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Items filtered by date: May 2014

Friday, 30 May 2014 14:37

Haier Group

 Haier Group

 Haier Group is a home appliance and consumer electronic manufacturing company (Haeir Group, 2013). The company has it’s headquarter in China and distributed its product in different countries of the world. The company has the largest market share in the world’s domestic appliance market.

 Haier’s Resources

One of the key resources that the Haier Group possesses is finances. The home appliance manufacturer has recorded good financial performance in the past years. In 2012, the group earned revenues of over US $25.8 billion and profits of over US $ 1.42 billion (Haeir Group, 2013). Financial resources are essential to the growth of a company. They enable a company to finance growth projects without depending on expensive sources of capital. Availability of financial resources also enables an organization to finance activities such as marketing, research and development.

Another key resource for the Haier Group is a wide variety of products. The group manufactures and distributes a wide range of home appliances including refrigerators, freezers, television sets, air conditioners, dishwashers, washing machines, and small appliances (Haeir Group, 2013). The company also manufactures and distributes commercial air conditioners and medical equipment. The wide variety of products enables the group to reach a wide market thus generating more revenue and reducing the risk of depending on one product. It also enables the company the ability to satisfy multiple needs of the customer under one roof.

 Haier’s Capabilities

Innovation is one Haier’s capabilities. Haier provides innovative solutions to the home appliances needs of customers. The group has five research and development centers around the world. The group has also established partnership with research institutions, universities, and suppliers with the aim of creating an innovative ecosystem. The company has established a network of over 1.2 million scientists and engineers to drive its innovation (Haeir Group, 2013). In 2012, Haier Group had over 13,952 patent applications. The group also appeared in the Boston Consulting Group’s list of “World’s 50 Most Innovative Companies”, in 2012.Customer service is also a significant capability for the Haier Group.

The company’s commercial ecosystem is founded on an interactive and delivery platform that seeks to enhance customer satisfaction. The company provides delivery and installation services to users by leveraging its service, logistic and marketing networks (Haeir Group, 2013). Providing quality services to customers is a vital capability as it enables the company to create customer loyalty.Another capability that is visible in Haier Group is effective management.

Haier group has developed an innovative win-win models that seek to align customers goals with employees goals (Haeir Group, 2013). The management structure allows employees to generate value for users. Haier Group inverted pyramid and flat organizational structure has led to empowerment of employees and creation of a dynamic workforce. Haier’s management model has attracted attention from famous business schools and its case has been included in collections of business schools for purposes of teaching and research.

 Distinctiveness of Haier’s Capabilities

The ability to mobilize financial resource is not a distinctive capability. Many companies, within the same industry, have also recorded good financial performance and, therefore, are capable of raising finances (Bryson, Ackermann & Eden, 2007). In addition, even companies that have experienced poor financial performance can raise finances through other avenues such a loans. The ability to deliver a variety of products is also not distinct.  There are numerous other manufacturers that produce a wide range of home appliances.Innovation is a distinctive capability because it is difficult for other companies to replicate what Haier Group is doing.

The company has established partnerships and a complex network of researchers and engineers in order to drive its innovation needs. It is difficult for another organization to replicate this strategy (Bryson, Ackermann, & Eden, 2007).  In addition, innovation is not just about research and development. It is a culture that is developed through the interaction of multiple organizational factors such as leadership, employee empowerment, learning and availability of resources. This makes it difficult for other companies to achieve a similar kind of innovation.  

Effective customer service is also a distinctive capability. Haier’s has managed to create an effective customer service system by developing effective marketing, delivery and installation systems. It is difficult for another company to recreate such a system. Similarly, customer service is also a culture. It is created through the interaction of multiple organizational factors (Bryson, Ackermann & Eden, 2007). Since other organizations cannot replicate all factors that exist in Haier, they cannot recreate the same customer service approach. Effective management is also a distinctive capability as it founded on unique aspects of the organization. This makes it difficult for competing firms to replicate this capability.

 What it takes to make Capabilities Distinct

Capabilities are made distinct by linking them to unique aspects within the organization (Bryson, Ackermann & Eden, 2007). Distinct capabilities are capabilities that cannot be replicated easily by competitors. They give an organization a competitive advantage. Linking capabilities to unique organizational aspects make it difficult for other organization to replicate these capabilities. One of the unique aspects of an organization is the organizational culture (Bryson, Ackermann & Eden, 2007). Organizational culture refers to a set of values, traditions and beliefs that influence the behavior of an organization.

It represents the normal way of doing things within an organization. Organizational culture is generated through interaction of multiple organizational factors such as organizational values, organizational policies, leadership, skills and motivation of employees, the organizational structure, organizational history and many other factors. Each organization has a unique culture that differentiates it from other organization. Entrenching capabilities into the culture of an organization makes it extremely difficult for other companies to replicate these capabilities.

This is because it is impossible for other organization to recreate the culture of Haier.Distinctiveness can also be created by linking capabilities in order to create a unique pattern (Bryson, Ackermann & Eden, 2007). A capability may not be unique. For instance, the ability to provide a variety of products is not a distinctive capability. However, Haier can achieve distinctiveness by linking this capability with other capabilities such as availability of finances, innovation, effective management, customer service. While the ability to provide a variety of products is not distinct, providing a variety of innovative products through effective customer management system may create distinctiveness. Similarly, while the ability to mobilize financial resources is not unique, this capability used to reinforce other capabilities such as innovation, customer service, and management leading to the development of unique pattern.

 Haier Strengths and Weaknesses

Strengths are factors within an organization that present advantages to the organization (Thompson, 20120. Haier has several areas of strength including strong financial base, a large scale of operation, a wide range of products, innovation, effective customer services, and effective management. Weaknesses refer to factors within an organization that present disadvantages to the organization. Haeir weaknesses include a large scale of operation and lack of specialization.Haier has a large scale of operation as the firm distributes its product globally. This characteristic of the organization can be considered as strength as it enables the company to reach a wide market (Thompson, 2012). It also enables the company to minimize the impact of geographic specific risks.

A large scale of operation also gives the company advantages of the economy of scale. However, a large scale of operation can also be considered as weakness as it presents several disadvantages. One of the disadvantages is reduced flexibility. The process of making and implementing decision is slow in such a large organization making it least responsive to changes in the external factors.Delivering a wide range of products is also an area of strength as it enables the group to have multiple revenue streams thus increasing revenues and reducing risks. It also enables the organization to enhance customer experiences by meeting multiple needs (Thompson, 2012).

This characteristic can also be a source of weakness as it leads to lack of specialization. Companies that do not specialize limit their capacity to develop distinctiveness because they divide their attention and resource over so many products and processes. Focusing on a few areas and product enables an organization to concentrate its skills and resources thus delivering additional value to customers.Haier can prevent its strengths from becoming weakness by aligning the strength with opportunities (Thompson, 2012).

Opportunities are factors outside the organization that present advantages to the organization. Haier can use its strengths to take advantage of opportunities thus creating benefits for the company. Haier can also prevent its strengths from becoming weaknesses by using these strengths to overcome threats. Threats are factors outside the organization that present disadvantage to the organization. Haier can avoid losses by using its strength to overcome threats. For instance, the group can use it large scale operation to overcome threats of political and economic instability in some of its geographical markets.     

 Approach to Internal Analysis

Zhang should use the resource based view model to analyze its internal analysis ((Bryson, Ackermann & Eden, 2007). The resource based view model analyzes the internal environment by examining the organization tangible resources, intangible resources, and core competencies or capabilities. Zhang goals for the company are to deliver value and options to customers, increase market share, increase shareholder’s return, and create the best working environment for employees. The companies need to establish strategies and tactics that will exploit its resources and capabilities in order to realize these goals.  


Bryson J. Ackermann F. & Eden C. (2007). Implementing the Resource Based View Strategy. Public Administration Review.

Haeir Group (2013). About Haeir. November 7, 2013. http://www.haier.com/ae/header/201110/t20111027_111715.shtml

Thompson S. (2010). Building Competitive Advantage. November 7, 2013. http://www.swlearning.com/pdfs/chapter/0324226217_1.PDF


Published in Sociology
Friday, 30 May 2014 14:32

Case Questions

Case Questions

 Page 4

Question 1

Analytical procedures can be used in this case in determining the reasonableness of the assertion. This is if it is reasonable for each cookie to be having 7 chocolate chips. A suggestion for the analytical procedure would be to bake some chocolate chip cookies of the same size with seven and eight chips then weigh them so that to determine the difference of their weight and also the weight of Tate’s cookies in order to find out if the weight is close to what is expected.

 Question 2

In order to offer the assurance that all the cookies have at least 7 chocolate chips, the procedure that can be used is through counting the number of the chocolate chips in the sample of the real chocolate chip cookies. Through doing this, it will prove that there are at least 7 chocolate chips in every cookie.

 Page 5

Question 1

The objective of the attestation procedure that has been stated above is to determine whether every cookie has at least seven chips.

 Question 2

The attribute that is present in this case is that there are about seven chocolate chips for every cookie that has been selected while the exception for this is that, for every cookie that is selected, there aren’t at least seven chocolate chips.

 Question 3

The population in which a conclusion is being drawn from is the number of cookies that are being produced which are going to be sold from bake Shop’s assertion.

 Question 4

What will be considered as one item is one cookie. Since there are many cookies being produced, it will not be possible to consider one cookie as a unit. Selecting one cookie as one item will help in reducing the time needed for the sampling procedure. 


Published in Education
Friday, 30 May 2014 14:29

Endoscopy Nurse Practitioner

 Endoscopy Nurse Practitioner

             Evidence shows that endoscopy nurses are relevant in health care services simply because they have specialized role in the provision of endoscopy services. Responsibilities and roles in endoscopy nurse setting are wide ranging from research, stock requisition, and audit, and staffing, budgeting, training, diverse procedures, management of the unit activities, disinfection, and technical expertise in complex procedures. I am currently an endoscopy nurse working full time as Bronchoscopy nurse in University of Miami Hospital, Florida. In five years from now, I will have graduated with a master’s degree in nursing education meaning that I will have a number of roles in the endoscopy nurse setting, (Cohen et al. (2012). I will be assisting nurse specialists when they are using endoscopy on a patient.

Whenever a patient wants to know about anything I know I will be the first person to be contacted. My work will involve specialized services that cover pre and post endoscopy care in nursing setting. I will be providing nursing care based on instructions provided by the doctor in charge. Some areas of concern that I will be focusing include but not limited to supporting management, training, health education, and supporting disease prevention. I will be required to have the ability to assist the operator during patient procedures and take care of the patients who are under endoscopic examinations, (Cohen et al. (2012). There are several skills that need to obtain in order to achieve this future goal. I will have to receive task specific training based on endoscopy responsibilities.

Some of the trainings required include practical components and didactic training. During the training, I will be required to observe several endoscopic procedures. In the same time, I will be required to complete a series of didactic sessions on topics that relates to discharge procedures, post procedure monitoring, pre-procedure assessment, informed consent, and emergency drugs among others. The training will be monitored by a senior endoscopy nurse so as to validate on all practical trainings that I will go through. After the training, I will be required to pass a sedation qualifying test so as to proof my competent in the field of endoscopy, (Cohen et al. (2012). 

Different competencies and skills will be required so as to prepare me obtain the future dream goal. It is advisable to acquire certification in basic cardiac life support. During the training period, I will complete and acquire certification in advanced cardiac life support so as to help and serve patients in the best manner possible. I will require skills in assessing patients after and before sedation which include proper discharge criteria and the recovery phase. I need to be competent in the principles of respiratory knowledge of airway equipment, airway assessment, oxygen delivery, and physiology. It is a requirement that I possess the ability to identify all medications that are needed for reversal and sedation in potential side effects, administration guidelines, and pharmacology, (Cohen et al. (2012).


Cohen, L. B. et al. (2012) Propofol for endoscopic sedation: a protocol for safe and effective administration by the gastroenterologist. Gastrointest Endosc 2003; 58(5):725–32


Published in Nursing
Friday, 30 May 2014 14:21

Interview a Nurse Leader

  Interview a Nurse Leader

 Leaders are people who can be of positive influence towards anyone’s life. Leaders are individuals who provide a role model to the society making others imitate their behaviors or wish they could have lived such a life. Evidence shows that a leader exerts some influence to the society by giving flexible personal behavior reports, as well as strategies. A leader is simply a future oriented person who is defined and challenged by organization changes and has the ability to develop effective strategies and plans that help drive the firm in a forward direction.

The leader I selected to interview is FP who is an endoscopy nurse in University Hospital in Miami, Florida. The leader works in endoscopy unit as Bronchoscopy nurse leader. A leader is someone who has subordinates or followers who works closely with the leader in order to achieve goals and objectives of the organization. Just like in any other organizational setting, effective leadership is required in nursing environment so as to help practitioners provide quality patient care services to patients and at the same time guarantee safe patient outcomes. The paper will focus on the responses that will be provided by FP nurse leader in the endoscopy unit. FP has been the best nurse in the endoscopy nursing setting simply because the leader ensures that protocols inpatient services are followed and adhered to be based on the needs of the patient.

 Leadership Style

The interview of a health care leader was on FP nurse. FP work in University Hospital in Miami, Florida, in endoscopy unit as Bronchoscopy nurse as a leader. Just like a good number of leaders, FP has integrated principles of transformational leadership in the process of her style of leadership. According to FP, a good leader can either be born with the natural abilities of being a leader or one can be developed and groomed with relevant, training, mentorship and timely education so as to become perfect. A leader is someone who is as good as the team being lead and should be in a position to identify problems, develop strategies for identified problems, implement, and monitor those strategies on proper ways to solve the problems, (Cegarra-Navarro et al., 2011).

An effective leader is someone who should have the ability to guide the team, have effective communication skills, and be developed with proper education in order to manage to effectively lead a given group. On top of this, my leader feels that, in order for someone to become someone effective, one must have the ability to show good examples, have the ability to develop proper and sound working environment with others, and learn on how to do what is asked or wanted from the leader at any given time without any complains. Based on my leader’s argument, effective leaders are people who have the ability to work with employees given any condition and can request them to work either beyond or above the required state and employees have no objection towards the situation, (Parker & Hyrkas, 2011).Patient in the nursing setting is the most relevant component.

A leader in the nursing setting should be in a position to understand a patient and develop the required measures to be taken to the patient. The most vital and relevant qualities that leaders should have is on educational experience, clinical experience, and their knowledge so as to serve patients in the best manner. In nursing setting, there several organizational learning impacts such as patient safety, job satisfaction, and nursing care that should always be addressed and monitored in the best approach. A relational leader is someone who has the ability to work with employees without a lot of problems plus she, or he can bring the team together for the purpose of achieving goals and objectives in serving the patient. Leaders who are ethical always function in the best direction and will always deliver quality health care services plus establish strong relationships and collaborations within the working environment, (O'Connor & Stodard, 2012).

 Changes in Leadership Style

The evolving leadership role in the nursing setting has seen current nurses do some modification in their leadership style plus they have adopted receptive styles such as the transformational style in their leadership activities. Leaders who are transformational in their working environment involves in the nudging teammates to be creative so that they can establish an environment that favors patients needs at any given time. They are people who value the working environment of other employees and always inquire for the right measures to be put across in the establishment of the best patient, working conditions. Such leaders also think of effective strategies, which can be implemented in order to improve and transform the performance of the nursing setting. The field of nursing is ever growing; thus there is a constant need to the improvement of services offered to patients.

This means that there exist the needs to engage and encourage employees in the health care setting to suggest as well as to be innovative in developing ways that will be of help in improving patient care in the nursing setting. Based on the transformational leadership, the required emphasis should be to adhere to the status quo as well as set rules that establish new directions in performing different health care tasks and activities. A good transformational leadership system is one that allows the leader to provide support to the team members, (Sullivan & Decker, 2009).Evidence shows that a positive relationship can be established by a leader who genuinely shows concern towards his or her team. In an environment where team members are given a chance to share their views, it has been discovered that proper and sound activities are established.

A good leader in the nursing health care is someone who opens the channels of communication to followers and also encourages them to share their contributions and ideas in order to change their working environment. Improving the environment of nursing setting is establishing and environment where team members feel their contributions are respected and appreciated. Subordinates must realize that they are worth enough in building and developing the organization. In nursing environment, transformation leadership is of essence simply because allows leaders feel their role plus make them a source of inspiration to the followers. In the health care setting, nursing leaders should have the ability to demonstrate a high level of commitment to the health care setting by setting a deep set of values and ideas that the rest of the group in the nursing setting desire and admire to emulate, (Cegarra-Navarro et al., 2011).


Based on my leader suggestions, there are a number of challenges and problems that currently affects the field of nursing health care. The issue of staffing is one of the key challenging situations in most of the health care environments. The current nurse work ethic is different compared to the past work ethic that was used by nurse experts. My leader argued that the entire nursing industry faces one of the greatest problems which are on the proper measures required to solve the problem of nursing staffing. This is not a secret any more simply because there is a great shortage in nurses in health care and those available are overworked making it difficult to establish the required staffing system. Nursing shortage according to PF is a challenge that will elevate to drastic levels if the problem is not corrected any time soon. When I asked my leader if she had any suggestions on how to solve the problem, her response was very simple and direct to the point. She argued that leaders in the health care setting should listen to their followers and discover on the problems that these people face.

They should also learn and discover their wants and needs thus develop ways on how to deal with the challenges. According to the leader, irrespective of the position you hold in the nursing setting, a leader should always show support to the staff something that will cultivate a sense of moral support and loyalty, (Parker & Hyrkas, 2011).Apart from the issue of a nursing shortage, another challenge is based on the development of future nurse leaders. It is with no doubt that molding and developing future nurse leaders have become a significant challenge in nursing setting. The issue develops from the fact that current nursing industry is working with few nurses. These nurses have tight schedules that prevent them from getting time to train them on becoming future leaders. Their schedules are always busy something that pose a great risk in developing future leaders in the health care setting. Lack of morale and motivation because of the amount of workload they encounter, current nurses face problems of becoming future leaders. The current nurse pool is aging meaning that a good number of nurses are nearing the retirement, and the upcoming generation is not serious in entering healthcare environment. Nurse leaders have the obligation to provide directions to the next level of nursing healthcare setting, (Sullivan & Decker, 2009).

 Formal and Informal Power

Formal and informal types of powers are relevant and required in the field of nursing healthcare. Formal power is the authority that someone holds within an organization. The responsibilities and roles of a leader with formal power are recognized by the organization management through an elaborated organizational chart. The position held by this leader is demonstrated in a chart that shows power, duties, and role held by each of the leader in the organization. In a formal power setting, leaders are defined within their duties and proper indications are shown and who holds where and who is superior to whom as well as the chain of command. For the informal power setting, leaders in health care setting believe that this is a dominant situation. This is seen in those people who have exposure and experience in the nursing setting. Nurses are required to be answerable and have the ability to handle different problems and issues that develop in the health care setting, (O'Connor & Stodard, 2012).


Cegarra-Navarro, J. G., Wensley, A. K., & Sanchez-Polo, M. T. (2011). Improving quality of service of home healthcare units with health information technologies. Health Information Management Journal, 40(2), 30-38

O'Connor, T., & Stodard, K. (2012). Nursing leadership qualities come in many guises. Kai Tiaki Nursing New Zealand, 18(5), 14-17

Parker, S., & Hyrkas, K. (2011). Priorities in nursing management. Journal of Nursing Management, 19(5), 567-571

Sullivan, E. J., & Decker, P. J. (2009). Effective leadership and management in nursing (7th ed.). Upper Saddle River, NJ: Pearson Prentice Hall


Published in Nursing
Friday, 30 May 2014 14:15

Nurse Leader

Nurse Leader

The increasingly changing and challenging healthcare environment calls for all healthcare professionals, including    nurses, to develop their leadership skills.  A leader can simply be defined ad a future orientated individual who is challenged by change and is able to make effective plans and strategies that drive the organization forward.  A leader has followers/subordinates whom he or she works with to achieve an organizational goal. Effective leadership skills ensure that nurses are able to deliver quality patient care and guarantees safe patient outcomes.

Effective leadership also enhances job satisfaction levels. This assignment focuses on the responses provided by a nurse leader. The interview focused on the nurse leader leadership style and challenges involved in being a leader in the healthcare sector. Nurse RF is an endoscopy nurse who is in charge of the endoscopy unit at the Regional Medical center hospital in Miami, Florida. RF is highly experienced and professional having held the leadership post for close to three years. RF strives to be a guide and ideal example to other nurses by ensuring that all patient care protocols are adhered to the letter. Her dedication and emphasis on quality patient care has seen her gain respects and recognition among her peers, as well as patients.

 Leadership Style

A leader must ensure that he or she adopts the ideal leadership style within the institution. An effective leadership style will guarantee that employees within the organization work towards the same goal. In a healthcare facility, the need for an appropriate leadership style is crucial as it determine the overall running of the facility. Nurse leaders must ensure they adopt a leadership style that fosters cooperation and the provision of quality patient care. The leadership style adopted by nurse leader RF is the relational leadership style.

            The relational leadership style emphasizes on bringing people together to work towards achieving a common goal. Nurse RF believes that the relationship leadership style is appropriate as it encourages leaders to bring employees to work in unity. The nursing profession is a teamwork rather than individual work. Nurses are expected to work together when handling patients, assigning medication or caring patients. Nursing involves a lot of interconnectivity among nurses hence the need for the spirit of teamwork rather than individualism. Relational leadership is inclusive and involves integration of other people’s ideas and point of views. As a leader RF engages her colleagues in discourse on suggestions and ideas on improving patients care (Malloy, & Penprase, 2010). All nurses get the opportunity to contribute and make input, which is then discussed and adopted.

Relational leaders also operate on the principal that all employees have something to offer/contribute if given a chance hence the leader encourages learning at the individual and team level. A relational leader also brings employees together and ensures there is a commitment towards a goal. In the nursing profession, for instance, the ultimate goal is to enhance patient care and ensure the delivery of quality healthcare services. Relational leaders are also ethical, and their functioning is based on the values and moral standards of what are right. Overall, a relational leader focuses on establishing strong collaborations and relationships within the workplace. A Relational leader thus appeals to his or her colleague’s emotions and beliefs in order to form strong bonds and relationships.

 Changes in Leadership style

The evolving leadership role in nursing has seen current nurses modify their leadership style and adopt receptive styles such as the transformational style of leadership. RF has integrated principles of transformational leadership to her leadership role. Transformational leadership involves nudging followers to be creative and think of effective strategies that can be implemented so as to improve performance. In the nursing profession, the need for improvement of quality is constant hence the need to encourage nurses to be innovative and suggest ways to improve patient care. Under the transformational leadership, emphasis will not be only adhering to set rules and the status quo, but establishing new ways of performing different tasks (Crosby, & Shields, 2010).

Transformational leadership also involves offering support to followers. A leader can foster a positive relationship with his followers if he genuinely shows concern for his followers. A transformation leader can also open the channels of communication and encourage his followers to share their ideas sand contributions. A transformational leader must make his subordinates feel worthy. In nursing practice, transformational leadership is mandatory as it ensures that a leader is flexible to the changing face of healthcare management. The transformational leader is also a role model and a source of inspiration to his followers. In nursing practice, the leader should demonstrate a high level of commitment, as a deep set of values and ideas that followers admire and desire to emulate.


The healthcare industry has changed significantly in the past decade. The continuing changes pose numerous challenges to leaders who have to find ways to accommodate these changes. As a nurse leader, the main challenge that RF has faced is staff constraints. The issues of nurse shortage have been an overbearing burden in the healthcare industry for many decades.  Nurses are overworked as there is hardly any department within a single facility that has adequate nurses.

Nurses have had to work extra hours so as to cover for shortages. Unfortunately, the continued overwork and nurse shortage in healthcare facilities demoralizes interested students from taking nursing as a profession. Nurses’ shortage is a critical issue that can interfere with the quality of services that patients receive.Nurses are also at risk of fatigue, burnout and sleep deprivation which can further hamper their ability to be productive. There is a need for nurse leaders to a source of inspiration and motivation for leaders (Hintea2006). Nurse leaders must work with available nurses to build a strong force that is still able to offer quality services despite shortages.

Older and experienced nurses should also act as a role model to the new nurses who are yet comprehend the profession. Most new nurses give up due to lack of on-the-job training, which affects their self esteem and confidence levels. A nurse leader should ensure that new nurses get adequate on the job training and guidance. This will motivate them and encourage them to stay on as nurses. A nurse leader, together with his followers must create a duty roster, which will ensure that work is evenly distributed across the available nurses. Distribution of work minimizes the risk of fatigue, burnout and stress related illnesses (Sanford, 2010).Another significant challenge in the nursing profession involves the development of future nurse leaders.

It has become increasingly difficult to find and mould future nurse leaders. This is attributed to factors such as nurse shortages that see healthcare facilities work with very few nurses. The few nurses are unable find time to train and become nurse leaders due to their busy schedules (Crosby, & Shields, 2010). The lack of motivation and morale due to work overload further puts off most nurses from taking leadership positions. Additionally, the nurse-pool is aging, and the young generation is not keen to take up nursing a profession. This means that there are many nurses who are nearing the retirement age and very few young nurses. There is a need for nurse leaders to provide direction to the available nurses.

 Formal and Informal Power

Formal power refers to the actual authority that, different leaders within an organization hold. There positions and responsibilities are recognized by management, which provides an elaborate organizational chart. The organizational chart demonstrates the positions held, duties and power held by each leader. The organizational chart also demonstrates who each leader is in charge of and which superior leader he is answerable to. Informal power, on the other hand, refers to power that originate from influence. An individual can have informal power and be able to lead and exert authority among his colleagues.

In any healthcare facility, there exists formal and informal power (Hintea, 2006). Persons with formal power such as nurse leader are charged with the duty of overseeing other nurses within their department. As the formal leaders, it is the responsibility of the nurse leaders to ensure that all followers perform their duties as required. Formal power thus gives the organization some form of guidance and direction ensuring that all subordinates work towards achieving a common goal.Informal power, on the other hand, is dominant in healthcare organizations.

In nursing practice, for instance, informal power is seen among nurses that have experience and exposure in the profession. With experience, these nurses are able to handle different challenging situations that may arise within the department. The experienced nurses are also a source of inspiration to new nurses who are inexperienced and need the guidance of professionals (Malloy, & Penprase, 2010). The formation of groups within a facility can also lead to the rise of informal powers. Nurses, for instance, form groups among themselves. The nurses use these groups to share their grievances, concerns and views. It is the responsibility of formal nurse leaders to reach out to these nurses and form lasting relationships based on understanding and making the nurses’ work environment right.


 Effective nursing leadership style is mandatory for the delivery of quality healthcare services to patients. Effective nursing leadership also ensures that nurses work in an environment that fosters positive development, motivating and growth. Leaders who integrate relational leadership styles with transformational mode of leadership are able to witness increased motivation at work, job satisfaction, self-confidence, low employee turnover and improved work performance.


Crosby, F. & Shields, C. (2010). Preparing the next generation of nurse leaders: An educational needs assessment. The Journal of Continuing Education in Nursing, 41(8), 363

Hintea, C. (2006).  Leadership and management in healthcare systems. Transylvanian review of administrative sciences. P89-104

Malloy, T. & Penprase, B. (2010). Nursing leadership style and psychosocial work environment. Journal of Nursing Management, 18(6), 715-725. Doi:10.1111/j.1365-2834.2010.01094.x

Sanford, K. (2010). Overview of nursing leadership. Chapter 1. Catholic health initiative


Published in Nursing
Friday, 30 May 2014 14:07

Influence Of Ocean On Global Climate

Influence Of Ocean On Global Climate

Earth’s climate is a result of the physical, chemical, and oceanographic properties of its components. The climate system consists of five main components that include the atmosphere, ocean, stratosphere, biosphere and the lithosphere.  Both regional and global climate patterns depend on long-term interactions between the ocean and the atmosphere.  The ocean plays a a complex role in climate system. Oceans store most of the sun’s energy that reaches the earth and acts as the greatest earth’s heat buffer.  

It is estimated that almost quarter of the earth’s anthropogenic surface warming is absorbed by the ocean, which has postponed the consequences of global warming (Herr  & Galland, 2009). Oceans cover approximately 71% of the earth, and they absorb a large part of the solar radiation. Some of the important characteristics of the ocean that influence their role in climate include the high heat capacity of the huge volumes of water, heat redistribution, greenhouse gases (water vapor), and the sea-ice cover.

The climate system is driven by energy from the sun, with nearly half of the solar radiation absorbed at the earth’s surface. Almost one third is reflected back to space by the atmosphere and from the surface and about 20% directly absorbed in the atmosphere. Both radiative processes and ocean and atmosphere circulations transfer energy from the low latitude surface where it is initially absorbed, to higher latitude and to global upper atmosphere from whence it is radiated back to space. The ocean vital role in the climate system results from its great capacity to store and transport heat, water and radioactively active gases around the globe and exchanges these with the atmosphere.

 Many oceanic and coupled ocean-atmosphere processes, occurring in a wide range of space and rime scales, are involved.The growing concerns on climate change and global warming have gained momentum all over the globe. A lot of resources have been dedicated to reducing the effect of global warming.  Ocean is one the key players in world climate. Therefore, it is important investigate how ocean influence global climate so as to develop effective measures to curb climate change. The purpose of this paper is to explore the various mechanisms through which ocean influence global climate.  

 Ocean currents

Ocean flows have major climatic effects they have been attributed to water density variation, rotation of the earth, solar heating at the surface, gravitational tidal effects, prevailing winds and water evaporation. Ocean flows are basically classified into surface currents, deep currents, updwelling and downdwelling (Innes, 2007).  The surface currents are easy to measure, subject to change, and have a major effect of climate.  The primary currents move in circular patterns known as gyres. The circular patterns reflect the prevailing winds on the ocean surface.  It changes with wind change during an El Nino in the Pacific Ocean surface. Typically, air flows from low attitudes in the poles to the equator due to the pressure gradient related to temperature differences, moving the surface water in this direction. The air from the poles is warmed as it travels down to equator and then it   rises and returns to the poles at high latitudes.

The rise of warm air occurs at a boundary region called intertropical convergence zone, and the air movement is known as the Walker circulation. Ocean currents transport heat around the earth and influence local climate as they warm or cool the air above the seas.  The chief surface ocean currents move in an identical direction as the major wind belts since wind pushes the sea water. For example, the westerly winds drag North pacific water from the west to east while the trade winds pushes surface currents westard both north and south of the equator.  These currents run into a continent, and the Coriolis effects cause them to turn right to the northern Hemisphere. The currents flow all along the continents until they dashes in a westward moving current going in the reverse direction.

 The result is surface currents that travel in loops called gyres, which rotate clockwise in the Northern hemisphere and counterclockwise in the southern hemisphere.  The North Atlantic gyre has an enormous influence on the climate of the northern Europe.  However, at the southern part of the gyre, the sun warms the seawater as it moves from east to west across the equator. When it reaches Americas, the current turns right and becomes the Gulf Stream, which raises the temperature. Ocean currents also distribute heat from the surface water into the deep ocean.  The north Atlantic water sinks into the deep sea because the formation of sea ice removes the fresh water and leaves behind very saline and cold water (Desonie, 2008).  

The ocean conveyor

Large-scale ocean circulation has an enormous impact on global climate.  According to Imura (2010), there are two types of circulation: wind driven and the thermohaline.  The thermohaline circulation has the greatest impact on the global climate.  The great conveyor belt is driven by sinking of cold and salty water. Currently, the world’s ocean, the warm, salty surface water found in the Caribbean, Gulf of Mexico and the equatorial Atlantic flows northward to the Gulf Stream.

As the warm water reaches the high latitudes in the north, they give up the heat and moisture to the surrounding atmosphere, leaving when they are cold, salty and denser.  The dense water sinks to the bottom of the ocean, flows southward and beneath the Gulf to the southern ocean and then through the Indian Ocean and the pacific.Wind, heat and freshwater fluxes at the ocean surface, together with tidal and other energy sources, are responsible for global ocean circulation, mixing, and the formation of a broad range of water masses.  On the global scale, individual shallow and deep-ocean currents form an interconnected pattern known as the thermohaline circulation (THC)

.according to Stouffer (2006) the importance of Atlantic THC to climate and climate change originates from its two unique properties that include its large northward heat transport and nonlinear dynamical behavior. The thermohaline circulation of the world ocean is driven by buoyancy caused by heat and freshwater fluxes at the surface of the ocean.  These fluctuations lead to the formation of dense water masses especially in the Greenland-Iceland-Norwegian (GIN) seas, around the Antarctica and in the Labrador Sea. These dense waters from the Nordic seas then flow in deep western boundary currents southward into the southern ocean from where they are distributed into the deep Indian Ocean and the pacific oceans. The return flow of these waters takes several paths through the Indonesian passage and around Africa into the Atlantic.

 This global circulation is often described in terms of a conveyor belt. THC strongly influences climate on regional-to-hemisphere scales.  In the Atlantic Ocean, THC carries the meridinal heat and due to the surface and deep western boundaries currents.  In the Atlantic, heat is absorbed by warm surface waters which are flowing northward and cold saline waters from the north Atlantic returning at depth.  This yields a northward meridional heat flux in the Atlantic at all latitudes with a minimum of about 1015 W. The presence of warm water at the western mid-latitudes in the North Atlantic is associated with intense storms systems whose transient eddies also transport substantial heat northward.  

The THC plays an important role in transferring heat from the ocean to the atmosphere, causing the water to become colder and denser, thus renewing the cycle.  The THC is responsible for much of the heat energy from the equatorial oceans to the Polar Regions and has a large influence on the global climate (Hughes N & Hughes P, 2013). The counter-interaction of the pressure across the tropical pacific between the Indo-Australian convergence Zone and the southern oscillation is the largest and most geographically widespread annual scale climatic interaction between the ocean and the atmosphere.  In the mean, surface pressure is low in the western pacific and high in the southeast pacific pressure (The walker circulation).

  When this “normal” condition is accentuated then, there is often a La Nina climate anomaly, but when the pressure gradient across the pacific is reduced there tends to be an El Nino climate anomaly. Some relaxation of the east-west gradients occur annually, causing warmer than usual water to appear in the equatorial eastern pacific, as upwelling decreases, and for a warm current to appear along the southern American coast where there is usually cold, northward flow (Oliver, 2008).  The El Nino and Elnina form the El Nino/Southern oscillation (ONSO) that affects weather patterns and climate around the globe. ENSO is one of the numerous oscillations in the ocean that occur naturally over different geographic scales and time.

 The effects of El Nino or La Nina are felt around the globe.  The rearrangement of atmospheric pressure, which controls wind patterns, and sea-surface temperature, which plays a great role in atmospheric pressure and patterns of precipitation may result to a massive and drastic rearrangement of regional weather patterns.   ENSO affects ocean circulation and weather patterns, which can result to economic and social hardships in the affected regions.  Positive and negative ENSO events are associated with extreme climatic events.  Some parts of America and Africa have been ravaged by severe storms and flooding while countries such as Indonesia and Australia have recorded intense drought and fires.

 Global hydrological cycle

The global hydrological cycle is the quintessence of climate on earth. The impacts of changes in the hydrological cycle are among the most worrying aspects of climate variation.Transport of water in the earth-atmosphere system and changes of phase modulate substantially the global energy and entropy balances.  The ocean contains 96% by mass of the earth’s total water content.

 The atmosphere contains only about 0.001% of the total water on earth, mainly in vapor form (Curry & Webster, 2009).  The water on the continents is distributed among several reservoirs including ocean, ground water, lakes, rivers and glaciers.Hydrology cycle is the continual movement of water among the reservoirs of ocean, atmosphere, and land. The total amount of water on earth remains effectively constant on times scales of thousands of years, but changes state between liquid, solid and gaseous forms as it moves through the hydrological cycle.

 The role of water in the Earth System may be grouped into three processes; physically informing climate and shaping topography by transporting heat and sediments respectively, chemically in weathering rocks, and biologically in supporting soil-vegetation ecosystems.  Climate, topography and ecosystems, are the products of hydrological processes.  The hydrology process has five main components which affect climate: clouds and radiation, atmospheric pressure, precipitation, ocean fluxes and the land surface processes.  Other components of hydrology processes important in global climate include the snow, ice, and underground water and river runoffs.

 Phytoplankton and cloud formation

Clouds play an important role in the reflection of solar energy from the atmosphere, which affects the temperature of the earth. Phytoplankton, which are marine organisms, release huge amounts of a sulfurous gas named dimethyl sulfide, which influences how clouds are formed in the atmosphere (Meskhidze and Nene, 2006). First, sunlight catalyzes a chemical reaction that changes the gas to sulfate aerosols.  The microscopic aerosols then causes water vapor to condense forming clouds.  Clouds play a significant role of determining the amount of solar energy that reaches the earth. Therefore, any process that influences the process of cloud formation influences the amount of sunlight reaching the atmosphere and consequently the temperature of the global.

 Heat storage and transportation

Oceans play a great role in slowing global changes in temperatures through the exchange of heat.  The even distribution of temperature and variation in region results into the uneven distribution of climate.  The difference in temperature between poles and the tropics leads to winds and ocean currents, which transports heat from tropics to the Polar Regions.  Ocean transport heat from tropics while winds carry heat to high latitudes.   Storage and transport of energy is one of the most important roles of the ocean. Concerning the heat storage, the ocean has a much larger heat capacity than the atmosphere.The three major ocean basins have different heat transports. The pacific and Indian ocean is similar to the global mean. The heat transport is nearly antisymmetric about the equator, and heat is transported poleward in both hemispheres.  The most remarkable pattern of heat transfer occurs in the Atlantic.

 Oceans and regional climates

 Differences in temperature between the land and water masses drive monsoon winds.  During winters, the center of the continent is colder that the surrounding ocean. This results into the cold air flowing out of the continent. During the summer, the opposite happens. The center of the continent experiences high temperatures than the ocean. This results into moisture being drawn from the atmosphere resulting into summer rains.  

Cities adjacent to ocean enjoys sea breeze.  Sea breezes are also caused by differences in temperature between the ocean and the land mass.  The ocean and the atmosphere are connected.  Ocean temperatures have a direct influence on the rainfall pattern through the globe.  Over the years, scientists have been monitoring ocean temperatures to predict floods or droughts.  For example, ENSO warns the equatorial Pacific Ocean in the South America.  Sea surface temperature is the temperature of the top layer/millimeters if the ocean.  Tropical Ocean is a major source of most of the rainfall in the world.  The monsoon winds, especially in Asia, generate consequential rainfalls.

 Influence of greenhouse gases (water vapor)

Water vapor plays a significant role in shaping the climate of the globe.  Water is an important greenhouse gas, and it links evaporation and precipitation (Soden 2012). Ocean is the largest source of water vapor.  Warmer oceans results into more water vapor which consequently increases its greenhouse effect. Water vapor makes a large contribution to the greenhouse effects. Its spatial distribution is controlled mainly be evaporation, condensation and transport process on a global scale it is not thought to be affected by human resources and sinks.

Researchers have intensively investigated the interactions of water vapors, clouds, oceans and sea ice with global climate systems in order to refine computer models and understand the impacts on the sub-system (Pierrehumbert, 2010).  Water vapor plays a number of vital roles in affecting both climate and weather. The amount of water vapor in the atmosphere is not at all uniform, but changes drastically and abruptly often in a matter of hours to cause, for example, storms.  Water vapor is one of the most important “storehouse” of energy in the atmosphere and in the climate system. The energy does not disappear but instead heat the atmosphere.  Thus, energy is redistributed through the process of evaporation and condensation.

 When the water condenses to form clouds, it has another important effect on the climate.  It “shades” or protect the Earth’s surface and lower temperature by reflecting solar energy (Gaan, 2008). Water vapor, in its vaporous state, has an important heat trapping “greenhouse effect.”  This is explained by water vapor’s being relatively transparent to the shorter wavelength at the visible and ultraviolet end of the light spectrum.  After this energy has warned the earth’s surface and been re-radiated upward in the infrared bands of spectrum, water vapor readily absorbs the trapping heat in the lower atmospheric sphere.  Therefore, water vapor may cause heat trapping, and consequently contribute to global warming.

 Oceans and atmospheric regulation

The atmosphere and the surface ocean waters are closely connected both in temperature and in concentration of carbon dioxide. The atmosphere contains less than 1.7% per cent of the carbon dioxide held by the oceans, and the amount absorbed by surface ocean water rapidly regulates the concentration in the atmosphere.  The absorption of carbon dioxide by the ocean is the greatest where the water is rich in organic matter or where it is cold.  Thus, oceans are capable of regulating atmospheric carbon dioxide, of changing the greenhouse effect, and contributing to climate change (Barry & Chorley).

The most important aspect of the carbon cycle linking atmosphere and the ocean is the difference between the partial pressure of carbon dioxide in the lower atmosphere and that in the upper oceanic layer.  This results in atmospheric carbon dioxide being dissolved in the oceans and in some of this being subsequently converted into particulate carbon, mainly through the agency of the plankton, ultimately sinking to form carbon-rich deposits in the deep ocean.  Therefore, ocean warming increases its carbon dioxide equilibrium partial pressure and decreases the abundance of plankton, which play a part in the formation of clouds.   


Oceans cover approximately 71% of the earth and it plays a complex role in the climate system. The climate system consists of five main components that include the atmosphere, ocean, cryosphere, biosphere and the lithosphere.  Both regional and global climate patterns depend on long-term interactions between the ocean and the atmosphere.  Some of the most crucial interactions between the ocean and the global climate include ocean currents, atmospheric regulation, regional climates, precipitation,

Heat storage and transportation, cloud formation, Influence of greenhouse gases, hydrological cycle, ocean conveyor and THC. Ocean currents transport heat around the earth and influence the climate of different regions as they warm or cool the air above the seas.  The chief surface ocean currents follow the direction of the major wind belts because wind pushes the sea water. The thermohaline circulation has the greatest impact on the global climate. The THC plays an important role in transferring heat from the ocean to the atmosphere. It is responsible for much of the heat energy from the equatorial oceans to the Polar Regions and has a large influence on the global climate.

The counter-interaction of the pressure across the tropical pacific between the Indo-Australian convergence Zone and the southern oscillation is the largest and most geographically widespread annual scale climatic interaction between the ocean and the atmosphere. Clouds play an important role in the reflection of solar energy from the atmosphere, which affects the temperature of the earth. Phytoplankton, which are marine organisms, release huge amounts of a sulfurous gas named dimethyl sulfide, which influences how clouds are formed in the atmosphere. The absorption of carbon dioxide by the ocean is the greatest where the water is rich in organic matter or where it is cold.  Thus, oceans are capable of regulating atmospheric carbon dioxide, or changing the greenhouse effect, and contributing to climate change


Barry G & Chorley (1999). Atmosphere, weather and climate. Methuen & Co. Ltd. New York, USA.

Bonfils, C., Santer, B. D., Pierce, D. W., Hidalgo, H. G., Bala, G., Das, T., & ... Nozawa, T. (2008). Detection and Attribution of Temperature Changes in the Mountainous Western United States. Journal of Climate, 21(23), 6404-6424.

Desonie Dana (2008). Climate: causes and effects of climate change. Infobase Publishing.  New York, USA.

Gaan N (2008). Climate change and international politics.  Kalpaz  Publication. New Delhi, India. 

Guilyardi, E., & Stockdale, T et al (2009). UNDERSTANDING EL NIÑO IN OCEAN—ATMOSPHERE GENERAL CIRCULATION MODELS. Bulletin Of The American Meteorological Society, 90(3), 325.

Herr D & Galland R (2009). The ocean and climate change: tools and guideline for action. IUCN, Gland, Switzerland. P72.


Hughes R.N., Hughes D.J. & Smith P (2013). Oceanography and marine biology: an Annual review. CRC Press, New York, USA.

Innes W (2007). Climate con? History and science of the global warming. Authorhouse, Bloomington, UK.

Logan, C. A. (2010). A Review of Ocean Acidification and America's Response. Bioscience, 60(10), 819. Doi:10.1525/bio.2010.60.10.8

Oliver J (2005). The encyclopedia of world climatology.  Springer Publishers. USA.

Peterson, T. C., Heim Jr.et al (2013). Monitoring and Understanding Changes In Heat Waves, Cold Waves, Floods, And Droughts In The United States. Bulletin of the American Meteorological Society, 94(6), 821-834. Doi:10.1175/Bams-D-12-00066.1

Pierrehumbert R (2010). Principles of planetary climate.  Cambridge University Press. Cambridge, UK.

Schubert, S., Gutzler, D., Hailan, W. et al. (2009). A U.S. CLIVAR Project to Assess and Compare the Responses of Global Climate Models to Drought-Related SST Forcing Patterns: Overview and Results. Journal of Climate, 22(19), 5251-5272. Doi:10.1175/2009JCLI3060.1

Thomas F., Knutti R & Platter G (2010). The future of the thermohaline circulation. A perspective. Geophysical Monograpy Geophysics. Union, Washington, D. C. 


Published in Education
Friday, 30 May 2014 14:00

Obesity in San Joaquin

Obesity in San Joaquin

Health Preparedness in San Joaquin County, California

San Joaquin is one of the populous counties in California, with a population of over 680,000 people (San Joaquin County Public Health Services, 2012). The human population of this county has grown significantly with the largest proportion of growth exhibited among minority ethnic groups. Approximately, 28% of adults in San Joaquin lack health insurance. The rate of uninsured is much higher among African American and Hispanic Americans than other ethnic groups (San Joaquin County Public Health Services, 2012). Lack of healthcare insurance affects the ability of these individuals to maintain health. The region is characterized by high preterm birth rates and low birth weight, which have increased the rate of infant mortality.

The region suffers from various communicable disease including AIDS, Amoebiasis, tuberculosis, Chlamydia, and gonorrhea. There are huge ethnic disparities in terms of the spread of communicable diseases, with the African American community recording the highest rate. Chronic disease such as coronary heart disease, stroke, cancer, and diabetes are the major health concern in the region (San Joaquin County Public Health Services, 2012). These diseases are not only the major causes of deaths but also the major causes of disability. Diseases of the heart are the number one causes of death in the county followed by cancer. There are also significant ethnic disparities in terms of prevalence of chronic illnesses. African Americans have the highest rates.

 Sociopolitical, Economic and Ethnic Characteristics affecting Health

Economic status is one of the factors that have a significant impact on the health of African American community. Generally, San Joaquin is poorer that California as whole. A large percentage of the population lives below the federal poverty line (San Joaquin County Public Health Services, 2012). In Addition, African Americans have lower median income than whites and Asian American. Statistics reveal that 30% of African Americans in San Joaquin while living in poverty as compared to 8% of white Americans and 15% of Asian Americans (San Joaquin County Public Health Services, 2012).

Consequently, many African American have low standards of living that white and Asian American. Due to their economic status, many African Americans live in neighborhoods that have fewer opportunities for physical activities, high insecurity, and poor sanitation (Blanchard, 2009). Black neighborhoods are least likely to have parks, beaches, pools and green spaces. Other barriers to physical activities include transportation problems, and neighborhood safety.The social economic status of African American communities also limits their access to affordable healthy foods (Blanchard, 2009).

 A study revealed that white neighborhoods have 4 times as many supermarkets than Black neighborhoods. The presence of supermarkets is often associated with accessibility to vegetables and fruits. It has also been noted that African American children spend more hours on television that their white and Hispanic peers. Spending many hours on television not only limits the children’s physical activities, but also exposes these children to food advertisement, which influence their eating habits. Spending many hours on television is also associated with increased intake of food. Researches indicate that an extra hour spent on television leads to consumption of 127 additional calories per day.

Low socioeconomic status is also associated with high levels of stress, especially among African American women (Blanchard, 2009). Research indicates that high stress level may lead to the development of metabolic syndrome that alters the capacity of the body to clear glucose. Poverty also leads to social withdrawal that reducing participation in physical activities. Ethnic patterns also have an impact on the health status of African American people. African American parents use the term “big bone” to refer to their obese children (Stevenson, 2011). They encourage obesity among children by claiming that the obese children take after them. They view obesity as of little health concern. Genetics is also a major risk factor for the development of obesity among African American (Alio & Salihu, 2006)

 Educational Level of African Americans in San Joaquin County

Education level of African Americans living in Stockton was assessed by comparing education attainment of the African American with that of other ethnic community. The assessment revealed that though education attainment among African American was lower compared to Asian and Non-Hispanic Whites, the rate of attainment was higher than in Hispanic and Native Americans (National Center for Education Statistics, 2013). Education attainment of this community was also assessed by comparing education attainment of Stockton population with that of the entire country. The education level in Stockton City is lower compared to the general education level in the entire country. For population above 25 years, only 75% have attained a high-school level education compared to rate of 90% in the entire country (City Data.com, 2013).

Only 17.3% of residents who are above 25 years have attained the bachelor’s degree level of education as compared to a rate of 33% in the entire country. There is a close relationship between education level and obesity. Communities with lower levels of education exhibit high rates of obesity. This is because education has a significant impact on income and economic status. For instance, the median household income in Stockton City was $ 44,310, in 2011, compared to a median household income of $57,287 in the entire California region (City Data.com, 2013). As already explained in previous sections, socioeconomic status has an impact on healthcare status of communities. In addition, education limits the capacity of the community to understand health implication of various practices.

 Community Health Diagnosis

One of the global health problems that exist in Stockton City is obesity. Obesity is a condition that is characterized by increased levels of body fats. The assessment revealed that chronic diseases are the major health concern in Joaquin County. All these chronic ailments are associated with diabetes.  The rate of obesity, in the state of California, has increased by two folds in the last 15 years. In 2011, 24.8% of adults met the threshold of obesity while 61.4% of adults were classified as overweight and obese (Center for Disease Control, 2013).

With a population of 37.2 million people, an overweight rate of 61.4% implies that over 23 million adults living in California are overweight. The consequences of increased cases of obesity and overweight are dire. The California Healthline (2012) predicts that the rate of obesity in California will double by the year 2030. Obesity has led to increased prevalence of other chronic diseases. Illness such as hypertension, diabetes, heart failure, and cancer are on the increase. Heart disease has now become the largest killer in the state and the country. It is also projects that healthcare related cost will increase by $ 66 billion by the year 2030 if the current obesity trends in state prevail (California Healthline, 2012).

Obesity rates in California differ from county to another. San Joaquin County, whose center is Stockton city, has been identified as one of the counties with obesity rates of over 30%. Obesity rates in California also vary from one ethnic group to the next (Center for Disease Control, 2013). According to the Kaiser Family Foundation (2013), the African American ethnic group had the highest overweight rate in California, in 2011. The percentage of overweight adults in the state of California stood at 72.1%. Hispanic Americans and Native American also had a high overweight rate standing at 70.1% and 69.2% respectively (Kaiser Family Foundation, 2013). The Asian and Pacific Islander had the lowest rates at 38.3%.

 Intervention Program

The intervention program focuses on addressing obesity problem among African American people living in San Joaquin County. Specifically, the program will target the city of Stockton, the largest urban center in San Joaquin County. The proposed intervention is a family outreach program that targets African American families with children with obesity problem. The student will work together with education institutions within the city to identify African American children with diabetic problem. The identified children will direct the intervention team to the family members where the educational program will be conducted. The students and the intervention team will move to different schools across the city within the 6 week period.

 Program Objectives

  1. To conduct nutritional education in 500 African American households within the 6 week period.
  2. To conduct physical education in 500 African American households within the 6 week period.

Support for the Effectiveness of this Program

            Many studies have shown a close relationship between physical activities and obesity. Individuals who have low levels of physical activities are likely to become obese. According to Jakicic and Otto (2005), obesity is a condition that is brought about by an imbalance between energy intake and energy expenditure. Individuals who have low levels of physical activities often have energy expenditures that are lower than their energy intake.

Thus, it is reasonable for any program that seeks to address the challenge of obesity to promote physical activities. Similarly, there is a close connection between obesity and nutrition. A study conducted by Swinburn, Caterson and Seidell (2004) revealed that people who take diets that are characterized by energy-dense foods, sugar sweetened foods, and micronutrient poor food have a high likelihood of become obese. The study also linked fast food culture to increased prevalence of obesity in the country. Thus, any program that seeks to address the challenge of obesity needs to consider enlightening the target population about the nutritional effects on obesity.

  This intervention program focuses on involving families and community in the obesity awareness campaign in order to enhance the effectiveness of this program. Research has revealed that; when it comes to addressing obesity, community based approaches have the highest positive outcome (Hopkins, 2013). This is because apart from being a medical problem, obesity is a social problem. Thus, interventions need to address social and environmental factors that promote this condition in order to realize the desired goals. Community based interventions take a comprehensive approach in addressing this problem. Apart from eliminating individual risks factors, community based approach eliminate social and environmental risk factors for obesity.

 Teaching Aids

Two main teaching aids with be used in this program; the nutritional manual and physical activity manual. The nutritional manual will contain a list of healthy foods including fruits and vegetables. The nutrition manual will also provide information about portion sizes of every food for a given age group. The nutritional manual will be tailored to reflect locally available and affordable foods in order to cater for the social economic status of this ethnic group. The purpose of the nutritional manual is to educated families about healthy nutrition. A copy of the nutritional manual will be left with the family for reference.

The physical activity manual will contain simple direction of physical activities in which African American families can participate. The manual will identify activities that reflect the social economic status of the African American people. These activities will not require heavy investment of finances in order to encourage all families to participate. The goal of this manual is to promote physical exercise within this community. A copy of the manual will also be left with the family for future reference. Other teaching aids include video files and charts.

 Evaluation of Results

            Results of this intervention program will be evaluated based on the objectives of the program. Both formative and summative evaluation will be conducted. Formative evaluations are usually conducted when the program is in progress in order to establish whether the program is on track. Key milestones will be identified that will assist in the formative evaluation. For instance, the first milestone may target to reach 100 families at the end of the first week. A formative evaluation that is based on this milestone will enable the intervention team to determine whether the progress is on course in terms of meeting the objectives.

            Summative evaluation is performed at the end of the program to examine the effectiveness of the program in meeting its target. For instance, the summative evaluation may focus on examining the number of families that the program was able to reach at the end of the 6 weeks period. Evaluation will also focus on assessing the impact of the outreach program on the target population. Impact evaluation will focus on assessing the obesity trends among African American with the city. However, it will take time before the impact of the outreach program become visible and, therefore, impact assessment can only be conducted a few months after the program is completed.


Alio A. & Salihu H. (2006). Obesity Research and the Forgotten African American Child. Ethnicity and Disease. 16: 569- 574

Blanchard S. (2009). Variables Associated with Obesity among African-American Women. The American Journal of Occupational Therapy. 63 (1): 58- 68\

California Healthline (2012). California Obesity Rate to Double by 2030. November 5, 2013. http://www.californiahealthline.org/articles/2012/9/19/california-obesity-rate-to-double-by-2030-new-report-projects

City Data.com (2013). Stockton, California. November 5, 2013. http://www.city-data.com/city/Stockton-California.html

Hopkins J. (2013). Community-based Intervention Programs more effective at Preventing Obesity on Children. Bloomberg School of Public Health

Jakicic J. & Otto A. (2005). Physical Activity Considerations for the Treatment and Prevention of Obesity. American Journal of Clinical Nutrition. 82 (1): 2265- 2295

Kaiser Family Foundation (2013). Overweight and Obesity Rates for Adults. November 5, 2013. http://kff.org/other/state-indicator/adult-overweightobesity-rate-by-re/

National Center for Education Statistics (2013). Education Attainment. November 5, 2013. http://nces.ed.gov/fastfacts/display.asp?id=27

San Joaquin County Public Health Services (2012). Community Health Status Report. November 5, 2013. http://www.sjcphs.org/disease/documents/FINAL%20Updated%20Health%20Status%204-1-11.pdf

Stevenson N. (2011). Family Environmental Factors associated with Obesity among African Americans. November 5, 2013. http://drum.lib.umd.edu/bitstream/1903/10727/1/Stevenson.pdf

Swinburn B. Caterson I. and Seidell J. (2004). Diet, Nutrition and the Prevention of Excess Weight Gain and Obesity. Public Health Nutrition. 7 (1): 123- 146

The Center for Disease Control (2013). California’s Response to Obesity. November 5, 2013. http://www.cdc.gov/obesity/stateprograms/fundedstates/california.html


Appendix I: Obesity and Overweight Rates in California by Ethnic Group


Published in Nursing
Friday, 30 May 2014 13:52

Oil and Gas Industry

  Oil and Gas Industry


Critical Industry Competition Analysis

 The oil and gas industry is volatile, expensive, and highly political. It is also vital for every citizen of the world (Inkpen & Moffett, 2011). It fuels nearly all other industries, in the world, from information technology to agriculture. Oil and gas power vehicles, heat homes, and facilitate growth of agricultural plants, which are important for production of food. This is the reason why the global energy demand is expected to grow by at least 33% when the clock hits 2035, with a high proportion of energy being supplied by oil and gas (Chauhan, 2010).

Share of Primary Fuels in the World Power






















Mitchell, Marcel and Mitchell, Beth, 2012

The industry is oligopolistic (Randall, 2008). Only a few industry giants including Tullow Oil, British Petroleum, and Premium Oil have the capital and cutting-edge technologies essential for expanding and improving yields while monitoring and managing environmental impacts. Hence, the industry is an oligopoly, where entry is barred for companies whose production and distribution capacity do not match that of the industry giants.  The competition between these companies is driven by factors, in the macro environment, including government policies, cost inflation factors, and the changing price dynamics. At the level of supply, unconventional resource development, such as shale gas and globalization of gas are some of the most important determinants of competition. At the level of demand, demand surge in developing countries and a dip in demand, in developed countries are the major issues.


Chauhan, S.P.S. (2010), Macroeconomics: An Advanced Treatise, New Delhi: Learning Private Limited

Inkpen Andrew and Moffett Michael (2011), Global Oil & Gas Industry, Tulsa, OK: PennWell Corporation

Mitchell, John, Marcel, Valerie, and Mitchell, Beth (2012), What Next for the Oil and Gas Industry?, London: Chatham House

Randall, Scott (2008), Energy, Risk, and Competitive Advantage, Tulsa, OK: PennWell Corporation


Published in Business Studies

 Reversing the Extroverted Leadership Advantage: The Role of Employee Proactivity

In this article, Grant et al (2011), explore the effectiveness of extroverted leadership trait across teams with different characteristics. The authors hypothesized that not all groups perform well under extroverted leadership. They suggest that extroverted leadership trait only works effectively in teams where members are passive. However, this style may not work effectively teams where member are proactive because extroverted leaders are least receptive to proactivity. The authors based this argument on the dominance complimentarity theory.

According to this theory, effective interaction between two parties can only be achieved when dominant behavior of one party is matched by submissive behavior of the other party. This action brings balance into an interpersonal relationship thus fostering effective interaction. Dominance complementarity advocates for existence of status hierarchy in order to achieve stability in a team.  In the extroverted leader- proactive team relationship, both parties have dominant behaviors thus limiting the effectiveness of their interaction. In this relationship, stability is lost because both parties exhibit dominant behavior leading to the disappearance of status hierarchy.

The complementarity theory suggests that less extroverted leaders stand a greater chance of achieving effectiveness in proactive teams than highly extroverted leaders. This is because least extroverted leaders are willing to listen to proactive team members.  In order to test their hypothesis, the authors collected data from the US Pizza delivery company concerning the group performance, group proactivity, and leadership traits in several of the company’s branches. Result revealed that when employees engaged in low proactivity, in extroverted leadership, the store recorded high profits and vice versa. These results confirmed the authors’ hypothesis that extroverted leadership traits only work effectively in teams that are not proactive.

There are other leadership traits/ styles that can vary their effectiveness depending on the makeup of the team. One of the leadership styles that can vary their effectiveness in line with the composition of the team is participatory leadership. Participatory leaders seek to inspire their followers and rally them behind a certain vision. These leaders create a vision and focus on getting the followers to buy-in this vision and establish means for achieving the vision. The leader emphasize on the need to empower followers and allow them to participate actively in the planning and implementation of strategies. Participatory leaders take a participatory approach of leadership, where they are willing to listen to their follows and incorporate their ideas into the activities of the organization.

However, for this leadership style to work effectively, the team must consist of members of are highly motivated. This is because, in participatory leadership, leaders only provide the vision and rely on followers to contribute ideas for realizing this vision. Thus, team members must be highly motivated and highly skilled in order to fulfill this expectation. Team members must also be self driven because participatory leaders assign high level of autonomy to team members. Thus, if the team members are not self driven, they will not be able to complete tasks required in order to realize the vision of the organization.

Emotional stability is one of the personality traits that make effective leaders. Leadership position exposes a person to major challenges that require sound judgment and decisions. Emotions can act as significant barriers to effective decision making. Leaders who cannot control their emotion often make erratic decisions, which end up becoming costly to the team. Emotional stability gives a leader the capability to make decisions amidst challenging times. They inspire confidence in their team during tough moments.   


Grant A. et al (2011). Reversing the Extroverted Leadership Advantage: The Role of Employee Proactivity. Academy of Management Journal. 54 (3): 528- 550


Published in History

Influence of Culture on Substance Abuse among Adolescents

Culture refers to a set of values, traditions and belief that influences the behavior of individual (Saldana, 2010). Culture has significant implication on drug abuse cases among adolescents. While some cultural values act as protective factors against drug abuse others act as risk factors for this behavior. Culture also has an impact on how an individual perceive heath and healthcare. Thus, drug abuse specialist need to develop cultural competency in order to design effective approaches of treating and preventing drug abuse disorders among teenagers.

 Knowledge, Skills, and Attitudes of Cultural Competency

Cultural competency refers to policies, behaviors and attitudes that interact in a system or among professional in order to enable them to work effectively in cross-cultural environments (Saldana, 2010). Cultural competency plays a critical role in bridging the gap between drug abuse specialist and adolescent having drug abuse disorders. It enables specialists to have a meaningful interaction with patients, as well as, with the patient’s family members without cultural differences hindering their interaction. Cultural competence enables the specialist to be responsive to cultural beliefs of the patient thus bringing about positive outcomes. Drug abuse specialist needs given knowledge, skills and attitudes in order to develop cultural competency.Drug abuse specialists need to have knowledge about the patient culture (Saldana, 2010).

This includes the patient’s history, family systems, values, traditions and artistic expression. The specialist must also have knowledge on how these cultural elements affect the patient’s behaviors, attitude and disorder. This knowledge will enable the specialist to design the best treatment approach for the patient. The specialist must also possess knowledge about the communication patterns and styles of the patient. Communication between patients and the specialist is critical in the diagnosis and treatment process. Knowledge of the patient’s communication pattern and style enhances the effectiveness of the communication process. The specialist must also have knowledge on how professional values may conflict or accommodate the cultures of different patients.

The specialist must also assess skills such as the ability to understand and accommodate different communication styles and patterns in order to promote cultural competency (Saldana, 2010). The practitioner must demonstrate the ability to interview and discern the meaning from the interaction with the patient. Negotiation skills are also critical to the development of cultural competency. The specialist must have the ability to negotiate with patient in order to encourage the patient to drop cultural elements that have a negative impact on treatment.  The specialist must also exhibit a high degree of tolerance towards other people’s culture. Attitudes such as acceptance of ethnic differences, empathy, warmth and professionalism are also critical to the development of cultural competency. The specialist also needs to manage stereotypes and biases.

 Dimensions of Culture that Impact Adolescent Treatment and Prevention of Substance Abuse

The Hosfstede model of cultural dimensions identifies five dimensions of culture that have an impact on healthcare. The first dimension is individualism versus collectivism. This dimension focuses on the relationship between the patient and various groups such as family, society and school of which the patient is a part (Gale, 2006). In collective culture, the group is viewed as the basic unit of society while, in individualistic cultures, the individual is given a central position.

Collective culture promotes a high level of interdependence among members of the same community. The group assumes responsibility of its members. Thus, collective cultures act as protective factors against drug abuse.The second dimension is power distance. Power distance is the degree to which less powerful members of a given society accept that power is distributed unequally (Gale, 2006). Societies with high powerful distance have a clear hierarchy and a defined pecking order thus promoting predictability and stability. Thus, high power distance provides a protective power against drug abuse and vice versa. The third dimension of culture is uncertainty avoidance (Gale, 2006). Uncertainty avoidance refers to the amount of effort that an individual is willing to make in order to reduce unexpected events.

Individuals with high uncertainty avoidance prefer explicit directions and detail about the procedures of care. On the other hand, individuals with low uncertainty avoidance may get irritated by detailed explanations and directions. The fourth dimension is masculinity (Gale, 2006). High masculine cultures value social power, control and achievement. They have significant differences in gender roles. This culture may undermine treatment and prevention of substance abuse because it does not promote cooperation among family members. The final dimension is long term orientation. Long term orientation refers to the extent to which a given cultural group values long standing as opposed to short-term goals. Long term oriented cultures are likely to support treatment and prevention efforts.  

 Cultural Groups that Adolescents Join

The culture of adolescent can be defined in terms of race, ethnic group, age, gender, religion, cultural orientation, physical status, subculture, psychiatric status, and economic status (Ray & Ksir, 2002). Some of these cultural groups may promote drug abuse behaviors while others may discourage and even punish this behavior. For instance, religion is a cultural element that discourages drug abusing behaviors. Adolescents who associate themselves with certain religious values are least likely to develop drug abusing behaviors. On the other hand, subcultures such as delinquent gangs can support drug abuse behaviors (Ray & Ksir, 2002). Adolescent who join such subcultures interact with people who have negative behaviors thus leading to the development of overt behaviors such as drug abuse. Joining cultural groups lead to assimilation of adolescents into these groups where they acquire the value, norms and identity of these groups.  

 Impact of Explanatory Model on Patient’s and Family’s Treatment and Prevention Practice

Explanatory model is a framework that attempt to explain how people make sense of their illnesses (DeLisser, 2009). Understand the explanatory model of the patient and family will enable the specialist to understand how the patient perceives his drug abuse problem, as well as, the personal and social meaning associated with the drug abuse disorder.  The explanation models also help the specialist to reveal the expectation of the patient and his family concerning what will happen in the future.Inaccurate explanation model may hinder the treatment and prevention practice.

In some cases, adolescent have misconceptions about their drug abuse problem. Some adolescent often think that drug abuse behavior is norm among other teenagers and, therefore, the problem is not unique to his situation. Such misconception about the illness may hinder the patient from seeking medical treatment or taking preventive measures. Having unrealistic expectations about future outcomes can also hinder the treatment and prevention of drug abuse problems.Similarly, some cultural groups associate illness with spiritual matter (DeLisser, 2009). When a person fall seeks they tend to seek spiritual remedies for the patient problem. Such explanatory theories have an impact on willingness to accept treatment interventions.

 Impacts of Cultural Movements on Substance Use and Abuse

Moving from culture to another can promote substance use and abuse behaviors (Ray & Ksir, 2002). Cultural groups influence the behaviors of individual by impacting on the values, identity and traditions. Adolescents who move from one cultural group to another are likely to get exposed to negative influence leading to development substance use and abuse behaviors.


Culture has a significant impact on drug abuse cases among adolescents. Various dimensions of culture act as risk factors for drug abuse problems while others act as protective factors. In order to administer effective interventions, drug abuse specialist need to have an understanding of the patient’s culture and how to affects his disorder. Culture also affects how patient respond to treatment. Therefore, specialists need to design interventions that respond to unique aspects of the patient’s culture.


DeLisser J. (2009) Kleinman’s Explanatory Model of Illness. November 4, 2013. http://onlinelibrary.wiley.com/doi/10.1002/9781444311686.app2/pdf

Gale D. (2006). Cultural Sensitivity beyond Ethnicity: A Universal Precautions Model. Journal of Allied Health & Nursing. 4 (1):

Ray O. & Ksir C. (2002). Drugs, Society, and Human Behavior. USA. McGraw-Hill Publishers

Saldana D. (2010). Cultural Competency. October 4, 2013. http://www.hogg.utexas.edu/uploads/documents/cultural_competency_guide.pdf


Published in Sociology
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