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Wednesday, March 9, 2016

Environmental Analysis and the Role of SMEs

Launching small business is really an interesting matter for new businessmen who invest in the market. Such new investors as Ahmed have to learn about everything concerning the business he is going to open such as in which environment the business is going to be done. Small businesses' environment is what is going to be discussed and analyzed here referring to Kuwait as an example. STEEP analysis will be presented in this essay in addition to discussing entrepreneurship and small business benefits.
Question one (350 words, 35 marks)
Ahmed wanted to know more about environmental factors that affect business organization.   In this context,
Explain STEEP analysis and discuss the importance of analysing environmental factors (STEEP) for an organization.  Provide examples to support your answer.  (35 marks)
There are many tools for analyzing business external environment such as STEEP analysis which is used to address issues of factors that affect the small business in any country such as Technological factors, Sociological Factors, Environmental Factors, Economic factors and Political factors as Ahmed will use it to help him with his business. In Kuwait, Technological factors can represent the factors that have relations with modern technologies and updates programs of the internet and other tools of communication. The  revolutionary movement of technology in Kuwait can be seen in companies as Fast Telecom and Quality net that provide services of communication and internet widely and strongly. Companies as Zain and Wataniya are representing great communication services which enables small investors to communicate easily with any one around the world to make their business easier and more flexible. In Kuwait it is important for any business to look into sociological factors as work sorts, culture, language, religion, population and Arabic traditions of Kuwaiti population who is esteemed to be 3 millions in 2013. As environmental factors in Kuwait are reflected on stakeholders who are attracted to a business environment without any negative effects, this can be seen through Kuwait legislations, employees, pressure groups and customers. It is seen that Kuwait laws encourage small business and provide them with all investing chances as it is believed in Kuwait that small business supports the general business atmosphere. In Kuwait, economic factors reflects the all stable economy and the economical state that helps investors of small businesses work with eagerness and ambitious as with its Kuwaiti Dinar as a strong currency with its exchange rates that are always high everywhere worldwide. This also means that inflation rates off KD are low as according to 2013 statistics, they were 28% with a$165.8 billion as Kuwait GDP. (CIA Factbook Kuwait, 2014) Political factors in Kuwait reflect the Kuwait government policy of not forcing businessmen and investors to pay taxes which assist small investors who always worry of taxes in addition to the government tendency of supporting infrastructures projects and educational ones which provides a suitable climate for small investors to work freely.  

Question two (350 words, 35 marks)
Ahmed wants to start a small business initially and wants to expand it later.  In light of this statement:
Discuss briefly the benefits of small business and outline its role in general for the growth and development of a nation.  Support your answer with relevant examples. (35 marks)
To launch a small business is a matter that has many benefits such as providing chances of working in new job opportunities and helping in employing many persons who are in need for work as, for example, a business that depends on retailing will provide job opportunities for distributors, drivers for delivery, sales assistants, call center and many other jobs according to each business. This helps decrease and end unemployment rates in the country which promotes it as a whole nation. Small businesses also widen the range of services in the market as large companies may not save such simple services for customers. Due to the knowledge a small business has about areas it covers, each customer in the limited are will be thought of as a customer to whom good services is provided. Another benefit of small businesses is the innovation techniques they follow as bureaucracy has no place here which gives small businesses owners the chance to control the business freely, provide a variety of different activities and change functions easily according to what customers really need. Small businesses costs as not as high as the big businesses costs. Small businesses also share in developing the country and raise its growth rates. The country local infrastructure is also supported by the help of small businesses through attracting great investments depending on the trading movement that small businesses do. A small business provides a variety of available goods and needs of customers that can not be found in big businesses which makes the domestic product a unique one. Many great companies began as small ones such as Apple Company for computers and iPhones as this great company had a small and a simple start as Steve Jobs and Steve Wozniak began their business when they were university students by designing devices that can log on the call computers then began to sell such devices forming their company which now is one of the greatest businesses in the world. In spite of the limited resources they had, their love for technology and business enabled them to produce more devices as microcomputers and chips and others. They succeeded and achieved what they aspired for and more.  (Apple Investor Relations FAQ, 2014)


Question three (300 words, 30 marks)
Ahmed has been reading widely about the success stories of entrepreneurs.  He is interested to know the entrepreneurial qualities and traits thoroughly. In this context:
Define Entrepreneurship and explain briefly some the entrepreneurial qualities and traits with examples that Ahmed should have to get success in his ventures.  (30 marks)
The entrepreneurship refers to the work that entrepreneurs do of activities that launch new products, new services, new fields of business and also open new markets as well by using new and developed techniques of operate the business processes. Entrepreneurship has both traits and qualities such as performing the business in a very free method, achieving the business with large money amounts, achieving great success results due to getting into risks which are studied and meant to reach unexpected success, having no boss over the entrepreneurs which enables him to take decisions freely and be more respected by others and to control the business human resources well and properly by good leadership techniques and motivation tools which helps the business to succeed in addition to the ability of an entrepreneur to apply new innovation ideas and methods which raises the level of the business performance. Challenges that an entrepreneur faces enable him to work harder to raise the business level of competitive advantage in the market. (Long, 2014) In Kuwait, Lulu hypermarket is a big entrepreneur and a big business as his owner use risky techniques and ways for doing ideas that are innovated and updated as the business is decided to open new branches in KSA and other different Arab countries in addition to the branches opened already in some Arab countries as Qatar to present the different variety of products that come from everywhere around the world specially from India and Malaysia. The business is recruiting many human resources from salesmen, distributors, security, accountants and others who are being lead by strong and successful professional managers to provide the good team work that serves customers properly. The business is being widen and is receiving success from all people scales in Kuwait from all nationalities.

Conclusion
Kuwait represents a very good environment for launching a new small business such as Ahmed's experience as there are many factors that supports this idea including the government helpful attitudes, the people nature that loves shopping and making business, the political state, stability of its currency and other factors above mentioned. Entrepreneurship  provides many great opportunities for business success as being presented in this essay.

 References 


Analyzing texts linguistically

Introduction
There are many relations between texts meanings such as the experiential meanings that could be understood by being analyzed which provides a chance to learn about grammar choices and how they are related to the interpretive view of a text. All texts can be liable to such kinds of analysis such as comparing two texts discussing one topic in a different way which shows the differences in forming both texts, the way the theme is presented and evaluated and the author point of view. This assignment is discussing how texts can be analyzed and this is through providing an analysis for two different texts discussing the same topic and showing the differences between them both. 

Body
Task 1: The two texts were selected and approved.
Task 2 (analyzing experiential meanings)
Text1

Bickering over Brazil
Despite the efforts by Brazil’s ruling Workers Party to keep their plans for the future of Latin America’s largest and most populous country under wraps, the party’s weaknesses have not escaped the vigilant eyes of its rivals,/1 among them AécioNeves and his Brazilian Social Democracy Party (PSDB) and environmentalist Marina Silva and her Brazilian Socialist Party,/2
If the decision to throw in the towel was an onerous one for the PSDB, even more difficult was working out a way to woo Silva’s Socialist Party supporters./3

Brazilian President DilmaRousseff, 66, whose Workers Party has run Brazil since 2003,/4 won 41.59 per cent of the vote in the first-round poll on 5 October, or not quite enough to beat outright the PSDB’s Neves, the darling of big business in Brazil./5 The latter has signalled that he will promulgate pro-business laws and put in place policies aimed at buoying up the faltering Brazilian economy should he be elected, thereby wooing the country’s business community/6.

“The truth is that Brazilians are far more concerned with the monsters of the present: high inflation, recession and corruption,” Neves said in criticisms of Rousseff and her Workers Party./7 Rousseff retorted that the business-friendly candidate would not necessarily be the winner in the tight presidential race. /8“Investors don’t win elections in Brazil. /9
http://weekly.ahram.org.eg/News/7547/19/Bickering-over-Brazil.aspx
Text 2
DilmaRousseff has won the election. But she has some serious problems to address
When President DilmaRousseff stood on a podium in a hotel in Brasilia on Sunday night to celebrate the narrowest of victories over her Brazilian Social Democracy Party opponent, 1/ AécioNeves, the first thing she did was thank her Workers' Party predecessor, LuizInácio Lula da Silva – popularly known as Lula.2/ She even called him “president.”3/ (If, as is now being suggested, Lula decides to run for a third term in 2018, he would probably win in a landslide.4/
Then, lengthy salutations dealt with, she called for unity. “I urge, without exception, all Brazilians to unite in favor of the future of our country,” she said.5/
Exposing the economic, racial and class-based fault lines that divide Brazil, much as everyone would prefer to admit they don’t,6/ and helped Rousseff win this election.7/
She could begin her "reunification" process by admitting that the huge social and economic advances Brazil has enjoyed under Rousseff and,8/ more significantly, under Lula owe something to the economic reforms introduced by Lula’s predecessor, Fernando Henrique Cardoso9/ – known as FHC — of the Brazilian Social Democracy Party. 10/These stabilized the economy and allowed the country to grow.11/ Then the two sides could admit that both their parties have done good for the country.12/
The first text written in AlAhram newspaper consists of 9 clauses including 214 words and these clauses have top levels ones such as clause 1:" Despite the efforts by Brazil's ruling workers party……………., the party's weakness..", clause 3: " If the decision………………….., even more difficult…", clause 4 "Brazilian president …., whose workers party…", clause6 and clause 7:" The truth is that………..". There are also embedded clauses such as clause 2 :"Among them………..", clause 5 :" the darling of big business……", clause 8: " Rousseff retorted that………" and clause 9:" investors don't win ………". The top- level clauses provide basic information while the embedded ones add extra additional information. The proportion of top level clauses to embedded ones is 55,6% to 44,4%. There are different processes and each one has its functional type, for example, clause 1 works as an agent that provides stated materialistic ideas to the readers showing that the ruling workers party is a weak one which is criticized by its rivals. Some embedded clauses added information such as clause 5 referring to PSDB'S Neves as the darling of big business in Brazil. Some clauses were just copied by the tongue of those who said them without any hints by the author such as clause 9 which provides an opinion said by Rousseff. Embedded clauses are also relational ones as they are well connected with the top-levels clauses to provide more explanations for them. The grammar of the first text is used to show the workers party of Brazil as having a weak agency against the rival participants, present perfect was first used in clause1 "have not escaped". If the conditional was used in clause 3 to tell that it is difficult for the party to woo the supporters of the socialist party, the pronoun "he" was used in clause 6 two times to support its agency role. Passive was used with should to support the idea.
The second text written in Washington post is consisting of 203
Words are divided into 12 clauses among top-level ones and embedded ones. Top-level clauses can be clause 1 :" When president DilmaRousseff stood…………", clause 4: " If, as is now being suggested……….", clause 5 "I urge, without exception,…………..", clause 6 :" exposing the economic…………." , clause 8:" She could begin her………………….", clause 11:" these stabilized the economy…………" and clause 12 :" then the two sides could admit……………". Embedded clauses are clause 2:" AécioNeves, the first thing she did was thank………." clause3:" she even called………" clause7:" and helped ………"clause 9:" more significantly………." and clause 10:" known as FHC- ………."  The top level clauses state facts and basic important information for readers while embedded ones provide opinions of the authors or additional information that could make the readers more aware with the theme dimensions. The texts clauses have their main functions and processes that are materialistic DilmaRousseff as a president for Brazil. Clause 2 is a relational one which gives the reader more information about the predecessor of the workers party. The third clause is a verbal one referring to how DilmaRoussef called Lula. There are more verbal processes such as in clauses 5 which is telling words said by DilmaRoussef. The proportion of top-level clauses against embedded ones is 58,3% to 41,7%. The grammar is used to show neutral presentation of the president of Brazil DilmaRousseff as the author used past simple tense to tell real events such as in clause1 and 2 stating how the president acted and where, the pronoun "she" was used more than one time in the text to assert her strong agency and her participant role as a president. Both parties and presidents were equally presented and referred to as they were referred to with words as "the two sides", " both" "their"  with a use of the present perfect to assert the current effects the country is enjoying. (Matrix, 2014)
(Arab Open University, Book 3 (Getting Practical: Evaluating everyday texts; Unit 13.)

Information
Text1
Text2
Number of words
214
203
Number of Clauses
9
12
Number of Top-level clauses
5
7
Number of embedded clauses
4
5
Proportions of top level clauses to embedded ones
55,6% to 44,4%
58,3% to 41,7%
Table1

Task 3 (comparison of the 2 articles)
The two texts if compared to each other, they both discussing the same topic which is Brazil ruling by the worker party president against its rivals from other parties and Dilma Rousseff role in being a president of Brazil. Yet each text was written to address specific audience and there are differences between them in many points. The first text was written to address Arab audience. The title of the first text tells preset determining opinions as it says:" Bickering over Brazil" which gives the reader a feeling of suspense which is a feature needed by Arab authors to attract the Arabic audience whose interests need to be aroused to be eager to read. The text tendency and affectedness seem to be figuring the worker party and its president to be weak side against its rivals which provides the Arabic reader who may not be well acquainted with the roots the author's attitude which is purely presented to the reader as a way of facts. The participants' nature is shown to be non-human as referring to them in most times as parties which is clear in the little use of pronouns. The two rivals are presented in a relation of hostility which may not be true in fact as the Arabic writer nature tends to exaggerate a little in motions and feelings as well as the Arabic audience who is reading the article as this clear in sentences as: "have not escaped the vigilant eyes of its rivals". Using the present perfect tense shows that events are recent enough to refer to current problems in Brazil. The verbal use was too much as there were many words by its sayers to tell specific meanings but little explanations were presented by the writer which reflects little background of him. Dilma Rousseff was almost presented as a sayer. Her role was also agentless passive and not a major actor. The second text if compared to the first one is also discussing the same topic of rivals of the president place in Brazil but in a less stressed voice which reflects the western nature of the author and this also is clear from the title which is not interesting or attracting as it states facts as it says:" DilmaRousseff has won the election. But she has some serious problems to address." Which could be strange if found in a newspaper that addressing Arabic audiences as western audiences are not in need to be greatly aroused, a western reader goes to the news and looks for what he or she needs to read. The participants' nature is presented as human as the author referred to the characters as their personal identities with pronouns as "she", "her" and "they" that is mainly because the author is near to such characters from media and real meetings. The writer used neutral text tendency and affectedness as his own opinions were not directly mentioned and he did not seem to be in favor of a specific party as the roles of the participants were equally presented which was clear in sentences stating his own suggestions based on facts regarding the country such as: " These stabilized the economy and allowed the country to grow." Then the two sides could admit that both their parties have done good for the country." This was because the author's presentation for his views was neutral enough without any exaggerations in feelings or emotions as a normal nature of a western writer addressing a western audience with the same nature when receiving news. Affectedness is used by making only suggestions but without normalizations which reflects a deeper analysis for the problem by the author who seems to be having a deeper knowledge background than the author of the first text. The author set clear goals for writing his article such as giving the audience a chance to judge the current situation of both presidents despite showing his own point of view which is also clear and well stated without any exaggerations. (Goshen College, 2014)
(Arab Open University, Book 3 (Getting Practical: Evaluating everyday texts; Unit 13.)

Conclusion
The text analysis helps how to understand the reasons behind writing a text and choosing a specific theme to discuss and this depends on many measurements regarding experiential meanings and grammar use. This assignment was discussing and analyzing two texts discussing the same topic from different magazines that addressing different audiences which showed how the two texts differed grammatically and in their tendencies and effectiveness. 

References

Monday, March 7, 2016

Recognition and rewarding as motivation tools

Recognition of employees is very important to motivate them as recognition means to distinguish and identify those whose work is apparent and creative within the business organization and declaring their role within the organization to all who can respect their work and in turn imitate them. Recognition is a good and effective way of motivating employees because it depends on raising the employees' morale and encouraging them to do more good works that help them be soon motivated and promoted to higher positions in the organization. Recognition is also effective best with employees who need to be appreciated with non monetary methods of motivation as this can be by celebrating them in a public party for the employee of the month for example or in a meeting. 
Rewarding employees is another technique used for motivating them and it is important to make employees satisfied and having a high job morale and self confidence which raises their desire in staying in the business organization and this means to use rewards and a means for retaining employees and stop their turnover to other organization, this can help the organization reach competitive advantage easily because it enables it to have special talented employees who are feeling high belonging to the organization and enjoying many advantages inside it. Rewards can be monetary and non monetary as it can be through money grants or a celebration and this makes employees more job satisfied and more retained to the organization. 
Rewards and recognition as tools for motivation are used to make the business organization able to achieve its organizational goals easily by a group of talented employees who can feel belonging to the organization and can provide it with the best they can do. 

Sensors and Transducers

Introduction
Many different applications of today use sensors widely as the sensor technology has become very essential for many instances as this occurred due to the existence of a wide range of companies that use sensors in their products and applications related to improve these products. Oman is a country where people like to cope with the latest technologies of mobile phones and internet. Omani people of today prefer the i- phone applications as they contain high efficient sensors and other applications. Intelligent manufacturing processing uses sensors to provide benefits to its users. Some safety devices use sensors in safety insurance matters and in monitoring systems. The current research is discussing a sensors application used by many people today which is i-phone 4 with its sensors. Apple iphone 4 has many sensors such as a compass, a proximity sensor, an accelerometer and an ambient light sensor and others. The current research is discussing proximity sensors within the iphone 4 as they give the mobile phones the ability to perform recognition forms that are within the user interface. The user can hold the phone and put it near the face to speak then the proximity sensor recognizes if it is the speaker. The jobs of keys and touch screen are disabled to stop not needed touches.
The physical construction of the proximity sensor, its characteristics and working principle of i-phone 4
  1. Physical construction
Proximity sensors of the mobile phones are capacitive sensors that are able to detect both metal and nonmetal things and they are  generally constructed of capacitive proximity sensor are plate, output circuit, oscillator and a threshold detector. When the person comes near the field of the sensor, it works to stop the works of the touch screen. Capacitance is raised when the object comes close and it is reduced when the object goes away.
  1. Characteristics
A proximity sensor is characterized with its ability to recognize the existence of an object within a certain detection range which is specified according to the device abilities and the sensor boundaries, the sensor can recognize the person when the mobile phone is near his ear or face with certain distance, then the sensor can stop the work of keys of the mobile phone and other touching screen jobs in order to prevent turning the keys off or doing any unwanted actions that occur by touch. Proximity sensors include many types of sensors such as those found in mobile phones especially smart phones such as iphone 4. It depends on the physical contact in its operation. Manufacturers use proximity sensors in a commercial purpose which is raising the efficiency of the smart phone to attract more customers to buy it.
  1. Working principle
The principle that proximity sensors work according to is its emitting for a beam or an electromagnetic radiation which is usually infrared, then the sensor works to detect the existence of changes in the field and if it doesn't find, the signal is returned by it. When the object is found, the sensor begins its operation. The found thing is called the proximity sensor's target.  There is a specific distance where the sensor can detect humans or things and it has a maximum known as the nominal range. There are sensors that are adjusted to the nominal range by a certain distance for detection. As proximity sensors don't have mechanical parts or physical contact with the sensed object, they are able to last for long time working properly. 
Result
A proximity sensor is a type of sensors that can be found in applications such as iphone 4 and it is using a detection process for objects or human found within the detection field and within the sensor's boundaries. The proximity sensor is based on the non contact detection which is different from other sensors. It can be helpful when the users of the iphone are talking and they don't fear the work of the touch screen such as turning the phone off or doing any relevant actions. Proximity sensors are accurate in detection jobs and they add extra commercial values to the product they are added to. The only disadvantage they have is the limited area of detection they sense. Proximity sensors are important for mobile phones manufacturers who consider them very important applications as many users of iphone look for such application so it is considered a commercial and an industrial success. 
Analysis and Discussion
A sensor is a device which works by receiving signals and sending certain signals which are used to express the needed task such as light, voice, sounds or motion. The sensor's job is turning the signal to a digital representation or to analog that represents the output. There are many different conditions that sensors work according to the specific job they are assigned to. Proximity sensors are set mainly for detection purposes. They work to convert the signals into readable outputs. The proximity sensors are not including mechanical parts or missions as they only use signals.
The type of sensors used to enhance the efficiency of iphone 4 is the capacitive sensors as they can detect both metallic and non metallic objects. This means that any smart phone can bear the capability of having a proximity sensor. Targeting motions is meant to be the basis of using this sensor in mobile phones.
The sensitivity of the capacitive proximity sensor and the application uses it can be measured by a method prepared mainly for this purpose, the application is iphone4. For tuning sensor placement, 2D sensor data plots were used and found more accurate but a 3D sensor data plots were found to be more effective for comparing sensors according to their efficiency and intensity as the differences between sensors used by many applications are shown and declared. Sensitivity measurements are important to measure the level of performance of the sensors. The phone is used by the users holding it with many possible ways and the sensor can work when the user is talking or browsing tasks. The sensor is physical sensitive and working in electric fields. Many modifications can be made for sensors of the mobile phones as most people look for new versions and updates of the iphone they have and issuing a new update of the mobile phone means that there is an improvement in the sensor applications. Thermal stress analysis can be done for other types of proximity sensors such as the inductive proximity sensors. Element analysis also can be made by the finite element method.
Conclusion and Future Work
In conclusion, it is important to report that sensors are widely used in many applications of computers and mobile phones especially those smart phones such as iphone4 which uses sensors for doing many tasks in the mobile that raise its efficiency and meets the needs of the customers. Proximity sensors are sensors that use signals in a way that is meant to detect the face of people talking or browsing the iphone 4 application screen in order to stop the touch screen work until the person goes away as the sensors send the signals and the function of the touch screen is delayed. Sensors are considered a commercial helping factor that manufacturers focus on in order to use them in new innovated applications that are helpful to the person and the society and provides welfare and luxury options in mobile phones. More future work is needed to enrich the literature review about this topic which is sensors and this future work can mainly depend on researches, questionnaires, surveys and discussions with the customers in order to measure their satisfaction with the application. Sensors have a long time validity but they soon can be updated to new versions which can be able to extend the field where detection process is occurring. More modifications can be added to the device in order to enhance its capabilities and raise its efficiency and abilities of performing the jobs required to be done by him. More studies will also be helpful in the field of sensors. Many researches should be conducted with different ways of analyzing the data collected about the use of inductive proximity sensors.

    Muhamed Anwar Asaddat Reputation

    Introduction
    Research famous people's life and legacy is a very important matter which is directly related with reputation. Reputation detecting is a matter that requires special skills such as finding evidences on what is known as a person's reputation. Politics is a very important field that includes many famous characters whose reputation and news are of great importance to the public locally and globally, the acts they do during their life and the period they engaged in politics affect their reputation as well as talks about them by public people or by critics or political historians. In this essay, the reputation of a famous Arab leader and a peacemaker Egyptian president Muhamed Anwar Al Sadat is going to be discussed so as to know things about his life, the period when he ruled Egypt, 73 war, peace with Israel, his relation with Islamists and his death killed.

    Body
    Muhammed Anwar Al Sadat was born in 1913 and died in 198. He was the president of Egypt since 1970-1981.His death added too much to his reputation as he was killed when he was attending a military review on the remembrance of the 73 victories. His early life was a simple life of a villager who was greatly affected by many political figures such as Kamal Ataturk and Adolf Hitler and others. He ruled Egypt in a difficult time after Nasser in 1970 but he had a different policy from that of Nasser. He was a good leader during the period who ruled Egypt and proved his abilities to lead a great war and to held peace agreements as Camp David peace agreement with Israel in 1978. He received the Nobel prize for peace as a reward for this act. All these acts affected his reputation in his country, in the Arab world and internationally with supporting voices and opponent ones which were both extreme. This peace strengthened his relationships with the west and he began to apply a policy of encouraging business, importing and exporting which helped the economical situation in Egypt but at the same time aroused the anger and opposition of other groups such as fundamentalist Muslim groups and other Nasser supporters to the extent that some people accused him of betraying the country by peace with Israel. Assassins belonging to Muslim groups ended his life in public in 1981 which was a dramatic end for a man who was considered by many people as a leader and a peacemaker or by others as a businessman. (Alagna, 2004)

    Historical interpretations differed regarding Sadat as he was a character that caused many arguments in the politics field and among the public. His decision to begin a war against Israel was interpreted by many people and historians as some saw that he was just pretending to be strong and others saw that he was right. Benny Morris, for example who is an Israeli historian thinks Sadat was a gambler and the peace agreement caused the Arab world to be loose and to lose its unity. He thinks that 1973 was a victory for Israel. (Farouky, 2008) This view was adopted by some Arabs and Egyptians who saw the war and the agreement were as a trap for all Arabs. Yet this historical event can be interpreted as bravery, peace initiation and a good step towards Egypt prosperity. Many Arab historians see him as a man of war and peace and others see him as a man who wants to bring wealth easily and quickly and this made him to let down basics of policy with Israel and that Camp David was a great disaster on Egypt. His relations with the United States of America and the business deals he held with it aroused many arguments and different interpretations about him as some thought him a dare man with an ideology and others thought him a conceited and a fame lover and he will be the reason for naturalization relationships with Israel and America which will retard the Arab nation generally and Egypt specifically. (Alagna, 2004)

    Such historical interpretations must not be launched without evidences and such evidences should be well understood and discussed. Sadat's policy is obviously against that of Nasser, the victory of 73 was a good work but why he stopped? This is a question raised by many historians and the Arab poets and writers to the extent that made a poet like Amal Donkol  write a very famous poem asking him not to make the treaty with Israel. It is real that Arab OPEC countries got great benefits from the agreement and trade became better in the Arab world and economic aids for Egypt by USA was helpful at the time of the economic crisis in 1970s but today Egyptian sees American aids as obstacles in the way of their freedom and political stability. In 1981 Sadat began to arrest his opponents which was evidence on his failure with his people and this was accompanied with retarded economic state. Communists voices as well as Islamists voices caused people to make some kind of a revolution on the president. This situation proved the president failure and lead him to his dramatic end which was not very sympathized by Egyptians, the way he was killed in the parade caused many argued voices against him to assure that he was wrong in his encouraging for Islamists and his contradictory in making peace with Israel. ( World Africa, 2012)

    Sadat was considered for many people and historians in East and West as a myth because he was presented the impossible dream of peace with Israel which itself was not true but a myth in their points of view. A great Egyptian poltical historian, Moussa Sabri commented in his book, "Sadat the Truth and the Myth" on how was this man presenting true victory for Arabs with myths of peace and prosperity. He sees Sadat as a man of war and peace who brought Sinai back at a very difficult time but the book at the same time refers to his perplexed soul affected by Hitler and this turned him to a myth which increased his dreams and that peace was not a try to humiliate Arabs but a real try to get a better world. Sadat's myth is considered to be his imaginatory sol that was may be over ambitious. His wife Jehan Alsadat stated that Nasser's myth affected him passively in his first years of ruling Egypt which perhaps lead him to try to achieve great things for Egypt, he really did and at the same time he could not achieve the Nasser's myth at his people but his efforts can never be denied. Perhaps his tendency to make relationships with the West and Israel were the main factors to make him seen as a man who wanted to be a myth as such relations were considered a kind of imagination but people who understood him learned exactly what he wanted. (Ezzat, 2011)  

    After Nasser, came Sadat to be the president that people waited many things to be done from him not only in Egypt but in the whole Arab world, calling him a myth requires to be evidenced whether this was in his favor or against him. His great power that cold be the reason to make him a myth was his insisting on altering Nasser's policy to a more open one. The criticism he faced was so much for an ordinary man to bear but he found a good place for himself in history as he got the Nobel Prize, was the man of peace and war at the same time, his outer looking gave him a more mythology appearance with his pipe, black color as Egyptian, Arabs and even the West saw him as the Pharaonic God or leader who will do great achievements and bring virtue and wealth to Egypt. Evidences show that he tried hard to do this and added too much to the Arab culture with a distinguished peaceful legacy that no one had. His myth character was affirmed after his death and the way he was killed with was not helpful in increasing the myth about him, the killer was known, arrested and the reason was also known.(Kessler and MingJi, 2009) 

    Conclusion
    Mohamed Anwar A l Sadat reputation was discussed in this essay as he was known for being Egypt president in the most difficult period of 73 war and he was having a good reputation as a leader, a man of peace and war and a character that had a charisma that all people admired or argued. Reputation of Sadat was constructed according to his activities during the period of ruling Egypt, bringing victory and holding the Camp David agreement with Israel which reduced his Arabic popularity and added passive impressions on his reputation. Sadat reputation was also constructed according to his relationships with Islamists and Muslim fundamentalists who ended his life although he supported tem at many times of his life. In spite of all argued opinions with or against the Egyptian president Sadat, he left a rich legacy still argued till today. 

    References
    • Ezzat, 2011, Dina, Sadat Contested Legacy.
    • Kessler, E. H, MingJi, Wong, 2009. Cultural Mythology and Global Leadership. Cultural Mythology and Global Leadership


    B301A

    As a rule of thumb, any startup business needs to express its own strategy in order to set its objectives and inspirations for the future both internally and externally. To accomplish such objectives, the company needs to set a strategy that reflects its different logistics and tactics. According to Porter, strategic decision making process is the basis of the company strategy that focus on reaching better competitive position while still sustaining implemented performance. In our current paper, we will focus our attention towards the four strategic theories and how far they are relevant to the contemporary business environment by making a comparison between similarities and differences between these theories.
    Q1: Characteristics of strategic theories
    Strategic theories or approaches are distinguished by different features; they include four basic approaches, processual perspective theory, classical perspective theory, evolutionary perspective theory, and systemic theory. Each theory is distinguished by its own features which can be helpful to strategic decision makers or the top management to use as a reference in business strategy formulation.
    Beginning with the classic theory, top management try to set a rational strategy that sounds logical in terms of the defined objectives. They tend to see the future logically by reviewing all potential situations that may affect their decisions. This perspective is not applicable to small businesses or startups. Let's have an example of the American economy in the last few decades of the twentieth century; it was then known with the strongest and most stable marketing environment that supported huge companies in taking decisions appropriate to the lack of competing challenges. Moreover, stability extended to specific industries, such as the automotive industry that flourished to a large extent in this era. Profit maximization was then the main objective that large companies working in the field of vehicle production, like General Motors, sought to achieve; this perhaps uncover the first characteristics of this classical theory which is the focus on internal procedures performed by decision makers or top management. In this later example of General Motors, the company had a target of maximizing profit by gaining a competitive advantage over other competitors in the same market. Let's have another example from the Middle East, we will find that some companies working in the telecommunication market, like Zain for instance, adopt the classical perspective by having the objective of obtaining a competitive advantage involved in implementing its telecommunication services provided to both current and potential customers, by providing lower price offers or service packages from time to time, to gain the loyalty of its current customers and attract the attention of other prospects.
    The second theory is processual perspective which decision makers depend on adopting crafted strategies to handle market fluctuations. This perspective was first adopted in 1970s to handle oil crisis which in turn, participated in raising fuel price. Negotiations and policies are the tools used in this theory to deal with market challenges and fluctuations, which requires immediate modification in business policy. All startup companies adopt this theory at the beginning of their activity, as the theory implies the dependence on taking decisions that support later experiences. Decision makers in small companies tend to apply this perspective because they still need time to understand the marketing environment. They tend to set a strategy that can help them achieve their successful accomplishment in the middle of a new business environment which is not completely obvious for them.
    The third perspective is the evolutionary perspective; it was first adopted in the United Kingdom in the eighties of the last century. Business survival is the main target of this theory, which implies the focus on performance enhancement. For instance, the UK government desired to invade the social economy so it adopted system privatization. Strong entities took this chance to show up, locally and internationally, due to advanced technology in telecommunication. Telecommunication companies began to open new branches for itself everywhere, so they can better survive. External investing became the target of decision makers who desired to stay in competition in different markets. This perspective resembles the Darwinian Theory as it is based on looking for investment chance everywhere for the purpose of business survival. No matter where to invest, no matter how many branches we will posses, the main and most important objective is to be able to survive. This, therefore, let to a strategy that tends to orienting investments in different fields in order to gain a strong trademark and a better reputation. Example from Kuwait is Kuwait Finance House (KFH) which is a bank that invests in different areas, such as Kuwait, Saudi Arabia, UAE, Bahrain, Malaysia, the Cayman Islands and Turkey. Investments include market shares and other types of securities that the business tends to incorporate in order to enlarge its marketing capabilities, and so it can posses a better position in the area.
    The fourth and last theory is the systemic theory which considers the firm strategy as a part of its objectives, this makes this perspectives based mainly on embedded strategies that can be run in local environment. It focuses mainly on community and society, which makes it appropriate to social corporations, not-for-profit organization and educational organizations, such as schools and universities, like Kuwait University (KU) for instance. This type of organization focuses mainly on the purpose of its existence. Companies and organizations that tend to adopt this perspective use it for the purpose of supporting their local position in the market among different competitors, while maintaining customer satisfaction. Nokia Company, for instance, tends to produce mobile appliances at lower price and medium quality so it can make a large scale of population satisfied to the product it offer to them, in terms of both quality and price. Customer satisfaction is not an easy equation to solve; lower prices however are not always the best choice for each customer, when a customer take the decision to purchase certain product, each one sets his/her own preferences which are not always based on prices and/or quality only. In this perspective, the norms that guide company strategy are based on cultural rules in the local community.
    Q2: Four theories of strategy are relevant to 21st century
    Some researchers believe that the four theories or perspectives mentioned above are not the best choice to be used in the twenty first century. However, most or perhaps all businesses and organizations all over the world adopt these four perspectives in their process of strategy formation. These four approaches may be used separately by different companies or can be used all at the same time by one organization in setting its different strategies and policies. This is not a declaration that any company can use to inform the community of its perspective, we can find out which theory used, instead, by analyzing different decisions and policies the company issued. Work and environment differences can be the reason of using different approaches by various companies, which is affected mostly by the market nature and work environment.
    If we take the example of Kuwait Finance House, we will notice that this bank follows the evolutionary perspective in defining its marketing strategies, with an objective of raising shares sales and increase profits. Top management in this bank decided to run researches and surveys in order to learn about different ways they can adopt to achieve the company objective. They went through deep marketing researching and analysis to learn every detail pertaining to customers' preferences and market environment. They became capable using the information received from these researches to set definite strategies that tend to raise profit and shares sale inside and outside Kuwait. Enhanced relationships between this company and other external factors, such as market suppliers and bargainers, were good factors that helped the company achieve its goals and objectives. The company relied on its good relations to maximize profit so it can guarantee a more stable position in the money market among other competitors. This example gives us a clear idea about how important to maintain better relationships with suppliers and other external factors, in some industries it is a good way to secure perpetual source of raw material. A matter of question for different companies in this regard focuses on the availability of raw materials or supplies source and how important would it be to locate it near the manufacturing facility. Power stations, for instance, need to be build near coal mines and other fossil energy sources as a manner to reduce transportation costs. Semi-processed food factories also must be built near farmlands so we can get fresh vegetables and fruits from the farmland to the manufacturing facility directly. So, it is better to keep distribution and supplies channels close to factories to lower costs and raise quality which in turns raise profitability.
    In some national companies in Kuwait, top management focus on adopting evolutionary theory to be able to survive while still preserving their trademarks and maintain the stability of its market position among other competitors of Kuwait or outside it. They tend to adopt a strategy that is based on the evolutionary perspective; they tend to enlarge the scale of their business in different marketing fields and areas, such as vehicle sales, advertising, real estate, and security trading, like the example we mentioned above of Kuwait Finance House. Some other companies tend to focus its activities towards transportations and logistics, industrial production, nutrition processing, and tourism sector. The company strategy is the denominator of all these companies, whatever the activity it excel; the chosen strategy should seek to hunt different opportunities in order to achieve company stability and business survival within an extremely complex marketing environment.
    Furthermore, mobile phone businesses, such as Nokia, adopt the evolutionary theory in setting its strategies and policies. Nokia, for instance, tend to make product updates frequently based on analyzing customer needs and expectation, which in turns will enhance its market position that will help it achieve the survival objective. Facing strong competitors, like Sony, in the mobile phone market sounds like a challenge in itself that Nokia need to take different precautions in order to be ready to deal with perpetually. Other competitors like Samsung and Panasonic are strong enough to work as a challenge for Nokia. If any one of these companies develops a new cell phone appliance the other competitors will tend to follow the same pathway in order to save its position in the market. A good example is the Galaxy series of Samsung which was a natural reaction to the IPhone series of Apple. To maintain your position you need to keep an eye on other competitors and their activities, to finally be able to survive. For Samsung products, we may notice that they target middle-aged ABC1 business men and women, features like hand free, speaker, touch screen and other hundreds of cell phone appliances features can be targeted to specific population segment. This is called product differentiation according to different market segmentations. In this regards, appears the role of R&D department in any company to exploit every new technology to enhance products and services provided by the company, so it appears like Research and Development department in any company plays a key role in adopting evolutionary strategy of the company; this department gives the company the chance to launch new products or product updates which can enhance its position in the market.
    For the Processual perspective, different businesses adopt it everywhere in the globe. By adopting this perspective, top management tries to use different available scenarios that can be a tool for a successful future for the company. The company learns from past experiences and this will help decision makers to take the most favorable decisions. At time of world crisis, like in 2009, in the Middle East unplanned decisions may be taken as a result of unstable economic conditions; this may lead small businesses to fold and small entrepreneurs to leave the market in a specific country based on their fears from potential losses. Some other investors may decide to take the risk and try to modify the current strategies and implementations. Costs reduction is an example of strategy modification as a way to decrease potential losses and raise profits slightly. In 2009 crisis, many strong businesses working in the automotive industry, like General Motors, adopted the processual theory to face the financial crisis that they were an integral part of it. There is a strong point of views that support the adoption of the processual perspective by small businesses and startups in taking strategic decisions, because they still experience the business life and learn from the market fluctuations and from their own mistakes. They can set their internal strategies aiming to make frequent modifications of both decisions and internal policies in a way that can cut out large portion of costs and expenses. The target will be focused towards reducing operational expenses dramatically, so many companies during the 2009 crisis adopted the costs downsizing approach by retiring a large portion of labor to reduce wages and training costs. Another approach proposes to fold some branches in remote areas. This other solution will reduce different kinds of costs, like transportation, wages and training, raw materials, and other similar costs and expenses. These proposed solutions or approaches can help a company, like General Motors, in time of financial crisis to better handle economic disappointments and market fluctuations.
    Some other companies tend to adopt the systemic theory or perspective. Educational and social organizations are the obvious examples of companies following systemic approach. For profit educational institutions, like universities, AUC for instance, are business entities that have for objective to raise its funds and cut costs to its minimal. They focus their strategic objectives towards educational inspirations and students culturing. Top management, therefore, is mostly interested in achieving satisfaction of social needs of parents and other elements in society interested in education and how far it is beneficial to students. This will imply the necessity that these organizations need to follow the systemic perspective in setting up their strategies and in taking different strategic decisions, either internally or externally. There are other types of organizations that tend to adopt this systemic approach, such as banks that tend to serve the society locally by fulfilling local social needs of the community. Examples of these banks in Kuwait are NBK bank and KFH bank; there is a long list of similar powerful banks and institutions that tend to follow the same scenario of these banks in the area. They have a purpose of supporting society needs by supporting the performance of its members, which in turns can be a good tool towards future success of this bank or organization, or an incentive to community members to turn their attention towards this bank or organization.
    Q3: Comparing two strategic theories
    In order to define the aspects of differences and similarities between these theories, we need to run a comparison between two of them. We will choose the classic and evolutionary perspectives for this comparison. Both of them have aspects of differences and aspects of similarities. Beginning with the classic approach, in determining its policies and objectives, it tends to set a formal strategy. On the other hand, the evolutionary perspective the strategy needs to be good enough to handle market fluctuations. Another characteristic that is obvious for the classic theory is its rationality; the decision maker follows logic in the process of strategy formulation. Contrarily, rationality is not a clear characteristic for the evolutionary theory, because it targets the enhancement of a better position in the market perpetually, which is the pathway for survival. Speaking about goals setting in both theories, we find that the main goal of the top management that adopts the classic approach of strategic planning is to maximize profit to highest levels while minimizing costs to its lowest levels. This goal can be achieved by maintaining a better competitive advantage in terms of quality, price or any other similar factor, such as using the latest technology to update the product or create a new product line. These ways can lead to ameliorate the product quality which in turns raises sales of the product or service provided. For the evolutionary approach, decision makers focus on the external market environment in the process of strategy formulation. This implies that enhancing the company position in the market implies the sophisticated search for potential market opportunities and threats. Top management will decide then to make benefit of the available opportunities, such as the lack of strong competitors or the low quality of the competing products, and/or to handle potential threats, such as the increasing numbers of entrants or governmental limitations and regulations. These steps will lead decision makers to achieve survival as the targeted goal of the organization. Some large scale organizations solve the question of survival by being existent in different markets and opening branches in different areas all over the world. However, according to the classic perspective, the top management tends to make extensive analysis of the market believing that this will affect how the strategy will be formulated. Decision makers, in this scenario, set objectives aiming at enhancing organizational performance as a pathway to support the company marketing position. Making the strategy according to this evolutionary approach resembles the Darwinian Theory as a way of investment that depends on catching and hunting any possible chance in the market. According to this strategic thinking, the organization needs to be ready to catch any available opportunity in the market. This can be obvious in the organizations that tend to invest in different areas and have more than one product line in different areas; this can also be related to the distribution map of the organization that can be extended locally and internationally. The evolutionary approach refers to the possibility to modify the working manner the company follows and extend to the business nature as a way to have a better position among other competitors in the market.
    In summary, it is a rule of thumb that any organization needs to formulate a good strategy as a way to ameliorate and maintain its position in the market, and be capable of dealing with different challenges that may face it. It is helpful for any company to adopt a specific perspective or theory in its preparation of the strategy, in order to be able to understand it. In this paper we discussed the four strategic theories and how far they can be valuable to businesses and market environment in the 21st century, by running a comparison between tow of them that revealed the aspects of similarities and differences between them.
     
    References
    1. Samsung, new product development, 2014, at: http://businesscasestudies.co.uk/samsung/launching-high-end-technology-products/brand-building.html#axzz3GyqOgide, passed: 2014-10-22
    2. Joseph B., 1994, Comeback: The Fall and Rise of the American Automobile Industry , New York: Simon and Schuster
    3. Bhushan, N. and Rai, K. (2004). Strategic decision making. London: Springer.
    4. Dawson, P. (2003). Reshaping change. London [u.a.]: Routledge.
    5. Jagdev, H., Brennan, A. and Browne, J. (2004). Strategic decision making in modern manufacturing. Boston: Kluwer Academic.
    6. Stead, W. and Stead, J. (1992). Management for a small planet. Newberry Park, Calif.: Sage Publications.

    Heart failure

    Heart failure has been given much interest in healthcare field as chronic heart failure is a disease that threatens life as about 300,000 persons in Australia are affected with it( Heart Foundation, 2014), it affects more than 25 million persons worldwide and more than 5 millions in America (American Heart Association, 2014) and in KSA there is a percentage of 22% of total deaths resulting from heart failure yearly most occurring in older ages. (Saudi Heart Failure Group, 2013) The current assignment is going to present a critical discussion for nursing role in providing care for chronic heart failure patients to be self caring and the role of the multidisciplinary team in supporting chronic illness patients. Some key terms related with heart failure will be presented within this assignment such as self care management, multidisciplinary team and chronic illness in addition to explaining chronic illness characteristics and how it affects patients to be dependent in life.

    According to Van Cleave et al. (2010) Chronic illness could be defined as a case of illness that lasts for a long period of time which could be more than three months and the treatment provided to a chronic illness patient lasts for a long term, such case of chronic illness is always accompanied with pathological symptoms which are difficult to stop without medical interfering and it is not sure to bring the full recovery for this case or symptoms. Chronic Heart failure is an example of such chronic illness that requires special care and treatment on long terms. A multidisciplinary team (MDT) is defined as a team of professionals from different specialties who work in the field of healthcare to deliver the best service to patients as they should be skilled and with the needed expert physically and psychologically and it can include physicians, nurses, nurse managers, psychologists, physical therapists, social workers, chemists, dietarian  and others and each member has a role that is done by the interaction and communication with other members to produce the best quality of care using a group of methods and strategies which are evidence bases to provide the utmost healthcare services to patients with chronic illness. ( Dziegielewski, 2010) Self care management is very necessary for heart failure patients as they need to learn how to cope with the illness by themselves as self care management can be defined as to care for oneself and follow actions learned from a physician and nursing staff in order to promote one's health by coping with the illness and to act properly with other members of family so as to co operate with them to reach the best results physically and mentally in addition to fight the disease conditions and prevent complications that patients may suffer and managing difficulties that hinder their nature lives in order to survive the illness and live happily. (  Goodacre and McArthur, 2013)

    Chronic illness has various characteristics such as being prolonged lasting for long periods of time with little chance of spontaneous cure or complete one, it is always accompanied with deviations from the normal state which is usually continuous in addition to beyond repair changes, disabilities and serious psychological effects, it requires special self care management in addition to special nursing programs and a program of reformation.(Lewis, 2014) Example of chronic illness is Chronic Heart Failure affects patients when the patient's heart has no ability on pumping the required blood amount that the body needs as this occurs when the strength of the heart to pump becomes weak. (Greenberg et al, 2011) The impacts chronic illnesses leave on chronic patients are great on both physical and emotional sides as they affect the patients' capabilities to be dependent. Among these impacts is the social isolation when a nurse can diagnose it by finding a patient who wishes to engage with others but lacking the ability to do this and suffering loneliness feelings. Social stigma is another impact that lies as a burden on both the patient of a chronic illness and the family as trying to enjoy public meetings becomes a problem for the patient due to others comments, inquiries and showing over sympathy which results in staying at home and being unable to trust one's abilities and being dependence. (Larsen and Lubkin, 2011) Chronic illness affects the patient physically to the extent of having disability and being unable to do everyday simple actions as praying, eating, work and move. It also affects the patient's quality of life and psychological state. (Collingwood, 2010)

    Nurses have an important role in strengthening chronic heart failure patients' self caring and controlling the symptoms of chronic heart failure as they have to relieve complications by telling patients to stop doing hard efforts, stop smoking and stop drinking alcohol. A nurse's role includes educating the patient with chronic heart failure about diet that limits sodium intake, includes the needed supplements of within small numerous meals everyday, keeping the patient on the right calories and cholesterol percentages specially when there is excessive weight or hypertension. A nurse has to follow the patients drug intake, teach the patient what symptoms and signs related to each stage of the illnesss, monitor blood pressure, make schedules of the patients meals and medications, help patients get rid of depression and anxiety, keep comfortable circumstances, keep the patient in the right position and educate the patients family about diet and rest for the patient. (Stanfield, 2010) A nurse has to monitor and detect any complications that could occur by keeping measuring the pulse rate of the patient, respiratory rate and give the patient a time for resting prior to and pre all activities. Nursing interventions should include strategies for relaxation, teaching patients and families how to monitor patients well , teach them ways of pulse rate measuring, measure patients retention of fluids, teach a patient and a family the right way a patient should stay in bed as legs should be rested in a position to be above the levels of the heart, explain how medications and drugs work and train patients on the required exercises methods. (Moyet and Juall, 2009) Management chronic illness depends on good healthcare services that depend on high quality of care levels and providing the best care services to patients in order to improve patient's outcomes, wellbeing and quality of life, this includes stressing the importance of the multidisciplinary team in helping chronically ill patients progress and have good self care. There must be a staff of specialists who are skilled in many fields to make sure of providing the required service of care in a communicative co operative attitude among all members of the multidisciplinary team. The team has to prepare a plan of care based on each patient's case and such a team that is set mainly for chronic illness patients such as chronic heart failure must include a good nursing staff, physicians, a social worker and a specialist dietarian who work together for the purpose of supporting the patients and controlling their conditions symptoms to prevent or reduce disease complications. A nursing staff that should include nurse practitioners with high levels of experience and skills is responsible for managing the patients' daily, education tasks, monitoring intakes of patients, managing timed missions, following up consults of physicians, keeping good hospitalization, doing reports of patients' progress and preparing the patients physically and psychologically for receiving medications and treatments. Nurses are also responsible for keeping collaboration among the team members by the right communicative approaches. (Bisognano, 2009) The multidisciplinary team should have physicians who make decision of consultation, diagnose the case, prescribe the medications, perform the required treatments, do physical tests and is ready for patients and families enquiries. A dietarian is also an important member of the team as a dietarian has a very important task of  providing the team with the diet plan and guidelines for the diet, meal times, contents and number.( NICE, 2014) A social worker is also a very important element in a multidisciplinary team for chronically ill patients such as those with heart failure as a social worker can learn about patients conditions whether financially, socially or legally and do the required tasks to help patients overcome the social stigma they may suffer by teaching the whole family basics of dealing with society when they have a chronic illness patient.(Chang , 2014)

    Conclusion
    Chronic illness is a main cause of most today worldwide death rates as chronic illness is a case that requires treatments on the long run due to its continuous nature for a long period of time. Heart failure is an example of chronic illness, it requires special healthcare treatment to be presented for patients through a pre set plan by a well prepared experienced multidisciplinary team consisting of members as a nursing practitioners, physicians, social worker and a dietarian. Good care services must include the work of the multidisciplinary team so as to focus on helping patients how to practice self care basics, self management while being dependent as a result of having a chronic illness. A care plan is vital when dealing with patients with chronic illness as it should be done by a co operation strategy from a collaborative multidisciplinary team.  

    References

    1. American Heart Association, 2014. www.americanheart.org

    1. Bisognano, D. Baker, L. Early, B. (2009) Manual of Heart Failure Management. Springer Science & Business Medi.

    1. Chang, E. Johnson, A. (2014) Chronic Illness and Disability: Principles for Nursing Practice. Elsevier Health Sciences

    1. Collingwood, J. (2010). The Relationship Between Mental and Physical Health. Psych Central. Retrieved on October 19, 2014, from http://psychcentral.com/lib/the-relationship-between-mental-and-physical-health/0002949

    1. Dziegielewski, S. (2010). DSM-IV-TR in Action (p. 624). John Wiley & Sons.

    1. Goodacre, L. (2013). Rheumatology practice in occupational therapy promoting lifestyle management. Chichester, West Sussex, UK: John Wiley & Sons.

    1. Greenberg, B, (2011).  Barnard, D. Narayan, S. Teerlink, J. Management of Heart Failure. Wiley and Sons.

    1. Heart Foundation, 2014. Living Well with Chronic Heart Failure. http://www.heartfoundation.org.au/information-for-professionals/Clinical-Information/Pages/heart-failure.aspx

    1. Juall, L , Moyet. C. (2009). Nursing Care Plans & Documentation: Nursing Diagnoses and Collaborative Problems. Lippincott Williams & Wilkins.

    1. Lewis, S. (2014). Medical-surgical nursing: Assessment and management of clinical problems (9th ed.). St. Louis (Missouri): Elsevier, Mosby.

    1. Morof Lubkin, I., & Larsen, P. (2011). Chronic Illness: Impact and Intervention (p. 70-104). Jones & Bartlett.

    1. National Institute for Health and Care Excellence. (2014) Services for people with chronic heart failure. (n.d.). Retrieved October 24, 2014. http://www.nice.org.uk/guidance/cmg39/chapter/42-specifying-the-multidisciplinary-management-of-chronic-heart-failure

    1. Saudi Heart Failure Group, 2013. http://www.saudi-heart.com/?q=saudi-heart-failure-group

    1. Stanfield, (2010). S. Peggy. Nutrition and Diet Therapy: Self-Instructional Approaches. Jones and Bartlette Publishers. 

    1. Van Cleave J, Gortmaker SL, Perrin JM. 2010. Dynamics of obesity and chronic health conditions among children and youth: JAMA; 303:623–630.

    Saturday, March 5, 2016

    Nursing care for mentally ill patients

    It is not easy for a nurse to provide nursing care for mentally ill patients as it is a complex process that has special requirements. Great understanding for human minds and behaviors is needed by a nurse who has a therapeutic relationship with a mentally ill patient. (NHS, 2014) The current assignment is a personal reflection about an experience I had in the mental illness department at a hospital as training.  It reflects a therapeutic relationship with a patient who is mentally ill receiving the care. The assignment is reflecting the skills and experiences I gained through providing a holistic care for a patient in the mental health setting in the hospital in addition to reflecting the challenges and boundaries I faced through having such a therapeutic relationship with the patient. There will also be a discussion for the used strategies in developing a therapeutic relationship with the mental illness patient.
    Patients in mental health setting are not easy to deal with as other settings' patients due to what they suffer of mental and psychological problems and due to their unexpected reactions that may surprise a nurse dealing with them, shock her and perhaps make her frightened of treating such patients. Yet a therapeutic relationship between a nurse and a patient with mental illness is very important. My experience was in the setting of mental health in a hospital, I was at first hesitated and not very brave to deal with the patients there as a result of the background I had about strange actions of patients with mental illness but sooner I had some self confidence and I encouraged myself . I entered the ward with my colleagues who made some noise that seemed to annoy the patient female in the mental health ward as one of them suddenly shouted at my face as I was in the front of other colleagues, this scared me but after a moment, the patient laughed loudly and I also encouraged myself and entered. I then realized that voices of my colleagues disturbed the patients so this one shouted at us and laughed to alarm us not to make noise again. This made me understand that mental health patients must be dealt with great care, understanding and respect. I met another patient who was silent and straying but looked calm and decent. I smiled at her, she didn't smile at first then I smiled again gently and then she smiled to me. I got some information about her Ms. Jane was a 28 years old Saudi female who has schizophrenia for five years and was always alone, with aggressive attitudes. It was difficult for me to build a therapeutic nurse patient relationship with her, perhaps I did not have enough skills or experiences about how to break the ice with a mental illness patient. I tried talking with her by asking her about her name, age and family. She did not reply to me and then she said that "life is not a garden for children because it is not quiet" so I understand that she didn't want me to speak too much. I noticed that she needed to talk so I showed to her that I am listening to her carefully and she began talking freely. Hence I was sure that listening to the mentally ill patient is very important for a nurse to build a therapeutic relationship with a patient with mental illness in order to let the patient feel that the nurse is caring and interested in helping the patient and then to trust the nurse and talk which helps provide the proper nursing care for the patient. Ms. Jane is the only girl for her mother and father, she was never married before and her education level was mediate. The case began to suffer since past five years but her childhood history tells that she had epileptic seizures but she followed a mental therapy then seizures disappeared but she rarely has them now. 
    According to (Fortinash, 2008)mental illness is referred to as an illness which leaves effects on the person's abilities whether cognitive, social or emotional ones and hence the patient is in risk of causing harms to oneself and to other people, symptoms associated with it are such as irrational behaviors, hallucinations, delusions, mood disturbance and strange thought form. It can be diagnosed as depression, schizophrenia or others according to the symptoms. The relationship between a nurse and a client which must be a therapeutic one can be defined as an interaction that occurs between the nurse and the patient and it aims to provide a healing atmosphere that helps the patient by learning about his or her basic needs and limit any other further illness or complications and psychiatric mental health is mainly based upon such successful relationship. (Jakopac and Patel, 2011)
    I tried to make an interaction with my patient through learning about her needs and encouraging her to express herself. There are stages involved and required for a nurse client therapeutic relationship such as the orientation stage when assessment is very important to be done by the nurse as it involves introducing the nurse to the patient and explaining goal of care. (Ostendorf et al, 2013)I told Ms. Jane about my name and told her that I am the nurse to care for her, I also intended to use nonverbal communication methods with her as smiling and simple hand signs. I tried to assess her behaviors and reactions to recognize her needs as I collected as much information as possible about her. According to (Ballard et al, 2012), working stage follows that of orientation stage in the nurse patient relationship. The nurse has to spend enough time to convince the patient to talk and nonverbal communication is very important to do this, a nurse has to show respect and interest to the patient to raise levels of trust and relieve stress. (Rogers et al, 2012)  I gave X, my patient, a flower and then she smiled and I began some simple discussions with her as she expressed some fear of light and when I closed it, she relaxed and talked a little about herself. I assessed her readiness to communicate with me, her language and her desire and ability to talk. I noticed that the patient stopped talking when I tried to interrupt her or when I talked too much so I realized I shouldn't have done this. According to (Basavanthappa, 2011), the resolution stage comes next to the working stage in a nurse client therapeutic relationship. The last stage which is the termination stage or the resolution stage involves the nurse's review for patient's progress and relief of symptoms, evaluation for goals achievement, setting possible problems the patient may encounter after discharge and thanking the patient with promises of more interventions. (Videbeck, 2011). I thanked Ms. Jane and promised her to come again then I assessed my goals achieving, reviewed the progress of patient as she was very communicative when she trusted me and told many important points about her feelings and needs and I suggested that she might face problems of anxiety, loneliness and depression after discharge if her life circumstances did not change. (Craig and Davies, 2009) 
    The interpersonal relationship between a nurse and a patient with mental illness can be faced with challenges that may work as obstacles against the nurse's role in providing care within a client centered therapy. (Nizette et al, 2012)During my work with X, I faced many challenges such as encouraging her to speak as at first, she resisted to talk with me but I exerted great efforts to encourage her. Her language was not very clear when she talked as some words were not understood by me.  I also found some difficulties with dealing with the patient's family, they refused to confess she is mentally ill and her mother said she does not have to talk about her daughter's life. It seemed to me that culture and traditions of the family prevent them from confessing that they have a patient who is mentally ill. Among the challenges I faced was working in a noisy and busy environment as the room was not having enough quietness in addition to the existence of many persons around me. I also faced another challenge which was shortage of time as I didn't stay with my patient enough time due to many reasons as she had to take her medications. Another challenge was my lack of enough listening skills as sometimes I interrupted the patient which made her angry and stopped talking. Another challenge was that the patient's profile lacked some important information about the patient and her physician was very busy to provide me with the information I needed.
    I learnt many things through this experience such as learning that a nurse has a very important role in mental care as a caregiver but not to do her tasks only without deep assessment. (Boyd, 2008) I learned how to care for a patient with mental illness, how to communicate with the patient, nursing skills and many techniques of therapeutic communication such as how to build a successful client nurse relationship. According to (Lain et al, 2013), therapeutic communication is a very vital step for a nurse dealing with a mental illness patient as there are signs and body language that should be used with the patients and a good nurse should avoid any thing that can make the patient angry or nervous. I learned many skills and strategies of assessing the patient from many sides regarding her illness history, current physical state, violent attitudes, communication, needs and medication following. I also learnt to make self assessment for my work. According to (Varcarolis, 2010)assessment is a main step a nurse should process with patients with mental illness in order to learn about patients' suicide attitudes, depression, physical health and feelings of the patient in order to focus on the patient's problem leading her to have the illness. I learned to face any challenges that hindered my work and frustrated me as according to (Bonham et al, 2013) nurses can change work challenges to opportunities such as making good use of the limited time by specifying everything to be done with the patient before beginning the work. I didn't have good plan before beginning my work. I also learnt many things about how to deal with the patient's family and not to address them as having a mental patient if they cannot cope with this but to be careful when dealing with them to encourage them to help in the care process. According to(Shives, 2008), the family helps a lot in improving the state of patients who have psychiatric disorders because the family members can support the patient to overcome the illness and respond to treatment.
    Conclusion
    Nursing care provided for patients with mental illness require many strategies and procedures that nurses have to be acquainted with in order to provide a care that helps improving the patients' quality of life. A nurse's role is a major one that needs many skills to be learnt and it also needs to be assessed and evaluated by the nurse herself. There are many challenges that a nurse may face during providing the care in the mental illness setting but a good nurse needs to learn strategies to overcome such challenges so as not to work against care processes the nurse provides as being a major caregiver.      
      





















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