Studying and analysing the performance of UK Gambling 1252 Essay - 1

Examining and breaking down the presentation of UK Gambling 1252 - Essay Example So as to assess the presentation of UK’s betting industry, three driving betting associations; Ladbrokes PLC, Rank Group PLC and Sportech PLC’s money related execution has been thought of. The report presents reasons for the choice of betting industry and choice of the three betting firms to direct the examination (Chalabi, 2014). The specialist has quickly talked about the standpoint of the UK betting industry on the bases of factual portrayal and translations of three significant betting firms of UK. The report will expound about the inside and outer elements that have impacted execution of UK betting industry. In this manner, PEST examination has been directed to outline about Political, Economical, Social and Technological elements to decide outside ecological elements impacting the presentation of the business (Chalabi, 2014). In addition, administrative and natural concerns have additionally been examines regarding the ongoing revisions parents in law and guidelines of the legislature that has influenced gainfulness of the organizations. The second segment of the report centers interior variables of the betting business. Hence, proportion investigation and SWOT examination have been directed to decide money related and non monetary parts of firms and industry (Scherer and Palazzo, 2014). The proportion examination has been led utilizing five years money related consequences of the organization acquired from the yearly reports and mechanical proportions (Fridson and Alvarez, 2011). The proportion investigation has been utilized as an instrument to contrast the presentation of each firm with give understanding to the money related worries of the betting business. The third segment examines SWOT (quality, shortcoming, openings, and dangers) of the chose firms and industry, as it permits understanding possible chances and dangers of the UK’s betting industry. The report would fundamentally add to assessing and study the presentation of betting industry in UK. It will

Advocacy Campaign for Child Welfare

Section ONE SITUATION ANALYIS To have the option to think of a decent youngster government assistance promotion, the gathering surveyed the outside and inward circumstance. This section assesses the circumstances and patterns in a specific backing. It gives the data expected to arranging. Foundation of Child Welfare Child government assistance is an administration run administration for securing kids and youngsters who are underage which are as yet helpless against manhandles like business sexual misuse, dealing, kid work, and destructive conventional practice.It is evaluated that in our nation, around 100,000 kids kick the bucket every year from preventable illnesses, in excess of 2 million young kids are not contemplating, there were additionally as much as 2 million working kids and that road kids number around 200,000 out of 57 urban communities. UNICEF makes sense of the quantity of explicitly undermined youngsters at around 60,000. There are numerous associations here in the Ph ilippines that advance youngster government assistance that has one shared objective which is to support numerous kids, particularly kids who are destitute and had been deserted by their adoration ones.According to Presidential Decree No. 663 dated December 10, 1974 with respect to the Child and Youth Welfare Code Art. 3. Right of the Child plainly expresses that: All kids will be qualified for the rights thus set out without differentiation as to authenticity or wrongness, sex, societal position, religion, political, predecessors, and different components. (1) Every youngster is enriched with the respect and worth of an individual from the snapshot of his origination, as by and large acknowledged in clinical speech, and has, hence, the option to be brought into the world well. 2) Every kid has the privilege to a healthy family life that will furnish him with adoration, care and getting, direction and guiding, and good and material security. The needy or surrendered kid will be furn ished with the closest substitute for a home. (3) Every kid has the option to a balanced improvement of his character to the end that he may turn into a glad, valuable and dynamic citizen. The skilled youngster will be given chance and consolation to build up his unique talents.The sincerely upset or socially maladjusted kid will be treated with compassion and understanding, and will be qualified for treatment and equipped consideration. The genuinely or intellectually disabled youngster will be given the treatment, training and care required by his specific condition. (4) Every youngster has the option to a reasonable eating routine, satisfactory garments, adequate safe house, appropriate clinical consideration, and all the fundamental physical prerequisites of a sound and energetic life. 5) Every kid has the option to be raised in an environment of ethical quality and integrity for the improvement and the reinforcing of his character. (6) Every kid has the privilege to instruction equivalent with his capacities and to the advancement of his abilities for the improvement of his ability for administration to himself and to his fellowmen. (7) Every youngster has the privilege to full open doors for sheltered and healthy amusement and exercises, individual just as social, for the healthy utilization of his recreation hours. 8) Every youngster has the option to assurance against abuse, ill-advised influences,â dangers, and different conditions or conditions biased to his physical, mental, enthusiastic, social and good turn of events. (9) Every kid has the privilege to live in a network and a general public that can offer him a domain liberated from vindictive impacts and helpful for the advancement of his wellbeing and the development of his alluring qualities and properties. (10) Every youngster has the option to the consideration, help, and insurance of the State, especially when his folks or gatekeepers fizzle or can't rovide him with his central requirement s for development, advancement, and improvement. (11) Every kid has the privilege to a productive and genuine government that will develop his confidence in majority rules system and motivate him with the profound quality of the comprised specialists both in their open and private lives. (12) Every youngster has the option to grow up as a free individual, in a climate of harmony, getting, resilience, and widespread fellowship, and with the assurance to contribute his offer in the structure of a superior world.The Helping Juans gathering might want to advertise our promotion and furthermore to contribute in offering attention to everybody about kid government assistance particularly the guardians basically on the grounds that we might want to teach them in regards to worries about the government assistance of every single one’s kids, which means, we love our kids and they ought to be furnished with all the help, either truly, monetarily, inwardly, profoundly, and morally.Every kid has their own privileges and all of them should be treated in a correct manner. In any case, the youngster government assistance in the Philippines isn't given that much consideration in light of the fact that the sort of administration we have now is degenerate and can't be trustworthy all the occasions in light of innumerable issues that our nation is confronting and it is miserable to state that number of road kids are increasing.But if our legislature will simply compensate for every one of their errors and focus on our genuine issues particularly the absence of assets on each division including DSWD (Department of Social Welfare and Development), it would be an extraordinary help to everyone particularly those kids who are in a vagrant who had been relinquished and simply depending to their halfway house. Part TWO ADVOCACY CAMPAIGN Christmas for Little Juans is a promotion battle presented by Helping Juans, a gathering made out of nine individuals from MA101.We made this g athering for us to help surrendered kids even with simply straightforward things, such as taking care of them, giving them presents and giving them love particularly to this sort of season. These kids are frequently working in exceptionally troublesome conditions without enough food to eat and better than average spot to rest. The road is their solitary home. Our backing effort is to bring issues to light about these kids. We need them to be perceived and simultaneously to be minded and protected. It is our association's definitive objective in bringing issues to light about these children and furthermore in social occasion support for the government assistance and advantage of road youngsters in Manila.We are volunteer based and accept that the cash our givers give ought to be utilized carefully and effectively as could be expected under the circumstances. The objective members for our backing effort were the Asia Pacific College people group especially the understudies of APC. Be that as it may, that doesn’t imply that the battle is restricted uniquely to these individuals, yet rather, they are simply for the most part the market. APCians, along with the personnel and staff, were urged to join to enable the gathering to pick up assets for their backing effort and help their recipient foundation.These members didn’t lament helping the crusade however rather contacted their hearts and acknowledged how significant helping the penniless individuals is. The gathering didn't simply help other people yet in addition helped themselves in light of the fact that by helping others as well as could be expected, they naturally helped themselves. Aiding Juans accepted that it is their group’s just as the whole humanity's commitment to ensure these children get legitimate spot to live, appropriate instruction and appropriate treatment, with the goal that they can value their lives and look towards the more splendid side and possibly, some time or anoth er they can likewise have an effect in this world.CHAPTER THREE PARTNER ORGANIZATION The My Father’s House (MFH) is an authorized, charitable kid caring association serving the surrendered, ignored and stranded youngsters. This association means to acquaint every kid with Jesus Christ with the expectation that they come to realize Him as Lord and Savior of their lives through the advancement of control and dutifulness under God’s love and standard, give projects and administrations to create independence and independency, place youngsters in adoring stable Christian homes for their assurance and security, and execute all encompassing projects that will engage kids and youth.The association has an aggregate of 64 understudies, 10 of which are youth researcher under the Independent Living Program. Others were proclaimed deserted and intentionally gave up by guardians. They train these youngsters to watch regard and obligingness on their conduct and it is seen that the ki ds have gotten all the more tolerating of each other and of the power that the grown-ups have over them. They additionally execute conduct alteration techniques so they would turn out to be progressively open to parental figures and social specialists. Kids are being received by Filipino, American, Spanish and Finnish families.They are available to individuals who are happy to help and offer hands to the kids. They lean toward garments, school supplies and nourishment for the kids. MFH is situated at 135 Ramona Tirona corner Sison St. , BF East Phasi VI, Las Pinas, their area is inside the region and it has a high security which they can have the affirmation of the kids' wellbeing. They have places for kids to rest, eat, study and play. They have 3 bed rooms, one space for young ladies, one space for young men from 5-12 and another for teenagers.They have a kitchen which serves great food and they eat as a family. They have a different structure for considering and all around prepar ed educators for them. They have court, play ground and a pool for the youngsters to appreciate. MFH has a few accomplices like Benny Hinn Ministries and Partners, Department of Social Welfare and Development (DSWD), Inter-Country Adoption Board (ICAB), Association of Child-Caring Agencies in the Philippines (ACCAP), KRAFT Philippines, and Wide Horizons for Children, and so on. Part FOUR OBJECTIVES General Objectives: To have the option to bring kid government assistance mindfulness up in the Asia Pacific College people group adequately * To teach to the psyches of the individuals the pith of youngster government assistance * To develop sympathy for these kids * To let the vagrants experience God’s cherishing contact by sharing food, endowments and attire * To share love

10 Rad Female Authors to Read

10 Rad Female Authors to Read In response to Donna Tartts well-deserved Pulitzer win for The Goldfinch, Time magazine posted an article listing 21 female authors you should be reading. While there are some amazing authors on that list, if youre a book lover like me, many of them are probably already on your radar. If youre looking for a few more solid women to add to your reading repertoire, here are 10 more that you might not have heard of yet: 1. Cara Hoffman In  her second novel, Be Safe I Love You,  being published this month, Hoffmans considerable narrative talent is on display, as is her feminist bent through the voice of her protagonist. Though there have been many novels about the impact of the Iraq war, few if any focus on the female soldiers and their struggles when returning home. Hoffman is a strong addition to the literary world. 2. A.S. King  Kings novels have won just about every award that young adult fiction can win, including a few that arent so usual. Her novel  Ask the Passengers  was a finalist for the 2012 Lambda Literary award, and just about every one of her books has been listed for  ALA Best Fiction for Young Adults. She is constantly pushing the boundaries and worthwhile for all readers adult and teen to explore. 3.  Sara Farizan Farizans 2013 book If You Could Be Mine introduced the author as a much-needed voice in YA fiction. The novel  tackles the weighty topics of homosexuality and transgender issues in Iran, arranged marriages, and the very real possibility of imprisonment and execution. Shining a light on rarely explored subject matter, Farizans work has become a voice for teens who havent seen themselves in novels before. Her forthcoming novel, Tell Me Again How a Crush Should Feel (due in Oct. 2014), promises to deliver the same groundbreaking storytelling.   4. Megan Abbott   Writing noir crime fiction with a feminine twist, Abbotts Edgar award-winning novels explore things like the gritty underworld ofcheerleading? Yep, her  2012 novel Dare Me explores the viciousness of teenage girldom without resorting to stereotype. Its also been optioned for a movie, and Natalie Portman has been connected to the film.  Abbott also puts some academic muscle  into her work; shes published a non-fiction title called  The Street Was Mine: White Masculinity in Hardboiled Fiction and Film Noir. 5. Leslie Jamison   Essay collections are typically small releases, with little fanfare, but Jamisons collection,  The Empathy Exams,  has gotten the kind of press few writers published by small presses see. Her essays examine the pain of others and how it impacts the self; a memorable essay examines the difficulty of writing about female suffering and why we must do it anyway. Noteworthy and impactful. 6. Sarah MacLean   Shucking all of the damsel-in-distress tropes of historical romances, MacLean gives readers heroines that are feisty, rebellious, smart and as sexual as their heroes, particularly in her  The Rules of Scoundrels  series. And she doesnt resort to bizarre cliches when writing the naughty bits. Now thats a breath of fresh air for every romance lover.   7. Roxanne Gay    Its hard to believe that Gays novel, An Untamed State (out May 6th), is her debut, because her writing seems to be everywhere. Shes been published in  Virginia Quarterly Review,  The New York Times Book Review, The Los Angeles Times, The Rumpus, Salon, and so many more. But  An Untamed State  a story about a woman who is kidnapped in Haiti and held for ransom showcases her  startling narrative talent and marks her as one to watch.   8. Catherynne Valente   Best known for her YA Fairyland fantasy series, beginning with the novel  The Girl Who Circumnavigated Fairyland in a Ship of Her Own Making,  Valente has also won Hugo, Lamda Literary and  World Fantasy awards for her work.  She is also active and vocal in the male-centric Sci-Fi and Fantasy communities, and a huge proponant of the crowdfunding movement. In fact  The Girl Who Circumnavigated Fairyland  was the first crowdfunded novel to win a major literary award before traditional publication. 9. Helen Oyeyemi    Helen Oyeyemi is having a serious moment. Her novel  Boy, Snow, Bird  is on the surface  a retelling of the Snow White fairytale, and it is garnering rave reviews across and beyond the literary world. But Oyeyemis inventive and dazzling storytelling talent  is not just evident here. Having published  her first novel, The Icarus Girl, before she was 19, shes continued to prove shes a voice to be reckoned with, most recent with her  inclusion as  one of Grantas Best of Young  British Novelist in 2013. 10. Jennifer McMahon  McMahons supernatural thrillers are a genre unto themselves, with equal parts suspense and creepiness. Her latest,  The Winter People,  was published this February, to great acclaim. She also published a lesbian teen novel called  My Tiki Girl  in 2008 that was included in the ALAs Rainbow Reading list. What other great woman writers would you add to this list?

Business Information System - Types of Outsourcing Relationships Free Essay Example, 2000 words

The tie-up with Fan Li can be seen as a last measure for Tegan to help improve its poor sales lately. For starters, most of its toys are in the 50 range while the toys of Fan Li is only about a tenth or approximately 5 per item. This means profit margins are much lower and to help the company compensate for this lower margin, it must do a higher number of order transactions. This means a lower order size that was made up in the volume of transactions that will hopefully improve its revenues and thereby its profits as well. The toy industry is a low-margin industry which means profits per item are small. The firm needs to sell plenty of toys. As such, the accounts payable plays a significant part in the company's bottom line. As margins are low but turnovers high, Tegan must utilize its payment strategy with regards to its accounts payable to help boost profits by availing of supplier discounts with prompt payment. Industry practice allows for 1% to 2% for prompt payments but the o ther side of the coin is to make a payment only when it is due or when it becomes absolutely necessary without losing the payment discount. We will write a custom essay sample on Business Information System - Types of Outsourcing Relationships or any topic specifically for you Only $17.96 $11.86/page What is more is this is not yet the peak season and the system is already showing some signs of a breakdown with frequent re-boots, blocking of records and unexplained run-time errors. These events are clearly detrimental to the company's operations which are hinged on the founder's principles of integrity, honesty and speed. The accounting computer system had to be fixed early enough in time for the Christmas holiday season in December 2008 (ibid. 2) and fixed quickly.

Coach Carter Sports and Education - Free Essay Example

Sample details Pages: 3 Words: 843 Downloads: 2 Date added: 2019/10/10 Did you like this example? Teachers, coaches and parents have a role in guiding the young generation on how to carry on with their lives by insisting on what is best for them. Every teacher and parent wants to see students leading a successful and brighter future. As seen through Coach Carter, discipline is fundamental to the success of all students. Don’t waste time! Our writers will create an original "Coach Carter : Sports and Education" essay for you Create order This made him sign contract with students that they would only participate in sports if they can attain a mean grade of C, respect one another including their elders as well as putting on suits and ties on sports day. This was because there is a tendency of young people to neglecting what is expected of them like education for sports. Letting them to know what is expected of them as students and youth, thus, becomes a role of parents, coaches and teachers. These roles, however, diverge in that teachers and coaches play their roles at school while parents play their roles a home. This is because parents spend more time with their children at home while coaches and teachers spend more time with them at school. Coaches and teachers normally set goals in which they intend to achieve. This is as opposed to parents where most of them do not set goals for their children. Some of the parents send their children to school as a routine and never cares about their performance or discipline. This is because they spend a little time with them due to their busy schedules. The intersection of their roles appears through the techniques they use. These methods include encouragement, discouragement, teamwork, discipline and second chances are used by all. This is usually done by reminding these young people of their skills and capabilities with the aim of motivating them. At the same time motivation is also done by discouragement on what they are not capable of, and what is not expected of them. Education should come first before sports. Therefore, education is better than sporting activities for a young person if both are not well balanced. One can have a brighter future with education while in sports, even when one becomes successful; he still needs education for them to make sound judgements in life. A sport without education is not healthy at all. One may earn so much through sports but fails to manage their finances due to lack of education. Education enables one to know what is important for them at a certain time. For example, young people if they do not acquire the right guidance through education, they may fail to invest and end up spending their income lavishly. Insisting of education for them was important as different individuals have different skills in life. One may think he will do well in sports hence neglecting education, but latter come to realise that sports are not for them when is too late. As a student, education should be the priority. Sports are mainl y known as the extra curriculum activities. Class work is hence given the priority. Coach Cater having closed the gym due to the poor performance of the students who participated in basketball, parents become some furious as one claimed that the sporting activity had become the motivation for his son at school hence improving well in education. This made Cater concede to the wishes of the parents and school as well to reopen the gym. This was important as sports help students to open up their mind and perform better in class. However, the terms of the contract were to remain so as to cultivate respect and discipline from the students. The coach had even at the beginning received a blow from one of the students due to indiscipline. The student had to fall out of the practice together with a few who ended joining the gang in the community. Those who followed instructions from the coach were said to improve in class and in the long run started appreciating the terms of the contract. Another reason as to why the coach had to reopen the gym was due to his initial objecti ve that was changing the Richmond community through discipline. In my thoughts, both education and sports should be taken seriously. They are as important as each other. A student who participates in sports has a higher chance of performing better in class than those who do not. Sports help in opening up their mind as well as breaking the monotony of education. It thus serves as a motivating factor as to why students attend schools. Again, sports should not take much of the time for a student as education is the major reason as to why parents take their children to school. Education without sports is dull, and hence whether a contract is made between students or not, sports should be part of student’s life at school. Parents should as well create time to be with their children and try to guide them on what is important and expected of them as students. Setting goals together will help the students work towards achieving them.

Foundations of Leadership Free Essays

Foundations of Leadership Free Essays This paper examines foundations of leadership and the role behavior plays in leadership. Behavior defines a person’s ability to communicate and form active and powerful relationships within the organizational structure. Behavior influences how a leader will sustain communication to their team members and defines their strategy for leadership. We will write a custom essay sample on Foundations of Leadership or any similar topic only for you Order Now This influences their ability to motivate, build powerful teams and adjust to organizational conflict and change. One role model of effective leadership would Bill Clinton. This paper looks at not only organizational examples of leadership but also the political role model of president to aid in defining foundations for leadership. This paper examines how proactive leadership can be applied to the organizational structure and outcomes or implications result. In today’s business world, it is important to address how change agents influence the workplace and how leaders address such issues. In today’s marketplace, the pressure to succeed is intense. Never before has a company’s efficiency and profitability been so closely measured and studied. Without powerful, active leadership and a well-tuned team in place to motivate and encourage teamwork, a company is doomed to fail. This paper will explore key elements that build a foundation for leadership. See, sometimes what is not completely understood is that leadership involves so many other attributes found in a person. Two main attributes discussed in this paper is the ability to effectively communicate and display emotional intelligence. This brings into focus other skills needed to manage the day to day conflict and corporate environment of today’s changing business world. Not only is leadership a key to success and a reflection of the organization’s cultural values but it is group of skills needed. These skills include areas of expertise such as communication, motivation, and team building skills. In order for an organization to carry on success, it must turn to role models in the community for inspiration. Rather these role models be present within the culture is important but inherently, people will look around them to leadership already within the framework. This means looking to American culture for such leadership models. It can be continuously debated rather or not the most important leader in the world is effective. This person falls under tremendous scrutiny and accountability. The President of the United States must lead by example and be active in their leadership but one aspect of leadership that must be understood is that people are human and they err in the human way, nor are they perfect. As a role model, this paper will not only look at organizational examples of effective leadership skills but also examine the leadership of Bill Clinton. A key to the foundation for leadership is effective communication and one’s ability to behave intelligently. It can be easy to confuse the two concepts of management and leadership on an organizational level. George S. Odiorne (1987) writes, â€Å"one of the more popular definitions of management is that it consists of getting results through other people† (p. 13). In today’s company, the role of management also involves leadership within a team structure. Managers have the responsibility to set goals, maintain moral, aid in training and communicating corporate objectives. A good leader provides vision and clarity for the employee. Such a leader will be able to communicate and create a rapport with their team. This connection begins at a fundamental level of human sociology where the use of story is central. Howard Gardner (1995) reflects, â€Å"the ultimate impact of the leader depends most significantly on the particular story that he or she relates or embodies, and the receptions to that story on the part of the audiences† (p. 14). By telling stories, allows for a certain level of openness or vulnerability on the part of the leader and makes them human. By opening the line of communication, gives the employee knowledge of their environment and develops trust. The leader’s role is to sell the idea of commitment within a culture. Odiorne (1987) suggests, â€Å"if employees know what is expected, and what help and resources are available, they can then be relied upon to govern their actions to achieve the commitments they have made† (p. 138). This sets the stage for goals and achieving high performance. The culture in turn feeds off this energy and excitement. There are three reasons why leaders are important. First they are responsible for the effectiveness of organizations. Second, the change and upheaval of past years has left us with no place to hide. We need anchors in our lives as a guiding purpose. Third, there is a national concern about integrity of our institutions. Being mindful of own context is difficult for us. (p. 15-16) Managers with a keen understanding of leading represent these three key attributes and create a foundation from which to act. A leader must also display curiosity and have the guts to be daring. They must be a dominant force within the team. Bennis (1989) reflects, there are two kinds of people â€Å"those who are paralyzed by fear, and those who are afraid but go ahead away. Life is not about limitation but options† (p. 185). In the book Primal Leadership, authors David Goleman, Richard Boyatzis, and Annie McKee (2001) present their research on leadership styles within the organizational structure. The research discusses the relationship that these executives have with their emotional intelligence. Emotional intelligence is the study of emotions and their impact upon the work environment. The research investigates the different leadership styles evident in most organizations today. Mainly, leaders are categorized as either having the visionary, coaching, affiliative, democratic, pacesetting, or commanding leadership styles. Emotional Intelligence relies upon the fact the leader will be able to have a competent level of interaction with the employee by changing leadership styles and adapting to each unique situation throughout the time at work. It reflects successful leadership by allowing for complex relationships for team members by recognizing relationship building, capacity of visions and personal development. Emotional Intelligence for a leader means being able to read people, be read and allow for open dialogue or communication. Research stresses the importance of the leader’s flexibility and capability to adapt to his or her environment. An effective leader will understand not only their environment and people but also understand the potential for impact upon that environment. By understanding this key element, an effective leader will know how to define the environment. This is important because employees look to management for guidance. The leader defines the boundaries for the team and creates an atmosphere for building relationships and open communication. This in turn creates stronger teams. Any time people are brought together, behavior both positive and negative can occur. According to the American Heritage College Dictionary (1997), behavior is: â€Å"the manner in which one behaves or the actions or reactions of persons or things in response to external or internal stimuli. † Upon further investigating the verb form also in the American Heritage College Dictionary, the word ‘behave’ means â€Å"to conduct (oneself) in a specified way† or â€Å"to act† (p. 123). It is human nature to behave in a certain manner while existing in society. Over a period of time, we react differently to events that happen. How we respond to those events is essentially our behavior. How we communicate with one another is how we express behavior. Organizational Behavior focuses on the study of behavior within the organizational construct. This field of study concentrates on how an individual, group and structure affects the behavior within the organization. Therefore, this has direct bearing on communication as information is vital to learning within the organization. It is important for an organization to learn from its mistakes as this information enhances the organizations’ performance. This information when communicated can bring about change and growth within the organization’s functions and policies. Motivation can be a complex issue for a leader to communicate when managing a team of different personalities. One key to success is having an understanding of people and the many different things that motivate people, influencing their behaviors while performing a task therefore, influencing communication. A good leader will work to understand what motivates each individual on the team in an effort to improve communications. Still this brings up the issue of needs and how to get them met by the situation. Maslow’s Theory of Needs, suggests that individuals have a range of needs and will be motivated to fulfill whichever is the greatest need at that moment in time. In this construct, there are lower-order and higher-order needs. The lower-order needs are dominant until they are at least partially satisfied. Maslow predicted a normal person will turn their attention to higher-order needs once the lower ones were taken care of (Motivation 2005, par. 3). Lower-order needs include items like making a living for food and shelter while higher-order needs are more in tune with personality such as esteem and worth. A team leader will understand how his or her team members perceive themselves within the team and what needs are important to each member. This will aid the leader in knowing how to approach each individual and how to effectively discuss the every day team happenings. By understanding motivation, a leader can also understand which methods of communication work best for each employee. In this way, the leader can adapt his or her tone and body language to better convey the point. By knowing what motivates people, the leader can effectively communicate incentives to the team to boost their morale. This will lead to them offering the team ways to make work interesting and challenging while encouraging members to take ownership of tasks. This encourages the pursuit of goals. Once an employee is acknowledged, a higher level of pride and respect is achieved. This inspires them to take advantage of new learning opportunities and lead within the team. It is also important for the leader to give regular praise and positive feedback when the standard of work is high. On the other hand, it is also important for the leader to offer support during times of struggle and conflict in order to decrease the influence of stress. For managers who actively keep and open dialogue are putting their people first. They are more focused on nurturing and training. Research suggests leaders are more interested in mentoring and training their team rather than focusing on output of numbers or turn around time. This once again acts a mini-strategy to manage communication within the team. This development in team building allows for â€Å"providing people opportunities to learn from their work rather than taking them away from their work to learn† (Hughes, 2004, p. 4). A healthy culture inspires options and the innovations that grow out of creativity. Another issue when creating an intimate team experience is building trust. In an example, the South African Breweries, plc or SAB found itself needing to create trust in a post Apartheid era where racism was still very much causing conflict and lack of communication among workers. As part of implementing an integrated management process, the organization carried out workshops to target its 6,000 employees. These workshops encouraged open discussion about South Africa’s past, Apartheid’s influence and how shared values increased a sense of workplace community (Supporting workplace learning for high performance working, p. ). The President of the United States has a tremendous pressure on his shoulders as he represents our country to the world. The President can be considered the most powerful man in the world. Is he a good leader, effective in his communication, motivation, team orientation skills? Does he understand the needs of the people and actively lead on this premise of continually making the country a better place or is he a puppet acting out the agenda of his political party? From this standpoint, the United States government can be seen as the ultimate organization with the President as the CEO. Within this structure, is the foundation of leadership present or is the term just used to clean up past mistakes and create new policies only to be changed by future leaders? In this respect, it can be difficult to separate the human from the leader while in public view. He will be analyzed from every angle. From an Organizational Behavior standpoint, it is only logical to believe how one conducts his personal life also reflects his business integrity. Many would argue because of President Clinton’s indiscretions that he was a poor leader. He lied and therefore, that changes the public view of him and the level of trust that can be instilled in him. This indiscretion calls his accountability into question or does it? In order to examine Clinton’s leadership ability and skills, one must have a handle on their own Emotional Intelligence and be able to separate his business practices from his moral decision of his personal life. There is a reason the business world leaves the personal life at the door; there is a job to be done. Leon Panetta (2001) reflects, â€Å"Clinton is a paradox. He can be described as brilliant, dedicated, slick and dishonest† (p. ). Liberals claim he was passionate about the issues and succeeded in changing many policies concerning civil rights, education, the environment, medical ethics and women’s rights. Conservatives liked him because he was able to balance the federal budget, fight for free trade like NAFTA and create tough crime programs. Still does addressing these issues make him an effective leader? Panetta (2001) explains, â€Å"to get a better measure of the man and his presidency, it helps to look at him, both accomplishments and failures. Only then can we understand Bill Clinton, the leader† (p. ) Discussion, Application and Implications The issue of ethics raises another concern for Organizational Behavior and how one conducts themselves within the construct. Communication can lead to misunderstanding but so does lack of action. Sometimes it is not evident that taking action could have changed the outcome. What is important to an organization is that they follow through with every possibility. This is where employees pick up on non-verbal communications from management. If a leader appears not to be concerned, then more than likely the team members will not be either. Internal cues, both verbal and non-verbal are extremely important to not only success but just day-to-day functioning. First leadership must be put in place then a change of policy can be put into place. There must be consistent with the chain of command where both the product and the use of the product are concerned. Everyone must have the same perception of the organization’s objective. By having a trusting, open door policy with people creates an atmosphere of safety where communication can take place. Also another idea is to have a program of due diligence where people back each other up and support each other through periods of conflict. This will enable teams to have not just one chain but multiple chains of communications where information is double-checked and triple checked before put into use. This will ensure that any new issues or mistakes are found and addressed before they are put into real-world situations. This can also lead to teams thinking outside the box to create new innovative ideas to fix the problems. By building this type of culture, allows the organization to maintain a high level of integrity with the public but to also remain competitive within the market. The implications of doing business in today’s world means constantly being open-minded and remaining comfortable knowing that not every day is same. Some people cannot work in such conditions. As Stephen Robbins (2001) comments, â€Å"As humans, we are creatures of habit. Changes substitute ambiguity and uncertainty for the known† (p. 546). People, by human nature, inherently resist change. Management may find older employees are more loyal but have a harder time embracing new ideas like the Internet because they remember the old days. This resistance to change can result in conflict but it also creates opportunities for innovation. The practice of innovation also begins with embracing or adopting the unexpected. Peter Drucker (1998) describes, â€Å"unexpected successes and failures are such productive sources of innovation opportunities because most business dismiss them, disregard them, and even resent them† (p. 3) and this type of behavior represents people’s resistance to change but at the same time creates recognition of new opportunities within the market. Change in the global market, including multicultural demographics and new technologies, has required perceptions to change. The attitude toward knowledge has evolved because more than one type is needed in order to implement a new idea. This changes the needs of workers and organizations as diffusion of innovation takes place as many different points of view are considered. This adds value as it spawns creative thinking but it must also fall within economic reality. It is important to carry out a detailed implementation but also to remain on budget and schedule. The concept of innovation brings up other implications, however. It produces a whole new reality that employees may not be prepared to handle. Product diversification could mean failure. Technology, while it is wondrous and makes jobs easier, can also be dangerous. With telecommunications, a new breed of crime has been created with identity theft and corporate brand protection becoming important. Technology can be disastrous if put in the wrong hands. Antibiotics used to cure infections have saved numerous lives while there is a continued threat of biological weapons of mass destruction. With innovations come new inventions that make our lives easier but also have a higher risk when used. This is the nature of the realm of possibility. This can backfire as it can also destroy and impose new rules of conduct upon communities. As much as many like the idea of innovation, for those scared of change, it is difficult o embrace fully. This means as change rapidly flourishes out of control, those resistant aim to gain control of laws and rules to make change more difficult. This leads to Big Brother watching every public move and return to conservative leadership. One can look to the events of recent months to see the value of Bill Clinton’s leadership. He has not retreated from the limelight but instead applied his passion and hope for people in his daily life of action by carrying on his role as a leader. Rather it be his participation in aiding Tsunami victims or right here at home, recent victims of Katrina, he continues his objective of serving the people of the United States. This communicates to us that he cares. Panetta (2001) reflects. â€Å"only in crisis is a president fully tested as to what part of his character will prevail† (p. 6). He may have failed many times but he also used failure as a positive means to evolve as a better man and leader for today’s people and their needs. His ability to reach the every day man still defines his leadership power. This paper explored key elements that build a foundation for leadership. Two main attributes discussed in this paper is the ability to effectively communicate and display emotional intelligence. This brings into focus other skills needed to manage the day to day conflict and corporate environment of today’s changing business world. Not only is leadership a key to success and a reflection of the organization’s cultural values but it is group of skills needed. This paper also discussed how leadership skills have implications and define the work environment for employees. It discussed how leaders must be mindful of change agents and possible outcomes due to innovation and new technologies available. In this respect, the workplace is constantly evolving and without leadership as a framework, the organization would be motivated or able to communicate and teams would dissolve. In order for an organization to carry on success, it must turn to role models in the community for inspiration. Rather these role models be present within the culture is important but inherently, people will look around them to leadership already within the framework. This means looking to American culture for such leadership models. It can be continuously debated rather or not the most important leader in the world is effective. This person falls under tremendous scrutiny and accountability. The President of the United States must lead by example and be active in their leadership but one aspect of leadership that must be understood is that people are human and they err in the human way, nor are they perfect. As a role model, this paper looked at organizational examples of effective leadership skills but also examined the leadership of Bill Clinton. It is important in leadership to embrace change and stick to a vision. By having Emotional Intelligence one can â€Å"recogise the physical and mental signs of our feelings/emotions before we can act on them meaningfully and constructively† (Eby Ruin par. 20). It is by recognizing these attributes that one can build an effective team structure. A leader acts as a coach to not only reinforce the game plan with directions but also encourage creativity, new ideas and acquiring new skills. Foundations for Leadership include: effective communication, motivation and team building. In order to better understand leadership, we must look for role models within the organization but also outside to society. The President of the United States can be considered the ultimate definition of leadership but can he live up to the standard? This allows an organization to build a value system where the foundations of leadership are prized and seen as tools for success. And in order to survive in the business world, leadership and its foundations must be valued by the organization. How to cite Foundations of Leadership, Essay examples

Co-trimoxazole Prophylaxis and Antiretroviral Therapy

Question: To investigate if the wider use of co-trimoxazole prophylaxis and antiretroviral therapy can substantially reduce the morbidity of malaria in HIV/AIDS infected adults in sub-Saharan African region. Answer: Chapter 1: Introduction It has become obvious that the resource-deprived regions of the world, particularly the developing countries like Sub-Saharan Africa carries the burden of the Human Immunodeficiency Virus (HIV) (Lau Muula, 2004). Additionally, the possible pathophysiological interactions between HIV and tropical pathogens like Plasmodium falciparum raising the serious concern for healthcare providers (Alemu et al., 2013). Plasmodium falciparum is the major species responsible for 85% of malaria cases (WHO, 2015). Previous researches provide sufficient evidences claiming the higher prevalence of malaria among HIV patients in the region. The malarial incidence in AIDS patients is inversely correlated with the CD4 cell count (Van geertruyden, 2014; Idemyor., 2015). The use of co-trimoxazole prophylaxis is currently recommended to prevent the opportunistic infections like Toxoplasmosis and Pneumocystis in adults living with HIV/AIDS (WHO, 2015). Some studies showed the importance of co-trimoxazole prophylaxis along with the ART to decrease the prevalence of malaria in HIV-infected adults. So, it has become the point of interest to investigate the effectiveness of co-trimoxazole and ART in incidence of malaria in HIV-infected adults of Sub-Saharan Africa (Lawn et al., 2008; Harouna., 2015). Aim and Objectives The research paper aims to investigate whether the antiretroviral treatment (ART) and co-trimoxazole prophylaxis reduces the morbidity of malaria in adults infected with HIV/AIDS in the sub-Saharan Africa. The following are the identified objectives to guide the question. To investigate if co-trimoxazole prophylaxes decrease the prevalence of malaria in HIV/AIDS infected adults. To investigate if the wider usage of co-trimoxazole prophylaxis and ARVs therapy substantially reduce the morbidity from malaria in HIV infected patients. To investigate if the clinical interventions in the treatment of malaria in adults with HIV/AIDS reduce the morbidity and mortality rates from adults suffering from malaria and infected with HIV/AIDS. This chapter discusses the framework of the study by focusing on the background to the problem as well as purpose and objectives of the study. This chapter highlights the importance of the study and assumptions held by the researcher. Chapter 2 will focus on the review of related literature. Chapter 2: Literature review According to Bhatt et al., (2015) annually about 0.7 to 2.7 million people die from malaria, and more than 60% of them are from Sub-Saharan African countries. At such dreadful rate, the mortality will be estimated to get doubled by 2020, if effective control measures are not employed. Clinical manifestations of malaria mainly impair the cognitive functions and behaviour and produce a huge loss of resources in both tangible and intangibles form to the society (Ceesay et al., 2015). The link between malaria and HIV/AIDS According to Fehintola et al., (2016), the incidence of malaria and HIV/AIDS is very high in geographic regions like sub-tropical and tropical districts of the world, especially in sub-Saharan Africa. Both of the diseases mainly affect the poorest sections of the population, which might be more helpless against the disease because of rare healthcare facilities, knowledge etc (Achan et al., 2012). Ezeamama et al., (2014) reported that geographical overlapping of HIV and malaria is creating a serious mess for the government and healthcare agencies. Vamvaka et al., (2015) reported that HIV infection causes progressive cellular immunosuppression which is associated with the failure to prevent any infection. Furthermore, Kublin Steketee (2015) argue that in spite of the fact that malaria can increase the viral replication in the short term; the main concern is that the increment connected with malaria in viral replication could speed up the HIV/AIDS progression. Morbidity of Malaria in adults infected with HIV/AIDS in sub-Saharan Africa According to Zaba et al., (2013) the HIV/AIDS and malaria are two of the most important health problems in the world today. Both malaria and HIV/AIDS causes more than 4 million deaths a year, especially in children and young adults. Clinical Interventions in the treatment of Malaria in Adults with HIV/AIDS Malaria can be prevented by taking various precautions like avoiding the growth of larvae, cleanliness etc. It is entirely treatable disease with lot of treatment options. The use of anti-malarial medicines is highly recommended for HIV/AIDS infected adults with malaria (WHO, 2016). HIV/AIDS and malaria are common infections in Africa, and cause substantial morbidity and mortality and yet co-trimoxazole prophylaxis is a readily available, effective intervention for people with HIV infection in Africa and the world at large (Mermin et al., 2014). Parikh et al., (2013) reported that by prescribing the right drug at appropriate dose the risk of mortalities can be minimized. The prescription of non effective dosage or sub-therapeutic dose may cause recurrence of the infection. It may also lead to the rise in drug resistance. Adherence of the patient with prescription or drug regime can helps in effective treatment and diminishes the rate of mortality (Van geertruyden, 2014). A joint United Nations programme on HIV/AIDS recommended that all infected adults should be treated with Co-trimoxazole as it reduces the morbidity irrespective of any clinical disease stage or CD4 cell count (UNAIDS, 2011, Gupta et al., 2014). Drawing from the discussion given above, it can be assumed that the morbidity of malaria in HIV/AIDS cases is a growing concern not only in poor regions of the sub Saharan Africa but worldwide, hence the use of anti malaria medicines is highly recommended. The next chapter describes the research methodology and the research design that was employed in the study. Chapter 3: Methodology Research strategy The research strategy in this dissertation was to conduct a systematic literature review of contemporary evidence (within a time frame) to explore the role of clinical intervention. The review of secondary data in systematic review widely establishes the research strategy in healthcare and medicine (Taylor, Bogdan DeVault, 2015). The literature search strategy had three stages which included the electronic search, manual search and tracking references. The electronic search was done using the following search engines: Pub Med, Cinahl, Medline, Google Scholar, Psycho- Info and Kings Fund (Table 1) to ensure the full coverage of relevant published data. Search words The search used Pub Med, Embase, Cochrane Central Register of Controlled Trials and the International Standard Randomized Controlled trials using PICO research framework for the following terms: Co-trimoxazole, Anti-retroviral therapy, HIV/AIDS, Malaria and Sub-Saharan Africa (Table 1). These keywords were applied in different combinations to specify the outcome of every search. The present study was limited to the time frame of January, 2004 to June, 2016. Table 1: Search terms and health databases sources Search words Method Resources Infected HIV/AIDS All of the Keywords were used in different combinations on each database Pub Med Co-trimoxazole prophylaxis Cinahl Anti- retroviral therapy Medline Sub SaharanAfrica Embase Malaria Google scholar Morbidity Pyschos Fund Inclusion/Exclusion criteria The initial search of selected databases provided a large number of articles, however, a closer analysis of their title and abstract revelled that many of those articles were too broad or not fully relevant to the research objectives. The following inclusion and exclusion criteria have used in present study to select the relevant studies (Table 2). Table 2: Inclusion and exclusion criteria of the study Criteria of Inclusion Criteria of Exclusion All research studies discussing the ART and co-trimoxazole prophylaxis in lowering the morbidity of malaria in adults infected with HIV/AIDS. All studies irrelevant to the research topic. Latest publications (From Jan, 2004 to June, 2016) Older publications to rule out the repetitions. Authentic resources like peer review papers and books All sort of literature which is not credible will not be included. Studies published in English Studies in any other language will not be included. Articles from other credible sources that talk of implementations, barriers and compliance of the anti malaria regimes. Studies involving children The next chapter will focus on the data presentation, data analysis and interpretation in relation to the objectives outlined in chapter 1. Chapter 4: Results, data presentation, analysis and interpretation. This chapter focuses on the presentation, analysis and interpretation of the data reviewed from the articles selected. The main focus of this chapter is to present the findings in detail. It is important to reflect on the purpose of the study which is to investigate if the wider use of co-trimoxazole prophylaxis and antiretroviral therapy can substantially reduce the morbidity of malaria in HIV/AIDS infected adults in sub-Saharan African region. Results As per the inclusion and exclusion criteria, the number of paper relevant to our study is mentioned in Table 3 and Table 4. Table 3: Number of paper on various databases Resource Number of paper Pub Med 385 Cinahl Plus 831 Google scholar 331 Cochrane 37 On narrowing the research with time frame, a total of 90 papers were selected. On close examination of these articles, it has been observed that most of the articles did not meet the inclusion criteria as they were studies carried for other age groups (children and pregnant women with HIV/AIDS) and were not relevant to the research topic and so about 31 articles (Table 4) were selected and eventually 6 were identified for the review project (Table 5). The selected articles were analysed using the CASP appraisal tool which is a principle tool to review academic articles. This article review tool provides various parameters and yardsticks on the basis of which a reviewer can analyse and assess the various strength and weaknesses of a scholarly work. A CASP is a ten question guide retrieved from the internet (Google) as a Critical Appraisal skills programme. Table 4: Number of relevant papers selected Within the last 10 years Database Searched: Pub Med Database Searched: Cinahl Database Searched: e.g. Google scholar Database; Cochrane Total Total after limits applied 3 11 12 5 31 Table 5: Studies selected for systematic review Anglaret X Eholie S (2008) Prophylaxis with co-trimoxazole for HIV infected adults in Africa. BMJ. 337. A304. Harries A. D,Lawn S.D,Suthar A. B,Granich R, (2015) Benefits of combined preventive therapy with co-trimoxazole and isoniazid in adults living with HIV: time to consider a fixed-dose, single tablet co formulation.Lancet Infect Dis.1492-1496. Mermin J.Lule J.Ekwaru J.P,Malamba S,Downing R,Ransom R,Kaharuza F,Culver D,Kizito F,Bunnell R,Kigozi A,Nakanjako D,Wafula W,Quick R, Lancet, (2006) Effect of co-trimoxazole prophylaxis, antiretroviral therapy, and insecticide-treated bednets on the frequency of malaria in HIV-1-infected adults in Uganda: a prospective cohort study. Lancet. 367 (9518). p. 1256-61. Mermin J,Lule J,Ekwaru J.P,Malamba S,Downing R,Ransom R,Kaharuza F,Culver D,Kizito F,Bunnell R,Kigozi A,Nakanjako D,Wafula W,Quick R, (2004) Effect of co-trimoxazole prophylaxis on morbidity, mortality, CD4-cell count, and viral load in HIV infection in rural Uganda. Lancet. 364 (9443). p. 1428-34. Nunn A.J,Mwamba P.B,Chintu C,Crook A.M,Darbyshire J.H,Ahmed Y,Zumla A.I, (2011) Randomised, placebo-controlled trial to evaluate co-trimoxazole to reduce mortality and morbidity in HIV-infected post-natal women in Zambia (TOPAZ). Trop Med Int Health. 16 (4). p. 518-26. Walker A.S,Ford D,Gilks CF,Munderi P,Ssali F,Reid A,Katabira E,Grosskurth H,Mugyenyi P,Hakim J,Darbyshire J.H,Gibb D.M,Babiker A.G, (2010) Daily co-trimoxazole prophylaxis in severely immunosuppressed HIV-infected adults in Africa started on combination antiretroviral therapy: an observational analysis of the DART cohort. Lancet. 375 (9722). p. 1278-86. Anglaret Eholie (2008) reported the effectiveness of co-trimoxazole in the adult HIV infection treatment in peculiar cases where resistance of bacteria is extremely high. The study further concluded that the medication lessens the mortality in HIV patients in situations where resistance of bacteria might be high. Walker et al, (2010) reported that in Sub-Saharan Africa, mortality from HIV infection (untreated) can be reduced with proper clinical treatment of Co-trimoxazole prophylaxis, however, there is little evidence about the antiretroviral combination therapy, hence Walker et al, (2010) found it important to explore the effectiveness of a combination of antiretroviral therapy (ART) in adults. Furthermore, Walker et al., postulated that reinforcement of standard guidelines of WHO required for co-trimoxazole prophylaxis provision for all adults starting combination ART for at least 72 weeks in sub-Saharan Africa. Mermin et al., (2004) in this article has briefly but explicitly stated the context and purpose of this article, that the sub-Saharan Africa is a part of the world where bacterial resistance is reported to be extremely high in reported cases of co-trimoxazole. This is very much aligned to the title of the article. The aim of the researchers in this work was to assess effects of co-trimoxazole prophylaxis on mortality, morbidity, viral load and CD4-cell count among HIV infected patients in the sub-Saharan rural Uganda. The research purpose is highly rationalised by the arguments of Mermin et al (2004), regarding the high prevalence of bacterial resistance in the area. Mermin et al, (2004) found that proper clinical intervention with co-trimoxazole prophylaxis (daily dosage) was clearly and strongly linked with abridged mortality and morbidity and it also has valuable effects on viral load and CD4-cell count. Mermin et al, (2006), in describing the context and background of malaria and HIV-1, says that they are very common infections and cause considerable mortality and morbidity in Africa. With an increased incidence of malaria, and more severe diseases, HIV infection has been related. In this article Mermin et al, (2006) found that insecticide-treated bed nets and antiretroviral in combination of co-trimoxazole therapy, reduced the malaria frequency substantially in HIV affected adults. Nunn et al, (2011) have described the role of antibacterial prophylaxis (prophylactic trimethoprim-sulphamethoxazole), in dropping mortality and morbidity in post-natal women in southern Africa (sub-Saharan region). In this study, female HIV patients participants (cotton arm) were given a clinical intervention of daily co-trimoxazole of coordinated placebo in selected facilities at a teaching hospital in Zambia. Nunn et al, (2011), concluded that there was no evidence with poor follow-up rate that hospital admission or mortality or rates are reduced by co-trimoxazole prophylaxis, although in the cotton arm, fewer symptoms were reported hence its a well-tolerated and safe option. Harries et al., (2015) in this article has concluded that along with pyridoxine (vitamin B6), isoniazid and co-trimoxazole ought to be mixed into a single pill and given in fixed-dose to mitigate morbidity as a clinical intervention in reducing the morbidity of malaria in adults infected with HIV/AIDS. This chapter has focused on data presentation, analysis and interpretation in relation to the identified objectives. The main findings will be discussed in chapter 5. Chapter 5: Discussion Introduction This chapter focuses on explaining of the key findings of the study. Chapter 4 had presented the findings of the reviewed literature. This chapter will critically appraise the strength and limitations of the study. The broad purpose of the systematic review was to verify the effectiveness of clinical intervention of co-trimoxazole prophylaxis and antiretroviral therapy to substantially reduce the morbidity of malaria in HIV/AIDS infected adults in sub-Saharan region. Evidences described the effectiveness of clinical intervention of co-trimoxazole prophylaxis and antiretroviral therapy towards the reduction of malaria morbidity in HIV/AIDS infected adults. The objectives of the study were: To investigate if co-trimoxazole prophylaxes decrease the prevalence of malaria in HIV/AIDS infected adults. Mermin et al, (2006) found that insecticide-treated bed nets and antiretroviral in combination of co-trimoxazole therapy, reduced the malaria frequency substantially in HIV affected adults. All the other six articles were in agreement with the findings that co-trimoxazole prophylaxes decrease the prevalence of malaria in HIV/AIDS infected adults. Nunn et al, (2011), presented the findings showing that in the combined events, the results between the two treatment arms had no significant differences, over a range of symptoms but a decrease in morbidity was found. Some evidence found showed abridged mortality rate in peculiar cases. Hence, the results showed a lot of variability in the prevalence rates of adherence / non-adherence to treatment. Amongst the factors contributing to treatment adherence, the authors have highlighted greater understanding of the disease, severity of symptoms, dose gratuity of drugs, use of pictorial on the packaging of the antimalarials, and good guidance of health professionals in relation to drug and its effects. In relation to non-adherence to treatment, the following factors were also highlighted: forgetfulness, symptom improvement, inaccessibility, side effects of antimalarial, and lack of guidance and/or incorrect guidance on drugs made by the health professional. Walker et al, (2010) extensively made use of various previous studies and concluded that in the sub- Saharan region, malaria prevalence in HIV/AIDS adults can be substantially reduced with proper clinical treatment of co-trimoxazole prophylaxis although he differed in opinion on the effect of combined co trimoxazole and antiretroviral therapy (ART). In all six articles, the authors are in agreement that the use of co trimoxazole prophylaxis in the treatment of malaria in HIV/AIDS infected adults, may reduce the prevalence, in the African region. Yet, there is still a grey area to whether a combined usage of co-trimoxazole and ART is effective in reducing morbidity and mortality rates. Also, the issue of non-adherence to treatment is repeatedly mentioned by Nunn et al, (2011) and Walker et al (2010), thus leading the author to present it as the major recommendations for improvement. To investigate if the wider usage of co-trimoxazole prophylaxis and ARVs therapy substantially reduce the morbidity from malaria in HIV infected patients. From the literature reviewed, it can be concluded that the clinical interventions and the effect of antiretroviral treatment (ART) and co-trimoxazole prophylaxis certainly reduce the morbidity of malaria in adults infected with HIV/AIDS in the African continent (Harries et al, 2015). ART is the intervention, needed for reducing the morbidity and mortality rates in adult HIV patients, although, in poor, resource-limited and undeveloped areas, ART is reported sluggishly to have an effect with considerable early mortality and morbidity rates (Harries et al, 2015). Mermin et al, (2004) found at the end of the study that proper clinical intervention with co-trimoxazole prophylaxis (daily dosage) was clearly and strongly linked with abridged mortality and morbidity and it also has valuable effects on viral load and CD4-cell count. Mermin et al, (2006) brought up the comparison that insecticide- treated bed nets and antiretroviral in combination of co-trimoxazole therapy reduced morbidity i n HIV/AIDS infected adults with malaria. Walker et al, (2010) extensively made use of various previous studies and concluded that in Africa, malaria prevalence in HIV/AIDS adults can be substantially reduced with proper clinical treatment of co-trimoxazole prophylaxis although he differed in opinion on the effect of the combined co trimoxazole and antiretroviral therapy (ART), thus creating room for further studies of the grey area. Anglaret X Eholie S (2008) et al, (2008), concluded that the wider usage of co-trimoxazole prophylaxis reduce morbidity amongst HIV/AIDS adults infected with malaria, even in situations where resistance of bacteria might be high. Generally all the six authors agreed that wider usage of co-trimoxazole prophylaxis and ARVs therapy substantially reduce the morbidity from malaria in HIV infected patients. Walker et al (2010) differed in opinion on the effect of the combined co-trimoxazole and antiretroviral therapy (ART), thus it creates yet another grey area for further studies. To investigate if the clinical interventions in the treatment of malaria in adults with HIV/AIDS reduce the morbidity and mortality rates from adults suffering from malaria and infected with HIV/AIDS. All the six authors of the reviewed literature agree with the findings that clinical interventions in the treatment of malaria in adults with HIV/AIDS reduce the morbidity and mortality rates of malaria in HIV infected patients. Harries et al, (2015) concluded that along with pyridoxine (vitamin B6), isoniazid and co-trimoxazole ought to be mixed into a single pill and given in fixed-dose to mitigate morbidity as a clinical intervention in reducing the morbidity of malaria in adults infected with HIV/AIDS. Walker et al (2010) has concluded to reinforce and challenge the standard guidelines for World Health Organisation (WHO) and offered robust incentive for co-trimoxazole prophylaxis provision for all adults starting a combination ART for at least 72 weeks in sub-Saharan Africa. Mermin et al, (2004) strongly linked proper clinical intervention of co trimoxazole prophylaxis to an abridged mortality and morbidity rates in adults infected with HIV/AIDS and suffering from the chronic malaria. The results by Mermin et al, (2004) are very critical for this systematic review, as substantial evidence established the high effectiveness of clinical intervention in reducing the morbidity and mortality rates of malaria in adults infected with HIV/AIDS in the Sub Saharan Africa. All authors appear to be saying the same message that compliance to the clinical intervention of the treatment of malaria in adults with HIV/AIDS reduces the morbidity and mortality rates. One weakness identified by the authors is the non compliance by patients to clinical intervention which may have affected the results and outcome of most studies done to date, Harries et al, (2015). Compliance to medication and close monitoring by the HIV/AIDS team is important in order to get the best results of clinical interventions in the treatment of malaria and HIV/AIDS. In the studies analysed above they have cross- examined the effect of clinical interventions and the use of ARV therapy in the treatment of malaria in adults with HIV/AIDS and have concluded that clinical interventions reduce the morbidity from malaria in HIV infected adults. Models of public health As a public health practitioner, its important to offer sound advice and up to date information based on current evidence in order to educate patients falling into this category globally on how clinical interventions of co-trimoxazole prophylaxis and the use of ARV therapy is effective in the treatment of malaria in adults with HIV/AIDS. Three public health theories which focus on community drug non-compliance and useful to behaviour change in this project have been identified. According to the US Centres for Disease Control and Prevention of Chronic Disease and Health Promotion (2002) the following models have been identified; The Health Belief model For men and women to adopt the recommended physical activity behaviour, there is need to educate them on the importance of compliance to treatment so that their perception of the threat of malaria within an HIV/AIDS infected patient outweigh their perceived barriers to action. A nurse manager of HIV/AIDS infection is recommended to take charge of this activity Bethesda (1995). The Health Belief model will be effective to apply to adults infected with HIV/AIDS to adopt recommended physical activity behaviours being monitored by the nurse manager of HIV infection. The Information Processing model The model has an impact through persuasive communication, Bethesda (1995).It is mediated by three phases of message processing, that is attention to the message, comprehension of the content, and acceptance of the content, Bethesda (1995). Men and women can have correct, up to date information and renewed awareness on the effect of clinical interventions of co-trimoxazole prophylaxis on reducing morbidity of malaria in adults infected with HIV/AIDS on the dangers of engaging in drugs through the information model. In this study they can get helpful information on why it is important to be fully compliant to clinical intervention and antiretroviral therapy. The Community Organizational model The Community organizational model is ideal as it emphasizes on the active participation of the target group in identifying key health issues and strategies to address them. The model empowers the communities to improve their health thus making them participate in decision making. Strengths Mermin et al., (2004): Walker et al., (2010): Anglaret Eholie (2008): Nunn et al., (2011): Harries et al., (2015) agree with the findings that clinical interventions in the treatment of malaria in adults with HIV/AIDS reduce the morbidity and mortality rates of malaria in HIV infected patients. The effectiveness of using co-trimoxazole prophylaxis and antiretroviral therapy has not been disputed in all reviewed articles. All articles reviewed in this study had a common background of utilising a range of previous studies that provided a sound conceptual and theoretical basis to study. The use of various previous studies is a positive aspect of this study. Limitations Non treatment adherence has been identifies as one limiting factor towards compliance to clinical medication in some instances, hence this calls for close monitoring of patients by the HIV nurse practitioner who would understand the background and importance of medication compliance in the treatment of malaria morbidity in HIV/AIDS patients. There is need for further interventions targeting the wider usage of co-trimoxazole prophylaxis and ARVs therapy. Also, the limitation for using this kind of information is that the information constantly changes with new sites appearing every year and it is highly encouraged for policy makers to set global standard guidelines to benefit poor nations; The WHO and its Care Quality Commissions (CQC) to be seen vigilant with their inspectorate and Quality Assurance. Chapter 6: Conclusion In its quest to explore whether the clinical interventions and the effect of antiretroviral treatment (ART) and Co-trimoxazole prophylaxis reduce the morbidity of malaria in adults infected with HIV/AIDS in the Sub Saharan, this systematic review has concluded that the clinical interventions and the effect of antiretroviral treatment (ART) and Co-trimoxazole prophylaxis certainly reduce the morbidity of malaria in adults infected with HIV/AIDS in the Sub Saharan Africa. This systematic review now further recommends launching an inquiry to assess this effectiveness in male and female patient separately to enable the better and holistic understanding of the issue. The findings of this review are critical in establishing the high effectiveness of basic clinical intervention in extreme cases like HIV care. However, the compliance amongst patients to clinical medication in sub-Saharan Africa is very low. Hence within a public health system, lack of adherence to antiretroviral therapy must be considered as a problem of inefficiency that prevents the achievement of clinical effectiveness that can be achieved with the resources available for the treatment of HIV infection. For all this complexity of clinical management, it might be interesting to expose individual monitoring of patients, hospitalized by the nurse manager of HIV infection. Research for this purpose will contribute to the knowledge of the magnitude of the problem of non-adherence to treatment of malaria in those countries, especially if the authors worry in developing them with similar methodological designs. Brief recommendations for practice The results are precise as findings indicate that the wider use of co-trimoxazole prophylaxis and antiretroviral therapy can substantially reduce the morbidity of malaria in HIV/AIDS infected adults in sub-Saharan African region and indeed in the rest of the world. In summary, clinical interventions in the treatment of malaria in adults with HIV/AIDS is significantly associated with an improvement in overall wellbeing of persons infected with HIV/AIDS globally. However this is limited by the rate of adherence/non-adherence by individual victims. The authors used more than one method of measuring adherence and self-narrative was present in almost all studies. The definition of adherence was associated with complete follow - up of treatment, confirmed by counting medications. The results showed a lot of variability in the prevalence rates of adherence / non-adherence. In relation to non-adherence to treatment the following factors were highlighted, forgetfulness, symptom improvement, i naccessibility, side effects of antimalarial, and lack of guidance and / or incorrect guidance on drugs made by the health professional. Lack of adherence to antiretroviral therapy must be considered as a problem of inefficiency that prevents achieve clinical effectiveness that can be achieved with the resources available for the treatment of HIV infection (Walker et. al 2010), hence there is need to implement such programmes with sufficient human resources and expertise. Use of interactive individual groups is recommended to engage with the patients. Old policies need to be renewed with up to date policies, which address activity. Lastly, the interventions need to be internationally structured and not to translate only to sub-Saharan Africa. Brief suggestions of theory and practices A coordinated approach from the Public Health Services, Health Promotion Services, staff and patients should be put in place. Staff development workshops, peer education programs and policy development should be considered as strategies to bring and increase awareness of the importance of the use of co-trimoxazole prophylaxis and ART to the recipients. Results showed a lot of variability in the prevalence rates of adherence / non-adherence. Among the factors contributing to treatment adherence, highlighted greater understanding of the disease, severity of symptoms, dose gratuity of drugs, use of pictorial on the packaging of anti-malarial figures, and good guidance of health professionals in relation to drug and its effects (Walker et al, 2010). This systematic review does further recommend launching an inquiry to assess this effectiveness in male and female patients separately so that they can holistically understand the issue (Walker et al, 2010). Barriers to implementing the findings In relation to non-adherence to treatment the following factors are highlighted, forgetfulness, symptom improvement, inaccessibility, side effects of antimalarial, and lack of guidance and / or incorrect guidance on drugs made by the health professional. The systematic study of research has enabled the current status of the publications on adherence to malaria treatment and has found that there are gaps to be filled with future research. The writer suggests that studies are to be conducted in the sense to verify the adherence prevalence of malaria globally, considering that few publications have been made so far. Research for this purpose will contribute to the knowledge of the magnitude of the problem of non-adherence to treatment of malaria in those countries. This paper suggests avenues for further research. 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