Barriers to Accessing Reproductive Healthcare

Barriers to Accessing Reproductive Healthcare Hina Mirza As a part of Reproductive Health Course year III BScN, for community clinical we went to karimabad colony to assess family needs related to health. There I visit one family that I choose as my secondary client. After assessing different dimension of health when it comes to Reproductive health assessment, I took initiative by asking about normal menstrual cycle of the mother and her daughter as both were alone in the room. The mother told me that she has reached to menopause and the girl who is 22 year old was having normal Menstrual cycle. Further I proceed to another concern that has been came into noticed is leucorrhea; Studies shows that the prevalence of leucorrhea in Pakistan is very high which is 12%. (Chris Kenyon, 2013). The girl nod the head into yes while responding to me but her facial expression seems to be anxious towards me. I tried to dig on to this query which I had in mind that whether the girl has any concern related to reproductive issue which she thinks needs to t reated. After completing my question I made an efforts to ask more questions but it seems difficult for me when it comes to reproductive health because I was not confident and familiar with the vocabulary that is used in reproductive health and on the other hand it was my first interaction with that family so I don’t want to invade their privacy or make them feel uncomfortable. As soon as I finished my part the mother stated that â€Å"Yes, she complaint sometimes about discharge that is irritating and smelly and in addition to it some burning sensation in perineal area, might be she is having infection†. Afterwards I wanted to ask to the girl about characteristics of discharge and sexual behaviors that lead to infection as stated by her mother but suddenly, her Father came into the room and I stopped myself from asking more about it because I feel that it will bother her to talk about it in front of her father as well as I lost my confidence level in this particular c omponent of health, in terms of privacy. Moreover, she also felt uncomfortable and tried to change the topic. When I reflect back the situation, I feel I should not discontinue the topic because the girl might have some serious issue related to the discharge and there might be some reproductive health concerns that were in her mind. That is why when I asked her about the discharge, she respond to it so anxiously and promptly and it seems like that she wanted to share something with me. When I analyze at my part, that why this incident happened to me was firstly, due to lack of confidence in dealing with reproductive concerns of the client. According to Literature, â€Å"More general predisposition, such as comfort and confidence, that might influences nurses openness to dealing with patient sexuality† (Cort et al., 2001) Secondly, my own sociocultural barriers that how should I invade someone else privacy and also client’s perception that they might have while discussing such stuff. This made me overprotective for the conversation supported by the literature that â€Å"The first line of inquiry culminates in the classification of nurses as liberal or conservative in their views about specific sex-related behaviors† moreover according to literature, Reproductive health is not openly discussed in many cultures of the world and that is why client hesitate to raise questions and concern related to these issues with their health care provider (Tsai. Y, 2004). Thirdly, the communication problem contributes major part to this incident, it seems difficult for me to decide what best vocabulary and way of communication enable health care provider to make client understand about the main focus of the discussion evident by literature that â€Å"Communication about health and sexuality often differs by ethnicity, age, socioeconomic status, geographic location, and sexual o ­Ã‚ ­Ã‚ ­Ã‚ ­Ã‚ ­rientation. Communication patterns can form serious obstacles to care†( Moss.T, 2004) Lastly, if I look at the surrounding one more barrier in discussion was privacy factor because of her father came into the room and that made me hold back the discussion. Few of the things that I could have done so that I can help out the patient at that time related to their reproductive health issues by maintaining my confidence level by increasing competency in reproductive health nursing before visiting the client. According to the article, Nurses’ state that they do not initiate to assess reproductive health of client due to insufficient knowledge regarding problem that patient might raise during conversation (Magnan.M et al., 2005). In addition to it I could have kept my sociocultural barriers aside and making client needs as priority because reproductive concerns are majorly remain unaddressed and it has been observed that client wait and expect health care provider to initiate these topics. â€Å"Although patient have said that discussion with nurses is appropriate and that they would prefer having nurses initiate the discussion† (Magnan.M et al., 2005). Last but not the least if her father came into the room I could have been st op for a while but after seeing appropriate time I should have made the first move to ask her about her reproductive concern or if still she is uncomfortable I could tell her to talk to me in privacy, may be in other room or as she prefer. As evident by literature â€Å"Lack of confidentiality is often a barrier to the delivery of health care services, especially reproductive health care, for adolescents† (Committee on Adolescent Health Care, 2010) To conclude if this kind of scenario ever happens again the experience will facilitate me to boost up my confident by making me realize my mistake of neglecting one patient’s health. Besides this by gaining more competencies in vocabulary, knowledge and communication pattern in reproductive health will help me to address the client needs and initiate the concerns in which client face difficulty to elaborate. References Kenyon, C., Colebunders, R., Crucitti, T. (2013). The global epidemiology of bacterial vaginosis: a systematic review. American Journal of obstetrics and gynecology, 209(6), 505-523. Tsai, Y. (2004). Nurses’ facilitators and barriers for taking a sexual history in  Taiwan. Applied Nursing Research, 17(4), 257-264. doi: 10.1016/j.apnr.2004.09.011 M,T. (2004). Barriers to Health Care for Youth of Color. Retrieved from http://www.advocatesforyouth.org/publications/publications-a-z/705- barriers-to-health-care-for-youth-of-color Committee Opinion(460). (2010). Retrieved from The American College of obstetricians and Gynecologists womens health care physicians website: http://www.acog.org/~/media/Committee Opinions/Committee on Adolescent Health Care/co598.pdf?dmc=1ts=20140501T1128433150 Magnan,M.A., Reynolds,K.E., Galvin,E.A. (2005). Barriers to Addressing Patient Sexuality in Nursing Practice.MEDSURG NURSING,14(5). Retrieved from http://www.kc-courses.com/fundamentals/week15diversitygrief/barriers.pdf

Home Depot †Executive Summary Essay

The Home Depot (Ticker: HD) is the world’s largest home-improvement retailer along with being an American Fortune 50 company. The company operates 2,259 retail building supply/home improvement â€Å"warehouse† type stores all across the United States, Canada and Mexico. The Home Depot has over 340,000 team members and is based in Atlanta, Georgia. The average store size is just over 100,000 square feet along with an additional 24,000 square feet set aside for seasonal gardening. Target Group The Home Depot’s two main customers are at home â€Å"do-it-yourselfers† and contractors. The main products and services offered help solve the wants and needs of customers involved with home construction and maintenance, renovation and remodeling. Competitive Environment The competitive environment for the home-improvement industry is broken into three major players: The Home Depot, Lowe’s and local retailers. They compete with local retailers that specialize in nearly every product and service offering. The Home Depot and Lowe’s are both â€Å"all offerings† locations spread throughout North America. Over the past decade Home Depot was stickily focused on expanding the store count and business lines whereas Lowe’s was focused on store count growth and perfecting their supply chain and internal technology. Past Growth Over the past 13 years The Home Depot has more than doubled its store footprint. It was aided by two major factors; First being that the home improvement and building industries were growing quickly providing a constant demand for product. Second, funding was easy to receive and it was relatively cheap because of low interest rates. Management began to â€Å"empire build† with their now sold professional supply business (now known as HD Supply) and cut costs in their big box stores to help reduce costs. With the reduction of cost came the reduction in customer satisfaction. Return to Retail Noticing that customer satisfaction rating had severely slipped because of stock outs and poor team member engagement with the customer a new initiative was proposed. Marvin Ellison, Executive Vice President, U.S. Stores, proposed the â€Å"FIRST Relaunch†. The program focuses on putting the customers first, by â€Å"Do(ing) the unexpected†. The operational plan focused on customer service, being in stock on all products and creating a better store appearance (inside the physical store and within the community). In efforts to focus on customer service, more employees were hired and trained. Upper management also equipped each team member with more technology (PDA’s, walkie talkies, etc). There was a companywide initiative to integrate Hispanic merchandise, marketing and staffing. Home Depot switched to a regional distribution system while upgrading their internal information technology infrastructure to better keep stores’ inventory stocked properly. This major overhaul materialized into The Home Depot’s stock outs dramatically decreasing. To create a stronger public image, Home Depot created The Home Depot Foundation which helps with community home building, disaster relief and veteran job placement assistance. These initiatives have greatly improved customer satisfaction and recognition in the community by increasing ratings from 55% to 75% (2008 to 2012). Current Economic cycle Home Depot has clearly set itself up to be successful in the recent upswing in the housing markets. Their technology upgrade has proven to be successful in keeping stores stocked and employees more engaged with helping the customers. Management has responded to the late spring, summer, and early fall build up in construction needs by resorting to hiring part time and seasonal workers while still giving them the proper training to satisfy the customer. Management The current Chairman and Chief Executive Officer, Frank Blake, is often credited with the company’s turnaround ever since taking the helm. He sold the professional supply business (now known as HD Supply) to help the company focus on their core competencies. Blake also helped implement the customer first initiatives. All while cutting his own pay and switching his  future pay to stock and options, which are based on The Home Depot’s performance. Financial Position Since Home Depot has slowed their store expansions, cash reserves have grown to match total debt due in 5 years. Sales have increased steadily since the industry lows in 2008. Cash from operations have also steadily increased to match market high 2006-07 levels. A large portion of the cash flow each year has been focused toward share repurchases and steadily increasing their yearly shareholder dividends. Lending Risks The Home Depot is in the heart of an uncertain housing environment. The sales and financial results each year are closely tied to the consumer spending money on construction and housing maintenance. If the economic environment were to deteriorate it is likely many consumers would hold off on simple maintenance projects, which is currently the bulk of store sales. The housing market has seemingly bottomed but it still remains unclear to if the recent increase in housing sales is going to last.

Disaster Management Viii

An Introduction to Disaster Management for Class 8 Central Board of Secondary Education ‘Shiksha Kendra’, 2, Community Centre Preet Vihar, Delhi – 110092, India Tel : 91-011-22509252-57/59, Fax : 91-011-22515826 E-mail : [email  protected] vsnl. net. in Website : www. cbse. nic. in TOGETHER, TOWARDS, A SAFER INDIA An Introduction to Disaster Management for Class 8 FIRST EDITION 2003 ? CBSE, DELHI ACKNOWLEDGEMENTS AUTHORS Dr. Kamala Menon, Principal, Mirambika School, New Delhi Ms. A. Venkatachalam, Mother’s International School, New Delhi Ms. P. Thakur, Education Officer, Kendriya Vidyalaya Sangathan, New Delhi EDITORS Shri M. P. Sajnani, Director (Disaster Management), Ministry of Home Affairs, Govt. of India Ms. Aparna Kanda, Programme Associate (Vulnerability Reduction and Sustainable Environment) UNDP, New Delhi COORDINATOR Ms. Sugandh Sharma, Education Officer (Commerce), CBSE , Delhi CBSE ADVISORS Mr. Ashok Ganguly, Chairman Mr. G. Balasubramanian, Director (Academics) PUBLISHED BY : The Secretary, Central Board of Secondary Education, ‘Shiksha Kendra’, 2, Community Centre, Preet Vihar, Delhi 110 092 DESIGN & LAYOUT BY : CBSE, Delhi PRINTED BY : Tara Art Press, B-4, Hans Bhawan, B. S. Zafar Marg, New Delhi – 110 002 Ph. 23378626, 23379686 ii Hkkjr dk lafo/kku mIsf’kdk ge] Hkkjr ds yksx] Hkkjr dks ,d1 [lEiw. kZ izHkqRo&laiUu lektoknh iaFkfujis{k yksdra=kRed x. kjkT;] cukus ds fy,] rFkk mlds leLr ukxfjdksa dks% lkekftd] vkfFkZd vkSj jktuSfrd U;k;] fopkj] vfHkO;fDr] fo’okl] /keZ vkSj mikluk dh Lora=rk] izfr†Bk vkSj volj dh lerk izkIr djkus ds fy,] rFkk mu lc esa O;fDr dh xfjek vkSj2 [jk†V? h ,drk vkSj v[k. Mrk] lqfuf’pr djus okyh ca/kqrk csa vkSj mldk ifjj{k. k djsa( izkd`frd i;kZoj. k dh ftlds varxZr ou] >hy] unh] vkSj oU; tho gSa] j{kk djsa vkSj mldk lao/kZu djsa rFkk izkf. k ek= ds izfr n;kHkko j[ksa( oSKkfud n`f†Vdks. k] ekuookn vkSj KkuktZu rFkk lq/kkj dh Hkkouk dk fodkl djsa( lkoZtfud la ifYk dks lqjf{kr j[ksa vkSj fgalk ls nwj jgsa( O;fDrxr vkSj lkewfgd xfrfof/k;ksa ds lHkh {ks=ksa esa mRd†kZ dh vksj c

Encountering Development By Arturo Escobar A Multi...

In Encountering Development by Arturo Escobar, Escobar critiques the Development Project, a multi pronged initiative of socioeconomic management of the Third World, specifically Latin America, Asia, and Africa, via the First World powers, in question specifically the United States. The critique entails how industrialization and modernization of the Third World could be seen as the mode through which modernization could be achieved and this was enabled by bureaucratic entities, like the World Bank, whom subjected Third World economies to a heavy handed management via the modernization process which denied autonomy for Third World self sufficiency. The Development process thus denied any legitimate conceptualization of how to properly develop economic prosperity. The rapid â€Å"consolidation of power† into the hands of the capitalist First World Elite created a paradigm through which the support of cyclical poverty ensured a need for industrialization in order to fix defunct so cioeconomic issues. By creating bureaucratic agencies, like the World Bank, which provided specific subscriptor projects, like DRI, allowed for the First World entities to to create and sustain an ongoing unequal distribution of power between the Global North and the Global South. Escobar explains that the concept of â€Å"systemic pauperization† provided the First World with grounds for legitimacy when first creating the Development Project in the 1940s. What was respectively considered modern and impoverishedShow MoreRelatedOne Significant Change That Has Occurred in the World Between 1900 and 2005. Explain the Impact This Change Has Made on Our Lives and Why It Is an Important Change.163893 Words   |  656 PagesLinda Shopes, eds., Oral History and Public Memories Tiffany Ruby Patterson, Zora Neale Hurston and a History of Southern Life Lisa M. Fine, The Story of Reo Joe: Work, Kin, and Community in Autotown, U.S.A. Van Gosse and Richard Moser, eds., The World the Sixties Made: Politics and Culture in Recent America Joanne Meyerowitz, ed., History and September 11th John McMillian and Paul Buhle, eds., The New Left Revisited David M. Scobey, Empire City: The Making and Meaning of the New York City Landscape