Congressman Beyer on Affordable Housing - Free Essay Example

Sample details Pages: 5 Words: 1411 Downloads: 3 Date added: 2019/08/16 Category Society Essay Level High school Tags: Affordable Housing Essay Did you like this example? Congressman Don Beyer understands the inherent need for the families of civil servants and veterans to be provided with affordable housing to call home. Looking across the Potomac river, Congressman Don Beyer recognized the effectiveness of the Montgomery County program, the Moderately Priced Dwelling Unit (MPDU) system, and wishes to apply lessons learned across the river to his constituents in Virginia. Congressman Beyer plans to introduce a legislative initiative that would retool the current program Affordable Dwelling Home (ADH) in order to provide an overwhelming expansion of housing available for civil servants and veterans. Additionally, this initiative will conduct a total review of the application process for determining the need for housing based on the income of an applicant. Congressman Beyer also understands that in order to sustain future ADH development and foster a competitive, well rounded program, the needs of the program must be based upon square footage of housing units, rather than solely basing development of the program on the number of housing units built, so that the district, counties, townships can be better prepared to accommodate the influx of families. Don’t waste time! Our writers will create an original "Congressman Beyer on Affordable Housing" essay for you Create order During his tenure as congressman, Representative Beyer has voted in favor of numerous bills that protect the housing of veterans and civil servants in his district and around the nation. Drawing from his legislative and philanthropic record, Congressman Beyer has time and time again shown his total devotion to standing up for the housing rights for all that inhabit this country. In the house, Congressman Beyer is not afraid to stand up to Republicans, but has also shown his willingness to reach across the aisle to his Republican counterparts and reach legislative agreements between parties. The protection of housing rights of not only his constituents by the American people is of the utmost importance to the legislative agenda for Congressman Beyer. Congressman Beyer, a lifelong servant to Virginia and its people, offers a continuation of a positive choice for Virginias 8th Congressional District. Congressman Beyer is committed to fighting for every inch of legislation for Virginia, and will strive to create unbreakable bonds between Virginia and Capitol Hill, while reaching across party lines to better strengthen the standing of the United States. In 1991, social and political scientist Daniel Kelovich authored the book, Coming to public judgment: Making democracy work in a complex world, in which he wrote about the publics attitudes towards issues and credit claiming, and made a compelling distinction between public opinion and public judgment. According to Kelovich, public opinion reflects the current leanings of the public on an issue at any given moment. This then, by its nature, fluctuates at the total whim of the public. Public opinion is not necessarily based upon knowledge of facts, but more reliant upon the emotional ebb and flow driven by the media. Conversely, public judgment can be seen as less susceptible to the emotional ebb and flow of the public and based more upon facts than anything else. Therefore, when a constituency makes a judgment on an issue, according to Kelovich, it means that a semi-total understanding of an issue has been met. The public have checked their sources, collected multiple corroborating o pinions, and have weighed the future implications of a policy. Congress, then, is charged with the task of formulating legislative agendas and initiatives that reflect in theory the judgment of their consistency, as opposed to forming legislative agendas and initiatives based off of public opinion. Virginias 8th Congressional District makes up the better half of Northern Virginia. By the grace of its geographical location, the 8th district is directly across from the Washington D.C. , which means many of the individuals that work across the river for the federal government make up the Districts population. Furthermore, Northern Virginia is home to a handful of major government agencies headquarters; the Pentagon, Fort Myer, Fort Belvoir, Marine Corps Base Quantico, the United States Patent and Trademark Office, and the United States Geological Survey all reside within the 8th Congressional District of Virginia. It is not small leap then to identify why Representative Beyer has been the serving champion of the wants and needs for government employees and armed service members. By taking the stance of providing affordable housing to the underprivileged of the government working class, Representative Beyer telegraphs to his constituency that he understand their needs and wishes to endow them with the amenities that should be afforded to them for their service to the country. By providing the voter base with a solid voting record, greater amounts of trust can be endowed upon his legislative agenda. The first paragraph of the policy meme addresses Representative Beyers commitment to enacting policy that would directly impact his constituents, and sets forth a plan of action as to how the Affordable Dwelling Home (ADH) would be retooled to better serve the district. In addition to be connected with his voter base, Representative Beyer has the legislative record and political experience to prove that he will continue to fight for the representation of his constituency and the privileges they wish to be granted and upheld. Cosponsoring bills suchs as H. R. 5602, which seeks to amend the United States Housing Act of 1937 and to establish pass-through lease arrangements for uninhabitable dwelling units, and for other purposes (Affordable Housing Protection Act, section 2, 2018). This amendment to the original 1937 bill would, if passed, would create a safety net for individuals living within affordable housing by providing Any owner of a covered dwelling unit that was rendered uninhabitable shall, if approved by the Secretary, temporarily lease a habitable dwelling unit in another building for the covered resident for the period during which such unit is repaired (Affordable Housing Protection Act, section 2, line 7, 2018). In the second paragraph of the policy meme, Representative Beyers voting record is first hinted at, while maintain that he is still and able to stand up to Republicans, thus showing his total willingness to stand up for his constituency and be their champion in Washington D.C.. In 2017, Representative Beyer co sponsored a bill entitled, Housing Our Heroes Act, which would direct the Secretary of Veterans Affairs to establish a pilot grant program to acquire and renovate abandoned homes for homeless veterans (Housing Our Heroes Act, para 1, 2017). Representative Beyer was one of thirteen Democracy working with five Republicans to introduce the bill to the floor. Showing his willingness to reach across party lines to reach a consensus to benefit the entire country is noteworthy, especially in todays current political climate of polarization. Additionally, in 2017, Representative Beyer toured the construction site of St. James Plaza. As reported by AHC Inc., the non-profit financing the project: St. James Plaza will include a mix of efficiencies, one-two- and three-bedroom apartments. Rents will range from 40% to 60% of the Area Median Income. The property will also include underground parking, a fitness center, and a community room for residents. The building will meet the highest EarthCraft environmental certification. Families are expected to move into the building in mid-2018. By touring public work initiatives, it serves as an indication to the voters more importantly, the underprivileged that will be served by the project that his legislative initiative extends further than the halls of the Capitol building. Furthermore, Gary C. Jacobson, author of The Politics of Congressional Elections, asserts, At the most basic level, people hesitate to vote for candidates they know nothing at all about (Jacobson, 2013, 130). Therefore, the mear action of visiting a construction site of a project allows the voters to have a clear view of Representative Beyers actions, and allows the media to document and project his doings. The act of virtue signaling to his base could have a positive impact on future election and further support for his actions. A combination of the assertions of Gary C. Jacobson and Daniel Selovich indicate that public knowledge of your doings can help inform the judgment of voters, and, as indicated previously, prove to potentially be a powerful tool in campaigning for reelection. To conclude, the path towards success of Representative Beyers potential legislative agenda lies in his ability to inform the judgment of his constituent and entice them to join his camp by providing a solid voting record, while continually attempting to work across the aisle to secure a better future for his district and the nation. The success and caring of voters is paramount, and Representative Beyers voting record and trend as a legislator indicate his total resolve for his district.

Operations Management - 4008 Words

ADL 62 (Technology Management) Assignment – A ANS 1 (a) Economic analysis of technology. Economic analysis of technology deals with the evaluation of techno capitalism, technological diffusion, technology acceptance model, technology lifecycle, and technology transfer effects to the economy of a particular industry, group or country. Techno capitalism describes the changes in capitalism based on the changes in technology. Technological diffusion implies a form of conditional convergence as lagging countries catch up with technological leaders. Technology Acceptance Model which deals more specifically with the prediction of the acceptability of an information system. The purpose of this model is to predict†¦show more content†¦Technology scanning is a business process that fills the gap between market orientation and performance by facilitating innovation. It is a tool that managers of market-oriented firms can use to achieve superior performance by facilitating innovation. Technology scanning is a way of taking a creative look at the world of technological deve lopments and the cultural, regulatory, and business environments in which they emerge. Technology Scanning searches for technology developments in other industries, from other nations, federal laboratories, and other building sectors that could transferred and applied to the housing industry. Technology Scanning will be updated as technology developments dictate. Technology Scanning is comprised of a series of facts, each can be divided into the following categories: †¢ Design and Internet Tools †¢ Safety †¢ Surfaces and Interior Finishes †¢ Building Envelope Technologies †¢ Electrical †¢ Plumbing †¢ Heating, Ventilating and Air Conditioning †¢ Energy/Power Systems Generation †¢ Basic Materials †¢ Information Technology †¢ Sustainable Design Strategies †¢ Materials Recycling and Reuse †¢ Thermal and Moisture Protection †¢ Indoor Environmental Quality (d) Technology Life Cycle Most new technologies follow a similar technology maturity lifecycle describing the technological maturity of a product. This is not similar toShow MoreRelatedOperations Management : Operation Management1355 Words   |  6 PagesOperations Management Introduction Operations management is the activity of managing the resources that create and deliver services and products. The operations function is the part of the organization that is responsible for this activity. Every organization has an operations function because every organization creates some type of services and/or products. However, not all types of organization will necessarily call the operations function by this name. Operations managers are the people who haveRead MoreOperation Management - Cadburyworld2493 Words   |  10 Pagestechnology to streamline the operation process) and facility costs (old and outdated facilities) at lowest possible. In return, they have to compromise low costs with their other objectives. The unskilled staffs and outdated facilities are compromised with the quality in the core process. For example, the brief video (facility) in the packaging plant is outdated and requires commentary notes from some guides. However, the unskilled guides are not familiar with the operations so they need to read fromRead MoreOperation Management And Operations Management2148 Words   |  9 PagesOperation management Introduction Being an operations manager is not an easy task, it involves good control and responsibilities for the major activities within the organisations in order to achieve goals that might be in form of services or in form of goods. The operation management roles may be different from business to business depending on the size and resources available, each organisation has its own operations functions, and in order to produces goods or services they have to convert theRead MoreImportance Of Production And Operations Management2317 Words   |  10 Pagesthe production and operation of enterprises. In order to remain competitive, companies in different countries have different factors of competitive advantage. A clear competitive advantage is the key to gain success in production and operation management. An effective operations management is the foundation of enterprise competitive advantage and the fundamental guarantee to realize corporate strategy. This essay deals with the importance of production and operations management in the enterprise,Read MoreOperations Management : Operation Management Essay2171 Words   |  9 PagesOperation Management Operations administration concentrates on precisely dealing with the procedures to create and circulate items and administrations. Operations administration is the procedure, which joins and changes different assets utilized as a part of the creation/operations subsystem of the association into quality included item/benefits in a controlled way according to the arrangements of the association. In this way, it is that part of an association, which is worried with the changeRead MoreOperation Management2751 Words   |  12 PagesTABLE OF CONTENTS 1. OPERATION MANAGEMENT 3 1.1. DEFINITION OF OPERATION MANAGEMENT 3 1.2. THE ROLE OF OPERATION MANAGER 3 1.3. RELATIONSHIP OF OPERATION MANAGEMENT WITH OTHER CORE FUNCTIONS 3 2. CASE STUDIES 3 2.1. HEATHROW INTERNATIONAL AIRPORT 3 2.2. NESTLÉ UK CHOCOLATE FACTORY 3 3. MAJOR UNDERSTANDINGS OF THE STUDY 3 4. CONCLUSIONS 3 REFERENCES 3 1. Operation Management For the success of an organization, the management crew plays a major role. An organizational structure is based on differentRead MoreOperations Management986 Words   |  4 PagesOPERATIONS MANAGEMENT Select two organisations that you are familiar with – one with a service output and one with a product output, and compare and contrast these organisations with respect to the following aspects: 1.1 The process of transformation of inputs to outputs 1.2 Process and Capacity design 1.3 Supply Chain management 1.4 Scheduling Operations Management refers to the management of the production system that transforms inputs into finished goods and services, (http://csuponomaRead MoreOperations Management Chapter 18 Manual1950 Words   |  8 PagesChApter 18 Management of Waiting Lines Teaching Notes Some of the math and calculations can be left out in order to focus more clearly on the concepts of waiting lines. For example, all infinite source problems, including single channel (except constant service time) can be handled using the infinite source queuing table. In the past, queuing presented students with a good bit of computational requirements, and because of that, students frequently lost sight of the underlying concepts. WithRead MoreOperation Management2436 Words   |  10 PagesOPERATION MANAGEMENT IS IMPORTANT TO ALL BUSINESS To be able produce specialized managers capable of fulfilling strategic tasks within business and government enterprises the need for the practice of operations management cannot be forgone. Operations management is very significant in business operations since it forms the heart of the organisation by controlling the system of operation. Operations management deals with the design, operation, and enhancement of the systems that generate and deliverRead MoreOperations Management1791 Words   |  8 PagesQUESTION 1 Operations management must be managed properly in order to improve an organization’s productivity and profitability. In the Cadbury World case, several micro and macro processes are involved and those processes bring some impacts to Cadbury World. Thus, Cadbury World must possess a sustainable micro and macro processes to achieve the best outcome and performance. Micro processes that involved are easily to manage compared to macro processes because macro processes are hard to manage

Sustainable and Ecotourism Free Essays

string(113) " message of the Brundtland Report seems to be more and more accepted by the tourism industry all over the world\." Current economic issues and theory Sustainable and Ecotourism Tourism Tourism is one of the foremost economic activities around the world. It growth has been one of the major economic and social phenomena of the twentieth century. Tourism has expanded dramatically over the last years and has become a global industry. We will write a custom essay sample on Sustainable and Ecotourism or any similar topic only for you Order Now We can define tourism as the  Ã¢â‚¬Å"movement of people, spatially and temporally, out of their own communities for leisure and business purposes†. According to the  World Tourism Organisation  (WTO) tourist is a  Ã¢â‚¬Å"visitor staying for more than 24 hours in a country visited for business or leisure purposes†. The term tourism is an umbrella for all relationships and phenomena associated with people who are travelling, whatever the reason. It has no clear boundaries and could be viewed as an industry itself. In my work I would like to show the relationship between the tourism and environment. For the tourism service providers the most important is to grow the industry itself and attract more visitors to destinations. Their main purpose is to gain more and more profit. I think that these type of thinking can be harmful for environment. Similar essay: Role of Advertisement in Tourism Development Tourism and tourist can effect negatively the environment therefore we can talk about a form of tourism which is unsastainable. In this essay I will concern this issue too but my main topic is the sustainability. Fortunately in last years people recognised the importance of the environment and nowadays they are taking this issue seriously. The tourism has negative but also positive impact on the environment therefore we can talk about a sustainable tourism. In the following I deal with this issue more detailed and I try to find the answer how popular it is among tourists or tour operators. Unsustainable tourism As I mentioned tourism is now among the world’s most relevant industries generating jobs for millions of people and profit all over the world. At the same time tourism can have dire effects on the people and places it embraces. Mainly the mass toursim has negative effects. What can be the worst effects of unmanaged, unsustainable tourism? – previously undeveloped coastal villages can become sprawling, charmless towns o their seas poisoned by sewage their beaches stained with litter – historic towns and their streets choked with traffic – some of the world’s richest environments bruised by the tourist onslaught – distinctive wildlife driven to near-extinction – changes in the landscape coming from the construction of infrastructure, buildings and facilities – air pollution and waste – the intensive use of water and land by tourism and leisure facilities – the disturbance of fauna and local peop le (for example, by noise) We can write many pros and cons of tourism. I think the worst effect of unsustainable tourism is when only the financial profit come into the strong focus. Becuse tourism makes a few people extremely rich, while impoverishing the majority, who lose their land, their resources and their sense of self. Tourism is not just about money, it should give benefits for tourist and local communities too. The main goals of tourism should include: the satisfaction of tourists, profit for tourism industry, wealth to local people. Changes in the landscape coming from the construction of infrastructure, buildings and facilities is one of the disadvantage of sustainable tourism but this can also benefit to local communities. I think the cooperation between the tourism industry providers (relevant ministries, government, management) and local organizations and communities can mitigate the negative effects. Sustainable Tourism Definition Sustainable Tourism involves social responsibility, a strong commitment to nature and the integration of local people in any tourist operation or development. Sustainable tourism has several definitions. According to the definition of the Federation of Nature and National Parks, sustainable tourism is: â€Å"All forms of tourism development, management and activity that maintain the environmental, social and economic integrity and well-being of natural, built and cultural resources in perpetuity. † (FNNP, 1993) Sustainable tourism is defined by the  World Tourism Organisation(WTO), the  Tourism Council  (WTTC) and the  Earth Council  as: Sustainable Tourism Development meets the needs of present tourists, host regions while protecting and enhancing opportunity for the future. It is envisaged as leading to management of all resources in such a way that economic, social and aesthetic needs can be fulfilled while maintaining cultural integrity, essential ecological processes, biological diversity and life support systems. Sustainable tourism products are products which are operated in harmony with the local environment, community and cultures so that these become the beneficiaries not the victims of tourism development. Sum up these definitions I can say that sustainable tourism is the form of tourism that does not reduce the availability of resources and does not prevent future travelers from enjoying the same experience. Responsible Tourism, Soft Tourism, Minimum Impact Tourism and Alternative Tourism are terms with a similar meaning as Sustainable Tourism. Sustainable Tourism Development The significance and volume of tourism shows that it is not enough to develop new forms of â€Å"alternative† tourism in order to minimise the negative effects and maximise the positive impacts of tourism development. The whole sector must be developed and managed in a way that it does not damage the natural and socio-cultural environment. In my point of view it can be fully executed if the government, the managers and leaders of tourism industry recognise the harmful and negative effects of tourism and they introduce more regulations related to sustainability, they motivate tour opartors to promote this type of tourism among their clients and they release more related ads and topics in media. This is the responsibility of the world-wide tourism industry. The concept of sustainable development was introduced by the World Commission on Environment and Development in the Brundtland Report in 1987, defining sustainable development as â€Å"development that meets the needs of the present without compromising the ability of future generations to meet their own needs†. Since its publication, the role of tourism has been analysed and the concept of sustainable tourism appeared. The main message of the Brundtland Report seems to be more and more accepted by the tourism industry all over the world. You read "Sustainable and Ecotourism" in category "Essay examples" Ecological sustainability means that tourism development does not cause irreversible changes in a given destination’s ecosystem. There is an obvious need all over the world to protect natural resources from the negative impacts of tourism activities. In order to avoid or minimise unfavourable impacts, decision-makers must be aware of all the factors that play a role in the development process. Indicators of Sustainability â€Å"Indicators measure information with which decision-makers may reduce the chances of unknowingly taking poor decisions† (WTO, 1996). In other words, in the measurement of the progress that an individual destination is making towards sustainable tourism development, sustainability indicators are commonly accepted as one set of useful tools. â€Å"Indicators are both a tool for management today and an investment in the future, since they reduce the risk of inadvertent damage to the resource base on which the [tourist] industry depends† (WTO, 1996). There are some factors which are pushing the tourism industry towards a sustainable development approach: – Increasing regulatory measures The awareness by governments and operators that the growth of tourism can have a negative impact on the environment I think the government and the competent ministries should take the first steps. They should corporate with tourism service providers and with the management and create new regulations and laws. It is very important to take into account sustainability and preservation of nature. – Tourism professional s and operators recognise that environmental quality is essential for a competitive product – Growing wareness of cost savings from sensible resource consumption – Growing awareness of communities about their potential to influence tourism policy Similiar forms of tourism Responsible Tourism Tourism which operates in such a way as to minimize negative impacts on the environment. For example a  forest trip using â€Å"Leave No Trace† ethics would be considered responsible tourism while dune buggy tours would not. Nature-Based Tourism A term for any activity or travel experience with a focus on nature. These types of trips may or may not be environmentally sustainable or responsible. A cruise ships to view penguins in Antarctica fall into this category. I think that this type of tourism is sligthly more popular than sustainable tourism. It needs fewer responsibilty. Travels or trips in nature have always been very sought and beloved among families or other target groups. For example in my village and in the neighboring settlements exist tourist groups who regularly participate in different type of nature-based tours. They often go hiking, climbing, they participate on wine tours, visit thermal bathes or observe animals. They like nature and activities connected to nature but it is not guarantee that they conserve the nature and they improve the place they visit. Green Tourism Often used inter-changeably with eco-tourism and sustainable tourism   but more precisely described as â€Å"any activity or facility operating in an environmentally friendly fashion†. A lodge with composting toilets and solar powered lighting is probably â€Å"green†. There are varying degrees of â€Å"greenness†; an awareness of where resources are coming from and where wastes are going is at the heart of the idea. Ecotourism The Ecotourism Society defines it as â€Å"responsible travel to natural areas which conserves the environment and improves the welfare of the local people†. A rafting trip is ecotourism in that case when it raises awareness and help to protect the watershed. A walk in the rainforest is not ecotourism unless that particular walk somehow benefits that environment and the people who live there. Eco-tourism means when you go to a  trip and you will help to „conserve and improve† the place you visit. In the last few years ecotourism has become a buzz word to sell a variety of products. Almost any term prefixed with ‘eco’ will increase interest and sales. Thus, in the last few years there has been a proliferation of advertisements in the travel field with such references as ecotour, ecotravel, eco-vacation, eco (ad) ventures, eco-cruises, eco-safaris and of course, eco-tourism (Wight, 1994). In my opinion some companies use the word ’eco’ because of particular ineterest or benefit. Maybe that ’eco-products’ and ’eco-services’ make them better reputation or greater madia interest. Therefore I think there are some companies which are not totally aware of the meaning ’eco’ and they use it for their advantage. Marta Honey’s book â€Å"Ecotourism and Sustainable Development†Ã‚  determine 7 defining points of ecotourism:   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   1) Involves travel to natural destinations – remote areas, enviromental protection. In my point of view it can be dangerous because in remote areas there are living just small group of people who can form a quite closed community. For them it can be strange to accept and receive tourist, especially huge number of tourist. In other hand, growing tourism have other consequences – to build the necessary infrastructure which could change the local ’untouched’ environment. In that case I think the tour operators and organizers should keep the tourism under control, regulate the number of tourists, involve local people to the whole process. For example using private accomodation instead of big hotels can be a good idea or small restaurants which offer local foods can be attractive for tourist and prifitable for local people. 2) Minimizes impact – ecotourism – use recycled materials, plentyfully available local building materials, renewable sources of energy, recycling and safe disposal of waste and garbage, environmentally and culturally sensitive architectural design. In my opinion it is relevant to draw people’s attention to these methods or they should be regulated in order to ensure limited damage to the ecosystem. ) Builds environmental awareness  Ã¢â‚¬â€œ   education for both tourists and residents; free educational trips, reading materials – The Ecotourism Societies guidelines; well-trained, multilingual naturalist guides with skills in natural and cultural history, environmental interpretation, ethical principles and effective communication. I think it is important for tourist to gain some knowledge about the host country. Every nation has other regulations, habbits, values and culture. Environmental regulations and attitude to sustainability differ from country to country and therefore it is recommended to be informed of certain things. ) Provides direct financial benefits for conservation – park entrance fees, tour company, hotel, airline and airport taxes and voluntary contributions. 5) Provides financial benefits and empowerment for local people – local community must be involved with and receive income and other tangible benefits (potable water, roads, health clinics, etc. ) from the conservation area and it’s tourist facilities. I think the popular destination, for example National Parks and other conservation areas will only survive if there are â€Å"happy people† around their perimeters. ) Respects local culture – learning beforehand about the local customs, respecting dress codes and other social norms. As I earli er mentioned gain some knowledge about the host country will benefit us. 7) Supports human rights and democratic movements – Ecotourist need to be sensitive to the host country’s political environment and social climate and need to consider the merits of international boycotts called for by those supporting democratic reforms, majority rule, and human rights. Marketing for sustainable tourism According to my view an intensive marketing activity can greatly influence the success of a given topic. For instance if the marketers release lot of articles and ads about the sustainability and the importance of it as a  result more and more people are going to deal with the topic. If the marketers raise the public attention than they can make the next step more easily. Implementation of the marketing concept in tourism can be achieved through the use of a variety of marketing tools and techniques (Popadopolous, 1989; Calantone and Mazanec, 1991). Segmentation Successful market segmentation and targeting involve the appropriate matching of tourist needs with the experience being offered, and, in the case of sustainable tourism, the need for this match is particularly important (Tregear et al. , 1997). Tourism organizations need to give greater consideration to segmenting their market with a view to concentrating on those categories of visitor that are not only economically attractive, but are also likely to be susceptible to messages aimed at encouraging them to adopt sustainable behaviors (Dinan, 2000). I think that during the segmentation process the tourism organizations can choose the right target group who will address later with intensive markerting campaign. On the other hand it is also important to deal with people who are not yet the ecaxt target audience. There are key members, for example the tour oparators or travel agents who can influnce the tourists and encourage them to pay greater attention to sustainable tours. Marketing mix All elements of the marketing mix need to be in harmony in order to increase the success Product If we would like to achieve more sustainable tourism we should developing products which are more sustainable in nature- conservation holidays, vacation packages using public transport rather than private cars, small-scale rural community-based tourism initiatives- and moving away from offering products which are intrinsically not sustainable- hunting trips, destinations with poor environmental standards. Intermediaries between tourists and tourism service providers are tour operators who create complete holiday packages and bring together a variety of services. These packages are marketed to customers either directly or through travel agents. Each package generally consists of accommodation (often with food service), transport both to and from the destination, ground transport within the destination and events or activities. Today, many consumers expect from the tour operators to supply them products which provide not just quality and value-for-money, but also safeguard environmental and social sustainability. Example The Green Travel Market is a global facility to integrate sustainable products into the packages of European and Northern American tour operators. Green Travel Market gives up-to-date and reliable information on existing sustainable tourism products: destinations, protected areas, accommodation networks, individual accommodation, visitor attractions and activities, excursions or tours, incoming tour operators and transport services. Green Travel Marker is in contact with more than 1. 500 touroperators and with its wide range of services help to local products and services to reach European and US tour operators and media. Price The price paid by the tourist should cover the full cost of their holiday. The cost must also be high enough to: – Ensure a satisfactory experience for the tourist I think satisfactory experience means quality and value for the money paid by the tourist. In the case of sustainabilty there are added other values, for example connection to nature, preservation of the origin environment, improve the visited area or just raise awareness. I have heard several times that the tourists were not totally satisfied with their holiday. Maybe the accomodation had not that quality what the travel agency promised or tourists did not receive a service or the visited place were not an ecotourist destination however they paid for it. I guess in these cases the travel agencies are quilty or faulty because they always have to be aware of the services they offer. They always should have up-to-date information and organise trips for the agents in order to get familiar with the offered destination. – Provide a satisfactory level of profit for the tourism industry – Generate an appropriate level of benefits for the host community – Cover costs involved in putting right any damage caused by the tourist to the environment – Pay for the resources consumed by the tourist Place Place refers to the location at which any service component the subject of the marketing campaign will be delivered. Place also refer to the channels of information that are used to spread the message. Promotion I think promotion has the most important role of all elements of marketing mix. By using promotional techniques we can create more sustainable forms of tourism. We can reach large number of people by suing promotional methods. Sustainable promotion should focus on promoting and advertising a tourist site, highlighting the unique characteristics of the area in order not to cause disappointment and frustration among tourists. It is important to promote brochures and advertisements which reflect reality. In my opinion it is necessary to show pictures of a given destination in order to get more realistic picture. An other good idea can be to create a blog where tourists can share their experineces and give some advice for future travelers. Tourism organizations and destinations can also use literature and advertisements to raise tourist awareness relating to sustainability. They can undertake ‘green marketing’ or promote soft tourism and infomr tourists of the impacts of their presence. Tools Communicating sustainability It is essential to inform tourists in a positive way about sustainability efforts and draw attention that environmental quality means quality tourism experience. If we talk about environmental quality we can mention the following: small-scale, quality service, personal relations, traditions, intact and protected nature, rest, modern lifestyle and healthy and local food. Eco-labelled products provide good quality service and quality products should respect the environment. Example Communication efforts of VISIT The European VISIT initiative developed its own communication strategy for environmental quality in tourism. In 2002, the VISIT image campaign was launched under the motto: â€Å"Caring for the Environment †¦ is caring for the Visitor†. This slogan connects environmental quality with the quality of the product and experiences in addition it raises the overall awereness about this topic. They used print and online media (brochures, catalogues, website, publications) in order to spread the message. The VISIT Holiday Guide was launched in 2003 under the motto â€Å"Your visit makes the difference†. It provides detailed and structured description of more than 1,000 hotels, bed breakfasts, holiday houses, youth hostels, camping sites and restaurants. Education and awareness programmes Environmental education  is a learning process that increases people’s knowledge and awareness about the environment and associated challenges, develops the necessary skills and expertise to address the challenges, fosters attitudes, motivations and commitments to make informed decisions and take responsible action (UNESCO, Tbilisi Declaration, 1978). Education and awareness programm should address to both the professional sector and the general public. These programms should contain information about the direct and indirect impacts of tourism, the causes with his effects, the global and local issues, the immediate and long-term issues and good practices in the area. Key members of spreading information are tour operators. They can provide variety of information about sustainable tourism issues, encourage their clients to conserve, avoid negative impacts on environment and cultural heritage, to respect national egislation of the visited area as well as traditions of local communities. Education and awareness-raising is also required at all levels of government. The relevant ministries have to deal with tourism and enviromental issues. It is quite important to raise awareness within the academic sector responsible for training and research on issues regarding sustainable tourism. In my opinion the education and awareness programs m eans the most important tools of promotion and form the basis of the sustainable marketing. It is essential to start raise awareness in the kindergarten or in elementary school. If we show good example for children and we emphasize the importance of sustainability and preservation they will take this issue seriously form they childhood. I think that is the problem in many countries because people often feel that enviromental problems are just magnified and we have other problems in society or in our life which are more important or urgent. But it is not true because if we don’t take seriously these problems and don’t deal with that issue now maybe that we can do nothing in the future. It is the responsibilty of all people to conserve the environonment and draw other people attention to the importance of the issue. Ecotourism in Hungary In the last few years Hungary has taken a really proactive approach to ecotourism. The country has more than 300 nationally protected areas and over 1 000 locally protected sites. Hungary’s attitude towards conservation and preservation is one that facilitates ecotourism efforts by local businesses and ecotourism demand from tourists. Hungary is a great place where tourists and local people can find number of way to relax and have fun. In the following I  will show some good opportunity for ecotourism in Hungary. Budapest Budapest is the Hungary’s capital and an increasingly popular spot for tourists. With its rich and complex history, stunning architecture, lovely people, and fantastic culture, Budapest is one of the great cities of Eastern Europe. Budapest’s Urban Adventures offer some great, locally-run day tours with a touch of ecotourism for everyone. Their specially designed Budapest tours allow visitors to discover the city in a  personal and unique way. Unique  local experiences  are integral to responsible travel, and one of the classic local experiences in Budapest is to visit cities thermal baths. Visitors can learn about the country’s spa traditions and explore some of the city’s best landmarks on this adventure. These thermal baths are  icons of Budapest, and are frequented by both locals and tourists who are looking to soak away their problems and pains. Budapest Urban Adventures’  Sights Spas tour  puts a unique spin on the thermal bath experience by providing visitors with an insight into spa traditions and histories, as well as other traditional and architectural elements of the city. Sights and Spa tour – Highlights: Ride the continent’s oldest subway Learn about Hungarian spa traditions Visit a church carved into a hill Discover Budapest’s Jewish quarter See Europe’s largest synagogue Admire the buildings from a city tram Walk through City Park Experience the cosmopolitan vibe of Budapest An other interesting offer of this company is the ‚Budapest Explorer tour‘ by which visitors can explore the capital by tram, foot and metro. Budapest Explorer tour – Highlights: Explore the iconic city landmarks on this Budapest tour Ride the continent’s oldest subway Admire the waterfront from a city tram Walk through City Park Experience the atmosphere of a Budapest market Stroll along Andrassy Avenue Explore Franz Liszt’s old neighbourhood Discover local Budapest travel highlights and World Heritage sites Farm-House Hostel Many tourists come to Hungary and stay only in Budapest but it is worthwhile getting out of the city and  visiting other part of this wonderful country. In the south part of Hungary there is a tiny village Kiskassa where visitors find the extremely hospitable and totally endearing  Ecohun Hostel. Ecohun is a  traditional Hungarian farm-house  that is  locally owned and operated. The hostel has the same facilities as a typical hostel, in addition it offers guests a unique insight into the local agriculture industry and traditions. The hostel typically caters to short-term accommodation but for those who are seriously interested in sustainable agriculture and alternative technologies, longer-term accommodation is available. I  think this form of ecotourism is a  very interesting one beacause nowadays lots of people would like to escape from busy cities, hide in a  calm environment and enjoy the opportunities of the nature. I  have some experiences in that area. I  have worked for three summers in a  small hotel in Slovakia. This hotel accomodates tourists who came to the city because of the thermal bath. The hotel has the ideal potentials for ecotourism beacuse it has a  big garden and almost every food ingredients, vegetables and fruits come from that garden, there are lot of animals which are very popular among the hosts, they can stroke and feet them and the hotel is sorrounded by a  large yard with beautiful flowers and trees. They regularly organise traditional programs, for example riding days, arts and crafts camps or public picksticking. I  really enjoyed working here. One thing which I  can suggest to this hotel – to promote themselves more in ecotourism way beacuse they emphasized mainly the accomodation and the related services and such values as nature, original agricultural traditions, calm atmosphere were less highlighted. Local Birdwatching Tours Hungary is home to an exceptionally diverse cascade of birds, making it an  attractive ecotourism destination  for birding. The spring and summer onths are the best period for this type of  ecotourism in Hungary, because most of birds are present. Ecotours  describe themselves as the  natural leaders  in Eastern Europe. Ecotours offer a variety of tours to ecotourism destinations around the world, but the majority of their tours are in Hungary. Their tours are typically very specialised. They provide profesionally guided birding t rips, birdwatching, butterfly, wildlife, nature and culture tours. Taking a tour with Ecotours is a sure way to experience local fauna from one of the leaders in  ecotourism in Hungary. According to my opinion the county’s potentials are good but maybe not well-exploited. People are not well informed about ecotours and ecotravels. In many cases those people are attending on these kind of tours who have similiar hobbies. For example people who like birds and animals they are mostly participating on professionally guided bird watching tours or on wildlife tours or people who love sports are attending on cycling or hiking tours. This is not problem because they can enjoy their hobbies. On other hand I  think these programs can be promoted among people who are looking for a  relaxing weekend. Not just an expensive wellness hotel can provide carefree relaxation but a  trip in the nature can be memorable and restful. Hungary should more effectively and intesively advertise or promote its potentials. For example when I  was working in a  travel agency in Gyor during my internship I  did not meet with a brochure or catalogue which was focused on ecotourism. Our agency did not offer any type of program related to ecotourism. I  know just some organised cycling tours in Gyor which can be mentioned as ecotourism. Sum up I  think ecotourism must be developed and promoted in the following years beacuse despite of the favorable potentials, ecotourism is not quite popular in Hungary. As I  mentioned good marketing and communication tools can greatly help. Conclusion It is obvious that the tourism is the fastest and largest growing industry in the world beacuse millions of people are travelling every year. Travel and tourism is an important part of the world economy. Fortunately people realized the importance of the environment therefore sustainable and ecotourism started to develope rapidly. Eco travel or travel for the purpose of experiencing wildlife, natural attractions and indigenous cultures has become the fastest growing segment of global tourism. Ecotoursim in Hungary  is still growing and will likely continue to experience an increase in ecotourism operators as well as ecotourists. The country has a lot of potential and the right attitude therefore Hungary can become an attractive ecotourism destination in the near future. In my opinion building enviromental awereness is the most important part in the marketing process of sustainable tourism. It is very importatant to start education and awereness programs in elementary schools or kindergartens, organize free educational trips, supply reading materials about this issue. Education and awereness programs should address tourists, general public and government too. It is essential to draw attention to the importance of this topic because we have to care about the future generation. Resources ttp://www. guardian. co. uk/travel/2002/jul/07/travelnews. observerescapesection1 http://www. globalbasecamps. com/sustainable-tourism-ecotourism http://www. mynatour. org/destination/ecotourism-hungary-local-experiences http://www. untamedpath. com/Ecotourism/what_is_ecotourism. html http://www. untamedpath. com/Ecotourism/defining. html http://www. linkbc. ca/torc/downs1/vol26no1_article06. pdf http://www. biodiversity. ru/coastlearn/tourism-eng/tools_si. html http:/ /www. englisharticles. info/2010/06/19/unsustainable-tourism/ How to cite Sustainable and Ecotourism, Essay examples

Faecal Incontinence and Constipation †Free Samples to Students

Question: Discuss about the Faecal Incontinence and Constipation. Answer: Introduction The assignment deals with the case study of Ron (88, M) experiencing cough, headache, and fever since 8 days. The purpose of the assignment is to discuss the factors to be considered for conducting the health assessment for Ron. Further, it covers risk assessments needed for the patient supporting with rationale. The assignment discusses the implications of hospitalisation on the patient and his family and intends to high light the ways to overcome them. Based on the case study, the nursing care plan is developed using NANDA guidelines. These include nursing diagnosis, goals, and nursing interventions appropriate for Ron. Factors when considering the health assessment data There is a need of past medical history and need to know the physiological conditions. Past medication history is needed as certain medications are risk factors for constipation. For instance, the use of statins and antimuscarinics are known to be associated with clinical constipation. Past medical history is required to know the factors that may cause infection, or probability of other chronic illnesses such as COPD and others. Poor mental health can be the risk factor for older adults. Smoking, alcohols or drug abuse stress, anxiety and depression can lead to chronic conditions. Mental health and the cognitive ability (Confusion, and delirium) are the factors to be considered during the health assessment as they are contributors of may complicated illnesses (Iqbal, Gupta, Venkatarao, 2015). Social history is the other factors to be considered in the health assessment. Social isolation in old age leads to poor mental and physical health. Since Ron is restricted to home with decreased gait and mobility, he may be at risk of decreasing physical and mental health. In addition, Ron does not have his wife with him and hence he may be lacking the emotional support needed at this age. Social isolation leads to loneliness and depression at old age. It is necessary to know the family members support and other important people in the life of Ron. Further economic factors need to be considered to determine the care plan accordingly. Financial barrier may hamper the diagnosis and care process (Jarvis, 2015) Other factor to consider for risk is age. Ron is 88 years old and with aging alteration in mobility is evident. It is due to the decreasing muscle function, strength and loss of muscle mass and decrease gait. The decrease in gait is evident in Ron. Age is the risk factor for various chronic illnesses (Bickley Szilagyi, 2012). In addition there is need to consider the gender issues as there is a difference in the health reacted behaviour between men and women. Some patient may prefer to talk about health issue to same sex person. Knowing the patients culture and ethnicity is important as health belies vireos in different culture and may hamper the health assessment process. Language may act as barrier to health assessment, therefore it is required to know the language preferred by Ron and if he needs medical interpreter (Jarvis, 2015) Risk assessments and Rationale Fall risk assessment- Since Ron is needs assistance with activities of daily living as he has an unsteady gait and walks with the 4-wheelie walker; there is an increased risk of fall. Fall leads to complicated outcomes such as serious injury such as fracture, decline in functional status, admission in hospitals, and increased use of medical service, and death from injury. Most elderly people develop a fear of falling after a fall. Thus, it is necessary to assess the risk of fall or near falls in the case of Ron (Aranda-Gallardo, et al., 2013) Risk assessment for pressure ulcer- Ron is at high risk of pressure ulcer. Patients who are bound to bed or wheelchair are at high risk of developing pressure ulcer. These are more likely to occur at hips, buttocks, and sacrum. The risk of pressure ulcer needs to be assessed as it is difficult to treat. Pressure ulcers significantly hamper the patients quality of life and thus early identifying the conditions that may lead to this condition will help prevent(Chou, et al., 2013). Mental state assessment includes risk assessment for geriatric depression and cognitive impairment. The rationale for selecting this assessment is high prevalence of depression among older adults. Depression decreases the quality of life as it commonly accompanies complicating medical illnesses. Ron is 88 years old and lives with his daughter. He is dependent on her physically and may be at risk of depression. His depression can be due to social isolation for being mostly restricted to house (Conradsson, et al., 2013). Pneumonia risk assessment- The symptom commonly presented in pneumonia are fever, headache, cough, tachypnoea, increased confusion, loss of appetite, breathlessness and wheezing. These symptoms are also evident in Ron and hence it s necessary to identify if he is at risk of pneumonia. The vital signs of the patient include pulse 105, BP 125/70, respiratory rate 28, and temperature 37.8. Ron has not open bowels since four days and symptoms similar to this are found in pneumonia (Iinuma, et al., 2015). Implications of hospitalisations Illness hampers the quality of life and decreases the self-esteem of any patient. In this situation, the knowledge of body image and self identity can affect care. Ron may feel stressed about frailty and decreasing physical strength. Greater attention to body image can hamper the delivery of care. Many elderly patients after the illness and hospital admission may feel themselves as less attractive. Hospitalisation and illness are accompanied with dietary changes and social isolation and loneliness. The psychological implications of the illness and bed rest are worse. In addition to functional decline, the patients may feel anxious and depressed caused by feeling of dependency. Ron may experience a sudden change in the mental function. As Ron is dependent on his daughter for activities of daily living and emotional support, he may feel the loss of autonomy. He may not be able to participate in clinical decision-making and may have fear of compromising his preferences and values. The p atient may also feel a loss of respect and dignity. Hospitalisation of the household member leads to psychological distress among other members in the family due to uncertainty of the health outcomes (Bello, et al., 2014). The patient may feel homesickness and boredom, as he is mainly restricted to house due to poor mobility. The illness may affect the education of the other in the house such as grandchildren. It may influence the household responsibilities of Rons daughter and her husband. Admission to hospital involves financial burden. Depending on the length of the hospital stay, the financial difficulties may increase. If the socioeconomic status of the family is low then the illness is an added burden on the family. Ron may also feel like burden on the family (Berman, et al., 2014). Nurse can deliver patient centred care where the patients values, beliefs and preferences will be considered. Nurse can reduce the psychological implications in Ron by giving motivational session and involving him in clinical decision-making. It will reduce the anxiety, depression and poor self-image. By following the ethical principles of beneficence, non-maleficence and social justice, it is possible to overcome the psychological implications on Ron and his family (Berman, et al., 2014). Nursing process Nursing Diagnosis Goal Intervention Rationale Evaluation Risk of ineffective airway clearance and infection related to respiratory tract as evident from persistent fever, and cough since 8 days in the patient and high respiratory rate (North American Nursing Diagnosis Association., 2015) To reduce the infection like symptoms such as fever and headache and promote airway clearance in-patient which will be evidenced by decreased cough, tachypnoea and respiratory rate. Conduct lung assessment for breath sound and coarse crackles. Note cough for efficacy and coordinate with the respiratory therapist (Ghosh, OKelly, Roberts, Barker, Swift, 2016). The presence of coarse crackles during the late inspiration is indicative of fluid in airway. Airway obstruction can be confirmed by wheezing (Gatford Phillips, 2016). The patient demonstrates effective coughing, decrease in fever. The patient will demonstrate normal vital signs. No sign of tachypnea after the intervention Time- 48-72 hours Give medication as prescribed by the physician for fever and cough. These may include antibiotics, bronchodilators, mucolytic agents and monitor for side effects and effectiveness (Ghosh, OKelly, Roberts, Barker, Swift, 2016) A variety of medications are available to that treats the specific problem. Most of them may promote airway clearance. It may decrease the airway resistance (Bullock Manias, 2013). Educate the patient on coughing, deep breathing and splinting techniques and proper use of the medication and inhalers. The breathing technique that will be taught to the patient is to take deep breath, and hold for two seconds followed by coughing two to three times in succession(Ghosh, OKelly, Roberts, Barker, Swift, 2016). It is important for the patient to know the proper technique and underlying principle for keeping airway clean. An ineffective coughing leads to compromised airway clearance Patient education is necessary as understanding the prescription will promote the safe and effective administration of medication (Tiziani, 2017). Impaired elimination and exchange due to risk for constipation as evident from the stool retention for 4 days in Ron (North American Nursing Diagnosis Association., 2015) To improve the bowel movement of the patient and relief from discomfort due to unopened bowels. Encourage the patient to increase the fluid intake unless cardiac limitations (Ghosh, O'Kelly, Roberts, Barker, Swift, 2016) Adequate fluid amount is required to keep the faecal mass soft (Coggrave, Norton, Cody, 2014) The patient has improved bowel frequency that is normal at this age The patient demonstrates relive from discomfort. The patient learns the measure that treats constipation The patient maintain normal diet. Time- 48 hours Suggest balanced diet to the patient that consists of adequate fresh fruits, fibres, vegetables and grains (Ghosh, O'Kelly, Roberts, Barker, Swift, 2016) One should not have around 20 grams of fibres per day as it adds bulk to the stool and a makes the defecation process easier (Coggrave, Norton, Cody, 2014) The patient can be administered with laxative (Ghosh, O'Kelly, Roberts, Barker, Swift, 2016) Laxative irritate the bowel mucosa and causes rapid propulsion of the small intestine contents (Moini, 2015) Impaired safety due to risk of fall and injury as evident from decreased gait and mobility (North American Nursing Diagnosis Association., 2015) Improve patient safety by preventing fall, so the patient will be free of fall during his hospitalisation 1.During every shift the patient should asses the fall score of Ron and the nurse must screen Ron for stability and mobility skills(sit to stand, supine to sit, walking and turning around) (Zwar, et al., 2016) Fall scores helps to determine the risk of falling in the patient. Depending on the score preventive measures can be taught to the client. Screening will help to determine methods to ensure safety (Cangany, Back, Hamilton-Kelly, Altman, Lacey, 2015) The patient demonstrates safety behaviour in two weeks of time The patient has the knowledge of fall and fall prevention techniques Time -24-72 hours2. Nurse should keep the patients bed in the lowest position all the time and modify the environment such as removing tables and chairs in the path(Zwar, et al., 2016). n case the patient wakes up at night to drink water or toilet, lower bed positioning will reduce his risk of fall. It is necessary to remove obstacles in the patients path such as chairs and tables or any other object to avoid accident and fall or injury. It is evident from literature that majority of falls are related to toileting. Therefore it is necessary that path to washroom is clear (Cangany, Back, Hamilton-Kelly, Altman, Lacey, 2015) 3. Ron should be given yellow fall risk bracelet and yellow socks so that other nurses and staff will be aware of his delicate situation (Zwar, et al., 2016) Yellow bracelet and socks act as alert for other nursing staff. It will increase their vigilance and they will be greatly obliged to watch for falls (Cangany, Back, Hamilton-Kelly, Altman, Lacey, 2015) Conclusion The paper comprehensively discusses the factors that are to be considered for the health assessment of Ron. The risk assessment appropriate for the case study are highlighted and the implications of hospitalisation on the patient is discussed. Illness hampers the quality of life and decreases the self-esteem of any patient. It significantly hampers the mental wellbeing of the family members. The nursing process presented in this paper comprises of diagnosis and goals that are based on the NANDA principles. Risk of ineffective airway clearance and infection, risk of fall and injury, and Impaired elimination and exchange are the three priority nursing diagnosis. The interventions are designed corresponding to diagnosis and goals. NANDA guidelines are useful and effective in designing appropriate care for the patient. Bibliography Aranda-Gallardo, M., Morales-Asencio, J. M., Canca-Sanchez, J. C., Barrero-Sojo, S., Perez-Jimenez, C., Morales-Fernandez, A., Mora-Banderas, A. M. (2013). Instruments for assessing the risk of falls in acute hospitalized patients: a systematic review and meta-analysis.. BMC health services research,, 122. Bello, N. A., Claggett, B., Desai, A. S., McMurray, J. J., Granger, C. B., Yusuf, S., Solomon, S. D. (2014). Influence of prior heart failure hospitalization on cardiovascular events in patients with reduced and preserved ejection fraction. Circulation: Heart Failure, CIRCHEARTFAILURE, 113. Berman, A., Snyder, S. J., Kozier, B., Erb, G. L., Levett-Jones, T., Dwyer, T., Parker, B. (2014). Kozier Erb's Fundamentals of Nursing Australian Edition. Pearson Higher Education AU. Bickley, L., Szilagyi, P. G. (2012). Bates' guide to physical examination and history-taking. Lippincott Williams Wilkins. Bullock, S., Manias, E. (2013). Fundamentals of pharmacology. . Pearson Higher Education AU. Cangany, M., Back, D., Hamilton-Kelly, T., Altman, M., Lacey, S. (2015). Bedside nurses leading the way for falls prevention: an evidence-based approach. Critical care nurse, 82-84. Chou, R., Dana, T., Bougatsos, C., Blazina, I., Starmer, A. J., Reitel, K., Buckley, D. (2013). Pressure ulcer risk assessment and prevention.. Ann Intern Med,, 28-38. Coggrave, M., Norton, C., Cody, J. D. (2014). Management of faecal incontinence and constipation in adults with central neurological diseases.. The Cochrane Library. Conradsson, M., Rosendahl, E., Littbrand, H., Gustafson, Y., Olofsson, B., Lvheim, H. (2013). Usefulness of the Geriatric Depression Scale 15-item version among very old people with and without cognitive impairment. Aging mental health,, 638-645. Gatford, J. D., Phillips, N. (2016). Nursing Calculations E-Book. . Elsevier Health Sciences. Ghosh, S., O'Kelly, N., Roberts, E. J., Barker, C., Swift, J. (2016). Combined interventions for COPD admissions within an urban setting. . British Journal of Healthcare Management,, 123-131. Ghosh, S., OKelly, N., Roberts, E. J., Barker, C., Swift, J. (2016). The clinical and economic impact of the combined interventions of telehealth, specialist respiratory nursing care and health coaching interventions for COPD admissions within an urban setting. Iinuma, T., Arai, Y., Abe, Y., Takayama, M., Fukumoto, M., Fukui, Y., Komiyama, K. (2015). Denture wearing during sleep doubles the risk of pneumonia in the very elderly.. Journal of dental research,, 28S-36S. Iqbal, S., Gupta, S., Venkatarao, E. (2015). Stress, anxiety depression among medical undergraduate students their socio-demographic correlates. The Indian journal of medical research,, 354. Jarvis, C. (2015). Physical Examination and Health Assessment-. Elsevier Health Sciences. Moini, J. (2015). Fundamental Pharmacology for Pharmacy Technicians. . Cengage Learning. North American Nursing Diagnosis Association. (2015). Nursing diagnoses of NANDA: definitions and classification 2015-2017. Porto Alegre: Artmed. Tiziani, A. P. (2017). Havard's Nursing Guide to Drugs-Mobile Optimised Site. . Elsevier Health Sciences. Zwar, N. A., Bunker, J. M., Reddel, H. K., Dennis, S. M., Middleton, S., van Schayck, O. C., Xuan, W. (2016). Early intervention for chronic obstructive pulmonary disease by practice nurse and GP teams: a cluster randomized trial. . Family practice,, 663-670.