients with dementia find it difficult to prevent the old patients from falling. The restraints are used in cases where the patients fail to recognize the environmental hazards they are exposed to or forget to use their walking frames (Yamamoto & Aso, 2009).

The study conducted by Yamamoto and Aso (2009) suggested that falls are a common occurrence in old people with dementia and are known to cause disability and discomfort not only to them but also to the nursing staff. The authors collected the data for this study from an older man who was suffering from dementia and had experienced numerous falls, which gave rise to a hip fracture.

Yamamoto and Aso (2009) explain that many cases of falls can be prevented through restraints and other techniques. The techniques that can be used to prevent falls include putting bright lights in the rooms of the patients and ensuring that there are no “trip hazards” in the rooms. The nurses should also ensure old patients with dementia are reminded to walk with their walking frames whenever they feel like doing so.

Applying the Results to PICO Question in Clinical Situation
The clinical situation in the case study is beyond non-restraint mechanisms. The patient is so aggressive that he causes injuries to his own body owing to his funny behavior. The use of non-restraints in the patient’s case is even likely to expose the nursing staff to danger and as a result, other measures should be put in place to prevent the staff from such a risk (Yamamoto & Aso, 2009).

The behaviors observed in the 65-year-old patient warrants the use of restraints. The family of the patient should allow the nurses at the nursing home to keep the patient restrained. If the patient is restrained, he will be prevented from causing more injuries to himself, the staff members, and even the family. The benefits that the nursing home and the patient are likely to enjoy when he or she is restrained are superior to the shortcomings of the strategy (Yamamoto & Aso, 2009).

Conclusion
The clinical situation was about an observation made on a 65 year who had a wheelchair. The patient was suffering from dementia, a condition that seemed to have been worsened by agitation and restlessness of the patient. Her condition is in a very serious stage and therefore, requires the use of restraints. Non-restraints, in this case, are not adequate and cannot be relied upon in handling the patient. The information regarding the patients with dementia and the use of restraints to assist them was extracted from literature through a systematic review.

Reference
Yamamoto, M., & Aso, Y. (2009). Placing physical restraints on older people with dementia. Nursing Ethics, 16(2), 192-202.

Nursing Case Study

by admin | Mar 21, 2023 | Uncategorized

Nursing Case Study Case Study
Drug abuse has become a serious health problem in many healthcare sectors. These patients require specialized care and may benefit from collaborative care models and social services. In this case, the client, a 21-year-old woman, has severe medical problems besides taking drugs and smoking. Performing a medical examination or psychological assessments will guide a nursing practitioner on the treatment priorities for the patient. Devising a strategic plan can help the patient improve her health status. Additionally, allocating resources and providing proper education can be vital during the process of recovery.

What Data Can You Gather Based on Available Client Information?

First, during the interview, I understand that the client takes fewer meals than required. I will also note that she has not been feeling well in weeks, and her mental condition is poor. A physical examination of the patient’s vitals will be necessary. The client needs to understand that her isolated behavior can affect her health. By understanding the client’s level of addiction, a medical examination will be vital (Barringer et al., 2017). This examination will aid in proper diagnosis and case management. Furthermore, I will assess the patient’s sleep disorder, energy, concentration, appetite disorder and suicidal tendencies. This kind of information will reveal the exact problem at hand and the particular treatment for the diagnosis.

What Questions Should You Ask Yourself While Interviewing This Client?

During the interview, I can ask her about her nutrition status and her deficiencies. I will ask myself about the potential problems the client might be facing. It can include financial constraints, lack of proper shelter and lack of transport. I will also ask myself the possible challenges the client is facing and how well she can manage. An enquiry on whether has ever attempted to quit substance abuse and what working strategies she identified in the past will be crucial. I will ask myself how best I can connect her to the appropriate resources for optimum outcomes.

During Planning, How Can You, As the Nurse, Best Assist This Client?

The suitable approach I can use to assist the patient is to develop an effective patient-nurse support relationship. I will need to establish an environment of understanding the patient’s situation. A lack of a common ground will affect how the patient is giving information (Barringer et al., 2017). During planning, I can use therapeutic communication to develop trust with the client. Moreover, I plan to explain all the recommended social services to the client. Lastly, I can reassure her that with her compliance, there is hope for improvement.

What Are the Potential Strategies That Would Assist the Client in A “Better” Life?

One way to help the patient is to connect her to a social worker to aid with resources and addiction counselling. Social services will be able to provide a rehabilitation facility that is best suited for my client. Additionally, as a nurse, I will educate the patient on the significance of maintaining a healthy diet and the potential dangers of substance abuse (Barringer et al., 2017). I will also give her the necessary information on the support groups around her area. I will recommend a follow up at the clinic and the continued monitoring of her progress.

Conclusion
During the interview process, all the questions asked can be geared towards formulating a strategic plan to address the patient’s concerns. After the program has been devised, the necessary education and resources should be made available for better results. Poor lifestyle habits can lead to severe symptoms over time. Patients’ health can be managed if he/she complies with the nurse on an effective plan to improve their lifestyle. For the patient, a strategic plan can produce positive results if followed strictly.

Reference
Barringer, A., Hunter, B. A., Salina, D. D., & Jason, L. A. (2017). Empowerment and social support: Implications for practice and programming among minority women with substance abuse and criminal justice histories. The Journal of Behavioral Health Services & Research, 44(1), 75-88. Web.

Law Case Study

by admin | Mar 21, 2023 | Uncategorized

Contract Law: The Case Study Essay
A contract is a mutual agreement of obligation between two people or parties reaching consent. In most cases, such commitments are enforced by the law. The arrangement involves one side making an offer, which the other party accepts. A contract consists of such elements as offer and acceptance, appropriate consideration, and legality (Eisenberg, 2018). The parties involved should also have the contractual capacity to commit to the pact. Applying the law in contracting means that there are consequences if any participant forfeits the rules pertaining to the engagement. Therefore, breach of contract necessitates legal measures for failing to honor the deal or hindering the execution of the promise by the other party. This negligence is a case of punitive damage for which the complainant requires compensation for money and time wastage.

The scenario presented involves two individuals, Johnny, who is not a merchant under the Uniform Commercial Code, and his neighbor Mark, from whom he offers to buy a car for $30,000. The latter requires some time to consider the offer to which Johnny agrees and puts down in writing that his proposition is going to remain open for fourteen days. After a week, Johnny sees another car that fascinates him, buys it and informs Mark of his intention to revoke the initial offer. In response, Mark insists that Johnny’s proposal was in writing and still holds it. Johnny apologizes, saying he cannot keep the agreement but promises to give mark $10,000 for the assistance that he had received from him in the previous year around the house. Appeased, Mark accepts only for Johnny to annul his second pledge after a week. The former decides to sue Johnny for breach of contract on the two commitments, buying the car and the $10,000 offer.

There was a valid contract between the two, but Johnny dissipated both Marks’s time and money. He Hastily offers to buy the car instead of informing him that he hasn’t made a final decision and needs to check more cars before settling on one. Johnny also made the mistake of writing down his promise to Mark. Purchasing a car requires a lot of research and inquiries instead of choosing the first option due to the availability of more varieties that might even be cheaper in the market. After being approached by Mark, Johnny should have told him that he had not made a final decision because he still wanted to look around; therefore, he was unwilling to commit. The promising note written by Johnny caused the car to be withheld from other customers willing to purchase it. Mark, the car owner, had the opportunity to sell the machine, but he had the integrity to hold it. Johnny’s actions concerning the car are wrong, and he deserves to pay for them.

There is evidence of an oral contract between Mark and Johnny, although it is related to the first agreement, which Johnny also broke. He acknowledges Mark’s help on his property and offers to compensate him, making the latter cancel his initial disappointment on the car contract. This agreement makes Johnny legally liable to atone for all the words he fails to honor.

Breach of a contract is concluded when a party involved fails to perform their role and doesn’t give a valid excuse. In this view, the elements of a contract are not fully satisfied; therefore, Mark has an entitlement to take legal action against Johnny (Luntz et al., 2017). Having kept his part of the agreement, Mark deserves compensation for indemnity.

References
Eisenberg, M. A. (2018). The Theory of Efficient Breach. In Foundational principles of contract law. Oxford University Press.

Luntz, H., Hambly, D., Burns, K., Dietrich, J., Foster, N., Harder, S., & Grant, G. (2017). Torts: Cases and commentary (8th ed.). LexisNexis Butterworths.