Case Study: Osteoarthritis with a Total Knee Arthroplasty Essay

DN is a 68 year old Caucasian male who lives in Pomona, Missouri. On September 14, 2009, DN underwent a scheduled left total knee arthroplasty at Baxter County Regional Medical Center. A consultation appointment about a total knee arthroplasty was scheduled when DN had increasing pain in his knees while doing chores and working on his dairy farm. The increasing pain DN was having been due to a history of osteoarthritis and the wear-and-tear on his joints throughout his life, no specific injury was noted. Depending on the outcome of the left knee, DN was consulted on having his right knee done in the future due to his active lifestyle as a dairy farmer. DN is presently in very good health despite his pain from osteoarthritis. Osteoarthritis is caused from wear and tear on the joints. The bones between a joint is cushioned by cartilage which after many years of use decreases. When the bones no longer have the cushion, pain and stiffness develops when the bones rub together (Total Knee Replacement, 2009). His health history includes overcoming prostate cancer approximately six years ago. After a prostatectomy to remove his cancer, DN continues to experience erectile dysfunction even after seeing many specialists and trying many treatment options. In 1999, DN had his appendix removed at Ozark Medical Center. DN has a herniorrhaphy and cataract surgery prior to this hospitalization. DN has no known allergies to drugs, food, or environmental allergens. The patient lives at home with his wife on a dairy farm. He handles about 170 head of dairy cattle that are milked twice a day. He retired from Howell-Oregon County Electrical approximately five years ago to help manage his farm on a full time basis. DN and his wife raised three children and have several grandchildren who come and visit frequently. DN does not have any significant history of nicotine, alcohol, or drug use. His diet has consisted of fresh fruits and vegetables from the garden throughout his life. These factors have all played a part in helping DN stay healthy without any underlying chronic disease processe s. Physical Assessment My physical assessment was performed on September 16, 2009. DN’s vital signs consisted of an apical pulse of 98, a respiration rate of 20, a temperature of 99.1 degrees Fahrenheit, an oxygen saturation of 96%, a lying blood pressure of 117/78, a sitting blood pressure of 116/75, and a standing blood pressure of 116/74. Patient was alert and oriented to person, place, time, and situation. Patient was able to spell WORLD forward and backwards. PERLA and noted cardinal field of gaze were intact. Eyes were clear with conjunctiva pink and no discharge noted. Patient’s head and face was symmetrical with no apparent skin breakdown. Patient had dentures intact in mouth with healthy, pink gums with no lesions present inside the mouth. Thorax was symmetrical with no signs of pulsations or lesions. Breath sounds clear in all lobes. Unlabored breaths. Heart sounds S1, S2 were heard upon auscultation in all four cardiac areas with normal rhythm. Abdomen is soft, symmetrical with hyp oactive bowel sounds present in all four quadrants. Last bowel movement was on Sunday, September 13. Patient was passing flatus. No masses, distention, or lesions noted on the abdomen. No tenderness was noted in the abdomen. No edema was noted in the upper or lower extremities. Upper and lower extremities had no sign of lesions or discoloration. Saline locked on left forearm was intact with no redness or swelling. Surgical incision on lower left extremity had scant amounts of serosanguineous drainage, wound edges were well-approximated, slight erythemateous around incision, no odor present, and dressing was dry and intact. Pulses were strong and equal bilaterally- including carotid, brachial, radial, femoral, popliteal, dorsalis pedis, and posterior tibialis. Skin was warm and pink with no signs of cyanosis, rash, or skin breakdown. Gait was symmetrical and coordinated when using a walker, without the supportive device there is some unsteadiness due to the left total knee arthroplasty. There was no hearing deficit noted with normal conversation. Patient only had complaints of pain at surgical site after ambula tion, physical therapy or the CPM. Patient was taught he could ask for the pain medicine prior to these events to hopefully avoid intense pain. Current Medications Throughout DN’s hospital stay he was prescribed medicine to alleviate the pain caused from the total knee arthroplasty, help prevent any infection that had potential to be a problem, and prevent any complications. DN’s urrent medications while in the hospital were as follows: 1.) Docusate-Senna (Trade Name: Peri-Colace) 1 tablet by mouth, twice a day; used for softening and passage of stool for the relief of constipation caused by post operative anesthesia and decreased activity (Deglin & Vallerand, 2007). 2.) Enoxaparin (Trade Name: Lovenox) 40 mg by subcutaneous injection, once every morning; used for the prevention of thrombosis formation (Deglin & Vallerand, 2007). 3.) Psyllium (Trade Name: Metamucil) 1 tablespoon by mouth, twice a day; used for relief and prevention of constipation (Deglin & Vallerand, 2007). 4.) Acetaminophen-Oxycodone (Trade Name: Percocet 5/325) 1-2 tablets by mouth, every four hours; used for decreasing pain as well as decreasing a temperature (Deglin & Vallerand, 2007). 5.) Magnesium Hydroxide (Trade Name: Milk of Magnesia) 30 mL by mouth as needed; used for replacement in a deficient state or evacuation of the colon (Deglin & Vallerand, 2007). 6.) Morphine (Trade Name: Astramorph) 8 mg by intravenous piggyback, every three hours as needed; used for a decrease in the severity of pain (Deglin & Vallerand, 2007). 7.) Promethazine (Trade Name: Phenergan) 12.5 mg by intravenous piggyback, every four hours as needed; used for diminishing nausea and vomiting, as well as provide some sedation (Deglin & Vallerand, 2007). Diagnostic Tests DN had diagnostic tests prior to being admitted to the hospital for his total knee arthroplasty to determine the best treatment option for his osteoarthritis. After his surgery, more diagnostic tests were done to monitor for complications of the procedure. The results were compared to normal and were as follows for the patient: 1.) White Blood Cells (Normal Value: 5,000-10,000/mm3) Patient’s white blood cell count was 12,800/mm3, which is a high value. This value indicates the stress on the body and inflammation around the knee involved after the operation. The value is also a possible indicator of infection, which would require continued monitoring (Pagana & Pagana, 2006). 2.) Red Blood Cell Count (Normal Value: 4.7-6.1Ãâ€"106/ µl) Patient’s red blood cell count was 3.74Ãâ€"106/ µl, which is a low value. This value indicates the blood lost during surgery, which is a common finding after an invasive surgery. A decreased level may indicate a hemorrhage, overhydration, or a dietary deficiency, which may need to be corrected (Pagana & Pagana, 2006). 3.) Hemoglobin (Normal Value: 14-18 g/dL) Patient’s hemoglobin was 11.8 g/dL, which is a low value. This value is a common finding after surgery due to the blood loss, but the value may also indicate anemia or nutritional deficiency (Pagana & Pagana, 2006). 4.) Hematocrit (Normal Value: 42-52%) Patient’s hematocrit was 34.4%, which is a low value. This is a normal finding after surgery, but may indicate anemia, malnutrition, or a dietary deficiency that may need to be corrected (Pagana & Pagana, 2006). 5.) Mean Corpuscular Hemoglobin (Normal Value: 27-31 pg) Patient’s mean corpuscular hemoglobin was 31.8 pg, which is just slightly elevated. This value could possibly indicate a macrocytic anemia, but is not elevated enough to be a significant concern (Pagana & Pagana, 2006). Basic Conditioning Factors and Power Components Dorthea Orem identifies ten basic conditioning factors that identify the patient and help assess the need for care in her Self-Care Deficit Theory of Nursing. The basic conditioning factors identified by Orem consist of age, gender, Erikson’s developmental state, health state, sociocultural orientation, health care system factors, family system factors, patterns of living, environmental factors, and availability of resources (Caton, 2008). DN is a 68 year old Caucasian male who lives in Pomona, Missouri where he and his wife own a house. DN grew up in Dora, Missouri where he graduated high school, then relocated to Pomona at the age of nineteen. DN has three grown children and several grandchildren. DN’s family remains very close and visit often to where DN lives. DN quit his job at Howell-Oregon Electric in 1980 to become a full time farmer. DN and his wife own approximately 300 acres to operate a dairy and beef cattle farm with 170 head of cattle. They milk the cows twice a day keeping them very active throughout the day. DN considers himself to be in the middle-class economically, but with the unpredictable cattle market economic status can change throughout the year. DN has Medicare as primary insurance with supplements. Before his admission to the hospital, DN’s health state was good. DN’s health care system factors consist of a medical diagnosis of osteoarthritis. The treatment of choice for DN was a left total knee replacement. After discharge, home health will help organize physical therapy closer to home. DN does not have any underlying diseases, such as hypertension or diabetes, which can cause complications or alter the ability of DN to have a speedy recovery. He has a primary physician in Willow Springs for yearly check-ups and minor problems. DN’s patterns of living include hunting and fishing, going to church, and taking care of the farm. DN does not smoke or drink alcohol. According to Erikson, he is in a developmental stage of ego integrity versus despair (Berman et al., 2007). DN belongs in this psychosocial developmental stage because he is at a stage where he is content with his life and satisfied with everything that has happened in his life thus far. He is able to reflect on his past without regret. DN feels as if he has lived a life full of happiness. Orem identifies ten power components that are important in evaluating how much nursing care is needed by the patient. The ten power components consist of attention span and vigilance, control of physical energy, control of body movements, ability to reason, motivation for action, decision making skills, knowledge, repertoire of skills, ability to order self-care actions, and ability to integrate self-care actions into patterns of living (Caton, 2008). DN’s attention span ad vigilance is a strength because throughout the physical assessment and health history, he remained very attentive and honest when answering the questions. His control of physical energy is a potential weakness due to the fatigue DN could experience after his knee replacement. After surgery, becoming fatigued is easier due to the pain and inability to get a good night’s rest in the hospital. DN seemed to know his limits with what kind of physical energy he had to use throughout his stay. The patient’s control of body movements is a strength. Even though DN is recovering from a total knee replacement, he maintains good control over his movements. He also has a steady gait when walking with a supportive device. The patient’s ability to reason is a strength. When he needed help, he knew to ask his wife, a nurse, or an aide for help. He understood that Home Health would be a benefit once he was discharged from the hospital. Motivation for action is definitely a strength. DN was very motivated to get back on his feet as soon as he could. He knew physical therapy was what would help the most so he was always ready to go when physical therapy came to take him to the Joint Club. After returning after a trip to physical therapy, the patient stated, â€Å"The physical therapist said I did better than all of the other patients with knee replacements.† The patient’s decision making skills were strength because he took all options into consideration prior to getting his knee replacement. He knew it would be the best option with the active lifestyle that he has. Knowledge was a potential deficit for the patient because he had never had a knee replacement surgery before. The patient was informed of all the procedures, hospital stay, and expected outcomes during consultation appointments, but all the information at once can be overwhelming for the patient. Even after the surgery, the patient still questioned the health care team members throughout the hospital stay to refresh his memory. Repertoire of skills is a strength because the patient has a high school education, as well as the same occupation throughout his life. He is able to retain information and repeat skills if needed. DN’s ability to order self-care actions is a strength because he is able to decide what actions are most important and follow through with them. He decided to have his knee surgery to benefit his lifestyle and made it a priority to get it done as soon as he could. The ability to integrate self-care actions into his patterns of living is a strength for DN. He integrates a healthy diet and active lifestyle to prevent complications of his osteoarthritis. After trying minor treatment options to control pain and discomfort from the osteoarthritis, DN opted for surgical treatment and he realizes the physical therapy he will have to integrate into his lifestyle for full recovery. Universal Self-Care Requisites Orem’s General Theory of Nursing involves self-care, self-care deficit, and nursing systems. Orem’s definition of self-care is what people plan and do on their own behalf to maintain life, health, and wellness. The nursing systems that Orem identifies are wholly compensatory, partly compensatory, and supportive-educative. The universal self-care requisites that patient may be deficient, potentially deficient, or a strength in consists of air, water, food, elimination, activity and rest, solitude and social interaction, prevention of hazards to human life, and normalcy (Berman et al., 2007). Air: Potential Deficit Air is a potential deficit for this patient. Upon assessment, his respiratory rate was within normal range at 20 breaths per minute. Normal respirations for the age group of the client range from fifteen to twenty per minute (Berman et al., 2007). The patient has a stable respiration rate between this level, but with decrease red blood cells, hemoglobin, and hematocrit the patient’s oxygen level may increase to compensate for the lack of cells that can carry the oxygen, especially during physical therapy. DN’s lung sounds when auscultated were clear in all lobes, bilaterally. A critical side effect of morphine, one of the medications DN was taking while in the hospital, is respiratory depression, which can happen in a matter of minutes causing a deficit (Deglin & Vallerand, 2007). Water: Strength Water is a strength for DN. No edema was noted upon assessment. Good skin turgor was indicative that there was adequate hydration for the patient. DN’s average intake was 2000 mL of fluids, usually water and ice tea. This was within normal range with the requirements being set at a minimum of 1500 mL of fluids daily (Berman et al., 2007). Food: Strength Food is a strength for the patient. The patient was on a regular diet and had no trouble eating. On some occasions, his wife brought meals to the patient. DN consumes a healthy diet, full of fruits and vegetables from his own garden when home. Protein consumed in his diet usually consists of very lean beef from home grown cattle. DN consumed enough calories to aid in recovery of his surgery. Elimination: Deficit Elimination is a problem for the patient. He has not had a bowel movement since the day before he had the surgery. DN had an epidural anesthesia until the first day post-op and is taking narcotic analgesics for pain control, which both contributed to the impaired elimination. The side effects from the medication cause the intestines to decrease peristalsis. Monitoring bowel functions, as well as administer the stool softeners and laxatives that are ordered, are two important nursing interventions (Lemone & Burke, 2008). Activity and Rest: Deficit The patient had a deficit in both activity and rest. The patient stated he was not getting adequate rest in the hospital due to the different environment and the pain he was experiencing from his surgery. In the hospital, the patient was also put on activity restrictions due to his total knee arthroplasty. He was able to go to physical therapy three times a day, but normal activities were limited for DN. At home DN does not have activity or rest deficit, he participates in an active lifestyle with lots of walking and daily physical labor. He also gets approximately 7 or 8 hours of sleep a night which is adequate for a man his age (Berman et al., 2007). Solitude and Social Interaction: Potential Deficit The patient did not have a deficit with social interaction. His wife was in the room majority of the time and he also had many people drop in and see him throughout his hospital stay. DN also interacted with people on the health care team, whether it was the nurses or physical therapists, he was always having a conversation with someone. Due the many visitors and activities DN had during the day, solitude was a potential deficit. The physical therapists and nurses that came in the room consistently make it difficult for the patient to get any time to rest and relax by himself. Adequate rest is easier to obtain when there are no interruptions in the rest period and some solitude is allowed. Hazard Prevention: Deficit Hazard prevention is a deficit for DN. The total knee arthroplasty causes the patient to be at an increased risk for infection due to all the invasive procedures done. Prophylactic antibiotics were being considered to help prevent any infection that may develop. The patient is also at risk for falls. The intravenous line and pole make it difficult for the patient to ambulate on his own while dealing with his surgery. The medications DN were taking could cause confusion, dizziness, and sedation which could lead to a fall. The patient is also at risk for a deep vein thrombus due to the surgery, which could be a fatal complication if not prevented. Compression stockings and devices were used to decrease the chance of venous stasis. Promotion of Normality: Deficit Promotion of normality is a deficit for the patient. He has only been hospitalized two other times in his life and feels uncomfortable. Since DN is not used to being in the hospital, he is hesitant to ask for pain medication until the pain is already present. Teaching DN to ask for the pain medicine prior to activities and when he recognizes the pain coming back. DN’s normal routine at home will be changed to accommodate for the knee surgery he underwent. He will have to adjust to the limitations on his activities until he is fully recovered. For example, he will have to depend on his wife and other family members to help milk the cows and take care of the farm until he has full range of movement so he does not damage his newly replaced knee. Developmental Self-Care Requisites Developmental self-care requisites are associated with conditions that result in maturation (Berman et al., 2007). DN has lived a long, productive life and many life changing events have occurred throughout his life. He graduated high school and worked multiple jobs which gave him the experience he needed to now be a self-employed farmer. He and his wife raised a family with three children, and now have several grandchildren. All of these different aspects in DN life have helped DN mature, which puts him in a developmental stage of ego integrity versus despair. According to Erikson, people in this stage should have acceptance of their life and self-worth (Berman et al., 2007). DN seems very satisfied with everything that has happened in his life. He is able to reminisce about the things that have happened in his life with a smile. He does not have any regrets about his life. At this point in DN’s life, he is always thinking of others and enjoying the small things in life. Even though DN is in this developmental stage, he has not fully completed this stage. DN is in a position where he still works and provides for his family. He is not ready to leave his family at this point in his life. Health Deviation Self-Care Requisites According to Orem, there are six health deviation self-care requisites. The health care deviation self-care requisites consist of seeking and securing medical help when needed, responsibly attending to the effects and results of pathologic conditions, effectively carrying out prescribed interventions, responsibly attending to the regulation of effects resulting from prescribed interventions, accepting the fact that sometimes self or others need medical help when faced with certain life challenges, and learning to live productively with the effects of pathologic conditions and treatments while promoting continued personal development (Caton, 2007). The patient is strong in seeking and securing medical help when needed. As soon as the patient realized his pain was increasing in his knee, he scheduled an appointment with his family doctor who referred him to Dr. Know the orthopedic surgeon. The patient is also responsible in attending to the effects and results of pathologic conditions. The patient is aware of the physical therapy regime he needs to complete for full recovery, as well as the preventive measures he needs to take to protect his right knee. The third health deviation self-care requisite is to effectively carry out prescribed interventions, which is a strength for the patient. DN realizes he will continue with physical therapy after discharge on the hospital and will be on a few prescription medications. Other interventions, such as wearing TED hoses, limiting activities, and allowing home health to help with his care, will all be followed by the patient. The fourth health deviation self-care requisite is to responsibly attend to the regulation of effects resulting from prescribed interventions is a potential deficit. Even though the patient stated he will do the interventions asked of him, the task of depending on others for help may be difficult. As a farmer, it is difficult to let someone else do the chores the patient is usually doing on a daily basis. The fifth health deviation self-care requisite is accepting the fact that sometimes self or others need medical help when faced with certain life challenges. This health deviation self-care requisite is a strength for the patient. When DN realized his knee was not functioning at the level he needed it too, he sought help from professionals after trying alternative treatments. When DN had his prostate removed due to prostate cancer, he also pursued help from many specialists to deal with the many complications a prostatectomy can cause. The sixth health deviation self-care requisite is learning to live productively with the effects of pathologic conditions and treatments while promoting continued personal development. This is a strength for the DN because he looks forward to having better function in his knee to live a more productive life. The chores he does on the farm were becoming difficult with the increasing pain in his knee prior to the surgery. The patient now talks enthusiastically about getting back out on the farm to do the things he loves to do. Nursing Diagnosis I. Nursing Diagnosis #1: Acute Pain related to tissue trauma caused by surgery and intense physical therapy regime as evidenced by patient verbalizing his pain an 8 on a 1-10 scale. a. Expected Outcome: Patient verbalizes relief of pain as less than a 3 on a 1-10 scale at least thirty minutes after administration of pain medication. i. Intervention #1: Assess the patient’s description of pain and effectiveness of pain-relieving interventions. 1. Rationale: Assessing pain description leads to the best interventions to control the pain, as well as assess for any complications with a different pain description. Every patient has a right to effective pain relief (Gulanick & Vallerand, 2007). ii. Intervention #2: Instruct the patient to request pain medication before the pain becomes severe. 2. Rationale: Relief will take longer if the patient waits until the pain is too severe (Gulanick & Vallerand, 2007). The best pain control is proactive, not reactive. iii. Intervention #3: Administer narcotic analgesics as ordered by the doctor. 3. Rationale: With all of the tissue damage done during surgery, the nurse should assume the patient is in pain and needs analgesics (Gulanick & Vallerand, 2007). a. Implementation/Evaluation: Nurse assessed the patient’s description of pain to adequately treat the pain symptoms. Nurse taught the patient the request the pain medication at the onset of pain to reduce the amount of time it takes to start working. The goal was met because the patient verbalized his pain less than a 3 on a 1-10 scale within 30 minutes of administration of pain medication. b. Expected Outcome: Patient appears comfortable as evidenced by absence of facial grimacing and use of stress management techniques between doses of pain medication and throughout hospital stay. iv. Intervention #1: Nurse will teach patient to use guided imagery and progressive relaxation. 4. Rationale : Use of guided imagery and progressive relaxation will distract patient from the pain he is experiencing (Gulanick & Vallerand, 2007). v. Intervention #2: Nurse will teach patient to change position frequently. 5. Rationale: Changing positions (within limits) will relieve pressure and pain on bony prominences, reduce muscle spasm, and undue tension (Gulanick & Vallerand, 2007). vi. Intervention #3: Nurse will apply ice packs as ordered. 6. Rationale: Applying ice packs may decrease edema and enhance comfort (Gulanick & Vallerand, 2007). b. Implementation/Evaluation: Nurse taught the patient different comfort measure to relieve pain in between doses of pain medication. Using repositioning and relaxation measures helped the patient stay comfortable between doses of pain medication. The goal was met. II. Nursing Diagnosis #2: Impaired physical mobility related to pain after surgical procedure as evidenced by limited ability to ambulate. c. Expected Outcome: Patient will maintain optimal mobility within limitations throughout hospital stay. vii. Intervention #1: Assess postoperative range of motion in affected and unaffected joints. 7. Rationale: Assessment of range of motion will give a baseline to see if the patient is improving. Range of motion exercises are important to strengthen affected joint (within limitations) and unaffected joints need to maintain current mobility in periods of decreased activity because joints with arthritis lose function more rapidly (Gulanick & Vallerand, 2007). viii. Intervention #2: Nurse will assist patient to ambulate with less assistance as tolerated. 8. Rationale: This will allow for patient to become more independent before discharge (Gulanick & Vallerand, 2007). ix. Intervention #3: Nurse will encourage the patient to move from the bed to the chair as tolerated, as well as ambulate in the room three times a day. 9. Progress will be monitored toward normal activities patient will do once discharged from the hospital (Gulanick & Vallerand, 2007). c. Implementation/Evaluation: Nurse assessed postoperative range of motion to have a baseline of function. Improvement was noted th roughout shift that the patient was able to move more independently. d. Expected Outcome: Patient participates in rehabilitation program throughout hospital stay. x. Intervention #1: Assess the patient’s fear or anxiety in ambulating and going to physical therapy. 10. Rationale: If the patient’s fear and anxiety is too great, the patient may not get the full benefit of physical therapy and is at a greater risk for falls or other injuries (Gulanick & Vallerand, 2007). xi. Intervention #2: Nurse will encourage use of supportive walking devices, such as a walker. 11. Rationale: Use of a walker will help the patient feel more independent and encouraged to go to physical therapy as ordered. More weight bearing will progress throughout the use of walker (Gulanick & Vallerand, 2007). xii. Intervention #3: Nurse will reinforce instructions for rehabilitative activities as ordered. 12. Rationale: Reinforcing instructions will help the patient achieve mobility throughout the hospital stay and adhere to the physical therapy program (Gulanick & Vallerand, 2007). d. Implementation/Evaluation: The patient was enthusiastic about physical therapy and gaining full mobility of affected leg. He participated in the rehabilitation program and was able to go home on schedule, so the goal was met. III. Nursing Diagnosis #3: Self-care deficit related to impaired mobility as evidenced by inability to perform activities of daily living, such as dressing, bathing, and ambulate independently. e. Expected Outcome #1: Patient will safely perform all self-care activities of daily living independently before discharge. xiii. Intervention #1: Nurse will assess the patient’s ability to perform activities of daily living. 13. Rationale: This will provide a baseline to know where the priority deficits in the patient’s performance of ADLs and help nurse assist with the patient’s needs (Gulanick & Vallerand, 2007). xiv. Intervention #2: Assist the patient in accepting help from others. 14. Rationale: The patient may need to realize after a total knee replacement, some assistance may be needed and dependence on people or supportive devices may be necessary temporarily (Gulanick & Vallerand, 2007). xv. Intervention #3: Nurse will implement measures to facilitate independen ce, but be available to help patient when needed. 15. Rationale: Giving the patient independence will help encourage patient to attempt ADLs on his own, but with assistance when needed will prevent falls or other injuries (Gulanick & Vallerand, 2007). e. Implementation/Evaluation: Nurse assessed the patient’s ability to perform activities of daily living and realized where the patient needed assistance. Patient was encouraged to do ADLs on his own, but to recognize and ask for help if he needed it. Patient was able to ambulate on his own the bathroom, perform most activities independently, but required some help from his wife by discharge. This goal was met because the patient realized when he needed help and performed all ADLs safely by discharge. f. Expected Outcome #2: Resources are identified that are useful in optimizing the autonomy and independence of the patient by discharge from the hospital. xvi. Intervention #1: Nurse will assess what assistance will be needed when the patient is discharged. 16. Rationale: This will be helpful to the patient and other caregivers to recognize deficits until they are overcome (Gulanick & Vallerand, 2007). xvii. Intervention #2: Nurse will encourage patient to use assistive devices until no longer needed, and reassure patient that use of them can prevent falls and injuries. 17. Rationale: This allows patient to know total independence is not expected just because the patient is being discharged (Gulanick & Vallerand, 2007). xviii. Intervention #3: Nurse will help the patient set short term goals to becoming more independent. 18. Rationale: Setting short term goals will decrease the frustration the patient may have in not being able to do activities he could do before surgery (Gulanick & Vallerand, 2007). f. Implementation/Evaluation: Nurse assessed what assistance may be needed to help with activities of daily living. Patient used assistive devices and help from others when he recognized he could not do them independently. Short term goals were set and patient was able to be discharged with a walker and home health services. This expected outcome was met. IV. Nursing Diagnosis #4: Risk for ineffective tissue perfusion related to surgical procedure and impaired physical mobility. g. Expected Outcome: Patient maintains adequate tissue perfusion and remains free from deep vein thrombosis, as evidenced by warm extremities, good capillary refill, bilaterally equal pulses, negative Homan’s sign, and stable vital signs. xix. Intervention #1: Assess neurovascular status of affected limb preoperatively and postoperatively, as well as assess for signs and symptoms of deep vein thrombosis. 19. Rationale: Preoperatively a baseline should be established and assessing for changes postoperatively will be indication of a problem. Signs and symptoms could be an early indication of a blood clot which leads to early intervention (Gulanick & Vallerand, 2007). xx. Intervention #2: Nurse will assist patient in using thromboembolic disease support hoses and sequential compression devices as prescribed. 20. Antiembolic devices, such as TED hose and SC Ds, increase venous blood flow to the heart and decrease venous stasis, which could prevent a blood clot (Gulanick & Vallerand, 2007). xxi. Intervention #3: Nurse will administer thrombolytic and anticoagulant agents as ordered. 21. Rationale: Prophylactic anticoagulants will reduce the risk of deep vein thrombosis and thrombolytic drugs may decrease the complications if a blood clot does develop (Gulanick & Vallerand, 2007). g. Implementation/Evaluation: Patient was assessed preoperatively and postoperatively for neurovascular status. Patient was monitored closely for any signs of ineffective tissue perfusion. Nurse encouraged use of antiembolic devices and patient adhered to regimen. The goal was met because ineffective tissue perfusion was not a problem and not deep vein thrombosis developed. V. Nursing Diagnosis #5: Deficient knowledge related to a new procedure and unfamiliar with the discharge plan as evidenced by patient questioning health care team members about the process. h. Expected Outcome: Patient verbalizes understanding of procedure and discharge instructions. xxii. Intervention #1: Assess the patient’s current understanding of process in hospital and discharge instructions. 22. This will allow the nurse the individualize the teaching plan for the patient and teach only what the patient does not understand (Gulanick & Vallerand, 2007). xxiii. Intervention #2: Nurse will review total knee arthroplasty precautions according to what the patient does not already know, for example, using the walker, maintain proper body weight, and when to notify the physician. 23. Rationale: Reviewing the information will reinforce adherence to the rehabilitation program (Gulanick & Vallerand, 2007). xxiv. Intervention #3: Nurse will explain the discharge follow up instructions, and reinforce the need to continue with home health for physical therapy. 24. Rationale: Home health and physical therapy will increase the patient’s strength to have a full recovery. When the patient understands the process, he will be more motivated to continue with the program (Gulanick & Vallerand, 2007). h. Implementation/Evaluation: This goal was met. The patient had a full understanding of the limitations of a knee arthroplasty, in the hospital and after discharge. He understood the follow-up appointments and how home health would assist in his recovery. VI. Nursing Diagnosis #6: Constipation related to inactivity and medication use as evidenced by patient having frequent but nonproductive desire to defecate. VII. Nursing Diagnosis #7: Risk for infection related to invasive procedure. VIII. Nursing Diagnosis #8: Risk for falls related to unsteady gait and pain in left leg. References Berman, A., Snyder, S., Kozier, B., & Erb, G. (2007). Fundamentals of nursing: Concepts, process, and practice (8th ed.). Upper Saddle Road, NJ: Pearson. Caton, B. (2007). Orem’s self care requistes. Handout for NUR100 Fundamentals of Nursing. Missouri State University-West Plains, Fall 2007. Deglin, J.H., & Vallerand, A.H. (2007). Davis’s drug guide for nurses (10th ed.). Philadelphia: F.A. Davis. Gulanick, M., & Myers, J.L. (2007). Nursing care plans: Nursing diagnosis and intervention. St. Louis: MO: Elsevier. LeMone, P., & Burke, K.M. (2004). Medical-surgical nursing: Critical thinking in client care (3rd Ed.). Upper Saddle Road, NJ: Pearson. Pagana, K.D., & Pagana, T.J. (2006). Mosby’s manual of diagnostic and laboratory tests (3rd ed.). St. Louis, MO: Mosby. Total Knee Replacement (2009). American Academy of Orthopaedic Surgeons. Retrieved October 19, 2009, from http://orthoinfo.aaos.org/topic.cfm?topic=A00389.

The Purpose of a Liberal Arts Education

A liberal arts education can open many doors for you. However, it may not be for everyone. A four year liberal arts degree is meant to make you a well-rounded person, but many people don’t feel the need to take classes that don’t directly apply to their career. Liberal arts exercises your mid; it makes it stronger. It helps develop an ordered mind and good thinking habits. You may never use the things you learn in a computer programming class, but it will make you a better learner.It also teaches you to think for yourself; your fellow students and teachers will challenge what you know, think and believe. Imagine the doors of creativity that will be opened for you. You may not have known how much you enjoy paining until you took a mandatory general education art class. It can enhance your faith. Maybe you have an interest in taking a theology class so you can be closer to god, at a liberal arts college you can have that opportunity. You can better understand the bible, w ho wrote it, and why they were inspired to do so.A liberal arts education will not only make you a better learner, it will also make you a better teacher. The more molded your mind becomes, the more easily you can explain things to people. Even if you don’t plan on becoming a professional teacher, this can help you help your children with their homework, help train new employees, or even teach a Sunday School class. It will cultivate your mind; opening doors to art, music, symbolism, or even language, things you may not have even had an interest in before. You will learn to appreciate these things more.A Christian liberal art education may be the right thing for you. It can send you in the right direction if you want to teach in a private Christian school, want to be a missionary, a pastor, or even if you just want to be education with fellow Christians. Some of your classes may cause you to question not only your faith, but why you have it in the first place, which will make you see why you fell in love with God in the first place. But does this mean a liberal arts education is right for everyone? I don’t believe it does.A single mother going back to school may not have time for the required number of classes, most of which, she will never use on the job. A 40 year old works at a factory that is being shut down and he needs to learn a new skill quickly so he can go back to supporting his family. For people like this, a liberal arts education may not be the right road for them to take. A liberal arts education can do many more things for you than what I have mentioned. It’s like a treasure trove; you have the key, all you have to do is open the door and that wealth of knowledge could be yours.

American Economy 1940-1950 Assignment Example | Topics and Well Written Essays - 1250 words

American Economy 1940-1950 - Assignment Example I chose this decade because of the World War II, and I can easily demonstrate how it changed the economy of the American people (Jay 23). This decade was significant in making the United States of America the super power country in the economy and makes the country stable politically, economically, socially, and also, the technology of the country was being developed at a unusually high rate. After the war, the American men, came from war they had seen several events in the outside world. They have seen the importance of education and how education had helped to develop other countries well. The black people in the United States were then accepted to attend school and further their studies. They were allowed to go to college and acquire degrees and develop their knowledge about things in the continent. At the same time, ladies were also enjoying independence since they did not have to work at home all the time, they were allowed to go to school and acquire education that would then h elp them to get jobs. This greatly impacted the American economy since more people were learned and things were being done in a more civilized way (Jay 45). The scrap drives for steel, paper, and rubber became a source of supporting the war in America. In the year, 1942, the automobile production was stopped due to war issues, and the food was rationed in the year1943. As the war continued, several economic trends emerged in the United States; the American troops were gaining experience of the war and they were defeating the enemy troops. Soon United States of America became the super power after the Japanese bombing in 1945. Although still, United States was being challenged and opposed by the USSR still they had the lead of the war, and they had the say about what was to happen. This in turn, made American people become hard working so that they could afford to manage their status as a leading country in the world. The United States implemented a plan that was called the Marshall plan. The plans main objective was to help the countries that were more affected during the war to regain their economic status and rebuild their country. At the same time, the plan was to help in stabilizing the world economic levels. But, this could not take place since there were disputes that arose over the ideology to rebuild the war torn countries and enhance the status of the world economy. This then led to the rise of the cold war and the communism (Jay 65). After the American heroes had returned home, they realized the power and prejudice that in turn helped them to civil rights reforms that was to take place in the next decades. The servicemen’s’ readjustment Act ensured that the war soldiers were taken to college, and that they were given quality of education. In the 1949, many degrees were conferred more than 1940. This in turn, meant that, the levels of educated people had risen and that there were more employment opportunities that were created in the cou ntry. This increased the income revenues for the central government and made an impact in the economy of the United States. Television which had made its first break through in the 1939 war issue, but was interrupted by World War II made another come back in 1947. The commercial television had more than thirteen channels and was made public. People started to develop computers in the early forties. The first computer was digital it was called ENIAC and it weighed more than 29 tons

Ceramics Essay Example | Topics and Well Written Essays - 500 words

Ceramics - Essay Example This section contains a fine selection of tiles and large scale ceramics showing the architectural ceramics that existed in the 13th century to those in the present day. The tiles displayed are from countries such as Portugal Netherlands and the Islamic world which have great history on architectural ceramics.2 This gallery forms the greatest part of the Victoria and Albert museum ceramics section and it is in this room where you find Asian and Middle East ceramics that existed before the 1800. The collection is Brobdingnagian and is displayed on the walls according to the place of origin, time of manufacture and the technique used.3 This section contains the modern day ceramics that have been manufactures in the 20th century. The large influential companies of ceramic production such as the Royal Copenhagen and the Wedgwood have a lot of products in display. The history of ceramics dates back eight thousand years ago and the first ceramics were first made by the Chinese. They constructed earthenware ceramics using the porter’s wheel technology and this is demonstrated by the terracotta ceramic carvings in the tomb of the Emperor Qin. Over the centuries ceramic production was improved by new technologies and styles the most important being tri-color stoneware of the Tang dynasty. During this period the ceramics began to be used for ornamentation functions. As years went by, the celadon style was innovated and it brought about the technology of making elegant shapes and decorations. During the song dynasty, ceramics made of whiteware became popular and helped the Chinese thrive in ceramic trade.4 An advancement of the song dynasty was the blue and white porcelain that were created in the Yuan dynasty and was characterized by the glasslike finish on whitish clay bodies. The Qing period that occurred between 1644 and 1911 was the mos t innovative since it brought about the multicolored porcelain designs that are popular in the

History and Environment in the Mimbres Valley Article

History and Environment in the Mimbres Valley - Article Example The valley thus experienced a variation in the population over the years, and this affected its overall ecology. The research focuses on how the people survived in this valley; how its ecology changed, and how this differs from the present. The area features a short river, predominantly pinon, juniper and oak trees, orchards and alfalfa, and a floodplain, which continues to be farmed by gravity-fed small irrigation canals. The riverine environment contrasts significantly from surrounding areas, which also has more drought-resistant vegetation. Although it appears the land is fairly preserved, the significant recent degradation as the third cycle of human interference is resulting in more permanent consequences for plant and animal life. The original Mimbres people transformed from a lifestyle of hunting and gathering to farming supplemented their diet with wild plants and animals and were self-sufficient. Culturally, they resembled the Hopi and other pueblos. As their population increased, they cut down more trees, engaged in more intensive farming, used more weedy plants, and overexploited select larger animal species. This also denuded the valley bottom from plant life. Some of the check dams constructed in marginal areas to retain rainwater still remain. The first cycle of degradation then occurred between A.D. 1000 to 1130 despite evidence of some measures of environmental conservation. However, as noted by Lt. Emory in 1846, the environmental balance was later restored. This is attributable to the population decline by the 1400s and the preservation of the river. The next cycle of degradation was caused by the opening of a shelter during the later 1800s, in particular from the wood gathered to fuel it resulting in large-scale deforestation aided by steel tools, wagons, and horses. However, this situation reversed after the smelter was closed.  

The Paper Tiger Reasons for Legalizing Drugs Essay

The Paper Tiger Reasons for Legalizing Drugs - Essay Example Legalization arguments are paper tigers that, when confronted by reason, leave no doubt that drugs should not be legalized. Advocates will often point to our Constitution to justify the stand that all people should be free to ruin their life with a drug habit. Of course while no one but the most radical elements advocate legalization for children, assuming that it only applies to adults stretches the meaning of freedom to the point that it becomes unrecognizable. Adults are not simply individuals living in a vacuum, unaffected by and having no impact on the world around us. People have families, communities, cultures, and societies that they are a part of. A person's freedom of choice must be carefully balanced against societies obligation to protect all of its members. The myth that the abuser is the only victim of drug addiction simply does not apply to the parent who is neglecting their children because they are too high to understand the responsibilities of adequate parenting. Legalization advocates often link the ideal of freedom with ethics. They point to the inherent unfairness and hypocrisy of a government that condones alcohol use but condemns marijuana users to prison or probation. However, this argument merely draws attention away from the real issue. The controversy is not the safety and status of alcohol. The issue should remain focused on the legalization of drugs and not an issue of which drug is better or worse. Proponents likewise point to the unfairness in the application of the drug laws as a reason for legalization. They cite the disproportionate number of minorities and poor in prison for violating the drug statutes. Milton Friedman, a leading legalization advocate, asks, "Can any policy, however high-minded, be moral if it leads to widespread corruption, imprisons so many, has so racist an effect" (P14}. While his sympathy may be admirable, his reasoning is flawed. If police forces are using racism or a policy of corruption to enforce the law, then that is the issue that needs to be addressed. It is not t he drug law; it's the application that needs examined. If a preponderance of murderers on death row are minorities, and they probably are, no one would advocate legalizing murder, and we should not legalize drugs in a misguided effort to correct deficiencies in our enforcement efforts. Our current strategy of enforcement has resulted in a ballooning population of prison inmates, many who are there as either a direct or indirect result of drug addiction. Opponents of strict drug enforcement question whether we can afford the continued incarceration of drug offenders (Currie, P10). The real question is; can we afford not to Crimes resulting from drug use often fall into two categories; the property crime committed to get money to purchase drugs, and the crime committed during an altered state of mind and loss of rational behavior. Bennett tells us that if drugs were legalized, "drug use would soar" (P13). The crimes that result from the drug user's impaired judgment would increase proportionately. But would legalization reduce property crime Advocates would have us believe that the greater access to a legal supply

Bribery and Corruption in relation to International Business Research Paper

Bribery and Corruption in relation to International Business - Research Paper Example This is because bribery and corruption imposes large costs on conducting business, misallocates a nation’s resource, undermines the efficiency of a market and it also distorts competition. Bribery encourages unethical practices, erodes the public trust on their leaders, undermines significant development projects and slows down the economic growth of developing nations (Tanzi 20). Bribery becomes defined as the practice of giving something, usually money, to influence an individual in the execution of his/ her duties. Bribes are not only in the form of money, but also other advantages such as offering to pay for someone his/ her travel costs. Bribery also involves a business firm from one country giving financial or non financial benefits to officials or executives of other countries to gain a commercial benefit. Corruption, on the other hand it gets defined as the use of the public office for personal gain (Montagnon 13). The ever increasing growth in investment and the inter national trade in a number of the past decades have become accompanied by an increase in corruption and bribery. According to the World Bank, it has become estimated that nearly 5 percent of exports to the developing nations goes to the corrupt officials. It gets shown that nearly over a trillion dollars get paid as bribes each year (Cohen 24). Bribery is costly to the nations where it is prevalent. According to surveys done, money lost to bribery and corruption is the biggest potential source of funding available to a number of new democratic governments aside from direct foreign investment. Tackling the issue of bribery can lead to an increase in the national income and stimulate the economic growth, which in turn will lead to improvements in the quality of life. A reason for the rapid growth in corruption in the global market is due to the privatization of public enterprises globally. This has become accelerated by governments and the western creditors, and executed in a way that allows the multinational companies operate with impunity. These multinationals get supported by their governments and their respective agencies that give them room to participate in the practices at a vast scale. Most governments and the donor agencies like the International Monetary Fund create anti poverty and proper governance agendas, but what they do send different messages about where their priorities lay. Stern action against corruption and bribery has to include sanctions by developing countries against these multinationals that engage in these mal practices. Effective political transparency to disengage the room under which corruption exists (Montagnon 33). To these multinationals, bribery and corruption ensures they get contracts which they could not have succeeded in getting, or to do so in clear terms. Annually, these multinationals pay large sums of money in bribes to get a friend and to influence contracts. These bribes become estimated to be 80 billion US dollars (Co ok 26). This is the same amount UN estimates to be able to eradicate poverty in developing countries. The US Commerce Department provided the report that in the 5years preceding 1999 bribery was a serious issue in commercial contracts that were worth US $145 billion. In the 1996 issue of the magazine World Business, it got reported that bribes amounting to $ 3 billion got paid by the German companies. The French secret service report showed that nearly $2

Structure paper of presentation Essay Example | Topics and Well Written Essays - 750 words

Structure paper of presentation - Essay Example At a sore of 30 China features a low score on uncertainty shunning. Truth could also be relative although within the immediate social circles theres concern for Truth with a capital T and rules (but not essentially laws) abound. At a score of twenty China could be a extremely collectivist culture wherever individuals act within the interests of the cluster and not essentially of themselves. In-group considerations have an effect on hiring and promotions with nearer in-groups (such as family) are becoming discriminatory treatment. Worker commitment to the organization (but not essentially to the folks within the organization) is low. Whereas relationships with colleagues are cooperative for in-groups theyre cold or maybe hostile to out-groups. Personal relationships prevail over task and company. At sixty six China could be a masculine society –success minded and driven. The necessity to make sure success may be exemplified by the actual fact that a lot of Chinese can sacrifice family and leisure priorities to work. People are influenced by formal authority and sanctions and are normally optimistic regarding people’s capability for leadership and initiative. Individuals must not have aspirations exceeding their rank. The justice system ought to even have effective mechanisms for reducing, or altogether eliminating, scoundrel and corrupt parts of enforcement agencies. (Hedging against currency risk will add tier of safety to your offshore investments (Charles, 2002). Traditions are often custom-made to suit new conditions. Chinese folks acknowledge that government is by men instead of as within the Low LTO countries by an external influence like God or the law. Thinking ways in which specialize in the total or no confidence, contrastive with low LTO countries that suppose in probabilistic ways. There is abundant labour in

Employer Liability to Unlawful Acts of Employees Essay - 1

Employer Liability to Unlawful Acts of Employees - Essay Example However, from 1941, a series of laws were made which prohibited employers from firing employees for no reason. The Executive Order 8802, was the first law that prohibited racial discrimination, later in 1964, the Civil Rights Issue and amendments were created, in 1990 the Americans with Disabilities Act was created which protected disabled Americans. In 1993, the Medical and Family Leave Act and many other laws that protected employees were formed (Mackey & Daniel, 1986). The employment law came into existence to protect employees’ rights. The Fair Labor Standards Act ensures that employees’ overtime pay is paid to the employees who work for more than 40 hours a week and it also regulates employees’ minimum wages. The Americans Disability Act ensures equal treatment for persons with disability, it protects employees with disabilities from being mistreated by their employers and fellow employees (Walsh & David, 2013). Employment Law prohibits racial discrimination, all employees are supposed to be treated equally regardless of race, sex, religion, gender, age and national origin. These laws ensure equal employment opportunities and every employee is subject to wages. There are three major exceptions; the public-policy exception, under this exception an employer should not terminate an employee for claiming compensation after being injured in the line of duty. The other exception is the implied-contract, this is where there is a formation of an implied contract between an employee and an employer but there is no written documentation regarding the employment but the relationship exists (Walsh & David, 2013). Lastly, the Covenant-of-good-faith means that any malicious decisions by the employer are prohibited.

The Inclusion of the Charter of Rights and Freedoms in the Canadian Essay

The Inclusion of the Charter of Rights and Freedoms in the Canadian Constitution - Essay Example Opponents also point that the inclusion of the set of rights Americanizes Canadian politics. They disagree that Canada’s Constitution is not like the American Constitution, which incorporated the Bill of Rights and supports a strong sense of individualism among Americans. They argue that although the notion of individuality is important in Canada, the â€Å"Canadians also see themselves in terms of collectives or a part of a group† which they actualized in some legislative efforts. They claim that the inclusion â€Å"will erode collective tendencies.† It may be counter-argued that opponents value also individuality without sacrificing collective spirit of Canadians and since Canadians were able to show their collective efforts in Medicare and employment insurance under the present constitution, then working collectively under the present set up has confirmed the effectiveness of the present constitution for the collective spirit. It is hereby concluded that maint aining the inclusion of the Charter of Rights and Freedom under the present Canadian Constitution benefits Canadians more. Having explained and rebutted the opponents’ counter arguments, there is a basis to sustain the thesis of this paper. A constitution contains the government powers and maintaining the Charter therein is one way of preventing the abuse of these powers. Allan Cairns might be correct in saying that â€Å"from the evidence available, there is little possibility that a new constitution will emerge.†

Free

Freedom Fighters Essay Nelson Mandela was a visionary freedom fighter who brought about the end of an apartheid society and solidified the democratic elections of presidents by majority rule to South Africa. Born in 1918, Mandela’s early introduction to leadership in the Thembu tribe molded his democratic beliefs (Nelson Mandela, 2009). His youth found him exposed to Western culture which ultimately led him to abandon the Thembu culture and relocate to Johannesburg (Nelson Mandela, 2009). It was during his early years in Johannesburg that he explored the many political philosophies that surrounded him. It was also during this time that Mandela began thoughtful observation and contemplation of the struggles of the black men and women in South Africa. Mandela came to the conclusion, â€Å"It was not lack of ability that limited my people, but lack of opportunity† (Sohail, 2005). His profound dissatisfaction with the apartheid society and the oppression of his people eventually led him to join the African National Congress or ANC in 1944 (Nelson Mandela, 2009). In 1948, the Afrikaner dominated National Party established the apartheid customs into law (Sohail, 2005). In response to this the ANC initiated the Campaign for the Defiance of Unjust Laws at the urging of Mandela (Sohail, 2005). This was the turning point for the ANC and the beginning of Mandela’s rise to recognized leader within the ANC. Prior to this campaign the ANC was committed to peaceful negotiations. With Mandela’s convincing they converted to nonviolent protesting with the goal of overthrowing the white minority government and putting an end to the apartheid laws (Nelson Mandela, 2009). These unsuccessful protests were met with violent opposition. It was one such violent encounter that propelled Nelson Mandela and the ANC to adopt violence as a means of protest. In 1960, sixty nine protestors were killed by government police, this act ultimately lead to the development of Umkhonto we Sizwe (Spear of the Nation) by Nelson Mandela (Nelson Mandela, 2009). The Umkhonto we Sizwe was an offshoot of the ANC whose sole purpose was to engage in violent sabotage of the government. It was Nelson Mandela’s activities within the Umkhonto we Sizwe that ultimately led to his capture and incarc eration. His trial and sentencing captivated a world audience and forced the actions of the South African government into an international spotlight.(Nelson Mandela, 2009). Fully expecting the  death penalty, Mandela rebutted the idea of seeking appeal recognizing the strength of his position in regard to the cause; â€Å"If anything we might serve the cause greater in death as martyrs than we ever could in life† (Sohail, 2005). Nelson Mandela was sentenced to life imprisonment and solidified his standing as a symbolic embodiment of South African’s fight for freedom (Nelson Mandela, 2009). While incarcerated the violence that Mandela birthed continued to escalate over the years. The world continued to pay attention and the United Nations began supporting sanctions against the South African government (Sohail, 2005). Mandela, aware of the violent chaos, began to contemplate a change in strategy. Recognizing that the movement he began was not vast enough to outright overthrow the existing government he began to consider the possibility of negotiations. At the height of the violence and with increasing international pressure the South Afric an government was ready to negotiate as well. The first of many secret meeting took place in 1988 between President Botha and Nelson Mandela (Nelson Mandela, 2009). While these negotiations failed to produce any compromises they set the precedent for Botha’s successor F.W. de Klerk in 1989. President de Klerk was committed to change and meaningful negotiations. With the help of President de Klerk, Mandela established the foundation on which the ANC and the South African Government would negotiate (Sohail, 2005). President de Klerk overturned several of the apartheid laws and ensured Mandela his freedom. Nelson Mandela, to the celebration of millions, was released on February 11, 1990 (Sohail, 2005). After spending 27 years in prison, Nelson Mandela and F.W. de Klerk mediated the negotiation of the multiparty Convention for a Democratic South Africa (Nelson Mandela, 2009). The culmination of these negotiations was the Record of Understanding signed by Mandela and de Klerk in 1992 establishing a â€Å"freely elected constitutional assembly† (Nelson Mandela, 2009) and the drafting of a new constitution. The first free democratic elect ions took place on April 27, 1994 (Nelson Mandela, 2009), effectively ending the minority white reign and the apartheid laws. For Mandela’s significant contributions and sacrifices to bring about these social and political changes he was awarded the Nobel Peace Prize in 1993(Nelson Mandela, 2009). Andrew Jackson was a revolutionist and the 7th President of the United States. It was though this pursuit of the United States presidency  that he changed the political landscape; changing the way presidents were elected and solidifying presidential power. He further initiated significant change with the displacement of the Native Americans westward. (Red Hill Productions, 2007) Andrew Jackson was born 1767 in South Carolina. Orphaned by the Revolutionary War at the age of 15, he quickly developed a reputation of being â€Å"hot tempered and violent† (Red Hill Productions, 2007). Yet at the same time, he maintained a strong work ethic and earned a law degree. He relocated to the frontier lands of Tennessee at the age of 20 to serve as a public prosecutor. It was during this period in his life that he first experienced formal politics. Serving as Tennessee’s first Congressman he quickly became disenchanted with the political scene. Frustrated with ineffective committee meetings and what he saw as far reaching corruption, he returned to Tennessee where he became a superior court judge. (Red Hill Productions, 2007) At the urging of his supporters and amid far reaching popularity, Jackson once again entered politics with a bid for the 1822 presidential race. Andrew Jackson was defeated in 1824 despite winning the popular vote. John Quincy Adams was awarded the presidency at the discretion of the sitting House of Representative (Andrew Jackson, 1997). Empowered by what they saw as a corrupt election process where presidents were decided via the political elite and not the will of the common people, Jackson’s supports organized the first Democratic Party (Red Hill Productions, 2007). United under the Democratic Party the common people led a feverish campaign. This campaign culminated in the electing of Andrew Jackson to the presidency in 1828 (Red Hill Productions, 2007). Recognizing the political power of an organized party the Republican Party was realized later in the decade. Originally dubbed â€Å"the National Whig Party† (Red Hill Productions, 2007), the birth of this party laid the foundation for a two party political system that continues to dominate politics today. During Andrew Jackson’s two term presidency he further enacted political change by redefining the role of President within the government. In juxtaposition with the founding fathers, Jackson saw the role of the President as the leader in gov ernment rather than the Congress (Red Hill Productions, 2007). Being the only position in government to be elected by the vast majority of the common people, Andrew Jackson envisioned the presidential responsibility as to â€Å"serve the good of all people† (Red Hill Productions, 2007). With  this responsibility came great power which Jackson wielded with great efficiency. He invoked his executive power and utilized his veto power vehemently (Red Hill Productions, 2007). With this wide sweeping reform and successful transition of political power to the President, Andrew Jackson is credited with being the first modern President (Red Hill Productions, 2007). While serving as President, Andrew Jackson determined to secure westward expansion of the United States enacted even further political and social change with the Indian Removal Act of 1830 (Red Hill Productions, 2007). Jackson was the catalyst that ultimately concluded with the displacement of the Native Americans east of the Mississippi (Red Hill Productions, 2007). Recognizing the significance of westward expansion for the continued success of the United States, Jackson introduced the Indian Removal Act in a message to Congress in 1830 (Red Hill Productions, 2007). This displacement of the Native Americans wou ld open Native American lands for the white Americans to develop and expand westward. The Indian Removal Act was passed by Congress in 1830 (Red Hill Productions, 2007). Despite the Supreme Court ruling in favor of the Cherokee people, Andrew Jackson moved forward with the Indian Removal Act forcing a westward movement of the Cherokee people (Red Hill Productions, 2007). This westward movement was famously termed â€Å"the Trail of Tears† (Red Hill Productions, 2007). This impacted the Creek and Seminole people as well and effectively solidified the expansion of the white farmers and business entrepreneurs on the land west of the Mississippi for the American people (Red Hill Productions, 2007). Andrew Jackson’s contribution of the establishing of political parties and the expansion of presidential power solidifies his legacy of enacting significant political and social change. These contributions continue to remain the foundation of politics in the United States. His Indian Removal Act was an equally significant example of political and social change that allowed the United States to expand westward. This westward expansion firmly cemen ted the continued success of the United States. References Andrew Jackson. (1997). In Biography Reference Bank. Retrieved from http://ehis.ebscohost.com/ehost/delivery?sid=986fb1e9-82c5-4a86-8443-28de1ed235%40sessionmgr112vid=13hid=4208 Nelson Mandela. (2009). In Biography

Analysis of Online Recruitment Process With TAM

Analysis of Online Recruitment Process With TAM ANALYSIS OF ONLINE RECRUITMENT PROCESS FOR JOBSEEKERS USING TECHNOLOGY ACCEPTANCE MODEL(TAM) 1) S.Munzarin, 2) A. Manimegalai 3) G. Latha, 4) B. Sindhuja ABSTRACT I.INTRODUCTION Today, online recruitment has become a major tool for many organizations. However, little is known about jobseekers reactions to this new technology. This article is aimed at developing a web-based and central recruitment Process system for the HR Group of the company. Some features of this system will be creating vacancies, storing application data, and Interview process initiation, Scheduling interviews, storing Interview results for the applicant and finally Hiring of the applicant. This online website provides jobseekers to register themselves by attending the registration exam. Reports may be required to be generated for the use of the HR group. This paper provides an insight for jobseekers on the effective use of e-recruitment website and strategy to attract potential jobseekers for employment in reducing the manual work of HR correcting the Test, Short-listing the candidates, Informing the candidates etc. Data gathered from 332 job applicants at System Group Corp. shows useful ness and perceived ease of use – as core constructs of TAM model – are two main factors that predict jobseekers behavioral intentions to use recruitment websites. Keywords:, Technology Acceptance Model, online recruitment, e-recruitment efficient usage, jobseekers, behavioral intentions. Nowadays, e-recruitment is a method to recruit potential employees; with over 90% of Fortune 500 companies using some form of online recruiting (Feldman Klaas, 2002). Job seekers are also conducting their searches online; with over 52 million Americans have used online job searches (Jansen, Jansen, and Spink, 2005). Online recruiting and hiring as a business tool has not only changed the way companies recruit employees and how job seekers search for jobs, it has also impacted both parties involved. If the effectiveness of an organizations web site in attracting potential employees is considered to be a crucial determinant of an organizations ability to generate qualified applicants (Willianson et al., 2003), identifying the factors that influence jobseekers attraction to organization website has to be a high priority.This fact was highlighted by a recent study of college students reporting that 26% of students rejected potential employers from job search consideration because of the poor design of their web sites (Karr, 2000). This paper attempts to use Technology Acceptance Model (TAM) introduced by Davis, (1989) – as one of the most successful models explaining the user/technology adaption – to identify some factors influencing jobseekers behavioral intentions in using e-recruitment websites. The findings of the current paper not only provides an insight for managers on the effective use of organizations recruitment websites but also, by providing a sound theore tical framework, would help to eliminate the shortcomings associated with former studies in the area of online recruitment. To begin our discussion, we first review the existing online recruitment literature. We then explain Technology Acceptance Model as our research framework, and introduce the related hypotheses. Finally, we explain the practical implications of the research, as well as our study limitations. 2. TECHNOLOGY ACCEPTANCE MODEL (TAM) In IT literature, the TAM is the most influential model use to measure technology acceptance. This model is the extension of Ajzen and Fishbein’s Theory of Reasoned Action (TRA), by Fred Davis and Richard Bagozzi (Bagozzi et al., 1992; Davis et al., 1989) to explain the computer-usage behavior. The main purpose of TAM was: to provide an explanation of the determinants of computer acceptance that is generally, capable of explaining user behavior across a broad range of end-user computing technologies and user populations, while at the same time being both parsimonious and theoretically justified (Davis et al., 1989, p. 985). Numerous empirical studies have found that TAM consistently explains a substantial proportion of the variance (about 40%) in usage intentions and behavior (Venkatesh and Bala, 2008), and TAM compares favorably with alternative models such as the Theory of Reasoned Action (TRA) and Theory of Planned Behavior (TPB) (Venkatesh and Davis, 1996). As of December 2007, the Social Science Citation Index listed over 1,700 citations to the two journal articles that introduced TAM (Davis, 1989; Davis et al., 1989). TAM theorize that an individuals behavioral intention to use a system is determined by two beliefs: perceived usefulness, defined as the extent to which a person believes that using a system will enhance his or her job performance, and perceived ease of use, defined as the extent to which a person believes that using a system will be free of effort (Venkatesh and Davis, 1996). According to TAM, perceived usefulness is also influenced by perceived ease of use because, other things being equal, the easier the system is to use the more useful it can be(Venkatesh and Davis, 1996).Many researchers empirical studies have replicated and tested the model under different conditions for TAMs extended variables as general measures by explicitly including IT acceptance variables (e.g., Davis et al., 1992; Compeau and Higgins, 1995; Ma and Liu, 20 04). However, Davis et al. (1989) TAM assumes that perceived ease of use and perceived usefulness are of primary relevance for computer acceptance. In the next section, with a full introduction of these two core constructs of TAM perceived ease of use and perceived usefulness – the research hypotheses are presented and the research framework is explained. 2.1.1. Perceived Usefulness (PU) Perceived usefulness is defined here as the degree to which a person believes that using a particular system would enhance his or her job performance. Within an organizational context, people are generally reinforced for good performance by raises, promotions, bonuses, and other rewards (Pfeffer, 1982). A system high in perceived usefulness, in turn, is one for which a user believes in the existence of a positive use-performance relationship. Organizations recruitment websites often support jobseekers with comprehensive job information including, salary information, benefits, rewards, and organizational programs (Cober et al., 2000). Perceiving system usefulness as antecedent of e-recruitment utilization, such as using these information and tools to enhance the effectiveness of job application, would draw the attention of many employed jobseekers into adopting the technology for job search (Tong, 2008). 2.1.2. Perceived Ease of Use (PEU) Perceived ease of use, in contrast, refers to the degree to which a person believes that using a particular system would be free of effort. This follows from the definition of ease: freedom from difficulty or great effort. All else being equal, we claim, an application perceived to be easier to use than another is more likely to be accepted by users. On the contrary, a complex system, that is difficult to use, is less likely to be adopted since it requires significant effort and interest on the part of the user (Teo, 2001). As perceived ease of use has an inverse relationship with the perceived complexity of use of the technology, it affects perceived usefulness. TAM thus posits that perceived usefulness is influenced by perceived ease of use (Sanchez- Franco and Roldan, 2005). Similarly, in the e-recruitment context, jobseekers would prefer the system if it is easy to use compared to other methods of job applications. 2.1.3. Behavioral Intention Bagozzi et al. (1992), believe that new technologies (e.g., recruitment websites) are complex, Thus, people form attitudes and intentions toward trying to learn to use the new technology prior to initiating efforts directed at using (Tong, 2008). Sanchez- Franco and Roldan (2005) study found that the relationship between perceived usefulness and behavioral intention was strong among goal-directed users. Consequently, this study relates PEOU to PU and PU to BI with the following hypotheses: H1: Perceived Ease of Use (PEU) positively influences Perceived Usefulness (PU) in Erecruitment adoption. H2: Perceived Usefulness (PU) positively influences Behavioral Intention (BI) to use  organizations e-recruitment website. Therefore, given empirical tested studies of modified TAM and the significant causal link among the three constructs by previous researchers, the author attempts to use Structural Equation Modeling (SEM) to test these highly validated studies with PEOU, PU, as independent variables and BI as the dependent variable  for this study. The research framework is also illustrated in Figure 1. Figure1. Research framework forjobseekers e-recruitment technology adoption 3. METHOD 3.1. Participants The participants of the study were 347 applicants for System Group Corp. While having more than 1200 employees, System Group Corp. is considered to be the biggest active organization in manufacturing software technologies in Iran. The data was gathered in a two-month period, during which 421 applicants logged on to the organizations website. From among these applicants, 347 questionnaires were gathered by the researcher, and at the end, a number of 332 questionnaires were analyzed (response rate 82%). The respondents of the study included 63 percent male, 73 percent single, and the majority of them ranged between 21 to 25 years old. Participation was completely anonymous and on a voluntary basis. 3.2. Procedure The researchers did not have access to the actual application data due to stringent privacy regulations. Rather, data on the measures were collected using an online questionnaire that was administered subsequent to the online application procedure. we will first describe the data that were collected as part of the application procedure followed by a description of the research questionnaire. 3.2.1. Application Procedure Applicants could search for positions on the System Group official website. Here, candidates could find general information on the organization and its conditions of employment. More specifically, information could be found on the organization’s culture, structure, development opportunities, and benefits. All applicants had to fill out an online form after they had accepted a privacy statement. The form consisted of information on contact details, date of birth, gender, education, and qualifications obtained from college, work experience, and skills. In addition, applicants had the opportunity to give additional information and to upload personal documents such as a curriculum vitae. 3.2.2. Research Questionnaire After completion and submission of the online application, a questionnaire was presented in a pop-up window on a separate web page. This questionnaire was also accessible via a link which could be found in an email confirming the receipt of the applicant’s online application. The confirmation email was sent immediately after the online application had been submitted. A short introductory text accompanied the link to the online survey. 3.2.3. Measures The questionnaire was preceded by a short introductory text. Anonymity and confidentiality of the participants’ responses were emphasized. It was explicitly mentioned that responses could not affect the selection process in any way and that the company did not have access to individual responses. It took respondents approximately 5 min to complete the questionnaire. The questionnaire was offered in both Farsi and English languages. Translations were made from English to Farsi, which were checked by native speakers. All responses were assessed on the following five-point Likert scale (1=completely disagree, 3=neutral, and 5= completely agree), with the exception of items on general background information. The questionnaire was consist of 18 items. To assess behavioral intentions (BI) the measure of Tompson et al., (2008) were obtained. This construct was assessed by five items. Example item is I would like to work for this organization. Perceived ease of use and perceived usefu lness each assessed using five (Williamson et al., 2003) and eight (Palmer, 2002) items scales, respectively. Where applicable, the original wording computerized process was replaced by online application process for consistency throughout the questionnaire. Example items are My interaction with online application processes was clear and understandable; and The organizations recruitment website provides all the information required to apply for job. At the end of the survey, space was provided for remarks or suggestions and respondents were thanked for their participation. 3.2.4. Analysis The descriptive characteristics of the sample (Table 1) were assessed using SPSS 11.0 statistical package, based on the guidelines provided by Dimitriadis (2003). The research model (Figure 1) was tested using structural equation modeling (SEM) using LISREL 8.7. As it has been suggested, the structural equation approach has several advantages over traditional analyses (Bagozzi and Yi, 1989). Data were analyzed using the two-step approach suggested by Anderson and Gerbing (1998) and. In the first step, a confirmatory factor analysis (CFA) was performed, which helps assess the adequacy of the measurement model (Chang, 1998), or in other words, [. . .] the measurement models (or confirmatory factor models) specify how hypothetical constructs are measured in terms of the observed variables (Lin and Lee, 2004). In the second step of the data analysis, the structural model is tested using SEM; structural equation models specify causal relationships among latent variables (Lin and Lee, 2004 ). 4. EXISTING SYSTEM In recent days, staffs are monitoring the candidates during the recruitment process which is nearly the waste of time. Currently all the jobseekers register for their jobs in prior which are stored in the database of the company due to which more space is consumed. After registration all the jobseekers attend the aptitude test and proceed further but only certain candidates are selected for the further process. Presently recruitment is done manually. That is if a company or organization needs employees they make an announcement through newspaper or websites. People who are eligible send application to the organization or company. From these applications they are called for interviews or tests. After tests company has to do short listing manually. From these shortlisted candidates, they are called for interviews. After interview short listed candidates are employed. So it’s all a time consuming procedure too. It may take one month or long. People around the world cannot apply. This is very convenient because in the manual system there are lot of difficulties in conducting and managing a recruitment exam, short listing, maintaining staff etc 5.PROPOSED SYSTEM Online Recruitment is aimed at developing a web-based and central recruitment Process system for the HR Group for a company. Some features of this system will be creating vacancies, storing application data, and Interview process initiation, Scheduling Interviews, Storing Interview results for the applicant and finally hiring of the applicant. Based on the outcome of the exam the jobseekers will be shortlisted. The details of the examination Date of the examination will be made available to them through the website. People all around the world can apply and register. It has made all the process easy. System Analysis is the detailed study of the various operations performed by the system and their relationships within and outside the system. Here we are using the TAM model for analysing the system performance. ADVANTAGES This paper enables the users to have the typical examination facilities and features at their disposal. It resolves typical issues of manual examination processes and activities into a controlled and closely monitored work flow in the architecture of the application. This multi platform solution brings in by default, the basic intelligence and immense possibilities for further extension of the application as required by the user. The system makes it friendly to distribute, share and manage the examination entities with higher efficiency and easiness. It is a comprehensive resource for finding a job online. 6. DISCUSSION In the final model of the study, perceived usefulness and perceived ease of use have strong path coefficients( 0.71 and 0.82 respectively) in relation with behavioral intentions. Thus, from a causal point of view, the results of structural equation modeling confirm a strong causal relation between PEU and PU in one hand, and PU and BI on the other hand. The linear relation between PU and BI suggests that the perceived usefulness construct has a direct positive effect on applicants behavioral intentions to use recruitment websites. 7.CONCLUSION In todays competing world, the success of recruitment efforts in organizations is bound with attracting an appropriate group of qualified job applicants using the least possible sources. E-recruitment – as a growing recruitment tool – is not an exception. Therefore, identifying factors that influence e-recruitment success in attracting the qualified group of applicants should be a high priority. Using a TAM model in the area of erecruitment, this study tried to identify two of the most influential factors on the applicants behavioral intentions to use organization recruitment website and the consequent employment decisions. 8. REFERENCES Kroustalis, C., (2012). Internet Recruitment: Examining the Roles of Information, Attitudes, and Perceived Fit on Applicant Attraction, A thesis presented to Graduate School of Clemson University, (P. Raymark, R. Pak, C. Pury Eds.), Proquest Information andLearning Company.37. Lin, H.; Lee, G. Chatzoglou, P.; Vraimaki, E. (2009), Knowledge-sharing behavior of bank employees in Greece, Business Process  Management Journal, 15 (2), 245-266. Venkatesh, V., Bala, H. (2008). Technology accpetance model 3 and a research agenda on interventions. Decision Science , 39 (2), 273-315. Tong, D. (2008). A study of e-recruitment technology adoption in Malaysia. Industrial Management Data Systems , 109 (2),281-300. Thompson, L., Braddy, P., Wuensch, K.E-recruitment and the benefits of organizational web appeal. Computer in Human Behavior , 24, 2384-2398. Bock, G.; Kim, Y. (2002), Breaking the myths of rewards: an exploratory study of attitudes about knowledge sharing, Information Resources Management Journal, 15 (2), 14-21. Bock, G.; Kim, Y, Breaking the myths of rewards: an exploratory study of attitudes about knowledge sharing, Information Resources Management Journal, 15 (2), 14-21.

Aggregate Supply Curve In Malaysia

Aggregate Supply Curve In Malaysia Since 1970, Malaysia has transformed itself from raw materials producer into rising multi-sector economy. Under present Prime Minister, Malaysia is trying to reach high-income status and to increase value-added production series by attracting investments in Islamic finance, technology manufacturing, biotechnology, and services. The government is trying to enhance local demand and lessen economys reliance on exports since exports remain an economy major initiative. As oil and gas exporter, Malaysia has gained profit from higher world force prices, even though government subsidies is forced to cut down due to the growing domestic gasoline and diesel gas cost, mixed with overwrought government finances. The government is also aiming to lessen its reliance on state oil producer PETRONAS as oil and gas segment contributes above 40% of government income. The central bank retains good foreign trade stores, and well-developed regulatory system has restricted Malaysias disclosure to threaten financial mechanism and global financial crisis. On the other hand, Malaysia could be at risk to fall in product prices or broad decelerate in worldwide economic activity because exports are Gross Domestic Product (GDP) main element. Prime Minister has lift up potential adjustments to the unusual economic and social favorites with the purpose of attract increased investment; however he has met major conflict, particularly from Malay nationalists and other vested interests. However, during global financial crisis in year 2008-2009, although Malaysian financial system was protected from the direct effects of financial contact due to disallowed of new derivatives into the country, the global financial crisis has transmit uncertainty on the Governments plans to attain vision 2020 because of collapse in exports and slowdown in foreign direct investment (FDI). Theoretical Background Aggregate demand (AD) is aggregate quantity demanded for goods and services in economy at given general price level. It is symbolized by aggregate demand curve, which illustrates the negative relationship effect between price level and total output assuming no variation in government spending, net taxes or monetary policy variable. Aggregate demand curve is downward sloping because of wealth effect, interest effect and exchange rate effect. At each point along aggregate demand curve, the total quantity demanded is exactly equal to planned aggregate expenditure, which is the combination of consumption, investment and government spending. Each point on aggregate demand curve stands for certain level of aggregate expenditure that is dependable with equilibrium in goods and money market at given price. When the aggregate demand curve is moved along, the change of price level is presumed to cause equilibrium GDP change but other determinants of equilibrium GDP remain constant. When other determinants except price level lead the equilibrium GDP change, aggregate demand curve will shift itself. The other determinants of equilibrium GDP are consumption expenses, investment spending, government expenditure, taxes, net export and money supply. Aggregate supply (AS) is total goods and services supplied that are produced in economy at particular overall price level. It is corresponded to aggregate supply curve or price/output response curve, which demonstrates positive relationship effect between total output amount supplied and overall price level. The curve also draws out the price and output choices of all markets and firms in economy under given set of circumstances. In short run aggregate supply, the idea of fixed capacity plays role in macroeconomics. At low output point in economy, there is possible to be surplus capacity in economy. An increase in aggregate demand is possible to outcome in increase in amount produced with slightly or no raise in overall price. Thus, aggregate supply curve is likely to be flat at low aggregate output level. The economy maybe works below capability if there is cyclical unemployment even if firms are not holding surplus labor and capital. The short-run aggregate supply curve is upward sloping, because the price of a few inputs are supposed to be decided under auction-like situations, caused by markup pricing and/or presumed informational irregularities. In long run aggregate supply, firms reaction to an increase in aggregate demand varies from primarily increasing output to principally increasing prices as unemployment rate falls, wages and cost of inputs will increase. When economy is producing at its maximum capacity, aggregate supply curve becomes vertical. There must be time delay between change in input price and change in output price for aggregate supply curve to slope upward. If input prices altered instantly to output prices, the aggregate supply curve would be vertical. Wage rates may increase at similar rate as overall price if price level increases in fully foreseen. The reasons of the shifts of short-run aggregate supply curve are cost of production, expectation on future price level, economic growth, public policy and weather condition. Meanwhile, the causes of shifts of long-run aggregate supply curve are change in labor, capital, natural resources and technology. Equilibrium price level is the price level at which the aggregate demand and aggregate supply curves meet. Equilibrium price level matches up with equilibrium in the goods money markets and lays down price/output decisions on part of all firms in economy AD/AS agenda is applied to assess the effects of monetary fiscal policy on the economy. Potential GDP is aggregate output level that can be continued in the long run without inflation. Economists consider costs cover behind price level changes in the short run; eventually move with the overall price level in long run. If the price level increases at a fixed rate, inflation may be fully foreseen built into labor contracts. Discuss and argument Aggregate Supply is the total supply of all goods and services in an economy.Normally , the aggregate supply curve is draw like vertical line, also name as classical range.But , in reality, this Aggregate supply are divided into 3 range , which is Keynesian range , intermediate range and also classical range. Keynesian range occur in the short run and show a horizontal segment on of the aggreagate supply curve (blue line) , which represent the economy is under the recession condition.Base on table below ,the price level is fixed regardless how many the output had been produce by the country.When AD shift rightward from AD1 to AD2 ,the total output has increase but the price level remain the same.This is due to the substaintial idle production capacity such as unemployed worker competing for available jobs can put to work . The intermediate range ,as show in the pink line,is the rising of aggragate supply curve when the economy is approaching full employment output.When the AD shift rightward from AD3 to AD4, the output and also price level increase .This show that they have the positive relationship between price level and real GDP .When the price level increase , this had cause the inflation occur.There are 3 factor cause this inflation occur, the first one is bottleneck occur because the firm no fully utilise the resources .Example,if the steel industry no fully supply to the steel firm .Bottleneck cause steel firm no enough raw material to produce their product and the cost of steel become higher, so they will also increase the price of thier product , so inflation occur.Moreover, when the company are earning higher profit, their worker will tend to ask for higher wages.The wage demand to increase is hardly to reject because company fear the worker will quit or strike .Beside , the company also can pass the cost on to consumer side easily because in this stage ,the unemployement rate is lower, all people got thier job and they are expect higher price of goods as they feel that will be more quality.Lastly is that sometime the firm still using the less produtivity worker or outdate machinery.This will cause the cost of production increase and become higher product price. Lastly the classical range is occur only in Long run supply curve where the curve is vertical shape ,which show that the real GDP remain constant at full employment output at point Yn, regardless how many the price level had increase or decrease.When the AD shift rightward from AD4 to AD5, the output remain constant ,but it will cause the price increase, as a consequency economy suffer inflation. The effect of increase in Aggregate demand AD1 AD2 AD3 AD4 AD5 AD6 YN Aggregate_supply_svg.png Now we consider the aggregate demand curve is stationary and the factor that influence the aggregate supply curve to shift.This factor are call non-price-level determinants. What happen aggreagte supply curve in Malaysia recently? During the year 2008, the oil price in Malaysia suddenly increase sharpy to US$147.27 ,compare to the year 2002 which the oil price is merely US$20 (Hour, 2009). This issues was cause many household and also firm suffer a lot .As we know that the changes of aggregate demand is base on changes in total demand for all final goods and services.In the statistics of consumer price index (CPI) had found that every cunsumer use 68% from their income for consuming food, non-alcholic beverages, housing , utility, gas ,transportation and also fuel.After the fuel hike in june 2008, the CPI immediate rose to a 27-year high of 7.7% instead of 3.8% in may,2008, which had increase 3.9% within 1 month.Increase in input price had cause the price level of economy increase, the household purchase power will drop because their real income had decrease.For example, before increase in oil price, one plate of nasi lemak is cost RM2.00.but after increase the input price, the seller need to bear higher cost to transport the same quantity of nasi lemak, so they will transfer the cost to consumer by increase the selling price to RM4.00.Now ,with the same plate of nasi lemak , the buyer need to paid double price , therefore their purchase power decrease. Moreover, it also will affects the households monetary wealth drop .As a consequence, the total consumption decrease ,aggregate expenditure reduce, and finally affect aggregate demand drop . Aggregate supply curve will shift based on changes in input price.As we know that most of the firms need the oil price for transport and deliver their product.When the oil price increase , the firms input cost will be increase as well, therefore , the firms will supply less outputs.then the short run aggregate supply curve will shift to left, then the price level increase ,total output decrease .When the output decrease, the manage will try to reduce the input cost such as layoff some existing labor.Therefore the unemployment rate will increase. Why suppy shock will occur in Malaysia? The first reason the affects the oil price shock occur in Malaysia is because 80% of the worlds oil reserves are own by state-owned oil firms so it tend to limited the international companies to access (Hour, 2009). Beside, the cause of shortage of oil supply is because of most of the big located field are found in the a few decade ago and one days this field will also be used up as the raw material are limited in this world.Furthermore, the size of the oil field found recently are very small and costly to operate .For example, if we found 10 small oil field in seperate location, that mean the firms need to set up 10 rigs compare to a big oil field they just need a big rig. The suppy shock can solve antomatically? In long run, the oil price shock can be solve automatically if the government or central bank does not implement any policy.When the oil price increase,the input price for the supplier will be increase, then the short run aggregate suppy will shift to the left,price level will increase from Po to P1,aggregate output will decrease from Yo yo Y1.In the long term, the drop in the total output will cause the firms want to layoff the employees to reduce their cost,so the unemployement rate in market will rise .The price expectation of employees for higher wage will drop and cause the firms have more money to increase more outputs to supply. So the short run aggregate suppy curve will shift back to right from SRAS1 to SRASo.Therefore , the price level and also total output are back to equilibrium level and the stagflation is solve. P YN Y1 P1 P0 LRAS SRASO ADo Y SRAS1 The supply shock can solve by government? Although the oil price shock can be solve in long term , but in the short term the citizen are suffer a lot especially for the low income family and also the unemployement rate increase rapidly.The umemployed citizen are depend on the money in their saving account for survive.If the price level increase more higher ,they is stuck with high cost of living without any compensation from the government.So, government must implement the expansionary fiscal policy to solve the unemployement .When inplement this policy, the Aggregate demand curve will shift rightward from ADo to AD1.Then the price level will increase from P1 to P2,total output will increase back to equilibrium level of output from Y 1 to Y2, and now Y2=Y1.The price level had increase higher than before , and the output back to equilibrium level, and the higher inflation occur. SRASO SRAS1 ADo AD1 LRAS P Y YN= Y2 Y1 P1 P0 P2 Factor to shift the aggregate demand curve Aggregate demand(AD) is the total number of demand of goods and services in economy. The AD is almost equal with aggregate expenditure(AE). The factor will affect the AD curve are based on equation of aggregate expenditure, AE=C+I+G+NX. In the AD curve, each point is representing certain level of AE that same with the equilibrium in money market at given price. When AD curve is moving along, price level change as due to the change of equilibrium GDP but other determinants are remain constant. When opposite direction, change of other determinants change the equilibrium of GDP, AD curve shift itself. Therefore, the other determinants are consumption spending, investment spending, government spending, taxes, net export and money supply. The quantity of money supplied at a given price level will affect the AD curve. When money supply is increase, the curve shift to the right from Ms0 to Ms1. The interest rate will drop from r0 to r1. The interest drop due to the increase of investment spending and the AE increase cause the real GDP increase. AE curve shift upward show that the output will decrease. At the end, the AD curve will shift right from AD0 to AD1 to remain the price at the constant. P AE=Y AE1 AE Y Y0 Y1 I r0 I0 I1 Md r1 r r Ms0 Ms1 Md M r0 r1 P Y AD0 AD1 P0 Y0 Y1 In the others hand, if there are spending shock, means the government spending is increase, this will affect the AD curve shift to the right. Shown from the graph below, when the increase in government spending at any given price level, the AE curve will shift upward and rise the real GDP. when the real GDP higher the given price level, it cause the AD curve shift to the right from AD0 to AD1. P Y AD0 AD1 P0 Y0 Y1 P AE=Y AE1 AE Y Y0 Y1 G Why oil price shock will affect aggregate demand curve? Aggregate demand is based on changes in total demand for all final goods and services. During the oil price shock, the oil price increase in Malaysia. This increase of oil price cause the price level of economy increase. The price level affect the real income decrease and reduce the purchase power of household. Household purchase power drop mean that the consumption decrease. Consumption spending is one of the factor to shift the AD curve. When consumption decrease, it shift the AD curve to the left from AD0 to AD1. Therefore, the price will decrease from P0 to P1 and the output also decrease from Y0 to Y1 AD1 P0 AS AD0 P1 LRAS P Y Y0 Y1 How to solve the aggregate demand automatically? If the government or central bank do not implement any policy during the shock of the oil price, this has to solve the aggregate demand automatically. After the aggregate demand shift to the left from AD0 to AD1, the price and the output were reduced. When the output drop, the employment decrease and unemployment increase. This affect the expected price drop and the wage rate decrease. At the same time, the short run supply curve shift to the right from AS0 to AS1. At the end, in the long run, output will return back from Y1 to the natural output Y0, but the price will keep on decrease from P0 to P1 and P2. This cause the deflation occur in the economy. Y0=Yn AD1 AS1 P0 AS0 AD P1 LRAS P Y Y1 P2 How the government or central bank solve the supple shock? When the supply shock solve by automatically, it will stay back the output value but the price decrease continuously. This affect the whole market economy and become deflation. The deflation will make the economy down and this will make suffer to the whole country. Therefore, government should implement the policy to solve this problem. To shift back the aggregate demand curve, government need to implement the expansionary fiscal policy. This policy can shift the aggregate demand curve to the right from AD1 back to AD0. In the long run, the price back to the natural price P0 and the output also change from Y1 to the natural output of Y0. AS LRAS Y AD1 AD0 Pn=P0 P1 P Y0=Yn Y1 Conclusion The oil price shock in 2008 had brought a large impact for Malaysias economy. After rising in oil price, producers need to pay higher input price for the production purpose. Thus, firms sold their goods for higher price which causing consumers purchasing power dropped and the aggregate demand decrease. The increasing input prices also causing firms to produce less output which might cause the unemployment rate increase. In short run, government can implement the expansionary fiscal policy to solve the unemployment problem. However, the price will increase even higher than before which might cause hyperinflation. If the government or central bank does not implement any policy during the oil price shock, the problem will be solved automatically in the long run but it might cause consumer to suffer a lot in the short run. We recommend Malaysia government to develop reasonable oil price setting instrument, obtain cheap oil from foreign country, searching alternative resources, give subsidies to firms and increase wage rate of workers in order to minimize the consequences of increasing oil price. Throughout this assignment, we have a better understanding about the aggregate demand and aggregate supply and able to apply it in real economy situation. We had also learned how to work in a team efficiently and effectively in terms of collaboration and time management in order to accomplish the task given. Recommendation Increasing in oil prices is a serious issue that may affect aggregate supply and aggregate demand which bring large impact to Malaysias economy. Appropriate ways need to be taken in order to minimize the consequences of increasing oil price in Malaysia. Our suggestions are as follow: Reasonable Oil Price Setting Instrument First, government needs to develop reasonable oil price setting instrument which may ensure the oil prices are setting within a range which is reasonable and affordable for citizens, and allow realistic profit for oil industries. There are three aspects that should be taken into consideration while determine the oil price range, which are the consumers purchasing power, an estimation of profit for oil industries in reasonable level, and the international oil prices. With the help of this mechanism, Malaysias oil prices will be more realistic and reasonable which may prevent uncontrollable increasing of oil prices in Malaysia. When the oil prices are set in a reasonable level, there will be no large impact on the aggregate demand and aggregate supply curve. Obtain Cheap Oil from Foreign Country In order to minimize the impact of high oil price, government is suggested to search for the new sources of low-cost oil from other country. Malaysias government can import cheap and low quality oil from foreign country and refine it to become better quality oil which is qualified to issue to the market with lower cost. The reservation of the cheap oil in a certain amount is also necessary in order to avoid Malaysia from being the victim of increasing prices in the cheap oil. With the available of cheaper oil (input), firms will increase the aggregate supply of the outputs which might prevent shortage of goods in the market. When there is an increasing output in the market, the price of the goods will be reduced and the aggregate demand will increase to a certain level. Searching Alternative Resources High oil price problem only can be solved by associate effort of both government and individual. In order to minimize the impact of high oil price, the organization should attempt to do some investigation or discover the substitute of the oil like bio gas and electronic bike and should try to innovation so that the product of the organization can be produce on other alternatives. In this situation, the company can reduce the quantity of the oil which used to produce the output. Then, the supplier or provider would not reduce the quantity of supply which affects the aggregate supply shift to the left. On the other side, aggregate demand also relatively would not be affected which the curve shift to the left because the consumer can continue to consume the product in the normal price. Give Subsidies Once the oil prices increase, it will directly or indirectly affect the whole production cost, including the fee of the transportation or other else. In order to solve it, the government should provide subsidies to the supplier or provider in order to control the market price. After the suppliers receive the subsidies from government, they will not increase the retail price of their products since they want to maintain their organizations profit. By implementing this strategy, the inflation problem can be avoided because the supplier would not increase the price of product due to the higher input price. Hence, the aggregate demand and aggregate supply would not be affected. Increase Wage Rate In the market, increasing oil prices may lead to inflation problem in Malaysia. This problem will caused our citizens suffer from financial burden and their purchasing power will decrease. In this case, government can raise the amount of minimum wage in order to make sure the organization provides the cost of living to the employee. This can help the employee are able to maintain their basic needs in their daily life although the high oil price situation happened in Malaysia. Individual who using the vehicle during the daily life, the oil price increase will directly increase their daily expense. Purchasing power of the individual will be decreased and finally it will affect the aggregate demand shift to the left because consumer consume less than before. After increasing wages rate, this problem can be solved and the curve of the aggregate demand will back to original.